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Sample records for coronaria descendente anterior

  1. Disección de arterias coronarias asociada con el consumo de cocaína

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    Guillermo Marchetti; Juan Arellano; Flavio Salvaggio; Luis Gariglio; Gabriel Pérez Baztarrica; Alejandro Botbol; Rafael Porcile

    2008-01-01

    La disección espontánea de arterias coronarias es en extremo rara y escasamente documentada en la bibliografía mundial. Una de las causas en pacientes jóvenes es la adicción a la cocaína. Se presenta el caso de un paciente con historia de consumo reciente de cocaína que ingresa derivado por infarto de miocardio para cinecoronariografía y angioplastia. En la cinecoronariografía se evidencia una disección espontánea de la arteria descendente anterior con flujo TIMI III. Debido al contexto clíni...

  2. Implante de stents farmacológicos na artéria descendente anterior: indicadores de eventos tardios Implante de Stents farmacológicos en la arteria descendente anterior: indicadores de eventos tardíos Pharmacological stent deployment in the left anterior descending artery: late event indicators

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    Marcelo de Freitas Santos

    2009-01-01

    Full Text Available FUNDAMENTO: A eficácia dos stents farmacológicos em reduzir os índices de eventos cardíacos não é uniforme a todos os subgrupos de lesões ou pacientes. OBJETIVO: Avaliar a evolução clínica tardia dos pacientes submetidos a implante de stents farmacológicos nas lesões ateroscleróticas da artéria descendente anterior e identificar, entre as características clínicas, angiográficas e do ultra-som intravascular, quais as que permitem predizer risco de eventos cardíacos. MÉTODOS: De maio de 2002 a agosto de 2005, foram tratados 205 pacientes com implante de 236 stents farmacológicos guiados pelo ultra-som intravascular. RESULTADOS: Com um acompanhamento médio de 711 dias, a taxa de trombose do stent foi de 0,48%, a mesma observada para infarto agudo do miocárdio ou cirurgia de revascularização. A taxa de revascularização da lesão tratada foi de 7,31% e a taxa global de eventos de 10,24%. Os indicadores de eventos, conforme análise multivariada, foram o implante de mais de um stent na mesma artéria, lesões concêntricas e área mínima intra-stent medida pelo ultra-som intravascular menor que 3,88 mm². CONCLUSÃO: Baseados nos dados obtidos, concluímos que a revascularização da artéria descendente anterior com implante de stents farmacológicos escolhidos e otimizados pelo ultra-som intravascular apresenta baixo índice de eventos tardios. O implante de dois stents farmacológicos para o tratamento das lesões longas foi o principal fator independente para a ocorrência de eventos tardios. A área luminal final maior que 3,88 mm² obtidos nos segmentos de pequenos diâmetros de referência é um indicador independente de evolução livre de eventos.FUNDAMENTO: La eficacia de los stents farmacológicos para reducir los índices de eventos cardiacos no es la misma para todos los subgrupos de lesiones o pacientes. OBJETIVO: Evaluar la evolución clínica tardía de los pacientes sometidos a implante de stents farmacol

  3. O acometimento isquêmico obstrutivo na cardiomiopatia hipertrófica do tipo septal assimétrico com envolvimento da artéria descendente anterior

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    Albanesi Fº Francisco Manes

    1997-01-01

    Full Text Available OBJETIVO: Avaliar o papel da doença arterial coronária (DAC com comprometimento da artéria descendente anterior (ADA na cardiomiopatia hipertrófica (CMH e sua repercussão na evolução, visto ser controverso o significado da necrose e fibrose do septo interventricular (SIV nesta cardiomiopatia. MÉTODOS: Entre 158 pacientes com CMH, selecionamos 6 (3,79% com CMH e DAC com lesão obrigatória de ADA, sendo 4 homens, entre 52 e 70 (x= 65,16 nos, 4 com a forma obstrutiva da CMH. O tempo de diagnóstico da CMH foi de 78 a 182 (x=141 meses e da DAC de 1 dia a 106 (x= 42 meses. Os pacientes foram acompanhados com avaliações clínicas e exames complementares periódicos. RESULTADOS: A forma de apresentação da DAC foi em 5 com angina instável e um com infarto do miocárdio. A ADA estava comprometida entre 60 a 100%, sendo em um lesão única e nos 5 restantes com lesão em 2 ou mais vasos. Na evolução, 3 foram submetidos a revascularização miocárdica (RM, um associada a miomectomia septal, um a angioplastia e 2 somente a tratamento clínico. No período de observação de 76 a 124 meses após o diagnóstico da DAC, ocorreu um óbito. No fim do estudo observamos redução nos valores médios do SIV de 1,53 para 1,40cm, gradiente de pressão entre o corpo e a via de saída do ventrículo esquerdo (VE de 56 para 15,75mmHg, com discreto aumento no diâmetro diastólico do VE de 4,55 para 4,85cm e do diâmetro sistólico de 2,83 para 3,13cm, sem alterar a dimensão do átrio esquerdo (4,13cm. CONCLUSÃO: A DAC da ADA é bem tolerada na CMH septal assimétrica, participando do processo fibrótico septal e melhorando o desempenho cardíaco, não representando problema adverso na evolução da CMH.

  4. Disección coronaria espontánea postparto: descripción de un caso y revisión de la literatura

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    Fabián A Giraldo

    2013-04-01

    Full Text Available Se describe un caso de disección coronaria espontánea del tronco coronario izquierdo asociado a enfermedad nativa de las arterias descendente anterior y circunfleja, en una paciente puérpera de 37 años de edad. Se expone el cuadro clínico, los hallazgos del cateterismo cardiaco, la evolución clínica y el resultado postquirúrgico, y adicionalmente, se hace una revisión de la literatura.

  5. Miopatia ocular descendente

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    Nunjo Finkel

    1972-06-01

    Full Text Available São relatados 4 casos de miopatia ocular descendente (MOD com história familial levantada em três gerações. Biópsia musculares e eletromiografia em um caso confirmaram o caráter miogênico da doença. A MOD nada mais seria do que uma forma clínica especial de distrofia muscular, de início tardio.

  6. Angiotomografia coronariana multislice na avaliação da origem anômala das artérias coronarianas Angiotomografía coronaria multislice en la evaluación del origen anómalo de las arterias coronarias Multislice coronary angiotomography in the assessment of coronary artery anomalous origin

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    Daniel Rocha Rabelo

    2012-03-01

    Full Text Available Fundamento: A origem anômala das artérias coronarianas é uma entidade relativamente rara, podendo se apresentar de várias formas clínicas e evoluir de forma adversa. A angiotomografia multislice das artérias coronarianas vem ganhando espaço na prática clínica diária, representando importante método propedêutico, com grande potencial na avaliação anatômica dessas artérias. Objetivo: O objetivo deste estudo é descrever os achados angiotomográficos e a evolução de pacientes com origem anômala das artérias coronarianas. Métodos: Durante o período de janeiro de 2008 a março de 2011, foram avaliados consecutivamente 404 pacientes encaminhados para realização de angiotomografia das coronárias por diversos motivos, com tempo médio de seguimento de 21 meses. Resultados: Nove pacientes (2,2% apresentaram origem anômala das artérias coronárias, sendo quatro com origem anômala da artéria circunflexa (Cx em Coronária Direita (CD, dois com origem anômala da CD (um com origem de CD em Cx, e um com origem de CD em seio coronariano esquerdo, um paciente com tronco coronariano único (descendente anterior e Cx saindo do seio coronariano esquerdo, um com trajeto anômalo do tronco da coronária esquerda entre aorta e artéria pulmonar e um paciente apresentando tronco coronariano esquerdo originando-se do seio coronariano direito. Dos pacientes avaliados, um paciente recebeu um cardiodesfibrilador implantável; um paciente evoluiu com morte súbita durante internação hospitalar; e os outros não tiveram intercorrências. Conclusão: A angiotomografia multislice das coronárias representa método propedêutico minimamente invasivo que possibilita detectar a origem, o curso e terminação das anomalias de origem das artérias coronarianas com excelente acurácia, possibilitando o correto diagnóstico e auxiliando no planejamento terapêutico.RESUMEN FUNDAMENTO: El origen anómalo de las arterias coronarias es una entidad

  7. Fluxometria da artéria torácica interna esquerda na revascularização da artéria descendente anterior com e sem circulação extracorpórea Flowmetry of left internal thoracic artery graft to left anterior descending artery: comparison between on-pump and off-pump surgery

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    Filinto Marques de Cerqueira Neto

    2012-06-01

    Full Text Available INTRODUÇÃO: A cirurgia de revascularização do miocárdio (RM sem circulação extracorpórea (CEC é uma técnica amplamente utilizada. A fluxometria coronariana é a técnica mais usada para avaliação dos enxertos, porém, poucos estudos comparam os dados fluxométricos na RM com e sem CEC. O objetivo deste estudo foi comparar as variáveis fluxométricas dos enxertos de artéria torácica interna esquerda para a artéria descendente anterior em pacientes submetidos à RM com e sem CEC. MÉTODOS: Entre março e setembro de 2010, foram analisados retrospectivamente 35 pacientes consecutivos, não randomizados, submetidos à RM. Foram alocados 10 pacientes no grupo A (com CEC e 25 no grupo B (sem CEC. O fluxo médio do enxerto (FME, o índice pulsátil (PI e a porcentagem de enchimento diastólico (ED foram obtidos por meio da fluxometria por tempo de trânsito. Foi utilizado o teste exato de Fisher e Mann-Whitney, sendo considerado estatisticamente significante PBACKGROUND: Off-pump coronary bypass grafting (OPCAB has become a widely used technique. Coronary flowmetry is the most common method employed to assess graft patency, nevertheless, few studies compare flow patterns between ONCAB and OPCAB surgery. The objective of this study was to compare flowmetry data in left internal mammary artery grafts bypasses to the left anterior descendent artery. METHODS: From March to September of 2010, thirtyfive consecutive, non-randomized patients underwent CABG and were retrospectively evaluated. Ten patients were located on group A (On Pump, and twenty-five on group B (Off Pump. The mean graft flow (MGF, pulsatile index (PI and diastolic filling (DF were obtained using Transit Time Flowmetry (TTFM. The Fisher exact test, and Mann Whitney test were used, and a P value of < 0.05 was considered to indicate statistical significance. RESULTS: There were no deaths, AMI, re-interventions or PTCA in a 30-day period. The number of bypasses performed per

  8. Infarto do miocárdio causado por lesão arterial coronariana após trauma torácico fechado Infarto de miocardio causado por lesión arterial coronaria post traumatismo torácico cerrado Myocardial infarction caused by coronary artery injury after a blunt chest trauma

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    Márcio Silva Miguel Lima

    2009-07-01

    Full Text Available Relatamos o caso de um indivíduo do sexo masculino de 29 anos de idade, vítima de um acidente de carro no qual sofreu trauma torácico fechado, evoluindo com insuficiência cardíaca congestiva. O paciente apresentava boa saúde previamente, sem sintomas de doença cardiovascular. Na avaliação inicial, o eletrocardiograma mostrou ondas Q nas derivações precordiais e o ecocardiograma mostrou disfunção ventricular esquerda importante. A angiografia coronária mostrou uma lesão na artéria coronária descendente anterior esquerda (ADE, com acinesia da parede anterior na ventriculografia com contraste. A tomografia computadorizada por emissão de fóton único (SPECT com Tálio-201 não mostrou viabilidade. O paciente foi mantido em tratamento clínico com boa evolução.Relatamos el caso de un individuo del sexo masculino, de 29 años de edad, víctima de accidente automovilístico en el cual sufrió traumatismo torácico cerrado, evolucionando con insuficiencia cardíaca congestiva. El paciente presentaba buena salud previamente, sin síntomas de enfermedad cardiovascular. En la evaluación inicial, el electrocardiograma mostró ondas Q en las derivaciones precordiales y el ecocardiograma mostró disfunción ventricular izquierda importante. La angiografía coronaria mostró una lesión en la arteria coronaria descendente anterior izquierda (ADI, con acinesia de la pared anterior en la ventriculografía de contraste. La tomografía computada por emisión de fotón único (SPECT con Talio-201 no mostró viabilidad. El paciente fue mantenido en tratamiento clínico con buena evolución.We report the case of a 29-year-old man, victim of a car accident, who suffered a severe blunt chest trauma, with evolving congestive heart failure. He had previously had a good overall health status, with no symptoms of cardiovascular disease. At the initial assessment, the electrocardiogram showed Q waves in the precordial leads and the echocardiogram

  9. Diabetes y Enfermedad Coronaria

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    Alfredo Jácome Roca

    1997-06-01

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    La Diabetes Mellitus es un síndrome con etiología multifactorial y con variadas expresiones en la clínica y en las complicaciones. Las formas más comunes son la diabetes tipo 11 o diabetes no insulino dependiente (DMNID y la tipo 1 (antigua juvenil o insulino-dependiente (DMID. Las más notables diferencias entre la frecuencia e intensidad de sus manifestaciones clínicas y complicaciones así como de su etiología son muy conocidas pero las anotaremos a manera de repaso.

    En la DMID o tipo 1 (la menos frecuente al menos dos genes localizados en el sistema HLA, región de antígenos de histocompatibilidad en el brazo corto del cromosoma 6, aumentan el riesgo. Se observa la presencia en el haplotipo de los antígenos B8/BWI5 y DW3/DW4. Posteriormente un virus (paperas, sarampión, mononucleosis, Cocksakie B desencadenarían una destrucción autoinmune de islotes!.

    En la DMNID o tipo II influyen la herencia y la obesidad como factores más notorios. Como en la DMID la producción de insulina es cerca a cero o cero, hay mayor tendencia a hiperglicemias marcadas, coma diabético y complicaciones microvasculares (nefropatía, retinopatía y neuropatía, pero también pueden haber complicaciones “macrovasculares” o aterogénicas, como enfermedad coronaria y arterioesclerosis periférica. La DMNID o tipo 11 presenta mayor incidencia de la última clase de complicaciones y menos de las primeras y generalmente hay “hiperinsulinemia” y obesidad asociadas. Los tipo 1generalmente mueren de falla renal y ciegos mientras los de tipo 11 mueren de infarto

    Como noticias recientes en diabetes, se ha comprobado que el control estricto de la hiperglicemia (manifestado por normalización de la hemoglobina glicosilada Al en la diabetes tipo 1previene o retarda la presencia de complicaciones microvasculares; esto se logra con un manejo intensivo, que incluye también uso intensivo de regímenes de insulina.

    Pero ¿qué pasa con la

  10. Miopatia ocular descendente Descending ocular myopathy

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    Nunjo Finkel

    1972-06-01

    Full Text Available São relatados 4 casos de miopatia ocular descendente (MOD com história familial levantada em três gerações. Biópsia musculares e eletromiografia em um caso confirmaram o caráter miogênico da doença. A MOD nada mais seria do que uma forma clínica especial de distrofia muscular, de início tardio.Four cases of the so-called descending ocular myopathy with a family history in three generations are reported. In the first case muscular biopsy and electromyographic studies proved the myogenic nature of the process. Descending ocular myopathy seems to be just a clinical form of muscular distrophy of late onset.

  11. Análise cefalométrica comparativa das alturas faciais, anterior e posterior, em jovens brasileiros, descendentes de xantodermas e leucodermas, com oclusão normal Cephalometric comparative analysis of facial heights, anterior and posterior, in brazilian youths, descendents of japanese and caucasian, with normal occlusion

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    Ricardo Takahashi

    2005-12-01

    Full Text Available OBJETIVOS: avaliou-se cefalometricamente as estruturas esqueléticas da face no sentido crânio-caudal (vertical para: obter os valores médios de normalidade de jovens brasileiros, descendentes de xantodermas e leucodermas, com oclusão normal; verificar a presença ou ausência de dimorfismo entre os gêneros e investigar a existência de diferenças ou semelhanças entre os grupos raciais estudados. METODOLOGIA: estudo cefalométrico. RESULTADOS: após a obtenção da média e do desvio padrão de cada medida cefalométrica estudada, para ambos os gêneros e grupos raciais, os resultados sinalizaram, em algumas das grandezas cefalométricas, a presença de dimorfismo entre os gêneros para ambos os grupos raciais e diferenças entre os grupos raciais. CONCLUSÕES: verificou-se a necessidade de se utilizar um padrão cefalométrico específico, no sentido crânio-caudal (vertical, para os brasileiros, descendentes de xantodermas e leucodermas.AIM: this study was meant to verify the cephalometrics of the skeletal structures of the face in the vertical direction in order to obtain the mean values of normality for brazilian youths, japanese and caucasian descendents, with normal occlusion; to verify the presence or absence of dimorphism between the genders; and to investigate the differences or similarities between those racial groups. METHODS: cephalometric evaluation. RESULTS: after the determination of the average and standard deviation for each cephalometric measure under study, in both genders and racial groups, the results of the research evidenced, in some cephalometric measures, the presence of dimorphism between the genders in both racial groups and difference between the racial groups. CONCLUSIONS: it was verified the need to use a specific cephalometric standard, in the vertical direction, for brazilians, japanese and caucasian descendents.

  12. Relato de caso: mediastinite necrotizante descendente

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    José Mauro da Silva Rodrigues

    2016-10-01

    Full Text Available Introdução: Mediastinite é um processo inflamatório raro do tecido conectivo do mediastino e pode ter como base infecções bacterianas da orofaringe (denominada, mediastinite necrotizante descendente (MND. Cerca de 70% tem como origem infecções odontogênicas. Possui alta mortalidade e o diagnóstico precoce, a intervenção cirúrgica e o uso de antibióticos são essenciais à resolução do quadro. Objetivo: relatar um caso de MND acompanhado no Conjunto Hospitalar de Sorocaba (CHS em abril de 2016. Metodologia: acompanhamento das cirurgias, revisão do prontuário e da literatura. Relato de caso: M.D.B, masculino, 27 anos, entrou na emergência do CHS com quadro de abcesso em região cervical, dor em tórax e dispneia há 3 dias. Negou comorbidades. Ao exame encontrava-se em mau estado geral, febril (39ºC, com diminuição global do murmúrio vesicular do hemitórax D; FR=30 ipm, sat 90%,FC=110 bpm e PA= 160 x 100 mmHg. O raio-x de tórax demonstrou: opacificação em hemitórax D, aumento de mediastino e silhueta cardíaca. A tomografia evidenciou derrame pleural difuso em hemitórax D, ar e líquido no mediastino e derrame pericárdico. A hipótese de Mediastinite e empiema de origem odontogênica foi considerada, sendo indicada a cirurgia. Foi efetuada a Toracotomia anterolateral D com retirada de grande quantidade de fibrina e secreção purulenta por toda a cavidade torácica, além de pus em mediastino e pericárdio. O paciente foi encaminhado para a UTI e após 11 dias passou por nova cirurgia, pelo mesmo acesso cirúrgico, devido à nova coleção em loja superior do mediastino. Houve boa evolução e o paciente recebeu alta após 23 dias. Conclusão: MND é uma doença rara e possui alta mortalidade. O diagnóstico precoce e tratamento adequado fazem-se necessários para resolução do quadro.

  13. Enfermedad coronaria en pacientes con psoriasis

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    Walter Masson

    2013-10-01

    Full Text Available Comunicaciones previas asociaron la psoriasis con la enfermedad coronaria. Desconocemos si en nuestro país o región existe dicha asociación. Se realizó un estudio transversal analizando los datos de la historia clínica electrónica de un sistema de salud de Buenos Aires. Analizamos todos los pacientes mayores de 18 años con diagnóstico de psoriasis entre el 1 de enero de 2003 y el 31 de julio de 2011 y los comparamos con un grupo control, en una relación 2:1, obtenido en forma aleatoria del mismo sistema de salud, apareados por edad y sexo. Determinamos la prevalencia de los factores de riesgo cardiovascular y de enfermedad coronaria. Analizamos la asociación entre la enfermedad coronaria y la psoriasis mediante análisis uni y multivariado. Se incluyeron 3 833 sujetos (1 286 pacientes con psoriasis y 2 547 controles. La prevalencia de hipertensión arterial (50% vs. 38%, p < 0.001, tabaquismo (25% vs. 17%, p < 0.001, diabetes (12% vs. 8%, p < 0.001 y enfermedad coronaria (4.98% vs. 3.06%, p = 0.003 fue mayor en los sujetos con psoriasis en comparación con el grupo control. Independientemente de la edad, la presencia de diabetes, hipertensión arterial o tabaquismo, hubo una asociación significativa entre la enfermedad coronaria y la psoriasis (OR 1.48, IC95% 1.04-2.11, p = 0.03. En conclusión, en esta población de Buenos Aires, los pacientes con psoriasis tuvieron una mayor prevalencia de diabetes, hipertensión arterial, tabaquismo y enfermedad coronaria. La asociación entre la psoriasis y la enfermedad coronaria fue independiente de los factores de riesgo explorados.

  14. OCLUSIÓN TOTAL CRÓNICA DEL TRONCO CORONARIO IZQUIERDO Y ESTENOSIS DE LA CORONARIA DERECHA / Chronic total occlusion of the left main coronary artery and right coronary artery stenosis

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    Roberto Bermúdez Yera

    2012-01-01

    Full Text Available ResumenLa estenosis del tronco coronario izquierdo se encuentra entre el 3-5 % de los pacientes a los que se les realiza una coronariografía, pero su oclusión total es rara (0,05-0,1 %. En este artículo presentamos el caso de un paciente de 42 años con oclusión total de este vaso, que presentaba además, una estenosis de 85 % en la arteria coronaria derecha y fue revascularizado quirúrgicamente de forma exitosa. Se implantaron 3 injertos, mamaria a la descendente anterior, y vena safena a una obtusa marginal y a la descendente posterior. Se presentan las imágenes angiográficas y de la cirugía, y se comentan las alternativas terapéuticas, donde lo más importante es individualizar el tratamiento, con el objetivo de brindar la mejor opción a cada paciente en particular. Para lograrlo es imprescindible una excelente relación del equipo de trabajo donde, como en este caso, el cardiólogo intervencionista y el cirujano cardiovascular se complementen, para el bien del paciente. AbstractThe left main coronary artery stenosis is found in 3-5 % of patients who undergo coronary angiography, but total occlusion is rare (0,05-0,1 %. In this article, the case of a 42-year-old patient with chronic total occlusion of the left main coronary artery is presented. This patient, who also had 85 % stenosis of the right coronary artery, was surgically and successfully revascularized. 3 grafts were implanted: mammary artery to the anterior descending artery and saphenous vein to the obtuse marginal and posterior descending artery. The angiographic and surgery images are shown, and treatment options are discussed, where the most important thing is to individualize treatment in order to provide the best option for each patient. It order to achieve this, an excellent team work is essential, in which, as in this case, the interventional cardiologist and cardiovascular surgeon complement each other for the good of the patient.

  15. Lesiones arteriales coronarias ajenas a aterosclerosis

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    Alberto Rangel-Abundis

    2007-01-01

    La aterosclerosis es la causa más frecuente de cardiopatía isquémica. Actualmente se ha ampliado la lista de padecimientos ajenos a aterosclerosis que dañan las arterias coronarias, uniéndose al catálogo enfermedades autoinmunes que afectan las arterias epicárdicas y la microcirculación coronaria y lesiones observadas en la sala de cateterismo. Las enfermedades adquiridas ajenas a la aterosclerosis aparecen como anomalías primarias o como parte de un desorden multiorgánico que semeja a la ate...

  16. Ectasia coronaria y lesiones trombóticas como causa de síndrome coronario agudo

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    Paula Awamleh

    2017-03-01

    Full Text Available Se presenta un caso de manejo complicado y decisiones difíciles. Un paciente con antecedente de disección aórtica tipo A y dilatación residual de la aorta descendente de hasta 60 mm es ingresado por un síndrome coronario agudo sin elevación del ST. La coronariografía pone de manifiesto una marcada ectasia coronaria y unos defectos de perfusión de dudoso origen. ¿Trombos o falsas imágenes por flujo muy lentificado? Asumiendo que pudiera tratarse de trombos, el paciente es tratado con anticoagulación repitiéndose la coronariografía al cabo de dos meses. En este segundo estudio se observa la completa desaparición de las imágenes, confirmándose el origen trombótico de las mismas. En este momento se plantea ¿cuál debe ser el tratamiento crónico del paciente? No hay evidencia científica disponible acerca del tratamiento de la ectasia coronaria y se trata de un paciente de alto riesgo por su antecedente de disección aórtica. Finalmente se decide, de forma empírica, mantener la anticoagulación de forma indefinida. Tras dos años y seis meses de seguimiento no ha habido incidencias clínicas.

  17. Revascularización coronaria sin circulación extracorpórea: Unidad de Cirugía Cardiovascular "UNICAR" Guatemala C.A.

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    Rodolfo Bonilla

    2002-12-01

    Full Text Available Introducción: Se trata de un procedimiento diferente al tradicional, el cirujano no usa la máquina Corazón-Pulmón o de circulación extracorpórea durante el mismo, en su lugar se usan instrumentos para estabilizar el área destinada para colocar el injerto coronario. Esto permite continuar con el flujo de sangre coronario natural, sin interrupción. Material y Métodos: En la Unidad de Cirugía Cardiovascular de Guatemala "UNICAR" de Agosto de 1999 a Septiembre 2002, 71 pacientes fueron operados de revascularización coronaria con éste método con edades comprendidas entre 35 y 80 años, siendo más frecuente el grupo de 51 a 55 años. Resultados: El porcentaje de Hemoductos realizados por paciente fue de 1.7%, utilizándose en todos Arteria Mamaria Interna para revascularizar la arteria descendente anterior. Se utilizó Arteria Radial en 4 casos. El promedio de estancia en cuidado intensivo fue de 24 horas en el 72%. En el 82% no hubo ninguna complicación, 2 pacientes presentaron derrame pleural (2.81%. Siete pacientes (9.85% presentaron fallo cardiaco que resolvió en las primeras 48 horas. Un paciente desarrolló Infarto del Miocardio trans-operatorio sin ninguna repercusión hemodinámica (1.4%. La mortalidad fue del 2.85% (2 pacientes que desarrollaron uno neumonía postoperatoria y el segundo hizo fallo multisistémico por sepsis de causas no cardíacas. Conclusiones: La Revascularización Coronaria sin Circulación Extracorpórea reduce el trauma del músculo cardíaco y órganos blandos. La recuperación es rápida y disminuye la estadía hospitalaria. Reduce el riesgo de sangrado, accidente cerebrovascular y fallo renal. Reduce los problemas psicomotores y cognositivos que se presentan en el método tradicional, la morbi-mortalidad es baja.lntroduction: Beating heart Bypass is different from tradicional bypass surgery because is performed while the heart continues with his beating. The surgeons do not use the heart-fung machine

  18. PACIENTES DIABÉTICOS CON ENFERMEDAD CORONARIA MULTIVASO, TRATADOS MEDIANTE INTERVENCIONISMO CORONARIO PERCUTÁNEO / Diabetic patients with multivessel coronary disease treated by percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Suilbert Rodríguez Blanco

    2013-10-01

    Full Text Available Resumen Introducción: La enfermedad coronaria es la principal causa de morbilidad y mortalidad en los pacientes diabéticos. Muchos estudios han comparado el tratamiento médico más intervencionismo percutáneo con tratamiento médico más cirugía, en pacientes diabéticos con enfermedad de múltiples vasos. La cirugía de revascularización continúa siendo el tratamiento de elección. Objetivo: Caracterizar los pacientes diabéticos con enfermedad coronaria multivaso, tratados mediante intervencionismo coronario percutáneo. Método: Estudio observacional, descriptivo y transversal en 57 pacientes diabéticos con enfermedad de múltiples vasos, tratados mediante intervencionismo coronario percutáneo en el Laboratorio de Hemodinámica del Hospital "Hermanos Ameijeiras", entre enero de 2010 y julio de 2011. Resultados: Predominaron el sexo masculino (66,66 % y el grupo entre 50-64 años (36,85 %. El factor de riesgo cardiovascular más identificado fue la hipertensión arterial (54,38 %, seguido de la dislipidemia (49,12 %. En el grupo de edad más representado predominó la dislipidemia y el hábito de fumar. El diagnóstico más observado fue la angina de esfuerzo estable (45 pacientes, 78,95 %. El tipo de stent más utilizado fue el liberador de fármaco (54,39 % y la arteria más revascularizada fue la descendente anterior (36 pacientes, 63,15 %. Conclusiones: Se encontró una relación entre los pacientes sin éxito angiográfico con la dislipidemia y la obesidad; y entre los pacientes sin éxito del procedimiento, con el tabaquismo y también con la obesidad. / Abstract Introduction: Coronary heart disease is the leading cause of morbidity and mortality in diabetic patients. Many studies have compared medical therapy plus percutaneous intervention with medical therapy plus surgery in diabetic patients with multivessel disease. Bypass surgery remains the treatment of choice. Objective: To characterize diabetic patients with multivessel

  19. 142. Insuficiencia mitral y enfermedad coronaria

    Directory of Open Access Journals (Sweden)

    I. Moriones Elosegui

    2010-01-01

    Conclusiones: a la GR.A presentó mayor comorbilidad, alteraciones preoperatorias de la función cardíaca, complicaciones, estancia media y más mortalidad que los del GR.B; b la asociación de enfermedad coronaria en el GR.B no afectó a los resultados en este grupo, y c la reparación mitral en el GR.A aportó mejores resultados que la sustitución.

  20. Enfermedad coronaria en pacientes con psoriasis

    OpenAIRE

    Walter Masson; María L. Galimberti; Carolina L. Anselmi; Arturo Cagide; Ricardo L. Galimberti

    2013-01-01

    Comunicaciones previas asociaron la psoriasis con la enfermedad coronaria. Desconocemos si en nuestro país o región existe dicha asociación. Se realizó un estudio transversal analizando los datos de la historia clínica electrónica de un sistema de salud de Buenos Aires. Analizamos todos los pacientes mayores de 18 años con diagnóstico de psoriasis entre el 1 de enero de 2003 y el 31 de julio de 2011 y los comparamos con un grupo control, en una relación 2:1, obtenido en forma aleatoria del mi...

  1. Ectasia coronaria, angina inestable e insuficiencia aórtica

    Directory of Open Access Journals (Sweden)

    Róger A Lanzas Rodríguez

    2009-12-01

    Full Text Available Se presenta el caso de una paciente femenina de 79 años, conocida portadora de cardiopatía hipertensiva, insuficiencia aórtica y dislipidemia, que se hospitalizó con un síndrome coronario agudo. Durante su evolución presentó cambios electrocardiográficos de isquemia subepicardica anterior extensa e inferior, por lo que se le realizó una coronariografia selectiva bilateral, detectándose ectasia de la arteria coronaria derecha, con flujo lento y retención del medio de contraste. Se refirió el caso para cirugía de reemplazo valvular.Coronary artery ectasia, unstable angina and aortic insufficiency The case of a 79 year old female patient, who was hospitalized with acute coronary syndrome (ACS, is presented. She had known hypertensive heart disease, aortic insufficiency and dyslipidemia. During the evolution of her ACS, she presented electrocardiographic changes of ischemia. Selective coronary angiography detected ectasia of the right coronary artery with slow flow and retention of contrast medium. The patient was referred for aortic valve replacement surgery.

  2. 142. Insuficiencia mitral y enfermedad coronaria

    OpenAIRE

    I. Moriones Elosegui; A. De la Fuente Calixto; R. Sánchez Quintana; J.L. Fernández Rodríguez; L. Jiménez Alfaro

    2010-01-01

    Analizamos los parámetros clínicos y resultados quirúrgicos comparativos entre la insuficiencia mitral isquémica (GR.A) y la insuficiencia mitral de otras causas con lesiones coronarias acompañantes (GR.B). Material y métodos: Ochenta pacientes cuya edad media es 67 años. Varones fueron 58 y mujeres 22. Pertenecían al GR.A 49 y 31 al GR.B. Clínica comparativa entre el GR.A y GR.B fue: fracción de eyección [FE] = 0,43 frente a 0,45 (p = no significativa [NS]). GF.IV = 66 frente a 35% (p < 0...

  3. Wirus mozaiki ogórka na zawilcu (Anemone coronaria L. [Cucumber mosaic virus on Anemone coronaria L.

    Directory of Open Access Journals (Sweden)

    J. Kochman

    2015-06-01

    Full Text Available From Anemone coronaria cucumber mosaic virus (Cucumis virus 1 Smith was isolated. It caused a general chlorosis, reduction of leaves blades and of the whole plants. 66 species of test plants were inoculated with the sap from infected cucumber plants. 33 of these were infected systemically and 11 only locally. Among 22 noninfected plants was Anemone coronaria which indicated as it was experimentally proved, that this species is infected only by the aphids – Myzus persicae Sulz.

  4. Tratamiento endovascular de la aorta torácica descendente. Tratamiento endovascular de la aorta torácica descendente.

    Directory of Open Access Journals (Sweden)

    Hernán G. Bertoni

    2007-01-01

    Full Text Available ObjetivoEl propósito de esta publicación es comunicar nuestros resultados inmediatos y a mediano plazo del tratamiento endovascular de la aorta torácica descendente mediante implante de endoprótesis.Material y métodosEntre agosto de 1999 y agosto de 2006, 74 pacientes consecutivos, 53 hombres y 21 mujeres, fueron tratados por vía endovascular con implante de una prótesis autoexpandible. La edad media fue de 60 ± 14,8 años. Las indicaciones para tratamiento fueron disección aguda (n = 8; 11%, disección crónica (n = 31; 42%, hematoma intramural (n = 5; 7%, aneurisma verdadero (n = 17; 23%, úlcerapenetrante (n = 4; 5% y seudoaneurisma traumático (n = 9; 12%.ResultadosEl implante del dispositivo fue exitoso en 73 (98,6% pacientes; no se requirió conversión quirúrgica en ninguno de ellos. Ningún paciente presentó paraplejía o déficit neurológico. La mortalidad a los 30 días fue del 8,1% (n = 6. La mediana de seguimiento fue de 33,5 meses (rango 1-79 y la sobrevida global fue del 84% (IC 69-92% y del 91% (IC 77-97%, según se incluyese o no la mortalidad temprana. El 93% (IC 84-97% de los pacientes estaban libres de complicaciones relacionadas con el procedimiento. La mayoría de las complicaciones ocurrieron durante el primer año de seguimiento.ConclusionesEl tratamiento endovascular de la aorta torácica descendente con implante de endoprótesis autoexpandible es factible y seguro. La baja incidencia de eventos en relación con las series quirúrgicas publicadas hace que este procedimiento sea de elección en pacientes seleccionados.

  5. Toelating Herbasan SC welkom voor dahlia, A. coronaria en narcis

    NARCIS (Netherlands)

    Leeuwen, van P.J.; Koster, A.T.J.; Trompert, J.P.T.

    2005-01-01

    Onlangs is Herbasan SC voor de onkruidbestrijding in onder meer dahlia, narcis en Anemone coronaria toegelaten. PPO ging na hoe het middel het beste is in te zetten. In dit artikel zijn de resultaten van het onderzoek vermeld en een advies voor toepassing

  6. ¿Cirugía coronaria sin bomba para todos?

    Directory of Open Access Journals (Sweden)

    José María Melero Tejedor

    2006-10-01

    Full Text Available En la pasada década importantes desarrollos técnicos han hecho posible que la cirugía coronaria sin circulación extracorpórea se convierta en un procedimiento rutinario y reproducible. Se presenta la evolución de esta técnica en nuestro hospital durante estos 10 años, el protocolo quirúrgico utilizado, los resultados obtenidos y las motivaciones para extender su uso a todos los pacientes. A pesar de las controversias suscitadas, se espera que la cirugía coronaria sin circulación extracorpórea continúe expandiéndose y los futuros cirujanos cardíacos deben estar preparados para ello.

  7. DISECCIÓN CORONARIA ESPONTANEA EN PACIENTE FUMADOR

    Directory of Open Access Journals (Sweden)

    Juan Carlos Juez N.

    2011-01-01

    Full Text Available La disección coronaria (DC es la division de las capas que conforman la arteria coronaria, tiene una incidencia de 0.07% a 1.1% en cateterismo cardíaco, siendo más frecuente en mujeres post parto. Las causas de DC se dividen en ateroescleróticas y no ateroescleróticas, existiendo relación del tabaco con la ateroesclerosis. Este caso presenta a un hombre de 43 años, con tabaquismo pesado, en el contexto de un infarto agudo del miocardio secundario DC, por lo cual se hace una revisión del daño endotelial que produce el tabaquismo y la fisiopatología de la disección coronaria. La importancia de este reporte radica en la poca información que existe acerca de los factores de riesgo de este tipo de enfermedad y la presentación clínica inusual del caso.

  8. Sensibilidad y especificidad de la prueba de esfuerzo y el estudio de perfusión miocárdica con SESTAMIBI para detección de enfermedad arterial coronaria, en el Hospital San Juan de Dios Sensitivity and Specificity of Treadmill Test and Myocardial Perfusion Imaging with SESTAMIBI in the detection of Coronary Artery Disease at the Hospital San Juan de Dios

    Directory of Open Access Journals (Sweden)

    Juan Pablo Solís-Barquero

    2010-07-01

    Full Text Available Objetivo: La coronariopatía arterio esclerótica continúa siendo la principal causa de mortalidad mundial y Costa Rica no escapa a esta realidad. La prueba de esfuerzo, la imagen de perfusión con SESTAMIBI y la angiografía coronaria son métodos que permiten detectar esta entidad. El país no cuenta con datos sobre la información que proporcionan estas pruebas. El objetivo del estudio es determinar la rentabilidad diagnóstica de cada una de ellas. Métodos: Es un estudio observacional, analítico de cohorte. Se incluyeron pacientes con factores de riesgo cardiovascular, que tuvieran prueba de esfuerzo, estudio de perfusión miocárdica y angiografía coronaria realizadas en el Hospital San Juan de Dios, desde 2003 a 2007. Se calculó la sensibilidad y especificidad de estos estudios. También se llevó a cabo un análisis con una estadística descriptiva de las características de la muestra y de los diferentes factores de riesgo cardiovascular. Resultados: Se incluyeron 83 pacientes en el estudio, 75% hombres. Los principales factores de riesgo encontrados fueron dislipidemia (84% e hipertensión arterial (70%. La prueba de esfuerzo tuvo una sensibilidad del 40% y una especificidad del 57%; el estudio de perfusión miocárdica con SESTAMIBI tuvo una sensibilidad del 66% y una especificidad del 71%. La mayoría de los pacientes tuvieron afección de uno o dos vasos coronarios, con lesiones mayores al 90%, y especialmente en la arteria descendente anterior. Conclusión: Los factores de riesgo convencionales se presentaron en un alto porcentaje de la población estudiada. La prueba de esfuerzo mostró una baja sensibilidad y especificidad, sin embargo, coincide con el rango descrito en la literatura. El estudio de perfusión miocárdica con SESTAMIBI mostró un rendimiento diagnóstico significativamente superior (p =0.05.Aim: Coronary artery disease is the first cause of mortality around the world, and Costa Rica does not escape from this

  9. Prospects of isolated microspore culture for haploid production in Anemone coronaria L.

    NARCIS (Netherlands)

    Paladines, R.; Jurado, D.; Riksen-Bruinsma, T.; Quiñones, A.M.

    2012-01-01

    The aim of this study was to establish a procedure to obtain haploid plants from microspore cultures of Anemone coronaria L., an important ornamental crop known worldwide due to its commercial value in the cut flower industry. Microspores were isolated from two genotypes of A. coronaria: ‘Blue’

  10. Prospects of isolated microspore culture for haploid production in Anemone coronaria L.

    NARCIS (Netherlands)

    Paladines, R.; Jurado, D.; Riksen-Bruinsma, T.; Quiñones, A.M.

    2012-01-01

    The aim of this study was to establish a procedure to obtain haploid plants from microspore cultures of Anemone coronaria L., an important ornamental crop known worldwide due to its commercial value in the cut flower industry. Microspores were isolated from two genotypes of A. coronaria: ‘Blue’ (pla

  11. Diferencias en la agregación plaquetaria de sangre coronaria y periférica de pacientes con enfermedad coronaria. Implicaciones clínicas

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    Jaime Cabrales, MD

    2010-11-01

    Conclusión: Se describe la presencia de mayor agregación plaquetaria en el seno coronario de pacientes con enfermedad aterosclerótica, la cual es significativa para ADP, colágeno y epinefrina. Se sugiere la aparición de factores locales asociados con la enfermedad coronaria que aumentan la agregación plaquetaria. La agregación plaquetaria periférica no refleja el comportamiento local en pacientes con aterosclerosis coronaria.

  12. DIETA Y ENFERMEDAD CORONARIA Diet and coronary health disease

    OpenAIRE

    Guillermo Mora Pabón

    2005-01-01

    Las enfermedades cardiocerebrovasculares, entre ellas la enfermedad coronaria, constituyen un problema de salud pública en Colombia, siendo la primera causa de muerte en población mayor de 45 años. Existen diversos factores relacionados con la alimentación que se han asociado consistentemente con la aparición de estas enfermedades como el alto consumo de grasa saturada, ácidos grasos trans (AGT), colesterol, carbohidratos y sodio, entre otros. El proceso de cuidado nutricional del individuo c...

  13. Anthocyanins from the scarlet flowers of Anemone coronaria.

    Science.gov (United States)

    Toki, K; Saito, N; Shigihara, A; Honda, T

    2001-04-01

    Three acylated anthocyanins were isolated from the scarlet flowers of Anemone coronaria 'St. Brigid Red' along with a known pigment, pelargonidin 3-lathyroside. The structures of the acylated pigments were based on a pelargonidin 3-lathyroside skeleton acylated at different positions with malonic acid. The first pigment was identified as pelargonidin 3-O-[2-(beta-D-xylopyranosyl)-6-O-(malonyl)-beta-D-galactopyranoside], the second was pelargonidin 3-O-[2-O-(beta-D-xylopyranosyl)-6-O-(methyl-malonyl)-beta-D-galactopyranoside], and the third was (6''-O-(pelargonidin 3-O-[2''-O-(beta-D-xylopyranosyl)-beta-D-galactopyranosyl]))((4-O-(beta-D-glucopyranosyl)-trans-caffeoyl)-O-tartatryl)malonate.

  14. DIETA Y ENFERMEDAD CORONARIA Diet and coronary health disease

    Directory of Open Access Journals (Sweden)

    Guillermo Mora Pabón

    2005-04-01

    Full Text Available Las enfermedades cardiocerebrovasculares, entre ellas la enfermedad coronaria, constituyen un problema de salud pública en Colombia, siendo la primera causa de muerte en población mayor de 45 años. Existen diversos factores relacionados con la alimentación que se han asociado consistentemente con la aparición de estas enfermedades como el alto consumo de grasa saturada, ácidos grasos trans (AGT, colesterol, carbohidratos y sodio, entre otros. El proceso de cuidado nutricional del individuo con enfermedad coronaria comprende la evaluación nutricional, la determinación de requerimientos nutricionales y de las características de la dieta y una evaluación constante para efectuar los ajustes necesarios. Este paciente requiere la atención integral por parte del equipo de salud, con un criterio interdisciplinario, en donde el papel del profesional nutricionista dietista es esencial para llevar a cabo el proceso de cuidado nutricional anteriormente descrito.Cardiovascular diseases, such as the coronary disease are a problem of public health in Colombia, being the first cause of death in people older than 45 years old. There are many factors related to food that have been strongly associated with the existence of these diseases, for instance: a high intake of saturated fat, trans fatty acids (TFA, cholesterol, carbohydrates and sodium, among others. The process of nutritional care of the person with coronary disease involves nutritional assessment, the determination of the nutritional requirements and the constant surveillance in order to do the necessary changes. This patient needs integral attention from the health team, with an interdisciplinary criterion; the role of the dietician is very important in order to carry out the process of nutritional care previously described.

  15. Tomografía computada multidetector de arterias coronarias: estado del arte. Parte II: Aplicaciones clínicas

    OpenAIRE

    Meave González,Aloha; Alexánderson Rosas,Erick; Rodríguez Valero,Mónica; Meléndez Ramírez,Gabriela; Martínez García, Alfonso; Sierra Fernández,Carlos; Calleja Torres,Rodrigo; García-Rojas Castillo,Leonardo; Lamothe Molina,Pedro Alberto; Herrera Zarza,Mary Carmen; Armas de Ávila,Martha; Ochoa López,Juan Manuel; Vázquez-Lamadrid,Jorge; Kimura Hayama,Eric

    2008-01-01

    En los inicios de la evaluación de enfermedad coronaria la tomografía computada multidetector de arterias coronarias (TCMD) se limitaba casi exclusivamente a la detección de placas calcificadas en las arterias coronarias con el cálculo del índice de Calcio, cuyo valor por sí solo es limitado. Sin embargo, en la actualidad gracias al advenimiento de nueva tecnología, las aplicaciones clínicas potenciales de este método incluyen la detección de estenosis arterial coronaria, la evaluación de pue...

  16. Aneurisma gigante en primera porción de coronaria derecha

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    José Miguel Beltrán

    2006-07-01

    Full Text Available Los aneurismas son anomalías infrecuentes en la circulación coronaria. Se presenta el caso de un varón de 51 años, sin antecedentes de interés, que debutó con un cuadro de taponamiento cardíaco. El estudio diagnóstico puso de manifiesto la existencia de un aneurisma de 4 cm de diámetro en la primera porción de la arteria coronaria derecha. La cirugía consistió en la exéresis del aneurisma y restablecimiento de la circulación coronaria derecha mediante injerto con arteria mamaria interna derecha. La evolución natural de esta enfermedad y su manejo terapéutico permanecen no aclarados. La cirugía ha mostrado excelentes resultados cuando está correctamente indicada.

  17. Aneurisma gigante en primera porción de coronaria derecha

    OpenAIRE

    José Miguel Beltrán; Andrés Gutiérrez; José María Vallejo; Marta Matamala; Fernando Sorribas; Carlos Ballester; Fernando Ibarra

    2006-01-01

    Los aneurismas son anomalías infrecuentes en la circulación coronaria. Se presenta el caso de un varón de 51 años, sin antecedentes de interés, que debutó con un cuadro de taponamiento cardíaco. El estudio diagnóstico puso de manifiesto la existencia de un aneurisma de 4 cm de diámetro en la primera porción de la arteria coronaria derecha. La cirugía consistió en la exéresis del aneurisma y restablecimiento de la circulación coronaria derecha mediante injerto con arteria mamaria interna derec...

  18. Pseudo-aneurisma post-traumático de tronco de arteria coronaria izquierda

    Directory of Open Access Journals (Sweden)

    Melina M. Gallo

    2011-08-01

    Full Text Available El pseudo-aneurisma de arteria coronaria es extremadamente raro. Su historia natural es poco conocida y su tratamiento discutido. Se presenta el caso de un paciente con pseudo-aneurisma de tronco de la coronaria izquierda e infarto antero-apical del ventrículo izquierdo cinco años después de un paro cardíaco secundario a un traumatismo no penetrante de tórax. Se consideró entonces que la lesión no era pasible de corrección percutánea o quirúrgica por lo que se optó por tratamiento médico conservador. Una angiografía coronaria por tomografía computarizada multicorte realizada 10 años después del evento inicial mostró ausencia de progresión de la lesión.

  19. Conocimientos previos de la mujer en la enfermedad coronaria: un estudio fenomenológico

    Directory of Open Access Journals (Sweden)

    David Sancho Cantus

    2015-09-01

    Full Text Available Introducción: La enfermedad coronaria posee unas características distintas en función del sexo en su presentación, diagnóstico o abordaje terapéutico. Objetivo: explorar los conocimientos previos que posee la mujer sobre la enfermedad coronaria. Metodología: Diseño cualitativo basado en la Fenomenología, en una muestra de 17 mujeres que padecían Cardiopatía Isquémica. La recogida de datos mediante entrevista semiestructurada. Para el análisis de los datos se utilizó el método de Giorgi. Resultados: Destacan un déficit de conocimientos previos sobre la enfermedad y el menosprecio de los síntomas iniciales. Conclusión: Existe un déficit de conocimientos previos por parte de la mujer sobre su enfermedad coronaria.

  20. Factores de riesgo y extensión de la enfermedad coronaria evaluada por angiografía coronaria no invasiva

    Directory of Open Access Journals (Sweden)

    Eduardo Diez

    2008-01-01

    Full Text Available AntecedentesA pesar de que numerosos estudios han establecido una clara asociación entre los factores de riesgo (FR y los eventos cardiovasculares, la relación entre la extensión total de la aterosclerosis coronaria y los FR no se ha establecido categóricamente.ObjetivoExplorar la relación entre factores de riesgo coronario tradicionales y la presencia y extensión de aterosclerosis coronaria mediante angiografía coronaria por tomografía computarizada multicorte (ACTCM de alta resolución.Material y métodosEn este estudio monocéntrico observacional, pacientes consecutivos en ritmo sinusal se estudiaron mediante angiografía coronaria por tomografía computarizada multicorte. La población se categorizó prospectivamente en tres grupos de acuerdo con el número de FR.ResultadosSe incluyeron en el estudio 117 pacientes. La edad media fue de 58,5 ± 10,6 años, el 81% eran hombres y el 19% eran diabéticos.Se observó una correlación significativa entre la prevalencia de cualquier lesión (p = 0,001, de lesiones significativas (p < 0,001, de múltiples lesiones no significativas (p < 0,001 y de múltiples lesiones significativas (p < 0,001 y el número de FR. En paralelo, tanto el número de lesiones (1,9 ± 2,3 versus 4,3 ± 3,3 versus 6,6 ± 2,6, p < 0,001 como el puntaje de calcio [2,79 (0,0; 44,0 versus 64,0 (0,0; 273,2 versus 539,0 (74,0; 1.405,9, p = 0,001] fueron significativamente mayores en pacientes con múltiples FR.Individualmente, numerosos FR se asociaron con la presencia de lesiones. La edad, la diabetes, la hipercolesterolemia, la hipertensión, el antecedente de IAM y el tabaquismo se encontraron relacionados con la presencia de aterosclerosis, ya sea por evidenciar mayor prevalencia de lesiones, mayor número total de lesiones y/o mayor puntaje de calcio.ConclusionesEn el presente estudio se encontró una relación significativa entre el número de factores de riesgo, así como de numerosos FR per se, y la extensión de

  1. La experiencia del desempeño de diferentes roles en la mujer con enfermedad coronaria

    OpenAIRE

    Castañeda Méndez, Jeny Francenet

    2014-01-01

    OBJETIVO: Describir la experiencia del desempeño de los diferentes roles en la mujer con enfermedad coronaria. MATERIALES Y MÉTODOS: Se realizó un estudio cualitativo, descriptivo interpretativo, con metodología de análisis de contenido, muestreo por saturación de información. Se realizaron dieciocho entrevistas, a mujeres con enfermedad coronaria que cumplían criterios de inclusión. RESULTADOS: Emergieron tres categorías, que se analizaron a la luz de dos teorías de enfe...

  2. Taponamiento cardiaco posterior a intervención coronaria percutánea

    OpenAIRE

    Gabriel Carvajal Valdy; Marco Antonio Siles Varela; Jorge Fernández Acuña

    2013-01-01

    La perforación coronaria es una rara complicación de la intervención coronaria percutánea, pero puede desencadenar un taponamiento cardiaco potencialmente letal. Esta complicación ha sido reportada en 0,1 - 3,0 % de los procedimientos. Este reporte describe un caso de hemopericardio y taponamiento cardiaco posterior a una intervención percutánea en un paciente anticoagulado con warfarina y con síndrome coronario agudo sin elevación del segmento ST. Una rápida intervención aseguró una excelent...

  3. Antioxidant and antiinflammatory activities of the flowers of Tabernaemontana coronaria (l R.BR

    Directory of Open Access Journals (Sweden)

    Thambi Priya

    2006-01-01

    Full Text Available The ethanol and aqueous extracts of Tabernaemontana coronaria flowers possessed significant in vitro superoxide, hydroxyl radicals, nitric oxide scavenging, and lipid peroxidation inhibiting activities. The antiinflammatory activity of the ethanol extract was evaluated by carrageenan-induced acute and formalin-induced chronic antiinflammatory models in mice. The extract showed remarkable antiinflammatory activity in both models, comparable to the standard reference drug diclofenac. The results suggest that the antiinflammatory activity of the ethanol extract of T. coronaria is possibly attributed to its free radical scavenging properties.

  4. Presencia de placas coronarias vulnerables en mujeres de mediana edad que sufrieron muerte cerebral

    OpenAIRE

    Enrique Gurfinkel; Carlos Vigliano; Patricia Cabeza Meckert; Alejandro Bertolotti; Roberto Favaloro; Juan Carlos Troncoso; Rubén Laguens

    2009-01-01

    RESUMENIntroducciónLas placas vulnerables de las arterias coronarias se encuentran habitualmente en varonessin sintomatología previa que fallecieron súbitamente o debido a un síndrome coronarioagudo. La frecuencia y las características de estas placas en la población femenina de medianaedad se desconocen.ObjetivoIndagar acerca de la presencia de placas coronarias vulnerables en mujeres de medianaedad que sufrieron muerte cerebral.Material y métodosDe un total de 652 corazones de donantes para...

  5. Taponamiento cardiaco posterior a intervención coronaria percutánea

    OpenAIRE

    Gabriel Carvajal Valdy; Marco Antonio Siles Varela; Jorge Fernández Acuña

    2013-01-01

    La perforación coronaria es una rara complicación de la intervención coronaria percutánea, pero puede desencadenar un taponamiento cardiaco potencialmente letal. Esta complicación ha sido reportada en 0,1 - 3,0 % de los procedimientos. Este reporte describe un caso de hemopericardio y taponamiento cardiaco posterior a una intervención percutánea en un paciente anticoagulado con warfarina y con síndrome coronario agudo sin elevación del segmento ST. Una rápida intervención aseguró una excelent...

  6. Enfermedad Coronaria y ejercicio físico

    Directory of Open Access Journals (Sweden)

    Juan Carlos Sánchez-Delgado

    2016-08-01

    Full Text Available Este artículo describe de manera general el tratamiento farmacológico y de revascularización percutánea en sujetos con enfermedad coronaria, el cual genera resultados exitosos en un 90% de los casos, traducidos en la desaparición clínica de la angina de pecho. Además, se hace énfasis en el ejercicio físico como estrategia de manejo y control de la enfermedad, el cual está normalmente incluido en los programas de rehabilitación cardiaca y su objetivo fundamental es incrementar la capacidad funcional (CF, variable medida a través de una prueba de esfuerzo (PE y que está fuertemente relacionada con la reducción  de la mortalidad total, mortalidad y morbilidad cardiovascular. Sin duda, los beneficios del ejercicio físico en estos pacientes son múltiples y entre los más relevantes están el efecto antitrombótico y antiisquémico, el control de lípidos sanguíneos, glicemia, presión arterial, composición corporal, reducción de los niveles de depresión secundaria a un evento coronario y por supuesto de los costos sanitarios que se traducen en menor número de hospitalizaciones e incremento de la productividad laboral. En conclusión, el tratamiento oportuno e integral en estos pacientes puede cambiar de manera satisfactoria el inicio así como la evolución de la enfermedad, permitiendo una mayor sobrevida libre de eventos y una mejor calidad de vida.

  7. Origen anómalo de la arteria coronaria izquierda en la arteria coronaria derecha y curso ínter-arterial

    Directory of Open Access Journals (Sweden)

    Nilson López, MD

    2010-11-01

    Full Text Available El origen del tronco coronario principal izquierdo a partir de la arteria coronaria derecha o del seno de Valsava opuesto, es una anomalía extremadamente rara con un riesgo potencial de mortalidad. En este informe se describe el caso de una paciente con esta anomalía, inicialmente detectada por coronariografía y posteriormente confirmada mediante resonancia magnética cardiaca.

  8. Dynamic Transcription profiles of Qinguan apple (Malus × domestica leaves in response to Marssonina coronaria inoculation

    Directory of Open Access Journals (Sweden)

    Junke eZhang

    2015-10-01

    Full Text Available Marssonina apple blotch, caused by the fungus Marssonina coronaria, is one of the most destructive apple diseases in China and East Asia. A better understanding of the plant’s response to fungi during pathogenesis is urgently needed to improve plant resistance and to breed resistant cultivars. To address this, the transcriptomes of ‘Qinguan’ (a cultivar with high resistance to M. coronaria apple leaves were sequenced at 12, 24, 48 and 72 hours post-inoculation (hpi with Marssonina coronaria. The comparative results showed that a total of 1956 genes were differentially expressed between the inoculated and control samples at the 4 time points. Gene ontology (GO term enrichment analysis of differentially expressed genes (DEGs revealed changes in cellular component, secondary metabolism including chalcone isomerase activity, phytoalexin biosynthetic process, anthocyanin-containing compound biosynthetic process, lignin biosynthetic process, positive regulation of flavonoid biosynthetic process; and molecular functions or biological processes related to the defense response, biotic stimulus response, wounding response and fungus response. Kyoto Encyclopedia of Genes and Genomes (KEGG pathway analysis showed that DEGs were significantly enriched in flavonoid biosynthesis, vitamin B6 metabolism, phenylpropanoid biosynthesis, and the stilbenoid, diarylheptanoid and gingerol biosynthesis pathways. Furthermore, the importance of changes in cellular components and partial polyphenol compounds when encountering M. coronaria are discussed.

  9. El origen anatómico de la arteria coronaria septal del hámster sirio es un carácter heredable

    OpenAIRE

    Soto Navarrete, María Teresa; Arqué Gibernau, José M; Durán Boyero, Ana Carmen; Fernández Domínguez, María Carmen; Fernández Corujo, Borja; Lorenzale García, Miguel; Sans-Coma, Valentín

    2016-01-01

    Introducción y objetivos: En los roedores, incluidos los empleados en el laboratorio, las arterias coronarias son intramiocárdicas. Normalmente se distinguen 3 arterias coronarias, la derecha, que irriga el corazón derecho, la izquierda, que irriga el corazón izquierdo, y la septal, que irriga el septo interventricular. En el hámster sirio, una especie empleada como modelo en estudios sobre anomalías congénitas de las arterias coronarias, la arteria septal se origina de la coronaria derecha o...

  10. Taponamiento cardiaco posterior a intervención coronaria percutánea

    Directory of Open Access Journals (Sweden)

    Gabriel Carvajal Valdy

    2013-12-01

    Full Text Available La perforación coronaria es una rara complicación de la intervención coronaria percutánea, pero puede desencadenar un taponamiento cardiaco potencialmente letal. Esta complicación ha sido reportada en 0,1 - 3,0 % de los procedimientos. Este reporte describe un caso de hemopericardio y taponamiento cardiaco posterior a una intervención percutánea en un paciente anticoagulado con warfarina y con síndrome coronario agudo sin elevación del segmento ST. Una rápida intervención aseguró una excelente evolución clínica del paciente.

  11. Cervicoplastia anterior Anterior cervicoplasty

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    Lucas Gomes Patrocínio

    2004-10-01

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

  12. Disección coronaria espontánea en paciente fumador

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    Juan Carlos Juez N.

    2012-09-01

    Full Text Available La disección coronaria (DC es la division de las capas que conforman la arteria coronaria, tiene una incidencia de 0.07% a 1.1% en cateterismo cardíaco,  siendo más frecuente en mujeres post parto. Las causas de DC se dividen en ateroescleróticas y no ateroescleróticas, existiendo relación del tabaco con  la ateroesclerosis. Este caso presenta a un hombre de 43 años, con tabaquismo pesado, en el contexto de un infarto agudo del miocardio secundario DC,  por lo cual se hace una revisión del daño endotelial que produce el tabaquismo y la fisiopatología de la disección coronaria. La importancia de este reporte  radica en la poca información que existe acerca de los factores de riesgo de este tipo de enfermedad y la presentación clínica inusual del caso.

  13. METODOLOGÍA PARA EL DISEÑO ÓPTIMO DE EVAPORADORES DE PELÍCULA DESCENDENTE

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    Christian O. Díaz-Ovalle

    2013-01-01

    Full Text Available En este trabajo se presenta un modelo como una forma de solución del problema en base a las especificaciones geométricas de los evaporadores de película descendente. El modelo incluye balances de masa y energía en una forma general para cualquier secuencia; y, correlaciones de transferencia de calor para el cálculo del área de transferencia de calor. Así, el diseño óptimo es posible considerando el costo de los tubos en la longitud, diámetro y costo de energía. El problema es formulado como MINLP para minimizar el costo total al seleccionar un diámetro óptimo. Los resultados muestran una aceptable aplicación sobre un proceso real.

  14. Úlceras penetrantes aórticas múltiples y aneurisma torácico descendente

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    María Bueno

    2006-01-01

    Full Text Available Las úlceras penetrantes de aorta (UPA están causadas por ruptura de una placa aterosclerótica. Asociadas a hematoma intramural, son equivalentes a una disección. Evolucionan a disección, ruptura y aneurismas. Varón de 78 años con antecedentes de hipertensión y neoplasia de colon intervenida con enfermedad residual. En la TC de control aparece imagen de aneurisma de aorta torácica descendente. La RM muestra UPA y aneurisma (Fig. 1. Se realizó tratamiento endovascular por vía femoral y anestesia general, monitorizando la presión del líquido cefalorraquídeo. Se excluyeron el aneurisma y las úlceras (Fig. 2. Fue dado de alta en 48 h.

  15. Regulación colinérgica y endotelial de la circulación coronaria de resitencia

    OpenAIRE

    Simonsen, Ulf

    2012-01-01

    Se ha estudiado la regulación colinérgica de la circulación coronaria de resistencia. La actividad de las enzimas de síntesis y de degradación de la acetilcolina (ach) fue mayor en los segmentos dístales de la circulación coronaria, indicando que la inervación es más densa a este nivel. La estimulación eléctrica transmural de las arterias coronarias de resistencia indujo una respuesta vasorrelajante neurogénica sensible a la atropina, lo que indica la presencia de una inervación colinérgica f...

  16. Strain longitudinal global para la detección de estenosis coronaria significativa en pacientes con infarto agudo del miocardio

    OpenAIRE

    Acosta, Rafael

    2015-01-01

    Introducción: La evaluación de la función miocárdica global y regional juega una papel crítico en el diagnóstico y manejo de los pacientes con enfermedad coronaria con importantes implicaciones pronosticas, las nuevas técnicas ecocardiográficas como la evaluación del STRAIN han sido validadas como una herramienta objetiva, comprehensiva y precisa para evaluar dichos parámetros. Objetivo: Determinar la capacidad del strain global longitudinal para la detección de estenosis coronaria sig...

  17. Adherencia a la prevención secundaria de la enfermedad coronaria

    OpenAIRE

    Emiliano Rossi; Gastón Perman; Hernán Michelangelo; Claudia B. Alonzo; Laura Brescacin; Karin S. Kopitowski; José L. Navarro Estrada

    2014-01-01

    Se comparó la adherencia a la prevención secundaria de enfermedad coronaria mediante el uso indicado de fármacos de probada eficacia, al momento del egreso hospitalario y a 3 años de seguimiento, en una cohorte de pacientes afiliados al Plan de Salud del Hospital Italiano. Se realizó un estudio de cohorte retrospectivo que incluyo 125 pacientes menores de 80 años de edad, afiliados a una red integrada de salud, con internación por síndrome coronario agudo. En el análisis se utilizó el test de...

  18. VALORES E PADRÕES DO VOCÁBULO “VELHO”: INDICADORES DE DESCENDENTES JAPONESES NO BRASIL

    Directory of Open Access Journals (Sweden)

    Sônia Maria Toyoshima Lima

    2008-06-01

    Full Text Available O crescimento contínuo da população idosa vem sendo constatado na sociedade humana, sendo, portanto, necessário utilizar medidas tanto de ação individual quanto coletiva, numa concentração de esforços que objetive reduzir os estigmas e os preconceitos instaurados na sociedade. A longevidade tem sido significativamente aumentada, mas os preconceitos em relação ao idoso encontram-se muito presentes em nosso meio social. Na discussão dessas questões, relataremos os depoimentos de alguns indivíduos com mais de 60 anos de um grupo cultural descendente de japoneses, como dos isseis (primeira geração de japoneses no Brasil e dos nisseis (segunda geração: filhos de japoneses nascidos no Brasil. Este estudo caracterizou-se como sendo do tipo descritivo, utilizando a bibliografia específica relacionada ao tema proposto e com aplicação de uma entrevista estruturada sobre a questão de quem é considerado velho e idoso para eles. De acordo com os resultados obtidos, um dos aspectos que nos chamaram a atenção, nas entrevistas, foi que, mesmo estando em uma sociedade chamada moderna, os descendentes de japoneses entrevistados não se consideram velhos, e não gostam de que os chamem dessa forma, contrariando conceitos e preconceitos estabelecidos sobre esta etapa da vida. A idade para eles não é relevante, mas a relevância da questão “idade” está aí instaurada e organizada de modo a conservar a forma instituída pelo meio social. Outro aspecto relevante em nosso estudo foi constatar que o importante para as pessoas idosas entrevistadas é a valorização da vida, a apreciação do dia-a-dia, desfrutar o prazer de viver. Não carregam consigo uma linguagem do declínio, mas enfatizam, sim, a valorização da vida, procurando encontrar prazeres nas coisas mais simples do cotidiano. É interessante ressaltar que, com raras exceções, eles não se sentem velhos e gostam de estar sempre ativos.

  19. Cirugía coronaria con doble arteria mamaria: nuestra experiencia inicial y resultados a corto plazo

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    Jorge Alcocer-Diéguez

    2017-05-01

    Conclusiones: La cirugía coronaria con doble mamaria es una técnica segura y con excelentes resultados de morbimortalidad a corto plazo. Son necesarios estudios de seguimiento clínico y angiográfico a largo plazo para determinar la mejor estrategia quirúrgica a emplear.

  20. Antibacterial Activities and In Vitro Anti-Inflammatory (Membrane Stability Properties of Methanolic Extracts of Gardenia coronaria Leaves

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    Amin Chowdhury

    2014-01-01

    Full Text Available This work is carried out with Gardenia coronaria leaves that belong to the family Rubiaceae, which is a small-to-medium-sized but tall, deciduous tree, 7.6–9 m high on an average. Leaves are used for the treatment of rheumatic pain and bronchitis. The leaf of the plant consists of coronalolide, coronalolic acid, coronalolide methyl ester, ethyl coronalolate acetate triterpenes (secocycloartanes, and so forth. Methanol extract from the leaves of Gardenia coronaria was completely screened for membrane stability and antibacterial activity. The lower concentrations of Methanolic leaf extract of Gardenia coronaria gave good antimicrobial and anti-inflammatory activity, but higher concentrations gave relatively more projecting antibacterial activity in vitro as compared with Kanamycin. The crude drug’s anti-inflammatory effects were compared with those of Aspirin as positive control. The Methanolic extracts of Gardenia coronaria leaves possessed a broad spectrum antibacterial activity against a variety of both Gram-negative and Gram-positive organisms like Streptococcus agalactiae, Escherichia coli, Pseudomonas aeruginosa, Bacillus cereus, Shigella sonnei, Shigella boydii, and Proteus mirabilis, with a zone of inhibition from 10 to 16 mm. The extract also showed good membrane stability to be considered as having significant anti-inflammatory action.

  1. Psicocardiología: Su importancia en la prevención y la rehabilitación coronarias

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    Laham, Mirta

    2008-09-01

    Full Text Available La Psicocardiología es el área de la Psicología de la Salud que detecta e interviene sobre los diversos factores psicosociales de riesgo coronario que desarrollan la enfermedad y obstaculizan su rehabilitación. Reúne varias disciplinas, en particular cardiología y psicología, trabajando conjuntamente tanto en la prevención primaria como en la rehabilitación de la coronariopatía. Es hoy un enfoque interdisciplinario de la enfermedad coronaria. Ha surgido del contacto cotidiano con el paciente coronario, de ver como él está pobremente informado de las caracter ísticas de la enfermedad; de sus causas, de cómo prevenirla; de cómo encarar su tratamiento y de lo imprescindible de su rehabilitación. En este artículo se tratan los factores psicológicos de la enfermedad coronaria, los aspectos sociales de la salud coronaria, y la terapia psicocardiológica en la rehabilitación coronaria.

  2. 281. Rescate Mediante Cirugía Coronaria Convencional en Pacientes en Estudio Para Trasplante Cardíaco

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    P. Mairano Iuliano

    2012-04-01

    Conclusiones: la cirugía convencional de revascularización coronaria sigue siendo una opción terapéutica en pacientes con disfunción grave isquémica de VI, con muy buenos resultados a corto y medio plazo.

  3. Dynamic transcription profiles of “Qinguan” apple (Malus × domestica) leaves in response to Marssonina coronaria inoculation

    Science.gov (United States)

    Xu, Jianhua; Li, Miaomiao; Jiao, Peng; Tao, Hongxia; Wei, Ningning; Ma, Fengwang; Zhang, Junke

    2015-01-01

    Marssonina apple blotch, caused by the fungus Marssonina coronaria, is one of the most destructive apple diseases in China and East Asia. A better understanding of the plant's response to fungi during pathogenesis is urgently needed to improve plant resistance and to breed resistant cultivars. To address this, the transcriptomes of “Qinguan” (a cultivar with high resistance to M. coronaria) apple leaves were sequenced at 12, 24, 48, and 72 h post-inoculation (hpi) with Marssonina coronaria. The comparative results showed that a total of 1956 genes were differentially expressed between the inoculated and control samples at the 4 time points. Gene ontology (GO) term enrichment analysis of differentially expressed genes (DEGs) revealed changes in cellular component, secondary metabolism including chalcone isomerase activity, phytoalexin biosynthetic process, anthocyanin-containing compound biosynthetic process, lignin biosynthetic process, positive regulation of flavonoid biosynthetic process; and molecular functions or biological processes related to the defense response, biotic stimulus response, wounding response and fungus response. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that DEGs were significantly enriched in flavonoid biosynthesis, vitamin B6 metabolism, phenylpropanoid biosynthesis, and the stilbenoid, diarylheptanoid and gingerol biosynthesis pathways. Furthermore, the importance of changes in cellular components and partial polyphenol compounds when encountering M. coronaria are discussed. PMID:26528306

  4. Perfil de descendentes de poloneses residentes no sul do Brasil: a constituição da(s identidade(s

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    Silvia Regina Delong

    2014-09-01

    Full Text Available O Paraná é um dos Estados do Brasil que mais recebeu imigrantes poloneses no início do século passado. Entretanto, hoje ainda se sabe pouco a respeito deles, principalmente porque se carece de trabalhos que abordem as questões identitárias desse grupo étnico. O objetivo deste artigo é discutir como, na fala de um jovem padre descendente de poloneses, ele constitui a sua identidade étnica e social e como a religiosidade dessa etnia ajuda a manter a língua viva entre os falantes, inclusive os da área urbana. Na perspectiva desse descendente de imigrantes poloneses, abordam-se questões cultural e religiosa e algumas formas de preconceitos sofridos na infância e na adolescência, principalmente o linguístico. A despeito do preconceito, são a língua e a religiosidade que constituem a identidade social e étnica desse grupo de descendentes de imigrantes residentes no Brasil.

  5. Changes in chloroplast lipid contents and chloroplast ultrastructure in Sulla carnosa and Sulla coronaria leaves under salt stress.

    Science.gov (United States)

    Bejaoui, Fatma; Salas, Joaquín J; Nouairi, Issam; Smaoui, Abderrazak; Abdelly, Chedly; Martínez-Force, Enrique; Youssef, Nabil Ben

    2016-07-01

    The possible involvement of chloroplast lipids in the mechanisms of NaCl tolerance was studied in leaves of two varieties of Fabaceae: Sulla carnosa and Sulla coronaria, which were subjected to 200mM NaCl over 20days. Changes in membrane lipid peroxidation, chloroplast lipids content, fatty acids (FA) composition and the ultrastructure of chloroplasts under salt stress were investigated. Chloroplast lipids were separated and quantified by high performance liquid chromatography coupled to evaporative light scattering detection (HPLC/ELSD). The results showed that salinity induced a significant decrease in digalactosyldiacylglycerol (DGDG), phosphatidylglycerol (PG) and sulfoquinovosylglycerol (SQDG) content in both S. carnosa and S. coronaria leaves, whereas monogalactosyldiacylglycerol (MGDG) content did not change significantly in S. carnosa leaves. The MGDG/DGDG ratio remained stable in S. coronaria leaves but increased in those of S. carnosa. In addition, the unsaturated-to-saturated fatty acids ratio (UFAs:SFAs) did not change under salt stress in S. coronaria leaves, while it decreased significantly in S. carnosa leaves. Moreover, salinity did not induce significant changes in MGDG and DGDG unsaturation level in S. carnosa leaves, in contrast to S. coronaria, in which salinity seems to enhance the unsaturation level in MGDG, DGDG and PG. Furthermore, the level of membrane lipid peroxidation, as expressed by malondialdehyde (MDA) levels, increased at 200mM in S. carnosa leaves, while it did not change significantly in those of S. coronaria. With respect to the ultrastructure of chloroplasts at 200mM NaCl, investigated by transmission electron microscopy (TEM), salt-stress caused the swelling of thylakoids in S. carnosa mesophyll. These ultrastructural changes were observed especially in the spongy tissue in S. coronaria. Taken together, these findings suggest that the stability of MGDG/DGDG ratio, the unchanged unsaturation level, and increasing unsaturation

  6. Origen anómalo de la coronaria izquierda en la arteria pulmonar: resultados de la cirugía correctora

    OpenAIRE

    Andrés J. Schlichter; María I. Román; Christian Kreutzer; Ignacio Lugones

    2010-01-01

    IntroducciónEl origen anómalo de la arteria coronaria izquierda en la arteria pulmonar es una cardiopatía congénita rara que produce isquemia miocárdica con disfunción ventricular izquierda e insuficiencia mitral de grado variable. Las técnicas actuales han modificado la historia natural de esta enfermedad mediante el restablecimiento de un sistema de doble irrigación coronaria.ObjetivosEvaluar la experiencia institucional en la corrección quirúrgica del origen anómalo de la coronaria izquier...

  7. Eating behavior and nutritional status in patients who underwent coronary angioplasty La conducta alimentaria y estado nutricional en pacientes sometidos a angioplastia coronaria

    Directory of Open Access Journals (Sweden)

    L. Proença Vieira

    2012-02-01

    la enfermedad coronaria. Objetivos: Identificar las etapas de cambio de la conducta alimentaria y su relación con el estado nutricional, consumo de alimentos y los eventos cardiovasculares anteriores en pacientes sometidos a angioplastia coronaria. Métodos: Estudio transversal con 200 pacientes de un hospital especializado en cardiología, después de angioplastia coronaria electiva. Se aplicaron un algoritmo que identifica la disposición del cambio de hábitos de alimentación para un patrón mas saludable. Las variables medidas fueron las etapas de cambio de la conducta alimentaria, estado nutricional, consumo de alimentos y eventos cardiovasculares (infarto de miocardio o angioplastia previos. Resultados: los pacientes fueron clasificados en las siguientes etapas: 36% en mantenimiento, 26% en preparación, 17% en precontemplación, 12% en acción y 9% en contemplación. Se observaron mas eventos cardiovasculares en mantenimiento/ acción (p = 0,04, mayor consumo de calorías (p = 0,04, carne y huevos (p = 0,01 y dulces (p = 0,03 en la etapa de preparación, en comparación con el de mantenimiento, y ninguna asociación entre el estado nutricional y las etapas de cambio (p = 0,13, aunque el 62% de los individuos en la etapa de mantenimiento estaban con sobrepeso. Conclusiones: Este trabajo contribuyó por la identificación de las etapas de cambio y las condiciones que favorecen los cambios en el patrón de alimentación. Mismo los pacientes que se clasificaron a la fase de mantenimiento hay la necesidad de ajustar sus hábitos alimenticios con el fin de lograr un peso saludable.

  8. Avaliação da Velocidade Média na Aorta Torácica Descendente em Fetos com Anemia

    Directory of Open Access Journals (Sweden)

    Taveira Marcos Roberto

    2001-01-01

    Full Text Available Objetivo: verificar se existe correlação significativa entre a velocidade média na dopplerfluxometria da artéria aorta torácica descendente e o grau de anemia fetal. Métodos: estudo prospectivo, transversal, no qual foram analisados 66 fetos de gestantes isoimunizadas, em que se realizou a cordocentese para a realização de transfusões intra-uterinas pela via intravascular (66,7%. Nos fetos que foram submetidos à transfusão intra-uterina pela via intraperitoneal, ou naqueles casos em que não houve necessidade de tratamento intra-uterino (33,3%, a determinação da concentração de hemoglobina do cordão foi realizada pela punção do cordão umbilical, no momento da interrupção da gestação. Neste grupo de fetos estudados, foi realizado exame dopplerfluxométrico da artéria aorta torácica descendente, sendo calculada a velocidade média de fluxo. Foi realizado estudo de associação entre as variáveis. Foram também calculados os valores de sensibilidade, especificidade, valores preditivos positivo e negativo. Resultados: observou-se correlação significativa e inversa entre a velocidade média na artéria aorta torácica descendente e o nível de hemoglobina fetal. A velocidade média na dopplerfluxometria da artéria aorta torácica descendente apresentou sensibilidade de 47,5% para anemia fetal moderada (Hg<10 g/dL, com o teste exato de Fisher apresentando valor de p<0,01, e de 54,5% para anemia fetal grave (Hg<7,0 g/dL, com um valor de p=0,01. Conclusões: houve associação significativa entre a velocidade média na aorta torácica descendente e o grau de diagnóstico de anemia fetal.

  9. Presencia de placas coronarias vulnerables en mujeres de mediana edad que sufrieron muerte cerebral

    Directory of Open Access Journals (Sweden)

    Enrique Gurfinkel

    2009-01-01

    Full Text Available RESUMENIntroducciónLas placas vulnerables de las arterias coronarias se encuentran habitualmente en varonessin sintomatología previa que fallecieron súbitamente o debido a un síndrome coronarioagudo. La frecuencia y las características de estas placas en la población femenina de medianaedad se desconocen.ObjetivoIndagar acerca de la presencia de placas coronarias vulnerables en mujeres de medianaedad que sufrieron muerte cerebral.Material y métodosDe un total de 652 corazones de donantes para trasplante obtenidos entre 1996 y 2007, seseleccionaron los provenientes de individuos aparentemente sanos y mayores de 40 añosque murieron a causa de un accidente traumático o cerebrovascular. De los 160 órganos quecumplieron los criterios de selección, se estudiaron 70 corazones femeninos en los que seexaminaron las arterias coronarias en cortes consecutivos a intervalos de 3 mm. Las áreascon estrechamiento luminal se procesaron para su posterior estudio histológico einmunohistoquímico. Las placas se clasificaron según la American Heart Association (AHA.ResultadosLa edad promedio de las mujeres fue de 50,7 ± 5,7 años. El grado de oclusión vascularpromedio fue del 28,66% ± 17,35%. Cuarenta y un corazones poseían sólo lesionesateroscleróticas no avanzadas (tipos I, II y III de la clasificación de la AHA. En los 29restantes se encontraron 58 placas consideradas de alto riesgo o vulnerables (AHA tipos IV,V y VI. Éstas fueron menos frecuentes que en los varones (p < 0,001 y se asociaron con elpeso del órgano (OR 1,02, IC 95% 1,01-1,04; p < 0,001 y con la edad (OR 1,11, IC 95% 1,01-1,23; p = 0,038. No se encontró una relación significativa con la causa de la muerte (p =0,065.ConclusionesEl 41,4% de las mujeres que sufrieron muerte cerebral presentaron placas vulnerables enlos vasos coronarios no asociadas con una reducción significativa de la luz. De esta seriepuede inferirse que existe un promedio de 0,82 lesiones propensas a

  10. Acylated anthocyanins from the blue-violet flowers of Anemone coronaria.

    Science.gov (United States)

    Saito, Norio; Toki, Kenjiro; Moriyama, Hidekazu; Shigihara, Atsushi; Honda, Toshio

    2002-06-01

    Five polyacylated anthocyanins were isolated from blue-violet flowers of Anemone coronaria 'St. Brigid'. They were identified as delphinidin 3-O-[2-O-(2-O-(trans-caffeoyl)-beta-D-glucopyranosyl)-6-O-(malonyl)-beta-D-galactopyranoside]-7-O-[6-O-(trans-caffeoyl)-beta-D-glucopyranoside]-3'-O-[beta-D-glucuronopyranoside], and its demalonylated form, delphinidin 3-O-[2-O-(2-O-(trans-caffeoyl)-beta-D-glucopyranosyl)-6-O-(2-O-tartaryl)malonyl)-beta-D-galactopyranoside]-7-O-[6-O-(trans-caffeoyl)-beta-D-glucopyranoside]-3'-O-[beta-D-glucuronopyranoside], and its cyanidin analog as well as delphinidin 3-O-[2-O-(2-O-(trans-caffeoyl)-beta-D-glucopyranosyl)-6-O-(2-O-(tartaryl)malonyl)-beta-D-galactopyranoside]-7-O-[6-O-(trans-caffeoyl)-beta-D-glucopyranoside].

  11. Disección de arterias coronarias: ¿y ahora qué hago?

    Directory of Open Access Journals (Sweden)

    Marta Matamala-Adell

    2015-11-01

    Conclusiones: La conducta a seguir es variada sin existir consenso ni estandarización. Si el paciente está estable y el vaso es pequeño puede considerarse tratamiento médico. Si el paciente está inestable hay una mayor indicación de intervencionismo. En los casos de disección del tronco coronario izquierdo y multivaso la tendencia es hacia la cirugía de bypass coronaria. Dada la escasa incidencia de la enfermedad sería interesante el estudio de series mayores de casos para la confrontación de resultados y poder determinar de una manera más eficaz el mejor tratamiento a seguir.

  12. Adherencia a la prevención secundaria de la enfermedad coronaria

    Directory of Open Access Journals (Sweden)

    Emiliano Rossi

    2014-04-01

    Full Text Available Se comparó la adherencia a la prevención secundaria de enfermedad coronaria mediante el uso indicado de fármacos de probada eficacia, al momento del egreso hospitalario y a 3 años de seguimiento, en una cohorte de pacientes afiliados al Plan de Salud del Hospital Italiano. Se realizó un estudio de cohorte retrospectivo que incluyo 125 pacientes menores de 80 años de edad, afiliados a una red integrada de salud, con internación por síndrome coronario agudo. En el análisis se utilizó el test de McNemar. La edad media de los participantes fue 63.7 años (DS 10.08 y el 65.6% (IC95% 56.6-73.9 fue de sexo masculino. El 76.8% (IC95% 68.4-83.9 presentó como evento calificante un síndrome coronario agudo sin elevación del segmento ST. El tiempo de seguimiento promedio fue 2.94 años (DS 0.25. Se observó que el uso de drogas de probada eficacia en la prevención secundaria de enfermedad coronaria descendió entre el momento del egreso hospitalario y los 3 años de seguimiento: antiagregantes de 97.6 a 88.0% (p = 0.012; beta-bloqueantes de 94.4 a 84.8% (p = 0.021; estatinas 91.2 a 83.7% (p = 0.035. Uso combinado de antiagregantes, betabloqueantes y estatinas de 86.4 a 66.3% (p < 0.0001. Es necesario estudiar las causas de la disminución de la adherencia a drogas cardioprotectoras a largo plazo.

  13. Cierre de fístula coronaria con Amplatzer vascular plug en el paciente pediátrico

    Directory of Open Access Journals (Sweden)

    Ricardo Gamboa

    2008-01-01

    Full Text Available La fístula coronaria congénita es una patología poco frecuente y en general asintomática, por lo que muchas veces se diagnostica por un hallazgo incidental. Con dependencia de la repercusión hemodinámica, algunos siguen una conducta conservadora, otros indican tratamiento quirúrgico o, más recientemente, oclusión por cateterismo.Se presenta el caso de una paciente con una gran fístula coronaria-cameral, que se trató mediante embolización percutánea con dispositivo Amplatzer vascular plug. No se presentaron complicaciones durante el procedimiento ni en el seguimiento.

  14. Colgajo libre córtico-perióstico de la arteria genicular descendente en el tratamiento de la seudoartritis distal de tibia

    OpenAIRE

    2010-01-01

    Presentamos un caso de un varón de 35 años con pseudoartrosis aséptica de tibia distal con escaso defecto óseo, intervenido previamente mediante recambio del material de osteosíntesis e injerto de cresta iliaca, que fracasó. Tras estudio de las diferentes opciones de tratamiento, se le propuso estabilizar el foco mediante enclavado endomedular y aumentar la capacidad osteogénica con un colgajo córtico-perióstico de la arteria genicular descendente, según la técnica de Sakai. Discusión: El man...

  15. Pliegue diagonal del lóbulo auricular (de Frank y su relación con enfermedad coronaria

    Directory of Open Access Journals (Sweden)

    Manuel Agustín Paz

    2014-07-01

    Full Text Available La presencia de pliegue diagonal auricular debe alertar al médico para entender su asociación con la enfermedad cardíaca coronaria y la enfermedad isquémica del corazón, especialmente en aquellos pacientes asintomáticos o pacientes con factores de riesgo tradicionales y no tradicionales. Por lo tanto, esta anormalidad puede ser interpretada como un "marcador cutáneo" de la enfermedad cardíaca coronaria. Este signo también podría servir para identificar mejor a los grupos de alto riesgo cardiovascular y para comenzar con la implementación de las medidas de las estrategias de prevención. Hay otros signos clínicos, además del pliegue de la oreja, que pueden reflejar el envejecimiento arterial y aterosclerosis, independientemente del número, duración o alcance de los factores de riesgo cardiovascular tradicionales. El hallazgo de pliegue auricular no debe sustituir a una historia clínica completa, la aplicación de métodos detallados, exámenes de laboratorio y físicos utilizados con excelente rendimiento en el diagnóstico de la enfermedad coronaria en la actualidad.

  16. Colesterol inmune y aterosclerosis coronaria demostrada por angiografía Immune cholesterol and coronary arteriosclerosis demonstrated by angiography

    Directory of Open Access Journals (Sweden)

    Giovanna Pereira Roca

    2001-04-01

    Full Text Available Se evaluaron los niveles de colesterol inmune a través de un estudio descriptivo transversal, donde se analizaron 102 pacientes atendidos en la Consulta de Cardiopatía Isquémica del Instituto Nacional de Cardiología y Cirugía Cardiovascular, por padecer supuestamente de la enfermedad, quienes concurrieron durante el período de un año (sin selección alguna. Se les indicó la angiografía coronaria como parte de su estudio, con vistas a conocer la utilidad clínica del colesterol inmune como marcador diagnóstico para la aterosclerosis coronaria, así como asociar el colesterol inmune con otros parámetros lipídicos. Se observó que la concentración de colesterol inmune fue menor en sujetos supuestamente normales que en pacientes con aterosclerosis coronaria, y a su vez dentro de estos últimos fue mayor en pacientes con grado 3 de estenosis. Se comprobó que existe una asociación positiva entre los niveles de colesterol inmune, colesterol total, y c-LDL, en el suero de los pacientes estudiados y el grado de severidad de la enfermedad arterial coronaria. No se demostró asociación entre el colesterol inmune y el resto de las variables lipídicas estudiadas. Niveles de "colesterol inmune" iguales o superiores a 17 mg/mL incrementan el riesgo de la aterosclerosis coronaria desde 1,3 a 8 veces, comportándose como mejor predictor de la severidad de la lesión coronaria y presencia de la aterosclerosis coronaria que los marcadores de riesgo lipídicos más comúnmente conocidos.A descriptive and cross-sectional study was conducted to evaluate the levels of immune cholesterol. 102 patients who received attention at the Consulting Room of Ischemic Heart Disease of the National Institute of Cardiology and Cardiovascular Surgery during a year (no selection was made were analyzed. These patients that apparently suffered from this disease underwent coronary angiography as part of the study in order to know the clinical usefulness of immune

  17. Ruptura traumática de la aorta descendente torácica Traumatic ruptura of the descending thoracic aorta

    Directory of Open Access Journals (Sweden)

    Gabriel González Sosa

    2013-03-01

    Full Text Available Los traumatismos torácicos graves (TT, ya sean abiertos o cerrados, pueden ocurrir secundarios a lesiones por arma de fuego, arma blanca, accidentes de tránsito, caídas de altura o compresiones torácicas por aplastamientos, entre otros y se han transformado en una causa importante de morbilidad y mortalidad, pero son las lesiones vasculares directamente responsables de un 20 a un 25 % del total de las muertes, causadas por estos traumatismos. La mayoría de los afectados por estas lesiones son personas jóvenes previamente sanas, fundamentalmente del sexo masculino. Se presenta un caso clínico de un paciente de 38 años de edad, con antecedentes de salud previos, que durante una riña, sufrió una herida en la región posterior del hemitórax derecho, por debajo del borde inferior de la escápula, penetrante en la cavidad torácica, ocasionada por un objeto corto punzante de fabricación artesanal, cuyo pedazo quedó dentro de esta cavidad, lo cual provocó una lesión de alrededor de 3 cm de longitud, aproximadamente a nivel de la aorta descendente torácica. El paciente fue intervenido quirúrgicamente de manera urgente, y se logró suturar la lesión vascular con éxito, proceder que casi nunca es posible debido al alto índice de mortalidad de este tipo de lesiones, pues la mayoría de las personas fallecen antes de su llegada a un centro especializado de salud.Severe thoracic traumatisms, either open or close, may occur secondary to injuries caused by firearms, knifes, traffic accidents, falls from height or thoracic compression due to crushing, among others. They have become an important cause of mortality and morbidity but they are vascular injuries directly responsible for 20 to 25 % of the total number of deaths caused by this type of traumatism. Most of the injuries occurred in healthy young people, mainly men. This is the case of a 38 years-old patient with a history of health problems, who in a street fight, suffered an injury

  18. Angioplastia coronaria en la República Argentina. Comparación de los resultados en la fase hospitalaria de los estudios CONAREC V y CONAREC XIV

    Directory of Open Access Journals (Sweden)

    Sergio Baratta

    2007-01-01

    Full Text Available La angioplastia coronaria (ATC es una técnica para el tratamiento de la enfermedad coronaria que se encuentra en constante evolución. El registro CONAREC V relevó características de pacientes sometidos a angioplastia durante el año 1996. Diez años después publicamos los resultados del estudio CONAREC XIV. ObjetivoComparar las características demográficas y clínicas, la utilización de dispositivos y de pruebas funcionales, los resultados y las complicaciones de la ATC en el estudio CONAREC V con el estudio CONAREC XIV. Material y métodosSe unificaron las bases de datos de ambos protocolos. Se compararon las variables continuas por medio de la prueba de la t y las categóricas con la prueba de chi cuadrado. Se construyó un modelo de regresión logística para determinar si disminuyó la tasa de complicaciones en el año 2005, ajustando por confundidores.ResultadosLos pacientes del CONAREC XIV fueron más añosos (62,8 ± 10,8 versus 60,6 ± 10,9 años, con mayor prevalencia de hipertensión arterial (72,4% versus 61,3%; p < 0,001 y diabetes (19,2% versus 16,9%; p = 0,017 y menor de tabaquismo (22% versus 38%; p < 0,001; presentaron enfermedad de tres vasos (20,2% versus 14,8%; p < 0,001 y ATC de más de un vaso con mayor frecuencia (25,3% versus 11,8%; p < 0,001; se incrementaron el uso de stents (94,5% versus 48%; p < 0,001 y la indicación por cuadros estables (36,3% versus 18,2%; p < 0,001. El uso de pruebas funcionales en este contexto fue menor en el año 2005 (54% versus 65%; p < 0,001.En pacientes con infarto agudo de miocardio, en el CONAREC XIV se observó una prevalencia menor de infarto anterior (46% versus 57,8%; p < 0,005 y de shock cardiogénico (7,3% versus 13,5%; p = 0,017. La tasa de complicaciones mayores fue menor en el último protocolo, CONAREC XIV (3,1% versus 8,9%; p < 0,001. En el modelo multivariado, pertenecer al último estudio disminuyó el riesgo de padecer eventos (OR 0,41, IC 95% 0,26-0,64; p < 0

  19. Actividad de la proteína transportadora de ésteres de colesterol. Polimorfismos del gen en pacientes colombianos con enfermedad coronaria

    Directory of Open Access Journals (Sweden)

    Alejandra M. Giraldo, MSc.

    2012-07-01

    Conclusión: no se halló asociación entre la actividad de la CETP, los polimorfismos TaqBI, MspI, Rsal y la obstrucción coronaria. En este trabajo se describen por primera vez los niveles de CETP en los polimorfismos TaqIB, MspI, Rsal para un grupo de pacientes colombianos. Se debe refinar la descripción del evento coronario, el contexto metabólico de los pacientes y el estudio de haplotipos para encontrar relaciones con enfermedad coronaria.

  20. Relación de la aterosclerosis de aorta y coronarias con la densidad mineral ósea lumbar y femoral: estudio en fallecidos

    OpenAIRE

    Solís Alfonso, Lesly

    2015-01-01

    Para demostrar la asociación existente entre las lesiones ateroscleróticas de aorta y arterias coronarias con la densidad mineral ósea de columna lumbar y fémur proximal se estudiaron 129 necropsias, realizando densitometría postmorten de columna lumbar y fémur proximal, definiendo los niveles de densidad mineral ósea (DMO) según T score en: normal, osteopenia y osteoporosis; seguido del examen patomorfológico y morfométrico de las tres coronarias epicárdicas principales y de aorta aplicando ...

  1. Psicocardiología: Su importancia en la prevención y la rehabilitación coronarias

    OpenAIRE

    Laham, Mirta

    2008-01-01

    La Psicocardiología es el área de la Psicología de la Salud que detecta e interviene sobre los diversos factores psicosociales de riesgo coronario que desarrollan la enfermedad y obstaculizan su rehabilitación. Reúne varias disciplinas, en particular cardiología y psicología, trabajando conjuntamente tanto en la prevención primaria como en la rehabilitación de la coronariopatía. Es hoy un enfoque interdisciplinario de la enfermedad coronaria. Ha surgido del contacto cotidiano con el paciente ...

  2. El talón de Aquiles de la cirugía coronaria: el ictus postoperatorio

    Directory of Open Access Journals (Sweden)

    Fernando Hornero

    2017-05-01

    Full Text Available Los pacientes con factores de riesgo preexistentes de enfermedad cerebrovascular tienen durante la cirugía coronaria un mayor riesgo de presentar un ictus postoperatorio. Entre los principales factores de riesgo a considerar esta la edad, las comorbilidades y la técnica quirúrgica, en especial la manipulación de la aorta. Este artículo revisa la información médico-quirúrgica actual de la lesión neurológica tipo ictus durante la CABG aislada.

  3. Tratamiento percutáneo de la enfermedad coronaria en pacientes diabéticos mediante stent liberador de Tacrolimus.

    OpenAIRE

    Ferrer Gracia, Maria Cruz; Sabaté Tena, Manel; Pérez Lorenz, Juan Blas; Macaya Miguel, Carlos

    2009-01-01

    La diabetes (DM) es predictor de reestenosis y eventos clínicos tras la revascularización coronaria percutánea. Los stents liberadores de fármacos (sirolimus [SLS] y paclitaxel [SLP]) resultan más beneficiosos que los convencionales (SC) en este contexto. Estudiamos la efectividad del stent liberador de tacrolimus en estos pacientes frente a SLS, SLP y SC. Se trata de un estudio prospectivo, multicéntrico en el que se incluyeron 80 pacientes de características similares (30% DM insulinodepen...

  4. El Incremental Shuttle Walking Test en personas mayores con enfermedad coronaria isquémicas : estudio preliminar

    OpenAIRE

    Ruescas-Nicolau, Mª Arántzazu

    2013-01-01

    Introducción: En las personas mayores, la enfermedad coronaria isquémica (ECI) es la principal causa de mortalidad y morbilidad. Los cambios cardiovasculares y las comorbilidades asociados al envejecimiento, además del miedo a las condiciones adversas de la enfermedad así como la alta predisposición a la depresión y aislamiento social, resultan en un ciclo de inactividad y desacondicionamiento que disminuyen la capacidad funcional del mayor. Para ellos, los programas de Rehabilitación Cardíac...

  5. Factores de riesgo para enfermedad coronaria en escolares y adolescentes: análisis de 23 estudios

    OpenAIRE

    Ruiz Manrique, Nini Johanna; Muñoz, Yesid Alejandro

    2012-01-01

    El estudio describe, analiza y compila información sobre Factores de Riesgo identificados con mayor prevalencia para Enfermedad Coronaria en población escolar y adolescente; se tiene como insumo los estudios consultados en las bases de datos SCIELO, MEDLINE, LILACS, Elsevier, y Google Académico del 2002 a 2012. Metodología: selección de descriptores para búsqueda documental, revisión no sistémica de documentos, selección de estudios, creación de matriz de revisión, análisis y evaluación de la...

  6. Tratamento endovascular de ruptura traumática da aorta torácica descendente Endovascular treatment of traumatic descending thoracic aortic rupture

    Directory of Open Access Journals (Sweden)

    João Roberto Breda

    2007-06-01

    Full Text Available Paciente do sexo feminino, 55 anos de idade, vítima de atropelamento, foi admitida em unidade de emergência, onde se realizou o diagnóstico clínico, radiológico e tomográfico de ruptura traumática da aorta torácica descendente. Diante do achado, a paciente foi encaminhada para tratamento endovascular com colocação de endoprótese auto-expansível (stent pela artéria femoral. O tratamento obteve sucesso, evidenciado pela exclusão da lesão localizada previamente no istmo aórtico. O tratamento endovascular tem sido indicado nas afecções de aorta torácica descendente com bons resultados iniciais. Na ruptura traumática de aorta, a terapêutica endovascular representa uma alternativa aceitável, especialmente devido aos riscos do tratamento operatório convencional.A 55-year-old, female patient who was run over by a motor vehicle was admitted at an emergency room. Clinical, radiological and tomographic diagnosis of traumatic descending aortic thoracic rupture was performed. The patient was referred for endovascular treatment with placement of a self-expandable stent through the femoral artery. Treatment was successful, with exclusion of the lesion previously located in the aortic isthmus. Endovascular treatment has been indicated in the treatment of descending thoracic aortic diseases, with good initial results. In case of traumatic aortic rupture, endovascular treatment is a feasible alternative, especially due to risks offered by the conventional surgical treatment.

  7. The effect on the transcriptome of Anemone coronaria following infection with rust (Tranzschelia discolor.

    Directory of Open Access Journals (Sweden)

    Marina Laura

    Full Text Available In order to understand plant/pathogen interaction, the transcriptome of uninfected (1S and infected (2I plant was sequenced at 3'end by the GS FLX 454 platform. De novo assembly of high-quality reads generated 27,231 contigs leaving 37,191 singletons in the 1S and 38,393 in the 2I libraries. ESTcalc tool suggested that 71% of the transcriptome had been captured, with 99% of the genes present being represented by at least one read. Unigene annotation showed that 50.5% of the predicted translation products shared significant homology with protein sequences in GenBank. In all 253 differential transcript abundance (DTAs were in higher abundance and 52 in lower abundance in the 2I library. 128 higher abundance DTA genes were of fungal origin and 49 were clearly plant sequences. A tBLASTn-based search of the sequences using as query the full length predicted polypeptide product of 50 R genes identified 16 R gene products. Only one R gene (PGIP was up-regulated. The response of the plant to fungal invasion included the up-regulation of several pathogenesis related protein (PR genes involved in JA signaling and other genes associated with defense response and down regulation of cell wall associated genes, non-race-specific disease resistance1 (NDR1 and other genes like myb, presqualene diphosphate phosphatase (PSDPase, a UDP-glycosyltransferase 74E2-like (UGT. The DTA genes identified here should provide a basis for understanding the A. coronaria/T. discolor interaction and leads for biotechnology-based disease resistance breeding.

  8. Las emociones y el estrés en personas con enfermedad coronaria

    Directory of Open Access Journals (Sweden)

    Natalia Tobo-Medina

    2010-01-01

    Full Text Available Estudios han identificado que comportamientos, emociones y estrés están asociados con la enfermedad de arterias coronarias (EAC. Existe soporte a la hipótesis de que una zona de la corteza cerebral, ligada con las emociones, se activa ante condiciones estresantes y genera respuestas como hipertensión e infarto. Los aspectos que preceden o generan estrés y comportamientos de riesgo para EAC no son abordados en la atención en salud, y su estudio se ha centrado en la ansiedad o la depresión. La pregunta fue: ¿cuáles son los estados afectivos y emociones más frecuentes y predominantes que subyacen a la experiencia del estrés en las personas con EAC, y su diferencia según algunas características socio-demográficas? Métodos: estudio transversal correlacional, participaron 65 personas con EAC. Se empleó un cuestionario sobre 38 estados afectivos y emocionales para identificar las emociones características según frecuencia, predominio y fuerza de aparición. Resultados: se identificaron 12 características predominantes, de las cuales 10 los define afectivamente: hipersensibilidad, impaciencia, infalibilidad, miedo, excesiva preocupación por otros, autorrepresión emocional, rigidez moral, deseo de ser ejemplo para otros, sobreprotección, soledad y aislamiento. Estas se correlacionaron significativamente con la culpa, el sentimiento de infelicidad, la desolación, la angustia extrema y la desesperanza. Discusión: la excesiva importancia a la razón, al reconocimiento por otros, en detrimento de expresión de emociones y necesidades afectivas, señala conflictos internos persistentes, deficiente autocuidado y estrés emocional. Se sugiere investigar aspectos emocionales para prevención temprana y rehabilitación.

  9. Characterization of efficient plant-growth-promoting bacteria isolated from Sulla coronaria resistant to cadmium and to other heavy metals.

    Science.gov (United States)

    Chiboub, Manel; Saadani, Omar; Fatnassi, Imen Challougui; Abdelkrim, Souhir; Abid, Ghassen; Jebara, Moez; Jebara, Salwa Harzalli

    2016-01-01

    The inoculation of plants with plant-growth-promoting rhizobacteria has become a priority in the phytoremediation of heavy-metal-contaminated soils. A total of 82 bacteria were isolated from Sulla coronaria root nodules cultivated on four soil samples differently contaminated by heavy metals. The phenotypic characterization of these isolates demonstrated an increased tolerance to cadmium reaching 4.1mM, and to other metals, including Zn, Cu and Ni. Polymerase Chain Reaction/Restriction Fragment Length Polymorphism (PCR/RFLP) analysis showed a large diversity represented by genera related to Agrobacterium sp., R. leguminosarum, Sinorhizobium sp., Pseudomonas sp., and Rhizobium sp. Their symbiotic effectiveness was evaluated by nodulation tests. Taking into consideration efficiency and cadmium tolerance, four isolates were chosen; their 16SrRNA gene sequence showed that they belonged to Pseudomonas sp. and the Rhizobium sullae. The selected consortium of soil bacteria had the ability to produce plant-growth-promoting substances such as indole acetic acid and siderophore. The intracellular Cd accumulation was enhanced by increasing the time of incubation of the four soil bacteria cultivated in a medium supplemented with 0.1mM Cd. The existence of a cadmium-resistant gene was confirmed by PCR. These results suggested that Sulla coronaria in symbiosis with the consortium of plant-growth-promoting rhizobacteria (PGPR) could be useful in the phytoremediation of cadmium-contaminated soils.

  10. Crystallization and preliminary X-ray diffraction studies of the cysteine protease ervatamin A from Ervatamia coronaria

    Energy Technology Data Exchange (ETDEWEB)

    Chakraborty, Sibani; Biswas, Sampa; Chakrabarti, Chandana; Dattagupta, Jiban K., E-mail: jibank.dattagupta@saha.ac.in [Saha Institue of Nuclear Physics, Crystallography and Molecular Biology Division, 1/AF Bidhannagar, Kolkata 700 064 (India)

    2005-06-01

    Ervatamin A is a papain-family cysteine protease with high activity and stability. It has been isolated and purified from the latex of the medicinal flowering plant E. coronaria and crystallized by the vapour-diffusion technique. Crystals diffracted to 2.1 Å and the structure was solved by molecular replacement. The ervatamins are highly stable cysteine proteases that are present in the latex of the medicinal plant Ervatamia coronaria and belong to the papain family, members of which share similar amino-acid sequences and also a similar fold comprising two domains. Ervatamin A from this family, a highly active protease compared with others from the same source, has been purified to homogeneity by ion-exchange chromatography and crystallized by the vapour-diffusion method. Needle-shaped crystals of ervatamin A diffract to 2.1 Å resolution and belong to space group C222{sub 1}, with unit-cell parameters a = 31.10, b = 144.17, c = 108.61 Å. The solvent content using an ervatamin A molecular weight of 27.6 kDa is 43.9%, with a V{sub M} value of 2.19 Å{sup 3} Da{sup −1} assuming one protein molecule in the asymmetric unit. A molecular-replacement solution has been found using the structure of ervatamin C as a search model.

  11. Enfermedad de Kawasaki: cuadro clínico, exámenes de laboratorio y lesiones coronarias

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    Luis Martín Garrido-García

    2015-08-01

    Full Text Available La enfermedad de Kawasaki es una vasculitis aguda, sistémica, de etiología desconocida y que remite generalmente de manera espontánea; ocurre principalmente en pacientes menores de cinco años de edad (80%. La enfermedad de Kawasaki se caracteriza por fiebre, conjuntivitis no supurativa bilateral, eritema de los labios y de la mucosa oral, alteraciones en las extremidades, exantema y adenopatía cervical. Su diagnóstico oportuno es un reto para el médico ya que no existe una prueba específica y se siguen utilizando los criterios clínicos descritos en 1967. Los resultados de laboratorio en la fase aguda de la enfermedad no son específicos ni diagnósticos. Objetivo: describir las características clínicas, exámenes de laboratorio, tratamiento empleado y presencia de lesiones coronarias en la etapa aguda de pacientes con enfermedad de Kawasaki atendidos en un hospital pediátrico de tercer nivel en la Ciudad de México.  Materiales y métodos: estudio retrospectivo, observacional, en pacientes con diagnóstico de enfermedad de Kawasaki tratados entre agosto de 1995 y diciembre de 2013. Se recabó información que incluyó datos demográficos de los pacientes, características clínicas, exámenes de laboratorio, tratamiento empleado y hallazgos ecocardiográficos en la etapa aguda de la enfermedad. Resultados: se estudiaron 338 casos de enfermedad de Kawasaki en 322 pacientes. La edad media al diagnóstico fue de 38.94 ± 36.53 meses (rango de 2 a 200 meses. El predominio fue de pacientes masculinos (66.9% con una relación masculino:femenino de 2:1. La gran mayoría de los pacientes (82.2% tuvo presentación completa de la afección. Se administró inmunoglobulina endovenosa en 88.2% de los casos. En 287 casos la fiebre remitió 48 horas después de administrar inmunoglobulina endovenosa y solamente en 12 casos se administró una segunda dosis. De 1995 a 2003 se diagnosticaron 48 casos de enfermedad de Kawasaki

  12. Diagnóstico fractal de disfunción cardíaca severa. Dinámica fractal de la ramificación coronaria izquierda

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    Javier O. Rodríguez, MD

    2012-09-01

    Conclusiones: se generalizó una nueva metodología diagnóstica de aplicación clínica que detecta disfunciones cardiacas severas sub-diagnosticadas con las metodologías actuales, mediante la caracterización de la dinámica total de la ramificación coronaria izquierda.

  13. Efectos de un programa de ejercicio físico de 12 semanas en sujetos con revascularización coronaria o postangioplastia transluminal percutánea

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    Mirary Mantilla-Morrón

    2017-03-01

    Conclusiones: El programa de ejercicio físico que fue utilizado en este estudio, pudo en todos los sujetos incrementar la capacidad cardiorrespiratoria y la tolerancia al ejercicio, y disminuir el perímetro abdominal. Los efectos benéficos obtenidos cambian el pronóstico de la enfermedad coronaria y disminuyen los factores de riesgo metabólicos.

  14. Intervenciones coronarias percutáneas en pacientes diabéticos

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    Igor F. Palacios

    2009-01-01

    Full Text Available Es bien conocido que la diabetes confiere un riesgo mayor de desarrollo de enfermedadcoronaria y que conlleva un pronóstico adverso a largo plazo con tratamiento médico encomparación con los pacientes no diabéticos. Los diabéticos presentan además una incidenciamayor de infarto de miocardio con mayor mortalidad frente a los no diabéticos. En consecuencia,es frecuente que los diabéticos con enfermedad coronaria requieran tratamientomediante revascularización miocárdica. Los resultados a largo plazo del tratamiento médicoy de las estrategias intervencionistas o quirúrgicas en los pacientes diabéticos con enfermedadcoronaria son peores que en los no diabéticos. Es sumamente importante reconocereste hecho porque la presencia de diabetes aumenta en extremo el riesgo de complicacionesy de reestenosis.El seguimiento a largo plazo de los ensayos clínicos que compararon los resultados de laangioplastia (ATC con la cirugía de revascularización miocárdica (CRM demuestran quela cirugía continúa siendo la estrategia recomendada para los pacientes diabéticos con enfermedadmultivaso. Sin embargo, los recientes avances en las intervenciones coronariaspercutáneas (ICP han producido un cambio en el paradigma de la revascularización coronariaen los pacientes diabéticos.En el presente artículo de revisión se analizan los resultados de los estudios comparativosentre CRM e IPC realizados en tres etapas diferentes del desarrollo tecnológico de los métodospercutáneos: la angioplastia con balón, con stent convencional y los más recientes constents farmacológicos, que parecen haber mejorado el pronóstico de la ATC en los pacientesdiabéticos. A la luz de estos resultados, se discuten las indicaciones actuales de las guíasinternacionales para seleccionar el tratamiento de revascularización en estos pacientes.Finalmente, se comentan los resultados de estudios recientes, como BARI 2D y CARDIA, ylos que se encuentran en curso (FREEDOM, que

  15. Resultado del tratamiento percutáneo de las bifurcaciones coronarias

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    Alfonsina Candiello

    2008-01-01

    Full Text Available IntroducciónEl surgimiento de los stents liberadores de droga (SLD ha disminuido la tasa de reintervención del vaso tratado (RVT. No obstante, incluso con SLD, el tratamiento percutáneo de lesiones en bifurcación aún constituye un desafío debido a una tasa todavía elevada de RVT.ObjetivoEvaluar los resultados clínicos en pacientes con bifurcaciones tratados con SLD o sin éstos en un centro de alto volumen.Material y métodosDesde abril de 2003 hasta agosto de 2006 se realizaron 1.910 angioplastias; 235 (12,3% pacientes presentaron bifurcaciones.ResultadosLa edad de los pacientes incluidos fue de 62 ± 11 años; el 86% era de sexo masculino, el 19,2% padecía diabetes y el 22,7% tenía cirugía coronaria previa. El 54% de los pacientes presentaron bifurcaciones verdaderas. Se utilizó SLD en el 44,3%; el 22,5% requirió el implante de dos stents (en ambas ramas, mientras que el procedimiento se concluyó con kissing balloon final en el 24,5% de los casos. En el seguimiento alejado (mediana 430 días, la RVT fue del 16,7%, 13,9% con SLD y 17,2% con stent convencional (SC (p = ns. La tasa de trombosis angiográfica fue del 3%, 1,9% para SLD y 4,6% para stent convencional (p = ns. Las tasas de infarto y muerte cardíaca fueron del 3,4% y del 2,9%, respectivamente, sin diferencias entre los dos grupos. La tasa combinada de muerte cardíaca, infarto, trombosis y RVT fue del 21,7%, 16,3% con SLD y 25,2% con stent convencional (p = 0,04.ConclusiónEl tratamiento percutáneo de lesiones en bifurcación continúa siendo un desafío. Es probable que técnicas más simples con implante de un solo stent, preferentemente SLD, y la implementación de kissing balloon final sea la opción más recomendable en la mayoría de los casos.

  16. Uso da prótese endovascular auto-expansível para tratamento das doenças da aorta torácica descendente

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    STOLF Noedir A. G.

    1998-01-01

    Full Text Available Os autores relatam a experiência com o tratamento de aneurisma e dissecção da aorta descendente associada ou não a comprometimento do arco aórtico com o uso de prótese intraluminal auto-expansível introduzida cirurgicamente através do arco aórtico. Foram operados 11 pacientes, 9 do sexo masculino e com idades variando de 49 a 78 anos. O diagnóstico era de aneurisma em 6, sendo 2 rotos e dissecção em 5, sendo aguda em 2. Quatro doentes apresentavam afecções cirúrgicas associadas: aneurisma de aorta ascendente (1, aneurisma de arco (1, insuficiência coronária (1 e insuficiência da valva aórtica (1. Os pacientes foram operados com colocação de prótese intraluminal auto-expansível cirurgicamente através do arco aórtico sob hipotermia profunda e parada circulatória total. Em 4 pacientes foram realizadas operações associadas: troca da valva aórtica (1, substituição da aorta ascendente (2, troca do arco aórtico (1 e revascularização miocárdica (1. Houve um óbito intra-operatório por dissecção da aorta ascendente e dois óbitos hospitalares por associação de complicações. Oito pacientes tiveram alta sendo que 1 faleceu no terceiro mês de pós-operatório. Os sobreviventes estavam bem clinicamente e o estudo por imagem mostrou adequada correção da doença. Os autores concluem que o uso da prótese intraluminal simplifica e corrige adequadamente as afecções da aorta descendente. A morbimortalidade observada nessa série deve-se a outros fatores independentes da técnica.

  17. Coesão e diversificação: os descendentes da nobreza na França, no final do século XX

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    Monique de Saint Martin

    2002-10-01

    Full Text Available Como analisar um antigo grupo, o dos descendentes da nobreza, inventado e reinventado diversas vezes no curso de sua história, suprimido da Constituição e a seguir reabilitado de modo mais ou menos visível, e que, na França, bem como em outros países, não cessa de se desagregar? Como pensar a extrema diversidade e a unidade relativa desse conjunto, das quais é preciso também indagar se são ou não fictícias? Mais, talvez, que os recursos simbólicos comuns, o que contribui para a manutenção de uma forma de coesão é a densidade das relações e das trocas de toda sorte entre eles. Mas essa coesão tende a tornar-se cada vez mais difícil. No atual estado da pesquisa, parece que os descendentes da nobreza não podem ser analisados como um corpo nem como um grupo relativo ­ ainda que essas interpretações mereçam atenção ­, e sim como um espaço, sob condição de que se examine a dinâmica e os processos que o atravessam.How should one analyze the descendants of the nobility in France? This ancient group has been invented and re-invented many times along its history. The Constitution suppressed it, then later on it was quite visibly rehabilitated, and it is always becoming disaggregated, in France as well as in other countries. How should one approach both this group's extreme diversity and its relative unity, which also have to be questioned as to their fictitiousness? Maybe the dense relationships and exchanges of all sorts between the descendants of the nobility contribute to the maintenance of some form of cohesion more than the symbolic resources they have in common. But this cohesion is becoming ever more difficult. At the present moment of the research, it seems that the descendants of the nobility cannot be analyzed neither as a body nor as a relative group ­ even though these interpretations deserve attention ­ but rather as a space, as long as the dynamism and the processes that crosscut it are analyzed as well.

  18. Ruptured thoracic aortic aneurysm in patient with systemic lupus erythematosus Aneurisma roto da aorta descendente em paciente com lúpus eritematoso sistêmico

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    Daniel Oliveira De Conti

    2011-03-01

    Full Text Available It is reported a ruptured descending thoracic aortic aneurysm in a 25-year-old systemic lupus erythematosus woman who underwent 19 years steroid therapy. She was treated with 2 endovascular stent-grafts, discharged from hospital 13 days after the procedure in good health. Three months later she returned with hemorrhagic shock due to high digestive hemorrhage secondary to an aortic-esophageal fistula. She underwent to an open emergency surgery, and died during the post-operative period.Paciente de 25 anos, do sexo feminino, portadora de lúpus eritematoso sistêmico, fazendo uso de corticoesteroide havia 19 anos, deu entrada em unidade de emergência com aneurisma roto de aorta torácica descendente. Foi submetida a tratamento endovascular com 2 stents, recebeu alta hospitalar no 13º dia de pós-operatório, em boas condições de saúde. Três meses depois, retornou em choque hemorrágico secundário a hemorragia digestiva alta. Feito o diagnóstico de fístula aorto-esofágica, foi submetida à cirurgia aberta de emergência, indo a óbito durante o período pós-operatório.

  19. Comportamientos de autocuidado y adherencia terapéutica en personas con enfermedad coronaria que reciben atención en una institución hospitalaria de Ibagué, Colombia

    OpenAIRE

    Olivella Fernandez, Madeleine; Universidad Del Tolima

    2016-01-01

    PACIENTES CON ENFERMEDAD CORONARIAObjetivo: valorar en forma global los comportamientos de autocuidado y de adherencia terapeutica a los tratamientos en un grupo de personas con enfermedad coronaria en Ibagué, año 2013. Metodologia: Estudio descriptivo, transversal, realizado en una Institucion Hospitalaria de Ibagué, Tolima (Colombia). La muestra fue de 55 pacientes con enfermedad coronaria diagnosticada. La información se recogió utilizando el instrumento de adherencia de Bonilla y De-Reale...

  20. Utilização de endoprótese auto-expansível (Stent introduzida através da artéria femoral para tratamento de dissecção da aorta descendente

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    Fonseca José Honório Palma da

    1998-01-01

    Full Text Available OBJETIVO: Apresentar a correção de dissecção da aorta descendente, utilizando stent recoberto com dácron® introduzido através da artéria femoral na sala de hemodinâmica. MÉTODOS: Quatro pacientes foram submetidos à sedação, anestesia local de ambas regiões inguinais e a heparinização sistêmica, com cateter contendo o stent introduzido, através da artéria femoral comum, previamente dissecada, até a aorta descendente no seu terço médio. RESULTADOS: A expansão do stent foi realizada no local onde existia a lesão da íntima, diagnosticada por arteriografia e ecocardiograma. A oclusão da falsa luz foi imediata. O tempo do procedimento foi em média de 1h e 30min. A alta hospitalar ocorreu sem complicações. CONCLUSÃO: Este procedimento poderá proporcionar uma melhora substancial nos resultados do tratamento das dissecções da aorta descendente.

  1. Factores de riesgo y morbi-mortalidad coronaria a los 28 años de seguimiento de una cohorte con baja incidencia de la enfermedad: el estudio de Manresa

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    Luis Tomás Abadal

    2004-01-01

    Full Text Available Fundamento: Estudio de la morbimortalidad coronaria y mortalidad total asociadas a los denominados factores de riesgo coronario de una cohorte industrial de varones seguida durante 28 años. Métodos: Población laboral de 1.059 varones de 30-59 años libres de cardiopatía en el examen inicial (1968, reexaminados cada cinco años hasta 1988 y con el examen final en 1996. Durante el tiempo de seguimiento se obtuvo información del 96,4% del total de participantes. Resultados: Las tasas de incidencia de enfermedad coronaria, mortalidad coronaria y muerte total por 105 (personas-años de observación fueron: 499,80; 235,80 y 925,33, respectivamente. Los niveles elevados de colesterol y el consumo habitual de cigarrillos se asociaron independientemente con la incidencia de cardiopatía coronaria y la mortalidad coronaria ajustado por edad, presión arterial, glucemia e índice de masa corporal. Los niveles elevados de colesterol sérico, glucemia y consumo de cigarrillos se asociaron independientemente con el riesgo de muerte por todas las causas. Conclusiones: En esta población, con incidencia relativamente baja de enfermedad coronaria, el tabaco y el colesterol sérico mantuvieron el valor predictivo independiente, durante los 28 años de seguimiento.

  2. Angioplastia coronaria vs terapia trombolítica en infarto agudo de miocardio. Clínica Marshfield-Hospital St Joseph, Wisconsin, EE.UU, 1999

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    Juan Pulido

    2001-04-01

    Full Text Available El tratamiento del infarto agudo de miocardio (IAM está en
    investigación por sus implicaciones en la práctica médica y por la
    comprensión más detallada de la fisiopatología. El objetivo del estudio es comparar clínica y angiográficamente la angioplastia coronaria con la trombolisis aguda en pacientes con IAM de menos de 24 horas de evolución. La administración de agentes trombolíticos después de una oclusión coronaria aguda ha disminuido la mortalidad intrahospitalaria, el tamaño del infarto y el número de complicaciones asociadas.

  3. Enfermedad de Kawasaki, conceptos sobre la cirugía de revascularización coronaria en edad pediátrica

    OpenAIRE

    2006-01-01

    La enfermedad de Kawasaki ha rebasado en muchos países a la fiebre reumática como primera causa de cardiopatía adquirida en la edad pediátrica. Tal vez la complicación más grave de la enfermedad es la afección coronaria que se manifiesta en forma de aneurismas de diversos tamaños que característicamente pueden presentar regresión y condicionar estenosis coronaria. Tanto el manejo de los eventos coronarios agudos como los crónicos en la edad pediátrica se basó en un inicio en la extrapolación ...

  4. ¿Se están alcanzando las metas en el perfil lipídico de personas con enfermedad coronaria previa?

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    Alonso Merchán, MD

    2011-08-01

    Conclusiones: después de nueve años de la publicación de las guías del NCEP-ATPIII y de las recomendaciones posteriores sobre las metas del perfil lipídico en pacientes con enfermedad coronaria y a pesar de la divulgación de las mismas a través de conferencias, congresos y publicaciones, estas metas las cumple un porcentaje bajo de pacientes, tal como lo demuestra este estudio observacional en sujetos hospitalizados por causas diferentes a la enfermedad coronaria pero con este antecedente. Una de las explicaciones para este pobre resultado es el uso de lovastatina, estatina de baja efectividad para reducir el cLDL. Se analizan otras posibles causas y se hacen propuestas para lograr los objetivos.

  5. Tratamiento quirúrgico de origen anómalo de la arteria coronaria derecha con nacimiento de la arteria pulmonar

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    Germán J. Chaud

    2016-05-01

    Full Text Available El origen anómalo de la arteria coronaria derecha de la arteria pulmonar (ARCAPA es una entidad de muy baja frecuencia. Pocos casos se han publicado en la literatura sobre la misma en la edad adulta. La forma de presentación varía según el tipo de anomalía coronaria y la cantidad de circulación colateral. Nuestro caso resalta la rareza de presentación de esta enfermedad, así como su única forma de tratamiento en un paciente de 43 años con ángor que se presenta en la consulta ambulatoria.

  6. 119. Reparación quirúrgica de la salida anómala del tronco de la coronaria izquierda desde el seno coronario derecho

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    E. Bernabeu

    2012-04-01

    Conclusiones: el origen anómalo de las coronarias es una alteración congénita rara asociada a muerte súbita. Cuando existe un trayecto intramural, el unroofing es la técnica más empleada. La TCMD es útil para la planificación preoperatoria, permitiendo individualizar la reconstrucción quirúrgica, y para evaluar en el postoperatorio el resultado anatómico.

  7. Mediastinite descendente necrosante: tratamento cirúrgico torácico minimamente invasivo Descending necrotizing mediastinitis: minimally invasive thoracic surgical treatment

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    Cromwell Barbosa de Carvalho Melo

    2010-12-01

    Full Text Available OBJETIVO: Relatar uma série de casos de pacientes com mediastinite descendente necrosante (MDN tratados com cirurgia torácica minimamente invasiva. MÉTODOS: Relatamos os casos de três pacientes com MDN submetidos à desbridamento mediastinal através de cirurgia torácica videoassistida no Hospital São Paulo, São Paulo (SP, desde a sua admissão até o desfecho final. RESULTADOS: Os três pacientes apresentaram boa evolução pós-operatória, com tempo médio de internação de 16,7 dias. CONCLUSÕES: Concluímos que a videotoracoscopia é uma técnica efetiva para a drenagem mediastinal no tratamento da MDN, com os benefícios da cirurgia minimamente invasiva: menos dor pós-operatória, menor liberação de fatores inflamatórios, retorno precoce às atividades diárias e melhores resultados estéticos.OBJECTIVE: To report a case series of patients with descending necrotizing mediastinitis (DNM who were treated with minimally invasive thoracic surgery. METHODS: We report three cases of male patients with DNM who underwent mediastinal debridement by video-assisted thoracic surgery at the Hospital São Paulo, located in the city of São Paulo, Brazil, from admission to the final outcome. RESULTS: The postoperative evolution was favorable in all three cases. The mean length of hospital stay was 16.7 days. CONCLUSIONS: We conclude that video-assisted thoracoscopy is an effective technique for mediastinal drainage in the treatment of DNM, with the benefits common to minimally invasive surgery: less postoperative pain, lower production of inflammatory factors, earlier return to activities of daily living, and better aesthetic results.

  8. Pseudo-aneurisma post-traumático de tronco de arteria coronaria izquierda Post-traumatic false (pseudo aneurysm of the left main coronary artery

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    Melina M. Gallo

    2011-08-01

    Full Text Available El pseudo-aneurisma de arteria coronaria es extremadamente raro. Su historia natural es poco conocida y su tratamiento discutido. Se presenta el caso de un paciente con pseudo-aneurisma de tronco de la coronaria izquierda e infarto antero-apical del ventrículo izquierdo cinco años después de un paro cardíaco secundario a un traumatismo no penetrante de tórax. Se consideró entonces que la lesión no era pasible de corrección percutánea o quirúrgica por lo que se optó por tratamiento médico conservador. Una angiografía coronaria por tomografía computarizada multicorte realizada 10 años después del evento inicial mostró ausencia de progresión de la lesión.Coronary pseudo-aneurysm is an extremely rare entity. Its natural history is scarcely known and its treatment is controversial. We report a case of pseudo-aneurysm of the left main coronary artery associated with an antero-apical infarct of the left ventricle diagnosed five years after a cardiac arrest following a non-penetrating thoracic trauma. The patient was treated conservatively because percutaneous or surgical correction were not considered suitable for this lesion. A multidetector computed tomography coronary angiogram performed 10 years after the initial event showed no evidence of progression.

  9. Precisión diagnóstica de la angiografía coronaria por tomografía computarizada multislice aplicada al “mundo real”

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    Claudio Llauradó

    2006-01-01

    Full Text Available Objetivo Evaluar la precisión diagnóstica de la angiografía coronaria por tomografía computarizada multislice (ACTCM para la detección de estenosis significativas en arterias coronarias. Material y métodos Se estudiaron pacientes con indicación de cinecoronariografía diagnóstica sin antecedents de alergia al contraste, insuficiencia renal ni arritmias. Para la adquisición de imágenes se utilizó un tomógrafo multislice (multicorte ( Brilliance 40, Philips, The Netherlands gatillado electrocardiográficamente. Se administraron 90-125 ml de contraste yodado por vía endovenosa. La obesidad, la diabetes, los segmentos difusamente calcificados, con diámetro < 2,0 mm, y aquellos tratados con stents no constituyeron criterios de exclusión. Las lesiones se definieron significativas cuando presentaron una reducción luminal = 50% por ACTCM y angiografía cuantitativa coronaria (QCA. Resultados Previo a la intervención se escanearon 38 pacientes. De ellos, uno (3% fue excluido debido a calidad de imagen insuficiente. Los 37 restantes (444 segmentos, con calidad de scan satisfactoria, se incluyeron en el estudio (81% hombres, edad media 62,43 ± 12,5 años, 13,5% diabéticos. El tiempo medio de scan fue de 15,12 ± 2,6 segundos. Se analizaron 444 segmentos por ambas técnicas. Se encontraron 88 (17% y 93 (18% lesiones significativas por CCG y ACTCM, respectivamente. La sensibilidad, la especificidad, el valor predictivo positivo y el valor predictivo negativo de la ACTCM para detectar estenosis significativas fueron del 82%, 93%, 72% y 96%, respectivamente. Conclusión En pacientes seleccionados para cinecoronariografía, la angiografía coronaria por tomografía computarizada multislice presenta un alto valor predictivo negativo para la detección de enfermedad obstructiva coronaria.

  10. Actividad in vitro de la mezcla de alcaloides de Ervatamia coronaria (Jacq Staff. Apocynaceae sobre amastigotes de Leishmania braziliensis

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    Amanda Moreno Rodríguez

    2008-09-01

    Full Text Available A leishmaniose é considerada uma importante causa de morbidade e mortalidade a nível mundial, principalmente nos países tropicais. As formas cutânea e mucocutânea são causadas, entre outras espécies, por Leishmania braziliensis. Na procura de compostos leishmanicidas de origem natural, foi estudada a atividade da mistura de alcalóides de Ervatamia coronaria (Apocynaceae contra amastigotas de L. braziliensis em 6 concentrações diferentes (1, 10, 20, 25, 50 e 100 µg/mL. Foram tratados macrófagos de ratos da linha J774, infectados com promastigotas de L. braziliensis, com a mistura de alcalóides 1 hora após-infecção e diariamente por 3 dias sem mudança de meio. As experiências de citotoxicidade foram efetuadas sobre os macrófagos com azul tripam. Todos os cultivos foram feitos de forma triplicada e os grupos de controle não foram submetidos à mistura de alcalóides. Foi obtido que o composto adicionado exerce atividade doses/dependente sobre a parasita. No entanto, as concentrações mais altas (50 e 100 µg/mL, adicionado durante 3 dias, mostraram os maiores índices de infecção, provavelmente devido a diminuição no número de macrófagos, sobre os quais não foi observado efeito tóxico do tratamento durante 24 horas DL50/24h = 233,52 µg/mL. Os resultados dessa pesquisa revelaram uma nova atividade farmacológica de alcalóides da espécie Ervatamia coronaria sobre a forma amastigota de Leishmania braziliensis, com IC50 = 2,6 e 12,4 µg/mL sem mostrar toxicidade sobre a célula hospedeira.

  11. Evaluación de las placas coronarias por tomografía computarizada multidetector de 16 filas. Correlación con ecografía intravascular

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    Patricia Carrascosa

    2008-01-01

    Full Text Available IntroducciónEl 50% de las muertes de etiología cardiovascular se deben a la enfermedad arteriosclerótica. Estudios recientes demostraron que las placas ateromatosas más propensas al desarrollo de un evento coronario son las que presentan ciertas características particulares, como un centro o core lipídico y remodelación positiva, denominadas placas vulnerables. La determinación temprana de la presencia de este tipo de placas ateroscleróticas tendría un impacto clínico de suma importancia y podría ayudar a prevenir el desarrollo de un síndrome coronario agudo en el futuro.ObjetivoDeterminar la certeza diagnóstica de la angiografía coronaria por tomografía computarizada multidetector de 16 filas (16-ACTCM en la identificación, la caracterización y la cuantificación de las lesiones arterioscleróticas coronarias en comparación con la ecografía intravascular (EIV.Material y métodosSe estudiaron 45 pacientes con indicación de angiografía coronaria con 16-ACTCM y EIV.En cada segmento coronario se analizaron la carga de placa y las características de la placa aterosclerótica, que se clasificó en blanda, fibrosa y cálcica. La certeza diagnóstica de la 16-ACTCM para determinar la carga de placa y la identificación de placas coronarias se calculó con el método exacto binomial. Sobre la base de un análisis con curvas ROC se determinó el punto de corte para cada tipo de placa, así como la densidad media y la desviación estándar en unidades Hounsfield [UH]. Se evaluó además la certeza diagnóstica de la ACTCM para el diagnóstico de estenosis coronaria = 50%.ResultadosPara la detección de carga de placa, la sensibilidad fue del 96,2% y la especificidad fue del 81,9%. Para la detección de placas blandas, fibrosas y calcificadas, la sensibilidad y la especificidad fueron del 94,6% y 92,62%, del 94,9% y 98,5% y del 93,2% y 95,1%, respectivamente.Con un valor de corte de 85 UH, la 16-ACTCM diferenció correctamente el 86

  12. CONGENITAL ANTERIOR TIBIOFEMURAL SUBLUXATION

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    A. Shahla

    2008-06-01

    Full Text Available Congenital anterior tibiofemoral subluxation is an extremely rare disorder. All reported cases accompanied by other abnormalities and syndromes. A 16-year-old high school girl referred to us with bilateral anterior tibiofemoral subluxation as the knees were extended and reduced at more than 30 degrees flexion. Deformities were due to tightness of the iliotibial band and biceps femuris muscles and corrected by surgical release. Associated disorders included bilateral anterior shoulders dislocation, short metacarpals and metatarsals, and right calcaneuvalgus deformity.

  13. Reactor de película líquida descendente para la sulfonación de ésteres metílicos con trióxido de azufre

    OpenAIRE

    Torres Ortega, Jesús Alfonso; Díaz Aldana, Luís Alejandro; Sánchez Castellanos, Francisco José

    2010-01-01

    Se realizó un conjunto de experimentos de sulfonación de dodecilbenceno (DDB) y ésteres metílicos (ME) derivados de la esteari- na hidrogenada de palma, con SO3 gaseoso desorbido del óleum, en un reactor de sulfonación en película líquida descendente a escala banco de 40 cm de longitud y ½ pulgada de diámetro interno. Mediante titulaciones volumétricas se determinaron los porcentajes de materia sulfonada y contenido de ácido sulfúrico, así como el porcentaje de aceite libre mediante e...

  14. Determinación de las características anatómicas de las arterias coronarias de cerdo mediante técnica de inyección con látex

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    Guillermo Rivera

    2015-06-01

    Full Text Available Objetivo: Determinar las características anatómicas de las arterias coronarias del cerdo, mediante inyección con látex. Materiales y métodos: Se usaron 100 corazones de cerdo. Se insertaron sondas Nelaton a través de las arterias coronarias y se les inyectó solución de látex y tinta china. Se determinó el diámetro y el punto de origen para la coronaria derecha, coronaria izquierda, interventricular paraconal y circunfleja. Se cuantificaron el número de ramas diagonales, marginales ventriculares izquierdas y postero laterales. Se determinó frecuencia de ramus intermedius y tipo de dominancia. Se realizó análisis estadístico con un error estándar del 5%, con el Epidat 3,1. Resultados: El 100% de los orígenes anatómicos de las arterias coronarias fueron normales. La dominancia mas frecuente fue la derecha, 73%. El promedio de número de ramas marginales izquierdas, diagonales y posterolaterales fue de 3. La frecuencia de ramus intermedius fue de 12%. El calculo de chi cuadrado de Pearson mostró significancia entre el ramus intermedius y número de ramas marginales izquierdas (p=0,0009. Conclusiones: Las características anatómicas de las arterias coronarias del cerdo son similares a las del humano. El ramus intermedius se comporta como una primera rama marginal izquierda y no como una primera rama diagonal como lo afirman algunos autores.

  15. Factores asociados a la calidad de vida relacionada a la salud en pacientes con cardiopatía coronaria y diabetes mellitus.

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    Moises Barrantes

    2010-07-01

    Full Text Available mellitus. Material y métodos: Se utilizó el cuestionario (SF-36 y se incluyeron 70 pacientes diabéticos y 140 no diabéticos admitidos por un evento coronario agudo en la Unidad Coronaria del Hospital Nacional Edgardo Rebagliati Martins entre diciembre 2006 y diciembre 2007. Se realizó análisis multivariado para determinar los factores asociados a los dos componentes sumarios de la calidad de vida relacionada a la salud (CVRS y si la diabetes mellitus era un factor independiente. Resultados: Ambos grupos de estudio tuvieron, en general, similares características basales. En la estimación de la calidad de vida global, los pacientes diabéticos tuvieron índices significativamente menores de percepción solamente en el componente sumario físico. Se construyeron modelos de regresión lineal múltiple entre ambos componentes sumario de la CVRS y las variables de estudio, identificándose la edad avanzada, el género femenino y la diabetes mellitus como los principales factores asociados a la CVRS. Conclusión: La edad, el género, el sobrepeso y la obesidad, la hemoglobina glucosilada, la diabetes mellitus, el antecedente de enfermedad coronaria, las comorbilidades, el estado civil y el nivel socioeconómico son factores asociados a la CVRS en pacientes con cardiopatía coronaria y diabetes mellitus.(Rev Med Hered 2010;21:118-127.

  16. Angiografía coronaria por tomografía computarizada multidetector con gatillado electrocardiográfico prospectivo. Análisis de la calidad de imagen y de la dosis de radiación

    OpenAIRE

    PATRICIA CARRASCOSA; CARLOS CAPUÑAY; ALEJANDRO DEVIGGIANO; Tajer,Carlos D.; JAVIER VALLEJOS; ALEJANDRO GOLDSMIT; García, Mario J.

    2009-01-01

    RESUMENIntroducciónLa angiografía coronaria por tomografía computarizada multidetector (ACTCM) se ha convertidoen una herramienta diagnóstica útil para la cuantificación directa de la estenosiscoronaria, la identificación de anomalías coronarias y la evaluación de bypass. Pese a que suvalor clínico en ocasiones se ve cuestionado debido a la dosis de radiación efectiva (DRE)que recibe cada paciente, ésta no es mayor que la de otros estudios. No obstante, es motivode permanente preocupación la ...

  17. Adherencia a criterios de pertinencia de revascularización coronaria del colegio americano de cardiología, servicio de hemodinamia Fundación Cardioinfantil- Bogotá 2011

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    Blanquicett Anaya, Marco Luis

    2012-01-01

    Titulo: Adherencia a criterios de pertinencia de revascularización coronaria del colegio americano de cardiología 2009, en el servicio de hemodinámica de la fundación cardioinfantil Bogotá 2011. Introducción: La enfermedad cardiovascular es la principal causa de morbimortalidad a nivel mundial, teniendo mayor prevalencia enfermedad coronaria. Existen guías especificas para el manejo de esta enfermedad sin embargo su aplicación se entorpece por factores diversos. Este estud...

  18. Diagnóstico fractal de disfunción cardéaca severa: Dinámica fractal de la ramificación coronaria izquierda Fractal diagnosis of severe cardiac dysfunction: Fractal dynamic of the left coronary branching

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    Javier O Rodréguez

    2012-10-01

    Full Text Available INTRODUCCIÓN Y OBJETIVOS: la geometría fractal evalúa la irregularidad de los objetos naturales, permitiendo caracterizar de forma imparcial la totalidad de la ramificación coronaria izquierda a diferencia de la metodología actual que evalúa únicamente partes de ésta. Con base en esta medida se generalizó una nueva metodología diagnóstica para detectar cualquier tipo de disfunción cardiaca severa. MÉTODOS: estudio de concordancia diagnóstica en el que se utilizó el método de box counting para medir dimensiones fractales de imágenes consecutivas entre sístole y diástole de la ramificación coronaria izquierda en proyección oblicua derecha anterior de angiografías de ocho pacientes con enfermedad arterial oclusiva leve. Así mismo, se evaluaron sus cambios por medio de los conceptos de variabilidad y diferencia neta y se compararon estos resultados con pacientes sin enfermedad arterial oclusiva, con enfermedad arterial oclusiva moderada y severa evaluados previamente de igual forma, para obtener una metodología matemática que evalúa el impacto de cualquier patología en la dinámica cardiaca. RESULTADOS: los casos que presentan diferencias netas de cero corresponden a pacientes con disfunciones cardiacas severas, independientemente del grado o ausencia de enfermedad arterial oclusiva diagnosticada. CONCLUSIONES: se generalizó una nueva metodología diagnóstica de aplicación clínica que detecta disfunciones cardiacas severas sub-diagnosticadas con las metodologías actuales, mediante la caracterización de la dinámica total de la ramificación coronaria izquierda.INTRODUCTION AND OBJETIVES: fractal geometry evaluates the irregularity of natural objects, allowing impartially characterize the entire left coronary branching unlike the current methodology which evaluates only parts of it. Based on this measure, a new diagnostic method was generalized to detect any type of severe cardiac dysfunction. METHODS: Concordance

  19. Prevención y tratamiento de la hipertensión arterial sistémica en el paciente con enfermedad arterial coronaria

    OpenAIRE

    Mendoza-González,Celso; Rosas,Martín; Lomelí Estrada,Catalina; Lorenzo,José Antonio; Méndez,Arturo; Martínez-Reding,Jesús; Martínez-Sánchez,Carlos; Pastelín,Gustavo; Férez-Santander,Sergio Mario; Attie,Fause

    2008-01-01

    La asociación entre hipertensión arterial sistémica (HAS) y enfermedad arterial coronaria está bien demostrada a través de diversos estudios epidemiológicos. La hipertensión arterial es un factor de riesgo independiente importante para el desarrollo de coronariopatía, enfermedad vascular cerebral y nefropatía. Existen avances importantes en el conocimiento de factores neurohumorales y hemodinámicos que confluyen en la fisiopatología de la hipertensión y en el desarrollo de enfermedad coronari...

  20. Perfil clinico y seguimiento a largo plazo de los distintos sindromes anginosos sin lesiones coronarias significativas con prueba de esfuerzo positiva y negativa

    OpenAIRE

    Missorici Corso, Mario Antonio

    2004-01-01

    Introducción: La angina variante por vasoespasmo coronario y el síndrome X han sido mencionados como responsables de angina en ausencia de lesión coronaria significativa. Sin embargo no todos los pacientes en esta situación clínica cumplen criterios para ser agrupados en estas entidades patológicas.Pacientes y Métodos: Se estudiaron 328 pacientes consecutivos divididos en 4 grupos: A: Angina vasoespástica (n:165). B: Síndrome X (SDX) [sin vasoespasmo (VSP) con prueba de esfuerzo (PE) positiva...

  1. Histopatologia da seromiotomia dupla e sutura seromuscular no cólon descendente de ratos Histopathology of double seromyotomy and seromuscular suturing on the descending colon of mice

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    Aldérico Luiz da Silva Júnior

    1999-12-01

    Full Text Available Realizamos um estudo experimental em ratos com o objetivo de retardar o trânsito intestinal no cólon e verificar as alterações macroscópicas nas fezes e as histopatológicas ocorridas no intestino grosso. Foram operados 15 ratos e 15 ratas num total de trinta, divididos em três grupos denominados 30, 60 e 90 dias, conforme o tempo proposto para relaparotomia. Todos os ratos foram submetidos a duas seromiotomias extramucosas, no cólon descendente, com incisões circunferenciais (360°. Elas se localizavam, uma a 1 cm e a outra a 2 cm acima da reflexão peritoneal. Após as seromiotomias, fez-se a sutura seromuscular circundando todo o perímetro do cólon. Analisaram-se os aspectos clínicos e histopatológicos. Concluiu-se que há formação de um anel fibroso, com elevação da mucosa em direção à luz, do tipo valvular e descontinuidade da musculatura longitudinal e transversal.Experiments were carried out on mice, aiming to retard bowel movement in the descending colon. The microscopic alterations in the stools and the histopathological changes in the large intestine were observed. Fifteen male mice and fifteen female mice have been operated on and divided into three groups named 30, 60 and 90 days, according to the time set for the relaparotomy. All mice have been submitted to two extramucous seromytomies in the descending colon with circunferential incisions (360. One of them was located one centimeter; and the other two centimeters, above the peritoneal reflection. After the seromytomias, a seromuscular suture surrouding all over the colon area was performed. We observed visceral and perineal adherence in the three groups, the majority without organic repercurssion. However a mouse from the 60 days group had partial obstructive manifestation that resulted in death on the 40th pos-surgical day. There were complications with total colon obstruction for stools impact in the operated area of two female mice that also developed into

  2. Anterior cervical plating

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    Gonugunta V

    2005-01-01

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

  3. Proteção medular em cirurgia da aorta descendente com uso de "bio-pump" e exsangüinação controlada Spinal protection during descending aortic surgery

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    Henrique Murad

    1994-06-01

    Full Text Available Os autores utilizam como método de proteção medular em cirurgia de aorta descendente, circulação extracorpórea átrio esquerdo-femoral esquerda, com baixa dose de heparina (1 mg/kg, bomba centrífuga (bio-pump e exsangüinação controlada. Operaram 4 doentes com esta metodologia sem que houvesse mortalidade, paraplegia ou sangramento excessivo.The authors have used for spinal cord protection during descending aortic surgery, partial extracorporeal circulation from left atrium to left femoral artery, low dose of heparin (1 mg/kg, centrifugal pump (bio-pump and controlled exsanguination. They have operated upon with this methodology 4 patients without mortality, paraplegia or excessive bleeding.

  4. Predictores de riesgo en cirugía coronaria sin circulación extracorpórea: análisis de 1.000 pacientes

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    Juan M. Vrancic

    2006-01-01

    Full Text Available Objetivo Analizar los resultados posoperatorios e identificar predictores de morbimortalidad a los 30 días en la cirugía de revascularización coronaria (CRM sin circulación extracorpórea (CEC. Material y métodos Se incluyeron en el estudio 1.000 pacientes consecutivos operados entre enero de 1997 y agosto de 2005, a quienes se les efectuó CRM sin CEC únicamente. Resultados El 86% eran hombres, con edad promedio de 64,7 ± 15,7 años. El 27% era mayor de 70 años. La mortalidad global fue del 3,3% (CRM electiva, del 1,8%; no electiva, del 6%; p < 0,001. La mortalidad según Euroscore fue la siguiente: riesgo bajo 1,42%, medio 2,5% y alto 8,04% (p < 0,001. En el análisis multivariado resultaron predictores independientes para mortalidad hospitalaria la edad (OR 1,01, p = 0,013, IC 95% 1,00-1,03, la CRM previa (OR 3,87, p = 0,01, IC 95% 1,33-11,28, la angina inestable (OR 4,97, p = 0,01, IC 95% 1,41-17,48, la cirugía no electiva (OR 2,36, p = 0,02, IC 95% 1,09-5,09, la conversión a cirugía con CEC (OR 5,91, p = 0,01, IC 95% 1,43-24,45. Las complicaciones mayores ocurrieron en el 5,4% de los pacientes. Se identificaron como predictores independientes para morbilidad la conversión a CRM con CEC (OR 15,96, p < 0,001, IC 95% 5,24-48,53, la angina inestable (OR 3,01, p = 0,01, IC 95% 1,30-7,03 y la presencia de mayor enfermedad coronaria (OR 1,39, p = 0,04, IC 95% 1-1,9. Conclusiones La CRM sin CEC presentó una incidencia baja de morbimortalidad posoperatoria. La presencia de angina inestable, cirugía no electiva, conversión a cirugía con CEC, CRM previa y la edad se identificaron como predictores de mortalidad. La presencia de mayor enfermedad coronaria, la conversión a cirugía con CEC y la angina inestable resultaron predictores de morbilidad posoperatoria.

  5. Surco diagonal en el lóbulo de la oreja: ¿signo de enfermedad arterial coronaria? Diagonal earlobe crease: a sign of coronary artery disease?

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    Sebastián B. Lamot

    2007-08-01

    Full Text Available El surco diagonal es un signo encontrado en el lóbulo de la oreja, que estaría relacionado con la enfermedad arterial coronaria. Nuestro objetivo fue estudiar la utilidad del signo. Se examinaron 104 pacientes (entre 30 y 80 años clasificados por sexo y edad. Cuarenta y nueve tenían enfermedad arterial coronaria diagnosticada por coronariografía (obstrucción > del 70% en una de las grandes arterias y/o gamagrafía de perfusión miocárdica con Talio 201 (defecto fijo. El grupo control estuvo compuesto por 55 pacientes (asintomáticos, con electrocardiograma normal. Los datos obtenidos fueron sensibilidad (61.2%, especificidad (78.2%, valor predictivo positivo de (71.4% y valor predictivo negativo (69.3%.. Observamos una relación significativa entre la presencia de surco diagonal y enfermedad arterial coronaria. Consideramos que este signo podría resultar de utilidad en la práctica clínica, fundamentalmente para los pacientes entre 30 y 60 años.The diagonal earlobe crease is a sign theorically related to coronary artery disease. The purpose of this study was to prove the usefulness of this sign. A total of 104 patients were examined (ages 30 to 80 grouped by age and sex. Forty nine of them were diagnosed of having coronary artery disease by coronary angiography (a 70% obstruction of one of the major arteries, and/or myocardial perfusion imaging with Thallium 201 (fixed defects. The control group included 55 patients (asymptomatic with normal electrocardiogram. Data here obtained included sensitivity (61.2%, specificity (78.2%, positive predictive value (71.4% and negative predictive value (69.3%. We found a significant relation between the presence of the diagonal earlobe crease and coronary artery disease. We consider it a sign that could prove useful in clinical practice, mainly among patients aged between 30 and 60.

  6. Caracterización de los síntomas de angina en hombres adultos con cateterismo cardíaco positivo para enfermedad coronaria

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    Clemencia Bernal

    2013-06-01

    Full Text Available Introducción: en Colombia la enfermedad coronaria ocasionó 29.394 muertes en 2011 ocupando el primer lugar como causa de mortalidad, según el Departamento Nacional de Estadística. Es importante disminuir el tiempo entre el inicio de los síntomas y el tratamiento, etapa en que la sintomatología, la interpretación y la manifestación del paciente son esenciales, así como su reconocimiento por parte del personal de salud para la definición oportuna del tratamiento. Objetivo: describir los síntomas de angina de un grupo de hombres con edades entre 40 y 80 años, con cateterismo cardíaco positivo para enfermedad coronaria en el marco de la teoría de Elizabeth Lenz según factores determinantes, dimensiones y consecuencias del síntoma. Materiales y métodos: estudio descriptivo con abordaje cualitativo. Se realizó entrevista semiestructurada a 27 hombres en relación con las características de los síntomas experimentados y se analizó la información mediante la técnica de análisis de contenido. Resultados: categorías emergentes relevantes dentro de factores determinantes: "Pienso que hice un sobreesfuerzo", "No controlo la comida", "Es la herencia", "Tanto estrés". Dimensiones: las palabras más utilizadas fueron: "dolor", a veces acompañado de "presión" en el pecho y "dolor de oreja a oreja". Irradiación a brazo izquierdo y ocasionalmente a espalda. Síntomas acompañantes: gastrointestinales, fatiga y hormigueo. Consecuencias: "Me toca cambiar", "Nada va a cambiar", "Me va a afectar". Conclusiones: se obtuvo un perfil característico que refleja la forma de vivir la enfermedad coronaria que facilita la comprensión del fenómeno y que orienta los cuidados pertinentes.

  7. ANGIOPLASTIA PERCUTÁNEA CON STENT EN EL TRONCO PRINCIPAL DE LA ARTERIA CORONARIA IZQUIERDA / Percutaneous angioplasty with stent in the left main coronary artery

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    Javier Almeida Gómez

    2012-10-01

    Full Text Available ResumenIntroducción y objetivos: La afectación significativa del tronco común izquierdo, es la más letal de las presentaciones de la enfermedad arterial coronaria. El tratamiento de elección, es la cirugía de derivación aorto-coronaria. En varios estudios multicéntricos, se sugiere la posibilidad de tratar la enfermedad de tronco mediante el intervencionismo coronario percutáneo con implantación de prótesis endoluminal o stent. El objetivo de esta investigación fue caracterizar la angioplastia percutánea con stent en el tronco principal de la arteria coronaria izquierda. Método: Se realizó un estudio observacional, descriptivo y transversal en 21 pacientes con angioplastia percutánea con stent en el tronco principal de la arteria coronaria izquierda, realizadas en el laboratorio de Hemodinámica y Cardiología Intervencionista del Hospital "Hermanos Ameijeiras", entre enero 2010 y julio 2011. Resultados: No existió diferencia significativa en el sexo. Predominó el grupo de edad entre 50-64 años (47,6 % y el color de la piel blanca (76,19 %. El factor de riesgo cardiovascular más encontrado fue la HTA (85,71 %, seguido de dislipidemia (47,61 %. El diagnóstico más observado fue la angina de esfuerzo estable, 14 casos (66,66 %. La lesión en el cuerpo del tronco (12 pacientes, 57,1 %, fue la más encontrada, seguida de la ostial (8 casos. El tipo de stent más utilizado fue el liberador de fármacos (61,9 %, y solamente 4 pacientes presentaban troncos protegidos quirúrgicamente. Conclusiones: La mayor cantidad de casos fueron electivos, con predominio de los troncos no protegidos. El factor de riesgo coronario más encontrado fue la HTA. Se encontró asociación significativa entre la diabetes mellitus y la localización ostial de la lesión tratada. / AbstractIntroduction and Objectives: Significant impairment of the left main coronary artery is the most lethal presentation of coronary artery disease. The treatment of choice

  8. Tratamiento de la compresión del tronco de la arteria coronaria izquierda en pacientes con hipertensión pulmonar

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    María L. Talavera

    2011-10-01

    Full Text Available La angina de pecho es un síntoma frecuente en pacientes con hipertensión pulmonar (HP de cualquier etiología. Aunque su fisiopatología no está aclarada, las causas propuestas son: la isquemia subendocárdica por aumento del estrés parietal del ventrículo derecho, la dilatación de la arteria pulmonar por incrementos transitorios de la presión pulmonar y la compresión extrínseca del tronco de la arteria coronaria izquierda (TCI por la arteria pulmonar (AP dilatada. Se presentan tres casos que muestran la relación entre la angina de pecho y la compresión del TCI en pacientes con HP asociada a cardiopatías congénitas, tratados mediante implante de stent coronario.

  9. Cirugía coronaria con circulación extra corpórea y corazón batiente en pacientes de alto riesgo

    OpenAIRE

    SEGUEL S,ENRIQUE; FARÍAS M,JUAN; González L,Roberto; ALARCÓN C,EMILIO; STOCKINS L,ALECK; CÁRDENAS M,PATRICIO

    2011-01-01

    Introducción: La técnica habitual para la cirugía coronaria incluye el uso de circulación extracorpórea (CEC) y cardioplejia. En pacientes de alto riesgo esta cirugía tiene alta morbi-mortalidad. La cirugía con CEC y corazón batiente es una alternativa para estos casos. Se describe nuestra experiencia con la técnica. Pacientes y Métodos: 11 pacientes operados entre 2007 y 2008, 10 hombres (promedio 59,5 años). Cuatro pacientes con infarto en evolución, dos con lesión de tronco coronario izqui...

  10. Sustitución valvular mitral con perfusión coronaria contínua y el corazón latiendo

    OpenAIRE

    Mojena Morfa, Guillermo

    2010-01-01

    Existe un interés creciente por realizar revascularizaciones miocárdicas con el corazón latiendo, sin pinzamiento aórtico y siempre que sea posible, sin el uso de la máquina de circulación extracorpórea (CEC), debido a que se pueden obtener mejores resultados que los que se observan con técnicas de protección miocárdica con soluciones cardioplégicas. Esto condujo a nuestro grupo a considerar también la realización de sustitución valvular mitral (SVM) con perfusión coronaria continua y el cora...

  11. ¿Se están alcanzando las metas en el perfil lipídico de personas con enfermedad coronaria previa?

    Directory of Open Access Journals (Sweden)

    Alonso Merchán

    Full Text Available Objetivos: verificar el nivel de cumplimiento de las metas en colesterol LDL, colesterol no-HDL, triglicéridos y colesterol HDL, de acuerdo con lo indicado por la guía del NCEP-ATPIII y las recomendaciones actuales, en una población de pacientes hospitalizados por causa no cardiovascular pero con antecedente de enfermedad coronaria. Analizar, además, los hipolipemiantes que utiliza esta población, así como la prevalencia de síndrome metabólico, glucemia anormal en ayunas y diabetes mellitus tipo 2. Metodología: el porcentaje de cumplimiento de estas metas se evaluó mediante el programa de análisis estadístico STATA. Se compararon los hallazgos del perfil lipídico con la propuesta de la guía del NCEP-ATPIII y las recomendaciones actuales (punto final primario. Igualmente, se analizaron los hipolipemiantes utilizados, así como la prevalencia de glucemia anormal en ayunas, diabetes mellitus tipo 2 y síndrome metabólico (punto final secundario. Resultados: se identificaron 281 pacientes que cumplían con los criterios de inclusión. En la tabla 2 se resumen los resultados del punto final primario. De acuerdo con el NCEP-ATPIII, en el riesgo alto, el porcentaje de pacientes que cumplían con las metas en el cLDL (objetivo principal en el tratamiento de las dislipidemias, era de 57,2 y en el riesgo muy alto de 23,5%. En la actualidad, a los pacientes con enfermedad coronaria, independiente de la presencia de síndrome metabólico o diabetes mellitus, se les recomienda una meta para el cLDL menor de 70 mg/dL (Recomendación IIa, la cual se observó en 21,7% de los pacientes estudiados. La prevalencia de glucemia anormal en ayunas fue de 25,6%, la de diabetes mellitus tipo 2 de 20% y la de síndrome metabólico de 45,2%. Con respecto a los hipolipemiantes utilizados, se observó que 56% usaba lovastatina, 14% no utilizaba hipolipemiantes y ninguno tenía asociación de estos fármacos. Conclusiones: después de nueve años de la

  12. Anterior crucate ligament (ACL) injury

    Science.gov (United States)

    ... An anterior cruciate ligament injury is the over-stretching or tearing of the anterior cruciate ligament (ACL) ... may be injured. This is a medical emergency. Prevention Use proper techniques when playing sports or exercising. ...

  13. Angioplastia del tronco de la arteria coronaria izquierda no protegido en pacientes con alto riesgo quirúrgico

    Directory of Open Access Journals (Sweden)

    Victor Mauro

    2008-01-01

    Full Text Available IntroducciónEl tratamiento de elección de la enfermedad del tronco de la coronaria izquierda (TCI es la cirugía de revascularización miocárdica (CRM. Un número creciente de pacientes presenta comorbilidades y/o inestabilidad clínica que condicionan un alto riesgo quirúrgico.ObjetivosEvaluar los resultados de la angioplastia (ATC del TCI no protegido en pacientes con alto riesgo para CRM (EUROSCORE = 6.Material y métodosDe 59 pacientes con ATC de TCI no protegido se excluyeron 8 con infarto agudo de miocardio (IAM en shock cardiogénico y 12 sin características de alto riesgo; de los restantes pacientes de alto riesgo fueron objeto de este estudio los 32 tratados con stents convencionales.Se comparó la mortalidad hospitalaria predicha por EUROSCORE logístico con la observada, así como la incidencia de complicaciones mayores y su evolución alejada.ResultadosLa mediana de edad fue de 76,5 años, el 41% tenía 80 años o más, el 22% eran mujeres, el 28% diabéticos, el 56% tenía disfunción ventricular moderada a grave, el 31% insuficiencia renal crónica, el 50% vasculopatía periférica, el 53% angina refractaria, el 22% IAM reciente, el 28% procedimientos de emergencia y la mediana de EUROSCORE fue de 10,5 puntos.El 41% de los pacientes presentaban compromiso del TCI distal. El éxito angiográfico fue del 94%. Se utilizaron inhibidores IIb/IIIa en el 47%, cutting balloon en el 28%, Rotablator® en el 3% y balón de contrapulsación en el 31%. En todos se implantó un stent y en el 50% se trataron otras obstrucciones.La mortalidad hospitalaria fue del 3,1% (intervalo de confianza del 95% 0,2%-14,5%, p = 0,003, en tanto que la predicha era del 23,8%. Ningún paciente presentó déficit neurológico, IAM transmural ni requirió diálisis. Un paciente debió ser sometido a CRM electiva por fracaso del procedimiento.La mediana de seguimiento fue de 15,5 meses, período en el que se registraron 6 muertes (2 cardiovasculares y 4

  14. Diabetes y Enfermedad Coronaria

    OpenAIRE

    Alfredo Jácome Roca

    1997-01-01

    La Diabetes Mellitus es un síndrome con etiología multifactorial y con variadas expresiones en la clínica y en las complicaciones. Las formas más comunes son la diabetes tipo 11 o diabetes no insulino dependiente (DMNID) y la tipo 1 (antigua juvenil) o insulino-dependiente (DMID). Las más notables diferencias entre la frecuencia e intensidad de sus manifestaciones clínicas y complicaciones así como de su etiología son muy conocidas pero las anotaremos a manera de repaso.

    <...

  15. Facetas em dentes anteriores

    OpenAIRE

    Veloso, Helena Rafaela Lourenço Martins

    2015-01-01

    Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária A presente revisão bibliográfica aborda as facetas estéticas em dentes anteriores, pela crescente valorização de um sorriso esteticamente agradável, facto que faz com que as pessoas procurem cada vez mais alternativas de tratamento para melhorar a aparência do seu sorriso. Os dentes anteriores são decisivos na aparência estética e, c...

  16. Anterior Urethral Valves

    Directory of Open Access Journals (Sweden)

    Vidyadhar P. Mali

    2006-07-01

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

  17. Intradural anterior transpetrosal approach.

    Science.gov (United States)

    Ichimura, Shinya; Hori, Satoshi; Hecht, Nils; Czabanka, Marcus; Vajkoczy, Peter

    2016-10-01

    The standard anterior transpetrosal approach (ATPA) for petroclival lesions is fundamentally an epidural approach and has been practiced for many decades quite successfully. However, this approach has some disadvantages, such as epidural venous bleeding around foramen ovale. We describe here our experience with a modified technique for anterior petrosectomy via an intradural approach that overcomes these disadvantages. Five patients with petroclival lesions underwent surgery via the intradural ATPA. The intraoperative hallmarks are detailed, and surgical results are reported. Total removal of the lesions was achieved in two patients with petroclival meningioma and two patients with pontine cavernoma, whereas subtotal removal was achieved in one patient with petroclival meningioma without significant morbidity. No patient experienced cerebrospinal fluid leakage. The intradural approach is allowed to tailor the extent of anterior petrosectomy to the individually required exposure, and the surgical procedure appeared to be more straightforward than via the epidural route. Caveats encountered with the approach were the temporal basal veins that could be spared as well as identification of the petrous apex due to the lack of familial epidural landmarks. The risk of injury to the temporal bridging veins is higher in this approach than in the epidural approach. Intradural approach is recommended in patients with a large epidural venous route, such as sphenobasal and sphenopetrosal vein. Navigation via bone-window computed tomography is useful to identify the petrous apex.

  18. Migration and mental health: Japanese Brazilians in Japan and in Brazil Migração e saúde mental: brasileiros descendentes de japoneses no Japão e no Brasil

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    Lincoln Sakiara Miyasaka

    2007-01-01

    Full Text Available OBJECTIVE: Brazil is the country with the largest community of Japanese descendants in the world, from a migration movement that started in 1908. However, more recently (1988, a movement in the opposite direction began. Many of these descendants went to Japan for work purposes and suffered mental distress. Some of them sought treatment in Japan, while others returned to Brazil to seek treatment. The aim of the present study was to compare the sociodemographic profile and diagnoses of Japanese Brazilian psychiatric outpatients in Japan (remaining group and in Brazil (returning group. METHOD: All consecutive Japanese Brazilian outpatients who received care from the psychiatric units in Japan and Brazil from April 1997 to April 2000 were compared. The diagnoses were based on ICD-10 and were made by psychiatrists. Sociodemographic data and diagnoses in Brazil and Japan were compared by means of the Chi-Squared Test. RESULTS: The individuals who returned to Brazil were mostly male and unmarried, had lived alone in Japan, had stayed there for short periods and were classified in the schizophrenia group. The individuals who remained in Japan were mostly female and married, were living with family or friends, had stayed there for long periods and were classified in the anxiety group. Logistic regression showed that the most significant factors associated with the returning group were that they had lived alone and stayed for short periods (OR = 0.93 and 40.21, respectively. CONCLUSION: We conclude that living with a family and having a network of friends is very important for mental health in the context evaluated.OBJETIVO: O Brasil é o país com a maior comunidade de descendentes japoneses do mundo (migração iniciada em 1908. No entanto, mais recentemente (1988 um movimento migratório em direção oposta se iniciou. Muitos desses descendentes têm migrado para o Japão a trabalho e sofrem distúrbios mentais. Alguns deles procuram tratamento no Jap

  19. Cirurgia da aorta descendente e tóraco-abdominal com técnica de oclusão proximal isolada da aorta ("open distal" Surgical treatment of descending thoracic and thoracoabdominal aorta with the "open distal" technique

    Directory of Open Access Journals (Sweden)

    Bayard Gontijo Filho

    1995-09-01

    Full Text Available O presente relato apresenta a experiência obtida em um período de 4 anos (jan/91 - jan/95 com a técnica "open distal" descrita por Cooley, em 1990³, para tratamento cirúrgico de doenças da aorta torácica descendente e aorta tóraco-abdominal. Nesse período foram realizadas 35 operações (25 para aorta descendente e 10 para aorta tóraco-abdominal. Os aneurismas de origem degenerativa e as dissecções aórticas ocorreram em freqüência semelhante (48,5% e 40%, respectivamente; em 8 pacientes havia rotura da aorta, parcialmente tamponada pelo pulmão (5 casos, órgãos abdominais (2 casos e esófago (1 caso. O acesso cirúrgico foi obtido por toracotomia póstero-lateral esquerda ou tóraco-freno-laparotomia. Heparina foi usada na dose de 1,5 mg/kg e todo sangue do campo cirúrgico foi coletado a um reservatório e reinfundido pela veia femoral. Houve 4 (11.4% óbitos hospitalares e 2 (5,8% pacientes portadores de aneurisma tóraco-abdominal desenvolveram paraplegia. A morbi-mortalidade do grupo foi diretamente relacionada à condição clínica per-operatória e à extensão do segmento aórtico acometido. Na nossa opinião, a técnica "open distal" é um método alternativo simples e eficaz no tratamento cirúrgico das doenças da aorta descendente e tóraco-abdominal. Em casos de ressecções extensas com períodos longos de oclusão aórtica, métodos para proteção medular deverão ser avaliadosSince Jan/91 we have been using the "open distal" technique (ODT described by Cooley, for surgical treatment of diseases of the descending thoracic and thoracoabdominal aorta. From jan/91 to jan/95, the technique was used in 35 instances (25 for descending aorta and 10 for thoracoabdominal aorta. Degenerative aneurysms and aortic dissections had similar incidence in this group (48.5% and 40.0%, respectively. In 8 patients the aorta was ruptured which was partially occluded by the lung (5 cases, abdominal organs (2 cases and esophagus (1

  20. Enterorrafias em plano aposicional convencionale com adesivo à base de cianoacrilato no cólon descendente de eqüinos Conventional appositional pattern and cyanoacrylate tissue adhesive in descending colon enterorrhaphy in horses

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    Claudia Acosta Duarte

    2002-08-01

    Full Text Available Em eqüinos, as enterotomias no cólon descendente são necessárias para remover enterólitos, corpos estranhos e material alimentar compactado que não podem ser removidos por técnicas conservativas. Este segmento intestinal possui um suprimento sangüíneo pobre, além de predisposição a complicações pós-operatórias relacionadas à contaminação bacteriana. Assim, este estudo foi conduzido com o objetivo de efetuar avaliações clínicas e anatomopatológicas do emprego de adesivo tecidual à base de cianoacrilato no cólon descendente de eqüinos, comparando-o a uma técnica de sutura aposicional convencional. A intervenção cirúrgica foi realizada em 15 animais posicionados em decúbito lateral direito, através de laparotomia pelo flanco esquerdo, sob anestesia geral inalatória. Após a exteriorização do cólon descendente, foram realizadas duas enterotomias de cinco centímetros de extensão cada, distanciadas 20cm uma da outra. Os animais foram aleatoriamente distribuídos em cinco tempos de observação de três animais cada e sacrificados aos três, sete, 14, 35 e 70 dias de pós-operatório. O adesivo butil-2-cianoacrilato e o fio de poliglactina 910 mostraram-se igualmente apropriados para uso em enterorrafias desse órgão, sendo que o fio de poliglactina 910 provocou inflamação inicial mais intensa que o cianoacrilato e, mais tardiamente, ambos causaram inflamação granulomatosa do tipo corpo estranho observada, primeiramente, junto ao fio de poliglactina 910 (7º dia e, a partir do 35º dia, ao redor do cianoacrilato.The descending colon enterotomies in horses are necessary to remove enteroliths, foreign body and impacted material that can not be removed with conservative technique. This intestinal segment has a poor blood supply and the predisposition to post operation complications related to bacterium contamination. This trial was conducted in order to evaluate, clinically and anatomopathologically, the use of

  1. Anterior knee pain

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-04-15

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

  2. Seguridad de la angiografía por tomografía computada coronaria en pacientes con dolor torácico agudo para el alta del servicio de urgencias

    Directory of Open Access Journals (Sweden)

    G. Castrillon

    2016-07-01

    Conclusión: La angio-TC coronaria es una ayuda diagnóstica útil para la valoración de pacientes con dolor torácico agudo. Constituye una herramienta segura y de rápida realización, que permite definir los resultados negativos o la existencia de placas no obstructivas desde el mismo servicio de urgencias.

  3. The anterior cingulate cortex

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2009-01-01

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

  4. Myocardial infarction induced by oral terazosin in a patient with predisposing structural cardiomyopathy: case report

    Directory of Open Access Journals (Sweden)

    Alejandro Vidal Margenat

    2016-06-01

    Full Text Available Describimos el caso de un hombre de 71 años de edad, que presentó un infarto agudo de miocardio debido a la obstrucción dinámica del tracto de salida del ventrículo izquierdo inducida por la terazosina. Luego de recibir dicha medicación el paciente presentó un síncope y posteriormente angina de pecho. El electrocardiograma evidenció ondas Q y sobreelevación del segmento ST en las derivaciones precordiales e inferiores. La angiografía coronaria evidenció una oclusión crónica de la arteria descendente anterior y el ecocardiograma Doppler reveló aquinesia apical, segmentos basales hiperdinámicos, movimiento anterior sistólico de la válvula mitraI y obstrucción dinámica del tracto de salida del ventrículo izquierdo. La administración intravenosa de suero fisiológico y atenolol determinó una clara mejoría clínica. Un infarto agudo de miocardio hemodinámico fue el resultado de la caída de la presión de perfusión coronaria en un paciente con disminución crónica de la reserva coronaria.

  5. Resistencia al ácido acetil salicílico en pacientes con enfermedad coronaria Acetylsalicylic acid resistance in patients with chronic ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Boris E. Vesga

    2006-08-01

    Full Text Available Introducción: la anti-agregación plaquetaria es "piedra angular" en el tratamiento de la enfermedad cardiovascular. El ácido acetil salicílico es la terapia de elección en dosis entre 81-325 mg para la prevención y tratamiento de la enfermedad coronaria. Objetivo: caracterizar la agregación plaquetaria en sujetos con enfermedad coronaria estable, consumidores de ácido acetil salicílico, para determinar la prevalencia de resistencia. Metodología: previa aprobación por los Comités de Ética y de Investigaciones de la Institución, se efectuó un estudio descriptivo transversal en sujetos de 40 años y mayores, con diagnóstico de angina estable que ingresaron para realización de angiografía coronaria. Se obtuvo una muestra de sangre venosa periférica para determinar la agregación plaquetaria mediante ácido araquidónico, epinefrina, colágeno y ADP en un agregómetro HELENA PACKS-4. La resistencia al ácido acetil salicílico se definió al tener agregaciones con ácido araquidónico mayores al 20%. El análisis estadístico se desarrolló con la prueba exacta de Fisher, prueba t de Student y Mann-Whitney de acuerdo con la distribución de las variables. Resultados: se incluyeron 71 sujetos; 51 (71,8% varones, edad 63,5 ± 9,4 años. Con factores de riesgo: 52 (73,2% con dislipidemia, 48 (67,6% con hipertensión arterial, 15 (21,1% con diabetes mellitus y 9 (12,7% con tabaquismo. Angiografía coronaria con enfermedad de 1 vaso en 31 (15,9%, y enfermedad multivaso en 58 (81,7%. Los valores de agregometría plaquetaria obtenidos fueron: ADP 64 ± 19,1%, colágeno 72 ± 18,9%, epinefrina 43,8 ± 23,9% y ácido araquidónico 26,1 ± 33,7%, siendo este el mejor marcador del efecto del ácido acetil salicílico. La prevalencia de resistencia fue de 28,2% (IC 95%: 18,1-40,1. Conclusión: la resistencia al ácido acetil salicílico en nuestra población es altamente prevalente, por lo que se debe considerar la medición de rutina de la

  6. Análisis de costos médicos y resultados de la cirugía coronaria sin circulación extracorpórea

    Directory of Open Access Journals (Sweden)

    Raúl A. Borracci

    2006-01-01

    Full Text Available Antecedentes Algunos estudios han sugerido que la cirugía coronaria “sin bomba” disminuiría la morbimortalidad posoperatoria y reduciría los costos al compararlos con la cirugía tradicional. Una característica regional importante para la Argentina es el alto costo de los insumos, en su mayoría importados, y el relativo bajo costo de internación, lo cual crea condiciones locales diferentes al pretender comparar la relación costo-efectividad de la cirugía sin circulación extracorpórea (CEC. Objetivos Realizar una evaluación de los costos médicos y los resultados de la cirugía coronaria sin CEC en comparación con la técnica tradicional y estimar a la vez su relación costo-eficacia. Material y métodos El análisis retrospectivo de costos se realizó a partir de una serie de 200 cirugías coronarias con CEC y sin CEC, efectuadas entre 2004 y 2005. Se empleó la técnica de microcosteo directo para determinar los costos de quirófano y se extrapoló el valor día/cama de la internación, de acuerdo con los datos suministrados por el prestador, para el caso de cirugías sin complicaciones (caso base. La influencia de las complicaciones en el costo final se estimó en forma indirecta mediante el uso de las tasas de complicaciones publicadas en ensayos clínicos controlados y su correspondiente costo incremental por evento, según modelos probabilísticos publicados previamente. Por tratarse de un modelo parcialmente estocástico, se informan sólo los costos netos con uno y otro procedimiento, a fin de obtener la diferencia o beneficio neto entre el uso de cirugía con CEC y sin CEC. Finalmente, se realizó un análisis de sensibilidad de costos por medio de una simulación dinámica computarizada (parámetros predictores: número de usos del estabilizador y tasa de uso de cirugía sin CEC. Resultados En una cirugía coronaria que evoluciona sin complicaciones, el costo se halló entre $9.340 y $12.540 (mediana = $10.750 para el

  7. A identidade dos descendentes de alemães em "Um rio imita o Reno", de Vianna Moog * The identity of German descendants on “Um rio imita o Reno”, by Vianna Moog

    Directory of Open Access Journals (Sweden)

    JULIANA BEZERRA OLIVEIRA SACHINSKI

    2014-05-01

    Full Text Available Resumo: Este artigo irá abordar o âmbito das questões de integração cultural do povo alemão na obra de autor brasileiro Vianna Moog, Um Rio Imita o Reno. O espaço do romance é marcado pela existência de uma cidade imaginária chamada Blumental, e o próprio trabalho traz aspectos muito representativas da cultura do sul do Brasil, marcados por estereótipos e costumes originários das tradições dos imigrantes que viveram nesta região e seus descendentes.Palavras-chave: Vianna Moog – Identidade – Estudos culturais. Abstract: This article will address the scope of the issues of cultural integration of German people in the work of Brazilian author Vianna Moog, Um Rio Imita o Reno. The space of this novel is marked by the existence of an imaginary city called Blumental, and the work itself brings aspects very representative of the culture of southern Brazil, marked by stereotypes and customs originating in the traditions of immigrants who have lived in this region and their descendants.Keywords: Vianna Moog – Identity – Cultural studies.

  8. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  9. Anterior knee pain: uncommon aetiologies

    Directory of Open Access Journals (Sweden)

    Q. Louw

    2003-02-01

    Full Text Available The aim of this review is to inform clinicians of less common causes of anterior knee pain. Relatively less common conditions leading to anterior knee pain include infra-patellar contracture syndrome, conditions affecting the fat pad, saphenous nerve entrapment, prepatellar neuromas, increased intraosseous pressure of the patella, ganglions of the anterior cruciate ligament and cysts. The aetiology, clinical presentation, risk factors and management  of each condition are outlined. Due to the common occurrence of anterior knee pain clinicians must remain vigilant in assessing the cause of this clinical presentation.

  10. Asociación entre la capacidad de la agencia de autocuidado y la adherencia a tratamientos farmacológicos y no farmacológicos en personas con alguna condición de enfermedad coronaria

    Directory of Open Access Journals (Sweden)

    CLARA VICTORIA BASTIDAS SÁNCHEZ

    2007-12-01

    Full Text Available El propósito del estudio con un diseño descriptivo, transversal y correlacional- fue explorar la relación entre agencia de autocuidado y adherencia en 115 pacientes con enfermedad coronaria seleccionados intencionalmente de una población de pacientes coronarios que asistieron a la consulta de cardiología en una clínica de la ciudad de Ibagué durante cuatro meses del año 2005. Se midió la capacidad de la agencia con el instrumento Evaluación de la Capacidad de la Agencia de Autocuidado, validado en su versión al español, y se calculó la adherencia a tratamientos farmacológicos y no farmacológicos en el mismo grupo mediante una escala que corresponde al resultado de adherencia y sus indicadores de la taxonomía NOC acompañada de una guía de valoración. Esa escala traducida al español fue evaluada en su comprensión por un grupo de enfermeras con experiencia clínica y docente en el área. El perfil clínico del grupo consistió en tres grupos, de acuerdo con la complejidad del régimen de medicamentos: 24, 58, 911 y de la condición de la enfermedad coronaria con tratamiento convencional, enfermedad coronaria con tratamiento intervencionista y pacientes con falla coronaria. Mediante pruebas de correlación tipo Pearson se pudo confirmar una asociación moderadamente positiva entre la capacidad de la agencia de autocuidado y la adherencia a tratamientos farmacológicos y no farmacológicos, aspecto este que se había sugerido al proponer el estudio; es decir que la adherencia y la capacidad de la agencia de autocuidado son comportamientos positivos que están presentes con características similares en personas con enfermedad coronaria como las de esta muestra. Se confirmó que la complejidad del régimen terapéutico tiene influencia en la adherencia, aun cuando en este grupo solo se mostró en una manera leve pero positiva, concordante con lo encontrado en otros estudios reportados por la OMS.

  11. Angioplastia coronaria en centros con residencia de cardiología en la Argentina. Estudio CONAREC XIV - Área de Investigación de la SAC

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    Bruno Linetzky

    2007-01-01

    Full Text Available IntroducciónLos nuevos tratamientos médicos y los avances técnicos, junto con la mayor experiencia adquirida en cardiología intervencionista, hicieron necesaria la realización de este nuevo registro, el protocolo CONAREC XIV, sobre empleo de angioplastia coronaria (ATC, un procedimiento que es seguro y eficaz para el tratamiento de la enfermedad coronaria.ObjetivoEvaluar las características de los pacientes, las indicaciones y los resultados de la ATC en nuestro país.Material y métodosSe realizó un registro prospectivo y consecutivo durante 6 meses de pacientes tratados con ATC en centros con residencia de cardiología. Se determinaron antecedentes, cuadro clínico de ingreso, tratamiento, resultados y complicaciones intrahospitalarias.ResultadosSe registraron 1.500 pacientes. La edad promedio fue de 62,8 ± 10,8 años y el 78,3% eran hombres. Antecedentes: 72% hipertensión arterial, 56,6% dislipidemia, 19,2% diabetes y 22,4% tabaquismo. Los cuadros clínicos de presentación fueron: 20% asintomáticos, 16,2% angina crónica estable, 45% síndrome coronario agudo sin supradesnivel del ST (SCA-SST, 19% síndrome coronario agudo con supradesnivel del ST (IAM-ST. En el 74,7% de los casos se realizó ATC de un vaso. Se utilizaron stents en el 94,5% de los casos y en el 18,7%, stents liberadores de drogas. El uso de pruebas funcionales previas a la ATC en cuadros estables fue del 53,9%, mientras que en el SCA-SST fue del 31,6%. La mediana de tiempo de evolución hasta la ATC en el SCA-SST fue de 1 día con un rango intercuartil 25-75% (RIC de 0 a 3. En el IAM-ST, el tiempo puerta-balón fue de 60 minutos (RIC 40-105 y la mortalidad fue del 8%.ConclusionesLa ATC se utiliza principalmente para el tratamiento de síndromes coronarios agudos. Se evidenció una tasa alta de uso de stents y de stents liberadores de drogas. El empleo de pruebas funcionales fue bajo. La tasa de complicaciones fue similar a la de los registros internacionales.

  12. Evaluación de los niveles plasmáticos de células progenitoras en pacientes con enfermedad coronaria crónica

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    Juan Gagliardi

    2007-01-01

    Full Text Available IntroducciónEl ejercicio físico es útil para los pacientes con enfermedad coronaria y es un estímulo para el desarrollo de circulación colateral. Ésta podría estar determinada por un aumento en la producción y circulación de células progenitoras.ObjetivoEvaluar el efecto del ejercicio físico programado sobre la producción y el número circulante de células progenitoras en pacientes coronarios crónicos estables.Material y métodosEstudio prospectivo, controlado, aleatorizado y abierto con la inclusión de 18 pacientes (8 en grupo ejercicio y 10 en grupo control con enfermedad coronaria estable, < 75 años, que no hubieran participado en grupos de ejercicio programado en los últimos 3 meses. La determinación de las células progenitoras se realizó por citometría de flujo utilizando marcaciones con anticuerpos monoclonales CD45-FITC, CD34-FITC y CD133/1-PE.ResultadosEn el grupo control, el nivel de CD45 no tuvo variación significativa (0,724 ± 0,256 versus 0,765 ± 0,216 [media ± EE cada 100.000 eventos], mientras que en el grupo ejercicio el nivel de CD45(+/CD133(+ se incrementó de 0,497 ± 0,161 a 2,265 ± 1,003 luego de un mes de actividad física programada sin alcanzar significación estadística.Al analizar los niveles de CD34 se observó que en el grupo control se incrementaron de 0,196 ± 0,086 a 0,235 ± 0,063 (p = NS. En el grupo ejercicio, la variación fue mucho mayor: 0,220 ± 0,078 a 0,844 ± 0,172 (p = 0,0046; p = 0,0092 versus el grupo control. ConclusiónEl ejercicio físico programado en pacientes coronarios promueve un incremento de las células progenitoras circulantes. Su estímulo persistente podría ser la base para un mayor desarrollo de circulación colateral.

  13. Cirugía coronaria sin circulación extracorpórea versus cirugía coronaria con mini-circulación extracorpórea comparación de parámetros hematológicos y evolución postoperatoria /

    OpenAIRE

    Muñoz Guijosa, Christian

    2009-01-01

    Descripció del recurs: 5 novembre 2010 INTRODUCCIÓN La incidencia de la cardiopatía isquémica es cada día mayor. El desarrollo de nuevas técnicas para su tratamiento, conlleva que los pacientes derivados para cirugía de revascularización presenten mayor edad, mayor comorbilidad y peores anatomías coronarias. El riesgo quirúrgico de esta población es, consecuentemente, cada vez mayor. La cirugía de revascularización miocárdica supone la intervención más frecuente realizada en todos los Serv...

  14. [Anterior cervical hypertrichosis: case report].

    Science.gov (United States)

    Orozco-Gutiérrez, Mario H; Sánchez-Corona, José; García-Ortiz, José E; Castañeda-Cisneros, Gema; Dávalos-Rodríguez, Nory O; Corona-Rivera, Jorge R; García-Cruz, Diana

    2016-10-01

    The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years.

  15. Origen anómalo de la arteria coronaria izquierda originándose de la arteria pulmonar. Reporte de caso y revisión de literatura

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    José Jiménez Vega

    2007-01-01

    Full Text Available Se presenta el caso de un lactante de 2 meses de edad que consultó por tos y dificultad respiratoria; al ser admitido en el servicio de urgencias, el abordaje inicial fue de una infección respiratoria baja (bronquiolitis pero la evolución tórpida y la presencia de cardiomegalia hizo sospechar una cardiopatía, diagnosticándose origen anómalo de la arteria coronaria izquierda que nace de la arteria pulmonar, la cual fue tratada quirúrgicamente con resultado favorable.2 month old male who was brought to the emergency department with a history of non productive cold, was noticed with difficulty breathing. He was admitted with the possible diagnosis of bronquioloitis. The poor evolution of the patient, and the presence of cardiomegaly, made the physicians look for a cardiopathy, and a diagnosis of anomalous left coronary artery from the pulmonary artery was made. He was stabilized and then was taken to the operating room and had his anomalous coronary artery reimplanted to his aorta

  16. Coronary artery abnormalities in pediatric patients: classification. Anomalías de las arterias coronarias en pacientes pediátricos: clasificación.

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    José Jesús García Mendiola

    Full Text Available Coronary artery anomaly is defined as any anatomical pattern that is apart from the normal element in regard to their origin, number, distribution and course. Through different mechanisms, it could be the cause of t thoracic pain, sudden death, myocardiopathy, syncope, myocardial infarction and ventricular fibrillation. These constitute a group of malformations which can be classified into, congenital, acquired and associated to other cardiac entities malformations. Due to the importance of this topic for cardiologists and specifically to pediatric cardiologists, this bibliographical revision about abnormalities classification is carried out.
    Se define como anomalía de las arterias coronarias a cualquier patrón anatómico que se aparte de lo normal en lo referente a su origen, número, distribución y trayecto. Mediante diferentes mecanismos, pueden ser la causa de dolor torácico, muerte súbita, miocardiopatía, síncope, infarto de miocardio y fibrilación ventricular. Constituyen un grupo de malformaciones que pueden clasificarse en: congénitas, adquiridas y asociadas a otras entidades cardiacas. Por la importancia que reviste para cardiólogos en general y sobre todo para cardiólogos pediatras, se realiza una revisión bibliográfica acerca de la clasificación de estas anomalías.

  17. Inestabilidad Anterior de Hombro

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    Pablo David Flint Kuran

    2013-11-01

    Full Text Available In­tro­duc­ción La luxación recidivante de hombro es una patología frecuente en pacientes jóvenes, laboralmente activos. Existen numerosas técnicas quirúrgicas para la inestabilidad glenohumeral. La técnica de Bristow, discutida por no ser anatómica y por sus complicaciones, continúa vigente debido al bajo índice de reluxaciones. Los objetivos fueron determinar el índice de recidiva, alteraciones funcionales e índice de consolidación del injerto. Materiales­ y­ Métodos Se evaluaron 24 pacientes del sexo masculino, de entre 19 y 40 años, operados por luxación anterior recidivante de hombro según la técnica de Bristow, entre enero de 2003 y agosto de 2011. Se evaluó la tasa de reluxación, la función articular según el puntaje de Constant y el posicionamiento del injerto con respecto a la superficie articular con tomografía y radiografías para evaluar la consolidación del injerto. Se registraron las complicaciones quirúrgicas. Resultados ­Todos los pacientes eran hombres, con rango de edad de 19 a 40 años. La causa fue traumática en 24 pacientes. Dieciséis pacientes presentaron más de 3 episodios de luxación prequirúrgicos. Según la escala de Constant, 21 obtuvieron entre 96 y 100 puntos, y los restantes, entre 90 y 95 puntos. No hubo nuevos episodios de luxaciones. La tomografía mostró la consolidación en todos los casos. Un paciente tuvo una imagen osteolítica alrededor del tornillo, sin compromiso funcional del hombro. Conclusión La técnica de Bristow para tratar la luxación anterior recidivante de hombro provocó un bajo índice de complicaciones, con resultados funcionales entre excelentes y buenos. No hubo episodios de reluxación y se logró la consolidación del injerto óseo en todos los casos.

  18. Transesophageal access to the cardiac cavities and descending thoracic aorta via echoendoscopy: An experimental study Acceso transesofágico a cavidades cardiacas y aorta torácica descendente mediante ecoendoscopia: Estudio experimental

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    A. López Martín

    2009-09-01

    trabajo pretenden evaluar la anatomía cardiaca, su abordaje, la seguridad del procedimiento experimental y los cambios morfológicos e histológicos derivados. Material y métodos: se ha trabajado con dos animales adultos de la especie porcina a los que se han practicado diversos abordajes a cavidades cardiacas y aorta torácica descendente con excelentes resultados. Resultados: se han identificado y abordado diversas estructuras cardiacas (aurícula derecha, aurícula izquierda, ventrículo izquierdo, válvulas cardiacas y grandes vasos. El uso de contraste intracavitario y desde una vía venosa periférica ha permitido asegurar los espacios anatómicos estudiados. Durante los procedimientos se ha monitorizado la aparición de arritmias, el comportamiento hemodinámico, la posibilidad de infección mediante la obtención de hemocultivos antes y después de aquellos y la respuesta a las punciones. Conclusiones: el presente trabajo nos ha permitido evaluar el acceso al corazón desde la luz esofágica mediante ultrasonografía endoscópica, con unos resultados muy similares a los observados en la literatura, ofreciendo dos novedades como la punción de la aurícula derecha a través del tabique interauricular y de la aorta torácica descendente, de forma fácil y aparentemente segura.

  19. Anterior Knee Pain (Chondromalacia Patellae).

    Science.gov (United States)

    Garrick, James G.

    1989-01-01

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

  20. Diffuse anterior retinoblastoma: current concepts

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    Yang J

    2015-07-01

    Full Text Available Jing Yang,1–3 Yalong Dang,1–3 Yu Zhu,1 Chun Zhang2,3 1Department of Ophthalmology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou City, Henan Province, 2Department of Ophthalmology, Peking University Third Hospital, 3Clinical Stem Cell Research Center, Peking University Third Hospital, Beijing, People’s Republic of China Abstract: Diffuse anterior retinoblastoma is a rare variant of retinoblastoma seeding in the area of the vitreous base and anterior chamber. Patients with diffuse anterior retinoblastoma are older than those with the classical types, with the mean age being 6.1 years. The original cells of diffuse anterior retinoblastoma are supposed to be cone precursor. Patients most commonly present with pseudouveitis, pseudohypopyon, and increased intraocular pressure. The retina under fundus examination is likely to be normal, and the clinical features mimic the inflammation progress, which can often lead to misdiagnosis. The published diffuse anterior retinoblastoma cases were diagnosed after fine-needle aspiration biopsy running the potential risk of inducing metastasis. The most common treatment for diffuse anterior retinoblastoma is enucleation followed by systematic chemotherapy according to the patient’s presentation and clinical course. This review summarizes the recent advances in etiology (including tumorigenesis and cell origin, pathology, diagnosis, differential diagnosis, and new treatment. The challenges of early diagnosis and prospects are also discussed. Keywords: pathology, microenvironment, treatment, diagnosis 

  1. Anterior chamber depth during hemodialysis

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    Gracitelli CPB

    2013-08-01

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

  2. Evolución a medio plazo de los pacientes con enfermedad del tronco común intervenidos de revascularización coronaria con y sin circulación extracorpórea

    OpenAIRE

    Rios Barrera, Remedios

    2016-01-01

    La cardiopatía isquémica es la principal causa de mortalidad en el primer mundo. Existen varios abordajes terapéuticos pero la cirugía de revascularización coronaria con circulación extracorpórea es la terapéutica más extendida en el tratamiento de esta enfermedad dado sus buenos resultados tanto a corto, medio o largo plazo. No obstante, también es conocido que el empleo de la circulación extracorpórea puede conllevar una serie de efectos nocivos sobre el organismo. En un intento de evitar o...

  3. Aneurisma de tronco de coronaria izquierda y síndrome antifosfolípido: sobrevida a 12 años. Informe de un caso y revisión de la literatura

    OpenAIRE

    Paz Soldán-Patiño,Claudia Patricia; Rojas-Velasco,Gustavo; Arias-Mendoza,María Alexandra; Enríquez-Gómez,Edmundo; Meave-González,Aloha; Álvarez-Sangabriel,Amada; Amigo,Mary Carmen; Vargas-Barrón,Jesús; Martínez-Sánchez,Carlos Rodolfo

    2012-01-01

    Los aneurismas coronarios son una patología poco frecuente, con una incidencia anual del 1% a 2%. Su origen puede ser atereosclerótico, congénito o deberse a otras causas menos habituales. Su manifestación inicial puede ser el infarto de miocardio y la muerte súbita, como consecuencia de su rotura o por la existencia de trombos intracoronarios. Los aneurismas coronarios de gran tamaño, no ateroscleróticos y localizados en el tronco común de la arteria coronaria izquierda son excepcionales. El...

  4. Estudio comparativo de la tomografía computarizada coronaria versus la ecografía intracoronaria e histología virtual en el diagnostico de la vasculopatía del injerto tras el trasplante cardiaco

    OpenAIRE

    Romero Rodríguez, María de las Nieves

    2016-01-01

    Falta palabras clave La enfermedad vascular del injerto (EVI) constituye la primera causa de muerte en los pacientes trasplantados de corazón tras el primer año. Se caracteriza por una hiperplasia intimal coronaria difusa concéntrica cuyo diagnóstico es complejo en las fases iniciales, precisamente cuando es posible modificar las pautas de tratamiento, debido en gran parte a la denervación del injerto que provoca la ausencia de síntomas. La técnica de gold standar para el diagnóstico es la...

  5. Perfil clínico y seguimiento a largo plazo de los distintos síndromes anginosos sin lesiones coronarias significativas con prueba de esfuerzo positiva y negativa

    OpenAIRE

    Missorici, Mario Antonio

    2004-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada Introducción: La angina variante por vasoespasmo coronario y el síndrome X han sido mencionados como responsables de angina en ausencia de lesión coronaria significativa. Sin embargo no todos los pacientes en esta situación clínica cumplen criterios para ser agrupados en estas entidades patológicas. Pacientes y Métodos: Se estudiaron 328 pacientes consecutivos divididos en 4 grupos: A: Angina vasoespástica (n:165). B: Sí...

  6. Alteraciones en el eje hipotálamo-tejido adiposo y su relación con el riesgo para la aterosclerosis coronaria Alterations in hypothalamus-adipose tissue axis in relation with the risk of coronary atherosclerosis

    OpenAIRE

    Raúl I Coniglio; Ernesto Dahinten; Mónica Boeri; Fernanda Lebrun; Ana M. Monsalve

    2004-01-01

    Estudios poblacionales en la región sur de Argentina mostraron una elevada prevalencia de sobrepeso y obesidad en sujetos de ambos sexos, sobre todo luego de los 50 años de edad; la obesidad central se halló fuertemente asociada con la presencia del síndrome metabólico (SM) y con la enfermedad coronaria demostrada por angiografía. La regulación de la homeostasis de la energía se realiza a través de la interacción entre el sistema nervioso central (neurotransmisores y neuropéptidos) y el siste...

  7. Identificación de enfermedad cardiaca coronaria en individuos asintomáticos con diabetes mellitus: Tamizar o no tamizar

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    Paco Eduardo Bravo

    2015-03-01

    Full Text Available La enfermedad de la arterias coronarias (EAC es muy prevalente en pacientes con diabetes mellitus (DM, y continúa siendo la principal causa de muerte en estos pacientes. Desafortunadamente, muchos diabéticos pueden carecer de síntomas de alerta en la presencia de isquemia miocárdica, por lo cual el diagnóstico de EAC puede ocurrir de manera tardía. Estudios observacionales han sugerido que la prevalencia de isquemia miocárdica puede ser alta en diabéticos asintomáticos (10 al 62% según la serie y la mortalidad es mayor en esos pacientes. Por esto, el uso de pruebas para detección de EAC en el paciente diabético asintomático parece atractivo y es recomendado en ciertas circunstancias. Sin embargo, no fue si no hasta hace poco que dos estudios investigaron el verdadero rol de estas pruebas de manera randomizada. En conjunto, 2,023 pacientes diabéticos asintomáticos fueron aleatorizados a recibir o no una prueba para detección de EAC y fueron seguidos en promedio por 4.4 ± 1.4 años. Al final de seguimiento, ambos estudios mostraron menos eventos cardiovasculares de los esperados, y el uso de pruebas para detección de EAC no redujo la tasa de eventos cardiovasculares comparado al no uso de estas pruebas. Los resultados de estos ensayos clínicos no soportan actualmente el uso de estas pruebas en el paciente diabético asintomático. Sin embargo, estos estudios tienen limitaciones importantes, y posibles hipótesis para explicar los resultados que son discutidas en el artículo.

  8. Estudo da motilidade espontânea de segmentos de cólon ascendente, transverso e descendente de ratos, em banhos fisiológicos para órgãos isolados Study of spontaneous motility of parts of colon in physiologic chamber for isolated organ, in rats

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    Francisco Rodrigues de Sales

    2004-01-01

    Full Text Available OBJETIVO: Identificar as diferenças na freqüência, amplitude de contrações, traçados negativos e forma das ondas. MÉTODOS: Fez-se um estudo da motilidade espontânea de segmentos de cólon ascendente, transverso e descendente de ratas, em banhos fisiológicos para órgãos isolados. RESULTADOS: Verificou-se grande variabilidade de freqüências e amplitudes das contrações registradas. Embora tenha havido predominância de contrações fortes no cólon descendente e de contrações menores no cólon transverso, todos os tipos de ondas foram encontrados nos três segmentos. CONCLUSÕES: O cólon apresenta motilidade muito variável, não permitindo identificar padrão característico inconfundível para cada um dos três segmentos, ascendente, transverso e descendente. O cólon transverso apresentou maior quantidade de traçados negativos, menor amplitude de contrações e menor freqüência de contrações. O cólon descendente apresentou o menor número de traçados negativos e a maior média de amplitude de contrações dos três segmentos.PURPOSE: The aim was to identify the difference in frequency, amplitude of contractions, negative tracing and shape of the waves. METHODS: We made one study of spontaneous motility of parts of colon from mouse, in physiologic chamber for isolated organ. RESULTS: It was found the biggest frequence variability and amplitude of contractions registered. Although there has been predominancy of strong contractions in the descending colon and weaker contractions in the transverse one, all kinds of waves were found in the three segments. CONCLUSIONS: The colon shows variable motility, which does not permit identify the unmistakable characteristic pattern for each of the three segments, ascendent, transverse and descending. The transverse colon shows a bigger quantity of negative traces, smaller amplitude of contractions and less frequency of contractions. The descending colon showed a smaller number of

  9. Trombosis de la vena yugular interna y mediastinitis aguda necrosante descendente debido a una faringoamigdalitis aguda Thrombosis of the internal jugular vein and descending necrotizing mediastinitis due to acute pharyngotonsilitis

    Directory of Open Access Journals (Sweden)

    Celia Sánchez Acedo

    2010-09-01

    Full Text Available El síndrome de Lemierre es una patología muy infrecuente en la época actual, pero muy grave, y siempre debe considerarse ante un cuadro de fiebre con antecedente de infección orofaríngea, tumefacción laterocervical a lo largo del músculo esternocleidomastoideo y signos de sepsis. El diagnóstico de este síndrome es fundamentalmente clínico, y las pruebas complementarias tan sólo ayudan a confirmar el cuadro. Presentamos el caso de un varón de 31 años que acudió a urgencias con clínica de faringoamigdalitis junto con tumefacción en la región submandibular izquierda e importante dolor cervical ipsilateral, que mostró un deterioro rápido y progresivo del estado general pese al tratamiento antibiótico intravenoso. Finalmente tuvo que ser intervenido debido al desarrollo de mediastinitis aguda necrosante descendente desde la región pretiroidea hasta el diafragma, con trombosis de la vena yugular interna izquierda. Se le realizó toracotomía urgente y cervicotomía izquierda con drenaje de abundante material purulento y ligadura de la vena yugular interna.Lemierre syndrome is a potentially fatal condition after an oropharyngeal infection. It is characterized by thrombophlebitis of head and neck veins with systemic dissemination of septic emboli. The diagnosis of this syndrome is mainly clinical and complementary test only serve as aid to confirm it. We report an unusual case of Lemierre syndrome in a 31-year-old man caused by Gemella spp. and Streptococcus pyogenes. It developed following a pharyngotonsillitis infection, which deteriorated rapidly and progressively despite intravenous antibiotic treatment. He finally had to be intervened due to developing acute descending necrotizing mediastinitis from the pre-thyroid region to the diaphragm, with thrombosis of the internal jugular vein. An urgent thoracotomy and left cervicotomy was performed, with drainage of abundant purulent material and ligature of the internal jugular vein

  10. Efecto de la velocidad de deformación en la recristalización dinámica de un cobre ETP durante su compresión en caliente con temperatura descendente

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    Torrente, G.

    2011-12-01

    Full Text Available The main purpose of this project is to establish the effect of strain rate in the dynamic recrystallization of an ETP copper during its hot deformation with descending temperature. For this, there were made some tests of hot compression until true deformations close to one, with four strain rates while the temperature was descending. The tests that were made to the two lowest strain rates, showed a multiple peaks dynamic recrystallization with a rise of the tension instead it reaches the steady state, maybe due a continuous decline of the temperature.With the increase of rate the rest of the tests showed simple peak recrystallization and recovering respectively. The experimental results were compared with the results of a simulation based on the Damped Cosine Avrami Model. The simulation produced results closed to those measured during the multiple peaks dynamic recrystallization. These suggest that the application of this Model may be extended to multiple peaks dynamic recrystallization processes with changeable temperature.

    En el presente trabajo se estudia el efecto de la velocidad de deformación en la recristalización dinámica de un cobre electrolítico puro durante su deformación en caliente con temperatura descendente. Para ello, se realizaron ensayos de compresión en caliente hasta deformaciones verdaderas cercanas a uno, con cuatro velocidades de deformación, mientras descendía la temperatura. Los ensayos realizados a las dos velocidades de deformación más bajas mostraron recristalización dinámica de picos múltiples con un ascenso de la tensión en lugar del estado de saturación, debido probablemente al continuo descenso de la temperatura. Con el aumento de la velocidad, los ensayos restantes mostraron recristalización de pico simple y solo restauración, respectivamente. Los resultados experimentales se compararon con los de una simulación basada en el modelo cosenoidal amortiguado de Avrami. La simulación arroj

  11. Hiperplasia epitelial focal (doença de Heck em descendente de índios brasileiros: relato de caso Focal epithelial hyperplasia (Heck's disease in Brazilian indian descent: report of a case

    Directory of Open Access Journals (Sweden)

    Pedro Paulo de Andrade Santos

    2007-12-01

    Full Text Available A hiperplasia epitelial focal, ou doença de Heck, é uma enfermidade rara, benigna, que afeta a mucosa oral de crianças e adultos jovens de diversas regiões do mundo e em diferentes grupos étnicos, como indígenas e esquimós. Apresenta correlação com o papilomavírus humano (HPV no qual os tipos 13 e 32 têm sido consistentemente detectados nessas lesões. Este artigo relata um caso de uma paciente de 18 anos de idade, descendente de índios potiguares, que compareceu ao serviço de estomatologia da Universidade Federal do Rio Grande do Norte (UFRN, exibindo lesões bem definidas, arredondadas, planas, localizadas em cavidade oral, com tempo de evolução de aproximadamente dois anos. As lesões foram submetidas a biópsias incisionais, constatado-se no exame histopatológico alterações epiteliais, como acantose, cristas epiteliais em forma de "taco de golfe" além de células mitosóides. Esses achados histopatológicos foram compatíveis com a hipótese clínica de hiperplasia epitelial focal (doença de Heck.The focal epithelial hyperplasia or Heck's disease is a benign rare pathology, that affects children and young adults oral mucosal in many world regions, and different ethnic groups, for example Indians and Eskimos. Presents correlation with the subtypes 13 and 32 of human papillomavirus (HPV. This article report a case of an 18-year-old patient, descent of potiguar indian, attended in stomatology service of Federal University of Rio Grande do Norte (UFRN, presenting well defined lesions, round, plane, localized in oral cavity with an evolution of two years. The lesions were submitted to incisional biopsies, verifying in histopathologic exam, epithelial alterations, like acanthosis, epithelial projections in "parquet block of golf" beyond mitosoid cells. These histopathological findings were compatible with clinical hypothesis of focal epithelial hyperplasia (Heck's disease.

  12. Exploración de las arterias coronarias de pacientes con síndrome de Tako-Tsubo con tomografía multislice: lesiones e inferencias fisiopatológicas

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    Omar Santaera

    2009-01-01

    Full Text Available Existen numerosos casos comunicados sobre la disfunción ventricular izquierda reversibleprecipitada por estrés emocional, pero su mecanismo no se conoce. En esta presentación sedescribe la evaluación de dos pacientes que consultaron con un cuadro clínico típico desíndrome de Tako-Tsubo, dolor precordial luego de un estrés emocional, disfunción ventricularizquierda transitoria y arterias coronarias angiográficamente normales. Con el objetivo deprofundizar el conocimiento de las arterias coronarias y la fisiopatología de esta enfermedad,a ambas se les realizó una tomografía multislice, en la que se evidenciaron lesionescoronarias similares a las halladas en accidentes de placa responsables de síndromescoronarios agudos. Si bien estos hallazgos deben completarse con estudios posteriores conun número mayor de pacientes, sugieren que al menos un subgrupo de pacientes con síndromede Tako-Tsubo tiene un sustrato fisiopatológico similar a los síndromes coronariosagudos.REV ARGENT CARDIOL 2009;77:227-230.

  13. Relation between stressors and sociodemographic and clinical characteristics of patients hospitalized at a coronary unit Relación entre estresores y características sociodemográficas y clínicas de pacientes internados en una unidad coronaria Relação entre estressores e características sócio-demográficas e clínicas de pacientes internados em uma unidade coronariana

    Directory of Open Access Journals (Sweden)

    Carina Aparecida Marosti

    2006-10-01

    Full Text Available This descriptive study aimed to correlate the stressors of patients hospitalized at a coronary care unit and their sociodemographic and clinical characteristics. We interviewed 43 patients who were hospitalized at a large hospital. The stressors were evaluated by means of a 4-point Likert scale, which measured stress intensity for 42 possible stressors, ranging from 1 (not stressful to 4 (very stressful. We collected data on sociodemographic and clinical characteristics and about the coronary unit. Data were analyzed through non parametrical statistics, using Mann-Whitney, Kruskal-Wallis and Spearman's correlation test. A 0.05 significance level was adopted. Greater stress was found among younger female patients who did not receive psychotherapeutic medication, including the presence of more than two pieces of equipment and no earlier hospitalization at this kind of intensive therapy unit.La finalidad de este estudio descriptivo fue establecer correlación entre los estresores de los pacientes internados en una unidad coronaria y sus características sociodemográficas y clínicas. Entrevistamos a 43 individuos internados en un hospital de gran porte. Para la evaluación de los estresores utilizamos una escala Likert de 4 puntos que evaluó la intensidad del estrés para 42 posibles estresores, variando de 1 (no estresante a 4 (muy estresante. Recopilamos datos para la caracterización sociodemográfica y clínica y respecto a la unidad coronaria. Para el análisis de los datos utilizamos la estadística no paramétrica, con los tests de Mann-Whitney y de Kruskal Wallis y el test de correlación de Spearman. El nivel de significancia adoptado fue de 0,05. Constatamos mayor estrés entre los pacientes más jóvenes, del sexo femenino, no medicados con psicoterápicos, con presencia de más de dos equipamientos y sin internación anterior en este tipo de unidad de terapia intensiva.Estudo descritivo, realizado com objetivo de correlacionar os

  14. Anterior cruciate ligament - updating article

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    Marcus Vinicius Malheiros Luzo

    2016-08-01

    Full Text Available ABSTRACT This updating article on the anterior cruciate ligament (ACL has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques.

  15. Anterior cruciate ligament - updating article.

    Science.gov (United States)

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques.

  16. Válvula de uretra anterior Anterior urethral valves

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    Silvio Tucci Jr.

    2003-02-01

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

  17. Biología y resultados de la arteria mamaria interna

    Directory of Open Access Journals (Sweden)

    José Manuel Martínez Comendador

    2011-10-01

    Full Text Available Numerosos injertos arteriales y venosos han sido utilizados en la revascularización miocárdica quirúrgica, sin llegar a la unanimidad de cuál es el mejor injerto a utilizar, a excepción de la arteria mamaria interna (AMI, que se considera el injerto de primera elección, fundamentalmente, cuando se revasculariza la coronaria descendente anterior. Esta afirmación está basada en la bibliografía que demuestra su mejor permeabilidad a largo plazo respecto a otros injertos. La clave de su superioridad es la casi inexistencia de arteriosclerosis en seguimientos superiores a 20 años, debido a sus peculiares características anatómicas, histológicas y biológicas.

  18. Polimorfismo inserción/deleción del gen de la enzima convertidora de angiontensina y enfermedad coronaria en la población de Montería, Córdoba

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    Manolo I Jaramillo

    2013-09-01

    Full Text Available Antecedentes y objetivo: el polimorfismo inserción/deleción del gen de la enzima convertidora de angiotensina, ha sido identificado como un potente factor de riesgo de enfermedad coronaria. Para la población de Montería se desconocen las frecuencias con las que se expresan los alelos de este gen y el carácter de su interacción con condiciones de riesgo cardiovascular. El objetivo de este trabajo fue determinar, para dicha población, la asociación de este polimorfismo y el riesgo de sufrir enfermedad coronaria. Método: se llevó a cabo un estudio retrospectivo con 70 casos y 70 controles; como casos se consideraron pacientes con padecimientos coronarios confirmados por electrocardiograma, remitidos a la Organización Cardiodiagnóstico de Córdoba, y como controles individuos voluntarios sin antecedentes cardiovasculares y sin relación filial. El ADN requerido se extrajo a partir de sangre periférica. La caracterización del polimorfismo se hizo mediante reacción en cadena de la polimerasa. Resultados: la distribución de genotipos de la enzima convertidora de angiotensina en pacientes casos no fue significativamente diferente a la estimada en pacientes controles (X2=3.687, p=0,1583. El genotipo más frecuente en la población fue ID (40,72%. En el grupo casos, el genotipo II fue más frecuente que el genotipo DD comparado con el grupo control (p<0,05. El modelo de regresión logística múltiple ajustado, indicó no significancia del genotipo DD como factor de riesgo coronario (razón de disparidad = 0,51 IC95% = 0,25 – 1,06. Conclusión: el polimorfismo I/D del gen de la enzima convertidora de angiotensina no mostró ser un factor de riesgo significativo para enfermedad coronaria en la población de Montería.

  19. Epidermoid cyst in Anterior, Middle

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    Kankane Vivek Kumar

    2016-09-01

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

  20. 38 CFR 3.379 - Anterior poliomyelitis.

    Science.gov (United States)

    2010-07-01

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

  1. Fenestration of the anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-08-01

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

  2. La tomografía computarizada en cardiopatía isquémica: de la calcificación coronaria a la caracterización tisular miocárdica

    Directory of Open Access Journals (Sweden)

    Jordi Estornell Erill

    2015-03-01

    Full Text Available Durante las últimas 2 décadas las técnicas de imagen han alcanzado un papel indispensable en prácticamente todas las enfermedades cardiovasculares. La tomografía computarizada cardiaca, en el campo de la cardiopatía isquémica, proporciona información irreemplazable para la investigación clínica y básica, y se ha convertido también en imprescindible para guiar la actitud terapéutica de los pacientes con enfermedad coronaria en la práctica diaria. Revisamos su estado actual desde la mirada de su utilidad quirúrgica.

  3. Resultados inmediatos y a los 5 años de la cirugía de pacientes portadores de lesión del tronco de la coronaria izquierda

    Directory of Open Access Journals (Sweden)

    Rodolfo A. Ahuad Guerrero

    2008-01-01

    Full Text Available AntecedentesLa cirugía de revascularización miocárdica se considera hasta el momento el mejor tratamiento para los pacientes portadores de enfermedad del tronco de la coronaria izquierda (TCI; pese a ello existen pocos datos locales que comuniquen los resultados de esta cirugía.ObjetivosDescribir los resultados inmediatos y a los 5 años de una serie de cirugías coronarias en pacientes con lesiones del TCI.Material y métodosEn el período 2003-2007 se estudiaron 174 cirugías coronarias del TCI realizadas en forma consecutiva en tres servicios quirúrgicos asociados. Se analizaron los resultados quirúrgicos a los 30 días y en el seguimiento hasta 5 años, en los que se tuvieron en cuenta la mortalidad de causa cardiovascular y por otras causas, los eventos cardiovasculares mayores, la necesidad de nueva revascularización y la supervivencia libre de síntomas. Las curvas se compararon con la supervivencia esperada para el mismo grupo de edad y sexo.ResultadosEl 90,8% de los pacientes tuvieron lesiones múltiples. La mortalidad a los 30 días fue del 4,0%, similar a la esperada según el EuroSCORE (6,4%, OR = 0,62, IC 95% 0,21-1,78; p = 0,333, y los eventos cardiovasculares mayores incluyeron 2,9% de infarto y 1,7% de accidente cerebrovascular (ACV. El seguimiento fue de 506 pacientes-años (12 a 60 meses e involucró al 91% de los pacientes. Al considerar la mortalidad cardiovascular, la supervivencia a los 5 años fue del 83,7%, similar a la esperada en la población general. La supervivencia en el mismo plazo descendió al 77,6% cuando se computaron todas las causas de muerte (p = 0,436. La supervivencia a los 5 años libre de angina y de nueva revascularización fue del 72,2% y del 88,1%, respectivamente.ConclusionesEn este estudio observacional de pacientes operados con lesión del TCI se demostró una mortalidad quirúrgica algo inferior a la calculada con el EuroSCORE y una tasa de ACV e infarto de entre el 1,7% y el 2,9%. El

  4. ¿La prueba del frío podría predecir la aparición de eventos cardiovasculares en pacientes sin enfermedad coronaria demostrada?

    Directory of Open Access Journals (Sweden)

    Jorge Lerman

    2010-01-01

    Full Text Available La disfunción endotelial es la primera alteración conocida que interviene en el desarrollo de la cardiopatía isquémica. La falta de metodologías adecuadamente desarrolladas que permitan reconocer en la etapa preclínica de la enfermedad a los pacientes en riesgo de padecer un evento cardiovascular alertan sobre la necesidad de adoptar métodos adicionales de diagnóstico para su identificación precoz. La función endotelial en las arterias coronarias fue evaluada con perfusión miocárdica SPECT y la prueba del frío.ObjetivosDeterminar la prevalencia de la prueba del frío en 511 pacientes sin cardiopatía isquémica demostrada, como también de los factores de riesgo coronario asociados en aquellos con resultado positivo y analizar la incidencia de eventos cardiovasculares en un seguimiento de cincuenta meses.Material y métodosEn un servicio de medicina nuclear se realizó en 511 pacientes un estudio tomográfico de perfusión miocárdica (SPECT, cuyo resultado ante el ejercicio reveló una captación uniforme del radiotrazador. Ningún paciente tenía antecedentes de revascularización miocárdica ni de infarto previo. Entre los dos y los cinco días posteriores al ingreso en el protocolo se efectuó la prueba del frío. Se considera que ésta es positiva cuando se observa hipocaptación del radioisótopo en algún segmento que no existía en el estudio del esfuerzo y negativo cuando no hay cambios en la captación entre ambos estudios.El seguimiento promedio fue de 24 ± 13 meses, el cual pudo completarse en el 95% de los participantes. Se analizaron los eventos mortalidad cardíaca, infarto de miocardio, accidente cerebrovascular y procedimientos de revascularización.ResultadosLa edad media fue de 58,7 años con una prevalencia del sexo masculino del 52,6%. Prevalencia de factores de riesgo: diabetes 10,3%, dislipidemia 69,3%, hipertensión arterial 63,4%, obesidad 25,2% y tabaquismo 22,3%.En el 32,4% de los pacientes la prueba fue

  5. [Anterior skull-base schwannoma].

    Science.gov (United States)

    Esquivel-Miranda, Miguel; De la O Ríos, Elier; Vargas-Valenciano, Emmanuelle; Moreno-Medina, Eva

    2017-06-24

    Schwannomas are nerve sheath tumours that originate in Schwann cells. They are usually solitary and sporadic and manifest on peripheral, spinal or cranial nerves. Intracranial schwannomas tend to manifest on the eighth cranial nerve, particularly in patients with neurofibromatosis type2. Anterior skull-base schwannomas represent less than 1% of all intracranial schwannomas. They are more frequent in young people and are typically benign. These tumours represent a diagnostic challenge due to their rarity and difficult differential diagnosis, and numerous theories have been postulated concerning their origin and development. In this article, we present the case of a 13-year-old male with a single anterior cranial-base tumour not associated with neurofibromatosis who presented with headache, papilloedema, eye pain and loss of visual acuity. Complete resection of the tumour was performed, which was histopathologically diagnosed as a schwannoma. The patient made a complete clinical recovery with abatement of all symptoms. We conducted a review of the literature and found 66 cases worldwide with this diagnosis. We describe the most relevant epidemiological and clinical characteristics of this kind of tumour and its relation with the recently discovered and similar olfactory schwannoma. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

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

  7. Imaging findings of anterior hip dislocations

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-06-15

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

  8. Positioning of anterior teeth in removable dentures

    Directory of Open Access Journals (Sweden)

    Strajnić Ljiljana

    2002-01-01

    Full Text Available Introduction The aim of this paper was to present methods of placement of artificial anterior teeth in edentulous individuals. The following review takes account of the majority of papers published during the last 100 years. The review has been divided into sections regarding the method used to determine the position of artificial anterior teeth. Geometric aspect Gysi (1895-1920 produced the first scientific theory about the position of artificial anterior teeth. Physiognomic theory The aim of this theory is to find the most natural position for artificial anterior teeth for each individual. Camper's "face angle" as a physiognomic criterion, has been introduced in papers of Wehrli (1961, Marxhors (1966, Tanzer (1968, Lombardi (1973. Esthetic aspect Important names in the field of dental esthetics are: Schön and Singer (1961, Arnheim (1965, Krajiček (1969, Tanzer (1968, Lombardi (1973, Goldstein (1976. They have introduced principles of visual aspects for selection of contours, dimension and position of artificial anterior teeth. Constitution aspect Flagg (1880, Williams (1913 and Hrauf (1957, 1958, have considered body constitution and individual characteristics regarding position of artificial anterior teeth. Physiological theory In 1971, Marxhors pointed to the fact that the position of artificial teeth corresponds with the function of the surrounding soft tissue and from the aspect of physiognomy as well. Phonetic aspect According to Silverman (1962 artificial anterior teeth are nearest when we pronounce the sound "S". Cephalometrical research Rayson (1970, Watson (1989, Strajnić Lj. (1999, Bassi F. (2001 have presented cephalometric radiographic analyses of natural anterior teeth compared with cephalometric radiographic analyses of artificial anterior teeth. A review of dental literature shows several factors suggesting modalities which should determine the position of artificial anterior teeth. Numerous methods have been designed for

  9. Incidental Anterior Cruciate Ligament Calcification: Case Report.

    Science.gov (United States)

    Hayashi, Hisami; Fischer, Hans

    2016-03-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding.

  10. Unilateral anterior ischemic optic neuropathy

    DEFF Research Database (Denmark)

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

    2013-01-01

    The intrinsically photosensitive retinal ganglion cells (ipRGCs) express the photopigment melanopsin, which is sensitive to blue light. Previous chromatic pupillometry studies have shown that the post-illumination response is considered an indicator of the melanopsin activation. The aim......-affected eyes, compared with the non-affected fellow eyes, suggesting dysfunction of the ipRGCs. Compared with the responses of the healthy controls, the blue light post-illumination pupil responses were similar in the affected eyes and increased in the fellow non-affected eyes. This suggests a possible...... of this study was to investigate the ipRGC mediated pupil response in patients with a unilateral non-arteritic anterior ischemic optic neuropathy (NAION). Consensual pupil responses during and after exposure to continuous 20 s blue (470 nm) or red (660 nm) light of high intensity (300 cd/m(2)) were recorded...

  11. Toxic Anterior Segment Syndrome (TASS

    Directory of Open Access Journals (Sweden)

    Özlem Öner

    2011-12-01

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

  12. Resposta circulatória à caminhada de 50 m na unidade coronariana, na síndrome coronariana aguda Respuesta circulatoria a la caminata de 50m en la unidad coronaria, en la síndrome coronaria aguda Circulatory response to a 50-m walk in the coronary care unit in acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Cristiane Maria Carvalho Costa Dias

    2009-02-01

    Full Text Available FUNDAMENTO: Ausência de técnica padronizada e monitorada para iniciar a reabilitação de pacientes com síndrome coronariana aguda (SCA, na unidade coronariana. OBJETIVO: Descrever a técnica e a resposta circulatória à caminhada de 50 m (C50m. MÉTODOS: Estudo experimental, transversal, com 65 pacientes com SCA; destes 36 (54% com infarto agudo do miocárdio (IAM, Killip I; 29 (45,2% com angina instável (AI; 61,5% do sexo masculino, idade 62,8 ± 12,7 anos. Caminhada com início 45 ± 23 horas pós-internamento. Mensuraram-se pressão arterial sistólica (PAS mmHg e diastólica (PAD mmHg, freqüência cardíaca (FC bpm, duplo produto (PAS mmHg X FC bpm, saturação periférica de oxigênio (SpO2%, tempo de caminhada e percepção do esforço pela escala de Borg (EB. Obtiveram-se medições nas posições supina, sentada e ortostase (fase 1 - estresse gravitacional, no final da caminhada e pós-repouso de 5 minutos (fase 2 - estresse físico. RESULTADOS: Observou-se aumento da FC ao estresse gravitacional sentado (Δ = 4,18 e em ortostase (Δ = 2,69, (p 142 mmHg ao sentar associou-se com aumento significativo (p = 0,031 de 11 mmHg ao exercício em 13 pacientes com sobrepeso/obesidade e 85% com hipertensão. Verificaram-se efeitos adversos em 19 (29,2% pacientes, tonturas em 23,1%, com impedimento da caminhada em três deles. CONCLUSÃO: Nesta amostra, após 24 horas do evento coronariano, não se verificaram efeitos colaterais graves à C50m.FUNDAMENTO: Ausencia de técnica estandarizada y de monitoreo para iniciarse la rehabilitación de pacientes con síndrome coronaria aguda (SCA, en la unidad coronaria. OBJETIVO: Describir la técnica y la respuesta circulatoria a la caminata de 50m (C50m./ MÉTODOS: Estudio experimental, transversal, con 65 pacientes con SCA; el número de 36 (54% de ellos con infarto agudo de miocardio (IAM, Killip I; un total de 29 (45,2% con angina instable (AI; el 61,5% del sexo masculino, edad 62,8 ± 12,7 a

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

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    Su-Na Lee

    2014-01-01

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

  14. Anterior segment complications of retinal photocoagulation.

    Science.gov (United States)

    Kanski, J J

    1975-03-01

    Seven patients had anterior segment complications following xenon arc retinal photocoagulation. Irreversible keratopathy was induced in two cases; all patients showed evidence of iris injury. The absorption of radiation by the iris was considered the main factor in producing overheating of the anterior segment.

  15. Anterior cervical hypertrichosis: a sporadic case.

    Science.gov (United States)

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-03-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature.

  16. Recurrent anterior uveitis in Henoch Schonlein's vasculitis.

    Science.gov (United States)

    Erer, Burak; Kamali, Sevil; Cingu, Kursat; Kilicaslan, Isin; Gul, Ahmet; Inanc, Murat; Aral, Orhan; Tugal-Tutkun, Ilknur

    2010-08-01

    Uveitis is an important component of many rheumatic diseases. The main causes of recurrent uveitis are seronegative spondylarthropathies and Behçet's disease. We describe a rare case of Henoch Schönlein vasculitis (HSV) along with multiple recurrences of acute anterior uveitis. In cases of skin rash and recurrent anterior uveitis, HSV should be considered in the differential diagnosis.

  17. Totally thrombosed giant anterior communicating artery aneurysm

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    V R Roopesh Kumar

    2015-01-01

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

  18. Anterior urethral diverticulum: A rare presentation

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    Annavarupu Gopalkrishna

    2016-01-01

    Full Text Available Congenital anomalies of the urogenital tract are the most common anomalies found in the foetus, neonates and infants, but anterior urethral valves and diverticula are rare. Here, we present a case with congenital anterior urethral diverticulum associated with patent ductus arteriosus and polydactyly.

  19. Alteraciones en el eje hipotálamo-tejido adiposo y su relación con el riesgo para la aterosclerosis coronaria Alterations in hypothalamus-adipose tissue axis in relation with the risk of coronary atherosclerosis

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    Raúl I. Coniglio

    2004-04-01

    Full Text Available Estudios poblacionales en la región sur de Argentina mostraron una elevada prevalencia de sobrepeso y obesidad en sujetos de ambos sexos, sobre todo luego de los 50 años de edad; la obesidad central se halló fuertemente asociada con la presencia del síndrome metabólico (SM y con la enfermedad coronaria demostrada por angiografía. La regulación de la homeostasis de la energía se realiza a través de la interacción entre el sistema nervioso central (neurotransmisores y neuropéptidos y el sistema periférico (hormonas mediante complejos mecanismos. Alteraciones genéticas o adquiridas en estos sistemas de regulación pueden conducir a la obesidad y en especial a la obesidad central. Considerando al tejido adiposo visceral como un órgano secretor, incrementos de su masa pueden generar estados de insulino-resistencia (IR, la cual directa o indirectamente puede conducir a la disfunción endotelial y a la aterosclerosis coronaria. Aunque un 40% de IR serían de origen genético, una elevada proporción de ellos son adquiridos por conductas inadecuadas en el estilo de vida (exceso de ingesta de calorías y baja actividad física. Un mayor conocimiento de la regulación central y periférica de los hábitos alimentarios y del balance energético podría ayudar a desarrollar tratamientos para disminuir la incidencia de estas alteraciones metabólicas y con ello la probabilidad de enfermar o morir por enfermedad coronaria.Recent population studies in Southern Argentina have found a sharp rise in prevalence of overweight and obesity in both sexes and specially after fifty years of age. Hence, the obesity in itself was found associated with the presence of metabolic syndrome (MS and coronary heart disease, which have been demonstrated by angiography studies. The regulation of energy homeostasis is controlled by interactions between the central nervous system (neurotransmitters and neuropeptides and the peripheric system (hormones through very

  20. Anterior Segment Imaging in Combat Ocular Trauma

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    Denise S. Ryan

    2013-01-01

    Full Text Available Purpose. To evaluate the use of ocular imaging to enhance management and diagnosis of war-related anterior segment ocular injuries. Methods. This study was a prospective observational case series from an ongoing IRB-approved combat ocular trauma tracking study. Subjects with anterior segment ocular injury were imaged, when possible, using anterior segment optical coherence tomography (AS-OCT, confocal microscopy (CM, and slit lamp biomicroscopy. Results. Images captured from participants with combat ocular trauma on different systems provided comprehensive and alternate views of anterior segment injury to investigators. Conclusion. In combat-related trauma of the anterior segment, adjunct image acquisition enhances slit lamp examination and enables real time In vivo observation of the cornea facilitating injury characterization, progression, and management.

  1. Corrección quirúrgica del síndrome de Bland-White-Garland en un adulto joven

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    Filiberto Villanueva-Rustrián

    2009-01-01

    Full Text Available Presentamos el caso de un varón de 21 años de edad, el cual ingresa a nuestra institución a causa de disnea y descubrimiento fortuito de soplo continuo. Terminado el estudio correspondiente, diagnosticamos la presencia de una coronariopatía congénita del tipo nacimiento anómalo de la arteria coronaria izquierda con origen en el tronco de la arteria pulmonar (síndrome de Bland-White-Garland. El tratamiento elegido durante el acto quirúrgico fue la ligadura de la coronaria anómala en la parte exterior del tronco de la pulmonar, complementando con la anastomosis de la arteria mamaria interna izquierda a la descendente anterior. No se presentaron complicaciones en el procedimiento ni en el postoperatorio inmediato. Un año después, el paciente se encuentra asintomático. Teniendo en cuenta que se trata de una malformación de poca frecuencia en esta edad y que la experiencia quirúrgica actual no es suficiente, consideramos que el manejo quirúrgico elegido en este caso es una alternativa segura en aquellos pacientes en los que no sea posible una corrección anatómica total.

  2. Asociación de los indicadores antropométricos y de composición corporal en la predicción de la resistencia a la insulina en pacientes con enfermedad de las arterias coronarias

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    Larissa Pessoa Vila Nova

    Full Text Available Introducción: en los últimos años la importancia de identificar la resistencia a la insulina (RI en pacientes con enfermedades cardiovasculares isquémicas viene siendo debatida. Métodos alternativos, como los indicadores antropométricos y de composición corporal, han sido señalados como una buena opción y contribuyen para identificar anomalías metabólicas y prevenir complicaciones. Objetivo: asociar indicadores antropométricos y de composición corporal como predictores de la resistencia a la insulina (RI en pacientes con enfermedad de las arterias coronarias. Métodos: estudio transversal realizado en el hospital de referencia cardiológica de Pernambuco, en el periodo de junio a septiembre de 2014, con pacientes adultos y ancianos hospitalizados, de ambos sexos. Se verificaron los siguientes parámetros: estilo de vida, la presencia del síndrome metabólico (SM y otras comorbilidades. Se analizó la RI por el cálculo del HOMA-IR. Los pacientes se sometieron a la impedancia bioeléctrica (BIA y a las verificaciones antropométricas. Resultados: la muestra fue constituida por 75 pacientes con edad media de 63,75 ± 12,43 años, con un 64% de ancianos. Se encontró el diagnóstico de SM en el 65,3% de los pacientes, el 81,3% de sedentarios y el 37,4% con exceso de peso. Se diagnosticó la RI en el 28% de los pacientes. Se observó correlación entre el HOMA-IR y el diámetro abdominal sagital (DAS (r = 0,476; p = 0,016, el índice de masa corporal (r = 0,233; p = 0,040 y el porcentual de grasa corporal (r = 0,276; p = 0,016. Conclusión: el DAS fue el indicador antropométrico que presentó mejor correlación con la RI en pacientes con enfermedad de las arterias coronarias hospitalizados.

  3. Lifestyle changes in descendants of parents with diabetes type 2 Cambio en los patrones de vida en descendientes de progenitores con diabetes mellitus tipo 2 del noreste de Mexico Mudança em os padrões de vida em descendentes de progenitores com diabetes mellitus tipo 2 do nordeste do México

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    Rosalinda Guerra-Juárez

    2007-10-01

    Full Text Available This study aimed to explore the disposition of diabetic parents' descendents in changing eating and physical activity patterns. It was based on the heritability concept and Prochaska's Transtheoretical Model. This is a descriptive-correlational study; participants included 30 parents, randomly selected, and 60 children. Results and conclusion: 68% of the children was classified as obese, 42% with insulin resistance, and 15% with carbohydrate intolerance. None of the risk factors was associated with the stages of change. The heritability factor was 1.37%; more people younger than 40 and women report decreasing in the consumption of fat food (Xi² = 6.04, p = .020; and 4.41, p = .040, respectively. These results suggest a high influence of environmental factors on the participants' unhealthy life styles.El objetivo general del estudio fue explorar la disposición al cambio de patrones alimentarios y actividad física en descendientes de progenitores con diabetes mellitus tipo 2 (DMT2, aplicando un diseño descriptivo correlacional. La base teórica la constituyó el componente genético heredabilidad (h² y el Modelo Transteorético de Prochaska; participaron 30 progenitores con DMT2 y 60 descendientes. Resultados y Conclusión: El 68% de los descendientes fueron obesos, 60% con riesgo de enfermedad cardiovascular, 42% con resistencia a la insulina (RI y 15% intolerantes a la glucosa; ninguno de los factores de riesgo se asoció con las etapas de cambio. El componente genético para RI fue mínimo (h² = 1.37%. Una mayor proporción de menores de 40 años (p = .020 y de mujeres "contemplan" disminuir el consumo de grasas (p = .040. Estos resultados sugieren un mayor peso de factores del medio ambiente sobre el estilo de vida nocivo de los participantes.O objetivo geral do estudo foi explorar à disposição à mudança dos padrões alimentares e atividade física nos descendentes de progenitores com diabetes mellitus tipo 2 (DMT2. Aplicou-se un

  4. Presença de microfonismo coclear no peate-clique: diagnóstico diferencial entre espectro da neuropatia auditiva e perdas auditivas cocleares descendentes em crianças Presence of cochlear microphonics in click-ABR: differential diagnosis between auditory neuropathy spectrum disorder and steeply sloping cochlear hearing loss in children

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    Gabriela Ribeiro Ivo Rodrigues

    2010-12-01

    Full Text Available TEMA: diagnóstico diferencial entre espectro da neuropatia auditiva e perdas auditivas cocleares descendentes em crianças com presença de microfonismo coclear no PEATE-clique. PROCEDIMENTOS: este relato de caso descreve os resultados da avaliação audiológica de duas crianças atendidas no Centro "Audição na Criança" da Divisão de Educação e Reabilitação dos Distúrbios da Comunicação da Pontifícia Universidade Católica de São Paulo (CeAC/DERDIC/PUCSP que apresentaram microfonismo coclear no registro do PEATE-clique. As crianças foram submetidas às avaliações utilizando-se o PEATE-clique, o registro das emissões otoacústicas e a avaliação audiológica tonal, com a técnica da Audiometria de Reforço Visual. RESULTADOS: as avaliações comportamental, eletroacústica e eletrofisiológica revelaram que as crianças apresentam perda auditiva sensorioneural (coclear com configuração descendente, de modo que a presença do microfonismo coclear no registro do PEATE-clique era provavelmente gerada pela preservação da cóclea nas frequências baixas. CONCLUSÃO: os casos apresentados mostram que na ausência das emissões otoacústicas e presença do microfonismo coclear, não se deve interpretar isoladamente cada exame, para que não ocorram equívocos no diagnóstico, que pode ser confundido com o Espectro da Neuropatia Auditiva. O microfonismo coclear pode aparecer em outras condições, tais como em perdas auditivas cocleares descendentes.BACKGROUND: differential diagnosis between auditory neuropathy spectrum disorder andsteeply sloping cochlear hearing loss in children with presence of cochlear microphonics for click-ABR. PROCEDURES: this case report describes the results of the audiological evaluation for two children assisted at Centro "Audição na Criança" of Divisão de Educação e Reabilitação dos Distúrbios da Comunicação of Pontifícia Universidade Católica of São Paulo (CeAC/DERDIC/PUCSP with presence

  5. Estudo comparativo da cicatrização de enterorrafias em planos aposicional e invaginante no cólon descendente de eqüinos Comparative study between appositional and inverting pattern for closure of descending colon enterotomies in equines

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    F.A. Lucas

    2001-10-01

    Full Text Available O estudo foi conduzido com o objetivo de comparar o processo cicatricial do cólon descendente de eqüinos, quando submetido a duas técnicas de sutura, uma em plano aposicional e outra em dois planos com invaginação. Foram utilizados 15 eqüinos sadios e a intervenção cirúrgica foi realizada com os animais em decúbito lateral direito, sob anestesia geral inalatória. O acesso à cavidade abdominal foi feito pelo flanco esquerdo, e após exteriorização do cólon descendente, realizaram-se duas enterotomias de 5cm de extensão cada, distanciadas 20cm uma da outra. Os animais foram aleatoriamente distribuídos em cinco grupos de três animais cada e sacrificados aos 3, 7, 14, 21 e 35 dias pós-operatório. O exame necroscópico revelou presença de aderências nos dois padrões de sutura. Em nove eqüinos foram observadas aderências no padrão de sutura aposicional (60,0% ± 12,6 e em quatro no padrão com invaginação (26,6 % ± 11,4. Não foi verificada interferência com o trânsito intestinal em nenhum paciente. O exame histopatológico revelou regeneração da camada mucosa a partir do sétimo dia de pós-operatório em ambos os tipos de sutura. O fio de poliglactina 910 empregado nas enterorrafias do cólon descendente se mostrou resistente, de fácil manuseio e com boa capacidade para manter os nós aplicados, causando moderada reação inflamatória do tipo granulomatosa.This trial was carried out in order to compare the healing process of the descending colon in horses, submitted to two distinctive suture techniques - appositional pattern and inverting pattern. Fifteen healthy horses were used and the surgical intervention was accomplished with the animals in right lateral recumbency, under inhalatory anesthesia. The abdominal cavity approach was done by the left flank, and after exteriorization of the descending colon, two enterotomies, 5cm long, and 20cm apart one from each other were done. The horses were randomly distributed

  6. Anterior space management: interdisciplinary concepts.

    Science.gov (United States)

    Ittipuriphat, Iyarint; Leevailoj, Chalermpol

    2013-02-01

    This case report describes the treatment of one patient with maxillary anterior spacing, caused by bilateral lateral peg-shaped incisors, using a planned sequence of multidisciplinary approaches for esthetic treatment. An asymmetrical gingival line was visible when the patient smiled. To evaluate the desired gingival level and the proportion of restoration to be made using the recurring esthetic dental (RED) proportion method, a diagnostic wax-up model was fabricated. Esthetic crown lengthening corrected the gingival line. RED proportion analysis suggested minor tooth movement prior to any restoration. Two weeks' use of an orthodontic removable appliance with finger springs achieved the proper dental proportion. Home whitening was prescribed for 2 weeks, with an additional 2-week waiting period to ensure tooth color stability. Resin composite treatment corrected the mesial contour of the maxillary canines and reduced the space between the canines and lateral incisors. Final restoration was obtained by placing ceramic veneers on the lateral peg-shaped incisors. The esthetic treatment achieved excellent results; after veneer cementation, the patient exhibited greater confidence with a new smile. Esthetic dental treatment requires various disciplines to achieve the treatment goal. This case report is an example of well-planned sequences of treatment from the beginning to complete treatment. By conservative and practical treatment approaches used in this case, the clinician will be able to manage to obtain the highest result of esthetic treatment. © 2012 Wiley Periodicals, Inc.

  7. Alterations of the myenteric plexus of the ileum and the descending colon caused by Toxoplasma gondii (genotype III Alterações do plexo mientérico do íleo e cólon descendente causadas por Toxoplasma gondii (genótipo III

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    Elaine Yae Yamashita Sugauara

    2008-09-01

    Full Text Available Alterations caused by a genotype III strain of Toxoplasma gondii were assessed with respect to the number and the morphometry of the myenteric neurons in the terminal ileum and the descending colon. Eighteen rats were divided into four groups: Acute Control Group (ACG, n=4; Acute Experimental Group (AEG, n=4; Chronic Control Group (CCG, n=5 and Chronic Experimental Group (CEG, n=5. NaCl solution was administered through gavage to the animals in the ACG and CCG. Toxoplasma gondii tachyzoites (10(4 from a genotype III strain were orally administered to the AEG and CEG. Acute Groups were died after 24 hours, and the Chronic Groups after 30 days. Neuronal loss was not observed in both organs. The neurons atrophied in the terminal ileum as the opposite occurred with the neurons at the descending colon during the chronic phase of infection. In the terminal ileum, the neurons atrophied during the chronic phase of the infection as no alteration was found during the acute phase. For the descending colon, the neurons became hypertrophic during the chronic infection in opposition to the atrophy found during the acute phase.Objetivou-se avaliar as alterações causadas por uma cepa genótipo III de Toxoplasma gondii, sobre o número e a morfometria de neurônios mientéricos, do íleo terminal e do cólon descendente. Dividiu-se dezoitos ratos em quatro grupos: controle agudo (GCA, n=4, experimental agudo (GEA, n=4, controle crônico (GCC, n=5 e experimental crônico (GEC, n=5. Os animais do GCA e GCC receberam solução de NaCl por gavagem, e os animais do GEA e GEC 10(4 taquizoítos de uma cepa genótipo III de T. gondii por via oral. Os grupos agudos após 24 horas foram mortos e os crônicos após 30 dias. Observou-se que não houve perda neuronal em ambos os órgãos. No íleo terminal, os neurônios atrofiaram-se na fase crônica da infecção, enquanto nenhuma alteração ocorreu na fase aguda. Já no cólon descendente, os neurônios tornaram

  8. Infecção crônica por Toxoplasma gondii induzindo hipertrofia de neurônios do plexo mientérico do cólon descendente de Rattus norvegicus Chronic infection due to Toxoplasma gondii inducing neuron hypertrophy of the myenteric plexus of Rattus norvegicus descending colon

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    Janaína Soares

    2009-06-01

    Full Text Available Neste estudo, foram avaliados os efeitos da infecção crônica por taquizoítos de Toxoplasma gondii sobre os neurônios mientéricos do cólon descendente de ratos adultos. Utilizaram-se 10 ratos Wistar machos, com 60 dias de idade, divididos em grupo controle e experimental, que foram inoculados por via oral com 10(5 taquizoítos do genótipo I de T. gondii. Após 30 dias, os animais foram anestesiados e submetidos à laparatomia. O cólon descendente foi retirado, mensurado, dissecado e seus preparados de membrana submetidos à técnica de Giemsa, para coloração dos neurônios do plexo mientérico, seguido por análise morfométrica e quantitativa. Verificou-se que a infecção não causou alterações nas dimensões do órgão ou na população neuronal, porém houve um aumento significativo da área do pericário e citoplasma.The effects of the chronic infection due to Toxoplasma gondii tachyzoites on the myenteric neurons of the adult rat descending colon were assessed in this study. Ten male, 60-day-old, Wistar rats, divided into control and experimental group were orally inoculated with 10(5 tachyzoites from Toxoplasma gondii genotype I strain. After 30 days, the animals were anesthetized and submitted to laparotomy. The descending colon was removed, dissected, and the whole-mounts were staining by Giemsa, in order to observe neurons of the myenteric plexus, followed by quantitative and morphometric analysis. It was verified that the infection caused alterations neither with respect to the dimensions of the organ nor the neuronal population; however, there was a significant increase of the perikarion area and the cytoplasm.

  9. Periodontal profile and presence of periodontal pathogens in young African-Americans from Salvador, BA, Brazil Condição periodontal e presença de patógenos periodontais em uma população jovem de brasileiros afro-descendentes

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    Ligia Valéria Victor

    2008-06-01

    Full Text Available This cross-sectional study evaluated the periodontal status and the presence of periodontopathogens in 132 young, black ethnic subjects who live in Salvador/Bahia-Brazil and have never smoked. Periodontal Probing Depth (PPD, Clinical Attachment Level (CAL, Plaque Index (PI and Gingival Index (GI were measured and analyzed by ANOVA and Wilcoxon tests (pO objetivo do presente estudo foi avaliar a condição periodontal e presença de periodonto-patógenos em uma amostra de 132 jovens não fumantes, afro-descendentes, residentes em Salvador/Bahia-Brasil. Profundidade de Sondagem (PS, Nível Clínico de Inserção (NCI, Índice de Placa (IP e Índice Gengival (IG foram mensurados e analisados pelos testes ANOVA e Wilcoxon (p<0,05 em função do gênero e idade dos indivíduos. A. actinomycetemcomitans, P. gingivalis, E. corrodens e F. nucleatum foram identificados por PCR e analisados por ANOVA, Wilcoxon e t de Student (p<0,05. Foram observados valores médios de PS e NCI de 2,18 e 1,0mm respectivamente. Os parâmetros clínicos avaliados não sofreram influência dos fatores gênero e idade (p<0,05. E. corrodens foi a bactéria mais prevalente (95.45%, seguido de F. nucleatum (68.18%, A. actinomycetemcomitans (45.45% e P. gingivalis (40.9%. Não foi observada associação entre os patógenos periodontais pesquisados com o gênero e idade dos indivíduos (p<0,05. PS, NCI e IP não estiveram associados a presença de P. gingivalis, todavia para o parâmetro IG este mostrou alta freqüência entre os indivíduos que não alocaram P. gingivalis. Nessa população jovem de brasileiros afro-descendentes um percentual (96,96% elevado de indivíduos apresentou pelo menos um patógeno periodontal, mas mostraram-se clinicamente saudáveis. Outras investigações são necessaries para avaliar a real influencia da presença dessas espécies bacterianas.

  10. Mini-open anterior lumbar interbody fusion.

    Science.gov (United States)

    Gandhoke, Gurpreet S; Ricks, Christian; Tempel, Zachary; Zuckerbraun, Brian; Hamilton, D Kojo; Okonkwo, David O; Kanter, Adam S

    2016-07-01

    In deformity surgery, anterior lumbar interbody fusion provides excellent biomechanical support, creates a broad surface area for arthrodesis, and induces lordosis in the lower lumbar spine. Preoperative MRI, plain radiographs, and, when available, CT scan should be carefully assessed for sacral slope as it relates to pubic symphysis, position of the great vessels (especially at L4/5), disc space height, or contraindication to an anterior approach. This video demonstrates the steps in an anterior surgical procedure with minimal open exposure. The video can be found here: https://youtu.be/r3bC4_vu1hQ .

  11. How I do it: Anterior pull-through tympanoplasty for anterior eardrum perforations.

    Science.gov (United States)

    Harris, Jeffrey P; Wong, Yu-Tung; Yang, Tzong-Hann; Miller, Mia

    2016-01-01

    Conclusions This technique is offered as a convenient and reliable method for cases with anterior TM perforation and inadequate anterior remnant. Objectives Chronic otitis media surgery is one of the most common procedures in otology. Anterior tympanic membrane (TM) perforation with inadequate anterior remnant is associated with higher rates of graft failure. It was the goal of this series to evaluate the anatomical and functional outcomes of a modified underlay myringoplasty technique-the anterior pull-through method. Materials and methods In a retrospective clinical study, 13 patients with anterior TM perforations with inadequate anterior remnants underwent tympanoplasty with anterior pull-through technique. The anterior tip of the temporalis fascia was pulled through and secured in a short incision lateral to the anterior part of the annulus. Data on graft take rate, pre-operative, and post-operative hearing status were analyzed. Results A graft success rate of 84.6% (11 out of 13) was achieved, without lateralization, blunting, atelectasia, or epithelial pearls. The air-bone gap was 21.5 ± 6.8 dB before intervention and 11.75 ± 5.7 dB after surgery (p = 0.003).

  12. Quadriceps muscle contraction protects the anterior cruciate ligament during anterior tibial translation.

    Science.gov (United States)

    Aune, A K; Cawley, P W; Ekeland, A

    1997-01-01

    The proposed skiing injury mechanism that suggests a quadriceps muscle contraction can contribute to anterior cruciate ligament rupture was biomechanically investigated. The effect of quadriceps muscle force on a knee specimen loaded to anterior cruciate ligament failure during anterior tibial translation was studied in a human cadaveric model. In both knees from six donors, average age 41 years (range, 31 to 65), the joint capsule and ligaments, except the anterior cruciate ligament, were cut. The quadriceps tendon, patella, patellar tendon, and menisci were left intact. One knee from each pair was randomly selected to undergo destructive testing of the anterior cruciate ligament by anterior tibial translation at a displacement rate of 30 mm/sec with a simultaneously applied 889 N quadriceps muscle force. The knee flexion during testing was 30 degrees. As a control, the contralateral knee was loaded correspondingly, but only 5 N of quadriceps muscle force was applied. The ultimate load for the knee to anterior cruciate ligament failure when tested with 889 N quadriceps muscle force was 22% +/- 18% higher than that of knees tested with 5 N of force. The linear stiffness increased by 43% +/- 30%. These results did not support the speculation that a quadriceps muscle contraction contributes to anterior cruciate ligament failure. In this model, the quadriceps muscle force protected the anterior cruciate ligament from injury during anterior tibial translation.

  13. Tronco de coronária esquerda ocluso secundário a Lues terciária Tronco de coronaria izquierda ocluido secundario a Lúes terciaria Occlusion of the left coronary trunk secondary to tertiary syphilis

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    Ricardo Wang

    2009-09-01

    Full Text Available Paciente de 27 anos, portador de sífilis terciária, manifestando isquemia miocárdica, com angina instável, secundária à oclusão do tronco da coronária esquerda. O diagnóstico foi confirmado pelos achados da sorologia e da patologia do fragmento da aorta.Paciente de 27 años, portador de sífilis terciaria, manifestando isquemia miocárdica, con angina inestable, secundaria a la oclusión del tronco de la coronaria izquierda. El diagnóstico fue confirmado por los resultados de la serología y de la patología del fragmento de la aorta.A 27-year-old patient with tertiary syphilis, manifested as myocardial ischemia, presenting unstable angina, secondary to left coronary trunk occlusion. The diagnosis was confirmed by the serological findings and the pathological assessment of the aorta fragment.

  14. ¿Se están alcanzando las metas en el perfil lipídico de personas con enfermedad coronaria previa? Goals on the lipid profile of people with previous coronary artery disease are being achieved?

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    Alonso Merchán

    2011-10-01

    Full Text Available Objetivos: verificar el nivel de cumplimiento de las metas en colesterol LDL, colesterol no-HDL, triglicéridos y colesterol HDL, de acuerdo con lo indicado por la guía del NCEP-ATPIII y las recomendaciones actuales, en una población de pacientes hospitalizados por causa no cardiovascular pero con antecedente de enfermedad coronaria. Analizar, además, los hipolipemiantes que utiliza esta población, así como la prevalencia de síndrome metabólico, glucemia anormal en ayunas y diabetes mellitus tipo 2. Metodología: el porcentaje de cumplimiento de estas metas se evaluó mediante el programa de análisis estadístico STATA. Se compararon los hallazgos del perfil lipídico con la propuesta de la guía del NCEP-ATPIII y las recomendaciones actuales (punto final primario. Igualmente, se analizaron los hipolipemiantes utilizados, así como la prevalencia de glucemia anormal en ayunas, diabetes mellitus tipo 2 y síndrome metabólico (punto final secundario. Resultados: se identificaron 281 pacientes que cumplían con los criterios de inclusión. En la tabla 2 se resumen los resultados del punto final primario. De acuerdo con el NCEP-ATPIII, en el riesgo alto, el porcentaje de pacientes que cumplían con las metas en el cLDL (objetivo principal en el tratamiento de las dislipidemias, era de 57,2 y en el riesgo muy alto de 23,5%. En la actualidad, a los pacientes con enfermedad coronaria, independiente de la presencia de síndrome metabólico o diabetes mellitus, se les recomienda una meta para el cLDL menor de 70 mg/dL (Recomendación IIa, la cual se observó en 21,7% de los pacientes estudiados. La prevalencia de glucemia anormal en ayunas fue de 25,6%, la de diabetes mellitus tipo 2 de 20% y la de síndrome metabólico de 45,2%. Con respecto a los hipolipemiantes utilizados, se observó que 56% usaba lovastatina, 14% no utilizaba hipolipemiantes y ninguno tenía asociación de estos fármacos. Conclusiones: después de nueve años de la

  15. Tratamiento de la compresión del tronco de la arteria coronaria izquierda en pacientes con hipertensión pulmonar Treatment of compression of the left main coronary artery in patients with pulmonary hypertension

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    María L. Talavera

    2011-10-01

    Full Text Available La angina de pecho es un síntoma frecuente en pacientes con hipertensión pulmonar (HP de cualquier etiología. Aunque su fisiopatología no está aclarada, las causas propuestas son: la isquemia subendocárdica por aumento del estrés parietal del ventrículo derecho, la dilatación de la arteria pulmonar por incrementos transitorios de la presión pulmonar y la compresión extrínseca del tronco de la arteria coronaria izquierda (TCI por la arteria pulmonar (AP dilatada. Se presentan tres casos que muestran la relación entre la angina de pecho y la compresión del TCI en pacientes con HP asociada a cardiopatías congénitas, tratados mediante implante de stent coronario.Chest pain is a frequent symptom in patients with pulmonary hypertension of any etiology. Its pathophysiology has not been clearly established, the proposed causes are ischemia due to increased right ventricle wall stress, transient increased pulmonary hypertension resulting in acute pulmonary artery dilatation and external compression of the left main coronary artery (LMCA by a dilated pulmonary artery. We report and discuss here three cases where the association between chest pain and compression of the LMCA by a dilated pulmonary artery could be shown, and they were treated with coronary stenting.

  16. Care of children with anterior uveitis.

    Science.gov (United States)

    Kanski, J J

    1981-09-01

    The clinical features of 290 children with anterior uveitis are presented. The vast majority suffered from chronic uveitis. Specific uveitis entities in children include the syndrome of 'chronic iridocyclitis' in girls, heterochromic cyclitis, and pars planitis. Systemic associations include sarcoidosis, the Vogt-Harada-Koyanagi syndrome, and the seronegative arthritides (juvenile chronic arthritis, juvenile ankylosing spondylitis, psoriatic arthritis, and rarely Reiter's and Beçet's syndromes). Children with a pauciarticular onset of juvenile chronic arthritis, especially when combined with positive findings for antinuclear antibody, are at particular risk of developing chronic anterior uveitis. Most cases of chronic anterior uveitis can be controlled with topical corticosteroids. Those that are resistant to both topical and systemic corticosteroids may have to be treated with chlorambucil. The operation of lensectomy is a great advance in the management of complicated cataract. Secondary glaucoma is the most devastating complication of chronic anterior uveitis in children and responds poorly to therapy.

  17. Guideline on anterior cruciate ligament injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan); M.T. Poldervaart (Michelle T.); R.L. Diercks (Ron L.); A.W.F.M. Fievez (Alex W.F.M.); T.W. Patt (Thomas W.); C.P. van der Hart (Cor P.); E.R. Hammacher (Eric); F. van der Meer (Fred); E.A. Goedhart (Edwin A.); A.F. Lenssen (Anton F); S.B. Muller-Ploeger (Sabrina B); M.A. Pols (Margreet); D.B.F. Saris (Daniel)

    2012-01-01

    textabstractThe Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulate

  18. Head positioning for anterior circulation aneurysms microsurgery

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    Feres Chaddad-Neto

    2014-11-01

    Full Text Available Objective To study the ideal patient's head positioning for the anterior circulation aneurysms microsurgery. Method We divided the study in two parts. Firstly, 10 fresh cadaveric heads were positioned and dissected in order to ideally expose the anterior circulation aneurysm sites. Afterwards, 110 patients were submitted to anterior circulation aneurysms microsurgery. During the surgery, the patient's head was positioned accordingly to the aneurysm location and the results from the cadaveric study. The effectiveness of the position was noted. Results We could determine mainly two patterns for head positioning for the anterior circulation aneurysms. Conclusion The best surgical exposure is related to specific head positions. The proper angle of microscopic view may minimize neurovascular injury and brain retraction.

  19. Upper anterior zone restoration with composites

    OpenAIRE

    Lamas Lara, César; CD, Docente del Área de Operatoria Dental y Endodoncia de la Facultad de Odontología de la UNMSM.; Angulo de la Vega, Giselle; CD, Alumna de la Especialidad de Rehabilitación Oral de la Facultad de Odontología de la UNMSM.

    2014-01-01

    The anterior sector problems are very common in our professional practice and became vital importance to make a suitable rehabilitation in these cases; we can not do a good rehabilitation if we do not know the basic characteristics, both aesthetic and functional. Today the composites are a valid alternative for the restoration of the anterior sector, since they offer to us a conservative and aesthetic possibility, but independently of the material to use we have to based on certain rules or p...

  20. Erlotinib-related bilateral anterior uveitis

    Science.gov (United States)

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

    2011-01-01

    The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors’ knowledge, this is the first case of erlotinib-related anterior uveitis. PMID:22694887

  1. Produção de geléia real por abelhas Apis mellifera italianas, africanizadas e descendentes de seus cruzamentos - DOI: 10.4025/actascianimsci.v27i1.1254 Royal jelly production by Italian and Africanized honeybees Apis mellifera, descendants of their crossing - DOI: 10.4025/actascianimsci.v27i1.1254

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    Regina Helena Nogueira Couto

    2005-03-01

    Full Text Available Este experimento objetivou comparar a produção de geléia real de abelhas descendentes de rainhas italianas irmãs, inseminadas com zangões africanizados (T1, ou com zangões italianos (T2, e de rainhas africanizadas irmãs, fecundadas no vôo (T3, comparando-a com fatores ambientais. As operárias híbridas (T1 aceitaram mais larvas transferidas (45,41 %, embora a diferença não tenha sido significativa, e depositaram maior (P This work aimed at comparing royal jelly production among descendants of Italian queen sisters inseminated by Africanized drones (T1, Italian drones (T2 and Africanized queen sisters in natural mating (T3. The workers cross-bred (T1 accepted more transferred larvae (45.41% but there was no significant difference. They deposited more (P < 0.05 royal jelly in each cup (243.5 mg than Italians (T2 – 31.36% and 214.7 mg and Africanized workers (T3 – 33.63% and 209.3 mg, respectively. The result showed a best production in each colony which suggests heterosis. These parameters showed positive relation with pollen and workers quantities and with environmental temperature. The best production occurred in February and March, period of absence of flower in orange and eucalyptus culture in this region

  2. Anterior Eye Imaging with Optical Coherence Tomography

    Science.gov (United States)

    Huang, David; Li, Yan; Tang, Maolong

    The development of corneal and anterior segment optical coherence tomography (OCT) technology has advanced rapidly in recently years. The scan geometry and imaging wavelength are both important choices to make in designing anterior segment OCT systems. Rectangular scan geometry offers the least image distortion and is now used in most anterior OCT systems. The wavelength of OCT light source affects resolution and penetration. An optimal choice of the OCT imaging wavelength (840, 1,050, or 1,310 nm) depends on the application of interest. Newer generation Fourier-domain OCT technology can provide scan speed 100-1000 times faster than the time-domain technology. Various commercial anterior OCT systems are available on the market. A wide spectrum of diagnostic and surgical applications using anterior segment OCT had been investigated, including mapping of corneal and epithelial thicknesses, keratoconus screening, measuring corneal refractive power, corneal surgery planning and evaluation in LASIK, intracorneal ring implantation, assessment of angle closure glaucoma, anterior chamber biometry and intraocular lens implants, intraocular lens power calculation, and eye bank donor cornea screening.

  3. Laser peripheral iridotomy changes anterior chamber architecture.

    Science.gov (United States)

    Theinert, Christian; Wiedemann, Peter; Unterlauft, Jan D

    2017-01-19

    The pressure gradient between anterior and posterior chamber in acute angle closure (AAC) and primary angle closure suspects is balanced by a sufficient laser peripheral iridotomy (LPI). The anterior chamber changes induced by LPI in patients with unilateral AAC were examined and compared to healthy eyes to define threshold values, which may help to discriminate between healthy and diseased eyes. Using Scheimpflug photography, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), and central corneal thickness (CCT) were measured before and after LPI in both eyes of unilateral AAC cases. These measurements were compared to a group of healthy control eyes to determine threshold values for ACD, ACV, and ACA. The ACD, ACV, and ACA increased significantly in the 25 AAC eyes after LPI. The ACD, ACV, ACA, and CCT values in the AAC eyes obtained before LPI were compared to a control group of 59 healthy eyes with wide open chamber angles. The cutoff values revealed by receiver operating characteristic analysis were 2.1 mm for ACD, 90.5 mm2 for ACV, and 27.25° for ACA. Our results confirm the significant changes of the anterior segments architecture induced by LPI in AAC eyes. The found threshold values for ACD, ACV, and ACA may help in daily clinical routine to discriminate between healthy eyes and those in need for a prophylactic LPI.

  4. Dissecção aguda de artéria coronária após troca de valva aórtica Disección aguda de arteria coronaria tras reemplazo de válvula aórtica Acute coronary artery dissection after aortic valve replacement

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    Fernando de Paula Machado

    2010-02-01

    Full Text Available A dissecção de aorta pode ocorrer tardiamente após cirurgia de troca de valva aórtica e raramente no primeiro mês pós-operatório. A dissecção de artéria coronariana é rara e normalmente ocorre depois de angiografia coronariana. Relata-se um caso raro de dissecção de artéria coronária, seguido de infarto do miocárdio, no pós-operatório imediato de troca de valva aórtica com correção e evolução bem-sucedidas.La disección de aorta puede ocurrir tardíamente tras cirugía de reemplazo de válvula aórtica y raramente en el primer mes postoperatorio. La disección de arteria coronaria es rara y normalmente ocurre después de angiografía coronaria. Se relata un caso raro de disección de arteria coronaria, seguido de infarto de miocardio, en el postoperatorio inmediato de reemplazo de válvula aórtica con corrección y evolución exitosas.Late aortic dissection can occur after aortic valve replacement surgery, but rarely in the first postoperative month. Coronary artery dissection is rare and usually occurs after coronary angiography. We report a rare case of coronary artery dissection followed by myocardial infarction in the immediate postoperative period of a successful aortic valve replacement with a good postoperative evolution.

  5. [Surgical anatomy of the anterior mediastinum].

    Science.gov (United States)

    Biondi, Alberto; Rausei, Stefano; Cananzi, Ferdinando C M; Zoccali, Marco; D'Ugo, Stefano; Persiani, Roberto

    2007-01-01

    The mediastinum is located from the thoracic inlet to the diaphragm between the left and right pleural cavities and contains vital structures of the circulatory, respiratory, digestive, and nervous system. Over the years, since there are no fascial or anatomic planes, anatomists and radiologists have suggested various schemes for subdividing the mediastinum and several anatomical and radiological classifications of the mediastinum are reported in the literature. The most popular of these scheme divides medistinum, for purposes of description, into two parts: an upper portion, above the upper level of the pericardium, which is named the superior mediastinum; and a lower portion, below the upper level of the pericardium. For clinical purposes, the mediastinum may be subdivided into three major areas, i.e. anterior, middle, and posterior compartments. The anterior mediastinum is defined as the region posterior to the sternum and anterior to the heart and brachiocephalic vessels. It extends from the thoracic inlet to the diaphragm and contains the thymus gland, fat, and lymph nodes. This article will review surgical anatomy of the anterior mediastinum and will focus on the surgical approch to anterior mediastinum and thymic diseases.

  6. Obesidade e doença arterial coronariana: papel da inflamação vascular Obesidad y enfermedad arterial coronaria: papel de la inflamación vascular Obesity and coronary artery disease: role of vascular inflammation

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    Fernando Gomes

    2010-02-01

    Full Text Available A obesidade vem se tornando uma epidemia global. Cerca de 1,1 bilhões de adultos e 10% das crianças do mundo são atualmente considerados portadores de sobrepeso ou obesos. Classicamente associada a fatores de risco para doença cardiovascular, como diabete melito e hipertensão arterial sistêmica, a obesidade vem sendo cada vez mais encarada como fator de risco independente para doença arterial coronariana (DAC. A aterosclerose coronariana compreende uma série de respostas inflamatórias em nível celular e molecular, cujas reações se encontram mais exacerbadas em pacientes obesos. Antes considerado mero depósito de gordura, o tecido adiposo é visto hoje em dia como órgão endócrino e parácrino ativo, produtor de diversas citocinas inflamatórias, como as adipocinas. Este artigo visa alertar para o grave problema de saúde pública em que a obesidade se tornou nas últimas décadas e correlacionar o processo inflamatório exacerbado nos indivíduos obesos com a maior incidência de DAC nessa população.La obesidad se está tornando una epidemia global. Cerca de 1,1 billones de adultos y el 10% de los niños del mundo están considerados actualmente portadores de sobrepeso u obesos. Clásicamente asociada a factores de riesgo para enfermedad cardiovascular, como diabetes melitus e hipertensión arterial sistémica, la obesidad se está considerando cada vez más factor de riesgo independiente para enfermedad arterial coronaria (EAC. La aterosclerosis coronaria comprende una serie de respuestas inflamatorias a nivel celular y molecular, cuyas reacciones se encuentran más exacerbadas en pacientes obesos. Antes considerado mero depósito de grasa, el tejido adiposo está visto hoy en día como órgano endócrino y parácrino activo, productor de diversas citocinas inflamatorias, como las adipocinas. Este artículo apunta a alertar sobre el grave problema de salud pública en que se convirtió la obesidad en las últimas décadas y

  7. Efecto de un programa de rehabilitación cardíaca en la alimentación, peso corporal, perfil lipídico y ejercicio físico de pacientes con enfermedad coronaria

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    Marlene Roselló Araya

    2001-08-01

    Full Text Available Efecto de un programa de rehabilitación cardíaca en la alimentación, peso corporal, perfil lipídico y ejercicio físico de pacientes con enfermedad coronaria. Justificación y objetivo: Los programas de rehabilitación cardíaca (PRC, constituyen el mejor tratamiento para el control de los factores de riesgo cardiovascular en pacientes con enfermedad coronaria. El objetivo del presente estudio fue determinar los efectos de un PRC en el perfil lipídico, índice de masa corporal (IMC y alimentación de éstos pacientes. Métodos: El estudio fue prospectivo. Al inicio y final del programa se realizaron evaluaciones antropométricas, bioquímicas, dietéticas y de la capacidad funcional. El programa consistió de intervenciones educativas al paciente y su familia, la práctica de ejercicio físico (tres veces / semana, durante doce semanas, sesiones de psicología (una vez / semana y sesiones nutricionales (una vez al mes por siete meses. Resultados: Participaron 61 pacientes, 76% masculino, la edad promedio de la población fue 53±12 años. Al momento de sufrir el evento coronario, 60% suspendió el fumado, 19% era diabético, 59% hipertenso, 80% dislipidémico y 61% sedentario. Al finalizar se observaron mejoras en el IMC (-1,47%, relación cintura / cadera (-1,14%, HDL-C (+3,76%, TG (-2,2%, LDL-C (-7,0%, Colesterol total (-4,9% y en la capacidad aeróbica (+193%. Se encontró un patrón alimentario que reflejó la orientación nutricional recibida, aumento en la ingesta de frutas y vegetales, modificaciones en el consumo de grasa saturada por insaturada y consumo de leche descremada. Se presentó una mejoría de la capacidad funcional, aumentaron el umbral de la angina y se negativizaron el 10,7% de las pruebas de esfuerzo. Conclusión: Los datos evidencian que los PRC constituyen una alternativa viable para mejorar la calidad de vida de los pacientes después de sufrir un infarto.Effect the Cardiac Rehabilitation Program on food patterns

  8. Erythrocyte membrane, plasma and atherosclerotic plaque lipid pattern in coronary heart disease Perfil lipídico de membrana de eritrocito, plasma y placa ateromatosa en la enfermedad coronaria

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    Natalia R. Lausada

    2007-10-01

    Full Text Available The objective was to analyze the lipid composition of the atherosclerotic plaque (AP, plasma and erythrocyte membrane (EM in patients with advanced coronary heart disease (CHD. AP were obtained through endarterectomy in 18 patients. Ten normolipemic healthy subjects were selected to obtain the normal lipid pattern profile. Total lipids of AP and EM were determined by HPTLC, and the fatty acid profile from AP, EM and plasma using TLC-FID. The relative amount of the lipid species analyzed in AP was in line with the data in the literature [phospholipids: 23.5 mol% ± 3.5; total cholesterol 68.9 mol% ± 7.9; triglyceride 7.6 mol% ± 3.4]. Plasma and EM from CHD patients compared to controls, showed a decrease in polyunsaturated fatty acids and an increase in saturated fatty acids leading to a decrease in the unsaturation index (plasma: 1.67 ± 0.06 vs. 1.28 ± 0.03, PEl objetivo fue analizar la composición lipídica de las membranas de eritrocitos (ME, plasma y placas ateromatosas (PA en pacientes con enfermedad coronaria avanzada (ECV. Las PA fueron obtenidas de endarterectomías coronarias de 18 pacientes. Fueron seleccionados 10 sujetos sanos, normolipémicos, como grupo control. Los lípidos totales de PA y ME se determinaron utilizando HPTLC, y el perfil de ácidos grasos de las PA, ME y plasma mediante TLC-FID. La cantidad relativa de las especies lipídicas obtenidas de las PA coinciden con la literatura [fosfolípidos 23.5 mol% ± 3.5; colesterol total 68.9 mol% ± 7.9; triglicéridos 7.6 mol% ± 3.4]. En el plasma y en las ME de los pacientes con ECV se observó, comparando con los pacientes controles, una disminución de los ácidos grasos poli-no saturados acompañado de un aumento de los ácidos grasos saturados que provocó el descenso del índice de instauración (plasma: 1.67 ± 0.06 vs. 1.28 ± 0.03, P<0.05; ME: 2.28 ± 0.04 vs. 1.25 ± 0.010, P<0.05 y el incremento del cociente AG saturados/insaturados (plasma: 0.35 ± 0.02 vs. 0

  9. Resultados de la cirugía coronaria sin circulación extracorpórea en pacientes premedicados con clopidogrel y sin él: análisis comparativo

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    Guillermo N. Vaccarino

    2007-01-01

    Full Text Available IntroducciónEs conocido que las drogas antiplaquetarias administradas en el preoperatorio de cirugía cardíaca aumentan los riesgos de sangrado y reoperación. La cirugía coronaria sin circulación extracorpórea es una técnica segura y reproducible y además permitiría disminuir los riesgos de sangrado y reoperación. No obstante ello, la administración previa a la cirugía de clopidogrel podría reducir estas ventajas.ObjetivoEvaluar el efecto del clopidogrel preoperatorio sobre la incidencia de reoperación por sangrado, transfusión y morbimortalidad posoperatoria en pacientes con CRM sin CEC.Material y métodosEn el período comprendido entre enero de 2003 y diciembre de 2006 se efectuó CRM aislada sin CEC a 1.104 pacientes consecutivos. Se definieron dos grupos según la administración preoperatoria de clopidogrel: grupo clopidogrel (clopidogrel < 7 días y grupo control (sin clopidogrel. Se analizaron las características perioperatorias con un score de propensión.ResultadosMediante el análisis de propensión se seleccionaron 97 pacientes para cada grupo. En el grupo clopidogrel hubo una incidencia mayor de transfusiones (59% versus 39%; p = 0,009 y de reoperación por sangrado (5% versus 0%; p = 0,02. No hubo diferencias significativas en días de estada y en mortalidad.ConclusiónLos pacientes premedicados con clopidogrel y CRM sin CEC presentaron una incidencia mayor de transfusión y de reoperación por sangrado, con igual mortalidad

  10. Esthetic crown lengthening for maxillary anterior teeth.

    Science.gov (United States)

    Sonick, M

    1997-08-01

    In the maxillary anterior region, the gingival labial margin position is an important parameter in the achievement of an ideal smile. The relationship between the periodontium and the restoration is critical if gingival health and esthetics are to be achieved. Periodontal therapy is a necessary and useful adjunct when any anterior restoration is undertaken. Anterior surgical crown lengthening may be undertaken to avoid restorative margin impingement on the biologic width. Crown lengthening is also used to alter the gingival labial profiles. This article discusses the esthetic parameters of ideal gingival labial positions and presents a classification of crown-lengthening procedures and the procedure for a two-stage crown-lengthening technique. The two-stage crown-lengthening technique is surgically precise because healing is predictable.

  11. THYMOLIPOMA: A RARE, LARGE ANTERIOR MEDIASTINAL MASS

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    Premananth

    2015-07-01

    Full Text Available Thymolipoma is a rare benign tumor of anterior mediastinum, described by Lange in 1916. 1 Less than 200 cases have been reported worldwide. 2 It accounts for 2% to 9% of thymic tumours. 3 We report a case of thymolipoma in a 37 year s old male patient, who pre sented with cough, dys p nea, chest pain for 2 months. CT THORAX revealed a large anterior mediastinal mass extending in to right hemithorax arising from thymus gland, with multiple areas of fat density, no significant mediastinal adenopathy, complete collap se of right middle and lower lobe suggestive of thymolipoma. CT guided biopsy suggestive of thymic neoplasm. The tumour was removed enbloc through surgery. Histopathological examination of large mass lesion confirmed thymolipoma. We report this case to emp hasize the importance of considering thymolipoma as a differential diagnosis of anterior mediastinal mass, although rare.

  12. Nonnecrotizing anterior scleritis mimicking orbital inflammatory disease

    Directory of Open Access Journals (Sweden)

    Lynch MC

    2013-08-01

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

  13. Anterior ischemic optic neuropathy following dengue fever.

    Science.gov (United States)

    Ramakrishnan, Reshma; Shrivastava, Saurabh; Deshpande, Shrikant; Patkar, Priyanka

    2016-01-01

    Dengue fever is caused by a flavivirus. This infection is endemic in the tropics and warm temperate regions of the world. Ocular manifestations of dengue fever include subconjunctival, vitreous, and retinal haemorrhages; posterior uveitis; optic neuritis; and maculopathies, haemorrhage, and oedema. However anterior ischemic optic neuropathy is a rare presentation. Optic nerve ischemia most frequently occurs at the optic nerve head, where structural crowding of nerve fibers and reduction of the vascular supply may combine to impair perfusion to a critical degree and produce optic disc oedema. Here we present a case of anterior ischemic optic neurapathy associated with dengue fever.

  14. Dual (type IV left anterior descending artery

    Directory of Open Access Journals (Sweden)

    Ozdil Baskan

    2013-11-01

    Full Text Available Congenital coronary artery anomalies are uncommon. Dual left anterior descending coronary artery (LAD is defined as the presence of two LADs within the anterior interventricular sulcus (AIVS, and is classified into four types. Type IV is a rarely reported subtype and differs from the others, with a long LAD originating from the right coronary artery (RCA. Dual LAD is a benign coronary artery anomaly, but should be recognised especially before interventional procedures. With the increasing use of multidedector computed tomography (MDCT, it is essential for radiologists to be aware of this entity and the cross-sectional findings.

  15. ANTERIOR OSTEOPHYTE IDENTIFICATION IN CERVICAL VERTEBRAE

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    A. T. Chougale

    2011-06-01

    Full Text Available Radiologist always examines X-ray to determine abnormal changes in cervical, lumbar & thoracic vertebrae. Osteophyte (bony growth may appear at the corners of vertebrae so that vertebral shape becomes abnormal. This paper presents the idea from Image processing techniques such as customised Hough transform which will be used for segmentation which should be independent of rotation, scale, noise & shape. This segmented image will be then used for computing size invariant, convex hull based features to differentiate normal cervical vertebrae from cervical vertebrae containing anterior osteophyte. This approach effectively finds anterior osteophytes in cervical vertebrae.

  16. Microsurgical management of anterior communicating artery aneurysms

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    YANG Guo-jun

    2012-02-01

    Full Text Available Objective To explore the operative experience of anterior communicating artery (ACoA aneurysms treated with microsurgery via pterional approach. Methods The clinical manifestations, angiograms, and surgical operation in 52 patients with ACoA were retrospectively analyzed. Results Clipping of aneurysms was successfully achieved in all cases. According to Glasgow Outcome Scale (GOS, 47 patients (90.38% were discharged in good condition, 3 patients (5.77% were in slight disability, 2 patients (3.85% were in moderate disability. Conclusion Pterional approach to an anterior communicating artery aneurysm is an excellent accessing method.

  17. Study of aqueous humour in anterior uveitis

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    Kalsy Jairaj

    1990-01-01

    Full Text Available Aetiological diagnosis of anterior uveitis was made clinically and substantiated with relevant investigations. Aqueous humour obtained under aseptic conditions, was analyzed for the cells study, culture and protein profile, using polyacrylamide gel electrophoresis. The results were analysed with the help of known clinical facts. Culture and smears were invariably negative, while the lymphocytes were present in varying numbers, polymorphs and macrophages afforded a useful clue for confirmatory diagnosis. The electrophoretic pattern of the proteins was related to the duration of the disease and was same in a group while it was distinctive among different groups of anterior uveitis.

  18. Comparative study of descendent colon rupture resistance considering traction force of rupture and total energy of rupture in rats Estudo comparativo da resistência de ruptura de cólon descendente por meio de ensaio uniaxial força de ruptura à tração e energia total de ruptura em ratos

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    Feng Chung Wu

    2006-04-01

    Full Text Available PURPOSE: To compare total energy of rupture and traction force of rupture tests within a rupture resistance study of descendent colon of rats. METHODS: Twelve descendent colon segments of rats were considered to perform the study. For each one of the specimens, total energy of rupture and traction force of rupture necessary to promote colic wall burst were evaluated through the biomechanical total energy of rupture test using the Biomechanical Data Acquisition and Analysis System, version 2.0. Average, standard deviation, standard error of average and coefficient of variation were considered for analysis of results. RESULTS: Traction force of rupture average, standard deviation, standard error of average and coefficient of variation were 380.05 gf, 98.74, 28.5 e 25.98%, respectively while total energy of rupture presented average of 244.85 gf, standard deviation of 57.76, standard error of average of 16.67 and coefficient of variation of 23.59. CONCLUSION: Although, total energy of rupture considered a larger number of attributes to its calculation related to non-linear viscoelastic materials, such as colic wall, it presented a smaller coefficient of variation when compared to traction force of rupture, thus demonstrating to constitute a possible parameter to analyze intestinal resistance of rats.OBJETIVO: Comparação das grandezas físicas Energia Total de Ruptura e Força de Ruptura à Tração no estudo da resistência de ruptura do cólon descendente de ratos. MÉTODOS: Doze segmentos de cólon descendente de ratos foram utilizados como corpos de prova. Por meio do Teste Biomecânico Energia Total de Ruptura, obteve-se, de cada espécime, a Força de Ruptura à Tração e a Energia Total de Ruptura necessárias para promover o rompimento da parede cólica. Com esses valores, calculou-se a média, o desvio padrão, o erro padrão e o coeficiente de variação, sendo esse último atributo usado para a comparação das grandezas f

  19. Endoprótese revestida de jugular preservada de bovino: estudo comparativo da resposta tecidual em aorta torácica descendente e veia cava inferior de suínos Bovine preserved jugular covered stent-graft: comparative study of tissue response at swine thoracic descendent aorta and inferior vena cava

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    Celso Luiz Muhlethaler Chouin

    2008-08-01

    Full Text Available OBJETIVO: Avaliar e comparar a resposta tecidual de uma endoprótese biosintetica implantada na aorta torácica descendente e veia cava inferior de suínos. MÉTODO: Foi implantada uma endoprótese auto-expansível composta de aço inoxidável, revestida por veia jugular de bovino, processada pelo método L-hydro, com auxilio de uma bainha de liberação Taheri-Leonhardt (Flórida, EUA na aorta torácica descendente, e a veia cava infra-renal de 10 suínos. Sessenta dias após, as endopróteses foram retiradas e analisadas sob o ponto de vista macro e microscópicos. Foram observados: perviedade, grau de incorporação a parede do vaso, tipo de reação inflamatória, e local de maior resposta, tanto em relação a camada do vaso quanto ao local de contato com o anel de aço RESULTADOS: Todas as endopróteses encontravam-se pérvias, e incorporadas à parede. No setor venoso, seis apresentaram traves fibrosas em sua luz, e quatro apresentaram fibrose perivascular. No setor arterial somente uma prótese apresentou discreta estenose, sem fibrose perivascular. A reação inflamatória crônica tipo corpo estranho ocorreu em 100% das peças, a camada média foi a mais acometida no setor venoso, enquanto a íntima foi mais constante na artéria, o grau de incorporação foi mais firme na veia em comparação a artéria. A reação tecidual mostrou maior tendência nas áreas em intimo contato com o anel de aço (intra-anelar, mais intensa na artéria do que na veia. CONCLUSÃO: A prótese apresentou baixa trombogenicidade em ambos os sistemas, houve maior reação tecidual e baixa biocompatibilidade no setor venoso.BACKGROUND: To evaluate and compare the tissue response, in swine, to a biosynthetic stent-graft when implanted in both thoracic aorta and inferior vena cava. METHOD: It was used a self-expanding stainless stent, covered by segment of bovine jugular veins, processed by the method L-hydro, and delivered by Taheri-Leonhardt system (Florida

  20. Anterior Chamber Live Loa loa: Case Report.

    Science.gov (United States)

    Kagmeni, G; Cheuteu, R; Bilong, Y; Wiedemann, P

    2016-01-01

    We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis.

  1. ANTERIOR COLUMN FRACTURES OF THE ACETABULUM

    NARCIS (Netherlands)

    HEEG, M; OTTER, N; KLASEN, HJ

    1992-01-01

    We retrospectively reviewed 20 patients at three to 19 years after displaced anterior fracture-dislocations of the hip. Eighteen of them were treated by traction, after ensuring that the femoral head was adequately reduced beneath the undisrupted part of the weight-bearing dome. Two required operati

  2. Causes of anterior cruciate ligament injuries

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    Ristić Vladimir

    2010-01-01

    Full Text Available In order to prevent anterior cruciate ligament injuries it is necessary to define risk factors and to analyze the most frequent causes of injuries - that being the aim of this study. The study sample consisted of 451 surgically treated patients, including 400 sportsmen (65% of them being active and 35% recreational sportsmen, 29% female and 71% male; of whom 90% were younger than 35. Sports injuries, as the most frequent cause of anterior cruciate ligament injuries, were recorded in 88% of patients (non-contact ones in 78% and contact ones in 22%, injuries occurring in everyday activities in 11% and in traffic in 1%. Among sportsmen, reconstruction of the anterior cruciate ligament was most frequently performed in football players (48%, then in handball players (22%, basketball players (13%, volleyball players (8%, martial arts fighters (4%. However, the injury incidence was the highest among the active basketball players (1 injured among 91 active players. Type of footwear, warming up before the activity, genetic predisposition and everyday therapy did not have a significant influence on getting injured. Anterior cruciate ligament injuries happened three times more often during matches, in the middle and at the end of a match and training session (79%, at landing after the jump or when changing direction of movement (75% without a contact with other competitors, on dry surfaces (79%, among not so well prepared sportsmen.

  3. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  4. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

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

    2015-01-01

    STUDY QUESTION: In young active adults with an acute anterior cruciate ligament (ACL) rupture, do patient reported or radiographic outcomes after five years differ between those treated with rehabilitation plus early ACL reconstruction and those treated with rehabilitation and optional delayed ACL...

  5. Guideline on anterior cruciate ligament injury

    NARCIS (Netherlands)

    Meuffels, Duncan E; Poldervaart, Michelle T; Diercks, Ronald; Fievez, Alex W F M; Patt, Thomas W; Hart, Cor P van der; Hammacher, Eric R; Meer, Fred van der; Goedhart, Edwin A; Lenssen, Anton F; Muller-Ploeger, Sabrina B; Pols, Margreet A; Saris, Daniel B F

    2012-01-01

    The Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steer

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

    Science.gov (United States)

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

    2007-01-01

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

  7. Novel Insights into Anterior Cruciate Ligament Injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan)

    2011-01-01

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

  8. Balanitis xerotica obliterans involving anterior urethra.

    Science.gov (United States)

    Herschorn, S; Colapinto, V

    1979-12-01

    Balanitis xerotica obliterans (BXO) is known to affect the urethral meatus, glans, and prepuce. We describe a case of biopsy-proved BXO that involves not only the usual areas but the anterior urethra as well. Of added interest is the subsequent development of squamous cell carcinoma in the fossa navicularis. The literature is reviewed.

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

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    Miesje K. Purwanegara

    2015-09-01

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

  10. Anterior Segment Ischemia after Strabismus Surgery

    Science.gov (United States)

    Göçmen, Emine Seyhan; Atalay, Yonca; Evren Kemer, Özlem; Sarıkatipoğlu, Hikmet Yavuz

    2017-01-01

    A 46-year-old male patient was referred to our clinic with complaints of diplopia and esotropia in his right eye that developed after a car accident. The patient had right esotropia in primary position and abduction of the right eye was totally limited. Primary deviation was over 40 prism diopters at near and distance. The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle recession. Ten months after the first operation, full-thickness tendon transposition of the superior and inferior rectus muscles (with Foster suture) was performed. On the first postoperative day, slit-lamp examination revealed corneal edema, 3+ cells in the anterior chamber and an irregular pupil. According to these findings, the diagnosis was anterior segment ischemia. Treatment with 0.1/5 mL topical dexamethasone drops (16 times/day), cyclopentolate hydrochloride drops (3 times/day) and 20 mg oral fluocortolone (3 times/day) was initiated. After 1 week of treatment, corneal edema regressed and the anterior chamber was clean. Topical and systemic steroid treatment was gradually discontinued. At postoperative 1 month, the patient was orthophoric and there were no pathologic symptoms besides the irregular pupil. Anterior segment ischemia is one of the most serious complications of strabismus surgery. Despite the fact that in most cases the only remaining sequel is an irregular pupil, serious circulation deficits could lead to phthisis bulbi. Clinical properties of anterior segment ischemia should be well recognized and in especially risky cases, preventative measures should be taken. PMID:28182149

  11. Acute multiple infarction involving the anterior circulation.

    Science.gov (United States)

    Bogousslavsky, J; Bernasconi, A; Kumral, E

    1996-01-01

    To evaluate the frequency and clinical, topographic, and etiologic patterns of acute multiple infarction involving the anterior circulation. Data analysis from a prospective acute stroke registry in a community-based primary care center. Among 751 patients with first ischemic stroke in the anterior circulation over a 4-year period, 40 patients (5%) had acute multiple infarcts involving the anterior circulation. On computed tomography and magnetic resonance imaging with gadolinium enhancement, there were four topographic patterns of infarction: (1) superficial infarcts (11 patients [28%]); (2) superficial and deep infarcts (12 patients [30%]); (3) deep infarcts (three patients [8%]); and (4) infarcts involving the anterior and the posterior circulation (14 patients [35%]). Both cerebral hemispheres were involved in one fourth of the cases. A specific clinical picture was found in up to 20% of the patients. This included global aphasia with left hemianopia, hemisensory loss or hemiparesis (in right-handed patients), transcortical mixed aphasia with hemianopia, and acute pure cognitive impairment ("dementia"). Large-artery disease was found in 13 patients (33%); a cardiac source of embolism was found in 11 patients (28%); and both were found in three patients (8%). Bilateral infarcts were related to cardioembolism (four patients) and bilateral large-artery disease (three patients). One month after stroke, one fourth of the patients were independent, one third had some disability, and 40% were either dead or completely dependent. Acute multiple infarcts involving the anterior circulation may be bilateral more frequently than is currently thought, and they are often associated with posterior circulation infarcts. They mainly involve the pial hemispheral territories, commonly being caused by cardioembolism or bilateral carotid atheroma. They may be associated with a specific neurologic-neuropsychological dysfunction pattern in up to one fifth of the patients, allowing

  12. Arthroscopic Findings in Anterior Shoulder Instability

    Science.gov (United States)

    Hantes, Michael; Raoulis, Vasilios

    2017-01-01

    Background: In the last years, basic research and arthroscopic surgery, have improved our understanding of shoulder anatomy and pathology. It is a fact that arthroscopic treatment of shoulder instability has evolved considerably over the past decades. The aim of this paper is to present the variety of pathologies that should be identified and treated during shoulder arthroscopy when dealing with anterior shoulder instability cases. Methods: A review of the current literature regarding arthroscopic shoulder anatomy, anatomic variants, and arthroscopic findings in anterior shoulder instability, is presented. In addition, correlation of arthroscopic findings with physical examination and advanced imaging (CT and MRI) in order to improve our understanding in anterior shoulder instability pathology is discussed. Results: Shoulder instability represents a broad spectrum of disease and a thorough understanding of the pathoanatomy is the key for a successful treatment of the unstable shoulder. Patients can have a variety of pathologies concomitant with a traditional Bankart lesion, such as injuries of the glenoid (bony Bankart), injuries of the glenoid labrum, superiorly (SLAP) or anteroinferiorly (e.g. anterior labroligamentous periosteal sleeve avulsion, and Perthes), capsular lesions (humeral avulsion of the glenohumeral ligament), and accompanying osseous-cartilage lesions (Hill-Sachs, glenolabral articular disruption). Shoulder arthroscopy allows for a detailed visualization and a dynamic examination of all anatomic structures, identification of pathologic findings, and treatment of all concomitant lesions. Conclusion: Surgeons must be well prepared and understanding the normal anatomy of the glenohumeral joint, including its anatomic variants to seek for the possible pathologic lesions in anterior shoulder instability during shoulder arthroscopy. Patient selection criteria, improved surgical techniques, and implants available have contributed to the enhancement of

  13. Las diferencias en los criterios diagnósticos de síndrome metabólico son útiles para identificar sujetos en riesgo, pero pierden relevancia en pacientes con enfermedad coronaria Differences in metabolic syndrome diagnostic criteria are useful for identifying risk subjects, but loose relevance in patients with coronary disease

    Directory of Open Access Journals (Sweden)

    Patricio López-Jaramillo

    2006-08-01

    Full Text Available Antecedentes: actualmente existe controversia con respecto a la existencia del síndrome metabólico como una entidad independiente y además existen diferencias en los criterios diagnósticos propuestos para su diagnóstico. Objetivo: determinar si existen diferencias en la frecuencia de diagnóstico de síndrome metabólico al utilizar los criterios del Adult Treatment Panel III (ATPIII y la International Diabetes Federation (IDF en la población latinoamericana con y sin enfermedad aterosclerótica coronaria. Diseño-método: estudio transversal analítico. Se incluyeron 265 hombres, 166 sin enfermedad arterial coronaria (-EAC y 99 hombres con manifestaciones clínicas sugestivas de enfermedad arterial coronaria (+EAC de los cuales 36,3% tenían demostración angiográfica de enfermedad arterial coronaria luminal. Se realizó un examen físico completo y determinaciones de glicemia y perfil lipídico. Se aplicaron los criterios de la ATPIII y de la IDF para el diagnóstico de síndrome metabólico y se calculó su frecuencia en cada uno de los grupos. Resultados: en los dos grupos estudiados la aplicación de los criterios del ATPIII registró menores frecuencias de síndrome metabólico que con los criterios de la IDF; sin embargo esta diferencia sólo alcanzó significancia en el grupo de pacientes sin antecedente de enfermedad arterial coronaria (-EAC (IDF= 33,1% vs. ATP-III= 13,4% p=0,01 +EAC (IDF= 52,2% vs. ATP-III= 47,2% p= 0,2. Conclusiones: estos resultados demuestran que la incorporación de la obesidad central dentro de los criterios diagnósticos para síndrome metabólico y la definición de puntos de corte propios para cada región, es importante en la identificación de latinoamericanos con síndrome metabólico.Antecedents: there is actually a controversy with regard to the existence of metabolic syndrome as an independent entity and there are also differences in the criteria proposed for its diagnosis. Objective: to determine

  14. Endoventriculoplasty using autologous endocardium for anterior left ventricular aneurysms

    NARCIS (Netherlands)

    Grandjean, JG; Mariani, MA; D'Alfonso, A; Musazzi, A; Boonstra, PW

    Background: There is currently consensus that endoventriculoplasty is the treatment of choice for an anterior left ventricular aneurysm. We describe here a new technique of endoventriculoplasty using autologous endocardium for left ventricular anterior aneurysm. Method: From 1990 until 2003, 49

  15. Surgical Management of Intramyocardial Left Anterior Descending Artery.

    Science.gov (United States)

    De Salvatore, Sergio; Segreto, Antonio; Chiusaroli, Alessandro; Congiu, Stefano; Bizzarri, Federico

    2015-11-01

    An intramyocardial left anterior descending artery can be found in up to 30% of patients undergoing coronary artery bypass graft procedures. We review the various techniques available to identify an intramyocardial left anterior descending artery.

  16. Current approach in diagnosis and management of anterior uveitis

    Directory of Open Access Journals (Sweden)

    Agrawal Rupesh

    2010-01-01

    Full Text Available Uveitis is composed of a diverse group of disease entities, which in total has been estimated to cause approximately 10% of blindness. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis based on the anatomical involvement of the eye. Anterior uveitis is, however, the commonest form of uveitis with varying incidences reported in worldwide literature. Anterior uveitis can be very benign to present with but often can lead to severe morbidity if not treated appropriately. The present article will assist ophthalmologists in accurately diagnosing anterior uveitis, improving the quality of care rendered to patients with anterior uveitis, minimizing the adverse effects of anterior uveitis, developing a decision-making strategy for management of patients at risk of permanent visual loss from anterior uveitis, informing and educating patients and other healthcare practitioners about the visual complications, risk factors, and treatment options associated with anterior uveitis.

  17. TOMOGRAFÍA DE COHERENCIA ÓPTICA Y ANGIOGRAFÍA CORONARIA COMO COMPLEMENTO EN DECISIONES TERAPÉUTICAS / Optical coherence tomography and coronary angiography as complement in therapeutic decisions

    Directory of Open Access Journals (Sweden)

    José R. Nodarse Valdivia

    2012-10-01

    Full Text Available ResumenLa tomografía de coherencia óptica es una técnica de diagnóstico intracoronario con una alta resolución, su advenimiento ha permitido llevar a cabo un mejor diagnóstico para el tratamiento de las afecciones vasculares. El desarrollo de nuevos sistemas de esta tomografía, que evitan la oclusión de la arteria, favorece que esta técnica tenga mayor utilidad y se convierta en práctica habitual en los laboratorios de hemodinámica, para la caracterización de la placa aterosclerótica coronaria y la evaluación del stent implantado. Se presenta un paciente que en el curso de un síndrome coronario agudo con elevación del segmento ST, fue tratado con trombolíticos y no se lograron signos de reperfusión. La coronariografía realizada no demostró estenosis significativa en relación con la topografía del infarto, por lo que se realizó tomografía de coherencia óptica y se diagnosticó una imagen compatible con proliferación neointimal y presencia de trombo dentro del stent previamente implantado en la arteria circunfleja, que se correspondía con los cambios del electrocardiograma. Se decidió aplicar tratamiento percutáneo con implantación de stent fármaco-activo. La tomografía de coherencia óptica permitió diagnosticar y tratar una imagen angiográfica dudosa. / AbstractOptical coherence tomography is an intracoronary diagnostic technique of high resolution, and its arrival has allowed a better diagnosis for the treatment of vascular diseases. The development of new systems for this tomography, which prevent artery occlusion, allows this technique to have greater utility and become standard practice in the hemodynamic laboratories for the characterization of coronary atherosclerotic plaque and for evaluating the inserted stent. The case of a patient that during an acute coronary syndrome with ST segment elevation was treated with thrombolytics and no signs of reperfusion were achieved is presented. Coronary angiography

  18. Resultados clínicos y complicaciones de la angioplastía coronaria con STENT en el Hospital México (Costa Rica en el período 2005-2007

    Directory of Open Access Journals (Sweden)

    Esteban Coto Valldeperas

    2009-12-01

    Full Text Available Introducción: La angioplastía coronaria percutánea es un procedimiento seguro y eficaz para tratar la cardiopatía isquémica, enfermedad de alta prevalencia y gran impacto en la morbilidad y mortalidad en la población. El propósito de este trabajo consistió en cuantificar los resultados obtenidos con esta terapia en el período comprendido entre enero del año 2005 y diciembre del año 2007 en el Hospital México de Costa Rica. Metodología: Se realizó un estudio observacional retrospectivo de una cohorte de 285 pacientes intervenidos en ese período, mediante revisión de expedientes. Se realizó un análisis descriptivo de todos los pacientes y de los subgrupos de pacientes diabéticos y no diabéticos. Resultados: Se documentó una mortalidad global a un año de 2.74%; reintervención de 8.07%: 4.56% restenosis, 1.05% trombosis tardía -es decir, 5.61% por "falla del vaso tratado"- y 2.46% de reintervenciones de lesiones nuevas. Ocurrieron complicaciones en 2.75% (sangrado mayor 1.75%, trombosis aguda de stent en 2.5% y trombosis subaguda en 1.4%. En los pacientes diabéticos se detectó, en comparación con pacientes no diabéticos, mayor incidencia de trombosis tardía de stent (3.75% vs. 0%, reintervención (12.5% vs. 6.34% y reestenosis (7.5% vs. 3.41% del vaso tratado. Se logró reducción o supresión de síntomas anginosos en el 91.95% de los casos, sin diferencias entre pacientes diabéticos y no diabéticos. Conclusión: La mortalidad global fue discretamente mayor que a nivel mundial, pero la "falla del vaso tratado" y la necesidad de reintervención fueron menores. Las complicaciones trombóticas fueron más frecuentes que en estudios comparables a nivel mundial y la diabetes mellitus fue un factor estadísticamente significativo para eventos trombóticos tardíos.

  19. Anterior cruciate ligament reconstruction without drill holes.

    Science.gov (United States)

    Brief, L P

    1991-01-01

    Anterior cruciate ligament (ACL) reconstruction in adolescents with open physes remains a difficult problem for the orthopedic surgeon, especially in view of growing teenage participation in contact sports. Traditionally, treatment of ACL tears in adolescents has been conservative; the patient is advised to delay surgery up to several years for fear of damaging physes by drilling holes across them. Unfortunately, this waiting period may inflict irreparable knee damage. This paper suggests an ACL reconstruction technique that utilizes no drill holes, thus causing no harm to physes or other essential knee structures. A graft consisting of semitendinosus and gracilis (SG) tendons is passed under the anterior horn of the medial meniscus through the knee joint, then brought out through the posterior capsule and secured to the lateral femoral metaphysis. The graft is augmented with an iliotibial band tenodesis. Designed primarily but not exclusively for teenagers with open physes, the procedure has produced encouraging results thus far in a small series.

  20. Displaced fracture through the anterior atlantal synchondrosis

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-09-01

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

  1. Anterior uveitis in juvenile rheumatoid arthritis.

    Science.gov (United States)

    Kanski, J J

    1977-10-01

    The ocular and systemic characteristics of 160 patients with anterior uveitis and seronegative juvenile rheumatoid arthritis are reviewed. Chronic uveitis occurred in 131 patients, 76% of whom were girls. Both eyes were involved in 70% of the cases. Band keratopathy occurred in 41% of the eyes, cataract in 42%, and secondary glaucoma in 19%. Only 11 patients had uveitis before the onset of arthritis. Notable correlations included a pauciarticular onset of arthritis in 95% of the patients, and positive tests for antinuclear antibody in 82%. Of 29 patients with acute anterior uveitis, 27 were boys. The inflammation responded well to therapy, and serious complications did not occur. At follow-up 21 patients had typical ankylosing spondylitis, and five had sacroiliitis. The incidence of positive results of tests for HLA-B27 antigen was 94%.

  2. Cataract Surgery in Anterior Megalophthalmos: A Review

    Science.gov (United States)

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

    2015-01-01

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

  3. Anterior diffuse scleritis diagnosed as conjunctivitis

    Directory of Open Access Journals (Sweden)

    K. P. Mashige

    2012-12-01

    Full Text Available This article presents a case of anterior diffuse scleritis that initially was diagnosed as conjunctivitis. Anterior diffuse scleritis (ADS is a potentially vision-threatening inflammation of the sclera whose etiology may include autoimmune and systemic conditions such as rheumatoid arthritis and tuberculosis. The signs and symptoms of ADS include pain, tearing, tenderness, redness, painful sensitivity to light and decreased visual acuity. Ocular and physical examinations including blood tests to rule out underlying causes are important. Medications such as corticosteroids, non-steroidal anti-inflam-matory drugs and possibly immune-suppressants are used in the management of ADS. If care is not taken, ADS can be mis-diagnosed as conjunctivitis because the redness is similar in both conditions. Such mis-diagnosis can be sight-threatening and therefore it is essential that primary eye care practitioners are cautious in all diagnoses of red eye conditions. (S Afr Optom 2012 71(1 51-54

  4. [Esthetic restorations of primary anterior teeth].

    Science.gov (United States)

    Elqadir, A Jamil; Shapira, J; Ziskind, K; Ram, D

    2013-04-01

    Esthetic treatment of primary teeth is one of the greatest challenges to pediatric dentists. A variety of restorative options using full coverage are available for anterior primary teeth. In the last half century the emphasis on treatment of severely decayed primary teeth shifted from extraction to restoration. In the past, restorations consisted of placement of stainless steel crowns on severely decayed teeth. However, they are esthetically unacceptable today. Over the last decade parents expect a higher esthetic standard for their children's primary teeth. Thus, the restoration should provide esthetic appearance and durability in addition to restoring function. The purpose of this review is to describe the types of full coverage options for anterior primary teeth currently available.

  5. Surgical treatment of anterior cruciate ligament injury in adults.

    Science.gov (United States)

    Alazzawi, Sulaiman; Sukeik, Mohamed; Ibrahim, Mazin; Haddad, Fares S

    2016-04-01

    Anterior cruciate ligament injury is among the most common soft tissue injuries of the knee joint and reconstruction of the anterior cruciate ligament is the gold standard treatment for young active symptomatic patients. This review summarizes the surgical treatment of anterior cruciate ligament injury.

  6. Uveítes anteriores associadas a doenças sistêmicas Anterior uveitis associated to systemic diseases

    Directory of Open Access Journals (Sweden)

    Maria Angélica Pavão Dimantas

    2003-01-01

    Full Text Available As uveítes anteriores são caracterizadas pela inflamação preponderante do segmento anterior do olho. Hiperemia conjuntival, reação de câmara anterior com células e "flare", precipitados ceráticos e sinéquias posteriores são sinais que compõem o quadro inflamatório. Aspectos clínicos de algumas doenças sistêmicas envolvidas na etiologia das uveítes anteriores serão abordados neste artigo.Anterior uveitis describes a disease predominantly limited to the anterior segment of the eye. Conjunctival hyperemia, anterior chamber cell and flare, keratic precipitates, and iris abnormalities including posterior synechiae characterize the inflammation. This article discusses clinical aspects of the systemic diseases that cause anterior uveitis with review of the literature.

  7. Gravity orientation tuning in macaque anterior thalamus.

    Science.gov (United States)

    Laurens, Jean; Kim, Byounghoon; Dickman, J David; Angelaki, Dora E

    2016-12-01

    Gravity may provide a ubiquitous allocentric reference to the brain's spatial orientation circuits. Here we describe neurons in the macaque anterior thalamus tuned to pitch and roll orientation relative to gravity, independently of visual landmarks. We show that individual cells exhibit two-dimensional tuning curves, with peak firing rates at a preferred vertical orientation. These results identify a thalamic pathway for gravity cues to influence perception, action and spatial cognition.

  8. Anterior Tibial Artery Pseudoaneurysm: Case Report

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    Funda Tor

    2012-06-01

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

  9. THERAPY OF FIBRINOUS PLASTIC ANTERIOR UVEITIS

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    A. L. Onishchenko

    2015-01-01

    Full Text Available Aim. To analyze the efficacy of modified pupillary massage technique using cycloplegic agent Appamide Plus in the treatment of anterior uveitis. Patients and methods. 45 patients (25 men and 20 women aged 21‑69 with endogenous uveitis (51 eyes were enrolled in the study. Etiology of uveitis was identified in 57.7 % of cases: herpes simplex virus (22.2 %; systemic disorders — rheumatoid arthritis, Reiter syndrome, Bechterew’s disease, psoriasis (17.7 %; local infection — purulent periodontitis or sinusitis (11 %. Patients were divided into two groups. Group I received basic therapy in combination with traditional pupillary massage. Group II received basic therapy in combination with modified pupillary massage using Appamide Plus (muscarinic receptor antagonist and alpha adrenergic agonist and plasma exchange with cell mass ozonation. Results. Inflammation of the uveal tract was prevented in all patients. In group I (traditional pupil massage, posterior synechiae persisted in 26 % of cases. In group II (pupil massage using Appamide Plus, anterior chamber humor was transparent, posterior synechiae were broken, normal pupillary response was re-established. Additionally, inflammatory exudate in the anterior chamber and endothelial precipitates resolved by 3.3 days earlier than in group I (р < 0.05. Visual outcomes were also better in Appamide Plus group. T cell-mediated immunity study revealed initial CD3+ cell and T cell subpopulation deficiency. Relative and absolute references of T cells and their subpopulations tended to decrease even when uveitis signs reduced. Conclusions. T cell-mediated immunity depression is probably due to pharmacotherapy. Appamide Plus eye drops are highly effective for therapeutic mydriasis and pupillary massage in the course of anterior uveitis treatment to prevent synechiae formation in enlarged or small pupil.

  10. Anterior sacral meningocele presenting as constipation

    Directory of Open Access Journals (Sweden)

    Anup Mohta

    2011-01-01

    Full Text Available Anterior sacral meningocele (ASM is a rare form of spinal dysraphism in children. Usually asymptomatic, it can present as constipation, urinary problems or rarely neurological symptoms. High index of suspicion with careful clinical examination is necessary to make early diagnosis. Magnetic resonance imaging is the investigation of choice. We describe a successfully managed young child with ASM associated with rib and vertebral defects.

  11. Symptomatic anterior subtalar arthrosis after ankle arthrodesis.

    Science.gov (United States)

    Lui, Tun Hing

    2014-05-13

    A 76-year-old man reported right lateral heel pain 11 years after ankle arthrodesis. Clinically, there was tenderness in the right sinus tarsi and over the junction point between the talonavicular and calcaneocuboid joints. Radiographs showed that the joint spaces of the posterior subtalar joint and the talonavicular joint were preserved although there were osteophytes at both joints. Arthroscopic findings showed degeneration of the anterior subtalar and talonavicular joints. The symptoms subsided after arthroscopic debridement. 2014 BMJ Publishing Group Ltd.

  12. Guideline on anterior cruciate ligament injury

    OpenAIRE

    Meuffels, Duncan; Poldervaart, Michelle T.; Diercks, Ron L; Fievez, Alex W.F.M.; Patt, Thomas W.; van der Hart, Cor P.; Hammacher, Eric; van der Meer, Fred; Goedhart, Edwin A; Lenssen, Anton F; Muller-Ploeger, Sabrina B; Pols, Margreet; Saris, Daniel

    2012-01-01

    textabstractThe Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steering group of the Dutch Orthopaedic Association. • What is the role of physical examination and additional diagnostic tools? • Which patient-related outcome measures should be used? • Wh...

  13. Diurnal Variation of Anterior Chamber Flare

    Directory of Open Access Journals (Sweden)

    Mehmet Adam

    2015-04-01

    Full Text Available Objectives: To investigate the ideal time and reproducibility of anterior chamber flare measurements. Materials and Methods: Anterior chamber flare measurements were performed with laser flaremetre device at 8 am to 45 volunteers and these measurements were repeated on the same day at 12 pm and 4 pm. Results: Twenty-five (55.5% of the volunteers were women and 20 (44.5% were men; mean age was 28.67±7.40 (18-49 years. The mean anterior chamber flare measurements taken following the ophthalmologic examination were 5.94±1.41 foton/msn at 8 am, 5.65±1.45 foton/msn at 12 pm, and 5.79±1.20 foton/msn at 4 pm. No statistical difference was found between the measurements (p=0.08. Subgroup analysis according to eye color, revealed no significant difference between flare measurements in brown, hazel, and green eyes (p=0.21. Correlation analysis demonstrated association between age and all flare measurements within the day (r=0.24, p=0.03; r=0.41, p=0.01, r=0.27, p=0.01. Conclusion: No significant diurnal change was detected in the flare measurements of our study subjects but positive correlation with age was observed. Hence, all flare measurements within a day are reliable and have high repeatability in healthy subjects. (Turk J Ophthalmol 2015; 45: 52-5

  14. Anterior cruciate ligament ganglion: case report

    Directory of Open Access Journals (Sweden)

    André Pedrinelli

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

  15. Anterior septal deviation and contralateral alar collapse.

    Science.gov (United States)

    Schalek, P; Hahn, A

    2011-01-01

    Septal deviation is often found in conjunction with other pathological conditions that adversely affect nasal patency. Anterior septal deviation, together with contralateral alar collapse, is a relatively rare type of anatomical and functional incompetence. In our experience, it can often be resolved with septoplasty, without the necessity of surgery involving the external valve. The aim of this paper was to verify this hypothesis prospectively. Twelve patients with anterior septal deviation and simultaneous alar collapse on the opposite side were prospectively enrolled in the study. Subjective assessment of nasal patency was made on post-operative day 1, and again 6 months after surgery, using a subjective evaluation of nasal breathing. The width of the nostril (alar-columellar distance) on the side with the alar collapse was measured during inspiration pre-operatively, 1 day after surgery and again 6 months after surgery. Immediately after surgery, all patients reported improved or excellent nasal breathing on the side of the original septal deviation. On the collapsed side, one patient reported no change in condition. With the exception of one patient, all measurements showed some degree of improvement in the extension of the alar-columellar distance. The average benefit 6 months after surgery was an improvement of 4.54 mm. In our group of patients (anterior septal deviation and simultaneous contralateral alar collapse and no obvious structural changes of the alar cartilage) we found septoplasty to be entirely suitable and we recommend it as the treatment of choice in such cases.

  16. A Novel Technique for Anterior Vaginal Wall Prolapse Repair: Anterior Vaginal Wall Darn

    Directory of Open Access Journals (Sweden)

    Osman Köse

    2013-01-01

    Full Text Available Aim. The aim of this study is to introduce a new technique, anterior vaginal wall darn (AVWD, which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women. Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1 cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized. Results. Data were collected six months after operation. Cough stress test (CST, Pelvic Organ Prolapse Quantification (POP-Q evaluation, Incontinence Impact Questionnaire (IIQ-7, and Urogenital Distress Inventory (UDI-6 scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected. Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method.

  17. Calidad de vida de los pacientes con enfermedad arterial coronaria incluidos en el programa de rehabilitación cardiaca del hospital San Vicente de Paúl en Heredia

    Directory of Open Access Journals (Sweden)

    Hilda Loáisiga Ledezma

    2008-12-01

    Full Text Available Introducción: La enfermedad cardiovascular es la primera causa de muerte en nuestro país, alcanzando aproximadamente la tercera parte de la mortalidad general, y la enfermedad ateroesclerótica coronaria representa la mayoría de la mortalidad en este grupo. La rehabilitación cardiaca representa uno de los pilares fundamentales, junto con la terapia farmacológica y los procedimientos de revascularización, para el tratamiento de esta enfermedad. Los objetivos de este estudio fueron valorar el impacto que tiene el programa de rehabilitación cardiaca en la calidad de vida de los pacientes y su familia, así como conocer los factores que pueden interferir en este proceso. Material y métodos: Es un estudio observacional, transversal en una población de 330 pacientes, con enfermedad coronaria, con más de seis meses de asistencia al Programa de Rehabilitación Cardiaca de nuestro hospital, realizado en octubre del 2005. Utilizamos un instrumento mixto de recolección de datos constituido por una encuesta supervisada al paciente, complementado con medición de variables cuantificables y una prueba de esfuerzo. Resultados: No se observaron diferencias significativas de género en el grupo estudiado. El 98% de los pacientes consideró mejoría en su calidad de vida. Un 97% consideró que su familia comprende mejor su enfermedad, pero sólo el 45% reportó que su familia se integró al programa. Los tres factores que más frecuentemente limitan el proceso, en orden decreciente son; espacio insuficiente 57%, trabajo 29% y lugar de residencia 9%. Los datos obtenidos de las pruebas de esfuerzo realizadas mostraron entre otros, que el 74% tuvo una prueba negativa por isquemia, 25% positiva por isquemia y 1% positiva con alto riesgo. Conclusión: Creemos que la mejoría en la calidad de vida reportada por los pacientes representa un punto alto de nuestro pro-grama. Los datos obtenidos de la valoración con prueba de esfuerzo nos muestran que en general

  18. Insulino resistencia y síndrome metabólico en pacientes con enfermedad coronaria definida por angiografía Insulin-resistance and metabolic syndrome in patients with coronary heart disease defined by angiography

    Directory of Open Access Journals (Sweden)

    Silvia Benozzi

    2009-04-01

    Full Text Available Se examinó la frecuencia de insulino-resistencia (IR y síndrome metabólico (SM en pacientes coronarios empleando diferentes criterios de definición y se analizó cuáles mostraban mejor asociación con la presencia y gravedad de la afección. Fue un estudio casos-controles en 100 pacientes con edades entre 40 y 70 años que concurrieron a un centro hospitalario para realizarse una angiografía. IR fue definido por insulina >15 mU/l, el modelo hemostático de insulino-resistencia (HOMA-IR >3.1 y la combinación del índice de masa corporal (IMC >27.5 kg/m² con HOMA-IR >3.6. SM fue definido según International Diabetes Federation y American Heart Association / National Heart, Lung, and Blood. Insulina >15 mU/l y HOMA-IR >3.1 tuvieron la misma sensibilidad, (60.3%, y se asociaron significativamente con la extensión de la enfermedad coronaria, p = 0.001 y p = 0.009 respectivamente. En cambio, IMC >27.5 kg/m² con HOMA-IR >3.6 mostró menor sensibilidad, (43.1%, y menor asociación con la gravedad, (p = 0.028. Los odds ratio (OR para enfermedad coronaria fueron respectivamente: 3.16 (IC 95% 1.28-7.79, p = 0.012; 2.93 (IC 95% 1.20-7.19 p = 0.019; 2.86 (IC 95% 1.10-7.41, P = 0.031. La frecuencia de SM definida según American Heart Association / National Heart, Lung, and Blood fue mayor en coronarios versus controles (62.1% versus 33.3%, p = 0.003, se asoció con la enfermedad en uno o en múltiples vasos (p = 0.011 y fue su predictor, OR = 4.22 (IC 95% 1.65-10.83 p = 0.003. Sin embargo, SM definido según International Diabetes Federation no se asoció con la presencia ni con la gravedad de la enfermedad.The frequency of insulin-resistance (IR and metabolic syndrome (MS were examined in coronary patients using different criteria of definition. It was also analyzed which of them indicated a strong association with the presence and severity of the disease. This was a case-control study on 100 patients between 40 and 70 years old, assisted in a

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-01

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

  20. Absent anterior communicating artery and varied distribution of anterior cerebral artery.

    Science.gov (United States)

    Ozturk, Hakan A; Sanli, Emine C; Kurtoglu, Zeliha

    2008-10-01

    During the cerebral dissection of a 67-year-old male cadaver, a unique combination of variations at the circle of Willis and anterior cerebral artery (ACA) distribution were encountered. The A1 segment of both ACA were fused without an anterior communicating artery (ACoA), forming an X shape and giving rise to a common pericallosal artery (CPA), an incomplete distal ACA, and an incomplete distal anterior cerebral artery (IACA). The IACA had an unusual course, which may be important from the surgical point of view. The CPA continued as the A2 and A3 segments, and bifurcated into 2 pericallosal arteries. Branching patterns of the varied arteries to the interhemispheric region were evaluated, and results were discussed. Additionally, both posterior communicating arteries were hypoplastic. There was no aneurysm formation at the circle of Willis and its branches.

  1. Variabilidad de la dimensión fractal de la ramificación coronaria izquierda en ausencia y presencia de enfermedad arterial oclusiva moderada y severa Variability in fractal dimension of left coronary artery ramification during absence and presence of moderate and severe occlusive arterial disease

    Directory of Open Access Journals (Sweden)

    Javier Rodríguez

    Full Text Available La teoría fractal permite la caracterización objetiva de objetos irregulares. La ramificación coronaria izquierda es un objeto irregular que en la actualidad se evalúa por medio de la arteriografía, donde se determina la enfermedad arterial oclusiva a partir de la comparación de medidas entre segmentos arteriales, sin evaluar el impacto de la lesión en la ramificación coronaria total. La irregularidad de la totalidad de la ramificación coronaria puede evaluarse con dimensiones fractales. De manera fractal se caracterizaron imágenes consecutivas entre sístole y diástole de nueve pacientes con enfermedad arterial oclusiva moderada y se confrontaron con las medidas de siete pacientes con enfermedad arterial oclusiva severa y siete sin enfermedad arterial oclusiva mediante comparaciones de la variabilidad y la diferencia neta. Los pacientes con lesión moderada y sin enfermedad arterial oclusiva, presentan un comportamiento matemático que se caracteriza por mayor variabilidad, mientras que los pacientes con enfermedad arterial oclusiva severa presentan diferencias netas generalmente iguales a 0.The fractal theory allows the objective characterization of irregular objects. The left coronary artery ramification is an irregular object actually evaluated by means of arteriography, in which the occlusive arterial disease is evaluated through the comparison of measures between arterial segments, without evaluating the impact of the lesion in the whole coronary ramification. The irregularity of the whole coronary ramification can be evaluated through fractal dimensions. Consecutive images between systole and diastole of nine patients with moderate occlusive arterial disease were characterized in a fractal way and were confronted with the measures of seven patients with severe occlusive arterial disease and with seven without occlusive arterial disease by comparing the variability and the net difference. Patients with moderate lesion and

  2. Toxic anterior-segment syndrome (TASS

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    Cetinkaya S

    2014-10-01

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

  3. Infections after reconstructions of anterior cruciate ligament

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    Ristić Vladimir

    2014-01-01

    Full Text Available Introduction. Infections after anterior cruciate ligament reconstructions are rare, but, on the other hand, they are difficult to be treated. The aim of this study was to analyze causes of infections, risk factors, diagnostics, and possibilities of their prevention. Material and Methods. Seventeen deep infections (1.2% were found in 1425 patients who had undergone anterior cruciate ligament reconstructions. Fifteen patients were males and two were females. Out of 475 professional athletes nine (1.9% had this postoperative complication. Eleven patients with septic arthritis were allergic to penicillin. Three of them had immunosuppressive diseases. Results. Staphylococcus aureus was isolated in eleven cases (65%, other Staphylococcus and Streptococcus groups were found in four and three patients, respectively; while one patient had infection although the punctate was negative. Out of 965 patients with the patellar tendon grafts, ten (1.03% had this complication, while the incidence was 1.52% (7/460 in those with the hamstring grafts. Fifteen infections were acute with obvious symptoms within 14 days after surgery. Severe pain, limited range of motion, swelling of the knee joint and fever were the most common symptoms, while rubor and pus developed rarely. The infection was three times more frequent in the patients who had undergone surgery lasting more than 1.5 hour. Discussion and Conclusion. The following population groups are at risk of developing septic arthritis after anterior cruciate ligament reconstructions: professional athletes, those who are allergic to penicillin, and those with immunosuppressive diseases. Staphyllococus aureus is the most common cause of infection. The patients with the hamstring autografts have a higher risk than those with the patellar tendon grafts. Preventive measures that should be performed include aseptic conditions in operative rooms, irrigation of the graft before its placement into the bone tunnels

  4. [LAPAROSCOPIC ANTERIOR UTERINE LIGAMENTOPEXY--OUR EXPERIENCE].

    Science.gov (United States)

    Blagovest, Bechev; Magunska, Nadya; Kovachev, Emil; Ivanov, Stefan

    2015-01-01

    A great number operative techniques for correction of retroverted uterus are reported in the last years. The aim of these different methods is correction of the retroversion of the uterus, which is connected with pelvic congestion and symptomatic relief. We present a clinical case of 26 years old patient with one Caesarean section. The lady complains of chronic pelvic pain, dispareunia and dismenorrhea. The US exam shows an uterus in strong retroversion position. We restored the anatomic position of the uterus using laparoscopic anterior ligementopexy.

  5. Tunnel widening in anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

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

    1999-01-01

    .1% in the patella tendon group (P = film measurements. Tunnel widening did not correlate with the clinical findings, knee scores, KT-1000 or isokinetic muscle strength. Tunnel widening is marked in the hamstring group. Tunnel widening does not correlate with instability......We report a prospective series evaluating the incidence and degree of tunnel widening in a well-matched series of patients receiving a hamstring or patella tendon graft for anterior cruciate ligament (ACL) deficiency. We correlated tunnel widening with clinical factors, knee scores, KT-1000...

  6. Biological fixation in anterior cruciate ligament surgery

    Directory of Open Access Journals (Sweden)

    Chih-Hwa Chen

    2014-04-01

    Full Text Available Successful anterior cruciate ligament (ACL reconstruction with tendon graft requires extensive tendon-to-bone healing in the bone tunnels and progressive graft ligamentization for biological, structural, and functional recovery of the ACL. Improvement in graft-to-bone healing is crucial for facilitating early, aggressive rehabilitation after surgery to ensure an early return to pre-injury activity levels. The use of various biomaterials for enhancing the healing of tendon grafts in bone tunnels has been developed. With the biological enhancement of tendon-to-bone healing, biological fixation of the tendon graft in the tunnel can be achieved in ACL reconstruction.

  7. The Anterior Cingulate Cortex and Pain Processing

    Directory of Open Access Journals (Sweden)

    Perry Neil Fuchs

    2014-05-01

    Full Text Available The neural network that contributes to the suffering which accompanies persistent pain states involves a number of brain regions. Of primary interest is the contribution of the cingulate cortex in processing the affective component of pain. The purpose of this review is to summarize recent data obtained using novel behavioral paradigms in animals based on measuring escape and/or avoidance of a noxious stimulus. These paradigms have successfully been used to study the nature of the neuroanatomical and neurochemical contributions of the anterior cingulate cortex to higher order pain processing in rodents.

  8. Anterior segment spectral domain optical coherence tomography imaging of patients with anterior scleritis.

    Science.gov (United States)

    Levison, Ashleigh L; Lowder, Careen Y; Baynes, Kimberly M; Kaiser, Peter K; Srivastava, Sunil K

    2016-08-01

    The purpose of the study was to describe the findings seen on anterior segment spectral domain optical coherence tomography (SD-OCT) in patients with anterior scleritis and determine the feasibility of using SD-OCT to image and grade the degree of scleral inflammation and monitor response to treatment. All patients underwent slit lamp examination by a uveitis specialist, and the degree of scleral inflammation was recorded. Spectral domain OCT imaging was then performed of the conjunctiva and scleral tissue using a standardized acquisition protocol. The scans were graded and compared to clinical findings. Twenty-eight patients with anterior scleritis and ten patients without ocular disease were included in the study. Seventeen of the scleritis patients were followed longitudinally. Common findings on SD-OCT in patients with active scleritis included changes in hyporeflectivity within the sclera, nodules, and visible vessels within the sclera. There was significant variation in findings on SD-OCT within each clinical grade of active scleritis. These changes on SD-OCT improved with treatment and clinical improvement. SD-OCT imaging provided various objective measures that could be used in the future to grade inflammatory activity in patients with anterior scleritis. Longitudinal imaging of patients with active scleritis demonstrated that SD-OCT may have great utility in monitoring response to treatment.

  9. Late spontaneous resolution of a double anterior chamber post deep anterior lamellar keratoplasty

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    Andrea Passani

    2017-01-01

    Full Text Available A 31-year-old healthy male underwent deep anterior lamellar keratoplasty with big-bubble technique for treatment of keratoconus in his right eye. One week after surgery, he presented with detachment of the endothelium-Descemet complex with formation of a double anterior chamber, despite the apparent absence of an intraoperative Descemet membrane rupture. A subsequent intervention with the intent to relocate the corneal graft button was not effective, because the detachment appeared again one day later. The authors hypothesized that, at the time of the stromal dissection with big bubble technique, a small amount of air penetrated into the anterior chamber, creating a false pathway through the trabecular meshwork. The aqueous humor then penetrated the graft flowing through the false pathway, causing the endothelium-Descemet detachment. The persistence of that pathway, even after the intervention of graft repositioning, caused the failure of the latter procedure and persistence of the double chamber. We decided to wait and observe. The double anterior chamber spontaneously resolved in approximately three months.

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

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    Mete Güler

    2013-02-01

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

  11. Accuracy of Lachman and Anterior Drawer Tests for Anterior Cruciate Ligament Injuries

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    Hadi Makhmalbaf

    2013-12-01

    Full Text Available   Background: The knee joint is prone to injury because of its complexity and weight-bearing function. Anterior cruciate ligament (ACL ruptures happen in young and physically active population and can result in instability, meniscal tears, and articular cartilage damage. The aim of this study is to evaluate the accuracy of Lachman and anterior drawer test in ACL injury in compare with arthroscopy.   Methods: In a descriptive, analytical study from 2009 to 2013, 653 patients who were suspected to ACL rapture were entered the study. Statistical analysis was performed by the usage of SPSS 19.0. Multiple comparison procedure was performed for comparing data between clinical examination and arthroscopic findings and their relation with age and sex. Results: Mean age of patients was 28.3±7.58 years (range from 16 to 68 years. From 428 patients, 41.2% (175 patients were between 26 and 35, 38.8% (165 ones between 15 and 25 and 20% (85 patients over 36 years. 414 patients were male (97.2% and 12 were female (2.8%. Sensitivity of anterior drawer test was 94.4% and sensitivity of Lachman test was 93.5%. Conclusion: The diagnosis and decision to reconstruct ACL injury can be reliably made regard to the anterior drawer and Lachman tests result. The tests did not have privilege to each other. These test accuracy increased considerably under anesthesia especially in women.

  12. Accuracy of Lachman and Anterior Drawer Tests for Anterior Cruciate Ligament Injuries

    Directory of Open Access Journals (Sweden)

    Hadi Makhmalbaf

    2013-12-01

    Full Text Available Background: The knee joint is prone to injury because of its complexity and weight-bearing function. Anterior cruciate ligament (ACL ruptures happen in young and physically active population and can result in instability, meniscal tears, and articular cartilage damage. The aim of this study is to evaluate the accuracy of Lachman and anterior drawer test in ACL injury in compare with arthroscopy.   Methods: In a descriptive, analytical study from 2009 to 2013, 653 patients who were suspected to ACL rapture were entered the study. Statistical analysis was performed by the usage of SPSS 19.0. Multiple comparison procedure was performed for comparing data between clinical examination and arthroscopic findings and their relation with age and sex. Results: Mean age of patients was 28.3±7.58 years (range from 16 to 68 years. From 428 patients, 41.2% (175 patients were between 26 and 35, 38.8% (165 ones between 15 and 25 and 20% (85 patients over 36 years. 414 patients were male (97.2% and 12 were female (2.8%. Sensitivity of anterior drawer test was 94.4% and sensitivity of Lachman test was 93.5%. Conclusion: The diagnosis and decision to reconstruct ACL injury can be reliably made regard to the anterior drawer and Lachman tests result. The tests did not have privilege to each other. These test accuracy increased considerably under anesthesia especially in women.

  13. The normal anterior cruciate ligament as a model for tensioning strategies in anterior cruciate ligament grafts

    NARCIS (Netherlands)

    Arnold, MP; Verdonschot, N; van Kampen, A

    2005-01-01

    Background: There is some confusion about the relationship between the tension placed on the graft and the joint position used in the fixation of anterior cruciate ligament grafts. This is because of deficiency in accurate basic science about this important interaction in the normal and reconstructe

  14. The normal anterior cruciate ligament as a model for tensioning strategies in anterior cruciate ligament grafts.

    NARCIS (Netherlands)

    Arnold, M.P.; Verdonschot, N.J.J.; Kampen, A. van

    2005-01-01

    BACKGROUND: There is some confusion about the relationship between the tension placed on the graft and the joint position used in the fixation of anterior cruciate ligament grafts. This is because of deficiency in accurate basic science about this important interaction in the normal and reconstructe

  15. Adjacent Segment Pathology after Anterior Cervical Fusion.

    Science.gov (United States)

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon; Kim, Sung Kyu

    2016-06-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion.

  16. Penghentian Karies Gigi Sulung Anterior (Laporan Penelitian

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    Titi Pratiwi Indra Yoga

    2015-10-01

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

  17. MRI of anterior cruciate ligament autografts

    Energy Technology Data Exchange (ETDEWEB)

    Ogi, Shigeyuki; Ariizumi, Mitsuko; Yamagishi, Tsuneo [The Aoyama Tokyo Metropolitan office' s Hospital (Japan); Agata, Toshihiko; Tada, Shinpei; Fukuda, Kunihiko

    2000-09-01

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

  18. Anterior cutaneous nerve entrapment syndrome: management challenges

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    Chrona E

    2017-01-01

    Full Text Available Eleni Chrona,1,2 Georgia Kostopanagiotou,1 Dimitrios Damigos,3 Chrysanthi Batistaki1 1Second Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, 2Department of Anesthesiology, General Hospital of “Ag. Panteleimon,” Piraeus, 3Department of Medical Psychology, Medical School of Ioannina, University of Ioannina, Ioannina, Greece Abstract: Anterior cutaneous nerve entrapment syndrome (ACNES is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic, ultrasound-guided blocks, chemical neurolysis, and surgical ­neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed ­management strategies for ACNES. Keywords: anterior cutaneous nerve entrapment syndrome, intercostal, neuralgia, management

  19. Indicadores antropométricos de obesidad y su relación con la enfermedad isquémica coronaria Obesity anthropometrics indicators and the association with coronary ischemic disease

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    G. Oviedo

    2006-12-01

    Full Text Available Los indicadores antropométricos son valores de composición corporal usados para el diagnostico nutricionalde un individuo. En el presente trabajo los indicadores antropométricos fueron usados para analizar la relación entre éstos en estado de obesidad y la enfermedad isquémica coronaria (EIC. Se estudió una muestra de 120 hombres, divididos en grupo A (n = 60 con EIC y grupo B (n = 60 sin EIC y aparentemente sanos; edad 35-55 años; procedentes de Valencia-Estado Carabobo, Venezuela. Se interrogó antecedentes clínicos y edad Se midió peso, talla, circunferencia de brazo, cintura, cadera, pliegues cutáneos tricipital y subescapular; se calcularon los Indicadores índice de masa corporal (IMC, área grasa (AG e índice cintura/cadera (C/C. Resultados: Grupo A: edad promedio 45,2 ± 9,1 años, IMC de 28,5 ± 4,1 kg/m2² y C/C de 0,96 ± 0,004 cm; Grupo B edad 40,8 ± 4,8 años, IMC de 26,39 ± 4,4 kg/m² y C/C 0,90 ± 0,06 cm. Al comparar las medias se encontró diferencia significativa para la edad y el IMC (p Objective: To analyze the association of obesity anthropometrics indicators in coronary ischemic disease (CID. Methodology: A sample of 120 men was studied; group A (n = 60 with CID and group B (n = 60 without CID and apparent healthy, between 35-55 years old;from Valencia, Venezuela. Age and clinical data were obtained. Weight, height, circumferences of arm, waist, hip, skinfold tricipital and subescapular, were measured; body mass index (BMI, fatty area (FA and waist/hip index (W/H were calculated. Results: The mean age for Group A was 45,2 ± 9,1 years old; BMI 28,5 ± 4,1 kg/m² and W/H index of 0,96 ± 0,004 cm; for Group B age was 40,8 ± 4,8 years old, BMI 26,39 ± 4,4 kg/m2² and W/H index 0,90 ± 0,06 cm. A significant difference for age and BMI (p < 0,05 and for the W/H index (p < 0,01 was found. For men with CID, 40% were obese, 76% had high W/H index and 30% high AG, finding a significant association (p < 0,01 for the

  20. Factores de riesgo en la enfermedad coronaria

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    Francisco Grajales

    1988-02-01

    Full Text Available

    We performed a case-control study comparing 40 cases of clinically, electrocardiographically and enzymatically proven myocardial infarction with 16 controls matched for age, sex and Institution. We found association between the myocardial infarction and cigarette smoking, high blood pressure, cholesterol above 250 mg/dl, triglycerides above 150 mg/dl, uric acid over 8 mg/dill men or 6 mg/dill women, family history of diabetes or coronary heart disease, sedentary Life style, amount of coffee drinking and use of birth-control pills. These factors were synergistic. The high prevalence of smoking In the general population leads to the suggestion that It Is the most Important risk factor and that It could explain the greater number of cases of coronary disease, even If the association was not strong. Any public health actions aimed at reducing the frequency of this disease should include smoking reduction.

    Mediante un estudio de casos y controles, se compararon 40 pacientes con infarto del m 10- cardio comprobado clínica, electrocardiográfica y enzimáticamente, con 16 controles equiparados por edad, sexo e Institución; se comprobó asociación con el hábito de fumar, la presión arterial elevada, el colesterol de 250 ó más mg/dl; los triglicéridos de 150 ó más mg/dl, el ácido úrico de 8 ó más mg/dl en hombres y de 6 ó más mg/dl en mujeres; los antecedentes familiares de diabetes y enfermedad coronarla; la vida sedentaria; la Ingestión de café y el uso de anticonceptivos orales; también se demostró el sinergismo de dichos factores.

    Por la elevada prevalencia de fumadores en la población general se presume que el hábito de fumar fue el factor de riesgo más Importante y que podría explicar el mayor número de casos de enfermedad coronarla, aunque su asociación con ésta no fue muy fuerte; por ello se postula que cualquier campana de prevención primaria de dicha enfermedad deberla tratar de controlar este hábito

  1. Winging of scapula due to serratus anterior tear

    Institute of Scientific and Technical Information of China (English)

    Varun Kumar Singh; Gauresh Shantaram Vargaonkar

    2014-01-01

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

  2. Double anterior chamber in a patient with glaucoma and microspherophakia

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    Hamid Khakshoor

    2011-01-01

    Full Text Available We report the case of a 16-year-old woman with microspherophakia and secondary open angle glaucoma. The patient presented with a membrane dividing the anterior chamber into two segments without edema or Descemet′s membrane detachment. Slit lamp biomicroscopy, Pentacam, and specular microscopy images were obtained. Double anterior chamber is primarily found in patients with anterior chamber anomalies when there is no history of surgery or trauma.

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

    Directory of Open Access Journals (Sweden)

    Egemen Kucuk

    2014-04-01

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS....... On this basis it was decided to discontinue the study prematurely for ethical reasons. CONCLUSION: Decompression of the anastomosis with a transanal stent does not reduce the risk of anastomotic leakage after anterior resection....

  5. Winging of scapula due to serratus anterior tear

    Directory of Open Access Journals (Sweden)

    Varun Singh Kumar

    2014-10-01

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

  6. Morphogenesis of the anterior segment in the zebrafish eye

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    Link Brian A

    2005-06-01

    Full Text Available Abstract Background The ocular anterior segment is critical for focusing incoming light onto the neural retina and for regulating intraocular pressure. It is comprised of the cornea, lens, iris, ciliary body, and highly specialized tissue at the iridocorneal angle. During development, cells from diverse embryonic lineages interact to form the anterior segment. Abnormal migration, proliferation, differentiation, or survival of these cells contribute to diseases of the anterior segment such as corneal dystrophy, lens cataract, and glaucoma. Zebrafish represent a powerful model organism for investigating the genetics and cell biology of development and disease. To lay the foundation for genetic studies of anterior segment development, we have described the morphogenesis of this structure in zebrafish. Results As in other vertebrates, the zebrafish anterior segment derives from diverse origins including surface ectoderm, periocular mesenchyme, and neuroepithelium. Similarly, the relative timing of tissue differentiation in the anterior segment is also conserved with other vertebrates. However, several morphogenic features of the zebrafish anterior segment differ with those of higher vertebrates. These include lens delamination as opposed to invagination, lack of iris muscles and ciliary folds, and altered organization in the iridocorneal angle. In addition, substantial dorsal-ventral differences exist within the zebrafish anterior segment. Conclusion Cumulatively, our anatomical findings provide a reference point to utilize zebrafish for genetic studies into the mechanisms of development and maintenance of the anterior segment.

  7. Radiographic features of the development of the anterior tibial tuberosity.

    Science.gov (United States)

    Vergara-Amador, E; Davalos Herrera, D; Moreno, L Á

    2016-01-01

    Few studies have evaluated the radiologic characteristics of the development of the anterior tibial tuberosity. This study aimed to evaluate the radiologic characteristics of the anterior tibial tuberosity in a pediatric population broken down into age groups. We assessed 210 plain-film X-rays of the knee from patients aged from 10 to 17 years, divided into groups according to age and sex, for the presence of ossification of the anterior tibial tuberosity, the distance between the anterior tibial tuberosity and the metaphysis, and fusion with the epiphysis. At 10 years of age, the anterior tibial tuberosity was ossified in 50% of the girls but in only 25% of the boys. In all the girls, the anterior tibial tuberosity was ossified at 11 years, fusion of the anterior tibial tuberosity with the epiphysis had started at 12 years, and fusion was complete by 17 years. In boys, the process is delayed by one year compared to girls. A single center of ossification was found in all cases. The ossification of the anterior tibial tuberosity starts distally, then the proximal part fuses with the rest of the epiphysis, and finally the distal part fuses with the tibia. The results of this study help enable a better analysis of the anterior tibial tuberosity in cases of knee pain. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Early Diagnosis of Keratoconus with Orbscan- Ⅱ Anterior System

    Institute of Scientific and Technical Information of China (English)

    李新宇; 刘磊; 邱良秀

    2002-01-01

    Summary: Orbscan- Ⅱ anterior system was used for early diagnosis of keratoconus. 48 Eyes of 24patients with suspicious keratoconus were examined by Orbscan-Ⅱ anterior system from Dec.1999 to Dec. 2000 and followed up. The values of Diff and anterior chamber depth (ACD) wererecorded. Results indicated that values of Diff and ACD were increased in 4 eyes of 2 patients withkeratoconus trend during follow-up. Taking advantage of Orbscan- Ⅱ anterior system to observethe values of Diff and ACD can early diagnose the sub-clinical keratoconus. The values of Diff andACD can sensitively report the progression of keratoconus.

  9. Avaliação de progênies obtidas de cruzamentos de descendentes do Híbrido de Timor com as cultivares Catuaí Vermelho e Catuaí Amarelo Evaluation of coffee progenies from crosses of Catuaí Vermelho and Catuaí Amarelo with "Hibrido de Timor" descents

    Directory of Open Access Journals (Sweden)

    Paulo Bonomo

    2004-01-01

    Full Text Available Avaliou-se com este trabalho o comportamento de 28 progênies F3 de Coffea arabica obtidas de cruzamentos das cultivares Catuaí Vermelho e Catuaí Amarelo com descendentes do Híbrido de Timor, realizados pela Epamig em conjunto com a UFV. Estimaram-se os parâmetros genéticos e as correlações entre caracteres, buscando conhecer a estrutura genética da população e seu potencial para o melhoramento. O experimento foi instalado em Patrocínio, Estado de Minas Gerais, em delineamento de blocos casualizados com seis repetições, contendo 28 progênies F3 e duas testemunhas da cultivar Catuaí Vermelho IAC 15. Analisaram-se as produções obtidas nas quatro colheitas iniciais, de 1997 a 2000 e alguns caracteres vegetativos. As progênies avaliadas apresentaram média de produção de grãos superior à testemunha, e grande variabilidade genética, sugerindo a possibilidade de se obter linhagens superiores. As progênies avaliadas apresentaram-se resistentes às raças fisiológicas da ferrugem presentes na região do experimento. A progênie 505-9-2 se destaca como material produtivo e vigoroso e de porte alto, enquanto as progênies 514-7-10 e 514-7-6 além de produtivas e vigorosas apresentaram porte baixo semelhante à cultivar Catuaí Vermelho IAC 15. A produção de grãos apresentou correlação genotípica alta e positiva com os caracteres diâmetro do caule, vigor, porte, altura e diâmetro da planta, mas não apresentou resultados consistentes de correlação com carga pendente. A produção de grãos de anos de colheita mostrou-se correlacionada com a produção total de quatro anos apenas a partir do segundo ano de produção.This research aimed to evaluate the behavior of twenty eight F3 progenies of arabica coffee obtained from crosses between Catuaí cultivar and the Híbrido de Timor descents, done by Epamig in association with UFV. Genetic parameters and correlation coefficients among agronomic traits were estimated in order

  10. Avaliação da dispersão de curvas força x elongação de segmentos de cólon descendente de ratos por meio do modelo sigmoidal de Boltzmann Evaluation of the force x elongation curves dispersion of descending colon of rats using Boltzmann's sigmoidal model

    Directory of Open Access Journals (Sweden)

    Eduardo Lucas Konrad Burin

    2009-03-01

    Full Text Available OBJETIVO: avaliar a dispersão de curvas Força x Elongação (FE representativas do comportamento mecânico de alça cólica íntegra de ratos. MATERIAIS E MÉTODOS: dez segmentos de cólon descendente de ratos machos Wistar foram submetidos ao teste biomecânico Energia Total de Ruptura. Cada curva gerada por esse ensaio foi ajustada ao modelo de Boltzmann, o qual correlaciona os valores de força e elongação por meio da combinação dos parâmetros A1, A2, x0 e d x. Nesse contexto, para cada parâmetro, foram calculadas as médias, os desvios padrão e correlações. Após, determinou-se a dispersão resultante da força em todo processo de deformação através de uma análise que considera as correlações entre as grandezas, com base na lei de propagação das incertezas. Para determinar um intervalo no qual estarão contidos 95% dos valores de força, a dispersão resultante foi multiplicada por um fator de abrangência considerando-se uma distribuição normal. RESULTADOS: os valores da média, do desvio padrão e das correlações foram determinados. A dispersão resultante dos valores de força foi expandida, delineando-se limites dentro dos quais estarão contidas as curvas FE para um intervalo de confiança de 95%. CONCLUSÃO: essa metodologia poderá auxiliar na avaliação de variáveis que interfiram no comportamento mecânico intestinal.PURPOSE: to evaluate the dispersion of Force x Elongation curves (FE that represents the mechanical behavior of rat's colon. MATERIALS AND METHODS: ten descending colon segments were submitted to the Total Energy of Rupture Test. Each curve generated by this test was fitted to Boltzmann model that correlates the values of force and elongation through the combination of the parameters A1, A2, x0 and d x. Then, for each parameter were calculated the mean, standard deviation and their correlations. Later, the resultant dispersion was determinated in the whole deformation process by an analysis that

  11. Síndrome tóxica do segmento anterior Toxic anterior segment syndrome

    Directory of Open Access Journals (Sweden)

    Luiz Filipe de Albuquerque Alves

    2013-02-01

    Full Text Available A síndrome tóxica do segmento anterior (STSA é uma severa reação inflamatória aguda causada por agente não infeccioso que entra no segmento anterior, resultando em lesão celular tóxica com necrose e apoptose mediado por resposta imunológica. Neste relato de caso de STSA são enfatizadas as causas mais comuns para o aparecimento da síndrome, apontam para os cuidados que devem ser tomados no processo de esterilização do material cirúrgico além de revisar a melhor conduta diante desses casos. Em conclusão notou-se que o foco principal deve ser a prevenção, pois o tratamento busca apenas suprimir a resposta inflamatória secundária. O tratamento nos casos de STSA consiste em intensa instilação de esteróides tópicos com seguimento rigoroso e controle de complicações tardias como o glaucoma.Toxic anterior segment syndrome is acute inflammatory reaction caused by a noninfectious substance that enters the anterior segment, resulting in extracellular damage with necrosis and apoptosis during an immune response. We have the report of a case of toxic anterior segment syndrome (TASS, in which the authors seek to emphasize the most common causes of the appearance of these syndrome. They point out the care that must be taken in the process of sterilization of surgical material, in addition to reviewing the best conduct when faced with these cases. In conclusion, it was noted that the main focus should be on prevention, as treatment only seeks to suppress the secondary inflammatory response. Treatment in cases of toxic anterior segment syndrome (TASS consists of intense instillation of topical steroids with strict follow-up and control of late complications such as glaucoma.

  12. Day case arthroscopic anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Elgafy, H; Elsafty, M

    1998-10-01

    This is a report of the first 33 consecutive patients who had arthroscopic anterior cruciate ligament (ACL) reconstruction in the day unit of Sandwell District General Hospital. Bone-patellar tendon-bone autograft was used. This study assessed post-operative pain control, clinical results and patient satisfaction with day case surgery. The mean age was 29 years, (range 17-43). The mean period between injury and reconstruction was 29 months, (range 2-50). The mean follow-up period was 16 months (range 6-31). In 31 patients (94%), adequate post-operative pain control was achieved with oral non opioid analgesic. No patient required readmission for pain control, nausea, vomiting or urinary retention. At the last follow up, the mean Lysholm score was 93.9, (range 68-100). Thirty-one patients (94%) were satisfied with the day case surgery and believed that they did not require hospitalization after surgery.

  13. RETAINED STONE PIECE IN ANTERIOR CHAMBER

    Directory of Open Access Journals (Sweden)

    ZvornicaninJasmin, Nadarevic-VodencarevicAmra

    2015-04-01

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

  14. Neurologic complication after anterior sciatic nerve block.

    Science.gov (United States)

    Shah, Shruti; Hadzic, Admir; Vloka, Jerry D; Cafferty, Maureen S; Moucha, Calin S; Santos, Alan C

    2005-05-01

    The lack of reported complications related to lower extremity peripheral nerve blocks (PNBs) may be related to the relatively infrequent application of these techniques and to the fact that most such events go unpublished. Our current understanding of the factors that lead to neurologic complications after PNBs is limited. This is partly the result of our inability to conduct meaningful retrospective studies because of a lack of standard and objective monitoring and documentation procedures for PNBs. We report a case of permanent injury to the sciatic nerve after sciatic nerve block through the anterior approach and discuss mechanisms that may have led to the injury. Intraneural injection and nerve injury can occur in the absence of pain on injection and it may be heralded by high injection pressure (resistance).

  15. Essentials of anterior cruciate ligament rupture management.

    Science.gov (United States)

    Klinge, Stephen A; Sawyer, Gregory A; Hulstyn, Michael J

    2013-05-01

    Anterior cruciate ligament (ACL) rupture is a common knee injury and an understanding of current medical knowledge regarding its management is essential. Accurate and prompt diagnosis requires an awareness of injury mechanisms and risk factors, common symptoms and physical/radiologic findings. Early mobilization and physical therapy improves outcomes regardless of treatment modality. Many older patients regain sufficient stability and function after non-operative rehabilitation. Early ACL reconstruction is appropriate for younger patients and those who engage in activities requiring frequent pivoting and rapid direction changes. ACL surgery involves reconstruction of the torn ligament tissue with various replacement graft options, each with advantages and disadvantages. The guidance of a knowledgeable and experienced therapist is required throughout an intensive and prolonged rehabilitation course. Generally excellent outcomes and low complication rates are expected, but treatment does not prevent late osteoarthritis.

  16. Anterior uveitis and diabetes mellitus: immunological study.

    Science.gov (United States)

    Castagna, I; Famà, F; Salmeri, G

    1995-01-01

    The association between anterior uveitis (AU) and diabetes mellitus (DM) has always been known. The purpose of this study was to estimate the incidence of this association and to consider a possible role of the cell-mediated immune system. During the years 1989-1992, 196 diabetics (66 patients affected by type I DM and 130 by type II DM) were studied. The study of the lymphocytic subsets and the measurement of the circulating immunocomplexes and autoantibodies (ANA, AMA, ADNA, ASMA, APCA) were carried out, and the results were compared with those of a control group. The results underline the correlation between AU and type I DM. Many immunological reactions could play a crucial role: the high levels of CD8 subsets found could be an expression of the unstable lymphocytic equilibrium.

  17. Concrescent triplets involving primary anterior teeth

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2013-01-01

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

  18. Clinical Outcomes Following Revision Anterior Shoulder Stabilization

    Science.gov (United States)

    Frank, Rachel M.; Mellano, Chris; Shin, Jason J.; Feldheim, Terrence F.; Mascarenhas, Randhir; Yanke, Adam Blair; Cole, Brian J.; Nicholson, Gregory P.; Romeo, Anthony A.; Verma, Nikhil N.

    2015-01-01

    Objectives: The purpose of this study was to determine the clinical outcomes following revision anterior shoulder stabilization performed either via all-arthroscopic soft tissue repair or via Latarjet coracoid transfer. Methods: A retrospective review of prospectively collected data on 91 shoulders undergoing revision anterior shoulder stabilization was performed. All patients underwent prior soft tissue stabilization; those with prior open bone grafting procedures were excluded. For patients with 25% glenoid bone loss, Latarjet was performed (n=28). Patients were queried regarding recurrent instability (subluxation or dislocation). Clinical outcomes were evaluated using validated patient reported outcome questionnaires including the American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), visual analog scale (VAS) for pain, and Western Ontario Shoulder Instability Index (WOSI). Results: A total of 63 shoulders in 62 patients (46 males, 16 females) with an average age of 23.2 ± 6.9 years were included in the revision arthroscopy group. At an average follow-up of 46.9 ± 16.8 months (range, 15 to 78), the mean WOSI score was 80.1 (range, 15.0 to 100), and there were significant improvements (pLatarjet group. Thirteen (46%) had more than one previous stabilization attempt. ), the average WOSI score was 71.9, and there were significant improvements (pLatarjet. Conclusion: Both arthroscopic revision stabilization and Latarjet coracoid transfer result in satisfactory outcomes in patients who have failed previous arthroscopic capsulolabral repair. Recurrent instability rates were higher in the all-arthroscopic group (19% versus 7%). Longer-term studies are required to determine whether similar results are maintained over time, and to provide guidance on focused clinical indications for this challenging patient population.

  19. Etiological aspects of anterior open bite

    Directory of Open Access Journals (Sweden)

    Stojanović Ljiljana

    2007-01-01

    Full Text Available Introduction. Open bite is a multifactorial phenomenon and no single factor can account for open-bite. Etiology plays an important role in diagnosis. Heredity, unfavorable growth patterns, incorrect jaw postoure, are the characteristics of skeletal open bite. Digit sucking. Depending on where the thumb is placed, a number of different types of dental problems can develop. Malocclusions of the late mixed or permanent dentitions, caused by thumb sucking are not self corrected and orthodontic treatment is necessary for their correction. Lymphatic tissue. In order to produce oral respiration, the mandible is postured inferiorly with the tongue protruded and resting against the oral floor. This postural alteration induces dental and skeletal modifications similar to those caused by thumb sucking. This may cause excessive eruption of the posterior teeth, leading to an increase in the vertical dimension of the face and result in development of anterior open bite. Tongue thrust. Tongue habits cause an anterior open bite or they develop secondarily to thumb sucking. In skeletal open bite the tongue habit acts as a secondary factor which helps to maintain or exacerbate the condition. Many orthodontists have had a discouraging experience of completing dental treatment, with what appeared to be good results, only to discover that the case had relapsed because the patient had a tongue thrust swallowing pattern. Conclusion. Dentoalveolar or habitual open bite is caused by habits, which influence the growth and development of dentoalveolar processes and contribute to occlusal disharmonies. Prior to eruption of adult dentition, open bite related to oral habits is usually not a concern as when the habits stop, because the erupting dentition tends to improve spontaneously. Treatment is usually not necessary until permanent teeth erupt (~6 years old. .

  20. Endoscopic anterior decompression in cervical disc disease

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2014-01-01

    Full Text Available Background: Although microscopic anterior cervical discectomy with or without fusion are common surgical procedures for treatment of cervical herniated discs, loss of disc height, pseudarthrosis, and adjacent disc degeneration are some of the problems associated with it. This study is aimed to evaluate results of endoscopic microforaminotomy in cervical disc diseases. Materials and Methods: A prospective study of 50 patients of mono segmental soft or hard disc causing myeloradiculopathy was undertaken. A visual analogue scale (VAS for neck and arm pain and functional outcomes using the Nurick grading system were assessed. There were 28, 12, 8, and 2 patients at C5-6, C6-7, C4-5, and C3-4 levels disc diseases, respectively. Patients with two or more level disc, instabilities, disc extending more than half vertebral body height, and previous operation at the same segment were excluded. Results: Age ranged from 21 to 67 years. Average postoperative reduction in disc height, operating time, and blood loss was 1.1 mm, 110 minutes, and 30 ml, respectively. Average pre-operative VAS score for arm pain and Nurick grading was 7.6 and 2.7, which improved to 1.9 and 0.82, respectively. All patients improved; 1, 2, 3 grade improvement was seen in 10, 27, and 10 patients, respectively. There was no significant complication or any mortality. Conclusion: Although longer follow up of large number of patients is required, endoscopic microforaminotomy is a safe and an effective alternative to microscopic anterior discectomy with or without fusion.

  1. Anterior Cingulate epilepsy: mechanism and modulation

    Directory of Open Access Journals (Sweden)

    Bai-Chuang eShyu

    2014-01-01

    Full Text Available Epilepsy is a common neurological disorder, about 1% population worldwide suffered from this disease. In 1989, the International League Against Epilepsy (ILAE classified anterior cingulate epilepsy as a form of frontal lobe epilepsy (FLE. FLE is the second most common type of epilepsy. Previous clinical studies showed that FLE account an important cause in refractory epilepsy, therefore to find alternative approach to modulate FLE is very important. Basic research using animal models and brain slice have revealed some insights on the epileptogenesis and modulation of seizure in anterior cingulate cortex (ACC. Interneurons play an important role in the synchronization of cingulate epilepsy. Research has shown that the epileptogenesis of seizure originated from mesial frontal lobe might be caused by a selective increase in nicotine-evoked -aminobutyric acid (GABA inhibition, because the application of the GABAA receptor antagonist picrotoxin inhibited epileptic discharges. Gap junctions are also involved in the regulation of cingulate epilepsy. Previous studies have shown that the application of gap junction blockers could attenuate ACC seizures, while gap junction opener could enhance them in an in vitro preparation. -Opioid receptors have been shown to be involved in the epileptic synchronization mechanism in ACC seizures in a brain slice preparation. Application of the -Opioid agonist DAMGO significantly abolished the ictal discharges in a 4-aminopyridine (4-AP induced electrographic seizure model in ACC. Basic research has also found that thalamic modulation has an inhibitory effect on ACC seizures. Studies have shown that the medial thalamus may be a target for deep brain stimulation to cure ACC seizures.

  2. Combined operative technique with anterior surgical approach and video-assisted thoracoscopic surgical lobectomy for anterior superior sulcus tumours.

    Science.gov (United States)

    Yokoyama, Yuhei; Chen, Fengshi; Aoyama, Akihiro; Sato, Toshihiko; Date, Hiroshi

    2014-11-01

    Video-assisted thoracoscopic surgery (VATS) has been widely used, but surgical resections of superior sulcus tumours remain challenging because of their anatomical location. For such cases, less-invasive procedures, such as the anterior transcervical-thoracic and transmanubrial approaches, have been widely performed because of their excellent visualization of the subclavian vessels. Recently, a combined operative technique with an anterior surgical approach and VATS for anterior superior sulcus tumours has been introduced. Herein, we report three cases of anterior superior sulcus tumours successfully resected by surgical approaches combined with a VATS-based lobectomy. In all cases, operability was confirmed by VATS, and upper lobectomies with hilar and mediastinal lymph node dissections were performed. Subsequently, dissections of the anterior inlet of the tumours were performed using the transmanubrial approach in two patients and the anterior trans-cervical-thoracic approach in one patient. Both approaches provided excellent access to the anterior inlet of the tumour and exposure of the subclavian vessels, resulting in radical resection of the tumour with concomitant resection of the surrounding anatomical structures, including the chest wall and vessels. In conclusion, VATS lobectomy combined with the anterior surgical approach might be an excellent procedure for the resection of anterior superior sulcus tumours.

  3. Tireoide ectópica no mediastino anterior Ectopic thyroid in the anterior mediastinum

    Directory of Open Access Journals (Sweden)

    Maria José Araújo da Cunha Guimarães

    2009-04-01

    Full Text Available A ectopia de tireoide é rara, e a sua localização no mediastino anterior é excepcional, estando descritos apenas 5 casos nos últimos 30 anos. Os autores apresentam 2 casos clínicos, além de uma revisão da literatura abordando a etiologia, a embriologia e manifestações clínicas de ectopia de tireoide.Ectopic thyroid is a rare condition, and its location in the anterior mediastinum is even rarer, there having been only 5 reported cases in the past 30 years. Here, we describe 2 clinical cases and present a review of the literature regarding the etiology, embryology and clinical manifestations of ectopic thyroid.

  4. Transphyseal anterior cruciate ligament reconstruction in a skeletally immature knee using anterior tibialis allograft.

    Science.gov (United States)

    Cho, Yool; Jang, Soo-Jin; Son, Jung-Hwan

    2011-05-18

    Anterior cruciate ligament (ACL) injury in the skeletally immature individual is being recognized with increasing frequency. Nonoperative treatment of ACL injuries in skeletally immature patients have not been favorable. Surgical treatment options for complete ACL tears include primary ligament repair, extraarticular tenodesis, transphyseal reconstruction, partial transphyseal reconstruction, and physeal-sparing reconstruction. The advantage of transphyseal reconstruction is placement of the graft tissue in an isometric position, which provides better results, according to the literature. The potential disadvantage is angular or limb-length discrepancy caused by physeal violation. Controversy exists in allograft selection about whether bone or soft tissue passes into physes. The use of standard tunnels provides reliable results, but carries the risk of iatrogenic growth disturbance from physeal injury.This article presents 4 cases of transphyseal ACL reconstruction using anterior tibialis allograft in skeletally immature patients that had satisfactory functional outcomes with no growth disturbances. This is the first report of transphyseal ACL reconstruction using anterior tibialis allograft in skeletally immature patients in the English-speaking literature. All patients underwent transphyseal ACL reconstruction using anterior tibialis tendon allograft. None of the patients had angular deformities. No early physeal arrest was measured between the preoperative and postoperative radiographs. At last follow-up, the results of the Lachman test were normal for 3 patients and nearly normal for 1 patient. All patients demonstrated full range of knee motion (comparing the reconstructed knee to the contralateral knee). The results of the pivot-shift test were normal for 3 patients and nearly normal for 1 patient. No patients reported giving way.

  5. Bilateral piercing of anterior scalene muscle by anterior branches of C5 & C6

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    Cankara N

    2009-07-01

    Full Text Available During routine dissection of a 25-year-old male cadaver, we observed C5 and C6 nerve roots pierced anterior scalene muscle bilaterally and then formed the superior trunk of brachial plexus after merging on the anterolateral aspect of the muscle. Suprascapular nerve originated from the superior trunk bilaterally. Knowledge of such variations may be important in the diagnosis of upper limb paresthesias.

  6. Experimental Study on the Prevention of Anterior Segment Ischemia by Preservation of Anterior Ciliary Vessels

    Institute of Scientific and Technical Information of China (English)

    Yanna Li; Guanghuan Mai; Zhijian Wang; Xinping Yu; Huanyun Yu; Yan Guo; Xiaoming Lin; Daming Deng; Ying Kang

    2003-01-01

    Purpose: To observe the effect of preserving anterior ciliary vessels (ACVs) on anteriorsegments of rabbit eyes undergoing tenotomy of extraocular muscles.Methods: Thirty-two adult New Zealand white rabbits were divided into four groups.Same procedures were done in both eyes in each group except that left eyes underwentpreservation of ACVs. In the first group medial and lateral recti, in the second group,superior and inferior recti, in the third group, medial, lateral and superior or inferior rectiand in the fourth group, all four recti, underwent tenotomy. Slit-lamp examination,intraocular pressure (IOP) measurement, total protein and lactic acid quantification inaqueous humor were done in all eyes pre- and post-operatively. By four weeks afteroperation, the eyes were enucleated for histological examination and electron microscopy.All data were analyzed using SPSS version 10.Results: In the left eyes of both group 1 and group 2, no inflammatory response wasobserved. In the left eyes of group 3 and 4, we observed mild inflammatory response withslit-lamp examination, which disappeared in one wk. However, we did not findsignificant changes in IOP, total protein and lactic acid of aqueous humor, histology andelectron microscopic examination in these groups. In the right eyes in group 2, 3 and 4,we observed moderate to severe inflammatory changes, a few even developed anteriorsegment ischemia, appeared as decreased IOP, increased total protein and lactic acid inaqueous humor, along with pathological and electron-microscopic changes.Conclusion: Simultaneous tenotomy of three or four recti or two vertical recti on one eyemay decrease anterior segment blood flow even lead to ischemia. ACVs preservation mayprotect the blood circulation in anterior segment. Our study suggests that ACVspreservation in strabismus surgeries especially those involving multi-recti tenotomies mayprevent potential anterior segment ischemia.

  7. A study of ICP-CR difference in children with normal anterior overjet and anterior crossbite

    OpenAIRE

    石川, 亜実; 宇賀, 茂; 桑原, 幹夫; 六車, 武史; 高木, さやか; 丹下, 貴司; 藤川, 隆義; 五十嵐, 清治; 溝口, 到; イシカワ, アミ; ウガ, シゲル; クワバラ, ミキオ; ムグルマ, タケシ; タカギ, サヤカ; タンゲ, タカシ

    2001-01-01

    This study evaluated ICP-CR (Intercuspal Position -Centric Relation) difference at bilateral condyles and incisors in growing patients with anteriro crossbite (mean age; 9 years 2 months), and compared with that of subjects with normal anterior overjet (mean age; 9 years 8 months), using an indicator of the mandibular position, Mandibular Positioning Indicator (MPI). With respect to direction of the ICP-CR difference at condyles and incisors, there were no significant defferences between subj...

  8. Temporal and spatial requirements for Nodal-induced anterior mesendoderm and mesoderm in anterior neurulation.

    Science.gov (United States)

    Gonsar, Ngawang; Coughlin, Alicia; Clay-Wright, Jessica A; Borg, Bethanie R; Kindt, Lexy M; Liang, Jennifer O

    2016-01-01

    Zebrafish with defective Nodal signaling have a phenotype analogous to the fatal human birth defect anencephaly, which is caused by an open anterior neural tube. Previous work in our laboratory found that anterior open neural tube phenotypes in Nodal signaling mutants were caused by lack of mesendodermal/mesodermal tissues. Defects in these mutants are already apparent at neural plate stage, before the neuroepithelium starts to fold into a tube. Consistent with this, we found that the requirement for Nodal signaling maps to mid-late blastula stages. This timing correlates with the timing of prechordal plate mesendoderm and anterior mesoderm induction, suggesting these tissues act to promote neurulation. To further identify tissues important for neurulation, we took advantage of the variable phenotypes in Nodal signaling-deficient sqt mutant and Lefty1-overexpressing embryos. Statistical analysis indicated a strong, positive correlation between a closed neural tube and presence of several mesendoderm/mesoderm-derived tissues (hatching glands, cephalic paraxial mesoderm, notochord, and head muscles). However, the neural tube was closed in a subset of embryos that lacked any one of these tissues. This suggests that several types of Nodal-induced mesendodermal/mesodermal precursors are competent to promote neurulation.

  9. [Organic and functional limitations due to milking phenomenon: a clinical case report].

    Science.gov (United States)

    Gómez-Henry, Juan Carlos; Rodríguez-Pérez, Francisco Antonio

    2014-01-01

    INTRODUCCIÓN: según series angiográficas, la incidencia del fenómeno de milking oscila entre 0.6 y 4 %, sin embargo, en estudios de autopsias hasta en 85 % se ha identificado puente miocárdico, patognómónico de este trastorno. La malformación del fenómeno de milking no es identificada en la mayoría de las ocasiones, pero puede tener grandes repercusiones. El propósito es ejemplificar un caso de fenómeno de milking con consecuencias de incapacidad permanente y consecuencias laborales. CASO CLÍNICO: hombre de 44 años de edad que laboralmente se ocupaba como peón albañil y peón agrícola. Como antecedentes refirió amigdalectomía y artrosis, tabaquismo de 10 cigarrillos diarios, dos o tres tazas de café diarias y dos o tres copas de vino en fin de semana. Mediante electrocardiograma se identificó ritmo sinusal y bloqueo incompleto de la rama derecha del fascículo atrioventricular. Su frecuencia cardiaca fue de 90 latidos por minuto. Para la prueba de esfuerzo se utilizó el protocolo de Bruce, que se detuvo en el primer estadio debido a crisis hipertensiva y fibrilación auricular paroxística. El cateterismo mostró tronco común izquierdo, arteria coronaria cincunfleja y arteria coronaria derecha sin lesiones, arteria descendente anterior sin lesiones con trayecto intramiocárdico y compresión sistólica en segmento medio, con lo cual se integró el diagnóstico de milking coronario. El paciente requirió incapacidad permanente total con limitación para actividades que necesitaran esfuerzo moderado.

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

    Energy Technology Data Exchange (ETDEWEB)

    Moon, W.-J. [Department of Diagnostic Radiology, Samsung Medical Center, Seoul (Korea); Institute of Neuroradiology, University of Frankfurt (Germany); Porto, L.; Lanfermann, H.; Zanella, F.E. [Institute of Neuroradiology, University of Frankfurt (Germany); Weis, R. [Department of Pediatric Neurology, University of Frankfurt (Germany)

    2002-02-01

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

  11. Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

    NARCIS (Netherlands)

    van Eijk, F.

    2009-01-01

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

  12. Anterior commissure absence without callosal agenesis: a new brain malformation.

    Science.gov (United States)

    Mitchell, T N; Stevens, J M; Free, S L; Sander, J W; Shorvon, S D; Sisodiya, S M

    2002-04-23

    The authors report a novel human brain malformation characterized by the absence of the anterior commissure without callosal agenesis, but associated with gross unilateral panhemispheric malformation incorporating subependymal heterotopia, subcortical heterotopia, and gyral abnormalities including temporal malformation and polymicrogyria. In contrast, a normal anterior commissure was found in 125 control subjects and in 113 other subjects with a range of brain malformations.

  13. Anterior urethral recurrence of superficial bladder cancer: its clinical significance.

    Directory of Open Access Journals (Sweden)

    Saika T

    2003-12-01

    Full Text Available The aim of this study was to reveal the clinical features of anterior urethral recurrence in patients with superficial bladder cancer, and to determine the appropriate treatment. Three hundred and three patients with superficial bladder cancer, who were newly diagnosed and initially treated conservatively in our hospital between 1965 and 1990, were followed for at least 5 years and their clinical outcomes were analyzed. Clinical factors, including anterior urethral recurrence, were evaluated statistically regarding tumor progression. Eight patients (2.6% had anterior urethral recurrence following superficial bladder cancer. Twenty-four patients (7.9% had tumor progression and 149 (49.2% had tumor recurrence. In a multivariate analysis using a logistic model, anterior urethral recurrence was the most important factor, followed by histological grade. Four of 5 patients who were treated for anterior urethral recurrent tumors by transurethral resection showed progression and died of the cancer within one year. Two of the remaining three patients who underwent radical cysto-urethrectomy at the time of anterior urethral recurrence survived. Anterior urethral recurrence following superficial bladder cancer is a predictor for rapid subsequent malignant progression. Once there is anterior urethral recurrence, radical intensive therapy, including radical cysto-urethrectomy, should be carried out immediately.

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

    NARCIS (Netherlands)

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

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

  15. [Bilateral anterior uveiopapillitis, suspicious of Lyme disease--case report].

    Science.gov (United States)

    Nicula, Cristina; Nicula, D; Rusu, Ioana; Popescu, Raluca

    2013-01-01

    We present the case of a patient which associated bilateral anterior uveitis manifestations with those of bilateral anterior inflammatory optic neuropathy. We followed the evolution of the case under treatment and we discussed the differential diagnosis and the association of the two ocular pathologies.

  16. Modified Anchor Shaped Post Core Design for Primary Anterior Teeth

    OpenAIRE

    R. Rajesh; Kusai Baroudi; K. Bala Kasi Reddy; Praveen, B. H.; V. Sumanth Kumar; Amit, S

    2014-01-01

    Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention.

  17. Modified Anchor Shaped Post Core Design for Primary Anterior Teeth

    Directory of Open Access Journals (Sweden)

    R. Rajesh

    2014-01-01

    Full Text Available Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention.

  18. Modified anchor shaped post core design for primary anterior teeth.

    Science.gov (United States)

    Rajesh, R; Baroudi, Kusai; Reddy, K Bala Kasi; Praveen, B H; Kumar, V Sumanth; Amit, S

    2014-01-01

    Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention.

  19. Review for the generalist: evaluation of anterior knee pain

    Directory of Open Access Journals (Sweden)

    Houghton Kristin M

    2007-05-01

    Full Text Available Abstract Anterior knee pain is common in children and adolescents. Evaluation and management is challenging and requires a thorough history and physical exam, and understanding of the pediatric skeleton. This article will review common causes of chronic anterior knee pain in the pediatric population with a focus on patellofemoral pain.

  20. [Key points in anterior esthetic restorations with all ceramic].

    Science.gov (United States)

    Luo, Xiaoping; Qian, Dongdong; Yuan, Yu; Meng, Xiangfeng

    2013-04-01

    This paper introduced the key points in fabricating anterior esthetic restorations with all ceramic materials, including pre-operative smile design, standard tooth preparation, provisional restoration fabrication, all ceramic materials selection, all ceramic restoration bonding, ceramic crack and fracture prevention. And then, the authors summarized and reviewed the clinical common problems in anterior esthetic restorations.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-09-15

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

  2. Method for measuring anterior chamber volume by image analysis

    Science.gov (United States)

    Zhai, Gaoshou; Zhang, Junhong; Wang, Ruichang; Wang, Bingsong; Wang, Ningli

    2007-12-01

    Anterior chamber volume (ACV) is very important for an oculist to make rational pathological diagnosis as to patients who have some optic diseases such as glaucoma and etc., yet it is always difficult to be measured accurately. In this paper, a method is devised to measure anterior chamber volumes based on JPEG-formatted image files that have been transformed from medical images using the anterior-chamber optical coherence tomographer (AC-OCT) and corresponding image-processing software. The corresponding algorithms for image analysis and ACV calculation are implemented in VC++ and a series of anterior chamber images of typical patients are analyzed, while anterior chamber volumes are calculated and are verified that they are in accord with clinical observation. It shows that the measurement method is effective and feasible and it has potential to improve accuracy of ACV calculation. Meanwhile, some measures should be taken to simplify the handcraft preprocess working as to images.

  3. Variant attachments of the anterior horn of the medial meniscus.

    Science.gov (United States)

    Jakubowicz, Marian; Ratajczak, Wojciech; Pytel, Andrzej

    2003-01-01

    The purpose of this study was to analyse the occurrence of variants of anomalous insertions of the anterior horn of the medial meniscus in human knee joints. The study was carried out on 78 human lower limbs of both sexes (42 males and 36 females). Out of 78 knee joints, 10 knee joints (12.82%) presented atypical attachments of the anterior horn of the medial meniscus. In 9 cases we found that the anterior horn of the medial meniscus was attached to the transverse ligament of the knee and in 1 case it was attached to the coronary ligament. In the remaining cases the anterior horn of the medial meniscus was attached to the anterior intercondylar area of the tibia.

  4. Anterior endoderm and head induction in early vertebrate embryos.

    Science.gov (United States)

    de Souza, F S; Niehrs, C

    2000-05-01

    Early work on the formation of the vertebrate body axis indicated the existence of separate head- and trunk-inducing regions in Spemann's organizer of the amphibian gastrula. In mammals some head-organizing activity may be located in anterior visceral (extraembryonic) endoderm (AVE). By analogy, the equivalent structure in the Xenopus laevis gastrula, the anterior endoderm, has been proposed to be the amphibian head organizer. Here we review recent data that challenge this notion and indicate that the involvement of AVE in head induction seems to be an exclusively mammalian characteristic. In X. laevis and chick, it is the prechordal endomesoderm that is the dominant source of head-inducing signals during early gastrulation. Furthermore, head induction in mammals needs a combination of signals from anterior primitive endoderm, prechordal plate, and anterior ectoderm. Thus, despite the homology of vertebrate anterior primitive endoderm, a role in head induction seems not to be conserved.

  5. Anterior commissure versus corpus callosum: A quantitative comparison across mammals.

    Science.gov (United States)

    Ashwell, Ken W S

    2016-04-01

    Mammals rely on two major pathways to transfer information between the two hemispheres of the brain: the anterior commissure and the corpus callosum. Metatheria and monotremes rely exclusively on the anterior commissure for interhemispheric transfer between the isocortices and olfactory allocortices of each side, whereas Eutheria use a combination of the anterior commissure and an additional pathway exclusive to Eutheria, the corpus callosum. Midline cross-sectional area of the anterior commissure and corpus callosum were measured in a range of mammals from all three infraclasses and plotted against brain volume to determine how midline anterior commissure area and its size relative to the corpus callosum vary with brain size and taxon. In Metatheria, the square root of anterior commissure area rises in almost direct proportion with the cube root of brain volume (i.e. the ratio of the two is relatively constant), whereas among Eutheria the ratio of the square root of anterior commissure area to the cube root of brain volume declines slightly with increasing brain size. The total of isocortical and olfactory allocortical commissure area rises more rapidly with increasing brain volume among Eutheria than among Metatheria. This means that the midline isocortical and olfactory allocortical commissural area of metatherians with large brains (about 70 ml) is only about 50% of that among eutherians with similarly sized brains. On the other hand, isocortical and olfactory allocortical commissural area is similar in Metatheria and Eutheria at brain volumes around 1 ml. Among the Eutheria, some groups make less use of the anterior commissure pathway than do others: soricomorphs, rodents and cetaceans have smaller anterior commissures for their brain size than do afrosoricids, erinaceomorphs and proboscideans. The findings suggest that use of the anterior commissural route for isocortical commissural connections may have placed limitations on interhemispheric transfer of

  6. The relationship between the morphological features of A1 segment of anterior cerebral artery and anterior communicating artery aneurysms

    Institute of Scientific and Technical Information of China (English)

    冯文峰

    2013-01-01

    Objective To improve the predictability of surgical clipping and guide the steam shaping of microcatheters in endovascular embolization by analyzing the association of morphological features of A1 segment of anterior cerebral artery(ACA) with formation and classification of anterior

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

    Directory of Open Access Journals (Sweden)

    Ramon Coral Ghanem

    2004-08-01

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

  8. Combined Anterior Sclera Staphylectomy and Vitrectomy with Anterior Sclera Staphyloma and Vitreous Hemorrhage Occurring 38 Years after Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Qinxiang Zheng

    2011-01-01

    Full Text Available Introduction. To report a case of anterior sclera staphyloma and vitreous hemorrhage occurring over 38 years after bilateral cataract surgery. Methods. A 58-year-old man presented with anterior sclera staphyloma and vitreous hemorrhage in the right eye, after bilateral cataract surgery, over 38 years ago. We performed combined anterior sclera staphylectomy and vitrectomy of right eye for anterior sclera staphyloma and vitreous hemorrhage. Results. Forty-eight months after the combined surgery, best-corrected visual acuity was 0.3 (+10.00/−4.50 × 60 with eutopic stitches of the corneoscleral junction on the superior nasal quadrant and a stable ocular surface. Conclusions. This is the first reported case of anterior sclera staphyloma with vitreous hemorrhage successfully managed by combined surgery.

  9. Failure of Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Gonzalo Samitier

    2015-10-01

    Full Text Available The present review classifies and describes the multifactorial causes of anterior cruciate ligament (ACL surgery failure, concentrating on preventing and resolving such situations. The article particularly focuses on those causes that require ACL revision due to recurrent instability, without neglecting those that affect function or produce persistent pain. Although primary ACL reconstruction has satisfactory outcome rates as high as 97%, it is important to identify the causes of failure, because satisfactory outcomes in revision surgery can drop to as much as 76%. It is often possible to identify a primary or secondary cause of ACL surgery failure; even the most meticulous planning can give rise to unexpected findings during the intervention. The adopted protocol should therefore be sufficiently flexible to adapt to the course of surgery. Preoperative patient counseling is essential. The surgeon should limit the patient’s expectations for the outcome by explaining the complexity of this kind of procedure. With adequate preoperative planning, close attention to details and realistic patient expectations, ACL revision surgery may offer beneficial and satisfactory results for the patient.

  10. Failure of Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Gonzalo Samitier

    2015-09-01

    Full Text Available The present review classifies and describes the multifactorial causes of anterior cruciate ligament (ACL surgery failure, concentrating on preventing and resolving such situations. The article particularly focuses on those causes that require ACL revision due to recurrent instability, without neglecting those that affect function or produce persistent pain. Although primary ACL reconstruction has satisfactory outcome rates as high as 97%, it is important to identify the causes of failure, because satisfactory outcomes in revision surgery can drop to as much as 76%. It is often possible to identify a primary or secondary cause of ACL surgery failure; even the most meticulous planning can give rise to unexpected findings during the intervention. The adopted protocol should therefore be sufficiently flexible to adapt to the course of surgery. Preoperative patient counseling is essential. The surgeon should limit the patient’s expectations for the outcome by explaining the complexity of this kind of procedure. With adequate preoperative planning, close attention to details and realistic patient expectations, ACL revision surgery may offer beneficial and satisfactory results for the patient.

  11. Anterior cutaneous nerve entrapment syndrome: management challenges

    Science.gov (United States)

    Chrona, Eleni; Kostopanagiotou, Georgia; Damigos, Dimitrios; Batistaki, Chrysanthi

    2017-01-01

    Anterior cutaneous nerve entrapment syndrome (ACNES) is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic), ultrasound-guided blocks, chemical neurolysis, and surgical neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed management strategies for ACNES. PMID:28144159

  12. Anterior Interhemispheric Approach for Olfactory Groove Meningioma

    Directory of Open Access Journals (Sweden)

    Imam Hidayat

    2016-09-01

    Full Text Available Objective: To evaluate the surgical technique with bifrontal interhemispheric approach for total removal of tumor in olfactory groove meningioma (OGM. Methods: This study described a case of a 38-year-old woman with bilateral blindness, anosmia, and behaviour changes. Imaging studies show a tumor mass in midfrontal base. Surgery using a bifrontal interhemispheric approach was performed and total removal was achieved and postoperative computed tomography (CT scan was performed to confirm the result. Histopathological findings established a diagnosis of meningioma. Results: A coronal skin incision behind the hairline was utilized. The scalp was elevated, taking care to reserve the vascularized pericranium medial to the linea temporalis of each side, and preserving the 2 supraorbital nerves. Eight burr holes were used, with the two initial holes made on each side of the orbitotemporal region, and the other four holes at the midline. A bifrontal craniotomy was performed. The tumor was first detached from its attachment with bipolar cautery and debulked. During this step, the main tumor feeder arteries from the anterior and posterior ethmoidal artery were interrupted, and the tumor devascularized. Total tumor removal through surgical intervention was achieved and confirmed by head CT-scan postoperatively. Conclusions: This case report supports the suitability of the bifrontal interhemispheric approach for OGM resection with additional radiation therapy.

  13. Restoring primary anterior teeth: updated for 2014.

    Science.gov (United States)

    Waggoner, William F

    2015-01-01

    The purpose of this paper was to review the current literature associated with the techniques and materials for the restoration of primary anterior teeth and make clinical recommendations based upon the available literature. A variety of esthetic restorative materials are available to utilize for restoring primary incisors. Awareness of the specific strengths, weakness, and properties of each material can enhance the clinician's ability to make the best choice of selection for each individual situation. Intracoronal restorations of primary teeth may utilize resin composites, glass ionomer cements, resin-modified ionomers, or polyacid-modified resins. Full coronal restoration of primary incisors may be indicated for a number of reasons. Crowns available for restoration of primary incisors include those that are directly bonded onto the tooth, which generally are a resin material, and crowns that are luted onto the tooth and are either some type of stainless steel or zirconia crown. There is insufficient controlled, clinical data to suggest that one type of restoration is superior to another. Operator preferences, esthetic demands by parents, the child's behavior, the amount of tooth structure remaining, and moisture and hemorrhage control are all variables that affect the decision and ultimate outcome of whatever restorative solution is chosen.

  14. Anterior cruciate ligament injury in professional dancers.

    Science.gov (United States)

    Meuffels, Duncan E; Verhaar, Jan A N

    2008-08-01

    Anterior cruciate ligament injury (ACL) is a common sport injury; however, there are no data concerning dance and ACL injury. We report the incidence, injury mechanism, and clinical follow-up of ACL injury in professional dancers. In a retrospective cohort study involving the three major dance companies in the Netherlands, by interviewing all 253 dancers who had had a full-time contract during 1991-2002, dancers with symptomatic ACL injury or past ACL reconstruction were identified and examined. 6 dancers (2 of whom were women) had had a symptomatic ACL rupture and reconstruction. Interestingly, all had been on the left side and had had a similar trauma mechanism: while dancing a classical variation they landed, after a jump, on their left leg, in the turned out position with a valgus force on their knee. There was a higher risk of ACL injury in the classical company than in the two contemporary companies. The risk of dancers having a rupture of the left ACL during a 10-year career in this classical company was 7%. ACL injuries are not an infrequently seen type of injury in professional classical dancers, with a very specific mechanism of injury--a landing on the left leg in exorotation. More attention and prophylactic measures should be given to this specific injury mechanism.

  15. Distal tendinosis of the tibialis anterior tendon.

    Science.gov (United States)

    Beischer, Andrew D; Beamond, Ben M; Jowett, Andrew J L; O'Sullivan, Richard

    2009-11-01

    Disorders of the tibialis anterior (TA) tendon have infrequently been reported but spontaneous rupture of this tendon is well recognized. The clinical presentation of tendinosis without rupture of the distal TA has not previously been reported and is the basis of this paper. A study of 29 patients diagnosed with distal TA tendinosis was undertaken. Data collected included, patient demographics, weight, height, pain profile and examination findings. All patients underwent MRI of the symptomatic foot. Operative findings of those patients undergoing surgery for this condition were collected. Twenty-nine patients (32 feet) were included in the study group. Their mean age was 62 years and 27 patients were female. Twenty-one patients were overweight. The usual presenting symptom was burning medial midfoot pain that was often reported to be worst at night. Swelling over the TA tendon was frequently observed. On MRI the TA was thickened in all patients. Longitudinal split tears were observed in 19 feet. Chondral thinning and/or osteophyte formation at the first tarsometatarsal or medial naviculocuneiform joints was observed in 11 feet. Eleven feet underwent surgery. Universally the TA tendon was macroscopically thickened and had lost its normal fibrillary appearance. Longitudinal split tears were observed in eight tendons. Pathology was typical of a degenerative tendinosis. Distal TA tendinosis is a condition that seems to predominantly affect overweight elderly women. It often presents with nocturnal burning medial midfoot pain.

  16. Doença arterial coronariana, exercício físico e estresse oxidativo Enfermedad arterial coronaria, ejercicio físico y estrés oxidativo Coronary heart disease, physical exercise and oxidative stress

    Directory of Open Access Journals (Sweden)

    Ricardo Aurino de Pinho

    2010-04-01

    Full Text Available As doenças cardiovasculares (DCV lideram os índices de morbidade e mortalidade no Brasil e no mundo, sendo a doença arterial coronariana (DAC a causa de um grande número de mortes e de gastos em assistência médica. Inúmeros fatores de risco para a DAC estão diretamente relacionados à disfunção endotelial. A presença desses fatores de risco induz a diminuição da biodisponibilidade de óxido nítrico (NO, o aumento da formação de radicais livres (RL e o aumento da atividade endotelial. Essas mudanças podem levar a uma capacidade vasodilatadora prejudicada. Inúmeras intervenções são realizadas no tratamento da DAC, incluindo agentes farmacológicos, mudança nos hábitos alimentares, suplementação nutricional e exercício físico regular, cujos efeitos benéficos sobre a função endotelial vêm sendo demonstrados em experimentos com animais e humanos. Entretanto, a literatura ainda é controversa quanto à intensidade de esforço necessária para provocar alterações protetoras significativas na função endotelial. Da mesma forma, exercícios intensos estão também relacionados ao aumento no consumo de oxigênio e ao consequente aumento na formação de radicais livres de oxigênio (RLO.Las enfermedades cardiovasculares (ECV lideran los índices de morbilidad y mortalidad en Brasil y en el mundo, siendo la enfermedad arterial coronaria (EAC la causa de un gran número de muertes y de gastos en asistencia médica. Numerosos factores de riesgo para EAC están directamente relacionados a la disfunción endotelial. La presencia de estos factores de riesgo induce la disminución de la biodisponibilidad de óxido nítrico (NO, el aumento de la formación de radicales libres (RL y el aumento de la actividad endotelial. Esos cambios pueden perjudicar la capacidad vasodilatadora. En el tratamiento de la EAC se realizan numerosas intervenciones, incluyendo agentes farmacológicos, cambio en los hábitos alimentarios, suplemento

  17. Acesso radial em intervenções coronarianas percutâneas: panorama atual brasileiro Acceso radial en intervenciones coronarias percutáneas: panorama actual brasileño Radial approach in percutaneous coronary interventions: current status in Brazil

    Directory of Open Access Journals (Sweden)

    Pedro Beraldo de Andrade

    2011-04-01

    Full Text Available FUNDAMENTO: Embora a técnica radial exiba resultados incontestáveis na redução de complicações vasculares e ocorrência de sangramento grave quando comparada à técnica femoral, seu emprego permanece restrito a poucos centros que a elegeram como via de acesso preferencial. OBJETIVO: Avaliar o cenário atual das intervenções coronarianas percutâneas no Brasil quanto à utilização da via de acesso radial. MÉTODOS: Análise dos dados cadastrados de forma espontânea na Central Nacional de Intervenções Cardiovasculares (CENIC durante o quadriênio de 2005-2008, o que totaliza 83.376 procedimentos. RESULTADOS: A técnica radial foi utilizada em 12,6% dos procedimentos efetivados, e a técnica femoral, em 84,3%. Os 3,1% restantes foram representados pela dissecção ou punção braquial. Com uma taxa de sucesso de 97,5%, a opção pelo acesso radial associou-se à redução significativa de complicações vasculares quando comparado ao femoral (2,5% versus 3,6%, p FUNDAMENTO: Aunque la técnica radial exhiba resultados incontestables en la reducción de complicaciones vasculares y ocurrencia de sangrado grave cuando es comparada a la técnica femoral, su empleo permanece restringido a pocos centros que la eligieron como vía de acceso preferencial. OBJETIVO:Evaluar el escenario actual de las intervenciones coronarias percutáneas en el Brasil en cuanto a la utilización de la vía de acceso radial. MÉTODOS:Análisis de los datos registrados de forma espontánea en la Central Nacional de Intervenciones Cardiovasculares (CENIC durante el cuatrienio de 2005-2008, lo que totaliza 83.376 procedimientos. RESULTADOS:La técnica radial fue utilizada en 12,6% de los procedimientos efectuados, y la técnica femoral, en 84,3%. Los 3,1% restantes fueron representados por la disección o punción braquial. Con una tasa de éxito de 97,5%, la opción por el acceso radial se asoció a la reducción significativa de complicaciones vasculares cuando

  18. Doença arterial coronariana e vivência de perdas Enfermedad arterial coronaria y vivencia de pérdidas Coronary artery disease and experiences of losses

    Directory of Open Access Journals (Sweden)

    Rachel Jurkiewicz

    2009-10-01

    Full Text Available FUNDAMENTO: Na literatura, a depressão aparece associada a doenças cardiovasculares. A partir da experiência clínica, observou-se a categoria vivência de perdas associada à instalação e ao desenvolvimento da coronariopatia. A vivência de perdas, desencadeada por evento(s significativo(s apontado(s pelo paciente, implica em processo de luto, remetendo-o aos fatores psicossociais predisponentes ao adoecer. OBJETIVO: Investigar vivência de perdas por meio da avaliação do estado de luto e de depressão, e verificar a relação entre ambos, em pacientes internados com doença arterial coronariana. MÉTODOS: Avaliaram-se 44 pacientes internados, com os diagnósticos de infarto agudo do miocárdio ou angina, de 33 a 65 anos, 50% homens e 50% mulheres. Foram utilizados dois instrumentos: entrevista semi-estruturada para investigação de vivência de perdas e avaliação do estado de luto, e inventário de depressão de Beck para avaliação de depressão. Os resultados foram relacionados pelo programa Statistical Package for Social Sciences, versão 11.0. RESULTADOS: O estado de luto pode ser identificado em 66% dos casos, com significativa relação entre luto e depressão (p FUNDAMENTO: En la literatura, la depresión aparece asociada a enfermedades cardiovasculares. A partir de la experiencia clínica, se observó la categoría vivencia de pérdidas asociada a la instalación y al desarrollo de la coronariopatía. La vivencia de pérdidas, desencadenada por evento(s significativo(s señalados(s por el paciente, implica en el proceso de luto, y remetiéndole a los factores psicosociales predisponentes a lo volverse enfermo. OBJETIVO: Investigar la vivencia de pérdidas por medio de la evaluación del estado de luto y de depresión, y verificar la relación entre ambos, en pacientes internados con enfermedad arterial coronaria. MÉTODOS: Se evaluaron a 44 pacientes internados, con los diagnósticos de infarto agudo de miocardio o angina

  19. Unusual Morphology of the Anterior Arch of Atlas

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    Srinivasa Rao Sirasanagndla

    2016-10-01

    Full Text Available Anomalies of anterior arch of atlas vertebra are seldom reported in the literature. Presence of inferior accessory ossicle is one of the reported anomalies of the anterior arch of atlas. In the present case, we report a rare case of unusual morphology of the atlas vertebra. It was observed in one of the bones macerated locally for the teaching purpose. There were two wide accessory bony laminae extending from the middle three fourth of the superior and inferior aspect of the anterior arch proper. Each bony lamina was measured 4 cm x 0.3 mm. Further, there were small foramina along the attached border of the each bony lamina. Anterior tubercle was situated at the lower edge of the anterior arch proper. Accessory bony lamina may interfere with rotatory movements of the atlas and may lead to degenerative changes of the dense. Reporting of unusual morphology of anterior arch of atlas vertebra is clinically important during diagnostic procedures of neck pain. Sometimes this extra growth of the anterior arch may be mistaken for the pathologic mass.

  20. Measurement of anterior chamber volume with rotating scheimpflug camera and anterior segment optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    FU Jing; LI Shu-ning; WANG Xiao-zhen; WU Ge-wei; MU Da-peng; WANG Jian; WANG Ning-li

    2010-01-01

    Background Measurement of anterior segment parameters plays an important role in diagnosis and treatment of glaucoma. The objective of this study was to evaluate the repeatability and reproducibility of anterior chamber volume (ACV) measurements with rotating scheimpflug camera (RSC) and to examine agreement with anterior segment optical coherence tomography (AS-OCT). Methods Thirty nine healthy normal subjects were recruited from the Eye Center of Tongren Hospital. ACV was measured using RSC and AS-OCT in a randomly selected eye for each subject. For RSC measurements, both automatic and manual ACV measurements and 2 independent operators' ACV measurements were obtained. All subjects were invited for 3 visits within a week to evaluate repeatability and reproducibility of ACV measurement by RSC. Agreement was evaluated between RSC and AS-OCT. Results Good repeatability and reproducibility were found for both automatic and manual ACV measurements obtained by RSC. For intrasession repeatability, coefficient of variation (CVw) and intraclass correlation coefficient (ICC) values for automatic were 3.52% and 0.98; the values for manual were 3.44% and 0.97, respectively. For intersession reproducibility, the respective CVw and ICC values were 3.96% and 0.96. Good agreement was also found in 2 operators for both automatic and manual ACV measurements; nevertheless, poor agreement was found between RSC and AS-OCT (95% confidence interval (CI) for agreement of automatic RSC measurement versus AS-OCT were -96.3 to 72.8 μl and 95% CI for agreement of manual RSC measurement versus AS-OCT were between -41.7 to 10.1 μl). Conclusions Both RSC automatic and manual ACV measurements showed good repeatability and reproducibility, and showed comparable agreement between 2 independent operators, but poor agreement was found between RSC and AS-OCT.

  1. Measurement of anterior chamber volume with rotating scheimpflug camera and anterior segment optical coherence tomography.

    Science.gov (United States)

    Fu, Jing; Li, Shu-ning; Wang, Xiao-zhen; Wu, Ge-wei; Mu, Da-peng; Wang, Jian; Wang, Ning-li

    2010-01-20

    Measurement of anterior segment parameters plays an important role in diagnosis and treatment of glaucoma. The objective of this study was to evaluate the repeatability and reproducibility of anterior chamber volume (ACV) measurements with rotating scheimpflug camera (RSC) and to examine agreement with anterior segment optical coherence tomography (AS-OCT). Thirty nine healthy normal subjects were recruited from the Eye Center of Tongren Hospital. ACV was measured using RSC and AS-OCT in a randomly selected eye for each subject. For RSC measurements, both automatic and manual ACV measurements and 2 independent operators' ACV measurements were obtained. All subjects were invited for 3 visits within a week to evaluate repeatability and reproducibility of ACV measurement by RSC. Agreement was evaluated between RSC and AS-OCT. Good repeatability and reproducibility were found for both automatic and manual ACV measurements obtained by RSC. For intrasession repeatability, coefficient of variation (CVw) and intraclass correlation coefficient (ICC) values for automatic were 3.52% and 0.98; the values for manual were 3.44% and 0.97, respectively. For intersession reproducibility, the respective CVw and ICC values were 3.96% and 0.96. Good agreement was also found in 2 operators for both automatic and manual ACV measurements; nevertheless, poor agreement was found between RSC and AS-OCT (95% confidence interval (CI) for agreement of automatic RSC measurement versus AS-OCT were -96.3 to 72.8 microl and 95% CI for agreement of manual RSC measurement versus AS-OCT were between -41.7 to 10.1 microl). Both RSC automatic and manual ACV measurements showed good repeatability and reproducibility, and showed comparable agreement between 2 independent operators, but poor agreement was found between RSC and AS-OCT.

  2. Fibrinous anterior uveitis following laser in situ keratomileusis

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    Parmar Pragya

    2009-01-01

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

  3. Management of anterior dental crossbite with removable appliances

    Directory of Open Access Journals (Sweden)

    Ayca Tuba Ulusoy

    2013-01-01

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

  4. Orbicularis oris musculomucosal flap for anterior palatal fistula

    Directory of Open Access Journals (Sweden)

    Tiwari V

    2006-01-01

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

  5. Anterior cruciate ligament remnant and its values for preservation

    Directory of Open Access Journals (Sweden)

    Takeshi Muneta

    2017-01-01

    Full Text Available Controversy surrounds the remnant-preserving anterior cruciate ligament surgery. Advantages of remnant preservation have been reported in regard to better healing and knee function, although no consensus has been reached. This review article discussed the value and meaning of anterior cruciate ligament remnant preservation in several sections such as effects on healing, remnant classification, biomechanical evaluation, relation to proprioception, animal studies, and clinical studies. We hope that this review will facilitate further discussion and investigation for better treatment of anterior cruciate ligament injuries. So far, the current reviews have not provided sufficient scientific evidence to support the value of preserving the remnant.

  6. Anterior ablatives of the gerund in the Mozarabic Chronicle

    Directory of Open Access Journals (Sweden)

    Jana Mikulová

    2012-12-01

    Full Text Available In the Mozarabic Chronicle of 754, there are ablatives of the gerund that can be interpreted as anterior to the main predicate. Aspectual characteristics and context are considered to be the main factors for the previous interpretation. The use of the anterior ablative of the gerund gives evidence of the approximation between the present participle and the ablative of the gerund in Late Latin. The anterior ablative of the gerund, however, does not seem to be frequently used in contemporary texts.

  7. Multi drug resistant tuberculosis presenting as anterior mediastinal mass

    Directory of Open Access Journals (Sweden)

    Parmarth Chandane

    2016-01-01

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

  8. Symptomatic Type IV Dual Left Anterior Descending Coronary Artery

    Directory of Open Access Journals (Sweden)

    Kyriacos Papadopoulos MD

    2016-12-01

    Full Text Available Dual left anterior descending coronary artery is a rare congenital anomaly with 4 subtypes. Double left anterior descending coronary artery originating from the left main stem and the right coronary artery (type IV dual left anterior descending artery has been reported to occur in 0.01% to 0.7% of patients undergoing cardiac catheterization. We report a case of a 49-year-old woman who was found to have this anomaly during coronary angiography. The patient had been complaining of chest pain that mimics angina pectoris and exercise tolerance test was positive for myocardial ischemia.

  9. Anterior Cruciate Ligament Injuries in Wakeboarding

    Science.gov (United States)

    Starr, Harlan M.; Sanders, Brett

    2012-01-01

    Background: Wakeboarding is an increasingly popular sport that involves aggressive stunts with high risk for lower extremity injury, including anterior cruciate ligament (ACL) rupture. Little has been reported on prevalence or mechanism of ACL injury while wakeboarding. Hypothesis: The prevalence of ACL injury in wakeboarding approaches that of other high-risk sports. Analyzing the mechanism of ACL injury may aid in future efforts of prevention. Study Design: Descriptive epidemiology study. Methods: In sum, 1580 surveys were sent internationally to professional and amateur wakeboarders. The survey questioned the participants on their history of an ACL tear while wakeboarding and asked them to describe the mechanism of injury and treatment. Results: A total of 123 surveys were returned. Of this group, 52 (42.3%) acknowledged having had an ACL tear while wakeboarding. The majority described feeling a pop or buckle after attempting to land a high jump. Only 5 participants (13.5%) described a rotational mechanism created by catching the board edge in the water. Thirty-seven participants (71.15%) said that the injury ruined their ability to wakeboard before reconstruction, and 41 (78.85%) had the injury repaired surgically. Conclusion: The prevalence of ACL tears in this data set, 42.3%, is the highest reported in the literature for wakeboarding and one of the highest for any sport. The main mechanism of injury appears to involve axial compression while one lands in a provocative position; it is not related to a rotational force created by fixed bindings. The injury should be surgically repaired to effectively continue the sport. Further study is needed to determine if wakeboarding represents a high-risk sport for ACL injury. Clinical Significance: Wakeboarding may be a high-risk sport for ACL injury. Noncontact axial compression appears to be the main mechanism of injury. PMID:23016104

  10. Toxic anterior segment syndrome: common causes.

    Science.gov (United States)

    Cutler Peck, Carolee M; Brubaker, Jacob; Clouser, Sue; Danford, Chris; Edelhauser, Henry E; Mamalis, Nick

    2010-07-01

    To identify the most common risk factors associated with toxic anterior segment syndrome (TASS). Ophthalmic surgical centers in the United States, Argentina, Brazil, Italy, Mexico, Spain, and Romania. A TASS questionnaire on instrument cleaning and reprocessing and extraocular and intraocular products used during cataract surgery was placed on the American Society of Cataract and Refractive Surgery web site. A retrospective analysis of questionnaires submitted by surgical centers reporting cases of TASS was performed between June 1, 2007, and May 31, 2009, to identify commonly held practices that could cause TASS. Members of the TASS Task Force made site visits between October 1, 2005, and May 31, 2009, and the findings were evaluated. Data from 77 questionnaires and 54 site visits were analyzed. The reporting centers performed 50 114 cataract surgeries and reported 909 cases of TASS. From January 1, 2006, to date, the 54 centers reported 367 cases in 143 919 procedures; 61% occurred in early 2006. Common practices associated with TASS included inadequate flushing of phaco and irrigation/aspiration handpieces, use of enzymatic cleansers, detergents at the wrong concentration, ultrasonic bath, antibiotic agents in balanced salt solution, preserved epinephrine, inappropriate agents for skin prep, and powdered gloves. Reuse of single-use products and poor instrument maintenance and processing were other risk factors. The survey identified commonly held practices associated with TASS. Understanding these findings and the safe alternatives will allow surgical center personnel to change their practices as needed to prevent TASS. No author has a financial or proprietary interest in any material or method mentioned. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Asociación entre el volumen de grasa epicárdica y las placas coronarias diagnosticadas por tomografía multicorte/ Associationbetweenepicardialfatvolume and coronary plaques diagnosedbymultislicecomputedtomography

    Directory of Open Access Journals (Sweden)

    José A. Morán Quijada

    2015-12-01

    Full Text Available Introduction: Coronary atherosclerotic disease is a major cause of death in Cuba and elsewhere. The volume of epicardial fat is considered a new cardiovascular risk factor because of its association with coronary atherogenesis. Objective: To determine, by multislice computed tomography, the association between epicardial fat volume and the presence of coronary atherosclerotic plaques. Method: A descriptive study was conducted with a universe of 130 patients with chest pain suggestive of ischemic heart disease, of which 117 were selected by opinion sampling. These patients underwent a calcium score study, a coronary angiography and a measurement of the epicardial fat volume. Results: Male patients predominated (54.7% and those aged 60-69 years (32.5%. A high volume of epicardial fat was found in 51.3% of patients, affecting 52.8% of women; 78.9% of patients with a calcium score between 100 and 399 UH had a high volume of epicardial fat, just as 71.2% of those with plaques and 100% of those with 4 or 5 plaques; 41% of patients had various types of plaque, which were mainly located in the anterior descending artery (88.1%. Conclusions: The measurement of the volume of epicardial fat is a useful tool to estimate the presence of coronary disease. When it was high, it was associated with older age, female gender and the presence of a higher calcium score, more plaques, more injuries and a greater involvement of the anterior descending artery.

  12. Estudio comparativo en pacientes con implante de stent liberador de droga y stent convencional. Resultados clínicos e indicaciones

    Directory of Open Access Journals (Sweden)

    Mariano Albertal

    2006-01-01

    Full Text Available Antecedentes Estudios aleatorizados demostraron la superioridad del uso de stents liberadores de droga (SL sobre el stent convencional (SC. La información en nuestro medio sobre el implante de SL es escasa. Objetivo Comparar los resultados clínicos obtenidos en pacientes sometidos a implante de SL versus SC en un centro terciario de la Argentina. Material y métodos Se incluyeron todos los pacientes sometidos a angioplastia electiva desde abril de 2003 hasta junio de 2005 y se dividieron en dos grupos: los pacientes sometidos a implante de uno o más SL (grupo SL, n = 373 y los sometidos solamente a implante de SC (grupo SC, n = 857. Resultados Las características basales fueron similares entre los dos grupos. En el grupo SL se observó un porcentaje mayor de lesiones en la arteria descendente anterior (50,6 versus 40,6%; p 0,001, gracias a una reducción de la tasa de cirugía coronaria (1,4% versus 5,8%; p = 0,045. Conclusión El uso de SL en un centro terciario de la Argentina demostró que es seguro y, en comparación con el implante de sólo SC, dio por resultado una tasa menor de reintervención, primariamente por haber reducido la tasa de cirugía de revascularización miocárdica

  13. The role of the anterior commissure in callosal agenesis.

    Science.gov (United States)

    Barr, Melodie S; Corballis, Michael C

    2002-10-01

    Two individuals with callosal agenesis (J.P. and M.M.) and 10 neurologically normal participants were tested on tasks requiring interhemispheric visual integration. M.M., whose anterior commissure was within normal limits, was much worse at matching colors and letters between visual fields than within visual fields, whereas J.P., whose anterior commissure was greatly enlarged, showed no evidence of interhemispheric disconnection. This suggests that in some cases of callosal agenesis, probably a minority, an enlarged anterior commissure may compensate for the lack of the corpus callosum. Neither acallosal participant showed interhemispheric disconnection on tasks requiring integration of location and orientation, however, suggesting that the anterior commissure plays no role in such tasks. These tasks may depend on subcortical commissures, such as the intertectal commissure.

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

    LENUS (Irish Health Repository)

    Walker, Cameron

    2009-12-01

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

  15. CARTILAGE-LIKE PHENOMENON IN THE ANTERIOR CRUCIATE LIGAMENT

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective. To detect histological characteristic of anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Methods. In each of 20 skeletally mature male mongrels and 4 men, the ACL and MCL were examined by standard hematoxylin-eosin procedure and toluidine blue staining for histologic observation. Results. The fibroblasts in medial collateral are elongated to spindle shape and aligned in a row between the bundles of collagenous fibers. Toluidine blue staining is negative. The anterior cruciate ligament demonstrated more heterogenous cell types and arrangement. It had three major cell forms:spindle, round and ovoid type, which were shorter but greater than the cells in medial collateral ligament. Toluidine blue staining was positive in anterior cruciate ligament. Most cells in anterior cruciate ligament were enclosed within lacunae. Conclusion. This study suggests that the ACL has different histological characteristics from MCL, and is more cartilage-like in nature.

  16. CARTILAGE-LIKE PHENOMENON IN THE ANTERIOR CRUCIATE LIGAMENT

    Institute of Scientific and Technical Information of China (English)

    蒋青; 林共周; 典绵域; 崔国庆; 滕华建

    2001-01-01

    Objective. To detect histological characteristic of anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Methods. In each of 20 skeletally mature male mongrels and 4 men, the ACL and MCL were examined by standard hematoxylin-eosin procedure and toluidine blue staining for histologic observation. Results. The fibroblasts in medial collateral are elongated to spindle shape and aligned in a row between the bundles of collagenous fibers. Toluidine blue staining is negative. The anterior cruciate ligament demonstrated more heterogenous cell types and arrangement. It had three major cell forms: spindle, round and ovoid type,which were shorter but greater than the cells in medial collateral ligament. Toluidine blue staining was positive in anterior cruciate ligament. Most cells in anterior cruciate ligament were enclosed within lacunae. Conclusion. This study suggests that the ACL has different histological characteristics from MCL, and is more cartilage-like in nature.

  17. QUADROS CONCEITUAIS DO CETICISMO ANTERIOR A SEXTO EMPÍRICO

    Directory of Open Access Journals (Sweden)

    Rodrigo Pinto de Brito

    2013-08-01

    Full Text Available Artigo em que demonstramos, através de tabelas que servem como ferramentas depesquisa, os principais ganhos conceituais do ceticismo anterior a Sexto Empírico, em suasdiferentes fases.

  18. Sandwich-like reconstruction of anterior skull base defects

    Institute of Scientific and Technical Information of China (English)

    WANG Zhengmin; WANG Dehui

    2002-01-01

    @@ RESULTS From October, 1984 to October, 1998, 116 patients underwent transcranial or transcranial-facial approach for the resection of malignant or benign aggressive tumor, and sandwich-like repairs were performed for the anterior skull base defect.

  19. Anterior Palatal Island Advancement Flap for Bone Graft Coverage ...

    African Journals Online (AJOL)

    2015 Journal of Surgical Technique and Case Report | Published by Wolters Kluwer - Medknow. 42. Anterior Palatal Island ... prosthodontic treatments should have ideal characteristics, as .... are rotated palatal flap and palatal advanced flap.

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

    African Journals Online (AJOL)

    2015-06-11

    Jun 11, 2015 ... Primary synovial sarcoma is a very rare tumor of the mediastinum, which is unreported in the entire ... and cytogenetics are required to therapeutic management ... off the left upper lung zone and resected from the anterior.

  1. Application and experience of anterior vitrectomy in phacoemulsification

    Directory of Open Access Journals (Sweden)

    Xiao-Bo Zeng

    2016-02-01

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

  2. Reconstruction of a complex anterior abdominal wall defect with ...

    African Journals Online (AJOL)

    Prof. Oluwatosin

    2011-09-13

    Sep 13, 2011 ... defect with autologous tissues – a case report ... The anterior abdominal wall is a complex fascio-muscular structure, defects of which may ... The histology of the excised specimen, surprisingly, came back as a malignant ...

  3. Crowned odontoid process and osteoarthrosis of the anterior atlantoaxial joint

    Energy Technology Data Exchange (ETDEWEB)

    Skaane, P.; Klott, K.J.

    1981-01-01

    Crowned odontoid process and osteoarthrosis of the anterior atlantoaxial joint. The so-called peridentale aureole ( crowned odontoid ), a horseshoelike calcification around the odontoid process, can occasionally be shown on transbuccal views of the occipito-atlantoaxial region, but is commonly only seen on a.p. tomography in patients with osteoarthrosis of the anterior atlantoxial joint. Tomographic examinations reveal that these irregular horseshoe-like calcifications around the odontoid peg represent mainly the osteophyte formation on the superior border of the anterior arch of the atlas. These calcifications are often surrounding a smaller calcification on the tip of the odontoid peg sometimes with a bucket-handle appearance corresponding to the ostephyte formation on the odontoid process. The peridentale aureole or crowned odontoid process is easily overlooked unless tomography is performed, and misinterpretations are possible if the radiologist is not familiar with this appearance of osteoarthrosis and some other joint diseases of the anterior atlantoaxial joint.

  4. Restoration of primary anterior teeth: review of the literature.

    Science.gov (United States)

    Lee, Jacob K

    2002-01-01

    This paper reviews the published data on restorations of primary anterior teeth. The discussion includes Class III restorations, Class V restorations, various forms of full coronal restorations, atraumatic restorative technique (ART) and recommendations for future research.

  5. Acute exertional anterior compartment syndrome in an adolescent female.

    Science.gov (United States)

    Fehlandt, A; Micheli, L

    1995-01-01

    Acute compartment syndromes usually occur as a complication of major trauma. While the chronic exertional anterior tibial compartment syndrome is well described in the sports medicine literature, reports of acute tibial compartment syndromes due to physical exertion, or repetitive microtrauma, are rare. The case of an adolescent female who developed an acute anterior compartment syndrome from running in a soccer game is described in this report. Failure to recognize the onset of an acute exertional compartment syndrome may lead to treatment delay and serious complications. Whereas the chronic exertional anterior compartment syndrome is characterized by pain that diminishes with the cessation of exercise, the onset of the acute exertional anterior compartment syndrome is heralded by pain that continues, or increases, after exercise has stopped. Compartment pressure measurement confirms the clinical diagnosis and helps guide treatment. True compartment syndromes require urgent fasciotomy.

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

    Science.gov (United States)

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

    2008-02-01

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

  7. Anterior chest wall involvement in patients with pustulosis palmoplantaris.

    Science.gov (United States)

    Jurik, A G

    1990-01-01

    With the aim of determining the frequency and radiographic features of anterior chest wall involvement in patients with pustulosis palmoplantaris, a questionnaire was sent to 107 patients. Ninety-three patients returned the questionnaire, five of whom were excluded from further analysis due to the appearance of psoriatic lesions. Twenty-five (28%) of the remaining 88 patients reported pain and/or swelling of joints or bones in the anterior chest wall. All were examined radiographically, using tomography, and a group of 20 patients without anterior chest wall complaints were examined similarly. Sixteen of the patients with, but none of the patients without, complaints were found to have arthro-osteitis of the anterior chest wall, consisting of diffuse sclerosis of the manubrium sterni in one patient, localized sclerosis in seven patients, and sequelae of arthritis of the sternoclavicular, upper sternocostal and/or manubriosternal joint in eight patients.

  8. Anterior sacral meningocoele presenting as a peri-anal abscess.

    Science.gov (United States)

    Buxton, N; Bassi, S; Firth, J

    2002-06-01

    Anterior sacral meningoceole is a rare occurrence and presentation as a perianal abscess has not been previously reported. The case is presented and the condition discussed. The potential risks of failing to establish the diagnosis, prior to surgery, are outlined.

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Esthetic Challenges in Rehabilitating the Anterior Maxilla: A Case Report.

    Science.gov (United States)

    Miranda, M E; Olivieri, K A; Rigolin, F J F; de Vasconcellos, A A

    2016-01-01

    The rehabilitation of an unesthetic smile in the anterior maxilla is always a clinical challenge, especially when an improper shape and size, old restorations, and unesthetic shading are present. In addition, an irregular gingival zenith contour in the anterior maxilla can affect the smile's harmony. Thus, detailed treatment planning is needed to define a functional and esthetic prosthetic rehabilitation. This study describes a clinical case in which a 55-year-old woman was rehabilitated using Digital Smile Design planning and full ceramic crowns (metal free) in the anterior zone of the maxilla and mandible. To normalize the gingival zenith, a dynamic compression technique was performed using provisional restorations to condition the gingival tissues and harmonize the proportional length of the anterior upper teeth.

  11. Asteroid hyalosis removal during phacoemulsification: an anterior approach

    Directory of Open Access Journals (Sweden)

    Mohamed Anbar

    2017-01-01

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

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

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    NARCIS (Netherlands)

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

    2007-01-01

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

  14. Simple self-reduction method for anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Reiner Wirbel

    2014-01-01

    Conclusion: The presented Boss-Holzach-Matter method for reduction of anterior shoulder dislocation is a simple method without the need of anaesthesia, but cooperation from patients is crucial. The successful rate is comparable with other established methods.

  15. ATP economy of force maintenance in human tibialis anterior muscle

    DEFF Research Database (Denmark)

    Nakagawa, Yoshinao; Ratkevicius, Aivaras; Mizuno, Masao

    2005-01-01

    PURPOSE: The aim of this study was investigate ATP economy of force maintenance in the human tibialis anterior muscle during 60 s of anaerobic voluntary contraction at 50% of maximum voluntary contraction (MVC). METHODS: ATP turnover rate was evaluated using P magnetic resonance spectroscopy (P......-MRS). The total volume of ankle dorsiflexor muscles was assessed by H magnetic resonance imaging (MRI) (H-MRI), and the fiber type composition of the tibialis anterior muscle was evaluated using histochemical analysis of muscle biopsies. RESULTS: The tibialis anterior muscle occupied 59.7 +/- 0.6% (mean +/- SEM......) of the total ankle dorsiflexor muscle volume, which was 267 +/- 10 cm. Relative cross-sectional areas occupied by Type I, IIA, and IIB fibers in the tibialis anterior were 69.3 +/- 2.2, 27.4 +/- 2.76, and 3.2 +/- 1.0%, respectively. ATP economy of force maintenance did not change significantly during the 60-s...

  16. An overlay partial denture to restore worn mandibular anterior teeth.

    Science.gov (United States)

    Samant, Asha; DeSciscio, Peter

    2014-01-01

    Restoring worn anterior mandibular teeth is a challenge, especially when teeth are small, esthetics are a concern, the long-term prognosis is questionable, and/or patient finances are an issue. This article describes an alternate treatment for a patient with a collapsed bite, missing posterior mandibular teeth, an ill-fitting complete maxillary denture with poor esthetics, and irregular, worn mandibular anterior teeth.

  17. Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

    DEFF Research Database (Denmark)

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

    2014-01-01

    OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN...... and longitudinal changes including osteoarthritis (OA) features. Joint features assessed were acute osteochondral injury, traumatic and degenerative bone marrow lesions (BMLs), meniscus morphology and extrusion, osteophytes, collateral and cruciate ligaments including ACL graft, Hoffa-synovitis and effusion...

  18. Neovascular glaucoma treatment with extraction of anterior chamber fibrovascular tissue.

    Science.gov (United States)

    Nadal, Jeroni; Carreras, Elisa; Kudsieh, Bachar; Canut, Maribel

    2013-08-01

    The use of antibody to vascular endothelial growth factor to treat neovascular glaucoma yields good anatomic results in most cases. However, this type of glaucoma can cause angle closure with decompensation of intraocular pressure secondary to fibrovascular tissue contraction in the anterior chamber. Our surgical technique treats the cause by removing the anterior chamber fibrous complex after administration of antibody to vascular endothelial growth factor, thus restoring the chamber angle.

  19. [Chondroblastoma in the anterior cruciate ligament origo: a case report].

    Science.gov (United States)

    Aydin, Hafız; Turhan, Ahmet Uğur; Karataş, Metin; Onay, Atilgan; Yildiz, Kadriye

    2012-01-01

    Chondroblastoma is a rarely seen cartilage originated tumor. It is mostly localized in the epiphysis of long bones. In this article, we present an 18-year-old male case in whom the tumor was located in the right distal femoral lateral condyle and destroyed anterior cruciate ligament origo. The tumor was curetted and the cavity was filled with cement. Anterior cruciate ligament resection was mandatory for this treatment. The patient had no complaint in the postoperative period.

  20. Resorption of labial bone in maxillary anterior implant

    OpenAIRE

    Cho, Young-Bum; Moon, Seung-Jin; Chung, Chae-Heon; Kim, Hee-Jung

    2011-01-01

    PURPOSE The purpose of this study was to evaluate the amount of resorption and thickness of labial bone in anterior maxillary implant using cone beam computed tomography with Hitachi CB Mercuray (Hitachi, Medico, Tokyo, Japan). MATERIALS AND METHODS Twenty-one patients with 26 implants were followed-up and checked with CBCT. 21 OSSEOTITE NT® (3i/implant Innovations, Florida, USA) and 5 OSSEOTITE® implants (3i/implant Innovations, Florida, USA) were placed at anterior region and they were posi...

  1. Inhibitory reflex responses of masseter muscle in anterior open bite

    OpenAIRE

    Priyada, SANTILAKANAWONG; Hiroaki, KIRIMOTO; Yoichiro, SEKI; Kunimichi, SOMA; Orthodontic Science, Department of Orofacial Development and Function, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University

    2003-01-01

    Animal studies indicated that loss of occlusal contact between maxillary and mandibular teeth causes altered functional activity of periodontal mechanoreceptors. The alteration of periodontal mechanoreceptors may influence jawmuscle reflex and masticatory muscle activity. In this study, the inhibitory reflex response of masseter muscle in subjects with anterior open bite was investigated. The study population included 10 subjects with anterior open bite with no muscle pain or craniomandibular...

  2. Increased CD40 ligand in patients with acute anterior uveitis

    DEFF Research Database (Denmark)

    Øgard, Carsten; Sørensen, Torben Lykke; Krogh, Erik

    2005-01-01

    The inflammatory response in acute anterior uveitis (AU) is believed to be primarily mediated by autoreactive T-cells. We wanted to evaluate whether the T-cell activation marker CD40 ligand is involved in the AU immunopathogenesis.......The inflammatory response in acute anterior uveitis (AU) is believed to be primarily mediated by autoreactive T-cells. We wanted to evaluate whether the T-cell activation marker CD40 ligand is involved in the AU immunopathogenesis....

  3. Altered anterior visual system development following early monocular enucleation

    Directory of Open Access Journals (Sweden)

    Krista R. Kelly

    2014-01-01

    Conclusions: The novel finding of an asymmetry in morphology of the anterior visual system following long-term survival from early monocular enucleation indicates altered postnatal visual development. Possible mechanisms behind this altered development include recruitment of deafferented cells by crossing nasal fibres and/or geniculate cell retention via feedback from primary visual cortex. These data highlight the importance of balanced binocular input during postnatal maturation for typical anterior visual system morphology.

  4. The etiological features of anterior uveitis in a Turkish population.

    Science.gov (United States)

    Guney, Esra; Akcay, Betul Ilkay Sezgin; Erdogan, Gurkan; Unlu, Cihan; Akcali, Gulunay; Bayramlar, Huseyin

    2012-01-01

    To identify any patterns in the cause of anterior uveitis in a Turkish population and compare them with results from previous studies. The clinical records of 75 patients between January 2009 and January 2010 were retrospectively analyzed and classified as anterior uveitis according to Standardization of Uveitis Nomenclature criteria. Complete blood count, sedimentation rate, chest radiography, purified protein derivative skin test, and venereal disease research laboratory test were done on all patients. Additional serologic and radiographic tests were performed when indicated. Forty-one (54.6%) were male and 34 (45.3%) were female patients. The mean age at presentation was 39.1 ± 12.6 years. Fifty-six (74.6%) had unilateral and 19 (25.3%) had bilateral disease at presentation. A specific diagnosis was able to be established in 54 (72%) patients. The most common diagnoses were anterior uveitis associated with human leukocyte antigen B27 (14.6%) and Fuchs uveitis syndrome (14.6%). The second most common diagnosis was uveitis associated with herpes simplex virus (13.3%), followed by Behcet's uveitis (6.6%). Systemic disease associations were noted in 15 (20%) patients, and the most commonly associated systemic disease was Behcet's disease (6.6%). Fuchs uveitis syndrome and anterior uveitis associated with human leukocyte antigen B27 were the most common form of anterior uveitis in this study. Using a systematic approach, a diagnosis was able to be established in 72% of the anterior uveitis cases.

  5. Relevance of anterior mandibular body ostectomy in mandibular prognathism

    Science.gov (United States)

    Bansal, Pankaj; Singh, Virender; Anand, S. C.; Bansal, Sumidha

    2013-01-01

    Purpose: We tried to find out the relevance of anterior mandibular body ostectomy in deformities of the mandible specially prognathism, which is primarily limited to anterior part only. Patients and Methods: Ten patients with skeletal deformity along with malocclusion, which was limited to anterior body of mandible were selected. Selected patients had proper molar interdigitation (even if class 3) and in general had anterior crossbite (except one). All patients had crossed their growth spurts and had no hormonal influence on facial deformity. Specific protocol, including cephelometric analysis cephalometry for orthognathic surgery, prediction tracing and model surgeries were devised. Pre and post-surgical orthodontics and body ostectomy were performed in all patients along with 18-month post-op follow-up. Results: There was significant reduction in prognathism and horizontal dysplasia in all ten patients. Anterior crossbite as well as axis of incisiors over mandibular plane was corrected in all patients due to decrease in length of mandibular body. All patients showed decreased facial height and better lip competence with intact posterior occlusion and no (negligible or transient) sensory loss. Conclusions: Our study could confirm that people whose deformity is limited to the anterior part of mandible with reasonable occlusion posteriorly can get satisfactory cosmetic and functional results through body ostectomy alone rather than going for surgical procedure in the ramal area, which is liable to cause sensory and occlusal disturbances. PMID:24163554

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Armando Alemán Rivera

    2001-06-01

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

  8. A Technique of Improved Medial Meniscus Visualization by Anterior Cruciate Ligament Graft Placement in Chronic Anterior Cruciate Deficient Knees.

    Science.gov (United States)

    Vertullo, Christopher J; Wijenayake, Lahann; Grayson, Jane E

    2016-04-01

    It is customary to perform medial meniscus repair before anterior cruciate ligament (ACL) graft placement when undertaken as a combined procedure. However, in chronic ACL-deficient knees, intraoperative anterior tibiofemoral translation can cause the medial meniscus repair to be more technically challenging. Intraoperative anterior tibiofemoral translation can both reduce the visualization of the medial meniscus and make its reduction unstable. An operative sequence alteration of ACL graft placement and tensioning before medial meniscal repair improves medial meniscus visualization in chronically ACL-deficient knees by using the ACL graft's ability to prevent anterior tibiofemoral translation. The technique sequence is as follows: (a) the medial meniscus is reduced, (b) ACL reconstruction is undertaken using a hamstring graft without final tibia fixation,

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

    Energy Technology Data Exchange (ETDEWEB)

    Tirman, P.F.J. [San Francisco Magnetic Resonance Center, San Francisco, CA (United States); Steinbach, L.S. [Department of Radiology, University of California, San Francisco, CA (United States); Feller, J.F. [Department of Veterans Affairs, David Grant USAF Medical Center, Travis Air Force Base, CA (United States); Stauffer, A.E. [Radiologic Imaging Associates, Mission Viejo, CA (United States)

    1996-11-01

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

  10. Grande fístula bilateral da artéria coronária: a escolha do tratamento clínico Gran fístula bilateral de la arteria coronaria: la selección del tratamiento clínico Large bilateral coronary artery fistula: the choice of clinical treatment

    Directory of Open Access Journals (Sweden)

    Luciana Oliveira Cascaes Dourado

    2009-09-01

    Full Text Available Relatamos o caso de um paciente do sexo feminino, assintomática, com grande fístula bilateral da artéria coronária-artéria pulmonar. O monitoramento clínico foi a opção escolhida para tratamento. Discutimos os pormenores das opções terapêuticas, enfatizando a tendência excessiva de utilizar a abordagem cirúrgica e a grande escassez de acompanhamentos clínicos de longo prazo em pacientes assintomáticos.Relatamos el caso de un paciente del sexo femenino, asintomática, con gran fístula bilateral de la arteria coronaria-arteria pulmonar. El monitoreo clínico fue la opción elegida para el tratamiento. Discutimos los pormenores de las opciones terapéuticas, enfatizando la tendencia excesiva de utilizar el abordaje quirúrgico y la gran escasez de seguimientos clínicos de largo plazo en pacientes asintomáticos.

  11. Silicone Oil Tamponade Combined with Lensectomy Preserving Anterior Lens Capsule

    Institute of Scientific and Technical Information of China (English)

    LuL; YangJ

    1999-01-01

    Purpose:To investigate the therapeutic effect and indicatio n of silicone oil tamponade combined with lensectomy preserving anterior lens capsule.Methods:Silicone oil tamponade combined with lensectomy preserving anterior lens capsule was performed in 33 cases (33 eyes)of high myopia ,proliferative vitroretinopathy(PVR)D grade and giant retinal tear(GRT).10 cases were onlyeye and 11 cases had harder nucleus of lens.The surgical methods included:1.smashing lens nucleus and lensectomy preserving complete anterior capsule;2,vitrectomy and membrane peeling;3,usage of liquid perfluorocarbin or retinotomy or drainage;4.silicone oil tamponade;5.postoperative Nd;YAG laser for anterior capsulectomy. Results:Follow-up time was 6 months or more in 29 cases.Total retinal reattachment was achieved in 22 cases,macular retinal reattachment in 5 cases.The visual acuity was 20/800 to 20/200 in 13 cases,20/100 to 20/50 in 12 cases.Visual acuity was significantly improved in GRT group(P<0.05).Complications included unexpected anterior capsule break intraoperatively,anterior capsule opacity,silicone oil emulsification and liquid perfluorocarbin remainig postoperatively.Conclusions:Silicone oil tamponade combined with lensectomy preserving anterior capsule was safe and can reduce the operative complications.The indications included:1.GRT complicated with high myopia;2,advanced PVR cases complicated with high myopia in which silicone oil must be used;3.severe lens opacity cases in which silicone oil must be used;4.complex retinal detachment of only ye.

  12. The etiological features of anterior uveitis in a Turkish population

    Directory of Open Access Journals (Sweden)

    Guney E

    2012-06-01

    Full Text Available Esra Guney, Betul Ilkay Sezgin Akcay, Gurkan Erdogan, Cihan Unlu, Gulunay Akcali, Huseyin BayramlarOphthalmology Clinic, Umraniye Research and Training Hospital, Istanbul, TurkeyPurpose: To identify any patterns in the cause of anterior uveitis in a Turkish population and compare them with results from previous studies.Methods: The clinical records of 75 patients between January 2009 and January 2010 were retrospectively analyzed and classified as anterior uveitis according to Standardization of Uveitis Nomenclature criteria. Complete blood count, sedimentation rate, chest radiography, purified protein derivative skin test, and venereal disease research laboratory test were done on all patients. Additional serologic and radiographic tests were performed when indicated.Results: Forty-one (54.6% were male and 34 (45.3% were female patients. The mean age at presentation was 39.1 ± 12.6 years. Fifty-six (74.6% had unilateral and 19 (25.3% had bilateral disease at presentation. A specific diagnosis was able to be established in 54 (72% patients. The most common diagnoses were anterior uveitis associated with human leukocyte antigen B27 (14.6% and Fuchs uveitis syndrome (14.6%. The second most common diagnosis was uveitis associated with herpes simplex virus (13.3%, followed by Behcet’s uveitis (6.6%. Systemic disease associations were noted in 15 (20% patients, and the most commonly associated systemic disease was Behcet’s disease (6.6%.Conclusion: Fuchs uveitis syndrome and anterior uveitis associated with human leukocyte antigen B27 were the most common form of anterior uveitis in this study. Using a systematic approach, a diagnosis was able to be established in 72% of the anterior uveitis cases.Keywords: anterior uveitis, differential diagnosis, etiology, laboratory investigations

  13. Histological analysis of the tibial anterior cruciate ligament insertion.

    Science.gov (United States)

    Oka, Shinya; Schuhmacher, Peter; Brehmer, Axel; Traut, Ulrike; Kirsch, Joachim; Siebold, Rainer

    2016-03-01

    This study was performed to investigate the morphology of the tibial anterior cruciate ligament (ACL) by histological assessment. The native (undissected) tibial ACL insertion of six fresh-frozen cadaveric knees was cut into four sagittal sections parallel to the long axis of the medial tibial spine. For histological evaluation, the slices were stained with haematoxylin and eosin, Safranin O and Russell-Movat pentachrome. All slices were digitalized and analysed at a magnification of 20×. The anterior tibial ACL insertion was bordered by a bony anterior ridge. The most medial ACL fibres inserted from the medial tibial spine and were adjacent to the articular cartilage of the medial tibial plateau. Parts of the bony insertions of the anterior and posterior horns of the lateral meniscus were in close contact with the lateral part of the tibial ACL insertion. A small fat pad was located just posterior to the functional ACL fibres. The anterior-posterior length of the medial ACL insertion was an average of 10.8 ± 1.1 mm compared with the lateral, which was only 6.2 ± 1.1 mm (p flat and 'c-shaped' way. The most anterior part of the tibial ACL insertion was bordered by a bony anterior ridge and the most medial by the medial tibial spine. No posterolateral fibres nor ACL bundles have been found histologically. This histological investigation may improve our understanding of the tibial ACL insertion and may provide important information for anatomical ACL reconstruction.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

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

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

    Science.gov (United States)

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

    2013-01-01

    Antecedentes: la arteria cerebral anterior se origina de la bifurcación de la arteria carótida interna lateral al quiasma óptico, posteriormente se une con su homóloga contralateral mediante la arteria comunicante anterior. El complejo precomunicante(A1)-arteria comunicante anterior es el lugar más frecuente de variantes anatómicas y el sitio con mayor cantidad de aneurismas (30 a 37%). Objetivo: conocer la anatomía microquirúrgica, las variantes anatómicas y la importancia del complejo segmento precomunicante-arteria comunicante anterior en cirugía neurológica de la patología vascular, principalmente aneurismas, en población mexicana. Material y métodos: estudio prospectivo y descriptivo efectuado en el Departamento de Anatomía de la Facultad de Medicina (UNAM) en 30 encéfalos inyectados. Se estudió la anatomía microquirúrgica (longitud y calibre) del complejo segmento precomunicante-arteria comunicante anterior de la arteria cerebral anterior y sus variantes. Resultados: se encontraron 60 segmentos precomunicantes. La longitud promedio del lado izquierdo fue de 11.35 mm y del derecho de 11.84 mm. El calibre medio en el lado izquierdo fue de 1.67 mm y en el derecho de 1.64 mm. El número promedio de perforantes en el lado izquierdo fue de 7.9 y en el derecho de 7.5. La arteria comunicante anterior se encontró en 29 encéfalos sobre el quiasma óptico, su trayecto dependió de la longitud del segmento A1. La longitud media del segmento fue de 2.84 mm, el calibre fue de 1.41 mm y el número promedio de perforantes de 3.27. En 18 encéfalos (60%) se encontraron variantes del complejo A1-arteria comunicante anterior y dos aneurismas tipo blíster. Conclusión: es necesario entender la anatomía microquirúrgica del complejo segmento precomunicante-arteria comunicante anterior y conocer las variantes para tener una visión en tercera dimensión durante la cirugía de aneurismas.

  16. Evaluation of Anterior Segment's Structures in Tilted Disc Syndrome

    Science.gov (United States)

    Ozsoy, Ercan; Demirel, Ersin Ersan; Cumurcu, Tongabay

    2016-01-01

    Purpose. To evaluate anterior segment's structures by Pentacam in patients with tilted disc syndrome (TDS). Methods. Group 1 included forty-six eyes of forty-six patients who have the TDS. Group 2 including forty-six eyes of forty-six cases was the control group which was equal to the study group in age, gender, and refraction. A complete ophthalmic examination was performed in both groups. All cases were evaluated by Pentacam. The axial length (AL) of eyes was measured by ultrasound. Quantitative data obtained from these measurements were compared between two groups. Results. There was no statistically significant difference for age, gender, axial length, and spherical equivalent measurements between two groups (p = 0.625, p = 0.830, p = 0.234, and p = 0.850). There was a statistically significant difference for central corneal thickness (CCT), corneal volume (CV), anterior chamber angle (ACA), and pupil size measurements between two groups (p = 0.001, p = 0.0001, p = 0.003, and p = 0.001). Also, there was no statistically significant difference for anterior chamber depth (ACD), anterior chamber volume (ACV), and lens thickness (LT) measurements between two groups (p = 0.130, p = 0.910, and p = 0.057). Conclusion. We determined that CCT was thinner, CV was less, and ACA was narrower in patients with TDS. There are some changes in the anterior segment of the eyes with tilted disc. PMID:27648303

  17. Myringoplasty for anterior and subtotal perforations using KTP-532 laser.

    Science.gov (United States)

    Gerlinger, Imre; Ráth, Gábor; Szanyi, István; Pytel, József

    2006-09-01

    A retrospective study was performed on patients who underwent myringoplasty for either anterior or subtotal perforations over an 8-year period (from 1994 till 2004). We used the KTP-laser assisted anterior anchoring technique combining with anterior "pull-back" method. Patients' ages ranged from 6-62 years (median 36.5). The mean follow-up period was 2.8 years (minimum 6 months). The audiological results were analysed with the "Pytel software", which was developed in our department. As for the procedure, the drum remnant was freed from the malleus handle with the use of the laser and elevated out of it's sulcus anterior-superiorly. Large fascia graft was fashioned with a split of 4-5 mm in the middle of one edge. The graft was placed using the underlay technique medial to the handle of the malleus. A pull-back tunnel was created at the border of the anterior quadrants to further facilitate the survival of the graft. In this series the graft taking rate was 100%. Reperforation due to an undersized fascia was observed in one case. Post-operative audiological results indicated no bone conduction threshold elevation in any frequencies. Using the laser, cochlear trauma can be prevented, double fixation of the drum prevents lateralisation and blunting. Wide canalplasty makes both the approach and the follow-up very easy. Thorough soft tissue and bone work is advantageous from the fascia taking rate point of view.

  18. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens

    Science.gov (United States)

    Spierer, Oriel; O'Brien, Terrence P.

    2016-01-01

    A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful. PMID:27462251

  19. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens.

    Science.gov (United States)

    Spierer, Oriel; O'Brien, Terrence P

    2016-01-01

    A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful.

  20. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens

    Directory of Open Access Journals (Sweden)

    Oriel Spierer

    2016-05-01

    Full Text Available A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful.

  1. Diffuse Anterior Retinoblastoma with Sarcoidosis-Like Nodule

    Directory of Open Access Journals (Sweden)

    Koji Kitazawa

    2015-12-01

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

  2. Anterior chamber lenses. Part II: A laboratory study.

    Science.gov (United States)

    Apple, D J; Hansen, S O; Richards, S C; Ellis, G W; Kavka-Van Norman, D; Tetz, M R; Pfeffer, B R; Park, R B; Crandall, A S; Olson, R J

    1987-03-01

    An analysis of 606 surgically removed anterior chamber intraocular lens (IOL) specimens revealed that 351 or 58% of these were small-diameter, round loop, closed-loop styles. Because of the extremely high percentage of IOLs with this design received in our laboratory and the correlation of clinical histories with our histopathologic findings, we have concluded that such IOLs do not provide the safety and efficacy achieved by other anterior chamber lens designs. The finely polished, one-piece, all-PMMA styles fared well in our study. Although these one-piece styles comprise well over 50% of the American market share of anterior chamber IOLs, they comprise only 14% of all anterior chamber IOLs accessioned in our laboratory, compared to 58% for closed-loop designs. We believe that implantation of anterior chamber lenses with small-diameter, round, closed loops is no longer warranted. Patients in whom these IOLs have already been implanted should be carefully followed. It is our opinion that the FDA should recall or closely monitor all IOLs of this design and that implantation of closed-loop lenses should be discontinued in the United States. Furthermore, we believe that an IOL deemed to be not medically sound or worthy of implantation in the United States should not be marketed or donated outside of this country.

  3. Features extraction in anterior and posterior cruciate ligaments analysis.

    Science.gov (United States)

    Zarychta, P

    2015-12-01

    The main aim of this research is finding the feature vectors of the anterior and posterior cruciate ligaments (ACL and PCL). These feature vectors have to clearly define the ligaments structure and make it easier to diagnose them. Extraction of feature vectors is obtained by analysis of both anterior and posterior cruciate ligaments. This procedure is performed after the extraction process of both ligaments. In the first stage in order to reduce the area of analysis a region of interest including cruciate ligaments (CL) is outlined in order to reduce the area of analysis. In this case, the fuzzy C-means algorithm with median modification helping to reduce blurred edges has been implemented. After finding the region of interest (ROI), the fuzzy connectedness procedure is performed. This procedure permits to extract the anterior and posterior cruciate ligament structures. In the last stage, on the basis of the extracted anterior and posterior cruciate ligament structures, 3-dimensional models of the anterior and posterior cruciate ligament are built and the feature vectors created. This methodology has been implemented in MATLAB and tested on clinical T1-weighted magnetic resonance imaging (MRI) slices of the knee joint. The 3D display is based on the Visualization Toolkit (VTK).

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

    Science.gov (United States)

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

    2015-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Antonio Egydio de Carvalho Junior

    2010-01-01

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

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

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    Irene Rojas Rondón

    2010-01-01

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

  7. Unilateral persistent fetal vasculature coexisting with anterior segment dysgenesis.

    Science.gov (United States)

    Khokhar, Sudarshan; Gupta, Shikha; Arora, Tarun; Gogia, Varun; Dada, Tanuj

    2013-08-01

    Persistent fetal vasculature (PFV) is a common congenital developmental anomaly of the eye which results from failure of the embryological primary vitreous and hyaloid vasculature to regress by the time of birth (Int Ophthalmol Clin 48: 53-62, 2008). Typically, it is divided into anterior, posterior or combined types and is characterized by the presence of a vascular stalk located between the optic disc and the posterior lens capsule (Int Ophthalmol Clin 48: 53-62, 2008). Although it has been reported to manifest itself differently, in our case it presented in a microphthalmic eye as anterior segment dysgenesis with broad-based mid-peripheral synechiae, posterior embryotoxon, iridoschisis, ectropion uveae, hypotony and subluxated cataractous lens with a taut anterior hyaloid face which are rare associations with PFV.

  8. Noninvasive optical interrogation of the ocular anterior chamber

    Science.gov (United States)

    Blue, Robert; Uttamchandani, Deepak G.; Wilson, Clive G.

    1998-06-01

    Ophthalmic drug research and ocular diagnostics is hampered by an inability to perform continuous sampling of the aqueous humor contained within the anterior chamber by paracentesis is technically problematic and is associated with the use of local or general anesthesia. Moreover, sampling by direct injection exposes the eye to the risk of infection. We report results obtained from an optical instrumentation technique which is concerned with the direct and non-invasive measurements of optical scattering, absorbance and fluorescence produced in the aqueous humor by various compounds, thus avoiding the need for direct sampling. Light scatter in the anterior chamber arises from particulate matter, such as cell debris and chemical precipitates following eye surgery. Absorbance is caused by the presence of materials such as haemoglobin, or results from the penetration of drugs such as hydroxyquinolines applied to the cornea. Fluorescence can be used to provide a sensitive measurements of fluoroquinolines in the anterior chamber.

  9. Dysphagia Secondary to Anterior Osteophytes of the Cervical Spine.

    Science.gov (United States)

    Egerter, Alexander C; Kim, Eric S; Lee, Darrin J; Liu, Jonathan J; Cadena, Gilbert; Panchal, Ripul R; Kim, Kee D

    2015-10-01

    Study Design Retrospective case series. Objective Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier disease involves hyperostosis of the spinal column. Hyperostosis involving the anterior margin of the cervical vertebrae can cause dysphonia, dyspnea, and/or dysphagia. However, the natural history pertaining to the risk factors remain unknown. We present the surgical management of two cases of dysphagia secondary to cervical hyperostosis and discuss the etiology and management of DISH based on the literature review. Methods This is a retrospective review of two patients with DISH and anterior cervical osteophytes. We reviewed the preoperative and postoperative images and clinical history. Results Two patients underwent anterior cervical osteophytectomies due to severe dysphagia. At more than a year follow-up, both patients noted improvement in swallowing as well as their associated pain. Conclusion The surgical removal of cervical osteophytes can be highly successful in treating dysphagia if refractory to prolonged conservative therapy.

  10. Misdiagnosis induced intraocular lens dislocation in anterior megalophthalmos

    Institute of Scientific and Technical Information of China (English)

    WANG Qi-wei; XU Wen; ZHU Ya-nan; LI Jin-yu; ZHANG Li; YAO Ke

    2012-01-01

    Anterior megalophthalmos (AM) is an uncommon developmental anomaly of the anterior segment of the eye with a constellation of findings that includes enlarged cornea,deep anterior chamber,posterior positioning of the iris and lens,iris stroma atrophy,hypoplasia of iris dilator,pupil displacement,large capsular bag,lens subluxation,prematurely cataract and the tendency to retinal detachment.AM,especially when symptoms are mild,is not an easy disease to diagnose.We present 3 AM cases that were misdiagnosed as congenital cataract with weak zonule and megalocornea.Intraocular lenses (IOLs) dislocated after standard cataract surgeries and subsequent surgery (replacing the dislocated IOLs with iris-claw intraocular lenses) achieved satisfactory outcome.Although rare,AM should be included in the differential diagnosis of enlarged cornea and we recommend implanting Artisan lens in AM patients.

  11. Anterior Segment Imaging in Ocular Surface Squamous Neoplasia

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    Sally S. Ong

    2016-01-01

    Full Text Available Recent advances in anterior segment imaging have transformed the way ocular surface squamous neoplasia (OSSN is diagnosed and monitored. Ultrasound biomicroscopy (UBM has been reported to be useful primarily in the assessment of intraocular invasion and metastasis. In vivo confocal microscopy (IVCM shows enlarged and irregular nuclei with hyperreflective cells in OSSN lesions and this has been found to correlate with histopathology findings. Anterior segment optical coherence tomography (AS-OCT demonstrates thickened hyperreflective epithelium with an abrupt transition between abnormal and normal epithelium in OSSN lesions and this has also been shown to mimic histopathology findings. Although there are limitations to each of these imaging modalities, they can be useful adjunctive tools in the diagnosis of OSSN and could greatly assist the clinician in the management of OSSN patients. Nevertheless, anterior segment imaging has not replaced histopathology’s role as the gold standard in confirming diagnosis.

  12. Complex aesthetic treatment on anterior maxillary teeth with malposition

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    Febriastuti Febriastuti

    2008-12-01

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

  13. Compartment syndrome with mononeuropathies after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Kindle, Brett J; Murthy, Naveen; Stolp, Kathryn

    2015-05-01

    Compartment syndrome rarely follows anterior cruciate ligament reconstruction. However, when it does, it may result in mononeuropathies that are amenable to neurolysis. The authors of this study present an 18-yr-old woman who sustained a right anterior cruciate ligament tear and underwent uneventful anterior cruciate ligament reconstruction using femoral and popliteal nerve blocks. Postoperatively, she developed compartment syndrome requiring emergent fasciotomies. At 11 wks after fasciotomy, results of electrophysiologic tests showed evidence of severe fibular and tibial neuropathies. Magnetic resonance images showed extensive tricompartmental myonecrosis. Fibular and tibial neurolysis as well as decompression were performed, followed by intensive outpatient rehabilitation. At the 6-mo follow-up, she reported resolution of pain as well as significant improvement in sensation, strength, and function. Early recognition and intervention are crucial to prevent serious neurologic damage. Excessive tourniquet pressure and anesthetic nerve blocks may have been responsible.

  14. Infraoptic course of the anterior cerebral artery: case report

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    Seo, Myong Hee; Lee, Ghi Jai; Shim, Jae Chan; Kwon, O Ki; Koh, Young Cho; Kim, Ho Kyun [Inje University College of Medicine, Seoul (Korea, Republic of)

    2002-12-01

    An infraoptic anterior cerebral artery (ACA) arising at a low bifurcation of the internal carotid artery is a rare anomaly, of which about 33 cases have been reported to date, often in association with cerebral aneurysms. We describe a case involving an infraoptic ACA in which a ruptured middle cerebral artery aneurysm was also present. Angiography revealed the presence of an abnormal solitary ACA, arising from the intracranial proximal internal carotid artery near the origin of the ophthalmic artery, and a contralateral middle cerebral artery aneurysm. Magnetic resonance imaging showed that the ACA passed below the ipsilateral optic nerve, anterior to the optic chiasm, to join the normally positioned anterior communicating artery above the optic chiasm.

  15. Perforation forces of the intact porcine anterior lens capsule.

    Science.gov (United States)

    Ullrich, Franziska; Lussi, Jonas; Felekis, Dimitrios; Michels, Stephan; Petruska, Andrew J; Nelson, Bradley J

    2016-09-01

    During the first step of cataract surgery, the lens capsule is perforated and a circular hole is created with a sharp instrument, a procedure called capsulorhexis. To develop automated systems that can assist ophthalmologists during capsulorhexis, the forces required must be quantified. This study investigates perforation forces of the central anterior lens capsule in porcine eyes, which are used as a conservative model for the human eye. A micro-mechanical characterisation method is presented that measures capsular bag perforation forces with a high precision positioning and high-resolution force sensing system. The force during perforation of the anterior lens capsule was measured with various sized needles and indentation speeds and is found to be 15-35mN. A bio-mechanical model is identified that describes an exponential correlation between indentation force and depth, indicating strain hardening behaviour of the porcine anterior lens capsule.

  16. Sandwich-like Reconstruction of Anterior Skull Base Defects

    Institute of Scientific and Technical Information of China (English)

    Wang Zheng-min; Wang De-hui

    2001-01-01

    Objective: To evaluate the safety and efficacy of new modality of anterior skull base repair,namely sandwich-like reconstruction of anterior skull base defects. Methods: A retrospective analysis of patients who underwent transcranial or transcranial-facial resections of malignant or benign aggressive tumors involving the anterior skull base was conducted in our department. We used the sandwich-like reconstruction, using pedicled pericranial flap, frontal muscle flap and free abdominal adipose tissue between them, to separate of cranial cavity and aerodigest tract and keep the frontal lobes in place following resections of anterior skull base tumors. Results: From October, 1984 to October, 1998, 116 patients underwent transcranial or transcranialfacial approach for the resection of malignant or aggressive benign tumor, and sandwich-like repairs were performed for the anterior skull base defect. 54 (46.6 % ) patients had previous operation, with a maximum of 5 surgeries. The average age of patients was 35.9 years old, ranging form 6 to 73 years old. Forty-eight (41.4%)patients had malignant neoplasmas, and sixty-eight (58.6%) patients had benign aggressive tumors. In our series, with the maximal follow-ups for as long as 14 years, NO one had early failure of the one-stage reconstruction. CSF fluid leakage was not encountered, nor was ascending bacterial meningitis observed. No immediate or delayed prolapse of dura or frontal lobes was observed. Conclusion: We conclude that the sandwich-like reconstruction, using pericranial flap, frontal muscle flap and free abdominal adipose between them, is an extremely safe and effective procedure for the repair of skull base defect, even when tumor extensively involves anterior skull base.

  17. Sandwich-like Reconstruction of Anterior Skull Base Defects

    Institute of Scientific and Technical Information of China (English)

    WangZheng-min,MD; WangDe-hui,MD

    2001-01-01

    Objective:To evaluate the safety and efficacy of new modality of anterior skull base repair,namely sandwich-like reconstruction of anterior skull base defects. Methods : A retrospective analysis of patients who underwent wanscranial or wanscranial-facial resections of malignant or benign aggressive tumors involving the anterior skull base was conducted in our department. We used the sandwich-like reconstruction, using pedicled pericranial flap, frontal muscle flap and free abdominal adipose tissue between them, to separate of cranial cavity and aerodigest tract and keep the frontal lobes in place following resections of anterior skull base tumors. Results: From October, 1984 to October, 1998, 116 patients underwent tmnscranial or tmnscranial-facial approach for the resection of malignant or aggressive benign tumor, and sandwich-like repairs were performed for the anterior skull base defect.54 (46.6%) patients had previous operation, with a maximum of 5 surgeries. The average age of patients was 35.9 years old, ranging form 6 to 73 years old. Forty-eight (41.4%) patients had malignant neoplasmas, and sixty-eight (58.6%) patients had benign aggressive tumors. In our series, with the maximal follow-ups for as long as 14 years, NO one had early failure of the one-stage reconstruction. CSF fluid leakage was not encountered, nor was ascending bacterial meningitis observed. No immediate or delayed prolapse of dura or frontal lobes was observed. Conclusion: We conclude that the sandwich-like reconstruction, using pericranial flap, frontal muscle flap and free abdominal adipose between them, is an extremely safe and effective procedure for the repair of skull base defect, even when tumor extensively involves anterior skull base.

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

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    Strajnić Ljiljana

    2013-01-01

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

  19. Refraction and eye anterior segment parameters in schizophrenic patients

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    Tongabay Cumurcu

    2015-06-01

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

  20. Role of Optical Coherence Tomography in Assessing Anterior Chamber Angles

    Science.gov (United States)

    Kochupurakal, Reema Thomas; Jha, Kirti Nath; Rajalakshmi, A.R.; Nagarajan, Swathi; Ezhumalai, G.

    2016-01-01

    Introduction Gonioscopy is the gold standard in assessing anterior chamber angles. However, interobserver variations are common and there is a need for reliable objective method of assessment. Aim To compare the anterior chamber angle by gonioscopy and Spectral Domain Optical Coherence Tomography (SD-OCT) in individuals with shallow anterior chamber. Materials and Methods This comparative observational study was conducted in a rural tertiary multi-speciality teaching hospital. A total of 101 eyes of 54 patients with shallow anterior chamber on slit lamp evaluation were included. Anterior chamber angle was graded by gonioscopy using the shaffer grading system. Angles were also assessed by SD-OCT with Trabecular Iris Angle (TIA) and Angle Opening Distance (AOD). Chi-square test, sensitivity, specificity, positive and negative predictive value to find correlation between OCT parameters and gonioscopy grading. Results Females represented 72.7%. The mean age was 53.93 ±8.24 years and mean anterior chamber depth was 2.47 ± 0.152 mm. Shaffer grade ≤ 2 were identified in 95(94%) superior, 42(41.5%) inferior, 65(64.3%) nasal and 57(56.4%) temporal quadrants. Cut-off values of TIA ≤ 22° and AOD ≤ 290 μm were taken as narrow angles on SD-OCT. TIA of ≤ 22° were found in 88(92.6%) nasal and 87(87%) temporal angles. AOD of ≤ 290 μm was found in 73(76.8%) nasal and 83(83%) temporal quadrants. Sensitivity in detecting narrow angles was 90.7% and 82.2% for TIA and AOD, while specificity was 11.7% and 23.4%, respectively. Conclusion Individuals were found to have narrow angles more with SD-OCT. Sensitivity was high and specificity was low in detecting narrow angles compared to gonioscopy, making it an unreliable tool for screening. PMID:27190851

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

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    Wen-xiang YUE

    2015-01-01

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

  2. Component rotation and anterior knee pain after total knee arthroplasty.

    Science.gov (United States)

    Barrack, R L; Schrader, T; Bertot, A J; Wolfe, M W; Myers, L

    2001-11-01

    All patients undergoing cruciate-retaining primary total knee arthroplasty for degenerative osteoarthritis at one center were studied prospectively. Clinical and radiographic followup was obtained at a minimum 5 years in 102 knees in 73 patients. Patients were asked specifically about the presence of the pain in the anterior aspect of the knee in the vicinity of the patella and rated the severity of the pain on a visual analog scale. Significant anterior knee pain rating at least 3 of 10 on the visual analog scale was present in 16 knees (13 patients). Eleven patients with 14 symptomatic knees agreed to undergo computed tomography scanning to accurately determine the rotation of the tibial and femoral components. The epicondylar axis and tibial tubercle were used as references using a previously validated technique. A control group of 11 asymptomatic patients (14 knees), matched for age, gender, and length of followup also underwent computed tomography scanning. All patients in both groups had normal axial alignment. There was a highly significant difference in tibial component rotation between the two groups with the patients with anterior knee pain averaging 6.2 degrees internal rotation compared with 0.4 degrees external rotation in the control group. There also was a significant difference in combined component rotation with the patients with anterior knee pain averaging 4.7 degrees internal rotation compared with 2.6 degrees external rotation in the control group. There was no significant difference in the degree of radiographic patellar tilt or patellar subluxation between the two groups. Patients with combined component internal rotation were more than five times as likely to experience anterior knee pain after total knee arthroplasty compared with those with combined component external rotation. Component malrotation is a significant factor in the development of anterior knee pain after total knee arthroplasty.

  3. Anterior Cingulate Implant for Obsessive-Compulsive Disorder.

    Science.gov (United States)

    De Ridder, Dirk; Leong, Sook Ling; Manning, Patrick; Vanneste, Sven; Glue, Paul

    2017-01-01

    Obsessive-compulsive disorder (OCD) is a brain disorder with a lifetime prevalence of 2.3%, causing severe functional impairment as a result of anxiety and distress, persistent and repetitive, unwanted, intrusive thoughts (obsessions), and repetitive ritualized behavior (compulsions). Approximately 40%-60% of patients with OCD fail to satisfactorily respond to standard treatments. Intractable OCD has been treated by anterior capsulotomy and cingulotomy, but more recently, neurostimulation approaches have become more popular because of their reversibility. Implants for OCD are commonly being used, targeting the anterior limb of the internal capsula or the nucleus accumbens, but an implant on the anterior cingulate cortex has never been reported. We describe a patient who was primarily treated for alcohol addiction, first with transcranial magnetic stimulation, then by implantation of 2 electrodes overlying the rostrodorsal part of the anterior cingulate cortex bilaterally. Her alcohol addiction developed as she was relief drinking to self-treat her OCD, anxiety, and depression. After the surgical implant, she underwent placebo stimulation followed by real stimulation of the dorsal anterior cingulate cortex, which dramatically improved her OCD symptoms (decrease of 65.5% on the Yale-Brown Obsessive Compulsive Drinking Scale) as well as her alcohol craving (decrease of 87.5%) after 36 weeks of treatment. Although there were improvements in all the scores, there was only a modest reduction in the patient's weekly alcohol consumption (from 50 units to 32 units). Based on these preliminary positive results we propose to further study the possible beneficial effect of anterior cingulate cortex stimulation for intractable OCD. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Barreras para la participación en programas de rehabilitación cardiaca en pacientes sometidos a revascularización percutánea por enfermedad coronaria

    Directory of Open Access Journals (Sweden)

    Juan Carlos Sánchez-Delgado

    2016-03-01

    Resultados: Las mayores barreras por ítem fueron: «yo encuentro al ejercicio fatigante y/o doloroso», con un promedio de 2,86, seguido por «Yo hago actualmente ejercicio» y «Yo no sabía de la rehabilitación cardiaca» con un promedio de 2,73. El de menor puntaje fue: «Muchas personas sufren del corazón y no van», con 1,73. Presentaron más barreras quienes no asistieron a un programa de rehabilitación cardíaca (p < 0,05 que quienes sí lo hicieron; además las mayores barreras se encontraron en los dominios de necesidades percibidas y comorbilidades/estado funcional (p < 0,05. Lo anterior hace suponer falta de orientación y educación respecto a los beneficios que pueden obtener los usuarios al ingresar y adherirse a un programa de rehabilitación cardíaca, independiente de como se sientan o el tipo de limitación funcional que tengan.

  5. 89. Estudio multicéntrico español de la capacidad predictiva de las escalas de riesgo CHADS2 y CHA2DS2vasc en el accidente cerebrovascular tras cirugía coronaria aislada

    Directory of Open Access Journals (Sweden)

    E. Martín

    2012-04-01

    Resultados: Veinte mil novecientos ochenta pacientes incluidos, 282 desarrollaron ACV postoperatorio (1,34%. La incidencia de ACV fue superior en pacientes con insuficiencia cardíaca congestiva (ICC y/o fracción de eyección inferior al 40% (4,10 vs 0,83%, diabéticos (1,70 vs 1,11%, hipertensos (1,60 vs 0,98%, ACV previo (2,72 vs 1,26% y a enfermedad arterial periférica (EAP (3,04 vs 1,04%; p < 0,05. En el análisis multivariante, ICCC (odds ratio [OR]: 4,06, ACV previo (OR: 1,48, EAP (OR: 1,49 constituyeron factores de riesgo independientes para el desarrollo de ACV postoperatorio (p < 0,05. El AUC para CHADS2 fue 0,666, y para CHA2DS2VASc 0,655 (p < 0,0001. La distribución de las tasas de ACV postoperatorio según las puntuaciones de las anteriores escalas se recoge en la figura 1 (p < 0,0001. Conclusiones: Las escalas de riesgo CHADS2 y CHA2DS-2VASC pueden resultar útiles en la práctica clínica para estratificar el riesgo de desarrollo de ACV postoperatorio en pacientes sometidos a CCA.

  6. A chondrosarcoma in the anterior mediastinum mimicking a thymoma

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  7. Periodontics: 8. Periodontal problems associated with compromised anterior teeth.

    Science.gov (United States)

    Byrne, Patrick J; Irwin, Chris; Mullally, Brian; Allen, Edith; Ziada, Hassan

    2008-01-01

    Periodontal disease can significantly impact on the appearance of the anterior teeth. Prior to any definitive treatment, stabilization of the periodontal condition is a requirement. Treatment options can range from the placement of simple restorations, through orthodontic realignment, to the extraction and replacement of hopeless teeth. Each treatment plan must be individually tailored to the patient and level of periodontal disease, and must include provision for maintenance periodontal therapy. Periodontal diseases may compromise the prognosis of anterior teeth. Management is challenging and clinicians should take into consideration the short and long-term survival in treatment planning.

  8. Anterior mediastinal paraganglioma: A case for preoperative embolization

    Directory of Open Access Journals (Sweden)

    Shakir Murtaza

    2012-07-01

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

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

    Directory of Open Access Journals (Sweden)

    S Ahmad

    2015-03-01

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

  10. Anterior internal lenticonus accompanied by congenital nuclear cataract

    Institute of Scientific and Technical Information of China (English)

    LIU Zhe; SUN Chuan-bin; YAO Ke

    2011-01-01

    Internal lenticonus is a very rare morphologic abnormality of crystalline lens which has been reported in only several cases in the literature.We herein reported the clinical characteristics and surgical findings of the anterior internal lenticonus accompanied by congenital nuclear cataract.Cataract extraction accompanied with intraocular lens implantation was uneventfully performed,and a good visual outcome was achieved in this case.Viral infection during embryonal and fetal period might account for the formation of the anterior internal lenticonus and congenital nuclear cataract in our case.

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

    Directory of Open Access Journals (Sweden)

    Karpagam S

    2005-01-01

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

  12. Anterior hippocampus: the anatomy of perception, imagination and episodic memory

    Science.gov (United States)

    Zeidman, Peter; Maguire, Eleanor A.

    2017-01-01

    The brain creates a model of the world around us. We can use this representation to perceive and comprehend what we see at any given moment, but also to vividly re-experience scenes from our past and imagine future (or even fanciful) scenarios. Recent work has shown that these cognitive functions — perception, imagination and recall of scenes and events — all engage the anterior hippocampus. Here we capitalise on new findings from functional neuroimaging to propose a model that links high-level cognitive functions to specific structures within the anterior hippocampus. PMID:26865022

  13. Brain stimulation for intractable epilepsy: Anterior thalamus and responsive stimulation

    Directory of Open Access Journals (Sweden)

    Vibhor Krishna

    2014-01-01

    Full Text Available Despite medications, resective surgery, and vagal nerve stimulation, some patients with epilepsy continue to have seizures. In these patients, other approaches are urgently needed. The biological basis of stimulation of anterior thalamic nucleus and epileptogenic focus is presented. Results from two large randomized controlled trials Stimulation of Anterior Nucleus of Thalamus for Epilepsy (SANTE and Neuropace pivotal trial are discussed. Neuromodulation provides effective treatment for a select group of refractory epilepsy patients. Future investigations into the mechanism underlying ′response′ to brain stimulation are desired.

  14. Usurering af osteosyntesemateriale gennem øsofagus efter anterior cervikalkirurgi

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  15. Proprioception in anterior cruciate ligament deficient knees and its relevance in anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Mandeep S Dhillon

    2011-01-01

    Full Text Available Injury to the anterior cruciate ligament (ACL not only causes mechanical instability but also leads to a functional deficit in the form of diminished proprioception of the knee joint. "Functional" recovery is often incomplete even after "anatomic" arthroscopic ACL reconstruction, as some patients with a clinically satisfactory repair and good ligament tension continue to complain of a feeling of instability and giving way, although the knee does not sublux on clinical testing. Factors that may play a role could be proprioceptive elements, as the intact ACL has been shown to have significant receptors. Significant data have come to light demonstrating proprioceptive differences between normal and injured knees, and often between injured and reconstructed knees. ACL remnants have been shown to have proprioceptive fibers that could enhance functional recovery if they adhere to or grow into the reconstructed ligament. Conventionally the torn remnants are shaved off from the knee before graft insertion; modern surgical techniques, with remnant sparing methods have shown better outcomes and functional recovery, and this could be an avenue for future research and development. This article analyzes and reviews our understanding of the sensory element of ACL deficiency, with specific reference to proprioception as an important component of functional knee stability. The types of mechanoreceptors, their distribution and presence in ACL remnants is reviewed, and suggestions are made to minimize soft tissue shaving during ACL reconstruction to ensure a better functional outcome in the reconstructed knee.

  16. Clinical commissioning of an in vivo range verification system for prostate cancer treatment with anterior and anterior oblique proton beams

    Science.gov (United States)

    Hoesl, M.; Deepak, S.; Moteabbed, M.; Jassens, G.; Orban, J.; Park, Y. K.; Parodi, K.; Bentefour, E. H.; Lu, H. M.

    2016-04-01

    The purpose of this work is the clinical commissioning of a recently developed in vivo range verification system (IRVS) for treatment of prostate cancer by anterior and anterior oblique proton beams. The IRVS is designed to perform a complete workflow for pre-treatment range verification and adjustment. It contains specifically designed dosimetry and electronic hardware and a specific software for workflow control with database connection to the treatment and imaging systems. An essential part of the IRVS system is an array of Si-diode detectors, designed to be mounted to the endorectal water balloon routinely used for prostate immobilization. The diodes can measure dose rate as function of time from which the water equivalent path length (WEPL) and the dose received are extracted. The former is used for pre-treatment beam range verification and correction, if necessary, while the latter is to monitor the dose delivered to patient rectum during the treatment and serves as an additional verification. The entire IRVS workflow was tested for anterior and 30 degree inclined proton beam in both solid water and anthropomorphic pelvic phantoms, with the measured WEPL and rectal doses compared to the treatment plan. Gafchromic films were also used for measurement of the rectal dose and compared to IRVS results. The WEPL measurement accuracy was in the order of 1 mm and after beam range correction, the dose received by the rectal wall were 1.6% and 0.4% from treatment planning, respectively, for the anterior and anterior oblique field. We believe the implementation of IRVS would make the treatment of prostate with anterior proton beams more accurate and reliable.

  17. Nocardia Septic Arthritis Complicating an Anterior Cruciate Ligament Repair.

    Science.gov (United States)

    Yong, Elaine X L; Cheong, Elaine Y L; Boutlis, Craig S; Chen, Darren B; Liu, Eunice Y-T; McKew, Genevieve L

    2015-08-01

    Nocardia infection following anterior cruciate ligament (ACL) allograft reconstruction is a rare occurrence. We report a case of Nocardia infection of an allograft ACL reconstruction and septic arthritis of the knee joint due to an organism most similar to the novel Nocardia species Nocardia aobensis.

  18. Anastomotic leakage after anterior resection for rectal cancer: risk factors

    DEFF Research Database (Denmark)

    Bertelsen, C A; Andreasen, A H; Jørgensen, Torben;

    2010-01-01

    OBJECTIVE: The study aimed to identify risk factors for clinical anastomotic leakage (AL) after anterior resection for rectal cancer in a consecutive national cohort. METHOD: All patients with an initial first diagnosis of colorectal adenocarcinoma were prospectively registered in a national...

  19. Primary treatment of the anterior vocal commissure squamous carcinoma

    NARCIS (Netherlands)

    Bradley, Patrick J.; Rinaldo, Alessandra; Suarez, Carlos; Shaha, Ashok R.; Leemans, C. Rene; Langendijk, Johannes A.; Patel, Snehal G.; Ferlito, Alfio

    2006-01-01

    Squamous cell carcinoma may involve the anterior commissure (AC) area of the laryngeal glottis, and can be grouped morphologically into four groups; (1) tumor confined to the AC, (2) tumor involving one cord and the AC, (3) tumor involving the AC and a portion of both vocal cords, and (4) tumor invo

  20. Anterior cingulate cortex involvement in subclinical social anxiety.

    Science.gov (United States)

    Duval, Elizabeth R; Hale, Lisa R; Liberzon, Israel; Lepping, Rebecca; N Powell, Joshua; Filion, Diane L; Savage, Cary R

    2013-12-30

    We demonstrated differential activation in the anterior cingulate cortex (ACC) between subjects with high and low social anxiety in response to angry versus neutral faces. Activation in the ACC distinguished between facial expressions in the low, but not the high, anxious group. The ACC's role in threat processing is discussed.

  1. Loop overlay tympanoplasty for anterior or subtotal perforations.

    Science.gov (United States)

    Lee, Heung-Yeup; Auo, Hyeon-Jin; Kang, Jun-Myung

    2010-04-01

    To report our experience with "loop overlay" tympanoplasty, a modified overlay technique with a superiorly based skin flap, for the reconstruction of anterior, subtotal or total tympanic membrane (TM) perforations. Retrospective review of patients undergoing loop overlay tympanoplasty from March 1998 to February 2007 was performed. Four hundred and twenty-nine patients who underwent loop overlay tympanoplasty and then follow-up visits a minimum of 6 months later were included in this study. Hearing test results were reported using a four-frequency (0.5, 1, 2, and 3kHz) pure tone average air-bone gap. The outcome was considered successful if the TM was intact without lateralization or anterior blunting after the follow-up visit. There was a 98.8% success rate. There was no graft lateralization, anterior blunting, neocholesteatoma, or sensorineural hearing loss. The mean preoperative to postoperative four-tone air-bone gap improved from 23.5 to 8.1dB, which is a mean gain of 15dB; this was statistically significant (poverlay graft method is a safe and effective technique for reconstruction of anterior, subtotal or total TM perforations, with excellent graft take and significant improvement of hearing. It provides a precise replacement of the flap and a preserved healing plane. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Sugahara M

    2013-05-01

    Full Text Available Michitaka Sugahara, Takayuki Fujimoto, Kyoko Shidara, Kenji Inoue, Masato Wakakura Inouye Eye Hospital, Tokyo, Japan Introduction: Here, we describe a patient who presented with anterior ischemic optic neuropathy (AION and subsequently developed uveitis. Case: A 69-year-old man was referred to our hospital and initially presented with best-corrected visual acuities (BCVA of 20/40 (right eye and 20/1000 (left eye and relative afferent pupillary defect. Slit-lamp examination revealed no signs of ocular inflammation in either eye. Fundus examination revealed left-eye swelling and a pale superior optic disc, and Goldmann perimetry revealed left-eye inferior hemianopia. The patient was diagnosed with nonarteritic AION in the left eye. One week later, the patient returned to the hospital because of vision loss. The BCVA of the left eye was so poor that the patient could only count fingers. Slit-lamp examination revealed 1+ cells in the anterior chamber and the anterior vitreous in both eyes. Funduscopic examination revealed vasculitis and exudates in both eyes. The patient was diagnosed with bilateral panuveitis, and treatment with topical betamethasone was started. No other physical findings resulting from other autoimmune or infectious diseases were found. No additional treatments were administered, and optic disc edema in the left eye improved, and the retinal exudates disappeared in 3 months. The patient's BCVA improved after cataract surgery was performed. Conclusion: Panuveitis most likely manifests after the development of AION. Keywords: anterior ischemic optic neuropathy, uveitis

  3. Scrotal pop off in a congenital anterior urethral diverticulum.

    Science.gov (United States)

    Abrol, N; Deshpande, A V; Berry, C S; Devasia, A

    2014-08-01

    Congenital anterior urethral diverticulum is a rare entity. This teaching video shows the scrotal pop-off mechanism for an anterior urethral diverticulum and the unique voiding pattern of a boy who empties his bladder by compression of his scrotum. The findings during urethroscopy and open reconstruction are also demonstrated. A four-year-old boy presented to the clinic with a poor urinary stream and scrotal swelling during voiding. Physical examination during voiding revealed a dumbbell-shaped anterior urethral diverticulum with scrotal pop off and preserved renal function. Open excision of the scrotal part of diverticulum was performed. Urethroplasty was conducted using a de-epithelialised diverticular wall flap from the penobulbar urethra. On follow up the boy voided with a good flow and resolution of symptoms. Scrotal pop off with completion of voiding by manual compression of the diverticulum may preserve bladder and renal function. The preferred treatment of anterior urethral diverticulum is open excision of the diverticulum and reconstruction. The wall of the diverticulum may be used to reinforce the repair ventrally, where the corpus spongiosum is deficient. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  4. Holistic approach to understanding anterior knee pain. Clinical implications.

    Science.gov (United States)

    Sanchis-Alfonso, Vicente

    2014-10-01

    Anterior knee pain is one of the most frequent reasons for consultation within knee conditions. The aetiology is not well known, which explains the sometimes unpredictable results of its treatment. Normally, when we see a patient in the office with anterior knee pain, we only study and focus on the knee. If we do this, we are making a big mistake. We must not forget to evaluate the pelvis and proximal femur, as well as the psychological factors that modulate the course of the illness. Both the pelvifemoral dysfunction as well as the psychological factors (anxiety, depression, catastrophization and kinesiophobia) must be included in our therapeutic targets of the multidisciplinary treatment of anterior knee pain. We must not only focus on the knee, we must remember to "look up" to fully understand what is happening and be able to solve this difficult problem. The aetiology of anterior knee pain is multifactorial. Therefore, diagnosis and treatment of patellofemoral disorders must be individualized. Our findings stress the importance of tailoring physiotherapy, surgery and psycho-educational interventions to each patient.

  5. Rare times rare: The hyponatremia, rhabdomyolysis, anterior compartment syndrome sequence.

    Science.gov (United States)

    Dubin, Ina; Gelber, Moshe; Schattner, Ami

    2016-05-01

    Primary polydipsia occurs in up to 25% of patients with chronic psychiatric disorders (especially schizophrenia), related to the disease, its treatment or both. Urine output fails to match intake >10 L/day and water intoxication may develop. Rhabdomyolysis is a rare complication of hyponatremia, and an acute anterior compartment syndrome of the leg, an emergency, may be very rarely associated.

  6. Predictive factors for anterior chamber fibrin formation after vitreoretinal surgery

    Directory of Open Access Journals (Sweden)

    Leonardo Provetti Cunha

    2014-04-01

    Full Text Available Purpose: The aim of this study was to investigate possible predictive factors related to anterior chamber fibrin formation after vitreoretinal surgery in a large series of patients. Methods: The data of 185 eyes of 185 patients submitted to vitreoretinal surgery was reviewed. The following variables were evaluated: the postoperatively presence of fibrin, age, diabetes mellitus, the vitrectomy system gauge (20, 23 or 25 gauge, the type of vitreous substitute, the influence of prior surgical procedures and the combination with cataract extraction. To evaluate predictive factors for anterior chamber fibrin formation, univariate analysis was performed. A multivariate stepwise logistic regression model was adjusted to investigate factors associated with fibrin formation (p<0.05. Results: Fibrinoid anterior chamber reaction was found in 12 (6.4% patients. For multivariate logistic regression analysis, balanced salt solution (BSS, the chance of fibrin occurrence was 5 times greater (odds ratio 4.83, CI 95% 1.302 - 17.892; p=0.019, while combination with phacoemulsification increased the chance of fibrin formation by 20 times (odds ratio 20, CI 95% 2.480 - 161.347; p=0.005. No significant difference was found regarding other variables. Conclusion: Anterior chamber fibrin formation is an unwanted complication after vitreoretinal surgery. Factors such as combined performance of phacoemulsification and the use of balanced salt solution as a vitreous substitute may predispose the occurrence of this complication.

  7. Innovation in prediction planning for anterior open bite correction.

    Science.gov (United States)

    Almuzian, Mohammed; Almukhtar, Anas; O'Neil, Michael; Benington, Philip; Al Anezi, Thamer; Ayoub, Ashraf

    2015-05-01

    This study applies recent advances in 3D virtual imaging for application in the prediction planning of dentofacial deformities. Stereo-photogrammetry has been used to create virtual and physical models, which are creatively combined in planning the surgical correction of anterior open bite. The application of these novel methods is demonstrated through the surgical correction of a case.

  8. Anterior Colporrhaphy Technique and Approach Choices: Turkey Evaluation

    Directory of Open Access Journals (Sweden)

    Serdar Aydın

    2016-09-01

    Full Text Available Aim: To evaluate the diversity in techniques and approaches for anterior colporrhaphy among operators in Turkey. Methods: A survey evaluating the preoperative examination, technique of anterior colporrhaphy, operation choice and postoperative care was presented to surgeons. We contacted via directly, mail or telephone. We used 28 item questionnaire. Results: Majority (87.9% was composed of young gynecologists. Urologists composed of the 9.5% of the study population. The rate of paravaginal defect evaluation was 75.9% and mostly by inspection the presence of vaginal rugae. The use of transperineal 3D pelvic floor ultrasonography was low (5.7%. The evaluation of levator ani muscle defect was 46.6%. The usage of the transperineal 3D ultrasonography for levator ani muscle defect was 19 percent of operators. There were diversity in use of hydrodissection, fascial plication, excision of vaginal mucosa and suture choice. Usage of mesh for anterior colporrhaphy was limited (17.8% and mostly in recurrent cases (12.2%. Paravaginal defect repair rate was 31.9%. The urinary catheter was generally removed one or two day after operation. Vaginal pack usually removed 24 hours after. Conclusion: Several techniques and approaches for anterior vaginal wall repair among operators in Turkey. The variety of techniques suggested that there is no consensus on best surgical technique.

  9. Esthetic rehabilitation of crowded and protruded anterior dentition

    Directory of Open Access Journals (Sweden)

    Cecilia G. J. lunardhi

    2009-03-01

    Full Text Available Background: Recent trends put estheticrehabilitationas a demandingtreatmentin order to correct malpositionedanteriordentition. This is enhanced by the patient’s background, especially careers that require prime appearance for the public. Purpose: To describe that even though there are many treatment alternatives and procedures, esthetic rehabilitation on crowded and protruded anterior dentition using endodontic treatment, cast posts and all ceramic crowns, can improve patient’s appearance. Case: This article presents a case report on esthetic rehabilitation of crowded and protruded anterior dentition. Treatment was done due to patient’s refusal in receiving orthodontic treatment. The patient requested esthetic rehabilitation as an expectation for faster and instant esthetic result. Case management: Endodontic treatment was done to the involved dentition prior to the final restoration. Cast posts and all ceramic crowns were used as final restoration to correct the crowded and protruded anterior teeth. Conclusion: Esthetic rehabilitation can be done successfully on crowded and protruded anterior dentition. Instant result could be achieved by this treatment. This is supported by the fact that dentists should be aware of not only choosing the right treatment and materials but also patient’s expectations and conditions.

  10. Breast Reinnervation: DIEP Neurotization Using the Third Anterior Intercostal Nerve

    Directory of Open Access Journals (Sweden)

    Aldona J. Spiegel, MD

    2013-11-01

    Conclusion: DIEP flap neurotization using the third anterior intercostal nerve is an effective technique to provide a significant increase in sensory recovery for breast reconstruction patients, while adding minimal surgical time. Additionally, the use of a nerve conduit produces increased sensory recovery when compared direct coaptation.

  11. Spindle neurons of the human anterior cingulate cortex

    Science.gov (United States)

    Nimchinsky, E. A.; Vogt, B. A.; Morrison, J. H.; Hof, P. R.; Bloom, F. E. (Principal Investigator)

    1995-01-01

    The human anterior cingulate cortex is distinguished by the presence of an unusual cell type, a large spindle neuron in layer Vb. This cell has been noted numerous times in the historical literature but has not been studied with modern neuroanatomic techniques. For instance, details regarding the neuronal class to which these cells belong and regarding their precise distribution along both ventrodorsal and anteroposterior axes of the cingulate gyrus are still lacking. In the present study, morphological features and the anatomic distribution of this cell type were studied using computer-assisted mapping and immunocytochemical techniques. Spindle neurons are restricted to the subfields of the anterior cingulate cortex (Brodmann's area 24), exhibiting a greater density in anterior portions of this area than in posterior portions, and tapering off in the transition zone between anterior and posterior cingulate cortex. Furthermore, a majority of the spindle cells at any level is located in subarea 24b on the gyral surface. Immunocytochemical analysis revealed that the neurofilament protein triple was present in a large percentage of these neurons and that they did not contain calcium-binding proteins. Injections of the carbocyanine dye DiI into the cingulum bundle revealed that these cells are projection neurons. Finally, spindle cells were consistently affected in Alzheimer's disease cases, with an overall loss of about 60%. Taken together, these observations indicate that the spindle cells of the human cingulate cortex represent a morphological subpopulation of pyramidal neurons whose restricted distribution may be associated with functionally distinct areas.

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

    African Journals Online (AJOL)

    B Gupta, MD; N B Vaid, MD; A Suneja, MD; K Guleria, MD; S Jain, MD. University College of ... patch. The anterior border of the mesh was slightly curved to avoid covering the ..... Women's Health Initiative: Gravity and gravidity. Am J Obstet ...

  13. Anterior cruciate ligament: 3-D fiber anatomy, fluorescence arthroscopy & healing

    NARCIS (Netherlands)

    Nguyen, D.T.

    2015-01-01

    One of the current emphases in optimizing anterior cruciate ligament (ACL) reconstructions is closer mimicking the anatomy of the ACL. The aim of Chapter 2 and Chapter 3 is to develop and validate a methodology to quantify the 3-D collagen fiber orientation of ligaments, accurately and at a high res

  14. Anterior Cingulate Cortex in Schema Assimilation and Expression

    Science.gov (United States)

    Wang, Szu-Han; Tse, Dorothy; Morris, Richard G. M.

    2012-01-01

    In humans and in animals, mental schemas can store information within an associative framework that enables rapid and efficient assimilation of new information. Using a hippocampal-dependent paired-associate task, we now report that the anterior cingulate cortex is part of a neocortical network of schema storage with NMDA receptor-mediated…

  15. Computed tomography of the human developing anterior skull base

    NARCIS (Netherlands)

    J. van Loosen (J.); A.I.J. Klooswijk (A. I J); D. van Velzen (D.); C.D.A. Verwoerd (Carel)

    1990-01-01

    markdownabstractAbstract The ossification of the anterior skull base, especially the lamina cribrosa, has been studied by computed tomography and histopathology. Sixteen human fetuses, (referred to our laboratory for pathological examination after spontaneous abortion between 18 and 32 weeks of ge

  16. Orthodontic and orthopaedic treatment for anterior open bite in children

    NARCIS (Netherlands)

    Lentini-Oliveira, D.; Carvalho, F. R.; Qingsong, Y.; Junjie, L.; Saconato, H.; Machado, M. A. C.; Prado, L. B. F.; Prado, G. F.

    2007-01-01

    Background Anterior open bite occurs when there is a lack of vertical overlap of the upper and lower incisors. The aetiology is multifactorial including: oral habits, unfavourable growth patterns, enlarged lymphatic tissue with mouth breathing. Several treatments have been proposed to correct this m

  17. Value, search, persistence and model updating in anterior cingulate cortex

    NARCIS (Netherlands)

    Kolling, N.; Wittmann, M.K.; Behrens, T.E.J.; Boorman, E.D.; Mars, R.B.; Rushworth, M.F.S.

    2016-01-01

    Dorsal anterior cingulate cortex (dACC) carries a wealth of value-related information necessary for regulating behavioral flexibility and persistence. It signals error and reward events informing decisions about switching or staying with current behavior. During decision-making, it encodes the avera

  18. A congenital mucocele of the anterior dorsal tongue

    NARCIS (Netherlands)

    Wong Chung, J.E.; Ensink, R.J.H.; Thijs, H.F.; Hoogen, F.J.A. van den

    2014-01-01

    We report on a new-born with a congenital mucocele on the anterior dorsal side of the tongue. The presentation as well as the differential diagnosis of congenital oral swellings is discussed. Because of breastfeeding problems the mucinous swelling was incised and drained two days after birth. Immedi

  19. Anterior orbital varix presenting as a lacrimal sac mucocele.

    Science.gov (United States)

    Nasr, A M; Huaman, A M

    1998-05-01

    A 35-year-old woman was referred to the Oculoplastics Clinic because of a left nasal swelling and intermittent tearing of 1 year's duration. The clinical examination and echographic and radiologic findings were consistent with an anterior venous anomaly. Complete surgical excision was performed and histopathology confirmed the diagnosis of a varix.

  20. Editorial Commentary: Anterior Cruciate Ligament Reconstruction: Auto or Allo?

    Science.gov (United States)

    Verma, Nikhil N

    2016-01-01

    Considerable controversy exists regarding appropriate graft choice for patients undergoing anterior cruciate ligament reconstruction. Allografts pretreated with high-dose irradiation should be avoided. Otherwise, multiple factors should be considered to individualize patient decision making, including patient age and activity level, graft type, and fixation type.

  1. Clinical outcomes of surgical management of anterior bilateral mandibular fractures

    NARCIS (Netherlands)

    Boffano, P.; Gallesio, C.; Roccia, F.; van den Bergh, B.; Forouzanfar, T.

    2013-01-01

    Purpose: The aims of this study were to assess the clinical outcomes of patients with anterior bifocal mandibular fractures and to discuss the management of this peculiar type of trauma. Methods: From the systematic computer-assisted database that has continuously recorded patients hospitalized with

  2. Orthodontic and orthopaedic treatment for anterior open bite in children

    NARCIS (Netherlands)

    Lentini-Oliveira, D.; Carvalho, F. R.; Qingsong, Y.; Junjie, L.; Saconato, H.; Machado, M. A. C.; Prado, L. B. F.; Prado, G. F.

    2007-01-01

    Background Anterior open bite occurs when there is a lack of vertical overlap of the upper and lower incisors. The aetiology is multifactorial including: oral habits, unfavourable growth patterns, enlarged lymphatic tissue with mouth breathing. Several treatments have been proposed to correct this m

  3. Esthetic removable partial denture design in replacing maxillary anterior teeth.

    Science.gov (United States)

    Oh, Won-Suk; Basho, Shveta

    2010-01-01

    Prosthodontic rehabilitation of missing maxillary anterior teeth requires special consideration to restore function and esthetics. This case report describes the prosthodontic management of a patient who lost three maxillary incisors due to a motor vehicle accident. A rotational path removable partial denture was constructed, for which a proximal undercut was created by means of a composite buildup to provide the retention for the prosthesis.

  4. Left Anterior Descending Artery-Pulmonary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Turan Ege

    2011-12-01

    Full Text Available Despite the fact that coronary arteriovenous fistulas constitute approximately half (48% of coronary artery anomalies, they are rarely seen anomalies. In this report,we aim to present a coronary arteriovenous fistula case detected during a coronary angiography between left anterior descending artery and pulmonary artery.

  5. Palpation for muscular tenderness in the anterior chest wall

    DEFF Research Database (Denmark)

    Christensen, H.W.; Vach, W.; Manniche, C.

    2003-01-01

    palpating for intercostal tenderness or tenderness in the minor and major pectoral muscles in a population of patients with and without chest pain. This may hamper the ability of clinicians to diagnose and classify the musculoskeletal component of chest pain if based exclusively on palpation of the anterior...

  6. Clinical outcomes of surgical management of anterior bilateral mandibular fractures

    NARCIS (Netherlands)

    Boffano, P.; Gallesio, C.; Roccia, F.; van den Bergh, B.; Forouzanfar, T.

    2013-01-01

    Purpose: The aims of this study were to assess the clinical outcomes of patients with anterior bifocal mandibular fractures and to discuss the management of this peculiar type of trauma. Methods: From the systematic computer-assisted database that has continuously recorded patients hospitalized with

  7. Management of anterior urethral strictures with buccal mucosa: Our ...

    African Journals Online (AJOL)

    Abdelwahab Elkassaby

    2016-03-02

    Mar 2, 2016 ... different uses of buccal mucosal graft as a reconstructive and replacement tool for anterior urethral .... of excessive mobilization and penile curvature. ... established that a strip of penile skin would inevitably form a tube if left in ...

  8. The effect of anterior cruciate ligament injury on bone curvature

    DEFF Research Database (Denmark)

    Hunter, D J; Lohmander, Stefan; Makovey, J

    2014-01-01

    OBJECTIVE: Investigate the 5-year longitudinal changes in bone curvature after acute anterior cruciate ligament (ACL) injury, and identify predictors of such changes. METHODS: In the KANON-trial (ISRCTN 84752559), 111/121 young active adults with an acute ACL tear to a previously un-injured knee ...

  9. Esthetic Rehabilitation of Anterior Teeth with Laminates Composite Veneers

    OpenAIRE

    Dino Re; Gabriele Augusti; Massimo Amato; Giancarlo Riva; Davide Augusti

    2014-01-01

    No- or minimal-preparation veneers associated with enamel preservation offer predictable results in esthetic dentistry; indirect additive anterior composite restorations represent a quick, minimally invasive, inexpensive, and repairable option for a smile enhancement treatment plan. Current laboratory techniques associated with a strict clinical protocol satisfy patients’ restorative and esthetic needs. The case report presented describes minimal invasive treatment of four upper incisors with...

  10. Removal of a giant intrathoracic cyst from the anterior mediastinum

    NARCIS (Netherlands)

    Bouma, Wobbe; Klinkenberg, Theo J.; Van De Wauwer, Caroline; Timens, Wim; Mariani, Massimo A.

    2014-01-01

    A 45-year-old caucasian man with progressive dyspnea appeared to have a giant intrathoracic cyst in the anterior mediastinum encasing the heart and compressing both lungs. He underwent succesful removal of the cyst through a median sternotomy. Recovery was uneventful. Gross examination revealed a th

  11. Genetic studies in congenital anterior midline cervical cleft

    DEFF Research Database (Denmark)

    Jakobsen, L P; Pfeiffer, P; Andersen, M

    2012-01-01

    Congenital anterior midline cervical cleft (CAMCC) is a rare anomaly, with less than 100 cases reported. The cause of CAMCC is unknown, but genetic factors must be considered as part of the etiology. Three cases of CAMCC are presented. This is the first genetic study of isolated CAMCC. Conventional...

  12. Complications of the anterior approach to the cervical spine

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    Marcelo Lemos Vieira da Cunha

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate the complications of anterior approach to the cervical spine in patients who underwent cervical arthrodesis with instrumentation. METHODS: Prospective and descriptive study was conducted from January 2009 to April 2010. All patients who underwent arthrodesis of the cervical spine by anterior approach were included, regardless the diagnosis. Access was made by the anterior approach on the right side. We evaluated the number of operated levels (1, 2 or 3 levels and, the type of procedure performed: discectomy and placement of cage and plate (D+C+P, discectomy with placement of a cage (D+C or corpectomy with placement of cage and plate (C+C+P. All complications related to surgical approach were reported. RESULTS: We studied 34 patients, 70% male. The average age was 50 years and mean follow-up was 8 months. Eighteen percent of patients had complications, distributed as follows: dysphasia (33% and dysphonic (67%. Among patients who developed complications, most underwent to D+C+P (83% and no complications were found in patients where no cervical plate was used. Regarding levels, both complications were identified in patients operated to one or two levels. However, in patients operated on three levels, only dysphonia was identified. CONCLUSION: The most frequent complication was dysphonia. Patients who presented more complications were those undergoing discectomy and fusion with cage and anterior cervical plate. All cases of dysphonia were in this group. The number of accessible levels does not seem to have affected the incidence of complications.

  13. Anastomoselaekage efter lav anterior resektion for cancer recti

    DEFF Research Database (Denmark)

    Bülow, S; Moesgaard, F A; Billesbølle, P;

    1997-01-01

    the routine use of a peroperative leakage test and selective use of prophylactic ostomy in cases of unsatisfactory anastomosis. Furthermore, it is recommended that low anterior resection for rectal cancer is limited to few surgeons in each department in order to ensure a uniform quality and hopefully also...

  14. Intervenção coronariana percutânea no Brasil: resultados do Sistema Único de Saúde Intervención coronaria percutánea en el Brasil: Resultados del Sistema Único de Salud Percutaneous coronary intervention in Brazil: results from the Brazilian Public Health System

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    Leopoldo Soares Piegas

    2011-04-01

    Full Text Available FUNDAMENTO: O Sistema Único de Saúde (SUS realiza aproximadamente 80% das intervenções coronarianas percutâneas (ICP no Brasil. O conhecimento desses dados permitirá planejar adequadamente o tratamento da doença arterial coronariana (DAC. OBJETIVO: Analisar e discutir os resultados das ICP realizadas pelo SUS. MÉTODOS: Foram avaliados os dados do SIH/DATASUS disponibilizados para consulta pública. RESULTADOS: Entre os anos de 2005 a 2008 foram realizados 166.514 procedimentos em 180 hospitais. A mortalidade hospitalar média foi de 2,33%, variando de 0% a 11,35%, sendo mais baixa no Sudeste, 2,03% e mais alta na região Norte, 3,64% (p 0,05. A mortalidade foi maior no gênero feminino (p 65 a (p FUNDAMENTO: El Sistema Único de Salud (SUS realiza aproximadamente 80% de las intervenciones coronarias percutáneas (ICP en el Brasil. El conocimiento de esos datos permitirá planear adecuadamente el tratamiento de la enfermedad arterial coronaria (EAC. OBJETIVO: Analizar y discutir los resultados de las ICP realizadas por el SUS. MÉTODOS:Fueron evaluados los datos del SIH/DATASUS disponibles para la consulta pública. RESULTADOS: Entre los años 2005 a 2008 fueron realizados 166.514 procedimientos en 180 hospitales. La mortalidad hospitalaria media fue de 2,33%, variando de 0% a 11,35%, siendo más baja en el Sudeste, 2,03% y más alta en la región Norte, 3,64% (p 0,05. La mortalidad fue mayor en el género femenino (p 65 a (p BACKGROUND: The Brazilian Public Health System (SUS holds approximately 80% of percutaneous coronary interventions (PCI in Brazil. Being aware of these data will enable to design a proper plan for the treatment of coronary artery disease (CAD. OBJECTIVE: To review and discuss the results of PCIs performed by the SUS. METHODS: We reviewed data from SIH/DATASUS available for public consultation. RESULTS: From 2005 to 2008, 166,514 procedures were performed in 180 hospitals. Average hospital mortality was 2.33%, ranging

  15. Anterior and posterior centers jointly regulate Bombyx embryo body segmentation.

    Science.gov (United States)

    Nakao, Hajime

    2012-11-15

    Insect embryo segmentation is largely divided into long and short germ types. In the long germ type, each segment primordium is represented on a large embryonic rudiment of the blastoderm, and segmental patterning occurs nearly simultaneously in the syncytium. In the short germ type, however, only anterior segments are represented in the small embryonic rudiment, usually located on the egg posterior, and the rest of the segments are added sequentially from the posterior growth zone in a cellular context. The long germ type is thought to have evolved from the short germ type. It is proposed that this transition, which appears to have occurred multiple times over the course of evolution, was realized through the acquisition of a localized anterior instruction center. Here, I examined the early segmentation process in the silkmoth Bombyx mori, a lepidopteran insect, in which the mechanisms of anterior-posterior (AP) axis formation have not been well analyzed. In this insect, both the long germ and short germ features have been reported. The mRNAs for two key genes involved in insect AP axis formation, orthodenticle (Bm-otd) and caudal (Bm-cad), are localized maternally in the germ anlage, where they act as anterior and posterior instruction centers, respectively. RNAi studies indicate that, while Bm-cad affects the formation of all the even skipped (Bm-eve) stripes, there is also anterior Bm-eve stripe formation activity that involves Bm-otd. Thus, there is redundancy in Bm-eve stripe formation activity that must be coordinated. Some genetic interactions, identified either experimentally or hypothetically, are also introduced, which might enable robust AP formation in this organism.

  16. Diagnóstico e tratamento do lenticone anterior

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    Ana Luiza Biancardi

    2011-08-01

    Full Text Available Relato de caso de um paciente de 18 anos com sindrome de Alport apresentando perda visual progressiva. A biomicroscopia revelou lenticone anterior bilateral. O paciente realizou tomografia de córnea e segmento anterior com o sistema Scheimpflug (Pentacam e aberrometria e topografia corneana (i-Trace. O paciente foi submetido à facoemulsificação com implante de lente intraocular peça única hidrofóbica (Acrysof® SN60AT. As imagens de Scheimpflug documentaram o lenticone anterior. A aberrometria total mostrou acentuado astigmatismo miópico com acentuada aberração esférica negativa, havendo grande impacto das aberrações de alta ordem (HOA na conversão da letra E de Snellen. O mapa de integração da aberrometria do olho todo com a topografia corneana mostrou maior semelhança das aberrrações totais com as aberrações intraoculares do que com as aberrações da superfície anterior da córnea. Após a cirurgia, o paciente apresentou acuidade visual corrigida igual a 20/20 em ambos os olhos, as imagens de Scheimpflug revelaram lentes intraoculares tópicas e os mapas diferenciais revelaram resolução da miopia e redução das aberrações da alta ordem (total e interna. Os exames de imagem foram úteis para demonstrar o impacto do lenticone anterior na qualidade visual e a resolução das aberrações ópticas após a cirurgia.

  17. The management of over closured anterior teeth due to attrition

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    Eha Djulaeha

    2009-12-01

    Full Text Available Background: Tooth is the hardest tissue in human body, that can be injured because of attrition process. For old people, denture attrition process is caused by psysiological process relating with the mastication function which also supported by some bad habits such an bruxism, premature contact, and consuming habit of abrasive food. Attrition or abrasion can also be happened with patien’t dentition who does not have teeth subtutition for long time due the lost of their maxillary as well as mandibulary. The pasient will loose their vertical dimension of occlusion, injure, and the lower jaw becomes over closed which is called over closure. Purpose: This article reported the management of over closured anterior teeth due to attrition. Case: a seventy six year old woman patient came to Prosthodontic Clinic in Faculty of Dentistry, Airlangga University, to rehabilitate her upper and lower severe attrited anterior teeth and her posterior teeth. The patient has experienced of wearing acrylic removable mandibular partial denture ten years ago. Unfortunaly, the denture was uncomfortable, and she did not wear it anymore since five years ago. Case management: The severe attrition of anterior teeth with the lost of occlusal vertical dimension can be treated by improving the occlusal vertical dimension gradually. The treatment is then followed by the increasing of the height of the anterior teeth by lengthening the crown teeth of upper jaw with 12 units of span bridge and the acrylic removable partial denture of lower jaw. Conclusion: The severe attrition of anterior teeth with the lost of occlusal vertical dimension can be treated by improving the occlusal vertical dimension gradually, using long span bridge and acrylic removable partial denture.

  18. FUNCTIONAL OUTCOME OF ARTHROSCOPIC RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT TEARS

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    Ashok Kumar

    2016-02-01

    Full Text Available BACKGROUND Anterior Cruciate Ligament (ACL tear is the most common serious ligamentous injury to the knee joint. Anterior Cruciate Ligament (ACL injury is quite common among young active population, athletes and contact sports. The exact incidence of anterior cruciate ligament tears is not known as the cases are being under reported. The ACL is the primary stabilizer against anterior translation of the tibia on the femur and is important in counteracting rotation and valgus stress. MATERIALS AND METHODS Between November 2012 to October 2014, 34 consecutive patients who underwent arthroscopic assisted ACL reconstructions in the Department of Orthopedics and Traumatology, King George Hospital, Visakhapatnam were the material in our study. Age groups between 18 to 45 years considered. We utilised both BPTB and Quadrupled hamstring graft depending on the patient’s age, outcome testing in all cases was performed at the latest follow-up (at least 6 months. Post-operative physiotherapy rehabilitation protocol followed for 06 months. RESULTS Standard protocol of Lysholm and IKDC knee scoring system were used for evaluation of the results of the surgery during followup. Patients were evaluated periodically at preop, 3 months, 6 months, 12 months, 18 months and 24 months. CONCLUSION Patients with isolated ACL injury had better outcome compared to patients who underwent associated meniscectomy. Most common mechanism of injury was activity of sports in 20 patients. Postoperatively at 3 months, anterior drawer’s was 1+ in 6, 29 (85.2% patients had normal range of motion; 29 (85.29% patients had 5/5 quadriceps power (MRC grading 94% of them had 5/5 power at latest followup. No significant difference between outcomes of BPTB and Hamstrings graft. Functional outcome of our study were similar to the previously published studies.

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

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    Yashavantha Kumar C

    2013-01-01

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

  20. Morphological character of cervical spine for anterior transpedicular screw fixation

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    Rong-Ping Zhou

    2013-01-01

    Full Text Available Background: Anterior cervical interbody grafts/cages combined with a plate were frequently used in multilevel discectomies/corpectomies. In order to avoid additional posterior stabilization in patients who undergo anterior reconstructive surgery, an anterior cervical transpedicular screw fixation, which offers higher stability is desirable. We investigated in this study the anatomical (morphologic characters for cervical anterior transpedicular screw fixation. Materials and Methods: Left pedicle parameters were measured on computed tomography (CT images based on 36 cervical spine CT scans from healthy subjects. The parameters included outer pedicle width (Distance from lateral to medial pedicle surface in the coronal plane, outer pedicle height (OPH (Distance from upper to lower pedicle surface in the sagittal plane, maximal pedicle axis length (MPAL, distance transverse insertion point (DIP, distance of the insertion point to the upper end plate (DIUP, pedicle sagittal transverse angle (PSTA and pedicle transverse angle (PTA at C3 to C7. Results: The values of outer pedicle width and MPAL in males were larger than in females from C3 to C7. The OPH in males was larger than in females at C3 to C6, but there was no difference at C7. The DIP and PTA were significantly greater in males than in females at C3, but there was no difference in the angle at C4-7. The PSTA was not statistically different between genders at C3, 4, 7, but this value in males was larger than females at C5, 6. The DIUP was significantly greater in males at C3, 4, 6, 7 but was non significant at C5. Conclusions: The placement of cervical anterior transpedicular screws should be individualized for each patient and based on a detailed preoperative planning.