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Sample records for edentados unilaterais inferiores

  1. Avaliação das disfunções craniomandibulares em pacientes parcialmente edentados unilaterais: um estudo longitudinal sobre o efeito da utilização de Prótese Parcial Removível (PPR

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    GIL Carlos

    1999-01-01

    Full Text Available O objetivo deste estudo foi comparar a severidade dos sinais e sintomas das desordens craniomandibulares em 29 pacientes edentados parciais unilaterais, submetidos a tratamento protético corretivo, acompanhados e avaliados longitudinalmente, por meio de investigação clínica, dois anos após a instalação da prótese parcial removível. Em cada um dos casos, a comparação das diferenças clínicas, antes e após os procedimentos de reconstrução protética, baseou-se na mensuração e registro das variáveis por meio da utilização de uma metodologia de testes de escores. As observações clínicas objetivas e subjetivas consistiram no exame da sensibilidade dolorosa muscular e da ATM, na auscultação dos ruídos articulares e no registro dos movimentos mandibulares (MM. Vinte e nove outros pacientes, totalmente dentados, atuaram como grupo controle. Após análise estatística não-paramétrica, conclui-se que os pacientes apresentavam uma prevalência significativamente maior na severidade das desordens craniomandibulares antes do tratamento protético e que o tratamento corretivo por meio da instalação de prótese parcial removível (PPR bem indicada e planejada, atuou positivamente na diminuição da severidade destes distúrbios nesses pacientes.

  2. Atos jurídicos unilaterais e a inaplicabilidade do princípio do contrato no direito brasileiro

    OpenAIRE

    Amora, Fernanda Peres

    2013-01-01

    Neste estudo, pretende-se expor o pensamento de Pontes de Miranda a respeito da ampla consideração eficácia! dos atos unilaterais como fontes autónomas de relações jurídicas obrígacionais, contraponde-se suas teorizações com a tese tradicionalmente defendida pela doutrina, que sustenta a limitação da eficácia obrigacional desses atos aos tipos legais. Ainda, como confirmação do pensamento ponteano, abordar-se-á as figuras da confissão de dívida e da ação monitoria, que suscitaram novas discus...

  3. Inferiority is compex

    Science.gov (United States)

    Wade, Jess

    2017-07-01

    In Inferior: How Science Got Women Wrong and the New Research That's Rewriting the Story, author Angela Saini puts forward the idea that bad science has been used to endorse the cultural prejudice that women are both biologically and psychologically second rate to men.

  4. Varices en Miembros Inferiores

    OpenAIRE

    Velásquez, Edna

    2015-01-01

    Insuficiencia venosa, es cuando las venas de las extremidades inferiores no son capaces de devolver al corazón toda la sangre que les llega y de hacerlo al ritmo y velocidad debidos, se puede afirmar que sufren insuficiencia venosa.

  5. Incarcerated inferior lumbar (Petit's) hernia.

    Science.gov (United States)

    Astarcioğlu, H; Sökmen, S; Atila, K; Karademir, S

    2003-09-01

    Petit's hernia is an uncommon abdominal wall defect in the inferior lumbar triangle. Colonic incarceration through the inferior lumbar triangle, which causes mechanical obstructive symptoms, necessitates particular diagnostic and management strategy. We present a rare case of inferior lumbar hernia, leading to mechanical bowel obstruction, successfully treated with prosthetic mesh reinforcement repair.

  6. Semicontinuidad Inferior por Redes

    OpenAIRE

    Sanjuán, Arturo; Universidad Distrital Francisco José de Caldas

    2014-01-01

    Se presenta una construcción de la noción de semicontinuidad inferior a través de las redes. Dicha construcción es diferente a las usualmente presentadas, pues no usa imágenes inversas de conjuntos o filtros. Adicionalmente, se demuestra la equivalencia de una definición usual con la definición propuesta y se presenta un ejemplo de funcionales semicontinuos en donde sea útil la definición propuesta.

  7. Anatomia interna dos caninos inferiores

    OpenAIRE

    Oliveira, Simone H.G; Iorio, Lecy S.

    2010-01-01

    A falta de conhecimento da anatomia da cavidade pulpar é uma das principais razões do insucesso da terapia endodôntica dos caninos inferiores. Foram utilizados 1040 caninos inferiores cuja incidência de bifurcações foi avaliada através de estudo radiográfico e comparada com o método de injeção e diafanização dos mesmos dentes. Também foram estudadas outras características internas visualizad...

  8. Leiomyosarcoma of the inferior turbinate

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    Christopher W. Harper, Jr., MD

    2017-09-01

    Full Text Available We report a case of leiomyosarcoma of the inferior nasal turbinate. The patient, a 68-year-old Caucasian male, presented with 4–6 weeks of epistaxis that was resistant to nasal packing and septal cautery. Upon inspection in the operating room, a small mass was excised from the inferior turbinate. High-power H&E-stained microscopy demonstrated bundles of malignant smooth muscle cells, and immunohistochemical stains were strongly positive for desmin, smooth muscle actin and vimentin, while negative for pankeratin EA1/EA3 and CaM 5.2, suggesting leiomyosarcoma as the diagnosis. Clear margins were obtained at a second surgery. At the time of this writing it is 8 months since his last surgery and he has remained symptom free.

  9. Desvios Axiais dos Membros Inferiores

    OpenAIRE

    Cassiano Neves, M; Campagnolo, J

    2009-01-01

    As deformidades axiais dos membros inferiores constituem um dos principais motivos de consulta na área de Ortopedia Infantil. Esta situação deve-se, por um lado, ao facto de haver uma grande percentagem de crianças (cerca de 20%) que apresentam uma deformidade fisiológica durante o desenvolvimento e, por outro, à «tradição» existente, segundo a qual estes desvios necessitam de um tratamento, usualmente por calçado ortopédico. Torna-se, por isso, imperioso destrinçar o fisiológico do ...

  10. Bilateral inferior petrosal sinus sampling.

    Science.gov (United States)

    Zampetti, Benedetta; Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo; Loli, Paola

    2016-07-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing's syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88-100% and 67-100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50-70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. © 2016 The authors.

  11. Bilateral inferior petrosal sinus sampling

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    Benedetta Zampetti

    2016-08-01

    Full Text Available Simultaneous bilateral inferior petrosal sinus sampling (BIPSS plays a crucial role in the diagnostic work-up of Cushing’s syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88–100% and 67–100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50–70% makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres.

  12. The adverse effects of inferior innovations

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    Chang Joseph W.

    2017-09-01

    Full Text Available This research advances brand innovation research by examining the adverse effects of inferior innovative extensions on the brand innovability of own parent brands. Brand innovability conceptually consists of brand quality and innovativeness. The results reveal that radical and incremental inferior innovations exert asymmetric adverse effects on brand quality and innovability. For brand quality, inferior radical innovations exert more negative impacts on the quality of pioneer brands than on the quality of follower brands. However, inferior incremental innovations exert identical negative impacts on the quality of both pioneer and follower brands. For brand innovability, both inferior radical and incremental innovations exert more negative impacts on the innovability of pioneer brands than on the innovability of follower brands. In comparison, brand innovability is less susceptible than brand quality to inferior innovation information. The findings suggest that it is more justified to evaluate innovative brands with brand innovability, instead of brand quality, for two reasons. Firstly, brand innovability is more realistic than brand quality because brand innovability is more relevant than brand quality to profits. Secondly, brand innovability is inclusive of brand innovativeness, which ameliorates adverse effects when innovative extensions are inferior. The threat of inferior innovative extensions is less horrible than expectation if the adverse effects on the innovative brands are assessed with brand innovability, instead of brand quality. However, being innovative is like a double-edged sword. On the one hand, it helps generating more profits. On the other hand, it endangers innovative brands to be more susceptible to inferior innovative extensions. Therefore, for marketing implications, pioneer brands are more obliged than follower brands to ensure the success of radical innovations in order to avoid the possible adverse effects of inferior

  13. Tuberculosis pulmonar de campos inferiores

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    Alejandra González

    2010-10-01

    Full Text Available La tuberculosis (TB que compromete sólo los campos pulmonares inferiores (TBCI es poco frecuente en el adulto y en general está asociada a alguna causa de inmunodepresión. El objetivo de nuestro trabajo fue determinar la incidencia de TBCI en nuestra población y comparar sus características respecto de la TB pulmonar de localización habitual. Se estudiaron en forma retrospectiva en el período de 2004 a 2008, 42 pacientes con TBCI que fueron comparados con 84 pacientes con TB pulmonar de localización habitual (grupo control. Se excluyeron pacientes con HIV. La TBCI representó el 6% del total de TB pulmonar. No se encontraron diferencias significativas en cuanto a edad, sexo, presencia de cavidades en la radiografía, días de evolución y nivel de albúmina. La TBCI tuvo significativamente mayor proporción de comorbilidades (p < 0.001, presencia de condensación (p < 0.001 y compromiso unilateral (p < 0.001 en la radiografía de tórax, junto con mayor número de internaciones (p = 0.02. Cabe destacar que sólo16 de los 42 pacientes con TBCI (38% tenían alguna comorbilidad demostrada. La TBCI puede presentarse aun sin comorbilidades asociadas y debe sospecharse en neumonías de evolución tórpida independientemente de su localización.

  14. Traumatismos de veia cava inferior

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    Cleinaldo de Almeida Costa

    Full Text Available OBJETIVO: Avaliar a incidência, o perfil clínico e as estratégias operatórias dos ferimentos de Veia Cava Inferior (VCI. MÉTODOS: Foram analisados retrospectivamente os prontuários de 76 doentes com ferimento de VCI atendidos nos dois prontossocorros de Manaus, no período de janeiro de 1997 a julho de 2002. Mecanismo de lesão, mortalidade, estado hemodinâmico, índice de trauma abdominal penetrante (PATI, achados intra-operatórios e conduta cirúrgica foram estudados. RESULTADOS: Quarenta e nove (65% doentes sofreram lesão por arma branca, 26 (34% por arma de fogo e um por traumatismo abdominal fechado. Quarenta e um (54% doentes sobreviveram. Quase todos chegaram acordados, entretanto 40% estavam hipotensos (pressão arterial sistólica < 70mmHg. O índice de trauma abdominal penetrante (PATI médio foi maior que 40. À laparotomia, todos demonstraram sangramento retroperitoneal ativo ou hematoma retroperitoneal em expansão. Vinte e um pacientes possuíam lesão de VCI retro-hepática, enquanto nos outros 55 a lesão era infra-hepática. O reparo operatório predominante foi a venorrafia lateral em 65 doentes. Houve necessidade de tóraco-freno-laparotomia em quatro doentes do total de oito doentes que foram à toracotomia direita por lesão retro-hepática. Foram realizados shunts átrio-cavais em seis doentes, dos quais três sobreviveram. CONCLUSÕES: O ferimento de VCI é uma lesão de alta letalidade e possui uma relação intrínseca com a violência urbana. A sobrevivência depende de uma imediata e vigorosa reposição de volume, um manejo operatório adequado e todo esforço em evitar-se hipotermia.

  15. Superior versus inferior Ahmed glaucoma valve implantation.

    Science.gov (United States)

    Pakravan, Mohammad; Yazdani, Shahin; Shahabi, Camelia; Yaseri, Mehdi

    2009-02-01

    To compare the efficacy and safety of Ahmed glaucoma valve (AGV) (New World Medical Inc., Rancho Cucamonga, CA) implantation in the superior versus inferior quadrants. Prospective parallel cohort study. A total of 106 eyes of 106 patients with refractory glaucoma. Consecutive patients with refractory glaucoma underwent AGV implantation in the superior or inferior quadrants. Main outcome measures included intraocular pressure (IOP) and rate of complications. Other outcome measures included best corrected visual acuity (BCVA), number of glaucoma medications, and success rate (defined as at least 30% IOP reduction and 5AGV implantation in the superior and inferior quadrants, respectively. Baseline characteristics were comparable in the study groups, except for preoperative IOP, which was higher in the superior group (P = 0.01). Patients were followed for a mean period of 10.6+/-8.49 months and 10.58+/-6.75 months in the superior and inferior groups, respectively (P = 0.477). BCVA was comparable between the groups at all postoperative visits (P>0.122). After 1 year, statistically significant but comparable IOP reduction from baseline (PAGV implants have similar intermediate efficacy in terms of IOP reduction, decrease in number of glaucoma medications, and preservation of vision. However, the inferior quadrants entail significantly more complications. It may be prudent to avoid AGV implantation in the inferior quadrants if the superior quadrants have no contraindications to surgery. Proprietary or commercial disclosure may be found after the references.

  16. Anatomy of Inferior Mesenteric Artery in Fetuses

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    Ayesha Nuzhat

    2016-01-01

    Full Text Available Aim. To analyze Inferior Mesenteric Artery in fetuses through its site of origin, length, diameter, and variation of its branches. Method. 100 fetuses were collected from various hospitals in Warangal at Kakatiya Medical College in Andhra Pradesh, India, and were divided into two groups, group I (second-trimester fetuses and group II (third-trimester fetuses, followed by dissection. Result. (1 Site of Origin. In group I fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra in 33 out of 34 fetuses (97.2%. In one fetus it was at first lumbar vertebra, 2.8%. In all group II fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra. (2 Length. In group I fetuses it ranged between 18 and 30 mm, average being 24 mm except in one fetus where it was 48 mm. In group II fetuses the length ranged from 30 to 34 mm, average being 32 mm. (3 Diameter. In group I fetuses it ranged from 0.5 to 1 mm, and in group II fetuses it ranged from 1 to 2 mm, average being 1.5 mm. (4 Branches. Out of 34 fetuses of group I, 4 fetuses showed variation. In one fetus left colic artery was arising from abdominal aorta, 2.9%. In 3 fetuses, Inferior Mesenteric Artery was giving a branch to left kidney, 8.8%. Out of 66 fetuses in group II, 64 had normal branching. In one fetus left renal artery was arising from Inferior Mesenteric Artery, 1.5%, and in another fetus one accessory renal artery was arising from Inferior Mesenteric Artery and entering the lower pole of left kidney. Conclusion. Formation, course, and branching pattern of an artery depend on development and origin of organs to attain the actual adult position.

  17. Iatrogenic injury to the inferior alveolar nerve

    DEFF Research Database (Denmark)

    Hillerup, Søren

    2008-01-01

    The purpose of this prospective, non-randomised, descriptive study is to characterise the neurosensory deficit and associated neurogenic discomfort in 52 patients with iatrogenic injury to the inferior alveolar nerve (IAN). All patients were examined and followed up according to a protocol assess...

  18. Endovascular treatment of ruptured distal posterior inferior ...

    African Journals Online (AJOL)

    Objective: To investigate the clinical characteristics and endovascular treatment of ruptured distal posterior inferior cerebellar artery (PICA) aneurysms. Methods: 11 consecutive patients (7 women, 4 men, mean age of 49.2 years) with ruptured distal PICA aneurysms were studied retrospectively. All had onset of acute ...

  19. Inferior Oblique Botulinum Toxin Injection: A Postoperative Diplopia Test for Secondary Inferior Oblique Muscle Overaction.

    Science.gov (United States)

    Bansal, Shveta; Marsh, Ian B

    2016-01-01

    To evaluate the utility of botulinum toxin injection into the inferior oblique muscle for secondary inferior oblique muscle overaction. A retrospective review of 18 patients and 23 injections performed over a 9-year period. Indications and deviations in primary position and contralateral gaze before and after injection were recorded. Functional outcomes and further management (conservative vs surgical) were observed. In 14 patients, chemodenervation resulted in a temporary improvement in symptoms. Eleven of these patients went on to have inferior oblique myectomy with resolution of their diplopia. Two patients preferred to receive regular injections of botulinum toxin as a treatment. Botulinum toxin chemodenervation of the inferior oblique muscle in cases of secondary inferior oblique muscle overaction is useful where one needs to establish a risk of overcorrection following planned inferior oblique muscle weakening. This is particularly true in cases where the primary position deviation may be small but symptoms of diplopia exist on contralateral side gaze, giving rise to a narrowed field of binocular single vision. Copyright 2016, SLACK Incorporated.

  20. Inferior alveolar nerve repositioning and orthognathic surgery.

    Science.gov (United States)

    Rahpeyma, Amin; Khajehahmadi, Saeedeh

    2014-09-01

    Inferior alveolar nerve (IAN) repositioning is a well-known technique in implant dentistry. This invaluable technique can be combined with orthognathic techniques to enhance the effect of orthognathic surgery in some selected cases. In a retrospective study, data were obtained from the archived files of Department of Oral and Maxillofacial Surgery, Mashhad University of Medical Sciences, Iran, from 2007 to 2012. Patients undergoing mandibular orthognathic surgery alone or in combination with maxillary surgery were searched. Cases with IAN repositioning were selected. In this study, in 4% of orthognathic surgical procedures involving the mandibular bone, IAN repositioning was indicated. Genioplasty, body ostectomy, total mandibular subapical alveolar osteotomy, and inferior border osteotomy for correction of asymmetric mandibular excess in hemimandibular hyperplasia were in this list. In carefully selected orthognathic patients, IAN repositioning can enhance the effect of orthognathic surgery and should be considered in the treatment plan strategies as an option.

  1. Does Wal-Mart Sell Inferior Goods?

    OpenAIRE

    Emek Basker

    2008-01-01

    I estimate the aggregate income elasticity of Wal-Mart's and Target's revenues using quarterly data for 1997-2006. I find that Wal-Mart's revenues increase during bad times, whereas Target's revenues decrease, consistent with Wal-Mart selling "inferior goods" in the technical sense of the term. An upper bound on the aggregate income elasticity of demand for Wal-Mart's wares is -0.5.

  2. Non-inferiority trials: are they inferior? A systematic review of reporting in major medical journals.

    Science.gov (United States)

    Rehal, Sunita; Morris, Tim P; Fielding, Katherine; Carpenter, James R; Phillips, Patrick P J

    2016-10-07

    To assess the adequacy of reporting of non-inferiority trials alongside the consistency and utility of current recommended analyses and guidelines. Review of randomised clinical trials that used a non-inferiority design published between January 2010 and May 2015 in medical journals that had an impact factor >10 (JAMA Internal Medicine, Archives Internal Medicine, PLOS Medicine, Annals of Internal Medicine, BMJ, JAMA, Lancet and New England Journal of Medicine). Ovid (MEDLINE). We searched for non-inferiority trials and assessed the following: choice of non-inferiority margin and justification of margin; power and significance level for sample size; patient population used and how this was defined; any missing data methods used and assumptions declared and any sensitivity analyses used. A total of 168 trial publications were included. Most trials concluded non-inferiority (132; 79%). The non-inferiority margin was reported for 98% (164), but less than half reported any justification for the margin (77; 46%). While most chose two different analyses (91; 54%) the most common being intention-to-treat (ITT) or modified ITT and per-protocol, a large number of articles only chose to conduct and report one analysis (65; 39%), most commonly the ITT analysis. There was lack of clarity or inconsistency between the type I error rate and corresponding CIs for 73 (43%) articles. Missing data were rarely considered with (99; 59%) not declaring whether imputation techniques were used. Reporting and conduct of non-inferiority trials is inconsistent and does not follow the recommendations in available statistical guidelines, which are not wholly consistent themselves. Authors should clearly describe the methods used and provide clear descriptions of and justifications for their design and primary analysis. Failure to do this risks misleading conclusions being drawn, with consequent effects on clinical practice. Published by the BMJ Publishing Group Limited. For permission to use

  3. Efeitos da dominância unilateral dos membros inferiores na flexibilidade e no desempenho isocinético em mulheres saudáveis

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    Gabriel Peixoto Leão Almeida

    Full Text Available INTRODUÇÃO: A dominância unilateral dos membros inferiores pode causar desequilíbrios entre os grupos musculares contralaterais, predispondo ambas as pernas a lesões. Assim, o conhecimento de deficits comparativos unilaterais é importante nas medidas de prevenção e avaliação do paciente. OBJETIVO: Verificar a influência das atividades diárias na diferença dos membros dominante (MD e não dominante (MND quanto a flexibilidade, Pico de Torque (PT, Trabalho Máximo (TM, Potência Máxima (PM dos flexores e extensores do joelho. MÉTODOS: A amostra foi constituída por 23 mulheres saudáveis e não praticantes de atividade física. A flexibilidade foi avaliada pelo Teste do Ângulo Poplíteo (TAP para isquiostibiais e Teste de Thomas (TT para quadríceps-femoral; a avaliação isocinética foi realizada no modo concêntrico para extensão e flexão do joelho. Para o PT e o TM, foram realizadas cinco repetições na velocidade angular de 60º/seg e, para PM, 15 repetições em 240º/seg. Todas as avaliações foram realizadas pelo mesmo pesquisador. RESULTADOS: Não houve diferença estatisticamente significante quanto à flexibilidade obtida pelo TAP e pelo TT (p > 0,05. Porém, em todas as variáveis isocinéticas avaliadas houve uma diferença significativamente relevante entre o MD e o MND (p < 0,01, com média do índice de simetria dos membros superior a 10%. CONCLUSÃO: De acordo com os dados obtidos, as atividades do cotidiano em mulheres saudáveis causam diferenças entre o MD e o MND, sendo constatadas pela avaliação isocinética quanto a PT, TM e PM; porém, tais diferenças não foram visualizadas quanto à flexibilidade.

  4. A novel technique for inferior rectus recession

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    Gokyigit B

    2014-01-01

    Full Text Available Birsen Gokyigit, Serpil Akar, Omer Faruk YilmazDepartment of Strabismus, Istanbul Beyoglu Educational and Research Eye Hospital, Istanbul, TurkeyPurpose: To introduce a novel technique of inferior rectus recession operation to allow larger amounts of recession without causing lower lid retraction and to compare this method with the results obtained in standard inferior rectus recession.Material and methods: This study included 20 patients operated on in the authors' clinic. The median age of the patients was 24.5±18.6 (4–73 years and the median follow-up was 9.3±11.8 (3–43 months. Ten patients operated on with the standard method were labeled Group 1 and ten patients operated on with the new method were labeled Group 2. Without exceeding 4 mm, inferior rectus recession to the whole muscle was performed in Group 1 patients. Inferior rectus recession was also performed on patients in Group 2 following the new method. Using a spatula, approximately 10% of the muscle surface fibers were detached intact as a thin layer, and the remaining 90% of deeper fibers were recessed 4–8 mm as planned. Patients' preoperative deviations and lower lid positions were recorded. The same parameters were checked in the first and third month postoperatively. Both groups were evaluated retrospectively by screening their files, and the Mann–Whitney U test was used for statistical evaluation.Results: Lower lid retraction was seen in four patients of Group 1. There was no retraction in Group 2. While there was a need to perform additional vertical muscle procedures for vertical deviations and lower lid retractions in Group 1, it was observed that there was no need for additional procedures in Group 2 patients. There was a statistically meaningful difference between the two procedures (P<0.05.Conclusion: This novel technique was found to be an effective surgical method for permitting more recession without the risk of lower lid retraction.Keywords: inferior rectus

  5. PERFORATION OF INFERIOR ALVEOLAR NERVE BY MAXILLARY ARTERY. Perforation of inferior alveolar nerve by maxillary artery

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    Prakash B Billakanti

    2016-03-01

    Full Text Available La fosa infratemporal es un área anatómica clínicamente importante para la administración de agentes anestésicos locales en odontología y cirugía maxilofacial. Fueron estudiadas variaciones en la anatomía del nervio alveolar inferior y la arteria maxilar en la disección infratemporal. Durante la disección rutinaria de la cabeza en el cadáver de un varón adulto, fue observada una variación excepcional en el origen del nervio alveolar inferior y su relación con las estructuras circundantes. El nervio alveolar inferior se originaba en el nervio mandibular por dos raíces y la primera parte de la arteria maxilar estaba incorporada entre ambas. El origen embriológico de esta variación y sus implicaciones clínicas es debatido. Dado que la arteria maxilar transcurría entre las dos raíces del nervio alveolar inferior, y el nervio estaba fijado entre el foramen oval y el foramen mandibular, el atrapamiento vásculo-nervioso pudo causar entume-cimiento o dolor de cabeza e interferir con la inyección de anestésicos locales en la fosa infratemporal.  Variaciones anatómicas en esta región deben ser tenidas en cuenta, especialmente en casos de tratamiento fallido de neuralgia del trigémino. Infratemporal fossa is clinically important anatomical area for the delivery of local anesthetic agents in dentistry and maxillofacial surgery. Variations in the anatomy of the inferior alveolar nerve and maxillary artery were studied in infratemporal dissection. During routine dissection of the head in an adult male cadaver an unusual variation in the origin of the inferior alveolar nerve and its relationship with the surrounding structures was observed. The inferior alveolar nerve originated from the mandibular nerve by two roots and the first part of the maxillary artery was incorporated between them. An embryologic origin of this variation and its clinical implications is discussed. Because the maxillary artery runs between the two roots of

  6. Added clinical value of the inferior temporal EEG electrode chain.

    Science.gov (United States)

    Bach Justesen, Anders; Eskelund Johansen, Ann Berit; Martinussen, Noomi Ida; Wasserman, Danielle; Terney, Daniella; Meritam, Pirgit; Gardella, Elena; Beniczky, Sándor

    2017-10-07

    To investigate the diagnostic added value of supplementing the 10-20 EEG array with six electrodes in the inferior temporal chain. EEGs were recorded with 25 electrodes: 19 positions of the 10-20 system, and six additional electrodes in the inferior temporal chain (F9/10, T9/10, P9/10). Five-hundred consecutive standard and sleep EEG recordings were reviewed using the 10-20 array and the extended array. We identified the recordings with EEG abnormalities that had peak negativities at the inferior temporal electrodes, and those that only were visible at the inferior temporal electrodes. From the 286 abnormal recordings, the peak negativity was at the inferior temporal electrodes in 81 cases (28.3%) and only visible at the inferior temporal electrodes in eight cases (2.8%). In the sub-group of patients with temporal abnormalities (n = 134), these represented 59% (peak in the inferior chain) and 6% (only seen at the inferior chain). Adding six electrodes in the inferior temporal electrode chain to the 10-20 array improves the localization and identification of EEG abnormalities, especially those located in the temporal region. Our results suggest that inferior temporal electrodes should be added to the EEG array, to increase the diagnostic yield of the recordings. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  7. Outcome of Inferior Patellar Pole Avulsion Fractures

    Directory of Open Access Journals (Sweden)

    Ruban Raj Joshi

    2016-12-01

    Full Text Available Introduction: The optimal treatment for inferior pole patella avulsion fractures has still been a topic of debate. The options include (a internal fixation of the pole fragment and (b resection of the avulsed fragment and repair of the patellar ligament to the patella. We present the comparative outcomes for patients with displaced inferior pole patella treated by resection and transosseous Ethibond® Krackow suture repair of patellar ligament with open reduction and internal fixation with modified tension band wiring and circumferential wiring. Methods: During a three year period between August 2013 and September 2016, twenty consecutive patients with distal pole fractures of the patella were prospectively enrolled in this study. These patients were divided into two groups. Group-T patients were treated with open reduction and internal fixation with modified tension band wire and  group-R patients by resection of the avulsed fragment and reattachment of the patellar ligament to the patella with #5 Ethibond®. Data entry and analysis was done by using SPSS version 20. Anatomical and functional outcome were compared. Results: Consecutive 20 patients were treated either with resection lower patellar pole (n=10 or with open reduction internal fixation with tension band wiring (n=10. Demographics were matched in two groups. Group-T required a longer hospital stay (U=13.5, p=0.005. Complications were seen more often in Goup-T compared to Group-R (p=0.005. Group-R had better scores (Bostman score U=6, p=0.001; SFMA U=7.5, p=0.001 and range of movement (p<0.05. Conclusion: Resection of the avulsed fragment and reattachment of the patellar ligament to the patella had better outcome according to the Bostman and SFMA dysfunction score, shorter hospital stay, and less complications as compared to open reduction and internal fixation with tension band wire and circumferential wiring.

  8. Bilateral inferior petrosal sinus sampling using vasopressin

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    Narendra Kotwal

    2016-01-01

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

  9. Through the looking glass: understanding non-inferiority

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    Wittes Janet T

    2011-05-01

    Full Text Available Abstract Non-inferiority trials test whether a new product is not unacceptably worse than a product already in use. This paper introduces concepts related to non-inferiority, and discusses the regulatory views of both the European Medicines Agency and the United States Food and Drug Administration.

  10. Leiomyosarcoma of the inferior vena cava.

    Science.gov (United States)

    Sulpice, L; Rayar, M; Levi Sandri, G-B; de Wailly, P; Henno, S; Turner, K; Lesimple, T; Boudjema, K; Meunier, B

    2016-06-01

    Leiomyosarcoma (LMS) of the inferior vena cava (IVC) is a rare tumor with poor prognosis. Optimal treatment includes complete resection of the malignant lesion. From 1997 to 2013, eight patients underwent surgery in our department for IVC LMS. LMS was considered to arise from the IVC if the tumor presented intraluminal development or if complete resection (R0) required removal of part of the IVC with an extraluminal mass. There were two grade 1 tumors (25%), four grade 2 (50%) and two grade 3 (25%). The median length of stay was 16 days and there were no peri-operative deaths. Median of follow-up was 56 months and mean overall survival was 120 months. Mean 3-year survival rate was 87.5%. Six patients (75%) developed a local recurrence. Four patients died from disease progression. Two patients underwent to surgery for recurrence. IVC LMS have a poor prognosis if surgical resection cannot be achieved. Long-term survival is related to an extensive surgery, in the event of recurrence, surgery should again be proposed and may be effective for controlling disease progression, possibly improving survival. Copyright © 2016. Published by Elsevier Masson SAS.

  11. Surgical management of leiomyosarcoma of the inferior vena cava.

    Science.gov (United States)

    Jiang, Hua; Wang, You-Xin; Li, Bing; Jiang, Yan-Yong; Miao, Cheng-Li; Liao, Dai-Xiang; Zhao, Rong-Hua; Luo, Cheng-Hua

    2015-06-01

    The optimal surgical management of patients with leiomyosarcoma of inferior vena cava remains a controversy. From 1975 and 2009, five patients with leiomyosarcoma of inferior vena cava were treated at the Chinese PLA General Hospital and Beijing Shijitan Hospital. The age ranged 39-61 years and the duration of symptoms ranged from 18 to 36 months. Abdominal and back pain are the most common complaints. A combination of various imaging modalities is essential for treatment planning. R0, R1, R2, and biopsy only were accomplished in 2, 1, 1, and 1 case, respectively. Combined resections included inferior vena cava, right kidney, adrenal gland, psoas, colon, duodenal, gallbladder, liver, and/or aorta, without inferior vena cava reconstruction. No inferior vena cava-related postoperative complication was seen in our series. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  12. Inferior patellar pole fragmentation in children: just a normal variant?

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H.; Vogelius, Esben S.; Orth, Robert C.; Guillerman, R.P.; Jadhav, Siddharth P. [Texas Children' s Hospital, E.B. Singleton Pediatric Radiology, Houston, TX (United States)

    2015-06-15

    Fragmentary ossification of the inferior patella is often dismissed as a normal variant in children younger than 10 years of age. The purpose of this study was to determine whether fragmentary inferior patellar pole ossification is a normal variant or is associated with symptoms or signs of pathology using MRI and clinical exam findings as reference. A retrospective review was performed on 150 patients ages 5-10 years who underwent 164 knee radiography and MRI exams (45.1% male, mean age: 7.8 years). The presence or absence of inferior patellar pole fragmentation on radiography was correlated with the presence or absence of edema-like signal on MR images. Clinical notes were reviewed for the presence of symptoms or signs referable to the inferior patellar pole. These data were compared with a 1:1 age- and sex-matched control group without inferior pole fragmentation. Statistical analysis was performed using two-tailed t-tests. Forty of 164 (24.4%) knee radiographs showed fragmentary ossification of the inferior patella. Of these 40 knees, 62.5% (25/40) had edema-like signal of the inferior patellar bone marrow compared with 7.5% (3/40) of controls (P = 0.035). Patients with fragmentary ossification at the inferior patella had a significantly higher incidence of documented focal inferior patellar pain compared with controls (20% vs. 2.5%, P = 0.015). Inferior patellar pole fragmentation in children 5 to 10 years of age may be associated with localized symptoms and bone marrow edema-like signal and should not be routinely dismissed as a normal variant of ossification. (orig.)

  13. MDCT of inferior mesenteric vein: normal anatomy and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Akpinar, E.; Turkbey, B. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey); Karcaaltincaba, M. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)], E-mail: musturayk@yahoo.com; Karaosmanoglu, D.; Akata, D. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)

    2008-07-15

    Multidetector computed tomography (MDCT) is a useful technique for imaging the inferior mesenteric vein. The aim of the present review was to discuss the normal anatomy and the pathologies of the inferior mesenteric vein, including partial or total thrombosis secondary to inflammation (pyophlebitis) and malignancy, occlusion, dilatation and reversed flow, which are rarely encountered. Optimal reconstruction techniques are also discussed. The pathologies of the inferior mesenteric vein can be clearly demonstrated using MDCT using curved-planar reformatted multiplanar reconstruction (MPR) and minimum intensity projection (MIP) images.

  14. Incidental right Bochdalek hernia with interruption of the inferior ...

    African Journals Online (AJOL)

    Incidental right Bochdalek hernia with interruption of the inferior vena cava and ... SA Journal of Radiology ... A 36-year-old asymptomatic female had a routine chest radiograph to exclude pulmonary tuberculosis, as part of an employee ...

  15. Giant leiomyosarcoma of inferior vena cava. A surgical challenge.

    Science.gov (United States)

    Kumar, Santosh; Devana, Sudheer Kumar; Kuthe, Sachin; Yadav, Thakur Deen; Prasad, Seema

    2014-09-01

    We describe the case of a 37-year-old woman who presented with an unusually large (26 × 20 × 16 cm) extraluminal leiomyosarcoma arising from segment I (below the renal vessels) of the inferior vena cava. She was successfully managed with radical surgical excision and reconstruction of the inferior vena cava with synthetic graft. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  16. Inferior alveolar nerve sensitivity changes after mandibular trauma

    OpenAIRE

    Simonas Grybauskas; Algirdas Lukosiunas; Gintautas Sabalys; Ricardas Kubilius; Dainius Razukevicius

    2010-01-01

    The investigation was performed on 195 patients, who had fracture on mandibular angle zone. In control group pain thresholds of infraorbital nerve and inferior alveolar nerve did not differ significantly (p > 0.05). Consequently, lesion degree of inferior alveolar nerve and its functional recovery dynamics were estimated objectively according to pain threshold and lesion index of neural function. Stump dislocation extent has influence on neural lesion: the more expressed dislocation, the high...

  17. The effect of shoulder position on inferior glenohumeral mobilization.

    Science.gov (United States)

    Witt, Dexter W; Talbott, Nancy R

    2017-03-09

    Cross-sectional clinical measurement study. Inferior mobilizations are used to treat patients with shoulder dysfunctions. Common positions recommended for promoting an inferior glide include: (1) an open-packed position (OPP) in which the shoulder is in 55° of abduction, 30° of horizontal adduction, and no rotation; (2) neutral position (NP) of the shoulder; and (3) position of 90° of shoulder abduction (ABDP). Studies comparing the impact of position on inferior mobilization are lacking. To determine the effect of shoulder position on humeral movement and mobilization force during inferior mobilizations. Twenty-three subjects were tested bilaterally. Subjects were placed in the OPP, and an ultrasound transducer placed over the superior glenohumeral joint. As inferior mobilization forces were applied through a dynamometer, ultrasound images were taken at rest and during 3 grades of inferior mobilization. This process was repeated in the NP and the ABDP. In the NP, movements during grade 1, 2, and 3 mobilizations were 1.8, 3.8, and 4.5 mm, respectively. Movements measured in the OPP (1.0, 2.4, and 3.6 mm, respectively) and in the ABDP (1.0, 2.2, and 2.3 mm, respectively) were less. Forces were higher in the NP during grade 1, 2, and 3 mobilizations (51.8, 138.7, and 202.1 N, respectively) than in the OPP (37.2, 91.2, and 139.9 N, respectively) and the ABPD (42.5, 115.3, and 165.5 N, respectively). Mobilization position altered the movement and force during inferior mobilizations. Shoulder position should be considered when utilizing inferior mobilizations. NA. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  18. [Congenital anomalies of the inferior vena cava: role of imaging].

    Science.gov (United States)

    Manfredi, R; Cotroneo, A R; Pirronti, T; Macis, G; Marano, P

    1995-10-01

    In recent years, clinics and radiology of congenital anomalies of the inferior vena cava have increased in importance in planning abdominal surgery, liver or kidney transplantation, or new interventional or diagnostic procedures such as the positioning of inferior vena cava filters to prevent pulmonary embolism, varicocel sclerotherapy and renal venous sampling. In the past, the radiologic assessment of these rare anomalies was performed only with angiography, which remains the most accurate diagnostic method. Today, besides angiography, less invasive examinations can be performed, e.g., US, CT and MRI, with MRA. In the last two years, 5 patients with inferior vena cava anomalies were examined: 3 had double inferior vena cava and 2 azygos continuation. All of them were submitted to US, CT, MRI and MRA and 3 patients underwent also angiography, two of them with double puncture. US can suggest the diagnosis but may be limited by technical factors and in the assessment of the whole inferior vena cava. Enhanced CT can depict anomaly extent, but uses contrast agents and ionizing radiations. Angiography better depicts craniocaudal spread and collateral networks but is an invasive procedure and sometimes needs a double puncture (double inferior vena cava). MRI, with MRA, yields the same information as the other modalities, but without contrast agents or ionizing radiations. The development of velocity encoded sequences will probably make this technique the method of choice in the study of inferior vena cava anomalies. Our study was aimed at reviewing the embryo-genesis of inferior vena cava anomalies and to assess the relative importance of different diagnostic procedures in the diagnosis and staging of these anomalies.

  19. Opioid modulation of GABA release in the rat inferior colliculus

    Directory of Open Access Journals (Sweden)

    Forge Andrew

    2004-09-01

    Full Text Available Abstract Background The inferior colliculus, which receives almost all ascending and descending auditory signals, plays a crucial role in the processing of auditory information. While the majority of the recorded activities in the inferior colliculus are attributed to GABAergic and glutamatergic signalling, other neurotransmitter systems are expressed in this brain area including opiate peptides and their receptors which may play a modulatory role in neuronal communication. Results Using a perfusion protocol we demonstrate that morphine can inhibit KCl-induced release of [3H]GABA from rat inferior colliculus slices. DAMGO ([D-Ala(2, N-Me-Phe(4, Gly(5-ol]-enkephalin but not DADLE ([D-Ala2, D-Leu5]-enkephalin or U69593 has the same effect as morphine indicating that μ rather than δ or κ opioid receptors mediate this action. [3H]GABA release was diminished by 16%, and this was not altered by the protein kinase C inhibitor bisindolylmaleimide I. Immunostaining of inferior colliculus cryosections shows extensive staining for glutamic acid decarboxylase, more limited staining for μ opiate receptors and relatively few neurons co-stained for both proteins. Conclusion The results suggest that μ-opioid receptor ligands can modify neurotransmitter release in a sub population of GABAergic neurons of the inferior colliculus. This could have important physiological implications in the processing of hearing information and/or other functions attributed to the inferior colliculus such as audiogenic seizures and aversive behaviour.

  20. [Anatomy of fractures of the inferior scapular angle].

    Science.gov (United States)

    Bartoníček, J; Tuček, M; Malík, J

    2018-01-01

    The aim of this study is to describe the anatomy of fractures of the inferior angle and the adjacent part of the scapular body, based on 3D CT reconstructions. In a series of 375 scapular fractures, we identified a total of 20 fractures of the inferior angle of the scapular body (13 men, 7 women), with a mean patient age of 50 years (range 3373). In all fractures, 3D CT reconstructions were obtained, allowing an objective evaluation of the fracture pattern with a focus on the size and shape of the inferior angle fragment, propagation of the fracture line to the lateral and medial borders of the infraspinous part of the scapular body, fragment displacement and any additional fracture of the ipsilateral scapula and the shoulder girdle. We identified a total of 5 types of fracture involving the distal half of the infraspinous part of the scapular body. The first type, recorded in 5 cases, affected only the apex of the inferior angle, with a small part of the adjacent medial border. The second type, occurring in 4 cases, involved fractures separating the entire inferior angle. The third type, represented by 4 cases, was characterized by a fracture line starting medially close above the inferior angle and passing proximolaterally. The separated fragment had a shape of a big drop, carrying also the distal half of the lateral pillar in addition to the inferior angle. In the fourth type identified in 5 fractures, the separated fragment was formed both by the inferior angle and a variable part of the medial border. The fifth type, being by its nature a transition to the fracture of the infraspinous part of the body, was recorded in 2 cases, with the same V-shaped fragment. Fractures of the inferior angle and the adjacent part of the scapular body are groups of fractures differing from other infraspinous fractures of the scapular body. Although these fractures are highly variable in terms of shape, they have the same course of fracture line and the manner of displacement

  1. Vernal keratoconjunctivitis with giant papillae on the inferior tarsal conjunctiva.

    Science.gov (United States)

    Asada, Yosuke; Ebihara, Nobuyuki; Funaki, Toshinari; Yokoi, Norihiko; Murakami, Akira; Matsuda, Akira

    2014-01-01

    In vernal keratoconjunctivitis (VKC), giant papillae are commonly observed on the superior tarsal conjunctiva. We found 3 cases of giant papillae on the inferior tarsal conjunctiva, and diagnosed them as being VKC based on their clinical and histopathological features. Three patients with inferior tarsal giant papillae were studied. In 2 patients, the giant papillae were resected for therapeutic purposes. Immunohistochemical analysis was carried out by indirect immunofluorescent staining using anti-CD3, anti-CD20, anti-CD35 antibodies. In all 3 patients, giant papilla formation was observed on the inferior lid margin. Clusters of CD20 B lymphocytes with CD35 follicular dendritic cells, and CD3 marginal zone T lymphocytes, common features of lymphoid neogenesis, were observed. In 2 patients, typical giant papillary formation was also observed on the superior tarsal conjunctiva. In all the patients, topical dexamethasone and tacrolimus treatments were found to be effective. The giant papillae of VKC can occur not only on the superior tarsal conjunctiva but also on the inferior tarsal conjunctiva. The possibility of the presence of giant papillae on the inferior tarsal conjunctiva should be considered in the clinical examination of patients with VKC.

  2. Symptomatic duodenal perforation by inferior vena cava filter.

    Science.gov (United States)

    Baptista Sincos, Anna Pw; Sincos, Igor R; Labropoulos, Nicos; Donegá, Bruno C; Klepacz, Andrea; Aun, Ricardo

    2017-01-01

    Objectives Duodenal perforation by an inferior vena cava filter is rare and life threatening. Our objective is to find out number of occurrences and compare diagnosis and treatments. Method The reference list of Malgor's review in 2012 was considered as well as all new articles with eligible features. Search was conducted on specific databases: MEDLINE, Web of Sciences, and Literatura Latino-Americana e do Caribe em Ciências da Saúde. Results Most of the patients presented with upper abdominal pain and the use of radiologic studies was crucial for diagnosis. The most common treatment was laparotomy with filter or strut removal plus duodenum repair. However, clinical conditions of patients must be considered and the endovascular technique with endograft deployment into inferior vena cava may be an alternative. Conclusion Duodenal perforation by an inferior vena cava filter is uncommon and in high-risk surgical patients endovascular repair must be considered.

  3. Isquemia aguda de miembros inferiores secundaria a ergortismo

    Directory of Open Access Journals (Sweden)

    Franco J. Vallejo, MD

    2011-11-01

    Full Text Available Paciente de género femenino, de 21 años de edad, quien ingresó por dolor progresivo e intenso en miembros inferiores, y refirió antecedente reciente de ingestión de derivados del ergot. Al examen físico se observó ausencia de pulsos en ambos miembros inferiores. Por angiotomografia se documentó disminución severa, generalizada y bilateral, del calibre de los vasos arteriales de miembros inferiores. Se diagnosticó isquemia arterial aguda secundaria a ergotismo y se inició tratamiento con vasodilatadores y calcio-antagonistas, que resolvió los síntomas en su totalidad.

  4. Traumatic neuroma of the inferior alveolar nerve: a case report.

    Science.gov (United States)

    Arribas-García, Ignacio; Alcalá-Galiano, Andrea; Gutiérrez, Ramón; Montalvo-Moreno, Juan José

    2008-03-01

    Traumatic neuromas are rare entities which characteristically arise subsequently to surgery and are usually accompanied by pain, typically neuralgic. We present an unusual case of an intraosseous traumatic neuroma of the inferior alveolar nerve following tooth extraction. A 56-year-old man consulted for paresthesias and hyperesthesia in the left mandibular region following extraction of the left mandibular third molar (#38). The panoramic radiograph revealed a radiolucent lesion in the inferior alveolar nerve canal, and CT demonstrated the existence of a mass within the canal, producing widening of the same. Nerve-sparing excisional biopsy was performed. Histopathology and immunohistochemistry were consistent with traumatic neuroma of the left inferior alveolar nerve. After 3 years of follow-up, the patient is asymptomatic and there are no signs of recurrence.

  5. Adaptive coupling of inferior olive neurons in cerebellar learning.

    Science.gov (United States)

    Tokuda, Isao T; Hoang, Huu; Schweighofer, Nicolas; Kawato, Mitsuo

    2013-11-01

    In the cerebellar learning hypothesis, inferior olive neurons are presumed to transmit high fidelity error signals, despite their low firing rates. The idea of chaotic resonance has been proposed to realize efficient error transmission by desynchronized spiking activities induced by moderate electrical coupling between inferior olive neurons. A recent study suggests that the coupling strength between inferior olive neurons can be adaptive and may decrease during the learning process. We show that such a decrease in coupling strength can be beneficial for motor learning, since efficient coupling strength depends upon the magnitude of the error signals. We introduce a scheme of adaptive coupling that enhances the learning of a neural controller for fast arm movements. Our numerical study supports the view that the controlling strategy of the coupling strength provides an additional degree of freedom to optimize the actual learning in the cerebellum. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Agenesia de veia cava inferior associada à trombose venosa profunda Agenesis of inferior vena cava associated with deep venous thrombosis

    Directory of Open Access Journals (Sweden)

    Clovis Luis Konopka

    2010-09-01

    Full Text Available A agenesia da veia cava inferior é uma anomalia congênita rara, que foi recentemente identificada como um importante fator de risco para o desenvolvimento e a recorrência de trombose venosa profunda de membros inferiores em jovens. O objetivo deste trabalho foi relatar o caso de uma paciente que apresentou trombose venosa profunda dois meses após a realização de cirurgia de varizes. A angiotomografia computadorizada demonstrou a presença de anomalia venosa complexa com ausência da veia cava inferior.The agenesis of the inferior vena cava is a rare congenital anomaly, which was recently identified as an important risk factor for the development and recurrence of deep venous thrombosis especially in young people. The goal of this work was to report the case of a patient who presented deep venous thrombosis approximately two months after varicose vein surgery. The computerized angiotomography demonstrated the presence of a complex venous anomaly with absence of the inferior vena cava.

  7. Pseudo-dissection of ascending aorta in inferior myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Grahame K. Goode

    2011-06-01

    Full Text Available Acute aortic dissection is a cardiac emergency which can present as inferior myocardial infarction. It has high morbidity and mortality requiring prompt diagnosis and treatment. Rapid advances in noninvasive imaging modalities have facilitated the early diagnosis of this condition and in ruling out this potentially catastrophic illness. We report an interesting case of a 57 year- old -man who presented with inferior myocardial infarction requiring thrombolysis and temporary pacing wire for complete heart block. An echocardiogram was highly suspicious of aortic dissection. CT scan confirmed that the malposition of the temporary pacing wire through the aorta mimicked aortic dissection.

  8. Abordagem fisioterapêutica do linfedema bilateral de membros inferiores

    OpenAIRE

    Tacani, Pascale Mutti; Machado, Aline Fernanda Perez; Tacani, Rogério Eduardo

    2012-01-01

    INTRODUÇÃO: O linfedema é um acúmulo de proteína no interstício em virtude de deficiência do sistema linfático, sendo recomendada a utilização da Terapia Física Complexa como forma de tratamento. OBJETIVO: Verificar os efeitos da Terapia Física Complexa no tratamento e na manutenção do linfedema bilateral de membros inferiores. MÉTODOS: Participaram deste estudo sete pacientes com linfedema bilateral nos membros inferiores, de faixa etária entre 59 e 85 anos, os quais foram submetidos a: 1ª a...

  9. INFERIOR VENA-CAVA OBSTRUCTION AFTER ORTHOTOPIC LIVER-TRANSPLANTATION

    NARCIS (Netherlands)

    BROUWERS, MAM; DEJONG, KP; PEETERS, PMJG; BIJLEVELD, CMA; KLOMPMAKER, IJ; SLOOFF, MJH

    Post-operative inferior vena cava (IVC) obstruction is reported as an uncommon complication after orthotopic liver transplantation (OLT). We report 6 cases after 245 OLT's in the period between March '79 and December '92. Compression or torsion of the IVC or a technical problem were underlying

  10. Transhepatic approach for extracardiac inferior cavopulmonary connection stent fenestration.

    LENUS (Irish Health Repository)

    Kenny, Damien

    2012-02-01

    We report on a 3-year-old male who underwent transcatheter stent fenestration of the inferior portion of an extracardiac total cavopulmonary connection in the setting of hypoplastic left heart syndrome. Transhepatic approach, following an unsuccessful attempt from the femoral vein facilitated delivery of a diabolo-shaped stent.

  11. Does the reduction of inferior turbinate affect lower airway functions?

    Science.gov (United States)

    Unsal, Ozlem; Ozkahraman, Mehtap; Ozkarafakili, Mufide Arzu; Akpinar, Meltem; Korkut, Arzu Yasemin; Kurt Dizdar, Senem; Uslu Coskun, Berna

    2017-11-06

    Although the nose and lungs are separate organs, numerous studies have reported that the entire respiratory system can be considered as a single anatomical and functional unit. The upper and lower airways affect each other either directly or through reflex mechanisms. In this study, we aimed to evaluate the effects of the radiofrequency ablation of persistent inferior turbinate hypertrophy on nasal and pulmonary function. Twenty-seven patients with bilateral persistent inferior turbinate hypertrophy without septal deviation were included in this study. All of the patients were evaluated using anterior rhinoscopy, nasal endoscopy, acoustic rhinometry, a visual analogue scale, and flow-sensitive spirometry on the day before and 4 months after the radiofrequency ablation procedure. The post-ablation measurements revealed that the inferior turbinate ablation caused an increase in the mean cross-sectional area and volume of the nose, as well as in the forced expiratory volume in 1s, forced vital capacity, and peak expiratory flow of the patients. These differences between the pre- and post-ablation results were statistically significant. The post-ablation visual analogue scale scores were lower when compared with the pre-ablation scores, and this difference was also statistically significant. This study demonstrated that the widening of the nasal passage after the reduction of the inferior turbinate size had a favorable effect on the pulmonary function tests. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  12. Inferior lumbar triangle hernia: case report | Naidoo | East African ...

    African Journals Online (AJOL)

    A patient with a spontaneously acquired hernia along the inferior lumbar triangle commonly referred to as lumbar triangle of Petit is presented. This was confirmed on CT scan and successfully treated surgically. A review of the literature relevant to this condition is presented. It is likely that with advances in imaging ...

  13. Inferior vena cava leiomyosarcoma: vascular reconstruction is not ...

    African Journals Online (AJOL)

    Leiomyosarcoma (LMS) of inferior vena cava is a rare and aggressive tumor, arising from the smooth muscle cells in the vessel wall. A large complete surgical resection is the essential treatment. The need of vascular reconstruction is not always mandatory. It's above all to understand the place of the reconstruction with ...

  14. Case Report: Supernumerary right renal vein draining inferior to the ...

    African Journals Online (AJOL)

    With recent increase in renal transplantations, renovascular reconstructions and imaging advances, meticulous knowledge of the normal and variant anatomy of the renal vasculature is important to avoid potential pitfalls. We report a case of an accessory renal vein arising from the right kidney, and draining into the inferior ...

  15. Pelvic girdle chondrosarcoma and inferior vena cava thrombosis

    NARCIS (Netherlands)

    Hoekstra, HJ; Pras, B; Mooyaart, ELM; van Ginkel, R; Molenaar, WM

    1997-01-01

    Pelvic girdle chondrosarcomas in children and adolescents are extremely rare, These high grade malignant chondrosarcomas with a locally aggressive growth pattern have a high tendency for thrombus formations in the afferent tumour vessels, associated with an increased risk of inferior vena cava

  16. Pulmonary embolism presenting with ST segment elevation in inferior leads

    OpenAIRE

    Muzaffer Kahyaoğlu; Elnur Alizade; Abdurrahman Naser; Akin İzgi

    2017-01-01

    Acute pulmonary embolism is a form of venous thromboembolism that is widespread and sometimes mortal. The clinical presentation of pulmonary embolism is variable and often nonspecific making the diagnosis challenging. In this report, we present a case of pulmonary embolism characterized by ST segment elevation in inferior leads without reciprocal changes in the electrocardiogram.

  17. Inferior oblique muscle paresis as a sign of myasthenia gravis.

    Science.gov (United States)

    Almog, Yehoshua; Ben-David, Merav; Nemet, Arie Y

    2016-03-01

    Myasthenia gravis may affect any of the six extra-ocular muscles, masquerading as any type of ocular motor pathology. The frequency of involvement of each muscle is not well established in the medical literature. This study was designed to determine whether a specific muscle or combination of muscles tends to be predominantly affected. This retrospective review included 30 patients with a clinical diagnosis of myasthenia gravis who had extra-ocular muscle involvement with diplopia at presentation. The diagnosis was confirmed by at least one of the following tests: Tensilon test, acetylcholine receptor antibodies, thymoma on chest CT scan, or suggestive electromyography. Frequency of involvement of each muscle in this cohort was inferior oblique 19 (63.3%), lateral rectus nine (30%), superior rectus four (13.3%), inferior rectus six (20%), medial rectus four (13.3%), and superior oblique three (10%). The inferior oblique was involved more often than any other muscle (pmuscle is rarely encountered (other than as a part of oculomotor nerve palsy). Hence, when a patient presents with vertical diplopia resulting from an isolated inferior oblique palsy, myasthenic etiology should be highly suspected. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Simultaneous Fractures of Acromion, Coracoid Process and Inferior ...

    African Journals Online (AJOL)

    Shoulder dislocations are the most frequent among all articular dislocations. They can lead to major shoulder instability especially when they are associated with scapula fractures. We report an unusual case of antero- inferior shoulder dislocation associated with a triple fracture of the scapula. It is a twenty eight-year old ...

  19. The Role of Inferior Vena Cava Filters in Cancer Patients

    Science.gov (United States)

    Pandhi, Mithil B.; Desai, Kush R.; Ryu, Robert K.; Lewandowski, Robert J.

    2016-01-01

    Cancer induces a hypercoagulable state and renders patients susceptible to venous thromboembolism. While anticoagulation remains the mainstay of treatment, many of these patients require placement of an inferior vena cava (IVC) filter, often due to a contraindication to or failure of anticoagulation. In this article, the available data on IVC filter usage in cancer patients will be reviewed. PMID:27247473

  20. Brucellosis and thrombosis of the inferior vena cava.

    Science.gov (United States)

    Rüegger, Kristina; Tarr, Philip; Karatolios, Konstantinos; Humburg, Jörg; Hügli, Rolf; Jeanneret, Christina

    2017-01-01

    We describe the case of a 23-year old woman with a newly diagnosed thrombosis of the inferior vena cava associated with a Brucella melitensis infection. We suggest possible mechanisms leading to brucellosis-associated venous thrombosis and review 14 previously reported cases.
.

  1. Renal Angiomyolipoma Associated with Inferior Vena Cava Thrombus

    Directory of Open Access Journals (Sweden)

    Xavier Durand

    2009-01-01

    Full Text Available A 57-year-old woman was found to have an inferior vena cava involvement of a known sinusal angiomyolipoma incompletely resected three years beforehand. Intravascular extension into the IVC of angiomyolipoma has rarely been reported. We present a new case and reconsider the literature about this uncommon complication of a benign renal tumor.

  2. Pulmonary embolism presenting with ST segment elevation in inferior leads

    Directory of Open Access Journals (Sweden)

    Muzaffer Kahyaoğlu

    2017-03-01

    Full Text Available Acute pulmonary embolism is a form of venous thromboembolism that is widespread and sometimes mortal. The clinical presentation of pulmonary embolism is variable and often nonspecific making the diagnosis challenging. In this report, we present a case of pulmonary embolism characterized by ST segment elevation in inferior leads without reciprocal changes in the electrocardiogram.

  3. Central representation of the inferior rectal nerve of the rat.

    Science.gov (United States)

    Peirce, Colin; Alexander, Lauren E; O'herlihy, Colm; O'connell, P Ronan; Jones, James F X

    2010-03-01

    Obstetric injury to the pudendal nerve contributes significantly to fecal incontinence. The inferior rectal nerve, a terminal branch of the motor division of the pudendal nerve, innervates the external anal sphincter. Animal models have been developed to establish the scientific basis of sacral neuromodulation. The aims of this study were to determine the spinal location of inferior rectal nerve motoneurons projecting to the external anal sphincter and whether the inferior rectal nerve carries sensory fibers. Ten female virgin Wistar rats were used; 7 underwent bilateral inferior rectal nerve section and application of the neuronal tracer fluorogold. Five days later dorsal root ganglia L5 to S2 and the lumbosacral spinal cord were harvested and stained for activating transcription factor 3, a molecular marker of nerve injury. Three animals were used to confirm the specificity of activating transcription factor 3 nuclear labeling as a marker of axotomy. Fluorogold-labeled motoneurons were found exclusively at L6 in the dorsomedial sections of Onuf's nuclei (left and right), which contained 30 +/- 9 motoneurons with a median diameter of 28.3 microm (24.4-31.0) (25th-75th centiles). Double-labeled sensory neurons (fluorogold-labeled cytoplasm and activating transcription factor 3-labeled nuclei) were found in dorsal root ganglia L6 to S2 and were smaller in diameter (20.5 microm (17.8-26.7); median (25th-75th centiles)) than motoneurons (P inferior rectal nerve. Activating transcription factor 3 nuclear staining may prove useful for quantifying the degree of nerve injury in animal models of fecal incontinence.

  4. A role for the inferior colliculus in multisensory speech integration.

    Science.gov (United States)

    Champoux, François; Tremblay, Corinne; Mercier, Claude; Lassonde, Maryse; Lepore, Franco; Gagné, Jean-Pierre; Théoret, Hugo

    2006-10-23

    Multisensory integration can occur at relatively low levels within the central nervous system. Recent evidence suggests that multisensory audio-visual integration for speech may have a subcortical component, as acoustic processing in the human brainstem is influenced by lipreading during speech perception. Here, stimuli depicting the McGurk illusion (a demonstration of auditory-visual integration using speech stimuli) were presented to a 12-year-old child (FX) with a circumscribed unilateral lesion of the right inferior colliculus. When McGurk-type stimuli were presented in the contralesional hemifield, illusory perception reflecting bimodal integration was significantly reduced compared with the ipsilesional hemifield and a group of age-matched controls. These data suggest a functional role for the inferior colliculus in the audio-visual integration of speech stimuli.

  5. Right Ventricular Involvement in either Anterior or Inferior Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Firoozeh Abtahi

    2016-06-01

    Full Text Available Background: Unlike left ventricular function, less attention has been paid to Right Ventricular (RV function after Myocardial Infarction (MI. Objectives: The current study aimed to compare RV function in patients with inferior and anterior MI. Patients and Methods: During the study period, 60 patients consecutively presented to the Emergency Department with chest pain were divided into two groups based on their electrocardiographic findings. Accordingly, 25 patients had inferior MI (IMI group and 35 ones had anterior MI (AMI group. Echocardiography was performed 48 hours after starting the standard therapy. Conventional echocardiographic parameters and Tissue Doppler Imaging (TDI measurements were acquired from the standard views. Student t-test and the chi-square test were respectively used for comparisons of the normally distributed continuous and categorical variables in the two groups. Besides, P < 0.05 was considered to be statistically significant.

  6. Deep Vein Thrombosis Provoked by Inferior Vena Cava Agenesis

    Directory of Open Access Journals (Sweden)

    Raad A. Haddad

    2015-01-01

    Full Text Available Inferior vena cava agenesis (IVCA is a rare congenital anomaly that can be asymptomatic or present with vague, nonspecific symptoms, such as abdominal or lower back pain, or deep vein thrombosis (DVT. Here, we present a 55-year-old male who came with painless swelling and redness of his left lower limb. On examination, swelling and redness were noted extending from the left foot to the upper thigh; it was also warm compared to his right lower limb. Venous Doppler ultrasound was done which showed DVT extending up to the common femoral vein. Subsequently, computed-tomography (CT of the chest and abdomen was done to exclude malignancy or venous flow obstruction; it revealed congenital absence (agenesis of the infrarenal inferior vena cava (IVC.

  7. Optional inferior vena caval filters: where are we now?

    LENUS (Irish Health Repository)

    Keeling, A N

    2008-08-01

    With the advent of newer optional\\/retrievable inferior vena caval filters, there has been a rise in the number of filters inserted globally. This review article examines the currently available approved optional filter models, outlines the clinical indications for filter insertion and examines the expanding indications. Additionally, the available evidence behind the use of optional filters is reviewed, the issue of anticoagulation is discussed and possible future filter developments are considered.

  8. Las alteraciones posturales en miembros inferiores en el surf

    OpenAIRE

    Gaspe, Guillermina

    2015-01-01

    Cuando el equilibrio neuromuscular no es óptimo durante la práctica de un deporte, es posible que, a largo plazo, aparezcan trastornos posturales que, dependiendo del tiempo de entrenamiento, pueden convertirse en un obstáculo para la salud. Es por esto, que mediante esta investigación he pretendido mostrar las alteraciones posturales que el surf puede llegar a provocar en quienes lo practican. Objetivo: Analizar las alteraciones posturales en los miembros inferiores de surfist...

  9. Distal posterior inferior cerebellar artery aneurysm in a child

    Directory of Open Access Journals (Sweden)

    J. Francisco Salomão

    1992-06-01

    Full Text Available The case of a 7-year-old boy presenting with recurrent episodes of subarachnoid hemorrhage due to a distal posterior inferior cerebellar artery aneurysm (PICA, successfully operated, is reported.' The low incidence of intracranial aneurysms in the first decade of life and the rare occurrence of distal PICA aneurysms are unusual features of this case. The theories regarding the origin of intracranial berry aneurysms are discussed.

  10. [Aneurysm of the anterior inferior cerebellar artery: case report].

    Science.gov (United States)

    Adorno, Juan Oscar Alarcón; de Andrade, Guilherme Cabral

    2002-12-01

    The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA) are considered rare, can cause cerebello pontine angle (CPA) syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  11. Suspected spinocellular carcinoma of the inferior eyelid resulted multiple chalazion.

    Science.gov (United States)

    Onesti, Maria Giuseppina; Troccola, Antonietta; Maruccia, Michele; Conversi, Andrea; Scuderi, Gianluca

    2013-01-01

    Chalazion is a subacute granulomatous inflammation of the eyelid caused by retention of tarsal gland secretions and it's the most common inflammatory lesion of the eyelid. In cases of doubtful clinical presentation the diagnosis with a biopsy and a histopathological examination is important because it can orientate an appropriate surgical treatment. We report a case of a 64-years-old diabetic man, suspected for a spinocellular lesion of the inferior eyelid of the left eye, it resulted unexpectedly a chalazion.

  12. Bruxism elicited by inferior alveolar nerve injury: a case report.

    Science.gov (United States)

    Melis, Marcello; Coiana, Carlo; Secci, Simona

    2012-02-01

    The aim of this case report is to describe the history of a patient who received an injury to the right inferior alveolar nerve after placement of a dental implant, with bruxism noted afterward. The symptoms were managed by the use of an occlusal appliance worn at night and occasionally during the day, associated with increased awareness of parafunction during the day to reduce muscle pain and fatigue. Paresthesia of the teeth, gingiva, and lower lip persisted but were reduced during appliance use.

  13. Tinnitus-related changes in the inferior colliculus

    Directory of Open Access Journals (Sweden)

    Joel I Berger

    2015-03-01

    Full Text Available Tinnitus is highly complex, diverse, and difficult to treat, in part due to the fact that the underlying causes and mechanisms remain elusive. Tinnitus is generated within the auditory brain, however, consolidating our understanding of tinnitus pathophysiology is difficult due to the diversity of reported effects and the variety of implicated brain nuclei. Here, we focus on the inferior colliculus, a midbrain structure that integrates the vast majority of ascending auditory information and projects via the thalamus to the auditory cortex. The IC is also a point of convergence for corticofugal input and input originating outside the auditory pathway. We review the evidence, from both studies with human subjects and from animal models, for the contribution the inferior colliculus makes to tinnitus. Changes in the IC, caused by either noise exposure or drug administration, involve fundamental, heterogeneous alterations in the balance of excitation and inhibition. However, differences between hearing loss-induced pathology and tinnitus-related pathology are not well understood. Moreover, variability in tinnitus induction methodology has a significant impact on subsequent neural and behavioural changes, which could explain some of the seemingly contradictory data. Nonetheless, the inferior colliculus is likely involved in the generation and persistence of tinnitus perception.

  14. Prosthetic replacement of the infrahepatic inferior vena cava for leiomyosarcoma.

    Science.gov (United States)

    Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Giacobbi, Daniela; Papaspyropoulos, Vassilios; Ceccanei, Gianluca

    2006-09-01

    Resection of the infrahepatic inferior vena cava associated with prosthetic graft replacement for caval leiomyosarcoma is an acceptable procedure to obtain prolonged and good-quality survival. A consecutive sample clinical study with a mean follow-up of 40 months. The surgical department of an academic tertiary center and an affiliated secondary care center. Eleven patients, with a mean age of 51 years, who have primary leiomyosarcoma of the infrahepatic inferior vena cava. All of the patients underwent radical resection of the tumor en bloc with the affected segment of the vena cava. Reconstruction consisted of 10 cavocaval polytetrafluoroethylene grafts and 1 cavobiliac graft. An associated right nephrectomy was performed in 2 cases. The left renal vein was reimplanted in the graft in 3 cases. Cumulative disease-specific survival, disease-free survival, and graft patency rates expressed by standard life-table analysis. No patients died in the postoperative period. The cumulative (SE) disease-specific survival rate was 53% (21%) at 5 years. The cumulative (SE) disease-free survival rate was 44% (19%) at 5 years. The cumulative (SE) graft patency rate was 67% (22%) at 5 years. Radical resection followed by prosthetic graft reconstruction is a valuable method for treating primary leiomyosarcoma of the infrahepatic inferior vena cava.

  15. Inferior hip dislocation after falling from height: A case report.

    Science.gov (United States)

    Tekin, Ali Çağrı; Çabuk, Haluk; Büyükkurt, Cem Dinçay; Dedeoğlu, Süleyman Semih; İmren, Yunus; Gürbüz, Hakan

    2016-01-01

    Traumatic inferior hip dislocation is the least common of all hip dislocations. Adult inferior hip dislocations usually occur after high-energy trauma, very few cases are reported without fracture. A 26-year-old female was brought to the emergency department with severe pain in the left hip, impaired posture and restricted movement following a fall from 15m height. The hip joint was fixed in 90° flexion, 15° abduction, and 20° external rotation. No neurovascular impairment was determined. On radiologic examination, a left ischial type inferior hip dislocation was detected. Hemorrhagic shock which developed due to acute blood loss to thoracic and abdominal cavity and patient died at third hour after she was brought to the hospital. Traumatic hip dislocations have high morbidity and mortality rates due to multiple organ damage, primarily of the extremities, chest and abdomen. In the treatment of traumatic hip dislocation, closed reduction is recommended through muscle relaxation under general anesthesia or sedation. This procedure should be applied before any intervention for concomitant extremity injuries. A detailed evaluation on emergency presentation, a multi-disciplinary approach and early diagnosis with the rapid application of imaging methods could be life-saving for such patients. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. The absent inferior epigastric artery: a unique anomaly and implications for deep inferior epigastric artery perforator flaps.

    Science.gov (United States)

    Rozen, Warren M; Houseman, Nicholas D; Ashton, Mark W

    2009-06-01

    The abdominal wall is particularly advantageous as a donor site due to the reliability of its vascular supply. Although the cutaneous perforators of the deep inferior epigastric artery (DIEA) and the superficial inferior epigastric artery (SIEA) may show significant individual variability, the DIEA itself has been shown to be ever-present as a vascular pedicle and to be highly dependable. The increasing use of preoperative computed tomographic angiography (CTA) has led to increasing reports of anatomic variability. With the use of preoperative CTA, we describe a unique case of a completely absent DIEA in patient who had not previously undergone any open abdominal surgery. The absence of the DIEA had led to vascular changes throughout the abdominal wall, including dilatation of both SIEAs and the ipsilateral deep superior epigastric artery. Preoperative CTA in this setting helped us identify this anomaly and aided surgical planning. The incidence of this anomaly was subsequently reviewed in 150 consecutive CTA scans performed at our institution.

  17. Sinonasal Quality of Life in Children After Outfracture of Inferior Turbinates and Submucous Inferior Turbinoplasty for Chronic Nasal Congestion.

    Science.gov (United States)

    Manzi, Brian; Sykes, Kevin J; Wei, Julie L

    2017-05-01

    Chronic nasal congestion often persists in children despite empirical treatment using intranasal corticosteroids, systemic antihistamines, and/or leukotriene receptor antagonists. Symptoms are often reported even with negative results of skin or blood allergy testing. Inferior turbinoplasty has been effective in adults and children, but outfracture of inferior turbinates in children is rarely reported, as is use of validated quality-of-life measures to quantify improvements after intervention. Effective use of these 2 procedures for treating chronic nasal congestion may reduce the need for medication and improve sinonasal quality of life. To quantify changes in sinonasal quality of life for children after outfracture of inferior turbinates and concomitant submucous microdebrider inferior turbinoplasty for chronic nasal congestion. A case series with planned data collection was conducted in an ambulatory pediatric otolaryngology clinic among 43 patients with chronic nasal congestion who underwent surgical intervention between January 1, 2014, and May 31, 2015. Microdebrider submucous inferior turbinoplasty (without bony resection) and outfracture of inferior turbinates. Demographics and medication use before and after the procedure were reviewed. Scores on the Sinus and Nasal Quality of Life Survey (SN-5) and quality-of-life scores were collected at baseline, 4 to 6 weeks after the procedure, and more than 6 months after the procedure. Among the 43 patients (14 girls and 29 boys; mean age, 11.2 years [range, 4.8-17.6 years]), every domain showed significant improvements in scores on the Sinus and Nasal Quality of Life Survey and quality-of-life scores 1 to 2 months after the proecdure: sinus infection (-2.55; 95% CI, 1.85-3.26), nasal obstruction (-3.51; 95% CI, 2.88-4.14), allergy symptoms (-2.14; 95% CI, 1.43-2.86), emotional distress (-2.37; 95% CI, 1.68-3.06), activity limitation (-1.70; 95% CI, 1.14-2.25), and overall quality of life (3.72; 95% CI, 2

  18. Anesthetic technique for inferior alveolar nerve block: a new approach

    Directory of Open Access Journals (Sweden)

    Dafna Geller Palti

    2011-02-01

    Full Text Available BACKGROUND: Effective pain control in Dentistry may be achieved by local anesthetic techniques. The success of the anesthetic technique in mandibular structures depends on the proximity of the needle tip to the mandibular foramen at the moment of anesthetic injection into the pterygomandibular region. Two techniques are available to reach the inferior alveolar nerve where it enters the mandibular canal, namely indirect and direct; these techniques differ in the number of movements required. Data demonstrate that the indirect technique is considered ineffective in 15% of cases and the direct technique in 13-29% of cases. OBJECTIVE: The aim of this study was to describe an alternative technique for inferior alveolar nerve block using several anatomical points for reference, simplifying the procedure and enabling greater success and a more rapid learning curve. MATERIAL AND METHODS: A total of 193 mandibles (146 with permanent dentition and 47 with primary dentition from dry skulls were used to establish a relationship between the teeth and the mandibular foramen. By using two wires, the first passing through the mesiobuccal groove and middle point of the mesial slope of the distolingual cusp of the primary second molar or permanent first molar (right side, and the second following the oclusal plane (left side, a line can be achieved whose projection coincides with the left mandibular foramen. RESULTS: The obtained data showed correlation in 82.88% of cases using the permanent first molar, and in 93.62% of cases using the primary second molar. CONCLUSION: This method is potentially effective for inferior alveolar nerve block, especially in Pediatric Dentistry.

  19. Impact of Middle vs. Inferior Total Turbinectomy on Nasal Aerodynamics

    Science.gov (United States)

    Dayal, Anupriya; Rhee, John S.; Garcia, Guilherme J. M.

    2016-01-01

    Objectives This computational study aims to: (1) Use virtual surgery to theoretically investigate the maximum possible change in nasal aerodynamics after turbinate surgery; (2) Quantify the relative contributions of the middle and inferior turbinates to nasal resistance and air conditioning; (3) Quantify to what extent total turbinectomy impairs the nasal air conditioning capacity. Study Design Virtual surgery and computational fluid dynamics (CFD). Setting Academic tertiary medical center. Subjects and Methods Ten patients with inferior turbinate hypertrophy were studied. Three-dimensional models of their nasal anatomies were built based on pre-surgery computed tomography scans. Virtual surgery was applied to create models representing either total inferior turbinectomy (TIT) or total middle turbinectomy (TMT). Airflow, heat transfer, and humidity transport were simulated at a 15 L/min steady-state inhalation rate. The surface area stimulated by mucosal cooling was defined as the area where heat fluxes exceed 50 W/cm2. Results In both virtual total turbinectomy models, nasal resistance decreased and airflow increased. However, the surface area where heat fluxes exceed 50 W/cm2 either decreased (TIT) or did not change significantly (TMT), suggesting that total turbinectomy may reduce the stimulation of cold receptors by inspired air. Nasal heating and humidification efficiencies decreased significantly after both TIT and TMT. All changes were greater in the TIT models than in the TMT models. Conclusion TIT yields greater increases in nasal airflow, but also impairs the nasal air conditioning capacity to a greater extent than TMT. Radical resection of the turbinates may decrease the surface area stimulated by mucosal cooling. PMID:27165673

  20. Impact of Middle versus Inferior Total Turbinectomy on Nasal Aerodynamics.

    Science.gov (United States)

    Dayal, Anupriya; Rhee, John S; Garcia, Guilherme J M

    2016-09-01

    This computational study aims to (1) use virtual surgery to theoretically investigate the maximum possible change in nasal aerodynamics after turbinate surgery, (2) quantify the relative contributions of the middle and inferior turbinates to nasal resistance and air conditioning, and (3) quantify to what extent total turbinectomy impairs the nasal air-conditioning capacity. Virtual surgery and computational fluid dynamics. Academic tertiary medical center. Ten patients with inferior turbinate hypertrophy were studied. Three-dimensional models of their nasal anatomies were built according to presurgery computed tomography scans. Virtual surgery was applied to create models representing either total inferior turbinectomy (TIT) or total middle turbinectomy (TMT). Airflow, heat transfer, and humidity transport were simulated at a steady-state inhalation rate of 15 L/min. The surface area stimulated by mucosal cooling was defined as the area where heat fluxes exceed 50 W/m(2). In both virtual total turbinectomy models, nasal resistance decreased and airflow increased. However, the surface area where heat fluxes exceed 50 W/m(2) either decreased (TIT) or did not change significantly (TMT), suggesting that total turbinectomy may reduce the stimulation of cold receptors by inspired air. Nasal heating and humidification efficiencies decreased significantly after both TIT and TMT. All changes were greater in the TIT models than in the TMT models. TIT yields greater increases in nasal airflow but also impairs the nasal air-conditioning capacity to a greater extent than TMT. Radical resection of the turbinates may decrease the surface area stimulated by mucosal cooling. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  1. Epicardial Brugada syndrome ablation unmasking inferior J waves.

    Science.gov (United States)

    Lee, Adam; Kohler, Heidi; Wright, Daniel; Haqqani, Haris M

    2017-11-01

    Patients with Brugada syndrome are at risk of life-threatening ventricular arrhythmias. Epicardial substrate ablation for Brugada syndrome has been described as a means of controlling these arrhythmias and recent reports describe elimination of the Brugada phenotype with ablation. We describe a unique case in which a patient developed inferior J waves with an early repolarization-type electrocardiogram following successful epicardial infundibular substrate ablation (which eliminated the Brugada syndrome electrocardiogram on ajmaline challenge). We discuss the likely underlying pathophysiology responsible for this phenomenon, its relationship to the anatomic obstacles encountered during epicardial ablation, and the implications for long-term arrhythmic risk. © 2017 Wiley Periodicals, Inc.

  2. Laparoscopic management of inferior lumbar hernia (Petit triangle hernia).

    Science.gov (United States)

    Ipek, T; Eyuboglu, E; Aydingoz, O

    2005-05-01

    Lumbar hernias are rare defects in the posterolateral abdominal wall that may be congenital or acquired. We present a case of laparoscopic approach to repair an acquired inferior triangle (Petit) lumbar hernia in a woman by using polytetrafluoroethylene mesh. The size of the hernia was 8 x 10 cm. The length of her hospital stay was 2 days. The patient resumed normal activities in less than 2 weeks. The main advantage of this approach is excellent operative visualization, thus avoiding injury to structures near the hernia during repair. Patients benefit from a minimally invasive approach with less pain, shortened hospital course, less analgesic requirements, better cosmetic result, and minimal life-style interference.

  3. Complete inferior rectus muscle transection secondary to orbital blowout fracture.

    Science.gov (United States)

    Carrere, Jonathan M; Lewis, Kyle T

    2018-01-05

    Complete extraocular muscle transection is uncommon in the setting of blunt trauma. We report a case of a 53-year-old male that developed diplopia after hitting his face directly on a concrete slab after a fall. On examination, he had a right hypertropia with a complete infraduction deficit. A CT scan of the face showed an orbital floor blowout fracture with complete inferior rectus transection. On surgical exploration, the distal and proximal ends of the muscle were identified and sutured together, and the floor fracture was repaired. At his post-operative visits, the patient had a persistent infraduction deficit, but subjectively had improved diplopia.

  4. Atrioventricular nodal reentrant tachycardia ablation and inferior vena cava agenesis.

    Science.gov (United States)

    Galand, Vincent; Pavin, Dominique; Behar, Nathalie; Mabo, Philippe; Martins, Raphaël P

    2016-10-01

    Congenital anomalies of the inferior vena cava (IVC) are rare and very often diagnosed in asymptomatic patients during computed tomography performed for other purposes. These anomalies can have significant clinical implications, for example if electrophysiology procedures are needed. Diagnostic and ablation procedures are difficult since catheter manipulation and positioning are more complex. We present here a case of successful atrioventricular nodal reentrant tachycardia ablation in a patient with unexpected IVC agenesis, using an azygos route. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Retro-aortic, left inferior renal capsular vein

    Directory of Open Access Journals (Sweden)

    Umberto G Rossi

    2015-01-01

    Full Text Available In our case report, abdominal multi-detector computed tomography was used for the pre-operative anatomy evaluation in a living kidney donor. The early phase of the test revealed normal kidneys in the donor. The vascular phase detected a venous variant on the left side: An inferior renal capsular vein, which had a loop and a retro-aortic course. This preoperative knowledge was crucial for the laparoscopic nephrectomy as a surgical procedure for harvesting kidney from the living donor.

  6. Omental flap transposition for inferior vena cava filter penetration

    Directory of Open Access Journals (Sweden)

    Junji Yamaguchi, MD

    2017-03-01

    Full Text Available A 40-year-old woman presented with uterine malignancy, deep vein thrombosis, and nonmassive pulmonary embolism in both lungs. Gunter-tulip filter was inserted, because she had severe genital bleeding, which is one of the contraindications to anticoagulation therapy. Total hysterectomy was conducted and anticoagulation therapy was started afterward. The thrombus worsened perioperatively, and the filter could not be retrieved. Since there was lymph node recurrence, the second time operation was performed. During operation, the struts were found to be penetrating the inferior vena cava. Omental flap was used to cover the struts, and no associated complications occurred after operation.

  7. Inferior Vena Cava Duplication: Incidental Case in a Young Woman

    Directory of Open Access Journals (Sweden)

    Danilo Coco

    2016-01-01

    Full Text Available A case of a double inferior vena cava (IVC with retroaortic left renal vein, azygos continuation of the IVC, and presence of the hepatic portion of the IVC drained into the right renal vein is reported and the embryologic, clinical, and radiological significance is discussed. The diagnosis is suggested by multidetector computed tomography (MDCT, which reveals the aberrant vascular structures. Awareness of different congenital anomalies of IVC is necessary for radiologists to avoid diagnostic pitfalls and they should be remembered because they can influence several surgical interventions and endovascular procedures.

  8. Amiloidosis renal en paciente con osteomielitis de extremidad inferior

    Directory of Open Access Journals (Sweden)

    María Vicente Santos

    2012-09-01

    Full Text Available La amiloidosis secundaria (AA sistémica es una entidad frecuente, asociada con enfermedades inflamatorias e infecciones de larga evolución, así como con algunas neoplasias. Presentamos el caso de un varón de 58 años, con antecedente de úlcera en miembro inferior derecho de más de 30 años de evolución y con síndrome nefrótico secundario a amiloidosis AA.

  9. A Novel Technique for Inferior Vena Cava Filter Extraction

    Energy Technology Data Exchange (ETDEWEB)

    Johnston, Edward William, E-mail: ed.johnston@doctors.org.uk; Rowe, Luke Michael Morgan; Brookes, Jocelyn; Raja, Jowad; Hague, Julian, E-mail: julian.hague@uclh.nhs.uk [University College Hospital, Multidisciplinary Endovascular Team (United Kingdom)

    2013-05-02

    Inferior vena cava (IVC) filters are used to protect against pulmonary embolism in high-risk patients. Whilst the insertion of retrievable IVC filters is gaining popularity, a proportion of such devices cannot be removed using standard techniques. We describe a novel approach for IVC filter removal that involves snaring the filter superiorly along with the use of flexible forceps or laser devices to dissect the filter struts from the caval wall. This technique has used to successfully treat three patients without complications in whom standard techniques failed.

  10. Inferior phrenic artery pseudoaneurysm complicating drug-induced acute pancreatitis.

    Science.gov (United States)

    Salem, Jean F; Haydar, Ali; Hallal, Ali

    2014-01-02

    Inferior phrenic artery (IPA) pseudoaneurysm is an extremely rare complication of chronic pancreatitis with only three cases reported in the literature so far. It is a serious condition that can be life-threatening if not diagnosed promptly. Recent advances in endovascular interventions made angiography with embolisation the modality of choice for diagnosis and treatment. We presented the first report of a case of ruptured IPA pseudoaneurysm complicating a drug-induced acute pancreatitis that was successfully treated by transcatheter arterial embolisation. Despite its rarity, rupture of pseudoaneurysm due to drug-induced pancreatitis should be suspected and included in the differential diagnosis when associated with haemodynamic instability.

  11. Inferior ST-Elevation Myocardial Infarction Associated with Takotsubo Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Oliver Koeth

    2010-01-01

    Full Text Available Takotsubo cardiomyopathy (TCM is usually characterized by transient left ventricular apical ballooning. Due to the clinical symptoms which include chest pain, electrocardiographic changes, and elevated myocardial markers, Takotsubo cardiomyopathy is frequently mimicking ST-elevation myocardial infarction in the absence of a significant coronary artery disease. Otherwise an acute occlusion of the left anterior descending coronary artery can produce a typical Takotsubo contraction pattern. ST-elevation myocardial infarction (STEMI is frequently associated with emotional stress, but to date no cases of STEMI triggering TCM have been reported. We describe a case of a female patient with inferior ST-elevation myocardial infarction complicated by TCM.

  12. ST depression in lead aVL differentiates inferior ST-elevation myocardial infarction from pericarditis.

    Science.gov (United States)

    Bischof, Johanna E; Worrall, Christine; Thompson, Peter; Marti, David; Smith, Stephen W

    2016-02-01

    ST-segment elevation (STE) due to inferior STE myocardial infarction (STEMI) may be misdiagnosed as pericarditis. Conversely, this less life-threatening etiology of ST elevation may be confused for inferior STEMI. We sought to determine if the presence of any ST-segment depression in lead aVL would differentiate inferior STEMI from pericarditis. Retrospective study of 3 populations. Cohort 1 included patients coded as inferior STEMI, cohort 2 included patients with a discharge diagnosis of pericarditis who presented with chest pain and at least 0.5 mm of ST elevation in at least 1 inferior lead. We analyzed the presenting electrocardiogram in both populations, with careful assessment of leads II, III, aVF, and aVL. In addition, we retrospectively studied a third cohort of patients with subtle inferior STEMI (pericarditis group, all 49 had some inferior STE but none had any ST-segment depression in lead aVL (specificity, 100%; confidence interval, 91%-100%). In the third cohort, there were 272 inferior MIs with coronary occlusion, of which 54 were "subtle." Of these, 49 had some ST depression in lead aVL. When there is inferior ST-segment elevation, the presence of any ST depression in lead aVL is highly sensitive for coronary occlusion in inferior myocardial infarction and very specific for differentiating inferior myocardial infarction from pericarditis. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. MICROCIRUGÍA RECONSTRUCTIVA EN TRAUMA DE EXTREMIDADES INFERIORES

    Directory of Open Access Journals (Sweden)

    Dr. Günther Mangelsdorff G.

    2016-01-01

    Full Text Available La complejidad y extensión de las lesiones traumáticas del miembro inferior son muy variables, incluyendo dehiscencias de abordajes quirúrgicos en lesiones cerradas, fracturas expuestas, avulsiones y amputaciones. El aporte de la cirugía plástica en estos pacientes radica especialmente en la reconstrucción mediante la movilización local o a distancia de tejidos vitales bien irrigados. La microcirugía es una herramienta fundamental para lograr reconstrucciones complejas con un diseño versátil, así los colgajos libres otorgan coberturas bien vascularizadas y se adaptan a requerimientos tan diversos. El éxito final de una reconstrucción debe ser evaluado en cuanto a la reinserción del paciente a sus actividades de vida diaria y a su calidad de vida. La coordinación y trabajo con los distintos profesionales necesarios en este proceso permite aproximarse a este objetivo. Revisaremos en este artículo las estrategias de reconstrucción en trauma de extremidad inferior y las técnicas de reconstrucción microquirúrgica más utilizadas.

  14. Low scar abdominoplasty with inferior positioning of the umbilicus.

    Science.gov (United States)

    Colwell, Amy S; Kpodzo, Dzifa; Gallico, G Gregory

    2010-05-01

    Miniabdominoplasty with umbilical free float has received little attention in the literature in 15 years and has been criticized for an abnormally low umbilicus. We hypothesized the umbilicus in women presenting for abdominal contouring is positioned higher than ideal and thus may benefit from lowering. In addition, we felt modifications of the original umbilical float technique would improve aesthetic results. A retrospective review identified 60 patients aged 34 to 56 who had abdominoplasty with umbilical fascial transection and inferior positioning. Technical modifications included low placement of a full transverse abdominal scar, abdominal flap undermining to the rib cage, more inferior umbilical repositioning, flank liposuction, and plication of diastasis recti from xiphoid to pubis. Patients did not have enough excess skin to allow traditional abdominoplasty without a high-transverse or vertical midline scar. No umbilical or incisional skin necrosis occurred. To assess optimal umbilical position, plastic surgeons were asked to draw the ideal position on pre- and postoperative photographs from 5 patients. The mean ideal umbilical position was 2.2 cm lower than the actual position (P diastasis recti but a normal body mass index.

  15. Modified trans-oral approach with an inferiorly based flap.

    Science.gov (United States)

    Al-Holou, Wajd N; Park, Paul; Wang, Anthony C; Than, Khoi D; Marentette, Lawrence J

    2010-04-01

    The trans-oral approach allows direct access to pathologies of the anterior craniocervical junction. However, the classic midline incision of the posterior pharyngeal wall can be surgically burdensome and limits lateral exposure. We reviewed the medical records of nine patients undergoing the trans-oral approach. The sites of the pathology ranged from the clivus to C2, and surgical exposure ranged from the clivus to C3. Each operation utilized an inferiorly based flap. None of the patients experienced vascular or neurologic complications, and no patient had a cerebrospinal fluid fistula, pseudomeningocele, or meningitis postoperatively. The trans-oral approach with an inferiorly based flap can therefore be safely and effectively performed with minimal oropharyngeal and neurologic morbidity. Not only does a U-shaped flap allow adequate exposure from the lower half of the clivus to C3, a flap improves lateral exposure, provides a clear operating field, and allows superficial mucosal closure not directly overlying the operative field. (c) 2009 Elsevier Ltd. All rights reserved.

  16. Ausência de veia cava inferior: relato de caso Absence of the inferior vena cava: case report

    Directory of Open Access Journals (Sweden)

    Elton Correia Alves

    2010-12-01

    Full Text Available A ausência congênita de veia cava inferior é achado incomum e ocasional durante exames complementares ou cirurgias do abdome. Em razão de a maioria dos pacientes sem outras malformações serem assintomáticos, há dificuldade em estimar a prevalência dessas anomalias. O objetivo deste trabalho foi relatar o caso de um paciente de 28 anos, sexo masculino, referido para radiografia de tórax devido a quadro de febre alta (39ºC não-responsiva à medicação. Radiografia de tórax sugeriu dilatação de veia ázigos. Em inquérito dirigido para sintomas cardiovasculares, referiu dor torácica (durante atividade física e em repouso e dispneia ocasionais durante o sono associada ao período em que intensificou a prática de exercícios. Realizada tomografia computadorizada sem contraste e, posteriormente, contrastada. As mesmas não esclareceram o caso, fazendo-se necessário angiotomografia, a qual evidenciou ausência de veia cava inferior torácica.The congenital absence of the inferior vena cava is a rare and occasional finding at complementary exams or abdominal surgeries. As the majority of patients without other malformations are asymptomatic, it is hard to estimate the prevalence of these anomalies. Our goal was to report a case of a 28-year-old patient, male, referred to thorax X-ray due to high fever state (39ºC, nonresponder to medication. The X-ray suggested azygos vein dilatation. The interview about cardiovascular symptoms revealed thoracic pain during both physical exercises and at rest, and occasional dyspnea during sleep related to the period of intensification of physical exercises. Computadorized tomography with and without contrast did not solve the case, what explain the request of an angiotomography, that showed absence of thoracic inferior vena cava.

  17. Abordagem fisioterapêutica do linfedema bilateral de membros inferiores

    Directory of Open Access Journals (Sweden)

    Pascale Mutti Tacani

    Full Text Available INTRODUÇÃO: O linfedema é um acúmulo de proteína no interstício em virtude de deficiência do sistema linfático, sendo recomendada a utilização da Terapia Física Complexa como forma de tratamento. OBJETIVO: Verificar os efeitos da Terapia Física Complexa no tratamento e na manutenção do linfedema bilateral de membros inferiores. MÉTODOS: Participaram deste estudo sete pacientes com linfedema bilateral nos membros inferiores, de faixa etária entre 59 e 85 anos, os quais foram submetidos a: 1ª avaliação fisioterapêutica, quando permaneceram sem tratamento (período controle; 2ª avaliação, quando receberam o tratamento fisioterapêutico (período tratamento - terapia física complexa - fase de redução; 3ª avaliação, quando receberam alta (período manutenção - terapia física complexa - fase de manutenção; e 4ª avaliação, para acompanhamento desse último período. O intervalo entre cada avaliação foi de 10 a 12 semanas. Os dados da perimetria foram transformados em volume do membro, por meio da fórmula do cone truncado, e a região do tornozelo foi avaliada pelo método da Figura Oito. RESULTADOS: A média da Figura Oito e do volume dos membros foi de 62,32 cm e 6233 ml, 62,57 cm e 6308 ml, 56,75 cm e 5505 ml, 57 cm e 5566 ml, respectivamente para 1ª, 2ª, 3ª e 4ª avaliações. Pelos testes de Friedman e Wilcoxon, observou-se diferença significativa entre a 3ª e a 4ª avaliações, quando comparadas à 1ª e à 2ª (p < 0,001, para ambas as variáveis, mostrando redução significante do linfedema e sua estabilização durante o período de manutenção. CONCLUSÃO: A terapia física complexa foi eficaz no tratamento e na manutenção do linfedema bilateral de membros inferiores.

  18. Endovascular treatment of the posterior inferior cerebellar artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Bradac, G.B.; Bergui, M. [Neuroradiology, Univ. di Torino, Turin (Italy)

    2004-12-01

    Aneurysms may arise at various locations along the course of the posterior inferior cerebellar artery. Brainstem and cranial nerves manipulation make the surgical approach to proximal aneurysms difficult, while the occlusion of the parent vessel is sometimes unavoidable in peripheral aneurysms. Endovascular treatment can be a good alternative, but also with this approach the location of the aneurysm is critical. If occlusion of the parent vessel is planned, anatomical variations and vascular territories of the brainstem should be considered. We report our experience with 18 consecutive aneurysms (12 proximal, 6 peripheral) treated by coils. Complete occlusion was achieved in 14 patients and subtotal in 4. In three patients the parent vessel had to be sacrificed. During treatment two perforations occurred; aneurysms were completely occluded without clinical consequences. Two small asymptomatic cerebellar infarctions were seen on postoperative computed tomography. Clinical outcome was good in 16 patients. (orig.)

  19. Frustrative reward omission increases aggressive behaviour of inferior fighters

    DEFF Research Database (Denmark)

    Vindas, Marco A.; Johansen, Ida B.; Vela-Avitua, Sergio

    2014-01-01

    to associate a light with reward. Thereafter, the reward was omitted for half of the fish prior to a contest between individuals possessing a 36–40% difference in RHP. Small control individuals displayed submissive behaviour and virtually no aggression. By contrast, small OER individuals were more aggressive......Animals use aggressive behaviour to gain access to resources, and individuals adjust their behaviour relative to resource value and own resource holding potential (RHP). Normally, smaller individuals have inferior fighting abilities compared with larger conspecifics. Affective and cognitive......, and twoout of 11 became socially dominant. Increased aggression insmall OER individuals was accompanied by increased serotonin levels in the dorsomedial pallium (proposed amygdala homologue), but no changes in limbic dopamine neurochemistry were observed in OER-exposed individuals. The behavioural...

  20. Auditory recognition memory is inferior to visual recognition memory.

    Science.gov (United States)

    Cohen, Michael A; Horowitz, Todd S; Wolfe, Jeremy M

    2009-04-07

    Visual memory for scenes is surprisingly robust. We wished to examine whether an analogous ability exists in the auditory domain. Participants listened to a variety of sound clips and were tested on their ability to distinguish old from new clips. Stimuli ranged from complex auditory scenes (e.g., talking in a pool hall) to isolated auditory objects (e.g., a dog barking) to music. In some conditions, additional information was provided to help participants with encoding. In every situation, however, auditory memory proved to be systematically inferior to visual memory. This suggests that there exists either a fundamental difference between auditory and visual stimuli, or, more plausibly, an asymmetry between auditory and visual processing.

  1. Marker-Negative Pheochromocytoma Associated with Inferior Vena Cava Thrombosis

    Directory of Open Access Journals (Sweden)

    S. Poudyal

    2017-01-01

    Full Text Available Pheochromocytoma associated with inferior vena cava (IVC thrombosis is very rare. A 27-year-old female presented with right flank pain and hypertensive urgency. Contrast-enhanced CT abdomen and gadolinium-contrast MRI abdomen revealed right adrenal mass suspicious of malignancy with invasion and compression to the right IVC wall along with IVC thrombus extending from the level of renal veins to the level of confluence with hepatic veins. Her routine laboratory investigations including 24-hour urine fractionated metanephrines, vanillylmandelic acid, and cortisol were normal. Right adrenalectomy with IVC thrombectomy was done. Perioperative period was uneventful. Histopathology of the mass turned out to be pheochromocytoma with thrombus revealing fibroadipose tissue with fibrin. Pheochromocytoma may present with IVC thrombus as well as normal serum and urinary markers. Thus, clinical suspicion is imperative in perioperative management of adrenal mass.

  2. Efficiency of Intraligamentary Anesthesia of Inferior Molars for Endodontic Treatment

    Directory of Open Access Journals (Sweden)

    Peycheva K.

    2014-12-01

    Full Text Available The periodontal ligament injection appears to be the most consistently reliable in achieving clinically adequate pulpal anaesthesia. Materials and Methods: 130 inferior molar teeth; technique: The tooth was first cleaned with chlorhexidine 0.2% solution. The penetration of the ligament is performed with special intraligamentary needle (30 G - 9, 17,21 mm “sliding” along the side of the tooth, 300º angle between the needle and the tooth, having taken the care of determining support points which will prevent the needle from twisting. The penetration must be deep enough to obtain the seal required for the injection, injection for each root in particular points; volume of solution per root is 0.2-0.4 ml. Results: In 125 cases the technique was absolutely efficient. In only 5 cases with pulpitis chronica ulcerosa there was need for additional intrapulpal anesthesia. Conclusions: The method could be used as a primary anesthetic method for endodontic treatment.

  3. Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional

    Directory of Open Access Journals (Sweden)

    Adrián J Da Silva-De Abreu

    2009-01-01

    Full Text Available Los pseudoaneurismas son complicaciones infrecuentes de los infartos del miocardio. Consisten en un saco pericárdico que comunica con la cavidad ventricular a través de un cuello de menor diámetro. Se presenta el caso de una paciente de 68 años de edad, con DM II e HTA, sufre Infarto Agudo del Miocardio en Mayo del 2008, presentando disnea y tos por una semana, con diaforesis profusa de inicio súbito y síncope sin dolor precordial. El electrocardiograma reporta zonas de isquemia transmural y subendocárdica en caras inferolateral y lateral alta, respectivamente, y zona eléctricamente inactivable en cara inferior. El ecocardiograma transtorácico muestra el ventrículo izquierdo con dilatación severa, disminución de la fracción de eyección (25% y un pseudoaneurisma de la pared inferior con cuello de 3 mm a través del cual se evidencia flujo bidireccional, de entrada al ventrículo durante la diástole y salida al pseudoaneurisma en sístole. El flujo bidireccional y el gasto cardíaco disminuido contribuyen a evitar el taponamiento cardiaco, sin embargo, en condiciones de mayor demanda el pseudoaneurisma podría perforarse y ocasionar dicha entidad. De ello, la importancia del diagnostico diferencial con los aneurismas verdaderos, lo cual permite llevar a cabo la terapéutica adecuada y evitar tal complicación.

  4. Clinical anatomy and palpability of the inferior lateral pterygoid muscle.

    Science.gov (United States)

    Stratmann, U; Mokrys, K; Meyer, U; Kleinheinz, J; Joos, U; Dirksen, D; Bollmann, F

    2000-05-01

    The intraoral palpation technique of the inferior belly of the inferior lateral pterygoid (ILP) muscle is a standard diagnostic examination method for temporomandibular joint dysfunction syndrome, although different studies have revealed inconsistent results. This study assessed the feasibility of the ILP muscle palpation by a simulated clinical setting. Three dentists performed a bilateral palpation of the ILP muscle in 53 fresh and unfixed human cadavers and decided whether the muscle was palpable or unpalpable. In a second step, it was observed through the dissected infratemporal fossa, whether the examiner's finger did or did not touch the ILP muscle by simulating the performed palpation. Palpatory findings were supplemented by 1-dimensional measurements for determination of topographic relations of the ILP muscle within the infratemporal fossa. For statistical analysis, sensitivity, specificity, and negative and positive predictive values of the palpation technique were calculated. Interexaminer agreement was estimated with the kappa value. In 86 of 106 dissected specimens, a superficial fascicle of the medial pterygoid muscle was found in direct proximity to the ILP muscle. In these cases, a residual distance of 7.8 +/- 3.2 mm remained between the ILP muscle and buccinator fascia indented by the tip of the examiner's finger. In 10 of 20 specimens with an absent superficial fascicle, the finger was able to reach the ILP muscle. It is recommended that the ILP muscle palpation technique should no longer be considered as a standard clinical procedure because it is nearly impossible to palpate the ILP muscle anatomically and because the risk of false-positive findings (by palpation of the medial pterygoid muscle) is high.

  5. Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional

    Directory of Open Access Journals (Sweden)

    Adrián J Da Silva-De Abreu

    2011-01-01

    Full Text Available Los pseudoaneurismas son complicaciones infrecuentes de los infartos del miocardio. Consisten en un saco pericárdico que comunica con la cavidad ventricular a través de un cuello de menor diámetro. Se presenta el caso de una paciente de 68 años de edad, con DM II e HTA, sufre Infarto Agudo del Miocardio en Mayo del 2008, presentando disnea y tos por una semana, con diaforesis profusa de inicio súbito y síncope sin dolor precordial. El electrocardiograma reporta zonas de isquemia transmural y subendocárdica en caras inferolateral y lateral alta; respectivamente, y zona eléctricamente inactivable en cara inferior. El ecocardiograma transtorácico muestra el ventrículo izquierdo con dilatación severa, disminución de la fracción de eyección (25% y un pseudoaneurisma de la pared inferior con cuello de 3 mm a través del cual se evidencia flujo bidireccional: de entrada al ventrículo durante la diástole y salida al pseudoaneurisma en sístole. El flujo bidireccional y el gasto cardíaco disminuido contribuyen a evitar el taponamiento cardiaco, sin embargo, en condiciones de mayor demanda el pseudoaneurisma podría perforarse y ocasionar dicha entidad. De ello, la importancia del diagnostico diferencial con los aneurismas verdaderos, lo cual permite llevar a cabo la terapéutica adecuada y evitar tal complicación. Palabras claves: Pseudoaneurisma, Infarto del Miocardio, Diabetes.

  6. Immediate Effect of Grade IV Inferior Hip Joint Mobilization on Hip Abductor Torque: A Pilot Study

    OpenAIRE

    Makofsky, Howard; Panicker, Siji; Abbruzzese, Jeanine; Aridas, Cynthia; Camp, Michael; Drakes, Jonelle; Franco, Caroline; Sileo, Ray

    2007-01-01

    Joint mobilization and manipulation stimulate mechanoreceptors, which may influence the joint and surrounding muscles. The purpose of this pilot study was to determine the effect of grade IV inferior hip joint mobilization on hip abductor torque. Thirty healthy subjects were randomly assigned to a control group (grade I inferior hip joint mobilization) or an experimental group (grade IV inferior hip joint mobilization). Subjects performed a pre- and post-intervention test of five isometric re...

  7. Factores asociados con lesiones neoplasicas del tracto genital inferior femenino en adolescentes del departamento de Caldas

    National Research Council Canada - National Science Library

    Nunez Rojas, Ariel Cesar; Vallejo Gutierrez, Maria Teresa; Astrid Ramirez Diaz, Myriam; Escobar Velasquez, Gloria Mercedes; Gallego Sanchez, Paula Andrea; Velez Alvarez, Consuelo; Catano Buitrago, Maria Yoana

    2008-01-01

    ...: conocer y determinar como se asocian factores biologicos y psicosociales con la presencia de lesiones neoplasicas del tracto genital inferior femenino en una poblacion adolescente del departamento...

  8. Inferior vena cava dimensions in patients with acute kidney injury

    Directory of Open Access Journals (Sweden)

    Andres Yepes-Hurtado

    2016-07-01

    Full Text Available Background: Volume contraction frequently contributes to the development of acute kidney injury.  The rapid assessment of volume status in patients with acute kidney injury could improve decision making and outcomes. Methods: The maximum and minimum diameters and percent collapsibility of the inferior vena cava (IVC were measured in 30 patients admitted to the medical intensive care unit with laboratory evidence of acute kidney injury.  These measurements were made on the day of admission and 24 hours following admission.  Information about age, gender, body mass index, serum creatinine levels, and fluid balances was recorded. Results: This study included 30 patients with a mean age is 62.4 ±16.0 years.  The mean initial creatinine was 4.3 ± 4.2 mg/dL (range: 1.7 mg/dL to 22.1 mg/dL.  The mean fractional excretion of sodium was 2.06 ± 2.65%.  The mean maximum diameter of inferior vena cava was 1.8 ± 0.5 cm with the range is 0.4-2.65 cm.  The mean percent collapse was 32 ± 20%.  Five patients had evidence of hypovolemia using guidelines from the American Society of Echocardiology; 6 patients had evidence of hypervolemia.  Nineteen patients had measurements between these 2 categories.  There is no significant change in mean diameters following fluid administration for 24 hours.  An initial IVC diameter of 0.94 cm predicted ≥ 30% collapsibility with an area under the curve is 0.748. Discussion: Patients with acute kidney injury based on laboratory measurements had evidence for hypovolemia, euvolemia, and hypervolemia based on IVC measurements.  There was no consistent change in IVC dimensions following fluid administration, even though the creatinine fell in most patients.  Simple bedside measurements of IVC dimensions can facilitate fluid administration decisions but must be used with clinical assessment.

  9. Pacemaker Lead Induced Inferior Vena Caval Thrombosis Leading to Portal Hypertension

    Directory of Open Access Journals (Sweden)

    Sharad Chandra, MD, DM

    2013-03-01

    Full Text Available Inferior vena caval thrombosis is an unusual complication of permanent pacemaker implantation. The clinical presentation due to thrombosis depends on the site of thrombus. We have described here a rare case of pacemaker lead associated thrombosis of inferior vena cava, its diagnostic work up and briefly reviewed the existing literature of this uncommon complication.

  10. Left Bundle Branch Block and Complete Heart Block Complicating Inferior Myocardial Infarction.

    Science.gov (United States)

    Gruber, Jillian S; Stair, Brad; Aktas, Mehmet; Bravo-Jaimes, Katia

    2017-01-01

    Left bundle branch block following inferior myocardial infarction remains uncommon and scarcely reported in the literature. We describe a rare presentation of a 58-year-old male patient who developed left bundle branch block and third degree atrioventricular block after inferior myocardial infarction requiring permanent pacemaker placement. Pathophysiology, impact on mortality, and management options are discussed. © 2016 Wiley Periodicals, Inc.

  11. Thickening of the inferior glenohumeral capsule: an ultrasound sign for shoulder capsular contracture.

    Science.gov (United States)

    Michelin, Paul; Delarue, Yohann; Duparc, Fabrice; Dacher, Jean Nicolas

    2013-10-01

    The aim of this retrospective study was to measure the inferior glenohumeral capsule thickness of shoulders clinically affected by capsular contracture by comparison to the contralateral asymptomatic side. Bilateral shoulder ultrasound (US) examinations of 20 patients with clinically or MRI proven unilateral capsular contracture were retrospectively assessed. Inferior capsule evaluation was performed with a transducer placed within the axilla in maximally abducted shoulders. Measurements were symmetrically performed orthogonally to the inferior glenohumeral ligament (IGHL) in the axial plane; the coronal plane was used to ensure the tension of the IGHL. The significance of any difference in thickening was assessed with the Mann-Whitney test. The average thickness was 4.0 mm in shoulders with capsular contracture vs. 1.3 mm in asymptomatic contralateral shoulders (P contracture and inferior capsule thickness increase showed US features of other painful diseases of the rotator cuff. The thickness of the inferior capsule is measurable through ultrasound examination and appears to be increased in shoulders with capsular contracture. Exploration of the inferior aspect of the shoulder joint could be added to shoulder US examination protocols for capsular contracture assessment even if other rotator cuff abnormalities are diagnosed by US. • Ultrasound is increasingly used to diagnose shoulder problems. • The thickness of the inferior glenohumeral ligament is measurable in the axilla. • The inferior glenohumeral ligament appears thickened in shoulders with capsular contracture. • Capsular contracture ultrasound features can be associated with other rotator cuff problems.

  12. Blunt injury of the infrarenal inferior vena cava — imaging and ...

    African Journals Online (AJOL)

    Blunt injury of the infrarenal inferior vena cava — imaging and conservative management. Ian C Duncan, Basil J Sher, Leslie M Fingleson. Abstract. Isolated rupture of the infrarenal segment of the inferior vena cava due to blunt trauma is relatively rare. It may be missed clinically and even diagnostic peritoneal lavage may ...

  13. Is 2 mm a safe distance from the inferior alveolar canal to avoid ...

    African Journals Online (AJOL)

    Aim: The aim of the present study was to compare the neurosensory complications related to implants inserted closer than 2 mm to the inferior alveolar canal (IAC) with those inserted further than 2 mm. Materials and ... complications. Keywords: Dental implants, inferior alveolar nerve injury, neurosensory complication ...

  14. Left inferior parietal lobe engagement in social cognition and language.

    Science.gov (United States)

    Bzdok, Danilo; Hartwigsen, Gesa; Reid, Andrew; Laird, Angela R; Fox, Peter T; Eickhoff, Simon B

    2016-09-01

    Social cognition and language are two core features of the human species. Despite distributed recruitment of brain regions in each mental capacity, the left parietal lobe (LPL) represents a zone of topographical convergence. The present study quantitatively summarizes hundreds of neuroimaging studies on social cognition and language. Using connectivity-based parcellation on a meta-analytically defined volume of interest (VOI), regional coactivation patterns within this VOI allowed identifying distinct subregions. Across parcellation solutions, two clusters emerged consistently in rostro-ventral and caudo-ventral aspects of the parietal VOI. Both clusters were functionally significantly associated with social-cognitive and language processing. In particular, the rostro-ventral cluster was associated with lower-level processing facets, while the caudo-ventral cluster was associated with higher-level processing facets in both mental capacities. Contrarily, in the (less stable) dorsal parietal VOI, all clusters reflected computation of general-purpose processes, such as working memory and matching tasks, that are frequently co-recruited by social or language processes. Our results hence favour a rostro-caudal distinction of lower- versus higher-level processes underlying social cognition and language in the left inferior parietal lobe. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Inferior alveolar nerve cutting; legal liability versus desired patient outcomes.

    Science.gov (United States)

    Kim, Soung Min; Lee, Jong Ho

    2017-10-01

    Mandibular angle reduction or reduction genioplasty is a routine well-known facial contouring surgery that reduces the width of the lower face resulting in an oval shaped face. During the intraoral resection of the mandibular angle or chin using an oscillating saw, unexpected peripheral nerve damage including inferior alveolar nerve (IAN) damage could occur. This study analyzed cases of damaged IANs during facial contouring surgery, and asked what the basic standard of care in these medical litigation-involved cases should be. We retrospectively reviewed a total of 28 patients with IAN damage after mandibular contouring from August 2008 to July 2015. Most of the patients did not have an antipathy to medical staff because they wanted their faces to be ovoid shaped. We summarized three representative cases according to each patient's perceptions and different operation procedures under the approvement by the Institutional Review Board of Seoul National University. Most of the patients did not want to receive any further operations not due to fear of an operation but because of the changes in their facial appearance. Thus, their fear may be due to a desire for a better perfect outcome, and to avoid unsolicited patient complaints related litigation. This article analyzed representative IAN cutting cases that occurred during mandibular contouring esthetic surgery and evaluated a questionnaire on the standard of care for the desired patient outcomes and the specialized surgeon's position with respect to legal liability.

  16. Dopaminergic Input to the Inferior Colliculus in Mice

    Directory of Open Access Journals (Sweden)

    Alexander A Nevue

    2016-01-01

    Full Text Available The response of sensory neurons to stimuli can be modulated by a variety of factors including attention, emotion, behavioral context, and disorders involving neuromodulatory systems. For example, patients with Parkinson’s disease have disordered speech processing, suggesting that dopamine alters normal representation of these salient sounds. Understanding the mechanisms by which dopamine modulates auditory processing is thus an important goal. The principal auditory midbrain nucleus, the inferior colliculus (IC, is a likely location for dopaminergic modulation of auditory processing because it contains dopamine receptors and nerve terminals immunoreactive for tyrosine hydroxylase (TH, the rate-limiting enzyme in dopamine synthesis. However, the sources of dopaminergic input to the IC are unknown. In this study, we iontophoretically injected a retrograde tracer into the IC of mice and then stained the tissue for TH. We also immunostained for dopamine beta-hydroxylase (DBH, an enzyme critical for the conversion of dopamine to norepinephrine, to differentiate between dopaminergic and noradrenergic inputs. Retrogradely labeled neurons that were positive for TH were seen bilaterally, with strong ipsilateral dominance, in the subparafascicular thalamic nucleus (SPF. All retrogradely labeled neurons that we observed in other brain regions were TH-negative. Projections from the SPF were confirmed using an anterograde tracer, revealing TH-positive and DBH-negative anterogradely labeled fibers and terminals in the IC. While the functional role of this dopaminergic input to the IC is not yet known, it provides a potential mechanism for context dependent modulation of auditory processing.

  17. Effect of Preoperative Pain on Inferior Alveolar Nerve Block

    Science.gov (United States)

    Aggarwal, Vivek; Singla, Mamta; Subbiya, Arunajatesan; Vivekanandhan, Paramasivam; Sharma, Vikram; Sharma, Ritu; Prakash, Venkatachalam; Geethapriya, Nagarajan

    2015-01-01

    The present study tested the hypothesis that the amount and severity of preoperative pain will affect the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. One-hundred seventy-seven adult volunteer subjects, actively experiencing pain in a mandibular molar, participated in this prospective double-blind study carried out at 2 different centers. The patients were classified into 3 groups on the basis of severity of preoperative pain: mild, 1–54 mm on the Heft-Parker visual analog scale (HP VAS); moderate, 55–114 mm; and severe, greater than 114 mm. After IANB with 1.8 mL of 2% lidocaine, endodontic access preparation was initiated. Pain during treatment was recorded using the HP VAS. The primary outcome measure was the ability to undertake pulp access and canal instrumentation with no or mild pain. The success rates were statistically analyzed by multiple logistic regression test. There was a significant difference between the mild and severe preoperative pain group (P = .03). There was a positive correlation between the values of preoperative and intraoperative pain (r = .2 and .4 at 2 centers). The amount of preoperative pain can affect the anesthetic success rates of IANB in patients with symptomatic irreversible pulpitis. PMID:26650491

  18. Disparity selectivity of neurons in monkey inferior temporal cortex.

    Science.gov (United States)

    Uka, T; Tanaka, H; Yoshiyama, K; Kato, M; Fujita, I

    2000-07-01

    The inferior temporal cortex (IT) of the monkey, a final stage in the ventral visual pathway, has been known to process information on two-dimensional (2-D) shape, color, and texture. On the other hand, the dorsal visual pathway leading to the posterior parietal cortex has been known to process information on location in space. Likewise, neurons selective for binocular disparity, which convey information on depth, have been found mainly in areas along the dorsal visual pathway. Here, we report that many neurons in the IT are also selective for binocular disparity. We recorded extracellular activity from IT neurons and found that more than half of the neurons changed their response depending on the disparity added. The change was not attributed to monocular responses or eye movements. Most neurons selective for disparity were "near" or "far" cells; they preferred either crossed or uncrossed disparity, and only a small population was tuned to zero disparity. Disparity-selective neurons were also selective for shape. Most preferred the same type of disparity irrespective of the shape presented. Disparity preference was also invariant for the fronto-parallel translation of the stimuli in most of the neurons. Finally, nearby neurons exhibited similar disparity selectivity, suggesting the existence of a functional module for processing of binocular disparity in the IT. From the above and our recent findings, we suggest that the IT integrates shape and binocular disparity information, and plays an important role in the reconstruction of three-dimensional (3-D) surfaces.

  19. Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters

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    Iliescu, Bogdan; Haskal, Ziv J., E-mail: ziv2@mac.com [University of Maryland School of Medicine, Division of Vascular and Interventional Radiology (United States)

    2012-08-15

    Inferior vena cava (IVC) filters have proven valuable for the prevention of primary or recurrent pulmonary embolism in selected patients with or at high risk for venous thromboembolic disease. Their use has become commonplace, and the numbers implanted increase annually. During the last 3 years, in the United States, the percentage of annually placed optional filters, i.e., filters than can remain as permanent filters or potentially be retrieved, has consistently exceeded that of permanent filters. In parallel, the complications of long- or short-term filtration have become increasingly evident to physicians, regulatory agencies, and the public. Most filter removals are uneventful, with a high degree of success. When routine filter-retrieval techniques prove unsuccessful, progressively more advanced tools and skill sets must be used to enhance filter-retrieval success. These techniques should be used with caution to avoid damage to the filter or cava during IVC retrieval. This review describes the complex techniques for filter retrieval, including use of additional snares, guidewires, angioplasty balloons, and mechanical and thermal approaches as well as illustrates their specific application.

  20. Participation of the left inferior frontal gyrus in human originality.

    Science.gov (United States)

    Kleinmintz, Oded M; Abecasis, Donna; Tauber, Amitay; Geva, Amit; Chistyakov, Andrei V; Kreinin, Isabella; Klein, Ehud; Shamay-Tsoory, Simone G

    2018-01-01

    Human creative cognition is commonly described as a twofold cyclic process that involves an idea generation phase and an idea evaluation phase. Although the evaluation phase makes a crucial contribution to originality, its underlying mechanisms have not received sufficient research attention. Here, we suggest that the left inferior frontal gyrus (lIFG) plays a major role in the interplay between the evaluation and generation networks and that inhibiting this region's activity may have an effect on "releasing" the generation neural network, resulting in greater originality. To examine the neural networks that mediate the generation and evaluation of ideas, we conducted an fMRI experiment on a group of healthy human participants (Study 1), in which we compared an idea generation task to an idea evaluation task. We found that evaluating the originality of ideas is indeed associated with a relative increase in lIFG activation, as opposed to generating original ideas. We further showed that temporarily inhibiting the lIFG using continuous theta-burst stimulation (Study 2) results in less strict evaluation on the one hand and increased originality scores on the other. Our findings provide converging evidence from multiple methods to show that the lIFG participates in evaluating the originality of ideas.

  1. Renal transplant in children with previous inferior vena cava thrombosis.

    Science.gov (United States)

    Martinez-Urrutia, Maria Jose; Pereira, Pedro Lopez; Ramirez, Luis Avila; Romera, Roberto Lobato; Melgar, Angel Alonso; Monereo, Enrique Jaureguizar; Larrucea, Juan Tovar

    2007-06-01

    Our experience with renal transplantation in children with inferior vena cava thrombosis is presented in this study. Of the 238 children who have received renal transplants at our institution, four had IVC thrombosis (discovered during pretransplant evaluation: three patients; found at surgery: one patient). The pretransplant US evaluation diagnosis of IVC thrombosis in three patients was confirmed by transjugular retrograde cavography. There were no signs of hypercoagulability or IVC thrombosis symptoms prior to diagnosis in any patient. The graft was implanted in a left orthotopic position in three patients. Venous drainage was attained to the infrahepatic vena cava or native renal vein after ipsilateral nephrectomy. The renal artery of the graft was anastomosed to the aorta. In one patient, the graft was placed in the left iliac fossa. Patient and graft survival are 100%. Three grafts are functioning normally after a mean follow-up of 3.7 yr. The graft placed in the iliac fossa has moderate dysfunction due to high pressure venous outflow. Children with IVC thrombosis can be successfully transplanted orthotopically. Candidates with any suspicious-looking occlusion on ultrasound should be studied by retrograde venography to confirm diagnosis prior to transplantation.

  2. Deep inferior epigastric artery perforator flap harvest after full abdominoplasty.

    Science.gov (United States)

    Zeltzer, Assaf A; De Baerdemaeker, Randy A; Hendrickx, Benoit; Seidenstücker, Katrin; Brussaard, Carola; Hamdi, Moustapha

    2018-03-01

    Abdominal scars are no longer a contra-indication for abdominal perforator flap harvesting. Few research data exists about the regeneration potential of the abdominal wall's perforator system. Therefore, previous abdominoplasty with umbilical transposition is an absolute contra-indication for a DIEaP-flap (deep inferior epigastric artery perforator flap). A 50-year-old patient required a breast reconstruction of the right breast, 10 years after an abdominoplasty with undermining of the superior abdomen and umbilical transposition. The patient was scheduled for a free lumbar artery perforator (LaP) flap. The preoperative computed tomography-angiography mapping showed nice lumbar perforators and to our surprise a good-sized DIEa perforator in the peri-umbilical region. The DIEa perforator on the right hemi-abdomen, consisting of two veins and one artery, was pulsatile and found suitable in size. A classical flap harvest and transfer was further performed. This case report is the first in which a dominant perforator is found in the area of undermining after a full abdominoplasty with umbilical repositioning. Further investigations regarding the nature and timing of re-permeation or regeneration of perforators after abdominoplasty are to be done. Nevertheless, we are convinced that with appropriate perforator mapping and a suitable plan B, previous abdominoplasty is no longer an absolute but a relative contra-indication for performing DIEaP-flap.

  3. Regional Pericarditis Mimicking Inferior Myocardial Infarction following Abdominal Surgery

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    Ahmad T. Alhammouri

    2014-01-01

    Full Text Available Acute pericarditis is common but illusive, often mimicking acute coronary syndrome in its clinical and electrocardiographic presentation. Regional pericarditis, though rare, presents further challenge with a paucity of published diagnostic criteria. We present a case of postoperative regional pericarditis and discuss helpful electrocardiographic findings. A 66-year-old male with history of open drainage of a liver abscess presented with abdominal pain and tenderness. CT of the abdomen was concerning for pneumatosis intestinalis of the distal descending colon. He underwent lysis of liver adhesions; exploration revealed only severe colonic impaction, for which he had manual disimpaction and peritoneal irrigation. Postoperatively, he developed sharp chest pain. Electrocardiogram revealed inferior ST elevation. Echocardiogram revealed normal left and right ventricular dimensions and systolic function without wall motion abnormalities. Emergent coronary angiography did not identify a culprit lesion, and left ventriculogram showed normal systolic function without wall motion abnormalities. He received no intervention, and the diagnosis of regional pericarditis was entertained. His cardiac troponin was 0.04 ng/dL and remained unchanged, with resolution of the ECG abnormalities in the following morning. Review of his preangiography ECG revealed PR depression, downsloping baseline between QRS complexes, and reciprocal changes in the anterior leads, suggestive of regional pericarditis.

  4. Compression of the Inferior Vena Cava in Bowel Obstruction

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    Alessandro Cina

    2013-01-01

    Full Text Available Introduction. We investigated whether (a the inferior vena cava (IVC is compressed in bowel obstruction and (b some tracts are more compressed than others. Methods. Two groups of abdominal computed tomography (CT examinations were collected retrospectively. Group O ( scans were positive for bowel obstruction, group C ( scans were negative for diseases. IVC anteroposterior and lateral diameters (APD, LAD were assessed at seven levels. Results. In group C, IVC section had an elliptic shape (APD/LAD: .76 ± .14, the area of which increased gradually from 1.9 (confluence of the iliac veins to 3.1 cm2/m2 of BSA (confluence of the hepatic veins with a significant narrowing in the hepatic section. In group O, bowel obstruction caused a compression of IVC (APD/LAD: .54 ± .17. Along its course, IVC section area increased from 1.3 to 2.5 cm2/m2. At ROC curve analysis, an APD/LAD ratio lower than 0.63 above the confluence of the iliac veins discriminated between O and C groups with sensitivity of 74% and specificity of 96%. Conclusions. Bowel obstruction caused a compression of IVC, which involved its entire course except for the terminal section. APD/LAD ratio may be useful to monitor the degree of compression.

  5. Inferior Glenohumeral Dislocation in a Division One Collegiate Wrestler

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    Alexander J. Gilmore

    2016-05-01

    Full Text Available Background: A twenty-two year old male collegiate wrestler with no previous history of any shoulder injuries experienced an inferior glenohumeral dislocation on his right arm during practice. The athlete was in in a front headlock by a teammate who attempted to roll him. The athlete was forced into hyperflexion and abduction. The athlete felt a pop and his arm was “stuck” in approximately ninety degrees of abduction. An obvious deformity was palpable in his armpit. The athlete then proceeded to make his way to the athletic training room where he was able to relax and the dislocation reduced itself. After relocation the athlete had no obvious deformity, immediate swelling, or ecchymosis. He was experiencing very generalized soreness and was tender to palpate. His range of motion was very limited due to pain and we were unable to get a good evaluation on him at the time of injury. The next day he was still pretty sore and experienced pain with internal and external rotation. He was experiencing weakness in his rotator cuff and had diffuse neuropraxia. Differential Diagnosis: Labral Tear, shoulder instability, fracture to the humeral head. Treatment: The athlete saw the team physician the day of injury, was placed in a sling, and followed up with x-rays and a visit with the team physician the next day. No bony abnormalities were shown on the x-rays. The team physician discussed options of surgery or waiting with the athlete, who was pretty set on surgery, which he ended up getting the next week. He saw the team physician one week post-operation where the surgery and pictures were reviewed and explained. Athlete was doing well with no complaints. He had good range of motion for one week post-op. At this point we had to explain to him that he needed to be patient in order to let himself heal. We were told to continue his rehabilitation program of active internal and external rotation, passive supination/pronation, and putty squeezes and that he

  6. The role of left posterior inferior temporal cortex in spelling.

    Science.gov (United States)

    Rapcsak, Steven Z; Beeson, Pélagie M

    2004-06-22

    To determine whether damage to left posterior inferior temporal cortex (PITC) is associated with agraphia and to characterize the nature of the spelling impairment. Left angular gyrus may play a critical role in spelling. However, this traditional view is challenged by reports of agraphia after left temporo-occipital lesions and by functional imaging studies demonstrating activation of left PITC during writing in normal individuals. Patients with focal damage to the left temporo-occipital cortex and normal control subjects were administered a comprehensive spelling battery that included regular words, irregular words, and nonwords as stimuli. Although patients performed worse than control subjects in all experimental conditions, the spelling deficit was particularly severe for irregular words, whereas regular word and nonword spelling were less impaired. Additional analyses indicated that orthographic regularity and word frequency had a much more pronounced effect on spelling accuracy in patients compared with control subjects. Most errors on irregular words were phonologically plausible, consistent with reliance on a sublexical phonologic spelling strategy (i.e., phoneme-grapheme conversion). Overall, the spelling impairment of the patients showed the characteristic profile of lexical agraphia. Lesion analyses indicated that the damage in the majority of patients encompassed an area within the left PITC (BA 37/20) where the authors previously obtained evidence of activation in a functional imaging study of writing in normal participants. The behavioral and neuroanatomic observations in the patients are consistent with functional imaging studies of writing in neurologically intact individuals and provide converging evidence for the role of left PITC in spelling. Together, these findings implicate left PITC as a possible neural substrate of the putative orthographic lexicon that contains stored memory representations for the written forms of familiar words.

  7. Inferior vena cava filters in pulmonary embolism: A historic controversy.

    Science.gov (United States)

    Jerjes-Sanchez, Carlos; Rodriguez, David; Navarrete, Aline; Parra-Cantu, Carolina; Joya-Harrison, Jorge; Vazquez, Eduardo; Ramirez-Rivera, Alicia

    Rationale for non-routine use of inferior venous cava filters (IVCF) in pulmonary embolism (PE) patients. Thrombosis mechanisms involved with IVCF placement and removal, the blood-contacting medical device inducing clotting, and the inorganic polyphosphate in the contact activation pathway were analyzed. In addition, we analyzed clinical evidence from randomized trials, including patients with and without cancer. Furthermore, we estimated the absolute risk reduction (ARR), the relative risk reduction (RRR), and the number needed to treat (NNT) based on the results of each study using a frequency table. Finally, we analyzed the outcome of our PE patients that were submitted to thrombolysis with short and long term follow-up. IVCF induces thrombosis by several mechanisms including placement and removal, rapid protein adsorption, and simultaneous surface-induced activation via the contact activation pathway. Also, inorganic polyphosphate has an important role as a procoagulant, reversing the effect of anticoagulants. Randomized control trials included 904 cancer and non-cancer PE patients. In terms of ARR, RRR, and NNT, there is no evidence for routine use of IVCF. In 290 patients with proved PE, extensive thrombotic burden and right ventricular dysfunction under thrombolysis and oral anticoagulation, we observed a favorable outcome in a short- and long-term follow-up; additionally, IVCF was only used in 5% of these patients. Considering the complex mechanisms of thrombosis related with IVCF, the evidence from randomized control trials and ARR, RRR, and NNT obtained from venous thromboembolism patients with and without cancer, non-routine use of IVCF is recommended. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  8. The inferior parietal lobule and temporoparietal junction: A network perspective.

    Science.gov (United States)

    Igelström, Kajsa M; Graziano, Michael S A

    2017-10-01

    Information processing in specialized, spatially distributed brain networks underlies the diversity and complexity of our cognitive and behavioral repertoire. Networks converge at a small number of hubs - highly connected regions that are central for multimodal integration and higher-order cognition. We review one major network hub of the human brain: the inferior parietal lobule and the overlapping temporoparietal junction (IPL/TPJ). The IPL is greatly expanded in humans compared to other primates and matures late in human development, consistent with its importance in higher-order functions. Evidence from neuroimaging studies suggests that the IPL/TPJ participates in a broad range of behaviors and functions, from bottom-up perception to cognitive capacities that are uniquely human. The organization of the IPL/TPJ is challenging to study due to the complex anatomy and high inter-individual variability of this cortical region. In this review we aimed to synthesize findings from anatomical and functional studies of the IPL/TPJ that used neuroimaging at rest and during a wide range of tasks. The first half of the review describes subdivisions of the IPL/TPJ identified using cytoarchitectonics, resting-state functional connectivity analysis and structural connectivity methods. The second half of the article reviews IPL/TPJ activations and network participation in bottom-up attention, lower-order self-perception, undirected thinking, episodic memory and social cognition. The central theme of this review is to discuss how network nodes within the IPL/TPJ are organized and how they participate in human perception and cognition. Copyright © 2017. Published by Elsevier Ltd.

  9. Humeral avulsion of the inferior glenohumeral ligament in college female volleyball players caused by repetitive microtrauma.

    Science.gov (United States)

    Taljanovic, Mihra S; Nisbet, Jon K; Hunter, Tim B; Cohen, Randy P; Rogers, Lee F

    2011-05-01

    Humeral avulsion of the inferior glenohumeral ligament is a rare injury resulting from hyperabduction and external rotation, and it is most commonly seen with sports-related injuries, including those from volleyball. The anterior band of the inferior glenohumeral ligament is most commonly injured (93%), whereas the posterior band is infrequently injured. The axillary pouch humeral avulsion of the inferior glenohumeral ligament as a result of repetitive microtrauma has not been yet described in the English literature. Humeral avulsions of the inferior glenohumeral ligaments are identifiable in volleyball players without acute injuries, and they have a unique pathologic pattern in these athletes. Case series; Level of evidence, 4. Four female college volleyball players with pain in their dominant shoulder and with inferior capsular laxity and/or instability—without a known history of trauma or dislocation of the same shoulder—were referred by an experienced sports medicine orthopaedic surgeon for the magnetic resonance arthrogram procedure of the same shoulder. The imaging findings were retrospectively correlated with the initial interpretation and arthroscopic findings. All 4 patients had an axillary pouch humeral avulsion of the inferior glenohumeral ligament. Three had articular surface partial-thickness rotator cuff tear, and 3 had a labral tear. All were outside hitters or middle blockers who consequently performed multiple hitting maneuvers in practice and games. Repetitive microtrauma from overhead hitting in volleyball generates forces on the inferior capsule of the shoulder joint that may cause inferior capsular laxity and subsequent failure of the humeral side of the axillary pouch portion of the inferior glenohumeral ligament.

  10. Creation of the permanent inferior vena cava filter for prevention of pulmonary artery embolism

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    Yа.O. Povar

    2016-05-01

    Full Text Available The aim of the study was to create a new permanent cava filter to improve functional capacities of the construction and achieve high clinical parameters. A new geometry of the permanent inferior vena cava filter was presented which has high blood clot-capturing ability, does not cause thrombus fragmentation, makes migration impossible. The inferior vena cava filter does not injure the vessel wall and preserves integrity under long-term use. The inferior vena cava filter installation is safe and controllable, the filter self-positioning and reposition are possible, the delivery system size is 6F, the blood flow changing is minimal.

  11. [Massive inferior vena cava thrombosis in a patient with autosomal dominant polycystic hepatorenal disease].

    Science.gov (United States)

    Peces, R; Gil, F; Costero, O; Pobes, A

    2002-01-01

    We report a 68-year-old man with autosomal dominant polycystic kidney disease, who developed multiple venous thromboses (inferior vena cava, left renal vein and iliofemoral veins) caused by local compression of the intrahepatic inferior vena cava by hepatic cysts. To our knowledge this is the first reported case of inferior vena cava thrombosis caused by hepatic cysts compression. Doppler ultrasound, computed tomography, and magnetic resonance imaging were effective in documenting the venous thromboses and the underlying lesions non-invasively. Long-term anticoagulation was an efficient and safe treatment.

  12. A rare variation in the course of the inferior alveolar nerve.

    Science.gov (United States)

    Manikandhan, R; Mathew, P C; Naveenkumar, J; Anantanarayanan, P

    2010-02-01

    Extra-canalicular variations of the inferior alveolar nerve are exceedingly rare and unreported. The authors report an unusual presentation of the inferior alveolar nerve perforating the ramus of the mandible with a very short intra-bony course and exiting laterally in a 20 year old indian female diagnosed with hemifacial microsomia. There was concomitant absence of the ipsilateral inferior alveolar canal and mental foramen. Variations in nerve architecture like these are of importance to clinicians who deal with surgery of the facial skeleton. Copyright 2009 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Outcome of inferior vena cava and noncaval venous leiomyosarcomas.

    Science.gov (United States)

    Illuminati, Giulio; Pizzardi, Giulia; Calio', Francesco; Pacilè, Maria Antonietta; Masci, Federica; Vietri, Francesco

    2016-02-01

    Leiomyosarcoma (LMS) is a rare tumor arising from the smooth muscle cells of arteries and veins. LMS may affect both the inferior vena cava (IVC) and non-IVC veins. Because of its rarity, the experience with the outcome of the disease originating from the IVC compared with that with non-IVC offspring is overall limited. In this study, we compared the clinical features and outcomes after operative resection of IVC and non-IVC LMS to detect possible significant differences that could affect treatment and prognosis. Twenty-seven patients undergoing operative resection of a venous LMS at a single tertiary care center and one secondary care hospital were reviewed retrospectively and divided into 2 groups: IVC-LMS (Group A, n = 18) and non-IVC LMS (Group B, n = 9). As primary end points, postoperative mortality and morbidity, disease-specific survival and, if applicable, patency of venous reconstruction were considered. Bivariate differences were compared with the χ(2) test. Disease-specific survival was expressed by a life-table analysis and compared using the log-rank test. No postoperative mortality was observed in either group. Postoperative morbidity was 28% in group A and 11% in group B (P = .33). The mean duration of follow-up was 60 months (range, 13-140). Disease-specific survival was 60% in group A and 75% in group B at 3 years (P = .48), and it was 54% in group A and 62% in group B at 5 years (P = .63). Seven grafts were occluded in group A (39%) and 1of 3 were occluded in group B (33%) (P = .85). IVC and non-IVC LMS exhibit similar outcomes in terms of postoperative course and survival. Operative resection associated with vascular reconstruction, if applicable, eventually followed by radiation and chemotherapy may be curative and is associated with good functional results. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Tuberculosis pulmonar de campos inferiores Lower lung field tuberculosis

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    Alejandra González

    2010-10-01

    Full Text Available La tuberculosis (TB que compromete sólo los campos pulmonares inferiores (TBCI es poco frecuente en el adulto y en general está asociada a alguna causa de inmunodepresión. El objetivo de nuestro trabajo fue determinar la incidencia de TBCI en nuestra población y comparar sus características respecto de la TB pulmonar de localización habitual. Se estudiaron en forma retrospectiva en el período de 2004 a 2008, 42 pacientes con TBCI que fueron comparados con 84 pacientes con TB pulmonar de localización habitual (grupo control. Se excluyeron pacientes con HIV. La TBCI representó el 6% del total de TB pulmonar. No se encontraron diferencias significativas en cuanto a edad, sexo, presencia de cavidades en la radiografía, días de evolución y nivel de albúmina. La TBCI tuvo significativamente mayor proporción de comorbilidades (p Tuberculosis (TB that affects lower lung fields (LLFTB is infrequent in the adult population and is generally associated with immunodeficiency. The objective of our study was to determine the incidence of LLFTB in our patients population and compare the characteristics of these patients with those who presented TB of typical pulmonary localization. We studied 42 patients with LLFTB retrospectively between 2004 and 2008 and compared them to 84 patients with TB of typical localization (control group. HIV-positive patients were excluded. LLFTB represented 6% of the pulmonary TB cases. No significant differences were found with respect to age, sex, the presence of cavities in chest x-rays, days of evolution, and albumin levels. LLFTB had a significantly greater proportion of comorbilities (p < 0.001, the presence of condensation (p < 0.001, and unilateral involvement (p < 0.001, with a higher number of hospital admissions (p = 0.02. The observation that only 16 of the 42 patients with LLFTB (38% had a notable comorbility is important. Thus, LLFTB can be present without associated comorbilities and must be suspected in

  15. Language outcomes after resection of dominant inferior parietal lobule gliomas.

    Science.gov (United States)

    Southwell, Derek G; Riva, Marco; Jordan, Kesshi; Caverzasi, Eduardo; Li, Jing; Perry, David W; Henry, Roland G; Berger, Mitchel S

    2017-10-01

    OBJECTIVE The dominant inferior parietal lobule (IPL) contains cortical and subcortical regions essential for language. Although resection of IPL tumors could result in language deficits, little is known about the likelihood of postoperative language morbidity or the risk factors predisposing to this outcome. METHODS The authors retrospectively examined a series of patients who underwent resections of gliomas from the dominant IPL. Postoperative language outcomes were characterized across the patient population. To identify factors associated with postoperative language morbidity, the authors then compared features between those patients who experienced postoperative deficits and those who experienced no postoperative language dysfunction. RESULTS Twenty-four patients were identified for analysis. Long-term language deficits occurred in 29.2% of patients (7 of 24): 3 of these patients had experienced preoperative language deficits, whereas new long-term language deficits occurred in 4 patients (16.7%; 4 of 24). Of those patients who exhibited preoperative language deficits, 62.5% (5 of 8) experienced long-term resolution of their language deficits with surgical treatment. All patients underwent intraoperative brain mapping by direct electrical stimulation. Awake, intraoperative cortical language mapping was performed on 17 patients (70.8%). Positive cortical language sites were identified in 23.5% of these patients (4 of 17). Awake, intraoperative subcortical language mapping was performed in 8 patients (33.3%). Positive subcortical language sites were identified in 62.5% of these patients (5 of 8). Patients with positive cortical language sites exhibited a higher rate of long-term language deficits (3 of 4, 75%), compared with those who did not (1 of 13, 7.7%; p = 0.02). Although patients with positive subcortical language sites exhibited a higher rate of long-term language deficits than those who exhibited only negative sites (40.0% vs 0.0%, respectively), this

  16. Posterior inferior cerebellar artery aneurysms: Anatomical variations and surgical strategies

    Science.gov (United States)

    Singh, Rohit K.; Behari, Sanjay; Kumar, Vijendra; Jaiswal, Awadhesh K.; Jain, Vijendra K.

    2012-01-01

    Context: Posterior inferior cerebellar artery (PICA) aneurysms are associated with multiple anatomical variations of the parent vessel. Complexities in their surgical clipping relate to narrow corridors limited by brain-stem, petrous-occipital bones, and multiple neurovascular structures occupying the cerebellomedullary and cerebellopontine cisterns. Aims: The present study focuses on surgical considerations during clipping of saccular PICA aneurysms. Setting and Design: Tertiary care, retrospective study. Materials and Methods: In 20 patients with PICA aneurysms, CT angiogram/digital substraction angiogram was used to correlate the site and anatomical variations of aneurysms located on different segments of PICA with the approach selected, the difficulties encountered and the final outcome. Statistical Analysis: Comparison of means and percentages. Results: Aneurysms were located on PICA at: vertebral artery/basilar artery (VA/BA)-PICA (n=5); anterior medullary (n=4); lateral medullary (n=3); tonsillomedullary (n=4); and, telovelotonsillar (n=4) segments. The Hunt and Hess grade distribution was I in 15; II in 2; and, III in 3 patients (mean ictus-surgery interval: 23.5 days; range: 3-150 days). Eight patients had hydrocephalus. Anatomical variations included giant, thrombosed aneurysms; 2 PICA aneurysms proximal to an arteriovenous malformation; bilobed or multiple aneurysms; low PICA situated at the foramen magnum with a hypoplastic VA; and fenestrated PICA. The approaches included a retromastoid suboccipital craniectomy (n=9); midline suboccipital craniectomy (n=6); and far-lateral approach (n=5). At a follow-up (range 6 months-2.5 years), 13 patients had no deficits (modified Rankin score (mRS) 0); 2 were symptomatic with no significant disability (mRS1); 1 had mild disability (mRS2); 1 had moderately severe disability (mRS4); and 3 died (mRS6). Three mortalities were caused by vasospasm (2) and, rupture of unclipped second VA-BA junctional aneurysm (1

  17. Methods of defining the non-inferiority margin in randomized, double-blind controlled trials : a systematic review

    NARCIS (Netherlands)

    Althunian, Turki A; de Boer, Anthonius; Klungel, Olaf H; Insani, Widya N; Groenwold, Rolf H H

    2017-01-01

    BACKGROUND: There is no consensus on the preferred method for defining the non-inferiority margin in non-inferiority trials, and previous studies showed that the rationale for its choice is often not reported. This study investigated how the non-inferiority margin is defined in the published

  18. Methods of defining the non-inferiority margin in randomized, double-blind controlled trials : a systematic review

    NARCIS (Netherlands)

    Althunian, Turki A.; de Boer, Anthonius; Klungel, Olaf H.; Insani, Widya N.; Groenwold, Rolf H. H.

    2017-01-01

    Background There is no consensus on the preferred method for defining the non-inferiority margin in non-inferiority trials, and previous studies showed that the rationale for its choice is often not reported. This study investigated how the non-inferiority margin is defined in the published

  19. Ensaio de desbaste dos ramos inferiores do cafeeiro

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    J. E. Teixeira Mendes

    1946-12-01

    Full Text Available A cultura do cafeeiro no Estado de São Paulo é feita plantando-se diversas mudas em uma mesma cova. Porisso, não se pode adotar nenhum tipo regular de poda, como se faz nos outros paises cafeicultores. Há algumas práticas que se executam com a finalidade de se manter o que se convencionou chamar de pé de café em condições de produzir satisfatòriamente. Um dêsses usos, aceito por uns e combatido por outros, é o que consiste na retirada dos ramos primários inferiores e sua ramificação, diminuindo-se assim a "saia" dos cafeeiros. O ensaio em exame teve por fim determinar se há ou não vantagem em se fazer a eliminação dêsses ramos. Foi plantado em 1932, na Estação Experimental Central de Campinas. A variedade empregada foi o Café Nacional, isto é, C. arabica L var. typica Cramer. Duas foram as séries examinadas : a desbastada ; b não desbastada. Cada série se compunha de 5 repetições de 25 cafeeiros cada uma. A série desbastada foi regular e anualmente limpa de ramos primários, desde o ano seguinte ao da plantação (1933, mantendo-se os cafeeiros livres de ramos até a uma altura de mais ou menos 50 cm do solo. Os ramos ladrões, quando deixados, também eram submetidos a poda idêntica. As adubações e tratos culturais foram idênticos para ambas as séries. As colheitas foram iniciadas em 1935. Neste trabalho são examinadas as produções de 10 anos, relativos ao período 1935-1944. A produção foi quase que em todos os anos maior na série não desbastada. Apenas no ano de 1944 a colheita da série desbastada foi superior à da não desbastada. Houve diferença significativa (P = 1% para a produção das parcelas não desbastadas, no total dos dez anos. A maturação foi um pouco apressada nas séries desbastadas. Não houve, até ao presente, efeito do desbaste sobre o tamanho das sementes produzidas. Podemos, portanto, considerar como de efeito contraproducente a prática do desbaste dos ramos inferiores do

  20. Bilateral Inferior Rectus Muscle Recession in Patients With Graves Orbitopathy: Is It Effective?

    NARCIS (Netherlands)

    Jellema, Hinke Marijke; Saeed, Peerooz; Everhard-Halm, Yolande; Prick, Liesbeth; Mourits, Maarten

    2012-01-01

    Purpose: To evaluate the effect of bilateral inferior rectus recession regarding improvement of elevation, reduction of abnormal head tilt and vertical squint angle in patients with Graves orbitopathy. Method: Retrospective case series. Patients with Graves orbitopathy who underwent symmetric or

  1. Fainting as an unusual presentation of a large inferior vena cava leiomyosarcoma.

    Science.gov (United States)

    De Luca, Giuseppe Massimiliano; Gurrado, Angela; Marzullo, Andrea; Piccinni, Giuseppe; Memeo, Riccardo; Vacca, Angelo; Testini, Mario

    2015-08-01

    Primary tumors of the inferior vena cava are rare, with leiomyosarcoma representing the vast majority. A 60-year-old man was admitted in emergency for fainting and mild anemia. A whole-body computed tomography revealed a retroperitoneal mass of approximately 8 cm in diameter, invading the lumen of the inferior vena cava, extending to the renal vein confluence. An en bloc resection of the solid mass was performed. Macroscopically the tumor did not seem to insist on the resection margin. Histopathological examination confirmed the diagnosis of leiomyosarcoma of the inferior vena cava. Postoperative recovery was uneventful and the patient was discharged after eight days, starting adjuvant chemotherapy. During the follow-up, the patient did not show other fainting episode, and at 24 months he is disease free. Unusually, fainting could even be the isolated sign of a large leiomyosarcoma of the inferior vena cava, also when it affects its middle portion. © The Author(s) 2014.

  2. Does the left inferior longitudinal fasciculus play a role in language? A brain stimulation study

    National Research Council Canada - National Science Library

    Mandonnet, Emmanuel; Nouet, Aurélien; Gatignol, Peggy; Capelle, Laurent; Duffau, Hugues

    2007-01-01

    ...), its function remains poorly understood. Recently, it was suggested that the subcortical network subserving the language semantics could be constituted, in parallel with the inferior occipitofrontal fasciculus, by the left ILF, joining...

  3. Spontaneous alignment of crowded inferior incisives after the extractionof temporary canines

    OpenAIRE

    Orellana Manrique, Tomás Oriel; Departamento Académico de Estomatología Pediátrica. Facultad de Odontología UNMSM. Lima Perú.; Calderón Cortez, Iván; Estudiante de pre grado. Facultad de Odontología UNMSM. Lima Perú.; Orellana Manrique, Martín; Estudiante de Maestría. Facultad de Odontología UNMSM. Lima Perú.

    2014-01-01

    This investigation evaluated the behavior of permanent inferior incisives after the primary canine’s extractions. The study was carried out in the Pediatric Clinic of Dental Faculty of San Marcos University. The sample was conformed by 10 patients, male and female children, between 8 and 9 years of age, with good general health, having Class I malocclusion and severe crowding of the inferior incisives. It was taken Cephalometric and Panoramic radiographies, as well as models to make the ortho...

  4. Glenohumeral eklemin inferior çıkığı (luxatio erecta)

    OpenAIRE

    F, Ozan; A, Bora O

    2010-01-01

    Shoulder joint is the most luxatable joint. Luxation may take place either anterior, posterior, superior or inferior. Inferior glenohumeral dislocation (luxatio erecta) is rarely encountered, usually caused by a hyperabduction injury to the arm. The incidence of luxatio erecta has been estimated to be 0.5% of all shoulder dislocations. The clinical presentation of luxatio erecta is characteristic, with the arm elevated and the forearm fixed, resting on the head. The humeral head is palpable o...

  5. An unusual case of colon vascularization by the inferior mesenteric artery

    Directory of Open Access Journals (Sweden)

    Serghei Covanțev

    2017-04-01

    Full Text Available Abstract In this article we present a rare variant in which the large intestine was vascularized by the inferior mesenteric artery. It was encountered during macro and microscopic dissection of the cadaver of a 63-year-old woman at a university department of human anatomy. In this case, the ascending, transverse, descending, and sigmoid colon and rectum were vascularized by the inferior mesenteric artery, whereas the small intestine, cecum and appendix were supplied by the superior mesenteric artery.

  6. Inferior subconjunctival dislocation of posterior chamber intraocular lens after blunt trauma

    Directory of Open Access Journals (Sweden)

    Amit Mohan

    2017-01-01

    Full Text Available Traumatic subconjunctival dislocation of the posterior chamber intraocular lens (PCIOL is a rare and emergency condition. Here, we report an interesting variation of rare case of inferior subconjuctival dislocation of PCIOL in a 75-year-old female patient following blunt trauma to her right eye with cow's head. All the previous literature with subconjuctival dislocation of PCIOL has reported the superior dislocation of intraocular lens. Inferior subconjunctival dislocation has never been reported in previous literature.

  7. [Investigation of the age-dependent development of brachygnathia inferior in the East Friesian milk sheep].

    Science.gov (United States)

    Pielmeier, Ricarda; Kerkmann, Andrea; Distl, Ottmar

    2012-01-01

    Shortness of the lower jaw (brachygnathia inferior, underbite) is a common anomaly in sheep. In order to study the age-dependent development of brachygnathia inferior, data of 73 East Friesian milk sheep from a breeding experiment over six generations were analysed. Data were recorded in regular intervals of four weeks from birth up to an age of at least 25 weeks. Brachygnathia inferior was determined by the distance between the edge of the central incisor of the lower jaw and the anterior surrounding of the upper jaw (DIFF-UK) using a measuring tape. Four main types of brachygnathia inferior were distinguished using means, standard deviations and maximum values of the individual animals.The thresholds were a maximum and mean DIFF-UK of 0.5 cm and a standard deviation of 0.266 cm. A total of 14 sheep (main types 3 and 4) showed an obvious brachygnathia inferior with mean DIFF-UK larger than 0.5 cm whereof ten animals showed a large variation of DIFF-UK values (standard deviation > 0.226 cm). Mean DIFF-UK values of 59 sheep were smaller than 0.5 cm (main types 1 and 2). One of these 59 animals had during the first four weeks of life DIFF-UK values of 1 cm and than decreasing values reaching zero within the next nine months (main type 2). Five of the 58 animals with main type 1 had a perfect occlusion of jaws, all with DIFF-UK values at zero during the whole recording period. Parents with severe or mild brachygnathia inferior had severely affected progeny. Selection of sheep for breeding with a perfect occlusion of jaws decreases the risk to pass on the hereditary disposition for brachygnathia inferior. An early inspection of potential breeding animals is advisable to detect all cases of brachygnathia inferior even if the underbite decreases in the first year of life.

  8. [Current situation of surgical treatment of inferior polar fracture of patella].

    Science.gov (United States)

    Zhang, Xinglin; Chen, Xu; Jiang, Junjie; Jia, Peitong; Zhou, Zhiyong; Sun, Tao; Liu, Shaoxian

    2010-04-01

    To investigate the advance in surgical treatment of inferior pole fracture of patella and to explore the existing problems and further research directions. Domestic and foreign literature in recent years on patella fracture was extensively reviewed, the surgical treatment of inferior pole fracture of patella was summarized by combining the research findings with clinical experience. The surgical treatment of inferior pole of patella fractures included retaining the integrity of the patella and partial patellectomy of inferior pole of patella and extending knee installation reconstruction. There were kinds of ways to retain the integrity of the patella, such as circular wire fixation, tension band fixation, NiTi-patella concentrator fixation, basket plate fixation, reforming McLaughlin way and polydioxanone suture net fixation; the latter category is partial patellectomy and extensor device reconstruction. Every surgical way had its advantages and limitations. Most studies tend to retain the integrity of the patella, but some researches have shown that partial resection of inferior pole of patella had no significant effect on knee function. It is important to obtain the security excisional range and elongation range postoperative by experiment for regulating the treatment of comminuted fractures of inferior pole of patella.

  9. Some practical considerations in three-arm non-inferiority trial design.

    Science.gov (United States)

    Zhou, Ming; Kundu, Sudeep

    2016-11-01

    Non-inferiority trials aim to demonstrate whether an experimental therapy is not unacceptably worse than an active reference therapy already in use. When applicable, a three-arm non-inferiority trial, including an experiment therapy, an active reference therapy, and a placebo, is often recommended to assess assay sensitivity and internal validity of a trial. In this paper, we share some practical considerations based on our experience from a phase III three-arm non-inferiority trial. First, we discuss the determination of the total sample size and its optimal allocation based on the overall power of the non-inferiority testing procedure and provide ready-to-use R code for implementation. Second, we consider the non-inferiority goal of 'capturing all possibilities' and show that it naturally corresponds to a simple two-step testing procedure. Finally, using this two-step non-inferiority testing procedure as an example, we compare extensively commonly used frequentist p -value methods with the Bayesian posterior probability approach. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Significance of localization of mandibular foramen in an inferior alveolar nerve block.

    Science.gov (United States)

    Thangavelu, K; Kannan, R; Kumar, N Senthil; Rethish, E; Sabitha, S; Sayeeganesh, N

    2012-07-01

    The mandibular foramen (MF) is an opening on the internal surface of the ramus for divisions of the mandibular vessels and nerve to pass. The aim of this study is to determine the position of the MF from various anatomical landmarks in several dry adult mandibles. A total of 102 human dry mandibles were examined, of which 93 were of dentulous and 9 were of edentulous. The measurements were taken from the anterior border of the ramus (coronoid notch) to the midportion of the MF and then from the midportion of the MF to the other landmarks such as internal oblique ridge, inferior border, sigmoid notch, and condyle were measured and recorded. The data were compared using Student's t-test. The MF is positioned at a mean distance of 19 mm (with SD 2.34) from coronoid notch of the anterior border of the ramus. Superio-inferiorly from the condyle to the inferior border MF is situated 5 mm inferior to the midpoint of condyle to the inferior border distance (ramus height). We conclude that failures in the anesthesia of the inferior alveolar nerve are due to the operator error and not due to the anatomical variation.

  11. Endovascular recanalization for nonmalignant obstruction of the inferior vena cava.

    Science.gov (United States)

    Erben, Young; Bjarnason, Haraldur; Oladottir, Gudrun L; McBane, Robert D; Gloviczki, Peter

    2018-01-11

    The aim of this study was to evaluate outcomes of endovascular recanalization of the inferior vena cava (IVC) and iliac veins with long-standing chronic venous obstruction caused by nonmalignant disease. Medical records for 66 patients who underwent endovascular recanalization of the IVC with or without iliac veins from January 2001 to December 2014 at our medical center were retrospectively reviewed. Primary outcomes included morbidity and mortality; secondary outcomes included primary, primary assisted, and secondary patency and resolution of symptoms. Forty-five (68%) patients were male; the mean age was 43 years (range, 17-83 years). All but one patient had chronic symptoms (mean duration, 8 ± 9 years). Clinical, Etiology, Anatomy, and Pathophysiology classes included 3, 4a, 4b, 5, and 6 in 41, 2, 1, 2, and 20 patients, respectively. Mean Venous Clinical Severity Score was 12.4 ± 6.5. Fifty-nine patients (89%) had history of deep venous thrombosis, and 13 also had pulmonary embolism. Twenty-five patients (38%) had an IVC filter; 20 (30%) had thrombophilia. The obstruction involved the infrarenal IVC in 44 patients and both the infrarenal and suprarenal IVC in 22 patients. All recanalizations were performed under conscious sedation and local anesthesia and involved sequential angioplasty and stent placement into the IVC, with or without iliac vein stenting. Venous access included bilateral femoral veins and right internal jugular vein. Stents used were Wallstents (Boston Scientific, Marlborough, Mass; n = 70), Protegé stents (ev3, Plymouth, Minn; n = 49), Gianturco (Cook Medical, Bloomington, Ind; n = 44), and Luminexx (Bard, Tempe, Ariz; n = 1). Pressure gradients were 6.7 ± 4.0 mm Hg before and 0.9 ± 1.1 mm Hg after stenting (P pulmonary embolism. Four patients had five complications: two developed an arteriovenous fistula, one patient developed groin hematoma that required open evacuation, and one had peri-IVC hematoma and femoral vein

  12. The position of the mandibular canal and histologic feature of the inferior alveolar nerve.

    Science.gov (United States)

    Kilic, C; Kamburoğlu, K; Ozen, T; Balcioglu, H A; Kurt, B; Kutoglu, T; Ozan, H

    2010-01-01

    The inferior alveolar nerve is the one of the large branches of the mandibular division of the trigeminal nerve. It is vulnerable during surgical procedures of the mandible. Despite its importance, no anatomical and histological examination has been conducted to provide a detailed cross-sectional morphology of the mandibular canal according to dental status. Therefore, the present study aimed to identify the position of the mandibular canal through direct measurement and to determine the branches of the inferior alveolar nerve through histologic examination. The area between the anterior margin of the third molar and the anterior margin of the second premolar of dentulous, partially dentulous, and edentulous hemimandible specimens (n = 49) from 26 human cadavers was serially sectioned into seven segments, and specific distances were measured using digital calipers. Following this, 5-microm cross-sections were prepared along the mandibular canal and mental foramen, and examined by fluorescence microscopy. The mandibular canal was located at a mean distance of 10.52 mm above the inferior margin of the mandible. The mean maximum diameters of the mandibular canal, inferior alveolar nerve, inferior alveolar artery, and inferior alveolar vein were 2.52, 1.84, 0.42, and 0.58 mm, respectively. This study found that the inferior alveolar nerve often gives rise to several branches at each level (range 0-3). To minimize the risk of injury, knowledge of the small branches of the nerve and of the detailed findings regarding the position of the mandibular canal reported here should be considered when planning mandibular surgery, especially during implant placement.

  13. Dual joint space arthrography in temporomandibular joint disorders: Comparison with single inferior joint space arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyung Sik; Chang, Duk Soo; Lee, Kyung Soo; Kim, Woo Sun; Sung, Jung Ho; Jun, Young Hwan [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

    1989-02-15

    The temporomandibular joint(TMJ) is really a complex of two synovial space separated by fibrocartilaginous disc. Single inferior joint space arthrography is commonly performed for evaluation of TMJ disorders, which is known to be superior in demonstrating joint dynamics. But it reveals only the inferior surface of the disc. Therefore, dual space arthrography is superior to demonstrate the soft tissue anatomic feature of the joint such as disc position and shape. Authors performed 83 TMJ arthrograms in TMJ problems. Initially, the inferior joint space was done and then the superior space was sequentially contrasted. The follow results were noted: 1. In all cases, dual space arthrography revealed accurate disc shape and positions. 2. Concordant findings between the two techniques: 68 cases (82%). Discordance between the two techniques: 15 cases (18%) 3. Possible causes of discordance between inferior and dual space arthrography. a) Normal varians of anterior recess: 3 cases b) Posterior disc displacement: 4 cases c) Influence of the patient's head position change :4 cases d) False perforation: 2 cases e) Reduction change: 2 cases 4. In 5 cases with anterior displacement, dual space arthrography gave additional findings such as adhesion within the superior space, which could not be evaluated by single inferior space.

  14. [MASSIVE HEMORRHAGE FROM THE FISTULA FORMATION BETWEEN CUTANEOUS URETEROSTOMY AND INFERIOR EPIGASTRIC ARTERY: A CASE REPORT].

    Science.gov (United States)

    Fujinami, Hiroyuki; Shibuya, Tadamasa; Mori, Kenichi; Shin, Toshitaka; Sumino, Yasuhiro; Sato, Fuminori; Mimata, Hiromitsu; Sato, Yoshiyasu; Matsubara, Takanori; Sakamoto, Sadaaki; Kamei, Noritaka; Hongo, Tetsuo

    2015-04-01

    A 87-year-old man received radical nephroureterectomy for right renal pelvic cancer in 2009 and left cutaneous ureterostomy after radical cystectomy for bladder cancer in 2013. He visited the hospital for exchanging a 7 or 8 Fr single-J catheter every 2 to 4 weeks. Eleven months after the 2nd operation, massive bleeding from the stoma occurred when ureteral catheter was exchanged. Contrast-enhanced computed tomography showed that left inferior epigastric artery was located close to left ureter. Angiography of the left inferior epigastric artery didn't show an obvious fistula, but revealed the stoma was surrounded by ramified new blood vessels from left inferior epigastric artery. We suspected a rupture of the vessels and performed embolization for the branch of inferior epigastric artery to left ureter. This embolization made it possible for the bleeding to be controlled. Massive bleeding from the branch of inferior epigastric artery is very rare, and we report the case and review the literature.

  15. Sensorimotor integration for speech motor learning involves the inferior parietal cortex

    Science.gov (United States)

    Shum, Mamie; Shiller, Douglas M.; Baum, Shari R.; Gracco, Vincent L.

    2011-01-01

    Sensorimotor integration is important for motor learning. The inferior parietal lobe (IPL), through its connections with the frontal lobe and cerebellum, has been associated with multisensory integration and sensorimotor adaptation for motor behaviours other than speech. In the present study, the contribution of the inferior parietal cortex to speech motor learning was evaluated using repetitive transcranial magnetic stimulation (rTMS) prior to a speech motor adaptation task. Subjects' auditory feedback was altered in a manner consistent with the auditory consequences of an unintended change in tongue position during speech production and adaptation performance was used to evaluate sensorimotor plasticity and short-term learning. Prior to the feedback alteration, rTMS or sham stimulation was applied over the left supramarginal gyrus (SMG). Subjects who underwent the sham stimulation exhibited a robust adaptive response to the feedback alteration whereas subjects who underwent rTMS exhibited a diminished adaptive response. The results suggest that the inferior parietal region, in and around SMG, plays a role in sensorimotor adaptation for speech. The interconnections of the inferior parietal cortex with inferior frontal cortex, cerebellum and primary sensory areas suggest that this region may be an important component in learning and adapting sensorimotor patterns for speech. PMID:22098364

  16. Sensorimotor integration for speech motor learning involves the inferior parietal cortex.

    Science.gov (United States)

    Shum, Mamie; Shiller, Douglas M; Baum, Shari R; Gracco, Vincent L

    2011-12-01

    Sensorimotor integration is important for motor learning. The inferior parietal lobe, through its connections with the frontal lobe and cerebellum, has been associated with multisensory integration and sensorimotor adaptation for motor behaviors other than speech. In the present study, the contribution of the inferior parietal cortex to speech motor learning was evaluated using repetitive transcranial magnetic stimulation (rTMS) prior to a speech motor adaptation task. Subjects' auditory feedback was altered in a manner consistent with the auditory consequences of an unintended change in tongue position during speech production, and adaptation performance was used to evaluate sensorimotor plasticity and short-term learning. Prior to the feedback alteration, rTMS or sham stimulation was applied over the left supramarginal gyrus (SMG). Subjects who underwent the sham stimulation exhibited a robust adaptive response to the feedback alteration whereas subjects who underwent rTMS exhibited a diminished adaptive response. The results suggest that the inferior parietal region, in and around SMG, plays a role in sensorimotor adaptation for speech. The interconnections of the inferior parietal cortex with inferior frontal cortex, cerebellum and primary sensory areas suggest that this region may be an important component in learning and adapting sensorimotor patterns for speech. © 2011 The Authors. European Journal of Neuroscience © 2011 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

  17. Restoration of diaphragmatic function after diaphragm reinnervation by inferior laryngeal nerve; experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    de Barros Angelique

    2006-01-01

    Full Text Available Abstract Objectives To assess the possibilities of reinnervation in a paralyzed hemidiaphragm via an anastomosis between phrenic nerve and inferior laryngeal nerve in rabbits. Reinnervation of a paralyzed diaphragm could be an alternative to treat patients with ventilatory insufficiency due to upper cervical spine injuries. Material and method Rabbits were divided into five groups of seven rabbits each. Groups I and II were respectively the healthy and the denervated control groups. The 3 other groups were all reinnervated using three different surgical procedures. In groups III and IV, phrenic nerve was respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the trunk of the inferior laryngeal nerve. In group V, the fifth and fourth cervical roots were respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the nerve of the sternothyroid muscle (originating from the hypoglossal nerve. Animals were evaluated 4 months later using electromyography, transdiaphragmatic pressure measurements, sonomicrometry and histological examination. Results A poor inspiratory activity was found in quiet breathing in the reinnervated groups, with an increasing pattern of activity during effort. In the reinnervated groups, transdiaphragmatic pressure measurements and sonomicrometry were higher in group III with no significant differencewith groups IV and V. Conclusion Inspiratory contractility of an hemidiaphragm could be restored with immediate anastomosis after phrenic nerve section between phrenic nerve and inferior laryngeal nerve.

  18. Microscopic characteristics of the inferior tarsal muscle and its surroundings in Korean

    Directory of Open Access Journals (Sweden)

    Hee Bae Ahn

    2013-04-01

    Full Text Available AIM: To investigate the detailed microscopic anatomic structures of the lower eyelid in Korean cadavers.METHODS: Eight lower eyelids of 4 formalin-fixed Asian cadavers (4 males; age range, 48-69 years; mean age, 60.2 years were examined. Three perpendicular dissected sections with a 2mm thickness were obtained from each eyelid to investigate anatomic shapes, size and relationship with surrounding structures. One section was obtained from the midline and 2 the other sections were obtained from a 3mm apart from the lateral and medial tarsus margins.RESULTS:The inferior tarsal muscle fibers were not directly attached to the tarsus but were only linked to the tarsus with enclosed fibrous fascia. The inferior tarsal muscles connected loosely with the capsulopalpebral fascia anteriorly and the conjunctiva posteriorly. The inferior tarsal muscle runs horizontally to the tarsus according to the shape of muscle fibers. The capsulopalpebral fascia consisted of an anterior and posterior layer. The anterior layer reached the orbital septum and subcutaneous fat but the posterior layer forwarded into the tarsus. Lockwood''s ligament was separated from the inferior tarsal muscle and capsulopalpebral fascia or fused into the capsulopalpebral fascia.CONCLUSION: This study suggests that the inferior tarsal muscle which runs horizontally and doesn’t insert directly into the tarsus, plays an important role in the movement and localization of the lower eyelid.

  19. Neuropharmacologic characterization of strychnine seizure potentiation in the inferior olive lesioned rat

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, M.C.

    1988-01-01

    Cerebellar stimulation is associated with anticonvulsant activity in several animal models. There are two afferent inputs to cerebellar Purkinje cells: (1) parallel fibers, which relay mossy fiber input, from brainstem, spinal cord, cerebral cortex and cerebellum, and (2) climbing fibers, arising from the inferior olive. Both climbing and parallel fibers release excitatory amino acid neurotransmitters, which stimulate Purkinje cells and cause GABA release in the deep cerebellar nuclei. Climbing fibers also exert tonic inhibition over Purkinje cell activity by producing an absolute refractory period following stimulation, rendering Purkinje cells unresponsive to parallel fibers. Climbing fiber deafferentation by bilateral inferior olive lesions produced a specific decrease in threshold for strychnine-seizures in the rat. Inferior olive lesions produced no change in threshold to seizures induced by picrotoxin, bicuculline or pentylenetetrazole. Inferior olive lesions also produced abnormal motor behavior including, myoclonus, backward locomotion and hyperextension, which was significantly aggravated by strychnine, brucine, picrotoxin, bicuculline and pentylenetetrazole. Inferior olive lesions produced a significant increase in quisqualate sensitive ({sup 3}H)AMPA ((Rs)-alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid) binding to cerebellar membranes. AMPA is a glutamate analog with high affinity for quisqualate sensitive receptors.

  20. Inferior ST-Elevation Acute Myocardial Infarction or an Inferior-Lead Brugada-like Electrocardiogram Pattern Associated With the Use of Pregabalin and Quetiapine?

    Science.gov (United States)

    Brunetti, Natale D; Ieva, Riccardo; Correale, Michele; Cuculo, Andrea; Santoro, Francesco; Guaricci, Andrea I; De Gennaro, Luisa; Gaglione, Antonio; Di Biase, Matteo

    2016-01-01

    The Brugada electrocardiogram pattern is characterized by coved-type ST-elevation (>2 mm) in the right precordial leads. We report the case of a 62-year-old man, with bipolar disorder, admitted to the emergency department because of dyspnea and chest discomfort. The patient was on treatment with pregabalin and quetiapine. Unexpectedly, electrocardiogram at admission showed diffuse ST-elevation, more evident in inferior leads, where a Brugada-like pattern was present. The patient underwent coronary angiography with a diagnosis of suspected acute coronary syndrome. Coronary angiography, however, showed mild coronary artery disease not requiring coronary angioplasty. Echocardiography did not reveal left ventricular dysfunction or pericardial effusion. Troponin levels remained normal over serial controls. Eventually, chest radiography showed lung opacities and consolidation suggestive for pneumonia. To the best of our knowledge, this is one of the first cases showing a transient Brugada-like electrocardiogram pattern in inferior leads, probably amplified by the administration of pregabalin and quetiapine.

  1. A case of atherosclerotic inferior mesenteric artery aneurysm secondary to high flow state.

    Science.gov (United States)

    Troisi, Nicola; Esposito, Giovanni; Cefalì, Pietro; Setti, Marco

    2011-07-01

    Inferior mesenteric artery aneurysms are very rare and they are among the rarest of visceral artery aneurysms. Sometimes, the distribution of the blood flow due to chronic atherosclerotic occlusion of some arteries can establish an increased flow into a particular supplying district (high flow state). A high flow state in a stenotic inferior mesenteric artery in compensation for a mesenteric occlusive disease can produce a rare form of aneurysm. We report the case of an atherosclerotic inferior mesenteric aneurysm secondary to high flow state (association with occlusion of the celiac trunk and severe stenosis of the superior mesenteric artery), treated by open surgical approach. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  2. Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: Case report

    Directory of Open Access Journals (Sweden)

    Ferrón JA

    2010-06-01

    Full Text Available Abstract Background Visceral artery aneurysms (VAA, although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA and celiac trunk, successfully treated with surgery. Methods A 65-year-old man presented with abdominal pain and hypovolemic shock. Abdominal CT scan showed an aneurysm of the inferior mesenteric artery with retroperitoneal hematoma. In addition, an obstructive disease of the superior mesenteric artery and celiac axis was observed. Results Upon emergency laparotomy a ruptured inferior mesenteric artery aneurysm was detected. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis. Conclusions This report discusses the etiology, presentation, diagnosis and case management of inferior mesenteric artery aneurysms.

  3. Estratégias em reconstrução do lábio inferior

    OpenAIRE

    Siqueira, Evandro José; Alvarez, Gustavo Steffen; Laitano, Francisco Felipe; Martins, Pedro Djacir Escobar; Oliveira, Milton Paulo de

    2012-01-01

    INTRODUÇÃO: Os lábios superiores e inferiores representam as estruturas anatômicas funcionais e estéticas mais importantes do segmento inferior da face. Além disso, possuem funções complexas, sendo a reconstrução de defeitos labiais um desafio ao cirurgião plástico. MÉTODO: Trinta pacientes apresentando defeitos de espessura total do lábio inferior foram submetidos a reconstrução do lábio baseada na extensão dos defeitos após exérese tumoral. RESULTADOS: Seis (20%) pacientes apresentavam lesõ...

  4. TVT-O vs. TVT for the treatment of SUI: a non-inferiority study.

    Science.gov (United States)

    Yang, Xiang; Jiang, Min; Chen, Xinliang; Tong, Xiaowen; Li, Huaifang; Qiu, Jin; Shao, Lingyun

    2012-01-01

    This study aimed to prospectively compare, in terms of efficacy and safety, the tension-free vaginal tape (TVT) and the transobturator vaginal tape inside-out (TVT-O) procedure for stress urinary incontinence. A cough stress test was applied to the objective outcomes, while urinary incontinence-specific quality of life questionnaire was applied to the subjective outcomes. A test for non-inferiority was carried out for detecting the success rate between the two groups. The objective success rates were found to be 95.4% (62/65) in the TVT group and 96.4% (108/112) in the TVT-O group. No significant difference was found between these two groups in the success rate by non-inferiority test (P 0.05). In the study, the TVT-O procedure could be defined to be identical to the TVT approach in success rate by non-inferiority test.

  5. In-vivo measurements of force and humeral movement during inferior glenohumeral mobilizations.

    Science.gov (United States)

    Witt, Dexter W; Talbott, Nancy R

    2016-02-01

    Inferior joint mobilization has been proposed as an assessment technique and an intervention for individuals with shoulder dysfunctions. While such techniques are common, few quantitative in vivo measures of manual movement of the humeral head have been reported. The purpose of this study was to measure in vivo inferior translational movements occurring in the glenohumeral joint during manual mobilization techniques and to determine the intratester reliability of those inferior translational movements. Cross sectional reliability study. Twenty three healthy volunteers participated. Subjects were positioned supine with the shoulder in 55 degrees of abduction and 30 degrees of horizontal adduction. Visualizing the humeral head and the acromion, ultrasound images of the superior aspect of the glenohumeral joint were taken with the arm at rest and as an examiner applied a grade 1, a grade 2 and a grade 3 inferior mobilization. This process was repeated three times on each shoulder. Humeral head position was measured in reference to the superior aspect of the acromion and the amount of inferior movement determined by the distance the humeral head moved from the rest position. The mean differences between the rest position and a grade 1, a grade 2 and a grade 3 mobilization were 0.96 mm, 2.44 mm and 3.64 mm respectively. Intraclass correlation coefficients (ICC) for movements were moderate for grade one (ICC = 0.681) and good for grade 2 (0.889) and grade 3(0.898). Results support the ability of one examiner to reliably reproduce three different grades of inferior mobilization. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Inferior oblique weakening surgery on ocular torsion in congenital superior oblique palsy

    Directory of Open Access Journals (Sweden)

    Jinho Lee

    2015-06-01

    Full Text Available AIM:To investigate changes in fundus excyclotorsion after inferior oblique myectomy or myotomy.METHODS:The records of 21 patients undergoing strabismus surgery by a single surgeon between 2009 and 2012 were examined. Only patients who had undergone an inferior oblique myectomy or myotomy, with or without horizontal rectus muscle surgery, were evaluated. Digital fundus photographs were obtained, and the angle formed by a horizontal line passing through the optic disc center and a reference line connecting the foveola and optic disc center was measured. Associated clinical factors examined include age at the time of surgery, presence or absence of a head tilt, degree of preoperative vertical deviation, torsional angle, inferior oblique muscle overaction/superior oblique muscle underaction, and surgery laterality. Whether the procedure was performed alone or in combination with a horizontal rectus muscle surgery was also examined.RESULTS:Mean preoperative torsional angle was 12.0±6.4°, which decreased to 6.9±5.7° after surgery (P<0.001, paired t-test. Torsional angle also decreased from 15.1±7.0° to 6.2±4.3° in the myectomy group (P<0.001, paired t-test but there were no significant changes in the myotomy group (P=0.093, Wilcoxon signed rank test. Multivariable linear regression analysis showed that preoperative torsional angle, degree of inferior oblique overaction, and age at surgery independently and significantly affected postoperative torsional angle.CONCLUSION:Mean torsional angle decreased after inferior oblique myectomy. Degree of preoperative torsional angle, inferior oblique overaction, and age at surgery influence postoperative torsional angle.

  7. Connexin 43 contributes to ectopic orofacial pain following inferior alveolar nerve injury.

    Science.gov (United States)

    Kaji, Kaori; Shinoda, Masamichi; Honda, Kuniya; Unno, Syumpei; Shimizu, Noriyoshi; Iwata, Koichi

    2016-01-01

    Clinically, it is well known that injury of mandibular nerve fiber induces persistent ectopic pain which can spread to a wide area of the orofacial region innervated by the uninjured trigeminal nerve branches. However, the exact mechanism of such persistent ectopic orofacial pain is not still known. The present study was undertaken to determine the role of connexin 43 in the trigeminal ganglion on mechanical hypersensitivity in rat whisker pad skin induced by inferior alveolar nerve injury. Here, we examined changes in orofacial mechanical sensitivity following inferior alveolar nerve injury. Furthermore, changes in connexin 43 expression in the trigeminal ganglion and its localization in the trigeminal ganglion were also examined. In addition, we investigated the functional significance of connexin 43 in relation to mechanical allodynia by using a selective gap junction blocker (Gap27). Long-lasting mechanical allodynia in the whisker pad skin and the upper eyelid skin, and activation of satellite glial cells in the trigeminal ganglion, were induced after inferior alveolar nerve injury. Connexin 43 was expressed in the activated satellite glial cells encircling trigeminal ganglion neurons innervating the whisker pad skin, and the connexin 43 protein expression was significantly increased after inferior alveolar nerve injury. Administration of Gap27 in the trigeminal ganglion significantly reduced satellite glial cell activation and mechanical hypersensitivity in the whisker pad skin. Moreover, the marked activation of satellite glial cells encircling trigeminal ganglion neurons innervating the whisker pad skin following inferior alveolar nerve injury implies that the satellite glial cell activation exerts a major influence on the excitability of nociceptive trigeminal ganglion neurons. These findings indicate that the propagation of satellite glial cell activation throughout the trigeminal ganglion via gap junctions, which are composed of connexin 43, plays a

  8. Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass

    Directory of Open Access Journals (Sweden)

    Christian Steinberg

    2013-01-01

    Full Text Available Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

  9. Appendicular abscess as an unprecedented cause of an inferior lumbar hernia.

    Science.gov (United States)

    Ali, S M; Subramaniam, S

    2017-02-01

    Inferior lumbar hernias are uncommon hernias resulting from a defect in the abdominal wall. They can occur during infancy (congenital defect), albeit less frequently, or spontaneously after trauma or surgery with a lumbar incision. With fewer than 300 cases reported over the past 3 centuries, clinical diagnosis is often confusing owing to non-specific symptoms, relating to the gastrointestinal, genitourinary or musculoskeletal systems. We present a case of an inferior lumbar hernia following spontaneous rupture of a retrocaecally tracked appendicular abscess and a brief literature review.

  10. Reconstrucción de extremidades inferiores con colgajo sural diferido

    OpenAIRE

    Victor Huiman Lazo; Alberto Bardales Lasteros; Dante Arce Chirinos; Jesús Iriarte Blas

    2004-01-01

    Objetivo: Evaluar la viabilidad del colgajo sural, en lesiones de extremidades inferiores que comprometen la zona de su pedículo vascular utilizando la técnica quirúrgica de transposición diferida o de retardo. Materiales y Métodos: Se estudiaron 08 pacientes sometidos a cirugía reconstructiva con colgajo sural diferido por lesiones en tercio distal de extremidades inferiores que comprometían la zona de su pedículo vascular, desde junio 2001 a mayo 2003, en el Servicio de Cirugía Plástica del...

  11. Calidad de vida en pacientes con amputación de extremidad inferior

    National Research Council Canada - National Science Library

    Muniesa, J.M; Pou, M; Marco, E; Boza, R; Guillén, A; Duarte, E; Escalada, F; Belmonte, R; Tejero, M

    2009-01-01

    ... o que pongan en peligro la vida del individuo 2 . En este contexto es evidente que la amputación de una extremidad inferior, cualquiera que sea su causa, comporta una fuerte repercusión en aspectos físicos, funcionales y emocionales pues afecta la calidad de vida de la persona amputada 3–6 . Sin embargo, éste es uno de los aspectos menos estudiados en la bibliografía que hace referencia a los pacientes afectos de amputación de extremidad inferior ya que la mayoría de los trabajos se han centrado en el estudio ...

  12. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    OpenAIRE

    Yang, Catherine; Trad, Henrique Simão; Mendonça, Silvana Machado; Trad, Clovis Simão

    2013-01-01

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return fro...

  13. Penetracion del hipoclorito de sodio al comparar cuatro sistemas rotatorios de preparacion en conductos mesovestibulares de molares inferiores

    National Research Council Canada - National Science Library

    Covo Morales, Eduardo Enrique; Simancas Pallares, Miguel Angel; Ruiz Llorente, Angela Maria

    2015-01-01

    Objetivo: Comparar la diferencia de longitud de penetracion del hipoclorito de sodio al emplear cuatro sistemas rotatorios de preparacion en conductos mesovestibulares de molares inferiores. Metodos...

  14. Nuevos datos sobre la fauna del Cámbrico Inferior (Marianense) de Llerena (Badajoz)

    OpenAIRE

    Gil Cid, María Dolores

    1988-01-01

    Se dan nuevos datos sobre los invertebrados fósiles encontrados en el río Viar (Badajoz) de edad Cámbrico Inferior (Mananense), dándose una relación de fauna que consiste en: Trilobites (Serrodiscus, Termierella, Aldonaia, Saukianda e Hicksia), Celentéreos (Scenella), Braquiópodos (inarticulados indet.) y Moluscos (Hyolitha).

  15. Aberrant network integrity of the inferior frontal cortex in women with anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Stephanie Kullmann

    2014-01-01

    These results suggest that AN patients have reduced connectivity within the cognitive control system of the brain and increased connectivity within regions important for salience processing. Due to its fundamental role in inhibitory behavior, including motor response, altered integrity of the inferior frontal cortex could contribute to hyperactivity in AN.

  16. Diffusion tensor imaging of the inferior colliculus and brainstem auditory-evoked potentials in preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Reiman, Milla; Lehtonen, Liisa; Lapinleimu, Helena [Turku University Central Hospital, Department of Paediatrics, Turku (Finland); Parkkola, Riitta [Turku University Central Hospital, Department of Radiology and Turku PET Centre, Turku (Finland); Johansson, Reijo [Turku University Central Hospital, Department of Otorhinolaryngology, Turku (Finland); Jaeaeskelaeinen, Satu K. [Turku University Central Hospital, Department of Clinical Neurophysiology, Turku (Finland); Kujari, Harry [Turku University Central Hospital, Department of Pathology, Turku (Finland); Haataja, Leena [Turku University Central Hospital, Department of Paediatric Neurology, Turku (Finland)

    2009-08-15

    Preterm and low-birth-weight infants have an increased risk of sensorineural hearing loss. Brainstem auditory-evoked potentials (BAEP) are an effective method to detect subtle deficits in impulse conduction in the auditory pathway. Abnormalities on diffusion tensor imaging (DTI) have been shown to be associated with perinatal white-matter injury and reduced fractional anisotropy (FA) has been reported in patients with sensorineural hearing loss. To evaluate the possibility of a correlation between BAEP and DTI of the inferior colliculus in preterm infants. DTI at term age and BAEP measurements were performed on all very-low-birth-weight or very preterm study infants (n=56). FA and apparent diffusion coefficient (ADC) of the inferior colliculus were measured from the DTI. Shorter BAEP wave I, III, and V latencies and I-III and I-V intervals and higher wave V amplitude correlated with higher FA of the inferior colliculus. The association between the DTI findings of the inferior colliculus and BAEP responses suggests that DTI can be used to assess the integrity of the auditory pathway in preterm infants. (orig.)

  17. Patella fracture in a boy with bilateral inferior pole bipartite patellae.

    Science.gov (United States)

    Peek, A C; Barry, M

    2012-10-01

    We present the case of a 12 year old boy who had bilateral inferior pole fragment (Saupe type 1) bipartite patellae, and who sustained a traumatic separation through the right patella while playing basket ball, the left remaining asymptomatic. We have reviewed and discussed the previously published literature and case reports. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

  18. Providing initial transthoracic echocardiography training for anesthesiologists: simulator training is not inferior to live training.

    Science.gov (United States)

    Edrich, Thomas; Seethala, Raghu R; Olenchock, Benjamin A; Mizuguchi, Annette K; Rivero, Jose M; Beutler, Sascha S; Fox, John A; Liu, Xiaoxia; Frendl, Gyorgy

    2014-02-01

    Transthoracic echocardiography (TTE) is finding increased use in anesthesia and critical care. Efficient options for training anesthesiologists should be explored. Simulator mannequins allow for training of manual acquisition and image recognition skills and may be suitable due to ease of scheduling. The authors tested the hypothesis that training with a simulator would not be inferior to training using a live volunteer. Prospective, randomized trial. University hospital. Forty-six anesthesia residents, fellows, and faculty. After preparation with a written and video tutorial, study subjects received 80 minutes of TTE training using either a simulator or live volunteer. Practical and written tests were completed before and after training to assess improvement in manual image acquisition skills and theoretic knowledge. The written test was repeated 4 weeks later. Performance in the practical image-acquisition test improved significantly after training using both the live volunteer and the simulator, improving by 4.0 and 4.3 points out of 15, respectively. Simulator training was found not to be inferior to live training, with a mean difference of -0.30 points and 95% confidence intervals that did not cross the predefined non-inferiority margin. Performance in the written retention test also improved significantly immediately after training for both groups but declined similarly upon repeat testing 4 weeks later. When providing initial TTE training to anesthesiologists, training using a simulator was not inferior to using live volunteers. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. The inferior frontal cortex in artificial syntax processing: An rTMS study

    NARCIS (Netherlands)

    Udden, J.; Folia, V.; Forkstam, C.H.; Ingvar, M.; Fernandez, G.S.E.; Overeem, S.; Elswijk, G.A.F. van; Hagoort, P.; Petersson, K.M.

    2008-01-01

    The human capacity to implicitly acquire knowledge of structured sequences has recently been investigated in artificial grammar learning using functional magnetic resonance imaging. It was found that the left inferior frontal cortex (IFC; Brodmann's area (BA) 44/45) was related to classification

  20. The inferior frontal cortex in artificial syntax processing : an rTMS study

    NARCIS (Netherlands)

    Udden, J.; Folia, V.; Forkstam, C.; Ingvar, M.; Fernandez, G.S.E.; Overeem, S.; Elswijk, G. van; Hagoort, P.; Petersson, K.M.

    2008-01-01

    The human capacity to implicitly acquire knowledge of structured sequences has recently been investigated in artificial grammar learning using functional magnetic resonance imaging. It was found that the left inferior frontal cortex (IFC; Brodmann's area (BA) 44/45) was related to classification

  1. The right posterior inferior frontal gyrus contributes to phonological word decisions in the healthy brain

    DEFF Research Database (Denmark)

    Hartwigsen, Gesa; Price, Cathy J; Baumgaertner, Annette

    2010-01-01

    There is consensus that the left hemisphere plays a dominant role in language processing, but functional imaging studies have shown that the right as well as the left posterior inferior frontal gyri (pIFG) are activated when healthy right-handed individuals make phonological word decisions. Here we...

  2. Leiomyosarcoma of the right inferior pulmonary vein: 2 years survival with multimodality therapy.

    Science.gov (United States)

    Galeone, Antonella; Validire, Pierre; Debrosse, Denis; Folliguet, Thierry; Laborde, François

    2013-09-01

    Primary leiomyosarcoma of the heart is an extremely rare and aggressive tumor. The authors report a case of a 29-year-old man with a leiomyosarcoma of the right inferior pulmonary vein who underwent surgery, chemotherapy, and radiotherapy. The patient experienced two local recurrences and he finally died 2 years after onset of symptoms because of multiple distal metastases.

  3. Evaluation of macular thickness change after inferior oblique muscle recession surgery

    Directory of Open Access Journals (Sweden)

    Ece Turan-Vural

    2014-01-01

    Full Text Available Purpose: This study aimed to evaluate the changes in macular thickness following inferior oblique muscle recession surgery. Materials and Methods: Thirty-eight eyes from 21 patients undergoing ocular muscle surgery were included. Patients were grouped into three groups based on the type of surgical intervention: Group I (n = 12, inferior oblique recession surgery alone; Group II (n = 12, inferior oblique plus horizontal muscle surgery; Group III (n = 14, horizontal muscle surgery alone. Each eye was scanned using the optical coherence tomography (OCT device preoperatively and on the first postoperative day to measure macular thickness. Results: Following surgery, a significant increase in foveal thickness occurred in Group I (P < 0.05 and Group II (P < 0.01. In addition, a statistically significant difference was observed between the groups with regard to the increase in foveal thickness (P = 0.016, with significantly lower changes in Group III. Conclusion: Our findings suggested that inferior oblique muscle recession surgery is associated with an increase in macular thickness.

  4. Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-01-01

    The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use.

  5. Sex segregation and equality in a multicultural society: inferiority as a standard for legal acceptability

    NARCIS (Netherlands)

    Brink, Marjolein van den; Loenen, T.; Tigchelaar, Jet

    2010-01-01

    This contribution explores the legal acceptability of old and new forms of sex segregation, using a multilayered ‘inferiority test’ that can be regarded as a specification of (inter)national equality and non-discrimination standards. The test is applied to a number of topical cases of sex

  6. Sex segregation and equality in a multicultural society: inferiority as a standard for legal acceptability

    Directory of Open Access Journals (Sweden)

    Marjolein van den Brink

    2010-06-01

    Full Text Available This contribution explores the legal acceptability of old and new forms of sex segregation, using a multilayered ‘inferiority test’ that can be regarded as a specification of (international equality and non-discrimination standards. The test is applied to a number of topical cases of sex segregation: 1 A traditional case of rather uncontested sex segregation in sports, specifically in amateur football; 2 A more controversial case that seems to be on the rise once again: sex-segregated education; 3 The highly controversial case of sex-segregated integration courses in the Netherlands. The outcome shows that each sex-segregated practice is problematic in the light of one or more criteria of this inferiority test, but not necessarily the same criteria. Specific attention is paid to the merits of the test in a multicultural context. The inferiority test is a useful tool in dealing with multicultural complexity, although not in every respect. It allows the impact of sex segregation on minority women to be taken into account, as well as cultural and religious reasons which women may have in demanding sex-segregation facilities, unless this will result in perpetuating their or other women’s subordination. Our findings suggest that the inferiority test is quite useful as an analytical tool to assess contested practices of sex segregation. However, the multilayered character of the test needs some fine-tuning when the various elements of the test lead to different conclusions.

  7. Application of augmented reality for inferior alveolar nerve block anesthesia: A technical note.

    Science.gov (United States)

    Won, Yu-Jin; Kang, Sang-Hoon

    2017-06-01

    Efforts to apply augmented reality (AR) technology in the medical field include the introduction of AR techniques into dental practice. The present report introduces a simple method of applying AR during an inferior alveolar nerve block, a procedure commonly performed in dental clinics.

  8. HISTOLOGICAL STUDIES OF THE EFFECTS OF MONOSODIUM GLUTAMATE ON THE INFERIOR COLLICULUS OF ADULT WISTAR RATS.

    Directory of Open Access Journals (Sweden)

    A.O. Eweka.

    2008-01-01

    Full Text Available Histological effects of Monosodium glutamate (MSG commonly used as food additive on the inferior colliculus (IC of adult Wistar rats were carefully studied. The rats of both sexes (n=24, average weight of 185g were randomly assigned into two treatments (n=16 and control (n=8 groups. The rats in the treatment groups received 3g and 6g of MSG thoroughly mixed with their feeds for fourteen days, while the control rats received equal amounts of feeds without MSG added. The rats were fed with growers' mash purchased from Edo Feeds and Flour Mill Ltd, Ewu, Edo State and were given water liberally. The rats were sacrificed on day fifteen of the experiment. The inferior colliculus was carefully dissected out and quickly fixed in 10% formal saline for routine histological study after H&E method.The histological findings after H&E methods indicated that the treated sections of the inferior colliculus showed some cellular degenerative changes, cellular hypertrophy, and autophagic vacuoles with some intercellular vacuolations appearing in the stroma, and some degree of neuronal hypertrophy when compared to the control sections.These findings indicate that MSG consumption may have a deleterious effect on the neurons of the inferior colliculus (IC. MSG may probably have adverse effects on the auditory sensibilities by its deleterious effects on the nerve cells of the IC of adult Wistar rats. It is recommended that further studies aimed at corroborating these observations be carried out.

  9. Inferior Frontal Gyrus Activity Triggers Anterior Insula Response to Emotional Facial Expressions

    NARCIS (Netherlands)

    Jabbi, Mbemba; Keysers, Christian

    2008-01-01

    The observation of movies of facial expressions of others has been shown to recruit similar areas involved in experiencing one's own emotions: the inferior frontal gyrus (IFG). the anterior insula and adjacent frontal operculum (IFO). The Causal link bet between activity in these 2 regions,

  10. Attention, Emotion, and Deactivation of Default Activity in Inferior Medial Prefrontal Cortex

    Science.gov (United States)

    Geday, Jacob; Gjedde, Albert

    2009-01-01

    Attention deactivates the inferior medial prefrontal cortex (IMPC), but it is uncertain if emotions can attenuate this deactivation. To test the extent to which common emotions interfere with attention, we measured changes of a blood flow index of brain activity in key areas of the IMPC with positron emission tomography (PET) of labeled water…

  11. Laser-activated solder weld repair of the inferior alveolar nerve in rats

    Science.gov (United States)

    Curtis, Nigel J.; Lauto, Antonio; Trickett, Rodney I.; Owen, Earl R.; Walker, D. M.

    1997-05-01

    A new laser activated solder weld technique is described for the microsurgical repair of the inferior alveolar nerve in rats. The laser weld technique used an albumin based solder, containing indocyanine cardiogreen, plus an infrared diode laser. Seven animals had inferior alveolar nerve repairs performed using the laser weld technique and these were compared against corresponding unoperated controls plus three cases of nerve section without repair. Histochemical analysis was performed utilizing neuron counts and horseradish peroxidase tracer (HRP) uptake in the trigeminal ganglion following sacrifice and staining of frozen sections with cresyl violet and diaminobenzidene. The results of this analysis showed comparable mean neuron counts and mean HRP uptake by neurons for the unoperated control and laser weld groups with considerable reduction of mean values in cases of nerve section with no repair. Sections of the repaired inferior alveolar nerves, stained with Masson's trichrome, showed no adverse reactions by axons or epineurium to the coagulative repair with the solder and demonstrated regeneration of myelinated axons at the time of sacrifice. In summary a new technique of laser weld repair of the inferior alveolar nerve is described which, on initial analysis, appears to be a reliable alternative to traditional techniques.

  12. Age-Related Increase in Inferior Frontal Gyrus Activity and Social Functioning in Autism Spectrum Disorder

    NARCIS (Netherlands)

    Bastiaansen, Jojanneke A.; Thioux, Marc; Nanetti, Luca; van der Gaag, Christiaan; Ketelaars, Cees; Minderaa, Ruud; Keysers, Christian

    2011-01-01

    Background: Hypoactivation of the inferior frontal gyrus during the perception of facial expressions has been interpreted as evidence for a deficit of the mirror neuron system in children with autism. We examined whether this dysfunction persists in adulthood, and how brain activity in the mirror

  13. The contribution of the inferior parietal cortex to spoken language production

    NARCIS (Netherlands)

    Geranmayeh, F.; Brownsett, S.L.; Leech, R.; Beckmann, Christian; Woodhead, Z.; Wise, R.J.

    2012-01-01

    This functional MRI study investigated the involvement of the left inferior parietal cortex (IPC) in spoken language production (Speech). Its role has been apparent in some studies but not others, and is not convincingly supported by clinical studies as they rarely include cases with lesions

  14. Inferior vena cava filter removal after prolonged dwell time of 2310 days.

    Science.gov (United States)

    Shah, Ankit H; Lichliter, Andrew; Cura, Marco

    2016-07-01

    Inferior vena cava filters are commonly placed for a variety of indications, often when anticoagulation is contraindicated. Although technical success is high and complication rates low, there are complications that are important to be aware of. We present the case of a 29-year-old woman with a prolonged filter dwell time resulting in complications.

  15. "A Hidden Part of Me": Latino/a Students, Silencing, and the Epidermalization of Inferiority

    Science.gov (United States)

    Irizarry, Jason G.; Raible, John

    2014-01-01

    Using Critical Race Theory (CRT) and Latino/a Critical Race Theory (LatCrit) as analytical tools, this article examines the experiences of a seven Latino/a high school students at various points of engagement with the school-to-prison pipeline. Building on and extending Franz Fanon's (1952) concept of the epidermalization of inferiority, the…

  16. Cytoarchitectural and functional abnormalities of the inferior colliculus in sudden unexplained perinatal death.

    Science.gov (United States)

    Lavezzi, Anna M; Pusiol, Teresa; Matturri, Luigi

    2015-02-01

    The inferior colliculus is a mesencephalic structure endowed with serotonergic fibers that plays an important role in the processing of acoustic information. The implication of the neuromodulator serotonin also in the aetiology of sudden unexplained fetal and infant death syndromes and the demonstration in these pathologies of developmental alterations of the superior olivary complex (SOC), a group of pontine nuclei likewise involved in hearing, prompted us to investigate whether the inferior colliculus may somehow contribute to the pathogenetic mechanism of unexplained perinatal death. Therefore, we performed in a wide set of fetuses and infants, aged from 33 gestational weeks to 7 postnatal months and died of both known and unknown cause, an in-depth anatomopathological analysis of the brainstem, particularly of the midbrain. Peculiar neuroanatomical and functional abnormalities of the inferior colliculus, such as hypoplasia/structural disarrangement and immunonegativity or poor positivity of serotonin, were exclusively found in sudden death victims, and not in controls. In addition, these alterations were frequently related to dysgenesis of connected structures, precisely the raphé nuclei and the superior olivary complex, and to nicotine absorption in pregnancy. We propose, on the basis of these results, the involvement of the inferior colliculus in more important functions than those related to hearing, as breathing and, more extensively, all the vital activities, and then in pathological conditions underlying a sudden death in vulnerable periods of the autonomic nervous system development, particularly associated to harmful risk factors as cigarette smoking.

  17. Acute Anterior Myocardial Infarction Accompanied by Acute Inferior Myocardial Infarction: A Very Rare Coronary Artery Anomaly

    Directory of Open Access Journals (Sweden)

    Y. Alsancak

    2015-01-01

    Full Text Available Coronary artery anomalies are rare and mostly silent in clinical practice. First manifestation of this congenital abnormality can be devastating as syncope, acute coronary syndrome, and sudden cardiac death. Herein we report a case with coronary artery anomaly complicated with ST segment myocardial infarction in both inferior and anterior walls simultaneously diagnosed during primary percutaneous coronary intervention.

  18. Moyamoya disease associated with an anterior inferior cerebellar artery arising from a persistent trigeminal artery

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, A.; Sawada, A.; Takase, Y.; Kudo, S. [Department of Radiology, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501 (Japan); Koizumi, T. [Department of Neurosurgery, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501 (Japan)

    2002-07-01

    The authors present a case of moyamoya disease associated with a persistent trigeminal artery from which the anterior inferior cerebellar artery arose. We reviewed previously reported cases of moyamoya disease associated with persistent carotid-basilar arterial anastomosis and investigated the embryology of this rare arterial variation. (orig.)

  19. The Premise of Black Inferiority: An Enduring Obstacle Fifty Years Post-"Brown"

    Science.gov (United States)

    O'Connor, Carla

    2006-01-01

    Gloria Ladson-Billings explains in her chapter that, in part, the promise of "Brown v. Board of Education" has not been realized because it was premised on black inferiority. She elaborates that "instead of addressing the underlying pathology of the defendant--White supremacy"--the evidence, case, and accordant ruling…

  20. Transfusion policy after severe postpartum haemorrhage: a randomised non-inferiority trial

    NARCIS (Netherlands)

    Prick, B. W.; Jansen, A. J. G.; Steegers, E. A. P.; Hop, W. C. J.; Essink-Bot, M. L.; Uyl-de Groot, C. A.; Akerboom, B. M. C.; van Alphen, M.; Bloemenkamp, K. W. M.; Boers, K. E.; Bremer, H. A.; Kwee, A.; van Loon, A. J.; Metz, G. C. H.; Papatsonis, D. N. M.; van der Post, J. A. M.; Porath, M. M.; Rijnders, R. J. P.; Roumen, F. J. M. E.; Scheepers, H. C. J.; Schippers, D. H.; Schuitemaker, N. W. E.; Stigter, R. H.; Woiski, M. D.; Mol, B. W. J.; van Rhenen, D. J.; Duvekot, J. J.

    2014-01-01

    To assess the effect of red blood cell (RBC) transfusion on quality of life in acutely anaemic women after postpartum haemorrhage. Randomised non-inferiority trial. Thirty-seven Dutch university and general hospitals. Women with acute anaemia (haemoglobin 4.8-7.9 g/dl [3.0-4.9 mmol/l] 12-24 hours

  1. Drenagem anômala de veia pulmonar inferior direita em veia cava inferior associada a apêndice hepático intracardíaco Anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to intrathoracic hepatic appendix

    Directory of Open Access Journals (Sweden)

    Carlos R Moraes

    1988-08-01

    Full Text Available Descreve-se o caso de uma paciente de 61 anos de idade, com drenagem anômala de veia pulmonar inferior direita em veia cava inferior, associada a apêndice hepático intratorácico, herniado através de fenda no diafragma. A correção cirúrgica foi realizada por anastomose direta da veia anômala com o átrio esquerdo, pela redução do apêndice hepático para a cavidade abdominal e, finalmente, pelo fechamento do defeito diafragmático. O pós-operatório decorreu sem qualquer complicação. Os autores chamam a atenção para a raridade do caso.The authors present a case of a 61-year-old woman with anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to an intrathoracic hepatic appendix herniated through a diaphragmatic defect. Surgical correction was obtained by direct anastomosis of the anomalous vein to the left atrium, reduction of the hepatic appendix to the abdominal cavity and closure of the diphragmatic defect. The postoperative course was unevenftul. The rarity of this condition is stressed.

  2. Cellular mechanisms of auditory processing in the inferior colliculus: An in vivo patch clamp study

    NARCIS (Netherlands)

    M.L. Tan

    2009-01-01

    textabstractIn this thesis, different aspects of central auditory processing in the inferior colliculus (IC) of young-adult mice and rats are described. With the “in vivo patch-clamp” technique we investigated the contribution of membrane properties and synaptic integration of excitatory and

  3. Combined anterior and inferior ST segment elevation during the exercise stress testing.

    Science.gov (United States)

    Aygul, Nazif; Ozdemir, Kurtulus; Aydin, Meryem Ulku; Duzenli, Mehmet Akif

    2008-11-28

    Exercise induced ST elevation, especially in anterior derivations, does localize the ischemic region. We describe a patient who presented with exercise induced ST elevation in both anterior and inferior leads without prior myocardial infarction. Coronary angiography showed a "wrap around LAD" with significant proximal lesion.

  4. Is 2 mm a safe distance from the inferior alveolar canal to avoid ...

    African Journals Online (AJOL)

    2015-10-30

    Oct 30, 2015 ... related to implants inserted closer than 2 mm to the inferior alveolar canal (IAC) with those inserted further than 2 ... regarding implant proximity to the IAC (Group 1, distance ≤2 mm, Group 2, distance >2 mm). Postoperative .... such injury occurs, a complete healing is difficult if the extent of the injury is not ...

  5. VALIDACIÓN DE LA RADIOGRAFÍA PANORÁMICA EN LA DETERMINACIÓN DE LA POSICIÓN DEL TERCER MOLAR INFERIOR RESPECTO AL CONDUCTO DENTARIO INFERIOR EN CRÁNEOS DE ADULTOS. AREQUIPA.2013

    OpenAIRE

    OCOLA TICONA, BERLIE CESAR

    2014-01-01

    RADIOGRAFÍA PANORÁMICA HISTORIA Y EVOLUCIÓN FUNDAMENTOS DE LA RADIOGRAFÍA PANORÁMICA TERCEROS MOLARES CRITERIOS GENERALES CASUÍSTICA ETIOLOGÍA ETIOPATOGENIA CONDICIONES ANATÓMICAS DIAGNOSTICO CLASIFICACIÓN DE LAS IMPACTACIONES DEL TERCER MOLAR RELACIÓN DEL TERCER MOLAR INFERIOR CON EL CONDUCTO DENTARIO INFERIOR FORMAS DE PREVENCIÓN

  6. Tiempo máximo aceptable de trabajo para tareas ejecutadas con miembros superiores e inferiores

    Directory of Open Access Journals (Sweden)

    Juan C. Velásquez V.

    2015-12-01

    Full Text Available Introducción: La carga física de trabajo es uno de los principales factores de riesgo a los que se enfrentan los trabajadores. En la actualidad los métodos propuestos para evaluar la carga física dinámica contemplan el trabajo con todo el cuerpo y no discriminan por segmentos corporales. Objetivo: Determinar el tiempo máximo aceptable de trabajo cuando el trabajo se ejecuta con todo el cuerpo, con los miembros superiores o los miembros inferiores. Métodos: Se realizó medición de consumo de oxígeno mediante ergoespirometria y monitorización de la frecuencia cardiaca en 30 trabajadores expuestos a diversas cargas ejecutadas con todo el cuerpo, miembros inferiores y miembros superiores. Se determinó el umbral anaeróbico por coeficiente respiratorio, el cual sirvió de base para de determinación del tiempo máximo aceptable de trabajo. Resultados: Los tiempos máximos aceptables de trabajo fueron similares para tareas con todo el cuerpo y con miembros inferiores, pero significativamente menores para tareas realizadas con miembros superiores. Se halló un modelo de correlación exponencial negativo entre en tiempo de trabajo, el consumo de oxígeno, y la frecuencia cardiaca, R > 0,9 en todos los casos. Se plantearon 9 ecuaciones de regresión para determinar el tiempo máximo aceptable de trabajo. Conclusiones: El tiempo máximo aceptable de trabajo para miembros inferiores y para todo el cuerpo se comportan de manera similar. El tiempo máximo aceptables de trabajo con miembros superiores es significativamente inferior a los anteriores. La frecuencia cardiaca relativa parece ser el mejor indicador para medir el tiempo máximo aceptables de trabajo en campo.

  7. Value of the left inferior thyroid artery peak systolic velocity in diagnosing autoimmune thyroid disease.

    Science.gov (United States)

    Banaka, Ioanna; Thomas, Dimitrios; Kaltsas, Gregory

    2013-11-01

    The purpose of this study was to calculate a number of thyroid grayscale and Doppler sonographic parameters in healthy individuals and patients with Hashimoto thyroiditis or Graves disease and assess their sensitivity and specificity for the diagnosis of autoimmune thyroid disease using receiver operating characteristic curves. A consecutive series of 153 patients (70 euthyroid and 54 hypothyroid patients with Hashimoto thyroiditis and 29 patients with Graves disease), all selected from an outpatient endocrine clinic, and 48 age- and sex-matched healthy control participants were evaluated with grayscale and power Doppler sonography. An irregular echo pattern in the thyroid parenchyma had 92.8% sensitivity for the diagnosis of autoimmune thyroid disease, and a left inferior thyroid artery peak systolic velocity (PSV) greater than 26.11 cm/s had 91.7% specificity. Of 8 patients with Hashimoto thyroiditis and normal grayscale sonographic characteristics, 6 had a left inferior thyroid artery PSV greater than 26.11 cm/s. A left inferior thyroid artery PSV greater than 61.65 cm/s had 82.8% sensitivity and 86.9% specificity for differentiating Hashimoto thyroiditis from Graves disease. The left inferior thyroid artery PSV was the most accurate sonographic parameter for the diagnosis of autoimmune thyroid disease. Measurement of the inferior thyroid artery PSV could be used in patients with a normal grayscale sonographic appearance and inconclusive clinical and biochemical parameters to substantiate the diagnosis of autoimmune thyroid disease. Further studies are needed to evaluate and expand the use of this index.

  8. [Leiomyosarcoma of the inferior vena cava. Case report and literature review].

    Science.gov (United States)

    López-Ruiz, José Antonio; Tallón-Aguilar, Luis; Marenco-de la Cuadra, Beatriz; López-Pérez, José; Oliva-Mompeán, Fernando; Padillo-Ruiz, Javier

    Large vessel sarcomas are rare tumours. Leiomyosarcoma of the inferior vena cava is the most common. About 300 cases have been reported in the literature. They tend to be large, and not develop metastasis. The prognosis of these tumours is poor. An 81 year-old woman who complained of pain in the right flank, with no other symptoms. Abdominal computed tomography showed a large retroperitoneal mass, which affected the inferior vena cava, with signs of thrombosis inside. It also encompassed the right renal vein and the right kidney. Excision of the tumour was performed in block, performing an autologous saphenous vein bypass between left the renal vein and proximal segment of inferior vena cava. Leiomyosarcomas of the inferior vena cava are classified according to their relationship with adjacent structures. The clinical signs and symptoms are generally non-specific. Diagnosis is made using computed tomography or magnetic resonance imaging, and biopsy of the retroperitoneal mass. Surgery is the only treatment capable of providing prolonged survival. The surgical management is determined by: the level of involvement, the extension, and the presence or absence of collateral veins. The role of adjuvant therapy is controversial. Inferior vena cava leiomyosarcomas remain a challenge for surgeons. At present, radical resection with negative margins, offers the highest survival rate. The best results are obtained with a multidisciplinary approach by experienced teams in the management of these tumours. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  9. Aneurisma da artéria cerebelar ântero-inferior: relato de caso Aneurysm of the anterior inferior cerebellar artery: case report

    Directory of Open Access Journals (Sweden)

    Juan Oscar Alarcón Adorno

    2002-12-01

    Full Text Available Os aneurismas intracranianos do sistema vértebro-basilar representam cerca de 5 a 10% de todos os aneurismas cerebrais. Os aneurismas da artéria cerebelar ântero-inferior (AICA são considerados raros, podendo causar síndrome do ângulo ponto cerebelar, com ou sem hemorragia subaracnóidea. Desde 1948, foram descritos poucos casos na literatura. Apresentamos o caso de uma paciente, de 33 anos, na qual, após investigação de quadro de hemorragia subaracnóidea, diagnosticou-se aneurisma sacular da AICA esquerda. Foi submetida a clipagem do aneurisma, com ótimo resultado pós operatório.The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA are considered rare, can cause cerebello pontine angle (CPA syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  10. Hombre de 75 años con edemas y sangrado digestivo inferior A 75 years old man with edema and inferior gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Alberto Carlos Reino Buelvas

    2004-02-01

    Full Text Available Se presenta el caso de un hombre de 75 años, quien consultó por edemas generalizados originados en un síndrome nefrótico, secundario a una glomerulopatía clasificada como de cambios mínimos. Se le iniciaron esteroides con mejoría de su proteinuria, pero al disminuir las dosis de éstos, recayó, por lo que requirió nueva hospitalización en la que se le documentaron trombosis venosa profunda y sangrado por tracto gastrointestinal inferior. Se le implantó un filtro de vena cava inferior y se le practicó una colonoscopia, en la que se encontró poliposis coli. Al estudio histológico se reportó un linfoma no Hodgkin compatible con un linfoma del manto (poliposis linfomatoide versus linfoma marginal tipo MALT de bajo grado. The case of a 75 year old man is presented. He consulted because of generalized edema and the diagnosis of nephrotic syndrome was done. Histologic study of a renal biopsy reported a glomerulopathy of minimal changes. Treatment with steroids improved of proteinuria, but on reducing the doses, proteinuria returned. In a second hospitalization deep venous thrombosis and gastrointestinal bleeding were diagnosed. A cava vein filter was implanted, colonoscopy was performed and Polyposis Coli was found. A non Hodgkin lymphoma compatible with MANTLE CELL lymphoma (lymphomatous polyposis vs MALT lymphoma was reported in the colonic biopsy.

  11. Inferior anchor cortical perforation with arthroscopic Bankart repair: a cadaveric study.

    Science.gov (United States)

    Lim, Tae Kang; Koh, Kyoung Hwan; Lee, Sang Hak; Shon, Min Soo; Bae, Tae Soo; Park, Won Hah; Yoo, Jae Chul

    2013-01-01

    The aims of this study were to evaluate the incidence of anchor penetration of the far cortex of the glenoid neck after arthroscopic Bankart repair and to compare the biomechanical properties of anchors in the 4- and 5:30- to 6-o'clock positions on the glenoid. Twelve (6 matched pairs) fresh-frozen human cadaveric shoulders were used to simulate arthroscopic Bankart repair in the lateral decubitus position. The most inferior anchor (5:30 to 6 o'clock) and that above it (4 o'clock) were inserted via the anteroinferior portal on the glenoid using the standard technique. After both anchor insertions, anchor perforation of the glenoid far cortex was identified. Biomechanical properties were measured to determine cyclic displacement of anchors at 100 and 500 cycles, stiffness, yield load, and ultimate failure strength. All 12 suture anchors (100%) at 5:30 to 6 o'clock penetrated throughout the far cortex, whereas only 4 anchors (33%) at 4 o'clock did so (P = .005). The mean distance the anchor tip traveled into far cortex was significantly longer at 5:30 to 6 o'clock than at 4 o'clock (6.8 ± 1.6 mm v 2.0 ± 1.6 mm, P = .001). In terms of mechanical strength, anchors at 5:30 to 6 o'clock had greater 100- and 500-cycle mean displacements than those at 4 o'clock (3.0 ± 0.5 mm v 2.5 ± 0.3 mm, P = .018 for 100 cycles; 3.5 ± 0.7 mm v 2.8 ± 0.3 mm, P = .018 for 500 cycles), although no differences in ultimate failure strength after cyclic loading were found between 2 positions (133.4 ± 40.3 and 133.7 ± 29.2 N, respectively; P = .985). For arthroscopic Bankart repair, insertion of the most inferior anchor via the anteroinferior portal with standard technique, in the lateral decubitus position, carries a high risk of perforating the inferior far cortex of the glenoid (100% in our study). This may result in mechanical weakness of the most inferior repair specifically in the early postoperative period. Perforation of the glenoid far cortex by the most inferior anchor and

  12. Subacute sclerosing panencephalitis with bilateral inferior collicular hyperintensity on magnetic resonance imaging brain

    Directory of Open Access Journals (Sweden)

    Maya Thomas

    2012-01-01

    Full Text Available Subacute sclerosing panencephalitis (SSPE is chronic encephalitis occurring after infection with measles virus. An 8-year-old boy presented with progressive behavioral changes, cognitive decline and myoclonic jerks, progressing to a bed bound state over 2 months. Magnetic resonance imaging (MRI brain showed T2-weighted hyperintensities in the subcortical areas of the left occipital lobe and brachium of the inferior colliculus on both sides. EEG showed bilateral, synchronous periodic discharges. Serum/cerebrospinal fluid measles IgG titer was significantly positive. The overall features were suggestive of SSPE. MRI finding of bilateral inferior colliculus changes on MRI without significant involvement of other commonly involved areas suggests an uncommon/rare imaging pattern of SSPE.

  13. Modified basket plate for inferior patellar pole avulsion fractures—A report of three cases

    Directory of Open Access Journals (Sweden)

    Hui-Cheng Huang

    2012-11-01

    Full Text Available In patients who have sustained an avulsion fracture of the inferior patellar pole, the extensor mechanism is disrupted and should be repaired. The normal height of the patella can be maintained by preserving the patellar pole, but fractures of the inferior pole of the patella are not easy to reduce and fix firmly. In contrast with partial patellectomy, which requires postoperative immobilization, internal fixation with a basket plate allows for immediate mobilization and early weight-bearing. Owing to the unavailability of the basket plate in Taiwan, we have modified the plate with the titanium mesh as a possible alternative. We present three cases of this modified basket plate, which took place between 2008 and 2010. This technique avoided long-term immobilization of the knee with good clinical results.

  14. Influence of electrode misplacement on the electrocardiographic signs of inferior myocardial ischemia.

    Science.gov (United States)

    Rudiger, Alain; Schöb, Lukas; Follath, Ferenc

    2003-11-01

    Electrocardiographic (ECG) artifacts resulting from misplacements of electrodes are frequent, difficult to detect, and can become of clinical importance. We investigated 2 healthy volunteers and 3 patients with ECG signs of inferior myocardial scars. We exchanged the peripheral electrodes in a defined manner and investigated the resulting ECG for morphology and possible diagnostic errors. In the volunteers, ECG signs of inferior ischemia could be produced. In the patients with ischemic heart disease, normal ECG without signs of ischemia resulted by placing the electrode of the left leg to the left arm. The automatic ECG analyzer was not helpful in detecting artifacts by misplaced electrodes. A very low amplitude of the QRS complex in lead I, II, or III was pathognomonic for electrode misplacement in half of the cases. ECG artifacts must also be suspected when abnormal QRS- or P-axis occur or when QRS morphology does not match with the clinical presentation of the patient.

  15. Memory of music: roles of right hippocampus and left inferior frontal gyrus.

    Science.gov (United States)

    Watanabe, Takamitsu; Yagishita, Sho; Kikyo, Hideyuki

    2008-01-01

    We investigated neural correlates of retrieval success for music memory using event-related functional magnetic resonance imaging. To minimize the interference from MRI scan noise, we used sparse temporal sampling technique. Newly composed music materials were employed as stimuli, which enabled us to detect regions in absence of effects of experience with the music stimuli in this study. Whole brain analyses demonstrated significant retrieval success activities in the right hippocampus, bilateral lateral temporal regions, left inferior frontal gyrus and left precuneus. Anatomically defined region-of-interests analyses showed that the activity of the right hippocampus was stronger than that of the left, while the activities of the inferior frontal gyri showed the reverse pattern. Furthermore, performance-based analyses demonstrated that the retrieval success activity of the right hippocampus was positively correlated with the corrected recognition rate, suggesting that the right hippocampus contributes to the accuracy of music retrieval outcome.

  16. Patent abdominal subcutaneous veins caused by congenital absence of the inferior vena cava: a case report

    Directory of Open Access Journals (Sweden)

    Lipp Rainer W

    2010-07-01

    Full Text Available Abstract Introduction Patent paraumbilical and abdominal subcutaneous veins are found frequently as collaterals in patients due to portal hypertension mainly in liver cirrhosis. Case presentation For evaluation of portal hypertension in a 72-year-old Caucasian man without liver cirrhosis, magnetic resonance imaging with gadolinium contrast-enhancement was performed and demonstrated a missing inferior vena cava. A blood return from the lower extremities was shown through enlarged collateral veins of the abdominal wall, vena azygos and hemiazygos continuation, and multiple liver veins emptying into the right cardiac atrium. We describe a rare case of abdominal subcutaneous wall veins as collaterals caused by a congenitally absent infrarenal inferior vena cava with preservation of a hypoplastic suprarenal segment. Conclusion Knowledge of these congenital variations can be of clinical importance and it is imperative for the reporting radiologist to identify these anomalies as they can have a significant impact on the clinical management of the patient.

  17. Is Consent Based on Trust Morally Inferior to Consent Based on Information?

    Science.gov (United States)

    Kongsholm, Nana Cecilie Halmsted; Kappel, Klemens

    2017-07-01

    Informed consent is considered by many to be a moral imperative in medical research. However, it is increasingly acknowledged that in many actual instances of consent to participation in medical research, participants do not employ the provided information in their decision to consent, but rather consent based on the trust they hold in the researcher or research enterprise. In this article we explore whether trust-based consent is morally inferior to information-based consent. We analyse the moral values essential to valid consent - autonomy, voluntariness, non-manipulation, and non-exploitation - and assess whether these values are less protected and promoted by consent based on trust than they are by consent based on information. We find that this is not the case, and thus conclude that trust-based consent if not morally inferior to information-based consent. © 2017 John Wiley & Sons Ltd.

  18. Radiofrequency Coblation Versus Intramural Bipolar Cautery for the Treatment of Inferior Turbinate Hypertrophy.

    Science.gov (United States)

    Shah, Anil N; Brewster, Douglas; Mitzen, Kelly; Mullin, David

    2015-09-01

    Compare intramural bipolar electrocautery and radiofrequency coblation in the treatment of inferior turbinate hypertrophy with regards to objective and subjective improvement in nasal obstruction, rate and type of complications, experience during the procedure, and rate of recovery. Prospective, single-blinded study. Single tertiary medical center from 2008 to 2010. Forty-one adult patients with inferior turbinate hypertrophy refractory to medical management were treated with radiofrequency coblation in one nostril and intramural bipolar cautery in the other. Subjective and objective data, including use of a Visual Analog Scale (VAS) for subjective outcomes, acoustic rhinometry, and nasal endoscopy, were then obtained from each patient comparing the 2 techniques. Radiofrequency coblation was significantly less painful than intramural bipolar cautery during the procedure (P = .03) and during the early postoperative period (P hypertrophy with less discomfort during the procedure and early post-operative period. © The Author(s) 2015.

  19. Distichiasis following transconjunctival approach to the inferior orbital rim and orbital floor

    Directory of Open Access Journals (Sweden)

    Saoussen Salhi

    2015-09-01

    Full Text Available Zygoma fractures are often associated with orbital floor fractures, which can be approached through a transconjunctival or transcutaneous incision. The transconjunctival approach has gained popularity over the transcutaneous one for its overall lower complication rate. We describe a patient with a zygoma fracture where the inferior orbital rim and orbital floor were exposed, reduced and fixated through a transconjunctival incision. Postoperatively, the patient developed a row of eyelashes posterior to the normal lash line, a condition termed distichiasis, causing corneal irritation and ulceration. This is believed to be caused by the postoperative eyelid inflammation induced by the transconjunctival incision. The condition was treated by electrolysis with no recurrence of symptoms. This condition has never been described as a postoperative complication of a transconjunctival approach to an inferior orbital rim and orbital floor fracture.

  20. Testing of Hypothesis in Equivalence and Non Inferiority Trials-A Concept.

    Science.gov (United States)

    Juneja, Atul; Aggarwal, Abha R; Adhikari, Tulsi; Pandey, Arvind

    2016-04-01

    Establishing the appropriate hypothesis is one of the important steps for carrying out the statistical tests/analysis. Its understanding is important for interpreting the results of statistical analysis. The current communication attempts to provide the concept of testing of hypothesis in non inferiority and equivalence trials, where the null hypothesis is just reverse of what is set up for conventional superiority trials. It is similarly looked for rejection for establishing the fact the researcher is intending to prove. It is important to mention that equivalence or non inferiority cannot be proved by accepting the null hypothesis of no difference. Hence, establishing the appropriate statistical hypothesis is extremely important to arrive at meaningful conclusion for the set objectives in research.

  1. Subacute sclerosing panencephalitis with bilateral inferior collicular hyperintensity on magnetic resonance imaging brain.

    Science.gov (United States)

    Thomas, Maya; Sivadasan, Ajith; Alexander, Mathew; Patil, Anil Kumar B

    2012-10-01

    Subacute sclerosing panencephalitis (SSPE) is chronic encephalitis occurring after infection with measles virus. An 8-year-old boy presented with progressive behavioral changes, cognitive decline and myoclonic jerks, progressing to a bed bound state over 2 months. Magnetic resonance imaging (MRI) brain showed T2-weighted hyperintensities in the subcortical areas of the left occipital lobe and brachium of the inferior colliculus on both sides. EEG showed bilateral, synchronous periodic discharges. Serum/cerebrospinal fluid measles IgG titer was significantly positive. The overall features were suggestive of SSPE. MRI finding of bilateral inferior colliculus changes on MRI without significant involvement of other commonly involved areas suggests an uncommon/rare imaging pattern of SSPE.

  2. Attention, emotion, and deactivation of default activity in inferior medial prefrontal cortex

    DEFF Research Database (Denmark)

    Geday, Jacob; Gjedde, Albert

    2008-01-01

    Attention deactivates the inferior medial prefrontal cortex (IMPC), but it is uncertain if emotions can attenuate this deactivation. To test the extent to which common emotions interfere with attention, we measured changes of a blood flow index of brain activity in key areas of the IMPC...... significantly lowered blood flow (rCBF) in left IMPC, left and right insula, and right amygdala, and significantly raised blood flow in motor cortex and right precuneus. Restricted searches of rCBF changes by emotion, at coordinates of significant effect in previous studies of the medial prefrontal and temporal...... inputs from multiple brain regions, as predicted by the theory of a default mode of brain function. The absent emotional interference with the deactivation of the default state suggests that the inferior prefrontal cortex continued to serve the attention rather than submit to the distraction....

  3. Caracterización tecnomorfológica del complejo inferior de Ambrona

    Directory of Open Access Journals (Sweden)

    Joaquín Panera Gallego

    1996-01-01

    Full Text Available La industria achelense correspondiente al Complejo Inferior de Ambrona, atribuida al Pleistoceno medio, se sitúa en la órbita de la de Áridos, La Maya II, El Sartalejo y Torralba. Mediante su caracterización tecnomorfológica y su contextualización en el Paleolítico inferior de la Península Ibérica, pretendemos paliar la carencia originada por la falta de trabajos en profundidad sobre su estudio.The Acheulian industry of «The Lower Compiex» in Ambrona, appointed to the Middle Pleistocene, is situated in the orbit of Áridos, La Maya II, El Sartalejo and Torralba. We propose palliate the lacks, originated for the non-existence ofjobs about his study, by his technomorphological analysis in the Lower Paleolithic of the Iberian Península.

  4. Bilateral spondylolysis of inferior articular processes of the fourth lumbar vertebra: a case report.

    Science.gov (United States)

    Koakutsu, Tomoaki; Morozumi, Naoki; Hoshikawa, Takeshi; Ogawa, Shinji; Ishii, Yushin; Itoi, Eiji

    2012-03-01

    Lumbar spondylolysis, a well known cause of low back pain, usually affects the pars interarticularis of a lower lumbar vertebra and rarely involves the articular processes. We report a rare case of bilateral spondylolysis of inferior articular processes of L4 vertebra that caused spinal canal stenosis with a significant segmental instability at L4/5 and scoliosis. A 31-year-old male who had suffered from low back pain since he was a teenager presented with numbness of the right lower leg and scoliosis. Plain X-rays revealed bilateral spondylolysis of inferior articular processes of L4, anterolisthesis of the L4 vertebral body, and right lateral wedging of the L4/5 disc with compensatory scoliosis in the cephalad portion of the spine. MR images revealed spinal canal stenosis at the L4/5 disc level. Posterior lumbar interbody fusion of the L4/5 was performed, and his symptoms were relieved.

  5. Parallel, multi-stage processing of colors, faces and shapes in macaque inferior temporal cortex

    OpenAIRE

    Lafer-Sousa, Rosa; Conway, Bevil R.

    2013-01-01

    Visual-object processing culminates in inferior temporal (IT) cortex. To assess the organization of IT, we measured fMRI responses in alert monkey to achromatic images (faces, fruit, bodies, places) and colored gratings. IT contained multiple color-biased regions, which were typically ventral to face patches and, remarkably, yoked to them, spaced regularly at four locations predicted by known anatomy. Color and face selectivity increased for more anterior regions, indicative of a broad hierar...

  6. Estilos de personalidad, modos de afrontamiento y clima social familiar en pacientes amputados de miembro inferior

    OpenAIRE

    Díaz Acosta, Ana Gloria

    2015-01-01

    El objetivo de la presente investigación es relacionar estilos de personalidad, modos de afrontamiento al estrés y clima social familiar en pacientes amputados de miembro inferior. El estudio es de tipo correlacional; la muestra estuvo conformada por 100 participantes varones y 81 mujeres, que fueron atendidos en un establecimiento de salud de Lima y evaluados con los cuestionarios MIPS, COPE y escala FES. Los resultados indican que existe relación significativa entre estilos de personalidad,...

  7. Primary leiomyosarcoma of the juxtarenal inferior vena cava: a case report.

    Science.gov (United States)

    Kumar, Surjeet; Kumar, Anil; Guleria, Sandeep

    2013-06-01

    Primary juxtrarenal leiomyosarcoma of the inferior vena cava (IVC) is a rare disease and is invariably malignant. Prognosis depends on early patient diagnosis and management. We report a case of a primary IVC tumor in a 66-year-old woman which was managed successfully by surgical resection of involved IVC along with right nephrectomy. IVC reconstruction was done using a Dacron interposition graft, and the left renal vein was anastomosed end to side to the Dacron graft.

  8. Recent Inferior Myocardial Infarction Complicated with a Right Ventricular Thrombus Detected by Three Cardiac Imaging Modalities.

    Science.gov (United States)

    Kuno, Toshiki; Imaeda, Syohei; Hashimoto, Kenji; Ryuzaki, Toshinobu; Saito, Tetsuya; Yamazaki, Hiroyuki; Tabei, Ryota; Kodaira, Masaki; Hase, Manabu; Numasawa, Yohei

    2018-03-01

    We report the case of a 71-year-old woman diagnosed with recent inferior myocardial infarction complicated with right ventricular infarction and a right ventricular thrombus. Three-dimensional transthoracic echocardiography, contrast-enhanced computed tomography, and cardiac magnetic resonance imaging clearly detected a thrombus. We consider cases with a recent right ventricular infarction to require assessment for thrombus formations in the right ventricle. Fortunately, vigorous anticoagulation therapy resolved the thrombi in both the right ventricle and right coronary artery.

  9. The inferiority complex in paranoia readdressed. A study with the Implicit Association Test

    OpenAIRE

    von Collani, Gernot; Werner, Ronny; Moritz, Steffen

    2006-01-01

    It has been theorised that patients with persecutory delusions display a lack of covert self-esteem (formerly termed the 'inferiority complex'), while at the same time displaying normal or even heightened levels of explicit self-esteem. However, the empirical basis for this assumption is inconsistent. Methods. In view of apparent shortcomings of prior studies to assess implicit self-esteem, the Implicit Association Test was utilised to readdress this theory. The Rosenberg scale served as an i...

  10. Inferior Vena Cava and Renal Vein Thrombosis Associated with Thymic Carcinoma

    Directory of Open Access Journals (Sweden)

    Vlad Teodor Berbecar

    2017-01-01

    Full Text Available Thymic tumors are rare mediastinal tumors that can present with a wide variety of symptoms. They can cause distant manifestations and are frequently associated with paraneoplastic syndromes. In our case, we describe the evolution of a 68-year-old male whose first manifestation was thrombosis of the inferior vena cava and renal veins. Thrombosis of large abdominal veins is rare, especially without being associated with any other comorbidity or risk factors.

  11. Inferior Turbinate Asymmetry Is a Feature of the Unilateral Complete Cleft Lip and Palate Nasal Deformity.

    Science.gov (United States)

    Dentino, Kelley M; Sierra-Vasquez, Daniel; Padwa, Bonnie L

    2016-04-01

    Patients with unilateral complete cleft lip and palate (UCLP) have a characteristic bilateral septal deformity, and septal deviation can be associated with turbinate hyperplasia, leading to paradoxical nasal obstruction. The purpose of the present study was to measure and compare the bony and mucosal dimensions of the inferior turbinate on the cleft and non-cleft sides in patients with UCLP. We implemented a retrospective cohort study of patients with UCLP who had undergone computed tomography (CT) scan between 2002 to 2013. Subjects who had undergone nasal revision, septoplasty, turbinectomy, or Le Fort I osteotomy before the imaging date were excluded. The primary predictor variable was the subject side (cleft vs noncleft side), and the primary outcome variable was the turbinate cross-sectional area. The secondary predictor variables included the site of measurement along the sagittal axis of the turbinate (anterior, middle, posterior) and tissue type (turbinate whole, bone, mucosa). The Wilcoxon signed rank test for paired samples compared the turbinate dimensions on the cleft and noncleft sides, with statistical significance set at P ≤ .05. The sample included 53 patients (32 females and 21 males). The inferior turbinates were measured bilaterally on CT images obtained at a mean age of 12.2 ± 0.8 years. The inferior turbinate on the noncleft side was significantly larger in both bone and mucosa (P = .003). This relationship did not change when controlling for age and gender. The results of the present study have confirmed bony and mucosal enlargement of the inferior turbinate on the noncleft side in patients with UCLP. This might contribute to bilateral nasal obstruction and should be considered during treatment planning for nasopharyngeal and orthognathic surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Afección musculoesquelética asociada a amputados de miembro inferior

    National Research Council Canada - National Science Library

    Lagares Alonso, A.M; Lagares Alonso, N; Álvarez Salas, M; Garcés Pérez, L; Lérida Benitez, L; Romero Romero, B

    2012-01-01

    ... y el tratamiento de las afecciones que se asocian a los amputados de miembro inferior de la Unidad de Prótesis y Ortesis del Hospital Universitario Virgen Macarena de Sevilla. En segundo lugar, comparar estos datos con la bibliografía. Material y método Realizamos un estudio descriptivo transversal, en el que se incluyeron 46 pacientes con amputaciones de miembro...

  13. [The development of an electrosurgery appliance used in non-bleeding inferior conha cutting operation].

    Science.gov (United States)

    Wang, S; Wu, G; Miao, A

    1997-11-01

    It can be only a simple mechanic cutting by means of the traditional inferior concha scissor. Since the nose capacity is deep, narrow and rich in blood vessels, it is easy to bleed. We instruct a new type of non-bleeding nose operation appliance--is under the high frequency electric control, with light source and negative pressure abstracting installment. It has cutting, lighting, abstracting function. It dissolve the problems of pre and post operation bleeding with good effects.

  14. Individual structural differences in left inferior parietal area are associated with schoolchildrens’ arithmetic scores

    Directory of Open Access Journals (Sweden)

    Yongxin eLi

    2013-12-01

    Full Text Available Arithmetic skill is of critical importance for academic achievement, professional success and everyday life, and childhood is the key period to acquire this skill. Neuroimaging studies have identified that left parietal regions are a key neural substrate for representing arithmetic skill. Although the relationship between functional brain activity in left parietal regions and arithmetic skill has been studied in detail, it remains unclear about the relationship between arithmetic achievement and structural properties in left inferior parietal area in schoolchildren. The current study employed a combination of voxel-based morphometry (VBM for high-resolution T1-weighted images and fiber tracking on diffusion tensor imaging (DTI to examine the relationship between structural properties in the inferior parietal area and arithmetic achievement in 10-year-old schoolchildren. VBM of the T1-weighted images revealed that individual differences in arithmetic scores were significantly and positively correlated with the grey matter (GM volume in the left intraparietal sulcus (IPS. Fiber tracking analysis revealed that the forceps major, left superior longitudinal fasciculus (SLF, bilateral inferior longitudinal fasciculus (ILF and inferior fronto-occipital fasciculus (IFOF were the primary pathways connecting the left IPS with other brain areas. Furthermore, the regression analysis of the probabilistic pathways revealed a significant and positive correlation between the fractional anisotropy (FA values in the left SLF, ILF and bilateral IFOF and arithmetic scores. The brain structure-behavior correlation analyses indicated that the GM volumes in the left IPS and the FA values in the tract pathways connecting left IPS were both related to children’s arithmetic achievement. The present findings provide evidence that individual structural differences in the left IPS are associated with arithmetic scores in schoolchildren.

  15. Reciprocal ST segment changes in acute inferior myocardial infarction: Clinical, hemodynamic and angiographic implications

    Directory of Open Access Journals (Sweden)

    Hatem El Atroush

    2012-09-01

    Conclusion: The significance of reciprocal ST depression on the electrocardiogram during the course of inferior MI remains uncertain, opinion is divided as to whether it is a benign electrical phenomenon or a sign of a greater myocardial necrosis and more frequent left coronary artery disease, from our study we support the latter opinion. This simple ECG finding may be used to differentiate high risk patients for a more aggressive approach.

  16. CT demonstration of accessory nasal turbinates: secondary middle turbinate and bifid inferior turbinate

    Energy Technology Data Exchange (ETDEWEB)

    Aksungur, Erol H. [Department of Radiodiagnosis, Cukurova University, Balcali Hospital, Adana, 01330 (Turkey); Bicakci, Kenan [Department of Radiodiagnosis, Cukurova University, Balcali Hospital, Adana, 01330 (Turkey); Inal, Mehmet [Department of Radiodiagnosis, Cukurova University, Balcali Hospital, Adana, 01330 (Turkey); Akguel, Erol [Department of Radiodiagnosis, Cukurova University, Balcali Hospital, Adana, 01330 (Turkey); Binokay, Figen [Department of Radiodiagnosis, Cukurova University, Balcali Hospital, Adana, 01330 (Turkey); Aydogan, Barlas [Department of ENT, Cukurova University, Balcali Hospital, Adana, 01330 (Turkey); Oguz, Mahmut [Department of Radiodiagnosis, Cukurova University, Balcali Hospital, Adana, 01330 (Turkey)

    1999-09-01

    Normally, there are three pairs of nasal turbinates in the nasal cavity. Coronal computed tomographies of 253 cases of sinusitis were examined for the presence of additional turbinates and bilateral secondary middle turbinates were detected in two cases. Also, we describe another accessory turbinate, 'bifid inferior turbinate', in one of these cases. Existence of these accessory turbinates may occur during embryologic development of lateral nasal wall.

  17. Response inhibition of face stimuli linked to inferior frontal gyrus microstructure in adolescents

    DEFF Research Database (Denmark)

    Holm-Skjold, Jonathan; Baaré, William Frans Christiaan; Jernigan, Terry Lynne

    . Inhibition of negative faces has been shown to be more difficult than that of positive faces1,3. The brain network underlying response inhibition includes the right inferior frontal gyrus (IFG), right presupplementary motor area (preSMA), and superior longitudinal fasciculus (SLF) bilaterally 4–6. The white...... that better response inhibition (i.e. lower false alarm rate) of negative faces would be associated with higher FA in right IFG, right preSMA, and bilateral SLF in adolescents....

  18. Lymphangiomatosis Involving the Inferior Vena Cava, Heart, Pulmonary Artery and Pelvic Cavity

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun; Seo, Hye Sun; Seo, Jon; Kim, Hee Kyung; Her, Keun [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Suk, Eun Ha [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    A 38-year-old woman who had undergone pelvic lymphangioma resection two months previously presented with cough and dyspnea. Transthoracic echocardiography and CT demonstrated the presence of a mixed cystic/solid component tumor involving the inferior vena cava, heart and pulmonary artery. Complete resection of the cardiac tumor was performed and lymphangioma was confirmed based on histopathologic examination. To the best of our knowledge, this is the first report of lymphangiomatosis with cardiac and pelvic involvement in the published clinical literature.

  19. Study of the course of inferior epigastric artery with reference to laparoscopic portal

    OpenAIRE

    Manvikar Purushottam Rao; Vatsala Swamy; Vasanti Arole; Paramatma Mishra

    2013-01-01

    Introduction: Laparoscopy has been in vogue for more than 2 decades. Making portals in the anterior abdominal wall for introducing laparoscopic instruments is done with trocar and cannula which is a blind procedure. Stab incision and trocar insertion, though safe, at times can lead to injury of blood vessels of anterior abdominal wall more so the inferior epigastric artery (IEA). Trauma to abdominal wall vessels is 0.2%-2% of laparoscopic procedures and said to be 3 per 1000 cases. Injury to ...

  20. Endovascular recanalization of occluded superior mesenteric artery using retrograde access through the inferior mesenteric artery

    Directory of Open Access Journals (Sweden)

    Eduardo Keller Saadi, MD

    2017-09-01

    Full Text Available Symptomatic occlusion of the superior mesenteric artery can be treated by open repair, hybrid procedure, or endovascular revascularization. In most cases, endovascular procedures are done by the antegrade approach. We report a case of a 67-year-old woman who presented with acute-on-chronic mesenteric ischemia successfully treated by retrograde endovascular recanalization of an occluded common hepatomesenteric trunk through the inferior mesenteric artery and arc of Riolan.

  1. Correction: Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-11-30

    ABSTRACT: Following the publication of our article [Inferior alveolar nerve injury with laryngeal mask airway: a case report. Journal of Medical Case Reports 2011, 5:122] it was brought to our attention that we inadvertently used the registered trademark of the Laryngeal Mask Company Limited (LMA) as the abbreviation for laryngeal mask airway. A Portex(R) Soft Seal(R) Laryngeal Mask was used and not a device manufactured by the Laryngeal Mask Company.

  2. Inferior vena cava aneurysm in an infant presenting with a renal mass.

    Science.gov (United States)

    Unzueta-Roch, José L; García-Abós, Miriam; Sirvent-Cerdá, Sara; de Prada, Inmaculada; Martínez de Azagra, Amelia; Ollero, Jose M; Madero-López, Luis

    2014-10-01

    Aneurysm of the inferior vena cava is a rare finding in the pediatric population. We report the case of a 5-month-old infant presenting with anemia, hypertension, and dehydration in the emergency room. A renal mass was found with ultrasound and MRI and a renal tumor was first considered. Histopathologic review of the surgical specimen led to the diagnosis of aneurysmal dilatation of the vena cava.

  3. Is rice becoming an inferior good? Food demand in the Philippines

    OpenAIRE

    Ingco, Merlinda D.

    1991-01-01

    What are the prospects for demand for the main foodstuffs, particularly rice, in the Philippines? Countries which have traditionally consumed rice as the basic staple such as Japan, the Republic of Korea, and Taiwan are eating more wheat and wheat products. There is also a shift towards increased consumption of meats, dairy products, vegetable oils, and fruits and vegetables. A recent study found rice to be an inferior good in Japan, Taiwan, Malaysia, Singapore, Thailand, and Nepal. In this p...

  4. Anatomical Landmarks for Safe Elevation of the Deep Inferior Epigastric Perforator Flap: A Cadaveric Study

    OpenAIRE

    Chowdhry, Saeed; Hazani, Ron; Collis, Philip; Wilhelmi, Bradon J.

    2010-01-01

    Background: Breast reconstruction techniques have focused increasingly on using autologous tissue, with emphasis being placed on employing muscle sparing adipocutaneous flaps to reduce abdominal wall complications such as hernias, bulges, weakness, and length of hospital stay. The result has been the emergence of the deep inferior epigastric perforator (DIEP) flap for breast reconstruction. Isolating perforator vessels challenges most surgeons. We describe surface anatomical landmarks to pred...

  5. Polyneuronal Innervation of Single Muscle Fibers in Cat Eye Muscle: Inferior Oblique

    OpenAIRE

    Dimitrova, Diana M.; Allman, Brian L.; Shall, Mary S.; Goldberg, Stephen J.

    2009-01-01

    Single muscle fibers with multiple axonal endplates (multiply innervated fibers) are normally present in adult extraocular muscles (EOMs), while most other mammalian skeletal muscles contain fibers with a single myoneural junction. Recent findings by others led us to investigate for the presence of polyneuronal innervation (innervation of a single muscle fiber by >1 motoneuron) in the inferior oblique (IO) muscle of pentobarbital anesthetized cats. The IO muscle nerve branches, as they course...

  6. Síntomas, postura y factores lesivos de los miembros inferiores, en la industria cementera

    OpenAIRE

    Risso, Leonardo

    2015-01-01

    La industria cementera, como todo trabajo, implica riesgos para el cuerpo de los trabajadores, que pueden ser evitados, o bien disminuidos. En este caso se investiga y describe la presencia de la diversa sintomatología encontrada en sus miembros inferiores, factores de riesgo, hábitos y posturas, entre otras. Con el fin de incrementar el conocimiento acerca de estos temas y así tratar de concientizar al obrero, para poder prevenir futuras posibles lesiones de manera efectiva. ...

  7. Anomalous inferior vena cava in association with omphalocele: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Antoniou, E.E.H. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Matsuoka, S. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Mori, K. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Hayabuchi, Y. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Kuroda, Y. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan)

    1995-06-01

    We present the case of a 6-year-old boy who had an omphalocele repaired at day 1 of life. He had a secundum atrial septal defect and an anomalous inferior vena cava of a type which has not been previously reported. Cine-MRI was a useful noninvasive tool for diagnosing the anomalous subaortic innominate vein and four immature vessels which make up the venous drainage systems of the lumbar region. (orig.)

  8. Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery

    Directory of Open Access Journals (Sweden)

    Roberto de Cleva

    2014-07-01

    Full Text Available OBJECTIVE:Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior.METHODS:We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique.RESULTS:The mean age of the patients was 56±13 years, and 41.6% 25 were female; 50 patients (83.3% had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior. The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6±0.6 L and FVC (2.0±0.7 L with maintenance of FEV1/FVC of 0.8±0.2 in both groups. The maximum intra-abdominal pressure values were similar (p= 0.59 for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed.CONCLUSIONS:Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery.

  9. Role of suture anchors in management of fractures of inferior pole of patella

    Directory of Open Access Journals (Sweden)

    Anand Ashish

    2010-01-01

    Full Text Available Background: The traditional recommendation for displaced comminuted inferior pole fractures is excision of the comminuted pole followed by reattachment of the patellar tendon with transosseous suture. To the best of our knowledge there has been no previous published study mentioning the use of suture anchors for fracture inferior pole of patella. We present a retrospective analysis of five cases of patients doing well at final follow-up of two years. Materials and Methods: Five patients treated at our institute using suture anchors for repair of comminuted inferior pole fractures of patella between January 2007 to March 2007. (range 28 years-55 years. There were three males and two females. Results: The average follow-up was 25 months (range 24 months-26 months. The patients were evaluated for range of motion, strength, patellofemoral scores and any alteration of patellar height. The outcome of the procedure was assessed with use of the patellofemoral scoring system of Noyes et al, 5 as adapted by Saltzman et al. 6 The final patellofemoral score (maximum 100 points was 94.6 (range 93-96. Conclusion: We believe it is a novel extended indication of the use of suture anchors and should be in the armament of every trauma surgeon.

  10. [Surgical treatment of inferior pole comminuted fractures of patella with new type tension band].

    Science.gov (United States)

    Sun, B; Zhang, Z S; Zhou, F; Tian, Y; Ji, H Q; Guo, Y; Lv, Y; Yang, Z W

    2015-04-18

    To study the effectiveness of inferior pole fracture of patella treating by the new tension band. From Dec. 2011 to Dec. 2013, 21 patients with inferior pole fracture of patella were treated with the new tension band which consisted of cannulated screw, titanium cable and shims. There were 21 patients[10 males, 11 females, the average age was 54 years(21 to 79)],of whom,all were "fell on knees". The average operation time was 89 min (57-197 min),the follow-up visits were done from 7-31 months (average 18 months), the bone healing time was from 8-12 weeks (average 10.5 weeks). The post operation assessment was done by Bostman score, from 20-30 (average 27),10 excellent,and 11 good. No complication occurred. The new tension band is the effective treatment for inferior pole fracture of patella. The internal fixation is reliable, it is simple to operate, and patients can take exercises as early as possible. Therefore, the new tension band has a better clinical value.

  11. Impaired Motor Learning in a Disorder of the Inferior Olive: Is the Cerebellum Confused?

    Science.gov (United States)

    Shaikh, Aasef G; Wong, Aaron L; Optican, Lance M; Zee, David S

    2017-02-01

    An attractive hypothesis about how the brain learns to keep its motor commands accurate is centered on the idea that the cerebellar cortex associates error signals carried by climbing fibers with simultaneous activity in parallel fibers. Motor learning can be impaired if the error signals are not transmitted, are incorrect, or are misinterpreted by the cerebellar cortex. Learning might also be impaired if the brain is overwhelmed with a sustained barrage of meaningless information unrelated to simultaneously appearing error signals about incorrect performance. We test this concept in subjects with syndrome of oculopalatal tremor (OPT), a rare disease with spontaneous, irregular, roughly pendular oscillations of the eyes thought to reflect an abnormal, synchronous, spontaneous discharge to the cerebellum from the degenerating neurons in the inferior olive. We examined motor learning during a short-term, saccade adaptation paradigm in patients with OPT and found a unique pattern of disturbed adaptation, quite different from the abnormal adaption when the cerebellum is involved directly. Both fast (seconds) and slow (minutes) timescales of learning were impaired. We suggest that the spontaneous, continuous, synchronous output from the inferior olive prevents the cerebellum from receiving the error signals it needs for appropriate motor learning. The important message from this study is that impaired motor adaptation and resultant dysmetria is not the exclusive feature of cerebellar disorders, but it also highlights disorders of the inferior olive and its connections to the cerebellum.

  12. Leiomyosarcoma of the inferior vena cava level II involvement: curative resection and reconstruction of renal veins

    Science.gov (United States)

    2012-01-01

    Leiomyosarcoma of the inferior vena cava (IVCL) is a rare retroperitoneal tumor. We report two cases of level II (middle level, renal veins to hepatic veins) IVCL, who underwent en bloc resection with reconstruction of bilateral or left renal venous return using prosthetic grafts. In our cases, IVCL is documented to be occluded preoperatively, therefore, radical resection of tumor and/or right kidney was performed and the distal end of inferior vena cava was resected and without caval reconstruction. None of the patients developed edema or acute renal failure postoperatively. After surgical resection, adjuvant radiation therapy was administrated. The patients have been free of recurrence 2 years and 3 months, 9 months after surgery, respectively, indicating the complete surgical resection and radiotherapy contribute to the better survival. The reconstruction of inferior vena cava was not considered mandatory in level II IVCL, if the retroperitoneal venous collateral pathways have been established. In addition to the curative resection of IVCL, the renal vascular reconstruction minimized the risks of procedure-related acute renal failure, and was more physiologically preferable. This concept was reflected in the treatment of the two patients reported on. PMID:22742531

  13. Development of Right-hemispheric Dominance of Inferior Parietal Lobule in Proprioceptive Illusion Task.

    Science.gov (United States)

    Naito, Eiichi; Morita, Tomoyo; Saito, Daisuke N; Ban, Midori; Shimada, Koji; Okamoto, Yuko; Kosaka, Hirotaka; Okazawa, Hidehiko; Asada, Minoru

    2017-11-01

    Functional lateralization can be an indicator of brain maturation. We have consistently shown that, in the adult brain, proprioceptive processing of muscle spindle afferents generating illusory movement of the right hand activates inferior frontoparietal cortical regions in a right-side dominant manner in addition to the cerebrocerebellar motor network. Here we provide novel evidence regarding the development of the right-dominant use of the inferior frontoparietal cortical regions in humans using this task. We studied brain activity using functional magnetic resonance imaging while 60 right-handed blindfolded healthy children (8-11 years), adolescents (12-15 years), and young adults (18-23 years) (20 per group) experienced the illusion. Adult-like right-dominant use of the inferior parietal lobule (IPL) was observed in adolescents, while children used the IPL bilaterally. In contrast, adult-like lateralized cerebrocerebellar motor activation patterns were already observable in children. The right-side dominance progresses during adolescence along with the suppression of the left-sided IPL activity that emerges during childhood. Therefore, the neuronal processing implemented in the adult's right IPL during the proprioceptive illusion task is likely mediated bilaterally during childhood, and then becomes right-lateralized during adolescence at a substantially later time than the lateralized use of the cerebrocerebellar motor system for kinesthetic processing. © The Author 2017. Published by Oxford University Press.

  14. Immediate Effect of Grade IV Inferior Hip Joint Mobilization on Hip Abductor Torque: A Pilot Study.

    Science.gov (United States)

    Makofsky, Howard; Panicker, Siji; Abbruzzese, Jeanine; Aridas, Cynthia; Camp, Michael; Drakes, Jonelle; Franco, Caroline; Sileo, Ray

    2007-01-01

    Joint mobilization and manipulation stimulate mechanoreceptors, which may influence the joint and surrounding muscles. The purpose of this pilot study was to determine the effect of grade IV inferior hip joint mobilization on hip abductor torque. Thirty healthy subjects were randomly assigned to a control group (grade I inferior hip joint mobilization) or an experimental group (grade IV inferior hip joint mobilization). Subjects performed a pre- and post-intervention test of five isometric repetitions on the Cybex Normö dynamometer; the average torque was determined for both pre- and post-intervention measurements. These data were analyzed using the independent samples t-test with the significance level set at Phip abductor torque in the experimental group (P=0.03). The experimental group demonstrated a 17.35% increase in average torque whereas the control group demonstrated a 3.68% decrease in average torque. These findings are consistent with other studies demonstrating that the use of grade IV non-thrust mobilization improves strength immediately post-intervention in healthy individuals. The results of this pilot study provide physical therapists with further support for the utilization of manual therapy in conjunction with therapeutic exercise to enhance muscle strength.

  15. Leiomyosarcoma of the inferior vena cava level II involvement: curative resection and reconstruction of renal veins

    Directory of Open Access Journals (Sweden)

    Wang Quan

    2012-06-01

    Full Text Available Abstract Leiomyosarcoma of the inferior vena cava (IVCL is a rare retroperitoneal tumor. We report two cases of level II (middle level, renal veins to hepatic veins IVCL, who underwent en bloc resection with reconstruction of bilateral or left renal venous return using prosthetic grafts. In our cases, IVCL is documented to be occluded preoperatively, therefore, radical resection of tumor and/or right kidney was performed and the distal end of inferior vena cava was resected and without caval reconstruction. None of the patients developed edema or acute renal failure postoperatively. After surgical resection, adjuvant radiation therapy was administrated. The patients have been free of recurrence 2 years and 3 months, 9 months after surgery, respectively, indicating the complete surgical resection and radiotherapy contribute to the better survival. The reconstruction of inferior vena cava was not considered mandatory in level II IVCL, if the retroperitoneal venous collateral pathways have been established. In addition to the curative resection of IVCL, the renal vascular reconstruction minimized the risks of procedure-related acute renal failure, and was more physiologically preferable. This concept was reflected in the treatment of the two patients reported on.

  16. Developmental studies of the inferior olivary nucleus in staggerer mutant mice.

    Science.gov (United States)

    Zanjani, H S; Herrup, K; Guastavino, J M; Delhaye-Bouchaud, N; Mariani, J

    1994-10-14

    The neurological mutation, staggerer, causes a severe disruption in the integrity of the olivo-cerebellar circuitry. The primary site of action is the Purkinje cell population which is reduced in cell number, with cells that are atrophic in dendritic structure, small in size and ectopic in position. This primary defect has a cascade effect on the Purkinje cell-afferent populations, leading to the target-related cell death of virtually all of the cerebellar granule cells and the majority of the neurons in the inferior olive. As part of our ongoing study of the cell-cell interactions in the cerebellar circuitry, we have studied the inferior olive of the staggerer mutant from birth to adulthood. We find that the reduction in olive neuron number does not occur until after birth in the mutants. On the day of birth, the number of cells is indistinguishable in mutants and in wild type. Similarly, we find that the four principal subnuclei of the olive are well defined at birth, but regress to a state of poor resolution during the first 3 postnatal weeks. Finally, Golgi impregnations reveal that of the two morphological classes of inferior olive neurons, only one class--the Type II or complex dendritic type survive in the mutant. These results are discussed in terms of their implications for the cell--cell interactions in the developing olivocerebellar circuit.

  17. Isquemia aguda de miembros inferiores secundaria a ergortismo Acute ischemia of lower limbs secondary to ergotism

    Directory of Open Access Journals (Sweden)

    Franco J Vallejo

    2011-12-01

    Full Text Available Paciente de género femenino, de 21 años de edad, quien ingresó por dolor progresivo e intenso en miembros inferiores, y refirió antecedente reciente de ingestión de derivados del ergot. Al examen físico se observó ausencia de pulsos en ambos miembros inferiores. Por angiotomografia se documentó disminución severa, generalizada y bilateral, del calibre de los vasos arteriales de miembros inferiores. Se diagnosticó isquemia arterial aguda secundaria a ergotismo y se inició tratamiento con vasodilatadores y calcio-antagonistas, que resolvió los síntomas en su totalidad.21 years old female patient admitted for progressive and intense pain in lower limbs, that narrated a recent history of ergot ingestion. On physical examination there was absence of pulses in both lower limbs. Severe, generalized and bilateral decrease of caliber of arterial vessels of the lower limbs was documented by angiotomography. Acute arterial ischemia of lower limbs secondary to ergotism was diagnosed and treatment with vasodilators and calcium antagonists was initiated, resolving entirely the symptoms.

  18. Right ventricular involvement in patients with inferior myocardial infarction, correlation of electrocardiographic findings with echocardiography data.

    Science.gov (United States)

    Javed, Sumbul; Rajani, Ali Raza; Govindaswamy, Pushparani; Radaideh, Ghazi Ahmed; Abubaraka, Harb Ahmed; Qureshi, Tariq Ilyas; Arshad, Hassaan Bin

    2017-03-01

    To determine the right ventricular involvement in patients with inferior myocardial infarction by echocardiography in relation to electrocardiographic findings. This observational, prospective study was conducted at Rashid Hospital, Dubai, the United Arab Emirates, from January to September 2013, and comprised patients with inferior myocardial infarction. All patients aged above 18 years were included. Right ventricular myocardial infarction was defined by the electrocardiographic criteria of > 1mV ST elevation in V4R-V5R leads. RV infarction was assessed on echocardiography by fractional area change, tricuspid annular plane systolic excursion and tricuspid annular systolic velocity by tissue Doppler imaging. SPSS 21 was used for data analysis. Of the 73 patients, there were 68(93%) men and 5(7%) women. The three modalities used to assess the right ventricular infarction showed right ventricular involvement in 36(49.3%) cases by fractional area change, 28(38.4%) cases by tricuspid annular plane systolic excursion and 31(42.5%) cases by tissue Doppler imaging in patients with inferior myocardial infarction. Tissue Doppler imaging and right ventricular function showed low degree of negative correlation (p=0.16) while the correlation between tricuspid annular plane systolic excursion and right ventricular function showed significant positive correlation (pright ventricular infarction by echocardiography helped to diagnose right ventricular infarction in greater number of cases compared to surface electrocardiogram.

  19. Cloxacillin versus pristinamycin for superficial pyodermas: a randomized, open-label, non-inferiority study.

    Science.gov (United States)

    Chosidow, O; Bernard, P; Berbis, P; Humbert, P; Crickx, B; Jarlier, V

    2005-01-01

    Superficial pyodermas may require systemic antibiotics. In a previous open-label trial, oxacillin and pristinamycin achieved similar cure rates, but its design was not truly that of a non-inferiority study. To assess the efficacy and safety of oral cloxacillin versus pristinamycin (both 2 g/day) to treat superficial pyodermas. Multicentre, parallel-group, open-label, randomized non-inferiority trial. French general practitioners in private practice included 334 out-patients (mean age: 42 years). At the follow-up (day 14), the cure rates (primary efficacy end point) for the intent-to-treat populations were 80.7% (138/171) for cloxacillin and 82.8% (135/163) for pristinamycin. The observed difference between cure rates was -2.1%, with the lower limit of the two-sided 95% confidence interval higher than the non-inferiority threshold of -15%. The per-protocol analysis yielded similar results. Therapy was discontinued for 10 patients (cloxacillin: 1, pristinamycin: 9; p = 0.01). Cloxacillin could be an alternative to pristinamycin in out-patients with superficial pyodermas. 2005 S. Karger AG, Basel

  20. Inferior Prefrontal Cortex Mediates the Relationship between Phosphatidylcholine and Executive Functions in Healthy, Older Adults.

    Science.gov (United States)

    Zamroziewicz, Marta K; Zwilling, Chris E; Barbey, Aron K

    2016-01-01

    Objectives: This study examines the neural mechanisms that mediate the relationship between phosphatidylcholine and executive functions in cognitively intact older adults. We hypothesized that higher plasma levels of phosphatidylcholine are associated with better performance on a particular component of the executive functions, namely cognitive flexibility, and that this relationship is mediated by gray matter structure of regions within the prefrontal cortex (PFC) that have been implicated in cognitive flexibility. Methods: We examined 72 cognitively intact adults between the ages of 65 and 75 in an observational, cross-sectional study to investigate the relationship between blood biomarkers of phosphatidylcholine, tests of cognitive flexibility (measured by the Delis-Kaplan Executive Function System Trail Making Test), and gray matter structure of regions within the PFC. A three-step mediation analysis was implemented using multivariate linear regressions and we controlled for age, sex, education, income, depression status, and body mass index. Results: The mediation analysis revealed that gray matter thickness of one region within the PFC, the left inferior PFC (Brodmann's Area 45), mediates the relationship between phosphatidylcholine blood biomarkers and cognitive flexibility. Conclusion: These results suggest that particular nutrients may slow or prevent age-related cognitive decline by influencing specific structures within the brain. This report demonstrates a novel structural mediation between plasma phosphatidylcholine levels and cognitive flexibility. Future work should examine the potential mechanisms underlying this mediation, including phosphatidylcholine-dependent cell membrane integrity of the inferior PFC and phosphatidylcholine-dependent cholinergic projections to the inferior PFC.

  1. Inferior vena cava and right atrial thrombosis in children with nephroblastoma: diagnostic and therapeutic problems.

    Science.gov (United States)

    Giannoulia-Karadana, A; Moschovi, M; Koutsovitis, P; Tolis, G; Tzortzatou-Stathopoulou, F

    2000-10-01

    The neoplastic thrombus in Wilms' tumor rarely can extend in to the inferior vena cava or to the right atrium. The neoplastic thrombus usually is diagnosed concurrently with the tumor, although in some cases the diagnosis of the thrombus may precede the diagnosis of nephroblastoma. Among 90 children with Wilms' tumor who were treated in the authors' unit, 4 had extensive tumor thrombosis of the inferior vena cava or the right atrium. One of these patients was found with a life-threatening thrombosis of the inferior vena cava and the right atrium, which was treated surgically; in this case, the diagnosis of nephroblastoma was made postoperatively. As for the 3 remaining patients the diagnosis of neoplastic thrombosis and Wilms' tumor was made simultaneously. In the first case, the patient underwent surgical excision of the thrombus with cardiopulmonary bypass and a short period of hypothermic cardiopulmonary arrest. In the other 3 cases the thrombus resolved with chemotherapy only. Surgical excision of extensive neoplastic thrombosis is suggested in the case of life-threatening thrombosis even with cardiopulmonary bypass. Chemotherapy is suggested in cases lacking clinical symptoms of thrombosis.

  2. Topography of the inferior alveolar nerve in human embryos and fetuses. An histomorphological study.

    Directory of Open Access Journals (Sweden)

    Sergey Lvovich Kabak

    2017-11-01

    Full Text Available The aim of this study is to establish the position of the inferior alveolar nerve in relation to the Meckel’s cartilage, the anlage of the mandibular body and primordia of the teeth, and also to trace the change in nerve trunk structure in the human prenatal ontogenesis. Serial sections (20µm from thirty-two 6-12 weeks-old entire human embryos and serial sections (10µm of six mandibles of 13-20 weeks-old human fetuses without developmental abnormalities were studied. Histological sections were impregnated with silver nitrate according to Bilshovsky-Buke and stained with hematoxylin and eosin. During embryonic development, the number of branches of the inferior alveolar nerve increases and its fascicular structure changes. In conclusion, the architecture of intraosseous canals in the body of the mandible, as well as the location of the foramina, is predetermined by the course and pattern of the vessel/nerve branching in the mandibular arch, even before the formation of bony trabeculae. Particularly, the formation of the incisive canal of the mandible can be explained by the presence of the incisive nerve as the extension of the inferior alveolar nerve. It has also been established that Meckel’s cartilage does not participate in mandibular canal morphogenesis.

  3. Sacrospinous hysteropexy versus vaginal hysterectomy with suspension of the uterosacral ligaments in women with uterine prolapse stage 2 or higher: multicentre randomised non-inferiority trial

    NARCIS (Netherlands)

    Detollenaere, R.J.; Boon, J. den; Stekelenburg, J.; Hout, J. in't; Vierhout, M.E.; Kluivers, K.B.; Eijndhoven, H.W. van

    2015-01-01

    OBJECTIVE: To investigate whether uterus preserving vaginal sacrospinous hysteropexy is non-inferior to vaginal hysterectomy with suspension of the uterosacral ligaments in the surgical treatment of uterine prolapse. DESIGN: Multicentre randomised controlled non-blinded non-inferiority trial.

  4. CONDUCTO ALVEOLAR INFERIOR. CORRELATO ANATOMO-IMAGENOLOGICO E IMPLICANCIA EN LOS PROCEDIMIENTOS QUIRURGICOS DE MANDIBULA. Inferior alveolar canal. Imaginological anatomical correlation and implication in jaw surgical procedures

    Directory of Open Access Journals (Sweden)

    Andrés C Limardo

    2016-03-01

    Full Text Available Introducción: Las lesiones iatrogénicas del nervio dentario inferior son complicaciones documentadas de diversos procedimientos quirúrgicos en la mandíbula. Debido a ello se justifica una descripción más detallada con referencias morfométricas de dicho conducto, como así también una correlación con imágenes. Materiales y métodos: Se realizó un estudio descriptivo observacional con una muestra de 44 hemimandíbulas secas y 100 tomografías computadas de mandíbulas de pacientes al azar. Se realizaron mediciones del foramen mandibular y mentoniano con respecto a bordes mandibulares. Se hicieron cortes en la rama y el cuerpo con sus respectivas mediciones. Se utilizaron Tomografías Computadas Cone Beam 3D de 100 pacientes las cuales fueron procesadas por el programa Compudent Navigator 3D®. Utilizando este programa se pudieron realizar las mismas mediciones que en los preparados anatómicos, como así también la reconstrucción del conducto. En una segunda etapa se realizó una correlación entre los valores morfométricos del estudio anatómico y se comparó con los estudios por imágenes (TC con reconstrucción 3D Dental Scan. Resultados: Se expresaron en tablas con diversas variables. Discusión: Los textos clásicos de anatomía y los libros de cirugía de la especialidad describen en detalle el recorrido y las relaciones del CAI, y presentan datos morfométricos pero no lo hacen en poblaciones locales. Como conclusión podemos afirmar que, tomando como punto de partida la anatomía y correlacionándola con la imagenologia, podemos llegar a evitar lesiones del nervio alveolar inferior en el transcurso de diversos procedimientos realizados en la mandíbula. Introduction: Iatrogenic inferior alveolar nerve injuries are documented complications of different surgical procedures in the jaw. It should justify a more detailed description with morphometric references of the duct and a correlation with images. Materials and method: A

  5. Avaliação da inclinação do incisivo inferior através da tomografia computadorizada Computed tomographic evaluation of inferior incisor position

    Directory of Open Access Journals (Sweden)

    Leopoldino Capelozza Filho

    2008-12-01

    Full Text Available INTRODUÇÃO: durante muito tempo, a Ortodontia baseou-se em valores normativos obtidos através das análises cefalométricas existentes, utilizando a telerradiografia em norma lateral como exame principal no diagnóstico ortodôntico, ditando o plano de tratamento. O incisivo inferior, em particular, recebeu normas cefalométricas propostas por diversos autores, dentre eles Tweed. Entretanto, os exames radiográficos possuem limitações, pois, em uma imagem bidimensional de uma estrutura tridimensional, a superposição de determinadas estruturas ósseas e dentárias é constante. O advento da tomografia computadorizada disponibilizou meios diagnósticos mais precisos e confiáveis, principalmente pela possibilidade de obtenção da imagem das estruturas em três dimensões. Nesse contexto, parece razoável questionar os dados oriundos da análise clássica da radiografia lateral da face, com intuito de criar fatores de comparação com dados que passarão a ser gerados a partir da mesma imagem obtida pela tomografia. OBJETIVOS: para isso, propusemo-nos a avaliar o ângulo formado entre o longo eixo do incisivo inferior e o plano mandibular, a grandeza IMPA da cefalometria, na telerradiografia convencional e na tomografia computadorizada. MÉTODOS: dezenove pacientes selecionados para tratamento ortodôntico constituíram a amostra deste estudo, 12 do gênero feminino e 7 do masculino, com idades entre 16 anos e 4 meses e 28 anos e 2 meses. Após a coleta de dados, feita por dois examinadores, análises estatísticas para a obtenção dos erros intra e inter-examinadores foram feitas, utilizando nível de significância de 5%. RESULTADOS E CONCLUSÕES: concluiu-se que a obtenção dos valores para o ângulo formado entre o longo eixo do incisivo inferior e o plano mandibular (IMPA na telerradiografia lateral é um método confiável para uso clínico, porque embora apresente, como regra, valores menores que os encontrados em tomografia

  6. Alteraciones nerviosas tras la extracción quirúrgica de terceros molares inferiores. Estudio prospectivo

    OpenAIRE

    Valmaseda Castellón, Eduardo

    1999-01-01

    1)OBJETIVOS:Determinar la incidencia de lesiones del nervio dentario inferior y del nervio lingual tras la extracción quirúrgica de terceros molares inferiores e identificar los factores de riesgo de dichas lesiones. Establecer un modelo de regresión logística para predecir la probabilidad de lesión de los nervios dentario inferior y lingual. Describir la evolución de las alteraciones sensoriales.2) MATERIAL Y MÉTODOS:Se recogieron datos para un estudio prospectivo preliminar sobre 449 extrac...

  7. Binaural electric-acoustic interactions recorded from the inferior colliculus of Guinea pigs: the effect of masking observed in the central nucleus of the inferior colliculus.

    Science.gov (United States)

    Noh, Heil; Lee, Dong-Hee

    2012-09-01

    To investigate the electric-acoustic interactions within the inferior colliculus of guinea pigs and to observe how central masking appears in invasive neural recordings of the inferior colliculus (IC). A platinum-iridium wire was inserted to scala tympani through cochleostomy with a depth no greater than 1 mm for intracochlear stimulation of electric pulse train. A 5 mm 100 µm, single-shank, thin-film, penetrating recording probe was inserted perpendicularly to the surface of the IC in the coronal plane at an angle of 30-40° off the parasagittal plane with a depth of 2.0-2.5 mm. The peripheral and central masking effects were compared using electric pulse trains to the left ear and acoustic noise to the left ear (ipsilateral) and to the right ear (contralateral). Binaural acoustic stimuli were presented with different time delays and compared with combined electric and acoustic stimuli. The averaged evoked potentials and total spike numbers were measured using thin-film electrodes inserted into the central nucleus of the IC. Ipsilateral noise had more obvious effects on the electric response than did contralateral noise. Contralateral noise decreased slightly the response amplitude to the electric pulse train stimuli. Immediately after the onset of acoustic noise, the response pattern changed transiently with shorter response intervals. The effects of contralateral noise were evident at the beginning of the continuous noise. The total spike number decreased when the binaural stimuli reached the IC most simultaneously. These results suggest that central masking is quite different from peripheral masking and occurs within the binaural auditory system, and this study showed that the effect of masking could be observed in the IC recording. These effects are more evident and consistent with the psychophysical data from spike number analyses than with the previously reported gross potential data.

  8. F6H8 as an Intraoperative Tool and F6H8/Silicone Oil as a Postoperative Tamponade in Inferior Retinal Detachment with Inferior PVR

    Directory of Open Access Journals (Sweden)

    Gian Marco Tosi

    2014-01-01

    Full Text Available Purpose. To evaluate the effectiveness and safety of perfluorohexyloctane (F6H8 for intraoperative flattening of the retina and of F6H8/silicone oil (SO 1000 cSt as a postoperative tamponade for inferior retinal detachment with inferior proliferative vitreoretinopathy. Methods. This is a retrospective review of 22 patients who underwent pars plana vitrectomy using F6H8 as an intraoperative tool to flatten the retina. At the end of the surgery a direct partial exchange between F6H8 and SO 1000 cSt was performed, tamponing the eye with different ratios of F6H8/SO (70/30, 60/40, 50/50, 40/30, and 30/70. Anatomical and functional results and complications were evaluated over the follow-up period (mean 22.63 months. Results. F6H8 was efficacious for intraoperative flattening of the retina. Twenty-one of the 22 patients achieved a complete retinal reattachment. Postoperative visual acuity (VA ranged from light perception to 20/70, with 72% of patients obtaining VA better than 20/400. No emulsification/inflammation was observed whatever the ratio of F6H8/SO used. With higher ratios of F6H8/SO (70/30 and 60/40 cloudiness of the tamponade was observed. A transparent mixture was present with all the other ratios. Conclusions. The surgical technique adopted is very simple and safe. The optimal F6H8/SO ratio seems to be between 50/50 and 30/70.

  9. Inferior J waves in patients with vasospastic angina might be a risk factor for ventricular fibrillation.

    Science.gov (United States)

    Fumimoto, Tomoko; Ueyama, Takeshi; Shimizu, Akihiko; Yoshiga, Yasuhiro; Ono, Makoto; Kato, Takayoshi; Ishiguchi, Hironori; Okamura, Takayuki; Yamada, Jutaro; Yano, Masafumi

    2017-09-01

    There is little information about the relationship between J waves and the occurrence of ventricular fibrillation (VF) in patients with vasospastic angina (VSA). The present study aimed to assess the incidence of J waves and the occurrence of VF in patients with VSA. The subjects consisted of 62 patients with VSA diagnosed by acetylcholine provocation tests in our institution from 2002 to 2014. We investigated the VF events, prevalence of J waves, and relationship between the VF events and J waves. J waves were observed in 16 patients (26%) and VF events were documented in 11 (18%). The incidence of VF in the patients with J waves was significantly higher than that in those without J waves (38% vs 11%, p=0.026). J waves were observed in the inferior leads in 14 patients, lateral leads in 5, and anterior leads in 3. A univariate analysis indicated that the incidence of VF in the inferior leads of J wave positive patients (46%=6/14) was significantly (p=0.01) higher than that in the inferior leads of J wave negative patients (10%=5/48). The J waves in the anterior and/or lateral leads were not related to the incidence of VF. Notched type and slurred type J waves were not associated with VF. A multivariate analysis revealed that J waves in VSA patients were associated with VF [odds ratio (OR) 6.41, 95% confidence interval (CI) 1.37-29.93, p=0.02] and organic stenosis (OR 6.98, 95% CI 1.39-35.08, p=0.02). Further, J waves in the inferior leads were strongly correlated with VF (OR 11.85, 95% CI 2.05-68.42, p=0.006). The results suggest that the existence of J waves, especially in the inferior leads, might be a risk factor for VF in VSA patients. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  10. Determining the sample size required to establish whether a medical device is non-inferior to an external benchmark

    National Research Council Canada - National Science Library

    Adrian Sayers; Michael J Crowther; Andrew Judge; Michael R Whitehouse; Ashley W Blom

    2017-01-01

    ... to the performance benchmark of interest. We aim to describe the methods and sample size required to conduct a one-sample non-inferiority study of a medical device for the purposes of benchmarking...

  11. Clinical utility of a multigated modified anterior projection in the detection of left ventricular inferior and apical wall motion abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Polak, J.F.; Bianco, J.A.; Kemper, A.J.; Tow, D.E.

    1982-04-01

    Recent evidence indicates that the left anterior oblique projection (LAO) multigated radionuclide ventriculogram (RVG) underestimates presence and extent of apical and inferior left ventricular (LV) wall motion abnormalities. We investigated, prospectively, the sensitivity and specificity of a modified anterior projection (MAP), which incorporates cephalad tilting. Thirty-three consecutive patients undergoing cardiac catheterization suspected to have coronary artery disease were studied with RVG, using both the MAP and LAO views. LAO views were analyzed using the ejection fraction image (REFI), and the regional ejection fraction (REF) of the inferoapical region. The MAP studies were analyzed using stroke volume image (SVI) to evaluate apical and inferior LV regions. Results were as follows: (Formula: see text), Both intraobserver and interobserver variabilities were comparable to those of conventional angiographic studies used in detection of apical and inferior asynergy. It is concluded that the multigated MAP offers additional information about abnormalities of the LV inferior and apical regions.

  12. Implications of a 5-liter urinary bladder: inferior vena cava syndrome leading to bilateral pulmonary artery emboli.

    Science.gov (United States)

    Sharma, Vidit; McGuire, Barry B; Nadler, Robert B

    2014-06-01

    Compression of the inferior vena cava by the distended urinary bladder is rare but is usually found in the presence of lower extremity edema. Here, we present the case of a 68-year-old man found to have multiple pulmonary emboli as the first manifestation of inferior vena cava compression from a distended urinary bladder 5 L in capacity. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. A comparison of the ultrasound measurement of the inferior vena cava obtained with cardiac and convex transducers

    OpenAIRE

    Andruszkiewicz, Paweł; Sobczyk, Dorota; Nycz, Krzysztof; Górkiewicz-Kot, Izabela; Ziętkiewicz, Mirosław; Wierzbicki, Karol; Wojtczak, Jacek; Kowalik, Ilona

    2017-01-01

    Background: Ultrasound measurement of the inferior vena cava diameter and its respiratory variability are amongst the predictors of fluid volume status. The primary purpose of the present study was to compare the consistency of inferior vena cava diameter measurements and the collapsibility index, obtained with convex and cardiac transducers. A secondary aim was to assess the agreement of the patient’s allocation to one of the two groups: “fluid responder” or “fluid non-respond...

  14. Factors associated with failure to identify the culprit artery by the electrocardiogram in inferior ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Tahvanainen, Minna; Nikus, Kjell C; Holmvang, Lene

    2011-01-01

    Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored.......Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored....

  15. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Catherine; Trad, Clovis Simao [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Trad, Henrique Simao, E-mail: hstrad@terra.com.br [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Universidade de Sao Paulo (HC-FMRPUSP), Ribeirao Preto, SP (Brazil). Fac. de Medicina. Hospital das Clinicas; Mendonca, Silvana Machado [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil)

    2013-06-15

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications. (author)

  16. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Catherine Yang

    2013-07-01

    Full Text Available Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications.

  17. Prevalence of pain on palpation of the inferior pole of the patella among patients with complaints of knee pain

    Directory of Open Access Journals (Sweden)

    Leonardo Addêo Ramos

    2009-03-01

    Full Text Available CONTEXT AND OBJECTIVE: Patellar tendinopathy is a common condition in sports. It may occur at any location of the patellar tendon, but the most commonly affected area is the inferior pole of the patella. Among various diagnostic tests, the one most used is palpation of the inferior pole of the patella. The aim of this study was to investigate the prevalence of pain complaints among individuals with pathological knee conditions and to evaluate palpation of the inferior pole of the patella as a diagnostic test for patellar tendinopathy. METHODS: Palpation of the patellar tendon was performed on 318 individuals who presented with knee-related complaints. Palpation was performed with the individual in the supine position and the knee extended. The age, gender, physical activity and labor activity of each individual were recorded at the time the symptoms appeared; the diagnosis was also recorded. RESULTS: Of the total number of individuals evaluated, 124 (39% felt pain on palpation of the inferior pole of the patella. Of these, only 40 (32.3% received a diagnosis of patellar tendinopathy. We did not observe any difference with respect to gender and age distribution. When evaluating daily physical activity levels, however, we observed that individuals with pain on palpation of the inferior pole of the patella experienced more intense physical activity. CONCLUSIONS: Palpation of the inferior pole of the patella is a diagnostic procedure with high sensitivity and moderate specificity for diagnosing patellar tendinopathy, especially among individuals who perform activities with high functional demands.

  18. Responses from two firing patterns in inferior colliculus neurons to stimulation of the lateral lemniscus dorsal nucleus

    Directory of Open Access Journals (Sweden)

    Xiao-ting Li

    2016-01-01

    Full Text Available The γ-aminobutyric acid neurons (GABAergic neurons in the inferior colliculus are classified into various patterns based on their intrinsic electrical properties to a constant current injection. Although this classification is associated with physiological function, the exact role for neurons with various firing patterns in acoustic processing remains poorly understood. In the present study, we analyzed characteristics of inferior colliculus neurons in vitro, and recorded responses to stimulation of the dorsal nucleus of the lateral lemniscus using the whole-cell patch clamp technique. Seven inferior colliculus neurons were tested and were classified into two firing patterns: sustained-regular (n = 4 and sustained-adapting firing patterns (n = 3. The majority of inferior colliculus neurons exhibited slight changes in response to stimulation and bicuculline. The responses of one neuron with a sustained-adapting firing pattern were suppressed after stimulation, but recovered to normal levels following application of the γ-aminobutyric acid receptor antagonist. One neuron with a sustained-regular pattern showed suppressed stimulation responses, which were not affected by bicuculline. Results suggest that GABAergic neurons in the inferior colliculus exhibit sustained-regular or sustained-adapting firing patterns. Additionally, GABAergic projections from the dorsal nucleus of the lateral lemniscus to the inferior colliculus are associated with sound localization. The different neuronal responses of various firing patterns suggest a role in sound localization. A better understanding of these mechanisms and functions will provide better clinical treatment paradigms for hearing deficiencies.

  19. Isolated primary amyloidosis of the inferior rectus muscle mimicking Graves' orbitopathy.

    Science.gov (United States)

    Monteiro, Mário Luiz Ribeiro; Gonçalves, Allan Christian Pieroni; Bezerra, Alanna Mara Pinheiro Sobreira

    2016-01-01

    The diagnosis of Graves' orbitopathy is usually straightforward. However, orbital diseases that mimick some clinical signs of Graves' orbitopathy may cause diagnostic confusion, particularly when associated to some form of thyroid dysfunction. This report describes the rare occurrence of localized inferior rectus muscle amyloidosis in a patient with autoimmune hypothyroidism, who was misdiagnosed as Graves' orbitopathy. A 48-year-old man complained of painless progressive proptosis on the left side and intermittent vertical diplopia for 6 months. The diagnosis of Graves' orbitopathy was entertained after magnetic resonance imaging revealing a markedly enlarged, tendon-sparing inferior rectus enlargement on the left side, and an autoimmune hypothyroidism was disclosed on systemic medical workup. After no clinical improvement with treatment, the patient was referred to an ophthalmologist and further investigation was performed. The presence of calcification in the inferior rectus muscle on computed tomography, associated with the clinical findings led to a diagnostic biopsy, which revealed amyloid deposition. This report emphasizes that a careful evaluation of atypical forms of Graves' orbitopathy may be crucial and should include, yet with rare occurrence, amyloidosis in its differential diagnosis. RESUMO O diagnóstico de orbitopatia de Graves usualmente é fácil de ser estabelecido. No entanto, doenças da órbita que simulam alguns sinais clínicos da orbitopatia de Graves podem levar à confusão diagnóstica, particularmente quando associada à alguma forma de disfunção tireoidiana. Relatamos a ocorrência rara de amiloidose localizada no músculo reto inferior em paciente com hipotireoidismo autoimune, que recebeu inicialmente o diagnóstico errôneo de orbitopatia de Graves. Paciente masculino, 48 anos, com queixa de proptose progressiva e indolor do lado esquerdo e diplopia vertical intermitente há 6 meses. O diagnóstico de orbitopatia de Graves foi

  20. Comparative proteomics analysis of superior and inferior spikelets in hybrid rice during grain filling and response of inferior spikelets to drought stress using isobaric tags for relative and absolute quantification.

    Science.gov (United States)

    Dong, Minghui; Gu, Junrong; Zhang, Li; Chen, Peifeng; Liu, Tengfei; Deng, Jinhua; Lu, Haoqian; Han, Liyu; Zhao, Buhong

    2014-09-23

    The biological functions of the differentially abundant proteins between superior and inferior spikelet grains were investigated based on the isobaric tags for relative and absolute quantification to further clarify the mechanism of rice grain filling at the proteomic level, as well as the response of inferior spikelets to drought dress (-20kPa or -40kPa). Compared with superior spikelets, inferior ones had lower sink strength due to the lower sink activities (lower abundances of ADP-glucose pyrophosphorylase, granule-bound starch synthase, starch branching enzyme and pullulanase) and smaller sink sizes (lower abundances of structural proteins). The slower and later grain filling resulted from the weaker decomposition and conversion of photoassimilate and the slower cell division. Moderate drought stress (-20kPa) promoted the grain filling of inferior spikelets through regulating the proteins associated with photoassimilate supply and conversion. These proteins may be important targets for rice breeding programs that raise the rice yield under drought condition. The findings offer new insights into rice grain-filling and provide theoretical evidences for better quality control and scientific improvement of super rice in practice. Rice cultivars with large panicles do not always guarantee high yield and grain quality probably due to the slow grain filling and many unfilled grains of inferior spikelets. In general, earlier-flowering superior spikelets, which are usually located on apical primary branches, fill faster and produce larger and heavier grains. In contrast, later-flowering inferior spikelets located on proximal secondary branches are either sterile or fill slowly and poorly, and the differences are more significant in large panicle rice or super rice. The increase of rice yield has been limited by the unsatisfactory grain filling of inferior spikelets, and the inferior spikelets are more prone to environmental factors during grain filling. Thus, we herein

  1. The isolated inferior glenohumeral labrum injury, anterior to posterior (the ILAP): A case series.

    Science.gov (United States)

    Irion, Val; Cheah, Michael; Jones, Grant L; Bishop, Julie Y

    2015-01-01

    We describe the presentation, exam findings, surgical repair techniques, and short-term outcomes in a series of patients with isolated inferior labral tears. A retrospective chart review was performed at a large academic medical center. Isolated inferior labral tears were defined as between the 4 o'clock and 8 o'clock position of the glenoid as determined by direct arthroscopic visualization. Tears that were smaller were also included but were required to cross the 6 o'clock point, having anterior and posterior components. Patients were excluded if they had any other pathology or treatment of the shoulder. 1-year follow-up was required. Of the 17 patients who met inclusion criteria for review, 12 were available for a minimum 1-year follow-up. Average total follow-up for patients to complete the phone interview/Oxford Shoulder Instability Score (OSIS) was an average of 37.7 months (range: 16-79 months). Postoperatively, all reported symptom improvement or resolution since surgery. The mean preoperative pain on a scale of 0-10 was 6.3 (range: 0-10). Mean postoperative pain on a scale of 0-10 was 2.25 (range: 0-5). Eleven of 12 patients (91.7%) had returned to the level of activity desired. The mean OSIS was 41.4 (median: 43; range: 27-47). Eleven of 12 patients (91.7%) had good or excellent scores. Ten of 12 patients (83.3%) had a feeling of stability in the shoulder. All 12 patients reached were satisfied with the procedure and would undergo surgery again in a similar situation. We have presented our series of patients with isolated inferior labral injury, and have shown that when surgically treated, outcomes of this uncommon injury are good to excellent and a full return to sports can be expected.

  2. Bidirectional plasticity in the primate inferior olive induced by chronic ethanol intoxication and sustained abstinence.

    Science.gov (United States)

    Welsh, John P; Han, Victor Z; Rossi, David J; Mohr, Claudia; Odagiri, Misa; Daunais, James B; Grant, Kathleen A

    2011-06-21

    The brain adapts to chronic ethanol intoxication by altering synaptic and ion-channel function to increase excitability, a homeostatic counterbalance to inhibition by alcohol. Delirium tremens occurs when those adaptations are unmasked during withdrawal, but little is known about whether the primate brain returns to normal with repeated bouts of ethanol abuse and abstinence. Here, we show a form of bidirectional plasticity of pacemaking currents induced by chronic heavy drinking within the inferior olive of cynomolgus monkeys. Intracellular recordings of inferior olive neurons demonstrated that ethanol inhibited the tail current triggered by release from hyperpolarization (I(tail)). Both the slow deactivation of hyperpolarization-activated cyclic nucleotide-gated channels conducting the hyperpolarization-activated inward current and the activation of Ca(v)3.1 channels conducting the T-type calcium current (I(T)) contributed to I(tail), but ethanol inhibited only the I(T) component of I(tail). Recordings of inferior olive neurons obtained from chronically intoxicated monkeys revealed a significant up-regulation in I(tail) that was induced by 1 y of daily ethanol self-administration. The up-regulation was caused by a specific increase in I(T) which (i) greatly increased neurons' susceptibility for rebound excitation following hyperpolarization and (ii) may have accounted for intention tremors observed during ethanol withdrawal. In another set of monkeys, sustained abstinence produced the opposite effects: (i) a reduction in rebound excitability and (ii) a down-regulation of I(tail) caused by the down-regulation of both the hyperpolarization-activated inward current and I(T). Bidirectional plasticity of two hyperpolarization-sensitive currents following chronic ethanol abuse and abstinence may underlie persistent brain dysfunction in primates and be a target for therapy.

  3. Dysregulated left inferior parietal activity in schizophrenia and depression: functional connectivity and characterization

    Directory of Open Access Journals (Sweden)

    Veronika I. Müller

    2013-06-01

    Full Text Available The inferior parietal cortex (IPC is a heterogeneous region that is known to be involved in a multitude of diverse different tasks and processes, though its contribution to these often-complex functions is yet poorly understood. In a previous study we demonstrated that patients with depression failed to deactivate the left IPC during processing of congruent audiovisual information. We now found the same dysregulation (same region and condition in schizophrenia. By using task-independent (resting state and task-dependent (MACM analyses we aimed at characterizing this particular region with regard to its connectivity and function. Across both approaches, results revealed functional connectivity of the left inferior parietal seed region with bilateral IPC, precuneus and posterior cingulate cortex (PrC/PCC, medial orbitofrontal cortex (mOFC, left middle frontal (MFG as well as inferior frontal (IFG gyrus. Network-level functional characterization further revealed that on the one hand, all interconnected regions are part of a network involved in memory processes. On the other hand, sub-networks are formed when emotion, language, social cognition and reasoning processes are required. Thus, the IPC-region that is dysregulated in both depression and schizophrenia is functionally connected to a network of regions which, depending on task demands may form sub-networks. These results therefore indicate that dysregulation of left IPC in depression and schizophrenia might not only be connected to deficits in audiovisual integration, but is possibly also associated to impaired memory and deficits in emotion processing in these patient groups.

  4. Separate vertical wiring for the fixation of comminuted fractures of the inferior pole of the patella.

    Science.gov (United States)

    Song, Hyung Keun; Yoo, Je Hyun; Byun, Young Soo; Yang, Kyu Hyun

    2014-05-01

    Among patients over 50 years of age, separate vertical wiring alone may be insufficient for fixation of fractures of the inferior pole of the patella. Therefore, mechanical and clinical studies were performed in patients over the age of 50 to test the strength of augmentation of separate vertical wiring with cerclage wire (i.e., combined technique). Multiple osteotomies were performed to create four-part fractures in the inferior poles of eight pairs of cadaveric patellae. One patella from each pair was fixed with the separate wiring technique, while the other patella was fixed with a combined technique. The ultimate load to failure and stiffness of the fixation were subsequently measured. In a clinical study of 21 patients (average age of 64 years), comminuted fractures of the inferior pole of the patellae were treated using the combined technique. Operative parameters were recorded from which post-operative outcomes were evaluated. For cadaveric patellae, whose mean age was 69 years, the mean ultimate loads to failure for the separate vertical wiring technique and the combined technique were 216.4±72.4 N and 324.9±50.6 N, respectively (p=0.012). The mean stiffness for the separate vertical wiring technique and the combined technique was 241.1±68.5 N/mm and 340.8±45.3 N/mm, respectively (p=0.012). In the clinical study, the mean clinical score at final follow-up was 28.1 points. Augmentation of separate vertical wiring with cerclage wire provides enough strength for protected early exercise of the knee joint and uneventful healing.

  5. Densiron® 68 as an intraocular tamponade for complex inferior retinal detachments

    Directory of Open Access Journals (Sweden)

    Hussain RN

    2011-05-01

    Full Text Available Rumana N Hussain, Somnath BanerjeeLeicester Royal Infirmary, Leicester, UKIntroduction: Densiron® 68 is a high-density liquid used to tamponade inferior retinal detachments. We present a case series of 12 patients treated with Densiron as an intraocular tamponade agent.Methods: A retrospective analysis of 12 eyes in 12 patients was carried out. The primary endpoint was anatomic reattachment of the retina following removal of Densiron oil.Results: All patients had inferior detachments; 33% had associated proliferative vitreoretinopathy (PVR. Densiron was utilized as a primary agent in five patients (42%; the remaining patients had prior unsuccessful surgery for retinal reattachment, including pars plana vitrectomy, cryotherapy, laser, encirclement, gas (C3F8 or C2F6, or silicone oil. Eleven patients (91% had successful reattachment of the retina at 3 months following removal of Densiron; one patient had extensive PVR, total retinal detachment, preretinal macula fibrosis, and chronic hypotony, and surgical intervention was unsuccessful. Six patients (50% had raised intraocular pressure (IOP, resolving in the majority of cases following Densiron removal; two patients had long-term raised IOP requiring topical or surgical therapy. Of the six phakic patients, 50% developed significant cataract in the operated eye. Of those with successful retinal reattachment, visual outcome was variable, with 36% patients gaining two to four lines on Snellen, 27% remaining objectively the same, and 36% losing one to two lines.Conclusion: The anatomic success rate is high (91% in patients requiring Densiron tamponade for inferior retinal detachments with or without evidence of PVR either as a primary or secondary intervention. A common complication is raised IOP; however, this most often resolves following removal of the oil.Keywords: intraocular tamponade, silicone oil, retinal detachment, retinal reattachments

  6. Computational Modeling of Blood Flow in the TrapEase Inferior Vena Cava Filter

    Energy Technology Data Exchange (ETDEWEB)

    Singer, M A; Henshaw, W D; Wang, S L

    2008-02-04

    To evaluate the flow hemodynamics of the TrapEase vena cava filter using three dimensional computational fluid dynamics, including simulated thrombi of multiple shapes, sizes, and trapping positions. The study was performed to identify potential areas of recirculation and stagnation and areas in which trapped thrombi may influence intrafilter thrombosis. Computer models of the TrapEase filter, thrombi (volumes ranging from 0.25mL to 2mL, 3 different shapes), and a 23mm diameter cava were constructed. The hemodynamics of steady-state flow at Reynolds number 600 was examined for the unoccluded and partially occluded filter. Axial velocity contours and wall shear stresses were computed. Flow in the unoccluded TrapEase filter experienced minimal disruption, except near the superior and inferior tips where low velocity flow was observed. For spherical thrombi in the superior trapping position, stagnant and recirculating flow was observed downstream of the thrombus; the volume of stagnant flow and the peak wall shear stress increased monotonically with thrombus volume. For inferiorly trapped spherical thrombi, marked disruption to the flow was observed along the cava wall ipsilateral to the thrombus and in the interior of the filter. Spherically shaped thrombus produced a lower peak wall shear stress than conically shaped thrombus and a larger peak stress than ellipsoidal thrombus. We have designed and constructed a computer model of the flow hemodynamics of the TrapEase IVC filter with varying shapes, sizes, and positions of thrombi. The computer model offers several advantages over in vitro techniques including: improved resolution, ease of evaluating different thrombus sizes and shapes, and easy adaptation for new filter designs and flow parameters. Results from the model also support a previously reported finding from photochromic experiments that suggest the inferior trapping position of the TrapEase IVC filter leads to an intra-filter region of recirculating

  7. Percutaneous Transluminal Angioplasty for Complete Membranous Obstruction of Suprahepatic Inferior Vena Cava: Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Kucukay, Fahrettin, E-mail: fkucukay@hotmail.com [Turkiye Yuksek Ihtisas Hospital, Department of Interventional Radiology (Turkey); Akdogan, Meral, E-mail: akdmeral@yahoo.com [Turkiye Yuksek Ihtisas Hospital, Department of Gastroenterology (Turkey); Bostanci, Erdal Birol, E-mail: ebbostanci@yahoo.com [Turkiye Yuksek Ihtisas Hospital, Department of Gastrointestinal Surgery (Turkey); Ulus, Ahmet Tulga, E-mail: uluss@yahoo.com [Hacettepe University, Department of Cardiovascular Surgery (Turkey); Kucukay, Murat Bulent, E-mail: dr-mbk@hotmail.com [Lokman Hekim Hospital, Department of Internal Medicine (Turkey)

    2016-10-15

    PurposeTo determine the long-term results of percutaneous transluminal angioplasty (PTA) for a complete membranous obstruction of the suprahepatic inferior vena cava.MethodsPatients (n = 65) who were referred to the interventional unit for PTA for a complete membranous obstruction of the suprahepatic inferior vena cava between January 2006 and October 2014 were included in the study. Thirty-two patients (18 males, 14 females, mean age 35 ± 10.7, range 20–42 years) were treated. The patients presented with symptoms of ascites (88 %), pleural effusion (53 %), varicose veins (94 %), hepatomegaly (97 %), abdominal pain (84 %), and splenomegaly (40 %). Transjugular liver access set and re-entry catheter were used to puncture and traverse the obstruction from the jugular side. PTA balloon dilations were performed. The mean follow-up period was 65.6 ± 24.5 months. The objective was to evaluate technical success, complications, primary patency, and clinical improvement in the symptoms of the patients.ResultsThe technical success rate was 94 %. In two patients, obstruction could not be traversed. These patients underwent cavoatrial graft bypass surgery. There were no procedure-related complications. Clinical improvements were achieved in all patients within 3 months. The primary patency rate at 4 years was 90 %. There was no primary assisted patency. There was no need for metallic stent deployment in the cohort. The secondary patency rate at 4 years was 100 %.ConclusionsPercutaneous transluminal angioplasty for a complete membranous obstruction of the suprahepatic inferior vena cava is safe and effective, and the long-term results are excellent.

  8. Intracellular responses to frequency modulated tones in the dorsal cortex of the mouse inferior colliculus

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    Ruediger eGeis

    2013-01-01

    Full Text Available Frequency modulations occur in many natural sounds, including vocalizations. The neuronal response to frequency modulated (FM stimuli has been studied extensively in different brain areas, with an emphasis on the auditory cortex and the central nucleus of the inferior colliculus. Here, we measured the responses to FM sweeps in whole-cell recordings from neurons in the dorsal cortex of the mouse inferior colliculus. Both up- and downward logarithmic FM sweeps were presented at two different speeds to both the ipsi- and the contralateral ear. Based on the number of action potentials that were fired, between 10-24% of cells were selective for rate or direction of the FM sweeps. A somewhat lower percentage of cells, 6-21%, showed selectivity based on EPSP size. To study the mechanisms underlying the generation of FM selectivity, we compared FM responses with responses to simple tones in the same cells. We found that if pairs of neurons responded in a similar way to simple tones, they generally also responded in a similar way to FM sweeps. Further evidence that FM selectivity can be generated within the dorsal cortex was obtained by reconstructing FM sweeps from the response to simple tones using three different models. In about half of the direction selective neurons the selectivity was generated by spectrally asymmetric synaptic inhibition. In addition, evidence for direction selectivity based on the timing of excitatory responses was also obtained in some cells. No clear evidence for the local generation of rate selectivity was obtained. We conclude that FM direction selectivity can be generated within the dorsal cortex of the mouse inferior colliculus by multiple mechanisms.

  9. Distal posterior inferior cerebellar artery aneurysm: case report Aneurisma da artéria cerebelar posterior e inferior distal: relato de caso

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    Ricardo Ramina

    2005-06-01

    Full Text Available The majority of posterior inferior cerebellar artery (PICA aneurysms are usually found on the bifurcation of the vertebral artery (VA - PICA junction. Aneurysms arising from more peripheral PICA segments named distal PICA aneurysm are uncommon. The major clinical manifestation is that of an intracranial bleeding and the site of hemorrhage is related to the PICA segment originating the aneurysm. Lesions originating from distal PICA segments, particularly those arising from the telovelotonsillar segment, are associated with hemorrhage extending into the ventricular system, mainly the IV ventricle. A case of a 50-year-old woman with sudden headaches and vomiting, and intraventricular hemorrhage (four ventricles caused by an aneurysm of the telovelotonsillar segment of the PICA, is presented. No signs of subarachnoidal hemorrhage were found in the computerized tomography. The aneurysm was clipped and the patient presented a favorable outcome. Anatomical aspects and clinical series are reviewed.A maioria dos aneurismas da artéria cerebelar posterior inferior (PICA é geralmente encontrada na junção artéria vertebral (VA - PICA. Aneurismas originando-se nos segmentos mais distais da PICA são considerados raros. A manifestação clínica em geral por hemorragia intracraniana, e o local desta está relacionado ao segmento que origina o aneurisma. Lesões localizadas em segmentos mais distais da PICA, em especial os originados do segmento telovelotonsilar, estão associados a hemorragias no sistema ventricular, particularmente no quarto ventrículo. Relatamos o caso de mulher de 50 anos de idade que desenvolveu quadro de cefaléia súbita e vômitos, com hemorragia nos quatro ventrículos, causada por ruptura de aneurisma localizado no segmento telovelotonsilar da PICA. Não havia sinais de hemorragia subaracnóidea na tomografia computadorizada de crânio. O aneurisma foi clipado e a paciente apresentou evolução favorável. Aspectos anatômicos e

  10. Glucocorticoides como profiláctico antinflamatorio en cirugía de terceras molares inferiores.

    OpenAIRE

    Manrique-Guzmán, Jorge; Facultad de Odontología de la Universidad Nacional Federico Villarreal. Lima.; Chávez-Reátegui, Beatriz; Facultad de Estomatología. Universidad Peruana Cayetano Heredia. Lima.; Manrique-Chávez, Jorge; Facultad de Estomatología. Universidad Peruana Cayetano Heredia. Lima.

    2014-01-01

    Objetivo: Comparar la presencia de inflamación aguda severa en pacientes con y sin medicación antes del procedimiento de exodoncia de terceros molares inferiores, atendidos en la Clínica Odontológica de la Universidad Nacional Federico Villarreal. Material y métodos: Se tomó como muestra 116 pacientes de ambos sexos, entre 21 y 45 años de edad los cuales fueron divididos en dos grupos aleatoriamente, solo uno recibió medicación con Glucocorticoides antes del tratamiento. Resultados: Se encont...

  11. Diseño de dispositivo adaptado a planos inclinables para la movilidad de miembros inferiores

    OpenAIRE

    Paniagua del Mazo, Marina

    2014-01-01

    El presente proyecto trata sobre el diseño de un dispositivo para la movilidad de los miembros inferiores, en concreto los pies y tobillos, adaptado a los planos inclinables. Se focaliza el uso tanto en tratamientos de rehabilitación como para aportar una nueva actividad para personas con discapacidad de grado parapléjico. Los beneficios que presenta este dispositivo son muchos, desde la mejora de la circulación sanguínea hasta una notable reducción de espasmos musculares. L...

  12. Dyslexic children lack word selectivity gradients in occipito-temporal and inferior frontal cortex

    Directory of Open Access Journals (Sweden)

    O.A. Olulade

    2015-01-01

    Full Text Available fMRI studies using a region-of-interest approach have revealed that the ventral portion of the left occipito-temporal cortex, which is specialized for orthographic processing of visually presented words (and includes the so-called “visual word form area”, VWFA, is characterized by a posterior-to-anterior gradient of increasing selectivity for words in typically reading adults, adolescents, and children (e.g. Brem et al., 2006, 2009. Similarly, the left inferior frontal cortex (IFC has been shown to exhibit a medial-to-lateral gradient of print selectivity in typically reading adults (Vinckier et al., 2007. Functional brain imaging studies of dyslexia have reported relative underactivity in left hemisphere occipito-temporal and inferior frontal regions using whole-brain analyses during word processing tasks. Hence, the question arises whether gradient sensitivities in these regions are altered in dyslexia. Indeed, a region-of-interest analysis revealed the gradient-specific functional specialization in the occipito-temporal cortex to be disrupted in dyslexic children (van der Mark et al., 2009. Building on these studies, we here (1 investigate if a word-selective gradient exists in the inferior frontal cortex in addition to the occipito-temporal cortex in normally reading children, (2 compare typically reading with dyslexic children, and (3 examine functional connections between these regions in both groups. We replicated the previously reported anterior-to-posterior gradient of increasing selectivity for words in the left occipito-temporal cortex in typically reading children, and its absence in the dyslexic children. Our novel finding is the detection of a pattern of increasing selectivity for words along the medial-to-lateral axis of the left inferior frontal cortex in typically reading children and evidence of functional connectivity between the most lateral aspect of this area and the anterior aspects of the occipito-temporal cortex. We

  13. Renal angiomyolipoma with inferior vena caval thrombus in a 32-year-old male

    Directory of Open Access Journals (Sweden)

    Matthew W Christian

    2009-01-01

    Full Text Available Renal angiomyolipoma (AML rarely presents with evidence of extension into the renal vein, inferior vena cava (IVC or atrium. We report a case of a renal AML with a tumor thrombus to the IVC in a 32-year-old male. The patient subsequently underwent a right radical nephrectomy with IVC tumor thrombectomy. To our knowledge, there are four published cases of renal AML presenting with tumor thrombus in males. This case report describes the management of the youngest male ever to develop a renal AML with IVC tumor thrombus.

  14. Mobilização precoce na fase aguda da trombose venosa profunda de membros inferiores

    OpenAIRE

    Penha,Geane de Souza; Damiano,Ana Paula; Carvalho,Tales de; Lain,Vinícius; Serafim,João Daniel

    2009-01-01

    O tratamento convencional da trombose venosa profunda na fase aguda consiste em restrição ao leito. Porém, estudos recentes contestam essa abordagem terapêutica, enfatizando que a mobilização precoce propicia resultados clínicos favoráveis. O objetivo deste estudo foi pesquisar em literatura científica, principalmente ensaios clínicos controlados, sobre a mobilização precoce de pacientes portadores de trombose venosa profunda de membros inferiores na fase aguda. Utilizou-se como estratégia de...

  15. Double trouble with acute inferior myocardial infarction and left anterior descending artery thrombi

    Directory of Open Access Journals (Sweden)

    Özlem Yıldırımtürk, MD

    2017-09-01

    Full Text Available Concomitant occlusion of multiple epicardial coronary arteries is an uncommon finding in patients presenting with ST-segment elevation myocardial infarction. We reported a 50 years-old male patient who presented with inferior myocardial infarction. Coronary angiography revealed simultaneous occlusion of left anterior descending (LAD and right coronary artery (RCA. The RCA occlusion treated successfully with percutaneous coronary intervention while LAD occlusion treated with antithrombotic and glycoprotein 2B/3A administration. Although multiple coronary thromboses of coronary arteries in the course of myocardial infarction is uncommon, it is crucial to determine proper treatment for these patients.

  16. Sex segregation and equality in a multicultural society: inferiority as a standard for legal acceptability

    OpenAIRE

    Marjolein van den Brink; Titia Loenen; Jet Tigchelaar

    2010-01-01

    This contribution explores the legal acceptability of old and new forms of sex segregation, using a multilayered ‘inferiority test’ that can be regarded as a specification of (inter)national equality and non-discrimination standards. The test is applied to a number of topical cases of sex segregation: 1) A traditional case of rather uncontested sex segregation in sports, specifically in amateur football; 2) A more controversial case that seems to be on the rise once again: sex-segregated educ...

  17. Prevention of type II endoleak by laparoscopic inferior mesenteric artery ligation.

    Science.gov (United States)

    Brenes, Robert A; Panait, Lucian; Abbas, Hussain M A; Tapias, Leonidas; Tripodi, Giuseppe; Ajemian, Michael S; Macaron, Shady H

    2013-08-01

    Abdominal aortic aneurysm repair by endovascular techniques have gained wide acceptance as a treatment option. A potential well-known complication of endovascular repair includes endoleak. Specifically, type II endoleak, which is described as retrograde flow into the aneurysm sac through collateral vessels, can occur in up to 30% of patients. Certain preoperative factors can predict which patients may develop type II endoleak. This article describes laparoscopic inferior mesenteric artery ligation prior to endovascular abdominal aortic aneurysm repair as a viable treatment option in the prevention of type II endoleak.

  18. Skin and mucosal ischemia as a complication after inferior alveolar nerve block

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    Pedro Christian Aravena

    2016-01-01

    Full Text Available The anesthetic block of the inferior alveolar nerve (IAN is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block.

  19. Cement embolus trapped in the inferior vena cava filter during percutaneous vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Li, Zhi; Ni, Rui Fang; Zhao, Xin; Yang, Chao; Li, Ming Ming [First Affiliated Hospital of Soochow University, Suzhou (China)

    2013-06-15

    A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.

  20. Point-of-Care Ultrasound in Diagnosis and Treatment of Luxatio Erecta (Inferior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Abraham Flinders

    2016-06-01

    Why an emergency physician should be aware of this: POC-US is a useful tool for the emergency physician when confronted with shoulder dislocation. US not only confirms the dislocation, but also differentiates between anterior versus posterior versus inferior dislocation. POC-US can guide the placement of intraarticular lidocaine for anesthesia which then potentially reduces time, expense, and risk of procedural sedation. Finally, POC-US may reduce failed reductions by providing immediate visual confirmation and in the case of reductions performed under sedation, may prevent the need for repeat sedation.

  1. Radiation exposure of the lung after endolymphatic radionuclide therapy (ELRT) of melanomas of the inferior extremities

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, R.P.; Peters, P.E.

    1985-01-01

    The authors present 230 patients submitted to postoperative intralymphatic radiotherapy (ELRT) with radioactive Lipiodol UF because of a malignant melanoma of the inferior extremity. The incidence and volume of a possible invasion of the contrast medium into the lung and the resulting radiation exposure is indicated. Even if very low quantities of the contrast medium (3.5 ml and 7.0 ml, respectively) are used, only 22% of the cases show no pulmonary activity at all. Those patients who underwent bipedal ELRT showed more frequently higher radiation exposure. A correlation between lymph node weight and radiation exposure of the lung could not be demonstrated.

  2. Right double inferior vena cava associated with retrocaval ureter: computed tomographic findings in two cases.

    Science.gov (United States)

    Shin, Mack; Lee, Jong Beum; Park, Sung Bin; Park, Hyun Jeong; Kim, Yang Soo

    2014-01-01

    Two cases of right double inferior vena cava (RDIVC) were observed on computed tomography. In one case, the duplicated IVCs were both located to the right of the abdominal aorta and were nearly on the same coronal plane. In the other case, the right IVC showed partial duplication. The right ureter coursed posterior to the lateral IVC, then emerged between the duplicated IVC in both cases. The findings from the two cases presented in this report showed novel anatomical differences, likely attributable to different embryologic processes, as compared to previously reported cases of RDIVC. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Rectal cancer presenting tumor thrombosis in the inferior vena cava and common iliac vein: case report

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Sun Jung; Park, Seong Jin; Lee, Hae Kyung; Yi, Boem Ha; Park, Sung Il; Hong, Soo Jin; Kim, Hee Kyung; Park, Jeong Mi [Soonchunhyang University Hospital, Bucheon (Korea, Republic of)

    2008-10-15

    We report the radiologic findings of a rectal carcinoma case with tumor thrombus in the inferior vana cava and left common iliac vein of a 48-year-old woman. The patient complained of swelling in the left leg and consequently underwent a lymphoscintigraphy, CT venography, abdominal CT, PET-CT, pelvis MRI, and ultrasound doppler. The rectal cancer was determined via a colonoscopy. The tissue biopsy of tumor thrombus in the IVC was done during insertion of IVC filter and poorly differentiated adenocarcinoma was revealed by pathology.

  4. Extracción y Seguimiento de los Miembros Inferiores sin Marcadores

    OpenAIRE

    Henao, Lorenza; Manzanera, Antoine; Romero, Eduardo

    2010-01-01

    International audience; Este artículo presenta el desarrollo de un método que permite el análisis de la marcha sin marcadores. Los marcadores alteran el gesto natural del movimiento, son inestables y su ubicación varía entre experimentos sucesivos. Este método captura el movimiento mediante una cámara convencional, estima el fondo y segmenta la silueta de los miembros inferiores, y mediante una transformación de distancia que esqueletoniza la silueta, detecta y sigue los puntos articulares qu...

  5. Nurses versus physician-led interhospital critical care transport: a randomized non-inferiority trial.

    Science.gov (United States)

    van Lieshout, Erik Jan; Binnekade, Jan; Reussien, Elmer; Dongelmans, Dave; Juffermans, Nicole P; de Haan, Rob J; Schultz, Marcus J; Vroom, Margreeth B

    2016-07-01

    Regionalization and concentration of critical care increases the need for interhospital transport. However, optimal staffing of ground critical care transport has not been evaluated. In this prospective, randomized, open-label, blinded-endpoint non-inferiority trial, critically ill patients on mechanical ventilation transported by interhospital ground critical care transport were randomized between transport staffed by a dedicated team comprising a critical care nurse and paramedic (nurses group) or a dedicated team including a critical care physician (nurses + physician group). The primary outcome was the number of patients with critical events, both clinical and technical, during transport. Clinical events included decrease in blood pressure, oxygen saturation, or temperature, blood loss, new cardiac arrhythmias, or death. Non-inferiority was assumed if the upper limit of the two-sided 90 % confidence interval (CI) for the between-group difference lies below the non-inferiority margin of 3 %. Of 618 eligible transported critically ill patients, 298 could be analyzed after randomization and allocation to the nurses group (n = 147) or nurses + physician group (n = 151). The percentages of patients with critical events were 16.3 % (24 incidents in 147 transports) in the nurses group and 15.2 % (23 incidents in 151 transports) in the nurses + physician group (difference 1.1 %, two-sided 90 % CI [-5.9 to 8.1]). Critical events occurred in both groups at a higher than the expected (0-1 %) rate. In the nurses group consultations for physician assistance were requested in 8.2 % (12 in 147 transports), all of which were performed prior to transport. The number of patients with critical events did not markedly differ between critical care transports staffed by a critical care nurse and paramedic compared to a team including a critical care physician. However, as a result of an unexpected higher rate of critical events in both groups recorded by an

  6. Características de la Aberrometría en Pacientes miopes con estafiloma inferior

    OpenAIRE

    Delgado Tirado, Santiago

    2014-01-01

    Estudiar y comparar el frente de onda aberrométrico en una muestra de pacientes miopes afectos de miopía patológica con estafiloma inferior, respecto a pacientes en los que no se encontraba este hallazgo funduscópico. MATERIAL Y MÉTODOS :Se reclutaron 51 pacientes (95 ojos) en las instalaciones del Instuto de Oalmobiología Aplicada (IOBA) y el Hospital Clínico Universitario de Valladolid (HCUV), a los cuales se les realizó diferentes procedimientos diagnóscos para recoger lo...

  7. Examen Doppler de la insuficiencia venosa de miembros inferiores: consenso entre especialistas

    OpenAIRE

    Berardi, H.; A. Ciccioli

    2015-01-01

    Se logró un consenso entre especialistas del Diagnóstico por Imágenes y cirujanos flebólogos en el protocolo de realización de los estudios Doppler para la insuficiencia venosa de miembros inferiores (MMII), incluyendo un acuerdo sobre la fisiopatología de la enfermedad, la nomenclatura y diámetros de los vasos que componen los distintos sistemas venosos y los parámetros Doppler a utilizar en la confección del informe de los estudios. Se realizó una reunión entre 6 cirujanos vasculares y 1...

  8. Seminoma Presenting as Renal Mass, Inferior Vena Caval Thrombus, and Regressed Testicular Mass

    Directory of Open Access Journals (Sweden)

    Valary T. Raup

    2015-01-01

    Full Text Available Testicular cancer is the most common malignancy of men aged 15–40. Metastatic spread classically begins with involvement of the retroperitoneal lymph nodes, with metastases to the liver, lung, bone, and brain representing advancing disease. Treatment is based on pathologic analysis of the excised testicle and presence of elevated tumor markers. We report a case of a 34-year-old male presenting with back pain who was found to have a right renal mass with tumor extension into the inferior vena cava. Subsequent biopsy was consistent with seminoma. We review this rare case and discuss the literature regarding its diagnosis and management.

  9. Telemedicine Provides Non-Inferior Research Informed Consent for Remote Study Enrollment: A Randomized Controlled Trial

    Science.gov (United States)

    Bobb, Morgan R.; Van Heukelom, Paul G.; Faine, Brett A.; Ahmed, Azeemuddin; Messerly, Jeffrey T.; Bell, Gregory; Harland, Karisa K.; Simon, Christian; Mohr, Nicholas M.

    2016-01-01

    Objective Telemedicine networks are beginning to provide an avenue for conducting emergency medicine research, but using telemedicine to recruit participants for clinical trials has not been validated. The goal of this consent study is to determine whether patient comprehension of telemedicine-enabled research informed consent is non-inferior to standard face-to-face research informed consent. Methods A prospective, open-label randomized controlled trial was performed in a 60,000-visit Midwestern academic Emergency Department (ED) to test whether telemedicine-enabled research informed consent provided non-inferior comprehension compared with standard consent. This study was conducted as part of a parent clinical trial evaluating the effectiveness of oral chlorhexidine gluconate 0.12% in preventing hospital-acquired pneumonia among adult ED patients with expected hospital admission. Prior to being recruited into the study, potential participants were randomized in a 1:1 allocation ratio to consent by telemedicine versus standard face-to-face consent. Telemedicine connectivity was provided using a commercially available interface (REACH platform, Vidyo Inc., Hackensack, NJ) to an emergency physician located in another part of the ED. Comprehension of research consent (primary outcome) was measured using the modified Quality of Informed Consent (QuIC) instrument, a validated tool for measuring research informed consent comprehension. Parent trial accrual rate and qualitative survey data were secondary outcomes. Results One-hundred thirty-one patients were randomized (n = 64, telemedicine), and 101 QuIC surveys were completed. Comprehension of research informed consent using telemedicine was not inferior to face-to-face consent (QuIC scores 74.4 ± 8.1 vs. 74.4 ± 6.9 on a 100-point scale, p = 0.999). Subjective understanding of consent (p=0.194) and parent trial study accrual rates (56% vs. 69%, p = 0.142) were similar. Conclusion Telemedicine is non-inferior to face

  10. Does intravenous administration of recombinant tissue plasminogen activator for ischemic stroke can cause inferior myocardial infarction?

    Directory of Open Access Journals (Sweden)

    Mostafa Almasi

    2016-06-01

    Full Text Available Recombinant tissue plasminogen activator (rTPA is one of the main portions of acute ischemic stroke management, but unfortunately has some complications. Myocardial infarction (MI is a hazardous complication of administration of intravenous rTPA that has been reported recently. A 78-year-old lady was admitted for elective coronary artery bypass graft surgery. On the second day of admission, she developed acute left hemiparesis and intravenous rTPA was administered within 120 minutes. Three hours later, she has had chest pain. Rescue percutaneous coronary intervention was performed on right coronary artery due to diagnosis of inferior MI, and the symptoms were resolved.

  11. Tratamiento de la isquemia crítica de miembros inferiores

    OpenAIRE

    Samir Jozami; Mariano Albertal; Patricio Zaefferer; Guillermo Pfund; Gerardo Nau; Jorge Thierer; Alejandro Fabiani; Fernando Cura; Jorge Belardi; Lucio Padilla

    2010-01-01

    RESUMENIntroducciónLa isquemia crítica de miembros inferiores representa una manifestación extrema de laenfermedad vascular periférica crónica. La revascularización quirúrgica es el tratamientode elección para los pacientes con esta patología, ya que pese a ser un procedimiento invasivoreduce la tasa de amputación y de mortalidad. Sin embargo, tiene una tasa alta de complicaciones.Durante la última década, el perfeccionamiento y la introducción de nuevas tecnologíaspercutáneas han derivado en...

  12. Why there are two rows of deep inferior epigastric artery perforators despite variability in the number of deep inferior epigastric artery trunks: An anatomical and embryological argument.

    Science.gov (United States)

    Rozen, Warren M; Kapila, Shivam; Donahoe, Simon

    2011-09-01

    The deep inferior epigastric artery (DIEA) distributes musculocutaneous perforators in a uniform pattern that comprises "medial row" versus "lateral row" perforators, with these two rows having anatomical and functional differences. This pattern of two perforator rows is distributed from the DIEA regardless of the number of major DIEA trunks, with there variably being one to four major trunks. As such, a single DIEA trunk will still distribute two perforator rows, as will four major DIEA trunks. What remains to be answered is how such an anatomical fact may come to be? The answer probably lies in the anatomy and embryology of the rectus abdominis muscle itself. With two muscle heads to each hemiabdominal rectus abdominis muscle present from early in its development, it is highly likely that each head of rectus abdominis muscle draws its own blood supply from its source DIEA pedicle, one "perforator row" for each head, regardless of DIEA branching pattern from which these rows are drawn, thus providing an embryological and anatomical basis for the observation of two uniform perforator rows. Copyright © 2011 Wiley-Liss, Inc.

  13. Mayer-Rokitansky-Kuster-Hauser Syndrome Associated with Severe Inferior Vena Cava Stenosis

    Directory of Open Access Journals (Sweden)

    Laura Londra

    2014-01-01

    Full Text Available Precis. The postoperative course of a neovagina creation procedure in a young woman with Meyer-Rokitansky-Kuster-Hauser syndrome was complicated, despite prophylaxis, by extensive pelvic deep venous thrombosis secondary to unsuspected severe inferior vena cava stenosis. Background. Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome is characterized by congenital vaginal agenesis and an absent or rudimentary uterus in genotypical females. Malformations of the inferior vena cava (IVC are not commonly associated with MRKH syndrome. We report a case of a patient with MRKH syndrome with severe IVC stenosis that was diagnosed when the patient presented with extensive pelvic deep venous thrombosis (DVT during the postoperative course of a neovagina creation. Case. A 19-year-old female underwent a McIndoe procedure. Despite DVT prophylaxis, extensive pelvic DVT of the femoral vein was diagnosed on postoperative day 7. Therapeutic anticoagulation was initiated, and pharmacological and mechanical thrombolysis were performed. During these procedures, a hypoplastic IVC was noted. Conclusion. MRKH syndrome can be associated with IVC malformations, which constitute an anatomical risk factor for postoperative DVT.

  14. Inhibition shapes selectivity to vocalizations in the inferior colliculus of awake mice

    Directory of Open Access Journals (Sweden)

    Zachary eMayko

    2012-10-01

    Full Text Available The inferior colliculus (IC is a major center for integration of auditory information as itreceives ascending projections from a variety of brainstem nuclei as well as descending projectionsfrom the thalamus and auditory cortex. The ascending projections are both excitatory andinhibitory and their convergence at the IC results in a microcircuitry that is important forshaping responses to simple, binaural, and modulated sounds in the IC. Here, we examined therole inhibition plays in shaping selectivity to vocalizations in the IC of awake, normal-hearingadult mice (CBA/CaJ strain. Neurons in the IC of mice show selectivity in their responses tovocalizations, and we hypothesized that this selectivity is created by inhibitory microcircuitryin the IC. We compared single unit responses in the IC to pure tones and a variety of ultrasonicmouse vocalizations before and after iontophoretic application of GABAA receptor (GABAARand glycine receptor (GlyR antagonists. The most pronounced effects of blocking GABAAR andGlyR on IC neurons were to increase spike rates and broaden excitatory frequency tuning curvesin response to pure tone stimuli, and to decrease selectivity to vocalizations. Thus, inhibitionplays an important role in creating selectivity to vocalizations in the inferior colliculus.

  15. The anatomical relationship between the roots of mandibular second molars and the inferior alveolar nerve.

    Science.gov (United States)

    Chong, B S; Quinn, A; Pawar, R R; Makdissi, J; Sidhu, S K

    2015-06-01

    To evaluate the anatomical relationship between the roots of mandibular second molars and the inferior alveolar nerve (IAN) in relation to the risk of potential nerve injury during root canal treatment. Cone-beam computed tomography (CBCT) images from the patient record database at a dental hospital were selected. The anonymized CBCT images were reconstructed and examined in three planes (coronal, axial and sagittal) using 3D viewing software. The relationship between each root apex of mandibular second molars and the IAN was evaluated by measuring the horizontal and vertical distances from coronal CBCT sections, and the actual distance was then calculated mathematically using Pythagoras' theorem. In 55% of the 272 mandibular second molar roots evaluated, from a total of 134 scans, the distance between the anatomical root apex and the IAN was ≤3 mm. In over 50% of the cases evaluated, there was an intimate relationship between the roots of mandibular second molars and the inferior alveolar nerve (IAN). Therefore, root canal treatment of mandibular second molars may pose a more significant potential risk of IAN injury; necessary precautions should be exercised, and the prudent use of CBCT should be considered if an intimate relationship is suspected. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  16. Força de membros inferiores como indicador de incapacidade funcional em idosos

    Directory of Open Access Journals (Sweden)

    Rafaela G. dos Santos

    2013-09-01

    Full Text Available O propósito deste estudo foi discriminar a quantidade de repetições no teste sentar e levantar da cadeira na estimativa da incapacidade funcional. Estudo epidemiológico de corte transversal com amostra probabilística de 622 indivíduos, idade > 60 anos. A capacidade funcional autopercebida foi analisada como variável dicotômica: ausência de dependência versus dependência na realização de atividade básicas (ABVD e instrumentais da vida diária (AIVD. Aplicou-se o teste sentar e levantar da cadeira durante 30 segundos (número de repetições máximas para avaliar a força de membros inferiores. O teste mostrou-se como discriminador da incapacidade funcional devido os valores apresentados pelas áreas sob as curvas ROC serem >0,60. O ponto de corte para determinar a incapacidade funcional nas ABVD foi < 10 repetições (homens e < 9 repetições (mulheres; nas AIVD < 14 repetições (homens e < 10 repetições (mulheres. A força de membros inferiores pode ser utilizada como preditor da incapacidade funcional nas ABVD e AIVD.

  17. Trombosis de la vena cava inferior y tromboembolia pulmonar de origen tumoral

    Directory of Open Access Journals (Sweden)

    Alejandro Vázquez

    2008-04-01

    Full Text Available Puérpera de 25 años diagnosticada de tumoración renal izquierda de 17 cm de diámetro, ocupando el hipocondrio izquierdo y desplazando la línea media (Fig. 1, así como trombosis de la vena cava inferior desde las venas ilíacas hasta su porción retrohepática, y tromboembolia a nivel de la arteria pulmonar principal derecha (Figs. 2 A y B. No se evidenciaron metástasis a distancia. Fue intervenida quirúrgicamente realizando nefrectomía radical izquierda y linfadenectomía regional; trombectomía de la vena cava inferior, exéresis de la vena ovárica izquierda y trombectomía de la arteria pulmonar derecha mediante el uso de circulación extracorpórea y parada circulatoria a 24°C, sin complicaciones.

  18. Unilateral Cleft Lip Revision with Conversion to the Modified Inferior Triangle.

    Science.gov (United States)

    Li, Weiwei; Steinbacher, Derek M

    2015-09-01

    Unilateral cleft lip revision may be necessary to address visible scars, unequal anatomical boundaries, vermillion inequities, or some combination thereof. In the setting of more than one stigma, a complete recreation of the defect and repair is necessary. This study anthropometrically evaluates the results of cleft lip revision following conversion to the modified inferior triangle. A retrospective analysis of patients who underwent cleft lip revision using the modified inferior triangle was included. Standard preoperative and postoperative photographs were obtained and evaluated. Anthropometric points were placed and measurements performed. Results were corroborated by two independent, blinded reviewers (Pearson correlation test), and compared using the paired t test. Twenty-seven patients were included (mean age, 10.89 years; female, n = 10) over a 35-month period. Intraobserver and interobserver ratios were shown to be reliable. Significant differences (p 0.05) were noted in the PCH, HL, and HL' postoperatively. Significant changes (p triangle. Significant changes (p triangle repair, improving the lip appearance with improved anthropometric measures. Therapeutic, IV.

  19. Time dependence of binaural responses in the rat's central nucleus of the inferior colliculus.

    Science.gov (United States)

    Zhang, Huiming; Kelly, Jack B

    2010-09-01

    Recordings were made from single neurons in the rat's central nucleus of the inferior colliculus. Excitatory/inhibitory binaural interactions and interaural-level difference curves were determined for responses to 100 ms dichotic tone bursts presented to the left and right ears simultaneously. Most neurons with sustained responses to tone bursts had the same binaural response type throughout the 100 ms stimulus period. However, some neurons (39% of our sample) showed qualitatively different binaural response types during the early and late parts of the stimulus (the first 20 ms versus the last 80 ms of the tone burst). Also, for many neurons with consistent early and late binaural response patterns, the strength of binaural interaction was different during the early and late periods. For example, for neurons excited by the contralateral ear and inhibited by the ipsilateral ear during the entire 100 ms period (the most common binaural response type), the degree of inhibition was generally greater during the later part of a stimulus. This change in the strength and/or quality of binaural interaction during dichotic stimulation likely reflects a complex pattern of converging excitatory and inhibitory inputs to the inferior colliculus from lower brainstem structures as well as the time course of local synaptic events. The temporal properties of binaural interaction may influence how sound source location is represented in the central auditory system. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  20. The inferior emissary vein: a reliable landmark for right adrenal vein sampling.

    Science.gov (United States)

    Kohi, Maureen P; Agarwal, Vishal K; Naeger, David M; Taylor, Andrew G; Kolli, K Pallav; Fidelman, Nicholas; LaBerge, Jeanne M; Kerlan, Robert K

    2015-04-01

    Right adrenal vein (RAV) catheterization can be a very challenging step in adrenal venous sampling (AVS). Visualization of the inferior emissary vein (IEV) may be an indication of successful RAV catheterization. To compare the rate of successful RAV sampling in the presence of the IEV. Retrospective review of all consecutive patients with PA who underwent AVS between April 2009 and April 2012 was performed. A total of 30 patients were identified. Procedural images, cortisol, and aldosterone values obtained from sampling of the RAV and inferior vena cava (IVC) were reviewed. Cortisol measurements obtained from RAV samples were divided by measurements from the infra-renal IVC blood samples in order to calculate the selectivity index (SI). An SI >3 was considered indicative of technically successful RAV sampling. RAV sampling was considered technically successful in 29 out of 30 cases (97%). In cases of successful RAV sampling (29 patients), the IEV was identified in 25 patients (86%). The IEV was visualized in isolation in 16 patients (64%), and in conjunction with visualization of the RAV or right adrenal gland stain in nine patients (36%). The IEV was not visualized in the one case of unsuccessful RAV sampling. Visualizing the IEV had a sensitivity of 86.2% for successful RAV sampling. The IEV may serve as a reliable landmark for the RAV during RAV sampling. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. Técnica de Charles en elefantiasis de extremidad inferior: caso clínico

    Directory of Open Access Journals (Sweden)

    Laia Obregón-Palaín

    Full Text Available La primera opción terapéutica para el linfedema consiste en medidas conservadoras conocidas como terapia descongestiva compleja, de la que se benefician muchos pacientes. Sin embargo, los casos refractarios severos requieren abordaje quirúrgico. Existen numerosas técnicas disponibles con tasas de recurrencia variables. La técnica de Charles es una alternativa apropiada para los casos más severos. Presentamos nuestra experiencia en un caso en varón de 21 años de edad con elefantiasis masiva de la extremidad inferior izquierda secundaria a linfedema congénito sin respuesta al tratamiento conservador. Tras una valoración clínica y radiológica exhaustiva se propone cirugía ablativa según la técnica de Charles, que llevamos a cabo en 3 tiempos quirúrgicos en 8 meses con resultados globalmente favorables. De paso revisamos la práctica actualmente aceptada para el tratamiento del linfedema de la extremidad inferior y las opciones terapéuticas disponibles.

  2. Study of the anesthetic efficacy of inferior alveolar nerve block using articaine in irreversible pulpitis.

    Science.gov (United States)

    Ahmad, Zeeshan H; Ravikumar, H; Karale, Rupali; Preethanath, R S; Sukumaran, Anil

    2014-01-01

    The purpose of this study was to determine the anesthetic efficacy of inferior alveolar nerve block (IANB) using 4% articaine and 2% lidocaine supplemented with buccal infiltration. Forty five patients, diagnosed with irreversible pulpitis of a mandibular posterior tooth were included in the study. The first group of 15 patients received 2% lidocaine with 1:200000 epinephrine, the second group 2% lidocaine with 1: 80,000 epinephrine and the third group of 15 subjects received 4% articaine with 1:100000 epinephrine. During the access cavity preparation those patients who complained of pain received an additional buccal infiltration. The percentage of subjects who got profound anesthesia and failure to achieve anesthesia were calculated and tabulated using a visual analog scale. The results revealed that 87% of subjects who received 4% Articaine with 1:100,000 epinephrine got satisfactory anesthesia with inferior alveolar nerve block alone. Only 2 (13%) subjects received an additional buccal infiltration and none of the patients failed to obtain complete anesthesia with articaine. In comparison only 40% of subjects got complete anesthesia with 2% lidocaine with 1:200000 and 60% with 2% lidocaine with 1:80,000. It can be concluded that 4% articaine can be used effectively for obtaining profound anesthesia for endodontic procedures in patients with irreversible pulpitis.

  3. Pulmonary embolism due to compression of the inferior vena cava by a hepatic hemangioma.

    Science.gov (United States)

    Paolillo, V; Sicuro, M; Nejrotti, A; Rizzetto, M; Casaccia, M

    1993-01-01

    We describe a 35-year-old man who had a pulmonary embolism with thrombosis of the inferior vena cava, apparently resulting from compression by a hepatic hemangioma. The diagnosis of pulmonary embolism was confirmed by pulmonary angiography; however, the hemangioma was detected only incidentally, as a hyperechoic mass, during an echocardiogram for intracardiac thrombosis. Abdominal sonography, computed tomography, celiac angiography, technetium 99m-labeled red blood cell scintigraphy, and ultrasound-guided liver biopsy all assisted in the diagnosis of hepatic hemangioma and its compression of the inferior vena cava. Because of the multisegmental and perihilar involvement of the tumor, surgery was not performed. For dissolution of the clots, the patient was given thrombolytic therapy followed by heparin administration. He was then placed on long-term warfarin therapy and is well after 5 years; the size of the hemangioma is unchanged. Cases of pulmonary embolism due to diseases of the upper abdominal organs are rare and probably underestimated. This case stresses the need for a systematic investigation of the abdomen when a pulmonary embolism is present without evidence of deep vein thrombosis. Images PMID:8508068

  4. Radiological examinations of the anatomy of the inferior turbinate using digital volume tomography (DVT).

    Science.gov (United States)

    Balbach, L; Trinkel, V; Guldner, C; Bien, S; Teymoortash, A; Werner, J A; Bremke, M

    2011-06-01

    Since the last 120 years there were only few descriptions of the anatomical sizes of the inferior turbinate in the literature. On this background the current study should evaluate the radiological dimensions of the inferior turbinate and the septum using DVT. The latest generation of the Accu-I-tomo was used. The data of 100 adult patients have been evaluated. The bony length was found to be 38.9 mm, the mucosal length 51.0 mm. The findings of the total mucosal thickness at different measuring points were between 8.1 mm and 10.9 mm, those of the bony thickness were between 0.9 mm and 2.3 mm and those of the bony height were between 3.9 mm and 20.8 mm. The results of this radiological study are able to point out the importance of preoperative anatomical evaluation of radiological images. The preoperative focus on the individual anatomy is very important because of the choice of an adequate surgical treatment. Today new radiological techniques can help to find out whether the reason for hypertrophied turbinates is caused by bone, mucosa or both. This knowledge enables a concerted treatment concept.

  5. Analysis of occlusal stresses transmitted to the inferior alveolar nerve by multiple threaded implants.

    Science.gov (United States)

    Sammartino, G; Wang, Hom-Lay; Citarella, R; Lepore, M; Marenzi, G

    2013-11-01

    Potential nerve injury or loss of sensation can occur after mandibular implant placement or loading. To avoid this type of damage, it is critical to determine the proper distance from implants to the mandibular nerve. Hence, the purpose of this study is to use biomechanical analyses to determine the safe distance from multiple implants to the inferior alveolar nerve. Using the boundary element method, a numerical mandibular model was designed to simulate a mandibular segment containing multiple threaded fixtures. This model allows assessment of the pressure, as induced by occlusal loads, on the trigeminal nerve. Such pressure distribution was evaluated against different distances from the fixtures to the mandibular canal, against the possible lack of the central fixture in a three-abutment configuration, and against different levels of implant osseointegration. All the simulations considered a canal that is orthogonal to the implant axis. Nerve pressure increased quickly when the implant-canal distance decreased in the range studied. Lack of the central implant to support the central abutment caused major increases in nerve pressure. This study suggests a minimal implant-canal distance of 1 mm to prevent inferior alveolar nerve damage caused by three connected implants. For clinical safety, an additional 0.5 mm is recommended as a cushion, so a 1.5-mm minimal distance should be planned to avoid potential nerve injury.

  6. The law of unintended consequences: current design challenges in inferior vena cava filters.

    Science.gov (United States)

    Magnowski, Audrey; Brown, Matthew; Schramm, Kristofer; Lindquist, Jonathan; Rochon, Paul J; Johnson, D Thor; Kondo, Kimi L; Desai, Kush; Lewandowski, Robert J; Ryu, Robert K

    2017-10-01

    Venous thromboembolic disease (VTD) encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE) is a commonly encountered condition with potentially fatal sequelae. When unable to be adequately anticoagulated, patients require a mechanical means to prevent PE. This review discusses the history of inferior vena cava interruption and the development of inferior vena cava filters (IVCF). Areas covered: Milestone innovations in the mechanical treatment of VTD, their successes and shortcomings are discussed. The unforeseen complications that have occurred with implantation of IVCF have a profound impact on the present utilization of retrievable filters. Particular attention is dedicated to the evidence for safe and effective use of IVCF and the challenges presented to further improvement of these technologies. Expert commentary: While evidence suggests that IVCF are effective in preventing PE, the recent 'de-volution' from permanent to retrievable design has unleashed an epidemic device-related complications. Retrievable filter design is reliant on a 'Goldilocks' premise: make the device stable (so it doesn't migrate), but not too stable (so you can still retrieve it). Efforts must be aimed at optimizing utilization using decision support tools, meticulous follow up after deployment, and conversion from retrievable to permanent devices if the patient requires lifelong mechanical prophylaxis.

  7. European guidelines on perioperative venous thromboembolism prophylaxis: Inferior vena cava filters.

    Science.gov (United States)

    Comes, Raquel Ferrandis; Mismetti, Patrick; Afshari, Arash

    2018-02-01

    : The indications for the use of an inferior vena cava filter (IVCF) in the context of deep venous thrombosis to prevent pulmonary embolism remain controversial. Despite wide use in clinical practice, great variation exists in national and international guidelines in regard to the indications. In addition, clinical practice is based on poor-quality data from trauma and bariatric surgery with a high incidence of complications. It is often difficult to assess their efficacy and lack of filter retrieval appears to be a substantial issue compared with a potential benefit by insertion of these devices. Complications usually refer to increased risk of deep venous thrombosis, filter perforation, filter penetration, filter migration, inferior vena cava occlusion and subsequently failure in pulmonary embolism prevention. Evidence from low-quality studies or registries, with small numbers of patients and conflicting findings, does not allow for a strong recommendation for or against the use of IVCFs. IVCFs should only be considered in cases of very high risk of pulmonary embolism and in perioperative situations at very high risk of bleeding, resulting in a prolonged contra-indication to pharmacological prophylaxis.

  8. Is it worth adding an inferior vena cava filter to anticoagulation in thromboembolic disease?

    Directory of Open Access Journals (Sweden)

    Alexandra Yunes

    2017-06-01

    Full Text Available Resumen A pesar del tratamiento anticoagulante, algunos pacientes que han presentado un episodio de enfermedad tromboembólica persisten con riesgo elevado de recurrencia. Se ha planteado que adicionar un filtro de vena cava inferior podría disminuir este riesgo, pero la real utilidad clínica no está clara. Para responder esta pregunta utilizamos la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en múltiples fuentes de información. Identificamos tres revisiones sistemáticas que en conjunto incluyen cuatro ensayos aleatorizados que responden la pregunta. Extrajimos los datos, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. Concluimos que podría existir poca o nula diferencia en cuanto a la ocurrencia de trombosis venosa profunda al agregar un filtro de vena cava inferior en pacientes anticoagulados, y que no está claro si existen diferencias en cuanto a la ocurrencia de tromboembolismo pulmonar o mortalidad porque la certeza de la evidencia es muy baja.

  9. Relationship between maximum dynamic force of inferior members and body balance in strength training apprentices

    Directory of Open Access Journals (Sweden)

    Ariane Martins

    2010-08-01

    Full Text Available The relationship between force and balance show controversy results and has directimplications in exercise prescription practice. The objective was to investigate the relationshipbetween maximum dynamic force (MDF of inferior limbs and the static and dynamic balances.Participated in the study 60 individuals, with 18 to 24 years old, strength training apprentices.The MDF was available by mean the One Maximum Repetition (1MR in “leg press” and “kneeextension” and motor testes to available of static and dynamic balances. The correlation testsand multiple linear regression were applied. The force and balance variables showed correlationin females (p=0.038. The corporal mass and static balance showed correlation for the males(p=0.045. The explication capacity at MDF and practices time were small: 13% for staticbalance in males, 18% and 17%, respectively, for static and dynamic balance in females. Inconclusion: the MDF of inferior limbs showed low predictive capacity for performance in staticand dynamic balances, especially for males.

  10. Short-Term and Procedural Memory for Colours and Inferior Temporal Cortex Activity

    Directory of Open Access Journals (Sweden)

    E. Castro-Sierra

    1997-01-01

    Full Text Available Two children (male, 10 years, and female, 13 years one month with tumours of the inferior temporal (IT cortex of the brain were studied post-surgically for their abilities to carry out a short-term memory test. This involved: differences in colour, number and shape of small plastic objects; differences in receptacles where these objects should be placed and in ways in which this placement should be done; a procedural task involving differences either in colour or in size of wooden rings employed in the task. Their performances in these tests, and those of patients with tumours of other encephalic areas, were compared with the performances of normal controls. The subjects with IT tumours spent a significantly greater amount of time than normal subjects of their age in carrying out the procedural task involving differences in colour. One of the IT subjects also spent a significantly greater amount of time in the procedural task involving size differences. Other differences in the performances of patients with encephalic tumours and the performances of normal controls were not significant. Results are discussed in relation to findings of colour and size perception and memory localized to the inferior temporal and middle temporal cortices.

  11. Titanium greenfield inferior vena cava filter; effectiveness of percutaneous placement for prevention of pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Bong Gak; Hahn, Seong Tai; Jung, Jung Im; Lee, Sang Hoon; Koh, Ki Young; Park, Seog Hee; Shinn, Kyung Sub [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2000-11-01

    To evaluate the effectiveness of percutaneous placement of a Greenfield titanium filter in the inferior vena cava (IVC) for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis (DVT). Twelve patients with DVT underwent percutaneous Greenfield titanium filter placement. The indications included recurrent pulmonary embolism or failed anticoagulation therapy in six patients, extensive PE in three, and prophylaxis for high risk of PE in the remaining three. In all cases the filter was positioned after confirming the anatomy, patency, and presence of thrombosis of the IVC and renal veins by inferior vena cavography. Long-term follow-up study involved clinical evaluation, plain radiography, Doppler ultrasonography and CT scanning. Filter placement [infrarenal in ten patients (83%) and suprarenal in two (17%)] was technically successful in all cases (100%). The venous approach involved the right femoral vein in eight patients (67%) and the right internal jugular vein in four (33%). Complications included overlapping of the filter legs in three patients (25%), and misplacement in one (8%). After filter placement, no further PE developed. In all of five patients followed up for two years, the IVC maintained patency without evidence of caval perforation or occlusion. In patients with DVT, percutaneous placement of a Greenfield titanium filter is a safe and effective method for the prevention of PE.

  12. [Symmetrical phlebothrombosis of lower extremities resulting from congenital malformation of vena cava inferior].

    Science.gov (United States)

    Halcín, A; Kovácová, E; Mikla, F; Reptová, A; Bedeová, J

    2009-12-01

    Agenesis/atresia ofvena cava inferior is a rare congenital anomaly, caused by an aberrance of embryonal venous system development. This is in most cases asymptomatic, because of well developed collateral venous circulation. However, in some cases, it can be manifested with occurence of deep thrombosis in area of pelvis and lower limbs. In this case report, we repon a 21 year old male with painful swelling of both lower limbs. Ultrasonographic examination revealed a bilateral thrombosis in deep venous system of lower limbs and pelvis. Subsequent CT angiography showed atresia ofinfrarenal segment ofvena cava inferior. According to the CT image thrombotic proces affected also collateral venous system, that joined mostly to vena azygos and hemiazygos. Examination of coagulation system didn't reveal a procuring cause ofthrombotic occurrence. We realized a systemic trombolysis with streptokinase during 5 days. Starting from the fifth day we administered a low molecular weight heparin in anticoagulant dose. This treatment showed a good clinical effect. Pacient was discharged with a long-term oral warfarin therapy in combination with acetylsalicylic acid. In next four months of taking recommended therapy no relapse of thrombotic process nor evolvement of bleeding complication was observed.

  13. Selective functional connectivity abnormality of the transition zone of the inferior parietal lobule in schizophrenia.

    Science.gov (United States)

    Liu, Xingyun; Zhuo, Chuanjun; Qin, Wen; Zhu, Jiajia; Xu, Lixue; Xu, Yongjie; Yu, Chunshui

    2016-01-01

    Structural and functional alterations in the inferior parietal lobule (IPL) in schizophrenia have been frequently reported; however, the IPL connectivity changes in schizophrenia remain largely unknown. Based on heterogeneity of the IPL in structure, connection and function, we hypothesize that the resting-state functional connectivities (rsFCs) of the IPL subregions are differentially affected in schizophrenia. This study included 95 schizophrenia patients and 104 healthy controls. The IPL subregions were defined according to a previous in vivo connection-based parcellation study. We calculated the rsFC of each IPL subregion and compared them between the two groups while controlling for the effects of age, gender, and grey matter volume. Among the six subregions of the left IPL and the five subregions of the right IPL, only the bilateral PFm (a transition zone of the IPL) subregions exhibited abnormal rsFC in schizophrenia. Specifically, the left PFm showed increased rsFC with the bilateral lingual gyri in schizophrenia patients than in healthy controls. The right PFm exhibited increased rsFC with the right lingual gyrus and inferior occipital gyrus, and bilateral mid-cingulate and sensorimotor cortices in schizophrenia patients. These findings suggest a selective rsFC abnormality in the IPL subregions in schizophrenia, characterized by the increased rsFC between the PFm subregion of the IPL and the visual and sensorimotor areas.

  14. The clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgery

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    S. V. Mukhtarulina

    2014-12-01

    Full Text Available Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 % patients. Supernumerary renal arteries and veins observed in 5 (4.9 % patients; retroaortic left renal vein type I and II – in 3 (3.0 % patients. Double vena cava inferior detected in 1 (1.0 % patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %, the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

  15. The clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgery

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    S. V. Mukhtarulina

    2014-01-01

    Full Text Available Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 % patients. Supernumerary renal arteries and veins observed in 5 (4.9 % patients; retroaortic left renal vein type I and II – in 3 (3.0 % patients. Double vena cava inferior detected in 1 (1.0 % patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %, the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

  16. Clinical Study of Seven Patients with Infarction in Territories of the Anterior Inferior Cerebellar Artery.

    Science.gov (United States)

    Ogawa, Katsuhiko; Suzuki, Yutaka; Takahashi, Keiko; Akimoto, Takayoshi; Kamei, Satoshi; Soma, Masayoshi

    2017-03-01

    The prominent features of anterior inferior cerebellar artery (AICA) infarction are vertigo, cerebellar ataxia, and impaired hearing. The present study investigated neurological characteristics associated with AICA infarction. The locations of infarcts in 7 patients (age, 32-72 years) with AICA infarction were divided into the lower lateral pons, the middle cerebellar peduncle (MCP), and the cerebellum. Ischemic lesions were located in the MCP in 6 patients, spread to the lower lateral pons in 3, and involved the cerebellum in 4 patients. Standing posture and gait were impaired in all patients. Five and 4 patients had impaired hearing and vertigo, respectively. Two patients had only symptoms of labyrinthine disease, and 1 had these symptoms accompanied by impaired hearing. The symptoms in 2 patients with the lesion in the lateral pons were consistent with those in Gasperini syndrome. Two of 3 patients without vertigo had ataxia of the extremities. Stenosis of the vertebral artery or basilar artery in 5 patients indicated that the etiology was branch atheromatous disease. The most prominent symptom of truncal and gait ataxia and the frequent association between vertigo and impaired hearing were consistent with the characteristics of AICA infarction. Two patients without vertigo had ataxia of the trunk and extremities that might have been due to involvement of the dorsal spinocerebellar tract in the inferior cerebellar peduncle. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. Determining the sample size required to establish whether a medical device is non-inferior to an external benchmark.

    Science.gov (United States)

    Sayers, Adrian; Crowther, Michael J; Judge, Andrew; Whitehouse, Michael R; Blom, Ashley W

    2017-08-28

    The use of benchmarks to assess the performance of implants such as those used in arthroplasty surgery is a widespread practice. It provides surgeons, patients and regulatory authorities with the reassurance that implants used are safe and effective. However, it is not currently clear how or how many implants should be statistically compared with a benchmark to assess whether or not that implant is superior, equivalent, non-inferior or inferior to the performance benchmark of interest.We aim to describe the methods and sample size required to conduct a one-sample non-inferiority study of a medical device for the purposes of benchmarking. Simulation study. Simulation study of a national register of medical devices. We simulated data, with and without a non-informative competing risk, to represent an arthroplasty population and describe three methods of analysis (z-test, 1-Kaplan-Meier and competing risks) commonly used in surgical research. We evaluate the performance of each method using power, bias, root-mean-square error, coverage and CI width. 1-Kaplan-Meier provides an unbiased estimate of implant net failure, which can be used to assess if a surgical device is non-inferior to an external benchmark. Small non-inferiority margins require significantly more individuals to be at risk compared with current benchmarking standards. A non-inferiority testing paradigm provides a useful framework for determining if an implant meets the required performance defined by an external benchmark. Current contemporary benchmarking standards have limited power to detect non-inferiority, and substantially larger samples sizes, in excess of 3200 procedures, are required to achieve a power greater than 60%. It is clear when benchmarking implant performance, net failure estimated using 1-KM is preferential to crude failure estimated by competing risk models. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  18. Malformação de veia cava inferior e trombose venosa profunda: fator de risco de trombose venosa em jovens Inferior vena cava malformation and deep venous thrombosis: a risk factor of venous thrombosis in the young

    Directory of Open Access Journals (Sweden)

    Renan Roque Onzi

    2007-06-01

    Full Text Available A ausência da veia cava inferior, alteração no processo de formação embriológica que ocorre entre a sexta e a oitava semanas de gestação, é uma rara anomalia congênita. Porém, recentemente foi confirmada como sendo um fator de risco importante para o desenvolvimento de trombose venosa profunda, especialmente em jovens. Apresentamos um caso de trombose em veias cava inferior, ilíacas, femorais e poplíteas num jovem de 16 anos com agenesia de um segmento de veia cava infra-renal e veia renal esquerda retroaórtica.Absence of inferior vena cava, caused by aberrant development within the sixth to eighth weeks of gestation, is a rare congenital anomaly. However, it has been recently confirmed as a major risk factor for the development of deep venous thrombosis, especially in young patients. We report a case of inferior vena cava, iliac, femoral and popliteal vein thrombosis in a 16-year-old patient with inferior vena cava agenesis and retroaortic left renal vein.

  19. Biomechanical properties of the anterior band of the inferior glenohumeral ligament under stress Propriedades biomecânicas da banda anterior do ligamento glenoumeral inferior submetido a estresse

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    José Atualpa Pinheiro Júnior

    2003-04-01

    Full Text Available This paper is aimed at studying the behavior of the band of inferior glenohumeral ligament subjected to uniaxial traction. Twenty ligaments were distributed in two groups: Group I ( ligaments with bony origin and insertion and Group II ( medial portion of the ligament. Uniaxial traction was applied to all tendons utilizing a traction machine develop in the Department of Physics of UFC. Hooke's Law was used for evaluation of ligament behavior during elastic phase and the Exponential stress-strain Law, for rigidity phase. All ligaments had the same behavior, presenting a phase of elasticity , followed by one of rigidity. After evaluation of the elastic phase , applying Hooke's Law, ligaments constants were 10.507 N/mm ( group I and 13.80 N/mm ( group II, suffering a straining of 2.83% and 2.84%,respectively, until the ligament became rigid. During rigidity phase, the constants were 511.56% N/mm (group I and 156.84% N/mm (group II. It is concluded that the ligament submitted to traction suffers a small elongation until becoming rigid along with an important increase in force constants during rigidity phase.Com o objetivo de estudar o comportamento da banda anterior do ligamento glenoumeral inferior quando submetido a tração uniaxial, estudaram-se 20 ligamentos glenoumerais, especificamente sua banda anterior, divididos em dois grupos: Grupo I, ligamento com origem e inserção óssea e Grupo II, parte média do ligamento. Realizou-se tração uniaxial em máquina desenvolvida no Departamento de Física da Universidade Federal do Ceará, sendo utilizada a Lei de Hooke para avaliação do comportamento do ligamento na fase elástica e a Lei Exponencial stress-strain, para fase de rigidez . Todos os ligamentos tiveram o mesmo comportamento, tendo apresentado uma fase de elasticidade, seguida de uma de rigidez. Após avaliação da fase elástica, utilizando a Lei de Hooke, os ligamentos apresentaram as constantes de 10,507 N/mm para o grupo I e de

  20. Morphological variation of the anterior inferior iliac spine affects hip range of motion in flexion after rotational acetabular osteotomy.

    Science.gov (United States)

    Hamada, Hidetoshi; Takao, Masaki; Sakai, Takashi; Sugano, Nobuhiko

    2017-10-28

    Reduced range of motion (ROM) in flexion and internal rotation are associated with impaired activities of daily living (ADL) after rotational acetabular osteotomy (RAO). This study focused on the morphological variation of the anterior inferior iliac spine in developmental dysplasia of the hip (DDH) and its impact on post-operative bony ROM after RAO. This study aimed to investigate the association between bony ROM after RAO and pre-operative morphological factors of the pelvis and femur, including a positional variation of the anterior inferior iliac spine. Bony ROM in 52 patients with DDH was assessed after virtual RAO using computed tomography (CT). Post-operative acetabular coverage was set at lateral and anterior centre-edge angles of 30° and 55°, respectively. The position of the anterior inferior iliac spine was classified as higher or lower. Multiple regression analysis revealed that the lower anterior inferior iliac spine and higher femoral neck shaft angle were significantly associated with the lower flexion angle after RAO. Lower femoral anteversion, higher femoral neck shaft angle and higher alpha angle at the anterosuperior part were significantly associated with lower internal rotation angle at 90° flexion after RAO. Therefore, morphological variation of the anterior inferior iliac spine affected bony ROM in flexion and that of the femoral neck affected bony ROM in internal rotation at flexion after RAO.

  1. DOES THE INFERIOR FRONTAL SULCUS PLAY A FUNCTIONAL ROLE IN DECEPTION? A NEURONAVIGATED THETA-BURST TRANSCRANIAL MAGNETIC STIMULATION STUDY

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    Bruno eVerschuere

    2012-10-01

    Full Text Available Background. By definition, lying involves withholding the truth. Response inhibition may therefore be the cognitive function at the heart of deception. Neuroimaging research has shown that the same brain region that is activated during response inhibition tasks, namely the inferior frontal region, is also activated during deception paradigms. This led to the hypothesis that the inferior frontal region is the neural substrate critically involved in withholding the truth. Objective. We critically examine the functional necessity of the inferior frontal region in withholding the truth during deception. Method. We experimentally manipulated the neural activity level in right inferior frontal sulcus (IFS by means of neuronavigated continuous theta burst stimulation (cTBS. Individual structural magnetic resonance brain images (MRI were used to allow precise stimulation in each participant. Twenty-six participants answered autobiographical questions truthfully or deceptively before and after sham and real cTBS. Results. Deception was reliably associated with more errors, longer and more variable response times than truth telling. Despite the potential role of IFS in deception as suggested by neuroimaging data, the cTBS-induced disruption of right IFS did not affect response times or error rates, when compared to sham stimulation. Conclusions. The present findings do not support the hypothesis that the right inferior frontal sulcus is critically involved in deception.

  2. Synaptic alterations in the medial geniculate bodies and the inferior colliculi in Alzheimer's disease: a Golgi and electron microscope study.

    Science.gov (United States)

    Baloyannis, Stavros J; Mauroudis, Ioannis; Manolides, Spyros L; Manolides, Leonidas S

    2009-04-01

    The neuronal loss and the alteration of the synapses in the medial geniculate bodies and the inferior colliculi may be involved in the impairment of communication and symbolic sound perception, which is noticed even in the early stages of Alzheimer's disease. Alzheimer's disease (AD) is a neurodegenerative disorder, causing a progressive decline of intellectual faculties, gradual impairment of behavior and social performance, impairment of communication and speech eloquence, and various neurological manifestations. We attempted to figure out the synaptic alterations in the medial geniculate bodies and the inferior colliculi in 12 early cases of Alzheimer's disease, who fulfilled the clinical, and laboratory diagnostic criteria of Alzheimer's disease. For the histological study we applied routine neuropathological techniques as well as Bodian staining and rapid Golgi method. We proceeded to electron microscopy for the ultrastructural study of synapses and dendritic spines. The morphological and morphometric analysis revealed substantial neuronal loss and synaptic alterations in the medial geniculate bodies as well as in inferior colliculi. Dendritic spines of the polyhedral and elongated cells of the medial geniculate bodies were decreased in number. Mitochondrial alterations and fragmentation of Golgi apparatus were seen in 15% of the neurons of the medial geniculate bodies and in 5% of the neurons of the inferior colliculi. Senile plaques and neurofibrillary tangles were not seen in either the medial geniculate bodies or the inferior colliculi.

  3. Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial

    Science.gov (United States)

    Montserrat-Bosch, Marta; Nogueira-Magalhães, Pedro; Arnabat-Dominguez, Josep; Valmaseda-Castellón, Eduard; Gay-Escoda, Cosme

    2014-01-01

    Objectives: To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB). Study Design: A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed. Results: A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three failures were recorded, 2 of them in the experimental group. No relevant local or systemic complications were registered. Conclusions: Both IANB techniques used in this trial are suitable for lower third molar removal. However, performing an inferior alveolar nerve block in a more inferior position (modified technique) extends the onset time, does not seem to reduce the risk of intravascular injections and might increase the risk of lingual nerve injuries. Key words:Dental anesthesia, inferior alveolar nerve block, lidocaine, third molar, intravascular injection. PMID:24608204

  4. [EFFECTIVENESS OF DEEP INFERIOR EPIGASTRIC ARTERY PERFORATOR FLAP FOR REPAIR OF PERINEAL AND PERIANAL CICATRICIAL CONTRACTURE].

    Science.gov (United States)

    Du, Liping; You, Xiaobo; Tang, Kuangyun; Fu, Rong

    2015-08-01

    To discuss the effectiveness of deep inferior epigastric artery perforator flap to repair perineal and perianal cicatricial contracture. Between March 2007 and December 2013, 23 patients with perineal and perianal cicatricial contracture were treated with deep inferior epigastric artery perforator flap. There were 15 males and 8 females, aged from 21 to 62 years (mean, 42 years). Burn depth was III degree. The burning scars involved in the fascia, even deeper, which was rated as peripheral type (mild stenosis of the anal region and perianal cicatricial contracture) in 13 cases and as central type (severe stenosis of the anal region and anal canal with shift or defect of external genitalia) in 10 cases. All patients had limited hip abduction and squatting. Repair operation was performed at 3 months to 2 years (mean, 6 months) after wound healing. The size of soft tissue defects ranged from 10 cmx6 cm to 28 cm x 13 cm after scar excision and release. The size of flaps ranged from 12 cmx7 cm to 30 cmx15 cm. The donor site was sutured directly in 16 cases and repaired by autograft of skin in 7 cases. The flap had distal necrosis, distal cyanosis, and spotted necrosis in 1 case, 2 cases, and 1 case respectively, which were cured after symptomatic treatment; the other flaps survived and wound healed primarily. Twenty-one patients were followed up 6 months to 2 years (mean, 1 year). Nineteen patients had good appearance of the perinea and position of external genitalia, normal function of defecation function; stenosis of the anal region was relived, and the flaps had good texture and elasticity. Linear scar contracture was observed at the edge of flap in 2 cases, and the appearance of the perineum was restored after Z plasty. The hip abduction reached 30-40°. No abdominal hernia was found at donor site. Deep inferior epigastric artery perforator flap has stable blood supply and flexible design, which is similar to the perianal and perineal tissues. The good effectiveness

  5. Mild Perceptual Categorization Deficits Follow Bilateral Removal of Anterior Inferior Temporal Cortex in Rhesus Monkeys.

    Science.gov (United States)

    Matsumoto, Narihisa; Eldridge, Mark A G; Saunders, Richard C; Reoli, Rachel; Richmond, Barry J

    2016-01-06

    In primates, visual recognition of complex objects depends on the inferior temporal lobe. By extension, categorizing visual stimuli based on similarity ought to depend on the integrity of the same area. We tested three monkeys before and after bilateral anterior inferior temporal cortex (area TE) removal. Although mildly impaired after the removals, they retained the ability to assign stimuli to previously learned categories, e.g., cats versus dogs, and human versus monkey faces, even with trial-unique exemplars. After the TE removals, they learned in one session to classify members from a new pair of categories, cars versus trucks, as quickly as they had learned the cats versus dogs before the removals. As with the dogs and cats, they generalized across trial-unique exemplars of cars and trucks. However, as seen in earlier studies, these monkeys with TE removals had difficulty learning to discriminate between two simple black and white stimuli. These results raise the possibility that TE is needed for memory of simple conjunctions of basic features, but that it plays only a small role in generalizing overall configural similarity across a large set of stimuli, such as would be needed for perceptual categorical assignment. The process of seeing and recognizing objects is attributed to a set of sequentially connected brain regions stretching forward from the primary visual cortex through the temporal lobe to the anterior inferior temporal cortex, a region designated area TE. Area TE is considered the final stage for recognizing complex visual objects, e.g., faces. It has been assumed, but not tested directly, that this area would be critical for visual generalization, i.e., the ability to place objects such as cats and dogs into their correct categories. Here, we demonstrate that monkeys rapidly and seemingly effortlessly categorize large sets of complex images (cats vs dogs, cars vs trucks), surprisingly, even after removal of area TE, leaving a puzzle about how

  6. PERBANDINGAN ANTARA KOMBINASI LATIHAN STABILISASI BAHU DAN TRAKSI HUMERUS KE INFERIOR DENGAN KOMBINASI LATIHAN FUNGSIONAL BAHU DAN TRAKSI HUMERUS KE INFERIOR DALAM MENURUNKAN DISABILITAS BAHU DAN LENGAN PADA SUBACROMIAL IMPINGEMENT SYNDROME MAHASISWA AKAD

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    Mawaddah -

    2015-08-01

    Full Text Available Shoulder impingement causing interference on the motion of the shoulder joint activities and result in functional activity disorder. These injuries usually are caused by faulty movement, overuse, poor posture, occupational factors and trauma. This will cause a burden on one part of the body and cause imbalances in anatomy, which will eventually lead to disruption of the body that experienced work. This study aimed to investigate the effect of functional shoulder exercise and traction humerus to inferior with shoulder stabilization exercises and traction humerus to inferior to the decline in the shoulder and arm disabilities in subacromial impingement syndrome. This research method was experimental clinical trials with pre test and post test group design. Population student Academy Physiotherapy Widya Husada Semarang, which consists of 3 men and 12 women, aged between 18-21 years, divided into two groups. Group I was given Shoulder Stabilization exercises and Traction humerus to Inferior (n=7 and group II Functional Shoulder Exercise and Traction humerus to Inferior (n=8. This research was conducted for 3 weeks. Measurement of the value of disability shoulder and arm by using the Shoulder Pain and Disability Index (SPADI. The test results on the group I average value pre 34.17, SB = 6.31, and the average value of post 11.54, SB = 4.02, p = 0.001 found significant differences obtained test results paired sample t-test, and testing group II average value pre 40.18, SB = 3.53, and the average value of post 7.82, SB = 1.57, p = 0.001 found significant differences obtained test results paired sample t-test. Comparison of Group I and II, p = 0.005 there were significant differences, test results obtained independent sample t-test. Conclusions: The combination of shoulder stabilization exercises and traction humerus to inferior can reduce disability shoulder and arm on subacromial impingement syndrome. The combination functional shoulder exercise and

  7. Trombosis del sector ilio-cava: trombosis puerperal y trombosis en agenesia de la cava inferior Thrombosis of the ileo-caval sector: puerperal thrombosis and agenesia thrombosis of the inferior vena cava

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    Jorge García Egea

    2011-03-01

    Full Text Available La trombosis de la vena cava inferior supone alrededor del 15 % del total de los casos de trombosis venosa profunda. Se presenta un caso de una puérpera primigesta con parto por cesárea que presentó una trombosis con inicio en la vena ovárica derecha y extensión hasta la cava inferior. Fue tratada con heparina de bajo peso molecular en dosis anticoagulantes, reposo con extremidades elevadas y elastocompresión. Tras la evolución satisfactoria del proceso, con lisis parcial del trombo, se comenzó anticoagulación oral con acenocumarol durante 6 meses. El segundo paciente, un varón de 73 años, con antecedentes de hidatidosis hepática intervenida, presentó una trombosis de la cava inferior infrarrenal y agenesia del segmento retrohepático de la cava inferior. El enfermo sigue con tratamiento anticoagulante con acenocumarol, elastocompresión y cuidados higiénicos. Como secuela presentó un síndrome posflebítico con episodios de úlceras flebostásicas y reagudizaciones del edema, que han obligado a su hospitalización en dos ocasiones.The thrombosis of the inferior vena cava account for around the 15% of the cases of deep venous thrombosis. This is the case of a puerperal primigravida with a cesarean section labor presenting with a thrombosis initially in the right ovarian vein and then extension to the inferior vena cava. Treatment included low molecular weight heparin in anticoagulant doses; rest with elevation of the extremities and elastic bandage. After a satisfactory process evolution with partial lysis of the thrombus, the oral anticoagulation with Acenocumarol for 6 months was started. The second patient, a man aged 73 with backgrounds of an operated hepatic hydatidosis, had a thrombosis of the infrarenal inferior vena cava and agenesia of retrohepatic segment of the inferior vena cava. The patient remains with anticoagulant treatment including Acenocumarol, elastic bandage and hygienic care. As sequela he had a postphlebitic

  8. Situacion de salud bucal y estado protesico del paciente edentado bimaxilar que acude a la Facultad de Odontologia de la Universidad de Antioquia: un estudio piloto

    National Research Council Canada - National Science Library

    Arboleda Cadavid, Alejandro; Zea Restrepo, Francisco J; Gomez Gil, Diana P; Moreno Castillo, Jenny A; Agudelo Suarez, Andres A; Montoya Sepulveda, Andres F

    2012-01-01

    .... Se consideraron las siguientes variables: edad, sexo, estrato socioeconomico, nivel educativo, frecuencia de cepillado, utilizacion de enjuagues, limpieza de la mucosa, remocion nocturna de la protesis, presencia de estomatitis, ulceras...

  9. Using a Posterolateral Portal to Pass and Tie the Suture of the Inferior Anchor During Arthroscopic Bankart Repair.

    Science.gov (United States)

    Reda, Walid; Khedr, Ahmed

    2016-12-01

    Using a posterolateral portal in passing and tying the inferior knot allows good labral reduction and adequate capsular shift to treat anterior shoulder instability. In this technique, the most inferior anchor is placed through a low anterolateral portal. A penetrating grasper is introduced from a posterolateral portal situated 2 to 3 cm distal and lateral to the viewing portal. This portal is used to pass the 2 limbs of the anchor suture as inferior as possible through the labrum and capsule close to 6 o'clock position to form the 2 limbs of the first mattress suture. Finally, knot tying is performed through this posterolateral portal, thus allowing better superior shift of the capsulolabral tissue. The other 2 anchor sutures are passed and tied through the low anterolateral portal.

  10. The role of cholinergic networks of the anterior basal and inferior frontal lobes in the predatory behaviour of Sepia officinalis.

    Science.gov (United States)

    Halm, M P; Chichery, M P; Chichery, R

    2002-06-01

    The predatory behaviour of the cuttlefish has been the subject of a few detailed studies and can be divided into several stages: prey detection, orientation, positioning, prey-seizing, prey-manipulation and ingestion. Nevertheless, the data about its control by the CNS remain fragmentary. By injecting a cholinergic agonist (nicotine) and antagonists (alpha-bungarotoxin, mecamylamine), the implication of cholinergic networks of the anterior basal and inferior frontal lobes in the control of predatory behaviour are demonstrated. Through these cholinergic networks, the anterior basal lobe takes an important part in the orientation and positioning. The inferior frontal lobe seems to play a role in the control of brachial manipulative and buccal mass activities. The implication of cholinergic networks of the anterior basal and inferior frontal lobes in the predatory behaviour and the pharmacology of nicotinic receptors are discussed.

  11. Septic thrombophlebitis of the inferior mesenteric vein and associated mesenteric abscess complicating sigmoid diverticulitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Seong Jae; Lee, Hae Kyung; Yi, Beom Ha; Lee, Min Hee; Hong, Hyun Sook [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2013-07-15

    Thrombophlebitis occurs secondarily to inflammatory conditions of adjacent organs, and radiologic finding is essential for diagnosis. However, because of the rarity on clinical cases that involve the inferior mesenteric vein, many radiologists are unfamiliar with its location and appearance. We experience a case of septic thrombophlebitis with abscess complication sigmoid diverticulitis. CT scans reveals a low density thrombus and air in the inferior mesenteric vein, combining with perivascular fat infiltration, and focal wall defects with abscess formation. After surgical treatment, the abscess was not visible in the follow-up CT scans. Septic thrombophlebitis of the inferior mesenteric vein, although being a rare disease, should be diagnosed on CT according to the given unique location, the appearance of inflamed vein and the adjacent descending mesocolon.

  12. Vascular loops in the anterior inferior cerebellar artery, as identified by magnetic resonance imaging, and their relationship with otologic symptoms

    Directory of Open Access Journals (Sweden)

    Luiz de Abreu Junior

    Full Text Available Abstract Objective: To use magnetic resonance imaging to identify vascular loops in the anterior inferior cerebellar artery and to evaluate their relationship with otologic symptoms. Materials and Methods: We selected 33 adults with otologic complaints who underwent magnetic resonance imaging at our institution between June and November 2013. Three experienced independent observers evaluated the trajectory of the anterior inferior cerebellar artery in relation to the internal auditory meatus and graded the anterior inferior cerebellar artery vascular loops according to the Chavda classification. Kappa and chi-square tests were used. Values of p < 0.05 were considered significant. Results: The interobserver agreement was moderate. Comparing ears that presented vascular loops with those that did not, we found no association with tinnitus, hearing loss, or vertigo. Similarly, we found no association between the Chavda grade and any otological symptom. Conclusion: Vascular loops do not appear to be associated with otoneurological manifestations.

  13. Socioeconomic status and paranoia: the role of life hassles, self-mastery, and striving to avoid inferiority.

    Science.gov (United States)

    Anderson, Fraser; Freeman, Daniel

    2013-08-01

    Paranoid ideation is more common in the general population than previously thought, and it is associated with low socioeconomic status. Daily life hassles, self-mastery, and striving to avoid inferiority may partly account for this association, but these factors have not been examined in relation to paranoid thoughts. Two hundred fifteen individuals from the general population completed self-report assessments of paranoid thoughts during the last month, daily life hassles, self-mastery, striving to avoid inferiority, and socioeconomic classification. A greater number of daily hassles, low self-mastery, and insecure striving were all associated with greater levels of paranoid thinking. Each variable was associated with markers of socioeconomic status. This study demonstrates for the first time the association of paranoid thoughts with life hassles, self-mastery, and striving to avoid inferiority. Each of the factors examined may be a plausible candidate to account for why lower socioeconomic status is associated with greater perceptions of threat from other people.

  14. The use of the inferior epigastric artery for accessory lower polar artery revascularization in live donor renal transplantation.

    Science.gov (United States)

    El-Sherbiny, M; Abou-Elela, A; Morsy, A; Salah, M; Foda, A

    2008-01-01

    This study describes the surgical technique and outcomes of live donor renal allografts with multiple arteries in which the lower polar artery was anastomosed to the inferior epigastric artery after declamping. Between 1988 and 2004, 477 consecutive live donor renal transplants were performed, including 429 with single and 48 with multiple arteries. Anastomosis of the lower polar artery to the inferior epigastric artery was used for 15 grafts with multiple arteries. Successful revascularization of all areas of the transplanted graft was confirmed by Doppler ultrasonography in most patients and radionuclide renal scanning +/- MRA in some patients. In live donor renal transplantation with multiple arteries, the anastomosis of the lower polar artery to the inferior epigastric artery after declamping avoids prolongation of the ischemia time that occurs with other surgical and microsurgical techniques of intracorporeal and ex vivo surgeries.

  15. Inferior vena cava anomalies-a common cause of DVT and PE commonly not diagnosed.

    Science.gov (United States)

    Nanda, Sudip; Bhatt, Surya Prakash; Turki, Mohamed A

    2008-05-01

    A 62-year-old white male presented with recurrent pulmonary embolism (PE) despite having an inferior vena cava (IVC) filter. Investigations ruled out upper limb deep vein thrombosis (DVT) and IVC thrombus, the common causes for a PE in the presence of IVC filter. The culprit was double IVC with a persisting left supracardinal vein that allowed an alternate route for the leg DVT to cause PE. IVC anomalies have a propensity to cause lower limb DVT. Although rarely suspected recent studies have revealed that IVC anomalies are not rare if anticipated and evaluated. Chest CT scans in cases of suspected idiopathic PE should extend up to the renal veins as this will identify common IVC anomalies. Therapy to prevent recurrent DVT can be instituted. A good quality venacavagram should always precede any IVC filter placement as this will identify almost all IVC anomalies and appropriate steps can prevent a recurrent PE.

  16. Apophysitis of the lower limbs: imaging findings; Apofisites dos membros inferiores: aspectos de imagem

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa, Priscila Rodrigues; Santos, Durval C. Barros; Longo, Carlos Henrique; Luna, Rodrigo de Castro; Kim, Nelson Ji Tae; Rosemberg, Laercio A.; Funari, Marcelo Gusmao Buarque [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Dept. de Imagem]. E-mail: pill-rb@uol.com.br

    2005-07-01

    Apophyses are secondary ossification centers that appear during growth. These ossification centers are under traction forces because of insertion of muscles and ligaments. When traction stress become greater in magnitude and frequency irritation of physis (growth plate) may occur resulting in apophysitis. Apophysitis injuries typically occur in active adolescents and usually presents as peri-articular pain associated with growth, skeletal immaturity, repetitive microtrauma and muscle-tendon imbalance. The most common types of apophysitis of the include Osgood-Schlatter disease (tibial tuberosity), apophysitis of the hip (iliac crest, ischial tuberosity), Sever's disease (posterior calcaneus), Sindig-Larsen-Johansson syndrome (inferior patella), and Iselin's disease (fifth metarsal base). The aim of this study was to show the main magnetic resonance imaging and X-rays findings in patients with these diseases and to discuss the frequent differential diagnosis. (author)

  17. Super obesity is not necessarily a contraindication to deep inferior epigastric perforator flap breast reconstruction.

    Science.gov (United States)

    Papadakis, Marios; Schuster, Frauke; Djedovic, Gabriel; Rahmanian-Schwarz, Afshin

    2018-01-24

    The deep inferior epigastric perforator (DIEP) flap is widely recognised as a safe and reliable flap for use as a first-choice option in autologous tissue breast reconstruction. Patients with obesity represent a challenging group for autologous breast reconstruction, as they are at increased risk of developing major and minor complications in comparison with patients with normal weight. We report a 59-year-old woman with super obesity, who presented to our department with right breast skin necrosis after implant reconstruction following mastectomy for right breast cancer. After implant removal and local treatment with both surgical debridement and negative pressure wound therapy, the patient successfully underwent a DIEP flap breast reconstruction. We conclude that super obesity should not be a contraindication to DIEP flap breast reconstruction. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Acute bilateral cerebellar infarction in the territory of the medial branches of posterior inferior cerebellar arteries.

    Science.gov (United States)

    Gurer, G; Sahin, G; Cekirge, S; Tan, E; Saribas, O

    2001-10-01

    The most frequent type of cerebellar infarcts involved the posterior inferior cerebellar artery (PICA) and superior cerebellar artery territories but bilateral involvement of lateral or medial branches of PICA is extremely rare. In this report, we present a 55-year-old male who admitted to hospital with vomiting, nausea and dizziness. On examination left-sided hemiparesia and ataxic gait were detected. Infarct on bilateral medial branch of PICA artery territories was found out with cranial magnetic resonance imaging (MRI) technique and 99% stenosis of the left vertebral artery was found out with digital subtraction arteriography. The patient was put on heparin treatment. After 3 weeks, his complaints and symptoms had disappeared except for mild gait ataxia.

  19. Utilization of Inferiorly Based Dermofat Flap in Breast Reconstruction after Simple Mastectomy due to Gigantomastia.

    Science.gov (United States)

    Bogdanov-Berezovsky, A; Krieger, Y; Shoham, Y; Silberstein, E

    2013-01-01

    Gigantomastia (GM) is a rare disabling condition characterized by excessive breast tissue growth. To date, there is no universal classification and definition of GM. At present, GM is determined as weight over 1.5 kg per breast (Dancey et al., 2008) or 3% or more of the patient's total body weight (Dafydd et al., 2011). The lack of generally acknowledged approach regarding GM is expressed by the different methods of its treatment ranging from hormonal prescription to mastectomy and subsequent complex breast reconstruction (Shoma et al., 2011). We describe a treatment approach, including simple mastectomy and immediate breast reconstruction by an inferiorly based dermofat flap with silicone implants and nipple grafting.

  20. Free deep inferior epigastric perforator flap used for management of post-pneumonectomy space empyema.

    Science.gov (United States)

    Manley, Kate; Gelvez, Sandra; Meldon, Charlotte J; Levai, Irisz; Malata, Charles M; Coonar, Aman S

    2013-04-01

    Various solutions exist for management of post-pneumonectomy space empyema. We describe the use of a free deep inferior epigastric perforator (DIEP) flap to fill the space and close a pleural window. Previously, flaps involving abdominal muscle or omentum have been used for this purpose. Abdominal surgery to harvest such flaps can impair ventilatory mechanics. The DIEP flap--harvested from the abdomen, and composed primarily of skin and muscle avoids this problem, thus is a desirable technique in patients with impaired lung function. We believe this is the first report of the DIEP flap to close a postpneumonectomy empyema space. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Brachytherapy for the prevention of neointimal hyperplasia in the canine inferior vena cava after stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Isota, Masayuki; Kaminou, Toshio; Sakai, Yukimasa; Nakamura, Kenji; Yamada, Ryusaku [Osaka City Univ. (Japan). Medical School

    2002-06-01

    The aim of this study was to evaluate the efficacy of brachytherapy for preventing neointimal hyperplasia in the inferior vena cava (IVC) after stent placement. Sixteen beagles underwent Z-stent placement in the IVC and the aorta. For 8 of 16 beagles, irradiation (15 Gy) was delivered endoluminally to the stented segments of each vessel immediately after stent placement using the {sup 192}Ir. All animals were sacrificed after 6 weeks for morphometric and histopathologic examination. Morphometrically, neointimal thickness in the IVC of the radiation group was significantly decreased compared with the control group as well as that in the aorta (p<0.05). Histopathologic findings showed the neointima in the IVC of the control group contained markedly organization of thrombus and neovascularization though that in the IVC of the radiation group consisted mainly of smooth muscle cells without organization of thrombus and neovascularization. From these data intravenous irradiation may prevent clinical restenosis after stent placement. (author)

  2. Efectos del entrenamiento de fuerza en miembros inferiores sobre el perfil antropométrico

    OpenAIRE

    Montealegre Mesa, Lina María

    2013-01-01

    Introducción: en este artículo se describen los efectos del entrenamiento de la fuerza en miembros inferiores luego de la aplicación de tres técnicas: el desarrollo muscular, la pirámide ascendente y la pirámide descendente a las mujeres que asistieron al gimnasio de la Universidad Cooperativa de Colombia, seccional Neiva, en el periodo 2008-2009. Metodología: el tipo de investigación es cuasi-experimental, en la cual se aplica una evaluación inicial y final de la fuerza muscular para determi...

  3. Entrapment of Guide Wire in an Inferior Vena Cava Filter: A Technique for Removal

    Energy Technology Data Exchange (ETDEWEB)

    Abdel-Aal, Ahmed Kamel, E-mail: akamel@uabmc.edu; Saddekni, Souheil [University of Alabama at Birmingham, Department of Radiology (United States); Hamed, Maysoon Farouk [University of Alabama at Birmingham, Department of Anesthesia (United States); Fitzpatrick, Farley [Radiology Specialists of Louisville (United States)

    2013-04-15

    Entrapment of a central venous catheter (CVC) guide wire in an inferior vena cava (IVC) filter is a rare, but reported complication during CVC placement. With the increasing use of vena cava filters (VCFs), this number will most likely continue to grow. The consequences of this complication can be serious, as continued traction upon the guide wire may result in filter dislodgement and migration, filter fracture, or injury to the IVC. We describe a case in which a J-tipped guide wire introduced through a left subclavian access without fluoroscopic guidance during CVC placement was entrapped at the apex of an IVC filter. We describe a technique that we used successfully in removing the entrapped wire through the left subclavian access site. We also present simple useful recommendations to prevent this complication.

  4. Preservation of spectrotemporal tuning between the nucleus laminaris and the inferior colliculus of the barn owl.

    Science.gov (United States)

    Christianson, G Björn; Peña, José Luis

    2007-05-01

    Performing sound recognition is a task that requires an encoding of the time-varying spectral structure of the auditory stimulus. Similarly, computation of the interaural time difference (ITD) requires knowledge of the precise timing of the stimulus. Consistent with this, low-level nuclei of birds and mammals implicated in ITD processing encode the ongoing phase of a stimulus. However, the brain areas that follow the binaural convergence for the computation of ITD show a reduced capacity for phase locking. In addition, we have shown that in the barn owl there is a pooling of ITD-responsive neurons to improve the reliability of ITD coding. Here we demonstrate that despite two stages of convergence and an effective loss of phase information, the auditory system of the anesthetized barn owl displays a graceful transition to an envelope coding that preserves the spectrotemporal information throughout the ITD pathway to the neurons of the core of the central nucleus of the inferior colliculus.

  5. Enteral Antibiotics are Non-inferior to Intravenous Antibiotics After Complicated Appendicitis in Adults

    DEFF Research Database (Denmark)

    Kleif, Jakob; Rasmussen, Louise; Fonnes, Siv

    2017-01-01

    BACKGROUND: Prolonging post-operative antibiotic treatment beyond 3 days does not seem to reduce the incidence of post-operative abscess formation or wound infection after surgery for complicated appendicitis. The route of administration seems to be based on an empirical basis. Using enteral...... appendicitis. METHODS: A retrospective study of adult patients having surgery for complicated appendicitis within a period of 32 months in the Capital Region of Denmark. Primary outcome was the incidence of post-operative abscess formation, and secondary outcome was wound infections, both within 30 days...... a wound infection compared to patients treated post-operatively with intravenous antibiotics. CONCLUSION: Treatment with enteral antibiotics was non-inferior compared to treatment with intravenous antibiotics during the first 3 days after surgery for complicated appendicitis....

  6. Inferior vena cava thrombosis: a rare complication of fibrocalcific pancreatic diabetes.

    Science.gov (United States)

    Mishra, R; Yathish, B E; Himanshu, D; Usman, K

    2013-04-22

    A 42-year-old man presented with a history of recurrent loose motions for the previous 7 months. The patient also had a history of diabetes mellitus for the last 10 years and was uncontrolled on oral hypoglycaemic agents but responded to insulin. There was no history of any addiction. Examination and investigations showed the presence of malabsorption along with a calcified pancreas. The presence of a thrombus was also noted in the inferior vena cava. In the absence of alcohol intake, a diagnosis of fibrocalcific pancreatic diabetes was made and the patient was investigated for other hypercoagulable states but none was found. The patient was put on oral anticoagulants, insulin and pancreatic enzyme supplements, and currently, he is under regular follow-up for diabetes.

  7. Processing of noise by single units of the inferior colliculus of the bar Rhinolophus ferrumequinum.

    Science.gov (United States)

    Engelstätter, R; Vater, M; Neuweiler, G

    1980-12-01

    For inferior colliculus units the response patterns and the thresholds for pure tones and noise of variable bandwidth were determined. In a threshold-bandwidth plot the noise thresholds usually fell along two regression lines whose point of intersection established the size of the neuronal critical bandwidth (nCB). The relevance of the small nCBs (0.2-0.4 kHz) obtained for the frequency range of the constant frequency part of the orientation call is discussed. No fixed relation was found either between the nCBs and the neuronal critical ratios or between the size of nCB and the width of the tuning curve 3 dB above threshold of the best frequency.

  8. Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

    Science.gov (United States)

    Saseendar, S; Agarwal, Dinesh K; Patro, Dilip K; Menon, Jagdish

    2009-01-01

    Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in English literature. Closed reduction by the two-step maneuver was successful with a single attempt. MRI revealed posterior labral tear and a Hill-Sachs variant lesion on the superolateral aspect of humeral head. Immobilisation in a chest-arm bandage followed by physiotherapy yielded excellent results. The case is first of its kind; the unusual mechanism, unique radiological findings and alternate method of treatment are discussed. PMID:19883514

  9. Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

    Directory of Open Access Journals (Sweden)

    Patro Dilip K

    2009-11-01

    Full Text Available Abstract Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in English literature. Closed reduction by the two-step maneuver was successful with a single attempt. MRI revealed posterior labral tear and a Hill-Sachs variant lesion on the superolateral aspect of humeral head. Immobilisation in a chest-arm bandage followed by physiotherapy yielded excellent results. The case is first of its kind; the unusual mechanism, unique radiological findings and alternate method of treatment are discussed.

  10. A Discontinuous Tonotopic Organization in the Inferior Colliculus of the Rat

    Science.gov (United States)

    Malmierca, Manuel S.; Izquierdo, Marco A.; Cristaudo, Salvatore; Hernández, Olga; Pérez-González, David; Covey, Ellen; Oliver, Douglas L.

    2008-01-01

    Audible frequencies of sound are encoded in a continuous manner along the length of the cochlea, and frequency is transmitted to the brain as a representation of place on the basilar membrane. The resulting tonotopic map has been assumed to be a continuous smooth progression from low to high frequency throughout the central auditory system. Here, physiological and anatomical data show that best frequency is represented in a discontinuous manner in the inferior colliculus, the major auditory structure of the midbrain. Multiunit maps demonstrate a distinct stepwise organization in the order of best frequency progression. Furthermore, independent data from single neurons show that best frequencies at ∼⅓ octave intervals are more prevalent than others. These data suggest that in the IC there is a defined space of tissue devoted to a given frequency bandwidth that input within this frequency band may be pooled for higher-level processing. PMID:18448653

  11. Insufficiency Fracture of the Superior and Inferior Pubic Rami in a Patient with Osteomalacia: Case Report

    Directory of Open Access Journals (Sweden)

    Barış Nacır

    2010-08-01

    Full Text Available Insufficiency fractures are subtype of stres fractures which occur when normal or physiological stresses are placed on weakened bone. These fractures occur in a variety of conditions in which the mineral content or the elasticity of bone is abnormal. The most common cause of insufficieny fracture is postmenopausal osteoporosis. The other important causes are senile osteoporosis, pelvic irradiation, corticosteroid treatment and rheumatoid arthritis. They also occured in vitamin D deficieny/osteomalacia. The diagnosis of pelvic insufficiency fracture due to osteomalacia should be suspected in a postmenopausal women presenting with severe groin and buttock pain and weakness.We presented here the clinical and radiological findings of superior and inferior pubic ramus insufficiency fracture in a patient with osteomalacia. (Osteoporoz Dünyasından 2010;16:44-8

  12. Incidental Finding of Inferior Vena Cava Atresia Presenting with Deep Venous Thrombosis following Physical Exertion

    Directory of Open Access Journals (Sweden)

    Shalini Koppisetty

    2015-01-01

    Full Text Available Inferior vena cava atresia (IVCA is a rare but well described vascular anomaly. It is a rare risk factor for deep venous thrombosis (DVT, found in approximately 5% of cases of unprovoked lower extremity (LE DVT in patients <30 years of age. Affected population is in the early thirties, predominantly male, often with a history of major physical exertion and presents with extensive or bilateral DVTs. Patients with IVC anomalies usually develop compensatory circulation through the collateral veins with enlarged azygous/hemizygous veins. Despite the compensatory circulation, the venous drainage of the lower limbs is often insufficient leading to venous stasis and thrombosis. We describe a case of extensive and bilateral deep venous thrombosis following physical exertion in a thirty-six-year-old male patient with incidental finding of IVCA on imaging.

  13. Dissonance encoding in human inferior colliculus covaries with individual differences in dislike of dissonant music.

    Science.gov (United States)

    Kim, Seung-Goo; Lepsien, Jöran; Fritz, Thomas Hans; Mildner, Toralf; Mueller, Karsten

    2017-07-18

    Harmony is one of the most fundamental elements of music that evokes emotional response. The inferior colliculus (IC) has been known to detect poor agreement of harmonics of sound, that is, dissonance. Electrophysiological evidence has implicated a relationship between a sustained auditory response mainly from the brainstem and unpleasant emotion induced by dissonant harmony. Interestingly, an individual's dislike of dissonant harmony of an individual correlated with a reduced sustained auditory response. In the current paper, we report novel evidence based on functional magnetic resonance imaging (fMRI) for such a relationship between individual variability in dislike of dissonance and the IC activation. Furthermore, for the first time, we show how dissonant harmony modulates functional connectivity of the IC and its association with behaviourally reported unpleasantness. The current findings support important contributions of low level auditory processing and corticofugal interaction in musical harmony preference.

  14. Nurse-Moderated Internet-Based Support for New Mothers: Non-Inferiority, Randomized Controlled Trial.

    Science.gov (United States)

    Sawyer, Michael G; Reece, Christy E; Bowering, Kerrie; Jeffs, Debra; Sawyer, Alyssa C P; Mittinty, Murthy; Lynch, John W

    2017-07-24

    Internet-based interventions moderated by community nurses have the potential to improve support offered to new mothers, many of whom now make extensive use of the Internet to obtain information about infant care. However, evidence from population-based randomized controlled trials is lacking. The aim of this study was to test the non-inferiority of outcomes for mothers and infants who received a clinic-based postnatal health check plus nurse-moderated, Internet-based group support when infants were aged 1-7 months as compared with outcomes for those who received standard care consisting of postnatal home-based support provided by a community nurse. The design of the study was a pragmatic, preference, non-inferiority randomized control trial. Participants were recruited from mothers contacted for their postnatal health check, which is offered to all mothers in South Australia. Mothers were assigned either (1) on the basis of their preference to clinic+Internet or home-based support groups (n=328), or (2) randomly assigned to clinic+Internet or home-based groups if they declared no strong preference (n=491). The overall response rate was 44.8% (819/1827). The primary outcome was parenting self-competence, as measured by the Parenting Stress Index (PSI) Competence subscale, and the Karitane Parenting Confidence Scale scores. Secondary outcome measures included PSI Isolation, Interpersonal Support Evaluation List-Short Form, Maternal Support Scale, Ages and Stages Questionnaire-Social-Emotional and MacArthur Communicative Development Inventory (MCDI) scores. Assessments were completed offline via self-assessment questionnaires at enrolment (mean child age=4.1 weeks, SD 1.3) and again when infants were aged 9, 15, and 21 months. Generalized estimating equations adjusting for post-randomization baseline imbalances showed that differences in outcomes between mothers in the clinic+Internet and home-based support groups did not exceed the pre-specified margin of

  15. Mechanisms contributing to cluster formation in the inferior olivary nucleus in brainstem slices from postnatal mice

    DEFF Research Database (Denmark)

    Kølvraa, Mathias; Müller, Felix C; Jahnsen, Henrik

    2014-01-01

    The inferior olivary nucleus (IO) in in vitro slices from postnatal mice (P5.5-P15.5) spontaneously generates clusters of neurons with synchronous calcium transients, and intracellular recordings from IO neurons suggest that electrical coupling between neighbouring IO neurons may serve......-5-methyl-4-isoxazolepropionic acid receptors. Spikelets and a small transient depolarizing response were observed during glutamate-induced cluster formation. Calcium transients spread with decreasing velocity during cluster formation, and somatic action potentials and cluster formation...... are accompanied by large dendritic calcium transients. In conclusion, cluster formation depends on gap junctions, sodium action potentials and spontaneous clusters occur randomly throughout the IO. The relative slow signal spread during cluster formation, combined with a strong dendritic influx of calcium, may...

  16. Spontaneous cluster activity in the inferior olivary nucleus in brainstem slices from postnatal mice

    DEFF Research Database (Denmark)

    Rekling, Jens C; Reveles Jensen, Kristian; Jahnsen, Henrik

    2012-01-01

    A distinctive property of the cerebellar system is olivocerebellar modules, where synchronized electrical activity in neurons in the inferior olivary nucleus (IO) evokes organized activity in the cerebellar cortex. However, the exact function of these modules, and how they are developed, is still...... calcium transients. The spatiotemporal activity pattern was occasionally organized in clusters of co-active neighbouring neurons, with regular (16/min) and irregular (2-3/min) repeating cluster activity in the dmcc and PO, respectively. IO clusters had a diameter of 100-170 µm, lasted ~1 s, and increased......-active with separate clusters at different times. The coherence between calcium transients in IO neurons decreased with Euclidean distance between the cells reaching low values at 100-200 µm distances. Intracellular recordings from IO neurons during cluster formation revealed the presence of spikelet-like potentials...

  17. High baseline activity in inferior temporal cortex improves neural and behavioral discriminability during visual categorization

    Directory of Open Access Journals (Sweden)

    Nazli eEmadi

    2014-11-01

    Full Text Available Spontaneous firing is a ubiquitous property of neural activity in the brain. Recent literature suggests that this baseline activity plays a key role in perception. However, it is not known how the baseline activity contributes to neural coding and behavior. Here, by recording from the single neurons in the inferior temporal cortex of monkeys performing a visual categorization task, we thoroughly explored the relationship between baseline activity, the evoked response, and behavior. Specifically we found that a low-frequency (< 8 Hz oscillation in the spike train, prior and phase-locked to the stimulus onset, was correlated with increased gamma power and neuronal baseline activity. This enhancement of the baseline activity was then followed by an increase in the neural selectivity and the response reliability and eventually a higher behavioral performance.

  18. Avulsion Fracture of the Anterior Inferior Iliac Spine Mimicking a Bone Tumor: A Case Report

    Directory of Open Access Journals (Sweden)

    Mehmet Incedayi

    2014-05-01

    Full Text Available This is a case of a 17-year-old boy who was admitted to the clinic suffering from right hip-inguinal region pain which began after a soccer match. He had an avulsion fracture in the anterior inferior iliac spine and CT/MR images showed similarities to a bone tumor. These fractures are especially seen in the apophyses which are within the ossification process. The radiological appearance of these fractures during the healing period may be involved with bone tumors. In the control MRI of the patient after one year, the fracture was almost healed completely. Treatment is generally conservative. Good results have been reported with rest, analgesic and anti-inflammatory drugs. Familiarity with radiological findings of these avulsion fractures in this region not only protects the patient from invasive procedures but also avoids the involvement of the practitioner in legal consequences resulting from a misdiagnosis of sarcoma.

  19. Seasonal dynamics of plankton in a mountain lake in the southern Alps (Laghetto Inferiore, Switzerland

    Directory of Open Access Journals (Sweden)

    Viera STRAŠKRABOVÁ

    1999-08-01

    Full Text Available The pelagic populations in Laghetto Inferiore (southern Swiss Alps were studied between 1996 and 1998 during the ice-free period. Investigations revealed a considerable number of phytoplankton species but few zooplankton species. The vertical distribution of the main species of algae shows a marked vertical stratification, with higher biomass concentrations in the deep zone. Along this profile, species in the same taxonomic class tend to be distributed at different depths, according to their specific light requirements. During the study period no clear seasonal succession of populations was observed, also because of the influence of precipitation on the biological cycles. On the whole there was a good correspondence between the biomass values of phytoplankton and those of chlorophyll-a, both in integral samples of the whole water column and in the vertical profile.

  20. Spontaneous healing and complete disappearance of a ruptured posterior inferior cerebellar artery dissecting aneurysm.

    Science.gov (United States)

    Su, Tsung-Ming; Cheng, Ching-Hsiao; Chen, Wu-Fu; Hsu, Shih-Wei

    2014-05-01

    A 7-month-old baby presented with a 4-day history of drowsiness and vomiting after a falling accident. Magnetic resonance imaging demonstrated diffuse subarachnoid hemorrhage, intraventricular hemorrhage, and variable stages of subdural hematoma in bilateral occipital and left temporal subdural spaces. A partially thrombosed aneurysm was noted in the right craniocervical junction. Ophthalmological examination revealed bilateral retinal petechial hemorrhages. Conventional cerebral angiography revealed a dissecting aneurysm in the right posterior inferior cerebellar artery (PICA). Endovascular embolization was suggested, but the family refused. After conservative treatment, follow-up MRI revealed that the PICA aneurysm had remodeled and ultimately disappeared completely at the 10th month. This case illustrates the relatively plastic nature of intracranial aneurysms in pediatric patients. More studies are necessary to clarify the natural history of spontaneously thrombosed aneurysms to assist in their overall management.

  1. Metastatic Testicular Cancer to Left Atrium via the Left Inferior Pulmonary Vein: A Case Report

    Directory of Open Access Journals (Sweden)

    Shital Vachhani

    2017-03-01

    Full Text Available Testicular cancer is one of the most common cancers diagnosed in young men. Frequent sites of metastasis include the retroperitoneum, lungs, liver, brain, and bone. Intracardiac metastasis has also been described. An 18-year-old boy with a history of mixed testicular germ cell tumor presented to our institution for surgical resection of his metastatic disease. Intraoperative transesophageal echocardiography during his surgery confirmed a tumor thrombus into the left atrium coming from the left pulmonary vein. We report a case of metastatic testicular cancer with rare tumor extension from the left inferior pulmonary vein into the left atrium. Perioperative transesophageal echocardiography was necessary to aid intraoperative diagnosis and confirmation of the intracardiac tumor, providing data to guide surgical strategy.

  2. A Dedicated Inferior Vena Cava Filter Service Line: How to Optimize Your Practice

    Science.gov (United States)

    Karp, Jennifer K.; Desai, Kush R.; Salem, Riad; Ryu, Robert K.; Lewandowski, Robert J.

    2016-01-01

    Despite the increased placement of retrievable inferior vena cava filters (rIVCFs), efforts to remove these devices are not commensurate. The majority of rIVCFs are left in place beyond their indicated usage, and often are retained permanently. With a growing understanding of the clinical issues associated with these devices, the United States Food and Drug Administration (FDA) has prompted clinicians to remove rIVCF when they are no longer indicated. However, major obstacles exist to filter retrieval, chief among them being poor clinical follow-up. The establishment of a dedicated IVC filter service line, or clinic, has been shown to improve filter retrieval rates. Usage of particular devices, specifically permanent versus retrievable filters, is enhanced by prospective physician consultation. In this article, the rationale behind a dedicated IVC filter service line is presented as well as described the structure and activities of the authors' IVC filter clinic; supporting data will also be provided when appropriate. PMID:27247479

  3. First-trimester sonographic findings associated with a Dandy-Walker malformation and inferior vermian hypoplasia.

    Science.gov (United States)

    Bornstein, Eran; Goncalves Rodríguez, José Luis; Álvarez Pavón, Erika Carolina; Quiroga, Héctor; Or, Drorit; Divon, Michael Y

    2013-10-01

    We report 2 cases in which first-trimester measurements of the intracranial translucency and the brain stem-to-occipital bone diameter were markedly enlarged. This finding was thought to represent an abnormal fourth ventricle-cisterna magna complex. Subsequently, the diagnoses of a Dandy-Walker malformation with partial vermian agenesis in 1 case and inferior vermian hypoplasia in the other were established and confirmed by either postmortem autopsy or postnatal magnetic resonance imaging. These cases suggest that evaluation of the fourth ventricle-cisterna magna complex, by measuring the intracranial translucency or brain stem-to-occipital bone diameter may identify some cases with structural malformations of the cerebellum as early as the first trimester.

  4. Bilateral inferior vena cava filter insertion in a patient with duplication of the infrarenal vena cava.

    LENUS (Irish Health Repository)

    Leong, S

    2010-06-19

    BACKGROUND: Inferior vena cava (IVC) filter insertion is a commonly performed procedure for indications such as recurrent pulmonary emboli or contraindication to anticoagulation. Symptomatic duplication of the IVC is exceedingly rare with only a handful of cases being described in the literature. AIM: We report an unusual case of a patient with symptomatic duplication of the IVC. RESULT: A 53-year-old woman presented at our hospital for resection of a cerebral metastasis from a non-small cell lung cancer following a recent diagnosis of bilateral lower limb deep venous thrombosis. This required perioperative reversal of anticoagulation and IVC filter insertion. Conventional venography performed during filter insertion documented the existence of a duplicated IVC. CONCLUSION: We present a case of a symptomatic duplication of the IVC requiring filter insertion. We review the developmental anatomy of the IVC along with the diagnostic findings and management strategies available.

  5. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava

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    Pradeepkumar Charlagorla

    2016-01-01

    Full Text Available Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC, atrial and visceral situs inversus, left-sided superior vena cava (SVC, and left-sided interrupted inferior vena cava (IVC with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

  6. Aberrant network integrity of the inferior frontal cortex in women with anorexia nervosa

    Science.gov (United States)

    Kullmann, Stephanie; Giel, Katrin E.; Teufel, Martin; Thiel, Ansgar; Zipfel, Stephan; Preissl, Hubert

    2014-01-01

    Neuroimaging studies investigating the neural profile of anorexia nervosa (AN) have revealed a predominant imbalance between the reward and inhibition systems of the brain, which are also hallmark characteristics of the disorder. However, little is known whether these changes can also be determined independent of task condition, using resting-state functional magnetic resonance imaging, in currently ill AN patients. Therefore the aim of our study was to investigate resting-state connectivity in AN patients (n = 12) compared to healthy athlete (n = 12) and non-athlete (n = 14) controls. For this purpose, we used degree centrality to investigate functional connectivity of the whole-brain network and then Granger causality to analyze effective connectivity (EC), to understand directional aspects of potential alterations. We were able to show that the bilateral inferior frontal gyrus (IFG) is a region of special functional importance within the whole-brain network, in AN patients, revealing reduced functional connectivity compared to both healthy control groups. Furthermore, we found decreased EC from the right IFG to the midcingulum and increased EC from the bilateral orbitofrontal gyrus to the right IFG. For the left IFG, we only observed increased EC from the bilateral insula to the left IFG. These results suggest that AN patients have reduced connectivity within the cognitive control system of the brain and increased connectivity within regions important for salience processing. Due to its fundamental role in inhibitory behavior, including motor response, altered integrity of the inferior frontal cortex could contribute to hyperactivity in AN. PMID:24936412

  7. Distinct roles of left inferior frontal regions that explain individual differences in second language acquisition.

    Science.gov (United States)

    Sakai, Kuniyoshi L; Nauchi, Arihito; Tatsuno, Yoshinori; Hirano, Kazuyoshi; Muraishi, Yukimasa; Kimura, Masakazu; Bostwick, Mike; Yusa, Noriaki

    2009-08-01

    Second language (L2) acquisition is more susceptible to environmental and idiosyncratic factors than first language acquisition. Here, we used functional magnetic resonance imaging for L2 learners of different ages of first exposure (mean: 12.6 and 5.6 years) in a formal school environment, and compared the cortical activations involved in processing English sentences containing either syntactic or spelling errors, where the testing ages and task performances of both groups were matched. We found novel activation patterns in two regions of the left inferior frontal gyrus (IFG) that correlated differentially with the performances of the late and early learners. Specifically, activations of the dorsal and ventral triangular part (F3t) of the left IFG correlated positively with the accuracy of the syntactic task for the late learners, whereas activations of the left ventral F3t correlated negatively with the accuracy for the early learners. In contrast, other cortical regions exhibited differential correlation patterns with the reaction times (RTs) of the syntactic task. Namely, activations of the orbital part (F3O) of the left IFG, as well as those of the left angular gyrus, correlated positively with the RTs for the late learners, whereas those activations correlated negatively with the RTs for the early learners. Moreover, the task-selective activation of the left F3O was maintained for both the late and early learners. These results explain individual differences in L2 acquisition, such that the acquisition of linguistic knowledge in L2 is subserved by at least two distinct inferior frontal regions of the left F3t and F3O. (c) 2008 Wiley-Liss, Inc.

  8. Clinical features and surgical outcomes of isolated inferior rectus muscle paralysis.

    Science.gov (United States)

    Akbari, Mohammad Reza; Ameri, Ahmad; Keshtkar Jaafari, Alireza; Fard, Masoud Aghsaei; Eshraghi, Bahram; Mirmohammadsadeghi, Arash

    2014-06-01

    To describe clinical features of patients with unilateral isolated inferior rectus (IR) muscle paralysis along with type of surgical treatment and results after surgery. Patients diagnosed with unilateral isolated IR muscle palsy between 2009 and 2012 that required surgical treatment were included in the study. Diagnosis of IR muscle palsy was done by hypertropia with the largest angle in depression and abduction and inferior rectus muscle underaction. Twenty-two patients remained in the study; 17 patients (77.3%) had left eye involvement. IR muscle paresis was traumatic in 12 patients (54.5%), congenital in 9 patients (40.9%), and vascular in 1 patient (4.5%). Limitation of duction in the gaze of IR muscle was -2 to -3 in all cases. 3 patients, paradoxically, had contralateral compensatory head tilt (compensatory head tilt to the opposite side of IR muscle palsy). Intraoperatively, we did not detect any gross abnormalities in the IR muscles. The surgical plan at the first operation was IR muscle resection alone in 13 patients (59.1%). At the last follow-up visit, 15 patients (68%) had no deviations in primary position and downgaze. Three cases needed reoperation. The presence of both ipsilateral and contralateral compensatory head postures in our patients showed that three-step or head-tilt test is not helpful in the diagnosis of IR muscle palsy. In comparison with other studies, more patients in our study were treated with IR muscle resection alone. Also, our reoperation rate was lower than other studies. Absence of gross abnormality in the IR muscles at the operation and partial nature of the paresis may explain these good results. Thus, a considerable number of IR muscle palsy cases with the above characteristics may be treated successfully by one muscle surgery (IR muscle resection).

  9. Evaluation of Inferior Oblique Muscle Overaction Existence Time and Surgical Outcomes in Infantile Esotropia

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    Mehmet Ragıp Ekmen

    2013-12-01

    Full Text Available Purpose: Evaluation of inferior oblique muscle overaction (IOOA existence time and surgical outcomes in infantile esotropia. Material and Method: A total of 100 patients who underwent operation for infantile esotropia (IE were included in the study. Full ophthalmic assessment, including ocular motility, best-corrected visual acuity, cycloplegic refraction, any of alternant prism cover test or Hirschberg/Krimsky test, was performed. Results: Forty-nine patients (49% were male and (51% were female. The mean age at IE diagnosis was 23.2±18.6 months. The mean follow-up time was 43.7±18.0 months. The mean horizontal deviation - corrected and uncorrected - was 36.75±10.45 PD and 40.05±8.39 PD, respectively. We found that there was no statistically significant relationship between existence time of IOOA and the age at IE diagnosis (p: 0.486, p: 0.251. IOOA was detected in 69 patients. Inferior oblique (IO muscle weakening procedures were performed in 45 of 69 patients. In 45 patients who had undergone surgery for IOOA, 24 (53.3% had bilateral IO recession, 10 (22.2% had bilateral IO tenotomy, 8 (17.7% had unilateral IO tenotomy, 1(2.2% had unilateral myectomy, 1 (2.2% had bilateral myectomy, and 1 (2.2% had bilateral anteroposition. IOOA degrees after IO recession and tenotomy surgery were found to be significantly lower than the preoperative values (p=0.0586, p=0.7258. Discussion: There was no statistically significant relationship between the existence time of IOOA and the age of IE diagnosis. We concluded that IO tenotomy and IO recession surgical techniques are effective and safe procedures for cases which have IOOA associated with IE. (Turk J Ophthalmol 2013; 43: 419-23

  10. VENOUS SAMPLING FOR CUSHING DISEASE: COMPARISON OF INTERNAL JUGULAR VEIN AND INFERIOR PETROSAL SINUS SAMPLING.

    Science.gov (United States)

    Radvany, Martin G; Quinones-Hinojosa, Alfredo; Gallia, Gary L; Wand, Gary S; Salvatori, Roberto

    2016-09-01

    Because magnetic resonance imaging (MRI) fails to detect many adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas, inferior petrosal sinus sampling (IPSS) is considered the gold standard to differentiate Cushing disease (CD) from ectopic ACTH secretion syndrome (EAS). Some authors have suggested internal jugular vein sampling (IJVS) as an alternative to IPSS. We simultaneously compared IJVS to IPSS in 30 consecutive patients referred for ACTH-dependent Cushing syndrome and equivocal MRI exams. Five sites were simultaneously sampled in each patient (right and left IPS, right and left IJV, and femoral vein) before and after the administration of corticotrophin-releasing hormone or desmopressin. The test was considered consistent with CD when the IPS to peripheral ratio was >2 at baseline or >3 after stimulus and the IJV to peripheral ratio was >1.7 at baseline or >2 after stimulus. In 27 of 30 patients, IPSS results were consistent with a central source of ACTH. Two of the other 3 patients had EAS (one lung carcinoid and one occult), and 1 patient had pathology-proven CD. The sensitivity of IPSS was 96.4%. Only 64.2% of these patients had results meeting criteria for a central source of ACTH by IJVS criteria. Twenty patients with centralizing IPPS have undergone pituitary surgery. Of these, the central origin of excessive ACTH was confirmed with certainty in 16 patients. Among these 16 patients, the IPSS sensitivity was 93.8%, whereas 5 patients had false-negative IJVS (68.7% sensitivity). These results do not support the routine use of IJVS in establishing if the pituitary is the source of excessive ACTH. ACTH = adrenocorticotropic hormone CD = Cushing disease CRH = corticotrophin-releasing hormone CS = Cushing syndrome DDAVP = desmopressin EAS = ectopic ACTH secretion IJVS = internal jugular vein sampling IPSS = inferior petrosal sinus sampling JVS = jugular venous sampling MRI = magnetic resonance imaging.

  11. The representation of sound localization cues in the barn owl’s inferior colliculus

    Directory of Open Access Journals (Sweden)

    Martin eSingheiser

    2012-07-01

    Full Text Available The barn owl is a well-known model system for studying auditory processing and sound localization. This article reviews the morphological and functional organization, as well as the role of the underlying microcircuits, of the barn owl’s inferior colliculus (IC. We focus on the processing of frequency and interaural time (ITD and level differences (ILD. We first summarize the morphology of the sub-nuclei belonging to the inferior colliculus and their differentiation by antero- and retrograde labeling and by staining with various antibodies. We then focus on the response properties of neurons in the three major sub-nuclei of IC (core of the central nucleus of the IC (ICCc; lateral shell of the central nucleus of the IC (ICCls and the external nucleus of the IC (ICX. ICCc projects to ICCls, which in turn sends its information to ICX. The responses of neurons in ICCc are sensitive to changes in ITD but not to changes in ILD. The distribution of ITD sensitivity with frequency in ICCc can only partly be explained by optimal coding. We continue with the tuning properties of ICCls neurons, the first station in the midbrain where the ITD and ILD pathways merge after they have split at the level of the cochlear nucleus. The ICCc and ICCls share similar ITD and frequency tuning. By contrast, ICCls shows sigmoidal ILD tuning which is absent in ICCc. Both ICCc and ICCls project to the forebrain, and ICCls also projects to ICX, where space-specific neurons are found. Space-specific neurons exhibit side-peak suppression in ITD tuning, bell-shaped ILD tuning, and are broadly tuned to frequency. These neurons respond only to restricted positions of auditory space and form a map of two-dimensional auditory space. Finally, we briefly review major IC features, including multiplication-like computations, correlates of echo suppression, plasticity, and adaptation.

  12. Detectability index measures of binaural masking level difference across populations of inferior colliculus neurons.

    Science.gov (United States)

    Jiang, D; McAlpine, D; Palmer, A R

    1997-12-01

    In everyday life we continually need to detect signals against a background of interfering noise (the "cocktail party effect"): a task that is much easier to accomplish using two ears. The binaural masking level difference (BMLD) measures the ability of listeners to use a difference in binaural attributes to segregate sound sources and thus improve their discriminability against interfering noises. By computing the detectability of tones from rate-versus-level functions in the presence of a suprathreshold noise, we previously demonstrated that individual low-frequency delay-sensitive neurons in the inferior colliculus are able to show BMLDs. Here we consider the responses of a population of such neurons when the noise level is held constant (as conventionally in psychophysical paradigms). We have sampled the responses of 121 units in the inferior colliculi of five guinea pigs to identical noise and 500 Hz tones at both ears (NoSo) and to identical noise but with the 500 Hz tone at one ear inverted (NoSpi). The result suggests that the neurons subserving detection of So tones in No (identical noise at the two ears) noise are those neurons with best frequencies (BFs) close to 500 Hz that respond to So tones with an increase in their discharge rate from that attributable to the noise. The detection of the inverted (Spi) signal is also attributable to neurons with BFs close to 500 Hz. However, among these neurons, the presence of the Spi tone was indicated by an increased discharge rate in some neurons and by a decreased discharge rate in others.

  13. [Experimental study of the influence of mandibular distraction osteogenesis on inferior alveolar nerve function].

    Science.gov (United States)

    Wang, Xiaoxia; Wang, Xing; Li, Zili; Yang, Zhaohui

    2002-01-01

    To evaluate the influence of mandibular distraction osteogenesis on inferior alveolar nerve function. 16 young Macaca rhesus monkeys were used as experiment animals. 5 days after mandibular osteotomy under general anesthesia, 10 male monkeys were distracted at right side and 6 females were bilaterally distracted at a rate of 0.5 mm x 2/day, for 15 days. The mandible was lengthened to an average of 13.5 mm. The Sensory Nerve Action Potential (SNAP) test was successfully applied in 16 monkeys before operation and at 0, 2, 4, 6, 9 and 12 weeks after distraction finished. Eight-channel EMG equipment was used for SNAP wave recording. The recordings were made with needle electrodes at foramen ovale and the stimulation was done at the mental foramen with two surface electrodes. The metal ground electrode was fixed on the right forearm. The stimulation intensities were five times of thresholds of each animal. The latency was measured at the first wave peak and the amplitude was measured between two wave peaks. Just after distraction finished, the latency period was 22.18% longer than before operation and gradually shortened as time lapsed. When distraction finished, the amplitude of SNAP wave was only 28.54% of that before operation, and after 12 weeks, it increased to the level of 99.84% of that before operation. The mandibular distraction osteogenesis has temporary influence on the function of inferior alveolar nerve, but it is little and reversible, along with the regeneration of nerve sheath and axon, the nerve function can gradually return to normal level.

  14. Inferior mesenteric artery stump pressure is an unreliable predictor of the outcome of colorectal anastomosis.

    Science.gov (United States)

    Hsu, Tzu-Chi

    2007-12-01

    Ankle/brachial pressure is used as a predictor for the outcome of femoro-popliteal bypass. It has been suggested that a mean inferior mesenteric artery stump pressure (IMASP) below 40 mmHg after aortic reconstruction may be similarly predictive of postoperative ischemic colitis. No previous report has considered IMASP as a predictor of the integrity of colorectal anastomosis. The aim of the study is to examine the correlation between IMASP and anastomotic leakage rate after left colectomy. From April 2004 to March 2006, 99 patients undergoing left colon resection by a single surgeon were measured for their IMASP and arm systemic pressure (SP). All but two patients were operated for carcinoma of the colon or rectum. Sixty-nine patients had primary anastomosis without diverting stomies. The stump mean pressure varied from 24 to 75 mmHg. Seventy-nine patients (79.8%) had pressures equal or above 40 mmHg. IMASP/SP ratios ranged from 0.21 to 0.7. Sixty-seven patients (67.7%) had IMASP/SP ratios equal or above 0.4. Two patients were found to have postoperative leakage of anastomosis. Their IMASP were 35 and 70 mmHg, and their IMASP/SP ratios were 0.28 and 0.62, respectively. We could not identify a significant difference between the two groups, and the pressure of the inferior mesenteric artery could not be proven to be a relevant predictor of anastomotic leakage. This series suggested that IMASP lower than 40 mmHg or an IMASP/SP ratio less than 0.4 does not correlate with an increased leakage rate. Neither IMASP nor the IMASP/SP ratio is a reliable indicator for predicting the outcome of colorectal anastomosis.

  15. Inferior visual field reductions are associated with poorer functional status among older adults with glaucoma.

    Science.gov (United States)

    Black, Alex A; Wood, Joanne M; Lovie-Kitchin, Jan E

    2011-05-01

    To examine the relationship between visual impairment and functional status in a community-dwelling sample of older adults with glaucoma. This study included 74 community-dwelling older adults with open-angle glaucoma (aged 74 ± 6 years). Assessment of central vision included high-contrast visual acuity and Pelli-Robson contrast sensitivity. Binocular integrated visual fields were derived from merged monocular Humphrey Field Analyser visual field plots. Functional status outcome measures included physical performance tests (6-min walk test, timed up and go test and lower limb strength), a physical activity questionnaire (Physical Activity Scale for the Elderly) and an overall functional status score. Correlation and linear regression analyses, adjusting for age and gender, examined the association between visual impairment and functional status outcomes. Greater levels of visual impairment were significantly associated with lower levels of functional status among community-dwelling older adults with glaucoma, independent of age and gender. Specifically, lower levels of visual function were associated with slower timed up and go performance, weaker lower limb strength, lower self-reported physical activity, and lower overall functional status scores. Of the components of vision examined, the inferior visual field and contrast factors were the strongest predictors of these functional outcomes, whereas the superior visual field factor was not related to functional status. Greater visual impairment, particularly in the inferior visual field and loss of contrast sensitivity, was associated with poorer functional status among older adults with glaucoma. The findings of this study highlight the potential links between visual impairment and the onset of functional decline. Interventions which promote physical activity among older adults with glaucoma may assist in preventing functional decline, frailty and falls, and improve overall health and well-being. © 2011 The

  16. Inferior alveolar nerve injury with laryngeal mask airway: a case report

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    Masud Sarmad

    2011-03-01

    Full Text Available Abstract Introduction The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use. Case presentation A 35-year-old Caucasian man presented to our facility for elective anterior cruciate ligament repair. He had no background history of any significant medical problems. He opted for general anesthesia over a regional technique. He was induced with fentanyl and propofol and a size 4 laryngeal mask airway was inserted without any problems. His head was in a neutral position during the surgery. After surgery in the recovery room, he complained of numbness in his lower lip. He also developed extensive scabbing of the lower lip on the second day after surgery. The numbness and scabbing started improving after a week, with complete recovery after two weeks. Conclusion We report the first case of vascular occlusion and injury to the inferior alveolar nerve, causing scabbing and numbness of the lower lip, resulting from laryngeal mask airway use. This is an original case report mostly of interest for anesthetists who use the laryngeal mask airway in day-to-day practice. Excessive inflation of the laryngeal mask airway cuff could have led to this complication. Despite the low incidence of cranial nerve injury associated with the use of the laryngeal mask airway, vigilant adherence to evidence-based medicine techniques and recommendations from the manufacturer's instructions can prevent such complications.

  17. The potential role of hyaluronic acid in postoperative radiofrequency surgery for chronic inferior turbinate hypertrophy.

    Science.gov (United States)

    Casale, Manuele; Manuele, Casale; Ciglia, Giacomo; Giacomo, Ciglia; Frari, Valeria; Valeria, Frari; Incammisa, Antonino; Antonino, Incammisa; Mazzola, Francesco; Francesco, Mazzola; Baptista, Peter; Peter, Baptista; Mladina, Ranko; Ranko, Mladina; Salvinelli, Fabrizio; Fabrizio, Salvinelli

    2013-01-01

    We prospectively evaluated the efficacy of hyaluronic acid (HA) as an adjuvant treatment to hasten the improvement of nasal respiration and to minimize patients' discomfort in the postoperative radiofrequency volumetric tissue reduction (RFVTR) of inferior turbinates. We enrolled 57 patients randomly assigned into two groups, HA (22 patients) and saline group (35 patients), which received isotonic saline nasal irrigation. We used the monopolar device somnoplasty for all patients. Visual analogic scale (VAS) and nasal endoscopy were used to assess the outcomes of the treatments during the 1st month of follow-up. The mean VAS score of the HA group at the 1st week was significantly lower than the control group (3.36 ± 1.89 versus 6.95 ± 1.52; p VAS score remained significantly lower in the HA group also at the 2nd week (3.43 ± 1.27 versus 5.75±1.39; p < 0.05), becoming similar to the control group at the 4th week (p = ns). Since the first visit the HA group also showed significantly lower crust score than the saline group (p < 0.05), and there was no crust found in either group at the last visit. The compliance to treatment was similar in both groups. The results of this prospective study suggest a role of HA as a supportive treatment for faster improvement of nasal respiration, also minimizing patients' discomfort in postoperative nasal surgery, promoting nasal mucosa healing in postoperative RFVTR for inferior turbinate hypertrophy.

  18. New quantitative classification of the anatomical relationship between impacted third molars and the inferior alveolar nerve.

    Science.gov (United States)

    Wang, Wei-Quan; Chen, Michael Y C; Huang, Heng-Li; Fuh, Lih-Jyh; Tsai, Ming-Tzu; Hsu, Jui-Ting

    2015-12-07

    Before extracting impacted lower third molars, dentists must first identify the spatial relationship between the inferior alveolar nerve (IAN) and an impacted lower third molar to prevent nerve injury from the extraction. Nevertheless, the current method for describing the spatial relationship between the IAN and an impacted lower third molar is deficient. Therefore, the objectives of this study were to: (1) evaluate the relative position between impacted lower third molars and the IAN; and (2) investigate the relative position between impacted lower third molars and the IAN by using a cylindrical coordinate system. From the radiology department's database, we selected computed tomography images of 137 lower third molars (from 75 patients) requiring removal and applied a Cartesian coordinate system by using Mimics, a medical imaging software application, to measure the distribution between impacted mandibular third molars and the IAN. In addition, the orientation of the lower third molar to the IAN was also measured, but by using a cylindrical coordinate system with the IAN as the origin. According to the Cartesian coordinate system, most of the IAN runs through the inferior side of the third molar (78.6 %), followed by the lingual side (11.8 %), and the buccal side (8.9 %); only 0.7 % is positioned between the roots. Unlike the Cartesian coordinate system, the cylindrical coordinate system clearly identified the relative position, r and θ, between the IAN and lower third molar. Using the cylindrical coordinate system to present the relationship between the IAN and lower third molar as (r, θ) might provide clinical practitioners with a more explicit and objective description of the relative position of both sites. However, comprehensive research and cautious application of this system remain necessary.

  19. Primary Intraventricular Brain Abscess Resulting in Isolated Dilation of the Inferior Horn and Unilateral Hydrocephalus

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    Joji Inamasu

    2015-07-01

    Full Text Available Primary intraventricular brain abscesses are rare, and there are no established treatment guidelines for this condition. We report a case in which isolated ventricular dilatation and unilateral hydrocephalus developed after seemingly successful conservative management and which required surgical diversion of the cerebrospinal fluid. A 59-year-old woman presented to our emergency department with high-grade fever and headache. Brain magnetic resonance imaging (MRI revealed abscesses in the bilateral posterior horn. Although surgical evacuation of the abscesses was considered, conservative management with antibiotics was selected because of the paucity of severe neurological deficits and the concern that an attempt to evacuate the intraventricular abscess might lead to inadvertent rupture of the abscess capsule and acute ventriculitis. Despite reduction in the abscess volume, the patient developed an altered mental status 4 weeks after admission. Follow-up MRI revealed isolated dilation of the left inferior horn, compressing the brainstem. Emergency fenestration of the dilated inferior horn was performed, and endoscopic observation revealed an encapsulated abscess with adhesion to the ventricular wall which was thought responsible for the ventricular dilation and unilateral hydrocephalus. Two weeks after the initial surgery, the unilateral hydrocephalus was treated by placement of a ventriculoperitoneal shunt. Eradication of the intraventricular brain abscesses without surgical evacuation may justify the conservative management of this patient. However, the possibility that earlier surgical evacuation might have prevented development of the isolated ventricular dilation cannot be denied. Additional clinical experience is required to determine which treatment (surgical vs. conservative is more appropriate in patients with primary intraventricular brain abscesses.

  20. Auditory attention enhances processing of positive and negative words in inferior and superior prefrontal cortex.

    Science.gov (United States)

    Wegrzyn, Martin; Herbert, Cornelia; Ethofer, Thomas; Flaisch, Tobias; Kissler, Johanna

    2017-11-01

    Visually presented emotional words are processed preferentially and effects of emotional content are similar to those of explicit attention deployment in that both amplify visual processing. However, auditory processing of emotional words is less well characterized and interactions between emotional content and task-induced attention have not been fully understood. Here, we investigate auditory processing of emotional words, focussing on how auditory attention to positive and negative words impacts their cerebral processing. A Functional magnetic resonance imaging (fMRI) study manipulating word valence and attention allocation was performed. Participants heard negative, positive and neutral words to which they either listened passively or attended by counting negative or positive words, respectively. Regardless of valence, active processing compared to passive listening increased activity in primary auditory cortex, left intraparietal sulcus, and right superior frontal gyrus (SFG). The attended valence elicited stronger activity in left inferior frontal gyrus (IFG) and left SFG, in line with these regions' role in semantic retrieval and evaluative processing. No evidence for valence-specific attentional modulation in auditory regions or distinct valence-specific regional activations (i.e., negative > positive or positive > negative) was obtained. Thus, allocation of auditory attention to positive and negative words can substantially increase their processing in higher-order language and evaluative brain areas without modulating early stages of auditory processing. Inferior and superior frontal brain structures mediate interactions between emotional content, attention, and working memory when prosodically neutral speech is processed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. The short- and ultrashort-pedicle deep inferior epigastric artery perforator flap in breast reconstruction.

    Science.gov (United States)

    Colohan, Shannon; Maia, Munique; Langevin, Claude Jean; Donfrancesco, Andrea; Shirvani, Arash; Trussler, Andrew P; Saint-Cyr, Michel

    2012-02-01

    Breast reconstruction using the deep inferior epigastric perforator (DIEP) flap is becoming more common and can help reduce donor site morbidity. The authors proposed that dissection of the deep inferior epigastric artery (DIEA) and vein (DIEV) to their external iliac source may not be required for safe flap transfer. Sixteen whole fresh cadaveric hemiabdomens were used to dissect transverse abdominal-based flaps. Latex injection of the DIEA system was carried out, and the diameters of the DIEA/DIEV vessels were assessed at various points along the course of the pedicle from the origin to the perforator. A clinical study of 26 patients who underwent a short and ultrashort pedicle DIEP flaps was carried out. The average DIEA and DIEV vessel diameters were relatively similar from the external iliac origin to a point just caudal to the bifurcation. At the lateral rectus edge, the average DIEA diameter was 3.2 mm, and the DIEV diameter was 3.1 mm. The average pedicle length obtained with classic DIEP dissection was 16.9 cm, short-pedicle DIEP dissection 10.4 cm, ultrashort technique 8.1 cm, and free TRAM technique 6.5 cm. Venous injection study demonstrated rich venous interconnections between both venae comitantes. In their clinical study, the authors were able to achieve average pedicle lengths of 11.0 cm when transecting cranial to the lateral edge of the rectus, with average diameters of 2.5 mm (artery) and 2.9 mm (vein). Transection of the DIEA/DIEV pedicle at the lateral rectus edge or more proximally is safe and can help reduce operative time and donor-site morbidity. Therapeutic, IV.

  2. Anatomical landmarks for safe elevation of the deep inferior epigastric perforator flap: a cadaveric study.

    Science.gov (United States)

    Chowdhry, Saeed; Hazani, Ron; Collis, Philip; Wilhelmi, Bradon J

    2010-05-28

    Breast reconstruction techniques have focused increasingly on using autologous tissue, with emphasis being placed on employing muscle sparing adipocutaneous flaps to reduce abdominal wall complications such as hernias, bulges, weakness, and length of hospital stay. The result has been the emergence of the deep inferior epigastric perforator (DIEP) flap for breast reconstruction. Isolating perforator vessels challenges most surgeons. We describe surface anatomical landmarks to predict the location of the deep inferior epigastric artery (DIEA) and its perforators to aid in the efficient elevation of this flap. Ten fresh hemi-abdomens were dissected with loupe magnification. The DIEA and its perforators were identified, and measurements in relation to the rectus muscle, xiphoid, umbilicus, and pubis were taken. Statistical analysis was undertaken to determine distance ratios to account for variance in patient size. Average distance from the xiphoid to umbilicus was 18.2 +/- 1.27 cm. The distance from the umbilicus to pubis was 14.9 +/- 2.3 cm. The vertical distance from the umbilicus to the DRJ (DIEA rtctus junction) was 10.45 +/- 1.58 cm, and the vertical distance from the level of the umbilicus to where the first DIEA perforator traverses the RAM was 7.4 +/- 1.64 cm. The distance between the umbilicus and the DRJ is approximately 0.7 times the distance between the umbilicus and the pubic symphysis. The distance between the umbilicus and the first perforator is approximately 0.5 times the distance between the umbilicus and the pubic symphysis. Knowledge of anatomical landmarks can aid the surgeon in more efficiently harvesting the DIEP flap. Surface landmarks along the abdominal midline coupled with normalizing ratios can aid surgeons in predicting the location of the DIEA and its first perforator. The DIEA crosses the rectus at approximately two thirds of the distance between the umbilicus and pubis, and the first perforator can reliably be located at one half of

  3. Anterior Transposition of the Inferior Oblique Muscle for Primary Unilateral Superior Oblique Muscle Palsy

    Directory of Open Access Journals (Sweden)

    Hasan Altınkaynak

    2011-12-01

    Full Text Available Pur po se: To evaluate the efficacy and safety of unilateral anterior transposition of the inferior oblique (ATIO muscle in patients with unilateral superior oblique palsy (SOP. Ma te ri al and Met hod: In this study, the medical records of 52 patients with SOP were retrospectively reviewed. The study comprised patients with a preoperative vertical squint of less than 25 prism diopters (PD and a (+3 - (+4 inferior oblique hyperfunction (IOHF; all cases were Knapp’s class 1 or class 3. The angle shift in the primary gaze position, the presence of abnormal head posture, and IOHF were evaluated before and after surgery. Re sults: The mean postoperative follow-up time was 10 months. The mean preoperative angle of hypertropia at the primary gaze position was 15.3±7.89 PD, and the mean postoperative angle was 0.84±1.49 PD (0-4. Of the 32 patients with head tilt before surgery, 29 (91% patients recovered fully after surgery. Improvement was noted in 88% of patients with preoperative IOHF. At the postoperative follow-up, none of the patients showed hypotropia in the primary gaze position, limitation of the superior gaze, elevation of lower lid in the superior gaze, or diplopia in the superior gaze position, but in other eyes of three cases, secondary IOHF occurred. Dis cus si on: AIn unilateral SOP accompanied by secondary IOHF that has more than 15 PD squint, ATIO surgery is an effective and safe method for reduction of hypertropia as well as for elimination of IOHF in primary position and abnormal head posture. The short-term complication rate was very low, but a longer follow-up period is required. (Turk J Ophthalmol 2011; 41: 392-5

  4. Compensatory hypertrophy of the contralateral inferior turbinate in patients with unilateral nasal septal deviation. A computed tomography study.

    Science.gov (United States)

    Chiesa Estomba, Carlos; Rivera Schmitz, Teresa; Ossa Echeverri, Carla C; Betances Reinoso, Frank A; Osorio Velasquez, Alejandra; Santidrian Hidalgo, Carmelo

    2015-01-01

    The compensatory hypertrophy of the inferior turbinate in patients with septal deviation to one of the nostrils is considered to protect the airways from the excess of air that could enter through the nostril and its potential negative effects such as dryness, alteration of air filtration, mucociliary flow, or lung involvement. A prospective, longitudinal, non-randomized study. Patients were divided in two groups: 10 consecutive patients, with nasal septal deviation and compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity (10 non-hypertrophied turbinates as control and 10 contralateral hypertrophied turbinates as study cases), and the second group with 5 patients without any nasal pathology (10 turbinates without any obvious pathology). In both groups CT scans of the nasal region were performed. A comparison of patients with nasal septal deviation with compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity and with non-pathological inferior turbinate was carried out. When analyzing the groups of patients with septal deviation, the contralateral hypertrophied turbinate and the non-hypertrophied turbinate side, we found a significant hypertrophy in the anterior portion of the inferior turbinate, at the level of the medial mucosa (P = 0.002) and bone (P = 0.001) in the group of patients with contralateral hypertrophied turbinate. However, when we compared the contralateral hypertrophic turbinate with the turbinate of patients without septal deviation, we found a significant difference in all volumes of the medial and lateral mucosa and the bone portion (P = 0.001, P = 0.005). Surgical correction of the nasal septum and lateralization or reduction of the volume of the inferior turbinate (which may include the medial mucosa, head or part of the bone) is necessary in order to improve air passage into the nasal valve.

  5. When the bi-directional Glenn is an unfavourable option: primary extracardiac inferior cavopulmonary connection as an alternative palliation.

    Science.gov (United States)

    Dodge-Khatami, Ali; Aggarwal, Avichal; Taylor, Mary B; Maposa, Douglas; Salazar, Jorge D

    2016-10-01

    The superior cavopulmonary anastomosis - bi-directional Glenn - is the standard palliation for single ventricle physiology. When upper body systemic venous anatomic concerns such as superior caval vein stenosis, hypoplasia, or inadequate collateral tributaries are present, a Glenn may be precluded or have a high risk of poor outcome. A primary inferior cavopulmonary connection with an extracardiac conduit is an alternative palliation that provides a generous pathway for pulmonary blood flow, with the additional benefit of including hepatic venous return. We report a case of primary extracardiac inferior cavopulmonary connection in a patient unsuitable for Glenn, with successful post-operative outcome and early follow-up.

  6. Superselective embolization of the inferior vesical artery for the treatment of intractable hematuria from pelvic malignancy: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jung; Jeon, Eui Yong [Hallym Univ. Sacred Heart Hospital/Hallym Univ. College of Medicine, Anyang, (Korea, Republic of); Choi, Sun Young [Ewha Womans Univ. Seoul (Korea, Republic of); Han, Kum Hyun [Inje Univ. Ilsan Paik Hospital/Inje Univ. College of Medicine, Goyang (Korea, Republic of)

    2012-05-15

    Intractable hematuria in from pelvic malignancy can be managed with conservative treatment in most patients. However, when treatment fails, surgical intervention may be required. Unfortunately, in most cases, the general condition of most patients is unfavorable for major surgery, with many patients having an inoperable status. We present two cases where intractable hematuria was successfully controlled by bilateral embolization of the inferior vesical artery with polyvinyl alcohol particles. Hematuria did not recur during the subsequent period and no complication was observed. Thus, bilateral embolization of the inferior vesical artery should be considered as an alternative method for the treatment of massive intractable hematuria caused by pelvic malignancy.

  7. Comparison of two needle models in terms of bevel deformation during truncal block of the inferior alveolar nerve

    OpenAIRE

    Almendros Marqués, Nieves; Delgado Molina, Esther; Tamarit Borrás, Meritxell; Berini Aytés, Leonardo; Gay Escoda, Cosme

    2007-01-01

    Objetivos: Evaluar las posibles diferencias existentes en cuanto a la deformación del bisel de dos tipos de aguja de igual longitud y calibre externo, pero de distinto diámetro interno, durante el bloqueo troncal del nervio dentario inferior. Diseño del estudio: Cuatro operadores de similar formación quirúrgica realizaron el bloqueo troncal del nervio dentario inferior y la anestesia infiltrativa del nervio bucal para proceder a la extracción quirúrgica o convencional del tercer molar infe...

  8. Chemical Neurolysis of the Inferior Hypogastric Plexus for the Treatment of Cancer-Related Pelvic and Perineal Pain

    Directory of Open Access Journals (Sweden)

    Sahar Abd-Elbaky Mohamed

    2013-01-01

    Full Text Available BACKGROUND: Various interventions, including the superior hypogastric plexus block and ganglion impar block, are commonly used for the treatment of pelvic or perineal pain caused by cancer. The inferior hypogastric plexus block (performed using a trans-sacral approach under fluoroscopy and using a local anesthetics/steroid combination for the diagnosis and treatment of chronic pain conditions involving the lower pelvic viscera was first described in 2007. Neurolysis of the inferior hypogastric plexus may be useful for the treatment of pelvic and perineal pain caused by cancer.

  9. Abdominal wall phlebitis due to Prevotella bivia following renal transplantation in a patient with an occluded inferior vena cava.

    Science.gov (United States)

    Janssen, S; van Donselaar-van der Pant, K A M I; van der Weerd, N C; Develter, W; Bemelman, F J; Grobusch, M P; Idu, M M; Ten Berge, I J M

    2013-02-01

    Pre-existing occlusion of the inferior vena cava may complicate renal transplantation. Suppurative abdominal wall phlebitis following renal transplantation was diagnosed in a patient with pre-existing thrombosis of the inferior vena cava of unknown cause. The phlebitis developed in the subcutaneous collateral veins of the abdominal wall contra-laterally to the renal transplant. Cultures from abdominal wall micro-abscesses yielded Prevotella bivia as the causative agent. This complication has not been described before in the context of renal transplantation. The pathogenesis and management of this serious complication are discussed in this paper.

  10. Inferior vestibular neuritis: 3 cases with clinical features of acute vestibular neuritis, normal calorics but indications of saccular failure

    Directory of Open Access Journals (Sweden)

    Økstad Siri

    2006-12-01

    Full Text Available Abstract Background Vestibular neuritis (VN is commonly diagnosed by demonstration of unilateral vestibular failure, as unilateral loss of caloric response. As this test reflects the function of the superior part of the vestibular nerve only, cases of pure inferior nerve neuritis will be lost. Case presentations We describe three patients with symptoms suggestive of VN, but normal calorics. All 3 had unilateral loss of vestibular evoked myogenic potential. A slight, asymptomatic position dependent nystagmus, with the pathological ear down, was observed. Conclusion We believe that these patients suffer from pure inferior nerve vestibular neuritis.

  11. "A vengefulness of the impotent": The pain of in-group inferiority and schadenfreude toward successful out-groups

    NARCIS (Netherlands)

    Leach, C.W.; Spears, R.

    2008-01-01

    Nietzsche (1887/1967) suggested that the emotional pain individuals feel about their in-group's inferiority leads them to feel the pleasure of schadenfreude when a successful out-group fails. To test this idea, 2 studies examined a fictitious competition between real universities. Individuals' pain

  12. "A Vengefulness of the Impotent" : The Pain of In-Group Inferiority and Schadenfreude Toward Successful Out-Groups

    NARCIS (Netherlands)

    Leach, Colin Wayne; Spears, Russell

    2008-01-01

    Nietzsche (1887/1967) suggested that the emotional pain individuals feel about their in-group's inferiority leads them to feel the pleasure of schadenfreude when a successful out-group fails. To test this idea, 2 studies examined a fictitious competition between real universities. Individuals' pain

  13. Perturbation of the left inferior frontal gyrus triggers adaptive plasticity in the right homologous area during speech production

    DEFF Research Database (Denmark)

    Hartwigsen, Gesa; Saur, Dorothee; Price, Cathy J

    2013-01-01

    functions. Alternatively, the right hemisphere may actively contribute to language functions by supporting disrupted processing in the left hemisphere via interhemispheric connections. To test this hypothesis, we applied off-line continuous theta burst stimulation (cTBS) over the left inferior frontal gyrus...

  14. Inferior displacement of the lower belly of the lateral pterygoid muscle: a sign of temporomandibular joint lesions.

    Science.gov (United States)

    Ochoa Escudero, Martin; Juliano, Amy F; Curtin, Hugh D

    2015-01-01

    The purposes of this article are to report the imaging finding of inferior displacement of the lower belly of the lateral pterygoid muscle (LPM) in patients with lesions arising from the temporomandibular joint (TMJ) and to propose that this imaging finding is suggestive of the presence of a TMJ lesion. We reviewed computed tomographic and magnetic resonance images of 9 patients with lesions involving the TMJ. Images were evaluated for identification of an inferiorly displaced lower belly of the LPM. Pathology reports were reviewed to determine the histopathologic diagnosis of the TMJ lesion. Inferior displacement of the lower belly of the LPM was observed in all cases on magnetic resonance images, computed tomographic images, or both. In 2 cases, the diagnosis was calcium pyrophosphate deposition disease. The remaining cases were ganglion cyst, joint effusion due to dermatomyositis, septic arthritis, chondromyxoid fibroma, synovial chondromatosis, pigmented villonodular synovitis, and giant cell tumor of bone. Inferior displacement of the lower belly of the LPM is a useful radiologic sign to suggest that a lesion arises from the TMJ.

  15. Stimulating the Brain's Language Network: Syntactic Ambiguity Resolution after TMS to the Inferior Frontal Gyrus and Middle Temporal Gyrus

    NARCIS (Netherlands)

    Acheson, D.J.; Hagoort, P.

    2013-01-01

    The posterior middle temporal gyrus (MTG) and inferior frontal gyrus (IFG) are two critical nodes of the brain's language network. Previous neuroimaging evidence has supported a dissociation in language comprehension in which parts of the MTG are involved in the retrieval of lexical syntactic

  16. An Experimental Study to Determine the Role of Inferior Vena Cava Filter in Preventing Bone Cement Implantation Syndrome

    OpenAIRE

    Guo; Zheng,; Li; Shi; Xiang; Wang,

    2015-01-01

    Background Inferior vena cava filters (IVCF) are frequently used for preventing pulmonary embolism (PE) following deep venous thromboembolism. Objectives The present study was designed to investigate whether IVCF could prevent or impede the occurrence of bone cement implantation syndrome (BCIS), since PE is considered as the central mechanism of BCIS. Materials and Methods Fifteen ...

  17. Patellar Shape-Memory Fixator for the Treatment of Comminuted Fractures of the Inferior Pole of the Patella

    Science.gov (United States)

    Liu, Xin-Wei; Shang, Hui-Juan; Xu, Shuo-Gui; Wang, Zhi-Wei; Zhang, Chun-Cai; Fu, Qing-Ge

    2011-07-01

    Comminuted and displaced fractures of the inferior pole of the patella are not easy to reduce and it is difficult to fix the fragments soundly enough to allow early movement of the knee. The purpose of this study is to evaluate the clinical effectiveness of the internal fixation technique with Patellar Shape-Memory Fixator (PSMF) in acute comminuted fractures of the inferior pole of the patella. We retrospectively studied 25 patients with comminuted fractures of the inferior pole of the patella who were treated with PSMF and followed up for a mean period of 26 months (14 to 60). All the fractures healed at a mean of 6 weeks (5 to 7). The mean grading at the final follow-up was 29.5 points (27 to 30) using the Bostman score, with no observable restriction of movement. No breakage of the PSMF or infection occurred. No delayed union, nonunion, and infection were seen. This technique preserved the length of the patella, reduced the comminuted fragments of the inferior pole and avoided long-term immobilization of the knee.

  18. Evaluation of Inferior Alveolar Nerve Regeneration by Bifocal Distraction Osteogenesis with Retrograde Transportation of Horseradish Peroxidase in Dogs

    Science.gov (United States)

    Isomura, Emiko Tanaka

    2014-01-01

    Background Bifocal distraction osteogenesis has been shown to be a reliable method for reconstructing segmental mandibular defects. However, there are few reports regarding the occurrence of inferior alveolar nerve regeneration during the process of distraction. Previously, we reported inferior alveolar nerve regeneration after distraction, and evaluated the regenerated nerve using histological and electrophysiological methods. In the present study, we investigated axons regenerated by bifocal distraction osteogenesis using retrograde transportation of horseradish peroxidase in the mandibles of dogs to determine their type and function. Methods and Findings Using a bifocal distraction osteogenesis method, we produced a 10-mm mandibular defect, including a nerve defect, in 11 dogs and distracted using a transport disk at a rate of 1 mm/day. The regenerated inferior alveolar nerve was evaluated by retrograde transportation of HRP in all dogs at 3 and 6 months after the first operation. At 3 and 6 months, HRP-labeled neurons were observed in the trigeminal ganglion. The number of HRP-labeled neurons in each section increased, while the cell body diameter of HRP-labeled neurons was reduced over time. Conclusions We found that the inferior alveolar nerve after bifocal distraction osteogenesis successfully recovered until peripheral tissue began to function. Although our research is still at the stage of animal experiments, it is considered that it will be possible to apply this method in the future to humans who have the mandibular defects. PMID:24732938

  19. Anatomy of the inferior extensor retinaculum and its role in lateral ankle ligament reconstruction: a pictorial essay

    NARCIS (Netherlands)

    Dalmau-Pastor, M.; Yasui, Y.; Calder, J. D.; Karlsson, J.; Kerkhoffs, G. M. M. J.; Kennedy, J. G.

    2016-01-01

    The inferior extensor retinaculum (IER) is an aponeurotic structure, which is in continuation with the anterior part of the sural fascia. The IER has often been used to augment the reconstruction of the lateral ankle ligaments, for instance in the Broström-Gould procedure, with good outcomes

  20. Evaluation of inferior alveolar nerve regeneration by bifocal distraction osteogenesis with retrograde transportation of horseradish peroxidase in dogs.

    Directory of Open Access Journals (Sweden)

    Yosuke Shogen

    Full Text Available BACKGROUND: Bifocal distraction osteogenesis has been shown to be a reliable method for reconstructing segmental mandibular defects. However, there are few reports regarding the occurrence of inferior alveolar nerve regeneration during the process of distraction. Previously, we reported inferior alveolar nerve regeneration after distraction, and evaluated the regenerated nerve using histological and electrophysiological methods. In the present study, we investigated axons regenerated by bifocal distraction osteogenesis using retrograde transportation of horseradish peroxidase in the mandibles of dogs to determine their type and function. METHODS AND FINDINGS: Using a bifocal distraction osteogenesis method, we produced a 10-mm mandibular defect, including a nerve defect, in 11 dogs and distracted using a transport disk at a rate of 1 mm/day. The regenerated inferior alveolar nerve was evaluated by retrograde transportation of HRP in all dogs at 3 and 6 months after the first operation. At 3 and 6 months, HRP-labeled neurons were observed in the trigeminal ganglion. The number of HRP-labeled neurons in each section increased, while the cell body diameter of HRP-labeled neurons was reduced over time. CONCLUSIONS: We found that the inferior alveolar nerve after bifocal distraction osteogenesis successfully recovered until peripheral tissue began to function. Although our research is still at the stage of animal experiments, it is considered that it will be possible to apply this method in the future to humans who have the mandibular defects.

  1. Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial.

    Science.gov (United States)

    Montserrat-Bosch, Marta; Figueiredo, Rui; Nogueira-Magalhães, Pedro; Arnabat-Dominguez, Josep; Valmaseda-Castellón, Eduard; Gay-Escoda, Cosme

    2014-07-01

    To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB). A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed. A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three failures were recorded, 2 of them in the experimental group. No relevant local or systemic complications were registered. Both IANB techniques used in this trial are suitable for lower third molar removal. However, performing an inferior alveolar nerve block in a more inferior position (modified technique) extends the onset time, does not seem to reduce the risk of intravascular injections and might increase the risk of lingual nerve injuries.

  2. [The experimental study on inside-out vein graft for repairing inferior alveolar nerve defect in the rabbit].

    Science.gov (United States)

    Chen, P; Li, H; Zhang, G

    2000-10-01

    This study describes a modification of the vein graft technique inside-out vein graft, creates an autogenous vein conduct with the collagen-rich and Schwann cells exposed to regenerating axons. To compare regeneration of inferior alveolar nerves through two conduits: inside-out vein graft and the standard vein graft. 18 adult white rabbits were selected and vena facialises of both sides were harvested. Turned the right vena facialis into inside-out vein and used to bridge an 8 mm defect created in the right inferior alveolar nerve. An 8 mm defect of the left inferior alveolar nerve was bridged by the standard vein graft. After rabbits sacrificed at 8, 14 and 20 weeks, the regenerating nerve cables were harvested from the conduits and performed histologic study. At 20 weeks, performed also electrophysiologic studies and statistical analysis of conductive velocities and histological results. Regenerating nerves connected with proximal and distal nerve stumps on both sides postoperation 8 weeks, a number of regenerating nerve fibers and thickness of axon were gradually increasing. At 20 weeks regenerating nerve on the inside-out vein graft side showed superior function results--faster conduction velocities (P nerve regeneration by an environment with collagen-rich and Schwann cells. The inside-out vein graft is an original way to repair inferior alveolar nerve.

  3. Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression : randomised controlled non-inferiority trial

    NARCIS (Netherlands)

    Huijbers, Marloes J.; Spinhoven, Philip; Spijker, Jan; Ruhe, Henricus G.; van Schaik, Digna J. F.; van Oppen, Patricia; Nolen, Willem A.; Ormel, Johan; Kuyken, Willem; van der Wilt, Gert Jan; Blom, Marc B. J.; Schene, Aart H.; Donders, A. Rogier T.; Speckens, Anne E. M.

    Background Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. Aims To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM.

  4. The Medial Temporal Lobe and the Left Inferior Prefrontal Cortex Jointly Support Interference Resolution in Verbal Working Memory

    Science.gov (United States)

    Oztekin, Ilke; Curtis, Clayton E.; McElree, Brian

    2009-01-01

    During working memory retrieval, proactive interference (PI) can be induced by semantic similarity and episodic familiarity. Here, we used fMRI to test hypotheses about the role of the left inferior frontal gyrus (LIFG) and the medial temporal lobe (MTL) regions in successful resolution of PI. Participants studied six-word lists and responded to a…

  5. A comparison of the ultrasound measurement of the inferior vena cava obtained with cardiac and convex transducers.

    Science.gov (United States)

    Andruszkiewicz, Paweł; Sobczyk, Dorota; Nycz, Krzysztof; Górkiewicz-Kot, Izabela; Ziętkiewicz, Mirosław; Wierzbicki, Karol; Wojtczak, Jacek; Kowalik, Ilona

    2017-12-01

    Ultrasound measurement of the inferior vena cava diameter and its respiratory variability are amongst the predictors of fluid volume status. The primary purpose of the present study was to compare the consistency of inferior vena cava diameter measurements and the collapsibility index, obtained with convex and cardiac transducers. A secondary aim was to assess the agreement of the patient's allocation to one of the two groups: "fluid responder" or "fluid non-responder", based on inferior vena cava collapsibility index calculation made with two different probes. 20 experienced clinicians blinded to the purpose of the study analysed forty anonymized digital clips of images obtained during ultrasound examination of 20 patients. For each patient, one digital loop was recorded with a cardiac and the second with a convex probe. The participants were asked to determine the maximal and minimal diameters of the inferior vena cava in all presented films. An independent researcher performed a comparative analysis of the measurements conducted with both probes by all participants. The calculation of the collapsibility index and allocation to "fluid responder" or "fluid non-responder" group was performed at this stage of the study. The comparison of measurements obtained with cardiac and convex probes showed no statistically significant differences in the measurements of the maximal and minimal dimensions and in the collapsibility index. We also noticed that the decision of allocation to the "fluid responder" or "non-responder" group was not probe-dependent. Both transducers can be used interchangeably for the estimation of the studied dimensions.

  6. Impact of Coronary Collateral Circulation on In-Hospital Death in Patients with Inferior ST Elevation Myocardial Infarction

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    Baris Yaylak

    2015-01-01

    Full Text Available Objectives. Coronary collateral circulation (CCC may limit the size of right ventricular (RV infarcts but does not fully explain the relationship between CCC and clinical adverse events in patients with inferior STEMI. In this study, it was aimed to assess the relationship between preintervention angiographic evidence of CCC and clinical outcomes in patients with inferior STEMI who have undergone percutaneous coronary intervention. Methods. A total of 235 inferior STEMI patients who presented within the first 12 hours from the symptom onset were included. CCC to the right coronary artery (RCA before angioplasty were angiographically assessed, establishing two groups: 147 (63% patients without CCC and 88 (37% with CCC according to presence of CCC. Results. RV infarction, complete atrioventricular block, VT/VF, cardiogenic shock, and in-hospital death were noted less frequently in patients with CCC than in those without CCC. Absence of CCC to RCA was found to be the independent predictor for in-hospital death among them (odds ratio 4.0, 95% CI 1.8–12.6; p=0.03. Conclusion. Presence of angiographically detectable CCC was associated with better in-hospital outcomes including RV infarction, complete AV block, cardiogenic shock, and VT/VF in patients with inferior STEMI.

  7. Satellite images and geodetic measurements applied to the monitoring of the Horcones Inferior Glacier, Mendoza, Argentina

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    M. Gabriela Lenzano

    2011-06-01

    Full Text Available This work analyzes the monitoring of the covered and regenerated Horcones Inferior Glacier (HIG since the implementation of a semi-permanent GNSS station (HISS on its surface during the summer seasons of 2009 and 2010. The glacier is located at 32° 41's and 69° 57'w, at the foot of the south wall of Mt. Aconcagua, Aconcagua Provincial Park, Mendoza, Argentina. The average velocities obtained from the HISS station were of 1.3 cm/d and 3.5 cm/d during the 2009 and 2010 seasons respectively. The data procured using satellite images during the last surges (1984 and 2003 gave average velocities for the HIG front of 8.7 m/d for the first event and 11.5 m/d for the second one. These results allowed getting accurate and reliable movement tendency at the terminal part of the HIG during the 1984-2010 period.El presente trabajo realiza el monitoreo del glaciar Horcones Inferior, cubierto y regenerado a partir de la implementación de una estación GNSS semi-permanente (HISS, instalada sobre su superficie durante las temporadas de verano de 2009 y 2010 respectivamente. El glaciar se encuentra ubicado a los 32° 41's y 69° 57'w, al pie de la pared sur del C° Aconcagua, en el Parque Provincial Aconcagua, Mendoza, Argentina. La estación HISS registró valores de velocidades medias de 1.3 cm/d y 3.5 cm/d durante las temporadas de 2009 y 2010. Se utilizaron imágenes satelitales para el seguimiento del frente del glaciar durante los últimos surges (1984 y 2003, cuyas velocidades medias fueron de 8.7 m/d para el primero y de 11.5 m/d para el segundo evento. Estos resultados permitieron obtener de manera precisa y confiable la tendencia de movimiento de la parte terminal del GHI durante el periodo 1984-2010.

  8. Identification of a Circadian Clock in the Inferior Colliculus and Its Dysregulation by Noise Exposure.

    Science.gov (United States)

    Park, Jung-Sub; Cederroth, Christopher R; Basinou, Vasiliki; Meltser, Inna; Lundkvist, Gabriella; Canlon, Barbara

    2016-05-18

    Circadian rhythms regulate bodily functions within 24 h and long-term disruptions in these rhythms can cause various diseases. Recently, the peripheral auditory organ, the cochlea, has been shown to contain a self-sustained circadian clock that regulates differential sensitivity to noise exposure throughout the day. Animals exposed to noise during the night are more vulnerable than when exposed during the day. However, whether other structures throughout the auditory pathway also possess a circadian clock remains unknown. Here, we focus on the inferior colliculus (IC), which plays an important role in noise-induced pathologies such as tinnitus, hyperacusis, and audiogenic seizures. Using PER2::LUC transgenic mice and real-time bioluminescence recordings, we revealed circadian oscillations of Period 2 protein in IC explants for up to 1 week. Clock genes (Cry1, Bmal1, Per1, Per2, Rev-erbα, and Dbp) displayed circadian molecular oscillations in the IC. Averaged expression levels of early-induced genes and clock genes during 24 h revealed differential responses to day or night noise exposure. Rev-erbα and Dbp genes were affected only by day noise exposure, whereas Per1 and Per2 were affected only by night noise exposure. However, the expression of Bdnf was affected by both day and night noise exposure, suggesting that plastic changes are unlikely to be involved in the differences in day or night noise sensitivity in the IC. These novel findings highlight the importance of circadian responses in the IC and emphasize the importance of circadian mechanisms for understanding central auditory function and disorders. Recent findings identified the presence of a circadian clock in the inner ear. Here, we present novel findings that neurons in the inferior colliculus (IC), a central auditory relay structure involved in sound processing, express a circadian clock as evidenced at both the mRNA and protein levels. Using a reporter mouse that expresses a luciferase protein

  9. Non-inferiority of retrospective data collection for assessing perioperative morbidity

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    Amour B.U. Patel

    2015-12-01

    Full Text Available Background. Postoperative morbidity has immediate and delayed consequences for surgical patients, including excess risk of premature death. Capturing these data objectively and routinely in large electronic databases using tools such as the Postoperative Morbidity Survey (POMS would offer tremendous clinical and translational potential. However, POMS has thus far only utilised prospective data collection by research staff. We hypothesised that retrospective data collection from routinely collated hospital data from paper and electronic charts, medical and nursing notes was non-inferior to prospective data collection requiring research staff capturing POMS-defined morbidity in real-time.Methods. Morbidity was recorded by a trained investigator as defined by POMS prospectively on postoperative days 3 and 7. Separately, an independent investigator blinded to prospectively acquired data retrospectively assessed the same patients’ morbidity as defined by POMS criteria, using medical charts, nursing summaries and electronic data. Equivalence was accepted when the confidence limits for both modes of data collection fell completely inside the equivalence bounds, with the maximum equivalence difference (i.e., the largest value of the difference in sensitivities deemed to reach a conclusion of equivalence set a priori at 0.2. Differences for confidence limits between retrospective and prospective data collection were based on Nam’s RMLE method. The relationship between morbidity on postoperative day 3 as recorded by each data collection method on time to become morbidity free and length of hospital stay was compared using the log-rank test.Results. POMS data from 85 patients undergoing elective or emergency surgery were analyzed. At postoperative day 3, POMS-defined morbidity was similar regardless of whether data were collected prospectively or retrospectively (95% CI [−0.13–0.013]; p < 0.001. Non-inferiority for sensitivity was observed for all

  10. Curative effect comparison of stem cell transplantation of supprior-inferior autologous corneal limbus in the treatment of pterygium

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    Zheng-Jun Hu

    2015-08-01

    Full Text Available AIM: To compare the curative effect of autologous corneal limbus stem cell with bulbar conjunctiva transplantation of supprior-inferior bulbar conjunctiva in the treatment of pterygium and effect of postoperative scarring on bulbar conjunctiva on performing glaucoma filtration surgery in the future.METHODS: A total of 182 patients(252 eyeswith initial pterygium were divided into two groups by sortition randomization method. Eighty-five patients of the group A(110 eyesaccepted pterygium resection combined stem cell transplantation of supprior autologous corneal limbus, while 97 patients of the group B(142 eyesof pterygium excision combined stem cell transplantation of inferior autologous corneal limbus in treatment of pterygium. Postoperative follow-up from 1~12mo. Recurrence rate and conjunctival scar formation after autologous corneal limbus stem cells being taken were observed in the two groups to judge the impact on the future glaucoma filtration surgery.RESULTS: After follow-up from 1~12mo, there was no significant difference of postoperative recurrence between the group A and group B(χ2=0.015, P>0.05. Stem cell taken from supprior autologous corneal limbus in the group A caused supprior bulbar conjunctiva scarring, while it caused inferior scarring in the group B. For routine glaucoma filtration surgery usually is being done in the upper bulbar conjunctiva, on the nose or superior bulbar conjunctival area above the temporal region, and the above healthy bulbar conjunctiva has being kept in the group B which retained area for future glaucoma filtration surgery.CONCLUSION: Autologous corneal limbus stem cell transplantation of supprior-inferior bulbar conjunctiva could be effective in the treatment of pterygium, but stem cell transplantation of inferior autologous corneal limbus could keep area for glaucoma filtration surgery.

  11. Posición primaria de la mirada en hiperfunción de oblicuos inferiores con y sin desviación vertical disociada

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    Adriana Sánchez Landeros

    2017-07-01

    Conclusiones: En pacientes con hiperfunción de oblicuos inferiores y DVD prevalece la doble hipertropía en la PPM y en pacientes con hiperfunción de oblicuos inferiores sin DVD la hiperhipotropía, con una diferencia estadísticamente significativa.

  12. Acute iliofemoral venous thrombosis in patients with atresia of the inferior vena cava can be treated successfully with catheter-directed thrombolysis

    DEFF Research Database (Denmark)

    Broholm, Rikke; Jørgensen, Maja; Just, Sven

    2011-01-01

    To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT).......To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT)....

  13. Anorexia Nervosa during Adolescence Is Associated with Decreased Gray Matter Volume in the Inferior Frontal Gyrus.

    Science.gov (United States)

    Fujisawa, Takashi X; Yatsuga, Chiho; Mabe, Hiroyo; Yamada, Eiji; Masuda, Masato; Tomoda, Akemi

    2015-01-01

    Anorexia nervosa (AN) is an eating disorder characterized by the relentless pursuit to lose weight, mostly through self-starvation, and a distorted body image. AN tends to begin during adolescence among women. However, the underlying neural mechanisms related to AN remain unclear. Using voxel-based morphometry based on magnetic resonance imaging scans, we investigated whether the presence of AN was associated with discernible changes in brain morphology. Participants were 20 un-medicated, right-handed patients with early-onset AN and 14 healthy control subjects. Group differences in gray matter volume (GMV) were assessed using high-resolution, T1-weighted, volumetric magnetic resonance imaging datasets (3T Trio scanner; Siemens AG) and analyzed after controlling for age and total GMV, which was decreased in the bilateral inferior frontal gyrus (IFG) (left IFG: FWE corrected, p < 0.05; right IFG: uncorrected, p < 0.05) of patients with AN. The GMV in the bilateral IFG correlated significantly with current age (left IFG: r = -.481, p < .05; right IFG: r = -.601, p < .01) and was limited to the AN group. We speculate that decreased IFG volume might lead to deficits in executive functioning or inhibitory control within neural reward systems. Precocious or unbalanced neurological trimming within this particular region might be an important factor for the pathogenesis of AN onset.

  14. Anorexia Nervosa during Adolescence Is Associated with Decreased Gray Matter Volume in the Inferior Frontal Gyrus.

    Directory of Open Access Journals (Sweden)

    Takashi X Fujisawa

    Full Text Available Anorexia nervosa (AN is an eating disorder characterized by the relentless pursuit to lose weight, mostly through self-starvation, and a distorted body image. AN tends to begin during adolescence among women. However, the underlying neural mechanisms related to AN remain unclear. Using voxel-based morphometry based on magnetic resonance imaging scans, we investigated whether the presence of AN was associated with discernible changes in brain morphology. Participants were 20 un-medicated, right-handed patients with early-onset AN and 14 healthy control subjects. Group differences in gray matter volume (GMV were assessed using high-resolution, T1-weighted, volumetric magnetic resonance imaging datasets (3T Trio scanner; Siemens AG and analyzed after controlling for age and total GMV, which was decreased in the bilateral inferior frontal gyrus (IFG (left IFG: FWE corrected, p < 0.05; right IFG: uncorrected, p < 0.05 of patients with AN. The GMV in the bilateral IFG correlated significantly with current age (left IFG: r = -.481, p < .05; right IFG: r = -.601, p < .01 and was limited to the AN group. We speculate that decreased IFG volume might lead to deficits in executive functioning or inhibitory control within neural reward systems. Precocious or unbalanced neurological trimming within this particular region might be an important factor for the pathogenesis of AN onset.

  15. Recurrent locked knee caused by an impaction fracture following inferior patellar dislocation: a case report

    Directory of Open Access Journals (Sweden)

    Sutcliffe William

    2011-08-01

    Full Text Available Abstract Introduction Locked knee caused by inferior patellar dislocation is considered rare in elderly patients. It was originally thought that, in the osteoarthritic knee, osteophytes on the pole of the patella become entrapped in the inter-condylar notch, which is managed by performing closed reduction and immobilization in a knee splint for three to four weeks. We present an unusual case of a locked knee with an impaction fracture. To the best of our knowledge, there have been no previous reports of such impaction fractures managed with arthroscopy. Case presentation We present an unusual case of an 88-year-old Caucasian woman with moderate arthritis who had a locked knee caused by an impaction fracture of the patella into the lateral femoral condyle. In this case report, we describe the need for arthroscopic surgery to prevent relocking of the knee in these patients. Conclusions This case report emphasizes the need for careful assessment of locked knees in elderly patients. Impaction fractures should be considered in all rare cases of patellar dislocation, and we advocate arthroscopic assessment of the articular cartilage in these patients. This is an important consideration, as the population demographics change and such impaction fractures may become more common in patients with degeneration in the knees.

  16. Variations of Occipital Artery-Posterior Inferior Cerebellar Artery Bypass: Anatomic Consideration.

    Science.gov (United States)

    Matsushima, Ken; Matsuo, Satoshi; Komune, Noritaka; Kohno, Michihiro; Lister, J Richard

    2017-07-07

    Advances in diagnosis of posterior inferior cerebellar artery (PICA) aneurysms have revealed the high frequency of distal and/or dissecting PICA aneurysms. Surgical treatment of such aneurysms often requires revascularization of the PICA including but not limited to its caudal loop. To examine the microsurgical anatomy involved in occipital artery (OA)-PICA anastomosis at various anatomic segments of the PICA. Twenty-eight PICAs in 15 cadaveric heads were examined with the operating microscope to take morphometric measurements and explore the specific anatomy of bypass procedures. OA bypass to the p2, p3, p4, or p5 segment was feasible with a recipient vessel of sufficient diameter. The loop wandering near the jugular foramen in the p2 segment provided sufficient length without requiring cauterization of any perforating arteries to the brainstem. Wide dissection of the cerebellomedullary fissure provided sufficient exposure for the examination of some p3 segments and all p4 segments hidden by the tonsil. OA-p5 bypass was placed at the main trunk before the bifurcation in 5 hemispheres and at the larger hemispheric trunk in others. Understanding the possible variations of OA-PICA bypass may enable revascularization of the appropriate portion of the PICA when the parent artery must be occluded. A detailed anatomic understanding of each segment clarifies important technical nuances for the bypass on each segment. Dissection of the cerebellomedullary fissure helps to achieve sufficient exposure for the bypass procedures on most of the segments.

  17. Essential infantile esotropia with inferior oblique hyperfunction: long term follow-up of 6 muscles approach.

    Science.gov (United States)

    Magli, Adriano; Carelli, Roberta; Chiariello Vecchio, Elisabetta; Esposito, Francesca; Rombetto, Luca; Esposito Veneruso, Paolo

    2016-01-01

    To evaluate long term follow-up (10y) of 6 muscle surgical approach in essential infantile esotropia (EIE). A 6 muscle approach to EIE was retrospectively evaluated in patients with inferior oblique (IO) hyperfunction and lateral rectus (LR) pseudoparalysis, who underwent surgery at different ages. Different clinical characters were analyzed pre- and postoperatively, in patients who underwent a 6 muscles approach ≤4 years of age. All patients underwent a multiple muscles approach: bilateral medial recti (MR) recession (4-5 mm), bilateral LR resection (lower than 7 mm) and bilateral IO recession and anteroposition. Of 108 children with preoperative angle ≥+30 prism diopters (PD) and IO hyperfunction were selected from larger cohort of patients (n=213, 103 females and 110 males) after excluding patients with: angle variability, who underwent reoperation and with incomplete follow up. Preoperative assessment and complete orthoptic examination were performed. Follow-up was performed 3mo, 2, 5 and 10y after surgery. Statistical analysis was performes using SAS statistical software package (version 9.1, SAS Institute Inc., Cary, NC, USA). Ten years follow up data analysis showed the following percentage of orthotropic patients: (0 PD): 3mo, 22.2%; 2y, 16.7%; 5y, 25.0% and 10y, 27.8%. A slight, significant (Pmuscles surgical approach in the treatment of patients affected by EIE with OI hyperfunction.

  18. Conservative treatment of anterior inferior and superior avulsion fractures of spina iliaca in adolescent amateur footballer

    Directory of Open Access Journals (Sweden)

    Umut Hatay Gölge

    2015-06-01

    Full Text Available The anterior inferior iliac spine (AIIS and the anterior superior iliac spine (ASIS avulsion fracture is a rare injury of pelvis. It usually occurs during the sport activities especially in football while hitting the ball. It is commonly misdiagnosed so that a detailed history and physical examination have a great importance. We present two cases of AIIS and ASIS avulsion fracture. Both of the patients applied to outpatient clinics with hip pain and difficulty in walking. History revealed the complaints started after hitting the ball during the football match and hip movements were limited. The patients were fifteen and sixteen years and after physical examination and radiological evaluation, avulsion fracture of the AIIS and the ASIS were diagnosed. Patients were treated conservatively with non-steroidal anti-inflammatory drugs and limited weight bearing with crutches for a month. The patients were free of pain and had full range of hip movements after one month period. At the end of the second month patients returned to active sports. AIIS and ASIS avulsion fractures are more common in adolescent football players but clinicians sometimes fail to diagnose this rare injury. We emphasize the importance of the detailed history and clinical examination and direct radiography could be enough for the diagnosis.

  19. Anosognosia for Hemiplegia: The Contributory Role of Right Inferior Frontal Gyrus

    Science.gov (United States)

    Kortte, Kathleen B.; McWhorter, Jessica Wolfman; Pawlak, Mikolaj A.; Slentz, Jamie; Sur, Sandeepa; Hillis, Argye E.

    2014-01-01

    Objective Awareness of motor functioning is most likely a complex process that requires integration of sensory-motor feedback in order to constantly update the system on the functioning of the limb during motor behavior. Using lesion mapping procedures and behavioral measures, the current study aimed to evaluate neural correlates of anosognosia for hemiplegia (AHP) in the acute stage (first 48 hours) of right hemisphere stroke. Method Thirty-five individuals with right hemisphere stroke who presented to an urban medical center within 24 hours of symptom onset were included in the study. All thirty-five individuals had hemiplegia, and eight of these individuals exhibited AHP. Results Fisher exact test statistical map of lesion-deficit association (range is between-log(p) 4 to 11) found maximal value of 10.9 located in pars orbitalis (Brodmann’s Area 47; BA). In this selected location, six out of eight patients with AHP had tissue abnormality, whereas none of the unaffected subjects had tissue abnormality in BA 47. Right BA 44/45 was also found to be lesioned more frequently in individuals with AHP (75%) than without AHP (11%). Conclusions The current study findings provide preliminary support for unique involvement of the right inferior frontal gyrus (IFG), pars orbitalis (BA 47) in AHP. The current data suggest that frontal operculum may play a key role in awareness of limb functioning. PMID:25133319

  20. Unusual Presentation of Testicular Cancer with Tumor Thrombus Extending to the Inferior Vena Cava

    Directory of Open Access Journals (Sweden)

    Marie Dusaud

    2015-01-01

    Full Text Available A 45-year-old man with a left testis tumor with a 25 mm para-aortic lymph node swelling, multiple bilateral pulmonary metastases, bilateral pulmonary embolism, and inferior vena cava (IVC thrombus underwent a radical orchidectomy in our institution. The thrombus extended from the left gonadal vein to the left renal vein to the IVC. The fluorine-18 fluorodeoxyglucose (f-FDG positron emission tomography (PET computerized tomography (CT demonstrated a hypermetabolic focus in the retroperitoneum and in the IVC thrombus. Before orchidectomy only lactate dehydrogenase (LDH was high but all the serum tumor markers increased postoperatively. The tumor was staged pT1N2M1aS1, which was an intermediate prognosis, based on the International Germ Cell Cancer Collaborative Group consensus (IGCCCG. After 4 courses of bleomycin, etoposide, and cisplatin (BEP chemotherapy the patient’s tumor markers normalized and the thrombus disappeared. There was only one residual retroperitoneal lymph node M1. Retroperitoneal lymph node dissection was performed. The pathological examination revealed only necrotic tissues. The patient has been disease-free since surgery.

  1. Left Inferior-Parietal Lobe Activity in Perspective Tasks: Identity statements

    Directory of Open Access Journals (Sweden)

    Aditi eArora

    2015-06-01

    Full Text Available We investigate the theory that the left inferior parietal lobe (IPL is closely associated with tracking potential differences of perspective. Developmental studies find that perspective tasks are mastered at around four years of age. Our first study, meta-analyses of brain imaging studies shows that perspective tasks specifically activate a region in the left IPL and precuneus. These tasks include processing of false belief, visual perspective, and episodic memory. We test the location specificity theory in our second study with an unusual and novel kind of perspective task: identity statements. According to Frege’s classical logical analysis, identity statements require appreciation of modes of presentation (perspectives. We show that identity statements, e.g., the tour guide is also the driver activate the left IPL in contrast to a control statements, the tour guide has an apprentice. This activation overlaps with the activations found in the meta-analysis. This finding is confirmed in a third study with different types of statements and different comparisons. All studies support the theory that the left IPL has as one of its overarching functions the tracking of perspective differences. We discuss how this function relates to the bottom-up attention function proposed for the bilateral IPL.

  2. Achilles' ear? Inferior human short-term and recognition memory in the auditory modality.

    Directory of Open Access Journals (Sweden)

    James Bigelow

    Full Text Available Studies of the memory capabilities of nonhuman primates have consistently revealed a relative weakness for auditory compared to visual or tactile stimuli: extensive training is required to learn auditory memory tasks, and subjects are only capable of retaining acoustic information for a brief period of time. Whether a parallel deficit exists in human auditory memory remains an outstanding question. In the current study, a short-term memory paradigm was used to test human subjects' retention of simple auditory, visual, and tactile stimuli that were carefully equated in terms of discriminability, stimulus exposure time, and temporal dynamics. Mean accuracy did not differ significantly among sensory modalities at very short retention intervals (1-4 s. However, at longer retention intervals (8-32 s, accuracy for auditory stimuli fell substantially below that observed for visual and tactile stimuli. In the interest of extending the ecological validity of these findings, a second experiment tested recognition memory for complex, naturalistic stimuli that would likely be encountered in everyday life. Subjects were able to identify all stimuli when retention was not required, however, recognition accuracy following a delay period was again inferior for auditory compared to visual and tactile stimuli. Thus, the outcomes of both experiments provide a human parallel to the pattern of results observed in nonhuman primates. The results are interpreted in light of neuropsychological data from nonhuman primates, which suggest a difference in the degree to which auditory, visual, and tactile memory are mediated by the perirhinal and entorhinal cortices.

  3. Are meals at full-service and fast-food restaurants "normal" or "inferior"?

    Science.gov (United States)

    Kim, DaeHwan; Leigh, J Paul

    2011-12-01

    Whereas some studies show statistically significant linear associations between consumption at full-service restaurants and consumer incomes, studies of fast-food restaurants fail to find statistically significant linear associations. In this study, nationally representative data were drawn from the 1994-1996 Continuing Survey of Food Intakes by Individuals and the accompanying Diet and Health Knowledge Survey. The sample contained 4972 individuals who were 21 years of age or older. Dependent variables measured number of restaurant visits on 2 nonconsecutive days. Income was total annual household income. Control variables reflected sociodemographic, economic, lifestyle, and attitudinal variables. To capture possible curvilinear relationships between income and food consumption, we analyzed frequency distributions, regressions on full samples including income squared, and we divided samples into above- and below-average income groups. Zero-inflated negative binomial regressions accounted for excessive zeros within dependent variables. We found that fast-food restaurants were "normal goods" for below-average income, but "inferior goods" for above-average income, whereas full-service restaurants were "normal" for virtually all income levels. Earlier studies were flawed because they only tested for linear associations. Our results have implications for the poverty and obesity debate.

  4. Autogenous Partial Bone Chip Grafting on the Exposed Inferior Alveolar Nerve After Cystic Enucleation.

    Science.gov (United States)

    Seo, Mi Hyun; Eo, Mi Young; Cho, Yun Ju; Kim, Soung Min; Lee, Suk Keun

    2017-10-26

    This prospective study evaluated the clinical effectiveness of the new approach of partial autogenous bone chip grafts for the treatment of mandibular cystic lesions related to the inferior alveolar nerve (IAN). A total of 38 patients treated for mandibular cysts or benign tumors were included in this prospective study and subsequently divided into 3 groups depending on the bone grafting method used: cystic enucleation without a bone graft (group 1), partial bone chip graft covering the exposed IAN (group 2), and autogenous bone graft covering the entire defect (group 3). We evaluated the symptoms, clinical signs, and radiographic changes using dental panorama preoperatively, immediate postoperatively, and at 1, 3, 6, and 12 months postoperatively. Radiographic densities were compared using Adobe Photoshop CS5 (Adobe Systems Inc., San Jose, CA). Repeated measures analysis of variance was used for statistical evaluation with SPSS 22.0 (SPSS Inc, Chicago, IL), and P < 0.05 was considered statistically significant.Radiopacities were the most increased at 1 year postoperative in group 3; groups 2 and 3 did not show statistically significant differences, whereas groups 1 and 3 were statistically significant. In terms of radiographic bone healing with clinical regeneration of the exposed IAN, healing occurred in all patients, although the best healing was achieved in group 2.This autogenous partial bone chip grafting procedure to cover the exposed IAN is suggested as a new surgical protocol for the treatment of cystic lesions associated with the IAN.

  5. Low-rise scar deep inferior epigastric artery perforator flap for breast reconstruction.

    Science.gov (United States)

    Akita, Shinsuke; Mitsukawa, Nobuyuki; Tokumoto, Hideki; Kuriyama, Motone; Kubota, Yoshitaka; Kira, Tomoe; Sasahara, Yoshitaro; Sakakibara, Masahiro; Nagashima, Takeshi; Satoh, Kaneshige

    2015-09-01

    To achieve an unnoticeable postoperative scar in patients with little abdominal skin laxity for breast reconstruction by deep inferior epigastric artery perforator (DIEP) flap, we devised a new design called the low-rise scar DIEP flap; the skin paddle of this flap is located lower with a smaller vertical width, and more adipose tissue is elevated to obtain enough volume. The purpose of this report is to evaluate the utility of the low-rise scar DIEP flap compared with that of the conventionally designed flap. Twelve patients who underwent low-rise scar DIEP flaps (study group) and 11 patients who underwent conventionally-designed DIEP flaps (control group) were included in the present study. The distance from the umbilicus to horizontal scar was divided by the patient's height. The length of the scar was divided by the abdominal circumference. These ratios were compared between groups. All flaps survived completely and no recipient site complication was observed, except for one case in the control group with small-range fat necrosis. No donor site complication was observed in either group. The distance ratio was significantly larger in study group (scar DIEP flap leaves a lower and shorter postoperative scar. © 2015 Wiley Periodicals, Inc.

  6. Noise reduction of coincidence detector output by the inferior colliculus of the barn owl.

    Science.gov (United States)

    Christianson, G Björn; Peña, José Luis

    2006-05-31

    A recurring theme in theoretical work is that integration over populations of similarly tuned neurons can reduce neural noise. However, there are relatively few demonstrations of an explicit noise reduction mechanism in a neural network. Here we demonstrate that the brainstem of the barn owl includes a stage of processing apparently devoted to increasing the signal-to-noise ratio in the encoding of the interaural time difference (ITD), one of two primary binaural cues used to compute the position of a sound source in space. In the barn owl, the ITD is processed in a dedicated neural pathway that terminates at the core of the inferior colliculus (ICcc). The actual locus of the computation of the ITD is before ICcc in the nucleus laminaris (NL), and ICcc receives no inputs carrying information that did not originate in NL. Unlike in NL, the rate-ITD functions of ICcc neurons require as little as a single stimulus presentation per ITD to show coherent ITD tuning. ICcc neurons also displayed a greater dynamic range with a maximal difference in ITD response rates approximately double that seen in NL. These results indicate that ICcc neurons perform a computation functionally analogous to averaging across a population of similarly tuned NL neurons.

  7. Binaural interaction in the inferior colliculus of the big brown bat, Eptesicus fuscus.

    Science.gov (United States)

    Lu, Yong; Jen, Philip H-S

    2003-03-01

    Binaural interaction plays an important role in shaping response properties of central auditory neurons. Using single unit recording and iontophoresis, we examined frequency tuning curves (FTCs), interaural intensity difference (IID) curves, and rate-intensity functions of inferior collicular (IC) neurons of the big brown bat, Eptesicus fuscus, under closed system or free field stimulation conditions. We isolated 46 EI (excitation-inhibition), 24 EO (monaural excitation) and 6 EE (excitation-excitation) neurons. Inhibitory FTCs of EI neurons plotted under ipsilateral sound stimulation fell within (n=10, 22%), partly overlapped (n=26, 56%), or almost entirely encompassed (n=10, 22%) excitatory FTCs plotted by contralateral sound stimulation. The discharge rate of EI neurons was a sigmoid function of IID. The peak discharge rate occurred at IIDs at which contralateral sound stimulation was stronger than ipsilateral sound stimulation. Application of bicuculline, an antagonist for gamma-aminobutyric acid A receptors, raised the IID curves and broadened the excitatory FTCs but partly or completely abolished the ipsilateral inhibitory FTCs. For EE neurons, excitatory FTCs and rate-intensity functions plotted by contralateral sound stimulation were always broader and higher than those plotted by ipsilateral sound stimulation. The sharpness of FTCs of EI neurons was significantly greater at ipsilateral 30 degrees than at 30 degrees contralateral. This direction-dependent frequency tuning was effectively abolished by occlusion of the ipsilateral ear. Possible mechanisms underlying these observations are discussed.

  8. The organization of frequency and binaural cues in the gerbil inferior colliculus.

    Science.gov (United States)

    Graña, Gilberto David; Hutson, Kendall A; Badea, Alexandra; Pappa, Andrew; Scott, William; Fitzpatrick, Douglas C

    2017-06-15

    The inferior colliculus (IC) is the common target of separate pathways that transmit different types of auditory information. Beyond tonotopy, little is known about the organization of response properties within the 3-dimensional layout of the auditory midbrain in most species. Through study of interaural time difference (ITD) processing, the functional properties of neurons can be readily characterized and related to specific pathways. To characterize the representation of ITDs relative to the frequency and hodological organization of the IC, the properties of neurons were recorded and the sites recovered histologically. Subdivisions of the IC were identified based on cytochrome oxidase (CO) histochemistry. The results were plotted within a framework formed by an MRI atlas of the gerbil brain. The central nucleus was composed of two parts, and lateral and dorsal cortical areas were identified. The lateral part of the central nucleus had the highest CO activity in the IC and a high proportion of neurons sensitive to ITDs. The medial portion had lower CO activity and fewer ITD-sensitive neurons. A common tonotopy with a dorsolateral to ventromedial gradient of low to high frequencies spanned the two regions. The distribution of physiological responses was in close agreement with known patterns of ascending inputs. An understanding of the 3-dimensional organization of the IC is needed to specify how the single tonotopic representation in the IC central nucleus leads to the multiple tonotopic representations in core areas of the auditory cortex. © 2016 Wiley Periodicals, Inc.

  9. A function for binaural integration in auditory grouping and segregation in the inferior colliculus.

    Science.gov (United States)

    Nakamoto, Kyle T; Shackleton, Trevor M; Magezi, David A; Palmer, Alan R

    2015-03-15

    Responses of neurons to binaural, harmonic complex stimuli in urethane-anesthetized guinea pig inferior colliculus (IC) are reported. To assess the binaural integration of harmonicity cues for sound segregation and grouping, responses were measured to harmonic complexes with different fundamental frequencies presented to each ear. Simultaneously gated harmonic stimuli with fundamental frequencies of 125 Hz and 145 Hz were presented to the left and right ears, respectively, and recordings made from 96 neurons with characteristic frequencies >2 kHz in the central nucleus of the IC. Of these units, 70 responded continuously throughout the stimulus and were excited by the stimulus at the contralateral ear. The stimulus at the ipsilateral ear excited (EE: 14%; 10/70), inhibited (EI: 33%; 23/70), or had no significant effect (EO: 53%; 37/70), defined by the effect on firing rate. The neurons phase locked to the temporal envelope at each ear to varying degrees depending on signal level. Many of the cells (predominantly EO) were dominated by the response to the contralateral stimulus. Another group (predominantly EI) synchronized to the contralateral stimulus and were suppressed by the ipsilateral stimulus in a phasic manner. A third group synchronized to the stimuli at both ears (predominantly EE). Finally, a group only responded when the waveform peaks from each ear coincided. We conclude that these groups of neurons represent different "streams" of information but exhibit modifications of the response rather than encoding a feature of the stimulus, like pitch. Copyright © 2015 the American Physiological Society.

  10. Intracellular recordings reveal novel features of neurons that code interaural intensity disparities in the inferior colliculus.

    Science.gov (United States)

    Li, Na; Gittelman, Joshua X; Pollak, George D

    2010-10-27

    Many cells in the inferior colliculus (IC) are excited by contralateral and inhibited by ipsilateral stimulation and are thought to be important for sound localization. These excitatory-inhibitory (EI) cells comprise a diverse group, even though they exhibit a common binaural response property. Previous extracellular studies showed the diversity results from different circuits that generate the same EI property among the IC population, where some inherit the property from a lower nucleus, some are formed de novo in the IC, and others inherit EI features that are modified by inhibitory circuits. Here we evaluated the differential circuitry by recording inputs (postsynaptic potentials) and outputs (spikes) with in vivo whole-cell recordings from the IC of awake Mexican free-tailed bats. We show that in a minority of EI cells, either they inherited their binaural property from a lower binaural nucleus or the EI property was created in the IC via inhibitory projections from the ipsilateral ear, features consistent with those observed in extracellular studies. However, in a majority of EI cells, ipsilateral signals evoked subthreshold EPSPs that behaved paradoxically in that EPSP amplitudes increased with intensity, even though binaural signals with the same ipsilateral intensities generated progressively greater spike suppressions. We propose circuitry that can account for the responses we observed and suggest that the ipsilaterally evoked EPSPs could influence the responsiveness of IC cells to dynamic signals with interaural intensity disparities that change over time, such as moving sound sources or multiple sounds that occur in complex acoustic environments.

  11. Monaural and binaural inhibition underlying duration-tuned neurons in the inferior colliculus.

    Science.gov (United States)

    Sayegh, Riziq; Casseday, John H; Covey, Ellen; Faure, Paul A

    2014-01-08

    Duration-tuned neurons (DTNs) in the mammalian inferior colliculus (IC) arise from a combination of excitatory and inhibitory synaptic inputs. Previous research has shown that the inhibition responsible for creating DTNs has a shorter latency than that of excitation and lasts longer than the stimulus duration. We used monotic and dichotic paired tone stimulation and recorded responses of DTNs from the IC of the bat to assess the relative contributions of each ear in forming duration-tuned circuits. The stimulus consisted of a short best duration (BD) excitatory tone and a longer duration nonexcitatory (NE) tone. In the monotic condition, when the BD and NE tones were presented to the contralateral ear and were sufficiently close in time, the NE tone always suppressed spikes evoked by the BD tone. In the dichotic condition, when the BD tone was presented to the contralateral ear and the NE tone to the ipsilateral ear, half of DTNs no longer showed spike suppression to the NE tone. Of those DTNs with suppression in both conditions, the latency of the inhibition was shorter and the duration of the inhibition was longer in the monotic condition. Therefore, in the monotic condition, DTNs received a contralaterally evoked inhibitory input that preceded the excitatory input to the same neuron. In the dichotic condition, DTNs received an ipsilaterally evoked inhibitory input that was weaker, longer in latency, and shorter in duration than the inputs from the contralateral ear. These findings indicate that the neural mechanisms that create DTNs in the IC are monaural.

  12. A function for binaural integration in auditory grouping and segregation in the inferior colliculus

    Science.gov (United States)

    Shackleton, Trevor M.; Magezi, David A.; Palmer, Alan R.

    2014-01-01

    Responses of neurons to binaural, harmonic complex stimuli in urethane-anesthetized guinea pig inferior colliculus (IC) are reported. To assess the binaural integration of harmonicity cues for sound segregation and grouping, responses were measured to harmonic complexes with different fundamental frequencies presented to each ear. Simultaneously gated harmonic stimuli with fundamental frequencies of 125 Hz and 145 Hz were presented to the left and right ears, respectively, and recordings made from 96 neurons with characteristic frequencies >2 kHz in the central nucleus of the IC. Of these units, 70 responded continuously throughout the stimulus and were excited by the stimulus at the contralateral ear. The stimulus at the ipsilateral ear excited (EE: 14%; 10/70), inhibited (EI: 33%; 23/70), or had no significant effect (EO: 53%; 37/70), defined by the effect on firing rate. The neurons phase locked to the temporal envelope at each ear to varying degrees depending on signal level. Many of the cells (predominantly EO) were dominated by the response to the contralateral stimulus. Another group (predominantly EI) synchronized to the contralateral stimulus and were suppressed by the ipsilateral stimulus in a phasic manner. A third group synchronized to the stimuli at both ears (predominantly EE). Finally, a group only responded when the waveform peaks from each ear coincided. We conclude that these groups of neurons represent different “streams” of information but exhibit modifications of the response rather than encoding a feature of the stimulus, like pitch. PMID:25540219

  13. Left-sided and duplicate inferior vena cava: a case series and review.

    Science.gov (United States)

    Ang, Wee Choen; Doyle, Terry; Stringer, Mark D

    2013-11-01

    Left-sided and duplicate inferior vena cava (IVC) are two major anatomical variants within the spectrum of IVC malformations, both of which are developmental abnormalities of the supracardinal veins. Four clinical cases are described to highlight the computed tomographic appearances of these vascular malformations and provide novel data on venous dimensions. A systematic review of the recent literature (2000-2011) was conducted focusing on the anatomy, demographics, and associated pathology (congenital and acquired) of isolated left-sided and duplicate IVC. A total of 73 relevant articles were retrieved, consisting of case reports and small case series. The prevalence of left-sided IVC is about 0.1-0.4% and that for duplicate IVC about 0.3-0.4%; both anomalies show a slight male preponderance. In each condition, there are documented variations in the course and tributaries of the IVC. The clinical importance of these anomalies lies in three principal areas: the potential for misdiagnosis on imaging; technical difficulties during retroperitoneal surgery (particularly abdominal aortic aneurysm repair and live donor nephrectomy); and their significance in relation to the etiology and management of venous thromboembolism. Copyright © 2012 Wiley Periodicals, Inc.

  14. Frequency discrimination and stimulus deviance in the inferior colliculus and cochlear nucleus.

    Science.gov (United States)

    Ayala, Yaneri A; Pérez-González, David; Duque, Daniel; Nelken, Israel; Malmierca, Manuel S

    2012-01-01

    Auditory neurons that exhibit stimulus-specific adaptation (SSA) decrease their response to common tones while retaining responsiveness to rare ones. We recorded single-unit responses from the inferior colliculus (IC) where SSA is known to occur and we explored for the first time SSA in the cochlear nucleus (CN) of rats. We assessed an important functional outcome of SSA, the extent to which frequency discriminability depends on sensory context. For this purpose, pure tones were presented in an oddball sequence as standard (high probability of occurrence) or deviant (low probability of occurrence) stimuli. To study frequency discriminability under different probability contexts, we varied the probability of occurrence and the frequency separation between tones. The neuronal sensitivity was estimated in terms of spike-count probability using signal detection theory. We reproduced the finding that many neurons in the IC exhibited SSA, but we did not observe significant SSA in our CN sample. We concluded that strong SSA is not a ubiquitous phenomenon in the CN. As predicted, frequency discriminability was enhanced in IC when stimuli were presented in an oddball context, and this enhancement was correlated with the degree of SSA shown by the neurons. In contrast, frequency discrimination by CN neurons was independent of stimulus context. Our results demonstrated that SSA is not widespread along the entire auditory pathway, and suggest that SSA increases frequency discriminability of single neurons beyond that expected from their tuning curves.

  15. Frequency discrimination and stimulus deviance in the inferior colliculus and cochlear nucleus

    Directory of Open Access Journals (Sweden)

    Yaneri A. Ayala

    2013-01-01

    Full Text Available Auditory neurons that exhibit stimulus-specific adaptation (SSA decrease their response to common tones while retaining responsiveness to rare ones. We recorded single-unit responses from the inferior colliculus (IC where SSA is known to occur and we explored for the first time SSA in the cochlear nucleus (CN of rats. We assessed an important functional outcome of SSA, the extent to which frequency discriminability depends on sensory context. For this purpose, pure tones were presented in an oddball sequence as standard (high probability of occurrence or deviant (low probability of occurrence stimuli. To study frequency discriminability under different probability contexts, we varied the probability of occurrence and the frequency separation between tones. The neuronal sensitivity was estimated in terms of spike-count probability using signal detection theory. We reproduced the finding that many neurons in the IC exhibited SSA, but we did not observe significant SSA in our CN sample. We concluded that strong SSA is not a ubiquitous phenomenon in the CN. As predicted, frequency discriminability was enhanced in IC when stimuli were presented in an oddball context, and this enhancement was correlated with the degree of SSA shown by the neurons. In contrast, frequency discrimination by CN neurons was independent of stimulus context. Our results demonstrated that SSA is not widespread along the entire auditory pathway, and suggest that SSA increases frequency discriminability of single neurons beyond that expected from their tuning curves.

  16. Background noise improves gap detection in tonically inhibited inferior colliculus neurons.

    Science.gov (United States)

    Wilson, Willard W; Walton, Joseph P

    2002-01-01

    Single units in the inferior colliculus (IC) in the C57Bl/6 inbred mouse strain were tested for their temporal processing ability as measured by their minimum gap threshold (MGT), the shortest silent interval in an ongoing white-noise stimulus which a unit could encode. After ascertaining the MGT in quiet, units were re-tested in various levels of background noise. The focus of this report is on two types of tonically responding units found in the IC. Tonically inhibited (TI) units encoded gaps poorly in quiet and low levels of background noise as compared with tonically excited (TE) units. In quiet, the MGTs of TI units were about an order of magnitude longer than the MGTs typical of TE units. Paradoxically, gap encoding was improved in high levels of background noise for TI units. This result is unexpected from the traditional viewpoint that noise necessarily degrades signal processing and is inconsistent with psychophysical observations of diminished speech and gap detection processing in noisy environments. We believe the improved feature detection described here is produced by the adaptation of inhibitory input. Continuous background noise would diminish the inhibitory efficacy of the gap stimulus by increasing the latency to the onset of inhibition and decreasing its duration. This would allow more spontaneous activity to "bleed through" the silent gap, thus signaling its presence. Improved feature detection in background noise resulting from inhibitory adaptation would seem an efficient neural mechanism and one that might be generally useful in other signal detection tasks.

  17. Stimulus-specific adaptation and deviance detection in the inferior colliculus

    Directory of Open Access Journals (Sweden)

    Yaneri eAguilar Ayala

    2013-01-01

    Full Text Available Deviancy detection in the continuous flow of sensory information into the central nervous system is of vital importance for animals. The task requires neuronal mechanisms that allow for an efficient representation of the environment by removing statistically redundant signals. Recently, the neuronal principles of auditory deviance detection have been approached by studying the phenomenon of stimulus-specific adaptation (SSA. SSA is a reduction in the responsiveness of a neuron to a common or repetitive sound while the neuron remains highly sensitive to rare sounds (Ulanovsky et al., 2003. This phenomenon could enhance the saliency of unexpected, deviant stimuli against a background of repetitive signals. SSA shares many similarities with the evoked potential known as the ‘mismatch negativity,’ and it has been linked to cognitive process such as auditory memory and scene analysis (Winkler et al., 2009 as well as to behavioral habituation (Netser et al., 2011. Neurons exhibiting SSA can be found at several levels of the auditory pathway, from the inferior colliculus (IC up to the auditory cortex (AC. In this review, we offer an account of the state-of-the art of SSA studies in the IC with the aim of contributing to the growing interest in the single-neuron electrophysiology of auditory deviance detection. The dependence of neuronal SSA on various stimulus features, e.g., probability of the deviant stimulus and repetition rate, and the roles of the AC and inhibition in shaping SSA at the level of the IC are addressed.

  18. Gene Transfection of Human Turbinate Mesenchymal Stromal Cells Derived from Human Inferior Turbinate Tissues

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    Jin Seon Kwon

    2016-01-01

    Full Text Available Human turbinate mesenchymal stromal cells (hTMSCs are novel stem cells derived from nasal inferior turbinate tissues. They are easy to isolate from the donated tissue after turbinectomy or conchotomy. In this study, we applied hTMSCs to a nonviral gene delivery system using polyethyleneimine (PEI as a gene carrier; furthermore, the cytotoxicity and transfection efficiency of hTMSCs were evaluated to confirm their potential as resources in gene therapy. DNA-PEI nanoparticles (NPs were generated by adding the PEI solution to DNA and were characterized by a gel electrophoresis and by measuring particle size and surface charge of NPs. The hTMSCs were treated with DNA-PEI NPs for 4 h, and toxicity of NPs to hTMSCs and gene transfection efficiency were monitored using MTT assay, fluorescence images, and flow cytometry after 24 h and 48 h. At a high negative-to-positive charge ratio, DNA-PEI NPs treatment led to cytotoxicity of hTMSCs, but the transfection efficiency of DNA was increased due to the electrostatic effect between the NPs and the membranes of hTMSCs. Importantly, the results of this research verified that PEI could deliver DNA into hTMSCs with high efficiency, suggesting that hTMSCs could be considered as untapped resources for applications in gene therapy.

  19. Inferior Vena Cava Filters in Stable Patients with Acute Pulmonary Embolism Who Receive Thrombolytic Therapy.

    Science.gov (United States)

    Stein, Paul D; Matta, Fadi; Hughes, Mary J

    2018-01-01

    There is a need for further analyses of subgroups of patients with pulmonary embolism who might benefit from vena cava filters. In the present investigation, we analyze mortality with vena cava filters in the subgroup of stable patients with pulmonary embolism who received thrombolytic therapy. We use a different database than used previously, and we analyze data in more recent years. Administrative data were analyzed from the Premier Healthcare Database, 2010-2014, in hospitalized stable patients with pulmonary embolism who received thrombolytic therapy and may or may not have received a vena cava filter. Patients were identified on the basis of International Classification of Disease, Ninth Revision, Clinical Modification codes. In-hospital all-cause mortality in stable patients who received a vena cava filter in addition to thrombolytic therapy was 139 of 2660 (5.2%), compared with 697 of 4332 (16.1%) who did not receive a filter (P pulmonary embolism who receive thrombolytic therapy, irrespective of the reason, the additional use of an inferior vena cava filter results in a lower in-hospital mortality. Copyright © 2018. Published by Elsevier Inc.

  20. Inferior vena cava diameter change after intravenous furosemide in patients diagnosed with acute decompensated heart failure.

    Science.gov (United States)

    Tchernodrinski, Stefan; Lucas, Brian P; Athavale, Ambarish; Candotti, Carolina; Margeta, Bosko; Katz, Ariel; Kumapley, Rudolf

    2015-03-01

    Measurement of the inferior vena cava (IVC) diameters may improve decision-making for patients hospitalized with acute decompensated heart failure. Nevertheless, little is known about how the IVC is affected by loop diuretics. We sought to determine if bolus infusions of intravenous furosemide affect IVC diameters measured by hand-carried ultrasonography. We conducted a prospective cohort study at a public teaching hospital from September 2009 through June 2010. Physician investigators performed IVC ultrasonography on a convenience sample of 70 hospitalized adults who were prescribed intravenous furosemide for the diagnosis of acute decompensated heart failure. Participants' median baseline IVC diameter was 2.38 cm (interquartile range, 1.91-2.55 cm). At 1-2 hours after furosemide, IVC diameters decreased an average of 0.21 cm (95% CI, 0.13-0.29 cm) and remained significantly below baseline at 2-3 hours after furosemide by an average of 0.15 cm (95% CI, 0.07-0.22 cm). IVC diameters of adults diagnosed with acute decompensated heart failure become measurably smaller after single doses of intravenous furosemide. Whether this represents a true change in volume status has not been studied. © 2014 Wiley Periodicals, Inc.

  1. Inferior Oblique Weakening and Abnormal Head Position: Controlled Myotomy versus Recession

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    R. Migliorini

    2016-01-01

    Full Text Available Purpose. Randomized controlled trial aimed at comparing surgical outcomes in a group of patients suffering from hyperfunction of the inferior oblique (IO muscle with abnormal head position (AHP. The surgical techniques being compared are Recession and (thread Controlled Myotomy. Materials and Methods. The group of 20 patients suffering from medium-high hyperfunction of the IO was assessed through an ophthalmological and orthoptic examination. 10 patients underwent traditional Recession (Group  A and 10 were treated with Controlled Myotomy (Group  B. Results. The average age was 19 years ± 10.7 SD. After 1 year, 20% of Group  A showed a small Vertical Deviation associated with a small AHP, while 80% had orthophoria and 40% of them had a small AHP. 80% of Group  B showed a small Vertical Deviation associated with an equally small AHP, while 20% had orthophoria with a full resolution of AHP. Conclusion. Based on the results obtained and the fewer intrasurgical risks involved, thread Controlled Myotomy proved to be a valid alternative to Recession. Furthermore, in case of Recession, over the long period a small residual AHP remained in the patients who had orthophoria, unlike Myotomy which led to a total resolution.

  2. Self-esteem and patients' satisfaction after deep inferior epigastric perforator flap breast reconstruction.

    Science.gov (United States)

    Haekens, Christel M; Enajat, Morteza; Keymeulen, Kristien; Van der Hulst, Rene R W J

    2011-01-01

    The objective of this article is to assess the impact of deep inferior epigastric perforator (DIEP) flap breast reconstruction on self-esteem and to analyze the correlation between aesthetic outcome and self-esteem. Global self-esteem was evaluated using the Rosenberg Self-Esteem Scale in 31 patients who underwent DIEP flap breast reconstructions. A study-specific questionnaire and photographic evaluation were used by the patient, the plastic surgeon, and the oncological surgeon to measure satisfaction with the aesthetic outcome. Patients' satisfaction and self-esteem were analyzed for any existing correlation. Overall patients' satisfaction had a mean score of 6.55 (range, 0-10) on the Patient Satisfaction Questionnaire. A mean score of 32.48 (range, 10-40) was found on the Rosenberg Self-Esteem Scale. More than 80% of patients were content with their decision to undergo this procedure and would recommend this to a friend. Surgeons tended to rate the aesthetic outcome better than patients. Patients' satisfaction and self-esteem were found to be positively correlated. Patients are generally content with the outcome of primary DIEP flap breast reconstruction. The favorable aesthetic result of this procedure has a beneficial effect on patients' self-esteem.

  3. Radiological assessment of the inferior alveolar artery course in human corpse mandibles

    Energy Technology Data Exchange (ETDEWEB)

    Bertl, Kristina [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Malmoe University, Department of Periodontology, Faculty of Odontology, Malmoe (Sweden); Hirtler, Lena [Medical University of Vienna, Center for Anatomy and Cell Biology, Department of Systematic Anatomy, Vienna (Austria); Dobsak, Toni [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Medical University of Vienna, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Vienna (Austria); Austrian Cluster for Tissue Regeneration, Vienna (Austria); Heimel, Patrick [Medical University of Vienna, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Vienna (Austria); Austrian Cluster for Tissue Regeneration, Vienna (Austria); Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna (Austria); Gahleitner, Andre [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Medical University of Vienna, Department of Diagnostic Radiology, Division of Osteoradiology, General Hospital, Vienna (Austria); Ulm, Christian [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Plenk, Hanns [Medical University of Vienna, Bone and Biomaterials Research, Institute for Histology and Embryology, Vienna (Austria)

    2015-04-01

    CT assessment of the entire course of the inferior alveolar artery (IAA) within the mandibular canal. After contrast medium injection (180 or 400 mg/ml iodine concentration) into the external carotid arteries of 15 fresh human cadaver heads, the main IAA's position in the canal (cranial, buccal, lingual or caudal) was assessed in dental CT images of partially edentulous mandibles. The course of the main IAA could be followed at both iodine concentrations. The higher concentration gave the expected better contrast, without creating artefacts, and improved visibility of smaller arteries, such as anastomotic sections, dental branches and the incisive branch. The main IAA changed its position in the canal more often than so far known (mean 4.3 times, SD 1.24, range 2-7), but with a similar bilateral course. A cranial position was most often detected (42 %), followed by lingual (36 %), caudal (16 %) and buccal (6 %). With this non-invasive radiologic method, the entire course of the main IAA in the mandibular canal could be followed simultaneously with other bone structures on both sides of human cadaver mandibles. This methodology allows one to amend existing anatomical and histological data, which are important for surgical interventions near the mandibular canal. (orig.)

  4. Uterine artery embolisation for uterine fibroids using a 4F Rosch inferior mesenteric catheter

    Energy Technology Data Exchange (ETDEWEB)

    Ho, Simon S.M. [Chinese University of Hong Kong, Department of Diagnostic Radiology and Organ Imaging, Hong Kong (China); Cowan, Nigel C. [Churchill Hospital, Department of Radiology, Oxford (United Kingdom)

    2005-06-01

    Purpose:To evaluate in a prospective study the use of a 4F Rosch inferior mesenteric (RIM) catheter for uterine artery embolisation (UAE). UAE was performed in 72 women over a 37-month period. A 4F RIM braided J-curve 65-cm catheter was used in combination with an angled hydrophilic 150 cm, 0.035'' flexible tip guide-wire to catheterise the horizontal portion of both uterine arteries (UA) from a right common femoral artery (CFA) approach. Technical success was defined as successful catheterisation and embolisation of both uterine arteries. Fluoroscopic and procedure times were recorded. Mean subject age=43.7 years (range=25-57 years). Technical success was 98.6% (n=71/72). A single approach via the right CFA was used in 88.9% (n=64/72) and a bilateral CFA approach in 11.1% (n=8/72). Bilateral uterine artery catheterisation using a single 4F RIM catheter via the right CFA approach was successful in 79.2% (n=57/72). Microcatheters were used in 2.8% of patients (n=2/72). Mean fluoroscopic time=13.6{+-}5.3 min (mean{+-}SD). Mean procedure time=44.2{+-}16.5 min. High technical success rate for UAE is possible using a single 4F RIM catheter via a unilateral right CFA approach, which obviates the need for Waltman loop formation, reversed curve catheters and complex suture-catheter arrangements. (orig.)

  5. Tones inferior to eye movements in the EMDR treatment of PTSD.

    Science.gov (United States)

    van den Hout, Marcel A; Rijkeboer, Marleen M; Engelhard, Iris M; Klugkist, Irene; Hornsveld, Hellen; Toffolo, Marieke J B; Cath, Danielle C

    2012-05-01

    Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder (PTSD). During EMDR, patients make eye movements (EMs) while recalling traumatic memories, but recently therapists have replaced EMs by alternating beep tones. There are no outcome studies on the effects of tones. In an earlier analogue study, tones were inferior to EMs in the reduction of vividness of aversive memories. In a first EMDR session, 12 PTSD patients recalled trauma memories in three conditions: recall only, recall + tones, and recall + EMs. Three competing hypotheses were tested: 1) EMs are as effective as tones and better than recall only, 2) EMs are better than tones and tones are as effective as recall only, and 3) EMs are better than tones and tones are better than recall only. The order of conditions was balanced, each condition was delivered twice, and decline in memory vividness and emotionality served as outcome measures. The data strongly support hypothesis 2 and 3 over 1: EMs outperformed tones while it remained unclear if tones add to recall only. The findings add to earlier considerations and earlier analogue findings suggesting that EMs are superior to tones and that replacing the former by the latter was premature. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Retrieval of TRAPEASE and OPTEASE Inferior Vena Cava Filters with Extended Dwell Times.

    Science.gov (United States)

    Scher, Daniel; Venbrux, Anthony; Okapal, Kevin; Gabriel, Gaby; Dufour, Robert; Chun, Albert; Sarin, Shawn; Akman, Andrew

    2015-10-01

    To demonstrate that OPTEASE and TRAPEASE filters can be removed after dwell times greater than 60 days. A retrospective review was performed of patients who underwent an attempted removal of a TRAPEASE or OPTEASE filter with a greater than 60-day dwell time between 2009 and 2015 at a single institution. Eleven patients within that time span were identified, and 10 were included in the review. One patient was excluded from the study because the date of filter placement was unknown. All filters were successfully retrieved. The average dwell time for removed TRAPEASE filters was 1,273 days (range, 129-3,582 d), with a median of 492 days (n = 5). The average dwell time for OPTEASE filters was 977 days (range, 123-2,584 d), with a median of 661 days (n = 5). The average dwell time of all filters was 1,125 days (range, 123-3,582 d), with a median of 577 days (n = 10). All patients exhibited inferior vena cava (IVC) stenosis after filter retrieval. An IVC pseudoaneurysm was present following retrieval in one case and resolved. In one case, a fractured filter strut was left completely embedded in the caval wall. Two patients reported unilateral leg swelling on clinical follow-up, and the remainder reported no leg swelling or tightness. Initial experience suggests that TRAPEASE and OPTEASE filters can be removed after extended dwell times. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

  7. Echocardiographic Characterization of the Inferior Vena Cava in Trained and Untrained Females.

    Science.gov (United States)

    Hedman, Kristofer; Nylander, Eva; Henriksson, Jan; Bjarnegård, Niclas; Brudin, Lars; Tamás, Éva

    2016-12-01

    The aim of the study was to explore the long- and short-axis dimensions, shape and collapsibility of the inferior vena cava in 46 trained and 48 untrained females (mean age: 21 ± 2 y). Echocardiography in the subcostal view revealed a larger expiratory long-axis diameter (mean: 24 ± 3 vs. 20 ± 3 mm, p < 0.001) and short-axis area (mean: 5.5 ± 1.5 vs. 4.7 ± 1.4 cm2, p = 0.014) in trained females. IVC shape (the ratio of short-axis major to minor diameters) and the relative decrease in IVC dimension with inspiration were similar for the two groups. The IVC long-axis diameter reflected short-axis minor diameter and was correlated to maximal oxygen uptake (r = 0.52, p < 0.01). In summary, the results indicate that trained females have a larger IVC similar in shape and respiratory decrease in dimensions to that of untrained females. The long-axis diameter corresponded closely to short-axis minor diameter and, thus, underestimates maximal IVC diameter. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  8. Greater Left Inferior Frontal Activation for SVO than VOS During Sentence Comprehension in Kaqchikel

    Directory of Open Access Journals (Sweden)

    Masatoshi Koizumi

    2016-10-01

    Full Text Available Cortical activations during the processing of sentences with different word orders in Kaqchikel were investigated using functional magnetic resonance imaging. Kaqchikel is an endangered Mayan language spoken in Guatemala. The word order in this language is relatively flexible. We observed higher cortical activations in the left inferior frontal gyrus for sentences with the subject-verb-object (SVO word order, as compared to sentences with the verb-object-subject (VOS word order, suggesting that VOS is easier to process than SVO. This supports the traditional interpretation in Mayan linguistics that the syntactically simplest word order of transitive sentences is VOS in Kaqchikel, as in many other Mayan languages. More importantly, the results revealed that the subject-before-object word order preference in sentence comprehension, observed in a number of previous studies on other languages, might not reflect a universal aspect of human languages; rather, processing preference may be language-specific to some extent, reflecting syntactic differences in individual languages.

  9. Bilateral Serous Retinal Detachment Associated with Inferior Posterior Staphyloma Treated with Scleral Shortening and Vitrectomy

    Directory of Open Access Journals (Sweden)

    Akihito Kasai

    2016-05-01

    Full Text Available Purpose: We report a case of bilateral serous retinal detachment (SRD associated with inferior posterior staphyloma (IPS treated successfully with scleral shortening. Patient and Methods: A 63-year-old woman presented with bilateral visual loss due to an SRD with IPS. The best-corrected visual acuity levels were 0.6 (20/30 and 0.5 (20/40 in the right and left eye, respectively. The patient underwent vitrectomy and scleral shortening in the right eye. The lamellar scleral crescent was resected 4 mm in width from the 5- to 8-o'clock positions. Seven interrupted 5-0 polyester sutures were placed at the edge of the lamellar scleral crescent. After 25-gauge three-port vitrectomy, the sutures were tightened. Optical coherence tomography showed decreased curvature at the staphyloma border. The choroidal thickness decreased in the superior flat portion of the fundus and increased slightly in the staphyloma. The SRD resolved 3 months postoperatively. The best-corrected visual acuity in the right eye improved to 0.8 (20/25 6 months postoperatively. Angiography 6 months postoperatively showed decreased diffuse dye leakage at the fovea in the right eye; indocyanine green angiography did not show marked changes. Discussion: Scleral shortening with vitrectomy changes the eye wall shape, may improve the retinal pigment epithelial integrity, and may be a treatment option for SRD with IPS.

  10. Role of Colonial Subjects in Making Themselves Inferior in Chinua Achebe’s Things Fall Apart

    Directory of Open Access Journals (Sweden)

    Zahra Sadeghi

    2014-12-01

    Full Text Available Chinua Achebe in his novel Things Fall Apart gives us a unique picture of life in Africa before the arrival of Christianity and colonization and the era afterwards. He shows how African people lost their traditional culture and values, replacing them with foreign beliefs. In this article, the way black people lived before the arrival of white people, how they encountered and reacted to white colonizers, in addition to how they converted to Christianity and subsequently to White culture, as portrayed in this novel, will be analyzed. The purpose of this study is to trace the roots of this rapid pace of colonialism back to when colonial subjects lost their original culture to the new-coming people and to what extent those colonized people were affectively actualizing their inferiority and subordination to the white society. Frantz Fanon’s theories on the relation between language and culture or language and civilization, as well as his discussion of White notion of Blacks and Blacks’ conception of themselves are discussed and analyzed in Achebe’s masterpiece Things Fall Apart to prove that black people attempted to make up for their deep feeling of incompleteness by imitating white people and forming a white personality in a black statue as a result of their own conscious volition.

  11. Mobilization of the inferior alveolar nerve with simultaneous implant insertion: a new technique. Case report.

    Science.gov (United States)

    Bovi, Mauro

    2005-08-01

    For reconstruction of an atrophied posterior mandible, different therapeutic options have been proposed, such as autologous bone grafting, guided bone regeneration for vertical ridge augmentation, and inferior alveolar nerve (IAN) mobilization with simultaneous implant placement. The possible dehiscence of soft tissues covering the surgical zone makes the first and second techniques unpredictable. Moreover, two surgical sites are necessary and a long treatment time is required (about 12 months). With IAN mobilization, only one surgical intervention is required and the total treatment time is shorter (about 6 months). However, this technique risks irreversible damage to the IAN, with consequent functional alterations. Current studies have shown extreme variability in the examination of functionality of the neurovascular bundle after its mobilization. This variability can be attributed both to the methodology used for the tests, which evoke subjective answers from the patient, and to the surgical procedure, which is highly dependent on operator technique. Nerve damage can be the result of an overstretched mucoperiosteal flap in the premolar area to achieve optimal visibility of the surgical zone. This article reports a case in which a new surgical approach to IAN mobilization is performed using a specifically engineered device for simplified bone surgery (Mectron Piezosurgery). This device enables the surgeon to cut hard tissue without injuring the soft tissues. Therefore, there is a lower risk of damaging the IAN, and it is possible to reduce overstretching of the mental nerve by creating a smaller bone window and using an apicocoronal inclination of instruments to capture the neurovascular bundle.

  12. Recency Effects in the Inferior Parietal Lobe during Verbal Recognition Memory

    Directory of Open Access Journals (Sweden)

    Bradley Russell Buchsbaum

    2011-07-01

    Full Text Available The most recently encountered information is often most easily remembered in psychological tests of memory. Recent investigations of the neural basis of such recency effects have shown that activation in the lateral inferior parietal cortex (LIPC tracks the recency of a probe item when subjects make recognition memory judgments. A key question regarding recency effects in the LIPC is whether they fundamentally reflect the storage (and strength of information in memory, or whether such effects are a consequence of task difficulty or an upswing in resting state network activity. Using functional magnetic resonance imaging (fMRI we show that recency effects in the LIPC are independent of the difficulty of recognition memory decisions, that they are not a by-product of an increase in resting state network activity, and that they appear to dissociate from regions known to be involved in verbal working memory maintenance. We conclude with a discussion of two alternative explanations – the memory strength and expectancy hypotheses, respectively -- of the parietal lobe recency effect.

  13. A new method in thoracoscopic inferior mediastinal lymph node biopsy: a case report

    Directory of Open Access Journals (Sweden)

    Sanlı Maruf

    2009-11-01

    Full Text Available Abstract Introduction We performed video-thoracoscopy with a video-mediastinoscope to conduct a mediastinal lymph node biopsy. Here, we discuss the various advantages of the method. Case presentation A 56-year-old Turkish Caucasian man had been complaining of dyspnea on exertion, hacking cough, fever and continuous sweating for one and a half months. Thoracic computed tomography revealed enlarged paratracheal and aorticopulmonary lymph nodes, the largest of which was 1 cm in diameter and reticulo-micronodular interstitial infiltration extending symmetrically to the pleural surfaces in both pulmonary perihilar areas. Computed tomography supported positron emission tomography showed increased fluorodeoxyglucose retention in lymph nodes in both hilar areas (10R and 10L (maximum standardized uptake values 5.6 and 5.7, and in the right lower paratracheal (4R (maximum standardized uptake value 4.1 and right para-esophageal (8 (maximum standardized uptake value 8.9 lymph nodes. Pathological examination of the right lymph node number 8 biopsy using the video-mediastinoscope revealed the presence of granulomatous inflammation. No problems were observed during the postoperative period. Conclusion The use of the video-mediastinoscope for inferior lymph node biopsy in thoracoscopy is an easy, safe and practical method, especially in patients with pleural adhesions.

  14. Anorexia Nervosa during Adolescence Is Associated with Decreased Gray Matter Volume in the Inferior Frontal Gyrus

    Science.gov (United States)

    Mabe, Hiroyo; Yamada, Eiji; Masuda, Masato; Tomoda, Akemi

    2015-01-01

    Anorexia nervosa (AN) is an eating disorder characterized by the relentless pursuit to lose weight, mostly through self-starvation, and a distorted body image. AN tends to begin during adolescence among women. However, the underlying neural mechanisms related to AN remain unclear. Using voxel-based morphometry based on magnetic resonance imaging scans, we investigated whether the presence of AN was associated with discernible changes in brain morphology. Participants were 20 un-medicated, right-handed patients with early-onset AN and 14 healthy control subjects. Group differences in gray matter volume (GMV) were assessed using high-resolution, T1-weighted, volumetric magnetic resonance imaging datasets (3T Trio scanner; Siemens AG) and analyzed after controlling for age and total GMV, which was decreased in the bilateral inferior frontal gyrus (IFG) (left IFG: FWE corrected, p < 0.05; right IFG: uncorrected, p < 0.05) of patients with AN. The GMV in the bilateral IFG correlated significantly with current age (left IFG: r = -.481, p < .05; right IFG: r = -.601, p < .01) and was limited to the AN group. We speculate that decreased IFG volume might lead to deficits in executive functioning or inhibitory control within neural reward systems. Precocious or unbalanced neurological trimming within this particular region might be an important factor for the pathogenesis of AN onset. PMID:26067825

  15. Morphological study on the inferior olivary nuclear complex of the donkey (Equus asinus).

    Science.gov (United States)

    Rashed, Reda; Imagawa, Tomohiro; Uehara, Masato

    2006-12-01

    This study provides basic data on the normal structure of the inferior olivary complex (IOC) of the donkey, Equus asinus, at the light microscopic level. In common with that of other mammals, the donkey IOC consisted of three major nuclei and four minor groups of cells. The former was comprised of the medial and dorsal accessory olives (MAO and DAO, respectively) and the principal olive (PO), and the latter was comprised of the dorsal cap, nucleus beta, ventrolateral outgrowth and dorsomedial cell column. The MAO had the longest rostral to caudal representation and formed the caudal pole of IOC. The DAO was located dorsally to the MAO in the caudal half of the IOC. In the rostral half, the DAO bended ventrally and merged with the dorsal lamella of PO. More rostrally, the DAO lost its connection with the dorsal lamella and then conversely connected with the ventral lamella of PO. The DAO formed the rostral pole of the IOC. The PO extended through the rostral half of the IOC. The dorsal cap was a small group of cells. Overall, the donkey IOC is similar to that of other mammals.

  16. The cutaneous course of deep inferior epigastric perforators: implications for flap thinning.

    Science.gov (United States)

    Rozen, W M; Murray, A C A; Ashton, M W; Bloom, R J; Stella, D L; Phillips, T J; Taylor, G I

    2009-08-01

    The deep inferior epigastric artery (DIEA) perforator flap is frequently used for autologous breast reconstruction following mastectomy. Thinning of the flap is often performed to debulk the flap of excess fatty tissue, such as in partial mastectomy defects. Thinning may disrupt the blood supply to the flap and compromise viability, however adequate guidelines for thinning are lacking from the literature. Clinical and anatomical studies were concurrently undertaken to explore the cutaneous course of perforators as a guide to flap thinning. Twenty consecutive patients undergoing DIEA perforator flap breast reconstruction underwent preoperative computerised tomography angiography (CTA), and a cadaveric study was also undertaken, in which six fresh, whole abdominal walls underwent CTA. All perforators greater than 2 mm were analysed for their cutaneous course. In all cases, perforators emerged from the anterior rectus sheath and traversed an oblique, but direct course through the deep layer of adipose tissue, before reaching Scarpa's fascia. Branching of perforators occurred in two planes of the superficial adipose layer: just superficial to Scarpa's fascia (the fascial plexus) and in the subdermal plexus. Thinning of DIEA perforator flaps can only be performed safely deep to Scarpa's fascia. Thinning performed superficial to Scarpa's fascia threatens the intrinsic blood supply to the flap.

  17. Raising perforator flaps for breast reconstruction: the intramuscular anatomy of the deep inferior epigastric artery.

    Science.gov (United States)

    Rozen, Warren M; Ashton, Mark W; Pan, Wei R; Taylor, G Ian

    2007-11-01

    The deep inferior epigastric artery (DIEA) perforator flap is used increasingly for breast reconstruction, preferred as a muscle-sparing operation over traditional transverse rectus abdominis musculocutaneous (TRAM) flaps. Complications related to the inclusion of rectus abdominis include abdominal wall weakness and a predisposition to ventral abdominal wall hernias. DIEA perforator flaps still present this complication, with clinical experience demonstrating frequent transection of rectus fibers during dissection of perforators. Despite this, published descriptions of the DIEA in the literature describe a "direct" course through rectus abdominis. This study interprets these clinical findings by analyzing the intramuscular course of the perforators. The investigation was performed on 31 hemiabdominal walls from both fresh and embalmed cadavers, using a combination of dissection and radiography of multiple cross-sectional planes. Intramuscular distances were measured using the distances between entry and exit points of perforators from rectus abdominis muscle, allowing characterization of the intramuscular course. Substantial longitudinal (mean, 1.52 cm; range, 0.2 to 4.1 cm) and transverse (mean, 1.32 cm; range, 0.3 to 3.5 cm) distances were traversed by each of the 76 perforators within the muscle. A significant transverse distance was shown to be traversed by perforators, confirming the need for division of rectus abdominis fibers during operation. This information may help explain the clinical findings of abdominal wall morbidity following perforator flaps, and may pave the way for improved preoperative selection of patients for DIEA perforator flaps.

  18. Deep inferior epigastric artery (DIEA) skin flap: clinical experience of 15 cases.

    Science.gov (United States)

    Kostakoğlu, N; Keçik, A

    1998-01-01

    Skin flaps devoid of rectus muscle, raised on a single musculocutaneous perforator (14 cases), and on two musculocutaneous perforators (1 case) of the deep inferior epigastric artery (DIEA) were used in 14 patients to cover various defects during a period of 3 years. The flaps were raised on the perforator arising slightly lateral to the centre of the muscle below the umbilicus, which is a sub-branch of the lateral branch of DIEA. The defects were located on the upper limb in four, the lower limb in nine, and the scalp and forehead in the remaining two cases. In one patient, the flap was preexpanded for 4 weeks prior to transfer. The longest flap was 40 x 12 cm, and the widest flap was 30 x 18 cm in dimension. All donor defects were closed primarily. Two flaps were lost due to venous thrombosis on the fourth postoperative day. Tip necrosis was observed in two flaps, both of which were salvaged from venous thrombosis at 36 hours and 5 days postoperatively. The remaining 11 flaps survived completely. The DIEA skin flap was found to provide the following benefits: (1) the largest available skin flap where the donor site could be closed primarily; (2) decreased possibility of abdominal wall weakness and hernia formation; and (3) potential of obtaining a thin flap either by trimming of the subcutaneous fat or by preexpansion.

  19. Preservation of deep inferior epigastric artery at kidney transplantation prevents atrophy of lower rectus abdominis muscle.

    Science.gov (United States)

    Iwami, Daiki; Harada, Hiroshi; Morita, Ken; Oba, Koji; Fukuzawa, Nobuyuki; Hotta, Kiyohiko; Sasaki, Hajime; Miyazaki, Chihoko; Nonomura, Katsuya

    2012-05-27

    The deep inferior epigastric artery (DIEA), which feeds the lower rectus abdominis muscle (lower RAM), is usually transected in kidney transplantation. In this study, we investigated whether preservation of DIEA can prevent lower RAM atrophy. Two hundred and forty-five kidney transplant recipients (150 men and 95 women) were enrolled in the study (mean age 39.9 years) and were divided into two groups according to whether DIEA was transected (group A, n = 175) or preserved (group B, n = 70). The extent of lower RAM atrophy calculated in computed tomography (performed 1 year after transplantation) and incidence of lower RAM atrophy were compared between the two groups. The most predictive factors for lower RAM atrophy were assessed using a multivariate logistic regression model. The extent of lower RAM atrophy was significantly lower in group B (15.0 ± 18.5%) than that in group A (38.9 ± 25.4%, P = 0.003). The incidence of lower RAM atrophy was less prevalent in group B (20.0%) compared with that in group A (62.9%, P DIEA was the only independent predictive factor for lower RAM atrophy (P DIEA during kidney transplant can prevent lower RAM atrophy.

  20. Polyneuronal innervation of single muscle fibers in cat eye muscle: inferior oblique.

    Science.gov (United States)

    Dimitrova, Diana M; Allman, Brian L; Shall, Mary S; Goldberg, Stephen J

    2009-06-01

    Single muscle fibers with multiple axonal endplates (multiply innervated fibers) are normally present in adult extraocular muscles (EOMs), while most other mammalian skeletal muscles contain fibers with a single myoneural junction. Recent findings by others led us to investigate for the presence of polyneuronal innervation (innervation of a single muscle fiber by >1 motoneuron) in the inferior oblique (IO) muscle of pentobarbital anesthetized cats. The IO muscle nerve branches, as they coursed through the orbit, were further divided for independent or simultaneous electrical stimulation with bipolar electrodes. Four of five established tests for polyneuronal innervation gave positive results. The sum of the twitch (1) and tetanic (2) tensions in response to individual nerve branch stimulation was greater than that for simultaneous (whole) nerve stimulation. The summed electromyographic (EMG) responses (3) gave a similar positive result. The result for crossed tetanic potentiation (4) was negative for polyneuronal innervation while the crossed fatigue (5) test was positive. These results are consistent with recent studies. That the EOMs exhibit polyneuronal innervation further explains the eye-movement system's functional integrity during some neuromuscular disorders as well as its ability to operate with precision after the loss of numerous motoneurons.

  1. rTMS over bilateral inferior parietal cortex induces decrement of spatial sustained attention

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    Jeyeon eLee

    2013-02-01

    Full Text Available Sustained attention is an essential brain function that enables a subject to maintain attention level over the time of a task. In previous work, the right inferior parietal lobe (IPL has been reported as one of the main brain regions related to sustained attention, however, the right lateralization of vigilance/sustained attention is unclear because information about the network for sustained attention is traditionally provided by neglect patients who typically have right brain damage. Here, we investigated sustained attention by applying a virtual lesion technique, transcranial magnetic stimulation (TMS, over the left and right superior parietal lobe (SPL and IPL. We used two different types of visual sustained attention tasks: spatial (location based and non-spatial (feature based. When the participants performed the spatial task, repetitive TMS (rTMS over either the right or left IPL induced a significant decrement of sustained attention causing a progressive increment of errors and response time. In contrast, participants’ performance was not changed by rTMS on the non-spatial task. Also, omission errors (true negative gradually increased with time on right and left IPL rTMS conditions, while commission errors (false positive were relatively stable. These findings suggest that the maintenance of attention, especially in tasks regarding spatial location, is not uniquely lateralized to the right IPL, but may also involve participation of the left IPL as well.

  2. Intracavitary physiotherapy is not inferior to endometrial scratching in patients with recurrent implantation failure.

    Science.gov (United States)

    Zhang, Qian; Zhang, Bo; Yan, Junhao; Zhang, Chu; Tang, Rong; Sheng, Yan; Wang, Na; Chen, Zi-Jiang

    2015-01-01

    To investigate whether intracavitary physiotherapy is superior to endometrial scratching in patients with recurrent implantation failure (RIF) after in vitro fertilization/intracytoplasmic sperm injection- embryo transfer (IVF/ICSI-ET) cycles. According to the inclusion criteria defined by our hospital, 63 patients with RIF were included in the retrospective study. 20 patients who received intracavitary physiotherapy were classified into Group A, 8 patients with both intracavitary physiotherapy and endometrial scratching were into Group B, and 35 patients who underwent endometrial scratching were into Group C. The primary outcome measures were implantation and clinical pregnancy rates. The secondary outcome measure was pregnancy outcome. There were no statistical differences in implantation and clinical pregnancy rates between Groups A and C (29.41 vs 35.59 %, 45.00 vs 48.57 % respectively, P > 0.05), Groups B and C (36.36 vs 35.59 %, 50.00 vs 48.57 % respectively, P > 0.05). In addition, no statistical differences were discovered in pregnancy outcomes between Groups A and C (P > 0.05), Groups B and C (P > 0.05). Intracavitary physiotherapy is not inferior to endometrial scratching on improving implantation and clinical pregnancy rates in patients with RIF after IVF/ICSI cycles.

  3. Surgical Resection of a Leiomyosarcoma of the Inferior Vena Cava Mimicking Hepatic Tumor

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    Junji Ueda

    2013-01-01

    Full Text Available Introduction. Leiomyosarcomas of vascular origin are particularly rare tumors occurring mainly in the inferior vena cava (IVC. They are malignant, slow-growing tumors with a poor prognosis. This paper reports on a rare case of surgical resection of an IVC leiomyosarcoma mimicking a hepatic tumor. Case Presentation. A 65-year-old Japanese male was admitted for evaluation of an abdominal tumor. Enhanced computed tomography of the abdomen revealed a slightly enhanced heterogeneous tumor, 18 mm in diameter, between the Spiegel lobe of the liver and the IVC in early-phase images, with no enhancement or washout in late-phase images. We diagnosed this tumor as either a hepatic tumor in the Spiegel lobe or a retroperitoneal tumor such as leiomyosarcoma or liposarcoma and performed a laparotomy. On the basis of surgical findings, we extirpated the tumor by performing a wedge resection of the wall of the IVC and suturing the primary IVC wall. Pathological findings led to a further diagnosis of the tumor as a leiomyosarcoma originating in the IVC. Thirty-seven months after the operation, multiple liver and lung metastases were detected, and the patient died from multiple organic failures. Conclusion. We experienced a rare case of a leiomyosarcoma of IVC mimicking hepatic tumor.

  4. Estimation of central venous pressure using inferior vena caval pressure from a femoral endovascular cooling catheter.

    Science.gov (United States)

    Lee, Byung Kook; Lee, Hyoung Youn; Jeung, Kyung Woon; Jung, Yong Hun; Lee, Geo Sung

    2013-01-01

    Endovascular cooling using the femoral cooling catheter is widely practiced. Central venous pressure (CVP) monitoring in patients undergoing femoral endovascular cooling may require the placement of another catheter near the right atrium (RA). We sought to estimate the agreement between the CVP recorded from catheters placed in the superior vena caval pressure (SVCP) and the inferior vena caval pressure (IVCP) recorded from the femoral cooling catheter in patients undergoing femoral endovascular cooling. We enrolled adult cardiac arrest survivors undergoing femoral endovascular cooling. A commercially available central venous catheter was placed in the SVC (superior vena cava) near the RA via subclavian venous access. Both SVCP and IVCP were recorded every 4 hours during therapeutic hypothermia. Arterial pressure, heart rate, peak inspiratory pressure (PIP), and positive end expiratory pressure (PEEP) at the time of vena caval pressure measurements were obtained. A total of 323 pairs of SVCP and IVCP measurements were collected. The correlation coefficient between SVCP and IVCP was 0.965 (P monitoring CVP. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Males have Inferior Achilles Tendon Material Properties Compared to Females in a Rodent Model.

    Science.gov (United States)

    Pardes, A M; Freedman, B R; Fryhofer, G W; Salka, N S; Bhatt, P R; Soslowsky, L J

    2016-10-01

    The Achilles tendon is the most commonly ruptured tendon in the human body. Numerous studies have reported incidence of these injuries to be upwards of five times as common in men than women. Therefore, the objective of this study was to investigate the sex- and hormone-specific differences between Achilles tendon and muscle between female, ovariectomized female (ovarian hormone deficient), and male rats. Uninjured tissues were collected from all groups for mechanical, structural, and histological analysis. Our results showed that while cross-sectional area and failure load were increased in male tendons, female tendons exhibited superior tendon material properties and decreased muscle fiber size. Specifically, linear and dynamic moduli were increased while viscoelastic properties (e.g., hysteresis, percent relaxation) were decreased in female tendons, suggesting greater resistance to deformation under load and more efficient energy transfer, respectively. No differences were identified in tendon organization, cell shape, cellularity, or proteoglycan content. Additionally, no differences in muscle fiber type distribution were observed between groups. In conclusion, inferior tendon mechanical properties and increased muscle fiber size may explain the increased susceptibility for Achilles tendon injury observed clinically in men compared to women.

  6. Tratamiento de la isquemia crítica de miembros inferiores

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    Samir Jozami

    2010-01-01

    Full Text Available RESUMENIntroducciónLa isquemia crítica de miembros inferiores representa una manifestación extrema de laenfermedad vascular periférica crónica. La revascularización quirúrgica es el tratamientode elección para los pacientes con esta patología, ya que pese a ser un procedimiento invasivoreduce la tasa de amputación y de mortalidad. Sin embargo, tiene una tasa alta de complicaciones.Durante la última década, el perfeccionamiento y la introducción de nuevas tecnologíaspercutáneas han derivado en un crecimiento importante en la estrategia endovascular.Su baja morbilidad comparada con la de la alternativa quirúrgica ha llevado a un rápido yexplosivo incremento en su indicación.ObjetivoEvaluar los resultados clínicos en pacientes con lesiones críticas de miembros inferiorestratados de forma endovascular en un centro de alto volumen.Material y métodosDesde enero de 2005 hasta diciembre de 2008 se realizaron 60 procedimientos en 55 pacientes.ResultadosLa edad de los pacientes fue de 72,5 ± 10,6 años (rango 49-91; el 60,7% eran de sexomasculino, el 57% padecían diabetes y el 48,8%, enfermedad coronaria. El 50% de los pacientespresentaron dolor del miembro en reposo y el resto, lesiones tróficas menores en el41% y mayores en el 9%. Se trataron en total 74 lesiones: 14 aortoilíacas, 23 femoropoplíteas,28 infrapoplíteas y 9 bypass vasculares. En el seguimiento a 30 días, la tasa de reintervenciónde urgencia fue del 10,9%, la de amputación del 5,4%, la de muerte del 3,6% y la de eventoscardíacos mayores (muerte, infarto agudo de miocardio, accidente cerebrovascular,reintervención o amputación fue del 10,9%. Luego de 30 días, el seguimiento alejado (media727 ± 442 días arrojó las siguientes tasas: reintervención 11,7%, amputación 7,4%,infarto agudo de miocardio 2%, accidente cerebrovascular 2%, muerte 11,7% y eventos cardíacosmayores 27,4%. Las tasas de reintervención, amputación y eventos cardíacos mayoresdurante

  7. Correlações entre as estruturas dos membros inferiores Correlations between lower limb structures

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    Francis Trombini-Souza

    2009-09-01

    Full Text Available A literatura sugere que mudanças no ângulo Q podem alterar o arco plantar longitudinal e que um mau alinhamento do retropé poderia também modificar a postura do antepé. Contudo, não foram encontrados estudos que correlacionem quantitativamente, na postura ortostática bipodal, todos esses segmentos. Assim, o propósito deste estudo foi avaliar quantitativamente e verificar eventuais correlações entre o ângulo Q, arco plantar longitudinal, alinhamento frontal do tendão do calcâneo e antepé, na postura ortostática bipodal, por meio de fotogrametria. Foram avaliados 30 indivíduos jovens (60 membros inferiores de ambos os sexos, com idade entre 18 e 24 anos. Foi feita captura fotográfica digital no plano frontal anterior de joelho e antepé; no plano frontal posterior, do tendão do calcâneo; e da impressão plantar exposta no podoscópio. Os dados foram analisados estatisticamente e o nível de signficância fixado em 5%. Foram obtidas as seguintes correlações entre: ângulo Q X arco plantar, r=0,29 (p=0,021; ângulo Q X antepé, r=0,23 (p=0,092; ângulo Q X tendão do calcâneo, r=0,06 (p=0,627; arco plantar X antepé, r=0,09 (p=0,464; arco plantar X tendão do calcâneo, r=-0,05 (p=0,680; e antepé X tendão do calcâneo, r=-0,02 (p=0,857. A única correlação significativa encontrada, embora fraca, foi entre o ângulo Q e o arco plantar longitudinal medial, o que sugere cautela ao se inferirem correlações entre estruturas dos membros inferiores.Literature often reports that changes in the Q angle may alter the longitudinal plantar arch and that a misalignment of the rearfoot might also modify forefoot position. However, no studies could be found that quantitatively establish correlations between those lower limb segments in orthostatic bipedal posture. The goal of this study was to quantitatively assess possible correlations between the Q angle, longitudinal plantar arch, frontal forefoot and rearfoot alignment in bipedal

  8. La fauna del pleistoceno inferior de la Sierra de Quibas (Abanilla, Murcia

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    Szyndlar, Z.

    1999-08-01

    de las serpientes, Elaphe cf. E. sealaris, apenas se hallan representadas en el registro fósil. Hay además varias especies de aves cuya aparición en Quibas supone la primera cita en el Pleistoceno inferior de la Península Ibérica. Entre los mamíferos posee una especial relevancia la presencia del cercopitécido Macaca sylvanus. La asociación de los taxones Arvieola deuealion, Castillomys rivas rivas, Eliomys intermedius, Equus altidens y Capra sp. aff. C. alba permite la correlación con Plines 1, Orce 3 y Venta Micena, entre otros. El yacimiento de Quibas puede situarse, por tanto, antes del final del Pleistoceno inferior, con una antigüedad entre 1.3 y 1 Ma. Por lo que se refiere a las condiciones paleoclimáticas, podemos inferir a partir de la asociación faunística un régimen xerófilo, muy semejante al actual en el área geográfica, aunque quizás con valores de humedad y temperatura algo superiores. El entorno de la cavidad kárstica estaba formado por roquedo calcáreo con áreas abiertas de matorral, pero en las proximidades se desarrollaron humedales y zonas arboladas, como así lo atestigua la presencia de aves y micromamíferos típicos de estos hábitats.

  9. Intracranial Bypass of Posterior Inferior Cerebellar Artery Aneurysms: Indications, Technical Aspects, and Clinical Outcomes.

    Science.gov (United States)

    Bonda, David J; Labib, Mohamad; Katz, Jeffrey M; Ortiz, Rafael A; Chalif, David; Setton, Avi; Langer, David J; Dehdashti, Amir R

    2017-10-01

    For some posterior inferior cerebellar artery (PICA) aneurysms, there is no constructive endovascular or direct surgical clipping option. Intracranial bypass is an alternative to a deconstructive technique. To evaluate the clinical features, surgical techniques, and outcome of PICA aneurysms treated with bypass and obliteration of the diseased segment. Retrospective review of PICA aneurysms treated via intracranial bypass was performed. Outcome measurements included postoperative stroke, cranial nerve deficits, gastrostomy/tracheostomy requirement, bypass patency, modified Rankin scale (mRS) at discharge, and mRS at 6 mo. Seven patients with PICA aneurysms treated with intracranial bypass were identified. Five had fusiform aneurysms (4 ruptured, 1 unruptured), 1 had a giant partially thrombosed saccular aneurysm (unruptured), and 1 had a dissecting traumatic aneurysm (ruptured). Two aneurysms were at the anteromedullary segment, 4 at the lateral medullary segment, and 1 at the tonsillomedullary segment. Three patients underwent PICA-to-PICA side to side anastomoses, 2 PICA-to-PICA reanastomosis, 1 vertebral artery-to-PICA bypass, and 1 occipital artery-PICA bypass. Six out of 7 aneurysms were obliterated surgically and 1 with additional endovascular occlusion after the bypass. All bypasses were patent intraoperatively; 2 were later demonstrated occluded without radiological signs or symptoms of stroke. No patients had new cranial nerve deficit postoperatively. With the exception of 1 death due to pulmonary emboli 3 mo postoperatively, all others remain at a mRS ≤ 2. Constructive bypass and aneurysm obliteration remains a viable alternative for treatment of PICA aneurysms not amenable to direct surgical clipping or to a vessel-preserving endovascular option.

  10. Q-ball of inferior fronto-occipital fasciculus and beyond.

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    Eduardo Caverzasi

    Full Text Available The inferior fronto-occipital fasciculus (IFOF is historically described as the longest associative bundle in the human brain and it connects various parts of the occipital cortex, temporo-basal area and the superior parietal lobule to the frontal lobe through the external/extreme capsule complex. The exact functional role and the detailed anatomical definition of the IFOF are still under debate within the scientific community. In this study we present a fiber tracking dissection of the right and left IFOF by using a q-ball residual-bootstrap reconstruction of High-Angular Resolution Diffusion Imaging (HARDI data sets in 20 healthy subjects. By defining a single seed region of interest on the coronal fractional anisotropy (FA color map of each subject, we investigated all the pathways connecting the parietal, occipital and posterior temporal cortices to the frontal lobe through the external/extreme capsule. In line with recent post-mortem dissection studies we found more extended anterior-posterior association connections than the "classical" fronto-occipital representation of the IFOF. In particular the pathways we evidenced showed: a diffuse projections in the frontal lobe, b fronto-parietal lobes connections trough the external capsule in almost all the subjects and c widespread connections in the posterior regions. Our study represents the first consistent in vivo demonstration across a large group of individuals of these novel anterior and posterior terminations of the IFOF detailed described only by post-mortem anatomical dissection. Furthermore our work establishes the feasibility of consistent in vivo mapping of this architecture with independent in vivo methodologies. In conclusion q-ball tractography dissection supports a more complex definition of IFOF, which includes several subcomponents likely underlying specific function.

  11. Un primitivo Notonychopidae (Litopterna del Paleoceno inferior de Punta Peligro, Chubut, Argentina

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    Morales, J.

    1997-12-01

    Full Text Available The discovery of a new ungulate species, Requisia vidmari gen. nov., nov. sp. in the lower Paleocene of Punta Peligro, Chubut (Argentine represents the earliest known record of Litopterna. The dental morphology of this new genus is very similar to that known for Notonychops powelli Soria, 1989, differing mainly by its more primitive M3, which is less elongated and less selenodont. Requisia vidmari, together with Wainka tshotshe Simpson, 1948, can be included in the family Notonychopidae, which appear to represent an ancestral grade in the evolution of Litopterna. Because cladogenesis of South American ungulates clearly took place prior to the Punta Peligro fauna and was apparently rapid, phylogenetic interpretation is difficult.Se comunica un nuevo ungulado con dentición pre-selenodonta del Paleoceno inferior, Peligrense, de Patagonia, Argentina. Su morfología dentaria es muy similar a la de Notonychops powelli Soria, 1989, pero con caracteres más primitivos. La morfología de las cúspides, el tipo de desgaste y los caracteres crescentiformes del M3 indican que Requisia vidmari gen. nov., sp. nov. presenta fuertes evidencias del desarrollo de caracteres selenodontos, por lo que se lo considera como el más primitivo representante del orden Litopterna. Requisia vidmari y probablemente Wainka tshotshe Simpson, 1948, son primitivos en relación a Notonychops, pero su similitud morfológica justificaría su inclusión en la misma familia Notonychopidae. Se considera que la radiación adaptativa de los ungulados paleocenos de América del Sur fue precoz, eventualmente rápida, lo que dificulta encontrar un modelo filogenético suficientemente explicativo.

  12. Challenging diagnostic and therapeutic modalities for leiomyosarcoma of inferior vena cava.

    Science.gov (United States)

    Mastoraki, Aikaterini; Leotsakos, George; Mastoraki, Sotiria; Papanikolaou, Ioannis S; Danias, Nikolaos; Smyrniotis, Vasilios; Arkadopoulos, Nikolaos

    2015-01-01

    Leiomyosarcoma of the inferior vena cava (IVCL) is a rare malignant tumour originating from the smooth muscle cells of the media with intra- or extra-luminal growth. The type of the lesion is further divided into three levels in relation to hepatic and renal veins respectively. The aim of this review was to evaluate the results of surgical treatment of IVCL with special reference to the extent of its histological spread and to analyse the recent literature in order to provide an update on the current concepts of diagnostic and therapeutic management of this entity. IVCL's patients may present with non-specific complaints such as dyspnoea, malaise, weight loss, nausea, vomiting, fever and abdominal pain. Haematogenous metastasis is frequent. At a later stage, IVCL may also spread through lymphatic. Multiple diagnostic imaging techniques have been proposed for accurate preoperative diagnosis, including Doppler ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI), individually or in combination with cavography echocardiography or CT-guided biopsy. Despite recent research on the therapeutic strategies against IVCL, surgical resection appears the only potentially curative approach. Unfortunately, a mere minority of patients is eligible to undergo surgical intervention. In addition, surgical removal of IVCL does not necessarily guarantee patient's long-term survival. Alternative therapies, such as radio- and chemo-therapy often proved insufficient. Debate continues regarding the optimal management of the IVC after tumour resection, with primary repair, ligation and IVC reconstruction all have been utilized with varying success. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  13. Role of the right inferior parietal cortex in auditory selective attention: An rTMS study.

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    Bareham, Corinne A; Georgieva, Stanimira D; Kamke, Marc R; Lloyd, David; Bekinschtein, Tristan A; Mattingley, Jason B

    2018-02-01

    Selective attention is the process of directing limited capacity resources to behaviourally relevant stimuli while ignoring competing stimuli that are currently irrelevant. Studies in healthy human participants and in individuals with focal brain lesions have suggested that the right parietal cortex is crucial for resolving competition for attention. Following right-hemisphere damage, for example, patients may have difficulty reporting a brief, left-sided stimulus if it occurs with a competitor on the right, even though the same left stimulus is reported normally when it occurs alone. Such "extinction" of contralesional stimuli has been documented for all the major sense modalities, but it remains unclear whether its occurrence reflects involvement of one or more specific subregions of the temporo-parietal cortex. Here we employed repetitive transcranial magnetic stimulation (rTMS) over the right hemisphere to examine the effect of disruption of two candidate regions - the supramarginal gyrus (SMG) and the superior temporal gyrus (STG) - on auditory selective attention. Eighteen neurologically normal, right-handed participants performed an auditory task, in which they had to detect target digits presented within simultaneous dichotic streams of spoken distractor letters in the left and right channels, both before and after 20 min of 1 Hz rTMS over the SMG, STG or a somatosensory control site (S1). Across blocks, participants were asked to report on auditory streams in the left, right, or both channels, which yielded focused and divided attention conditions. Performance was unchanged for the two focused attention conditions, regardless of stimulation site, but was selectively impaired for contralateral left-sided targets in the divided attention condition following stimulation of the right SMG, but not the STG or S1. Our findings suggest a causal role for the right inferior parietal cortex in auditory selective attention. Copyright © 2017 Elsevier Ltd. All rights

  14. Effect of background noise on neuronal coding of interaural level difference cues in rat inferior colliculus

    Science.gov (United States)

    Mokri, Yasamin; Worland, Kate; Ford, Mark; Rajan, Ramesh

    2015-01-01

    Humans can accurately localize sounds even in unfavourable signal-to-noise conditions. To investigate the neural mechanisms underlying this, we studied the effect of background wide-band noise on neural sensitivity to variations in interaural level difference (ILD), the predominant cue for sound localization in azimuth for high-frequency sounds, at the characteristic frequency of cells in rat inferior colliculus (IC). Binaural noise at high levels generally resulted in suppression of responses (55.8%), but at lower levels resulted in enhancement (34.8%) as well as suppression (30.3%). When recording conditions permitted, we then examined if any binaural noise effects were related to selective noise effects at each of the two ears, which we interpreted in light of well-known differences in input type (excitation and inhibition) from each ear shaping particular forms of ILD sensitivity in the IC. At high signal-to-noise ratios (SNR), in most ILD functions (41%), the effect of background noise appeared to be due to effects on inputs from both ears, while for a large percentage (35.8%) appeared to be accounted for by effects on excitatory input. However, as SNR decreased, change in excitation became the dominant contributor to the change due to binaural background noise (63.6%). These novel findings shed light on the IC neural mechanisms for sound localization in the presence of continuous background noise. They also suggest that some effects of background noise on encoding of sound location reported to be emergent in upstream auditory areas can also be observed at the level of the midbrain. PMID:25865218

  15. Circuits for Processing Dynamic Interaural Intensity Disparities in the Inferior Colliculus

    Science.gov (United States)

    Pollak, George D.

    2013-01-01

    Interaural intensity disparities (IIDs), the cues all animals use to localize high frequency sounds, are initially processed in the lateral superior olive (LSO) by a subtractive process where inputs from one ear excite and inputs from the other ear inhibit LSO neurons. Such cells are called excitatory-inhibitory (EI) neurons and are prominent not only in the LSO but also in higher nuclei, which include the dorsal nucleus of the lateral lemniscus (DNLL) and inferior colliculus (IC). The IC is of particular interest since its EI cells receive diverse innervation patterns from a large number of lower nuclei, which include the DNLLs and LSOs, and thus comprise a population with diverse binaural properties. The first part of this review focuses on the circuits that create EI cells in the LSO, DNLL and IC. The second section then turns to the responses evoked by dynamic IIDs that change over time, as with multiple sounds that emanate from different regions of space or moving sound sources. I show that many EI neurons in the IC respond to dynamic IIDs in ways that are not predictable from their responses to static IIDs, IIDs presented one at a time. In the final section, results from in vivo whole cell recording in the IC are presented and address the connectional basis for the responsiveness to dynamic IIDs. The principal conclusion is that EI cells comprise a diverse population. The diversity is created by the particular set of inputs each EI type receives and is expressed in the differences in the responses to dynamic IIDs that are generated by those inputs. These results show that the construction of EI neurons in the IC imparts features that not only encode the location of an individual sound source, but also that allow animals to determine the direction of a moving sound and to focus and localize a single sound in midst of many sounds, as typically occurs in the daily lives of all animals. PMID:22343068

  16. Altered voltage-gated calcium channels in rat inferior colliculus neurons contribute to alcohol withdrawal seizures

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    N’Gouemo, Prosper

    2015-01-01

    We have previously reported that enhanced susceptibility to alcohol withdrawal seizures (AWS) parallels the enhancement of the current density of high-threshold voltage-gated Ca2+ (CaV) channels in rat inferior colliculus (IC) neurons. However, whether this increased current density is a cause or consequence of AWS is unclear. Here, I report changes in the current density of CaV channels in IC neurons during the course of alcohol withdrawal and the potential anticonvulsant effect of intra-IC infusions of L- and P-type CaV channel antagonists. Whole-cell currents were activated by depolarizing pulses using barium as the charge carrier. Currents and seizure susceptibility were evaluated in control animals 3 h after alcohol intoxication, as well as 3 h (before AWS), 24 h (when AWS susceptibility is maximal), and 48 h (when AWS susceptibility is no longer present) after alcohol withdrawal. Nifedipine, nimodipine (L-type antagonists) or ω-agatoxin TK (P-type antagonist) were infused intra-IC to probe the role of CaV channels in the pathogenesis of AWS. CaV current density and conductance in IC neurons were significantly increased 3 and 24 h after alcohol withdrawal compared with the control group or the group tested 3 h following ethanol intoxication. Blockade of L-type CaV channels within the IC completely suppressed AWS, and inhibition of P-type channels reduced AWS severity. These findings suggest that the enhancement of CaV currents in IC neurons occurs prior to AWS onset and that alterations in L- and P-type CaV channels in these neurons may underlie the pathogenesis of AWS. PMID:25914156

  17. Inferior frontal gyrus preserves working memory and emotional learning under conditions of impaired noradrenergic signaling

    Directory of Open Access Journals (Sweden)

    Benjamin eBecker

    2013-12-01

    Full Text Available Compensation has been widely applied to explain neuroimaging findings in neuropsychiatric patients. Functional compensation is often invoked when patients display equal performance and increased neural activity in comparison to healthy controls. According to the compensatory hypothesis increased activity allows the brain to maintain cognitive performance despite underlying neuropathological changes. Due to methodological and pathology-related issues, however, the functional relevance of the increased activity and the specific brain regions involved in the compensatory response remain unclear. An experimental approach that allows a transient induction of compensatory responses in the healthy brain could help to overcome these issues. To this end we used the nonselective beta-blocker propranolol to pharmacologically induce sub-optimal noradrenergic signaling in healthy participants. In two independent fMRI experiments participants received either placebo or propranolol before they underwent a cognitive challenge (experiment 1: working memory; experiment 2: emotional learning: Pavlovian fear conditioning. In experiment 1 propranolol had no effects on working memory performance, but evoked stronger activity in the left inferior frontal gyrus (IFG. In experiment 2 propranolol produced no effects on emotional memory formation, but evoked stronger activity in the right IFG. The present finding that sub-optimal beta-adrenergic signaling did not disrupt performance and concomitantly increased IFG activity is consistent with, and extends, current perspectives on functional compensation. Together, our findings suggest that under conditions of impaired noradrenergic signaling, heightened activity in brain regions located within the cognitive control network, particularly the IFG, may reflect compensatory operations subserving the maintenance of behavioral performance.

  18. Virtual Reality simulator for dental anesthesia training in the inferior alveolar nerve block

    Directory of Open Access Journals (Sweden)

    Cléber Gimenez CORRÊA

    Full Text Available Abstract Objectives This study shows the development and validation of a dental anesthesia-training simulator, specifically for the inferior alveolar nerve block (IANB. The system developed provides the tactile sensation of inserting a real needle in a human patient, using Virtual Reality (VR techniques and a haptic device that can provide a perceived force feedback in the needle insertion task during the anesthesia procedure. Material and Methods To simulate a realistic anesthesia procedure, a Carpule syringe was coupled to a haptic device. The Volere method was used to elicit requirements from users in the Dentistry area; Repeated Measures Two-Way ANOVA (Analysis of Variance, Tukey post-hoc test and averages for the results’ analysis. A questionnaire-based subjective evaluation method was applied to collect information about the simulator, and 26 people participated in the experiments (12 beginners, 12 at intermediate level, and 2 experts. The questionnaire included profile, preferences (number of viewpoints, texture of the objects, and haptic device handler, as well as visual (appearance, scale, and position of objects and haptic aspects (motion space, tactile sensation, and motion reproduction. Results The visual aspect was considered appropriate and the haptic feedback must be improved, which the users can do by calibrating the virtual tissues’ resistance. The evaluation of visual aspects was influenced by the participants’ experience, according to ANOVA test (F=15.6, p=0.0002, with p<0.01. The user preferences were the simulator with two viewpoints, objects with texture based on images and the device with a syringe coupled to it. Conclusion The simulation was considered thoroughly satisfactory for the anesthesia training, considering the needle insertion task, which includes the correct insertion point and depth, as well as the perception of tissues resistances during the insertion.

  19. Low dimensional representation of face space by face-selective inferior temporal neurons.

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    Salehi, Sina; Dehaqani, Mohammad-Reza A; Esteky, Hossein

    2017-05-01

    The representation of visual objects in primate brain is distributed and multiple neurons are involved in encoding each object. One way to understand the neural basis of object representation is to estimate the number of neural dimensions that are needed for veridical representation of object categories. In this study, the characteristics of the match between physical-shape and neural representational spaces in monkey inferior temporal (IT) cortex were evaluated. Specifically, we examined how the number of neural dimensions, stimulus behavioral saliency and stimulus category selectivity of neurons affected the correlation between shape and neural representational spaces in IT cortex. Single-unit recordings from monkey IT cortex revealed that there was a significant match between face space and its neural representation at lower neural dimensions, whereas the optimal match for the non-face objects was observed at higher neural dimensions. There was a statistically significant match between the face and neural spaces only in the face-selective neurons, whereas a significant match was observed for non-face objects in all neurons regardless of their category selectivity. Interestingly, the face neurons showed a higher match for the non-face objects than for the faces at higher neural dimensions. The optimal representation of face space in the responses of the face neurons was a low dimensional map that emerged early (~150 ms post-stimulus onset) and was followed by a high dimensional and relatively late (~300 ms) map for the non-face stimuli. These results support a multiplexing function for the face neurons in the representation of very similar shape spaces, but with different dimensionality and timing scales. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  20. Factors affecting Cook Gunther Tulip and Cook Celect inferior vena cava filter retrieval success.

    Science.gov (United States)

    Glocker, Roan J; Novak, Zdenek; Matthews, Thomas C; Patterson, Mark A; Jordan, William D; Pearce, Benjamin J; Passman, Marc A

    2014-01-01

    Success rates vary for the retrieval of inferior vena cava filters (IVCFs). The optimal retrieval time and factors influencing retrieval success remain unproven. This study aims to determine optimal time and evaluate factors related to successful IVCF retrieval. An institutional prospectively maintained database was reviewed for all IVCF retrieval attempts from 2006 to 2012. Patient demographics, comorbidities, indications for procedure, placement technique, IVCF type, presence of angulation, and time to retrieval were evaluated with respect to success or failure of retrieval. Statistical analyses (t-test, χ(2), correlations, and Kaplan-Meier plots) were performed comparing successful and unsuccessful retrievals. Of 121 attempted IVCF retrievals, 92 (76%) were successful and 29 (24%) were unsuccessful. There were no significant differences between the successful and unsuccessful attempts in terms of patient demographics, comorbidities, indications for procedure, placement technique, or IVCF type, which included 93 Celect (77%) and 28 Gunther Tulip (23%). Time since IVCF placement was significantly different (P = .025) between the successful and unsuccessful retrieval groups (medians were 105 [7-368] and 162 [43-379] days, respectively). Time since IVCF placement greater than 117 days correlated significantly with unsuccessful IVCF retrieval (R = 0.218; P = .017; odds ratio, 2.88; P = .02). Angulation greater than 20 degrees on anteroposterior radiograph was noted in seven of 29 (24%) unsuccessful retrievals compared with seven of 92 (8%) successful retrievals and was significant (P = .012). Cook Gunther Tulip and Celect IVCF retrieval is most likely to be successful within 3 to 4 months of placement. Unsuccessful retrieval attempts are more likely to occur when IVCF position is angulated. Copyright © 2014 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.