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  1. The da Vinci robotic surgical assisted anterior lumbar interbody fusion: technical development and case report.

    Science.gov (United States)

    Beutler, William J; Peppelman, Walter C; DiMarco, Luciano A

    2013-02-15

    Technique development to use the da Vince Robotic Surgical System for anterior lumbar interbody fusion at L5-S1 is detailed. A case report is also presented. To evaluate and develop the da Vinci robotic assisted laparoscopic anterior lumbar stand-alone interbody fusion procedure. Anterior lumbar interbody fusion is a common procedure associated with potential morbidity related to the surgical approach. The da Vinci robot provides intra-abdominal dissection and visualization advantages compared with the traditional open and laparoscopic approach. The surgical techniques for approach to the anterior lumbar spine using the da Vinci robot were developed and modified progressively beginning with operative models followed by placement of an interbody fusion cage in the living porcine model. Development continued to progress with placement of fusion cage in a human cadaver, completed first in the laboratory setting and then in the operating room. Finally, the first patient with fusion completed using the da Vinci robot-assisted approach is presented. The anterior transperitoneal approach to the lumbar spine is accomplished with enhanced visualization and dissection capability, with maintenance of pneumoperitoneum using the da Vinci robot. Blood loss is minimal. The visualization inside the disc space and surrounding structures was considered better than current open and laparoscopic techniques. The da Vinci robot Surgical System technique continues to develop and is now described for the transperitoneal approach to the anterior lumbar spine. 4.

  2. Punções do estroma anterior no tratamento da ceratopatia bolhosa

    OpenAIRE

    Gomes,José Alvaro Pereira; Haraguchi,Daniel Keizo de Medeiros; Zambrano,Delbis Uzcátegui; Villavicencio,Luis Izquierdo; Cunha,Marcelo C.; Freitas,Denise de

    2000-01-01

    Objetivo: Avaliar o efeito terapêutico das punções do estroma anterior corneal em pacientes com ceratopatia bolhosa (CB). Métodos:Vinte e cinco pacientes com CB sintomáticos, com baixa visão, com e sem indicação de transplante de córnea, foram avaliados antes, uma, 4 e 12 semanas após punções estromais anteriores realizadas com agulha #25 à lâmpada de fenda. Em cada visita, os pacientes foram questionados sobre intensidade da dor, fotofobia, sensação de corpo estranho, além de serem submetido...

  3. Anatomia microcirúgica da substâcia perfurada anterior basal humana Microsurgical anatomy of the human basal anterior perforated substance

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    Arlindo Alfredo Silveira D’Ávila

    2006-06-01

    Full Text Available A substância perfurada anterior constitui referencial na base do encéfalo. Localizada acima da bifurcação subaracnóidea da artéria carótida interna em sua porção basal e junto à artéria comunicante anterior na face inter-hemisférica, é transfixada por ramos perfurantes dirigidos aos núcleos telencefálicos corticais, cápsula interna e parte do tálamo. Por injeção intravascular de gelatina carminada, resina de Batson e látex, analisamos 50 hemisférios cerebrais humanos adultos de ambos os sexos, sob o microscópio cirúrgico. Objetivamos contribuir para a determinação da origem, número e topografia dos ramos destinados a essa região, seu curso, anastomoses e territórios de penetração. Propusemo-nos também a analisar a contribuição da artéria comunicante anterior à substância perfurada anterior. Foram encontradas variações anatômicas, incluindo anastomoses, envolvendo principalmente a artéria cerebral média e a artéria coróidea anterior. Estes conhecimentos são de interesse clínico-cirúrgico em razão da freqüência de patologias vasculares e tumorais a ela relacionadas.The anterior perforated substance (APS is a landmark in the basal forebrain. It has a basal face located above the carotid bifurcation in the subarachnoid space, and an interhemispheric one. It is the site of passage of the arteries to the caudate nucleus, putamen, internal capsule, adjacent areas of the globus pallidus and thalamus. Fifty hemispheres from twenty-five adult cadavers were obtained. The arteries were perfused with colored latex, Batson’s resin and gelatin colored with carmine. Using a surgical microscope we have determined the origin, local and number of origin from the parent vessel. The sites of penetration in the mediolateral and anteroposterior direction were also recorded. The anterior communicating artery contribution to the basal APS was reviewed. Significant vascular variations and anastomoses were encountered

  4. Mini-implantes ortodônticos como auxiliares da fase de retração anterior Orthodontic mini-implants assisting the anterior retraction phase

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    Carlo Marassi

    2008-10-01

    Full Text Available INTRODUÇÃO: os mini-implantes ortodônticos se estabeleceram como um importante método de ancoragem e vêm auxiliando os ortodontistas nas várias etapas do tratamento ortodôntico, eliminando, em grande parte, a necessidade de colaboração dos pacientes e tornando os resultados mais previsíveis. OBJETIVO: este artigo descreve os principais aspectos do uso dos mini-implantes como auxiliares da fase de retração anterior, trazendo considerações sobre suas indicações, quantidade de movimentação dos dentes anteriores, os vetores de força de retração, o controle vertical, o posicionamento dos mini-implantes, os tipos de apoio na região anterior e a força a ser utilizada. São citados os sítios de instalação mais usados para a retração anterior e abordados fatores que deverão ser controlados durante o fechamento de espaço. Por fim, são citadas algumas considerações clínicas sobre o uso dos mini-implantes nessa importante fase do tratamento ortodôntico.INTRODUCTION: The use of orthodontic mini-implants has settled as an important anchorage method and is aiding the orthodontists in the several stages of the treatment, largely eliminating the need of patients' compliance, and turning the results more predictable. AIM: This article describes the main aspects of the use of mini-implants as auxiliaries on the retraction phase of the anterior teeth, bringing considerations about their indications, amount of movement of the anterior teeth, the vectors of retraction force, the vertical control and evaluation of the incisors vestibulolingual tipping, the positioning of the mini-implants, the support types in the anterior area and the force to be applied. The placement sites best used for the anterior retraction are mentioned, and the factors that should be controlled during the space closure are approached. Lastly, some clinical considerations on the use of mini-implants in such important phase of the orthodontic treatment are

  5. Tratamento microcirúrgico de aneurismas da artéria comunicante anterior

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    Luiz Carlos Mendes Faleiro

    1973-12-01

    Full Text Available Os autores descrevem o tratamento microcirúrgico realizado em oito pacientes que tiveram hemorragia subaracnóidea espontânea por rotura de aneurisma da artéria comunicante anterior. A conduta clínica pré-operatória é apresentada sendo dada ênfase às condições do paciente antes do ato cirúrgico. A técnica cirúrgica é descrita em detalhe, sendo salientado o uso do microscópio binocular. Dos 8 pacientes, dois (25% tinham mais de um aneurisma que foram tratados durante a mesma operação. A única complicação cirúrgica foi meningite pós-operatória em um paciente; esta complicação cedeu completamente ao tratamento. Após a operação 88% dos pacientes retornaram ao seu trabalho, não tendo havido óbito em virtude do tratamento.

  6. Tratamento artroscópico da instabilidade anterior do ombro: estudo retrospectivo de 159 casos Anterior instability of the shoulder: retrospective study on 159 cases

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    Arnaldo Amado Ferreira Neto

    2011-01-01

    Full Text Available OBJETIVO: Análise dos resultados de 159 pacientes com instabilidade anterior do ombro submetidos ao tratamento artroscópico de janeiro de 2001 a dezembro de 2005. MÉTODOS: Estudo retrospectivo de prontuários com dados completos. RESULTADOS: Em 108 pacientes notou-se a lesão de Bankart e em 62 pacientes a lesão do tipo SLAP estava presente. Utilizou-se em média 2,7 âncoras. Apresentaram complicações 42 casos; 14 tinham dor aos esforços, 12 tinham algum grau de diminuição da rotação externa, 16 apresentaram recidiva. Os pacientes que evoluíram com complicações utilizaram em média 2,5 âncoras, enquanto naqueles sem complicações a média foi de 2,8 (pOBJECTIVE: To analyze the results of 159 patients with anterior instability of the shoulder submitted to arthroscopic treatment from January 2001 to December 2005. METHODS: Retrospective study of complete patient records. RESULTS: In 108 patients the Bankart lesion was found, while in 62 patients, SLAP type lesions were found. An average of 2.7 anchors was used. 42 cases presented complications; 14 had pain on effort, 12 had some degree of reduction of external rotation, and 16 had recorrence. The patients who developed complications used an average of 2.5 anchors, while those without complications used an average of 2.8 anchors (p<0.05. Of the 35 patients with anterior glenoid bone lesion, 8 had recorrence, while of the 124 patients without fractures, 8 had recorrence (p<0.05. Of the 113 patients with first-time traumatic dislocations, 12 developed limitation of external rotation, while in 46 atraumatic cases none developed limitation (p<0.05. Of the patients with SLAP lesion, 11 developed pain, while in the cases without this lesion, only 3 presented pain (p<0.05. CONCLUSION: There were more recurrences (deveria ser plural e recurrences, nao recurrence in cases of anterior glenoid bone lesion. Post-operative pain was more frequent when the lesion type was SLAP. Limitation of

  7. Efetividade da crioterapia após reconstrução do ligamento cruzado anterior Effectiveness of cryotherapy after anterior cruciate ligament reconstruction

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    Camila Dambros

    2012-01-01

    Full Text Available OBJETIVO: Avaliar a efetividade da crioterapia no pós-operatório imediato de reconstrução do ligamento cruzado anterior (LCA, em relação à redução da dor e melhora da amplitude de movimento (ADM do joelho. MÉTODOS: Trata-se do estudo piloto de um ensaio clínico prospectivo randomizado. Os pacientes (n=25 foram randomizados em dois grupos: (A Grupo Intervenção (n=10 que realizou um protocolo fisioterapêutico e fez uso do gelo por 20 minutos, duas vezes ao dia; e o Grupo (B Controle (n=9, que realizou o mesmo protocolo, duas vezes ao dia. A intensidade da dor foi avaliada pela Escala Análoga Visual e a ADM pela goniometria. RESULTADOS: O Grupo (A Intervenção obteve melhora absoluta e percentual quando comparado ao (B Controle, tanto para os parâmetros de dor, ADM de flexão e extensão do joelho. CONCLUSÃO: A crioterapia no pós-operatório imediato de reconstrução do LCA foi efetiva para melhorar a dor e a ADM do joelho. Nível de Evidência I, Estudo Clínico Randomizado.OBJECTIVE: The purpose of this study was to evaluate cryotherapy effectiveness in the immediate postoperative period of ACL reconstruction to improve pain and range of motion (ROM of the knee. METHODS: This is a pilot study of a prospective and randomized clinical trial. Patients (n=25 were divided into two groups: Intervention (A group (n=10: patients were submitted to an inpatient physical therapy protocol and received ice compress for 20 minutes, twice a day; Control (B group (n=9: patients had the same protocol, twice a day. The pain intensity was evaluated with the visual analogic scale (VAS and range of motion was measured with a goniometer. RESULTS: The Intervention (A group had important absolute and percentual improvement when compared with the Control (B group regarding measures of pain and knee flexion/extension ROM. CONCLUSION: Cryotherapy in the immediate postoperative period of ACL reconstruction was effective to improve pain and range of

  8. Avaliação da composição molecular da cápsula anterior da lente de cães idosos com catarata de alto risco

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    Ana Paula Hvenegaard

    Full Text Available Resumo: Atualmente, a cápsula anterior e o epitélio da lente tem sido cada vez mais estudados, com o intuito de reduzir as possíveis complicações do pós-operatório da remoção da catarata, tal como a opacidade da cápsula posterior, alteração ocasionada principalmente pela diferenciação e migração das células do epitélio lenticular para a cápsula posterior da lente. O objetivo deste estudo foi analisar a composição molecular da cápsula anterior da lente pela técnica histoquímica de PAS (avaliação de proteoglicanos e picrosirius red (avaliação de colágeno IV, em cães idosos com catarata diabética e não diabética do tipo hipermadura, submetidos ao uso ou não de azul de tripano a 0,1 % durante a facoemulsificação. Vinte e sete cães foram estudados, incluindo 21 fêmeas e 6 machos, de 8 a 12 anos de idade (média = 9,6 anos, de diversas raças e divididos em 2 grupos: GC (catarata hipermadura e GCD (catarata diabética. Os resultados das análises realizadas mostraram que ambas as amostras, tanto as provenientes das cataratas hipermaduras, quanto das diabéticas, apresentam semelhante composição molecular de proteoglicanos e colágeno IV e isto independente da utilização de azul de tripano a 0,1 %. Conclui-se, portanto, que se os resultados obtidos forem decorrentes de alterações provocadas pelo rápido metabolismo da catarata diabética e pela cronicidade da catarata hipermadura sugere-se que o comprometimento da estrutura capsular seja de intensidade equivalente e, por consequência, que isto também possa prejudicar o metabolismo das células do epitélio anterior da lente, diminuindo assim a incidência da opacidade da cápsula posterior de cães com catarata diabética e hipermadura submetidos à facoemulsificação.

  9. 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

  10. Instrumentação anterior da coluna em espondilite tuberculosa mal de pott: Relato de caso

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    Farage Luciano

    2002-01-01

    Full Text Available Relatamos caso de tratamento cirúrgico com instrumentação anterior em espondilite tuberculosa (mal de Pott, em mulher de 71 anos, que se encontrava em tratamento para tuberculose na forma pulmonar e evoluiu com dor lombar, dificuldade progressiva para deambular, cifose e disfunção vesical. A ressonância magnética revelou lesão nos corpos vertebrais de T12 e L1 com abcesso paravertebral. A paciente foi tratada cirurgicamente por acesso tóraco-abdominal lateral. Os corpos vertebrais foram ressecados, foi instalado uma gaiola vertical (mesh cage e a coluna foi estabilizada com placa lateral (Z plate e parafusos fixados em T11 e L2. Essa técnica permite boa artrodese dos corpos vertebrais remanescentes e boa estabilidade da coluna, sem comprometer a eficácia dos tuberculostáticos. A paciente foi avaliada um ano após a operação e não apresentava déficit motor, dor residual e a cifose foi desfeita.

  11. Luxação anterior exposta do quadril em um adulto: relato de caso e revisão da literatura

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    Anderson Luiz de Oliveira

    2014-01-01

    Full Text Available A luxação anterior exposta do quadril é condição rara e resulta de trauma de alta energia. Até o momento, foram descritos na literatura 10 casos. Sua raridade deve-se à estabilidade inerente da articulação e à posição profunda na pelve, com fortes ligamentos e musculatura volumosa ao seu redor. Influenciam o prognóstico dessa lesão diversos fatores, tais como grau de contaminação, lesões de partes moles, idade do paciente e, principalmente, atraso na redução. As principais complicações são: artrose do quadril, com incidência que pode chegar a 50% dos casos, quando associada a fraturas da cabeça femoral; e osteonecrose da cabeça do fêmur, com incidência entre 1,7% e 40% (nos casos de luxação anterior fechada. Por causa da raridade e da potencial incapacidade funcional decorrente dessa lesão, relatamos o caso de um homem de 46 anos vítima de acidente automobilístico. Foi feita redução do quadril (luxação do tipo anterior alta nas primeiras três horas pós-trauma. O paciente foi mantido sem carga até a sexta semana, com carga total após a 10ª semana. Após um ano de seguimento, observou-se resultado funcional pobre (Harris Hip Score: 52, provavelmente por causa de lesão labral associada, porém sem sinais na ressonância nuclear magnética de osteonecrose da cabeça femoral.

  12. Estudo radiográfico da reconstrução do ligamento cruzado anterior pela via transtibial

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    Rafael de Souza Campos Fernandes

    2014-07-01

    Full Text Available INTRODUÇÃO: A ruptura do ligamento cruzado anterior (LCA é frequente devido às atividades esportivas, e sua reconstrução tem sofrido constantes modificações com o aprimoramento das técnicas cirúrgicas. OBJETIVO: Avaliar radiologicamente o posicionamento dos túneis tibial e femoral com o uso da técnica transtibial auxiliada pela pré-perfuração femoral. MÉTODO: Análise radiológica (AP e perfil, na quarta semana de pós-operatório de 98 pacientes, totalizando 100 casos de reconstrução do LCA. Três examinadores avaliaram o posicionamento dos túneis tibial e femoral pelos seguintes métodos: Scanlan, Staubli e Rauschning e Bernard. RESULTADOS: O posicionamento do ângulo α (AP foi de 64,13o (± 4,29o e do ângulo β (perfil, de 57,28o (± 4,41o. A média de posicionamento tibial foi de 41,99% (± 5,14%. O enxerto do LCA foi inserido no côndilo lateral do fêmur e a média em porcentagem de posicionamento no quadrante verde foi de 62%, no quadrante amarelo, de 37% e de 1% no vermelho. CONCLUSÕES: A técnica transtibial de reconstrução do LCA auxiliada pela pré-perfuração femoral proporciona o posicionamento anatômico do enxerto na grande maioria dos casos, conforme comprovação radiológica.

  13. Diamond burr superficial keratectomy in the treatment of visually-significant anterior corneal lesions Ceratectomia superficial com broca de diamante no tratamento de lesões anteriores da córnea

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    João Baptista Nigro Santiago Malta

    2008-06-01

    Full Text Available PURPOSE: To evaluate the efficacy and safety of diamond burr superficial keratectomy in the treatment of visually-significant anterior corneal lesions. METHODS: A retrospective review of 23 eyes (23 patients. Pre- and postoperative visual acuities and refractions, slit-lamp biomicroscopic findings, and the incidence of recurrence of disease after keratectomy were studied. RESULTS: Nineteen eyes had map-dot-fingerprint basement membrane dystrophy and 4 had Salzmann's nodular degeneration. All patients presented with decreased vision, as well as varying degrees of glare, halos, and monocular diplopia. Postoperative follow-up ranged from 3 to 39 months (mean 10.6 months, and no recurrence of the original disease occurred within this period. This procedure improved the best-corrected visual acuity from 20/36 (LogMar 0.250 to 20/24 (LogMar 0.076 by LogMar statistical evaluation (pOBJETIVO: Avaliar a eficácia e segurança da ceratectomia superficial com broca de diamante no tratamento das lesões anteriores da córnea. MÉTODOS: Foi realizado estudo retrospectivo de 23 olhos de 23 pacientes. Foram avaliados acuidade visual e refração pré e pós-operatório, biomicroscopia e incidência de recorrência da doença após ceratectomia. RESULTADOS: Dos 23 olhos avaliados, 19 olhos apresentavam distrofia da membrana basal (map-dot-fingerprint e 4 degeneração nodular de Salzmann. Todos os pacientes apresentavam diminuição da acuidade visual, assim como graus variados de ofuscamento, halos e diplopia monocular. O seguimento pós-operatório variou entre 3 e 39 meses (média de 10,6 meses e não houve recorrência da doença original nesse período. O procedimento melhorou a acuidade visual com melhor correção de 20/36 (LogMar 0,250 para 20/24 (LogMar 0,076 com p<0,001. Em relação as mudanças refracionais não houve significância (p=0,232 sendo o equivalente esférico pré-operatório de - 0,36 ± 2,28DE e pós-operatório de -0,71 ± 2,26DE. As

  14. Estabilidade do reposicionamento anterior da maxila através de análise cefalométrica lateral Lateral cephalometric analysis of the stability of maxillary anterior repositioning

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    Rodrygo Nunes Tavares

    2005-06-01

    Full Text Available Este estudo cefalométrico retrospectivo foi proposto objetivando analisar a estabilidade do reposicionamento anterior da maxila, utilizando-se a osteotomia Le Fort I. A amostra consistiu de 30 telerradiografias de dez pacientes submetidos a um avanço cirúrgico da maxila, sem segmentação desta ou associação com qualquer cirurgia na mandíbula, realizado pela Área de Cirurgia Buco-Maxilo-Facial da Faculdade de Odontologia de Piracicaba - Unicamp. A mesma técnica de fixação interna rígida foi utilizada para todos os pacientes, e nenhum enxerto ou substituto ósseo foi usado. Três radiografias cefalométricas laterais foram realizadas para cada paciente, nos períodos pré e pós-operatórios imediatos, e com, no mínimo, seis meses após a cirurgia. Sobre estas radiografias foram feitas linhas de referência horizontal e vertical. Os pontos cefalométricos utilizados para calcular as mudanças de posição da maxila foram tanto esqueléticos, quanto dentários. A análise estatística (teste t de student pareado não demonstrou diferença estatística significante entre os intervalos pós-operatórios imediato e com no mínimo seis meses. Concluímos que o reposicionamento anterior da maxila, utilizando-se a osteotomia Le Fort I, com fixação interna rígida e sem o uso de enxertos autógenos ou qualquer substituto ósseo, é um procedimento estável.This is a retrospective cephalometric study designed to investigate the stability after anterior maxilla repositioning, by Le Fort I osteotomy. Thirty cephalometric radiographs were selected, from ten patients submitted to one-piece surgical maxillary advancement, with no concomitant mandibular surgery, performed by the Division of Oral and Maxillofacial Surgery of Piracicaba Dental School - Unicamp. These cases were submitted to the same internal rigid fixation technique, with no use of bone grafts or any bone substitute. Three lateral cephalometric radiographs were obtained for each

  15. Long-term stability of an anterior open-bite malocclusion treated in the mixed dentition: a case report Estabilidade a longo prazo do tratamento da mordida aberta anterior na dentadura mista: relato de caso clínico

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    Márcio Rodrigues de Almeida

    2006-12-01

    Full Text Available A clinical case with anterior open-bite, treated in the mixed dentition, is presented. This approach demonstrates one of the possible approaches of treatment, which is capable of interfering with growth and redirecting its vectors. Orthodontic and orthopedic methods were used, consisting of slow maxillary expansion, through a fixed palatal crib soldered in a bi-helix appliance, and high-pull traction on the mandible for 16 hours a day. After eight years of follow-up, stable outcomes were accomplished. These results may be explained by the fact that treatments were performed at the appropriate period of development, thus establishing perioral muscular equilibrium, matching the final period of facial growth. The combination of orthodontic and orthopedic treatments was necessary to prevent the need of further orthognathic surgery treatment.Apresentou-se um relato de caso clínico de mordida aberta anterior, tratada em dentadura mista, demonstrando uma das possíveis formas de tratamento, capaz de interferir no crescimento e redirecionar seus vetores. Os protocolos ortodônticos e ortopédicos utilizados foram a expansão lenta da maxila, utilizando grade palatina soldada a um expansor bihélice, com tração alta na mandíbula, num período diário de 16 horas. Oito anos de estabilidade foram alcançados, explicados pelo fato de o tratamento ter sido conduzido no momento oportuno do desenvolvimento, o que estabeleceu equilíbrio entre os músculos peribucais, em conjunto com o período final do crescimento. A combinação do tratamento ortodôntico e ortopédico foi necessária para se evitar a necessidade de tratamento cirúrgico.

  16. Uveíte anterior como manifestação da Doença de Kikuchi e Fujimoto Anterior Uveitis as an ocular manifestation of Kikuchi and Fujimoto's Disease

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    Marco Aurelio Varella Figueiredo

    2008-04-01

    Full Text Available Apresentação de um caso de febre de origem obscura numa paciente feminina de 35 anos, com queda do estado geral, adenomegalia cervical posterior, monilíase oral, parotidite e irite.Após o parecer oftalmológico, o tratamento foi iniciado e posteriormente com o resultado do exame histopatológico de um linfonodo, diagnosticou-se a Doença de Kikuchi e Fujimoto. Sugerimos que a uveíte anterior seja reconhecida como mais um sinal de suspeita desta doença. São comentados os achados oculares, os aspectos histopatológicos e o tratamento da Doença de Kikuchi e Fujimoto.Report of a case on Kikuchi and Fujimoto's Disease in a young lady who developed a long standing spiking fever, weight loss, cervical adenomegalia, oral moniliasis, parotiditis and iritis.The histopathological findings, course and treatment as well as the importance of a multidisciplinar approach are commented.

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

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    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.

  18. O papel da membrana de Descemet na patogenia do edema corneano após cirurgia de segmento anterior

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    Karine Feitosa Ximenes

    2014-10-01

    Full Text Available Objetivo: Encontrar fatores importantes na patogenia do edema corneano pós-cirúrgico, em casos de pós-facectomia e pósceratoplastia, por meio do estudo dos achados histopatológicos, a fim de ver o que pode ser feito para evitar sucessivas ceratoplastias. Métodos: Estudo retrospectivo descritivo das alterações histopatológicas de casos de edema corneano pós-cirúrgicos. Os tecidos foram provenientes de ceratoplastia penetrante no período compreendido entre setembro de 2009 e agosto de 2013. Foi realizada revisão de prontuários em busca principalmente de informações sobre cirurgias prévias. Resultados: Foram incluídos 70 botões corneanos, sendo 34 de pacientes do sexo masculino e 36 do sexo feminino. A média das idades foi de 63,1±17,20 (média ± DP anos. A maioria dos casos era de falência após transplante (71,43%. A rarefação celular foi a principal alteração encontrada no endotélio (58 casos, sendo também a alteração histopatológica mais frequente. Na membrana de Descemet, predominaram as alterações de integridade (53 casos, seja na forma de ruptura, de descolamento isolado ou de descolamento associado à ruptura. Foi frequente a associação de alterações endoteliais à ausência da integridade da membrana de Descemet. Conclusão: Descolamento da membrana de Descemet é um achado histopatológico frequente nos casos de edema corneano pós-cirúrgicos estudados, devendo ser considerado um fator importante na patogenia dos mesmos. Essa alteração deve ser procurada com atenção nos pós-operatórios, a fim de ser diagnosticada e tratada precocemente, vindo possivelmente a evitar muitas indicações de ceratoplastia.

  19. Resultados da cirurgia de latarjet no tratamento da instabilidade anterior traumática do ombro associada à erosão óssea da cavidade glenoidal - seguimento mínimo de um ano Results from latarjet surgery for treating traumatic anterior shoulder instability associated with bone erosion in the glenoid cavity, after minimum follow-up of one year

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    Roberto Yukio Ikemoto

    2011-10-01

    Full Text Available OBJETIVO: Avaliar o resultado da cirurgia de Latarjet para pacientes com luxação recidivante anterior do ombro com perda óssea maior que 25% da cavidade glenoidal. MÉTODO: Avaliamos 26 pacientes submetidos à cirurgia de Latarjet. O tempo médio de seguimento foi de 38 meses e a média etária, de 28 anos. Os pacientes foram avaliados quanto à amplitude de movimento e pelas escalas de Rowe e UCLA, no período pré-operatório como no período pós-operatório, radiografias do ombro para avaliar a presença de artrose, posição e consolidação do enxerto e posicionamento dos parafusos. A análise estatística foi utilizada para avaliar se haveria relação entre o número de episódios de luxação, presença de artrose, correlação entre artrose e limitação da rotação lateral. Comparar a diferença entre o arco de movimento do lado operado com o não acometido e avaliação funcional pré e pós-operatória das escalas de UCLA e Rowe. RESULTADOS: A elevação e rotação lateral foram estatisticamente inferiores do lado operado. A escala de UCLA e a de Rowe mostrou uma melhora estatisticamente significante dos resultados clínico-funcionais (P OBJECTIVE: Evaluate the results from the Latarjet procedure in patients with anterior recurrent dislocation of the shoulder who present bone loss of the glenoid cavity greater than 25%. METHODS: Twenty six male patients underwent the Latarjet procedure, The bone loss was evaluated by means of radiography using the Bernageau view and by means of CAT scan. The patients were evaluated with regard to range of motion, using the Rowe and UCLA scales, before and after the operation, and by radiographs to assess the presence of arthrosis, position and consolidation of the graft and positioning of the screws. Statistical analysis was used to assess whether there was any relationship between the number of episodes of dislocation and the presence of arthrosis, , and any relationship between arthrosis and

  20. Territórios de distribuição da artéria coroídea anterior em hemisférios cerebrais humanos de brancos e negros

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    José Furlani

    1970-03-01

    Full Text Available Foi estudada a distribuição da a. coroídea anterior em 10 hemisférios cerebrais humanos de brancos e negros. Todas as peças foram injetadas a fresco, com massa corada e fixadas em formol. Nelas, a a. coroídea anterior foi dissecada desde a sua origem até a sua incorporação ao plexo coróide do corno inferior do ventrículo lateral. Em seguida à dissecção, as peças foram cortadas em fatias horizontais, de aproximadamente 0,5 cm de espessura. Constatou-se que a a. coroídea anterior se origina da a. carótida interna, e que ela não apresenta diferenças étnicas e sexuais, estatisticamente significantes, no que diz respeito ao seu território de distribuição. Este compreende, segundo nossas observações, as seguintes estruturas: úncus, hipocampo, tracto óptico, plexo coróide do corno inferior do ventrículo lateral e braço posterior da cápsula interna (100%; cauda do núcleo caudado (99% ± 0,99; 3/5 intermédios da porção cranial da base do pedúnculo cerebral, corpo amigdalóide e zona incerta (98% ± 1,40; 1/5 lateral da porção cranial da base do pedúnculo cerebral (92% ± 2,71; porção anterior do corpo geniculado lateral (89% ± 3,13; segmento medial do globo pálido (88% ± 3,25; núcleo subtalâmico (39% ± 4,88; grupamento nuclear lateral do tálamo (26% ± 4,39; segmento lateral do globo pálido (17% ± 3,76; grupamento nuclear posterior do tálamo (13% ± 3,36; porção posterior do putamen (9% ± 2,86; 1/5 medial da porção cranial da base do pedúnculo cerebral (7% ± 2,55 e substância negra (3% ± 1,71.

  1. Anterior approach to the cervicothoracic junction: case series and literature review Acceso anterior de las lesiones de la unión cérvicotoracica: serie de casos y revisión de la literatura Acesso anterior das lesões da junção cérvicotorácica: série de casos e revisão da literatura

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    Asdrubal Falavigna

    2009-06-01

    normalmente manejadas con abertura del manubrio a fin de obtener un adecuado campo de trabajo para la resección de las lesiones y estabilización. La abertura del manubrio aumenta el índice de complicaciones, tiempo quirúrgico, sangramiento, intensidad del dolor y tiempo de internación.OBJETIVO: relatar a experiência dos autores no acesso anterior da junção cervicotorácica C7 a T4, em relação à definição de quando é necessária a realização da manubriotomia, quais as particularidades desta cirurgia e a avaliação dos resultados. MÉTODOS: estudo de coorte prospectivo com 14 pacientes tratados cirurgicamente de doenças da transição cervicotorácica durante o período de janeiro de 1996 a janeiro de 2009. Os pacientes foram avaliados no pré-operatório com tomografia computadorizada e ressonância magnética a fim de identificar em quais casos a manubriotomia seria necessária. A cirurgia foi realizada preferencialmente pelo lado esquerdo, utilizando-se a via de acesso anterior de Smith-Robinson e, se houvesse necessidade, combinado à abertura do manúbrio. Quando realizada a corpectomia, foram utilizados Mesh e placa cervical para estabilização, enquanto na cirurgia de hérnia discal C7-T1, a reconstrução foi feita com PEEK e placa cervical. RESULTADOS: a média de idade foi 63 anos, sendo 7 pacientes do sexo masculino. A patologia mais comum foi a doença metastática (n=8 seguida pela hérnia discal C7-T1 (n=4. As complicações relacionadas ao procedimento cirúrgico foram duas: um paciente com disfonia causada por hematoma local e outro caso com infecção pulmonar. O tempo médio da cirurgia, o volume de sangramento, a intensidade da dor, a necessidade de medicação analgésica e o tempo de hospitalização foram menores nos pacientes nos quais a manubriotomia não foi necessária. CONCLUSÃO: o acesso anterior à junção cervicotorácica é um acesso rápido e de baixa morbidade. Lesões que envolvem o corpo vertebral de T1 ou o espaço discal

  2. Autotransplante de cordas tendíneas: nova técnica para o tratamento cirúrgico da insuficiência mitral por rotura de cordas tendíneas da cúspide anterior Allotransplantation of chordae tendineae: new technique for the surgical approach of mitral insufficiency

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    Francisco Gregori Jr

    1992-12-01

    Full Text Available Uma das causas mais freqüentes de prolapso valvar mitral, com conseqüente regurgitação, é a rotura de cordas tendíneas. Várias técnicas têm sido empregadas em tal situação. Entretanto, a substituição valvar mitral tem sido o procedimento mais utilizado. E apresentada uma nova técnica cirúrgica empregada em 4 pacientes com insuficiência valvar mitral severa devido a rotura de cordas tendíneas da cúspide anterior da valva mitral. Um autotransplante de cordas da valva tricúspide para a valva mitral é realizado. Em 2 casos, um retalho é retirado da cúspide anterior da valva tricúspide com cordas tendíneas e parte do músculo papilar correspondente. Nos outros 2 casos a cúspide posterior da valva tricúspide foi retirada, inteiramente, com cordas e músculo papilar. Na primeira variante técnica, a cúspide anterior da valva tricúspide foi reparada e, na segunda, através, da plicatura do anel, a valva tricúspide foi transformada em bicúspide. A peça retirada é transplantada para a valva mitral, sendo suturada a cúspide doadora com a cúspide anterior da valva mitral e o músculo papilar doador com o topo do músculo papilar posterior da valva mitral em 3 casos e com o músculo papilar anterior e 1 caso. Os 4 pacientes foram reestudados clínica e laboratorialmente aos 15, 11, 2 e 1 mês de pós-operatório, respectivamente, com execelente evolução. Apesar da limitada experiência, acreditamos ser esta nova técnica uma boa alternativa para o tratamento cirúrgico da insuficiência mitral por rotura de cordas tendíneas da cúspide anterior.One of the most frequent causes of mitral valve prolapse is rupture of the chordae tendineae. Several techniques have been used to correct severe mitral regurgitation. However, mitral valve replacement is the principal surgical approach to it. We describe a technique used in four patients with marked mitral regurgitation due to ruptured chordae tendineae of the anterior leaflet. We

  3. Papel da videoendoscopia da laringe no diagnóstico de lesão do nervo laríngeo recorrente na abordagem cervical anterior Papel de la videoendoscopía de laringe en el diagnóstico de lesión del nervio laríngeo recurrente en el abordaje cervical por vía anterior The importance of larynx videoendoscopy in diagnosis of recurrent laryngeal nerve injury after anterior approach

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    Alexandre Coutinho Borba

    2010-12-01

    Full Text Available INTRODUÇÃO: o reconhecimento da lesão do nervo laríngeo recorrente (NLR após tratamento cirúrgico de hérnia discal cervical via anterior é importante na evolução clínica do paciente e, em especial, nos casos de reintervenção. O real papel da videoendoscopia da laringe (VEL de rotina no pós-operatório não tem sido completamente estudado. OBJETIVO: identificar a prevalência de lesões do NLR em pacientes sintomáticos ou não através da VEL após cirurgia de hérnia cervical via anterior. MÉTODOS: no período de Junho de 2009 a Julho de 2010 selecionamos 30 pacientes submetidos a tratamento cirúrgico de hérnia discal no Hospital São Lucas da PUC-RS. Realizou-se avaliação por VEL no pré-operatório e no décimo dia após a cirurgia. Pacientes que apresentaram um resultado anormal da VEL foram considerados com lesão do NLR e foram reavaliados mensalmente até a recuperação espontânea, ou no período máximo de seis meses, quando a lesão foi considerada definitiva. RESULTADOS: encontramos evidência de lesão do NLR em 3/30 (10% dos pacientes, sendo que todos se apresentavam assintomáticos no momento do exame. Dentre as lesões, 2/30 (66,6% ocorreram após abordagem cirúrgica pelo lado direito e 1/30 (33,3% pelo lado esquerdo. Não encontramos nenhuma lesão definitiva, sendo o período máximo de recuperação de 120 dias. CONCLUSÃO: a avaliação por VEL no período pós-operatório pode ser útil para diagnosticar lesões do NLR, principalmente em pacientes assintomáticos. A falta de suspeita clínica não exclui a possibilidade de lesão do LNR.INTRODUCCIÓN: el reconocimiento de la lesión del nervio laríngeo recurrente (NLR después del tratamiento quirúrgico de hernia de disco cervical por la vía anterior es importante en la evolución clínica del paciente y, principalmente, en los casos de reintervención. El real papel de la videoendoscopía de laringe (VEL de rutina en el postoperatorio no ha sido

  4. Approach-related morbidity in transthoracic anterior spine surgery: a clinical study and review of literature Morbilidad relacionada con el abordaje torácico anterior de la columna: estudio clínico y revisión de la literatura Morbidade relacionada à abordagem transtorácica anterior da coluna: estudo clínico e revisão da literatura

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    Juliane Zenner

    2010-03-01

    intercostal fueron observados en 14% de los pacientes. En ambos grupos la presencia de neuralgia intercostal tuvo impacto significativo y presentó correlación con la morbilidad (pINTRODUÇÃO: A abordagem anterior da coluna torácica tem sido utilizada por meio da toracotomia aberta (TA ou vídeo-assistida (TVA. A abordagem vídeo-assistida tem sido mencionada como a de menor morbidade do procedimento, apesar de não existir evidência científica que confirme essa observação. OBJETIVO: Observar os resultados relacionados à morbidade da toracotomia aberta para a correção de deformidade da coluna vertebral e toracotomia para a colocação de tubo de drenagem torácica, utilizando um grupo de pacientes como controle. MÉTODOS: Com base em questionário relacionado com a avaliação da morbidade da abordagem anterior da coluna torácica respondido pelos pacientes, e utilizando critérios estritos de inclusão dos pacientes, foram avaliados, em termos de porcentagem (morbidade %, 43 pacientes submetidos à toracotomia aberta para tratamento da escoliose (Grupo OTC e 30 pacientes portadores de outras doenças de menor gravidade submetidos à toracotomia para a colocação de dreno de tórax após o procedimento (por exemplo, pneumotórax (Grupo CTT. RESULTADOS: A média de idade dos pacientes de ambos os grupos foi 50,2 e 16,5 anos; seguimento clínico médio foi de 32,2 e 58,4 meses; e a extensão da incisão da pele 2,5 e 25,5 cm, respectivamente. A média do número de vértebras artrodesadas foi 5,8 no grupo submetido à toracotomia aberta para a correção de deformidade. A morbidade média (variando de 0%, nenhuma morbidade, a 100%, alta morbidade no grupo de pacientes submetidos à toracotomia para colocação de dreno de tórax foi 10,8±15,4 (0-59,5%, e 42% dos pacientes não apresentavam morbidade. No grupo submetido à toracotomia aberta para a colocação do dreno de tórax, foi observada neuralgia intercostal em 16,7%, e 35,5% dos pacientes apresentavam

  5. EFFECTS OF FLUNIXIN MEGLUMINE CONJUNCTIVAL SHOT OVER THE HUMOR AQUEOUS PROTEIN OF DOGS SUBMITTED TO THE PARACENTESIS OF THE ANTERIOR CHAMBER AVALIAÇÃO DOS EFEITOS DA FLUNIXINA MEGLUMINA, POR VIA SUBCONJUNTIVAL, SOBRE A CONCENTRAÇÃO E PADRÃO PROTEICO DO HUMOR AQUOSO DE CÃES SUBMETIDOS À PARACENTESE DA CÂMARA ANTERIOR

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    Paula Diniz Galera

    2009-12-01

    Full Text Available

    Flunixin meglumine effects, over aqueous humor proteins of eyes on dogs who were submitted to paracentesis of the anterior chamber, were evaluated. To ten adult dogs clinically healthy were given a subconjunctival shot with flunixin meglumine (1.1mg/Kg on the right eye and sterilized saline solution 0.9% on the left eye, with the same volume. After general anesthesia, were submitted to two paracentesis of the both eyes to collect 0.2mL of first and second aqueous. The samples were submitted to Bradford test, wich proteins concentrations were  15.98mg/dL ± 4.48 e 11.46mg/dL ± 2.72 for the right and the left eyes, respectively, on the first paracentesis and 119.8mg/dL ± 6.74 e 120.63mg/dL ± 22.4 for the right and the left eyes, on the second paracentesis. There was no significant statistically differences between the protein values of the treated eyes in comparison with the control one. When compared, the proteins concentrations between the first and second paracentesis of the right and left eyes, statistic differences were found between these two moments (p<0.001. SDS-PAGE showed differences in the protein patterns of aqueous humor in result of the paracentesis.

    KEY WORDS: Aqueous humor, eye, flunixin meglumine, paracentesis, proteíns.

    Avaliaram-se os efeitos da flunixina meglumina, pela via subconjuntival, sobre as proteínas do humor aquoso de olhos de cães submetidos à paracentese da câmara anterior. Dez animais adultos, clinicamente sadios, receberam, por aplicação subconjuntival, flunixina meglumina (1,1mg/kg no olho direito e solução salina estéril a 0,9% no olho esquerdo, em igual volume. Mediante anestesia geral, foram submetidos a duas paracenteses de ambos os olhos para coleta de 0,2mL de aquoso primário e secundário, respectivamente. As amostras foram submetidas ao Teste de Bradford, cujas concentrações proteicas (média e desvio-padrão obtidas foram de 15

  6. Anterior surgical management of the cervicothoracic junction lesions at T1 and T2 vertebral bodies Manejo cirúrgico via anterior das lesões da junção cérvico-torácica nos corpos vertebrais de T1 e T2

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    Asdrubal Falavigna

    2008-06-01

    Full Text Available Lesions of the cervicothoracic junction have a high propensity for causing instability and present unique challenges in the surgical treatment. Several surgical approaches to this region have been described in the literature. We report our experience in the surgical treatment of six patients with unstable lesions involving the cervicothoracic junction at T1 and T2 vertebral bodies. The patients underwent an anterior left Smith-Robinson approach and manubriotomy. Mesh and cervical plate system were used for stabilization and reconstruction of the region. No complication related to the surgical procedure was observed. In our experience, in injuries involving the T1 and T2 vertebral bodies, the transmanubrial approach offers good working room to remove the lesions and anterior reconstruction.Lesões da junção cérvico-torácica têm alta tendência em causar instabilidade e apresentam grandes desafios ao tratamento cirúrgico. Diversas abordagens cirúrgicas a esta região foram descritas na literatura. Relatamos nossa experiência no tratamento cirúrgico de seis pacientes com lesões instáveis envolvendo a junção cérvico-torácica em corpos vertebrais de T1 e T2. Os pacientes foram submetidos a uma abordagem anterior de Smith-Robinson pela esquerda e manubriotomia. Mesh e placa cervical foram utilizados para estabilização e reconstrução da região. Nenhuma complicação relacionada ao procedimento cirúrgico foi observada. Em nossa experiência, em lesões que envolvem os corpos vertebrais de T1 e T2, a abordagem transmanubrial oferece bom campo de trabalho para remoção das lesões e estabilização anterior.

  7. Descrição de técnica de redução cirúrgica das luxações facetárias da coluna cervical baixa por via anterior Descripción de la técnica quirúrgica para reducción de las luxaciones facetarias de la columna cervical baja por acceso anterior Description of surgical technique for reduction of facet dislocations of the lower cervical spine by anterior approach

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    André Rafael Hübner

    2012-12-01

    Full Text Available O trabalho descreve uma técnica cirúrgica de redução anterior das luxações facetárias da coluna cervical e discute as indicações para cirurgia por via anterior para as luxações da coluna cervical baixa. A técnica descrita neste artigo oferece excelentes resultados, conforme revisão bibliográfica e dos resultados do Serviço, tendo sido aplicada em até 95% dos casos de fraturas-luxações. Não será abordada a apresentação de resultados neste trabalho, apenas a descrição e discussão da técnica aberta por via anterior. Observações de quarenta e um pacientes tratados nos últimos dez anos por esta técnica demonstram bons resultados quanto a pós-operatório menos doloroso, recuperação funcional extremamente rápida e complicações pouco frequentes.El artículo describe una técnica quirúrgica para las luxaciones facetarias de la columna cervical y discute las indicaciones para la cirugía de luxación de la columna cervical baja por lo acceso anterior. La técnica descrita en este artículo proporciona excelentes resultados según la revisión de la literatura y los resultados del Servicio, después de haber sido aplicado a 95% de los casos de fracturas-luxaciones. No serán abordados resultados, sino que únicamente la descripción y discusión de la técnica de reducción abierta por acceso vía anterior. Las observaciones en cuarenta y un pacientes operados en los últimos diez años por esta técnica muestran resultados sorprendentes con respecto a un pos operatorio menos doloroso, con recuperación funcional extremadamente rápida y complicaciones menos frecuentes.This paper describes a surgical technique for anterior reduction of the spinal facets dislocations and discusses its indications for surgery of lower cervical dislocations by anterior approach. The technique described in this article provides excellent results according to literature review and the results of the Service, having been applied to 95% of

  8. Prevalência de mordida aberta anterior e protrusão dentária em pré-escolares da cidade do Recife (PE, Brasil Prevalence of anterior open bite and overjet preschoolers in the city of Recife (PE, Brazil

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    Ana Flávia Granville-Garcia

    2010-10-01

    Full Text Available O objetivo deste trabalho foi verificar a prevalência de maloclusões (mordida aberta anterior, protrusão dentária e sua associação com idade, gênero e tipo de escola em 2.651 pré-escolares da cidade do Recife, PE, Brasil. As crianças foram sentadas em cadeiras escolares na sala da própria creche/escola para a execução do exame clínico; os menores de dois anos foram atendidos no sistema perna-perna ou joelho-joelho, por meio de iluminação natural e artificial. A protrusão dentária foi considerada quando sobressaliência maior que 3 mm, mensurada por meio de sonda periodontal milimetrada. A mordida aberta anterior foi registrada quando não houve contato com os dentes anteriores e os posteriores se mantiveram em oclusão. Foi registrada em ficha clínica a combinação dos dois tipos de maloclusão, ou seja, de mordida aberta e de protrusão dentária. Os dados foram avaliados estatisticamente pelo teste Qui-quadrado e a medida para avaliar a associação entre os eventos foi o odds ratio. A prevalência de protrusão dentária foi 66,1% e mordida aberta anterior, 19,8%; houve associação entre as maloclusões, idade e tipo de escola, porém não houve associação estatisticamente significante entre maloclusão e gênero. Conclui-se que a prevalência de maloclusões em pré-escolares foi elevada e esteve associada à idade e tipo de escola.The objective of this work was to verify the prevalence of malocclusions (anterior open bite, overjet and its association with age, gender and type of school with a sample of 2,651 preschool children in the city of Recife, PE, Brazil. The children were seated in school chairs in the room of the day care/school for the clinical exam, children aging two years or less were assisted in the system knee-knee, through natural and artificial illumination. The dental protrusion was verified when the overjet was larger than 3 mm through periodontal probe in millimeters. The presence of anterior open

  9. Effectiveness of intra-articular lidocaine injection for reduction of anterior shoulder dislocation: randomized clinical trial Efetividade da injeção intrarticular de lidocaína na redução das luxações anteriores do ombro: ensaio clínico randomizado

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    Marcel Jun Sugawara Tamaoki

    2012-01-01

    Full Text Available CONTEXT AND OBJECTIVE: Shoulder dislocation is the most common dislocation among the large joints. The aim here was to compare the effectiveness of reduction of acute anterior shoulder dislocation with or without articular anesthesia. DESIGN AND SETTING: Prospective randomized trial conducted in Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp. METHODS: From March 2008 to December 2009, 42 patients with shoulder dislocation were recruited. Reductions using traction-countertraction for acute anterior shoulder dislocation with and without lidocaine articular anesthesia were compared. As the primary outcome, pain was assessed through application of a visual analogue scale before reduction, and one and five minutes after the reduction maneuver was performed. Complications were also assessed. RESULTS: Forty-two patients were included: 20 in the group without analgesia (control group and 22 in the group that received intra-articular lidocaine injection. The group that received intra-articular lidocaine had a statistically greater decrease in pain over time than shown by the control group, both in the first minute (respectively: mean 2.1 (0 to 5.0, standard deviation, SD 1.3, versus mean 4.9 (2.0 to 7.0, SD 1.5; P CONTEXTO E OBJETIVO: A luxação do ombro é a mais frequente luxação das grandes articulações. O objetivo foi comparar a efetividade da redução da luxação anterior aguda do ombro, com ou sem anestesia articular. TIPO DE ESTUDO E LOCAL: Ensaio clínico randomizado desenvolvido na Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-Unifesp. MÉTODOS: De março de 2008 a dezembro de 2009 foram recrutados 42 pacientes com luxação anterior do ombro agudas. Foi comparada a redução de tração e contra-tração com e sem anestesia intra-articular com lidocaína. Como desfecho primário, a dor foi avaliada por meio da escala visual analógica antes da redução e um e cinco minutos após a

  10. Implantação do mixoma infeccioso do coelho na câmara anterior do ôlho da cobaia

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    C. Magarinos Torres

    1948-09-01

    Full Text Available Mammalian cancer as well as the Rous chicken sarcoma has been successfully transplanted into the anterior chamber of the eyes of guinea pigs. It was of interest, therefore, to see if the infectious myxomatosis of rabbits, another representative of the infectious tumors, could be grown in the anterior chamber of the guinea pig eye, and, if growth occurred, to compare the tumor's behaviour with that of growths of the above mentioned etiology. Forty-three full-grown guinea pigs from mixed stocks were used throughout, and seventy-eight heterologous transplantation experiments were performed. The grafts measuring less than 2 mm. in diameter were cut from the subcutaneous tissue in skin lesions of rabbits with infectious myxomatosis recently killed. The transfer to the anterior chamber was performed after the usual technique. Some degree of partial survival was found in 23,8% of the grafts, in which typical myxoma cells could be demonstrated fifteen days after the transplantation. The transplant apparently does not increase in size, differing in that respect from that of the Rous chicken sarcoma, which increases in size by 2 or 3 diameters in 2 weeks (Shrigley, Greene & Duran-Reynals, 1945. The virus was still alive in 26% of the grafts 21 days after transplantation, and was able to induce a typical disease when injected to normal rabbits. No alteration in the properties of the virus after growth in the guinea pig was noticed, and this also is different from what happens with the Rous chicken sarcoma.

  11. Avaliação da anastomose de artéria torácica interna esquerda com artéria interventricular anterior pela ecodopplercardiografia Evaluation of left internal thoracic artery anastomosis with left anterior descending coronary artery by Doppler echocardiography

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    Adelaide Arruda

    1997-12-01

    Full Text Available OBJETIVO: Avaliar o valor do ecocardiograma Doppler(ECO transtorácico na identificação de perviabilidade da anastomose entre artéria torácica interna esquerda (ATIE e interventricular anterior, realizada pela técnica de revascularização miocárdica pela minitoracotomia sem circulação extracorpórea. MÉTODOS: Estudaram-se os primeiros 12 pacientes, consecutivos, no período de pós-operatório intra-hospitalar pelo ECO, utilizando-se transdutores de 5MHz, pela via paraesternal esquerda, preferencialmente. Foram analisadas velocidades máximas e integrais de velocidade dos componentes sistólico e diastólico das curvas espectrais de fluxo Doppler. Todos pacientes foram submetidos à cinecoronariografia, enquanto hospitalizados. RESULTADOS: O ECO foi exeqüível em 93% dos pacientes. Nos com anastomose pérvia (6/7, observou-se ao estudo Doppler amplo componente diastólico (padrão A. Naqueles com anastomose obstruída (4/4 o padrão observado foi de predomínio sistólico (padrão B (p=0,003*. CONCLUSÃO: O ECO da ATIE anastomosada com a artéria interventricular anterior, após cirurgia de revascularização miocárdica pela técnica de minitoracotomia, permitiu caracterizar precocemente, com precisão, a perviabilidade da anastomose.PURPOSE: To study the value of Doppler echocardiography as a tool for the evaluation of left internal thoracic artery graft (LITAG patency in patients who underwent coronary revascularization using minimally invasive bypass surgery without extracorporeal circulation. METHODS: The first 12 consecutive patients were studied after coronary artery bypass surgery using a 5MHz Doppler transducer. Doppler signals for the systolic and diastolic flow velocities were preferably obtained in the second intercostal space. All patients underwent coronary angiography while hospitalized. RESULTS: The exam was feasible in 93% of patients. Doppler flow pattern was predominantly diastolic (pattern A in patients with patent

  12. Avulsion fractures of the anterior inferior iliac spine: spectrum of imaging findings; Avulsao da espinha iliaca antero-inferior: espectro dos achados de imagem

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Joao Luiz [Hospital Santa Lucia, Brasilia, DF (Brazil). Dept. de Ressonancia Magnetica; Viana, Sergio Lopes; Mendonca, Jose Luiz Furtado de; Freitas, Flavia Mendes Oliveira; Lima, Gylse-Anne de Souza; Vila, Ana Fabiola da; Ribeiro, Nelmar [Clinica Radiologica Vila Rica, Brasilia, DF (Brazil). Dept. de Ressonancia Magnetica]. E-mail: radiolog@uol.com.br

    2005-07-15

    Avulsive injuries of the pelvic aphophyses are relatively common among 13-18 year old athletes, particularly among soccer players in Brazil. Diagnosis is made upon clinical and imaging findings. These lesions show three distinct phases: acute, repair and consolidation phases. Although acute and consolidation phases usually represent no diagnostic challenge, the repair phase may appear as an aggressive process on diagnostic images simulating neoplasic lesions. In this paper, the authors present the imaging findings of patients with avulsion of the anterior inferior iliac spine on plain radiographs, computerized tomography and magnetic resonance imaging, emphasizing the typical features of the three evolutive phases of these lesions. (author)

  13. A gênese da favela carioca. A produção anterior às ciências sociais

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    Valladares Licia

    2000-01-01

    Full Text Available O artigo mostra o lugar ocupado pela favela e seus moradores no debate político e social da primeira metade do século XX, ressaltando a produção de conhecimento que foi gerada por jornalistas, médicos, engenheiros e assistentes sociais no período que antecede o desenvolvimento das ciências sociais e da universidade no Brasil. Propõe que o processo de construção social da representação da favela, que então se inicia, deve ser analisado a partir de uma periodização distinta daquela já consagrada e que tem como marco de referência a relação do Estado com a favela e desta com o tipo de regime político vigente em diferentes momentos históricos. A periodização sugerida pela autora compreende um momento inicial, marcado por um mito de origem, a visão de Euclides da Cunha do arraial de Canudos em sua obra Os sertões, período em que a favela carioca é descoberta e descrita transpondo-se a dualidade litoral versus sertão para a cena urbana, pela oposição da cidade à favela. Segue-se a este período de descoberta um período de transformação da favela em problema social e urbano, seguido de um terceiro momento, quando a idéia de administrar o problema toma a forma de medidas e políticas concretas. Um quarto momento inclui a produção de dados oficiais através de censos de favelas e a transformação de um fenômeno local em realidade nacional. O artigo mostra que à favela centenária corresponde uma representação social que já é praticamente centenária também, um legado importante que as ciências sociais de hoje não podem descartar.

  14. Válvula de uretra anterior Anterior urethral valves

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    Silvio Tucci Jr.

    2003-02-01

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

  15. Avaliação do tratamento da discopatia degenerativa cervical pela artrodese via anterior utilizando placas associadas a cages ou cages em peek isoladamente Evaluación del tratamiento de la enfermedad degenerativa del disco cervical por la artrodesis anterior utilizando placas asociadas con jaulas o jaulas en peec, aisladamente Evaluation of cervical degenerative disc disease treatment by anterior arthrodesis using plates associated with cages or cages in peek alone

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    André Rafael Hübner

    2011-01-01

    Full Text Available OBJETIVOS: Avaliar comparativamente o tratamento da discopatia degenerativa cervical por discectomia e artrodese cervical via anterior utilizando placas associadas a cages ou cages em PEEK isoladamente. MÉTODOS: Foi realizado um estudo retrospectivo comparativo entre dois grupos de pacientes operados pela técnica de discectomia e artrodese cervical via anterior. Foram selecionados aleatoriamente 70 pacientes, 35 operados com o método de fixação com placas associadas a cages - denominado Grupo I - e 35 com o cage em PEEK isoladamente - Grupo II. Realizou-se anamnese, exame físico, escores de dor (escala visual e analógica da dor e função (critérios de Odom's, SF-36, Indice de incapacidade do pescoço o pré e pós-operatório e exames de imagem. RESULTADOS: Houve predominância de pacientes do sexo feminino em ambos os grupos, com média de idade de 55 anos no Grupo I e 47 no Grupo II. Ambos os grupos apresentaram distribuição semelhante quanto ao número de níveis operados, assim como nas complicações encontradas e escores de dor, cervicalgia e SF36 no pré e pós-operatório. Houve 97.1% de fusão com 94.3% de bons resultados no Grupo I e 100% de fusão, com 97 % de bons resultados no Grupo II. CONCLUSÕES: O estudo comparativo da utilização de placas com cages e cages em PEEK isoladamente apresentou resultados semelhantes e satisfatórios para os grupos estudados, não se constatando superioridade ou inferioridade de um método com relação ao outro.OBJETIVOS: Evaluar comparativamente el tratamiento de la enfermedad degenerativa del disco cervical por discectomía y artrodesis cervical vía anterior, utilizando placas asociadas con el uso de jaulas o estas en PEEK [Poliéster-Éter-Éter-Cetona], aisladamente. MÉTODOS: fue realizado un estudio retrospectivo comparativo de dos grupos de pacientes tratados con la técnica de discectomía y artrodesis cervical vía anterior. Se seleccionaron al azar 70 pacientes, 35 operados

  16. Estudo dos parâmetros periodontais para a avaliação morfológica da papila gengival interdental na região anterior da maxila

    OpenAIRE

    Marinho, Carlos Frederico de Carvalho

    2007-01-01

    O alto grau de exigência estética de pacientes e profissionais no atual estágio da implantodontia implica num exame de diagnóstico extremamente apurado, devido as possíveis alterações na margem gengival e na papila interproximal advindas do tratamento com implantes unitários. O objetivo deste trabalho foi avaliar o efeito dos parâmetros periodontais sobre a altura da papila interdental na região de incisivos centrais, incisivos laterais, caninos e primeiros pré-molares superior...

  17. Análise da medida de fluxo por tempo de trânsito da artéria torácica interna direita anastomosada para a artéria interventricular anterior comparada com a artéria torácica interna esquerda

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    Rodrigo Milani

    2014-04-01

    Full Text Available Introdução: Avaliamos por meio da medida de fluxo por tempo de trânsito o desempenho das artérias torácicas direita e esquerda quando utilizadas como enxerto para revascularização da artéria interventricular anterior. Métodos: Cinquenta pacientes submetidos à operação para revascularização do miocárdio sem circulação extracorpórea foram divididos em dois grupos. No grupo A, os pacientes receberam enxerto de artéria torácica interna direita para o ramo interventricular anterior. No grupo B, os pacientes receberam enxerto de artéria torácica interna esquerda para o mesmo ramo. Ao término da operação, o fluxo foi avaliado por meio da medida de fluxo por tempo de trânsito. Resultados: No grupo A, idade média foi de 60,6±9,49 anos. A média de peso e altura do grupo foi de 80,4±10,32 Kg e 169,2±6,86 cm. A média de pontes por paciente neste grupo foi de 3,28±1,49. O fluxo médio e a resistência distal obtidos na artéria torácica interna direita foi de 42,1±23,4 ml/min e 2,8±0,9 respectivamente. No grupo B, a idade média foi de 59,8±9,7 anos. A média de peso e altura deste grupo foi de 77,7±14,2215,7 Kg e 166,0±8,2 cm. A média de pontes por paciente neste grupo foi de 3,08±0,82. O fluxo médio e a resistência distal observados neste grupo foi de 34,2±19,1ml⁄min e 2,0±0,7. Não houve óbitos nesta série. Conclusão: A artéria torácica interna direita apresentou um comportamento similar ao da artéria torácica interna esquerda quando anastomosada ao ramo interventricular anterior da coronária esquerda. Não houve diferença estatística entre a medida de fluxo obtida entre ambas as artérias.

  18. Anterior perineal hernia after anterior exenteration

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    Ka Wing Wong

    2017-10-01

    Full Text Available Perineal hernia is a rare complication of anterior exenteration. We reported this complication after an anterior exenteration for bladder cancer with bleeding complication requiring packing and second-look laparotomy. Perineal approach is a simple and effective method for repair of perineal hernia.

  19. Partial time use of anterior repositioning splints in the management of TMJ pain and dysfunction: a one-year controlled study Utilização de placas protrusivas em tempo parcial no tratamento da dor e disfunção da ATM: estudo controlado de um ano

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    Paulo César Rodrigues Conti

    2005-12-01

    Full Text Available This study aimed at evaluating the effectiveness of partial use of anterior repositioning appliances in the management of TMJ pain and dysfunction when compared to stabilization splints and a control group in a one-year follow-up. Sample was initially constituted by 60 patients, randomly divided into three groups: I- stabilization splints, II- repositioning splints and III- no treatment. The whole sample was evaluated by means of TMJ and muscle palpation, mandibular AROM, analysis of occlusal contacts, joint sounds inspection and Visual Analogue Scale (VAS for one year; 52 patients composed the final sample. A significant (after 15 days improvement in pain report (VAS and palpation index was found for group II (pO objetivo desse estudo foi avaliar a efetividade das placas oclusais reposicionadoras no controle de patologias intra-articulares da ATM, quando comparadas a um tratamento convencional (placa estabilizadora e um grupo sem tratamento (controle. A amostra final constou de 52 pacientes portadores de sinais e sintomas de desordens intra-articulares da ATM, divididos, aleatoriamente em três grupos, de acordo com o procedimento empregado: grupo I (n=20, utilizou placa estabilizadora, grupo II (n=18 utilizou placa reposicionadora e grupo III (n=14, sem nenhum tratamento.Toda a amostra foi acompanhada durante um ano, sendo avaliada através de questionários anamnésicos, palpação muscular e da ATM, movimentação mandibular e detecção de sons articulares.Uma avaliação da condição oclusal também foi realizada nos diferentes períodos de exame. Os resultados demonstraram uma maior efetividade das placas reposicionadoras na redução inicial da dor relatada pelo paciente, assim como uma diminuição na sensibilidade a palpação na ATM.Todos os grupos mostraram-se semelhantes após seis meses de controle em relação aos sintomas, assim como em relação aos ruídos articulares. Os índices de palpação muscular mostraram-se melhor

  20. Avaliação da inibição recíproca em humanos durante contrações isométricas dos músculos tibial anterior e sóleo Assessment of reciprocal inhibition in humans during isometric contractions of the tibialis anterior and soleus muscles

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    José Eduardo Pompeu

    2009-09-01

    Full Text Available Os objetivos do presente trabalho foram: (1 desenvolver um método para estimar o grau de inibição recíproca (IR entre músculos antagonistas em humanos (sóleo e tibial anterior e (2 comparar os níveis de IR no repouso, na dorsiflexão (DF e na flexão plantar (FP. Participaram nove sujeitos saudáveis com idade entre 20 e 30 anos, quatro homens e cinco mulheres. Os sujeitos permaneceram sentados numa cadeira com o pé direito apoiado e fixo num pedal acoplado a um torquímetro; as medições foram feitas no repouso e durante contração isométrica dos músculos dorsiflexores e flexores plantares do tornozelo. A onda H do músculo sóleo foi captada por eletrodos de superfície. O reflexo H (RH "teste" do músculo sóleo foi medido aplicando-se um estímulo na fossa poplítea (nervo tibial. O reflexo H "condicionado" foi obtido pelo pareamento de dois estímulos: o primeiro aplicado sobre a cabeça da fíbula e o segundo, na fossa poplítea, após 1 a 3 ms.. As amplitudes pico-a-pico dos RH teste e condicionado foram utilizadas para o cálculo da IR. Os valores de IR foram: 16,41%±8,68 no repouso; 21,94%±5,39 na DF e 3,12%±11,84 na FP. Foi constatada menor inibição recíproca na FP quando comparada às demais condições (pThe purposes of the present study were (1 to develop a method to estimate the level of reciprocal inhibition (RI between antagonist (soleus and anterior tibial muscles in humans, and (2 to compare RI levels during rest, dorsiflexion (DF and plantar flexion (PF. Nine healthy subjects (four men, five women aged between 20 and 30 years were assessed. Each subject remained seated with his/her right foot strapped to a rigid foot plate coupled to a torquemeter; measurements were taken at rest and during isometric contraction of the ankle dorsiflexor and plantar flexor muscles. The soleus muscle H-wave was captured by surface electrodes. A "test" H- reflex was elicited by a stimulus (electrical pulse to the popliteal fossa

  1. Glycosaminoglycan loss from cartilage after anterior cruciate ligament rupture: influence of time since rupture and chondral injury Perda de glicosaminoglicanas da cartilagem após ruptura do ligamento cruzado anterior: influência do tempo de ruptura e da lesão condral

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    SMG Mattiello-Rosa

    2008-02-01

    Full Text Available OBJECTIVE: To quantify the concentration of sulfated glycosaminoglycans (GAGs concentration in the synovial fluid (SF of knees with chronic anterior cruciate ligament (ACL rupture and to identify possible associations between GAG concentration in SF and the time elapsed since rupture and degree of chondral injury. METHOD: Fourteen adult male subjects with total unilateral ACL rupture, which had occurred between 5 and 144 months earlier, were assessed. All subjects underwent joint aspiration; it was possible to collect SF from ten individuals. The samples were quantified to determine the GAG concentration using dimethylmethylene blue (DMMB staining. The degree of chondral injury was macroscopically evaluated using the modified Mankin histological scale. Spearman correlation test (OBJETIVO: Quantificar a concentração de glicosaminoglicanas sulfatadas (GAGs no líquido sinovial (LS de joelhos com ruptura crônica do ligamento cruzado anterior (LCA e identificar uma possível correlação entre a concentração de GAGs no LS e o tempo pós-ruptura e grau de lesão condral. MÉTODOS: Foram avaliados 14 indivíduos adultos do sexo masculino com ruptura total unilateral do LCA, ocorrida entre cinco a 144 meses. Todos os sujeitos foram puncionados, sendo possível a coleta de LS em dez indivíduos. As amostras foram quantificadas para determinar a concentração de GAGs usando a coloração azul de dimetilmetileno, método descrito por Farndale21. O grau de lesão condral foi macroscopicamente avaliado pela escala histológica de Mankin modificada por Messner14. As correlações entre concentração de GAGs e lesão condral foram feitas pelo teste de correlação de Sperman (p< 0,05 e a concentração de GAGs e tempo pós-ruptura pelo teste de correlação de Pearson (p< 0,05. RESULTADOS: Concentração de GAGs no LS apresentou variação média de 73,84 ± 40,75µg/mL, sendo o tempo médio pós-ruptura de 40,4 + 40,3 meses. Não houve correla

  2. Efeito do ajustamento da produção de leite para período de serviço anterior sobre os valores genéticos de bovinos da raça Holandesa Effect of adjusting production records for days open on breeding values in Holsteins

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    Nilson Milagres Teixeira

    2001-04-01

    Full Text Available Registros de produção e reprodução de 6.877 lactações de 4.673 vacas foram usados para se determinar o efeito do ajustamento para período de serviço anterior em avaliações genéticas. Os valores genéticos previstos para produção de leite em kg foram calculados usando-se três modelos: Modelo 1 - sem correção para período de serviço, com os efeitos fixos de rebanho-ano-estação de parto, grupo genético (1-PO, 2-PC, idade ao parto como covariável até 2º grau e os efeitos aleatórios de animal, meio permanente e erro; Modelo 2 - mesmo anterior com a inclusão de período de serviço anterior; Modelo 3 - mesmo que o modelo 1, com as produções padronizadas para 100 dias de período de serviço anterior, por meio de fatores de ajustamento. Os valores genéticos previstos obtidos para cada modelo foram comparados. Vacas entre as 2% melhores apresentaram, em média, mudanças de nove e onze posições, respectivamente, quando os modelos 2 e 3 foram usados, comparadas com suas ordens obtidas com o modelo 1. Além disso, oito e onze vacas foram excluídas da relação das 2% melhores quanto aos seus valores genéticos para produção de leite, quando avaliadas, respectivamente, pelos modelos 2 e 3. As confiabilidades dos valores genéticos previstos obtidos usando-se os três modelos foram semelhantes. As correlações de ordem entre os valores genéticos estimados, tanto para vacas quanto para touros, para todos os modelos foram próximas de um. Portanto, o ajustamento para período de serviço anterior não alterou a ordem dos animais nesta avaliação genética na raça Holandesa no Estado de Minas Gerais.Production and breeding records from 6,877 lactations of 4,673 cows were used to evaluate the effect of adjusting for previous days open on genetic evaluations. Predicted breeding values for kg of milk were calculated using three animal models. Model 1 - contained no adjustment for days open and accounted for the fixed effects

  3. Efeito da natação associado a diferentes dietas sobre o músculo tibial anterior do rato: estudo morfológico e histoquímico Efecto de la natación asociado a diferentes dietas sobre el músculo tibial anterior del ratón: estudio morfológico e histo-químico Effect of swimming associated with diet on the anterior tibial muscle of rats: morphological and hystochemical study

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    Olimpia Ciabattari

    2005-04-01

    Full Text Available O objetivo deste estudo foi investigar o efeito da associação de diferentes freqüências de programas de natação e dietas nas características do músculo tibial anterior. Foram utilizados 24 ratos machos Wistar. Estes foram aleatoriamente divididos em três grupos: não treinados (controle, grupo treinado (2x/sem e grupo treinado (5x/sem. Cada grupo foi dividido em dois grupos, os quais receberam uma das dietas: normal ou hipercalórica. Depois do período de treinamento, amostras do músculo foram coletadas e congeladas a -70ºC. Cortes histológicos (8µm obtidos em um micrótomo criostato (-20º foram submetidos aos métodos HE e NADH-TR, m-ATPase (pH 4,4 e Sudan Black. A morfologia e o grau de hipertrofia foram avaliados usando o método do menor diâmetro. Os dados foram submetidos ao teste de variância (ANOVA-one way. As fibras musculares foram classificadas como SO, FOG e FG, apresentando um padrão de distribuição em mosaico em todos os grupos. As fibras musculares revelaram leve hipertrofia em todos os grupos. Os pesos inicial e final foram significativamente diferentes nos grupos treinados. Nos grupos treinados, especialmente no grupo de 5x/sem, as fibras musculares revelaram hipertrofia e splitting com alguns mionúcleos internos. Algumas fibras revelaram-se atrofiadas e esta observação sugeriu desnervação. O metabolismo oxidativo foi mais intenso nas fibras SO e FOG; não houve alterações na habilidade contrátil do músculo e o teor de lipídios foi intenso nas fibras SO, moderado nas FOG e fraco nas FG. O presente estudo, com este protocolo, treinamento de 2x/sem e 5x/sem, causou diferentes tipos de lesões morfológicas nas fibras. A dieta hipercalórica não causou resultados estatisticamente significantes em comparação com a dieta normal.El objetivo de ese estudio fue investigar el efecto de la asociación de frecuencias diferentes de programas de natación y dietas en las características del músculo tibial

  4. Congenital anterior urethral diverticulum

    International Nuclear Information System (INIS)

    Jung, Hyun Sub; Chung, Young Sun; Suh, Chee Jang; Won, Jong Jin

    1985-01-01

    Two cases of congenital anterior urethral diverticular which have occurred in a 4 year old and one month old boy are presented. Etiology, diagnostic procedures, and its clinical results are briefly reviewed

  5. Resultados imediatos da correção cirúrgica de escoliose idiopática do adolescente por via posterior com instrumentação após liberação anterior por videotoracoscopia Resultados inmediatos de la corrección quirúrgica de escoliosis idiopática del adolescente por vía posterior con instrumentación después de liberación anterior por videotoracoscopia Short term results of surgical correction of adolescents' idiopathic scoliosis by posterior approach instrumentation following videothoracoscopic anterior release

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    Eduardo Barros Puertas

    2009-12-01

    Full Text Available OBJETIVO: descrever os resultados imediatos da aplicação da liberação anterior por videotoracoscopia, seguida de instrumentação por via posterior para correção cirúrgica da escoliose idiopática do adolescente. MÉTODOS: foram selecionados 20 pacientes, no período de agosto de 1989 a maio de 2001, com escoliose idiopática do adolescente, padrão de curva torácica direita rígida, King III. Inicialmente realizou-se a abordagem pela via anterior com liberação por videotoracoscopia e depois a via posterior para correção e fixação com instrumental de Hartshill, em um mesmo tempo cirúrgico. RESULTADOS: todos os procedimentos foram completados com sucesso com videotoracoscopia, sem necessidade de conversão para toracotomia. A média de idade dos pacientes foi de 15,7 anos (12 a 21 anos. Em relação aos dias de internação, obteve-se um tempo médio de permanência de 9,45 dias (5 a 26 dias. A média entre os valores angulares foi, no pré-operatório, de 66,25º Cobb (48º a 92º Cobb, e no pós-operatório, de 31,2º Cobb (15º a 45º Cobb. Como complicações, quatro pacientes tiveram nevralgia intercostal (20% e um caso de atelectasia (5%. CONCLUSÕES: a discectomia por videotoracoscopia é um método efetivo e seguro para tornar flexíveis as curvas escolióticas rígidas. No entanto, trata-se de um procedimento tecnicamente difícil, que requer treinamento árduo e prolongado, com curva de aprendizado extensa.OBJETIVO: describir los resultados inmediatos de la aplicación de la liberación anterior por videotoracoscopia, seguida de instrumentación por vía posterior para corrección quirúrgica de escoliosis idiopática del adolescente. MÉTODOS: fueron seleccionados 20 pacientes, en el periodo de agosto de 1989 a mayo de 2001, con escoliosis idiopática del adolescente, con un padrón de curva torácica derecha rígida, King III. Inicialmente se realizó un abordaje por la vía anterior con liberación por

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

    Directory of Open Access Journals (Sweden)

    Ramon Coral Ghanem

    2004-08-01

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

  7. Avaliação citométrica dos adipócitos localizados no tecido subcutâneo da parede anterior do abdome após infiltração percutânea de CO2

    Directory of Open Access Journals (Sweden)

    Célia Sampaio Costa

    Full Text Available OBJETIVO: Avaliar os efeitos da infiltração de dióxido de carbono em adipócitos presentes na parede abdominal. MÉTODOS: Quinze voluntárias foram submetidas a sessões de infusão de CO2 durante três semanas consecutivas (duas sessões por semana com intervalos de dois a três dias entre cada sessão. O volume de gás carbônico infundido por sessão, em pontos previamente demarcados, foi sempre calculado com base na superfície da área a ser tratada, com volume infundido fixo de 250 mL/100cm² de superfície tratada. Os pontos de infiltração foram demarcados respeitando-se o limite eqüidistante 2cm entre eles. Em cada ponto se injetou 10mL, por sessão, com fluxo de 80mL/min. Foram colhidos fragmentos de tecido celular subcutâneo da parede abdominal anterior antes e após o tratamento. O número e as alterações histomorfológicas dos adipócitos (diâmetro médio, perímetro, comprimento, largura e número de adipócitos por campos de observação foram mensurados por citometria computadorizada. Os resultados foram analisados com o teste t de Student pareado, adotando-se nível de significância de 5% (p<0,05. RESULTADOS: Encontrou-se redução significativa no número de adipócitos da parede abdominal e na área, diâmetro, perímetro, comprimento e largura após o uso da hipercapnia (p=0,0001. CONCLUSÃO: A infiltração percutânea de CO2 reduz a população e modifica a morfologia dos adipócitos presentes na parede abdominal anterior.

  8. Diagnóstico e tratamento do lenticone anterior

    Directory of Open Access Journals (Sweden)

    Ana Luiza Biancardi

    2011-08-01

    Full Text Available Relato de caso de um paciente de 18 anos com sindrome de Alport apresentando perda visual progressiva. A biomicroscopia revelou lenticone anterior bilateral. O paciente realizou tomografia de córnea e segmento anterior com o sistema Scheimpflug (Pentacam e aberrometria e topografia corneana (i-Trace. O paciente foi submetido à facoemulsificação com implante de lente intraocular peça única hidrofóbica (Acrysof® SN60AT. As imagens de Scheimpflug documentaram o lenticone anterior. A aberrometria total mostrou acentuado astigmatismo miópico com acentuada aberração esférica negativa, havendo grande impacto das aberrações de alta ordem (HOA na conversão da letra E de Snellen. O mapa de integração da aberrometria do olho todo com a topografia corneana mostrou maior semelhança das aberrrações totais com as aberrações intraoculares do que com as aberrações da superfície anterior da córnea. Após a cirurgia, o paciente apresentou acuidade visual corrigida igual a 20/20 em ambos os olhos, as imagens de Scheimpflug revelaram lentes intraoculares tópicas e os mapas diferenciais revelaram resolução da miopia e redução das aberrações da alta ordem (total e interna. Os exames de imagem foram úteis para demonstrar o impacto do lenticone anterior na qualidade visual e a resolução das aberrações ópticas após a cirurgia.

  9. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

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

    2007-01-01

    Anterior diastemata may compromise the harmony of a patient's smile. Consideration of etiologic factors, previous gingival conditioning, and individual treatment planning are essential in the proper management of anterior diastemata. An integrated orthodontic-restorative approach may enhance the ...

  10. Anterior Urethral Valves

    Directory of Open Access Journals (Sweden)

    Vidyadhar P. Mali

    2006-07-01

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

  11. N-terminal prolactin-derived fragments, vasoinhibins, are proapoptoptic and antiproliferative in the anterior pituitary.

    Science.gov (United States)

    Ferraris, Jimena; Radl, Daniela Betiana; Zárate, Sandra; Jaita, Gabriela; Eijo, Guadalupe; Zaldivar, Verónica; Clapp, Carmen; Seilicovich, Adriana; Pisera, Daniel

    2011-01-01

    The anterior pituitary is under a constant cell turnover modulated by gonadal steroids. In the rat, an increase in the rate of apoptosis occurs at proestrus whereas a peak of proliferation takes place at estrus. At proestrus, concomitant with the maximum rate of apoptosis, a peak in circulating levels of prolactin is observed. Prolactin can be cleaved to different N-terminal fragments, vasoinhibins, which are proapoptotic and antiproliferative factors for endothelial cells. It was reported that a 16 kDa vasoinhibin is produced in the rat anterior pituitary by cathepsin D. In the present study we investigated the anterior pituitary production of N-terminal prolactin-derived fragments along the estrous cycle and the involvement of estrogens in this process. In addition, we studied the effects of a recombinant vasoinhibin, 16 kDa prolactin, on anterior pituitary apoptosis and proliferation. We observed by Western Blot that N-terminal prolactin-derived fragments production in the anterior pituitary was higher at proestrus with respect to diestrus and that the content and release of these prolactin forms from anterior pituitary cells in culture were increased by estradiol. A recombinant preparation of 16 kDa prolactin induced apoptosis (determined by TUNEL assay and flow cytometry) of cultured anterior pituitary cells and lactotropes from ovariectomized rats only in the presence of estradiol, as previously reported for other proapoptotic factors in the anterior pituitary. In addition, 16 kDa prolactin decreased forskolin-induced proliferation (evaluated by BrdU incorporation) of rat total anterior pituitary cells and lactotropes in culture and decreased the proportion of cells in S-phase of the cell cycle (determined by flow cytometry). In conclusion, our study indicates that the anterior pituitary production of 16 kDa prolactin is variable along the estrous cycle and increased by estrogens. The antiproliferative and estradiol-dependent proapoptotic actions of this

  12. N-terminal prolactin-derived fragments, vasoinhibins, are proapoptoptic and antiproliferative in the anterior pituitary.

    Directory of Open Access Journals (Sweden)

    Jimena Ferraris

    Full Text Available The anterior pituitary is under a constant cell turnover modulated by gonadal steroids. In the rat, an increase in the rate of apoptosis occurs at proestrus whereas a peak of proliferation takes place at estrus. At proestrus, concomitant with the maximum rate of apoptosis, a peak in circulating levels of prolactin is observed. Prolactin can be cleaved to different N-terminal fragments, vasoinhibins, which are proapoptotic and antiproliferative factors for endothelial cells. It was reported that a 16 kDa vasoinhibin is produced in the rat anterior pituitary by cathepsin D. In the present study we investigated the anterior pituitary production of N-terminal prolactin-derived fragments along the estrous cycle and the involvement of estrogens in this process. In addition, we studied the effects of a recombinant vasoinhibin, 16 kDa prolactin, on anterior pituitary apoptosis and proliferation. We observed by Western Blot that N-terminal prolactin-derived fragments production in the anterior pituitary was higher at proestrus with respect to diestrus and that the content and release of these prolactin forms from anterior pituitary cells in culture were increased by estradiol. A recombinant preparation of 16 kDa prolactin induced apoptosis (determined by TUNEL assay and flow cytometry of cultured anterior pituitary cells and lactotropes from ovariectomized rats only in the presence of estradiol, as previously reported for other proapoptotic factors in the anterior pituitary. In addition, 16 kDa prolactin decreased forskolin-induced proliferation (evaluated by BrdU incorporation of rat total anterior pituitary cells and lactotropes in culture and decreased the proportion of cells in S-phase of the cell cycle (determined by flow cytometry. In conclusion, our study indicates that the anterior pituitary production of 16 kDa prolactin is variable along the estrous cycle and increased by estrogens. The antiproliferative and estradiol-dependent proapoptotic

  13. Perawatan Ortodontik Gigitan Terbuka Anterior

    Directory of Open Access Journals (Sweden)

    Yuniar Zen

    2014-06-01

    Full Text Available Perawatan gigitan terbuka anterior telah lama dianggap sebagai tantangan bagi ortodontis. Prevalensi gigitan terbuka anterior antara 3,5% hingga 11% terdapat pada berbagai usia dan kelompok etnis, serta ada sekitar 17% pasien ortodonti memiliki gigitan terbuka. Stabilitas hasil perawatan gigitan terbuka anterior sangat sulit, karena adanya kombinasi diskrepansi anteroposterior dengan gigitan terbuka skeletal sehingga dibutuhkan tingkat keterampilan diagnosis dan klinis yang tinggi. Etiologi gigitan terbuka anterior sangat kompleks karena dapat melibatkan skeletal, dental, dan faktor-faktor habitual. Eliminasi faktor etiologi merupakan hal yang penting dalam perawatan gigitan terbuka anterior. Berbagai cara perawatan untuk koreksi gigitan terbuka anterior diantaranya bedah ortognatik dan perawatan ortodontik kamuflase, seperti high-pull headgear, chincup, bite blocks, alatfungsional, pencabutan gigi, multi-loop edgewise archwires dan mini implan. Stabilitas hasil perawatan adalah kriteria yang paling penting dalam menentukan cara perawatan gigitan terbuka anterior. Orthodontic Treatment of Anterior Open Bite. An anterior open bite therapy has long been considered a challenge to orthodontist. The prevalence of anterior openbite range from 3,5 % to 11% among various age and ethnic groups and it has been shown that approximately 17% of orthodontic patients have open bite. Stability of treatment result of anterior open bite with well-maintained results is difficult, because the combination of anteroposteriorly discrepancy with skeletal open bite requires the highest degree of diagnostic and clinical skill. The etiology is complex, potentially involving skeletal, dental and habitual factors. The importance of an anterior open bite therapy is to eliminate the cause of the open bite. Various treatment modalities for the correction of an anterior open bite have been proposed, orthognatic surgery and orthodontic camouflage treatment such as high

  14. Anterior knee pain

    International Nuclear Information System (INIS)

    LLopis, Eva; Padron, Mario

    2007-01-01

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

  15. Anterior knee pain

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-04-15

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

  16. The anterior cingulate cortex

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2009-01-01

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

  17. Bioengineered anterior cruciate ligament

    Science.gov (United States)

    Martin, Ivan (Inventor); Altman, Gregory (Inventor); Kaplan, David (Inventor); Vunjak-Novakovic, Gordana (Inventor)

    2001-01-01

    The present invention provides a method for producing an anterior cruciate ligament ex vivo. The method comprises seeding pluripotent stem cells in a three dimensional matrix, anchoring the seeded matrix by attachment to two anchors, and culturing the cells within the matrix under conditions appropriate for cell growth and regeneration, while subjecting the matrix to one or more mechanical forces via movement of one or both of the attached anchors. Bone marrow stromal cells are preferably used as the pluripotent cells in the method. Suitable matrix materials are materials to which cells can adhere, such as a gel made from collagen type I. Suitable anchor materials are materials to which the matrix can attach, such as Goinopra coral and also demineralized bone. Optimally, the mechanical forces to which the matrix is subjected mimic mechanical stimuli experienced by an anterior cruciate ligament in vivo. This is accomplished by delivering the appropriate combination of tension, compression, torsion, and shear, to the matrix. The bioengineered ligament which is produced by this method is characterized by a cellular orientation and/or matrix crimp pattern in the direction of the applied mechanical forces, and also by the production of collagen type I, collagen type III, and fibronectin proteins along the axis of mechanical load produced by the mechanical forces. Optimally, the ligament produced has fiber bundles which are arranged into a helical organization. The method for producing an anterior cruciate ligament can be adapted to produce a wide range of tissue types ex vivo by adapting the anchor size and attachment sites to reflect the size of the specific type of tissue to be produced, and also adapting the specific combination of forces applied, to mimic the mechanical stimuli experienced in vivo by the specific type of tissue to be produced. The methods of the present invention can be further modified to incorporate other stimuli experienced in vivo by the

  18. [Anterior guidance in complete dentures].

    Science.gov (United States)

    Dubreuil, J; Trevelo, A

    1990-01-01

    Although the anterior guidance in complete dentures is not really a guide, the arrangement of the anterior maxillary and mandibular prosthetic teeth, defines a propulsive line called the virtual anterior guidance, a part from the cinematic criterias. The influence of this guide on cuspal movement is superior, in all mandibular points, to the influence of the condylar pathway. If this line is not respected, the practitioner may have to do excessive grindings during occlusal adjustments.

  19. Anterior stromal puncture in the treatment of bullous keratopathy

    OpenAIRE

    Gomes, José Alvaro Pereira; Haraguchi, Daniel Keizo de Medeiros; Zambrano, Delbis Uzcátegui; Villavicencio, Luis Izquierdo; Cunha, Marcelo C.; Freitas, Denise de

    2000-01-01

    Objetivo: Avaliar o efeito terapêutico das punções do estroma anterior corneal em pacientes com ceratopatia bolhosa (CB). Métodos:Vinte e cinco pacientes com CB sintomáticos, com baixa visão, com e sem indicação de transplante de córnea, foram avaliados antes, uma, 4 e 12 semanas após punções estromais anteriores realizadas com agulha #25 à lâmpada de fenda. Em cada visita, os pacientes foram questionados sobre intensidade da dor, fotofobia, sensação de corpo estranho, além de serem submetido...

  20. Avaliação do resultado da reconstrução artroscópica do ligamento cruzado anterior do joelho com enxerto dos tendões flexores Evaluation of the results of arthroscopic ACL reconstruction with autogenous flexor tendons

    Directory of Open Access Journals (Sweden)

    Alexandre Almeida

    2010-01-01

    Full Text Available OBJETIVO: Avaliar o resultado da reconstrução do ligamento cruzado anterior (LCA com o autoenxerto dos tendões flexores da coxa. Serão analisados os dados com relação ao sexo, ao índice de massa corporal (IMC e a associação com fratura no membro inferior (MI. MÉTODOS: Foi analisado um grupo de 265 pacientes submetidos à artroscopia do joelho para fins de reconstrução do LCA com enxerto ipsilateral dos tendões flexores da coxa no período de 6 de julho de 2000 a 19 de novembro de 2007. RESULTADOS: 176 pacientes foram avaliados com média de 34,95 ± 18,8 meses (mediana 31 meses (IIQ: 20-48 meses. A avaliação mínima foi aos 12 meses e a máxima aos 87 meses. Obtivemos 138 (78,4% pacientes com resultado excelente, 22 (12,5% com resultado bom, oito (4,5% com resultado regular e oito (4,5% pacientes apresentaram resultado ruim. Não foi considerada significativa a maior incidência de bons e excelentes resultados para o sexo masculino (p = 0,128, para os pacientes com IMC OBJETIVE: To evaluate the results of single band arthroscopic anterior cruciate ligament (ACL reconstruction with flexor tendon autografts. We analyzed data about sex, body mass index (BMI and lower limb fracture associated with the initial trauma. METHODS: Two hundred and sixty-five patients who underwent arthroscopic anterior cruciate ligament (ACL reconstruction with ipsilateral thigh flexor tendon autografts from July 6, 2000, to November 19, 2007, were evaluated. RESULTS: One hundred and seventy-six patients were evaluated at an average follow up time of 34.95 ± 18.8 months (Median 31 months (IIQ: 20 - 48 months. The minimum evaluation time was 12 months and the maximum 87 months. One hundred and thirty-eight (78.4% patients had excellent results, 22 (12.5% patients good, 8 (4.5% patients fair, and 8 (4.5% poor results. No statistical significance was found for the better results for males (p = 0.128, for patients with a BMI < 25 (p = 0.848, or for patients

  1. anomalous left anterior cerebral artery with hypoplastic right anterior ...

    African Journals Online (AJOL)

    2018-02-28

    Feb 28, 2018 ... We report an extremely rare anomalous variation of left anterior cerebral artery arising from the ... paraclinoid internal carotid artery and right ... Studies on the arteries of the brain: II-The anterior cerebral artery: Some anatomic ...

  2. Avaliação transversal e vertical da maxila, após expansão rápida, utilizando um método de padronização das radiografias póstero-anteriores Transversal and vertical maxillary evaluation, after rapid expansion, using a standardization method for posteroanterior radiographs

    Directory of Open Access Journals (Sweden)

    Gustavo Mattos Barreto

    2005-12-01

    Full Text Available OBJETIVO: na presente pesquisa utilizou-se o aparelho Hyrax tendo como objetivo avaliar as alterações transversais e verticais da maxila. Foram selecionados 20 pacientes de ambos os gêneros, entre 7 e 11 anos de idade, que apresentavam mordida cruzada posterior uni ou bilateral. METODOLOGIA: foram realizadas telerradiografias em norma frontal (PA antes e após a expansão. A fim de evitar que a falta de padronização dessas radiografias pudesse influenciar nos resultados, idealizou-se um método de padronização para tais radiografias. RESULTADOS E CONCLUSÕES: os resultados mostraram que a correção da mordida cruzada posterior com o aparelho Hyrax, que ocorreu em todos os casos, foi em função tanto da abertura da sutura palatina mediana como também da inclinação dos molares. A medida JgE-JgD relacionada com a expansão maxilar aumentou significantemente em todos os casos tratados. Nas avaliações dentárias, as medidas verticais não apresentaram diferenças significantes, ao contrário das medidas transversais (FTE-FTD; FBE-FBD; LO.BTE; LO.BTD; BTE.BTD. A largura da cavidade nasal também aumentou significantemente (CNE-CND. O método de padronização proposto permite, portanto, utilizar as medidas que avaliam a expansão rápida da maxila, através das radiografias póstero-anteriores, com segurança, também no sentido vertical.AIM: in the atresia maxillary cases, the most indicated treatment is rapid maxillary expansion that can be achieved by different therapies. In the present research the Hyrax appliance was used in order to evaluate the transverse and vertical outcomes in maxillary base. METHODS: twenty patients of both gender, from 7 to 11 years old, presenting uni or bilateral posterior crossbite were selected. Posteroanterior radiographs were performed before and after expansion. These radiographs were standardized in order to avoid that problems with lack of standardization influence the results. RESULTS AND CONCLUSION

  3. Bloqueio 3-em-1 prolongado versus analgesia sistêmica no tratamento da dor pós-operatória após a reconstrução do ligamento cruzado anterior do joelho Bloqueo 3 en 1 prolongado versus analgesia sistemica en el tratamiento del dolor postoperatorio después de la reconstrucción del ligamento cruzado anterior de la rodilla Extended three-in-one block versus intravenous analgesia for postoperative pain management after reconstruction of anterior cruciate ligament of the knee

    Directory of Open Access Journals (Sweden)

    Víctor A. Contreras-Domínguez

    2007-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio femoral contínuo (3-em-1 é usado para a analgesia pós-operatória de artroplastia de quadril e joelho com bons resultados, apresentando vantagens sobre outras técnicas de analgesia locorregional ou sistêmica e com baixa incidência de complicações. O objetivo deste estudo foi avaliar clinicamente a utilidade do bloqueio femoral contínuo em comparação com a analgesia por via venosa na reconstrução do ligamento cruzado anterior. MÉTODO: Foi realizado um estudo prospectivo, controlado, com 60 pacientes com estado físico ASA I. Os paciente foram divididos em dois grupos: Grupo 1 (n = 30: bloqueio femoral contínuo com infusão de bupivacaína e clonidina; Grupo 2 (n = 30: infusão por via venosa de cetoprofeno. A intervenção cirúrgica foi realizada sob raquianestesia e sedação. O tratamento da dor pós-operatória foi feito com analgesia controlada pelo paciente (PCA usando morfina. A dor pós-operatória foi registrada 2, 4, 6, 24 e 36 horas após a intervenção cirúrgica usando a Escala Visual Analógica (VAS. O consumo de morfina, a satisfação dos pacientes e as complicações também foram registradas. RESULTADOS: No Grupo 1, o VAS pós-operatório entre 4 e 48 horas após a intervenção cirúrgica foi de 21 mm ± 2 e no Grupo 2 foi de 45 mm ± 4 (p JUSTIFICATIVA Y OBJETIVOS: El bloqueo femoral continuo (tres-en-uno se usa para la analgesia postoperatoria de artroplastia de cadera y rodilla con buenos resultados, presentando ventajas sobre otras técnicas de analgesia loco regional o sistemica y con baja incidencia de complicaciones. El objetivo de este estudio fue el de evaluar clínicamente la utilidad del bloqueo femoral continuo en comparación con la analgesia intravenosa en la reconstrucción del ligamento cruzado anterior. MÉTODOS: Se realizó un estudio prospectivo controlado con 60 pacientes de estado físico ASA I. Los pacientes fueron divididos en dos grupos: Grupo 1 (n

  4. Qualitative analysis of the diet of a probabilistic sample of schoolchildren from Florianópolis, Santa Catarina State, Brazil, using the Previous Day Food Questionnaire Análise qualitativa da dieta de amostra probabilística de escolares de Florianópolis, Santa Catarina, Brasil, com o uso do Questionário Alimentar do Dia Anterior

    Directory of Open Access Journals (Sweden)

    Maria Alice Altenburg de Assis

    2010-07-01

    Full Text Available A qualitative evaluation of the diet of a probabilistic sample of 7-10 year old schoolchildren (n = 1,232 from Florianópolis (southern Brazil was carried out by analyzing compliance with recommendations from the Brazilian Food Guidelines. The strengths and limitations of the Previous Day Food Questionnaire (PDFQ are also presented. Frequencies of intake were defined as how many times per day the food group was reported on the PDFQ. The percentages of schoolchildren who met the minimum recommendations and who ate foods that were not recommended in the guidelines were compared for boys versus girls, private versus public school and by family income level. Although most of the children complied with the guidelines regarding consumption of meat/fish, dry beans, sweets, and eating three meals and two snacks, only 6.5% of the children met the recommendations for cereals, and 15% for fruit and vegetables. The PDFQ was confirmed as a practical and cost-effective method for the evaluation of compliance with health promotion targets.Avaliação qualitativa da dieta de uma amostra probabilística de escolares de 7-10 anos (n = 1.232 de Florianópolis, Santa Catarina, Brasil, é apresentada por meio de uma análise da concordância com as recomendações do guia alimentar para a população brasileira. Os aspectos positivos e as limitações do Questionário Alimentar do Dia Anterior (QUADA são também discutidos. As freqüências de consumo foram definidas em vezes por dia que os grupos de alimentos foram relatados no QUADA. As porcentagens de escolares que atingiram as recomendações mínimas do guia e que consumiram alimentos não recomendados foram comparadas entre os sexos, tipo de escola (pública versus privada e nível de salário familiar. A maioria das crianças apresentou concordância com o guia para o consumo de carnes/peixes, feijão, doces e realização de três refeições e dois lanches; somente 6,5% atingiram as recomendações dos

  5. Integridade do músculo subescapular após a cirurgia aberta para tratamento da luxação recidivante glenoumeral: avaliação clínica e radiológica Integrity of the subscapularis tendon after open surgery for the treatment of anterior shoulder instability: a clinical and radiological evaluation

    Directory of Open Access Journals (Sweden)

    Osvandré Lech

    2009-10-01

    Full Text Available OBJETIVO: Avaliar a integridade do músculo subescapular através da força, função e ressonância nuclear magnética após acesso deltopeitoral para tratamento da luxação glenoumeral anterior recidivante. MÉTODOS: Foram avaliados 20 pacientes com luxação recidivante do ombro. Todos os casos possuíam seguimento mínimo de 12 meses, com média de 40 meses. Os pacientes eram todos do sexo masculino, com média de idade de 29 anos (20-42 anos. Os pacientes foram submetidos a exame físico para avaliar mobilidade, força muscular, "Belly" Teste e teste de Gerber. A força isocinética em rotação interna e externa, em velocidades angulares de 60º/s e 180º/s, em ambos os ombros, foi medida utilizando-se um dinamômetro. Em 15 pacientes foi realizada ressonância nuclear magnética (RNM em ambos os ombros para avaliação da espessura, área e possível hipotrofia do músculo subescapular. RESULTADOS: Houve diferença significativa entre os picos de torque para a velocidade de 60º/s para as rotações interna (p = 0,036 e externa (p = 0,008. Porém, para a velocidade de 180º/s a situação se inverte (rotação interna: p = 0,133; rotação externa: p = 0,393. A espessura e a área do subescapular são significativamente menores que as do lado normal, com déficit de 19% e 23%, respectivamente. De acordo com os escores de Rowe e da UCLA, observamos excelentes e bons resultados na maioria dos pacientes, com média de 88 e 31,6 pontos, respectivamente. CONCLUSÃO: Apesar dos bons resultados funcionais, a cirurgia aberta pode restringir a força, bem como reduzir a espessura e a área da seção transversal do músculo subescapular. Os melhores resultados ocorreram no lado dominante.OBJECTIVE: To evaluate the integrity of the subscapularis tendon by strength, function and magnetic resonance imaging after deltopectoralis access for anterior shoulder instability. METHODS: 20 patients with anterior shoulder instability have been evaluated

  6. Anterior cervical fusion: the role of anterior plating.

    Science.gov (United States)

    Daffner, Scott D; Wang, Jeffrey C

    2009-01-01

    Treatment of cervical pathology requires a clear understanding of the biomechanical benefits and limitations of cervical plates, their indications, and their associated complications. The use of anterior cervical plates has evolved significantly since their early application in cervical trauma. They have become widely used for anterior cervical decompression and fusion for cervical spondylosis. Plate design has undergone significant refinement and innovation, from the initial unlocked plates requiring bicortical purchase to the latest rotationally and translationally semiconstrained dynamic plates. Excellent clinical results have been reported for single-level anterior cervical decompression and fusion with or without plate fixation; however, the addition of an anterior cervical plate clearly leads to earlier fusion and better clinical results in longer fusions. Longer fusions should ideally consist of corpectomies and strut grafting because the decreased number of fusion surfaces tends to lead to higher fusion rates. Although anterior plate fixation leads to higher fusion rates in fusions of three or more levels, the associated pseudarthrosis rate is still high. The use of dynamic plates, through increased load sharing across the graft and decreased stress shielding, may improve fusion rates, particularly in long fusions. Nevertheless, adjuvant posterior fixation is recommended for fusions of more than three vertebral levels. Anterior plate fixation may be of particular benefit in the management of traumatic injuries, in revision settings, and in the treatment of smokers. Complications unique to plate fixation include hardware breakage and migration as well as ossification of the adjacent disk levels.

  7. Anterior ankle arthroscopy, distraction or dorsiflexion?

    OpenAIRE

    de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

    2010-01-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, where...

  8. Anterior Knee Pain (Chondromalacia Patellae).

    Science.gov (United States)

    Garrick, James G.

    1989-01-01

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

  9. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

    Zurlo, J.V.; Towers, J.D.; Golla, S.

    2001-01-01

    Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy.Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected.Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. (orig.)

  10. Algunas hernias abdominales anteriores

    Directory of Open Access Journals (Sweden)

    Augusto Salazar Sánchez

    1947-09-01

    Full Text Available Las hernias epigástricas se presentan en dos tipos de individuos: los atléticos y los asténicos. Son casi una exclusividad del sexo masculino. En los atléticos aparecen durante la juventud y son la consecuencia de esfuerzos durante los cuales la resistencia de la línea alba cede a la presión intraabdominal, produciendose una ruptura de esa línea, generalmente de tamaño muy pequeño pero suficiente para que por allí pase una porción de la grasa pre-peritoneal, quedando constituida la hernia. Más tarde, la grasa arrastra consigo al peritoneo parietal y este contrae adherencia con el anillo hernario, siendo esta la fase en la cual el enfermo se da cuenta de su afección, porque es entonces cuando sobrevienen los dolores y demás sintomatología clínica que es propia de este tipo de hernias.

  11. Anterior ankle arthroscopy, distraction or dorsiflexion?

    NARCIS (Netherlands)

    de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

    2010-01-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly

  12. Anterior ethmoid anatomy facilitates dacryocystorhinostomy.

    Science.gov (United States)

    Blaylock, W K; Moore, C A; Linberg, J V

    1990-12-01

    The ethmoid air cell labyrinth lies adjacent to the medial orbital wall, extending even beyond the sutures of the ethmoid bone. Its anatomic relationship to the lacrimal sac fossa is important in lacrimal surgery. We evaluated computed tomographic scans of 190 orbits with normal ethmoid anatomy to define the anatomic relationship of anterior ethmoid air cells to the lacrimal sac fossa. In 93% of the orbits, the cells extended anterior to the posterior lacrimal crest, with 40% entering the frontal process of the maxilla. This anatomic relationship may be used to facilitate the osteotomy during dacryocystorhinostomy. During a 10-year period (310 cases), one of us routinely entered the anterior ethmoid air cells to initiate the osteotomy during dacryocystorhinostomy. This technique has helped to avoid lacerations of the nasal mucosa.

  13. Unilateral anterior ischemic optic neuropathy

    DEFF Research Database (Denmark)

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

    2013-01-01

    of this study was to investigate the ipRGC mediated pupil response in patients with a unilateral non-arteritic anterior ischemic optic neuropathy (NAION). Consensual pupil responses during and after exposure to continuous 20 s blue (470 nm) or red (660 nm) light of high intensity (300 cd/m(2)) were recorded...

  14. Dopaminergic Neurons Controlling Anterior Pituitary Functions: Anatomy and Ontogenesis in Zebrafish.

    Science.gov (United States)

    Fontaine, Romain; Affaticati, Pierre; Bureau, Charlotte; Colin, Ingrid; Demarque, Michaël; Dufour, Sylvie; Vernier, Philippe; Yamamoto, Kei; Pasqualini, Catherine

    2015-08-01

    Dopaminergic (DA) neurons located in the preoptico-hypothalamic region of the brain exert a major neuroendocrine control on reproduction, growth, and homeostasis by regulating the secretion of anterior pituitary (or adenohypophysis) hormones. Here, using a retrograde tract tracing experiment, we identified the neurons playing this role in the zebrafish. The DA cells projecting directly to the anterior pituitary are localized in the most anteroventral part of the preoptic area, and we named them preoptico-hypophyseal DA (POHDA) neurons. During development, these neurons do not appear before 72 hours postfertilization (hpf) and are the last dopaminergic cell group to differentiate. We found that the number of neurons in this cell population continues to increase throughout life proportionally to the growth of the fish. 5-Bromo-2'-deoxyuridine incorporation analysis suggested that this increase is due to continuous neurogenesis and not due to a phenotypic change in already-existing neurons. Finally, expression profiles of several genes (foxg1a, dlx2a, and nr4a2a/b) were different in the POHDA compared with the adjacent suprachiasmatic DA neurons, suggesting that POHDA neurons develop as a distinct DA cell population in the preoptic area. This study offers some insights into the regional identity of the preoptic area and provides the first bases for future functional genetic studies on the development of DA neurons controlling anterior pituitary functions.

  15. Epidermoid cyst in Anterior, Middle

    Directory of Open Access Journals (Sweden)

    Kankane Vivek Kumar

    2016-09-01

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

  16. Anterior ankle arthroscopy, distraction or dorsiflexion?

    Science.gov (United States)

    de Leeuw, Peter A J; Golanó, Pau; Clavero, Joan A; van Dijk, C Niek

    2010-05-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7-1.5) and 0.7 cm (range 0.5-0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy.

  17. Anterior spinal cord syndrome of unknown etiology

    OpenAIRE

    Klakeel, Merrine; Thompson, Justin; Srinivasan, Rajashree; McDonald, Frank

    2015-01-01

    A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome.

  18. Anterior fixation of the axis.

    Science.gov (United States)

    Traynelis, Vincent C; Fontes, Ricardo B V

    2010-09-01

    Although anterior fixation of the axis is not commonly performed, plate fixation of C2 is an important technique for treating select upper cervical traumatic injuries and is also useful in the surgical management of spondylosis. To report the technique and outcomes of C2 anterior plate fixation for a series of patients in which the majority presented with symptomatic degenerative spondylosis. Forty-six consecutive patients underwent single or multilevel fusions over a 7-year period; 30 of these had advanced degenerative disease manifested by myelopathy or deformity. Exposure was achieved with rostral extension of the standard anterior cervical exposure via careful soft tissue dissection, mobilization of the superior thyroid artery, and the use of a table-mounted retractor. It was not necessary to remove the submandibular gland, section the digastric muscle, or make additional skin incisions. Screws were placed an average of 4.6 mm (+/- 2.3 mm) from the inferior C2 endplate with a mean sagittal trajectory of 15.7 degrees (+/- 7.6 degrees). Short- and long-term procedure-related mortality was 4.4%, and perioperative morbidity was 8.9%. Patients remained intubated an average of 2.5 days following surgery. Dysphagia was initially reported by 15.2% of patients but resolved by the 8th postoperative week in all patients. Arthrodesis was achieved in all patients available for long-term follow-up. Multilevel fusions were not associated with longer hospitalization or morbidity. Anterior plate fixation of the axis for degenerative disease can be accomplished with acceptable morbidity employing an extension of the standard anterolateral route.

  19. 38 CFR 3.379 - Anterior poliomyelitis.

    Science.gov (United States)

    2010-07-01

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

  20. Fenestration of the anterior cerebral artery

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  1. Tratamento cirúrgico do câncer da porção distal do têrço inferior do reto pela ressecção anterior ultrabaixa e interesfinctérica com anastomose coloanal por videolaparoscopia Surgical treatment of ultra-low rectal cancer by laparoscopic coloanal anastomosis and intersphincteric resection

    Directory of Open Access Journals (Sweden)

    José Reinan Ramos

    2009-09-01

    Full Text Available OBJETIVO: Identificar as complicações pós-operatórias, a duração da internação hospitalar, os resultados funcionais clínicos, e os resultados oncológicos num seguimento médio de 2,5 anos nos pacientes com câncer do reto distal submetidosà ressecção anterior ultrabaixa e interesfinctérica com anastomose coloanal por videolaparoscopia. CASUÍSTICA E MÉTODOS: De um total de 491 pacientes operados pelo acesso videolaparoscópico, foram selecionados para esse estudo prospectivo 13 doentes , nove do sexo feminino,com câncer da porção distal do reto inferior entre os 172 pacientes com câncer do reto.Nenhum tumor T4 ou com resposta completa à quimiorradioterapia foi selecionado. A quimiorradioterapia neo-adjuvante foi aplicada em 8 doentes. RESULTADOS: A taxa de complicaçãos pós-operatória foi de 23,1%., sendo de 7,7% o índice de fístula anastomótica. A mortalide foi nula. A alta hospitalar ocorreu até o 7° dia de pós-operatório para 8 pacientes (61,5%, 4 dos quais no quinto dia.. O número médio de linfonodos por peça foi 13. A margem distal média foi de 1,5 cm. A margem circunferencial foi positiva em um caso (7,7%. Evacuação fracionada foi relatada por 11 pacientes (91% e incontinência fecal por 5 pacientes (41%. Onze pacientes (84% estão satisfeitos com a operação. Um paciente continua ileostomizado (7,7%. Em um seguimento médio de 30 meses ocorreu uma recidiva local (7,7% e dois casos de metástase pulmonar (15,4 %. As três pacientes faleceram da doença. Dez pacientes (77% estão sem doença. CONCLUSÕES: Apesar da pequena casuística, a analise permitiu as seguintes conclusões: a A técnica empregada mostrou ser viável e segura, pois apresentou baixo índice de complicação pós-operatória e mortalidade nula; b O emprego dessa técnica permitiu período de internação hospitalar pós-operatório curto; c Apesar dos resultados funcionais com avaliação clínica regular, evitou-se a colostomia

  2. Tendinopatia do compartimento anterior do tornozelo Tendinopathy of the anterior compartment of the ankle

    Directory of Open Access Journals (Sweden)

    Antonio Egydio de Carvalho Junior

    2010-01-01

    Full Text Available OBJETIVO: Análise retrospectiva da etiopatogenia, diagnóstico e opções de tratamento nos casos de tendinopatias do compartimento anterior do tornozelo (TCAT. MÉTODO: No período de setembro de 1998 a fevereiro de 2009, 13 pacientes foram operados por tendinopatia do compartimento anterior do tornozelo. A casuística constou de 10 pacientes do sexo masculino e três do feminino. O lado direito foi acometido em 12 pés e um do esquerdo. A média de idade foi de 35 anos (15-67. A etiologia foi traumática em oito pacientes e em cinco, degenerativa (atraumática. O tempo médio do diagnóstico ao tratamento foi de 19 meses (1-60 e o seguimento foi de 34 meses (4-127. O diagnóstico foi feito através da história e exame clínico. A ressonância magnética foi realizada em nove pacientes para estadiamento e planejamento. O tratamento cirúrgico foi personalizado para cada caso (sinovectomia, ressecção de ventre muscular, solidarização com o tendão adjacente e enxerto livre de tendão semitendíneo. Para a avaliação dos resultados foram utilizadas as escalas: 1 graduação subjetiva de satisfação, 2 AOFAS e 3 Maryland. RESULTADO: Em relação à escala de graduação subjetiva de satisfação, 12 pacientes satisfeitos e um paciente insatisfeito. A média da escala AOFAS foi de 80 pontos, a média da escala Maryland foi de 86 pontos. CONCLUSÃO: O tratamento cirúrgico é eficaz para recuperação funcional. As técnicas cirúrgicas devem ser personalizadas. A opção do enxerto livre de tendão semitendíneo é eficiente nas falhas maiores que cinco centímetros.OBJECTIVE: To carry out a retrospective analysis of the etiopathogeny, diagnosis and therapeutic options in cases of tendinopathies of the anterior compartment of the ankle. METHOD: 13 patients underwent surgery between September 1998 and February 2009; ten men and three women. The right side was involved in twelve patients and the left in one. The averaging age was 35 years of

  3. Anterior cruciate ligament reconstruction using the double bundle technique - evaluation in the biomechanics laboratory

    OpenAIRE

    D'Elia, Caio Oliveira; Bitar, Alexandre Carneiro; Castropil, Wagner; Garofo, Antônio Guilherme Padovani; Cantuária, Anita Lopes; Orselli, Maria Isabel Veras; Luques, Isabela Ugo; Duarte, Marcos

    2011-01-01

    OBJETIVO: O objetivo deste estudo é descrever a metodologia da análise da rotação do joelho utilizando instrumentos do laboratório de biomecânica e apresentar os resultados preliminares de um estudo comparativo com pacientes submetidos à reconstrução do ligamento cruzado anterior com a técnica de duplo feixe. MÉTODOS: Descreveu-se o protocolo atualmente utilizado em nosso laboratório e realizou-se a análise cinemática tridimensional e medida da amplitude de rotação do joelho de oito pacientes...

  4. Evaluation of three-dimensional angiography for surgery of aneurysms on the anterior communicating artery

    International Nuclear Information System (INIS)

    Isobe, Naoyuki; Oki, Shuichi; Murakami, Taro; Ooyama, Shigeru; Kureshima, Makoto; Kurokawa, Yasuharu

    2007-01-01

    Obtaining detailed anatomical information is crucial before aneurysm microsurgery. The anterior cerebral communicating artery complex (AcoC) is particularly complicated compared to other parts. The anatomical structure of the AcoC is sometimes difficult to understand using conventional angiography. We evaluated the advantages of 3-dimensional digital angiography (3D-DA) for aneurysm microsurgery on the anterior cerebral communicating artery. Subjects comprised 10 men and 5 women (mean age, 61 years; range, 33-79 years) who underwent surgery in our hospital between November 2002 and October 2005. Twelve aneurysms were ruptured, and 3 aneurysms were unruptured. We compared 3D-DA images and surgical findings to assess aneurysmal morphology and relationships to neighboring vessels. We also examined both the presence and visualization of variations on AcoC. In all cases, surgical findings corresponded well to 3D-DA images. Variations on AcoC included fenestration (n=3), azygos (n=1) and aplasia or hypoplasia of the A1 segment of a unilateral anterior cerebral artery (n=9), and these were all well-visualized in 3D-DA. In addition, 3D-DA was also useful for aneurysms with 2 domes for selection of surgical approach, and provided assessment of not only aneurysmal morphology, but also variations of AcoC. This tool provided useful information for the selection of operation approach and intraoperative manipulations by using it together with 2-dimensional digital substraction angiography. (author)

  5. Gnathostomiasis of the anterior chamber

    Directory of Open Access Journals (Sweden)

    Barua P

    2007-01-01

    Full Text Available Ocular involvement with Gnathostoma spinigerum occurs years after the initial infection that is acquired by ingestion of poorly cooked, pickled seafood or water contaminated with third stage larvae. Here we report a case of gnathostomiasis of the left eye of a 32-year-old lady hailing from Meghalaya, India. Her vision had deteriorated to hand movement. Slit lamp examination revealed a live, actively motile worm in the anterior chamber, which was extracted by supra temporal limbal incision and visual acuity was restored.

  6. Robotic Anterior and Midline Skull Base Surgery: Preclinical Investigations

    International Nuclear Information System (INIS)

    O'Malley, Bert W.; Weinstein, Gregory S.

    2007-01-01

    Purpose: To develop a minimally invasive surgical technique to access the midline and anterior skull base using the optical and technical advantages of robotic surgical instrumentation. Methods and Materials: Ten experimental procedures focusing on approaches to the nasopharynx, clivus, sphenoid, pituitary sella, and suprasellar regions were performed on one cadaver and one live mongrel dog. Both the cadaver and canine procedures were performed in an approved training facility using the da Vinci Surgical Robot. For the canine experiments, a transoral robotic surgery (TORS) approach was used, and for the cadaver a newly developed combined cervical-transoral robotic surgery (C-TORS) approach was investigated and compared with standard TORS. The ability to access and dissect tissues within the various areas of the midline and anterior skull base were evaluated, and techniques to enhance visualization and instrumentation were developed. Results: Standard TORS approaches did not provide adequate access to the midline and anterior skull base; however, the newly developed C-TORS approach was successful in providing the surgical access to these regions of the skull base. Conclusion: Robotic surgery is an exciting minimally invasive approach to the skull base that warrants continued preclinical investigation and development

  7. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

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

  8. Influência da Aprendizagem Organizacional e da Inovação no Desempenho Organizacional de Empresas do Setor Vinícola

    OpenAIRE

    Frizzo, Patricia; Gomes, Giancarlo

    2017-01-01

    O presente estudo tem por objetivo analisar a influência da aprendizagem organizacional e da inovação no desempenho organizacional de empresas do setor vinícola. A aprendizagem organizacional foi verificada por meio da aquisição do conhecimento, distribuição da informação, interpretação da informação e memória organizacional. Já a inovação foi dividida em administrativa, de produto e de processo. Estudos anteriores sugerem a interação da aprendizagem organizacional, da inovação e do desempenh...

  9. Imaging findings of anterior hip dislocations

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-06-15

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

  10. Herniation of the anterior lens capsule

    Directory of Open Access Journals (Sweden)

    Pereira Nolette

    2007-01-01

    Full Text Available Herniation of the anterior lens capsule is a rare abnormality in which the capsule bulges forward in the pupillary area. This herniation can be mistaken for an anterior lenticonus where both the capsule and the cortex bulge forward. The exact pathology behind this finding is still unclear. We report the clinical, ultrasound biomicroscopy (UBM and histopathological findings of a case of herniation of the anterior lens capsule. UBM helped to differentiate this entity from anterior lenticonus. Light microscopy revealed capsular splitting suggestive of capsular delamination and collection of fluid (aqueous in the area of herniation giving it a characteristic appearance.

  11. Toxic Anterior Segment Syndrome (TASS

    Directory of Open Access Journals (Sweden)

    Özlem Öner

    2011-12-01

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

  12. Irradiação contralateral de força para a ativação do músculo tibial anterior em portadores da doença de Charcot-Marie-Tooth: efeitos de um programa de intervenção por FNP Contralateral force irradiation for the activation of tibialis anterior muscle in carriers of Charcot-Marie-Tooth disease: effect of PNF intervention program

    Directory of Open Access Journals (Sweden)

    Paula C. Meningroni

    2009-10-01

    Full Text Available OBJETIVO: Avaliar a resposta do músculo tibial anterior (TA após um protocolo de cinco semanas com irradiação contralateral de força através de diagonais de facilitação neuromuscular proprioceptiva (FNP em pacientes com polineuropatia desmielinizante associada à doença de Charcot-Marie-Tooth do tipo 1A (CMT-1A. MÉTODOS: Participaram deste estudo 12 pacientes, de ambos os sexos. Eles foram tratados em uma frequência de duas vezes por semana, durante cinco semanas. Em cada sessão, foram utilizadas as diagonais de Chopping, extensão-adução com rotação interna (EARI e flexão-abdução com rotação interna (FARI. As diagonais foram repetidas quatro vezes, em ambos os membros superiores e inferiores; cada diagonal tinha duração média de 6 segundos. Durante as execuções, a resposta muscular do TA foi registrada por um eletromiógrafo de superfície, desprezando-se os 2 segundos iniciais e finais de cada diagonal. A média dos valores de Root Mean Square (RMS das quatro repetições foi normalizada em porcentagem. Os dados iniciais e finais foram submetidos ao teste em t para amostras pareadas com valores de p significativos OBJECTIVE: To evaluate the response of the tibialis anterior (TA muscle following a five-week protocol with contralateral irradiation force through Proprioceptive Neuromuscular Facilitation (PNF diagonals in patients with demyelinating polyneuropathy associated with Charcot-Marie-Tooth disease type 1A (CMT-1A. METHODS: The study included 12 patients of both sexes. They were treated twice-weekly for 5 weeks. At each session, they performed the following diagonal patterns: chopping, extension-adduction with internal rotation (EAIR and flexion-abduction with internal rotation (FAIR. The diagonals were repeated four times, in both upper and lower limbs, with each repetition lasting six seconds on average. During execution, the response of the TA muscle was recorded by a surface electromyograph disregarding the

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

    Directory of Open Access Journals (Sweden)

    Su-Na Lee

    2014-01-01

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

  14. Anterior capsular rupture following blunt ocular injury

    Science.gov (United States)

    Gremida, Anas; Kassem, Iris; Traish, Aisha

    2011-01-01

    Summary A 10-year-old boy suffered a large, oblique anterior capsular tear following blunt injury to his right eye. The boy was followed daily for hyphema resolution and progressive traumatic cataract formation. After the hyphema had resolved, the lens was removed using an anterior approach and an intraocular lens was placed with excellent visual outcome. PMID:23362402

  15. Totally thrombosed giant anterior communicating artery aneurysm

    Directory of Open Access Journals (Sweden)

    V R Roopesh Kumar

    2015-01-01

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

  16. Atraumatic Anterior Dislocation of the Hip Joint

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    Tadahiko Ohtsuru

    2015-01-01

    Full Text Available Dislocation of the hip joint in adults is usually caused by high-energy trauma such as road traffic accidents or falls from heights. Posterior dislocation is observed in most cases. However, atraumatic anterior dislocation of the hip joint is extremely rare. We present a case of atraumatic anterior dislocation of the hip joint that was induced by an activity of daily living. The possible causes of this dislocation were anterior capsule insufficiency due to developmental dysplasia of the hip, posterior pelvic tilt following thoracolumbar kyphosis due to vertebral fracture, and acetabular anterior coverage changes by postural factor. Acetabular anterior coverage changes in the sagittal plane were measured using a tomosynthesis imaging system. This system was useful for elucidation of the dislocation mechanism in the present case.

  17. Long anterior zonules and pigment dispersion.

    Science.gov (United States)

    Moroi, Sayoko E; Lark, Kurt K; Sieving, Paul A; Nouri-Mahdavi, Kouros; Schlötzer-Schrehardt, Ursula; Katz, Gregory J; Ritch, Robert

    2003-12-01

    To describe pigment dispersion associated with long anterior zonules. Multicenter observational case series. Fifteen patients, seven of whom were treated for glaucoma or ocular hypertension, were identified with long anterior zonules and pigment dispersion. Transmission electron microscopy was performed on one anterior capsule specimen. All patients had anterior zonules that inserted centrally on the lens capsule. Signs of pigment dispersion included corneal endothelial pigmentation, loss of the pupillary ruff, and variable trabecular meshwork pigmentation. Ultrasound biomicroscopy verified the lack of posterior iris insertion and concavity. There was no exfoliation material. Transmission electron microscopy showed zonular lamellae with adherent pigment granules, and no exfoliation material. Long anterior zonules inserted onto the central lens capsule may cause mechanical disruption of the pigment epithelium at the pupillary ruff and central iris leading to pigment dispersion.

  18. Anterior capsulotomy using the CO2 laser

    Science.gov (United States)

    Barak, Adiel; Ma-Naim, Tova; Rosner, Mordechai; Eyal, Ophir; Belkin, Michael

    1998-06-01

    Continuous circular capsulorhexis (CCC) is the preferred technique for removal of the anterior capsule during cataract surgery due to this technique assuring accurate centration of the intraocular lens. During modern cataract surgery, especially with small or foldable intra ocular lenses, centration of the lens is obligatory. Radial tears at the margin of an anterior capsulotomy may be associated with the exit of at least one loop of an intraocular lens out of the capsular bag ('pea pod' effect) and its subsequent decentration. The anterior capsule is more likely to ream intact if the continuous circular capsulorhexis (CCC) technique is used. Although manual capsulorhexis is an ideal anterior capsulectomy technique for adults, many ophthalmologists are still uncomfortable with it and find it difficult to perform, especially in complicated cases such as these done behind small pupil, cataract extraction in children and pseudoexfoliation syndrome. We have developed a technique using a CO2 laser system for safe anterior capsulotomy and tested it in animal eyes.

  19. Variedades da Democracia no Brasil

    Directory of Open Access Journals (Sweden)

    Fernando Bizzarro

    Full Text Available Resumo Neste artigo apresentamos resultados coletados pelo projeto Variedades da Democracia para o Brasil. Descrevemos a evolução histórica da democracia brasileira entre 1900 e 2015 enfocando seus cinco principais componentes (eleitoral, liberal, participativo, deliberativo e igualitário e duas dimensões adjacentes ao regime (corrupção e partidos políticos. Por fim, nós comparamos os dados para o Brasil com resultados obtidos para outros países da América do Sul. A análise dos dados aponta: a. a existência de uma trajetória “em espiral” dos regimes políticos no Brasil, na qual novas experiências democráticas tendem a superar experiências anteriores em todos os quesitos; b. os avanços e limites da experiência democrática contemporânea em que se combinam bons resultados nos indicadores eleitoral, liberal e deliberativo da democracia, e resultados menos elevados nos componentes igualitário e participativo do regime, bem como em suas dimensões adjacentes.

  20. Síndrome tóxica do segmento anterior

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    Luiz Filipe de Albuquerque Alves

    2013-02-01

    Full Text Available A síndrome tóxica do segmento anterior (STSA é uma severa reação inflamatória aguda causada por agente não infeccioso que entra no segmento anterior, resultando em lesão celular tóxica com necrose e apoptose mediado por resposta imunológica. Neste relato de caso de STSA são enfatizadas as causas mais comuns para o aparecimento da síndrome, apontam para os cuidados que devem ser tomados no processo de esterilização do material cirúrgico além de revisar a melhor conduta diante desses casos. Em conclusão notou-se que o foco principal deve ser a prevenção, pois o tratamento busca apenas suprimir a resposta inflamatória secundária. O tratamento nos casos de STSA consiste em intensa instilação de esteróides tópicos com seguimento rigoroso e controle de complicações tardias como o glaucoma.

  1. A tomografia de córnea e segmento anterior na propedêutica do exame complementar na avaliação de ectasia

    Directory of Open Access Journals (Sweden)

    Bruno de Freitas Valbon

    2013-02-01

    Full Text Available Descrevemos a importância da tomografia de córnea e segmento anterior na propedêutica do exame complementar na avaliação de ectasia. Esta descrição da interpretação clínica dos índices da tomografia de córnea e segmento anterior (Pentacam - Oculus, Wetzlar, Germany neste relato de caso, demonstra a relevância de uma nova tecnologia na avaliação da córnea e segmento anterior na suspeita de ceratocone. O diagnóstico de ceratocone foi excluído pela análise dos índices tomográficos de ectasia. Detectou-se assimetria entre os lados nasal e temporal por meio da avaliação do mapa de profundidade de câmara anterior. No exame biomicroscópico sob midríase foi constatado subluxação do cristalino, sendo assim devemos estar atentos não somente aos índices tomográficos corneanos na avaliação do exame complementar e sim analisarmos outros dados importantes oferecidos pela tomografia de córnea e segmento anterior.

  2. Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment

    NARCIS (Netherlands)

    Notten, K. J. B.; Essers, B. A.; Weemhoff, M.; Rutten, A. G. H.; Donners, J. J. A. E.; van Gestel, I.; Kruitwagen, R. F. M. P.; Roovers, J. P. W. R.; Dirksen, C. D.

    2015-01-01

    We investigated patients' preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse. Labelled discrete choice experiment. Three Dutch teaching hospitals. Women with anterior vaginal wall prolapse Pelvic Organ Prolapse Quantification stage 2 or

  3. MRI of tibialis anterior tendon rupture

    International Nuclear Information System (INIS)

    Gallo, Robert A.; DeMeo, Patrick J.; Kolman, Brett H.; Daffner, Richard H.; Sciulli, Robert L.; Roberts, Catherine C.

    2004-01-01

    Ruptures of the tibialis anterior tendon are rare. We present the clinical histories and MRI findings of three recent male patients with tibialis anterior tendon rupture aged 58-67 years, all of whom presented with pain over the dorsum of the ankle. Two of the three patients presented with complete rupture showing discontinuity of the tendon, thickening of the retracted portion of the tendon, and excess fluid in the tendon sheath. One patient demonstrated a partial tear showing an attenuated tendon with increased surrounding fluid. Although rupture of the tibialis anterior tendon is a rarely reported entity, MRI is a useful modality in the definitive detection and characterization of tibialis anterior tendon ruptures. (orig.)

  4. Anterior pseudoarthrectomy for symptomatic Bertolotti's syndrome.

    Science.gov (United States)

    Malham, Gregory M; Limb, Rebecca J; Claydon, Matthew H; Brazenor, Graeme A

    2013-12-01

    Painful L5/S1 pseudoarthrosis has been previously managed with posterior excision and/or lumbar fusion. To our knowledge, the anterior approach for L5/S1 pseudoarthrectomy in the treatment of Bertolotti's syndrome has not been described. We present two patients with severe symptomatic L5/S1 pseudoarthroses that were successfully excised via an anterior retroperitoneal approach with 2 year clinical and radiological follow-up. The literature regarding surgical treatments for Bertolotti's syndrome is reviewed. The technique for an anterior retroperitoneal approach is described. This approach has been safe and effective in providing long term symptomatic relief to our two patients. Further studies comparing the outcomes of anterior versus posterior pseudoarthrectomy will guide the management of this condition. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Tratamiento de la mordida cruzada anterior con plano inclinado anterior. Efecto sobre los arcos dentales

    OpenAIRE

    Carolina Rodríguez Manjarrés; Jesús Alberto Hernández Silva

    2017-01-01

    Objetivo: Evaluar los cambios dimensionales de los arcos dentales primarios tratados con plano inclinado anterior como método de corrección de la mordida cruzada anterior. Métodos: Se trataron 10 pacientes con edades entre 3 y 5 años afectados con mordida cruzada anterior completa, se colocó un plano inclinado anterior elaborado en acrílico, que estuvo en posición en promedio 8.5 semanas. Se obtuvieron modelos de estudio en 3 momentos T0: antes del tratamiento; T1: 6 meses después de iniciado...

  6. Influência do suporte e fixação anterior na resistência mecânica do fixador interno vertebral Influencia del soporte y de la fijación anterior sobre la resistencia mecánica del fijador interno vertebralartrodesis cervical anterior por hernia del disco cervica The influence of anterior reconstruction and fixation on the mechanical performance of an internal fixator

    Directory of Open Access Journals (Sweden)

    Gisele Cristina Ale dos Santos

    2009-03-01

    Full Text Available OBJETIVO: avaliar a influência da reconstrução e fixação anterior no desempenho mecânico do fixador interno da coluna vertebral. MÉTODOS: foram formados três grupos experimentais de acordo com a reconstrução e fixação anterior: grupo I -sem suporte anterior; grupo II - com suporte anterior; grupo III - com suporte e fixação anterior. Os corpos de prova foram submetidos a ensaios mecânicos de flexo-compressão, flexão lateral e torção, realizados em máquina de universal de ensaios, tendo sido realizados dez ensaios para cada modalidade (flexo-compressão, flexão lateral e torção em cada grupo experimental, perfazendo um total de 90 ensaios mecânicos. As propriedades mecânicas estudadas foram: o momento-fletor, o torque e a rigidez obtidos a partir da curva carga x deflexão de cada ensaio mecânico. RESULTADOS: observou-se que a colocação do suporte e da fixação anterior aumentou a resistência mecânica nos ensaios de flexo-compressão. Nos ensaios de flexão lateral observou-se aumento da resistência mecânica somente com a fixação anterior. CONCLUSÃO: nos ensaios de torção o suporte anterior e a fixação anterior não aumentaram a resistência mecânica do sistema de fixação vertebral.OBJETIVO: evaluar la influencia de la reconstrucción y fijación anterior en el desempeño mecánico del fijador interno de la columna vertebral. MÉTODOS: fueron formados tres grupos experimentales de acuerdo com la reconstrucción y fijación anterior: grupo I- sin soporte anterior, grupo II- con soporte anterior y grupo III- con soporte y fijación anterior. Los cuerpos de prueba fueron sometidos a ensayos mecánicos de flexocompresión, flexión lateral y torción, realizados en la máquina universal de ensayos, habiéndose realizados 10 ensayos para cada modalidad (flexocompresión, flexión lateral y torción en cada grupo experimental,con untotal de 90 ensayos mecánicos. Las propiedades mecánicas estudiadas fueron el

  7. Aphasia following anterior cerebral artery occlusion

    International Nuclear Information System (INIS)

    Shimosaka, Shinichi; Waga, Shiro; Kojima, Tadashi; Shimizu, Takeo; Morikawa, Atsunori

    1982-01-01

    We have report two cases of aphasia that had infarcts in the distribution of the left or right anterior cerebral artery, as confirmed by computed tomography. Case 1 is a right-handed, 65-year-old man in whom computerized tomographic scanning revealed an infarction of the territory of the left anterior cerebral artery after the clipping of the anterior communicating artery aneurysm. The standard language test of aphasia (SLTA) revealed non-fluent aphasia with dysarthria, good comprehension, almost normal repetition with good articulation, and a defectiveness in writing. This syndrome was considered an instance of transcortical motor aphasia. Although three years had passed from the onset, his aphasia did not show any improvement. Case 2 is a 37-year-old man who is right-handed but who can use his left hand as well. He was admitted because of subarachnoid hemorrhage from an anterior communicating aneurysm. Because of postoperative spasm, an infarction in the distribution of the right anterior cerebral artery developed. He was totally unable to express himself vocally, but he could use written language quite well to express his ideas and had a good comprehension of spoken language. This clinical picture was considered that of an aphemia. After several weeks, his vocalization returned, but the initial output was still hypophonic. (J.P.N.)

  8. Innervation of the Anterior Sacroiliac Joint.

    Science.gov (United States)

    Cox, Marcus; Ng, Garrett; Mashriqi, Faizullah; Iwanaga, Joe; Alonso, Fernando; Tubbs, Kevin; Loukas, Marios; Oskouian, Rod J; Tubbs, R Shane

    2017-11-01

    Sacroiliac joint pain can be disabling and recalcitrant to medical therapy. The innervation of this joint is poorly understood, especially its anterior aspect. Therefore, the present cadaveric study was performed to better elucidate this anatomy. Twenty-four cadaveric sides underwent dissection of the anterior sacroiliac joint, with special attention given to any branches from regional nerves to this joint. No femoral, obturator, or lumbosacral trunk branches destined to the anterior sacroiliac joint were identified in the 24 sides. In 20 sides, one or two small branches (less than 0.5 mm in diameter) were found to arise from the L4 ventral ramus (10%), the L5 ventral ramus (80%), or simultaneously from both the L4 and L5 ventral rami (10%). The length of the branches ranged from 5 to 31 mm (mean, 14 mm). All these branches arose from the posterior part of the nerves and traveled to the anterior surface of the sacroiliac joint. No statistical significance was found between sides or sexes. An improved knowledge of the innervation of the anterior sacroiliac joint might decrease suffering in patients with chronic sacroiliac joint pain. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. A Descoberta da Morte e Mundo Homérico

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    Linneu Camargo Schutzer

    1956-11-01

    Full Text Available A insistência com que os historiadores da filosofia apresentam o mundo grego a partir do naturalismo jônio, com breves referências ao pensamento helênico anterior, leva-nos algumas vêzes a aceitar a ordem natural como a primeira sugestão para um pensamento racional, nela procurando a própria origem da noção de devir.

  10. URETHROPLASTY FOR COMPLICATED ANTERIOR URETHRAL STRICTURES.

    Science.gov (United States)

    Aoki, Katsuya; Hori, Shunta; Morizawa, Yosuke; Nakai, Yasushi; Miyake, Makito; Anai, Satoshi; Torimoto, Kazumasa; Yoneda, Tatsuo; Tanaka, Nobumichi; Yoshida, Katsunori; Fujimoto, Kiyohide

    2016-01-01

    (Objectives) To compare efficacy and outcome of urethroplasty for complicated anterior urethral strictures. (Methods) Twelve patients, included 3 boys, with anterior urethral stricture underwent urethroplasty after the failure of either urethral dilatation or internal urethrotomy. We evaluated pre- and post-operative Q max and surgical outcome. (Results) Four patients were treated with end-to-end anastomosis, included a case of bulbar urethral elongation simultaneously, one patient was treated with augmented anastomotic urethroplasty, three patients were treated with onlay urethroplasty with prepucial flap, one patient was treated with tubed urethroplasty with prepucial flap (Ducket procedure) and three patients were treated with onlay urethroplasty with buccal mucosal graft. Postoperative Qmax improved in all patients without major complications and recurrence during follow-up periods ranging from 17 to 102 months (mean 55 months). (Conclusions) Urethroplasty is an effective therapeutic procedure for complicated anterior urethral stricture.

  11. Anterior cruciate ligament tears: MRI versus arthroscopy

    International Nuclear Information System (INIS)

    Tosch, U.; Felix, R.; Schauwecker, W.; Dreithaler, B.

    1992-01-01

    Because of suspected rupture of the anterior cruciate ligament sixteen acute traumatised patients were investigated by MR and arthroscopy. The MR diagnosis of a lesion of the anterior cruciate ligament proved to be correct by arthroscopy in fifteen of sixteen cases. Diagnostic criteria for lesions of the anterior cruciate ligament were: increased signal intensity in T 1 - and T 2 weighted images, increased volume and discontinuity of ligamentous structures. Additional MR findings of meniscal tears were correct in three of four cases laterally and in four of four cases medially. Femoral cartilage lesions were correctly identified by MR in three cases. MR normal findings proved to be correct by arthroscopy in another five cases. (orig.) [de

  12. Nonnecrotizing anterior scleritis mimicking orbital inflammatory disease

    Directory of Open Access Journals (Sweden)

    Lynch MC

    2013-08-01

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

  13. Morphometric Study of the Anterior Thalamoperforating Arteries

    Science.gov (United States)

    Kim, Sung-Ho; Yeo, Dong-Kyu; Shim, Jae-Joon; Yoon, Seok-Mann; Chang, Jae-Chil

    2015-01-01

    Objective To evaluate the morphometry of the anterior thalamoperforating arteries (ATPA). Methods A microanatomical study was performed in 79 specimens from 42 formalin-fixed adult cadaver brains. The origins of the ATPAs were divided into anterior, middle, and posterior segments according to the crowding pattern. The morphometry of the ATPAs, including the premammillary artery (PMA), were examined under a surgical microscope. Results The anterior and middle segments of the ATPAs arose at mean intervals of 1.75±1.62 mm and 5.86±2.05 mm from the internal carotid artery (ICA), and the interval between these segments was a mean of 3.17±1.64 mm. The posterior segment arose at a mean interval of 2.43±1.46 mm from the posterior cerebral artery (PCA), and the interval between the middle and posterior segments was a mean of 3.45±1.39 mm. The mean numbers of perforators were 2.66±1.19, 3.03±1.84, and 1.67±0.98 in the anterior, middle, and posterior segments, respectively. The PMA originated from the middle segment in 66% of cases. A perforator-free zone was located >2 mm from the ICA in 30.4% and >2 mm from the PCA in 67.1% of cases. Conclusion Most perforators arose from the anterior and middle segments, within the anterior two-thirds of the posterior communicating artery (PCoA). The safest perforator-free zone was located closest to the PCA. These anatomical findings may be helpful to verify safety when treating lesions around the PCoA and in the interpeduncular fossa. PMID:26113962

  14. Inferior Oblique Overaction: Anterior Transposition Versus Myectomy.

    Science.gov (United States)

    Rajavi, Zhale; Feizi, Mohadeseh; Behradfar, Narges; Yaseri, Mehdi; Sayanjali, Shima; Motevaseli, Tahmine; Sabbaghi, Hamideh; Faghihi, Mohammad

    2017-07-01

    To compare the efficacy of inferior oblique myectomy and anterior transposition for correcting inferior oblique overaction (IOOA). This retrospective study was conducted on 56 patients with IOOA who had either myectomy or anterior transposition of the inferior oblique muscle from 2010 to 2015. The authors compared preoperative and postoperative inferior oblique muscle function grading (-4 to +4) as the main outcome measure and vertical and horizontal deviation, dissociated vertical deviation (DVD), and A- and V-pattern between the two surgical groups as secondary outcomes. A total of 99 eyes of 56 patients with a mean age of 5.9 ± 6.5 years were included (47 eyes in the myectomy group and 52 eyes in the anterior transposition group). There were no differences in preoperative best corrected visual acuity, amblyopia, spherical equivalent, and primary versus secondary IOOA between the two groups. Both surgical procedures were effective in reducing IOOA and satisfactory results were similar between the two groups: 61.7% and 67.3% in the myectomy and anterior transposition groups, respectively (P = .56). After adjustment for the preoperative DVD, there was no statistically significant difference between the two groups postoperatively. The preoperative hypertropia was 6 to 14 and 6 to 18 prism diopters (PD) in the myectomy and anterior transposition groups, respectively. After surgery, no patient had a vertical deviation greater than 5 PD. Both the inferior oblique myectomy and anterior transposition procedures are effective in reducing IOOA with similar satisfactory results. DVD and hypertropia were also corrected similarly by these two surgical procedures. [J Pediatr Ophthalmol Strabismus. 2017;54(4):232-237.]. Copyright 2017, SLACK Incorporated.

  15. Reflex muscle contraction in anterior shoulder instability.

    Science.gov (United States)

    Wallace, D A; Beard, D J; Gill, R H; Eng, B; Carr, A J

    1997-01-01

    Reduced proprioception may contribute to recurrent anterior shoulder instability. Twelve patients with unilateral shoulder instability were investigated for evidence of deficient proprioception with an activated pneumatic cylinder and surface electromyography electrodes; the contralateral normal shoulder was used as a control. The latency between onset of movement and the detection of muscle contraction was used as an index of proprioception. No significant difference in muscle contraction latency was detected between the stable and unstable shoulders, suggesting that there was no significant defect in muscular reflex activity. This study does not support the use proprioception-enhancing physiotherapy in the treatment of posttraumatic anterior shoulder instability.

  16. Roentgenographic findings following anterior cervical fusion

    Energy Technology Data Exchange (ETDEWEB)

    Gore, D R; Gardner, G M; Sepic, S B; Murray, M P

    1986-10-01

    We reviewed the pre- and postoperative lateral cervical roentgenograms in 90 patients who had anterior fusions and compared their findings with age and sex-matched people without neck problems. The average interval from surgery to review was 5 years. Preoperatively, all patients had a higher incidence of degenerative spondylosis at the levels to be fused than their asymptomatic counterparts. Postoperatively, there was no difference in the incidence of degenerative change between the operated and the control group at the levels above and below the fusion with the exception of anterior osteophyte formation which was more frequent in those with fusions.

  17. Anterior tibial stress fractures treated with anterior tension band plating in high-performance athletes.

    Science.gov (United States)

    Cruz, Alexandre Santa; de Hollanda, João Paris Buarque; Duarte, Aires; Hungria Neto, José Soares

    2013-06-01

    The non-surgical treatment of anterior tibial cortex stress fractures requires long periods of abstention from sports activities and often results in non-union. Many different surgical techniques have already been previously described to treat these fractures, but there is no consensus on the best treatment. We describe the outcome of treatment using anterior tibial tension band plating in three high-performance athletes (4 legs) with anterior tibial cortex stress fractures. Tibial osteosynthesis with a 3.5-mm locking compression plate in the anterolateral aspect of the tibia was performed in all patients diagnosed with anterior tibial stress fracture after September 2010 at Santa Casa Hospital. All of the fractures were consolidated within a period of 3 months after surgery, allowing for an early return to pre-injury levels of competitive sports activity. There were no infection, non-union, malunion or anterior knee pain complications. Anterior tibial tension band plating leads to prompt fracture consolidation and is a good alternative for the treatment of anterior tibial cortex stress fractures. Bone grafts were shown to be unnecessary.

  18. Combination nivolumab- and cabiralizumab-associated acute bilateral anterior and posterior scleritis and anterior uveitis

    Directory of Open Access Journals (Sweden)

    John A. Gonzales

    2018-06-01

    Full Text Available Purpose: To report on a case of uveitis and scleritis resulting as an immune-mediated side effect of cancer immunotherapy with nivolumab and cabiralizumab. Observations: Bilateral anterior nongranulomatous anterior uveitis and bilateral diffuse anterior and posterior scleritis occurred following the use of combination cancer immunotherapy. The uveitis and scleritis resolved following temporary discontinuation of nivolumab and cabiralizumab as well as systemic prednisone. Conclusions and importance: Ophthalmologists should be aware of the possibility of acute ocular inflammation developing with cancer immunotherapy. Systemic corticosteroids play a first-line role in managing such immune-mediated side effects. Keywords: Uveitis, Scleritis, Cancer immunotherapy, Side effects, Nivolumab, Cabiralizumab

  19. Novel Insights into Anterior Cruciate Ligament Injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan)

    2011-01-01

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

  20. Optical coherence tomography in anterior segment imaging

    Science.gov (United States)

    Kalev-Landoy, Maya; Day, Alexander C.; Cordeiro, M. Francesca; Migdal, Clive

    2008-01-01

    Purpose To evaluate the ability of optical coherence tomography (OCT), designed primarily to image the posterior segment, to visualize the anterior chamber angle (ACA) in patients with different angle configurations. Methods In a prospective observational study, the anterior segments of 26 eyes of 26 patients were imaged using the Zeiss Stratus OCT, model 3000. Imaging of the anterior segment was achieved by adjusting the focusing control on the Stratus OCT. A total of 16 patients had abnormal angle configurations including narrow or closed angles and plateau irides, and 10 had normal angle configurations as determined by prior full ophthalmic examination, including slit-lamp biomicroscopy and gonioscopy. Results In all cases, OCT provided high-resolution information regarding iris configuration. The ACA itself was clearly visualized in patients with narrow or closed angles, but not in patients with open angles. Conclusions Stratus OCT offers a non-contact, convenient and rapid method of assessing the configuration of the anterior chamber. Despite its limitations, it may be of help during the routine clinical assessment and treatment of patients with glaucoma, particularly when gonioscopy is not possible or difficult to interpret. PMID:17355288

  1. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  2. Post caesarean section anterior abdominal wall endometriosis ...

    African Journals Online (AJOL)

    Abdominal wall endometriosis is a likely sequelae of caesarean section as viable endometrial tissue are deposited in the peritoneal cavity or anterior abdominal wall. One such case to sensitize clinicians of this rare presentation of the disease is presented. The patient was a 48 year old woman who presented with a lesion ...

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

    Science.gov (United States)

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

    2007-01-01

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

  4. Tunnel widening in anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

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

    1999-01-01

    We report a prospective series evaluating the incidence and degree of tunnel widening in a well-matched series of patients receiving a hamstring or patella tendon graft for anterior cruciate ligament (ACL) deficiency. We correlated tunnel widening with clinical factors, knee scores, KT-1000 and i...

  5. Anterior interbody fusion for cervical osteomyelitis

    Science.gov (United States)

    Bartal, A. D.; Schiffer, J.; Heilbronn, Y. D.; Yahel, M.

    1972-01-01

    Interbody fusion for stabilization of the cervical spine after osteomyelitic destruction of the body of C5 vertebra is reported in a patient with quadriplegia and sphincter disturbances secondary to an epidural abscess. The successful union of the bone graft along with complete neurological recovery after anterior decompression and evacuation of the epidural mass seem to justify the procedure. Images PMID:4554587

  6. Anterior process fractures of the calcaneus

    International Nuclear Information System (INIS)

    Renfrew, D.L.; El-Khoury, G.Y.

    1985-01-01

    Fractures of the anterior process of the calcaneus are often missed. This error follows from the tendency to focus exclusively on the mortise and malleoli when a history of ankle trauma is supplied. Seven patients with this fracture are presented. The anatomy, mechanism of injury, clinical presentation, and the radiographic features of this injury are discussed. (orig.)

  7. Anterior Segment Ischemia after Strabismus Surger

    Directory of Open Access Journals (Sweden)

    Emine Seyhan Göçmen

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Miesje K. Purwanegara

    2015-09-01

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

  9. Insuficiência tricúspide pós trauma associada a agnesia de músculo papilar anterior Post-traumatic tricuspid insufficiency associated with agenesis of the anterior papillary muscle

    Directory of Open Access Journals (Sweden)

    Ronaldo Ducceschi FONTES

    2000-09-01

    Full Text Available Relatamos o caso de paciente do sexo masculino com 36 anos de idade com sinais e sintomas de insuficiência cardíaca direita. A história revelou trauma torácico há aproximadamente cinco anos. Submetido a operação para tratamento de insuficiência tricúspide, notou-se ausência do músculo papilar anterior da valva tricúspide, fenda na cúspide anterior e dilatação do anel tricuspídeo. Foi realizada sutura da fenda localizada na cúspide anterior e feita sua sustentação utilizando-se tira de pericárdio bovino fixada na face atrial e base do músculo papilar posterior. A operação foi completada com anuloplastia de Revuelta. O paciente obteve nítida melhora dos sintomas no pós-operatório imediato, mantendo-se em classe funcional I (NYHA, após 22 meses de evolução.Tricuspid regurgitation arising from chest trauma five years earlier was successfully corrected by valve reconstruction in a 36 year-old man. During correction a fissure of the anterior leaflet, absence of the anterior papillary muscle, chordae tendineae and tricuspid annulus dilatation were found. Tricuspid valvuloplasty was feasible using an anchored suture of the anterior leaflet fissure, artificial bovine chordae, pericardium implantation and Revuelta ring annuloplasty. There were no complications and no early or late mortality. At 22 months follow-up tricuspid valve function has remained with mild regurgitation. The patient is in good clinical condition.

  10. Fiber-reinforced Composite for Chairside Replacement of Anterior ...

    African Journals Online (AJOL)

    Fiber-reinforced Composite for Chairside Replacement of Anterior Teeth: A Case Report. ... investigation will be required to provide additional information on the survival of directly-bonded anterior fixed prosthesis made with FRC systems.

  11. Displaced fracture through the anterior atlantal synchondrosis

    International Nuclear Information System (INIS)

    Thakar, Chrishan; Allibone, James; Harish, Srinivasan; Saifuddin, Asif

    2005-01-01

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

  12. A brief review on anterior urethral strictures

    Directory of Open Access Journals (Sweden)

    Li Cheng

    2018-04-01

    Full Text Available The treatment of urethral strictures remains a challenging field in urology even though there are a variety of procedures to treat it at present, as no one approach is superior over another. This paper reviewed the surgical options for the management of different sites and types of anterior urethral stricture, providing a brief discussion of the controversies regarding this issue and suggesting possible future advancements. Among the existing procedures, simple dilation and direct vision internal urethrotomy are more commonly used for short urethral strictures ( <1 cm, soft and no previous intervention. Currently, urethroplasty using buccal mucosa or penile skin is the most widely adopted clinical techniques and have proved successful. Nonetheless, complications such as donor site morbidity remain problem. Tissue engineering techniques are considered as a promising solution for urethral reconstruction, but require further investigation, as does stem cell therapy. Keywords: Anterior urethral strictures, Urethral reconstruction, Tissue engineering, Urethral strictures

  13. Bypass grafting to the anterior tibial artery.

    Science.gov (United States)

    Armour, R H

    1976-01-01

    Four patients with severe ischaemia of a leg due to atherosclerotic occlusion of the tibial and peroneal arteries had reversed long saphenous vein grafts to the patent lower part of the anterior tibial artery. Two of these grafts continue to function 19 and 24 months after operation respectively. One graft failed on the fifth postoperative day and another occluded 4 months after operation. The literature on femorotibial grafting has been reviewed. The early failure rate of distal grafting is higher than in the case of femoropopliteal bypass, but a number of otherwise doomed limbs can be salvaged. Contrary to widely held views, grafting to the anterior tibial artery appears to give results comparable to those obtained when the lower anastomosis is made to the posterior tibial artery.

  14. Displaced fracture through the anterior atlantal synchondrosis

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-09-01

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

  15. Cataract Surgery in Anterior Megalophthalmos: A Review

    Science.gov (United States)

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

    2015-01-01

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

  16. Lentes fácicas de câmara anterior

    Directory of Open Access Journals (Sweden)

    Walton Nosé

    2012-08-01

    Full Text Available Os implantes em olhos fácicos apresentam-se como uma opção para a correção de altas ametropias. De acordo com sua localização podem ser classificados como de câmara anterior ou posterior, sendo que os primeiros subdividem-se em fixação iriana ou de suporte angular. Além da correção da miopia, as lentes de fixação iriana apresentam modelos para hipermétropes e astigmatas. Várias modificações no desenho das lentes foram propostas nas últimas décadas com a finalidade de reduzir complicações tardias, como a perda endotelial progressiva. Cuidados no intraoperatório devem ser tomados de forma a diminuir a perda endotelial aguda relacionada ao trauma. Avanços nos métodos de triagem pré-operatória também melhoraram a segurança do procedimento. A estimativa do poder dióptrico é baseada nos cálculos de Van der Heijde, sendo dependente da profundidade de câmara anterior, do equivalente esférico da refração e da média ceratométrica. Resultados a longo prazo demonstram a eficácia, previsibilidade e segurança do procedimento. Dependendo do modelo, além da possibilidade de perda endotelial, outras possíveis complicações incluem: irite, dispersão pigmentar, atrofia de íris, ovalização pupilar, rotação, descentração ou deslocamento da lente, hipertensão ocular e bloqueio pupilar. Modelos dobráveis atualmente disponíveis vêm apresentado resultados bastante promissores com redução da taxa de complicações.

  17. Epiphyseal osteochondroma of the anterior cruciate ligament.

    Science.gov (United States)

    Chekofsky, K M; Scott, W N; Fielding, J W

    1979-01-01

    An 8-year-old Black boy complained of pain, swelling, and a decreased range of motion in the knee. One arthrotomy operation was reported to show a normal knee joint. Six months later, a second arthrotomy demonstrated an osteochondroma growing from the epiphysis into the anterior cruciate ligament. Epiphyseal osteochondroma should be added to the working differential diagnosis on children with effusion and decrease of knee motion.

  18. Anterior rectal duplication: a diagnostic challenge.

    Science.gov (United States)

    Amjadi, K; Poenaru, D; Soboleski, D; Hurlbut, D; Kamal, I

    2000-04-01

    The authors present an anterior rectal cyst in a 14-month-old girl. This rare variant of rectal duplications presented with recurrent urinary infections. The diagnosis was challenging in view of the multiple differential diagnoses to be considered. Magnetic resonance imaging appeared to be the most accurate preoperative investigation. The cyst was removed uneventfully by partial excision and mucosal ablation. An awareness of this variant can lead to early diagnosis and curative resection.

  19. Anterior colorectal duplication presenting as rectal prolapse.

    Science.gov (United States)

    Ramirez-Resendiz, Amador; Asz, Jose; Medina-Vega, F Antonio; Ortega-Salgado, J Arturo

    2007-09-01

    Duplications of the gastrointestinal (GI) tract are rare. Only 5% of them are rectal and there are very few reports of rectal prolapse (RP) caused by a duplication. An 11 month-old female presented with a RP caused by a blind-ended anterior tubular colorectal duplication. The duplication was successfully opened and connected to the normal rectum without complications. Although infrequent, a rectal duplication should be considered in the differential diagnosis of RP.

  20. Arthroscopic Findings in Anterior Shoulder Instability

    OpenAIRE

    Hantes, Michael; Raoulis, Vasilios

    2017-01-01

    Background: In the last years, basic research and arthroscopic surgery, have improved our understanding of shoulder anatomy and pathology. It is a fact that arthroscopic treatment of shoulder instability has evolved considerably over the past decades. The aim of this paper is to present the variety of pathologies that should be identified and treated during shoulder arthroscopy when dealing with anterior shoulder instability cases. Methods: A review of the current literature regarding arthros...

  1. Anterior Tibial Artery Pseudoaneurysm: Case Report

    Directory of Open Access Journals (Sweden)

    Funda Tor

    2012-06-01

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

  2. Unilateral Anterior Epistaxis Electrocautery versus Chemical Cautery

    International Nuclear Information System (INIS)

    Umar, A. S.; Rahat, Z. M.; Hussain, S. S.; Khan, M. Z.; Fareed, G.

    2013-01-01

    Objective: To evaluate and compare the two methods, electrocautery versus chemical cautery, for controlling unilateral anterior epistaxis and to identify the complications. Design: Randomized control trial. Place and Duration: This study was conducted in ENT Department PNS Shifa Hospital Karachi from August 2009 to June 2011. Patients and Methods: Ninety two cases with unilateral anterior epistaxis were divided using random number trials into two groups i.e. group A and group B containing 46 cases each. In group A electrocautery and in group B chemical cautery with 50% silver nitrate was done and the results were compared. Results: In this study 92 cases were divided randomly into two groups i.e. group A and group B containing 46 cases in each group. In group A 44 (95.6%) out of 46 cases were treated successfully with a single visit as an outpatient by electrocautery, the patients were called for follow up on the fifth day and then fortnightly for three months after the procedure, only 2 (4.3%) cases reported in first five days with mild recurrence of bleeding. In group B 42 (91.3%) cases out of 46 cases were treated successfully in a single visit and recurrence of bleeding occured in 4 (8.7%) cases who required a second visit during the first five days. There were no major complications found in either group except few complaints of post cauterization pain and mucosal inflammation observed slightly more in group B patients. Conclusion: Electrocautery and chemical cautery with 50% silver nitrate both are equally effective procedures to control anterior epistaxis if the bleeding point is visible and small. Both procedures are reliable and there are no major complications. Occasionally if the bleeding point in the anterior nasal septum is large then electrocautery may be a preferred option. (author)

  3. CT evaluation of the anterior epitympanic recess

    International Nuclear Information System (INIS)

    Yamasoba, Tatsuya; Kikuchi, Shigeru; Takeuchi, Naonobu; Harada, Takehiko; Nomura, Yasuya

    1991-01-01

    The structures of the anterior epitympanic recess and its surrounding tissues were examined among non-inflammatory ear, chronic otitis media with central perforation and cholesteatoma, using axial scans of high resolution computed tomography. The length and width of the recess, as well as the number of the slices where the cog was determined, had no significant differences among them. Thus, the bony structure of the recess was considered to be seldom influenced by inflammatory processes. In the non-inflammatory ear, the degree of pneumatization around the recess was similar to that of the petrous apex cells and lower than that of the mastoid cells. In the chronic otitis media with central perforation and cholesteatoma, the pneumatization of the whole temporal bones was suppressed and the tendency was also found that the cells around the recess were less pneumatized than the mastoid cells. When cholesteatoma invaded into the anterior epitympanic recess, the destruction of the bony protrusion of the lateral wall between the recess and the epitympanum was recognized, as well as the disappearance of the cog. The bony protrusion was considered to be an inferior extention of the cog toward the anterior tympanic spine. (author)

  4. Anterior cruciate ligament ganglion: case report

    Directory of Open Access Journals (Sweden)

    André Pedrinelli

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

  5. Traumatic Anterior Cerebral Artery Pseudoaneurysmal Epistaxis.

    Science.gov (United States)

    Liu, Qing Lin; Xue, Hao; Qi, Chang Jing; Zhao, Peng; Wang, Dong Hai; Li, Gang

    2017-04-01

    Pseudoaneurysmal epistaxis is a rare but emergent condition. We report a case of traumatic anterior cerebral artery pseudoaneurysmal epistaxis and review the published literature. A 49-year-old man sustained severe head trauma. He was diagnosed with multiple skull bone fractures, left subdural hematoma, subarachnoid hemorrhage, pneumocephalus, and right frontal hematoma. Subdural hematoma evacuation was done at a local hospital. In the following months, he experienced repeated epistaxis that required nasal packing to stop the bleeding. Digital subtraction angiography showed an anterior cerebral artery pseudoaneurysm protruding into the posterior ethmoid sinus. Embolization of the aneurysm was performed with microcoils, and the parent artery was occluded by thrombosis. The patient presented 1 month later with another epistaxis episode. Digital subtraction angiography showed recanalization of the parent artery and recurrence of the aneurysm. The parent artery was occluded for the second time with coils and Onyx embolic agent. Pseudoaneurysmal epistaxis is rare, and this is the first report of an anterior cerebral artery pseudoaneurysm that manifested with epistaxis. Endovascular intervention has become the first choice of treatment for this disease. The high recurrence rate is the main disadvantage of endovascular intervention. Aneurysm trapping with bypass surgery is another treatment option. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Anterior Face Height Values in a Nigerian Population | Folaranmi ...

    African Journals Online (AJOL)

    ... Anterior Upper Face Height 47.7 (4) mm, Anterior Total Face Height (ATFH) 108.5 (5) mm, ratio of ALFH to ATFH ALFH: ATFH 56 (4)%. Conclusion: This study provides anterior face height measurements, which will be of great significance in evaluating facial proportions andesthetics in orthodontics, orthognathic surgery, ...

  7. Cadmium mimics estrogen-driven cell proliferation and prolactin secretion from anterior pituitary cells.

    Directory of Open Access Journals (Sweden)

    Sonia A Ronchetti

    Full Text Available Cadmium (Cd is a heavy metal of considerable occupational and environmental concern affecting wildlife and human health. Recent studies indicate that Cd, like other heavy metals, can mimic effects of 17β-estradiol (E2 involving E2 receptor (ER activation. Lactotrophs, the most abundant cell type in anterior pituitary gland, are the main target of E2, which stimulates cell proliferation and increases prolactin secretion through ERα. The aim of this work was to examine whether Cd at nanomolar concentrations can induce cell proliferation and prolactin release in anterior pituitary cells in culture and whether these effects are mediated through ERs. Here we show that 10 nM Cd was able to stimulate lactotroph proliferation in anterior pituitary cell cultures from female Wistar rats and also in GH3 lactosomatotroph cell line. Proliferation of somatotrophs and gonadotrophs were not affected by Cd exposure. Cd promoted cell cycle progression by increasing cyclins D1, D3 and c-fos expression. Cd enhanced prolactin synthesis and secretion. Cd E2-like effects were blocked by the pure ERs antagonist ICI 182,780 supporting that Cd acts through ERs. Further, both Cd and E2 augmented full-length ERαexpression and its 46 kDa-splicing variant. In addition, when co-incubated Cd was shown to interact with E2 by inducing ERα mRNA expression which indicates an additive effect between them. This study shows for the first time that Cd at nanomolar concentration displays xenoestrogenic activities by inducing cell growth and stimulating prolactin secretion from anterior pituitary cells in an ERs-dependent manner. Cd acting as a potent xenoestrogen can play a key role in the aetiology of different pathologies of the anterior pituitary and in estrogen-responsive tissues which represent considerable risk to human health.

  8. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture

    OpenAIRE

    Fukui, Shinji; Aoki, Katsuya; Kaneko, Yoshiteru; Samma, Shoji; Fujimoto, Kiyohide

    2014-01-01

    A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed...

  9. Capsulorhexis contraction after cataract surgery: Comparison of sharp anterior edge and modified anterior edge acrylic intraocular lenses

    DEFF Research Database (Denmark)

    Corydon, C.; Lindholt, M.; Knudsen, E.B.

    2007-01-01

    eyes) were included in a prospective randomized study. All had phacoemulsification followed by implantation of an IOL with a modified anterior edge (38 eyes) or a sharp anterior edge (46 eyes). One day (baseline) and 3 months postoperatively, the area of the anterior capsule opening was measured using...... retroillumination photographs. RESULTS: There was a significant reduction in the area of the anterior capsule opening from 1 day to 3 months postoperatively in both groups (Psharp...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-01

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

  11. An anterior signaling center patterns and sizes the anterior neuroectoderm of the sea urchin embryo.

    Science.gov (United States)

    Range, Ryan C; Wei, Zheng

    2016-05-01

    Anterior signaling centers help specify and pattern the early anterior neuroectoderm (ANE) in many deuterostomes. In sea urchin the ANE is restricted to the anterior of the late blastula stage embryo, where it forms a simple neural territory comprising several types of neurons as well as the apical tuft. Here, we show that during early development, the sea urchin ANE territory separates into inner and outer regulatory domains that express the cardinal ANE transcriptional regulators FoxQ2 and Six3, respectively. FoxQ2 drives this patterning process, which is required to eliminate six3 expression from the inner domain and activate the expression of Dkk3 and sFRP1/5, two secreted Wnt modulators. Dkk3 and low expression levels of sFRP1/5 act additively to potentiate the Wnt/JNK signaling pathway governing the positioning of the ANE territory around the anterior pole, whereas high expression levels of sFRP1/5 antagonize Wnt/JNK signaling. sFRP1/5 and Dkk3 levels are rigidly maintained via autorepressive and cross-repressive interactions with Wnt signaling components and additional ANE transcription factors. Together, these data support a model in which FoxQ2 initiates an anterior patterning center that implements correct size and positions of ANE structures. Comparisons of functional and expression studies in sea urchin, hemichordate and chordate embryos reveal striking similarities among deuterostome ANE regulatory networks and the molecular mechanism that positions and defines ANE borders. These data strongly support the idea that the sea urchin embryo uses an ancient anterior patterning system that was present in the common ambulacrarian/chordate ancestor. © 2016. Published by The Company of Biologists Ltd.

  12. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture.

    Science.gov (United States)

    Fukui, Shinji; Aoki, Katsuya; Kaneko, Yoshiteru; Samma, Shoji; Fujimoto, Kiyohide

    2014-05-01

    A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed when he was 5 years. After excision of the scarred portions of the urethra, the defect of the urethra was 20 mm. Transperineal bulbar urethral mobilization was performed, and a single-stage end-to-end anterior urethroplasty without tension could be performed simultaneously.

  13. Post Operative Voiding Efficacy after Anterior Colporrhaphy

    Directory of Open Access Journals (Sweden)

    Behnoosh Miladpoor

    2010-02-01

    Full Text Available The aim of this study was to determine the most effective and suitable time to remove the urinary catheter (Foley after anterior and posterior colporrhaphy surgery. Patients who experience anterior Colporrhaphy operation for genuine stress incontinency or pelvic organ prolapsed will have post operative voiding dysfunction. These patients need postoperative drainage. One of the methods preferred for this purpose is to apply Foley Catheter, but there is no particular regimen available for the exact time of catheter removal in these patients. We have tried to find out the best time to remove Foley catheter after which the repeated Foley catheter is not required or minimized. One hundred and eighty nine patients who have been undergone Colporrhaphy have been selected randomly and divided into three groups' as 1, 2 and 4 days of catheter removal. The number of patients in each group was 62, 63 and 64 respectively. In all three groups, before removing urinary catheter, it was clamped every 4 hrs, for 3 times. After removing of Foley, the patients were guided for urination; the voiding and residual volume was measured. In the patients with an increase of residual volume, the  repeated Foley requirement was increased. However,  5.6 % of the patients with residual volume of ≤ 33 percent and 23.9% of the patients with residual volume between 33 to 68 percent, and finally  64.8% of the patients with residual volume of ≥ 68% had repeated Foley insertion. When considering the number of days, 85, 65 and 35.7 percent of the patients needed repeated Foley after 1, 2, and 4 days of catheter removal respectively. Interestingly, in the third group ( 4 days of the catheter removal with residual volume of ≤ 33% the repeated Foley requirement was nil, with no increase risk of urinary infection. We suggest that the best time to remove the urinary Foley catheter after anterior and posterior Colporrhaphy is the day four.

  14. Toxic anterior-segment syndrome (TASS

    Directory of Open Access Journals (Sweden)

    Cetinkaya S

    2014-10-01

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

  15. Surgical management of anterior chamber epithelial cysts.

    Science.gov (United States)

    Haller, Julia A; Stark, Walter J; Azab, Amr; Thomsen, Robert W; Gottsch, John D

    2003-03-01

    To review management strategies for treatment of anterior chamber epithelial cysts. Retrospective review of consecutive interventional case series. Charts of patients treated for epithelial ingrowth over a 10-year period by a single surgeon were reviewed. Cases of anterior chamber epithelial cysts were identified and recorded, including details of ocular history, preoperative and postoperative acuity, intraocular pressure (IOP), and ocular examination, type of surgical intervention, and details of further procedures performed. Seven eyes with epithelial cysts were identified. Patient age ranged from 1.5 to 53 years at presentation. Four patients were children. In four eyes, cysts were secondary to trauma, one case was presumably congenital, one case developed after corneal perforation in an eye with Terrien's marginal degeneration, and one case developed after penetrating keratoplasty (PK). Three eyes were treated with vitrectomy, en bloc resection of the cyst and associated tissue, fluid-air exchange and cryotherapy. The last four eyes were treated with a new conservative strategy of cyst aspiration (three cases) or local excision (one keratin "pearl" cyst), and endolaser photocoagulation of the collapsed cyst wall/base. All epithelial tissue was successfully eradicated by clinical criteria; one case required repeat excision (follow-up, 9 to 78 months, mean 45). Two eyes required later surgery for elevated IOP, two for cataract extraction and one for repeat PK. Final visual acuity ranged from 20/20 to hand motions, depending on associated ocular damage. Best-corrected visual results were obtained in the more conservatively managed eyes. Anterior chamber epithelial cysts can be managed conservatively in selected cases with good results. This strategy may be particularly useful in children's eyes, where preservation of the lens, iris, and other structures may facilitate amblyopia management. Copyright 2003 by Elsevier Science Inc.

  16. Treatment for acute anterior cruciate ligament tear

    DEFF Research Database (Denmark)

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

    2015-01-01

    STUDY QUESTION: In young active adults with an acute anterior cruciate ligament (ACL) rupture, do patient reported or radiographic outcomes after five years differ between those treated with rehabilitation plus early ACL reconstruction and those treated with rehabilitation and optional delayed AC...... AND WHAT THIS PAPER ADDS: The relative efficacy of surgical reconstruction and rehabilitation for short and long term outcomes of ACL rupture is debated. Clinicians and young active adult patients should consider rehabilitation as a primary treatment option following an acute ACL tear....

  17. Superior labrum anterior-to-posterior tear.

    Science.gov (United States)

    Sum, Jonathan C; Omid, Reza

    2012-12-01

    The patient was a 25-year-old male college student with a chief complaint of right shoulder pain. The patient was initially diagnosed with bicipital tendinitis by his physician and had been treated for 4 weeks by a physical therapist. However, his symptoms did not improve and he was unable to return to his preinjury activity levels, so he sought the services of another physical therapist for a second opinion. Due to concern for a labrum tear, the physical therapist referred the patient to an orthopaedic surgeon. Magnetic resonance arthrography revealed findings consistent with a superior labrum anterior-to-posterior tear.

  18. Conservative treatment of excessive anterior pelvic tilt

    DEFF Research Database (Denmark)

    Brekke, Anders Falk

    of Clinical Research, University of Southern Denmark, Denmark 3Department of Physiotherapy, University College Zealand, Denmark 4Center for Evidence-Based Medicine, Odense University Hospital, Denmark Correspondence Anders Falk Brekke E-mail: afbrekke@health.sdu.dk Mob: +45 7248 2626 Add: Sdr. Boulevard 29......Conservative treatment of excessive anterior pelvic tilt: A systematic review Anders Falk Brekke1,2,3, Søren Overgaard1,2, Asbjørn Hróbjartsson4, Anders Holsgaard-Larsen1,2 1Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital 2Department...

  19. Outcomes in Anterior Cruciate Ligament Reconstruction Surgery

    Directory of Open Access Journals (Sweden)

    Roman Mihai

    2016-11-01

    Full Text Available Improving the outcomes in reconstructive surgery of the anterior cruciate ligament (ACL requires a rigorous and permanent assessment of specific parameters. Therefore, we can increase the degree of reproducibility of the procedure and identify particular aspects in order to achieve an adequate and individualized therapeutic approach for each case. In order to accomplish this goal, the use of complex means (scores of quantifying results is required. That includes objective means of verifying the parameters in knee surgery, and a subjective evaluation of the patient in order to compare the results.

  20. Genetic disorders of the anterior pituitary gland.

    Science.gov (United States)

    Teller, W M

    1985-01-01

    This survey deals with disorders caused by genetically disturbed function of the anterior pituitary gland. Genetic Dwarfism may be caused by isolated growth hormone deficiency (IGHD) or panpituitary diseases, such as congenital absence of the pituitary or familial panhypopituitarism. Genetic disturbances of isolated pituitary hormone secretion without dwarfism may occur as isolated gonadotropin deficiency (IGD), isolated luteinizing hormone deficiency ("fertile eunuch"), Kallmann syndrome (olfactogenital dysplasia), isolated thyrotropin deficiency (ITD) and isolated corticotropin deficiency (ICD). Pituitary dysfunction may also be associated with other genetic disease entities.

  1. [Anterior shoulder instabilities: about 73 cases].

    Science.gov (United States)

    Jamal, Louaste; Bousbaa, Hicham; Cherrad, Taoufik; Wahidi, Mohammed; Amhajji, Larbi; Rachid, Khalid

    2016-01-01

    Between 2005 and 2014, 73 patients (77 shoulders) underwent Latarjet procedure for anterior shoulder instability. This retrospective study aims to evaluate the clinical and radiographic results of this surgical technique. Surgical intervention was performed to treat 69 cases with recurrent dislocation, 5 cases with recurrent painful subluxation and 3 cases with painful shoulder. All patients underwent radiographic evaluation before surgery and during the most recent medical control. According to Rowe score, 73 (94.8%) of 77 shoulders got a good or excellent result. In the longest follow-up, 74 shoulders were free from glenohumeral arthrosis.

  2. Surgical versus nonsurgical treatment in first traumatic anterior dislocation of the shoulder in athletes

    Directory of Open Access Journals (Sweden)

    Gustavo Gonçalves Arliani

    2011-03-01

    Full Text Available Gustavo Gonçalves Arliani, Diego da Costa Astur, Carina Cohen, Benno Ejnisman, Carlos Vicente Andreoli, Alberto Castro Pochini, Moises CohenCentro de Traumatologia do Esporte (CETE, Departamento de Ortopedia e Traumatologia da Universidade Federal de São Paulo, São Paulo, BrazilAbstract: Anterior traumatic dislocation is a common problem faced by orthopedic surgeons. After the first episode of shoulder dislocation, a combination of lesions can lead to chronic instability. The management in treatment of young athletes after the first acute anterior shoulder dislocation is controversial. The available literature supports early surgical treatment for young male athletes engaged in highly demanding physical activities after the first episode of traumatic dislocation of the shoulder. This is because of the best functional results and lower recurrence rates obtained with this treatment in this population. However, further clinical trials of good quality comparing surgical versus nonsurgical treatment for well-defined lesions are needed, especially for categories of patients who have a lower risk of recurrence.Keywords: athlete, conservative treatment, surgical treatment, immobilization, stabilization, primary treatment, shoulder dislocation

  3. Bony Reconstruction of the Anterior Glenoid Rim.

    Science.gov (United States)

    Willemot, Laurent B; Elhassan, Bassem T; Verborgt, Olivier

    2018-04-13

    Recurrent anterior shoulder instability is associated with glenohumeral bone loss. Glenoid deficiency compromises the concavity-compression mechanism. Medial Hill-Sachs lesions can result in an off-track humeral position. Anterior glenoid reconstruction or augmentation prevents recurrence by addressing the pathomechanics. In Bristow and Latarjet procedures, the coracoid process is harvested for conjoint tendon transfer, capsular reinforcement, and glenoid rim restoration. Complications and the nonanatomic nature of the procedure have spurred research on graft sources. The iliac crest is preferred for autogenous structural grafts. Tricortical, bicortical, and J-bone grafts have shown promising results despite the historical association of Eden-Hybinette procedures with early degenerative joint disease. Allogeneic osteochondral grafts may minimize the risk of arthropathy and donor site morbidity. Tibial plafond and glenoid allografts more closely match the native glenoid geometry and restore the articular chondral environment, compared with conventional grafts. Graft availability, cost, risk of disease transmission, and low chondrocyte viability have slowed the acceptance of osteochondral allografts.

  4. Microneurosurgical management of anterior choroid artery aneurysms.

    Science.gov (United States)

    Lehecka, Martin; Dashti, Reza; Laakso, Aki; van Popta, Jouke S; Romani, Rossana; Navratil, Ondrej; Kivipelto, Leena; Kivisaari, Riku; Foroughi, Mansoor; Kokuzawa, Jouji; Lehto, Hanna; Niemelä, Mika; Rinne, Jaakko; Ronkainen, Antti; Koivisto, Timo; Jääskelainen, Juha E; Hernesniemi, Juha

    2010-05-01

    Anterior choroid artery aneurysms (AChAAs) constitute 2%-5% of all intracranial aneurysms. They are usually small, thin walled with one or several arteries originating at their base, and often associated with multiple aneurysms. In this article, we review the practical microsurgical anatomy, the preoperative imaging, surgical planning, and the microneurosurgical steps in the dissection and the clipping of AChAAs. This review, and the whole series on intracranial aneurysms (IAs), are mainly based on the personal microneurosurgical experience of the senior author (J.H.) in two Finnish centers (Helsinki and Kuopio) that serve, without patient selection, the catchment area in Southern and Eastern Finland. These two centers have treated more than 10,000 patients with IAs since 1951. In the Kuopio Cerebral Aneurysm Database of 3005 patients with 4253 IAs, 831 patients (28%) had altogether 980 internal carotid artery (ICA) aneurysms, of whom 95 patients had 99 (2%) AChAAs. Ruptured AChAAs, found in 39 patients (41%), with median size of 6 mm (range = 2-19 mm), were associated with intracerebral hematoma (ICH) in only 1 (3%) patient. Multiple aneurysms were seen in 58 (61%) patients. The main difficulty in microneurosurgical management of AChAAs is to preserve flow in the anterior choroid artery originating at the base and often attached to the aneurysm dome. This necessitates perfect surgical strategy based on preoperative knowledge of 3 dimensional angioarchitecture and proper orientation during the microsurgical dissection. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. Anterior Temporal Lobe Morphometry Predicts Categorization Ability.

    Science.gov (United States)

    Garcin, Béatrice; Urbanski, Marika; Thiebaut de Schotten, Michel; Levy, Richard; Volle, Emmanuelle

    2018-01-01

    Categorization is the mental operation by which the brain classifies objects and events. It is classically assessed using semantic and non-semantic matching or sorting tasks. These tasks show a high variability in performance across healthy controls and the cerebral bases supporting this variability remain unknown. In this study we performed a voxel-based morphometry study to explore the relationships between semantic and shape categorization tasks and brain morphometric differences in 50 controls. We found significant correlation between categorization performance and the volume of the gray matter in the right anterior middle and inferior temporal gyri. Semantic categorization tasks were associated with more rostral temporal regions than shape categorization tasks. A significant relationship was also shown between white matter volume in the right temporal lobe and performance in the semantic tasks. Tractography revealed that this white matter region involved several projection and association fibers, including the arcuate fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus. These results suggest that categorization abilities are supported by the anterior portion of the right temporal lobe and its interaction with other areas.

  6. MRI of anterior cruciate ligament autografts

    International Nuclear Information System (INIS)

    Ogi, Shigeyuki; Ariizumi, Mitsuko; Yamagishi, Tsuneo; Agata, Toshihiko; Tada, Shinpei; Fukuda, Kunihiko

    2000-01-01

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

  7. Approach-avoidance activation without anterior asymmetry

    Directory of Open Access Journals (Sweden)

    Andero eUusberg

    2014-03-01

    Full Text Available Occasionally, the expected effects of approach-avoidance motivation on anterior EEG alpha asymmetry fail to emerge, particularly in studies using affective picture stimuli. These null findings have been explained by insufficient motivational intensity of, and/or overshadowing interindividual variability within the responses to emotional pictures. These explanations were systematically tested using data from 70 students watching 5 types of affective pictures ranging from very pleasant to unpleasant. The stimulus categories reliably modulated self-reports as well as the amplitude of late positive potential, an ERP component reflecting orienting towards motivationally significant stimuli. The stimuli did not, however, induce expected asymmetry effects either for the sample or individual participants. Even while systematic stimulus-dependent individual differences emerged in self-reports as well as LPP amplitudes, the asymmetry variability was dominated by stimulus-independent interindividual variability. Taken together with previous findings, these results suggest that under some circumstances anterior asymmetry may not be an inevitable consequence of core affect. Instead, state asymmetry shifts may be overpowered by stable trait asymmetry differences and/or stimulus-independent yet situation-dependent interindividual variability, possibly caused by processes such as emotion regulation or anxious apprehension.

  8. Anterior eye protection with orbital neoplasia

    International Nuclear Information System (INIS)

    Hancock, S.L.

    1986-01-01

    The administration of adequate doses of radiation to tumors involving the orbit and surrounding facial structures and sinuses is often complicated by the need to protect the sensitive ocular components, the lens and cornea. A technique has been devised that uses four photon beam fields and an optional electron field to treat the contents of both orbits and adjacent sinuses with effective, reproducible protection of cornea and lens. Essential features include: alignment of the corneal surfaces with the central plane of rotation of the treatment machine, use of a narrow eye block across the entire beam to shield a strip equal to the width of the cornea, positioned symmetrically across the central plane of rotation, fine alignment of the eye block with both corneal surfaces by altering pedestal angle, treatment with paired, wedged, anterior oblique fields to encompass desired orbital and sinus volumes with additional blocking placed as needed, and complementary, lateral strip fields using collimators set to eye block thickness to equalize dose in the posterior orbit shielded by the strip eye block. A similar anterior electron beam strip field may be added to boost the medial orbit and ethmoid regions covered by the eye block. Bite block head immobilization and easy, direct daily visualization of block position assures eye protection for each treatment and provides substantial reduction in dose to the cornea, lens and iris. Additional blocking may be incorporated to provide partial lacrimal and parotid sparing

  9. Penghentian Karies Gigi Sulung Anterior (Laporan Penelitian

    Directory of Open Access Journals (Sweden)

    Titi Pratiwi Indra Yoga

    2015-10-01

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

  10. Anterior Temporal Lobe Morphometry Predicts Categorization Ability

    Directory of Open Access Journals (Sweden)

    Béatrice Garcin

    2018-02-01

    Full Text Available Categorization is the mental operation by which the brain classifies objects and events. It is classically assessed using semantic and non-semantic matching or sorting tasks. These tasks show a high variability in performance across healthy controls and the cerebral bases supporting this variability remain unknown. In this study we performed a voxel-based morphometry study to explore the relationships between semantic and shape categorization tasks and brain morphometric differences in 50 controls. We found significant correlation between categorization performance and the volume of the gray matter in the right anterior middle and inferior temporal gyri. Semantic categorization tasks were associated with more rostral temporal regions than shape categorization tasks. A significant relationship was also shown between white matter volume in the right temporal lobe and performance in the semantic tasks. Tractography revealed that this white matter region involved several projection and association fibers, including the arcuate fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus. These results suggest that categorization abilities are supported by the anterior portion of the right temporal lobe and its interaction with other areas.

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

    Directory of Open Access Journals (Sweden)

    Mete Güler

    2013-02-01

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

  12. Immediate postoperative anterior knee stability: double- versus triple-bundle anterior cruciate ligament reconstructions.

    Science.gov (United States)

    Mae, Tatsuo; Shino, Konsei; Matsumoto, Norinao; Yoneda, Kenji; Yoshikawa, Hideki; Nakata, Ken

    2013-02-01

    The purpose of this study was to compare the triple-bundle (TB) anterior cruciate ligament (ACL) reconstruction with the double-bundle (DB) ACL reconstruction in immediate postoperative anterior knee stability. This study involved 133 patients who had undergone the anatomic ACL reconstruction with autogenous hamstring tendon unilaterally. Then 83 patients (mean age, 28.8 years) underwent the DB between November 2004 and December 2005, and 50 patients (mean age, 29.6 years) underwent the TB ACL reconstruction between January and December 2006. The 2 femoral tunnels were created in the ideal ACL attachment area, whereas 2 tibial tunnels for the DB and 3 tunnels for the TB were created in the ACL footprint. The 2 doubled tendon grafts were fixed with EndoButton-CL (Smith & Nephew Endoscopy, Andover, MA) on the femur. The grafts were fixed to the tibia using a Double Spike Plate and a screw under the total initial tension of 20 N at 20° of flexion, after meticulous in situ pretensioning using a tensioning boot. Then immediate postoperative anterior knee laxity in response to 89 N of anterior load was measured by one experienced examiner (T.M.) with the KT-2000 Knee Arthrometer (MEDmedtric, San Diego, CA) under general anesthesia at 30° of knee flexion with muscle relaxants. The measured anterior laxity was 3.4 ± 1.2 mm in the DB and 2.5 ± 0.7 mm in the TB ACL reconstruction, a statistically significant difference. The side-to-side difference of the laxity was -3.2 ± 1.6 mm in the DB and -4.2 ± 2.0 mm in the TB, again a significant difference. TB ACL reconstruction resulted in better immediate postoperative anterior knee stability than DB ACL reconstruction under 89 N of anterior tibial load (P = .031). Level III, therapeutic retrospective comparative study. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  13. IMPORTÂNCIA E INTERACÇÕES DA INTENSIDADE DA DISTRIBUIÇÃO COM A PERFORMANCE: ESTUDO EXPLORATÓRIO DE ÁGUA ENGARRAFADA

    Directory of Open Access Journals (Sweden)

    Joana Cabeçadas

    2006-04-01

    Full Text Available Este estudo pretende abordar a importância da variável intensidade da distribuição como estratégia de marketing, bem como as interações com outras variáveis relevantes para as empresas. Tal análise revela-se extremamente importante, já que, para produtos para os quais não faz sentido adotar estratégias de diferenciação, as empresas devem compreender bem as implicações e determinantes da intensidade da distribuição. Procura-se avaliar a importância da competitividade da força de vendas, enquanto força interna. O estudo demonstra e justifica a relação positiva que existe entre a competitividade da força de vendas e as variáveis intensidade da distribuição e performance da força de vendas. Como o mercado em estudo é extremamente competitivo, evidencia-se a relevância da intensidade da competição. Verifica-se que um aumento dessa variável tem um impacto positivo na intensidade da distribuição e na performance da força de vendas. Na maioria dos casos confirma-se que a quota de mercado, enquanto medida de performance do ano anterior, influencia positivamente a nossa variável estratégica. Por sua vez, o aumento da intensidade da distribuição melhora a performance da força de vendas e, conseqüentemente, o desempenho da empresa.

  14. Current approach in diagnosis and management of anterior uveitis

    OpenAIRE

    Agrawal, Rupesh V; Murthy, Somasheila; Sangwan, Virender; Biswas, Jyotirmay

    2010-01-01

    Uveitis is composed of a diverse group of disease entities, which in total has been estimated to cause approximately 10% of blindness. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis based on the anatomical involvement of the eye. Anterior uveitis is, however, the commonest form of uveitis with varying incidences reported in worldwide literature. Anterior uveitis can be very benign to present with but often can lead to severe morbidity if not treated...

  15. Postural stability in subjects with anterior cruciate ligament injury

    OpenAIRE

    Kolář, Miroslav

    2011-01-01

    6 Abstract Title: Postural stability in subjects with anterior cruciate ligament injury. Objectives: The aim of this thesis was to find out if the postural stability is differed in subjects with anterior cruciate ligament injury and in the control group after the "4 steps - one leg stance" test had been performed. Methods: This study compared a group with anterior cruciate ligament injury and a control group on the basis of the "4 steps - one leg stance" test. Methods of comparison and analys...

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

    Directory of Open Access Journals (Sweden)

    Egemen Kucuk

    2014-04-01

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

  17. A small absorbable stent for treatment of anterior glottic web.

    Science.gov (United States)

    Bhongmakapat, Thongchai; Kantapasuantara, Kanjalak; Praneevatakul, Phurich

    2012-03-01

    A new one-stage approach for treatment of selected anterior glottic web has been successful. This case report illustrates its simplicity in microlaryngoscopy with complete lysis of the anterior glottic web by CO(2) laser. Then a small neck horizontal incision is made at the level of anterior commissure to gain exposure to thyroid cartilage. Absorbable suture is passed through the midline of thyroid cartilage below and above the anterior commissure. A knot is tied over thyroid ala. The suture acts as a tiny stent to prevent recurrence of the web. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  18. Winging of scapula due to serratus anterior tear

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    Varun Singh Kumar

    2014-10-01

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

  19. Anterior corneal profile with variable asphericity.

    Science.gov (United States)

    Rosales, Marco A; Juárez-Aubry, Montserrat; López-Olazagasti, Estela; Ibarra, Jorge; Tepichín, Eduardo

    2009-12-10

    We present a corneal profile in which the eccentricity, e(Q=-e(2)), has a nonlinear continuous variation from the center outwards. This nonlinear variation is intended to fit and reproduce our current experimental data in which the anterior corneal surface of the human eye exhibits different values of e at different diameters. According to our clinical data, the variation is similar to an exponential decay. We propose a linear combination of two exponential functions to describe the variation of e. We then calculate the corneal sagittal height by substituting e in the first-order aspherical surface equation to obtain the corneal profile. This corneal profile will be used as a reference to analyze the resultant profiles of the customized corneal ablation in refractive surgery.

  20. RETAINED STONE PIECE IN ANTERIOR CHAMBER

    Directory of Open Access Journals (Sweden)

    ZvornicaninJasmin, Nadarevic-VodencarevicAmra

    2015-04-01

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

  1. Concrescent triplets involving primary anterior teeth

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    Urvashi Sharma

    2013-01-01

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

  2. Foreign Body Embedded in Anterior Chamber Angle

    Directory of Open Access Journals (Sweden)

    Shmuel Graffi

    2012-01-01

    Full Text Available Introduction. We present a case of a metallic foreign body embedded in the anterior chamber angle. After standing in close proximity to a construction worker breaking a tile, a 26-year-old woman using soft contact lens for the correction of mild myopia presented to emergency department for evaluation of a foreign body sensation of her right eye. Methods and Results. Diagnosis was confirmed by gonioscopic examination and a noncontrast CT scan of head and orbits. The foreign body was removed by an external approach without utilizing a magnet. The patient's final outcome was favorable. Discussion. The above is a rare clinical situation, which is impossible to detect on slit-lamp examination without a gonioscopic view. Proper imaging and a specific management are mandatory in order to achieve favorable outcome.

  3. The anterior interhemispheric approach: a safe and effective approach to anterior skull base lesions.

    Science.gov (United States)

    Mielke, Dorothee; Mayfrank, Lothar; Psychogios, Marios Nikos; Rohde, Veit

    2014-04-01

    Many approaches to the anterior skull base have been reported. Frequently used are the pterional, the unilateral or bilateral frontobasal, the supraorbital and the frontolateral approach. Recently, endoscopic transnasal approaches have become more popular. The benefits of each approach has to be weighted against its complications and limitations. The aim of this study was to investigate if the anterior interhemispheric approach (AIA) could be a safe and effective alternative approach to tumorous and non-tumorous lesions of the anterior skull base. We screened the operative records of all patients with an anterior skull base lesion undergoing transcranial surgery. We have used the AIA in 61 patients. These were exclusively patients with either olfactory groove meningioma (OGM) (n = 43), ethmoidal dural arteriovenous fistula (dAVF) ( n = 6) or frontobasal fractures of the anterior midline with cerebrospinal fluid (CSF) leakage ( n = 12). Patient records were evaluated concerning accessibility of the lesion, realization of surgical aims (complete tumor removal, dAVF obliteration, closure of the dural tear), and approach related complications. The use of the AIA exclusively in OGMs, ethmoidal dAVFs and midline frontobasal fractures indicated that we considered lateralized frontobasal lesions not suitable to be treated successfully. If restricted to these three pathologies, the AIA is highly effective and safe. The surgical aim (complete tumor removal, complete dAVF occlusion, no rhinorrhea) was achieved in all patients. The complication rate was 11.5 % (wound infection (n = 2; 3.2 %), contusion of the genu of the corpus callosum, subdural hygroma, epileptic seizure, anosmia and asymptomatic bleed into the tumor cavity (n = 1 each). Only the contusion of the corpus callosum was directly related to the approach (1.6 %). Olfaction, if present before surgery, was preserved in all patients, except one (1.6 %). The AIA is an effective and a safe approach

  4. Action of vanillin (Vanilla planifolia) on the morphology of tibialis anterior and soleus muscles after nerve injury.

    Science.gov (United States)

    Peretti, Ana Luiza; Antunes, Juliana Sobral; Lovison, Keli; Kunz, Regina Inês; Castor, Lidyane Regina Gomes; Brancalhão, Rose Meire Costa; Bertolini, Gladson Ricardo Flor; Ribeiro, Lucinéia de Fátima Chasko

    2017-01-01

    To evaluate the action of vanillin (Vanilla planifolia) on the morphology of tibialis anterior and soleus muscles after peripheral nerve injury. Wistar rats were divided into four groups, with seven animals each: Control Group, Vanillin Group, Injury Group, and Injury + Vanillin Group. The Injury Group and the Injury + Vanillin Group animals were submitted to nerve injury by compression of the sciatic nerve; the Vanillin Group and Injury + Vanillin Group, were treated daily with oral doses of vanillin (150mg/kg) from the 3rd to the 21st day after induction of nerve injury. At the end of the experiment, the tibialis anterior and soleus muscles were dissected and processed for light microscopy and submitted to morphological analysis. The nerve compression promoted morphological changes, typical of denervation, and the treatment with vanillin was responsible for different responses in the studied muscles. For the tibialis anterior, there was an increase in the number of satellite cells, central nuclei and fiber atrophy, as well as fascicular disorganization. In the soleus, only increased vascularization was observed, with no exacerbation of the morphological alterations in the fibers. The treatment with vanillin promoted increase in intramuscular vascularization for the muscles studied, with pro-inflammatory potential for tibialis anterior, but not for soleus muscle. Avaliar a ação da vanilina (Vanilla planifolia) sobre a morfologia dos músculos tibial anterior e sóleo após lesão nervosa periférica. Ratos Wistar foram divididos em quatro grupos, com sete animais cada, sendo Grupo Controle, Grupo Vanilina, Grupo Lesão e Grupo Lesão + Vanilina. Os animais dos Grupos Lesão e Grupo Lesão + Vanilina foram submetidos à lesão nervosa por meio da compressão do nervo isquiático, e os Grupos Vanilina e Grupo Lesão + Vanilina foram tratados diariamente com doses orais de vanilina (150mg/kg) do 3o ao 21o dia após a indução da lesão nervosa. Ao término do

  5. National trends in anterior cervical fusion procedures.

    Science.gov (United States)

    Marawar, Satyajit; Girardi, Federico P; Sama, Andrew A; Ma, Yan; Gaber-Baylis, Licia K; Besculides, Melanie C; Memtsoudis, Stavros G

    2010-07-01

    Population-based database analysis. To analyze trends in patient- and healthcare-system-related characteristics, utilization and outcomes associated with anterior cervical spine fusions. Anterior cervical decompression and spine fusion (ACDF) is one of the most commonly performed surgical procedures of the spine. However, few data analyzing trends in patient- and healthcare-system-related characteristics, utilization and outcomes exist. Data from 1990 to 2004 collected in the National Hospital Discharge Survey were accessed. ACDF procedures were identified. Five-year periods of interest (POI) were created for temporal analysis and changes in the prevalence and utilization of this procedure as well as in patient- and healthcare-system-related variables were examined. The changes in the occurrence of procedure-related complications were evaluated. An estimated total of 771,932 discharges after ACDF were identified. Temporally, an almost 8-fold increase in total prevalence was accompanied by a similar increase in utilization (23/100.000 civilians/POI to 157/100.000/civilians/POI). The highest increase in utilization was observed in those > or =65 years (28-fold). Average age increased from 47.2 years to 50.5 years over time. Length of hospital stay decreased from 5.17 days to 2.38 days. Overall procedure-related complication rates decreased from 4.6% to 3.03%. The prevalence of hypertension, diabetes mellitus, hypercholesterolemia, obesity, pulmonary, and coronary artery increased over time among patients undergoing ACDF. Despite limitations inherent to secondary analysis of large databases, we identified a number of significant changes in the utilization, demographics, and outcomes associated with ACDF, which can be used to assess the effect of changes in medical care, direct health care resources, and future research. The effect of the increased prevalence of comorbidities on medical practice remains to be evaluated. Further studies are necessary to evaluate causal

  6. The anterior hypothalamus in cluster headache.

    Science.gov (United States)

    Arkink, Enrico B; Schmitz, Nicole; Schoonman, Guus G; van Vliet, Jorine A; Haan, Joost; van Buchem, Mark A; Ferrari, Michel D; Kruit, Mark C

    2017-10-01

    Objective To evaluate the presence, localization, and specificity of structural hypothalamic and whole brain changes in cluster headache and chronic paroxysmal hemicrania (CPH). Methods We compared T1-weighted magnetic resonance images of subjects with cluster headache (episodic n = 24; chronic n = 23; probable n = 14), CPH ( n = 9), migraine (with aura n = 14; without aura n = 19), and no headache ( n = 48). We applied whole brain voxel-based morphometry (VBM) using two complementary methods to analyze structural changes in the hypothalamus: region-of-interest analyses in whole brain VBM, and manual segmentation of the hypothalamus to calculate volumes. We used both conservative VBM thresholds, correcting for multiple comparisons, and less conservative thresholds for exploratory purposes. Results Using region-of-interest VBM analyses mirrored to the headache side, we found enlargement ( p cluster headache compared to controls, and in all participants with episodic or chronic cluster headache taken together compared to migraineurs. After manual segmentation, hypothalamic volume (mean±SD) was larger ( p cluster headache compared to controls (1.72 ± 0.15 ml) and migraineurs (1.68 ± 0.19 ml). Similar but non-significant trends were observed for participants with probable cluster headache (1.82 ± 0.19 ml; p = 0.07) and CPH (1.79 ± 0.20 ml; p = 0.15). Increased hypothalamic volume was primarily explained by bilateral enlargement of the anterior hypothalamus. Exploratory whole brain VBM analyses showed widespread changes in pain-modulating areas in all subjects with headache. Interpretation The anterior hypothalamus is enlarged in episodic and chronic cluster headache and possibly also in probable cluster headache or CPH, but not in migraine.

  7. Anterior open bite treatment with magnets.

    Science.gov (United States)

    Kiliaridis, S; Egermark, I; Thilander, B

    1990-11-01

    The aim of this study was to examine the effects of repelling magnets on the treatment of anterior open bite and compare them with the effects of acrylic posterior bite-blocks. Twenty patients, aged 9-16 years with skeletal anterior open bite, were randomly divided into two groups. In one group the patients wore posterior repelling magnet splints and in the other they wore acrylic posterior bite-blocks of the same thickness as the magnet splints. The patients were instructed to use their appliance as much as possible (the minimum accepted being 18 hours daily) during a 6-month period. Dental casts, intra-oral photos, and lateral cephalograms were taken before and after treatment, and the patients were also examined regularly to identify the development of any craniomandibular disorders. In the first group, the dental and skeletal vertical relation responded quickly to the magnet treatment. The open bite was generally closed in just under 4 months, especially in patients in early mixed dentition. Spacing in the labial segments decreased in some cases, while slight crowding was induced in others. Transverse problems, i.e. unilateral cross-bite, sometimes followed by scissor-bite on the opposite side, was observed in those patients who were in the early mixed dentition and had used the magnets intensively. The patients who wore acrylic posterior bite-blocks also showed improvement in the dental and skeletal vertical relationships, especially during the first months. This was followed by a 'plateau' period. No transverse problems were found in these patients.

  8. Congenital dermoid inclusion cyst over the anterior fontanel: report of three cases Cisto dermóide de inclusão congênita sobre a fontanela anterior: relato de três casos

    Directory of Open Access Journals (Sweden)

    Humberto Belem de Aquino

    2003-06-01

    Full Text Available Congenital dermoid inclusion cyst over the anterior fontanel (CDIC is an uncommon cystic lesion located over the anterior fontanel. It is a benign and curative lesion and most of the time, can be diagnosed at birth. From 1994 to 2001, three patients were operated with this kind of lesion and after reviewing the literature we found 229 cases and only 6 cases described in Brazil. Our objective in this study is to report three more cases.Cisto dermóide de inclusão congênita sobre a fontanela anterior (CDIC é lesão rara localizada na região da fontanela anterior. Trata-se de lesão benigna e curável que, na maioria das vezes, é diagnosticada no nascimento. De 1994 a 2001, três pacientes foram operados com este tipo de lesão e, através dos dados disponíveis na literatura, verificamos somente 229 casos descritos, apenas 6 descritos no Brasil, o que nos motivou a registrar mais três casos.

  9. Resultados do tratamento de fraturas crônicas pela via anterior em pacientes com osteoporose Resultados del tratamiento de fracturas crónicas por la via anterior en pacientes con osteoporosis Results of treatment of chronic fractures by anterior approach in patients with osteoporosis

    Directory of Open Access Journals (Sweden)

    Fabio Leme de Oliveira Pinto

    2011-01-01

    Full Text Available OBJETIVO: Analisar os resultados da cirurgia de corpectomia e artrodese por via anterior nos pacientes com fratura tipo explosão da coluna toracolombar e com osteoporose, que foram submetidos a tratamento conservador prévio por no mínimo sete meses, sem melhora importante do quadro doloroso. MÉTODOS: Foram tratadas seis pacientes idosas com fratura-explosão da coluna toracolombar em um único nível, depois de, no mínimo, sete meses do trauma, pela via anterior, com corpectomia, uso de enxerto autólogo de costela e fixação com parafusos pediculares nos níveis adjacentes. A dor foi avaliada pela EVA no pré-operatório, três semanas, três meses, seis meses e um anos após a cirurgia. RESULTADO: As pacientes apresentaram melhora significativa da dor pós-operatória, com diminuição substancial do uso de medicação analgésica. CONCLUSÕES: Os autores recomendam a via anterior isolada como método de tratamento para fraturas tipo explosão crônicas em pacientes com osteoporose pela baixa taxa de complicações e pelos resultados satisfatórios encontrados.OBJECTIVO: Analizar los resultados de la cirugía de corpectomía y artrodesis por la vía anterior, en pacientes con fracturas tipo explosión de la columna toracolumbar y, con osteoporosis, que habían sido sometidos a tratamiento conservador previo por lo menos durante siete meses, sin mejora importante del cuadro de dolor. MÉTODOS: fueron tratadas seis pacientes ancianas del sexo femenino con la fractura-explosión de la columna toracolumbar en solamente un nivel, después de, como mínimo, siete meses del traumatismo, a través de la vía anterior, con corpectomía, utilización del injerto autólogo de costilla y fijaci��n con tornillos pediculares en los niveles adyacentes. El dolor fue evaluado con EVA en pre-operatorio, tres semanas, tres meses, seis meses y un año después de la cirugía. RESULTADO: Las pacientes presentaron mejoría significativa del dolor

  10. Anterior Visceral Endoderm SMAD4 Signaling Specifies Anterior Embryonic Patterning and Head Induction in Mice

    Science.gov (United States)

    Li, Cuiling; Li, Yi-Ping; Fu, Xin-Yuan; Deng, Chu-Xia

    2010-01-01

    SMAD4 serves as a common mediator for signaling of TGF-β superfamily. Previous studies illustrated that SMAD4-null mice die at embryonic day 6.5 (E6.5) due to failure of mesoderm induction and extraembryonic defects; however, functions of SMAD4 in each germ layer remain elusive. To investigate this, we disrupted SMAD4 in the visceral endoderm and epiblast, respectively, using a Cre-loxP mediated approach. We showed that mutant embryos lack of SMAD4 in the visceral endoderm (Smad4Co/Co;TTR-Cre) died at E7.5-E9.5 without head-fold and anterior embryonic structures. We demonstrated that TGF-β regulates expression of several genes, such as Hex1, Cer1, and Lim1, in the anterior visceral endoderm (AVE), and the failure of anterior embryonic development in Smad4Co/Co;TTR-Cre embryos is accompanied by diminished expression of these genes. Consistent with this finding, SMAD4-deficient embryoid bodies showed impaired responsiveness to TGF-β-induced gene expression and morphological changes. On the other hand, embryos carrying Cre-loxP mediated disruption of SMAD4 in the epiblasts exhibited relatively normal mesoderm and head-fold induction although they all displayed profound patterning defects in the later stages of gastrulation. Cumulatively, our data indicate that SMAD4 signaling in the epiblasts is dispensable for mesoderm induction although it remains critical for head patterning, which is significantly different from SMAD4 signaling in the AVE, where it specifies anterior embryonic patterning and head induction. PMID:20941375

  11. Múltiplas modernidades ou variedade da modernidade?

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    Volker H. Schmidt

    2007-06-01

    Full Text Available O artigo apresenta uma avaliação crítica do conceito de "múltiplas modernidades" que ganhou terreno na Sociologia na década de 1990. Ele rejeita essa noção como tanto conceitualmente equivocada quanto empiricamente infundada e propõe um conceito alternativo - de "variedades da modernidade" -, que se acredita resolver mais facilmente as questões substantivas do conceito anterior, ao mesmo tempo em que permite que se fale de "modernidade" no singular. A principal fonte de inspiração para esse conceito alternativo são as variedades do paradigma capitalista que guia a literatura da Nova Economia Política; uma de suas vantagens em relação ao paradigma das múltiplas modernidades é o foco nas instituições, muito mais que nas vagas e pouco explicativas noções de "cultura" e "diferença cultural". Entretanto, a abordagem de variedades da modernidade que siga essa via tem que ser muito mais ampla e compreensiva e deve, portanto, ser mais difícil de desenvolver e de aplicar que o paradigma de variedades do capitalismo. Mas mesmo que em última instância ela prove-se impraticável, a mera consideração de seus pré-requisitos metodológicos ainda promete fornecer valiosas sugestões para os pesquisadores da modernidade.

  12. Efeito da demonstração distribuída na aprendizagem do saque do voleibol

    Directory of Open Access Journals (Sweden)

    Suziane Peixoto Santos-Naves

    2014-12-01

    Full Text Available O presente estudo investigou o efeito da distribuição das demonstrações na aprendizagem do saque japonês do voleibol. Dezoito sujeitos foram distribuídos em três grupos: G1 (oito demonstrações anteriores à prática, G2 (quatro demonstrações anteriores e quatro na 40º tentativa e G4 (duas anteriores, duas na 20º, 2 na 40º, duas na 60º tentativas. A execução de uma pessoa habilidosa na tarefa foi filmada e utilizada como forma de demonstração para todos os grupos. O experimento consistiu de pré-teste com 10 tentativas, fase de aquisição com 80 tentativas e teste de retenção após 24 horas com 10 tentativas. Os resultados mostraram que as demonstrações anteriores à sessão de prática levaram a melhoras no escore e a demonstração distribuída levou a melhoras no padrão de movimento.

  13. Perineal anterior dislocation of the hip with avulsion fracture of ...

    African Journals Online (AJOL)

    Traumatic anterior dislocation of the hip is rare even in children. Very uncommon also is the perineal variant of the inferior type of anterior dislocation with concomitant avulsion fracture of the greater trochanter. We report such a case highlighting the peculiarity of its management. No similar case of triumvirate injury of the hip ...

  14. Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

    DEFF Research Database (Denmark)

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

    2014-01-01

    OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN...

  15. Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

    OpenAIRE

    van Eijk, F.

    2009-01-01

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

  16. Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

    NARCIS (Netherlands)

    van Eijk, F.

    2009-01-01

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

  17. Superior dislocation hip with anterior column acetabular fracture ...

    African Journals Online (AJOL)

    Superior variety of anterior dislocation of the hip is a rare injury. Its occurrence with acetabular fractures has been documented infrequently. We report a case of superior dislocation of the hip with anterior column acetabular fracture. Open reduction of the hip and internal fixation of the fracture was carried out using a twin ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-09-15

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

  19. Causes and consequences of anterior pharyngeal pouch after total laryngectomy.

    Science.gov (United States)

    Anderson, S; Hogan, D; Panizza, B

    2014-07-01

    To assess the frequency of anterior pharyngeal pouch formation after total laryngectomy, and to discuss the causes and consequences of anterior pharyngeal pouch formation. A prospective, observational study of 43 patients undergoing total laryngectomy. Data collected included laryngeal defect closure type, tumour staging and demographic information. A barium swallow was performed on day 7-14 after surgery to assess for anterior pharyngeal pouch formation and fistula formation. The incidence of anterior pharyngeal pouch formation was 47 per cent. Patients who did not have an anterior pharyngeal pouch on swallow imaging assessment were less likely to develop a pharyngo-cutaneous fistula. There was no statistically significant association between laryngeal defect closure type and anterior pharyngeal pouch formation. The anterior pharyngeal pouch is a dynamic phenomenon best investigated with a fluoroscopic swallow imaging study. Its causes are multi-factorial. Absence of an anterior pharyngeal pouch appears to confer protection against pharyngo-cutaneous fistula formation, hastening commencement of adjuvant therapy and an oral diet.

  20. Direct composite restoration of permanent anterior teeth uncomplicated crown fractures

    Directory of Open Access Journals (Sweden)

    Ashley Evans Nicholas

    2018-01-01

    Full Text Available An uncomplicated crown fracture is a fracture that involves only the tooth enamel or the dentin and tooth enamel without any damage or exposure to the pulp. Crown fracture of the anterior teeth usually caused by traumatic forces such as falls, accidents, violence, or sports activities. Traumatic injuries of the oral region frequently involve the anterior teeth, especially maxillary incisors due to the anatomic factors which may affect the functional and aesthetical values of the teeth. The objective of this literature study was to know more about uncomplicated crown fracture of the anterior teeth and its restoration. This research was a literature study performed by researching, highlighting various interesting facts and compiling the relevant published journals. The most common and ideal direct restoration of the anterior teeth was the composite resin restoration. The anterior teeth restoration was considered to be a complex and challenging case to solves due to the fact that besides reconstructing the tooth and regaining the function, the aesthetical aspect was also becoming the main objectives. The permanent anterior teeth uncomplicated crown fracture was the most common case of tooth fractures which was mainly caused by traumatic injuries such as falls, accidents, excessive forces, violence, and also sports activities. Dental injuries of the anterior teeth also affected the aesthetical properties and the function of the tooth. Composite resin restoration was able to performed directly on the permanent anterior teeth uncomplicated crown fracture.

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

    NARCIS (Netherlands)

    van Dooren, Bart T. H.; Mulder, Paul G. H.; Nieuwendaal, Carla P.; Beekhuis, W. Houdijn; Melles, Gerrit R. J.

    2004-01-01

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

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

    NARCIS (Netherlands)

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

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

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

    International Nuclear Information System (INIS)

    Moon, W.-J.; Porto, L.; Lanfermann, H.; Zanella, F.E.; Weis, R.

    2002-01-01

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

  4. Factors predicting dysphagia after anterior cervical surgery

    Science.gov (United States)

    Wang, Tao; Ma, Lei; Yang, Da-Long; Wang, Hui; Bai, Zhi-Long; Zhang, Li-Jun; Ding, Wen-Yuan

    2017-01-01

    Abstract A multicenter retrospective study. The purpose of this study was to explore risk factors of dysphagia after anterior cervical surgery and factors affecting rehabilitation of dysphagia 2 years after surgery. Patients who underwent anterior cervical surgery at 3 centers from January 2010 to January 2013 were included. The possible factors included 3 aspects: demographic variables—age, sex, body mass index (BMI): hypertension, diabetes, heart disease, smoking, alcohol use, diagnose (cervical spondylotic myelopathy or ossification of posterior longitudinal ligament), preoperative visual analogue scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA), surgical-related variables—surgical option (ACDF, ACCF, ACCDF, or Zero profile), operation time, blood loss, operative level, superior fusion segment, incision length, angle of C2 to C7, height of C2 to C7, cervical circumference, cervical circumference/height of C2 to C7. The results of our study indicated that the rate of dysphagia at 0, 3, 6, 12, and 24 months after surgery was 20%, 5.4%, 2.4%, 1.1%, and 0.4%, respectively. Our results showed that age (58.8 years old), BMI (27.3 kg/m2), course of disease (11.6 months), operation time (103.2 min), blood loss (151.6 mL), incision length (9.1 cm), cervical circumference (46.8 cm), angle of C2 to C7 (15.3°), cervical circumference/height of C2 to C7 (4.8), preoperative VAS (7.5), and ODI (0.6) in dysphagia group were significantly higher than those (52.0, 24.6, 8.6, 88.2, 121.6, 8.6, 42.3, 12.6, 3.7, 5.6, and 0.4, respectively) in nondysphagia group; however, height of C2 to C7 (9.9 vs 11.7 cm) and preoperative JOA (8.3 vs 10.7) had opposite trend between 2 groups. We could also infer that female, smoking, diabetes, ossification of posterior longitudinal ligament, ACCDF, multilevel surgery, and superior fusion segment including C2 to C3 or C6 to C7 were the risk factors for dysphagia after surgery immediately. However

  5. Filosofia da análise da estabilidade da liquidez

    Directory of Open Access Journals (Sweden)

    Rodrigo Antônio Chaves da Silva

    2005-07-01

    Full Text Available A informação foi considerada finalidade de nosso conhecimento, até o período em os pensadores e pesquisadores da contabilidade passaram a raciocinar sobre o conteúdo e o significado dos informes. Nesta busca da razão sobre os estados patrimoniais, surgiu a análise contábil que procura por meio de relações e identidades, o significado da dinâmica expressa da estaticamente na informação. O primeiro aspecto que surgiu no objeto de análise foi o estudo da liquidez, que é um dos principais exercícios do patrimônio. A estabilidade também é outro exercício básico e imprescindível, pois este é que promove o equilíbrio do organismo administrativo. A ciência contábil após a sua dignidade científica passou a trilhar caminhos esplendorosos, amparados em doutrina que permite alcançar os píncaros filosóficos. Os estudos concernentes aos aspectos de interação da estabilidade na liquidez são, complexos e somente com os recursos filosóficos da contabilidade se pode estudá-los com o panorama holístico e sublime. A filosofia da contabilidade não é alheia às suas práticas tecnológicas, podendo buscar pontos sublimes de panoramas abrangentes, para o estudo analítico da liquidez e estabilidade, observando todas as dimensionalidades e essencialidades de acontecimentos, na comprovação e orientação dos estados de ineficácia e eficácia patrimonial.

  6. Anterior tension band plating for anterior tibial stress fractures in high-performance female athletes: a report of 4 cases

    NARCIS (Netherlands)

    Borens, Olivier; Sen, Milan K.; Huang, Russel C.; Richmond, Jeffrey; Kloen, Peter; Jupiter, Jesse B.; Helfet, David L.

    2006-01-01

    Stress fracture of the anterior tibial cortex is an extremely challenging fracture to treat, especially in the high-performance female athlete who requires rapid return to competition. Previous reports have not addressed treating these fractures in the world-class athlete with anterior plating. We

  7. Radiographic localization of unerupted mandibular anterior teeth.

    Science.gov (United States)

    Jacobs, S G

    2000-10-01

    The parallax method and the use of 2 radiographs taken at right angles to each other are the 2 methods generally used to accurately localize teeth. For the parallax method, the combination of a rotational panoramic radiograph with an occlusal radiograph is recommended. This combination involves a vertical x-ray tube shift. Three case reports are presented that illustrate: (1) how this combination can accurately localize unerupted mandibular anterior teeth, (2) how a deceptive appearance of the labiolingual position of the unerupted tooth can be produced in an occlusal radiograph, (3) how increasing the vertical angle of the tube for the occlusal radiograph makes the tube shift easier to discern, (4) why occlusal radiographs are preferable to periapical radiographs for tube shifts, and (5) how localization can also be carried out with 2 radiographs at right angles to each other, one of which is an occlusal radiograph taken with the x-ray tube directed along the long axis of the reference tooth.

  8. Exercise Rehabilitation after Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Keun Ok An

    2017-06-01

    Full Text Available OBJECTIVES Exercise rehabilitation after anterior cruciate ligament (ACL reconstruction has changed dramatically in recent years. In this review, we discuss recent changes in exercise programs related to ACL rehabilitation. METHODS We conducted a literature review of recently published articles related exercise programs after ACL reconstruction. RESULTS The accelerated rehabilitation program, which allows patients to achieve full extension ofthe knee early in the postoperative period, is now a widely practiced rehabilitation program. A prospective study of rehabilitation programs after ACL reconstruction showed that early joint exercises do not interfere with the healing of grafts. Instead, they alleviate pain, thereby reducing the negative impact. Moreover, according to several biomechanical studies, open kinetic chain exercises are potentially disadvantageous to knee stability. There is no evidence that early weight bearing results in weakening of graft distraction or internal fixation compared with delayed weight bearing. CONCLUSIONS In conclusion, prevention of ACL injuries and rehabilitative exercise training can help to achieve optimal exercise performance while avoiding the risk of sports-related injury.

  9. Sobre arquitetura da informação

    Directory of Open Access Journals (Sweden)

    Jaime Robredo

    2011-04-01

    Full Text Available As origens da expressão 'arquitetura da informação', mostram a contribuição de Wurman (ele mesmo arquiteto, que comprovadamente cunhou a expressão em 1979, como uma afortunada metáfora que desenvolveu posteriormente com uma abrangente visão sistêmica em suas obras Information Anxiety e Information Anxiety 2, publicadas respectivamente em 1989 e 2001, e traduzidas e publicadas no Brasil em 2001 e 2005. Destaca-se, finalmente, a apropriação da expressão 'arquitetura da informação' para aspectos relativos à interface usuário-sistema, nos sistemas de informação computadorizados e na Internet, por outros autores, com destaque para Morville e Rosenfeld, com sua obra de grande sucesso "Information Architecture for the World Wide Web" (3ª ed., 2000, os quais reconhecem que muito tem contribuído para o sucesso de suas idéias a própria experiência anterior no campo da ciência da informação. Cabe esperar que a interação e mútuo enriquecimento dessas diversas abordagens teóricas e práticas continuem e aumentem, provocando mudanças e aprimoramentos nos programas de pós-graduação em ciência da informação.

  10. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture

    Directory of Open Access Journals (Sweden)

    Shinji Fukui

    2014-05-01

    Full Text Available A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed when he was 5 years. After excision of the scarred portions of the urethra, the defect of the urethra was 20 mm. Transperineal bulbar urethral mobilization was performed, and a single-stage end-to-end anterior urethroplasty without tension could be performed simultaneously.

  11. Ceratoconjuntivite alérgica e complicações no segmento ocular anterior de pacientes Evaluation of anterior ocular segment complications in patients with allergic keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Patrícia Bezerra de Menezes Botelho

    2003-01-01

    Full Text Available INTRODUÇÃO: A alergia ocular é condição que pode ocasionar sintomas de coceira, ardor e lacrimejamento, podendo também ser ameaçadora para visão. A fisiopatologia envolve mecanismos de hipersensibilidade imunológica. Devido a fatores imunológicos, o segmento anterior destes pacientes está mais suscetível a alterações que ameaçam a acuidade visual, tais como: opacidades corneanas, ceratocone e catarata. MÉTODOS: Foram revistos, retrospectivamente, 186 pacientes com ceratoconjuntivite alérgica e selecionados pacientes que possuíam alterações de segmento anterior e acuidade visual menor ou igual a 0,6 corrigida em um ou ambos os olhos. A AV 0,6 foi escolhida aleatoriamente a fim de agrupar os pacientes. Estes pacientes foram analisados quanto à idade, sexo, tipo de alergia, tempo de aparecimento da doença (considerado como tempo de aparecimento de sintomas, tempo de latência (tempo que surgiu a complicação após o primeiro dia de atendimento, alterações sistêmicas, efeitos colaterais das drogas e complicações oculares. Estes pacientes não poderiam melhorar a AV com tratamento tópico e tinham acompanhamento mínimo de 3 meses. RESULTADOS: As alterações de segmento anterior que causaram AV menor ou igual a 0,6 (refração ou estenopeico sem possibilidade de melhora com medicação tópica foram: úlcera em escudo: 5 casos, catarata: 3 casos, opacidade corneana: 6 casos, perfuração ocular: 2 casos e ceratocone: 13 casos. CONCLUSÃO: Pacientes com ceratoconjuntivite alérgica podem ter como principais causas de baixa acuidade visual alterações de segmento anterior, entre elas, opacidades corneanas, ceratocone e catarata.PURPOSE: To evaluate complications of allergic keratoconjuctivitis that caused reduction in visual acuity to 0.6 or less and that could not solve with clinic treatment. METHODS: We analyzed retrospectively 186 charts and selected patients with visual acuity less than 0.6 on Snellen chart, associated

  12. Landmarks for Identifying the Suprascapular Foramen Anteriorly: Application to Anterior Neurotization and Decompressive Procedures.

    Science.gov (United States)

    Manouvakhova, Olga V; Macchi, Veronica; Fries, Fabian N; Loukas, Marios; De Caro, Raffaele; Oskouian, Rod J; Spinner, Robert J; Tubbs, R Shane

    2018-02-01

    Additional landmarks for identifying the suprascapular nerve at its entrance into the suprascapular foramen from an anterior approach would be useful to the surgeon. To identify landmarks for the identification of this hidden site within an anterior approach. In 8 adult cadavers (16 sides), lines were used to connect the superior angle of the scapula, the acromion, and the coracoid process tip thus creating an anatomic triangle. The suprascapular nerve's entrance into the suprascapular foramen was documented regarding its position within this anatomical triangle. Depths from the skin surface and specifically from the medial-most point of the clavicular attachment of the trapezius to the suprascapular nerve's entrance into the suprascapular foramen were measured using calipers and a ruler. The clavicle was then fractured and retracted superiorly to verify the position of the nerve's entrance into the suprascapular foramen. From the trapezius, the nerve's entrance into the foramen was 3 to 4.2 cm deep (mean, 3.5 cm). The mean distance from the tip of the corocoid process to the suprascapular foramen was 3.8 cm. The angle best used to approach the suprascapular foramen from the surface was 15° to 20°. Based on our study, an anterior suprascapular approach to the suprascapular nerve as it enters the suprascapular foramen can identify the most medial fibers of the trapezius attachment onto the clavicle and insert a finger at an angle of 15° to 20° laterally and advanced to an average depth of 3.5 cm. Copyright © 2017 by the Congress of Neurological Surgeons

  13. Divulgação da informação contábil sobre depreciação: o antes e o depois da adoção das IFRS

    OpenAIRE

    Samantha Valentim Telles

    2014-01-01

    Dada sua origem no code law, a Contabilidade brasileira era baseada em regras e muito influenciada pelas normas fiscais. Com a adoção das IFRS, esperava-se que essa Contabilidade se aproximasse mais da essência econômica. Contudo, é possível encontrar estudos que apontam para o fato de existirem evidências da permanência da utilização de certos aspectos da Contabilidade anterior. Ao mesmo tempo, com a adoção das normas internacionais, a depreciação acabou ganhando uma importância maior devido...

  14. Dysphonia and dysphagia after anterior cervical decompression.

    Science.gov (United States)

    Tervonen, Hanna; Niemelä, Mika; Lauri, Eija-Riitta; Back, Leif; Juvas, Anja; Räsänen, Pirjo; Roine, Risto P; Sintonen, Harri; Salmi, Tapani; Vilkman, S Erkki; Aaltonen, Leena-Maija

    2007-08-01

    In this paper, the authors investigate the effects of anterior cervical decompression (ACD) on swallowing and vocal function. The study comprised 114 patients who underwent ACD. The early group (50 patients) was examined immediately pre- and postoperatively, and the late group (64 patients) was examined at only 3 to 9 months postoperatively. Fifty age- and sex-matched patients from the Department of Otorhinolaryngology-Head and Neck Surgery who had not been intubated in the previous 5 years were used as a control group. All patients in the early and control groups were examined by a laryngologist; patients in the late group were examined by a laryngologist and a neurosurgeon. Videolaryngostroboscopy was performed in all members of the patient and control groups, and the function of the ninth through 12th cranial nerves were clinically evaluated. Data were collected concerning swallowing, voice quality, surgery results, and health-related quality of life. Patients with persistent dysphonia were referred for phoniatric evaluation and laryngeal electromyography (EMG). Those with persistent dysphagia underwent transoral endoscopic evaluation of swallowing function and videofluorography. Sixty percent of patients in the early group reported dysphonia and 69% reported dysphagia at the immediate postoperative visit. Unilateral vocal fold paresis occurred in 12%. The prevalence of both dysphonia and dysphagia decreased in both groups 3 to 9 months postoperatively. All six patients with vocal fold paresis in the early group recovered, and in the late group there were two cases of vocal fold paresis. The results of laryngeal EMG were abnormal in 14 of 16 patients with persistent dysphonia. Neither intraoperative factors nor age or sex had any effect on the occurrence of dysphonia, dysphagia, or vocal fold paresis. Most patients were satisfied with the surgical outcome. Dysphonia, dysphagia, and vocal fold paresis are common but usually transient complications of ACD

  15. STRATIFICATION TECHNIQUE IN MAXILLARY ANTERIOR INCISORS RESTORATION

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    Janet Kirilova

    2014-08-01

    Full Text Available Background: Because of their main characteristics: transparency, opalescence and color density, the tooth structures are extremely difficult to restore by means of completely inconspicuous restorations of the natural tooth tissue characteristics. The aim is to show successful aesthetic restoration of III Class dental lesions in upper incisors by means of high quality composites. Materials and method: A female patient visited the clinic being not satisfied with the esthetics of her front teeth. The intraoral examination showed previous restorations and carious lesions in 12, 11, 21, 22. After defining the tooth color a silicone key was made. The treatment was performed under anesthesia, the existing restorations were removed and the carious lesions in teeth 11, 12, 21, 22 were treated with restorations using Vanini edge preparation. The teeth were restored by means of stratification technique. After etching and rinsing, bonding was applied for 20 sec. and then polymerized. After fixing the silicone key enamel shade was applied and then dentine shades UD2, UD3, UD4 of 0.5mm thickness each. The polymerization was done layer by layer. Applied were 10 to 15 layers in total. The composite material was preheated in oven up to 55. Teeth 21 and 22 are restored with Enamel Plus HRi (Micerium. Results and Discussion: Excellent aesthetics is achieved with composite material. They have enamel and dentine shades and allow high quality aesthetics. The polishing is excellent in Enamel Plus HRi (Micerium which is typical for this type of composite. The result of the carious lesion treatment in this patient is real improvement of the dental appearance of her anterior incisors. Conclusion: Materials show excellent aesthetic results due to their characteristics and the stratification technique used.

  16. Anterior Commissure-posterior commissure revisited

    International Nuclear Information System (INIS)

    Choi, Sang Han; Chi, Je Geun; Kim, Young Bo; Cho, Zang Hee

    2013-01-01

    The anterior commissure (AC) and posterior commissure (PC) are the two distinct anatomic structures in the brain which are difficult to observe in detail with conventional MRI, such as a 1.5T MRI system. However, recent advances in ultra-high resolution MRI have enabled us to examine the AC and PC directly. The objective of the present study is to standardize the shape and size of the AC and PC using a 7.0T MRI and to propose a new brain reference line. Thirty-four, 21 males and 13 females, healthy volunteers were enrolled in this study. After determining the center of each AC and PC, we defined the connection of these centers as the central intercommissural line (CIL). We compared the known extra- and intra-cerebral reference lines with the CIL to determine the difference in the angles. Additionally, we obtained horizontal line from flat ground line of look front human. The difference in angle of the CIL and the tangential intercommissural line (TIL) from the horizontal line was 8.7 ± 5.1 (11 ± 4.8) and 17.4 ± 5.2 (19.8 ± 4.8) degrees in males and females, respectively. The difference in angle between the CIL and canthomeatal line was 10.1 in both male and female, and there was no difference between both sexes. Likewise, there was no significant difference in angle between the CIL and TIL between both sexes (8.3 +/- 1.1 in male and 8.8 +/- 0.7 in female). In this study, we have used 7.0T MRI to define the AC and PC quantitatively and in a more robust manner. We have showed that the CIL is a reproducible reference line and serves as a standard for the axial images of the human brain.

  17. Analise dos pés através da baropodometria e da classificação plantar em escolares de Guaratinguetá

    OpenAIRE

    Azevedo, Liliana Aparecida de Paula [UNESP

    2006-01-01

    O presente estudo teve por objetivo realizar um levantamento do padrão do pé em crianças no início da segunda infância. A metodologia utilizou duas plataformas de força para detecção da distribuição das pressões plantares e da impressão plantar para mensurar o arco longitudinal medial, por conseguinte, classificar os tipos de pés. Foram comparadas as forças plantares da porção medial, lateral e as forças plantares da região anterior e posterior dos pés. Os pés, após serem classificados, foram...

  18. Orbicularis oris musculomucosal flap for anterior palatal fistula

    Directory of Open Access Journals (Sweden)

    Tiwari V

    2006-01-01

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

  19. Fibrinous anterior uveitis following laser in situ keratomileusis

    Directory of Open Access Journals (Sweden)

    Parmar Pragya

    2009-01-01

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

  20. Multi drug resistant tuberculosis presenting as anterior mediastinal mass

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    Parmarth Chandane

    2016-01-01

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

  1. Management of anterior dental crossbite with removable appliances

    Directory of Open Access Journals (Sweden)

    Ayca Tuba Ulusoy

    2013-01-01

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

  2. Desmoplastic ameloblastoma in the anterior mandible crossing the midline: A rare variant

    Directory of Open Access Journals (Sweden)

    Appaji Athota

    2009-01-01

    Full Text Available Desmoplastic ameloblastoma (DA is a rare variant of ameloblastoma. One hundred and forty-five cases of desmoplastic ameloblastoma have been reported till 2007 in the literature. This article presents a rare case of desmoplastic ameloblastoma in the parasymphysial region. Review of the literature has revealed that the tumor most commonly occurs in the third to fifth decade of life, with a male predilection of 3:2. The anterior region of the maxilla is the part that is most commonly found to be affected. The radiological features reveal a mixed radiolucent-radiopaque lesion with poorly defined to well-defined borders. However, our case differed from the reviewed cases, as it was found to be with well-defined borders. The histological findings of the case were consistent with the histological appearance of the reviewed cases and showed extensive stromal desmoplasia and small tumor nests of odontogenic epithelium scattered in the stroma.

  3. Aquisição da linguagem: considerações da perspectiva da interação social Language acquisition: explanations of the social interaction perspective

    Directory of Open Access Journals (Sweden)

    Lucivanda Cavalcante Borges

    2003-01-01

    Full Text Available Os estudos sobre a influência dos fatores sociais na aquisição da linguagem tiveram grande impulso com as críticas às considerações de Chomsky de que havia uma "pobreza dos estímulos" e, portanto, a criança não poderia adquirir a linguagem a partir do meio social. Autores da perspectiva da Interação Social no estudo da linguagem desafiam a posição chomskiana, e evidenciam a importância da interação social para a aquisição da linguagem, especialmente as relações da criança com a mãe. Essas relações representam um sistema dinâmico, segundo o qual ambos contribuem com suas experiências e conhecimentos para o curso da interação. A linguagem é entendida, nesta perspectiva, enquanto comunicação, e portanto é anterior ao surgimento das palavras. Neste trabalho, pretende-se apresentar as explicações desta perspectiva teórica sobre o processo de aquisição da linguagem infantil. Serão discutidos os efeitos da fala materna (motherese e sua influência na aquisição da linguagem por parte da criança, assim como os diferentes estilos de input lingüístico, considerando também a importância das características da criança na interação.The studies on the influence of social factors on language acquisition were largely influenced by the criticism made to Chomsky's ideas. Researchers following the social interaction perspective disagree with Chomsky and stress the influence of input on language acquisition. This perspective recognises the role of social interaction between adult and child, especially the mother, in the development of infant language. The relationship is characterised by a bidirectional model in which both parts contribute to the course of interaction. In this perspective, language is considered communication, and so initiate before the emission of words. The aim of this paper is to present the explanations of Social Interaction perspective regarding children's language acquisition. Maternal speech

  4. Passage of an Anterior Odontoid Screw through Gastrointestinal Tract.

    Science.gov (United States)

    Leitner, L; Brückmann, C I; Gilg, M M; Bratschitsch, G; Sadoghi, P; Leithner, A; Radl, R

    2017-01-01

    Purpose . Anterior screw fixation has become a popular surgical treatment method for instable odontoid fractures. Screw loosening and migration are a rare, severe complication following anterior odontoid fixation, which can lead to esophagus perforation and requires revision operation. Methods . We report a case of screw loosening and migration after anterior odontoid fixation, which perforated the esophagus and was excreted without complications in a 78-year-old male patient. Results . A ventral dislocated anterior screw perforated through the esophagus after eight years after implantation and was excreted through the gastrointestinal (GI) tract. At a 6-month follow-up after the event the patient was asymptomatic. Conclusion . Extrusion via the GI tract is not safe enough to be considered as a treatment option for loosened screws. Some improvements could be implemented to prevent such an incident. Furthermore, this case is a fine example that recent preoperative imaging is mandatory before revision surgery for screw loosening.

  5. Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

    Directory of Open Access Journals (Sweden)

    L. Leitner

    2017-01-01

    Full Text Available Purpose. Anterior screw fixation has become a popular surgical treatment method for instable odontoid fractures. Screw loosening and migration are a rare, severe complication following anterior odontoid fixation, which can lead to esophagus perforation and requires revision operation. Methods. We report a case of screw loosening and migration after anterior odontoid fixation, which perforated the esophagus and was excreted without complications in a 78-year-old male patient. Results. A ventral dislocated anterior screw perforated through the esophagus after eight years after implantation and was excreted through the gastrointestinal (GI tract. At a 6-month follow-up after the event the patient was asymptomatic. Conclusion. Extrusion via the GI tract is not safe enough to be considered as a treatment option for loosened screws. Some improvements could be implemented to prevent such an incident. Furthermore, this case is a fine example that recent preoperative imaging is mandatory before revision surgery for screw loosening.

  6. Prosthodontic Rehabilitation of Patient with Anterior Hyper Function Syndrome

    Directory of Open Access Journals (Sweden)

    Vesna Korunoska-Stevkovska

    2017-12-01

    CONCLUSION: Anterior hyperfunction syndrome with its high incidence is a disease with the need of interdisciplinary therapy approach. Fast diagnosis, thorough clinical examination using all available diagnostic tools, and choosing the right treatment is very challenging.

  7. Laparoscopic repair of paraesophageal hernia with anterior gastropexy

    DEFF Research Database (Denmark)

    Daigle, Christopher R; Funch-Jensen, Peter; Calatayud, Dan

    2015-01-01

    despite significant dysphagia rates. We present our multicenter prospective data on laparoscopic PEH repairs using a modified Boerema anterior gastropexy without fundoplication. METHODS: We prospectively followed patients after modified Boerema PEH repair at three institutions. Patient demographics...

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

    Science.gov (United States)

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

    2008-02-01

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

  9. Anterior vaginal wall repair (surgical treatment of urinary incontinence) - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100110.htm Anterior vaginal wall repair (surgical treatment of urinary incontinence) - series— ... to slide 4 out of 4 Overview The vaginal opening lies just below the urethral opening, and ...

  10. Memory-guided attention in the anterior thalamus.

    Science.gov (United States)

    Leszczyński, Marcin; Staudigl, Tobias

    2016-07-01

    The anterior thalamus is densely connected with both the hippocampus and the prefrontal cortex. It is known to play a role in learning and episodic memory. Given its connectivity profile with the prefrontal cortex, it may also be expected to contribute to executive functions. Recent studies in both rodents and humans add to our understanding of anterior thalamic function, suggesting that it is a key region for allocating attention. We discuss the convergence between studies in rodents and humans, both of which imply that the anterior thalamus may play a key role in memory-guided attention. We suggest that efficient allocation of attention to memory representations requires interaction between the memory-related hippocampal and the attention related fronto-parietal networks. We further propose that the anterior thalamus is a hub that connects and modulates both systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Examination of the sprained ankle: Anterior drawer test or arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Laehde, S.; Putkonen, M.; Puranen, J.; Raatikainen, T.

    1988-11-01

    The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis.

  12. ARTHROSCOPIC TREATMENT OF ANTERIOR IMPINGEMENT IN THE ANKLE

    Directory of Open Access Journals (Sweden)

    Martin Mikek

    2004-12-01

    Full Text Available Background. Anterior soft tissue impingement is a common cause of chronic pain in the ankle. The preferred method of operative treatment is an arthroscopic excision of hypertrophic fibrous and synovial tissue in the anterior part of the ankle joint.Methods. We present the results of arthroscopic treatment of anterior ankle impingement in group of 14 patients.Results. Subjective improvement after the procedure was observed in all patients and 13 of them (93% were without any symptoms after the operation. One patient reported of intermittent pain, especially when walking on uneven grounds.Conclusions. We conclude that arthroscopic excision of hypertrophic synovial tissue in the anterior part of the ankle which causes the symptoms of impingement is a minimally invasive procedure that is both safe and reliable. When used for appropriate indications, an improvement can be expected in over 90% of patients.

  13. Examination of the sprained ankle: Anterior drawer test or arthrography?

    International Nuclear Information System (INIS)

    Laehde, S.; Putkonen, M.; Puranen, J.; Raatikainen, T.

    1988-01-01

    The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis. (orig.)

  14. work in miners following anterior cruciate ligament reconstruction

    African Journals Online (AJOL)

    Return to work in miners following anterior cruciate ligament reconstruction. ... Patients were evaluated in terms of range of motion (ROM) values; Lysholm, Cincinati and ... pain inside the knee were the most significant reason which affected ...

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

    NARCIS (Netherlands)

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

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

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

    Science.gov (United States)

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

    2016-01-01

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

  17. Challenges and outcomes of management of anterior abdominal ...

    African Journals Online (AJOL)

    Challenges and outcomes of management of anterior abdominal wall defects in a Nigerian tertiary hospital. ... African Journal of Paediatric Surgery ... Postoperative complication rate was 32.1% and overall mortality was 30.4%, with the ...

  18. Anterior ischemic optic neuropathy in patients undergoing hemodialysis

    NARCIS (Netherlands)

    DoorenbosBot, ACC; Geerlings, W; Houtman, IA

    Four patients are discussed who underwent hemodialysis and developed anterior ischemic optic neuropathy (AION). Three patients had been treated by hemodialysis for several years. One patient developed bilateral optic neuropathy after the first hemodialysis session, So far, only four hemodialysis

  19. Application and experience of anterior vitrectomy in phacoemulsification

    Directory of Open Access Journals (Sweden)

    Xiao-Bo Zeng

    2016-02-01

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

  20. A conservative approach for restoring anterior guidance: a case report.

    Science.gov (United States)

    Pontons-Melo, Juan Carlos; Pizzatto, Eduardo; Furuse, Adilson Yoshio; Mondelli, José

    2012-06-01

    One of the most common dental problems in today's clinics is tooth wear, specifically when related to bruxism. In such cases, the esthetics of anterior teeth may be compromised when excessive wear to the incisal surfaces occurs. Anterior tooth wear resulting from parafunctional bruxism can be conservatively treated with the use of direct resin composite restorations. This restorative approach has the advantages of presenting good predictability, load resistance, acceptable longevity, preservation of healthy dental tissues, and lower cost when compared with indirect restorations. The use of resin composites to solve esthetic problems, however, requires skill and practice. Thus, the present article demonstrates a conservative approach for restoring the esthetics and function of worn anterior teeth with the aid of direct resin composite restorations and selective occlusal adjustment. A conservative approach to restore anterior teeth with excessive wear is possible with direct resin composites. © 2011 Wiley Periodicals, Inc.

  1. A censervative programme for treatment of anterior knee pain in ...

    African Journals Online (AJOL)

    week conservative rehabilitation programme in addressing anterior knee pain in adolescents. Design. Subjects were randomly allocated to a control group (N=12) and an experimental group (N=18). The experimental group was subjected to a ...

  2. Anterior vaginal prolapse repair: A randomised trial of traditional ...

    African Journals Online (AJOL)

    Women with symptomatic anterior vaginal prolapse ≥POPQ stage II were included. Those with concomitant stress urinary ... ation, erosion, bleeding and discharge, pain and dyspareunia.[9] The .... which is similar to reports in other studies.

  3. Acute anterior uveitis following intravitreal bevacizumab but not subsequent ranibizumab

    Directory of Open Access Journals (Sweden)

    Antonopoulos C

    2011-11-01

    Full Text Available Christina Antonopoulos1, Maxwell Stem2, Grant M Comer21Department of Ophthalmology, Boston University, Boston, MA, USA; 2WK Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor, MI, USAPurpose: Previous reports have identified noninfectious uveitis as a potential sequela following both intravitreal bevacizumab and ranibizumab injections. We present two unique cases of acute anterior uveitis following intravitreal bevacizumab that did not occur with subsequent ranibizumab injections.Methods: Case report.Conclusion: These cases may reflect differences in the etiology of anterior uveitis following intravitreal bevacizumab and ranibizumab. Given these differences, it may be reasonable to offer ranibizumab to patients who have experienced presumed bevacizumab-induced anterior uveitis.Keywords: adverse effect, age-related macular degeneration, anterior uveitis, bevacizumab, ranibizumab, uveitis

  4. Pigment dispersion syndrome masquerading as acute anterior uveitis.

    Science.gov (United States)

    Gonzalez-Gonzalez, Luis Alonso; Rodríguez-García, Alejandro; Foster, C Stephen

    2011-06-01

    Signs and symptoms of pigment dispersion may be confused with those of acute anterior uveitis. This case series is intended to aid the ophthalmologist in the clinical differentiation between these two disorders. The authors present a series of 6 patients with pigment dispersion who were initially diagnosed as having acute anterior uveitis and treated with anti-inflammatory medication, including corticosteroids. The patients were referred for a second opinion due to poor or no response to therapy and were found to have pigment dispersion instead of uveitis. Symptoms of pigment dispersion may consist of blurred vision, redness, ocular pain, and photophobia, all of which are also symptoms of acute anterior uveitis. These symptoms, plus the fact that pigment floating in the aqueous humor can be mistaken for inflammation, make diagnosis challenging. Moreover, the possible co-existence of true anterior uveitis and pigment dispersion makes the diagnosis and treatment more difficult.

  5. Automatic anterior chamber angle assessment for HD-OCT images.

    Science.gov (United States)

    Tian, Jing; Marziliano, Pina; Baskaran, Mani; Wong, Hong-Tym; Aung, Tin

    2011-11-01

    Angle-closure glaucoma is a major blinding eye disease and could be detected by measuring the anterior chamber angle in the human eyes. High-definition OCT (Cirrus HD-OCT) is an emerging noninvasive, high-speed, and high-resolution imaging modality for the anterior segment of the eye. Here, we propose a novel algorithm which automatically detects a new landmark, Schwalbe's line, and measures the anterior chamber angle in the HD-OCT images. The distortion caused by refraction is corrected by dewarping the HD-OCT images, and three biometric measurements are defined to quantitatively assess the anterior chamber angle. The proposed algorithm was tested on 40 HD-OCT images of the eye and provided accurate measurements in about 1 second.

  6. Asteroid hyalosis removal during phacoemulsification: an anterior approach

    Directory of Open Access Journals (Sweden)

    Mohamed Anbar

    2017-01-01

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

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

    African Journals Online (AJOL)

    2015-06-11

    Jun 11, 2015 ... We present a case of primary monophasic synovial sarcoma of the anterior ... Here, we report a case of ... fatigue and anorexia, but no weight loss. ..... Primary intrathoracic synovial sarcoma: A clinicopathologic study of. 40 t (X ...

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

    LENUS (Irish Health Repository)

    Walker, Cameron

    2009-12-01

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

  9. Incipient nonarteritic anterior ischemic optic neuropathy.

    Science.gov (United States)

    Hayreh, Sohan Singh; Zimmerman, M Bridget

    2007-09-01

    To describe the clinical entity of incipient nonarteritic anterior ischemic optic neuropathy (NAION). Cohort study. Fifty-four patients (60 eyes) seen in our clinic from 1973 through 2000. At their first visit to our clinic, all patients gave a detailed ophthalmic and medical history and underwent a comprehensive ophthalmic evaluation, color fundus photography, and fluorescein fundus angiography. At each follow-up visit (of 49 patients [55 eyes]), the same ophthalmic evaluation was performed, except for fluorescein fundus angiography. Clinical features of incipient NAION. Mean age (+/- standard deviation) of the patients was 58.7+/-15.9 years. Median follow-up time was 6.3 years (interquartile range [IQR], 2.1-8.5). At initial visit, all had optic disc edema (ODE) without any visual loss attributable to NAION. In 55%, the fellow eye had classic NAION; in 25%, incipient progressed to classic NAION (after a median time of 5.8 weeks [IQR, 3.2-10.1]); and in 20%, classic NAION developed after resolution of the first episode of incipient NAION. Patients with incipient, compared with classic, NAION had a greater prevalence of diabetes mellitus (Pheart disease (P = 0.046). Patients who progressed to classic NAION versus those who did not were significantly younger (P = 0.025), and their visual acuity worsened in 31% and 0%, respectively, and remained stable in 62% and 98%, respectively; in the eyes with progression, central (in 31%) and peripheral (in 77%) visual fields worsened compared with only 1 eye and 2 eyes, respectively, that did not (P = 0.01 and Pversus 9.6 weeks (IQR, 6.0-17.7) in those who did not progress. The results show that incipient NAION is a distinct clinical entity, with asymptomatic ODE and no visual loss attributable to NAION. When a patient seeks treatment with asymptomatic ODE, incipient NAION must be borne in mind as a strong possibility in those who have had classic NAION in the fellow eye, in diabetics of all ages, and in those with high risk

  10. Integrity of the subscapularis tendon after open surgery for the treatment of anterior shoulder instability: a clinical and radiological evaluation

    OpenAIRE

    Lech, Osvandré; Piluski, Paulo; Tambani, Renato; Castro, Nero; Pimentel, Gilnei

    2009-01-01

    OBJETIVO: Avaliar a integridade do músculo subescapular através da força, função e ressonância nuclear magnética após acesso deltopeitoral para tratamento da luxação glenoumeral anterior recidivante. MÉTODOS: Foram avaliados 20 pacientes com luxação recidivante do ombro. Todos os casos possuíam seguimento mínimo de 12 meses, com média de 40 meses. Os pacientes eram todos do sexo masculino, com média de idade de 29 anos (20-42 anos). Os pacientes foram submetidos a exame físico para avaliar mo...

  11. A Sintaxe da Janela

    Directory of Open Access Journals (Sweden)

    Luís Antônio Jorge

    1993-12-01

    Full Text Available A preocupação fundamenta! do trabalho é de caráter ontológico: esboçar o problema das significações apriorísticas e autônomas dos elementos que compõem a sintaxe arquitetônica. O trabalho elege um desses elementos: a janela. Este artigo parte da aproximação histórica entre a janela e a secção da pirâmide visual, construção imaginária da teoria da perspectiva renascentista. A consideração da janela na linguagem arquitetônica implica reconhecer uma ambigüidade essencial: a janela deve inserir-se ordenadamente no plano da parede - raciocínio típico da modenatura - mas também relacionar-se com a imagem vista através dela, que extrapola o plano, ressaltando a tridimensionalidade - herança da perspectiva renascentista, fundamentada no espaço euclidiano. Ver janela ou ver através da janela são alternativas que se colocam tanto ao observador interno ao edifício, quanto ao externo. Texto de duplaface, a sintaxe da janela versa sobre o relacionamento desses dois lados

  12. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    Energy Technology Data Exchange (ETDEWEB)

    Petrover, David [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Hopital Beaujon, Service de Radiologie, Paris (France); Schweitzer, Mark E. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Laredo, J.D. [Hopital Lariboisiere, Service de Radiologie, Paris (France)

    2007-07-15

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  13. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    International Nuclear Information System (INIS)

    Petrover, David; Schweitzer, Mark E.; Laredo, J.D.

    2007-01-01

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

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

    Science.gov (United States)

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

    2013-01-01

    The anterior cerebral artery originates from the bifurcation of the internal carotid artery lateral to the optic chiasm, then joins with its contralateral counterpart via the anterior communicating artery. A1-anterior communicating artery complex is the most frequent anatomical variants and is the major site of aneurysms between 30 to 37%. Know the anatomy microsurgical, variants anatomical and importance of complex precommunicating segment-artery anterior communicating in surgery neurological of the pathology vascular, mainly aneurysms, in Mexican population. The study was performed in 30 brains injected. Microanatomy was studied (length and diameter) of A1-anterior communicating artery complex and its variants. 60 segments A1, the average length of left side was 11.35 mm and 11.84 mm was right. The average diameter of left was 1.67 mm and the right was 1.64 mm. The average number of perforators on the left side was 7.9 and the right side was 7.5. Anterior communicating artery was found in 29 brains of the optic chiasm, its course depended on the length of the A1 segment. The average length of the segment was 2.84 mm, the average diameter was 1.41 mm and the average number of perforators was 3.27. A1-anterior communicating artery complex variants were found in 18 (60%) and the presence of two blister-like aneurysms. It is necessary to understand the A1-anterior communicating artery complex microanatomy of its variants to have a three-dimensional vision during aneurysm surgery.

  15. Does concomitant anterior fundoplication promote dysphagia after laparoscopic Heller myotomy?

    Science.gov (United States)

    Tapper, Donovan; Morton, Connor; Kraemer, Emily; Villadolid, Desiree; Ross, Sharona B; Cowgill, Sarah M; Rosemurgy, Alexander S

    2008-07-01

    Concerns for gastroesophageal reflux after laparoscopic Heller myotomy for achalasia justify considerations of concomitant anterior fundoplication. This study was undertaken to determine if concomitant anterior fundoplication reduces symptoms of reflux after myotomy without promoting dysphagia. From 1992 to 2004, 182 patients underwent laparoscopic Heller myotomy without fundoplication. After a prospective randomized trial justified its concomitant application, anterior fundoplication was undertaken with laparoscopic Heller myotomy in 171 patients from 2004 to 2007. All patients have been prospectively followed. Pre and postoperatively, patients scored the frequency and severity of symptoms of achalasia (including dysphagia, choking, vomiting, regurgitation, chest pain, and heartburn) using a Likert Scale (0 = never/not bothersome to 10 = always/very bothersome). Before myotomy, symptoms of achalasia were frequent and severe for all patients. After myotomy, the frequency and severity of all symptoms of achalasia significantly decreased for all patients (P Heller myotomy alone, concomitant anterior fundoplication led to significantly less frequent and severe heartburn after myotomy (P Heller myotomy reduces the frequency and severity of symptoms of achalasia. Concomitant anterior fundoplication decreases the frequency and severity of heartburn and dysphagia after laparoscopic Heller myotomy. Concomitant anterior fundoplication promotes salutary relief in the frequency and severity of symptoms after myotomy and is warranted.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS AND METH....... On this basis it was decided to discontinue the study prematurely for ethical reasons. CONCLUSION: Decompression of the anastomosis with a transanal stent does not reduce the risk of anastomotic leakage after anterior resection.......OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS...... AND METHODS: Randomized open trial of 194 patients operated in 11 hospitals during September 2000 to September 2003 with anterior resection for a mobile rectal tumour, 115 men and 79 women, median age 68 years (range 37-90 years). The surgeon decided upon the use of a protective ileostomy, and after...

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

    Directory of Open Access Journals (Sweden)

    Armando Alemán Rivera

    2001-06-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

  19. Anterior, posterior, left anterior oblique, and geometric mean views in gastric emptying studies using a glucose solution

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, W.T. [Dept. of Radiology, Univ. of Texas Health Science Center, San Antonio, TX (United States); McMahan, C.A. [Dept. of Pathology, Univ. of Texas Health Science Center, San Antonio, TX (United States); Lasher, J.C. [Dept. of Radiology, Univ. of Texas Health Science Center, San Antonio, TX (United States); Blumhardt, M.R. [Dept. of Pathology, Univ. of Texas Health Science Center, San Antonio, TX (United States); Schwartz, J.G. [Dept. of Pathology, Univ. of Texas Health Science Center, San Antonio, TX (United States)

    1995-02-01

    Previous research has shown that the single anterior view of the stomach overestimates the gastric half-emptying time of a solid meal compared to the geometric mean of the anterior and posterior views. Little research has been performed comparing the various views of gastric emptying of a glucose solution. After an overnight fast, 49 nondiabetic subjects were given a 450 ml solution containing 50 g of glucose and 200 {mu}Ci of technetium-99m sulfur colloid. Sequential 1-min anterior, posterior, and left anterior oblique views were obtained every 15 min. The mean percent solution remaining in the stomach for all three views differed from the geometric mean by 1.9% or less at all time points. Average gastric half-emptying times were: geometric mean, 62.7{+-}3.3 min; anterior, 61.9{+-}3.2 min; posterior, 63.5{+-}3.5 min; and left anterior oblique, 61.6{+-}3.3 min. These half-emptying times were not statistically different. For individual patients, differences between all three views and the geometric mean were not clinically important. Approximately 95% of all patients are expected to have gastric half-emptying times measured by any of the three single views within 17 min of the gastric half-emptying time obtained using the geometric mean. The imaging of gastric emptying using glucose solutions can be performed using a convenient single view which allows continuous dynamic imaging. (orig.)

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

    International Nuclear Information System (INIS)

    Tirman, P.F.J.; Steinbach, L.S.; Feller, J.F.; Stauffer, A.E.

    1996-01-01

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

  1. Relação entre a lesão condral e o pico de torque após reconstrução do ligamento cruzado anterior do joelho: estudo de casos

    OpenAIRE

    Traete,RF; Pinto,KNZ; Mattiello-Rosa,SM

    2007-01-01

    CONTEXTUALIZAÇÃO: A associação entre lesão do ligamento cruzado anterior (LCA) e desenvolvimento de osteoartrite (OA) secundária tem sido objeto de vários estudos. A lesão ligamentar predispõe a lesões da cartilagem articular, influenciando, assim, o controle motor e o pico de torque. OBJETIVO: Avaliar a influência do grau de lesão condral no pico de torque da musculatura anterior e posterior da coxa após lesão e reconstrução do LCA. MÉTODO: Seis sujeitos do sexo masculino com lesão total e u...

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

    International Nuclear Information System (INIS)

    AbouZeid, Amr Abdelhamid; Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

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

  4. Tópicos da teoria da relatividade

    OpenAIRE

    Fragata, Paulo Renato Ferreira

    2013-01-01

    Dissertação de Mestrado, Matemática para Professores, 25 de Outubro 2013, Universidade dos Açores. Qualquer descrição física da natureza tem por base a especificação da posição e do instante em que decorre determinado acontecimento. Para tal, é necessário recorrer a um sistema de coordenadas, escolhido por cada observador, do modo que ele achar mais pertinente. Dada a generalidade na escolha do sistema de coordenadas, é útil conhecer as regras que nos permitem comparar cálculos feitos em d...

  5. Anterior Cortical Development During Adolescence in Bipolar Disorder.

    Science.gov (United States)

    Najt, Pablo; Wang, Fei; Spencer, Linda; Johnston, Jennifer A Y; Cox Lippard, Elizabeth T; Pittman, Brian P; Lacadie, Cheryl; Staib, Lawrence H; Papademetris, Xenophon; Blumberg, Hilary P

    2016-02-15

    Increasing evidence supports a neurodevelopmental model for bipolar disorder (BD), with adolescence as a critical period in its development. Developmental abnormalities of anterior paralimbic and heteromodal frontal cortices, key structures in emotional regulation processes and central in BD, are implicated. However, few longitudinal studies have been conducted, limiting understanding of trajectory alterations in BD. In this study, we performed longitudinal neuroimaging of adolescents with and without BD and assessed volume changes over time, including changes in tissue overall and within gray and white matter. Larger decreases over time in anterior cortical volumes in the adolescents with BD were hypothesized. Gray matter decreases and white matter increases are typically observed during adolescence in anterior cortices. It was hypothesized that volume decreases over time in BD would reflect alterations in those processes, showing larger gray matter contraction and decreased white matter expansion. Two high-resolution magnetic resonance imaging scans were obtained approximately 2 years apart for 35 adolescents with bipolar I disorder (BDI) and 37 healthy adolescents. Differences over time between groups were investigated for volume overall and specifically for gray and white matter. Relative to healthy adolescents, adolescents with BDI showed greater volume contraction over time in a region including insula and orbitofrontal, rostral, and dorsolateral prefrontal cortices (p adolescence in BDI in anterior cortices, including altered developmental trajectories of anterior gray and white matter. Published by Elsevier Inc.

  6. Psychological Aspects of Recovery Following Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Christino, Melissa A; Fantry, Amanda J; Vopat, Bryan G

    2015-08-01

    Recovery following anterior cruciate ligament reconstruction is an arduous process that requires a significant mental and physical commitment to rehabilitation. Orthopaedic research in recent years has focused on optimizing anterior cruciate ligament surgical techniques; however, despite stable anterior cruciate ligament reconstructions, many athletes still never achieve their preinjury ability or even return to sport. Psychological factors associated with patient perceptions and functional outcomes following anterior cruciate ligament reconstruction are important to acknowledge and understand. Issues related to emotional disturbance, motivation, self-esteem, locus of control, and self-efficacy can have profound effects on patients' compliance, athletic identity, and readiness to return to sport. The psychological aspects of recovery play a critical role in functional outcomes, and a better understanding of these concepts is essential to optimize the treatment of patients undergoing anterior cruciate ligament reconstruction, particularly those who plan to return to sport. Identifying at-risk patients, encouraging a multidisciplinary approach to patient care, and providing early referral to a sports psychologist may improve patient outcomes and increase return-to-play rates among athletes. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

  7. Phase image characterization of ventricular contraction in left anterior hemiblock

    International Nuclear Information System (INIS)

    Ono, Akifumi; Mizuno, Haruyoshi; Tahara, Yorio; Ishikawa, Kyozo

    1991-01-01

    We investigated whether or not left anterior hemiblock is present in patients with left axis deviation using first-harmonic Fourier analysis of gated blood-pool images. Gated blood-pool images were taken in 50 patients without contraction abnormality. They included 14 normal subjects, 8 patients with right bundle branch block (RBBB), 20 with left axis deviation (LAD) and 8 with both RBBB and LAD (RBBB+LAD). ECG gated blood-pool scans were acquired in the anterior and 'best septal' left anterior oblique projections. First, the phase images were displayed cinematically as a continuous-loop movie. Next, for quantitative analysis of the phase image, the whole left ventricular and left ventricular high lateral regions of interest were drawn. The 'regional phase shift' (RPS) was then defined as {RPS=A-a} where 'A' is the mean value of the whole left ventricular phase angles and 'a' is that of phase angles in the high lateral region. The left ventricular phase changes and the RPSs in the RBBB and LAD groups were similar to those in the normal group. In the RBBB+LAD group, the latest phase changes occurred in the high anterolateral region. The RPSs of this group were significantly lower than those in the other 3 groups (p<0.01). These data suggest that left anterior hemiblock might coexist with RBBB in patients with RBBB+LAD, whereas left anterior hemiblock might not exist in the majority of patients with LAD alone. (author)

  8. Diffuse Anterior Retinoblastoma with Sarcoidosis-Like Nodule

    Directory of Open Access Journals (Sweden)

    Koji Kitazawa

    2015-12-01

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

  9. Evaluation of the anterior chamber angle in pseudoexfoliation syndrome.

    Science.gov (United States)

    Iwanejko, Małgorzata; Turno-Kręcicka, Anna; Tomczyk-Socha, Martyna; Kaczorowski, Kamil; Grzybowski, Andrzej; Misiuk-Hojło, Marta

    2017-08-01

    Pseudoexfoliation syndrome (PEX) is the most frequently identifiable cause of secondary open-angle glaucoma, known as pseudoexfoliation glaucoma. The exact pathophysiology and etiology of PEX and associated glaucoma remains obscure. The purpose of this study was to determine the differences in the morphology of the anterior chamber angle in people with pseudoexfoliation syndrome and pseudoexfoliation glaucoma compared to a control group. We also evaluated the correlation between intraocular pressure (IOP) and pigmentation of the angle with the amount of exfoliated material in the anterior segment. The study group was composed of 155 eyes from 103 patients aged between 43 and 86 years. Each patient underwent a complete ophthalmological examination. Some difference was found in intraocular pressure between the PEX group and the control group and between the pseudoexfoliation glaucoma group and the control group, but no significant difference was found between the 2 study groups. There was a significant difference in the incidence of some degree of pigmentation in the anterior chamber angle and no difference in the widths of the angle between each group. A significant positive relationship was observed between intraocular pressure and the degree of pigmentation of the anterior chamber angle in both the PEX group and the pseudoexfoliation glaucoma group. The results of this study indicate that the amount of pigmentation and exfoliation material in the anterior segment significantly correlates with the level of IOP and possibly with the degree of trabecular dysfunction. It seems that for clear identification of PEX and pseudoexfoliation glaucoma factors, clinical assessment appears to be insufficient.

  10. Experience with titanium cages in anterior cervical discectomy and fusion

    International Nuclear Information System (INIS)

    Junaid, M.; Afsheen, A.; Bukhari, S.S.; Rashid, M.U.; Kalsoom, A.

    2016-01-01

    Background: Anterior cervical discectomy is a common procedure for treating patients for cervical disc prolapse. This study was conducted to study the surgical outcome and demographic characteristics of patients who were treated for anterior cervical disc prolapse. Methods: Study was conducted in the combined military hospital (CMH) Peshawar. Study interval was 3 years from 1st September, 2011 to 31st August, 2014. Total number of patients were 84. Males were 54 (64.28 percentage) and females were 30 (35.71 percentage). All the patients had undergone the procedure of anterior cervical discectomy and fusion with titanium cages (ACDF). All the patients had plain MRI cervical spine done for diagnosis of anterior cervical disc prolapse. Results: Total 84 patients were operated. In the patients who complained of brachialgia, 100 percentage improvement was seen after the operation. Three (3.5 percentage) of the patients, who presented with axial neck pain, continued to complain of pain and 2 (2.5 percentage) of the patients complained of pain at the donor site after the operation. One of the patient had dural tear which resulted in subcutaneous cerebrospinal fluid (CSF) accumulation and was treated conservatively with repeated aspiration. Fusion rate was 100 percentage with titanium cages used for fusion after anterior cervical discectomy. No complications were noted after the surgery at 1 year of interval. Conclusion: Results with titanium cages are expectedly good. Symptoms resolved and fusion rate was 100 percentage at 1 year follow up. (author)

  11. Anabolic steroids alter the physiological activity of aggression circuits in the lateral anterior hypothalamus.

    Science.gov (United States)

    Morrison, T R; Sikes, R W; Melloni, R H

    2016-02-19

    Syrian hamsters exposed to anabolic/androgenic steroids (AAS) during adolescence consistently show increased aggressive behavior across studies. Although the behavioral and anatomical profiles of AAS-induced alterations have been well characterized, there is a lack of data describing physiological changes that accompany these alterations. For instance, behavioral pharmacology and neuroanatomical studies show that AAS-induced changes in the vasopressin (AVP) neural system within the latero-anterior hypothalamus (LAH) interact with the serotonin (5HT) and dopamine (DA) systems to modulate aggression. To characterize the electrophysiological profile of the AAS aggression circuit, we recorded LAH neurons in adolescent male hamsters in vivo and microiontophoretically applied agonists and antagonists of aggressive behavior. The interspike interval (ISI) of neurons from AAS-treated animals correlated positively with aggressive behaviors, and adolescent AAS exposure altered parameters of activity in regular firing neurons while also changing the proportion of neuron types (i.e., bursting, regular, irregular). AAS-treated animals had more responsive neurons that were excited by AVP application, while cells from control animals showed the opposite effect and were predominantly inhibited by AVP. Both DA D2 antagonists and 5HT increased the firing frequency of AVP-responsive cells from AAS animals and dual application of AVP and D2 antagonists doubled the excitatory effect of AVP or D2 antagonist administration alone. These data suggest that multiple DA circuits in the LAH modulate AAS-induced aggressive responding. More broadly, these data show that multiple neurochemical interactions at the neurophysiological level are altered by adolescent AAS exposure. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

  12. Preliminary results of anterior lumbar interbody fusion, anterior column realignment for the treatment of sagittal malalignment.

    Science.gov (United States)

    Hosseini, Pooria; Mundis, Gregory M; Eastlack, Robert K; Bagheri, Ramin; Vargas, Enrique; Tran, Stacie; Akbarnia, Behrooz A

    2017-12-01

    OBJECTIVE Sagittal malalignment decreases patients' quality of life and may require surgical correction to achieve realignment goals. High-risk posterior-based osteotomy techniques are the current standard treatment for addressing sagittal malalignment. More recently, anterior lumbar interbody fusion, anterior column realignment (ALIF ACR) has been introduced as an alternative for correction of sagittal deformity. The objective of this paper was to report clinical and radiographic results for patients treated using the ALIF-ACR technique. METHODS A retrospective study of 39 patients treated with ALIF ACR was performed. Patient demographics, operative details, radiographic parameters, neurological assessments, outcome measures, and preoperative, postoperative, and mean 1-year follow-up complications were studied. RESULTS The patient population comprised 39 patients (27 females and 12 males) with a mean follow-up of 13.3 ± 4.7 months, mean age of 66.1 ± 11.6 years, and mean body mass index of 27.3 ± 6.2 kg/m 2 . The mean number of ALIF levels treated was 1.5 ± 0.5. Thirty-three (84.6%) of 39 patients underwent posterior spinal fixation and 33 (84.6%) of 39 underwent posterior column osteotomy, of which 20 (60.6%) of 33 procedures were performed at the level of the ALIF ACR. Pelvic tilt, sacral slope, and pelvic incidence were not statistically significantly different between the preoperative and postoperative periods and between the preoperative and 1-year follow-up periods (except for PT between the preoperative and 1-year follow-up, p = 0.018). Sagittal vertical axis, T-1 spinopelvic inclination, lumbar lordosis, pelvic incidence-lumbar lordosis mismatch, intradiscal angle, and motion segment angle all improved from the preoperative to postoperative period and the preoperative to 1-year follow-up (p < 0.05). The changes in motion segment angle and intradiscal angle achieved in the ALIF-ACR group without osteotomy compared with the ALIF-ACR group with osteotomy

  13. Depressão e ansiedade em profissionais da educação das regiões da Amerios e da AMEOSC

    Directory of Open Access Journals (Sweden)

    Roque Strieder

    2010-07-01

    Full Text Available Estudos anteriores evidenciaram a existência de baixa autoestima em profissionais da educação. Esta, aliada ao sentimento de pessimismo, sensação de fracasso, culpa e autodepreciação, torna temeroso o sucesso de ações educacionais. São sentimentos que conduzem a atitudes de indecisão e irritabilidade; podem prejudicar o processo educacional e aprendente. Com o uso de escalas oficiais, da psicologia, propõe-se dimensionar a propensão a sintomas de depressão e ansiedade em professores das regiões da Amerios e da AMEOSC, como forma de contribuir com a tomada de decisões tanto em relação à qualificação quanto de ajuda a ser prestada aos professores. Foram envolvidos na pesquisa, aproximadamente, 20% dos professores da rede estadual e municipal das duas regiões. Eles responderam às questões dos formulários: Inventário de Depressão de Beck (depressão e Escala de Avaliação de Hamilton (ansiedade. Os resultados mostram que os professores pesquisados da rede estadual apresentam tendências a estados depressivos e de ansiedade superiores aos da rede municipal. Conclui-se que, para além da necessária qualificação profissional, os professores necessitam de outras formas de ajuda, como melhor compreensão do ambiente de trabalho, das formas inter-relacionais da atualidade, das formas de fortalecimento da autoestima e confiança, do reconhecimento humano, social e econômico; também, é importante elaborar estratégias de ação que impeçam a perda da autoestima; por último, reconhece-se que os professores precisam de atenção, ajuda e valorização.

  14. Evisceración en estafiloma escleral anterior gigante Evisceration of the giant anterior scleral staphyloma

    Directory of Open Access Journals (Sweden)

    Irene Rojas Rondón

    2010-01-01

    Full Text Available La evisceración es la técnica quirúrgica seleccionada para el tratamiento de muchas afecciones oculares graves como: endoftalmitis, ojo ciego doloroso por trauma crónico, glaucoma absoluto, desprendimiento de retina crónico, uveítis crónica, pthisis bulbi, buftalmos y por razones estéticas. Paciente de 21 años de edad que acude a consulta solicitando mejoría de su apariencia facial. Al examen ocular encontramos aumento de volumen localizado en toda la zona superior del globo ocular desde hora 9 hasta hora 3 del ojo derecho, donde se observaba adelgazamiento escleral con extensas zonas de coroides expuesta, leucoma corneal que ocupaba eje visual y exotropia 30° x Hirshberg, como secuela de trauma ocular. El diagnóstico fue estafiloma escleral anterior en el ojo derecho con riesgo de perforación escleral. La evisceración fue el proceder quirúrgico de elección en este tipo de afección, se colocó implante orbitario, sin complicaciones. Inmediatamente después de la cirugía se coloca conformador en la cavidad y luego de un mes se coloca prótesis ocular. De esta forma se logra mejorar el componente estético así como una adecuada rehabilitación y por ello la calidad de vida de nuestro paciente.Evisceration is the surgical technique selected for the treatment of many serious ocular illnesses such as endophthalmitis, painful blind eye due to chronic trauma, absolute glaucoma, chronic retinal detachment, chronic uveitis, pthisis bulbi, buphthalmos and for aesthetic reasons. A 21 years-old patient went to the doctor's office to request some assistance to improve her facial look. On ocular exam, increased volume located in the upper area of the eyeball from hour 9 to hour 3 of the right eye was observed; also scleral thinning with extensive areas of exposed choroid, corneal leukoma occupying the visual axis and 30° exotropia x Hirshberg, as ocular trauma sequel. The diagnosis was anterior scleral staphyloma with risk of scleral

  15. Resultados do procedimento artroscópico de "remplissage" na luxação anterior recidivante do ombro Results from filling "remplissage" arthroscopic technique for recurrent anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Mauro Emilio Conforto Gracitelli

    2011-01-01

    Full Text Available OBJETIVO: Avaliar o resultado clínico da técnica de "remplissage" associada ao reparo da lesão de Bankart (BK para o tratamento da luxação anterior recidivante do ombro. MÉTODOS: Nove pacientes (10 ombros, com seguimento médio de 13,7 meses, apresentaram luxação traumática anterior recidivante do ombro. Todos tinham lesão de BK associada à lesão de Hill e Sachs (HS, com sinal do "encaixe". O defeito das lesões de HS foi medido e apresentava em média 17,3% (7,7% a 26,7% de perda óssea em relação ao diâmetro da cabeça do úmero. Todos foram submetidos ao reparo artroscópico da lesão de BK associado ao preenchimento ("remplissage" da lesão de HS pela tenodese do infraespinal. RESULTADOS: O escore de Rowe variou de 22,5 (10 a 45 no período pré-operatório para 80,5 (5 a 100 no período pós operatório (p OBJECTIVE: To evaluate the clinical result from the filling ("remplissage" technique in association with Bankart lesion repair for treating recurrent anterior shoulder dislocation. METHODS: Nine patients (10 shoulders, with a mean follow-up of 13.7 months, presented traumatic recurrent anterior shoulder dislocation. All of them had a Bankart lesion, associated with a Hill-Sachs lesion showing the "engaging" sign. The Hill-Sachs lesion defect was measured and showed an average bone loss of 17.3% (7.7% to 26.7% in relation to the diameter of the humeral head. All the cases underwent arthroscopic repair of the Bankart lesion, together with filling of the Hill-Sachs lesion by means of tenodesis of the infraspinatus. RESULTS: The Rowe score ranged from 22.5 (10 to 45 before the operation to 80.5 (5 to 100 after the operation (p < 0.001. The UCLA score ranged from 18.0 (8 to 29 to 31.1 (21 to 31 (p < 0.001. The measurements of external and internal rotation at abduction of 90º after the operation were 63.5º (45º to 90º and 73º (50º to 92º respectively. Two patients presented recurrence (one with dislocation and the other

  16. Relation between anterior displacement of the temporomandibular joint disc and size of the condyle

    International Nuclear Information System (INIS)

    Ohgushi, Masatoshi; Kubota, Hisashi; Yamaguchi, Kouichi; Shibata, Takanori

    1996-01-01

    To elucidate the cause of anterior displacement of the disc, we evaluated the relation between anterior displacement and the size of the condyle from MR images in 301 patients (602 TMJs) with clinical diagnosis of internal derangement. We found that the size of condyles with anterior displacement of the disc was significantly smaller than that of condyles without anterior displacement. This result suggests that small condyles may give rise to anterior displacement of the disc. (author)

  17. Sonourethrography in the evaluation of anterior urethral strictures

    International Nuclear Information System (INIS)

    Kim, Jong Chul; Kwag, Jin Geun

    1994-01-01

    To determine the reliability of sonourethrography (SUG) in the evaluation of male anterior urethral strictures. Both SUG with retrograde saline infusion and retrograde urethrography (RUG) were performed in 5 young normal volunteers and 20 patients with symptoms of impaired urine flow. Those findings were compared with urethroscopic and operative findings in all patients. SUG was more accurate in the evaluation of the stricture length and degree than RUG in 7 patients with anterior urethral strictures, when compared with their subsequent open urethroplasty findings. Only SUG could classify the degree of spongiofibrosis surrounding the strictures in 15 patients. So, SUG was diagnostically as efficacious as or, superior to, RUG in all 20 patients. SUG can be used as one of complementary and reliable tools for diagnosis, evaluation and follow-up of anterior urethral strictures

  18. Complex aesthetic treatment on anterior maxillary teeth with malposition

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    Febriastuti Febriastuti

    2008-12-01

    Full Text Available Background: Complex aesthetic treatment on anterior teeth involves more than one caries tooth with malformed shape and malposition. Purpose: The purpose of this paper is to find the alternative treatment for anterior maxillary teeth with malposition. Case: In this case, a 25 year-old man with a peg shaped teeth and caries on several teeth and malposition can be treated with complex aesthetic treatment. Case management: Endodontic pulpectomy treatment on anterior maxillary teeth and post construction with splint porcelain fused to metal crowns on 11, 12, and 21, 22 to correct the shape and position into normal position. Conclusion: Malformed and malpositioned teeth with caries can be treated with complex aesthetic treatment.

  19. Imaging assessment of anterior knee pain and patellar maltracking

    International Nuclear Information System (INIS)

    McNally, E.G.

    2001-01-01

    Anterior knee pain is a common complaint in the orthopaedic clinic. The differential diagnosis is wide and the principal goal of initial assessment is to detect remediable causes. The majority of patients do not have a specific disease and increasingly interest has focused on the role of patello-femoro-tibial morphology and of patellar maltracking in the aetiology of anterior knee pain. Classification in this group of patients is poor and there is no uniform agreement on which patient groups benefit from treatment and which treatment is best. Much of the literature involves relatively small numbers of patients, is poorly controlled and there is little agreement on outcome measures [1, 2]. The purpose of this review is to outline the current status of the imaging assessment of recalcitrant anterior knee pain with particular reference to patellar maltracking. (orig.)

  20. Contribuições da psicanálise para a reconstrução da crítica à ideologia

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    Pedro Sobrino Laureano

    2015-09-01

    Full Text Available Buscamos elaborar uma compreensão da ideologia atual através da psicanálise e de alguns autores da filosofia, como Benjamin e Zizek. Neste sentido, investigamos os argumentos de Sloterdijk, para  quem o cinismo constitui a forma dominante de consciência em uma era pós-ideológica, forma caracterizada por aquilo que o autor chama paradoxalmente de “falsa consciência esclarecida”. Em seguida, buscamos em Marx, em Freud e no modernismo artístico de Malevich e de Duchamp elementos para uma renovação da crítica da ideologia em uma época pretensamente desencantada, apontando os limites da crítica anterior e de algumas intepretações reducionistas de Marx e de Freud.  Concluímos com algumas reflexões críticas sobre o debate concernente à crise da autoridade social e com apontamentos sobre a ideologia a partir do conceito de gozo em Lacan. Nosso objetivo é compreender as transformações do poder no capitalismo contemporâneo a partir das ideias da psicanálise acerca das relações entre crença, verdade e gozo.

  1. Refraction and eye anterior segment parameters in schizophrenic patients

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    Tongabay Cumurcu

    2015-06-01

    Full Text Available ABSTRACT Purpose: To evaluate the difference in terms of refractive errors and anterior segment parameters between schizophrenic patients and healthy volunteers. Methods: This study compared 70 patients (48 men who were diagnosed with schizophrenia with a control group of 60 (35 men who were similar in terms of age, gender, education, and socioeconomic level. Anterior segment examination was performed using a Scheimflug system. Axial length and lens thickness (LT were measured using optic biometry. The following tests were administered to the psychiatric patient group: Brief Psychiatric Rating Scale (BPRS, Scale for the Assessment of Negative Symptoms (SANS, and Scale for the Assessment of Positive Symptoms (SAPS. Results: Mild myopia was detected in both the schizophrenic and control groups, with no statistically significant difference (p>0.005. Corneal volume (CV, anterior chamber volume (ACV, anterior chamber depth (ACD, and central corneal thickness (CCT values were lower in the schizophrenic group, and there was a statistically significant between-group difference (p=0.026, p=0.014, p=0.048, and p=0.005, respectively. LT was greater in schizophrenics, and the difference was found to be statistically significant (p=0.006. A statistically significant negative correlation was found between SAPS and cylinder values (p=0.008. The axial eye length, cylinder value, pupil diameter, mean keratometric value, and anterior chamber angle revealed no statistically significant difference between the groups (p>0.05. Conclusion: No statistically significant difference was detected in terms of refraction disorders between schizophrenics and the healthy control group, while some differences in anterior chamber parameters were present. These results demonstrate that schizophrenics may exhibit clinical and structural differences in the eye.

  2. Glaucoma anterior chamber morphometry based on optical Scheimpflug images.

    Science.gov (United States)

    Alonso, Ruiz Simonato; Ambrósio Junior, Renato; Paranhos Junior, Augusto; Sakata, Lisandro Massanori; Ventura, Marcelo Palis

    2010-01-01

    To compare the performance of gonioscopy and noncontact morphometry with anterior chamber tomography (High Resolution Pentacam - HR) using optical Scheimpflug images in the evaluation of the anterior chamber angle (ACA). Transversal study. 112 eyes from 74 subjects evaluated at the Glaucoma Department, Fluminense Federal University, underwent gonioscopy and Pentacam HR. Using gonioscopy, the ACA was graded using the Shaffer Classification (SC) by a single experienced examiner masked to the Pentacam HR findings. Narrow angle was determined in eyes in which the posterior trabecular meshwork could not be seen in two or more quadrants on non-indentation gonioscopy (SC Grade 2 or less). Pentacam HR images of the nasal and temporal quadrants were evaluated by custom software to automatically obtain anterior chamber measurements, such as: anterior chamber angle (ACA), anterior chamber volume (ACV) and anterior chamber depth (ACD). Based on gonioscopy results, 74 (60.07%) eyes of patients classified as open-angle (SC 3 and 4) and 38 (33.93%) eyes of patients classified as narrow-angle (SC 1 and 2). Noncontact morphometry with Scheimpflug images revealed a mean ACA of 39.20 ± 5.31 degrees for open-angle and 21.18 ± 7.98 degrees for narrow-angle. The open-angle group showed significant greater ACV and ACD values when compared to narrow-angle group (ACV of 193 ± 36 mm³ vs. 90 ± 25 mm³, respectively, p<0.001; and ACD of 3,09 ± 0,42 mm vs. 1,55 ± 0,64 mm, respectively, p<0.0001.). In screening eyes with open-angle and narrow-angle with the Pentacam ACA of 20º (SC Grade 2) using the ROC curves, the analysis showed 52.6% of sensitivity and 100% of specificity. The Pentacam showed ability in detecting eyes at risk for angle closure analyzing ACV and ACD.

  3. Anterior mediastinal synovial sarcoma: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Wen-xiang YUE

    2015-01-01

    Full Text Available Objective To study the clinical manifestations, pathologic features, diagnosis, treatment and prognosis of primary synovial sarcoma in the anterior mediastinum. Methods A case of primary synovial sarcoma in the anterior mediastinum was reported. Clinical features, imaging manifestations, pathology features and therapeutic effect were analysed and the relevant literature was reviewed. Results A 48-year-male patient was admitted with complaint of right chest pain for 4 days. Chest computerized tomography revealed a large mass located at the right anterior mediastinum, and it was primarily diagnosed as invasive thymoma. Pathological examination by CT-guided percutaneous needle biopsy manifested that, under microscope, the tumor cells were short and spindle in shape forming a nest structure, suggested it was a thymoma. The patient then underwent resection of thymoma with removal of fat and connective tissue in the anterior mediastinum. During the operation the size of the tumor was 15cm×15cm×10cm, being located at the anterior mediastinum, and it tended to bleed. The diagnosis of primary monophasic synovial sarcoma in the mediastinum was confirmed by postoperative/pathology examination. Immunohistochemistry staining showed that the tumor cells were positive for the markers Bcl-2 and EMA, but negative for the markers CK (pan and S100. The patient suffered from local recurrence with metastases to lung 4 months after surgery. The patient received 2 chemotherapeutic courses with ifosfamide, epirubicin and cisplatin. He died 6 months after surgery. Conclusion Primary synovial sarcoma in the anterior mediastinum is an extremely rare and highly malignant tumor with poor prognosis. The diagnosis depends on the pathological features, immunohistochemistry and RT-PCR. Radical resection combined with comprehensive treatment may improve the survival rate. DOI: 10.11855/j.issn.0577-7402.2014.12.12

  4. The significance of biometric parameters in determining anterior teeth width

    Directory of Open Access Journals (Sweden)

    Strajnić Ljiljana

    2013-01-01

    Full Text Available Background/Aim. An important element of prosthetic treatment of edentulous patients is selecting the size of anterior artificial teeth that will restore the natural harmony of one’s dentolabial structure as well as the whole face. The main objective of this study was to determine the correlation between the inner canthal distance (ICD and interalar width (IAW on one side and the width of both central incisors (CIW, the width of central and lateral incisors (CLIW, the width of anterior teeth (ATW, the width between the canine cusps (CCW, which may be useful in clinical practice. Methods. A total of 89 subjects comprising 23 male and 66 female were studied. Their age ranged from 19 to 34 years with the mean of 25 years. Only the subjects with the preserved natural dentition were included in the sample. All facial and intraoral tooth measurements were made with a Boley Gauge (Buffalo Dental Manufacturing Co., Brooklyn NY, USA having a resolution of 0.1mm. Results. A moderate correlation was established between the interalar width and combined width of anterior teeth and canine cusp width (r = 0.439, r = 0.374. A low correlation was established between the inner canthal distance and the width of anterior teeth and canine cusp width (r = 0.335, r = 0.303. The differences between the two genders were highly significant for all the parameters (p < 0.01. The measured facial distances and width of anterior teeth were higher in men than in women. Conclusion. The results of this study suggest that the examined interalar width and inner canthal distance cannot be considered reliable guidelines in the selection of artificial upper anterior teeth. However, they may be used as a useful additional factor combined with other methods for objective tooth selection. The final decision should be made while working on dentures fitting models with the patient’s consent.

  5. Milton Friedman e a efetividade da política fiscal

    Directory of Open Access Journals (Sweden)

    Francisco Luiz C. Lopreato

    2013-08-01

    Full Text Available O objetivo do artigo é discutir a visão de Milton Friedman sobre o papel da política fiscal. O trabalho estrutura-se a partir da discussão de quatro pontos. O primeiro relembra traços da trajetória do autor, desde a fase inicial em que dá relevância à política fiscal até o momento em que a renega. O segundo retoma questões apresentadas no tópico anterior e os argumentos usados para negar a efetividade da política fiscal. O terceiro volta-se à apresentação da hipótese da renda permanente e a sua posição contra o uso e as implicações da função consumo nos estudos de caráter keynesiano da velha síntese. O último ponto destaca a crítica contra as ações discricionárias, com ênfase na discussão dos lags existentes na política fiscal. O retorno ao autor justifica-se porque as suas ideias influenciaram o modo de a atual teoria macroeconômica dominante pensar tópicos relevantes da área fiscal.

  6. A chondrosarcoma in the anterior mediastinum mimicking a thymoma

    International Nuclear Information System (INIS)

    Østergaard, Mia L; Petersen, Rene H; Kalhauge, Anna

    2015-01-01

    A chondrosarcoma in the anterior mediastinum is a rare finding with a relatively good prognosis. We describe a case of a 75-year-old man with a 2-year history of neck discomfort and weight loss. Imaging showed a homogenous tumor with a minor compression on the anterior part of the heart. It had close relation to the ribs, no surrounding fat, and a thymoma was suspected. Biopsy prior to surgery was impossible due to the location of the tumor. Unfortunately, final pathology from the surgical specimen revealed a chondrosarcoma

  7. Correction of anterior open bite in a case of achondroplasia

    Directory of Open Access Journals (Sweden)

    Karpagam S

    2005-01-01

    Full Text Available Treatment planning for patients with skeletal deformities is often considered challenging. This article reports a female patient with achondroplasia who presented with severe maxillary retrognathism and vertical excess along with anterior open bite. The clinical and cephalometric findings of the patient are detailed here. The treatment plan consisted of modified anterior maxillary osteotomy for simultaneous vertical and sagittal augmentation along with orthodontic intervention. The course of surgical-orthodontic treatment and the results are presented. This treatment is to be followed by correction of vertical maxillary excess after completion of growth. This paper concludes that the dentoalveolar component of a skeletal deformity can be handled independent of the craniofacial management.

  8. Efficacy and complications of radiotherapy of anterior visual pathway tumors

    International Nuclear Information System (INIS)

    Capo, H.; Kupersmith, M.J.

    1991-01-01

    A progressive disturbance in visual acuity or visual field, along with an unexplained optic nerve atrophy, suggests the possibility of a tumor. Tumors that frequently affect the anterior visual pathway include primary optic nerve sheath meningiomas, intracranial meningiomas, optic gliomas, pituitary tumors, and craniopharyngiomas. The location of these tumors sometimes prohibits a complete surgical excision that might jeopardize the visual system. Radiation therapy, however, can be beneficial in these cases. This article reviews the indications for radiotherapy of tumors that involve the anterior visual pathway, along with the possible complications. Cases that present the effect of radiation therapy and radiation damage are presented.131 references

  9. Clearance from the anterior chamber of RBCs from human diabetics

    International Nuclear Information System (INIS)

    Williams, G.A.; Hatchell, D.L.; Collier, B.D.; Knobel, J.

    1984-01-01

    Erythrocytes from diabetic patients manifest decreased deformability and increased adherence. These abnormal membrane properties may diminish the ability of erythrocytes (RBCs) from diabetics to undergo deformation in passage through the trabecular meshwork. Using sodium chromate Cr 51-labeled RBCs from type I diabetic patients with proliferative retinopathy and normal control subjects, we studied RBC clearance from the rabbit anterior chamber. The mean time for 50% clearance (T50) of RBCs from diabetics (76 hours) was significantly longer than that for RBCs from normal subjects (19.5 hours). In this model, RBCs from diabetics have a slower clearance from the anterior chamber than do RBCs from normal subjects

  10. Traumatic Anterior Dislocation of Hip in a Child- Case Report

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    S Ahmad

    2015-03-01

    Full Text Available Traumatic hip dislocation in children is relatively rare accounting for about 5% of all hip dislocations. Most of the hip dislocations seen in children are of the posterior type but the much rarer anterior and anterior-inferior (obturator types have also been described. We present the case of an eight years old girl with an obturator type of hip dislocation following trivial trauma. She was treated with closed reduction and immobilisation in skin traction for three weeks. She was followed up closely for one year and did not develop any complications during that period.

  11. Anterior celiac plexus block for interventional biliary procedures

    International Nuclear Information System (INIS)

    Benenati, J.F.; Widlus, D.M.; Venbrux, A.C.; Lynch-Nyhan, A.; Osterman, F.A.; Taylor, D.R.; Tewes, P.A.; Cassidy, F.P.

    1989-01-01

    This paper reports temporary celiac ganglion block for pain relief during biliary procedures performed without complication in 65 patients. The block was given from an anterior approach, with 30 mL of bupivacaine injected over the right T-12 pedicle. Fluoroscopy was used to guide the needle 2 cm anterior to the spine. Patients were assigned to one of three groups based on degree of anesthesia. In group 1, there was no benefit (20%); in group 2, moderate regional anesthesia (22%); and in group 3, excellent anesthesia (58%). The procedure may be performed at the start of or any time during the examination and provides satisfactory regional anesthesia in 80% of patients

  12. Anterior mediastinal paraganglioma: A case for preoperative embolization

    Directory of Open Access Journals (Sweden)

    Shakir Murtaza

    2012-07-01

    Full Text Available Abstract Background Paraganglioma is a rare but highly vascular tumor of the anterior mediastinum. Surgical resection is a challenge owing to the close proximity to vital structures including the heart, trachea and great vessels. Preoperative embolization has been reported once to facilitate surgical treatment. Case presentation We report a case of anterior mediastinal paraganglioma that was embolized preoperatively, and was resected without the need for cardiopulmonary bypass and without major bleeding complications. Conclusion We make a case to further the role of preoperative embolization in the treatment of mediastinal paragangliomas.

  13. Mucoepidermoid carcinoma of the anterior maxilla: A rare entity

    Directory of Open Access Journals (Sweden)

    Smitha Kullaje

    2014-01-01

    Full Text Available Mucoepidermoid carcinoma is the second most common salivary gland tumor primarily involving major salivary glands and intraoral minor salivary glands. Although rare, it can occur in the jaw bones, but it is very rare in the maxillary anterior region. Here, we present a case of mucoepidermoid carcinoma occurring in maxillary anterior region in a 33-year-old male patient presented as painless swelling clinically appearing similar to a periapical or nasopalatine cyst. The final diagnosis of this lesion was made after microscopic examination of biopsy specimen.

  14. Usurering af osteosyntesemateriale gennem øsofagus efter anterior cervikalkirurgi

    DEFF Research Database (Denmark)

    Wiis, Julie Therese; Nittby, Henrietta Carolina; Lauritsen, Anne Oberg

    2014-01-01

    The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal perforation, occurs after surgical trauma or due to erosion by migrating hardware. Symptoms are hoarseness, dysphagia, neck/throat pain, subcutaneous emphysema and fever. Imaging and endoscopic diagnosis...... can give false negative results. We present a case of a 74-year-old male, who was readmitted with sepsis and abscess in the operation area three weeks after anterior cervical surgery. Veillonella parvula was found in the abscess material and computed tomography confirmed the diagnosis of oesophageal...

  15. MACIEZ DA CARNE BOVINA

    Directory of Open Access Journals (Sweden)

    Antonio Bento Mancio

    2006-10-01

    Full Text Available Dentre as características de qualidade da carne bovina, a maciez assume posição de destaque, sendo considerada a característica organoléptica de maior influência na aceitação da carne por parte dos consumidores. A dureza da carne pode ser dividida em dureza residual, causada pelo tecido conjuntivo e outras proteínas do estroma, e dureza de actomiosina, causada pelas proteínas miofibrilares. Dentre os fatores que influenciam a maciez da carne, podem ser destacados a genética, a raça, a idade ao abate, o sexo, a alimentação, o uso de agentes hormonais (?-adrenérgicos e os tratamentos post-mortem. A qualidade final da carne é resultante de tudo o que aconteceu com o animal durante toda a cadeia produtiva. Devem-se assegurar procedimentos adequados de transporte, armazenamento, manipulação, exposição e preparo da carne, a fim de se obter um produto de melhor qualidade. PALAVRAS-CHAVE: Calpaínas, calpastatina, qualidade da carne, rigor mortis, tecido muscular.

  16. GERONTOLOGIA: ESTADO DA ARTE

    Directory of Open Access Journals (Sweden)

    Vera M.A.Tordino Brandão

    2010-02-01

    Full Text Available O Programa de Gerontologia da PUC desenvolve pesquisas focando o ser na perspectiva do envelhecimento. As atividades são interdisciplinares e reúnem docentes, alunos e ex-alunos. Nesta mesa redonda apresentamos um panorama sobre estes estudos. Na área da educação e comunicação o foco está centrado na longevidade e na preparação e representação social da velhice. São ressaltadas como temáticas: a formação continuada de profissionais e pesquisadores; o significado da religiosidade/espiritualidade ao longo da trajetória, e sua repercussão na qualidade de vida do idoso; os programas sócio-educacionais para idosos e concepções sobre educação; o monitoramento da mídia na cobertura da crescente longevidade e seus impactos. Em identidade e modos de morar reflete-se sobre soluções planejadas e sua adequação para a inclusão do envelhecimento populacional como questão fundamental, que implica a elaboração de novas políticas, investigações e, especialmente, apresenta-se como questão a ser analisada, refletida e vivenciada pela sociedade em geral. Quanto à saúde, o Programa desenvolve várias pesquisas numa abordagem interdisciplinar tendo como objetos de estudo: a terapia assistida com animais direcionada a idosos com diagnóstico de Alzheimer; o acompanhamento terapêutico e o atendimento psicoterapêutico em grupo, a aplicação da técnica de Calatonia em idosos moradores de ILPI, além da investigação sobre impasses clínicos no idoso frágil. Palavras-chave: gerontologia, longevidade, envelhecimento

  17. Conjecturas da Epistemológia Jurídica e Aspectos da Teoria da Linguagem

    OpenAIRE

    Oliveira, Rita de Cássia Cartelli de; Cesumar; Motta, Ivan Dias; Cesumar

    2008-01-01

    Apresentar-se-ão reflexões em torno da epistemologia jurídica e alguns aspectos da teoria da linguagem; a necessidade de acompanhamento e aprimoramento da linguagem jurídica, para que o direito não se distancie da realidade, mantendo-se apenas como um sistema do status quo; uma breve análise de algumas teorias da ciência do direito e da linguagem; as especificidades dos termos lingüísticos para a análise da ciência do direito, pautada na contemporaneidade sob a perspectiva humanista, buscando...

  18. Partial gastrectomy associated to anterior truncal vagotomy: alterations in metabolism of the calcium. Experimental study in rats Gastrectomia parcial e vagotomia troncular anterior: alterações no metabolismo de cálcio. Estudo experimental em ratos

    Directory of Open Access Journals (Sweden)

    Elisvânia Freitas dos Santos

    2009-06-01

    Full Text Available BACKGROUND: The calcium is not absorbed in the lack of hydrochloric acid and the osteomalacia and osteoporosis may occurs; it is well recognized in patients that had gastric resection. AIM: To evaluate the effects of the partial gastrectomy associated to anterior truncal vagotomy in the absorption and metabolism of calcium. METHODS: Eighteen adults male Wistar rats were submitted to partial gastrectomy associated to anterior truncal vagotomy (GXT, eight animals and the sham operation (10 animals, control group. The diet consumption and the weight gains of the animals were measured three times during the week. The animals received formulated experimental diet orally (AIN-93M by eight weeks. The serum calcium, urinary and fecal calcium, apparent absorption of the calcium, activity of the enzyme alkaline fosfatase and calcium in the bone were measured after 60 days. RESULTS: The sham operated animals showed higher diet consumption, weight gains, serum and urinary calcium, excretion of calcium in feces, apparent absorption of calcium and activity of the enzyme alkaline fosfatase (PRACIONAL: O cálcio não é absorvido na ausência de ácido clorídrico e a osteomalácia e osteoporose podem ocorrer; este fato é bem reconhecido em pacientes que se submeteram à gastrectomias. OBJETIVO: Avaliar os efeitos da gastrectomia parcial associada à vagotomia troncular anterior na absorção e metabolismo de cálcio. MÉTODOS: Dezoito ratos Wistar machos e adultos foram submetidos à gastrectomia parcial e vagotomia troncular anterior (oito animais e à laparotomia simples como grupo controle (10 animais. O consumo de dieta e o peso dos animais foram monitorados três vezes por semana. Os animais receberam dieta oral formulada experimentalmente (AIN-93M, durante 8 semanas. O cálcio sérico, cálcio urinário e fecal, absorção aparente de cálcio, atividade da enzima fosfatase alcalina e cálcio ósseo foram mensurados após 60 dias de observa

  19. CONDICIONANTES DA COMPETITIVIDADE EMPRESARIAL

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    José Luiz Contador

    2010-03-01

    Full Text Available Este trabalho examina teoricamente os fatores determinantes da competitividade do produto e do negócio, imprescindíveis à elaboração de estratégias competitivas que visam à obtenção e sustentação de vantagens competitivas. Esse tema é objeto tanto da área de marketing estratégico quanto da de estratégia empresarial. Nas duas áreas, há um ponto de consenso que afirma que a empresa deve diferenciar sua oferta para conquistar e manter vantagem competitiva. Mas, os estudos conduzidos por meio do modelo de Campos e Armas da Competição revelaram que a empresa pode diferenciar seu produto e/ou serviço de modo mais amplo, levando em consideração, na formulação da sua estratégia competitiva, também o campo da competição, quer do produto, quer dela própria. Assim, o objetivo deste artigo é evidenciar que, para a empresa ser competitiva, além de diferenciar seu produto e/ou seu serviço no sentido tradicional, ela precisa: 1 diferenciar seu produto incluindo a definição em quais campos vai competir em cada segmento; e 2 escolher as armas da competição que irá utilizar e definir a intensidade de cada arma. Para atingir tal objetivo, foram necessários vários conceitos do modelo de Campos e Armas da Competição: campo da competição, arma da competição, tese do modelo, configuração dos campos da competição, campo coadjuvante, produto coadjuvante e par produto-mercado. Como uma proposta inovadora sempre desperta dúvida, é mostrado o processo de validação do modelo de Campos e Armas da Competição e são discutidas sua universalidade, consistência e completude.

  20. [The "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for anterior decompression at upper cervical spine].

    Science.gov (United States)

    Wu, Xiang-Yang; Zhang, Zhe; Wu, Jian; Lü, Jun; Gu, Xiao-Hui

    2009-11-01

    To investigate the "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for the exposure and decompression and instrumentation of the upper cervical spine. From Jan. 2000 to July 2008, 5 patients with upper cervical spinal injuries were treated by surgical operation included 4 males and 1 female with and average age of 35 years old ranging from 16 to 68 years. There were 2 cases of Hangman's fractures (type II ), 2 of C2.3 intervertebral disc displacement and 1 of C2 vertebral body tuberculosis. All patients underwent the upper cervical anterior retropharyngeal approach through the "window" between the hypoglossal nerve and the superior laryngeal nerve and pharynx and carotid artery. Two patients of Hangman's fractures underwent the C2,3 intervertebral disc discectomy, bone graft fusion and internal fixation. Two patients of C2,3 intervertebral disc displacement underwent the C2,3 intervertebral disc discectomy, decompression bone graft fusion and internal fixation. One patient of C2 vertebral body tuberculosis was dissected and resected and the focus and the cavity was filled by bone autografting. C1 anterior arch to C3 anterior vertebral body were successful exposed. Lesion resection or decompression and fusion were successful in all patients. All patients were followed-up for from 5 to 26 months (means 13.5 months). There was no important vascular and nerve injury and no wound infection. Neutral symptoms was improved and all patient got successful fusion. The "window" surgical exposure surgical technique of the upper cervical anterior retropharyngeal approach is a favorable strategy. This approach strategy can be performed with full exposure for C1-C3 anterior anatomical structure, and can get minimally invasive surgery results and few and far between wound complication, that is safe if corresponding experience is achieved.

  1. Clinical commissioning of an in vivo range verification system for prostate cancer treatment with anterior and anterior oblique proton beams

    Science.gov (United States)

    Hoesl, M.; Deepak, S.; Moteabbed, M.; Jassens, G.; Orban, J.; Park, Y. K.; Parodi, K.; Bentefour, E. H.; Lu, H. M.

    2016-04-01

    The purpose of this work is the clinical commissioning of a recently developed in vivo range verification system (IRVS) for treatment of prostate cancer by anterior and anterior oblique proton beams. The IRVS is designed to perform a complete workflow for pre-treatment range verification and adjustment. It contains specifically designed dosimetry and electronic hardware and a specific software for workflow control with database connection to the treatment and imaging systems. An essential part of the IRVS system is an array of Si-diode detectors, designed to be mounted to the endorectal water balloon routinely used for prostate immobilization. The diodes can measure dose rate as function of time from which the water equivalent path length (WEPL) and the dose received are extracted. The former is used for pre-treatment beam range verification and correction, if necessary, while the latter is to monitor the dose delivered to patient rectum during the treatment and serves as an additional verification. The entire IRVS workflow was tested for anterior and 30 degree inclined proton beam in both solid water and anthropomorphic pelvic phantoms, with the measured WEPL and rectal doses compared to the treatment plan. Gafchromic films were also used for measurement of the rectal dose and compared to IRVS results. The WEPL measurement accuracy was in the order of 1 mm and after beam range correction, the dose received by the rectal wall were 1.6% and 0.4% from treatment planning, respectively, for the anterior and anterior oblique field. We believe the implementation of IRVS would make the treatment of prostate with anterior proton beams more accurate and reliable.

  2. Meningiomas anteriores e antero-laterais do forame magno Anterior and lateral foramen magnum meningiomas

    Directory of Open Access Journals (Sweden)

    Osvaldo Inácio de Tella Jr

    2006-06-01

    Full Text Available Relatamos nossa experiência com 11 pacientes portadores de meningiomas do forame magno, oito cranioespinhais e três espinocraniais. A média de idade foi 50,8 anos, o sintoma mais comum foi cefaléia occipital com duração média de 18,6 meses. Os principais achados neurológicos foram tetraparesia e comprometimento dos nervos cranianos baixos. O tratamento foi cirúrgico, sempre com exposição da artéria vertebral em sua entrada na dura-máter da fossa posterior e ressecção de parte do côndilo occipital apenas em três casos. Ressecção total foi possível em sete pacientes e parcial nos demais, devido às aderências a vasos e nervos. O prognóstico esteve relacionado com as condições neurológicas pré-operatórias.We report our experience with 11 cases of foramen magnum meningiomas, eight originating inside the posterior fossa and three in the caudal region. The mean age of the patients was 50.8 years and the main complaint was cervical headache for at least 18.6 months and at the neurological examination, tetraparesis and deficit of the lower cranial nerves were very often observed. All patients were submitted to surgical treatment, always with exposition of the vertebral artery at the entry zone in the duramater of the posterior fossa, with partial removal of the occipital condyle in only three cases. Total resection was obtained in seven patients and partial removal in the other four due to adherences to vessels and nerves. The prognostic was related to the neurological condition before surgery.

  3. Cabeçalho da página OPEN JOURNAL SYSTEMS Ajuda do sistema USUÁRIO Login Senha Lembrar usuário Acesso NOTIFICAÇÕES Visualizar Assinar / Cancelar assinatura de notificações IDIOMA CONTEÚDO DA REVISTA Pesquisa Pesquisar Procurar Por Edição Por Autor Por título Outras revistas TAMANHO DE FONTE Make font size smallerMake font size defaultMake font size larger INFORMAÇÕES Para leitores Para Autores Para Bibliotecários CAPA SOBRE ACESSO CADASTRO PESQUISA ATUAL ANTERIORES NOTÍCIAS Capa > v. 1, n. 1 (2015 >\tSantos Empreendimento de economia solidária: Uma análise da autogestão coletiva / Venture solidarity economy: An analysis of collective self-management

    Directory of Open Access Journals (Sweden)

    Luciane Cristina Ribeiro dos Santos

    2017-06-01

    Full Text Available Com o predomínio na sociedade de um modelo socioeconômico baseado no capitalismo neoliberal, novas experiências vêm se desenvolvendo no interior de algumas comunidades como alternativas a esse contexto. O Clube de Trocas da Amizade, concebido em 2003 pelo hoje denominado Centro Educacional Marista Curitiba, como parte da Rede Pinhão de Clubes de Troca, consiste em um empreendimento de Economia Solidária, que permite visualizar diferentes manifestações de uma proposta ainda incipiente. Este estudo busca analisar a partir das questões relacionadas à Ecossocioeconomia Urbana, Economia Solidária e às Políticas Públicas o papel do Clube de Trocas da Amizade enquanto proposta de organização social. A pesquisa apresentou caráter qualitativo-descritivo, baseado em método analítico-exploratório. Entre os resultados obtidos, verificou-se que soluções práticas, no caso do Clube de Trocas da Amizade, possibilitavam não só o provimento da subsistência de seus participantes, como também o incentivo à criatividade, à educação, ao convívio social, à valorização de tais pessoas e o aumento de sua autoestima. Acredita-se que a promoção desse tipo de iniciativa em nível comunitário tanto urbano quanto rural, considerando-se suas particularidades, poderia desenvolver atividades mais integradoras entre os seus moradores, das quais um maior número de cooperativas poderiam se beneficiar, conforme os princípios da Economia Solidária.

  4. Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas Minicraniotomia supra-orbitária superciliar no tratamento de meningiomas na fossa craniana anterior e para-selares

    Directory of Open Access Journals (Sweden)

    Manoel Antonio de Paiva-Neto

    2010-06-01

    Full Text Available The improvement of surgical techniques as well as the introduction of new surgical instruments promoted the use of keyhole craniotomies in neurosurgery. We evaluated the technical aspects of the supra-orbital keyhole approach considering the indications, limitations, and complications of this approach to treat anterior cranial fossa and parasellar meningiomas. Twenty-four patients (21 females; mean age, 53±8.6 years operated on between 2002 and 2006 through a supra-orbital eyebrow approach were studied. Maximal tumor diameter ranged from 1.6 to 6 cm. Gross total resection was done in 20 (83.3%. All tumors were histologically benign. Two patients (8% experienced CSF rinorhea and another two patients suffered transitory diabetes insipidus (8%. One patient experienced transitory hemiparesis. There was one case of meningitis and one mortality. Follow-up ranged between 6 to 66 months (mean 31.5±20.1 months, with no recurrence. The supra-orbital keyhole craniotomy is a useful minimally invasive approach to treat selected anterior fossa and parasellar meningiomas.A evolução técnica e a introdução de instrumentais cirúrgicos mais delicados proporcionaram o uso de craniotomias menores no tratamento de patologias intracranianas. Avaliamos os aspectos técnicos da minicraniotomia supra-orbitária superciliar, considerando as indicações, limitações e complicações no tratamento de meningiomas na fossa craniana anterior e para-selares. Vinte e quarto pacientes (21 mulheres; idade média, 53±8,6 anos operados entre 2002 e 2006 foram estudados. O diâmetro tumoral máximo variou de 1,6 a 6 cm. Ressecção total foi obtida em 20 (83,3%. Todos os tumores eram histologicamente benignos. Dois pacientes (8% apresentaram fistula liquórica pós-operatória e outros dois diabetes insipido transitórioa (8%. Um paciente evoluiu com hemiparesia transitória. Houve um caso de meningite e um de evolução fatal. O seguimento variou de 6 a 66 meses (m

  5. Visual Internal Urethrotomy in the Management of Anterior Urethral ...

    African Journals Online (AJOL)

    Objective: Urethral stricture disease is common in our environment. The aim of this study is to report our experience with visual internal urethrotomy (VIU) in the management of this disease. Patients and Methods: Seventy male patients with a mean age of 30.6 years were treated for anterior urethral stricture by VIU at the Jos ...

  6. Sinonasal metallic foreign body penetration of the anterior cranial fossa

    Directory of Open Access Journals (Sweden)

    Madeleine B. Samuelson

    2017-03-01

    Conclusion: Intracranial metallic foreign bodies may have significant potential morbidity. Recent advances in endonasal techniques for anterior skull base access may enhance outcomes through reduced morbidity and mortality, improved speed and precision, shorter hospital stays, and lower post-operative pain [1,2,4]. Technical nuances of these approaches and medical decision-making in the context of various neurosurgical considerations are discussed.

  7. [A case of double monster--duplicitas anterior with diprosopia].

    Science.gov (United States)

    Meyer, R

    1983-01-01

    Report on a delivery of a double monster, duplicitas anterior with diprosopia. The course of delivery is compared with literature. The exclusion of malformations in early pregnancy is possible and necessary. Perinatal mortality can be reduced by abortion in time. The psychic burden of women concerned needs a special regard.

  8. The anterior temporal lobes support residual comprehension in Wernicke's aphasia.

    Science.gov (United States)

    Robson, Holly; Zahn, Roland; Keidel, James L; Binney, Richard J; Sage, Karen; Lambon Ralph, Matthew A

    2014-03-01

    Wernicke's aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory-verbal comprehension is significantly impaired in Wernicke's aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke's aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke's aphasia and 12 control participants performed semantic animate-inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke's aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke's aphasia group displayed an 'over-activation' in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke's aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions.

  9. Anterior Cingulate Cortex in Schema Assimilation and Expression

    Science.gov (United States)

    Wang, Szu-Han; Tse, Dorothy; Morris, Richard G. M.

    2012-01-01

    In humans and in animals, mental schemas can store information within an associative framework that enables rapid and efficient assimilation of new information. Using a hippocampal-dependent paired-associate task, we now report that the anterior cingulate cortex is part of a neocortical network of schema storage with NMDA receptor-mediated…

  10. Breast Reinnervation: DIEP Neurotization Using the Third Anterior Intercostal Nerve

    Directory of Open Access Journals (Sweden)

    Aldona J. Spiegel, MD

    2013-11-01

    Conclusion: DIEP flap neurotization using the third anterior intercostal nerve is an effective technique to provide a significant increase in sensory recovery for breast reconstruction patients, while adding minimal surgical time. Additionally, the use of a nerve conduit produces increased sensory recovery when compared direct coaptation.

  11. current concepts in the management of anterior urethral strictures

    African Journals Online (AJOL)

    iam

    such as calculi, urethral hair and stent encrustation which may be useful in ... and 7 o'clock to the prostatic urethra, 3 and 9 o'clock ... anterior urethra the use of stents is limited to but ... take such as radiotherapy, peripheral vascular disease.

  12. Bacteriology of the Anterior Genitalia of the Domestic House Cat ...

    African Journals Online (AJOL)

    The bacteriology of the anterior genitalia of the domestic house cat was determined using vaginal swabs collected from sixty apparently healthy female domestic cats (20 kittens, 20 pregnant and 20 non-pregnant adults). The swabs were streaked on blood agar, Mac Conkey agar and eosin methylene blue agar plates ...

  13. Innovation in prediction planning for anterior open bite correction.

    Science.gov (United States)

    Almuzian, Mohammed; Almukhtar, Anas; O'Neil, Michael; Benington, Philip; Al Anezi, Thamer; Ayoub, Ashraf

    2015-05-01

    This study applies recent advances in 3D virtual imaging for application in the prediction planning of dentofacial deformities. Stereo-photogrammetry has been used to create virtual and physical models, which are creatively combined in planning the surgical correction of anterior open bite. The application of these novel methods is demonstrated through the surgical correction of a case.

  14. Ocular Adnexal and Anterior Segment Manifestations of HIV/AIDS ...

    African Journals Online (AJOL)

    Background: Benue State has the highest rate of sero-prevalence to human immuno virus (HIV) infections among the ten hyper-endemic states in Nigeria. This study evaluates the pattern of ocular adnexal and anterior segment manifestations in HIV/AIDS patients attending the HIV clinic at the NAF Hospital in Makurdi, ...

  15. Quadriceps Strength and Anterior Knee Pain following Tibia ...

    African Journals Online (AJOL)

    2017-07-17

    Jul 17, 2017 ... prior history of knee pain, but had unilateral tibiofibular fracture, who had internal fixation with ... It may take several months for healing and subsequent .... time after surgery and those with anterior knee pain may never get ...

  16. Genetic studies in congenital anterior midline cervical cleft

    DEFF Research Database (Denmark)

    Jakobsen, L P; Pfeiffer, P; Andersen, M

    2012-01-01

    Congenital anterior midline cervical cleft (CAMCC) is a rare anomaly, with less than 100 cases reported. The cause of CAMCC is unknown, but genetic factors must be considered as part of the etiology. Three cases of CAMCC are presented. This is the first genetic study of isolated CAMCC. Conventional...

  17. A case of anterior ischemic optic neuropathy associated with uveitis

    Directory of Open Access Journals (Sweden)

    Sugahara M

    2013-05-01

    Full Text Available Michitaka Sugahara, Takayuki Fujimoto, Kyoko Shidara, Kenji Inoue, Masato Wakakura Inouye Eye Hospital, Tokyo, Japan Introduction: Here, we describe a patient who presented with anterior ischemic optic neuropathy (AION and subsequently developed uveitis. Case: A 69-year-old man was referred to our hospital and initially presented with best-corrected visual acuities (BCVA of 20/40 (right eye and 20/1000 (left eye and relative afferent pupillary defect. Slit-lamp examination revealed no signs of ocular inflammation in either eye. Fundus examination revealed left-eye swelling and a pale superior optic disc, and Goldmann perimetry revealed left-eye inferior hemianopia. The patient was diagnosed with nonarteritic AION in the left eye. One week later, the patient returned to the hospital because of vision loss. The BCVA of the left eye was so poor that the patient could only count fingers. Slit-lamp examination revealed 1+ cells in the anterior chamber and the anterior vitreous in both eyes. Funduscopic examination revealed vasculitis and exudates in both eyes. The patient was diagnosed with bilateral panuveitis, and treatment with topical betamethasone was started. No other physical findings resulting from other autoimmune or infectious diseases were found. No additional treatments were administered, and optic disc edema in the left eye improved, and the retinal exudates disappeared in 3 months. The patient's BCVA improved after cataract surgery was performed. Conclusion: Panuveitis most likely manifests after the development of AION. Keywords: anterior ischemic optic neuropathy, uveitis

  18. Quadriceps strength and anterior knee pain following tibia ...

    African Journals Online (AJOL)

    The tension generated on extension of the knee against a resistance using tensiometer was measured in Newton. The ranges of motion of the knees were documented, as well as Lysholm score which measures activities and document the presence and limitation caused by anterior knee pain. Results: A total of 36 patients ...

  19. Modified protrusion arch for anterior crossbite correction - a case report.

    Science.gov (United States)

    Roy, Abhishek Singha; Singh, Gulshan Kr; Tandon, Pradeep; Chaudhary, Ramsukh

    2013-01-01

    Borderline and mild skeletal Class III relationships in adult patients are usually treated by orthodontic camouflage. Reasonably rood results have been achieved with nonsurgical teatment of anterior crossbite. Class III malocclusion may be associated with mandibular prognathism, maxillary retrognathism, or both. Class III maxillary retrognathism generally involves anterior crossbite, which must be opened if upper labial brackets are to be bonded. If multiple teeth are in crossbite, after opening the bite usual step is to ligate forward or advancement arch made of 0.018" or 0.020" stainless steel or NiTi wire main arch that must be kept separated 2 mm from the slot ofupper incisor braces. Two stops or omegas are made 1 mm mesial to the tubes of the molar bands that will impede main arch from slipping,and in this manner the arch will push the anterior teeth forward Here we have fabricated a modified multiple loop protrusion arch to correct an anterior crossbite with severe crowding that was not amenable to correct by advancement arches.

  20. Value, search, persistence and model updating in anterior cingulate cortex

    NARCIS (Netherlands)

    Kolling, N.; Wittmann, M.K.; Behrens, T.E.J.; Boorman, E.D.; Mars, R.B.; Rushworth, M.F.S.

    2016-01-01

    Dorsal anterior cingulate cortex (dACC) carries a wealth of value-related information necessary for regulating behavioral flexibility and persistence. It signals error and reward events informing decisions about switching or staying with current behavior. During decision-making, it encodes the

  1. [Anterior lumbar interbody fusion. Indications, technique, advantages and disadvantages].

    Science.gov (United States)

    Richter, M; Weidenfeld, M; Uckmann, F P

    2015-02-01

    Anterior lumbar interbody fusion (ALIF) for lumbar interbody fusion from L2 to the sacrum has been an established technique for decades. The advantages and disadvantages of ALIF compared to posterior interbody fusion techniques are discussed. The operative technique is described in detail. Complications and avoidance strategies are discussed. This article is based on a selective literature search using PubMed and the experience of the authors in this medical field. The advantages of ALIF compared to posterior fusion techniques are the free approach to the anterior disc space without opening of the spinal canal or the neural foramina. This gives the possibility of an extensive anterior release and placement of the largest possible cages without the risk of neural structure damage. The disadvantages of ALIF are the additional anterior approach and the related complications. The most frequent complication is due to damage of vessels. The rate of complications is significantly increased in revision surgery. The ALIF technique meaningfully expands the repertoire of the spinal surgeon especially for the treatment of non-union after interbody fusion, in patients with epidural scar tissue at the index level and spinal infections. Advantages and disadvantages should be considered when evaluating the indications for ALIF.

  2. The concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction

    NARCIS (Netherlands)

    Hofbauer, M.; Muller, B. [=Bart; Murawski, C. D.; van Eck, C. F.; Fu, F. H.

    2014-01-01

    To describe the concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction. The PubMed/Medline database was searched using keywords pertaining to ACL reconstruction. Relevant articles were reviewed in order to summarize important concepts of individualized surgery in ACL

  3. Management of anterior urethral strictures with buccal mucosa: Our ...

    African Journals Online (AJOL)

    Abdelwahab Elkassaby

    2016-03-02

    Mar 2, 2016 ... face of the cheeks from the line of contact of the opposing lips anteriorly to the line of ... as catheterization and endoscopic procedures, but it decreases with ... But with detailed history, most of these patients are found to have tolerated ..... central tendon of the perineum, the bulbo-spongiosum muscle and.

  4. Predictive factors for anterior chamber fibrin formation after vitreoretinal surgery

    Directory of Open Access Journals (Sweden)

    Leonardo Provetti Cunha

    2014-04-01

    Full Text Available Purpose: The aim of this study was to investigate possible predictive factors related to anterior chamber fibrin formation after vitreoretinal surgery in a large series of patients. Methods: The data of 185 eyes of 185 patients submitted to vitreoretinal surgery was reviewed. The following variables were evaluated: the postoperatively presence of fibrin, age, diabetes mellitus, the vitrectomy system gauge (20, 23 or 25 gauge, the type of vitreous substitute, the influence of prior surgical procedures and the combination with cataract extraction. To evaluate predictive factors for anterior chamber fibrin formation, univariate analysis was performed. A multivariate stepwise logistic regression model was adjusted to investigate factors associated with fibrin formation (p<0.05. Results: Fibrinoid anterior chamber reaction was found in 12 (6.4% patients. For multivariate logistic regression analysis, balanced salt solution (BSS, the chance of fibrin occurrence was 5 times greater (odds ratio 4.83, CI 95% 1.302 - 17.892; p=0.019, while combination with phacoemulsification increased the chance of fibrin formation by 20 times (odds ratio 20, CI 95% 2.480 - 161.347; p=0.005. No significant difference was found regarding other variables. Conclusion: Anterior chamber fibrin formation is an unwanted complication after vitreoretinal surgery. Factors such as combined performance of phacoemulsification and the use of balanced salt solution as a vitreous substitute may predispose the occurrence of this complication.

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

    African Journals Online (AJOL)

    Primary synovial sarcoma is a very rare tumor of the mediastinum, which is unreported in the entire subcontinent of West Africa, and presents daunting challenges from diagnosis to management with lack of standard management strategies. We present a case of primary monophasic synovial sarcoma of the anterior ...

  6. Anastomotic leakage after anterior resection for rectal cancer

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    On the basis of the literature about anastomotic leakage after anterior resection for rectal cancer a review is presented of the frequency, potential risk factors and consequences of leakage. The risk factors are evaluated according to the level of scientific evidence of the individual background...

  7. Porcine skin collagen implants for anterior vaginal wall prolapse

    DEFF Research Database (Denmark)

    Hviid, Ulla; Hviid, Thomas; Rudnicki, Peter Martin

    2010-01-01

    INTRODUCTION AND HYPOTHESIS: The effect of a Pelvicol graft compared with a conventional anterior vaginal repair was evaluated in this randomised controlled study. METHODS: Only patients with a stage II or higher (Ba >or= -1) defect were included. RESULTS: Thirty-one patients were allocated to a ...

  8. Spindle neurons of the human anterior cingulate cortex

    Science.gov (United States)

    Nimchinsky, E. A.; Vogt, B. A.; Morrison, J. H.; Hof, P. R.; Bloom, F. E. (Principal Investigator)

    1995-01-01

    The human anterior cingulate cortex is distinguished by the presence of an unusual cell type, a large spindle neuron in layer Vb. This cell has been noted numerous times in the historical literature but has not been studied with modern neuroanatomic techniques. For instance, details regarding the neuronal class to which these cells belong and regarding their precise distribution along both ventrodorsal and anteroposterior axes of the cingulate gyrus are still lacking. In the present study, morphological features and the anatomic distribution of this cell type were studied using computer-assisted mapping and immunocytochemical techniques. Spindle neurons are restricted to the subfields of the anterior cingulate cortex (Brodmann's area 24), exhibiting a greater density in anterior portions of this area than in posterior portions, and tapering off in the transition zone between anterior and posterior cingulate cortex. Furthermore, a majority of the spindle cells at any level is located in subarea 24b on the gyral surface. Immunocytochemical analysis revealed that the neurofilament protein triple was present in a large percentage of these neurons and that they did not contain calcium-binding proteins. Injections of the carbocyanine dye DiI into the cingulum bundle revealed that these cells are projection neurons. Finally, spindle cells were consistently affected in Alzheimer's disease cases, with an overall loss of about 60%. Taken together, these observations indicate that the spindle cells of the human cingulate cortex represent a morphological subpopulation of pyramidal neurons whose restricted distribution may be associated with functionally distinct areas.

  9. Histomorphological features of atherosclerosis in the left anterior ...

    African Journals Online (AJOL)

    The pattern of coronary artery atherosclerosis is valuable in informing mitigation strategies for coronary heart disease. Histomorphological data on this disease among Africans living in Sub Saharan Africa are, however, scarce. The left anterior descending is one of the most commonly afflicted arteries. This study, therefore ...

  10. Traumatic injuries to the anterior teeth of Nigerian urban public ...

    African Journals Online (AJOL)

    Falls (78.4%) and luxation/enamel fracture (31.9%) accounted for the majority of the injuries. Upper jaw (86.6%) and upper central incisors (75.5%) suffered traumatic anterior injuries most often. Conclusion: Within the limitations of the study, traumatic dental injuries were fairly common and it is suggested that preventive ...

  11. Anterior palatal island advancement flap for bone graft coverage ...

    African Journals Online (AJOL)

    ... Palatal Island Advancement Flap was effective in bone graft coverage in premaxillary edentulous area. Conclusion: It can be used as an aid for bone graft coverage of premaxillary edentulous ridge, where the need for mucosa is small in width but long in length. Keywords: Anterior maxilla, bone graft, dental implant, ...

  12. Brachial plexus injury in anterior dislocation of shoulder -case report ...

    African Journals Online (AJOL)

    Brachial plexus injury in anterior dislocation of shoulder -case report and literature review. D Dhar. Abstract. No Abstract. Nigerian Journal of Orthopaedics and Trauma Vol. 6 () 2007: pp. 37-38. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  13. Pericardial effusion presenting as an anterior mediastinal mass

    International Nuclear Information System (INIS)

    Schlesinger, A.E.; Fernbach, S.K.; Northwestern Univ., Chicago, IL

    1986-01-01

    The authors present a case of pericardial effusion in a patient with previous cardiac surgery. Because the pericardium is opened and not reclosed during surgery, fluid can extend superior to the normal upper reflections of the pericardium and simulate an anterior mediastinal mass. (orig.)

  14. ANTERIOR SUPERIOR DISLOCATION OF THE HIP JOINT: A ...

    African Journals Online (AJOL)

    Owing to the ligamentous and muscle forces around the hip, it is only rarely ... operating table, the femoral head was exposed via an anterior approach and found just below the sartorius muscle. The ligamentum teres was found avulsed, and the iliopubic .... of the socket tearing the iliofemoral ligament in the process, or ...

  15. Anastomoselaekage efter lav anterior resektion for cancer recti

    DEFF Research Database (Denmark)

    Bülow, S; Moesgaard, F A; Billesbølle, P

    1997-01-01

    the routine use of a peroperative leakage test and selective use of prophylactic ostomy in cases of unsatisfactory anastomosis. Furthermore, it is recommended that low anterior resection for rectal cancer is limited to few surgeons in each department in order to ensure a uniform quality and hopefully also...

  16. Anterior Weqatal in the Hebrew Bible and the Qumran Documents

    DEFF Research Database (Denmark)

    Siegismund, Kasper

    2017-01-01

    weqatal in Qumran are examined. In the larger, relatively non-fragmentary texts, scholars examining the verbal system of Qumran Hebrew have noticed an almost complete absence of this form. This contribution draws the attention to the use of anterior weqatal in other, more fragmentary texts, evaluating...... of Qumran Hebrew as a deliberately archaizing literary language are tentatively proposed....

  17. Hypospadiac Duplication of Anterior Urethra-a Rare Congenital Anomaly.

    Science.gov (United States)

    Goyal, Bhawana; Gupta, Suresh; Goyal, Parag

    2017-02-01

    Duplication of the urethra is a complex and rarely seen congenital anomaly with three anatomic variants: epispadiac (dorsal), hypospadiac (ventral), and Y-type. We report here a case of hypospadiac duplication of anterior urethra with dorsal blind ending urethra in a 9-year-old boy who presented with complaint of passing urine from the ventral aspect of penis.

  18. Anterior Colporrhaphy Technique and Approach Choices: Turkey Evaluation

    Directory of Open Access Journals (Sweden)

    Serdar Aydın

    2016-09-01

    Full Text Available Aim: To evaluate the diversity in techniques and approaches for anterior colporrhaphy among operators in Turkey. Methods: A survey evaluating the preoperative examination, technique of anterior colporrhaphy, operation choice and postoperative care was presented to surgeons. We contacted via directly, mail or telephone. We used 28 item questionnaire. Results: Majority (87.9% was composed of young gynecologists. Urologists composed of the 9.5% of the study population. The rate of paravaginal defect evaluation was 75.9% and mostly by inspection the presence of vaginal rugae. The use of transperineal 3D pelvic floor ultrasonography was low (5.7%. The evaluation of levator ani muscle defect was 46.6%. The usage of the transperineal 3D ultrasonography for levator ani muscle defect was 19 percent of operators. There were diversity in use of hydrodissection, fascial plication, excision of vaginal mucosa and suture choice. Usage of mesh for anterior colporrhaphy was limited (17.8% and mostly in recurrent cases (12.2%. Paravaginal defect repair rate was 31.9%. The urinary catheter was generally removed one or two day after operation. Vaginal pack usually removed 24 hours after. Conclusion: Several techniques and approaches for anterior vaginal wall repair among operators in Turkey. The variety of techniques suggested that there is no consensus on best surgical technique.

  19. Extrinsic stretching narrowing and anterior indentation of the rectosigmoid junction

    International Nuclear Information System (INIS)

    Schulman, A.; Fataar, S.

    1979-01-01

    Thirty-five cases of extrinsic narrowing or anterior indentation of the rectosigmoid junction (RSJ) have been studied. The RSJ lies directly behind the pouch of Douglas which is a favoured site for peritoneal metastasis, abscess and endometriosis. Any space-occupying lesion of sufficient size at this site will indent the anterior aspects of the RSJ. Causes include distension or tumour of the ileum or sigmoid colon, gross ascites (when the patient is erect), and tumours below the pelvic peritonium, such as gynaecological neoplasm and internal iliac artery aneurysm. When a desmoplastic metastasis in the pouch of Douglas infiltrates the outer layers of the RSJ, the fibrosis produces an eccentric shortening on its anterior aspect, which in turn causes a pleating of the mucosa with the folds radiating towards the shortened area. This is also seen with primary pelvic carcinomas directly adherent to the rectum, endometriosis with repeated bleeding and increasing eccentric, submucosal fibrosis, and chronic abscess in the pouch of Douglas. Not all extrinsic narrowing of the RSJ are pathological. One case of anterior indentation followed operation for rectal prolapse. Ten additional cases showed narrowing due to a technical artefact air-distended colon rising into the upper abdomen to cause stretching at the RSJ. As with ascites, this narrowing due to 'high-rise sigmoid' disappeared when the patients became recumbent and the colonic air redistributed. (author)

  20. Fatores de exposição, experiência no trânsito e envolvimentos anteriores em acidentes de trânsito entre estudantes universitários de cursos na área da saúde, Ponta Grossa, PR, Brasil Factors of exposure, experience in the traffic and previous involvements in traffic accidents among college students of health courses, Ponta Grossa, PR, Brazil

    Directory of Open Access Journals (Sweden)

    Valéria Beatris Labiak

    2008-03-01

    Full Text Available Os tipos de vítimas mais freqüentes nos acidentes de trânsito são os jovens, principalmente os do sexo masculino. Essa alta incidência tem sido atribuída aos comportamentos próprios da idade, que poderiam levar os jovens a transgredir leis de trânsito e, conseqüentemente, provocar acidentes. Assim, este estudo teve como objetivo descrever o perfil socioeconômico e demográfico, além de caracterizar a exposição e os antecedentes em acidentes de trânsito, dos estudantes universitários de cursos na área da Saúde da Universidade Estadual de Ponta Grossa (PR, em 2005. Utilizou-se um questionário auto-respondido, de forma anônima, cuja amostra compreendeu 624 acadêmicos. As variáveis estudadas foram: características demográficas e socioeconômicas, fatores de exposição e experiência no trânsito, uso do cinto de segurança e antecedentes em acidentes de trânsito. O perfil dos estudantes caracterizou-se pela maioria do sexo feminino (66,67%, com idade entre 18 e 23 anos, morando com a família e com renda igual ou inferior a 10 salários mínimos. Quanto à idade de aprendizagem de direção, a maior freqüência no sexo masculino foi entre 15 e 17 anos e no sexo feminino, 18 anos ou mais. Encontrou-se número expressivo de relatos de aprendizagem de direção com menos de 14 anos, em ambos os sexos. A associação do uso do cinto com o lugar ocupado no carro (condutor, passageiro do banco dianteiro e passageiro do banco traseiro, segundo o sexo, revelou que a utilização do dispositivo independe do sexo. A associação entre envolvimento em acidentes de trânsito e sexo indicou pré-disposição do sexo masculino.The most frequent type of victims in traffic accidents is youngsters, mainly of the masculine sex. This high incidence has been attributed to age-related behaviors that could make youngsters transgress traffic laws and, consequently, provoke accidents. Thus, the present study aimed to describe the socioeconomic and

  1. Efeito da eutonia no tratamento da fibromialgia

    OpenAIRE

    Maeda,Cecília; Martinez,José Eduardo; Neder,Matilde

    2006-01-01

    OBJETIVO: avaliar a eutonia como método terapêutico auxiliar no tratamento da fibromialgia (FM). MÉTODOS: estudou-se um grupo de 20 mulheres, segundo os critérios do American College of Rheumatology (ACR), com duração mínima de seis meses, sem alterações no tratamento medicamentoso ou prescrição de exercícios nesse período. As pacientes foram avaliadas através do questionário de dados sociodemográficos; Escala Visual Analógica (EVA) para dor e questionário genérico de avaliação da qualidade d...

  2. Het Italiaanse voorzetsel da

    NARCIS (Netherlands)

    Boer, M.G. de

    2010-01-01

    SAMENVATTING In een voorzetselstudie in het kader van Jackendoffs semantische theorie wordt het sterk polyseme Italiaanse voorzetsel da geanalyseerd als een verzameling deelbetekenissen waarbij de meeste door een of meer semantische regels afgeleid kunnen worden van de basisbetekenis ruimtelijke

  3. ESPECTROS INFRAVERMELHOS DA CREATINA

    Directory of Open Access Journals (Sweden)

    Kumiko K. Sakane

    2011-08-01

    Full Text Available São apresentados espectros infravermelhos da creatina, na faixa de 4000 a 400 cm−1. Os resultados são comparados com espectros observados e calculados, publicados na literatura.

  4. Significados Ocultos da Enfermagem

    Directory of Open Access Journals (Sweden)

    Wiliam César alves Machado

    2011-04-01

    Full Text Available Sabe-se que as ações de cuidar em enfermagem foram sendo moldadas através da história da humanidade e deram-se, majoritariamente, na esfera do subjetivo que permeia as interações existenciais do ser humano que cuida e daquele que recebe cuidados. Campo fecundo para intercâmbios eletromagnéticos. Suas origens remontam ao cuidado prestado por mães, pais, avós, irmãos e demais familiares incumbidos da responsabilidade de ajudar entes recém-natos, crianças, doentes e idosos em suas necessidades de cuidados para preservação da vida.

  5. Passive Anterior Tibial Subluxation in the Setting of Anterior Cruciate Ligament Injuries: A Comparative Analysis of Ligament-Deficient States.

    Science.gov (United States)

    McDonald, Lucas S; van der List, Jelle P; Jones, Kristofer J; Zuiderbaan, Hendrik A; Nguyen, Joseph T; Potter, Hollis G; Pearle, Andrew D

    2017-06-01

    Static anterior tibial subluxation after an anterior cruciate ligament (ACL) injury highlights the abnormal relationship between the tibia and femur in patients with ACL insufficiency, although causal factors including injuries to secondary stabilizers or the time from injury to reconstruction have not been examined. To determine static relationships between the tibia and femur in patients with various states of ACL deficiency and to identify factors associated with anterior tibial subluxation. Cross-sectional study; Level of evidence, 3. Patients treated for ACL injuries were identified from an institutional registry and assigned to 1 of 4 cohorts: intact ACL, acute ACL disruption, chronic ACL disruption, and failed ACL reconstruction (ACLR). Anterior tibial subluxation of the medial and lateral compartments relative to the femoral condyles were measured on magnetic resonance imaging (MRI), and an MRI evaluation for meniscal tears, chondral defects, and injuries to the anterolateral ligament (ALL) was performed. One hundred eighty-six ACL-insufficient knees met inclusion criteria, with 26 patients without an ACL injury utilized as a control group. In the lateral compartment, the mean anterior tibial subluxation measured 0.78 mm for the control group (n = 26), 2.81 mm for the acute ACL injury group (n = 74), 3.64 mm for the chronic ACL injury group (n = 40), and 4.91 mm for the failed ACLR group (n = 72). In the failed ACLR group, 37.5% of patients demonstrated lateral compartment anterior subluxation ≥6 mm, and 11.1% of this group had anterior subluxation of the lateral compartment ≥10 mm. Multivariate regression revealed that the presence of both medial and lateral chondral defects was associated with a mean 1.09-mm increase in subluxation of the medial compartment ( P = .013). The combination of medial and lateral meniscal tears was an independent predictor of increased lateral tibia subluxation by 1.611 mm ( P = .0022). Additionally, across all knee states

  6. Pembuatan Cantilever Bridge Anterior Rahang Atas sebagai Koreksi Estetik

    Directory of Open Access Journals (Sweden)

    Yusrina Sumartati

    2012-12-01

    Full Text Available Latar belakang. Kehilangan gigi anterior rahang atas mengakibatkan gangguan fungsi fonetik dan estetik. Gangguan fungsi estetik menyebabkan pasie menjadi rendah diri. Kondisi ini dapat diatasi oleh dokter gigi, salah satunya dengan pembuatan cantilever bridge. Tujuan. Penulisan ini yaitu untuk memberi informasi bahwa pada kasus kehilangan gigi-gigi anterior rahang atas dengan space yang telah menyempit dan malposisi gigi dapat dibuatkan protesa berupa gigi tiruan cekat dengan desain cantilever bridge. Kasus dan perawatan. Laporan kasus ini membahas tentang pasien perempuan umur 39 tahun yang datang ke Rumah Sakit Gigi dan Mulut Prof. Soedomo, dengan keluhan merasa kurang percaya diri karena gigi depan rahang atas hilang sejak 5 tahun yang lalu akibat kecelakaan. Gigi-gigi anterior rahang atas yang masih ada mengalami malposisi akibat pemakaian gigi tiruan sebagian lepasan yang tidak baik. Perawatan yang dilakukan adalah dengan pembuatan cantilever bridge pada gigi 11, 12, 13 dan 21, 22, 23. Kesimpulan. Gangguan fungsi estetik pada gigi anterior rahang atas dapat diatasi dengan pembuatan cantilever bridge.   Background. Maxillary anteriortooth loss resulting in impaired function of phonetic and aesthetic. Impaired function of aesthetic cause patients to become self conscious. This condition can be treated by a dentist, one with a cantilever bridge. Purpose. To inform that in case of missing anterior teeth of the upper jaw with a space that has been narrowed, and malposition of teeth can be made prosthesis denture fixed bridge with a cantilever design. Case and treatment. This case report discusses the 39 years old female patient who came to he Dental Hospital Prof. Soedomo, with complaints of feeling less confident due to the maxillary front teeth missing since 5 years ago due to an accident. Anterior teeth of the upper jaw are still experiencing malposition due to the use of removable partial dentures are not good. The treatment is done is by

  7. ORIGEM DA ANGTIA MODERNA

    Directory of Open Access Journals (Sweden)

    Edvino Rabuske

    1971-01-01

    Full Text Available O tema que me foi proposto "origem da angtia moderna". Por certo, um tema extremamente complexo. Trata-se de surpreender as modalidades modernas de um fenomeno, antigo como o prrio homem. Visando contribuir numa semana de reflexo sobre a esperan crist em, que esta abordada a partir, de diversos gulos, parece indicado que esta exposio n se atenha a um ico aspeto da angtia.

  8. Anterior transposition of the radial nerve--a cadaveric study.

    Science.gov (United States)

    Yakkanti, Madhusudhan R; Roberts, Craig S; Murphy, Joshua; Acland, Robert D

    2008-01-01

    The radial nerve is at risk during the posterior plating of the humerus. The purpose of this anatomic study was to assess the extent of radial nerve dissection required for anterior transposition through the fracture site (transfracture anterior transposition). A cadaver study was conducted approaching the humerus by a posterior midline incision. The extent of dissection of the nerve necessary for plate fixation of the humerus fracture was measured. An osteotomy was created to model a humeral shaft fracture at the spiral groove (OTA classification 12-A2, 12-A3). The radial nerve was then transposed anterior to the humeral shaft through the fracture site. The additional dissection of the radial nerve and the extent of release of soft tissue from the humerus shaft to achieve the transposition were measured. Plating required a dissection of the radial nerve 1.78 cm proximal and 2.13 cm distal to the spiral groove. Transfracture anterior transposition of the radial nerve required an average dissection of 2.24 cm proximal and 2.68 cm distal to the spiral groove. The lateral intermuscular septum had to be released for 2.21 cm on the distal fragment to maintain laxity of the transposed nerve. Transfracture anterior transposition of the radial nerve before plating is feasible with dissection proximal and distal to the spiral groove and elevation of the lateral intermuscular septum. Potential clinical advantages of this technique include enhanced fracture site visualization, application of broader plates, and protection of the radial nerve during the internal fixation.

  9. Histologic Anatomy of the Anterior Vagina and Urethra.

    Science.gov (United States)

    Mazloomdoost, Donna; Westermann, Lauren B; Mutema, George; Crisp, Catrina C; Kleeman, Steven D; Pauls, Rachel N

    Vaginal and urethral histology is important to understanding the pathophysiology of the pelvic floor. En bloc removal of 4 female cadaveric pelvises was performed, with 18 to 25 serial sections obtained from each. The vaginal and urethral lengths were divided into distal and proximal sections; urethra was divided into anterior and posterior segments as well. Innervation and vasculature were qualified as small and large and quantified per high-power field. The mean vaginal length was 7.45 cm, and the mean urethral length was 3.38 cm. A distinct vaginal fibromuscular layer was noted, without evidence of a dense sheet of continuous collagen. An epithelial, lamina propria, and muscular layer surrounded the urethral lumen. Adipose and loose fibroconnective tissue separated the urethra from the anterior vagina in 41% of slides. Nerves and vasculature were concentrated in the lamina propria. More small nerves and vessels were grossly seen compared with larger counterparts in both the vagina and urethra. No significant differences in layer thickness, innervation, or vasculature were observed along the vaginal length. The posterior urethra had greater innervation than did the anterior (P = 0.012). The distal posterior urethra had more large vessels than did the proximal posterior urethra (P = 0.03). No other differences were noted in urethral sections. A vaginal fibromuscular layer was confirmed, refuting a true fascia. Innervation and vasculature were quantitatively the same along the anterior vagina. However, the posterior urethra had greater innervation than did anterior and is most innervated proximally. Nerve and vascular histology may relate to pelvic floor disorder etiology.

  10. The management of over closured anterior teeth due to attrition

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    Eha Djulaeha

    2009-12-01

    Full Text Available Background: Tooth is the hardest tissue in human body, that can be injured because of attrition process. For old people, denture attrition process is caused by psysiological process relating with the mastication function which also supported by some bad habits such an bruxism, premature contact, and consuming habit of abrasive food. Attrition or abrasion can also be happened with patien’t dentition who does not have teeth subtutition for long time due the lost of their maxillary as well as mandibulary. The pasient will loose their vertical dimension of occlusion, injure, and the lower jaw becomes over closed which is called over closure. Purpose: This article reported the management of over closured anterior teeth due to attrition. Case: a seventy six year old woman patient came to Prosthodontic Clinic in Faculty of Dentistry, Airlangga University, to rehabilitate her upper and lower severe attrited anterior teeth and her posterior teeth. The patient has experienced of wearing acrylic removable mandibular partial denture ten years ago. Unfortunaly, the denture was uncomfortable, and she did not wear it anymore since five years ago. Case management: The severe attrition of anterior teeth with the lost of occlusal vertical dimension can be treated by improving the occlusal vertical dimension gradually. The treatment is then followed by the increasing of the height of the anterior teeth by lengthening the crown teeth of upper jaw with 12 units of span bridge and the acrylic removable partial denture of lower jaw. Conclusion: The severe attrition of anterior teeth with the lost of occlusal vertical dimension can be treated by improving the occlusal vertical dimension gradually, using long span bridge and acrylic removable partial denture.

  11. Anterior Lens Capsule and Iris Thicknesses in Pseudoexfoliation Syndrome.

    Science.gov (United States)

    Batur, Muhammed; Seven, Erbil; Tekin, Serek; Yasar, Tekin

    2017-11-01

    The aim of this study was to evaluate anatomic properties of the lens capsule and iris by anterior segment optical coherence tomography (AS-OCT) in patients with pseudoexfoliation (PEX). This prospective study included 62 eyes of 62 patients with PEX syndrome and 43 eyes of 43 age- and gender-matched controls. All subjects underwent full ophthalmologic examinations including AS-OCT. Pupillary diameter, midperipheral stromal iris thickness, central and temporal lens capsule thicknesses, and peripheral pseudoexfoliation material thickness on the anterior lens capsule surface were measured and recorded. Mean age was 66.8 ± 9.3 years in the PEX group and 65.5 ± 8.9 years in the control group (p = 0.44). The PEX group consisted of 62 patients: 38 men (61.3%) and 24 women (38.7%); the control group included 43 subjects: 25 men (58.1%) and 18 women (41.9%). Pupillary diameter after pharmacologic mydriasis was 21% smaller in the PEX group than controls. Mean midperipheral iris thickness was 36 ± 7.2 μm (7.8%) thinner in the PEX group than that of control group (p = 0.047). The central anterior capsule was a mean of 3.40 ± 0.51 μm (18%) thicker in the PEX group compared to the control group (p = 0.0001). The temporal anterior lens capsule was a mean of 0.17 ± 0.15 μm thicker in the PEX group compared to the control group (p = 0.81). With high-resolution OCT imaging, it has become possible to evaluate the anterior lens capsule without histologic examination and demonstrate that it is thicker than normal in PEX patients.

  12. Tratamiento ortodóncico-quirúrgico de una adaquia anterior Orthodontic-surgical treatment of anterior open bite

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    Anselmo López Rodríguez

    2004-08-01

    Full Text Available En la práctica y desarrollo de la cirugía ortognática en el Hospital Universitario "Comandante Manuel Fajardo" a lo largo de los años, la morbilidad de diferentes anomalías del desarrollo maxilo-mandibulares ha mostrado que la adaquia o mordida abierta anterior es bastante frecuente. Desde tempranas edades se detectan y son tratadas por el especialista en Ortodoncia. El cerrar una adaquia en ocasiones se torna difícil y es cuando el análisis del paciente debe realizarse en el grupo multidisciplianrio integrado por cirujanos maxilofaciales, ortodoncistas y protesistas. Se han detectado diferentes causas que pueden producir una adaquia y en su mayor parte son hábitos nocivos que perduran en el paciente; por ejemplo, la interferencia con el centro de crecimiento condilar, la succión del pulgar, la deglución atípica o lengua protractil, la respiración bucal, entre otras. Este trabajo está encaminado en mostrar los diferentes tratamientos que en la actualidad se emplean para reducir una mordida abierta anterior y presenta el caso de una niña de 14 años de edad portadora de una adaquia de más de 18 mm.In the context of orthognathic surgery practice and development at "Comandante Manuel Fajardo" university hospital, morbidity from several anomalies in the maxillomandibular growth has shown that anterior open bite is pretty common. Such anomalies are detected and treated by the orthodontist at early childhood. To close an anterior open bite is difficult sometimes and requires the analysis of the patient by a multidisciplinary group made up of maxillofacial surgeons, orthodontists and denture specialists. A number of causes may be the origin of anterior open bite, mainly harmful habits that persist in the patient such as interference with the condylar growth center, dummy sucking, atypical deglutition or proctatile tongue, mouth breathing, among others. This paper is aimed at showing different therapies that presently reduce anterior open

  13. Os jardins de Glaziou para a Quinta da Boa Vista, Rio de Janeiro / RJ

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    Jeanne Trindade

    2014-05-01

    Full Text Available O projeto dos jardins da Quinta da Boa Vista foi apresentado ao Imperador D. Pedro II por Auguste François-Marie Glaziou em 1868 e as obras, efetivamente, iniciadas em 1872. Construídos para o deleite não só da família imperial, seus convidados e das pessoas que moravam no interior da propriedade, o acesso era aberto à população em geral aos domingos, talvez, numa tentativa de acalmar os ânimos revolucionários do povo, tal qual acontecera na Inglaterra nos séculos anteriores. Inspirado nos jardins paisagísticos franceses, aliado aos conhecimentos das matas nacionais, o projeto executado por Glaziou para a Quinta da Boa Vista produz grande impacto nos frequentadores devido aos contrastes proporcionados. A utilização maciça de vegetação arbórea — principalmente em suas extremidades — produz um distanciamento visual da cidade que pode promover uma evasão tanto da situação geográfica como de seus problemas, gerando uma sensação de conforto e bem-estar, característica de vários parques da época.

  14. Assessment of the anterior loop of mental nerve in an Iranian population using cone beam computed tomography scan

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    Mitra Karbasi Kheir

    2017-01-01

    Conclusion: Great care is required when placing implants in proximity to mental foramen to avoid anterior loop injury. Because of the variations of anterior loop length in each patient, a fixed distance anterior to the mental foramen is not safe, and the anterior loop length should be determined for each individual. The use of CBCT provides accurate measurements of the length of anterior loop.

  15. As dobras da imagem

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    Profª. Drª. Fátima Antunes da Silva (Yaska Antunes

    2009-05-01

    Full Text Available O presente trabalho tem por objetivo tentar compreender a produção da imagem visual no teatro. Para isso se vale da apropriação livre do conceito de “dobra? de Gilles Deleuze para se referir à multiplicidade de imagens criadas pelas diversas modalidades artísticas. Como no teatro há o entrelaçamento de imagens verbais – palavras enunciadas pelo texto dramático ou teatral – com imagens visuais – a visualidade advinda da composição cênica concreta que organiza no espaço ator e objeto –, a ênfase só podia recair sobre estas duas formas imagéticas. No caso do teatro, surge ainda a percepção de que para além da materialidade da cena, outras imagens emergem do confronto entre palco e platéia. Nesse sentido, imagem teatral seria então aquilo que surge da interação entre ator e espectador. A contribuição desse trabalho pode estar no fato de atualizar certos conceitos sobre a criação da imagem poética na poesia e no cinema para aplicá-los ao teatro. Ao recuperar o pensa-mento de Otávio Paz, Alfredo Bosi, Sergei Eisenstein, entre outros, bus-ca-se promover uma reflexão mais aprofundada sobre a construção visual no teatro.

  16. As diferentes faces da razão (II. Risco, ciência e peritos

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    C. M. Novais Madureira

    2012-10-01

    Full Text Available Em texto anterior argumentou-se contra os excessos do cientismo com que, na linha de Sokal e Bricmont, António Manuel Baptista ataca as análises sociológicas dos processos e produtos da ciência, nomeadamente as posições de Boaventura de Sousa Santos. Neste outro texto, pretende-se contestar AMB e os sokalistas no seu próprio campo, o da ciência pura e dura, mostrando que eles próprios não compreendem o estatuto das suas ciências, e tentando ponderar afirmações menos precisas, frequentes na análise da sociogénese da ciência. Trazendo a discussão para o nosso tempo, abordaremos também uma problemática não tratada no texto anterior, a do estatuto dos cientistas e tecnólogos enquanto peritos nas instâncias de decisão. Por último, tratará de analisar-se como as controvérsias entre peritos, hoje tão frequentes, são vividas no seio da comunidade científica e qual a evolução que geram na própria prática pericial.

  17. Muscle involvement in leprosy: study of the anterior tibial muscle in 40 patients Alterações musculares na lepra: estudo do músculo tibial anterior em 40 pacientes

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    LINEU CESAR WERNECK

    1999-09-01

    Full Text Available The involvement of skeletal striated muscle in leprosy is considered secondary due to peripheral neuropathy, but some studies point it to a primary muscle lesion. In order to investigate the muscle involvement in leprosy, we studied 40 patients (lepromatous 23, tuberculoid 13, borderline 2 and indeterminate 2. The motor nerve conduction of the peroneal nerves had a reduction of the velocity, decreased compound muscle action potential and sometimes absence of potentials. The electromyographic study of the anterior tibial muscle showed signs of recent and chronic denervation in 77.5% of the cases and no myopathic potentials. The anterior tibial muscle biopsy revealed denervation in 45% of the cases, interstitial inflammatory myopathy in 30% and mixed (myopathic and neuropathic pattern in 12.5%. Acid fast bacillus was detected in 25% of the cases, always in the interstitial tissue. Inflammatory reaction was present in the interstitial space and in patients with the lepromatous type. The histological findings clearly defined the presence of the so-called "Leprous Interstitial Myositis" on the top of denervation signs.O envolvimento do músculo estriado na lepra é considerado secundário à lesão dos nervos periféricos, mas alguns estudos relataram acometimento muscular primário. A fim de verificar esta controvérsia estudamos 40 pacientes com lepra, sendo 23 da forma lepromatosa, 13 da tuberculoide, 2 borderline e 2 indeterminada. Realizamos a neurocondução do nervo peroneiro, junto com eletromiografia e biópsia do músculo tibial anterior. Encontramos redução de velocidade de condução, da amplitude e algumas vezes ausência de potenciais no nervo peroneiro. A eletromiografia do tibial anterior mostrou sinais de desinervação recente e crônica em 77,5% dos casos e não foi encontrada evidência de padrão "miopático". A biópsia do músculo tibial anterior revelou desinervação em 45% dos casos, miopatia inflamatória intersticial em

  18. Trauma da Veia Porta

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    Gustavo Pereira Fraga

    Full Text Available OBJETIVO: O trauma da veia porta é raro e freqüentemente fatal por causa de exsanguinação e alta incidência de lesões de estruturas adjacentes. Devido às pecualiaridades desta lesão e diferentes condutas propostas na literatura, o objetivo dos autores é relatar a experiência neste tipo de lesão. MÉTODO: Estudo retrospectivo, de janeiro de 1994 e dezembro de 2001, de 1370 pacientes submetidos à laparotomia devido trauma abdominal. Entre esses, 15 pacientes apresentavam lesão da veia porta. As lesões foram classificadas conforme a sua extensão e localização. RESULTADOS: O mecanismo de trauma predominante foi o penetrante. O diagnóstico da lesão foi realizado no intraoperatório. Os procedimentos executados foram: sutura, anastomose término-terminal e ligadura da veia porta. A mortalidade foi de 53,3%. CONCLUSÃO: A lesão da veia porta possui alta taxa de mortalidade e o atendimento adequado está diretamente relacionado à sobrevida.

  19. Anterior internal impingement of the shoulder in rugby players and other overhead athletes

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    Siddharth R. Shah, MBBS, MSc Sports Medicine (UK, MRCS-Ed

    2017-04-01

    Conclusion: This series of anterior internal impingement, which we believe is the largest in the literature to date, demonstrates the value of an to assess and successfully treat overhead athletes with anterior impingement syndrome.

  20. Lesão do ligamento cruzado anterior: tratamento e reabilitação. Perspectivas e tendências atuais Anterior cruciate ligament injury: treatment and rehabilitation. Current perspectives and trends

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    Gustavo Gonçalves Arliani

    2012-04-01

    Full Text Available OBJETIVO: O objetivo deste estudo é avaliar as condutas e procedimentos realizados pelos cirurgiões de joelho do Brasil no tratamento e reabilitação das lesões do ligamento cruzado anterior. MÉTODOS: Um questionário de 21 questões fechadas foi elaborado abordando tópicos relacionados ao tratamento e reabilitação após reconstrução do LCA. O questionário foi aplicado a cirurgiões brasileiros de joelho durante os três dias do 42º Congresso Brasileiro de Ortopedia e Traumatologia do ano de 2010. RESULTADOS: No total, 226 cirurgiões preencheram completamente o questionário e fizeram parte da amostra analisada. A maior parte destes era proveniente da região Sudeste do País. Os tipos de enxerto mais utilizados foram os tendões flexores e o terço central do tendão patelar ipsilateral à lesão, utilizados por 82,3% e 53,5% da amostra, respectivamente. A técnica de reconstrução com banda única transtibial é a preferida, sendo realizada por 66,4% dos participantes. O período de uma a quatro semanas entre a lesão e a realização do procedimento cirúrgico foi o considerado ideal pela maioria dos participantes (52,65%. Queixa de falseio/instabilidade do paciente e presença da manobra de pivot-shift positiva no exame físico foram os fatores considerados mais determinantes na decisão de operar o paciente. Já a satisfação do paciente e a ausência de queixas de instabilidade no pós-operatório foram os critérios julgados mais importantes para considerar a cirurgia um sucesso. CONCLUSÕES: Existem claras tendências em evolução no tratamento e reabilitação do LCA no Brasil. No entanto, mais estudos prospectivos controlados são necessários para avaliar o benefício clínico e científico destas tendências.OBJECTIVE: The aim of this study was to evaluate the procedures used by knee surgeons in Brazil for treating and rehabilitating anterior cruciate ligament injuries. METHODS: A questionnaire consisting of 21 closed

  1. Considerações sobre o diagnóstico parasitológico da esquistossomose mansoni

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    Celso Affonso de Oliveira

    1967-02-01

    Full Text Available O autor tece comentários sobre o valor do exame parasitológico das fezes anterior a qualquer tratamento para o diagnóstico da esquistossomose mansoni, acentuando que a sua positividade traduz sempre infecção esquistossomótica e parasitose ativa. Considera, a seguir, o valor da biópsia retal, mostrando que êste método evidencia a infecção em 95% dos casos portadores da forma intestinal e em 75% daqueles com esquistossomose hepatoesplênica; o exame coprológico é, portanto, superior para o diagnóstico da forma hepatoesplênica. O encontro exclusivo de ovos mortos e/ou granulomas e/ou cascas firma o diagnóstico da infecção.

  2. Tomografia computadorizada no diagnóstico da otosclerose fenestral

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    Vicente Andy de Oliveira

    2004-01-01

    Full Text Available OBJETIVO: Identificar os principais achados tomográficos da otosclerose fenestral e avaliar a utilidade da tomografia computadorizada de alta resolução (TCAR, como método diagnóstico dessa osteodistrofia. FORMA DE ESTUDO: Estudo prospectivo multicêntrico com tomografia computadorizada (TC de ossos temporais. MATERIAL E MÉTODO: 54 pacientes com diagnóstico clínico e cirúrgico de otosclerose. Foi realizada uma análise tomográfica, em que foi avaliada a sensibilidade da TC no diagnóstico radiológico da otosclerose fenestral, sendo verificados os principais sítios de lesões dessa doença, como também a sua bilateralidade e simetria. Foram incluídos neste estudo 22 pacientes submetidos à TC de ossos temporais para investigação de outras afecções otológicas, que constituíram o grupo controle. RESULTADOS: A TC foi positiva em 87% dos pacientes (77% das orelhas. Os achados tomográficos foram bilaterais na maioria dos casos (78,7%, e o foco fenestral mais prevalente foi o foco anterior à janela oval (FAJO. CONCLUSÕES: A TC apresentou um alto índice de positividade e o FAJO foi o foco mais prevalente nessa população, podendo ser considerado um achado tomográfico altamente sugestivo de otosclerose.

  3. Anterior Segmental Distraction Osteogenesis in the Hypoplastic Cleft Maxilla

    Science.gov (United States)

    Rao (Janardhan), Sruthi; Kotrashetti, S. M.; Lingaraj, J. B.; Pinto, P. X.; Keluskar, K. M.; Jain, Siddharth; Sone, Piyush; Rao, Santhosh

    2013-01-01

    Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate (CLP). Advancement of the anterior maxilla alone without interfering with the velopharyngeal sphincter may be advantageous in cleft patients, who more commonly have speech deficits and dental crowding. We present a case series of anterior maxillary segmental distraction for maxillary hypoplasia in 5 CLP patients with a one-year follow-up. A custom-made tooth-borne distraction device with a hyrax screw positioned anteroposteriorly was used. The evaluation comprised of hard and soft tissue analysis and speech assessment. A stable occlusion with positive overjet and correction of dental-crowding without extraction was achieved at one year post-distraction. Facial profile and lip support improved. There was no deterioration in speech. PMID:23984033

  4. Nongranulomatous anterior uveitis in a patient with Usher syndrome.

    Science.gov (United States)

    Alzuhairy, Sultan Abdulaziz S; Alfawaz, Abdullah

    2013-10-01

    A 34-year-old female with Usher syndrome, but no family history of similar illness, presented with complaints of vision reduction, redness, and photophobia. Biomicroscopic examination showed mildly injected conjunctivae bilateral, small, round keratic precipitates; bilateral +2 cells with no flare reaction in the anterior chamber; and bilateral posterior subcapsular cataracts. No associated posterior synechiae, angle neovascularization, or iris changes were detected; normal intraocular pressures were obtained. Fundus examination demonstrated waxy pallor of both optic nerves, marked vasoconstriction in retinal vessels, and retinal bone spicule pigment formation, with a normal macula. Electroretinography confirmed the diagnosis of retinitis pigmentosa, optical coherent tomography was normal and otolaryngology consultation was conducted. To our knowledge, an association between Usher syndrome and bilateral nongranulomatous anterior uveitis has not been previously reported, and our purpose is to report this association.

  5. Prokaryotic adenylate cyclase toxin stimulates anterior pituitary cells in culture

    International Nuclear Information System (INIS)

    Cronin, M.J.; Evans, W.S.; Rogol, A.D.; Weiss, A.A.; Thorner, M.O.; Orth, D.N.; Nicholson, W.E.; Yasumoto, T.; Hewlett, E.L.

    1986-01-01

    Bordetella pertussis synthesis a variety of virulence factors including a calmodulin-dependent adenylate cyclase (AC) toxin. Treatment of anterior pituitary cells with this AC toxin resulted in an increase in cellular cAMP levels that was associated with accelerated exocytosis of growth hormone (GH), prolactin, adrenocorticotropic hormone (ACTH), and luteinizing hormone (LH). The kinetics of release of these hormones, however, were markedly different; GH and prolactin were rapidly released, while LH and ACTH secretion was more gradually elevated. Neither dopamine agonists nor somatostatin changes the ability of AC toxin to generate cAMP (up to 2 h). Low concentrations of AC toxin amplified the secretory response to hypophysiotrophic hormones. The authors conclude that bacterial AC toxin can rapidly elevate cAMP levels in anterior pituitary cells and that it is the response that explains the subsequent acceleration of hormone release

  6. BILATERAL SIMULTANEOUS ANTERIOR AND POSTERIOR LENTICONUS WITHOUT SYSTEMIC SIGNS

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    Hima Bindu

    2015-02-01

    Full Text Available A 21 year male came for eye checkup with a refractive error OD - 12.00 sph, - 2.25 @ 160° cyl and OS - 15.00 sph, - 2.50 @ 5°cyl and was referred to department of refractive surgery for opinion His BCVA in OD 6 / 18, OS 6/ 24. Slit lamp examination under dilation with phenylephrine plus tropic amide revealed the abnormal contour of the anterior and posterior lens capsule. Rest of the findings were normal with clear cornea, Von Herricks grade 3 deep anterior chamber, open angles in Gonioscopy. Retro illumination showed the typical’ oil droplet configuration’ in the lens. Retinal examination with the 90 D lens was otherwise normal except of the peculiar ‘OMEGA' shaped curving of the slit beam over the retina which occurred due the difference in the refractive power of the lens in the axial and paraxial zones of the lens

  7. What are patient goals after an anterior colporrhaphy operation?

    DEFF Research Database (Denmark)

    Kousgaard, Sabrina J; Bjørk, Jonna; Glavind, Karin

    2017-01-01

    OBJECTIVES: The aim of this study was to describe patient-reported goals after an anterior colporrhaphy operation for anterior vaginal wall prolapse, the fulfilment of goals, and the correlation with subjective patient-reported outcomes. STUDY DESIGN: A prospective study involving 100 women....... Preoperatively, patients completed three modified questions from the International Consultation on Incontinence Questionnaire - Vaginal Symptoms (ICIQ-VS) named ICIQ-VS short form (ICIQ-VS SF) and stated three goals for the operation. A telephone interview was performed 3 months postoperatively. RESULTS......: A Visual Analogue Scale (VAS) score from one to 10 estimated the extent to which goals were achieved. Goals were divided into eight groups: 1: mechanical symptoms (bulging), 2: voiding symptoms, 3: quality of life (physical), 4: quality of life (emotional), 5: avoidance of urinary tract infection, 6: cure...

  8. Low anterior anastomotic dehiscence following preoperative irradiation with 6000 rads

    Energy Technology Data Exchange (ETDEWEB)

    Blake, D.P.; Bubrick, M.P.; Kochsiek, G.G.; Feeney, D.A.; Johnston, G.R.; Strom, R.L.; Hitchcock, C.R.

    1984-03-01

    Twenty mongrel dogs received 6000 rads of irradiation to the rectum and colon using the Nominal Standard Dosage Equation. Three weeks after irradiation each dog underwent anterior resection of the rectosigmoid with reconstruction randomized to either an EEA stapled or a two layer handsewn anastomosis. Each dog was studied digitally and by barium enema at the time of surgery, on the seventh postoperative day, and at autopsy. Five clinically significant leaks and three radiographic leaks occurred in the EEA stapled anastomoses. The handsewn anastomoses had five clinically significant leaks and two radiographic leaks. The data indicate that low anterior resection with either an EEA stapled or handsewn anastomosis cannot be done safely after 6000 rad preoperative irradiation.

  9. Low anterior anastomotic dehiscence following preoperative irradiation with 6000 rads

    International Nuclear Information System (INIS)

    Blake, D.P.; Bubrick, M.P.; Kochsiek, G.G.; Feeney, D.A.; Johnston, G.R.; Strom, R.L.; Hitchcock, C.R.

    1984-01-01

    Twenty mongrel dogs received 6000 rads of irradiation to the rectum and colon using the Nominal Standard Dosage Equation. Three weeks after irradiation each dog underwent anterior resection of the rectosigmoid with reconstruction randomized to either an EEA stapled or a two layer handsewn anastomosis. Each dog was studied digitally and by barium enema at the time of surgery, on the seventh postoperative day, and at autopsy. Five clinically significant leaks and three radiographic leaks occurred in the EEA stapled anastomoses. The handsewn anastomoses had five clinically significant leaks and two radiographic leaks. The data indicate that low anterior resection with either an EEA stapled or handsewn anastomosis cannot be done safely after 6000 rad preoperative irradiation

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

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    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.

  11. [Fractographic analysis of clinically failed anterior all ceramic crowns].

    Science.gov (United States)

    DU, Qian; Zhou, Min-bo; Zhang, Xin-ping; Zhao, Ke

    2012-04-01

    To identify the site of crack initiation and propagation path of clinically failed all ceramic crowns by fractographic analysis. Three clinically failed anterior IPS Empress II crowns and two anterior In-Ceram alumina crowns were retrieved. Fracture surfaces were examined using both optical stereo and scanning electron microscopy. Fractographic theory and fracture mechanics principles were applied to disclose the damage characteristics and fracture mode. All the crowns failed by cohesive failure within the veneer on the labial surface. Critical crack originated at the incisal contact area and propagated gingivally. Porosity was found within the veneer because of slurry preparation and the sintering of veneer powder. Cohesive failure within the veneer is the main failure mode of all ceramic crown. Veneer becomes vulnerable when flaws are present. To reduce the chances of chipping, multi-point occlusal contacts are recommended, and layering and sintering technique of veneering layer should also be improved.

  12. Case of prostate cancer with anterior localization multiparametric MRI study

    International Nuclear Information System (INIS)

    Georgiev, A.

    2016-01-01

    Prostate cancer most often originates from acinar epithelium. Most of the clinically palpable carcinomas are located predominantly in the rear/dorzo-lateraI zones of the gland, but the tumors in the transition zone anatomical may spread to the periphery. The detection of a neoplastic process in the front parts of the gland is rare and poses difficulties in diagnosis. We present a rare case of anterior location of prostate carcinoma with invasion of bladder, blood vessels and seminal vesicles. At present, diagnosis of prostate cancer in most men is demonstrated by elevated serum levels of prostate-specific antigen (PSA), or positive rectal examination or ultrasonography. Multi parametric MR study is a promising method for detecting prostate cancer. When used in conjunction with PSA values and rectal examination, MRI is increasingly accepted as a standard for the diagnosis and characterization of prostate carcinoma. Key words; Prostate Cancer. Anterior Localization. Multi Parametric MRI

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS...... completion of the operation the patients were randomized in two groups with and without a transanal stent. RESULTS: A clinically significant leakage was diagnosed in 25 patients (13%). No significant difference was found 17 of 98 patients with a stent and 8 of 96 without (P = 0.09), or in 9 of 44 ileostomy...... patients with a stent and in 3 of 45 without (P = 0.07). Several leaks over a short time led to an interim analysis after inclusion of 194 of 448 planned patients. The analysis showed no significant protective effect of the stent, and more leakages in the stent group, although not statistically significant...

  14. Is antibiotic prophylaxis in nasal packing for anterior epistaxis needed?

    Directory of Open Access Journals (Sweden)

    Francisco Pérez

    2016-03-01

    Full Text Available La epistaxis es un problema extremadamente común que en ocasiones requiere de taponamiento anterior. Usualmente se indican antibióticos de forma concomitante para la prevención de complicaciones infecciosas, aunque el rol de esta medida es controvertido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos una revisión sistemática que incluye tres estudios primarios, ninguno de ellos controlado y aleatorizado. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que no está claro si los antibióticos profilácticos disminuyen las complicaciones infecciosas en pacientes con taponamiento nasal por epistaxis anterior porque la certeza de la evidencia es muy baja.

  15. Complications and Management of Deep Anterior Lamellar Keratoplasty

    Directory of Open Access Journals (Sweden)

    Banu Torun Acar

    2014-10-01

    Full Text Available Objectives: To report the intraoperative and postoperative follow-up complications and management of these in deep anterior lamellar keratoplasty (DALK surgery. Materials and Methods: Two hundred eighty-four eyes of 252 patients followed up in our cornea clinic who underwent DALK using Anwar’s big-bubble technique with healthy Descemet’s membrane and endothelium were included in this study. Intraoperative and postoperative complications as well as the management and treatment of these complications were evaluated. Results: Big bubble was created in 220 (77.5% eyes of 284 eyes, and lamellar dissection was performed in 64 (22.5% eyes. Perforation occurred during trephination in 4 eyes, and the procedure was accomplished by penetrating keratoplasty (PK. Intraoperative microperforation occurred in 44 eyes. Perforation enlarged in 4 eyes and PK was performed. Operation was continued in 40 eyes with air injection into the anterior chamber. In postopertive follow-up period, double anterior chamber (DAC occurred in 32 of 40 eyes. DAC spontaneously regressed in 8 eyes, and air was given into the anterior chamber with a second surgical intervention in 24 eyes. DAC improved in 20 eyes. Four eyes underwent PK. Fungal keratitis evolved at the interface in one eye, because of no healing during the follow-up period, this eye underwent PK under antifungal therapy. Eyes with interface haze and Descemet’s membrane folds were followed. Conclusion: DALK is a difficult technique with a steep learning curve. In addition to the complications seen in PK, specific complications can occur in lamellar surgery. (Turk J Ophthalmol 2014; 44: 337-40

  16. Anterior ischemic optic neuropathy precipitated by acute primary angle closure

    Directory of Open Access Journals (Sweden)

    Choudhari Nikhil

    2010-01-01

    Full Text Available A 59-year-old man with a history of longstanding systemic hypotension developed asymmetric non-arteritic anterior ischemic optic neuropathy (NAION apparently precipitated by bilateral sequential acute primary angle closure. NAION is very rarely reported in association with raised intraocular pressure. In contrast to optical coherence tomography, the failure of scanning laser polarimetry to detect axonal swelling was another interesting finding. Possible reasoning for these observations is discussed.

  17. Decoding Pedophilia: Increased Anterior Insula Response to Infant Animal Pictures

    Directory of Open Access Journals (Sweden)

    Jorge Ponseti

    2018-01-01

    Full Text Available Previous research found increased brain responses of men with sexual interest in children (i.e., pedophiles not only to pictures of naked children but also to pictures of child faces. This opens the possibly that pedophilia is linked (in addition to or instead of an aberrant sexual system to an over-active nurturing system. To test this hypothesis we exposed pedophiles and healthy controls to pictures of infant and adult animals during functional magnetic resonance imaging of the brain. By using pictures of infant animals (instead of human infants, we aimed to elicit nurturing processing without triggering sexual processing. We hypothesized that elevated brain responses to nurturing stimuli will be found – in addition to other brain areas – in the anterior insula of pedophiles because this area was repeatedly found to be activated when adults see pictures of babies. Behavioral ratings confirmed that pictures of infant or adult animals were not perceived as sexually arousing neither by the pedophilic participants nor by the heathy controls. Statistical analysis was applied to the whole brain as well as to the anterior insula as region of interest. Only in pedophiles did infants relative to adult animals increase brain activity in the anterior insula, supplementary motor cortex, and dorsolateral prefrontal areas. Within-group analysis revealed an increased brain response to infant animals in the left anterior insular cortex of the pedophilic participants. Currently, pedophilia is considered the consequence of disturbed sexual or executive brain processing, but details are far from known. The present findings raise the question whether there is also an over-responsive nurturing system in pedophilia.

  18. Decoding Pedophilia: Increased Anterior Insula Response to Infant Animal Pictures.

    Science.gov (United States)

    Ponseti, Jorge; Bruhn, Daniel; Nolting, Julia; Gerwinn, Hannah; Pohl, Alexander; Stirn, Aglaja; Granert, Oliver; Laufs, Helmut; Deuschl, Günther; Wolff, Stephan; Jansen, Olav; Siebner, Hartwig; Briken, Peer; Mohnke, Sebastian; Amelung, Till; Kneer, Jonas; Schiffer, Boris; Walter, Henrik; Kruger, Tillmann H C

    2017-01-01

    Previous research found increased brain responses of men with sexual interest in children (i.e., pedophiles) not only to pictures of naked children but also to pictures of child faces. This opens the possibly that pedophilia is linked (in addition to or instead of an aberrant sexual system) to an over-active nurturing system. To test this hypothesis we exposed pedophiles and healthy controls to pictures of infant and adult animals during functional magnetic resonance imaging of the brain. By using pictures of infant animals (instead of human infants), we aimed to elicit nurturing processing without triggering sexual processing. We hypothesized that elevated brain responses to nurturing stimuli will be found - in addition to other brain areas - in the anterior insula of pedophiles because this area was repeatedly found to be activated when adults see pictures of babies. Behavioral ratings confirmed that pictures of infant or adult animals were not perceived as sexually arousing neither by the pedophilic participants nor by the heathy controls. Statistical analysis was applied to the whole brain as well as to the anterior insula as region of interest. Only in pedophiles did infants relative to adult animals increase brain activity in the anterior insula, supplementary motor cortex, and dorsolateral prefrontal areas. Within-group analysis revealed an increased brain response to infant animals in the left anterior insular cortex of the pedophilic participants. Currently, pedophilia is considered the consequence of disturbed sexual or executive brain processing, but details are far from known. The present findings raise the question whether there is also an over-responsive nurturing system in pedophilia.

  19. Endoscopic Anatomy of the Tensor Fold and Anterior Attic.

    Science.gov (United States)

    Li, Bin; Doan, Phi; Gruhl, Robert R; Rubini, Alessia; Marchioni, Daniele; Fina, Manuela

    2018-02-01

    Objectives The objectives of the study were to (1) study the anatomical variations of the tensor fold and its anatomic relation with transverse crest, supratubal recess, and anterior epitympanic space and (2) explore the most appropriate endoscopic surgical approach to each type of the tensor fold variants. Study Design Cadaver dissection study. Setting Temporal bone dissection laboratory. Subjects and Methods Twenty-eight human temporal bones (26 preserved and 2 fresh) were dissected through an endoscopic transcanal approach between September 2016 and June 2017. The anatomical variations of the tensor fold, transverse crest, supratubal recess, and anterior epitympanic space were studied before and after removing ossicles. Results Three different tensor fold orientations were observed: vertical (type A, 11/28, 39.3%) with attachment to the transverse crest, oblique (type B, 13/28, 46.4%) with attachment to the anterior tegmen tympani, and horizontal (type C, 4/28, 14.3%) with attachment to the tensor tympani canal. The tensor fold was a complete membrane in 20 of 28 (71.4%) specimens, preventing direct ventilation between the supratubal recess and anterior epitympanic space. We identified 3 surgical endoscopic approaches, which allowed visualization of the tensor fold without removing the ossicles. Conclusions The orientation of the tensor fold is the determining structure that dictates the conformation and limits of the epitympanic space. We propose a classification of the tensor fold based on 3 anatomical variants. We also describe 3 different minimally invasive endoscopic approaches to identify the orientation of the tensor fold while maintaining ossicular chain continuity.

  20. Microimplant in Lingual Tori to Correct Anterior Crossbite in Adult

    Directory of Open Access Journals (Sweden)

    Deepak Rai

    2012-01-01

    Full Text Available Anterior crossbites are difficult to correct in adults. A case where microimplants were placed in the lingual tori of an adult patient along with a lingual appliance is reported. The use of the esthetic lingual appliance along with the stable anchorage provided by the microimplants, aids in decreasing the duration of treatment as well as making the same more acceptable to the patient.

  1. Nongranulomatous anterior uveitis in a patient with Usher syndrome

    OpenAIRE

    Alzuhairy, Sultan Abdulaziz S.; Alfawaz, Abdullah

    2013-01-01

    A 34-year-old female with Usher syndrome, but no family history of similar illness, presented with complaints of vision reduction, redness, and photophobia. Biomicroscopic examination showed mildly injected conjunctivae bilateral, small, round keratic precipitates; bilateral +2 cells with no flare reaction in the anterior chamber; and bilateral posterior subcapsular cataracts. No associated posterior synechiae, angle neovascularization, or iris changes were detected; normal intraocular pressu...

  2. [Collaboration from periodontics in the aesthetic restoration of anterior teeth].

    Science.gov (United States)

    Qintao, Wang; Yumei, Zhang

    2017-10-01

    Anterior teeth are the main zones that reflect oral aesthetics. The histological structure, outside appearance, relative ratios, and other characteristics of tissues must be understood to obtain relatively ideal and natural restoration effects. A collaboration of different disciplines must be implemented to obtain harmonious and stable restoration outcomes that help the majority appreciate beauty. This article aims to discuss the role of periodontics in this collaboration and introduce several common techniques.

  3. ACTH radioimmunocytochemistry (RICH) on rat anterior pituitary cells

    International Nuclear Information System (INIS)

    Rappay, G.; Karteszi, M.; Makara, G.B.

    1979-01-01

    Radioimmunocytochemistry (RICH) was applied to detect corticotrophs in adult rat pituitaries and 8-day-old anterior pituitary monolayers by incubating sections and cultures with 125 I-ACTH-anti ACTH immune complexes. After incubations autoradiography was made. In comparison, 'conventional' immunostaining was carried out on adjacent sections and parallel cultures. It has been established that RICH is suitable for detection of corticotrophs. (orig.) [de

  4. Safety and resource utilization of anterior cervical discectomy and fusion

    OpenAIRE

    Yu-Tung Feng; Shiuh-Lin Hwang; Chih-Lung Lin; I-Chen Lee; King-Teh Lee

    2012-01-01

    Degenerative cervical spondylosis (DCS) is part of the aging process and is the most common reason for degenerative changes with the spinal column. Anterior cervical discectomy and fusion (ACDF) is a major option for operative management of DCS in our institution. This retrospective study investigated the frequency of postoperative complications and resource utilization in 145 patients who underwent ACDF procedures from January 2009 to December 2011. Patients with degenerative changes that in...

  5. What role for the anterior cingulate in analogical reasoning?

    Science.gov (United States)

    O'Boyle, Michael W

    2010-06-01

    Abstract While prefrontal and frontal cortex of the brain are well documented to mediate many executive functions, including creativity, flexibility, and adaptability, the anterior cingulate cortex (ACC) is known to be involved in error detection and conflict resolution, and is crucial to reward-based learning. A case is made for the notion that any neural model of analogical reasoning must incorporate the critical (and specialized) contributions of the ACC.

  6. Fungal Infection of the Sinus and Anterior Skull Base

    Directory of Open Access Journals (Sweden)

    Morteza Javadi

    2008-11-01

    Full Text Available   Abstract   Background: Invasive fungal infection is an opportunistic infection caused commonly   by mucoraccae and aspergillus. It mostly occurs in patients with underlying disease.   Since it has a high mortality and morbidity rate, considering a treatment strategy seems   necessary.   Objective: Since there has not been a clear protocol for treating these patients, we decided   to establish a protocol for fungal infection of sinus and anterior skull base management.   Methods: This retrospective and descriptive case study series included 30 patients.   After confirming the pathogen, the authors came to a proper protocol for treatment which   is mentioned later.   Results: The site involvement included nose and orbital cavity (53.3%, anterior skull   base and brain in conjunction with sinonasal (36.6% and simple nasal cavity involvement   (10%. 86.6% of the patients had underlying diseases. 56.6% of patients had diabetes   as a single underlying disease, while 13.3% had both diabetes and renal failure in   combination. Acute lymphocytic leukemia was present in 6.6%, renal failure in 3.3%, lupus   in 3.3% and chronic lymphocytic leukemia in 3.3% of patients. Mortality rate was   40%. We categorized the patients into 3 groups: only sinonasal, sinonasal and orbit, and   associated anterior skull base and brain involvement.   Conclusion: Early diagnosis is an important factor in improving survival. Anterior   skull base and brain involvement has a very poor prognosis.  

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

    OpenAIRE

    Demet Pepele

    2014-01-01

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

  8. Morphometric Analysis of Bone Resection in Anterior Petrosectomies.

    Science.gov (United States)

    Ahmed, Osama; Walther, Jonathan; Theriot, Krystle; Manuel, Morganne; Guthikonda, Bharat

    2016-06-01

    Introduction The anterior petrosectomy is a well-defined skull base approach to lesions such as petroclival meningiomas, posterior circulation aneurysms, petrous apex lesions (chondrosarcomas, cholesteatomas), ventrolateral brainstem lesions, clival chordomas, trigeminal neurinomas, and access to cranial nerves III, IV, V, and VII. Methods and Materials Fourteen anterior petrosectomies on eight cadaveric heads were performed in a skull base dissection laboratory. Predissection and postdissection thin-cut computed tomography scans were obtained to compare the bone resection. A computer program was used (InVivo5, Anatomage, San Jose, California, United States) to measure the bone resection and the improved viewing angle. Results The average bone removed in each plane was as follows: anterior to posterior plane was 10.57 mm ± 2.00 mm, superior to inferior was 9.39 mm ± 1.67 mm, and lateral to medial was 17.46 mm ± 4.64 mm. The average increased angle of view was 13.01 ± 2.35 degrees (Table 1). The average volume was 1786.94 ± 827.40 mm(3). Conclusions Anterior petrosectomy is a useful approach to access the ventrolateral brainstem region. We present a cadaveric study quantitating the volume of bone resection and improvement in the viewing angle. These data provide useful preoperative information on the utility of this skull base approach and the gain in the viewing angle after bony removal.

  9. Anterior capsulotomy with an ultrashort-pulse laser.

    Science.gov (United States)

    Tackman, Ramon Naranjo; Kuri, Jorge Villar; Nichamin, Louis D Skip; Edwards, Keith

    2011-05-01

    To assess the precision of laser anterior capsulotomy compared with that of manual continuous curvilinear capsulorhexis (CCC). Asociación Para Evitar La Ceguera en México IAP, Hospital Dr. Luis Sánchez Bulnes, Mexico City, Mexico. Nonrandomized single-center clinical trial. In patients presenting for cataract surgery, the LensAR Laser System was used to create a laser anterior capsulotomy of the surgeon's desired size. Capsule buttons were retrieved and measured and then compared with buttons retrieved from eyes having a manually torn CCC. Deviation from the intended diameter and the regularity of shape were assessed. When removing the capsule buttons at the start of surgery, the surgeon rated the ease of removal on a scale of 1 to 10 (1 = required manual capsulorhexis around the whole diameter; 10 = button free floating or required no manual detachment from remaining capsule during removal). The mean deviation from the intended diameter was 0.16 mm ± 0.17 (SD) for laser anterior capsulotomy and 0.42 ± 0.54 mm for CCC (P=.03). The mean absolute deviation from the intended diameter was 0.20 ± 0.12 mm and 0.49 ± 0.47 mm, respectively (P=.003). The mean of the average squared residuals was 0.01 ± 0.03 and 0.02 ± 0.04, respectively (P=.09). The median rating of the ease of removal was 9 (range 5 to 10). Laser anterior capsulotomy created a more precise capsule opening than CCC, and the buttons created by the laser procedure were easy to remove at the beginning of cataract surgery. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  10. New Treatments for Nonarteritic Anterior Ischemic Optic Neuropathy.

    Science.gov (United States)

    Foroozan, Rod

    2017-02-01

    Despite increasing knowledge about the risk factors and clinical findings of nonarteritic anterior ischemic optic neuropathy (NAION), the treatment of this optic neuropathy has remained limited and without clear evidence-based benefit. Historical treatments of NAION are reviewed, beginning with the Ischemic Optic Neuropathy Decompression Trial. More recent treatments are placed within the historical context and illustrate the need for evidence-based therapy for ischemic optic neuropathy. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Nonarteritic anterior ischemic optic neuropathy: cause, effect, and management.

    Science.gov (United States)

    Berry, Shauna; Lin, Weijie V; Sadaka, Ama; Lee, Andrew G

    2017-01-01

    Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common form of ischemic optic neuropathy and the second most common optic neuropathy. Patients are generally over the age of 50 years with vasculopathic risk factors (eg, diabetes mellitus, hypertension, and obstructive sleep apnea). The exact mechanism of NAION is not fully understood. In addition, several treatment options have been proposed. This article summarizes the current literature on the diagnosis, treatment, and management of NAION.

  12. Plurihormonal cells of normal anterior pituitary: Facts and conclusions

    OpenAIRE

    Mitrofanova, Lubov B.; Konovalov, Petr V.; Krylova, Julia S.; Polyakova, Victoria O.; Kvetnoy, Igor M.

    2017-01-01

    Introduction plurihormonality of pituitary adenomas is an ability of adenoma cells to produce more than one hormone. After the immunohistochemical analysis had become a routine part of the morphological study, a great number of adenomas appeared to be multihormonal in actual practice. We hypothesize that the same cells of a normal pituitary gland releases several hormones simultaneously. Objective To analyse a possible co-expression of hormones by the cells of the normal anterior pituitary of...

  13. Acute anterior uveitis as the initial presentation of alkaptonuria.

    Science.gov (United States)

    John, S S; Padhan, P; Mathews, J V; David, S

    2009-01-01

    Alkaptonuria is a rare autosomal recessive metabolic disorder that may present with multi-system involvement such as ochronotic arthropathy, renal, urethral and prostatic calculi, cardiac valvular lesions and pigmentation of the skin, sclera, cartilage and other connective tissues. An association of the disease with uveitis has never been reported. We report the first case of alkaptonuria with ochronotic arthropathy presenting with recurrent acute anterior uveitis as the initial manifestation. The possible common link with the HLA-B27 gene is discussed.

  14. Linguatula serrata in the anterior chamber of the eye

    Directory of Open Access Journals (Sweden)

    Muna Bhende

    2014-01-01

    Full Text Available We report a case of intraocular Linguatula in healthy young female who presented with a history of trivial trauma, dislocated lens, inflammation and secondary glaucoma. A mobile worm was seen in the anterior chamber. Pars plana lensectomy and vitrectomy was planned to remove both the cataractous lens and the parasite during which the worm disappeared from view but was later recovered from the cassette fluid. It was identified as the nymphal form of Linguatula serrata (tongue worm.

  15. THE MINIMALLY INVASIVE METHODS OF TREATMENT OF ANTERIOR URETHRA STRICTURES

    Directory of Open Access Journals (Sweden)

    V. L. Medvedev

    2017-01-01

    Full Text Available This review is to evaluate literature concerning different methods of treatment of anterior urethra strictures: internal optical urethrotomy (OIU, laser urethrotomy, urethra stenting, urethra dilatation, OIU in combination with selfdilatation, OIU combined with chemicals injection. Evaluation of expedience, advisability and reasonableness of the chosen methods and techniques. Hereby presented statistical assessment of longtime postoperative data, low efficiency researches analysis. This research is compiled using Medline, PubMed and Embase databases.

  16. Invisible Cost Effective Mechanics for Anterior Space Closure.

    Science.gov (United States)

    Jumle, Aatish Vinod; Bagrecha, Saurabh; Gharat, Ninad; Misal, Abhijit; Toshniwal, N G

    2015-01-01

    The shifting paradigm towards invisible orthodontic treatment and also awareness in patients has allured their focus towards the most esthetic treatment approach. Also the lingual treatment is proved successful and is very well accepted by the patients. The problem that persist is its high expenses, which is not affordable by all patients. This article is a effort to treat a simple Class I malocclusion with anterior spacing using a simple, esthetic, Cost effective approach with acceptable results when esthetics plays a priority role.

  17. A functional dissociation of conflict processing within anterior cingulate cortex

    OpenAIRE

    Chobok Kim; James Kroger; Jeounghoon Kim

    2008-01-01

    Goal-directed behavior requires cognitive control to regulate neural processing when conflict is encountered. The dorsal anterior cingulate cortex (dACC) has been associated with detecting response conflict during conflict tasks. However, recent findings have indicated not only that two distinct subregions of dACC are involved in conflict processing but also that the conflict occurs at both perceptual and response levels. We clarified a functional dissociation of the caudal dACC (cdACC) and t...

  18. Indirect veneer treatment of anterior maxillary teeth with enamel hypoplasia

    OpenAIRE

    Juniarti, Devi Eka

    2010-01-01

    Background: Nowadays, aesthetic rehabilitation becomes a necessity. It is affected by patient’s background, especially career, social and economic status. The aesthetic abnormality of anterior teeth i.e discoloration, malposition and malformation can affect patient’s appearance, especially during smile. These dental abnormalities, as a result, can decrease patient’s performance. Dental malformation, for instance, can be caused by developmental tooth defect, such as enamel hypoplasia. Enamel h...

  19. Mini-Open Latarjet Procedure for Recurrent Anterior Shoulder Instability

    Directory of Open Access Journals (Sweden)

    Numa Mercier

    2011-01-01

    Full Text Available Anterior shoulder instability is a common problem. The Latarjet procedure has been advocated as an option for the treatment of anteroinferior shoulder instability. The purpose of this paper is to explain our surgical procedure titled “Mini-open Latarjet Procedure.” We detailed patient positioning, skin incision, subscapularis approach, and coracoid fixation. Then, we reviewed the literature to evaluate the clinical outcomes of this procedure.

  20. Má oclusão Classe I de Angle, com mordida aberta anterior, tratada com extração de dentes permanentes Angle Class I malocclusion, with anterior open bite, treated with extraction of permanent teeth

    Directory of Open Access Journals (Sweden)

    Mírian Aiko Nakane Matsumoto

    2011-02-01

    Full Text Available A mordida aberta é uma anomalia com características distintas que, além da complexidade dos múltiplos fatores etiológicos, traz consequências estéticas e funcionais. Muitas alternativas têm sido utilizadas em seu tratamento, entre elas a grade palatina, forças ortopédicas, ajuste oclusal, camuflagem com ou sem exodontias, mini-implantes ou miniplacas e cirurgia ortognática. O diagnóstico preciso e a determinação da etiologia permitem estabelecer os objetivos e o plano de tratamento ideal para essa má oclusão. O presente relato descreve o tratamento de uma má oclusão Classe I de Angle, com padrão esquelético de Classe II e mordida aberta anterior, realizado em duas fases e que foi apresentado à diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO, representando a categoria 2, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.Open bite is an anomaly with distinct characteristics which, in addition to involving complex, multiple etiologic factors, entails aesthetic and functional consequences. Many alternative approaches have been employed to treat open bite, including palatal crib, orthopedic forces, occlusal adjustment, camouflage with or without extractions, mini-implants or mini-plates, and orthognathic surgery. By determining accurate diagnosis and etiology professionals can set the goals and ideal treatment plan for this malocclusion. This report, describing the two stages treatment of a Angle Class I malocclusion with Class II skeletal pattern and anterior open bite, was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO, representative of category 2, as partial fulfillment of the requirements for obtaining the title of BBO Diplomate.

  1. Nonarteritic anterior ischemic optic neuropathy: cause, effect, and management

    Directory of Open Access Journals (Sweden)

    Berry S

    2017-09-01

    Full Text Available Shauna Berry,1 Weijie V Lin,2 Ama Sadaka,1 Andrew G Lee1–7 1Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA; 2Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA; 3Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch (UTMB, Galveston, TX, USA; 4Department of Ophthalmology, 5Department of Neurology, 6Department of Neurosurgery, Weill Cornell Medicine, Houston, TX, USA; 7Department of Ophthalmology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: Nonarteritic anterior ischemic optic neuropathy (NAION is the most common form of ischemic optic neuropathy and the second most common optic neuropathy. Patients are generally over the age of 50 years with vasculopathic risk factors (eg, diabetes mellitus, hypertension, and obstructive sleep apnea. The exact mechanism of NAION is not fully understood. In addition, several treatment options have been proposed. This article summarizes the current literature on the diagnosis, treatment, and management of NAION. Keywords: anterior ischemic optic neuropathy, nonarteritic anterior ischemic optic neuropathy, ischemic optic neuropathy

  2. Unilateral anterior uveitis complicating zoledronic acid therapy in breast cancer

    Directory of Open Access Journals (Sweden)

    El Saghir Nagi S

    2005-12-01

    Full Text Available Abstract Background Zoledronic acid is very widely used in patients with metastatic bone disease and osteoporosis. Only one case of bilateral uveitis was recently reported related to its use. Case presentation We report the first case of severe unilateral anterior uveitis in a patient with breast cancer and an intraocular lens. Following zoledronic acid infusion, the patient developed severe and dramatic right eye pain with decreased visual acuity within 24 hours and was found to have a fibrinous anterior uveitis of moderate severity The patient was treated with topical prednisone and atropine eyedrops and recovered slowly over several months. Conclusion Internists, oncologists, endocrinologists, and ophtalmologists should be aware of uveitis as a possible complication of zoledronic acid therapy. Patients should be instructed to report immediately to their physicians and treatment with topical prednisone and atropine eyedrops should be instituted immediately at the onset of symptoms. This report documents anterior uveitis as a complication of zoledronic acid therapy. This reaction could be an idiosyncratic one but further research may shed more light on the etiology.

  3. Diagnosis and treatment of anterior uveitis: optometric management

    Directory of Open Access Journals (Sweden)

    Harthan JS

    2016-03-01

    Full Text Available Jennifer S Harthan,1 Dominick L Opitz,2 Stephanie R Fromstein,1 Christina E Morettin3 1Cornea Center for Clinical Experience, 2Ophthalmology Services and Practice Development, 3Urgent Eye Care Service, Illinois College of Optometry, Chicago, IL, USA Abstract: Anterior uveitis encompasses inflammation of the iris and/or ciliary body and is one of the most common types of ocular inflammation that primary eye care practitioners will encounter. Anterior uveitis may be caused by a variety of etiologies, including infectious, noninfectious, and masquerade diseases. The short-term and long-term treatment of uveitis should include the evaluation of location, duration, pathology, and laterality, in addition to presenting signs and symptoms of the disease. A complete review of systems, thorough examination, and laboratory testing, may assist the practitioner in narrowing the list of possible causes for the uveitis. This is imperative as once a list of diagnoses has been made, a targeted approach to treatment can be pursued. Keywords: anterior uveitis, iritis, inflammation

  4. Hong's grading for evaluating anterior chamber angle width.

    Science.gov (United States)

    Kim, Seok Hwan; Kang, Ja Heon; Park, Ki Ho; Hong, Chul

    2012-11-01

    To compare Hong's grading method with anterior segment optical coherence tomography (AS-OCT), gonioscopy, and the dark-room prone-position test (DRPT) for evaluating anterior chamber width. The anterior chamber angle was graded using Hong's grading method, and Hong's angle width was calculated from the arctangent of Hong's grades. The correlation between Hong's angle width and AS-OCT parameters was analyzed. The area under the receiver operating characteristic curve (AUC) for Hong's grading method when discriminating between narrow and open angles as determined by gonioscopy was calculated. Correlation analysis was performed between Hong's angle width and intraocular pressure (IOP) changes determined by DRPT. A total of 60 subjects were enrolled. Of these subjects, 53.5 % had a narrow angle. Hong's angle width correlated significantly with the AS-OCT parameters (r = 0.562-0.719, P < 0.01). A Bland-Altman plot showed relatively good agreement between Hong's angle width and the angle width obtained by AS-OCT. The ability of Hong's grading method to discriminate between open and narrow angles was good (AUC = 0.868, 95 % CI 0.756-0.942). A significant linear correlation was found between Hong's angle width and IOP change determined by DRPT (r = -0.761, P < 0.01). Hong's grading method is useful for detecting narrow angles. Hong's grading correlated well with AS-OCT parameters and DRPT.

  5. Activation of anterior insula during self-reflection.

    Directory of Open Access Journals (Sweden)

    Gemma Modinos

    Full Text Available BACKGROUND: Functional neuroimaging studies have suggested activation of midline frontoparietal brain regions to be at the core of self-related processes. However, although some studies reported involvement of the insula, little attention has been paid to this region as forming part of the "self"-network. METHODOLOGY/PRINCIPAL FINDINGS: Using functional magnetic resonance imaging (fMRI, we aimed at replicating and extending previous studies by scanning subjects whilst reflecting upon their own personal qualities as compared to those of an acquaintance. A third condition with statements about general knowledge was used to control for attention, semantic processing and decision making processes. The results showed a significant effect of task in brain activity, consistent with previous findings, by which both person conditions recruited a common set of medial prefrontal and posterior regions, yet significant differences between self and other were found in the medial prefrontal cortex (MPFC and the anterior cingulate cortex (ACC. Notably, significant neural activation in the left anterior insula was observed as uniquely associated with self-reflection. CONCLUSIONS/SIGNIFICANCE: The results provide further evidence for the specific recruitment of anterior MPFC and ACC regions for self-related processing, and highlight a role for the insula in self-reflection. As the insula is closely connected with ascending internal body signals, this may indicate that the accumulation of changes in affective states that might be implied in self-processing may contribute to our sense of self.

  6. Activation of anterior insula during self-reflection.

    Science.gov (United States)

    Modinos, Gemma; Ormel, Johan; Aleman, André

    2009-01-01

    Functional neuroimaging studies have suggested activation of midline frontoparietal brain regions to be at the core of self-related processes. However, although some studies reported involvement of the insula, little attention has been paid to this region as forming part of the "self"-network. Using functional magnetic resonance imaging (fMRI), we aimed at replicating and extending previous studies by scanning subjects whilst reflecting upon their own personal qualities as compared to those of an acquaintance. A third condition with statements about general knowledge was used to control for attention, semantic processing and decision making processes. The results showed a significant effect of task in brain activity, consistent with previous findings, by which both person conditions recruited a common set of medial prefrontal and posterior regions, yet significant differences between self and other were found in the medial prefrontal cortex (MPFC) and the anterior cingulate cortex (ACC). Notably, significant neural activation in the left anterior insula was observed as uniquely associated with self-reflection. The results provide further evidence for the specific recruitment of anterior MPFC and ACC regions for self-related processing, and highlight a role for the insula in self-reflection. As the insula is closely connected with ascending internal body signals, this may indicate that the accumulation of changes in affective states that might be implied in self-processing may contribute to our sense of self.

  7. Encephalitozoon cuniculi causes focal anterior cataract and uveitis in dogs.

    Science.gov (United States)

    Nell, B; Csokai, J; Fuchs-Baumgartinger, A; Maaß, G

    2015-01-01

    Three mongrel dogs, aged 10 months (case 1), 14 months (case 2) and 7.5 years (case 3), were presented because of ophthalmologic disorders of 4 months, 6 months and 7 years duration, respectively. All three dogs were offspring of stray dogs from Hungary and Serbia and had positive serum antibody titres against Encephalitozoon (E.) cuniculi. The two young dogs showed unilateral, the older dog bilateral chronic anterior uveitis with posterior synechia and focal anterior cortical cataract. The fundi that could be evaluated developed focal tapetal hyporeflective lesions in the course of the disease. Dogs 1 and 2 underwent removal of the lens via phacoemulsification. PCR of the lens material was positive for E. cuniculi strains IV and II, respectively. In dog 2 findings suggestive of microsporidia were detected underneath the anterior lens capsule by immunohistochemical staining. In all cases medical treatment consisted of systemic fenbendazole, prednisolone, and topical anti-inflammatory drugs, and additional brinzolamid/timolol for dog 3. For the time being all cases (follow up 23 months, 6 months and 3 months, respectively) are still on topical anti-inflammatory therapy. It is concluded that E. cuniculi infections can cause cataract and chorioretinal lesions in dogs.

  8. Effects of primary selective laser trabeculoplasty on anterior segment parameters

    Science.gov (United States)

    Guven Yilmaz, Suzan; Palamar, Melis; Yusifov, Emil; Ates, Halil; Egrilmez, Sait; Yagci, Ayse

    2015-01-01

    AIM To investigate the effects of selective laser trabeculoplasty (SLT) on the main numerical parameters of anterior segment with Pentacam rotating Scheimpflug camera in patients with ocular hypertension (OHT) and primary open angle glaucoma (POAG). METHODS Pentacam measurements of 45 eyes of 25 (15 females and 10 males) patients (12 with OHT, 13 with POAG) before and after SLT were obtained. Measurements were taken before and 1 and 3mo after SLT. Pentacam parameters were compared between OHT and POAG patients, and age groups (60y and older, and younger than 60y). RESULTS The mean age of the patients was 57.8±13.9 (range 20-77y). Twelve patients (48%) were younger than 60y, while 13 patients (52%) were 60y and older. Measurements of pre-SLT and post-SLT 1mo were significantly different for the parameters of central corneal thickness (CCT) and anterior chamber volume (ACV) (P0.05). CONCLUSION SLT leads to significant increase in CCT and decrease in ACV at the 1st month of the procedure. Effects of SLT on these anterior segment parameters, especially for CCT that interferes IOP measurement, should be considered to ensure accurate clinical interpretation. PMID:26558208

  9. Hemodynamics Modeling and Simulation of Anterior Communicating Artery Aneurysms

    Directory of Open Access Journals (Sweden)

    Jianjun Li

    2014-07-01

    Full Text Available It is a general agreement that hemodynamics plays very important role in the initiation, growth, and rupture of cerebral aneurysms and hemodynamics in the anterior communicating artery aneurysms is considered the most complex in all cerebral aneurysms and it is difficult to find some reasonable relationship between the hemodynamics parameters and the rupture risk. In this paper, the 3D geometries of four anterior communicating artery aneurysms were generated from the CTA data and the computational models with bilateral feeding arteries for the four aneurysms were constructed. The blood flow was simulated by computational fluid dynamics software and the hemodynamics parameters such as velocity, wall shear stress, and oscillatory shear index were calculated. The following results were observed: one of the four models only needs the left feeding artery; the max normalized wall shear stress locates at the aneurysmal neck of the largest aneurysm; the max oscillatory shear index locates at the aneurysmal sac of the largest aneurysm. The conclusion was drawn that the anterior communicating artery aneurysm has higher rupture risk from the hemodynamics viewpoint if the max wall shear stress locates at the neck and the max oscillatory shear index locates at the dome.

  10. Hypertrophic anterior cervical osteophytes causing dysphagia and airway obstruction.

    Science.gov (United States)

    Lin, Harrison W; Quesnel, Alicia M; Holman, Allison S; Curry, William T; Rho, Michael B

    2009-10-01

    Hyperostosis of anterior cervical vertebral osteophytes can produce otolaryngological symptoms ranging from mild dysphagia, dysphonia, and foreign body sensation to severe food impaction and stridulous dyspnea. Airway compromise necessitating a tracheostomy is very rare. We discuss the case of an elderly man who presented with progressive dysphagia and a large hypopharyngeal mass as his initial manifestations of hypertrophic anterior cervical osteophytes. After a biopsy of the mass, the patient went into airway distress due to bilateral vocal fold fixation by the enlarging mass and consequently required a surgical airway. A combined team approach to the removal of the osteophytes successfully resolved his symptoms. The clinical, diagnostic, radiologic, and therapeutic principles involved in this case are presented and discussed. The recognition of hypertrophic osteophytes as a potential cause of common otolaryngological symptoms in the elderly population is paramount, as these symptoms can rapidly progress and lead to life-threatening airway obstruction. Medical and surgical interventions can be employed for the treatment of hypertrophic anterior cervical osteophytes, and they often result in favorable outcomes.

  11. Is biologic width of anterior and posterior teeth similar?

    Directory of Open Access Journals (Sweden)

    Amir Alireza Rasouli Ghahroudi

    2014-09-01

    Full Text Available The biologic width (BW includes attached epithelial cells and connective tissue attachment complex being very important in the periodontal health during prosthetic treatments as invading this zone can cause bone resorption and gingival recession. The present study investigated biologic width values in the normal periodontium in anterior and posterior teeth. 30 patients that referred from restorative department to periodontics department of Tehran University of medical sciences who need crown lengthening procedure on their teeth with no history of orthodontic, prosthodontic and periodontal treatment were randomly enrolled in this cross-sectional trial. Sulcus depths (SD as well as the distance between free gingival margin and the bone crest (FB of anterior and posterior teeth were measured by UNC-15 probe and compared. periodontium thickness was also assessed. The data were subjected to Student t test. Mean BW in the 43 anterior and 47 posterior teeth was measured and not significantly different (1.4651±0.39 mm vs. 1.6312±0.49 mm was observed; however, BW was significantly more in the teeth with thick periodontium compared to those with thin periodontium (1.703±0.5 vs. 1.408±0.35; P=0.002. BW not only is different in individuals but also could be dissimilar in different teeth and should be calculated independently prior to restorative treatments.

  12. Clinical decisions for anterior restorations: the concept of restorative volume.

    Science.gov (United States)

    Cardoso, Jorge André; Almeida, Paulo Júlio; Fischer, Alex; Phaxay, Somano Luang

    2012-12-01

    The choice of the most appropriate restoration for anterior teeth is often a difficult decision. Numerous clinical and technical factors play an important role in selecting the treatment option that best suits the patient and the restorative team. Experienced clinicians have developed decision processes that are often more complex than may seem. Less experienced professionals may find difficulties making treatment decisions because of the widely varied restorative materials available and often numerous similar products offered by different manufacturers. The authors reviewed available evidence and integrated their clinical experience to select relevant factors that could provide a logical and practical guideline for restorative decisions in anterior teeth. The presented concept of restorative volume is based on structural, optical, and periodontal factors. Each of these factors will influence the short- and long-term behavior of restorations in terms of esthetics, biology, and function. Despite the marked evolution of esthetic restorative techniques and materials, significant limitations still exist, which should be addressed by researchers. The presented guidelines must be regarded as a mere orientation for risk analysis. A comprehensive individual approach should always be the core of restorative esthetic treatments. The complex decision process for anterior esthetic restorations can be clarified by a systematized examination of structural, optical, and periodontal factors. The basis for the proposed thought process is the concept of restorative volume that is a contemporary interpretation of restoration categories and their application. © 2012 Wiley Periodicals, Inc.

  13. Anterior-posterior regionalized gene expression in the Ciona notochord.

    Science.gov (United States)

    Reeves, Wendy; Thayer, Rachel; Veeman, Michael

    2014-04-01

    In the simple ascidian chordate Ciona, the signaling pathways and gene regulatory networks giving rise to initial notochord induction are largely understood and the mechanisms of notochord morphogenesis are being systematically elucidated. The notochord has generally been thought of as a non-compartmentalized or regionalized organ that is not finely patterned at the level of gene expression. Quantitative imaging methods have recently shown, however, that notochord cell size, shape, and behavior vary consistently along the anterior-posterior (AP) axis. Here we screen candidate genes by whole mount in situ hybridization for potential AP asymmetry. We identify 4 genes that show non-uniform expression in the notochord. Ezrin/radixin/moesin (ERM) is expressed more strongly in the secondary notochord lineage than the primary. CTGF is expressed stochastically in a subset of notochord cells. A novel calmodulin-like gene (BCamL) is expressed more strongly at both the anterior and posterior tips of the notochord. A TGF-β ortholog is expressed in a gradient from posterior to anterior. The asymmetries in ERM, BCamL, and TGF-β expression are evident even before the notochord cells have intercalated into a single-file column. We conclude that the Ciona notochord is not a homogeneous tissue but instead shows distinct patterns of regionalized gene expression. Copyright © 2013 Wiley Periodicals, Inc.

  14. [Compressive anterior thoracoplasty (modified Abramson's repair) for pectus carinatum repair].

    Science.gov (United States)

    Álvarez Muñoz, V; Prado Valle, M A; López López, A J; Martínez Suárez, M A; Oviedo Gutiérrez, M; Montalvo Ávalos, C; Fernández García, L

    2014-04-15

    For anterior protruding chest wall deformities treatment, mainly pectus carinatum, pediatric surgeons have been managing either orthotic methods or open surgical repairs. Anterior compressive thoracoplasty (Abramson's technique) has widened the therapeutic options. We describe herein a modification of this technique in the first reported Europen series. From 2010 to 2012, a total of five patients (four male and one female) underwent a modified Abramson's technique to correct pectus carinatum or combined protrusion of the chest at our center. We report the operative technique used for these reconstructions. In all five cases, the operation was completed uneventfully and with excellent results either for the surgical team or the patients. Mean operative time was 190 minutes and hospitalization lasted for three to six days, at the time of analgesic drugs withdrawal. We consider the anterior compresive thorocoplasty (modified Abramson's technique) a safe and feasible method to correct protruding chest deformities, particularly in those patients with stiff chest or lack of compliance, in order to avoid the agressive open procedures.

  15. Reduced anterior internal capsule white matter integrity in primary insomnia.

    Science.gov (United States)

    Spiegelhalder, Kai; Regen, Wolfram; Prem, Martin; Baglioni, Chiara; Nissen, Christoph; Feige, Bernd; Schnell, Susanne; Kiselev, Valerij G; Hennig, Jürgen; Riemann, Dieter

    2014-07-01

    Chronic insomnia is one of the most prevalent central nervous system diseases, however, its neurobiology is poorly understood. Up to now, nothing is known about the integrity of white matter tracts in insomnia patients. In this study, diffusion tensor imaging (DTI) was used in a well-characterized sample of primary insomnia (PI) patients and good sleeper controls to fill this void. Voxelwise between-group comparisons of fractional anisotropy (FA) were performed in 24 PI patients (10 males; 14 females; 42.7 ± 14.5 years) and 35 healthy good sleepers (15 males; 20 females; 40.1 ± 9.1 years) with age and sex as covariates. PI patients showed reduced FA values within the right anterior internal capsule and a trend for reduced FA values in the left anterior internal capsule. The results suggest that insomnia is associated with a reduced integrity of white matter tracts in the anterior internal capsule indicating that disturbed fronto-subcortical connectivity may be a cause or consequence of the disorder.

  16. Age-related motor unit remodeling in the Tibialis Anterior.

    Science.gov (United States)

    Siddiqi, Ariba; Kumar, Dinesh; Arjunan, Sridhar

    2015-01-01

    Limited studies exist on the use of surface electromyogram (EMG) signal features to detect age-related motor unit remodeling in the Tibialis Anterior. Motor unit remodeling leads to declined muscle strength and force steadiness during submaximal contractions which are factors for risk of falls in the elderly. This study investigated the remodeling phenomena in the Tibialis Anterior using sample entropy and higher order statistics. Eighteen young (26.1 ± 2.9 years) and twelve elderly (68.7 ± 9.0 years) participants performed isometric dorsiflexion of the ankle at 20% maximal voluntary contraction (MVC) and their Tibialis Anterior (TA) EMG was recorded. Sample entropy, Gaussianity and Linearity Test statistics were calculated from the recorded EMG for each MVC. Shapiro-Wilk test was used to determine normality, and either a two-tail student t-test or Wilcoxon rank sum test was performed to determine significant difference in the EMG features between the young and old cohorts. Results show age-related motor unit remodeling to be depicted by decreased sample entropy (p <; 0.1), increased non-Gaussianity (p <; 0.05) and lesser degree of linearity in the elderly. This is due to the increased sparsity of the MUAPs as a result of the denervation-reinnervation process, and the decrease in total number of motor units.

  17. Stability of anterior open-bite treatment with occlusal adjustment.

    Science.gov (United States)

    Janson, Guilherme; Crepaldi, Marcus Vinicius; Freitas, Karina Maria Salvatore; de Freitas, Marcos Roberto; Janson, Waldyr

    2010-07-01

    In this study, we aimed to evaluate the long-term stability of anterior open-bite treatment with occlusal adjustment and the dentinal sensitivity caused by this procedure in the long term. The sample comprised 17 open-bite patients who experienced relapse of the negative vertical overbite after orthodontic treatment and were retreated with occlusal adjustment. The cephalometric changes were evaluated on lateral cephalograms obtained before and after the occlusal adjustment and in the long term (mean, 3.4 years after occlusal adjustment). Dentinal sensitivity was also evaluated before the occlusal adjustment, and 1.35 months, 4.61 months, and 3.4 years later. The cephalometric statuses between the 3 evaluations were compared with analysis of variance (ANOVA) and Tukey tests. The percentages of clinically significant relapse were calculated. To compare dentinal sensitivity at the several stages, nonparametric Friedman and Wilcoxon tests were performed. Statistically significant relapse of anterior open bite occurred in 33.3% of the patients. Those who had the procedure before 21 years of age were most likely to experience relapse. Dentinal sensitivity remained within the normal range in the long term. Despite the statistically significant relapse of anterior open bite, clinically significant stability was found in 66.7% of the patients. Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  18. Anterior cervical decompression and fusion with caspar plate fixation

    International Nuclear Information System (INIS)

    Rehman, L.; Akbar, H.; Das, G.; Hashim, A.S.M.

    2013-01-01

    Objective: To evaluate the role of anterior cervical decompression and fixation with Caspar plating in cervical spine injury on neurological outcome. Study Design: A case series. Place and Duration of Study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2008 to March 2011. Methodology: Thirty patients admitted with cervical spine injuries were inducted in the study. All cases were evaluated for their clinical features, level of injury and degree of neurological injury was assessed using Frankel grading. Pre and postoperative record with X-rays and MRI were maintained. Cervical traction was applied to patients with sub-luxation. All patients underwent anterior cervical decompression, fusion and Caspar plate fixation. The follow-up period was 6 months with clinical and radiological assessment. Results: Among 30 patients, 24 (80%) were males and 6 (20%) were females. Age ranged from 15 to 55 years. Causes of injury were road traffic accident (n = 20), fall (n = 8) and assault (n = 2). Commonest mode of injury was road traffic accident (66.6%). Postoperative follow-up showed that pain and neurological deficit were improved in 21 patients. There was no improvement in 7 patients, one patient deteriorated and one expired. All patients developed pain at donor site. Conclusion: Anterior decompression, fusion and fixation with Caspar plate is an effective method with good neurological and radiological outcome. However, it is associated with pain at donor site. (author)

  19. Three-dimensional bone kinematics in an anterior laxity test of the ankle joint

    NARCIS (Netherlands)

    Kerkhoffs, G.; Blankevoort, L.; Kingma, I.; van Dijk, C.N.

    2007-01-01

    Questions addressed in this in-vitro study are (1) what are the actual three-dimensional kinematics of talus and calcaneus during an anterior drawer test as performed with the quasi-static anterior ankle tester (QAAT) (2) does laxity measurement with the QAAT represent the true anterior translation

  20. Prevalence and factors associated with anterior open bite in 2 to 5 ...

    African Journals Online (AJOL)

    Prevalence and factors associated with anterior open bite in 2 to 5 year old children in Benin city, Nigeria. ... Background: Anterior open bite is said to exist when there is an actual vertical gap between the upper and lower incisors with the teeth in centric occlusion. This could occur in the anterior or posterior region, and may ...

  1. Germ Cell Tumor Located in the Midline of the Anterior Neck

    OpenAIRE

    Tatyana PIRDOPSKA; Ivan TERZIEV; Sv. HRISTOVA; W. MLADENOVSKY; R. PETKOV

    2011-01-01

    Primary germ cell tumors involving midline of the anterior neck are extremely rare. Here we report a 68-year-old male who was operated due to a mass lesion in the anterior neck with infiltration of the isthmus of the thyroid gland. Histopathological examination revealed a germ cell tumor with extragonadal localization in the anterior neck infiltrating the isthmus of the thyroid gland.

  2. Fisher Grading Scale Associated with Language Disorders in Patients with Anterior Circulation Aneurysmal Subarachnoid Hemorrhage.

    Science.gov (United States)

    de Souza, Moysés Loiola Ponte; Vieira, Ana Cláudia C; Andrade, Gustavo; Quinino, Saul; de Fátima Leal Griz, Maria; Azevedo-Filho, Hildo R C

    2015-08-01

    To associate the presence of language deficits with varying scores of the Fisher grading scale in patients with subarachnoid hemorrhage in the period preceding the treatment of aneurysm in the anterior circulation, as well as to compare the scores of this scale, identifying the grades more associated with the decline of language. Database analysis of 185 preoperative evaluations of language, through the Montreal Toulouse Protocol Alpha version and verbal fluency through CERAD battery, of patients from "Hospital da Restauração" with aneurysmal subarachnoid hemorrhage, divided according to the Fisher grading scale (Fisher I, II, III, or IV) and compared with a control group of individuals considered normal. The various scores of the Fisher grading scale have different levels of language deficits, more pronounced as the amount of blood increases. Fisher III and IV scores are most associated with the decline of language. Our study made it possible to obtain information not yet available in the literature, by correlating the various scores of the Fisher grading scale with language yet in the period preceding treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Fatores anteriores ao ingresso como preditivos de evasão nos anos iniciais dos cursos superiores de tecnologia

    OpenAIRE

    Rafaela de Menezes Souza Brissac

    2009-01-01

    Resumo: A evasão de estudantes do ensino superior evidencia-se como fenômeno complexo, com conseqüências de ordem pessoal, institucional e social. Entre os estudos que buscam aprofundar o conhecimento sobre este fenômeno encontram-se os que se detém a pesquisar as causas e fatores associados à evasão de alunos neste nível de ensino. No que se refere às variáveis associadas à ocorrência da evasão, os estudos têm mostrado que é possível localizar fatores que são anteriores ao ingresso do estuda...

  4. Da Vinci Linjen

    DEFF Research Database (Denmark)

    Nissen, Poul

    Afsluttende evalueringsrapport fra følgeforskningen gennem tre år i forbindelse med dety pædagogiske arbejde på Blåbjerggårdskolens Da Vinci Linje for skolemotiverede og underpræsterende elever på 7. til 9. klassetrin.......Afsluttende evalueringsrapport fra følgeforskningen gennem tre år i forbindelse med dety pædagogiske arbejde på Blåbjerggårdskolens Da Vinci Linje for skolemotiverede og underpræsterende elever på 7. til 9. klassetrin....

  5. O Desenvolvimento da Noção de Tempo como Integração da Distância e da Velocidade The Development of the Concept of Time as Integration of Distance and Speed

    Directory of Open Access Journals (Sweden)

    Antonio Roazzi

    2001-01-01

    Full Text Available O artigo investiga como surge e se desenvolve o conceito de tempo como integração da distância e da velocidade em uma amostra de 46 crianças de sete a dez anos de idade que estudavam em uma escola da rede pública de ensino. Os resultados diferem de achados anteriores porque mostram que mesmo as crianças de dez anos não utilizaram uma regra de divisão para realizar os julgamentos sobre tempo. Estes resultados apontam mais para diferenças em termos de experiência sociocultural e escolar do que para diferenças transculturais no desenvolvimento da noção de tempo como integração da distância e da velocidade.This study aimed at verifying how the concept of time as an integration of speed and distance emerged and developed in a sample of 46 seven to ten year-old public school children. Results were different from previous studies because even ten years-old children did not use a division rule to achieve judgements about time. These results are interpreted as due more to differences in social, cultural, and school experience than to cross-cultural differences in the development of the notion of time as integration of distance and speed.

  6. Profilaxia da peste

    Directory of Open Access Journals (Sweden)

    Renato dos Santos Araújo

    1967-12-01

    Full Text Available O autor parte da premissa de que a profilaxia da doença infecciosa decorre do encadeamento epidemiológico: fonte de infecção-veículo transmissor - receptivel, para explicar a da peste, baseada no mesmo princípio. Depois de citar os 4 principais complexos epidemiológicos da peste e afirmar que tôda a profilaxia da doença consiste em atingir os dois primeiros elos dessas cadeias e proteger o último, passa a classificar os vários métodos profiláticos empregados em 2 grandes grupos: o das medidas destrutivas ou provisórias e o das medidas supressivas ou definitivas. Entre as primeiras arrola a desratização e a despulização, às quais acrescenta o tratamento e isolamento do doente e do portaãor, e entre as segundas inclui a anti-ratização e a imunização. A seguir, passa a explicar em que consistem essas várias medidas profiláticas e quais os agentes de que se tem lançado mão para executá-las, expendendo ao curso dessa exposição o conceito que formula a respeito de cada uma delas, à guisa de apreciação do seu valor relativo. Enaltece sobretudo as medidas supressivas ou definitivas, às quais empresta a maior significação na luta antipestosa, chamando a atenção, em especial, para a necessidade de estudos imunológicos para aperfeiçoamento do poder imunitário das vacinas de germes vivos avirulentos, que considera um grande recurso para a profilaxia da doença, sobretudo para a proteção do rurícola, cujo labor e modo de vida o expõem inevitavelmente a se infectar, por ocasião da ocorrência de epizootias de origem silvestre. Concluída essa primeira parte, passa a fazer o histórico de como se desenvolveu a campanha contra a peste, no Brasil, desde a época da sua invasão em 1899 pelo pôrto de Santos até os nossos dias. Nesse histórico, detem-se um pouco para expôr a atuação do extinto Serviço Nacional de Peste, o qual, criado em 1941, após a reorganização do Departamento Nacional de Saúde, passou

  7. Pregenual Anterior Cingulate Dysfunction Associated with Depression in OCD: An Integrated Multimodal fMRI/1H MRS Study.

    Science.gov (United States)

    Tadayonnejad, Reza; Deshpande, Rangaprakash; Ajilore, Olusola; Moody, Teena; Morfini, Francesca; Ly, Ronald; O'Neill, Joseph; Feusner, Jamie D

    2018-04-01

    Depression is a commonly occurring symptom in obsessive-compulsive disorder (OCD), and is associated with worse functional impairment, poorer quality of life, and poorer treatment response. Understanding the underlying neurochemical and connectivity-based brain mechanisms of this important symptom domain in OCD is necessary for development of novel, more globally effective treatments. To investigate biopsychological mechanisms of comorbid depression in OCD, we examined effective connectivity and neurochemical signatures in the pregenual anterior cingulate cortex (pACC), a structure known to be involved in both OCD and depression. Resting-state functional magnetic resonance imaging (fMRI) and 1 H magnetic resonance spectroscopy (MRS) data were obtained from participants with OCD (n=49) and healthy individuals of equivalent age and sex (n=25). Granger causality-based effective (directed) connectivity was used to define causal networks involving the right and left pACC. The interplay between fMRI connectivity, 1 H MRS and clinical data was explored by applying moderation and mediation analyses. We found that the causal influence of the right dorsal anterior midcingulate cortex (daMCC) on the right pACC was significantly lower in the OCD group and showed significant correlation with depressive symptom severity in the OCD group. Lower and moderate levels of glutamate (Glu) in the right pACC significantly moderated the interaction between right daMCC-pACC connectivity and depression severity. Our results suggest a biochemical-connectivity-psychological model of pACC dysfunction contributing to depression in OCD, particularly involving intracingulate connectivity and glutamate levels in the pACC. These findings have implications for potential molecular and network targets for treatment of this multi-faceted psychiatric condition.

  8. Perawatan gigi impaksi anterior rahang atas pada remaja (The treatment of maxillary anterior impacted teeth in adolescent

    Directory of Open Access Journals (Sweden)

    Herdi Eko Pranjoto

    2005-09-01

    Full Text Available The incidence of impacted tooth in adolescent is usually found by oral surgeon or orthodontist during their sequence of treatments. The maxillary anterior teeth, especially canine and third lower molar are the most common impacted teeth found as the result of their eruption disturbances. The surgical technique principle is to facilitate the impacted tooth, so that it can be erupted by creating a window and take the bone obstructed surrounding the tooth crown surgically and afterward it is orthodontically tracted. In a case of third molar germ which is predicted to be impacted in mesio version position, germinectomy is preferred to prevent anterior mechanical drive during its development which may cause mal-alignment of the mandibular teeth. Germinectomy which is usually easier than odontectomy, the germ position, and less complication after the surgical intervention are three factors that should be considered in making decision.

  9. Prevalence and Length of the Anterior Loop of the Inferior Alveolar Nerve in Iranians.

    Science.gov (United States)

    Moghddam, Maryam Rastegar; Davoudmanesh, Zeinab; Azizi, Nasim; Rakhshan, Vahid; Shariati, Mahsa

    2017-10-01

    The anterior loop of the inferior alveolar nerve is a sensitive anatomical feature that should be taken into account during installation of dental implants anterior to the mental foramen. This study was conducted to explore the controversy regarding prevalence and length. A total of 452 mandible quadrants of 234 patients (age: 50.1 ± 13.3 years, 113 males, 121 females) were studied using cone-beam computerized tomography. After reconstructing axial, frontal, and sagittal slices, the region between the most anterior point on the mental foramen and the most anterior part of the mandibular nerve was inspected for signs of anterior loop presence. If positive, the length of the anterior loop was measured in mm as the distance between the anterior border of mental foramen and the anterior border of the loop. Prevalence and length of the anterior loop were compared statistically between sexes and age groups. The anterior loop was observed in 106 quadrants (23.5% of 451 quadrants) of 95 patients (40.6% of 234 patients), of whom 11 had bilateral anterior loops. Prevalences were similar in males (41%) and females (39%, chi-square P =.791). The mean anterior loop length was 2.77 ± 1.56 mm (95% CI: 2.5-3.1 mm), without significant sex (regression beta = -0.159, P = .134) or age (beta = -0.059, P = .578) differences. The anterior loop might exist in about 40% of patients, regardless of their gender. The mean safe anterior distance from the anterior loop is about 3 mm + (2.5-3.1 mm) = 5.5-6.1 mm, regardless of age.

  10. Gestão estratégica da região de Lisboa e Vale do Tejo - Relatório 1

    OpenAIRE

    Sousa, Vanessa Duarte de

    2003-01-01

    O projecto “Gestão Estratégica da RLVT”, implementado pela Comissão de Coordenação da Região de Lisboa e Vale do Tejo, constitui uma experiência inovadora no campo da aplicação prática da monitorização da gestão estratégica de uma região. Com dois documentos de relevo para a Região já editados, o “Guia para a Gestão Estratégica da RLVT” e o “Relatório 0”, apresenta-se agora o “Relatório 1”. A estrutura do “Relatório 1” reproduz a lógica do anterior, encontrando-se organizado por domínios ...

  11. Early experience using the da Vinci Surgical System for the treatment of mediastinal tumors.

    Science.gov (United States)

    Kajiwara, Naohiro; Taira, Masahiro; Yoshida, Koichi; Hagiwara, Masaru; Kakihana, Masatoshi; Usuda, Jitsuo; Uchida, Osamu; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

    2011-10-01

    The da Vinci Surgical System has been used in only a few cases for treating mediastinal tumors in Japan. Recently, we used the da Vinci Surgical System for various types of anterior and middle mediastinal tumors in clinical practice. We report our early experience using the da Vinci Surgical System. Seven patients gave written informed consent to undergo robotic surgery for mediastinal tumor dissection using the da Vinci Surgical System. We evaluated the safety and feasibility of this system for the surgical treatment of mediastinal tumors. Two specialists in thoracic surgery who are certified to use the da Vinci S Surgical System and another specialist acted as an assistant performed the tumor dissection. We were able to access difficult-to-reach areas, such as the mediastinum, safely. All the resected tumors were classified as benign tumors histologically. The average da Vinci setting time was 14.0 min, the average working time was 55.7 min, and the average overall operating time was 125.9 min. The learning curve for the da Vinci setup and manipulation time was short. Robotic surgery enables mediastinal tumor dissection in certain cases more safely and easily than conventional video-assisted thoracoscopic surgery and less invasively than open thoracotomy.

  12. Multiquadrant robotic colorectal surgery: the da Vinci Xi vs Si comparison.

    Science.gov (United States)

    Protyniak, Bogdan; Jorden, Jeffrey; Farmer, Russell

    2018-03-01

    The newly introduced da Vinci Xi Surgical System hopes to address the shortcomings of its predecessor, specifically robotic arm restrictions and difficulty working in multiple quadrants. We compare the two robot platforms in multiquadrant surgery at a major colorectal referral center. Forty-four patients in the da Vinci Si group and 26 patients in the Xi group underwent sigmoidectomy or low anterior resection between 2014 and 2016. Patient demographics, operative variables, and postoperative outcomes were compared using descriptive statistics. Both groups were similar in age, sex, BMI, pelvic surgeries, and ASA class. Splenic flexure was mobilized in more (p = 0.045) da Vinci Xi cases compared to da Vinci Si both for sigmoidectomy (50 vs 15.4%) and low anterior resection (60 vs 29%). There was no significant difference in operative time (219.9 vs 224.7 min; p = 0.640), blood loss (170.0 vs 188.1 mL; p = 0.289), length of stay (5.7 vs 6 days; p = 0.851), or overall complications (26.9 vs 22.7%; p = 0.692) between the da Vinci Xi and Si groups, respectively. Single-dock multiquadrant robotic surgery, measured by splenic flexure mobilization with concomitant pelvic dissection, was more frequently performed using the da Vinci Xi platform with no increase in operative time, bleeding, or postoperative complications. The new platform provides surgeons an easier alternative to the da Vinci Si dual docking or combined robotic/laparoscopic multiquadrant surgery.

  13. Elastic Knee Sleeves Limit Anterior Tibial Translation in Healthy Females

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    Robert Csapo, Simona Hosp, Ramona Folie, Robert Eberle, Michael Hasler, Werner Nachbauer

    2016-03-01

    Full Text Available Knee sleeves or braces represent auxiliary tools that have repeatedly been used by athletes, in an attempt to increase knee stability and, thus, reduce the risk of (recurrent ligamentous injuries. Since ACL injuries typically occur in situations involving either torsion or hyperextension of the knee, it has been speculated that braces might protect the ACL by countering excessive anterior translation of the tibia with respect to the femur (Beynnon et al., 1997. However, the preponderance of in vivo studies to test this hypothesis was performed in cohorts of patients suffering from existent ligamentous (Branch et al., 1988; Colville et al., 1986 or other knee injury (Beynnon et al., 1997; Fleming et al., 2000. This complicates the extrapolation of results to healthy subjects. Further, the braces used in these studies were mostly rigid constructs that consisted of either uni- or bilateral hinged bars (Rishiraj et al., 2009. Such braces might hinder performance (Veldhuizen et al., 1991 and would be rejected by the vast majority of healthy athletes. For these reasons, we would like to use this letter to the editor to report the results of our experiments investigating whether a relatively light elastic knee sleeve would limit the degree of anterior tibial translation in computerized arthrometry tests as performed in a sample of non-injured subjects. We recruited ten female college students (age: 23.4 ± 3.2 yrs, height: 1.68 ± 0.05 m, mass: 59.9 ± 5.5 kg who were free of acute or previous injury or any form of orthopaedic disease of the knee joints. The anterior displacement of the tibia was measured using the GNRB® computerized arthrometer (GeNouRob, Laval, France. With subjects lying in the supine position, the lower leg was firmly fixed with plastic caps mounted over the ankle joint and patella. An electrical pressure pad then exerted increasing pressure of up to 250 N on the calf, while a motion sensor, which was positioned on the ventral

  14. Pseudoaneurysm of the Anterior Tibial Artery following Ankle Arthroscopy in a Soccer Player

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    Ichiro Tonogai

    2017-01-01

    Full Text Available Ankle arthroscopy carries a lower risk of vascular complications when standard anterolateral and anteromedial portals are used. However, the thickness of the fat pad at the anterior ankle affords little protection for the thin-walled anterior tibial artery, rendering it susceptible to indirect damage during procedures performed on the anterior ankle joint. To our knowledge, only 11 cases of pseudoaneurysm involving the anterior tibial artery after ankle arthroscopy have been described in the literature. Here we reported a rare case of a 19-year-old soccer player who presented with pseudoaneurysm of the anterior tibial artery following ankle arthroscopy using an ankle distraction method and underwent anastomosis for the anterior tibial artery injury. Excessive distraction of the ankle puts the neurovascular structures at greater risk for iatrogenic injury of the anterior tibial artery during ankle arthroscopy. Surgeons should look carefully for postoperative ankle swelling and pain after ankle arthroscopy.

  15. Abdominoplastia por plicatura anterior longitudinal na síndrome de prune belly: experiência inicial do hospital municipal Jesus

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    Lisieux Eyer de Jesus

    Full Text Available OBJETIVO: Apresentar os resultados iniciais com o uso da técnica de abdominoplastia longitudinal anterior por plicatura parietal descrita por Furness et al (1998 no Hospital Municipal Jesus. MÉTODO: Descrevemos as características e resultados dos primeiros pacientes tratados em nosso serviço, inclusive duas modificações adotadas com relação à técnica descrita, a saber, a exploração retroperitoneal sistemática para cura da criptorquia bilateral simultânea à abdominoplastia e a celiotomia "de segurança" para todos os pacientes operados. RESULTADOS: O seguimento dos pacientes foi de 1,5 ano, 15 meses e 10 meses, respectivamente. Foi possível demonstrar que a técnica adotada foi de fácil execução e pequena morbidade, com resultados estéticos satisfatórios, grande melhora das condições psicológicas e do convívio social para os pacientes desde o pós-operatório imediato, melhora da constipação crônica, capacidade aeróbica e postura. Quanto às repercussões urodinâmicas, aguardamos reavaliação a longo prazo, para conclusões mais efetivas. CONCLUSÃO: A abdominoplastia longitudinal anterior é uma técnica de fácil execução e segura para o tratamento da síndrome de prune belly e melhora a capacidade funcional muscular abdominal. Tem conseqüências urodinâmicas, que necessitam de avaliação após longo prazo.

  16. Anterior lumbar fusion with titanium threaded and mesh interbody cages.

    Science.gov (United States)

    Rauzzino, M J; Shaffrey, C I; Nockels, R P; Wiggins, G C; Rock, J; Wagner, J

    1999-12-15

    The authors report their experience with 42 patients in whom anterior lumbar fusion was performed using titanium cages as a versatile adjunct to treat a wide variety of spinal deformity and pathological conditions. These conditions included congenital, degenerative, iatrogenic, infectious, traumatic, and malignant disorders of the thoracolumbar spine. Fusion rates and complications are compared with data previously reported in the literature. Between July 1996 and July 1999 the senior authors (C.I.S., R.P.N., and M.J.R.) treated 42 patients by means of a transabdominal extraperitoneal (13 cases) or an anterolateral extraperitoneal approach (29 cases), 51 vertebral levels were fused using titanium cages packed with autologous bone. All vertebrectomies (27 cases) were reconstructed using a Miami Moss titanium mesh cage and Kaneda instrumentation. Interbody fusion (15 cases) was performed with either the BAK titanium threaded interbody cage (in 13 patients) or a Miami Moss titanium mesh cage (in two patients). The average follow-up period was 14.3 months. Seventeen patients had sustained a thoracolumbar burst fracture, 12 patients presented with degenerative spinal disorders, six with metastatic tumor, four with spinal deformity (one congenital and three iatrogenic), and three patients presented with spinal infections. In five patients anterior lumbar interbody fusion (ALIF) was supplemented with posterior segmental fixation at the time of the initial procedure. Of the 51 vertebral levels treated, solid arthrodesis was achieved in 49, a 96% fusion rate. One case of pseudarthrosis occurred in the group treated with BAK cages; the diagnosis was made based on the patient's continued mechanical back pain after undergoing L4-5 ALIF. The patient was treated with supplemental posterior fixation, and successful fusion occurred uneventfully with resolution of her back pain. In the group in which vertebrectomy was performed there was one case of fusion failure in a patient with

  17. Novel spatula and dissector for safer deep anterior lamellar keratoplasty

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    Gustavo ,2,3 Bonfadini

    2014-10-01

    Full Text Available Objective: We describe a novel spatula and dissector to facilitate the big-bubble technique in deep anterior lamellar keratoplasty (DALK. Methods: A 29-year-old man who was diagnosed with bilateral keratoconus underwent deep anterior lamellar keratoplasty (DALK. After 350μm partial thickness incision of the recipient cornea, the Bonfadini dissector was inserted at the deepest point in the peripheral incision and could be advanced to the center of the cornea safely because of its "semi-sharp" tip. After achieving the big-bubble (BB separation of Descemet membrane (DM from the overlying stroma, the anterior stromal disc was removed. Viscoelastic material was placed on the stromal bed to prevent uncontrolled collapse and perforation of DM during the paracentesis blade incision into the BB. We could detect the safe opening of the BB using the Bonfadini dissector by the leakage of air bubbles into the viscoelastic material. After injecting viscoelastic material into the BB space, we inserted the Bonfadini spatula into the bigbubble safely because of its curved profile and blunt edges. The groove along the length of the Bonfadini spatula enables safe and efficient incision or the residual stromal tissue using the pointed end of a sharp blade while protecting the underlying DM. After removal of posterior stroma, the donor button was sutured with 16 interrupted 10-0 nylon sutures. Results: This technique and the use of the Bonfadini spatula and dissector facilitate exposure of Descemet membrane. Conclusion: The smooth Bonfadini DALK spatula and dissector facilitate safe and efficient completion of DALK surgery.

  18. Fusion Rates of Different Anterior Grafts in Thoracolumbar Fractures.

    Science.gov (United States)

    Antoni, Maxime; Charles, Yann Philippe; Walter, Axel; Schuller, Sébastien; Steib, Jean-Paul

    2015-11-01

    Retrospective CT analysis of anterior fusion in thoracolumbar trauma. The aim of this study was to compare fusion rates of different bone grafts and to analyze risk factors for pseudarthrosis. Interbody fusion is indicated in anterior column defects. Different grafts are used: autologous iliac crest, titanium mesh cages filled with cancellous bone, and autologous ribs. It is not clear which graft offers the most reliable fusion. Radiologic data of 116 patients (71 men, 45 women) operated for type A2, A3, B, or C fractures were analyzed. The average age was 44.6 years (range, 16-75 y) and follow-up was 2.7 years (range, 1-9 y). All patients were treated by posterior instrumentation followed by an anterior graft: 53 cases with iliac crest, 43 cases with mesh cages, and 20 with rib grafts. Fusion was evaluated on CT and classified into complete fusion, partial fusion, unipolar pseudarthrosis, and bipolar pseudarthrosis. Iliac crest fused in 66%, cages in 98%, and rib grafts in 90%. The fusion rate of cages filled with bone was significantly higher as the iliac graft fusion rate (P=0.002). The same was applied to rib grafts compared with iliac crest (P=0.041). Additional bone formation around the main graft, bridging both vertebral bodies, was observed in 31 of the 53 iliac crests grafts. Pseudarthrosis occurred more often in smokers (P=0.042). A relationship between fracture or instrumentation types, sex, age, BMI, and fusion could not be determined. Tricortical iliac crest grafts showed an unexpected high pseudarthrosis rate in thoracolumbar injuries. Their cortical bone is dense and their fusion surface is small. Rib grafts led to a better fusion when used in combination with the cancellous bone from the fractured vertebral body. Titanium mesh cages filled with cancellous bone led to the highest fusion rate and built a complete bony bridge between vertebral bodies. Smoking seemed to influence fusion. Case control study, Level III.

  19. Clinical analysis of acute anterior uveitis in 215 cases

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    Xue-Wei Zhou

    2013-11-01

    Full Text Available AIM: To analyze the etiology, therapeutic effects,risk of relapse and prognosis of acute anterior uveitis.MEHTODS: Medical history of 215 patients with acute anterior uveitis who underwent treatment in Department of Ophthalmology, People's Hospital of Fenghua was collected, together with results of clinical examinations and auxiliary examinations. The data were studied in terms of therapeutic effects, etiological factors, prognosis and relapse rate. RESULTS: In 85 cases(39.5%, the cause was identified, and among the among the most frequent causes were traumatic or surgical injury, viral infection and glaucomatocyclitic crisis. After treatment, the best corrected visual acuity was no less than 1.0 in 153 cases(71.2%, between 0.5 and 1.0 in 55 cases(25.6%, between 0.3 and 0.5 in 4 cases(1.9%, between 0.05 and 0.3 in 2 cases(0.9%, and less than 0.05 in 1 case(0.5%. During the follow-up of more than 6 months, relapse occurred in 4 cases(1.9%during 4-6 months, in 7 cases(3.2%during 7-12 months, in 10 cases(4.7%during 13-24 months, and in 3 cases(1.4%during 25-60 months. CONCLUSION: The etiology of acute anterior uveitis is complicated and mostly idiopathic. Vision prognosis is good after treatment, but therelapse rate is high and can cause visual impairment, so better understanding should be gained of its relapse and its prevention and early treatment should be emphasized.

  20. Effects of primary selective laser trabeculoplasty on anterior segment parameters

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    Suzan Guven Yilmaz

    2015-10-01

    Full Text Available AIM:To investigate the effects of selective laser trabeculoplasty (SLT on the main numerical parameters of anterior segment with Pentacam rotating Scheimpflug camera in patients with ocular hypertension (OHT and primary open angle glaucoma (POAG.METHODS: Pentacam measurements of 45 eyes of 25 (15 females and 10 males patients (12 with OHT, 13 with POAG before and after SLT were obtained. Measurements were taken before and 1 and 3mo after SLT. Pentacam parameters were compared between OHT and POAG patients, and age groups (60y and older, and younger than 60y.RESULTS: The mean age of the patients was 57.8±13.9 (range 20-77y. Twelve patients (48% were younger than 60y, while 13 patients (52% were 60y and older. Measurements of pre-SLT and post-SLT 1mo were significantly different for the parameters of central corneal thickness (CCT and anterior chamber volume (ACV (P<0.05. These parameters returned back to pre-SLT values at post-SLT 3mo. Decrease of ACV at post-SLT 1mo was significantly higher in younger than 60y group than 60y and older group. There was no statistically significant difference in Pentacam parameters between OHT and POAG patients at pre- and post-treatment measurements (P>0.05.CONCLUSION:SLT leads to significant increase in CCT and decrease in ACV at the 1st month of the procedure. Effects of SLT on these anterior segment parameters, especially for CCT that interferes IOP measurement, should be considered to ensure accurate clinical interpretation.

  1. Placement of implant bridge anterior maxilla post autograft (Serial case

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    Rifaat Nurrahma

    2016-06-01

    Full Text Available An advanced technology with implants based has now been developed in recent years.Implant with the bridge superstructure method is employed after variety of considerations where it is expected to meet its function, aesthetics, and comfortability.The alveolar bone existed is one reason for the process of adding bone (bonegraft.This case report proposes to determine the successful insertion of a superstructure anterior implant bridge post autograft.Two female patients were asked to use dental implant anterior with bridge system.The first case, the autograft application is made for a 20-year-old woman with edentulous teeth 11, 21, 22. One year later it was then inserted in the area of dental implant fixture 11 and 22. After 9 months, the healing abutments and the superstructure were inserted too.2 weeks after, the abutments of bridge and crowns of teeth 11, 21 and 22 with a pontic in the teeth 21 had been inserted. The second case, a 46-year-old woman with edentulous 11,12,21,22.They want to change the denture because they did not feel comfortable with the removable denture acrylic.Fixture placement was done a year after autograft.Insertion of healing abutments and the superstructure printing can be done after 6 months.A month later implant abutments and crowns could be inserted.Labial fullness is corrected; an implant-retained in the region of 12 and 21, 12, and 22 used the pontic.Prosthodontic rehabilitation with a fixed denture using the implant bridge after autograft anterior maxilla is an alternative fixed denture placement with satisfactory results, aesthetic correction and comfortably.

  2. Anterior urethral valves: not such a benign condition…

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    Omar eCruz-Diaz

    2013-11-01

    Full Text Available Purpose: Anterior urethral valves (AUV is an unusual cause of congenital obstruction of the male urethra, being 15 to 30 times less common than posterior urethral valves (PUV. It has been suggested that patients with congenital anterior urethral obstruction have a better prognosis than those with PUV.The long term prognosis of anterior urethral valves is not clear in the literature. In this report we describe our experience and long-term follow up of patients with AUV.Materials and methods: We retrospectively identified 13 patients who presented with the diagnosis of AUV in our institutions between 1994 and 2012. From the 11 patients included, we evaluated the gestational age, ultrasound and voiding cystourethrogram findings, age upon valve ablation, micturition pattern, creatinine and clinical follow up.Results: Between 1994 and 2012 we evaluated 150 patients with the diagnosis of urethral valves, where 11 patients (7.3% had AUV and an adequate follow up. Mean follow up is 6.3 years. 5 patients (45.4% had pre-natal diagnosis of AUV. The most common prenatal ultrasonographic finding was bilateral hydronephrosis and distended bladder.The mean gestational age was 37.6 weeks. Postnatally, 90% had trabeculated bladder, 80% hydronephrosis and 40% renal dysplasia. The most common clinical presentation was urinary tract infection in 5 patients (45.4%.7 patients (63.6% had primary transurethral valve resection or laser ablation and 3 patients (27.2% had primary vesicostomies. One boy (9.1% had urethrostomy with urethral diverticulum excision. 2 patients (18.2% developed end-stage renal disease (ESRD.Conclusions: Early urinary tract obstruction resulted in ESRD in 18% of our patient population. In our series, the complication rate and the evolution to renal failure are high and similar to patients with PUV. In patients with AUV we recommend long-term follow up and close evaluation of patient’s bladder and renal function.

  3. Clinical outcomes of pars plicata anterior vitrectomy: 2-year results

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    Priya Narang

    2015-01-01

    Full Text Available Purpose: To demonstrate the safety and outcome of a surgical approach that uses pars plicata site for anterior vitrectomy during phacoemulsification procedure complicated by posterior capsule rupture and residual cortical matter. Design: Single center, retrospective, interventional, noncomparative study. Materials and Methods: Medical records of a consecutive series of 35 eyes of 35 patients who underwent pars plicata anterior vitrectomy (PPAV were reviewed. The main outcome measures were corrected and uncorrected distance visual acuity (CDVA, UDVA, early and late postoperative complications and intraocular pressure (IOP. Ultrasound biomicroscopic (UBM evaluation of sclerotomy site and spectral domain optical coherence tomography analysis for central macular thickness (CMT was performed. The final visual outcome at 2 years was evaluated. Results: At 2 years follow-up, the mean postoperative UDVA (logarithm of the minimum angle of resolution [logMAR] and CDVA (logMAR was 0.49 ± 0.26 and 0.19 ± 0.14, respectively. There was no significant change in the IOP (P = 0.061 and the mean CMT at 2 years was 192.5 ± 5.54 mm. The postoperative UBM image of the sclerotomy site at 8 weeks demonstrated a clear wound without any vitreous adhesion or incarceration. Intraoperative hyphema was seen in 1 (2.8% case and postoperative uveitis was seen in 2 (5.7% cases, which resolved with medications. No case of an iatrogenic retinal break or retinal detachment was reported. Conclusions: PPAV enables a closed chamber approach, allows thorough cleanup of vitreous in the pupillary plane and anterior chamber and affords better access to the subincisional and retropupillary cortical remnant with a significant visual outcome and an acceptable complication rate.

  4. Recurrent instability after revision anterior shoulder stabilization surgery.

    Science.gov (United States)

    Friedman, Lisa Genevra Mandeville; Griesser, Michael J; Miniaci, Anthony A; Jones, Morgan H

    2014-03-01

    The purpose of this study was to perform a systematic review of the literature to compare outcomes of revision anterior stabilization surgeries based on technique. This study also sought to compare the impact of bone defects on outcomes. A systematic review of the electronic databases PubMed, Cochrane Central Register of Controlled Trials, and Scopus was performed in July 2012 and March 2013. Of 345 articles identified in the search, 17 studies with Level I to IV Evidence satisfied the inclusion criteria and were analyzed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Recurrent instability was defined as redislocation, resubluxation, or a positive apprehensive test after revision surgery. Procedures were categorized as arthroscopic Bankart repair, open Bankart repair, Bristow-Latarjet procedure, and other open procedures. In total, 388 shoulders were studied. Male patients comprised 74.1% of patients, 66.7% of cases involved the dominant shoulder, the mean age was 28.2 years, and the mean follow-up period was 44.2 months. The surgical procedures classified as "other open procedures" had the highest rate of recurrent instability (42.7%), followed by arthroscopic Bankart repair (14.7%), the Bristow-Latarjet procedure (14.3%), and open Bankart repair (5.5%). Inconsistent reporting of bone defects precluded drawing significant conclusions. A number of different procedures are used to address recurrent instability after a primary operation for anterior shoulder instability has failed. There is significant variability in the rate of recurrent instability after revision anterior shoulder stabilization surgery. Level IV, systematic review of Level I to IV studies. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse.

    Science.gov (United States)

    Altman, Daniel; Väyrynen, Tapio; Engh, Marie Ellström; Axelsen, Susanne; Falconer, Christian

    2011-05-12

    The use of standardized mesh kits for repair of pelvic-organ prolapse has spread rapidly in recent years, but it is unclear whether this approach results in better outcomes than traditional colporrhaphy. In this multicenter, parallel-group, randomized, controlled trial, we compared the use of a trocar-guided, transvaginal polypropylene-mesh repair kit with traditional colporrhaphy in women with prolapse of the anterior vaginal wall (cystocele). The primary outcome was a composite of the objective anatomical designation of stage 0 (no prolapse) or 1 (position of the anterior vaginal wall more than 1 cm above the hymen), according to the Pelvic Organ Prolapse Quantification system, and the subjective absence of symptoms of vaginal bulging 12 months after the surgery. Of 389 women who were randomly assigned to a study treatment, 200 underwent prolapse repair with the transvaginal mesh kit and 189 underwent traditional colporrhaphy. At 1 year, the primary outcome was significantly more common in the women treated with transvaginal mesh repair (60.8%) than in those who underwent colporrhaphy (34.5%) (absolute difference, 26.3 percentage points; 95% confidence interval, 15.6 to 37.0). The surgery lasted longer and the rates of intraoperative hemorrhage were higher in the mesh-repair group than in the colporrhaphy group (Pmesh-repair group and 0.5% in the colporrhaphy group (P=0.07), and the respective rates of new stress urinary incontinence after surgery were 12.3% and 6.3% (P=0.05). Surgical reintervention to correct mesh exposure during follow-up occurred in 3.2% of 186 patients in the mesh-repair group. As compared with anterior colporrhaphy, use of a standardized, trocar-guided mesh kit for cystocele repair resulted in higher short-term rates of successful treatment but also in higher rates of surgical complications and postoperative adverse events. (Funded by the Karolinska Institutet and Ethicon; ClinicalTrials.gov number, NCT00566917.).

  6. Pure laparoscopic right hepatectomy for giant hemangioma using anterior approach.

    Science.gov (United States)

    Kim, Seok-Hwan; Kim, Ki-Hun; Kirchner, Varvara A; Lee, Sang-Kyung

    2017-05-01

    Laparoscopic major hepatectomy remains a challenging procedure [1, 2]. In the case of giant tumors in the right liver, conventional approach (complete mobilization of the right liver before parenchymal transection) could be dangerous during mobilization because of large volume and weight [3, 4]. We present the case of a pure laparoscopic right hepatectomy for a giant hemangioma using an anterior approach. We achieved the informed consent with this patient and approved by the Ethics Committee of the Asan Medical Center. Giant hemangioma (13 × 11 × 14 cm) was located in right liver. After glissonean approach [5], Pringle maneuver was performed during the hepatic parenchymal transection. For the transection, the Cavitron Ultrasonic Surgical Aspirator was used. Small hepatic vein branches along the middle hepatic vein and small glissonean pedicles were sealed and divided with a THUNDERBEATTM (Olympus), which is the device with integration of both bipolar and ultrasonic energies delivered simultaneously. iDriveTM Ultra Powered Stapling device (Medtronic) was used for division of right glissonean pedicle and large hepatic veins. Hemangioma was removed through the lower abdominal transverse incision using the endo-bag. This technique has the advantage of avoiding excessive bleeding caused by avulsion of the hepatic vein and caval branches, iatrogenic tumor rupture [3]. By means of the anterior approach, pure laparoscopic right hepatectomy was performed successfully without intraoperative complications and transfusions. The operation time was 202 min, and the estimated blood loss was less than 150 ml. On postoperative day 3, computed tomographic scan showed no pathological findings. The patient was discharged on postoperative day 5 without complications. Laparoscopic approach has good results because of the view with magnification enabling meticulous hemostasis and the small wounds that give patients less pain [6, 7]. The authors recommend that the laparoscopic

  7. da Zehirlenmeleri

    Directory of Open Access Journals (Sweden)

    Necati Akbulut

    2015-02-01

    Full Text Available Gıda Teknolojisinin gelişmesi ile, gıda maddesinin tüketici için daha alımlı olmasını sağlamak, kısa zamanda bozulmasını engellemek ve pazara yeni çeşitler sunmak için bazı kimyasal maddeler kullanılmaya başlanılmıştır. Bunun yanında tarımda kullanılan kimyasal maddeler artmış, ambalaj sanayi gelişmiş, bu dada maddelerine bulaşan maddelerin türlerini arttırmıştır. Ayrıca gıda maddelerine belirli amacı olmadan katılan maddelerde vardır. Diğer taraftan tüketiciyi aldatmak, hile yapmak, çok kar sağlamak veya kötü kaliteyi gizlemek amacı ile de kullanılan maddeler bulunmaktadır. İster teknik zorunluk, ister hile amacıyla olsun bu tür yabancı maddeler öncelikle insan sağlığını ilgilendirmektedir. Bazı maddelerin vücuda alınması sakıncasız olduğu halde, bazıları sakıncalıdır. Sakıncasız olanlarında belirli bir sınırın üzerinde uzun süre alınmaları zararlı olabilmektedir. Bu toplum sağlığı sorunu birçok ülkeyi gıda sanayiinde kullanılan kimyasal maddelerin hoşgörü sınırlarının hesaplanması noktasına götürmüştür.

  8. Anatomical evidence for the anterior plate fixation of sacroiliac joint.

    Science.gov (United States)

    Bai, Zhibiao; Gao, Shichang; Liu, Jia; Liang, Anlin; Yu, Weihua

    2018-01-01

    The iatrogenic injuries to the lumbar nerves during the fixation the sacroiliac (SI) joint fractures with anterior plates were often reported. No specific method had been reported to avoid it. This study was done to find a safer way of placing the anterior plates and screws for treating the sacroiliac (SI) joint fracture and/or dislocation. The research was performed using 8 male and 7 female normal corpse pelvic specimens preserved by 10% formalin solution. Try by measuring the horizontal distance from L4, L5 nerve roots to the sacroiliac joint and perpendicular distance from L4, L5 nerve roots to the ala sacralis, the length of L4, L5 nerve roots from intervertebral foramen to the edge of true pelvis, the diameter of L4, L5 nerve roots. The angles between the sacroiliac joint and sagittal plane were measured on the CT images. The horizontal distance between the lateral side of the anterior branches of L4, L5 nerve roots and the sacroiliac joint decreased gradually from the top to the bottom. The widest distances for L4,5 were 2.1 cm (range, 1.74-2.40) and 2.7 cm (range, 2.34-3.02 cm), respectively. The smallest distances for L4, 5 were 1.2 cm (range, 0.82-1.48 cm) and 1.5 cm (range, 1.08-1.74 cm), respectively. On CT images, the angle between the sacroiliac joint and sagittal plane was about 30°. If we use two anterior plates to fix the sacroiliac joint, It is recommended to place one plate on the superior one third part of the joint, with exposing medially no more than 2.5 cm and the other in the middle one third part of the joint, with elevating periosteum medially no more than 1.5 cm. The screws in the sacrum are advised to incline medially about 30° directing to the true pelvis. Copyright © 2017. Published by Elsevier B.V.

  9. Separation of cells from the rat anterior pituitary gland

    Science.gov (United States)

    Hymer, W. C.; Hatfield, J. Michael

    1984-01-01

    Data concerned with analyzing the cellular organization of the rat anterior pituitary gland are examined. The preparation of the cell suspensions and the methods used to separate pituitary cell types are described. Particular emphasis is given to velocity sedimentation at unit gravity, density gradient centrifugation, affinity methods, fluorescence activated cell sorting, and density gradient and continuous-flow electrophoresis. The difficulties encountered when attempting to compare data from different pituitary cell separation studies are discussed, and results from various experiments are presented. The functional capabilities of the separated cell populations can be tested in various culture systems.

  10. A checklist for endonasal transsphenoidal anterior skull base surgery.

    Science.gov (United States)

    Laws, Edward R; Wong, Judith M; Smith, Timothy R; de Los Reyes, Kenneth; Aglio, Linda S; Thorne, Alison J; Cote, David J; Esposito, Felice; Cappabianca, Paolo; Gawande, Atul

    2016-06-01

    OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management

  11. Anterior Cruciate Ligament Reconstruction in Ehlers-Danlos Syndrome

    Directory of Open Access Journals (Sweden)

    John Williams

    2015-01-01

    Full Text Available This report details the reconstruction of the anterior cruciate ligament in an 18-year-old man with Ehlers-Danlos syndrome (EDS. The reduced mechanical properties of the tissue in EDS can pose a challenge to the orthopaedic surgeon. In this case, we describe the use of a hamstring autograft combined with a Ligament Advanced Reinforcement System (LARS. There was a good radiographical, clinical, and functional outcome after two years. This technique gave a successful outcome in the reconstruction of the ACL in a patient with EDS and therefore may help surgeons faced with the same clinical scenario.

  12. Recurrent unicystic ameloblastoma in mandibular anterior teeth area

    International Nuclear Information System (INIS)

    Lee, Won Do; Lee, Wan; Kim, Jin Hoa; Choi, Dong Hoon; Paeng, Jun Young; Kim, Eun Cheol

    2008-01-01

    The unicystic ameloblastoma (UA) is a variant of the solid or multicystic ameloblastoma, a less encountered variant of the ameloblastoma. It appears more frequently in the second or third decade with no sexual or racial predilection. It is almost exclusively encountered asymptomatically in the posterior mandible. We report a case of a 43-year old patient with UA, who had previously undergone a surgical treatment on the same site about 1 year ago, this lesion recurred and presented as an exophytic gingival lesion in the anterior mandibular region.

  13. Anteriorly placed tumors to the conus: removal by interradicular window.

    Science.gov (United States)

    Ciappetta, P; Taurone, S; Spoletini, M; Artico, M

    2017-01-01

    Tumors anteriorly situated to the medullary conus are rarely encountered and represent a true surgical challenge. We examined the literature on this topic, concluding that there are no previous reports on alternative surgical techniques different to the traditional one. We report two cases of intradural extramedullary tumor operated on by a technique performed through a window opened between the spinal roots, which allows an easy, effective and useful resection. We describe a new operative technique which ensures a complete removal of these tumors and discuss clinical implications in the light of the available literature on this topic.

  14. Nonarteritic anterior ischaemic optic neuropathy in Addison's disease.

    Science.gov (United States)

    Ross, A H; Haider, S; Bailey, C C

    2010-10-01

    To report three cases of Nonarteritic anterior ischaemic optic neuropathy (NAAION) in patients with Addison's disease. We present a retrospective review of patients presenting with NAAION with underlying Addison's disease. Three eyes of two young patients presented with NAAION. Both patients had underlying Addison's disease with episodes of prolonged hypotension. To our knowledge, this is the first published report of NAAION associated with Addison's disease. As hypotension may be one of the few situations, in which NAAION may be treatable and the visual loss reversible, it is important to recognize and treat sustained episodes of hypotension in these individuals.

  15. Progressive bilateral anterior sacral meningoceles in Marfan syndrome

    International Nuclear Information System (INIS)

    Scheck, R.J.; Schramm, T.; Gloning, K.P.; Vogl, T.; Ostermayer, E.

    1995-01-01

    Anterior sacral meningoceles (ASM) in Marfan syndrome are rare. They may cause constipation, urinary frequency, dysmenorrhoea, and low back pain or numbness. This report describes bilateral ASM at the level of S1, S2 and S3 in a woman with Marfan syndrome who was admitted to the gynaecology department for evaluation of left lower abdominal pain. The magnetic resonance appearance of the meningoceles is discussed and compared with findings from transvaginal ultrasound and CT. As MRI offers excellent delineation of spinal and pelvic structures, it is the most useful technique available in establishing the diagnosis and planning the treatment of ASM. (orig.)

  16. Progressive bilateral anterior sacral meningoceles in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Scheck, R J [Dept. of Radiology, Univ. Muenchen (Germany); Schramm, T [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany); Gloning, K P [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany); Vogl, T [Dept. of Radiology, Univ. Muenchen (Germany); Ostermayer, E [Dept. of Gynaecology and Obstetrics, 1. Frauenklinik, Univ. Muenchen (Germany)

    1995-08-01

    Anterior sacral meningoceles (ASM) in Marfan syndrome are rare. They may cause constipation, urinary frequency, dysmenorrhoea, and low back pain or numbness. This report describes bilateral ASM at the level of S1, S2 and S3 in a woman with Marfan syndrome who was admitted to the gynaecology department for evaluation of left lower abdominal pain. The magnetic resonance appearance of the meningoceles is discussed and compared with findings from transvaginal ultrasound and CT. As MRI offers excellent delineation of spinal and pelvic structures, it is the most useful technique available in establishing the diagnosis and planning the treatment of ASM. (orig.)

  17. Sensitivitas Gigi Anterior Perempuan Suku Sasak yang Melaksanakan Tradisi Ngasaq

    Directory of Open Access Journals (Sweden)

    Edeh Roletta Haroen

    2015-09-01

    Full Text Available “Nqasaq” or tooth grinding traditional is the one of the culture of the Sasak’s ethnic group in Lombok. The sensation of tingling or acute tooth pain as the result of tooth erosion have been the symptom that became the prominent complaint of the “pengasaq”. The aim of the research were obtained the illustration and the difference in sensitivity interelements of the anterior tooth of the adolescent and young adult Sasak’s ethnic group women that carried out “ngasaq”. The method of the research was quasi experimental through the approach of the electrical stimulus from the dentotest tester to induce the physiological tooth pain, that were measured the NARN, pain reaction threshold. The subjects of the research were the anterior tooth of the 30 healthy adolescent and young adult Sasak’s ethnic group women that carried out “ngasaq” and as the control of the research were the tooth of the 30 subjects without “ngasaq”. The results of the research showed that the mean of the pain reaction threshold (NARN of the maxillary and mandibulary anterior tooth that were the central incisors, and the canines after “ngasaq” in the adolescent were: 4.15; 4.38; 5.48 and 3.08; 3.75; 4.85; in the young adult were: 2.26; 2.78; 4.03; and 2.52; 2.77; 3.70. Without “ngasaq”, in the adolescent were: 4.52; 5.37; 6.25 and 3.40; 3.77; 5.25; in the young adult: 3.00; 3.23; 34.33 and 3.17; 3.40; 4.12. The statistical test t Student (p = 0.05 in the adolescent showed that t were: 1.52; 1.43; 1.10 and 0.99; 0.56; 0.77; in young adult were: 0.808; 1.38; 0.793 and 0.588; 0.517; 0.992. The conclusion of the research showed that the mean of the “pengasaq” tooth sensitivity was relatively more lower than tooth sensitivity without “ngasaq”, so that was no significant tooth sensitivity difference in the interelements of the anterior tooth, in the adolescent and young adult of the Sasak’s ethnic group women.

  18. Pregnancy tumor: A rare case report in mandibular anteriors

    Directory of Open Access Journals (Sweden)

    Swati Phore

    2017-01-01

    Full Text Available Pregnancy in a woman's life is associated with a variety of physiological, anatomical, and hormonal changes that can affect the cardiovascular, respiratory, and gastrointestinal systems. Such hormonal changes may lead to periodontal diseases and may be associated with generalized or localized gingival enlargements. Pregnancy does not cause the condition, but altered tissue metabolism in pregnancy accentuates the response to the local irritants, thereby causing gingival enlargements. In this report, a 25-year-old pregnant female had a localized gingival enlargement in the labial aspect of the mandibular anterior region.

  19. Acute anterior uveitis as the initial presentation of alkaptonuria

    Directory of Open Access Journals (Sweden)

    Padhan P

    2009-01-01

    Full Text Available Alkaptonuria is a rare autosomal recessive metabolic disorder that may present with multi-system involvement such as ochronotic arthropathy, renal, urethral and prostatic calculi, cardiac valvular lesions and pigmentation of the skin, sclera, cartilage and other connective tissues. An association of the disease with uveitis has never been reported. We report the first case of alkaptonuria with ochronotic arthropathy presenting with recurrent acute anterior uveitis as the initial manifestation. The possible common link with the HLA-B27 gene is discussed.

  20. Eder Puestow dilatation of benign rectal stricture following anterior resection.

    Science.gov (United States)

    Woodward, A; Tydeman, G; Lewis, M H

    1990-01-01

    Benign anastomotic stricture following anterior resection can be difficult to manage when the stricture is proximal. The acceptable surgical options are either a redo low resection with its accompanying hazards or, alternatively, the formation of a permanent colostomy. Although dilatation of such strictures is possible by blind passage of metal bougies, the authors believe that this technique must be regarded as hazardous. A technique of dilatation is described that is usually reserved for esophageal stricture, namely, Eder Puestow dilatation over a guide wire inserted under direct vision. Although this technique may not be without risk, this readily available equipment may be valuable in making a further resection unnecessary.

  1. Return to Play Following Anterior Shoulder Dislocation and Stabilization Surgery.

    Science.gov (United States)

    Donohue, Michael A; Owens, Brett D; Dickens, Jonathan F

    2016-10-01

    Anterior shoulder instability in athletes may lead to time lost from participation and decreases in level of play. Contact, collision, and overhead athletes are at a higher risk than others. Athletes may successfully be returned to play but operative stabilization should be considered for long-term treatment of recurrent instability. Open and arthroscopic stabilization procedures for athletes with less than 20% to 25% bone loss improve return to play rates and decrease recurrent instability, with a slightly lower recurrence with open stabilization. For athletes with greater than 20% to 25% bone loss, an open osseous augmentation procedure should be considered. Published by Elsevier Inc.

  2. Ceratectomia lamelar anterior profunda usando a técnica "big-bubble" em pacientes com ceratocone

    Directory of Open Access Journals (Sweden)

    Sandro Antonini Coscarelli

    2012-02-01

    Full Text Available OBJETIVOS: Avaliar através de um estudo retrospectivo pacientes com ceratocone, a partir do 12º mês após a ceratectomia lamelar anterior profunda usando a técnica "big-bubble". MÉTODOS: Estudo retrospectivo de consecutivos 79 olhos de 71 pacientes com ceratocone moderado a grave, com baixa acuidade visual após as correções ópticas e intolerantes à adaptação de lente de contato. Todos os transplantes foram realizados pelo mesmo experiente cirurgião, no período de janeiro de 2007 a fevereiro de 2009, utilizando a técnica de ceratectomia lamelar anterior profunda pelo "big-bubble". Os dados analisados foram sexo, idade, paquimetria corneana, densidade endotelial, astigmatismo dinâmico e melhor acuidade visual corrigida (BCVA após a ceratectomia. RESULTADOS: A idade média verificada foi de 30,4 (± 10,2 anos, com 39 (54,9% do sexo feminino e 32 (45,1% do masculino. A paquimetria ultrassônica média foi de 518,6 (± 29,5 μm. Setenta e dois (91,1% dos transplantes realizados obtiveram acuidade visual dinâmica corrigida melhor ou igual a 20/50. A média do astigmatismo dinâmico foi de - 3,5 (± 1,5 dioptrias cilíndricas. A média da densidade endotelial encontrada conforme a faixa etária teve a distribuição com os pacientes de 11 a 20 anos com 3.053 (± 532 cél/mm²; 21 a 30 anos com 2.674 (± 725 cél/mm²; 31 a 40 anos com 2.737 (± 575 cél/mm²; 41 a 50 anos com 2.585 (± 476 cél/mm² e 51 a 60 anos com 2.398 (± 667 cél/mm². Microperfuração no per-operatório teve uma incidência de 8,8%. CONCLUSÃO: A ceratectomia lamelar anterior profunda pela técnica "big-bubble" é um valioso tratamento para pacientes com ceratocone, alcançando uma melhor acuidade visual corrigida final semelhante ao transplante penetrante. A contagem média de células endoteliais apresenta-se dentro da normalidade para a faixa etária após o procedimento. Não foram encontradas córneas rejeitadas ou com edema após a retirada de todos os

  3. Factores de Risco da Asma Grave

    Directory of Open Access Journals (Sweden)

    N. Adel

    1999-07-01

    Full Text Available RESUMO: Apesar da rápida progressão do conhecimento da fisiopatologia da asma e da larga difusão de meios terapêuticos de eficácia acrescida, observase um aumento da morbalidade e da morbildade da asma em numerosos paises, em particular nos paises industrialtzados, por razões ainda pouco conhecidas Estes factos permitem questionar o funcionamento do sistema de cuidados de saúde e a difusão dos progressos terapêuticos na população asmática. Os autores definem o concetto de asma aguda grave, salientando dois tipos: o tipo 1, de «instalação progressiva» em algumas horas ou dtas eo upo 2 de «instalação brutal» em menos de três horas Os factores de risco para cada urn deles parecem ser diferentes.Os autores fazem uma revisão dos factores de risco da asma grave, tendo em conta as caracterisucas individuais do doente, os factores ambientats e a intervenção da sociedade.Em relação aos factores individuais como a idade e o sexo, verificase que na infância, as taxas de internarmento por asma são mais elevadas no sexo masculino, sendo no total de internamentos em todas as idades, mais elevadas no sexo feminino e em doentes com internamentos anteriores por asma. O aumento da mortalidade por asma atinge em particular os doentes jovens economicamente desfavorecidos, pela dificuldade no acesso aos cuidados de saúde e na compra dos medicamentos, por utilizarem com menor frequência os tratamentos de crise e de fundo. Os factores psicológicos podem predispor à morte por asma no adolescente, sendo relevantes a subvalo-rização e a negação da doença por parte do doente ou da família Verificase por outro lado, um aumento da prevalência da depressão e do desespero nas cnanças com asma grave. As reacçõs psicológicas face a acontecimentos negauvos, como a morte de um ente próximo, a perda de emprego, conflitos familiares, provocam maior

  4. A REFORMA DA IGREJA

    Directory of Open Access Journals (Sweden)

    Vítor Galdino Feller

    2014-01-01

    Full Text Available O pontificado do papa Francisco trouxe à tona o tema da reforma da Igreja. Retoma-se essa causa que acompanha a história da Igreja desde os seus primórdios e que interessa a todos os membros do povo santo de Deus. O texto divide-se em quatro partes. Primeiro, faz-se um apanhado histórico dos anseios de reforma da Igreja, mostrando que, muitas vezes em instâncias subterrâneas, sempre houve o desejo e também ações concretas de renovação. Em seguida, apresenta-se como razão para a reforma da Igreja o anúncio e a realização do Reino de Deus, pelo qual é preciso que a Igreja se volte à concretude humana e histórica de Jesus de Nazaré, pela superação do apego ao poder e às estruturas religiosas. Num terceiro momento, trata-se do critério pelo qual se mede a realização e a veracidade da reforma da Igreja: a santidade de cada fiel e do povo cristão no meio do mundo. Por fim, conclui-se que o caminho para a reforma da Igreja está na escuta dos clamores do Espírito Santo, que fala na própria Igreja e no mundo através do sensus fidei dos fiéis, das Igrejas particulares, dos pobres, das mulheres e das realidades terrestres. ABSTRACT: The pontificate of Pope Francis brought to the surface the theme of reform of the Church. This essay takes up this cause that accompanies the history of the Church from its beginnings and concerns all the members of the holy people of God. The text is divided into four parts. First, it gives a historical summary of the yearnings for reform of the Church, showing that, in many instances subterranean, there has always been the desire and also the concrete actions of renewal. Following from this, the essay presents as the reason for the reform of the Church the proclamation and the realization of the Kingdom of God, whereby it is necessary that the Church return to the concrete human and historical Jesus of Nazareth, in order to overcome the addiction to power and to religious structures. In the

  5. A cultura da internet

    OpenAIRE

    Cádima, Francisco Rui

    2017-01-01

    O novo ambiente digital é cada vez mais perturbante na sua dimensão ‘visível’ e está, em boa parte, incontrolável nessa área ainda algo desconhecida da Internet negra, conhecida por deep web ou dark net, convoca-nos para uma reflexão profunda de largo espectro, que não se pode vincular apenas às questões de mercado, tecnológicas e de redes, mas que nos vem alertar sobretudo para a ordem do político e da cidadania, do ‘desconhecido’ e do conhecimento e, enfim, do acesso à rede, quer no que is...

  6. [da Vinci surgical system].

    Science.gov (United States)

    Watanabe, Gou; Ishikawa, Norihiro

    2014-07-01

    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  7. A utilização da teoria da aprendizagem significativa no ensino da Enfermagem

    OpenAIRE

    Alana Tamar Oliveira de Sousa; Nilton Soares Formiga; Simone Helena dos Santos Oliveira; Marta Miriam Lopes Costa; Maria Júlia Guimarães Oliveira Soares

    2015-01-01

    RESUMO Objetivo: sintetizar a produção científica acerca da Teoria da Aprendizagem Significativa no processo de ensino-aprendizagem em Enfermagem. Método: revisão integrativa realizada nas bases de dados MEDLINE, LILACS, SciELO, BDENF e CINAHL, com artigos que abordaram a temática ou aspectos da teoria da aprendizagem significativa de David Ausubel. Fizeram parte da amostra dez artigos, sendo seis escritos no idioma português e quatro no inglês, publicados de 1998 a 2013. Resultados: cinco...

  8. Os (descaminhos da identidade

    Directory of Open Access Journals (Sweden)

    Oliveira Roberto Cardoso de

    2000-01-01

    Full Text Available A conferência procurou apresentar uma interpretação das vicissitudes da identidade étnica e/ou nacional quando observada em situações de ambigüidade. É quando o processo identitário expressa crises reais ou virtuais, como as que têm lugar entre imigrantes latino-americanos nos Estados Unidos, entre povos de diferentes regiões da Espanha emigrados para Barcelona, entre catalães espanhóis, franceses e andorranos residentes em Andorra, e entre povos indígenas em regiões de fronteira do Brasil com países vizinhos. O exame do processo identitário que tem lugar em diferentes latitudes, nas Américas e na Europa, sugere que os fenômenos socioculturais de etnicidade e de nacionalidade possuem em comum características tais como a busca de reconhecimento da pessoa moral, o respeito à diferença e, como corolário ético, a elevação do que se pode definir como "taxa de consideração".

  9. Hepatotoxicidade da cianotoxina microcistina

    Directory of Open Access Journals (Sweden)

    Andréa de Castro Leal

    2004-01-01

    Full Text Available Constitui interesse emergente em saúde pública avaliar a possibilidade de intoxicação humana por biotoxinas de algas cianofíceas, principalmente as hepatotoxinas do grupo das microcistinas. A microcistina, um heptapeptídeo monocíclico, é produzida principalmente pela cianobactéria Microcistis aeruginosa. São caracterizadas por alguns aminoácidos variáveis, dois deles com uma estrutura não usual que possuem importante papel na hepatotoxidade da microcistina. Apesar do acometimento humano atribuído as microcistinas incluírem gastroenterite, reações alérgicas ou irritativas, neurotoxicidade, o principal alvo da toxina é o fígado. Nos hepatócitos as microcistinas são carreadas pelo sistema transportador do ácido biliar, inibindo a atividade da proteína fosfatase no citoplasma. A inibição leva a mudanças morfológicas na membrana plasmática pela hiperfosforilação de citoqueratinas, e à atividade de promoção tumoral pelas proteínas hiperfosforiladas. Os métodos de detecção e quantificação de microcistinas no ambiente incluem a cromatografia líquida, o bioensaio em camundongos e os testes imunoenzimáticos. O último vem ganhando destaque pela praticidade e alta sensibilidade.

  10. Comparação entre a atividade EMG do peitoral maior, deltóide anterior e tríceps braquial durante os exercícios supino reto e crucifixo Comparación entre la actividad EMG del pectoral mayor, deltoide anterior y tríceps braquial durante los ejercicios supino recto y cruz Comparison among the EMG activity of the pectoralis major, anterior deltoidis and triceps brachii during the bench press and peck deck exercises (200/2005

    Directory of Open Access Journals (Sweden)

    Valdinar de Araújo Rocha Júnior

    2007-02-01

    Full Text Available A identificação das peculiaridades de cada movimento e sua adequação aos objetivos do treinamento é uma tarefa que exige a interação de vários conhecimentos. Tal tarefa é fundamental para o sucesso nas diversas modalidades esportivas e programas de treinamento com fins de reabilitação e/ou estética. O objetivo do presente estudo foi comparar a atividade eletromiográfica (EMG dos músculos peitoral maior (PM, deltóide anterior (DA e tríceps braquial (TB durante a execução dos exercícios supino reto com barra (SP e crucifixo na máquina (CR. As atividades EMG dos músculos PM, DA e TB foram avaliadas durante a realização de 10 repetições máximas no CR e SP em 13 homens treinados. Os resultados não revelaram diferenças na atividade do PM e DA entre os exercícios. A atividade do TB foi maior na realização do SP em comparação com o CR. Durante o SP, a atividade do PM foi maior em relação ao TB, sem diferenças entre PM e DA ou DA e TB. No CR, a atividade do PM e a do DA foram maiores em relação ao TB, sem diferenças entre DA e PM. De acordo com os resultados obtidos no presente estudo pode-se concluir que, caso o objetivo do treinamento seja promover estímulos para o DA ou PM, ambos os exercícios podem ser usados, dependendo da disponibilidade de materiais e/ou da especificidade da atividade motora na qual se procura melhorar a performance.La identificación de las peculiaridades de cada movimiento y su adecuación a los objetivos de entrenamiento es una tarea que exige la interacción de varias áreas de conocimiento. Tal tarea es fundamental para el éxito en las diversas modalidades deportivas y programas de entrenamiento con fines de rehabilitación y/o estética. El objetivo del presente estudio ha sido comparar la actividad electromiográfica (EMG de los músculos pectoral mayor (PM, deltoides anterior (DA y tríceps braquial (TB durante la ejecución de los ejercicios supino recto con barra (SP y de cruz en

  11. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    Energy Technology Data Exchange (ETDEWEB)

    De Brito, Ana Caroline Ramos; Nejaim, Yuri; De Freitas, Deborah Queiroz [Dept. of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Sao Paulo (Brazil); De Oliveira Santos, Christiano [Dept. of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Sao Paulo (Brazil)

    2016-09-15

    The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.

  12. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    International Nuclear Information System (INIS)

    De Brito, Ana Caroline Ramos; Nejaim, Yuri; De Freitas, Deborah Queiroz; De Oliveira Santos, Christiano

    2016-01-01

    The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region

  13. Surgical approach to giant aneurysms of the anterior circulation.

    Science.gov (United States)

    Giombini, S; Solero, C L; Ferraresi, S; Melcarne, A; Broggi, G; Pluchino, F

    1988-01-01

    The surgical approach to cerebral giant aneurysms is still a source of great concern. We describe our experience with giant aneurysms of the anterior circulation and discuss the different surgical techniques adopted. During the period January 1972-December 1985, a total of 33 patients were operated upon at the Istituto Neurologico "C. Besta" of Milan for a giant aneurysm of the anterior circulation. Nineteen cases had suffered subarachnoid haemorrhage before admission; in 14 cases the hospitalization was due to evidence of mass effect on the surrounding neurovascular structures. All aneurysms were directly approached: in 24 cases the neck was occluded by a suitable clip, in 4 cases intramural thrombosis was attempted, in 3 cases the aneurysms were definitively trapped and in one case aneurysmorrhaphy was performed after resection of the sac. Operative mortality was 12%. Long-term follow-up shows good results whenever exclusion of the aneurysm from cerebral circulation had been achieved, either after removal of the sac or not; on the contrary, only fair or poor results were evident when other surgical techniques were adopted, either electively or out of necessity. The importance of intraoperative protection and monitoring of brain function is stressed.

  14. Sonourethrography of anterior urethral strictures: assessment of length and degree

    International Nuclear Information System (INIS)

    Kim, Jong Chul; Jeong, Youn Sin

    1994-01-01

    We reviewed out experience of sonourethrography(SUG) in male anterior urethral strictures to correlate the stricture length and degree seen on SUG with those on urethroscopy, surgery or biopsy. During the recent 6 years,both the retrograde urethrography (RUG) and SUG were preformed in 50 occasions for 47 patients with anteriorurethral stricture, that were subsequently evaluated urethroscopically or at surgery. As a whole, the length of the stricture seen on SUG did not correlate very well with that seen on RGU (r2=0.71, p<0.005). Considering the data from the operation as the gold standard, SUG was more accurate than RUG in depicting the exact stricturelength (r2=0.97 and 0.75 respectively,p<0.005). The shorter the lesion, the more accurate the data obtained.Although SUG certainly identified periurethral tissue, it was not adequate in predicting the depth of spongiofibrosis compared with full-depth biopsies in 20 patients. In conclusion, SUG, a dynamic study, accurately defined the stricture site, number and calibre. When compared with RUG, SUG was more accurate in the measurement of stricture length and in the demonstration of periurethral tissue, making it a valuable method in the evaluation of patients with suspected anterior urethral strictures

  15. Treatment of anterior communicating artery aneurysms with Guglielmi detachable coils

    International Nuclear Information System (INIS)

    Xu Yi; Liu Jianmin; Hong Bo; Zhao Wenyuan; Huang Qinghai; Zhang Xin; Zhang Long

    2003-01-01

    Objective: To summarize the experience on endovascular treatment of anterior communicating artery aneurysms with Guglielmi detachable coils (GDCs) in 262 cases. Methods: All aneurysms were embolized with GDCs. Catheterization at both ICA was used to monitor the patency of parent arteries for patients with well-developed A1 segment of both ACAs. Microcatheter-assisted or microwire-assisted technique was undertaken to keep patency of parent arteries if the aneurysmal neck was involved with A2 segment. Thirty-four cases with multiple aneurysms had been treated successfully only in one session. Results: Complete embolization was achieved in 160 cases, while subtotal in 56 (>90%) and partial in 46 (<90%). Occlusion of parent arteries developed in 10 cases because of over-occlusion, and cerebral infarction was found in 16 cases after the procedure. Three cases with procedure-related thrombosis were revascularized by urokinase profusion. Follow-up angiograms of 3-6 months showed recanalization in 8 cases requiring a second time session. One case of recurrent aneurysm after GDC treatment was cured by surgical clipping. Conclusions: The result of endovascular treatment of anterior communicating artery aneurysms is fruitful and seems to be an alternative method in improving the rate of occlusion and reducing the cerebral infarction

  16. STUDY OF ANTERIOR CRUCIATE LIGAMENT INJURY AND ITS MANAGEMENT

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    Tummala Venkata

    2016-03-01

    Full Text Available BACKGROUND The anterior cruciate ligament is the weaker of the two cruciate ligaments stabilizing the knee joint, and therefore gets torn easier than the posterior cruciate ligament. OBJECTIVE To determine pattern of anterior cruciate ligament injury and its management in a tertiary care center. MATERIALS AND METHODS A prospective study was carried out for two years, 28 patients with ACL injury were included. A detailed history regarding the pattern of injury was noted and ACL reconstruction was done using BT Bautograft with mini-arthrotomy and arthroscopic assisted ACL reconstruction. RESULTS The mean age of the study subjects was 30.6±7.3 years & majority were males. Majority of the ACL injury was sports related & was on the right knee. 64% underwent arthroscopic assisted ACL reconstruction & majority of them had normal range of motion of the knee. CONCLUSION Our present study concludes that most common age group involved was 20-30 years & ACL injury was more common among males. Patients with an early ACL reconstruction were more satisfied with the end result. Also, ACL reconstruction techniques using BTB auto graft leads to good ligamentous stability and function of the knee.

  17. Bilateral anterior thalamic low densities in descending transtentorial herniation

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    Nagashima, Chikao; Watanabe, Takao

    1985-02-01

    Round, well-demarcated, symmetrical low densities in a bilateral thalamus in a case of descending transtentorial herniation due secondarily to acute traumatic left subdural hematoma are reported. An 8-year-old boy, on whom emergency surgery was refused by his parents, showed a marked shift due to the hematoma on admission; this was followed by a low density in the left PCA territory and round, equivocal hypodensities in the anterior thalamus 44 hours post-trauma. The equivocal hypodensities became definite, well-demarcated, round low densities situated symmetrically in the anterior thalamus on the 39th day post-trauma. Akinetic mutism was noted at this time. The symmetrical low densities and the PCA-territory low density persisted as late as the 39th day post-trauma, suggesting infarcts. The downward stretch of the bilateral thalamoperforators, which was effected by a narrowing of the interpeduncular fossa with an approximation of the bilateral perforators, plus a downward shift of the PCA due to descending transtentorial herniation, was assumed to be the mechanism involved. (author).

  18. Anterior chamber angle assessment using gonioscopy and ultrasound biomicroscopy.

    Science.gov (United States)

    Narayanaswamy, Arun; Vijaya, Lingam; Shantha, B; Baskaran, Mani; Sathidevi, A V; Baluswamy, Sukumar

    2004-01-01

    Comparison of anterior chamber angle measurements using ultrasound biomicroscopy (UBM) and gonioscopy. Five hundred subjects were evaluated for grading of angle width by the Shaffer method. UBM was done in the same group to document angle width, angle opening distance (AOD 500), and anterior chamber depth. Biometric parameters were documented in all subjects. UBM and gonioscopic findings were compared. A study was conducted in 282 men and 218 women with a mean age of 57.32 +/- 12.48 years. Gonioscopic grading was used to segregate occludable (slit-like, grades 1 and 2) from nonoccludable (grades 3 and 4) angles. Subjective assessment by gonioscopy resulted in an overestimation of angle width within the occludable group when compared with values obtained by UBM. This did not affect the segregation of occludable versus nonoccludable angles by gonioscopy. Biometric parameters in eyes with occludable angles were significantly lower in comparison with eyes with nonoccludable angles, except for lens thickness. AOD 500 correlated well with angle width. We concluded that clinical segregation into occludable and nonoccludable angles by an experienced observer using gonioscopy is fairly accurate. However, UBM is required for objective quantification of angles, and AOD 500 can be a reliable and standard parameter to grade angle width.

  19. A new skeletal retention system for retaining anterior open bites

    Directory of Open Access Journals (Sweden)

    Bodore Albaker

    2013-01-01

    Full Text Available Objectives: Relapse of anterior open bite after treatment poses a challenge to orthodontists and warrants finding new methods. We aimed to compare the effect of a skeletal retention (SR system to the conventional retention (CR commonly used. Materials and Methods: Twenty patients participated in this study. SR group ten patients (five females and five males with mean age of 16.2 years, CR group ten patients (five females and five males with mean age of 17.1 years in pretreatment stage. The SR system is comprised of four self-drilling miniscrews and vacuum retainers with interarch elastics where the CR group is comprised of removable or fixed retainers. Pretreatment (T1, posttreatment (T2, and 1-year follow up (T3 lateral cephalograms were taken and analyzed to compare the stability of both retention modalities. Results: The overbite in the CR group showed more relapse in the form of significant reduction when compared to the SR group (P < 0.001. The overbite was reduced only by 0.1 mm (±0.3 in the SR group compared to 1.4 mm (±0.9 in the CR group. In the CR group, the upper incisors and first molar showed a more significant relapse compared to the SR group (P < 0.05. Conclusion: Skeletal retention using miniscrews and vertical elastic is an effective method for retention of anterior open bite cases.

  20. Extradural anterior clinoidectomy: Technical nuances from a learner's perspective

    Science.gov (United States)

    Mishra, Shashwat; Leão, Baltazar; Rosito, Diego Mendez

    2017-01-01

    Background: Extradural removal of the anterior clinoid process (ACP) is a crucial step in the proper surgical exposure of various pathologies in and around the central skull base. Since the pioneering description by Dolenc, the technique of extradural clinoidectomy has undergone several refinements in the light of improved understanding of microsurgical anatomy and maturation of neurosurgical techniques. Mastery of the surgical nuances involved in performing this surgical exercise will allow the young neurosurgeon to execute this step without undue reluctance and trepidation. Objective: This paper is an attempt to describe in detail, from a learner's viewpoint, the sequence of maneuvers involved in extradural removal of the ACP. Materials and Methods: The standard pterional approach and extradural anterior clinoidectomy was performed on four sides of two formalin fixed and latex injected cadaver heads. Important steps were photographed through the surgical microscope. Conclusion: An accurate understanding of the microsurgical anatomy of this region and the surgical nuances relevant to extradural clinoidectomy helps simplify the complexity of this surgical step. PMID:28484528

  1. Steal phenomenon through the anterior communicating artery in Moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Soo Mee [Ewha Womans University, Department of Radiology, Mok-dong Hospital, College of Medicine, Seoul (Korea); Chae, Eun Jin; Kim, Min Yeong; Kim, Sang Joon; Choi, Choong Gon; Pyun, Hae Wook; Suh, Dae Chul [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Kim, Jae Kyun [Seoul Veterans Hospital, Department of Radiology, Seoul (Korea); Ahn, Jae Sung; Ra, Young-Shin [University of Ulsan, Asan Medical Center, Department of Neurosurgery, College of Medicine, Seoul (Korea); Kim, Jong-Uk; Hahm, Kyung Don [University of Ulsan, Asan Medical Center, Department of Anesthesiology, College of Medicine, Seoul (Korea)

    2007-01-15

    Branch occlusion of the anterior cerebral artery (ACA) is regarded as a part of Moyamoya disease. The purpose of this study is to define the ACA steal phenomenon (SP) in Moyamoya disease and to evaluate temporal changes according to the disease progression. From 139 Moyamoya patients we defined ACASP as narrowing of the ipsilateral A1-2 junction while preserving the anterior communicating artery and supplying the contralateral ACA cortical branches with the development of leptomeningeal collaterals by the ipsilateral middle cerebral artery into the hypoperfused ipsilateral ACA territory. Direction of the steal related to the stage in both hemispheres by Suzuki classification was statistically analyzed using the binomial test based on binomial distribution. Follow-ups of ACASP were evaluated in five patients. We identified ACASP in 13 (9%) patients (male:female=7:6, mean age 18 years, range: 2-58 years) of the 139 study patients. The presenting pattern was ischemic in 12 and hemorrhagic in one. The direction of SP occurred from the hemisphere in the lower to the higher stage of Suzuki classification (two-tail P value=0.0002). After revascularization surgery, ACASP disappeared or diminished. ACASP may occur in bilaterally different stages of Moyamoya disease as a transient self-adaptive process. It regresses after revascularization surgery. (orig.)

  2. Peripapillary Pachychoroid in Nonarteritic Anterior Ischemic Optic Neuropathy

    Science.gov (United States)

    Nagia, Lina; Huisingh, Carrie; Johnstone, John; Kline, Lanning B.; Clark, Mark; Girard, Michael J. A.; Mari, Jean Martial; Girkin, Christopher A.

    2016-01-01

    Purpose This study examined the peripapillary choroidal thickness (PCT) in nonarteritic ischemic optic neuropathy (NAION) in comparison to contralateral eyes and normal eyes. Methods We used enhanced depth imaging spectral-domain optical coherence tomography to image the optic nerve head of 20 NAION, 10 contralateral eyes, and 102 normal eyes. Following compensation, the scans were manually delineated to identify relevant surfaces including Bruch's membrane opening (BMO), Bruch's membrane, and anterior sclera. The PCT was defined as the measurement between Bruch's membrane and the anterior sclera and was measured at increasing distance from BMO. Models adjusted for age, BMO area, and axial length were used to compare the mean PCT between NAION and normal eyes, and contralateral eyes and normal eyes. Paired t-tests were used to compare the PCT between NAION and contralateral eyes. Results The mean PCT was thicker in NAION and contralateral eyes when compared with normal eyes at all distances from BMO (P < 0.001). The PCT was not significantly thicker in contralateral eyes when compared with affected NAION eyes. Choroidal thickness was thinnest in the inferior quadrant in all eyes regardless of the group. Conclusions Increased peripapillary choroidal thickness was noted in both NAION and contralateral eyes. The thicker choroid may be an associated feature or a result of the disorder. Although further longitudinal study is required to determine causation, these findings may suggest that a thickened peripapillary choroid may be a component of the disk-at-risk clinical phenotype. PMID:27583829

  3. Sellar plasmacytoma presenting with symptoms of anterior pituitary dysfunction

    Directory of Open Access Journals (Sweden)

    Ana G Ferreira

    2017-11-01

    Full Text Available Sellar plasmacytomas are rare and the differential diagnosis with non-functioning pituitary adenomas might be difficult because of clinical and radiological resemblance. They usually present with neurological signs and intact anterior pituitary function. Some may already have or eventually progress to multiple myeloma. We describe a case associated with extensive anterior pituitary involvement, which is a rare form of presentation. A 68-year-old man was referred to our Endocrinology outpatient clinic due to gynecomastia, reduced libido and sexual impotence. Physical examination, breast ultrasound and mammography confirmed bilateral gynecomastia. Blood tests revealed slight hyperprolactinemia, low testosterone levels, low cortisol levels and central hypothyroidism. Sellar MRI showed a heterogeneous sellar mass (56 × 60 × 61 mm, initially suspected as an invasive macroadenoma. After correcting the pituitary deficits with hydrocortisone and levothyroxine, the patient underwent transsphenoidal surgery. Histological examination revealed a plasmacytoma and multiple myeloma was ruled out. The patient was unsuccessfully treated with radiation therapy (no tumor shrinkage. Myeloma ultimately developed, with several other similar lesions in different locations. The patient was started on chemotherapy, had a bone marrow transplant and is now stable (progression free on lenalidomide and dexamethasone. The presenting symptoms and panhypopituitarism persisted, requiring chronic replacement treatment with levothyroxine, hydrocortisone and testosterone.

  4. Laparoscopic anterior resection: new anastomosis technique in a pig model.

    Science.gov (United States)

    Bedirli, Abdulkadir; Yucel, Deniz; Ekim, Burcu

    2014-01-01

    Bowel anastomosis after anterior resection is one of the most difficult tasks to perform during laparoscopic colorectal surgery. This study aims to evaluate a new feasible and safe intracorporeal anastomosis technique after laparoscopic left-sided colon or rectum resection in a pig model. The technique was evaluated in 5 pigs. The OrVil device (Covidien, Mansfield, Massachusetts) was inserted into the anus and advanced proximally to the rectum. A 0.5-cm incision was made in the sigmoid colon, and the 2 sutures attached to its delivery tube were cut. After the delivery tube was evacuated through the anus, the tip of the anvil was removed through the perforation. The sigmoid colon was transected just distal to the perforation with an endoscopic linear stapler. The rectosigmoid segment to be resected was removed through the anus with a grasper, and distal transection was performed. A 25-mm circular stapler was inserted and combined with the anvil, and end-to-side intracorporeal anastomosis was then performed. We performed the technique in 5 pigs. Anastomosis required an average of 12 minutes. We observed that the proximal and distal donuts were completely removed in all pigs. No anastomotic air leakage was observed in any of the animals. This study shows the efficacy and safety of intracorporeal anastomosis with the OrVil device after laparoscopic anterior resection.

  5. Magnetic resonance imaging of traumatic anterior instability of the shoulder

    International Nuclear Information System (INIS)

    Horii, Motoyuki

    1994-01-01

    The diagnostic capability of MRI in depicting abnormalities in traumatic anterior instability of the shoulder (TAI) was evaluated with special attention to MR arthrogram enhanced by joint effusion or saline solution. Sixty five shoulders with TAI and 19 control shoulders were scanned using the field gradient echo method (STAGE technique) on axial plane with a 1.0 or 1.5 Tesla system. MR arthrogram was obtained in 36 shoulders with TAI (Group A) and 11 control shoulders (Group C). Conventional MRI was obtained in 29 shoulders with TAI (Group B) and 8 control shoulders (Group D). Abnormalities in Bankart lesion were assessed according to signal intensity and labral shape. Abnormal signal was obtained in 8 shoulders (27.6%) in group B. Changes in shape were seen in 35 shoulders (97.2%) in group A and 18 (62.1%) in group B. Interruption of the anterior capsule was suspected in 3 (8.3%) in group A. Hill-Sachs lesion was suspected in 60 shoulders. Shoulders in the control group showed no abnormal change. Details of Bankart lesion confirmed by subsequent arthroscopy were diagnosed correctly in all of 14 shoulders on MR arthrogram and 8 of 16 shoulders on conventional MRI. These results show that MRI, MR arthrogram in particular, is useful for depicting abnormalities in TAI. (author)

  6. Anterior Temporal Lobe Tracks the Formation of Prejudice.

    Science.gov (United States)

    Spiers, Hugo J; Love, Bradley C; Le Pelley, Mike E; Gibb, Charlotte E; Murphy, Robin A

    2017-03-01

    Despite advances in understanding the brain structures involved in the expression of stereotypes and prejudice, little is known about the brain structures involved in their acquisition. Here, we combined fMRI, a task involving learning the valence of different social groups, and modeling of the learning process involved in the development of biases in thinking about social groups that support prejudice. Participants read descriptions of valenced behaviors performed by members of novel social groups, with majority groups being more frequently encountered during learning than minority groups. A model-based fMRI analysis revealed that the anterior temporal lobe tracked the trial-by-trial changes in the valence associated with each group encountered in the task. Descriptions of behavior by group members that deviated from the group average (i.e., prediction errors) were associated with activity in the left lateral PFC, dorsomedial PFC, and lateral anterior temporal cortex. Minority social groups were associated with slower acquisition rates and more activity in the ventral striatum and ACC/dorsomedial PFC compared with majority groups. These findings provide new insights into the brain regions that (a) support the acquisition of prejudice and (b) detect situations in which an individual's behavior deviates from the prejudicial attitude held toward their group.

  7. Changes in interdental papillae heights following alignment of anterior teeth.

    Science.gov (United States)

    Kandasamy, Sanjivan; Goonewardene, Mithran; Tennant, Marc

    2007-05-01

    Orthodontic alignment of overlapped incisors can reduce the apparent heights of the interdental papillae leading to unsightly dark triangles or open gingival embrasures. To determine if certain pretreatment contact point relationships between the maxillary anterior teeth were accompanied by changes in the heights of the interdental papillae after orthodontic alignment. Pre- and post-treatment intra-oral 35 mm slides, lateral cephalometric radiographs and study casts of 143 patients (60 males, 83 females) between 13 and 16 years of age were used. The patients had diastamata closed, imbricated teeth aligned and palatally or labially placed teeth repositioned. A sample of 25 patients (12 males, 13 females) between 13 and 16 years of age who had well-aligned anterior teeth at the start of treatment acted as a control group. All patients were treated for approximately 18 months. The clinical crowns of the maxillary incisors and the heights of the interdental papilla between the incisors were measured on projected images of the slides. The percentage increases or reductions in the heights of the interdental papillae were compared. The heights of the interdental papillae increased following palatal movement of labially placed (p teeth and the intrusion of one tooth relative to another. On the other hand, dark triangles are more likely to develop following labial movement of imbricated or palatally placed incisors and closure of a diastema. Clinicians should be alert to the possibility of dark triangles developing in the latter group, particularly in older patients.

  8. Anterior chamber angle imaging with swept-source optical coherence tomography: measuring peripheral anterior synechia in glaucoma.

    Science.gov (United States)

    Lai, Isabel; Mak, Heather; Lai, Gilda; Yu, Marco; Lam, Dennis S C; Leung, Christopher K S

    2013-06-01

    To investigate the use of swept-source optical coherence tomography (OCT) for measuring the area and degree of peripheral anterior synechia (PAS) involvement in patients with angle-closure glaucoma. Cross-sectional study. Twenty-three eyes with PAS (detected by indentation gonioscopy) from 20 patients with angle-closure glaucoma (20 eyes had primary angle-closure glaucoma and 3 eyes had angle-closure glaucoma secondary to chronic anterior uveitis [n = 2] and Axenfeld-Rieger syndrome [n = 1]). The anterior chamber angles were evaluated with indentation gonioscopy and imaged by swept-source OCT (Casia OCT, Tomey, Nagoya, Japan) in room light and in the dark using the "angle analysis" protocol, which was composed of 128 radial B-scans each with 512 A-scans (16-mm scan length). The area and degree of PAS involvement were measured in each eye after manual detection of the scleral spur and the anterior irido-angle adhesion by 2 masked observers. The interobserver variability of the PAS measurements was calculated. The agreement of PAS assessment by gonioscopy and OCT, the area and the degree of PAS involvement, and the intraclass correlation coefficient (ICC) of interobserver PAS measurements. The area of PAS (mean ± standard deviation) was 20.8 ± 16.9 mm(2) (range, 3.9-74.9 mm(2)), and the degree of PAS involvement was 186.5 ± 79.9 degrees (range, 42-314 degrees). There was no difference in the area of PAS (P = 0.90) and the degree of PAS involvement (P = 0.95) between images obtained in room light and in the dark. The interobserver ICCs were 0.99 (95% confidence interval [CI], 0.98-1.00) for the area of PAS and 0.99 (95% CI, 0.97-1.00) for the degree of PAS involvement. There was good agreement of PAS assessment between gonioscopy and OCT images (kappa = 0.79; 95% CI, 0.67-0.91). Swept-source OCT allows visualization and reproducible measurements of the area and degree of PAS involvement, providing a new paradigm for evaluation of PAS progression and risk assessment

  9. Domínio geográfico da língua portuguesa

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    Rolando Morel Pinto

    1966-09-01

    Full Text Available O português é o estádio atual de uma língua anterior, o latim vulgar ou corrente, outrora falado em todo o Império Romano. Diversas foram as causas, externas e internas, da diversificação do latim na Ibéria. Das primeiras, a mais importante foi, sem dúvida, o fato político-social da fragmentação do vasto império de Roma. No entanto, as causas intrínsecas constituem a essência mesma da diversificação. Destacam-se: o polidialetismo do latim vulgar invasor, a cronologia das invasões e a influência do substrato lingüístico peninsular.

  10. Ocorrência de mordida aberta anterior e hábitos bucais deletérios em crianças de 4 a 6 anos Occurrence of anterior open bite and harmful oral habits in children from 4 to 6-year old

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    Maritza Zapata

    2010-04-01

    Full Text Available OBJETIVO: verificar a ocorrência de mordida aberta anterior e de hábitos orais deletérios em crianças de quatro a seis anos de idade. MÉTODOS: foram avaliadas 266 crianças de quatro a seis anos incompletos, de ambos os gêneros, na cidade de Suzano - São Paulo. As avaliações constaram de aplicação de ficha de avaliação para detecção de ocorrência de hábitos bucais deletérios aos responsáveis e da realização de exame clínico constituído por avaliação da oclusão das crianças. RESULTADOS: verificou-se que 221 crianças (83,1% apresentaram pelo menos um hábito bucal deletério, sendo o mais frequente o uso de mamadeira 167 (75,6%. A ocorrência simultânea de hábitos deletérios e alterações de oclusão dentária foi observada em 119 crianças (44,1% da amostra e nestas, a maior prevalência foi a presença da mordida aberta anterior, presente em 89 (79,8%. CONCLUSÃO: a mordida aberta anterior (MAA foi a alteração oclusal mais prevalente nas crianças, havendo associação estatisticamente significante entre hábitos orais deletérios, como uso de mamadeira, chupeta e ocorrência de bruxismo e presença de mordida aberta anterior.PURPOSE: to determine the occurrence of anterior open bite and harmful oral habits in children from four to six-year old. METHODS: a total of 266 four-to-six-year-old male and female children in the city of Suzano (São Paulo, Brazil were evaluated. An assessment chart for detecting the occurrence of harmful oral habits was administered to the guardians and clinical exams were performed for assessing occlusion in the children. RESULTS: a total of 221 children (83.1% had at least one harmful oral habit, the most frequent of which was the use of a feeding bottle (n=167; 75.6%. The occurrence of simultaneous harmful habits and dental occlusion abnormalities was observed in 119 children (44.1% of the sample; among these children, the greatest prevalence was of anterior open bite (n=89; 79

  11. The effect of regulatory mode on procrastination: Bi-stable parahippocampus connectivity with dorsal anterior cingulate and anterior prefrontal cortex.

    Science.gov (United States)

    Zhang, Chenyan; Ni, Yan; Feng, Tingyong

    2017-06-30

    Previous research has elucidated that procrastination can be influenced by regulatory mode orientations. However, the neural mechanism of regulatory modes affecting procrastination is not well understood. To address this question, we employed resting-state functional magnetic resonance imaging (RS-fMRI) to test the influence of two regulatory modes (assessment and locomotion) on procrastination. The behavioral results showed that procrastination was positively correlated with assessment orientation but negatively correlated with locomotion orientation. Neuroimaging results indicated that the functional connectivity between parahippocampal cortex (PHC) and dorsal anterior cingulate (dACC) was negatively correlated with assessment scores, while the functional connectivity between anterior prefrontal cortex (aPFC) and parahippocampal cortex (PHC) was negatively correlated with locomotion scores. Critically, mediation analysis showed that the different effects of two distinct regulatory modes on procrastination were mediated by PHC-dACC and aPFC-PHC functional connectivity respectively. These results suggested that people's procrastination could be predicted by regulatory mode orientations, which is mediated by PHC connectivity with dACC and aPFC respectively. The present study extends our knowledge on procrastination and provides neural mechanism for understanding the link between regulatory mode orientations and procrastination. Copyright © 2017. Published by Elsevier B.V.

  12. A Rare Case of Neglected Traumatic Anterior Dislocation of Hip in a Child.

    Science.gov (United States)

    Mootha, Aditya Krishna; Mogali, Kasi Viswanadam

    2016-01-01

    Post traumatic hip dislocations are very rare in children. Neglected anterior hip dislocations in children are not described in literature so far. Here, we present a case of 6 weeks old anterior hip dislocation successfully managed by open reduction. A 9-year-old male child presented with neglected anterior hip dislocation on left side. Open reduction carried out through direct anterior approach to hip. Congruent reduction is achieved. At final follow up of 1 year, the child had unrestricted activities of daily living and no radiological signs of osteonecrosis or any joint space reduction. There is paucity of literature over neglected post traumatic anterior hip dislocations in children. The treatment options vary from closed reduction after heavy traction to sub trochanteric osteotomy. However, we feel that open reduction through direct anterior approach is the preferred mode of management whenever considered possible.

  13. Unilateral hypoplasia with contralateral hypertrophy of anterior belly of digastric muscle: a case report.

    Science.gov (United States)

    Ochoa-Escudero, Martin; Juliano, Amy F

    2016-10-01

    Anomalies of the anterior belly of the digastric muscle (DM) are uncommon. We present a case of hypoplasia of the anterior belly of the left DM with hypertrophy of the anterior belly of the contralateral DM. The importance of recognizing this finding is to differentiate hypoplasia of the anterior belly of the DM from denervation atrophy, and not to confuse contralateral hypertrophy with a submental mass or lymphadenopathy. In denervation atrophy of the anterior belly of the DM, associated atrophy of the ipsilateral mylohyoid muscle is present. Hypertrophy of the anterior belly of the contralateral DM can be differentiated from a submental mass or lymphadenopathy by recognizing its isodensity on computed tomography and isointensity on magnetic resonance imaging to other muscles, without abnormal contrast enhancement.

  14. Lenticonus diagnosis in Alport's syndrome: Anterior capsule apical angle calculation using Scheimpflug imagery.

    Science.gov (United States)

    Jarrín, E; Jarrín, I; Arnalich-Montiel, F

    2015-08-01

    We describe a simplified method to detect anterior lenticonus. Three eyes of 2 patients with anterior lenticonus, plus 16 eyes from 16 healthy controls underwent Scheimpflug imaging of their anterior segment with Pentacam. The anterior capsule apex angle was manually identified and automatically measured by AutoCAD. The mean angle was 173.06° (SD: 1.91) in healthy subjects, and 158.33° (SD: 3.05) in anterior lenticonus eyes. The angle obtained from patients was more than 3 SD steeper than those from healthy subjects. The apical angle calculation method seems to discriminate well between normal eyes and eyes suspected of having anterior lenticonus. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  15. Operation for recurrent cystocele with anterior colporrhaphy or non-absorbable mesh: patient reported outcomes

    DEFF Research Database (Denmark)

    Nüssler, Emil Karl; Greisen, Susanne; Kesmodel, Ulrik Schiøler

    2013-01-01

    Abstract INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare patient reported outcomes and complications after repair of recurrent anterior vaginal wall prolapse in routine health care settings using standard anterior colporrhaphy or non-absorbable mesh. METHODS: The study is based...... on prospective data from the Swedish National Register for Gynaecological Surgery. 286 women were operated on for recurrent anterior vaginal wall prolapse in 2008-2010; 157 women had an anterior colporrhaphy and 129 were operated on with a non-absorbable mesh. Pre-, and perioperative data were collected from...... (0.6 %) in the anterior colporrhaphy group (p = 0.58). The infection rate was higher after mesh (8.5 %) than after anterior colporrhaphy (2.5 %; OR 3.19 ; 1.07-14.25). CONCLUSION: Implantation of synthetic mesh during operation for recurrent cystocele more than doubled the cure rate, whereas...

  16. Radial head button holing: a cause of irreducible anterior radial head dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su-Mi; Chai, Jee Won; You, Ja Yeon; Park, Jina [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Bae, Kee Jeong [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Orthopedic Surgery, Seoul (Korea, Republic of)

    2016-10-15

    ''Buttonholing'' of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign. Magnetic resonance imaging (MRI) clearly demonstrated anterior dislocation of the fractured radial head through the torn annular ligament. The anterior joint capsule and proximal portion of the annular ligament were interposed between the radial head and capitellum, preventing closed reduction of the radial head. Familiarity with this condition and imaging findings will aid clinicians to make a proper diagnosis and fast decision to perform an open reduction. (orig.)

  17. Biomechanical Measures During Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury After Anterior Cruciate Ligament Reconstruction and Return to Sport

    Science.gov (United States)

    Paterno, Mark V.; Schmitt, Laura C.; Ford, Kevin R.; Rauh, Mitchell J.; Myer, Gregory D.; Huang, Bin; Hewett, Timothy E.

    2016-01-01

    Background Athletes who return to sport participation after anterior cruciate ligament reconstruction (ACLR) have a higher risk of a second anterior cruciate ligament injury (either reinjury or contralateral injury) compared with non–anterior cruciate ligament–injured athletes. Hypotheses Prospective measures of neuromuscular control and postural stability after ACLR will predict relative increased risk for a second anterior cruciate ligament injury. Study Design Cohort study (prognosis); Level of evidence, 2. Methods Fifty-six athletes underwent a prospective biomechanical screening after ACLR using 3-dimensional motion analysis during a drop vertical jump maneuver and postural stability assessment before return to pivoting and cutting sports. After the initial test session, each subject was followed for 12 months for occurrence of a second anterior cruciate ligament injury. Lower extremity joint kinematics, kinetics, and postural stability were assessed and analyzed. Analysis of variance and logistic regression were used to identify predictors of a second anterior cruciate ligament injury. Results Thirteen athletes suffered a subsequent second anterior cruciate ligament injury. Transverse plane hip kinetics and frontal plane knee kinematics during landing, sagittal plane knee moments at landing, and deficits in postural stability predicted a second injury in this population (C statistic = 0.94) with excellent sensitivity (0.92) and specificity (0.88). Specific predictive parameters included an increase in total frontal plane (valgus) movement, greater asymmetry in internal knee extensor moment at initial contact, and a deficit in single-leg postural stability of the involved limb, as measured by the Biodex stability system. Hip rotation moment independently predicted second anterior cruciate ligament injury (C = 0.81) with high sensitivity (0.77) and specificity (0.81). Conclusion Altered neuromuscular control of the hip and knee during a dynamic landing task

  18. Anterior makeover on fractured teeth by simple composite resin restoration

    Directory of Open Access Journals (Sweden)

    Eric Priyo Prasetyo

    2011-09-01

    Full Text Available Background: In daily practice dentists usually treat tooth fractures with more invasive treatments such as crown, veneer and bridges which preparation require more tooth structure removal. While currently there is trend toward minimal invasive dentistry which conserves more tooth structure. This is enhanced with the vast supply of dental materials and equipment in the market, including restorative materials. Provided with these supporting materials and equipment and greater patient’s demand for esthetic treatment, dentists must aware of the esthetics and basic principle of conserving tooth which should retain tooth longevity. Purpose: This article showed that a simple and less invasive composite resin restoration can successfully restore anterior esthetic and function of fractured teeth which generally treated with more invasive treatment options. Case: A 19 year-old female patient came with fracture on 21 and 22. This patient had a previous history of dental trauma about nine years before and was brought to a local dentist for debridement and was given analgesic, the involved teeth were not given any restorative treatment. Case management: The fractured 21 and 22 were conventionally restored with simple composite resin restoration. Conclusion: Fracture anterior teeth would certainly disturbs patient’s appearance, but these teeth could be managed conservatively and economically by simple composite resin restoration.Latar belakang: Dalam praktek sehari-hari pada umumnya dokter gigi merawat fraktur dengan restorasi invasif seperti mahkota, veneer dan jembatan yang semuanya memerlukan pengambilan jaringan gigi lebih banyak, sedangkan saat ini trend perawatan gigi lebih menuju kearah invasif minimal yang mempertahankan jaringan gigi sebanyak mungkin. Keadaan ini ditunjang oleh tersedianya berbagai macam bahan dan peralatan kedokteran gigi di pasaran, termasuk bahan restorasi. Dengan tersedianya bahan dan peralatan yang mendukung serta tingginya

  19. Endoscopic transnasal resection of anterior cranial fossa meningiomas.

    Science.gov (United States)

    de Divitiis, Enrico; Esposito, Felice; Cappabianca, Paolo; Cavallo, Luigi M; de Divitiis, Oreste; Esposito, Isabella

    2008-01-01

    The extended transnasal approach, a recent surgical advancements for the ventral skull base, allows excellent midline access to and visibility of the anterior cranial fossa, which was previously thought to be approachable only via a transcranial route. The extended transnasal approach allows early decompression of the optic canals, obviates the need for brain retraction, and reduces neurovascular manipulation. Between 2004 and 2007, 11 consecutive patients underwent transnasal resection of anterior cranial fossa meningiomas--4 olfactory groove (OGM) and 7 tuberculum sellae (TSM) meningiomas. Age at surgery, sex, symptoms, and imaging studies were reviewed. Tumor size and tumor extension were estimated, and the anteroposterior, vertical, and horizontal diameters were measred on MR images. Medical records, surgical complications, and outcomes of the patients were collected. A gross-total removal of the lesion was achieved in 10 patients (91%), and in 1 patient with a TSM only a near-total (> 90%) resection was possible. Four patients with preoperative visual function defect had a complete recovery, whereas 3 patients experienced a transient worsening of vision, fully recovered within few days. In 3 patients (2 with TSMs and 1 with an OGM), a postoperative CSF leak occurred, requiring a endoscopic surgery for skull base defect repair. Another patient (a case involving a TSM) developed transient diabetes insipidus. The operative time ranged from 6 to 10 hours in the OGM group and from 4.5 to 9 hours in the TSM group. The mean duration of the hospital stay was 13.5 and 10 days in the OGM and TSM groups, respectively. Six patients (3 with OGMs and 3 with TSMs) required a blood transfusion. Surgery-related death occurred in 1 patient with TSM, in whom the tumor was successfully removed. The technique offers a minimally invasive route to the midline anterior skull base, allowing the surgeon to avoid using brain retraction and reducing manipulation of the large vessels and

  20. Loading effects of anterior cervical spine fusion on adjacent segments

    Directory of Open Access Journals (Sweden)

    Chien-Shiung Wang

    2012-11-01

    Full Text Available Adjacent segment degeneration typically follows anterior cervical spine fusion. However, the primary cause of adjacent segment degeneration remains unknown. Therefore, in order to identify the loading effects that cause adjacent segment degeneration, this study examined the loading effects to superior segments adjacent to fused bone following anterior cervical spine fusion. The C3–C6 cervical spine segments of 12 sheep were examined. Specimens were divided into the following groups: intact spine (group 1; and C5–C6 segments that were fused via cage-instrumented plate fixation (group 2. Specimens were cycled between 20° flexion and 15° extension with a displacement control of 1°/second. The tested parameters included the range of motion (ROM of each segment, torque and strain on both the body and inferior articular process at the superior segments (C3–C4 adjacent to the fused bone, and the position of the neutral axis of stress at under 20° flexion and 15° extension. Under flexion and Group 2, torque, ROM, and strain on both the bodies and facets of superior segments adjacent to the fused bone were higher than those of Group 1. Under extension and Group 2, ROM for the fused segment was less than that of Group 1; torque, ROM, and stress on both the bodies and facets of superior segments adjacent to the fused bone were higher than those of Group 1. These analytical results indicate that the muscles and ligaments require greater force to achieve cervical motion than the intact spine following anterior cervical spine fusion. In addition, ROM and stress on the bodies and facets of the joint segments adjacent to the fused bone were significantly increased. Under flexion, the neutral axis of the stress on the adjacent segment moved backward, and the stress on the bodies of the segments adjacent to the fused bone increased. These comparative results indicate that increased stress on the adjacent segments is caused by stress-shielding effects