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Sample records for oligoceno superior-mioceno inferior

  1. Organismos de un arrecife fósil (Oligoceno Superior-Mioceno Inferior, del Caribe de Costa Rica

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    Teresita Aguilar Alvarez

    1999-09-01

    Full Text Available En la localidad de Jesús María, Turrialba, afloran de 12-30 m de calizas arrecifales, areniscas y conglomerados de edad Oligocena Superior-Miocena Inferior, que se asocian con la Formación Punta Pelada. En ésta localidad se registra una de las primeras comunidades arrecifales de la actual región Caribe de Costa Rica y constituye una de las pocas localidades de arrecifes de ésta edad en el área. Los afloramientos se interpretan como parches arrecifales debido a su distribución irregular y a su poca extensión lateral (50m, los cuales se desarrollaron bajo la influencia de diversos procesos: variación en la energía del medio, cambios en el nivel del mar, plataformas angostas, excesiva sedimentación clástica posiblemente desde islas. Se analizaron 460 ejemplares, los cuales corresponden a más de 36 especies, que permitieron hacer una recosnstrucción de la estructura y de las condiciones ambientales en que se desarrollaron. Los arrecifes constituyeron comunidades de baja diversidad: cuatro especies de corales (tres de constructores, 31 especies de moluscos (21 de Gastrópodos: una especie nueva, 14 de carnívoros, tres de herbívoros, tres de hábitos alimenticios desconocidos; 10 especies de Bivalvos: cinco endobentónicos, cinco epibentónicos, algas (representantes de por lo menos tres grupos, equinodermos, foraminíferos, crustáceos. La equidad también es muy baja, principalmente en lo referente a los corales Scleractinia, con un predominio muy marcado de Antiguastrea celullosa (80% de las formas encontradas. Esto permite inferir que se desarrollaron en un ambiente de poca profundidad (50-80 m, muy variable, con influencia ocasional de corrientes marinas fuertes y aporte de sedimentos terrígenos procedentes de islas cercanas.This paper describes the fossils, materials and paleoenvironmental conditions found in some outcrops near the town of Jesús María, Turrialba, Costa Rica. The rock materials (reefal limestone, sandstones

  2. Estratigrafía y sedimentología de las formaciones lacustres del tránsito Eoceno-Oligoceno del NE de la Cuenca del Ebro

    OpenAIRE

    Sáez Ruiz, Alberto

    1987-01-01

    Durante el tránsito Eoceno-Oligoceno en el sector NE de la Cuenca del Ebro y por encima de los depósitos marinos eocénicos, se diferencian tres complejos o sistemas deposicionales: el Sistema Aluvial Pirenaico, el Sistema Aluvial Catalánide y el Sistema Lacustre Catalán o Central.El estudio de mamíferos y carófitas fósiles hallados en los materiales del Sistema Lacustre Catalán ha permitido distinguir tres biozonas de carófitas y cuatro de mamíferos de valor estrictamente local. Estas biozona...

  3. Inferiority is compex

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    Wade, Jess

    2017-07-01

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

  4. Isolated inferior mesenteric portal hypertension with giant inferior mesenteric vein and anomalous inferior mesenteric vein insertion

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    G Raghavendra Prasad

    2013-01-01

    Full Text Available Extrahepatic portal hypertension is not an uncommon disease in childhood, but isolated inferior mesenteric portal varices and lower gastrointestinal (GI bleed have not been reported till date. A 4-year-old girl presented with lower GI bleed. Surgical exploration revealed extrahepatic portal vein obstruction with giant inferior mesenteric vein and colonic varices. Inferior mesenteric vein was joining the superior mesenteric vein. The child was treated successfully with inferior mesenteric - inferior vena caval anastomosis. The child was relieved of GI bleed during the follow-up.

  5. Leiomyosarcoma of the inferior turbinate

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    Christopher W. Harper, Jr., MD

    2017-09-01

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

  6. Tuberculosis pulmonar de campos inferiores

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    Alejandra González

    2010-10-01

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

  7. Inferior alveolar nerve block: Alternative technique.

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    Thangavelu, K; Kannan, R; Kumar, N Senthil

    2012-01-01

    Inferior alveolar nerve block (IANB) is a technique of dental anesthesia, used to produce anesthesia of the mandibular teeth, gingivae of the mandible and lower lip. The conventional IANB is the most commonly used the nerve block technique for achieving local anesthesia for mandibular surgical procedures. In certain cases, however, this nerve block fails, even when performed by the most experienced clinician. Therefore, it would be advantageous to find an alternative simple technique. The objective of this study is to find an alternative inferior alveolar nerve block that has a higher success rate than other routine techniques. To this purpose, a simple painless inferior alveolar nerve block was designed to anesthetize the inferior alveolar nerve. This study was conducted in Oral surgery department of Vinayaka Mission's dental college Salem from May 2009 to May 2011. Five hundred patients between the age of 20 years and 65 years who required extraction of teeth in mandible were included in the study. Out of 500 patients 270 were males and 230 were females. The effectiveness of the IANB was evaluated by using a sharp dental explorer in the regions innervated by the inferior alveolar, lingual, and buccal nerves after 3, 5, and 7 min, respectively. This study concludes that inferior alveolar nerve block is an appropriate alternative nerve block to anesthetize inferior alveolar nerve due to its several advantages.

  8. Anomalies of the vena cava inferior

    International Nuclear Information System (INIS)

    Koen, F.R.; Bouwer, A.J.; Bornman, M.S.; Du Plessis, D.J.

    1986-01-01

    Two cases of anomalous inferior vena cava are presented, with the emphasis on embryology. The firts patient was investigated by venography for a clinically proven varicocele as a probable cause of infertility. A double inferior vena cava was found during venography, and was confirmed by computed tomography (CT). In the second case a left-sided inferior vena cava was an incidental finding when a CT scan was done as a diagnostic procedure in a case of Hodgkin's disease. A short summary of the embryology and the significance of the variants is presented

  9. Traumatismos de veia cava inferior

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    Cleinaldo de Almeida Costa

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

  10. Superior versus inferior Ahmed glaucoma valve implantation.

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

    2009-02-01

    To compare the efficacy and safety of Ahmed glaucoma valve (AGV) (New World Medical Inc., Rancho Cucamonga, CA) implantation in the superior versus inferior quadrants. Prospective parallel cohort study. A total of 106 eyes of 106 patients with refractory glaucoma. Consecutive patients with refractory glaucoma underwent AGV implantation in the superior or inferior quadrants. Main outcome measures included intraocular pressure (IOP) and rate of complications. Other outcome measures included best corrected visual acuity (BCVA), number of glaucoma medications, and success rate (defined as at least 30% IOP reduction and 5glaucoma surgery, phthisis bulbi, or loss of light perception. Of a total of 106 eyes, 58 and 48 eyes underwent AGV implantation in the superior and inferior quadrants, respectively. Baseline characteristics were comparable in the study groups, except for preoperative IOP, which was higher in the superior group (P = 0.01). Patients were followed for a mean period of 10.6+/-8.49 months and 10.58+/-6.75 months in the superior and inferior groups, respectively (P = 0.477). BCVA was comparable between the groups at all postoperative visits (P>0.122). After 1 year, statistically significant but comparable IOP reduction from baseline (Pglaucoma medications was comparable after 1 year (1.3+/-1.2 vs. 1.9+/-0.8 for superior and inferior implants, respectively, P = 0.256). Success rates were also similar at 1 year: 27 eyes (81.8%) versus 20 eyes (95.2%) for superior and inferior implants, respectively (P = 0.227). However, the overall rate of complications, such as implant exposure necessitating removal, cosmetically unappealing appearance, and endophthalmitis, was higher in the inferior group: 12 eyes (25%) versus 3 eyes (5.2%) for superior and inferior groups, respectively, (P = 0.004). Superior and inferior AGV implants have similar intermediate efficacy in terms of IOP reduction, decrease in number of glaucoma medications, and preservation of vision. However

  11. Anatomy of Inferior Mesenteric Artery in Fetuses

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    Ayesha Nuzhat

    2016-01-01

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

  12. Inferior hilar window on lateral chest radiographs

    International Nuclear Information System (INIS)

    Park, C.K.; Webb, W.R.; Klein, J.S.

    1990-01-01

    This paper determines the accuracy of lateral chest radiography in the detection of masses in the inferior hilar window, a normally avascular hilar region anterior to the lower lobe bronchi. Fifty patients with normal thoracic CT scans and 25 with hilar masses/adenopathy were selected retrospectively. The 75 corresponding lateral chest radiographs were blindly evaluated for visibility of the anterior walls of the lower lobe bronchi and the presence and laterality of abnormal soft tissue (>1 cm) in the inferior hilar window. Only a 7 x 7-cm square of the lateral radiograph was viewed

  13. Iatrogenic injury to the inferior alveolar nerve

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    Hillerup, Søren

    2008-01-01

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

  14. Inferior Oblique Overaction: Anterior Transposition Versus Myectomy.

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    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. The bihemispheric posterior inferior cerebellar artery

    International Nuclear Information System (INIS)

    Cullen, Sean P.; Ozanne, Augustin; Alvarez, Hortensia; Lasjaunias, Pierre

    2005-01-01

    Rarely, a solitary posterior inferior cerebellar artery (PICA) will supply both cerebellar hemispheres. We report four cases of this variant. We present a retrospective review of clinical information and imaging of patients undergoing angiography at our institution to identify patients with a bihemispheric PICA. There were four patients: three males and one female. One patient presented with a ruptured arteriovenous malformation, and one with a ruptured aneurysm. Two patients had normal angiograms. The bihemispheric PICA was an incidental finding in all cases. The bihemispheric vessel arose from the dominant left vertebral artery, and the contralateral posterior inferior cerebellar artery was absent or hypoplastic. In all cases, contralateral cerebellar supply arose from a continuation of the ipsilateral PICA distal to the choroidal point and which crossed the midline dorsal to the vermis. We conclude that the PICA may supply both cerebellar hemispheres. This rare anatomic variant should be considered when evaluating patients with posterior fossa neurovascular disease. (orig.)

  16. Rare Inferior Shoulder Dislocation (Luxatio Erecta)

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    Cift, Hakan; Soylemez, Salih; Demiroglu, Murat; Ozkan, Korhan; Ozden, Vahit Emre; Ozkut, Afsar T.

    2015-01-01

    Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitat...

  17. Temporary Blindness after Inferior Alveolar Nerve Block.

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    Barodiya, Animesh; Thukral, Rishi; Agrawal, Shaila Mahendra; Rai, Anshul; Singh, Siddharth

    2017-03-01

    Inferior Alveolar Nerve Block (IANB) anaesthesia is one of the common procedures in dental clinic. This procedure is safe, but complications may still occur. Ocular complications such as diplopia, loss of vision, or ophthalmoplegia are extremely rare. This case report explains an event where due to individual anatomic variation of the sympathetic vasoconstrictor nerve and maxillary and middle meningeal arteries, intravascular administration of anaesthetic agent caused unusual ocular signs and symptoms such as temporary blindness.

  18. Inferior alveolar nerve block: Alternative technique

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    Thangavelu, K.; Kannan, R.; Kumar, N. Senthil

    2012-01-01

    Background: Inferior alveolar nerve block (IANB) is a technique of dental anesthesia, used to produce anesthesia of the mandibular teeth, gingivae of the mandible and lower lip. The conventional IANB is the most commonly used the nerve block technique for achieving local anesthesia for mandibular surgical procedures. In certain cases, however, this nerve block fails, even when performed by the most experienced clinician. Therefore, it would be advantageous to find an alternative simple techni...

  19. Transcatheteral occlusion of the inferior mesenteric artery

    Energy Technology Data Exchange (ETDEWEB)

    Vogel, H; Buecheler, E

    1981-06-01

    Three times the inferior mesenteric artery was embolized in one patient with recurrent gastrointestinal hemorrhage due to hypernephroma invading the left colon (tumorrecurrency after nephrectomy and radiation-therapy). The patient was inoperable. The bleeding could be stopped repetedly for several weeks. Fibrospum particles were used with the aim to obtain incomplete ischemia. So the danger to produce local necrosis was thought to be limited.

  20. Does Wal-Mart Sell Inferior Goods?

    OpenAIRE

    Emek Basker

    2008-01-01

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

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

    DEFF Research Database (Denmark)

    Bach Justesen, Anders; Eskelund Johansen, Ann Berit; Martinussen, Noomi Ida

    2018-01-01

    Objective To investigate the diagnostic added value of supplementing the 10–20 EEG array with six electrodes in the inferior temporal chain. Methods EEGs were recorded with 25 electrodes: 19 positions of the 10–20 system, and six additional electrodes in the inferior temporal chain (F9/10, T9/10, P...... in the inferior chain) and 6% (only seen at the inferior chain). Conclusions Adding six electrodes in the inferior temporal electrode chain to the 10–20 array improves the localization and identification of EEG abnormalities, especially those located in the temporal region. Significance Our results suggest...

  2. Comparative study of unilateral versus bilateral inferior oblique recession/anteriorization in unilateral inferior oblique overaction.

    Science.gov (United States)

    Mostafa, Attiat M; Kassem, Rehab R

    2018-05-01

    To compare the effect of, and the rate of subsequent development of iatrogenic antielevation syndrome after, unilateral versus bilateral inferior oblique graded recession-anteriorization to treat unilateral inferior oblique overaction. Thirty-four patients with unilateral inferior oblique overaction were included in a randomized prospective study. Patients were equally divided into 2 groups. Group UNI underwent unilateral, group BI bilateral, inferior oblique graded recession-anteriorization. A successful outcome was defined as orthotropia, or within 2 ∆ of a residual hypertropia, in the absence of signs of antielevation syndrome, residual inferior oblique overaction, V-pattern, dissociated vertical deviation, or ocular torticollis. A successful outcome was achieved in 11 (64.7%) and 13 (76.5%) patients in groups UNI and BI, respectively (p = 0.452). Antielevation syndrome was diagnosed as the cause of surgical failure in 6 (35.3%) and 2 (11.8%) patients, in groups UNI and BI, respectively (p = 0.106). The cause of surgical failure in the other 2 patients in group BI was due to persistence of ocular torticollis and hypertropia in a patient with superior oblique palsy and a residual V-pattern and hypertropia in the other patient. The differences between unilateral and bilateral inferior oblique graded recession-anteriorization are insignificant. Unilateral surgery has a higher tendency for the subsequent development of antielevation syndrome. Bilateral surgery may still become complicated by antielevation syndrome, although at a lower rate. In addition, bilateral surgery had a higher rate of undercorrection. Further studies on a larger sample are encouraged.

  3. Design of Phase II Non-inferiority Trials.

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    Jung, Sin-Ho

    2017-09-01

    With the development of inexpensive treatment regimens and less invasive surgical procedures, we are confronted with non-inferiority study objectives. A non-inferiority phase III trial requires a roughly four times larger sample size than that of a similar standard superiority trial. Because of the large required sample size, we often face feasibility issues to open a non-inferiority trial. Furthermore, due to lack of phase II non-inferiority trial design methods, we do not have an opportunity to investigate the efficacy of the experimental therapy through a phase II trial. As a result, we often fail to open a non-inferiority phase III trial and a large number of non-inferiority clinical questions still remain unanswered. In this paper, we want to develop some designs for non-inferiority randomized phase II trials with feasible sample sizes. At first, we review a design method for non-inferiority phase III trials. Subsequently, we propose three different designs for non-inferiority phase II trials that can be used under different settings. Each method is demonstrated with examples. Each of the proposed design methods is shown to require a reasonable sample size for non-inferiority phase II trials. The three different non-inferiority phase II trial designs are used under different settings, but require similar sample sizes that are typical for phase II trials.

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

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    Prakash B Billakanti

    2016-03-01

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

  5. Hepatocellular carcinomas supplied by inferior phrenic arteries.

    Science.gov (United States)

    Tanabe, N; Iwasaki, T; Chida, N; Suzuki, S; Akahane, T; Kobayashi, N; Ishii, M; Toyota, T

    1998-07-01

    To assess the arterial supply to hepatocellular carcinomas (HCCs) by inferior phrenic arteries (IPA). A total of 126 consecutive cases of HCC were studied by contract-enhanced CT and conventional arteriography. Blood supply from an IPA was suspected when the size of the HCC mass as seen on contrast-enhanced CT did not match the size of the tumor mass as seen on hepatic arteriography. Inferior phrenic arteriography was employed to confirm these findings. HCCs fed by the IPA were analyzed in terms of size, location, and history of prior treatment. In 14 (11%) of the 126 cases, the tumor was found to have a blood supply from an IPA. Eleven of these tumors were located in segments 2 and 7. Three tumors, which had not been treated previously, had a blood supply from an IPA. Six tumors were almost exclusively fed by an IPA and were located in segments 1, 1, and 4. HCCs located in segments which form the bare area of the liver (S1, S2, S7) can be supplied by an IPA. This should be suspected when a lesion or part of a lesion is identified on contrast-enhanced CT but not on hepatic arteriography.

  6. Hepatocellular carcinomas supplied by inferior phrenic arteries

    International Nuclear Information System (INIS)

    Tanabe, N.; Iwasaki, T.; Akahane, T.; Kobayashi, N.; Ishii, M.; Toyota, T.; Chida, N.; Suzuki, S.

    1998-01-01

    Purpose: To assess the arterial supply to hepatocellular carcinomas (HCCs) by inferior phrenic arteries (IPA). Material and Methods: A total of 126 consecutive cases of HCC were studied by contrast-enhanced CT and conventional arteriography. Blood supply from an IPA was suspected when the size of the HCC mass as seen on contrast-enhanced CT did not match the size of the tumor mass as seen on hepatic arteriography. Inferior phrenic arteriography was employed to confirm these findings. HCCs fed by the IPA were analyzed in terms of size, location, and history of prior treatment. Results: In 14 (11%) of the 126 cases, the tumor was found to have a blood supply from an IPA. Eleven of these tumors were located in segments 2 and 7. Three tumors, which had not been treated previously, had a blood supply from an IPA. Six tumors were almost exclusively fed by an IPA and were located in segments 7, 1, and 4. Conclusion: HCCs located in segments which form the bare area of the liver (S1, S2, S7) can be supplied by an IPA. This should be suspected when a lesion or part of a lesion is identified on contrast-enhanced CT but not on hepatic arteriography. (orig.)

  7. Hepatocellular carcinomas supplied by inferior phrenic arteries

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, N.; Iwasaki, T.; Akahane, T.; Kobayashi, N.; Ishii, M.; Toyota, T. [Tohoku Univ. School of Medicine (Japan). Third Dept. of Internal Medicine; Chida, N.; Suzuki, S. [National Sendai Hospital (Japan). Dept. of Gastroenterology

    1998-07-01

    Purpose: To assess the arterial supply to hepatocellular carcinomas (HCCs) by inferior phrenic arteries (IPA). Material and Methods: A total of 126 consecutive cases of HCC were studied by contrast-enhanced CT and conventional arteriography. Blood supply from an IPA was suspected when the size of the HCC mass as seen on contrast-enhanced CT did not match the size of the tumor mass as seen on hepatic arteriography. Inferior phrenic arteriography was employed to confirm these findings. HCCs fed by the IPA were analyzed in terms of size, location, and history of prior treatment. Results: In 14 (11%) of the 126 cases, the tumor was found to have a blood supply from an IPA. Eleven of these tumors were located in segments 2 and 7. Three tumors, which had not been treated previously, had a blood supply from an IPA. Six tumors were almost exclusively fed by an IPA and were located in segments 7, 1, and 4. Conclusion: HCCs located in segments which form the bare area of the liver (S1, S2, S7) can be supplied by an IPA. This should be suspected when a lesion or part of a lesion is identified on contrast-enhanced CT but not on hepatic arteriography. (orig.)

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

    Science.gov (United States)

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

    2018-01-01

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

  9. Collateral circulations in inferior vena cava obstruction

    International Nuclear Information System (INIS)

    Lee, Jong Beum; Park, Jae Hyung; Han, Man Chung; Park, Soo Soung

    1985-01-01

    Obstruction of the inferior vena cava (IVC) is an uncommon condition, and the collateral pathway varies according to the level, extent, duration and the cause of obstruction. Membranous obstruction of IVC in its hepatic portion might be one of the principle cause among Korean, though not reported till now. Analytical study was performed in 26 cases of IVC obstruction with various cause. 1. The level of the obstruction showed relatively even distribution as follows, upper caval in 11 cases, middle caval in 6 cases and infrarenal in 9 cases. 2. The main cause of upper caval obstruction was membranous obstruction. 3. As a whole, the main collateral pathway was the central route (22 cases: 85%). 4. Characteristic collateral pathway unique to upper caval obstruction was transhepatic venous collateral, developed between the obstructed segment and unobstructed segment of IVC. 5. Scalloping of left cardiac border produced by pericardiophrenic venous collateral was characteristic simple chest x-ray finding in IVC obstruction

  10. Inferior vena cava obstruction and shock

    Directory of Open Access Journals (Sweden)

    Megri Mohammed

    2018-01-01

    Full Text Available Shock is one of the most challenging life-threatening conditions with high mortality and morbidity; the outcomes are highly dependent on the early detection and management of the condition. Septic shock is the most common type of shock in the Intensive Care Unit. While not as common as other subsets of shock, obstructive shock is a significant subtype due to well defined mechanical and pathological causes, including tension pneumothorax, massive pulmonary embolism, and cardiac tamponade. We are presenting a patient with obstructive shock due to inferior vena cava obstruction secondary to extensive deep venous thrombosis. Chance of survival from obstructive shock in our patient was small; however, there was complete and immediate recovery after treatment of the obstruction on recognizing the affected vessels. This case alerts the practicing intensivist and the emergency medicine physician to consider occlusion of the great vessels other than the pulmonary artery or aorta as causes of obstructive shock.

  11. Rare Inferior Shoulder Dislocation (Luxatio Erecta

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    Hakan Cift

    2015-01-01

    Full Text Available Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitation of range of motion of their shoulder at their last control. Luxatio erecta is seen rarely, and these patients may have neurovascular injury. These patients should be carefully examined and treated by the orthopaedic and traumatology surgeons.

  12. Rare Inferior Shoulder Dislocation (Luxatio Erecta)

    Science.gov (United States)

    Cift, Hakan; Soylemez, Salih; Demiroglu, Murat; Ozkan, Korhan; Ozden, Vahit Emre; Ozkut, Afsar T.

    2015-01-01

    Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients' ages were 78, 62, 65, and 76. All patients' reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitation of range of motion of their shoulder at their last control. Luxatio erecta is seen rarely, and these patients may have neurovascular injury. These patients should be carefully examined and treated by the orthopaedic and traumatology surgeons. PMID:25883820

  13. Total laparoscopic retrieval of inferior vena cava filter.

    Science.gov (United States)

    Benrashid, Ehsan; Adkar, Shaunak Sanjay; Bennett, Kyla Megan; Zani, Sabino; Cox, Mitchell Wayne

    2015-01-01

    While there is some local variability in the use of inferior vena cava filters and there has been some evolution in the indications for filter placement over time, inferior vena cava filters remain a standard option for pulmonary embolism prophylaxis. Indications are clear in certain subpopulations of patients, particularly those with deep venous thrombosis and absolute contraindications to anticoagulation. There are, however, a variety of reported inferior vena cava filter complications in the short and long term, making retrieval of the filter desirable in most cases. Here, we present the case of a morbidly obese patient complaining of chronic abdominal pain after inferior vena cava filter placement and malposition of the filter with extensive protrusion outside the inferior vena cava. She underwent successful laparoscopic retrieval of her malpositioned inferior vena cava filters after failure of a conventional endovascular approach.

  14. Total laparoscopic retrieval of inferior vena cava filter

    Directory of Open Access Journals (Sweden)

    Ehsan Benrashid

    2015-08-01

    Full Text Available While there is some local variability in the use of inferior vena cava filters and there has been some evolution in the indications for filter placement over time, inferior vena cava filters remain a standard option for pulmonary embolism prophylaxis. Indications are clear in certain subpopulations of patients, particularly those with deep venous thrombosis and absolute contraindications to anticoagulation. There are, however, a variety of reported inferior vena cava filter complications in the short and long term, making retrieval of the filter desirable in most cases. Here, we present the case of a morbidly obese patient complaining of chronic abdominal pain after inferior vena cava filter placement and malposition of the filter with extensive protrusion outside the inferior vena cava. She underwent successful laparoscopic retrieval of her malpositioned inferior vena cava filters after failure of a conventional endovascular approach.

  15. Bilateral inferior petrosal sinus sampling using vasopressin

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    Narendra Kotwal

    2016-01-01

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

  16. Inferior phrenic artery embolization in the treatment of hepatic neoplasms

    International Nuclear Information System (INIS)

    Duprat, G.; Charnsangavej, C.; Wallace, S.; Carrasco, C.H.

    1988-01-01

    Twenty-nine inferior phrenic artery embolizations were performed in 20 patients with primary or metastatic hepatic neoplasms. All patients had interruption of their hepatic arteries by previous infusion of chemotherapy, hepatic arterial embolization or surgical ligation. In one patient, bilateral pleural effusions developed following embolization of the inferior phrenic artery. No other severe complications occurred. Inferior phrenic artery embolization is a safe procedure and permits the continuation of transcatheter treatment of hepatic neoplasms. (orig.)

  17. Inferior phrenic artery embolization in the treatment of hepatic neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Duprat, G.; Charnsangavej, C.; Wallace, S.; Carrasco, C.H.

    Twenty-nine inferior phrenic artery embolizations were performed in 20 patients with primary or metastatic hepatic neoplasms. All patients had interruption of their hepatic arteries by previous infusion of chemotherapy, hepatic arterial embolization or surgical ligation. In one patient, bilateral pleural effusions developed following embolization of the inferior phrenic artery. No other severe complications occurred. Inferior phrenic artery embolization is a safe procedure and permits the continuation of transcatheter treatment of hepatic neoplasms.

  18. Retroperitoneal arteriovenous malformation extending through the inferior vena cava into the heart and causing inferior vena cava dissection

    International Nuclear Information System (INIS)

    Sung, Yon Mi; Choe, Yeon Hyeon; Park, Seung Woo; Park, Pyo Won; Sung, Chang Ohk

    2005-01-01

    We present a case of retroperitoneal arteriovenous malformation extending through the inferior vena cava into the heart, which was associated with dissection of the inferior vena cava in a 32-year-old female. Computed tomography and magnetic resonance imaging showed a double-lumen inferior vena cava and a rod-like solid component attached to a sac-like lesion in the right heart chambers. Digital subtraction angiography showed an arteriovenous malformation draining to the inner lumen of the inferior vena cava. (orig.)

  19. Adaptive global synchrony of inferior olive neurons

    International Nuclear Information System (INIS)

    Lee, Keum W; Singh, Sahjendra N

    2009-01-01

    This paper treats the question of global adaptive synchronization of inferior olive neurons (IONs) based on the immersion and invariance approach. The ION exhibits a variety of orbits as the parameter (termed the bifurcation parameter), which appears in its nonlinear functions, is varied. It is seen that once the bifurcation parameter exceeds a critical value, the stability of the equilibrium point of the ION is lost, and periodic orbits are born. The size and shape of the orbits depend on the value of the bifurcation parameter. It is assumed that bifurcation parameters of the IONs are not known. The orbits of IONs beginning from arbitrary initial conditions are not synchronized. For the synchronization of the IONs, a non-certainty equivalent adaptation law is derived. The control system has a modular structure consisting of an identifier and a control module. Using the Lyapunov approach, it is shown that in the closed-loop system, global synchronization of the neurons with a prescribed relative phase is accomplished, and the estimated bifurcation parameters converge to the true parameters. Unlike the certainty-equivalent adaptive control systems, an interesting feature of the designed control system is that whenever the estimated parameters coincide with the true values, the parameter estimates remain frozen thereafter, and the closed-loop system recovers the performance of the deterministic closed-loop system. Simulation results are presented which show that in the closed-loop system, the synchrony of neurons with prescribed phases is accomplished despite the uncertainties in the bifurcation parameters.

  20. 'Pseudothrombus' of the inferior vena cava

    International Nuclear Information System (INIS)

    Takebayashi, Shigeo; Odagiri, Kunio; Matsui, Kengo; Hayano, Ikuo.

    1983-01-01

    Normal Inferior Vena Cava (IVC) of 15 cases were studies on CT with bolus injection in the foot vein.FWell dilated IVC were obtained on scan both at full-inspiration and full-expiration. As the normal findings of IVC, different opacification patterns which may be designate ''homogenous'', ''layered'' and ''pseudothrombus'' were obtained. The ''homogenous'' opacification was noted both at full-inspiration and full-expiration. In homogenous patterns as noted as ''layered'' and ''pseudothrombus'' were suspected to occur in the case of insufficient mixing of contrast agent with blood and/or insufficient amount of contrast agent. And both these patterns were observed in dilated IVC. The ''layered'' opacified IVC was shown on scan at full-inspiration at which respiratory phase the blood flow in IVC may decrease.FThe ''pseudothrombus'' pattern was generally noted at full-expiration at which the blood flow may increase.FAlthough bolus injection of contrast agent into foot vein is useful for evaluation of IVC, one shound be aware of normal opacification of IVC including ''pseudothrombus'' pattern. (author)

  1. Endovascular management of inferior vena cava filter thrombotic occlusion.

    Science.gov (United States)

    Branco, Bernardino C; Montero-Baker, Miguel F; Espinoza, Eduardo; Gamero, Maria; Zea-Vera, Rodrigo; Labropoulos, Nicos; Leon, Luis R

    2018-01-01

    Objective Inferior vena cava occlusion is a potentially life-threatening complication related to caval filters. We present our experience with filter-induced inferior vena cava occlusion in order to assess the feasibility, safety, and effectiveness of endovascular management. Methods A retrospective review of all patients undergoing inferior vena cava filter placement over a 60-month study period was performed. From this cohort, a total of 10 cases of inferior vena cava occlusion after filter placement were identified. Demographics, clinical data, procedures, and outcomes were extracted. Patients were followed to the last clinic visit or until they died. Results One-hundred eighty filters were placed by our group practice during the study period. Of those, a total of 10 patients were identified. Overall, there were 7 males; the mean age was 57.1 years (25-78 years). The median time between inferior vena cava filter placement and filter occlusion was 105 days (range 5-4745 days). All patients were clinically symptomatic at the time of their presentation. Nine out of 10 patients were successfully managed endovascularly. Trellis™-8 thrombectomy was the most common endovascular strategy performed ( n = 9). Four patients had balloon angioplasty, two of those with stent placement for chronically occluded inferior vena cava/iliac veins. No thromboembolic complications developed during a median follow-up period of 233 days (range 4-1083 days). Conclusions Endovascular management of inferior vena cava occlusion is feasible, safe, and effective in decreasing thrombus burden in the presence of an inferior vena cava filter. Further studies evaluating long-term inferior vena cava patency and optimal surveillance regimen after endovascular management of filter-related inferior vena cava occlusion are warranted.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

  3. The clinical application of inferior vena caval CO2-DSA

    International Nuclear Information System (INIS)

    Guo Jinhe; Teng Gaojun; Zhu Guangyu; Li Guozhao; Fang Wen; He Shicheng; Deng Tang

    2007-01-01

    Objective: To explore the feasibility and safety of inferior vena caval CO 2 -DSA and evaluate the results of inferior vena cavography using CO 2 -DSA or iodinated contrast media. Methods: 25 patients diagnosed as deep venous thrombosis of lower limb were prepared to conceive the implantation of inferior vena caval filter. The inferior vena cava and right renal vein CO 2 -DSA and iodinated contrast media DSA were carried out through jugular or femoral vein approach in all patients. Results: The inferior vena caval angiography with CO 2 -DSA or iodinated contrast media were carried out successfully in all patients. The quality of the inferior vena caval angiogram showed: with CO 2 as contrast media, 14 cases obtained excellent images and 11 cases had good images; with iodinated contrast media the images of 18 cases were excellent and 7 cases were good. No thrombus and variation of inferior vena cava were found by the two kinds of angiography. The diameter of inferior vena cava showed: (20.01 ± 0.83) mm with CO 2 contrast media and (20.15 ± 0.92) mm with iodinated contrast media, (P=0.006); having statistical significance between them. The safety of angiography with CO 2 presented only 1 case with transient slight decrease of O 2 saturation. No abnormal changes were found in blood pressure, heart rate and so on. Conclusions: Inferior vena caval CO 2 -DSA is feasible and safe, with statistical significance in the measurement of inferior vena caval diameter comparing with iodinated contrast material but with no influence on the implantation of filter. (authors)

  4. The role of inferior parietal and inferior frontal cortex in working memory.

    Science.gov (United States)

    Baldo, Juliana V; Dronkers, Nina F

    2006-09-01

    Verbal working memory involves two major components: a phonological store that holds auditory-verbal information very briefly and an articulatory rehearsal process that allows that information to be refreshed and thus held longer in short-term memory (A. Baddeley, 1996, 2000; A. Baddeley & G. Hitch, 1974). In the current study, the authors tested two groups of patients who were chosen on the basis of their relatively focal lesions in the inferior parietal (IP) cortex or inferior frontal (IF) cortex. Patients were tested on a series of tasks that have been previously shown to tap phonological storage (span, auditory rhyming, and repetition) and articulatory rehearsal (visual rhyming and a 2-back task). As predicted, IP patients were disproportionately impaired on the span, rhyming, and repetition tasks and thus demonstrated a phonological storage deficit. IF patients, however, did not show impairment on these storage tasks but did exhibit impairment on the visual rhyming task, which requires articulatory rehearsal. These findings lend further support to the working memory model and provide evidence of the roles of IP and IF cortex in separable working memory processes. ((c) 2006 APA, all rights reserved).

  5. Symplastic Leiomyoma in the Suprarenal Inferior Vena Cava

    International Nuclear Information System (INIS)

    Kahveci, Volkan; Ogur, Torel; Cipe, Gokhan; Ozdemir, Sevim; Hazinedaroglu, Selcuk

    2012-01-01

    Leiomyomas are benign tumors of the soft tissue and may develop in any location where smooth muscle is present. Leiomyoma in the inferior vena cava is a rarely seen pathology, and symplastic leiomyoma is also a rare histological variant of leiomyoma. In this case, we present a rare histological variant of symplastic leiomyoma in the inferior vena cava (IVC). This is the first radiologically reported case of a symplastic leiomyoma of the IVC

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

    OpenAIRE

    Tongjaroenbungam, Walaiporn; Jongkamonwiwat, Nopporn; Cunningham, Joanna; Phansuwan-Pujito, Pansiri; Dodson, Hilary C; Forge, Andrew; Govitrapong, Piyarat; Casalotti, Stefano O

    2004-01-01

    Abstract Background The inferior colliculus, which receives almost all ascending and descending auditory signals, plays a crucial role in the processing of auditory information. While the majority of the recorded activities in the inferior colliculus are attributed to GABAergic and glutamatergic signalling, other neurotransmitter systems are expressed in this brain area including opiate peptides and their receptors which may play a modulatory role in neuronal communication. Results Using a pe...

  7. Collateral veins in inferior caval vein occlusion demonstrated via CT

    International Nuclear Information System (INIS)

    Lien, H.H.; Lund, G.

    1983-01-01

    CT-scans of 12 patients with tumour-induced occlusion of the inferior vena cava were studied with regard to collateral veins. A comparison was performed with findings at phlebography in 10 patients and at autopsy in 2. The site and appearance of the main collateral pathway are presented. A close study of vascular structures renders useful information on collateral circulation in occlusion of the inferior vena cava. (orig.)

  8. A basic review on the inferior alveolar nerve block techniques

    OpenAIRE

    Khalil, Hesham

    2014-01-01

    The inferior alveolar nerve block is the most common injection technique used in dentistry and many modifications of the conventional nerve block have been recently described in the literature. Selecting the best technique by the dentist or surgeon depends on many factors including the success rate and complications related to the selected technique. Dentists should be aware of the available current modifications of the inferior alveolar nerve block techniques in order to effectively choose b...

  9. Estuary deposits in the Río Baguales Formation (Chattian-Aquitanean, Magallanes Province, Chile Depósitos estuarinos en la Formación Río Baguales (Chattiano-Aquitaniano, Provincia de Magallanes, Chile

    Directory of Open Access Journals (Sweden)

    Jacobus P Le Roux

    2010-07-01

    Full Text Available Very little work has been done on the stratigraphy and sedimentology of the upper Oligocene-Lower Miocene Río Baguales Formation in the Magallanes Province of southern Chile since its original definition in 1957. A detailed stratigraphic section of the upper part of the formation exposed west of the Baguales River is presented, with an interpretation of depositional environments. This indicates a prograding shoreline in which estuary mouth, middle estuary (lagoon and bay head delta facies are represented. Large-scale delta slope foresets indicate progradation towards the north and northwest, whereas southeast-directed cross-beds on the delta front probably suggest wave action. The general sequence reflects a gradual sea-level fall largely counteracted by tectonic subsidence, which provided the ne-cessary accommodation space for thick tidal flat and subtidal deposits to accumulate. A longer period of transgression towards the top of the succession may be related to a rise in sea-level or accelerated tectonic subsidence, whereas a major regression commencing at around 23.3 Ma probably coincides with the opening of the Drake Passage and the growth of the East Antarctic Ice Sheet.Hay muy pocos trabajos sobre la estratigrafía y sedimentología de la Formación Río Baguales del Oligoceno superior-Mioceno inferior en la Provincia de Magallanes del sur de Chile, luego de su primera definición en 1957. Se presenta un perfil estratigráfico detallado de la parte superior de la formación al oeste del río Baguales, con una interpretación de los ambientes de depositación. Se identificó una costa progradante con facies de boca de estuario, medio de estuario (laguna y delta de cabecera. Las grandes capas frontales del talud deltaico indican progradación hacia el norte y noroeste, mientras que la presencia de laminación cruzada inclinada hacia el sureste sugiere la acción de oleaje. La sucesión en general refleja una caída gradual del nivel del

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

    Directory of Open Access Journals (Sweden)

    Forge Andrew

    2004-09-01

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

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

    Science.gov (United States)

    Tongjaroenbungam, Walaiporn; Jongkamonwiwat, Nopporn; Cunningham, Joanna; Phansuwan-Pujito, Pansiri; Dodson, Hilary C; Forge, Andrew; Govitrapong, Piyarat; Casalotti, Stefano O

    2004-01-01

    Background The inferior colliculus, which receives almost all ascending and descending auditory signals, plays a crucial role in the processing of auditory information. While the majority of the recorded activities in the inferior colliculus are attributed to GABAergic and glutamatergic signalling, other neurotransmitter systems are expressed in this brain area including opiate peptides and their receptors which may play a modulatory role in neuronal communication. Results Using a perfusion protocol we demonstrate that morphine can inhibit KCl-induced release of [3H]GABA from rat inferior colliculus slices. DAMGO ([D-Ala(2), N-Me-Phe(4), Gly(5)-ol]-enkephalin) but not DADLE ([D-Ala2, D-Leu5]-enkephalin or U69593 has the same effect as morphine indicating that μ rather than δ or κ opioid receptors mediate this action. [3H]GABA release was diminished by 16%, and this was not altered by the protein kinase C inhibitor bisindolylmaleimide I. Immunostaining of inferior colliculus cryosections shows extensive staining for glutamic acid decarboxylase, more limited staining for μ opiate receptors and relatively few neurons co-stained for both proteins. Conclusion The results suggest that μ-opioid receptor ligands can modify neurotransmitter release in a sub population of GABAergic neurons of the inferior colliculus. This could have important physiological implications in the processing of hearing information and/or other functions attributed to the inferior colliculus such as audiogenic seizures and aversive behaviour. PMID:15353008

  12. Inferior ectopic pupil and typical ocular coloboma in RCS rats.

    Science.gov (United States)

    Tsuji, Naho; Ozaki, Kiyokazu; Narama, Isao; Matsuura, Tetsuro

    2011-08-01

    Ocular coloboma is sometimes accompanied by corectopia in humans and therefore ectopic pupil may indicate ocular coloboma in experimental animals. The RCS strain of rats has a low incidence of microphthalmia. We found that inferior ectopic pupil is associated exclusively with small-sized eyes in this strain. The objective of the current study was to evaluate whether inferior ectopic pupil is associated with iridal coloboma and other types of ocular coloboma in RCS rats. Both eyes of RCS rats were examined clinically, and those with inferior ectopic pupils underwent morphologic and morphometric examinations. In a prenatal study, coronal serial sections of eyeballs from fetuses at gestational day 16.5 were examined by using light microscopy. Ectopic pupils in RCS rats were found exclusively in an inferior position, where the iris was shortened. Fundic examination revealed severe chorioretinal coloboma in all cases of inferior ectopic pupil. The morphologic characteristics closely resembled those of chorioretinal coloboma in humans. Histopathologic examination of primordia showed incomplete closure of the optic fissure in 4 eyeballs of RCS fetuses. Neither F(1) rats nor N(2) (progeny of RCS × BN matings) displayed any ocular anomalies, including ectopic pupils. The RCS strain is a suitable model for human ocular coloboma, and inferior ectopic pupil appears to be a strong indicator of ocular coloboma.

  13. A Case of Blunt Trauma of the Eyeball Associated With an Inferior Oblique Muscle and an Inferior Rectus Muscle Rupture.

    Science.gov (United States)

    Nitta, Keisuke; Kashima, Tomoyuki; Miura, Fumihide; Hiroe, Takashi; Akiyama, Hideo; Kishi, Shoji

    2016-01-01

    Rupture of the extraocular muscle in the absence of significant injury to the eyeball and adnexa is uncommon. The authors report a case of blunt trauma of the eyeball associated with an inferior oblique muscle and an inferior rectus muscle rupture. A 55-year-old man slipped and fell down hitting his eye on an extended windshield wiper blade. Although he had treatment in the emergency room, he complained of diplopia in the primary position 1 day postoperatively. After noticing ruptures of the inferior oblique muscle and an inferior rectus muscle during exploratory surgery, the authors carefully repaired it. Diplopia in the primary position had disappeared within 1 month after the operation and by 6 months postoperatively. The movement of the eye had almost completely recovered.

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

    Science.gov (United States)

    Bartoníček, J; Tuček, M; Malík, J

    2018-01-01

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

  15. The effects of inferior olive lesion on strychnine seizure

    International Nuclear Information System (INIS)

    Anderson, M.C.; Chung, E.Y.; Van Woert, M.H.

    1990-01-01

    Bilateral inferior olive lesions, produced by systemic administration of the neurotoxin 3-acetylpyridine (3AP) produce a proconvulsant state specific for strychnine-induced seizures and myoclonus. We have proposed that these phenomena are mediated through increased excitation of cerebellar Purkinje cells, through activation of glutamate receptors, in response to climbing fiber deafferentation. An increase in quisqualic acid (QA)-displaceable [ 3 H]AMPA [(RS)-alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid] binding in cerebella from inferior olive-lesioned rats was observed, but no difference in [ 3 H]AMPA binding displaced by glutamate, kainic acid (KA) or glutamate diethylester (GDEE) was seen. The excitatory amino acid antagonists GDEE and MK-801 [(+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclo-hepten-5,10 imine] were tested as anticonvulsants for strychnine-induced seizures in 3AP inferior olive-lesioned and control rats. Neither drug effected seizures in control rats, however, both GDEE and MK-801 produced a leftward shift in the strychnine-seizure dose-response curve in 3AP inferior olive-lesioned rats. GDEE also inhibited strychnine-induced myoclonus in the lesioned group, while MK-801 had no effect on myoclonus. The decreased threshold for strychnine-induced seizures and myoclonus in the 3AP-inferior olive-lesioned rats may be due to an increase in glutamate receptors as suggested by the [ 3 H]AMPA binding data

  16. A basic review on the inferior alveolar nerve block techniques.

    Science.gov (United States)

    Khalil, Hesham

    2014-01-01

    The inferior alveolar nerve block is the most common injection technique used in dentistry and many modifications of the conventional nerve block have been recently described in the literature. Selecting the best technique by the dentist or surgeon depends on many factors including the success rate and complications related to the selected technique. Dentists should be aware of the available current modifications of the inferior alveolar nerve block techniques in order to effectively choose between these modifications. Some operators may encounter difficulty in identifying the anatomical landmarks which are useful in applying the inferior alveolar nerve block and rely instead on assumptions as to where the needle should be positioned. Such assumptions can lead to failure and the failure rate of inferior alveolar nerve block has been reported to be 20-25% which is considered very high. In this basic review, the anatomical details of the inferior alveolar nerve will be given together with a description of its both conventional and modified blocking techniques; in addition, an overview of the complications which may result from the application of this important technique will be mentioned.

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

    Science.gov (United States)

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

    2016-03-01

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

  18. Anterior ST segment depression in acute inferior myocardial infarction as a marker of greater inferior, apical, and posterolateral damage

    International Nuclear Information System (INIS)

    Ruddy, T.D.; Yasuda, T.; Gold, H.K.; Leinbach, R.C.; Newell, J.B.; McKusick, K.A.; Boucher, C.A.; Strauss, H.W.

    1986-01-01

    The clinical significance of anterior precordial ST segment depression during acute inferior myocardial infarction was evaluated in 67 consecutive patients early after onset of symptoms with gated blood pool scans, thallium-201 perfusion images, and 12-lead ECGs. Patients with anterior ST depression (n = 33) had depressed mean values for left ventricular ejection fraction (54 +/- 2% [mean +/- S.E.M.] vs 59 +/- 2%; p = 0.02), cardiac index (3.1 +/- 0.2 vs 3.6 +/- 0.2 L/m2; p = 0.03), and ratio of systolic blood pressure to end-systolic volume (2.0 +/- 0.1 vs 2.5 +/- 0.3 mm Hg/ml; p = 0.04) compared to patients with no anterior ST depression (n = 34). Patients with anterior ST depression had (1) lower mean wall motion values for the inferior, apical, and inferior posterolateral segments (p less than 0.05) and (2) greater reductions in thallium-201 uptake in the inferior and posterolateral regions (p less than 0.05). However, anterior and septal (1) wall motion and (2) thallium-201 uptake were similar in patients with and without ST depression. Thus, anterior precordial ST segment depression in patients with acute inferior wall myocardial infarction represents more than a reciprocal electrical phenomenon. It identifies patients with more severe wall motion impairment and greater hypoperfusion of the inferior and adjacent segments. The poorer global left ventricular function in these patients is a result of more extensive inferior infarction and not of remote septal or anterior injury

  19. Isquemia aguda de miembros inferiores secundaria a ergortismo

    Directory of Open Access Journals (Sweden)

    Franco J. Vallejo, MD

    2011-11-01

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

  20. Symptomatic duodenal perforation by inferior vena cava filter.

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Clovis Luis Konopka

    2010-09-01

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

  2. Maksilektomi Inferior pada Karsinoma Sel Skuamosa Palatum Durum

    Directory of Open Access Journals (Sweden)

    Sukri Rahman

    2016-01-01

    Full Text Available Abstrak          Karsinoma Palatum Durum adalah keganasan daerah kepala dan leher yang jarang terjadi dimana setengah diantaranya merupakan Karsinoma Sel Skuamosa. Pada fase awal keganasan ini dapat bersifat asimptomatis namun dapat juga menimbulkan gejala berupa ulkus yang terasa nyeri pada perkembangan penyakitnya. Operasi maksilektomi inferior merupakan salah satu pilihan tindakan yang dapat dilakukan dalam tatalaksana kasus ini, diikuti oleh pemberian radioterapi. Kasus ini dibuat untuk memahami penatalaksanaan karsinoma palatum durum. Dilaporkan kasus seorang laki-laki 45 tahun dengan diagnosis Karsinoma Sel Skuamosa Palatum Durum (Well to Moderately Differentiated Keratinized stadium IVa (T4aN0M0 dilakukan operasi maksilektomi inferior, namun tidak diikuti dengan radioterapi karena pasien menolak. Maksilektomi inferior merupakan pilihan pembedahan pada tumor yang terbatas pada palatum, lantai sinus maksila dan kavum nasi. Prognosis karsinoma sel skuamosa palatum durum cukup baik dan angka harapan hidup lima tahun akan bertambah bila dilakukan operasi diikuti dengan pemberian radioterapi. Kata kunci: Karsinoma sel skuamosa, maksilektomi inferior, radioterapi AbstractCarcinoma of the hard palate is a rare head and neck cancer in which half of it was Squamous Cell Carcinoma. In the initial phase of this malignancy may be asymptomatic, but can also cause symptoms such as painful ulcers in the development of the disease. Inferior maxillectomy is one of the choice of operation that can be performed, followed by radiotherapy to understand the management of carcinoma of the hard palate. Reported one case of a man 45 years old with diagnosis Squamous Cell Carcinoma of hard palate (Well to Moderately Differentiated Keratinized stage IVa (T4aN0M0 treated by inferior maxillectomy surgery, but not followed by radiotherapy because the patient refused. Inferior Maksilektomi is a surgical option in tumor that limited to the palate, floor of the

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

    Directory of Open Access Journals (Sweden)

    Grahame K. Goode

    2011-06-01

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

  4. [Contralateral Recession of the Inferior Oblique Muscle in Grave's Disease Patients with Mild M. rectus inferior fibrosis].

    Science.gov (United States)

    Eckstein, A; Raczynski, S; Dekowski, D; Esser, J

    2015-10-01

    The aim of this study was to evaluate the dose effect and the resulting binocular single vision for inferior oblique muscle recession in patients with Grave's orbitopathy. The evaluation covered all patients (n = 13) between 2010-2013 treated with recession of the inferior oblique muscle for vertical deviation caused by inferior fibrosis of the contralateral eye. The inclusion criterion was a small vertical squint angle with excyclotorsion. The corrected vertical squint angle was 3.75° [7 pdpt] (median, min 1.5° [3 pdpt], max 8° [16 pdpt]) in primary position and 5.5° in adduction [11pdpt] (median, min 3°[6 pdpt], max 9°[18pdpt]). Excyclotorsion was 4° [8 pdpt] (median, min 1° [2 pdpt], max 9° [18 pdpt]). Elevation was only slightly impaired and the side difference was 5° (median). The recession distance was preoperatively determined: 0.5° squint angle reduction per mm recession distance (calculation from patients who received surgery before 2010). Inferior oblique recession generated a good field of binocular single vision (BSV) for all patients. All patients reached BSV in the central area (20°) and within 30° of downgaze. Sixty nine percent of the patients were completely diplopia free in downgaze. Diplopia persisted in more than half of the patients in up gaze outside 15°. Squint reduction was 0.5° [1 pdpt] [0.45-0.67]/per mm recession distance in primary position and 0.65° [1.3 pdpt] [0.55-0.76]/per mm for the vertical deviation in adduction. Excyclotorsion was reduced to ≤ 2° in 77 % of the patients. Inferior oblique muscle recession can be very successfully performed on the contralateral eye in patients with mild inferior rectus muscle fibrosis. Surgery at the contralateral yoke muscle prevents the risk of overeffect with resulting diplopia in downgaze, which could occur if small distance recession had been performed at the inferior rectus muscle. An overeffect in relation to inferior oblique recession will only

  5. Buccal Infiltration versus Inferior Alveolar Nerve Block in Mandibular ...

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... Purpose: The purpose of this study is to compare the success rates of inferior alveolar nerve block (IANB) and buccal infiltration anesthesia of mandibular second premolar with irreversible pulpitis and to evaluate the level of patient discomfort with these methods. Matherials and Methods: Forty patients, who.

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

    Science.gov (United States)

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

    2017-11-06

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

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

    African Journals Online (AJOL)

    2014-05-30

    May 30, 2014 ... Case Report doi:10.4102/sajr.v18i1.592 http://sajr.org.za. Incidental right Bochdalek hernia with interruption of the inferior vena cava and hepatic venous collateral continuation: A case report. Authors: Farzanah I. Ismail1. Rule Human2. Anith Chacko1. Parmanand Naran2. Samia Ahmad1. Siraj Ellemdin2.

  8. reduction mammoplasty using inferior pedicle in heavy breasts

    African Journals Online (AJOL)

    2011-09-09

    Sep 9, 2011 ... sexual relationships. Reduction mammoplasty procedure provides weight and volume reduction of the breast as well as enhancement of the aesthetic appearance of the breasts. In this study, the inferior pedicle technique was used in reduction of thirty five patients over the last four years with macromastia.

  9. Renal Angiomyolipoma Associated with Inferior Vena Cava Thrombus

    Directory of Open Access Journals (Sweden)

    Xavier Durand

    2009-01-01

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

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

    African Journals Online (AJOL)

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

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

    Directory of Open Access Journals (Sweden)

    Muzaffer Kahyaoğlu

    2017-03-01

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

  12. EFEKTIVITAS TEKNIK MANAJEMEN DIRI UNTUK MENGATASI INFERIORITY FEELING

    Directory of Open Access Journals (Sweden)

    Kartika

    2016-04-01

    Full Text Available Siswa yang memiliki inferiority feeling selalu memandang rendah kemampuan yang dimiliki oleh dirinya. Untuk menutupi harga dirinya yang lemah, mereka akan melakukan kompensasi dengan cara menarik diri, bersikap agresif, ataupun membuat alasan. Sebagai upaya mengatasi inferiority feeling adalah dengan mengimplementasikan konseling kelompok dengan teknik manajemen diri. Teknik ini lebih menekankan pada pengelolaan diri yang timbul dari keinginan diri siswa. Penelitian ini bertujuan untuk menguji efektivitas konseling kelompok dengan menggunakan teknik manajemen diri untuk mengatasi inferiority feeling. Pengambilan subyek penelitian dilakukan secara non random menggunakan teknik purposive sampling. Metode penelitian yang digunakan adalah kuasi eksperimen dengan desain non equivalent pretest posttest design. Hasil penelitian menunjukkan bahwa intervensi menggunakan teknik manajemen diri efektif untuk menurunkan inferiority feeling pada subyek penelitian. Rekomendasi: (a Konselor sekolah, melakukan pemantauan secara berkala kepada siswa yang telah menjalani intervensi untuk melihat pengaruh jangka panjang dari intervensi yang telah diberikan; (b bagi peneliti selanjutnya dapat melakukan penelitian dengan keterlibatan pihak keluarga ataupun sahabat sebagai pendukung dalam memperoleh data mengenai keadaan sesungguhnya yang dialami oleh konsel

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

    LENUS (Irish Health Repository)

    Kenny, Damien

    2012-02-01

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

  14. Asymptomatic Lumbar Vertebral Erosion from Inferior Vena Cava Filter Perforation

    International Nuclear Information System (INIS)

    Fang, Wayne; Hieb, Robert A.; Olson, Eric; Carrera, Guillermo F.

    2007-01-01

    In 2002, a 24-year-old female trauma patient underwent prophylactic inferior vena cava filter placement. Recurrent bouts of renal stones prompted serial CT imaging in 2004. In this brief report, we describe erosion and ossification of the L3 vertebral body by a Greenfield filter strut

  15. Injuries of the retrohepatic inferior vena cava and the liver

    Directory of Open Access Journals (Sweden)

    Koprivica Radenko

    2008-01-01

    Full Text Available Beckground. Injuries of the retrohepatic inferior vena cava, and the liver have mortality rate up to 71-78%. We presented a patient with combined injury of the retrohepatic inferior vena cava, liver, craniocerebral and thoracic traumas, inflicted in a traffic accident. Case report. Man, 20 years old has been injured in a traffic accident. At admission, 20 minutes after the injury, the patient was comatose and hypotensive. Bloody content was obtained by abdominal tracer. The patient underwent emergent laparotomy, utilizing trifurcated incision and cell saver device. Abdominal exploration revealed two liters of free blood and massive retroperitoneal hematoma. Manual compression of the liver was done, as well as perihepatic packing, complete hepatic vascular exclusion and mobilization of the right liver lobe. Due to impressive chemodynamic instability supraceliac aortic clamping was performed. Upon exposure of the retrohepatic inferior vena cava and right liver lobe, multiple lacerations of retrohepatic inferior vena cava and right hepatic vein, and right hepatic vein avulsion were found. We also identified an injury of VII and VIII segments of the liver (grade V according to the Moore's classification. Nonexpansive hepatoduodenal ligament hematoma and the injury of II and III segments of the liver group II/III according to Moore were found. Venorrhaphy of the inferior vena cava was done in the area of circumference of the right hepatic vein, a portion of which served as autologous vein patch. Continuous prolene 3/0 venorrhaphy of the distal caval laceration was done. Total caval and aorta clamping time of the inferior vena cava was 41 minutes. Atypical resection, debridment, of hepatic segments was done by using a harmonic scalpel. Hepatoduodenal ligament was declamped after 65 minutes. Fibrin glue was applied on the resectioned area of liver. The patient received 3.2 l of autologuos blood transfusion with 5 units of packed red blood cells, 6

  16. Some problems with non-inferiority tests in psychotherapy research: psychodynamic therapies as an example.

    Science.gov (United States)

    Rief, Winfried; Hofmann, Stefan G

    2018-02-14

    In virtually every field of medicine, non-inferiority trials and meta-analyses with non-inferiority conclusions are increasingly common. This non-inferiority approach has been frequently used by a group of authors favoring psychodynamic therapies (PDTs), concluding that PDTs are just as effective as cognitive-behavioral therapies (CBT). We focus on these examples to exemplify some problems associated with non-inferiority tests of psychological treatments, although the problems also apply to psychopharmacotherapy research, CBT research, and others. We conclude that non-inferiority trials have specific risks of different types of validity problems, usually favoring an (erroneous) non-inferiority conclusion. Non-inferiority trials require the definition of non-inferiority margins, and currently used thresholds have a tendency to be inflationary, not protecting sufficiently against degradation. The use of non-inferiority approaches can lead to the astonishing result that one single analysis can suggest both, superiority of the comparator (here: CBT) and non-inferiority of the other treatment (here PDT) at the same time. We provide recommendations how to improve the quality of non-inferiority trials, and we recommend to consider them among other criteria when evaluating manuscripts examining non-inferiority trials. If psychotherapeutic families (such as PDT and CBT) differ on the number of investigating trials, and in the fields of clinical applications, and in other validity aspects mentioned above, conclusions about their general non-inferiority are no more than a best guess, typically expressing the favored approach of the lead author.

  17. Cushing's disease; inferior petrosal sinus venography and samplings

    International Nuclear Information System (INIS)

    Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Lee, Hyun Chul; Huh, Kap Bum; Kim, Young Soo; Chung, Sang Sup

    1991-01-01

    Hypersecretion of ACTH in patients with Cushing's syndrome originates from either a pituitary tumor (Cushing's disease) or an ectopic ACTH-secreting tumor. These 2 entities may be clinically indistinguishable, and additional difficulty arise because pituitary microadenomas may be radiologically occult. Recently, bilateral selective venous sampling from the inferior petrosal sinuses became the procedure of choice for confirming a false negative study of a combined hormonal test and pituitary ACTH hypersecretion. We performed selective venous catheterization and sampling for ACTH. The central location of the lesion was detected in 1 case (intersinus gradient = 1.1 : 1), and the remaining 5 cases revealed lateralization of the lesions (intersinus gradient = 3.7 - 20.1 : 1), which correlated well with transsphenoidal microadenomectomies in all the cases. We concluded that selective venous ACTH sampling from the inferior petroal sinus is a reliable and useful aid in the diagnosis of Cushing's disease when standard clinical and biochemical studies are inconclusive

  18. 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.

  19. Arched needle technique for inferior alveolar mandibular nerve block.

    Science.gov (United States)

    Chakranarayan, Ashish; Mukherjee, B

    2013-03-01

    One of the most commonly used local anesthetic techniques in dentistry is the Fischer's technique for the inferior alveolar nerve block. Incidentally this technique also suffers the maximum failure rate of approximately 35-45%. We studied a method of inferior alveolar nerve block by injecting a local anesthetic solution into the pterygomandibular space by arching and changing the approach angle of the conventional technique and estimated its efficacy. The needle after the initial insertion is arched and inserted in a manner that it approaches the medial surface of the ramus at an angle almost perpendicular to it. The technique was applied to 100 patients for mandibular molar extraction and the anesthetic effects were assessed. A success rate of 98% was obtained.

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

    LENUS (Irish Health Repository)

    Keeling, A N

    2008-08-01

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

  1. Delayed ventricular septal rupture complicating acute inferior wall myocardial infarction

    OpenAIRE

    Cho, Jae Hyung; Sattiraju, Srinivasan; Mehta, Sanjay; Missov, Emil

    2013-01-01

    Background Ventricular septal rupture is a potentially fatal complication of acute myocardial infarction. Its incidence has declined with modern reperfusion therapy. In the era of percutaneous coronary interventions, it occurs a median of 18?24?hours after myocardial infarction and is most commonly associated with anterior myocardial infarction. We present a case of delayed ventricular septal rupture complicating acute inferior wall myocardial infarction. Case presentation A 53-year-old Cauca...

  2. Coronectomy - A viable alternative to prevent inferior alveolar nerve injury

    Directory of Open Access Journals (Sweden)

    Alok Sagtani

    2015-12-01

    Full Text Available Background and Objectives: Coronectomy is a relatively new method to prevent the risk of Inferior Alveolar Nerve (IAN injury during removal of lower third molars with limited scientific literature among Nepalese patients. Thus, a study was designed to evaluate coronectomy regarding its use, outcomes and complications.Materials and Methods: A descriptive study was conducted from December 2012 to December 2013 among patients attending Department of Oral and Maxillofacial Surgery, College of Dental Sciences, BP Koirala Institute of Health Sciences, Dharan, Nepal for removal of mandibular third molars. After reviewing the radiograph for proximity of third molar to the IAN, coronectomy was advised. A written informed consent was obtained from the patients and coronectomy was performed. Patients were recalled after one week. The outcome measures in the follow-up visit were primary healing, pain, infection, dry socket, root exposure and IAN injury. The prevalence of IAN proximity of lower third molars and incidence of complications were calculated.Results: A total 300 mandibular third molars were extracted in 278 patients during the study period. Out of 300 impacted mandibular third molar, 41 (13.7% showed close proximity to inferior alveolar nerve . The incidence of complications and failed procedure was 7.4% among the patients who underwent coronectomy. During the follow up visit, persistent pain and root exposure was reported while other complications like inferior alveolar nerve injury, dry socket and infection was not experienced by the study patients.Conclusion: With a success rate of 92.6% among the 41 patients, coronectomy is a viable alternative to conventional total extraction for mandibular third molars who have a higher risk for damage to the inferior alveolar nerve.JCMS Nepal. 2015;11(3:1-5.

  3. Inferior olive mirrors joint dynamics to implement an inverse controller.

    Science.gov (United States)

    Alvarez-Icaza, Rodrigo; Boahen, Kwabena

    2012-10-01

    To produce smooth and coordinated motion, our nervous systems need to generate precisely timed muscle activation patterns that, due to axonal conduction delay, must be generated in a predictive and feedforward manner. Kawato proposed that the cerebellum accomplishes this by acting as an inverse controller that modulates descending motor commands to predictively drive the spinal cord such that the musculoskeletal dynamics are canceled out. This and other cerebellar theories do not, however, account for the rich biophysical properties expressed by the olivocerebellar complex's various cell types, making these theories difficult to verify experimentally. Here we propose that a multizonal microcomplex's (MZMC) inferior olivary neurons use their subthreshold oscillations to mirror a musculoskeletal joint's underdamped dynamics, thereby achieving inverse control. We used control theory to map a joint's inverse model onto an MZMC's biophysics, and we used biophysical modeling to confirm that inferior olivary neurons can express the dynamics required to mirror biomechanical joints. We then combined both techniques to predict how experimentally injecting current into the inferior olive would affect overall motor output performance. We found that this experimental manipulation unmasked a joint's natural dynamics, as observed by motor output ringing at the joint's natural frequency, with amplitude proportional to the amount of current. These results support the proposal that the cerebellum-in particular an MZMC-is an inverse controller; the results also provide a biophysical implementation for this controller and allow one to make an experimentally testable prediction.

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

    Science.gov (United States)

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

    2006-09-01

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

  5. Bilateral catheterization of inferior petrosal sinous: Utility in Cushing syndrome

    International Nuclear Information System (INIS)

    Ferrer, Maria D; Fajardo, Carmen; Esteban Enrique; Cosin Octavio, Valldecabres Carmen; Reig, Marian

    2010-01-01

    The aim of this study is to present our experience on bilateral and simultaneous inferior petrous sinus catheterization, on those patients with ACTH -dependent Cushing's syndrome. We describe the procedure and our results. Material and Method: A retrospective study was held between January 2003 and September 2009, including nine patients (2 men, 7 women) presenting ACTH - dependent Cushing's syndrome. Simultaneous inferior petrosal sinus catheterization was performed in all of them, sampling basal ACTH and after CRH stimulation. ACTH levels gradient in different pituitary locations and peripheral blood levels was recorded. Diagnosis was suggested when inappropriate and maintained hypercortisolemia. High urinary free cortisol levels and no response to dexamethasone suppression were detected. Eight out of nine patients had a prior negative imaging test result. Results: Inferior petrosal sinus bilateral catheterization was successfully performed in all cases, with no evidence of further complications. The results showed definitive diagnosis in all cases. In four patients ACTH levels gradient was lateralized to the left, leading to a specific surgical approach. One patient presented pituitary ACTH - secreting adenoma. Two other patients showed ectopic ACTH production, one showed suprarenal adenoma secreting ACTH and other one showed response to pituitary stimulation without side lateralisation, presenting a histological diagnosis of pituitary hyperplasia. Conclusion: Petrosal sinus catheterization is shown to be an efficient procedure to manage Cushing's syndrome differential diagnosis and to obtain specific anatomical information.

  6. Chemical cautery of the inferior turbinates with trichloroacetic acid

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    Azevedo, Alexandre Fernandes de

    2011-10-01

    Full Text Available Introduction: Chronic secondary nasal obstruction, the hypertrophy of the inferior turbinates is a common symptom of great morbidity in our society. Several surgical techniques are described to cases refractory to medical treatments, however, there are controversy about which one of them is more effective and less subject to complications. Objective: Evaluate the efficacy, security and practicability of using ambulatory trichloroacetic acid to treat the hypertrophy of the inferior turbinates. Method: Prospective study with 29 patients submitted to the ambulatory technique of 30% trichloroacetic acid infiltration in the inferior turbinate's submucosa, under topic anesthesia. The symptoms of rhinorrhea and nasal obstruction were evaluated using the analogical and visual scale (AVS 010 pre-cautery and one year post-procedure. Results: Significant nasal obstruction and rhinorrhea reduction one year post-procedure. The complications were light synechia in two patients and small bleedings in four spontaneous resolution cases. Conclusion: The proposed method showed excellent results concerning nasal obstruction and rhinorrhea, can be conducted in ambulatory environment, and has proved to be a low-complication method.

  7. Intrahepatic venous collaterals forming via the inferior right hepatic vein in 3 patients with obstruction of the inferior vena cava

    International Nuclear Information System (INIS)

    Takayasu, K.; Moriyama, N.; Muramatsu, Y.

    1985-01-01

    When the inferior vena cava is obstructed, collateral veins enlarge, connecting with the inferior (acessory) right hepatic vein (IRHV) and thence through various hepatic veins to the right atrium. Three such cases are described. In one patient, most contrast material flowed into the IRHV and from there to the left hepatic vein. The second patient had several large collaterals arising from the IRHV and flowing into the right and middle hepatic veins, while the third patient demonstrated anastomoses between the IRHV and the middle hepatic vein. All of these hepatic venous shunts eventually drained into the right atrium. There were no clinical manifestations such as ascites, edema, or dilatation of the abdominal veins. Cavography alone or combined with computed tomography proved to be diagnostic in the assessment of these intrahepatic collaterals

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

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    Dafna Geller Palti

    2011-02-01

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

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

    Science.gov (United States)

    PALTI, Dafna Geller; de ALMEIDA, Cristiane Machado; RODRIGUES, Antonio de Castro; ANDREO, Jesus Carlos; LIMA, José Eduardo Oliveira

    2011-01-01

    Background Effective pain control in Dentistry may be achieved by local anesthetic techniques. The success of the anesthetic technique in mandibular structures depends on the proximity of the needle tip to the mandibular foramen at the moment of anesthetic injection into the pterygomandibular region. Two techniques are available to reach the inferior alveolar nerve where it enters the mandibular canal, namely indirect and direct; these techniques differ in the number of movements required. Data demonstrate that the indirect technique is considered ineffective in 15% of cases and the direct technique in 1329% of cases. Objective Objective: The aim of this study was to describe an alternative technique for inferior alveolar nerve block using several anatomical points for reference, simplifying the procedure and enabling greater success and a more rapid learning curve. Materials and Methods A total of 193 mandibles (146 with permanent dentition and 47 with primary dentition) from dry skulls were used to establish a relationship between the teeth and the mandibular foramen. By using two wires, the first passing through the mesiobuccal groove and middle point of the mesial slope of the distolingual cusp of the primary second molar or permanent first molar (right side), and the second following the oclusal plane (left side), a line can be achieved whose projection coincides with the left mandibular foramen. Results The obtained data showed correlation in 82.88% of cases using the permanent first molar, and in 93.62% of cases using the primary second molar. Conclusion This method is potentially effective for inferior alveolar nerve block, especially in Pediatric Dentistry. PMID:21437463

  10. Omental flap transposition for inferior vena cava filter penetration

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    Junji Yamaguchi, MD

    2017-03-01

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

  11. Surgical approach to posterior inferior cerebellar artery aneurysms.

    Science.gov (United States)

    La Pira, Biagia; Sturiale, Carmelo Lucio; Della Pepa, Giuseppe Maria; Albanese, Alessio

    2018-02-01

    The far-lateral is a standardised approach to clip aneurysms of the posterior inferior cerebellar artery (PICA). Different variants can be adopted to manage aneurysms that differ in morphology, topography, ruptured status, cerebellar swelling and surgeon preference. We distinguished five paradigmatic approaches aimed to manage aneurysms that are: proximal unruptured; proximal ruptured requiring posterior fossa decompression (PFD); proximal ruptured not requiring PFD; distal unruptured; distal ruptured. Preoperative planning in the setting of PICA aneurysm surgery is of paramount importance to perform an effective and safe procedure, to ensure an adequate PFD and optimal proximal control before aneurysm manipulation.

  12. Transient Amaurosis and Diplopia After Inferior Alveolar Nerve Block.

    Science.gov (United States)

    Odabaşi, Onur; Şahin, Onur; Polat, Mehmet Emrah

    2017-10-01

    A 40-year-old female patient was admitted to the authors' oral and maxillofacial clinic for removal of her lower left second molar under local anesthesia. The patient's medical history revealed that she had cardiac arhythmia and hypertension. Inferior alveolar nerve block was achieved using 2 mL of sefacaine (%3 mepivacaine HCL, without epinephrine). The patient complained of loss of vision in her left eye. All procedures were stopped immediately. Within 2 minutes the patient reported diplopia. All of the symptoms disappeared about 5 minutes after initial observation. Follow-up after 1 day revealed no complications. The procedure was then performed uneventfully.

  13. Symptomatic caval penetration by a Celect inferior vena cava filter

    International Nuclear Information System (INIS)

    Bogue, Conor O.; John, Philip R.; Connolly, Bairbre L.; Rea, David J.; Amaral, Joao G.

    2009-01-01

    We report a case of penetration of the inferior vena cava (IVC) by all four primary struts of a Celect caval filter in a 17-year-old girl with Klippel-Trenaunay syndrome. The girl presented with acute lower abdominal and right leg pain 17 days after filter insertion. An abdominal radiograph demonstrated that the filter had moved caudally and that the primary struts had splayed considerably since insertion. Contrast-enhanced CT confirmed that all four primary struts had penetrated the IVC wall. There was a small amount of retroperitoneal hemorrhage. The surrounding vessels and viscera were intact. The filter was subsequently retrieved without complication. (orig.)

  14. Retro-aortic, left inferior renal capsular vein

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    Umberto G Rossi

    2015-01-01

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

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

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    Oliver Koeth

    2010-01-01

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

  16. Liver trauma and transection of the inferior vena cava

    International Nuclear Information System (INIS)

    Radin, D.R.

    1992-01-01

    CT of a child with severe liver trauma due to a seat belt injury demonstrated avulsion of a portion of the lateral segment of the left lobe of the liver. The location of nondependent extravasated contrast material aided in identification of the visceral fracture site (the sentinel contrast sign). Associated transection of the inferior vena cava was evidenced by hypoatenuating zones adjacent to all the major hepatic veins and vena cava (hepatic perivenous tracking). Recognition of these two signs is important so that the radiologist can help the surgeon select the optimal operative approach. (orig.)

  17. Superior and inferior vena cavae: Embryology, variants, and pathology

    International Nuclear Information System (INIS)

    Mendelson, D.S.; Mitty, H.; Janus, C.; Gendal, E.; Berson, B.

    1987-01-01

    The superior and inferior venae cavae may be involved in a host of disease processes. Knowledge of the normal anatomy and variants of these structures is valuable in interpreting plain films and the results of angiographic procedures and all cross-sectional modalities. The authors review the embryology of venae cavae and proceed to describe their normal anatomy and variants. An awareness of the variants can prevent mistaking variants for pathologic processes. Finally, the authors describe pathology involving these vessels and demonstrate the radiographic manifestations

  18. Axillary artery injury secondary to inferior shoulder dislocation.

    Science.gov (United States)

    Plaga, Brad R; Looby, Peter; Feldhaus, Steven J; Kreutzmann, Karl; Babb, Aaron

    2010-11-01

    Dislocation injuries of the glenohumeral joint are common in the general public and generally are corrected without complication. One serious complication with shoulder dislocations, or the subsequent reduction, is a lesion to the axillary artery. This specific complication is most frequently seen in the elderly population, where vascular structures have become less flexible. Also, these injuries are most common in association with anterior dislocations of the shoulder. To bring awareness to the possibility of axillary artery injury with inferior dislocation of the shoulder, the treatment options, and a review. We report a 15-year-old male athlete who inferiorly dislocated his shoulder during wrestling practice. The injury was reduced at the scene with manual traction and the patient was transferred to our clinic for evaluation. The patient was determined to have a pseudoaneurysm of the axillary artery, and the history and treatment of the illness are presented. Axillary artery injuries secondary to shoulder dislocations are rare, especially in the young athlete, and proper recognition and treatment offer patients a full recovery. Copyright © 2010. Published by Elsevier Inc.

  19. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

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    Gintaras Juodzbalys

    2011-01-01

    Full Text Available Objectives: The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement.Material and Methods: Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveolar nerve injury implant, inferior alveolar nerve damage, inferior alveolar nerve paresthesia and inferior alveolar nerve repair. The search was restricted to English language articles, published from 1972 to November 2010. Additionally, a manual search in the major anatomy, dental implant, periodontal and oral surgery journals and books were performed. The publications there selected by including clinical, human anatomy and physiology studies.Results: In total 136 literature sources were obtained and reviewed. Aetiological factors of inferior alveolar nerve injury, risk factors, mechanism, clinical sensory nerve examination methods, clinical symptoms and treatment were discussed. Guidelines were created to illustrate the methods used to prevent and manage inferior alveolar nerve injury before or after dental implant placement.Conclusions: The damage of inferior alveolar nerve during the dental implant placement can be a serious complication. Clinician should recognise and exclude aetiological factors leading to nerve injury. Proper presurgery planning, timely diagnosis and treatment are the key to avoid nerve sensory disturbances management.

  20. Endovascular treatment of the posterior inferior cerebellar artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-12-01

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

  1. Anatomy and radiology of the anterior inferior cerebellar artery

    International Nuclear Information System (INIS)

    Heimans, J.J.

    1983-01-01

    This study describes the variations of the Anterior Inferior Cerebellar Artery (AICA) and identifies its types of appearance in normal angiograms as well as in angiograms of patients suffering from posterior fossa tumours or from ischemic lesions in the vertebro-basilar territory. For this purpose a study of 20 normal specimens was undertaken. Four main types of the AICA are distinguished. One hundred normal vertebral angiograms, made between 1976 and 1982 in the Valeriuskliniek and the Academisch Ziekenhuis der Vrije Univesiteit are reviewed. The AICA's are classified in the same way as in the anatomical study. The same classification was used in the analysis of 41 vertebral angiograms of patients with posterior fossa tumours and nine angiograms of patients with ischemic disturbances in the posterior cranial fossa. (Auth.)

  2. Recidiva en vena cava inferior de carcinoma suprarrenal

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    Javier Orrit

    2005-01-01

    Full Text Available Paciente de 15 meses sometido a resección de masa suprarrenal derecha. Estudio de extensión negativo e histología de tumor adrenocortical. Dos meses después presenta recidiva tumoral en vena cava inferior (VCI a nivel de venas suprahepáticas que se reseca bajo hipotermia profunda y parada circulatoria (19 min (Fig. 1. Se extrae una masa friable de 25 × 20 mm que ocluye la VCI, sin evidencia de resto tumoral, aunque se considera resección incompleta al estar infiltradas las paredes de VCI. La histología confirma carcinoma suprarrenal (Fig. 2. A los 5 meses sigue quimioterapia sin datos de nueva invasión de VCI.

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

    Science.gov (United States)

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

    2009-04-07

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

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

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    Peycheva K.

    2014-12-01

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

  5. THE ANTONINE PLAGUE IN DACIA AND MOESIA INFERIOR

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    Dragoș Mitrofan

    2014-07-01

    Full Text Available  The study of epidemics, especially the ancient ones, has long eluded our scientists. And so, we have tried to use a different approach and different ways of studying the disastrous effects of such an epidemic, in the 2nd  century A.D. The goal of this paper is to analyze aspects such as chronology, expansion, and the effects of the disease, and especially, to raise a question about its presence in the roman provinces of Dacia and Moesia Inferior. Whether the presence of a full scale epidemic can be argued, evidence of disturbance can be found by numerous means .In the end, such scientific approach on epidemics can hold valuable clues regarding the rise and fall of civilizations and empires.      

  6. Anesthetic Efficacy of Bupivacaine Solutions in Inferior Alveolar Nerve Block

    Science.gov (United States)

    Volpato, Maria Cristina; Ranali, José; Ramacciato, Juliana Cama; de Oliveira, Patrícia Cristine; Ambrosano, Glaúcia Maria Bovi; Groppo, Francisco Carlos

    2005-01-01

    The purpose of this study was to compare the anesthetic efficacy of 2 bupivacaine solutions. Twenty-two volunteers randomly received in a crossover, double-blinded manner 2 inferior alveolar nerve blocks with 1.8 mL of racemic bupivacaine and a mixture of 75% levobupivacaine and 25% dextrobupivacaine, both 0.5% and with 1 : 200,000 epinephrine. Before and after the injection, the first mandibular pre-molar was evaluated every 2 minutes until no response to the maximal output (80 reading) of the pulp tester and then again every 20 minutes. Data were analyzed using the Wilcoxon paired test and the paired t test. No differences were found between the solutions for onset and duration of pulpal anesthesia and duration of soft tissue anesthesia (P > .05). It was concluded that the solutions have similar anesthetic efficacy. PMID:16596912

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

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    S. Poudyal

    2017-01-01

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

  8. Indications, management, and complications of temporary inferior vena cava filters

    International Nuclear Information System (INIS)

    Linsenmaier, Ulrich; Rieger, Johannes; Schenk, Franz; Rock, Clemens; Mangel, Eugen; Pfeifer, Klaus Juergen

    1998-01-01

    Purpose: We describe the results of a preliminary prospective study using different recently developed temporary and retrievable inferior vena cava (IVC) filters.Methods: Fifty temporary IVC filters (Guenther, Guenther Tulip, Antheor) were inserted in 47 patients when the required period of protection against pulmonary embolism (PE) was estimated to be less than 2 weeks. The indications were documented deep vein thrombosis (DVT) and temporary contraindications for anticoagulation, a high risk for PE, and PE despite DVT prophylaxis.Results: Filters were removed 1-12 days after placement and nine (18%) had captured thrombi. Complications were one PE during and after removal of a filter, two minor filter migrations, and one IVC thrombosis.Conclusion: Temporary filters are effective in trapping clots and protecting against PE, and the complication rate does not exceed that of permanent filters. They are an alternative when protection from PE is required temporarily, and should be considered in patients with a normal life expectancy.

  9. RASGOS GEOGRÁFICOS DEL VALLE DEL RIO AGRIO INFERIOR.

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    Celia Torren

    1993-12-01

    Full Text Available El presente artículo es una síntesis del trabajo "Rasgos Geográficos del Valle del Río Agrio Inferior, el cual es un estudio de base para el conocimiento de la geografía de la región: - apoyando el esfuerzo que está realizando la población del área para lograr una identidad propia y una definitiva integración al contexto provincial; - aportando al proyecto "Rescate Arqueológico en Quili Malal, Neuquén" (subsidiado por CONICET y UNESCO, cuya dirección está a cargo de la profesora Susana Rodríguez de la U.N.C., a través de la confección del mapa geomorfológico del área; y - contribuyendo a los estudios que resultan necesarios ante la construcción de una obra hidroeléctrica de la magnitud de "El Chihuido I", emprendimiento que será llevado a cabo por Agua y Energía eléctrica de la Nación. Los límites del área estudiada fueron establecidos teniendo en cuenta el área del valle inferior del Río Agrio que será completamente inundada por el futuro embalse de la represa "El Chihuido I", a emplazarse 5,5 Km aguas abajo de la confluencia de los ríos Agrio y Neuquén. Además de esta área de afectación directa se tomó también una zona de perilago estrechamente vinculada a la anterior. De esta manera los límites este y oeste quedaron establecidos por la confluencia de los ríos antes mencionados y la localidad de Bajada del Agrio, respectivamente.

  10. Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional

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    Adrián J Da Silva-De Abreu

    2011-01-01

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

  11. Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional

    Directory of Open Access Journals (Sweden)

    Adrián J Da Silva-De Abreu

    2009-01-01

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

  12. Percutaneous placement of bird's nest inferior vena cava filter

    International Nuclear Information System (INIS)

    Lee, Seung Hoon; Sung, Kyu Bo; Yoon, Hyun Ki

    1999-01-01

    To describe clinical experiences of the use of Bird's Nest inferior vena cava(IVC) filter. Between August 1991 and August 1997, IVC filter was percutaneously inserted in 51 patients with pulmonary embolism(PE) and deep vein thrombosis of the lower extremities. Indications for the placement of this filter were contraindication to anticoagulation in 17 patients, prophylaxis of PE in 17, failed anticoagulation in 11, massive PE with residual floating thrombus in three and complications involving anticoagulation in 3. In order to delineate the location of renal vein and extension of deep vein thrombosis into the IVC, all patients under went inferior vena cavography before filter placement. Thirty filters were inserted through the right femoral vein, 19 through the right internal jugular vein and three through the left femoral vein. The patients involved were followed up for periods ranging from one week to six years (mean 10 months). A Bird's Nest IVC filter was placed in the infrarenal IVC in 44 patients and in the suprarenal IVC in 7. Certain complicatioins ensued. IVC penetration occurred in three patients(5.9%), and in seven(1.37%) the filter wire prolapsed. Except for transient pain, however, there were no serious IVC penetration-related complications and no evidence of recurrence of PE in the cases involving prolapse of the filter wire. During follow up, clinically suspected recurrent PE was noted in two patients(3.9%), but there was no evidence of newly developed occlusion of the IVC. In patients who under went follow up, Bird's Nest IVC filter effectively prevented the development and recurrence of PE, and there were no complications. To prevent of penetration of the IVC and prolapse of the filter, however, technical skill was needed

  13. Detection by means of CT of inferior vena cava filters

    International Nuclear Information System (INIS)

    Zurera Tendero, L.J.; Canis Lopez, M.; Oteros Fernandez, R.; Ramos Gomez, M.; Garcia Revillo, J.; Roman Rios, G.

    1995-01-01

    Vena cava filters are an excellent tool for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis (DVT) of the lower limbs. However, these devices are not entirely free of complications as thrombi can develop inside them, threatening to occlude them completely. The objective of this report is to study the incidence of thrombosis in vena cava filters, as well as their impact on prognosis. We also mention the importance of CT as an imaging technique in the study of this complication. We present 30 patients in whom different filters were implanted and their prospective follow-up by means of CT over a mean follow-up period of 36 months. Chi-square analysis was used to determine whether there was a significant relationship among the complications encountered (p<0,05), and their course over time was studied by means of Kaplan-Meyer curves. Five cases (16%) of complete thrombosis of the filter were observed among patients in whom the Gunther model had been implanted, yielding an index of probability of complete permeability of the inferior vena cava at 13 months of 82%. Thrombi of different degrees (between 5% and 60%) were also observed inside the filter in ten patients (33%) with Gunther, Simon-Nitional and LGM models. Filter thrombosis was not significantly associated with the onset of recurrent PE or of venous disorders involving lower limbs, the relationship between PE and preimplantation presence of inferior vena cava thrombosis was significant (p<0.01). It was also observed that post implantation anti coagulation did not significantly prevent later onset of filter thrombosis. (Author)

  14. Middle and Inferior Temporal Gyrus Gray Matter Volume Abnormalities in Chronic Schizophrenia: An MRI Study

    OpenAIRE

    Onitsuka, Toshiaki; Shenton, Martha E.; Salisbury, Dean F.; Dickey, Chandlee C.; Kasai, Kiyoto; Toner, Sarah K.; Frumin, Melissa; Kikinis, Ron; Jolesz, Ferenc A.; McCarley, Robert W.

    2004-01-01

    Objective: The middle temporal gyrus and inferior temporal gyrus subserve language and semantic memory processing, visual perception, and multimodal sensory integration. Functional deficits in these cognitive processes have been well documented in patients with schizophrenia. However, there have been few in vivo structural magnetic resonance imaging (MRI) studies of the middle temporal gyrus and inferior temporal gyrus in schizophrenia. Method: Middle temporal gyrus and inferior temporal gyru...

  15. Spiral CT in aplasia of the pre-renal inferior vena cava as a cause of phlebothrombosis from the femoral veins to the inferior vena cava; Spiral-CT einer Aplasie der praerenalen Vena cava inferior als Ursache einer Phlebothrombose von den Oberschenkelvenen bis in die Vena cava inferior

    Energy Technology Data Exchange (ETDEWEB)

    Schweiger, U. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Schedel, H. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Thiede, U. [Deutsches Herzzentrum Berlin (Germany). Arbeitsgruppe Digitale Bildbearbeitung; Felix, R. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany)

    1994-12-31

    The case report focuses on the computed tomography of the thrombotic okklusion of the inferior vena cava, venae iliacae and femorales communes due to congenital interruption of the prerenal inferior vena cava. The embryology of the abnormality was discussed. (orig.) [Deutsch] Anhand einer Fallstudie wurden die Moeglichkeiten der computertomographischen Diagnostik bei einer durch Teilplasie der `praerenalen` Vena cava inferior hervorgerufenen Thrombose der Vv. femorales superficiales et profundae, der grossen Beckenvenen und der Vena cava inferior erlaeutert. In der Diskussion wurde auf die Embryologie der Missbildung eingegangen. (orig.)

  16. Strain Distribution in the Anterior Inferior Tibiofibular Ligament, Posterior Inferior Tibiofibular Ligament, and Interosseous Membrane Using Digital Image Correlation.

    Science.gov (United States)

    Xu, Daorong; Wang, Yibei; Jiang, Chunyu; Fu, Maoqing; Li, Shiqi; Qian, Lei; Sun, Peidong; Ouyang, Jun

    2018-05-01

    Ligament repair and augmentation techniques can stabilize syndesmosis injuries. However, little is known about the mechanical behavior of syndesmotic ligaments. The aim of this study was to analyze full-field strain, strain trend under foot rotation, and subregional strain differences of the anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), and interosseous membrane (IOM). Eleven fresh-frozen lower limbs were dissected to expose the AITFL, PITFL, and IOM. The foot underwent rotation from 0° to 25° internal and 35° external, with 3 ankle positions (neutral, 15° dorsiflexion, and 25° plantarflexion) and a vertical load of 430 N. Ligament strain was recorded using digital image correlation. The mean strain on the AITFL with 35° external rotation was greater in the proximal portion compared with distal portion in the neutral position ( P = .009) and dorsiflexion ( P = .003). The mean strain in the tibial insertion and midsubstance near tibial insertion were greater when compared with other regions ( P = .018 and P = .009). The subregions of mean strain in the PITFL and IOM groups were not significantly different. The strain trend of AITFL, PITFL, and IOM showed common transformation, just when the foot was externally rotated. The findings of this study show that a significantly high strain was observed on the proximal part and the midsubstance near the Chaput tubercle of the AITFL when the ankle was externally rotated. All 3 ligaments resisted the torque in the syndesmosis by external rotation of the foot. This study allows for better understanding of the mechanical behavior of the syndesmosis ligaments, which could influence the repair technique and AITFL augmentation techniques.

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

    African Journals Online (AJOL)

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

  18. Computed tomographic diagnosis of calcified inferior vena cava thrombus in a child with Wilm's tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kirks, D R; Ponzi, J W; Korobkin, M

    1980-01-01

    A calcified thrombus in the inferior vena cava of infants and children may be imaged by computed tomography. The precise location of the calcification within the inferior vena cava may be confirmed by computed tomographic scanning during injection of intravenous contrast material.

  19. 75 FR 9228 - Draft Guidance for Industry on Non-Inferiority Clinical Trials; Availability

    Science.gov (United States)

    2010-03-01

    ... regulatory, study design, scientific, and statistical issues associated with the use of non-inferiority... as the advantages and disadvantages of available methods. The third part addresses commonly asked...- inferiority clinical trials. It does not create or confer any rights for or on any person and does not operate...

  20. Retrocaval ureter and anomalies of inferior vena cava

    International Nuclear Information System (INIS)

    Tsubogo, Yoshitaka; Hiraoka, Hisaki; Tonariya, Yoshito; Miyamae, Tatsuya; Fujioka, Mutsumi

    1980-01-01

    We report two cases of retrocaval ureter: one with the usual hook-shaped pattern of the course of ureter (Type 1 according to Kenawi and Williams) and the other with the ureter medially displaced in a large curving fashion without kinking or obstruction. (Type 2). The second case was diagnosed on CT without resorting to any invasive procedure. It can be classified as Type 2 of Kenawi and Williams because of the absence of obstruction and kinking of ureter. The first case is associated with a complicated anomaly of inferior vena cava previously not reported which shows the duplication of infrarenal segment of cava with azygos continuation via the right persistent supracardinal vein. This anomaly is also complicated by the persistent posterior cardinal vein which is continuous with the normal prerenal segment of cava after receiving the right renal vein. This persistent posterior cardinal vein is the cause of retrocaval ureter in this case. It is also stressed that the knowledge of various caval anomalies is important in the interpretation of CT. (author)

  1. Propagation of a hybrid inferior wave in axisymmetrical plasma

    International Nuclear Information System (INIS)

    Fivaz, M.; Appert, K.; Krlin, L.

    1990-05-01

    The linear propagation of hybrid inferior waves in an axisymmetrical plasma (magnetohydrodynamic equilibrium of the Soloviev type) has been numerically simulated. The evolution of k // (component of the wave vector k parallel to the magnetic field B), important for current drive modelling, has been studied as a function of the geometric parameters of the equilibrium: aspect ratio, ellipticity and triangularity. The results show that k // depends abruptly on the parameters; the engendered structures are very rich. Two mechanisms by which k // increases have been shown: the 'resonance' occurring in small bands of the space of the parameters and which is associated with trajectories in (R,Z) near stabilization; a stochastic evolution resembling diffusion in equlibriums of very high triangularity. However, a strong increase of k // of a part of the waves, susceptible of engendering a current in the plasma, has only been observed in a minority of cases. In literature current drive experiments have been reported which work and whose parameters are a priori such that our model cannot be expected to show the desired growth of k // . Consequently, our model, which is similar to normally used models, does not explain the current drive. 5 refs., 16 figs

  2. Effect of Preoperative Pain on Inferior Alveolar Nerve Block

    Science.gov (United States)

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

    2015-01-01

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

  3. Somatomotor and oculomotor inferior olivary neurons have distinct electrophysiological phenotypes

    Science.gov (United States)

    Urbano, Francisco J.; Simpson, John I.; Llinás, Rodolfo R.

    2006-01-01

    The electrophysiological properties of rat inferior olive (IO) neurons in the dorsal cap of Kooy (DCK) and the adjacent ventrolateral outgrowth (VLO) were compared with those of IO neurons in the principal olive (PO). Whereas DCK/VLO neurons are involved in eye movement control via their climbing fiber projection to the cerebellar flocculus, PO neurons control limb and digit movements via their climbing fiber projection to the lateral cerebellar hemisphere. In vitro patch recordings from DCK/VLO neurons revealed that low threshold calcium currents, Ih currents, and subthreshold oscillations are lacking in this subset of IO neurons. The recordings of activity in DCK neurons obtained by using voltage-sensitive dye imaging showed that activity is not limited to a single neuron, but rather that clusters of DCK neurons can be active in unison. These electrophysiological results show that the DCK/VLO neurons have unique properties that set them apart from the neurons in the PO nucleus. This finding indicates that motor control, from the perspective of the olivocerebellar system, is fundamentally different for the oculomotor and the somatomotor systems. PMID:17050678

  4. Effect of Preoperative Pain on Inferior Alveolar Nerve Block.

    Science.gov (United States)

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

    2015-01-01

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

  5. Decoding rule search domain in the left inferior frontal gyrus

    Science.gov (United States)

    Babcock, Laura; Vallesi, Antonino

    2018-01-01

    Traditionally, the left hemisphere has been thought to extract mainly verbal patterns of information, but recent evidence has shown that the left Inferior Frontal Gyrus (IFG) is active during inductive reasoning in both the verbal and spatial domains. We aimed to understand whether the left IFG supports inductive reasoning in a domain-specific or domain-general fashion. To do this we used Multi-Voxel Pattern Analysis to decode the representation of domain during a rule search task. Thirteen participants were asked to extract the rule underlying streams of letters presented in different spatial locations. Each rule was either verbal (letters forming words) or spatial (positions forming geometric figures). Our results show that domain was decodable in the left prefrontal cortex, suggesting that this region represents domain-specific information, rather than processes common to the two domains. A replication study with the same participants tested two years later confirmed these findings, though the individual representations changed, providing evidence for the flexible nature of representations. This study extends our knowledge on the neural basis of goal-directed behaviors and on how information relevant for rule extraction is flexibly mapped in the prefrontal cortex. PMID:29547623

  6. Inferior Glenohumeral Dislocation in a Division One Collegiate Wrestler

    Directory of Open Access Journals (Sweden)

    Alexander J. Gilmore

    2016-05-01

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

  7. Retrievable Inferior Vena Cava Filters: Factors that Affect Retrieval Success

    Energy Technology Data Exchange (ETDEWEB)

    Geisbuesch, Philipp, E-mail: philippgeisbuesch@gmx.de; Benenati, James F.; Pena, Constantino S.; Couvillon, Joseph; Powell, Alex; Gandhi, Ripal; Samuels, Shaun; Uthoff, Heiko [Baptist Cardiac and Vascular Institute, Division of Vascular and Interventional Radiology (United States)

    2012-10-15

    Purpose: To report and analyze the indications, procedural success, and complications of retrievable inferior vena cava filters (rIVCF) placement and to identify parameters that influence retrieval attempt and failure. Methods: Between January 2005 and December 2010, a total of 200 patients (80 men, median age 67 years, range 11-95 years) received a rIVCF with the clinical possibility that it could be removed. All patients with rIVCF were prospectively entered into a database and followed until retrieval or a decision not to retrieve the filter was made. A retrospective analysis of this database was performed. Results: Sixty-one percent of patients had an accepted indication for filter placement; 39% of patients had a relative indication. There was a tendency toward a higher retrieval rate in patients with relative indications (40% vs. 55%, P = 0.076). Filter placement was technically successful in all patients, with no procedure-related mortality. The retrieval rate was 53%. Patient age of >80 years (odds ratio [OR] 0.056, P > 0.0001) and presence of malignancy (OR 0.303, P = 0.003) was associated with a significantly reduced probability for attempted retrieval. Retrieval failure occurred in 7% (6 of 91) of all retrieval attempts. A time interval of > 90 days between implantation and attempted retrieval was associated with retrieval failure (OR 19.8, P = 0.009). Conclusions: Patient age >80 years and a history of malignancy are predictors of a reduced probability for retrieval attempt. The rate of retrieval failure is low and seems to be associated with a time interval of >90 days between filter placement and retrieval.

  8. Venous Thromboembolism After Removal of Retrievable Inferior Vena Cava Filters

    International Nuclear Information System (INIS)

    Yamagami, Takuji; Tanaka, Osamu; Yoshimatsu, Rika; Miura, Hiroshi; Nishimura, Tsunehiko

    2010-01-01

    The purpose of this study was to examine the incidence of new or recurrent venous thromboembolism (VTE) after retrieval of inferior vena cava (IVC) filters and risk factors associated with such recurrence. Between March 2001 and September 2008, at our institution, implanted retrievable vena cava filters were retrieved in 76 patients. The incidence of new or recurrent VTE after retrieval was reviewed and numerous variables were analyzed to assess risk factors for redevelopment of VTE after filter retrieval. In 5 (6.6%) of the 76 patients, redevelopment or worsening of VTE was seen after retrieval of the filter. Three patients (4.0%) had recurrent deep venous thrombosis (DVT) in the lower extremities and 2 (2.6%) had development of pulmonary embolism, resulting in death. Although there was no significant difference in the incidence of new or recurrent VTE related to any risk factor investigated, a tendency for development of VTE after filter retrieval was higher in patients in whom DVT in the lower extremities had been so severe during filter implantation that interventional radiological therapies in addition to traditional anticoagulation therapies were required (40% in patients with recurrent VTE vs. 23% in those without VTE; p = 0.5866 according to Fisher's exact probability test) and in patients in whom DVT remained at the time of filter retrieval (60% in patients with recurrent VTE vs. 37% in those without VTE; p = 0.3637). In conclusion, new or recurrent VTE was rare after retrieval of IVC filters but was most likely to occur in patients who had severe DVT during filter implantation and/or in patients with a DVT that remained at the time of filter retrieval. We must point out that the fatality rate from PE after filter removal was high (2.6%).

  9. Hemiazygos continuation of v.cava inferior: a case report

    International Nuclear Information System (INIS)

    Incedayi, M.; Aribal, S.; Sivrioglu, A.; Kara, K.

    2012-01-01

    Full text: A 78-year-old female patient was suffering from dyspnoea and tachypnoea in our hospital's orthopaedic clinic. Because she had an operation of right femoral mid-diaphizer fracture a week ago, we decided to perform a pulmonary computerized tomography angiography (CTA) examination with her clinicians in order to evaluate a possible pulmonary embolism and to make a further evaluation. In her CTA exam there were no pulmonary embolism was seen. There were some chronic changes in her lungs, bilateral pleural effusion and hilar lymphadenomagalies. A dilated and tortiozed vascular structure which was retrocrural and retroaortic placed at the level of the thorachoabdominal transition and joined to left brachiocephalic vein was seen. Then we realized that the liver was symmetrical and transverse localization the upper abdomen and the stomach and spleen was in the right upper quadrant. Because the cardiac apex was left-sided we decided that a kind of situs ambiguous. After that the patient was underwent a abdominal contrast enhanced CT which was including the both arterial and venous phases. In this examination the suprarenal part of the inferior vena cava (IVC) was interrupted and it was continuing as hemiazygos vein to the thorax something like the previous CT exam. The hepatic veins were drained into a short segment vein and then the right atrium. Multiple nodular parenchymal images which were enhanced like spleen in all phases were seen in right upper quadrant of the abdomen (polysplenia). And also partial agenesis of the pancreas and annular pancreas configuration was seen. Anomalies of the IVC occur rarely and the patient are usually asymptomatic. Non-invasive imaging modalities such as CT and MRI allow better identification of these anomalies. In these cases different organ anomalies accompanies the IVC anomalies

  10. Retrievable Inferior Vena Cava Filters: Factors that Affect Retrieval Success

    International Nuclear Information System (INIS)

    Geisbüsch, Philipp; Benenati, James F.; Peña, Constantino S.; Couvillon, Joseph; Powell, Alex; Gandhi, Ripal; Samuels, Shaun; Uthoff, Heiko

    2012-01-01

    Purpose: To report and analyze the indications, procedural success, and complications of retrievable inferior vena cava filters (rIVCF) placement and to identify parameters that influence retrieval attempt and failure. Methods: Between January 2005 and December 2010, a total of 200 patients (80 men, median age 67 years, range 11–95 years) received a rIVCF with the clinical possibility that it could be removed. All patients with rIVCF were prospectively entered into a database and followed until retrieval or a decision not to retrieve the filter was made. A retrospective analysis of this database was performed. Results: Sixty-one percent of patients had an accepted indication for filter placement; 39% of patients had a relative indication. There was a tendency toward a higher retrieval rate in patients with relative indications (40% vs. 55%, P = 0.076). Filter placement was technically successful in all patients, with no procedure-related mortality. The retrieval rate was 53%. Patient age of >80 years (odds ratio [OR] 0.056, P > 0.0001) and presence of malignancy (OR 0.303, P = 0.003) was associated with a significantly reduced probability for attempted retrieval. Retrieval failure occurred in 7% (6 of 91) of all retrieval attempts. A time interval of > 90 days between implantation and attempted retrieval was associated with retrieval failure (OR 19.8, P = 0.009). Conclusions: Patient age >80 years and a history of malignancy are predictors of a reduced probability for retrieval attempt. The rate of retrieval failure is low and seems to be associated with a time interval of >90 days between filter placement and retrieval.

  11. Distal anterior inferior cerebellar artery syndrome after acoustic neuroma surgery.

    Science.gov (United States)

    Hegarty, Joseph L; Jackler, Robert K; Rigby, Peter L; Pitts, Lawrence H; Cheung, Steven W

    2002-07-01

    To define a clinicopathologic syndrome associated with persistent cerebellar dysfunction after acoustic neuroma (AN) excision. Case series derived from radiographic and clinical chart review. Tertiary referral center. In 12 patients with AN, persistent cerebellar dysfunction developed after AN removal. Each case demonstrated abnormality in the ipsilateral cerebellar peduncle on postoperative magnetic resonance imaging. Cerebellar function and ambulatory status over the first postoperative year. On magnetic resonance imaging scans, the extent of cerebellar peduncle infarcts was variable. It ranged from focal brain injury (2 cm) spanning the full thickness of the peduncle. Peduncular infarcts were associated with large tumor size (average 3.8 cm, range 2.0-5.5 cm diameter). The long-term functional outcomes (>1 yr) varied. Dysmetria was unchanged or improved in over half of the patients (6 of 11 patients). Gait recovered to normal or to preoperative levels in 5 patients. In the 6 patients with persistent impaired mobility, 2 had mild gait disturbance, 3 required regular use of a cane, and 1 has been dependent on a walker. One patient had sustained mild motor weakness. Three of 11 patients remained dependent on others for activities of daily living. Peduncle injury most likely stems from interruption of distal branches of the anterior inferior cerebellar artery (AICA). These small vessels are intimately related to the capsule of the tumor and may supply both the neoplasm and the brain parenchyma. It has long been recognized that interruption of the proximal segment of the AICA results in severe injury to the pons, with devastating neurologic sequelae. A limited AICA syndrome caused by loss of its distal ramifications seems a more plausible explanation for peduncular infarction than either venous insufficiency or direct surgical trauma.

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

    Science.gov (United States)

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

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

  13. Inferior vena cava segmentation with parameter propagation and graph cut.

    Science.gov (United States)

    Yan, Zixu; Chen, Feng; Wu, Fa; Kong, Dexing

    2017-09-01

    The inferior vena cava (IVC) is one of the vital veins inside the human body. Accurate segmentation of the IVC from contrast-enhanced CT images is of great importance. This extraction not only helps the physician understand its quantitative features such as blood flow and volume, but also it is helpful during the hepatic preoperative planning. However, manual delineation of the IVC is time-consuming and poorly reproducible. In this paper, we propose a novel method to segment the IVC with minimal user interaction. The proposed method performs the segmentation block by block between user-specified beginning and end masks. At each stage, the proposed method builds the segmentation model based on information from image regional appearances, image boundaries, and a prior shape. The intensity range and the prior shape for this segmentation model are estimated based on the segmentation result from the last block, or from user- specified beginning mask if at first stage. Then, the proposed method minimizes the energy function and generates the segmentation result for current block using graph cut. Finally, a backward tracking step from the end of the IVC is performed if necessary. We have tested our method on 20 clinical datasets and compared our method to three other vessel extraction approaches. The evaluation was performed using three quantitative metrics: the Dice coefficient (Dice), the mean symmetric distance (MSD), and the Hausdorff distance (MaxD). The proposed method has achieved a Dice of [Formula: see text], an MSD of [Formula: see text] mm, and a MaxD of [Formula: see text] mm, respectively, in our experiments. The proposed approach can achieve a sound performance with a relatively low computational cost and a minimal user interaction. The proposed algorithm has high potential to be applied for the clinical applications in the future.

  14. Assessment of inferior wall in 123I-metaiodobenzylguanidine myocardial SPECT in diabetic patients

    International Nuclear Information System (INIS)

    Fukumoto, Yoshihiro; Kuroda, Yasuhisa; Ohta, Jun; Osono, Ken; Saitou, Miyoko; Suzuki, Mituaki; Nakajima, Toshiki

    1994-01-01

    A phantom experiment and a clinical assessment have been made with the purpose of investigating the causes of low accumulation and deficiency of the inferior wall in 123 I-metaiodobenzylguanidine (MIBG) myocardial SPECT and the method for its evaluation. By the phantom experiment, assessments were made regarding (1) influence of the liver positioned adjacently; and (2) involvement of absorption and attenuation of the inferior wall. For the clinical assessment, 84 patients with diabetes in whom no abnormality was observed by exercise myocardial SPECT ( 201 TlCl) and 5 cases of inferior myocardial infarction (OMI group) were adopted as subjects. The inferior walls were evaluated as visually deficient because of the adjacently-positioned liver, but no low value was exhibited by quantitative evaluation. By pulmonary mediastinal phantom (-), improvement of the inferior wall was observed visually and quantitatively, compared with pulmonary mediastinal phantom (+). By quantitative evaluation, the patients were classified into normal MIBG group (N group); segmentally deficient group (S group); and non-accumulated group (DH group). In addition, S group was classified by severity score into those from S 1 to S 4 groups. No significant difference was observed in Relative Regional Uptake (RRU) in the inferior wall between S 4 group and OMI group. To sum up, we considered the causes for low accumulation and deficiency of the inferior wall, (1) adjacently-positioned liver; (2) absorption and attenuation; and (3) the lesion itself. Visual evaluation is not sufficient as the evaluating method. Quantitative evaluation becomes necessary. (author)

  15. Primary research on direct multi-slice spiral CT venography in inferior vena cava

    International Nuclear Information System (INIS)

    Gong Peiyou; Liu Fengli; Ma Xianying; Zhao Li; Wang Liping; Li Xuehua; Li Jian

    2010-01-01

    Objective: To investigate the superiority of direct multi-slice spiral CT venography in inferior vena cava. Methods: Twenty-eight patients performed MSCT venography in inferior vena cava, including 2 cases with both indirect and direct venography, 10 cases with indirect venography, 20 cases with direct venography through unilateral or bilateral lower extremity venous injection. The image quality and enhancement degree of the inferior vena cava were compared in double-blind method. Results: Of 10 cases with indirect venography of inferior vena cava, 1 case was failed due to mild enhancement in inferior vena cava. Image quality was good in 2 cases, poor in 7 cases, no excellent case. Of 20 cases with direct venography of inferior vena cava, the enhancement degree was scored 1, 2 degree in 16, 4 cases respectively and no case was scored 3 degree, the image quality was excellent, good in 16, 4 cases and no case was bad. The success rate was 100%. Conclusion: The image quality of direct MSCT venography in inferior vena cava is better than that of indirect method. (authors)

  16. CT diagnosis of tumor thrombus of the renal vein and inferior vena cava

    International Nuclear Information System (INIS)

    Masuda, Fujio; Chen, Zuicho; Oishi, Yukihiko; Machida, Toyohei

    1980-01-01

    We used computed tomography (CT) for diagnosis in 4 cases of renal tumor associated with tumor thrombus of the renal vein and inferior vana cava. The results obtained are described below: A total of 4 cases consisting of 3 cases of renal cell carcinoma and one case of squamous cell carcinoma of the renal pelvis, treated at the Jikei University Hospital during the six months period from January to June of 1979, were studied. The affected side was right in 3 cases and left in one case. In all of the former cases the tumor thrombus was extending from the renal vein to the inferior vena cava, while in the latter case it was confined in the renal vein. All these 4 cases received CT together with renal arteriography and inferior venacavography, followed by nephrectomy, and were confirmed of the presence of tumor thrombus in the renal vein and inferior vena cava operatively. CT findings revealed a pronounced enlargement of the renal vein, and tumor thrombus of the renal vein was diagnosed in all of the 4 cases. In 2 of 3 cases in which tumor thrombus extended to the inferior vena cava, the dilated renal vein was found to be connected to the slightly dilated inferior vena cava, while in the remaining one case the outline of the inferior vena cava was obscure, showing no clear dilatation. After contrast enhancement, a filling defect was seen in the inferior vena cava. CT findings of tumor thrombus in the vein indicated a dilatation of the renal vein and inferior vena cava. In addition, a filling defect was found after contrast enhancement, suggesting that CT is helpful as a diagnostic aid. (author)

  17. Detecting and accounting for violations of the constancy assumption in non-inferiority clinical trials.

    Science.gov (United States)

    Koopmeiners, Joseph S; Hobbs, Brian P

    2018-05-01

    Randomized, placebo-controlled clinical trials are the gold standard for evaluating a novel therapeutic agent. In some instances, it may not be considered ethical or desirable to complete a placebo-controlled clinical trial and, instead, the placebo is replaced by an active comparator with the objective of showing either superiority or non-inferiority to the active comparator. In a non-inferiority trial, the experimental treatment is considered non-inferior if it retains a pre-specified proportion of the effect of the active comparator as represented by the non-inferiority margin. A key assumption required for valid inference in the non-inferiority setting is the constancy assumption, which requires that the effect of the active comparator in the non-inferiority trial is consistent with the effect that was observed in previous trials. It has been shown that violations of the constancy assumption can result in a dramatic increase in the rate of incorrectly concluding non-inferiority in the presence of ineffective or even harmful treatment. In this paper, we illustrate how Bayesian hierarchical modeling can be used to facilitate multi-source smoothing of the data from the current trial with the data from historical studies, enabling direct probabilistic evaluation of the constancy assumption. We then show how this result can be used to adapt the non-inferiority margin when the constancy assumption is violated and present simulation results illustrating that our method controls the type-I error rate when the constancy assumption is violated, while retaining the power of the standard approach when the constancy assumption holds. We illustrate our adaptive procedure using a non-inferiority trial of raltegravir, an antiretroviral drug for the treatment of HIV.

  18. CT and angiographic appearances of hepatocellular carcinoma partially fed by right inferior phrenic artery

    Energy Technology Data Exchange (ETDEWEB)

    Ohtomo, Kuni; Furui, Shigeru; Yoshikawa, Hiroki; Yashiro, Naofumi; Araki, Tsutomu [Tokyo Univ. (Japan). Faculty of Medicine

    1983-04-01

    CT and angiographic appearances of 8 hepatocellular carcinomas which were partially fed by right inferior phrenic artery were discussed. CT demonstrated tumor fully occupied posterior segment of right hepatic lobe in 6 cases which were composed of 3 solitary massive, 2 massive nodular and 1 confluent massive angiographically. In the other 2 cases, CT showed encapsulated tumor in posterior inferior portion of posterior segment protruded from the liver. In 6 out of these 8 cases, tumor vessels and tumor stain were chiefly derived from posterior branch of right inferior phrenic artery.

  19. Bilateral, Mirror-imaged, Postero-inferior Cerebellar Artery Aneurysms: Report of a Rare Case

    Directory of Open Access Journals (Sweden)

    G R Sharma

    2011-06-01

    Full Text Available A 60-year-old right-handed lady presented with the features of subarachnoid haemorrhage. The CT angiogram showed a pair of very rare bilateral, mirror-imaged distal postero-inferior cerebellar artery aneurysms. Both aneurysms were clipped via the midline posterior fossa craniectomy under general anaesthesia. The literatures is reviewed on the incidence, presentation, management and outcome of bilateral distal posterior-inferior cerebellar artery aneurysms. Keywords: bilateral mirror image, distal postero-inferior cerebellar artery aneurysms, posterior fossa craniectomy, microsurgical clipping

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

    Directory of Open Access Journals (Sweden)

    Yа.O. Povar

    2016-05-01

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

  1. Evaluation of detectability of right inferior phrenic artery root in dynamic CT

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Osamu [Akashi Municipal Hospital, Hyogo (Japan); Kizu, Osamu; Shimizu, Toshihisa; Takahashi, Takeshi; Ohno, Koji; Ohmura, Makoto; Maeda, Tomoho

    1995-05-01

    We evaluated the detectability of the root of the right inferior phrenic artery in dynamic CT over the entire liver as used for the diagnosis of hepatocellular carcinoma. The results showed no detection in three cases, poor detection in seven, detection in 12 and good detection in eight. The right inferior phrenic artery could be detected in many cases. Identification was easier in cases with direct branching from the aorta. It can be concluded that for angiographic examination, dynamic CT over the entire liver is useful for catheterization to the right inferior phrenic artery. (author).

  2. Evaluation of detectability of right inferior phrenic artery root in dynamic CT

    International Nuclear Information System (INIS)

    Sato, Osamu; Kizu, Osamu; Shimizu, Toshihisa; Takahashi, Takeshi; Ohno, Koji; Ohmura, Makoto; Maeda, Tomoho.

    1995-01-01

    We evaluated the detectability of the root of the right inferior phrenic artery in dynamic CT over the entire liver as used for the diagnosis of hepatocellular carcinoma. The results showed no detection in three cases, poor detection in seven, detection in 12 and good detection in eight. The right inferior phrenic artery could be detected in many cases. Identification was easier in cases with direct branching from the aorta. It can be concluded that for angiographic examination, dynamic CT over the entire liver is useful for catheterization to the right inferior phrenic artery. (author)

  3. CT and angiographic appearances of hepatocellular carcinoma partially feeded by right inferior phrenic artery

    International Nuclear Information System (INIS)

    Ohtomo, Kuni; Furui, Shigeru; Yoshikawa, Hiroki; Yashiro, Naofumi; Araki, Tsutomu

    1983-01-01

    CT and angiographic appearances of 8 hepatocellular carcinomas which were partially feeded by right inferior phrenic artery were discussed. CT demonstrated tumor fully occupied posterior segment of right hepatic lobe in 6 cases which were composed of 3 solitary massive, 2 massive nodular and 1 confluent massive angiographically. In the other 2 cases, CT showed encapsulated tumor in posterior inferior portion of posterior segment protruded from the liver. In 6 out of these 8 cases, tumor vessels and tumor stain were chiefly derived from posterior branch of right inferior phrenic artery. (author)

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

    Science.gov (United States)

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

    2016-02-01

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

  5. Ensaio de desbaste de ramos inferiores do cafeeiro II

    Directory of Open Access Journals (Sweden)

    J. E. Teixeira Mendes

    1951-12-01

    Full Text Available Foi continuado o ensaio do desbaste dos ramos inferiores do cafeeiro, instalado na Estação Experimental Central de Campinas, em 1932. O ensaio compreende duas séries : a desbastada ; b não desbastada. Cada série se compõe de 5 repetições com 25 cafeeiros cada uma. A variedade em cultivo foi a Coffea arabica L. var. typica Cramer. A série desbastada foi mantida sem os ramos primários até uma altura de 50 cm do solo. Na série não desbastada não se interferiu de modo algum nessa parte da planta. As colheitas foram iniciadas em 1935. A série não desbastada produziu significativamente mais, no período todo examinado, isto é, em dezesseis safras (1935-1950. Não houve grande diferença no tamanho das sementes. A maturação foi um pouco apressada na série desbastada. O ensaio demonstra que não houve vantagem em se fazer esta operação.The experiment, begun at the Central Experiment Station at Campinas in 1932, on the pruning of the lower branches of coffee plants, has been continued. The trial contains two series, a pruned and b not pruned. Each series consists of five replicates, each with 25 coffee plants. The variety is Coffea arabica L. var. typica Cramer. The pruned trees were kept free from primary branches to a height of 50 cm. The unpruned trees were left entirely untouched in this region. Harvesting began in 1935. The unpruned trees have yielded significantly better (P = 5% over the period of the 16 years of the trial (1935-1950. There was no great difference in size of seeds. Ripening was advanced a little in the pruned trees. The experiment showed that there was no advantage to be gained by pruning ; on the contrary, the operation appears to be prejudicial to the yield.

  6. A case of residual inferior sinus venosus defect after ineffective surgical closure.

    Science.gov (United States)

    Uga, Sayuri; Hidaka, Takayuki; Takasaki, Taiichi; Kihara, Yasuki

    2014-10-03

    A 38-year-old woman presented with cyanosis and heart failure 34 years after patch closure of an atrial septal defect and partial anomalous pulmonary venous connection. CT and cardiac catheterisation showed a residual defect that caused right-to-left shunting. The patch almost blocked the inferior vena cava from the right atrium, resulting in uncommon drainage of the inferior vena cava into the left atrium. Other anomalies included the coronary-to-pulmonary artery fistula and duplicate inferior vena cava with dilated azygos venous system. A second surgery was performed, and we confirmed an inferior sinus venosus defect, which is rare and can be misdiagnosed. The ineffective patch closure had caused a haemodynamic status that rarely occurs. We describe the diagnostic process and emphasise the importance of correctly understanding the entity. 2014 BMJ Publishing Group Ltd.

  7. Deep Venous Thrombosis Associated With Inferior Vena Cava Abnormalities And Hypoplastic Kidney In Siblings

    Directory of Open Access Journals (Sweden)

    Duicu Carmen

    2016-06-01

    Full Text Available Congenital inferior vena cava anomalies have a reduced frequency in general population, many times being an asymptomatic finding. Patients caring such anomalies are at risk to develop deep vein thrombosis. In this paper, we present 2 siblings with deep venous thrombosis and inferior vena cava abnormalities, with a symptomatic onset at similar age. The inferior vena cava abnormality was documented by an angio-CT in each case. The thrombophilic workup was negative. Patients were treated with conservative therapy: low molecular weight heparin anticoagulants converted later to oral anticoagulant with resolution of symptoms and disappearance of the thrombus. Finally, in the absence of any risk factor in a young patient admitted with deep vein thrombosis investigations to exclude inferior vena cava anomalies are mandatory.

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

    African Journals Online (AJOL)

    2015-10-30

    Oct 30, 2015 ... surgery, endodontic treatment, local anesthetic injection, ... KEYWORDS: Dental implants, inferior alveolar nerve injury, neurosensory complication. Department .... hemorrhage into the canal or contamination of drilling debris ...

  9. A Bayesian non-inferiority test for two independent binomial proportions.

    Science.gov (United States)

    Kawasaki, Yohei; Miyaoka, Etsuo

    2013-01-01

    In drug development, non-inferiority tests are often employed to determine the difference between two independent binomial proportions. Many test statistics for non-inferiority are based on the frequentist framework. However, research on non-inferiority in the Bayesian framework is limited. In this paper, we suggest a new Bayesian index τ = P(π₁  > π₂-Δ₀|X₁, X₂), where X₁ and X₂ denote binomial random variables for trials n1 and n₂, and parameters π₁ and π₂ , respectively, and the non-inferiority margin is Δ₀> 0. We show two calculation methods for τ, an approximate method that uses normal approximation and an exact method that uses an exact posterior PDF. We compare the approximate probability with the exact probability for τ. Finally, we present the results of actual clinical trials to show the utility of index τ. Copyright © 2013 John Wiley & Sons, Ltd.

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

    African Journals Online (AJOL)

    . Conclusion: When 2 mm is considered as a safety distance, the distance of the implants to the IAC did not yield any statistical difference regarding postoperative neurosensory complications. Keywords: Dental implants, inferior alveolar nerve ...

  11. Is there a relationship between the diameter of the inferior vena cava ...

    African Journals Online (AJOL)

    2015-04-12

    Apr 12, 2015 ... Key words: Central venous pressures, critically ill patients, inferior vena cava. Date of Acceptance: ... Regardless of the cause of the patient's status, the blood/ .... AUC=Area under ROC curve, IAP=Anteroposterior diameter of.

  12. Inferior vena cava filter penetration following Whipple surgical procedure causing ureteral injury.

    Science.gov (United States)

    Abdel-Aal, Ahmed Kamel; Ezzeldin, Islam B; Moustafa, Amr Soliman; Ertel, Nathan; Oser, Rachel

    2015-12-01

    We report a case of an indwelling inferior vena cava filter that penetrated the IVC wall after Whipple's pancreatico-duodenectomy procedure performed in a patient with ampullary carcinoma, resulting in right ureteral injury and obstruction with subsequent hydroureter and hydronephrosis. This was incidentally discovered on a computed tomography scan performed as routine follow up to evaluate the results of the surgery. We retrieved the inferior vena cava filter and placed a nephrostomy catheter to relieve the ureteral obstruction. Our case highlights the importance of careful inferior vena cava manipulation during abdominal surgery in the presence of an inferior vena cava filter, and the option of temporary removal of the filter to be placed again after surgery in order to avoid this complication, unless protection is required against clot migration during the surgical procedure.

  13. Graded versus ungraded inferior oblique anterior transposition in patients with asymmetric dissociated vertical deviation.

    Science.gov (United States)

    Rajavi, Zhale; Feizi, Mohadeseh; Naderi, Ali; Sabbaghi, Hamideh; Behradfar, Narges; Yaseri, Mehdi; Faghihi, Mohammad

    2017-12-01

    To report the surgical outcomes of graded versus ungraded inferior oblique anterior transposition (IOAT) in treatment of patients with asymmetric dissociated vertical deviation (DVD) and bilateral inferior oblique overaction (IOOA). A total of 74 eyes of 37 patients with asymmetric DVD (interocular difference of ≥5 Δ ) and bilateral IOOA of > +1 were included in this randomized clinical trial. In the ungraded group (n = 18), both inferior oblique muscles were sutured at the inferior rectus level; in the graded group (n = 19), the inferior oblique muscles of eyes with more DVD were sutured at the level of the inferior rectus and inferior oblique muscles of eyes with less DVD were sutured 2 mm posterior to the level of the inferior rectus muscle. DVD was significantly reduced in each group (P < 0.001 for both). Although the postoperative mean difference of asymmetry of DVD was less in the ungraded group compared to the graded group (1.2 ± 1.9 vs 3.2 ± 1.2 [P = 0.001]), the absolute amounts of reduction of DVD asymmetry were similar (4.3 ± 2.3 vs 4.4 ± 3.1 [P = 0.78]). IOOA and V patterns were also reduced postoperatively. Each method of IOAT was effective in reducing DVD, asymmetry, IOOA, and V patterns. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  14. Co-activation-based parcellation of the lateral prefrontal cortex delineates the inferior frontal junction area

    OpenAIRE

    Muhle-Karbe, Paul Simon; Derrfuss, Jan; Lynn, Maggie; Neubert, Franz Xaver; Fox, Peter; Brass, Marcel; Eickhoff, Simon

    2016-01-01

    The inferior frontal junction (IFJ) area, a small region in the posterior lateral prefrontal cortex (LPFC), has received increasing interest in recent years due to its central involvement in the control of action, attention, and memory. Yet, both its function and anatomy remain controversial. Here, we employed a meta-analytic parcellation of the left LPFC to show that the IFJ can be isolated based on its specific functional connections. A seed region, oriented along the left inferior frontal ...

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

    Science.gov (United States)

    Pielmeier, Ricarda; Kerkmann, Andrea; Distl, Ottmar

    2012-01-01

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

  16. Radiological evidence of double inferior vena cava in a young adult male

    International Nuclear Information System (INIS)

    Nevruz, O.; Ural, U.; Kirici, Y.; Kilic, C.; Bozlar, U.

    2007-01-01

    The development of the inferior vena cava IVC is a complex process comprising the formation and regression of some anastomoses, so various anomalies may occur during embryogenesis. These variations can increase the difficulty of aneurysm resection as well as the risk of venous injury and subsequent excessive bleeding during retroperitoneal and thoracic surgical interventions. Here, we report a patient with double inferior vena cava by radiographically during his investigation for the etiology of pancytopenia. (author)

  17. Spontaneous tilting after placement of the gunther-tulip inferior vena caval filter: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Tae Seok; Cha, In Ho; Seol, Hae Young; Park, Cheol Min [Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2006-10-15

    Tilting of a deployed filter in the inferior vena cava (IVC) is a particular kind of periprocedural complication and this can reduce the filter's clot-trapping ability and increase the occlusion of the IVC at a later period. The authors report here on a case of spontaneous tilting of an inferior vena caval filter that was associated with thrombosis in the IVC within 2 weeks of the initially successful placement of the filter without tilting.

  18. Spontaneous tilting after placement of the gunther-tulip inferior vena caval filter: a case report

    International Nuclear Information System (INIS)

    Seo, Tae Seok; Cha, In Ho; Seol, Hae Young; Park, Cheol Min

    2006-01-01

    Tilting of a deployed filter in the inferior vena cava (IVC) is a particular kind of periprocedural complication and this can reduce the filter's clot-trapping ability and increase the occlusion of the IVC at a later period. The authors report here on a case of spontaneous tilting of an inferior vena caval filter that was associated with thrombosis in the IVC within 2 weeks of the initially successful placement of the filter without tilting

  19. Prevalence, morphological and electrophysiological characteristics of confluent inferior pulmonary veins in patients with atrial fibrillation

    International Nuclear Information System (INIS)

    Yamane, Teiichi; Date, Taro; Tokuda, Michifumi

    2008-01-01

    Although the common trunk of left pulmonary veins (PVs) has been reported as a relatively popular anatomical variation of PVs, little is known about the coalescence of contralateral PVs. The present study was conducted to reveal the prevalence and electrophysiologic characteristics of the confluent inferior common PVs. Anatomical variation in the PV drainage to the left atrium (LA) was assessed using the multidetector computed tomography scan in 326 patients with atrial fibrillation (AF) who underwent the PV isolation procedure. Coalescence of inferior PVs was observed in 5 cases (1.5%). Both inferior PVs conjoined prior to the junction with the LA in 3 cases, while they coalesced at the LA junction in the other 2 cases. The arrhythmogenic activities of the confluent inferior PVs were generally low in all cases without any ectopic firings triggering the observed AF. All inferior PVs, as well as the superior PVs, were successfully isolated either en bloc at the common trunk or individually at the orifice of each PV. Confluent inferior PVs were present in 1.5% of cases in patients with AF who underwent the PV isolation procedure. Preoperative recognition of this venous anomaly by 3-dimensional imaging is important for smooth and safe ablation. (author)

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

    Science.gov (United States)

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

    2012-07-01

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

  1. Retrievable Inferior vena cava filters in pregnancy: Risk versus benefit?

    Science.gov (United States)

    Crosby, David A; Ryan, Kevin; McEniff, Niall; Dicker, Patrick; Regan, Carmen; Lynch, Caoimhe; Byrne, Bridgette

    2018-03-01

    Venous thromboembolism remains one of the leading causes of maternal mortality in the developed world. Retrievable inferior vena cava (IVC) filters have a role in the prevention of lethal pulmonary emboli when anticoagulation is contraindicated or has failed [1]. It is unclear whether or not the physiological changes in pregnancy influence efficacy and complications of these devices. The decision to place an IVC filter in pregnancy is complex and there is limited information in terms of benefit and risk to the mother. The objective of this study was to determine the efficacy and safety of these devices in pregnancy and to compare these with rates reported in the general population. The aim of this study was report three recent cases of retrievable IVC filter use in pregnant women in our department and to perform a systematic review of the literature to identify published cases of filters in pregnancy. The efficacy and complication rates of these devices in pregnancy were estimated and compared to rates reported in the general population in a recent review [2]. Fisher's exact test was used for statistical analysis. In addition to our three cases, 16 publications were identified with retrievable IVC filter use in 40 pregnant women resulting in a total of 43 cases. There was no pulmonary embolus in the pregnant group (0/43) compared to 57/6291 (0.9%) in the general population. Thrombosis of the filter (2.3% vs. 0.9%, p = 0.33) and perforation of the IVC (7.0% vs 4.4%, p = 0.44) were more common in pregnancy compared to the general population but the difference was not statistically significant. Failure to retrieve the filter is more likely to occur in pregnancy (26% vs. 11%, p = 0.006) but this did not correlate with the type of device (p = 0.61), duration of insertion (p = 0.58) or mode of delivery (p = 0.37). Data for retrievable IVC filters in pregnancy is limited and there may be a publication bias towards complicated cases. This study

  2. Study of 99Tcm-annexin V distribution in inferior vena cava thrombus models of rabbits

    International Nuclear Information System (INIS)

    Wu Dayong; Zhang Wenyan; Bian Yanzhu; Hu Yujing

    2013-01-01

    To study 99 Tc m -Annexin V distribution in inferior vena cava thrombus models of rabbits and uptake of 99 Tc m -Annexin V in fresh and old venous thrombus. Rabbits (n=15) were randomly grouped into 3 groups (the fresh thrombus group, old thrombus group, and control group). The rabbits of two thrombus groups developed inferior vena cava thrombus models by operations. The control group received sham operation. The fresh thrombus group and control group rabbits were injected 99 Tc m -Annexin V after operating 1 d; the old thrombus group 14 d. After 1 h all rabbits were killed by injecting overdose pentobarbital sodium. The thrombus (or the inferior vena cava about 3 cm below inferior pole of right kidney level in the control group rabbits), blood, thrombus area inferior vena cava, head lateral inferior vena cava (except the control group), thigh muscle, stomach, myocardium, pulmonary, liver, kidney, spleen, bone and small intestine were obtained from all group rabbits. The ex tissue and blood were weighed and measured by a Well-type detector. The percentage of the injected dose per gram of ex tissue (or blood) was calculated by the above data. The thrombus to blood, thrombus area inferior vena cava, head lateral inferior vena cava and thigh muscle ratios were calculated by percentage of the injected dose per gram of ex tissue (or blood). The test was used to compare the fresh thrombus group and old thrombus group by SPSS 17.0. The percentage of' the injected dose per gram of thrombi (0.01894± 0.002 16% ID/g) in the fresh thrombus group was higher than the old thrombus group (0.00473±0.001 28% ID/g), P<0.05. The thrombus to blood, thrombus area inferior vena cava, head lateral inferior vena cava and muscle ratios (3.42±1.06, 26.32±13.60, 31.23 ±16.00, 111.62±52.23) in the fresh thrombus group were higher than the old thrombus group (0.98±0.09, 5.12±2.01, 6.25±2.38, 21.82±5.93), P<0.05 for all. All the thrombi of the fresh thrombus group were confirmed

  3. Relationship of distraction rate with inferior alveolar nerve degeneration-regeneration shift

    Directory of Open Access Journals (Sweden)

    Ying-hua Zhao

    2018-01-01

    Full Text Available Distraction osteogenesis is an important technique for the treatment of maxillofacial abnormities and defects. However, distraction osteogenesis may cause the injury of the inferior alveolar nerve. The relationship between distraction rate and nerve degeneration-regeneration shift remains poorly understood. In this study, 24 rabbits were randomly divided into four groups. To establish the rabbit mandibular distraction osteogenesis model, the mandibles of rabbits in distraction osteogenesis groups were subjected to continuous osteogenesis distraction at a rate of 1.0, 1.5 and 2.0 mm/d, respectively, by controlling rounds of screwing each day in the distractors. In the sham group, mandible osteotomy was performed without distraction. Pin-prick test with a 10 g blunt pin on the labium, histological and histomorphometric analyses with methylene blue staining, Bodian's silver staining, transmission electron microscopy and myelinated fiber density of inferior alveolar nerve cross-sections were performed to assess inferior alveolar nerve conditions. At 28 days after model establishment, in the pin-prick test, the inferior alveolar nerve showed no response in the labium to a pin pricks in the 2 mm/d group, indicating a severe dysfunction. Histological and histomorphometric analyses indicated that the inferior alveolar nerve suffered more degeneration and injuries at a high distraction rate (2 mm/d. Importantly, the nerve regeneration, indicated by newborn Schwann cells and axons, was more abundant in 1.0 and 1.5 mm/d groups than in 2.0 mm/d group. We concluded that the distraction rate was strongly associated with the inferior alveolar nerve function, and the distraction rates of 1.0 and 1.5 mm/d had regenerative effects on the inferior alveolar nerve. This study provides an experimental basis for the relationship between distraction rate and nerve degeneration-regeneration shift during distraction osteogenesis, and may facilitate reducing nerve

  4. Prehnite-pumpellyite facies metamorphism in the Cenozoic Abanico Formation, Andes of central Chile (33°50'S: chemical and scale controls on mineral assemblages, reaction progress and the equilibrium state Metamorfismo de facies prehnita-pumpellyita en la Formación Abanico del Cenozoico, Andes centrales de Chile (33°50'S: controles químicos y de escala sobre las asociaciones minerales, el progreso de la reacción y el estado de equilibrio

    Directory of Open Access Journals (Sweden)

    Marcia Muñoz

    2010-01-01

    los Bueyes, Cordillera Principal al este de Santiago (33°50'S, aflora una serie volcánica del Oligoceno Superior-Mioceno Inferior perteneciente a la Formación Abanico (Eoceno Tardío-Mioceno Temprano. Las sucesiones de roca expuestas en ambas areas, de ca. 3.300 m de espesor total, fueron afectadas por metamorfismo no deformativo de muy bajo grado en facies prehnita-pumpellyita. Esto está representado en el desarrollo extensivo de arreglos de minerales secundarios formados por epidota, inter-estratificados de clorita-esmectita, albita, cuarzo, mica blanca, y titanita. Estos arreglos minerales contienen además pumpellyita, prehnita o prehnita+actinolita en algunas muestras. Las características químicas tales como una baja variabilidad composicional de los interestratificados de clorita-esmectita y actinolita independientemente del dominio donde se hospedan estas fases, junto con una alta proporción de capas de clorita en las primeras, sugieren que estas fases representan cercanamente la composición efectiva de la roca total. Por el contrario, la composición de las pum-pellyitas muestra una mayor variabilidad y un fuerte control del metadominio donde éstas se desarrollan evidenciando una baja cinética de equilibrio y dejando sólo a aquellas desarrolladas en la matriz como formadas bajo un control composicional efectivo de la roca total. Los arreglos minerales de ambas areas muestran evidencias de haberse formado bajo un mismo evento metamórñco bajo el cual las reacciones se han desarrollado de manera equivalente. Aún así se reconocen diferencias químicas locales que controlan este proceso. Una mayor concentración de CO2 en los fluidos durante el metamorfismo en el area de El Volcán, con respecto al area de Rodeo de los Bueyes, se ve representada en la presencia escasa de prehnita, y abundante de calcita, en sus asociaciones minerales. La presion y temperatura de este evento metamórfico han sido gruesamente estimadas en valores inferiores a 2-3 kbar

  5. Hepatic Scintigraphic Findings of Budd-Chiari Syndrome due to Inferior Vena Caval Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Hoon; Chung, Soo Kyo; Byun, Jae Young; Lee, Sung Yong; Shinn, Kyung Sub; Kim, Choon Yul; Bahk, Yong Whee [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1988-03-15

    Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow. The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows: 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-02-15

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

  7. Peritoneal fluid causing inferior attenuation on SPECT thallium-201 myocardial imaging in women

    International Nuclear Information System (INIS)

    Rab, S.T.; Alazraki, N.P.; Guertler-Krawczynska, E.

    1988-01-01

    On SPECT thallium images, myocardial left ventricular (LV) anterior wall attenuation due to breast tissue is common in women. In contrast, in men, inferior wall counts are normally decreased compared to anterior counts. The purpose of this report is to describe cases of inferior wall attenuation of counts in women caused by peritoneal fluid, not myocardial disease. Twelve consecutive SPECT thallium myocardial studies performed in women on peritoneal dialysis, being evaluated for kidney transplant, were included in this study. For all studies, 3.5 mCi 201Tl were injected intravenously. Thirty-two images were acquired over 180 degrees (45 degrees RAO progressing to 45 degrees LPO) at 40 sec per stop. SPECT images were reviewed in short axis, horizontal long and vertical long axes. Data were also displayed in bullseye format with quantitative comparison to gender-matched normal files. Ten of 12 female patients studied had inferior wall defects on images, confirmed by bullseye display. All patients had approximately 2 liters of peritoneal fluid. Review of planar rotational views showed diaphragm elevation and fluid margin attenuations affecting left ventricular inferior wall. Thus, peritoneal fluid is a cause of inferior attenuation on 201Tl cardiac imaging

  8. Abstract Representations of Object-Directed Action in the Left Inferior Parietal Lobule.

    Science.gov (United States)

    Chen, Quanjing; Garcea, Frank E; Jacobs, Robert A; Mahon, Bradford Z

    2018-06-01

    Prior neuroimaging and neuropsychological research indicates that the left inferior parietal lobule in the human brain is a critical substrate for representing object manipulation knowledge. In the present functional MRI study we used multivoxel pattern analyses to test whether action similarity among objects can be decoded in the inferior parietal lobule independent of the task applied to objects (identification or pantomime) and stimulus format in which stimuli are presented (pictures or printed words). Participants pantomimed the use of objects, cued by printed words, or identified pictures of objects. Classifiers were trained and tested across task (e.g., training data: pantomime; testing data: identification), stimulus format (e.g., training data: word format; testing format: picture) and specific objects (e.g., training data: scissors vs. corkscrew; testing data: pliers vs. screwdriver). The only brain region in which action relations among objects could be decoded across task, stimulus format and objects was the inferior parietal lobule. By contrast, medial aspects of the ventral surface of the left temporal lobe represented object function, albeit not at the same level of abstractness as actions in the inferior parietal lobule. These results suggest compulsory access to abstract action information in the inferior parietal lobe even when simply identifying objects.

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

    Directory of Open Access Journals (Sweden)

    de Barros Angelique

    2006-01-01

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

  10. Quantitative measurement of radiofrequency volumetric tissue reduction by multidetector CT in patients with inferior turbinate hypertrophy.

    Science.gov (United States)

    Bahadir, Osman; Kosucu, Polat

    2012-12-01

    To objectively assess the efficacy of radiofrequency thermal ablation of inferior turbinate hypertrophy. Thirty-five patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. Radiofrequency energy was delivered to four sites in each inferior turbinate. Patients were evaluated before and 8 weeks after intervention. Subjective evaluation of nasal obstruction was performed using a visual analogue scale (VAS), and objective evaluation of the turbinate volume reduction was calculated using multidetector CT. Volumetric measurements of the preoperative inferior turbinate were compared with postoperative values on both sides. The great majority of patients (91.4%) exhibited subjective postoperative improvement. Mean obstruction (VAS) improved significantly from 7.45±1.48 to 3.54±1.96. Significant turbinate volume reduction was achieved by the surgery on both right and left sides [(preoperative vs. postoperative, right: 6.55±1.62cm(3) vs. 5.10±1.47cm(3), (PRadiofrequency is a safe and effective surgical procedure in reducing turbinate volume in patients with inferior turbinate hypertrophy. Multidetector CT is an objective method of assessment in detecting radiofrequency turbinate volume reduction. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. Computed tomographic (CT) study of watershed area supplied by the posterior inferior cerebellar artery (PICA)

    International Nuclear Information System (INIS)

    Nozaki, Junichi; Hirose, Satoshi; Hosotani, Kazuo; Kubota, Tetsuya; Kubota, Norihiko.

    1990-01-01

    Thirteen patients with clinical and computed tomographic (CT) evidence of cerebellar infarction were examined during 1987-1989. Six patients had onset of cerebellar infarction at ages ranging from 45 to 69, and seven patients had onset at ages over 70. In thirteen cases, we observed infarction in the inferior region of the cerebellum, and we studied these cases. CT demonstrated decreased density in 4 distinct anatomic areas. These areas are listed below, with estimation of the distribution of the hemispheric arteries of the posterior inferior cerebellar artery (PICA): Group 1 - posterior medial area, probably territory of the inferior vermian branch, tonsillar branch and/or medial artery of the hemispheric artery of the PICA; Group 2 - posterior intermediate area, probably territory of the intermediate artery of the hemispheric artery of the PICA; Group 3 - area including both areas of group 1 and group 3; Group 4 - lateral area, just posterior to pyramis, probably territory of the anterior inferior cerebellar artery and/or lateral artery of the hemispheric artery of PICA. The medial and intermedial cerebellar hemispheric segments were most commonly affected but the lateral segment was not. The PICA least frequently supplied the lateral segments. While the anterior inferior cerebellar artery usually anastomoses with the lateral artery of the hemispheric artery of the PICA. These vascular territories may provide good collateral circulation to this segment. And we also estimate the distribution of the PICA by the CT findings. (author)

  12. Hepatic Scintigraphic Findings of Budd-Chiari Syndrome due to Inferior Vena Caval Obstruction

    International Nuclear Information System (INIS)

    Kim, Sung Hoon; Chung, Soo Kyo; Byun, Jae Young; Lee, Sung Yong; Shinn, Kyung Sub; Kim, Choon Yul; Bahk, Yong Whee

    1988-01-01

    Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow. The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows: 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

  13. Massive hemothorax due to inferior phrenic artery injury after blunt trauma.

    Science.gov (United States)

    Aoki, Makoto; Shibuya, Kei; Kaneko, Minoru; Koizumi, Ayana; Murata, Masato; Nakajima, Jun; Hagiwara, Shuichi; Kanbe, Masahiko; Koyama, Yoshinori; Tsushima, Yoshito; Oshima, Kiyohiro

    2015-01-01

    Injury to the inferior phrenic artery after blunt trauma is an extremely rare event, and it may occur under unanticipated conditions. This case report describes an injury to the left inferior phrenic artery caused by blunt trauma, which was complicated by massive hemothorax, and treated with transcatheter arterial embolization (TAE). An 81 year-old female hit by a car while walking at the traffic intersection was transferred to the emergency department, computed tomography scanning revealed active extravasations of the contrast medium within the retrocrural space and from branches of the internal iliac artery. The patient underwent repeated angiography, and active extravasation of contrast medium was observed between the retrocrural space and the right pleural space originating from the left inferior phrenic artery. The injured left inferior phrenic artery was successfully embolized with N-butyl cyanoacrylate, resulting in stabilization of the patient's clinical condition. Inferior phrenic artery injury should be recognized as a rare phenomenon and causative factor for hemothorax. TAE represents a safe and effective treatment for this complication and obviates the need for a thoracotomy.

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

    International Nuclear Information System (INIS)

    Anderson, M.C.

    1988-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  16. Partially thrombosed giant aneurysm arising from a distal anterior inferior cerebellar artery–posterior inferior cerebellar artery variant: A case report

    Directory of Open Access Journals (Sweden)

    Hidetoshi Ooigawa

    2015-09-01

    Full Text Available Anterior inferior cerebellar artery (AICA–posterior inferior cerebellar artery (PICA is a well-known variant in cerebral arteries. However, aneurysms located on the variant are rare and a giant one has not been reported. We report a case of a partially thrombosed giant aneurysm arising from an AICA–PICA variant. The patient was a 42-year-old man who presented with right hearing loss and facial numbness associated with left hemidysesthesia. Magnetic resonance imaging revealed an approximately 3.0-cm mass lesion at the right cerebello-pontine angle (CPA. Angiography showed a partially thrombosed aneurysm arising from the right AICA–PICA. The aneurysm was treated with endovascular trapping and surgical thrombectomy. Although cerebral aneurysm is known to occur at this site, this case provides awareness, that manifestations of aneurysms in the CPA include progressive multiple cranial nerve palsies and sensory disturbance caused by brainstem compression.

  17. Importance of human right inferior frontoparietal network connected by inferior branch of superior longitudinal fasciculus tract in corporeal awareness of kinesthetic illusory movement.

    Science.gov (United States)

    Amemiya, Kaoru; Naito, Eiichi

    2016-05-01

    It is generally believed that the human right cerebral hemisphere plays a dominant role in corporeal awareness, which is highly associated with conscious experience of the physical self. Prompted by our previous findings, we examined whether the right frontoparietal activations often observed when people experience kinesthetic illusory limb movement are supported by a large-scale brain network connected by a specific branch of the superior longitudinal fasciculus fiber tracts (SLF I, II, and III). We scanned brain activity with functional magnetic resonance imaging (MRI) while nineteen blindfolded healthy volunteers experienced illusory movement of the right stationary hand elicited by tendon vibration, which was replicated after the scanning. We also scanned brain activity when they executed and imagined right hand movement, and identified the active brain regions during illusion, execution, and imagery in relation to the SLF fiber tracts. We found that illusion predominantly activated the right inferior frontoparietal regions connected by SLF III, which were not substantially recruited during execution and imagery. Among these regions, activities in the right inferior parietal cortices and inferior frontal cortices showed right-side dominance and correlated well with the amount of illusion (kinesthetic illusory awareness) experienced by the participants. The results illustrated the predominant involvement of the right inferior frontoparietal network connected by SLF III when people recognize postural changes of their limb. We assume that the network bears a series of functions, specifically, monitoring the current status of the musculoskeletal system, and building-up and updating our postural model (body schema), which could be a basis for the conscious experience of the physical self. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Bilateral catheterization of the inferior petrosal sinuses in 23 cases of ACTh-dependent hypercoarisolism

    International Nuclear Information System (INIS)

    Castro, E.; Nombela, L.; Brasa, J.

    1996-01-01

    Our purpose is to assess the results of catheterization of the inferior petrosal sinuses, a measure that is included in the diagnostic protocol for ACTH-dependent hypercortisolism. We analyzed retrospectively the data obtained for 23 patients (20 women and 3 men) subjected to this procedure. The test was complete (catheterization both inferior petrosal sinuses) in 21 patients (91%). The sensitivity in differentiating between Cushing's disease (n=21) and ectopic ACTH syndrome (n=21) was 95.2% after administration of CRH, with a specificity of 100%, and the positive predictive value for the intra pituitary localization of the micro adenoma (confirmed by histological study in 19 cases) was 61%. Catheterization of the inferior petrosal sinuses shows an elevated sensitivity and specificity in the diagnosis of Cushing's disease, although the positive predictive value for determining the intrapituitary localization of the adenoma is low. (Author) 12 refs

  19. Diagnosis of tricuspid insufficiency by Doppler flowmetry in the inferior vena cava

    International Nuclear Information System (INIS)

    Smith, H.J.

    1986-01-01

    Eighty-five patients subjected to routine heart catheterization were examined with duplex scanning of the inferior vena cava. Adequate Doppler recordings and a right ventricular angiography were obtained in 79 of them. Tricuspid insufficiency was found to be present in 34 patients at angiography and in 24 at duplex examination. No false positive Doppler diagnoses of tricuspid insufficiency occurred. The possibility of false positive angiographic diagnoses is discussed. A high correlation was found between percentage reversed flow in the inferior vena cava during ventricular systole and degree of angiographic tricuspid insufficiency. It is concluded that duplex scanning of the inferior vena cava seems to be a good alternative to angiography in the diagnosis and quantification of tricuspid insufficiency. (orig.)

  20. Roentgenologic diagnosis of pulmonary veins pathologically inflowing into vena cava inferior

    International Nuclear Information System (INIS)

    Shumskij, V.I.; Konstantinova, N.V.; Fedorovich, Yu.N.

    1986-01-01

    The authors considered the problem of X-ray semiotics of the right inferior pulmonary vein pathologically inflowing in the vena cava inferior (4 patients) and the false syndrome of the ''Turkish sabre'' (1 patients). Among the patients there were 2 adults and 3 children. It was noted that the abnormal inflowing of the right lower lobe vein in the vena cava inferior was often combined with different types of heart diseases and defects of the major vessels, mainly with the defect of the interatrial septum, the open arterial canal and hypoplasia of the right pulmonary artery. Radiodiagnosis for this group of patients should incorporate, in addition to routine X-ray methods, angiographic investigation, and its volume in each case should be determined on an individual basis

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

    Directory of Open Access Journals (Sweden)

    Ferrón JA

    2010-06-01

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

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

    Science.gov (United States)

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

    2011-07-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  4. Prone decubitus: A solution to inferior wall attenuation in thallium-201 myocardial tomography

    Energy Technology Data Exchange (ETDEWEB)

    Esquerre, J.P.; Coca, F.J.; Martinez, S.J.; Guiraud, R.F.

    1989-03-01

    We propose an efficient method to suppress inferior wall attenuation in /sup 201/TI 180 degrees myocardial tomography. We systematically performed redistribution studies in both supine and prone decubitus, assuming that the latter should result in shifting with respect to each other's cardiac structures and diaphragm as well as subphrenic organs possibly responsible for attenuation. The comparison of both studies in 25 normal subjects by visual interpretation and circumferential profiles analysis showed a complete suppression of significant attenuation in the inferior wall in prone studies. In addition and consequently, the standard deviation of activity in this area was markedly reduced and became close to its value in anterior and lateral walls. This simple technique now routinely performed in over 400 patients drastically improves specificity in the evaluation of inferior wall abnormalities by suppressing attenuation artifacts and, incidently, the effect of high individual variability in left phrenic and subphrenic anatomic configuration.

  5. Implante de filtro em veia cava inferior dupla: relato de caso e revisão da literatura Filter placement in duplicated inferior vena cava: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Rafael Demarchi Malgor

    2008-06-01

    Full Text Available Veia cava inferior dupla é uma variação anatômica rara cuja prevalência é de 0,2-3%. O implante de filtro de veia cava, quando indicado em casos com duplicidade da veia cava inferior, pode ser realizado de diferentes formas: em ambas as veias cavas; em uma delas, embolizando a anastomose entre ambas; em somente uma delas; ou por implante supra-renal. Relatamos um caso de trombose venosa profunda no pós-operatório de implante de prótese de quadril com contra-indicação para tratamento anticoagulante e cuja cavografia evidenciou duplicidade de veia cava inferior. O implante de filtro de veia cava inferior realizado em posição supra-renal mostrou-se opção adequada e segura.Double inferior vena cava is a rare anatomic variation with prevalence ranging between 0.2-3.0%. In cases of duplication, inferior vena cava filter placement options include placing it in both vena cava, coil-embolization of the intervenous segment plus placing a filter in the right inferior vena cava, or suprarenal filter placement. We report a case of deep venous thrombosis after unilateral primary total hip replacement, presenting with contraindications for anticoagulant therapy, in which cavography showed inferior vena cava duplication. Inferior vena cava filter placement was performed in the supra-renal portion and was proved to be an adequate and safe procedure.

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

    Directory of Open Access Journals (Sweden)

    Jinho Lee

    2015-06-01

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

  7. Study of the inferior alveolar canal and mental foramen on digital panoramic images.

    Science.gov (United States)

    Pria, Carlos M; Masood, Farah; Beckerley, Joy M; Carson, Robert E

    2011-07-01

    To study the radiographic location of the mental foramen and appearance of the inferior alveolar canal and the relationship between image gray values and the clarity of inferior alveolar canal on the digital panoramic images and to evaluate if the histogram equalization of the digital image would improve the visualization of the inferior alveolar canal outline on the digital panoramic images in the mandible. Five hundred digital panoramic images were evaluated by two examiners using a specific inclusion criteria. Only the right side of the mandible was studied. Chi-square analyses were used for comparisons of distributions. Mean and median pixel values were analyzed separately with a one-way analysis of variance. Also, percentages were calculated to report the usefulness of the histogram equalization for visualization of canal. RESULTS show variation in location of mental foramen. Most frequent location of the mental foramen was reported as first and second premolar region. Chi-square analysis showed that the frequency of occurrence of the mental foramen was equally probable for any of the three locations. The study did not find significant usefulness of the gray values obtained from the histogram equalization in predicting the clarity of inferior alveolar canal outlines. Knowing the normal relationship and the anatomical variation of the maxillofacial structures for each patient is important for surgical implant treatment planning to avoid future complications. It is also important to be familiar with the advantages and limitations of diagnostic aids available before making treatment planning decisions based on such findings. Digital imaging, Panoramic, Inferior alveolar canal, Mental foramen. How to cite this article: Pria CM, Masood F, Beckerley JM, Carson RE. Study of the Inferior Alveolar Canal and Mental Foramen on Digital Panoramic Images. J Contemp Dent Pract 2011;12(4):265-271. Source of support: Nil Conflict of interest: None declared.

  8. Comparison of dynamic ultrasound and stress radiology for assessment of inferior glenohumeral laxity in asymptomatic shoulders

    International Nuclear Information System (INIS)

    Cheng, S.C.; Wallace, W.A.; Hulse, D.; Fairbairn, K.J.; Clarke, M.

    2008-01-01

    To determine the level of agreement between dynamic ultrasound imaging and stress radiography used for the measurement of inferior glenohumeral laxity in asymptomatic shoulders, and to determine the repeatability of the dynamic ultrasound technique. Using a custom-made stress device to apply an inferior displacement force of 90 N, we assessed 20 asymptomatic male subjects for inferior glenohumeral laxity, using stress radiography and dynamic ultrasound. Paired differences between the two methods were evaluated by the 95% limits of agreement method. At a separate session, 19 subjects had inferior glenohumeral laxity assessed by two observers, using dynamic ultrasound. Inter- and intra-observer repeatability was determined for the ultrasound technique. The mean [± standard deviation (SD)] inferior translation was 4.7 ± 4.1 mm by stress radiography and 4.4 ± 2.3 mm by dynamic ultrasound. The 95% limits of agreement showed good agreement between the two methods. The paired difference between the two measurement methods varied with the magnitude of the measurement (P < 0.001). Intra-observer repeatability of dynamic ultrasound was determined by the use of intra-class correlation coefficients and was 0.94 and 0.89 for the two investigators. Inter-observer repeatability was 0.85. The standard error of the measurement was 0.60 mm and 0.66 mm, for repeated measurements by the two investigators, and 0.85 mm between investigators. Repeatability coefficients demonstrated excellent consistency of measurement between sessions and good consistency between observers. Dynamic ultrasound is a valid and reproducible method for the assessment and quantification of inferior glenohumeral laxity. (orig.)

  9. Immediate endovascular treatment of an aortoiliac aneurysm ruptured into the inferior vena cava.

    Science.gov (United States)

    Kopp, Reinhard; Weidenhagen, Rolf; Hoffmann, Ralf; Waggershauser, Tobias; Meimarakis, Georgios; Andrassy, Joachim; Clevert, Dirk; Czerner, Stephan; Jauch, Karl-Walter

    2006-07-01

    An aortocaval fistula is a severe complication of an aortoiliac aneurysm, usually associated with high perioperative morbidity and mortality during open operative repair. We describe the successful endovascular treatment of a symptomatic infrarenal aortic aneurysm ruptured into the inferior vena cava with secondary interventional coiling of a persistent type II endoleak because of retrograde perfusion of the inferior mesenteric artery. Endovascular exclusion of ruptured abdominal aneurysms seems to be a valuable treatment option for selected patients even with complicated vascular conditions like an aortocaval fistula.

  10. Hepatic Veins and Inferior Vena Cava Thrombosis in a Child Treated by Transjugular Intrahepatic Portosystemic Shunt

    International Nuclear Information System (INIS)

    Carnevale, Francisco Cesar; Santos, Aline Cristine Barbosa; Tannuri, Uenis; Cerri, Giovanni Guido

    2010-01-01

    We report the case of a 9-year-old boy with portal hypertension, due to Budd-Chiari syndrome, and retrohepatic inferior vena cava thrombosis, submitted to a transjugular intrahepatic portosystemic shunt (TIPS) by connecting the suprahepatic segment of the inferior vena cava directly to the portal vein. After 3 months, the withdrawal of anticoagulants promoted the thrombosis of the TIPS. At TIPS revision, thrombosis of the TIPS and the main portal vein and clots at the splenic and the superior mesenteric veins were found. Successful angiography treatment was performed by thrombolysis and balloon angioplasty of a severe stenosis at the distal edge of the stent.

  11. Diplopia after inferior alveolar nerve block: case report and related physiology.

    Science.gov (United States)

    You, Tae Min

    2015-06-01

    Although inferior alveolar nerve block is one of the most common procedures performed at dental clinics, complications or adverse effects can still occur. On rare occasions, ocular disturbances, such as diplopia, blurred vision, amaurosis, mydriasis, abnormal pupillary light reflex, retrobulbar pain, miosis, and enophthalmos, have also been reported after maxillary and mandibular anesthesia. Generally, these symptoms are temporary but they can be rather distressing to both patients and dental practitioners. Herein, we describe a case of diplopia caused by routine inferior alveolar nerve anesthesia, its related physiology, and management.

  12. Needle in the external auditory canal: an unusual complication of inferior alveolar nerve block.

    Science.gov (United States)

    Ribeiro, Leandro; Ramalho, Sara; Gerós, Sandra; Ferreira, Edite Coimbra; Faria e Almeida, António; Condé, Artur

    2014-06-01

    Inferior alveolar nerve block is used to anesthetize the ipsilateral mandible. The most commonly used technique is one in which the anesthetic is injected directly into the pterygomandibular space, by an intraoral approach. The fracture of the needle, although uncommon, can lead to potentially serious complications. The needle is usually found in the pterygomandibular space, although it can migrate and damage adjacent structures, with variable consequences. The authors report an unusual case of a fractured needle, migrating to the external auditory canal, as a result of an inferior alveolar nerve block. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Unusual facial pain secondary to inferior alveolar nerve compression caused by impacted mandibular second molar

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2014-01-01

    Full Text Available Symptoms of inferior alveolar nerve (IAN compression are reported during endodontic procedures, placement of implants, third molar surgeries, inferior alveolar nerve block injections, trauma, orthognathic injuries, ablative surgeries or use of medicaments. Presented is a rare case of a 15-year-old girl who reported severe pain in relation to an impacted permanent mandibular left second molar, the roots of which had entrapped the mandibular canal causing compression of IAN. Timely surgical intervention and sectional removal of the impacted molar is indicated to relieve the symptoms and avoid permanent damage to the nerve.

  14. Infarcts presenting with a combination of medial medullary and posterior inferior cerebellar artery syndromes.

    Science.gov (United States)

    Lee, Hyung; Baik, Seung Kug

    2004-09-15

    Cerebellar and medial medullary infarctions are well-known vertebrobasilar stroke syndromes. However, their development in a patient with distal vertebral artery occlusion has not been previously reported. A 49-year-old man with longstanding hypertension suddenly developed vertigo, right-sided Horner syndrome, and left-sided weakness. An MRI of the brain showed acute infarcts in the right inferior cerebellum (posterior inferior cerebellar artery territory) and the right upper medial medulla (direct penetrating branches of vertebral artery). Magnetic resonance angiogram showed occlusion of the distal vertebral artery on the right side. Atherothrombotic occlusion of the distal vertebral artery may cause this unusual combination of vertebrobasilar stroke.

  15. Mechanisms contributing to cluster formation in the inferior olivary nucleus in brainstem slices from postnatal mice

    DEFF Research Database (Denmark)

    Kølvraa, Mathias; Müller, Felix C; Jahnsen, Henrik

    2014-01-01

    The inferior olivary nucleus (IO) in in vitro slices from postnatal mice (P5.5-P15.5) spontaneously generates clusters of neurons with synchronous calcium transients, and intracellular recordings from IO neurons suggest that electrical coupling between neighbouring IO neurons may serve as a synch......The inferior olivary nucleus (IO) in in vitro slices from postnatal mice (P5.5-P15.5) spontaneously generates clusters of neurons with synchronous calcium transients, and intracellular recordings from IO neurons suggest that electrical coupling between neighbouring IO neurons may serve...

  16. Colgajos de perforantes de las arterias epigástricas inferiores profunda y superficial Deep and superficial inferior epigastric artery perforator flaps

    Directory of Open Access Journals (Sweden)

    A. R. Gagnon

    2006-12-01

    Full Text Available Con el desarrollo de los colgajos miocutáneos de recto abdominal (TRAM, el abdomen inferior ha sido reconocido como la principal área dadora de tejidos autólogos de alta calidad, especialmente útiles en reconstrucción mamaria. Más recientemente la habilidad para obtener componentes adiposocutáneos similares sin sacrificar el músculo recto ha revolucionado el campo de la Cirugía Reconstructiva. El advenimiento de los colgajos de perforantes ha permitido a los cirujanos plásticos lograr los mismos buenos resultados estéticos que con los colgajos miocutáneos tradicionales, pero con un considerable descenso en la morbilidad del área donante. Con los colgajos de perforantes de la arteria epigástrica inferior profunda (DIEP y de la arteria epigástrica inferior superficial (SIEA, los pacientes han incrementado sus opciones de reconstrucción. Este artículo revisa la anatomía quirúrgica de la pared abdominal relativa a los colgajos SIEA y DIEP. Se explican detalladamente los pasos principales para la preparación preoperatoria, la técnica quirúrgica y los cuidados postoperatorios. Se discuten las ventajas y desventajas y se presen- tan los trucos técnicos que pueden ayudar a mejorar el resultado final. Además se ilustran con ayuda de casos clínicos las indicaciones típicas y atípicas.Following the development of the transverse rectus abdominis myocutaneous (TRAM flap, the lower abdomen has been recognized as a prime source of high quality autogenous tissue, especially useful in breast reconstruction. More recently, the ability to harvest a similar adipocutaneous component without sacrifice of the rectus muscle has revolutionized the field of reconstructive surgery. The advent of perforator flaps has allowed plastic surgeons to achieve the same highly esthetic results as with the former myocutaneous flaps while significantly decreasing the donor site morbidity. With the deep inferior epigastric artery perforator (DIEP flap and

  17. Insertion of an active fixation lead in the inferior interatrial septum via a 9.0 Fr guiding catheter

    Directory of Open Access Journals (Sweden)

    Shumpei Mori, MD

    2014-04-01

    Full Text Available Placing an atrial lead in the inferior interatrial septum (IAS reportedly reduces the incidence of paroxysmal atrial fibrillation (AF and slows the progression to chronic AF; however, in certain cases, inferior IAS pacing is technically difficult. When this procedure is unsuccessful, insertion of the lead in the right atrial appendage can be considered, but it is associated with a risk of cardiac perforation. Here, we describe a technique for lead insertion in the inferior IAS via a 9.0 Fr guiding catheter, which may serve as an alternative technique for inferior IAS pacing when the conventional stylet-guided insertion is not successful.

  18. Male circumcision does not result in inferior perceived male sexual function - a systematic review

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel Mønsted; Düring, Signe; Frimodt-Møller, Cai

    2016-01-01

    -B). Following non-medical circumcision, no inferior sexual function was reported (A-B). Following medical circumcision, most outcomes were comparable (B); however, problems in obtaining an orgasm were increased (C) and erectile dysfunction was reported with inconsistency (D). A younger age at circumcision...

  19. Related anomalies of origin of left vertebral and left inferior thyroid arteries

    International Nuclear Information System (INIS)

    Sartor, K.; Freckmann, N.; Boeker, D.K.; Allgemeines Krankenhaus Altona, Hamburg

    1981-01-01

    The known rare occurrence of related anomalies of origin of vertebral and inferior thyroid arteries appears not to be documented in the angiographic literature. Three cases with manifestation on the left side are presented. Embryology is discussed briefly. Knowledge of such anomalies is of importance to surgeons as well as angiographers. (orig.) [de

  20. Umbilical vein draining into the inferior vena cava via the internal iliac vein, bypassing the liver

    International Nuclear Information System (INIS)

    Currarino, G.; Stannard, M.W.; Texas Univ., Dallas, TX; Kolni, H.

    1991-01-01

    This is the third report of an anomalous umbilical vein draining ectopically in a left pelvic vein, probably the left internal iliac, and through the inferior vena cava into the right atrium. The anomaly was encountered in a newborn infant with nonimmune hydrops fetalis, hypertrophic cardiomyopathy, multiorgan failure and possibly Noonan Syndrome. (orig.)

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

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    A.O. Eweka.

    2008-01-01

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

  3. The Antero-inferior Premaxillary Approach to Surgery of the Nasal ...

    African Journals Online (AJOL)

    For this procedure, sharp elevators like the Mackenty or even a scalpel may be used. The joint fibres are dense, and there may be scar tissue. Bone should be clearly exposed. Having defined the left anterior tunnel (1), proceed to define the right inferior tunnel (2), dissecting the mucosa off the pyriform fossa of the right side.

  4. Transcatheter lipiodol chemo-embolization of the inferior phrenic artery in hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Chen Fanghong; Luo Zuyan; Yuan Jianhua; Yu Wenqiang; Cai Xuexiang; Hu Tingyang; Liu Zijiang

    2002-01-01

    Objective: To evaluate the efficacy of transcatheter lipiodol chemo-embolization therapy (TOCE) for HCC via inferior phrenic artery (IPA) and to analyse the location of the tumor feeding inferior phrenic artery. Methods: Twenty-five cases of HCC underwent the procedure of TOCE via the IPA, as well as the hepatic artery using Seldinger's method. The patterns of tumor growth included huge type in 12 cases, solitary nodular type in 8 cases and multiple nodular type in 5 cases. Hepatic artery and inferior phrenic artery chemo-embolization were performed in all cases. Results: Inferior phrenic artery originated from celiac trunk in 16 cases (64%); abdomen aorta around celiac trunk in 8(32%). The site-sort tumors supplied by IPA in right lobe (VII, VIII segment) were 23 cases and left lobe (IV segment) 2 cases. The cumulative survival rates of IPA chemo-embolization for hepatocellular carcinoma were 84%(1 year) and 68%(2 years). No severe complications occurred. Conclusions: TOCE of the IPA is a safe and effective method in the management of HCC supplied by IPA. When the tumor site is adjacent to diaphragm, hepatic ligaments or bare area, may arouse the blood supply by IPA, especially in no tumor staining or staining defect in hepatic artery angiography but tumor enhancement on CT, and increase of the level of serum α-fetoprotein

  5. Effects of sexual reproduction of the inferior competitor Brachionus calyciflorus on its fitness against Brachionus angularis

    Science.gov (United States)

    Li, Chen; Niu, Cuijuan

    2015-03-01

    Sexual reproduction adversely affects the population growth of cyclic parthenogenetic animals. The density-dependent sexual reproduction of a superior competitor could mediate the coexistence. However, the cost of sex may make the inferior competitor more vulnerable. To investigate the effect of sexual reproduction on the inferior competitor, we experimentally paired the competition of one Brachionus angularis clone against three Brachionus calyciflorus clones. One of the B. calyciflorus clones showed a low propensity for sexual reproduction, while the other two showed high propensities. The results show that all B. calyciflorus clones were excluded in the competition for resources at low food level. The increased food level promoted the competition persistence, but the clones did not show a clear pattern. Both the cumulative population density and resting egg production increased with the food level. The cumulative population density decreased with the mixis investment, while the resting egg production increased with the mixis investment. A trade-off between the population growth and sexual reproduction was observed in this research. The results indicate that although higher mixis investment resulted in a lower population density, it would not determinately accelerate the exclusion process of the inferior competitor. On the contrary, higher mixis investment promoted resting egg production before being excluded and thus promised a long-term benefit. In conclusion, our results suggest that mixis investment, to some extent, favored the excluded inferior competitor under fierce competition or some other adverse conditions.

  6. The Intrinsic Inferiority of Efficiency Wages to Damages and Conditional Bonuses

    NARCIS (Netherlands)

    de Geest, G.G.A.; Dari Mattiacci, G.; Siegers, J.J.

    In this paper, we argue that, as an enforcement mechanism, efficiency wages are intrinsically inferior to damages and to conditional bonuses – an alternative positive sanction system overlooked in the labor economics literature, under which rents are only paid if monitoring has effectively taken

  7. The intrinsic inferiority of efficiency wages to damages and conditional bonuses

    NARCIS (Netherlands)

    Geest, Gerrit de; Dari Mattiacci, G.; Siegers, J.J.

    2004-01-01

    In this paper, we argue that, as an enforcement mechanism, efficiency wages are intrinsically inferior to damages and to conditional bonuses an alternative positive sanction system overlooked in the labor economics literature, under which rents are only paid if monitoring has effectively taken

  8. Inferior Frontal Sensitivity to Common Speech Sounds Is Amplified by Increasing Word Intelligibility

    Science.gov (United States)

    Vaden, Kenneth I., Jr.; Kuchinsky, Stefanie E.; Keren, Noam I.; Harris, Kelly C.; Ahlstrom, Jayne B.; Dubno, Judy R.; Eckert, Mark A.

    2011-01-01

    The left inferior frontal gyrus (LIFG) exhibits increased responsiveness when people listen to words composed of speech sounds that frequently co-occur in the English language (Vaden, Piquado, & Hickok, 2011), termed high phonotactic frequency (Vitevitch & Luce, 1998). The current experiment aimed to further characterize the relation of…

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

    NARCIS (Netherlands)

    Jabbi, Mbemba; Keysers, Christian

    2008-01-01

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

  10. Study on CT scanning technique of inferior horn of lateral ventricle

    International Nuclear Information System (INIS)

    Kakoi, Iwao; Okubo, Mitsuo; Nakamura, Sumio; Yoshinaga, Toshihiko; Shimono, Tetsuo

    1984-01-01

    It is said that temporal lobe epilepsy (TLE), one of the incurable epilepsies, results from the lesions of various structrues located in the medial and deep portion of the temporal lobe such as the hippocampus and amygdaloid nucleus. Routine CT scanning techniques cannot adequately delineate these structures in the assessment of TLE. The anatomical relationship between these medial temporal structures and the inferior horn of lateral ventricle which is lateral to them and easily identified by CT lead us to believe that the sections through the longitudinal plane of the inferior horn may clearly delineate them. The present experimental study was undertaken to develop the CT scan technique of the inferior horn of lateral ventricle, which results in the clear delineation of the region of the hippocampus and amygdaloid nucleus. As a result, A total of the 3-4 reversed axial 5 mm-thick section centered at 2.5 cm cephalad to the roof of the external auditory canal at a reversed 25 0 angle to ABL are adequate to delineate the inferior horn and the medial temporal structures. This scan technique is considered to be useful in the assessment of TLE. (author)

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

    Directory of Open Access Journals (Sweden)

    Ece Turan-Vural

    2014-01-01

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

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

    Science.gov (United States)

    O'Connor, Carla

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Marjolein van den Brink

    2010-06-01

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

  14. Bird's Nest Filter Causing Symptomatic Hydronephrosis Following Transmural Penetration of the Inferior Vena Cava

    International Nuclear Information System (INIS)

    Stacey, C.S.; Manhire, A.R.; Rose, D.H.; Bishop, M.C.

    2004-01-01

    We report a case of symptomatic hydronephrosis caused by transcaval penetration of a Bird's Nest filter. Perforation of the wall of the inferior vena cava (IVC) following insertion of a caval filter is a well-recognized complication. Whilst two cases of hydronephrosis have been described with Greenfield filters, no case involving a Bird's Nest filter has been reported previously

  15. Method of segmenting inferior horns of lateral ventricles using active contour models

    International Nuclear Information System (INIS)

    Hattori, Masumi; Koyama, Shuji; Kodera, Yoshie

    2007-01-01

    Recent research has suggested that the measurement of regional atrophy in the structure of the medial temporal lobe is a promising way to discriminate Alzheimer-type dementia patients from healthy control subjects. There are some reports that the inferior horns of the lateral ventricles are expanded by atrophying the structure of the medial temporal lobe. We developed a technique to automatically detect the region of the inferior horns of the lateral ventricles by gray-level thresholding and morphological processing. However, there were some incorrect regions in this method. Accordingly, we proposed a technique for which active contour models (ACM) were used. Our ACM incorporates the improved edge-based image and the external constraint to improve convergence and to reduce its dependence on initial estimation. In this study, we present the details of an algorithm that traces the contours of the inferior horns of the lateral ventricles and its performance relative to manual methods. The average degree of correspondence between the extract region and manual trace was measured in 30 inferior horns of 15 subjects. The average degree of correspondence of the proposed method was about 4% higher than that of the conventional method. These results suggest that the proposed method is more accurate than the conventional method. (author)

  16. Transection of the inferior vena cava from blunt thoracic trauma: case reports.

    Science.gov (United States)

    Peitzman, A B; Udekwu, A O; Pevec, W; Albrink, M

    1989-04-01

    Blunt thoracic trauma is a frequent cause of death in multiple trauma victims. Myocardial rupture may occur in up to 65% of patients who die with thoracic injuries. Two cases are presented with intrapericardial transection of the inferior vena cava, pericardial rupture, and myocardial rupture from blunt thoracic trauma. Both patients died.

  17. Inferior Alveolar Nerve Injury after Mandibular Third Molar Extraction: a Literature Review

    Directory of Open Access Journals (Sweden)

    Rafael Sarikov

    2014-12-01

    Full Text Available Objectives: The purpose of this study was to systematically review the comprehensive overview of literature data about injury to the inferior alveolar nerve after lower third molar extraction to discover the prevalence of injury, the risk factors, recovery rates, and alternative methods of treatment. Material and Methods: Literature was selected through a search of PubMed electronic databases. Articles from January 2009 to June 2014 were searched. English language articles with a minimum of 6 months patient follow-up and injury analysis by patient’s reporting, radiographic, and neurosensory testing were selected. Results: In total, 84 literature sources were reviewed, and 14 of the most relevant articles that are suitable to the criteria were selected. Articles were analyzed on men and women. The influence of lower third molar extraction (especially impacted on the inferior alveolar nerve was clearly seen. Conclusions: The incidence of injury to the inferior alveolar nerve after lower third molar extraction was about 0.35 - 8.4%. The injury of the inferior alveolar nerve can be predicted by various radiological signs. There are few risk factors that may increase the risk of injury to the nerve such as patients over the age of 24 years old, with horizontal impactions, and extraction by trainee surgeons. Recovery is preferable and permanent injury is very rare.

  18. Prone versus supine thallium myocardial SPECT: A method to decrease artifactual inferior wall defects

    International Nuclear Information System (INIS)

    Segall, G.M.; Davis, M.J.

    1989-01-01

    Artifactual inferior wall defects as a result of diaphragmatic attenuation of activity are a frequent source of error in thallium myocardial single photon emission computed tomography (SPECT) studies. Thirty-four patients and 11 clinically normal volunteers were studied prospectively to see if specificity of inferior wall defects for right coronary artery disease could be improved by scanning patients prone versus supine. All individuals were scanned both prone and supine, in random order, following symptom limited treadmill exercise. Images were acquired at 3 degrees steps, 25 sec per frame, in a 180 degrees elliptical orbit always beginning in the 45 degrees right anterior oblique position relative to the patient. Polar maps generated from the short axis slices were used to calculate the average regional activity. The prone studies showed consistently higher inferior wall activity compared to the supine studies on both the exercise (182 +/- 22 vs. 160 +/- 23, p less than or equal to 0.001) and 4-hr delay studies (183 +/- 20 vs. 175 +/- 21, p less than or equal to 0.001). Prone imaging resulted in a significantly higher specificity for RCA disease compared to supine imaging (90% vs. 66%, p less than 0.05) with an improvement in accuracy from 71% to 82%. Sensitivity, specificity, and accuracy for left anterior descending and left circumflex artery disease were not significantly affected by patient position during imaging. All patients having SPECT thallium myocardial perfusion studies should be imaged prone to minimize artifactual inferior wall defects and improve accuracy

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

    Directory of Open Access Journals (Sweden)

    Stephanie Kullmann

    2014-01-01

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

  20. Transient delayed facial nerve palsy after inferior alveolar nerve block anesthesia.

    Science.gov (United States)

    Tzermpos, Fotios H; Cocos, Alina; Kleftogiannis, Matthaios; Zarakas, Marissa; Iatrou, Ioannis

    2012-01-01

    Facial nerve palsy, as a complication of an inferior alveolar nerve block anesthesia, is a rarely reported incident. Based on the time elapsed, from the moment of the injection to the onset of the symptoms, the paralysis could be either immediate or delayed. The purpose of this article is to report a case of delayed facial palsy as a result of inferior alveolar nerve block, which occurred 24 hours after the anesthetic administration and subsided in about 8 weeks. The pathogenesis, treatment, and results of an 8-week follow-up for a 20-year-old patient referred to a private maxillofacial clinic are presented and discussed. The patient's previous medical history was unremarkable. On clinical examination the patient exhibited generalized weakness of the left side of her face with a flat and expressionless appearance, and she was unable to close her left eye. One day before the onset of the symptoms, the patient had visited her dentist for a routine restorative procedure on the lower left first molar and an inferior alveolar block anesthesia was administered. The patient's medical history, clinical appearance, and complete examinations led to the diagnosis of delayed facial nerve palsy. Although neurologic occurrences are rare, dentists should keep in mind that certain dental procedures, such as inferior alveolar block anesthesia, could initiate facial nerve palsy. Attention should be paid during the administration of the anesthetic solution.

  1. Facial blanching after inferior alveolar nerve block anesthesia: an unusual complication

    OpenAIRE

    Kang, Sang-Hoon; Won, Yu-Jin

    2017-01-01

    The present case report describes a complication involving facial blanching symptoms occurring during inferior alveolar nerve block anesthesia (IANBA). Facial blanching after IANBA can be caused by the injection of an anesthetic into the maxillary artery area, affecting the infraorbital artery.

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

    Science.gov (United States)

    Won, Yu-Jin; Kang, Sang-Hoon

    2017-06-01

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

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

    OpenAIRE

    Won, Yu-Jin; Kang, Sang-Hoon

    2017-01-01

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

  4. Facial blanching after inferior alveolar nerve block anesthesia: an unusual complication.

    Science.gov (United States)

    Kang, Sang-Hoon; Won, Yu-Jin

    2017-12-01

    The present case report describes a complication involving facial blanching symptoms occurring during inferior alveolar nerve block anesthesia (IANBA). Facial blanching after IANBA can be caused by the injection of an anesthetic into the maxillary artery area, affecting the infraorbital artery.

  5. Local anesthetic-induced myotoxicity as a cause of severe trismus after inferior alveolar nerve block.

    Science.gov (United States)

    Smolka, Wenko; Knoesel, Thomas; Mueller-Lisse, Ullrich

    2018-01-01

    A case of a 60-year-old man with severe trismus after inferior alveolar nerve block is presented. MRI scans as well as histologic examination revealed muscle fibrosis and degeneration of the medial part of the left temporal muscle due to myotoxicity of a local anesthetic agent.

  6. Comparison of Voice Quality Between Patients Who Underwent Inferior Turbinoplasty or Radiofrequency Cauterization.

    Science.gov (United States)

    Göker, Ayşe Enise; Aydoğdu, İmran; Saltürk, Ziya; Berkiten, Güler; Atar, Yavuz; Kumral, Tolgar Lütfi; Uyar, Yavuz

    2017-01-01

    The aim of this study was to analyze and compare the vocal quality in patients who underwent either submucosal turbinectomy or radiofrequency cauterization. In this study, we enrolled 60 patients diagnosed with inferior concha hypertrophy. These patients were divided into two groups by using computer program "Research Randomizer." Of the 60 patients, 30 underwent submucosal inferior turbinoplasty and 30 underwent radiofrequency cauterization. The control group was composed of 30 healthy adults with no nasal or upper aerodigestive system pathology. The patients were checked at weeks 1, 2, and 4. Voice records were taken before the procedure and at week 4 postprocedure. The mean age of patients in the inferior turbinoplasty group was 29.4 years (range: 19-42 years); in the radiofrequency group, it was 30.30 years (range: 18-50 years). There was no statistical difference in age between groups. In the inferior turbinoplasty group, there were 16 male and 14 female patients, and in the radiofrequency group, there were 13 male and 17 female patients. There was no significant difference in the number of males and females between groups. Voice professionals, especially singers, actors, and actresses, should be informed about possible voice changes before undergoing endonasal surgery because these individuals are more sensitive to changes in resonance organs. We believe that voice quality should be regarded as a highly important parameter when measuring the success of endonasal surgery. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  7. Umbilical vein draining into the inferior vena cava via the internal iliac vein, bypassing the liver

    Energy Technology Data Exchange (ETDEWEB)

    Currarino, G.; Stannard, M.W. (Children' s Medical Center, Dallas, TX (United States). Dept. of Radiology Texas Univ., Dallas, TX (United States). Southwestern Medical Center); Kolni, H. (Methodist Hospital, Dallas, TX (United States). Dept. of Pediatrics)

    1991-05-01

    This is the third report of an anomalous umbilical vein draining ectopically in a left pelvic vein, probably the left internal iliac, and through the inferior vena cava into the right atrium. The anomaly was encountered in a newborn infant with nonimmune hydrops fetalis, hypertrophic cardiomyopathy, multiorgan failure and possibly Noonan Syndrome. (orig.).

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-08-15

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

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

    International Nuclear Information System (INIS)

    Reiman, Milla; Lehtonen, Liisa; Lapinleimu, Helena; Parkkola, Riitta; Johansson, Reijo; Jaeaeskelaeinen, Satu K.; Kujari, Harry; Haataja, Leena

    2009-01-01

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

  10. Deep venous thrombosis and agenesis of the intrahepatic segment of inferior vena cava

    International Nuclear Information System (INIS)

    Velasco, J.; Fernandez, M.M.; Manzanares, R.; Hernando, A.

    1997-01-01

    We present a case of agenesis of the intrahepatic segment of inferior vena cava (IVC) with drainage through the azygos and hemiazygos systems. The presenting sign was deep venous thrombosis (DVT) in both lower extremities. The different imaging studies led to the diagnosis of both the congenital and acquired venous abnormalities, which are discussed. (Author) 14 refs

  11. The evaluation of the right inferior phrenic artery diameter in cirrhotic patients.

    Science.gov (United States)

    Esen, Kaan; Balci, Yuksel; Tok, Sermin; Ucbilek, Enver; Kara, Engin; Kaya, Omer

    2017-09-01

    The purpose of this study is to evaluate the relationship between right inferior phrenic artery diameter and portal hypertension in cirrhotic patients. CT examinations of 38 patients with chronic liver disease (patient group) and 40 patients without any liver disease (control group) were evaluated. The right inferior phrenic artery diameter of the patient and control group were measured. CT findings of portal hypertension, which were accepted as ascites, collaterals, splenomegaly and portal vein diameter greater than 13 mm, were determined and scored in the patient group. Patients obtained scores between one and four with respect to portal hypertension findings, and the scores were compared with phrenic artery diameters. Child-Pugh and MELD scores of the patients were also calculated. The mean diameter of the right inferior phrenic artery in the patient group was larger than that in the control group (p phrenic artery diameter of the patients with score 1 was significantly different from those with score 2 (p = 0.028), score 3 (p = 0.001) and score 4 (p = 0.005). We found a linear and moderate relationship between phrenic artery diameter values and Child-Pugh scores (p = 0.012, r = 0.405). Dilatation of the right inferior phrenic artery in cirrhotic patients may be a nonspecific sign of developing portal hypertension.

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

    Directory of Open Access Journals (Sweden)

    Carlos R Moraes

    1988-08-01

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

  13. Haematogenous tumour growth in the inferior vena cava in a patient with a nonseminomatous testicular tumour

    NARCIS (Netherlands)

    Ham, S J; Koops, H Schraffordt; Sleijfer, D T; Freling, N M; Molenaar, W M

    1991-01-01

    The case history is reported of a patient with an invasion of the inferior vena cava by metastases of a non-seminomatous testicular tumour. He was treated with combination chemotherapy, followed by laparotomy and resection of residual tumour tissue. Fourteen months after this operation he is in good

  14. Septic thrombosis of the inferior vena cava treated with percutaneous mechanical thrombectomy

    NARCIS (Netherlands)

    Burgmans, Mark C.; Rommes, Johannes H.; Spronk, Peter E.; van Nidek, Robert J. P. Brouerius; Bouma, Wim H.; Gratama, Jan Willem C.

    2006-01-01

    The present report describes a patient with septic thrombosis of the inferior vena cava (IVC) related to a subhepatic abscess adjacent to the IVC. Despite prolonged antimicrobial therapy and systemic anticoagulation, sepsis and septic embolism persisted while the size of the thrombus increased.

  15. The initial experience of transjugular retrieval of Geunther Tulip inferior vena cava filters

    International Nuclear Information System (INIS)

    Xiao Liang; Shen Jing; Tong Jiajie; Li Haiwei; Xu Ke

    2011-01-01

    Objective: To explore the indications and technical procedures of transjugular retrieval of Geunther Tulip inferior vena cava filters. Methods: Seventy-four patients (40 males and 34 females with a mean age of 45.8 years) with acute lower extremity deep venous thrombosis encountered in our hospital from September 2007 to Mar 2009 were involved in this study. The onset of the disease was from one day to 14 days. Clinical symptoms included swelling, pain, cyanosis or pallescence of the affected limb with higher or normal skin temperature. Thirty-one patients who complicated with pulmonary embolism suffered from dyspnoea, chest pain, hemoptysis, etc. Implantation of Geunther Tulip retrievable inferior vena cava filters through femoral or right internal jugular vein was carried out, which was followed by intravenous transcatheter thrombolysis. Vascular ultrasound and angiography showed no fresh or free thrombus in 12-80 days after initial treatment, then the Geunther Tulip filter was taken out from right internal jugular vein, and inferior vena cavography was performed again. All patients accepted anticoagulation and antibiotic treatment for 3-5 days after operation. A follow-up lasting for 4-12 months was made. Results: Successful implantation of Geunther Tulip retrievable inferior vena cava filter with only one session was obtained in all 74 patients. During implantation procedure one filter became tilted 25 degrees. Successful removal of Geunther Tulip retrievable inferior vena cava filter was achieved in 40 patients in 41.3 days (12-80 days) after the filter was delivered, and the procedure cost only 5.8 minutes (1-115 minutes) with a successful rate of 97.6% (40/41). Failure of retrieval of IVC filter due to compact adhesion of the filter to IVC wall happened in one patient. Inferior vena cavography again confirmed that there was no any sign of vascular perforation or rupture. Retrieval of IVC filter was not performed in other 33 patients and no clinical

  16. Analysis of variationfor horizontal deviation in the primary position after the inferior oblique muscle weakening

    Directory of Open Access Journals (Sweden)

    Ming-Yu Si

    2015-06-01

    Full Text Available AIM: To analyse the variation of horizontal deviation in the primary position after the inferior oblique muscle weakening, and to explore the effect of the inferior oblique muscle recession on horizontal deviations in primary position.METHODS:, In the study, 30 cases in the Department of ophthalmology of our hospital from January 2014 to September 2014 underwent the inferior oblique muscle recession as the sole without horizontal muscles surgery, who were superior obliquer paralysis and V pattern strabismus with small angle of horizontal strabismus, were analyzed. Of the 30 patients, 25 had unilateral inferior oblique muscle surgery, and then 5 had bilateral surgeries.Followed up for three to six mo, all patients were received full ophthalmologic and orthoptic examinations, including measurement of the deviation in the diagnostic positions of gaze at near 33cm and at distance 6m by prism and alternate cover test, synoptophore, Titmus stereo graph examination, Worth four lighting inspection, eye movement examination, and fundus photography preoperatively and postoperatively. The changes of horizontal deviations in the primary position after procedures were investigated. RESULT:(1The comparison of horizontal deviation showed significant difference pre- and post-operation in the exotropia group(P=0.00. It was postoperative respectively to reduce the original in external oblique average 3.35±2.87△ and 4.37±2.65△.(2The comparison of horizontal deviation showed significant difference pre-and post-operation in the esotropia group(P=0.02, and it decreased postoperatively in average 2.43±1.99△. There was no significant difference for horizontal deviation position between pre- and post-operation(P=0.089. CONCLUSION:The horizontal deviation in primary position, either exotropia or esotropia, will decrease after the Inferior oblique muscle recession. This change can be compensated by the gradually improving and establishing the fusion function.

  17. Heart block and cardiac embolization of fractured inferior vena cava filter.

    Science.gov (United States)

    Abudayyeh, Islam; Takruri, Yessar; Weiner, Justin B

    2016-01-01

    A 66-year-old man underwent a placement of an inferior vena cava filter before a gastric surgery 9 years prior, presented to the emergency room with a complete atrioventricular block. Chest x-ray and transthoracic echocardiogram showed struts migrating to right ventricle with tricuspid regurgitation. Cardiothoracic surgery was consulted and declined an open surgical intervention due to the location of the embolized fragments and the patient's overall condition. It was also felt that the fragments had migrated chronically and were adhered to the cardiac structures. The patient underwent a dual-chamber permanent pacemaker implantation. Post-implant fluoroscopy showed no displacement of the inferior vena cava filter struts due to the pacemaker leads indicating that the filter fracture had likely been a chronic process. This case highlights a rare combination of complications related to inferior vena cava filter fractures and the importance of assessing for such fractures in chronic placements. Inferior vena cava filter placement for a duration greater than 1 month can be associated with filter fractures and strut migration which may lead to, although rare, serious or fatal complications such as complete atrioventricular conduction system disruption and valvular damage including significant tricuspid regurgitation. Assessing for inferior vena cava filter fractures in chronic filter placement is important to avoid such complications. When possible, retrieval of the filter should be considered in all patients outside the acute setting in order to avoid filter-related complications. Filter retrieval rates remain low even when a retrievable filter is in place and the patient no longer has a contraindication to anticoagulation.

  18. Arrhythmia and conduction disorders in acute inferior myocardial infarction with right ventricular involvement

    International Nuclear Information System (INIS)

    Samadikhah, J.; Hakim, S.H.; Azarfarin, R.; Ghaffari, S.

    2007-01-01

    To assess the prognostic impact of Right Ventricular (RV) myocardial involvement in patients with inferior MI. One hundred seventy patients who were admitted to cardiac care unit of Madani Heart Hospital, Tabriz, Iran with the diagnosis of inferior MI with (group 1) or without (group 2) simultaneous involvement of RV were studied from 2005 to 2006. Patients presenting within 12 hours of symptom onset were eligible for inclusion. Those with simultaneous Anterior wall MI, patients undergoing primary percutaneous transluminal coronary angioplasty and those with renal impairment (creatinine >2 mg/dl) were excluded. Eighty eight percent of the patients with RVMI and 75% with isolated inferior MI had some type of arrhythmia. AV block occurred in 42% of the infarctions with RV involvement and only in 29% of the control group. Intra ventricular conduction disturbance (IVCD) also were more frequent in RVMI (29.4% VS 13.1%, p=0.021), especially the RBBB (20% VS 7.4%, P=0.003). Ventricular fibrillation (VF) was observed in 5.2% and 1.2% and ventricular tachycardia in 26% and 12.2% respectively. In 27% of patients with RVMI it was necessary to implant a pacemaker as compared to 10% in control group. Mortality was higher in the patients with inferior infarction extended to the RV (15.3% vs 3.5%., P=0.0001). There was not a meaningful difference in incidence of LBBB between group 1 and 2 (3.1% vs 2.9% P=0.9). Patients with inferior MI who also have RV myocardial involvement are at increased risk of death and arrhythmias. (author)

  19. Clinical implications of anterior S-T segment depression in patients with acute inferior myocardial infarction

    International Nuclear Information System (INIS)

    Croft, C.H.; Woodward, W.; Nicod, P.; Corbett, J.R.; Lewis, S.E.; Willerson, J.T.; Rude, R.E.

    1982-01-01

    To assess various factors associated with anterior S-T segment depression during acute inferior myocardial infarction, 47 consecutive patients with electrocardiographic evidence of a first transmural inferior infarction were studied prospectively with radionuclide ventriculography an average of 7.3 hours (range 2.9 to 15.3) after the onset of symptoms. Thirty-nine patients (Group I) had anterior S-T depression in the initial electrocardiogram and 8 (Group II) did not have such reciprocal changes. There was no difference between the two groups in left ventricular end-diastolic or end-diastolic volume index or left ventricular ejection fraction. Stroke volume index was greater in Group I than in Group II. There were no group differences in left ventricular total or regional wall motion scores. A weak correlation existed between the quantities (mV) or inferior S-T segment elevation and reciprocal S-T depression. No relation between anterior S-T segment depression and the left ventricular end-diastolic volume index could be demonstrated; the extent of left ventricular apical and right ventricular wall motion abnormalities, both frequently associated with inferior infarction, did not correlate with the quantity of anterior S-T depression. These data show that anterior S-T segment depression occurs commonly during the early evolution of transmural inferior infarction, is not generally a marker of functionally significant anterior ischemia and cannot be used to predict left ventricular function in individual patients. Anterior S-T segment depression may be determined by reciprocal mechanisms

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

    Directory of Open Access Journals (Sweden)

    Juan C. Velásquez V.

    2015-12-01

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

  1. The Incidence of Intravascular Needle Entrance during Inferior Alveolar Nerve Block Injection.

    Science.gov (United States)

    Taghavi Zenouz, Ali; Ebrahimi, Hooman; Mahdipour, Masoumeh; Pourshahidi, Sara; Amini, Parisa; Vatankhah, Mahdi

    2008-01-01

    Dentists administer thousands of local anesthetic injections every day. Injection to a highly vascular area such as pterygomandibular space during an inferior alveolar nerve block has a high risk of intravascular needle entrance. Accidental intravascular injection of local anesthetic agent with vasoconstrictor may result in cardiovascular and central nervous system toxicity, as well as tachycardia and hypertension. There are reports that indicate aspiration is not performed in every injection. The aim of the present study was to assess the incidence of intravascular needle entrance in inferior alveolar nerve block injections. Three experienced oral and maxillofacial surgeons performed 359 inferior alveolar nerve block injections using direct or indirect techniques, and reported the results of aspiration. Aspirable syringes and 27 gauge long needles were used, and the method of aspiration was similar in all cases. Data were analyzed using t-test. 15.3% of inferior alveolar nerve block injections were aspiration positive. Intravascular needle entrance was seen in 14.2% of cases using direct and 23.3% of cases using indirect block injection techniques. Of all injections, 15.8% were intravascular on the right side and 14.8% were intravascular on the left. There were no statistically significant differences between direct or indirect block injection techniques (P = 0.127) and between right and left injection sites (P = 0.778). According to our findings, the incidence of intravascular needle entrance during inferior alveolar nerve block injection was relatively high. It seems that technique and maneuver of injection have no considerable effect in incidence of intravascular needle entrance.

  2. The Incidence of Intravascular Needle Entrance during Inferior Alveolar Nerve Block Injection

    Directory of Open Access Journals (Sweden)

    Sara Pourshahidi

    2008-04-01

    Full Text Available

    Background and aims. Dentists administer thousands of local anesthetic injections every day. Injection to a highly vascular area such as pterygomandibular space during an inferior alveolar nerve block has a high risk of intravascular needle entrance. Accidental intravascular injection of local anesthetic agent with vasoconstrictor may result in cardiovascular and central nervous system toxicity, as well as tachycardia and hypertension. There are reports that indicate aspiration is not performed in every injection. The aim of the present study was to assess the incidence of intravascular needle entrance in inferior alveolar nerve block injections.

    Materials and methods. Three experienced oral and maxillofacial surgeons performed 359 inferior alveolar nerve block injections using direct or indirect techniques, and reported the results of aspiration. Aspirable syringes and 27 gauge long needles were used, and the method of aspiration was similar in all cases. Data were analyzed using t-test.

    Results. 15.3% of inferior alveolar nerve block injections were aspiration positive. Intravascular needle entrance was seen in 14.2% of cases using direct and 23.3% of cases using indirect block injection techniques. Of all injections, 15.8% were intravascular on the right side and 14.8% were intravascular on the left. There were no statistically significant differences between direct or indirect block injection techniques (P = 0.127 and between right and left injection sites (P = 0.778.

    Conclusion. According to our findings, the incidence of intravascular needle entrance during inferior alveolar nerve block injection was relatively high. It seems that technique and maneuver of injection have no considerable effect in incidence of intravascular needle entrance.

  3. 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)

  4. Right and left inferior extensions of the atrioventricular node may represent the anatomic substrate of the slow pathway in humans

    NARCIS (Netherlands)

    Katritsis, Demosthenes G.; Becker, Anton E.; Ellenbogen, Kenneth A.; Karabinos, Ilias; Giazitzoglou, Eleftherios; Korovesis, Socrates; Camm, A. John

    2004-01-01

    The purpose of this study was to investigate the electrophysiologic characteristics of the inferior extensions of the human atrioventricular (AV) node and their possible relationship to slow pathway conduction. The human heart contains right and left inferior extensions of the AV node that relate to

  5. Abdominal wall phlebitis due to Prevotella bivia following renal transplantation in a patient with an occluded inferior vena cava

    NARCIS (Netherlands)

    Janssen, S.; van Donselaar-van der Pant, K. A. M. I.; van der Weerd, N. C.; Develter, W.; Bemelman, F. J.; Grobusch, M. P.; Idu, M. M.; ten Berge, I. J. M.

    2013-01-01

    Pre-existing occlusion of the inferior vena cava may complicate renal transplantation. Suppurative abdominal wall phlebitis following renal transplantation was diagnosed in a patient with pre-existing thrombosis of the inferior vena cava of unknown cause. The phlebitis developed in the subcutaneous

  6. A randomized controlled, non-inferiority trial of modified natural versus artificial cycle for cryo-thawed embryo transfer

    NARCIS (Netherlands)

    Groenewoud, E. R.; Cohlen, B. J.; Al-Oraiby, A.; Brinkhuis, E. A.; Broekmans, F. J. M.; de Bruin, J. P.; van den Dool, G.; Fleisher, K.; Friederich, J.; Goddijn, M.; Hoek, A.; Hoozemans, D. A.; Kaaijk, E. M.; Koks, C. A. M.; Laven, J. S. E.; van der Linden, P. J. Q.; Manger, A. P.; Slappendel, E.; Spinder, T.; Kollen, B. J.; Macklon, N. S.

    2016-01-01

    Are live birth rates (LBRs) after artificial cycle frozen-thawed embryo transfer (AC-FET) non-inferior to LBRs after modified natural cycle frozen-thawed embryo transfer (mNC-FET)? AC-FET is non-inferior to mNC-FET with regard to LBRs, clinical and ongoing pregnancy rates (OPRs) but AC-FET does

  7. A randomized controlled, non-inferiority trial of modified natural versus artificial cycle for cryo-thawed embryo transfer

    NARCIS (Netherlands)

    Groenewoud, E. R.; Cohlen, B. J.; Al-Oraiby, A.; Brinkhuis, E. A.; Broekmans, F. J. M.; de Bruin, J. P.; van den Dool, G.; Fleisher, K.; Friederich, J.; Goddijn, M.; Hoek, A.; Hoozemans, D. A.; Kaaijk, E. M.; Koks, C. A. M.; Laven, J. S. E.; van der Linden, P. J. Q.; Manger, A. P.; Slappendel, E.; Spinder, T.; Kollen, B. J.; Macklon, N. S.

    STUDY QUESTION: Are live birth rates (LBRs) after artificial cycle frozen-thawed embryo transfer (AC-FET) non-inferior to LBRs after modified natural cycle frozen-thawed embryo transfer (mNC-FET)? SUMMARY ANSWER: AC-FET is non-inferior to mNC-FET with regard to LBRs, clinical and ongoing pregnancy

  8. A randomized controlled, non-inferiority trial of modified natural versus artificial cycle for cryo-thawed embryo transfer

    NARCIS (Netherlands)

    Groenewoud, E. R.; Cohlen, B. J.; Al-Oraiby, A.; Brinkhuis, E. A.; Broekmans, F. J M; De Bruin, J. P.; Van Den Dool, G.; Fleisher, K.; Friederich, J.; Goddijn, M.; Hoek, A.; Hoozemans, D. A.; Kaaijk, E. M.; Koks, C. A M; Laven, J. S E; Van Der Linden, P. J Q; Manger, A. P.; Slappendel, E.; Spinder, T.; Kollen, B. J.; Macklon, N. S.

    2016-01-01

    studyquestion: Are live birth rates (LBRs) after artificial cycle frozen-thawed embryo transfer (AC-FET) non-inferior to LBRs after modified natural cycle frozen-thawed embryo transfer (mNC-FET)? summaryanswer: AC-FET is non-inferior to mNC-FET with regard to LBRs, clinical and ongoing pregnancy

  9. Pre-operative assessment of impacted mandibular third molar and inferior alveolar canal using orthopantomograhpy and cone beam computed tomography

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    Mahmuda Akter

    2016-12-01

    Full Text Available The aim of this study was to assess the proximity and relation of impacted mandibular third molar and inferior alveolar canal on orthopantomogram and cone beam computed tomography (CBCT. Sixty impacted mandibular third molars having close proximity with the  inferior alveolar canal were included. CBCT images were done to determine the exact location and relationship of impacted third molar tooth and inferior alveolar canal. We assessed the radiographic signs from orthopantomogram, the course of  inferior alveolar canal and proximity to the third molar tooth in CBCT. The buccal course of  inferior alveolar canal was most frequently detected (n=36 in CBCT findings. The impacted lower third molar roots were 55% contact with the  inferior alveolar canal and 45% separate from the canal. On orthopantomogram, the following signs were strongly correlated with actual contact: Superimposed relationship between the third molar and the inferior alveolar canal. CBCT is useful as a presurgical planning in patients with impacted mandibular third molar showing close proximity to the  inferior alveolar canal.

  10. Application of three-dimensional CT reconstruction technology on inferior oblique muscle in congenital superior oblique palsy

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    Yang Zhang

    2014-05-01

    Full Text Available AIM: To investigate the viability of the morphology of inferior oblique muscle observed stereoscopically using 3-dimensional CT reconstruction technique. METHODS: This control study included of 29 cases which were clinically diagnosed with monocular congenital superior oblique palsy, examined by dimensional CT. The images of the inferior oblique muscle were reconstructed by Mimics software. 3D digital images on the basis of CT scanning data of the individuals were established. Observing the morphology of binocular inferior oblique muscle by self-controlled design, we compared the maximum transverse diameter of inferior oblique muscle of paralyzed eye with non-paralyzed one. We chose 5% as the significant level.RESULTS: The reconstructed results of 3-dimensional CT scan showed that not all of the inferior oblique abdominal muscle of paralyzed eyes were thinner than that of the non-paralyzed eye in maximum transverse diameter of cross-sectional area. The maximum transverse diameter of inferior oblique muscle was measured. The average maximum transverse diameter of the paralyzed eye was 6.797±1.083mm and the non-paralyzed eye was 6.507±0.848mm. The maximum transverse diameter of inferior oblique muscle of paralyzed eye did not, however, differ significantly from the normal(P>0.05. CONCLUSION: The three-dimensional CT reconstruction technology can be used for preoperative evaluation of the morphology of inferior oblique muscle.

  11. 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.

  12. The Anterior Branch of the Left Inferior Phrenic Artery Arising from the Right Inferior Phrenic Artery: An Angiographic and CT Study

    International Nuclear Information System (INIS)

    Hieda, Masashi; Toyota, Naoyuki; Kakizawa, Hideaki; Ishikawa, Masaki; Horiguchi, Jun; Ito, Katsuhide

    2009-01-01

    The purpose of this study was to retrospectively analyze the frequency and anatomical pattern of the anterior branch of the left inferior phrenic artery (LIPA) arising from the right inferior phrenic artery (RIPA). Angiography of the RIPA for patients (n = 140) with hepatic malignancy was retrospectively reviewed. The frequency at which the anterior branch of the LIPA arose from the RIPA was 14.3% (20 of 140 patients [pts]). Among the three branches that may arise from the RIPA in these cases (the anterior branch of the LIPA and the anterior and posterior branches of the RIPA), the anterior branch of the LIPA was the first branch of the RIPA in 9 of 20 pts (45%), and the posterior branch of the RIPA in 11 of 20 pts (55%). The anterior branch of the LIPA ran along the ventral side of the esophagus or stomach and supplied the esophagogastric region and dome of the left diaphragm in all cases. In conclusion, the anterior branch of the LIPA arises from the RIPA at a comparatively high frequency. In embolization of the RIPA, to effectively treat and avoid possible complications, interventionalists should be aware of this potential variant anatomy.

  13. One-way traffic: The inferior frontal gyrus controls brain activation in the middle temporal gyrus and inferior parietal lobule during divergent thinking.

    Science.gov (United States)

    Vartanian, Oshin; Beatty, Erin L; Smith, Ingrid; Blackler, Kristen; Lam, Quan; Forbes, Sarah

    2018-02-23

    Contrary to earlier approaches that focused on the contributions of isolated brain regions to the emergence of creativity, there is now growing consensus that creative thought emerges from the interaction of multiple brain regions, often embedded within larger brain networks. Specifically, recent evidence from studies of divergent thinking suggests that kernel ideas emerge in posterior brain regions residing within the semantic system and/or the default mode network (DMN), and that the prefrontal cortex (PFC) regions within the executive control network (ECN) constrain those ideas for generating outputs that meet task demands. However, despite knowing that regions within these networks exhibit interaction, to date the direction of the relationship has not been tested directly. By applying Dynamic Causal Modeling (DCM) to fMRI data collected during a divergent thinking task, we tested the hypothesis that the PFC exerts unidirectional control over the middle temporal gyrus (MTG) and the inferior parietal lobule (IPL), vs. the hypothesis that these two sets of regions exert bidirectional control over each other (in the form of feedback loops). The data were consistent with the former model by demonstrating that the right inferior frontal gyrus (IFG) exerts unidirectional control over MTG and IPL, although the evidence was somewhat stronger in the case of the MTG than the IPL. Our findings highlight potential causal pathways that could underlie the neural bases of divergent thinking. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Alberto Carlos Reino Buelvas

    2004-02-01

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

  15. Effects of single-sided inferior turbinectomy on nasal function and airflow characteristics.

    Science.gov (United States)

    Na, Yang; Chung, Kang Soo; Chung, Seung-Kyu; Kim, Sung Kyun

    2012-03-15

    Knowledge of airflow characteristics in the nasal cavity is essential to understanding the physiologic and pathologic aspects of nasal breathing. Airflows inside post-surgery models were investigated both experimentally and numerically to simulate the inferior turbinectomy. The left cavities of all three models are normal and right cavity is modified by (1) excision of the head of the inferior turbinate, (2) resection of the lower fifth of the inferior turbinate, and (3) resection of almost the entire inferior turbinate. Thin-slice CT (computed tomography) data (0.6mm deep) and meticulous refinement of the model surface by over a decade-long collaboration between engineers and an experienced ENT doctor resulted in the creation of sophisticated nasal cavity models. After numerical experiments and validation by comparison with the PIV results, the CFD code using the Reynolds stress turbulent model and variable temperature boundary condition on the mucosal wall was chosen as the proper numerical framework. Both global quantities (pressure drop, flow rate ratio, total wall heat transfer) and local changes (velocity, temperature, humidity, pressure gradient, and wall shear stress) were numerically investigated. The turbinectomy obviously altered the main stream direction. The flow rate in the upper airway near the olfactory slit decreased in models (1) and (3). This may weaken the olfactory function of the nose. Fluid and thermal properties that are believed to be related with physiology and prognosis are dependent on turbinate resection volume, position, and manner. Widening of the inferior airway does not always result in decreased flow resistance or wall heat transfer. The gains and losses of inferior turbinectomy were considered by analysis of the post-surgery model results. Nasal resistance was increased in model (1) due to sudden airway expansion. Nasal resistance increased and the wall heat transfer decreased in model (3) due to sudden airway expansion and

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

    Science.gov (United States)

    Watanabe, Takamitsu; Yagishita, Sho; Kikyo, Hideyuki

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Lipp Rainer W

    2010-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Maya Thomas

    2012-01-01

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

  19. Neural representations of social status hierarchy in human inferior parietal cortex.

    Science.gov (United States)

    Chiao, Joan Y; Harada, Tokiko; Oby, Emily R; Li, Zhang; Parrish, Todd; Bridge, Donna J

    2009-01-01

    Mental representations of social status hierarchy share properties with that of numbers. Previous neuroimaging studies have shown that the neural representation of numerical magnitude lies within a network of regions within inferior parietal cortex. However the neural basis of social status hierarchy remains unknown. Using fMRI, we studied subjects while they compared social status magnitude of people, objects and symbols, as well as numerical magnitude. Both social status and number comparisons recruited bilateral intraparietal sulci. We also observed a semantic distance effect whereby neural activity within bilateral intraparietal sulci increased for semantically close relative to far numerical and social status comparisons. These results demonstrate that social status and number comparisons recruit distinct and overlapping neuronal representations within human inferior parietal cortex.

  20. [Inferior hemiarthroplasty of the temporo-mandibular joint with articulated condylar prosthesis type Stryker].

    Science.gov (United States)

    Bucur, A; Dincă, O; Totan, C; Ghită, V

    2007-01-01

    The optimal reconstruction of the mandible and of the temporo-mandibular joint after mandibular hemi-resection with disarticulation is still controversial in literature. This paperwork presents our experience on four cases in the reconstruction of the mandible together with the inferior arthroplasty of the temporo-mandibular joint, after the resection of extended benign tumors of the mandible, based on fibular free vascularized grafts having attached a Stryker titanium condylar prosthesis reconstructing the inferior segment of the temporo-mandibular joint. Our results for the this technique were excellent, with a functional rehabilitation very close to normal. After reviewing the various techniques and their arguments in literature, with accent on the TMJ reconstruction, we consider this method to be optimal for the reconstruction of mandibular defects in patients with neoplastic conditions.

  1. Extranasopharyngeal Angiofibroma Originating in the Inferior Turbinate: A Distinct Clinical Entity at an Unusual Site

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    Baptista, Marco Antonio Ferraz de Barros

    2014-08-01

    Full Text Available Introduction The extranasopharyngeal angiofibroma is histologically similar to juvenile nasopharyngeal angiofibroma, differing from the latter in clinical and epidemiologic characteristics. Objectives We present a case of extranasopharyngeal angiofibroma originating in the inferior turbinate. Resumed Report The patient was a girl, 8 years and 6 months of age, who had constant bilateral nasal obstruction and recurrent epistaxis for 6 months, worse on the right side, with hyposmia and snoring. Nasal endoscopy showed a reddish lesion, smooth, friable, and nonulcerated. Computed tomography showed a lesion with soft tissue density in the right nasal cavity. We used an endoscopic approach and found the lesion inserted in the right inferior turbinate. We did a subperiosteal dissection and excision with a partial turbinectomy with a resection margin of 0.5 cm. Histopathology reported it to be an extranasopharyngeal angiofibroma. Conclusion Although rare, extranasopharyngeal angiofibroma should be considered in the diagnosis of vascular tumors of the head and neck.

  2. Extranasopharyngeal Angiofibroma Originating in the Inferior Turbinate: A Distinct Clinical Entity at an Unusual Site

    Science.gov (United States)

    Baptista, Marco Antonio Ferraz de Barros; Pinna, Fábio de Rezende; Voegels, Richard Louis

    2014-01-01

    Introduction The extranasopharyngeal angiofibroma is histologically similar to juvenile nasopharyngeal angiofibroma, differing from the latter in clinical and epidemiologic characteristics. Objectives We present a case of extranasopharyngeal angiofibroma originating in the inferior turbinate. Resumed Report The patient was a girl, 8 years and 6 months of age, who had constant bilateral nasal obstruction and recurrent epistaxis for 6 months, worse on the right side, with hyposmia and snoring. Nasal endoscopy showed a reddish lesion, smooth, friable, and nonulcerated. Computed tomography showed a lesion with soft tissue density in the right nasal cavity. We used an endoscopic approach and found the lesion inserted in the right inferior turbinate. We did a subperiosteal dissection and excision with a partial turbinectomy with a resection margin of 0.5 cm. Histopathology reported it to be an extranasopharyngeal angiofibroma. Conclusion Although rare, extranasopharyngeal angiofibroma should be considered in the diagnosis of vascular tumors of the head and neck. PMID:25992131

  3. Duplication of Inferior Gluteal Artery and Course of Superior Gluteal Artery Through the Lumbosacral Trunk

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    Satheesha Nayak B

    2017-07-01

    Full Text Available Internal iliac artery (IIA shows great deal of variations in its branching pattern. The knowledge of its variant branches is required for successful surgical, orthopedic, plastic surgery and radiological procedures. We observed variations of some of the branches of right IIA in an adult male cadaver. The iliolumbar artery originated from the main trunk of the IIA. After this, IIA divided into anterior and posterior divisions. The posterior division gave lateral sacral and superior gluteal arteries. Superior gluteal artery pierced the lumbosacral trunk before leaving the pelvis. The anterior division further divided into anterior and posterior trunks. Anterior trunk gave rise to superior vesical, inferior vesical, middle rectal and obturator arteries. The posterior trunk gave two inferior gluteal arteries and an internal pudendal artery.

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

    Science.gov (United States)

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

    2012-03-01

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

  5. Caracterización tecnomorfológica del complejo inferior de Ambrona

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    Joaquín Panera Gallego

    1996-01-01

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

  6. Bilateral inferior petrosal sinus sampling in the diagnosis of Cushing disease

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    Deipolyi AR

    2015-04-01

    Full Text Available Amy R Deipolyi,1 Rahmi Oklu21Vascular and Interventional Radiology, NYU Langone Medical Center, New York, NY, USA; 2Division of Vascular and Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USAAbstract: Bilateral inferior petrosal sinus sampling (BIPSS is a minimally invasive procedure performed in the workup of adrenocorticotropic hormone (ACTH-dependent Cushing syndrome (CS. Because noninvasive tests in the evaluation of CS patients lack sensitivity, BIPSS is the gold standard in diagnosing Cushing disease (CD, which is a pituitary source of excess ACTH. Here, the pathophysiology of CD and procedural details of BIPSS are reviewed.Keywords: pituitary adenoma, Cushing disease, inferior petrosal sinus, venous sampling

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

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-11-30

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

  8. Reversal of flow in the inferior vena cava and hepatic veins on dynamic CT

    International Nuclear Information System (INIS)

    Lelij, H. van der; Mallens, W.M.C.

    1988-01-01

    A tricuspid insufficiency may not be clinically evident and may remain unknown to the clinician. The phenomenon of a reversal of inferior vena caval blood flow and hepatic veins is known to occur in tricuspid regurgitation from right ventricular angiography and duplex scanning. Demonstration of such a reversal flow on a dynamic CT scan, as in our case, has, to our knowledge, not as yet been reported

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

    Directory of Open Access Journals (Sweden)

    Hatem El Atroush

    2012-09-01

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

  10. The diagnostic importance of the recognition of the inferior Vena cava abnormalities on CT-examinations

    International Nuclear Information System (INIS)

    Gouliamos, A.; Striggaris, K.; Haliasos, N.; Vlahos, N.; Pontifex, G.

    1981-01-01

    Two unusual variations of the Vena cava inferior, as shown by CT examinations, are reported and characteristic X-rays, as well as CT scans, are presented. The first case shows an IVC course to the left of the aorta and the second case absence of the intrahepatic portion of the IVC with azygos continuation. Difficulties in the differential diagnosis are analyzed and discussed, both demonstrated by plain X-rays and CT scans. (orig.) [de

  11. Diagnostic importance of the recognition of the inferior Vena cava abnormalities on CT-examinations

    Energy Technology Data Exchange (ETDEWEB)

    Gouliamos, A.; Striggaris, K.; Haliasos, N.; Vlahos, N.; Pontifex, G.

    1981-09-01

    Two unusual variations of the Vena cava inferior, as shown by CT examinations, are reported and characteristic X-rays, as well as CT scans, are presented. The first case shows an IVC course to the left of the aorta and the second case absence of the intrahepatic portion of the IVC with azygos continuation. Difficulties in the differential diagnosis are analyzed and discussed, both demonstrated by plain X-rays and CT scans.

  12. Inferior parietal and right frontal contributions to trial-by-trial adaptations of attention to memory.

    Science.gov (United States)

    Kizilirmak, Jasmin M; Rösler, Frank; Bien, Siegfried; Khader, Patrick H

    2015-07-21

    The attention to memory theory (AtoM) proposes that the same brain regions might be involved in selective processing of perceived stimuli (selective attention) and memory representations (selective retrieval). Although this idea is compelling, given consistently found neural overlap between perceiving and remembering stimuli, recent comparisons brought evidence for overlap as well as considerable differences. Here, we present a paradigm that enables the investigation of the AtoM hypothesis from a novel perspective to gain further insight into the neural resources involved in AtoM. Selective attention in perception is often investigated as a control process that shows lingering effects on immediately following trials. Here, we employed a paradigm capable of modulating selective retrieval in a similarly dynamic manner as in such selective-attention paradigms by inducing trial-to-trial shifts between relevant and irrelevant memory representations as well as changes of the width of the internal focus on memory. We found evidence for an involvement of bilateral inferior parietal lobe and right inferior frontal gyrus in reorienting the attentional focus on previously accessed memory representations. Moreover, we could dissociate the right inferior from the parietal activation in separate contrasts, suggesting that the right inferior frontal gyrus plays a role in facilitating attentional reorienting to memory representations when competing representations have been activated in the preceding trial, potentially by resolving this competition. Our results support the AtoM theory, i.e. that ventral frontal and parietal regions are involved in automatic attentional reorienting in memory, and highlight the importance of further investigations of the overlap and differences between regions involved in internal (memory) and external (perceptual) attentional selection. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Roberto de Cleva

    2014-07-01

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

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

    Science.gov (United States)

    Cleva, Roberto de; Assumpção, Marianna Siqueira de; Sasaya, Flavia; Chaves, Natalia Zuniaga; Santo, Marco Aurelio; Fló, Claudia; Lunardi, Adriana C; Jacob Filho, Wilson

    2014-07-01

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

  15. Rethinking non-inferiority: a practical trial design for optimising treatment duration.

    Science.gov (United States)

    Quartagno, Matteo; Walker, A Sarah; Carpenter, James R; Phillips, Patrick Pj; Parmar, Mahesh Kb

    2018-06-01

    Background Trials to identify the minimal effective treatment duration are needed in different therapeutic areas, including bacterial infections, tuberculosis and hepatitis C. However, standard non-inferiority designs have several limitations, including arbitrariness of non-inferiority margins, choice of research arms and very large sample sizes. Methods We recast the problem of finding an appropriate non-inferior treatment duration in terms of modelling the entire duration-response curve within a pre-specified range. We propose a multi-arm randomised trial design, allocating patients to different treatment durations. We use fractional polynomials and spline-based methods to flexibly model the duration-response curve. We call this a 'Durations design'. We compare different methods in terms of a scaled version of the area between true and estimated prediction curves. We evaluate sensitivity to key design parameters, including sample size, number and position of arms. Results A total sample size of ~ 500 patients divided into a moderate number of equidistant arms (5-7) is sufficient to estimate the duration-response curve within a 5% error margin in 95% of the simulations. Fractional polynomials provide similar or better results than spline-based methods in most scenarios. Conclusion Our proposed practical randomised trial 'Durations design' shows promising performance in the estimation of the duration-response curve; subject to a pending careful investigation of its inferential properties, it provides a potential alternative to standard non-inferiority designs, avoiding many of their limitations, and yet being fairly robust to different possible duration-response curves. The trial outcome is the whole duration-response curve, which may be used by clinicians and policymakers to make informed decisions, facilitating a move away from a forced binary hypothesis testing paradigm.

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

    OpenAIRE

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

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Vlad Teodor Berbecar

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yongxin eLi

    2013-12-01

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

  19. Catheter Displacement into Inferior Epigastric Vein Causing Local Phlebitis and Cellulitis

    Directory of Open Access Journals (Sweden)

    Noriko Hattori

    2012-01-01

    Full Text Available Catheter insertion for intravenous hyperalimentation is a commonly and widely used clinical technique. When compared with the incidence of complications associated with insertions into the internal jugular vein or the subclavian vein, complications associated with insertions into the femoral vein are less frequent. In this paper, we describe a very rare complication of femoral vein catheter insertion—namely, catheter displacement into the inferior epigastric vein.

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

    Science.gov (United States)

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

    2018-03-01

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

  1. E-learning in pediatric basic life support: a randomized controlled non-inferiority study.

    Science.gov (United States)

    Krogh, Lise Qvirin; Bjørnshave, Katrine; Vestergaard, Lone Due; Sharma, Maja Bendtsen; Rasmussen, Stinne Eika; Nielsen, Henrik Vendelbo; Thim, Troels; Løfgren, Bo

    2015-05-01

    Dissemination of pediatric basic life support (PBLS) skills is recommended. E-learning is accessible and cost-effective, but it is currently unknown whether laypersons can learn PBLS through e-learning. The hypothesis of this study was to investigate whether e-learning PBLS is non-inferior to instructor-led training. Participants were recruited among child-minders and parents of children aged 0-6 years. Participants were randomized to either 2-h instructor-led training or e-learning using an e-learning program (duration 17 min) including an inflatable manikin. After training, participants were assessed in a simulated pediatric cardiac arrest scenario. Tests were video recorded and PBLS skills were assessed independently by two assessors blinded to training method. Primary outcome was the pass rate of the PBLS test (≥8 of 15 skills adequately performed) with a pre-specified non-inferiority margin of 20%. In total 160 participants were randomized 1:1. E-learning was non-inferior to instructor-led training (difference in pass rate -4%; 95% CI -9:0.5). Pass rates were 100% among instructor-led trained (n=67) and 96% among e-learned (n=71). E-learners median time spent on the e-learning program was 30 min (range: 15-120 min) and the median number of log-ons was 2 (range: 1-5). After the study, all participants felt that their skills had improved. E-learning PBLS is non-inferior to instructor-led training among child-minders and parents with children aged 0-6 years, although the pass rate was 4% (95% CI -9:0.5) lower with e-learning. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. CaV3.1 is a tremor rhythm pacemaker in the inferior olive

    Science.gov (United States)

    Park, Young-Gyun; Park, Hye-Yeon; Lee, C. Justin; Choi, Soonwook; Jo, Seonmi; Choi, Hansol; Kim, Yang-Hann; Shin, Hee-Sup; Llinas, Rodolfo R.; Kim, Daesoo

    2010-01-01

    The rhythmic motor pathway activation by pacemaker neurons or circuits in the brain has been proposed as the mechanism for the timing of motor coordination, and the abnormal potentiation of this mechanism may lead to a pathological tremor. Here, we show that the potentiation of CaV3.1 T-type Ca2+ channels in the inferior olive contributes to the onset of the tremor in a pharmacological model of essential tremor. After administration of harmaline, 4- to 10-Hz synchronous neuronal activities arose from the IO and then propagated to cerebellar motor circuits in wild-type mice, but those rhythmic activities were absent in mice lacking CaV3.1 gene. Intracellular recordings in brain-stem slices revealed that the CaV3.1-deficient inferior olive neurons lacked the subthreshold oscillation of membrane potentials and failed to trigger 4- to 10-Hz rhythmic burst discharges in the presence of harmaline. In addition, the selective knockdown of CaV3.1 gene in the inferior olive by shRNA efficiently suppressed the harmaline-induced tremor in wild-type mice. A mathematical model constructed based on data obtained from patch-clamping experiments indicated that harmaline could efficiently potentiate CaV3.1 channels by changing voltage-dependent responsiveness in the hyperpolarizing direction. Thus, CaV3.1 is a molecular pacemaker substrate for intrinsic neuronal oscillations of inferior olive neurons, and the potentiation of this mechanism can be considered as a pathological cause of essential tremor. PMID:20498062

  3. A non-recurrent inferior laryngeal nerve in a man undergoing thyroidectomy: a case report

    Directory of Open Access Journals (Sweden)

    Sousa Daniel

    2010-11-01

    Full Text Available Abstract Introduction A non-recurrent variant of the inferior laryngeal nerve has been seldom reported. These reports are mostly based on cadaveric dissection studies or large chart review studies in which the emphasis is placed on the determination of the frequency of the variation, and not on the clinical appearance of this variant. We graphically describe the intraoperative identification of a non-recurrent inferior laryngeal nerve. Case Presentation A 44-year old Caucasian man was referred to the Head and Neck Surgery Outpatient Clinic with the diagnosis of a nodular mass in his left thyroid lobe that had been growing for one year. A fine needle aspiration puncture was compatible with thyroid papillary cancer. It was decided that the patient should undergo total thyroidectomy. During surgery, a non-recurrent right inferior laryngeal nerve was noted. This nerve emanated from the right vagus nerve, entering the larynx 3 cm after its origin. The nerve did not show a recurrent course. The nerve on the left side had a normal configuration. The surgery and post-operative period were uneventful, and the patient had no change in his voice. Conclusion This paper allows those interested to become acquainted with the normal intraoperative appearance of a non-recurrent inferior laryngeal nerve. This will undoubtedly be of significance for all of those performing invasive diagnostic and surgical procedures in the neck and upper thoracic regions, in order to minimize the risk of iatrogenic injury to this nerve. This is of extreme importance, since a unilateral lesion of this nerve may result in permanent hoarseness, and a bilateral lesion may lead to aphonia and life-threatening dyspnea.

  4. TrapEase inferior vena cava filter placement: use of the subclavian vein.

    Science.gov (United States)

    Stone, Patrick A; Aburahma, Ali F; Hass, Stephen M; Hofeldt, Matthew J; Zimmerman, William B; Deel, John T; Deluca, John A

    2004-01-01

    The purpose of this paper was to evaluate the safety and technical success of TrapEase inferior vena cava filter placement via the subclavian vein. As of yet, no reports in the literature have specifically investigated the use of the subclavian vein as a route for deploying TrapEase vena cava filters. Retrospective chart review was conducted of 135 patients with attempted TrapEase inferior vena cava filter placement over a 2-year period. In a majority of cases, the choice of subclavian vein approach was based primarily on surgeon preference. Other circumstances for subclavian vein deployment included cervical immobilization secondary to trauma, desire for concomitant placement of a subclavian long-term central venous access catheter, and patient body habitus limiting exposure to the internal jugular vein. One hundred and thirty-five filters were placed over this 2-year period. The internal jugular vein approach was used in 56 patients, the femoral vein approach in 39 patients, and the subclavian vein approach in 40 patients. Thirty-nine of the 40 TrapEase filter placements using the subclavian vein were successful. Twenty-six were deployed through the right subclavian vein and 14 through the left subclavian vein. The single failed subclavian deployment was due to the inability to pass the guidewire adequately into the inferior vena cava after successful cannulation of the right subclavian vein. The average deployment time for subclavian vein placement was 26 minutes when TrapEase filter placement was the only procedure performed. No insertional complications were encountered, specifically no pneumothoraces confirmed by chest radiography or fluoroscopy. The subclavian vein provides an alternative site of access for the TrapEase inferior vena cava filter. This route is comparable to other alternative methods evaluated both in average deployment time and complication occurrence. Furthermore, the subclavian vein route is valuable in patients with limited central access

  5. Classification of frequency response areas in the inferior colliculus reveals continua not discrete classes

    OpenAIRE

    Palmer, Alan R; Shackleton, Trevor M; Sumner, Christian J; Zobay, Oliver; Rees, Adrian

    2013-01-01

    A differential response to sound frequency is a fundamental property of auditory neurons. Frequency analysis in the cochlea gives rise to V-shaped tuning functions in auditory nerve fibres, but by the level of the inferior colliculus (IC), the midbrain nucleus of the auditory pathway, neuronal receptive fields display diverse shapes that reflect the interplay of excitation and inhibition. The origin and nature of these frequency receptive field types is still open to question. One proposed hy...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-06-01

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

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

    International Nuclear Information System (INIS)

    Antoniou, E.E.H.; Matsuoka, S.; Mori, K.; Hayabuchi, Y.; Kuroda, Y.

    1995-01-01

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

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

    Science.gov (United States)

    Aravena, Pedro Christian; Valeria, Camila; Nuñez, Nicolás; Perez-Rojas, Francisco; Coronado, Cesar

    2016-01-01

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

  9. [Accidental injection of sodium hypochlorite in inferior alveolar nerve block anesthesia].

    Science.gov (United States)

    Hongyan, Li; Jian, Xu; Baorong, Zhang; Yue, Jia; Minhua, Liu; Yilang, Luo; Jing, Zhao

    2016-12-01

    Sodium hypochlorite (NaClO) has been widely used in clinical practice as one of the most efficient root canal irrigants. Its properties include broad-spectrum antimicrobial activity and ability to dissolve necrotic tissues. However, when used improperly, NaClO can cause a series of adverse reactions, such as mucosal inflammation, irritation, or injury. This paper presents a case of accidental injection of NaClO in inferior alveolar nerve block anesthesia.

  10. P1-24: Neural Representation of Gloss in the Macaque Inferior Temporal Cortex

    OpenAIRE

    Akiko Nishio; Naokazu Goda; Hidehiko Komatsu

    2012-01-01

    The variation of the appearance such as gloss provides one of the most important information for object recognition. However, little is known about the neural mechanisms related to the perception of gloss. We examined whether the neurons in the inferior temporal (IT) cortex of the monkeys are coding gloss of objects. We made visual stimuli which have various surface reflectance properties, and tested responses of IT neurons to these stimuli while a monkey was performing a visual fixation task...

  11. Spatial organization of frequency preference and selectivity in the human inferior colliculus

    OpenAIRE

    De Martino, Federico; Moerel, Michelle; van de Moortele, Pierre-Francois; Ugurbil, Kamil; Goebel, Rainer; Yacoub, Essa; Formisano, Elia

    2013-01-01

    To date, the functional organization of human auditory sub-cortical structures can only be inferred from animal models. Here we use high-resolution functional MRI at ultra-high magnetic fields (7 Tesla) to map the organization of spectral responses in the human inferior colliculus (hIC), a sub-cortical structure fundamental for sound processing. We reveal a tonotopic map with a spatial gradient of preferred frequencies approximately oriented from dorso-lateral (low frequencies) to ventro-medi...

  12. Serial repositioning of a Guenther tulip retrievable inferior vena cava filter in a pediatric patient

    International Nuclear Information System (INIS)

    Haider, Ehsan A.; Rosen, J. Choi; Torres, Carlos; Valenti, David A.

    2005-01-01

    We report an 11-year-old boy who required inferior vena cava (IVC) filtration for a prolonged period of time. A retrievable IVC filter was placed and repositioned three times, providing a total of 60 days of IVC filtration. The filter was removed when his risk of pulmonary embolus had decreased substantially. This is a relatively uncommon practice in the pediatric population. The technique is presented, and the available literature is reviewed. (orig.)

  13. Guenther Tulip Filter Retrieval from a Left-sided Inferior Vena Cava

    International Nuclear Information System (INIS)

    Brountzos, Elias N.; Kaufman, John A.; Lakin, Paul L.

    2004-01-01

    Optional (retrievable) inferior cava filters (IVC) may have advantages over permanent filters in a certain subset of patients, especially in view of recent concerns about the long-term thrombotic complications of the latter. Retrieval of the Guenther Tulip Filter (GTF), an optional filter, has been reported in a total of 76 patients. We present the first description of GTF retrieval from a left-sided IVC using the right internal jugular approach

  14. Entrapment of Suprascapular Artery between Split Parts of Right Inferior Belly of Omohyoid Muscle - A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Naina Santosh Wakode

    2017-11-01

    Full Text Available Inferior belly of omohyoid is used as a landmark for endoscopic exploration of the brachial plexus. Variation of inferior belly of omohyoid muscle has immense clinical significance because of its relation to brachial plexus, external jugular vein, suprascapular nerve, vessels and phrenic nerve. The need to understand muscular variation is of greater importance because of the increased number of endoscopic surgeries and images for diagnosis. A number of variations of omohyoid muscle such as the absence of muscle, unusual sites of origin and insertion, and multiple bellies have been reported. Doubling or splitting of superior belly of the omohyoid has been reported several times. However, the splitting of the inferior belly of the omohyoid muscle is rarely reported. Herein we report a case of unusual splitting of inferior belly of omohyoid muscle. During the dissection for undergraduate students at AIIMS Bhubaneswar, unusual morphology of inferior belly of omohyoid muscle was observed in formalin embalmed 60-year-old male cadaver. The inferior belly of omohyoid was split. Another important finding observed was suprascapular artery entrapment between the split upper and lower parts of belly of inferior omohyoid with slight indentation mark on the artery suggestive of chronic compression. This muscle is used for various important clinical procedures and is an important landmark for radical neck dissection. So, the knowledge of possible anomalies of omohyoid is important.

  15. Intraosseous repair of the inferior alveolar nerve in rats: an experimental model.

    Science.gov (United States)

    Curtis, N J; Trickett, R I; Owen, E; Lanzetta, M

    1998-08-01

    A reliable method of exposure of the inferior alveolar nerve in Wistar rats has been developed, to allow intraosseous repair with two microsurgical techniques under halothane inhalational anaesthesia. The microsuturing technique involves anastomosis with 10-0 nylon sutures; a laser-weld technique uses an albumin-based solder containing indocyanine green, plus an infrared (810 nm wavelength) diode laser Seven animals had left inferior alveolar nerve repairs performed with the microsuture and laser-weld techniques. Controls were provided by unoperated nerves in the repaired cases. Histochemical analysis was performed utilizing neuron counts and horseradish peroxidase tracer (HRP) uptake in the mandibular division of the trigeminal ganglion, following sacrifice and staining of frozen sections with cresyl violet and diaminobenzidene. The results of this analysis showed similar mean neuron counts and mean HRP uptake by neurons for the unoperated controls and both microsuture and laser-weld groups. This new technique of intraosseous exposure of the inferior alveolar nerve in rats is described. It allows reliable and reproducible microsurgical repairs using both microsuture and laser-weld techniques.

  16. Massive Left-sided Congestive Colitis Due to Idiopathic Inferior Mesenteric Arteriovenous Malformation

    Directory of Open Access Journals (Sweden)

    Laura Martí Gelonch

    2017-01-01

    Full Text Available Arteriovenous malformations (AVM of the inferior mesenteric artery are rare. They may be primary (congenital or idiopathic or secondary (acquired after trauma or of iatrogenic origin. Of the abdominal AVM, the inferior mesenteric trunk is the least commonly involved. Most reported cases are of iatrogenic origin, resulting from colon surgery. Only 17 cases have been described and published in the literature. The objective of this work is to make known a case treated in our center. We present a case of 73-year old male, who came to the emergency service with symptoms of abdominal distension, pain lasting 48 hours along with months of diarrhoea. CT scan and an abdominal CT angiography showed a massive left-sided congestive colitis due to idiopathic inferior mesenteric arteriovenous malformation. In our case, the decision was to carry out the treatment in two stages. Embolisation was performed in the first stage in order to decrease the blood flow and the risk of intraoperative bleeding, followed by resective surgery of the affected colon.

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

    Directory of Open Access Journals (Sweden)

    Sergey Lvovich Kabak

    2017-11-01

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

  18. Right Inferior Frontal Gyrus Activation as a Neural Marker of Successful Lying

    Directory of Open Access Journals (Sweden)

    Oshin eVartanian

    2013-10-01

    Full Text Available There is evidence to suggest that successful lying necessitates cognitive effort. We tested this hypothesis by instructing participants to lie or tell the truth under conditions of high and low working memory (WM load. The task required participants to register a response on 80 trials of identical structure within a 2 (WM Load: high, low × 2 (Instruction: truth or lie repeated-measures design. Participants were less accurate and responded more slowly when WM load was high, and also when they lied. High WM load activated the fronto-parietal WM network including dorsolateral prefrontal cortex (PFC, middle frontal gyrus, precuneus, and intraparietal cortex. Lying activated areas previously shown to underlie deception, including middle and superior frontal gyrus and precuneus. Critically, successful lying in the high vs. low WM load condition was associated with longer response latency, and it activated the right inferior frontal gyrus—a key brain region regulating inhibition. The same pattern of activation in the inferior frontal gyrus was absent when participants told the truth. These findings demonstrate that lying under high cognitive load places a burden on inhibition, and that the right inferior frontal gyrus may provide a neural marker for successful lying.

  19. Pleural and Pulmonary Staining at Inferior Phrenic Arteriography Mimicking a Tumor Staining of Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Lee, Deok Hee; Hwang, Jae Cheol; Lim, Soo Mee; Yoon, Hyun-Ki; Sung, Kyu-Bo; Song, Ho-Young

    2000-01-01

    Purpose: To describe the findings of pleural and pulmonary staining of the inferior phrenic artery, which can be confused with tumor staining during transarterial chemoembolization (TACE) of hepatoma.Methods: Fifteen patients who showed pleural and pulmonary staining without relationship to hepatic masses at inferior phrenic arteriography were enrolled. The staining was noted at initial TACE (n = 8), at successive TACE (n = 5), and after hepatic surgery (n = 2). The angiographic pattern, the presence of pleural change on computed tomography (CT), and clinical history were evaluated.Results: Draining pulmonary veins were seen in all cases. The lower margin of the staining corresponded to the lower margin of the pleura in 10 patients. CT showed pleural and/or pulmonary abnormalities in all cases. After embolization of the inferior phrenic artery, the accumulation of iodized oil in the lung was noted.Conclusion: Understanding the CT and angiographic findings of pleural and pulmonary staining during TACE may help differentiate benign staining from tumor staining

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

    Science.gov (United States)

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

    2017-11-01

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

  1. Effect of the radiofrequency volumetric tissue reduction of inferior turbinate on expiratory nasal sound frequency.

    Science.gov (United States)

    Seren, Erdal

    2009-01-01

    We sought to evaluate the short-term efficacy of radiofrequency volumetric tissue reduction (RFVTR) in treatment of inferior turbinate hypertrophy (TH) as measured by expiratory nasal sound spectra. In our study, we aimed to investigate the Odiosoft-rhino (OR) as a new diagnostic method to evaluate the nasal airflow of patients before and after RFVTR. In this study, we have analyzed and recorded the expiratory nasal sound in patients with inferior TH before and after RFVTR. This analysis includes the time expanded waveform, the spectral analysis with time averaged fast Fourier transform (FFT), and the waveform analysis of nasal sound. We found an increase in sound intensity at high frequency (Hf) in the sound analyses of the patients before RFVTR and a decrease in sound intensity at Hf was found in patients after RFVTR. This study indicates that RFVTR is an effective procedure to improve nasal airflow in the patients with nasal obstruction with inferior TH. We found significant decreases in the sound intensity level at Hf in the sound spectra after RFVTR. The OR results from the 2000- to 4000-Hz frequency (Hf) interval may be more useful in assessing patients with nasal obstruction than other frequency intervals. OR may be used as a noninvasive diagnostic tool to evaluate the nasal airflow.

  2. [Clinical analysis of patients with lower extremity deep venous thrombosis complicated with inferior vena cava thrombus].

    Science.gov (United States)

    Dong, Dian-ning; Wu, Xue-jun; Zhang, Shi-yi; Zhong, Zhen-yue; Jin, Xing

    2013-06-04

    To explore the clinical profiles of patients with lower extremity deep venous thrombosis (DVT) complicated with inferior vena cava (IVC) thrombus and summarize their clinical diagnostic and therapeutic experiences. The clinical characteristics, diagnosis and treatment of 20 hospitalized patients with DVT complicated with inferior vena cava thrombus were analyzed retrospectively. All of them were of proximal DVT. There were phlegmasia cerulea dolens (n = 3), pulmonary embolism (n = 3) and completely occlusion of IVC (n = 5). Clinical manifestations were severe. Retrievable inferior vena cava filter (IVCF) was implanted for 17 cases. Catheter-directed thrombolysis (CDT) through ipsilateral popliteal vein was applied for 7 cases and systemic thrombolysis therapy for 8 cases. The effective rate of thrombolysis for fresh IVC thrombus was 100%. Among 5 cases with Cockett Syndrome, 3 cases underwent balloon dilatation angioplasty and endovascular stenting of iliac vein. And 17 IVCFs were retrieved successfully within 3 weeks. IVC thrombus disappeared completely in 15 cases. Systemic or local thrombolysis with protective IVCF is a safe and effective therapy for nonocclusive IVC thrombus in DVT. And CDT is recommended for symptomatic occlusive IVC thrombus.

  3. A Rare Location of Angiofibroma in the Inferior Turbinate in Young Woman

    Directory of Open Access Journals (Sweden)

    Salimov, Asif

    2015-01-01

    Full Text Available Introduction Juvenile nasopharyngeal angiofibroma is a rare benign neoplasm in the nasopharynx. The tumor tends to be locally aggressive and is typically seen in adolescent boys. Extranasopharyngeal angiofibromas have been reported sporadically in the literature. They most commonly originate from the maxillary sinus. Objectives A 26-year-old woman was referred to our clinic with intermittent epistaxis from the right nasal passage for the previous 2 months. Maxillofacial magnetic resonance imaging showed a lobular, contoured mass originating from the right inferior turbinate and hanging in the right nasal cavity, with dense contrast enhancement denoting hypervascularity. Resumed Report Vascular feeding of the mass was seen from the right internal maxillary artery with angiography, and this branch was embolized. On the following day, the patient underwent transnasal endoscopic excision of the mass. An approximately 3-cm-diameter mass was excised by partial turbinectomy, and the posterior edge of the remaining turbinate was cauterized. Conclusion Extranasopharyngeal angiofibromas are rarely seen, and the inferior turbinate is an extremely rare location for them. This young woman is the first case reported in the English literature of angiofibroma originating from the inferior turbinate. We should consider these neoplasms can be found in female, nonadolescent patients with extranasopharyngeal localization, and we should not perform biopsy because of its massive bleeding.

  4. Inferior petrosal sinus sampling in the diagnosis of adrenocorticotropin dependent Cushing syndrome with unknown origin

    International Nuclear Information System (INIS)

    Shen Xuefeng; Yuan Dequan; Yue Ming; Feng Juanjuan

    2011-01-01

    Objective: To evaluate the value of inferior petrosal sinus sampling (IPSS) in the diagnosis of adrenocorticotropic hormone (ACTH) dependent Cushing syndrome (CS) with unknown origin. Methods: IPSS was carried out for the diagnosis of 16 cases with ACTH dependent CS who had not been identified after a series of dexamethasone suppression tests and radiological examinations. The ratio of inferior petrosal sinus/peripheral ACTH was assayed. The sensitivity and specificity of diagnosis of the Cushing disease were estimated. Results: The inferior petrosal sinus/peripheral ACTH ratio was over 2.0 in 13 cases. Twelve cases underwent surgery with pathological diagnosis of pituitary ACTH adenoma, 1 patient relieved after γ knife treatment. The ratio was < 2.0 in 3 cases including 2 pulmonary carcinoid and one pituitary ACTH adenoma. The sensitivity and specify of IPSS for the diagnosis of Cushing disease were 13/14 and 2/2 respectively. Conclusion: IPSS was a safe technique with high sensitivity, specify and infrequent complications in the diagnosis of ACTH dependent Cushing disease. It had great clinical value in the differential diagnosis of ACTH dependent Cushing disease with unknown origin. (authors)

  5. Comparable cortical activation with inferior performance in women during a novel cognitive inhibition task.

    Science.gov (United States)

    Halari, R; Kumari, V

    2005-03-07

    Men are hypothesised to perform better than women at tasks requiring cognitive inhibition. The present study applied whole-brain functional magnetic resonance imaging to investigate the neural correlates of cognitive inhibition using a novel task, requiring detection of numbers decreasing in numerical order, in relation to sex. The study involved 19 young healthy subjects (9 men, 10 women). Behavioural sex differences favouring men were found on the inhibition, but not on the automatization (i.e. detection of numbers increasing in numerical order), condition of the task. Significant areas of activation associated with cognitive inhibition included the right inferior prefrontal and bilateral dorsolateral prefrontal cortices, left inferior and superior parietal lobes, and bilateral temporal regions across men and women. No brain region was significantly differently activated in men and women. Our findings demonstrate that (a) cognitive inhibition is dependent on intact processes within frontal and parietal regions, and (b) women show inferior cognitive inhibition despite of comparable activation to men in relevant regions. Equated behavioural performance may elicit sex differences in brain activation.

  6. The anatomic basis of lingual nerve trauma associated with inferior alveolar block injections.

    Science.gov (United States)

    Morris, Christopher D; Rasmussen, Jared; Throckmorton, Gaylord S; Finn, Richard

    2010-11-01

    This study describes the anatomic variability in the position of the lingual nerve in the pterygomandibular space, the location of the inferior alveolar nerve block injection. Simulated standard landmark-based inferior alveolar nerve blocks were administered to 44 fixed sagitally bisected cadaver heads. Measurements were made of the diameter of the nerves and distances between the needle and selected anatomic landmarks and the nerves. Of 44 simulated injections, 42 (95.5%) passed lateral to the lingual nerve, 7 (16%) passed within 0.1 mm of the nerve, and 2 (4.5%) penetrated the nerve. The position of the lingual nerve relative to bony landmarks within the interpterygoid fascia was highly variable. Variation in the position of the lingual nerve is an important contributor to lingual nerve trauma during inferior alveolar block injections. This factor should be an important part of preoperative informed consent. Copyright © 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Evaluation and clinical use of an intraoral inferior alveolar nerve block in the horse.

    Science.gov (United States)

    Henry, T; Pusterla, N; Guedes, A G P; Verstraete, F J M

    2014-11-01

    Local anaesthesia is often required to facilitate invasive procedures in equine dental patients under standing sedation. To show that an intraoral approach can be used to desensitise the inferior alveolar nerve in horses and report complications seen with this technique. The distance of the mandibular foramen from the distal (caudal) edge of the mandibular third molar tooth, rostral edge of the mandibular ramus and ventral margin of the mandible were measured in 26 adult equine skulls of various ages and breeds. Computed tomography (CT) was used to verify the placement of the local anaesthetic with a custom-made device on 4 equine cadaver heads. The technique was applied in 43 clinical cases having procedures performed on the mandibular quadrants using the delivery device. Computed tomography demonstrated that the intraoral approach provided deposition of the local anaesthetic at the mandibular foramen and anatomical localisation of mandibular foramen indicated that anaesthetic solution could be delivered with a 38 mm needle. Clinical patients to lerated invasive dental procedures following the inferior alveolar nerve block with a 5 ml dose of local anaesthetic, without evidence of self-inflicted lingual trauma. The inferior alveolar nerve was successfully desensitised with the intraoral approach with minimal complications. The reduced volume of local anaesthetic and ability to deposit the local anaesthetic in close proximity to the nerve compared with an extraoral technique may decrease the complication of self-inflicted lingual trauma. © 2013 EVJ Ltd.

  8. The Effect of 2 Injection Speeds on Local Anesthetic Discomfort During Inferior Alveolar Nerve Blocks.

    Science.gov (United States)

    de Souza Melo, Marcelo Rodrigo; Sabey, Mark Jon Santana; Lima, Carla Juliane; de Almeida Souza, Liane Maciel; Groppo, Francisco Carlos

    2015-01-01

    This randomized double-blind crossover trial investigated the discomfort associated with 2 injection speeds, low (60 seconds) and slow (100 seconds), during inferior alveolar nerve block by using 1.8 mL of 2% lidocaine with 1 : 100,000 epinephrine. Three phases were considered: (a) mucosa perforation, (b) needle insertion, and (c) solution injection. Thirty-two healthy adult volunteers needing bilateral inferior alveolar nerve blocks at least 1 week apart were enrolled in the present study. The anesthetic procedure discomfort was recorded by volunteers on a 10-cm visual analog scale in each phase for both injection speeds. Comparison between the 2 anesthesia speeds in each phase was performed by paired t test. Results showed no statistically significant difference between injection speeds regarding perforation (P = .1016), needle placement (P = .0584), or speed injection (P = .1806). The discomfort in all phases was considered low. We concluded that the 2 injection speeds tested did not affect the volunteers' pain perception during inferior alveolar nerve blocks.

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Wang Quan

    2012-06-01

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

  11. Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach

    Directory of Open Access Journals (Sweden)

    Endale Tefera

    2014-01-01

    Full Text Available Percutaneous closure of the patent arterial duct in patients with interrupted inferior caval vein poses a technical challenge. A 12-year-old girl with a patent ductus arteriosus (PDA and interrupted inferior caval vein is described in this report. The diagnosis of interrupted inferior caval vein and azygos continuation was made in the catheterization laboratory. A catheter was advanced and snared in the descending aorta. An exchange wire was advanced through the catheter and snared in the descending aorta. Then, an Amplatzer TorqVue 2 delivery sheath was advanced over the wire from the venous side and again snared in the descending aorta. An Amplatzer duct occluder (ADO size 8/6 was advanced through the sheath while still holding the sheath with a snare. The device was opened. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted. The device was then released and it attained a stable position. An aortic angiogram was performed which showed complete occlusion.

  12. Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach

    International Nuclear Information System (INIS)

    Tefera, Endale; Bermudez-Cañete, Ramon

    2014-01-01

    Percutaneous closure of the patent arterial duct in patients with interrupted inferior caval vein poses a technical challenge. A 12-year-old girl with a patent ductus arteriosus (PDA) and interrupted inferior caval vein is described in this report. The diagnosis of interrupted inferior caval vein and azygos continuation was made in the catheterization laboratory. A catheter was advanced and snared in the descending aorta. An exchange wire was advanced through the catheter and snared in the descending aorta. Then, an Amplatzer TorqVue 2 delivery sheath was advanced over the wire from the venous side and again snared in the descending aorta. An Amplatzer duct occluder (ADO) size 8/6 was advanced through the sheath while still holding the sheath with a snare. The device was opened. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted. The device was then released and it attained a stable position. An aortic angiogram was performed which showed complete occlusion

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

    Science.gov (United States)

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

    2017-01-01

    Abstract Functional lateralization can be an indicator of brain maturation. We have consistently shown that, in the adult brain, proprioceptive processing of muscle spindle afferents generating illusory movement of the right hand activates inferior frontoparietal cortical regions in a right-side dominant manner in addition to the cerebrocerebellar motor network. Here we provide novel evidence regarding the development of the right-dominant use of the inferior frontoparietal cortical regions in humans using this task. We studied brain activity using functional magnetic resonance imaging while 60 right-handed blindfolded healthy children (8–11 years), adolescents (12–15 years), and young adults (18–23 years) (20 per group) experienced the illusion. Adult-like right-dominant use of the inferior parietal lobule (IPL) was observed in adolescents, while children used the IPL bilaterally. In contrast, adult-like lateralized cerebrocerebellar motor activation patterns were already observable in children. The right-side dominance progresses during adolescence along with the suppression of the left-sided IPL activity that emerges during childhood. Therefore, the neuronal processing implemented in the adult's right IPL during the proprioceptive illusion task is likely mediated bilaterally during childhood, and then becomes right-lateralized during adolescence at a substantially later time than the lateralized use of the cerebrocerebellar motor system for kinesthetic processing. PMID:28968653

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

    Science.gov (United States)

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

    2015-04-18

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

  15. Inferior frontal gyrus activation predicts individual differences in perceptual learning of cochlear-implant simulations.

    Science.gov (United States)

    Eisner, Frank; McGettigan, Carolyn; Faulkner, Andrew; Rosen, Stuart; Scott, Sophie K

    2010-05-26

    This study investigated the neural plasticity associated with perceptual learning of a cochlear implant (CI) simulation. Normal-hearing listeners were trained with vocoded and spectrally shifted speech simulating a CI while cortical responses were measured with functional magnetic resonance imaging (fMRI). A condition in which the vocoded speech was spectrally inverted provided a control for learnability and adaptation. Behavioral measures showed considerable individual variability both in the ability to learn to understand the degraded speech, and in phonological working memory capacity. Neurally, left-lateralized regions in superior temporal sulcus and inferior frontal gyrus (IFG) were sensitive to the learnability of the simulations, but only the activity in prefrontal cortex correlated with interindividual variation in intelligibility scores and phonological working memory. A region in left angular gyrus (AG) showed an activation pattern that reflected learning over the course of the experiment, and covariation of activity in AG and IFG was modulated by the learnability of the stimuli. These results suggest that variation in listeners' ability to adjust to vocoded and spectrally shifted speech is partly reflected in differences in the recruitment of higher-level language processes in prefrontal cortex, and that this variability may further depend on functional links between the left inferior frontal gyrus and angular gyrus. Differences in the engagement of left inferior prefrontal cortex, and its covariation with posterior parietal areas, may thus underlie some of the variation in speech perception skills that have been observed in clinical populations of CI users.

  16. Right inferior frontal gyrus activation as a neural marker of successful lying.

    Science.gov (United States)

    Vartanian, Oshin; Kwantes, Peter J; Mandel, David R; Bouak, Fethi; Nakashima, Ann; Smith, Ingrid; Lam, Quan

    2013-01-01

    There is evidence to suggest that successful lying necessitates cognitive effort. We tested this hypothesis by instructing participants to lie or tell the truth under conditions of high and low working memory (WM) load. The task required participants to register a response on 80 trials of identical structure within a 2 (WM Load: high, low) × 2 (Instruction: truth or lie) repeated-measures design. Participants were less accurate and responded more slowly when WM load was high, and also when they lied. High WM load activated the fronto-parietal WM network including dorsolateral prefrontal cortex (PFC), middle frontal gyrus, precuneus, and intraparietal cortex. Lying activated areas previously shown to underlie deception, including middle and superior frontal gyrus and precuneus. Critically, successful lying in the high vs. low WM load condition was associated with longer response latency, and it activated the right inferior frontal gyrus-a key brain region regulating inhibition. The same pattern of activation in the inferior frontal gyrus was absent when participants told the truth. These findings demonstrate that lying under high cognitive load places a burden on inhibition, and that the right inferior frontal gyrus may provide a neural marker for successful lying.

  17. Evaluation of right ventricular regional wall motion in inferior myocardial infarction by cine MRI

    International Nuclear Information System (INIS)

    Nishino, Masami; Ohnishi, Shusaku; Hasegawa, Shinji

    1991-01-01

    The purpose of this study is to evaluate right ventricular regional wall motion in inferior myocardial infarction by cine MRI. Thirteen patients with inferior myocardial infarction were investigated by cine MRI and were divided into proximal group which consisted of seven patients: >90% stenosis in segment 1 or 2 of right coronary artery and distal group which consisted of six patients: >90% stenosis in segment 3 or 4 of right coronary artery. Cine MRI was performed by 1.5 tesla magnet system (Signa, GE). To depict the regional asynergy, right ventricular wall was divided into 6 segments as follows: Segments 1 and 2 were upper and lower segments in transverse planes, respectively. Segments 3 and 4 were free wall and diaphragmatic segments of outflow tract, and segments 5 and 6 were of inflow tract in sagittal planes. Our results were as follows: (1) In proximal group, right ventricular asynergy was detected in six patients but in distal group it was detected in only one patient; (2) Right ventricular asynergy was detected most frequently at diaphragmatic segments in sagittal planes; (3) All the patients who had shown the hemodynamic deterioration of right ventricle on acute phase of inferior myocardial infarction presented the broad asynergy in right ventricle; (4) Cine MRI is clinically useful in evaluating right ventricular regional wall movement and diagnosing right ventricular infarction. (author)

  18. CT evaluation of hepatocellular carcinomas supplied by right inferior phrenic arteries

    International Nuclear Information System (INIS)

    Wen Ming; Zhu Mingxia; Huang Yonghuo

    2002-01-01

    Objective: To evaluate the CT appearance of the hepatocellular carcinomas (HCC) supplied by the right inferior phrenic arteries (RIPA). Methods: A total of 195 consecutive cases of HCCs examined with helical CT and arteriography were studied. 15 proven HCCs cases were supplied by the RIPA. On arterial-phase CT images, the size of the RIPA, the left inferior phrenic arteries, and HCCs were measured, and the origin of RIPA and the location of HCCs were recorded. The CT findings in these 15 cases were correlated with arterio-graphic images. Results: CT showed RIPA on the right diaphragmatic crus as high attenuation in all patients. The origin of RIPA was demonstrated in 11 cases. The diameter of the RIPA (3.1 +- 1.1) mm was larger than that of the left inferior phrenic artery (1.3 +- 0.4) mm (P < 0.05). Conclusion: On CT images, if the RIPA asymmetrically dilates, and its diameter is larger than 2.5 mm, it is suggested that the HCC is supplied by the RIPA

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

    Directory of Open Access Journals (Sweden)

    Andrés C Limardo

    2016-03-01

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

  20. Déficit bilateral de las manifestaciones de la fuerza muscular de las extremidades inferiores en estudiantes universitarios

    OpenAIRE

    Ramón Candia-Luján; Karen Ileana Carreón Santa Cruz; Beatriz Anai Núnez Escudero; Lidia Guillermina De León Fierro; Claudia Esther Carrasco Legleu

    2018-01-01

    El objetivo del estudio fue determinar el déficit bilateral (DBL) de las manifestaciones de la fuerza muscular de los miembros inferiores en estudiantes universitarios, participaron16 hombres y 14 mujeres. Se les evaluó la fuerza máxima dinámica, la potencia muscular y la fuerza isométrica, en forma bilateral y unilateral de ambas extremidades inferiores. La suma de la fuerza máxima dinámica unilateral de las extremidades inferiores fue mayor que la fuerza bilateral 132,4 ± 38,1 kg y 114,6 ± ...

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

    Directory of Open Access Journals (Sweden)

    Gian Marco Tosi

    2014-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  3. Postero-Inferior Pedicle Surgical Technique for the Treatment of Grade III Gynecomastia.

    Science.gov (United States)

    Thiénot, Sophie; Bertheuil, Nicolas; Carloni, Raphaël; Méal, Cécile; Aillet, Sylvie; Herlin, Christian; Watier, Eric

    2017-06-01

    Surgical treatment of Grade III gynecomastia generally utilizes mastectomy techniques and free transplantation of the nipple-areola complex. Moreover, with rising obesity rates and the development of bariatric surgery, an increasing demand for correctional surgery for pseudogynecomastia has been observed, which is comparable to Grade III gynecomastia in terms of its surgical management. Here, we describe an innovative technique to deal with these new demands: fascio-cutaneous flap by postero-inferior pedicle. All patients in the Department of Plastic Surgery from our University Hospital suffering from Grade III gynecomastia or pseudogynecomastia underwent surgery via the postero-inferior pedicle flap technique. Briefly, we performed extensive liposuction of the infero-internal and infero-external mammary quadrants followed by liposuction of the deep tissues of the superior quadrants, except in the area of the pedicle. After removing the skin just above the dermis of the inferior quadrants and performing de-epithelialization of the postero-inferior pedicle flap, the thoracic flap was lowered and the areola transposed. Nine patients underwent surgery between March 2015 and March 2016, and their results were collected prospectively. The mean patient age was 46.6 years, the mean weight was 94.2 kg, and the mean body mass index was 30.8 kg/m 2 . In addition, the mean operative time was 132 min, the mean liposuction volume was 633 mL, the excised weight was 586 g, and the mean hospitalization and drainage durations were 3.8 days. No major complications occurred, no re-intervention was required, and no recurrence was found. We report a new operative technique using a postero-inferior pedicle. Its main advantage is preservation of neurovascular function, which makes this a promising technique for patients who wish to maintain nipple sensitivity. This surgery is reliable and reproducible. We recommend it as the first line treatment for Grade III gynecomastia because

  4. Anterior loop of the inferior alveolar nerve: Averages and prevalence based on CT scans.

    Science.gov (United States)

    Juan, Del Valle Lovato; Grageda, Edgar; Gómez Crespo, Salvador

    2016-02-01

    The treatment of edentulous patients by using a complete implant-supported fixed prosthetic with distal extension has been widely studied; success is mainly dependent upon the placement of the distal implants. The location of the inferior alveolar nerve determines implant placement, but the length, prevalence, and symmetry between the left and right side of the anterior loop of the alveolar nerve are unknown. The purpose of this clinical study was to measure the anterior loop of the inferior alveolar nerve, which determines the placement of distal implants, in a group of 55 Mexican participants. The study expected to ascertain the average length, prevalence, and symmetry between left and right side and any sex differences. To differentiate the inferior alveolar nerve path, a new technique was applied using Hounsfield unit (HU) thresholds. The null hypothesis was that no significant differences would be found between the left and right sides or between men and women for the anterior loop of the inferior alveolar nerve. Fifty-five computed tomography (CT) scans were made (Somatom Sensation 16; Siemens Healthcare) and were visualized with InVesalius software. Anterior loop measurements were made on 3-dimensional surfaces. To determine statistical differences between the left and right side and between the sexes, the t test was used. The interclass correlation coefficient test was also applied to verify the reliability of the measurements. Ninety percent of participants showed the anterior loop of the inferior alveolar nerve. The length of the anterior loop ranged between 0 and 6.68 mm, with a mean of 2.19 mm. No significant differences were found between the left and right sides or between men and women. The mean length for the anterior loop in the sample was 2.19 mm. As the anterior loop length shows a high degree of variability, these findings suggest that a CT scan for each patient is recommended in order to visualize a safety zone before placing implants close to

  5. A quantitative method for evaluating inferior glenohumeral joint stiffness using ultrasonography.

    Science.gov (United States)

    Tsai, Wen-Wei; Lee, Ming-Yih; Yeh, Wen-Lin; Cheng, Shih-Chung; Soon, Kok-Soon; Lei, Kin Fong; Lin, Wen-Yen

    2013-02-01

    Subluxation of the affected shoulder in post-stroke patients is associated with nerve disorders and muscle fatigue. Clinicians must be able to accurately and reliably measure inferior glenohumeral subluxation in patients to provide appropriate treatment. However, quantitative methods for evaluating the laxity and stiffness of the glenohumeral joint (GHJ) are still being developed. The aim of this study was to develop a new protocol for evaluating the laxity and stiffness of the inferior GHJ using ultrasonography under optimal testing conditions and to investigate changes in the GHJ from a commercially available humerus brace and shoulder brace. Multistage inferior displacement forces were applied to create a glide between the most cephalad point on the visible anterosuperior surface of the humeral head and coracoid process in seven healthy volunteers. GHJ stiffness was defined as the slope of the linear regression line between the glides and different testing loads. The testing conditions were defined by different test loading mechanisms (n=2), shoulder constraining conditions (n=2), and loading modes (n=4). The optimal testing condition was defined as the condition with the least residual variance of measured laxity to the calculated stiffness under different testing loads. A paired t-test was used to compare the laxity and stiffness of the inferior GHJ using different braces. No significant difference was identified between the two test loading mechanisms (t=0.218, p=0.831) and two shoulder constraining conditions (t=-0.235, p=0.818). We concluded that ultrasonographic laxity measurements performed using a pulley set loading mechanism was as reliable as direct loading. Additionally, constraining the unloaded shoulder was proposed due to the lower mean residual variance value. Moreover, pulling the elbow downward with loading on the upper arm was suggested, as pulling the elbow downward with the elbow flexed and loading on the forearm may overestimate stiffness

  6. Atypical leiomyoma arising in a hepatic vein with extension into the inferior vena cava and right atrium

    International Nuclear Information System (INIS)

    Dunlap, H.J.; Udjus, K.

    1990-01-01

    We report an atypical leiomyoma arising in a hepatic vein and extending into the inferior vena cava and right atrium in a fourteen year old boy. US, CT and MRI facilitated diagnosis and removal of this tumor. (orig.)

  7. Management of maxillary sinus inverted papilloma via endoscopic partial medial maxillectomy with an inferior turbinate reversing approach.

    Science.gov (United States)

    Wang, Feng; Yang, Yang; Wang, Shenqing; Chen, Haihong; Wang, Dehui; Wang, Qinying

    2017-12-01

    The aim of this study is to evaluate the efficacy of endoscopic treatment for maxillary inverted papilloma (IP) through partial medial maxillectomy with an inferior turbinate reversing approach. A retrospective analysis of patients treated in our institution for maxillary sinus IP between July 2011 and August 2015 was performed. Demographics, operative technique, characteristics of tumors, complications, postoperative follow-up, and recurrence were evaluated. Twenty-two patients were enrolled in the study. All tumor attachments were identified intraoperatively. Adequate visualization was obtained following our approach. All inferior turbinate and nasolacrimal ducts were preserved. The median follow-up time was 41 months. One recurrence occurred at the follow-up time of 27 months. Postoperative hemorrhage and numbness at the ipsilateral frontal teeth were reported in two and one patients, respectively. Endoscopic surgery through partial medial maxillectomy using an inferior turbinate reversing approach provides full access to the maxillary sinus and preserves the inferior turbinate and nasolacrimal duct.

  8. Percutaneous transfemoral placement of inferior vena cava filter to prevent pulmonary embolism in patients with malignant tumor

    International Nuclear Information System (INIS)

    Hu Baoshan; Li Yong; Luo Pengfei

    2005-01-01

    Objective: To evaluate the effectiveness and safety of inserting an inferior vena cava filter to prevent the pulmonary embolism (PE) due to detachment of the thrombus in the lower extremities. Methods: Inferior vena cava filter were placed in 37 patients with malignant tumor and deep venous thrombosis from 1998 to 2004. Malignancy was confirmed by pathological or cellular biological examination in all cases. The episode of pulmonary embolism was monitored during a post-intervention follow-up. Results: All the filters were placed in the inferior vena cava safely via a percutaneous femoral venous access. No serious complications such as pulmonary embolism occurred during the follow-up periods. Conclusion: The inferior vena cava filter placement is an effective and safe procedure in preventing the pulmonary embolism in patients with malignant tumor and deep venous thrombosis. (authors)

  9. High Intrapatient Variability of Tacrolimus Levels and Outpatient Clinic Nonattendance Are Associated With Inferior Outcomes in Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Dawn L. Goodall, MSc

    2017-08-01

    Conclusions. This study shows that high tacrolimus IPV and clinic nonattendance are associated with inferior allograft survival. Interventions to minimize the causes of high variability, particularly nonadherence are essential to improve long-term allograft outcomes.

  10. Thrombosis of the ileo-caval sector: puerperal thrombosis and agenesia thrombosis of the inferior vena cava

    International Nuclear Information System (INIS)

    Garcia Egea, Jorge; Lara Guerrero, Isabel; Fustero Aznar, Jose Miguel; Hermoso Cuenca, Vicente; Velez Lomana, Abel

    2011-01-01

    The thrombosis of the inferior vena cava account for around the 15% of the cases of deep venous thrombosis. This is the case of a puerperal primigravida with a cesarean section labor presenting with a thrombosis initially in the right ovarian vein and then extension to the inferior vena cava. Treatment included low molecular weight heparin in anticoagulant doses; rest with elevation of the extremities and elastic bandage. After a satisfactory process evolution with partial lysis of the thrombus, the oral anticoagulation with Acenocumarol for 6 months was started. The second patient, a man aged 73 with backgrounds of an operated hepatic hydatidosis, had a thrombosis of the infrarenal inferior vena cava and agenesia of retrohepatic segment of the inferior vena cava. The patient remains with anticoagulant treatment including Acenocumarol, elastic bandage and hygienic care. As sequela he had a postphlebitic syndrome and reworsening of the edema leading to its admission in two occasions.(author)

  11. Bilateral Deep Vein Thrombosis Associated with Inferior Vena Cava Agenesis in a Young Patient Manifesting as Low Back Pain

    Directory of Open Access Journals (Sweden)

    Felipe Langer

    2017-04-01

    Full Text Available Congenital absence of the inferior vena cava is a rare vascular anomaly, and most cases are asymptomatic. Nevertheless, patients with inferior vena cava malformations may have increased risk of deep venous thrombosis. Particularly, cases of bilateral deep venous thrombosis may arise owing to an insufficient collateral venous drainage from the lower limbs. We hereby describe a case of a previously healthy young male patient presenting with bilateral lower limb deep venous thrombosis as the initial clinical manifestation of congenital inferior vena cava agenesis. We conclude that in young patients presenting with deep venous thrombosis, especially when thrombosis occurs spontaneously, bilaterally, or recurrently, inferior vena cava anomalies should be thoroughly investigated and ruled out as appropriate.

  12. Successful Percutaneous Retrieval of an Inferior Vena Cava Filter Migrating to the Right Ventricle in a Bariatric Patient

    International Nuclear Information System (INIS)

    Veerapong, Jula; Wahlgren, Carl Magnus; Jolly, Neeraj; Bassiouny, Hisham

    2008-01-01

    The use of an inferior vena cava filter has an important role in the management of patients who are at high risk for development of pulmonary embolism. Migration is a rare but known complication of inferior vena cava filter placement. We herein describe a case of a prophylactic retrievable vena cava filter migrating to the right ventricle in a bariatric patient. The filter was retrieved percutaneously by transjugular approach and the patient did well postoperatively. A review of the current literature is given.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  14. Anteriorization of the Normally Acting Inferior Oblique Muscles to Treat Dissociated Vertical Deviation Associated With Juvenile Glaucoma.

    Science.gov (United States)

    Kassem, Rehab Rashad

    2017-10-09

    A case of dissociated vertical deviation, ptosis, and juvenile glaucoma is described. J deformity anteriorization of the normally acting inferior oblique muscles was chosen to preserve the superior fornix for glaucoma surgeries by avoiding superior rectus recession and to prevent narrowing of the palpebral fissure by avoiding an inferior rectus tuck. [J Pediatr Ophthalmol Strabismus. 2017;54:e63-e66.]. Copyright 2017, SLACK Incorporated.

  15. The use of ice-cream to reduce inferior and liver uptake of 99mTc Sestamibi

    International Nuclear Information System (INIS)

    Williams, R.C.; Jost, G.M.

    2002-01-01

    Aim: To determine if ice-cream has any role in reducing the main drawback of sestamibi imaging namely inferior and liver uptake of sestamibi in myocardial imaging. This inferior uptake from, Stomach, Loops of Bowel and Left Lobe of liver can make interpretation difficult Can obscure a defect in the inferior margin of the heart and Hot inferior uptake can produce false adjacent cold defect when using a Fourier kernel. Material and Methods: To remove the confounding factor of various 'stress' regimes adenosine exercise and Dobutamine, only resting Sestamibi scans were examined. Patients where Given ice cream on a stick (ice covered) just prior to injection Imaged at 90 mins post injection of 500 Mbq Tc99m Sestamibi with > 90% purity, using eccentric non-elliptical non circular orbit to maximise resolution, for 18 mins with 2 heads. Processing: Reconstruct (for this purpose) with a butterworth filter of 0.4 and a power factor of 2. Sum all coronal views: Make a rectangular ROI covering the inferior 1/2 or the myocardium. Duplicate this ROI and place at same vertical position over highest activity region of liver. Duplicate region and place immediately underneath cardiac region. Create a BGD region of interest between heart and liver. Data: Ratios of heart to liver and inferior to heart are created with and without background correction. Results: Summary: Ice cream reduces the inferior uptake of Sestamibi by 30%. Ice cream reduces the liver uptake by 14%. Conclusion: Given: The low risk of an ice cream intervention. The high acceptance by patients. The low cost. The effect on inferior uptake. The possible effect on liver uptake. I would recommend the use of Ice Cream for all Myocardial Sestamibi Imaging

  16. Middle and Inferior Temporal Gyrus Gray Matter Volume Abnormalities in First-Episode Schizophrenia: An MRI Study

    OpenAIRE

    Kuroki, Noriomi; Shenton, Martha Elizabeth; Salisbury, Dean; Hirayasu, Yoshio; Onitsuka, Toshiaki; Ersner-Hershfield, Hal; Yurgelun-Todd, Deborah; Kikinis, Ron; Jolesz, Ferenc A.; McCarley, Robert William

    2006-01-01

    Objective: Magnetic resonance imaging (MRI) studies of schizophrenia reveal temporal lobe structural brain abnormalities in the superior temporal gyrus and the amygdala-hippocampal complex. However, the middle and inferior temporal gyri have received little investigation, especially in first-episode schizophrenia. Method: High-spatial-resolution MRI was used to measure gray matter volume in the inferior, middle, and superior temporal gyri in 20 patients with first-episode schizophrenia, 20 pa...

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

    Directory of Open Access Journals (Sweden)

    Catherine Yang

    2013-07-01

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

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

    International Nuclear Information System (INIS)

    Yang, Catherine; Trad, Clovis Simao; Trad, Henrique Simao

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-06-15

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

  20. MRI appearance of surgically proven abnormal accessory anterior-inferior tibiofibular ligament (Bassett's ligament)

    International Nuclear Information System (INIS)

    Subhas, Naveen; Vinson, Emily N.; Cothran, R.L.; Helms, Clyde A.; Santangelo, James R.; Nunley, James A.

    2008-01-01

    A thickened accessory anterior-inferior tibiofibular ligament (Bassett's ligament) of the ankle can be a cause of ankle impingement. Its imaging appearance is not well described. The purpose of this study was to determine if the ligament could be identified on magnetic resonance imaging (MRI), to determine associated abnormalities, and to determine if MRI could be used to differentiate normal from abnormal. Eighteen patients with a preoperative ankle MRI and an abnormal Bassett's ligament reported at surgery were found retrospectively. A separate cohort of 18 patients was selected as a control population. The presence of Bassett's ligament and its thickness were noted. The integrity and appearance of the lateral ankle ligaments, talar dome cartilage, and anterolateral gutter were also noted. In 34 of the 36 cases (94%), Bassett's ligament was identified on MRI. The ligament was seen in all three imaging planes and most frequently in the axial plane. The mean thickness of the ligament in the surgically abnormal cases was 2.37 mm, compared with 1.87 mm in the control with a p value = 0.015 (t test). Nine of the 18 abnormal cases (50%) had talar dome cartilage lesions as a result of contact with the ligament at surgery, with only 3 cases of high-grade defects seen on MRI. Fourteen of the 18 abnormal cases (78%) had of synovitis or scarring in the lateral gutter at surgery, with only 5 cases with scarring seen on MRI. The anterior-inferior tibiofibular ligament was abnormal or torn in 8 of the 18 abnormal cases (44%) by MRI and confirmed in only 3 cases at surgery. Bassett's ligament can be routinely identified on MRI and was significantly thicker in patients who had it resected at surgery. An abnormal Bassett's ligament is often present in the setting of a normal anterior-inferior tibiofibular ligament. The cartilage abnormalities and synovitis associated with an abnormal Bassett's ligament are poorly detected by conventional MRI. (orig.)

  1. Do Superior or Inferior Interlaminar Approach or Bevel Orientation Predispose to Nonepidural Needle Penetration?

    Science.gov (United States)

    Koontz, Nicholas A; Wiggins, Richard H; Stoddard, Gregory J; Shah, Lubdha M

    2017-10-01

    There is a paucity of evidence-based literature regarding the advantages and disadvantages of the interlaminar approach and needle bevel orientation for performing a lumbar interlaminar epidural steroid injection (ESI). The purpose of this study was to determine if superior versus inferior lamina approach, needle bevel tip orientation, or both may predispose to inadvertent nonepidural penetration during lumbar interlaminar ESI. A prospective study was performed of patients with low back pain with or without radicular pain or neurogenic claudication referred for lumbar interlaminar ESI. Two hundred eleven patients were randomized by interlaminar approach (superior vs inferior) and bevel tip orientation (cranial vs caudal). Lumbar interlaminar ESI was performed by six interventionalists of varying levels of experience using fluoroscopic guidance with curved tip epidural needles, using loss-of-resistance technique and confirmation with contrast opacification. Exact Poisson regression was used to model the study outcome. Two hundred twenty-one lumbar interlaminar ESIs were performed on 211 patients, randomized to a superior (n = 121) or inferior lamina approach (n = 100) and to a cranial (n = 103) or caudal (n = 118) orientation of the bevel tip. Epidural needle placement was confirmed in 96.4% (n = 213) of cases. Nonepidural needle placement was most commonly associated with superior lamina approach and caudal bevel tip orientation, which was marginally significant (adjusted risk ratio, 6.88; 95% CI, 0.93-∞; p = 0.059). Inadvertent nonepidural needle penetration during fluoroscopically guided lumbar interlaminar ESI appears to be affected by approach, with superior lamina approach and caudal bevel tip orientation being the least favorable technique.

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

    Directory of Open Access Journals (Sweden)

    Ruediger eGeis

    2013-01-01

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

  3. Transvenous Lead Extraction via the Inferior Approach Using a Gooseneck Snare versus Simple Manual Traction.

    Science.gov (United States)

    Jo, Uk; Kim, Jun; Hwang, You-Mi; Lee, Ji-Hyun; Kim, Min-Su; Choi, Hyung-Oh; Lee, Woo-Seok; Kwon, Chang-Hee; Ko, Gi-Young; Yoon, Hyun-Ki; Nam, Gi-Byoung; Choi, Kee-Joon; Kim, You-Ho

    2016-03-01

    The number of patients with cardiac implantable electronic devices needing lead extraction is increasing for various reasons, including infections, vascular obstruction, and lead failure. We report our experience with transvenous extraction of pacemaker and defibrillator leads via the inferior approach of using a gooseneck snare as a first-line therapy and compare extraction using a gooseneck snare with extraction using simple manual traction. The study included 23 consecutive patients (43 leads) who underwent transvenous lead extraction using a gooseneck snare (group A) and 10 consecutive patients (17 leads) who underwent lead extraction using simple manual traction (group B). Patient characteristics, indications, and outcomes were analyzed and compared between the groups. The dwelling time of the leads was longer in group A (median, 121) than in group B (median, 56; p=0.000). No differences were noted in the overall procedural success rate (69.6% vs. 70%), clinical procedural success rate (82.6% vs. 90%), and lead clinical success rate (86% vs. 94.1%) between the groups. The procedural success rates according to lead type were 89.2% and 100% for pacing leads and 66.7% and 83.3% for defibrillator leads in groups A and B, respectively. Major complications were noted in 3 (mortality in 1) patients in group A and 2 patients in group B. Transvenous extraction of pacemaker leads via an inferior approach using a gooseneck snare was both safe and effective. However, stand-alone transvenous extraction of defibrillator leads using the inferior approach was suboptimal.

  4. Indications, complications and outcomes of elderly patients undergoing retrievable inferior vena cava filter placement.

    Science.gov (United States)

    Rottenstreich, Amihai; Kleinstern, Geffen; Bloom, Allan I; Klimov, Alexander; Kalish, Yosef

    2017-10-01

    The utilization of inferior vena cava filter placement for pulmonary embolism prevention in elderly patients has not been well characterized. The present study aimed to review indications, complications and follow-up data of elderly patients undergoing inferior vena cava filter placement. A retrospective review was carried out of consecutive admitted patients who underwent inferior vena cava filter insertion at a large university hospital with a level I trauma center. Overall, 455 retrievable filters were inserted between 2009 and 2014. A total of 133 patients (29.2%) were aged ≥70 years. Elderly patients were less likely to have their filter retrieved compared with non-elderly patients (5.3% vs 21.4%, P Filter-related complications occurred in 13% of non-elderly patients and 14.3% of elderly patients (P = 0.72), most of them occurring in the first 3 months after filter placement. Survival among elderly patients with no evidence of active malignancy was similar to the non-elderly patients with a 1-year survival rate of 76.3% versus 82% in non-elderly patients (P = 0.22), and a 2-year survival rate of 73.1% versus 78.6% in non-elderly patients (P = 0.27). Although decreased, survival rates among elderly patients with active cancer were still substantial, with a 1-year survival rate of 45% and 2-year survival rate of 40%. Elderly patients had significantly lower rates of filter retrieval with similar complication rate. Survival rates among elderly patients were substantial, and in elderly patients with no active cancer were even comparable with non-elderly patients. When feasible, filter retrieval should be attempted in all elderly patients in order to prevent filter-related complications. Geriatr Gerontol Int 2017; 17: 1508-1514. © 2016 Japan Geriatrics Society.

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

    Directory of Open Access Journals (Sweden)

    Veronika I. Müller

    2013-06-01

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

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

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    Hussain RN

    2011-05-01

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

  7. Pathways of the inferior frontal occipital fasciculus in overt speech and reading.

    Science.gov (United States)

    Rollans, Claire; Cheema, Kulpreet; Georgiou, George K; Cummine, Jacqueline

    2017-11-19

    In this study, we examined the relationship between tractography-based measures of white matter integrity (ex. fractional anisotropy [FA]) from diffusion tensor imaging (DTI) and five reading-related tasks, including rapid automatized naming (RAN) of letters, digits, and objects, and reading of real words and nonwords. Twenty university students with no reported history of reading difficulties were tested on all five tasks and their performance was correlated with diffusion measures extracted through DTI tractography. A secondary analysis using whole-brain Tract-Based Spatial Statistics (TBSS) was also used to find clusters showing significant negative correlations between reaction time and FA. Results showed a significant relationship between the left inferior fronto-occipital fasciculus FA and performance on the RAN of objects task, as well as a strong relationship to nonword reading, which suggests a role for this tract in slower, non-automatic and/or resource-demanding speech tasks. There were no significant relationships between FA and the faster, more automatic speech tasks (RAN of letters and digits, and real word reading). These findings provide evidence for the role of the inferior fronto-occipital fasciculus in tasks that are highly demanding of orthography-phonology translation (e.g., nonword reading) and semantic processing (e.g., RAN object). This demonstrates the importance of the inferior fronto-occipital fasciculus in basic naming and suggests that this tract may be a sensitive predictor of rapid naming performance within the typical population. We discuss the findings in the context of current models of reading and speech production to further characterize the white matter pathways associated with basic reading processes. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  8. Functional and anatomical connectivity abnormalities in left inferior frontal gyrus in schizophrenia.

    Science.gov (United States)

    Jeong, Bumseok; Wible, Cynthia G; Hashimoto, Ryu-ichiro; Kubicki, Marek

    2009-12-01

    Functional studies in schizophrenia demonstrate prominent abnormalities within the left inferior frontal gyrus (IFG) and also suggest the functional connectivity abnormalities in language network including left IFG and superior temporal gyrus during semantic processing. White matter connections between regions involved in the semantic network have also been indicated in schizophrenia. However, an association between functional and anatomical connectivity disruptions within the semantic network in schizophrenia has not been established. Functional (using levels of processing paradigm) as well as diffusion tensor imaging data from 10 controls and 10 chronic schizophrenics were acquired and analyzed. First, semantic encoding specific activation was estimated, showing decreased activation within the left IFG in schizophrenia. Second, functional time series were extracted from this area, and left IFG specific functional connectivity maps were produced for each subject. In an independent analysis, tract-based spatial statistics (TBSS) was used to compare fractional anisotropy (FA) values between groups, and to correlate these values with functional connectivity maps. Schizophrenia patients showed weaker functional connectivity within the language network that includes left IFG and left superior temporal sulcus/middle temporal gyrus. FA was reduced in several white matter regions including left inferior frontal and left internal capsule. Finally, left inferior frontal white matter FA was positively correlated with connectivity measures of the semantic network in schizophrenics, but not in controls. Our results indicate an association between anatomical and functional connectivity abnormalities within the semantic network in schizophrenia, suggesting further that the functional abnormalities observed in this disorder might be directly related to white matter disruptions. 2009 Wiley-Liss, Inc.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-10-15

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

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

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

    2008-02-04

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

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

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    Mostafa Almasi

    2016-06-01

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

  12. Unerupted Primary Molar Teeth Positioned Inferior to the Permanent Premolar: A Case Report

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    A. Bagheri

    2012-01-01

    Full Text Available Primary tooth impaction is a rare finding during the development of primary dentition. Several factors contribute to the impaction of a deciduous tooth. This report describes the diagnosis and treatment of a 10-year-old boy who presented an impacted second primary mandibular molar. This tooth, located inferior to the second premolar together with an odontoma, was positioned superior to the premolar teeth. Treatment consisted of surgical removal of the impacted deciduoustooth and odontoma and placement of a passive lower lingual holdingarch. Periodic examination was indicated for follow- up. Early intervention was recommended to manage orofacial disfigurement and to avoid consequent problems.

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

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    Pedro Christian Aravena

    2016-01-01

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

  14. Free radial forearm adiposo-fascial flap for inferior maxillectomy defect reconstruction

    Science.gov (United States)

    Thankappan, Krishnakumar; Trivedi, Nirav P.; Sharma, Mohit; Kuriakose, Moni A.; Iyer, Subramania

    2009-01-01

    A free radial forearm fascial flap has been described for intraoral reconstruction. Adiposo-fascial flap harvesting involves few technical modifications from the conventional radial forearm fascio-cutaneous free flap harvesting. We report a case of inferior maxillectomy defect reconstruction in a 42-year-old male with a free radial forearm adiposo-fascial flap with good aesthetic and functional outcome with minimal primary and donor site morbidity. The technique of raising the flap and closing the donor site needs to be meticulous in order to achieve good cosmetic and functional outcome. PMID:19881028

  15. Free radial forearm adiposo-fascial flap for inferior maxillectomy defect reconstruction

    Directory of Open Access Journals (Sweden)

    Thankappan Krishnakumar

    2009-01-01

    Full Text Available A free radial forearm fascial flap has been described for intraoral reconstruction. Adiposo-fascial flap harvesting involves few technical modifications from the conventional radial forearm fascio-cutaneous free flap harvesting. We report a case of inferior maxillectomy defect reconstruction in a 42-year-old male with a free radial forearm adiposo-fascial flap with good aesthetic and functional outcome with minimal primary and donor site morbidity. The technique of raising the flap and closing the donor site needs to be meticulous in order to achieve good cosmetic and functional outcome.

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

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    Valary T. Raup

    2015-01-01

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

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

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    O.A. Olulade

    2015-01-01

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

  18. Wolff-Parkinson-White syndrome concomitant with idiopathic ventricular fibrillation associated with inferior early repolarization.

    Science.gov (United States)

    Takahashi, Naohiko; Shinohara, Tetsuji; Hara, Masahide; Saikawa, Tetsunori

    2012-01-01

    We encountered a 39-year-old man with documented ventricular fibrillation (VF). His ECGs showed intermittent Wolff-Parkinson-White (WPW) syndrome pattern. During electrophysiological study, no ventricular preexcitation was observed. An accessory pathway located at the posterior mitral annulus was identified, and successfully eliminated by radiofrequency catheter ablation. VF was not induced. His ECGs in the absence of delta waves demonstrated early repolarization in the inferior leads. This case raises the possibility that patients with manifest WPW syndrome may have an arrhythmogenic substrate associated with early repolarization, and the characteristic J waves can be masked by the presence of ventricular preexcitation.

  19. COMPARISON OF FUNCTIONAL ACTIVITIES ON STRUCTURAL CHANGES OF THE INFERIOR PATELLAR POLE

    Science.gov (United States)

    Wallmann, Harvey; Stalcup, Patrick; DiTommaso, Katie

    2017-01-01

    Background It is well known that eccentric and concentric exercise produce varied amounts of stress on the connective tissues. Diagnostic ultrasound has been used to measure these structural changes by observing fascicle length, angle, and thickness; however, there is a lack of evidence comparing the structural changes as it relates to eccentric, concentric, and stretching protocols. Purpose The purpose of this study was to compare the acute effects of static stretching, eccentric, concentric, and a combination of eccentric/concentric exercises on structural changes of the muscle tendon unit at the inferior patellar pole utilizing the diagnostic ultrasound. Study Design A repeated measures 2 × 4 within factorial study design with repeated measures on both factors was used to determine the differences in patellar tendon thickness within and between groups. Methods Forty-seven healthy subjects were screened for any lower extremity deficits or orthopaedic pathology. Forty-four (N=44) subjects completed all four protocols; the attrition was due to injuries to the lower extremity, occurring unrelated to the study. A baseline measurement of the anterior inferior patellar tendon was performed with the diagnostic ultrasound prior to each participant completing one of the four interventions per week over a four-week period. Interventions completed by each participant included static stretching, concentric, eccentric, and combined concentric and eccentric exercises. Immediately following each intervention, a post-intervention inferior patellar tendon measurement was recorded using the diagnostic ultrasound. Results Significant differences in anterior to posterior tendon thickness of the inferior patellar tendon were observed between pre (4.983 ± 0.041mm) and post (5.198 ± 0.055mm) measurements (peffect of time. However, no differences in tendon thickness were noted comparing each intervention to one another (p=0.351). Conclusion Differences in tendon thickness

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

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    Matthew W Christian

    2009-01-01

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

  1. Binomial confidence intervals for testing non-inferiority or superiority: a practitioner's dilemma.

    Science.gov (United States)

    Pradhan, Vivek; Evans, John C; Banerjee, Tathagata

    2016-08-01

    In testing for non-inferiority or superiority in a single arm study, the confidence interval of a single binomial proportion is frequently used. A number of such intervals are proposed in the literature and implemented in standard software packages. Unfortunately, use of different intervals leads to conflicting conclusions. Practitioners thus face a serious dilemma in deciding which one to depend on. Is there a way to resolve this dilemma? We address this question by investigating the performances of ten commonly used intervals of a single binomial proportion, in the light of two criteria, viz., coverage and expected length of the interval. © The Author(s) 2013.

  2. Angiofibroma of inferior turbinate as an unusual complication of CO2 laser turbinoplasty.

    Science.gov (United States)

    Kang, Ju Wan; Kim, Yon Hee; Kim, Jeong Hong

    2013-01-01

    Angiofibroma is a benign vascular tumor that usually occurs in the nasopharynx, and extranasopharyngeal angiofibromas are rarely reported. We report the first case of an angiofibroma arising from the inferior turbinate after CO2 laser turbinoplasty. Endoscopic excisional biopsy was performed, but the tumor recurred after 2 months of surgery. The mass was excised by endoscopic approach including surrounding normal mucosal tissue. Histologic examination suggested the diagnosis of angiofibroma. The patient was asymptomatic, and there was no evidence of recurrence after 1 year of the second surgery.

  3. Avulsion fractures of the anterior inferior iliac spine: spectrum of imaging findings

    International Nuclear Information System (INIS)

    Fernandes, Joao Luiz; Viana, Sergio Lopes; Mendonca, Jose Luiz Furtado de; Freitas, Flavia Mendes Oliveira; Lima, Gylse-Anne de Souza; Vila, Ana Fabiola da; Ribeiro, Nelmar

    2005-01-01

    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)

  4. Base eletronica de dados clinicos e cirurgicos em isquemia cronica de membros inferiores

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    Carlos Seme Nejm Junior

    2013-09-01

    Full Text Available CONTEXTO: Um sistema eletrônico de protocolo seria capaz de armazenar dados clínicos e possibilitar futuras pesquisas, visando a rapidez, eficiência de cruzamentos e análise de tais dados. OBJETIVO: a criar uma base de dados clínicos cirúrgicos em doenças vasculares e, a partir desta, uma base em Isquemia Crônica de Membros Inferiores; b informatizar essa base sob forma de um protocolo eletrônico; c incorporar ao SINPE(c (Sistema Integrado de Protocolos Eletrônicos; d realizar um projeto piloto. MÉTODOS: Criou-se uma base teórica de dados clínicos sobre as doenças vasculares. O protocolo específico foi criado considerando-se as características individuais das doenças causadoras de Isquemia Crônica de Membros Inferiores. Após seu término, essa base eletrônica e informatizada seria incorporada ao SINPE(c. RESULTADOS: O usuário, previamente cadastrado, realizará o cadastro do paciente e selecionará, dentro do protocolo mestre, o protocolo específico em Isquemia Crônica de Membros Inferiores, para acesso aos seus respectivos dados clínicos. Orientado pelas alternativas diretas de preenchimento, o usuário seleciona apenas os dados pertencentes ao seu paciente. Estes podem ser resgatados para pesquisa, mostrando o número de coletas que satisfazem os parâmetros escolhidos e informações estatísticas sobre a mesma. CONCLUSÃO: a a criação da base teórica de dados clínicos e cirúrgicos em doenças vasculares e, a partir desta, em Isquemia Crônica de Membros Inferiores, foi factível; b a informatização da base teórica sob forma de protocolo eletrônico foi exequível; c o protocolo eletrônico mestre e específico poderá ser incorporado ao SINPE(c, d o projeto piloto foi criado com sucesso e testado através do módulo analisador do SINPE(c.

  5. High baseline activity in inferior temporal cortex improves neural and behavioral discriminability during visual categorization

    Science.gov (United States)

    Emadi, Nazli; Rajimehr, Reza; Esteky, Hossein

    2014-01-01

    Spontaneous firing is a ubiquitous property of neural activity in the brain. Recent literature suggests that this baseline activity plays a key role in perception. However, it is not known how the baseline activity contributes to neural coding and behavior. Here, by recording from the single neurons in the inferior temporal cortex of monkeys performing a visual categorization task, we thoroughly explored the relationship between baseline activity, the evoked response, and behavior. Specifically we found that a low-frequency (baseline activity. This enhancement of the baseline activity was then followed by an increase in the neural selectivity and the response reliability and eventually a higher behavioral performance. PMID:25404900

  6. Removal of a fractured needle during inferior alveolar nerve block: two case reports.

    Science.gov (United States)

    You, Jae-Seek; Kim, Su-Gwan; Oh, Ji-Su; Choi, Hae-In; Jih, Myeong-Kwan

    2017-09-01

    The inferior alveolar nerve block is the most common method of local anesthesia for intraoral surgery at the posterior mandibular region. However, unexpected complications may occur when administering the local anesthesia. One of these uncommon complications is the fracture of the needle. If the injection needle is broken during the surgery, it should be removed immediately. However, this is one of the most difficult procedures. In this report, we present two cases of needle fracture during the procedure, and its successful removal under general/local anesthesia administration.

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Enhanced activation of the left inferior frontal gyrus in deaf and dyslexic adults during rhyming.

    Science.gov (United States)

    MacSweeney, Mairéad; Brammer, Michael J; Waters, Dafydd; Goswami, Usha

    2009-07-01

    Hearing developmental dyslexics and profoundly deaf individuals both have difficulties processing the internal structure of words (phonological processing) and learning to read. In hearing non-impaired readers, the development of phonological representations depends on audition. In hearing dyslexics, many argue, auditory processes may be impaired. In congenitally profoundly deaf individuals, auditory speech processing is essentially absent. Two separate literatures have previously reported enhanced activation in the left inferior frontal gyrus in both deaf and dyslexic adults when contrasted with hearing non-dyslexics during reading or phonological tasks. Here, we used a rhyme judgement task to compare adults from these two special populations to a hearing non-dyslexic control group. All groups were matched on non-verbal intelligence quotient, reading age and rhyme performance. Picture stimuli were used since this requires participants to generate their own phonological representations, rather than have them partially provided via text. By testing well-matched groups of participants on the same task, we aimed to establish whether previous literatures reporting differences between individuals with and without phonological processing difficulties have identified the same regions of differential activation in these two distinct populations. The data indicate greater activation in the deaf and dyslexic groups than in the hearing non-dyslexic group across a large portion of the left inferior frontal gyrus. This includes the pars triangularis, extending superiorly into the middle frontal gyrus and posteriorly to include the pars opercularis, and the junction with the ventral precentral gyrus. Within the left inferior frontal gyrus, there was variability between the two groups with phonological processing difficulties. The superior posterior tip of the left pars opercularis, extending into the precentral gyrus, was activated to a greater extent by deaf than dyslexic

  9. A fractured inferior vena cava filter strut migrating to the left pulmonary artery

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    Tamer Hudali

    2015-01-01

    Full Text Available Inferior vena cava filters are increasingly used in patients with recurrent venous thromboembolism who are contraindicated to anticoagulation. Migration of a broken strut to the pulmonary artery is a very rare complication of these filters. We report the case of an 83-year-old female who experienced this complication with the migratory strut remaining in the same position for years. This case provides evidence that such filters probably have higher rates of complications than what has been thought that remain asymptomatic. The indications and the management of complications of such devices need to be studied further.

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

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    S. V. Mukhtarulina

    2014-12-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  12. Differential contributions of the superior and inferior parietal cortex to feedback versus feedforward control of tools.

    Science.gov (United States)

    Macuga, Kristen L; Frey, Scott H

    2014-05-15

    Damage to the superior and/or inferior parietal lobules (SPL, IPL) (Sirigu et al., 1996) or cerebellum (Grealy and Lee, 2011) can selectively disrupt motor imagery, motivating the hypothesis that these regions participate in predictive (i.e., feedforward) control. If so, then the SPL, IPL, and cerebellum should show greater activity as the demands on feedforward control increase from visually-guided execution (closed-loop) to execution without visual feedback (open-loop) to motor imagery. Using fMRI and a Fitts' reciprocal aiming task with tools directed at targets in far space, we found that the SPL and cerebellum exhibited greater activity during closed-loop control. Conversely, open-loop and imagery conditions were associated with increased activity within the IPL and prefrontal areas. These results are consistent with a superior-to-inferior gradient in the representation of feedback-to-feedforward control within the posterior parietal cortex. Additionally, the anterior SPL displayed greater activity when aiming movements were performed with a stick vs. laser pointer. This may suggest that it is involved in the remapping of far into near (reachable) space (Maravita and Iriki, 2004), or in distalization of the end-effector from hand to stick (Arbib et al., 2009). Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Long-term follow-up and patient satisfaction after reduction mammoplasty: Superomedial versus inferior pedicle

    Directory of Open Access Journals (Sweden)

    Mohamed Makboul

    2016-01-01

    Full Text Available Background: Surgery for hypertrophied breasts represents a challenge for plastic surgeons. The search for a good post-surgical cosmetic breast has led to the development of many techniques. Objectives for reduction mammoplasty are to achieve elevated, symmetrical breasts, a round shape, good projection, small cicatrices that are not very perceptible, and a lasting result. Patients and Methods: This study was carried out on sixty cases who had done reduction mammoplasty from January 2009 to December 2014. All patients were examined and were asked for late post-operative results and overall patients' satisfaction. Results: Long-term projection and contour of the breast were more satisfactory among patients who had superomedial pedicle with a statistically significant difference. No statistically significant difference was observed between patients underwent either superomedial or inferior pedicle reduction mammoplasty with regard to breast shape symmetry, nipple symmetry and sensation. The mean score for satisfaction was higher among patients who underwent superomedial pedicle rather than the inferior pedicle method. Conclusion: The superomedial pedicle shows better long-term cosmetic results.

  14. Response bias reveals enhanced attention to inferior visual field in signers of American Sign Language.

    Science.gov (United States)

    Dye, Matthew W G; Seymour, Jenessa L; Hauser, Peter C

    2016-04-01

    Deafness results in cross-modal plasticity, whereby visual functions are altered as a consequence of a lack of hearing. Here, we present a reanalysis of data originally reported by Dye et al. (PLoS One 4(5):e5640, 2009) with the aim of testing additional hypotheses concerning the spatial redistribution of visual attention due to deafness and the use of a visuogestural language (American Sign Language). By looking at the spatial distribution of errors made by deaf and hearing participants performing a visuospatial selective attention task, we sought to determine whether there was evidence for (1) a shift in the hemispheric lateralization of visual selective function as a result of deafness, and (2) a shift toward attending to the inferior visual field in users of a signed language. While no evidence was found for or against a shift in lateralization of visual selective attention as a result of deafness, a shift in the allocation of attention from the superior toward the inferior visual field was inferred in native signers of American Sign Language, possibly reflecting an adaptation to the perceptual demands imposed by a visuogestural language.

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

    Directory of Open Access Journals (Sweden)

    Ariane Martins

    2010-08-01

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

  16. Combined lateral rectus augmented transposition and inferior rectus recession for monocular elevation deficiency.

    Science.gov (United States)

    Jayakumar, Manjula; Kumar, Dhivya Ashok; Agarwal, Amar

    2018-04-01

    We report the case of a 21-year-old woman who presented with a drooping right upper eyelid and smaller-appearing right eye, evident since birth. Her visual acuity was 20/30 in the right eye and 20/20 in the left eye. In primary gaze she had a hypotropia of 25 Δ , with a marked elevation limitation and associated true upper lid ptosis of 3 mm. Under local anesthesia, the lateral rectus muscle was transposed to the superior rectus muscle and was augmented by a nonabsorbable suture attaching the superior rectus muscle and lateral rectus muscle 8 mm posterior to the insertion, accompanied by an inferior rectus recession. One year after surgery she was orthophoric in primary position and showed improvement in elevation. The surgical procedure can be performed at the same time as the inferior rectus recession and reduces the risk of anterior segment ischemia. Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2009-12-01

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

  18. Percutaneous insertion of inferior vean cava filter:clinical results of 8 patients

    International Nuclear Information System (INIS)

    Bae, Kyung Soo; Shin, Hyun Woong; Park, No Hyuck; Ryeom, Hun Kyu; Kim, Yong Joo

    1997-01-01

    To evaluate the efficacy and clinical results of percutaneous insertion of inferior vena cava(IVC) filter. Over a two year period, eight IVC filters were placed in eight patients with pulmonary thromboembolism resulting from deep vein thrombosis of the legs. The indications for placement were contraindication to anticoagulation(3), and recurrent pulmonary embolism during anticoagulant therapy(5). Both femoral(7) and jugular(1) routes were used for percutaneous transvenous insertion. To delineate the caval anatomy and to ensure placement just caudal to the renal vein, a cavogram was obtained before filter placement. Bird's Nest (7) and Greenfield (1) filters were inserted. Follow-up information was obtained by means of duplex sonography, CT scan, abdominal radiograph, and perfusion scan of the lungs, followed by clinical evaluation. In all cases, procedures were technically successful. Placement complications occurred in three patients. In one, the filter was inadvertently placed above the iliac bifurcation; in the other two, prolapse of the Bird's Nest filter wire occurred. Occlusion of IVC occurred in two patients, and recurrent pulmonary embolism was suspected in one, who suffered from chest pain and short-ness of breath. In the other patients, there was no clinical evidence of recurrence of the pulmonary embolism. Insertion of an inferior vena cava filter is a safe and effective method for the prevention of pulmonary embolism when anticoagulant therapy is either ineffective or contraindicated

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

    Directory of Open Access Journals (Sweden)

    Zachary eMayko

    2012-10-01

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

  20. 4% lidocaine versus 4% articaine for inferior alveolar nerve block in impacted lower third molar surgery.

    Science.gov (United States)

    Boonsiriseth, Kiatanant; Chaimanakarn, Sittipong; Chewpreecha, Prued; Nonpassopon, Natee; Khanijou, Manop; Ping, Bushara; Wongsirichat, Natthamet

    2017-03-01

    No study has compared lidocaine with articaine, each at a concentration of 4% and combined with epinephrine. The purpose of this study was to compare the effectiveness of 4% lidocaine with that of 4% articaine, with a concentration of 1:100,000 epinephrine added to each, in an inferior alveolar nerve block for surgery on impacted lower third molars. This study was conducted at the Faculty of Dentistry, Mahidol University in Bangkok, Thailand. The randomized, single-blind, comparative split-mouth study was carried out in patients with symmetrically impacted lower third molars, as identified on panoramic radiographs. Each patient underwent surgery for the removal of the lower third molars by the same surgeon under local anesthesia at two separate visits, 3 weeks apart. The onset and duration of local anesthesia, intra-operative pain, surgical duration, and number of additional anesthetics administered were recorded. The subjective and objective onset of action for the local anesthetics showed statistically significant differences (P inferior alveolar nerve block was clinically more effective in the onset of subjective and objective anesthesia as compared with the use of 4% lidocaine. Based on the pain scores from the visual analogue scale, 4% lidocaine provided more analgesia during the procedure, and patients noted less intra-operative pain than with 4% articaine; however, the difference was not clinically significant.

  1. Distribution and absorption of local anesthetics in inferior alveolar nerve block: evaluation by magnetic resonance imaging.

    Science.gov (United States)

    Ay, Sinan; Küçük, Dervisşhan; Gümüş, Cesur; Kara, M Isa

    2011-11-01

    The aim of this study was to evaluate the distribution and absorption of local anesthetic solutions in inferior alveolar nerve block using magnetic resonance imaging. Forty healthy volunteers were divided into 4 groups and injected with 1.5 mL for inferior alveolar nerve block and 0.3 mL for lingual nerve block. The solutions used for the different groups were 2% lidocaine, 2% lidocaine with 0.125 mg/mL epinephrine, 4% articaine with 0.006 mg/mL epinephrine, and 4% articaine with 0.012 mg/mL epinephrine. All subjects had axial T2-weighted and fat-suppressed images at 0, 60, and 120 minutes after injection. The localization, area, and intensity (signal characteristics) of the solutions were analyzed and onset and duration times of the anesthesia were recorded. There were no significant differences between groups with regard to the intensity and area of the solutions at 0, 60, and 120 minutes after injection, but differences were found within each group. No between-group differences were found on magnetic resonance imaging in the distribution and absorption of lidocaine with or without epinephrine and articaine with 0.006 and 0.012 mg/mL epinephrine. All solutions were noticeably absorbed at 120 minutes after injection. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Comparative study of the novel and conventional injection approach for inferior alveolar nerve block.

    Science.gov (United States)

    Boonsiriseth, K; Sirintawat, N; Arunakul, K; Wongsirichat, N

    2013-07-01

    This study aimed to evaluate the efficacy of anesthesia obtained with a novel injection approach for inferior alveolar nerve block compared with the conventional injection approach. 40 patients in good health, randomly received each of two injection approaches of local anesthetic on each side of the mandible at two separate appointments. A sharp probe and an electric pulp tester were used to test anesthesia before injection, after injection when the patients' sensation changed, and 5 min after injection. This study comprised positive aspiration and intravascular injection 5% and neurovascular bundle injection 7.5% in the conventional inferior alveolar nerve block, but without occurrence in the novel injection approach. A visual analog scale (VAS) pain assessment was used during injection and surgery. The significance level used in the statistical analysis was pinferior alveolar nerve block by the novel injection approach provided adequate anesthesia and caused less pain and greater safety during injection. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-01-01

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

  4. Comparative Analysis Between Computed and Conventional Inferior Alveolar Nerve Block Techniques.

    Science.gov (United States)

    Araújo, Gabriela Madeira; Barbalho, Jimmy Charles Melo; Dias, Tasiana Guedes de Souza; Santos, Thiago de Santana; Vasconcellos, Ricardo José de Holanda; de Morais, Hécio Henrique Araújo

    2015-11-01

    The aim of this randomized, double-blind, controlled trial was to compare the computed and conventional inferior alveolar nerve block techniques in symmetrically positioned inferior third molars. Both computed and conventional anesthetic techniques were performed in 29 healthy patients (58 surgeries) aged between 18 and 40 years. The anesthetic of choice was 2% lidocaine with 1: 200,000 epinephrine. The Visual Analogue Scale assessed the pain variable after anesthetic infiltration. Patient satisfaction was evaluated using the Likert Scale. Heart and respiratory rates, mean time to perform technique, and the need for additional anesthesia were also evaluated. Pain variable means were higher for the conventional technique as compared with computed, 3.45 ± 2.73 and 2.86 ± 1.96, respectively, but no statistically significant differences were found (P > 0.05). Patient satisfaction showed no statistically significant differences. The average computed technique runtime and the conventional were 3.85 and 1.61 minutes, respectively, showing statistically significant differences (P <0.001). The computed anesthetic technique showed lower mean pain perception, but did not show statistically significant differences when contrasted to the conventional technique.

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

    Directory of Open Access Journals (Sweden)

    Alexandra Yunes

    2017-06-01

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

  6. The role of the right inferior frontal gyrus in the pathogenesis of post-stroke psychosis.

    Science.gov (United States)

    Devine, Michael J; Bentley, Paul; Jones, Brynmor; Hotton, Gary; Greenwood, Richard J; Jenkins, I Harri; Joyce, Eileen M; Malhotra, Paresh A

    2014-03-01

    Psychotic symptoms have previously been reported following right hemisphere brain injury. We sought to identify the specific neuroanatomical basis of delusions following stroke by studying a series of patients with post-stroke psychosis. Lesion overlap analysis was conducted on three individuals with delusions following right hemisphere stroke. These cases were compared with a control group of patients with similar anatomical damage. The main outcome measures were presence of delusions and presence of behavioural susceptibility. The right inferior frontal gyrus and underlying white matter, including the superior longitudinal fasciculus and anterior corona radiata, were involved in all three cases. All three had a preexisting untreated psychiatric disorder. In contrast, only one of nine control cases with equivalent lesions had evidence of previous psychiatric disorder (p = 0.0182, Fisher's exact test), and this was being treated at the time of stroke. We provide clinical evidence from patients with structural brain lesions implicating damage to the right inferior frontal lobe in the generation of persistent psychosis following stroke. We suggest that preexisting psychiatric disease provided a behavioural susceptibility to develop delusions in these individuals.

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

    Directory of Open Access Journals (Sweden)

    E. Castro-Sierra

    1997-01-01

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

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

    Science.gov (United States)

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

    2017-08-28

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

  9. Subcomponents and connectivity of the inferior fronto-occipital fasciculus revealed by diffusion spectrum imaging fiber tracking

    Directory of Open Access Journals (Sweden)

    Yupeng Wu

    2016-09-01

    Full Text Available The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF are still controversial. In this study, we aimed to investigate the connectivity, asymmetry and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI analysis was performed on ten healthy adults and a 90-subject DSI template (NTU-90 Atlas. In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous standard definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient

  10. Subcomponents and Connectivity of the Inferior Fronto-Occipital Fasciculus Revealed by Diffusion Spectrum Imaging Fiber Tracking.

    Science.gov (United States)

    Wu, Yupeng; Sun, Dandan; Wang, Yong; Wang, Yibao

    2016-01-01

    The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF) are still controversial. In this study, we aimed to investigate the connectivity, asymmetry, and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI) analysis was performed on 10 healthy adults and a 90-subject DSI template (NTU-90 Atlas). In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI) was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous "standard" definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole, and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole, and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe, and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient sensitivity to

  11. Subcomponents and Connectivity of the Inferior Fronto-Occipital Fasciculus Revealed by Diffusion Spectrum Imaging Fiber Tracking

    Science.gov (United States)

    Wu, Yupeng; Sun, Dandan; Wang, Yong; Wang, Yibao

    2016-01-01

    The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF) are still controversial. In this study, we aimed to investigate the connectivity, asymmetry, and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI) analysis was performed on 10 healthy adults and a 90-subject DSI template (NTU-90 Atlas). In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI) was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous “standard” definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole, and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole, and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe, and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient sensitivity

  12. Dolutegravir as maintenance monotherapy for HIV (DOMONO): a phase 2, randomised non-inferiority trial.

    Science.gov (United States)

    Wijting, Ingeborg; Rokx, Casper; Boucher, Charles; van Kampen, Jeroen; Pas, Suzan; de Vries-Sluijs, Theodora; Schurink, Carolina; Bax, Hannelore; Derksen, Maarten; Andrinopoulou, Eleni-Rosalina; van der Ende, Marchina; van Gorp, Eric; Nouwen, Jan; Verbon, Annelies; Bierman, Wouter; Rijnders, Bart

    2017-12-01

    The high genetic barrier to resistance of dolutegravir might allow for its use as maintenance monotherapy in patients with HIV. We investigated whether dolutegravir monotherapy was non-inferior to combination antiretroviral therapy (ART) for maintaining virological suppression in patients with HIV-1 infection successfully treated with combination ART. We did this open-label, phase 2, randomised non-inferiority trial at two medical centres in the Netherlands. Eligible patients (aged ≥18 years) were on combination ART, had been virologically suppressed (HIV RNA <50 copies per mL) for at least 6 months, and had CD4 nadirs of 200 cells per μL or higher, HIV RNA zeniths of 100 000 copies per mL or less, and no history of virological failure. Patients were randomly assigned (1:1), via a web-based block randomisation method (variable block sizes of 4 and 6), to switch to dolutegravir monotherapy (50 mg once a day) either immediately or after a delay of 24 weeks of continued combination ART. Randomisation was stratified by HIV RNA zenith (<50 000 copies per mL vs 50 000-99 999 copies per mL). Investigators and patients were not masked to group allocation. The primary endpoint was the proportion of patients with plasma HIV RNA viral loads of less than 200 copies per mL at week 24, with a non-inferiority margin of 12%. We did analyses in the on-treatment and intention-to-treat populations. This trial is registered with ClinicalTrials.gov, NCT02401828. Between March 10, 2015, and Feb 4, 2016, we randomly assigned 51 patients to the immediate switch group and 53 patients to the delayed switch group. One patient who received immediate monotherapy discontinued treatment at week 12 because of disturbed sleep. At week 24, dolutegravir monotherapy was non-inferior to combination ART, with plasma HIV RNA loads of 200 copies per mL or higher observed in 2% (1/50) of patients in the immediate switch group and in no patients in the delayed switch group (difference 2%, 95% CI

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

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    Renan Roque Onzi

    2007-06-01

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

  14. Complications after the placement of domestic ZQL filter and imported inferior vena caval filter: a mid-and long-term comparative study

    International Nuclear Information System (INIS)

    Huang Kun; Zhao Yi; Xu Ke; Feng Bo; Liang Songnian

    2009-01-01

    Objective: To investigate the clinical value of domestic ZQL-type inferior vena caval filter through comparing its complications with that of imported inferior vena caval filter. Methods: Domestic ZQL-type inferior vena caval filter was placed in 62 patients (study group) and imported inferior vena caval filter in 58 patients (control group) for the treatment of deep venous thrombosis of the lower limb. Abdominal plain film, lower limb phlebography and/or pulmonary arteriography, color Doppler ultrasonography were performed after the procedure. 3D-CT scanning was carried out when pulmonary embolism was suspected. The complications were documented and analyzed. Results In all patients the inferior vena caval filter was successfully implanted in planned site. In study group, the complications included filter migration over 10 cm (n = 1), thrombus in the filter (n = 1), inferior vena cava obstruction (n = 2) and pulmonary embolism (n = 1). In control group, the complications included thrombus in the filter (n = 2), deep venous thrombus of the lower extremities (n = 2), inferior vena cava obstruction (n = 9), venous perforation by filter (n = 1) and pulmonary embolism (n = 1). The data were compared between two groups and statistic analysis showed no significant difference between two groups (P > 0.05). Conclusion: No significant difference in the occurrence of complications exists between domestic ZQL-type inferior vena caval filter and imported inferior vena caval filter, therefore, domestic ZQL-type inferior vena caval filter can safely substitute for the imported filter. (authors)

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

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    Bruno eVerschuere

    2012-10-01

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

  16. 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

  17. Congenital anomalies of the inferior vena cava: importance of multiplanar imaging methods: an iconographic essay; Anomalias congenitas da veia cava inferior: valor dos metodos multiplanares em seu diagnostico - ensaio iconografico

    Energy Technology Data Exchange (ETDEWEB)

    Viana, Sergio Lopes; Mendonca, Jose Luiz Furtado de; Freitas, Flavia Mendes Oliveira [Clinica Radiologica Vila Rica, Brasilia, DF (Brazil)] (and others). E-mail: radiolog@uol.com.br

    2006-10-15

    The inferior vena cava is the result of a complex embryologic process which takes place between 6 and 8 weeks of intra-uterine life. Several variations can occur during this process, and a defective embryogenesis of this vessel may lead to the development of anatomic variants. Although many of these variants are asymptomatic, the radiologist should be aware of them and of the potential medico-legal issues involved, especially in cases in which abdominal surgery or hemodynamic procedures are contemplated. In this paper, the major congenital anomalies involving the inferior vena cava are reviewed under the form of a pictorial essay, highlighting the role of the multiplanar imaging methods (volumetric computed tomography and magnetic resonance imaging) in their diagnosis. Keywords: Congenital variations; Inferior vena cava; Renal veins; Computed tomography; Magnetic resonance imaging. author)

  18. Atrophic inferior vena cava is a marker of chronicity of intra-filter and inferior vena cava thrombosis: based on CT findings.

    Science.gov (United States)

    Chen, Liang; Shi, Wanyin; Gu, Jianping; He, Xu; Lou, Wensheng

    2018-04-11

    A permanently indwelling filter in the inferior vena cava (IVC) may induce caval thrombosis, which could develop and evolve from an acute to a chronic phase. The differential diagnosis of acute and chronic thromboses determines the treatment strategy. The role of computed tomography (CT) in diagnosing acute and chronic intra-filter and IVC thromboses has not been well established. This retrospective study summarizes the CT signs that indicate acute and chronic phases of intra-filter and IVC thromboses. This study included eight patients who developed a lower-extremity deep venous thrombosis (DVT) and were treated with intracaval filter placement as an alternative to anticoagulation and thrombolysis. During the follow-up, all patients developed an intra-filter thrombosis in the IVC confirmed by CT and/or CT venography (CTV). Demographic and CT data of all patients during the follow-up period were collected for analysis. All patients had normal-appearing IVCs prior to filter placement, as shown on trans-femoral venography. Eight filters (five TrapEase, three OptEase) were placed in the eight IVCs, respectively. Subsequently, IVC-CT or CTV revealed acute intra-filter or IVC thrombosis in all eight patients, manifesting as an intracaval filling defect and thickened IVC wall. Filter protrusion and secondary caval atrophy seen on CT indicated a chronically occluded IVC. IVC thrombosis may result from filter placement. The chronicity of caval thrombotic occlusion is likely to be associated with filter protrusion and secondary IVC atrophy revealed on CT scans.

  19. ''The dermal internal brassiere flap,'' a new modification of inferior pedicle breast reduction technic.

    Science.gov (United States)

    Temel, Metin; Karakaş, Ali O; Dokuyucu, Recep; Türkmen, Arif

    2015-06-01

    The inferior pedicle mammaplasty is particularly applied to large breasts with a long sternal notch to nipple distance. The present study reports modifications developed to solve the bottoming-out deformity, the lack of upper pole fullness and the wound healing problems seen at the reverse T-zone, known disadvantages of the inferior pedicle reduction mammaplasty, and evaluates postoperative sensation. A total of 110 patients with a mean age of 32 underwent the same technique. In this technique, two pairs of quadrangular and triangular flaps were planned from the skin of resection sites. The triangular dermal flaps and quadrangular flaps were suspended from the periosteum of the 2nd and 4th ribs, respectively. The distance from the nipple to inframammary fold was measured at the postoperative 1st month and 1st year. In the postoperative period, a nipple-inframammary fold distance increase of over 2 cm was determined as bottoming-out deformity. Sensation evaluations were performed by subjective and objective tests. The mean sternal notch to nipple distance was 35.00 cm. After operation, the mean distance between the sternal notch and the nipple was 20.00 cm. NAC examination revealed normal sensation in all patients. Whereas the preoperative mean areolar threshold value was 36.70 g/mm(2), the postoperative first-year mean areolar pressure threshold value was 35.50 g/mm(2) (p value was 25.30 g/mm(2), whereas the postoperative first-year mean nipple pressure threshold value was 26.00 g/mm(2) (p = 0.5471). The postoperative first-month mean sternal notch to nipple distance value of the patients was 20.00 cm, whereas the postoperative first-year mean sternal notch to nipple distance value of the patients was 20.00 cm, (p = 0.0648). The postoperative first-month mean nipple to submammary fold distance value of the patients was 10.50 cm, the postoperative first-year mean nipple to submammary fold distance value of the patients was 11.00 cm (p disadvantages of the inferior

  20. Blefaroplastia inferior: poderia a cirurgia proporcionar satisfação aos pacientes?

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    Giovanni André Pires Viana

    2012-12-01

    Full Text Available OBJETIVO: Foi realizado um estudo prospectivo com objetivo de avaliar os resultados de cinquenta pacientes submetidos a blefaroplastia inferior transcutânea, visando a análise do resultado clínico e a satisfação dos pacientes na Universidade Federal de São Paulo, entre abril de 2005 e maio de 2007. MÉTODOS: Os pacientes foram alocados aleatoriamente em dois grupos cirúgicos. O Grupo Cirúrgico 1 (Grupo Controle foi composto por 25 pacientes submetidos a blefaroplastia inferior tradicional e cantopexia lateral de rotina. O Grupo Cirúrgico 2 (Grupo Experimental foi composto por 25 pacientes submetidos a blefaroplastia inferior com transposição das bolsas adiposas e cantopexia lateral de rotina. Para avaliar os resultados obtidos foi utilizado a avaliação da autoestima dos pacientes, por meio da Escala de Autoestima de Rosenberg UNIFESP/EPM. O outro método utilizado foi solicitar a participação de três cirurgiões independentes que avaliaram as fotografias de pré e pós-operatório e com auxílio de uma escala topográfica, quantificaram os resultados. RESULTADOS: A média de idade foi de 48,8 anos, com predomínio do sexo feminino (96%. A análise das fotografias mostrou que 96% dos pacientes apresentaram melhora significativa. A autoestima melhorou de um escore médio no pré-operatório de 5,1 (desvio padrão = 4,1 para um valor médio de 3,6 (desvio padrão = 3,5 após 6 meses da cirurgia (p=0,001. CONCLUSÃO: Os autores concluíram que ambos os procedimentos seriam seguros e eficazes, com baixo índice de complicação, apresentando melhora da autoestima, visível após seis meses da cirurgia.

  1. Transcranial Magnetic Stimulation over Left Inferior Frontal and Posterior Temporal Cortex Disrupts Gesture-Speech Integration.

    Science.gov (United States)

    Zhao, Wanying; Riggs, Kevin; Schindler, Igor; Holle, Henning

    2018-02-21

    Language and action naturally occur together in the form of cospeech gestures, and there is now convincing evidence that listeners display a strong tendency to integrate semantic information from both domains during comprehension. A contentious question, however, has been which brain areas are causally involved in this integration process. In previous neuroimaging studies, left inferior frontal gyrus (IFG) and posterior middle temporal gyrus (pMTG) have emerged as candidate areas; however, it is currently not clear whether these areas are causally or merely epiphenomenally involved in gesture-speech integration. In the present series of experiments, we directly tested for a potential critical role of IFG and pMTG by observing the effect of disrupting activity in these areas using transcranial magnetic stimulation in a mixed gender sample of healthy human volunteers. The outcome measure was performance on a Stroop-like gesture task (Kelly et al., 2010a), which provides a behavioral index of gesture-speech integration. Our results provide clear evidence that disrupting activity in IFG and pMTG selectively impairs gesture-speech integration, suggesting that both areas are causally involved in the process. These findings are consistent with the idea that these areas play a joint role in gesture-speech integration, with IFG regulating strategic semantic access via top-down signals acting upon temporal storage areas. SIGNIFICANCE STATEMENT Previous neuroimaging studies suggest an involvement of inferior frontal gyrus and posterior middle temporal gyrus in gesture-speech integration, but findings have been mixed and due to methodological constraints did not allow inferences of causality. By adopting a virtual lesion approach involving transcranial magnetic stimulation, the present study provides clear evidence that both areas are causally involved in combining semantic information arising from gesture and speech. These findings support the view that, rather than being

  2. Demonstration of the right inferior phrenic artery by using multislice helical CT

    International Nuclear Information System (INIS)

    Zhao Shaohong; Liu Xin; Cai Zulong; Zhao Hong; Yang Li

    2006-01-01

    Objective: To demonstrate the origin of the right inferior phrenic artery (RIPA) in normal and hepatocellular carcinoma (HCC) patients and provide valuable anatomical information for angiographers before and after transcatheter arterial chemoembolization (TACE). Methods: Four hundred and forty consecutive patients including 133 HCC cases who had biphase abdominal CT were assessed in this study. The routine abdominal enhanced CT scan (GE, LightSpeed16) was performed with 120 kV, 200-240 mAs, 10 mm collimation, 1.375 pitch, and 10 mm reconstruction interval at 22-25 seconds for arterial phase triggered by timing bolus, 60 seconds for portal venous phase after injection of 100 ml contrast material (300 mg I/ml) at a rate of 3.5 ml/s. Multiplanar reconstruction (MPR) and maximum intensity projection (MIP) images were generated using 1.25 mm images reconstructed with 1 mm interval in arterial phase and reviewed by two radiologists. An enhanced artery medial-posterior to the IVC, originated from aorta or its branches to the diaphragmatic dome was interpreted as the RIPA. Results: The RIPA was showed in all 440 patients (100%). Among 218 (49.5%) RIPAs originated from the aorta, 140 were from the fight side of the aorta, 22 from the left side of the aorta, 56 from the anterior wall of the aorta, 36 RIPAs had the same origin with the left inferior phrenic artery. Among 138 (31.4%) RIPAs from the celiac artery, 10 RIPAs had the same origin with the left gastric artery, and 33 RIPAs had the same origin with the left inferior phrenic artery. 78 (17.7%) were from the fight renal artery, 6 (1.4%) were from the left gastric artery (the left gastric artery from aorta). The dilatation of the RIPA was demonstrated in 16 of 133 hepatocellular carcinoma patients. Conclusion: Multislice helical CT could demonstrate the origin of the RIPA in arterial phase and provide useful anatomical information for angiographer before and after TACE. (authors)

  3. PERBANDINGAN ANTARA KOMBINASI LATIHAN STABILISASI BAHU DAN TRAKSI HUMERUS KE INFERIOR DENGAN KOMBINASI LATIHAN FUNGSIONAL BAHU DAN TRAKSI HUMERUS KE INFERIOR DALAM MENURUNKAN DISABILITAS BAHU DAN LENGAN PADA SUBACROMIAL IMPINGEMENT SYNDROME MAHASISWA AKAD

    Directory of Open Access Journals (Sweden)

    Mawaddah -

    2015-08-01

    Full Text Available Shoulder impingement causing interference on the motion of the shoulder joint activities and result in functional activity disorder. These injuries usually are caused by faulty movement, overuse, poor posture, occupational factors and trauma. This will cause a burden on one part of the body and cause imbalances in anatomy, which will eventually lead to disruption of the body that experienced work. This study aimed to investigate the effect of functional shoulder exercise and traction humerus to inferior with shoulder stabilization exercises and traction humerus to inferior to the decline in the shoulder and arm disabilities in subacromial impingement syndrome. This research method was experimental clinical trials with pre test and post test group design. Population student Academy Physiotherapy Widya Husada Semarang, which consists of 3 men and 12 women, aged between 18-21 years, divided into two groups. Group I was given Shoulder Stabilization exercises and Traction humerus to Inferior (n=7 and group II Functional Shoulder Exercise and Traction humerus to Inferior (n=8. This research was conducted for 3 weeks. Measurement of the value of disability shoulder and arm by using the Shoulder Pain and Disability Index (SPADI. The test results on the group I average value pre 34.17, SB = 6.31, and the average value of post 11.54, SB = 4.02, p = 0.001 found significant differences obtained test results paired sample t-test, and testing group II average value pre 40.18, SB = 3.53, and the average value of post 7.82, SB = 1.57, p = 0.001 found significant differences obtained test results paired sample t-test. Comparison of Group I and II, p = 0.005 there were significant differences, test results obtained independent sample t-test. Conclusions: The combination of shoulder stabilization exercises and traction humerus to inferior can reduce disability shoulder and arm on subacromial impingement syndrome. The combination functional shoulder exercise and

  4. Trombosis del sector ilio-cava: trombosis puerperal y trombosis en agenesia de la cava inferior Thrombosis of the ileo-caval sector: puerperal thrombosis and agenesia thrombosis of the inferior vena cava

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    Jorge García Egea

    2011-03-01

    Full Text Available La trombosis de la vena cava inferior supone alrededor del 15 % del total de los casos de trombosis venosa profunda. Se presenta un caso de una puérpera primigesta con parto por cesárea que presentó una trombosis con inicio en la vena ovárica derecha y extensión hasta la cava inferior. Fue tratada con heparina de bajo peso molecular en dosis anticoagulantes, reposo con extremidades elevadas y elastocompresión. Tras la evolución satisfactoria del proceso, con lisis parcial del trombo, se comenzó anticoagulación oral con acenocumarol durante 6 meses. El segundo paciente, un varón de 73 años, con antecedentes de hidatidosis hepática intervenida, presentó una trombosis de la cava inferior infrarrenal y agenesia del segmento retrohepático de la cava inferior. El enfermo sigue con tratamiento anticoagulante con acenocumarol, elastocompresión y cuidados higiénicos. Como secuela presentó un síndrome posflebítico con episodios de úlceras flebostásicas y reagudizaciones del edema, que han obligado a su hospitalización en dos ocasiones.The thrombosis of the inferior vena cava account for around the 15% of the cases of deep venous thrombosis. This is the case of a puerperal primigravida with a cesarean section labor presenting with a thrombosis initially in the right ovarian vein and then extension to the inferior vena cava. Treatment included low molecular weight heparin in anticoagulant doses; rest with elevation of the extremities and elastic bandage. After a satisfactory process evolution with partial lysis of the thrombus, the oral anticoagulation with Acenocumarol for 6 months was started. The second patient, a man aged 73 with backgrounds of an operated hepatic hydatidosis, had a thrombosis of the infrarenal inferior vena cava and agenesia of retrohepatic segment of the inferior vena cava. The patient remains with anticoagulant treatment including Acenocumarol, elastic bandage and hygienic care. As sequela he had a postphlebitic

  5. Diagnosis of tricuspid insufficiency by Doppler flowmetry in the inferior vena cava. A comparison with right ventricular angiography

    Energy Technology Data Exchange (ETDEWEB)

    Smith, H.J.

    Eighty-five patients subjected to routine heart catheterization were examined with duplex scanning of the inferior vena cava. Adequate Doppler recordings and a right ventricular angiography were obtained in 79 of them. Tricuspid insufficiency was found to be present in 34 patients at angiography and in 24 at duplex examination. No false positive Doppler diagnoses of tricuspid insufficiency occurred. The possibility of false positive angiographic diagnoses is discussed. A high correlation was found between percentage reversed flow in the inferior vena cava during ventricular systole and degree of angiographic tricuspid insufficiency. It is concluded that duplex scanning of the inferior vena cava seems to be a good alternative to angiography in the diagnosis and quantification of tricuspid insufficiency.

  6. The use of the inferior epigastric artery for accessory lower polar artery revascularization in live donor renal transplantation.

    Science.gov (United States)

    El-Sherbiny, M; Abou-Elela, A; Morsy, A; Salah, M; Foda, A

    2008-01-01

    This study describes the surgical technique and outcomes of live donor renal allografts with multiple arteries in which the lower polar artery was anastomosed to the inferior epigastric artery after declamping. Between 1988 and 2004, 477 consecutive live donor renal transplants were performed, including 429 with single and 48 with multiple arteries. Anastomosis of the lower polar artery to the inferior epigastric artery was used for 15 grafts with multiple arteries. Successful revascularization of all areas of the transplanted graft was confirmed by Doppler ultrasonography in most patients and radionuclide renal scanning +/- MRA in some patients. In live donor renal transplantation with multiple arteries, the anastomosis of the lower polar artery to the inferior epigastric artery after declamping avoids prolongation of the ischemia time that occurs with other surgical and microsurgical techniques of intracorporeal and ex vivo surgeries.

  7. Vascular loops in the anterior inferior cerebellar artery, as identified by magnetic resonance imaging, and their relationship with otologic symptoms

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    Luiz de Abreu Junior

    Full Text Available Abstract Objective: To use magnetic resonance imaging to identify vascular loops in the anterior inferior cerebellar artery and to evaluate their relationship with otologic symptoms. Materials and Methods: We selected 33 adults with otologic complaints who underwent magnetic resonance imaging at our institution between June and November 2013. Three experienced independent observers evaluated the trajectory of the anterior inferior cerebellar artery in relation to the internal auditory meatus and graded the anterior inferior cerebellar artery vascular loops according to the Chavda classification. Kappa and chi-square tests were used. Values of p < 0.05 were considered significant. Results: The interobserver agreement was moderate. Comparing ears that presented vascular loops with those that did not, we found no association with tinnitus, hearing loss, or vertigo. Similarly, we found no association between the Chavda grade and any otological symptom. Conclusion: Vascular loops do not appear to be associated with otoneurological manifestations.

  8. Activation in the Right Inferior Parietal Lobule Reflects the Representation of Musical Structure beyond Simple Pitch Discrimination

    Science.gov (United States)

    Royal, Isabelle; Vuvan, Dominique T.; Zendel, Benjamin Rich; Robitaille, Nicolas; Schönwiesner, Marc; Peretz, Isabelle

    2016-01-01

    Pitch discrimination tasks typically engage the superior temporal gyrus and the right inferior frontal gyrus. It is currently unclear whether these regions are equally involved in the processing of incongruous notes in melodies, which requires the representation of musical structure (tonality) in addition to pitch discrimination. To this aim, 14 participants completed two tasks while undergoing functional magnetic resonance imaging, one in which they had to identify a pitch change in a series of non-melodic repeating tones and a second in which they had to identify an incongruous note in a tonal melody. In both tasks, the deviants activated the right superior temporal gyrus. A contrast between deviants in the melodic task and deviants in the non-melodic task (melodic > non-melodic) revealed additional activity in the right inferior parietal lobule. Activation in the inferior parietal lobule likely represents processes related to the maintenance of tonal pitch structure in working memory during pitch discrimination. PMID:27195523

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

    Science.gov (United States)

    Lafer-Sousa, Rosa; Conway, Bevil R.

    2014-01-01

    Visual-object processing culminates in inferior temporal (IT) cortex. To assess the organization of IT, we measured fMRI responses in alert monkey to achromatic images (faces, fruit, bodies, places) and colored gratings. IT contained multiple color-biased regions, which were typically ventral to face patches and, remarkably, yoked to them, spaced regularly at four locations predicted by known anatomy. Color and face selectivity increased for more anterior regions, indicative of a broad hierarchical arrangement. Responses to non-face shapes were found across IT, but were stronger outside color-biased regions and face patches, consistent with multiple parallel streams. IT also contained multiple coarse eccentricity maps: face patches overlapped central representations; color-biased regions spanned mid-peripheral representations; and place-biased regions overlapped peripheral representations. These results suggest that IT comprises parallel, multi-stage processing networks subject to one organizing principle. PMID:24141314

  10. Sequential Venoplasty for Treatment of Inferior Vena Cava Stenosis Following Liver Transplant

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    Ahmad Parvinian

    2014-01-01

    Full Text Available Obstruction of the inferior vena cava (IVC is a rare complication of liver transplantation with significant consequences including intractable ascites and hepatic dysfunction. Although venoplasty and stenting are effective in many cases, patients who fail first-line treatment may require surgical intervention or re-transplantation. Scheduled sequential balloon dilation, an approach frequently used to treat fibrotic, benign biliary strictures, but less commonly vascular lesions, may avert the need for such high-risk alternatives while achieving favorable clinical and angiographic response. Herein, we report the case of a 36-year-old woman with transplant-related, initially angioplasty-resistant IVC stenosis that was successfully treated with sequential balloon dilation.

  11. Brachytherapy for the prevention of neointimal hyperplasia in the canine inferior vena cava after stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Isota, Masayuki; Kaminou, Toshio; Sakai, Yukimasa; Nakamura, Kenji; Yamada, Ryusaku [Osaka City Univ. (Japan). Medical School

    2002-06-01

    The aim of this study was to evaluate the efficacy of brachytherapy for preventing neointimal hyperplasia in the inferior vena cava (IVC) after stent placement. Sixteen beagles underwent Z-stent placement in the IVC and the aorta. For 8 of 16 beagles, irradiation (15 Gy) was delivered endoluminally to the stented segments of each vessel immediately after stent placement using the {sup 192}Ir. All animals were sacrificed after 6 weeks for morphometric and histopathologic examination. Morphometrically, neointimal thickness in the IVC of the radiation group was significantly decreased compared with the control group as well as that in the aorta (p<0.05). Histopathologic findings showed the neointima in the IVC of the control group contained markedly organization of thrombus and neovascularization though that in the IVC of the radiation group consisted mainly of smooth muscle cells without organization of thrombus and neovascularization. From these data intravenous irradiation may prevent clinical restenosis after stent placement. (author)

  12. CT of anomalies of the inferior vena cava and left renal vein

    International Nuclear Information System (INIS)

    Kokubo, Takashi; Oyama, Kazuyuki; Ohtomo, Kuni; Yashiro, Naobumi; Itai, Yuji; Iio, Masahiro; Masuyama, Shigeyoshi.

    1988-01-01

    Incidence of anomalies of the inferior vena cava (IVC) and left renal vein (LRV) was examined with post-contrast abdominal CT studies in the last five years and seven months retrospectively. Of the total 1100 cases, right retrocaval ureter was noted in two cases (0.2 %), left IVC was two (0.2 %) and bilateral IVC was twelve (1.1 %) about anomalies of the IVC. As to anomalies of the LRV, retroaortic LRV was four (0.4 %) and circumaortic LRV was six (0.5 %). These results did not always agree with those of previous reports on dissection cases. Particularly, incidence of anomalies of the LRV on CT was much lower than that on dissection. We speculated that racial difference was one of its causes. Clinical usefulness of CT for evaluation of anomalies of the IVC and LRV was stressed. (author)

  13. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava

    Directory of Open Access Journals (Sweden)

    Pradeepkumar Charlagorla

    2016-01-01

    Full Text Available Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC, atrial and visceral situs inversus, left-sided superior vena cava (SVC, and left-sided interrupted inferior vena cava (IVC with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

  14. Bilateral inferior vena cava filter insertion in a patient with duplication of the infrarenal vena cava.

    LENUS (Irish Health Repository)

    Leong, S

    2010-06-19

    BACKGROUND: Inferior vena cava (IVC) filter insertion is a commonly performed procedure for indications such as recurrent pulmonary emboli or contraindication to anticoagulation. Symptomatic duplication of the IVC is exceedingly rare with only a handful of cases being described in the literature. AIM: We report an unusual case of a patient with symptomatic duplication of the IVC. RESULT: A 53-year-old woman presented at our hospital for resection of a cerebral metastasis from a non-small cell lung cancer following a recent diagnosis of bilateral lower limb deep venous thrombosis. This required perioperative reversal of anticoagulation and IVC filter insertion. Conventional venography performed during filter insertion documented the existence of a duplicated IVC. CONCLUSION: We present a case of a symptomatic duplication of the IVC requiring filter insertion. We review the developmental anatomy of the IVC along with the diagnostic findings and management strategies available.

  15. Entrapment of Guide Wire in an Inferior Vena Cava Filter: A Technique for Removal

    International Nuclear Information System (INIS)

    Abdel-Aal, Ahmed Kamel; Saddekni, Souheil; Hamed, Maysoon Farouk; Fitzpatrick, Farley

    2013-01-01

    Entrapment of a central venous catheter (CVC) guide wire in an inferior vena cava (IVC) filter is a rare, but reported complication during CVC placement. With the increasing use of vena cava filters (VCFs), this number will most likely continue to grow. The consequences of this complication can be serious, as continued traction upon the guide wire may result in filter dislodgement and migration, filter fracture, or injury to the IVC. We describe a case in which a J-tipped guide wire introduced through a left subclavian access without fluoroscopic guidance during CVC placement was entrapped at the apex of an IVC filter. We describe a technique that we used successfully in removing the entrapped wire through the left subclavian access site. We also present simple useful recommendations to prevent this complication.

  16. Inferior alveolar nerve paresthesia after overfilling of endodontic sealer into the mandibular canal.

    Science.gov (United States)

    González-Martín, Maribel; Torres-Lagares, Daniel; Gutiérrez-Pérez, José Luis; Segura-Egea, Juan José

    2010-08-01

    The present study describes a case of endodontic sealer (AH Plus) penetration within and along the mandibular canal from the periapical zone of a lower second molar after endodontic treatment. The clinical manifestations comprised anesthesia of the left side of the lower lip, paresthesia and anesthesia of the gums in the third quadrant, and paresthesia and anesthesia of the left mental nerve, appearing immediately after endodontic treatment. The paresthesia and anesthesia of the lip and gums were seen to decrease, but the mental nerve paresthesia and anesthesia persisted after 3.5 years. This case illustrates the need to expend great care with all endodontic techniques when performing nonsurgical root canal therapy, especially when the root apices are in close proximity to vital anatomic structures such as the inferior alveolar canal. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  17. The importance of the ligation of the inferior thyroid artery in parathyroid function after subtotal thyroidectomy

    Directory of Open Access Journals (Sweden)

    Araujo Filho Vergilius José Furtado de

    2000-01-01

    Full Text Available We prospectively studied the effects of the ligation of the inferior thyroid artery (ITA on postoperative hypoparathyroidism in 48 patients who underwent functional subtotal thyroidectomy. Patients were randomized into two groups: A, with bilateral ligation of the ITA and B, without ligation of the ITA. Parathyroid function was checked preoperatively and after surgery by clinical examination and measurement of total calcium, intact PTH, urinary calcium, and AMPc. RESULTS: A significant incidence of postoperative hypocalcemia occurred: 17% in group A and 13% in B on the 4th postoperative day. Six months later, the incidence was 5% in Group A and 0% in Group B. These differences were not statistically significant between the two groups, and neither were any of the other clinical and laboratory observations. CONCLUSION: The ligation of the ITA was not an important causal factor for the occurrence of postoperative hypocalcemia after subtotal thyroidectomy.

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

    DEFF Research Database (Denmark)

    Geday, Jacob; Gjedde, Albert

    2008-01-01

    Attention deactivates the inferior medial prefrontal cortex (IMPC), but it is uncertain if emotions can attenuate this deactivation. To test the extent to which common emotions interfere with attention, we measured changes of a blood flow index of brain activity in key areas of the IMPC...... with positron emission tomography (PET) of labeled water (H(15)2O) uptake in brain of 14 healthy subjects. The subjects performed either a less demanding or a more demanding task of attention while they watched neutral and emotive images of people in realistic indoor or outdoor situations. In the less demanding...... cortices, revealed significant activation in the fusiform gyrus, independently of the task. In contrast, we found no effect of emotional content in the IMPC, where emotions failed to override the effect of the task. The results are consistent with a role of the IMPC in the selection among competitive...

  19. Is GABA neurotransmission enhanced in auditory thalamus relative to inferior colliculus?

    Science.gov (United States)

    Cai, Rui; Kalappa, Bopanna I.; Brozoski, Thomas J.; Ling, Lynne L.

    2013-01-01

    Gamma-aminobutyric acid (GABA) is the major inhibitory neurotransmitter in the central auditory system. Sensory thalamic structures show high levels of non-desensitizing extrasynaptic GABAA receptors (GABAARs) and a reduction in the redundancy of coded information. The present study compared the inhibitory potency of GABA acting at GABAARs between the inferior colliculus (IC) and the medial geniculate body (MGB) using quantitative in vivo, in vitro, and ex vivo experimental approaches. In vivo single unit studies compared the ability of half maximal inhibitory concentrations of GABA to inhibit sound-evoked temporal responses, and found that GABA was two to three times (P GABA levels and suggested a trend towards higher GABA concentrations in MGB than in IC. Collectively, these studies suggest that, per unit GABA, high affinity extrasynaptic and synaptic GABAARs confer a significant inhibitory GABAAR advantage to MGB neurons relative to IC neurons. This increased GABA sensitivity likely underpins the vital filtering role of auditory thalamus. PMID:24155003

  20. Nurse-Moderated Internet-Based Support for New Mothers: Non-Inferiority, Randomized Controlled Trial.

    Science.gov (United States)

    Sawyer, Michael G; Reece, Christy E; Bowering, Kerrie; Jeffs, Debra; Sawyer, Alyssa C P; Mittinty, Murthy; Lynch, John W

    2017-07-24

    Internet-based interventions moderated by community nurses have the potential to improve support offered to new mothers, many of whom now make extensive use of the Internet to obtain information about infant care. However, evidence from population-based randomized controlled trials is lacking. The aim of this study was to test the non-inferiority of outcomes for mothers and infants who received a clinic-based postnatal health check plus nurse-moderated, Internet-based group support when infants were aged 1-7 months as compared with outcomes for those who received standard care consisting of postnatal home-based support provided by a community nurse. The design of the study was a pragmatic, preference, non-inferiority randomized control trial. Participants were recruited from mothers contacted for their postnatal health check, which is offered to all mothers in South Australia. Mothers were assigned either (1) on the basis of their preference to clinic+Internet or home-based support groups (n=328), or (2) randomly assigned to clinic+Internet or home-based groups if they declared no strong preference (n=491). The overall response rate was 44.8% (819/1827). The primary outcome was parenting self-competence, as measured by the Parenting Stress Index (PSI) Competence subscale, and the Karitane Parenting Confidence Scale scores. Secondary outcome measures included PSI Isolation, Interpersonal Support Evaluation List-Short Form, Maternal Support Scale, Ages and Stages Questionnaire-Social-Emotional and MacArthur Communicative Development Inventory (MCDI) scores. Assessments were completed offline via self-assessment questionnaires at enrolment (mean child age=4.1 weeks, SD 1.3) and again when infants were aged 9, 15, and 21 months. Generalized estimating equations adjusting for post-randomization baseline imbalances showed that differences in outcomes between mothers in the clinic+Internet and home-based support groups did not exceed the pre-specified margin of

  1. The clinical application of inferior vena cava filters: the essential point is to use it appropriately

    International Nuclear Information System (INIS)

    Yang Zhengqiang; Li Linsun

    2011-01-01

    This paper aims to describe the history and current situation of the clinical application of inferior venal cava (IVC) filters. As there is a possible tendency for physicians to abuse the IVC filters in clinical practice, the authors think that it is necessary now to judge the advantages and disadvantages of the use of IVC filters again and to conscientiously reconsider what kind of patients are suitable for IVC filter implantation. In this article, the proper characteristics that an ideal IVC filter should possess are introduced, the indications for IVC filter implantation are discussed and the complications occurred after IVC filter implantation are analyzed. The authors believe that the retrievable filters will gradually substitute for permanent filters, for this reason, studies concerning IVC retrievable filters will become the hot spots of research in the near future. (authors)

  2. [The usage of inferior turbinate mucosal flap for repairing cleft lip].

    Science.gov (United States)

    Gao, Pu; Zhao, Min; Qi, Ke-ming; Zhao, Zhen-min; Xiong, Bin

    2004-05-01

    To evaluate a technique for decreasing the tension of the nasal floor during the procedures of repairing complete clef lip. With the designation of an inferior turbinate mucosal flap combined with an oral mucosal flap in the splitting side, the tension was effectively decreased and the nasal floor was closed easily. Eighteen patients was selected for the treatment with this technique since 2000. The follow-ups were 10 to 24 months. All of the patients showed wound healing well with the significant improvement in the donor site. The above mentioned technique may effectively decrease the tension and be used to close the nasal floor safely. It could also reduce the incidence of the complications.

  3. High baseline activity in inferior temporal cortex improves neural and behavioral discriminability during visual categorization

    Directory of Open Access Journals (Sweden)

    Nazli eEmadi

    2014-11-01

    Full Text Available Spontaneous firing is a ubiquitous property of neural activity in the brain. Recent literature suggests that this baseline activity plays a key role in perception. However, it is not known how the baseline activity contributes to neural coding and behavior. Here, by recording from the single neurons in the inferior temporal cortex of monkeys performing a visual categorization task, we thoroughly explored the relationship between baseline activity, the evoked response, and behavior. Specifically we found that a low-frequency (< 8 Hz oscillation in the spike train, prior and phase-locked to the stimulus onset, was correlated with increased gamma power and neuronal baseline activity. This enhancement of the baseline activity was then followed by an increase in the neural selectivity and the response reliability and eventually a higher behavioral performance.

  4. Patterns of Change in Psychological Variables Leading up to Competition in Superior Versus Inferior Performers.

    Science.gov (United States)

    Boat, Ruth; Taylor, Ian M

    2015-06-01

    The study explored patterns of change in a number of potentially performance-related variables (i.e., fatigue, social support, self-efficacy, autonomous motivation, mental skills) during the lead-up to a competitive triathlon, and whether these patterns of change differed for relatively superior versus inferior performers. Forty-two triathletes completed an inventory measuring the study variables every other day during a 2-week period leading up to competition. Performance was assessed using participants' race time, and using a self-referenced relative score compared with personal best times. Multilevel growth curve analyses revealed significant differences in growth trajectories over the 2-week period in mental skills use, social support, and fatigue. The results provide novel insight into how athletes' fluctuating psychological state in the 2 weeks before competition may be crucial in determining performance.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    There is consensus that the left hemisphere plays a dominant role in language processing, but functional imaging studies have shown that the right as well as the left posterior inferior frontal gyri (pIFG) are activated when healthy right-handed individuals make phonological word decisions. Here we...... used online transcranial magnetic stimulation (TMS) to examine the functional relevance of the right pIFG for auditory and visual phonological decisions. Healthy right-handed individuals made phonological or semantic word judgements on the same set of auditorily and visually presented words while......IFG impaired reaction times and accuracy of phonological but not semantic decisions for visually and auditorily presented words. TMS over left, right or bilateral pIFG disrupted phonological processing to a similar degree. In a follow-up experiment, the intensity threshold for delaying phonological judgements...

  6. Patient inertia and the status quo bias: when an inferior option is preferred.

    Science.gov (United States)

    Suri, Gaurav; Sheppes, Gal; Schwartz, Carey; Gross, James J

    2013-09-01

    Medical noncompliance is a major public-health problem. One potential source of this noncompliance is patient inertia. It has been hypothesized that one cause of patient inertia might be the status quo bias-which is the tendency to select the default choice among a set of options. To test this hypothesis, we created a laboratory analogue of the decision context that frequently occurs in situations involving patient inertia, and we examined whether participants would stay with a default option even when it was clearly inferior to other available options. Specifically, in Studies 1 and 2, participants were given the option to reduce their anxiety while waiting for an electric shock. When doing nothing was the status quo option, participants frequently did not select the option that would reduce their anxiety. In Study 3, we demonstrated a simple way to overcome status quo bias in a context relevant to patient inertia.

  7. Precordial ST-segment depression during acute inferior myocardial infarction: clinical, scintigraphic and angiographic correlations

    International Nuclear Information System (INIS)

    Gibson, R.S.; Crampton, R.S.; Watson, D.D.; Taylor, G.J.; Carabello, B.A.; Holt, N.D.; Beller, G.A.

    1982-01-01

    The cause and associated pathophysiology of precordial ST-segment depression during acute inferior myocardial infarction (IMI) are controversial. To investigate this problem, electrocardiographic findings in 48 consecutive patients with acute IMI were prospectively compared with results of coronary angiography, submaximal exercise thallium-201 ( 201 Tl) scintigraphy and multigated blood pool imaging, all obtained 2 weeks after IMI, and with clinical follow-up at 3 months. Patients were classified according to the admission ECG obtained 3.3 +/- 3.1 hours after the onset of chest pain. Twenty-one patients (group A) had no or 201 Tl perfusion abnormalities (p 201 Tl defects or wall motion abnormalities in anterior or septal segments

  8. Responses to amplitude modulated infrared stimuli in the guinea pig inferior colliculus

    Science.gov (United States)

    Richter, Claus-Peter; Young, Hunter

    2013-03-01

    Responses of units in the central nucleus of the inferior colliculus of the guinea pig were recorded with tungsten electrodes. The set of data presented here is limited to high stimulus levels. The effect of changing the modulation frequency and the modulation depth was explored for acoustic and laser stimuli. The selected units responded to sinusoidal amplitude modulated (AM) tones, AM trains of clicks, and AM trains of laser pulses with a modulation of their spike discharge. At modulation frequencies of 20 Hz, some units tended to respond with 40 Hz to the acoustic stimuli, but only at 20 Hz for the trains of laser pulses. For all modes of stimulation the responses revealed a dominant response to the first cycle of the modulation, with decreasing number of action potential during successive cycles. While amplitude modulated tone bursts and amplitude modulated trains of acoustic clicks showed similar patterns, the response to trains of laser pulses was different.

  9. Digital subtraction angiography of inferior gluteal artery through the infusion catheter of chemotherapy for bladder cancer

    International Nuclear Information System (INIS)

    Ishikawa, Satoru; Noguchi, Ryosuke; Kanoh, Shori; Shimazui, Toru; Uchida, Katsunori; Nemoto, Ryosuke; Koiso, Kenkichi

    1987-01-01

    More than fifty patients of invasive bladder cancer had been treated by selective intra-arterial chemotherapy through the inferior or superior gluteal arteries. The distribution of infused drugs had been evaluated by RI-angiography through a thin arterial infusion catheter. This time we performed digital subtraction angiography (DSA) through an infusion catheter in order to know the precise distribution of infused materials in seven patients with locally advanced bladder cancer. Pharmaco-DSA with norepinephrine was also done in four patients. Satisfactory spatial and contrast resolution were gained in four patients and pharmaco-DSA showed better quality. In our experience DSA through intra-arterial infusion catheter was a useful procedure in the evaluation of distribution of infused drugs. (author)

  10. Diagnostic imagings and embolotherapy for the superior mesenteric vein-inferior vena cava shunt

    International Nuclear Information System (INIS)

    Morita, Yutaka; Yamada, Masataka; Miyata, Mutsuhiko; Kubo, Kohzo.

    1994-01-01

    Diagnostic imaging and embolization therapy for the uncommon portal and mesenteric vein-inferior vena cave shunt (PV·SMV-IVC shunt) are reported. As the frequency of clinical symptoms such as hematemesis, melena and confusion caused by gastrointestinal varices, or hepatoencephalopathy was about 40%, it was important for this disease entity to be diagnosed with noninvasive diagnostic images. The careful examination of the area around the right renal vein was able to overcome the low diagnostic rate of 20-40% obtained with US and CT images. In cases of simple PV·SMV-IVC shut without gastrointestinal varices, embolization therapy using steel coils and done by the intravenous approach is easy and noninvasive. On the other hand, in cases of complex PV-SMV-IVC shunt with gastrointestinal varices, dual balloon occluded embolization therapy using a liquid sclerosing agent and done by the intravenous and portal approaches is preferable. (author)

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

    DEFF Research Database (Denmark)

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

    matter underlying these regions continues to develop throughout childhood and adolescence, as indicated by in an increase in fractional anisotropy (FA), possibly reflecting ongoing myelination, and/or increase in axon diameter and density7,8. Here we used an emotional Go/Nogo task to test the hypothesis......The ability to inhibit inappropriate behavior is an essential cognitive and social skill. Response inhibition of pre-potent motor responses as measured with a stop-signal or a Go/Nogo task improves throughout adolescence1,2. Performance on these tasks can be modulated by the valence of task stimuli....... Inhibition of negative faces has been shown to be more difficult than that of positive faces1,3. The brain network underlying response inhibition includes the right inferior frontal gyrus (IFG), right presupplementary motor area (preSMA), and superior longitudinal fasciculus (SLF) bilaterally 4–6. The white...

  12. Giant partially thrombosed 4 th ventricular posterior inferior cerebellar artery aneurysm; microsurgical management

    Directory of Open Access Journals (Sweden)

    Forhad Hossain Chowdhury

    2014-01-01

    Full Text Available A 42-year-old woman presented with a 3-month history of progressive occipital headache, vomiting, walking difficulty, and repeated fall. She had no history of sudden and severe headache. She had positive cerebellar signs, predominantly on the right side. Computerized tomography (CT scan, CT angiogram, and magnetic resonance image (MRI of the brain showed suspected partially thrombosed giant 4 th ventricular posterior inferior cerebellar artery aneurysm. Patient developed severe hypersensitivity reaction during both CT scan and MRI after contrast injection. Though needed, digital subtraction angiogram (DSA of cerebral vessels was not done. The aneurysm was managed by microsurgical clipping of the aneurysm neck and partial excision of thrombosed aneurysm. Here, we report the details of management of these difficult giant aneurysm without DSA.

  13. Enteral Antibiotics are Non-inferior to Intravenous Antibiotics After Complicated Appendicitis in Adults

    DEFF Research Database (Denmark)

    Kleif, Jakob; Rasmussen, Louise; Fonnes, Siv

    2017-01-01

    BACKGROUND: Prolonging post-operative antibiotic treatment beyond 3 days does not seem to reduce the incidence of post-operative abscess formation or wound infection after surgery for complicated appendicitis. The route of administration seems to be based on an empirical basis. Using enteral...... antibiotics could reduce length of stay and reduce overall costs. We aimed to examine whether treatment with enteral antibiotics during the first three post-operative days is non-inferior to intravenous antibiotics regarding intra-abdominal abscess formation or wound infection after surgery for complicated...... of surgery. Route of antibiotic administration for the first three post-operative days was registered for all patients. RESULTS: A total of 1141 patients were included in the study. The overall risk of developing an intra-abdominal abscess was 6.7% (95% CI 5.2%; 8.1%), and the risk of wound infection was 1...

  14. Incidental Finding of Inferior Vena Cava Atresia Presenting with Deep Venous Thrombosis following Physical Exertion

    Directory of Open Access Journals (Sweden)

    Shalini Koppisetty

    2015-01-01

    Full Text Available Inferior vena cava atresia (IVCA is a rare but well described vascular anomaly. It is a rare risk factor for deep venous thrombosis (DVT, found in approximately 5% of cases of unprovoked lower extremity (LE DVT in patients <30 years of age. Affected population is in the early thirties, predominantly male, often with a history of major physical exertion and presents with extensive or bilateral DVTs. Patients with IVC anomalies usually develop compensatory circulation through the collateral veins with enlarged azygous/hemizygous veins. Despite the compensatory circulation, the venous drainage of the lower limbs is often insufficient leading to venous stasis and thrombosis. We describe a case of extensive and bilateral deep venous thrombosis following physical exertion in a thirty-six-year-old male patient with incidental finding of IVCA on imaging.

  15. Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

    Directory of Open Access Journals (Sweden)

    Patro Dilip K

    2009-11-01

    Full Text Available Abstract Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in English literature. Closed reduction by the two-step maneuver was successful with a single attempt. MRI revealed posterior labral tear and a Hill-Sachs variant lesion on the superolateral aspect of humeral head. Immobilisation in a chest-arm bandage followed by physiotherapy yielded excellent results. The case is first of its kind; the unusual mechanism, unique radiological findings and alternate method of treatment are discussed.

  16. Interaural time sensitivity of high-frequency neurons in the inferior colliculus.

    Science.gov (United States)

    Yin, T C; Kuwada, S; Sujaku, Y

    1984-11-01

    Recent psychoacoustic experiments have shown that interaural time differences provide adequate cues for lateralizing high-frequency sounds, provided the stimuli are complex and not pure tones. We present here physiological evidence in support of these findings. Neurons of high best frequency in the cat inferior colliculus respond to interaural phase differences of amplitude modulated waveforms, and this response depends upon preservation of phase information of the modulating signal. Interaural phase differences were introduced in two ways: by interaural delays of the entire waveform and by binaural beats in which there was an interaural frequency difference in the modulating waveform. Results obtained with these two methods are similar. Our results show that high-frequency cells can respond to interaural time differences of amplitude modulated signals and that they do so by a sensitivity to interaural phase differences of the modulating waveform.

  17. CT arteriography via the right inferior phrenic artery developed parasitic perfusion into the liver

    International Nuclear Information System (INIS)

    Inaba, Yoshitaka; Arai, Yasuaki; Sueyoshi, Satoshi; Yamagami, Takuji; Aramaki, Takeshi; Yamaura, Hidekazu; Matsueda, Kiyoshi; Sasaki, Fumio; Takeuchi, Yoshihito.

    1998-01-01

    The distribution of arterial blood flow via the right inferior phrenic artery (rt-IPA) developing parasitic perfusion into the liver was evaluated by CT arteriography (CTA) in 50 cases with hepatic tumors. In all cases, CTA via rt-IPA showed hyperperfusion area including hepatic tumors in the posterior segment and the caudate lobe of the liver, and adding the left hepatic lobe in cases with hepatic arterial occlusion. In 82% of 33 cases obtained both CTA via rt-IPA and CTA via hepatic artery, the hyperperfusion area on CTA via rt-IPA exactly corresponded to perfusion defect area on CTA via hepatic artery. CTA was much useful for understanding hemodynamics in cases with parasitic perfusion into the liver and it could make transcatheter arterial therapy more effective. (author)

  18. Segmental variants of the inferior vena cava - typical findings correlated with embryological development for differential diagnosis

    International Nuclear Information System (INIS)

    Meyer, D.R.; Huggle, H.; Hueppe, T.; Friedrich, M.; Andresen, R.

    2001-01-01

    The vast variability of the overall rare congenital anomalies of the inferior vena cava (IVC) are mostly detected by accident through different imaging modalities. These cannot be classed as pathological findings, and should not be confused with lymphomas and has to differ from secondary collateral venous pathways. Based on 656 CT examinations 10.5% known forms of IVC anomalies were found. According to the embryological development three main groups of IVC variants could be nosologically classified: agenesis of the suprarenal IVC, anomalies of the pars renalis and anomalies of the infrarenal IVC. Additionally three unusual anomaly complexes were found. For the understanding details of the embryology based on a simplified depiction are presented. (orig.) [de

  19. CT arteriography via the right inferior phrenic artery developed parasitic perfusion into the liver

    Energy Technology Data Exchange (ETDEWEB)

    Inaba, Yoshitaka; Arai, Yasuaki; Sueyoshi, Satoshi; Yamagami, Takuji; Aramaki, Takeshi; Yamaura, Hidekazu; Matsueda, Kiyoshi; Sasaki, Fumio [Aichi Cancer Center, Nagoya (Japan); Takeuchi, Yoshihito

    1998-02-01

    The distribution of arterial blood flow via the right inferior phrenic artery (rt-IPA) developing parasitic perfusion into the liver was evaluated by CT arteriography (CTA) in 50 cases with hepatic tumors. In all cases, CTA via rt-IPA showed hyperperfusion area including hepatic tumors in the posterior segment and the caudate lobe of the liver, and adding the left hepatic lobe in cases with hepatic arterial occlusion. In 82% of 33 cases obtained both CTA via rt-IPA and CTA via hepatic artery, the hyperperfusion area on CTA via rt-IPA exactly corresponded to perfusion defect area on CTA via hepatic artery. CTA was much useful for understanding hemodynamics in cases with parasitic perfusion into the liver and it could make transcatheter arterial therapy more effective. (author)

  20. The Need for Anticoagulation Following Inferior Vena Cava Filter Placement: Systematic Review

    International Nuclear Information System (INIS)

    Ray, Charles E.; Prochazka, Allan

    2008-01-01

    Purpose. To perform a systemic review to determine the effect of anticoagulation on the rates of venous thromboembolism (pulmonary embolus, deep venous thrombosis, inferior vena cava (IVC) filter thrombosis) following placement of an IVC filter. Methods. A comprehensive computerized literature search was performed to identify relevant articles. Data were abstracted by two reviewers. Studies were included if it could be determined whether or not subjects received anticoagulation following filter placement, and if follow-up data were presented. A meta-analysis of patients from all included studies was performed. A total of 14 articles were included in the final analysis, but the data from only nine articles could be used in the meta-analysis; five studies were excluded because they did not present raw data which could be analyzed in the meta-analysis. A total of 1,369 subjects were included in the final meta-analysis. Results. The summary odds ratio for the effect of anticoagulation on venous thromboembolism rates following filter deployment was 0.639 (95% CI 0.351 to 1.159, p = 0.141). There was significant heterogeneity in the results from different studies [Q statistic of 15.95 (p = 0.043)]. Following the meta-analysis, there was a trend toward decreased venous thromboembolism rates in patients with post-filter anticoagulation (12.3% vs. 15.8%), but the result failed to reach statistical significance. Conclusion. Inferior vena cava filters can be placed in patients who cannot receive concomitant anticoagulation without placing them at significantly higher risk of development of venous thromboembolism

  1. Ratio superior, ratio inferior y el agustinismo de Tomás de Aquino

    Directory of Open Access Journals (Sweden)

    Moya Cañas, Patricia

    2013-12-01

    Full Text Available This article discusses Aquinas’ reception of the Augustinian distinction between ratio inferior and superior. Though not a central aspect of Aquinas’ thought, it is a signifi cant pointer to the presence of Augustinian patterns of thought in a non-theological part of his work. After a general survey of the presence of this distinction in the opera omnia of Aquinas, his use of this topic in some specific instances is discussed: the distinction between contemplative and active life, the division of human faculties, and the moral problem of peevish delight.El artículo discute la recepción que hace Tomás de Aquino de la distinción agustiniana entre razón superior e inferior. Si bien no se trata de uno de los tópicos centrales de la doctrina tomasiana, es un elemento significativo a la hora de considerar dentro de la obra de Tomás la presencia de patrones agustinianos de pensamiento que no sean primordialmente teológicos. Tras discutir de modo general la presencia de esta distinción en la obra del aquinate, y los estudios previos sobre este binomio, se procede a discutir su uso por parte de Tomás de Aquino ante tres problemas específicos: la distinción entre géneros de vida, la división de las facultades humanas, y el problema moral de la delectación morosa.

  2. Rule-guided executive control of response inhibition: functional topography of the inferior frontal cortex.

    Directory of Open Access Journals (Sweden)

    Weidong Cai

    Full Text Available The human inferior frontal cortex (IFC is a large heterogeneous structure with distinct cytoarchitectonic subdivisions and fiber connections. It has been found involved in a wide range of executive control processes from target detection, rule retrieval to response control. Since these processes are often being studied separately, the functional organization of executive control processes within the IFC remains unclear.We conducted an fMRI study to examine the activities of the subdivisions of IFC during the presentation of a task cue (rule retrieval and during the performance of a stop-signal task (requiring response generation and inhibition in comparison to a not-stop task (requiring response generation but not inhibition. We utilized a mixed event-related and block design to separate brain activity in correspondence to transient control processes from rule-related and sustained control processes. We found differentiation in control processes within the IFC. Our findings reveal that the bilateral ventral-posterior IFC/anterior insula are more active on both successful and unsuccessful stop trials relative to not-stop trials, suggesting their potential role in the early stage of stopping such as triggering the stop process. Direct countermanding seems to be outside of the IFC. In contrast, the dorsal-posterior IFC/inferior frontal junction (IFJ showed transient activity in correspondence to the infrequent presentation of the stop signal in both tasks and the left anterior IFC showed differential activity in response to the task cues. The IFC subdivisions also exhibited similar but distinct patterns of functional connectivity during response control.Our findings suggest that executive control processes are distributed across the IFC and that the different subdivisions of IFC may support different control operations through parallel cortico-cortical and cortico-striatal circuits.

  3. New quantitative classification of the anatomical relationship between impacted third molars and the inferior alveolar nerve

    International Nuclear Information System (INIS)

    Wang, Wei-Quan; Chen, Michael Y. C.; Huang, Heng-Li; Fuh, Lih-Jyh; Tsai, Ming-Tzu; Hsu, Jui-Ting

    2015-01-01

    Before extracting impacted lower third molars, dentists must first identify the spatial relationship between the inferior alveolar nerve (IAN) and an impacted lower third molar to prevent nerve injury from the extraction. Nevertheless, the current method for describing the spatial relationship between the IAN and an impacted lower third molar is deficient. Therefore, the objectives of this study were to: (1) evaluate the relative position between impacted lower third molars and the IAN; and (2) investigate the relative position between impacted lower third molars and the IAN by using a cylindrical coordinate system. From the radiology department’s database, we selected computed tomography images of 137 lower third molars (from 75 patients) requiring removal and applied a Cartesian coordinate system by using Mimics, a medical imaging software application, to measure the distribution between impacted mandibular third molars and the IAN. In addition, the orientation of the lower third molar to the IAN was also measured, but by using a cylindrical coordinate system with the IAN as the origin. According to the Cartesian coordinate system, most of the IAN runs through the inferior side of the third molar (78.6 %), followed by the lingual side (11.8 %), and the buccal side (8.9 %); only 0.7 % is positioned between the roots. Unlike the Cartesian coordinate system, the cylindrical coordinate system clearly identified the relative position, r and θ, between the IAN and lower third molar. Using the cylindrical coordinate system to present the relationship between the IAN and lower third molar as (r, θ) might provide clinical practitioners with a more explicit and objective description of the relative position of both sites. However, comprehensive research and cautious application of this system remain necessary

  4. Development of rostral inferior parietal lobule area functional connectivity from late childhood to early adulthood.

    Science.gov (United States)

    Wang, Mengxing; Zhang, Jilei; Dong, Guangheng; Zhang, Hui; Lu, Haifeng; Du, Xiaoxia

    2017-06-01

    Although the mirror neuron system (MNS) has been extensively studied in monkeys and adult humans, very little is known about its development. Previous studies suggest that the MNS is present by infancy and that the brain and MNS-related cognitive abilities (such as language, empathy, and imitation learning) continue to develop after childhood. In humans, the PFt area of the inferior parietal lobule (IPL) seems to particularly correlate with the functional properties of the PF area in primates, which contains mirror neurons. However, little is known about the functional connectivity (FC) of the PFt area with other brain areas and whether these networks change over time. Here, we investigated the FC development of the PFt area-based network in 59 healthy subjects aged 7-26 years at resting-state to study brain development from late childhood through adolescence to early adulthood. The bilateral PFt showed similar core FC networks, which included the frontal lobe, the cingulate gyri, the insula, the somatosensory cortex, the precuneus, the superior and inferior parietal lobules, the temporal lobe, and the cerebellum posterior lobes. Furthermore, the FC between the left PFt and the left IPL exhibited a significantly positive correlation with age, and the FC between the left PFt and the right postcentral gyrus exhibited a significantly negative correlation with age. In addition, the FC between the right PFt and the right putamen exhibited a significantly negative correlation with age. Our findings suggest that the PFt area-based network develops and is reorganized with age. Copyright © 2017 ISDN. Published by Elsevier Ltd. All rights reserved.

  5. Effects of childhood trauma on left inferior frontal gyrus function during response inhibition across psychotic disorders.

    Science.gov (United States)

    Quidé, Y; O'Reilly, N; Watkeys, O J; Carr, V J; Green, M J

    2018-07-01

    Childhood trauma is a risk factor for psychosis. Deficits in response inhibition are common to psychosis and trauma-exposed populations, and associated brain functions may be affected by trauma exposure in psychotic disorders. We aimed to identify the influence of trauma-exposure on brain activation and functional connectivity during a response inhibition task. We used functional magnetic resonance imaging to examine brain function within regions-of-interest [left and right inferior frontal gyrus (IFG), right dorsolateral prefrontal cortex, right supplementary motor area, right inferior parietal lobule and dorsal anterior cingulate cortex], during the performance of a Go/No-Go Flanker task, in 112 clinical cases with psychotic disorders and 53 healthy controls (HCs). Among the participants, 71 clinical cases and 21 HCs reported significant levels of childhood trauma exposure, while 41 clinical cases and 32 HCs did not. In the absence of effects on response inhibition performance, childhood trauma exposure was associated with increased activation in the left IFG, and increased connectivity between the left IFG seed region and the cerebellum and calcarine sulcus, in both cases and healthy individuals. There was no main effect of psychosis, and no trauma-by-psychosis interaction for any other region-of-interest. Within the clinical sample, the effects of trauma-exposure on the left IFG activation were mediated by symptom severity. Trauma-related increases in activation of the left IFG were not associated with performance differences, or dependent on clinical diagnostic status; increased IFG functionality may represent a compensatory (overactivation) mechanism required to exert adequate inhibitory control of the motor response.

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

    Directory of Open Access Journals (Sweden)

    Masud Sarmad

    2011-03-01

    Full Text Available Abstract Introduction The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use. Case presentation A 35-year-old Caucasian man presented to our facility for elective anterior cruciate ligament repair. He had no background history of any significant medical problems. He opted for general anesthesia over a regional technique. He was induced with fentanyl and propofol and a size 4 laryngeal mask airway was inserted without any problems. His head was in a neutral position during the surgery. After surgery in the recovery room, he complained of numbness in his lower lip. He also developed extensive scabbing of the lower lip on the second day after surgery. The numbness and scabbing started improving after a week, with complete recovery after two weeks. Conclusion We report the first case of vascular occlusion and injury to the inferior alveolar nerve, causing scabbing and numbness of the lower lip, resulting from laryngeal mask airway use. This is an original case report mostly of interest for anesthetists who use the laryngeal mask airway in day-to-day practice. Excessive inflation of the laryngeal mask airway cuff could have led to this complication. Despite the low incidence of cranial nerve injury associated with the use of the laryngeal mask airway, vigilant adherence to evidence-based medicine techniques and recommendations from the manufacturer's instructions can prevent such complications.

  7. VENOUS SAMPLING FOR CUSHING DISEASE: COMPARISON OF INTERNAL JUGULAR VEIN AND INFERIOR PETROSAL SINUS SAMPLING.

    Science.gov (United States)

    Radvany, Martin G; Quinones-Hinojosa, Alfredo; Gallia, Gary L; Wand, Gary S; Salvatori, Roberto

    2016-09-01

    Because magnetic resonance imaging (MRI) fails to detect many adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas, inferior petrosal sinus sampling (IPSS) is considered the gold standard to differentiate Cushing disease (CD) from ectopic ACTH secretion syndrome (EAS). Some authors have suggested internal jugular vein sampling (IJVS) as an alternative to IPSS. We simultaneously compared IJVS to IPSS in 30 consecutive patients referred for ACTH-dependent Cushing syndrome and equivocal MRI exams. Five sites were simultaneously sampled in each patient (right and left IPS, right and left IJV, and femoral vein) before and after the administration of corticotrophin-releasing hormone or desmopressin. The test was considered consistent with CD when the IPS to peripheral ratio was >2 at baseline or >3 after stimulus and the IJV to peripheral ratio was >1.7 at baseline or >2 after stimulus. In 27 of 30 patients, IPSS results were consistent with a central source of ACTH. Two of the other 3 patients had EAS (one lung carcinoid and one occult), and 1 patient had pathology-proven CD. The sensitivity of IPSS was 96.4%. Only 64.2% of these patients had results meeting criteria for a central source of ACTH by IJVS criteria. Twenty patients with centralizing IPPS have undergone pituitary surgery. Of these, the central origin of excessive ACTH was confirmed with certainty in 16 patients. Among these 16 patients, the IPSS sensitivity was 93.8%, whereas 5 patients had false-negative IJVS (68.7% sensitivity). These results do not support the routine use of IJVS in establishing if the pituitary is the source of excessive ACTH. ACTH = adrenocorticotropic hormone CD = Cushing disease CRH = corticotrophin-releasing hormone CS = Cushing syndrome DDAVP = desmopressin EAS = ectopic ACTH secretion IJVS = internal jugular vein sampling IPSS = inferior petrosal sinus sampling JVS = jugular venous sampling MRI = magnetic resonance imaging.

  8. Prominence vs. aboutness in sequencing: a functional distinction within the left inferior frontal gyrus.

    Science.gov (United States)

    Bornkessel-Schlesewsky, Ina; Grewe, Tanja; Schlesewsky, Matthias

    2012-02-01

    Prior research on the neural bases of syntactic comprehension suggests that activation in the left inferior frontal gyrus (lIFG) correlates with the processing of word order variations. However, there are inconsistencies with respect to the specific subregion within the IFG that is implicated by these findings: the pars opercularis or the pars triangularis. Here, we examined the hypothesis that the dissociation between pars opercularis and pars triangularis activation may reflect functional differences between clause-medial and clause-initial word order permutations, respectively. To this end, we directly compared clause-medial and clause-initial object-before-subject orders in German in a within-participants, event-related fMRI design. Our results showed increased activation for object-initial sentences in a bilateral network of frontal, temporal and subcortical regions. Within the lIFG, posterior and inferior subregions showed only a main effect of word order, whereas more anterior and superior subregions showed effects of word order and sentence type, with higher activation for sentences with an argument in the clause-initial position. These findings are interpreted as evidence for a functional gradation of sequence processing within the left IFG: posterior subportions correlate with argument prominence-based (local) aspects of sequencing, while anterior subportions correlate with aboutness-based aspects of sequencing, which are crucial in linking the current sentence to the wider discourse. This proposal appears compatible with more general hypotheses about information processing gradients in prefrontal cortex (Koechlin & Summerfield, 2007). Copyright © 2010 Elsevier Inc. All rights reserved.

  9. Auditory attention enhances processing of positive and negative words in inferior and superior prefrontal cortex.

    Science.gov (United States)

    Wegrzyn, Martin; Herbert, Cornelia; Ethofer, Thomas; Flaisch, Tobias; Kissler, Johanna

    2017-11-01

    Visually presented emotional words are processed preferentially and effects of emotional content are similar to those of explicit attention deployment in that both amplify visual processing. However, auditory processing of emotional words is less well characterized and interactions between emotional content and task-induced attention have not been fully understood. Here, we investigate auditory processing of emotional words, focussing on how auditory attention to positive and negative words impacts their cerebral processing. A Functional magnetic resonance imaging (fMRI) study manipulating word valence and attention allocation was performed. Participants heard negative, positive and neutral words to which they either listened passively or attended by counting negative or positive words, respectively. Regardless of valence, active processing compared to passive listening increased activity in primary auditory cortex, left intraparietal sulcus, and right superior frontal gyrus (SFG). The attended valence elicited stronger activity in left inferior frontal gyrus (IFG) and left SFG, in line with these regions' role in semantic retrieval and evaluative processing. No evidence for valence-specific attentional modulation in auditory regions or distinct valence-specific regional activations (i.e., negative > positive or positive > negative) was obtained. Thus, allocation of auditory attention to positive and negative words can substantially increase their processing in higher-order language and evaluative brain areas without modulating early stages of auditory processing. Inferior and superior frontal brain structures mediate interactions between emotional content, attention, and working memory when prosodically neutral speech is processed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Primary Leiomyosarcoma in the Inferior Vena Cava Extended to the Right Atrium: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Shuichi Fujita

    2016-10-01

    Full Text Available A 38-year-old woman had developed an abdominal distention, lower extremity edema, and dyspnea. Imaging examination revealed a large mass in the right atrium which was connected to lesions within the inferior vena cava. Although complete resection of the mass was not possible, partial surgical tumor resection was performed to avoid pulmonary embolization and circulatory collapse. Leiomyosarcoma was diagnosed histologically, and chemotherapy (doxorubicin followed by radiotherapy was started. By reviewing papers published in the past 10 years that included 322 patients, we also discuss the clinical presentations and prognosis of leiomyosarcoma in the inferior vena cava.

  11. Comparison of two needle models in terms of bevel deformation during truncal block of the inferior alveolar nerve

    OpenAIRE

    Almendros Marqués, Nieves; Delgado Molina, Esther; Tamarit Borrás, Meritxell; Berini Aytés, Leonardo; Gay Escoda, Cosme

    2007-01-01

    Objetivos: Evaluar las posibles diferencias existentes en cuanto a la deformación del bisel de dos tipos de aguja de igual longitud y calibre externo, pero de distinto diámetro interno, durante el bloqueo troncal del nervio dentario inferior. Diseño del estudio: Cuatro operadores de similar formación quirúrgica realizaron el bloqueo troncal del nervio dentario inferior y la anestesia infiltrativa del nervio bucal para proceder a la extracción quirúrgica o convencional del tercer molar infe...

  12. Abdominal wall phlebitis due to Prevotella bivia following renal transplantation in a patient with an occluded inferior vena cava.

    Science.gov (United States)

    Janssen, S; van Donselaar-van der Pant, K A M I; van der Weerd, N C; Develter, W; Bemelman, F J; Grobusch, M P; Idu, M M; Ten Berge, I J M

    2013-02-01

    Pre-existing occlusion of the inferior vena cava may complicate renal transplantation. Suppurative abdominal wall phlebitis following renal transplantation was diagnosed in a patient with pre-existing thrombosis of the inferior vena cava of unknown cause. The phlebitis developed in the subcutaneous collateral veins of the abdominal wall contra-laterally to the renal transplant. Cultures from abdominal wall micro-abscesses yielded Prevotella bivia as the causative agent. This complication has not been described before in the context of renal transplantation. The pathogenesis and management of this serious complication are discussed in this paper.

  13. Left kidney angiomyolipoma, spreading to the renal vein, inferior vena cava and involving the heart. Report of one case

    OpenAIRE

    INNOCENTI C, FRANCO; ALARCÓN C, EMILIO; ARIAS O, ESTEBAN; STOCKINS L, ALECK; SÁNCHEZ U, ROBERTO; MADARIAGA B, JAIME; TORRES-QUEVEDO Q, RODRIGO; CABRERA E, FELIPE; DÍAZ J, RAMÓN

    2008-01-01

    El angiomiolipoma renal es un tumor benigno mesenquimático. Constituyen sólo del 2 al 6% de los tumores renales. Existen alrededor de 12 casos reportados con invasión a las venas renales y la cava inferior. En menos de 5, hay extensión de trombo tumoral hasta aurícula derecha. Objetivo: Presentar el caso clínico, manejo y evolución de una paciente con un angiomiolipoma renal con extensión tumoral a vena renal y cava inferior y que compromete la cavidad auricular derecha casi en su totalidad. ...

  14. Reconstruction of a total avulsion of the hepatic veins and the suprahepatic inferior vena cava secondary to blunt thoracoabdominal trauma.

    Science.gov (United States)

    Kaemmerer, Daniel; Daffner, Wolfgang; Niwa, Martin; Kuntze, Thomas; Hommann, Merten

    2011-02-01

    Blunt injury to the inferior vena cava is a rare but dramatic event having a high mortality up to 80%. The mortality increases after total avulsion especially in combination with secondary intra-abdominal injuries. We report on a 15-year-old boy who sustained a blunt trauma with a total, partially covered avulsion of the hepatic veins and the suprahepatic inferior vena cava. We treated the patient under internal bypassing of the retrohepatic vena cava by using the heart-lung machine and reconstructed the hepatic veins and suprahepatic vena cava with a conduit made of pericard.

  15. Endobronchial Forceps-Assisted and Excimer Laser-Assisted Inferior Vena Cava Filter Removal: The Data, Where We Are, and How It Is Done.

    Science.gov (United States)

    Chen, James X; Montgomery, Jennifer; McLennan, Gordon; Stavropoulos, S William

    2018-06-01

    The recognition of inferior vena cava filter related complications has motivated increased attentiveness in clinical follow-up of patients with inferior vena cava filters and has led to development of multiple approaches for retrieving filters that are challenging or impossible to remove using conventional techniques. Endobronchial forceps and excimer lasers are tools for designed to aid in complex inferior vena cava filter removals. This article discusses endobronchial forceps-assisted and excimer laser-assisted inferior vena cava filter retrievals. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. The Medial Temporal Lobe and the Left Inferior Prefrontal Cortex Jointly Support Interference Resolution in Verbal Working Memory

    Science.gov (United States)

    Oztekin, Ilke; Curtis, Clayton E.; McElree, Brian

    2009-01-01

    During working memory retrieval, proactive interference (PI) can be induced by semantic similarity and episodic familiarity. Here, we used fMRI to test hypotheses about the role of the left inferior frontal gyrus (LIFG) and the medial temporal lobe (MTL) regions in successful resolution of PI. Participants studied six-word lists and responded to a…

  17. Cerebral Fat Embolism in a Trauma Patient with Captured Imaging of Echogenic Emboli in the Inferior Vena Cava

    Directory of Open Access Journals (Sweden)

    Nancy N. Wang

    2016-12-01

    Full Text Available The authors present a case of fat embolism syndrome after traumatic long-bone fracture in a patient with rapid neurologic deterioration and multiple cerebral embolic events. Diagnostic workup revealed the neuroradiologic findings classically described with cerebral fat emboli. The authors present hallmark ultrasound imaging of echogenic material actively traveling through the inferior vena cava.

  18. Anterior ST depression with acute transmural inferior infarction due to posterior infarction. A vectorcardiographic and scintigraphic study

    International Nuclear Information System (INIS)

    Mukharji, J.; Murray, S.; Lewis, S.E.; Croft, C.H.; Corbett, J.R.; Willerson, J.T.; Rude, R.E.

    1984-01-01

    The hypothesis that anterior ST segment depression represents concomitant posterior infarction was tested in 49 patients admitted with a first transmural inferior myocardial infarction. Anterior ST depression was defined as 0.1 mV or more ST depression in leads V1, V2 or V3 on an electrocardiogram recorded within 18 hours of infarction. Serial vectorcardiograms and technetium pyrophosphate scans were obtained. Eighty percent of the patients (39 of 49) had anterior ST depression. Of these 39 patients, 34% fulfilled vectorcardiographic criteria for posterior infarction, and 60% had pyrophosphate scanning evidence of posterior infarction. Early anterior ST depression was neither highly sensitive (84%) nor specific (20%) for the detection of posterior infarction as defined by pyrophosphate imaging. Of patients with persistent anterior ST depression (greater than 72 hours), 87% had posterior infarction detected by pyrophosphate scan. In patients with inferior myocardial infarction, vectorcardiographic evidence of posterior infarction correlated poorly with pyrophosphate imaging data. Right ventricular infarction was present on pyrophosphate imaging in 40% of patients with pyrophosphate changes of posterior infarction but without vectorcardiographic evidence of posterior infarction. It is concluded that: 1) the majority of patients with acute inferior myocardial infarction have anterior ST segment depression; 2) early anterior ST segment depression in such patients is not a specific marker for posterior infarction; and 3) standard vectorcardiographic criteria for transmural posterior infarction may be inaccurate in patients with concomitant transmural inferior myocardial infarction or right ventricular infarction, or both

  19. Ranibizumab in the treatment of choroidal neovascularization on the border of an inferior staphyloma associated with tilted disc syndrome

    Directory of Open Access Journals (Sweden)

    Luis Arias

    2010-03-01

    Full Text Available Luis Arias1,2, Jordi Monés21Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona; 2Institut de la Màcula i de la Retina, Centro Médico Teknon, BarcelonaPurpose: To describe a case of choroidal neovascularization (CNV on the border of an inferior staphyloma associated with tilted disc syndrome treated with intravitreal ranibizumab.Patients: Observational case report.Methods: A patient with CNV on the border of an inferior staphyloma associated with tilted disc syndrome was imaged using fluorescein angiography, autofluorescence and spectral domain optical coherence tomography, and treated with intravitreal injections of ranibizumab. Results: The patient received 3 ranibizumab injections during the 9-month follow-up. The visual acuity improved from 20/40 to 20/32 and the foveal thickness reduced from 470 microns to 248 microns. The angiograms showed resolution of leakage associated with CNV. There were no adverse events.Conclusion: Intravitreal ranibizumab is an efficacious and safe treatment in the management of choroidal neovascularization on the border of an inferior staphyloma associated with tilted disc syndrome.Keywords: intravitreal ranibizumab, choroidal neovascularization, tilted disc syndrome, inferior staphyloma

  20. Adult Wilms tumor with inferior vena cava thrombus and distal deep vein thrombosis - a case report and literature review.

    Science.gov (United States)

    Ratajczyk, Krzysztof; Czekaj, Adrian; Rogala, Joanna; Kowal, Pawel

    2018-02-23

    Adult Wilms tumor (WT, nephroblastoma) is a rare, but well-described renal neoplasm. Although inferior vena cava tumor thrombosis is present in up to 10% of Wilms tumors in childhood, only few cases of this clinical manifestation in adults have been reported. To the best of our knowledge, this is the first case of adult WT infiltrating into inferior vena cava (IVC) with concomitant distal deep vein thrombosis. A 28-year-old male patient with gross hematuria and right flank pain was diagnosed with right kidney tumor penetrating to IVC. Preoperatively, acute distal thrombosis in inferior vena cava and lower extremities veins occurred. Right radical nephrectomy with tumor thrombectomy via cavotomy was performed. In order to prevent pulmonary embolism, IVC was ligated below left renal vein level. Histopathological examination revealed a triphasic nephroblastoma without anaplastic features. Postoperatively, patient was diagnosed with metastatic liver disease, which was treated with two lines of chemotherapy followed by radiotherapy with achievement of complete response. Adult WT occurs usually in young patients, under 40 years of age. Neoadjuvant chemotherapy proved to be effective in children, resulting with tumor shrinkage and venous tumor thrombus regression. Therefore, percutaneous biopsy should be always considered in young patients presenting with renal tumor invading venous system. IVC ligation is a safe treatment option in the event of complete inferior vena cava occlusion due to distal thrombosis concomitant to tumor thrombus, provided collateral venous pathways are well-developed.

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

    Science.gov (United States)

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

    2014-07-01

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

  2. [The anesthetic effects of Gow-Gates technique of inferior alveolar nerve block in impacted mandibular third molar extraction].

    Science.gov (United States)

    Yang, Jieping; Liu, Wei; Gao, Qinghong

    2013-08-01

    To evaluate the anesthetic effects and safety of Gow-Gates technique of inferior alveolar nerve block in impacted mandibular third molar extraction. A split-mouth study was designed. The bilateral impacted mandibular third molar of 32 participants were divided into Gow-Gates technique of inferior alveolar nerve block (Gow-Gates group) and conventional technique of inferior alveolar nerve block (conventional group) randomly with third molar extracted. The anesthetic effects and adverse events were recorded. All the participants completed the research. The anesthetic success rate was 96.9% in Gow-Gates group and 90.6% in conventional group with no statistical difference ( P= 0.317); but when comparing the anesthesia grade, Gow-Gates group had a 96.9% of grade A and B, and conventional group had a rate of 78.1% (P = 0.034). And the Gow-Gates group had a much lower withdrawn bleeding than conventional group (P = 0.025). Two groups had no hematoma. Gow-Gates technique had a reliable anesthesia effects and safety in impacted mandibular third molar extraction and could be chosen as a candidate for the conventional inferior alveolar nerve block.

  3. Patellar Shape-Memory Fixator for the Treatment of Comminuted Fractures of the Inferior Pole of the Patella

    Science.gov (United States)

    Liu, Xin-Wei; Shang, Hui-Juan; Xu, Shuo-Gui; Wang, Zhi-Wei; Zhang, Chun-Cai; Fu, Qing-Ge

    2011-07-01

    Comminuted and displaced fractures of the inferior pole of the patella are not easy to reduce and it is difficult to fix the fragments soundly enough to allow early movement of the knee. The purpose of this study is to evaluate the clinical effectiveness of the internal fixation technique with Patellar Shape-Memory Fixator (PSMF) in acute comminuted fractures of the inferior pole of the patella. We retrospectively studied 25 patients with comminuted fractures of the inferior pole of the patella who were treated with PSMF and followed up for a mean period of 26 months (14 to 60). All the fractures healed at a mean of 6 weeks (5 to 7). The mean grading at the final follow-up was 29.5 points (27 to 30) using the Bostman score, with no observable restriction of movement. No breakage of the PSMF or infection occurred. No delayed union, nonunion, and infection were seen. This technique preserved the length of the patella, reduced the comminuted fragments of the inferior pole and avoided long-term immobilization of the knee.

  4. Academic Achievement and Behavioral Health among Asian American and African American Adolescents: Testing the Model Minority and Inferior Minority Assumptions

    Science.gov (United States)

    Whaley, Arthur L.; Noel, La Tonya

    2013-01-01

    The present study tested the model minority and inferior minority assumptions by examining the relationship between academic performance and measures of behavioral health in a subsample of 3,008 (22%) participants in a nationally representative, multicultural sample of 13,601 students in the 2001 Youth Risk Behavioral Survey, comparing Asian…

  5. Stimulating the Brain's Language Network: Syntactic Ambiguity Resolution after TMS to the Inferior Frontal Gyrus and Middle Temporal Gyrus

    NARCIS (Netherlands)

    Acheson, D.J.; Hagoort, P.

    2013-01-01

    The posterior middle temporal gyrus (MTG) and inferior frontal gyrus (IFG) are two critical nodes of the brain's language network. Previous neuroimaging evidence has supported a dissociation in language comprehension in which parts of the MTG are involved in the retrieval of lexical syntactic

  6. A case of mental nerve paresthesia due to dynamic compression of alveolar inferior nerve along an elongated styloid process

    NARCIS (Netherlands)

    Gooris, P.J.J.; Zijlmans, J.C.M.; Bergsma, J.E.; Mensink, G.

    2014-01-01

    Spontaneous paresthesia of the mental nerve is considered an ominous clinical sign. Mental nerve paresthesia has also been referred to as numb chin syndrome. Several potentially different factors have been investigated for their role in interfering with the inferior alveolar nerve (IAN) and causing

  7. Common and separate origins of the left and right inferior phrenic artery with a review of the literature.

    Science.gov (United States)

    Terayama, H; Yi, S-Q; Tanaka, O; Kanazawa, T; Suyama, K; Kosemura, N; Tetsu, S; Yamazaki, H; Sakamoto, R; Kawakami, S; Suzuki, T; Sakabe, K

    2017-01-01

    In a 94-year-old male cadaver, upon which routine dissection was being conducted, a rare variation was found in the gastrophrenic trunk (GPT), the common trunk of the left gastric artery (LGA), right inferior phrenic artery (RIPA), and left inferior phrenic artery (LIPA); the GPT arises from the abdominal aorta. A hepatosplenic trunk accompanied the variation. In this variation, the RIPA first branched from the GPT and then to the LIPA and LGA. Variations in the common trunk of the LIPA and RIPA in the GPT are common, but to our knowledge, a variation (separate inferior phrenic artery in the GPT) similar to our findings has not been previously reported. We discuss the incidence and developmental and clinical significance of this variation with a detailed review of the literature. Knowledge of such a case has important clinical significance for invasive and non-invasive arterial procedures. Therefore, different variations concerning the LGA and inferior phrenic artery should be considered during surgical and non-surgical evaluations.

  8. Changes in inferior vena cava blood flow velocity and diameter during breathing movements in the human fetus

    NARCIS (Netherlands)

    T. Huisman (T.); S. van den Eijnde (Stefan); P.A. Stewart (Patricia); J.W. Wladimiroff (Juriy)

    1993-01-01

    textabstractBreathing movements in the human fetus cause distinct changes in Doppler flow velocity measurements at arterial, venous and cardiac levels. In adults, breathing movements result in a momentary inspiratory collapse of the inferior vena cava vessel wall. The study objective was to quantify

  9. Transcranial direct current stimulation over left inferior frontal cortex improves speech fluency in adults who stutter.

    Science.gov (United States)

    Chesters, Jennifer; Möttönen, Riikka; Watkins, Kate E

    2018-04-01

    See Crinion (doi:10.1093/brain/awy075) for a scientific commentary on this article.Stuttering is a neurodevelopmental condition affecting 5% of children, and persisting in 1% of adults. Promoting lasting fluency improvement in adults who stutter is a particular challenge. Novel interventions to improve outcomes are of value, therefore. Previous work in patients with acquired motor and language disorders reported enhanced benefits of behavioural therapies when paired with transcranial direct current stimulation. Here, we report the results of the first trial investigating whether transcranial direct current stimulation can improve speech fluency in adults who stutter. We predicted that applying anodal stimulation to the left inferior frontal cortex during speech production with temporary fluency inducers would result in longer-lasting fluency improvements. Thirty male adults who stutter completed a randomized, double-blind, controlled trial of anodal transcranial direct current stimulation over left inferior frontal cortex. Fifteen participants received 20 min of 1-mA stimulation on five consecutive days while speech fluency was temporarily induced using choral and metronome-timed speech. The other 15 participants received the same speech fluency intervention with sham stimulation. Speech fluency during reading and conversation was assessed at baseline, before and after the stimulation on each day of the 5-day intervention, and at 1 and 6 weeks after the end of the intervention. Anodal stimulation combined with speech fluency training significantly reduced the percentage of disfluent speech measured 1 week after the intervention compared with fluency intervention alone. At 6 weeks after the intervention, this improvement was maintained during reading but not during conversation. Outcome scores at both post-intervention time points on a clinical assessment tool (the Stuttering Severity Instrument, version 4) also showed significant improvement in the group receiving

  10. Los Rumiantes (Artiodactyla, Mammalia del Mioceno inferior de La Encinilla (Colmenar Viejo, Madrid

    Directory of Open Access Journals (Sweden)

    Morales, J.

    2006-12-01

    Full Text Available This article is a preliminary study of the fossil ruminants found in the Early Miocene site of La Encinilla (Colmenar Viejo, Madrid. The morphological description of dentition and postcranial bones, along with the metrical and comparative study with material from localities of similar age in France and Spain has allowed us to confirm the presence of two Pecoran ruminants in La Encinilla: Andegameryx sp. and a larger species related to Teruelia Moyá-Solá, 1987. Although the identification in one of the cases should be confirmed with more material, the record in the Madrid Bassin would represent new information regarding the known biogeographical distribution of both taxa. The systematic position of Andegameryx and Teruelia is still under discussion, but both forms are clearly distinct from the Cervoidea ruminants found in Europe and the Iberian Peninsula at the same age, such as Amphitragulus, Oriomeryx, Bedenomeryx or Dremotherium.Este trabajo constituye un estudio preliminar de los restos de rumiantes fósiles hallados en el yacimiento del Mioceno inferior de La Encinilla (Colmenar Viejo, Madrid. La descripción morfológica de la dentición y del esqueleto postcraneal, así como el estudio métrico y comparativo con material procedente de localidades francesas y españolas de edad similar ha permitido constatar hasta el momento la presencia de dos formas de rumiantes Pecora en La Encinilla: Andegameryx sp. y un rumiante de mayor talla relacionado con Teruelia Moyá-Solá, 1987. Aunque la identificación en uno de los casos necesitaría confirmarse con más material, la presencia de estas dos formas en la Cuenca de Madrid ampliaría la distribución biogeográfica conocida para ambos taxones. La posición sistemática de Andegameryx y Teruelia permanece abierta a discusión, pero ambos géneros se diferencian de los Cervoidea del Mioceno inferior encontrados en Europa y la Península Ibérica, tales como Amphitragulus, Oriomeryx, Bedenomeryx

  11. Inferior knee arterial endoluminal angioplasty in treating severe lower limb ischemia though the DEEP balloon catheter

    International Nuclear Information System (INIS)

    Li Shaoqin; Jiang Guomin; Zhao Jinwei; Chen Yaxian; Tian Feng; Wang Yun; Huang Wenhua; Ni Caifang

    2008-01-01

    Objective: To evaluate the efficacy of inferior knee arterial endoluminal angioplasty for treating severe lower limb ischemia with the use of the DEEP balloon catheter. Methods: Eleven patients (17 limbs) with severe ischemia of lower extremities from August 2007 to April 2008 were retrospectively studied. All involved limbs suffered from rest pain including 6 limbs (6/17)complicated with ulcer, 2 (2/17) with toe gangrene or 3 (3/17)with both of the complaints. ABI (Ankle bxancial index) were 0.2-0.5 and 0.51-0.7 in 12 limbs and 5 limbs respectively, with average value 0.47. Results: The success rate of operation was 100% (17/17). Pain relieved obviously in 13 limbs (13/17) and reduced in 2 limbs (2/17). 2 limbs (2/17) still suffered from pain and underwent upper-knee amputation and other 2 with ulcerations(2/ 17)were healed. 3 (3/17) with toe gangrene underwent partial foot amputation, 1 with dried gangrene remained unchanged and the other was lost. Another one showed ulcer healed and toe was lost. Increase of ABI was more than 0.5 in 10 limbs(10/17) and 0.3-0.5 in 5 limbs(5/17) with average value of 0.83. 10 patients with sixteen limbs were followed up in an average period of 4.3 months (1-9 months). Of the 15 immediate pain-relieved limbs, 12(12/15) limbs remained free of pain and pain recurred in 3 other limbs; and 2 of them with pain-reduced after PTA again; the other 1 underwent amputation, Average value of ABI was 0.70. Conclusions: Inferior arterial endoluminal angioplasty for the treatment of severe limb ischemia with application of the DEEP balloon catheter show high successful rate and short-term encouraging clinical results but mid-term and long-terms follow up should be undertaken for further investigation. (authors)

  12. Infra-renal angles, entry into inferior vena cava and vertebral levels of renal veins.

    Science.gov (United States)

    Satyapal, K S

    1999-10-01

    Current norms for renal vasculature hold true in only half the population. Standard textbooks perpetuate old misconceptions regarding renal venous anatomy. This study is aimed to determine left and right infra-renal angles (L-IRA, R-IRA); entry level of renal veins into the inferior vena cava (IVC), and height of IVC under renal vein influence; and their vertebral level. One hundred morphologically normal en-bloc renal specimens randomly selected from post-mortem examinations were dissected and resin casted. IRA were also measured from venograms of 32 adult and 11 foetal cadavers, as were vertebral entry levels. IRA measurements (degrees) were as follows: left, 55 degrees +/- 16 degrees (20 degrees -102 degrees ); right, 60 degrees +/- 17 degrees (10 degrees -93 degrees ). Left vein entered IVC higher than right 54%, lower 36%, and opposite each other 10%. Vertical distance between lower borders of veins was 1.0 +/- 0.9 cm. Vertical distance of IVC under renal vein influence was 2.3 +/- 1.0 cm. Vertebral level of veins in adults lies between TI2-L2. In foetuses, IRA was as follows: left, 65 degrees +/- 12 degrees (45 degrees -90 degrees ); right, 58 degrees +/- 7 degrees (40 degrees -70 degrees ); vertebral level between T12 and L3. Similar IRA values from literature noted on right, 51 degrees (26 degrees -100 degrees ); differences on left, 77 degrees (43 degrees -94 degrees ), clearly differing from Williams et al. (Gray's Anatomy, 37(th) ed, 1989) statement that renal veins "open into the inferior vena cava almost at right angles." Large variations of IRA are not surprising since kidneys are considered normally "floating viscera," varying position with posture and respiratory movement as well as in live vs. cadaveric subjects. The entry level into the IVC also differs from Williams et al. This study uniquely quantitated actual height difference between lower borders of left and right veins. The data presented appears to be the first documentation of vertebral

  13. Semi-quantitative approach of tracer uptake abnormalities in myocardial SPECT: application to inferior defects

    International Nuclear Information System (INIS)

    Damien, J.; Bontemps, L.; Gabain, M.; Felecan, R.; Itti, R.

    1997-01-01

    This study was designed in order to evaluate in a more objective manner than visual inspection, the detection of myocardial inferior wall hypo-fixations in perfusion SPECT. We have studied 90 patients, divided into four groups: GO (7 M, 13 F, 55 ± 21 years) and G1 (9 M, 12 F, 49 ± 26 years) are groups of patients considered as normal; G2 (20 M, 3 F, 60 ± 12 years) corresponds to patients with reversible ischaemia, where the stress examination is abnormal but the resting one is close to normality; G3 (21 H, 5 F, 63 ± 8 years) includes infarcts where both examinations are definitely abnormal. Intra and inter-group statistical comparisons were first done using polar maps (Bull's eye) and an iterative method has then been developed for comparing each image of groups 1, 2 and to the mean normal data (GO). Finally, we have built a ROC (receiver operating characteristic) curves network for determining the best confidence interval and the optimal normality / abnormality criterion (number of pixels located without the confidence interval). The results are expressed in terms of sensitivity and specificity using the most favourable situation derived from the ROC curves. For 2.5 standard deviations, we obtain, for G2 (reversible injury) compared to G1, 78.3 % sensibility and 76.2 % for specificity at rest with at maximum 20 abnormal pixels as normality criterion, and at stress 81 % and 82.6 % for pixels. For G3 (permanent injury) compared to G1, the values are respectively : sensitivity = 88.5 % and specificity = 85.2 % at rest for 40 pixels; sensitivity = 92.3 % and specificity = 85.2 % at stress for 80 pixels. The method developed seems to be applicable on a wider scale, not only limited to inferior area abnormalities. It is able to optimise, for each situation, the confidence interval for an abnormal image definition and the most significant criterion, in terms of number of abnormal pixels, to detect a diseased myocardial area. (authors)

  14. Prolonged Delayed Graft Function Is Associated with Inferior Patient and Kidney Allograft Survivals.

    Directory of Open Access Journals (Sweden)

    Tainá Veras de Sandes-Freitas

    Full Text Available It is unclear if there is an association between the duration of delayed graft function (DGF and kidney transplant (KT outcomes. This study investigated the impact of prolonged DGF on patient and graft survivals, and renal function one year after KT. This single center retrospective analysis included all deceased donor KT performed between Jan/1998 and Dec/2008 (n = 1412. Patients were grouped in quartiles according to duration of DGF (1-5, 6-10, 11-15, and >15 days, designated as prolonged DGF. The overall incidence of DGF was 54.2%. Prolonged DGF was associated with retransplantation (OR 2.110, CI95% 1.064-4.184,p = 0.033 and more than 3 HLA mismatches (OR 1.819, CI95% 1.117-2.962,p = 0.016. The incidence of acute rejection was higher in patients with DGF compared with those without DGF (36.2% vs. 12.2%, p<0.001. Compared to patients without DGF, DGF(1-5, DGF(6-10, and DGF(11-15, patients with prolonged DGF showed inferior one year patient survival (95.2% vs. 95.4% vs. 95.5% vs. 93.4% vs. 88.86%, p = 0.003, graft survival (91% vs. 91.4% vs. 92% vs. 88.7% vs. 70.5%, p<0.001, death-censored graft survival (95.7% vs. 95.4% vs. 96.4% vs. 94% vs. 79.3%, p<0.001, and creatinine clearance (58.0±24.6 vs. 55.8±22.2 vs. 53.8±24.1 vs. 53.0±27.2 vs. 36.8±27.0 mL/min, p<0.001, respectively. Multivariable analysis showed that prolonged DGF was an independent risk factor for graft loss (OR 3.876, CI95% 2.270-6.618, p<0.001, death censored graft loss (OR 4.103, CI95% 2.055-8.193, p<0.001, and death (OR 3.065, CI95% 1.536-6.117, p = 0.001. Prolonged DGF, determined by retransplantation and higher HLA mismatches, was associated with inferior renal function, and patient and graft survivals at one year.

  15. Treatment with silver nitrate versus topical steroid treatment for umbilical granuloma: A non-inferiority randomized control trial.

    Directory of Open Access Journals (Sweden)

    Chikako Ogawa

    Full Text Available The aim of this prospective multicenter randomized controlled trial was to compare the efficacy of silver nitrate cauterization against that of topical steroid ointment in the treatment of neonatal umbilical granuloma.An open-label, non-inferiority randomized controlled trial was conducted from January 2013 to January 2016. The primary endpoint for the silver nitrate cauterization and topical steroid ointment groups was the healing rate after 2 weeks of treatment, applying a non-inferiority margin of 10%. The healing rate was evaluated until completion of 3 weeks of treatment.Participants comprised 207 neonates with newly diagnosed umbilical granuloma, randomized to receive silver nitrate cauterization (n = 104 or topical steroid ointment (n = 103. Healing rates after 2 weeks of treatment were 87.5% (91/104 in the silver nitrate cauterization and 82% (82/100 in the topical steroid ointment group group. The difference between groups was -5.5% (95% confidence interval, -19.1%, 8.4%, indicating that the non-inferiority criterion was not met. After 3 weeks of treatment, the healing rate with topical steroid ointment treatment was almost identical to that of silver nitrate cauterization (94/104 [90.4%] vs. 91/100 [91.0%]; 0.6% [-13.2 to 14.3]. No major complications occurred in either group.This study did not establish non-inferiority of topical steroid ointment treatment relative to silver nitrate cauterization, presumably due to lower healing rates than expected leading to an underpowered trial. However, considering that silver nitrate cauterization carries a distinct risk of chemical burns and that the overall efficacy of topical steroid ointment treatment is similar to that of silver nitrate cauterization, topical steroid ointment might be considered as a good alternative in the treatment of neonatal umbilical granuloma due to its safety and simplicity. To clarify non-inferiority, a larger study is needed.

  16. Reduced Inferior and Orbital Frontal Thickness in Adolescent Bulimia Nervosa Persists Over Two-Year Follow-Up.

    Science.gov (United States)

    Cyr, Marilyn; Kopala-Sibley, Daniel C; Lee, Seonjoo; Chen, Chen; Stefan, Mihaela; Fontaine, Martine; Terranova, Kate; Berner, Laura A; Marsh, Rachel

    2017-10-01

    Cross-sectional data suggest functional and anatomical disturbances in inferior and orbital frontal regions in bulimia nervosa (BN). Using longitudinal data, we investigated whether reduced cortical thickness (CT) in these regions arises early and persists over adolescence in BN, independent of symptom remission, and whether CT reductions are markers of BN symptoms. A total of 33 adolescent females with BN symptoms (BN or other specified feeding or eating disorder) and 28 healthy adolescents participated in this study. Anatomical magnetic resonance imaging and clinical data were acquired at 3 time points within 2-year intervals over adolescence, with 31% average attrition between assessments. Using a region-of-interest approach, we assessed group differences in CT at baseline and over time, and tested whether between- and within-subject variations in CT were associated with the frequency of BN symptoms. Reduced CT in the right inferior frontal gyrus persisted over adolescence in BN compared to healthy adolescents, even in those who achieved full or partial remission. Within the BN group, between-subject variations in CT in the inferior and orbital frontal regions were inversely associated with specific BN symptoms, suggesting, on average over time, greater CT reductions in individuals with more frequent BN symptoms. Reduced CT in inferior frontal regions may contribute to illness persistence into adulthood. Reductions in the thickness of the inferior and orbital frontal regions may be markers of specific BN symptoms. Because our sample size precluded correcting for multiple comparisons, these findings should be replicated in a larger sample. Future study of functional changes in associated fronto-striatal circuits could identify potential circuit-based intervention targets. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  17. Telephone cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: a randomized controlled non-inferiority trial.

    Science.gov (United States)

    Turner, Cynthia M; Mataix-Cols, David; Lovell, Karina; Krebs, Georgina; Lang, Katie; Byford, Sarah; Heyman, Isobel

    2014-12-01

    Many adolescents with obsessive-compulsive disorder (OCD) do not have access to evidence-based treatment. A randomized controlled non-inferiority trial was conducted in a specialist OCD clinic to evaluate the effectiveness of telephone cognitive-behavioral therapy (TCBT) for adolescents with OCD compared to standard clinic-based, face-to-face CBT. Seventy-two adolescents, aged 11 through 18 years with primary OCD, and their parents were randomized to receive specialist TCBT or CBT. The intervention provided differed only in the method of treatment delivery. All participants received up to 14 sessions of CBT, incorporating exposure with response prevention (E/RP), provided by experienced therapists. The primary outcome measure was the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Blind assessor ratings were obtained at midtreatment, posttreatment, 3-month, 6-month, and 12-month follow-up. Intent-to-treat analyses indicated that TCBT was not inferior to face-to-face CBT at posttreatment, 3-month, and 6-month follow-up. At 12-month follow-up, there were no significant between-group differences on the CY-BOCS, but the confidence intervals exceeded the non-inferiority threshold. All secondary measures confirmed non-inferiority at all assessment points. Improvements made during treatment were maintained through to 12-month follow-up. Participants in each condition reported high levels of satisfaction with the intervention received. TCBT is an effective treatment and is not inferior to standard clinic-based CBT, at least in the midterm. This approach provides a means of making a specialized treatment more accessible to many adolescents with OCD. Clinical trial registration information-Evaluation of telephone-administered cognitive-behaviour therapy (CBT) for young people with obsessive-compulsive disorder (OCD); http://www.controlled-trials.com; ISRCTN27070832. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  18. The arcuate nucleus of the C57BL/6J mouse hindbrain is a displaced part of the inferior olive.

    Science.gov (United States)

    Fu, Yu Hong; Watson, Charles

    2012-01-01

    The arcuate nucleus is a prominent cell group in the human hindbrain, characterized by its position on the pial surface of the pyramid. It is considered to be a precerebellar nucleus and has been implicated in the pathology of several disorders of respiration. An arcuate nucleus has not been convincingly demonstrated in other mammals, but we have found a similarly positioned nucleus in the C57BL/6J mouse. The mouse arcuate nucleus consists of a variable group of neurons lying on the pial surface of the pyramid. The nucleus is continuous with the ventrolateral part of the principal nucleus of the inferior olive and both groups are calbindin positive. At first we thought that this mouse nucleus was homologous with the human arcuate nucleus, but we have discovered that the neurons of the human nucleus are calbindin negative, and are therefore not olivary in nature. We have compared the mouse arcuate neurons with those of the inferior olive in terms of molecular markers and cerebellar projection. The neurons of the arcuate nucleus and of the inferior olive share three major characteristics: they both contain neurons utilizing glutamate, serotonin or acetylcholine as neurotransmitters; they both project to the contralateral cerebellum, and they both express a number of genes not present in the major mossy fiber issuing precerebellar nuclei. Most importantly, both cell groups express calbindin in an area of the ventral hindbrain almost completely devoid of calbindin-positive cells. We conclude that the neurons of the hindbrain mouse arcuate nucleus are a displaced part of the inferior olive, possibly separated by the caudal growth of the pyramidal tract during development. The arcuate nucleus reported in the C57BL/6J mouse can therefore be regarded as a subgroup of the rostral inferior olive, closely allied with the ventral tier of the principal nucleus. Copyright © 2012 S. Karger AG, Basel.

  19. Telephone Cognitive-Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: A Randomized Controlled Non-inferiority Trial

    Science.gov (United States)

    Turner, Cynthia M.; Mataix-Cols, David; Lovell, Karina; Krebs, Georgina; Lang, Katie; Byford, Sarah; Heyman, Isobel

    2014-01-01

    Objective Many adolescents with obsessive-compulsive disorder (OCD) do not have access to evidence-based treatment. A randomized controlled non-inferiority trial was conducted in a specialist OCD clinic to evaluate the effectiveness of telephone cognitive-behavioral therapy (TCBT) for adolescents with OCD compared to standard clinic-based, face-to-face CBT. Method Seventy-two adolescents, aged 11 through 18 years with primary OCD, and their parents were randomized to receive specialist TCBT or CBT. The intervention provided differed only in the method of treatment delivery. All participants received up to 14 sessions of CBT, incorporating exposure with response prevention (E/RP), provided by experienced therapists. The primary outcome measure was the Children’s Yale–Brown Obsessive-Compulsive Scale (CY-BOCS). Blind assessor ratings were obtained at midtreatment, posttreatment, 3-month, 6-month, and 12-month follow-up. Results Intent-to-treat analyses indicated that TCBT was not inferior to face-to-face CBT at posttreatment, 3-month, and 6-month follow-up. At 12-month follow-up, there were no significant between-group differences on the CY-BOCS, but the confidence intervals exceeded the non-inferiority threshold. All secondary measures confirmed non-inferiority at all assessment points. Improvements made during treatment were maintained through to 12-month follow-up. Participants in each condition reported high levels of satisfaction with the intervention received. Conclusion TCBT is an effective treatment and is not inferior to standard clinic-based CBT, at least in the midterm. This approach provides a means of making a specialized treatment more accessible to many adolescents with OCD. Clinical trial registration information–Evaluation of telephone-administered cognitive-behaviour therapy (CBT) for young people with obsessive-compulsive disorder (OCD); http://www.controlled-trials.com; ISRCTN27070832. PMID:25457928

  20. Acute iliofemoral venous thrombosis in patients with atresia of the inferior vena cava can be treated successfully with catheter-directed thrombolysis

    DEFF Research Database (Denmark)

    Broholm, Rikke; Jørgensen, Maja; Just, Sven

    2011-01-01

    To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT).......To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT)....

  1. Retrieval characteristics of the Bard Denali and Argon Option inferior vena cava filters.

    Science.gov (United States)

    Dowell, Joshua D; Semaan, Dominic; Makary, Mina S; Ryu, John; Khayat, Mamdouh; Pan, Xueliang

    2017-11-01

    The purpose of this study was to compare the retrieval characteristics of the Option Elite (Argon Medical, Plano, Tex) and Denali (Bard, Tempe, Ariz) retrievable inferior vena cava filters (IVCFs), two filters that share a similar conical design. A single-center, retrospective study reviewed all Option and Denali IVCF removals during a 36-month period. Attempted retrievals were classified as advanced if the routine "snare and sheath" technique was initially unsuccessful despite multiple attempts or an alternative endovascular maneuver or access site was used. Patient and filter characteristics were documented. In our study, 63 Option and 45 Denali IVCFs were retrieved, with an average dwell time of 128.73 and 99.3 days, respectively. Significantly higher median fluoroscopy times were experienced in retrieving the Option filter compared with the Denali filter (12.18 vs 6.85 minutes; P = .046). Use of adjunctive techniques was also higher in comparing the Option filter with the Denali filter (19.0% vs 8.7%; P = .079). No significant difference was noted between these groups in regard to gender, age, or history of malignant disease. Option IVCF retrieval procedures required significantly longer retrieval fluoroscopy time compared with Denali IVCFs. Although procedure time was not analyzed in this study, as a surrogate, the increased fluoroscopy time may also have an impact on procedural direct costs and throughput. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  2. Radiological assessment of the inferior alveolar artery course in human corpse mandibles

    Energy Technology Data Exchange (ETDEWEB)

    Bertl, Kristina [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Malmoe University, Department of Periodontology, Faculty of Odontology, Malmoe (Sweden); Hirtler, Lena [Medical University of Vienna, Center for Anatomy and Cell Biology, Department of Systematic Anatomy, Vienna (Austria); Dobsak, Toni [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Medical University of Vienna, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Vienna (Austria); Austrian Cluster for Tissue Regeneration, Vienna (Austria); Heimel, Patrick [Medical University of Vienna, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Vienna (Austria); Austrian Cluster for Tissue Regeneration, Vienna (Austria); Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna (Austria); Gahleitner, Andre [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Medical University of Vienna, Department of Diagnostic Radiology, Division of Osteoradiology, General Hospital, Vienna (Austria); Ulm, Christian [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Plenk, Hanns [Medical University of Vienna, Bone and Biomaterials Research, Institute for Histology and Embryology, Vienna (Austria)

    2015-04-01

    CT assessment of the entire course of the inferior alveolar artery (IAA) within the mandibular canal. After contrast medium injection (180 or 400 mg/ml iodine concentration) into the external carotid arteries of 15 fresh human cadaver heads, the main IAA's position in the canal (cranial, buccal, lingual or caudal) was assessed in dental CT images of partially edentulous mandibles. The course of the main IAA could be followed at both iodine concentrations. The higher concentration gave the expected better contrast, without creating artefacts, and improved visibility of smaller arteries, such as anastomotic sections, dental branches and the incisive branch. The main IAA changed its position in the canal more often than so far known (mean 4.3 times, SD 1.24, range 2-7), but with a similar bilateral course. A cranial position was most often detected (42 %), followed by lingual (36 %), caudal (16 %) and buccal (6 %). With this non-invasive radiologic method, the entire course of the main IAA in the mandibular canal could be followed simultaneously with other bone structures on both sides of human cadaver mandibles. This methodology allows one to amend existing anatomical and histological data, which are important for surgical interventions near the mandibular canal. (orig.)

  3. Repetition Suppression in the Left Inferior Frontal Gyrus Predicts Tone Learning Performance.

    Science.gov (United States)

    Asaridou, Salomi S; Takashima, Atsuko; Dediu, Dan; Hagoort, Peter; McQueen, James M

    2016-06-01

    Do individuals differ in how efficiently they process non-native sounds? To what extent do these differences relate to individual variability in sound-learning aptitude? We addressed these questions by assessing the sound-learning abilities of Dutch native speakers as they were trained on non-native tone contrasts. We used fMRI repetition suppression to the non-native tones to measure participants' neuronal processing efficiency before and after training. Although all participants improved in tone identification with training, there was large individual variability in learning performance. A repetition suppression effect to tone was found in the bilateral inferior frontal gyri (IFGs) before training. No whole-brain effect was found after training; a region-of-interest analysis, however, showed that, after training, repetition suppression to tone in the left IFG correlated positively with learning. That is, individuals who were better in learning the non-native tones showed larger repetition suppression in this area. Crucially, this was true even before training. These findings add to existing evidence that the left IFG plays an important role in sound learning and indicate that individual differences in learning aptitude stem from differences in the neuronal efficiency with which non-native sounds are processed. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Preliminary clinical study on endovascular treatment of posterior inferior cerebellar artery aneurysms

    International Nuclear Information System (INIS)

    Zhao Bing; Zhong Ming; Tan Xianxi; Zheng Kuang; Zhang Mingsheng; Yin Jian; He Wengen

    2009-01-01

    Objective: To study the methods and results of endovascular treatment of posterior inferior cerebellar artery (PICA) aneurysms. Methods: Twenty-one patients with PICA aneurysms were treated with endovascular treatment. The locations of aneurysm on PICA were evaluated through the DSA. Eight patients received single coil embolization, 5 received liquid Glue embolization, 2 received coil embolization combined with liquid Glue, 2 received coil embolization assisted with stents, and 4 underwent occlusion of the parent PICA. Outcome was evaluated with the Glasgow outcome scale (GOS). Results: There were complete (100%) occlusion in 5 patients, near complete (> 90%) occlusion in 2, and incomplete (85%) occlusion in 1 in single coil embolization. Seven patients with Glue embolization (n=5) or combination with coils (n=2) exhibited complete (100%) occlusion. There were near complete (>90%) occlusion in 2 cases with coil assisted with stents. Complete occlusion of the parent PICA was achieved in 3 patients, and near complete occlusion of PICA in one case. One patient suffered from new neurological deficits, and one patient treated with coils and stents died. None of the patients suffered from re-bleeding. There patients received follow-up during a mean period of (22 ± 8) months. Overall long-term outcome was good (GOS score 4 or 5) in 17 patients, poor (GOS score 2 or 3) in 3, and fatal (GOS score 1 ) in one case. Conclusions: According to the location of aneurysms on PICA, aneurysms can be effectively and safely treated with endovascular embolization. (authors)

  5. Disintegration of the 'waterfall phenomenon' in the inferior vena cava due to right heart failure.

    Science.gov (United States)

    Kira, S; Dambara, T; Mieno, T; Tamaki, S; Natori, H

    1996-03-01

    The concept of the waterfall phenomenon in Zone 2 in the pulmonary vasculature is well known from West's lung model. It is believed that the flow through this zone is determined by the pressure difference between the pulmonary artery and alveoli, and the left atrial pressure is not transmissible to the alveolar capillaries. However, it is impossible to see whether alveolar capillaries are really displaying the waterfall phenomenon or not. In this review, the interrelation between the flow and geometry of the alveolar capillaries in the waterfall phenomenon is analyzed based on physiological studies using a model system and isolated lung lobe experiments. Further, extending the concept to the analysis of ventilatory changes of the inferior vena cava (IVC) configuration, it is ascertained that the waterfall phenomenon normally occurs in the IVC during inspiration just before it enters the thorax and the waterfall phenomenon in the IVC disintegrates with elevation of the central venous pressure. Because these configurations of the IVC in normal and abnormal conditions are visible with ultrasonography, the technique is very useful as a noninvasive approach to diagnose right heart failure.

  6. Virtual lesions of the inferior parietal cortex induce fast changes of implicit religiousness/spirituality.

    Science.gov (United States)

    Crescentini, Cristiano; Aglioti, Salvatore M; Fabbro, Franco; Urgesi, Cosimo

    2014-05-01

    Religiousness and spirituality (RS) are two ubiquitous aspects of human experience typically considered impervious to scientific investigation. Nevertheless, associations between RS and frontoparietal neural activity have been recently reported. However, much less is known about whether such activity is causally involved in modulating RS or just epiphenomenal to them. Here we combined two-pulse (10 Hz) Transcranial Magnetic Stimulation (TMS) with a novel, ad-hoc developed RS-related, Implicit Association Test (IAT) to investigate whether implicit RS representations, although supposedly rather stable, can be rapidly modified by a virtual lesion of inferior parietal lobe (IPL) and dorsolateral prefrontal cortex (DLPFC). A self-esteem (SE) IAT, focused on self-concepts nonrelated to RS representations, was developed as control. A specific increase of RS followed inhibition of IPL demonstrating its causative role in inducing fast plastic changes of religiousness/spirituality. In contrast, DLPFC inhibition had more widespread effects probably reflecting a general role in the acquisition or maintenance of task-rules or in controlling the expression of self-related representations not specific to RS. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Excitatory stimulation of the right inferior parietal cortex lessens implicit religiousness/spirituality.

    Science.gov (United States)

    Crescentini, Cristiano; Di Bucchianico, Marilena; Fabbro, Franco; Urgesi, Cosimo

    2015-04-01

    Although religiousness and spirituality (RS) are considered two fundamental constituents of human life, neuroscientific investigation has long avoided the study of their neurocognitive basis. Nevertheless, recent investigations with brain imaging and brain damaged patients, and more recently with brain stimulation methods, have documented important associations between RS beliefs and experiences and frontoparietal neural activity. In this study, we further investigated how individuals' implicit RS self-representations can be modulated by changes in right inferior parietal lobe (IPL) excitability, a key region associated to RS. To this end, we combined continuous theta burst stimulation (cTBS), intermittent TBS (iTBS), and sham TBS with RS-related, Implicit Association Test (IAT) and with a control self-esteem (SE) IAT in a group of fourteen healthy adult individuals. A specific decrease of implicit RS, as measured with the IAT effect, was induced by increasing IPL excitability with iTBS; conversely cTBS, which is supposedly inhibitory, left participants' implicit RS unchanged. The performance in the control SE-IAT was left unchanged by any TBS stimulation. These data showed the causative role of right IPL functional state in mediating plastic changes of implicit RS. Implications of these results are also discussed in the light of the variability of behavioral effects associated with TBS. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Partial tripolar cochlear implant stimulation: Spread of excitation and forward masking in the inferior colliculus.

    Science.gov (United States)

    Bierer, Julie Arenberg; Bierer, Steven M; Middlebrooks, John C

    2010-12-01

    This study examines patterns of neural activity in response to single biphasic electrical pulses, presented alone or following a forward masking pulse train, delivered by a cochlear implant. Recordings were made along the tonotopic axis of the central nucleus of the inferior colliculus (ICC) in ketamine/xylazine anesthetized guinea pigs. The partial tripolar electrode configuration was used, which provided a systematic way to vary the tonotopic extent of ICC activation between monopolar (broad) and tripolar (narrow) extremes while maintaining the same peak of activation. The forward masking paradigm consisted of a 200 ms masker pulse train (1017 pulses per second) followed 10 ms later by a single-pulse probe stimulus; the current fraction of the probe was set to 0 (monopolar), 1 (tripolar), or 0.5 (hybrid), and the fraction of the masker was fixed at 0.5. Forward masking tuning profiles were derived from the amount of masking current required to just suppress the activity produced by a fixed-level probe. These profiles were sharper for more focused probe configurations, approximating the pattern of neural activity elicited by single (non-masked) pulses. The result helps to bridge the gap between previous findings in animals and recent psychophysical data. Copyright © 2010 Elsevier B.V. All rights reserved.

  9. Distinct contributions of the fornix and inferior longitudinal fasciculus to episodic and semantic autobiographical memory.

    Science.gov (United States)

    Hodgetts, Carl J; Postans, Mark; Warne, Naomi; Varnava, Alice; Lawrence, Andrew D; Graham, Kim S

    2017-09-01

    Autobiographical memory (AM) is multifaceted, incorporating the vivid retrieval of contextual detail (episodic AM), together with semantic knowledge that infuses meaning and coherence into past events (semantic AM). While neuropsychological evidence highlights a role for the hippocampus and anterior temporal lobe (ATL) in episodic and semantic AM, respectively, it is unclear whether these constitute dissociable large-scale AM networks. We used high angular resolution diffusion-weighted imaging and constrained spherical deconvolution-based tractography to assess white matter microstructure in 27 healthy young adult participants who were asked to recall past experiences using word cues. Inter-individual variation in the microstructure of the fornix (the main hippocampal input/output pathway) related to the amount of episodic, but not semantic, detail in AMs - independent of memory age. Conversely, microstructure of the inferior longitudinal fasciculus, linking occipitotemporal regions with ATL, correlated with semantic, but not episodic, AMs. Further, these significant correlations remained when controlling for hippocampal and ATL grey matter volume, respectively. This striking correlational double dissociation supports the view that distinct, large-scale distributed brain circuits underpin context and concepts in AM. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. A case of double inferior vena cava with renal, ovarian and iliac vein variation.

    Science.gov (United States)

    Ito, Taro; Ikeda, Yayoi

    2018-01-01

    We encountered a rare case of an anatomic variant of inferior vena cava (IVC) duplication with renal, ovarian and iliac vein variation in an 81-year-old Japanese female cadaver during a student dissection course of anatomy at Aichi Gakuin University School of Dentistry. The two IVCs ran upwards bilaterally to the abdominal aorta. The left IVC joined with the left renal vein (RV) to form a common trunk that crossed anterior to the aorta and ended at the right IVC. We detected a vein [interiliac vein (IiV)] connecting the two IVCs at the level of the aortic bifurcation. The IiV was formed by the union of two tributaries from the left IVC and a tributary from the left internal iliac vein (IIV) and ran obliquely upwards from left to right. Two right ovarian veins, arising separately from the ipsilateral pampiniform plexus, ran vertically in parallel to each other, and each one independently terminated at the right IVC and the right RV. Two right IIVs, connecting each other with small branches, ascended and separately joined the right external iliac vein. The right and left IIVs were connected to each other. These variations cause abnormal drainage, which could lead to clinical symptoms associated with the dysfunction of the vascular and urogenital systems. Here we describe the detailed anatomical features of the area and discuss the related anatomical and developmental aspects.

  11. Achilles' ear? Inferior human short-term and recognition memory in the auditory modality.

    Science.gov (United States)

    Bigelow, James; Poremba, Amy

    2014-01-01

    Studies of the memory capabilities of nonhuman primates have consistently revealed a relative weakness for auditory compared to visual or tactile stimuli: extensive training is required to learn auditory memory tasks, and subjects are only capable of retaining acoustic information for a brief period of time. Whether a parallel deficit exists in human auditory memory remains an outstanding question. In the current study, a short-term memory paradigm was used to test human subjects' retention of simple auditory, visual, and tactile stimuli that were carefully equated in terms of discriminability, stimulus exposure time, and temporal dynamics. Mean accuracy did not differ significantly among sensory modalities at very short retention intervals (1-4 s). However, at longer retention intervals (8-32 s), accuracy for auditory stimuli fell substantially below that observed for visual and tactile stimuli. In the interest of extending the ecological validity of these findings, a second experiment tested recognition memory for complex, naturalistic stimuli that would likely be encountered in everyday life. Subjects were able to identify all stimuli when retention was not required, however, recognition accuracy following a delay period was again inferior for auditory compared to visual and tactile stimuli. Thus, the outcomes of both experiments provide a human parallel to the pattern of results observed in nonhuman primates. The results are interpreted in light of neuropsychological data from nonhuman primates, which suggest a difference in the degree to which auditory, visual, and tactile memory are mediated by the perirhinal and entorhinal cortices.

  12. Achilles' ear? Inferior human short-term and recognition memory in the auditory modality.

    Directory of Open Access Journals (Sweden)

    James Bigelow

    Full Text Available Studies of the memory capabilities of nonhuman primates have consistently revealed a relative weakness for auditory compared to visual or tactile stimuli: extensive training is required to learn auditory memory tasks, and subjects are only capable of retaining acoustic information for a brief period of time. Whether a parallel deficit exists in human auditory memory remains an outstanding question. In the current study, a short-term memory paradigm was used to test human subjects' retention of simple auditory, visual, and tactile stimuli that were carefully equated in terms of discriminability, stimulus exposure time, and temporal dynamics. Mean accuracy did not differ significantly among sensory modalities at very short retention intervals (1-4 s. However, at longer retention intervals (8-32 s, accuracy for auditory stimuli fell substantially below that observed for visual and tactile stimuli. In the interest of extending the ecological validity of these findings, a second experiment tested recognition memory for complex, naturalistic stimuli that would likely be encountered in everyday life. Subjects were able to identify all stimuli when retention was not required, however, recognition accuracy following a delay period was again inferior for auditory compared to visual and tactile stimuli. Thus, the outcomes of both experiments provide a human parallel to the pattern of results observed in nonhuman primates. The results are interpreted in light of neuropsychological data from nonhuman primates, which suggest a difference in the degree to which auditory, visual, and tactile memory are mediated by the perirhinal and entorhinal cortices.

  13. A new method in thoracoscopic inferior mediastinal lymph node biopsy: a case report

    Directory of Open Access Journals (Sweden)

    Sanlı Maruf

    2009-11-01

    Full Text Available Abstract Introduction We performed video-thoracoscopy with a video-mediastinoscope to conduct a mediastinal lymph node biopsy. Here, we discuss the various advantages of the method. Case presentation A 56-year-old Turkish Caucasian man had been complaining of dyspnea on exertion, hacking cough, fever and continuous sweating for one and a half months. Thoracic computed tomography revealed enlarged paratracheal and aorticopulmonary lymph nodes, the largest of which was 1 cm in diameter and reticulo-micronodular interstitial infiltration extending symmetrically to the pleural surfaces in both pulmonary perihilar areas. Computed tomography supported positron emission tomography showed increased fluorodeoxyglucose retention in lymph nodes in both hilar areas (10R and 10L (maximum standardized uptake values 5.6 and 5.7, and in the right lower paratracheal (4R (maximum standardized uptake value 4.1 and right para-esophageal (8 (maximum standardized uptake value 8.9 lymph nodes. Pathological examination of the right lymph node number 8 biopsy using the video-mediastinoscope revealed the presence of granulomatous inflammation. No problems were observed during the postoperative period. Conclusion The use of the video-mediastinoscope for inferior lymph node biopsy in thoracoscopy is an easy, safe and practical method, especially in patients with pleural adhesions.

  14. The right inferior frontal gyrus processes nested non-local dependencies in music.

    Science.gov (United States)

    Cheung, Vincent K M; Meyer, Lars; Friederici, Angela D; Koelsch, Stefan

    2018-02-28

    Complex auditory sequences known as music have often been described as hierarchically structured. This permits the existence of non-local dependencies, which relate elements of a sequence beyond their temporal sequential order. Previous studies in music have reported differential activity in the inferior frontal gyrus (IFG) when comparing regular and irregular chord-transitions based on theories in Western tonal harmony. However, it is unclear if the observed activity reflects the interpretation of hierarchical structure as the effects are confounded by local irregularity. Using functional magnetic resonance imaging (fMRI), we found that violations to non-local dependencies in nested sequences of three-tone musical motifs in musicians elicited increased activity in the right IFG. This is in contrast to similar studies in language which typically report the left IFG in processing grammatical syntax. Effects of increasing auditory working demands are moreover reflected by distributed activity in frontal and parietal regions. Our study therefore demonstrates the role of the right IFG in processing non-local dependencies in music, and suggests that hierarchical processing in different cognitive domains relies on similar mechanisms that are subserved by domain-selective neuronal subpopulations.

  15. Evidence-Based Evaluation of Inferior Vena Cava Filter Complications Based on Filter Type

    Science.gov (United States)

    Deso, Steven E.; Idakoji, Ibrahim A.; Kuo, William T.

    2016-01-01

    Many inferior vena cava (IVC) filter types, along with their specific risks and complications, are not recognized. The purpose of this study was to evaluate the various FDA-approved IVC filter types to determine device-specific risks, as a way to help identify patients who may benefit from ongoing follow-up versus prompt filter retrieval. An evidence-based electronic search (FDA Premarket Notification, MEDLINE, FDA MAUDE) was performed to identify all IVC filter types and device-specific complications from 1980 to 2014. Twenty-three IVC filter types (14 retrievable, 9 permanent) were identified. The devices were categorized as follows: conical (n = 14), conical with umbrella (n = 1), conical with cylindrical element (n = 2), biconical with cylindrical element (n = 2), helical (n = 1), spiral (n = 1), and complex (n = 1). Purely conical filters were associated with the highest reported risks of penetration (90–100%). Filters with cylindrical or umbrella elements were associated with the highest reported risk of IVC thrombosis (30–50%). Conical Bard filters were associated with the highest reported risks of fracture (40%). The various FDA-approved IVC filter types were evaluated for device-specific complications based on best current evidence. This information can be used to guide and optimize clinical management in patients with indwelling IVC filters. PMID:27247477

  16. Auditory and visual interactions between the superior and inferior colliculi in the ferret.

    Science.gov (United States)

    Stitt, Iain; Galindo-Leon, Edgar; Pieper, Florian; Hollensteiner, Karl J; Engler, Gerhard; Engel, Andreas K

    2015-05-01

    The integration of visual and auditory spatial information is important for building an accurate perception of the external world, but the fundamental mechanisms governing such audiovisual interaction have only partially been resolved. The earliest interface between auditory and visual processing pathways is in the midbrain, where the superior (SC) and inferior colliculi (IC) are reciprocally connected in an audiovisual loop. Here, we investigate the mechanisms of audiovisual interaction in the midbrain by recording neural signals from the SC and IC simultaneously in anesthetized ferrets. Visual stimuli reliably produced band-limited phase locking of IC local field potentials (LFPs) in two distinct frequency bands: 6-10 and 15-30 Hz. These visual LFP responses co-localized with robust auditory responses that were characteristic of the IC. Imaginary coherence analysis confirmed that visual responses in the IC were not volume-conducted signals from the neighboring SC. Visual responses in the IC occurred later than retinally driven superficial SC layers and earlier than deep SC layers that receive indirect visual inputs, suggesting that retinal inputs do not drive visually evoked responses in the IC. In addition, SC and IC recording sites with overlapping visual spatial receptive fields displayed stronger functional connectivity than sites with separate receptive fields, indicating that visual spatial maps are aligned across both midbrain structures. Reciprocal coupling between the IC and SC therefore probably serves the dynamic integration of visual and auditory representations of space. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  17. Malignant inferior vena cava obstruction involving right atrium. Palliative treatment with self expandable metallic stent

    International Nuclear Information System (INIS)

    Shao Guoliang; Wang Jianhua; Zhou Kangrong; Yan Zhiping

    2001-01-01

    Objective: To investigate the safety and efficacy of placement of self-expandable metallic stent within right atrium and inferior vena cava (ICV) in patients with malignant ICV obstruction involving right atrium. Methods: There were 5 male patients with advanced hepatocellular carcinoma, aged from 42 to 65 years (mean 56.3 years). The malignancies invaded right atrium and ICV simultaneously, and caused obstruction of ICV. These patients presented symptoms and signs of obstruction of ICV such as hepatomegaly, ascites, edema of lower extremities. 'Z' type stainless steel stents (7.5-10.0 cm in length and 2.5 cm in diameter) were selected for these patients. Part (1.0-3.0 cm in length) of stent was placed in right atrium and the rest was in ICV. Results: All of stents were placed successfully and obstructed ICV reopened. The symptoms of obstruction of ICV relieved or disappeared. There were no recurrence of symptoms of obstruction of ICV and any cardiac complication related to placement of stents in follow-up period (67-188 days). Conclusion: Placement of self-expandable metallic stent within right atrium and ICV in treatment of patients with malignant ICV obstruction involving right atrium is one of the safe and effective methods

  18. Inferior vena cava collapsibility detects fluid responsiveness among spontaneously breathing critically-ill patients.

    Science.gov (United States)

    Corl, Keith A; George, Naomi R; Romanoff, Justin; Levinson, Andrew T; Chheng, Darin B; Merchant, Roland C; Levy, Mitchell M; Napoli, Anthony M

    2017-10-01

    Measurement of inferior vena cava collapsibility (cIVC) by point-of-care ultrasound (POCUS) has been proposed as a viable, non-invasive means of assessing fluid responsiveness. We aimed to determine the ability of cIVC to identify patients who will respond to additional intravenous fluid (IVF) administration among spontaneously breathing critically-ill patients. Prospective observational trial of spontaneously breathing critically-ill patients. cIVC was obtained 3cm caudal from the right atrium and IVC junction using POCUS. Fluid responsiveness was defined as a≥10% increase in cardiac index following a 500ml IVF bolus; measured using bioreactance (NICOM™, Cheetah Medical). cIVC was compared with fluid responsiveness and a cIVC optimal value was identified. Of the 124 participants, 49% were fluid responders. cIVC was able to detect fluid responsiveness: AUC=0.84 [0.76, 0.91]. The optimum cutoff point for cIVC was identified as 25% (LR+ 4.56 [2.72, 7.66], LR- 0.16 [0.08, 0.31]). A cIVC of 25% produced a lower misclassification rate (16.1%) for determining fluid responsiveness than the previous suggested cutoff values of 40% (34.7%). IVC collapsibility, as measured by POCUS, performs well in distinguishing fluid responders from non-responders, and may be used to guide IVF resuscitation among spontaneously breathing critically-ill patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Human inferior colliculus activity relates to individual differences in spoken language learning.

    Science.gov (United States)

    Chandrasekaran, Bharath; Kraus, Nina; Wong, Patrick C M

    2012-03-01

    A challenge to learning words of a foreign language is encoding nonnative phonemes, a process typically attributed to cortical circuitry. Using multimodal imaging methods [functional magnetic resonance imaging-adaptation (fMRI-A) and auditory brain stem responses (ABR)], we examined the extent to which pretraining pitch encoding in the inferior colliculus (IC), a primary midbrain structure, related to individual variability in learning to successfully use nonnative pitch patterns to distinguish words in American English-speaking adults. fMRI-A indexed the efficiency of pitch representation localized to the IC, whereas ABR quantified midbrain pitch-related activity with millisecond precision. In line with neural "sharpening" models, we found that efficient IC pitch pattern representation (indexed by fMRI) related to superior neural representation of pitch patterns (indexed by ABR), and consequently more successful word learning following sound-to-meaning training. Our results establish a critical role for the IC in speech-sound representation, consistent with the established role for the IC in the representation of communication signals in other animal models.

  20. Anorexia Nervosa during Adolescence Is Associated with Decreased Gray Matter Volume in the Inferior Frontal Gyrus.

    Directory of Open Access Journals (Sweden)

    Takashi X Fujisawa

    Full Text Available Anorexia nervosa (AN is an eating disorder characterized by the relentless pursuit to lose weight, mostly through self-starvation, and a distorted body image. AN tends to begin during adolescence among women. However, the underlying neural mechanisms related to AN remain unclear. Using voxel-based morphometry based on magnetic resonance imaging scans, we investigated whether the presence of AN was associated with discernible changes in brain morphology. Participants were 20 un-medicated, right-handed patients with early-onset AN and 14 healthy control subjects. Group differences in gray matter volume (GMV were assessed using high-resolution, T1-weighted, volumetric magnetic resonance imaging datasets (3T Trio scanner; Siemens AG and analyzed after controlling for age and total GMV, which was decreased in the bilateral inferior frontal gyrus (IFG (left IFG: FWE corrected, p < 0.05; right IFG: uncorrected, p < 0.05 of patients with AN. The GMV in the bilateral IFG correlated significantly with current age (left IFG: r = -.481, p < .05; right IFG: r = -.601, p < .01 and was limited to the AN group. We speculate that decreased IFG volume might lead to deficits in executive functioning or inhibitory control within neural reward systems. Precocious or unbalanced neurological trimming within this particular region might be an important factor for the pathogenesis of AN onset.