Sample records for posterior pharyngeal wall
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Timmermans, A. Jacqueline; Brandsma, Dieta; Smeele, Ludi E.; Rosingh, Andert W.; van den Brekel, Michiel W. M.; Lohuis, Peter J. F. M.
2013-01-01
Two patients with recurrent carcinoma of the posterior pharyngeal wall, previously treated with carbon dioxide (CO2) laser excision and (chemo)radiotherapy, presented with neck pain due to cervical osteomyelitis. In one patient this led to cervical spine instability, for which a haloframe was
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Glavey, Siobhan V; Keane, Niamh; Power, Maria; O'Regan, Anthony W
2013-12-01
Although oropharyngeal candidiasis is associated with inhaled corticosteroid (ICS) usage, there is sparse data on the prevalence of posterior pharyngeal candidiasis in those without any detectable oral candidiasis on clinical examination. We systematically investigated the relationship between oral candidiasis on clinical examination and the presence of posterior pharyngeal candidiasis at bronchoscopy. We conducted a cross-sectional study on a convenience sample of 100 patients undergoing bronchoscopy at our institution. Patients were assessed for symptoms of and risk factors for candida infection and had an examination of their oropharynx for evidence of candidiasis before bronchoscopy. They subsequently had a detailed assessment for posterior candidiasis at bronchoscopy. We performed a posteriori subgroup analysis, which focused solely on those patients on ICS maintenance therapy. Median age was 54.7 (27-84) years, and 55 patients were male; 47 % of patients were on ICS, and 20 % of this cohort received recent oral corticosteroids. Twenty-eight percent of this convenience sample had posterior pharyngeal candidiasis; however, only 10.7 % (3/28) of these patients had clinically detectable oral candidiasis on clinical examination before bronchoscopy. Factors that were independently associated with the presence of pharyngeal candidiasis at bronchoscopy were OR (95 % CI) ICS usage 6.9 (2.5-19.2), particularly fluticasone usage 6.8 (2.62-17.9) and the presence of dysphonia 3.2 (1.3-8.0). In the subgroup analysis of ICS usage, posterior pharyngeal candidiasis was correlated with the presence of dysphonia but was not independently associated with fluticasone or budesonide dosage. This study demonstrates that posterior pharyngeal candidiasis in the absence of clinically overt oral candidiasis is frequent amongst ICS users. A history of ICS use, particularly fluticasone usage, as well as the presence of dysphonia are associated with posterior pharyngeal candidiasis at
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Lateral Pharyngeal Diverticulum presenting with Dysphagia ...
African Journals Online (AJOL)
Lateral pharyngeal diverticulum (Pharyngocele) is the protrusion of pharyngeal mucosa through the pharyngeal wall, usually through either of two weak areas in the pharyngeal wall as an acquired or congenital case. Lateral diverticula are very rare and not to be mistaken for the rather more frequent and abundantly ...
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Directory of Open Access Journals (Sweden)
A Darehzereshki
2008-06-01
Full Text Available Background: For the purpose of ascertaining myocardial infarction (MI and ischemia, the sensitivity of the initial 12-lead ECG is inadequate. It is risky to diagnose posterior MI using only precordial reciprocal changes, since the other leads may be more optimally positioned for the identification of electrocardiographic changes. In this study, we evaluated the relationship between electrocardiography changes and wall motion abnormalities in patients with posterior MI for earlier and better diagnosis of posterior MI.Methods: In this prospective cross-sectional study, we enrolled patients with posterior MI who had come to the Emergency Department of Shariati Hospital with their first episode of chest pain. A 12-lead surface electrocardiogram using posterior leads (V7-V9 was performed for all participants. Patients with ST elevation >0.05 mV or pathologic Q wave in the posterior leads, as well as those with specific changes indicating posterior MI in V1-V2, were evaluated by echocardiography in terms of wall motion abnormalities. All data were analyzed using SPSS and p<0.05 were considered statistically significant.Results: Of a total 79 patients enrolled, 48 (60.8% were men, and the mean age was 57.35±8.22 years. Smoking (54.4% and diabetes (48% were the most prevalent risk factors. In the echocardiographic evaluation, all patients had wall motion abnormalities in the left ventricle and 19 patients (24.1% had wall motion abnormalities in the right ventricle. The most frequent segment with motion abnormality among the all patients was the mid-posterior. The posterior leads showed better positive predictive value than the anterior leads for posterior wall motion abnormality.Conclusion: Electrocardiography of the posterior leads in patients with acute chest pain can help in earlier diagnosis and in time treatment of posterior MI.
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Intraoperative CT in the assessment of posterior wall acetabular fracture stability.
Cunningham, Brian; Jackson, Kelly; Ortega, Gil
2014-04-01
Posterior wall acetabular fractures that involve 10% to 40% of the posterior wall may or may not require an open reduction and internal fixation. Dynamic stress examination of the acetabular fracture under fluoroscopy has been used as an intraoperative method to assess joint stability. The aim of this study was to demonstrate the value of intraoperative ISO computed tomography (CT) examination using the Siemens ISO-C imaging system (Siemens Corp, Malvern, Pennsylvania) in the assessment of posterior wall acetabular fracture stability during stress examination under anesthesia. In 5 posterior wall acetabular fractures, standard fluoroscopic images (including anteroposterior pelvis and Judet radiographs) with dynamic stress examinations were compared with the ISO-C CT imaging system to assess posterior wall fracture stability during stress examination. After review of standard intraoperative fluoroscopic images under dynamic stress examination, all 5 cases appeared to demonstrate posterior wall stability; however, when the intraoperative images from the ISO-C CT imaging system demonstrated that 1 case showed fracture instability of the posterior wall segment during stress examination, open reduction and internal fixation was performed. The use of intraoperative ISO CT imaging has shown an initial improvement in the surgeon's ability to assess the intraoperative stability of posterior wall acetabular fractures during stress examination when compared with standard fluoroscopic images. Copyright 2014, SLACK Incorporated.
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Wang, Hu; Utku, Kandemir; Zhuang, Yan; Zhang, Kun; Fu, Ya-Hui; Wei, Xing; Wang, Peng-Fei; Cong, Yu-Xuan; Lei, Jin-Lai; Zhang, Bin-Fei
2017-07-01
To evaluate the quality of reduction, clinical outcomes and complications of associated both column acetabular fractures with posterior wall involvement that are treated through single ilioinguinal approach and fixation of posterior wall by lag screws only. We conducted a retrospective review involving ninety-nine consecutive patients with associated both column fractures of acetabulum treated through single ilioinguinal approach. Patients were divided into two groups. The first group consisted of 35 patients presented with both column fractures with posterior wall involvement that fixation performed with lag screws. This group was compared to a second group of 64 patients with both column fractures without posterior wall involvement. The quality of reduction was assessed using criteria described by Matta. The size of posterior wall fragment was measured. Functional outcome was evaluated using Modified Postel Merle D'Aubigne score. Radiographs at the latest follow up were analyzed for arthritis (Kellgren-Lawrence classification), and femoral head avascular necrosis (Ficat/Arlet classification). The study showed no significant differences in all preoperative variables (P>0.05). While intraoperative blood loss and operative time in group 1 were increased compared to group 2, the difference was not statistically significant (P>0.05). The height, relative depth and peripheral length of posterior wall respectively were 27.8±2.5mm (range: 24-35mm), 71.5±5.4% (range: 65-88%), 23.0±2.3mm (range: 17-28mm). The mean posterior wall fracture displacement is 5.0±3.2mm (range: 0-11mm). There was no difference regarding the quality of reduction between the two groups (P>0.05). The excellent to good clinical outcome was around 71.4% in the group 1 versus 73.4% in the group 2 at the final follow-up, this difference was not statistically significant (P>0.05). There was no difference in rate of complications between the two groups (P>0.05). Lag screws fixation of posterior wall
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Jeong, Woo Shik; Kim, Young Chul; Chung, Yoo Sam; Lee, Chang Yeol; Choi, Jong Woo
2017-07-01
Although maxillomandibular advancement (MMA) is an orthognathic surgical procedure used to manage obstructive sleep apnea (OSA) in individuals who are noncompliant with continuous positive airway pressure therapy, simple MMA encounters problems in terms of aesthetic outcomes in Asian populations with preexisting dentoalveolar protrusion. Our current prospective investigation describes changes in posterior pharyngeal space and aesthetic outcomes after counterclockwise rotational orthognathic surgery, which is known to be quite difficult in terms of the maintenance of the skeletal stability in skeletal class II patients with OSA. This prospective study investigated the surgical outcome of patients who suffered from OSA following counterclockwise rotational orthognathic surgery. The patients were skeletal class II patients who underwent orthognathic surgery between March 2013 and December 2014. Cephalometric posterior airway analysis and a questionnaire for facial perception were used to assess pharyngeal airway and patient perception of facial appearance. A total of 14 patients were included. Satisfactory results were achieved without complications in all OSA patients. The airway parameters for anteroposterior length significantly increased. Thirteen patients answered a questionnaire on their facial appearance, and the visual analog scale averaged 7.31 points, indicating a favorable facial appearance. Counterclockwise rotational orthognathic surgery without maxilla advancement for the correction of OSA can effectively increase the posterior pharyngeal space, with favorable aesthetic results. With thoughtful application, this novel approach may be an alternative to standard approaches for the correction of OSA using orthognathic surgery.
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Age-Related Changes in Pharyngeal Lumen Size: A Retrospective MRI Analysis.
Molfenter, Sonja M; Amin, M R; Branski, R C; Brumm, J D; Hagiwara, M; Roof, S A; Lazarus, C L
2015-06-01
Age-related loss of muscle bulk and strength (sarcopenia) is often cited as a potential mechanism underlying age-related changes in swallowing. Our goal was to explore this phenomenon in the pharynx, specifically, by measuring pharyngeal wall thickness and pharyngeal lumen area in a sample of young versus older women. MRI scans of the neck were retrospectively reviewed from 60 women equally stratified into three age groups (20s, 60s, 70+). Four de-identified slices were extracted per scan for randomized, blinded analysis: one mid-sagittal and three axial slices were selected at the anterior inferior border of C2 and C3, and at the pit of the vallecula. Pixel-based measures of pharyngeal wall thickness and pharyngeal lumen area were completed using ImageJ and then converted to metric units. Measures of pharyngeal wall thickness and pharyngeal lumen area were compared between age groups with one-way ANOVAs using Sidak adjustments for post-hoc pairwise comparisons. A significant main effect for age was observed across all variables whereby pharyngeal wall thickness decreased and pharyngeal lumen area increased with advancing age. Pairwise comparisons revealed significant differences between 20s versus 70+ for all variables and 20s versus 60s for all variables except those measured at C2. Effect sizes ranged from 0.54 to 1.34. Consistent with existing sacropenia literature, the pharyngeal muscles appear to atrophy with age and consequently, the size of the pharyngeal lumen increases.
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Current management of posterior wall fractures of the acetabulum.
Moed, Berton R; Kregor, Philip J; Reilly, Mark C; Stover, Michael D; Vrahas, Mark S
2015-01-01
The general goals for treating an acetabular fracture are to restore congruity and stability of the hip joint. These goals are no different from those for the subset of fractures of the posterior wall. Nevertheless, posterior wall fractures present unique problems compared with other types of acetabular fractures. Successful treatment of these fractures depends on a multitude of factors. The physician must understand their distinctive radiologic features, in conjunction with patient factors, to determine the appropriate treatment. By knowing the important points of posterior surgical approaches to the hip, particularly the posterior wall, specific techniques can be used for fracture reduction and fixation in these often challenging fractures. In addition, it is important to develop a complete grasp of potential complications and their treatment. The evaluation and treatment protocols initially developed by Letournel and Judet continue to be important; however, the surgeon also should be aware of new information published and presented in the past decade.
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Streptococcal acute pharyngitis
Directory of Open Access Journals (Sweden)
Lais Martins Moreira Anjos
2014-07-01
Full Text Available Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-streptococcal glomerulonephritis. Symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Cough, coryza, conjunctivitis, and diarrhea are uncommon, and their presence suggests a viral cause. A diagnosis of pharyngitis is supported by the patient's history and by the physical examination. Throat culture is the gold standard for diagnosing streptococcus pharyngitis. However, it has been underused in public health services because of its low availability and because of the 1- to 2-day delay in obtaining results. Rapid antigen detection tests have been used to detect S. pyogenes directly from throat swabs within minutes. Clinical scoring systems have been developed to predict the risk of S. pyogenes infection. The most commonly used scoring system is the modified Centor score. Acute S. pyogenes pharyngitis is often a self-limiting disease. Penicillins are the first-choice treatment. For patients with penicillin allergy, cephalosporins can be an acceptable alternative, although primary hypersensitivity to cephalosporins can occur. Another drug option is the macrolides. Future perspectives to prevent streptococcal pharyngitis and post-infection systemic complications include the development of an anti-Streptococcus pyogenes vaccine.
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DEFF Research Database (Denmark)
Kaltoft, Britta; Kruse, Anders; Jensen, Lisa Toft
2012-01-01
to C3. Two months later, rupture of the pharyngeal wall was noted with exposure of the anterior cage. A few days later, the posterior scar ruptured. The anterior cage was removed and the pharyngeal wall was sutured. Revision of the posterior wound was performed, leaving the implants in place. To secure...... stability of the spine, the patient was treated with a HALO. Once again, the pharyngeal wall ruptured. Reconstruction of the posterior pharyngeal wall and the anterior column of the spine was performed with an osteocutaneous fibular flap from the skull base to C3. Five months later, a computed tomography...
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Pharyngeal chemosensitivity in patients with obstructive sleep apnea and healthy subjects.
Heiser, Clemens; Zimmermann, Ingo; Sommer, J Ulrich; Hörmann, Karl; Herr, Raphael M; Stuck, Boris A
2013-09-01
Signs of pharyngeal neurodegeneration have been detected in patients with obstructive sleep apnea (OSA). Along with this neurodegeneration, a decreased pharyngeal sensitivity to mechanical stimulation has been described. The decreased sensitivity may play a role in the pathophysiology of this disease. The aim of the study was to investigate the chemosensitivity of the pharyngeal mucosa in patients with OSA compared with controls. Healthy controls and patients with OSA (age: 30-60 years) were included. Testing of oropharyngeal chemosensitivity was performed with subjective intensity ratings of capsaicin (SIR, visual analogue scale 0-10), air puffs (presented with an olfactometer), and stimulation with CO2 at the posterior pharyngeal wall. A 2-point discrimination test at the soft palate, an intensity rating of capsaicin at the tongue, and a nasal lateralization test were performed. Twenty-six patients with OSA and 18 healthy controls were included. No differences were detected in the SIR of capsaicin at the tongue or in the nasal lateralization test. At the pharynx, a decreased sensitivity to capsaicin (OSA: 6.8 ± 2.3; healthy control: 8.6 ± 1.3), air puffs (OSA: 2.8 ± 1.9; healthy control: 4.2 ± 1.6), and stimulation with CO2 (OSA: 1.5 ± 1.7; healthy control: 2.8 ± 1.8) were demonstrated in patients with OSA (all P < 0.05). Two-point discrimination at the soft palate was reduced with statistical significance in the OSA group (OSA: 11.5 ± 5.4 mm; healthy control: 5.0 ± 2.4 mm). The results suggest reduced pharyngeal chemosensitivity in OSA patients in addition to the reduced mechanical pharyngeal sensitivity shown with 2-point discrimination. This demonstrates peripheral neurodegeneration in the context of this disease.
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Posterior vaginal wall Gartner′s duct cyst
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Ripan Bala
2015-01-01
Full Text Available Cyst of posterior vaginal wall is very rare. This case relates to a patient who presented with polypoidal mass protruding out from vagina which could have been easily mistaken as uterovaginal prolapse, but appropriate clinical evaluation supported with investigations clinched the diagnosis easily.
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Olson, S A; Bay, B K; Pollak, A N; Sharkey, N A; Lee, T
1996-01-01
The indications for open reduction and internal fixation of posterior wall acetabular fractures associated with a clinically stable hip joint are unclear. In previous work a large posterior wall defect (27% articular surface area) resulted in significant alteration of load transmission across the hip; specifically, there was a transition from evenly distributed loading along the acetabular articular surface to loading concentrated mainly in the superior portion of the articular surface during simulated single leg stance. However, the majority of posterior wall fractures involve a smaller amount of the articular surface. Posterior wall acetabular fractures not associated with instability of the hip are commonly treated nonoperatively. This practice does not account for the size of the posterior wall fracture. To study the biomechanical consequences of variably sized articular defects, a laboratory experiment was conducted evaluating three progressively larger posterior wall defects of the acetabulum during simulated single leg stance using superlow Fuji prescale film (Itochu International, New York): (a) 1/3 articular surface width through a 50 degrees arc along the posterior wall of the acetabulum, (b) 2/3, and (c) 3/3 articular width defects through the same 50 degrees arc along the posterior wall of the acetabulum. In the intact acetabulum, 48% of the total articular contact was located in the superior acetabulum. Twenty-eight percent of articular contact was in the anterior wall region of the acetabulum and 24% in the posterior wall region. After the 1/3 width posterior wall defect, 64% of the articular contact was located in the superior acetabulum (p = 0.0011). The 2/3 width posterior wall defect resulted in 71% of articular contact area being located in the superior acetabulum (p = 0.0006). After the 3/3 width posterior wall defect, 77% of articular contact was located in the superior acetabulum, significantly greater than the intact condition (p < 0
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Influence of x-irradiation on pharyngeal induction in the Planarian, Dugesia japonica japonica
International Nuclear Information System (INIS)
Asai, Etsuo
1980-01-01
Pharyngeal formation was examined in cases where normal or X-irradiated head pieces were transplanted into the postpharyngeal region of normal or irradiated worms. Transplantation experiments were carried out in four different combinations of hosts and grafts: (1) normal host and graft (control), (2) normal host and irradiated graft, (3) irradiated host and normal graft, (4) irradiated host and graft. In the first experiment, well developed pharynges were formed in the areas both anterior and posterior to the graft on the 14th day after transplantation. In the second experiment, formation of new pharynges was delayed compared with that in the first group. In the third experiment, only one pharynx developed in the area posterior to each graft in most cases. In the last experiment, no new pharynx appeared at all. From these results, the influence of X-rays on factors participating in pharyngeal induction was discussed. (author)
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Syamal, Mausumi N; Bryson, Paul C
2017-02-01
Stress velopharyngeal insufficiency (SVPI) is an uncommon but often career-threatening condition affecting professional brass and woodwind musicians. To review the evaluation of and treatment for SVPI in professional musicians with lipoinjection to the posterior pharyngeal wall. A retrospective medical record and literature review. Two professional musicians with SVPI treated with autologous lipoinjection to the posterior pharyngeal wall were included. Nasopharyngoscopy was performed while patients played their instrument both before and after injection. To assess the effectiveness of autologous fat injection to the posterior pharyngeal wall to treat stress velopharyngeal insufficiency in 2 professional instrumentalists. Successful treatment was the absence of VPI during playing as visualized by flexible nasopharyngoscopy. After autologous lipoinjection of the posterior pharyngeal wall, 1 patient resumed full play with complete resolution, now 3 years after lipoinjection pharyngoplasty. The other patient received temporary resolution. Both had no surgical complications. Stress VPI is often a career-threatening condition for professional brass and woodwind musicians, with a cited incidence of 34%. Various treatment options in the literature include observation, speech and language pathology referral for pharyngeal strengthening, lipoinjection of the soft palate, and more invasive options, such as sphincter pharyngoplasty, pharyngeal flaps and V-Y pushback. Autologous fat injection pharyngoplasty of the posterior pharyngeal wall may be a less invasive treatment option for musicians with SVPI.
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Mulliken, J B; Giargiana, F A; Claybaugh, G J; Hoopes, J E
1975-07-01
A long-term cineradiographic follow-up study of twenty patients with velo-pharyngeal incompetence fails to demonstrate predictable retrodisplacement of the levator insertion following combined levator retropositioning, pushback, and pharyngeal flap procedures. Simple levator retropositioning gave posterior displacement in the two patients evaluated. Patients with normal or posterior levator insertions pre-operatively all demonstrated post-operative anterior displacement following pharyngeal flap procedures, either alone or in combination with pushback. Anterior levator displacement may be the result of scar contraction or division of the levator sling (during insetting of a pharyngeal flap). Pre-operative and post-operative speech evaluation demonstrated substantial improvement in all except 3 patients; 2 of the poor speech results were patients with demonstrated levator retrodisplacement on post-operative cineradiography.
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The influence of the lateral pharyngeal wall anatomy on snoring and sleep apnoea.
Korhan, Ibrahim; Gode, Sercan; Midilli, Rasit; Basoglu, Ozen Kacmaz
2015-02-01
To elucidate the variations of the lateral pharyngeal wall anatomy on physical examination and to assess the clinical importance of the examination of the lateral pharyngeal wall on the presence and severity of obstructive sleep apnoea syndrome. The cross-sectional study was conducted at Ege University Medical School, Izmir, Turkey, between May 2010 and April 2011. The patients were divided into four equal groups: Group 1--snoring without apnoea (age 20-40); Group 2--snoring without apnoea (age 40-60); Group 3--apnoea-hypopnoea index 30/hr. Calibrated oropharynx pictures were taken. Distance between palatoglossal and palatopharyngeal arches, height of palatoglossal and palatopharyngeal arches, uvula width, uvula length and distance between tonsils were measured. SPSS 17 was used for statistical analysis. Of the 80 patients in the study, 44 (55%) were men. Mean distance between palatopharyngeal and palatoglossal arches were 1.55 ± 0.34 cm and 2.70 ± 0.43 cm respectively. Mean height of palatopharyngeal and palatoglossal arches were 0.60 ± 0.21 cm and 1.37 ± 0.36 cm respectively (p > 0.05). Mean uvula width and uvula length were 0.80 ± 0.12cm and 1.25 ± 0.27 cm respectively (p > 0.05). Mean distance between tonsils was 2.24 ± 0.56 cm (p > 0.05). Distance between palatopharyngeal arches was significantly different between groups 3 and 4 (p < 0.05). Palatopharyngeal arch anatomy was found to be significantly associated with obstructive sleep apnoea syndrome severity, especially in patients with normal or small tonsil size. Patients with the palatopharyngeal arches, which narrow the oropharyngeal inlet more than the tonsils, should further be investigated with polysomnography.
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Current status of superficial pharyngeal squamous cell carcinoma in Japan.
Rikitake, Ryoko; Ando, Mizuo; Saito, Yuki; Yoshimoto, Seiichi; Yamasoba, Tatsuya; Higashi, Takahiro
2017-10-01
To investigate the status and treatment of superficial pharyngeal squamous cell carcinoma in Japan. We analyzed all cases diagnosed between 2011 and 2013, as recorded in the national database of hospital-based cancer registries. We extracted data on patient sex, age, tumor locations, histology, presentation routes, initial treatments, and TNM stages. Additionally, we compared the characteristics of pharyngeal carcinoma to those of esophageal cancer. A total of 16,521 oropharyngeal and hypopharyngeal cancers from 409 institutions were included. Diagnosis of Tis tumors was infrequent, and both cancers were likely to be diagnosed at an advanced stage (n = 866, 5.3%). Tis diseases were the most commonly detected during follow-up examinations for other diseases (n = 608, 70%). While more oropharyngeal Tis patients were men compared to T1-4 patients (88 vs 82%, respectively), hypopharyngeal cancer patients comprised an equally high proportion of men (94 vs 92%, respectively). The most common location of oropharyngeal Tis tumors was the posterior wall (32%), whereas T1-4 tumors were most commonly found on the lateral wall (36%). In hypopharyngeal cancer, both Tis and T1-4 were most commonly located in the pyriform sinus (62%). The proportion of Tis tumors diagnosed at individual institutions showed a positive correlation with the number of endoscopic treatments (r = 0.32, P squamous cell carcinoma patients in Japan. Further improvements in early diagnosis and standardized treatments are warranted.
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Heare, Austin; Kramer, Nicholas; Salib, Christopher; Mauffrey, Cyril
2017-07-01
Despite overall improved outcomes with open reduction and internal fixation of acetabular fractures, posterior wall fractures show disproportionately poor results. The effect of weight bearing on outcomes of fracture management has been investigated in many lower extremity fractures, but evidence-based recommendations in posterior wall acetabular fractures are lacking. The authors systematically reviewed the current literature to determine if a difference in outcome exists between early and late postoperative weight-bearing protocols for surgically managed posterior wall acetabular fractures. PubMed and MEDLINE were searched for posterior wall acetabular fracture studies that included weight-bearing protocols and Merle d'Aubigné functional scores. Twelve studies were identified. Each study was classified as either early or late weight bearing. Early weight bearing was defined as full, unrestricted weight bearing at or before 12 weeks postoperatively. Late weight bearing was defined as restricted weight bearing for greater than 12 weeks postoperatively. The 2 categories were then compared by functional score using a 2-tailed t test and by complication rate using chi-square analysis. Six studies (152 fractures) were placed in the early weight-bearing category. Six studies (302 fractures) were placed in the late weight-bearing category. No significant difference in Merle d'Aubigné functional scores was found between the 2 groups. No difference was found regarding heterotopic ossification, avascular necrosis, superficial infections, total infections, or osteoarthritis. This systematic review found no difference in functional outcome scores or complication rates between early and late weight-bearing protocols for surgically treated posterior wall fractures. [Orthopedics. 2017: 40(4):e652-e657.]. Copyright 2017, SLACK Incorporated.
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Aksu, Muge; Taner, Tülin; Sahin-Veske, Pınar; Kocadereli, Ilken; Konas, Ersoy; Mavili, Mehmet Emin
2012-02-01
To investigate 1) the changes in pharyngeal airway sizes associated with maxillary distraction osteogenesis and 2) the correlations between maxillary skeletal variables and the pharyngeal airway in adult patients with cleft lip and palate. The study was carried out in 14 adult subjects with cleft lip and palate. Predistraction records were taken at a mean age of 22.7 ± 4.6 years. All patients had placement of a rigid external distraction device (RED I; KLS Martin, Tuttlingen, Germany) after Le Fort I osteotomy. Lateral cephalograms were assessed before surgery and at short-term follow-up (8.0 ± 6.4 months). The cephalometric skeletal and pharyngeal airway variables were statistically evaluated by use of the Wilcoxon signed-rank test. Spearman ρ correlation was performed to check the correlations between maxillary skeletal and pharyngeal variables. The maxillary movement was 8.7 mm (P maxillary depth angle (+7.9°) and effective maxillary length (9.4 mm) increased significantly (P distraction, whereas the palatal plane angle remained unchanged. Anterior nasal spine (8.2 mm) and Posterior nasal spine (6.9 mm) moved anteriorly. The overjet increased (9.5 mm) significantly (P maxillary movement. PNS changes showed the highest correlation with posterior airway changes. The significant anterior movement of the maxilla resulted in significant increases in posterior, superoposterior, and middle airway spaces. The posterior airway space showed the highest significant positive correlation with the movement of PNS. The posterior and superoposterior airway spaces also showed significant positive correlations with the maxillary skeletal variables. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
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Directory of Open Access Journals (Sweden)
Skand Sinha
2013-10-01
Full Text Available Introduction: Posterior dislocation of the hip joint with associated acetabular and intertrochanteric fracture is a complex injury. Early recognition, prompt and stable reduction is needed of successful outcome. Case Report: 45 year old male patient presented with posterior dislocation of the hip with transverse fracture with posterior wall fracture of acetabulam and intertrochanteric fracture on the ipsilateral side. The complex fracture geometry was confirmed by CT scan. The patient was successfully managed by open reduction and internal fixation of intertrochanteric fracture was achieved with dynamic hip screw (DHS plate fixation followed by fixation of acetabular fracture with reconstruction plate. Conclusion: Hip dislocation combined with acetabular fracture is an uncommon injury; this article presents a unique case of posterior wall and transverse fractures of ipsilateral acetabulum with intertrochanteric fracture in a patient who sustained traumatic posterior hip dislocation. Early surgical intervention is important for satisfactory outcomes of such complex fracture-dislocation injuries. Keywords: Hip dislocation; acetabular fractures; intertrochanteric fracture; operative treatment.
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[Species and quantitative characteristics of pharyngeal mucosa microflora in pregnant women].
Meshcheriakova, A K; Kostinov, M P; Magarshak, O O; Zaĭtseva, E V
2014-01-01
Species and quantitative characteristics of upper respiratory tract (URT) mucosa microflora in women at gestation period. The results of a bacteriological study of 68 samples of mucus from posterior pharyngeal wall in women at gestation period (from 14 weeks), 52 of those--from pregnant women with acute respiratory infection (ARI) symptoms and 16--from women without signs of disease, are presented. Qualitative and quantitative composition of microflora was studied by a generally accepted bacteriological method. During primary bacteriological study 111 microorganism cultures were isolated. 88 (79.3%) of strains belonged to Gram-positive flora, 20 (18.0%)--to Gram-negative, and Candida genus fungi constituted 3 (2.7%) isolates. Streptococcus pyogenes and Moraxella catarrhalis were isolated from pregnant women with ARI signs at 23.1% and 5.8% frequency of occurrence, respectively. A higher detectability of Staphylococcus aureus--in 31.3% and Candida spp.--in 6.3% of women who did not complain as opposed to patients with URT lesions (in 21.2 and 3.9%, respectively) was determined. In patients without ARI signs the amount of bacteria did not exceed 10(5)--10(6) CFU/ml, in pregnant women with ARI diagnosis in 8 of 52 cases semination of pharyngeal mucuswas observed--10(7)--10(8) CFU/ml. Prevalence of S. aureus, Streptococcus agalactiae, S. pyogenes, Streptococcus mutans in composition of pharyngeal mucus microflora of pregnant women both with URT lesion signs and without them was shown, however the degree of semination by pathogens in the groups was different that determined the severity of disease manifestations.
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Altman, Daniel; López, Annika; Kierkegaard, Jonas; Zetterström, Jan; Falconer, Christian; Pollack, Johan; Mellgren, Anders
2005-01-01
The aim of the present study was to compare clinical and radiological findings when assessing posterior vaginal wall prolapse. Defecography can be used to complement the clinical evaluation in patients with posterior vaginal wall prolapse. Further development of the defecography technique, using contrast medium in the urinary bladder and intraperitoneally, have resulted in cystodefecoperitoneography (CDP). Thirty-eight women underwent clinical examination using the pelvic organ prolapse quantification system (POP-Q) followed by CDP. All patients answered a standardized bowel function questionnaire. Statistical analysis measuring correlation between POP-Q and CDP using Pearson's correlation coefficient (r) and Spearman's rank order correlation coefficient (rs) demonstrated a poor to moderate correlation, r=0.49 and rs=0.55. Although there was a strong association between large rectoceles (>3 cm) at CDP and symptoms of rectal emptying difficulties (p<0.001), severity and prevalence of bowel dysfunction showed poor coherence with clinical prolapse staging and findings at radiological imaging. Vaginal topography and POP-Q staging predict neither radiological size nor visceral involvement in posterior vaginal wall prolapse. Radiological evaluation may therefore be a useful complement in selected patients.
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African Journals Online (AJOL)
have necrotic tissue and defects on the posterior pharyngeal wall which was managed ... offering a more reliable alternative to the face mask. ... pharyngeal wall four weeks into the treatment. ... the vascular surgeons advised a wait and watch.
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Measurement of pharyngeal sensory cortical processing: technique and physiologic implications
Directory of Open Access Journals (Sweden)
Ringelstein E Bernd
2009-07-01
Full Text Available Abstract Background Dysphagia is a major complication of different diseases affecting both the central and peripheral nervous system. Pharyngeal sensory impairment is one of the main features of neurogenic dysphagia. Therefore an objective technique to examine the cortical processing of pharyngeal sensory input would be a helpful diagnostic tool in this context. We developed a simple paradigm to perform pneumatic stimulation to both sides of the pharyngeal wall. Whole-head MEG was employed to study changes in cortical activation during this pharyngeal stimulation in nine healthy subjects. Data were analyzed by means of synthetic aperture magnetometry (SAM and the group analysis of individual SAM data was performed using a permutation test. Results Our results revealed bilateral activation of the caudolateral primary somatosensory cortex following sensory pharyngeal stimulation with a slight lateralization to the side of stimulation. Conclusion The method introduced here is simple and easy to perform and might be applicable in the clinical setting. The results are in keeping with previous findings showing bihemispheric involvement in the complex task of sensory pharyngeal processing. They might also explain changes in deglutition after hemispheric strokes. The ipsilaterally lateralized processing is surprising and needs further investigation.
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Desjardin, Marie; Roman, Sabine; des Varannes, Stanislas Bruley; Gourcerol, Guillaume; Coffin, Benoit; Ropert, Alain; Mion, François
2013-01-01
Background Pharyngeal pH probes and pH-impedance catheters have been developed for the diagnosis of laryngo-pharyngeal reflux. Objective To determine the reliability of pharyngeal pH alone for the detection of pharyngeal reflux events. Methods 24-h pH-impedance recordings performed in 45 healthy subjects with a bifurcated probe for detection of pharyngeal and oesophageal reflux events were reviewed. Pharyngeal pH drops to below 4 and 5 were analysed for the simultaneous occurrence of pharyngeal reflux, gastro-oesophageal reflux, and swallows, according to impedance patterns. Results Only 7.0% of pharyngeal pH drops to below 5 identified with impedance corresponded to pharyngeal reflux, while 92.6% were related to swallows and 10.2 and 13.3% were associated with proximal and distal gastro-oesophageal reflux events, respectively. Of pharyngeal pH drops to below 4, 13.2% were related to pharyngeal reflux, 87.5% were related to swallows, and 18.1 and 21.5% were associated with proximal and distal gastro-oesophageal reflux events, respectively. Conclusions This study demonstrates that pharyngeal pH alone is not reliable for the detection of pharyngeal reflux and that adding distal oesophageal pH analysis is not helpful. The only reliable analysis should take into account impedance patterns demonstrating the presence of pharyngeal reflux event preceded by a distal and proximal reflux event within the oesophagus. PMID:24917995
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Groenendijk, Annette G.; van der Hulst, Victor P.; Birnie, Erwin; Bonsel, Gouke J.
2008-01-01
To estimate the accuracy of clinical examination and the indications for defecography in patients with primary posterior wall prolapse. Fifty-nine patients with primary pelvic organ prolapse were evaluated with a questionnaire, clinical examination and defecography. Defecography was used as
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Hasenstab, Kathryn A; Sitaram, Swetha; Lang, Ivan M; Shaker, Reza; Jadcherla, Sudarshan R
2018-02-01
Pharyngeal-provocation induced aerodigestive symptoms in infants remain an enigma. Sources of pharyngeal provocation can be anterograde as with feeding, and retrograde as in gastroesophageal reflux. We determined maturational and dose-response effects of targeted pharyngeal-stimulus on frequency, stability, and magnitude of pharyngeal and respiratory waveforms during multiple pharyngeal swallowing responses in preterm-born infants when they were of full-term postmenstrual age (PMA). Eighteen infants (11 male) were studied longitudinally at 39.8 ± 4.8 weeks PMA (time-1) and 44.1 ± 5.8 weeks PMA (time-2). Infants underwent concurrent pharyngo-esophageal manometry, respiratory inductance plethysmography, and nasal airflow thermistor methods to test sensory-motor interactions between the pharynx, esophagus, and airway. Linear mixed models were used and data presented as mean ± SEM or %. Overall, responses to 250 stimuli were analyzed. Of the multiple pharyngeal swallowing responses (n = 160), with maturation (a) deglutition apnea duration decreases (p 0.05), and (c) respiratory changes were unaffected (p > 0.05). Initial and subsequent pharyngeal responses and respiratory rhythm interactions become more distinct with maturation. Interval oromotor experiences and volume-dependent increase in adaptive responses may be contributory. These mechanisms may be important in modulating and restoring respiratory rhythm normalcy.
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International Nuclear Information System (INIS)
Bossi, Alberto; De Wever, Ivo; Van Limbergen, Erik; Vanstraelen, Bianca
2007-01-01
Purpose: Preoperative external-beam radiation therapy (preop RT) in the management of Retroperitoneal Liposarcomas (RPLS) typically involves the delivery of radiation to the entire tumor mass: yet this may not be necessary. The purpose of this study is to evaluate a new strategy of preop RT for RPLS in which the target volume is limited to the contact area between the tumoral mass and the posterior abdominal wall. Methods and Materials: Between June 2000 and Jan 2005, 18 patients with the diagnosis of RPLS have been treated following a pilot protocol of pre-op RT, 50 Gy in 25 fractions of 2 Gy/day. The Clinical Target Volume (CTV) has been limited to the posterior abdominal wall, region at higher risk for local relapse. A Three-Dimensional conformal (3D-CRT) and an Intensity Modulated (IMRT) plan were generated and compared; toxicity was reported following the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events v3.0. Results: All patients completed the planned treatment and the acute toxicity was tolerable: 2 patients experienced Grade 3 and 1 Grade 2 anorexia while 2 patients developed Grade 2 nausea. IMRT allows a better sparing of the ipsilateral and the contralateral kidney. All tumors were successfully resected without major complications. At a median follow-up of 27 months 2 patients developed a local relapse and 1 lung metastasis. Conclusions: Our strategy of preop RT is feasible and well tolerated: the rate of resectability is not compromised by limiting the preop CTV to the posterior abdominal wall and a better critical-structures sparing is obtained with IMRT
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A Lateral Cephalometric Study of the Pharyngeal Growth in Korean Children
International Nuclear Information System (INIS)
Choi, Ki Chae; Lee, Sang Rae; Lee, Man Sup
1990-01-01
The aim of this study has been to investigate the growth of the pharynx and sexual differences in the lateral cephalograms of Korean children. The material includes 173 cepalograms from two groups composed of 51 males aged 12.0 years and 39 females aged 12.2 years in group 2, and 45 males aged 7.4 years and 39 females aged 7.5 year in group 1, respectively. In order to study and measure the pharyngeal area the following skeletal landmarks were selected: S, N, A, Ptm, B, H, H', M, S-N, FH and CV, and the angle CV-FH was measured to provide a factor for correction of error resulting from improper head positioning of subjects, especially in relative positions of A and H, while radiography. For each variable the statistically treated data have been presented in the table II, III, IV. The main results are presented as follows: 1. In general, the measurements of male were larger than those of female in antero-posterior dimension of pharyngeal cavity, but all variables did not show significant sexual differences in both groups when evaluated statistically. 2. All of the measurements were larger in male than in female in vertical dimensions of pharyngeal cavity in group 2, and there were statistical significances of sexual differences in the variables except M-H', but all variables did not show significant sexual differences in group 1 when evaluated statistically. 3. The dimensional increase of the pharynx by the growth in the vertical dimensions was shown to be greater than in the antero-posterior dimensions in the both sexes.
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Douglas, Yvonne L.; Mahtab, Edris A. F.; Jongbloed, Monique R. M.; Uhrin, Pavel; Zaujec, Jan; Binder, Bernd R.; Schalij, Martin J.; Poelmann, Robert E.; Deruiter, Marco C.; Gittenberger-De Groot, Adriana C.
The developing sinus venosus myocardium, derived from the posterior heart field, contributes to the atrial septum, the posterior atrial wall, the sino-atrial node, and myocardium lining the pulmonary and cardinal veins, all expressing podoplanin, a coelomic and myocardial marker. . We compared
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Directory of Open Access Journals (Sweden)
Qi Zhang
Full Text Available OBJECTIVE: This study aims to assess the medium-term results of the reconstruction of posterior wall fractures using a W-shaped acetabular angular plate (WAAP compared to those fixed using a reconstruction plate. METHODS: Between July 2006 and March 2009, we performed a retrospective study, which collected data for any patient treated for a posterior acetabular wall fracture. At the time of treatment, patients were either treated using a WAAP or a pelvic reconstruction plate. The intraoperative fluoroscopic images for both groups were compared. The quality of reduction and radiological grading were assessed according to the criteria developed by Matta. The clinical assessment was based on a modified Merle d'Aubigne and Postel scoring. RESULTS: 53 patients met the inclusion criteria and were followed up for an average of 38 months. 25 patients were treated with a WAAP (study group, and 28 patients were treated with a pelvic reconstruction plate (control group. The intraoperative fluoroscopic images of the study group confirmed extra-articular screw placement in all cases. In the control group, intra-articular screw placement was observed intraoperatively in 5 patients (17.86%, and the definitive location of the periarticular hardware could not be determined in 4 patients (14.29% during the operation. The differences between the two groups were statistically significant (p = 0.002. In contrast, the quality of fracture reduction, clinical outcomes, and radiological grading in the study group were not significantly different from those of the control group (p>0.05. The radiographic grade was strongly associated with the clinical outcomes in both the study and control groups (p<0.05. CONCLUSION: Reconstruction of posterior wall fractures of the acetabulum using a WAAP can help avoid screw penetration of the hip joint, provide a stable fixation of the posterior wall, and ensure good clinical outcomes.
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Streptococcal Pharyngitis and Appendicitis in Children.
Nielsen, Jason W; Abel, Stuart A; Kenney, Brian
2018-01-01
Several pathologies, including pharyngitis, are associated with abdominal pain that can mimic appendicitis. We sought to further understand the link between appendicitis-like symptoms and streptococcal (strep) pharyngitis. All patients undergoing ultrasound imaging for appendicitis in our emergency department during 2013 were reviewed (n = 1572). A total of 207 patients were identified who underwent both ultrasound for appendicitis and testing for strep pharyngitis. Demographic and outcomes data between rule out appendicitis patients who underwent strep testing and those who did not were compared. Strep testing was more common in younger patients (mean age = 8.26 vs 10.26 years P appendicitis and 35 (16.9%) patients tested positive for strep pharyngitis. No cases of concurrent strep pharyngitis and appendicitis were identified. The negative appendectomy rate in the strep pharyngitis tested group was 38.5% (5/13), compared with 7.7% (23/296) ( P = .003) in the nontested group. The appendicitis rate among the strep tested group was 3.8% (8/207) compared with 20% (273/1365) in the nontested group ( P appendicitis, and had a higher rate of negative appendectomy. A diagnosis of concurrent appendicitis and strep pharyngitis is rare. In cases of patients with sufficient symptoms to warrant testing for strep pharyngitis a diagnosis of appendicitis is less likely and surgical intervention leads to higher negative appendectomy rates.
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Milinevskiĭ, I V; Shabaldina, E V; Shamova, I P; Shabaldin, A V
2011-01-01
The analysis of the efficacy of citalopran for the treatment of chronic pharyngitis and pharyngeal neurosis was carried out. The positive outcome of the treatment was documented in 95% of the patients.
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STATUS OF THE IMMUNITY OF PATIENTS WITH CHRONIC STAPHYLOCOCCUS’S PHARYNGITIS
Directory of Open Access Journals (Sweden)
Ognivenko E.V.
2015-12-01
of IgG and mIgA and reducing values sIgA and lysozyme in oropharyngeal secretions. It has also been found that digesting and absorbing capability of bacterial particles neutrophils peripheral blood of patients with ChPh lower than that of healthy individuals. Low phagocytic ability of cell for patients with HF was observed in respect of opsonized autoserum bacteria. In all patients of the main group and the comparison group revealed a significant increase in antibody titer to bacterial etiological factors and common antigenic determinative (CAD bacteria. High antibody titers were detected for almost all microbes studied. The clinical observations have shown that under the influence of Polioksidonium patients with chronic staphylococcus’s pharyngitis on the 7th day after the treatment has shown a marked decrease or complete disappearance of the major clinical symptoms. All patients receiving Polioksidonium markedly improved overall health. The instrumental examination the 65% of the patients of the main group and the 70% of comparison group on the 7th day after the end of treatment were observed with swelling and hypertrophy of the mucous membrane of the posterior pharyngeal wall. On the 30th day after the end of treatment, 71.8% of the study group patients were without complaints (in the comparison group - 30 % of patients, and their clinical status was characterized by the norm. Pharyngoscope at 22 % of the patients of the main group and at 66% of the patients of the comparison group experienced a slight hypertrophy of the mucous membrane of the posterior pharyngeal wall. Microbiological examination of the main group found in 15,7 % of cases the рresent of pathogens, marked decrease in microbial associations without the appearance of fungal flora and 68% of the pathogenic microflora. In the control group half of the patients (52 % was sown pathogenic flora, a slight decrease in the amount of microbial associations. Under the effect of Polioksidonium the increase
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Directory of Open Access Journals (Sweden)
Jun Sik Kim
2012-11-01
Full Text Available Squamous cell carcinoma infrequently occurs at the soft palate. Although various methodscan be used for reconstruction of soft palate defects that occur after resecting squamous cellcarcinoma, it is difficult to obtain satisfactory results from the perspective of the functionalrestoration of the soft palate. A combination of bilateral palatal mucomuscular flap for theoral side and superiorly based posterior pharyngeal flap for the nasal side were performed ontwo patients who were diagnosed with squamous cell carcinoma of the soft palate in orderto reconstruct the soft palate defects after surgical resection. After surgery, the patients werefollowed-up for a mean period of 11 months. The flaps were well maintained in both patients.The donor site defects were epithelialized and completely recovered. Additionally, no recurrenceof the primary sites was shown. Slight hyponasality was observed in the voice assessmentsthat were conducted 6 months after surgery. No food regurgitation or aspiration was observedin the swallowing tests. We used a combination of bilateral palatal mucomuscular flap andsuperiorly based posterior pharyngeal flap to reconstruct the soft palate defects that occurredafter resecting the squamous cell carcinomas. We reduced the donor site complications andachieved functionally satisfactory outcomes.
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Abramovich, S.; Hannan, S. A.; Huins, C. T.; Georgalas, C.; McGuinness, J.; Vats, A.; Thompson, I.
2008-01-01
OBJECTIVE: To compare the effectiveness of bioactive glass implants and conchal cartilage in reconstructing the posterior canal wall during tympanomastoidectomy. STUDY DESIGN: Prospective cohort clinical study. SETTING: Teaching hospital. PATIENTS: Patients with clinically diagnosed chronic
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Gastroesophageal reflux and pharyngeal function
International Nuclear Information System (INIS)
Ekberg, O.; Lindgren, S.; Malmoe Allmaenna Sjukhus
1986-01-01
Pharyngeal function and gastroesophageal reflux were compared in 84 dysphagic patients examined clinically and radiologically. Cricopharyngeal muscle incoordination, assessed cineradiographically, was revealed in 5 of 41 patients (12%) without and 17 of 43 patients (40%) with gastroesophageal reflux assessed clinically (p<0.05). Thus, there was a postive correlation between dysfunction of the cricopharyngeal muscle and gastroesophageal reflux. There was no correlation with other types of pharyngeal dysfunction. Our results support the assumption of a positive relationship between gastroesophageal reflux and pharyngeal function in terms of cricopharyngeal dysfunction. The pathogenesis of this relation was, however, not revealed. (orig.)
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Gastroesophageal reflux and pharyngeal function
Energy Technology Data Exchange (ETDEWEB)
Ekberg, O.; Lindgren, S.
Pharyngeal function and gastroesophageal reflux were compared in 84 dysphagic patients examined clinically and radiologically. Cricopharyngeal muscle incoordination, assessed cineradiographically, was revealed in 5 of 41 patients (12%) without and 17 of 43 patients (40%) with gastroesophageal reflux assessed clinically (p<0.05). Thus, there was a postive correlation between dysfunction of the cricopharyngeal muscle and gastroesophageal reflux. There was no correlation with other types of pharyngeal dysfunction. Our results support the assumption of a positive relationship between gastroesophageal reflux and pharyngeal function in terms of cricopharyngeal dysfunction. The pathogenesis of this relation was, however, not revealed.
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International Nuclear Information System (INIS)
Iinuma, Toshitaka; Ishio, Ken-ichirou; Yoshinami, Hiroyoshi; Kuriyama, Jun-ichi; Hirota, Yoshiharu.
1993-01-01
A total of 59 cases of mild facial fractures (simple orbital wall fractures, 34 cases, other facial fractures, 25 cases) with the clinical suspects of orbital wall fractures were evaluated both by conventional views (Waters' and Caldwell views) and coronal CT scans. Conventional views were obtained, as an average, after 4 days and CT after 7 days of injuries. Both the medial wall and the floor were evaluated at two sites, i.e., anterior and posterior. The ethmoid-maxillary plate was also included in the study. The degree of fractures was classified as, no fractures, fractures of discontinuity, dislocation and fragmentation. The coronal CT images in bone window condition was used as reference and the findings were compared between conventional views and CT. The correct diagnosis was obtained as follows: orbital floor (anterior, 78%, posterior, 73%), medial orbital wall (anterior, 72%, posterior, 72%) and ethmoid-maxillary plate (64%). The false positive diagnosis was as follows: orbital floor (anterior only, 13%), medial orbital wall (anterior only, 7%) and ethmoid-maxillary plate (11%). The false negative diagnosis was as follows: orbital floor (anterior, 9%, posterior, 10%), medial orbital wall (anterior, 21%, posterior, 28%) and ethmoid-maxillary plate (21%). The results were compared with those of others in the past. (author)
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Overlapping sphincteroplasty and posterior repair.
Crane, Andrea K; Myers, Erinn M; Lippmann, Quinn K; Matthews, Catherine A
2014-12-01
Knowledge of how to anatomically reconstruct extensive posterior-compartment defects is variable among gynecologists. The objective of this video is to demonstrate an effective technique of overlapping sphincteroplasty and posterior repair. In this video, a scripted storyboard was constructed that outlines the key surgical steps of a comprehensive posterior compartment repair: (1) surgical incision that permits access to posterior compartment and perineal body, (2) dissection of the rectovaginal space up to the level of the cervix, (3) plication of the rectovaginal muscularis, (4) repair of internal and external anal sphincters, and (5) reconstruction of the perineal body. Using a combination of graphic illustrations and live video footage, tips on repair are highlighted. The goals at the end of repair are to: (1) have improved vaginal caliber, (2) increase rectal tone along the entire posterior vaginal wall, (3) have the posterior vaginal wall at a perpendicular plane to the perineal body, (4) reform the hymenal ring, and (5) not have an overly elongated perineal body. This video provides a step-by-step guide on how to perform an overlapping sphincteroplasty and posterior repair.
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Sinha, S; Sen, S; Chacko, J; Thomas, G; Karl, S; Mathai, J
2006-06-01
We have approached two patients with Y-duplication of the male urethra by a new two-staged technique to provide better results. A strip of anterior anorectal wall in continuity with the posterior urethra was used for posterior urethral lengthening and a tubed pedicled prepucial flap was used to reconstruct the anterior urethra without using the native urethra. This was done under a covering colostomy. After a gap of 6 months to allow for healing of the anorectum and to ensure adequate functioning of the perineal neourethra, second stage reconstruction was done using buried scrotal tube for the mid urethra along with colostomy closure. On follow-up at 8 and 12 months, respectively, both children were well with no stricture or fistula. There was normal anal continence and no stenosis. This technique tackles the problem in Y-duplication of the male urethra of lengthening the posterior urethral channel, which is often difficult to bring to the anterior half of the perineum especially if the opening is high up in the anorectum (case 2).
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Cutler, Michael J; Johnson, Jeremy; Abozguia, Khalid; Rowan, Shane; Lewis, William; Costantini, Otto; Natale, Andrea; Ziv, Ohad
2016-01-01
Fibrosis as a substrate for atrial fibrillation (AF) has been shown in numerous preclinical models. Voltage mapping enables in vivo assessment of scar in the left atrium (LA), which can be targeted with catheter ablation. We hypothesized that using the presence or absence of low voltage to guide ablation beyond pulmonary vein antral isolation (PVAI) will improve atrial arrhythmia (AF/AT)-free survival in persistent AF. Single-center retrospective analysis of 2 AF ablation strategies: (1) standard ablation (SA) versus (2) voltage-guided ablation (VGA). PVAI was performed in both groups. With SA, additional lesions beyond PVAI were performed at the discretion of the operator. With VGA, additional lesions to isolate the LA posterior wall were performed if voltage mapping of this region in sinus rhythm showed scar (LA voltage atrial size. Posterior wall ablation was performed in 57% of patient with SA compared to 42% with VGA. VGA ablation increased 1-year AF-/AT-free survival in patients when compared to SA (80% vs. 57%; P = 0.005). In a multivariate analysis, VGA was the only independent predictor of AF-/AT-free survival (hazard ratio of 0.30; P = 0.002). The presence of LA posterior wall scar may be an important ablation target in persistent AF. A prospective randomized trial is needed to confirm these data. © 2015 Wiley Periodicals, Inc.
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Pakistan prevalence survey in acute pharyngitis
International Nuclear Information System (INIS)
Rathi, S. K.
2014-01-01
Objective: To study the prevalence of Group A beta haemolytic Streptococcus in patients with acute pharyngitis and correlation of Modified Centor Score and Rapid Antigen Detection Test. Methods: The multi-centre, prospective, cross-sectional study was conducted in 8 major cities of Pakistan between June 2012 and February 2013, and comprised patients presenting with acute pharyngitis. The subjects were above 3 years of age presenting to primary care physician with sore throat, temperature over 100.4 (degree) F, tonsillar exudates and/or cervical adenopathy (duration of symptoms 4. Conclusion: The prevalence of Group A beta haemolytic Streptococcus as a cause of acute pharyngitis was 25.3%. Modified Centor Score had a strong positive correlation with Rapid Antigen Detection Test in identifying Group A beta haemolytic Streptococcus as a cause of acute pharyngitis. (author)
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Directory of Open Access Journals (Sweden)
Po Ding
2014-01-01
Conclusions: Endo-laparoscopic rendezvous approach is considered to represent the next revolution in surgery. The new technique is reliable and effective in clinical application, due to the advantages of accurate and quick localization for pericardial GIST within gastric posterior wall.
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Ding, Po; Zhao, Yongjie
2014-12-01
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tract and most frequently developed in the stomach, and surgical therapy is limited on removal of the tumor lesion. The aim of this study was to investigate the clinical values of endo-laparoscopic rendezvous approach for pericardial GISTs within gastric posterior wall. Surgical outcome and clinical data of 52 patients with pericardial GISTs within gastric posterior wall treated at Tianjin Peoples' Hospital from January 2004 to October 2013 were analyzed. Endo-laparoscopic rendezvous approach was used as an operative procedure for tumor resection ranged from 10 to 50 mm. Endoscopic ultrasound, computed tomography and microscopic findings all certified the gastric spindle type GIST locating in the submucosa to muscle proper. Endo-laparoscopic rendezvous approach was attempted in 52 patients (male/female: 31/21) with median age of 51 years (25-71 years). The median operating time was 80 min (range: 40-120 min) and median intra-operative blood loss was 26 ml (range: 10-50 ml). The median hospital stay was 5 days (range: 4-6 days), while the median tumor size was 25 mm (range: 7-50 mm). All operative margins were clear. There were no recurrences or metastases of all patients in a median follow-up of 24 months (range: 6-36 months). Endo-laparoscopic rendezvous approach is considered to represent the next revolution in surgery. The new technique is reliable and effective in clinical application, due to the advantages of accurate and quick localization for pericardial GIST within gastric posterior wall.
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Beryllium concentration in pharyngeal tonsils in children
Directory of Open Access Journals (Sweden)
Ewa Nogaj
2014-06-01
Full Text Available Power plant dust is believed to be the main source of the increased presence of the element beryllium in the environment which has been detected in the atmospheric air, surface waters, groundwater, soil, food, and cigarette smoke. In humans, beryllium absorption occurs mainly via the respiratory system. The pharyngeal tonsils are located on the roof of the nasopharynx and are in direct contact with dust particles in inhaled air. As a result, the concentration levels of beryllium in the pharyngeal tonsils are likely to be a good indicator of concentration levels in the air. The presented study had two primary aims: to investigate the beryllium concentration in pharyngeal tonsils in children living in southern Poland, and the appropriate reference range for this element in children’s pharyngeal tonsils. Pharyngeal tonsils were extracted from a total of 379 children (age 2–17 years, mean 6.2 ± 2.7 years living in southern Poland. Tonsil samples were mineralized in a closed cycle in a pressure mineralizer PDS 6, using 65% spectrally pure nitric acid. Beryllium concentration was determined using the ICP-AES method with a Perkin Elmer Optima 5300DVTM. The software Statistica v. 9 was used for the statistical analysis. It was found that girls had a significantly greater beryllium concentration in their pharyngeal tonsils than boys. Beryllium concentration varies greatly, mostly according to the place of residence. Based on the study results, the reference value for beryllium in pharyngeal tonsils of children is recommended to be determined at 0.02–0.04 µg/g.
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Causes and consequences of anterior pharyngeal pouch after total laryngectomy.
Anderson, S; Hogan, D; Panizza, B
2014-07-01
To assess the frequency of anterior pharyngeal pouch formation after total laryngectomy, and to discuss the causes and consequences of anterior pharyngeal pouch formation. A prospective, observational study of 43 patients undergoing total laryngectomy. Data collected included laryngeal defect closure type, tumour staging and demographic information. A barium swallow was performed on day 7-14 after surgery to assess for anterior pharyngeal pouch formation and fistula formation. The incidence of anterior pharyngeal pouch formation was 47 per cent. Patients who did not have an anterior pharyngeal pouch on swallow imaging assessment were less likely to develop a pharyngo-cutaneous fistula. There was no statistically significant association between laryngeal defect closure type and anterior pharyngeal pouch formation. The anterior pharyngeal pouch is a dynamic phenomenon best investigated with a fluoroscopic swallow imaging study. Its causes are multi-factorial. Absence of an anterior pharyngeal pouch appears to confer protection against pharyngo-cutaneous fistula formation, hastening commencement of adjuvant therapy and an oral diet.
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Platelet-Rich Plasma in Reconstruction of Posterior Meatal Wall after Canal Wall Down Mastoidectomy.
Elbary, Mohammad El-Sayed Abd; Nasr, Wail Fayez; Sorour, Samir Sorour
2018-04-01
Introduction Canal wall down (CWD) mastoidectomy has many drawbacks, including chronic otorrhea not responding to medications, granulations, dizziness on exposure to cold or hot water, and tendency of debris accumulation in the mastoid cavity, demanding periodic cleaning. Many of these problems can be solved by reconstruction of the posterior meatal wall (PMW). Objectives To assess the results of PMW reconstruction after CWD mastoidectomy for cholesteatoma using titanium mesh and platelet-rich plasma (PRP) mixed with bone pate. Methods This study was conducted with 20 patients that have atticoantral chronic suppurative otitis media. All cases were subjected to CWD mastoid surgery with complete elimination of the disease and reconstruction of the PMW by titanium mesh and the mixture of PRP with bone pate. All patients were exposed to a full preoperative evaluation and full postoperative assessment of the complications, the appearance of the external auditory canal contour, and the hearing gain expressed by the change of the air bone gap postoperatively. Results The PMW reconstructed by titanium mesh and the mixture of PRP with bone pate showed a smooth contour. During the follow-up of 12 to 36 months, the postoperative appearance of the external auditory canal contour was found to be smooth without hidden pouches, irregularities or stenosis in all cases. No granulation, foreign body reaction, or extrusion and/or displacement of the titanium mesh were registered. No facial palsy or recurrent cholesteatoma was reported. Conclusion The surgical reconstruction of the PMW using PRP, bone pate and titanium mesh after CWD mastoidectomy appears to be reliable without considerable complications, giving a smooth appearance to the PMW.
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How to perform posterior wall isolation in catheter ablation for atrial fibrillation.
Sugumar, Hariharan; Thomas, Stuart P; Prabhu, Sandeep; Voskoboinik, Aleksandr; Kistler, Peter M
2018-02-01
Catheter ablation has become standard of care in patients with symptomatic atrial fibrillation (AF). Although there have been significant advances in our understanding and technology, a substantial proportion of patients have ongoing AF requiring repeat procedures. Pulmonary vein isolation (PVI) is the cornerstone of AF ablation; however, it is less effective in patients with persistent as opposed to paroxysmal atrial fibrillation. Left atrial posterior wall isolation (PWI) is commonly performed as an adjunct to PVI in patients with persistent AF with nonrandomized studies showing improved outcomes. Anatomical considerations and detailed outline of the various approaches and techniques to performing PWI are detailed, and advantages and pitfalls to assist the clinical electrophysiologist successfully and safely complete PWI are described. © 2017 Wiley Periodicals, Inc.
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Wnt signaling balances specification of the cardiac and pharyngeal muscle fields
Mandal, Amrita; Holowiecki, Andrew; Song, Yuntao Charlie; Waxman, Joshua S.
2017-01-01
Canonical Wnt/β-catenin (Wnt) signaling plays multiple conserved roles during fate specification of cardiac progenitors in developing vertebrate embryos. Although lineage analysis in ascidians and mice has indicated there is a close relationship between the cardiac second heart field (SHF) and pharyngeal muscle (PM) progenitors, the signals underlying directional fate decisions of the cells within the cardio-pharyngeal muscle field in vertebrates are not yet understood. Here, we examined the temporal requirements of Wnt signaling in cardiac and PM development. In contrast to a previous report in chicken embryos that suggested Wnt inhibits PM development during somitogenesis, we find that in zebrafish embryos Wnt signaling is sufficient to repress PM development during anterior-posterior patterning. Importantly, the temporal sensitivity of dorso-anterior PMs to increased Wnt signaling largely overlaps with when Wnt signaling promotes specification of the adjacent cardiac progenitors. Furthermore, we find that excess early Wnt signaling can cell autonomously promote expansion of the first heart field (FHF) progenitors at the expense of PM and SHF within the anterior lateral plate mesoderm (ALPM). Our study provides insight into an antagonistic developmental mechanism that balances the sizes of the adjacent cardiac and PM progenitor fields in early vertebrate embryos. PMID:28087459
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Two cases of posterior scleritis and findings of computerized tomography and ultrasonography
International Nuclear Information System (INIS)
Ohara, Takakazu; Uji, Yukitaka; Fujioka, Chieko; Mori, Kazuma
1982-01-01
Two cases of unilateral posterior scleritis, seen in 56-year-old and 68-year-old females, are reported. Computerized tomography showed characteristic findings, as follows: 1) Thickening of the posterior sclera and surrounding tissue. 2) Irregularity of the posterior wall of the eyeball. 3) Increased radiographic density in the posterior wall of the eyeball. Ultrasonography also suggested thickening of the posterior sclera. Computerized tomography and ultrasonography are considered useful in the diagnosis of posterior scleritis. (author)
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Pharyngeal Dystonia Mimicking Spasmodic Dysphonia.
Shi, Lucy L; Simpson, C Blake; Hapner, Edie R; Jinnah, Hyder A; Johns, Michael M
2018-03-01
The aim of this study was to describe the presentation of pharyngeal dystonia (PD), which can occur as a focal or segmental dystonia with a primarily pharyngeal involvement for the discussion of treatment methods for controlling consequent symptoms. PD is specific to speech-related tasks. A retrospective medical record review of four patients with PD was performed. All patients were initially misdiagnosed with adductor spasmodic dysphonia and failed standard treatment with botulinum toxin type A (BTX). On laryngoscopy, the patients were discovered to have segmental or focal dystonia primarily affecting the pharyngeal musculature contributing to their vocal manifestations. A novel treatment regimen was designed, which involved directing BTX injections into the muscles involved in spasmodic valving at the oropharyngeal level. After titrating to an optimal dose, all patients showed improvement in their voice and speech with only mild dysphagia. These patients have maintained favorable results with repeat injections at 6- to 12-week intervals. PD, or dystonia with predominant pharyngeal involvement, is a rare entity with vocal manifestations that are not well described. It can be easily mistaken for spasmodic dysphonia. PD is specific to speech-related tasks. A novel method of BTX injections into the involved muscles results in a significant improvement in voice without significant dysphagia. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
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Altered pharyngeal muscles in Parkinson disease.
Mu, Liancai; Sobotka, Stanislaw; Chen, Jingming; Su, Hungxi; Sanders, Ira; Adler, Charles H; Shill, Holly A; Caviness, John N; Samanta, Johan E; Beach, Thomas G
2012-06-01
Dysphagia (impaired swallowing) is common in patients with Parkinson disease (PD) and is related to aspiration pneumonia, the primary cause of death in PD. Therapies that ameliorate the limb motor symptoms of PD are ineffective for dysphagia. This suggests that the pathophysiology of PD dysphagia may differ from that affecting limb muscles, but little is known about potential neuromuscular abnormalities in the swallowing muscles in PD. This study examined the fiber histochemistry of pharyngeal constrictor and cricopharyngeal sphincter muscles in postmortem specimens from 8 subjects with PD and 4 age-matched control subjects. Pharyngeal muscles in subjects with PD exhibited many atrophic fibers, fiber type grouping, and fast-to-slow myosin heavy chain transformation. These alterations indicate that the pharyngeal muscles experienced neural degeneration and regeneration over the course of PD. Notably, subjects with PD with dysphagia had a higher percentage of atrophic myofibers versus with those without dysphagia and controls. The fast-to-slow fiber-type transition is consistent with abnormalities in swallowing, slow movement of food, and increased tone in the cricopharyngeal sphincter in subjects with PD. The alterations in the pharyngeal muscles may play a pathogenic role in the development of dysphagia in subjects with PD.
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A Peduncular Cystic Compound Odontoma on the Posterior Wall of the Maxillary Sinus
Energy Technology Data Exchange (ETDEWEB)
Kang, Byung Chul [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chonam National University, Kwangju (Korea, Republic of)
1998-08-15
A cystic compound odontoma in the maxillary sinus occurred in a 13-years-old boy, who had missing right upper third molar without having the history of extraction of the wisdom tooth. He complained nasal stuffiness, headache, and pain on the affected face, resembling any sign and symptoms of the maxillary sinus problems. The cysteic compound, sized 2 x 1.5 cm in diameter was pedunculated and attached on the posterior wall of the right maxillary sinus and above the antral floor. The location of the compound odontoma in the maxillary sinus was confirmed after panoramic, waters, spiral tomographic, CT examinations and surgical exploration. Irs location was on the medical, posterior, superior to the normal position of the maxillary third molar or the maxillary dental arch. The cystic odontoma in the maxillary sinus made the patient have the sings and symptoms of maxillary sinusitis. The cystic compound odontoma might be originated from the dental lamina of the missing upper right third molar. The 'V principle' of the upper jaw growth and the pneumatization process of the maxillary sinus could explain why the compound odontoma had peduncular shape and the location of odontoma was on the medial, superior to the normal position of the maxillary dental arch.
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Guzman, Marco; Lanas, Andres; Olavarria, Christian; Azocar, Maria Josefina; Muñoz, Daniel; Madrid, Sofia; Monsalve, Sebastian; Martinez, Francisca; Vargas, Sindy; Cortez, Pedro; Mayerhoff, Ross M
2015-01-01
The present study aimed to assess three different singing styles (pop, rock, and jazz) with laryngoscopic, acoustic, and perceptual analysis in healthy singers at different loudness levels. Special emphasis was given to the degree of anterior-posterior (A-P) laryngeal compression, medial laryngeal compression, vertical laryngeal position (VLP), and pharyngeal compression. Prospective study. Twelve female trained singers with at least 5 years of voice training and absence of any voice pathology were included. Flexible and rigid laryngeal endoscopic examinations were performed. Voice recording was also carried out. Four blinded judges were asked to assess laryngoscopic and auditory perceptual variables using a visual analog scale. All laryngoscopic parameters showed significant differences for all singing styles. Rock showed the greatest degree for all of them. Overall A-P laryngeal compression scores demonstrated significantly higher values than overall medial compression and VLP. High loudness level produced the highest degree of A-P compression, medial compression, pharyngeal compression, and the lowest VLP for all singing styles. Additionally, rock demonstrated the highest values for alpha ratio (less steep spectral slope), L1-L0 ratio (more glottal adduction), and Leq (more vocal intensity). Statistically significant differences between the three loudness levels were also found for these acoustic parameters. Rock singing seems to be the style with the highest degree of both laryngeal and pharyngeal activity in healthy singers. Although, supraglottic activity during singing could be labeled as hyperfunctional vocal behavior, it may not necessarily be harmful, but a strategy to avoid vocal fold damage. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
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Le mal de pott sous occipital révélé par un abcès rétro pharyngien a ...
African Journals Online (AJOL)
Introduction : Pott's disease is the most frequent localisation of osteo-articular tuberculosis. The suboccipital localisation remains rare. Case report : A 12-years old boy, admitted for cervicalgy and dysphagia. His clinical exam revealed a swelling of posterior pharyngeal wall associated with a basicervical tumefaction ...
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Carotis interna som pulserende udfyldning i pharynx
DEFF Research Database (Denmark)
Wærsted, Stian; Dethloff, Thomas Joachim
2016-01-01
-scan showed a tortuous ICA protruding into the lateral and posterior pharyngeal wall. This condition may need treatment in itself, and it can lead to co-morbidity and serious surgical complications in undiagnosed patients. Referral to an oto-rhino-laryngologist is highly recommended for diagnostics....
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[Etiological analysis and individualized treatment of pharyngeal paraesthesia].
Lou, Zhengcai; Gong, Xuhong; Lou, Fangyi; He, Lanjuan; Zhu, Qiaoying
2009-07-01
To analyze the nosazontology of pharyngeal paraesthesia and investigate the treatment. Two hundred and twelve misdiagnosed pharyngeal paraesthesia patients were investigated by history inquiry, routine examination, 24-hour esophageal pH monitoring, barium X-ray of the oesophagus, anxieties-athymic private measuring scale, coefficient of variation of the R-R (CVR-R), bioavailable testosterone detection (Bio-T), erection experiment and questionnaire about man climacteric syndrome. The concomitant symptoms and positions of pharyngeal paresthesia were also studied. We adopted individuallized sequential multi-therapy for every patient according to the cause of disease. The cause of disease within 212 cases of pharyngeal paraesthesia included 62 psychic trauma, 32 endocrine system disease, 106 upper gastrointestinal disease, circulatory disease, 9 circulatory disease, 3 idiopathic. With individualized treatment, 110 cases had fully recovered, 63 cases excellence and 31 cases utility, and the efficiency rate was 96.23%. Pharyngeal paraesthesia can be caused by several factors. Thorough examination and comprehensive analysis should be applied to those incurable patient who has been treated for a long time. Short course of treatment and irrational drug use are the main causes of short-term recurrence and unsatisfactory curative effect.
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LOCAL TREATMENT FEATURES OF PHARYNGITIS IN CHILDREN
Directory of Open Access Journals (Sweden)
E. А. Lebedinskaya
2014-01-01
Full Text Available This paper reviews causes and treatment methods for inflammatory forms of pharynx pathology in children. It is shown that the primary cause of pharyngitis pathogenesis is the dysfunction of immunogenic resistance of pharyngeal mucous membrane. It is mucosal immune system that blocks viral and bacterial infections. Taking into account functional principles of mucosal immune system allows creating a personal programme of immunoreabilitation based on physiological and complex principles. At the same time in pediatric practice not only drug efficacy, but also its safety, ease of use and flavor become increasingly important. In this regard possibilities and advantages of locally applied antiseptics for acute pharyngitis treatment in children are considered.
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A radiological study on the velopharyngeal movement of dysarthric patients
Energy Technology Data Exchange (ETDEWEB)
Kim, M. J.; Oh, K. K.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)
1984-03-15
Velopharyngeal incompetency may be the main cause of dysarthria. Velopharyngeal incompetency can be induced by congenital anomalies, such as cleft palate and short soft palate and deformity of soft palte, or complication of adenoidectomy, and neuromuscular disorders affecting the velopharyngeal movement. The present study is aimed to evaluate the velopharyngeal movement in dysarthric patients. The material consisted of 38 cases of dysarthric patients and 30 cases of non-dysarthric control persons examined at the Department of Radiology, Yonsei University College of Medicine from September, 1982 through August, 1983. The radiologic examinations of the soft palate and pharynx were done at neutral and phonation state using Toshiba 500mA Imaging Intensifier. All cases were subjected to morphometric analysis by measuring the soft palate and pharynx. Results obtained were as follows: 1. In control group, the length of the soft palate was 40.7{+-}0.71mm in neutral state and increased 11% in vowel sound, 13% in consonant sound. The thickness of the soft palate was 9.4{+-}0.19mm in neutral state and increased 17% in vowel sound, 16% in consonant sound. The distance between the lateral pharyngeal walls was 36.2{+-}0.92mm in neutral state and decreased 8% in vowel sound, 11% consonant sound. The gap between the soft palate and posterior pharyngeal walla was not present and the levator eminence was higher than the level of the hard palate in phonation. 2. Among the dysarthric patients, 1) In group of dysarthric patients patients with morphological abnormality, the thickness of soft palate was minimally changed in relation to the control group, while the distance between the lateral pharyngeal walls was more decreased than the control group. The gap between the soft palate and posterior pharyngeal wall was more than 3 mm in 90.9% of these cases, and the levator eminence was at or below the level of hard palate. 2) In group of dysarthric patients with functional abnormality, the
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Diagnosis and management of group A streptococcal pharyngitis and associated complications [digest].
Vazquez, Michelle N; Sanders, Jennifere E; Wilson, Bryan
2017-12-21
Although group A Streptococcus (GAS) pharyngitis is the most common cause of bacterial pharyngitis in children and adolescents, many viral and bacterial infections mimic the symptoms of GAS pharyngitis. Emergency clinicians must recognize the symptomatology of GAS pharyngitis and use appropriate means of diagnosis and treatment to promote good antibiotic stewardship. This issue reviews the signs and symptoms of GAS pharyngitis, as well as associated complications, and provides recommendations for appropriate treatment that focuses on reducing the severity and duration of symptoms, reducing the incidence of nonsuppurative complications, and reducing transmission. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].
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COMPUTED TOMOGRAPHIC EVALUATION OF CANINE PHARYNGEAL NEOPLASIA
Carozzi, Gregorio
2016-01-01
Computed tomography (CT) is commonly used to investigate head tumours in dogs, and is a fundamental part of the diagnostic work-up, for diagnosis, staging and planning therapy in neoplastic disease. Nasal diseases, either neoplastic or non-neoplastic diseases, oral neoplasia, brain disease, thyroid or carotid body neoplasia have been extensively studied. However little information are available for lesions of the pharyngeal area. In this thesis, cases of dogs affected by pharyngeal neoplas...
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TREATMENT FOR ACUTE PHARYNGITIS AND TONSILLOPHARYNGITIS AMONG SICKLY CHILDREN
Directory of Open Access Journals (Sweden)
G.A. Samsygina
2007-01-01
Full Text Available Among the sickly children, pharyngitis and tonsillopharyngitis are quite often accompanied by pain and scratch in a throat, which is anguished for a child themselves and causes parents to worry. In the therapy for the indicated pathology, a certain place is held by a local antibiotic fusafungine. In the article, the author studies the effects of fusafungine on tonsillitis/tonsillopharyngitis and pharyngitis, running with pain in a throat, among the sickly children aged between 3 and 15. The research was carried on in 42 centers of different Russian regions and became a part of the multicentered research according to «Chibis» program. 2,609 children were examined, 1,907 of who Received fusafungine and 702 children did not. Among 78,1% of the children, the authors noted the phenomena of pharyngitis, rhinopharyngitis and acute tonsillopharyngitis. As the research showed the symptoms of rhinopharyngitis and tonsillopharync gitis were reliably arrested much faster, when applying fusafungine, thus, the clinical effects mostly emerged after 4th–5th day of the therapy. The acquired data allowed one to recommend the inclusion of fusafungine into the therapy for acute rhinopharyngitis, pharyngitis and tonsillopharyngitis among the sickly children.Key words: rhinopharyngitis, pharyngitis, tonsillopharyngitis, fusafungine, children, treatment.
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Variability of the pharyngeal phase of swallow in the cat.
Directory of Open Access Journals (Sweden)
Daniel G Spearman
Full Text Available The pharyngeal phase of swallow has been thought to be a stereotypical motor behavior.This is a prospective, preclinical, hypothesis driven, one group by three-task design.We sought to compare the effects of pharyngeal swabbing, water only, and water plus punctate mechanical stimulation on the spatiotemporal features of the pharyngeal phase of swallow in the cat. Swallow was elicited under these three conditions in six anaesthetized cats. Electromyographic activity was recorded from seven muscles used to evaluate swallow: mylohyoid, geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeus, cricopharyngeus, and parasternal.Pharyngeal swabbing in comparison to the other stimulus conditions, results in decreases in post-swallow cricopharyngeus activity (upper esophageal sphincter; a significant increase in parasternal (schluckatmung; swallow breath activity; and increases in thyrohyoid (laryngeal elevator, thyroarytenoid (laryngeal adductor and parasternal muscles burst duration. Pearson correlations were found of moderate strength between 19% of burst duration comparisons and weak to moderate relationships between 29% of burst amplitude comparisons. However, there were no positive significant relationships between phase durations and electromyogram amplitudes between any of the muscles studied during swallow.The results support the concept that a stereotypical behavior, such as pharyngeal swallowing in animal models, can be modified by sensory feedback from pharyngeal mucosal mechanoreceptors. Furthermore, differences in swallow phase durations and amplitudes provide evidence that separate regulatory mechanisms exist which regulate spatial and temporal aspects of the behavior.
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A radiological study on the velopharyngeal movement of dysarthric patients
International Nuclear Information System (INIS)
Kim, M. J.; Oh, K. K.; Park, C. Y.
1984-01-01
Velopharyngeal incompetency may be the main cause of dysarthria. Velopharyngeal incompetency can be induced by congenital anomalies, such as cleft palate and short soft palate and deformity of soft palte, or complication of adenoidectomy, and neuromuscular disorders affecting the velopharyngeal movement. The present study is aimed to evaluate the velopharyngeal movement in dysarthric patients. The material consisted of 38 cases of dysarthric patients and 30 cases of non-dysarthric control persons examined at the Department of Radiology, Yonsei University College of Medicine from September, 1982 through August, 1983. The radiologic examinations of the soft palate and pharynx were done at neutral and phonation state using Toshiba 500mA Imaging Intensifier. All cases were subjected to morphometric analysis by measuring the soft palate and pharynx. Results obtained were as follows: 1. In control group, the length of the soft palate was 40.7±0.71mm in neutral state and increased 11% in vowel sound, 13% in consonant sound. The thickness of the soft palate was 9.4±0.19mm in neutral state and increased 17% in vowel sound, 16% in consonant sound. The distance between the lateral pharyngeal walls was 36.2±0.92mm in neutral state and decreased 8% in vowel sound, 11% consonant sound. The gap between the soft palate and posterior pharyngeal walla was not present and the levator eminence was higher than the level of the hard palate in phonation. 2. Among the dysarthric patients, 1) In group of dysarthric patients patients with morphological abnormality, the thickness of soft palate was minimally changed in relation to the control group, while the distance between the lateral pharyngeal walls was more decreased than the control group. The gap between the soft palate and posterior pharyngeal wall was more than 3 mm in 90.9% of these cases, and the levator eminence was at or below the level of hard palate. 2) In group of dysarthric patients with functional abnormality, the
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Counseling a Patient with the Antenatal Diagnosis of a Cerebellar Abnormality and a Pharyngeal Cyst
Directory of Open Access Journals (Sweden)
Lissa Francois
2014-11-01
Full Text Available Introduction - Prenatal counseling with regards to the prognosis of a cerebellar abnormality is hindered not only by the diverse clinical presentations but also by the presence of subtle findings. We present a case of a distinct combination of asymmetric cerebellar hypoplasia secondary to an anterior meningoencephalocele through a clival defect that caused a severe airway obstruction in the newborn. Case Description - A 21-year-old gravida 4 para 0 mother with a dichorionic–diamniotic twin pregnancy was referred for a second trimester sonographic survey. An asymmetric cerebellar hypoplasia, mega cisterna magna, and a pharyngeal cystic mass were noted on twin A. Magnetic resonance imaging report confirmed posterior fossa abnormalities and shed no light on the differential diagnosis of the cystic mass. The pregnancy ended by Cesarean delivery at 32 weeksʼ gestation after a preterm premature rupture of the membranes. Twin A had a severe airway obstruction. Postnatal evaluation confirmed a midline anterior meningoencephalocele through a defect in the clivus. The microarray chromosomal analysis demonstrated a 5q15 variant with uncertain clinical significance. Conclusion - Antenatal recognition of the unique combination of a cerebellar hypoplasia with a pharyngeal cyst can impact the prenatal counseling as well as neonatal management.
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Pulmonary Renal Syndrome After Streptococcal Pharyngitis
Directory of Open Access Journals (Sweden)
Gopi Mara-Koosham PhD
2016-04-01
Full Text Available Pulmonary renal syndrome is a class of small vessel vasculitides that are characterized by the dual presentation of diffuse alveolar hemorrhage (DAH and glomerulonephritis. Pulmonary renal syndrome has multiple etiologies, but its development has been rarely reported following infection with group A streptococcus. We present the case of a 36-year-old Native American male who was transferred to our facility due to refractory hypoxic respiratory failure. He had been diagnosed with streptococcal pharyngitis 2 weeks prior to admission. Given the presence of hemoptysis, bronchoscopy was performed and was consistent with DAH. Urinalysis demonstrated hematuria and proteinuria, in the setting of elevated creatinine and blood urea nitrogen. Additionally, antistreptolysin O titer was positive. Given the constellation of laboratory findings and history of streptococcal pharyngitis, the patient was diagnosed with PRS secondary to streptococcal infection. High-dose methylprednisolone was initiated with concomitant plasmapheresis. He was extubated successfully after his respiratory status improved and was eventually discharged home after making a full recovery within 2 weeks after admission. This case illustrates the importance of clinically relevant sequelae of streptococcal infection as well as the appropriate treatment of PRS secondary to streptococcal pharyngitis with plasmapheresis and intravenous corticosteroids.
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Hellig, Christoph J.; Kerschbaumer, Michaela; Sefc, Kristina M.; Koblmüller, Stephan
2010-07-01
The morphological versatility of the pharyngeal jaw of cichlid fishes is assumed to represent a key factor facilitating their unparalleled trophic diversification and explosive radiation. It is generally believed that the functional design of an organism relates to its ecology, and thus, specializations to different diets are typically associated with distinct morphological designs, especially manifested in the cichlids’ pharyngeal jaw apparatus. Thereby, the lower pharyngeal jaw (LPJ) incorporates some of the most predictive features for distinct diet-related morphotypes. Thus, considering that piscivorous cichlids experience an ontogenetic dietary shift from typically various kinds of invertebrates to fish, concomitant morphological changes in the LPJ are expected. Using Lepidiolamprologus elongatus, a top predator in the shallow rocky habitat of Lake Tanganyika, as model, and applying geometric and traditional morphometric techniques, we demonstrate an allometric change in ontogenetic LPJ shape development coinciding with the completion of the dietary shift toward piscivory. The piscivorous LPJ morphotype is initiated in juvenile fish by increasing elongation and narrowing of the LPJ and—when the fish reach a size of 80-90 mm standard length—further refined by the elongation of the posterior muscular processes, which serve as insertion for the fourth musculus levator externus. The enlarged muscular processes of the fully mature piscivorous morphotype provide for the construction of a powerful lever system, which allows the large individuals to process large prey fish and rely on exclusive piscivory.
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Cuff inflation to aid nasotracheal intubation using the C-mac ...
African Journals Online (AJOL)
The main thrust of the technique is that cuff inflation of the endotracheal tube is used to lift the endotracheal tube off the posterior pharyngeal wall and thus direct it towards the glottis. The technique was used successfully in 5 consecutive patients needing nasotracheal intubation. Indeed a couple of these patients might have ...
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Streptococcus pyogenes pharyngeal colonization resulting in recurrent, prepubertal vulvovaginitis.
Hansen, Megan T; Sanchez, Veronica T; Eyster, Kathleen; Hansen, Keith A
2007-10-01
Recurrent, prepubertal, vaginal infections are an uncommon, troublesome problem for the patient and her family. Failure of initial therapy to alleviate vulvovaginitis may be related to vulvar skin disease, foreign body, sexual abuse, pinworms, reactions to medications, anatomic anomalies, or allergies. This report describes a case of recurrent Streptococcus pyogenes vulvovaginitis secondary to presumed vaginal re-inoculation from pharyngeal colonization. A 4-yr-old presented with one year of culture proven, recurrent Streptococcus pyogenes vulvovaginitis. Her symptoms repeatedly resolved with penicillin therapy, but continued to recur following cessation of antibiotic therapy. Evaluation included physical examination, trans-abdominal pelvic ultrasound, and vaginoscopy which all revealed normal upper and lower genital tract anatomy. Both the patient and her mother demonstrated culture proven, Group A Streptococcus pharyngeal colonization. Because of the possibility of repeated inoculations of the vaginal area from the colonized pharynx, they were both treated for decolonization with a regimen of amoxicillin and rifampin for ten days. Following this therapy there was resolution of vaginal symptoms with no further recurrence. Follow-up pharyngeal culture done on both mother and child on their last visit were negative for Group A Streptococcus. This case demonstrated an unusual specific cause of recurrent vaginitis resulting from presumed self or maternal re-inoculation with group A beta-hemolytic streptococcus from pharyngeal colonization. Group A beta-hemolytic streptococcus are consistently sensitive to penicillin, but up to 25% of acute pharyngitis cases treated with penicillin having continued asymptomatic, bacterial carriage within the nasopharynx. Thus initial alleviation of symptoms in a patient with Group A beta-hemolytic vulvovaginitis treated with penicillin, can have continued asymptomatic pharyngeal colonization which can result in recurrence of the
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Tang, Shi-xiong; Qing, Jing; Wang, Yao-wen; Chai, Liang; Zhang, Wei-min; Ye, Xian-wang; Zhang, Jie; Huang, Yi-qin; Cheng, Peng
2015-11-01
To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome (OSAHS). We conducted a non-randomized retrospective clinical trial of 75 patients with OSAHS. Fifty-four patients were managed by exercising of the pharyngeal musculature and genioglossus (exercising group). Twenty-one patients, who refused to undertake any treatment, were defined as the control group. We took the Epworth Sleepiness Scale (ESS), checked patients' polysomnography, and took 320-detector computed tomography (CT) before treatment. Six and twelve months later, we made records of apnea hypopnea index (AHI), lowest arterial oxygen saturation (LSaO2), body mass index (BMI), the shortest sagittal diameter, and transverse diameter, and the effective rates of exercising were calculated and compared with the 21 patients without any treatment (control group) at the same time. SPSS 10.0 was used to analyze the data. Before treatment, the ESS value was 7.67; 6 and 12 months later, the values were 3.54 and 3.25, respectively in the exercising group. AHI was decreased to 15.36 after 6 months and 13.79 after 12 months from 22.84 at the beginning. LSaO2 values were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. There were significant differences in ESS scores, AHI, and LSaO2 between pre-treatment and post-treatment in the exercising group (Pexercising. The effective rates were 70.37% and 74.07% after 6- and 12-month exercising, respectively. There were significant differences between the exercising and control groups (Pexercising group between 6 and 12 months of exercising (P>0.05). At 12 months of exercising, the compliance of the anteroposterior pharyngeal wall of the retropalatal area was lower (PExercising pharyngeal musculature and genioglossus is a kind of non-invasive and cost-effective method to treat some OSAHS patients, especially those who are old, without surgical complications, and especially
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TANG, Shi-xiong; QING, Jing; WANG, Yao-wen; CHAI, Liang; ZHANG, Wei-min; Ye, Xian-wang; Zhang, Jie; Huang, Yi-qin; Cheng, Peng
2015-01-01
Objective: To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome (OSAHS). Methods: We conducted a non-randomized retrospective clinical trial of 75 patients with OSAHS. Fifty-four patients were managed by exercising of the pharyngeal musculature and genioglossus (exercising group). Twenty-one patients, who refused to undertake any treatment, were defined as the control group. We took the Epworth Sleepiness Scale (ESS), checked patients’ polysomnography, and took 320 detector computed tomography (CT) before treatment. Six and twelve months later, we made records of apnea hypopnea index (AHI), lowest arterial oxygen saturation (LSaO2), body mass index (BMI), the shortest sagittal diameter, and transverse diameter, and the effective rates of exercising were calculated and compared with the 21 patients without any treatment (control group) at the same time. SPSS 10.0 was used to analyze the data. Results: Before treatment, the ESS value was 7.67; 6 and 12 months later, the values were 3.54 and 3.25, respectively in the exercising group. AHI was decreased to 15.36 after 6 months and 13.79 after 12 months from 22.84 at the beginning. LSaO2 values were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. There were significant differences in ESS scores, AHI, and LSaO2 between pre-treatment and post-treatment in the exercising group (Pexercising. The effective rates were 70.37% and 74.07% after 6- and 12-month exercising, respectively. There were significant differences between the exercising and control groups (Pexercising group between 6 and 12 months of exercising (P>0.05). At 12 months of exercising, the compliance of the anteroposterior pharyngeal wall of the retropalatal area was lower (PExercising pharyngeal musculature and genioglossus is a kind of non-invasive and cost-effective method to treat some OSAHS patients, especially those who are old, without
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INFLUENCE OF PASSIVE SMOKING ON CONTENT OF NICKEL IN CHILDREN PHARYNGEAL TONSILS
Directory of Open Access Journals (Sweden)
Jerzy Kwapuliński
2010-09-01
Full Text Available Subject of this study was pharyngeal tonsils which his anatomic location is interesing tissue. They are first tissue which has contact content in air inhalation substances in selective way. Pharyngeal tonsils came from children who lived in Silesia province. Some of these children have been expose to passive smoking. Contains nickel in pharyngeal tonsils was marked by the method of Inductively Coupled Plasma. Geometrical mean of contents of nickel in pharyngeal tonsils from exposed to tobacco smoke girls was 0,75 µg/g, in unexposed girls was 0,67 µg/g, in exposed to tobacco smoke boys was 0,55 µg/g and unexposed boys 0,6 µg/g was observed. The results have verified that sex, living place and exposure to tobacco smoke matter in accumulation nickel in pharyngeal tonsils. The cross-corelation analysis between content of Ni and other metals, found out positive corelation between Ni and Al, Cd, Cu, Pb, Zn, Ca, Mg.
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Pharyngeal airway changes following mandibular setback surgery
Directory of Open Access Journals (Sweden)
Babu Ramesh
2005-01-01
Full Text Available Treatment of dentofacial deformities with jaw osteotomies has an effect on airway anatomy and therefore mandibular setback surgery has the potential to diminish airway size. The purpose of this study was to evaluate the effect of mandibular setback surgery on airway size. 8 consecutive patients were examined prospectively. All patients underwent mandibular setback surgery. Cephalometric analysis was performed preoperatively and 3 months post operatively with particular attention to pharyngeal airway changes. Pharyngeal airway size decreased considerably in all, patients thus predisposing to development of obstructive sleep apnea. Therefore, large anteroposterior discrepancies should be corrected by combined maxillary and mandibular osteotomies.
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Co-morbidity and treatment outcomes of elderly pharyngeal cancer patients : A matched control study
Peters, Thomas T. A.; Langendijk, Johannes A.; Plaat, Boudewijn; Wedman, Jan; Roodenburg, Jan L. N.; van Dijk, Boukje A. C.; Sluiter, Wim J.; van der Laan, Bernard F. A. M.; Halmos, Gyorgy
2011-01-01
Treatment choice in elderly pharyngeal cancer patient is disputed. This study was aimed to asses association of co-morbidity, complications and survival in different treatment modalities of pharyngeal cancer patients. Retrospective analysis of pharyngeal cancer patients, diagnosed between 1997 and
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Risk factors for small pharyngeal airway dimensions in preorthodontic children
DEFF Research Database (Denmark)
Anandarajah, Seerone; Dudhia, Raahib; Sandham, Andrew
2017-01-01
Objective: To analyze which parameters, gathered from standard orthodontic diagnostic material, were most relevant for identifying small pharyngeal airway dimensions in preorthodontic children. Materials and Methods: The sample was composed of 105 cone beam computed tomography scans of healthy......, skeletal maturity and gender significant associations were found between pharyngeal airway dimensions and craniofacial morphology. Airway volume was positively associated with maxillary and mandibular width (P ... and sagittal jaw relationship were the most relevant factors for minimal cross-sectional area (r2 = 0.16). Conclusion: Pharyngeal airway dimensions were significantly associated with age, skeletal maturity, and craniofacial morphology in all three planes. Children with a reduced mandibular width and increased...
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Neurofibromas as bilateral cystic chest wall swellings. | Ugare ...
African Journals Online (AJOL)
A 35 year old male farmer presented with soft bilateral posterior chest wall swellings. He had no similar swellings elsewhere. There were no associated symptoms, except cosmetic deformity and discomfort when he lies on his back. A clinical diagnosis of posterior chest wall lipomata was made. However at surgery, the two ...
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Optical silencing of body wall muscles induces pumping inhibition in Caenorhabditis elegans
Takahashi, Megumi; Takagi, Shin
2017-01-01
Feeding, a vital behavior in animals, is modulated depending on internal and external factors. In the nematode Caenorhabditis elegans, the feeding organ called the pharynx ingests food by pumping driven by the pharyngeal muscles. Here we report that optical silencing of the body wall muscles, which drive the locomotory movement of worms, affects pumping. In worms expressing the Arch proton pump or the ACR2 anion channel in the body wall muscle cells, the pumping rate decreases after activatio...
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Dematteis, M; Levy, P; Pepin, J
2005-01-01
Background: Patients with severe apnoea may have an impaired pharyngeal dilating reflex related to decreased pharyngeal sensitivity. The accuracy of a simple new procedure to measure pharyngeal sensitivity and to diagnose sleep disordered breathing (SDB) was investigated.
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We can predict postpalatoplasty velopharyngeal insufficiency in cleft palate patients.
Leclerc, Jacques E; Godbout, Audrey; Arteau-Gauthier, Isabelle; Lacour, Sophie; Abel, Kati; McConnell, Elisa-Maude
2014-02-01
To find an anatomical measurement of the cleft palate (or a calculated parameter) that predicts the occurrence of velopharyngeal insufficiency (VPI) after palatal cleft repair. Retrospective cohort study. Charts were reviewed from cleft palate patients who underwent palatoplasty by the Von Langenbeck technique for isolated cleft palate or Bardach two-flap palatoplasty for cleft lip-palate. Seven anatomical cleft parameters were prospectively measured during the palatoplasty procedure. Three blinded speech-language pathologists retrospectively scored the clinically assessed VPI at 4 years of age. The recommendation of pharyngoplasty was also used as an indicator of VPI. From 1993 to 2008, 67 patients were enrolled in the study. The best predicting parameter was the ratio a/(30 - b1), in which a is defined as the posterior gap between the soft palate and the posterior pharyngeal wall and b1 is the width of the cleft at the hard palate level. An a/(30 - b1) ratio >0.7 to 0.8 is associated with a higher risk of developing VPI (relative risk = 2.2-5.1, sensitivity = 72%-81%, P cleft at the hard palate level and the posterior gap between the soft palate and the posterior pharyngeal wall were found to be the most significant parameters in predicting VPI. The best correlation was obtained with the ratio a/(30 - b1). 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
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Directory of Open Access Journals (Sweden)
T.A. Polunina
2011-01-01
Full Text Available Inflammatory disease of the throat — is a widespread pathology in childhood. The complex treatment of pharyngitis often includes solutions for gargling, sprays, tablets for sucking, hard candy or lozenges containing a variety of anti-inflammatory components. Their use reduces the severity of pain and the time treatment, but does not preclude the use of anti-inflammatory drugs for systemic effects. Key words: pharyhgitis, sore throat, treatment, children (Pediatric Pharmacology. — 2011; 8 (5: 106–108.
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Sefton, Elizabeth M; Piekarski, Nadine; Hanken, James
2015-01-01
The impressive morphological diversification of vertebrates was achieved in part by innovation and modification of the pharyngeal skeleton. Extensive fate mapping in amniote models has revealed a primarily cranial neural crest derivation of the pharyngeal skeleton. Although comparable fate maps of amphibians produced over several decades have failed to document a neural crest derivation of ventromedial elements in these vertebrates, a recent report provides evidence of a mesodermal origin of one of these elements, basibranchial 2, in the axolotl. We used a transgenic labeling protocol and grafts of labeled cells between GFP+ and white embryos to derive a fate map that describes contributions of both cranial neural crest and mesoderm to the axolotl pharyngeal skeleton, and we conducted additional experiments that probe the mechanisms that underlie mesodermal patterning. Our fate map confirms a dual embryonic origin of the pharyngeal skeleton in urodeles, including derivation of basibranchial 2 from mesoderm closely associated with the second heart field. Additionally, heterotopic transplantation experiments reveal lineage restriction of mesodermal cells that contribute to pharyngeal cartilage. The mesoderm-derived component of the pharyngeal skeleton appears to be particularly sensitive to retinoic acid (RA): administration of exogenous RA leads to loss of the second basibranchial, but not the first. Neural crest was undoubtedly critical in the evolution of the vertebrate pharyngeal skeleton, but mesoderm may have played a central role in forming ventromedial elements, in particular. When and how many times during vertebrate phylogeny a mesodermal contribution to the pharyngeal skeleton evolved remain to be resolved. © 2015 Wiley Periodicals, Inc.
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[Analysis of the characteristic of pharyngeal paraesthesia patients by high resolution manometry].
Gu, Yun; Qian, Wei
2015-09-01
To discuss the pressure changing characteristics of upper esophageal sphincter (UES), lower esophageal sphincter (LES) and the esophagus kinetic characteristics of pharyngeal paraesthesia patients. To take high resolution manometry in 44 cases of pharyngeal paraesthesia patients and 23 normal subjects separately. According to the RSI score,the 44 patients were divided into group A (the group without reflux, RSI 0.05). The esophagus DCI of group B was lower than that of group A and control group (P 0.05). The pharyngeal paresthesia symptoms of'patients was associated with the increasing of UES pressure. The pharyngeal paresthesia symptoms of group with reflux was related to low pressure of LES and high pressure of UES. The last part of esophagus of group with reflux had obstacles in powers, which weaken the peristalsis and declined the ability to clear the bolus and gastric reflux material.
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Pharyngeal branchial cyst: magnetic resonance findings
Energy Technology Data Exchange (ETDEWEB)
Cerezal, L.; Canga, A. [Department of Radiology of the ' Santa Cruz' Hospital Liencres, Cantabria (Spain); Morales, C. [Department of Otorhinolaryngology of the ' Sierrallana' Hospital Torrelavega, Cantabria (Spain); Abascal, F.; Usamentiaga, E.; Bustamante, M. [Department of Radiology of the University Hospital ' Marques de Valdecilla' , Av. de Valdecilla s/n Santander 39008 (Spain); Olcinas, O. [Department of Pathology of the University Hospital ' Marques de Valdecilla' , Av. de Valdecilla s/n Santander 39008 (Spain)
1998-11-01
An unusual case of pharyngeal cyst in a 25-year-old man studied by Magnetic Resonance (MR) is described. Anatomic location and pathological findings indicated the second branchial pouch origin. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)
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Pharyngeal branchial cyst: magnetic resonance findings
International Nuclear Information System (INIS)
Cerezal, L.; Canga, A.; Morales, C.; Abascal, F.; Usamentiaga, E.; Bustamante, M.; Olcinas, O.
1998-01-01
An unusual case of pharyngeal cyst in a 25-year-old man studied by Magnetic Resonance (MR) is described. Anatomic location and pathological findings indicated the second branchial pouch origin. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)
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Posterior mediastinal teratoma diagnosis by computerized tomography and ultrasonography
Energy Technology Data Exchange (ETDEWEB)
Choo, Yeon Myung; Im, Chung Kie; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)
1984-09-15
Teratomas, usually arising in the anterior mediastinum, are very uncommon in the posterior mediastinum. Embryologic development of anterior mediastinal teratoma is thought to be from thymic anlage which descends from the third bronchial cleft and pouch, while that of posterior mediastinal teratoma is thought to be from the remnant of notochord. CT findings of posterior mediastinal teratomas are not different from teratomas elsewhere, containing fat, calcification, soft tissue and thick walled cyst. Ultrasonographic findings are mixed echogenic mass containing cystic portion, highly reflective solid portion and area of acoustic shadowing. Authors recently experienced 2 cases of surgically proven posterior mediastinal teratoma and report with review of literature.
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Posterior mediastinal teratoma diagnosis by computerized tomography and ultrasonography
International Nuclear Information System (INIS)
Choo, Yeon Myung; Im, Chung Kie; Yeon, Kyung Mo; Han, Man Chung
1984-01-01
Teratomas, usually arising in the anterior mediastinum, are very uncommon in the posterior mediastinum. Embryologic development of anterior mediastinal teratoma is thought to be from thymic anlage which descends from the third bronchial cleft and pouch, while that of posterior mediastinal teratoma is thought to be from the remnant of notochord. CT findings of posterior mediastinal teratomas are not different from teratomas elsewhere, containing fat, calcification, soft tissue and thick walled cyst. Ultrasonographic findings are mixed echogenic mass containing cystic portion, highly reflective solid portion and area of acoustic shadowing. Authors recently experienced 2 cases of surgically proven posterior mediastinal teratoma and report with review of literature.
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Directory of Open Access Journals (Sweden)
Jaekyun Choi
2016-07-01
Full Text Available The sense of taste is an essential chemosensory modality that enables animals to identify appropriate food sources and control feeding behavior. In particular, the recognition of bitter taste prevents animals from feeding on harmful substances. Feeding is a complex behavior comprised of multiple steps, and food quality is continuously assessed. We here examined the role of pharyngeal gustatory organs in ingestion behavior. As a first step, we constructed a gustatory receptor-to-neuron map of the larval pharyngeal sense organs, and examined corresponding gustatory receptor neuron projections in the larval brain. Out of 22 candidate bitter compounds, we found 14 bitter compounds that elicit inhibition of ingestion in a dose-dependent manner. We provide evidence that certain pharyngeal gustatory receptor neurons are necessary and sufficient for the ingestion response of larvae to caffeine. Additionally, we show that a specific pair of pharyngeal gustatory receptor neurons, DP1, responds to caffeine by calcium imaging. In this study we show that a specific pair of gustatory receptor neurons in the pharyngeal sense organs coordinates caffeine sensing with regulation of behavioral responses such as ingestion. Our results indicate that in Drosophila larvae, the pharyngeal gustatory receptor neurons have a major role in sensing food palatability to regulate ingestion behavior. The pharyngeal sense organs are prime candidates to influence ingestion due to their position in the pharynx, and they may act as first level sensors of ingested food.
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Introducing a Virtual Lesion Model of Dysphagia Resulting from Pharyngeal Sensory Impairment
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Paul Muhle
2018-01-01
Full Text Available Background/Aims: Performing neurophysiological and functional imaging studies in severely affected patients to investigate novel neurostimulation techniques for the treatment of neurogenic dysphagia is difficult. Therefore, basic research needs to be conducted in healthy subjects. Swallowing is a motor function highly dependent on sensory afferent input. Here we propose a virtual peripheral sensory lesion model to mimic pharyngeal sensory impairment, which is known as a major contributor to dysphagia in neurological disease. Methods: In this randomized crossover study on 11 healthy volunteers, cortical activation during pneumatic pharyngeal stimulation was measured applying magnetoencephalography in two separate sessions, with and without pharyngeal surface anesthesia. Results: Stimulation evoked bilateral event-related desynchronization (ERD mainly in the caudolateral pericentral cortex. In comparison to the no-anesthesia condition, topical anesthesia led to a reduction of ERD in beta (13-30 Hz and low gamma (30-60 Hz frequency ranges (p<0.05 in sensory but also motor cortical areas. Conclusions: Withdrawal of sensory afferent information by topical anesthesia leads to reduced response to pneumatic pharyngeal stimulation in a distributed cortical sensorimotor network in healthy subjects. The proposed paradigm may serve to investigate the effect of neuromodulatory treatments specifically on pharyngeal sensory impairment as relevant cause of neurogenic dysphagia.
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Directory of Open Access Journals (Sweden)
Jesse D. Rochester
2017-09-01
Full Text Available In Caenorhabditis elegans, five pharyngeal gland cells reside in the terminal bulb of the pharynx and extend anterior processes to five contact points in the pharyngeal lumen. Pharyngeal gland cells secrete mucin-like proteins thought to facilitate digestion, hatching, molting and assembly of the surface coat of the cuticle, but supporting evidence has been sparse. Here we show pharyngeal gland cell expression of PQN-75, a unique protein containing an N-terminal signal peptide, nucleoporin (Nup-like phenylalanine/glycine (FG repeats, and an extensive polyproline repeat domain with similarities to human basic salivary proline-rich pre-protein PRB2. Imaging of C-terminal tagged PQN-75 shows localization throughout pharyngeal gland cell processes but not the pharyngeal lumen; instead, aggregates of PQN-75 are occasionally found throughout the pharynx, suggesting secretion from pharyngeal gland cells into the surrounding pharyngeal muscle. PQN-75 does not affect fertility and brood size in C. elegans but confers some degree of stress resistance and thermotolerance through unknown mechanisms.
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International Nuclear Information System (INIS)
Buelow, M.; Olsson, R.; Ekberg, O.
2005-01-01
Purpose: To study survival in two groups of dysphagic patients - one group unable to elicit the pharyngeal stage of swallow (APS) and another group with pharyngeal swallow (WPS) - and to compare recommendations regarding nutrition and therapeutic strategies based on the therapeutic swallowing study. Material and Methods: In this retrospective study, the records of dysphagic patients who have undergone a therapeutic videoradiographic swallowing study (TVSS) were reviewed. Forty patients without pharyngeal swallow were matched for age and gender with 40 patients with pharyngeal swallow; altogether 80 patients were included in the study. Survival was registered at 3, 12, and 72 months after the TVSS. Results: In this study, the APS group had a significantly shorter survival time compared to the WPS group when followed-up at 12 months. In the APS group, most patients (37.5% (15/40)) died within the 3 months after TVSS. At 72 months, 62.5% (25/40) of the patients in the APS group had died. In the WPS group, 5% (2/40) had died within 3 months and 47.4% (19/40) after 12 months. At 72 months, 52.5% (21/40) of the patients in the WPS group had died. Regarding nutritional and therapeutic recommendations based on TVSS, 34/40 in the APS group were recommended no oral intake. Eighteen naso-gastric tubes were placed directly after TVSS. The therapeutic strategies recommended were head-positioning, thermal tactile stimulation, and tongue exercises (in 8 patients). In the WPS group, all patients were recommended oral intake. Diet modification was recommended in 29 patients. The therapeutic strategies recommended were head-positioning, thermal tactile stimulation, tongue exercises, supraglottic swallow, and effortful swallow (in 24 patients). Conclusion: Patients unable to elicit the pharyngeal stage of swallow had a shorter survival time than patients with pharyngeal swallow, probably due to a more severe underlying disease. Tube feeding was more frequent in the APS group. Fewer
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CT findings of posterior pararenal effusion
International Nuclear Information System (INIS)
Koh, Byung Hee; Cho, On Koo; Kim, Sonn Yong
1990-01-01
The posterior pararenal space(PPS) is a potential space between the posterior renal fascia and the transversalis fascia. We reviewed 12 cases of posterior pararenal effusion. The causes of the effusion were retroperitoneal hemorrhage due to trauma(7 cases) or rupture of renal tumor(1 case), pancreatitis(2 cases), urinoma (1 case) and amebic colitis of the cecum(1 case). The CT findings of the effusion were semilunar fluid density in the dependant portion of the PPS(9/12), partial obliteration of the PPS extending to the flank stripe(2/12), and total obliteration of the PPS extending to the anterior abdominal wall(1/12). The effusion in the ipsilateral perirenal space and thickening of the ipsilateral posterior renal fascia were combined in all cases. The effusion in the ipsilateral anterior pararenal space was associated in 11 cases of 12. The effusion in the PPS is not uncommon findings of retroperitoneal hemorrhage or effusion, but usually related with perirenal or anterior pararenal effusion with no clinical significance
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International Nuclear Information System (INIS)
Yamaguchi, Fumie; Yamaguchi, Tetsutaro; Miyamoto, Asami; Maki, Koutaro
2007-01-01
This study examined the relationship between pharyngeal morphology measured with cone-beam computed tomography (CBCT) and maxillary morphology measured from lateral cephalograms. The subjects comprised 45 women, with a mean age of 27.9 years (range, 16-50 years), who attended the Department of Orthodontics at Showa University. The evaluation of pharyngeal morphology was based on 9 variables measured by CBCT: pharyngeal space volume, pharyngeal vertical length, pharyngeal sagittal length, pharyngeal coronal length, epiglottis length, epiglottis width, the distance from the genion to the hyoidale, the distance from the hyoidale to the aditus larynges base, and the distance from the aditus larynges base to the genion. Maxillary morphology was evaluated from 5 measured sites: SNA, S'-Ptm', A'-Ptm', the occiusal plane angle, and the palatal plane angle. Pearson's correlation coefficient was used to detect associations between pharyngeal and maxillary morphological variables. There were significant correlations between pharyngeal coronal length and SNA, the distance from the genion to the hyoidale and the occlusal plane angle, pharyngeal coronal length and A'-Ptm', pharyngeal vertical length and the palatal plane angle, as well as the aditus larynges base to the genion and the occlusal plane. This information has potential clinical value for better understanding obstructive sleep apnea in adult patients, and for structurally based treatments such as surgical orthodontics. (author)
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McIsaac criteria for diagnosis of acute group-A β-hemolytic streptococcal pharyngitis
Directory of Open Access Journals (Sweden)
Imanuel Y. Malino
2013-10-01
Conclusion A McIsaac criteria total score of <4 is favorable for excluding a diagnosis of GABHS pharyngitis. A McIsaac total criteria score of ≥4 requires further examination to confirm a diagnosis of GABHS pharyngitis.
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A lateral cephalometric study of pharyngeal cavity in Korean adults
International Nuclear Information System (INIS)
Lee, Sang Rae
1976-01-01
A study was performed to investigate the size of pharyngeal cavity and sexual differences between Korean adult mal e and female by introducing linear analysis of the lateral cephalogram. The radiograms were composed of 46 adult male aged 24.64 and 52 adult female aged 22.74 respectively. In order to study and measure the pharyngeal area, the following skeletal landmarks were selected: S,N,A,Ptm, B,H,H', M ,S-N, FH and CV, and the angle CV-FH was measured to provide a factor for correction of error resulting from improper he ad positioning of subjects, especially in the relative positions of A and H, while radiography. All points to be measured were projected at right angles to the Frankfort plane. For the purpose of measuring the anteroposterior dimensions of pharyngeal cavity the distances were measured in A-Ptm, A-S, S-Ptm and CV-H, and vertical measurements were made in SN-A, SN-PNS, SN-H' and M-H. The obtained results were as follows: 1. The pharyngeal cavity is broader in the vertical than in the anteroposterior diameter in both sex and the maximum sexual differences were showed in the distances between SN and H', and minimal sexual differences in the distances between S and Ptm. 2. In general, the measurements of male were larger than those of female in the anteroposterior dimensions of pharyngea l cavity, but the distances between A and S, between CV and H showed significant sexual differences when evaluated statistically. 3. All of the measurements were larger in male than in female in vertical dimensions of pharyngeal cavity, and there were statistical significances of sexual differences in all variables.
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A lateral cephalometric study of pharyngeal cavity in Korean adults
Energy Technology Data Exchange (ETDEWEB)
Lee, Sang Rae [Department of Dental Radiology, College of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)
1976-11-15
A study was performed to investigate the size of pharyngeal cavity and sexual differences between Korean adult mal e and female by introducing linear analysis of the lateral cephalogram. The radiograms were composed of 46 adult male aged 24.64 and 52 adult female aged 22.74 respectively. In order to study and measure the pharyngeal area, the following skeletal landmarks were selected: S,N,A,Ptm, B,H,H', M ,S-N, FH and CV, and the angle CV-FH was measured to provide a factor for correction of error resulting from improper he ad positioning of subjects, especially in the relative positions of A and H, while radiography. All points to be measured were projected at right angles to the Frankfort plane. For the purpose of measuring the anteroposterior dimensions of pharyngeal cavity the distances were measured in A-Ptm, A-S, S-Ptm and CV-H, and vertical measurements were made in SN-A, SN-PNS, SN-H' and M-H. The obtained results were as follows: 1. The pharyngeal cavity is broader in the vertical than in the anteroposterior diameter in both sex and the maximum sexual differences were showed in the distances between SN and H', and minimal sexual differences in the distances between S and Ptm. 2. In general, the measurements of male were larger than those of female in the anteroposterior dimensions of pharyngea l cavity, but the distances between A and S, between CV and H showed significant sexual differences when evaluated statistically. 3. All of the measurements were larger in male than in female in vertical dimensions of pharyngeal cavity, and there were statistical significances of sexual differences in all variables.
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Directory of Open Access Journals (Sweden)
Crole Martina R
2012-08-01
Full Text Available Abstract Background Tonsils are secondary lymphoid organs located in the naso- and oropharynx of most mammalian species. Most tonsils are characterised by crypts surrounded by dense lymphoid tissue. However, tonsils without crypts have also been recognised. Gut-associated lymphoid tissue (GALT, although not well-organised and lacking tonsillar crypts, is abundant in the avian oropharynx and has been referred to as the “pharyngeal tonsil”. In this context the pharyngeal folds present in the oropharynx of ratites have erroneously been named the pharyngeal tonsils. This study distinguishes between the different types and arrangements of lymphoid tissue in the pharyngeal region of D. novaehollandiae and S. camelus and demonstrates that both species possess a true pharyngeal tonsil which fits the classical definition of tonsils in mammals. Results The pharyngeal tonsil (Tonsilla pharyngea of D. novaehollandiae was located on the dorsal free surface of the pharyngeal folds and covered by a small caudo-lateral extension of the folds whereas in S. camelus the tonsil was similarly located on the dorsal surface of the pharyngeal folds but was positioned retropharyngeally and encapsulated by loose connective tissue. The pharyngeal tonsil in both species was composed of lymph nodules, inter-nodular lymphoid tissue, mucus glands, crypts and intervening connective tissue septa. In S. camelus a shallow tonsillar sinus was present. Aggregated lymph nodules and inter-nodular lymphoid tissue was associated with the mucus glands on the ventral surface of the pharyngeal folds in both species and represented the Lymphonoduli pharyngeales. Similar lymphoid tissue, but more densely packed and situated directly below the epithelium, was present on the dorsal, free surface of the pharyngeal folds and represented a small, non-follicular tonsil. Conclusions The follicular pharyngeal tonsils in D. novaehollandiae and S. camelus are distinct from the pharyngeal folds in
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Diagnosis of Swallowing Disorders: How We Interpret Pharyngeal Manometry.
Cock, Charles; Omari, Taher
2017-03-01
We provide an overview of the clinical application of novel pharyngeal high-resolution impedance manometry (HRIM) with pressure flow analysis (PFA) in our hands with example cases. In our Centre, we base our interpretation of HRIM recordings upon a qualitative assessment of pressure-impedance waveforms during individual swallows, as well as a quantitative assessment of averaged PFA swallow function variables. We provide a description of two global swallowing efficacy measures, the swallow risk index (SRI), reflecting global swallowing dysfunction (higher SRI = greater aspiration risk) and the post-swallow impedance ratio (PSIR) detecting significant post-swallow bolus residue. We describe a further eight swallow function variables specific to the hypopharynx and upper esophageal sphincter (UES), assessing hypo-pharyngeal distension pressure, contractility, bolus presence and flow timing, and UES basal tone, relaxation, opening and contractility. Pharyngeal HRIM has now come of age, being applicable for routine clinical practice to assess the biomechanics of oropharyngeal swallowing dysfunction. In the future, it may guide treatment strategies and allow more objective longitudinal follow-up on clinical outcomes.
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Hirai, Ryoji; Makiyama, Kiyoshi; Higuti, Yusho; Ikeda, Atsuo; Miura, Masatoshi; Hasegawa, Hisashi; Kinukawa, Noriko; Ikeda, Minoru
2012-10-01
A number of reports have investigated the relationship between laryngeal papilloma and human papilloma virus (HPV) infection. On the other hand, it is unclear whether the HPV infection is involved in the occurrence of pharyngeal papilloma. We hypothesized that HPV infection was involved in the occurrence of pharyngeal papilloma similarly to laryngeal papilloma. To verify this hypothesis, we investigated the presence of HPV infection. Furthermore, clinical manifestations of pharyngeal papilloma, which had rarely been reported, were discussed. A male-to-female ratio, solitary or multiple occurrences, and koilocytosis were examined in cases with pharyngeal papilloma. HPV DNA was examined with unfixed surgically resected specimens of pharyngeal papilloma. A screening test by the liquid-phase hybridization method was carried out for the HPV high-risk group (16, 18, 31, 33, 35, 39, 45, 51, 56, 58, 59, and 68) and HPV low-risk group (6, 11, 42, 43, 44). As a control, 15 cases with laryngeal papilloma for which the same screening test was carried out were employed. Pharyngeal papilloma occurred as a solitary lesion more often, whereas laryngeal papilloma occurred as multiple tumors more frequently. The HPV infection rate was 0% in pharyngeal papilloma cases, which was in stark contrast with 66.7% in the HPV low-risk group in laryngeal papilloma cases. Pharyngeal papilloma occurred as a solitary lesion in females more frequently. Contrary to our hypothesis, the involvement of HPV infection was unlikely in the occurrence of pharyngeal papilloma.
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Mazur, Elżbieta; Bochyńska, Ewa; Juda, Marek; Kozioł-Montewka, Maria
2014-01-01
Group A Streptococcus (GAS) pharyngitis is currently the only commonly occurring form of acute pharyngitis for which antibiotic therapy is definitely indicated. Polish guidelines advocate the use of modified Centor score (MCS) to assess the probability of GAS pharyngitis. They advise performing throat culture or rapid antigen detection test (RADT) in children with score 2-3 in MCS and treating with antibiotic only those in whom GAS was detected. Negative RADT results should be confirmed by culture. In children with score 4, the guidelines allow to introduce empiric antibiotic therapy. Phenoxymethyl penicillin is recommended as a drug of choice to treat GAS pharyngitis. The aim of our study was to evaluate the accuracy of strategy recommended by Polish guidelines in identifying those children with acute pharyngitis who require antibiotic treatment. Hence, diagnostic values of score 4 in MCS and RADT were assessed using throat culture as a reference standard. Phenoxymethyl penicillin efficacy in GAS eradication and prevention of post-streptococcal complications were estimated as well. Ninety children between 2 and 15 years of age with acute pharyngitis symptoms suggesting GAS etiology (MCS ≥ 2), participated in our study. At the initial visit MCS was evaluated and two throat swabs were collected to perform RADT and culture. In children with GAS pharyngitis treated with penicillin, microbiological cure was assessed by performing two control throat cultures. Next, children were under observation for 3 months. Positive predictive value of score 4 in MCS turned out to be 48.05% (95% CI: 36.5-59.7%). RADT sensitivity, specificity and diagnostic accuracy proved to be 100%, 96%, and 98%, respectively. GAS eradication rate in children treated with penicillin turned out to be 92.5%. No post-streptococcal sequelae occurred in any child in 3-month observation. Empiric antibiotic therapy in children with score 4 in MCS will result in significant overtreatment of those with
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A Novel Imaging Analysis Method for Capturing Pharyngeal Constriction During Swallowing.
Schwertner, Ryan W; Garand, Kendrea L; Pearson, William G
2016-01-01
Videofluoroscopic imaging of swallowing known as the Modified Barium Study (MBS) is the standard of care for assessing swallowing difficulty. While the clinical purpose of this radiographic imaging is to primarily assess aspiration risk, valuable biomechanical data is embedded in these studies. Computational analysis of swallowing mechanics (CASM) is an established research methodology for assessing multiple interactions of swallowing mechanics based on coordinates mapping muscle function including hyolaryngeal movement, pharyngeal shortening, tongue base retraction, and extension of the head and neck, however coordinates characterizing pharyngeal constriction is undeveloped. The aim of this study was to establish a method for locating the superior and middle pharyngeal constrictors using hard landmarks as guides on MBS videofluoroscopic imaging, and to test the reliability of this new method. Twenty de-identified, normal, MBS videos were randomly selected from a database. Two raters annotated landmarks for the superior and middle pharyngeal constrictors frame-by-frame using a semi-automated MATLAB tracker tool at two time points. Intraclass correlation coefficients were used to assess test-retest reliability between two raters with an ICC = 0.99 or greater for all coordinates for the retest measurement. MorphoJ integrated software was used to perform a discriminate function analysis to visualize how all 12 coordinates interact with each other in normal swallowing. The addition of the superior and middle pharyngeal constrictor coordinates to CASM allows for a robust analysis of the multiple components of swallowing mechanics interacting with a wide range of variables in both patient specific and cohort studies derived from common use imaging data.
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[Efficacy of retained rectal posterior mucosa in procedure for prolapse and hemorrhoids].
Zheng, Chenguo; Jin, Chun; Lian, Shaoxiong; Jin, Dingguo
2014-12-01
To evaluate the efficacy and necessity of retained rectal posterior mucosa in procedure for prolapse and hemorrhoids (PPH). Clinical data of 260 cases with severe hemorrhoids in our hospital from January 2010 to May 2012 were analyzed retrospectively. A total of 132 cases with severe hemorrhoids excluding in rectal posterior wall were enrolled in retained rectal posterior mucosa in PPH (improvement group), other 128 cases of severe hemorrhoids were assigned to PPH (conventional group). Operative parameters, efficacy and complication after operation were compared. Two groups of patients received successful operations. Postoperative pain duration, frequency of analgesic drugs and postoperative hospital stay in improvement group were significantly reduced [(1.3 ± 0.5) d vs. (4.8 ± 0.7) d, 1.1 ± 0.3 vs. 5.9 ± 0.6, (5.2 ± 0.8) d vs. (5.8 ± 0.5) d, all Phemorrhoids excluding in rectal posterior wall can significantly reduce postoperative complications. But long-term efficacy needs further observation.
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Teaching the pharyngeal flap and sphincter pharyngoplasty: The sticky note method.
Lee, Jake J; Jabbour, Noel
2015-11-01
To demonstrate a cost-effective, quick, and easily reproducible three-dimensional sticky note model to enhance the understanding and conceptualization of the geometry and steps of the pharyngeal flap and sphincter pharyngoplasty. The method involves making specified incisions and rearrangements of readily available components, including disposable clear plastic cups, yellow and pink sticky notes, and white paper. Once assembly is complete, further incisions and remodeling are performed to simulate a pharyngeal flap or sphincter pharyngoplasty. The cost of the materials to make one model was $0.94. Average construction time was less than 10 min. This three-dimensional model is an efficient, interactive, and simple visual aid to teach surgical trainees the geometry and steps of the pharyngeal flap and sphincter pharyngoplasty. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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International Nuclear Information System (INIS)
Okumura, Yasuo; Watanabe, Ichiro; Ashino, Sonoko
2007-01-01
The posterior right atrial transverse conduction capability during typical atrial flutter (AFL) is well known, but its relationship to the anatomical characteristics remains controversial. Thirty-four AFL and 16 controls underwent intracardiac echocardiography after placement of a 20-polar catheter at the posterior block site during AFL or pacing. In 31 patients, the effective refractory period (ERP) at the block site was determined as the longest coupling interval that resulted in double potentials during extrastimuli from the mid-septal (SW) and free (FW) walls. The block site was located 3.0-29.0 mm posterior to the crista terminalis (CT) in each AFL and control patient. The CT area indexed to the body surface area was larger in AFL patients than in control patients (16.4±6.5 mm 2 /m 2 vs 11.3±6.4 mm 2 /m 2 , p=0.01), and was positively correlated to age (r=0.34, p=0.02). The ERP was longer in the AFL patients than in controls (SW: median value 600 [270-725] ms vs 220 [200-253] ms; FW: 280 [230-675] ms vs 215 [188-260] ms, p<0.05 for each). A functional block line was located on the septal side of the CT in all patients. A limited conduction capability and age-related CT enlargement might have important implications for the pathogenesis in AFL. (author)
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Okubo, Tadashi; Takada, Shinji
2015-07-01
The pharyngeal arches (PAs) generate cranial organs including the tongue. The taste placodes, formed in particular locations on the embryonic tongue surface, differentiate into taste buds harbored in distinct gustatory papillae. The developing tongue also has a complex supply of cranial nerves through each PA. However, the relationship between the PAs and taste bud development is not fully understood. Ripply3 homozygous mutant mice, which have impaired third/fourth PAs, display a hypoplastic circumvallate papilla and lack taste buds, although the taste placode is normally formed. Formation of the glossopharyngeal ganglia is defective and innervation toward the posterior tongue is completely missing in Ripply3 mutant embryos at E12.5. Moreover, the distribution of neuroblasts derived from the epibranchial placode is severely, but not completely, atenuated, and the neural crest cells are diminished in the third PA region of Ripply3 mutant embryos at E9.5-E10.5. In Tbx1 homozygous mutant embryos, which exhibit another type of deficiency in PA development, the hypoplastic circumvallate papilla is observed along with abnormal formation of the glossopharyngeal ganglia and severely impaired innervation. PA deficiencies affect multiple aspects of taste bud development, including formation of the cranial ganglia and innervation to the posterior tongue. © 2015 Wiley Periodicals, Inc.
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Alić, A; Prasović, S; Hodzić, A; Besirović, H; Residbegović, Emina; Omeragić, J
2013-03-01
Streptocara spp. infections are reported to cause gastritis, proventriculitis, esophagitis, and pharyngitis in various waterfowls, especially diving ducks. In the present paper, we describe severe fatal diphtheritic pharyngitis and esophagitis caused by Streptocara incognita in three female mute swans (Cygnus olor) in Bosnia and Herzegovina. Prior to death, the swans were showing signs of lethargy, anorexia, and reluctance to move. At necropsy, in all swans severe diphtheritic pharyngitis and esophagitis with deep, dark red hemorrhagic ulcerations were observed. Numerous thin, white, up to 1-cm-long nematodes, identified as S. incognita, were observed embedded in the pharyngeal and esophageal mucosa under the diphtheritic membranes. Histopathology revealed severe fibrinonecrotic inflammation with numerous cross-sections of the parasites. To the authors' knowledge, this is the first report of severe, fatal streptocariasis in mute swans.
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Directory of Open Access Journals (Sweden)
Dharm Raj Bhatta
2014-02-01
Full Text Available Objective: To determine the incidence of carrier state of Haemophilus influenzae type b, Streptococcus pneumoniae (S. pneumoniae, Streptococcus pyogenes, Neisseria meningitidis and Corynebacterium diphtheriae among school children. Methods: Specimen from posterior pharyngeal wall and tonsils were collected on calcium alginate coated swabs from 1 02 participants. Processing of specimen and antimicrobial susceptibility testing was done by standard procedures. Results: Potential pathogens isolated in our study were S. pneumoniae (14.7%, Staphylococcus aureus (12.7%, Corynebacterium diphtheriae (3.9%, Streptococcus pyogenes (3.9% and Haemophilus influenzae (1.9%. Important findings in antibiogram include high resistance of S. pneumoniae to penicillin (73% and resistance of Staphylococcus aureus to oxacillin (23%. Conclusions: Pharyngeal colonization by S. pneumoniae among school children was found high and there is need of introduction of pneumococcal vaccines among children. Despite expected universal vaccination, pharyngeal colonization by Corynebacterium diphtheriae is possible and there is possibility of transmission.
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Topical Therapy of Acute Pharyngitis in Children
Directory of Open Access Journals (Sweden)
Yu.K. Bolbot
2015-02-01
Full Text Available The paper discusses the methods of topical antiinflammatory therapy for acute pharyngitis in children. The analysis of the complex of mechanisms (antiinflammatory, local analgesic ones of Tantum Verde® action and method of its application are provided.
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Cao, Yimei; Ma, Tingting; Wu, Di; Yin, Ningbei; Zhao, Zhenmin
2013-08-01
The aim was to evaluate clinical application of autologous fat transplantation in the posterior pharynx to treat velopharyngeal incompetence and cleft palate. Case series with chart review. Cleft Lip and Palate Center of Plastic Surgery Hospital, an academic medical center. We studied 11 patients (age, 5-26 years) with a cleft palate and velopharyngeal insufficiency who underwent autologous fat injection. Patients were followed for 9 to 40 months. Pronunciation evaluation, visual appearance of the palatopharyngeal area, nasopharyngeal fibroscopy (NPF), palatopharyngeal lateral radiography, and magnetic resonance imaging (MRI) were undertaken before and after the operation. Speech intelligibility was markedly increased in all patients. Pronunciation was good to excellent compared with the preoperative level (P = .001). Mean velopharyngeal insufficiency rate was significantly reduced from 26.05% to 6.96% (P = .028) by NPF and from 26.42% to 7.11% (P = .017) by MRI (axial plane). Magnetic resonance imaging indicated significantly reduced mean minimum velopharyngeal distance, from 10.39 to 3.65 mm (P = .012) in the sagittal plane, and markedly increased thickness of transplanted fat in the posterior pharyngeal wall (sagittal, 5.43 mm; axial, 4.74 mm). There were few complications (sleep apnea, nasopharyngeal regurgitation). Autologous fat transplantation in the posterior pharyngeal wall was a good method for treating velopharyngeal incompetence. The safety profile was good in our sample, and we got a consistent result in the follow-up period. In addition, it also could be combined with routine surgery.
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Epidemiology of oral and pharyngeal cancers: A retrospective study in Kermanshah, Iran
Directory of Open Access Journals (Sweden)
Mohammad Reza Zarei
2016-05-01
Full Text Available BACKGROUND AND AIM: The aim of this study was to determine the incidence and relative frequency of oral and pharyngeal cancers in Kermanshah, Iran, from March 1993 until March 2006. METHODS: The data used in this epidemiologic study were extracted directly from pathology records registered in 12 (all public and private pathology centers of Kermanshah province during the 13-year study period. The medical data of 13,323 cases of cancer were studied. RESULTS: During the 13-year period of this study, 350 new malignant cases occurred in the oral cavity and pharynx. 247 (70% were men and 103 (30% were women. The mean age for oral and pharyngeal cancers was 57 [standard deviation (SD = 17.09] with male to female ratio 2.39:1. The most common oral and pharyngeal cancers were squamous cell carcinoma (SCC with 283 patients. 211 (74.6% of the patients were men and 72 (25.4% of them were women; the mean age of SCC was 60 (SD = 16 with male to female ratio 2.93:1. The two most common sites of involvement were lips [166 (47.5%] and tongue [25 (7.14%]. The overall incidence rate of oral and pharyngeal cancers was 1.47 per 100000 populations. CONCLUSION: In summary, the incidence risk of oral and pharyngeal cancers in people living in Kermanshah province is similar to the most other provinces of Iran. However, this study showed that the rank of oral and pharyngeal cancers among males (9th most common cancer is low when compared to other regions of Iran and other countries such as India, Australia, and France.
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Sternocleidomastoid flap augmentation of the pharyngeal closure after total laryngectomy.
Ibrahim, Sherif Gabr; Wahba, Basim Metwally; Elbatawi, Ahmed Mahmoud; Eltelety, Ahmad Mohamed
2017-08-01
The objective of the study was to evaluate the effect of sternocleidomastoid (SCM) flap augmentation of the pharyngeal closure after total laryngectomy on the incidence of pharyngocutaneous fistula (PCF). Thirty patients with T4a laryngeal carcinoma and none of them receiving primary radiotherapy previously were divided into two equal groups. Group A patients had SCM flap augmentation of the pharyngeal closure after total laryngectomy. Group B patients had the standard pharyngeal closure without augmentation. Both groups were followed up for 30 days postoperatively for the development of PCF. The use of the SCM added about extra 15 min to the surgical procedure in all patients (p laryngectomy. Three patients in each group developed PCF either early (10 days or less postoperatively) or late (more than 10 days but less than 30 days postoperatively). There was no statistically significant difference in the length of hospital stay between the two groups. The use of SCM flap did not reduce the incidence of PCF after total laryngectomy.
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Comparative effectiveness of instructional methods: oral and pharyngeal cancer examination.
Clark, Nereyda P; Marks, John G; Sandow, Pamela R; Seleski, Christine E; Logan, Henrietta L
2014-04-01
This study compared the effectiveness of different methods of instruction for the oral and pharyngeal cancer examination. A group of thirty sophomore students at the University of Florida College of Dentistry were randomly assigned to three training groups: video instruction, a faculty-led hands-on instruction, or both video and hands-on instruction. The training intervention involved attending two sessions spaced two weeks apart. The first session used a pretest to assess students' baseline didactic knowledge and clinical examination technique. The second session utilized two posttests to assess the comparative effectiveness of the training methods on didactic knowledge and clinical technique. The key findings were that students performed the clinical examination significantly better with the combination of video and faculty-led hands-on instruction (p<0.01). All students improved their clinical exam skills, knowledge, and confidence in performing the oral and pharyngeal cancer examination independent of which training group they were assigned. Utilizing both video and interactive practice promoted greater performance of the clinical technique on the oral and pharyngeal cancer examination.
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Neubauer, Paul D; Hersey, Denise P; Leder, Steven B
2016-06-01
Identification of pharyngeal residue severity located in the valleculae and pyriform sinuses has always been a primary goal during fiberoptic endoscopic evaluation of swallowing (FEES). Pharyngeal residue is a clinical sign of potential prandial aspiration making an accurate description of its severity an important but difficult challenge. A reliable, validated, and generalizable pharyngeal residue severity rating scale for FEES would be beneficial. A systematic review of the published English language literature since 1995 was conducted to determine the quality of existing pharyngeal residue severity rating scales based on FEES. Databases were searched using controlled vocabulary words and synonymous free text words for topics of interest (deglutition disorders, pharyngeal residue, endoscopy, videofluoroscopy, fiberoptic technology, aspiration, etc.) and outcomes of interest (scores, scales, grades, tests, FEES, etc.). Search strategies were adjusted for syntax appropriate for each database/platform. Data sources included MEDLINE (OvidSP 1946-April Week 3 2015), Embase (OvidSP 1974-2015 April 20), Scopus (Elsevier), and the unindexed material in PubMed (NLM/NIH) were searched for relevant articles. Supplementary efforts to identify studies included checking reference lists of articles retrieved. Scales were compared using qualitative properties (sample size, severity definitions, number of raters, and raters' experience and training) and psychometric analyses (randomization, intra- and inter-rater reliability, and construct validity). Seven articles describing pharyngeal residue severity rating scales met inclusion criteria. Six of seven scales had insufficient data to support their use as evidenced by methodological weaknesses with both qualitative properties and psychometric analyses. There is a need for qualitative and psychometrically reliable, validated, and generalizable pharyngeal residue severity rating scales that are anatomically specific, image
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Pharyngeal diameter in various head and neck positions during exercise in sport horses
2014-01-01
Background In equine athletes, dynamic stenotic disorders of the upper airways are often the cause for abnormal respiratory noises and/or poor performance. There are hypotheses, that head and neck flexion may influence the morphology and function of the upper airway and thus could even induce or deteriorate disorders of the upper respiratory tract. Especially the pharynx, without osseous or cartilaginous support is prone to changes in pressure and airflow during exercise. The objective of this study was to develop a method for measuring the pharyngeal diameter in horses during exercise, in order to analyse whether a change of head-neck position may have an impact on the pharyngeal diameter. Results Under the assumption that the width of the epiglottis remains constant in healthy horses, the newly developed method for calculating the pharyngeal diameter in horses during exercise is unsusceptible against changes of the viewing-angle and distance between the endoscope and the structures, which are to be assessed. The quotient of the width of the epiglottis and the perpendicular from a fixed point on the dorsal pharynx to the epiglottis could be used to determine the pharyngeal diameter. The percentage change of this quotient (pharynx-epiglottis-ratio; PE-ratio) in the unrestrained head-neck position against the reference position was significantly larger than that of any other combination of the head-neck positions investigated. A relation between the percentage change in PE-ratio and the degree of head and neck flexion could not be confirmed. Conclusions It could be shown, that the pharyngeal diameter is reduced through the contact position implemented by the rider in comparison to the unrestrained head and neck position. An alteration of the pharyngeal diameter depending on the degree of head and neck flexion (represented by ground and withers angle) could not be confirmed. PMID:24886465
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Energy Technology Data Exchange (ETDEWEB)
Mayer, Stephanie W.; Kestel, Lauryn; Novais, Eduardo N. [Children' s Hospital Colorado and University of Colorado School of Medicine, Department of Orthopaedic Surgery, Aurora, CO (United States); Stewart, Jaime R.; Fadell, Michael F. [Children' s Hospital Colorado, University of Colorado School of Medicine, Department of Radiology, Aurora, CO (United States)
2015-08-15
Posterior hip dislocation in children and adolescents may involve the non-ossified posterior acetabular wall. Plain radiographs and computed tomography (CT) have been shown to underestimate injury to the unossified acetabulum as well as associated soft-tissue structures. The purpose of this study was to describe findings on radiographs, CT and magnetic resonance imaging (MRI) after posterior hip dislocation in a series of adolescents and to report the intraoperative findings, which are considered the gold standard. Measurements of the posterior wall length using MRI and CT scans were also performed. After institutional review board approval, 40 patients who sustained a traumatic posterior dislocation of the hip between September 2007 and April 2014 were identified. Inclusion criteria were (1) age younger than 16 years old and (2) availability of MRI obtained following closed reduction of the hip. Eight male patients and one female patient with an average age of 13.2 years (range: 10.1-16.2 years) underwent hip MRI following posterior dislocation. Seven of the nine patients also underwent evaluation by CT. Plain radiographs, CT scans and MRI were evaluated in all patients by a single pediatric radiologist blinded to surgical findings for joint space asymmetry, posterior wall fracture, femoral head fracture, labrum tear, complete or partial ligamentum teres rupture and presence of intra-articular fragments. Six patients underwent surgical treatment and the intraoperative findings were compared with the imaging findings. CT identified all bone injuries but underestimated the involvement of posterior wall fractures. Assessment of the posterior wall size and fracture displacement was possible with MRI. All surgically confirmed soft-tissue injuries, including avulsion of the posterior labrum, were identified preoperatively on MRI. The measurement of posterior wall length was not statistically different using CT and MRI. Intraoperative pathological findings at the time of
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Anatomical approach for surgery of the male posterior urethra.
Dalpiaz, Orietta; Mitterberger, Michael; Kerschbaumer, Andrea; Pinggera, Germar M; Bartsch, Georg; Strasser, Hannes
2008-11-01
To investigate, in a morphological study, the anatomy of the male rhabdosphincter and the relation between the membranous urethra, the rhabdosphincter and the neurovascular bundles (NVBs) to provide the anatomical basis for surgical approach of the posterior urethra as successful outcomes in urethral reconstructive surgery still remain a challenging issue. In all, 11 complete pelves and four tissue blocks of prostate, rectum, membranous urethra and the rhabdosphincter were studied. Besides anatomical preparations, the posterior urethra and their relationship were studied by means of serial histological sections. In the histological cross-sections, the rhabdosphincter forms an omega-shaped loop around the anterior and lateral aspects of the membranous urethra. Ventrally and laterally, it is separated from the membranous urethra by a delicate sheath of connective tissue. Through a midline approach displacing the nerves and vessels laterally, injuries to the NVBs can be avoided. With meticulous dissection of the delicate ventral connective tissue sheath between the ventral wall of the membranous urethra and the rhabdosphincter, the two structures can be separated without damage to either of them. This anatomical approach can be used for dissection of the anterior urethral wall in urethral surgery. Based on precise anatomical knowledge, the ventral wall of the posterior urethra can be dissected and exposed without injuring the rhabdosphincter and the NVBs. This approach provides the basis for sparing of the rhabdosphincter and for successful outcomes in urethral surgery for the treatment of bulbo-membranous urethral strictures.
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Does velopharyngeal closure pattern affect the success of pharyngeal flap pharyngoplasty?
Armour, Alexis; Fischbach, Simone; Klaiman, Paula; Fisher, David M
2005-01-01
Historically at The Hospital for Sick Children in Toronto, pharyngeal flap pharyngoplasty has been the treatment of choice for treatment of velopharyngeal insufficiency, regardless of velopharyngeal closure pattern. The authors hypothesize that pharyngeal flap pharyngoplasty is more effective in treating velopharyngeal insufficiency in patients with circular or sagittal velopharyngeal closure and less effective in treating the coronal closure pattern. Ninety-three patients who underwent superiorly based pharyngeal flap surgery for velopharyngeal insufficiency were evaluated in a retrospective chart review. Closure pattern was determined preoperatively by nasopharyngoscopy or multiview videofluoroscopy. Nasalance was assessed preoperatively and at 6 weeks and 1 year postoperatively. Nasalance during nonnasal speech was decreased on average, for all closure patterns, postoperatively. However, a significantly higher percentage of patients were corrected to normal nasalance scores in thenoncoronal group than in the coronal group (57 percent versus 35 percent, respectively) at 1 year postoperatively (p approach to the management of velopharyngeal insufficiency and are more inclined to treat coronal pattern velopharyngeal insufficiency with sphincter pharyngoplasty.
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Wang, Pan-Feng; Xu, Shuo-Gui; Zhang, Chun-Cai; Fu, Qing-Ge; Zhang, Yun-Tong; Liu, Xin-Wei; Niu, Yun-Fei; Tang, Yang
2013-11-01
To introduce a new trochanteric osteotomy,and evaluate the outcome of the procedure combined a posterior lateral approach in treating acetabular fractures which involving the roof. Between March 2007 and Novmber 2010,30 patients with displaced acetabular fractures involving the dome need trochanteric osteotomy were retrospectively reviewed. There were 21 males and 9 females,ranging in age from 18 to 70 years with an average of 35.2 years at the time of injury. According to Letournel-Judet classification, there were 10 posterior wall fractures,7 posterior column fractures,5 transverse fractures, 2 T-shape fractures, 1 transverse associated with posterior wall fracture, 3 posterior column and wall fractures and 2 bicolumn fractures. The standards of Matta,the modified Merle d'Aubigne-Postel, Medical Research Council were respectively used to evaluate the reduction result, function of hip joint and the strength of hip abduction. All patients were followed up with an average time of 25 months (18 to 40) and all osteotomy sites obtained bone union with an average time of 8.4 weeks (6 to 12). No bone non-union, bone block displaceing, internal fixation looseing and breaking,infection of deep part were found. Seventeen patients got anatomic reduction, 12 got satisfied reduction, and 1 got unsatisfied result according to the criteria of Matta. At final follow-up, function of hip joint obtained excellent results in 11 cases, good in 15, fair in 3 and poor in 1. The strength of the abductors of 3 patients were grade 4 and 27 patients were grade 5. Posterior partial great trochanteric osteotomy can enhance the exposure and provide a more accurate reduction and degrade the difficulty of acetabular fracture fixation without increasing the risk of complications. The method provide a new way for the treatment of the roof involved acetabular fractures.
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DEFF Research Database (Denmark)
Kjems, Julie; Gothelf, Anita B; Håkansson, Katrin
2016-01-01
on recurrence in the retropharyngeal region and level IB. METHODS AND MATERIALS: From 2005 to 2012, 942 patients with oropharyngeal, hypopharyngeal, laryngeal or oral cavity carcinomas were curatively treated with primary radiation therapy. The median follow-up period was 34 months, and 77% of the patients...... underwent intensity modulated radiation therapy. The retropharyngeal region was only routinely included in cases of involvement of the posterior pharynx wall and level IB only in cases of involvement of the oral cavity. In patients with regional recurrence, the anatomic site of the recurrence was assessed...... likely to develop recurrence in distant sites. CONCLUSIONS: Retropharyngeal or level IB recurrence after primary HNC radiation therapy is rare. Thus, inclusion of these regions in the elective treatment volumes should be limited to patients with involvement of the posterior pharyngeal wall or oral cavity....
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Pharyngeal video fluoroscopy: Selected unusual cases
International Nuclear Information System (INIS)
Conoley, P.M.; Fox, D.R.
1987-01-01
The videotape in this exhibit presents cases illustrative of the use of pharyngeal video fluoroscopy in diagnostic evaluations and therapeutic decision-making in a variety of speech and swallowing disorders of adults and children. Clinical problems addressed include an interesting compensatory speech mechanism in a cleft-palate patient, a preoperative candidate for a Lefort procedure, uncontrolled nasality in a singer, and dysphagia in an antimony worker
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[Zenker diverticulum: a case report].
Kocatürk, Sinan; Beriat, Güçlü Kaan; Doğan, Cem
2009-01-01
Zenker's diverticulum is a pulsion typed pharyngoeosophageal diverticle caused by the herniation of the pharyngeal mucosa, standing beside the posterior pharyngeal wall, through the Killian opening which is known as the weak area between the inferior constructor muscle's oblique fibres and transverse fibres of cricopharyngeal muscle. In patients with Zenker's diverticulum, symptoms such as disfagia, globus in the cervical area, weigh loss, regurgitation, cough, and aspiration. These patients are primarily admitted to the Gastroenterology and Othorhinolaryngology clinics with the complaint of disfagia and the diagnosis of this disease is mostly established late and the treatment is started late because the results of their physical examinations seem normal. Therefore, especially in the patients who have disfagia complaint, pharyngoeosophageal diverticle prediagnosis should be thought and that should be examined by passage graphies with barium and endoscopic methods, if needed. In this article, we presented the 67-year-old Zenker's diverticulum patient in whom we performed open diverticulectomy and posterior cricopharyngeal myotomy, and we specified the important points in choosing the patient and the type of surgery.
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Laryngeal sensation and pharyngeal delay time after (chemo)radiotherapy.
Maruo, Takashi; Fujimoto, Yasushi; Ozawa, Kikuko; Hiramatsu, Mariko; Suzuki, Atsushi; Nishio, Naoki; Nakashima, Tsutomu
2014-08-01
The objective of the study was to evaluate the association between changes in laryngeal sensation and initiation of swallowing reflex or swallowing function before and after (chemo)radiotherapy. A prospective study was conducted in a tertiary referral university hospital. Thirteen patients who received (chemo)radiotherapy for treatment of laryngeal or hypopharyngeal cancer were included. Laryngeal sensation was evaluated at the tip of the epiglottis before and 1, 3 months, and 1 year after (chemo)radiotherapy. Videofluoroscopy was performed at the same time. Quantitative determinations included changes in laryngeal sensation, computed analysis of pharyngeal delay time, the distance and velocity of hyoid bone movement during the phase of hyoid excursion, and pharyngeal residue rate (the proportion of the bolus that was left as residue in the pharynx at the first swallow). Laryngeal sensation significantly deteriorated 1 month after (chemo)radiotherapy, but there was a tendency to return to pretreatment levels 1 year after treatment. Neither pharyngeal delay time nor displacement of the hyoid bone changed significantly before and after (chemo)radiotherapy. In addition, there was no significant difference in the mean velocity of hyoid bone movement and the amount of stasis in the pharynx at the first swallow before and after (chemo)radiotherapy. After (chemo)radiotherapy, laryngeal sensation deteriorated. But, in this study, videofluoroscopy showed that swallowing reflex and function were maintained.
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CT findings of traumatic posterior hip dislocation after reduction
International Nuclear Information System (INIS)
Moon, Sung Kyoung; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook; Jin Wook
2008-01-01
To evaluate the CT images of reduced hips after posterior hip dislocation and to propose specific diagnostic criteria based on the CT results. We retrospectively reviewed the CT findings on 18 reduced hips from 17 patients with radiographs and clinical histories of traumatic posterior hip dislocations by evaluating 18 corresponding CT scans for joint space asymmetry, intra-articular abnormalities (intra-articular fat obliteration, loose bodies, and joint effusion), changes in posterior soft tissue (capsule, muscles, and adjacent fat), the presence, and location of fractures (acetabulum and femoral head). All 18 hips (100%) showed posterior soft tissue changes. In total, 17 hips (94.4%) had intra-articular abnormalities and 15 hips (83.3%) had joint space asymmetries. In addition, 17 hips (94.4%) had fractures involving the acetabula (15 cases, 88.2%) the femoral head (13 cases, 76.5%), or on both sides (11 cases, 64.7%). The most frequent fracture location was in he posterior wall (13/15, 86.7%) of the acetabulum and in the anterior aspect (10/13, 76.9%) of the femoral head. Patients with a prior history of posterior hip dislocation showed specific CT findings after reduction, suggesting the possibility of previous posterior hip dislocations in patients
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DEFF Research Database (Denmark)
Hung, Nguyen Manh; Ryan, Timothy M.; Stauffer, Jay R.
2015-01-01
We investigated whether food type influences development of the pharyngeal crushing apparatus of black carp (Mylopharyngodon piceus, Cyprinidae). Fish fed a hard diet had average standard lengths and weights larger than those fed a soft diet; these observations in part could be related to differe......We investigated whether food type influences development of the pharyngeal crushing apparatus of black carp (Mylopharyngodon piceus, Cyprinidae). Fish fed a hard diet had average standard lengths and weights larger than those fed a soft diet; these observations in part could be related...... to differences in nutritional value of the two food types. The lower pharyngeal bones, which bear molariform teeth were examined using three dimensional computed tomography (CT) scans. After adjusting for differences in the standard length of the fish, the total volume and exterior surface areas...... of the pharyngeal teeth were greater in fish fed hard diets than in those fed soft diets. Total weights of the pharyngeal arches were less in the fish fed a soft diet than in those fed a hard diet. These results indicated that food type affects development of the pharyngeal crushing mill of black carp and therefore...
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Huckabee, Maggie-Lee; Lamvik, Kristin; Jones, Richard
2014-08-15
Clinical data are submitted as documentation of a pathophysiologic feature of dysphagia termed pharyngeal mis-sequencing and to encourage clinicians and researchers to adopt more critical approaches to diagnosis and treatment planning. Recent clinical experience has identified a cohort of patients who present with an atypical dysphagia not specifically described in the literature: mis-sequenced constriction of the pharynx when swallowing. As a result, they are unable to coordinate streamlined bolus transfer from the pharynx into the esophagus. This mis-sequencing contributes to nasal redirection, aspiration, and, for some, the inability to safely tolerate an oral diet. Sixteen patients (8 females, 8 males), with a mean age of 44 years (range=25-78), had an average time post-onset of 23 months (range=2-72) at initiation of intensive rehabilitation. A 3-channel manometric catheter was used to measure pharyngeal pressure. The average peak-to-peak latency between nadir pressures at sensor-1 and sensor-2 was 15 ms (95% CI, -2 to 33 ms), compared to normative mean latency of 239 ms (95% CI, 215 to 263 ms). Rehabilitative responses are summarized, along with a single detailed case report. It is unclear from these data if pharyngeal mis-sequencing is (i) a pathological feature of impaired motor planning from brainstem damage or (ii) a maladaptive compensation developed in response to chronic dysphagia. Future investigation is needed to provide a full report of pharyngeal mis-sequencing, and the implications on our understanding of underlying neural control of swallowing. Copyright © 2014 Elsevier B.V. All rights reserved.
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Fluconazole resistant opportunistic oro-pharyngeal candida and non ...
African Journals Online (AJOL)
Background: Oro-Pharyngeal Candidiasis (OPC) continues to be considered the most common opportunistic fungal disease in HIV/AIDS patients globally. Azole antifungal agent has become important in the treatment of mucosal candidiasis in HIV patients. Presently, antifungal drug resistance is fast becoming a major ...
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Dysphagia associated with presumed pharyngeal dysfunction in 16 neonatal foals.
Holcombe, S J; Hurcombe, S D; Barr, B S; Schott, H C
2012-02-01
Dysphagia due to pharyngeal dysfunction occurs in human neonates and is associated with prematurity and hypoxic episodes. This syndrome probably occurs in neonatal foals but has not been reported. The objectives of this study were to describe 1) a series of neonatal foals with dysphagia due to pharyngeal dysfunction; 2) the progression, treatment and resolution of the dysphagia; 3) the comorbidities; and 4) the prognosis for life and athleticism for affected foals. Records from 3 referral equine hospitals were reviewed from neonatal foals with dysphagia of pharyngeal origin. Inclusion criteria were a normal to strong suckle, dysphagia evidenced by milk at the nostrils after nursing the dam, and endoscopic examination of the airway. Foals with mechanical reasons for dysphagia, botulism or hyperkalaemic periodic paralysis were not included. Sixteen neonatal foals qualified for the study. Eight (50%) were premature and/or diagnosed with hypoxic ischaemic encephalopathy. Twelve (75%) had aspiration pneumonia. Fifteen foals were discharged alive from the hospital, nursing the mare with no evidence of dysphagia (n = 14), or mild dysphagia (n = 1), a mean +/- s.d. of 7 +/- 6 days (median = 6.3 days, range 0-22 days) after hospital admission. One foal was subjectedto euthanasia in hospital. Follow-up nformation was available for 14 animals. Thirteen of 16 (81%) were alive and included one yearling and 12 horses >2 years old. Seven of the 14 (50%) were racing, training or in work, and 6 horses were pets, breeding animals or had unknown athletic status. Two had laryngeal deficits. One foal was subjected to euthanasia within weeks of discharge from the hospital due to aspiration pneumonia. Dysphagia related to pharyngeal dysfunction occurs in equine neonates and can resolve, but may require days to weeks of supportive care. Prognosis for life is favourable and for athleticism fair.
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Prognostic factors associated with the survival of oral and pharyngeal carcinoma in Taiwan
International Nuclear Information System (INIS)
Chen, Ping-Ho; Tu, Hung-Pin; Ko, Ying-Chin; Shieh, Tien-Yu; Ho, Pei-Shan; Tsai, Chi-Cheng; Yang, Yi-Hsin; Lin, Ying-Chu; Ko, Min-Shan; Tsai, Pei-Chien; Chiang, Shang-Lun
2007-01-01
In Taiwan, a distinct ethnic group variation in incidence and mortality rates has been suggested for most carcinomas. Our aim is to identify the role of prognostic factors associated with the survival of oral and pharyngeal carcinoma in Taiwan. Taiwan Cancer Registry records of 9039 subjects diagnosed with oral and pharyngeal carcinoma were analyzed. The population was divided into three ethnic groups by residence, which were Taiwanese aborigines, Hakka and Hokkien communities. Five-year survival rates were estimated by Kaplan-Meier methods. Ethnic curves differed significantly by log-rank test; therefore separate models for Taiwanese aborigines, Hakka and Hokkien were carried out. The Cox multivariate proportional hazards model was used to examine the role of prognostic factors on ethnic survival. The five-year survival rates of oral and pharyngeal carcinoma were significantly poorer for Hokkien community (53.9%) and Taiwanese aborigines community (58.1%) compared with Hakka community (60.5%). The adjusted hazard ratio of Taiwanese aborigines versus Hakka was 1.07 (95%CI, 0.86–1.33) for oral and pharyngeal carcinoma mortality, and 1.16 (95%CI, 1.01–1.33) for Hokkien versus Hakka. Males had significantly poor prognosis than females. Subjects with tongue and/or mouth carcinoma presented the worst prognosis, whereas lip carcinoma had the best prognosis. Subjects with verrucous carcinoma had better survival than squamous cell carcinoma. Prognosis was the worst in elderly subjects, and subjects who underwent surgery had the highest survival rate. Our study presented that predictive variables in oral and pharyngeal carcinoma survival have been: ethnic groups, period of diagnosis, gender, diagnostic age, anatomic site, morphologic type, and therapy
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Developmental origin of the posterior pigmented epithelium of iris.
Wang, Xiaobing; Xiong, Kai; Lu, Lei; Gu, Dandan; Wang, Songtao; Chen, Jing; Xiao, Honglei; Zhou, Guomin
2015-03-01
Iris epithelium is a double-layered pigmented cuboidal epithelium. According to the current model, the neural retina and the posterior iris pigment epithelium (IPE) are derived from the inner wall of the optic cup, while the retinal pigment epithelium (RPE) and the anterior IPE are derived from the outer wall of the optic cup during development. Our current study shows evidence, contradicting this model of fetal iris development. We demonstrate that human fetal iris expression patterns of Otx2 and Mitf transcription factors are similar, while the expressions of Otx2 and Sox2 are complementary. Furthermore, IPE and RPE exhibit identical morphologic development during the early embryonic period. Our results suggest that the outer layer of the optic cup forms two layers of the iris epithelium, and the posterior IPE is the inward-curling anterior rim of the outer layer of the optic cup. These findings provide a reasonable explanation of how IPE cells can be used as an appropriate substitute for RPE cells.
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Directory of Open Access Journals (Sweden)
Ronaldo Machado BUENO
1999-10-01
Full Text Available Aneurismas em átrio esquerdo são pouco comuns, podendo ocorrer na aurícula ou na parede do átrio esquerdo. Freqüentemente, são assintomáticos, podendo ocorrer arritmias, fenômenos tromboembólicos ou insuficiência cardíaca como complicação da sua evolução. Apresentamos paciente de 39 anos, do sexo feminino, com defeito do anel posterior da valva mitral levando a grande dilatação aneurismática da parede posterior do átrio esquerdo com insuficiência mitral. O diagnóstico foi feito pela radiografia de tórax (abaulamento de silhueta cardíaca esquerda e ecocardiograma (grande aneurisma do átrio esquerdo posteriormente à parede posterior do ventrículo esquerdo com insuficiência mitral. O estudo hemodinâmico sugeriu pseudo-aneurisma de ventrículo esquerdo. Submetida a tratamento cirúrgico com auxílio da circulação extracorpórea, realizou-se anuloplastia mitral e exclusão do aneurisma com reconstrução do assoalho do átrio esquerdo com retalho de pericárdio bovino. A paciente apresentou boa evolução pós-operatória, recebendo alta hospitalar no oitavo dia em boas condições clínicas.Atrial aneurysm is a rare condition and can be found on the atrial appendage or on the atrial wall. Most patients are asymptomatic, but arrhythmias, thromboembolism, and heart failure are common complications. We present a 39 years old female patient with posterior mitral ring defect causing a great aneurysm of the left posterior atrial wall with mitral insufficiency. The diagnosis was achieved by chest roentgenogram (marked prominence of the upper left heart border and echocardiography (great left atrial aneurysm behind the left posterior ventricular wall with mitral insufficiency. Left ventricular cineangiogram suggested the presence of a false aneurysm of the left ventricle. The patient subsequently underwent surgical treatment with cardiopulmonary bypass. Posterior mitral valve annuloplasty was performed with aneurysm exclusion
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Garand, K L; Schwertner, Ryan; Chen, Amy; Pearson, William G
2018-04-01
Swallowing impairment (dysphagia) is a common sequela in patients with motor neuron disease (MND). The purpose of this retrospective, observational pilot investigation was to characterize how pharyngeal swallowing mechanics are impacted in patients with MND using a comparison with healthy, non-dysphagic control group. Computational analysis of swallowing mechanics (CASM) was used to determine covariate biomechanics of pharyngeal swallowing from videofluoroscopic assessment in 15 patients with MND and 15 age- and sex-matched healthy controls. Canonical variant analysis with post hoc discriminate function analysis (DFA) was performed on coordinate data mapping functional muscle groups underlying pharyngeal swallowing. Differences in swallowing mechanics associated with group (MND; control), motor neuron predominance (upper; lower), onset (bulbar; spinal), and swallow task (thin, pudding) were evaluated and visualized. Pharyngeal swallowing mechanics differed significantly in patients with MND compared with healthy controls (D = 2.01, p mechanics by motor neuron predominance (D = 5.03, p mechanics of patients with MND differ from and are more heterogeneous than healthy controls. These findings suggest patients with MND may compensate reductions in pharyngeal shortening and tongue base retraction by extending the head and neck and increasing hyolaryngeal excursion. This work and further CASM investigations will lead to further insights into development and evaluation of targeted clinical treatments designed to prolong safe and efficient swallowing function in patients with MND.
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Kose, Engin; Sirin Kose, Seda; Akca, Deniz; Yildiz, Kerem; Elmas, Cengizhan; Baris, Mustafa; Anil, Murat
2016-08-01
We aimed to investigate the effect of rapid antigen detection test (RADT) in the diagnosis of streptococcal pharyngitis, its impact on antibiotic prescription decision of pediatricians and influence on reduction of antibiotic treatment costs in children with pharyngitis. The study group consisted of 223 patients who were diagnosed with pharyngitis by pediatricians. The sensitivity and specificity of RADT were 92.1% (95% Cl: 78.6-98.3%) and 97.3% (95% Cl: 93.8-99.1%), respectively. In the first assessment, before performing RADT, pediatricians decided to prescribe antibiotics for 178 (79.8%) patients with pharyngitis. After learning RADT results, pediatricians finally decided to prescribe antibiotics for 83 (37.2%) patients with pharyngitis, and antibiotic prescription decreased by 42.6%. Antibiotic costs in non-Group A streptococcus pharyngitis, Group A streptococcus pharyngitis and all subjects groups decreased by 80.8%, 48%, and 76.4%, respectively. Performing RADT in children with pharyngitis has an important impact on treatment decision of clinicians, reduction of unnecessary antibiotic prescriptions and antibiotic costs. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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Williamson, Deborah A; Moreland, Nicole J; Carter, Philip; Upton, Arlo; Morgan, Julie; Proft, Thomas; Lennon, Diana; Baker, Michael G; Dunbar, Rod; Fraser, John D
2014-01-24
To describe the molecular epidemiology of emm types associated with circulating pharyngeal group A streptococcus (GAS) isolates in Auckland, New Zealand. GAS isolates were collected over a 10-day period from a community pathology provider in Auckland. PCR analysis and sequencing of the emm gene was performed at the Institute of Environmental Science and Research. A total of 52 emm types were identified from 278 GAS isolates. The three most common emm types were emm1, emm89 and emm12. Overall, the experimental 30-valent GAS M protein vaccine covered 19 / 52 (37%) of emm types in our study. Our study provides baseline data on the circulating pharyngeal GAS emm types in Auckland. Future clinical and molecular surveillance of GAS pharyngitis is essential in the context of ongoing GAS vaccine development.
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Lymphogranuloma venereum in an Italian MSM: concurrent pharyngeal and rectal infection.
Foschi, Claudio; Filippini, Andrea; D'Antuono, Antonietta; Compri, Monica; Macca, Francesca; Banzola, Nicoletta; Marangoni, Antonella
2014-07-01
An Italian HIV-positive man having sex with men (MSM) attended the STIs Outpatients Clinic of Sant'Orsola Hospital in Bologna complaining of anal pain and constipation. According to patient's sexual history and repertoires, NAAT testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) was performed. Pharyngeal and anal swabs resulted positive for CT DNA detection and the following molecular genotyping identified a L2 serovar, coming to the final diagnosis of pharyngeal and rectal lymphogranuloma venereum (LGV) infection. After an antibiotic therapy with doxycycline 100 mg twice a day for 3 weeks, the patient completely recovered and the test of cure was negative for LGV infection.
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Directory of Open Access Journals (Sweden)
Rohan Diwakar
2015-01-01
Full Text Available Introduction: The purpose of this study was to evaluate the pharyngeal airway volume in individuals with different vertical growth patterns. Methods: Cone beam computed tomography scans were evaluated of 40 subjects with the age range from 14 to 25 years and were divided into three groups. Horizontal growers consisted of 13 subjects, normal growers consisted of 14 subjects, and the vertical growers consisted of 13 subjects. The pharyngeal airway volume was measured using In Vivo Dental 5.1 software (Anatomage, Anatomy Imaging Software, San Jose, CA, USA. Results: The results obtained were analyzed statistically. The statistical test used for the analysis of the result was Student′s t-test. The independent t-test was done to compare the mean of the pharyngeal airway between the normal growers and horizontal growers and between the normal growers and the vertical growers. No statistically significant difference between the three groups was found in the volumetric measurements of the various sections of airway. Conclusions: Pharyngeal airway volume does not differ significantly in different vertical jaw relationships. It was possible to evaluate the pharyngeal airway volume three dimensionally.
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Abidin, Diana Atiqah Zainal; Hashim, Marina; Das, Simon K.; Ghaffar, Mazlan Abd.
2015-09-01
Information on the feeding mechanism and diet of halfbeak fish species in harsh estuarine environment ecosystem is still lacking. The present study investigates the fine structure of pharyngeal jaw apparatus and diets of halfbeak fish Zenarchopterus buffonis. A total of 84 halfbeak fish samples have been collected from the coastal water of Peninsular Malaysia using fishing rod. Scanning electron microscopy was used to examine the micrographs of fine microstructure of the pharyngeal teeth. The fundamental anatomy of pharyngeal jaw apparatus displayed that the upper pharyngeal jaw (third pharyngobranchials) displays larger size of hook-like or tricuspid teeth which was analogous to tricuspid morphology. The lower pharyngeal jaw (fifth ceratobranchial) bears mainly conical teeth and appears triangular shape with two, short projections. The estimated TROPH values (1 - 3.2±0.55) denoted that halfbeak fish were omnivores in nature. The findings of this study was found to be useful as a baseline information for a better representation of the trophic flows associated with large medium and small surface water fishes.
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International Nuclear Information System (INIS)
Abidin, Diana Atiqah Zainal; Hashim, Marina; Ghaffar, Mazlan Abd.; Das, Simon K.
2015-01-01
Information on the feeding mechanism and diet of halfbeak fish species in harsh estuarine environment ecosystem is still lacking. The present study investigates the fine structure of pharyngeal jaw apparatus and diets of halfbeak fish Zenarchopterus buffonis. A total of 84 halfbeak fish samples have been collected from the coastal water of Peninsular Malaysia using fishing rod. Scanning electron microscopy was used to examine the micrographs of fine microstructure of the pharyngeal teeth. The fundamental anatomy of pharyngeal jaw apparatus displayed that the upper pharyngeal jaw (third pharyngobranchials) displays larger size of hook-like or tricuspid teeth which was analogous to tricuspid morphology. The lower pharyngeal jaw (fifth ceratobranchial) bears mainly conical teeth and appears triangular shape with two, short projections. The estimated TROPH values (1 − 3.2±0.55) denoted that halfbeak fish were omnivores in nature. The findings of this study was found to be useful as a baseline information for a better representation of the trophic flows associated with large medium and small surface water fishes
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Energy Technology Data Exchange (ETDEWEB)
Abidin, Diana Atiqah Zainal, E-mail: diana.atiqah@gmail.com; Hashim, Marina; Ghaffar, Mazlan Abd., E-mail: magfish05@yahoo.com [School of Environmental and Natural Resource Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor (Malaysia); Das, Simon K. [Marine Ecosystem Research Centre, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 UKM Bangi (Malaysia)
2015-09-25
Information on the feeding mechanism and diet of halfbeak fish species in harsh estuarine environment ecosystem is still lacking. The present study investigates the fine structure of pharyngeal jaw apparatus and diets of halfbeak fish Zenarchopterus buffonis. A total of 84 halfbeak fish samples have been collected from the coastal water of Peninsular Malaysia using fishing rod. Scanning electron microscopy was used to examine the micrographs of fine microstructure of the pharyngeal teeth. The fundamental anatomy of pharyngeal jaw apparatus displayed that the upper pharyngeal jaw (third pharyngobranchials) displays larger size of hook-like or tricuspid teeth which was analogous to tricuspid morphology. The lower pharyngeal jaw (fifth ceratobranchial) bears mainly conical teeth and appears triangular shape with two, short projections. The estimated TROPH values (1 − 3.2±0.55) denoted that halfbeak fish were omnivores in nature. The findings of this study was found to be useful as a baseline information for a better representation of the trophic flows associated with large medium and small surface water fishes.
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Abd El-Ghany, Shereen Mohamed; Abdelmaksoud, Abeer Ahmed; Saber, Sally Mohamed; Abd El Hamid, Dalia Hosni
2015-01-01
Improper prescription of antibiotics for treatment of acute pharyngitis predisposes to emergence of a carrier state and antibiotic-resistant strains of group A streptococci (GAS). We sought to identify the frequency and antimicrobial susceptibility patterns of group A streptococci among Egyptian children with acute pharyngitis compared with asymptomatic children. Case-control study conducted from September 2013 to August 2014 at a pediatric outpatient clinic in Egypt. Throat swabs were collected from children with acute pharyngitis and from asymptomatic children. We evaluated the accuracy of McIsaac scores and the rapid antigen detection test (RADT) for diagnosis of GAS pharyngitis with throat culture as a reference test. Antimicrobial susceptibility testing of GAS isolates was done by the disc diffusion method. Of 142 children with acute pharyngitis (cases) and 300 asymptomatic children (controls) (age range, 4-16 years), GAS pharyngitis was diagnosed in 60/142 children (42.2%); 48/300 (16%) were found to be carriers. All GAS isolates in the case group were sensitive to penicillin; however, an MIC90 (0.12 micro g/mL) for penicillin is high and an alarming sign. The resistance rate to macrolides was 70% with the cMLSB phenotype in 65.1%. The sensitivities and specificities were 78.3% and 73.2% for McIsaac score of >=4 and 81.1% and 93.9% for RADT, respectively. GAS isolates in the control group were 100% sensitive to penicillin, while 12.5% and 37.5% were resistant to macrolides and tetracycline, respectively. An increased MIC90 for GAS isolates to penicillin is an alarming sign. A high frequency of resistance to macrolides was also observed.
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Tuberculose faringolaríngea Laryngo-pharyngeal Tuberculosis
Directory of Open Access Journals (Sweden)
Leonardo Conrado Barbosa de Sá
2007-12-01
Full Text Available A apresentação faringolaríngea da tuberculose como forma isolada da doença é rara, entretanto, nos últimos anos, com o aumento progressivo do número de casos de tuberculose em geral, a possibilidade dessas localizações aumentou. OBJETIVO: Descrever caso de tuberculose faringolaríngea primária em paciente grávida e imunocompetente. RELATORIO DE CASO: Paciente do sexo feminino, 30 anos, com história de odinofagia há 10 meses, sem qualquer sintoma sistêmico ou outras queixas referentes às vias aéreas superiores. Apresentava lesão granulomatosa em orofaringe e laringe, e o resultado da biópsia revelou bacilos álcool-ácido resistentes. Exames clínico e radiológico do aparelho respiratório sem alterações. Realizado tratamento anti-tuberculose por nove meses com resolução completa do quadro. CONCLUSÃO: Autores realçam a importância epidemiológica da tuberculose e a necessidade de um alto grau de suspeição de lesões das vias aéreas superiores para o diagnóstico precoce da doença.Tuberculosis of the Larynx and pharynx only is rare. However, in the last few years, the number of tuberculosis cases in general have had a dramatic increase, thus increasing the possibility of isolated laryngo-pharyngeal lesions. AIM: To report a case of isolated laryngo-pharyngeal tuberculosis in a pregnant, immunocompetent host. CASE REPORT: A 30- year-old pregnant female had complained of odynophagia for the last ten months. There were no other respiratory or systemic symptoms. An oro-pharyngeal granulomatous lesion was found, and the biopsy revealed acid-fast bacilli. There were no clinical or radiologic pulmonary findings. She was submitted successfully to an tuberculosis treatment protocol for nine months. CONCLUSIONS: The authors point out the epidemiological importance of tuberculosis and the need for a higher degree of suspicion when dealing with uncommon upper airway lesions to make an early diagnosis.
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Directory of Open Access Journals (Sweden)
Eliane Menin
2006-03-01
Full Text Available The bucco-pharyngeal cavity of Salminus brasiliensis, an ichthyophagous species of fresh water, is anatomically adapted to predation. The wide buccal rift, the oral-aboral enlargement of the buccal cavity and the reduced thickness of the pharyngeal mastigatory apparatus favor the capture and deglutition of larger prey. In function of the oral and pharyngeal dentition type, pre-digestive food preparation does not occur. The pointed and curved teeth, together with the tongue which is relatively mobile, prevent the prey’s escape from the buccopharyngeal cavity. The passage of the food is facilitated by the absence of pronounced folds in the mucous membrane of this cavity and by the disposition of the oral and pharyngeal teeth. The characteristics of flat and thin lips, developed oral dentition, relatively mobile tongue, mucous membrane without folds, pharynx with denticules disposed in dentigerous areas and plates, and short and sharp gill-rackers are anatomical adaptations which are shared by S. brasiliensis and other ichthyophagous Characiformes species such as Salminus maxillosus, Salminus hilarii, Hoplias malabaricus, Hoplias lacerdae, Acestrorhynchus lacustris and Acestrorhynchus britskii. However, different to the mentioned species, except other Salmininae, S. brasiliensis possesses oral teeth of an unique type, present only in the jawbones and distributed in two series.
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DEFF Research Database (Denmark)
Salale, Nesrin; Treldal, Charlotte; Mogensen, Stine
2014-01-01
Unsedated upper gastrointestinal endoscopy (UGE) can induce patient discomfort, mainly due to a strong gag reflex. The aim was to assess the effect of a bupivacaine lozenge as topical pharyngeal anesthetic compared with standard treatment with a lidocaine spray before UGE. Ninety-nine adult...... with a lidocaine spray proved to be a superior option as topical pharyngeal anesthetic before an UGE....
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Sands, Scott A; Edwards, Bradley A; Terrill, Philip I; Taranto-Montemurro, Luigi; Azarbarzin, Ali; Marques, Melania; Hess, Lauren B; White, David P; Wellman, Andrew
2018-05-01
Therapies for obstructive sleep apnea (OSA) could be administered on the basis of a patient's own phenotypic causes ("traits") if a clinically applicable approach were available. Here we aimed to provide a means to quantify two key contributors to OSA-pharyngeal collapsibility and compensatory muscle responsiveness-that is applicable to diagnostic polysomnography. Based on physiological definitions, pharyngeal collapsibility determines the ventilation at normal (eupneic) ventilatory drive during sleep, and pharyngeal compensation determines the rise in ventilation accompanying a rising ventilatory drive. Thus, measuring ventilation and ventilatory drive (e.g., during spontaneous cyclic events) should reveal a patient's phenotypic traits without specialized intervention. We demonstrate this concept in patients with OSA (N = 29), using a novel automated noninvasive method to estimate ventilatory drive (polysomnographic method) and using "gold standard" ventilatory drive (intraesophageal diaphragm EMG) for comparison. Specialized physiological measurements using continuous positive airway pressure manipulation were employed for further comparison. The validity of nasal pressure as a ventilation surrogate was also tested (N = 11). Polysomnography-derived collapsibility and compensation estimates correlated favorably with those quantified using gold standard ventilatory drive (R = 0.83, P < 0.0001; and R = 0.76, P < 0.0001; respectively) and using continuous positive airway pressure manipulation (R = 0.67, P < 0.0001; and R = 0.64, P < 0.001; respectively). Polysomnographic estimates effectively stratified patients into high versus low subgroups (accuracy, 69-86% vs. ventilatory drive measures; P < 0.05). Traits were near-identical using nasal pressure versus pneumotach (N = 11, R ≥ 0.98, both traits; P < 0.001). Phenotypes of pharyngeal dysfunction in OSA are evident from spontaneous changes in ventilation and
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Primary posterior perineal herniation of urinary bladder
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Kurumboor Prakash
2013-01-01
Full Text Available Primary perineal hernia is a rare clinical condition wherein herniation of viscera occurs through pelvic diaphragm. They are usually mistaken for sciatic hernia, rectal prolapse or other diseases in the perineum. Correct identification of the type of hernia by imaging is crucial for planning treatment. We present a case of primary posterior herniation of urinary bladder and rectal wall through levator ani repaired laparoscopically using a mesh repair.
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Posterior epistaxis: Common bleeding sites and prophylactic electrocoagulation.
Liu, Juan; Sun, Xicai; Guo, Limin; Wang, Dehui
2016-01-01
Posterior epistaxis is a frequent emergency, and the key to efficient management is identification of the bleeding point. We performed a retrospective study of 318 patients with posterior epistaxis treated with endoscopic bipolar electrocautery during a 4-year period. Distribution of the bleeding sites was recorded. Patients with no definite bleeding sites in the first operation were assigned to Group A (n = 39) and Group B (n = 34). Patients in Group A were only observed in the ward. Patients in Group B were given prophylactic electrocoagulation at the common bleeding points. Of the 318 patients, bleeding sites were successfully identified and coagulated in 263 patients. All of them were located posteriorly, with 166 on the lateral nasal wall, 86 on the septum, and 11 on the anterior face of the sphenoid sinus. The rebleeding rate of Group B (8.8%) was lower than that of Group A (38.5%) (p < 0.01).
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Directory of Open Access Journals (Sweden)
MR. Zarei
2007-03-01
Full Text Available Objective: The aim of the present study was to estimate crude and age-standardized incidence rates for oral and pharyngeal nonsquamous cell malignant tumors in Kerman province over a period of 11 years.Materials and Methods: The data used in this retrospective population-based study were extracted from the records registered in all pathology centers of Kerman province from 1991 to 2001. All confirmed cases of oral and pharyngeal nonsquamous cell malignant tumors were included in the study. The crude and age-standardized incidence rates per 1 million populations were calculated based on the 1996 census data and the population growth rate.Results: The total number of new nonsquamous cell cancers was 61, representing 18.2% of all oral and pharyngeal cancers in Kerman province. The average annual ageadjusted incidence rate per 1,000,000 population was 3.45 for both oral and pharyngeal tumors. The temporal variations in the annual incidence of oral and pharyngeal nonsquamous cell cancers was statistically significant (p=0.015. The most common types of nonsquamous cell malignant tumors in the oral cavity and pharynx were minor salivary tumors and lymphomas, respectively. The age-adjusted incidence was 0.74 formalignant salivary gland tumors, 0.66 for malignant melanomas, 0.4 for different types of sarcomas, and 1.65 for lymphomas.Conclusion: It can be concluded that the incidence rate and other features of nonsquamous cell malignant tumors of the oral cavity and pharynx in residents of Kerman province are similar to those reported by other investigators.
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Recurrence in oral and pharyngeal cancer is associated with quantitative MGMT promoter methylation
International Nuclear Information System (INIS)
Taioli, Emanuela; Ragin, Camille; Wang, Xiao-hong; Chen, Jiangying; Langevin, Scott M; Brown, Ashley R; Gollin, Susanne M; Garte, Seymour; Sobol, Robert W
2009-01-01
Biomarkers that predict clinical response, tumor recurrence or patient survival are severely lacking for most cancers, particularly for oral and pharyngeal cancer. This study examines whether gene-promoter methylation of tumor DNA correlates with survival and recurrence rates in a population of patients with oral or pharyngeal cancer. The promoter methylation status of the DNA repair gene MGMT and the tumor suppressor genes CDKN2A and RASSF1 were evaluated by methylation-specific PCR in 88 primary oral and pharyngeal tumors and correlated with survival and tumor recurrence. Quantitative MGMT methylation was also assessed. 29.6% of the tumors presented with MGMT methylation, 11.5% with CDKN2A methylation and 12.1% with RASSF1 methylation. MGMT promoter methylation was significantly associated with poorer overall and disease-free survival. No differences in methylation status of MGMT and RASSF1 with HPV infection, smoking or drinking habits were observed. A significant inverse trend with the amount of MGMT methylation and overall and disease-free survival was observed (p trend = 0.002 and 0.001 respectively). These results implicate MGMT promoter methylation as a possible biomarker for oral and pharyngeal cancer prognosis. The critical role of MGMT in DNA repair suggests that defective DNA repair may be correlative in the observed association between MGMT promoter methylation and tumor recurrence. Follow-up studies should include further quantitative MSP-PCR measurement, global methylation profiling and detailed analysis of downstream DNA repair genes regulated by promoter methylation
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International Nuclear Information System (INIS)
Kumarasiri, A; Siddiqui, F; Liu, C; Kamal, M; Fraser, C; Chetty, I; Kim, J
2015-01-01
Purpose: To evaluate the anatomical changes and associated dosimetric consequences to the pharyngeal constrictor (PC) that occurs during head and neck radiotherapy (H&N RT). Methods: A cohort of 13 oro-pharyngeal cancer patients, who had daily CBCT’s for localization, was retrospectively studied. On every 5th CBCT, PC was manually delineated by a radiation oncologist. The anterior-posterior PC thickness was measured at the C3 level. Delivered dose to PC was estimated by calculating daily doses on CBCT’s, and accumulating to corresponding planning CT images. For accumulation, a parameter-optimized B- spline-based deformable image registration algorithm (Elastix) was used, in conjunction with an energy-mass mapping dose transfer algorithm. Mean and maximum dose (Dmean, Dmax) to PC was determined and compared with corresponding planned quantities. Results: The mean (±standard deviation) volume increase (ΔV) and thickness increase (Δt) over the course of 35 total fractions were 54±33% (11.9±7.6 cc), and 63±39% (2.9±1.9 mm), respectively. The resultant cumulative mean dose increase from planned dose to PC (ΔDmean) was 1.4±1.3% (0.9±0.8 Gy), while the maximum dose increase (ΔDmax) was 0.0±1.6% (0.0±1.1 Gy). Patients with adaptive replanning (n=6) showed a smaller mean dose increase than those without (n=7); 0.5±0.2% (0.3±0.1 Gy) vs. 2.2±1.4% (1.4±0.9 Gy). There was a statistically significant (p<0.0001) strong correlation between ΔDmean and Δt (Pearson coefficient r=0.78), and a moderate-to-strong correlation (r=0.52) between ΔDmean and ΔV. Correlation between ΔDmean and weight loss ΔW (r=0.1), as well as ΔV and ΔW (r=0.2) were negligible. Conclusion: Patients were found to undergo considerable anatomical changes to pharyngeal constrictor during H&N RT, resulting in non-negligible dose deviations from intended dose. Results are indicative that pharyngeal constrictor thickness, measured at C3 level, is a good predictor for the dose change to
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Energy Technology Data Exchange (ETDEWEB)
Kumarasiri, A; Siddiqui, F; Liu, C; Kamal, M; Fraser, C; Chetty, I; Kim, J [Henry Ford Health System, Detroit, MI (United States)
2015-06-15
Purpose: To evaluate the anatomical changes and associated dosimetric consequences to the pharyngeal constrictor (PC) that occurs during head and neck radiotherapy (H&N RT). Methods: A cohort of 13 oro-pharyngeal cancer patients, who had daily CBCT’s for localization, was retrospectively studied. On every 5th CBCT, PC was manually delineated by a radiation oncologist. The anterior-posterior PC thickness was measured at the C3 level. Delivered dose to PC was estimated by calculating daily doses on CBCT’s, and accumulating to corresponding planning CT images. For accumulation, a parameter-optimized B- spline-based deformable image registration algorithm (Elastix) was used, in conjunction with an energy-mass mapping dose transfer algorithm. Mean and maximum dose (Dmean, Dmax) to PC was determined and compared with corresponding planned quantities. Results: The mean (±standard deviation) volume increase (ΔV) and thickness increase (Δt) over the course of 35 total fractions were 54±33% (11.9±7.6 cc), and 63±39% (2.9±1.9 mm), respectively. The resultant cumulative mean dose increase from planned dose to PC (ΔDmean) was 1.4±1.3% (0.9±0.8 Gy), while the maximum dose increase (ΔDmax) was 0.0±1.6% (0.0±1.1 Gy). Patients with adaptive replanning (n=6) showed a smaller mean dose increase than those without (n=7); 0.5±0.2% (0.3±0.1 Gy) vs. 2.2±1.4% (1.4±0.9 Gy). There was a statistically significant (p<0.0001) strong correlation between ΔDmean and Δt (Pearson coefficient r=0.78), and a moderate-to-strong correlation (r=0.52) between ΔDmean and ΔV. Correlation between ΔDmean and weight loss ΔW (r=0.1), as well as ΔV and ΔW (r=0.2) were negligible. Conclusion: Patients were found to undergo considerable anatomical changes to pharyngeal constrictor during H&N RT, resulting in non-negligible dose deviations from intended dose. Results are indicative that pharyngeal constrictor thickness, measured at C3 level, is a good predictor for the dose change to
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Directory of Open Access Journals (Sweden)
Su Keng Tan
Full Text Available Mandibular setback osteotomies potentially lead to narrowing of the pharyngeal airways, subsequently resulting in post-surgical obstructive sleep apnea (OSA.To summarize current evidence from systematic reviews that has evaluated pharyngeal airway changes after mandibular setback with or without concomitant upper jaw osteotomies.PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched with no restriction of language or date. Systematic reviews studying changes in pharyngeal airway dimensions and respiratory parameters after mandibular setback with or without concomitant upper jaw osteotomies have been identified, screened for eligibility, included and analyzed in this study.Six systematic reviews have been included. While isolated mandibular setback osteotomies result in reduced oropharyngeal airway dimensions, the reduction is lesser in cases with concomitant upper jaw osteotomies. Only scarce evidence exists currently to what happens to naso- and hypo-pharyngeal airways. There is no evidence for post-surgical OSA, even though some studies reported reduced respiratory parameters after single-jaw mandibular setback with or without concomitant upper jaw osteotomies.Although mandibular setback osteotomies reduce pharyngeal airway dimensions, evidence confirming post-surgical OSA was not found. Nevertheless, potential post-surgical OSA should be taken into serious consideration during the treatment planning of particular orthognathic cases. As moderate evidence exists that double-jaw surgeries lead to less compromised post-surgical pharyngeal airways, they should be considered as the method of choice especially in cases with severe dentoskeletal Class III deformity.PROSPERO (registration number: CRD42016046484.
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Wang, Zhenjiang; Chen, Yuping; Guo, Tingting
2015-07-01
To investigate the influence of the local sensory abnormality in throat while the change of motility in the upper esophageal sphincter (UES) and lower esophageal sphincter (LES), as well as the change of esophageal body in pharyngeal paraesthesia. From January 2014 to January 2015 there were sixty-four patients who had pharyngeal susceptible syndrome (PSS) but without confirmed organic disease were enrolled as the PSS group, forty healthy volunteers as the control group. High resolution manometry (HRM) was utilized to distinguish esophageal motility patterns of PSS, including the muscular tension of LES and UES, the integrity, adaptability, amplitude, speed and duration of esophageal peristalsis at 10 swallows. The resting LES and UES pressures and the distal contractile integral (DCI) of esophagus in PSS group were lower than that in control group (P 0.05). The average peak pressure was similar in two groups (P > 0.05). Muscle tension around the UES has no obvious change when pharyngeal paraesthesia occurred, but the reduction of esophageal motor function, clearance ability, anti-reflux gastroesophageal junction, causing the abnormal reflux which hurt the pharyngeal surface mucosa maybe one of the most important reasons leading to pharyngeal paresthesia.
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The detection of pharyngeal incoordination and aspiration by radiosalivagram in cerebral palsy
Energy Technology Data Exchange (ETDEWEB)
Baikie, G.; Reddihough, D.; Olinsky, A.; South, M.J.; Bowe, J.; Cook, D.J. [Royal Children`s Hospital, Parkville, VIC, (Australia)
1997-09-01
Full text: Children with cerebral palsy (CP) may have abnormal respiratory function because of aspiration pneumonitis, chest deformity, upper airways obstruction or central respiratory control abnormalities. The diagnosis of aspiration has long confounded clinicians and is often made indirectly after exclusion of other causes of respiratory disease in susceptible individuals. The radiosalivagram is a technique which permits the demonstration of aspiration of pharyngeal contents in individuals with pharyngeal incoordination. It is a simple procedure which provides both qualitative and quantitative evidence of aspiration. Over an hour and while supine, 20 mL of {sup 99m}Tc-sulphur colloid is instilled into the pharynx via a thin plastic tube using a syringe pump. The neck, thorax and upper abdomen are imaged continuously In normal individuals, radioactivity is demonstrated in the pharynx, oesophagus and stomach; in the presence of pharyngeal incoordination, radioactivity is seen within one or both main bronchi and adjacent lung fields. The rate of clearance from the lungs varies and can be quantified. We have studied 31 children with severe non-ambulant CR The time to first aspiration, maximum quantity aspirated, and retention of aspirated material at 2h have been determined. These data have been compared with measurements of respiratory function. Preliminary results of this ongoing study reveal a broad range of outcomes. Seventeen children (17/31) had aspiration, in 15/17 aspiration was unilateral and in 14/17 there was spontaneous early clearance. The investigation was well tolerated by patients. The radiosalivagram is a simple, quantifiable investigation for demonstrating or excluding pharyngeal incoordination and aspiration in children with unexplained respiratory disease.
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The detection of pharyngeal incoordination and aspiration by radiosalivagram in cerebral palsy
International Nuclear Information System (INIS)
Baikie, G.; Reddihough, D.; Olinsky, A.; South, M.J.; Bowe, J.; Cook, D.J.
1997-01-01
Full text: Children with cerebral palsy (CP) may have abnormal respiratory function because of aspiration pneumonitis, chest deformity, upper airways obstruction or central respiratory control abnormalities. The diagnosis of aspiration has long confounded clinicians and is often made indirectly after exclusion of other causes of respiratory disease in susceptible individuals. The radiosalivagram is a technique which permits the demonstration of aspiration of pharyngeal contents in individuals with pharyngeal incoordination. It is a simple procedure which provides both qualitative and quantitative evidence of aspiration. Over an hour and while supine, 20 mL of 99m Tc-sulphur colloid is instilled into the pharynx via a thin plastic tube using a syringe pump. The neck, thorax and upper abdomen are imaged continuously In normal individuals, radioactivity is demonstrated in the pharynx, oesophagus and stomach; in the presence of pharyngeal incoordination, radioactivity is seen within one or both main bronchi and adjacent lung fields. The rate of clearance from the lungs varies and can be quantified. We have studied 31 children with severe non-ambulant CR The time to first aspiration, maximum quantity aspirated, and retention of aspirated material at 2h have been determined. These data have been compared with measurements of respiratory function. Preliminary results of this ongoing study reveal a broad range of outcomes. Seventeen children (17/31) had aspiration, in 15/17 aspiration was unilateral and in 14/17 there was spontaneous early clearance. The investigation was well tolerated by patients. The radiosalivagram is a simple, quantifiable investigation for demonstrating or excluding pharyngeal incoordination and aspiration in children with unexplained respiratory disease
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Domer, Amanda S; Leonard, Rebecca; Belafsky, Peter C
2014-10-01
To evaluate pharyngeal strength and upper esophageal sphincter opening in patients with unilateral vocal fold immobility (UVFI). Case control study. Charts of individuals with UVFI who underwent a videofluoroscopic swallow study were reviewed. To exclude confounding variables associated with pharyngeal weakness, inclusion was limited to patients with iatrogenic and idiopathic UVFI. Data abstracted included patient demographics, etiology of UVFI, pharyngeal constriction ratio (PCR), and upper esophageal sphincter (UES) opening (UESmax). Data were compared to age/gender-matched controls with no history of dysphagia or UVFI. Discrete variables were analyzed using a chi-square test of independence, and an independent samples t test was used to compare the UVFI and control groups (P = 0.05). A one-way analysis of variance (ANOVA) was used to compare iatrogenic and idiopathic UVFI groups. The mean age of the cohort (n = 25) was 61 (±14 SD) years and 52% was female. The etiologies of UVFI were iatrogenic (n = 17) and idiopathic (n = 8). Thirty-eight percent of UVFI patients (n = 25) aspirated compared to 0% of controls (P 0.05). Individuals with UVFI of iatrogenic and idiopathic etiologies with subjective dysphagia demonstrate objective evidence of pharyngeal weakness. The increased prevalence of aspiration in this population may not be solely the result of impaired airway protection. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.
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Post-operative cyst and orbital walls. A CT image analysis
Energy Technology Data Exchange (ETDEWEB)
Fukuta, Masahiro (Takeda General Hospital, Aizuwakamatsu, Fukushima (Japan)); Iinuma, Toshitaka
1989-07-01
A set of coronal CT images obtained by 118 sides (109 cases) of post-operative cysts of maxilla, seen from 1982 to 1988, was analyzed as to the orbital wall affections. Coronal images were grouped into five consecutive planes, i.e. the first plane being the one which is 5 mm posterior to the nasion, and the other planes in successive orders each being 5 mm apart. The orbital walls were classified into inferior, medial, and transition of these two. The orbital wall affections were classified into dehiscence, thinned-out (less than 1 mm), and normal. The orbital signs and symptoms (epiphora, pain, asthenopia, visual loss, diplopia, and exophthalmos) were analyzed based upon the questionnaires by patients. The inferior wall affections (dehiscence and thinned-out) were seen most often (57%) at the third plane (2 cm posterior to the nasion). The orbital signs and symptoms in general were seen in half of the cases of which 20% were of grave (visual loss, diplopia and exophthalmos). These signs and symptoms were the more often, the more anterior the site of affections located. Grave signs and symptoms were seen at 2 to 2.5 cm posterior to the nasion when the orbital floor was affected and the inferior rectus were either pushed up or in direct contact with the cysts. (author).
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Barium and meat. A comparison between pharyngeal swallow of fluid and solid boluses
Energy Technology Data Exchange (ETDEWEB)
Ekberg, O.; Liedberg, B.; Oewall, B.
The influence of bolus consistency on pharyngeal swallow was radiologically studied in 24 individuals by comparing liquid barium and solid meat after chewing. Pharyngeal function was apparently performed synchronously and symmetrically on both boluses. No definite conclusion about the influence on epiglottic mobility, closure of the laryngeal vestibule and relaxation of the circopharyngeal muscle could be drawn from this study. There was no difference in the elevation of the pharynx and larynx. The transit time for a solid bolus was shorter compared with that of a fluid bous. The transit time for the apex of the bolus was shorter than for the tail. A more marked elevation of the pharynx and larynx was followed by a shorter transit time. The width of the pharyngo-esophageal segment was larger in the transverse than in the sagittal diameter during the passage of the bolus and larger on solid compared with fluid swallow. Our results reflect the ability of pharyngeal swallow to be executed with precision and with few alterations due to variable bolus consistency.
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Directory of Open Access Journals (Sweden)
Ewa Nogaj
2010-03-01
Full Text Available The zinc is one of the most important microelements. Element this conditions has corrected the functioning the nervous system of, immunological, sense of taste and smell. It the weakness of activity was manifested was the shortage of zinc and children’s motive development. The aim of this study was samples of pharyngeal tonsils from children living on Malopolska Region, Silesia and village (made up the area of reference of Southern Poland. We investigated population 95 children, in this 40 girls (42% and 55 boys (58% in age from 2 till 15 years (average 6,8 years. The content of zinc was determined by ICP – AES method. Average the content of zinc in pharyngeal tonsils in whole studied children’s population carried out 74,51 µg/g. The statistical differences were not affirmed among average (the average geometrical content of ions of zinc in studied come from girls – 73,15 µg/g and the boys – 75,49 µg/g. The differences between sex appear, in case of ranges of changes, at boys range this it is clearly larger (55,86–97,59 µg/g in comparison to girls (58,34–88,68 µg/g how also near comparison of content answering 95 percentylowi (the incidental resulting with large environmental exposition contents it in the pharyngeal boys’ tonsils is larger – (87,73 µg/g in comparison to young girls (81,98 µg/g. It was established, on basis of report of changes quotient content zinc in pharyngeal tonsils in function of changes of content zinc in air dust, the physiological quantities of zinc in pharyngeal tonsil on level 42 µg/g.
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Pharyngeal Electrical Stimulation for Treatment of Dysphagia in Subacute Stroke
DEFF Research Database (Denmark)
Bath, Philip M W; Scutt, Polly; Love, Jo
2016-01-01
BACKGROUND AND PURPOSE: Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in 3 pilot randomized controlled trials. METHODS...
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Hanslik, Ulrike; Schoofs, Andreas; Niederegger, Senta; Heinzel, Hans-Georg; Spiess, Roland
2010-08-01
An anatomical description is given by the muscles in the pro- and mesothorax, and those associated with the feeding apparatus (cephalopharyngeal skeleton, CPS) that participate in feeding behavior in third instar Calliphora larvae. The body wall muscles in the pro- and mesothoracic segments are organized in three layers: internal, intermedial, and external. The muscles were labeled with roman numerals according to the nomenclature in use for the abdominal segments. Muscles associated with the CPS are labeled according to their function. The prothorax bears five pairs of lateral symmetrically longitudinal segmental body wall muscles and lacks the transversal muscle group present in the mesothorax and abdominal segments. Additionally, four pairs of intersegmental muscles project from the prothorax to the second, fourth, and fifth segment. The mesothorax bears 15 pairs of segmental longitudinal and 18 pairs of transversal muscles. The accessory pharyngeal muscles span the CPS and the cuticle. Three pairs of protractors and retractors and two pairs of mouth hook accessors (MH(AC)) exist, which move the CPS relative to the body. The pharyngeal muscles are exclusively attached to the structures of the CPS. The mouth hook elevators and depressors, which mediate the hooks rotation are attached to the ventral arm of the CPS and project to a dorsal (elevators) or ventral (depressors) protuberance of the mouth hooks. The cibarial dilator muscles (CDM) span the dorsal arms of the CPS and the dorsal surface of the esophagus and mediate food ingestion. The labial retractors (LRs) lack antagonists and project from the ventral surface of the CPS to the unpaired labium. Contractions of these muscles open the mouth cavity. J. Morphol. 271:960-968, 2010. (c) 2010 Wiley-Liss, Inc.
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Differentiation of posterior pararenal space infection from psoas abscess by gallium imaging
Energy Technology Data Exchange (ETDEWEB)
Bose, A.; Mishkin, F.; Delgado, J.
1983-01-01
Three of four patients whose cases fit the clinical description of psoas abscess proved on gallium imaging to have infection in the posterior pararenal space sparing the psoas muscle. This space provides a route for spread of infection connecting the spine, the anterior abdominal wall, the scrotum, the anterior thigh, and the gluteal region as demonstrated by the cases presented. Clinical differentiation between posterior pararenal space infection and psoas abscesses is difficult and CT studies may not demonstrate the process when the psoas space is not involved.
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Differentiation of posterior pararenal space infection from psoas abscess by gallium imaging
International Nuclear Information System (INIS)
Bose, A.; Mishkin, F.; Delgado, J.
1983-01-01
Three of four patients whose cases fit the clinical description of psoas abscess proved on gallium imaging to have infection in the posterior pararenal space sparing the psoas muscle. This space provides a route for spread of infection connecting the spine, the anterior abdominal wall, the scrotum, the anterior thigh, and the gluteal region as demonstrated by the cases presented. Clinical differentiation between posterior pararenal space infection and psoas abscesses is difficult and CT studies may not demonstrate the process when the psoas space is not involved
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The plant cell wall in the feeding sites of cyst nematodes.
Bohlmann, Holger; Sobczak, Miroslaw
2014-01-01
Plant parasitic cyst nematodes (genera Heterodera and Globodera) are serious pests for many crops. They enter the host roots as migratory second stage juveniles (J2) and migrate intracellularly toward the vascular cylinder using their stylet and a set of cell wall degrading enzymes produced in the pharyngeal glands. They select an initial syncytial cell (ISC) within the vascular cylinder or inner cortex layers to induce the formation of a multicellular feeding site called a syncytium, which is the only source of nutrients for the parasite during its entire life. A syncytium can consist of more than hundred cells whose protoplasts are fused together through local cell wall dissolutions. While the nematode produces a cocktail of cell wall degrading and modifying enzymes during migration through the root, the cell wall degradations occurring during syncytium development are due to the plants own cell wall modifying and degrading proteins. The outer syncytial cell wall thickens to withstand the increasing osmotic pressure inside the syncytium. Furthermore, pronounced cell wall ingrowths can be formed on the outer syncytial wall at the interface with xylem vessels. They increase the surface of the symplast-apoplast interface, thus enhancing nutrient uptake into the syncytium. Processes of cell wall degradation, synthesis and modification in the syncytium are facilitated by a variety of plant proteins and enzymes including expansins, glucanases, pectate lyases and cellulose synthases, which are produced inside the syncytium or in cells surrounding the syncytium.
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The plant cell wall in the feeding sites of cyst nematodes
Directory of Open Access Journals (Sweden)
Holger eBohlmann
2014-03-01
Full Text Available Plant parasitic cyst nematodes (genera Heterodera and Globodera are serious pests for many crops. They enter the host roots as migratory second stage juveniles (J2 and migrate intracellularly towards the vascular cylinder using their stylet and a set of cell wall degrading enzymes produced in the pharyngeal glands. They select an initial syncytial cell (ISC within the vascular cylinder or inner cortex layers to induce the formation of a multicellular feeding site called a syncytium, which is the only source of nutrients for the parasite during its entire life. A syncytium can consist of more than hundred cells whose protoplasts are fused together through local cell wall dissolutions. While the nematode produces a cocktail of cell wall degrading and modifying enzymes during migration through the root, the cell wall degradations occurring during syncytium development are due to the plants own cell wall modifying and degrading proteins. The outer syncytial cell wall thickens to withstand the increasing osmotic pressure inside the syncytium. Furthermore, pronounced cell wall ingrowths can be formed on the outer syncytial wall at the interface with xylem vessels. They increase the surface of the symplast-apoplast interface, thus enhancing nutrient uptake into the syncytium. Processes of cell wall degradation, synthesis and modification in the syncytium are facilitated by a variety of plant proteins and enzymes including expansins, glucanases, pectate lyases and cellulose synthases, which are produced inside the syncytium or in cells surrounding the syncytium.
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Watanabe, Kei; Yamazaki, Akiyoshi; Hirano, Toru; Izumi, Tomohiro; Sano, Atsuki; Morita, Osamu; Kikuchi, Ren; Ito, Takui
2010-09-15
Case report. To describe an iatrogenic aortic injury by pedicle screw instrumentation during posterior reconstructive surgery of spinal deformity. Iatrogenic major vascular injuries during anterior instrumentation procedures have been reported by several authors, but there have been few reports regarding iatrogenic major vascular injuries during posterior instrumentation procedures. A 57-year-old woman with thoracolumbar kyphosis due to osteoporotic T12 vertebral fracture underwent posterior correction and fusion (T10-L2), using segmental pedicle screw construct concomitant with T12 pedicle subtraction osteotomy. Postoperative routine plain radiographs and computed tomography myelography demonstrated a misplaced left T10 pedicle screw, which was in contact with the posteromedial aspect of the thoracic aorta, and suspected penetration of the aortic wall. The patient underwent removal of the pedicle screw, and repair of the penetrated aortic wall through a simultaneous anterior-posterior approach. The patient tolerated the procedure well without neurologic sequelae, and was discharged several days after removal of a left tube thoracostomy. Plain radiographs demonstrated solid fusion at the osteotomy site and no loosening of hardware. Preoperative neurologic symptoms improved completely at 18-months follow-up. Use of pedicle screw instrumentation has the potential to cause major vascular injury during posterior spinal surgery, and measures to prevent this complication must be taken. Timely diagnosis and treatment are essential to prevent both early and delayed complications and death.
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Directory of Open Access Journals (Sweden)
Salzburger Walter
2011-04-01
Full Text Available Abstract Background Phenotypic evolution and its role in the diversification of organisms is a central topic in evolutionary biology. A neglected factor during the modern evolutionary synthesis, adaptive phenotypic plasticity, more recently attracted the attention of many evolutionary biologists and is now recognized as an important ingredient in both population persistence and diversification. The traits and directions in which an ancestral source population displays phenotypic plasticity might partly determine the trajectories in morphospace, which are accessible for an adaptive radiation, starting from the colonization of a novel environment. In the case of repeated colonizations of similar environments from the same source population this "flexible stem" hypothesis predicts similar phenotypes to arise in repeated subsequent radiations. The Midas Cichlid (Amphilophus spp. in Nicaragua has radiated in parallel in several crater-lakes seeded by populations originating from the Nicaraguan Great Lakes. Here, we tested phenotypic plasticity in the pharyngeal jaw of Midas Cichlids. The pharyngeal jaw apparatus of cichlids, a second set of jaws functionally decoupled from the oral ones, is known to mediate ecological specialization and often differs strongly between sister-species. Results We performed a common garden experiment raising three groups of Midas cichlids on food differing in hardness and calcium content. Analyzing the lower pharyngeal jaw-bones we find significant differences between diet groups qualitatively resembling the differences found between specialized species. Observed differences in pharyngeal jaw expression between groups were attributable to the diet's mechanical resistance, whereas surplus calcium in the diet was not found to be of importance. Conclusions The pharyngeal jaw apparatus of Midas Cichlids can be expressed plastically if stimulated mechanically during feeding. Since this trait is commonly differentiated - among
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Muschick, Moritz; Barluenga, Marta; Salzburger, Walter; Meyer, Axel
2011-04-30
Phenotypic evolution and its role in the diversification of organisms is a central topic in evolutionary biology. A neglected factor during the modern evolutionary synthesis, adaptive phenotypic plasticity, more recently attracted the attention of many evolutionary biologists and is now recognized as an important ingredient in both population persistence and diversification. The traits and directions in which an ancestral source population displays phenotypic plasticity might partly determine the trajectories in morphospace, which are accessible for an adaptive radiation, starting from the colonization of a novel environment. In the case of repeated colonizations of similar environments from the same source population this "flexible stem" hypothesis predicts similar phenotypes to arise in repeated subsequent radiations. The Midas Cichlid (Amphilophus spp.) in Nicaragua has radiated in parallel in several crater-lakes seeded by populations originating from the Nicaraguan Great Lakes. Here, we tested phenotypic plasticity in the pharyngeal jaw of Midas Cichlids. The pharyngeal jaw apparatus of cichlids, a second set of jaws functionally decoupled from the oral ones, is known to mediate ecological specialization and often differs strongly between sister-species. We performed a common garden experiment raising three groups of Midas cichlids on food differing in hardness and calcium content. Analyzing the lower pharyngeal jaw-bones we find significant differences between diet groups qualitatively resembling the differences found between specialized species. Observed differences in pharyngeal jaw expression between groups were attributable to the diet's mechanical resistance, whereas surplus calcium in the diet was not found to be of importance. The pharyngeal jaw apparatus of Midas Cichlids can be expressed plastically if stimulated mechanically during feeding. Since this trait is commonly differentiated--among other traits--between Midas Cichlid species, its plasticity
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Directory of Open Access Journals (Sweden)
Hideaki Kikuta
2009-01-01
Full Text Available Efficacy of short-course therapy with cephalosporins for treatment of group A β-hemolytic streptococcus (GABHS pharyngitis is still controversial. Subjects were 226 children with a history of at least one episode of GABHS pharyngitis. Recurrence within the follow-up period (3 weeks after initiation of therapy occurred in 7 of the 77 children in the 5-day treatment group and in 1 of the 149 children in the 10-day treatment group; the incidence of recurrence being significantly higher in the 5-day treatment group. Bacteriologic treatment failure (GABHS isolation without overt pharyngitis at follow-up culture was observed in 7 of the 77 children in the 5-day treatment group and 17 of the 149 children in the 10-day treatment group. There was no statistical difference between the two groups. A 5-day course of oral cephalosporins is not always recommended for treatment of GABHS pharyngitis in children who have repeated episodes of pharyngitis.
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Clinical signs suggestive of pharyngeal dysphagia in preschool children with cerebral palsy.
Benfer, Katherine A; Weir, Kelly A; Bell, Kristie L; Ware, Robert S; Davies, Peter S W; Boyd, Roslyn N
2015-03-01
This study aimed to determine the discriminative validity, reproducibility, and prevalence of clinical signs suggestive of pharyngeal dysphagia according to gross motor function in children with cerebral palsy (CP). It was a cross-sectional population-based study of 130 children diagnosed with CP at 18-36 months (mean=27.4, 81 males) and 40 children with typical development (TD, mean=26.2, 18 males). Sixteen signs suggestive of pharyngeal phase impairment were directly observed in a videoed mealtime by a speech pathologist, and reported by parents on a questionnaire. Gross motor function was classified using the Gross Motor Function Classification System. The study found that 67.7% of children had clinical signs, and this increased with poorer gross motor function (OR=1.7, pDysphagia cut-points were modified to exclude a single cough on fluids, with a modified prevalence estimate proposed as 50.8%. Clinical signs suggestive of pharyngeal dysphagia are common in children with CP, even those with ambulatory CP. Parent-report on 16 specific signs remains a feasible screening method. While coughing was consistently identified by clinicians, it may not reflect children's regular performance, and was not sufficiently discriminative in children aged 18-36 months. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Batool Ali
2015-12-01
Full Text Available Abstract Introduction: Narrow airway dimensions due to mandibular deficiency can predispose an individual to severe respiratory distress. Hence, treatment with mandibular advancement devices at an early age might help improving the pharyngeal passage and reduce the risk of respiratory difficulties. Therefore, the aim of the current study was to evaluate the mean changes in the pharyngeal dimensions of children with mandibular deficiency treated with Clark's twin-block appliance (CTB followed by fixed orthodontic treatment. Methods: Orthodontic records of 42 children with mandibular deficiency were selected. Records comprised three lateral cephalograms taken at the start of CTB treatment, after CTB removal and at the end of fixed appliance treatment, and were compared with 32 controls from the Bolton-Brush study. Friedman test was used to compare pre-treatment, mid-treatment and post-treatment pharyngeal dimensions. Wilcoxon signed rank test was used to compare the airway between pre-treatment and post follow-up controls. Mann-Whitney U test was applied to compare the mean changes in pharyngeal dimensions between treatment group and controls from T2 to T0. Post-hoc Dunnet T3 test was used for multiple comparisons of treatment outcomes after CTB and fixed appliances, taking a p-value of ≤ 0.05 as statistically significant. Results: Superior pharyngeal space (p < 0.001 and upper airway thickness (p = 0.035 were significantly increased after CTB, and the change in superior pharyngeal space remained stable after fixed mechano-therapy. Conclusion: CTB can have a positive effect in improving pharyngeal space and the resultant increase in airway remains stable on an average of two and a half years.
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Ohno, Tomohisa; Ohno, Ryo; Fujishima, Ichiro
2017-10-01
A 53-year-old institutionalized male patient with a history of postoperative bilateral hypoglossal nerve injury was admitted for treatment of dysphagia. He experienced dysphagia involving oral cavity-to-pharynx bolus transportation because of restricted tongue movement and was treated with a palatal augmentation prosthesis (PAP), which resulted in improved bolus transportation, pharyngeal swallowing pressure, and clearance of oral and pharyngeal residue. The mean pharyngeal swallowing pressure at tongue base with the PAP (145.5±7.5mmHg) was significantly greater than that observed immediately after removal of the PAP (118.3±10.1mmHg; pDysphagia rehabilitation with the PAP was continued. Approximately 1 month after PAP application, the patient could orally consume three meals, with the exception of foods particularly difficult to swallow. The supporting contact between the tongue and palate enabled by the PAP resulted in improvement of bolus transportation, which is the most important effect of a PAP. The increase in pharyngeal swallowing pressure at the tongue base because of PAP-enabled tongue-palate contact might play an important role in this improvement. Since a PAP augments the volume of the palate, it enables easy contact between the tongue and palate, resulting in the formation of an anchor point for tongue movement during swallowing. Thus, application of a PAP increases the tongue force, especially that of the basal tongue. A palatal augmentation prosthesis helps improve pharyngeal swallowing pressure at the basal tongue region and might contribute to the decrease of oral as well as pharyngeal residue. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
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Hallucigenia's head and the pharyngeal armature of early ecdysozoans.
Smith, Martin R; Caron, Jean-Bernard
2015-07-02
The molecularly defined clade Ecdysozoa comprises the panarthropods (Euarthropoda, Onychophora and Tardigrada) and the cycloneuralian worms (Nematoda, Nematomorpha, Priapulida, Loricifera and Kinorhyncha). These disparate phyla are united by their means of moulting, but otherwise share few morphological characters--none of which has a meaningful fossilization potential. As such, the early evolutionary history of the group as a whole is largely uncharted. Here we redescribe the 508-million-year-old stem-group onychophoran Hallucigenia sparsa from the mid-Cambrian Burgess Shale. We document an elongate head with a pair of simple eyes, a terminal buccal chamber containing a radial array of sclerotized elements, and a differentiated foregut that is lined with acicular teeth. The radial elements and pharyngeal teeth resemble the sclerotized circumoral elements and pharyngeal teeth expressed in tardigrades, stem-group euarthropods and cycloneuralian worms. Phylogenetic results indicate that equivalent structures characterized the ancestral panarthropod and, seemingly, the ancestral ecdysozoan, demonstrating the deep homology of panarthropod and cycloneuralian mouthparts, and providing an anatomical synapomorphy for the ecdysozoan supergroup.
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Mingxing Zhu; Wanzhang Yang; Samuel, Oluwarotimi Williams; Yun Xiang; Jianping Huang; Haiqing Zou; Guanglin Li
2016-08-01
Pharyngeal phase is a central hub of swallowing in which food bolus pass through from the oral cavity to the esophageal. Proper understanding of the muscular activities in the pharyngeal phase is useful for assessing swallowing function and the occurrence of dysphagia in humans. In this study, high-density (HD) surface electromyography (sEMG) was used to study the muscular activities in the pharyngeal phase during swallowing tasks involving three healthy male subjects. The root mean square (RMS) of the HD sEMG data was computed by using a series of segmented windows as myoelectrical energy. And the RMS of each window covering all channels (16×5) formed a matrix. During the pharyngeal phase of swallowing, three of the matrixes were chosen and normalized to obtain the HD energy maps and the statistical parameter. The maps across different viscosity levels offered the energy distribution which showed the muscular activities of the left and right sides of the front neck muscles. In addition, the normalized average RMS (NARE) across different viscosity levels revealed a left-right significant correlation (r=0.868±0.629, pstronger correlation when swallowing water. This pilot study suggests that HD sEMG would be a potential tool to evaluate muscular activities in pharyngeal phase during normal swallowing. Also, it might provide useful information for dysphagia diagnosis.
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Milstone, Zachary J; Lawson, Grace; Trivedi, Chinmay M
2017-12-01
Craniofacial anomalies involve defective pharyngeal arch development and neural crest function. Copy number variation at 1p35, containing histone deacetylase 1 (Hdac1), or 6q21-22, containing Hdac2, are implicated in patients with craniofacial defects, suggesting an important role in guiding neural crest development. However, the roles of Hdac1 and Hdac2 within neural crest cells remain unknown. The neural crest and its derivatives express both Hdac1 and Hdac2 during early murine development. Ablation of Hdac1 and Hdac2 within murine neural crest progenitor cells cause severe hemorrhage, atrophic pharyngeal arches, defective head morphogenesis, and complete embryonic lethality. Embryos lacking Hdac1 and Hdac2 in the neural crest exhibit decreased proliferation and increased apoptosis in both the neural tube and the first pharyngeal arch. Mechanistically, loss of Hdac1 and Hdac2 upregulates cyclin-dependent kinase inhibitors Cdkn1a, Cdkn1b, Cdkn1c, Cdkn2b, Cdkn2c, and Tp53 within the first pharyngeal arch. Our results show that Hdac1 and Hdac2 function redundantly within the neural crest to regulate proliferation and the development of the pharyngeal arches by means of repression of cyclin-dependent kinase inhibitors. Developmental Dynamics 246:1015-1026, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
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Directory of Open Access Journals (Sweden)
Ali Karbasfrushan
2014-10-01
Full Text Available Introduction: Nausea and vomiting after ear, nose and throat (ENT surgery is one of the most common and notable problems facing anesthesiologists in this area. This study was conducted to determine the effect of a pharyngeal pack on the severity of nausea, vomiting, and sore throat among patients after ear, pharynx, and throat surgeries. Materials and Methods: This randomized clinical study was performed in 140 patients (61 men and 79 women; age range, 20–40 years who had undergone nasal surgery in 2010. Patients were divided into two groups: the first group were treated using a pharyngeal pack (case group and the second group were managed without a pharyngeal pack (control group. Statistical analysis was performed using the Chi-square test and the Mann-Whitney U test. SPSS software was used for data analysis. Results: The mean severity of nausea and vomiting in the two groups was 2.057, 1.371 and 1.100, respectively, with no significant differences between groups. However, the mean severity of sore throat was 1.714 in the group with the pharyngeal pack and 1.385 in the group without pharyngeal pack (P=0.010. Conclusion: Not only does a pharyngeal pack in ENT surgery not reduce the extent and severity of nausea and vomiting, but it also increases the severity of sore throat in patients when leaving the recovery room and discharging hospital.
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Pharyngeal transit time measured by scintigraphic and biomagnetic method
International Nuclear Information System (INIS)
Miquelin, C.A.; Braga, F.J.H.N.; Baffa, O.
1996-01-01
A comparative evaluation between scintigraphic and biomagnetic method to measure the pharyngeal transit is presented. Three volunteers have been studied. The aliment (yogurt) was labeled with 9 9 m Technetium for the scintigraphic test and with ferrite for the biomagnetic one. The preliminary results indicate a difference between the values obtained, probably due to the biomagnetic detector resolution
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Chronic Pharyngitis And Multiple Soft Palate Peforation In An HIV ...
African Journals Online (AJOL)
This report is at advocating the need for repeated investigation and screening for HIV particularly when there is persistent clinical feature strongly suggestive of AIDS. Should we even start to contemplate therapeutic of antiretroviral dugs in some cases? KEY WORDS: Chronic pharyngitis, Soft palate perforation, AIDS, HIV ...
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The appearance of a lurking ligament in Laparoscopic Sleeve Gastrectomy; Posterior Gastric Ligament
Directory of Open Access Journals (Sweden)
Mutlu Ünver
2017-03-01
Full Text Available Objective: The aim of this study was to demonstrate a lurking ligament and its various formation types and to mention the importance of this ligament in Laparoscopic sleeve gastrectomy Methods: One hundred and twelve patients had laparoscopic sleeve gastrectomy (LSG procedure in our clinic between March 2011 and September 2013. All procedures were performed with a standard operative technique. Only difference for the last 50 patients was to avoid the excessive dissection of posterior gastric wall. The existence of posterior gastric ligament was recorded and different types of posterior gastric ligament was demonstrated. Results: Posterior gastric ligament was observed in all of the cases in different formation types. Three types of ligament; complete, partial and skippy, was demonstrated. 53(47.3% of the patients had skippy, while 41 (36.6% had partial and 18 (16.1% had complete type of posterior gastric ligament. Conclusion: A ligament named as ‘posterior gastric ligament’ and its various forms were defined in the third dimensional plane of stomach. Posterior gastric ligament remains as the only structure in LSG for preventing the mobility and ability of the stomach to rotate. The excessive dissection of the posterior gastric ligament should be avoided to prevent complications such as kinking and volvulus
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Seoane-Mato, Daniel; Aragonés, Nuria; Ferreras, Eva; García-Pérez, Javier; Cervantes-Amat, Marta; Fernández-Navarro, Pablo; Pastor-Barriuso, Roberto; López-Abente, Gonzalo
2014-04-11
Although oral cavity, pharyngeal, oesophageal and gastric cancers share some risk factors, no comparative analysis of mortality rate trends in these illnesses has been undertaken in Spain. This study aimed to evaluate the independent effects of age, death period and birth cohort on the mortality rates of these tumours. Specific and age-adjusted mortality rates by tumour and sex were analysed. Age-period-cohort log-linear models were fitted separately for each tumour and sex, and segmented regression models were used to detect changes in period- and cohort-effect curvatures. Among men, the period-effect curvatures for oral cavity/pharyngeal and oesophageal cancers displayed a mortality trend that rose until 1995 and then declined. Among women, oral cavity/pharyngeal cancer mortality increased throughout the study period whereas oesophageal cancer mortality decreased after 1970. Stomach cancer mortality decreased in both sexes from 1965 onwards. Lastly, the cohort-effect curvature showed a certain degree of similarity for all three tumours in both sexes, which was greater among oral cavity, pharyngeal and oesophageal cancers, with a change point in evidence, after which risk of death increased in cohorts born from the 1910-1920s onwards and decreased among the 1950-1960 cohorts and successive generations. This latter feature was likewise observed for stomach cancer. While the similarities of the cohort effects in oral cavity/pharyngeal, oesophageal and gastric tumours support the implication of shared risk factors, the more marked changes in cohort-effect curvature for oral cavity/pharyngeal and oesophageal cancer could be due to the greater influence of some risk factors in their aetiology, such as smoking and alcohol consumption. The increase in oral cavity/pharyngeal cancer mortality in women deserves further study.
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Peculiar enlargement of the nasopharynx in patients with anorexia nervosa
Energy Technology Data Exchange (ETDEWEB)
Okamoto, K. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Ito, J. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Tokiguchi, S. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Kuwabara, G. [Department of Radiology, School of Medicine, Niigata University, Niigata (Japan); Nishihara, M. [Department of Radiology, School of Medicine, Niigata University, Niigata (Japan)
1995-11-01
We examined the nasopharynx and brain in 17 patients with anorexia nervosa by CT and compared the findings with those of 44 normal subjects and of 5 patients of the same age with marked emaciation caused by various psychiatric disorders. An enlarged nasopharyngeal space with a flattened posterior wall and enlarged lateral pharyngeal recesses were demonstrated in all patients with anorexia nervosa whose weight was lowest at the time of the CT examination, and these CT features regressed or became normal quickly after they had gained some weight. This characteristic enlargement of the nasopharynx and lateral pharyngeal recesses was observed neither in the markedly emaciated patients (2 with schizophrenia, 1 with major depression, 1 with stupor and the other with an extremely unbalanced diet) nor in 44 normal subjects without emaciation. These features were therefore thought to be characteristic and of diagnostic significance. (orig.). With 5 figs., 3 tabs.
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Peculiar enlargement of the nasopharynx in patients with anorexia nervosa
International Nuclear Information System (INIS)
Okamoto, K.; Ito, J.; Tokiguchi, S.; Kuwabara, G.; Nishihara, M.
1995-01-01
We examined the nasopharynx and brain in 17 patients with anorexia nervosa by CT and compared the findings with those of 44 normal subjects and of 5 patients of the same age with marked emaciation caused by various psychiatric disorders. An enlarged nasopharyngeal space with a flattened posterior wall and enlarged lateral pharyngeal recesses were demonstrated in all patients with anorexia nervosa whose weight was lowest at the time of the CT examination, and these CT features regressed or became normal quickly after they had gained some weight. This characteristic enlargement of the nasopharynx and lateral pharyngeal recesses was observed neither in the markedly emaciated patients (2 with schizophrenia, 1 with major depression, 1 with stupor and the other with an extremely unbalanced diet) nor in 44 normal subjects without emaciation. These features were therefore thought to be characteristic and of diagnostic significance. (orig.). With 5 figs., 3 tabs
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Oral Cavity, Pharyngeal, and Laryngeal Cancer Prevention (PDQ®)—Health Professional Version
Expert-reviewed information summary about factors that may influence the risk of developing oral cavity, pharyngeal, and laryngeal cancers and about approaches that may help in the prevention of these diseases.
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Hananta, I Putu Yuda; De Vries, Henry John Christiaan; van Dam, Alje P; van Rooijen, Martijn Sebastiaan; Soebono, Hardyanto; Schim van der Loeff, Maarten Franciscus
2017-11-01
Infection of Neisseria gonorrhoeae in the pharynx (pharyngeal Ng) is associated with gonococcal transmission and development of antimicrobial resistance. We assessed proportion of and determinants for persistence after treatment of pharyngeal Ng. At the STI clinic of Amsterdam, the Netherlands, females-at-risk and men who have sex with men are routinely screened for pharyngeal Ng using an RNA-based nucleic acid amplification test (NAAT; Aptima Combo 2). Patients with pharyngeal Ng were invited for a test-of-cure (TOC) 7 days after treatment with a 500 mg ceftriaxone intramuscularly. We retrospectively examined medical records of patients with pharyngeal Ng (January 2012-August 2015) who returned for a TOC 7-28 days after treatment. Persistence was defined as a positive NAAT at TOC. Out of 2204 pharyngeal Ng cases recorded in the study period, 781 cases (median time between first treatment and TOC of 8 (IQR 7-12) days) were included in the analysis. Persistence after treatment was found in 36 (4.6%) and was less likely among patients who received ceftriaxone in combination with other antibiotics (vs monotherapy) (adjusted OR (aOR) 0.36, 95% CI 0.12 to 1.04) and with longer time from treatment to TOC (aOR 0.74, 95% CI 0.60 to 0.90, per extra day). In those with a TOC 15-28 days after treatment, Ng persisted in only 1.0% (1/105 cases). A small proportion of pharyngeal Ng persists despite appropriate treatment. Combining ceftriaxone with other antibiotics appears to lead to faster clearance. A TOC for pharyngeal Ng 7 days after treatment may be too soon. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Poststreptococcal keratouveitis associated with group C streptococcus pharyngitis
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Nataneli N
2011-09-01
Full Text Available Nathaniel Nataneli1, Zenia P Aguilera1, Pearl S Rosenbaum1, Tamar Goldstein1,2, Martin Mayers11Department of Ophthalmology, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY, USA; 2Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelPurpose: To report the first case of poststreptococcal syndrome uveitis (PSU in association with group C streptococcus (GCS.Patients and methods: Chart review of a 24-year-old man who presented with bilateral ocular redness, pain, and photophobia for 5 days and "white rings" around his eyes for a duration of 3 days. The patient further reported fever and sore throat in the preceding week. Slit-lamp examination showed bilateral keratouveitis. A thorough uveitis workup, antistreptolysin O (ASLO titer, and throat culture were obtained. The patient was treated with frequent topical steroids and systemic doxycycline. The uveitis and keratitis subsided over the next few weeks, leaving extensive peripheral keratolysis.Results: The results of laboratory diagnostic testing revealed an elevated ASLO, C-reactive protein, as well as HLA-B27 positivity. Throat cultures grew beta-hemolytic GCS; group A streptococcus was culture negative.Conclusion: GCS pharyngitis may be a causative organism of PSU.Keywords: pharyngitis, keratolysis, keratouveitis
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International Nuclear Information System (INIS)
Cho, June Il; Kim, Hong In; Seol, Hae Young; Lee, Nam Joon; Kim, Jung Hyuk; Cha, In Ho
1997-01-01
To determine the anatomic variations that can lead to optic nerve damage during the sugical treatment of posterior paranasal sinus lesions two hundred optic nerves of 100 persons were examined using ostiomeatal unit CT(OMU CT). The anatomical features of this nerve and posterior paranasal sinuses were classified into four types:the optic nerve adjacent to the sphenoid sinus without indentation of the sinus wall (type 1);the optic nerve adjacent to the sphenoid sinus, causing indentation of the sinus wall (type 2);the optic nerve passing through the sphenoid sinus (type 3);and the optic nerve adjacent to the sphenoid sinus and posterior ethmoid sinus (type 4). Bony dehiscence around the optic nerve and pneumatization of the anterior clinoid process were also evaluated. The anatomical classification of the optic nerve and posterior paranasal sinuses was as follows:type 1, 1326(66%); type 2, 60(30%); type 3, 6(3%), and type 4, 2(1%). Bony dehiscence around the optic nerve had developed in 58 cases (29%) and pneumatization of the anterior clinoid process in 13(6.5%). These conditions were most common in type 3 optic nerve, and second most common in type 2. The 2 and 3 optic nerves, bony dehiscence around the optic nerve and pneumatization of the anterior clinoid process are the anatomic variations that can lead to optic nerve damage during the surgical treatment of posterior paranasal sinus lesions. To prevent optic nerve damage, these factors should be carefully evaluated by OMU CT
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A 10-year review of perioperative complications in pharyngeal flap surgery
Hofer, SOP; Dhar, BK; Robinson, PH; Goorhuis-Brouwer, SM; Nicolai, JPA
2002-01-01
A 10-year retrospective study was undertaken to investigate perioperative complications in pharyngeal flap surgery in one institution using inferiorly and superiorly based flaps. In this fashion the current practice of surgical technique based on local findings and perioperative care, through
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De Vries, Henry John Christiaan; van Dam, Alje P; van Rooijen, Martijn Sebastiaan; Soebono, Hardyanto; Schim van der Loeff, Maarten Franciscus
2017-01-01
Introduction Infection of Neisseria gonorrhoeae in the pharynx (pharyngeal Ng) is associated with gonococcal transmission and development of antimicrobial resistance. We assessed proportion of and determinants for persistence after treatment of pharyngeal Ng. Methods At the STI clinic of Amsterdam, the Netherlands, females-at-risk and men who have sex with men are routinely screened for pharyngeal Ng using an RNA-based nucleic acid amplification test (NAAT; Aptima Combo 2). Patients with pharyngeal Ng were invited for a test-of-cure (TOC) 7 days after treatment with a 500 mg ceftriaxone intramuscularly. We retrospectively examined medical records of patients with pharyngeal Ng (January 2012–August 2015) who returned for a TOC 7–28 days after treatment. Persistence was defined as a positive NAAT at TOC. Results Out of 2204 pharyngeal Ng cases recorded in the study period, 781 cases (median time between first treatment and TOC of 8 (IQR 7–12) days) were included in the analysis. Persistence after treatment was found in 36 (4.6%) and was less likely among patients who received ceftriaxone in combination with other antibiotics (vs monotherapy) (adjusted OR (aOR) 0.36, 95% CI 0.12 to 1.04) and with longer time from treatment to TOC (aOR 0.74, 95% CI 0.60 to 0.90, per extra day). In those with a TOC 15–28 days after treatment, Ng persisted in only 1.0% (1/105 cases). Conclusion A small proportion of pharyngeal Ng persists despite appropriate treatment. Combining ceftriaxone with other antibiotics appears to lead to faster clearance. A TOC for pharyngeal Ng 7 days after treatment may be too soon. PMID:28822976
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Shivappa, Nitin; Hébert, James R; Rosato, Valentina; Garavello, Werner; Serraino, Diego; La Vecchia, Carlo
2017-08-01
Diet and inflammation have been suggested to be important risk factors for oral and pharyngeal cancer. We examined the association between dietary inflammatory index (DII™) and oral and pharyngeal cancer in a large case-control study conducted between 1992 and 2009 in Italy. This study included 946 cases with incident, histologically confirmed oral and pharyngeal cancer, and 2,492 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a valid 78-item food frequency questionnaire and was adjusted for nonalcohol energy intake using the residual approach (E-DII™). Logistic regression models were used to estimate odds ratios (ORs), and 95% confidence intervals (CIs), adjusted for age, sex, non-alcohol energy intake, study center, year of interview, education, body mass index, tobacco smoking, and alcohol drinking. Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of oral and pharyngeal cancer, the OR being 1.80 (95% CI 1.36-2.38) for the highest versus the lowest DII quartile and 1.17 (95% CI 1.10-1.25) for a one-unit increase (8% of the DII range). When stratified by selected covariates, a stronger association was observed among women (OR quartile4 v.1 3.30, 95% CI 1.95-5.57). We also observed a stronger association for oral cancers and a strong combined effect of higher DII score and tobacco smoking or alcohol consumption on oral and pharyngeal cancer. These results indicate that the pro-inflammatory potential of the diet, as shown by higher DII scores, is associated with higher odds of oral and pharyngeal cancer. © 2017 UICC.
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Satoh, Koichi; Nagata, Junko; Shomura, Kenji; Wada, Takeshi; Tachimura, Takashi; Fukuda, Jinichi; Shiba, Ryosuke
2004-07-01
To describe the morphological changes of nasopharyngeal components after maxillary distraction and clarify whether the morphological characteristics are related to velopharyngeal function (VPF). Perceptual judgments of hypernasality and nasendoscopy were performed before and after treatment. Lateral cephalograms were obtained to describe the morphological changes. Department of Oral and Maxillofacial Surgery, Miyazaki Medical College, Miyazaki, Japan. Nine patients with repaired cleft palate in the mixed dentition stage underwent maxillary distraction using a face mask and an intraoral fixed appliance system. The severity of hypernasality, velopharyngeal insufficiency, and measurements such as pharyngeal depth, velar length, and the rotation of the palatal plane were evaluated. Increase in pharyngeal depth was not always proportional to the amount of advancement. It depended on the posture of the posterior pharyngeal wall and the rotation of palatal plane. Cephalometric measurements of the nasopharynx before and after surgery confirmed subsequent changes in VPF. These were suggested to be useful in predicting future VPF. When performing maxillary distraction in patients with cleft palate in the mixed dentition stage, and when velopharyngeal closure is found to occur by velar contact against the hypertrophied adenoid, patients should be counseled about risks of subsequent deterioration in their speech before surgery.
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Calcifying epithelial odontogenic tumor of the posterior maxilla
Directory of Open Access Journals (Sweden)
Vidya Ajila
2016-01-01
Full Text Available Calcifying epithelial odontogenic tumor (CEOT is a rare odontogenic neoplasm comprising <1% of all odontogenic tumors. It is commonly seen in the third to fifth decades of life without any gender predilection. It usually occurs in the mandibular posterior region. A painless, slow growing swelling with bone expansion is the most common clinical feature of CEOT. Radiographically, it presents as a mixed lesion with or without an associated impacted tooth. Confirmation of the diagnosis is by histopathological examination. We describe an unusual case of CEOT occurring in the maxillary posterior region and involving the maxillary sinus. The associated impacted third molar was displaced to the lateral wall of the nose and root resorption was seen in all the teeth associated with the lesion. There was no evidence of calcification in conventional as well as computed tomography images.
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Orbital apex syndrome associated with fractures of the inferomedial orbital wall
Directory of Open Access Journals (Sweden)
Sugamata A
2013-03-01
Full Text Available Akira SugamataDepartment of Plastic and Reconstructive Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, JapanAbstract: Although trauma is one of the main causes of orbital apex syndrome (OAS, reports of OAS associated with orbital fractures are relatively rare. We recently treated two patients who sustained severe visual impairment with damage to multiple cranial nerves (third to sixth associated with inferomedial orbital wall fractures. In these patients, posterior movement of the globe caused neuropathy of the cranial and optic nerves by posterior globe edema and hemorrhage, or direct impact between the globe and wall, which might then have induced OAS in the cases described in this report. Steroid therapy was unsuccessful for optic neuropathy due to the delay between injury and administration. When treating patients with inferomedial orbital blowout fractures due to globe-to-wall contact, it is necessary to routinely assess and monitor visual acuity since there may be a delay between the injury and OAS onset.Keywords: orbital apex syndrome, orbital fracture, blowout fracture, optic nerve, globe-to-wall contact mechanism
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Sleep apnea syndrome. Examination of pharyngeal obstruction with high-speed MR and polysomnography
International Nuclear Information System (INIS)
Suto, Y.; Inoue, Y.
1995-01-01
We attempted to determine the usefulness of high-speed MR imaging for evaluating the severity of sleep apnea syndrome (SAS) by comparing findings of pharyngeal obstruction obtained with high-speed MR with those of all-night polysomnography (PSG). A total of 33 patients with SAS underwent turbo-FLASH MR examination, while awake and after i.v. injection of hydroxyzine hydrochloride. Serial images were examined by cinemode. Pharyngeal findings on MR were divided into single-site obstruction (SO) at the velopharynx, multiple-site obstruction (MO), and no obstruction (NO). PSG findings were analyzed to determine the predominant type of apnea, severity as evaluated by an apnea index (AI), and the lowest SaO 2 value during sleep. Seventy-five percent of the central apnea group had SO, and 70% of the mixed apneas had MO, while only 15% of the obstructed apneas had MO. The percentage of patients with severe SAS (AI of 20% or higher) was 48% for the SO, and 70% for the MO. The lowest SaO 2 value tended to be low in the mixed apnea in the case of PSG, and tended to be low in the MO at MR examination. Analysis of pharyngeal dynamics using high-speed MR may provide some useful information for evaluating the severity of SAS. (orig.)
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Estimation of bladder wall location in ultrasound images.
Topper, A K; Jernigan, M E
1991-05-01
A method of automatically estimating the location of the bladder wall in ultrasound images is proposed. Obtaining this estimate is intended to be the first stage in the development of an automatic bladder volume calculation system. The first step in the bladder wall estimation scheme involves globally processing the images using standard image processing techniques to highlight the bladder wall. Separate processing sequences are required to highlight the anterior bladder wall and the posterior bladder wall. The sequence to highlight the anterior bladder wall involves Gaussian smoothing and second differencing followed by zero-crossing detection. Median filtering followed by thresholding and gradient detection is used to highlight as much of the rest of the bladder wall as was visible in the original images. Then a 'bladder wall follower'--a line follower with rules based on the characteristics of ultrasound imaging and the anatomy involved--is applied to the processed images to estimate the bladder wall location by following the portions of the bladder wall which are highlighted and filling in the missing segments. The results achieved using this scheme are presented.
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Energy Technology Data Exchange (ETDEWEB)
Hayakawa, Kimiko; Yoshikawa, Hiroshi; Suzuki, Miyako; Yokoi, Hidenori; Hosokawa, Akira; Hagiwara, Akiko; Ichikawa, Ginichirou [Juntendo Univ., Tokyo (Japan). School of Medicine
2003-05-01
In concluding surgery of the paranasal sinuses (anterior and posterior) and the sphenoidal sinus, caution is demanded because intraorbital complications may develop in the skull. It is well-known that there is substantial variation in the form of the internal wall of the orbit, and the anterior and posterior walls of the sphenoidal sinus. In the present study, we measured the size of the structure around the paranasal sinus on patient CTscans to be used in surgery on the paranasal sinuses. A total of 387 people (184 males and 203 females) with no destructive bone lesions who visited the Juntendo University Hospital between 1999 and June 2002 were investigated. A plane was selected 14 mm above a line drawn between the medial angle and the external acoustic orifice on CTscans performed using axial projection. This framework was used to conduct the measurements. We employed this method because we consider it ideal for rendering the ethmoidal sinuses, the internal wall of the orbit, medial rectus muscle, optic nerve, and the anterior and posterior walls of the sphenoidal sinus most clearly visible. We measured the length between these anatomically important regions. We measured 1) the length of a line drawn between the opening of the nose and the line drawn between the right and left optic canals, 2) the length between the nasal opening and the posterior wall of the sphenoidal sinus, on the same horizontal line drawn between the posterior end of the eyeball and the nasal septum, 3) the length of a line from the site where the optic nerve adheres to the nasal septum, 4) the length between the lateral wall of the ethmoidal sinus, 5) the length between the nasal septum and the medial side of the medial rectus muscle, 6) the length between the medial side of the medial rectus muscle and the medial side of the optic nerve. The measurements were performed on both sides. We analyzed the above results statistically according to gender and age. The results of the analysis
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Müller, Gerd B.
2018-01-01
Advances in imaging and modeling facilitate the calculation of biomechanical forces in biological specimens. These factors play a significant role during ontogenetic development of cichlid pharyngeal jaws, a key innovation responsible for one of the most prolific species diversifications in recent times. MicroCT imaging of radiopaque-stained vertebrate embryos were used to accurately capture the spatial relationships of the pharyngeal jaw apparatus in two cichlid species (Haplochromis elegans and Amatitlania nigrofasciata) for the purpose of creating a time series of developmental stages using finite element models, which can be used to assess the effects of biomechanical forces present in a system at multiple points of its ontogeny. Changes in muscle vector orientations, bite forces, force on the neurocranium where cartilage originates, and stress on upper pharyngeal jaws are analyzed in a comparative context. In addition, microCT scanning revealed the presence of previously unreported cement glands in A. nigrofasciata. The data obtained provide an underrepresented dimension of information on physical forces present in developmental processes and assist in interpreting the role of developmental dynamics in evolution. PMID:29320528
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Directory of Open Access Journals (Sweden)
Tim Peterson
Full Text Available Advances in imaging and modeling facilitate the calculation of biomechanical forces in biological specimens. These factors play a significant role during ontogenetic development of cichlid pharyngeal jaws, a key innovation responsible for one of the most prolific species diversifications in recent times. MicroCT imaging of radiopaque-stained vertebrate embryos were used to accurately capture the spatial relationships of the pharyngeal jaw apparatus in two cichlid species (Haplochromis elegans and Amatitlania nigrofasciata for the purpose of creating a time series of developmental stages using finite element models, which can be used to assess the effects of biomechanical forces present in a system at multiple points of its ontogeny. Changes in muscle vector orientations, bite forces, force on the neurocranium where cartilage originates, and stress on upper pharyngeal jaws are analyzed in a comparative context. In addition, microCT scanning revealed the presence of previously unreported cement glands in A. nigrofasciata. The data obtained provide an underrepresented dimension of information on physical forces present in developmental processes and assist in interpreting the role of developmental dynamics in evolution.
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Muderris, Togay; Gokcan, M Kursat; Yorulmaz, Irfan
2009-02-01
To determine the clinical value of pharyngeal pH monitoring for the diagnosis of laryngopharyngeal reflux (LPR) by using a double-probe, triple-sensor catheter in patients with symptoms of LPR. Prospective review of pH values recorded at the pharyngeal sensor, with the sensor placed in the proximal esophagus in patients with suspected LPR. Tertiary care university hospital. Thirty-three consecutive patients with symptoms of LPR. A pH test result was considered abnormal if a single reflux episode was detected in the hypopharynx and if, in the proximal esophagus, the total percentage of time the pH value was below 4 was 1.0% or higher. Data obtained from sensors were compared to determine the validity of pharyngeal sensor. Correlation between patients' reflux finding scores, reflux finding indexes, and reflux episodes were analyzed. Of 33 patients, 17 had more than 1 reflux episode detected by the pharyngeal sensor and 19 had pathological reflux detected by the proximal esophageal sensor. Four patients who had pharyngeal reflux had a normal esophageal acid exposure time, and 6 patients who had pathological reflux detected by the proximal esophageal sensor did not experienced any pharyngeal reflux episode. Four patients would have had a false-negative test result and 6 subjects would have had a false-positive test result if a hypopharyngeal pH sensor was not implemented. The adjustable, bifurcated, triple-sensor pH probe allows identifying true hypopharyngeal reflux episodes. If single-probe, double-sensor pH monitoring is to be performed, the proximal probe should be placed in the pharynx, not in the upper esophagus.
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International Nuclear Information System (INIS)
Chen, C.-C.; Chen, W.-C.; Lu, C.-H.; Wang, W.-H.; Lin, P.-Y.; Lee, K.-D.; Chen, M.-F.
2010-01-01
Purpose: Tumor eradication by chemoradiotherapy for pharyngeal cancer has not been particularly successful. Targeting epithelial growth factor receptor (EGFR) could be a potential treatment strategy providing additional benefits, but only a subset of these tumors gives a clinically significant response to EGFR inhibitors. The aim has been to identify the role of interleukin-6 (IL-6) signaling and its predictive power in the treatment response of pharyngeal cancer. Methods and Materials: Human pharyngeal cancer cell lines, including the hypopharyngeal cancer cell line FaDu and its derived cell line FaDu-C225-R, were selected. Changes in tumor growth, response to treatment, and responsible signaling pathway were investigated in vitro. Furthermore, 95 pharyngeal cancer tissue specimens were analyzed by immunohistochemical staining, and correlations were made between levels of IL-6, IL-6 receptor (IL-6R), p-AKT, and p-STAT3 expression and the clinical outcome of patients. Results: In vitro, either extrinsic IL-6 stimulation of cancer cells or intrinsically activated IL-6 signaling detected in FADu-C225-R cells results in resistance to irradiation and EGFR inhibitor. Blocking IL-6 signaling attenuated aggressive tumor behavior and sensitized the cells to treatments. The responsible mechanisms included decreased p-STAT3, less nuclear translocation of EGFR, and subsequently attenuated epithelial-mesenchymal transition. Regarding clinical data, staining of p-STAT3 and IL-6 was significantly linked with lower response rates to treatments and shorter survival in pharyngeal cancer patients. Conclusions: IL-6 and p-STAT3 may be significant predictors of pharyngeal carcinoma, and regulating IL-6 signaling can be considered a promising therapeutic approach.
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Tomazini Martins, Rodrigo; Carberry, Jayne C; Gandevia, Simon C; Butler, Jane E; Eckert, Danny J
2018-04-26
Pharyngeal and respiratory sensation is impaired in obstructive sleep apnea (OSA). Opioids may further diminish respiratory sensation. Thus, protective pharyngeal neuromuscular and arousal responses to airway occlusion that rely on respiratory sensation could be impaired with opioids to worsen OSA severity. However, little is known about the effects of opioids on upper airway and respiratory sensation in people with OSA. This study was designed to determine the effects of 40mg of MS-Contin on tactile sensation, respiratory load detection and respiratory magnitude perception in people with OSA during wakefulness. A double-blind, randomized, cross-over design (1 week wash-out) was used. 21 men with untreated OSA (apnea/hypopnea index=26{plus minus}17events/h) recruited from a larger clinical study completed the protocol. Tactile sensation using von Frey filaments on the back of the hand, internal mucosa of the cheek, uvula and posterior pharyngeal wall were not different between placebo and morphine (e.g. posterior wall=0.16[0.16,0.4]vs. 0.4[0.14,1.8]g, p=0.261). Similarly, compared to placebo, morphine did not alter respiratory load detection thresholds (nadir mask pressure detected=-2.05[-3.37,-1.55] vs. -2.19[-3.36,-1.41]cmH 2 O, p=0.767), or respiratory load magnitude perception (mean Borg scores during a 5 resistive load [range: 5-126cmH 2 O/L/s] protocol=4.5{plus minus}1.6 vs. 4.2{plus minus}1.2, p=0.347) but did reduce minute ventilation during quiet breathing (11.4{plus minus}3.3 vs. 10.7{plus minus}2.6L/min, prespiratory sensation in men with mild to moderate, untreated, OSA. This suggests that altered respiratory sensation to acute mechanical stimuli is not likely to be a mechanism that contributes to worsening of OSA with a moderate dose of morphine.
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Rohan Diwakar; Maninder Singh Sidhu; Mona Prabhakar; Seema Grover; Ritu Phogat
2015-01-01
Introduction: The purpose of this study was to evaluate the pharyngeal airway volume in individuals with different vertical growth patterns. Methods: Cone beam computed tomography scans were evaluated of 40 subjects with the age range from 14 to 25 years and were divided into three groups. Horizontal growers consisted of 13 subjects, normal growers consisted of 14 subjects, and the vertical growers consisted of 13 subjects. The pharyngeal airway volume was measured using In Vivo Dental 5.1 so...
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Directory of Open Access Journals (Sweden)
Maria Gerycka
2014-09-01
Full Text Available Introduction. Previous studies have confirmed that the pharyngeal tonsil is a good biomarker of exposure due to its position relative to inhaled air so that multiple elements can be accumulated in this organ. The aim of the study is to determine the share of soluble and insoluble compounds of individual elements in suspended particles in the accumulation of Pb, Be, Ba, Sr, Ca,Mg by the pharyngeal tonsils. Material and methods. The content of the analyzed elements is defined in 86 samples of pharyngeal tonsils from children living in Tychy and in 76 samples of pharyngeal tonsils from children living in Chorzów, as well as in the suspended particles in the air occurring in soluble and insoluble form. The specified coefficients k1, k2 present in the equation division allow the indication the greater importance of soluble and insoluble fraction of an element present in the inhaled air. Results. The value of the coefficients in the equation division based on gender confirmed its importance. Conclusions. The values detect area variation in relation to passive smoking in the extent of accumulation of Pb, Be, Ba, Sr, Mg, Ca in pharyngeal tonsils.
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DEFF Research Database (Denmark)
Holmborn, Katarina; Habicher, Judith; Kasza, Zsolt
2012-01-01
The present study addresses the roles of heparan sulfate (HS) proteoglycans and chondroitin sulfate (CS) proteoglycans in the development of zebrafish pharyngeal cartilage structures. uxs1 and b3gat3 mutants, predicted to have impaired biosynthesis of both HS and CS because of defective formation...... levels of CS than control larvae, whereas morpholino-mediated suppression of csgalnact1/csgalnact2 resulted in increased HS biosynthesis. Thus, the balance of the Extl3 and Csgalnact1/Csgalnact2 proteins influences the HS/CS ratio. A characterization of the pharyngeal cartilage element morphologies...
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Directory of Open Access Journals (Sweden)
S Ganapathy Sriram
2014-01-01
Full Text Available Objective: Orthognathic surgeries and distraction osteogenesis (DO of the jaw bones cause a change in the pharyngeal airway space (PAS. The aim of our study was to evaluate the magnitude of changes occurring in the pharyngeal airway after mandibular set-back surgeries and DO of maxilla/mandible. Materials and Methods: The study undertaken was a retrospective cephalometric study. Subjects included in our study had undergone mandibular set-back surgery or DO of maxilla/mandible. Lateral cephalograms of the subjects taken pre-operatively (T0, immediate post-operatively (T1 and after a minimum follow-up period of 6 months (T2 were studied. The cephalograms were traced manually and the following parameters were evaluated: Surface area of the PAS, pharyngeal airway width at the level of the base of the tongue, position of the hyoid bone and the tongue. Repeated measure ANOVA test was done to assess the presence of any significant changes in the proposed parameters at T0, T1 and T2. A correlation analysis was made between the mandibular/maxillary movements and the corresponding changes in the PAS. Results: Surgical movements of maxilla and mandible do have an effect on the pharyngeal airway. Conclusion: It was clearly evident that the effects of mandibular movements on the PAS and the hyoid bone is more significant than the maxillary movements.
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Godar, Dianne E; Tang, Rong; Merrill, Stephen J
2014-09-01
Because we found UV-exposed oral tissue cells have reduced DNA repair and apoptotic cell death compared with skin tissue cells, we asked if a correlation existed between personal UV dose and the incidences of oral and pharyngeal cancer in the United States. We analyzed the International Agency for Research on Cancer's incidence data for oral and pharyngeal cancers by race (white and black) and sex using each state's average annual personal UV dose. We refer to our data as 'white' rather than 'Caucasian,' which is a specific subgroup of whites, and 'black' rather than African-American because blacks from other countries around the world reside in the U.S. Most oropharyngeal carcinomas harboured human papilloma virus (HPV), so we included cervical cancer as a control for direct UV activation. We found significant correlations between increasing UV dose and pharyngeal cancer in white males (p=0.000808) and females (p=0.0031) but not in blacks. Shockingly, we also found cervical cancer in whites to significantly correlate with increasing UV dose (p=0.0154). Thus, because pharyngeal and cervical cancer correlate significantly with increasing personal UV dose in only the white population, both direct (DNA damage) and indirect (soluble factors) effects may increase the risk of HPV-associated cancer. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
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The role of high-resolution CT in evaluating disease of the posterior tympanum
International Nuclear Information System (INIS)
Funai, Hiroaki; Takubo, Masamichi; Iinuma, Toshitaka; Horiuchi, Yasuharu; Ichimura, Keiichi; Oyama, Kazuyuki.
1989-01-01
The posterior tympanum consists of several irregular eminences, ridges, and sinuses. These sinuses do not communicate with the mastoid air cell system, and cholesteatoma and/or granulation tissue prefer to fill them. This area cannot be visualized with ease by the usual surgical approach, and is thus quite important for surgeons. Recent developments in high-resolution computed tomography (HRCT) allow more than ever precise identification of subtle changes in the posterior tympanum. Axial HRCT sections provide essential information for the preoperative evaluation of the posterior tympanum. The performance of surgeons has been promoted both in evaluation and treatment planning of patient with suspected posterior tympanic lesions. HRCT findings were compared with the operative findings in 52 patients (54 ears) who had the operation for chronic otitis media. Important findings by HRCT diagnosis of posterior tympanum are as follows; (1) Bone destruction in the posterosuperior part of the tympanic anulus and in the lateral wall of the facial sinus are the important findings for the diagnosis of invasion of cholesteatoma in the posterior tympanum. (2) Similarly important finding is the bone destruction of the pyramidal eminence. This was found in 6 of 9 cases with cholesteatomas extending into the sinus tympani. (3) The soft tissue density in the posterior tympanum does not necessarily indicate pathological processes. Effusion in the posterior tympanum is imaged as soft tissue density, and can not be differentiated from cholesteatoma or granulation by present HRCT. (author)
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Miyachi, Yukiya; Arakawa, Mototaka; Kanai, Hiroshi
2018-07-01
In our studies on ultrasonic elasticity assessment, minute change in the thickness of the arterial wall was measured by the phased-tracking method. However, most images in carotid artery examinations contain multiple-reflection noise, making it difficult to evaluate arterial wall elasticity precisely. In the present study, a modified phased-tracking method using the pulse inversion method was examined to reduce the influence of the multiple-reflection noise. Moreover, aliasing in the harmonic components was corrected by the fundamental components. The conventional and proposed methods were applied to a pulsated tube phantom mimicking the arterial wall. For the conventional method, the elasticity was 298 kPa without multiple-reflection noise and 353 kPa with multiple-reflection noise on the posterior wall. That of the proposed method was 302 kPa without multiple-reflection noise and 297 kPa with multiple-reflection noise on the posterior wall. Therefore, the proposed method was very robust against multiple-reflection noise.
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Hananta, I. Putu Yuda; de Vries, Henry John Christiaan; van Dam, Alje P.; van Rooijen, Martijn Sebastiaan; Soebono, Hardyanto; Schim van der Loeff, Maarten Franciscus
2017-01-01
Infection of Neisseria gonorrhoeae in the pharynx (pharyngeal Ng) is associated with gonococcal transmission and development of antimicrobial resistance. We assessed proportion of and determinants for persistence after treatment of pharyngeal Ng. At the STI clinic of Amsterdam, the Netherlands,
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Posterior colporrhaphy does not affect the urethral closure mechanism
DEFF Research Database (Denmark)
Khayyami, Yasmine; Lose, Gunnar; Klarskov, Niels
2018-01-01
prolapse ≥stage II were examined before and after posterior colporrhaphy. We performed prolapse staging according to the Pelvic Organ Prolapse Quantification system, UPR measurements at rest, during squeezing and straining, and standardized stress tests with 300 ml saline. The women filled out...... International Consultation on Incontinence-Urinary incontinence (ICIQ-UI) short forms. The sample size was 18, with a power of 99.9% and a level of significance of 5%. Parameters were compared using paired t tests or Fisher's exact test, where appropriate; p values ... significant. RESULTS: Eighteen women with posterior vaginal wall prolapse ≥stage II were recruited. One woman did not undergo surgery. There were no changes in urethral pressure at rest (p = 0.4), during squeezing (p = 0.2) or straining (p = 0.2), before and after surgery. The results of the stress tests...
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International Nuclear Information System (INIS)
Shimizu, Takahiko; Hyodo, Haruo; Hayashi, Terumi; Yamamoto, Hideo; Yagi, Shigeru
1984-01-01
Regional wall motion of the left ventricle was evaluated in 21 patients with myocardial infarction using an animation system of gated cardiac computed tomographic (CT) images (animation gated CCT). The results obtained were compared with data by two-dimensional echocardiography (2-DE). 1. Evaluation of the asynergic area by animation gated CCT and 2-DE: Animation gated CCT detected the following specific regions with asynergy established by 2-DE; 10/10 cases (100%) at the anterior wall of the left ventricle, 14/14 cases (100%) at the interventricular septum, and 9/11 cases (81.8%) at the infero-posterior wall. In addition, one false positive case and one negative case were observed at the lateral wall and the apex, respectively. Of 37 instances with asynergic areas established by 2-DE, 21 cases or 89.2% were detected by animation gated CCT; the sensitivity was 91.9%. 2. Evaluation of severity of asynergy by animation gated CCT and 2-DE: The degree of asynergy evaluated by both methods was compared with each other, and the agreement was as follows: 10/10 cases (100%) at the left-ventricular anterior wall, 13/13 cases (100%) at the interventricular septum, and 7/9 cases (77.8%) at the infero-posterior wall. 3. Evaluation of the asynergic area by nonanimation gated CCT and 2-DE: Nonanimation gated CCT detected asynergic areas ascertained by 2-DE at the following areas; 8/10 cases (80%) at the left-ventricular anterior wall, 12/14 cases (85.7%) at the interventricular septum, and 4/11 cases (36.4%) at the infero-posterior wall. The difference between animation and nonanimation gated CCT was statistically significant (p<0.05). The severity of asynergy could not be evaluated by nonanimation gated CCT. (J.P.N.)
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Adverse Health Effects of Betel Quid and the Risk of Oral and Pharyngeal Cancers
Directory of Open Access Journals (Sweden)
Ping-Ho Chen
2017-01-01
Full Text Available Global reports estimate 600 million betel quid (BQ chewers. BQ chewing has been demonstrated not only to be a risk factor for cancers of the oral cavity and pharynx and oral potentially malignant disorders (OPMD but also to cause other cancers and adverse health effects. Herein, we summarized the international comparison data to aid in the understanding of the close relationship between the prevalence of BQ chewing, the occurrence of oral and pharyngeal cancers, and adverse health effects. Potential biomarkers of BQ carcinogens, such as areca nut, alkaloids, and 3-methylnitrosaminopropionitrile (MNPN, are closely associated with human health toxicology. Molecular mechanisms or pathways involving autophagy, hypoxia, COX-2, NF-κB activity, and stemness are known to be induced by BQ ingredients and are very closely related to the carcinogenesis of cancers of oral and pharynx. BQ abuse-related monoamine oxidase (MAO gene was associated with the occurrence and progress of oral and pharyngeal cancers. In summary, our review article provides important insights into the potential roles of environmental BQ (specific alkaloid biomarkers and nitrosamine products MNPN and genetic factors (MAO and offers a basis for studies aiming to reduce or eliminate BQ-related OPMD and oral/pharyngeal cancer incidences in the future.
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Adverse Health Effects of Betel Quid and the Risk of Oral and Pharyngeal Cancers
Mahmood, Qaisar; Chiang, Tai-An
2017-01-01
Global reports estimate 600 million betel quid (BQ) chewers. BQ chewing has been demonstrated not only to be a risk factor for cancers of the oral cavity and pharynx and oral potentially malignant disorders (OPMD) but also to cause other cancers and adverse health effects. Herein, we summarized the international comparison data to aid in the understanding of the close relationship between the prevalence of BQ chewing, the occurrence of oral and pharyngeal cancers, and adverse health effects. Potential biomarkers of BQ carcinogens, such as areca nut, alkaloids, and 3-methylnitrosaminopropionitrile (MNPN), are closely associated with human health toxicology. Molecular mechanisms or pathways involving autophagy, hypoxia, COX-2, NF-κB activity, and stemness are known to be induced by BQ ingredients and are very closely related to the carcinogenesis of cancers of oral and pharynx. BQ abuse-related monoamine oxidase (MAO) gene was associated with the occurrence and progress of oral and pharyngeal cancers. In summary, our review article provides important insights into the potential roles of environmental BQ (specific alkaloid biomarkers and nitrosamine products MNPN) and genetic factors (MAO) and offers a basis for studies aiming to reduce or eliminate BQ-related OPMD and oral/pharyngeal cancer incidences in the future. PMID:29376073
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Gaudreau, Philip A; Gessler, Eric M
2017-09-01
Our objective was to perform a pilot study comparing intracapsular radiofrequency ablation tonsillectomy with subcapsular tonsillectomy in adult patients with keratosis pharyngeous. Patients diagnosed with keratosis pharyngeous between December 2010 and February 2013 were randomized to undergo either intracapsular or subcapsular tonsillectomy using radiofrequency ablation. Postoperative pain scores and amount of pain medication taken were recorded for 2 weeks. A 6-month follow-up questionnaire was used to assess efficacy of the procedure. Twenty-two patients completed the initial 2-week questionnaire. Eighteen completed the 6-month follow-up questionnaire. The amount of pain medication consumed on postoperative days 8 (p = 0.0293), 9 (p = 0.0146), and 10 (p = 0.035) was significantly less in the intracapsular group. Risk of recurrence of tonsilloliths was significantly greater at the 6-month follow-up in the intracapsular cohort (p = 0.0291). Based on these findings, in patients undergoing tonsillectomy for keratosis pharyngeous, intracapsular radiofrequency ablation tonsillectomy may result in decreased pain medication consumption compared with subcapsular tonsillectomy. Intracapsular tonsillectomy, however, resulted in a higher rate of recurrence of tonsilloliths. The benefit of decreased pain medication may be offset by the greater likelihood for symptoms to recur. Larger studies are needed to confirm these findings.
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Directory of Open Access Journals (Sweden)
Ana NEMȚOI
2015-09-01
Full Text Available Introduction: Children with cleft lip and palate (CLP are known to have airway problems. Introduction of ConeBeam CT (CBCT and imaging software has facilitated generation of 3D images for assessing the volume of maxillary sinuses and pharyngeal airway. Consequently, the present study aimed at evaluating and comparing the maxillary sinus and pharyngeal airway volume of patients with cleft lip and palate in healthy patients, using cone beam computed tomography (CBCT images. Materials and method: The sample group included 27 individuals (15 with cleft lip and palate subjects and 12 healthy subjects. The pharyngeal airway and each maxillary sinus were three-dimensionally assessed, segmented and their volume was calculated. A comparison between the right and left sinus was performed by Student t-test, and the differences between the control and cleft groups were calculated using ANOVA. Results: No statistically significant differences were found when the maxillary sinuses volumes from each side were compared (p >0.05. The unilateral CLP patients presented the lowest sinus volume. Individuals with CLP did not exhibit a total airway volume smaller than the nonCLP controls. Conclusions: 3D imaging using CBCT and Romexis software is reliable for assessing maxillary sinus and pharyngeal airway volume. The present study showed that the pharyngeal airway is not compromised in CLP individuals. The unilateral CLP individuals present maxillary sinuses with smaller volumes, no differences being recorded between the cleft and non-cleft side.
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Observation the swallowing mechanism in elderly patients with pharyngeal dysphagia
Directory of Open Access Journals (Sweden)
Claudia Ximena Campo-Cañar
2010-09-01
Full Text Available Observation of the swallowing dynamics is an issue that demands close attention by the health professionals involved in the diagnosis and management of patients with dysphagia. This article is a review of the literature aimed to enhance the knowledge regarding the speech therapy assessment of pharyngeal dysphagia in elder adults. The disorder of the swallowing is called dysphagia and it is defined as difficulty swallowing. The dysphagia is often caused by affectation of mechanical or neuromuscular components of the swallowing mechanism. This type of disorder is likely to impact the the oral, pharyngeal and esophageal phases of the swallowing. The speech therapist should take into account assessing aspects such as level of consciousness, vital signs, whether or not the patient is ventilator dependent, means of feeding, if intubated what type of cannula, whether or not the patient uses a speaking valve (if a trach tube is present, nutritional status, the patient’s expressive and receptive language, the anatomical and physiological state of the oral motor structures. When assessing swallowing clinicians should also make sure to develop an adequate beside clinical, voice assessment and videofluoroscopy.
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International Nuclear Information System (INIS)
Hayakawa, Kimiko; Yoshikawa, Hiroshi; Suzuki, Miyako; Yokoi, Hidenori; Hosokawa, Akira; Hagiwara, Akiko; Ichikawa, Ginichirou
2003-01-01
In concluding surgery of the paranasal sinuses (anterior and posterior) and the sphenoidal sinus, caution is demanded because intraorbital complications may develop in the skull. It is well-known that there is substantial variation in the form of the internal wall of the orbit, and the anterior and posterior walls of the sphenoidal sinus. In the present study, we measured the size of the structure around the paranasal sinus on patient CTscans to be used in surgery on the paranasal sinuses. A total of 387 people (184 males and 203 females) with no destructive bone lesions who visited the Juntendo University Hospital between 1999 and June 2002 were investigated. A plane was selected 14 mm above a line drawn between the medial angle and the external acoustic orifice on CTscans performed using axial projection. This framework was used to conduct the measurements. We employed this method because we consider it ideal for rendering the ethmoidal sinuses, the internal wall of the orbit, medial rectus muscle, optic nerve, and the anterior and posterior walls of the sphenoidal sinus most clearly visible. We measured the length between these anatomically important regions. We measured 1) the length of a line drawn between the opening of the nose and the line drawn between the right and left optic canals, 2) the length between the nasal opening and the posterior wall of the sphenoidal sinus, on the same horizontal line drawn between the posterior end of the eyeball and the nasal septum, 3) the length of a line from the site where the optic nerve adheres to the nasal septum, 4) the length between the lateral wall of the ethmoidal sinus, 5) the length between the nasal septum and the medial side of the medial rectus muscle, 6) the length between the medial side of the medial rectus muscle and the medial side of the optic nerve. The measurements were performed on both sides. We analyzed the above results statistically according to gender and age. The results of the analysis
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Pharyngeal cavity and the gills are the target organ for the repellent action of pardaxin in shark.
Primor, N
1985-05-15
Pardaxin, an active principle of the repellent secretion of the Red Sea flatfish, Pardachirus marmoratus, elicited severe struggling, mouth paralysis, and transient increase in urea leakage from the gills only when administered to the medium bathing the shark's pharyngeal cavity and gills. An apparatus was constructed which prevents a mixing of the outflow from shark's gills with water bathing its surface skin. It is concluded that in sharks the gills and/or the pharyngeal cavity are the target organ for the repellent action of pardaxin.
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Pharyngitis – fatal infectious disease or medical error?
Directory of Open Access Journals (Sweden)
Marta Rorat
2015-08-01
Full Text Available Reporting on adverse events is essential to create a culture of safety, which focuses on protecting doctors and patients from medical errors. We present a fatal case of Streptococcus C pharyngitis in a 56-year-old man. The clinical course and the results of additional diagnostics and autopsy showed that sepsis followed by multiple organ failure was the ultimate cause of death. The clinical course appeared fatal due to a chain of adverse events, including errors made by the physicians caring for the patient for 10 days.
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Shivakumara, Tagginahalli N; Chaudhary, Sonam; Kamaraju, Divya; Dutta, Tushar K; Papolu, Pradeep K; Banakar, Prakash; Sreevathsa, Rohini; Singh, Bhupinder; Manjaiah, K M; Rao, Uma
2017-01-01
The complex parasitic strategy of Meloidogyne incognita appears to involve simultaneous expression of its pharyngeal gland-specific effector genes in order to colonize the host plants. Research reports related to effector crosstalk in phytonematodes for successful parasitism of the host tissue is yet underexplored. In view of this, we have used in planta effector screening approach to understand the possible interaction of pioneer genes ( msp-18 and msp-20 , putatively involved in late and early stage of M. incognita parasitism, respectively) with other unrelated effectors such as cell-wall modifying enzymes (CWMEs) in M. incognita . Host-induced gene silencing (HIGS) strategy was used to generate the transgenic eggplants expressing msp-18 and msp-20 , independently. Putative transformants were characterized via qRT-PCR and Southern hybridization assay. SiRNAs specific to msp-18 and msp - 20 were also detected in the transformants via Northern hybridization assay. Transgenic expression of the RNAi constructs of msp-18 and msp-20 genes resulted in 43.64-69.68% and 41.74-67.30% reduction in M. incognita multiplication encompassing 6 and 10 events, respectively. Additionally, transcriptional oscillation of CWMEs documented in the penetrating and developing nematodes suggested the possible interaction among CWMEs and pioneer genes. The rapid assimilation of plant-derived carbon by invading nematodes was also demonstrated using 14 C isotope probing approach. Our data suggests that HIGS of msp-18 and msp-20 , improves nematode resistance in eggplant by affecting the steady-state transcription level of CWME genes in invading nematodes, and safeguard the plant against nematode invasion at very early stage because nematodes may become the recipient of bioactive RNA species during the process of penetration into the plant root.
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Lymphogranuloma venereum in men screened for pharyngeal and rectal infection, Germany.
Haar, Karin; Dudareva-Vizule, Sandra; Wisplinghoff, Hilmar; Wisplinghoff, Fabian; Sailer, Andrea; Jansen, Klaus; Henrich, Birgit; Marcus, Ulrich
2013-03-01
To determine prevalence of lymphogranuloma venereum among men who have sex with men in Germany, we conducted a multicenter study during 2009-2010 and found high rates of rectal and pharyngeal infection in men positive for the causative agent, Chlamydia trachomatis. Many infections were asymptomatic. An adjusted C. trachomatis screening policy is justified in Germany.
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Park, Jeong Mee; Yong, Sang Yeol; Kim, Ji Hyun; Jung, Hong Sun; Chang, Sei Jin; Kim, Ki Young; Kim, Hee
2014-01-01
Objective To determine the cutoff value of the pharyngeal residue for predicting reduction of aspiration, by measuring the residue of valleculae and pyriformis sinuses through videofluoroscopic swallowing studies (VFSS) after treatment with neuromuscular electrical stimulator (VitalStim) in stroke patients with dysphagia. Methods VFSS was conducted on first-time stroke patients before and after the VitalStim therapy. The results were analyzed for comparison of the pharyngeal residue in the im...
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Posterior glenoid rim deficiency in recurrent (atraumatic) posterior shoulder instability
International Nuclear Information System (INIS)
Weishaupt, D.; Zanetti, M.; Hodler, J.; Nyffeler, R.W.; Gerber, C.
2000-01-01
Objective. To assess the shape of the posterior glenoid rim in patients with recurrent (atraumatic) posterior instability.Design and patients. CT examinations of 15 shoulders with recurrent (atraumatic) posterior instability were reviewed in masked fashion with regard to abnormalities of the glenoid shape, specifically of its posterior rim. The glenoid version was also assessed. The findings were compared with the findings in 15 shoulders with recurrent anterior shoulder instability and 15 shoulders without instability. For all patients, surgical correlation was available.Results. Fourteen of the 15 (93%) shoulders with recurrent (atraumatic) posterior shoulder instability had a deficiency of the posteroinferior glenoid rim. In patients with recurrent anterior instability or stable shoulders such deficiencies were less common (60% and 73%, respectively). The craniocaudal length of the deficiencies was largest in patients with posterior instability. When a posteroinferior deficiency with a craniocaudal length of 12 mm or more was defined as abnormal, sensitivity and specificity for diagnosing recurrent (atraumatic) posterior instability were 86.7% and 83.3%, respectively. There was a statistically significant difference in glenoid version between shoulders with posterior instability and stable shoulders (P=0.01).Conclusion. Recurrent (atraumatic) posterior shoulder instability should be considered in patients with a bony deficiency of the posteroinferior glenoid rim with a craniocaudal length of more than 12 mm. (orig.)
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Oral and pharyngeal cancer : Analysis of patient delay at different tumor stages
Brouha, XDR; Tromp, DM; Hordijk, GJ; Winnubst, JAM; de Leeuw, JRJ
2005-01-01
Background. The aim of this study was to examine which factors are related to patient delay in a cohort of consecutive patients with pharyngeal cancer and oral cancer and to determine whether the different stages of patient delay (ie, appraisal, illness, behavioral, and scheduling) were related to
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Energy Technology Data Exchange (ETDEWEB)
Olsson, Rolf
1995-08-01
The technique was used in nondysphagic volunteers and in dysphagic patients. Our normal values in nondysphagic volunteers are in accordance with normal values in the literature. Regarding catheter movement we found the a previously not described sensor movement where the sensor in the upper esophageal sphincter followed the laryngeal elevation with no response to soft palate elevation. We found a longitudinal asymmetry in the pharynx with higher contraction pressures at lower levels. In the experimental model we found that intrabolus pressure was dependent on bolus volume, lumen narrowing, sensor position, flow rate, and bolus viscosity. In patients with a cricopharyngeal indentation we found weak pharyngeal constrictors with outpouching of the lumen above and below. Finally, in dysphagic patients with a normal radiologic investigation, videomanometry displayed abnormalities in 74% of the patients. We conclude that barium swallow and manometry are complementary and we suggest the addition of pharyngeal solid state manometry, preferably with simultaneous videoradiography, in dysphagic patients. 128 refs, 4 figs.
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International Nuclear Information System (INIS)
Olsson, Rolf.
1995-08-01
The technique was used in nondysphagic volunteers and in dysphagic patients. Our normal values in nondysphagic volunteers are in accordance with normal values in the literature. Regarding catheter movement we found the a previously not described sensor movement where the sensor in the upper esophageal sphincter followed the laryngeal elevation with no response to soft palate elevation. We found a longitudinal asymmetry in the pharynx with higher contraction pressures at lower levels. In the experimental model we found that intrabolus pressure was dependent on bolus volume, lumen narrowing, sensor position, flow rate, and bolus viscosity. In patients with a cricopharyngeal indentation we found weak pharyngeal constrictors with outpouching of the lumen above and below. Finally, in dysphagic patients with a normal radiologic investigation, videomanometry displayed abnormalities in 74% of the patients. We conclude that barium swallow and manometry are complementary and we suggest the addition of pharyngeal solid state manometry, preferably with simultaneous videoradiography, in dysphagic patients. 128 refs, 4 figs
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van Rooijen, Martijn S.; van der Loeff, Maarten F. Schim; Morré, Servaas A.; van Dam, Alje P.; Speksnijder, Arjen G. C. L.; de Vries, Henry J. C.
2015-01-01
Objectives Pharyngeal Chlamydia trachomatis (chlamydia) might contribute to ongoing chlamydia transmission, yet data on spontaneous clearance duration are rare. We examined the prevalence, spontaneous clearance, chlamydial DNA concentration and genotypes of pharyngeal chlamydia among clinic patients
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DEFF Research Database (Denmark)
Taverniti, Valentina; Dalla Via, Alessandro; Minuzzo, Mario
2017-01-01
Group A streptococci (GAS) cause 20-30% of pediatric pharyngitis episodes, which are a major cause of ambulatory care visits. Therefore, a strategy to prevent GAS dissemination in children could significantly benefit public healthcare. Contextually, we assessed the possibility of employing...... alternative food-grade strategies to be used with the oral probiotic L. helveticus MIMLh5 for the prevention of pharyngeal infections. First, we demonstrated through an antagonism-by-exclusion assay that guaran may potentially prevent S. pyogenes adhesion on pharyngeal cells. Subsequently, we showed...
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Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (pfapa) syndrome in children.
Semianchuk, Vira B
Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome refers to a group of primary immunodeficiencies, namely autoinflammatory diseases. Most pediatricians and otolaryngologists do not suspect PFAPA syndrome when treating recurrent pharyngitis (according to Ukrainian classification - tonsillitis) and stomatitis. Therefore, patients with a given syndrome receive unnecessary treatment (antibiotic therapy or antiviral drugs) and the diagnosis is made late. The aim of the research was to provide pediatricians, family physicians and otolaryngologists with information on the importance of early diagnosis of PFAPA syndrome. The analysis of the prevalence and diagnosis of PFAPA syndrome in Ukraine and worldwide has been made as well as a late diagnosis of PFAPA syndrome in a child living in Ivano-Frankivsk, Ukraine has been described (case report). The Сase report 7-year-old boy, who grows and develops normally. The symptoms of pharyngitis including high body temperature (>40 º С), sore throat and white spots on the tonsils appeared for the first time at the age of two years. The boy received antibacterial drugs about 10 times a year. During a four-year period of recurrent episodes of the disease antimicrobial susceptibility testing to determine susceptibility of the oropharyngeal flora to the antibiotics were continuously performed, different blood tests for herpes viruses, Epstein-Barr virus infection and cytomegalovirus in particular were made using the enzyme immunoassay (EIA) and polymerase chain reaction (PCR) in addition to long-term treatment. An example of late diagnosing PFAPA syndrome (four years after the onset of first symptoms) resulting in regular examinations, medical manoeuvres, outpatient and inpatient treatment, use of antibiotic therapy including intravenous injections on a monthly basis has been studied.
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[Advantages and problems of traditional Chinese medicine in treatment of acute pharyngitis].
Zhang, Xia; Xie, Yan-Ming; Li, Guang-Xi; Gao, Yang; Zhao, Yuan-Chen; Tang, Jing-Jing; Yao, Xiao-Yan; Li, Meng
2017-10-01
This paper systematically studies relevant literatures at home and abroad in recent years. China National Knowledge Internet (CNKI) was used to collect the literatures for acute pharyngitis treated with traditional Chinese medicine from January 1, 2006, to December 31, 2016, and the bibliometric method was employed for statistical analysis. A total of 493 papers were preliminarily selected. According to the inclusion criteria and exclusion criteria, 182 eligible articles were selected. According to the evaluation and analysis of the literatures, the Guidelines for Clinical Research of New Drugs is currently used as the common standards for the diagnosis and treatment of acute pharyngitis; Chinese patent medicines are the main traditional Chinese medicine for treating this disease; Decoctions for treatment of this disease include Lonicerae Japonicae Flos, Scutellariae Radix, Platycodonis Radix, Forsythiae Fructus, Glycyrrhizae Radix et Rhizoma, Scrophdlariae Radix, Isatidis Radix, and Ophiopogonis Radix; The bloodletting puncture is the common external therapy. Traditional Chinese medicine and Western medicine have their own characteristics in the treatment of this disease. Western medicine for the treatment of acute pharyngitis are mainly antiviral, antibiotic and glucocorticoid drugs, whose disadvantages are toxicity, side effects, drug resistance and double infections. Traditional Chinese medicine doctors have rich experiences in the treatment of the disease, which is characterized by treatment determination based on syndrome differentiation, safe and reliable medication, significant curative effect, low drug resistance, and wide varieties of traditional Chinese medicine forms, convenient portability and taking, low price, and low toxic and side effects. It is an arduous and significant task to explore traditional Chinese medicine, and study and develop new-type effective drugs. Copyright© by the Chinese Pharmaceutical Association.
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Trend of oral and pharyngeal cancer mortality in Brazil in the period of 2002 to 2013
Perea, Lillia Magali Estrada; Peres, Marco Aurélio; Boing, Antonio Fernando; Antunes, José Leopoldo Ferreira
2018-01-01
ABSTRACT OBJECTIVE To analyze the trend of oral and pharyngeal cancer mortality rates in the period of 2002 to 2013 in Brazil according to sex, anatomical site, and macroregion of the country. METHODS The mortality data were obtained from the Mortality Information System and the population data were obtained from the Brazilian Institute of Geography and Statistics. The trend of the rates standardized by sex and age was calculated using the Prais-Winsten estimation, and we obtained the annual percentage change and the respective 95% confidence intervals, analyzed according to sex, macroregion, and anatomical site. RESULTS The average coefficient of oral cancer mortality was 1.87 per 100,000 inhabitants and it remained stable during the study period. The coefficient of pharyngeal cancer mortality was 2.04 per 100,000 inhabitants and it presented an annual percentage change of -2.6%. Approximately eight in every 10 deaths occurred among men. There was an increase in the rates of oral cancer in the Northeast region (annual percentage change of 6.9%) and a decrease in the Southeast region (annual percentage change of -2.9%). Pharyngeal cancer mortality decreased in the Southeast and South regions with annual percentage change of -4.8% and -5.1% respectively. Cancer mortality for tonsil, other major salivary glands, hypopharynx, and other and unspecified parts of mouth and pharynx showed a decreasing trend while the other sites presented stability. CONCLUSIONS Pharyngeal cancer mortality decreased in the period of 2002 to 2013. Oral cancer increased only in the Northeast region. Mortality for tonsil cancer, other major salivary glands, hypopharynx, and other and ill-defined sites in the lip, oral cavity, and pharynx decreased. PMID:29412371
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International Nuclear Information System (INIS)
Mendez, Jose C.; Gonzalez-Llanos, Francisco
2005-01-01
We present a case of vertebral artery pseudoaneurysm after a posterior C1-C2 transarticular screw fixation procedure that was effectively treated with endovascular coil occlusion. Vertebral artery pseudoaneurysm complicating posterior C1-C2 transarticular fixation is extremely rare, with only one previous case having been reported previously. Endovascular occlusion is better achieved in the subacute phase of the pseudoaneurysm, when the wall of the pseudoaneurysm has matured and stabilized. Further follow-up angiographies are mandatory in order to confirm that there is no recurrence of the lesion
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DEFF Research Database (Denmark)
Hermann, N. V.; Kreiborg, S.; Darvann, Tron Andre
2003-01-01
and posterior height, wide nasal cavity, short mandible, bimaxillary retrognathia, and reduced pharyngeal airway. The shortest mandible was found in RS followed by ICP and UCCLP; the pharyngeal airway was reduced in RS and ICP, compared with UCCLP; and the maxillary complex and nasal cavity were wider in UCCLP...
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Transvaginal bladder neck closure with posterior urethral flap for devastated urethra.
Rovner, Eric S; Goudelocke, Colin M; Gilchrist, Alienor; Lebed, Brett
2011-07-01
To present a modified transvaginal bladder neck closure (TV BNC) technique using a posterior urethral flap to minimize the potential risk of ureteral injury and fistula formation. Urethral and bladder neck destruction owing to chronic indwelling urethral catheters in female neurogenic patients is a devastating complication. A retrospective review was performed of all patients undergoing TV BNC at a single institution during a 3-year period. All patients had had a nonfunctional or destroyed urethra because of a long-term indwelling urethral catheter. In brief, the devastated outlet was closed using the dorsally bivalved urethra as a flap that was rotated cephalad onto the incised anterior bladder wall for closure, thereby rotating the suture line high into the retropubic space. A postoperative cystogram was obtained at 2-3 weeks. A total of 11 consecutive female patients with a devastated outlet underwent TV BNC, as described, with placement of a suprapubic tube. One patient experienced failure at 6 weeks postoperatively. The mean follow-up for the entire cohort was 9.6 months (range 1-36). Serial upper tract imaging at the last follow-up visit revealed no new hydroureteronephrosis. The results of our study have shown that TV BNC with a posterior urethral flap provides satisfactory early results. This technique creates a suture line far removed from the ureteral orifices, minimizing the risk of upper tract injury during closure. Also, the rotation of the posterior urethra onto the anterior bladder wall secures the suture line high into the retropubic space, minimizing the risk of failure and postoperative fistula formation. Copyright © 2011 Elsevier Inc. All rights reserved.
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International Nuclear Information System (INIS)
Buchbender, Christian; Heusner, Till A.; Treffert, Jon; Lehnerdt, Goetz; Mattheis, Stefan; Geiger, Bernhard; Bockisch, Andreas; Forsting, Michael; Antoch, Gerald
2012-01-01
The aim of this study was to evaluate whether a virtual 3-D 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT panendoscopy is feasible and can be used for noninvasive imaging of the upper airways and pharyngeal/laryngeal tumours. From 18 F-FDG PET/CT data sets of 40 patients (29 men, 11 women; age 61 ± 9 years) with pharyngeal or laryngeal malignancies virtual 3-D 18 F-FDG PET/CT panendoscopies were reconstructed and the image processing time was measured. The feasibility of assessing the oral cavity, nasopharynx, tongue base, soft palate, pharyngeal tonsils, epiglottis, aryepiglottic folds, piriform sinus, postcricoid space, glottis, subglottis, trachea, bronchi and oesophagus and of detecting primary tumours was tested. Results of fibre-optic bronchoscopy and histology served as the reference standard. The nasopharynx, tongue base, soft palate, pharyngeal tonsils, epiglottis, subglottis and the tracheobronchial tree were accessible in all 40, and the aryepiglottic folds, posterior hypopharyngeal wall, postcricoid space, piriform sinus, glottis, oral cavity and oesophagus in 37, 37, 37, 37, 33, 16 and 0 patients, respectively. In all 12 patients with restricted fibre-optic evaluation due to being primarily intubated, the subglottis was accessible via virtual panendoscopy. The primary tumour was depicted in 36 of 40 patients (90 %). The mean processing time for virtual 18 F-FDG PET/CT panendoscopies was 145 ± 98 s. Virtual 18 F-FDG PET/CT panendoscopy of the upper airways is technically feasible and can detect pharyngeal and laryngeal malignancies. This new tool can aid in the complete evaluation of the subglottic space in intubated patients and may be used for planning optical panendoscopies, biopsies and surgery in the future. (orig.)
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Evolutionary Trends of the Pharyngeal Dentition in Cypriniformes (Actinopterygii: Ostariophysi)
Pasco-Viel, Emmanuel; Charles, Cyril; Chevret, Pascale; Semon, Marie; Tafforeau, Paul; Viriot, Laurent; Laudet, Vincent
2010-01-01
Background : The fish order Cypriniformes is one of the most diverse ray-finned fish groups in the world with more than 3000 recognized species. Cypriniformes are characterized by a striking distribution of their dentition: namely the absence of oral teeth and presence of pharyngeal teeth on the last gill arch (fifth ceratobranchial). Despite this limited localisation, the diversity of tooth patterns in Cypriniformes is astonishing. Here we provide a further description of this diversity usin...
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2014-01-01
Background Various head and neck positions in sport horses are significant as they can interfere with upper airway flow mechanics during exercise. Until now, research has focused on subjectively described head and neck positions. The objective of this study was to develop an objective, reproducible method for quantifying head and neck positions accurately. Results Determining the angle between the ridge of the nose and the horizontal plane (ground angle) together with the angle between the ridge of nose and the line connecting the neck and the withers (withers angle) has provided values that allow precise identification of three preselected head and neck positions for performing sport horses. The pharyngeal diameter, determined on lateral radiographs of 35 horses, differed significantly between the established flexed position and the remaining two head and neck positions (extended and neutral). There was a significant correlation between the pharyngeal diameter and the ground angle (Spearman’s rank correlation coefficient −0.769, p horses. The ground angle and the withers angle show significant correlation with the measured pharyngeal diameter in resting horses. Hence, these angles provide an appropriate method for assessing the degree of head and neck flexion. Further research is required to examine the influence of increasing head and neck flexion and the related pharyngeal diameter on upper airway function in exercising horses. PMID:24886564
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Directory of Open Access Journals (Sweden)
Christelle Leung
Full Text Available The effect of the environment may result in different developmental outcomes. Extrinsic signals can modify developmental pathways and result in alternative phenotypes (phenotypic plasticity. The environment can also be interpreted as a stressor and increase developmental instability (developmental noise. Directional and fluctuating asymmetry provide a conceptual background to discriminate between these results. This study aims at assessing whether variation in dentition and shape of pharyngeal arches of the clonal fish Chrosomus eos-neogaeus results from developmental instability or environmentally induced changes. A total of 262 specimens of the Chrosomus eos-neogaeus complex from 12 natural sites were analysed. X-ray microcomputed tomography (X-ray micro-CT was used to visualize the pharyngeal arches in situ with high resolution. Variation in the number of pharyngeal teeth is high in hybrids in contrast to the relative stability observed in both parental species. The basal dental formula is symmetric while the most frequent alternative dental formula is asymmetric. Within one lineage, large variation in the proportion of individuals bearing basal or alternative dental formulae was observed among sites in the absence of genetic difference. Both dentition and arch shape of this hybrid lineage were explained significantly by environmental differences. Only individuals bearing asymmetric dental formula displayed fluctuating asymmetry as well as directional left-right asymmetry for the arches. The hybrids appeared sensitive to environmental signals and intraspecific variation on pharyngeal teeth was not random but reflects phenotypic plasticity. Altogether, these results support the influence of the environment as a trigger for an alternative developmental pathway resulting in left-right asymmetry in dentition and shape of pharyngeal arches.
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Directory of Open Access Journals (Sweden)
L. M. Kurtasova
2014-01-01
Full Text Available We have observed and examined 57 children 1 to 3 years old diagnosed with enlargement of pharyngeal tonsils. A control group was presented by 35 healthy children. Bioluminescence technique was applied for studying NAD(P-dependent dehydrogenase activity in peripheral blood lymphocytes. Activation of aerobic respiration and increasing activity of pentose phosphate cycle-dependent plastic processes were registered in blood lymphocytes of children with hypertrophic pharyngeal tonsils; along with decreased function of malate-aspartate shunt in energy metabolism of the cells, diminished anaerobic reaction of NADHdependent LDH, lower interaction between Krebs cycle and reactions of amino acid metabolism, and reduced activity of glutathione reductase.
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Anterior sagittal transanorectal approach to the posterior urethra in the pediatric age group.
Rossi, F; De Castro, R; Ceccarelli, P L; Dòmini, R
1998-09-01
Surgical access to the posterior urethra is often difficult and several surgical solutions have been proposed. We suggest an anterior sagittal transanorectal approach based on splitting the anterior rectal wall only. This alternative technique provides excellent exposure to the retrourethral region, permitting simple and safe surgery. Between 1994 and 1996 we performed surgery via the anterior sagittal transanorectal approach in 8 patients with a mean age of 9.06 years. Patients included 1 girl with a posttraumatic urethrovaginal fistula, 3 with intersex disorders (2 with mixed gonadal dysgenesis raised as boys and 1 with male dysgenetic pseudohermaphroditism with an enlarged urtricle) and 4 boys (1 with penile agenesis raised as girl, 2 with urethral duplication and 1 with prostatic rhabdomyosarcoma). The patient was placed in a knee-chest position. A midline sagittal incision was made through the anterior anorectal wall only and deepened through the perineal body to expose the posterior urethra and retrovesical space. After the pathological condition was corrected the anterior rectal wall and perineal body were reconstructed. The operation was completed with protective colostomy. In our final patient with prostatic rhabdomyosarcoma the anterior sagittal transanorectal approach was used without colostomy. Anorectal manometry was done 6 months postoperatively. All patients were completely continent of stool and urine. Convalescence was unremarkable in all cases. Postoperative manometry in 7 patients revealed no differences from preoperative measurements. This procedure should be considered a useful alternative to other techniques for various congenital and acquired pelvic disorders.
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Directory of Open Access Journals (Sweden)
Giuseppe Ivan Potente
2012-09-01
Full Text Available The stomach is one of the most common organs in which mucosa-associated lymphoid tissue (MALT lymphoma develops. It is well established that Helicobacter pylori (Hp infection plays a major role in the development of gastric MALT lymphoma and that the presence of Hp in the gastric mucosa is connected with mucosa-associated lymphatic tissue (MALT.The same tissue is located in the oral cavity and pharynx in Waldayer’s circuit. Recently, the oral cavity was proposed as an extragastric reservoir of Hp infection. We report the case of a 79-year-old female patient with concomitant pharyngeal (MALT lymphoma and Hp-related gastric MALT lymphoma. Gastric MALT lymphoma was detected both through endoscopic examination as well as in biopsies. Pharyngeal MALT lymphoma was also detected in biopsies. Hp has been recognized in the gastric mucosa by positive serum H. pylori antibody and urease tests. Treatment of the Hp infection in our patient using antibiotics led to the regression of both lesions. This is the first case report on the regression of a pharyngeal MALT lymphoma after Hp eradication.
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The principles of specifying diagnosis of malignant pharyngeal tumors
International Nuclear Information System (INIS)
Savyin, O.O.
1998-01-01
The conclusion about pharyngeal tumor was based on additional shadow of the tumor in one or several departments, thickening of the folds, narrowing of the lumen, deformity or absence of the lumen of the pyriform sinus and morgan's ventricles. ACT allowed to evaluate objectively not only localization, size, shape and structure of the growth, but also the state of the surrounding tissue (including the changes in the cartilage). ACT with 'e' sound pronunciation allowed to reveal the changes in the vocal cords which are not revealed by plain x-ray tomography
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International Nuclear Information System (INIS)
Poppele, G.
1980-01-01
In a study on the epidemiology of laryngeal and pharyngeal tumours, a coincidence was found between established alcohol abuse and tumours of the two organs. The results of surgery followed by gammatron radiotherapy (laryngeal tumours) or betatron therapy (pharyngeal tumours) are prescuted and discussed. (APR) [de
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Directory of Open Access Journals (Sweden)
R. M. Banakhevich
2014-06-01
Full Text Available Aim. 44 women with recurrent genital prolapse of the posterior segment of the vagina were examined and treated. Results of different types of synthetic implants were evaluated. Methods and results. 26 patients underwent transvaginal mesh with implant. In 18 patients implant Prolift posterior™ was used. The paper presents the features of the application and possible complications of the use of synthetic implants to correct the fascial defects of the posterior vaginal wall. Intraoperative bleeding after Prolift posterior™ installing were observed in 5.6 % of patients, that was lower than in the control group –7,7% (p<0,05. Extensive subcutaneous hematoma was observed in 88,7% of patients after installation of the Prolift posterior™, in the comparison group – in 15,4% of patients. Wounding anterior rectal wall was observed only in 1 (5,6% case when Prolift posterior™was installed. Conclusion. The analysis of the causes of postoperative complications and their prevention methods proposed. Recurrence after surgery with the use of synthetic materials in the operated segment was not observed.
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Directory of Open Access Journals (Sweden)
Swedin Linda
2012-05-01
Full Text Available Abstract Background Single-walled carbon nanotubes (SWCNT trigger pronounced inflammation and fibrosis in the lungs of mice following administration via pharyngeal aspiration or inhalation. Human exposure to SWCNT in an occupational setting may occur in conjunction with infections and this could yield enhanced or suppressed responses to the offending agent. Here, we studied whether the sequential exposure to SWCNT via pharyngeal aspiration and infection of mice with the ubiquitous intracellular parasite Toxoplasma gondii would impact on the immune response of the host against the parasite. Methods C57BL/6 mice were pre-exposed by pharyngeal administration of SWCNT (80 + 80 μg/mouse for two consecutive days followed by intravenous injection with either 1x103 or 1x104 green fluorescence protein and luciferase-expressing T. gondii tachyzoites. The dissemination of T. gondii was monitored by in vivo bioluminescence imaging in real time for 7 days and by plaque formation. The inflammatory response was analysed in bronchoalveolar lavage (BAL fluid, and by assessment of morphological changes and immune responses in lung and spleen. Results There were no differences in parasite distribution between mice only inoculated with T. gondii or those mice pre-exposed for 2 days to SWCNT before parasite inoculum. Lung and spleen histology and inflammation markers in BAL fluid reflected the effects of SWCNT exposure and T. gondii injection, respectively. We also noted that CD11c positive dendritic cells but not F4/80 positive macrophages retained SWCNT in the lungs 9 days after pharyngeal aspiration. However, co-localization of T. gondii with CD11c or F4/80 positive cells could not be observed in lungs or spleen. Pre-exposure to SWCNT did not affect the splenocyte response to T. gondii. Conclusions Taken together, our data indicate that pre-exposure to SWCNT does not enhance or suppress the early immune response to T. gondii in mice.
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Energy Technology Data Exchange (ETDEWEB)
Kim, Bom Sahn; Lee, Won Woo; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Kim, Sang Eun [College of Medicine, Seoul National University, Seoul (Korea, Republic of)
2004-07-01
LV parameters (LVEF. ESVI and EDVI) on adenosine stress/rest thallium-201 gated myocardial SPECT (gSPECT) are various from stress to rest. We investigated the reason why they were various in patients without coronary artery disease. Seventy-one patients(M:F=32:39, age 58.1{+-}9.7yrs), who underwent gSPECT and coronary angiography (CAG) due to chest pain or preoperative evaluation were included. CAG results were normal or insignificant. Exclusion criteria were atrial fibrillation, thyroid disease, primary cardiomyopathy, myocardial bridge, LBBB, MI, and valvular heart disease. Patients were calssified into 3 groups by EF difference ({delta}EF=rest-stress EF) on gSPECT : group1 ({delta}EF{>=}10), group2 (0 {<=}{delta}EF<10), and group3 ({delta}EF<0). LV parameters on gSPECT and thicknesses of IVS (interventricular septum) and LVPW (left ventricular posterior wall) on echocardiography were compared among the 3 groups. Myocardial perfusion status were normal or mild reversible/persistent perfusion defect in 76.1% (54/71). LVEFs at stress were not different among all 3 groups : 59.3{+-}8.54% in group 1 (61.3{+-}10.22% in group 2 and 64.8{+-}7.58% in group 3 (p>0.05). But LVEF at rest was smaller in group 3 (58.7{+-}8.38%) than the other groups (72.5{+-}8.77% in group1 and 66.7{+-}10.6% in group2) (p<0.01). EDVIs and ESVI at stress were larger than those at rest in all groups (p<0.05) except ESVI in group 3 (16.2{+-}6.21ml at stress and 17.5{+-}6.41ml at rest, p<0.01), and that was attributed to EF<0 in group 3. In echocardiographical analysis, group 3 had significantly increased wall thickness of LVPW (10.7{+-}1.2mm versus 9.4{+-}1.6mm, p=0.01) and decreased wall thickness ratio of IVS/LVPW (0.963{+-}0.102 versus 1.048{+-}0.104, p=0.035) than group 1. In patients without coronary artery disease, LVEF, EDVI and ESVI on gSPECT were various and decline of LVEF from stress to rest was caused by unnormalized ESVI . Asymmetrically thickened LVPW may play a crucial role and
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Jiao, Hongmei; Mei, Ling; Sharma, Tarun; Kern, Mark; Sanvanson, Patrick
2016-01-01
Oropharyngeal dysphagia due to upper esophageal sphincter (UES) dysfunction is commonly encountered in the clinical setting. Selective experimental perturbation of various components of the deglutitive apparatus can provide an opportunity to improve our understanding of the swallowing physiology and pathophysiology. The aim is to characterize the pharyngeal and UES deglutitive pressure phenomena in an experimentally induced restriction of UES opening in humans. We studied 14 volunteers without any dysphagic symptoms (7 men, 66 ± 11 yr) but with various supraesophageal reflux symptoms. To induce UES restriction, we used a handmade device that with adjustment could selectively apply 0, 20, 30, or 40 mmHg pressure perpendicularly to the cricoid cartilage. Deglutitive pharyngeal and UES pressure phenomena were determined during dry and 5- and 10-ml water swallows × 3 for each of the UES perturbations. External cricoid pressure against the UES resulted in a significant increase in hypopharyngeal intrabolus pressure and UES nadir deglutitive relaxation pressure for all tested swallowed volumes (P < 0.05). Application of external cricoid pressure increased the length of the UES high pressure zone from 2.5 ± 0.2 to 3.1 ± 0.2, 3.5 ± 0.1, and 3.7 ± 0.1 cm for 20, 30, and 40 mmHg cricoid pressure, respectively (P < 0.05). External cricoid pressure had no significant effect on pharyngeal peristalsis. On the other hand, irrespective of external cricoid pressure deglutitive velopharyngeal contractile integral progressively increased with increased swallowed volumes (P < 0.05). In conclusion, acute experimental restriction of UES opening by external cricoid pressure manifests the pressure characteristics of increased resistance to UES transsphincteric flow observed clinically without affecting the pharyngeal peristaltic contractile function. PMID:27198193
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Tubbs, R Shane; Griessenauer, Christoph J; Hendrix, Philipp; Oakes, Peter; Loukas, Marios; Chern, Joshua J; Rozzelle, Curtis J; Oakes, W Jerry
2015-07-01
The pathophysiology underlying Chiari I malformations (CIMs) provides room for debate with several theories attempting to address this issue. We retrospectively reviewed many of our past patients with pediatric CIMs (specifically, those with peri-odontoid pannus), and present a hypothesis for the development of the malformation in some of said patients. Our experience with the pediatric CIM has shown that almost 1 in 20 patients who present with symptoms is found to have a peri-odontoid pannus. These masses ranged in size from 4 to 11 mm in diameter. Forty percent had a history of clinically significant pharyngitis or pharyngeal abscess. Pannus formation around the dens (odontoid) resulted in ventral compression of the craniocervical junction in each of these patients. Highlighting the hypermobility that causes such lesions, following fusion, the pannus and symptoms in several patients were diminished. Impairment of normal cerebrospinal fluid circulation out of the fourth ventricle and across the craniocervical junction appears to be a plausible endpoint in this discussion and a suitable explanation for some patients with CIM. Still, the mechanisms by which cerebrospinal fluid circulation is compromised may be variable and are not well understood. This is the first study dedicated to the evaluation of pannus formation in the CIM population. We hypothesize that pharyngeal inflammatory conditions contribute to the formation and progression of hindbrain herniation in a small subset of patients with CIMs. © 2015 Wiley Periodicals, Inc.
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Directory of Open Access Journals (Sweden)
Kumara V. Nibhanipudi MD
2015-08-01
Full Text Available Objective: A study to compare the usage of throat swab testing for leukocyte esterase on a test strip(urine dip stick-multi stick to rapid strep test for rapid diagnosis of Group A Beta hemolytic streptococci in cases of acute pharyngitis in children. Hypothesis: The testing of throat swab for leukocyte esterase on test strip currently used for urine testing may be used to detect throat infection and might be as useful as rapid strep. Methods: All patients who come with a complaint of sore throat and fever were examined clinically for erythema of pharynx, tonsils and also for any exudates. Informed consent was obtained from the parents and assent from the subjects. 3 swabs were taken from pharyngo-tonsillar region, testing for culture, rapid strep & Leukocyte Esterase. Results: Total number is 100. Cultures 9(+; for rapid strep== 84(- and16 (+; For LE== 80(- and 20(+ Statistics: From data configuration Rapid Strep versus LE test don’t seem to be a random (independent assignment but extremely aligned. The Statistical results show rapid and LE show very agreeable results. Calculated Value of Chi Squared Exceeds Tabulated under 1 Degree Of Freedom (P<.0.0001 reject Null Hypothesis and Conclude Alternative Conclusions: Leukocyte esterase on throat swab is as useful as rapid strep test for rapid diagnosis of strep pharyngitis on test strip currently used for urine dip stick causing acute pharyngitis in children.
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Zenker's Diverticulum: Diagnostic Approach and Surgical Management
Directory of Open Access Journals (Sweden)
Carlos M. Nuño-Guzmán
2014-11-01
Full Text Available Zenker's diverticulum (ZD, also known as cricopharyngeal, pharyngoesophageal or hypopharyngeal diverticulum, is a rare condition characterized by an acquired outpouching of the mucosal and submucosal layers originating from the pharyngoesophageal junction. This false and pulsion diverticulum occurs dorsally at the pharyngoesophageal wall between the inferior pharyngeal constrictor and the cricopharyngeus muscle. The pathophysiology of ZD involves altered compliance of the cricopharyngeus muscle and raised intrabolus pressure. Decreased compliance of the upper esophageal sphincter and failure to open completely for effective bolus clearance both lead to an increase in the hypopharyngeal pressure gradient. Different open surgical techniques and transoral endoscopic approaches have been described for the management of ZD, although there is no consensus about the best option. We report the case of a 61-year-old patient with a 7-year history of dysphagia and odynophagia for solid food, which after 2 months progressed to dysphagia for liquids and after 4 months to regurgitation 2-6 h after meals. The patient experienced a 12-kg weight loss. Diagnosis was established by esophagogram, which showed a diverticulum through the posterior pharyngeal wall, suggestive of a ZD. Esophagogastroduodenoscopy showed a pouch with erythematous mucosa. Under general anesthesia, diverticulectomy and myotomy were performed. After an uneventful recovery and adequate oral intake, the patient remains free of symptoms at 4 months of follow-up.
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Prevalence of Beta-Hemolytic Streptococci Groups A, C, and G in Patients with Acute Pharyngitis
Directory of Open Access Journals (Sweden)
Trupti B Naik
2016-01-01
Conclusions: Although rate of pharyngitis associated with GCS and GGS is marginally lower than GAS, their carriage rate among healthy and relative higher drug resistance emphasizes the need for periodic surveillance of infection by the different serogroups of BHS.
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Remote effects of intermittent theta burst stimulation of the human pharyngeal motor system.
Mistry, Satish; Michou, Emilia; Rothwell, John; Hamdy, Shaheen
2012-08-01
Intermittent theta burst stimulation (iTBS) is a novel, non-invasive form of brain stimulation capable of facilitating excitability of the human primary motor cortex with therapeutic potential in the treatment of neurological conditions, such as multiple sclerosis. The objectives of this study were to evaluate the effects of iTBS on cortical properties in the human pharyngeal motor system. Transcranial magnetic stimulation (TMS)-evoked pharyngeal motor responses were recorded via a swallowed intra-luminal catheter and used to assess motor cortical pathways to the pharynx in both hemispheres before and for up to 90 min after iTBS in 15 healthy adults (nine male/six female, 22-59 years old). Active/sham iTBS comprised 600 intermittent repetitive TMS pulses, delivered in a double-blind pseudo-randomised order over each hemisphere on separate days at least 1 week apart. Abductor pollicis brevis (APB) recordings were used as control. Hemispheric interventional data were compared with sham using repeated-measures anova. iTBS was delivered at an average intensity of 43±1% of stimulator output. Compared with sham, iTBS to the hemisphere with stronger pharyngeal projections induced increased responses only in the contralateral weaker projection 60-90 min post-iTBS (maximum 54±19%, P≤0.007), with no change in stronger hemisphere responses. By contrast, iTBS to weaker projections had no significant effects (P=0.39) on either hemisphere. APB responses similarly did not change significantly (P=0.78) across all study arms. We conclude that iTBS can induce remote changes in corticobulbar excitability. While further studies will clarify the extent of these changes, iTBS holds promise as a potential treatment for dysphagia after unilateral brain damage. © 2012 The Authors. European Journal of Neuroscience © 2012 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.
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Kang, Moo Sung; Kim, Kyung Hyun; Park, Jeong Yoon; Kuh, Sung Uk; Chin, Dong Kyu; Jin, Byung Ho; Kim, Keun Su; Cho, Yong Eun
2017-06-01
To describe our experience in treating esophageal and pharyngeal perforation after anterior cervical spine surgery. Six patients with esophageal injury and one patient with pharyngeal injury after anterior cervical spinal surgery, managed at our department between 2000 and 2015, were analyzed retrospectively. During the study period, 7 patients (6 male and 1 female; mean age, 45 years) presented with esophageal perforation. The original anterior cervical spinal surgery was performed due to trauma in 2 patients and because of a degenerative cervical disorder in 5. Early esophageal perforation was diagnosed in 2 patients, and delayed esophageal injury due to chronic irritation with the cervical implants was noted in 5. Three of the five delayed perforation cases were related to cervical instrument displacement. Two patients showed no definite signs of infection, whereas 5 patients had various symptoms, including fever, neck pain, odynophagia, neck swelling, and upper extremity weakness. Two patients with a large defect underwent surgical repair and three with minimal perforation due to chronic irritation from the implants underwent instrument removal without direct repair of defect. Two asymptomatic patients received no intervention. Six patients with infection completely recovered from esophageal injury after treatment for a mean duration of 5.2 weeks (range, 4-8 weeks). One patient died because of postoperative pneumonia and sepsis after implant removal. Esophageal and pharyngeal injury after cervical spinal surgery may occur either directly due to spinal trauma and vigorous intraoperative retraction or due to chronic irritation with cervical implants. In cases of perforation associated with infection, various surgical modalities, including primary closure and reinforcement with a flap, could be considered depending on factors such as esophageal defect size, infection severity, and timing of recognition of injury. Copyright © 2017 Elsevier Inc. All rights reserved.
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Directory of Open Access Journals (Sweden)
Ping-Ho Chen
2014-01-01
Full Text Available Betel quid (BQ and areca nut (AN (major BQ ingredient are group I human carcinogens illustrated by International Agency for Research on Cancer and are closely associated with an elevated risk of oral potentially malignant disorders (OPMDs and cancers of the oral cavity and pharynx. The primary alkaloid of AN, arecoline, can be metabolized via the monoamine oxidase (MAO gene by inducing reactive oxygen species (ROS. The aim of this study was to investigate whether the variants of the susceptible candidate MAO genes are associated with OPMDs and oral and pharyngeal cancer. A significant trend of MAO-A mRNA expression was found in in vitro studies. Using paired human tissues, we confirmed the significantly decreased expression of MAO-A and MAO-B in cancerous tissues when compared with adjacent noncancerous tissues. Moreover, we determined that MAO-A single nucleotide polymorphism variants are significantly linked with oral and pharyngeal cancer patients in comparison to OPMDs patients [rs5953210 risk G-allele, odds ratio = 1.76; 95% confidence interval = 1.02-3.01]. In conclusion, we suggested that susceptible MAO family variants associated with oral and pharyngeal cancer may be implicated in the modulation of MAO gene activity associated with ROS.
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Chen, Ping-Ho; Huang, Bin; Shieh, Tien-Yu; Wang, Yan-Hsiung; Chen, Yuk-Kwan; Wu, Ju-Hui; Huang, Jhen-Hao; Chen, Chun-Chia; Lee, Ka-Wo
2014-01-01
Betel quid (BQ) and areca nut (AN) (major BQ ingredient) are group I human carcinogens illustrated by International Agency for Research on Cancer and are closely associated with an elevated risk of oral potentially malignant disorders (OPMDs) and cancers of the oral cavity and pharynx. The primary alkaloid of AN, arecoline, can be metabolized via the monoamine oxidase (MAO) gene by inducing reactive oxygen species (ROS). The aim of this study was to investigate whether the variants of the susceptible candidate MAO genes are associated with OPMDs and oral and pharyngeal cancer. A significant trend of MAO-A mRNA expression was found in in vitro studies. Using paired human tissues, we confirmed the significantly decreased expression of MAO-A and MAO-B in cancerous tissues when compared with adjacent noncancerous tissues. Moreover, we determined that MAO-A single nucleotide polymorphism variants are significantly linked with oral and pharyngeal cancer patients in comparison to OPMDs patients [rs5953210 risk G-allele, odds ratio = 1.76; 95% confidence interval = 1.02-3.01]. In conclusion, we suggested that susceptible MAO family variants associated with oral and pharyngeal cancer may be implicated in the modulation of MAO gene activity associated with ROS.
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Krzemień, Grażyna; Szmigielska, Agnieszka; Wawer, Zofia; Roszkowska-Blaim, Maria
2013-01-01
The incidence of posterior urethral valves is estimated to be from 3:1000 to 8:1000 and this is one of the most common causes of obstruction of urinary tract in boys. About 13-17% of children with posterior urethral valves develop end stage renal failure. We present a 6-month-old boy with late diagnosis of posterior urtehral valves. Antenatal ultrasound investigation of the urinary tract was normal. A small degree of oligohydramnios was found during delivery. At the age of six months the boy was admitted to hospital because of urinary tract infection, hypertension (130/90 mmHg) and acute kidney injury (urea - 46 mg/dL, creatinine - 1.1 mg/dL, GFR - 35.5 mL/min/1.73 m2 ). Bilateral hydronephrosis and megaureters, low-capacity bladder with hypertrophied wall were seen on ultrasound examination. Voiding cystourethrograhy revealed vesicoureteral refluxes (III/V), hypertrophy of the bladder wall with numerous diverticula and dilated posterior urethra. During urethroscopy urethral valves were resected. Increased intravesical pressure (leak point up to 305 cm H2 O) was found on urodynamic test. Renal scintigraphy (99mTc-EC) revealed decreased intake of isotope in the left kidney (5%), and the right kidney intake was 95% ERPF. The patient was qualified for left-sided nephrectomy, which was postponed because of high leak point and high risk of worsening of vesicoureteral reflux to right kidney after nephrectomy. Anticholinergic and α-blocker treatment was started. At the age of 11 months left-side nephrectomy was performed because of recurrent urinary tract infections. After 3.5-year follow-up blood pressure, physical development, kidney function tests, and urinalysis are normal. Additionally to this investigation the significance of early diagnosis including prenatal (PUV) for further development as well as further therapeutic procedure is discussed.
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Lung and pharyngeal abscess caused by enterotoxin G- and I-producing Staphylococcus aureus.
Barnett, S Y; Hattotuwa, K L; Teare, L
2012-05-01
We report a particularly serious case of extensive meticillin sensitive Staphylococcal lung and pharyngeal abscess. Our patient had no significant risk factors for severe infection. The detection of enterotoxin G and I here suggest that when present together, these toxins work synergistically to produce a more virulent strain of Staphylococcus aureus. Copyright © 2011. Published by Elsevier Ltd.
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Acute myocarditis with normal wall motion detected with 2D speckle tracking echocardiography
Directory of Open Access Journals (Sweden)
Thomas Sturmberger
2016-05-01
Full Text Available We present the case of a 26-year-old male with acute tonsillitis who was referred for coronary angiography because of chest pain, elevated cardiac biomarkers, and biphasic T waves. The patient had no cardiovascular risk factors. Echocardiography showed no wall motion abnormalities and no pericardial effusion. 2D speckle tracking revealed distinct decreased regional peak longitudinal systolic strain in the lateral and posterior walls. Ischemic disease was extremely unlikely in view of his young age, negative family history regarding coronary artery disease, and lack of regional wall motion abnormalities on the conventional 2D echocardiogram. Coronary angiography was deferred as myocarditis was suspected. To confirm the diagnosis, cardiac magnetic resonance tomography (MRT was performed, showing subepicardial delayed hyperenhancement in the lateral and posterior walls correlating closely with the strain pattern obtained by 2D speckle tracking echocardiography. With a working diagnosis of acute myocarditis associated with acute tonsillitis, we prescribed antibiotics and nonsteroidal anti-inflammatory drugs. The patient’s clinical signs resolved along with normalization of serum creatine kinase (CK levels, and the patient was discharged on the third day after admission. Learning points: • Acute myocarditis can mimic acute coronary syndromes. • Conventional 2D echocardiography lacks specific features for detection of subtle regional wall motion abnormalities. • 2D speckle tracking expands the scope of echocardiography in identifying myocardial dysfunction derived from edema in acute myocarditis.
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Chen, Hao; Jia, Pu; Bao, Li; Feng, Fei; Yang, He; Li, Jin-Jun; Tang, Hai
2015-12-05
The cross-section of thoracolumbar vertebral body is kidney-shaped with depressed posterior boundary. The anterior wall of the vertebral canal is separated from the posterior wall of the vertebral body on the lateral X-ray image. This study was designed to determine the sagittal distance between the anterior border of the vertebral canal and the posterior border of the vertebral body (DBCV) and to analyze the potential role of DBCV in the estimation of cement leakage during percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). We retrospectively recruited 233 patients who had osteoporotic vertebral compression fractures and were treated with PVP or PKP. Computed tomography images of T11-L2 normal vertebrae were measured to obtain DBCV. The distance from cement to the posterior wall of the vertebral body (DCPW) of thoracolumbar vertebrae was measured from C-arm images. The selected vertebrae were divided into two groups according to DCPW, with the fracture levels, fracture grades and leakage rates of the two groups compared. A relative operating characteristic (ROC) curve was applied to determine whether the DCPW difference can be used to estimate the degree of cement leakage. The data were processed by statistical software SPSS version 21.0 using independent sample t-test and Chi-square tests. The maximum DBCV was 6.40 mm and the average DBCV was 3.74 ± 0.95 mm. DBCV appeared to be longer in males than in females, but the difference was not statistically significant. The average DCPW of type-B leakage vertebrae (2.59 ± 1.20 mm) was shorter than that of other vertebrae (7.83 ± 2.38 mm, P 6.40 mm for type-C and type-S, but much higher for type-B. ROC curve revealed that DCPW only has a predictive value for type-B leakage (area under the curve: 0.98, 95% confidence interval: 0.95-0.99, P DBCV on C-arm images for safety during PVP or PKP.
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Chow, Eric Pf; Howden, Benjamin P; Walker, Sandra; Lee, David; Bradshaw, Catriona S; Chen, Marcus Y; Snow, Anthony; Cook, Stuart; Fehler, Glenda; Fairley, Christopher K
2017-03-01
Gonorrhoea is increasing among men who have sex with men (MSM). We aimed to determine whether Listerine, a commercial mouthwash product, has an inhibitory effect against Neisseria gonorrhoeae in a randomised controlled trial (RCT) and an in vitro study, and therefore may be a potentially useful agent for gonorrhoea control. In vitro: a suspension of ∼10 8 colony forming units per mL (CFU/mL) of N. gonorrhoeae was added to a serial of dilutions (up to 1:32) of alcohol-containing Listerine mouthwashes (Cool Mint and Total Care) for 1 min. A 10 µL aliquot was spread over the surface of a gonococcal agar plate and the number of N. gonorrhoeae colonies present at each dilution was calculated. The phosphate buffered saline (PBS) was used as a control. RCT: we recruited MSM with pharyngeal gonorrhoea who returned for treatment at the Melbourne Sexual Health Centre between May 2015 and February 2016. Untreated men were randomised to rinse and gargle either Listerine Cool Mint or saline for 1 min. Pharyngeal swabs were taken before and after rinsing and gargling for culture of N. gonorrhoeae . The analysis included only men who were culture positive for N. gonorrhoeae before using the allocated solution on the day of recruitment. In vitro: Listerine mouthwashes at dilutions of up to 1:4 for 1 min resulted in significant reduction of total N. gonorrhoeae counts but PBS has no inhibitory effect against N. gonorrhoeae . RCT: a total of 196 MSM were recruited, 58 (30%) were culture positive before using the solution. After gargling the allocated solution, men in the Listerine group were significantly less likely to be culture positive on the pharyngeal surface (52%) compared with men in the saline group (84%) (p=0.013). This data suggest Listerine, significantly reduces the amount of N. gonorrhoeae on the pharyngeal surface. With daily use it may increase gonococcal clearance and have important implications for prevention strategies. ACTRN12615000716561. Published by
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Adams, Spencer; Lin, Jie; Brown, Derek; Shriver, Craig D; Zhu, Kangmin
2016-01-01
Based on the hypothesis that ultraviolet radiation (UVR) exposure can cause DNA damage that may activate dormant viruses such as human papilloma virus, a recent ecological study, which estimated state-level UVR exposure, reported positive correlations between annual UVR exposure and the incidence of oral, pharyngeal, and cervical cancer in 16 U.S. states using the International Agency for Research on Cancer (IARC) data. The purpose of the current study was to further investigate whether the annual UVR level, estimated on a county level, is associated with incidence rates of such cancers using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) 18 data. If UVR exposure is associated with incidence of these cancer types, we would expect to see a similar or stronger association with melanoma because UVR exposure is a well-demonstrated risk factor for this disease. Thus, we also included melanoma in the study. The study subjects were White and Black individuals with oral, pharyngeal, cervical cancer or melanoma diagnosed between 1973 and 2011 from the SEER 18 data. UVR was estimated at the county level and grouped into high-, medium- and low-exposure levels. Age-adjusted incidence rates of cancer were calculated and compared among the UVR exposure groups. The comparisons were also stratified by sex and race. There was an inverse association between UVR exposure and incidence of oral, pharyngeal, and cervical cancer. The inverse association was also observed for melanoma. When stratified by race and sex, the inverse associations remained except for melanoma among Blacks. In contrast to a previous study, our study found that there were inverse associations between UVR exposure and the incidence of oral, pharyngeal, and cervical cancer, as well as of melanoma. Our findings are in agreement with several other published studies reporting no positive correlation between UVR exposure and the incidence rates of oral, pharyngeal, and cervical
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International Nuclear Information System (INIS)
Seo, J.H.; Ahn, B.C.; Bae, J.H.; Jeong, S.Y.; Lee, J.; Lee, K.B.
2004-01-01
Objective: Although gated SPECT(G-SPECT) using Tc-99m MIBI is well-known diagnostic modality in the evaluation of myocardial perfusion and wall motion analysis, there were limited reports for subjects with asymmetric septal hypertrophy (ASH). This study was performed to evaluate the clinical usefulness of G-SPECT for assessments of myocardial perfusion and wall motion analysis in patients with ASH on 2D-echocardiography(Echo). Methods: Thirty patients (male 18, 59 12 years) with ASH on Echo (septal wall thickness 13 mm and 1.3 times as thick as that of posterior wall) underwent Tc-99m MIBI G-SPECT. Two studies were performed within one month. No patient had experienced any significant cardiac event, nor had changed medical and surgical therapy during the studies. Functional parameters of the left ventricle were acquired with QGS software(AutoQUANTTM). Three experts performed visual interpretation for the presence of septal thickening and perfusion abnormalities on G-SPECT and two experienced cardiologists measured dimension, thickness and wall motion of the left ventricle on Echo. Results: Mean septum thickness measured by Echo was 1.90 0.50 cm, and the septum/posterior wall thickness ratio was 1.85 0.51. On visual SPECT analysis, 14 patients (46.7%) were interpreted as with thickened septum and 17 patients (57%) as with abnormal perfusion. All 3 patients who underwent coronary angiography showed significant luminal stenosis and also had perfusion abnormalities on SPECT. On Echo, only one patient showed septal hypokinesia, who showed anteroseptal infarction on SPECT, and the others showed normal septal wall motion. But 13 patients (54%) among 24 patients showed septal hypokinesia on G-SPECT. Patients with thickened septum on SPECT had thicker septum (2.3 vs 1.6 cm) and higher septum/posterior wall thickness ratio (2.2 vs 1.6) on Echo, compared with patients without septal thickening on SPECT. Conclusions: Although G-SPECT could proffer diagnostic accuracy for
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Flank pseudohernia following posterior rib fracture: a case report.
Butensky, Adam M; Gruss, Leah P; Gleit, Zachary L
2016-10-01
A pseudohernia is an abdominal wall bulge that may be mistaken for a hernia but that lacks the disruption of the abdominal wall that characterizes a hernia. Thus, the natural history and treatment of this condition differ from those of a hernia. This is the first report of a pseudohernia due to cough-associated rib fracture. A case of pseudohernia due to fractures of the 10 th and 11 th ribs in a 68-year-old white woman is presented. The patient suffered from a major coughing episode 1 year prior to her presentation, after which she noted a progressively enlarging bulge in her left flank. Computed tomography demonstrated a bulge in the abdominal wall containing bowel and spleen but with all muscle and fascial layers intact; in addition, lateral 10 th rib and posterior 11 th rib fractures were noted. As there was no defect in muscle or fascia, we diagnosed a pseudohernia, likely due to a denervation injury from the fractured ribs. Symptomatic treatment was recommended, including wearing a corset and referral to a pain management clinic. Symptomatic treatment is thought to be the mainstay of therapy for pseudohernias, as surgical intervention is unlikely to be of benefit.
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Posterior microphthalmos pigmentary retinopathy syndrome.
Pehere, Niranjan; Jalali, Subhadra; Deshmukh, Himanshu; Kannabiran, Chitra
2011-04-01
Posterior Microphthalmos Pigmentary Retinopathy Syndrome (PMPRS). Posterior microphthalmos (PM) is a relatively infrequent type of microphthalmos where posterior segment is predominantly affected with normal anterior segment measurements. Herein, we report two siblings with posterior microphthalmos retinopathy syndrome with postulated autosomal recessive mode of inheritance. A 13-year-old child had PM and retinitis pigmentosa (RP) and his 7-year-old sister had PM, RP, and foveoschisis. The genetics of this syndrome and variable phenotype is discussed. Importance of being aware of posterior microphthalmos and its posterior segment associations is highlighted.
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Normal anatomy of the anal wall and perianal spaces: An EUS, MRI and cadaveric correlative study
International Nuclear Information System (INIS)
Chung, Soo Young; Ryu, Sie Tae; Park, Ki Soon; Lee, Yul; Bae, Sang Hoon; Kang, Heung Sik
1994-01-01
To understand the normal endosonographic anatomy of the perianal spaces, and to evaluate the diagnostic efficacy and limitation of endorectal sonography(EUS), correlative study with MRI, cadaveric sectional image and cadaveric MRI were performed. EUS images of the normal 6 perianal spaces (pelvirectal, ischiorectal, intersphincteric, subcutaneous, central, submucous space) which were bounded by internal and external anal sphincters, rectal wall and levator ani muscle were correlated with MRI in 10 normal persons, cadaveric sectional images and cadaveric MRI in 2 cadavers. Pelvirectal space located superior to levator ani muscle could be demonstrable only on anterior wall scan but could not be visualized on lateral or posterior wall scan on EUS. Five perianal spaces located inferior to levator ani muscle were well seen on anterior, lateral, and posterior wall EUS. MRI was superior to EUS in the evaluation of pelvirectal and ischiorectal spaces but equal or inferior to EUS in the evaluation of intersphincteric, subcutaneous, central and submucous spaces. EUS was valuable in the evaluation of perianal spaces inferior to levator ani muscle but was limited in the evaluation of perianal spaces superior to levator ani muscle
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Nie, Xuguang; Brown, Christopher B.; Wang, Qin; Jiao, Kai
2011-01-01
Maldevelopment of outflow tract and aortic arch arteries is among the most common forms of human congenital heart diseases. Both Bmp4 and Tbx1 are known to play critical roles during cardiovascular development. Expression of these two genes partially overlaps in pharyngeal arch areas in mouse embryos. In this study, we applied a conditional gene inactivation approach to test the hypothesis that Bmp4 expressed from the Tbx1 expression domain plays a critical role for normal development of outflow tract and pharyngeal arch arteries. We showed that inactivation of Bmp4 from Tbx1-expressing cells leads to the spectrum of deformities resembling the cardiovascular defects observed in human DiGeorge syndrome patients. Inactivation of Bmp4 from the Tbx1 expression domain did not cause patterning defects, but affected remodeling of outflow tract and pharyngeal arch arteries. Our further examination revealed that Bmp4 is required for normal recruitment/differentiation of smooth muscle cells surrounding the PAA4 and survival of outflow tract cushion mesenchymal cells. PMID:21123999
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Directory of Open Access Journals (Sweden)
Marcos Soares Campos
2008-12-01
Full Text Available A retocele é uma projeção sacular anormal da parede retal, de etiologia multifatorial e uma causa muito significativa de sintomas anorretais como plenitude retal, sensação de peso anal durante a defecação, evacuação incompleta e dor retoanal. Muito tem se discutido sobre retoceles em mulheres, mas poucas publicações têm mencionado a presença de retocele em pacientes do sexo masculino e somente um artigo discute os detalhes da retocele em homens com distúrbios de defecação. A retocele posterior em homens, em especial, é uma disfunção incomum e possivelmente apresenta como causas a constipação intestinal, o esforço evacuatório longo e excessivo, a síndrome do descenso perineal, a fraqueza do assoalho pélvico e a contração paradoxal do músculo puborretal. É apresentado o caso de um paciente com história de dor anorretal crônica e defecação obstruída associadas à retocele posterior, doença hemorroidária, prolapso e intussuscepção retal.Rectocele is an abnormal sac-like projection of the rectum wall with multiple etiologies and an important cause of anorectal symptoms like rectoanal weight sensation during evacuation, incomplete evacuation and anorectal pain. Many reports have discussed rectoceles in women, but few have mentioned rectoceles in male patients and only one report has discussed the details of rectoceles in men with defecation disorders. Posterior rectocele in men, in particular, is an unusual disturb and possible causes are intestinal constipation, long and excessive straining, descending perineum syndrome, weakness of the pelvic floor and puborectalis muscle syndrome. We report a case of a male patient with chronic anorectal pain and outlet obstruction associated with posterior rectocele, hemorrhoidal disease, rectal mucous prolapse and intussusception.
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Craniofacial and pharyngeal airway morphology in patients with acromegaly.
Balos Tuncer, Burcu; Canigur Bavbek, Nehir; Ozkan, Cigdem; Tuncer, Cumhur; Eroglu Altinova, Alev; Gungor, Kahraman; Akturk, Mujde; Balos Toruner, Fusun
2015-08-01
The aim of this study was to assess differences in craniofacial characteristics, upper spine and pharyngeal airway morphology in patients with acromegaly compared with healthy individuals. Twenty-one patients with acromegaly were compared with 22 controls by linear and angular measurements on cephalograms. The differences between the mean values of cephalometric parameters were analyzed with Mann-Whitney U-test. With respect to controls, anterior (pacromegaly. Craniofacial changes were predominantly found in the frontal bone (pacromegaly exhibited diminished dimensions at nasal (pacromegaly. Current results point to the importance of the reduced airway dimensions and that dentists and/or orthodontists should be aware of the cranial or dental abnormalities in patients with acromegaly.
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Posterior fossa epidural hematoma
International Nuclear Information System (INIS)
Kushner, M.J.; Luken, M.G. III
1983-01-01
CT demonstrated posterior fossa epidural hematoma in three patients with head trauma in whom this diagnosis was not clinically apparent. No patient was in stupor or coma and no patient experienced a lucid interval. Only one patient had signs referable to the posterior fossa. Two patients had occipital skull fracture disclosed by plain radiographs. CT revealed a unilateral biconvex hematoma in two cases, and a bilateral hematoma with supratentorial extension in the third. All patients underwent suboccipital craniectomy and recovered. Therapeutic success in these cases was facilitated by early CT and the rapid disclosure of the unsuspected posterior fossa lesions. CT showing contiguous hematoma below and above the tentorium cerebelli after posterior head trauma is highly suggestive of epidural hematoma arising from the posterior fossa. (orig.)
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Ahmed, Intezar; Kureel, Shiv Narain; Chandra, Naveen
2010-01-01
Reverse (posterior) cloaca is itself a rare entity and association of this defect with other congenital syndromes or defects is extremely rare to find. To diagnose this unique anomaly one should be aware about this very infrequently encountered clinical entity. Reverse cloaca is a very rare variant of anorectal malformation in which urethra and vagina fused to form a urogenital sinus that diverts posteriorly and opens in the anterior rectal wall at the anus or immediately anterior to it. We report a neonate with the rare clinical entity of reverse cloaca type C, pseudophallus with rudimentary urethra as a component of female pseudohermaphrodism and congenital rectal stenosis. Surprisingly, there was no associated urological abnormality on ultrasonography and laparotomy. PMID:22797480
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Irreducible Traumatic Posterior Shoulder Dislocation
Directory of Open Access Journals (Sweden)
Blake Collier
2017-01-01
Full Text Available History of present illness: A 22-year-old male presented to the Emergency Department complaining of right shoulder pain after a motocross accident. He was traveling at approximately 10 mph around a turn when he lost control and was thrown over the handlebars, landing directly on his right shoulder. On arrival, he was holding his arm in adduction and internal rotation. An area of swelling was noted over his anterior shoulder. He was unable to abduct his shoulder. No humeral gapping was noted. He had normal neuro-vascular status distal to the injury. Significant findings: Radiographs demonstrated posterior displacement of the humeral head on the “Y” view (see white arrow and widening of the glenohumeral joint space on anterior-posterior view (see red arrow. The findings were consistent with posterior dislocation and a Hill-Sachs type deformity. Sedation was performed and reduction was attempted using external rotation, traction counter-traction. An immediate “pop” was felt during the procedure. Post-procedure radiographs revealed a persistent posterior subluxation with interlocking at posterior glenoid. CT revealed posterior dislocation with acute depressed impaction deformity medial to the biceps groove with the humeral head perched on the posterior glenoid, interlocked at reverse Hill-Sachs deformity (see blue arrow. Discussion: Posterior shoulder dislocations are rare and represent only 2% of all shoulder dislocations. Posterior shoulder dislocations are missed on initial diagnosis in more than 60% of cases.1 Posterior shoulder dislocations result from axial loading of the adducted and internally rotated shoulder, violent muscle contractions (resulting from seizures or electrocution, a direct posterior force applied to the anterior shoulder.1 Physical findings include decreased anterior prominence of the humeral head, increased palpable posterior prominence of the humeral head below the acromion, increased palpable prominence of the
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DEFF Research Database (Denmark)
Lajer, C B; Nielsen, F C; Friis-Hansen, L
2011-01-01
MicroRNAs (miRNAs) are small non-coding RNAs, which regulate mRNA translation/decay, and may serve as biomarkers. We characterised the expression of miRNAs in clinically sampled oral and pharyngeal squamous cell carcinoma (OSCC and PSCC) and described the influence of human papilloma virus (HPV)....
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Gandedkar, Narayan H; Chng, Chai Kiat; Basheer, Mohammad Abdul; Chen, Por Yong; Yeow, Vincent Kok Leng
2017-09-01
To evaluate the pharyngeal airway space changes in complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) individuals, and compare with age and sex-matched noncleft (NC) control subjects. Retrospective study. Cleft and Craniofacial Centre, KK Women's and Children's Hospital, Singapore. Twenty UCLP (mean age: 13.4 ± 0.5 years), 18 BCLP (mean age: 13.5 ± 0.5 years) and 20 skeletal Class I subjects (mean age: 13.4 ± 0.6 years) were included in the study. Cone beam computed tomography scans were assessed for pharyngeal airway space (PAS) (oropharyngeal, nasopharyngeal, total airway space volume), and compared with PAS of age and sex-matched skeletal Class I NC individuals. Pharyngeal airway space showed statistically significant differences in the UCLP, BCLP, and NC control subjects. Oropharyngeal (9338 ± 1108 mm 3 , P space (12 250 ± 1185 mm 3 , P .05). The pharyngeal airway space was significantly reduced in the BCLP group than were those in UCLP and control groups. This reduced PAS should be taken into account when planning treatment for these individuals.
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The oesophagus and cough: laryngo-pharyngeal reflux, microaspiration and vagal reflexes
2013-01-01
Gastro-oesophageal reflux disease is generally considered to be one of the commonest causes of chronic cough, however randomised controlled trials of proton pump inhibitors have often failed to support this notion. This article reviews the most recent studies investigating the mechanisms thought to link reflux and cough, namely laryngo-pharyngeal reflux, micro-aspiration and neuronal cross-organ sensitisation. How recent evidence might shed light on the failure of acid suppressing therapies and suggest new approaches to treating reflux related cough are also discussed. PMID:23590893
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Cabib, C; Ortega, O; Vilardell, N; Mundet, L; Clavé, P; Rofes, L
2017-11-01
The role of afferent sensory pathways in the pathophysiology of post-stroke oropharyngeal dysphagia is not known. We hypothesized that patients with chronic post-stroke dysphagia (PSD) would show impaired sensory cortical activation in the ipsilesional hemisphere. We studied 28 chronic unilateral post-stroke patients [17 PSD and 11 post-stroke non-dysphagic patients (PSnD)] and 11 age-matched healthy volunteers. Event-related sensory-evoked potentials to pharyngeal stimulation (pSEP) and sensory thresholds were assessed. We analyzed pSEP peak latency and amplitude (N1, P1, N2 and P2), and neurotopographic stroke characteristics from brain magnetic resonance imaging. Healthy volunteers presented a highly symmetric bihemispheric cortical pattern of brain activation at centroparietal areas (N1-P1 and N2-P2) to pharyngeal stimuli. In contrast, an asymmetric pattern of reduced ipsilesional activation was found in PSD (N2-P2; P = 0.026) but not in PSnD. PSD presented impaired safety of swallow (penetration-aspiration score: 4.3 ± 1.6), delayed laryngeal vestibule closure (360.0 ± 70.0 ms) and higher National Institute of Health Stroke Scale (7.0 ± 6.2 vs. 1.9 ± 1.4, P = 0.001) and Fazekas scores (3.0 ± 1.4 vs. 2.0 ± 1.1; P dysphagia is associated with stroke severity and degree of leukoaraoisis. Impaired conduction and cortical integration of pharyngeal sensory inputs at stroke site are key features of chronic PSD. These findings highlight the role of sensory pathways in the pathophysiology of post-stroke oropharyngeal dysphagia and offer a potential target for future treatments. © 2017 EAN.
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Kohl, F
1998-09-01
Since the introduction of the modern psychiatric diagnosis systems anxiety disorders have been intensively discussed. As clinical subtypes in panic disorder the cardial type and the vestibular type are widely accepted. We describe in a case report another of these subtypes, the pharyngeal type; it is characterised by symptoms that are related to the pharynx such as feeling a lump in the throat, swallow disturbance or pain in the pharynx region. It may therefore be called "throat-anxiety syndrome" or "phagophobia". Nosological implications are also discussed.
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Tazraei, Pedram; Riasi, Alireza; Takabi, Behrouz
2015-06-01
This work investigates a two dimensional numerical analysis of blood hammer through the posterior cerebral artery. The non-Newtonian and usual Newtonian blood models are compared in the case of blood hammer through the posterior cerebral artery to quantify the differences between the models. In this way, a validated CFD simulation is used to study non-Newtonian shear-thinning effects of blood. The governing equations for the modeling of two-dimensional transient flow are solved using a combination of characteristics and central finite difference methods, respectively for the hyperbolic and parabolic parts. Herein, the non-Newtonian viscosity characteristic of blood is incorporated by using the Carreau model. To convert the nonlinear terms available in the characteristics equation into the linear ones, the Newton-Kantorovich method is implemented. The verification and validation of the numerical results are carried out in detail. Hemodynamic characteristics of blood hammer through the posterior cerebral artery are derived with both the Newtonian and non-Newtonian models, and the results are meticulously compared and discussed. The results show that when blood hammer occurs, the non-Newtonian properties greatly influence the velocity and shear stress profiles. At the early stages of blood hammer, there is a 64% difference between magnitudes of wall shear stress in these two models, and the magnitude of the wall shear stress for the shear-thinning blood flow is lower than the Newtonian one. Copyright © 2015 Elsevier Inc. All rights reserved.
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Aural-pharyngeal polyps associated with Cryptosporidium infection in three iguanas (Iguana iguana).
Uhl, E W; Jacobson, E; Bartick, T E; Micinilio, J; Schimdt, R
2001-03-01
Cryptosporidium spp. infection was associated with aural-pharyngeal polyps in three iguanas (Iguana iguana). All iguanas were presented for masses protruding from the ear canal, and the disease was characterized by a chronic clinical course. The masses consisted of nests of cystic glands surrounded by abundant fibrous connective tissue and lined by hyperplastic cuboidal to pseudostratified columnar epithelium that was moderately to heavily colonized by cryptosporidial organisms. Electron microscopy revealed that the majority of organisms were trophozoites.
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Isolation of Streptococcus pyogenes from children with pharyngitis and emm type analysis
Directory of Open Access Journals (Sweden)
Azar D. Khosravi
2016-05-01
Conclusion: The result of the present study showed that penicillin and erythromycin are still the most effective antibiotics against the organism. The emm typing revealed that emm type-3 was detected in most of the isolates from patients with purulent pharyngitis. On the basis of the findings of this study, we may conclude that emm typing provides new insights on the genetic diversity of the M proteins, and is of demonstrable value for molecular studies of GAS.
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Directory of Open Access Journals (Sweden)
Di Pierro F
2016-11-01
Full Text Available Francesco Di Pierro,1 Alberto Zanvit,2 Maria Colombo3 1Scientific Department, Velleja Research, 2Biological Dentistry Department, Italian Stomatology Institute, 3ATS, District 5, Milan, Italy Abstract: Antipyretics and/or anti-inflammatory drugs along with a wait-and-see approach are the only treatments recommended in early acute otitis media (AOM or viral pharyngitis. Propolis has been widely investigated for its antibacterial, antiviral, and anti-inflammatory properties and could perhaps be administered as an add-on therapy during watchful waiting in AOM or for better control of symptoms in nonstreptococcal pharyngitis. However, propolis has well-known problems of poor solubility and low oral bioavailability. We therefore analyzed a proprietary propolis-based product (Propolisina® developed to overcome these limitations, in a retrospective, open-label, controlled study of Streptococcus pyogenes-negative children with a diagnosis of AOM or pharyngitis. Our results show that the use of propolis supplement for 72 hours lessens the severity of AOM and viral pharyngitis, reduces the use of antipyretics and anti-inflammatory drugs, and decreases the rate of evolution to tracheitis, bronchitis, and rhinosinusitis. Our study shows that propolis could be used as a safe add-on therapy in case of AOM and/or viral pharyngitis. Keywords: pediatric infections, cogrinding, bioavailability, propolis
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Hamasuna, Ryoichi; Takahashi, Satoshi; Uehara, Shinya; Matsumoto, Tetsuro
2012-06-01
Detection of Neisseria gonorrhoeae (NG) or Chlamydia trachomatis (CT) from the pharynx of women or men is not uncommon. However, there is no recommendation how urologists should care for the pharyngeal infection of men with urethritis in Japan. The aim of this study is to clarify the prevalence of NG or CT infection in the pharynx of men and to show a recommendation for urologists. The Japanese reports about the detection of NG or CT from the pharynx or the oral cavity of men in Japan are reviewed in the literature from 1990 to 2011. The prevalence of NG or CT in the pharynx was 4% or 6% in men who attended clinics, and 20% or 6% in men who were positive for NG or CT from genital specimens, respectively. Single 1-g dose ceftriaxone was recommended to treat pharyngeal NG, but no evidence was found for pharyngeal CT. There was not enough evidence for recommendation. However, when men with urethritis only caused by NG or CT are treated through the guideline of the Japanese Society of Sexually Transmitted Infection, we do not think additional tests or treatment for the pharynx are needed when a single 1-g dose ceftriaxone for gonococcal urethritis or a single 1- or 2- g dose azithromycin is prescribed for chlamydial urethritis in Japan.
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The Soft Palate Friendly Speech Bulb for Velopharyngeal Insufficiency.
Kahlon, Sukhdeep Singh; Kahlon, Monaliza; Gupta, Shilpa; Dhingra, Parvinder Singh
2016-09-01
Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of untreated bilateral cleft lip and palate associated with palatal insufficiency treated by means of palate friendly innovative speech bulb. This modified speech bulb is a combination of hard acrylic and soft lining material. The hard self-curing acrylic resin covers only the hard palate area and a permanent soft silicone lining material covering the soft palate area. A claw-shaped wire component was extended backwards from acrylic and was embedded in soft silicone to aid in retention and approximation of two materials. The advantage of adding the soft lining material in posterior area helped in covering the adequate superior extension and margins for maximal pharyngeal activity. This also improved the hypernasality, speech, comfort and overall patient acceptance.
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Directory of Open Access Journals (Sweden)
Caleb H. Creswell
2017-01-01
Full Text Available Foreign body ingestion occurs in not only children but also adults, particularly those with history of neurologic disease, alcohol use, or psychiatric disease. We present the case of a 40-year-old male with schizophrenia who presented to the emergency room with a long history of pharyngeal foreign body sensation which had recently progressed to include trismus, odynophagia, and dyspnea. Flexible laryngoscopy demonstrated fullness of the right posterior pharyngeal wall and computed tomography (CT showed a linear opaque foreign body extending from the level of the oropharynx to the thyroid ala. Further history elicited that he stabbed himself in the pharynx two years prior with a toothbrush following a command hallucination. The toothbrush was removed uneventfully via an external approach. The patient was discharged with psychiatry follow-up. This case is unusual due to the submucosal location of the foreign body and the length of retention. It demonstrates the atypical nature which patients with comorbid psychiatric illness may present following foreign body injury and the use of an external surgical approach for the removal of a retained foreign body based on CT reconstruction.
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Cine-MRI swallowing evaluation after tongue reconstruction
Energy Technology Data Exchange (ETDEWEB)
Hartl, Dana M. [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)], E-mail: dmhartl@aol.com; Kolb, Frederic; Bretagne, Evelyne [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Bidault, Francois; Sigal, Robert [Department of Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)
2010-01-15
Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.
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Cine-MRI swallowing evaluation after tongue reconstruction
International Nuclear Information System (INIS)
Hartl, Dana M.; Kolb, Frederic; Bretagne, Evelyne; Bidault, Francois; Sigal, Robert
2010-01-01
Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.
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Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance
International Nuclear Information System (INIS)
Stensby, J.D.; Baker, Jonathan C.; Fox, Michael G.
2016-01-01
The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries. (orig.)
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Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance
Energy Technology Data Exchange (ETDEWEB)
Stensby, J.D. [University of Virginia, Department of Radiology and Medical Imaging, 1218 Lee Street, Box 800170, Charlottesville, VA (United States); Mallinckrodt Institute of Radiology, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO (United States); Baker, Jonathan C. [Mallinckrodt Institute of Radiology, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO (United States); Fox, Michael G. [University of Virginia, Department of Radiology and Medical Imaging, 1218 Lee Street, Box 800170, Charlottesville, VA (United States)
2016-02-15
The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries. (orig.)
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Directory of Open Access Journals (Sweden)
Seyed Ziaeddin Rasihashemi
2017-09-01
Full Text Available Various surgical approaches may be employed for esophageal resection. Major airway injuries due to transhiatal esophagectomy include vertical tears in the membranous trachea. Tracheal injury is an uncommon but potentially fatal complication. This article describes the technique to repair the posterior membranous tracheal tear, extended just over the carina through a transcervical–transsternal approach, thereby avoiding a second thoracotomy. Six patients with posterior membranous tracheal injury underwent this procedure. The laceration ranged from 3 cm to 5 cm in length. Four patients had received neoadjuvant chemoradiation. The management of tracheal laceration added approximately 60 minutes to the total operation time. There was no mortality related to tracheal injury. Patients were followed up for 6 months after surgery, and both posterior tracheal wall and transverse tracheotomy remained intact without stenosis. The transcervical–transsternal approach decreases the need of thoracotomy and its complications in patients with tracheal laceration in any stage, even in cases of an extended tear down to the carina.
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Nie, Xuguang; Wang, Qin; Jiao, Kai
2014-01-01
MicroRNAs (miRNAs) play important roles in regulating gene expression during numerous biological/pathological processes. Dicer encodes an RNase III endonuclease that is essential for generating most, if not all, functional miRNAs. In this work, we applied a conditional gene inactivation approach to examine the function of Dicer during neural crest cell (NCC) development. Mice with NCC-specific inactivation of Dicer died perinatally. Cranial and cardiac NCC migration into target tissues was not affected by Dicer disruption, but their subsequent development was disturbed. NCC derivatives and their associated mesoderm-derived cells displayed massive apoptosis, leading to severe abnormalities during craniofacial morphogenesis and organogenesis. In addition, the 4th pharyngeal arch artery (PAA) remodeling was affected, resulting in interrupted aortic arch artery type B (IAA-B) in mutant animals. Taken together, our results show that Dicer activity in NCCs is essential for craniofacial development and pharyngeal arch artery morphogenesis. PMID:21256960
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Classification of posterior vitreous detachment
Kakehashi, Akihiro; Takezawa, Mikiko; Akiba, Jun
2014-01-01
Diagnosing a posterior vitreous detachment (PVD) is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography (OCT). By biomicroscopy, the vitreous condition is determined based on the presence or absence of a PVD. The PVD then is classified as either a complete posterior vitreous detachment (C-PVD) or a partial posterior vitreous detachment (P-PVD). A C-PVD is further divided into a C-PVD with collapse and a C-PVD without collapse, while a P-PVD is divided into a P-PVD with shrinkage of the posterior hyaloid membrane (P-PVD with shrinkage) and a P-PVD without shrinkage of the posterior hyaloid membrane (P-PVD without shrinkage). A P-PVD without shrinkage has a subtype characterized by vitreous gel attachment through the premacular hole in a posterior hyaloid membrane to the macula (P-PVD without shrinkage [M]). By OCT, a shallow PVD is classified as the absence of a shallow PVD or as a shallow PVD. A shallow PVD is then subclassified as a shallow PVD without shrinkage of the posterior vitreous cortex, a shallow PVD with shrinkage of the posterior vitreous cortex, and a peripheral shallow PVD. A shallow PVD without shrinkage of the posterior vitreous cortex has two subtypes: an age-related shallow PVD and a perifoveal PVD associated with a macular hole. PMID:24376338
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Streptococcal pharyngitis and rheumatic heart disease: the superantigen hypothesis revisited.
Hurst, Jacklyn R; Kasper, Katherine J; Sule, Akshay N; McCormick, John K
2018-07-01
Streptococcus pyogenes is a human-specific and globally prominent bacterial pathogen that despite causing numerous human infections, this bacterium is normally found in an asymptomatic carrier state. This review provides an overview of both bacterial and human factors that likely play an important role in nasopharyngeal colonization and pharyngitis, as well as the development of acute rheumatic fever and rheumatic heart disease. Here we highlight a recently described role for bacterial superantigens in promoting acute nasopharyngeal infection, and discuss how these immune system activating toxins could be crucial to initiate the autoimmune process in rheumatic heart disease. Copyright © 2018. Published by Elsevier B.V.
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Late-onset Alzheimer disease genetic variants in posterior cortical atrophy and posterior AD.
Carrasquillo, Minerva M; Khan, Qurat ul Ain; Murray, Melissa E; Krishnan, Siddharth; Aakre, Jeremiah; Pankratz, V Shane; Nguyen, Thuy; Ma, Li; Bisceglio, Gina; Petersen, Ronald C; Younkin, Steven G; Dickson, Dennis W; Boeve, Bradley F; Graff-Radford, Neill R; Ertekin-Taner, Nilüfer
2014-04-22
To investigate association of genetic risk factors for late-onset Alzheimer disease (LOAD) with risk of posterior cortical atrophy (PCA), a syndrome of visual impairment with predominant Alzheimer disease (AD) pathology in posterior cortical regions, and with risk of "posterior AD" neuropathology. We assessed 81 participants with PCA diagnosed clinically and 54 with neuropathologic diagnosis of posterior AD vs 2,523 controls for association with 11 significant single nucleotide polymorphisms (SNPs) from published LOAD risk genome-wide association studies. There was highly significant association with APOE ε4 and increased risk of PCA (p = 0.0003, odds ratio [OR] = 3.17) and posterior AD (p = 1.11 × 10(-17), OR = 6.43). No other locus was significant after corrections for multiple testing, although rs11136000 near CLU (p = 0.019, OR = 0.60) and rs744373 near BIN1 (p = 0.025, OR = 1. 63) associated nominally significantly with posterior AD, and rs3851179 at the PICALM locus had significant association with PCA (p = 0.0003, OR = 2.84). ABCA7 locus SNP rs3764650, which was also tested under the recessive model because of Hardy-Weinberg disequilibrium, also had nominally significant association with PCA risk. The direction of association at APOE, CLU, and BIN1 loci was the same for participants with PCA and posterior AD. The effects for all SNPs, except rs3851179, were consistent with those for LOAD risk. We identified a significant effect for APOE and nominate CLU, BIN1, and ABCA7 as additional risk loci for PCA and posterior AD. Our findings suggest that at least some of the genetic risk factors for LOAD are shared with these atypical conditions and provide effect-size estimates for their future genetic studies.
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Park, Won Young; Lee, Tae Hee; Ham, Nam Seok; Park, Ji Woong; Lee, Yang Gyun; Cho, Sang Jin; Lee, Joon Seong; Hong, Su Jin; Jeon, Seong Ran; Kim, Hyun Gun; Cho, Joo Young; Kim, Jin Oh; Cho, Jun Hyung; Lee, Ji Sung
2015-09-23
Currently, the videofluoroscopic swallowing study (VFSS) is the standard tool for evaluating dysphagia. We evaluated whether the addition of endoscopist-directed flexible endoscopic evaluation of swallowing (FEES) to VFSS could improve the detection rates of penetration, aspiration, and pharyngeal residue, compared the diagnostic efficacy between VFSS and endoscopist-directed FEES and assessed the adverse events of the FEES. In single tertiary referral center, a retrospective analysis of prospectively collected data was conducted. Fifty consecutive patients suspected of oropharyngeal dysphagia were enrolled in this study between January 2012 and July 2012. The agreement in the detection of penetration and aspiration between VFSS and FEES of viscous food (κ=0.34; 95% confidence interval [CI], 0.15 to 0.53) and liquid food (κ=0.22; 95% CI, 0.02 to 0.42) was "fair." The agreement in the detection of pharyngeal residue between the two tests was "substantial" with viscous food (κ=0.63; 95% CI, 0.41 to 0.94) and "fair" with liquid food (κ=0.37; 95% CI, 0.10 to 0.63). Adding FEES to VFSS significantly increased the detection rates of penetration, aspiration, and pharyngeal residue. No severe adverse events were noted during FEES, except for two cases of epistaxis, which stopped spontaneously without requiring any packing. This study demonstrated that the addition of endoscopist-directed FEES to VFSS increased the detection rates of penetration, aspiration, and pharyngeal residue.
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Comfort, Thomas; Baste, Valborg; Froufe, Miquel Angel; Namba, Robert; Bordini, Barbara; Robertsson, Otto; Cafri, Guy; Paxton, Elizabeth; Sedrakyan, Art; Graves, Stephen
2014-12-17
Differences in survivorship of non-posterior-stabilized compared with posterior-stabilized knee designs carry substantial economic consequences, especially with limited health-care resources. However, these comparisons have often been made between relatively small groups of patients, often with short-term follow-up, with only small differences demonstrated between the groups. The goal of this study is to compare the outcomes of non-posterior-stabilized and posterior-stabilized total knee arthroplasties with use of a unique collaboration of multiple established knee arthroplasty registries. A distributed health data network was developed by the International Consortium of Orthopaedic Registries and was used in this study to reduce barriers to participation (such as security, propriety, legal, and privacy issues) compared with a centralized data warehouse approach. The study included only replacements in osteoarthritis patients who underwent total knee procedures involving fixed-bearing devices from 2001 to 2010. The outcome of interest was time to first revision. On average, not resurfacing showed a more harmful effect than resurfacing did when posterior-stabilized and non-posterior-stabilized knee replacements were compared, while the risk of revision for posterior-stabilized compared with non-posterior-stabilized knees was highest in year zero to one, followed by year one to two, years eight through ten, and years two through eight. Posterior-stabilized knees did significantly worse than non-posterior-stabilized knees did when the patella was not resurfaced. This difference was most pronounced in the first two years (year zero to one: hazard ratio [HR] = 2.15, 95% confidence interval [CI] = 1.56 to 2.95, p < 0.001; year one to two: HR = 1.61, 95% CI = 1.48 to 1.75, p < 0.001). When the patella was resurfaced, posterior-stabilized knees did significantly worse than non-posterior-stabilized knees did. This was again most pronounced in the first two years (year zero
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Pearl, R M; Kaplan, E N
1976-04-01
Linear and angular cephalometric measurements of children who had had combined palatal pushbacks and superiorly-based pharyngeal flaps do not show later growth retardation of the face. There was an inherent tendency for children with overt clefts of the secondary palate, classic submucous clefts, or occult submucous clefts to demonstrate pre-operatively a narrow SNA and SNB--but the difference between these angles (ANB) was normal.
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New clinical staging for pharyngeal surgery in obstructive sleep apnea patients.
Vidigal, Tatiana Aguiar; Haddad, Fernanda Louise Martinho; Cabral, Rafael Ferreira Pacheco; Oliveira, Maria Claudia Soares; Cavalcante, Ricardo Rodrigues; Bittencourt, Lia Rita Azeredo; Tufik, Sergio; Gregório, Luis Carlos
2014-01-01
The success of pharyngeal surgery in the treatment of obstructive sleep apnea syndrome depends on the appropriate selection of patients. To propose a new staging for indication of pharyngeal surgery in obstructive sleep apnea syndrome. A total of 54 patients undergoing extended tonsillectomy were retrospectively included, divided into six stages. Stage I: patients with palatine tonsils grade 3/4 and modified Mallampati index 1/2; stage II: palatine tonsils 3/4 and modified Mallampati index 3/4; stage III: palatine tonsils 1/2 and modified Mallampati index 1/2; stage IV: palatine tonsils 1/2 and modified Mallampati index 3/4; stage V: body mass index ≥40 kg/m(2) with palatine tonsils 3/4 and modified Mallampati index 1, 2, 3, or 4. Stage VI: body mass index ≥40 with palatine tonsils 1/2 and modified Mallampati index 1, 2, 3, or 4. The surgical success rates were 88.9%, 75.0%, 35.7%, 38.5%, and 100.0% in stages I-V. The presence of hypertrophic palatine tonsils was the anatomical factor in common in the most successful stages (I, II, and V), regardless of body mass index. Although the modified Mallampati index classes 3 and 4 reduced the success rate of surgery in patients with hypertrophic tonsils (stage II), the presence of modified Mallampati index classes 1 and 2 did not favor surgical success in patients with normal tonsils (stage III). Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
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International Nuclear Information System (INIS)
Dutsch-Wicherek, Magdalena; Tomaszewska, Romana; Lazar, Agata; Wicherek, Lukasz; Skladzien, Jacek
2009-01-01
The purpose of this study has been to establish the level of RCAS1 – a membrane protein expressed in various cancer cells and able to induce apoptosis of CTLs and NK cells in pharyngeal and laryngeal cancer and its clear surgical margin – with respect to clinicopathological features and to patient's follow up and evaluate its possible role in cancer relapse. A total of 122 tissue samples were obtained: 51 samples from laryngeal and pharyngeal squamous cell carcinoma, 51 samples from the clear surgical margins of these tumors, and 20 tissue samples derived from the healthy mucous membranes of the upper respiratory tract mucosa of patients without cancerous tumors. Patients were observed for a total of 4 years following surgical treatment. The level of RCAS1 expression was assessed by immunohistochemistry and Western blot. RCAS1 was identified in all laryngeal and pharyngeal carcinomas and in almost all the clear surgical margin samples. The level of RCAS1 expression was significantly higher in the cancerous samples than in the clear surgical margins and was determined to be related to the grade of the cancer and the presence of lymph node metastases. In cases of cancer relapse, significantly higher levels of RCAS1 expression were observed in the clear surgical margins. Selective cytotoxic immune cell suppression concomitant with tumor growth and associated with RCAS1 expression seems to be an important event connected with cancer relapse
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Gürsoy, M H; Gedikoğlu, G; Tanyel, F C
1999-03-01
The authors present a 2-year-old boy with a skin defect located in the right lateral side of the neck. They suggest the defect is a partial failure of disappearance of the second pharyngeal (branchial) cleft and propose a name of lateral cervical cleft.
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Posterior capsule opacification.
Wormstone, I Michael; Wang, Lixin; Liu, Christopher S C
2009-02-01
Posterior Capsule Opacification (PCO) is the most common complication of cataract surgery. At present the only means of treating cataract is by surgical intervention, and this initially restores high visual quality. Unfortunately, PCO develops in a significant proportion of patients to such an extent that a secondary loss of vision occurs. A modern cataract operation generates a capsular bag, which comprises a proportion of the anterior and the entire posterior capsule. The bag remains in situ, partitions the aqueous and vitreous humours, and in the majority of cases, houses an intraocular lens. The production of a capsular bag following surgery permits a free passage of light along the visual axis through the transparent intraocular lens and thin acellular posterior capsule. However, on the remaining anterior capsule, lens epithelial cells stubbornly reside despite enduring the rigours of surgical trauma. This resilient group of cells then begin to re-colonise the denuded regions of the anterior capsule, encroach onto the intraocular lens surface, occupy regions of the outer anterior capsule and most importantly of all begin to colonise the previously cell-free posterior capsule. Cells continue to divide, begin to cover the posterior capsule and can ultimately encroach on the visual axis resulting in changes to the matrix and cell organization that can give rise to light scatter. This review will describe the biological mechanisms driving PCO progression and discuss the influence of IOL design, surgical techniques and putative drug therapies in regulating the rate and severity of PCO.
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Labidi, Moujahed; Watanabe, Kentaro; Loit, Marie-Pier; Hanakita, Shunya; Froelich, Sébastien
2018-02-01
Objectives To discuss the use of the posterior petrosal approach for the resection of a retrochiasmatic craniopharyngioma. Design Operative video. Results In this case video, the authors discuss the surgical management of a large craniopharyngioma, presenting with mass effect on the third ventricle and optic apparatus. A first surgical stage, through an endoscopic endonasal transtubercular approach, allowed satisfactory decompression of the optic chiasma and nerves in preparation for adjuvant therapy. However, accelerated growth of the tumor, with renewed visual deficits and mass effect on the hypothalamus and third ventricle, warranted a supplementary resection. A posterior transpetrosal 1 2 (also called "retrolabyrinthine transtentorial") was performed to obtain a better exposure of the tumor and the surrounding anatomy (floor and walls of the third ventricle, perforating vessels, optic nerves, etc.) 3 . Nuances of technique and surgical pearls related to the posterior transpetrosal are discussed and illustrated in this operative video, including the posterior mobilization of the transverse-sigmoid sinuses junction, preservation of the venous anatomy during the tentorial incision, identification and preservation of the floor of the third ventricle during tumor resection, and a careful multilayer closure. Conclusion Retrochiasmatic craniopharyngiomas are difficult to reach tumors that often require skull base approaches, either endoscopic endonasal or transcranial. The posterior transpetrosal approach is an important part of the surgical armamentarium to safely resect these complex tumors. The link to the video can be found at: https://youtu.be/2MyGLJ_v1kI .
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Varela-Centelles, P; Loira-Gago, M; Seoane-Romero, J M; Takkouche, B; Monteiro, L; Seoane, J
2015-11-01
A systematic search of MEDLINE, Embase, and Proceedings Web of Science was undertaken to assess the prevalence of the posterior superior alveolar artery (PSAA) in the lateral sinus wall in sinus lift patients, as identified using computed tomography (CT)/cone beam computed tomography (CBCT). For inclusion, the article had to report PSAA detection in the bony wall using CT and/or CBCT in patients with subsinus edentulism. Studies on post-mortem findings, mixed samples (living and cadaveric), those presenting pooled results only, or studies performed for a sinus pathology were excluded. Heterogeneity was checked using an adapted version of the DerSimonian and Laird Q test, and quantified by calculating the proportion of the total variance due to between-study variance (Ri statistic). Eight hundred and eleven single papers were reviewed and filtered according to the inclusion/exclusion criteria. Ten studies were selected (1647 patients and 2740 maxillary sinuses (study unit)). The pooled prevalence of PSAA was 62.02 (95% confidence interval (CI) 46.33-77.71). CBCT studies detected PSAA more frequently (78.12, 95% CI 61.25-94.98) than CT studies (51.19, 95% CI 42.33-60.05). Conventional CT revealed thicker arteries than CBCT. It is concluded that PSAA detection is more frequent when CBCT explorations are used. Additional comparative studies controlling for potential confounding factors are needed to ascertain the actual diagnostic value of radiographic explorations for assessing the PSAA prior to sinus floor elevation procedures. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
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Pearson, William G; Davidoff, Alisa A; Smith, Zachary M; Adams, Dorothy E; Langmore, Susan E
2016-02-28
To determine swallowing outcomes and hyolaryngeal mechanics associated with post radiation therapy head and neck cancer (rtHNC) patients using videofluoroscopic swallow studies. In this retrospective cohort study, videofluoroscopic images of rtHNC patients (n = 21) were compared with age and gender matched controls (n = 21). Penetration-aspiration of the bolus and bolus residue were measured as swallowing outcome variables. Timing and displacement measurements of the anterior and posterior muscular slings elevating the hyolaryngeal complex were acquired. Coordinate data of anatomical landmarks mapping the action of the anterior muscles (suprahyoid muscles) and posterior muscles (long pharyngeal muscles) were used to calculate the distance measurements, and slice numbers were used to calculate time intervals. Canonical variate analysis with post-hoc discriminant function analysis was performed on coordinate data to determine multivariate mechanics of swallowing associated with treatment. Pharyngeal constriction ratio (PCR) was also measured to determine if weak pharyngeal constriction is associated with post radiation therapy. The rtHNC group was characterized by poor swallowing outcomes compared to the control group in regards to: Penetration-aspiration scale (P time of displacement was abbreviated (P = 0.002) and distance of excursion was reduced (P = 0.02) in the rtHNC group. A canonical variate analysis shows a significant reduction in pharyngeal mechanics in the rtHNC group (P clearance. Using videofluoroscopy, this study shows rtHNC patients have worse swallowing outcomes associated with reduced hyolaryngeal mechanics and pharyngeal constriction compared with controls.
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Lei, Jianyin; Dong, Pengfei; Li, Zhiqiang; Zhu, Feng; Wang, Zhihua; Cai, Xianhua
2017-05-01
The aim of this study was to evaluate the biomechanical properties of common fixation systems for complex acetabular fractures. A finite element (FE) pelvic model with anterior column and posterior hemi-transverse acetabular fractures was created. Three common fixation systems were used to fix the posterior wall acetabular fractures: 1. Anterior column plate combined with posterior column screws (group I), 2. Anterior column plate combined with quadrilateral area screws (group II) and 3. Double-column plates (group III). And 600 N, representing the body weight, was loaded on the upper surface of the sacrum to simulate the double-limb stance. The amounts of total and relative displacements were compared between the groups. The total amount of displacement was 2.76 mm in group II, 2.81 mm in group III, and 2.83 mm in group I. The amount of relative displacement was 0.0078 mm in group II, 0.0093 mm in group III and 0.014 mm in group I. Our results suggested that all fixation systems enhance biomechanical stability significantly. Anterior column plate combined with quadrilateral area screws has quite comparable results to double column plates, they were superior to anterior column plate combined with posterior screws. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.
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International Nuclear Information System (INIS)
Kos, Sebastian; Bilecen, Deniz; Baumhoer, Daniel; Guillaume, Nicolas; Jacob, Augustinus L.
2010-01-01
A 72-year-old man was referred to our department with an incidentally diagnosed bronchogenic carcinoma of the right upper lobe. Positron emission tomography (PET) combined with computed tomography (PET-CT) revealed an unexpected hot spot in the ventral wall of the infrarenal segment of the inferior vena cava (IVC). Diagnostic biopsy of this lesion was performed under CT guidance with semiautomated 20G fine-needle aspiration (FNA) through a 19G coaxial needle. Cytology revealed few carcinoma cells, which led to the remarkable diagnosis of a distant metastasis to the IVC wall. Both the immediate postinterventional CT control and the further surveillance period of the patient were unremarkable; in particular, no signs of bleeding complications were detected. We conclude that coaxial FNA of an IVC wall lesion is technically feasible and may even help diagnose distant metastasis.
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International Nuclear Information System (INIS)
Pacurari, M.; Qian, Y.; Porter, D.W.; Wolfarth, M.; Wan, Y.; Luo, D.; Ding, M.; Castranova, V.; Guo, N.L.
2011-01-01
Due to the fibrous shape and durability of multi-walled carbon nanotubes (MWCNT), concerns regarding their potential for producing environmental and human health risks, including carcinogenesis, have been raised. This study sought to investigate how previously identified lung cancer prognostic biomarkers and the related cancer signaling pathways are affected in the mouse lung following pharyngeal aspiration of well-dispersed MWCNT. A total of 63 identified lung cancer prognostic biomarker genes and major signaling biomarker genes were analyzed in mouse lungs (n = 80) exposed to 0, 10, 20, 40, or 80 μg of MWCNT by pharyngeal aspiration at 7 and 56 days post-exposure using quantitative PCR assays. At 7 and 56 days post-exposure, a set of 7 genes and a set of 11 genes, respectively, showed differential expression in the lungs of mice exposed to MWCNT vs. the control group. Additionally, these significant genes could separate the control group from the treated group over the time series in a hierarchical gene clustering analysis. Furthermore, 4 genes from these two sets of significant genes, coiled-coil domain containing-99 (Ccdc99), muscle segment homeobox gene-2 (Msx2), nitric oxide synthase-2 (Nos2), and wingless-type inhibitory factor-1 (Wif1), showed significant mRNA expression perturbations at both time points. It was also found that the expression changes of these 4 overlapping genes at 7 days post-exposure were attenuated at 56 days post-exposure. Ingenuity Pathway Analysis (IPA) found that several carcinogenic-related signaling pathways and carcinogenesis itself were associated with both the 7 and 11 gene signatures. Taken together, this study identifies that MWCNT exposure affects a subset of lung cancer biomarkers in mouse lungs. - Research highlights: → Multi-Walled Carbon Nanotubes affect lung cancer biomarkers in mouse lungs. → The results suggest potentially harmful effects of MWCNT exposure on human lungs. → The results could potentially be used
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Directory of Open Access Journals (Sweden)
Steve J. Hodges
2009-01-01
Full Text Available The most common cause of lower urinary tract obstruction in male infants is posterior urethral valves. Although the incidence has remained stable, the neonatal mortality for this disorder has improved due to early diagnosis and intensive neonatal care, thanks in part to the widespread use of prenatal ultrasound evaluations. In fact, the most common reason for the diagnosis of posterior urethral valves presently is the evaluation of infants for prenatal hydronephrosis. Since these children are often diagnosed early, the urethral obstruction can be alleviated rapidly through catheter insertion and eventual surgery, and their metabolic derangements can be normalized without delay, avoiding preventable infant mortality. Of the children that survive, however, early diagnosis has not had much effect on their long-term prognosis, as 30% still develop renal insufficiency before adolescence. A better understanding of the exact cause of the congenital obstruction of the male posterior urethra, prevention of postnatal bladder and renal injury, and the development of safe methods to treat urethral obstruction prenatally (and thereby avoiding the bladder and renal damage due to obstructive uropathy are the goals for the care of children with posterior urethral valves[1].
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Lv, Nan; Wang, Chi; Karmonik, Christof; Fang, Yibin; Xu, Jinyu; Yu, Ying; Cao, Wei; Liu, Jianmin; Huang, Qinghai
2016-01-01
The conflicting findings of previous morphological and hemodynamic studies on intracranial aneurysm rupture may be caused by the relatively small sample sizes and the variation in location of the patient-specific aneurysm models. We aimed to determine the discriminators for aneurysm rupture status by focusing on only posterior communicating artery (PCoA) aneurysms. In 129 PCoA aneurysms (85 ruptured, 44 unruptured), clinical, morphological and hemodynamic characteristics were compared between the ruptured and unruptured cases. Multivariate logistic regression analysis was performed to determine the discriminators for rupture status of PCoA aneurysms. While univariate analyses showed that the size of aneurysm dome, aspect ratio (AR), size ratio (SR), dome-to-neck ratio (DN), inflow angle (IA), normalized wall shear stress (NWSS) and percentage of low wall shear stress area (LSA) were significantly associated with PCoA aneurysm rupture status. With multivariate analyses, significance was only retained for higher IA (OR = 1.539, p PCoA aneurysms.
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Directory of Open Access Journals (Sweden)
Paula Cristina Cola
2010-03-01
Full Text Available CONTEXT: The effect of sour taste and food temperature variations in dysphagic patients has not been entirely clarified. OBJECTIVE: To determine the effect of sour and cold food in the pharyngeal transit times of patients with stroke. METHODS: Patients participating in this study were 30 right-handed adults, 16 of which were male and 14 were female, aged 41 to 88 (average age 62.3 years with ictus varying from 1 to 30 days (median of 6 days. To analyze the pharyngeal transit time a videofluoroscopy swallow test was performed. Each patient was observed during swallow of a 5 mL paste bolus given by spoon, totaling four different stimuli (natural, cold, sour and cold sour, one at a time, room temperature (22ºC and cold (8ºC were used. Later, the tests were analyzed using specific software to measure bolus transit time during the pharyngeal phase. RESULTS: The results showed that the pharyngeal transit time was significantly shorter during swallow of cold sour bolus when compared with other stimuli. Conclusion - Sour taste stimuli associated to cold temperature cause significant change in swallowing patterns, by shortening the pharyngeal transit time, which may lead to positive effects in patients with oropharyngeal dysphagia.CONTEXTO: O efeito do sabor azedo e as variações da temperatura dos alimentos em indivíduos disfágicos, ainda não foi totalmente esclarecidos. OBJETIVO: Verificar o efeito do sabor azedo e da temperatura fria no tempo de trânsito faríngeo da deglutição em indivíduos após acidente vascular encefálico hemisférico isquêmico. MÉTODOS: Participaram deste estudo 30 indivíduos adultos, sendo 16 do gênero masculino e 14 do feminino, destros, com faixa etária variando de 41 a 88 anos (média de 62,3 anos e ictus que variou de 1 a 30 dias (mediana de 6 dias. Para analisar o tempo de trânsito faríngeo da deglutição foi realizado o exame de videofluoroscopia da deglutição. Cada indivíduo foi observado durante a
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Little, Paul; Stuart, Beth; Wingrove, Zoe; Mullee, Mark; Thomas, Tammy; Johnson, Sophie; Leydon, Gerry; Richards-Hall, Samantha; Williamson, Ian; Yao, Lily; Zhu, Shihua; Moore, Michael
2017-12-18
Reducing the use of antibiotics for upper respiratory tract infections is needed to limit the global threat of antibiotic resistance. We estimated the effectiveness of probiotics and xylitol for the management of pharyngitis. In this parallel-group factorial randomized controlled trial, participants in primary care (aged 3 years or older) with pharyngitis underwent randomization by nurses who provided sequential intervention packs. Pack contents for 3 kinds of material and advice were previously determined by computer-generated random numbers: no chewing gum, xylitol-based chewing gum (15% xylitol; 5 pieces daily) and sorbitol gum (5 pieces daily). Half of each group were also randomly assigned to receive either probiotic capsules (containing 24 × 10 9 colony-forming units of lactobacilli and bifidobacteria) or placebo. The primary outcome was mean self-reported severity of sore throat and difficulty swallowing (scale 0-6) in the first 3 days. We used multiple imputation to avoid the assumption that data were missing completely at random. A total of 1009 individuals consented, 934 completed the baseline assessment, and 689 provided complete data for the primary outcome. Probiotics were not effective in reducing the severity of symptoms: mean severity scores 2.75 with no probiotic and 2.78 with probiotic (adjusted difference -0.001, 95% confidence interval [CI] -0.24 to 0.24). Chewing gum was also ineffective: mean severity scores 2.73 without gum, 2.72 with sorbitol gum (adjusted difference 0.07, 95% CI -0.23 to 0.37) and 2.73 with xylitol gum (adjusted difference 0.01, 95% CI -0.29 to 0.30). None of the secondary outcomes differed significantly between groups, and no harms were reported. Neither probiotics nor advice to chew xylitol-based chewing gum was effective for managing pharyngitis. Trial registration: ISRCTN, no. ISRCTN51472596. © 2017 Joule Inc. or its licensors.
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Fattori, B; Giusti, P; Mancini, V; Grosso, M; Barillari, M R; Bastiani, L; Molinaro, S; Nacci, A
2016-10-01
The purpose of this study was to compare videofluoroscopy (VFS), fiberoptic endoscopic evaluation of swallowing (FEES) and oro-pharyngo- oesophageal scintigraphy (OPES) with regards to premature spillage, post-swallowing residue and aspiration to assess the reliability of these tests for detection of oro-pharyngeal dysphagia. Sixty patients affected with dysphagia of various origin were enrolled in the study and submitted to VFS, FEES and OPES using a liquid and semi-solid bolus. As a reference, we used VFS. Both the FEES and the OPES showed good sensitivity with high overall values (≥ 80% and ≥ 90% respectively). The comparison between FEES vs VFS concerning drop before swallowing showed good specificity (84.4% for semi-solids and 86.7% for liquids). In the case of post-swallowing residue, FEES vs VFS revealed good overall validity (75% for semi-solids) with specificity and sensitivity well balanced for the semi-solids. OPES vs. VFS demonstrated good sensitivity (88.6%) and overall validity (76.7%) for liquids. The analysis of FEES vs. VFS for aspiration showed that the overall validity was low (≤ 65%). On the other hand, OPES demonstrated appreciable overall validity (71.7%). VFS, FEES and OPES are capable of detecting oro-pharyngeal dysphagia. FEES gave significant results in the evaluation of post-swallowing residues. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.
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(Nematoda: Desmodoridae), a brood protecting free-living marine ...
African Journals Online (AJOL)
posterior of the pharyngeal region, in the former species, in the male amphids which are a closed loop in P. waweri and an open-loop in P. ovisetosum. The female of the species protects the developing eggs by attaching them to the ventral mid body anterior and posterior of the vulval region, while in P. ovisetosum eggs are ...
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Kittelberger, R.; McIntuyre, L.; Watts, S.; MacDiarmid, S.; Hannah, M.J.; Jenner, J.; Bueno, R.; Swainsbury, R.; Langeveld, J.P.M.; Keulen, van L.J.M.; Zijderveld, van F.G.; Wemheuer, W.M.; Richt, J.A.; Sorenson, S.J.; Pigott, C.J.; O'Keefe, J.S.
2014-01-01
AIMS: To estimate the number of cases of scrapie that would occur in sheep of different prion protein (PrP) genotypes if scrapie was to become established in New Zealand, and to compare the performance of two commercially available, rapid ELISA kits using ovine retro-pharyngeal lymph nodes (RLN)
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Directory of Open Access Journals (Sweden)
Martina R. Crole
2013-10-01
Full Text Available Avian mycobacteriosis (AM is a zoonotic disease caused by Mycobacterium aviumcomplex (MAC, which can spread from avians to other farmed animals such as cattle and pigs as well as to humans. This study is the first report of granulomatous inflammation, as a result of avian mycobacteriosis, in the follicular pharyngeal tonsils of a farmed ostrich. The head of an apparently healthy farmed adult ostrich was obtained after slaughter. Each pharyngeal fold displayed a large tissue mass. This tissue was routinely prepared for light microscopy and stained with haematoxylin and eosin, periodic acid Schiff, Grocott methenamine silver, Gram and Ziehl-Neelsen. Immunohistochemistry (IHC and polymerase chain reaction (PCR were performed to identify Mycobacterium spp. and Mycobacterium tuberculosis complex, respectively. Histologically, the tissue masses consisted of confluent mature micro-granulomata that were characterised by central caseous necrosis surrounded by multinucleated giant cells, macrophages and lymphoid cells and an outer mature fibrous connective tissue capsule. Within some foci of caseous necrosis were variably sized colonies of small, Gram-negative, acid-fast bacilli, which showed positive IHC labelling for Mycobacterium spp., leading to a presumptive diagnosis of AM. PCR thus proved useful in excluding the presence of notifiable Mycobacteriumspp. The significance and role of the pharyngeal tonsils of ratites in diseases such as AM warrant specific attention. Moreover, as ratites are known to present with AM infections with apparently no visible loss in body condition, as presumably occurred in the present case, it is imperative that unusual masses in apparently healthy ratites be thoroughly investigated.
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Uysalol, Metin; Tatlı, Burak; Uzel, Nedret; Çıtak, Agop; Aygün, Erhan; Kayaoğlu, Semra
2013-01-01
Background: Pharyngeal-cervical-brachial (PCB) variant is a rare form of Guillan-Barre Syndrome (GBS). Antibodies against other membrane proteins like GM1b and GD1a have been found only in a small number of patients with Guillan Barre syndrome variant. Case Report: Here, we report a 5.5 year-old boy diagnosed early with positive GD1a and GD1b gangliosides of Guillan-Barre syndrome pharyngeal cervical-Brachial variant, who improved and recovered fully in a short period. This is in co...
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Uysalol, Metin; Tatlı, Burak; Uzel, Nedret; Çıtak, Agop; Aygün, Erhan; Kayaoğlu, Semra
2014-01-01
Background: Pharyngeal-cervical-brachial (PCB) variant is a rare form of Guillan-Barre Syndrome (GBS). Antibodies against other membrane proteins like GM1b and GD1a have been found only in a small number of patients with Guillan Barre syndrome variant. Case Report: Here, we report a 5.5 year-old boy diagnosed early with positive GD1a and GD1b gangliosides of Guillan-Barre syndrome pharyngeal cervical-Brachial variant, who improved and recovered fully in a short period. This is in cont...
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Ficarra, Vincenzo; Gan, Melanie; Borghesi, Marco; Zattoni, Fabio; Mottrie, Alexandre
2012-12-01
The rationale of posterior musculofascial plate reconstruction during radical prostatectomy is to shorten the time to reach urinary continence recovery and to reduce the risk of bleeding and anastomosis leakage. We describe our original technique incorporating the posterior muscolofascial reconstruction into urethrovesical anastomosis using robot-assisted radical prostatectomy (RARP). For this reconstructive step, we use a 30-cm V-Loc 90 3-0 barbed suture (V-20 tapered needle). Specifically, the free edge of the posterior layer of the Denonvilliers fascia is approximated to the posterior part of the sphincteric apparatus in a running fashion from left to right. The musculature of the urethral wall is incorporated in this first layer of the running suture. This suture is then continued back to the left in a second layer incorporating the anterior layer of the Denonvilliers fascia (or prostatovesical muscle), the bladder neck, and again the urethra, this time also with urethral mucosa. The urethrovesical anastomosis is completed using a second running barbed suture (15-cm V-Loc 90 3-0 barbed suture, V-20 tapered needle). No intraoperative complications were observed during this step of the procedure. Anastomotic leakages were observed only in 2% of cases. Only 12.5% showed urinary incontinence after catheter removal (1-2 pads). At mean follow-up of 9 months, the urinary continence recovery was 95%, and an anastomosis stricture necessitating an endoscopic incision developed in only three (1.5%) patients. Recent systematic reviews of the literature showed only a minimal advantage in favor of posterior musculofascial reconstruction in terms of urinary continence recovery within 1 month after radical prostatectomy. We support the use of this step of RARP because it is simple, reproducible, with a very limited increase in operative time, and with only a slight risk of potential harm to the patient. Moreover, it could improve hemostasis and provide greater support for a
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EFFECT OF A BITTER BOLUS ON ORAL, PHARYNGEAL AND ESOPHAGEAL TRANSIT OF HEALTHY SUBJECTS
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Leda Maria Tavares ALVES
2013-03-01
Full Text Available Context During swallowing, boluses stimulate sensory receptors of the oral, pharyngeal, laryngeal, and esophageal regions. Sweet and tasteless foods are more acceptable for swallowing than bitter foods. A bitter bolus is unpleasant for most subjects. Our hypothesis was that the ingestion of a bitter bolus might alter the oral behavior, pharyngeal and esophageal transit when compared to a sweet bolus. Objective To evaluate whether the bitter taste of a liquid bolus causes alteration on oral, pharyngeal and/or esophageal transit in normal subjects in comparison with sweet bolus.' Method Scintigraphic evaluation of oral, pharyngeal and esophageal transit was performed in 43 asymptomatic subjects, 22 women and 21 men, ages 23-71 years, without problems with the ingestion of liquid and solid foods, and without digestive, cardiac or neurologic diseases. Each subject swallowed in random sequence and at room temperature 5 mL of a liquid bolus with bitter taste, prepared with 50 mL of water with 2 g of leaves of Peumus boldus, heated until boiling (boldus tea, and 5 mL of a liquid bolus with sweet taste, prepared with 50 mL of water with 3 g of sucrose, both labeled with 37 MBq of technetium phytate (Tc99m. Results There was no difference between the bitter bolus and the sweet bolus in mouth, pharynx and esophageal transit and clearance duration and in the amount of residues. Conclusion A bitter bolus, considered an unpleasant bolus, does not alter the duration of oral, pharyngeal and esophageal phases of swallowing, when compared with a sweet bolus, considered a pleasant bolus. Contexto Durante a deglutição o bolo estimula os receptores sensoriais da boca, faringe, laringe e esôfago. Os alimentos doces e sem gosto são mais aceitáveis para a deglutição do que os alimentos amargos, que tem gosto desagradável para a maioria dos indivíduos. A hipótese destes autores era que a ingestão de um bolo amargo pode alterar o trânsito oral
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Directory of Open Access Journals (Sweden)
Emily H Stewart
Full Text Available BACKGROUND: Pharyngitis management guidelines include estimates of the test characteristics of rapid antigen streptococcus tests (RAST using a non-systematic approach. OBJECTIVE: To examine the sensitivity and specificity, and sources of variability, of RAST for diagnosing group A streptococcal (GAS pharyngitis. DATA SOURCES: MEDLINE, Cochrane Reviews, Centre for Reviews and Dissemination, Scopus, SciELO, CINAHL, guidelines, 2000-2012. STUDY SELECTION: Culture as reference standard, all languages. DATA EXTRACTION AND SYNTHESIS: Study characteristics, quality. MAIN OUTCOME(S AND MEASURE(S: Sensitivity, specificity. RESULTS: We included 59 studies encompassing 55,766 patients. Forty three studies (18,464 patients fulfilled the higher quality definition (at least 50 patients, prospective data collection, and no significant biases and 16 (35,634 patients did not. For the higher quality immunochromatographic methods in children (10,325 patients, heterogeneity was high for sensitivity (inconsistency [I(2] 88% and specificity (I(2 86%. For enzyme immunoassay in children (342 patients, the pooled sensitivity was 86% (95% CI, 79-92% and the pooled specificity was 92% (95% CI, 88-95%. For the higher quality immunochromatographic methods in the adult population (1,216 patients, the pooled sensitivity was 91% (95% CI, 87 to 94% and the pooled specificity was 93% (95% CI, 92 to 95%; however, heterogeneity was modest for sensitivity (I(2 61% and specificity (I(2 72%. For enzyme immunoassay in the adult population (333 patients, the pooled sensitivity was 86% (95% CI, 81-91% and the pooled specificity was 97% (95% CI, 96 to 99%; however, heterogeneity was high for sensitivity and specificity (both, I(2 88%. CONCLUSIONS: RAST immunochromatographic methods appear to be very sensitive and highly specific to diagnose group A streptococcal pharyngitis among adults but not in children. We could not identify sources of variability among higher quality studies. The
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Directory of Open Access Journals (Sweden)
Lam Wynnie WM
2007-11-01
Full Text Available Abstract Background Restrictive impairment is the commonest reported pulmonary deficit in AIS, which improves following surgical operation. However, exact mechanism of how improvement is brought about is unknown. Dynamic fast breath-hold (BH-MR imaging is a recent advance which provides direct quantitative visual assessment of pulmonary function. By using above technique, change in lung volume, chest wall and diaphragmatic motion in AIS patients before and six months after posterior spinal fusion surgery were measured. Methods 16 patients with severe right-sided predominant thoracic scoliosis (standing Cobb's angle 50° -82°, mean 60° received posterior spinal fusion without thoracoplasty were recruited into this study. BH-MR sequences were used to obtain coronal images of the whole chest during full inspiration and expiration. The following measurements were assessed: (1 inspiratory, expiratory and change in lung volume; (2 change in anteroposterior (AP and transverse (TS diameter of the chest wall at two levels: carina and apex (3 change in diaphragmatic heights. The changes in parameters before and after operation were compared using Wilcoxon signed ranks test. Patients were also asked to score their breathing effort before and after operation using a scale of 1–9 with ascending order of effort. The degree of spinal surgical correction at three planes was also assessed by reformatted MR images and correction rate of Cobb's angle was calculated. Results The individual or total inspiratory and expiratory volume showed slight but insignificant increase after operation. There was significantly increase in bilateral TS chest wall movement at carina level and increase in bilateral diaphragmatic movements between inspiration and expiration. The AP chest wall movements, however, did not significantly change. The median breathing effort after operation was lower than that before operation (p There was significant reduction in coronal Cobb's angle
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Clegg, Herbert W; Ryan, Amy G; Dallas, Steven D; Kaplan, Edward L; Johnson, Dwight R; Norton, H James; Roddey, Oliver F; Martin, Edward S; Swetenburg, Raymond L; Koonce, Elizabeth W; Felkner, Mary M; Giftos, P Michael
2006-09-01
Two relatively small previous studies comparing once-daily amoxicillin with conventional therapy for group A streptococcal (GAS) pharyngitis reported similar rates of bacteriologic success for each treatment group. The purpose of this study was to further evaluate once-daily amoxicillin for GAS pharyngitis in a larger study. In a single pediatric practice, from October through May for 2 consecutive years (2001-2003), we recruited children 3 to 18 years of age who had symptoms and signs suggestive of GAS pharyngitis. Patients with a positive rapid test for GAS were stratified by weight (or=40 kg) and then randomly assigned to receive once-daily (750 mg or 1000 mg) or twice-daily (2 doses of 375 mg or 500 mg) amoxicillin for 10 days. We determined bacteriologic failure rates for GAS in the pharynx from subsequent swabs taken at 14 to 21 (visit 2) and 28 to 35 (visit 3) days after treatment initiation. We conducted a randomized, controlled, investigator-blinded, noninferiority trial to evaluate whether amoxicillin given once daily would have a bacteriologic failure rate no worse than that of amoxicillin given twice daily within a prespecified margin of 10%. GAS isolates were characterized to distinguish bacteriologic failures from new acquisitions. Adverse events were described and adherence was evaluated by review of returned daily logs and dosage bottles. Of 2139 potential study patients during the 2-year period, we enrolled 652 patients, 326 into each treatment group. Children in the 2 groups were comparable with respect to all demographic and clinical characteristics except that children <40 kg more often presented with rash in each treatment group. At visit 2, failure rates were 20.1% (59 of 294) for the once-daily group and 15.5% (46 of 296) for the twice-daily group (difference, 4.53%; 90% confidence interval [CI], -0.6 to 9.7). At visit 3, failure rates were 2.8% (6 of 216) for the once-daily group and 7.1% (16 of 225) for the twice-daily group (difference, -4
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Distrofia corneana policromática posterior Polychromatic posterior corneal dystrophy
Patrick Frensel de Moraes Tzelikis; Ulisses Roberto dos Santos; Marco Antônio Guarino Tanure; Fernando Cançado Trindade
2007-01-01
Os autores descrevem quatro raros casos de distrofia corneana policromática posterior, ainda não descrito na literatura nacional. Observam-se opacidades puntiformes, policromáticas, de tamanho uniforme, localização estromal profunda, distribuídas de limbo a limbo e que não interferem na acuidade visual. É apresentada uma revisão dos casos de distrofia pré-Descemet existentes na literatura.The authors describe four rare cases of polychromatic posterior corneal dystrophy, not describe in nation...
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Mesbah, Karim; Rana, M. Sameer; Francou, Alexandre; van Duijvenboden, Karel; Papaioannou, Virginia E.; Moorman, Antoon F.; Kelly, Robert G.; Christoffels, Vincent M.
2012-01-01
The 22q11.2 deletion syndrome (22q11.2DS) is the most common microdeletion disorder and is characterized by abnormal development of the pharyngeal apparatus and heart. Cardiovascular malformations (CVMs) affecting the outflow tract (OFT) are frequently observed in 22q11.2DS and are among the most
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Pavlidis, T E; Papaziogas, B T; Koutelidakis, I M; Papaziogas, T B
2002-02-01
During laparoscopic cholecystectomy, perforation of the gallbladder can occurs in extraction of the gallbladder. The fate of such lost gallstones, which can lead to the formation of an abscess, an abdominal wall mass, or a persistent sinus, has not been studied adequately. Herein we report the case of a persistent sinus of the abdominal wall after an emergent laparoscopic cholecystectomy in an 82-year-old woman with gangrenous cholecystitis and perforation of the friable wall in association with an empyema of the gallbladder. The culture of the obtained pus was positive for Escherichia coli. After a small leak of dirty fluid from the wound of the epigastric port site of 4 months' duration, surgical exploration under local anesthesia revealed that the sinus was caused by spilled gallstones impacting into the abdominal wall between the posterior sheath and left rectus abdominalis muscle. The removal of the stones resulted in complete healing. Long-term complications after laparoscopic cholecystectomy involving the abdominal wall are rare but important possible consequences that could be avoided.
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Bayesian inference of the heat transfer properties of a wall using experimental data
Iglesias, Marco
2016-01-06
A hierarchical Bayesian inference method is developed to estimate the thermal resistance and volumetric heat capacity of a wall. We apply our methodology to a real case study where measurements are recorded each minute from two temperature probes and two heat flux sensors placed on both sides of a solid brick wall along a period of almost five days. We model the heat transfer through the wall by means of the one-dimensional heat equation with Dirichlet boundary conditions. The initial/boundary conditions for the temperature are approximated by piecewise linear functions. We assume that temperature and heat flux measurements have independent Gaussian noise and derive the joint likelihood of the wall parameters and the initial/boundary conditions. Under the model assumptions, the boundary conditions are marginalized analytically from the joint likelihood. ApproximatedGaussian posterior distributions for the wall parameters and the initial condition parameter are obtained using the Laplace method, after incorporating the available prior information. The information gain is estimated under different experimental setups, to determine the best allocation of resources.
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Directory of Open Access Journals (Sweden)
Nam P Nguyen
Full Text Available PURPOSE: The study aims to assess the feasibility of Tomotherapy-based image-guided radiotherapy (IGRT to reduce the aspiration risk in patients with non-laryngeal and non-hypopharyngeal cancer. A retrospective review of 48 patients undergoing radiation for non-laryngeal and non-hypopharyngeal head and neck cancers was conducted. All patients had a modified barium swallow (MBS prior to treatment, which was repeated one month following radiotherapy. Mean middle and inferior pharyngeal dose was recorded and correlated with the MBS results to determine aspiration risk. RESULTS: Mean pharyngeal dose was 23.2 Gy for the whole group. Two patients (4.2% developed trace aspiration following radiotherapy which resolved with swallowing therapy. At a median follow-up of 19 months (1-48 months, all patients were able to resume normal oral feeding without aspiration. CONCLUSION AND CLINICAL RELEVANCE: IGRT may reduce the aspiration risk by decreasing the mean pharyngeal dose in the presence of large cervical lymph nodes. Further prospective studies with IGRT should be performed in patients with non-laryngeal and non-hypopharyngeal head and neck cancers to verify this hypothesis.
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Cohen, Jérémie F.; Cohen, Robert; Bidet, Philippe; Elbez, Annie; Levy, Corinne; Bossuyt, Patrick M.; Chalumeau, Martin
2017-01-01
There is controversy whether physicians can rely on signs and symptoms to select children with pharyngitis who should undergo a rapid antigen detection test (RADT) for group A streptococcus (GAS). Our objective was to evaluate the efficiency of signs and symptoms in selectively testing children with
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Directory of Open Access Journals (Sweden)
Ayşenur Paç Kısaarslan
2017-06-01
Full Text Available Periodic fever, aphthous stomatitis, pharyngitis, and cervical lymphadenitis (PFAPA syndrome is the most frequent cause of periodic fever in childhood. The pathogenesis of PFAPA is still unknown. Differantial diagnosis must be made with cyclic neutropenia and other autoinflammatory diseases. Because PFAPA is self limiting and benign, there is no certain treatment model. Treatment options must be specific to the patient, with a strong family and doctor relationship.
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Directory of Open Access Journals (Sweden)
Rebecca Kim
2014-01-01
Full Text Available Purpose. To report the results of the posterior pole sparing laser photocoagulation combined with intravitreal bevacizumab injection (IVB in retinopathy of prematurity (ROP. Methods. A retrospective chart review of premature babies with ROP, all of whom received laser photocoagulation with IVB. Eleven eyes of 6 infants with advanced zone I ROP underwent laser ablation sparing posterior pole with concurrent IVB. The results were compared with those of full-laser treatment combined with IVB to 8 eyes of 5 infants with advanced ROP without involvement of the posterior pole. Results. The posterior pole sparing laser with IVB was performed with zone I, stage 3+ ROP at the mean postmenstrual age of 36 weeks and 5 days. The plus sign decreased significantly at postoperative day 1, the neovascular proliferation regressed by postoperative week 1, and the normal vascularization started at postoperative day 32 on the average. Two months after treatment, vascularization of the spared avascular area was completed. There was no macular dragging, tractional retinal detachment, foveal destruction by laser scars, or any other adverse event. No significant anatomical differences were identified from those of full-laser ablation combined with IVB. Conclusions. Posterior pole sparing laser with IVB can give favorable results without destruction of posterior pole retina.
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Endoscopic Management of Posterior Epistaxis
Paul, J.; Kanotra, Sohit Paul; Kanotra, Sonika
2011-01-01
The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26–50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis. A total of 23 patients with posterior epistaxis were subjected to nasal endoscopy with the intent to stop bleeding by cauterization of ...
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Pharyngeal Airway Space Changes After Condylar Replacement and Mandibular Advancement Surgery.
Yuen, Holly; Rossouw, P Emile; Wolford, Larry M; Wang, Hongyue
2018-01-03
The aim of this study was to examine the total volume and cross-sectional areas of the pharyngeal airway after bilateral condylar replacement and mandibular advancement surgery. A total of 137 patients (126 women and 11 men) underwent bilateral temporomandibular joint total joint replacement performed by 1 surgeon. A subsample of 30 patients who underwent condylar replacement and only mandibular advancement were evaluated for impact on the airway. Measurements were taken preoperatively, postoperatively, and at a follow-up 1 year after surgery on cone beam computed tomography scans. InVivoDental 3-dimensional imaging (Anatomage, San Jose, CA) was used to measure airway space regarding total volume (in cubic centimeters); minimum cross-sectional area (in square millimeters); minimum cross sections of the first, second, and third cervical vertebrae; and whether the patient had mandibular retrognathia before surgery. A second operator was used to test for interoperator error. Descriptive and bivariate statistics were computed, and the P value was set at .05. There was a significant increase in all measurements at the follow-up visit compared with the preoperative visit. There were no significant differences between groups based on simultaneous Le Fort I surgery, mandibular retrognathia, and gender. However, there were statistically significant differences in cross sections 1 and 2, as well as minimum cross-sectional area, regarding age. Condylar replacement and mandibular advancement have a significant association with an increase in airway space. The intraclass correlation coefficient showed excellent agreement between interoperator measurements. Patients undergoing bilateral temporomandibular joint replacement and mandibular advancement surgery showed an increase in pharyngeal airway space at a 1-year follow-up. In this study, age was significantly associated with the cross-sectional areas of the airway, with older patients having smaller values. Copyright © 2018
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Park, Jeong Mee; Yong, Sang Yeol; Kim, Ji Hyun; Jung, Hong Sun; Chang, Sei Jin; Kim, Ki Young; Kim, Hee
2014-10-01
To determine the cutoff value of the pharyngeal residue for predicting reduction of aspiration, by measuring the residue of valleculae and pyriformis sinuses through videofluoroscopic swallowing studies (VFSS) after treatment with neuromuscular electrical stimulator (VitalStim) in stroke patients with dysphagia. VFSS was conducted on first-time stroke patients before and after the VitalStim therapy. The results were analyzed for comparison of the pharyngeal residue in the improved group and the non-improved group. A total of 59 patients concluded the test, in which 42 patients improved well enough to change the dietary methods while 17 did not improve sufficiently. Remnant area to total area (R/T) ratios of the valleculae before treatment in the improved group were 0.120, 0.177, and 0.101 for solid, soft, and liquid foods, respectively, whereas the ratios for the non-improved group were 0.365, 0.396, and 0.281, respectively. The ratios of the pyriformis sinuses were 0.126, 0.159, and 0.121 for the improved group and 0.315, 0.338, and 0.244 for the non-improved group. The R/T ratios of valleculae and pyriformis sinus were significantly lower in the improved group than the non-improved group in all food types before treatment. The R/T ratio cutoff values were 0.267, 0.250, and 0.185 at valleculae and 0.228, 0.218, and 0.185 at pyriformis sinuses. In dysphagia after stroke, less pharyngeal residue before treatment serves as a factor for predicting greater improvement after VitalStim treatment.
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International Nuclear Information System (INIS)
Souza, Izabella Soares de
2017-01-01
In the past decade microcomputerized tomography imaging using synchrotron radiation has become a powerful technique to generate high resolution images of Rhodinus prolixus. Images of soft tissues (protocerebrum and muscles) and dense structures (pharynx, trachea and esophagus) of R. prolixus head have been obtained using synchrotron radiation microtomography in mono and polychromatic configuration, respectively. Advancements in conventional microtomography have increased the achievable resolution and contrast, making this relatively inexpensive and widely available technology potentially useful for studies of insect internal morphology. The main goal of this work was to provide a new set of high quality microtomographic images of R. prolixus achieved by means of a desktop X-ray microtomograph. It allows the three-dimensional visualization of important chitinized structures: pharynx and tracheae. Pharyngeal and tracheal volumes were quantitatively evaluated at different days (1, 4, 10, 15 and 20) after feeding. The results suggest that variation of average volumes could be attributed to insect hormone 20-hydroxy-ecdysone (20-OH-Ec) pulse at 11 days after feeding. Pharyngeal volumes decrease 3.80 times. On the other hand, tracheal volumes increase 1.78 times. Head total volume showed similar trends than trachea. (author)
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Posterior labral injury in contact athletes.
Mair, S D; Zarzour, R H; Speer, K P
1998-01-01
Nine athletes (seven football offensive linemen, one defensive lineman, and one lacrosse player) were found at arthroscopy to have posterior labral detachment from the glenoid. In our series, this lesion is specific to contact athletes who engage their opponents with arms in front of the body. All patients had pain with bench pressing and while participating in their sport, diminishing their ability to play effectively. Conservative measures were ineffective in relieving their symptoms. Examination under anesthesia revealed symmetric glenohumeral translation bilaterally, without evidence of posterior instability. Treatment consisted of glenoid rim abradement and posterior labral repair with a bioabsorbable tack. All patients returned to complete at least one full season of contact sports and weightlifting without pain (minimum follow-up, > or = 2 years). Although many injuries leading to subluxation of the glenohumeral joint occur when an unanticipated force is applied, contact athletes ready their shoulder muscles in anticipation of impact with opponents. This leads to a compressive force at the glenohumeral joint. We hypothesize that, in combination with a posteriorly directed force at impact, the resultant vector is a shearing force to the posterior labrum and articular surface. Repeated exposure leads to posterior labral detachment without capsular injury. Posterior labral reattachment provides consistently good results, allowing the athlete to return to competition.
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DEFF Research Database (Denmark)
Stenfeldt, Anna Carolina; Belsham, Graham
2012-01-01
measurements of the levels of FMDV RNA in the DSP as well as mandibular and retropharyngeal lymph nodes beyond 28 days after infection. Results indicated only low levels of FMDV RNA present in samples of pharyngeal epithelia during both early and persistent phases of infection with significantly higher levels...... of virus detected in pharyngeal excretions. It is concluded that the targeted area for sampling within the DSP does not harbour significant levels of virus replication during acute or persistent FMDV infection in cattle. Furthermore, the DSP and the mandibular and retropharyngeal lymph nodes cannot...
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Energy Technology Data Exchange (ETDEWEB)
Fujii, Masataka; Furumatsu, Takayuki; Miyazawa, Shinichi; Kodama, Yuya; Hino, Tomohito; Kamatsuki, Yusuke; Ozaki, Toshifumi [Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama (Japan)
2017-08-15
(1) To reveal the prevalence of the bony recess (posterior dimple) and (2) to determine the position of the posterior dimple on the tibial plateau using three-dimensional computed tomography (3DCT). In this study, a retrospective review of 112 patients was performed to identify the posterior dimple and to evaluate its position on 3DCT. Magnetic resonance images (MRIs) were also used to determine the positional relationship among the posterior cruciate ligament (PCL), medial meniscus posterior insertion (MMPI), and posterior dimple. The posterior dimple was observed in 100 of 112 knees (89.3%) on 3DCT. The center of the posterior dimple was 13.6 ± 0.8 mm from the medial tibial eminence apex. MRI showed that the posterior dimple separated the tibial attachment of the PCL and MMPI. This is the first study to discuss the prevalence and position of the bony recess in the posterior intercondylar fossa. (orig.)
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International Nuclear Information System (INIS)
Fujii, Masataka; Furumatsu, Takayuki; Miyazawa, Shinichi; Kodama, Yuya; Hino, Tomohito; Kamatsuki, Yusuke; Ozaki, Toshifumi
2017-01-01
(1) To reveal the prevalence of the bony recess (posterior dimple) and (2) to determine the position of the posterior dimple on the tibial plateau using three-dimensional computed tomography (3DCT). In this study, a retrospective review of 112 patients was performed to identify the posterior dimple and to evaluate its position on 3DCT. Magnetic resonance images (MRIs) were also used to determine the positional relationship among the posterior cruciate ligament (PCL), medial meniscus posterior insertion (MMPI), and posterior dimple. The posterior dimple was observed in 100 of 112 knees (89.3%) on 3DCT. The center of the posterior dimple was 13.6 ± 0.8 mm from the medial tibial eminence apex. MRI showed that the posterior dimple separated the tibial attachment of the PCL and MMPI. This is the first study to discuss the prevalence and position of the bony recess in the posterior intercondylar fossa. (orig.)
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Imaging findings in posterior instability of the shoulder
International Nuclear Information System (INIS)
Harish, Srinivasan; Rebello, Ryan; O'Neill, John; Nagar, Arpit; Moro, Jaydeep; Pugh, David
2008-01-01
Posterior shoulder instability refers to the symptoms and signs resulting from excessive posterior translation of the humerus. Magnetic resonance (MR) imaging is the radiological modality of choice in the diagnostic assessment of posterior instability. Computed tomography (CT) is useful in the evaluation of osseous abnormalities associated with posterior instability. A detailed description of the posterior osseous and labroligamentous abnormalities has evolved recently, and many variant lesions of the posteroinferior labrum and/or capsular structures have been described. As the recommended surgical management of lesions associated with posterior instability is a lesion-specific approach, awareness of the specific lesions that have been described in association with posterior instability helps in pre-surgical planning. The purpose of this article is to review the classification of, and injury mechanisms leading to, posterior shoulder instability and to describe imaging findings associated with posterior instability, with emphasis on MR imaging. (orig.)
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Imaging findings in posterior instability of the shoulder
Energy Technology Data Exchange (ETDEWEB)
Harish, Srinivasan; Rebello, Ryan; O' Neill, John [St. Joseph' s Healthcare, Department of Diagnostic Imaging, Hamilton, ON (Canada); McMaster University, Faculty of Health Sciences, Hamilton (Canada); Nagar, Arpit [St. Joseph' s Healthcare, Department of Diagnostic Imaging, Hamilton, ON (Canada); Moro, Jaydeep [St. Joseph' s Healthcare, Department of Orthopedic Surgery, Hamilton, ON (Canada); McMaster University, Faculty of Health Sciences, Hamilton (Canada); Pugh, David [Brantford General Hospital, Department of Orthopedic Surgery, Brantford, ON (Canada)
2008-08-15
Posterior shoulder instability refers to the symptoms and signs resulting from excessive posterior translation of the humerus. Magnetic resonance (MR) imaging is the radiological modality of choice in the diagnostic assessment of posterior instability. Computed tomography (CT) is useful in the evaluation of osseous abnormalities associated with posterior instability. A detailed description of the posterior osseous and labroligamentous abnormalities has evolved recently, and many variant lesions of the posteroinferior labrum and/or capsular structures have been described. As the recommended surgical management of lesions associated with posterior instability is a lesion-specific approach, awareness of the specific lesions that have been described in association with posterior instability helps in pre-surgical planning. The purpose of this article is to review the classification of, and injury mechanisms leading to, posterior shoulder instability and to describe imaging findings associated with posterior instability, with emphasis on MR imaging. (orig.)
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Primary Posterior Mediastinum Hydatid Cyst
International Nuclear Information System (INIS)
Ahmed, M.; Eid, A. F.; Sheikh, M. Y.; Yiannakou, N.
2014-01-01
Primary posterior mediastinal hydatid cyst is a serious health problem for the Mediterranean countries. We diagnosed a case of a 46-year-old female with a primary posterior mediastinum hydatid cyst on CT and MRI. It was provisionally identified as either a hydatid cyst or bronchogenic cyst or neuroenteric cyst. CT guided aspiration with 18 gauge needle confirmed as hydatid sand. This is very rare in this population but it should be kept in mind when one is looking at any cyst in the posterior mediastinum. (author)
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Hui, Peilin; Xie, Yuping; Wei, Xiaoquan; Zhao, Lijun; Ma, Wei; Wang, Jinfeng; Ning, Jing; Xu, Chao; Yang, Qian; Kang, Hong
2015-03-01
To investigate the therapeutic effects of oral modified device combined with nasopharyngeal enlargement surgery and evaluate the oral modified device' s adjuvant therapy meaning in severe OSAHS patients after surgery treatment. 46 cases with severe OSAHS were diagnosed by PSG according to AHI and the lowest arterial oxygen saturation (LSaO2). We performed the nasal or pharyngeal cavity expansion surgery for them according to the pathological change part correspondingly. Then all subjects were divided into combined group (n=26) and surgery alone group (n=20) according to their personal willingness. We monitored the PSG for all subjects aftter 2 weeks and 3 months respectively, then we calculate the diversity between the two group or intragroup change on the basis of the AHI, LAT, LSaO2, mean arterial oxygen saturation (MSaO2) and sleep structures recorded by PSG. At the same time, we collected the subjective sensations by questionnaire. The AHI and LAT in combined group were significantly lower and LSaO2 was significantly higher than these in surgery alone group(P0. 05). The N 1% was more shorter and the N2% and N3% were more longer after nasal or pharyngeal operation compared with pre-operative states in both groups(P. 05). The data of PSG also showed that the shallow sleep proportion was more shorter and the slow wave sleep proportion was more longer in combined group compared with surgery alone group. The subjective sensations results also showed significantly alleviated in combined group, such as mental state, daytime sleepiness and physical strength. The efficiency ratio of treatment was 85. 0% and 92. 3% in surgery alone group and combined group respectively. Nasal and pharyngeal cavity enlargement surgery combined with oral modified device is a more effective treatment in patients with severe OSAHS, and it is meaningful for the long-term curative effect of surgery to prevent relapse and improve.
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Treatment implications of posterior fossa ependymoma subgroups.
Ramaswamy, Vijay; Taylor, Michael D
2016-11-15
Posterior fossa ependymoma comprises two distinct molecular entities, ependymoma_posterior fossa A (EPN_PFA) and ependymoma_posterior fossa B (EPN_PFB), with differentiable gene expression profiles. As yet, the response of the two entities to treatment is unclear. To determine the relationship between the two molecular subgroups of posterior fossa ependymoma and treatment, we studied a cohort of 820 patients with molecularly profiled, clinically annotated posterior fossa ependymomas. We found that the strongest predictor of poor outcome in patients with posterior fossa ependymoma across the entire age spectrum was molecular subgroup EPN_PFA, which was recently reported in the paper entitled "Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era: a retrospective multicohort analysis" in the Journal of Clinical Oncology. Patients with incompletely resected EPN_PFA tumors had a very poor outcome despite receiving adjuvant radiation therapy, whereas a substantial proportion of patients with EPN_PFB tumors can be cured with surgery alone.
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Tan, Kok-Yang; Seow-Choen, Francis; Hai, Chew Heng; Thye, Gan Kok
2009-03-01
Anal fissures can cause morbidity in an otherwise healthy young patient. The process of evacuation results in stretching and descent of the anoderm and perineum especially posteriorly. Posterior perineal support may provide counter pressure at the posterior aspect of the pelvic floor, balancing the pressure exerted by the faeces on the anal wall, thus improving evacuation and reducing the trauma associated with it, and reducing symptoms of anal fissures. Symptoms of constipation may also be reduced secondarily. We report the preliminary results with a novel, simple and noninvasive method of treatment provided by a toilet seat device. A prospective study was performed in 32 patients. The study was designed mainly to investigate the patients' subjective perceptions of their symptoms related to anal fissures and constipation. Questionnaires were provided to patients before, during and after treatment. The study revealed statistically significant improvement in pain, bleeding, symptoms of constipation and abdominal discomfort after 3 months usage of the device. The odds of patients perceiving an improvement in symptoms were also significantly increased after 3 months of treatment compared to 2 weeks of treatment. This preliminary study revealed that a posterior perineal support device can bring about significant improvement in the symptoms of patients with anal fissures. There may also be secondary benefits of a reduction in the symptoms of constipation. Although not conclusive, these results should serve as a springboard for further research into this area.
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Giant gallstone in abdominal wall: a rare complication of laparoscopic cholecystectomy
YİĞİTLER, Cengizhan; DUMAN, Kazım; ÖZCAN, Ali
2013-01-01
We aim to report a case of abdominal wall mass formation secondary to gallbladder perforation and stone spillage occurring during laparoscopic cholecystectomy (LC). A 73-year-old women presented with purulent discharge from one of her previous port sites one year after she underwent LC. The latter revealed a round opaque mass in an abscess like cavity, and subsequently an ultrasonography showed a round echogenity with acoustic shadow posteriorly. Axial CT images verified the presence of a wel...
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Lewis, Stephen J; Mohanty, Chandan; Gazendam, Aaron M; Kato, So; Keshen, Sam G; Lewis, Noah D; Magana, Sofia P; Perlmutter, David; Cape, Jennifer
2018-03-01
To determine the incidence of pseudarthrosis at the osteotomy site after three-column spinal osteotomies (3-COs) with posterior column reconstruction. 82 consecutive adult 3-COs (66 patients) with a minimum of 2-year follow-up were retrospectively reviewed. All cases underwent posterior 3-COs with two-rod constructs. The inferior facets of the proximal level were reduced to the superior facets of the distal level. If that was not possible, a structural piece of bone graft either from the local resection or a local rib was slotted in the posterior column defect to re-establish continual structural posterior bone across the lateral margins of the resection. No interbody cages were used at the level of the osteotomy. There were 34 thoracic osteotomies, 47 lumbar osteotomies and one sacral osteotomy with a mean follow-up of 52 (24-126) months. All cases underwent posterior column reconstructions described above and the addition of interbody support or additional posterior rods was not performed for fusion at the osteotomy level. Among them, 29 patients underwent one or more revision surgeries. There were three definite cases of pseudarthrosis at the osteotomy site (4%). Six revisions were also performed for pseudarthrosis at other levels. Restoration of the structural integrity of the posterior column in three-column posterior-based osteotomies was associated with > 95% fusion rate at the level of the osteotomy. Pseudarthrosis at other levels was the second most common reason for revision following adjacent segment disease in the long-term follow-up.
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LENUS (Irish Health Repository)
Aalbers, Jolien
2011-06-01
Abstract Background Stratifying patients with a sore throat into the probability of having an underlying bacterial or viral cause may be helpful in targeting antibiotic treatment. We sought to assess the diagnostic accuracy of signs and symptoms and validate a clinical prediction rule (CPR), the Centor score, for predicting group A β-haemolytic streptococcal (GABHS) pharyngitis in adults (> 14 years of age) presenting with sore throat symptoms. Methods A systematic literature search was performed up to July 2010. Studies that assessed the diagnostic accuracy of signs and symptoms and\\/or validated the Centor score were included. For the analysis of the diagnostic accuracy of signs and symptoms and the Centor score, studies were combined using a bivariate random effects model, while for the calibration analysis of the Centor score, a random effects model was used. Results A total of 21 studies incorporating 4,839 patients were included in the meta-analysis on diagnostic accuracy of signs and symptoms. The results were heterogeneous and suggest that individual signs and symptoms generate only small shifts in post-test probability (range positive likelihood ratio (+LR) 1.45-2.33, -LR 0.54-0.72). As a decision rule for considering antibiotic prescribing (score ≥ 3), the Centor score has reasonable specificity (0.82, 95% CI 0.72 to 0.88) and a post-test probability of 12% to 40% based on a prior prevalence of 5% to 20%. Pooled calibration shows no significant difference between the numbers of patients predicted and observed to have GABHS pharyngitis across strata of Centor score (0-1 risk ratio (RR) 0.72, 95% CI 0.49 to 1.06; 2-3 RR 0.93, 95% CI 0.73 to 1.17; 4 RR 1.14, 95% CI 0.95 to 1.37). Conclusions Individual signs and symptoms are not powerful enough to discriminate GABHS pharyngitis from other types of sore throat. The Centor score is a well calibrated CPR for estimating the probability of GABHS pharyngitis. The Centor score can enhance appropriate
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A pharyngeal jaw evolutionary innovation facilitated extinction in Lake Victoria cichlids.
McGee, Matthew D; Borstein, Samuel R; Neches, Russell Y; Buescher, Heinz H; Seehausen, Ole; Wainwright, Peter C
2015-11-27
Evolutionary innovations, traits that give species access to previously unoccupied niches, may promote speciation and adaptive radiation. Here, we show that such innovations can also result in competitive inferiority and extinction. We present evidence that the modified pharyngeal jaws of cichlid fishes and several marine fish lineages, a classic example of evolutionary innovation, are not universally beneficial. A large-scale analysis of dietary evolution across marine fish lineages reveals that the innovation compromises access to energy-rich predator niches. We show that this competitive inferiority shaped the adaptive radiation of cichlids in Lake Tanganyika and played a pivotal and previously unrecognized role in the mass extinction of cichlid fishes in Lake Victoria after Nile perch invasion. Copyright © 2015, American Association for the Advancement of Science.
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Endoscopic management of posterior epistaxis.
Paul, J; Kanotra, Sohit Paul; Kanotra, Sonika
2011-04-01
The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26-50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis. A total of 23 patients with posterior epistaxis were subjected to nasal endoscopy with the intent to stop bleeding by cauterization of the bleeding vessel. Of these, in four cases unsuspected diagnosis was made. Of the remaining 19, in three patients, the bleeding point could not be localized accurately and these patients were managed by anteroposterior packing. The rest of the 16 patients were managed by endoscopic cauterization. In four patients, there was recurrence of bleeding within 24 h. In one of these, cauterization controlled the bleeding while in the rest nasal packing had to be resorted to. Thus, of the 23 patients of posterior epistaxis subjected to nasal endoscopy, we could avoid nasal packing in 17 (74%). To conclude, endoscopic nasal cauterization is recommended as the first line to treatment in all cases of posterior epistaxis. This will not only prevent the uncomfortable and potentially dangerous nasal packing but also help in finding the underlying pathology.
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Removal of a Wire Brush Bristle from the Hypopharynx Using Suspension, Microscope, and Fluoroscopy
Directory of Open Access Journals (Sweden)
Matthew R. Naunheim
2015-01-01
Full Text Available Wire brush bristles are an increasingly recognized hazard that can present as a foreign body in the aerodigestive tract. Due to their small size and tendency to become embedded in surrounding tissue, these small metallic bristles present a unique operative challenge to otolaryngologists. Here we present a case of a 40-year-old woman who underwent endoscopic extraction of a wire bristle from the posterior pharyngeal wall using suspension, microscopy, and C-arm fluoroscopy. We believe this is the first published case of an endoscopic removal of a buried foreign body in the hypopharynx using these methods of localization concurrently. By leveraging multiple techniques for visualization, surgeons can avoid open exploration while ensuring complete removal of the object. Additionally, this case highlights the importance of regulatory oversight and consumer awareness of the hazards of grill brushes.
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Lee, Jonathan Y; Alizadeh, Kaveh
2016-01-01
In this series, the authors describe a modification of the facial artery musculomucosal flap for oronasal fistula repair. The spacer facial artery musculomucosal flap technique is characterized by a pedicle inset into the retromolar trigone and palate, obviating a second operative stage. This was performed in 14 patients with a 5.2-cm mean fistula size. Average follow-up was 4.3 years, with one partial flap necrosis but no recurrent oronasal fistula. There was a mean decrease of 18 percent in the distance between the velum and the posterior pharyngeal wall. The spacer facial artery musculomucosal flap provides a single-stage reconstruction of oronasal fistula while lengthening the palate through a pushback mechanism. Although further study of velopharyngeal function is needed, the spacer facial artery musculomucosal flap may be beneficial for patients with a short velum and an oronasal fistula. Therapeutic, IV.
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DEFF Research Database (Denmark)
Gurani, Sirwan Fernandez; Di Carlo, Gabriele; Cattaneo, Paolo M
2016-01-01
OBJECTIVES: Natural head position is recommended to be optimal at cone-beam computed tomography acquisition. For standardization purposes in control of treatment outcome, it is clinically relevant to discuss, if a change of posture from natural head position may have an effect on the pharyngeal...
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Management of posterior urethral disruption injuries.
Myers, Jeremy B; McAninch, Jack W
2009-03-01
Posterior urethral disruption is a traumatic injury to the male urethra, which most often results from pelvic fracture. After trauma, the distraction defect between the two ends of the urethra often scars and becomes fibrotic, blocking the urethra and bladder emptying. Increasing evidence suggests that many posterior urethral disruptions occur at the junction between the membranous urethra and the bulbar urethra, which is distal to the rhabdosphincter. In the acute setting, when a posterior urethral disruption is suspected, retrograde urethrography should be performed. Posterior urethral disruptions can be managed acutely by realignment of the urethra over a urethral catheter or by placement of a suprapubic catheter for bladder drainage only. Once fibrosis has stabilized, the patient can undergo posterior urethroplasty. In most cases, this procedure can be performed via a perineal approach in a single-stage surgery. The results of this single-stage perineal urethroplasty are excellent, and a patent urethra can be re-established in the majority of men who undergo surgery.
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Directory of Open Access Journals (Sweden)
Mousavian Alireza
2013-09-01
Full Text Available Traumatic hip dislocation is an uncommon injury in children and consists of less than 5% of their dislocations; but it’s one of the real orthopedic urgency. Its mechanism is low energy trauma in below 6 years old and high energy trauma above it.One of the common associated complications with hip dislocation is posterior wall injuries but column fractures are very rare. We reported an uncommon case of posterior hip dislocation with simultaneous subtrochanteric fracture and anterior column fracture, in which close reduction was impossible. Because of sever associated injuries surgery was done with 48 hours delay including open reduction of dislocation and fracture, and internally fixation of the subtrochanteric fracture with 3.5mm locked plate.In 6 month follow up that was done in ICU, range of motion and stability was good and union sign was visible on radiography. After 15 months the patient general conditions was good and no sign of avascular necrosis was seen
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International Nuclear Information System (INIS)
Keberle, M.; Wittenberg, G.; Trusen, A.; Hahn, D.; Baumgartner, W.
2001-01-01
Purpose: In contrast to esophageal perforations, the more radiopaque barium-suspensions are not as important as iodinated aqueous contrast agents for the detection of pharyngeal perforations. This study was performed to find out whether the highly different viscosities (of iodinated and barium-containing contrast agents with comparable radiopacities) are a reason for this. Methods: Viscosity, subjective difference in contrast, and CT-density of an iodinated aqueous (Telebrix) and a 50 wt/vol% barium-containing contrast agent (Micropaque) were determined. Moreover, to exclude postoperative perforation, 104 patients were prospectively examined by pharyngography using both contrast media. Pharyngographies of patients with perforation were later compared by two independent readers. All patients with perforation were followed up clinically to exclude complications due to barium administration. Results: In-vitro comparison showed comparable radiopacity but the 50 wt/vol% barium-suspension was much more viscous that the iodinated contrast agent. During pharyngography, totally, 14 perforations were clearly delineated with the iodinated aqueous contrast agent. However, two of them were not detected with the barium-suspension. All the other perforations presented equally. Conclusions: Given a sufficient radiopacity, a low viscosity appears to be essential for a contrast agent to detect especially pharyngeal perforations. Thus, we recommend the sole use of an iodinated contrast agent (at suspicion of aspiration as isoosmolar variant) for this purpose. (orig.) [de
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Directory of Open Access Journals (Sweden)
Di Pierro F
2012-11-01
Full Text Available Francesco Di Pierro,1 Guido Donato,2 Federico Fomia,3 Teresa Adami,4 Domenico Careddu,5 Claudia Cassandro,6 Roberto Albera61Scientific Department, Velleja Research, Milano, 2ASL 1, Cuneo, 3ASL 3, Brescia, 4Infective Diseases, Verona, 5ASL 13, Novara, 6Surgical Science Department, Università degli Studi, Torino, ItalyBackground: The oral probiotic Streptococcus salivarius K12 has been shown clearly to antagonize the growth of Streptococcus pyogenes, the most important bacterial cause of pharyngeal infections in humans, by releasing two bacteriocins named salivaricin A2 and salivaricin B. Unpublished observations indicate that it can also antagonize the growth of other bacteria involved in acute otitis media. Because of its ability to colonize the oral cavity and its safety profile, we have tested its efficacy in reducing the incidence of streptococcal pharyngitis and/or tonsillitis and episodes of acute otitis media.Methods: We enrolled 82 children, including 65 with and 17 without a recent diagnosis of recurrent oral streptococcal pathology. Of those with recurrent pathology, 45 were treated daily for 90 days with an oral slow-release tablet containing five billion colony-forming units of S. salivarius K12 (Bactoblis®, and the remaining 20 served as an untreated control group. The 17 children without a recent diagnosis of recurrent oral pathology were used as an additional control group. After 90 days of treatment, a 6-month follow-up period without treatment was included to evaluate a possible persistent protective role for the previously administered product.Results: The 41 children who completed the 90-day course of Bactoblis showed a reduction in their episodes of streptococcal pharyngeal infection (about 90% and/or acute otitis media (about 40%, calculated by comparing infection rates in the previous year. The 90-day treatment also reduced the reported incidence of pharyngeal and ear infections by about 65% in the 6-month follow-up period
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Delayed Single Stage Perineal Posterior Urethroplasty.
Ali, Shahzad; Shahnawaz; Shahzad, Iqbal; Baloch, Muhammad Umar
2015-06-01
To determine the delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture/distraction defect. Descriptive case series. Department of Urology, Jinnah Postgraduate Medical Centre, Karachi, from January 2009 to December 2011. Patients were selected for delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture / distraction defect. All were initially suprapubically catheterized followed by definitive surgery after at least 3 months. Thirty male patients were analyzed with a mean follow-up of 10 months, 2 patients were excluded as they developed failure in first 3 months postoperatively. Mean patient's age was 26.25 ± 7.9 years. On follow-up, 7 patients (23.3%) experienced recurrent stricture during first 10 months. Five (16.6%) patients were treated successfully with single direct visual internal urethrotomy. Two patients (6.6%) had more than one direct visual internal urethrotomy and considered failed. Re-do perineal urethroplasty was eventually performed. The overall success rate was 93.3% with permissive criteria allowing single direct visual internal urethrotomy and 76.6% with strict criteria allowing no more procedures postoperatively. Posterior anastomotic urethroplasty offers excellent long-term results to patients with posterior urethral trauma and distraction defect even after multiple prior procedures.
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Rodenstein, D O; Dooms, G; Thomas, Y; Liistro, G; Stanescu, D C; Culée, C; Aubert-Tulkens, G
1990-01-01
To characterise the relation between pharyngeal anatomy and sleep related disordered breathing, 17 men with complaints of snoring were studied by all night polysomnography. Ten of them had obstructive sleep apnoea (mean (SD) apnoea-hypopnoea index 56.3 (41.7), age 52 (10) years, body mass index 31.4 (5.3) kg/m2); whereas seven were simple snorers (apnoea-hypopnoea index 6.7 (4.6), age 40 (17) years, body mass index 25.9 (4.3) kg/m2). The pharynx was studied by magnetic resonance imaging in al...
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Reid, S; Lu, C; Hardy, N; Casikar, I; Reid, G; Cario, G; Chou, D; Almashat, D; Condous, G
2014-12-01
To use office gel sonovaginography (SVG) to predict posterior deep infiltrating endometriosis (DIE) in women undergoing laparoscopy. This was a multicenter prospective observational study carried out between January 2009 and February 2013. All women were of reproductive age, had a history of chronic pelvic pain and underwent office gel SVG assessment for the prediction of posterior compartment DIE prior to laparoscopic endometriosis surgery. Gel SVG findings were compared with laparoscopic findings to determine the diagnostic accuracy of office gel SVG for the prediction of posterior compartment DIE. In total, 189 women underwent preoperative gel SVG and laparoscopy for endometriosis. At laparoscopy, 57 (30%) women had posterior DIE and 43 (23%) had rectosigmoid/anterior rectal DIE. For the prediction of rectosigmoid/anterior rectal (i.e. bowel) DIE, gel SVG had an accuracy of 92%, sensitivity of 88%, specificity of 93%, positive predictive value (PPV) of 79%, negative predictive value (NPV) of 97%, positive likelihood ratio (LR+) of 12.9 and negative likelihood ratio (LR-) of 0.12 (P = 3.98E-25); for posterior vaginal wall and rectovaginal septum (RVS) DIE, respectively, the accuracy was 95% and 95%, sensitivity was 18% and 18%, specificity was 99% and 100%, PPV was 67% and 100%, NPV was 95% and 95%, LR+ was 32.4 and infinity and LR- was 0.82 and 0.82 (P = 0.009 and P = 0.003). Office gel SVG appears to be an effective outpatient imaging technique for the prediction of bowel DIE, with a higher accuracy for the prediction of rectosigmoid compared with anterior rectal DIE. Although the sensitivity for vaginal and RVS DIE was limited, gel SVG had a high specificity and NPV for all forms of posterior DIE, indicating that a negative gel SVG examination is highly suggestive of the absence of DIE at laparoscopy. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.
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Hematomas na fossa craniana posterior Haematomata in the posterior fossa
Directory of Open Access Journals (Sweden)
Mário S. Cademartori
1969-09-01
Full Text Available São relatados 6 casos de hematomas sub-tentorias (um de hematoma subdural crônico, quatro de hematomas intra-cerebelares, um de hematoma extra-dural. Salientando a pequena freqüência dos hematomas da fossa craniana posterior, o autor mostra a necessidade de vários exames complementares para o diagnóstico exato, indispensável para a aplicação de terapêutica cirúrgica adequada.Six cases of sub-tentorial haematomata (one chronic sub-dural, four intra-cerebellar, one extra-dural are reported. Emphasizing the relative rarity of haematomata in the posterior cranial fossa, the author claims the necessity of complementary examinations for proper diagnosis, indispensable for adequate surgical treatment.
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Posterior encephalopathy with vasospasm: MRI and angiography
International Nuclear Information System (INIS)
Weidauer, S.; Gaa, J.; Lanfermann, H.; Zanella, F.E.; Sitzer, M.; Hefner, R.
2003-01-01
Posterior encephalopathy is characterised by headache, impairment of consciousness, seizures and progressive visual loss. MRI shows bilateral, predominantly posterior, cortical and subcortical lesions with a distribution. Our aim was to analyse the MRI lesion pattern and angiographic findings because the pathophysiology of posterior encephalopathy is incompletely understood. We report three patients with clinical and imaging findings consistent with posterior encephalopathy who underwent serial MRI including diffusion-weighted imaging (DWI) and construction of apparent diffusion coefficient (ADC) maps, and four-vessel digital subtraction angiography (DSA). DWI revealed symmetrical subcortical and cortical parieto-occipital high signal. High and also low ADCs indicated probable vasogenic and cytotoxic oedema. On follow-up there was focal cortical laminar necrosis, while the white-matter lesions resolved almost completely, except in the arterial border zones. DSA revealed diffuse arterial narrowing, slightly more marked in the posterior circulation. These findings suggest that posterior encephalopathy may in some cases be due to diffuse, severe vasospasm affecting especially in the parieto-occipital grey matter, with its higher vulnerability to ischemia. Cerebral vasospasm due to digitoxin intoxication, resulting in posterior encephalopathy, has not yet been described previously. (orig.)
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Scutt, Polly; Lee, Han S.; Hamdy, Shaheen; Bath, Philip M.W.
2015-01-01
Background. Dysphagia after stroke is common, associated independently with poor outcome, and has limited treatment options. Pharyngeal electrical stimulation (PES) is a novel treatment being evaluated for treatment of poststroke dysphagia. Methods. We searched electronically for randomised controlled trials of PES in dysphagic patients within 3 months of stroke. Individual patient data were analysed using regression, adjusted for trial, age, severity, and baseline score. The coprimary outcom...
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Kao, Fu-Cheng; Tsai, Tsung-Ting; Niu, Chi-Chien; Lai, Po-Liang; Chen, Lih-Huei; Chen, Wen-Jer
2017-10-01
Treating thoracic infective spondylodiscitis with anterior surgical approaches carry a relatively high risk of perioperative and postoperative complications. Posterior approaches have been reported to result in lower complication rates than anterior procedures, but more evidence is needed to demonstrate the safety and efficacy of 1-stage posterior approaches for treating infectious thoracic spondylodiscitis.Preoperative and postoperative clinical data, of 18 patients who underwent 2 types of 1-stage posterior procedures, costotransversectomy and transforaminal thoracic interbody debridement and fusion and 7 patients who underwent anterior debridement and reconstruction with posterior instrumentation, were retrospectively assessed.The clinical outcomes of patients treated with 1-stage posterior approaches were generally good, with good infection control, back pain relief, kyphotic angle correction, and either partial or solid union for fusion status. Furthermore, they achieved shorter surgical time, fewer postoperative complications, and shorter hospital stay than the patients underwent anterior debridement with posterior instrumentation.The results suggested that treating thoracic spondylodiscitis with a single-stage posterior approach might prevent postoperative complications and avoid respiratory problems associated with anterior approaches. Single-stage posterior approaches would be recommended for thoracic spine infection, especially for patients with medical comorbidities.
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Zhang, Ying; Jing, Linkai; Liu, Jian; Li, Chuanhui; Fan, Jixing; Wang, Shengzhang; Li, Haiyun; Yang, Xinjian
2016-08-01
To identify clinical, morphological, and hemodynamic independent characteristic factors that discriminate posterior communicating artery (PCoA) aneurysm rupture status. 173 patients with single PCoA aneurysms (108 ruptured, 65 unruptured) between January 2012 and June 2014 were retrospectively collected. Patient-specific models based on their three-dimensional digital subtraction angiography images were constructed and analyzed by a computational fluid dynamic method. All variables were analyzed by univariate analysis and multivariate logistic regression analysis. Two clinical factors (younger age and atherosclerosis), three morphological factors (higher aspect ratio, bifurcation type, and irregular shape), and six hemodynamic factors (lower mean and minimum wall shear stress, higher oscillatory shear index, a greater portion of area under low wall shear stress, unstable and complex flow pattern) were significantly associated with PCoA aneurysm rupture. Independent factors characterizing the rupture status were identified as age (OR 0.956, p=0.015), irregular shape (OR 6.709, pPCoA aneurysm rupture were younger age, irregular shape, and low minimum wall shear stress. This may be useful for guiding risk assessments and subsequent treatment decisions for PCoA aneurysms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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Morris, William Z; Chen, Jason Y; Cooperman, Daniel R; Liu, Raymond W
2015-02-04
Many radiographic indices that are used to assess adolescents for femoroacetabular impingement rely on an ossified posterior acetabular wall. A recent study identified a secondary ossification center in the posterior rim of the acetabulum, the ossification of which may affect perceived acetabular coverage. The purpose of this study was to characterize ossification of the posterior rim of the acetabulum with use of a longitudinal radiographic study and quantify its impact on the radiographic assessment of femoroacetabular impingement. In this study, we utilized a historical collection of annual radiographs made in a population of healthy adolescents. Six hundred and twelve anteroposterior radiographs of the left hip of ninety-eight patients were reviewed to identify the appearance, duration, and fusion of the secondary ossification center in the posterior rim of the acetabulum. The center-edge angle was then measured before appearance and after fusion of the secondary ossification center in a subset of ten patients who had 40°), the use of radiographs in adolescents with incompletely ossified hips may lead to misinterpretation of acetabular coverage. In patients with open triradiate cartilage, magnetic resonance imaging may be considered for the assessment of femoroacetabular impingement. The posterior rim ossification sign is a normal finding in adolescent hip development and has important implications for the proper evaluation of femoroacetabular impingement. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.
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Spondylolisthesis and Posterior Instability
International Nuclear Information System (INIS)
Niggemann, P.; Beyer, H.K.; Frey, H.; Grosskurth, D.; Simons, P.; Kuchta, J.
2009-01-01
We present the case of a patient with a spondylolisthesis of L5 on S1 due to spondylolysis at the level L5/S1. The vertebral slip was fixed and no anterior instability was found. Using functional magnetic resonance imaging (MRI) in an upright MRI scanner, posterior instability at the level of the spondylolytic defect of L5 was demonstrated. A structure, probably the hypertrophic ligament flava, arising from the spondylolytic defect was displaced toward the L5 nerve root, and a bilateral contact of the displaced structure with the L5 nerve root was shown in extension of the spine. To our knowledge, this is the first case described of posterior instability in patients with spondylolisthesis. The clinical implications of posterior instability are unknown; however, it is thought that this disorder is common and that it can only be diagnosed using upright MRI
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Spondylolisthesis and Posterior Instability
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Niggemann, P.; Beyer, H.K.; Frey, H.; Grosskurth, D. (Privatpraxis fuer Upright MRT, Koeln (Germany)); Simons, P.; Kuchta, J. (Media Park Klinik, Koeln (Germany))
2009-04-15
We present the case of a patient with a spondylolisthesis of L5 on S1 due to spondylolysis at the level L5/S1. The vertebral slip was fixed and no anterior instability was found. Using functional magnetic resonance imaging (MRI) in an upright MRI scanner, posterior instability at the level of the spondylolytic defect of L5 was demonstrated. A structure, probably the hypertrophic ligament flava, arising from the spondylolytic defect was displaced toward the L5 nerve root, and a bilateral contact of the displaced structure with the L5 nerve root was shown in extension of the spine. To our knowledge, this is the first case described of posterior instability in patients with spondylolisthesis. The clinical implications of posterior instability are unknown; however, it is thought that this disorder is common and that it can only be diagnosed using upright MRI.
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Ha, Jennifer F; Ostwani, Waseem; Green, Glenn
2016-11-01
With the advent of improved neonatal and pediatric intensive care management, tracheostomy is increasingly performed in children requiring prolonged ventilation. Even though tracheostomy is generally a safe procedure, there remains mortality and morbidity associated with it. We report a rare complication of a tracheostomy tube resulting in extensive erosion and posterior tracheal false pouch secondary to a large tracheostomy tube and high positive end expiratory pressure in a 12-month-old infant. This was managed successfully with conservative treatment. A former 34-week premature infant was transferred to our pediatrics intensive care unit (PICU) with recurrent episodes of cardiopulmonary arrests due to suspected severe tracheobronchomalacia. The patient has bronchopulomonary dysplasia, severe restrictive lung disease and thoracic insufficiency from skeletal dysplasia requiring tracheostomy tube (TT) at two-month-old and mechanical ventilation. The 3.5 NEO TT was gradually upsized to a 5. The PEEP setting at transfer was 18cmH2O. The direct laryngoscopy and bronchoscopy showed moderate tracheomalacia at the innominate artery with a false pouch in the posterior tracheal wall that was 1.1cm below the tracheostomy stoma. A multi-disciplinary discussion including otolaryngology, PICU, Pulmonary Medicine, and Pediatric Surgery decided on conservative management. The false pouch healed and she was transferred back to referring PICU after a 46-day. Tracheal wall erosion resulting in a pouch formation is a rare complication, but it should be considered in patients with long term tracheostomy with difficulty ventilation and oxygenation with positional change. DLB is a useful tool in its diagnosis and conservative management can be successful. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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International Nuclear Information System (INIS)
Bhide, Shreerang A.; Gulliford, Sarah; Fowler, Jack; Rosenfelder, Nicola; Newbold, Katie; Harrington, Kevin J.; Nutting, Christopher M.
2010-01-01
Purpose: This study describes the acute response of oral and pharyngeal mucosa to chemo-IMRT schedules using different doses per fraction. Materials and methods: Patients, treated in prospective trials of concomitant chemo-IMRT with 2.17 Gy, 2.25 Gy and 2.4 Gy per fraction and identical dose of cisplatin, were included in this study. Acute toxicity was recorded prospectively using the CTCAE v2.0. We describe the incidence and prevalence of grade 3 oral mucositis and dysphagia over time and report the influence of overall treatment time (OTT). The association between the lengths of pharyngeal mucosa receiving 50 Gy (L50) and 60 Gy (L60) and grade 3 dysphagia was tested. Results: The incidence and the peak prevalence of grade 3 dysphagia were significantly higher in patients receiving 2.4 Gy per fraction. The peak prevalence of grade 3 dysphagia was higher and the recovery was slower in patients with lower OTT (median 38 days vs. 42 days) treatment. There was a significant correlation between L50, L60 and grade 3 dysphagia. A L50 and L60 greater than 8 cm resulted in greater than 60% and 70% incidence of grade 3 dysphagia, respectively. Conclusion: The length of pharyngeal mucosa receiving doses close to the prescription dose correlates with grade 3 dysphagia. It was observed that incidence of grade 3 dysphagia was lower and recovery from it was quicker in patients with greater OTT.
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Bhide, Shreerang A., E-mail: sabhide@yahoo.co [Royal Marsden Hospital, Sutton, London (United Kingdom); Institute of Cancer Research, Sutton, London (United Kingdom); Gulliford, Sarah [Institute of Cancer Research, Sutton, London (United Kingdom); Fowler, Jack [Department of Human Oncology, University of Wisconsin, Madison (United States); Department of Medical Physics, University of Wisconsin, Madison (United States); Rosenfelder, Nicola; Newbold, Katie [Royal Marsden Hospital, Sutton, London (United Kingdom); Harrington, Kevin J; Nutting, Christopher M [Royal Marsden Hospital, Sutton, London (United Kingdom); Institute of Cancer Research, Sutton, London (United Kingdom)
2010-10-15
Purpose: This study describes the acute response of oral and pharyngeal mucosa to chemo-IMRT schedules using different doses per fraction. Materials and methods: Patients, treated in prospective trials of concomitant chemo-IMRT with 2.17 Gy, 2.25 Gy and 2.4 Gy per fraction and identical dose of cisplatin, were included in this study. Acute toxicity was recorded prospectively using the CTCAE v2.0. We describe the incidence and prevalence of grade 3 oral mucositis and dysphagia over time and report the influence of overall treatment time (OTT). The association between the lengths of pharyngeal mucosa receiving 50 Gy (L50) and 60 Gy (L60) and grade 3 dysphagia was tested. Results: The incidence and the peak prevalence of grade 3 dysphagia were significantly higher in patients receiving 2.4 Gy per fraction. The peak prevalence of grade 3 dysphagia was higher and the recovery was slower in patients with lower OTT (median 38 days vs. 42 days) treatment. There was a significant correlation between L50, L60 and grade 3 dysphagia. A L50 and L60 greater than 8 cm resulted in greater than 60% and 70% incidence of grade 3 dysphagia, respectively. Conclusion: The length of pharyngeal mucosa receiving doses close to the prescription dose correlates with grade 3 dysphagia. It was observed that incidence of grade 3 dysphagia was lower and recovery from it was quicker in patients with greater OTT.
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Kinoshita, Hideaki; Umezawa, Takashi; Omine, Yuya; Kasahara, Masaaki; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Abe, Shinichi
2013-03-01
There is little or no information about the distribution of elastic fibers in the human fetal head. We examined this issue in 15 late-stage fetuses (crown-rump length, 220-320 mm) using aldehyde-fuchsin and elastica-Masson staining, and we used the arterial wall elastic laminae and external ear cartilages as positive staining controls. The posterior pharyngeal wall, as well as the ligaments connecting the laryngeal cartilages, contained abundant elastic fibers. In contrast with the sphenomandibular ligament and the temporomandibular joint disk, in which elastic fibers were partly present, the discomalleolar ligament and the fascial structures around the pterygoid muscles did not have any elastic fibers. In addition, the posterior marginal fascia of the prestyloid space did contain such fibers. Notably, in the middle ear, elastic fibers accumulated along the tendons of the tensor tympani and stapedius muscles and in the joint capsules of the ear ossicle articulations. Elastic fibers were not seen in any other muscle tendons or vertebral facet capsules in the head and neck. Despite being composed of smooth muscle, the orbitalis muscle did not contain any elastic fibers. The elastic fibers in the sphenomandibular ligament seemed to correspond to an intermediate step of development between Meckel's cartilage and the final ligament. Overall, there seemed to be a mini-version of elastic fiber distribution compared to that in adults and a different specific developmental pattern of connective tissues. The latter morphology might be a result of an adaptation to hypoxic conditions during development.
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Traumatic lesions of the posterior urethra.
Velarde-Ramos, L; Gómez-Illanes, R; Campos-Juanatey, F; Portillo-Martín, J A
2016-11-01
The posterior urethral lesions are associated with pelvis fractures in 5-10% of cases. The posterior urethra is attached to the pelvis bone by puboprostatic ligaments and the perineal membrane, which explains why disruption of the pelvic ring can injure the urethra at this level. To identify suspected cases of posterior urethral trauma and to perform the diagnosis and its immediate or deferred management. Search in PubMed of articles related to traumatic posterior urethral lesions, written in English or Spanish. We reviewed the relevant publications including literature reviews and chapters from books related to the topic. With patients with pelvis fractures, we must always rule out posterior urethral lesions. The diagnostic examination of choice is retrograde urethrography, which, along with the severity of the condition, will determine the management in the acute phase and whether the treatment will be performed immediately or deferred. Early diagnosis and proper acute management decrease the associated complications, such as strictures, urinary incontinence and erectile dysfunction. Despite the classical association between posterior urethral lesions and pelvic fractures, the management of those lesions (whether immediate or deferred) remains controversial. Thanks to the growing interest in urethral disease, there are an increasing number of studies that help us achieve better management of these lesions. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.
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Delayed Single Stage Perineal Posterior Urethroplasty
International Nuclear Information System (INIS)
Ali, S.; Shahnawaz; Shahzad, I.; Baloch, M. U.
2015-01-01
Objective: To determine the delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture/distraction defect. Study Design: Descriptive case series. Place and Duration of Study: Department of Urology, Jinnah Postgraduate Medical Centre, Karachi, from January 2009 to December 2011. Methodology: Patients were selected for delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture / distraction defect. All were initially suprapubically catheterized followed by definitive surgery after at least 3 months. Results: Thirty male patients were analyzed with a mean follow-up of 10 months, 2 patients were excluded as they developed failure in first 3 months postoperatively. Mean patients age was 26.25 ± 7.9 years. On follow-up, 7 patients (23.3 percentage) experienced recurrent stricture during first 10 months. Five (16.6 percentage) patients were treated successfully with single direct visual internal urethrotomy. Two patients (6.6 percentage) had more than one direct visual internal urethrotomy and considered failed. Re-do perineal urethroplasty was eventually performed. The overall success rate was 93.3 percentage with permissive criteria allowing single direct visual internal urethrotomy and 76.6% with strict criteria allowing no more procedures postoperatively. Conclusion: Posterior anastomotic urethroplasty offers excellent long-term results to patients with posterior urethral trauma and distraction defect even after multiple prior procedures. (author)
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Role of vesicostomy in the management of posterior urethral valve in Sub-Saharan Africa.
Lukong, C S; Ameh, E A; Mshelbwala, P M; Jabo, B A; Gomna, A; Anumah, M A; Nmadu, P T; Mfuh, A Y
2014-02-01
To review the role of vesicostomy in the management of posterior urethral valve (PUV), in neonates and infants, given the limitations for endoscopic treatment in this setting. A review of 35 patients who presented with posterior urethral valve over a 10-year period. Demographic and clinical information were prospectively recorded on a structured pro forma, and the data extracted analysed using SPSS 11.0. The 35 boys were aged 3 days to 10 years (median 3 weeks). Twenty-three (65.7%) had a vesicostomy (age range 3 days-3 years, median 3 weeks). The mode of presentation was poor urinary stream 15 (65.2%), urinary retention 4 (17.4%), and renal failure 6 (26.1%). Main findings were palpable bladder 23 (100%), hydronephrosis 4 (17.4%). Abdominal ultrasound confirmed hydronephrosis and thickened bladder wall, and voiding/expressive cystourethrogram confirmed dilated posterior urethra and vesicoureteric reflux in all 23 patients. Complications following vesicostomy were stoma stenosis 1 (4.3%), bladder mucosal prolapse 1 (4.3%), perivesicostomy abscess 1 (4.3%); there was no mortality. Following vesicostomy, 10 (43.5%) patients had excision of the valves and vesicostomy closure at age 2-8 years (median 4 years). They are well, with normal renal ultrasonographic findings, bladder capacity range 115-280 ml, and normal urea, serum electrolytes, creatinine, at 3 years of follow up. Thirteen (56.5%) are still awaiting valvotomy but have remained well and with normal ultrasonographic renal findings. Vesicostomy is a useful temporising mode of urinary diversion in neonates and infants with posterior urethral valve (in the absence of unobstructed upper tracts) when facilities for endoscopic valve ablation are not readily available. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
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Epidural hematomas of posterior fossa
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Radulović Danilo
2004-01-01
Full Text Available Background. Posterior fossa epidural hematomas represent 7-14% of all traumatic intracranial epidural hematomas. They are most frequently encountered posttraumatic mass lesions in the posterior fossa. The aim of this study was to identify clinical features that could lead to the early diagnosis of posterior fossa epidural hematoma. Methods. Between 1980 and 2002, 28 patients with epidural hematoma of the posterior fossa were operated on at the Institute for Neurosurgery, Belgrade. Clinical course neuroradiological investigations, and the results of surgical treatment of the patients with posterior fossa epidural hematomas were analyzed retrospectively. Results. Almost two thirds of patients were younger than 16 years of age. In 20 cases injury was caused by a fall, in 6 cases by a traffic accident, and in 2 by the assault. Clinical course was subacute or chronic in two thirds of the patients. On the admission Glasgow Coma Scale was 7 or less in 9 injured, 8-14 in 14 injured, and 15 in 5 injured patients. Linear fracture of the occipital bone was radiographically evident in 19 patients, but was intraoperatively encountered in all the patients except for a 4-year old child. In 25 patients the diagnosis was established by computer assisted tomography (CAT and in 3 by vertebral angiography. All the patients were operated on via suboccipital craniotomy. Four injured patients who were preoperatively comatose were with lethal outcome. Postoperatively, 24 patients were with sufficient neurologic recovery. Conclusion. Posterior fossa epidural hematoma should be suspected in cases of occipital injury, consciousness disturbances, and occipital bone fracture. In such cases urgent CAT-scan is recommended. Early recognition early diagnosis, and prompt treatment are crucial for good neurological recovery after surgery.
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Distrofia corneana policromática posterior Polychromatic posterior corneal dystrophy
Directory of Open Access Journals (Sweden)
Patrick Frensel de Moraes Tzelikis
2007-08-01
Full Text Available Os autores descrevem quatro raros casos de distrofia corneana policromática posterior, ainda não descrito na literatura nacional. Observam-se opacidades puntiformes, policromáticas, de tamanho uniforme, localização estromal profunda, distribuídas de limbo a limbo e que não interferem na acuidade visual. É apresentada uma revisão dos casos de distrofia pré-Descemet existentes na literatura.The authors describe four rare cases of polychromatic posterior corneal dystrophy, not describe in national literature. The opacities are deep in the stroma, dotlike, polychromatic, uniform in size, distributed from limbus to limbus, leading no reduction in visual acuity. It is also presented a bibliographic review of pre-Descemet's dystrophy.
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Directory of Open Access Journals (Sweden)
Ewa Nogaj
2011-03-01
Full Text Available The characteristic of occurrence calcium content in pharyngeal tonsils from 60 girls and 90 boys living in 9 region of Upper Silesia is presented in this article. Analysis of content of Ca in pharyngheal tonsils was observed in four groups of children: girls and boys exposed to tobacco smoke and unexposed to tabacco smoke, influence parameters environments on contents Ca in tissue tonsil and the cross-correlation analysis between content of ion Ca and other metals Al, Cd, Cu, Ni, Pb, Zn, Mg, Ba, showed repeating co-dependences between Ca in girls from Cd, Al., Zn, Ni, Pb. In case of boys colective dependence was been dependence Ca in Mg, Cd, Zn. Arithmetic mean of calcium in pharyngeal tonsils from exposed girls was 1345.00 µg/g, in comparison to unexposed girls 1292.88 µg/g, in exposed to tobacco smoke boys- 1832.63 µg/g and unexposed boys 565.05 µg/g. It turned out that gender perform important part in absorbed calcium and here noticeable was been big ability to concentrate toxic metals in girls
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An unusual case of grass inflorescence aspiration presenting as a chest wall tumour
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Karagoez, Beguel; Koeksal, Yavuz; Varan, Ali; Bueyuekpamukcu, Muenevver [Hacettepe University, Department of Paediatric Oncology, Institute of Oncology, Ankara (Turkey); Haliloglu, Mithat [Hacettepe University, Department of Radiology, Faculty of Medicine, Ankara (Turkey); Ekinci, Saniye [Hacettepe University, Department of Paediatric Surgery, Faculty of Medicine, Ankara (Turkey)
2006-05-15
A 9-year-old boy was referred to the Oncology Department because of a thoracic soft-tissue mass thought to be a chest wall tumour. He had a history of grass inflorescence (Hordeum murinum) aspiration 2 weeks prior to this admission. On physical examination a tender soft-tissue mass under the right scapula and diminished breath sounds from the right lower lobe were detected. Thoracic CT confirmed soft-tissue swelling of the right posterior chest wall. There was a hypodense area within the soft-tissue mass suggesting a foreign body and also focal consolidation of the right lower lobe adjacent to the soft-tissue swelling. We report here unique CT findings of grass inflorescence aspiration before and after its migration through the airways. (orig.)
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An unusual case of grass inflorescence aspiration presenting as a chest wall tumour
International Nuclear Information System (INIS)
Karagoez, Beguel; Koeksal, Yavuz; Varan, Ali; Bueyuekpamukcu, Muenevver; Haliloglu, Mithat; Ekinci, Saniye
2006-01-01
A 9-year-old boy was referred to the Oncology Department because of a thoracic soft-tissue mass thought to be a chest wall tumour. He had a history of grass inflorescence (Hordeum murinum) aspiration 2 weeks prior to this admission. On physical examination a tender soft-tissue mass under the right scapula and diminished breath sounds from the right lower lobe were detected. Thoracic CT confirmed soft-tissue swelling of the right posterior chest wall. There was a hypodense area within the soft-tissue mass suggesting a foreign body and also focal consolidation of the right lower lobe adjacent to the soft-tissue swelling. We report here unique CT findings of grass inflorescence aspiration before and after its migration through the airways. (orig.)
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Kang, Sang-Wook; Kandil, Emad; Kim, Min Jhi; Kim, Kwang Soon; Lee, Cho Rok; Jeong, Jong Ju; Nam, Kee-Hyun; Chung, Woong Youn; Park, Cheong Soo
2018-04-01
The posterior retroperitoneoscopic adrenalec tomy has several advantages compared with the transperitoneal approach such as a shorter and more direct route to the target organ, no breach of the intraperitoneal space, and no required retraction of the adjacent organs. It also is a safe procedure with a short learning curve.1 - 5 This report presents a challenging case of an extra-adrenal paraganglioma located in the aorto-caval space and managed using the retroperitoneal approach. A 39-year-old man was placed in the prone jackknife position, and three incisions were made in the right posterior abdominal wall for placement of the laparoscopic ports. The retroperitoneal space was entered with diathermy and blunt finger dissection, and retropneumoperitoneum was achieved with carbon dioxide insufflation pressure up to 18 mmHg. After identification of the right kidney and vessels, the tumor was meticulously dissected and excised with an energy device. The specimen was removed using a laparoscopic specimen retrieval bag, and the port sites were closed in layers. The operative time was 130 min, and the total blood loss was 30 ml. The tumor was diagnosed as a moderately differentiated extra-adrenal paraganglioma. The Von Hippel-Lindau gene mutation was detected using next-generation sequencing. The posterior retroperitoneoscopic approach is a safe, feasible, and effective method for excising an extra-adrenal paraganglioma even in the aorto-caval space. The authors suggest that this procedure is a useful surgical option for treatment of an aorto-caval paraganglioma for selected patients and by experienced surgeons.
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Directory of Open Access Journals (Sweden)
George A Syrogiannopoulos
Full Text Available BACKGROUND: An experimental 26-valent M protein Group A streptococcal (GAS vaccine has entered clinical studies. Pharyngeal GAS emm type surveillances in different areas and time-periods enhance the understanding of the epidemiology of GAS pharyngitis. Moreover, these surveillances, combined with the data on GAS invasive disease, can play a significant role in the formulation of multivalent type-specific vaccines. METHODS: During a 7-year period (1999-2005, 2408 GAS isolates were recovered from consecutive children with pharyngitis in Western Greece. The overall macrolide resistance rate was 22.8%. Along the study period we noted a tendency towards significantly decreased rates of resistance, with the lowest rates occurring in 2002 (15.3%, 2003 (15% and 2004 (16.7%. A random sample of isolates from each year, 338 (61.7% of the 548 macrolide-resistant and 205 (11% of the macrolide-susceptible, underwent molecular analysis, including emm typing. RESULTS: The 543 typed isolates had 28 different emm types. A statistically significant association was found between macrolide resistance and emm4, emm22 and emm77, whereas emm1, emm3, emm6, emm12, emm87 and emm89 were associated with macrolide susceptibility. A significant yearly fluctuation was observed in emm4, emm28 and emm77. The most common macrolide-resistant GAS were emm77 isolates harboring erm(A, either alone or in combination with mef(A, emm4 carrying mef(A, emm28 possessing erm(B, emm75 carrying mef(A, emm12 harboring mef(A and emm22 carrying erm(A. We estimated that 82.8% of the isolates belonged to emm types included in the novel 26-valent M protein vaccine. The vaccine coverage rate was determined mainly by the increased frequency of nonvaccine emm4 isolates. CONCLUSIONS: A limited number of emm types dominated among macrolide-susceptible and macrolide-resistant GAS isolates. We observed seasonal fluctuations, which were significant for emm4, emm28 and emm77. This type of data can serve as
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Posterior alien hand syndrome: case report
International Nuclear Information System (INIS)
Rohde, S.; Weidauer, S.; Lanfermann, H.; Zanella, F.
2002-01-01
The alien hand syndrome (AHS) is involuntary uncontrolled movement of an arm with a sense of estrangement from the limb itself. AHS was initially used to describe interhemispheric disconnection phenomena in patients with lesions in the anterior corpus callosum, but it has been found in patients with posterior cerebral lesions without involvement of the corpus callosum, for example parietal infarcts or corticobasal degeneration. The posterior alien hand syndrome is less frequent and presents with nonpurposive behaviour like lifting the arm or writhing fingers. We report an 80-year-old woman with a posterior AHS of the dominant right hand. MRI showed atrophy of the pre- and postcentral gyri without involvement of the corpus callosum. We discuss the aetiology of the posterior AHS and the differences from the anterior varieties. (orig.)
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Directory of Open Access Journals (Sweden)
Nan Lv
Full Text Available The conflicting findings of previous morphological and hemodynamic studies on intracranial aneurysm rupture may be caused by the relatively small sample sizes and the variation in location of the patient-specific aneurysm models. We aimed to determine the discriminators for aneurysm rupture status by focusing on only posterior communicating artery (PCoA aneurysms.In 129 PCoA aneurysms (85 ruptured, 44 unruptured, clinical, morphological and hemodynamic characteristics were compared between the ruptured and unruptured cases. Multivariate logistic regression analysis was performed to determine the discriminators for rupture status of PCoA aneurysms.While univariate analyses showed that the size of aneurysm dome, aspect ratio (AR, size ratio (SR, dome-to-neck ratio (DN, inflow angle (IA, normalized wall shear stress (NWSS and percentage of low wall shear stress area (LSA were significantly associated with PCoA aneurysm rupture status. With multivariate analyses, significance was only retained for higher IA (OR = 1.539, p < 0.001 and LSA (OR = 1.393, p = 0.041.Hemodynamics and morphology were related to rupture status of intracranial aneurysms. Higher IA and LSA were identified as discriminators for rupture status of PCoA aneurysms.
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Effects of pharyngeal electrical stimulation on swallowing performance.
Takeishi, Ryosuke; Magara, Jin; Watanabe, Masahiro; Tsujimura, Takanori; Hayashi, Hirokazu; Hori, Kazuhiro; Inoue, Makoto
2018-01-01
Pharyngeal electrical stimulation (PEStim) has been found to facilitate voluntary swallowing. This study investigated how PEStim contributed to modulation of swallowing function in 15 healthy humans. In the involuntary swallowing test, water was injected onto the pharynx at 0.05 ml/s and the onset latency of the first swallow was measured. In the voluntary swallowing test, subjects swallowed their own saliva as quickly as possible for 30 s and the number of swallows was counted. Voluntary and involuntary swallowing was evaluated before (baseline), immediately after, and every 10 min after 10-min PEStim for 60 min. A voluntary swallowing test with simultaneous 30-s PEStim was also conducted before and 60 min after 10-min PEStim. The number of voluntary swallows with simultaneous PEStim significantly increased over 60 min after 10-min PEStim compared with the baseline. The onset latency of the first swallow in the involuntary swallowing test was not affected by 10-min PEStim. The results suggest that PEStim may have a long-term facilitatory effect on the initiation of voluntary swallowing in healthy humans, but not on peripherally-evoked swallowing. The physiological implications of this modulation are discussed.
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Directory of Open Access Journals (Sweden)
Lauro Augusto de Oliveira
2006-12-01
Full Text Available O objetivo deste trabalho é alertar o oftalmologista da possibilidade de se deparar com casos raros de distrofias corneanas. Neste caso correlacionamos os achados clínicos da distrofia amorfa posterior com refração, topografia e biomicroscopia ultra-sônica.The purpose of this paper is to warn the ophthalmologist about the possibility of facing rare cases of corneal dystrophies. Clinical findings of a case of posterior amorphous dystrophy were correlated with refraction, topography, and ultrasound biomicroscopy.
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Altenburger, Andreas
2016-01-01
Kinorhynchs are ecdysozoan animals with a phylogenetic position close to priapulids and loriciferans. To understand the nature of segmentation within Kinorhyncha and to infer a probable ancestry of segmentation within the last common ancestor of Ecdysozoa, the musculature and the nervous system of the allomalorhagid kinorhynch Pycnophyes kielensis were investigated by use of immunohistochemistry, confocal laser scanning microscopy, and 3D reconstruction software. The kinorhynch body plan comprises 11 trunk segments. Trunk musculature consists of paired ventral and dorsal longitudinal muscles in segments 1-10 as well as dorsoventral muscles in segments 1-11. Dorsal and ventral longitudinal muscles insert on apodemes of the cuticle inside the animal within each segment. Strands of longitudinal musculature extend over segment borders in segments 1-6. In segments 7-10, the trunk musculature is confined to the segments. Musculature of the digestive system comprises a strong pharyngeal bulb with attached mouth cone muscles as well as pharyngeal bulb protractors and retractors. The musculature of the digestive system shows no sign of segmentation. Judged by the size of the pharyngeal bulb protractors and retractors, the pharyngeal bulb, as well as the introvert, is moved passively by internal pressure caused by concerted action of the dorsoventral muscles. The nervous system comprises a neuropil ring anterior to the pharyngeal bulb. Associated with the neuropil ring are flask-shaped serotonergic somata extending anteriorly and posteriorly. A ventral nerve cord is connected to the neuropil ring and runs toward the anterior until an attachment point in segment 1, and from there toward the posterior with one ganglion in segment 6. Segmentation within Kinorhyncha likely evolved from an unsegmented ancestor. This conclusion is supported by continuous trunk musculature in the anterior segments 1-6, continuous pharyngeal bulb protractors and retractors throughout the anterior
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Congenital abnormalities of the posterior fossa.
Bosemani, Thangamadhan; Orman, Gunes; Boltshauser, Eugen; Tekes, Aylin; Huisman, Thierry A G M; Poretti, Andrea
2015-01-01
The frequency and importance of the evaluation of the posterior fossa have increased significantly over the past 20 years owing to advances in neuroimaging. Nowadays, conventional and advanced neuroimaging techniques allow detailed evaluation of the complex anatomic structures within the posterior fossa. A wide spectrum of congenital abnormalities has been demonstrated, including malformations (anomalies due to an alteration of the primary developmental program caused by a genetic defect) and disruptions (anomalies due to the breakdown of a structure that had a normal developmental potential). Familiarity with the spectrum of congenital posterior fossa anomalies and their well-defined diagnostic criteria is crucial for optimal therapy, an accurate prognosis, and correct genetic counseling. The authors discuss the spectrum of posterior fossa malformations and disruptions, with emphasis on neuroimaging findings (including diagnostic criteria), neurologic presentation, systemic involvement, prognosis, and risk of recurrence. RSNA, 2015
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Fgf signaling controls pharyngeal taste bud formation through miR-200 and Delta-Notch activity.
Kapsimali, Marika; Kaushik, Anna-Lila; Gibon, Guillaume; Dirian, Lara; Ernest, Sylvain; Rosa, Frederic M
2011-08-01
Taste buds, the taste sensory organs, are conserved in vertebrates and composed of distinct cell types, including taste receptor, basal/presynaptic and support cells. Here, we characterize zebrafish taste bud development and show that compromised Fgf signaling in the larva results in taste bud reduction and disorganization. We determine that Fgf activity is required within pharyngeal endoderm for formation of Calb2b(+) cells and reveal miR-200 and Delta-Notch signaling as key factors in this process. miR-200 knock down shows that miR-200 activity is required for taste bud formation and in particular for Calb2b(+) cell formation. Compromised delta activity in mib(-/-) dramatically reduces the number of Calb2b(+) cells and increases the number of 5HT(+) cells. Conversely, larvae with increased Notch activity and ascl1a(-/-) mutants are devoid of 5HT(+) cells, but have maintained and increased Calb2b(+) cells, respectively. These results show that Delta-Notch signaling is required for intact taste bud organ formation. Consistent with this, Notch activity restores Calb2b(+) cell formation in pharyngeal endoderm with compromised Fgf signaling, but fails to restore the formation of these cells after miR-200 knock down. Altogether, this study provides genetic evidence that supports a novel model where Fgf regulates Delta-Notch signaling, and subsequently miR-200 activity, in order to promote taste bud cell type differentiation.
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Keberle, M; Wittenberg, G; Trusen, A; Baumgartner, W; Hahn, D
2001-08-01
In contrast to esophageal perforations, the more radiopaque barium-suspensions are not as important as iodinated aqueous contrast agents for the detection of pharyngeal perforations. This study was performed to find out whether the highly different viscosities (of iodinated and barium-containing contrast agents with comparable radiopacities) are a reason for this. Viscosity, subjective difference in contrast, and CT-density of an iodinated aqueous (Telebrix) and a 50 wt/vol% barium-containing contrast agent (Micropaque) were determined. Moreover, to exclude postoperative perforation, 104 patients were prospectively examined by pharyngography using both contrast media. Pharyngographies of patients with perforation were later compared by two independent readers. All patients with perforation were followed up clinically to exclude complications due to barium administration. In-vitro comparison showed comparable radiopacity but the 50 wt/vol% barium-suspension was much more viscous than the iodinated contrast agent. During pharyngography, totally, 14 perforations were clearly delineated with the iodinated aqueous contrast agent. However, two of them were not detected with the barium-suspension. All the other perforations presented equally. Given a sufficient radiopacity, a low viscosity appears to be essential for a contrast agent to detect especially pharyngeal perforations. Thus, we recommend the sole use of an iodinated contrast agent (at suspicion of aspiration as isoosmolar variant) for this purpose.
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International Nuclear Information System (INIS)
Ali, B.; Shaikh, A.; Fida, M.
2015-01-01
Background: Functional appliances have been used since many decades for the correction of mandibular retrognathism. Similar oral appliances are a treatment modality for patients with Obstructive sleep apnea. Hence, interception at the right age with these growth modification appliances might benefit a child from developing long term respiratory insufficiency. Therefore, the purpose of our study was to assess the short term effects of Twin block appliance (CTB) on pharyngeal airway size in subjects with skeletal Class II pattern in a sample of Pakistani population. Methods: A retrospective study was conducted from orthodontic records of 62 children (31 males, 31 females) with retrognathic mandibles using lateral cephalograms obtained at initial visit and after CTB treatment. Paired t-test was used to compare the pre-functional and post-functional treatment airway size. Independent sample t-test was used for comparison between the genders and statistical significance was kept at =0.05. Results: The upper airway width (p<0.001), nasopharyngeal depth (p=0.03) and upper airway thickness (p=0.008) was substantially improved after CTB treatment. Males showed a greater increase in upper airway width (p= 0.03) and nasopharyngeal depth (p=0.01) in comparison to the females. Conclusion: Functional appliance therapy can improve the narrow pharyngeal airway of growing children presenting with deficient mandibles having Class II skeletal pattern. (author)
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International Nuclear Information System (INIS)
Hamming-Vrieze, Olga; Kranen, Simon Robert van; Beek, Suzanne van; Heemsbergen, Wilma; Herk, Marcel van; Brekel, Michiel Wilhelmus Maria van den; Sonke, Jan-Jakob; Rasch, Coenraad Robert Nico
2012-01-01
Purpose: This study quantifies tumor shape variability in head-and-neck cancer patients during radiation therapy using implanted markers. Methods and Materials: Twenty-seven patients with oropharyngeal tumors treated with (chemo)radiation were included. Helical gold markers (0.35 × 2 mm, 3-10/patient, average 6) were implanted around the tumor. Markers were identified on planning computed tomography (CT) and daily cone beam CT (CBCT). After bony anatomy registration, the daily vector length on CBCT in reference to the planning CT and daily marker movement perpendicular to the gross tumor volume (GTV) surface at planning CT (d normal ) of each marker were analyzed. Time trends were assessed with linear regression of the normal > markers . In 2 patients, 2 markers were implanted in normal tissue to evaluate migration by measuring intermarker distances. Results: Marker implantation was feasible without complications. Three-dimensional vectors (4827 measurements, mean 0.23 cm, interquartile ratio 0.24 cm) were highest in base of tongue sublocalization (P<.001) and bulky tumors (vectors exceeded 0.5 cm in 5.7% [0-20 mL], 12.0% [21-40 mL], and 21.7% [≥41 mL], respectively [P<.001] of measurements). The measured inward time trend in 11/27 patients correlated with the visual observed marker pattern. In patients with an outward trend (5/27) or no trend (11/27), visual observation showed predominantly an inhomogeneous pattern. Remarkably, in 6 patients, outward marker movement was observed in the posterior pharyngeal wall. The difference in distance between normal tissue markers (1 SD) was 0.05-0.06 cm without time trend, indicating that implanted markers did not migrate. Conclusions: During head-and-neck radiation therapy, normal tissue markers remained stable. Changes in position of tumor markers depended on sublocalization and tumor volume. Large differences in marker patterns between patients as well as within patients were observed. Based on our study, the cranial
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Directory of Open Access Journals (Sweden)
Kumara V. Nibhanipudi MD, FAAP, FAAEM
2016-07-01
Full Text Available Objective. A study to determine if addition of palatal petechiae to Centor criteria adds more value for clinical diagnosis of acute strep pharyngitis in children. Hypothesis. In children, Centor Criteria does not cover all the symptoms and signs of acute strep pharyngitis. We hypothesize that addition of palatal petechiae to Centor Criteria will increase the possibility of clinical diagnosis of group A streptococcal pharyngitis in children. Methods. One hundred patients with a complaint of sore throat were enrolled in the study. All the patients were examined clinically using the Centor Criteria. They were also examined for other signs and symptoms like petechial lesions over the palate, abdominal pain, and skin rash. All the patients were given rapid strep tests, and throat cultures were sent. No antibiotics were given until culture results were obtained. Results. The sample size was 100 patients. All 100 had fever, sore throat, and erythema of tonsils. Twenty of the 100 patients had tonsillar exudates, 85/100 had tender anterior cervical lymph nodes, and 86/100 had no cough. In total, 9 out of the 100 patients had positive throat cultures. We observed that petechiae over the palate, a very significant sign, is not included in the Centor Criteria. Palatal petechiae were present in 8 out of the 100 patients. Six out of these 8 with palatal petechiae had positive throat culture for strep (75%. Only 7 out of 20 with exudates had positive strep culture. Sixteen out of the 100 patients had rapid strep test positive. Those 84/100 who had negative rapid strep also had negative throat culture. Statistics. We used Fisher’s exact test, comparing throat culture positive and negative versus presence of exudates and palatal hemorrhages with positive and negative throat cultures and the resultant P value <.0001. Conclusion. Our study concludes that addition of petechiae over the palate to Centor Criteria will increase the possibility of diagnosing acute
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Wang, Guangyao; Chen, Ping; Zong, Liang; Shi, Lei; Zhao, Wei
2014-02-01
Cellular schwannomas have been previously described at almost every anatomic location of the human body, but reports in the gastric wall are rare. The current study presents a rare case of cellular schwannoma originating from the gastric wall. Computed tomography revealed a 5.6×5.3×4.0-cm 3 solid mass located in the posterior wall of the stomach. Open laparotomy confirmed its mesenchymal origin. Microscopically, the tissue was composed of spindle-shaped and fascicularly-arranged cells, but mitotic figures were rare. Immunohistochemical staining showed that the tumor was negative for cluster of differentiation (CD)117, CD34, smooth muscle actin and desmin, but positive for S-100 and Ki67. The patient presented no evidence of recurrence and metastasis during follow-up. Gastric cellular schwannomas may be diagnosed by clinical characteristics, histological observations and immunohistochemical markers.
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Egoshina V. O.
2013-12-01
Full Text Available Found that in this pathology is a significant increase in pro-and anti-inflammatory cytokines in patients due to the predominance of pro-inflammatory cytokines during exacerbation of chronic inflammation of the lymphoid tissues of the pharynx. Found that after the standard treatment for patients with hypertrophic pharyngitis content IFN-γ levels and sIgA in the oropharyngeal secretions reaches levels of the control group , provided intermittent effect in terms ofreducing cytokine levels in the serum of 45 and 90 days after initiation of treatment and partial restoration of local immunity oropharynx. In a joint application Derinat and IRS-19 was observed acceleration of restoring the balance of cellular and humoral immunity, no recurrence of the disease for the entire period of observation, that the efficiency of treatment of chronic hypertrophic pharyngitis.
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Posterior Probability Matching and Human Perceptual Decision Making.
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Richard F Murray
2015-06-01
Full Text Available Probability matching is a classic theory of decision making that was first developed in models of cognition. Posterior probability matching, a variant in which observers match their response probabilities to the posterior probability of each response being correct, is being used increasingly often in models of perception. However, little is known about whether posterior probability matching is consistent with the vast literature on vision and hearing that has developed within signal detection theory. Here we test posterior probability matching models using two tools from detection theory. First, we examine the models' performance in a two-pass experiment, where each block of trials is presented twice, and we measure the proportion of times that the model gives the same response twice to repeated stimuli. We show that at low performance levels, posterior probability matching models give highly inconsistent responses across repeated presentations of identical trials. We find that practised human observers are more consistent across repeated trials than these models predict, and we find some evidence that less practised observers more consistent as well. Second, we compare the performance of posterior probability matching models on a discrimination task to the performance of a theoretical ideal observer that achieves the best possible performance. We find that posterior probability matching is very inefficient at low-to-moderate performance levels, and that human observers can be more efficient than is ever possible according to posterior probability matching models. These findings support classic signal detection models, and rule out a broad class of posterior probability matching models for expert performance on perceptual tasks that range in complexity from contrast discrimination to symmetry detection. However, our findings leave open the possibility that inexperienced observers may show posterior probability matching behaviour, and our methods
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A study of UGI series for improvement of diagnosis on the anterior wall of the stomach
International Nuclear Information System (INIS)
Lee, Won Hong; Son, Soon Yong; Kang, Hyoung Wook
1997-01-01
This paper is to investigate a more detailed method for the diagnosis of anterior wall of the stomach by making a comparative study with several hospitals. It has been true that there have been hospitals, that have not examined anterior wall of the stomach. However, it is very important for us to examine anterior wall of the stomach for an early detection of gastric carcinoma. The results of the study are as follows : 1. Frequency of occurrence of the early gastric carcinoma for the anterior wall were 50 cases and 34 cases for the posterior wall out of 84 cases. 2. Only a hospitals have examined the anterior wall of stomach. 3. In case of operation, only a hospitals have used two techniques at for same time single and double contrast studies. 4. Only one hospital used a compression pad and three hospitals had only filing state images taken. 5. In general, l chest of film was used and the number of exposures rouged from 1 to 2 times. Lesions on the anterior wall of the stomach can be shown by the combination of prone single compression and supine double contrast radiographs. Therefore, the conclusion came to the result that the prone single compression and supine double contract technique of the anterior wall are indispensable methods to the routine check of the stomach
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International Nuclear Information System (INIS)
Rothschild, Sacha; Studer, Gabriela; Seifert, Burkhardt; Huguenin, Pia; Glanzmann, Christoph; Davis, J Bernard; Lütolf, Urs M; Hany, Thomas F; Ciernik, I Frank
2007-01-01
Impact of non-pharmacological innovations on cancer cure rates is difficult to assess. It remains unclear, whether outcome improves with 2- [18-F]-fluoro-2-deoxyglucose-positron emission tomography and integrated computer tomography (PET/CT) and intensity-modulated radiotherapy (IMRT) for curative treatment of advanced pharyngeal carcinoma. Forty five patients with stage IVA oro- or hypopharyngeal carcinoma were staged with an integrated PET/CT and treated with definitive chemoradiation with IMRT from 2002 until 2005. To estimate the impact of PET/CT with IMRT on outcome, a case-control analysis on all patients with PET/CT and IMRT was done after matching with eighty six patients treated between 1991 and 2001 without PET/CT and 3D-conformal radiotherapy with respect to gender, age, stage, grade, and tumor location with a ratio of 1:2. Median follow-up was eighteen months (range, 6–49 months) for the PET/CT-IMRT group and twenty eight months (range, 1–168 months) for the controls. PET/CT and treatment with IMRT improved cure rates compared to patients without PET/CT and IMRT. Overall survival of patients with PET/CT and IMRT was 97% and 91% at 1 and 2 years respectively, compared to 74% and 54% for patients without PET/CT or IMRT (p = 0.002). The event-free survival rate of PET/CT-IMRT group was 90% and 80% at 1 and 2 years respectively, compared to 72% and 56% in the control group (p = 0.005). PET/CT in combination with IMRT and chemotherapy for pharyngeal carcinoma improve oncological therapy of pharyngeal carcinomas. Long-term follow-up is needed to confirm these findings
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Boelens, Oliver B; Maatman, Robert C; Scheltinga, Marc R; van Laarhoven, Kees; Roumen, Rudi M
2017-03-01
Most patients with chronic back pain suffer from degenerative thoracolumbovertebral disease. However, the following case illustrates that a localized peripheral nerve entrapment must be considered in the differential diagnosis of chronic back pain. We report the case of a 26-year-old woman with continuous excruciating pain in the lower back area. Previous treatment for nephroptosis was to no avail. On physical examination the pain was present in a 2 x 2 cm area overlying the twelfth rib some 4 cm lateral to the spinal process. Somatosensory testing using swab and alcohol gauze demonstrated the presence of skin hypo- and dysesthesia over the painful area. Local pressure on this painful spot elicited an extreme pain response that did not irradiate towards the periphery. These findings were highly suggestive of a posterior version of the anterior cutaneous nerve entrapment syndrome (ACNES), a condition leading to a severe localized neuropathic pain in anterior portions of the abdominal wall. She demonstrated a beneficial albeit temporary response after lidocaine infiltration as dictated by an established diagnostic and treatment protocol for ACNES. She subsequently underwent a local neurectomy of the involved superficial branch of the intercostal nerve. This limited operation had a favorable outcome resulting in a pain-free return to normal activities up to this very day (follow-up of 24 months).We propose to name this novel syndrome "posterior cutaneous nerve entrapment syndrome" (POCNES). Each patient with chronic localized back pain should undergo simple somatosensory testing to detect the presence of overlying skin hypo- and dysesthesia possibly reflecting an entrapped posterior cutaneous nerve.Key words: Chronic pain, back pain, posterior cutaneous nerve entrapment, peripheral nerve entrapment, surgical treatment for pain, anterior cutaneous nerve entrapment.
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Directory of Open Access Journals (Sweden)
van den Akker-Scheek Inge
2009-09-01
Full Text Available Abstract Background Prosthetic design for the use in primary total knee arthroplasty has evolved into designs that preserve the posterior cruciate ligament (PCL and those in which the ligament is routinely sacrificed (posterior stabilized. In patients with a functional PCL the decision which design is chosen depends largely on the favour and training of the surgeon. The objective of this study is to determine whether the patient's perceived outcome and speed of recovery differs between a posterior cruciate retaining total knee arthroplasty and a posterior stabilized total knee arthroplasty. Methods/Design A randomized controlled trial will be conducted. Patients who are admitted for primary unilateral TKA due to primary osteoarthrosis are included when the following inclusion criteria are met: non-fixed fixed varus or valgus deformity less than 10 degrees, age between 55 and 85 years, body mass index less than 35 kg/m2 and ASA score (American Society of Anaesthesiologists I or II. Patients are randomized in 2 groups. Patients in the posterior cruciate retaining group will receive a prosthesis with a posterior cut-out for the posterior cruciate ligament and relatively flat topography. In patients allocated to the posterior stabilized group, in which the posterior cruciate ligament is excised, the design may substitute for this function by an intercondylar tibial prominence that articulates with the femur in flexion. Measurements will take place preoperatively and 6 weeks, 3 months, 6 months and 1 year postoperatively. At all measurement points patient's perceived outcome will be assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Secondary outcome measures are quality of life (SF-36 and physician reported functional status and range of motion as determined with the Knee Society Clinical Rating System (KSS. Discussion In the current practice both posterior cruciate retaining and posterior stabilized designs
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Directory of Open Access Journals (Sweden)
Kyoung-Tak Kang
2017-01-01
Full Text Available This study aimed to determine the biomechanical effect of the posterior condylar offset (PCO and posterior tibial slope (PTS in posterior-stabilized (PS fixed-bearing total knee arthroplasty (TKA. We developed ±1, ±2, and ±3 mm PCO models in the posterior direction and −3°, 0°, 3°, and 6° PTS models using a previously validated FE model. The influence of changes in the PCO and PTS on the biomechanical effects under deep-knee-bend loading was investigated. The contact stress on the PE insert increased by 14% and decreased by 7% on average as the PCO increased and decreased, respectively, compared to the neutral position. In addition, the contact stress on post in PE insert increased by 18% on average as PTS increased from −3° to 6°. However, the contact stress on the patellar button decreased by 11% on average as PTS increased from −3° to 6° in all different PCO cases. The quadriceps force decreased by 14% as PTS increased from −3° to 6° in all PCO models. The same trend was found in patellar tendon force. Changes in PCO had adverse biomechanical effects whereas PTS increase had positive biomechanical effects. However, excessive PTS should be avoided to prevent knee instability and subsequent failure.
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Effects of radiotherapy on the thyroid function in oral, pharyngeal, and laryngeal tumors
Energy Technology Data Exchange (ETDEWEB)
Wilhelm, K.R.; Schulz-Wendtland, R.
1988-05-01
The irradiation of cervical lymphatics in case of oral and pharyngeal carcinomas as well as the irradiation of the operated area in case of laryngeal carcinomas leads to an exposition of the thyroid gland which may result in a dysfunction of this organ. An evaluation of our patients suffering from these tumors and treated during 1984 and 1985 showed a latent hypothyreosis in 46.7% of the patients treated only by cervical irradiation and in 20.7% of the cases treated by radiotherapy of the tumoral focus and additional irradiation of the cervical lymphatics (p < 0.1). Clinical symptoms were scarcely evident in both groups. For struma prophylaxis, thyreosubstitution with L-thyroxine is recommended.
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van den Boom, Lennard G. H.; Halbertsma, Jan P. K.; van Raaij, Jos J. A. M.; Brouwer, Reinoud W.; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge
2014-01-01
In the present study, knee joint kinematics (e.g. knee flexion/extension) and kinetics (e.g. knee flexion moments) are assessed after total knee arthroplasty (TKA) between patients implanted with either a unilateral posterior stabilized (PS) and a posterior cruciate-retaining (PCR) design. It was
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Posterior distributions for likelihood ratios in forensic science.
van den Hout, Ardo; Alberink, Ivo
2016-09-01
Evaluation of evidence in forensic science is discussed using posterior distributions for likelihood ratios. Instead of eliminating the uncertainty by integrating (Bayes factor) or by conditioning on parameter values, uncertainty in the likelihood ratio is retained by parameter uncertainty derived from posterior distributions. A posterior distribution for a likelihood ratio can be summarised by the median and credible intervals. Using the posterior mean of the distribution is not recommended. An analysis of forensic data for body height estimation is undertaken. The posterior likelihood approach has been criticised both theoretically and with respect to applicability. This paper addresses the latter and illustrates an interesting application area. Copyright © 2016 The Chartered Society of Forensic Sciences. Published by Elsevier Ireland Ltd. All rights reserved.
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Parapharyngeal branchial cleft cyst: a case report
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Marcele Oliveira dos Santos
2015-03-01
Full Text Available A 30-year-old woman presented with a 2-year history of right-sided pharyngeal foreign body sensation. There were no signs of dysarthria, dysphagia, odynophagia, or dyspnea. On physical examination, we observed a fluctuant, painless mass in the oropharynx, pressing against the right lateral pharyngeal wall, covered with normal mucosa. Full examination of the head and neck, including cranial nerve evaluation, detected no further abnormalities.
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MRI evaluation of the posterior meniscus root tear
International Nuclear Information System (INIS)
Zhang Jianjun; Zheng Zhuozhao; Li Xuan
2010-01-01
Objective: To determine the value of MRI for diagnosing the posterior meniscus root tear. Methods: MR examinations of 30 patients with tear of the posterior meniscus root confirmed by knee arthroscopies were retrospectively reviewed. Of the 30 patients, 17 with posterior medial meniscus root tear (MMRT) and 13 with posterior lateral meniscus root tear (LMRT). The diagnostic sensitivity of' MRI for the posterior meniscus root tear was analyzed. Fisher's exact test was used to compare the detection rate of MRI for MMRT with that for LMRT. Results: All 17 cases with MMRT and 9 cases out of 13 with LMRT were correctly diagnosed by MRI and the diagnostic sensitivity of MRI for the posterior meniscus root tear was 86.7% (26/30). The main MR appearance of the posterior meniscus root tear was distortion of the meniscal root, with its low signal replaced by abnormal high signal. The detection rate of MRI for MMRT (17/17) was significantly greater than that for LMRT (9/13) (P=0.026). The prevalence of MMRT associated with meniscus extrusion (15/17) was significantly greater than that of LMRT (6/13) (P=0.020), but the prevalence of MMRT associated with anterior cruciate ligament (ACL) injury (5/17) was significantly lower than that of LMRT (11/13) (P=0.004). Conclusion: MRI is a relatively good method for detection of posterior meniscus root tears and associated injuries. (authors)
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Variations of posterior vitreous detachment
Kakehashi, A.; Kado, M.; Akiba, J.; Hirokawa, H.
1997-01-01
AIMS—To identify variations in posterior vitreous detachment (PVD) and establish a clinical classification system for PVD. METHODS—400 consecutive eyes were examined using biomicroscopy and vitreous photography and classified the PVD variations—complete PVD with collapse, complete PVD without collapse, partial PVD with thickened posterior vitreous cortex (TPVC), or partial PVD without TPVC. RESULTS—In each PVD type, the most frequently seen ocular pathologies were as follows: in complete PVD ...
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Dixon, V L; Bzoch, K R; Habal, M B
1979-07-01
A comparison is made of the preoperative and postoperative speech evaluations of 15 selected subjects who had pharyngeal flap operations combined with palatal pushback. Postoperatively, 13 of the 15 patients (86 percent) showed no abnormal nasal emission and no evidence of significant hypernasality during word production. Gross substitution errors were also corrected by the surgical repair. While the number of patients is small, this study indicates equal effectiveness of the surgical technique described--regardless of the sex, the medical diagnosis, whether the procedure was primary or secondary, or the amount of postoperative time--providing there is good function of the muscles of the soft palate.
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Trends and ethnic disparities in oral and oro-pharyngeal cancers in South Africa, 1992-2001.
Ayo-Yusuf, O A; Lalloo, R; Johnson, N W
2013-05-01
To describe trends in the epidemiology of oral and of oro-pharyngeal (OAP) cancers in South Africa for the atest period available. Data were obtained from the South African pathology-based National Cancer Registry. All new cases of OAP cancers diagnosed and confirmed histologically from 1992 to 2001 are included for the ICD-10 sites C00 to C14, excluding those involving the major salivary glands (C07-C08) and the nasopharynx (C11). OAP cancer incidence is reported by demographics (gender, age, race/ethnicity) and the anatomical sites involved. The analysis on anatomical sites was restricted to squamous cell carcinomas. Overall, males had a much higher OAP cancer incidence rate (world age-Standardised incidence rate [ASIR] = 7.01/100 000 per year) than females (ASIR = 1.99). However, among Asian/Indian South Africans, OAP cancer incidence was higher among females (ASIR = 4.60) than among males (ASIR = 3.80). OAP cancer, excluding those involving the lip, was highest among Coloureds (ASIR = 5.72) and lowest among Blacks (ASIR = 3.16). OAP cancer incidence was stable overall, but incidence rates increased significantly among Coloured South Africans over the period under review (p Variations in the incidence of OAP cancers by gender, race/ethnicity and anatomic site indicate a need for culturally-targeted reductions in major risk factors, including promoting tobacco cessation and prevention of risky alcohol use. The implications of the role of the human papillomavirus (HPV) in the prevention of squamous cell carcinomas involving the oro-pharyngeal in South Africa require further investigation.
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Isolated posterior capsular rupture following blunt head trauma
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Mansour AM
2014-11-01
Full Text Available Ahmad M Mansour, Mahmoud O Jaroudi, Rola N Hamam, Fadi C Maalouf Department of Ophthalmology, American University of Beirut, Beirut, Lebanon Abstract: Closed-globe traumatic cataract is not uncommon in males in the pediatric age group. However, there is a relative paucity of literature on isolated posterior lens capsule rupture associated with closed-globe traumatic cataract. We report a case of a 6-year-old boy who presented with white cataract 1 day after blunt trauma to the forehead associated with posterior capsular rupture that was detected by B-scan ultrasonography preoperatively. No stigmata of trauma outside the posterior capsule could be detected by slit-lamp exam, funduscopy, and optical coherence tomography. Phacoemulsification with posterior chamber intraocular lens implant was performed 24 hours after trauma, with the patient achieving 6/6 visual acuity 1 week and 6 months after surgery. Our case is unique, being the youngest (amblyogenic age to be reported, with prompt surgical intervention, and with no signs of trauma outside the posterior capsule. Keywords: posterior capsule rupture, forehead trauma, traumatic cataract, pediatric cataract
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Energy Technology Data Exchange (ETDEWEB)
Harteveld, Anita A.; Kolk, Anja G. van der; Dieleman, Nikki; Siero, Jeroen C.W.; Luijten, Peter R.; Zwanenburg, Jaco J.M.; Hendrikse, Jeroen [University Medical Center Utrecht, Department of Radiology, Postbox 85500, Utrecht (Netherlands); Worp, H.B. van der; Frijns, Catharina J.M. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht (Netherlands); Kuijf, Hugo J. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)
2017-04-15
Several intracranial vessel wall sequences have been described in recent literature, with either 3-T or 7-T magnetic resonance imaging (MRI). In the current study, we compared 3-T and 7-T MRI in visualising both the intracranial arterial vessel wall and vessel wall lesions. Twenty-one elderly asymptomatic volunteers were scanned by 3-T and 7-T MRI with an intracranial vessel wall sequence, both before and after contrast administration. Two raters scored image quality, and presence and characteristics of vessel wall lesions. Vessel wall visibility was equal or significantly better at 7 T for the studied arterial segments, even though there were more artefacts hampering assessment. The better visualisation of the vessel wall at 7 T was most prominent in the proximal anterior cerebral circulation and the posterior cerebral artery. In the studied elderly asymptomatic population, 48 vessel-wall lesions were identified at 3 T, of which 7 showed enhancement. At 7 T, 79 lesions were identified, of which 29 showed enhancement. Seventy-one percent of all 3-T lesions and 59 % of all 7-T lesions were also seen at the other field strength. Despite the large variability in detected lesions at both field strengths, we believe 7-T MRI has the highest potential to identify the total burden of intracranial vessel wall lesions. (orig.)
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Evaluation of safe surgical treatment of peritonsillar abscess using computed tomography
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Ishii, Kasumi; Aramaki, Hajime; Arai, Yasuko; Uchimura, Kanako; Okabe, Kunihiko; Nishida, Motoko; Yoda, Keiko [Tokyo Women' s Medical Coll. (Japan). Daini Hospital
2002-03-01
With the development of new antimicrobial agents, the incidence of peritonsillar abscess (PTA) is on the decline. PTA is still often encountered in general practice, however, where it requires immediate diagnosis and treatment. Because the internal carotid artery runs medially to the medial parapharyngeal space, damage to nearby vascular or other structures is a surgical risk of PTA. We used contrast computed tomography (CT) from PTA patients to investigate the anatomical relationship between the abscess and parapharyngeal space, and to determine safe surgical sites. We observed 31 patients with PTA, 19 men and 12 women, between February 1997 and April 1999, all examined by contrast CT and undergoing drainage or incision. The average age was 30.7 years (range: 12-54 years). The abscess was on the right side in 20 cases and on the left side in 11. We determined the sites of the abscess and carotid artery, internal jugular vein, and surrounding soft tissue density area including nerves in the parapharyngeal space based on the angle and distance from recognizable anatomical structures in CT scans. The anterior margin of the parapharyngeal space was 29{+-}5 mm posterior from the upper posterior alveolar margin. The medial margin of that space was at 15{+-}2 deg laterally from the midline of the incisors, and 24{+-}4 mm laterally from the midline sagittal plane. The internal carotid artery was located medially to the parapharyngeal space, running on the sagittal plane containing the upper posterior alveolar margin. The distance from the anterior margin of the parapharyngeal space to the posterior wall of the PTA was 9{+-}4 mm, and the distance to the anterior wall of the abscess (including the pharyngeal mucosa) was 31{+-}5 cm. The relationship between the upper posterior alveolar margin and midline sagittal plane was useful for determining the site of the parapharyngeal space. Because the internal carotid artery is located on the same sagittal plane as the upper
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Evaluation of safe surgical treatment of peritonsillar abscess using computed tomography
International Nuclear Information System (INIS)
Ishii, Kasumi; Aramaki, Hajime; Arai, Yasuko; Uchimura, Kanako; Okabe, Kunihiko; Nishida, Motoko; Yoda, Keiko
2002-01-01
With the development of new antimicrobial agents, the incidence of peritonsillar abscess (PTA) is on the decline. PTA is still often encountered in general practice, however, where it requires immediate diagnosis and treatment. Because the internal carotid artery runs medially to the medial parapharyngeal space, damage to nearby vascular or other structures is a surgical risk of PTA. We used contrast computed tomography (CT) from PTA patients to investigate the anatomical relationship between the abscess and parapharyngeal space, and to determine safe surgical sites. We observed 31 patients with PTA, 19 men and 12 women, between February 1997 and April 1999, all examined by contrast CT and undergoing drainage or incision. The average age was 30.7 years (range: 12-54 years). The abscess was on the right side in 20 cases and on the left side in 11. We determined the sites of the abscess and carotid artery, internal jugular vein, and surrounding soft tissue density area including nerves in the parapharyngeal space based on the angle and distance from recognizable anatomical structures in CT scans. The anterior margin of the parapharyngeal space was 29±5 mm posterior from the upper posterior alveolar margin. The medial margin of that space was at 15±2 deg laterally from the midline of the incisors, and 24±4 mm laterally from the midline sagittal plane. The internal carotid artery was located medially to the parapharyngeal space, running on the sagittal plane containing the upper posterior alveolar margin. The distance from the anterior margin of the parapharyngeal space to the posterior wall of the PTA was 9±4 mm, and the distance to the anterior wall of the abscess (including the pharyngeal mucosa) was 31±5 cm. The relationship between the upper posterior alveolar margin and midline sagittal plane was useful for determining the site of the parapharyngeal space. Because the internal carotid artery is located on the same sagittal plane as the upper posterior
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Directory of Open Access Journals (Sweden)
Asdrubal Falavigna
2010-06-01
Full Text Available OBJETIVO: os autores relatam a experiência cirúrgica de 11 neurinomas em ampulheta de C2 comparando à via de acesso posterior com a posterolateral. MÉTODOS: onze pacientes com neurinomas em ampulheta de raiz cervical de C2 foram tratados cirurgicamente. A via de acesso utilizada para a remoção dos tumores foi a abordagem posterior em sete pacientes, e a posterolateral em quatro pacientes. RESULTADOS: houve predominância do sexo feminino (n=6 e a média de idade foi de 55,9±8,16 anos. O tempo médio de sintoma até o diagnóstico foi de 16,3 meses (±8,02 meses. Houve ressecção completa do tumor em todos os pacientes. O tempo cirúrgico médio na abordagem posterior foi de 180 minutos (±39,15 e de 192 minutos (±22,17 pela via posterolateral (p=0,52. Não houve diferença estatisticamente significativa entre as abordagens em relação ao sangramento transoperatório (posterior: 70,71±16,93; posterolateral: 65,00±24,15; p=0,64. Ocorreu uma complicação com a via de acesso posterior ligada à presença de uma fístula de líquor, sendo necessária nova intervenção e reconstrução da dura-máter utilizando a fáscia lata. CONCLUSÃO: a retirada completa do tumor em ampulheta da raiz de C2 é possível através das abordagens posterior e posterolateral, entretanto, a abordagem posterior é preferível por ser a via de acesso mais familiar ao cirurgião.OBJETIVO: os autores describen la experiencia quirúrgica de 11 neurinomas en reloj de arena de la raíz de C2 comparando el camino de acceso posterior y el postero-lateral. MÉTODOS: se trataron con cirugía 11 pacientes con neurinoma en reloj de arena de raíz cervical de C2. El camino de acceso utilizado para la retirada de los tumores fue la aproximación posterior en siete pacientes, y la aproximación postero-lateral, en 4. RESULTADOS: hubo predominio del sexo femenino (n=6, siendo la edad promedio de 55,9 ± 8,16 años. El tiempo medio de los síntomas hasta su diagnóstico fue
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Wang, Lin; Lv, Xiangguo; Jin, Chongrui; Guo, Hailin; Shu, Huiquan; Fu, Qiang; Sa, Yinglong
2018-02-01
To develop a standardized PU-score (posterior urethral stenosis score), with the goal of using this scoring system as a preliminary predictor of surgical complexity and prognosis of posterior urethral stenosis. We retrospectively reviewed records of all patients who underwent posterior urethral surgery at our institution from 2013 to 2015. The PU-score is based on 5 components, namely etiology (1 or 2 points), location (1-3 points), length (1-3 points), urethral fistula (1 or 2 points), and posterior urethral false passage (1 point). We calculated the score of all patients and analyzed its association with surgical complexity, stenosis recurrence, intraoperative blood loss, erectile dysfunction, and urinary incontinence. There were 144 patients who underwent low complexity urethral surgery (direct vision internal urethrotomy, anastomosis with or without crural separation) with a mean score of 5.1 points, whereas 143 underwent high complexity urethroplasty (anastomosis with inferior pubectomy or urethrorectal fistula repair, perineal or scrotum skin flap urethroplasty, bladder flap urethroplasty) with a mean score of 6.9 points. The increase of PU-score was predictive of higher surgical complexity (P = .000), higher recurrence (P = .002), more intraoperative blood loss (P = .000), and decrease of preoperative (P = .037) or postoperative erectile function (P = .047). However, no association was observed between PU-score and urinary incontinence (P = .213). The PU-score is a novel and meaningful scoring system that describes the essential factors in determining the complexity and prognosis for posterior urethral stenosis. Copyright © 2017. Published by Elsevier Inc.
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Early endoscopic realignment in posterior urethral injuries.
Shrestha, B; Baidya, J L
2013-01-01
Posterior urethral injury requires meticulous tertiary care and optimum expertise to manage successfully. The aim of our study is to describe our experiences with pelvic injuries involving posterior urethra and their outcome after early endoscopic realignment. A prospective study was carried out in 20 patients with complete posterior urethral rupture, from November 2007 till October 2010. They presented with blunt traumatic pelvic fracture and underwent primary realignment of posterior urethra in our institute. The definitive diagnosis of urethral rupture was made after retrograde urethrography and antegrade urethrography where applicable. The initial management was suprapubic catheter insertion after primary trauma management in casualty. After a week of conservative management with intravenous antibiotics and pain management, patients were subjected to the endoscopic realignment. The follow up period was at least six months. The results were analyzed with SPSS software. After endoscopic realignment, all patients were advised CISC for the initial 3 months. All patients voided well after three months of CISC. However, 12 patients were lost to follow up by the end of 6 postoperative months. Out of eight remaining patients, two had features of restricture and were managed with DVU followed by CISC again. One patient with restricture had some degree of erectile dysfunction who improved significantly after phospodiesterase inhibitors. None of the patients had features of incontinence. Early endoscopic realignment of posterior urethra is a minimally invasive modality in the management of complete posterior urethral injury with low rates of incontinence and impotency.
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Directory of Open Access Journals (Sweden)
Hamid Reza Fathi
2013-10-01
Full Text Available Background: Velopharyngeal insufficiency causes hypernasal vocal quality and can also result in audible nasal air emission and difficulty in producing pressure consonants. The resulting speech is often socially unacceptable and can be difficult to understand. Platelet-rich plasma is an autologous derivative of whole blood. Today, the importance of clinical use of Platelet-rich plasma in the plastic surgery is considered. This study was designed to evaluate the effectiveness of combined Platelet-rich plasma and fat injection in the treatment of velopharyngeal insufficiency. Methods: In this prospective clinicaltrial study, of 15 patients including 9 males and 6 females and aged 15-20 years with mild/ moderate velopharyngeal insufficiency who were injected with 5 mL of combined Platelet-rich plasma (1 mL and fat (4 mL in the front volume in the posterior pharyngeal wall in the pre-vertebral fascia under sedation. Speech samples were recorded by nasoendoscopy before the injection, and at 6 weeks and 6 months after the injection. Assessment of pathologic speech was done by speech therapist. Results: Velar displacement showed significantly increased at 6 weeks after the injection (P=0.049. Velopharyngeal gap disappeared in 60% of patients at 6 weeks after the injection (P=0.019. Lateral pharyngeal wall movement showed significantly increased in 73.3% of the patients at 6 months after the injection (P=0.04. After the treatment, aerodynamic assessment showed significantly decreased in nasal air escape during phonation and repeat the words (P<0.05. Assessment speech therapist showed significantly improve quality of phonation in these patients (P<0.05. Conclusion: It seems that, combined Platelet-rich plasma and fat injection lead to improve voice resonance and reduce nasal air escape in all treated cases. It can be a promising alternative to major procedures, such as velopharyngoplasties, for the treatment of mild/ moderate velopharyngeal insufficiency.
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Dua, K; Bardan, E; Ren, J; Sui, Z; Shaker, R
1998-01-01
Background—Cigarette smoking is known to affect adversely the defence mechanisms against gastro-oesophageal reflux. The effect of smoking on the supraoesophageal reflexes that prevent aspiration of gastric contents has not been previously studied. Aims—To elucidate the effect of cigarette smoking on two of the supraoesophageal reflexes: the pharyngo-upper oesophageal sphincter (UOS) contractile reflex; and the reflexive pharyngeal swallow. Methods—Ten chronic smokers and 10 non-...
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Kinoshita, Hideaki; Umezawa, Takashi; Omine, Yuya; Kasahara, Masaaki; Rodríguez-Vázquez, José Francisco; Murakami, Gen
2013-01-01
There is little or no information about the distribution of elastic fibers in the human fetal head. We examined this issue in 15 late-stage fetuses (crown-rump length, 220-320 mm) using aldehyde-fuchsin and elastica-Masson staining, and we used the arterial wall elastic laminae and external ear cartilages as positive staining controls. The posterior pharyngeal wall, as well as the ligaments connecting the laryngeal cartilages, contained abundant elastic fibers. In contrast with the sphenomandibular ligament and the temporomandibular joint disk, in which elastic fibers were partly present, the discomalleolar ligament and the fascial structures around the pterygoid muscles did not have any elastic fibers. In addition, the posterior marginal fascia of the prestyloid space did contain such fibers. Notably, in the middle ear, elastic fibers accumulated along the tendons of the tensor tympani and stapedius muscles and in the joint capsules of the ear ossicle articulations. Elastic fibers were not seen in any other muscle tendons or vertebral facet capsules in the head and neck. Despite being composed of smooth muscle, the orbitalis muscle did not contain any elastic fibers. The elastic fibers in the sphenomandibular ligament seemed to correspond to an intermediate step of development between Meckel's cartilage and the final ligament. Overall, there seemed to be a mini-version of elastic fiber distribution compared to that in adults and a different specific developmental pattern of connective tissues. The latter morphology might be a result of an adaptation to hypoxic conditions during development. PMID:23560235
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Yamasaki, Rosiane; Murano, Emi Z; Gebrim, Eloisa; Hachiya, Adriana; Montagnoli, Arlindo; Behlau, Mara; Tsuji, Domingos
2017-07-01
To compare vocal tract (VT) adjustments of dysphonic and non-dysphonic women before and after flexible resonance tube in water exercise (FRTWE) at rest and during phonation using magnetic resonance imaging. Prospective study. Twenty women, aged 20-40 years, 10 dysphonic with vocal nodules (VNG) and 10 controls (CG), underwent four sets of sagittal VT MRI: two pre-FRTWE, at rest and during phonation, and two post-FRTWE, during phonation and at rest. The subjects performed 3 minutes of exercise. Nine parameters at rest and 21 during phonation were performed. Pre-FRTWE, eight significant differences were found, three at rest and five during phonation: at rest - laryngeal vestibule area, distance from epiglottis to pharyngeal posterior wall (PPW) and interarytenoid complex length were smaller in the VNG; during phonation - laryngeal vestibule area, angle between PPW and vocal fold (VF), epiglottis to PPW, and anterior commissure of the larynx to laryngeal posterior wall were smaller in the VNG; tongue area was larger in the VNG. Post-FRTWE, only three significant differences were found, two during phonation and one at rest: during phonation - angle between PPW and VF and the membranous portion of the VF length were smaller in the VNG; at rest - distance from epiglottis to PPW was smaller in the VNG. Results suggest that the habitual VT adjustments of dysphonic and non-dysphonic women are different at rest and during phonation. The FRTWE promoted positive VT changes in the VNG, reducing the intergroup differences. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
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Nie, Xuguang; Deng, Chu-xia; Wang, Qin; Jiao, Kai
2008-01-01
TGFβ/BMP signaling pathways are essential for normal development of neural crest cells (NCCs). Smad4 encodes the only common Smad protein in mammals, which is a critical nuclear mediator of TGFβ/BMP signaling. In this work, we sought to investigate the roles of Smad4 for development of NCCs. To overcome the early embryonic lethality of Smad4 null mice, we specifically disrupted Smad4 in NCCs using a Cre/loxP system. The mutant mice died at mid-gestation with defects in facial primordia, pharyngeal arches, outflow tract and cardiac ventricles. Further examination revealed that mutant embryos displayed severe molecular defects starting from E9.5. Expression of multiple genes, including Msx1, 2, Ap-2α, Pax3, and Sox9, which play critical roles for NCC development, was downregulated by NCC disruption of Smad4. Moreover, increased cell death was observed in pharyngeal arches from E10.5. However, the cell proliferation rate in these areas was not substantially altered. Taken together, these findings provide compelling genetic evidence that Smad4-mediated activities of TGFβ/BMP signals are essential for appropriate NCC development. PMID:18334251
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Directory of Open Access Journals (Sweden)
Salustiano Gomes Lins
1971-06-01
Full Text Available Inicialmente é feita breve exposição dos cinco principais tipos de atividade lenta posterior descritas na literatura eletrencefalográfica: variedade lenta do ritmo alfa, ritmo theta posterior, ondas lentas posteriores a 4 hertz, ritmo delta associado ao pequeno mal e ondas Pi. Em seguida o autor expõe seus achados, baseado num material clínico composto por 760 pacientes, colhidos ao acaso, dos dois sexos e com idades variáveis entre 5 e 24 anos. Excetuando a variedade lenta do ritmo alfa, um ou mais dos outros quatro grafo-elementos referidos foram observados em 131 destes pacientes (80 do sexo masculino e 51 do sexo feminino pertencentes aos 3 primeiros grupos etários (5 a 19 anos. Sua predominância no sexo masculino não alcançou nível de significação estatística, mas a maior incidência nos grupos de menor idade foi significativa a 0,01. O ritmo theta posterior associou-se significativamente apenas a distúrbios de conduta com forte agressividade. Dos 131 casos referidos, 10 eram portadores de pequeno mal e destes, 5 apresentavam ritmo delta posterior (3 do sexo masculino e 2 do sexo feminino. Apenas em dois casos foi observado o ritmo lento posterior a 4 hertz, ambos com comemorativos de traumatismo craniano, seguido de distúrbios da conduta e agressividade.The five principal types of posterior slow activity are reviwed: the slow alpha variant rhythm; the posterior theta rhythm; the posterior slow waves at 4 c/s; the delta rhythm associated with petit mal; the so called Pi waves. The results with EEG tracings of 760 patients of both sexes with ages between 5 and 24 years are reviewed. Except for the slow alpha variant, at least one of the four other phenomena as observed in 131 patients (80 males end 51 females. The theta rhythm was observed in 49 cases (29 males and 20 females. This higher frequence among the males is not significant but the higher frequence among the younger and the association with a clinical picture of
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Characterization of the anisotropic mechanical behavior of human abdominal wall connective tissues.
Astruc, Laure; De Meulaere, Maurice; Witz, Jean-François; Nováček, Vit; Turquier, Frédéric; Hoc, Thierry; Brieu, Mathias
2018-06-01
Abdominal wall sheathing tissues are commonly involved in hernia formation. However, there is very limited work studying mechanics of all tissues from the same donor which prevents a complete understanding of the abdominal wall behavior and the differences in these tissues. The aim of this study was to investigate the differences between the mechanical properties of the linea alba and the anterior and posterior rectus sheaths from a macroscopic point of view. Eight full-thickness human anterior abdominal walls of both genders were collected and longitudinal and transverse samples were harvested from the three sheathing connective tissues. The total of 398 uniaxial tensile tests was conducted and the mechanical characteristics of the behavior (tangent rigidities for small and large deformations) were determined. Statistical comparisons highlighted heterogeneity and non-linearity in behavior of the three tissues under both small and large deformations. High anisotropy was observed under small and large deformations with higher stress in the transverse direction. Variabilities in the mechanical properties of the linea alba according to the gender and location were also identified. Finally, data dispersion correlated with microstructure revealed that macroscopic characterization is not sufficient to fully describe behavior. Microstructure consideration is needed. These results provide a better understanding of the mechanical behavior of the abdominal wall sheathing tissues as well as the directions for microstructure-based constitutive model. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Energy Technology Data Exchange (ETDEWEB)
Miquelin, C.A.; Braga, F.J.H.N.; Baffa, O. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Filosofia, Ciencias e Letras. Dept. de Fisica; Dantas, R.O.; Oliveira, R.B. [Faculdade de Medicina de Ribeirao Preto, SP (Brazil)
1996-12-31
A comparative evaluation between scintigraphic and biomagnetic method to measure the pharyngeal transit is presented. Three volunteers have been studied. The aliment (yogurt) was labeled with {sup 9}9{sup m} Technetium for the scintigraphic test and with ferrite for the biomagnetic one. The preliminary results indicate a difference between the values obtained, probably due to the biomagnetic detector resolution 3 refs., 2 figs., 1 tab.
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Cacciamani, G; De Marco, V; Siracusano, S; De Marchi, D; Bizzotto, L; Cerruto, M A; Motton, G; Porcaro, A B; Artibani, W
2017-06-01
A training model is usually needed to teach robotic surgical technique successfully. In this way, an ideal training model should mimic as much as possible the "in vivo" procedure and allow several consecutive surgical simulations. The goal of this study was to create a "wet lab" model suitable for RARP training programs, providing the simulation of the posterior fascial reconstruction. The second aim was to compare the original "Venezuelan" chicken model described by Sotelo to our training model. Our training model consists of performing an anastomosis, reproducing the surgical procedure in "vivo" as in RARP, between proventriculus and the proximal portion of the esophagus. A posterior fascial reconstruction simulating Rocco's stitch is performed between the tissues located under the posterior surface of the esophagus and the tissue represented by the serosa of the proventriculus. From 2014 to 2015, during 6 different full-immersion training courses, thirty-four surgeons performed the urethrovesical anastomosis using our model and the Sotelo's one. After the training period, each surgeon was asked to fill out a non-validated questionnaire to perform an evaluation of the differences between the two training models. Our model was judged the best model, in terms of similarity with urethral tissue and similarity with the anatomic unit urethra-pelvic wall. Our training model as reported by all trainees is easily reproducible and anatomically comparable with the urethrovesical anastomosis as performed during radical prostatectomy in humans. It is suitable for performing posterior fascial reconstruction reported by Rocco. In this context, our surgical training model could be routinely proposed in all robotic training courses to develop specific expertise in urethrovesical anastomosis with the reproducibility of the Rocco stitch.
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Directory of Open Access Journals (Sweden)
Furkan Erol Karabekmez
2015-01-01
Full Text Available The objectives of this study are to assess the velopharyngeal dimensions using cephalometric variables of the nasopharynx and oropharynx as well as to compare the Le Fort I osteotomy technique to Zisser’s anterior maxillary osteotomy technique based on patients’ outcomes within early and late postoperative follow-ups. 15 patients with severe maxillary deficiency treated with Le Fort I osteotomy and maxillary segmental osteotomy were assessed. Preoperative, early postoperative, and late postoperative follow-up lateral cephalograms, patient histories, and operative reports are reviewed with a focus on defined cephalometric landmarks for assessing velopharyngeal space dimension and maxillary movement (measured for three different tracing points. A significant change was found between preoperative and postoperative lateral cephalometric measurements regarding the distance between the posterior nasal spine and the posterior pharyngeal wall in Le Fort I osteotomy cases. However, no significant difference was found between preoperative and postoperative measurements in maxillary segmental osteotomy cases regarding the same measurements. The velopharyngeal area calculated for the Le Fort I osteotomy group showed a significant difference between the preoperative and postoperative measurements. Le Fort I osteotomy for advancement of upper jaw increases velopharyngeal space. On the other hand, Zisser’s anterior maxillary segmental osteotomy does not alter the dimension of the velopharyngeal space significantly.
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Selective posterior lumbosacral rhizotomy for the management ...
African Journals Online (AJOL)
tion in 95% of cases. The majority showed ... selective posterior rhizotomy technique whereby the cauda equina ... assessed pre- and postoperatively by means of clinical examination ... were attending cerebral palsy schools and receiving spe- cialised ... root sections on cats demonstrated clearly that posterior root section ...
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Possibly Ill-behaved Posteriors in Econometric Models
L.F. Hoogerheide (Lennart); H.K. van Dijk (Herman)
2008-01-01
textabstractHighly non-elliptical posterior distributions may occur in several econometric models, in particular, when the likelihood information is allowed to dominate and data information is weak. We explain the issue of highly non-elliptical posteriors in a model for the effect of education on
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International Nuclear Information System (INIS)
Lee, Kuan-Der; Lu, Chang-Hsien; Chen, Ping-Tsung; Chan, Chunghuang Hubert; Lin, Jen-Tsun; Huang, Cih-En; Chen, Chih-Cheng; Chen, Min-Chi
2009-01-01
The incidence of oral and pharyngeal (including oral cavity, oropharynx and hypopharynx) carcinoma increases rapidly in Asia and South Pacific because of betel quid chewing. Thus far, large-scale epidemiological studies are not available yet to stratify these patients by their risks of developing a second primary cancer in the digestive tract including esophagus, stomach, colon, and rectum. A population-based study was conducted using the database from the Taiwan National Cancer Registry for the period 1979-2003. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second primary cancers among 33,787 patients with initial diagnoses of oral and pharyngeal carcinoma. Among these four digestive tract organs, the esophagus was the only site of second cancer with excess risk in patients with oral and pharyngeal carcinoma. The incidence and risk of developing a second primary esophageal cancer differed by the site of the primary index tumor, most frequently seen in hypopharyngeal cancer (71/4,218 = 1.68%, SIR = 22.76, 95% CI 17.77-28.70), followed by oropharyngeal cancer (30/3,403 = 0.88%, SIR = 14.29, 95% CI 9.64-20.39) and the least in oral cavity cancer (99/26,166 = 0.38%, SIR = 5.57, 95% CI 4.53-6.78). In addition, the risk was extraordinarily high for patients with a follow-up interval ≤ 1 year and those with first primary cancer diagnosed at age ≤50. These patients may justify more close surveillance. The present study represents the first population-based study in Asia attempting to stratify the patients of oral and pharyngeal carcinoma by their risk of developing a second esophageal cancer. It helps identify patients at high risk and tailor the application of intense follow-up surveillance to the estimated risk in each individual case
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Wainwright, Peter C; Smith, W Leo; Price, Samantha A; Tang, Kevin L; Sparks, John S; Ferry, Lara A; Kuhn, Kristen L; Eytan, Ron I; Near, Thomas J
2012-12-01
The perciform group Labroidei includes approximately 2600 species and comprises some of the most diverse and successful lineages of teleost fishes. Composed of four major clades, Cichlidae, Labridae (wrasses, parrotfishes, and weed whitings), Pomacentridae (damselfishes), and Embiotocidae (surfperches); labroids have been an icon for studies of biodiversity, adaptive radiation, and sexual selection. The success and diversification of labroids have been largely attributed to the presence of a major innovation in the pharyngeal jaw apparatus, pharyngognathy, which is hypothesized to increase feeding capacity and versatility. We present results of large-scale phylogenetic analyses and a survey of pharyngeal jaw functional morphology that allow us to examine the evolution of pharyngognathy in a historical context. Phylogenetic analyses were based on a sample of 188 acanthomorph (spiny-rayed fish) species, primarily percomorphs (perch-like fishes), and DNA sequence data collected from 10 nuclear loci that have been previously used to resolve higher level ray-finned fish relationships. Phylogenies inferred from this dataset using maximum likelihood, Bayesian, and species tree analyses indicate polyphyly of the traditional Labroidei and clearly separate Labridae from the remainder of the traditional labroid lineages (Cichlidae, Embiotocidae, and Pomacentridae). These three "chromide" families grouped within a newly discovered clade of 40 families and more than 4800 species (>27% of percomorphs and >16% of all ray-finned fishes), which we name Ovalentaria for its characteristic demersal, adhesive eggs with chorionic filaments. This fantastically diverse clade includes some of the most species-rich lineages of marine and freshwater fishes, including all representatives of the Cichlidae, Embiotocidae, Pomacentridae, Ambassidae, Gobiesocidae, Grammatidae, Mugilidae, Opistognathidae, Pholidichthyidae, Plesiopidae (including Notograptus), Polycentridae, Pseudochromidae
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Utility of CT scan for the diagnosis of chest wall tuberculosis
Energy Technology Data Exchange (ETDEWEB)
Khalil, A.; Le Breton, C.; Tassart, M.; Korzec, J.; Bigot, J.M.; Carette, M.F. [Department of Radiology, Tenon Hospital, Paris (France)
1999-10-01
The objective of this study was to determine the utility of CT scan findings for the diagnosis of chest wall tuberculosis, excluding the spine. We reviewed 15 patients (13 Africans and 2 Indians) with chest wall tuberculosis, retrospectively. The radiologic examination consisted of a plain X-ray and a CT scan of the chest for each patient. The site of disease was the rib in 13 patients or the body of the sternum in 2 patients. One rib was involved in 11 patients, 2 contiguous ribs (one site) in 2 patients, and bilateral disease (two sites) was observed in the remaining patient. The 14 rib sites involved the posterior arc or costovertebral joint in 11 cases, the anterior arc in 2 cases, and the anterior and middle arc in 1 case. The CT scan findings were an abscess (n = 14) or a soft tissue mass (n = 2), osteolytic lesions (n = 13), periosteal reaction (n = 10), and sequestrum (n = 14). Bone sclerosis was observed only in 3 cases of rib involvement. The association of a soft tissue abscess, an osteolytic lesion, and sequestrum, especially in immigrants to France, suggests chest wall tuberculosis on CT scan. (orig.) With 5 figs., 2 tabs., 11 refs.
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Directory of Open Access Journals (Sweden)
Andreas Altenburger
2016-11-01
Full Text Available Abstract Background Kinorhynchs are ecdysozoan animals with a phylogenetic position close to priapulids and loriciferans. To understand the nature of segmentation within Kinorhyncha and to infer a probable ancestry of segmentation within the last common ancestor of Ecdysozoa, the musculature and the nervous system of the allomalorhagid kinorhynch Pycnophyes kielensis were investigated by use of immunohistochemistry, confocal laser scanning microscopy, and 3D reconstruction software. Results The kinorhynch body plan comprises 11 trunk segments. Trunk musculature consists of paired ventral and dorsal longitudinal muscles in segments 1–10 as well as dorsoventral muscles in segments 1–11. Dorsal and ventral longitudinal muscles insert on apodemes of the cuticle inside the animal within each segment. Strands of longitudinal musculature extend over segment borders in segments 1–6. In segments 7–10, the trunk musculature is confined to the segments. Musculature of the digestive system comprises a strong pharyngeal bulb with attached mouth cone muscles as well as pharyngeal bulb protractors and retractors. The musculature of the digestive system shows no sign of segmentation. Judged by the size of the pharyngeal bulb protractors and retractors, the pharyngeal bulb, as well as the introvert, is moved passively by internal pressure caused by concerted action of the dorsoventral muscles. The nervous system comprises a neuropil ring anterior to the pharyngeal bulb. Associated with the neuropil ring are flask-shaped serotonergic somata extending anteriorly and posteriorly. A ventral nerve cord is connected to the neuropil ring and runs toward the anterior until an attachment point in segment 1, and from there toward the posterior with one ganglion in segment 6. Conclusions Segmentation within Kinorhyncha likely evolved from an unsegmented ancestor. This conclusion is supported by continuous trunk musculature in the anterior segments 1–6, continuous
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Determining injuries from posterior and flank stab wounds using computed tomography tractography.
Bansal, Vishal; Reid, Chris M; Fortlage, Dale; Lee, Jeanne; Kobayashi, Leslie; Doucet, Jay; Coimbra, Raul
2014-04-01
Unlike anterior stab wounds (SW), in which local exploration may direct management, posterior SW can be challenging to evaluate. Traditional triple contrast computed tomography (CT) imaging is cumbersome and technician-dependent. The present study examines the role of CT tractography as a strategy to manage select patients with back and flank SW. Hemodynamically stable patients with back and flank SW were studied. After resuscitation, Betadine- or Visipaque®-soaked sterile sponges were inserted into each SW for the estimated depth of the wound. Patients underwent abdominal helical CT scanning, including intravenous contrast, as the sole abdominal imaging study. Images were reviewed by an attending radiologist and trauma surgeon. The tractogram was evaluated to determine SW trajectory and injury to intra- or retroperitoneal organs, vascular structures, the diaphragm, and the urinary tract. Complete patient demographics including operative management and injuries were collected. Forty-one patients underwent CT tractography. In 11 patients, tractography detected violation of the intra- or retroperitoneal cavity leading to operative exploration. Injuries detected included: the spleen (two), colon (one), colonic mesentery (one), kidney (kidney), diaphragm (kidney), pneumothorax (seven), hemothorax (two), iliac artery (one), and traumatic abdominal wall hernia (two). In all patients, none had negative CT findings that failed observation. In this series, CT tractography is a safe and effective imaging strategy to evaluate posterior torso SW. It is unknown whether CT tractography is superior to traditional imaging modalities. Other uses for CT tractography may include determining trajectory from missile wounds and tangential penetrating injuries.
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Posterior Reversible Encephalopathy (PRES)
International Nuclear Information System (INIS)
Moron E, Fanny E; Diaz Marchan, Pedro
2005-01-01
The Posterior Reversible Encephalopathy Syndrome (PRES) is a clinical Syndrome composed of cephalea, alteration in vision and convulsions, usually observed in patients with sudden elevation of arterial pressure. The imagenologic evidence shows reversible vasogenic brain edema without stroke. Its location is predominantly posterior; it affects the cortex and the subcortical white matter of the occipital, parietal and temporal lobes. The treatment with antihypertensive drugs and the removing of immunosupressor medication are generally associated with complete neurological recovery; this is reflected also in the images which return to their basal condition. The untreated hypertension, on the other side, can result in a progressive defect of the autoregulation system of the central nervous system with cerebral hemorrhage, irreversible brain stroke, coma and death
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Post-partum posterior reversible encephalopathy syndrome
B. V. Triveni; Salman Mohammed Sheikh; Deepak Shedde
2014-01-01
Posterior Reversible Encephalopathy Syndrome (PRES) is a clinicopathological syndrome associated with various clinical conditions presenting with headache, encephalopathy, seizure and cortical visual disturbances. Radiological findings in PRES are thought to be due to vasogenic edema predominantly in posterior cerebral hemispheres and are reversible with appropriate management. We present a case of post partum PRES,A 29 year old primigravida of 33 weeks 3 days period of gestation who prese...
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Algoanema aestuariense n.gen. n.sp. from Swartkops estuary, Port ...
African Journals Online (AJOL)
1986-09-12
Sep 12, 1986 ... dorsal tooth. Stoma surrounded by pharyngeal tissue. Pharynx with strongly muscular, violin-shaped duplex basal bulb, the latter 37 - 47 ~m long and 23 - 27 ~m wide, the anterior and posterior cuticularized sections separated by a distinct trans- verse break in the musculature. No pharyngo-intestinal valve.
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Posterior longitudinal ligament status in cervical spine bilateral facet dislocations
International Nuclear Information System (INIS)
Carrino, John A.; Manton, Geoffrey L.; Morrison, William B.; Flanders, Adam E.; Vaccaro, Alex R.; Schweitzer, Mark E.
2006-01-01
It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status. Retrospective case series. A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between various injury patterns and posterior longitudinal ligament status. The frequency of MRI abnormalities was: anterior longitudinal ligament disruption (26.7%), disc herniation or disruption (90%), posterior longitudinal ligament disruption (40%), facet fracture (63.3%) and disruption of the posterior column ligament complex (97%). There were no significant associations between injury to the posterior longitudinal ligament and other structures. Compared to surgical reports, MRI was accurate for determining the status for 24 of 26 ligaments (three of three anterior longitudinal ligament, seven of nine posterior longitudinal ligament, and 14 of 14 posterior column ligament complex) but generated false negatives in two instances (in both MRI showed an intact posterior longitudinal ligament that was torn at surgery). (orig.)
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Electron arc therapy: chest wall irradiation of breast cancer patients
International Nuclear Information System (INIS)
McNeely, L.K.; Jacobson, G.M.; Leavitt, D.D.; Stewart, J.R.
1988-01-01
From 1980 to October 1985 we treated 45 breast cancer patients with electron arc therapy. This technique was used in situations where optimal treatment with fixed photon or electron beams was technically difficult: long scars, recurrent tumor extending across midline or to the posterior thorax, or marked variation in depth of target tissue. Forty-four patients were treated following mastectomy: 35 electively because of high risk of local failure, and 9 following local recurrence. One patient with advanced local regional disease was treated primarily. The target volume boundaries on the chest wall were defined by a foam lined cerrobend cast which rested on the patient during treatment, functioning as a tertiary collimator. A variable width secondary collimator was used to account for changes in the radius of the thorax from superior to inferior border. All patients had computerized tomography performed to determine Internal Mammary Chain depth and chest wall thickness. Electron energies were selected based on these thicknesses and often variable energies over different segments of the arc were used. The chest wall and regional node areas were irradiated to 45 Gy-50 Gy in 5-6 weeks by this technique. The supraclavicular and upper axillary nodes were treated by a direct anterior photon field abutted to the superior edge of the electron arc field. Follow-up is from 10-73 months with a median of 50 months. No major complications were observed. Acute and late effects and local control are comparable to standard chest wall irradiation. The disadvantages of this technique are that the preparation of the tertiary field defining cast and CT treatment planning are labor intensive and expensive. The advantage is that for specific clinical situations large areas of chest wall with marked topographical variation can be optimally, homogeneously irradiated while sparing normal uninvolved tissues
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Petit, Damien; Menei, Philippe; Fournier, Henri-Dominique
2011-11-01
The authors describe the first case of spindle cell lipoma of the posterior neck invading the upper cervical spinal canal and the posterior cranial fossa. Spindle cell lipoma is an extremely rare variant of benign lipoma. It usually occurs as a solitary subcutaneous well-circumscribed lesion in the posterior neck or shoulders of adult men. Local aggressiveness is unusual. This 61-year-old man presented with an increased left cerebellar syndrome and headaches. He also had a posterior neck tumefaction, which had been known about for a long time. Computed tomography and MR imaging studies revealed a voluminous mass extending to the upper cervical canal and posterior cranial fossa and eroding the neighboring bones. The lesion was well delimited, and contrast enhancement was intense and heterogeneous. The tumor, which had initially developed under the muscles of the posterior neck, was totally resected. Histological assessment revealed numerous fat cells with spindle cells secreting collagen. The large size of the tumor and the submuscular location, bone erosion, and compression of the CNS were unusual in this rare subtype of benign adipose tumor. Its presentation could simulate a sarcoma.
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DEFF Research Database (Denmark)
Jensen, Kenneth; Lambertsen, Karin; Torkov, Peter
2007-01-01
Introduction. The aim of the study was to assess the value of the EORTC questionnaires C30 and H&N35, as an instrument for the study of side effects. Patients and methods. We invited all recurrence free patients, treated with radical radiotherapy for pharyngeal cancer between 1998 and 2002 at our...
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International Nuclear Information System (INIS)
Preisova, J.; Vlkova, E.; Svacinova, J.; Papouskova, D.
1990-01-01
A case study is presented of a patient with opaque media of the left eye for seclusion and occlusion of the pupil. The cause of the unilateral chronic uveitis was visualized using ultrasound in A mode. It was found that the calcified lens was dislocated into the vitreous body and fixed to the posterior wall of the eye. The finding was confirmed by a negative X-ray picture and positive CT finding of a small foreign body with high density. The dislocation of the lens occurred after a blow on the left eye during boxing 15 years before the patient sought medical assistance for pain in the practically blind eyeball. (author). 4 figs., 9 refs
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Directory of Open Access Journals (Sweden)
Jeroni Nadal
2015-01-01
Full Text Available Background. To evaluate visual outcomes, corneal changes, intraocular lens (IOL stability, and complications after repositioning posteriorly dislocated IOLs and sulcus fixation with polyester sutures. Design. Prospective consecutive case series. Setting. Institut Universitari Barraquer. Participants. 25 eyes of 25 patients with posteriorly dislocated IOL. Methods. The patients underwent 23-gauge vitrectomy via the sulcus to rescue dislocated IOLs and fix them to the scleral wall with a previously looped nonabsorbable polyester suture. Main Outcome Measures. Best corrected visual acuity (BCVA LogMAR, corneal astigmatism, endothelial cell count, IOL stability, and postoperative complications. Results. Mean follow-up time was 18.8 ± 10.9 months. Mean surgery time was 33 ± 2 minutes. Mean BCVA improved from 0.30 ± 0.48 before surgery to 0.18 ± 0.60 (p=0.015 at 1 month, which persisted to 12 months (0.18 ± 0.60. Neither corneal astigmatism nor endothelial cell count showed alterations 1 year after surgery. Complications included IOL subluxation in 1 eye (4%, vitreous hemorrhage in 2 eyes (8%, transient hypotony in 2 eyes (8%, and cystic macular edema in 1 eye (4%. No patients presented retinal detachment. Conclusion. This surgical technique proved successful in the management of dislocated IOL. Functional results were good and the complications were easily resolved.
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Nadal, Jeroni; Kudsieh, Bachar; Casaroli-Marano, Ricardo P
2015-01-01
Background. To evaluate visual outcomes, corneal changes, intraocular lens (IOL) stability, and complications after repositioning posteriorly dislocated IOLs and sulcus fixation with polyester sutures. Design. Prospective consecutive case series. Setting. Institut Universitari Barraquer. Participants. 25 eyes of 25 patients with posteriorly dislocated IOL. Methods. The patients underwent 23-gauge vitrectomy via the sulcus to rescue dislocated IOLs and fix them to the scleral wall with a previously looped nonabsorbable polyester suture. Main Outcome Measures. Best corrected visual acuity (BCVA) LogMAR, corneal astigmatism, endothelial cell count, IOL stability, and postoperative complications. Results. Mean follow-up time was 18.8 ± 10.9 months. Mean surgery time was 33 ± 2 minutes. Mean BCVA improved from 0.30 ± 0.48 before surgery to 0.18 ± 0.60 (p = 0.015) at 1 month, which persisted to 12 months (0.18 ± 0.60). Neither corneal astigmatism nor endothelial cell count showed alterations 1 year after surgery. Complications included IOL subluxation in 1 eye (4%), vitreous hemorrhage in 2 eyes (8%), transient hypotony in 2 eyes (8%), and cystic macular edema in 1 eye (4%). No patients presented retinal detachment. Conclusion. This surgical technique proved successful in the management of dislocated IOL. Functional results were good and the complications were easily resolved.
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Analytic posteriors for Pearson's correlation coefficient.
Ly, Alexander; Marsman, Maarten; Wagenmakers, Eric-Jan
2018-02-01
Pearson's correlation is one of the most common measures of linear dependence. Recently, Bernardo (11th International Workshop on Objective Bayes Methodology, 2015) introduced a flexible class of priors to study this measure in a Bayesian setting. For this large class of priors, we show that the (marginal) posterior for Pearson's correlation coefficient and all of the posterior moments are analytic. Our results are available in the open-source software package JASP.
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Analytic posteriors for Pearson's correlation coefficient
Ly, A.; Marsman, M.; Wagenmakers, E.-J.
2018-01-01
Pearson's correlation is one of the most common measures of linear dependence. Recently, Bernardo (11th International Workshop on Objective Bayes Methodology, 2015) introduced a flexible class of priors to study this measure in a Bayesian setting. For this large class of priors, we show that the (marginal) posterior for Pearson's correlation coefficient and all of the posterior moments are analytic. Our results are available in the open‐source software package JASP.
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Evaluation of the outcomes after posterior urethroplasty.
Liberman, Daniel; Pagliara, Travis J; Pisansky, Andrew; Elliott, Sean P
2015-03-01
Posterior urethral injury is a clinically significant complication of pelvic fractures. The management is complicated by the associated organ injuries, distortion of the pelvic anatomy and the ensuing fibrosis that occurs with urethral injury. We report a review of the outcomes after posterior urethroplasty in the context of pelvic fracture urethral injury.
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Hollenstein, Michael; Thwaites, Philip; Bütikofer, Simon; Heinrich, Henriette; Sauter, Matthias; Ulmer, Irina; Pohl, Daniel; Ang, Daphne; Eberli, Daniel; Schwizer, Werner; Fried, Michael; Distler, Oliver; Fox, Mark; Misselwitz, Benjamin
2017-09-01
The factors that determine how people eat when they are healthy or have disease have not been defined. We used high resolution manometry (HRM) to assess pharyngeal swallowing and oesophageal motility during ingestion of a solid test meal (STM) in healthy volunteers and patients with motility disorders. This study was based at University Hospital Zurich (Zürich, Switzerland). Healthy volunteers who responded to an advertisement completed HRM with ten single water swallows (SWS) in recumbent and upright positions followed by a 200 g rice STM in the upright position. Healthy volunteers were stratified for age and sex to ensure a representative population. For comparison, consecutive patients with major motility disorders on SWS and patients with dysphagia but no major motility disorders on SWS (disease controls) were selected from a database that was assembled prospectively; the rice meal data were analysed retrospectively. During STM, pharyngeal swallows were timed and oesophageal contractions were classified as representing normal motility or different types of abnormal motility in accordance with established metrics. Factors that could potentially be associated with eating speed were investigated, including age, sex, body-mass index, and presence of motility disorder. We compared diagnoses based on SWS findings, assessed with the Chicago Classification v3.0, with those based on STM findings, assessed with the Chicago Classification adapted for solids. These studies are registered with ClinicalTrials.gov, numbers NCT02407938 and NCT02397616. Between April 2, 2014, and May 13, 2015, 72 healthy volunteers were recruited and underwent HRM. Additionally, we analysed data from 54 consecutive patients with major motility disorders and 53 with dysphagia but no major motility disorders recruited between April 2, 2013, and Dec 18, 2014. We found important variations in oesophageal motility and eating speed during meal ingestion in healthy volunteers and patients. Increased
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Valentino, Francesca; Gentile, Luana; Terruso, Valeria; Mastrilli, Sergio; Aridon, Paolo; Ragonese, Paolo; Sarno, Caterina; Savettieri, Giovanni; D'Amelio, Marco
2017-11-13
hemorrhagic transformation is a threatening ischemic stroke complication. Frequency of hemorrhagic transformation differs greatly among studies, and its risk factors have been usually studied in patients with anterior ischemic stroke who received thrombolytic therapy. We evaluated, in a hospital-based series of patients with posterior ischemic stroke not treated with thrombolysis, frequency and risk factors of hemorrhagic transformation. Patients with posterior circulation stroke were seen in our Department during the period January 2004 to December 2009. Demographic and clinical information were collected. We estimated risk for spontaneous hemorrhagic transformation by means of uni- and multivariate logistic regression analyses. 119 consecutive patients were included (73 males, 61.3%). Hemorrhagic transformation was observed in 7 patients (5.9%). Only clinical worsening was significantly associated with hemorrhagic transformation (OR 6.8, 95% CI 1.3-34.5). Our findings indicate that patients with posterior have a low risk of spontaneous hemorrhagic transformation, suggesting that these patients might have greater advantage from intravenous thrombolysis.
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Management of Posterior Urethral Valves in Rural Kenya
African Journals Online (AJOL)
Management of Posterior Urethral Valves in Rural. Kenya .... Antwi S. Audit of Posterior Urethral Valve (PUV) in Children at ... Community Paediatrics Committee, Infectious. Diseases ... Effect of Circumcision on Risk of Urinary Tract. Infection in ...
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de Lima, R; Perdigão, C; Neves, L; Cravino, J; Dantas, M; Bordalo, A; Pais, F; Diogo, A N; Ferreira, R; Ribeiro, C
1990-09-01
The authors present a case of left ventricular free wall rupture post acute myocardial infarction, associated with mitral papillary posterior muscle necrosis, operated by infartectomy and mitral valvular protesis replacement. They refer the various complications occurred during the hospital staying, and discuss its medical and surgical approach. The patient was discharged alive and six months after the infarction keeps a moderate activity.
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Evaluation of a Thermoplastic Immobilization System for Breast and Chest Wall Radiation Therapy
International Nuclear Information System (INIS)
Strydhorst, Jared H.; Caudrelier, Jean-Michel; Clark, Brenda G.; Montgomery, Lynn A.; Fox, Greg; MacPherson, Miller S.
2011-01-01
We report on the impact of a thermoplastic immobilization system on intra- and interfraction motion for patients undergoing breast or chest wall radiation therapy. Patients for this study were treated using helical tomotherapy. All patients were immobilized using a thermoplastic shell extending from the shoulders to the ribcage. Intrafraction motion was assessed by measuring maximum displacement of the skin, heart, and chest wall on a pretreatment 4D computed tomography, while inter-fraction motion was inferred from patient shift data arising from daily image guidance procedures on tomotherapy. Using thermoplastic immobilization, the average maximum motion of the external contour was 1.3 ± 1.6 mm, whereas the chest wall was found to be 1.6 ± 1.9 mm. The day-to-day setup variation was found to be large, with random errors of 4.0, 12.0, and 4.5 mm in the left-right, superior-inferior, and anterior-posterior directions, respectively, and the standard deviations of the systematic errors were found to be 2.7, 9.8, and 4.1 mm. These errors would be expected to dominate any respiratory motion but can be mitigated by daily online image guidance. Using thermoplastic immobilization can effectively reduce respiratory motion of the chest wall and external contour, but these gains can only be realized if daily image guidance is used.
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Lee, Kyeong Duk; Kwon, Soon Chan; Muniandy, Sarawana; Park, Eun Suk; Sim, Hong Bo; Lyo, In Uk
2013-01-01
Summary There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirmed pre-operatively by Allcock’s test. PMID:24070079
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Convergence of posteriors for discretized log Gaussian Cox processes
DEFF Research Database (Denmark)
Waagepetersen, Rasmus Plenge
2004-01-01
In Markov chain Monte Carlo posterior computation for log Gaussian Cox processes (LGCPs) a discretization of the continuously indexed Gaussian field is required. It is demonstrated that approximate posterior expectations computed from discretized LGCPs converge to the exact posterior expectations...... when the cell sizes of the discretization tends to zero. The effect of discretization is studied in a data example....
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Posterior Mediastinal Tumors: Outcome of Surgery
International Nuclear Information System (INIS)
Abd Rahman, A.M.; Sedera, M.A.; Mourad, I.A.; Aziz, S.A.; Saber, T.K.H.; Al Sakary, M.A.
2005-01-01
The incidence of posterior mediastinal tumors relative to all tumors of the mediastinum is 23% to 30%. The posterior mediastinum is a potential space along each side of the vertebral column and adjacent proximal portion of the ribs. Primary tumors of posterior mediastinum are usually neurogenic. The aim of this study was to evaluate different surgical approaches used for the resection of posterior mediastinal tumors, and to assess morbidity, mortality and patients survival. Patients and Methods: Between January 200 I and January 2004, 30 patients with posterior mediastinal tumors were included. CT scan of the chest and CT guided biopsy were done for all patients; whereas MRI was done for suspected intraspinal extension. Posterolateral thoracotomy was the approach used in most of the patients. The Akwari approach was used in most of the patients with Dumbbell tumors. Neurogenic tumors constituted 67% of cases, being neuroblastoma in 60%. The non neurogenic tumors included a heterogenous group of rare tumors (n=10). Dumbbell tumors were found in 10 patients. Neuroblastoma was the commonest tumor to cause intraspinal extension (40%). Wide local excision was done in 13 patients; whereas extended resection was done in the remaining 17 patients. The mean intra-operative blood loss was 800cc and the mean hospital stay was 12 days. The size of the resected tumor ranged from 3X4cm to 30X22cm, 80% of tumors were malignant. Morbidity in relation to the procedures developed in 8 patients (atelectasis, meningitis, paraplegia, Horner syndrome and mild wound sepsis in 4, I, I, 1 and I of the patients; respectively). One postoperative mortality, due to meningitis was recorded. The overall survival by the end of three years was 87.7% with a mean survival of 30.4 months. The overall disease free survival was 55.9% with a mean disease free survival of 26.2 months. Posterior mediastinal tumors may reach large size before becoming symptomatic. Complete surgical excision (including
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Posterior amorphous corneal dystrophy: case report
Oliveira, Lauro Augusto de [UNIFESP; Vieira, Luiz Antônio [UNIFESP; Freitas, Denise de [UNIFESP; Sousa, Luciene Barbosa de [UNIFESP
2006-01-01
O objetivo deste trabalho é alertar o oftalmologista da possibilidade de se deparar com casos raros de distrofias corneanas. Neste caso correlacionamos os achados clínicos da distrofia amorfa posterior com refração, topografia e biomicroscopia ultra-sônica.The purpose of this paper is to warn the ophthalmologist about the possibility of facing rare cases of corneal dystrophies. Clinical findings of a case of posterior amorphous dystrophy were correlated with refraction, topography, and ultras...
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Posterior atlantoaxial dislocation without odontoid fracture
International Nuclear Information System (INIS)
Chaudhary, Reema; Raut, Abhijit; Chaudhary, Kshitij; Metkar, Umesh; Rathod, Ashok; Sanghvi, Darshana
2008-01-01
We report a case of posterior atlantoaxial dislocation without a fracture of the odontoid in a 35-year-old woman. There have been nine reported cases of similar injury in the English literature. The integrity of the transverse ligament following posterior atlantoaxial dislocations has not been well documented in these reports. In the present case, MRI revealed an intact transverse ligament, which probably contributed to the stability of the C1-C2 complex following closed reduction. (orig.)
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Vermian agenesis without posterior fossa cyst
International Nuclear Information System (INIS)
Adamsbaum, C.; Moreau, V.; Bulteau, C.; Burstyn, J.; Lair Milan, F.; Kalifa, G.
1994-01-01
We report 11 cases of vermian partial agenesis without posterior fossa cyst or hemispheric abnormalities. Characteristic MR signs were: absence of the posterior lobe, hypoplasia of the anterior lobe, a narrow sagittal cleft separating the hemispheres (''buttocks sign'') and fourth ventricle deformity. The main clinical signs were complex oculomotor dysfunction and developmental delay. None of the patients had respiratory symptoms. Consideration is given to the relationship between Joubert syndrome and this entity as well as to embroyological data. (orig.)
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Mature teratoma of the posterior mediastinum
International Nuclear Information System (INIS)
Kurosaki, Y.; Tanaka, Y.O.; Itai, Y.
1998-01-01
The vast majority of germ cell tumors in the thorax arise at or near the thymus. We report a case of a 41-year-old man with mature teratoma of the posterior mediastinum. He was asymptomatic and was incidentally found to have a posterior mediastinal mass. Computed tomography was helpful in suggesting a diagnosis of mature teratoma by demonstrating the presence of fat and calcification. The differential diagnosis included neurogenic tumors, liposarcoma, and extramedullary hematopoiesis. (orig.)
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Late presentation of posterior urethral valves.
Jalbani, Imran Khan; Biyabani, Syed Raziuddin
2014-05-01
Presence of posterior urethral valves (PUV) is the most common cause of urinary tract obstruction in the male neonate. Late presentation occurs in 10% of cases. We present a case of PUVs in an adult male who presented with history of obstructive lower urinary tract symptoms and hematuria. On evaluation, he was found to have raised serum creatinine level. A voiding cystourethrogram (VCUG) could not be completely performed because of narrowing in the posterior urethra. A rigid urethrocystoscopy was performed at which he was found to have type-I posterior urethral valve which were fulgurated. A repeat uroflowmetry revealed maximum flow rate of 12 ml/second. This case highlights that PUVs is not solely a disease of infancy but may also present late. VCUG is the radiological investigation of choice but the diagnosis may be missed. A urethrocystoscopy is advised if there is a high index of suspicion.
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Surgical revascularization of posterior coronary arteries without cardiopulomonary bypass
Directory of Open Access Journals (Sweden)
Lobo Filho J. Glauco
1999-01-01
Full Text Available OBJECTIVE: To assess the results observed during the early postoperative period in patients who had the posterior coronary arteries revascularized without cardiopulmonary bypass (CPB, in regard to the following parameters: age, sex,bypass grafts types, morbidity and mortality. METHODS: From January 1995 to June 1998, 673 patients underwent myocardial revascularization (MR. Of this total, 607 (90.20% MR procedures were performed without CPB. The posterior coronary arteries (PCA were revascularized in 298 (44.27% patients, 280 (93.95% without CPB. The age of the patients ranged from 37 to 88 years (mean, 61 years. The male gender predominated, with 198 men (70.7%. The revascularization of the posterior coronary arteries had the following distribution: diagonalis artery (31 patients, 10%; marginal branches of the circumflex artery (243 patients, 78.7%; posterior ventricular artery (4 patients, 1.3%; and posterior descending artery (31 patients, 10%. RESULTS: Procedure-related complications without death occurred in 7 cases, giving a morbidity of 2.5%. There were 11 deaths in the early postoperative period (mortality of 3.9%. CONCLUSION: Similarly to the anterior coronary arteries, the posterior coronary arteries may benefit from myocardial revascularization without CPB.
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Cisternography of the posterior fossa with metrizamide
Energy Technology Data Exchange (ETDEWEB)
Kobayashi, N.; Saito, Y.; Miyashita, T.; Tajika, Y.
1981-12-01
Nine patients underwent metrizamide cisternography of the posterior fossa. Excellent opacification of the fourth ventricle resulted when the patient's head was suitably positioned and the contrast material was introduced via a C1-2 puncture. With this technique, a benign aqueductal stenosis can be readily identified and the posterior fossa and fourth ventricle can be studied easily.
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Altieri, Andrea; Bosetti, Cristina; Gallus, Silvano; Franceschi, Silvia; Dal Maso, Luigino; Talamini, Renato; Levi, Fabio; Negri, Eva; Rodriguez, Teresa; La Vecchia, Carlo
2004-10-01
We examined the relation between consumption of different types of alcoholic beverages and the risk of oral and pharyngeal cancer, using data from a case-control study conducted in Italy and Switzerland between 1992 and 1997. This included a total of 749 cases of oral and pharyngeal cancer and 1,772 hospital controls, admitted for acute, non-neoplastic conditions, unrelated to alcohol and smoking consumption. Significant trends in risk were found with increasing total alcohol intake, with multivariate odds ratios (OR) of 2.1 for drinkers of 3-4 drinks/day, as compared to abstainers or light drinkers ( or = 12 drinks/day. Similar increased risks for subsequent levels of consumption were found for wine drinkers. After allowance for wine intake, the ORs for beer drinkers were 1.2 for 1-2 drinks/day, and 2.3 for > or = 3 drinks/day. Corresponding values for spirit drinkers were 1.0 and 1.9. Patterns of risk for wine drinkers were similar for wine only drinkers and drinkers of wine, plus beer and spirits. Our study indicates that in populations with frequent wine consumption, wine per se can strongly increase the risk of cancer of the oral cavity and pharynx, and confirms that the most prevalent alcoholic beverage in each population tends to be the one with the highest risk.
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Unsuccessful outcomes after posterior urethroplasty.
Engel, Oliver; Fisch, Margit
2015-03-01
Posterior urethroplasty is the most common strategy for the treatment of post-traumatic urethral injuries. Especially in younger patients, post-traumatic injuries are a common reason for urethral strictures caused by road traffic accidents, with pelvic fracture or direct trauma to the perineum. In many cases early endoscopic realignment is the first attempt to restore the junction between proximal and distal urethra, but in some cases primary realignment is not possible or not enough to treat the urethral injury. In these cases suprapubic cystostomy alone and delayed repair by stricture excision and posterior urethroplasty is an alternative procedure to minimise the risk of stricture recurrence.
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Kitagawa, Junichi; Takahashi, Yoshihiro; Matsumoto, Shigeji; Shingai, Tomio
2007-04-24
Many studies have reported the mechanism underlying umami taste. However, there are no investigations of responses to umami stimuli taste originating from chemoreceptors in the pharyngeal region. The pharyngeal branch of the glossopharyngeal nerve (GPN-ph) innervating the pharynx has unique responses to taste stimulation that differs from responses of the chorda tympani nerve and lingual branch of the glossopharyngeal nerve. Water evokes robust response, but NaCl solutions at physiological concentrations do not elicit responses. The present study was designed to examine umami taste (chemosensory) responses in the GPN-ph. Response characteristics to umami taste were compared between mice and rats. In mice, stimulation with compounds eliciting umami taste (0.1M monosodium L-glutamate (MSG), 0.01M inosine monophosphate (IMP) and the mixture of 0.1M MSG+0.01M IMP) evoked higher responses than application of distilled water (DW). However, synergistic response of a mixture of 0.1M MSG+0.01M IMP was not observed. In rats, there is no significant difference between the responses to umami taste (0.1M MSG, 0.01M IMP and the mixture of 0.1M MSG+0.01M IMP) and DW. Monopotassium glutamate (MPG) was used in rats to examine the contribution of the sodium component of MSG on the response. Stimulation with 0.1M MPG evoked a higher response when compared with responses to DW. The present results suggest that umami taste compounds are effective stimuli of the chemoreceptors in the pharynx of both mice and rats.
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Mature teratoma of the posterior mediastinum
Energy Technology Data Exchange (ETDEWEB)
Kurosaki, Y.; Tanaka, Y.O.; Itai, Y. [Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba-shi, Ibaraki-ken 305 (Japan)
1998-02-01
The vast majority of germ cell tumors in the thorax arise at or near the thymus. We report a case of a 41-year-old man with mature teratoma of the posterior mediastinum. He was asymptomatic and was incidentally found to have a posterior mediastinal mass. Computed tomography was helpful in suggesting a diagnosis of mature teratoma by demonstrating the presence of fat and calcification. The differential diagnosis included neurogenic tumors, liposarcoma, and extramedullary hematopoiesis. (orig.) With 2 figs., 18 refs.
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Examination of the reticular epithelium of the bovine pharyngeal tonsil
The nasopharyngeal tonsil (adenoid), located at the posterior of the nasopharynx is ideally positioned to sample antigens entering through the nasal cavity or oral cavity. Entering antigens will first contact tonsilar epithelium. To better understand the cellular composition of this important epithe...
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Directory of Open Access Journals (Sweden)
F Mir Mohammad Sadeghi
2002-09-01
Full Text Available Background: Cuffed pharyngeal tube is a device designed for ventilation of anesthetized patients. CPT has advantages over face mask including: maintaining of face mask can be difficult and boring after several minutes and mobility of the practitioner is reduced due to involvement of hands. Mask pressure can cause soft tissue and nerve damage around the nose. Anesthetic gas leakage from the mask adds to the operation room pollution. In difficult intubation CPT can be life-saving. Materials and Methods: In our study CPT was compared with endotracheal tube (ET in anesthetized patients. A scoring system for evaluating ventilation of patients was designed using symmetric chest wall motion during ventilation with anesthesia bag and sensing lung compliance through it, auscultation of breathing sounds, oscilation of bag with breathing and peripheral oxygen saturation by pulse oxymetry. Respiratory complications (pulmonary aspiration, Iaryngospasm and bronchospasm, nausea and vomiting were looked for during anesthesia. Results: The results showed that CPT was successful as ET in ventilation of spontaneously breathing patients and incidence of respiratory complications with CPT was no more than ET. Airway resistance was significantly greater with CPT than ET (P<0.05. Patients with ET had significantly greater incidence of sore throat than with CPT (P<0.05. Conclusion: Thus we concluded that CPT can be used for ventilation of anesthetized patients not predisposed to pulmonary aspiration and whose peak airway pressure does not exceed 20-25 CmH2O.
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Mihaescu, Mihai; Murugappan, Shanmugam; Kalra, Maninder; Khosla, Sid; Gutmark, Ephraim
2008-07-19
Computational fluid dynamics techniques employing primarily steady Reynolds-Averaged Navier-Stokes (RANS) methodology have been recently used to characterize the transitional/turbulent flow field in human airways. The use of RANS implies that flow phenomena are averaged over time, the flow dynamics not being captured. Further, RANS uses two-equation turbulence models that are not adequate for predicting anisotropic flows, flows with high streamline curvature, or flows where separation occurs. A more accurate approach for such flow situations that occur in the human airway is Large Eddy Simulation (LES). The paper considers flow modeling in a pharyngeal airway model reconstructed from cross-sectional magnetic resonance scans of a patient with obstructive sleep apnea. The airway model is characterized by a maximum narrowing at the site of retropalatal pharynx. Two flow-modeling strategies are employed: steady RANS and the LES approach. In the RANS modeling framework both k-epsilon and k-omega turbulence models are used. The paper discusses the differences between the airflow characteristics obtained from the RANS and LES calculations. The largest discrepancies were found in the axial velocity distributions downstream of the minimum cross-sectional area. This region is characterized by flow separation and large radial velocity gradients across the developed shear layers. The largest difference in static pressure distributions on the airway walls was found between the LES and the k-epsilon data at the site of maximum narrowing in the retropalatal pharynx.
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Directory of Open Access Journals (Sweden)
Suzel Ivón Lapido Polanco
2012-12-01
Full Text Available La miopía degenerativa constituye una de las causas fundamentales de pérdida de la visión. Esto está relacionado con las alteraciones del polo posterior, que afectan la retina neurosensorial, el epitelio pigmentario de la retina y las capas más internas de la coroides. Su curso lento y progresivo demanda una exploración integral, con seguimiento en el tiempo y constituye un reto para el oftalmólogo. Se realizó una revisión de artículos publicados e indexados en la base de datos de PubMed que se refirieran a las características clínicas del fondo de ojo en pacientes con miopía degenerativa, para describir las principales alteraciones del polo posterior del globo ocular en esta entidad. Se encontró entre las lesiones típicas de la alta miopía, al estafiloma posterior como un signo patognomónico de la enfermedad, asociado a la atrofia coriorretiniana en parches o difusa, así como las estrías de laca y las hemorragias maculares secundarias a ellas o provenientes de membranas neovasculares coroideas. La tomografía de coherencia óptica ha permitido un diagnóstico más preciso de otras lesiones maculares como la foveosquisis, el agujero macular y, más recientemente, la mácula en domo. Los cambios degenerativos del polo posterior parecen guardar relación unos con otros pero la patogenia no ha sido bien esclarecida a pesar de los avances tecnológicos.Degenerative myopia is one of the main causes of visual impairment. This is related to disorders in the posterior pole, affecting the neurosensorial retina, the retinal pigmented epithelium and the inner choroidal layers. The slow and progressive course of this condition demands comprehensive assessment and long follow-up, which is a challenging task for ophthalmologists. A review of the articles indexed in PubMed regarding the clinical characteristics of the fundus in patients with degenerative myopia was made to describe the main disorders of the posterior pole of the eyeball
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SIADH Induced by Pharyngeal Squamous Cell Carcinoma: Case Report and Literature Review
Directory of Open Access Journals (Sweden)
Hafiz Muhammad Sharjeel Arshad
2016-01-01
Full Text Available Background. The Syndrome of Inappropriate Antidiuretic Hormone (SIADH is considered to be the most common cause of euvolemic hyponatremia. The most common malignancy associated with SIADH is small cell lung cancer. We present a rare case of a patient with SIADH secondary to well differentiated squamous cell carcinoma of the naso-oropharynx. Case. A 46-year-old Caucasian woman presented to emergency department with four-week history of progressive dysphagia. On examination, she was found to have a pharyngeal mass. CT scan and MRI of neck confirmed a mass highly suspicious of carcinoma. Patient’s serum sodium level decreased to 118 mEq/L and other labs including serum and urine osmolality confirmed SIADH. She was started on fluid restriction and oral sodium tablets which gradually improved her serum sodium levels. Biopsy confirmed diagnosis of squamous cell carcinoma of pharynx. Conclusion. SIADH can be caused by squamous cell carcinoma. Appropriate management includes fluid restriction.
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Directory of Open Access Journals (Sweden)
MARIA VITÓRIA FRANÇA DO AMARAL
Full Text Available ABSTRACT We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion. The procedure proved to be technically feasible, with a still long surgical time. Considering the potential advantages of robotic surgery and those related to TAR and the results obtained when these two techniques are associated, we conclude that they seem to be a good option for the correction of complex abdominal wall defects.
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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.)
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Agenesis of the posterior arch of the atlas
Directory of Open Access Journals (Sweden)
Torriani Martin
2002-01-01
Full Text Available PURPOSE: To illustrate the radiological findings and review the current literature concerning a rare congenital abnormality of the posterior arch of the atlas. CASE REPORT: An adult female without neurological symptoms presented with an absent posterior arch of the atlas, examined with plain films and helical computerized tomography. Complete agenesis of the posterior arch of the atlas is a rare entity that can be easily identified by means of plain films. Although it is generally asymptomatic, atlantoaxial instability and neurological deficits may occur because of structural instability. Computerized tomography provides a means of assessing the extent of this abnormality and can help evaluate the integrity of neural structures. Although considered to be rare entities, defects of the posterior arch of the atlas may be discovered as incidental asymptomatic findings in routine cervical radiographs. Familiarity with this abnormality may aid medical professionals in the correct management of these cases.
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Tytgat, Tom; Vanholme, Bartel; De Meutter, Jan; Claeys, Myriam; Couvreur, Marjolein; Vanhoutte, Isabelle; Gheysen, Greetje; Van Criekinge, Wim; Borgonie, Gaetan; Coomans, August; Gheysen, Godelieve
2004-08-01
By performing cDNA AFLP on pre- and early parasitic juveniles, we identified genes encoding a novel type of ubiquitin extension proteins secreted by the dorsal pharyngeal gland in the cyst nematode Heterodera schachtii. The proteins consist of three domains, a signal peptide for secretion, a mono-ubiquitin domain, and a short C-terminal positively charged domain. A gfp-fusion of this protein is targeted to the nucleolus in tobacco BY-2 cells. We hypothesize that the C-terminal peptide might have a regulatory function during syncytium formation in plant roots.
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Intensity-modulated arc therapy simplified
International Nuclear Information System (INIS)
Wong, Eugene; Chen, Jeff Z.; Greenland, Jonathan
2002-01-01
Purpose: We present a treatment planning strategy for intensity-modulated radiation therapy using gantry arcs with dynamic multileaf collimator, previously termed intensity-modulated arc therapy (IMAT). Methods and Materials: The planning strategy is an extension of the photon bar arc and asymmetric arc techniques and is classified into three levels of complexity, with increasing number of gantry arcs. This principle allows us to generalize the analysis of the number of arcs required for intensity modulation for a given treatment site. Using a phantom, we illustrate how the current technique is more flexible than the photon bar arc technique. We then compare plans from our strategy with conventional three-dimensional conformal treatment plans for three sites: prostate (prostate plus seminal vesicles), posterior pharyngeal wall, and chest wall. Results: Our strategy generates superior IMAT treatment plans compared to conventional three-dimensional conformal plans. The IMAT plans spare critical organs well, and the trade-off for simplicity is that the dose uniformity in the target volume may not rival that of true inverse treatment plans. Conclusions: The analyses presented in this paper give a better understanding of IMAT plans. Our strategy is easier to understand and more efficient in generating plans than inverse planning systems; our plans are also simpler to modify, and quality assurance is more intuitive
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Neurenteric cyst of the posterior mediastinum
International Nuclear Information System (INIS)
Setty, H.A.N.; Hegde, K.K.S.; Narvekar, V.N.
2005-01-01
We report a case of a large posterior mediastinal neurenteric cyst in a neonate demonstrated by chest radiographs, barium swallow examination, ultrasonography and CT of the thorax. All the investigations revealed a large posterior mediastinal cystic mass with vertebral anomalies in the form of scoliosis and hemivertebra. The cyst was completely excised by a right posterolateral thoracotomy and biopsy showed the features of a neurenteric cyst. The rarity of the lesion prompted us to report this case Copyright (2005) Blackwell Publishing Asia Pty Ltd
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Directory of Open Access Journals (Sweden)
Mariano Augusto Noel
2010-09-01
Full Text Available INTRODUCCIÓN: durante los últimos diez años, hemos utilizado la toracotomía posterior para abordar la porción superior del tórax en procedimientos combinados anteriores y posteriores. Actualmente hemos extendido esta indicación a toda la columna torácica en remplazo de la toracotomía convencional y toracoscopía. OBJETIVO: evaluar el rango de posibilidades y complicaciones asociadas con este nuevo abordaje, que permite combinar la cirugía vertebral torácica anterior y posterior con la misma incisión cutánea posterior. Métodos: fueron evaluados, retrospectivamente, 35 pacientes operados entre los años del 2003 y 2007. En todos se realizó doble abordaje, combinando una toracotomía posterior y abordaje posterior, mediante una sola incisión medial, para diferentes objetivos: descompresión medular, artrodesis, osteotomías o vertebrectomías. Se evaluaron los valores angulares, las etiologías, la edad, los niveles vertebrales, la cantidad de toracotomías y las complicaciones. RESULTADOS: hubo un promedio de edad de 14,1 años (1-65, diez cifosis, valor promedio 96,8 (76-131; 24 escoliosis valor promedio 80 (60-105. Etiología: síndromes genéticos, 11; escoliosis idiopática, 6; neurológicas, 5; congénitas, 4; tumores, 4; fracturas, 2; hernia discal, 1; infección, 1. Toracotomía de 1 nivel 30 doble 5. Nivel superior T3 e inferior T10. Complicaciones: 1 hemotórax y dos infecciones de herida. CONCLUSIÓN: esta vía permite acceder a todo nivel torácico en procedimientos combinados mediante una sola incisión cutánea.INTRODUÇÃO: nos últimos dez anos, foi utilizada a toracotomia posterior para a abordagem da porção superior do tórax em procedimentos combinados anteriores e posteriores. Atualmente, esta indicação tem sido estendida por toda a coluna torácica ao invés da toracotomia convencional e da toracoscopia. OBJETIVO: avaliar as possibilidades e complicações associadas a esta nova abordagem, que permite
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Minimally invasive surgical approach to treat posterior urethral diverticulum
Directory of Open Access Journals (Sweden)
Ossamah Alsowayan
2015-01-01
Full Text Available Urethral diverticulum is a localized saccular or fusiform out-pouching of the urethra. It may occur at any point along the urethra in both male and females. Male urethral diverticulum is rare, and could be either congenital or acquired, anterior or posterior. The mainstay treatment of posterior urethral diverticulum (PUD is the open surgical approach. Here we discuss our minimally invasive surgical approach (MIS in managing posterior urethral diverticulum.
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van den Boom, L.G.H.; Brouwer, R.W.; van den Akker-Scheek, I.; Bulstra, S.K.; van Raaij, J.J.A.M.
2009-01-01
Background: Prosthetic design for the use in primary total knee arthroplasty has evolved into designs that preserve the posterior cruciate ligament (PCL) and those in which the ligament is routinely sacrificed (posterior stabilized). In patients with a functional PCL the decision which design is
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Distrofia corneana polimorfa posterior em Síndrome de Alport
Godoy, Flavia Ribeiro Monteiro de; Qahtani, Elham Al; Lyons, Christopher J.
2016-01-01
ABSTRACT We describe a six-year-old boy with a history of hematuria, posterior polymorphous corneal dystrophy and dots and fleck retinopathy. Alport syndrome should be ruled out in patients presenting with posterior polymorphous corneal dystrophy or anterior lenticonus and a family history of renal disease. RESUMO Descrevemos um paciente de 6 anos de idade com história de hematúria, distrofia corneana polimorfa posterior e retinopatia em "dots and flecks". Síndrome de Alport deve ser exclu...
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Distrofia policromática posterior da córnea
Coelho, Letícia Maria; Muinhos, Guilherme Kfoury; Tanure, Marco Antônio Guarino; Almeida, Homero Gusmão de; Sieiro, Reinaldo de Oliveira
2015-01-01
Os autores descrevem dois casos de distrofia policromática posterior da córnea, uma distrofia pré-Descemet, pouco descrita nas literaturas nacional e mundial, em que se observam pontos policromáticos difusos no estroma posterior da córnea, sem aparente comprometimento da visão. The authors describe two cases of posterior polychromatic corneal dystrophy, a pre-Descemet dystrophy, poorly described in national and world literatures, characterized by diffuse polychromatic points on the posteri...
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Difficult management of posterior urethra gunshot wound combined ...
African Journals Online (AJOL)
Posterior urethra gunshot wounds are poorly described in the literature. They are often associated with pelvic vital lesions making difficult early repair of urethral injuries. They can be complicated by urethrorectal fistula, which makes their management more complicated. We report a new case of posterior urethra disruption ...
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Directory of Open Access Journals (Sweden)
Rui Pimenta
2013-04-01
Full Text Available Posterior sternoclavicular dislocation is a rare traumatic injury that presents a potential risk of injury to mediastinal structures. The diagnosis is fundamentally clinical and treatment is done on an emergency basis. The authors report the clinical case of a young judo athlete with post-traumatic medial epiphyseal fracture-detachment, with posterior displacement (lesion equivalent to posterior sternoclavicular dislocation at pediatric ages. He underwent open reduction and ligament repair by means of a mini-anchor.The radiological and clinical outcome was excellent, and the athlete returned to his sports activity without limitations. We discuss the particular features of this pathological condition, along with the different therapeutic approaches and their complications
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Xu, Yong; Li, Feng; Guan, Hanfeng; Xiong, Wei
2015-01-01
Abstract Posterior atlantoaxial dislocation without odontoid fracture is extremely rare and often results in fatal spinal cord injury. According to the reported literature, all cases presented mild or no neurologic deficit, with no definite relation to upper spinal cord injury. Little is reported about traumatic posterior atlantoaxial dislocation, with incomplete quadriplegia associated with a spinal cord injury. We present a case of posterior atlantoaxial dislocation without associated fracture, but with quadriplegia, and accompanying epidural hematoma and subarachnoid hemorrhage. The patient underwent gentle traction in the neutral position until repeated cranial computed tomography revealed no progression of the epidural hematoma. Thereafter, the atlantoaxial dislocation was reduced by using partial odontoidectomy via a video-assisted transcervical approach and maintained with posterior polyaxial screw-rod constructs and an autograft. Neurological status improved immediately after surgery, and the patient recovered completely after 1 year. Posterior fusion followed by closed reduction is the superior strategy for posterior atlantoaxial dislocation without odontoid fracture, according to literature. But for cases with severe neurological deficit, open reduction may be the safest choice to avoid the lethal complication of overdistraction of the spinal cord. Also, open reduction and posterior srew-rod fixation are safe and convenient strategies in dealing with traumatic posterior atlantoaxial dislocation patients with neurological deficit. PMID:26512572
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(Pisces, Cyprinidae) from the eastern Cape Province, South Africa
African Journals Online (AJOL)
1990-03-05
Mar 5, 1990 ... small, aligned in regular rows, indistinct on nape and embedded between pectoral fins and antero-ventral region. .... major row teeth of Barbus omfltolicus sp.nov. B - Posterior view of the right pharyngeal bone and teeth of B. onwtoiicus sp.nov. Scale bar is 1 mm. 191. Figure 4 The nuptial tubercles on the ...
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Vaginal estrogen: a dual-edged sword in postoperative healing of the vaginal wall.
Ripperda, Christopher M; Maldonado, Pedro Antonio; Acevedo, Jesus F; Keller, Patrick W; Akgul, Yucel; Shelton, John M; Word, Ruth Ann
2017-07-01
Reconstructive surgery for pelvic organ prolapse is plagued with high failure rates possibly due to impaired healing or regeneration of the vaginal wall. Here, we tested the hypothesis that postoperative administration of local estrogen, direct injection of mesenchymal stem cells (MSCs), or both lead to improved wound healing of the injured vagina in a menopausal rat model. Ovariectomized rats underwent surgical injury to the posterior vaginal wall and were randomized to treatment with placebo (n = 41), estrogen cream (n = 47), direct injection of MSCs (n = 39), or both (n = 43). MSCs did not survive after injection and had no appreciable effects on healing of the vaginal wall. Acute postoperative administration of vaginal estrogen altered the response of the vaginal wall to injury with decreased stiffness, decreased collagen content, and decreased expression of transcripts for matrix components in the stromal compartment. Conversely, vaginal estrogen resulted in marked proliferation of the epithelial layer and increased expression of genes related to epithelial barrier function and protease inhibition. Transcripts for genes involved in chronic inflammation and adaptive immunity were also down-regulated in the estrogenized epithelium. Collectively, these data indicate that, in contrast to the reported positive effects of preoperative estrogen on the uninjured vagina, acute administration of postoperative vaginal estrogen has adverse effects on the early phase of healing of the stromal layer. In contrast, postoperative estrogen plays a positive role in healing of the vaginal epithelium after injury.
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Delayed primary realignment of posterior urethral rupture | Shittu ...
African Journals Online (AJOL)
The treatment of acute posterior urethral rupture is controversial. Twelve patients who presented with acute posterior urethral rupture over a five--year period were treated by delayed primary realignment of the injury. The technique of this procedure and the outcome are the subject of this presentation. Eight patients had ...
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International Nuclear Information System (INIS)
Kokubu, Michiyo; Amatsu, Mutsuo
1984-01-01
The purpose of the present study was to obtain a more natural tubal insufficiency than that obtained by the conventional methods to clarify the middle ear pathology associated with tubal dysfunction. For this purpose, the pharyngeal orifice of the auditory tube in the guinea pigs was irradiated with electron beam with a dose of 2,000 rad following the preliminary experiments to determine the appropriate dose. The guinea pigs with intact drum and normal Pryer reflex were used for the present experiment series. A specially devised apparatus was used for avoiding the dipersing beam. Histopathological changes of the middle ear and auditory tube were observed in a series of single specimen with H-E staining 1, 2, 3, 6, 12 months after irradiation. In this study, middle ear with effusion was used to clarify the dynamic process of the pathological changes between the auditory tube and the middle ear. In summary, the present study revealed that the electron beam irradiation to the pharyngeal orifice caused various grades of otitis media with effusion which could be classified into three groups. Of these groups 1) and 2), 3) were likely to be corresponding with so-called serous and purulent otitis media with effusion in human respectively. Infection due to the malfunction caused by the epithelial damage of the auditory tube was an important promoting factor to change the serous type effusion for the purulent type effusion. (J.P.N.)
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International Nuclear Information System (INIS)
Khan, M.A.; Ahmed, A.
2015-01-01
To compare efficacy and discomfort in posterior nasal packing with Foley's catheters versus BIPP gauze packing in cases of posterior epistaxis. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital (CMH) Kharian from October 2011 to October 2013. Material and Methods: A total of 206 patients of posterior epistaxis were included in the study through non-probability convenience sampling and randomly divided in two groups of 103 each. In group A patients were treated by posterior nasal packing with Foley's catheter and in group B patients were treated by posterior nasal packing with BIPP gauze and results in terms of control of epistaxis and discomfort during pack insertion, while the packs were in situ and pack removal, based on VAS (Visual Analogue Scale) were observed. Results: Average age in group A was 52.64 years (SD=9.57) and in group B it was 50.27 years (SD ± 10.13). There were 71 (68.9%) males in group A while 67 (65%) males in group B. During posterior nasal pack insertion, the mean pain score in Group A was 6.21 (SD ± I.13) and in Group B was 7.43 (SD ± 1.19). The mean pain score with the pack in situ was 4.27 (SD ± 0.08) in Group A versus 4.76 (SD ± 0.09) Group B. Similarly pack removal was also more painful in group B than group A (6.14 ± 0.91 vs 6.89 ± 1.09) (p =0.000). In the group A, 31 (30.1%) patients had rebleeding after pack removal, out of which 9 (8.7%) had significant bleeding requiring repacking. In 22 (21.4%) cases there was mild bleeding which settled without repacking. In group B 22 (21.4%) patients had rebleeding after pack removal, out of which 5 (4.7%) had significant bleeding requiring repacking. Conclusion: It is concluded that posterior nasal packing with BIPP gauze pack is effective for controlling posterior epistaxis but causes more discomfort to the patients as compared to Foley's catheter packing. (author)
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Directory of Open Access Journals (Sweden)
Mahmut Demirtaş
2018-04-01
Full Text Available Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis syndrome (PFAPA is a frequently seen, important medical condition, which must be kept in mind in periodic fever etiology. Although its etiology is not clearly understood, autoimmune etiology is suspected due to response to steroids. There is no specific test for the diagnosis of disease. Diagnosis is based on symptoms and physical examination. Although medical treatment is the first choice for the management of the disease, tonsillectomy take over in treatment options for termination of attacks and permanent results. We have presented a patient that was performed tonsillectomy in our clinic for frequent attacks despite recurrent medical therapy with diagnosis of PFAPA with review of current literature.
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Schoofs, Andreas; Hanslik, Ulrike; Niederegger, Senta; Heinzel, Hans-Georg; Spiess, Roland
2010-08-01
We describe the anatomy of the nerves that project from the central nervous system (CNS) to the pro- and mesothoracic segments and the cephalopharyngeal skeleton (CPS) for third instar Calliphora larvae. Due to the complex branching pattern we introduce a nomenclature that labels side branches of first and second order. Two fine nerves that were not yet described are briefly introduced. One paired nerve projects to the ventral arms (VAs) of the CPS. The second, an unpaired nerve, projects to the ventral surface of the cibarial part of the esophagus (ES). Both nerves were tentatively labeled after the structures they innervate. The antennal nerve (AN) innervates the olfactory dorsal organ (DO). It contains motor pathways that project through the frontal connectives (FC) to the frontal nerve (FN) and innervate the cibarial dilator muscles (CDM) which mediate food ingestion. The maxillary nerve (MN) innervates the sensory terminal organ (TO), ventral organ (VO), and labial organ (LO) and comprises the motor pathways to the mouth hook (MH) elevator, MH depressor, and the labial retractor (LR) which opens the mouth cavity. An anastomosis of unknown function exists between the AN and MN. The prothoracic accessory nerve (PaN) innervates a dorsal protractor muscle of the CPS and sends side branches to the aorta and the bolwig organ (BO) (stemmata). In its further course, this nerve merges with the prothoracic nerve (PN). The architecture of the PN is extremely complex. It innervates a set of accessory pharyngeal muscles attached to the CPS and the body wall musculature of the prothorax. Several anastomoses exist between side branches of this nerve which were shown to contain motor pathways. The mesothoracic nerve (MeN) innervates a MH accessor and the longitudinal and transversal body wall muscles of the second segment. J. Morphol. 271:969-979, 2010. (c) 2010 Wiley-Liss, Inc.
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Directory of Open Access Journals (Sweden)
Luciana D. V. Gauzzi
2008-12-01
Full Text Available OBJETIVO: Avaliar o uso da fontanela posterior em recém-nascidos prematuros (OBJECTIVE: To evaluate the use of the posterior fontanelle in premature neonates (< 37 weeks with a birth weight < 1,500 g in the ultrasound diagnosis of intraventricular/periventricular hemorrhage and to assess whether the use of the anterior fontanelle associated with the posterior fontanelle changes the interrater agreement. METHODS: Eighty-five premature neonates were evaluated in this prospective study. Ultrasound was performed using the anterior fontanelle, and later, the posterior fontanelle. A consensus diagnosis between two raters was used to analyze the agreement between the anterior fontanelle alone and in association with the posterior fontanelle. If there was no consensus, a third observer was involved to decide. RESULTS: Agreement between the first two raters had a kappa of 0.80 (95%CI 0.76-0.84. However, when the anterior fontanelle was evaluated alone, kappa was 0.74 (95%CI 0.70-0.78. Thirty-seven hemispheres had grade II hemorrhage, of which 17 (45.9% had their diagnosis performed using the anterior fontanelle; in 10 (27%, diagnosis was suspected by the anterior fontanelle and confirmed by the posterior fontanelle; and in 10 (27%, diagnosis was exclusively performed using the posterior fontanelle. Of the 454 hemispheres, in 20 (4.4% the diagnosis of intraventricular hemorrhage was performed exclusively by the posterior fontanelle (p < 0.001. CONCLUSIONS: In this study, the anterior fontanelle associated with the posterior fontanelle was better than the use of the anterior fontanelle alone in the identification of intraventricular/periventricular hemorrhage. Ultrasound using the posterior fontanelle allowed diagnosis of unsuspected grade II hemorrhage by the anterior fontanelle. Use of the posterior fontanelle was also useful to clarify presence of hemorrhage in inconclusive examinations by the anterior fontanelle.
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Lee, Kyeong Duk; Kwon, Soon Chan; Muniandy, Sarawana; Park, Eun Suk; Sim, Hong Bo; Lyo, In Uk
2013-01-01
There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirm...
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Intracranial arterial wall enhancement using gadolinium-enhanced 3D black-blood T1-weighted imaging
Energy Technology Data Exchange (ETDEWEB)
Takano, Koichi, E-mail: k-takano@fukuoka-u.ac.jp; Hida, Kosuke; Kuwabara, Yasuo; Yoshimitsu, Kengo
2017-01-15
Purpose: We investigated the enhancement of the intracranial arterial walls with gadolinium-enhanced, black-blood three-dimensional T1-weighted imaging (Gd-3DBB) by using an improved motion-sensitized driven-equilibrium (iMSDE)—prepared volumetric isotropic turbo spin-echo acquisition (VISTA). Methods: A total of 115 patients underwent FLAIR, 3D-TOF-MRA and Gd-3DBB with a 1.5-T scanner. The degree and distribution of the arterial wall enhancement on Gd-3DBB was assessed. The association of the degree of wall enhancement with brain infarction/ischemic lesions on FLAIR, luminal changes on 3D-TOF-MRA, and cardiovascular risk factors (CVRFs) was investigated by univariate and multiple logistic regression analyses. Results: Strong enhancement of the arterial walls was observed in 77 vertebral arteries (33.5%), 4 basilar arteries (3.5%), 31 supraclinoid internal carotid arteries (ICAs) (13.5%) and 8 middle cerebral arteries (3.5%). In addition, 221 intrapetrous ICAs (96.1%) showed strong enhancement. After adjusting for confounding factors, multivariate analyses showed that the patient age was independently associated with the strong wall enhancement of the arteries for both the posterior (OR, 1.088; 95% CI, 1.034–1.146) and the anterior circulation (OR, 1.098, 95% CI 1.029–1.172). In addition, the presence of the supratentorial brain infarctions was independently associated with the strong wall enhancement in the anterior circulation excluding the intrapetrous ICAs (OR, 4.097; 95% CI, 1.483–11.319). Conclusions: Although the arterial wall enhancement on the Gd-3DBB probably reflects normal aging, the enhancement in the anterior circulation might be related to brain infarctions. On the other hand, the intrapetrous ICA enhancement is considered a nonspecific finding and should not be mistaken for arterial pathologies such as atherosclerosis or arteritis.
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Intracranial arterial wall enhancement using gadolinium-enhanced 3D black-blood T1-weighted imaging
International Nuclear Information System (INIS)
Takano, Koichi; Hida, Kosuke; Kuwabara, Yasuo; Yoshimitsu, Kengo
2017-01-01
Purpose: We investigated the enhancement of the intracranial arterial walls with gadolinium-enhanced, black-blood three-dimensional T1-weighted imaging (Gd-3DBB) by using an improved motion-sensitized driven-equilibrium (iMSDE)—prepared volumetric isotropic turbo spin-echo acquisition (VISTA). Methods: A total of 115 patients underwent FLAIR, 3D-TOF-MRA and Gd-3DBB with a 1.5-T scanner. The degree and distribution of the arterial wall enhancement on Gd-3DBB was assessed. The association of the degree of wall enhancement with brain infarction/ischemic lesions on FLAIR, luminal changes on 3D-TOF-MRA, and cardiovascular risk factors (CVRFs) was investigated by univariate and multiple logistic regression analyses. Results: Strong enhancement of the arterial walls was observed in 77 vertebral arteries (33.5%), 4 basilar arteries (3.5%), 31 supraclinoid internal carotid arteries (ICAs) (13.5%) and 8 middle cerebral arteries (3.5%). In addition, 221 intrapetrous ICAs (96.1%) showed strong enhancement. After adjusting for confounding factors, multivariate analyses showed that the patient age was independently associated with the strong wall enhancement of the arteries for both the posterior (OR, 1.088; 95% CI, 1.034–1.146) and the anterior circulation (OR, 1.098, 95% CI 1.029–1.172). In addition, the presence of the supratentorial brain infarctions was independently associated with the strong wall enhancement in the anterior circulation excluding the intrapetrous ICAs (OR, 4.097; 95% CI, 1.483–11.319). Conclusions: Although the arterial wall enhancement on the Gd-3DBB probably reflects normal aging, the enhancement in the anterior circulation might be related to brain infarctions. On the other hand, the intrapetrous ICA enhancement is considered a nonspecific finding and should not be mistaken for arterial pathologies such as atherosclerosis or arteritis.
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Arthroscopic management of posterior instability: evolution of technique and results.
Savoie, Felix H; Holt, M Shaun; Field, Larry D; Ramsey, J Randall
2008-04-01
The purpose of this study was to evaluate the effectiveness of arthroscopic posterior shoulder reconstruction. We treated 136 shoulders in 131 patients with a diagnosis of primary posterior instability who failed 6 months of vigorous rehabilitation by operative stabilization between 1989 and 2001. Inclusion criterion was primary posterior instability that failed an extensive rehabilitative program with functional impairment and pain. Exclusion criterion was less than 12 months of follow-up and Suretac (Smith & Nephew, Andover, MA) or laser stabilization, leaving 92 shoulders in 90 patients available for the study (69 male, 21 female). Follow-up ranged from 12 to 132 months (average, 28 months). Each patient underwent diagnostic arthroscopy and surgical repair at the same time using one of several primary procedures. The procedure used was based on the pathologic entity noted at the time of surgery. At an average follow-up of 28 months, 97% of the shoulders were stable and considered a success based on the Neer-Foster rating scale. Posterior pathology varied, and a reverse Bankart lesion alone was found 51% of the time, a stretched posterior capsule 67% of the time, and a combination of a reverse Bankart lesion and capsular stretching 16% of the time. The rotator interval was obviously damaged in 61% of cases. Multiple accompanying lesions were found, including anterior-superior labral tears and SLAP tears (20%), superior glenohumeral ligament injury (7%), middle glenohumeral ligament injury (38%), anteroinferior glenohumaral ligament injury (37%), and an enlarged axillary pouch (20%). No essential lesion is present for posterior instability. Multiple varied pathologies will be present in a shoulder presenting with posterior instability. Arthroscopic surgery allows inspection of the joint and anatomic-specific repairs based on pathology. Careful attention to all the supporting structures of the shoulder, including the rotator interval, the anterior-superior labrum
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Tibialis Posterior Tenosynovitis: A Unique Musculoskeletal Manifestation of Gout.
Shupper, Peter; Stitik, Todd P
2018-02-01
Extra-articular manifestations of gout can present in several ways, including tenosynovitis. We present a rare case of acute tibialis posterior gouty tenosynovitis. An 82-year-old man with a history of well-controlled gout presented with acute onset of left ankle pain, occurring without inciting event. The medial ankle was slightly erythematous with moderate dorsal-medial swelling and mild dorsal-lateral swelling, with severe tenderness to palpation over the medial retro-malleolar region. Range of motion and manual muscle testing were pain limited throughout. Ultrasound examination revealed a left posterior tibialis tendon sheath tenosynovitis with effusion and overlying soft tissue edema. Tendon sheath aspirate revealed sodium urate crystals and a white blood cell count of 6400/μL. Tendon sheath injection with a mixture of 1% lidocaine and dexamethasone 4 mg resulted in symptom resolution. Repeat ultrasound examination demonstrated no evidence of tibialis posterior tendon sheath effusion. This case is unique not only because acute gouty posterior tibialis tenosynovitis is very rare, particularly in a normouricemic individual, but also because the sonographic evidence of gouty infiltration into the posterior tibialis tendon and overlying subcutaneous tissue considerably aided in arriving at the correct diagnosis in a timely manner.
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Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy
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Jorge Pablo Batista
2015-01-01
Full Text Available Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.
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[Posterior polymorphous dystrophy, case report and literature review].
Mendoza-Adam, G; Hernandez-Camarena, J C; Valdez-García, J E
2015-09-01
Posterior Polymorphous Dystrophy (DPP) is a rare posterior corneal dystrophy that is genetically transmitted as autosomal dominant. Corneal structures affected in this dystrophy are Descemet membrane and the endothelium. A case is presented on a 47 years old woman with no relevant history, with typical findings of DPP (vesicular and band lesions at the endothelium and posterior Descemet). To our knowledge there are no reported cases of DPP in Latin-American patients in the literature. The clinical manifestations in our patient were found to be very similar to the cases reported in other populations. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.
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Kadam, Abhijeet; Wigner, Nathan; Saville, Philip; Arlet, Vincent
2017-12-01
OBJECTIVE The authors' aim in this study was to evaluate whether sagittal plane correction can be obtained from the front by overpowering previous posterior instrumentation and/or fusion with hyperlordotic anterior lumbar interbody fusion (ALIF) cages in patients undergoing revision surgery for degenerative spinal conditions and/or spinal deformities. METHODS The authors report their experience with the application of hyperlordotic cages at 36 lumbar levels for ALIFs in a series of 20 patients who underwent revision spinal surgery at a single institution. Included patients underwent staged front-back procedures: ALIFs with hyperlordotic cages (12°, 20°, and 30°) followed by removal of posterior instrumentation and reinstrumentation from the back. Patients were divided into the following 2 groups depending on the extent of posterior instrumentation and fusion during the second stage: long constructs (≥ 6 levels with extension into thoracic spine and/or pelvis) and short constructs (lumbar lordosis increased from 44.3° to 59.8° (p lumbar levels that have pseudarthrosis from the previous posterior spinal fusion. Meticulous selection of levels for ALIF is crucial for safely and effectively performing this technique.
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Characteristics of wall pressure over wall with permeable coating
Energy Technology Data Exchange (ETDEWEB)
Song, Woo Seog; Shin, Seungyeol; Lee, Seungbae [Inha Univ., Incheon (Korea, Republic of)
2012-11-15
Fluctuating wall pressures were measured using an array of 16 piezoelectric transducers beneath a turbulent boundary layer. The coating used in this experiment was an open cell, urethane type foam with a porosity of approximately 50 ppi. The ultimate objective of the coating is to provide a mechanical filter to reduce the wall pressure fluctuations. The ultimate objective of the coating is to provide a mechanical filter to reduce the wall pressure fluctuations. The boundary layer on the flat plate was measured by using a hot wire probe, and the CPM method was used to determine the skin friction coefficient. The wall pressure autospectra and streamwise wavenumber frequency spectra were compared to assess the attenuation of the wall pressure field by the coating. The coating is shown to attenuate the convective wall pressure energy. However, the relatively rough surface of the coating in this investigation resulted in a higher mean wall shear stress, thicker boundary layer, and higher low frequency wall pressure spectral levels compared to a smooth wall.
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Traumatic posterior fossa epidural hematoma
International Nuclear Information System (INIS)
Ikeda, Yukio; Nakazawa, Shozo; Yamakawa, Kazuomi; Kobayashi, Shiro; Tsuji, Yukihide
1981-01-01
In this paper three acute cases and two subacute cases are reported. CT findings in acute cases show two different types. ''Type I'' shows crescent or lenticular high density area which is not enhanced after contrast infusion. ''Type II'' shows lenticular low density area with membranous high density region in its medial side after contrast infusion. In subacute cases plain CT scan shows lenticular iso or low density area with membranous high density region in its medial side. Forty five cases of posterior fossa epidural hematoma in the review of literature of this country are discussed. Disturbances of the consciousness are the most predominant symptoms in acute cases, while in subacute cases cerebellar signs, vomiting, headache and choked disc are noted. Angiographical examinations may not always be valuable in collecting the direct information of the existence of the epidural hematoma. Liquor cavity in the posterior fossa which is thought to serve as a buffer action of hematoma is about 20 ml, so we discuss about the volume of hematoma, especially of 20 ml, associated with clinical course and prognosis. Volume of epidural hematoma is one of the most important factors affecting clinical course and prognosis. In summary of these our experiences, we again emphasize the value of CT scan as the rapid, noninvasive, accurate radiological examination in the diagnosis of traumatic posterior fossa epidural hematoma. (author)
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Radial motion of the carotid artery wall: A block matching algorithm approach
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Effat Soleimani
2012-06-01
Full Text Available Introduction: During recent years, evaluating the relation between mechanical properties of the arterialwall and cardiovascular diseases has been of great importance. On the other hand, motion estimation of thearterial wall using a sequence of noninvasive ultrasonic images and convenient processing methods mightprovide useful information related to biomechanical indexes and elastic properties of the arteries and assistdoctors to discriminate between healthy and diseased arteries. In the present study, a block matching basedalgorithm was introduced to extract radial motion of the carotid artery wall during cardiac cycles.Materials and Methods: The program was implemented to the consecutive ultrasonic images of thecommon carotid artery of 10 healthy men and maximum and mean radial movement of the posterior wall ofthe artery was extracted. Manual measurements were carried out to validate the automatic method andresults of two methods were compared.Results: Paired t-test analysis showed no significant differences between the automatic and manualmethods (P>0.05. There was significant correlation between the changes in the instantaneous radialmovement of the common carotid artery measured with the manual and automatic methods (withcorrelation coefficient 0.935 and P<0.05.Conclusion: Results of the present study showed that by using a semi automated computer analysismethod, with minimizing the user interfere and no attention to the user experience or skill, arterial wallmotion in the radial direction can be extracted from consecutive ultrasonic frames
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Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Zhang, Yupeng; Liu, Zheng
2015-01-01
Objective: The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation.Methods: Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reco...