Berlini trahter toob Hollandi vennad Võsule

Index Scriptorium Estoniae

2005-01-01

Hollandi akustilise rockansambli G.E.T. kontsertidest Rakveres Berlini trahteris, Võsul ööklubis "7-Taevas", Tallinna pubis "Seiklusjutte maalt ja merelt", Pärnu jahtklubis ja Tartu pubis "Veerevad kivid"

Ed & Os : kahe Wilde näitemäng / Mati Unt

Index Scriptorium Estoniae

Unt, Mati, 1944-2005

1998-01-01

Mati Undi näidend Eduard Vilde ja Oscar Wilde'i kohtumisest. Illustratsiooniks Tiiu Kirsipuu Tartusse Wilde Irish Pubi ette loodava skulptuurigrupi kavand. Autori märkus : Tekst on kirjutatud Kahe Wilde Pubi avamiseks ja koostatud Wilde'i ja Vilde tekstidest.

Fleas and lice of mammals in New Mexico

Science.gov (United States)

Paulette L. Ford; Richard A. Fagerlund; Donald W. Duszynski; Paul J. Polechla

2004-01-01

All available records are compiled for three orders of ectoparasites of mammals in New Mexico: fleas (Siphonaptera), sucking lice (Anoplura), and chewing lice (Mallophaga). We have drawn from records at the University of New Mexico's Museum of Southwestern Biology, the Vector Control Program of the New Mexico Environment Department, the Environmental Health...

Intrapartum Pubic Symphysis Disruption

African Journals Online (AJOL)

Dhar S, Anderton JM. Rupture of the symphysis pubis during labor. Clin Orthop Relat Res 1992;283:252‑7. 6. Putschar WG. The structure of the human symphysis pubis with special consideration of parturition and its sequelae. Am. J Phys Anthropol 1976;45 (3 pt 2):589‑94. 7. Kharrazi FD, Rodgers WB, Kennedy JG, Lhowe ...

P-20: Osteitis Pubisli Futbolcularda İnguinal Herni Varlığının Araştırılması

Directory of Open Access Journals (Sweden)

Ali Eraslan

2017-03-01

Full Text Available GİRİŞ: Kasık ağrıları futbolda önemli sağlık problemlerindendir. Nedenleri arasında sıklıkla kas-tendon zorlanmaları, avülsiyon kırıkları, osteitis pubis, inguinal herni (gerçek herni kesesi varlığı ve sporcu hernisi (gerçek herni kesesi yokluğu bulunmaktadır.AMAÇ: Bu çalışmada osteitis pubis tanısı almış futbolcularda eski veya mevcut inguinal herni varlığını araştırmak amaçlandı.GEREÇ-YÖNTEM: Spor hekimliği polikliniğine 2011-2016 yılları arasında kasık ağrısıyla başvurmuş ve osteitis pubis tanısı almış erkek futbolcuların arşiv kayıtları retrospektif olarak tarandı. Sporcuların demografik özellikleri, MR görüntüleri ve varsa inguinal USG tetkik sonuçları incelendi. BULGULAR: Arşiv kayıtlarından profesyonel veya rekreasyonel olarak futbol oynayan 51 osteitis pubisli sporcunun MR görüntülerine ulaşıldı. Yaş ortalaması 24.5 (±7.7 yıl bulundu. İnguinal herniyle ilişkili 8 (%15.6 osteitis pubis olgusu bulundu. 3 sporcu (%5.8 polikliniğimize başvurmadan önce inguinal herni operasyonu geçirmişti. 26 sporcuya ise kasık ağrısıyla beraber herni semptomları da (valsalva ile artan inguinal ağrı ve/veya şişlik tarifledikleri için herni muayenesi ve inguinal USG uygulanmıştı. Bunların sadece 5’i (%9.8 gerçek herni kesesi saptanarak cerrahiye sevk edilmişti. 8 olgunun 7'sinde inguinal herniyle ipsilateral osteitis pubis bulguları kontrlateraldekinden daha belirgindi.TARTIŞMA: Çalışmamızın sonuçları osteitis pubisli futbolcularda eş zamanlı inguinal herni olabileceğini ve önceden inguinal herni tamiri geçirmiş bir futbolcuda osteitis pubis gelişebildiğini göstermiştir. Bunun yanında, inguinal duvardaki defektle ipsilateral pubik ramusta daha belirgin osteitis pubis bulgularının oluşu iki patolojiye yol açan mekanizmaların ortak olabileceğine işaret etmektedir. İnguinal herninin tedavisinde cerrahi girişim esastır ve s

Defining forces that are associated with shoulder dystocia: the use of a mathematic dynamic computer model.

Science.gov (United States)

Gonik, Bernard; Zhang, Ning; Grimm, Michele J

2003-04-01

A computer model was modified to study the impact of maternal endogenous and clinician-applied exogenous delivery loads on the contact force between the anterior fetal shoulder and the maternal symphysis pubis. Varying endogenous and exogenous loads were applied, and the contact force was determined. Experiments also examined the effect of pelvic orientation and the direction of load application on contact force behind the symphysis pubis. Exogenous loading forces (50-100 N) resulted in anterior shoulder contact forces of 107 to 127 N, with delivery accomplished at 100 N of applied load. Higher contact forces (147-272 N) were noted for endogenously applied loads (100-400 N), with delivery occurring at 400 N of maternal force. Pelvic rotation from lithotomy to McRoberts' positioning resulted in reduced contact forces. Downward lateral flexion of the fetal head led to little difference in contact force but required 30% more exogenous load to achieve delivery. Compared with clinician-applied exogenous force, larger maternally derived endogenous forces are needed to clear the impacted anterior fetal shoulder. This is associated with >2 times more contact force by the obstructing symphysis pubis. McRoberts' positioning reduces shoulder-symphysis pubis contact force. Lateral flexion of the fetal head results in the larger forces that are needed for delivery but has little effect on contact force. Model refinements are needed to examine delivery forces and brachial plexus stretching more specifically.

Static and dynamic MRI of a urinary control intra-vaginal device

International Nuclear Information System (INIS)

Maubon, A.J.; Boncoeur-Martel, M.P.; Juhan, V.; Rouanet, J.P.; Courtieu, C.R.; Thurmond, A.S.; Aubas, P.; Mares, P.

2000-01-01

The aim of this study was to describe by MRI, in dynamic conditions at rest and straining, the anatomical modifications induced by a commercially available intravaginal device (IVD) aimed at relieving female stress urinary incontinence. Ten female patients complaining of stress urinary incontinence (SUI) had pelvic MRI with static and dynamic sequences, without and with a self-inserted IVD. We studied positions and angulations of the IVD in the pelvis. Paired t-test allowed comparisons of: position of the bladder neck; urethral angulation with the pubis axis; position of the urethra; and posterior urethro-vesical angle (PUVA) without and with IVD. At rest, in ten of ten cases IVD laid cranial to the pubo-rectal muscle; with an average angulation of 95 ± 10 with the pubis axis, laterally tilted in three of ten cases. In maximum straining with IVD bladder neck descent was lower by an average of 5.2 ± 3.1 mm (p = 0.001), pubo-urethral angle opening was smaller by an average of 22 ± 20 (p = 0.015), and bladder neck to pubis distance was shorter by an average of 5.7 ± 4 mm. Posterior urethro-vesical angle was not significantly modified. Dynamic MRI allowed a non-invasive assessment of the mode of action of an IVD. The main modifications were a support of the bladder base and bladder neck, with a superior displacement of the urethra toward the pubis. (orig.)

Static and dynamic MRI of a urinary control intra-vaginal device

Energy Technology Data Exchange (ETDEWEB)

Maubon, A.J. [Department of Medical Imaging, C. M. C. Beausoleil, Montpellier (France); Department of Radiology, CHU Dupuytren, Limoges (France); Boncoeur-Martel, M.P. [Department of Radiology, CHU Dupuytren, Limoges (France); Juhan, V.; Rouanet, J.P. [Department of Medical Imaging, C. M. C. Beausoleil, Montpellier (France); Courtieu, C.R. [Department of Gynecology, C. M. C. Beausoleil, Montpellier (France); Department of Obstetrics and Gynecology, C. H. U., F-30029 Nimes (France); Thurmond, A.S. [Women' s Imaging, Meridian Park Hospital, Portland, OR (United States); Aubas, P. [Department of Medical Information, Hopital Arnaud de Villeneuve, F-34295 Montpellier (France); Mares, P. [Department of Obstetrics and Gynecology, C. H. U., F-30029 Nimes (France)

2000-06-01

The aim of this study was to describe by MRI, in dynamic conditions at rest and straining, the anatomical modifications induced by a commercially available intravaginal device (IVD) aimed at relieving female stress urinary incontinence. Ten female patients complaining of stress urinary incontinence (SUI) had pelvic MRI with static and dynamic sequences, without and with a self-inserted IVD. We studied positions and angulations of the IVD in the pelvis. Paired t-test allowed comparisons of: position of the bladder neck; urethral angulation with the pubis axis; position of the urethra; and posterior urethro-vesical angle (PUVA) without and with IVD. At rest, in ten of ten cases IVD laid cranial to the pubo-rectal muscle; with an average angulation of 95 {+-} 10 with the pubis axis, laterally tilted in three of ten cases. In maximum straining with IVD bladder neck descent was lower by an average of 5.2 {+-} 3.1 mm (p = 0.001), pubo-urethral angle opening was smaller by an average of 22 {+-} 20 (p = 0.015), and bladder neck to pubis distance was shorter by an average of 5.7 {+-} 4 mm. Posterior urethro-vesical angle was not significantly modified. Dynamic MRI allowed a non-invasive assessment of the mode of action of an IVD. The main modifications were a support of the bladder base and bladder neck, with a superior displacement of the urethra toward the pubis. (orig.)

Endoscopic Rectus Abdominis and Prepubic Aponeurosis Repairs for Treatment of Athletic Pubalgia.

Science.gov (United States)

Matsuda, Dean K; Matsuda, Nicole A; Head, Rachel; Tivorsak, Tanya

2017-02-01

Review of the English orthopaedic literature reveals no prior report of endoscopic repair of rectus abdominis tears and/or prepubic aponeurosis detachment. This technical report describes endoscopic reattachment of an avulsed prepubic aponeurosis and endoscopic repair of a vertical rectus abdominis tear immediately after endoscopic pubic symphysectomy for coexistent recalcitrant osteitis pubis as a single-stage outpatient surgery. Endoscopic rectus abdominis repair and prepubic aponeurosis repair are feasible surgeries that complement endoscopic pubic symphysectomy for patients with concurrent osteitis pubis and expand the less invasive options for patients with athletic pubalgia.

White piedra and pediculosis capitis in the same patient.

Science.gov (United States)

Marques, Silvio Alencar; Richini-Pereira, Virgínia Bodelão; Camargo, Rosângela Maria Pires de

2012-01-01

White piedra is a superficial mycosis caused by the genus Trichosporon. It is characterized by nodules on the hair shaft. Pediculosis capitis is caused by Pediculus humanus var. capitis of the suborder Anoplura. Whereas pediculosis is a common infestation, clinical reports of white piedra are rare. Molecular biology procedures identified T. inkin as the agent of white piedra in this case report. The authors present associations between the two diseases in the same patient in order to highlight their clinical differences.

Kamikaze pubi = Kamikaze pub / Madis Eek

Index Scriptorium Estoniae

Eek, Madis, 1966-

2001-01-01

Tallinnas Sõstra t. 2 asuva kõrtsi projekteeris Arhitektuuribüroo Eek & Mutso. Arhitektid Madis Eek, Reio Avaste. Konstruktsioonid: Projektibüroo Talone. Projekt 2000, hoone valmis 2001. 7 ill.: I korruse plaan, lõige, välis- ja sisevaated

Tinea profunda of atypical location – case report

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Anna Tchórzewska

2016-02-01

Full Text Available Introduction . Tinea profunda typically involves the scalp and beard. Infection within the mons pubis is rare. Objective . To present a case of tinea profunda in a rare location. Case report . A 19-year-old female, the owner of a hamster, noticed a nodule on her mons pubis. She had shaved this part of the skin some days before. The skin surrounding the nodule became erythematous and slightly scaly soon. She was treated with topical corticosteroids and oral antibiotics after consultation at an outpatient clinic. Despite the treatment, exacerbation of skin lesions was observed. The patient was admitted to the Department of Gynecology and, after consultation, was referred to the Department of Dermatology with the preliminary diagnosis of bacterial skin infection of the mons pubis and vulval area. Bacteriological tests were negative twice. Fungal mycelium was demonstrated on direct mycological examination and Trichophyton mentagrophytes var. granulosum was cultured. The patient was successfully treated with terbinafine, then fluconazole. Conclusions . Atypical location of fungal infection may cause a diagnostic and therapeutic dilemma.

Red herring: Acute back pain after combined spinal epidural for labor analgesia

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Yoong Chuan Tay

2018-04-01

Full Text Available Symphysis pubis diastases complicate 1:300 to 1:30,000 pregnancies. Peripartum pain in chronological sequence with labor epidural analgesia often attracts instinctive causation and distress. Predisposing risk factors include macrosomia, short second stage of labor, forceps use, multiparity, small pelvis, intense uterine contractions, previous pelvic ring pathology and trauma. A gestational diabetic primigravid parturient presents with acute post-partum back pain after an uneventful analgesic labor epidural. Her pain distributed over the right paravertebral L5-S1 region without radiculopathy, worsened with positional change and accompanied by urinary incontinence, precluding child care. Spine imaging incidentally revealed a 38 mm symphysis pubis diastasis. A pelvic binder by orthopaedics aided physiotherapy and ambulation. Pubic diastases are usually conservatively managed, unless separation exceeds 5 cm when early surgery may improve functional outcomes. Although symptoms may recur in subsequent pregnancies, it does not preclude vaginal delivery. Early recognition and prompt management aim to reduce parturient morbidity and promote resumption of activity. Keywords: Symphysis pubis diasthesis, Pubic symphysis diasthesis, Post-epidural pain, Labor epidural pain, Post-partum pain

[Forensic Analysis of the Characteristics of Pelvic Fracture in 65 Road Traffic Accident Death Cases].

Science.gov (United States)

Zhang, W

2016-12-01

To analyze the characteristics and mechanisms of pelvic fractures in the cases of road traffic accident deaths. Total 65 cases of road traffic accident deaths with pelvic fracture were collected, and the sites, characteristics and injury mechanisms of pelvic fracture were statistically analyzed. Among the 65 cases of pelvic fracture, 38 cases of dislocation of sacroiliac joint were found, and most combined with pubis symphysis separation or fracture of pubis. In the fractures of pubis, ischium and acetabulum, linear fractures were most common, while comminuted fractures were most common in sacrum and coccyx fractures. There were 54 cases combined with pelvic soft tissue injury, and 8 cases with pelvic organ injury and 44 cases with abdominal organ injury. In the types of pelvic ring injury, 32 cases were separation, 49.32%, followed by compression, 26.15% and only one case was verticality, 1.54%. Detailed and comprehensive examination of the body and determination of the pelvic fracture type contribute to analyze the mechanisms of injury. Copyright© by the Editorial Department of Journal of Forensic Medicine

Festival "Ruhrpott" toob Viljandisse dzässi ja tantsu

Index Scriptorium Estoniae

2007-01-01

Saksamaa Nordrhein-Westfafleni liidumaa kultuurifestivali "Ruhrpott" raames Viljandis 10. aprillil pubis Liverpool toimuvast kontserdist ja 11. aprillil Viljandi kultuuriakadeemias toimuvast tantsuetendusest "Blue Elephant"

Nipple placement in simple mastectomy with free nipple grafting for severe gynecomastia.

Science.gov (United States)

Murphy, T P; Ehrlichman, R J; Seckel, B R

1994-11-01

Severe gynecomastia with excessive skin is difficult to treat by only periareolar excision or suction-assisted lipectomy or both. In these patients, total mastectomy and free nipple grafting may be the best option. Placement of the nipple, however, has been arbitrary. With use of 20 "aesthetically perfect" men as models, standard nipple distances were identified. The average sternal notch-to-nipple measurement was 21 cm. In addition, two consistent ratios were identified. The nipple plane was located 0.33 times the distance from the sternal notch to the pubis, and the internipple distance was 0.23 times the chest circumference. With use of preoperatively obtained measurements of the sternal notch to pubis and chest circumference, accurate nipple placement can be accomplished.

Radiographic signs of radiolesions of the pelvis (excluding the femur) after irradiation for epithelioma of the cervix uteri

International Nuclear Information System (INIS)

Zenny, J.C.; Bergiron, C.; Chassagne, D.; Couanet, D.; Ibrahim, E.; Masselot, J.

1980-01-01

Radiolesions of the pelvic bones (excluding the femur) were observed in 29 patients after irradiation therapy for cervix uteri cancer. Three regions can be affected corresponding to the areas irradiated: the sacrum and internal part of the iliac wings, the pubis, and the cotyles. In most cases the lesions appeared after 1 to 4 years. Their radiological appearances are characteristic, the principal sign being irregular bone condensation in a demineralized bone, without true cavitation. The only lytic lesions observed were in the pubis. Calcification of soft tissues may occur and fractures are frequent. There is a slow progression of the lesions over long periods. Clinical, radiological, and progression signs differentiate radiolesions from other affections: metastases, invasion by contiguity, infections, and radio-induced sarcoma [fr

U-2 Bono sünnipäevapidu

Index Scriptorium Estoniae

2002-01-01

10. mail toimub Guitar Safari pubis Estonian U Fan Clubi eestvedamisel ansambli U-2 laulja-kitarristi Bono sünnipäevakontert. Üritust soojendab DJ Zwillig ning peaesinejateks on ansamblid The Bluesyard ja Sequence

Hahni pubist saab kord nädalas džässiklubi / Marge Lumisalu

Index Scriptorium Estoniae

Lumisalu, Marge

2009-01-01

Eesti Draamateatri näitleja Guido Kanguri eestvõttel kõlab Pärnus C. F. Hahni pubis (Riia mnt 129a) kolmapäeviti džässmuusika. 7. oktoobril toimunud esimesel kontserdil esinenud ansamblist Ajavares

Tartusse tuleb Wilde'i ja Vilde monument

Index Scriptorium Estoniae

1998-01-01

Tartu kesklinnas Wilde Irish Pubi ees peaks 1999. a. kevadel avatama kirjanike Oscar Wilde'i ja Eduard Vilde pronkskujud. Elusuuruses kirjanikud hakkavad istuma graniitistmel. Idee autorid - pubipidaja Liam Allen, ettevõtja Marju Unt, skulptor Tiiu Kirsipuu.

Guido Kangur toob C. F. Hahni pubisse jatsu / Urmas Hännile

Index Scriptorium Estoniae

Hännile, Urmas

2009-01-01

Eesti Draamateatri näitleja ja muusikafestivali Sõru Jazz korraldaja Guido Kanguri eestvõttel hakkab Pärnus C. F. Hahni pubis (Riia mnt 129a) kolmapäeviti kõlama džässmuusika, G. Kanguri tegemistest

Eesti Jazziliit alustab kontserdihooaega

Index Scriptorium Estoniae

2007-01-01

Villu Veski kvarteti kontserdist 14. sept. Tallinnas NO-teatris, džässihooaja alustamisest Tartu ülikooli kohvikus, Viljandis Liverpooli pubis, Rakvere teatrikohvikus, Pärnus Endla teatri kohvikus ja Kuressaares Jazz Del Mari džässiklubis

The Normal Position of Umbilicus in the Newborn: An Aid to Improve Cosmetic Result in Exomphalos Major

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H Davari

2004-02-01

Full Text Available Background: Position of umbilicus is an important esthetic landmark and its absence or deformity may be associated with poor self-image. In abdominoplasty, the creation of a normal-looking, well shaped and sufficiently deep umbilicus on a normal position seems essential. The aim of this study was to determine the normal position of umbilicus and hence to improve the cosmetic result of exomphalos major repair. Methods: In a cross-sectional study the position of umbilicus was determined in a random sample of 200 healthy and normal neonates (107 boys and 93 girls who were born in Isfahan University hospitals from Oct. 2002 till Mar. 2003, with respect to the xiphisternum and pubis. Results: The normal umbilical position was 59.3 ± 5.2 percent of the way from the inferior border of xiphisternum to the superior border of the pubis in the midline and it was independent of gender and neonatal Conclusions: Recent years have witnessed major improvements in the survival of newborns with exomphalocele. The primary repair of the abdominal wall with umbilicoplasty is generally considered the treatment of choice, and the cosmetic appearance of the navel becomes increasingly important as children grow older. In repair of exomphalos major, the most esthetically pleasing result is obtained if the umbilicus is placed 59.3% of the way from the xiphisternum to the pubis. Keywords: Umbilicus, Exomphalos, Neonate, Umbilicoplasty, Isfahan

Mastering the Physical Examination of the Athlete's Hip.

Science.gov (United States)

Trofa, David P; Mayeux, Sophie E; Parisien, Robert L; Ahmad, Christopher S; Lynch, T Sean

In this review, we describe precise methods for evaluating the athlete's hip or groin with an emphasis on recognizing the most common extra-articular and intra-articular pathologies, including adductor strains, athletic pubalgia, osteitis pubis, and femoroacetabular impingement with labral tears.

Pop nädal : Pink muutis taas imagot. Billboard 200 TOP 20 / Karolina Põder

Index Scriptorium Estoniae

Põder, Karolina

2002-01-01

Ameerika popstaarist Pink (Alecia Moorist). Crazy Town'i uuest albumist "Darkhorse". Hard Rock Club' üritusest Biker's Pubis Tallinnas 5. okt.. Impaled Nazarene HR STAR üritusel Nõmme kultuurimajas 25. okt.. Saksa popkuulsuse Alphaville saabumisest Riiga Krasdtmala festivalile 4. oktoobril

Estudo comparativo por ressonância magnética de púbis entre atletas e sedentários assintomáticos Comparative study between the pubis of asymptomatic athletes and non-athletes with MRI

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Rodrigo Castelo Branco

2010-01-01

Full Text Available OBJETIVO: Comparar os achados na ressonância magnética do púbis de atletas profissionais de futebol, sem histórico ou clínica de pubalgia, com sedentários também assintomáticos, determinando a prevalência de alterações compatíveis com sobrecarga púbica. MÉTODOS: Dezenove atletas profissionais de futebol, sem queixas álgicas na região púbica, e 17 sedentários, também assintomáticos, foram submetidos à ressonância magnética do púbis. Os resultados dos exames foram analisados quanto à presença de alterações degenerativas, edema medular ósseo e tendinopatia, comparando ambos os grupos estudados. RESULTADOS: Foi encontrada alta prevalência de edema ósseo e tendinopatia, bem como alterações degenerativas da sínfise púbica no grupo de atletas, encontrando-se valores maiores de odds ratio e risco relativo, com significância estatística na população estudada. CONCLUSÃO: Atletas profissionais de futebol apresentam maior risco de desenvolver alterações na região púbica, evidenciadas na ressonância magnética, se comparados a indivíduos sedentários. Estes achados não são obrigatoriamente causa de pubalgia, estando provavelmente relacionados a esforço intenso.OBJECTIVE: To compare the magnetic resonance imaging findings of the pubis of professional soccer players, without history of or clinical groin pain, and non-athletes, also without symptoms, determining the prevalence of changes compatible with pubic overload. METHODS: Nineteen professional soccer players without complaints of groin pain and seventeen non-athletes, also asymptomatic, underwent pubic magnetic resonance images. Exam findings were analyzed for the presence of degenerative changes, medullar edema and tendinopathy, comparing both groups. RESULTS: High prevalence of bone edema, tendinopathy and degenerative findings in the pubic symphysis was seen in athletes, with statistically significant higher odds ratios and relative risk for the

Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings

International Nuclear Information System (INIS)

Robinson, P.; Barron, D.A.; Grainger, A.J.; O'Connor, P.J.; Parsons, W.; Schilders, E.M.G.

2004-01-01

To evaluate gadolinium-enhanced MR imaging in athletes with chronic groin pain and correlate with the clinical features. MR examinations performed in 52 athletes (51 male, 1 female; median age 26 years) with chronic groin pain and 6 asymptomatic control athletes (6 male; median age 29 years) were independently reviewed by two radiologists masked to the clinical details. Symptom duration (median 6 months) and clinical side of severity were recorded. Anatomical areas in the pelvis were scored for abnormality (as normal, mildly abnormal or abnormal) and an overall assessment for side distribution of abnormality was recorded, initially without post-gadolinium sequences and then, 3 weeks later (median 29 days), the post-gadolinium sequences only. Correlation between radiological and clinical abnormality was calculated by Spearman's correlation. Abnormal anterior pubis and enthesis enhancement significantly correlated with clinical side for both radiologists (both P=0.008). Abnormal anterior pubis and adductor longus enthesis oedema was significant for one radiologist (P=0.009). All other features showed no significant correlation (P>0.05). In the control cases there was no soft tissue abnormality but symphyseal irregularity was present (n=2). For both radiologists assessment of imaging side severity significantly correlated with clinical side for post-gadolinium (P=0.048 and P=0.023) but not non-gadolinium sequences (P>0.05). The extent and side of anterior pubis and adductor longus enthesis abnormality on MR imaging significantly and reproducibly correlates with the athletes' current symptoms in chronic adductor-related groin pain. (orig.)

ORIGINAL ARTICLE ORIG ORIG CT for upper abdominal pathology ...

African Journals Online (AJOL)

ORIG. 14. SA JOURNAL OF RADIOLOGY • March 2007. ORIG. Abstract. Background. Current practice at our institution for routine abdominal. CT includes coverage from the diaphragm to the symphysis pubis and therefore includes pelvic organs. Limited upper abdominal imaging exists in other modalities, and tailoring the ...

COPEPODA, THERODAMASIDAE

African Journals Online (AJOL)

COPEPODA) parasitic on New Zealand freshwater fish with a re-examination of. Paeonodes exiguus Wilson. Zool. Pubis Vict. Univ. Wellington, 50: 32-39. TRIPATHI, Y S. 1960. Parasitic copepods from Indian fishes. II: two new families. Therodamasidae and Catlaphillidae. Sobretiro del libro homenage al Doctor Eduardo.

Ultrastructure of Proechinophthirus zumpti (Anoplura, Echinophthiriidae by scanning electron microscopy

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Dolores del Carmen Castro

2002-09-01

Full Text Available The ultrastructure of Proechinophthirus zumpti Werneck, 1955, mainly the external chorionic features of the egg, is described through electronic microscopy techniques. This species was first cited in Argentina, infesting Arctocephalus australis (Zimmermann, 1873. The morphological adaptations of adults and nymphs are described in both species of Proechinophthirus parasitic on Otariidae: P. fluctus (Ferris, 1916 and P. zumpti.

Selective Nonoperative Management of Penetrating Torso Injury From Combat Fragmentation Wounds

Science.gov (United States)

2008-02-01

outlines the paradigm of care: “Penetrating inju- ries below the nipples , above the symphysis pubis, and between the posterior axillary lines must be...abdo- men and were hemodynamically stable and without abdom- inal pain or tenderness. CT scan of some of these casualties revealed fragments in the lumen

Abdominal wall closure in bladder exstrophy complex repair by ...

African Journals Online (AJOL)

Background and Objectives: The Exstrophy Complex (EC) is a serious malformation of midline abdominal wall. Wide pubis prevents approximating the lateralized rectus muscle and leads to dehiscence and fi stula formation. Our aim was to recommend an easier method for abdominal wall closure in the Bladder Exstrophy ...

Review Article

African Journals Online (AJOL)

2007-12-02

Dec 2, 2007 ... Introduction. What prompted this review article is because of the wrong notion that the only standard abdominal incision is the midline incision. Cases have been seen in which an abdominal incision extends from the xyphoid process to the symphysis pubis just to remove a perforated appendix! The reason ...

Kejadian mikropenis pada anak obes

Directory of Open Access Journals (Sweden)

Siswanto Basuki

2009-07-01

Full Text Available Background : Obese children are more likely to have less testosterone, which may lead to disorder of penile development. Objectives : To assess the association between obesity in children and the occurrence of micropenis.  Methods : TA cross sectional study was carried out in 36 obese and 28 non- obese pubertal male children (10-13 years old and 49 obese and 36 non-obese prepubertal male children (4-7 years old. Obesity was defined as body mass index (BMI equivalent to or above the 95th percentile of the CDC 2000 growth reference standard. Length of the penis was measured perpendicular to the surface of the os symphysis pubis to the tip of the glans penis. Skinfold thickness was measured on the area of mons pubis using a caliper. Volume of the testis was measured using an orchidometer.  Results : The mean (SD of penis length in 36 pubertal obese and 28 non-obese children were 5.56 (1.14 cm and 6.05 (1.37 cm, respectively; whereas the mean (SD of penis length in 49 pre-pubertal obese and 39 non-obese children were 5.09 (0.76 cm and 5.36 (0.56 cm, respectively. There was significant difference in the mean (95% CI length of penis in pubertal obese and non-obese children (p = 0.04. Fisher's exact test showed that the occurrence of micropenis was not associated with obesity, age, fat thickness on mons pubis, and volume of the testicles. Conclusion : There was no significant difference in the occurrence of micropenis, but there was significant difference in the mean length of penis in obese children and children with normal age-related body mass index.

Sports hernia or groin disruption injury? Chronic athletic groin pain: a retrospective study of 100 patients with long-term follow-up.

Science.gov (United States)

Garvey, J F W; Hazard, H

2014-01-01

Chronic groin pain (athletic pubalgia) is a common problem in sports such as football, hockey, cricket, baseball and athletics. Multiple co-existing pathologies are often present which commonly include posterior inguinal canal wall deficiency, conjoint tendinopathy, adductor tendinopathy, osteitis pubis and peripheral nerve entrapment. The mechanism of injury remains unclear but sports that involve either pivoting on a single leg (e.g. kicking) or a sudden change in direction at speed are most often associated with athletic pubalgia. These manoeuvres place large forces across the bony pelvis and its soft tissue supports, accounting for the usual clinical presentation of multiple symptomatic abnormalities forming one pattern of injury. The diagnoses encountered in this series of 100 patients included rectus abdominis muscle atrophy/asymmetry (22), conjoint tendinopathy (16), sports (occult, incipient) hernia (16), groin disruption injury (16), classical hernia (11) traumatic osteitis pubis (5), and avulsion fracture of the pubic bone (4). Surgical management was generally undertaken only after failed conservative therapy of 3-6 months, but some professionals who have physiotherapy during the football season went directly to surgery at the end of the football season. A variety of operations were performed including groin reconstruction (15), open hernia repair with or without mesh (11), sports hernia repair (Gilmore) (7) laparoscopic repair (3), conjoint tendon repair (3) and adductor tenotomy (3). Sixty-six patients were available for follow at an average of 13 years after initial consultation and the combined success rate for both conservative treatment and surgery was 94%. The authors believe that athletic pubalgia or sports hernia should be considered as a 'groin disruption injury', the result of functional instability of the pelvis. The surgical approach is aimed at strengthening the anterior pelvic soft tissues that support and stabilise the symphysis pubis.

Sõpruslinnad toovad kultuuri / Arja Korhonen

Index Scriptorium Estoniae

Korhonen, Arja

2005-01-01

Teiste Soome päevade kultuuriürituste seas soome jazzviiuldaja ja laulja Heidi Piirala ja Jukka Lumme kvarteti ning akordionist Kaisa Kujanpää kontserdist Art Cafes 19. mail ja Soome simmanil Virma pubis 20. mail, Kaisa Kujanpää ja laulja Timo Kaitalahti kontserdist Väike-Maarja rahvamajas. Lappeenranna tsirkusekooli Tuikko etendustest

US in pubalgia.

Science.gov (United States)

Balconi, Giuseppe

2011-09-01

There is considerable confusion over the word "pubalgia" with regard to the definition and the etiological causes of this condition. The term pubalgia should be used to indicate disabling pain affecting the pubic region in people who practise sports. Pubalgia affects 10% of those who practise sports and it is particularly prevalent in football players. According to the literature, about 40% of cases of pubalgia are caused by overuse of the symphysis pubis with progressive lesions affecting the rectus abdominal muscles, adductors (rectal-adductor syndrome) and the symphysis itself (osteitis pubis and joint injury). An initial study of the tendons is carried out by ultrasound (US) whereas magnetic resonance imaging (MRI) should be performed to study the bones and joints.Another 40% of cases of pubalgia are caused by "sports hernia" defined as anteroinferior abdominal wall insufficiency. These alterations can only be identified at dynamic US examination.About 20% of cases of pubalgia are caused by diseases of the neighboring structures or joints such as diseases of the hip, iliopsoas, hamstring, sacred iliac or nerves, or by urogenital diseases.

Abdominoplastia y pexia de pubis: estandarización de medidas

OpenAIRE

O. Ballestas-Campo; A. Pomerane

2014-01-01

La abdominoplastia es el procedimiento de elección para corregir la flacidez abdominal, la lipodistrofia supra e infraumbilical y la diástasis de los rectos abdominales. Los nuevos métodos añaden liposucción para definir el contorno corporal. Presentamos una estandarización de medidas para lograr una cicatriz abdominal baja y pexia pubiana en casos de lipodistrofias tipo III y IV de Matarasso. Realizamos un estudio observacional, descriptivo y retrospectivo, evaluando las historias clínicas y...

Reconteo de los huesos del esqueleto humano

Directory of Open Access Journals (Sweden)

Óscar Andrés Alzate Mejía

2016-04-01

Conclusión. Se obtiene un nuevo conteo óseo donde se desagrupan el esternón en manubrio, cuerpo y proceso xifoides; en el sacro y el cóccix se cuentan sus vértebras independientes y el coxal se desagrupa contándose independientemente el ilion, el isquion y el pubis. No se tienen en cuenta huesos sesamoideos ni intersuturales.

A new basal sauropodiform dinosaur from the Lower Jurassic of Yunnan Province, China

Science.gov (United States)

Wang, Ya-Ming; You, Hai-Lu; Wang, Tao

2017-02-01

The Lufeng Formation in Lufeng Basin of Yunnan Province, southwestern China preserves one of the richest terrestrial Lower Jurassic vertebrate faunas globally, especially for its basal sauropodomorphs, such as Lufengosaurus and Yunnanosaurus. Here we report a new taxon, Xingxiulong chengi gen. et sp. nov. represented by three partial skeletons with overlapping elements. Xingxiulong possesses a number of autapomorphies, such as transversely expanded plate-like summit on top of the neural spine of posterior dorsal vertebrae, four sacral vertebrae, robust scapula, and elongated pubic plate approximately 40% of the total length of the pubis. Phylogenetic analysis resolves Xingxiulong as a basal member of Sauropodiformes, and together with another two Lufeng basal sauropodiforms Jingshanosaurus and Yunnanosaurus, they represent the basalmost lineages of this clade, indicating its Asian origin. Although being relatively primitive, Xingxiulong displays some derived features normally occurred in advanced sauropodiforms including sauropods, such as a four sacral-sacrum, a robust scapula, and a pubis with elongated pubic plate. The discovery of Xingxiulong increases the diversity of basal sauropodomorphs from the Lufeng Formation and indicates a more complicated scenario in the early evolution of sauropodiforms.

Marta maailm / Marta Vaarik

Index Scriptorium Estoniae

Vaarik, Marta, 1987-

2007-01-01

Laulja Lenna Kuurmaa otsib kodu. ETV saatejuht Marko Reikop asutas oma firma "Darren" kontserdisarja "Armastatud superhitid läbi aegade" läbiviimiseks. Soome suusahüppaja ja meelelahutaja Matti Nykänen rokkis märtsikuus Gran Canarial pubis Playa del Inglesis Berry. Laulja Ivo Linna koos abikaasa Imbiga külastasid Prantsusmaad. Singlil "Suusapalavik" laulavad Koit Toome, Taisi Pettai ja telereporter Lembitu Kuuse

Assessing the accuracy of body mass estimation equations from pelvic and femoral variables among modern British women of known mass.

Science.gov (United States)

Young, Mariel; Johannesdottir, Fjola; Poole, Ken; Shaw, Colin; Stock, J T

2018-02-01

Femoral head diameter is commonly used to estimate body mass from the skeleton. The three most frequently employed methods, designed by Ruff, Grine, and McHenry, were developed using different populations to address different research questions. They were not specifically designed for application to female remains, and their accuracy for this purpose has rarely been assessed or compared in living populations. This study analyzes the accuracy of these methods using a sample of modern British women through the use of pelvic CT scans (n = 97) and corresponding information about the individuals' known height and weight. Results showed that all methods provided reasonably accurate body mass estimates (average percent prediction errors under 20%) for the normal weight and overweight subsamples, but were inaccurate for the obese and underweight subsamples (average percent prediction errors over 20%). When women of all body mass categories were combined, the methods provided reasonable estimates (average percent prediction errors between 16 and 18%). The results demonstrate that different methods provide more accurate results within specific body mass index (BMI) ranges. The McHenry Equation provided the most accurate estimation for women of small body size, while the original Ruff Equation is most likely to be accurate if the individual was obese or severely obese. The refined Ruff Equation was the most accurate predictor of body mass on average for the entire sample, indicating that it should be utilized when there is no knowledge of the individual's body size or if the individual is assumed to be of a normal body size. The study also revealed a correlation between pubis length and body mass, and an equation for body mass estimation using pubis length was accurate in a dummy sample, suggesting that pubis length can also be used to acquire reliable body mass estimates. This has implications for how we interpret body mass in fossil hominins and has particular relevance

The role of allofibroblasts transplantation in cartilaginous tissue regeneration process

OpenAIRE

Khadjibaev Аbdukhakim Muminovich; Tilyakov Akbar Buriyevich; Magrupov Bokhodir Asadullaevich; Urazmetova Maisa Dmitriyevna; Ubaydullaev Bobur Sabirovich

2017-01-01

Aim of investigation. Ground of embryonal allofibroblasts in the process of cartilaginous tissue regeneration. Material and methods. Investigation is based on the study the results of stimulation cartilaginous tissue regeneration process in the conditions of embryonal allofibroblasts application in 24 experimental sexually mature rabbits in which the model of symphysis pubis rupture with its following recovery have been used. Pieces of cartilaginous tissue have been fixed in 10% neutral forma...

Survey on Aesthetic Vulvovaginal Procedures: What do PortugueseDoctors andMedical Students Think?

OpenAIRE

Vieira-Baptista, Pedro; Lima-Silva, Joana; Fonseca-Moutinho, José; Monteiro, Virgínia; Águas, Fernanda

2017-01-01

Abstract Objective To assess themedical doctors andmedical students’ opinion regarding the evidence and ethical background of the performance of vulvovaginal aesthetic procedures (VVAPs). Methods Cross-sectional online survey among 664 Portuguese medical doctors and students. Results Most participants considered that there is never or there rarely is amedical reason to perform: vulvar whitening (85.9% [502/584]); hymenoplasty (72.0% [437/607]); mons pubis liposuction (71.6% [426/595]); ...

Traumatic hemipelvectomy (amputae: Report of one case

Directory of Open Access Journals (Sweden)

Errol U. Hutagalung

2001-09-01

Full Text Available Traumatic hemipelvectomy (amputae is a catastrophic injury resulting front violent shearing forces which avulsed the lower limb at the level sacroiliac joint and symphisis pubis. Patients surviving traumatic hemipelvectomy are rare. One case of a 25 months old girl surviving traumatic hemipelvectomy, is presented. This is the first case reported from Indonesia. (Med J Indones 2001; 10: 169-73Keywords: Colostomy, skin graft, traffic accident

Cutaneous metastasis in anorectal adenocarcinoma

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Krishnendra Varma

2015-01-01

Full Text Available Cutaneous metastasis in anorectal adenocarcinoma is a rare entity. Here, we report the case of a 40-year-old female who presented with yellowish-brown, irregular, solid, elevated rashes over the pubis with a recent history off palliative colostomy for anorectal adenocarcinoma. Clinically, we suspected metastasis that was proved on biopsy. We report this case due to the rare presenting site (i.e., perineum of a metastatic adenocarcinoma.

Analysis of ureteral length in adult cadavers

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Hugo F. F. Novaes

2013-04-01

Full Text Available Introduction In some occasions, correlations between human structures can help planning surgical intra-abdominal interventions. The previous determination of ureteral length helps pre-operatory planning of surgeries, reduces costs of auxiliary exams, the correct choice of double-J catheter with low morbidity and fewer symptoms, and an adequate adhesion to treatment. Objective To evaluate ureteral length in adult cadavers and to analyze its correlation with anthropometric measures. Materials and Methods: From April 2009 to January 2012 we determined ureteral length of adult cadavers submitted to necropsy and obtained the following measures: height, distance from shoulder to wrist, elbow-wrist, xiphoid appendix-umbilicus, umbilicus-pubis, xiphoid appendix-pubis and between iliac spines. We analyzed the correlations between ureteral length and those anthropometric measures. Results We dissected 115 ureters from 115 adult corpses from April 2009 to January 2012. Median ureteral length didn't vary between sexes or according to height. It was observed no correlation among ureteral length and all considered anthropometric measures in all analyzed subgroups and in general population. There were no significant differences between right and left ureteral measures. Conclusions There is no difference of ureteral length in relation to height or gender (male or female. There is no significant correlation among ureteral length and the considered anthropometric measures.

Groin Injuries (Athletic Pubalgia) and Return to Play.

Science.gov (United States)

Elattar, Osama; Choi, Ho-Rim; Dills, Vickie D; Busconi, Brian

2016-07-01

Groin pain is a common entity in athletes involved in sports that require acute cutting, pivoting, or kicking such as soccer and ice hockey. Athletic pubalgia is increasingly recognized as a common cause of chronic groin and adductor pain in athletes. It is considered an overuse injury predisposing to disruption of the rectus tendon insertion to the pubis and weakness of the posterior inguinal wall without a clinically detectable hernia. These patients often require surgical therapy after failure of nonoperative measures. A variety of surgical options have been used, and most patients improve and return to high-level competition. PubMed databases were searched to identify relevant scientific and review articles from January 1920 to January 2015 using the search terms groin pain, sports hernia, athletic pubalgia, adductor strain, osteitis pubis, stress fractures, femoroacetabular impingement, and labral tears. Clinical review. Level 4. Athletic pubalgia is an overuse injury involving a weakness in the rectus abdominis insertion or posterior inguinal wall of the lower abdomen caused by acute or repetitive injury of the structure. A variety of surgical options have been reported with successful outcomes, with high rates of return to the sport in the majority of cases. © 2016 The Author(s).

Nonlocal Effects of Crack Curving.

Science.gov (United States)

1982-07-01

close vTcinity of the crack tip. Supported by the Office of Naval Research. 2 For brittle solids, a fracture criterion based on the maximum tensile...Reidel Pubi. Co. Dordrecht. Holland. pp. 271-318, 1978. [13] A.S. Jayatilaka, Fracture of Engineering Brittle Materials, Appl. Sci. Publishers, London...Crescent leach Road, Glen Cove * Long Island, New Tork 11542 Commanding Officer (2) U.s Amy Research Office PO, Sax 12211 Research Triangle Park. C 27709 8

Case report

African Journals Online (AJOL)

ebutamanya

13 oct. 2015 ... la grande lèvre gauche du bord inférieur de la vulve jusqu'au pubis emportant la masse. La dissection du plan était progressive avec une hémostase progressive aux fils Vicryl 2/0 parfois au bistouri électrique. Un rapprochement sous cutané a été fait en deux plans par des points en « U » au Vicryl 3/0 puis ...

CLINICAL TESTS FOR THE ASSESSMENT OF THE PELVIC GIRDLE PAIN IN PREGNANCY AND POSTPARTUM

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Darija Šćepanović

2018-02-01

Full Text Available Background: Pregnancy-related pelvic girdle pain (PGP refers to the pain in the lumbosacral region, the sacroiliac joints and the symphysis pubis joint. The results of the high methodological quality studies indicate that the point prevalence of pregnant women suffering from PGP is about 20 %. Pregnancy-related PGP requires a comprehensive physiotherapy assessment in order to make or confirm a diagnosis, plan the treatment and evaluate the patient’s condi- tion. Physiotherapy assessment includes clinical diagnostic tests which should satisfy the criteria of safety, feasibility, reliability, sensitivity, specificity and validity. The aim of the present paper was to systematically review the literature on clinical diagnostic tests of PGP in order to determine which clinical tests meet the necessary criteria and are appropriate for clinical examination of PGP in pregnancy and postpartum. Methods: PubMed, Cinahl, Embase, Index Medicus databases and the Cochrane controlled trials reg- ister from 1980 to 2008 were searched using the key words, pregnancy/pelvic girdle pain, pregnancy/clinical tests/sacroiliac joint/symphysis pubis. Only the articles/texts in English and Slovene were reviewed unless translated abstract was available. Additional manual searches of the reference lists in books and review articles were undertaken. Along with the randomized clinical studies the literature search encompassed also the basic studies. Results: Nine studies evaluating the tests for clinical examination of the pregnancy-related PGP met the criteria for inclusion in this review. The studies evaluated and analysed six provocation tests for the sacroiliac joint, namely, the Posterior pelvic pain provocation test (P4, Patrick’s Faber test, palpation of the long dorsal ligament, compression test, separation test, Menell’s test as well as two provocation tests for the symphysis pubis joint (pain palpation and a modified Trendelenburg test and one functional

La pubalgia como patología multifactorial y el tratamiento conservador y preventivo en futbolistas y atletas: revisión sistemática

OpenAIRE

Salazar Cantabrana, Daniel

2014-01-01

Antecedentes: la pubalgia o dolor púbico (inguinal) ocurre principalmente en futbolistas y atletas corredores. Los mecanismos responsables son gestos repetitivos, cambios repentinos de ritmo, velocidad y dirección, giros bruscos. Las estructuras involucradas son el aductor largo, recto del abdomen, iliopsoas y sínfisis del pubis. Objetivos: Revisar la evidencia científica en relación a las pruebas clínicas exploratorias y programas de tratamiento conservador y preventivo más adecuados para...

Influencia del deporte de impacto en la disfunción del suelo pélvico en la mujer activa

OpenAIRE

Santesteban López, Leyre

2014-01-01

Antecedentes: la pubalgia o dolor púbico (inguinal) ocurre principalmente en futbolistas y atletas corredores. Los mecanismos responsables son gestos repetitivos, cambios repentinos de ritmo, velocidad y dirección, giros bruscos. Las estructuras involucradas son el aductor largo, recto del abdomen, iliopsoas y sínfisis del pubis. Objetivos: Revisar la evidencia científica en relación a las pruebas clínicas exploratorias y programas de tratamiento conservador y preventivo más adecuados para...

US in pubalgia

OpenAIRE

Balconi, Giuseppe

2011-01-01

There is considerable confusion over the word “pubalgia” with regard to the definition and the etiological causes of this condition. The term pubalgia should be used to indicate disabling pain affecting the pubic region in people who practise sports. Pubalgia affects 10% of those who practise sports and it is particularly prevalent in football players. According to the literature, about 40% of cases of pubalgia are caused by overuse of the symphysis pubis with progressive lesions affecting th...

Virtual reconstruction of the Australopithecus africanus pelvis Sts 65 with implications for obstetrics and locomotion.

Science.gov (United States)

Claxton, Alexander G; Hammond, Ashley S; Romano, Julia; Oleinik, Ekaterina; DeSilva, Jeremy M

2016-10-01

Characterizing australopith pelvic morphology has been difficult in part because of limited fossilized pelvic material. Here, we reassess the morphology of an under-studied adult right ilium and pubis (Sts 65) from Member 4 of Sterkfontein, South Africa, and provide a hypothetical digital reconstruction of its overall pelvic morphology. The small size of the pelvis, presence of a preauricular sulcus, and shape of the sciatic notch allow us to agree with past interpretations that Sts 65 likely belonged to a female. The morphology of the iliac pillar, while not as substantial as in Homo, is more robust than in A.L. 288-1 and Sts 14. We created a reconstruction of the pelvis by digitally articulating the Sts 65 right ilium and a mirrored copy of the left ilium with the Sts 14 sacrum in Autodesk Maya. Points along the arcuate line were used to orient the ilia to the sacrum. This reconstruction of the Sts 65 pelvis looks much like a "classic" australopith pelvis, with laterally flared ilia and an inferiorly deflected pubis. An analysis of the obstetric dimensions from our reconstruction shows similarity to other australopiths, a likely transverse or oblique entrance of the neonatal cranium into the pelvic inlet, and a cephalopelvic ratio similar to that found in humans today. Copyright © 2016 Elsevier Ltd. All rights reserved.

Checklist and Bibliography of Benthic Marine Macroalgae Recorded from Northern Australia. I. Rhodophyta,

Science.gov (United States)

1984-01-01

Basson, P.W. (1979). "Marine algae of the Arabian Qilf coast of Saudi Arabia. II." Botanica mar., 22, 65-82. Belanger, C., Dory de Saint Vincent, J.B. and...Cook Island". Botanica mr., 20, 161-166. Chiang, Y.M. (1970). "Morphological studies of red algae of the family Cryptonemiaceas." Univ. Calif. Pubis Bot...western Indian Ocean." Botanica mar., 25, 401-444. 83 Parke, M. and Dixon, P.S. (1976). "Check-list of British marine algae - third revision." J. mar

Surgical management of complete penile duplication accompanied by multiple anomalies.

Science.gov (United States)

Karaca, Irfan; Turk, Erdal; Ucan, A Basak; Yayla, Derya; Itirli, Gulcin; Ercal, Derya

2014-09-01

Diphallus (penile duplication) is very rare and seen once every 5.5 million births. It can be isolated, but is usually accompanied by other congenital anomalies. Previous studies have reported many concurrent anomalies, such as bladder extrophy, cloacal extrophy, duplicated bladder, scrotal abnormalities, hypospadias, separated symphysis pubis, intestinal anomalies and imperforate anus; no penile duplication case accompanied by omphalocele has been reported. We present the surgical management of a patient with multiple anomalies, including complete penile duplication, hypo-gastric omphalocele and extrophic rectal duplication.

Parasitic infections of the external eye.

Science.gov (United States)

Pahuja, Shivani; Puranik, Charuta; Jelliti, Bechir; Khairallah, Moncef; Sangwan, Virender S

2013-08-01

To review the published literature on parasitic infections of external eye. Published articles and case reports on parasitic infections of external eye were reviewed and relevant information was collected. Parasitic infections of the eye are rare. However, being more commonly seen in developing nations, they require active measures for screening, diagnosis, and therapy. Parasites of importance causing external ocular disease are protozoan parasites, such as Leishmania; metazoans, such as nematodes (roundworms), cestodes (tapeworms), and trematodes (flatworms); or ectoparasites, such as Phthirus pubis and Demodex.

Insufficiency fractures following radiation therapy for gynecologic malignancies

Energy Technology Data Exchange (ETDEWEB)

Ikushima, Hitoshi; Takegawa, Yoshihiro; Matsuki, Hirokazu; Yasuda, Hiroaki; Kawanaka, Takashi; Shiba, Atsushi; Kishida, Yoshiomi; Iwamoto, Seiji; Nishitani, Hiromu [Tokushima Univ. (Japan). School of Medicine

2002-12-01

The purpose of this study was to investigate the incidence, clinical and radiological findings of insufficiency fractures (IF) of the female pelvis following radiation therapy. We retrospectively reviewed the radiation oncology records of 108 patients with gynecologic malignancies who underwent external beam radiation therapy of the whole pelvis. All patients underwent conventional radiography and computed tomography (CT) scan every 6 months in follow-up after radiation therapy and magnetic resonance imaging (MRI) and radionuclide bone scan were added when the patients complained of pelvic pain. Thirteen of 108 patients (12%) developed IF in the irradiated field with a median interval of 6 months (range 3-51) from the completion of external beam radiation therapy. All patients who developed IF were postmenopausal women. Age of the patients who developed IF was significantly higher than that of the other patients. The parts of IF were sacroiliac joints, pubis, sacral body and 5th lumbar vertebra and six of 14 patients had multiple lesions. Treatment with rest and nonsteroidal anti-inflammatory drugs lead to symptomatic relief in all patients, although symptoms lasted from 3 to 20 months. Radiation-induced pelvic IF following radiation therapy for gynecologic malignancies were frequently observed in the post-menopausal patients within 1 year after external beam radiation therapy. Symmetrical fractures of the bilateral sacroiliac joint and pubis were the characteristic pattern of pelvic IF. All patients healed with conservative treatment, and nobody became non-ambulant. (author)

Preventable long-term complications of suprapubic cystostomy after spinal cord injury: Root cause analysis in a representative case report

Directory of Open Access Journals (Sweden)

Singh Gurpreet

2011-10-01

Full Text Available Abstract Background Although complications related to suprapubic cystostomies are well documented, there is scarcity of literature on safety issues involved in long-term care of suprapubic cystostomy in spinal cord injury patients. Case Presentation A 23-year-old female patient with tetraplegia underwent suprapubic cystostomy. During the next decade, this patient developed several catheter-related complications, as listed below: (1 Suprapubic catheter came out requiring reoperation. (2 The suprapubic catheter migrated to urethra through a patulous bladder neck, which led to leakage of urine per urethra. (3 Following change of catheter, the balloon of suprapubic catheter was found to be lying under the skin on two separate occasions. (4 Subsequently, this patient developed persistent, seropurulent discharge from suprapubic cystostomy site as well as from under-surface of pubis. (5 Repeated misplacement of catheter outside the bladder led to chronic leakage of urine along suprapubic tract, which in turn predisposed to inflammation and infection of suprapubic tract, abdominal wall fat, osteomyelitis of pubis, and abscess at the insertion of adductor longus muscle Conclusion Suprapubic catheter should be anchored securely to prevent migration of the tip of catheter into urethra and accidental dislodgment of catheter. While changing the suprapubic catheter, correct placement of Foley catheter inside the urinary bladder must be ensured. In case of difficulty, it is advisable to perform exchange of catheter over a guide wire. Ultrasound examination of urinary bladder is useful to check the position of the balloon of Foley catheter.

Anatomic landmarks of fluoroscopy guided puncture of the pulseless femoral artery

International Nuclear Information System (INIS)

Jeon, Min Hee; Han, Gi Seok; Kim, Sung Jin; Park, Kil Sun; Cha, Sang Hoon; Bae, Il Hun; Lee, Seung Young

2006-01-01

We wanted to improve puncturing the pulseless femoral artery by evaluating the anatomic landmarks that suggest the course of the femoral artery on fluoroscopy. We analyzed 37 hemipelvis spot images that were centered on the arterial sheath after puncture of the femoral artery. The inguinal angles were measured between the inguinal line connecting the anterior superior iliac spine and the symphysis pubis, and the line of the arterial sheath. Inguinal ligament ratios were measured as the distance from the symphysis pubis to the arterial sheath to the length of the inguinal ligament on the inguinal line. The femoral head ratios were measured as the distance from the medial margin of the femur head to the arterial sheath to the transverse length of the femur head. The mean inguinal angle was 66.5 and the mean inguinal ligament ratio was 0.42 (± 0.03). The mean femoral head ratio was 0.08 (± 0.18). In comparing the men and women, there was no significant difference in the inguinal angle and the femoral head ratio, but the inguinal distance ratio was larger in women (men: 0.41 ± 0.033, women: 0.44 ± 0.031, ρ < 0.05). The femoral artery generally courses just lateral to the medial margin of the femur head (femoral head ratio: 0.08) and the medial 40% of the inguinal ligament (inguinal ligament ratio: 0.42). So, consideration of these relations may be helpful for puncturing the pulseless femoral artery

Tipos de pubalgia en futbolistas y atletas: entidades clínicas involucradas y abordaje fisioterápico

OpenAIRE

Bikandi Latxaga, Eder

2013-01-01

La pubalgia o el dolor inguinal en futbolistas es un campo a descubrir y un auténtico reto para los médicos. Se da mayoritariamente en deportistas, sobre todo futbolistas y atletas corredores. Los gestos repetitivos de cadera en flexión y aducción (chut y correr) son los mecanismos lesionales más comunes. El aductor largo, el recto del abdomen, el psoas y la sínfisis del pubis son las estructuras envueltas en la mayoría de las pubalgias. Las propuestas a tratamiento y rehabilit...

Magnetic resonance imaging of athletic pubalgia and the sports hernia: current understanding and practice.

Science.gov (United States)

Khan, Waseem; Zoga, Adam C; Meyers, William C

2013-02-01

Magnetic resonance imaging (MRI) has become the standard imaging modality for activity-related groin pain. Lesions, including rectus abdominis/adductor aponeurosis injury and osteitis pubis, can be accurately identified and delineated in patients with clinical conditions termed athletic pubalgia, core injury, and sports hernia. A dedicated noncontrast athletic pubalgia MRI protocol is easy to implement and should be available at musculoskeletal MR imaging centers. This article will review pubic anatomy, imaging considerations, specific lesions, and common MRI findings encountered in the setting of musculoskeletal groin pain. Copyright © 2013 Elsevier Inc. All rights reserved.

Pelvic radiograph in skeletal dysplasias: An approach

Directory of Open Access Journals (Sweden)

Manisha Jana

2017-01-01

Full Text Available The bony pelvis is constituted by the ilium, ischium, pubis, and sacrum. The pelvic radiograph is an important component of the skeletal survey performed in suspected skeletal dysplasia. Most of the common skeletal dysplasias have either minor or major radiological abnormalities; hence, knowledge of the normal radiological appearance of bony pelvis is vital for recognizing the early signs of various skeletal dysplasias. This article discusses many common and some uncommon radiological findings on pelvic radiographs along with the specific dysplasia in which they are seen; common differential diagnostic considerations are also discussed.

Comments to the paper "do we really need new medical information about the Turin Shroud?".

Science.gov (United States)

Bevilacqua, M; Fanti, G; D'Arienzo, M; De Caro, R

2015-10-01

Following the interesting arguments raised in a recent letter to the editor, about a paper recently published in this journal, the authors are happy to take a cue from them to clarify some facts that have not been sufficiently treated for space. After a description of the methods used, arguments regarding a blunt trauma on the right shoulder with consequent dislocation, the position of the hands on the pubis with brachial plexus injury, and the wrist nailing that caused retracted thumbs are discussed in detail. Copyright © 2015 Elsevier Ltd. All rights reserved.

Retropubic cartilaginous cyst presenting as stress urinary incontinence

DEFF Research Database (Denmark)

Elmelund, Marlene; Thind, Peter; Klarskov, Niels

2015-01-01

A pubic cartilaginous cyst is a rare condition and is considered a result of degenerative changes in the symphysis pubis, mainly described in elderly multiparous women. There are only a few reported cases in the literature, and patients presented most frequently with a painful vaginal/vulvar mass....... This case report is the first to describe a patient with rapidly progressing stress urinary incontinence (SUI) due to a retropubic cartilaginous cyst. The patient in this case underwent surgical intervention; symptoms improved postoperatively, suggesting that surgical intervention in symptomatic patients...

Management of chronic symphysis pubis pain following child birth with spinal cord stimulator.

LENUS (Irish Health Repository)

Idrees, Ahsan

2012-01-01

The case of a 39 year old woman who had diastasis of pubic symphysis following childbirth and later developed severe chronic neuropathic pain and disability is presented. She received extensive surgical and medical treatment for 6 years with no improvement of symptoms. The VNRS (Visual Numerical Rating Scale) pain score was 7\\/10 or more most of the time. This was quite disabling in terms of her quality of life. A spinal cord stimulator was inserted after failure of other modalities of pain management which resulted in dramatic improvement in the quality of life measured with SF-36 questionnaire. Her pain score became 0\\/10 VNRS and she was free from opioids and psychotropic medications within 3 months post insertion. Spinal cord stimulator can be considered for the management of pain due to diastasis of pubic symphysis, not amenable to other therapies.

Sequencing of a new target genome: the Pediculus humanus humanus (Phthiraptera: Pediculidae) genome project.

Science.gov (United States)

Pittendrigh, B R; Clark, J M; Johnston, J S; Lee, S H; Romero-Severson, J; Dasch, G A

2006-11-01

The human body louse, Pediculus humanus humanus (L.), and the human head louse, Pediculus humanus capitis, belong to the hemimetabolous order Phthiraptera. The body louse is the primary vector that transmits the bacterial agents of louse-borne relapsing fever, trench fever, and epidemic typhus. The genomes of the bacterial causative agents of several of these aforementioned diseases have been sequenced. Thus, determining the body louse genome will enhance studies of host-vector-pathogen interactions. Although not important as a major disease vector, head lice are of major social concern. Resistance to traditional pesticides used to control head and body lice have developed. It is imperative that new molecular targets be discovered for the development of novel compounds to control these insects. No complete genome sequence exists for a hemimetabolous insect species primarily because hemimetabolous insects often have large (2000 Mb) to very large (up to 16,300 Mb) genomes. Fortuitously, we determined that the human body louse has one of the smallest genome sizes known in insects, suggesting it may be a suitable choice as a minimal hemimetabolous genome in which many genes have been eliminated during its adaptation to human parasitism. Because many louse species infest birds and mammals, the body louse genome-sequencing project will facilitate studies of their comparative genomics. A 6-8X coverage of the body louse genome, plus sequenced expressed sequence tags, should provide the entomological, evolutionary biology, medical, and public health communities with useful genetic information.

Chondrosarcoma secondary to hereditary multiple exostosis treated by extended internal hemiplevectomy

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Ademar Lopes

Full Text Available The authors report on the case of a 28-year-old patient with extensive chondrosarcoma of the left ischium and pubis involving hip joint, skin, and soft tissue of the gluteal region, secondary to hereditary multiple exostosis submitted to an extended internal Enneking type II and Ill hemipelvectomy. No prosthesis or arthrodesis was used. A few years ago, patients with extensive tumors like this one were treated with interilioabdominal amputation, resulting in a loss of quality of Iife.Two years after the limb-preserving surgery, this patient was disease free, with good functional results, including bipedal ambulation with support.

Two Bacterial Genera, Sodalis and Rickettsia, Associated with the Seal Louse Proechinophthirus fluctus (Phthiraptera: Anoplura)

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Allen, Julie M.; Koga, Ryuichi; Fukatsu, Takema; Sweet, Andrew D.; Johnson, Kevin P.; Reed, David L.

2016-01-01

ABSTRACT Roughly 10% to 15% of insect species host heritable symbiotic bacteria known as endosymbionts. The lice parasitizing mammals rely on endosymbionts to provide essential vitamins absent in their blood meals. Here, we describe two bacterial associates from a louse, Proechinophthirus fluctus, which is an obligate ectoparasite of a marine mammal. One of these is a heritable endosymbiont that is not closely related to endosymbionts of other mammalian lice. Rather, it is more closely related to endosymbionts of the genus Sodalis associated with spittlebugs and feather-chewing bird lice. Localization and vertical transmission of this endosymbiont are also more similar to those of bird lice than to those of other mammalian lice. The endosymbiont genome appears to be degrading in symbiosis; however, it is considerably larger than the genomes of other mammalian louse endosymbionts. These patterns suggest the possibility that this Sodalis endosymbiont might be recently acquired, replacing a now-extinct, ancient endosymbiont. From the same lice, we also identified an abundant bacterium belonging to the genus Rickettsia that is closely related to Rickettsia ricketsii, a human pathogen vectored by ticks. No obvious masses of the Rickettsia bacterium were observed in louse tissues, nor did we find any evidence of vertical transmission, so the nature of its association remains unclear. IMPORTANCE Many insects are host to heritable symbiotic bacteria. These heritable bacteria have been identified from numerous species of parasitic lice. It appears that novel symbioses have formed between lice and bacteria many times, with new bacterial symbionts potentially replacing existing ones. However, little was known about the symbionts of lice parasitizing marine mammals. Here, we identified a heritable bacterial symbiont in lice parasitizing northern fur seals. This bacterial symbiont appears to have been recently acquired by the lice. The findings reported here provide insights into how new symbioses form and how this lifestyle is shaping the symbiont genome. PMID:26994086

Ectoparasites of Rodents Captured in Hamedan, Western Iran

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Hamid Zendehfili

2015-10-01

Full Text Available Background: Rodents with a population greater than the entire population of other mammals on earth are the source of economic losses and health conflicts. One of the major health problems with the rodents is their role as reservoir hosts of zoonotic diseases. The aim of this study was to assess the infestation of commensal rodents with ectoparasites in Hamedan City, Western Iran.Methods: The samples were collected by live traps during years 2012–2013. After transferring the samples to the Entomological Laboratory of Hamedan University of Medical Sciences, their ectoparasites were collected andidentified.Results: A total of 171 slides were prepared from 105 captured commensal rodents: Mus musculus, Rattus rattus and R. norvegicus comprising three orders namely Mesostigmata: Hypoaspis (Laelaspis astronomica, Dermanyssius sp, Pachylaelapidae (male. Metastigmata: Rhipicephalus sp and Anoplura: Polyplax spinulosa were recovered in Hamedan City. Seventy (66.6% rodents were found infested with at least one species of ectoparasites.Conclusion: The results of our study indicate that ectoparasites infestation in commensal rodents of Hamedan city is high and more attention by local health authorities is needed to prevent zoonotic diseases.

Parasites in harbour seals ( Phoca vitulina) from the German Wadden Sea between two Phocine Distemper Virus epidemics

Science.gov (United States)

Lehnert, K.; Raga, J. A.; Siebert, U.

2007-12-01

Parasites were collected from 107 harbour seals ( Phoca vitulina) found on the coasts of Schleswig-Holstein, Germany, between 1997 and 2000. The prevalence of the parasites and their associated pathology were investigated. Eight species of parasites, primarily nematodes, were identified from the examined organs: two anisakid nematodes ( Pseudoterranova decipiens (sensu lato) , Contracaecum osculatum (sensu lato)) from the stomach, Otostrongylus circumlitus (Crenosomatidae) and Parafilaroides gymnurus (Filaroididae) from the respiratory tract, one filarioid nematode ( Acanthocheilonema spirocauda) from the heart, two acanthocephalans, Corynosoma strumosum and C. semerme (Polymorphidae), from the intestine and an ectoparasite, Echinophthirius horridus (Anoplura, Insecta). Lungworm infection was the most prominent parasitological finding and secondary bacterial bronchopneumonia the most pathogenic lesion correlated with the parasites. Heavy nematode burdens in the respiratory tract were highly age-related and more frequent in young seals. A positive correlation was observed between high levels of pulmonary infection and severity of bronchopneumonia. The prevalence of lungworms in this study was higher than in seals that died during the 1988/1989 Phocine Distemper Virus epidemic, and the prevalence of acanthocephalans and heartworms had decreased compared to findings from the first die-off.

Biomechanical stability of a supra-acetabular pedicle screw internal fixation device (INFIX) vs external fixation and plates for vertically unstable pelvic fractures.

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Vigdorchik, Jonathan M; Esquivel, Amanda O; Jin, Xin; Yang, King H; Onwudiwe, Ndidi A; Vaidya, Rahul

2012-09-27

We have recently developed a subcutaneous anterior pelvic fixation technique (INFIX). This internal fixator permits patients to sit, roll over in bed and lie on their sides without the cumbersome external appliances or their complications. The purpose of this study was to evaluate the biomechanical stability of this novel supraacetabular pedicle screw internal fixation construct (INFIX) and compare it to standard internal fixation and external fixation techniques in a single stance pelvic fracture model. Nine synthetic pelves with a simulated anterior posterior compression type III injury were placed into three groups (External Fixator, INFIX and Internal Fixation). Displacement, total axial stiffness, and the stiffness at the pubic symphysis and SI joint were calculated. Displacement and stiffness were compared by ANOVA with a Bonferroni adjustment for multiple comparisons The mean displacement at the pubic symphysis was 20, 9 and 0.8 mm for external fixation, INFIX and internal fixation, respectively. Plate fixation was significantly stiffer than the INFIX and external Fixator (P = 0.01) at the symphysis pubis. The INFIX device was significantly stiffer than external fixation (P = 0.017) at the symphysis pubis. There was no significant difference in SI joint displacement between any of the groups. Anterior plate fixation is stiffer than both the INFIX and external fixation in single stance pelvic fracture model. The INFIX was stiffer than external fixation for both overall axial stiffness, and stiffness at the pubic symphysis. Combined with the presumed benefit of minimizing the complications associated with external fixation, the INFIX may be a more preferable option for temporary anterior pelvic fixation in situations where external fixation may have otherwise been used.

Dorsal Phalloplasty to Preserve Penis Length after Penile Prosthesis Implantation

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Osama Shaeer

2017-03-01

Full Text Available Objectives: Following penile prosthesis implantation (PPI, patients may complain of a decrease in visible penis length. A dorsal phalloplasty defines the penopubic junction by tacking pubic skin to the pubis, revealing the base of the penis. This study aimed to evaluate the efficacy of a dorsal phalloplasty in increasing the visible penis length following PPI. Methods: An inflatable penile prosthesis was implanted in 13 patients with severe erectile dysfunction (ED at the Kamal Shaeer Hospital, Cairo, Egypt, from January 2013 to May 2014. During the surgery, nonabsorbable tacking sutures were used to pin the pubic skin to the pubis through the same penoscrotal incision. Intraoperative penis length was measured before and after the dorsal phalloplasty. Overall patient satisfaction was measured on a 5-point rating scale and patients were requested to subjectively compare their postoperative penis length with memories of their penis length before the onset of ED. Results: Intraoperatively, the dorsal phalloplasty increased the visible length of the erect penis by an average of 25.6%. The average length before and after tacking was 10.2 ± 2.9 cm and 13.7 ± 2.8 cm, respectively (P <0.002. Postoperatively, seven patients (53.8% reported a longer penis, five patients (38.5% reported no change in length and one patient (7.7% reported a slightly shorter penis. The mean overall patient satisfaction score was 4.9 ± 0.3. None of the patients developed postoperative complications. Conclusion: A dorsal phalloplasty during PPI is an effective method of increasing visible penis length, therefore minimising the impression of a shorter penis after implantation.

Pelvic fractures following irradiation for endometrial carcinoma

International Nuclear Information System (INIS)

Konski, Andre; Sowers, Maryfran

1996-01-01

Purpose: To investigate the incidence and etiologic factors of pelvic fractures following radiation therapy for endometrial carcinoma. Methods and Materials: Tumor registry and radiation oncology records of patients treated for endometrial carcinoma at The Toledo Hospital between April 1989, and December 1992, were reviewed. Patients identified as having pelvic fractures without the presence of metastatic disease underwent total body mineral density measurement with dual x-ray densitometry. Results: Two of 75 patients (2.7%) were found to have pelvic fractures an average of 29 months from the completion of postoperative irradiation. One patient, who received preoperative irradiation, was also identified as having developed a fracture of the pelvis and was included in the analysis. All patients were treated prone with 10-15 MV photons in four fields daily. All three fracture patients received 45 Gy external beam radiation therapy. The two postoperative patients each received a single vaginal brachytherapy application delivering 20 Gy to 0.5 cm deep to the vaginal mucosa with a vaginal cylinder containing 30 mgRaeq 137 Cs. The preoperative patient received a single brachytherapy application with tandem and colpostats delivering 20 Gy to point A. Only one of the three fracture patients had the entire pubis included in the field of external beam treatment. One patient was taking nonsteroidal anti-inflammatory medication, one patient thyroid hormone replacement, and one patient was taking both types of medication. Conclusion: The etiology of pelvic fractures after irradiation is multifactorial. A complete medication history should be obtained, and care should be exercised in positioning the radiation fields to avoid inclusion of the entire pubis prior to the initiation of the radiation treatment

Correction of incomplete penoscrotal transposition by a modified Glenn-Anderson technique

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Saleh Amin

2010-01-01

Full Text Available Purpose: Penoscrotal transposition may be partial or complete, resulting in variable degrees of positional exchanges between the penis and the scrotum. Repairs of penoscrotal transposition rely on the creation of rotational flaps to mobilise the scrotum downwards or transpose the penis to a neo hole created in the skin of the mons-pubis. All known techniques result in complete circular incision around the root of the penis, resulting in severe and massive oedema of the penile skin, which delays correction of the associated hypospadias and increases the incidence of complications, as the skin vascularity and lymphatics are impaired by the designed incision. A new design to prevent this post-operative oedema, allowing early correction of the associated hypospadias and lowering the incidence of possible complications, had been used, whose results were compared with other methods of correction. Materials and Methods: Ten patients with incomplete penoscrotal transposition had been corrected by designing rotational flaps that push the scrotum back while the penile skin remains attached by small strip to the skin of the mons-pubis. Results : All patients showed an excellent cosmetic outcome. There was minimal post-operative oedema and no vascular compromise to the penile or scrotal skin. Correction of associated hypospadias can be performed in the same sitting or in another sitting, without or with minimal complications. Conclusion: This modification, which maintains the penile skin connected to the skin of the lower abdomen by a small strip of skin during correction of penoscrotal transposition, prevents post-operative oedema and improves healing with excellent cosmetic appearance, allows one-stage repair with minimal complications and reduce post-operative complications such as urinary fistula and flap necrosis.

Penile lengthening procedure with V-Y advancement flap and an interposing silicone sheath: A novel methodology

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B V Srinivas

2012-01-01

Full Text Available Surgery to augment penile length has become increasingly common. Lack of standardization of this controversial procedure has led to a wide variety of poorly documented surgical techniques, with unconvincing results. The most commonly used technique involves release of the suspensory ligament, with an advancement of an infrapubic skin flap onto the penis via a V-Y plasty. This technique has a major drawback of the possibility of reattachment of the penis to the pubis. We describe a new technique of interposing a silicone sheath along with V-Y advancement flap that overrides this drawback and minimizes the loss of the gained length.

Identification of Novel Voltage-Gated Sodium Channel Mutations in Human Head and Body Lice (Phthiraptera: Pediculidae).

Science.gov (United States)

Firooziyan, Samira; Sadaghianifar, Ali; Taghilou, Behrooz; Galavani, Hossein; Ghaffari, Eslam; Gholizadeh, Saber

2017-09-01

In recent years, the increase of head louse infestation in Iran (7.4%) and especially in West-Azerbaijan Province (248%) has raised the hypothesis of insecticide resistance development. There are different mechanisms of resistance to various groups of insecticides, and knockdown resistance (kdr) is a prominent mechanism of resistance to pyrethroids, an insecticide group which is used conventionally for pediculosis control. For detection of kdr-type well-known amino acid substitutions (M815I-T917I-L920F) and additional sodium channel mutations potentially associated with kdr resistance in head and body lice, louse populations were collected from West-Azerbaijan and Zanjan Provinces of Iran. Six novel mutations were found to be located in the IIS1-2 extracellular loop (H813P) and IIS5 (I927F, L928A, R929V, L930M, and L932M) of the α-subunit. Genotyping results showed that all specimens (100%) have at least one of these or the well-known mutations. Therefore, the presence of kdr-related and novel mutations in the sodium channel is likely to be the reason for the frequent use of pyrethroid insecticides due to treatment failure against lice. Further studies are now required to evaluate the prevalence of the kdr-like mutant allele for monitoring of insecticide resistance and the management of head and body lice in other provinces of the country. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sacral orientation and spondylolysis.

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Peleg, Smadar; Dar, Gali; Steinberg, Nili; Masharawi, Youssef; Been, Ella; Abbas, Janan; Hershkovitz, Israel

2009-12-01

A descriptive study (based on skeletal material) was designed to measure sacral anatomic orientation (SAO) in individuals with and without spondylolysis. To test whether a relationship between SAO and spondylolysis exists. Spondylolysis is a stress fracture in the pars interarticularis (mainly of L5). The natural history of the phenomenon has been debated for years with opinions divided, i.e., is it a developmental condition or a stress fracture phenomenon. There is some evidence to suggest that sacral orientation can be a "key player" in revealing the etiology of spondylolysis. The pelvis was anatomically reconstructed and SAO was measured as the angle created between the intersection of a line running parallel to the superior surface of the sacrum and a line running between the anterior superior iliac spine (ASIS) and the anterior-superior edge of the symphysis pubis (PUBIS).SAO was measured in 99 adult males with spondylolysis and 125 adult males without spondylolysis. The difference between the groups was tested using an unpaired t test. Spondylolysis prevalence is significantly higher in African-Americans compared to European-Americans: 5.4% versus 2.04% in males (P < 0.001) and 2.31% versus 0.4%, P < 0.001 in females. SAO was significantly lower in the spondylolytic group (44.07 degrees +/- 11.46 degrees) compared to the control group (51.07 degrees +/- 8.46 degrees, P < 0.001). A more horizontally oriented sacrum leads to direct impingement on L5 pars interarticularis by both L4 inferior articular facet superiorly and S1 superior articular facet inferiorly. Repetitive stress due to standing (daily activities) or sitting increases the "pincer effect" on this area, and eventually may lead to incomplete synostosis of the neural arch.

MRI in patients with chronic pubalgia: Is precise useful information provided to the surgeon? A case-control study.

Science.gov (United States)

Larbi, A; Pesquer, L; Reboul, G; Omoumi, P; Perozziello, A; Abadie, P; Loriaut, P; Copin, P; Ducouret, E; Dallaudière, B

2016-10-01

Recent studies described that MRI is a good examination to assess damage in chronic athletic pubalgia (AP). However, to our knowledge, no studies focus on systematic correlation of precise tendon or parietal lesion in MRI with surgery and histological assessment. Therefore, we performed a case-control study to determine if MRI can precisely assess Adductor longus (AL) tendinopathy and parietal lesion, compared with surgery and histology. MRI can determine if AP comes from pubis symphysis, musculotendinous or inguinal orifice structures. Eighteen consecutive patients were enrolled from November 2011 to April 2013 for chronic AP. To constitute a control group, we also enrolled 18 asymptomatic men. All MRI were reviewed in consensus by 2 skeletal radiologists for pubic symphysis, musculotendinous, abdominal wall assessment and compared to surgery and histology findings. Regarding pubis symphysis, we found 4 symmetric bone marrow oedema (14%), 2 secondary cleft (7%) and 2 superior ligaments lesions (7%). For AL tendon, we mainly found 13 asymmetric bone marrow oedema (46%), 15 hyperaemia (54%). Regarding abdominal wall, the deep inguinal orifice size in the group of symptomatic athletes and the control group was respectively 27.3±6.4mm and 23.8±6.3mm. The correlation between MRI and surgery/histology was low: 20% for the AL tendon and 9% for the abdominal wall. If we chose the criteria "affected versus unaffected", this correlation became higher: 100% for AL tendon and 73% for the abdominal wall. MRI chronic athletic pubalgia concerns preferentially AL tendinopathy and deep inguinal canal dehiscence with high correlation to surgery/histology when only considering the item "affected versus unaffected" despite low correlation when we try to precisely grade these lesions. III: case-control study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Traumatic Hemipelvectomy with Free Gluteus Maximus Fillet Flap Covers: A Case Report

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WI Faisham

2012-07-01

Full Text Available threatening injury. We report a case of a 16-year-old boy involved in a traffic accident who presented with an almost circumferential pelvic wound with wide diastasis of the right sacroiliac joint and symphysis pubis. The injury was associated with complete avulsion of external and internal iliac vessels as well as the femoral and sciatic nerves. He also had ipsilateral open comminuted fractures of the femur and tibia. Emergency debridement and completion of amputation with preservation of the posterior gluteal flap and primary anastomosis of the inferior gluteal vessels to the internal iliac artery stump were performed. A free fillet flap was used to close the massive exposed area.

Effect of Environmental Conditions and Toxic Compounds on the Locomotor Activity of Pediculus humanus capitis (Phthiraptera: Pediculidae).

Science.gov (United States)

Ortega-Insaurralde, I; Toloza, A C; Gonzalez-Audino, P; Mougabure-Cueto, G A; Alvarez-Costa, A; Roca-Acevedo, G; Picollo, M I

2015-09-01

In this work, we evaluated the effect of environmental variables such as temperature, humidity, and light on the locomotor activity of Pediculus humanus capitis. In addition, we used selected conditions of temperature, humidity, and light to study the effects of cypermethrin and N,N-diethyl-3-methylbenzamide (DEET) on the locomotor activity of head lice. Head lice increased their locomotor activity in an arena at 30°C compared with activity at 20°C. When we tested the influence of the humidity level, the locomotor activity of head lice showed no significant differences related to humidity level, both at 30°C and 20°C. Concerning light influence, we observed that the higher the intensity of light, the slower the movement of head lice. We also demonstrated that sublethal doses of toxics may alter locomotor activity in adults of head lice. Sublethal doses of cypermethrin induced hyperactivated responses in adult head lice. Sublethal doses of DEET evocated hypoactivated responses in head lice. The observation of stereotyped behavior in head lice elicited by toxic compounds proved that measuring locomotor activity in an experimental set-up where environmental conditions are controlled would be appropriate to evaluate compounds of biological importance, such as molecules involved in the host-parasite interaction and intraspecific relationships. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Treatment of Phthiriasis Palpebrarum and Crab Louse: Petrolatum Jelly and 1% Permethrin Shampoo.

Science.gov (United States)

Karabela, Yunus; Yardimci, Gurkan; Yildirim, Isik; Atalay, Eray; Karabela, Semsi Nur

2015-01-01

Phthiriasis palpebrarum is an uncommon cause of blepharoconjunctivitis in which Pthirus pubis infest the eyelashes. We report a case of unilateral phthiriasis palpebrarum with crab louse. A 45-year-old man presented with conjunctival hyperaemia and moderate itching associated with irritation, and crusty excretions of the eyelashes in the left eye. Careful slit-lamp examination revealed many lice and nits in left eye and mild conjunctival hyperaemia. No abnormality was found in the right eye. On dermatologic examination, only one louse was found at the pubic area. The patient was treated effectively with petrolatum jelly (Vaseline) and 1% permethrin shampoo (Kwellada 1% shampoo). At the end of the first week no louse or nit was present on eyelashes and pubic area.

Disfiguring molluscum contagiosum in a HIV-positive patient responding to antiretroviral therapy

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Sen Sumit

2009-01-01

Full Text Available Molluscum contagiosum (MC is caused by a double stranded DNA virus belonging to the pox virus family. MC lesions are usually pearly, dome shaped, small, discrete lesions with central umbilication. In HIV-positive patients atypical varieties are found. They may be large or nonumbilicated. Individual papules may join to form the agminate variety. This form is rare. Lesions of MC in healthy immunocompetent patients may occur at any part of the body including face, trunk, and limbs. Sexually active adults have lesions usually on the genitalia, pubis, and inner thigh, rarely on the face and scalp. We present a case of agminate MC occurring in a patient with acquired immunodeficiency disease responding to highly active antiretroviral therapy.

The Role of Magnetic Resonance Imaging in Athletic Pubalgia and Core Muscle Injury.

Science.gov (United States)

Coker, Dana J; Zoga, Adam C

2015-08-01

Magnetic resonance imaging (MRI) has become the standard of care imaging modality for a difficult, often misunderstood spectrum of musculoskeletal injury termed athletic pubalgia or core muscle injury. Armed with a dedicated noncontrast athletic pubalgia protocol and a late model phased array receiver coil, the musculoskeletal imager can play a great role in effective diagnosis and treatment planning for lesions, including osteitis pubis, midline pubic plate lesions, and rectus abdominis/adductor aponeurosis injury. Beyond these established patterns of MRI findings, there are many confounders and contributing pathologies about the pelvis in patients with activity related groin pain, including internal and periarticular derangements of the hip. The MRI is ideally suited to delineate the extent of expected injury and to identify the unexpected visceral and musculoskeletal lesions.

Traumatic hemipelvectomia in one year old girl. Report of case

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Fernando Medina González

2006-01-01

Full Text Available The trauma of pelvis is a complex condition that implies injuries of vital organs putting in risk the life of the patient. The traumatic hemipelvectomy is a extremely severe pelvic injury and is fatal almost always, caused generally to events of high energy. It causes traumatic dislocation of the sacroiliac joint and the symphysis pubis, and to the femoral vessels are avulsioned. Because survival rate it is so low it require prompt medical attention. In this pathology type dissabling and prostetic wear is very difficult. In the medical literature there is not report of any patient ho survived this type of lesion under three year's old. We report a case of traumatic hemipelvectomy in a girl of 21 months who survived a traffic accident.

THE DISTRIBUTION OF RICKETTSIA IN THE TISSUES OF INSECTS AND ARACHNIDS.

Science.gov (United States)

Cowdry, E V

1923-03-31

In the absence of a satisfactory definition of Rickettsia the observations herein recorded were arbitrarily limited to bacterium-like organisms which are intracellular and Gram-negative. Rickettsia of this type were found in the following species: Amblyomma americana, Amblyomma hebraeum, Boophilus decoloratus, Atomus sp., Casinaria infesta, Chrysopa oculata, Ctenocephalus canis, Dermacentor variabilis, Lepisma saccharina, Lucoppia curviseta, Margaropus annulatus, Margaropus annulatus australis, Ornithodoros turicata, Pulex irritans, Rhipicephalus sanguineus, Rhipicephalus evertsi, and Salticus scenicus. Since intracellular, Gram-negative Rickettsia have been recorded in the literature as existing in Cimex lectularius, Dermacentor venustus, Melophagus ovinus, and Pediculus humanus, the occasional occurrence of such bodies must be conceded in the following groups not closely related phylogenetically: Attidae, Trombidiidae, Argasidae, lxodidae, Cinura, Acanthiidae, Pediculidae, Hippoboscidae, Chrysopidae, Pulicidae, and Ichneumonidae. The species which harbor Rickettsia differ widely in diet and habitat. One such species is insectivorous throughout life, two are insectivorous in larval stages, becoming vegetarian in the adult condition, one is chiefly vegetarian but partakes of some animal products, and two are usually entirely vegetarian; while the remainder subsist wholly upon a diet of mammalian blood. Rickettsia are associated, in only a few cases, with diseases in mammals. The evidence at hand does not lead beyond the conclusion that the Rickettsia mentioned above are true Gram-negative microorganisms, easily distinguishable from mitochondria and all other cytoplasmic and nuclear granulations, rather completely adapted to an intracellular existence, exhibiting in some cases a remarkable degree of host specificity, and often inherited through the eggs.

Review of the systematics, biology and ecology of lice from pinnipeds and river otters (Insecta: Phthiraptera: Anoplura: Echinophthiriidae).

Science.gov (United States)

Soledad Leonardi, Maria; Palma, Ricardo Luis

2013-01-01

We present a literature review of the sucking louse family Echinophthiriidae, its five genera and twelve species parasitic on pinnipeds (fur seals, sea lions, walruses, true seals) and the North American river otter. We give detailed synonymies and published records for all taxonomic hierarchies, as well as hosts, type localities and repositories of type material; we highlight significant references and include comments on the current taxonomic status of the species. We provide a summary of present knowledge of the biology and ecology for eight species. Also, we give a host-louse list, and a bibliography to the family as complete as possible.

Synostosis Between Pubic Bones due to Neurogenic, Heterotopic Ossification

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Subramanian Vaidyanathan

2006-01-01

Full Text Available Neurogenic, heterotopic ossification is characterised by the formation of new, extraosseous (ectopic bone in soft tissue in patients with neurological disorders. A 33-year-old female, who was born with spina bifida, paraplegia, and diastasis of symphysis pubis, had indwelling urethral catheter drainage and was using oxybutynin bladder instillations. She was prescribed diuretic for swelling of feet, which aggravated bypassing of catheter. Hence, suprapubic cystostomy was performed. Despite anticholinergic therapy, there was chronic urine leak around the suprapubic catheter and per urethra. Therefore, the urethra was mobilised and closed. After closure of the urethra, there was no urine leak from the urethra, but urine leak persisted around the suprapubic catheter. Cystogram confirmed the presence of a Foley balloon inside the bladder; there was no urinary fistula. The Foley balloon ruptured frequently, leading to extrusion of the Foley catheter. X-ray of abdomen showed heterotopic bone formation bridging the gap across diastasis of symphysis pubis. CT of pelvis revealed heterotopic bone lying in close proximity to the balloon of the Foley catheter; the sharp edge of heterotopic bone probably acted like a saw and led to frequent rupture of the balloon of the Foley catheter. Unique features of this case are: (1 temporal relationship of heterotopic bone formation to suprapubic cystostomy and chronic urine leak; (2 occurrence of heterotopic ossification in pubic region; (3 complications of heterotopic bone formation viz. frequent rupture of the balloon of the Foley catheter by the irregular margin of heterotopic bone and difficulty in insertion of suprapubic catheter because the heterotopic bone encroached on the suprapubic track; (4 synostosis between pubic bones as a result of heterotopic ossification..Common aetiological factors for neurogenic, heterotopic ossification, such as forceful manipulation, trauma, or spasticity, were absent in this

Inhibition of radioemesis by disruption of catecholamines in dogs

International Nuclear Information System (INIS)

Luthra, Y.K.; Mattsson, J.L.; Yochmowitz, M.G.

1981-01-01

Dogs were treated 30 min to 1 h before x irradiation with α-methyl-p-tyrosine or 6-hydroxydopamine. A third group of dogs was given a known antiradioemetic drug, haloperidol to verify the sensitivity of the procedure. Irradiated but untreated controls were also used. Light methoxyflurane anesthesia was used for restraint during the exposure. Exposure dose was 800 rad kerma delivered at 50 rad/min to a 10 x 10-cm area covering the abdominal area from xiphoid to pubis. Haloperidol and 6-hydroxydopamine significantly reduced the number of emetic episodes and delayed the onset time to the first episode, α-Methyl-p-tyrosine caused no significant changes. The effectiveness of 6-hydroxydopamine indicates that catecholaminergic neurons are involved in radioemesis, whereas haloperidol and phenothiazine-derivative tranquilizers inhibit radiomesis by blocking catecholamine receptor neurons

A case of post-irradiation mesenchymal chondrosarcoma

Energy Technology Data Exchange (ETDEWEB)

Hayakawa, Yuji; Komori, Kazuya; Matsunaga, Tsuyoshi [Tsuchiura Kyodo General Hospital, Ibaraki (Japan); Shibata, Toshikatsu

2001-04-01

A woman was first admitted to our hospital in 1987 at the age of 56 vears because of cancer of the uterine cervix. Total hysterectomy was performed, and 50 Gy of {sup 60}CO was irradiated to the whole pelvis postoperatively. After these therapies, the patient enjoyed good health for twelve years. In 1999, she was admitted again because of a large pelvic tumor which adhered to pelvic bone. Pelvic CT showed a low density mass which invaded soft tissue and surrounded the right os pubis; however there was no obvious bone destruction. Chest CT showed multiple coin lesions in both lungs. A biopsy specimen of the lesion showed characteristic bimorphic pattern composed of highly cellular proliferation of undifferentiated small cells and zones of differentiated cartilaginous tissue. (author)

Canções, filmes e divas de Pubis Angelical na música de Charly Garcia (1972-1982

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Júlio Ogas

2011-06-01

Full Text Available In the first stage of Charly García‟s production, the cinema plays an important role. Several single songs, a thematic record and the music of two films are clear indications in this regard. The meaning space that opens from this subject allows appreciating some ideas that prevail in the author's proposal. Both the literal and the symbolic languages combine to convey a message of change to man extent but deeply involved in the social environment of his time.

The parasitic fauna of the European bison (Bison bonasus) (Linnaeus, 1758) and their impact on the conservation. Part 1. The summarising list of parasites noted.

Science.gov (United States)

Karbowiak, Grzegorz; Demiaszkiewicz, Aleksander W; Pyziel, Anna M; Wita, Irena; Moskwa, Bożena; Werszko, Joanna; Bień, Justyna; Goździk, Katarzyna; Lachowicz, Jacek; Cabaj, Władysław

2014-09-01

During the current century, 88 species of parasites have been recorded in Bison bonasus. These are 22 species of protozoa (Trypanosoma wrublewskii, T. theileri, Giardia sp., Sarcocystis cruzi, S. hirsuta, S. hominis, S. fusiformis, Neospora caninum, Toxoplasma gondii, Cryptosporidium sp., Eimeria cylindrica, E. subspherica, E. bovis, E. zuernii, E. canadensis, E. ellipsoidalis, E. alabamensis, E. bukidnonensis, E. auburnensis, E. pellita, E. brasiliensis, Babesia divergens), 4 trematodes species (Dicrocoelium dendriticum, Fasciola hepatica, Parafasciolopsis fasciolaemorpha, Paramphistomum cervi), 4 cestodes species (Taenia hydatigena larvae, Moniezia benedeni, M. expansa, Moniezia sp.), 43 nematodes species (Bunostomum trigonocephalum, B. phlebotomum, Chabertia ovina, Oesophagostomum radiatum, O. venulosum, Dictyocaulus filaria, D.viviparus, Nematodirella alcidis, Nematodirus europaeus, N. helvetianus, N. roscidus, N. filicollis, N. spathiger, Cooperia oncophora, C. pectinata, C. punctata, C. surnabada, Haemonchus contortus, Mazamastrongylus dagestanicus, Ostertagia lyrata, O. ostertagi, O. antipini, O. leptospicularis, O. kolchida, O. circumcincta, O. trifurcata, Spiculopteragia boehmi, S. mathevossiani, S. asymmetrica, Trichostrongylus axei, T. askivali, T. capricola, T. vitrinus, Ashworthius sidemi, Onchocerca lienalis, O. gutturosa, Setaria labiatopapillosa, Gongylonema pulchrum, Thelazia gulosa, T. skrjabini, T. rhodesi, Aonchotheca bilobata, Trichuris ovis), 7 mites (Demodex bisonianus, D. bovis, Demodex sp., Chorioptes bovis, Psoroptes equi, P. ovis, Sarcoptes scabiei), 4 Ixodidae ticks (Ixodes ricinus, I. persulcatus, I. hexagonus, Dermacentor reticulatus), 1 Mallophaga species (Bisonicola sedecimdecembrii), 1 Anoplura (Haematopinus eurysternus), and 2 Hippoboscidae flies (Lipoptena cervi, Melophagus ovinus). There are few monoxenous parasites, many typical for cattle and many newly acquired from Cervidae.

Las aporías de la visión en la novelística de Manuel Puig

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Geneviève Fabry

2016-03-01

Full Text Available En este artículo, se estudia la naturaleza fundamentalmente paradójica del objeto y sobre todo del acto de la visión en la obra novelística del escritor argentino Manuel Puig (1932-1990. El análisis contrastado de la representación del cuerpo en Boquitas pintadas y El beso de la mujer araña permite subrayar la existencia de una dialéctica entre no-representación y presencia del personaje. En segundo lugar, el análisis de los personajes obsesionados por el ansia de ver y saber pone de manifiesto el callejón sin salida que representa la pulsión "voyeurista" (Silvia, en Cae la noche tropical mientras que el descubrimiento de la existencia de una "verdad" arraigada en la aceptación de una no-visión (Ana en Pubis angelical abre un camino hacia el autoconocimiento y la reconciliación con uno mismo. En conclusión, la omnipresencia de la imagen y de la visión en el universo puigiano no es sino la señal paradójica de una invitacion sutil pero firme al abandono del ansia de dominio que encierra toda voluntad de ver y saber.   This article examines the fundamentally paradoxical nature of the object, and above all, the act of vision in the fiction of the Argentine Manuel Puig (1932-1990. A contrastive analysis of body representation in Boquitas Pintadas and in El Beso de la Mujer Araña, permits to underline the existence of a dialectical process between presence and non-representation of characters. Furthermore, tha analysis of characters obsessed by the crave to see y know makes manifest a blind alley suggested by the acceptance of a non-vision (Ana, in Pubis Angelical, opens the way to self-knowledge and self-acceptance. In conclusion, the omnipresence of image and vision in Puig's universe is nothing but a paradoxical beckoning to a subtle but firm invitation to give up the desire for dominance involved in the acts of the will to see and know.

WE-H-207A-04: Impact of Lesion Location On the Repeatability of 18F-NaF PET/CT

Energy Technology Data Exchange (ETDEWEB)

Lin, C; Perk, T; Harmon, S; Perlman, S; Liu, G; Jeraj, R [University of Wisconsin, Madison, WI (United States)

2016-06-15

Purpose: Quantifying the repeatability of imaging biomarkers is critical for assessing therapeutic response. While {sup 18}F-NaF PET/CT has shown to be a repeatable imaging method, research has not shown which factors may influence its repeatability. The purpose of this study was to evaluate whether the location of the lesion impacts the repeatability of quantitative {sup 18}F-NaF PET-derived SUV metrics. Methods: Metastatic castrate-resistant prostate cancer patients with multiple bone lesions received whole-body test-retest NaF PET/CT scans. Malignant bone lesions of PET-defined volume greater than 1.5 cm{sup 3} were identified by a nuclear medicine physician and automatically delineated using a SUV>15 threshold. The maximum (SUVmax), average (SUVmean), and total (SUVtotal) SUV were extracted from each lesion. Atlas-based segmentation was used to divide each patient skeleton into 25 skeletal regions. Test-retest repeatability of each SUV metric was assessed with coefficient of variation (CV). Results: A total of 265 malignant bone lesions from 18 patients were identified by nuclear medicine physician. The largest proportion of bone lesions were localized to the spine (41%), with 41% of those lesions localized to the thoracic spine. One-way ANOVA showed that measurement differences differed significantly for all three metrics across locations (p<0.01 for each metrics). Overall, CV was smallest for SUVmean at 5.3%, followed by SUVmax at 11.5% and SUVtotal at 20.4%. Lesions in the pubis were consistently the most repeatable (CV(SUVmax)= 5.6%, CV(SUVmean)= 0.6%, CV(SUVtotal)= 2.9%). According to SUVmean, repeatability was poorest in the cervical spine (CV = 6.2%), whereas according to SUVmax and SUVtotal, repeatability was poorest in the ribs (CV(SUVmax)= 15.0%, CV(SUVtotal)= 29.8%). Conclusion: Location of the lesion affects the repeatability of {sup 18}F-NaF PET/CT, with the ribs and cervical spine having the lowest repeatability and the pubis having the highest

Correlation Between Echodefecography and 3-Dimensional Vaginal Ultrasonography in the Detection of Perineal Descent in Women With Constipation Symptoms.

Science.gov (United States)

Murad-Regadas, Sthela M; Pinheiro Regadas, Francisco Sergio; Rodrigues, Lusmar V; da Silva Vilarinho, Adjra; Buchen, Guilherme; Borges, Livia Olinda; Veras, Lara B; da Cruz, Mariana Murad

2016-12-01

Defecography is an established method of evaluating dynamic anorectal dysfunction, but conventional defecography does not allow for visualization of anatomic structures. The purpose of this study was to describe the use of dynamic 3-dimensional endovaginal ultrasonography for evaluating perineal descent in comparison with echodefecography (3-dimensional anorectal ultrasonography) and to study the relationship between perineal descent and symptoms and anatomic/functional abnormalities of the pelvic floor. This was a prospective study. The study was conducted at a large university tertiary care hospital. Consecutive female patients were eligible if they had pelvic floor dysfunction, obstructed defecation symptoms, and a score >6 on the Cleveland Clinic Florida Constipation Scale. Each patient underwent both echodefecography and dynamic 3-dimensional endovaginal ultrasonography to evaluate posterior pelvic floor dysfunction. Normal perineal descent was defined on echodefecography as puborectalis muscle displacement ≤2.5 cm; excessive perineal descent was defined as displacement >2.5 cm. Of 61 women, 29 (48%) had normal perineal descent; 32 (52%) had excessive perineal descent. Endovaginal ultrasonography identified 27 of the 29 patients in the normal group as having anorectal junction displacement ≤1 cm (mean = 0.6 cm; range, 0.1-1.0 cm) and a mean anorectal junction position of 0.6 cm (range, 0-2.3 cm) above the symphysis pubis during the Valsalva maneuver and correctly identified 30 of the 32 patients in the excessive perineal descent group. The κ statistic showed almost perfect agreement (κ = 0.86) between the 2 methods for categorization into the normal and excessive perineal descent groups. Perineal descent was not related to fecal or urinary incontinence or anatomic and functional factors (sphincter defects, pubovisceral muscle defects, levator hiatus area, grade II or III rectocele, intussusception, or anismus). The study did not include a

Suprapubic micturition cystourethrography

Energy Technology Data Exchange (ETDEWEB)

Mohammed, S.H.

Suprapubic micturition cystourethrography is performed by puncturing the bladder aseptically, in the midline, 1 to 2 cm above the symphysis pubis with an 18 to 21 gauge needle. The needle is pointed 10 to 15/sup 0/ cranially to avoid puncture of the trigonum and urethra. Anaesthesia, antibiotic protection, and diuretics are not necessary. In 225 examinations performed on 200 patients, the only complications noted were transient haematuria (1.5%) and slight extravasation of contrast medium through the puncture sites (8%). None required any therapeutic measures. In 4 patients puncturing of the bladder needed ultrasound guidance. The technique is ideal for the study of vesicoureteral reflux, neurogenic bladder, urethral strictures, posterior urethral valves and other urethral pathology. It is also useful in balloon catheter dilatation of urethral strictures. Suprapubic micturition cystourethrography is safe, efficient and time-saving. It is well accepted by the patients and carries little risk of urinary infection.

Roentgenographic appearance of ossification centers in the Japanese fetus, stillborn and neonatal death infants, Hiroshima and Nagasaki

Energy Technology Data Exchange (ETDEWEB)

Kawamoto, Sadahisa

1964-01-01

A roentgenographic study of the presence of the ossification centers has been made on a total of 235 cases of miscarriage, therapeutic abortion, stillbirth and neonatal death according to criteria of sex, length of gestational age, and weight at birth. The cases were aged from 16 to 42 gestational weeks. The weight of the cases ranged from 110 g to 3780 g at birth. The order of appearance of the eight centers in fetal life was as follows: Ischium, pubis, calcaneus, talus, distal epiphysis of femur, hyoid, proximal epiphysis of tibia, and cuboid bone. Some of the eight ossification centers appeared earlier in girls than in boys of the same gestational age and birth weight. The osseous development of Japanese fetuses and infants weighing over 2000 g was judged less mature than in similar Caucasian and Negro subjects. 10 references, 1 figure, 6 tables.

Radiographic and ultrasonographic characteristics of ventral abdominal hernia in pigeons (Columba livia).

Science.gov (United States)

Amer, Mohammed S; Hassan, Elham A; Torad, Faisal A

2018-02-20

Five female egg-laying pigeons presented with painless, reducible, ventral abdominal swellings located between the keel and the pubis, or close to the cloaca. Based on clinical, radiographic, and ultrasonographic examination, these pigeons were diagnosed with ventral abdominal hernia requiring surgical interference. Reduction was successfully performed under general anesthesia. Radiographic and ultrasonographic examinations were beneficial for confirming the diagnosis and visualizing the hernial content for surgical planning. Lateral radiographs were more helpful than ventrodorsal radiographs for identification of the hernial content and its continuation with the abdominal muscles. Ultrasonographic examination offered a non-invasive diagnostic tool that allowed for the differentiation of hernia from other abdominal swellings. In addition, it played a beneficial role in identification of the hernial content and follow up after surgical interference. In conclusion, radiographic and ultrasonographic examinations were beneficial in the diagnosis, surgical planning, and follow up after surgical interference of ventral abdominal hernia in pigeons.

A case of pelvic psteosarcoma effectively treated with pamidronate

International Nuclear Information System (INIS)

Yano, M.; Mori, T.; Hoshino, Y.; Iwatani, N.; Murakami, M.; Sakai, H.; Tanigawa, T.; Maruo, K.

2010-01-01

A 7-year-old, 34 kg, castrated male Golden retriever was presented with a month history of lameness in the hind limbs, especially the left hind limb. The dog was referred to our hospital. Computed Tomography (CT) findings showed bone absorption in over 50% of the pubis and part of the ischial bone, in the left hip joint region. A CT-guided biopsy was performed. A histopathologic diagnosis of osteosarcoma was made. Treatment with the bisphosphonate drug pamidronate was performed every month. At one or two weeks after the first dose of pamidronate, the lameness disappeared. CT showed high bone remodeling of the affected region on the 146th day. Over the course of 11 administrations of pamidronate, serve side effects were not observed until the dog died on the 469th day. Therefore, pamidronate lead to an improvement in the quality of life

Cutaneous atypical mycobacteriosis in a clouded leopard (Neofelis nebulosa).

Science.gov (United States)

Cerveny, Shannon N S; Thompson, Michelle E; Corner, Sarah M; Swinford, Amy K; Coke, Rob L

2013-09-01

A 16-yr-old male clouded leopard (Neofelis nebulosa) was presented for lethargy and anorexia. A cutaneous abdominal mass extending from the pubis to just caudal to the xiphoid process was present. A biopsy revealed histologic lesions consistent with an atypical mycobacterial infection consisting of diffuse, severe, pyogranulomatous dermatitis and panniculitis, with clear vacuoles and 3-5 microm, intravacuolar, faintly eosinophilic, filamentous bacilli that stained positively with FiteFaraco modified acid-fast stain. The clouded leopard had biochemical findings suggestive of chronic renal failure and euthanasia was elected. Histological evaluation of tissues collected at postmortem examination revealed multicentric B-cell lymphoma involving the oral cavity, liver, spleen, and multiple lymph nodes, bilateral testicular seminomas, thyroid follicular cell adenoma, thyroid C cell adenoma, and biliary cystadenomas. Bacterial culture and molecular sequencing identified the causative agent of the cutaneous abdominal mass as belonging to the Mycobacterium fortuitum group.

Suprapubic micturition cystourethrography

International Nuclear Information System (INIS)

Mohammed, S.H.; Kamuzu Central Hospital, Lilongwe

1988-01-01

Suprapubic micturition cystourethrography is performed by puncturing the bladder aseptically, in the midline, 1 to 2 cm above the symphysis pubis with an 18 to 21 gauge needle. The needle is pointed 10 to 15 0 cranially to avoid puncture of the trigonum and urethra. Anaesthesia, antibiotic protection, and diuretics are not necessary. In 225 examinations performed on 200 patients, the only complications noted were transient haematuria (1.5%) and slight extravasation of contrast medium through the puncture sites (8%). None required any therapeutic measures. In 4 patients puncturing of the bladder needed ultrasound guidance. The technique is ideal for the study of vesicoureteral reflux, neurogenic bladder, urethral strictures, posterior urethral valves and other urethral pathology. It is also useful in balloon catheter dilatation of urethral strictures. Suprapubic micturition cystourethrography is safe, efficient and time-saving. It is well accepted by the patients and carries little risk of urinary infection. (orig.)

Groin Pain in Athletes: A Review of Diagnosis and Management.

Science.gov (United States)

Crockett, Matthew; Aherne, Emily; O'Reilly, Michael; Sugrue, Gavin; Cashman, James; Kavanagh, Eoin

2015-05-01

Groin pain is a common symptom in athletes, particularly in sports requiring sudden changes in speed and direction and those involving kicking. Despite a high prevalence of groin pain in this patient cohort, the diagnosis and management of the underlying pathological processes remains a challenge for surgeons and radiologists alike. The aim of this paper is to review the imaging findings and management of the common pathological processes which produce groin pain in athletes. The anatomy of the groin region will be defined as a basis for further discussion. The common pathological processes underlying groin pain such as adductor dysfunction, rectus abdominus injury, osteitis pubis, and femuro-acetabular impingement will then be reviewed and correlating radiological imaging findings presented. Current management options will also be considered. This paper will aid surgeons and radiologists in navigating the challenging diagnostic and management dilemma of groin pain in athletes.

Una nueva especie del género Hoplopleura Enderlein, 1904 (Anoplura, Hoplopleuridae parásita de Andinomys edax (Rodentia, Cricetidae

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González, A.

1996-12-01

Full Text Available The authors described a new species Hoplopleura zentaensi sp. n. based on specimens collected on Andinomys edax Thomas, l902, from Sierra de Zenta, Jujuy province, Argentina. Descriptions involve the holotype female; three nymphal instar, external architecture of eggs and sites of oviposition, providing differences with its close relative Hoplopleura hirsuta Ferris, l916 and Hoplopleura oxymycteri Ferris, l921. Comments on distribution of these species on their hosts are presented and they are included in the “erratica” group.Describimos en esta contribución a Hoplopleura zentaensi sp. n., a partir de la hembra, sus tres estadios ninfales y las características coriónicas externas del huevo de la referida especie parásita de Andinomys edax Thomas, 1902 (Rodentia, Cricetidae, capturado en Sierra de Zenta, Jujuy, Argentina. Hoplopleura zentaensi sp. n. es afín a Hoplopleura hirsuta Ferris, 1916 y de Hoplopleura oxymycteri Ferris, 1921, integrando junto a estas especies el grupo “erratica”.

Evaluation of symphysis pubis and sacroiliac joint distances in skeletally immature patients: A computerized tomography study of 1020 individuals.

Science.gov (United States)

Kalenderer, Önder; Turgut, Ali; Bacaksız, Tayfun; Bilgin, Emre; Kumbaracı, Mert; Akkan, Hasan Ali

2017-03-01

The aim of this study was to create a reference about normal pubic symphysis and sacroiliac joint widths of children and adolescents. A total of 1020 computerized tomography axial scans of patients without pelvic injury between 2 and 18 year-old were studied. The narrowest width of pubic symphysis and bilateral sacroiliac joints were measured. The average pubic symphyseal width at 2 years old boys was 6.35 ± 1.06 mm (4.88-9.13 mm). The average of right and left sacroiliac joints' widths at 2 years old boys was 4.56 ± 0.65 mm (3.59-6.07 mm) and 4.58 ± 0.66 mm (3.44-5.74 mm), respectively. The average pubic symphyseal width of 2 years old girls was 5.85 ± 1.14 mm (4.06-8.20 mm). The average of right and left sacroiliac joints' widths at 2 years old girls was found 4.36 ± 0.56 mm (3.50-5.37 mm) and 4.42 ± 0.59 mm (3.58-5.73 mm), respectively. The average pubic symphyseal width at 18 years old boys was found 3.68 ± 1.30 mm (1.90-5.79 mm). The average of right and left sacroiliac joints' widths at 18 years old boys was found 1.97 ± 0.21 mm (1.73-2.41 mm) and 2.04 ± 0.30 mm (1.70-2.65 mm), respectively. The average pubic symphyseal width at 18 years old girls was 3.92 ± 0.52 mm (2.97-4.76 mm). The average of right and left sacroiliac joints' widths at 18 years old girls was found 2.34 ± 0.40 mm (1.58-3.34 mm) and 2.33 ± 0.37 mm (1.58-3.10 mm), respectively. Our results suggest that one should be suspicious about pelvic injury if the width of pubic symphysis is over 10 mm and width of sacroiliac joint is over 8 mm especially in patients younger than 10 years-old. Level III Diagnostic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Human phthiriasis. Can dermoscopy really help dermatologists? Entodermoscopy: a new dermatological discipline on the edge of entomology.

Science.gov (United States)

Scanni, G

2012-02-01

The diagnosis of human phtiriasis (often referred to as the "crab" or the "pubic louse") can be more difficult than other types of pediculosis (Pediculus corporis and Pediculus capitis) because this insect has a smaller body of 1.2 x 0.8 mm, may be lighter in color, not as mobile and therefore harder to see to the naked eye. Can dermoscopy aid to perform a better analysis of the skin? The clinical experience developed in two patients gives an affirmative answer, moreover adding useful information of insect and its eggs already known to entomologists but never used in dermatological diagnosis. The identification in vivo can distinguish Phthirus pubis from other skin signs while the conical shape of the operculum and the wide fixing sleeve of egg to hair, tells what species of louse is infesting, even if the insect is unavailable or nits are elsewhere from the pubic area. Entodermoscopy, provided that dermatologists have some knowledge of entomology, therefore promises advantages over standard microscopic examination.

Giant iliopectineal bursitis presenting as neuropathy and severe edema of the lower limb: case illustration and review of the literature.

Science.gov (United States)

Iwata, Takahiro; Nozawa, Satoshi; Ohashi, Minoru; Sakai, Hiroshi; Shimizu, Katsuji

2013-05-01

We report a 61-year-old woman with rheumatoid arthritis (RA: Steinblocker stage III, class 3) who developed severe swelling and neuropathy of the right lower limb caused by an iliopectineal bursa associated with destruction of the hip joint. Physical examination revealed an inguinal mass and groin pain. X-ray examination indicated destruction of the hip joint. Contrast-enhanced computed tomography showed the bursa connected with the hip joint and a markedly compressed external iliac vein among the inguinal ligament, pubis, and bursa. The patient underwent partial synovial resection and total hip arthroplasty for recovery of hip function, and this led to successful resolution of the symptoms and bursa. We present the characteristic images from this case and review all previously reported cases of RA iliopsoas bursitis causing leg swelling or neuropathy, and summarize the background. Since this lesion may cause various symptoms, clinical awareness that iliopsoas bursitis may present with unique clinical symptoms may aid correct diagnosis.

Microlaparoscopic technique for partial salpingectomy using bipolar electrocoagulation.

Science.gov (United States)

Siegle, J C; Cartmell, L W; Rayburn, W F

2001-07-01

To describe a technique of performing a partial salpingectomy using a small-diameter (2-mm) laparoscope and bipolar electrocoagulation. Sixty consecutive women desiring permanent sterilization underwent laparoscopic partial salpingectomy using a 2-mm transumbilical laparoscope and secondary midline sites suprapubically and midway above the pubis. A midportion of the tube was coagulated using Kleppinger forceps, transected with scissors and removed using grasping forceps. Additional time to remove both coagulated tubal segments averaged 4 minutes (range, 3-10). Each segment (mean, 1.5 cm; range, 0.9-2.4 cm) was confirmed in the operating room, then histologically. The transected tubal edges were separated with no thermal injury to nearby structures and with no mesosalpingeal hemorrhage. No cases required conversion from microlaparoscopy to a traditional method, and recovery time was not prolonged. The puncture sites healed well without sutures. Successful removal of electrocoagulated tubal segments with histologic confirmation was undertaken microlaparoscopically, with minimal additional operative time.

A través de las fronteras: [Exilio, identidad y escritura en textos mexicanos de Manuel Puig

Directory of Open Access Journals (Sweden)

Graciela Beatriz Goldchluk

1998-11-01

Full Text Available El trabajo presenta un recorrido por los primeros textos de Manuel Puig escritos en su exilio mexicano, en particular, se detiene en el análisis de Pubis angelical [1978], Amor del bueno [1974], Muy señor mío [1975] y 'Serena' [1977]. Se reconoce en ellos la problemática de la identidad, planteada de manera polémica en la novela y gozosa y hasta lúdica en los otros textos, matrices de espectáculos. De este modo, Puig se afirma en la exclusión física para luchar contra la exclusión simbólica. Es en la intensidad de la polémica donde se reconocen las marcas del exilio, y en la proliferación de falsas identidades donde se percibe el movimiento deseante que ocurre en la escritura de Puig, en la que toda identidad es provisoria y la copia puede ser un modo de la sinceridad

Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

Science.gov (United States)

Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

2015-06-01

Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture.

Athletic Hip Injuries.

Science.gov (United States)

Lynch, T Sean; Bedi, Asheesh; Larson, Christopher M

2017-04-01

Historically, athletic hip injuries have garnered little attention; however, these injuries account for approximately 6% of all sports injuries and their prevalence is increasing. At times, the diagnosis and management of hip injuries can be challenging and elusive for the team physician. Hip injuries are seen in high-level athletes who participate in cutting and pivoting sports that require rapid acceleration and deceleration. Described previously as the "sports hip triad," these injuries consist of adductor strains, osteitis pubis, athletic pubalgia, or core muscle injury, often with underlying range-of-motion limitations secondary to femoroacetabular impingement. These disorders can happen in isolation but frequently occur in combination. To add to the diagnostic challenge, numerous intra-articular disorders and extra-articular soft-tissue restraints about the hip can serve as pain generators, in addition to referred pain from the lumbar spine, bowel, bladder, and reproductive organs. Athletic hip conditions can be debilitating and often require a timely diagnosis to provide appropriate intervention.

Giant condyloma acuminatum of vulva

Directory of Open Access Journals (Sweden)

S. M. Ramiz Ahmed

2017-09-01

Full Text Available In this paper, A 23 year old married woman who was diagnosed as a case of giant condyloma acuminatum of vulva measuring about 15 x 8 x 3 cm, irregular surface with multiple projections, oval in shape, firm to hard in consistency, mildly tender, exophytic, cauliflower like growth involving the whole vulva (lower part of mons pubis, labia, vestibule, clitoris, around vaginal opening. Another multiple small lesions were present at perineal region but there was no inguinal lymphadenopathy. She underwent a combined electro cauterization and cryotherapy for small to moderate size multiple primary and recurrent warty lesions and wide surgical excision with fasciocutaneous advancement flaps procedure for a giant lesions in the vulva. Excisional biopsies were performed to detect potential malignancy but malignancy was not found histologically. The patient was advised to first follow-up 1 month after operation when multiple small warty lesions were developed and treated and the subsequent follow-ups for 3 months.

Osteomesophycnosis. A new case

Energy Technology Data Exchange (ETDEWEB)

Schmidt, H.; Lengerke, H.J. von; Mannkopf, H.; Ullrich, K.

1989-07-01

A 10-year old, mentally and physically normally developed girl complained of back pain following an accident. Radiological findings revealed an inhomogeneous, coarse osteosclerosis along the endplates and posterior parts of the ovoid shaped vertebral bodies, in the proximal and distal femora, proximal humeri and tibia epiphyses, and along the lateral aspects of the femoral necks. The pelvis presented a mottled appearance of the trabecular pattern at the symphysis pubis and the lateral parts of ischii and sclerosis in the acetabular region. The only laboratory abnormality was a high serum parathormone level. The family history revealed an autosomal dominant inheritance. The name proposed by Maroteaux for this skeletal disorder is osteomesopycnosis, as the lesions were localized to the spine, pelvis and sometimes proximal femur. The skull, ribs, long bones, hands and feet were not involved in the reported 12 cases. Radiographs of this patient showed in addition changes in the hand. This disease must be distinguished from atypical axial osteomalacia. (orig.).

Characterisation of microsatellite loci in two species of lice, Polyplax serrata (Phthiraptera: Anoplura: Polyplacidae) and/nMyrsidea nesomimi (Phthiraptera: Amblycera: Menoponidae)

Czech Academy of Sciences Publication Activity Database

Martinů, Jana; Roubová, V.; Nováková, M.; Smith, V. S.; Hypša, Václav; Štefka, Jan

2015-01-01

Roč. 62, FEB 13 2015 (2015), 016 ISSN 1803-6465 R&D Projects: GA ČR GPP506/12/P529 Institutional support: RVO:60077344 Keywords : ectoparasite * population genetics * coevolution * Polypax * Myrsidea * evolution * Europe * Galapagos Subject RIV: EG - Zoology Impact factor: 1.271, year: 2015

Occurrence of ectoparasitic arthropods associated with rodents in Hail region northern Saudi Arabia.

Science.gov (United States)

Asiry, Khalid A; Fetoh, Badr El-Sabah A

2014-09-01

Ectoparasitic arthropods are a diverse element of the Saudi fauna. Due to this, a survey of ectoparasites associated with rodents was conducted as a preliminary study in five districts of Hail region of northern Saudi Arabia for the first time. Ectoparasites extracted from 750 rodents were sampled and identified by recording their frequency of appearance. Results revealed that 1,287 ectoparasites infested 316 of the captured rodent hosts. These ectoparasites parasitized on four species of rodents including three species of rats Rattus rattus rattus, Rattus rattus frugivorus, and Rattus rattus alexandrinus and one species of mouse Acomys dimidiatus (Rodentia: Muridae). The ectoparasites belong to four different groups: ticks, fleas, lice, and mites. Ticks were the highest in the number, while fleas were the lowest among all the extracted ectoparasite groups. The collected ectoparasitic arthropods consisted of seven species. Ticks were of two species: Rhipicephalus turanicus and Rhipicephalus sanguineus (Acari: Ixodidae), fleas were of two species: Xenopsylla cheopis and Xenopsyllus conformis mycerini (Siphonaptera: Pulicidae), lice was a single species: Polyplax serrata (Anoplura: Hoplopleuridae), and mites were of two species: Laelaps nuttali and Laelaps echidninus (Mesostigmata: Laelapidae). The findings of the study showed that the intensity of infestation was varied between rodent host sexes, wherein females had the highest rate of parasitic infestation, and the parasitic index of appearance was very high for one group of parasites (i.e., ticks). The parasitic prevalence was 42.13 % on rodents, and mites were the most prevalent parasite species. Overall, this study was carried out to establish baseline data for ectoparasite-infested rodents in Hail region, Saudi Arabia, and may help for appropriate planning to control zoonotic diseases in this area.

Comparative adequecy of colpocystourethrorectography and transrectal sonography in female urinary incontinence

International Nuclear Information System (INIS)

Braccini, G.; Pannocchia, P.; Alderigi, L.; Gigoni, R.; Calderazzi, A.

1991-01-01

In order to investigate the diagnostic reliability of transrectal US in the study of female urinary incontinence, the authors compared the static images obtained by means of colpocystourethrorectography with the ones obtained with transrectal US. The study population included 30 patients suffering from urinary incontinence. US images were obtained both at rest and during Valsalva's maneuver, some minutes before cystourethrography and employing part of its preparation (vesical filling with 250 cc of iodine contrast medium and positioning of a metallic bead chain in the urethra). On static images obtained with cystourethrography and transrectal US both at rest and during Valsalva, 4 parameters were evaluated: anterior and posterior vesical angles, urethral axis angle, and distance between symphysis pubis and urethral-vesical junction. As for posterior vesical angle, urethral axis angle, and symphysis-junction distance, the statistical comparison of the results did non demonstrate any significant differences. Anterior vesical angle was not included because it is too difficult to measure by transrectal US. In our experience, transrectal US was capable of yielding accurate information similar to that obtained with colpocystourethrorectography. 25 refs

An anthropometric classification of body contour deformities after massive weight loss.

Science.gov (United States)

Iglesias, Martin; Butron, Patricia; Abarca, Leonardo; Perez-Monzo, Mario F; de Rienzo-Madero, Beatriz

2010-08-01

Deformities caused by massive weight loss were originally subsidized at the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán." This caused great economical losses, which led to the development of a classification to select patients with functional problems secondary to massive weight loss. The parameter used is the size of the pannus in relation to fixed anatomic structures within the following anatomic regions: abdomen, arms, thighs, mammary glands, lateral thoracic area, back, lumbar region, gluteal region, sacrum, and mons pubis. Grade 3 deformities are candidates for body contouring surgery because they constitute a functional problem. Grade 2 deformities reevaluated whether the patient has comorbidities. Lesser grades are considered aesthetic procedures and are not candidates for surgical rehabilitation at the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán." This classification allowed an improvement in communication between the different surgical-medical specialties; therefore, we suggest its application not only for surgical-administrative reasons but also for academic purposes.

Penile suspensory ligament division for penile augmentation: indications and results.

Science.gov (United States)

Li, Chi-Ying; Kayes, Oliver; Kell, Phillip D; Christopher, Nim; Minhas, Suks; Ralph, David J

2006-04-01

This study assessed the management of patients requesting penile length enhancement by division of the penile suspensory ligament. From September 1998 to January 2005, 42 patients with a variety of etiologies were included; all underwent division of the penile suspensory ligament. The outcome was assessed objectively based on increase in flaccid stretched penile length (SPL) and subjectively using the rates of patient satisfaction. The mean increase in SPL was 1.3+/-0.9 cm (range, -1 to +3 cm), with the addition of a silicone spacer placed between the pubis and penis giving a better outcome (p<0.05). The overall patient satisfaction rate was 35% but lower in the group with penile dysmorphic disorder at 27%. Division of the penile suspensory ligament or other augmentation techniques may increase penile length but usually not to a degree that satisfies the patient. Men with penile dysmorphic disorder often have unrealistic expectations regarding the outcome of surgical intervention and should be encouraged to seek psychological help primarily, with surgery reserved as the last resort.

[Ultrasound in monitoring of the second stage of labour].

Science.gov (United States)

Fouché, C J; Simon, E G; Potin, J; Perrotin, F

2012-11-01

In the second stage of labor, fetal head rotation and fetal head position are determinant for the management of labor to attempt a vaginal delivery or a cesarean section. However, digital examination is highly subjective. Nowadays, delivery rooms are often equipped with compact and high performance ultrasound systems. The clinical examination can be easily completed by quantified and reproducible methods. Transabdominal ultrasonography is a well-known and efficient way to determine the fetal head position. Nevertheless, ultrasound approach to assess fetal head descent is less widespread. We can use translabial or transperineal way to evaluate fetal head position. We describe precisely two different types of methods: the linear methods (3 different types) and the angles of progression (4 different types of measurement). Among all those methods, the main pelvic landmarks are the symphysis pubis and the fetal skull. The angle of progression appears promising but the assessment was restricted to occipitoanterior fetal position cases. In the coming years, ultrasound will likely play a greater role in the management of labor. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Nonoperative Management, Rehabilitation, and Functional and Clinical Progression of Osteitis Pubis/Pubic Bone Stress in Professional Soccer Players: A Case Series.

Science.gov (United States)

McAleer, Stephen S; Lippie, Ed; Norman, Darcy; Riepenhof, Helge

2017-09-01

Study Design Case series. Background Pubic bone stress (PBS) is a common acute or chronic response of the pelvis in sports where sprinting, kicking, twisting, and cutting are the dominant movements. There are few nonoperative rehabilitation strategies for the condition reported in the literature, and the outcome of conservative treatment has not been documented. Case Description Five professional and academy soccer players complaining of pubic symphysis pain, confirmed as PBS on magnetic resonance imaging and objective assessment, were treated with a nonoperative rehabilitation program that featured functional and clinical objective markers as progression criteria. Interventions in the acute phase included pharmacological and physical therapeutic modalities to reduce pain initially. Rehabilitation management focused on improving range of motion at the hips and thorax, adductor strengthening, trunk and lumbopelvic stability, gym-based strength training, and field-based rehabilitation and conditioning. Clinical follow-up was performed at least 8 months following return to play. Outcomes All players demonstrated reduced or resolved pain, increased adductor squeeze strength, and return to pain-free training and match play. Return-to-training time averaged 40.6 days (range, 30-60 days) and return to play averaged 49.4 days (range, 38-72 days) within the 5 players. At final follow-up (mean, 29.6 months; range, 16-33 months), there had been no recurrences. Discussion This report of 5 cases suggests that a nonoperative protocol, using clinical and functional progression criteria, may be successful in rehabilitating athletes with PBS for return to sport within 11 weeks. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2017;47(9):683-690. Epub 3 Aug 2017. doi:10.2519/jospt.2017.7314.

Computational modelling of locomotor muscle moment arms in the basal dinosaur Lesothosaurus diagnosticus: assessing convergence between birds and basal ornithischians.

Science.gov (United States)

Bates, Karl T; Maidment, Susannah C R; Allen, Vivian; Barrett, Paul M

2012-03-01

Ornithischia (the 'bird-hipped' dinosaurs) encompasses bipedal, facultative quadrupedal and quadrupedal taxa. Primitive ornithischians were small bipeds, but large body size and obligate quadrupedality evolved independently in all major ornithischian lineages. Numerous pelvic and hind limb features distinguish ornithischians from the majority of other non-avian dinosaurs. However, some of these features, notably a retroverted pubis and elongate iliac preacetabular process, appeared convergently in maniraptoran theropods, and were inherited by their avian descendants. During maniraptoran/avian evolution these pelvic modifications led to significant changes in the functions of associated muscles, involving alterations to the moment arms and the activation patterns of pelvic musculature. However, the functions of these features in ornithischians and their influence on locomotion have not been tested and remain poorly understood. Here, we provide quantitative tests of bipedal ornithischian muscle function using computational modelling to estimate 3D hind limb moment arms for the most complete basal ornithischian, Lesothosaurus diagnosticus. This approach enables sensitivity analyses to be carried out to explore the effects of uncertainties in muscle reconstructions of extinct taxa, and allows direct comparisons to be made with similarly constructed models of other bipedal dinosaurs. This analysis supports some previously proposed qualitative inferences of muscle function in basal ornithischians. However, more importantly, this work highlights ambiguities in the roles of certain muscles, notably those inserting close to the hip joint. Comparative analysis reveals that moment arm polarities and magnitudes in Lesothosaurus, basal tetanuran theropods and the extant ostrich are generally similar. However, several key differences are identified, most significantly in comparisons between the moment arms of muscles associated with convergent osteological features in

Uncovering deep mysteries: the underwater life of an amphibious louse.

Science.gov (United States)

Leonardi, Maria Soledad; Aznar, F Javier; Crespo, Enrique A; Lazzari, Claudio R

2014-12-01

Despite the incredible success of insects in colonizing almost every habitat, they remain virtually absent in one major environment--the open sea. A variety of hypotheses have been raised to explain why just a few insect species are present in the ocean, but none of them appears to be fully explanatory. Lice belonging to the family Echinophthiriidae are ectoparasites on different species of pinnipeds and river otters, i.e. they have amphibious hosts, who regularly perform long excursions into the open sea reaching depths of hundreds of meters (thousands of feets). Consequently, lice must be able to support not only changes in their surrounding media, but also extreme variations in hydrostatic pressure as well as breathing in a low oxygen atmosphere. In order to shed some light on the way lice can survive during the diving excursions of their hosts, we have performed a series of experiments to test the survival capability of different instars of Antarctophthirus microchir (Phthiraptera: Anoplura) from South American sea lions Otaria flavescens, when submerged into seawater. These experiments were aimed at analyzing: (a) immersion tolerance along the louse life; (b) lice's ability to obtain oxygen from seawater; (c) physiological responses and mechanisms involved in survival underwater. Our experiments showed that the forms present in non-diving pups--i.e. eggs and first-instar nymphs--were unable to tolerate immersion in water, while following instars and adults, all usually found in diving hosts, supported it very well. Furthermore, as long as the level of oxygen dissolved in water was higher, the lice survival capability underwater increased, and the recovery period after returning to air declined. These results are discussed in relation to host ecology, host exploitation and lice functional morphology. Copyright © 2014 Elsevier Ltd. All rights reserved.

HIPERPLASIA ADRENAL KONGENITAL (HAK KLASIK SIMPLE VIRILIZING PADA ANAK UMUR 3 TAHUN

Directory of Open Access Journals (Sweden)

Alice Indradjaja

2015-01-01

Full Text Available Hiperplasia adrenal kongenital merupakan salah satu dari kelompok kelainan genetik akibat defisiensi enzim yang diperlukan untuk biosintesis steroid di korteks kelenjar adrenal. Bentuk kelainan hiperplasia adrenal kongenital yang tersering adalah defisiensi enzim 21-hidroksilase (21OHD hingga mencapai 90% kasus. Kelainan utama pada pasien dengan defisiensi enzim 21-hidroksilase adalah kegagalan sintesis kortisol secara adekuat. Defisiensi 21-hidroksilase klasik tipe virilisasi sederhana menyebabkan genitalia ambigu pada bayi perempuan. Dilaporkan sebuah kasus hiperplasia adrenal kongenital klasik tipe virilisasi sederhana pada anak perempuan usia tiga tahun. Pasien dirujuk ke Poliklinik anak RSUP Sanglah Denpasar dengan keluhan utama pembesaran dan pemanjangan klitoris yang progresif disertai tumbuhnya bulu pubis.  Pasien lahir dengan genitalia ambigu. Pasien didiagnosis defisiensi 21-hidroksilase berdasarkan hasil pemeriksaan kadar progesteron 17-OH >1.200ng/dl dan pemeriksaan fisik didapatkan prader derajat III. Pada pemeriksaan usia tulang menunjukkan usia tulang yang melebihi umurnya, USG abdomen dalam batas normal dengan hasil analisis kromosom 46,XX. Pasien tidak pernah mengalami krisis adrenal selama 3 tahun dan menjalani tindakan pembedahan pada usia 3 tahun. Keluarga pasien diberikan konseling, dilakukan monitor  berkala pada pasien dan terapi hidrokortison. Prognosis pada pasien ini baik. [MEDICINA 2014;45:58-64].

Hip and Groin Injuries in Baseball Players.

Science.gov (United States)

Mlynarek, Ryan A; Coleman, Struan H

2018-03-01

To discuss the clinical significance of the most common hip and groin injuries in baseball players, as well as an algorithmic approach to diagnosis and treatment of these injuries. (a) Limitations in throwing velocity, pitch control, and bat swing speed may be secondary to decreased mobility and strength within the proximal kinetic chain, which must harness power from the lower extremities and core. (b) Approximately 5.5% of all baseball injuries per year involve the hip/groin and may lead to a significant amount of time spent on the disabled list. Injuries involving the hip and groin are relatively common in baseball players. Our knowledge of the mechanics of overhead throwing continues to evolve, as does our understanding of the contribution of power from the lower extremities and core. It is paramount that the team physician be able to accurately diagnose and treat injuries involving the hip/groin, as they may lead to significant disability and inability to return to elite levels of play. This review focuses on hip- and groin-related injuries in the baseball player, including femoroacetabular impingement, core muscle injury, and osteitis pubis.

Unilateral phthiriasis palpebrarum infestation in a child during occlusion therapy for amblyopia: Case report.

Science.gov (United States)

Biler, Elif Demirkilinc; Selver, Ozlem Barut; Palamar, Melis; Uner, Ahmet; Uretmen, Onder

2016-01-01

An 8-year-old mentally retarded boy is brought to the hospital because of itching and burning at his right eye for 10 days. He was on full time right eye occlusion therapy for left amblyopia. Slit lamp examination revealed nits and adult lice anchored to the eyelashes in his occluded eye. Eyelashes and all detected lice and nits were mechanically trimmed, and sent for parasitological examination, which confirmed the diagnosis. Upon familial evaluation for additional infestation, the father was also found to have genital phthiriasis pubis and received appropriate treatment. While phthiriasis palpebrarum in children may signify sexual abuse, a detailed investigation by a child psychiatrist was performed and revealed no sign of abuse. Since the infestation was at only on occluded eye, the most possible explanation for the transmission was evaluated as the misusage of the adhesive patch in our case. In conclusion, sexual abuse should be excluded in children with phthiriasis palpebrarum and parents of amblyopic children on occlusion therapy should be warned about the importance of the hygiene of the patching in order to avoid any kind of infection and infestation.

Necrosis of the femoral head after /sup 60/Co radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Maruno, H; Kawai, K [Kobe Univ. (Japan). School of Medicine

1978-10-01

A patient (50-year-old woman) received 10500 rad of skin dose and 630 rad of tumor dose for treatment of cervical cancer 15 years ago. The depth dose at the hip-joint was 3590 rad at the right hip-joint and 4315 rad at the left. Hip-joint pain occurred about 15 years after the irradiation, and one more year later she could not walk because of severe pain. X-ray films revealed great bone destruction at the both hip-joints as well as necrosis of the femoral head and arthropathy. The same findings were seen at the ilium, ischium, and pubis. Histologically, the synovial membrane was highly thick, fibrotic, and cicatricial. Obstructive changes were observed also in the small arteries. A severe narrowing or obstruction was observed in the Harversian canal at the bone cortex. The femoral head at the whole area was necrotic. The trabeculae were entirely thinned and were partially thickened by appositional bone formation. This new bone was also necrotic. Edematous fibrous-fatty tissues predominated the bone marrow. There was no proliferation of fibrous cell or new bone formation at the sites other than the margin.

Efficacy of herbal shampoo base on native plant against head lice (Pediculus humanus capitis De Geer, Pediculidae: Phthiraptera) in vitro and in vivo in Thailand.

Science.gov (United States)

Soonwera, Mayura

2014-09-01

Head lice infestation (or pediculosis) is an important public health problem in Thailand, especially in children between the ages 5 and 11 years. Head lice resistance is increasing, chemical pediculicides have lost their efficacy, and, therefore, alternative pediculicides such as herbal shampoos have been proposed to treat head lice infestation. Thus, the present study investigated the efficacy of three herbal shampoos based on native plants in Thailand (Acorus calamus Linn., Phyllanthus emblica Linn., and Zanthoxylum limonella Alston) against head lice and compared them with carbaryl shampoo (Hafif shampoo, 0.6% w/v carbaryl), malathion shampoo (A-Lice shampoo, 1.0% w/v malathion), and commercial shampoos (Babi Mild Natural' N Mild and Johnson's baby shampoo) in order to assess their in vitro and in vivo efficacy. For in vitro study, doses of 0.12 and 0.25 ml/cm(2) of each herbal shampoo were applied to filter paper, then 10 head lice were place on the filter paper. The mortalities of head lice were recorded at 5, 15, 30, and 60 min. The results revealed that all herbal shampoo were more effective on pediculicidal activity than chemical and commercial shampoos with 100% mortality at 15 min; LT₅₀ values ranged from 0.25 to 1.90 min. Meanwhile, chemical shampoos caused 20-80% mortality, and LT₅₀ values ranged from 6.50 to 85.43 min. On the other side, commercial shampoos showed 4.0% mortality. The most effective pediculicide was Z. limonella shampoo, followed by A. calamus shampoo, P. emblica shampoo, carbaryl shampoo, malathion shampoo, and commercial shampoo, respectively. In vivo results showed that all herbal shampoos were also more effective for head lice treatment than chemical and commercial shampoos with 94.67-97.68% of cure rate after the first treatment; the second treatment, 7 days later, revealed that the cure rate was 100%. Meanwhile, chemical shampoo showed 71.67-93.0% of cure rate and, unfortunately, commercial shampoos were nontoxic to head lice and showed 0% of cure rate after the first and the second treatments. Our data showed that three herbal shampoos of native plants in Thailand in this study are suitable to be used as pediculicides for Thai children since it is safe for children and there is no side-effect after application.

Skeletal injuries associated with sexual abuse

Energy Technology Data Exchange (ETDEWEB)

Johnson, Karl; Chapman, Stephen [Department of Radiology, Birmingham Children' s Hospital, Steelhouse Lane, B4 6NH, Birmingham (United Kingdom); Hall, Christine M. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom)

2004-08-01

Background: Sexual abuse is often associated with physical abuse, the most common injuries being bruising and other soft-tissue injuries, but fractures occur in 5% of sexually abused children. The fractures described to date have formed part of the spectrum of injuries in these children and have not been specifically related to the abusive act. Objective: To describe concurrent sexual abuse and fractures. Materials and methods: Three children with pelvic or femoral shaft injuries in association with sexual abuse. Results: A 3-year-old girl with extensive soft-tissue injuries to the arms, legs and perineum also sustained fractures of both pubic rami and the sacral side of the right sacro-iliac joint. A 5-month-old girl with an introital tear was shown to have an undisplaced left femoral shaft fracture. A 5-year-old girl presented with an acute abdomen and pneumoperitoneum due to a ruptured rectum following sexual abuse. She had old healed fractures of both pubic rami with disruption of the symphysis pubis. Conclusions: Although the finding of a perineal injury in a young child may be significant enough for the diagnosis of abuse, additional skeletal injuries revealed by radiography will assist in confirmation of that diagnosis and may be more common than hitherto suspected. (orig.)

Skeletal injuries associated with sexual abuse

International Nuclear Information System (INIS)

Johnson, Karl; Chapman, Stephen; Hall, Christine M.

2004-01-01

Background: Sexual abuse is often associated with physical abuse, the most common injuries being bruising and other soft-tissue injuries, but fractures occur in 5% of sexually abused children. The fractures described to date have formed part of the spectrum of injuries in these children and have not been specifically related to the abusive act. Objective: To describe concurrent sexual abuse and fractures. Materials and methods: Three children with pelvic or femoral shaft injuries in association with sexual abuse. Results: A 3-year-old girl with extensive soft-tissue injuries to the arms, legs and perineum also sustained fractures of both pubic rami and the sacral side of the right sacro-iliac joint. A 5-month-old girl with an introital tear was shown to have an undisplaced left femoral shaft fracture. A 5-year-old girl presented with an acute abdomen and pneumoperitoneum due to a ruptured rectum following sexual abuse. She had old healed fractures of both pubic rami with disruption of the symphysis pubis. Conclusions: Although the finding of a perineal injury in a young child may be significant enough for the diagnosis of abuse, additional skeletal injuries revealed by radiography will assist in confirmation of that diagnosis and may be more common than hitherto suspected. (orig.)

Estimation of sex and age of ''virtual skeletons''-a feasibility study

International Nuclear Information System (INIS)

Grabherr, Silke; Cooper, Christine; Ulrich-Bochsler, Susi; Uldin, Tanya; Ross, Steffen; Oesterhelweg, Lars; Bolliger, Stephan; Thali, Michael J.; Christe, Andreas; Schnyder, Pierre; Mangin, Patrice

2009-01-01

This article presents a feasibility study with the objective of investigating the potential of multi-detector computed tomography (MDCT) to estimate the bone age and sex of deceased persons. To obtain virtual skeletons, the bodies of 22 deceased persons with known age at death were scanned by MDCT using a special protocol that consisted of high-resolution imaging of the skull, shoulder girdle (including the upper half of the humeri), the symphysis pubis and the upper halves of the femora. Bone and soft-tissue reconstructions were performed in two and three dimensions. The resulting data were investigated by three anthropologists with different professional experience. Sex was determined by investigating three-dimensional models of the skull and pelvis. As a basic orientation for the age estimation, the complex method according to Nemeskeri and co-workers was applied. The final estimation was effected using additional parameters like the state of dentition, degeneration of the spine, etc., which where chosen individually by the three observers according to their experience. The results of the study show that the estimation of sex and age is possible by the use of MDCT. Virtual skeletons present an ideal collection for anthropological studies, because they are obtained in a non-invasive way and can be investigated ad infinitum. (orig.)

Estimation of sex and age of 'virtual skeletons'-a feasibility study

Energy Technology Data Exchange (ETDEWEB)

Grabherr, Silke [University Hospital of Lausanne, Institute of Forensic Medicine, Lausanne (Switzerland)]|[University of Bern, Institute of Forensic Medicine, Bern (Switzerland)]|[University Hospital of Lausanne, Service of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Cooper, Christine; Ulrich-Bochsler, Susi [University of Bern, Institute for the History of Medicine, Historical Anthropology, Bern (Switzerland); Uldin, Tanya [Service of Osteo-Archaeology, Aesch (Switzerland); Ross, Steffen; Oesterhelweg, Lars; Bolliger, Stephan; Thali, Michael J. [University of Bern, Institute of Forensic Medicine, Bern (Switzerland); Christe, Andreas [University of Bern, Institute of Forensic Medicine, Bern (Switzerland)]|[University of Bern, Institute of Diagnostic Radiology, Bern (Switzerland); Schnyder, Pierre [University Hospital of Lausanne, Service of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Mangin, Patrice [University Hospital of Lausanne, Institute of Forensic Medicine, Lausanne (Switzerland)

2009-02-15

This article presents a feasibility study with the objective of investigating the potential of multi-detector computed tomography (MDCT) to estimate the bone age and sex of deceased persons. To obtain virtual skeletons, the bodies of 22 deceased persons with known age at death were scanned by MDCT using a special protocol that consisted of high-resolution imaging of the skull, shoulder girdle (including the upper half of the humeri), the symphysis pubis and the upper halves of the femora. Bone and soft-tissue reconstructions were performed in two and three dimensions. The resulting data were investigated by three anthropologists with different professional experience. Sex was determined by investigating three-dimensional models of the skull and pelvis. As a basic orientation for the age estimation, the complex method according to Nemeskeri and co-workers was applied. The final estimation was effected using additional parameters like the state of dentition, degeneration of the spine, etc., which where chosen individually by the three observers according to their experience. The results of the study show that the estimation of sex and age is possible by the use of MDCT. Virtual skeletons present an ideal collection for anthropological studies, because they are obtained in a non-invasive way and can be investigated ad infinitum. (orig.)

Radiological investigations of the hedgehog (Erinaceus concolor) appendicular skeleton.

Science.gov (United States)

Hashemi, Mohammad; Javadi, Shahram; Hadian, Mojtaba; Pourreza, Behzad; Behfar, Mahdi

2009-03-01

The normal radiographic anatomy of the healthy hedgehog can help to identify anatomic features unique to the hedgehog while comparing it with other small mammals, such as the dog and cat. Radiographic examination is a method that can play an important role in the diagnosis of a wide variety of skeletal diseases. Seven (2 males, 5 females) free-living hedgehogs (Erinaceus concolor) from the Urmia region of Iran were selected for this study. Lateral and craniocaudal radiographs from the front and hind limbs were obtained. The radiographs from these hedgehogs were compared with the normal canine and feline skeletal radiographic anatomy. On the forelimb radiographs, the clavicle was observed as a complete bone connected to the scapula and manubrium. There are three and five carpal bones in the proximal and distal rows, respectively, as in the dog and cat. The pelvis has a larger obturator foramen when compared with the dog and cat. In the lateral view, the pubis and ischium are relatively larger than in the dog and cat and have a more ventral position. The tarsal bones are similar to those of the dog and cat. The number of phalanges and sesamoid bones in the forelimb and hindlimb are likewise similar to those found in the dog and cat.

Effect of pubic bone marrow edema on recovery from endoscopic surgery for athletic pubalgia.

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Kuikka, L; Hermunen, H; Paajanen, H

2015-02-01

Athletic pubalgia (sportsman's hernia) is often repaired by surgery. The presence of pubic bone marrow edema (BME) in magnetic resonance imaging (MRI) may effect on the outcome of surgery. Surgical treatment of 30 patients with athletic pubalgia was performed by placement of totally extraperitoneal endoscopic mesh behind the painful groin area. The presence of pre-operative BME was graded from 0 to 3 using MRI and correlated to post-operative pain scores and recovery to sports activity 2 years after operation. The operated athletes participated in our previous prospective randomized study. The athletes with (n = 21) or without (n = 9) pubic BME had similar patients' characteristics and pain scores before surgery. Periostic and intraosseous edema at symphysis pubis was related to increase of post-operative pain scores only at 3 months after surgery (P = 0.03) but not to long-term recovery. Two years after surgery, three athletes in the BME group and three in the normal MRI group needed occasionally pain medication for chronic groin pain, and 87% were playing at the same level as before surgery. This study indicates that the presence of pubic BME had no remarkable long-term effect on recovery from endoscopic surgical treatment of athletic pubalgia. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Treatment of tophaceous pseudogout with custom-fitted temporomandibular joint: a two-staged approach

Directory of Open Access Journals (Sweden)

Robert Pellecchia, DDS

2015-12-01

Full Text Available Tophaceous pseudogout, a variant of calcium pyrophosphate dihydrate deposition, is a relatively rare juxta-articular disease. It is a metabolic condition, in which patients develop pseudo-tumoral calcifications associated with peri-articular structures secondary to calcium pyrophosphate deposition into joints with fibrocartilage rather than hyaline cartilage. These lesions are reported in the knee, wrist, pubis, shoulder, and temporomandibular joint (TMJ and induce a histocytic foreign body giant cell reaction. We report a case of tophaceous pseudogout affecting the left TMJ with destruction of the condyle and glenoid and middle cranial fossa that was reconstructed with a TMJ Concepts (Ventura, CA custom-fitted prosthesis in a 2-staged surgical approach using a silicone spacer. The surgical management using a patient-specific TMJ is a viable option when the fossa or condylar component has been compromised due to breakdown of bone secondary to a pathologic process. Our case describes and identifies the lesion and its rare occurrence in the region of the temporomandibular region. The successful management of tophaceous pseudogout of the TMJ must include a thorough patient workup including the involvement of other joints as well as the modification of bone of the glenoid fossa and condylar relationship of the TMJ.

Near-infrared spectroscopy of the bladder: a new technique for studying lower urinary tract function in health and disease

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Shadgan, Babak; Afshar, Kourosh; Stothers, Lynn; Macnab, Andrew

2010-02-01

Background: Continuous wave near-infrared spectroscopy (NIRS) can monitor chromophore change in the bladder detrusor muscle during voiding; oxygenation and hemodynamic data derived differ in health and disease. Application of wireless NIRS for evaluation of voiding dysfunction would benefit children. Methods: Subjects: 20 children (4-17 yrs) [5 normal, 15 with urinary tract pathology]. Instrumentation: self-contained device weight 84 gm; 3 paired light emitting diodes (760/850 nm) in a spatially resolved configuration; source-detector separation distances (30, 35 and 40 mm); silicon photodiode detector; and Bluetooth®. Procedure: Transcutaneous monitoring (midline abdominal skin 2 cm above pubis) during spontaneous voiding (bladder contraction) of oxygenated (O2Hb), deoxygenated (HHb) and total hemoglobin (tHb) and tissue oxygen saturation index (TSI %) at 10 Hz. Results: All 20 trials produced clear graphic data with no movement effect evident. Comparison of patterns of chromophore change between normal and symptomatic subjects revealed trend differences in O2Hb and tHb. (Normal positive; Symptomatic negative, and TSI% fell in symptomatic group). Conclusions: Wireless NIRS is technically feasible in ambulant children. Negative trends in chromophore concentration and falls in TSI% suggest a hemodynamic impairment may underlie some forms of voiding dysfunction, with abnormal physiology involving the microcirculation possibly resulting in muscle fatigue during voiding.

Value of noncontrast spiral CT for suspected acute appendicitis

International Nuclear Information System (INIS)

Choi, Pil Yeob; Lee, Sang Wook; Kwon, Jae Soo; Sung, Young Soon; Rho, Myoung Ho; Chang, Jeong A.

1998-01-01

To assess the diagnostic accuracy and clinical efficacy of noncontrast spiral CT in patients with suspected acute appendicitis. Over a six-month period, 100 patients with suspected acute appendicitis were prospectively evaluated with noncontrast spiral CT. All scans were obtained from the lower body of L3 to the symphysis pubis, with 5mm or 10mm collimation and pitch of 1 or 1.5, and without intravenous or oral contrast material. Diagnosis was established by means of surgical or clinical follow-up. Prospective diagnosis based on CT findings was compared with surgical results and clinical follow-up. Acute appendicitis was confirmed in 47 of 100 patients. On the basis of the Ct findings, SI patients were prospectively interpreted as positive for appendicitis, but in six the diagnosis was false-positive. Two of the 47 with acute appendicitis were prospectively interpreted as normal. The preoperative diagnosis of acute appendicitis was, thus, 45 true-positive, 47 true-negative, six false-positive and two false-negative yielding a sensitivity of 96%, a specificity of 89%, an accuracy of 92%, a positive predictive value of 88%, and a negative predictive value of 96%. Using CT, an alternative diagnosis was established in 14 patients. Noncontrast spiral CT is a useful technique for diagnosing acute appendicitis. =20

First Detection of the Kdr Mutation T929I in Head Lice (Phthiraptera: Pediculidae) in Schoolchildren of the Metropolitan Area of Nuevo Leon and Yucatan, Mexico.

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Ponce-Garcia, Gustavo; Villanueva-Segura, Karina; Trujillo-Rodriguez, Gerardo; Rodriguez-Sanchez, Iram P; Lopez-Monroy, Beatriz; Flores, Adriana E

2017-07-01

The head louse Pediculus humanus capitis (De Geer) is a hematophagous ectoparasite that inhabits the human scalp. Infestations by this insect are commonly known as pediculosis, which is more common in younger groups. These infestations are asymptomatic; however, skin irritation from scratching occasionally may cause secondary bacterial infections. In recent years, the prevalence of pediculosis has increased in children; this increase has been attributed to louse resistance to the insecticides used as a control measure for infestation. The aim of the present study was to determine the presence and frequency of the knockdown resistance mutation (kdr) T929I in 468 head lice collected from 32 elementary schools in the metropolitan area of Nuevo Leon (24) and Yucatan (8), Mexico. This is the first report of a knockdown resistance (kdr) mechanism in head lice from Mexico. The T929I mutation was present in all of the sampled schools, with variability observed in its allelic and genotypic frequencies. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Comprehensive Review and Case Study on the Management of Buried Penis Syndrome and Related Panniculectomy

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Burns, Hadley; Chowdhry, Saeed; Lee, Thomas; Schulz, Steven; Wilhelmi, Bradon J.

2018-01-01

Objective: This paper discusses the various surgical techniques and outcomes associated with management of buried penis syndrome. Methods: Presented is the case of a 49-year-old man with morbid obesity, leading to massive panniculus and buried penis. We review our technique for reconstruction of the buried penis and treatment of the overlying large panniculus. Literature search was conducted to review current techniques in correcting buried penis syndrome. Results: The patient underwent a successful panniculectomy with removal of all excess skin and tissue. Thoughtful planning and coordination between plastic surgery and urology were paramount to externalize the penis for an excellent functional and cosmetic result. Conclusions: Management of a buried, hidden penis is complex and difficult. Patients are often obese and have poor hygiene due to the inability to cleanse areas that are entrapped by excessive fat. Following removal of the overhanging panniculus, satisfactory reconstruction of a hidden penis is possible when proper care is taken to adhere the base of the penis to the pubis. Split-thickness skin grafts are often necessary but depend on the viability of the penile skin and whether it is restricting penile length. Complications with wound dehiscence and infection are not uncommon; however, patients generally recover well, are satisfied with results, and are reported to have fully regained urinary and sexual functions following surgical correction of the buried penis. PMID:29467914

Tuberculous, trochanteric and ischial bursitis

International Nuclear Information System (INIS)

San Roman, R.; Manjon, P.; Revilla, Y.; Rodriguez, P.

1998-01-01

To analyze the radiological signs and clinical presentation of tuberculous bursitis arising in the ischial and trochanteric territories, given the limited available knowledge on these entities and in view of the growing prominence of extra pulmonary tuberculosis (TB) in the field of infectious diseases. We present seven cases dealt with in our hospital from the first medical consultation to the definitive diagnosis and treatment. Five of the patients presented greater trochanter involvement, while ischium was the site in the remaining two, in one of whom the bursitis extended toward pubis. The radiographic images revealed demineralization and/or erosion of the bone surface in six cases, soft tissue calcification in four, soft tissue mass in two, coccygeal involvement in one and avulsion of a bone fragment one. An ultrasound study was carried out in a of case soft tissue abscess and fistulography in a case of peri-ischial abscess reaching the cutaneous level. Images of the ischial and trochanteric tuberosities such as those described in the present report should lead to a suspicion of bursitis accompanied by local osteitis. One of the etiologies that should be considered, probably the most common one, is tuberculosis, given the serious consequences that poor initial management would have (if is often treated as pyogenic) and its growing incidence. (Author) 10 refs

Location of the ovaries in girls from newborn to 18 years of age: reconsidering ovarian shielding

International Nuclear Information System (INIS)

Bardo, Dianna M.E.; Schenk, Kellie; Black, Michelle; Zaritzky, Mario F.

2009-01-01

Guidelines for ovarian shielding are to place a lead shield in the midline of the abdomen at the level of the umbilicus. However, the ovaries are routinely seen at other locations on all types of imaging examinations. To determine the position of the ovaries in girls, newborn to 18 years of age, in order to assess efficacy of ovarian shield placement. We identified 336 girls who underwent lumbar spine and pelvic MRI. Images were reviewed noting the position of the ovaries relative to anatomic landmarks: symphysis pubis, iliac crest and anterior superior iliac spine (ASIS). In 174 girls a total of 307 ovaries were visualized. The girls were divided into three age groups and analyzed together. Right and left ovaries were analyzed together. The mean, 95% confidence interval (CI), standard deviations and range were calculated. The ovaries lay at or below the iliac crest (the level of the umbilicus), most often just medial to the ASIS and above the pubic symphysis in girls of all ages. Current methods of shielding only the midline of the pelvis for the purpose of reducing radiation dose to the ovaries during radiographic imaging are ineffective given that the ovaries are almost always positioned laterally in the pelvis. Therefore current shielding techniques should be changed; lead ovarian shields should be placed in a lateral position or even abandoned if relevant anatomy will be obscured. (orig.)

Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

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Short, Steven M; Anloague, Philip A; Strack, Donald S

2016-08-01

Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

USING CUSTOM TRIFLANGE IMPLANT IN REVISION HIP ARTHROPLASTY IN PATIENT WITH PELVIC DISCONTINUITY (CASE REPORT

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R. M. Tikhilov

2016-01-01

Full Text Available Revision hip arthroplasty rate is growing, and pelvic discontinuity rate ranges from 1% to 5% of acetabular component revision reasons. According to AAOS acetabular defects classification, pelvic discontinuity is fourth type defect in which cranial part of hip bone is separated from caudal part at acetabular level. Usually it occurs from bone loss secondary to osteolysis, infection, fracture or aseptic loosening. There are a lot of techniques for pelvis discontinuity treatment. Published results of bulk allografts and antiprotrusion cages have generally been poor. More preferable methods with acceptable rate of good results are cup-cage systems and custom triflange acetabular components(CTAC. CTACs are designed based on preoperative CT scans to build a custom titanium 3D-printed implant to address the patient's specific bone defect and provide secure fixation in the ilium, pubis, and ischium. We faced pelvic discontinuity, in which extensive iliac bone loss was added to caudal hip bone part medial displacement and pelvic ring deformity, in patient with multiple hip surgeries. Preoperative investigation called into question the possibility of using off-the-shelf hip implants, which could restore the biomechanics of the hip and provide reliable primary fixation at the same time. We present case report of the patient with pelvic discontinuity and massive bone loss treatment using a custom triflange component.

Triple flap technique for vulvar reconstruction.

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Mercut, R; Sinna, R; Vaucher, R; Giroux, P A; Assaf, N; Lari, A; Dast, S

2018-04-09

Perineal defects are encountered ever more frequently, in the treatment of vulvar cancers or abdominoperineal resection. The surgical treatment of vulvar cancer leads to significant skin defect. The aim of the reconstruction is not to provide volume but rather to resurface perineum. We propose a new solution to cover the extensive skin defect remaining after excision. We report 3 patients who underwent large excision for vulvar cancer, with lymph node dissection. For reconstruction, we performed 3 advancement flaps. Two V-Y flaps cantered on the infra-gluteal folds and based on pudendal perforator arteries were used to cover the postero-lateral parts of the defect. The third advancement flap from the superior aspect of the defect was a Y-V Mons pubis flap. The defects were successfully covered by the 3 flap technique. The first patient suffered a non-union that slowly healed by secondary intention. For the other cases, we used the same technique, but applied negative pressure wound therapy on the sutures, with excellent results. The 3 flap technique is a simple and reliable method and the donor site morbidity is minimal. It can be realised without changing the position of the patient after tumour excision, and does not require delicate perforator dissection. This surgical option can be easily applied, allowing better management of these cases. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Management of chronic recurrent osteitis pubis/pubic bone stress in a Premier League footballer: Evaluating the evidence base and application of a nine-point management strategy.

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McAleer, Stephen S; Gille, Justus; Bark, Stefan; Riepenhof, Helge

2015-08-01

The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent chronic groin pain and evaluate the evidence of the interventions. A professional footballer presented with chronic recurrent OP/PBS. The injury was managed successfully with a nine-point programme - 1. Acute pharmacological management. 2. Tone reduction of over-active structures. 3. Improved ROM at hips, pelvis and thorax. 4. Adductor strength. 5. Functional movement assessment. 6. Core stability. 7. Lumbo-pelvic control. 8. Gym-based strengthening. 9. Field-based conditioning/rehabilitation. The evidence for these interventions is reviewed. The player returned to full training and match play within 41 and 50 days, respectively, and experienced no recurrence of his symptoms in follow up at 13 months. This case report displays a nine-point conservative management strategy for OP/PBS, with non-time dependent clinical objective markers as the progression criteria in a Premier League football player. Copyright © 2015 Elsevier Ltd. All rights reserved.

Relating appendicular skeletal variation of sigmodontine rodents to locomotion modes in a phylogenetic context.

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Carvalho Coutinho, Ludmilla; Alves de Oliveira, João

2017-10-01

Sigmodontinae rodents constitute the second-largest subfamily among mammals. Alongside the taxonomic diversity, they are also ecologically diverse, exhibiting a wide array of locomotion modes, with semifossorial, terrestrial, semiaquatic, scansorial, arboreal, and saltatorial forms. To understand the ecomorphologic aspects that allow these rodents to display such locomotion diversity, we analyzed 35 qualitative characters of the appendicular skeleton (humerus, ulna, radius, scapula, femur, tibia, ilium, ischium and pubis) in 795 specimens belonging to 64 species, 34 genera and 10 tribes, representing all locomotion modes assigned to this subfamily. We performed a statistical analysis based upon the coefficient of trait differentiation to test the congruence of character states and the different locomotion modes. We also mapped characters states in a molecular phylogeny in order to reconstruct ancestral states and to evaluate how appendicular characters evolved within main lineages of Sigmodontinae radiation under a phylogenetic framework. The statistical analyses revealed six characters related to specific locomotion modes, except terrestrial. The mapping and parsimony ancestral states reconstruction identified two characters with phylogenetical signal and eight characters that are exclusively or more frequently recorded in certain modes of locomotion, four of them also detected by the statistical analysis. Notwithstanding the documented morphological variation, few changes characterize the transition to each of the locomotion modes, at least regarding the appendicular skeleton. This finding corroborates previous results that showed that sigmodontines exhibit an all-purpose appendicular morphology that allows them to use and explore a great variety of habitats. © 2017 Anatomical Society.

Dynamic MRI evaluation of urethral hypermobility post-radical prostatectomy.

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Suskind, Anne M; DeLancey, John O L; Hussain, Hero K; Montgomery, Jeffrey S; Latini, Jerilyn M; Cameron, Anne P

2014-03-01

One postulated cause of post-prostatectomy incontinence is urethral and bladder neck hypermobility. The objective of this study was to determine the magnitude of anatomical differences of urethral and bladder neck position at rest and with valsalva in continent and incontinent men post-prostatectomy based on dynamic MRI. All subjects underwent a dynamic MRI protocol with valsalva and non-valsalva images and a standard urodynamic evaluation. MRI measurements were taken at rest and with valsalva, including (1) bladder neck to sacrococcygeal inferior pubic point line (SCIPP), (2) urethra to pubis, and (3) bulbar urethra to SCIPP. Data were analyzed in SAS using two-tailed t tests. A total of 21 subjects (13 incontinent and 8 continent) had complete data and were included in the final analysis. The two groups had similar demographic characteristics. On MRI, there were no statistically significant differences in anatomic position of the bladder neck or urethra either at rest or with valsalva. The amount of hypermobility ranged from 0.8 to 2 mm in all measures. There were also no differences in the amount of hypermobility (position at rest minus position at valsalva) between groups. We found no statistically significant differences in bladder neck and urethral position or mobility on dynamic MRI evaluation between continent and incontinent men status post-radical prostatectomy. A more complex mechanism for post-prostatectomy incontinence needs to be modeled in order to better understand the continence mechanism in this select group of men. © 2013 Wiley Periodicals, Inc.

Comparison between single and three portal laparoscopic splenectomy in dogs

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Khalaj Alireza

2012-09-01

Full Text Available Abstract Background Single incision laparoscopic surgery (SILS is a newly growing technique to replace a more invasive conventional multiple portal laparoscopic surgery. The objective of this study was to compare single (SILS with three portal (Conventional laparoscopic splenectomy in dogs. Mongrel dogs (n = 18, weighting 15 ± 3 kg, were selected for this study (n = 12 SILS; n = 6 conventional. The area from xiphoid to pubis was prepared under aseptic conditions in dorsal recumbency with the head down and tilted 30 degree in the right lateral position. Pneumoperitoneum was established by CO2 using an automatic high flow pressure until achieving 12 mm Hg. Instrumentation used consisted of curved flexible-tip 5 mm Maryland forceps and ultracision harmonic scalpel for sealing and cutting of the vessels and splenic attachments. Results All dogs recovered uneventfully. The splenectomy procedure using SILS and conventional methods were significantly different in the respective operative time (29.1 ± 1.65 vs. 42.0 + 2.69 min and the length of the surgical scar (51.6 ± 1.34 mm vs. 72.0 ± 1.63 mm; P  Conclusion This study demonstrated that SILS is a safe and feasible operation and could be used as an alternative approach to three portal (Conventional for splenectomy in dog.

Visualization of Penile Suspensory Ligamentous System Based on Visible Human Data Sets

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Chen, Xianzhuo; Wu, Yi; Tao, Ling; Yan, Yan; Pang, Jun; Zhang, Shaoxiang; Li, Shirong

2017-01-01

Background The aim of this study was to use a three-dimensional (3D) visualization technology to illustrate and describe the anatomical features of the penile suspensory ligamentous system based on the Visible Human data sets and to explore the suspensory mechanism of the penis for the further improvement of the penis-lengthening surgery. Material/Methods Cross-sectional images retrieved from the first Chinese Visible Human (CVH-1), third Chinese Visible Human (CVH-3), and Visible Human Male (VHM) data sets were used to segment the suspensory ligamentous system and its adjacent structures. The magnetic resonance imaging (MRI) images of this system were studied and compared with those from the Visible Human data sets. The 3D models reconstructed from the Visible Human data sets were used to provide morphological features of the penile suspensory ligamentous system and its related structures. Results The fundiform ligament was a superficial, loose, fibro-fatty tissue which originated from Scarpa’s fascia superiorly and continued to the scrotal septum inferiorly. The suspensory ligament and arcuate pubic ligament were dense fibrous connective tissues which started from the pubic symphysis and terminated by attaching to the tunica albuginea of the corpora cavernosa. Furthermore, the arcuate pubic ligament attached to the inferior rami of the pubis laterally. Conclusions The 3D model based on Visible Human data sets can be used to clarify the anatomical features of the suspensory ligamentous system, thereby contributing to the improvement of penis-lengthening surgery. PMID:28530218

Endometriosis-associated hydrocele of the canal of Nuck with immunohistochemical confirmation: a case report.

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Okoshi, Kae; Mizumoto, Masaki; Kinoshita, Koichi

2017-12-21

The canal of Nuck is an embryological vestige of the processus vaginalis, and presents a potential site for endometriosis seeding. Hydroceles in this region are a rare cause of inguinal swelling in females. In addition, endometriosis localized to the canal of Nuck is exceedingly rare. A 44-year-old Japanese woman presented with a painful mass overlying her right pubis. She underwent surgery to completely excise the mass. During surgery, division of the external oblique aponeurosis revealed a cyst that occupied the inguinal canal and it adhered to the transverse fascia, inguinal ligament, and pubic bone. The cyst was dissected from the round ligament, and the defect in the internal inguinal ring was repaired and reinforced with mesh. On macroscopic examination, the cyst had a heterogeneous fibrous aspect with dark brown inclusions. Microscopic examination revealed that the cyst was tortuous, lined by mesothelial-like cells, and accompanied by partial subcapsular hemorrhage. Endometrium-like tissue was observed in the cystic wall. Immunohistochemical staining for podoplanin confirmed the mesothelial origin of the cyst-lining cells. The epithelial cells and stromal cells were positive for estrogen receptors. In this case of an endometriosis-associated hydrocele of the canal of Nuck, the mesothelial origin of the cyst-lining cells and endometriosis were confirmed by positive immunohistochemical staining for podoplanin and estrogen receptors, respectively. We determined that hydrocele resection and reinforcement of the anterior inguinal canal wall (if necessary) are appropriate treatments for this condition.

Pubic contouring after massive weight loss in men and women: correction of hidden penis, mons ptosis, and labia majora enlargement.

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Alter, Gary J

2012-10-01

Weight gain and subsequent weight loss usually result in unsightly large fat deposition in the pubic areas along with ptosis of the fat pad and skin. Men also complain of burying of the penis and the woman complains of labia majora enlargement, both causing secondary sexual dysfunction, hygiene issues, discomfort, and aesthetic concerns. Even with weight loss, most of these deformities persist. The hidden (buried) penis is characterized by a lack of firm attachments between the Buck fascia surrounding the tunica albuginea of the corpora and the dartos fascia and skin. Successful treatment requires the penile skin and dartos fascia to be stabilized to the penile corporal bodies to make the penis one integrated unit. The method of surgery is usually to excise and lift excess pubic skin, eliminate the pubic fat without creating a significant pubic concavity, and stabilize the penile skin to the corporal bodies with tacking sutures dorsally and ventrally. If inadequate penile skin is present, scrotal flaps or skin grafts are used to cover the penis. Treatment of the mons pubis requires similar pubic lifting, fat excision, and pubic tacking. Labia majora reduction requires skin and usually fat excision. Results are excellent with the use of these techniques. Pubic contouring after massive weight loss in men and women is very successful and safe if performed meticulously. Treatment improves self-esteem along with the associated physical and aesthetic deformities.

3D scanning and printing skeletal tissues for anatomy education.

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Thomas, Daniel B; Hiscox, Jessica D; Dixon, Blair J; Potgieter, Johan

2016-09-01

Detailed anatomical models can be produced with consumer-level 3D scanning and printing systems. 3D replication techniques are significant advances for anatomical education as they allow practitioners to more easily introduce diverse or numerous specimens into classrooms. Here we present a methodology for producing anatomical models in-house, with the chondrocranium cartilage from a spiny dogfish (Squalus acanthias) and the skeleton of a cane toad (Rhinella marina) as case studies. 3D digital replicas were produced using two consumer-level scanners and specimens were 3D-printed with selective laser sintering. The fidelity of the two case study models was determined with respect to key anatomical features. Larger-scale features of the dogfish chondrocranium and frog skeleton were all well-resolved and distinct in the 3D digital models, and many finer-scale features were also well-resolved, but some more subtle features were absent from the digital models (e.g. endolymphatic foramina in chondrocranium). All characters identified in the digital chondrocranium could be identified in the subsequent 3D print; however, three characters in the 3D-printed frog skeleton could not be clearly delimited (palatines, parasphenoid and pubis). Characters that were absent in the digital models or 3D prints had low-relief in the original scanned specimen and represent a minor loss of fidelity. Our method description and case studies show that minimal equipment and training is needed to produce durable skeletal specimens. These technologies support the tailored production of models for specific classes or research aims. © 2016 Anatomical Society.

Survey on Aesthetic Vulvovaginal Procedures: What do Portuguese Doctors and Medical Students Think?

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Vieira-Baptista, Pedro; Lima-Silva, Joana; Fonseca-Moutinho, José; Monteiro, Virgínia; Águas, Fernanda

2017-08-01

Objective  To assess the medical doctors and medical students' opinion regarding the evidence and ethical background of the performance of vulvovaginal aesthetic procedures (VVAPs). Methods  Cross-sectional online survey among 664 Portuguese medical doctors and students. Results  Most participants considered that there is never or there rarely is a medical reason to perform: vulvar whitening (85.9% [502/584]); hymenoplasty (72.0% [437/607]); mons pubis liposuction (71.6% [426/595]); "G-spot" augmentation (71.0% [409/576]); labia majora augmentation (66.3% [390/588]); labia minora augmentation (58.3% [326/559]); or laser vaginal tightening (52.3% [313/599]). Gynecologists and specialists were more likely to consider that there are no medical reasons to perform VVAPs; the opposite was true for plastic surgeons and students/residents.Hymenoplasty raised ethical doubts in 51.1% (283/554) of the participants. Plastic surgeons and students/residents were less likely to raise ethical objections, while the opposite was true for gynecologists and specialists.Most considered that VVAPs could contribute to an improvement in self-esteem (92.3% [613/664]); sexual function (78.5% [521/664]); vaginal atrophy (69.9% [464/664]); quality of life (66.3% [440/664]); and sexual pain (61.4% [408/664]). Conclusions  While medical doctors and students acknowledge the lack of evidence and scientific support for the performance of VVAPs, most do not raise ethical objections about them, especially if they are students or plastic surgeons, or if they have had or have considered having plastic surgery. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

Pentoxifylline in the treatment of radiation-related pelvic insufficiency fractures of bone

International Nuclear Information System (INIS)

Bese, N.S.; Oezgueroglu, M.; Kamberoglu, K.; Karahasanoglu, T.; Oeber, A.

2003-01-01

The reported incidence of bone complications after radiation therapy is quite low. The most commonly seen bone complication is insufficiency fractures of the pubis and sacrum. Treatment of insufficiency fractures consists of conservative care, and mineral replacement may be useful. The resolution of symptoms takes at least one year with these treatments. Vascular damage has an important role in the etiology of late radiation injury in normal tissues. Progressive ischemic changes further weaken the bone structure, which can cause fractures, and healing is also delayed. Pentoxifylline is a methylxanthine derivative that is shown to increase tissue blood flow. Here, we present a 63-year-old male patient with pelvic insufficiency fractures due to postoperative pelvic irradiation for rectal adenocarcinoma. The patient received pelvic radiotherapy to a total dose of 50.4 Gy with concomitant 5-FU. Six months after the completion of radiotherapy, the patient presented with severe pelvic pain. Pelvic magnetic resonance imaging (MRI) demonstrated abnormal signal intensity with insufficiency fractures at the sacrum and bone marrow edema near the fractures, but not an abnormal intensity that revealed bone metastases. Neither distant nor locoregional recurrence was observed at his work-up. The final diagnosis was insufficiency fractures of the pelvic bones owing to irradiation, and pentoxifylline (400 mg, 3 times daily, peroral, 1,200 mg/day) was used for eight months as treatment. Dramatic clinical improvement was obtained in six months, and objective healing was revealed with MRI. We concluded that pentoxifylline is a cost-effective drug with minimal adverse effects in treating radiation damage of bone. (author)

Physical Examination for Men and Women With Urologic Chronic Pelvic Pain Syndrome: A MAPP (Multidisciplinary Approach to the Study of Chronic Pelvic Pain) Network Study.

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Yang, Claire C; Miller, Jane L; Omidpanah, Adam; Krieger, John N

2018-06-01

To examine the feasibility of implementing a standardized, clinically relevant genitourinary examination for both men and women, and to identify physical examination findings characteristic of urologic chronic pelvic pain syndrome (UCPPS). This study analyzed 2 samples: men and women with UCPPS who participated in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network Epidemiology and Phenotyping (EP) Study, and age-matched controls who were either positive for chronic fatigue syndrome or healthy (pain-free). We compared physical examination findings in both positive and healthy controls with UCPPS cases: findings from both the EP examinations and from an extended genitourinary examination. EP and extended examinations were performed on 143 participants: 62 UCPPS cases (30 women, 32 men), 42 positive controls (15 women, 27 men), and 39 healthy controls (22 women, 17 men). EP examinations showed that pelvic floor tenderness was more prevalent in cases (55.0%) than in positive (14.6%) or healthy controls (10.5%). Extended examinations revealed specific areas of tenderness in the pelvic floor musculature. Cases were also more likely than healthy controls to report tenderness in multiple areas, including suprapubic, symphysis pubis, and posterior superior iliac spine, and on bimanual examination. No comparative findings were specific to biological sex, and no evidence of pudendal neuropathy was observed on extended examination of cases or controls. The extended genitourinary examination is an easily administered addition to the assessment of men and women during evaluation for UCPPS. Physical findings may help to better categorize patients with UCPPS into clinically relevant subgroups for optimal treatment. Published by Elsevier Inc.

Genital beautification: a concept that offers more than reduction of the labia minora.

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Cihantimur, Bülent; Herold, Christian

2013-12-01

The interest and demand for female genital rejuvenation surgery are steadily increasing. This report presents a concept of genital beautification consisting of labia minora reduction, labia majora augmentation by autologous fat transplantation, labial brightening by laser, mons pubis reduction by liposuction, and vaginal tightening if desired. Genital beautification was performed for 124 patients between May 2009 and January 2012 and followed up for 1 year to obtain data about satisfaction with the surgery. Of the 124 female patients included in the study, 118 (95.2 %) were happy and 4 (3.2 %) were very happy with their postoperative appearance. In terms of postoperative functionality, 84 patients (67.7 %) were happy and 40 (32.3 %) were very happy. Only 2 patients (1.6 %) were not satisfied with the aesthetic result of their genital beautification procedures, and 10 patients (8.1 %) experienced wound dehiscence. The described technique of genital beautification combines different aesthetic female genital surgery techniques. Like other aesthetic surgeries, these procedures are designed for the subjective improvement of the appearance and feelings of the patients. The effects of the operation are functional and psychological. They offer the opportunity for sexual stimulation and satisfaction. The complication rate is low. Superior aesthetic results and patient satisfaction can be achieved by applying this technique. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Boomerang pattern correction of gynecomastia.

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Hurwitz, Dennis J

2015-02-01

After excess skin and fat are removed, a body-lift suture advances skin and suspends ptotic breasts, the mons pubis, and buttocks. For women, the lift includes sculpturing adiposity. While some excess fat may need removal, muscular men should receive a deliberate effort to achieve generalized tight skin closure to reveal superficial muscular bulk. For skin to be tightly bound to muscle, the excess needs to be removed both horizontally and vertically. To aesthetically accomplish that goal, a series of oblique elliptical excisions have been designed. Twenty-four consecutive patients received boomerang pattern correction of gynecomastia. In the last 12 patients, a J torsoplasty extension replaced the transverse upper body lift. Indirect undermining and the opposing force of a simultaneous abdominoplasty obliterate the inframammary fold. To complete effacement of the entire torso in 11 patients, an abdominoplasty was extended by oblique excisions over bulging flanks. Satisfactory improvement was observed in all 24 boomerang cases. A disgruntled patient was displeased with distorted nipples after revision surgery. Scar maturation in the chest is lengthy, with scars taking years to flatten and fade. Complications were limited and no major revisions were needed. In selected patients, comprehensive body contouring surgery consists of a boomerang correction of gynecomastia. J torsoplasty with an abdominoplasty and oblique excisions of the flanks has proven to be a practical means to achieve aesthetic goals. Gender-specific body lift surgery that goes far beyond the treatment of gynecomastia best serves the muscular male patient after massive weight loss. Therapeutic, IV.

Simultaneous bilateral robotic partial nephrectomy: Case report and critical evaluation of the technique.

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Giberti, Claudio; Gallo, Fabrizio; Schenone, Maurizio; Cortese, Pierluigi

2014-06-16

We report our first simultaneous bilateral robot assisted partial nephrectomy (RAPN) in order to show and critically discuss the feasibility of this procedure. Materials and methods A 69-year-old male patient visited our department due to incidental finding of bilateral mesorenal small masses (2.5 cm on the right and 3.5 cm on the left) suspicious for malignancy. We started from the right side with patient in flank position. Port placement: 12-mm periumbilical camera port, two 8-mm robotic ports in wide ''V''configuration, additional 12 mm assistant port on the midline between the umbilicus and symphysis pubis. A right unclamping RAPN with sliding clip renorrhaphy was performed. The trocars were removed and the robot undocked. Without interrupting the anesthesiological procedures, the patient was reported in supine position and, after 180 degrees rotation of the surgical bed, was newly placed in contralateral flank position. Using both the previous periumbilical and midline ports, two other 8-mm robotic trocars were placed. The robot was then redocked and RAPN was also performed on the left side using the same previously reported technique. Results Total time: 285 min. Estimated blood losses: 150 cc. Postoperative period: uneventful. Pathological examination: bilateral renal cell carcinoma, negative surgical margins. Conclusions Our experience was encouraging and confirmed the feasibility and safety of this procedure. The planning of our technique was time and cost effective with cosmetic benefit for the patient. However, we think that an appropriate selection of the patients and a skill in robotic renal surgery are advisable before approaching this type of surgery.

Comparison between single and three portal laparoscopic splenectomy in dogs

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2012-01-01

Background Single incision laparoscopic surgery (SILS) is a newly growing technique to replace a more invasive conventional multiple portal laparoscopic surgery. The objective of this study was to compare single (SILS) with three portal (Conventional) laparoscopic splenectomy in dogs. Mongrel dogs (n = 18), weighting 15 ± 3 kg, were selected for this study (n = 12 SILS; n = 6 conventional). The area from xiphoid to pubis was prepared under aseptic conditions in dorsal recumbency with the head down and tilted 30 degree in the right lateral position. Pneumoperitoneum was established by CO2 using an automatic high flow pressure until achieving 12 mm Hg. Instrumentation used consisted of curved flexible-tip 5 mm Maryland forceps and ultracision harmonic scalpel for sealing and cutting of the vessels and splenic attachments. Results All dogs recovered uneventfully. The splenectomy procedure using SILS and conventional methods were significantly different in the respective operative time (29.1 ± 1.65 vs. 42.0 + 2.69 min) and the length of the surgical scar (51.6 ± 1.34 mm vs. 72.0 ± 1.63 mm; P hernia formation and dehiscence up to one month after surgery. Meanwhile, the conversion to open surgery or application of additional portals was not required in both approaches. Conclusion This study demonstrated that SILS is a safe and feasible operation and could be used as an alternative approach to three portal (Conventional) for splenectomy in dog. PMID:22963734

A Comparison between Australian Football League (AFL Injuries in Australian Indigenous versus Non-indigenous Players

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Jessica Orchard

2013-09-01

Full Text Available It has previously been shown that being of aboriginal descent is a risk factor for hamstring injuries in Australian football. The aim of this study was to review the Australian Football League (AFL injury database to determine whether there were any injuries where indigenous players had different relative risks to non-indigenous players. Analysis was conducted using data from the AFL injury database, which included data from 4,492 players over 21 years (1992–2012, covering 162,683 player-matches at AFL level, 91,098 matches at lower levels and 328,181 weeks (possible matches of exposure. Compared to non-indigenous players, indigenous players had a significantly higher risk of hamstring injuries (RR 1.52, 95% CI 1.32–1.73 and calf strains (RR 1.30, 95% CI 1.00–1.69. Conversely, indigenous players had a significantly lower risk of lumbar/thoracic spine injuries (RR 0.61, 95% CI 0.41–0.91, groin strains/osteitis pubis (RR 0.75, 95% CI 0.58–0.96 and Achilles tendon injuries (RR 0.32, 95% CI 0.12–0.86. The results for the above injuries were also significant in terms of games missed. There was no difference between overall risk of injury (RR 1.03, 95% CI 0.96–1.10 or missed games (RR 1.00, 95% CI 0.97–1.04. This suggests that indigenous AFL players have the same overall number of injuries and missed games, but a slightly different injury profile.

Primary beam ionizing radiation for patients during coronary cineangiography

International Nuclear Information System (INIS)

Ramirez, Alfredo; Leyton, Fernando; Gamarra, Jorge; Oyarzun C, Carlos; Silva, Ana Maria; Ugalde, Hector; Dussaillant, Gaston

2001-01-01

Current cardiology practice incorporates hemodynamic and angiographic studies as normal procedures. Clinical actions have to be taken in interventionist cardiology that demand prolonged exposure times to radiation, which implies submitting patients to quantitatively significant doses. This work is a preliminary phase for clinical studies involving long procedures in hemodynamic and electrophysiological interventionist cardiology to show the magnitude of the radiation doses received by the patients after a proper diagnosis. The aim is to improve the patient's radiological protection as well as that of the staff involved. The study group consisted of 18 patients who underwent coronary angiography procedures with Siemens Angioskop D equipment and a Siemens Polidoros 80 generator. Four TLD Crystal detectors were used for the patient's dosimetry, which were located in the dorsal region along the left para scapular line, on the mid line of the thyroid region and a detector on the mid point between the umbilical zone and the pubis symphysis. For procedure times of 14±4.3 min., with fluoroscope times of 3.6±2.5 min., connection techniques of 87±15 kV. and 126±24 mA, the radiations recorded in the left inter scapular and right inter scapular regions were 215±199 mGy (1-710 mGy range) and 255±212 mGy ( 22 - 791mGy range ). The radiations in the pubic and thyroid regions were 0.23±0.07 mGy and 3.62±2.44 mGy, respectively (CO)

Conventional four-field pelvic radiotherapy technique without computed tomography-treatment planning in cancer of the cervix: potential geographic miss and its impact on pelvic control

International Nuclear Information System (INIS)

Kim, Robert Y.; McGinnis, L. Scott; Spencer, Sharon A.; Meredith, Ruby F.; Jennelle, Richard L.S.; Salter, Merle M.

1995-01-01

Purpose: To evaluate the impact of inadequate margins on pelvic control using the conventional four-field pelvic portals without computed tomography (CT)-treatment planning. Methods and Materials: Between 1986 and 1991, 34 patients with invasive cancer of the cervix were eligible for outcome study of conventional four-field radiation therapy (10 Stage I, 16 Stage II, 8 Stage III). The eligibility for this study includes four-field pelvic technique, definitive radiation therapy, and diagnostic CT scan of the pelvis. For this study, an inadequate margin is arbitrarily defined as ≤ 1.0 cm of normal tissue around the CT-defined tumor volume. Results: All 34 patients had adequate margins for anterio-posterior/posterio-anterior portals. However, 19 patients had an inadequate margin at the posterior border (S2-S3 interspace) and/or custom-shaped rectal block for lateral pelvic portals. Two patients had inadequate margins at the anterior border (level of symphysis pubis) due to an enlarged uterus. With a median follow-up of 36 months, pelvic control for adequate margins and inadequate margins was 100% and 71% for Stage IB disease and 88% and 50% for Stage IIB disease, respectively. However, pelvic control for Stage IIIB disease was 50% for both groups. There was no difference in total dose to point A or point B between the two groups. Conclusion: Our preliminary data show higher local failure in patients with an inadequate margin. For four-field pelvic radiation therapy, we strongly recommend CT-treatment planning. Otherwise, anterio-posterior/posterio-anterior pelvic therapy is the most reliable treatment for cancer of the uterine cervix

Role of perineal ultrasonography in postoperative evaluation of patients with stress incontinence

International Nuclear Information System (INIS)

Ko, Seog Wan; Jeong, Yong Yeon; Kang, Heoung Keun; Chung, Tae Woong; Seo, Jeong Jin; Park, Jin Gyoon; Kwon, Dong Deuk

2001-01-01

To evaluate the effectiveness of perineal ultrasonography in the evaluation of female stress incontinence after surgical management. Perineal ultrasonography was performed in 19 patients who were surgically treated for stress incontinence and this was performed in erect position. Nineteen patients were divided into two groups, group A for 11 patients with resolved incontinent after surgery and group B for 8 patients with persistent incontinence even after surgery. Using a sagittal scan of the anterior pelvis at the level of the symphysis pubis, the posterior urethrovesical angel (PUVA) and descent of the bladder neck were measured at rest and during stress (Valsalva maneuver), and these measured values obtained before and after surgery were compared between two groups, group A and B. Postoperative PUVA and descent of the bladder neck were decreased when compared with preoperative values measured at rest and during stress in both groups. There was a statistically significant difference in the postoperative PUVA between two groups (p< 0.05). The mean increment of PUVA during stress after surgery was 6.3 ± 3.8. deg in group A and 14.6 ± 6.4. deg in group B, respectively, showing statistically significant difference (p< 0.05). There was also a statistically difference in the mean descent of the bladder neck during stress after surgery between the two groups (p<0.05). The measurement and comparison of PUVA and descent of the bladder neck by perineal ultrasonography before and after surgery in patients with stress incontinence offered useful and objective information in evaluating the effectiveness of surgical management in females stress incontinence, the stress effectiveness in the stress incontinence.

Biomechanical study on the bladder neck and urethral positions: simulation of impairment of the pelvic ligaments.

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Brandão, Sofia; Parente, Marco; Mascarenhas, Teresa; da Silva, Ana Rita Gomes; Ramos, Isabel; Jorge, Renato Natal

2015-01-21

Excessive mobility of the bladder neck and urethra are common features in stress urinary incontinence. We aimed at assessing, through computational modelling, the bladder neck position taking into account progressive impairment of the pelvic ligaments. Magnetic resonance images of a young healthy female were used to build a computational model of the pelvic cavity. Appropriate material properties and constitutive models were defined. The impairment of the ligaments was simulated by mimicking a reduction in their stiffness. For healthy ligaments, valsalva maneuver led to an increase in the α angle (between the bladder neck-symphysis pubis and the main of the symphysis) from 91.8° (at rest) to 105.7°, and 5.7 mm of bladder neck dislocation, which was similar to dynamic imaging of the same woman (α angle from 80° to 103.3°, and 5mm of bladder neck movement). For 95% impairment, they enlarged to 124.28° and 12 mm. Impairment to the pubourethral ligaments had higher effect than that of vaginal support (115° vs. 108°, and 9.1 vs. 7.3mm). Numerical simulation could predict urethral motion during valsalva maneuver, for both healthy and impaired ligaments. Results were similar to those of continent women and women with stress urinary incontinence published in the literature. Biomechanical analysis of the pubourethral ligaments complements the biomechanical study of the pelvic cavity in urinary incontinence. It may be useful in young women presenting stress urinary incontinence without imaging evidence of urethral and muscle lesions or organ descend during valsalva, and for whom fascial damage are not expected. Copyright © 2014 Elsevier Ltd. All rights reserved.

Pubic apophysitis: a previously undescribed clinical entity of groin pain in athletes.

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Sailly, Matthieu; Whiteley, Rod; Read, John W; Giuffre, Bruno; Johnson, Amanda; Hölmich, Per

2015-06-01

Sport-related pubalgia is often a diagnostic challenge in elite athletes. While scientific attention has focused on adults, there is little data on adolescents. Cadaveric and imaging studies identify a secondary ossification centre located along the anteromedial corner of pubis beneath the insertions of symphysial joint capsule and adductor longus tendon. Little is known about this apophysis and its response to chronic stress. We report pubic apophysitis as a clinically relevant entity in adolescent athletes. The clinical and imaging findings in 26 highly trained adolescent football players (15.6 years ± 1.3) who complained of adductor-related groin pain were reviewed. The imaging features (X-ray 26/26, US 9/26, MRI 11/26, CT 7/26) of the pubic apophyses in this symptomatic group were compared against those of a comparison group of 31 male patients (age range 9-30 years) with no known history of groin pain or pelvic trauma, who underwent pelvic CT scans for unrelated medical reasons. All symptomatic subjects presented with similar history and physical findings. The CT scans of these patients demonstrated open pubic apophyses with stress-related physeal changes (widening, asymmetry and small rounded cyst-like expansions) that were not observed in the comparison group. No comparison subject demonstrated apophyseal maturity before 21 years of age, and immaturity was seen up to the age of 26 years. This retrospective case series identifies pubic apophyseal stress (or 'apophysitis') as an important differential consideration in the adolescent athlete who presents with groin pain. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Athletic pubalgia and the "sports hernia": MR imaging findings.

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Zoga, Adam C; Kavanagh, Eoin C; Omar, Imran M; Morrison, William B; Koulouris, George; Lopez, Hector; Chaabra, Avneesh; Domesek, John; Meyers, William C

2008-06-01

To retrospectively determine the sensitivity and specificity of magnetic resonance (MR) imaging findings in patients with clinical athletic pubalgia, with either surgical or physical examination findings as the reference standard. Institutional review board approval was granted for this HIPAA-compliant study, and informed consent was waived. MR imaging studies in 141 patients (134 male patients, seven female patients; mean age, 30.1 years; range, 17-71 years) who had been referred to a subspecialist because of groin pain were reviewed for findings including hernia, pubic bone marrow edema, secondary cleft sign, and rectus abdominis and adductor tendon injury. MR imaging findings were compared with surgical findings for 102 patients, physical examination findings for all 141 patients, and MR imaging findings in an asymptomatic control group of 25 men (mean age, 29.8 years; range, 18-39 years). Sensitivity and specificity of MR imaging for rectus abdominis and adductor tendon injury were determined by using a chi(2) analysis, and significance of the findings was analyzed with an unpaired Student t test. Disease patterns seen at MR imaging were compared with those reported in the surgical and sports medicine literature. One hundred thirty-eight (98%) of 141 patients had findings at MR imaging that could cause groin pain. Compared with surgery, MR imaging had a sensitivity and specificity, respectively, of 68% and 100% for rectus abdominis tendon injury and 86% and 89% for adductor tendon injury. Injury in each of these structures was significantly more common in the patient group than in the control group (P pubalgia, including rectus abdominis insertional injury, thigh adductor injury, and articular diseases at the pubic symphysis (osteitis pubis). (c) RSNA, 2008.

Guidelines on the implementation of radiation protection measures during diagnostic medical exposures of female patients of reproductive capacity

International Nuclear Information System (INIS)

2000-08-01

These guidelines were produced in response to a perceived need for clear guidance concerning the implementation of the 10-day and 28-day rules regarding radiological radiation protection practices. At the outset it is important to emphasise that, in all cases, the seriousness of the clinical situation must be taken into account as being of paramount importance and an overriding consideration to the guidelines. Radiographs of the chest, skull and extremities may be done at any time, provided that best practices are adhered to. All requests for radiological examinations of female patients, which place the uterus in or near the primary X-ray beam, i.e. irradiation between the diaphragm and pubis, or nuclear medicine examinations which are likely to result in a dose to the unborn child up to 10 mGy, should include the date of the last menstrual period. The prescriber and practitioner or radiographer should ask a patient beyond day 10 of the menstrual cycle whether she might be pregnant. This enquiry and the patient's answer should be recorded in writing. If the answer is no, the examination may proceed. If the answer is yes or uncertain, the examination should not proceed. In cases of medical emergency, the practitioner or the prescriber, if necessary following discussion with the practitioner or radiographer and taking justification into account, may decide to proceed with the examination. The practitioner or prescriber must record this decision in writing and sign it. The 10-day rule is recommended for certain high dose examinations where the dose to the uterus is likely to exceed 10 mGy. These include a small number of diagnostic X-ray and nuclear medicine procedures. (author)

Cryotherapy for massive vulvar lymphatic leakage complicated with lymphangiomas following gynecological cancer treatment.

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Yanazume, Shintaro; Douzono, Haruhiko; Kubo, Hidemichi; Nagata, Tomomi; Douchi, Tsutomu; Kobayashi, Hiroaki

2014-11-01

Vulvar lymphatic leakage is a severe complication associated with gynecological cancer treatments. However, standard treatment strategies have not yet been determined. We encountered a rare case of a 76-year-old multiparous woman suffering from massive lymphatic fluid leakage from the entire vulva, and papules developed and were identified as lymphangiomas. A large amount of straw-colored discharge continued from all vulvar papules, which extended over the mons pubis. Nine years ago, the patient had undergone a radical hysterectomy with concurrent chemoradiation for uterine cervical cancer treatment. Her serum albumin level was 1.9 mg/dl, which was attributed to the loss of a large amount of lymph fluid due to leakage from the vulva. Her quality of life gradually decreased because of general fatigue and the need for frequent diaper exchanges every 2 h. The patient received a less-invasive treatment with cryotherapy using liquid nitrogen. She also received a multimodality treatment consisting of the intravenous administration of albumin, massage of the lower limbs and intensive rehabilitation. Cryotherapy was administered once a week for 3 months. Her discharge almost stopped and vulvar lymphangiomas decreased without any major complications. To the best of our knowledge, this is the first case report of massive lymphatic leakage complicated with vulvar lymphangiomas. Additionally, this case may represent the first successful treatment of vulva lymph leakage by cryotherapy without recurrence. Cryotherapy may have the potential to improve the quality of life as a less-invasive treatment for gynecological cancer survivors without serious complications. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Erect penile dimensions in a cohort of 778 Middle Eastern men: establishment of a nomogram.

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Habous, Mohamad; Tealab, Alaa; Williamson, Ben; Binsaleh, Saleh; El Dawy, Sherif; Mahmoud, Saad; Abdelwahab, Osama; Nassar, Mohammed; Mulhall, John P; Veale, David; Muir, Gordon

2015-06-01

Accurate data regarding the size of the erect penis are of great importance to several disciplines working with male patients, but little high-quality research exists on the subject, particularly in different ethnic groups and for erect penis size. The aim of this study was to create a nomogram of erect penile dimensions in a large sample of Middle Eastern men. A retrospective cohort study of 778 men (mean age 43.7; range 20-82) attending urological outpatient clinics in Saudi Arabia was conducted. Exclusion criteria were age under 18 years, a presenting complaint of small or short penis, Peyronie's disease or complaint of congenital curvature, clinical hypogonadism, and previous penile surgery or trauma. Three erect penile dimensions following induction of erection using intracavernosal injection of Quadrimix. Mean patient body mass index (BMI) was 29.09 (standard deviation [SD] 5.76). The mean suprapubic skin-to-penile tip erect length was 12.53 cm (SD 1.93); the mean erect length from the symphysis pubis to the penile tip was 14.34 cm (SD 1.86); and the mean erect shaft circumference was 11.50 cm (SD 1.74). A nomogram was constructed and statistical analysis performed, demonstrating a weak negative correlation between BMI and erect penile length measured from the suprapubic skin (r = -0.283, P Middle Eastern men can be used as a standard when advising men with small penis anxiety. The importance of measuring erect size and allowing for infra-pubic fat interference in measurement is emphasized. We envisage that this tool can be used to educate and reassure concerned men about the size of their penises. © 2015 International Society for Sexual Medicine.

Treatment of aneurysmal bone cysts by percutaneous CT-guided injection of calcitonin and steroid

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Chang, Connie Y.; Kattapuram, Susan V.; Huang, Ambrose J.; Simeone, F.J.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital, Department of Radiology Division of Musculoskeletal Imaging and Intervention, Boston, MA (United States)

2017-01-15

To determine the efficacy and safety of percutaneous calcitonin and steroid injection in the treatment of aneurysmal bone cysts (ABCs). Our study was IRB-approved and HIPAA-compliant. We reviewed pre- and post-procedural imaging studies and medical records of all CT-guided percutaneous injections of ABCs with calcitonin and steroid performed at our institution between 2003 and 2015. Treatment success based on imaging was categorized as substantial (51-100 %), partial (1-50 %), or none (0 %) by comparing radiographs of the lesion before and after treatment. Our study group comprised 9 patients (7 female, 2 male; mean age 19 ± 5 (range 12-25) years). ABCs were located in the pubis (n = 3), femur (n = 2), and humerus/scapula/ilium/sacrum (n = 1 for each). One patient did not have any clinical or imaging follow-up. For the other 8 patients, clinical and imaging follow-up ranged from 1 to 93 months (mean 16 ± 29 months). One patient had two injections, and 1 patient had three injections. Six out of eight patients (75 %) had complete symptomatic relief and 2 patients (25 %) had partial symptomatic relief after initial injection. Imaging follow-up revealed substantial imaging response in 4 out of 8 patients (50 %). There was a partial imaging response in 2 patients (25 %) and no imaging response in 2 out of 8 patients (25 %), and all 4 of these patients had local recurrence. There were no complications. Percutaneous CT-guided injection of ABCs with calcitonin and steroid is a safe and effective treatment. Lack of imaging response may necessitate more aggressive treatment to minimize local recurrence. (orig.)

Bone anatomy of the pelvic girdle, the thigh and the leg of Myrmecophaga tridactyla (Myrmecophagidae: Pilosa

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Lucas de Assis Ribeiro

2013-11-01

Full Text Available The giant anteater (Myrmecophaga tridactyla is the largest anteater species in the world. It is an animal of terrestrial habits, however, it has some ability to climb tall trees and termite mounds. The hard skeletal structures are of crucial importance, since they join and protect the soft organs and help support the body, shape, and get involved in movement. The appendicular skeleton is an important part of the locomotor apparatus, whose anatomical information in wild species is scarce, making it difficult to interpret data on these bones. This paper aims to describe the pelvic girdle, the thigh, and the leg skeleton in the giant anteater. We used two specimens of Myrmecophaga tridactyla Linnaeus (1758, fixed in a 3.7% aqueous formaldehyde solution. At first, the limbs were disjointed and we removed the skin, viscera, and muscles associated to the bones of the pelvic girdle, the thigh, and the leg in the specimens. Then, they were macerated in boiling water, and, subsequently, placed in a hydrogen peroxide solution. Once clean and dry, the bones were identified and described. The pelvic girdle skeleton in the giant anteater consists of the hip bone, formed by the ilium, pubis, and ischium bones; the thigh consists of the femur bone, and the leg consists of the tibia and fibula bones. In the knee joint region there is the patella, a relatively small sesamoid bone, considering the large size of this animal. The giant anteater have osteological features of the pelvic girdle, the thigh, and the leg similar to those in domestic carnivores, however, some morphological differences are made evident, something which may reflect differences in locomotor patterns.

Error quantification of osteometric data in forensic anthropology.

Science.gov (United States)

Langley, Natalie R; Meadows Jantz, Lee; McNulty, Shauna; Maijanen, Heli; Ousley, Stephen D; Jantz, Richard L

2018-04-10

This study evaluates the reliability of osteometric data commonly used in forensic case analyses, with specific reference to the measurements in Data Collection Procedures 2.0 (DCP 2.0). Four observers took a set of 99 measurements four times on a sample of 50 skeletons (each measurement was taken 200 times by each observer). Two-way mixed ANOVAs and repeated measures ANOVAs with pairwise comparisons were used to examine interobserver (between-subjects) and intraobserver (within-subjects) variability. Relative technical error of measurement (TEM) was calculated for measurements with significant ANOVA results to examine the error among a single observer repeating a measurement multiple times (e.g. repeatability or intraobserver error), as well as the variability between multiple observers (interobserver error). Two general trends emerged from these analyses: (1) maximum lengths and breadths have the lowest error across the board (TEMForensic Skeletal Material, 3rd edition. Each measurement was examined carefully to determine the likely source of the error (e.g. data input, instrumentation, observer's method, or measurement definition). For several measurements (e.g. anterior sacral breadth, distal epiphyseal breadth of the tibia) only one observer differed significantly from the remaining observers, indicating a likely problem with the measurement definition as interpreted by that observer; these definitions were clarified in DCP 2.0 to eliminate this confusion. Other measurements were taken from landmarks that are difficult to locate consistently (e.g. pubis length, ischium length); these measurements were omitted from DCP 2.0. This manual is available for free download online (https://fac.utk.edu/wp-content/uploads/2016/03/DCP20_webversion.pdf), along with an accompanying instructional video (https://www.youtube.com/watch?v=BtkLFl3vim4). Copyright © 2018 Elsevier B.V. All rights reserved.

When do anterior external or internal fixators provide additional stability in an unstable (Tile C) pelvic fracture? A biomechanical study.

Science.gov (United States)

Mcdonald, E; Theologis, A A; Horst, P; Kandemir, U; Pekmezci, M

2015-12-01

This study aimed at evaluating the additional stability that is provided by anterior external and internal fixators in an unstable pelvic fracture model (OTA 61-C). An unstable pelvic fracture (OTA 61-C) was created in 27 synthetic pelves by making a 5-mm gap through the sacral foramina (posterior injury) and an ipsilateral pubic rami fracture (anterior injury). The posterior injury was fixed with either a single iliosacral (IS) screw, a single trans-iliac, trans-sacral (TS) screw, or two iliosacral screws (S1S2). Two anterior fixation techniques were utilized: external fixation (Ex-Fix) and supra-acetabular external fixation and internal fixation (In-Fix); supra-acetabular pedicle screws connected with a single subcutaneous spinal rod. The specimens were tested using a nondestructive single-leg stance model. Peak-to-peak (P2P) displacement and rotation and conditioning displacement (CD) were calculated. The Ex-Fix group failed in 83.3 % of specimens with concomitant single-level posterior fixation (Total: 15/18-7 of 9 IS fixation, 8 of 9 TS fixation), and 0 % (0/9) of specimens with concomitant two-level (S1S2) posterior fixation. All specimens with the In-Fix survived testing except for two specimens treated with In-Fix combined with IS fixation. Trans-sacral fixation had higher pubic rotation and greater sacral and pubic displacement than S1S2 (p < 0.05). Rotation of the pubis and sacrum was not different between In-Fix constructs combined with single-level IS and TS fixation. In this model of an unstable pelvic fracture (OTA 61-C), anterior fixation with an In-Fix was biomechanically superior to an anterior Ex-Fix in the setting of single-level posterior fixation. There was no biomechanical difference between the In-Fix and Ex-Fix when each was combined with two levels of posterior sacral fixation.

Review of forensically important entomological specimens in the period of 1972 - 2002.

Science.gov (United States)

Lee, H L; Krishnasamy, M; Abdullah, A G; Jeffery, J

2004-12-01

Forensic entomological specimens received by the Unit of Medical Entomology, IMR., from hospitals and the police in Malaysia in the last 3 decades (1972 - 2002) are reviewed. A total of 448 specimens were received. From these, 538 identifications were made with the following results: Eighteen species of cyclorrphaga flies were identified consisting of Chrysomya megacephala (Fabricius) 215 cases (47.99%), Ch. rufifacies (Masquart) 132 (29.46%), Ch. villeneuvi Patton 10 (2.23%), Ch. nigripes Aubertin 7 (1.56%), Ch. bezziana Villeneuve 4 (0.89%), Ch. pinguis (Walker) 1 (0.22%), Chrysomya sp. 47 (10.49%), Sarcophaga sp. 28 (6.25%), Lucilia sp. 21 (4.69%), Hermetia sp. 15 (3.35%), He. illucens (Linnaeus) 1 (0.22%), Hemipyrellia ligurriens (Wiedemann) 3 (0.67%), Hemipyrellia sp. 2 (0.45%), Ophyra spinigera 1 (0.22%), Ophyra sp. 6 (1.34%), Calliphora sp. 24 (5.36%), Synthesiomyia nudiseta (Wulp) 1 (0.22%) and Eristalis sp. 1 (0.22%). Other non - fly insect specimens are Pthirus pubis (Linnaeus) (Pubic louse) 2 (0.45%) and Coleoptera (Beetles) 1 (0.22%). Ch. megacephala and Ch. rufifacies were the commonest species found in cadavers from different ecological habitats. Sy. nudiseta is an uncommon species, thus far found only on cadavers from indoors. Sy. nudiseta is reported for the second time in Peninsular Malaysia. A total of 329 cases (73.44%) had a single fly infestation, 109 cases (24.33%) had double fly infestation and 10 cases (2.23%) had triple fly infestation. Five cases (1.12%) had eggs and 3 cases (0.67%) had larval stages that were not identifiable. No arthropods were retrieved from cadavers in 8 cases (1.79%). In conclusion, although large number of fly species were found on human cadavers, the predominant species are still those of Chrysomya.

Searching for ski-lift injury: an uphill struggle?

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Smartt, Pam; Chalmers, David

2010-03-01

Injuries arising from ski-lift malfunction are rare. Most arise from skier error when embarking or disembarking, or from improper lift operation. A search of the literature failed to uncover any studies focusing specifically on ski-lift injuries. The purpose of this study was to identify and characterise ski-lift injury resulting in hospitalisation and comment on barriers to reporting and reporting omissions. New Zealand hospitalised injury discharges 2000-2005 formed the primary dataset. To aid case identification these data were linked to ACC compensated claims for the same period and the data searched for all hospitalised cases of injury arising from ski-lifts. 44 cases were identified representing 2% of snow-skiing/snowboarding cases. 28 cases (64%) were male and 16 (36%) female, the average age was 32 yrs (range 5-73 yrs). The majority of cases were snow-skiers (35 cases, 80%). Most of the injuries were serious, or potentially so, with 1 case of traumatic pneumothorax, one of pulmonary embolism (after jumping from a ski-lift) and 28 cases sustaining fractures (six to the neck-of-femur, one to the lumbar spine and one to the pubis). ICISS scores for all cases ranged from 1.00 to 0.8182 (probability of dying in hospital 0-18.18%). Only 14 (32%) cases could be easily identified from ICD-10-AM e-codes and activity codes in the discharge summary. The ICD-10-AM external cause code for ski-lift injury V98 ("other specified transport accidents") was only assigned to 39% of cases. The type of ski-lift could only be determined in 24 cases (55%). Copyright 2009 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

A minimally invasive technique using a modified stoppa approach for periacetabular osteotomy: A preliminary cadaveric study

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Turgut Akgul

2017-01-01

Full Text Available Background: Developmental hip dysplasia is diagnosed when the femoral head is not sufficiently covered by the acetabulum. Anterior and lateral cover deficiency is seen, as a result a dysplastic hip joint. Various incision modifications have been developed because of the muscle dissection and wide wound scar in Smith-Peterson incision, which was originally used in Bernese osteotomy. This study evaluates applicability of the modified Stoppa approach in the performance of Bernese periacetabular osteotomy (PAO. Materials and Methods: Ten hemipelvises of five donor cadavers were used. The transverse Stoppa incision was made 2 cm over the symphysis pubis for quadrilateral surface exposure and pubic and ischial bone osteotomies. The second skin incision, a few centimeters lateral to the original incision, was made along the tensor fascia lata. Iliac bone osteotomy was performed starting just above the rectus femoris insertion. The displacement of the osteotomy was measured clinically and radiographically. Results: The mean anterior coverage calculated with center-edge angle was improved from 22.8° ±2.8 (range 20° min–28° max preoperatively to 44.1° ± 3.7 (range 36° min–48° max. The displacement of the osteotomy at the iliopectineal line calculated on the iliac inlet view radiographs was 22.1 ± 3.4 mm (range 15 mm min–26 mm max. The clinical amount of the anterior displacement on the cadavers was 17.8 ± 3.35 mm (range 11 mm–21 mm and lateral displacement was 20.3 ± 3.23 mm (range 15 mm–24 mm. The amount of the posterior intact bone enlargement at the quadrilateral surface was 5.3 ± 0.48 mm. Conclusion: This less traumatic two-incision exposure is an adequate technique for Bernese PAO, allowing the bone to be cut under direct visual observation and reducing the need to use fluoroscopy.

Morphometric analysis of torso arterial anatomy with implications for resuscitative aortic occlusion.

Science.gov (United States)

Stannard, Adam; Morrison, Jonathan J; Sharon, Danny J; Eliason, Jonathan L; Rasmussen, Todd E

2013-08-01

Hemorrhage is a leading cause of death in military and civilian trauma. Despite the importance of the aorta as a site of hemorrhage control and resuscitative occlusion, detailed knowledge of its morphometry is lacking. The objective of this study was to characterize aortic morphometry in a trauma population, including quantification of distances as well as and diameters and definition of relevant aortic zones. Center line measures were made (Volume Viewer) from contrast computed tomography (CT) scans of male trauma patients (18-45 years). Aortic zones were defined based on branch arteries. Zone I includes left subclavian to celiac; Zone II includes celiac to caudal renal; Zone III includes caudal renal to aortic bifurcation. Zone lengths were calculated and correlated to a novel external measure of torso extent (symphysis pubis to sternal notch). Eighty-eight males (mean [SD], 28 [4] years) had CT scans for the study. The median (interquartile range) lengths (mm) of Zones I, II, and III were 210 mm (202-223 mm), 33 mm (28-38 mm), and 97 mm (91-103 mm), respectively. Median aortic diameters at the left subclavian, celiac, and lowest renal arteries were 21 mm (20-23 mm), 18 mm (16-19 mm), and 15 mm (14-16 mm), respectively, and the terminal aortic diameter was 14 mm (13-15 mm). The correlation of determination for descending aortic length (all zones) against torso extend was r = 0.454. This study provides a morphometric analysis of the aorta in a male population, demonstrating consistency of length and diameter while defining distinct axial zones. Findings suggest that center line aortic distances correlate with a simple, external measure of torso extent. Morphometric study of the aorta using CT data may facilitate the development and implementation of occlusion techniques to manage noncompressible torso, pelvic, and junctional femoral hemorrhage.

Women who prefer longer penises are more likely to have vaginal orgasms (but not clitoral orgasms): implications for an evolutionary theory of vaginal orgasm.

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Costa, Rui Miguel; Miller, Geoffrey F; Brody, Stuart

2012-12-01

Research indicates that (i) women's orgasm during penile-vaginal intercourse (PVI) is influenced by fitness-related male partner characteristics, (ii) penis size is important for many women, and (iii) preference for a longer penis is associated with greater vaginal orgasm consistency (triggered by PVI without concurrent clitoral masturbation). To test the hypothesis that vaginal orgasm frequency is associated with women's reporting that a longer than average penis is more likely to provoke their PVI orgasm. Three hundred twenty-three women reported in an online survey their past month frequency of various sexual behaviors (including PVI, vaginal orgasm, and clitoral orgasm), the effects of a longer than average penis on likelihood of orgasm from PVI, and the importance they attributed to PVI and to noncoital sex. Univariate analyses of covariance with dependent variables being frequencies of various sexual behaviors and types of orgasm and with independent variable being women reporting vs. not reporting that a longer than average penis is important for their orgasm from PVI. Likelihood of orgasm with a longer penis was related to greater vaginal orgasm frequency but unrelated to frequencies of other sexual behaviors, including clitoral orgasm. In binary logistic regression, likelihood of orgasm with a longer penis was related to greater importance attributed to PVI and lesser importance attributed to noncoital sex. Women who prefer deeper penile-vaginal stimulation are more likely to have vaginal orgasm, consistent with vaginal orgasm evolving as part of a female mate choice system favoring somewhat larger than average penises. Future research could extend the findings by overcoming limitations related to more precise measurement of penis length (to the pubis and pressed close to the pubic bone) and girth, and large representative samples. Future experimental research might assess to what extent different penis sizes influence women's satisfaction and likelihood

Perineal Ultrasound Findings of Stress Urinary Incontinence : Differentiation from Normal Findings

International Nuclear Information System (INIS)

Baek, Seung Yon; Chung, Eun Chul; Rhee, Chung Sik; Suh, Jeong Soo

1995-01-01

Perineal ultrasonography is a noninvasive method that is easier than chain cystoure-thrography in the diagnosis of stress urinary incontinence(SUI). We report the findings of stress urinary incontinence at peritoneal ultrasound and its differential points form normal control. Twenty-two patients with SUI and l6 normal controls were included in our study. Aloka SSD 650 with 3.5MHz convex transducer was used, and sagittal image through the bladder, bladder base, urethrovesical junction and pubis was obtained from the vulva area, We measured thepdsterior urethrovesical angle(PUVA) at rest and stress, and calculated the difference between the two angles. We also measured the distance of bladder neck descent during stress and the diameter of proximal urethra at rest. The data were analyzed with student t-test. At rest, PUVA was 135.3 .deg. in patients with SUI group and 134.5 .deg. in normal control group(P=0.8376). During streets, PUVA was 149.5 .deg. in SUI group and 142.1 .deg. in normal group(P=0.0135). The difference PUVAs at rest and during stress was 14.2 .deg. in SUI group and 7.6 .deg. in normal group(P=0.0173). The distance of bladder neck descent during stress was 14.5mm in SUI group and 9.8mm in normal group(P=0.0029). The diameter of proxiaml urethra at rest was 4.4mm in SUI group and 3.6mm in normal group(P=0.0385). In conclusion, ultrasound parameters that include the PUVA during stress, the difference between PUVAs at rest and during stress, the distance of bladder neck descent during stress and the diameter of proximal ureyhra at rest are useful in diagnosis of the stress urinary incontinence

Degradation of endogenous and exogenous genes of genetically modified rice with Cry1Ab during food processing.

Science.gov (United States)

Zhang, Wei; Xing, Fuguo; Selvaraj, Jonathan Nimal; Liu, Yang

2014-05-01

In order to assess the degradation of endogenous and exogenous genes during food processing, genetically modified rice with Cry1Ab was used as raw material to produce 4 processed foods: steamed rice, rice noodles, rice crackers, and sweet rice wine. The results showed various processing procedures caused different degrees of degradation of both endogenous and exogenous genes. During the processing of steamed rice and rice noodles, the procedures were so mild that only genes larger than 1500 bp were degraded, and no degradation of NOS terminator and Hpt gene was detected. For rice crackers, frying was the most severe procedure, followed by microwaving, baking, boiling, 1st drying, and 2nd drying. For sweet rice wine, fermentation had more impact on degradation of genes than the other processing procedures. All procedures in this study did not lead to degradation of genes to below 200 bp, except for NOS terminator. In the case of stability of the genes studied during processing of rice crackers and sweet rice wine, SPS gene was the most, followed by the Cry1Ab gene, Hpt gene, Pubi promoter, and NOS terminator. In our study, we gained some information about the degradation of endogenous and exogenous genes during 4 foods processing, compared the different stabilities between endogenous and exogenous genes, and analyzed different effects of procedure on degradation of genes. In addition, the fragments of endogenous and exogenous genes about 200 bp could be detected in final products, except NOS terminator. As a result, we provided some base information about risk assessment of genetically modified (GM) food and appropriate length of fragment to detect GM component in processed foods. © 2014 Institute of Food Technologists®

The recognition and evaluation of patterns of compensatory injury in patients with mechanical hip pain.

Science.gov (United States)

Hammoud, Sommer; Bedi, Asheesh; Voos, James E; Mauro, Craig S; Kelly, Bryan T

2014-03-01

In active individuals with femoroacetabular impingement (FAI), the resultant reduction in functional range of motion leads to high impaction loads at terminal ranges. These increased forces result in compensatory effects on bony and soft tissue structures within the hip joint and hemipelvis. An algorithm is useful in evaluating athletes with pre-arthritic, mechanical hip pain and associated compensatory disorders. A literature search was performed by a review of PubMed articles published from 1976 to 2013. Level 4. Increased stresses across the bony hemipelvis result when athletes with FAI attempt to achieve supraphysiologic, terminal ranges of motion (ROM) through the hip joint required for athletic competition. This can manifest as pain within the pubic joint (osteitis pubis), sacroiliac joint, and lumbosacral spine. Subclinical posterior hip instability may result when attempts to increase hip flexion and internal rotation are not compensated for by increased motion through the hemipelvis. Prominence of the anterior inferior iliac spine (AIIS) at the level of the acetabular rim can result in impingement of the anterior hip joint capsule or iliocapsularis muscle origin against the femoral head-neck junction, resulting in a distinct form of mechanical hip impingement (AIIS subspine impingement). Iliopsoas impingement (IPI) has also been described as an etiology for anterior hip pain. IPI results in a typical 3-o'clock labral tear as well as an inflamed capsule in close proximity to the overlying iliopsoas tendon. Injury in athletic pubalgia occurs during high-energy twisting activities in which abnormal hip ROM and resultant pelvic motion lead to shearing across the pubic symphysis. Failure to recognize and address concomitant compensatory injury patterns associated with intra-articular hip pathology can result in significant disability and persistent symptoms in athletes with pre-arthritic, mechanical hip pain. B.

Laparoscopic hernia repair with adductor tenotomy for athletic pubalgia: an established procedure for an obscure entity.

Science.gov (United States)

Rossidis, Georgios; Perry, Andrew; Abbas, Husain; Motamarry, Isaac; Lux, Tamara; Farmer, Kevin; Moser, Michael; Clugston, Jay; Caban, Angel; Ben-David, Kfir

2015-02-01

Athletic pubalgia is a syndrome of chronic lower abdomen and groin pain that occurs in athletes. It is the direct result of stress and microtears of the rectus abdominis inserting on the pubis from the antagonizing adductor longus muscles, and weakness of the posterior transversalis fascia and bulging of the inguinal floor. Under IRB approval, we conducted a retrospective review of our prospectively competitive athlete patients with athletic pubalgia from 2007 to 2013. A cohort of 54 patients was examined. Mean age was 22.4 years. Most patients were football players (n = 23), triathlon (n = 11), track and field (n = 6), soccer players (n = 5), baseball players (n = 4), swimmers (n = 3), golfer (n = 1), and tennis player (n = 1). Fifty one were males and three were females. All patients failed medical therapy with physiotherapy prior to surgery. 76 % of patients had an MRI performed with 26 % having a right rectus abdominis stripping injury with concomitant strain at the adductor longus musculotendinous junction. 7 % of patients had mild nonspecific edema in the distal bilateral rectus abdominis muscles without evidence of a tear. Twenty patients had no findings on their preoperative MRI, and only one patient was noted to have an inguinal hernia on MRI. All patients underwent laparoscopic totally extraperitoneal inguinal hernia repair with synthetic mesh and ipsilateral adductor longus tenotomy. All patients were able to return to full sports-related activity in 24 days (range 21-28 days). One patient experienced urinary retention and another sustained an adductor brevis hematoma 3 months after completion of rehabilitation and surgical intervention. Mean follow up was 18 months. Athletic pubalgia is a disease with a multifactorial etiology that can be treated surgically by a laparoscopic totally extraperitoneal hernia repair with synthetic mesh accompanied with an ipsilateral adductor longus tenotomy allowing patients to return to sports-related activity early with

Inguinal Hernia in Athletes: Role of Dynamic Ultrasound.

Science.gov (United States)

Vasileff, William Kelton; Nekhline, Mikhail; Kolowich, Patricia A; Talpos, Gary B; Eyler, Willam R; van Holsbeeck, Marnix

Inguinal hernia is a commonly encountered cause of pain in athletes. Because of the anatomic complexity, lack of standard imaging, and the dynamic condition, there is no unified opinion explaining its underlying pathology. Athletes with persistent groin pain would have a high prevalence of inguinal hernia with dynamic ultrasound, and herniorrhaphy would successfully return athletes to activity. Case-control study. Level 3. Forty-seven amateur and professional athletes with sports-related groin pain who underwent ultrasound were selected based on history and examination. Patients with prior groin surgery or hip pathology were excluded. Clinical and surgical documentation were correlated with imaging. The study group was compared with 41 age-matched asymptomatic athletes. Ultrasound was positive for hernia with movement of bowel, bladder, or omental tissue anterior to the inferior epigastric vessels during Valsalva maneuver. The 47-patient symptomatic study group included 41 patients with direct inguinal hernias, 1 with indirect inguinal hernia, and 5 with negative ultrasound. Of 42 patients with hernia, 39 significantly improved with herniorrhaphy, 2 failed to improve after surgery and were diagnosed with adductor longus tears, and 1 improved with physical therapy. Five patients with negative ultrasound underwent magnetic resonance imaging and were diagnosed with hip labral tear or osteitis pubis. The 41-patient asymptomatic control group included 3 patients with direct inguinal hernias, 2 with indirect inguinal hernias, and 3 with femoral hernias. Inguinal hernias are a major component of groin pain in athletes. Prevalence of direct inguinal hernia in symptomatic athletes was greater than that for controls ( P < 0.001). Surgery was successful in returning these athletes to sport: 39 of 42 (93%) athletes with groin pain and inguinal hernia became asymptomatic. Persistent groin pain in the athlete may relate to inguinal hernia, which can be diagnosed with dynamic

Automated bone segmentation from large field of view 3D MR images of the hip joint

International Nuclear Information System (INIS)

Xia, Ying; Fripp, Jurgen; Chandra, Shekhar S; Schwarz, Raphael; Engstrom, Craig; Crozier, Stuart

2013-01-01

Accurate bone segmentation in the hip joint region from magnetic resonance (MR) images can provide quantitative data for examining pathoanatomical conditions such as femoroacetabular impingement through to varying stages of osteoarthritis to monitor bone and associated cartilage morphometry. We evaluate two state-of-the-art methods (multi-atlas and active shape model (ASM) approaches) on bilateral MR images for automatic 3D bone segmentation in the hip region (proximal femur and innominate bone). Bilateral MR images of the hip joints were acquired at 3T from 30 volunteers. Image sequences included water-excitation dual echo stead state (FOV 38.6 × 24.1 cm, matrix 576 × 360, thickness 0.61 mm) in all subjects and multi-echo data image combination (FOV 37.6 × 23.5 cm, matrix 576 × 360, thickness 0.70 mm) for a subset of eight subjects. Following manual segmentation of femoral (head–neck, proximal-shaft) and innominate (ilium+ischium+pubis) bone, automated bone segmentation proceeded via two approaches: (1) multi-atlas segmentation incorporating non-rigid registration and (2) an advanced ASM-based scheme. Mean inter- and intra-rater reliability Dice's similarity coefficients (DSC) for manual segmentation of femoral and innominate bone were (0.970, 0.963) and (0.971, 0.965). Compared with manual data, mean DSC values for femoral and innominate bone volumes using automated multi-atlas and ASM-based methods were (0.950, 0.922) and (0.946, 0.917), respectively. Both approaches delivered accurate (high DSC values) segmentation results; notably, ASM data were generated in substantially less computational time (12 min versus 10 h). Both automated algorithms provided accurate 3D bone volumetric descriptions for MR-based measures in the hip region. The highly computational efficient ASM-based approach is more likely suitable for future clinical applications such as extracting bone–cartilage interfaces for potential cartilage segmentation. (paper)

Automated bone segmentation from large field of view 3D MR images of the hip joint

Science.gov (United States)

Xia, Ying; Fripp, Jurgen; Chandra, Shekhar S.; Schwarz, Raphael; Engstrom, Craig; Crozier, Stuart

2013-10-01

Accurate bone segmentation in the hip joint region from magnetic resonance (MR) images can provide quantitative data for examining pathoanatomical conditions such as femoroacetabular impingement through to varying stages of osteoarthritis to monitor bone and associated cartilage morphometry. We evaluate two state-of-the-art methods (multi-atlas and active shape model (ASM) approaches) on bilateral MR images for automatic 3D bone segmentation in the hip region (proximal femur and innominate bone). Bilateral MR images of the hip joints were acquired at 3T from 30 volunteers. Image sequences included water-excitation dual echo stead state (FOV 38.6 × 24.1 cm, matrix 576 × 360, thickness 0.61 mm) in all subjects and multi-echo data image combination (FOV 37.6 × 23.5 cm, matrix 576 × 360, thickness 0.70 mm) for a subset of eight subjects. Following manual segmentation of femoral (head-neck, proximal-shaft) and innominate (ilium+ischium+pubis) bone, automated bone segmentation proceeded via two approaches: (1) multi-atlas segmentation incorporating non-rigid registration and (2) an advanced ASM-based scheme. Mean inter- and intra-rater reliability Dice's similarity coefficients (DSC) for manual segmentation of femoral and innominate bone were (0.970, 0.963) and (0.971, 0.965). Compared with manual data, mean DSC values for femoral and innominate bone volumes using automated multi-atlas and ASM-based methods were (0.950, 0.922) and (0.946, 0.917), respectively. Both approaches delivered accurate (high DSC values) segmentation results; notably, ASM data were generated in substantially less computational time (12 min versus 10 h). Both automated algorithms provided accurate 3D bone volumetric descriptions for MR-based measures in the hip region. The highly computational efficient ASM-based approach is more likely suitable for future clinical applications such as extracting bone-cartilage interfaces for potential cartilage segmentation.

Success of nonoperative management of adductor longus tendon ruptures in National Football League athletes.

Science.gov (United States)

Schlegel, Theodore F; Bushnell, Brandon D; Godfrey, Jenna; Boublik, Martin

2009-07-01

Acute complete ruptures of the proximal adductor longus tendon are rare but challenging injuries to treat. The limited literature supports operative treatment, but data from management of chronic groin pain in athletes indicate that anatomical attachment of the tendon to the pubis may not be required for high-level function. Nonoperative management of complete adductor rupture can provide equal results to surgical repair in terms of return to play in the National Football League. Case series; Level of evidence, 4. Using the National Football League Injury Surveillance System, adductor tendon ruptures documented by magnetic resonance imaging were identified in 19 National Football League players from 1992 to 2004. The team physician for each respective player completed a survey with information about history, physical examination, magnetic resonance imaging findings, treatment, and outcomes. Statistics were analyzed with a Student unpaired t test. Fourteen players were treated nonoperatively, and 5 players were treated with surgical repair using suture anchors. In both groups, all players eventually returned to play in the National Football League. Mean time for return to play was 6.1 +/- 3.1 weeks (range, 3-12 weeks) for the nonoperative group and 12.0 +/- 2.5 weeks (range, 10-16 weeks) for the operative group (P = .001). One player in the operative group suffered the complication of a draining wound and heterotopic ossification. Players represented a variety of positions, and 12 of 19 (63%) had experienced prior symptoms or events. Nonoperative treatment of proximal adductor tendon rupture results in a statistically significantly faster return to play than does operative treatment in athletes competing in the National Football League and avoids the risks associated with surgery while providing an equal likelihood of return to play at the professional level.

Usefulness of perineal ultrasonography after tension-free vaginal tape procedure for stress urinary incontinence

International Nuclear Information System (INIS)

Yoon, Seong Kuk

2005-01-01

To evaluate the usefulness of perineal ultrasonography after a tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence. Thirty-four patients with stress urinary incontinence who underwent the TVT procedure were included in this study. We compared the perineal ultrasonography findings before and after the procedure. The mean age was 49 years (rang: 32-75 years) and the mean follow-up time was 9.5 days (range: 5-19 days). We obtained the entire sagittal image of the bladder neck, urethra, urethrovesical junction and symphysis pubis. The posterior urethrovesical angle (PUVA) and descent of the bladder neck at rest and during stress, and the diameter of proximal urethra at rest were all evaluated. We compared these ultrasonographic changes before and after the procedure. Before the TVT procedure, the PUVA was 134.7 ± 5.9 .deg. at rest and 146.8 ± 8.5 .deg. during stress, and the difference between PUVA at rest and during stress was 12.2 ± 7.3 .deg. . After the TVT procedure, the PUVA significantly decreased to 125.6 ± 7.5 .deg. at rest and 132.5 ± 8.3 .deg. during stress, and the difference also significantly decreased to 7.0 ± 5.0 .deg. (ρ < 0.01). Before the procedure, the descent of the bladder neck was 17 ± 7.0 mm, while the descent significantly decreased to 7.7 ± 4.1 mm after the procedure (ρ < 0.01). Before the procedure, the diameter of the proximal urethra was 5.6 ± 1.4 mm at rest, but the diameter was 5.5 ± 1.1 mm, without significant change, after the procedure. Follow-up perineal ultrasonography after the TVT procedure may be useful for evaluating changes including the PUVA, descent and appearance of the bladder neck

Usefulness of perineal ultrasonography after tension-free vaginal tape procedure for stress urinary incontinence

Energy Technology Data Exchange (ETDEWEB)

Yoon, Seong Kuk [Donga University College of Medicine, Busan (Korea, Republic of)

2005-07-15

To evaluate the usefulness of perineal ultrasonography after a tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence. Thirty-four patients with stress urinary incontinence who underwent the TVT procedure were included in this study. We compared the perineal ultrasonography findings before and after the procedure. The mean age was 49 years (rang: 32-75 years) and the mean follow-up time was 9.5 days (range: 5-19 days). We obtained the entire sagittal image of the bladder neck, urethra, urethrovesical junction and symphysis pubis. The posterior urethrovesical angle (PUVA) and descent of the bladder neck at rest and during stress, and the diameter of proximal urethra at rest were all evaluated. We compared these ultrasonographic changes before and after the procedure. Before the TVT procedure, the PUVA was 134.7 {+-} 5.9 .deg. at rest and 146.8 {+-} 8.5 .deg. during stress, and the difference between PUVA at rest and during stress was 12.2 {+-} 7.3 .deg. . After the TVT procedure, the PUVA significantly decreased to 125.6 {+-} 7.5 .deg. at rest and 132.5 {+-} 8.3 .deg. during stress, and the difference also significantly decreased to 7.0 {+-} 5.0 .deg. ({rho} < 0.01). Before the procedure, the descent of the bladder neck was 17 {+-} 7.0 mm, while the descent significantly decreased to 7.7 {+-} 4.1 mm after the procedure ({rho} < 0.01). Before the procedure, the diameter of the proximal urethra was 5.6 {+-} 1.4 mm at rest, but the diameter was 5.5 {+-} 1.1 mm, without significant change, after the procedure. Follow-up perineal ultrasonography after the TVT procedure may be useful for evaluating changes including the PUVA, descent and appearance of the bladder neck.

Perineal Ultrasound Findings of Stress Urinary Incontinence : Differentiation from Normal Findings

Energy Technology Data Exchange (ETDEWEB)

Baek, Seung Yon; Chung, Eun Chul; Rhee, Chung Sik; Suh, Jeong Soo [Ewha Womans University Hospital, Seoul (Korea, Republic of)

1995-06-15

Perineal ultrasonography is a noninvasive method that is easier than chain cystoure-thrography in the diagnosis of stress urinary incontinence(SUI). We report the findings of stress urinary incontinence at peritoneal ultrasound and its differential points form normal control. Twenty-two patients with SUI and l6 normal controls were included in our study. Aloka SSD 650 with 3.5MHz convex transducer was used, and sagittal image through the bladder, bladder base, urethrovesical junction and pubis was obtained from the vulva area, We measured thepdsterior urethrovesical angle(PUVA) at rest and stress, and calculated the difference between the two angles. We also measured the distance of bladder neck descent during stress and the diameter of proximal urethra at rest. The data were analyzed with student t-test. At rest, PUVA was 135.3 .deg. in patients with SUI group and 134.5 .deg. in normal control group(P=0.8376). During streets, PUVA was 149.5 .deg. in SUI group and 142.1 .deg. in normal group(P=0.0135). The difference PUVAs at rest and during stress was 14.2 .deg. in SUI group and 7.6 .deg. in normal group(P=0.0173). The distance of bladder neck descent during stress was 14.5mm in SUI group and 9.8mm in normal group(P=0.0029). The diameter of proxiaml urethra at rest was 4.4mm in SUI group and 3.6mm in normal group(P=0.0385). In conclusion, ultrasound parameters that include the PUVA during stress, the difference between PUVAs at rest and during stress, the distance of bladder neck descent during stress and the diameter of proximal ureyhra at rest are useful in diagnosis of the stress urinary incontinence

Use of CT simulation for treatment of cervical cancer to assess the adequacy of lymph node coverage of conventional pelvic fields based on bony landmarks

International Nuclear Information System (INIS)

Finlay, Marisa H.; Ackerman, Ida; Tirona, Romeo G. B.Sc.; Hamilton, Paul; Barbera, Lisa; Thomas, Gillian

2006-01-01

Purpose: To assess the adequacy of nodal coverage of 'conventional' pelvic radiation fields for carcinoma of the cervix, with contoured pelvic vessels on simulation computed tomography (CT) as surrogates for lymph node location. Methods and Materials: Pelvic arteries were contoured on non-contrast-enhanced CT simulation images of 43 patients with cervix cancer, FIGO Stages I-III. Vessel contours were hidden, and conventional pelvic fields were outlined: (1) anterior/posterior fields (AP): superior border, L5-S1 interspace; inferior border, obturator foramina; lateral border, 2 centimeters lateral to pelvic brim. (2) Lateral fields (LAT): Anterior border, symphysis pubis; posterior border, S2-S3 interspace. Distances were measured between the following: (1) bifurcation of the common iliac artery and superior border (2) external iliac artery and lateral border of the AP field, and (3) external iliac artery and anterior border of the LAT field. The distances were considered as 'inadequate' if 20 mm. Results: Superiorly, 34 patients (79.1%) had inadequate coverage. On the AP, margins were generous in 19 (44.2%), but inadequate in 9 (20.9%). On the LAT, margins were inadequate in 30 (69.8%) patients. Overall, 41 (95.4%, CI, 84.2%-99.4%) patients had at least 1 inadequate margin, the majority located superiorly. Twenty-four (55.8%; CI, 39.9%-70.9%) patients had at least 1 generous margin, the majority located laterally on the AP field. Conclusion: Conventional pelvic fields based on bony landmarks do not provide optimal lymph node coverage in a substantial proportion of patients and may include excess normal tissue in some. CT simulation with vessel contouring as a surrogate for lymph node localization provides more precise and individualized field delineation

[Cosmetic surgery of the male genitalia].

Science.gov (United States)

Chevallier, D; Haertig, A; Faix, A; Droupy, S

2013-07-01

To describe the indications and results of techniques to change the appearance of the penis for aesthetic reasons. Provide recommendations concerning cosmetic surgery of the male genitalia. We have selected from Medline Database, articles published between 1990 and 2011. Forty articles have been selected excluding papers reporting populations less than five cases per type of procedure. There is no consensus on the size below which it is justifiable to accept or attempt to modify the size of the penis. Length of the penis in maximal tension less than 9.5 cm or 10 cm in erection can be considered as an acceptable limit, in a patient who suffers from it. The assessment of men asking for penile enlargement must include a psychosexological or psychiatric evaluation, looking for a dysmorphophobia or another psychiatric condition. Penile extenders under medical control must be the first-line treatment option for patient seeking penile lenghtening procedure when justified. In case of failure, three techniques can be used alone or in combination: penile lengthening by section of the suspensory ligaments and suprapubic skin advancement, lipectomy of Mons pubis and scrotal webbing section. The results are modest, the rate of complications significant and satisfaction low. Girth enlargement techniques by injection of autologous fat give inconsistent aesthetic results and satisfaction rates are low. All other techniques remain experimental. Cosmetic surgery of the penis is associated with a high risk of forensic exposure and surgery should be only proposed after a multidisciplinary consensus, followed by a time of reflection given to the patient after full disclosure. Applications for the purpose of reconstruction surgery after trauma or consequences of cancer treatment are justified. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Dinosaurios del Cretácico inferior de Galve (Teruel, España

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Santafé, J. V.

1987-12-01

Full Text Available The aim of this paper is to complete the study of the Dinosaur fauna of the syncline of Galve (Teruel, Spain. Most of the outcrops are Early Barremian in age. Nevertheless, the outcrop called Las Zabacheras could be Hauterivian and El Pelejón Hauterivian-Early Barremian in age. Theropod Dinosaurs are poorly represented. Three vertebral centra are described. They are identified as Theropoda indet. The several outcrops of Galve have yielded four forms of Sauropods. Three of them (cf. Astrodon sp., Camarasauridae indet., form A, Camarasauridae indet., form B have been identified based on isolated teeth. The Sauropod from Las Zabacheras (Lapparent, 1960; Sanz, 1982 has been proposed as a new taxon, Aragosaurus ischiaticus n. gen. et n. sp. The material which the new taxon is based on are the bones studied by Lapparent (Museo de la Diputación de Teruel and new ones: caudal vertebrae, chevrones, seapula, ilium, femur and autopodial material. After a research on evolutive polarity of some traits within the Sauropoda, the apomorphic character-states which define the new taxon are as follows: First caudal vertebrae with a great transversal development of the neuroapophysis (club-like, seapular blade terminally expansioned, with an intermediate development (for example between Cetiosaurs and Brachiosaurus or Rebbachisaurus. Great dorso-ventral development (acromio-glenoideus of the anterior seapular zone (ratio miminal width of the seapular blade/maximal acromio-glenoideus height of 0.27. lliac process of ischium well developed. Pubic process of ischium with great dorso-ventral development (ratio antero-posterior length of this process/lenght of ischiadic contact with pubis, 0.63. Ischiadic process of ischium with a conspicuous final expansion. Lenght ratio humerus/femur 0.82. Lateral bulge just distal to the femoral greater trochanter. Medial condyle of femur relatively developed (ratio maximal antero-posterior diameter of medial condyle

Solanum trilobatum extract-mediated synthesis of titanium dioxide nanoparticles to control Pediculus humanus capitis, Hyalomma anatolicum anatolicum and Anopheles subpictus.

Science.gov (United States)

Rajakumar, Govindasamy; Rahuman, Abdul Abdul; Jayaseelan, Chidambaram; Santhoshkumar, Thirunavukkarasu; Marimuthu, Sampath; Kamaraj, Chinnaperumal; Bagavan, Asokan; Zahir, Abdul Abduz; Kirthi, Arivarasan Vishnu; Elango, Gandhi; Arora, Pooja; Karthikeyan, Rajan; Manikandan, Sivan; Jose, Sujin

2014-02-01

Titanium dioxide nanoparticles (TiO2 NPs) are widely used in paints, printing ink, rubber, paper, cosmetics, sunscreens, car materials, cleaning air products, industrial photocatalytic processes, and decomposing organic matters in wastewater due to their unique physical, chemical, and biological properties. The present study was conducted to assess the antiparasitic efficacies of synthesized TiO2 NPs utilizing leaf aqueous extract of Solanum trilobatum against the adult head louse, Pediculus humanus capitis De Geer (Phthiraptera: Pediculidae); larvae of cattle tick Hyalomma anatolicum (a.) anatolicum Koch (Acari: Ixodidae), and fourth instar larvae of malaria vector Anopheles subpictus Grassi (Diptera: Culicidae). The green synthesized TiO2 NPs were analyzed by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), Scanning electron microscopy (SEM), Energy-dispersive X-ray spectroscopy analysis (EDX), and Atomic force microscopy (AFM). XRD analysis of synthesized TiO2 NPs revealed that the particles were in the form of nanocrystals as evidenced by the major peaks at 2θ values of 27.52°, 36.21°, and 54.43° identified as 110, 101, and 211 reflections, respectively. FTIR spectra exhibited a prominent peak at 3,466 cm(-1) and showed OH stretching due to the alcoholic group, and the OH group may act as a capping agent. SEM images displayed NPs that were spherical, oval in shape, individual, and some in aggregates with an average size of 70 nm. Characterization of the synthesized TiO2 NPs using AFM offered a three-dimensional visualization and uneven surface morphology. The pediculocidal and acaricidal activities of synthesized TiO2 NPs showed the percent mortality of 31, 42, 63, 82, 100; 36, 44, 67, 89, and 100 at 2, 4, 6, 8, and 10 mg/L, respectively, against P. h. capitis and H. a. anatolicum. The average larval percent mortality of synthesized TiO2 NPs was 38, 47, 66, 79, and 100 at 1, 2, 3, 4, and 5 mg/L, respectively, against A. subpictus

Reconstruction of partially amputated external ear with costal cartilage graft: case report.

Science.gov (United States)

Brunelli, A; Bottini, D J; Cervelli, V; Cervelli, G; Grimaldi, M

2004-06-01

Many causes are responsible for secondary anomalies of the outer ear, such as: car accidents, sport- or work-related accidents, assaults, bites from animals or humans, benign or malignant tumours, burns and the effects of surgical interventions of the ear (plastic surgery on the ear or attempts at correction of primary malformations of the ear). The anatomical complexity of the ear makes its reconstruction particularly complicated with post-operative results that are often disappointing. The Authors describe their experience in the reconstruction of a partially amputated outer ear following a dog bite. The therapeutic protocol required various surgical stages. Initially, a cutaneous expander was applied at the level of the mastoid in order to ensure a sufficient quantity of local skin. The second stage was to remove cartilage from the ribs, followed by construction of a cartilaginous model of the ear and its insertion into the subcutaneous mastoid region after removal of the cutaneous expander and any residual ear cartilage. The last stage was to separate the neo-formed outer ear from the mastoid skin with the insertion of a cartilage graft to the posterior region of the reconstructed ear. This graft was covered by the occipital fascia rotated at 180 degrees and by a skin graft removed from the pubis. The postoperative result was satisfactory with recuperation of a good aesthetic appearance of the ear. Aim of the present report is to describe the surgical technique employed in the reconstruction of secondary anomalies of the ear and to highlight errors committed during this procedure. These considerations have allowed us to stress some fundamental elements in the reconstruction of the ear. In particular, the watershed was the awareness that we had to create a cartilaginous model that respected, as far as possible, the anatomy of the outer ear with all its ridges, trenches and cavities. This as well as ensuring a sufficient quantity of local skin in order to cover

Patterns of Intraosseous Recurrence After Stereotactic Body Radiation Therapy for Coxal Bone Metastasis.

Science.gov (United States)

Ito, Kei; Shimizuguchi, Takuya; Nihei, Keiji; Furuya, Tomohisa; Ogawa, Hiroaki; Tanaka, Hiroshi; Sasai, Keisuke; Karasawa, Katsuyuki

2018-01-01

To analyze the detailed pattern of intraosseous failure after stereotactic body radiation therapy (SBRT) for coxal bone metastasis. Patients treated with SBRT to coxal bone metastasis were identified by retrospective chart review. The SBRT doses were 30 Gy or 35 Gy in 5 fractions. A margin of 5 to 10 mm was added to the gross tumor volume to create the clinical target volume. We evaluated the presence or absence of intraosseous recurrence using magnetic resonance imaging. Intraosseous recurrences were assessed as "in-field" or "marginal/out-of-field." In addition, we measured the distance between the center of the recurrent tumor and the nearest edge of the initial bone metastasis in cases of marginal/out-of-field recurrence. Seventeen patients treated for 17 coxal bone metastases were included. Median age was 64 years (range, 48-79 years). Coxal lesions involved the ilium in 14 cases, pubis in 3, and ischium in 4 (3 lesions crossed over multiple regions). Patients most commonly had renal cell carcinoma (29.4%), followed by lung, hepatic cell, and colorectal cancers (23.5%, 11.8%, and 11.8%, respectively). Median follow-up after SBRT was 13 months (range, 2-44 months). Among all 17 cases, 7 cases developed 8 intraosseous recurrences, including in-field recurrence in 1 case and marginal/out-of-field recurrences in 7 cases. Median time to intraosseous recurrence was 10 months (range, 2-35 months). Among 7 cases with marginal/out-of-field recurrence, mean distance to the center of the recurrent tumor from the nearest edge of the initial bone metastasis was 34 mm (range, 15-55 mm). Most recurrences were observed out-of-field in the same coxal bone. These results suggest that defining the optimal clinical target volume in SBRT for coxal bone metastasis to obtain sufficient local tumor control is difficult. Copyright © 2017 Elsevier Inc. All rights reserved.

Suggestion of optimal radiation fields in rectal cancer patients after surgical resection for the development of the patterns of care study

Energy Technology Data Exchange (ETDEWEB)

Kim, Jong Hoon; Park, Jin Hong; Kim, Dae Yong [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)] [and others

2003-06-01

To suggest the optimal radiation fields after a surgical resection based on a nationwide survey on the principles of radiotherapy for rectal cancer in the Korean Patterns of Care Study. A consensus committee, composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area, developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer after a surgical resection. The survey format included 19 questions on the principles of defining field margins, and was sent to the radiation oncologists in charge of gastrointestinal malignancies in all Korean hospitals (48 hospitals). Thirty three (69%) oncologists replied. On the basis of the replies and literature review, the committee developed guidelines for the optimal radiation fields for rectal cancer. The following guidelines were developed: superior border between the lower tip of the L5 vertebral body and upper sacroiliac joint; inferior border 2-3 cm distal to the anastomosis in patient whose sphincter was saved, and 2-3 cm distal to the perineal scar in patients whose anal sphincter was sacrificed; anterior margin at the posterior tip of the symphysis pubis or 2-3 cm anterior to the vertebral body, to include the internal iliac lymph node and posterior margin 1.5-2 cm posterior to the anterior surface of the sacrum, to include the presacral space with enough margin. Comparison with the guidelines, the replies on the superior margin coincided in 23 cases (70%), the inferior margin after sphincter saving surgery in 13 (39%), the inferior margin after abdominoperineal resection in 32 (97%), the lateral margin in 32 (97%), the posterior margins in 32 (97%) and the anterior margin in 16 (45%). These recommendations should be tailored to each patient according to the clinical characteristics such as tumor location, pathological and operative findings, for the optimal treatment. The adequacy of these guidelines should be proved by following the Korean Patterns of Care

Chronic female pelvic pain

Directory of Open Access Journals (Sweden)

Gaurab Maitra

2013-01-01

Full Text Available Chronic pelvic pain (CPP is defined as nonmalignant pain perceived in the structures related to the pelvis that has been present for more than 6 months or a non acute pain mechanism of shorter duration. Pain in the pelvic region can arise from musculoskeletal, gynaecological, urologic, gastrointestinal and or neurologic conditions. Key gynaecological conditions that contribute to CPP include pelvic inflammatory disease (PID, endometriosis, adnexa pathologies (ovarian cysts, ovarian remnant syndrome, uterine pathologies (leiomyoma, adenomyosis and pelvic girdle pain associated with pregnancy. Several major and minor sexually transmitted diseases (STD can cause pelvic and vulvar pain. A common painful condition of the urinary system is Interstitial cystitis(IC. A second urologic condition that can lead to development of CPP is urethral syndrome. Irritable bowel syndrome (IBS is associated with dysmenorrhoea in 60% of cases. Other bowel conditions contributing to pelvic pain include diverticular disease,Crohn′s disease ulcerative colitis and chronic appendicitis. Musculoskeletal pathologies that can cause pelvic pain include sacroiliac joint (SIJ dysfunction, symphysis pubis and sacro-coccygeal joint dysfunction, coccyx injury or malposition and neuropathic structures in the lower thoracic, lumbar and sacral plexus. Prolonged pelvic girdle pain, lasting more than 6 months postpartum is estimated in 3% to 30% of women. Nerve irritation or entrapment as a cause of pelvic pain can be related to injury of the upper lumbar segments giving rise to irritation of the sensory nerves to the ventral trunk or from direct trauma from abdominal incisions or retractors used during abdominal surgical procedures. Afflictions of the iliohypogastric, ilioinguinal, genitofemoral, pudendal and obturator nerves are of greatest concern in patients with pelvic pain. Patient education about the disease and treatment involved is paramount. A knowledge of the differential

Comparison of radiation dose and image quality of Siremobil-IsoC{sup 3D} with a 16-slice spiral CT for diagnosis and intervention in the human pelvic bone; Vergleich von Strahlenexposition und Bildqualitaet eines Siremobil-IsoC{sup 3D} mit einem 16-Zeilen-Spiral-CT bei Diagnostik und Intervention am humanen Becken

Energy Technology Data Exchange (ETDEWEB)

Wieners, G.; Pech, M.; Beck, A.; Wust, P.; Felix, R.; Schroeder, R.J. [Klinik fuer Strahlenheilkunde, Charite, Univ. Berlin (Germany); Koenig, B.; Erdmenger, U.; Stoeckle, U. [Klinik fuer Unfallchirurgie, Charite, Univ. Berlin (Germany)

2005-02-01

Purpose: to compare the image quality of 16-slice computed tomography with the image quality of Siremobil-IsoC{sup 3D} of the pelvic region and to measure simultaneously the radiation dose before and after implantation of a sacroiliac screw (SI-screw) Materials and methods: the pelvic region of 8 human cadavers was examined in the Siremobil-IsoC{sup 3D} at five different levels. We used a standard protocol for the 16-slice CT of the complete pelvic region before and after insertion of a pelvic screw, followed by stepwise reduction of the tube current to find the tube current that equalizes the image quality of both modalities. We controlled the image quality by judging important structures such as neuroforamen, nerves, sacroiliacal joint space, intervertebral space, osteophytes, iliopsoas muscle, acetabular surface, fovea centralis, hip joint and os pubis. The image quality was judged by three radiologists and three trauma surgeons using a ranking from 1 to 5. The dose was measured with an endorectally placed NOMEX Dosimeter, to obtain the gonadal dose. Results: the medium score for all viewers of the Siremobil-IsoC{sup 3D} examinations was between 3 and 4.3. The medium score for all CT-examinations with a tube current of 250 mA was between 1.3 and 2.2. The reduction of tube current down to 80 mA hardly influenced the marks for the analyzed structures. Under 80 mA, bony structures, even after implantation of a SI-screw, were still marked as good, but soft tissue differentiation was getting worse. For the examination of the pelvis, the average dose-length product for the IsoC{sup 3D} was 41.2 mGy x cm. The medium dose-length product for CT was 389 mGy x cm for 250 mA, 125 mGy x cm for 80 mA and 82 mGy x cm for 60 mA. (orig.)

Suggestion of optimal radiation fields in rectal cancer patients after surgical resection for the development of the patterns of care study

International Nuclear Information System (INIS)

Kim, Jong Hoon; Park, Jin Hong; Kim, Dae Yong

2003-01-01

To suggest the optimal radiation fields after a surgical resection based on a nationwide survey on the principles of radiotherapy for rectal cancer in the Korean Patterns of Care Study. A consensus committee, composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area, developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer after a surgical resection. The survey format included 19 questions on the principles of defining field margins, and was sent to the radiation oncologists in charge of gastrointestinal malignancies in all Korean hospitals (48 hospitals). Thirty three (69%) oncologists replied. On the basis of the replies and literature review, the committee developed guidelines for the optimal radiation fields for rectal cancer. The following guidelines were developed: superior border between the lower tip of the L5 vertebral body and upper sacroiliac joint; inferior border 2-3 cm distal to the anastomosis in patient whose sphincter was saved, and 2-3 cm distal to the perineal scar in patients whose anal sphincter was sacrificed; anterior margin at the posterior tip of the symphysis pubis or 2-3 cm anterior to the vertebral body, to include the internal iliac lymph node and posterior margin 1.5-2 cm posterior to the anterior surface of the sacrum, to include the presacral space with enough margin. Comparison with the guidelines, the replies on the superior margin coincided in 23 cases (70%), the inferior margin after sphincter saving surgery in 13 (39%), the inferior margin after abdominoperineal resection in 32 (97%), the lateral margin in 32 (97%), the posterior margins in 32 (97%) and the anterior margin in 16 (45%). These recommendations should be tailored to each patient according to the clinical characteristics such as tumor location, pathological and operative findings, for the optimal treatment. The adequacy of these guidelines should be proved by following the Korean Patterns of Care Study

The anal verge: localization with multi-slice spiral CT

International Nuclear Information System (INIS)

Wang Wei; Tang Guangjian

2010-01-01

Objective: To determine and evaluate the method of localization of anal verge by multislice spiral CT. To provide an imaging reference for operative guidance of low-rectal cancer. Methods Forty eight consecutive adult patients suspected of abnormalities other than rectal disease were evaluated with abdominal and pelvic CT scans since August, 2009. They were divided into two groups based on sex and age. There were 23 men and 25 women. The ages of young group were 28 to 50 years and the average age was 41 years. The ages of elderly group were 52 to 81 years and the average age was 64 years. A small cotton ball dipped with contrast media was put at the anal verge as a marker and CT scans were performed with 64-slice spiral CT scanner. The distances between the cotton balls and the lower margin of the pubis combination (La), the lower margin of the Sth sacral vertebra (Lb), the inferior aperture of minor pelvis (Lc) and the lower margin of the basement of external anal sphincter (Ld) were measured on the mid- sagittal images obtained by MPR. The averages, the standard deviations (s), the 95% and 80% confidence intervals of La, Lb, Lc and Ld were calculated. We took the intervals of ±1.96 s or ±1.28 s 0.05) between two different sex groups [male group, (10.0±1.2) mm], female group, (9.6±1.2) mm and between two age groups [young group, (9.6±1.2) mm, elderly group, (9.9±1.3) mm]. Conclusions: The lower margin of the basement of external anal sphincter was a useful anatomic landmark for localizing the anal verge, and could be definitely identified on the middle sagittal pelvic CT image. The distance between the structure and anal verge is constant enough and can be used in measuring distance from low rectal lesion to the anal verge. (authors)

Athletic pubalgia and associated rehabilitation.

Science.gov (United States)

Ellsworth, Abigail A; Zoland, Mark P; Tyler, Timothy F

2014-11-01

Evaluation and treatment of groin pain in athletes is challenging. The anatomy is complex, and multiple pathologies often coexist. Different pathologies may cause similar symptoms, and many systems can refer pain to the groin. Many athletes with groin pain have tried prolonged rest and various treatment regimens, and received differing opinions as to the cause of their pain. The rehabilitation specialist is often given a non-specific referral of "groin pain" or "sports hernia." The cause of pain could be as simple as the effects of an adductor strain, or as complex as athletic pubalgia or inguinal disruption. The term "sports hernia" is starting to be replaced with more specific terms that better describe the injury. Inguinal disruption is used to describe the syndromes related to the injury of the inguinal canal soft tissue environs ultimately causing the pain syndrome. The term athletic pubalgia is used to describe the disruption and/or separation of the more medial common aponeurosis from the pubis, usually with some degree of adductor tendon pathology. Both non-operative and post-operative treatment options share the goal of returning the athlete back to pain free activity. There is little research available to reference for rehabilitation guidelines and creation of a plan of care. Although each surgeon has their own specific set of post-operative guidelines, some common concepts are consistent among most surgeons. Effective rehabilitation of the high level athlete to pain free return to play requires addressing the differences in the biomechanics of the dysfunction when comparing athletic pubalgia and inguinal disruption. Proper evaluation and diagnostic skills for identifying and specifying the difference between athletic pubalgia and inguinal disruption allows for an excellent and efficient rehabilitative plan of care. Progression through the rehabilitative stages whether non-operative or post-operative allows for a focused rehabilitative program. As more

Miíase vulvar: relato de caso Vulvar myiasis: a case report

Directory of Open Access Journals (Sweden)

Carlos Augusto Real Martinez

2003-05-01

Full Text Available A miíase de localização vulvar é doença rara. O objetivo do presente relato é descrever um caso de miíase vulvar por larvas de Cochliomyia hominivorax em mulher de 77 anos, com precários hábitos higiênicos, apresentando dor, prurido e secreção de odor fétido na região genital há 10 dias. O exame ginecológico demonstrou lesão ulcerada no grande lábio vulvar, com seis centímetros, que se estendia ao monte do pube, preenchida por larvas. A doente evoluiu favoravelmente após remoção das larvas, desbridamento cirúrgico e curativos diários, sendo realizada, quatorze dias após o desbridamento, rotação de retalho cutâneo. Apresentou evolução satisfatória, estando assintomática dois meses após a intervenção. A miíase vulvar deve ser considerada no diagnóstico diferencial das doenças infecciosas vulvares de doentes com hábitos de higiene precários.Myiasis located in the vulva is a rarely described disease. The objective of the present report is to describe a case of vulvar myiasis due to larvae of Cochliomyia hominivorax. A 77-year-old woman with precarious hygienic habits presented pain, pruritus and secretions with a fetid smell in the genital region for 10 days. Gynecological examination demonstrated an ulcerated lesion in the labium majus of the vulva measuring six centimeters that extended to the mons pubis and was found to be filled with larvae. The patient progressed favorably after removal of the larvae, surgical debridement and daily dressings. Fourteen days after the debridement, she was submitted to skin flap rotation, with good local scar formation. Two months after the intervention, she remained asymptomatic. Vulvar myiasis must be considered in the differential diagnosis of infectious diseases of the vulva in patients with precarious hygienic habits.

Clinical and dosimetric predictors of acute hematologic toxicity in rectal cancer patients undergoing chemoradiotherapy

International Nuclear Information System (INIS)

Yang, T. Jonathan; Oh, Jung Hun; Apte, Aditya; Son, Christina H.; Deasy, Joseph O.; Goodman, Karyn A.

2014-01-01

Background and purpose: To identify clinical and dosimetric factors associated with hematologic toxicity (HT) during chemoradiotherapy for rectal cancer. Materials and methods: We analyzed 120 rectal cancer patients treated with neoadjuvant pelvic radiotherapy (PRT) with concurrent 5-fluorouracil-based chemotherapy. The coxal (ilium, ischium, and pubis) bone marrow (BM), sacral BM, and femoral BM were contoured and dose-volume parameters were extracted. Associations between cell count trend and clinical predictors were tested using repeated-measures analysis of variance (ANOVA) test. Associations between clinical variables, Vx (percentage volume receiving x Gy), and cell count ratio at nadir were tested using linear regression models. Results: Nadirs for white blood cell count (WBC), absolute neutrophil count (ANC), and platelets (PLT) occurred in the second week of PRT and the fifth week for hemoglobin and absolute lymphocyte count (ALC). Using cell count ratio, patients treated with 3DCRT had a lower WBC ratio trend during PRT compared to patients treated with IMRT (p = 0.04), and patients ⩾59 years of age had a lower hemoglobin ratio trend during PRT (p = 0.02). Using absolute cell count, patients treated with 3DCRT had lower ANC cell count trend (p = 0.03), and women had lower hemoglobin cell count trend compared to men (p = 0.03). On univariate analysis, use of 3DCRT was associated with a lower WBC ratio at nadir (p = 0.02). On multiple regression analysis using dosimetric variables, coxal BM V45 (p = 0.03) and sacral BM V45 (p = 0.03) were associated with a lower WBC and ANC ratio at nadir, respectively. Conclusions: HT trends during PRT revealed distinct patterns: WBC, ANC, and PLT cell counts reach nadirs early and recover, while hemoglobin and ALC decline steadily. Patients who were treated with 3DCRT and older patients experienced lower cell count ratio trend during PRT. Dosimetric constraints using coxal BM V45 and sacral BM V45 can be considered

Introital ultrasonography in female urinary incontinence

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Weon, Young Cheol; Cho, Kyoung Sik; Lee, Jin Seong; Choi, Sang Hee; Kim, Keon Seok; Choo, Myung Soo [Ulsan Univ. Asan Medical Center, Seoul (Korea, Republic of)

1996-06-01

To evaluate the usefulness of introital ultrasonography in the assessment of female urinary incontinence. Introital ultrasonography was performed in fifteen with stress urinary incontinence(mean age 50) and six patients without symptoms of incontinence(mean age 37). Using a sagittal section of the anterior pelvis in the plane of the symphysis pubis the posterior urethrovesical angle, the pubourethral distance and the pubo-yregrak abgle were measured at rest and during stress(Valsalva's maneuver state). The student T-test and the ANOVA test were used in statistical analysis. The posterior urethrovesical angles of the controls were 125.3 deg ({+-}10.9) at rest and 125.7 deg ({+-}7.6) during stress. In the patients, the corresponding angles were 135.3 deg ({+-}11.3) and 139.6 deg({+-}10.8). The posterior urethrovesical angles increased 0.3 deg ({+-}4.7) in the controls and 5.6 deg ({+-}4.0) in the patients(p=0.018). In the controls, the pubo-urethral distances were 21.8 mm({+-}5.8) at rest and 18.2 mm({+-}7.1) during stress, while in the patients these distances were 18.4 mm({+-}3.9) and 12.6 mm({+-}4.4). The pubo-urethral distance decreased 3.5 mm ({+-}1.5) in the controls and 5.8 mm ({+-}2.3) in the patients(p=0.039). In the patients with mild incontinence(Grade I), the posterior urethrovesical angles increased 3.4 deg ({+-}2.8) : 132.3 deg ({+-}12.5) at rest and 135.6 deg (12.8) during stress. In the patients with moderate incontinence(Grade II), the angles increased 8.1 deg({+-}3.8) : 136.0 deg({+-}6.5) at rest and 144.1 deg({+-}5.9) during stress. The change of the posterior urethrovesical angle was related to the grade of urinary incontinence in the patients(p<0.05). There was no statistical significancy in the pubo-urethral angle (p=0.315). Introital ultrasonography may be useful for assessment of stress urinary incontinence.

Clinical, Biomechanical, and Anatomic Investigation of Colles Fascia and Pubic Ramus Periosteum for Use During Medial Thighplasty.

Science.gov (United States)

Carney, Martin J; Matatov, Tim; Freeman, Matthew; Miller, John; Vemula, Rahul; Schuster, Jason; Dancisak, Michael; Lindsey, John; Rae, Guenevere

2017-06-01

pubis and ischium. Anchoring of the SFS to the periosteum did not improve our complication profile when compared with the literature. Both the biomechanical and histologic analyses demonstrate that the Colles fascia is highly variable in organizations with coincident variability in tissue strength. Our results require further study to identify the optimal surgical technique for medial thighplasty.

A Comparison of Sacroiliac and Pubic Rami Fracture Occurrences in Oblique Side Impact Tests on Nine Post Mortem Human Subjects.

Science.gov (United States)

Petit, Philippe; Trosseille, Xavier; Lebarbé, Mathieu; Baudrit, Pascal; Potier, Pascal; Compigne, Sabine; Masuda, Mitsutoshi; Yamaoka, Akira; Yasuki, Tsuyoshi; Douard, Richard

2015-11-01

The WorldSID dummy can be equipped with both a pubic and a sacroiliac joint (S-I joint) loadcell. Although a pubic force criterion and the associated injury risk curve are currently available and used in regulation (ECE95, FMVSS214), as of today injury mechanisms, injury criteria, and injury assessment reference values are not available for the sacroiliac joint itself. The aim of this study was to investigate the sacroiliac joint injury mechanism. Three configurations were identified from full-scale car crashes conducted with the WorldSID 50th percentile male where the force passing through the pubis in all three tests was approximately 1500 N while the sacroiliac Fy/Mx peak values were 4500 N/50 Nm, 2400 N/130 Nm, and 5300 N/150 Nm, respectively. These tests were reproduced using a 150 kg guided probe impacting Post Mortem Human Subjects (PMHS) at 8 m/s, 5.4 m/s and 7.5 m/s. The shape and the orientation of the impacting face of the probe were selected to match the WorldSID pubic Fy and sacroiliac Fy/Mx loads of the three vehicle test configurations. Three PMHS were tested in each of the three configurations (nine PMHS in total). In the first PMHS configuration, one specimen sustained an AIS 3 injury and one sustained an AIS 4 injury (an unstable pelvis with complete disruption of the posterior arch, a sacroiliac joint disruption associated with an iliac fracture, and a pubic symphysis separation). In the second configuration, all specimens sustained a fracture of the superior lateral iliac wing (AIS 2). In the third configuration, one specimen sustained a partial disruption of the anterior arch (AIS 2). Based on the data from strain gauges located on the pubic rami and near the sacroiliac joint, the pubic rami fractures were identified as occurring prior to the sacroiliac fractures. Out of nine impactor tests performed, the PMHS S-I joint injuries were observed to consistently be associated with pelvic anterior arch fractures. In addition, from the injury

[The artificial sphincter: therapy for faecal incontinence].

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Baumgartner, U

2012-08-01

Faecal incontinence (FI) challenges a patient's professional, social and sexual life. Often the patient becomes depressive and socially isolated. If able to break open for therapy the patient should receive as first line a conservative treatment (like dietary measures, pelvic re-education, biofeedback, bulking agents, irrigation). When is the time to implant an artificial anal sphincter? If conservative therapy fails as well as surgical options (like a sphincteroplasty - if indicated a reconstruction of the pelvic floor if insufficient, or a sacral nerve stimulation) an ultimo surgical procedure should be offered to appropriate and compliant patients: an artificial anal sphincter. Worldwide, there are two established devices on the market: the artificial bowel sphincter® (ABS) from A. M. S. (Minnetonka, MN, USA) and the soft anal band® from A. M. I. (Feldkirch, Austria). How to implant the artificial anal sphincter? Both devices consist of a silicon cuff which can be filled with fluid. Under absolute aseptic conditions this cuff is placed in the lithotomy position by perianal incisions around the anal canal below the pelvic floor. A silicon tube connects the anal cuff with a reservoir (containing fluid) which is placed either behind the pubis bone in front of the bladder (ABS) or below the costal arch (anal band). With a pump placed in the scrotum/labia (ABS) or by pressing the balloon (anal band) in both types operated by the patient the fluid is shifted forth and back between the anal cuff and the reservoir closing or opening the anal canal. Both systems are placed completely subcutaneously. Both devices improve significantly the anal continence. Both systems have a high rate of reoperations. However, the causes for the redos are different. The ABS is associated with high infection and anal penetration rates of the cuff leading to an explantation rate to up to 60 % of the implants. This kind of complication seems to be much lower with the anal band. The major

Retrograde lag screw placement in anterior acetabular column with regard to the anterior pelvic plane and midsagittal plane -- virtual mapping of 260 three-dimensional hemipelvises for quantitative anatomic analysis.

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Ochs, Bjoern Gunnar; Stuby, Fabian Maria; Ateschrang, Atesch; Stoeckle, Ulrich; Gonser, Christoph Emanuel

2014-10-01

Percutaneous screw placement can be used for minimally invasive treatment of none or minimally displaced fractures of the anterior column. The complex pelvic geometry can pose a major challenge even for experienced surgeons. The present study examined the preformed bone stock of the anterior column in 260 hemipelvises (130 male and 130 female). Screws were virtually implanted using iPlan(®) CMF (BrainLAB AG, Feldkirchen, Germany); the maximal implant length and the maximal implant diameter were assessed. The study showed, that 6.5mm can generally be used in men; in women however individual planning is essential in regard to the maximal implant diameter since we found that in 15.4% of women, screws with a diameter less than 6.5mm were necessary. The virtual analysis of the preformed bone stock corridor of the anterior column showed two constrictions of crucial clinical importance. These can be found after 18% and 55% (men) respectively 16% and 55% (women) measured from the entry point along the axis of the implant. The entry point of the retrograde anterior column screw in our collective was located lateral of tuberculum pubicum at the level of the superior-medial margin of foramen obturatum. In female patients, the entry point was located significantly more lateral of symphysis and closer to the cranial margin of ramus superior ossis pubis. The mean angle between the screw trajectory and the anterior pelvic plane in sagittal section was 31.6 ± 5.5°, the mean angle between the screw trajectory and the midsagittal plane in axial section was 55.9 ± 4.6° and the mean angle between the screw trajectory and the midsagittal plane in coronal section was 42.1 ± 3.9° with no significant deviation between both sexes. The individual angles formed by the screw trajectory and the anterior pelvic and midsagittal plane are independent from anthropometric parameters sex, age, body length and weight. Therefore, they can be used for orientation in lag screw placement keeping

Ectoparasitos de roedores da região urbana de Belo Horizonte, MG: III. Indices pulicidianos, anoplurianos e acarianos em Rattus Norvegicus norvegicus Ectoparasites in rodents of the urban region of Belo Horizonte, MG: III. Fleas, anoplura and acari indices in Rattus norvegicus norvegicus

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Pedro Marcos Linardi

1985-09-01

Full Text Available Indices pulicidianos, anoplurianos e acarianos, globais e específicos foram determinados para os ectoparasitos de Rattus norvegicus norvegicus capturados em zona urbana de Belo Horizonte, Minas Gerais, Brasil, no período de junho de 1980 a setembro de 1982. Tendo-se em vista os valores limites ou críticos atribuídos aos índices pulicidianos, sobretudo ao índice "cheopis" e propostos por diversos autores como medida complementar de vigilância epidemiológica para peste bubônica, a comunidade de Belo Horizonte poderia ter estado exposta a esta infecção, uma vez que os índices globais anuais de 0,3 a 2,4 e a pulga prevalente foi Xenopsylla cheopis (99,2%, com os maiores índices coincidindo com o final da estação seca-fria. Em duas ocasiões, a comunidade poderia ter permanecido altamente exposta à infecção, já que os índices-limites tolerados foram suplantados: 8,8 (outubro 1980 e 6,2 (setembro 1982. Sugere-se que medidas profiláticas como anti-ratização e desinsetização sejam eficazmente aplicadas ao final da estação seca-fria, ou anteriormente à chegada das chuvas, sendo sucedidas pela desratização. Informações sobre índices anoplurianos e acarianos são importantes para que se possa, no exclusivas de roedoresThe total and specific indices of fleas, lice and mites were determined for ectoparasites on Rattus norvegicus norvegicus capture in urban areas of Belo Horizonte, Minas state, Brazil, from June 1980 to September 1982. In view of the limiting or critical values attributed to flea indices above all the [quot ]cheopis[quot ] index, proposed by several authors as a complementary measure for bubonic plague surveillance, the community of Belo Horizonte would have been exposed to this infection. The annual total indices ranged from 0.3 to 2.4 and the prevalent flea was Xenopsylla cheopis (99.2%, with the highest indices coinciding with the late dry-cool season. On two occasions, in this period, the community would have remained highly exposed to infection, since the index-limits were superseded: 8.8 (October 1980 and 6.2 (September 1982. It is suggested that preventive measures, such as protection against rat insecticide treatment may be efficiently applied in the late dry-cool season, or previous to the rainy season, before the elimination of rats. Reports on indices of lice and mites are important as they may establish index-limits for certain infections exclusive to rodents.

Male Hypogonadism. A Case Report Hipogonadismo masculino. Presentación de un caso

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Lisandro Hernández Madrazo

2012-07-01

Full Text Available The case of a 26 years old male patient who attended the Internal Medicine consultation at the La Fortaleza Integral Diagnostic Center in Maracaibo, Zulia State, Venezuela because of decreased external genitalia size, with poor development from childhood and swelling of the breasts is presented. Physical examination showed a trunk of feminoid configuration caused by adipose tissue accumulated in the lower abdomen, breast and pubic; wide pelvis; lower limb dominance over higher limbs; enucoid proportions; volume diffusely  increased in both breasts (gynecomastia; deposit of fatty tissue at the pelvic girdle, and absent or sparse facial, axillary and pubic hair. We observed decreased size, poor pigmentation, and soft consistency in penis and testicles. Exam was performed on plasma testosterone, luteinizing hormone and follicle stimulating hormone, thus concluding, by the Endocrinology Service at the Maracaibo University Hospital, to be the case of hypogonadotropic hypogonadism of improvable cause. The clinical diagnosis of hypogonadism in adults is unusual in medical practice, a fact that provides with relevance the case we present.Se presenta el caso de un paciente de 26 años, que acudió a consulta de Medicina Interna en el Centro de Diagnóstico Integral La Fortaleza, Maracaibo, Estado Zulia, Venezuela, por presentar disminución del tamaño de los genitales externos, con escaso desarrollo de estos desde su niñez, y aumento de volumen de las mamas. Al examen físico se constató un tronco de configuración feminoide por panículo adiposo acumulado en bajo vientre, mama y pubis; pelvis ancha; predominio de las extremidades inferiores sobre las superiores, proporciones eunucoides; aumento de volumen de forma difusa en ambas mamas (ginecomastia; depósito de tejido graso a nivel de la cintura pélvica; y ausente o escaso vello facial, axilar y pubiano. Se observó tamaño disminuido, escasa pigmentación, y consistencia blanda, en pene y test

Risk Factors for Pelvic Insufficiency Fractures in Locally Advanced Cervical Cancer Following Intensity Modulated Radiation Therapy

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Ramlov, Anne, E-mail: anraml@rm.dk [Department of Oncology, Aarhus University Hospital, Aarhus (Denmark); Pedersen, Erik Morre; Røhl, Lisbeth [Department of Radiotherapy, Aarhus University Hospital, Aarhus (Denmark); Worm, Esben [Department of Medical Physics, Aarhus University Hospital, Aarhus (Denmark); Fokdal, Lars; Lindegaard, Jacob Chr. [Department of Oncology, Aarhus University Hospital, Aarhus (Denmark); Tanderup, Kari [Department of Oncology, Aarhus University Hospital, Aarhus (Denmark); Department of Medical Physics, Aarhus University Hospital, Aarhus (Denmark)

2017-04-01

Purpose: To investigate the incidence of and risk factors for pelvic insufficiency fracture (PIF) after definitive chemoradiation therapy for locally advanced cervical cancer (LACC). Methods and Materials: We analyzed 101 patients with LACC treated from 2008-2014. Patients received weekly cisplatin and underwent external beam radiation therapy with 45 Gy in 25 fractions (node-negative patients) or 50 Gy in 25 fractions with a simultaneous integrated boost of 60 Gy in 30 fractions (node-positive patients). Pulsed dose rate magnetic resonance imaging guided adaptive brachytherapy was given in addition. Follow-up magnetic resonance imaging was performed routinely at 3 and 12 months after the end of treatment or based on clinical indication. PIF was defined as a fracture line with or without sclerotic changes in the pelvic bones. D{sub 50%} and V{sub 55Gy} were calculated for the os sacrum and jointly for the os ileum and pubis. Patient- and treatment-related factors including dose were analyzed for correlation with PIF. Results: The median follow-up period was 25 months. The median age was 50 years. In 20 patients (20%), a median of 2 PIFs (range, 1-3 PIFs) were diagnosed; half were asymptomatic. The majority of the fractures were located in the sacrum (77%). Age was a significant risk factor (P<.001), and the incidence of PIF was 4% and 37% in patients aged ≤50 years and patients aged >50 years, respectively. Sacrum D{sub 50%} was a significant risk factor in patients aged >50 years (P=.04), whereas V{sub 55Gy} of the sacrum and V{sub 55Gy} of the pelvic bones were insignificant (P=.33 and P=.18, respectively). A dose-effect curve for sacrum D{sub 50%} in patients aged >50 years showed that reduction of sacrum D{sub 50%} from 40 Gy{sub EQD2} to 35 Gy{sub EQD2} reduces PIF risk from 45% to 22%. Conclusions: PIF is common after treatment of LACC and is mainly seen in patients aged >50 years. Our data indicate that PIFs are not related to lymph node

Osteology of Galeamopus pabsti sp. nov. (Sauropoda: Diplodocidae, with implications for neurocentral closure timing, and the cervico-dorsal transition in diplodocids

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Emanuel Tschopp

2017-05-01

Full Text Available Diplodocids are among the best known sauropod dinosaurs. Numerous specimens of currently 15 accepted species belonging to ten genera have been reported from the Late Jurassic to Early Cretaceous of North and South America, Europe, and Africa. The highest diversity is known from the Upper Jurassic Morrison Formation of the western United States: a recent review recognized 12 valid, named species, and possibly three additional, yet unnamed ones. One of these is herein described in detail and referred to the genus Galeamopus. The holotype specimen of Galeamopus pabsti sp. nov., SMA 0011, is represented by material from all body parts but the tail, and was found at the Howe-Scott Quarry in the northern Bighorn Basin in Wyoming, USA. Autapomorphic features of the new species include a horizontal canal on the maxilla that connects the posterior margin of the preantorbital and the ventral margin of the antorbital fenestrae, a vertical midline groove marking the sagittal nuchal crest, the presence of a large foramen connecting the postzygapophyseal centrodiapophyseal fossa and the spinopostzygapophyseal fossa of mid- and posterior cervical vertebrae, a very robust humerus, a laterally placed, rugose tubercle on the concave proximal portion of the anterior surface of the humerus, a relatively stout radius, the absence of a distinct ambiens process on the pubis, and a distinctly concave posteroventral margin of the ascending process of the astragalus. In addition to the holotype specimen SMA 0011, the skull USNM 2673 can also be referred to Galeamopus pabsti. Histology shows that the type specimen SMA 0011 is sexually mature, although neurocentral closure was not completed at the time of death. Because SMA 0011 has highly pneumatized cervical vertebrae, the development of the lamination appears a more important indicator for individual age than neurocentral fusion patterns. SMA 0011 is one of very few sauropod specimens that preserves the cervico

Shoulder dystocia in diabetic and non-diabetic pregnancies.

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Malinowska-Polubiec, Aneta; Romejko-Wolniewicz, Ewa; Szostak, Oksana; Dobrowolska-Redo, Agnieszka; Tolloczko, Justyna; Zareba-Szczudlik, Julia; Smolarczyk, Roman; Czajkowski, Krzysztof

2014-01-01

Shoulder dystocia remains an obstetric emergency. Maternal diabetes is considered to be one of the major risk factors for shoulder dystocia. The aim of this study was to analyze antepartum and peripartum risk factors and complications of shoulder dystocia in diabetic and non-diabetic women. We performed a retrospective analysis of 48 shoulder dystocia cases out of 28,485 vaginal deliveries of singleton, live-born infants over a 13 year period: 13 cases were diagnosed in diabetic women and 35 cases in non-diabetic women. The study was conducted in the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, from January 2000 to December 2012. Compared to non-diabetic women, diabetic patients had significantly higher pre-pregnancy body weight (83.4±23.8 kg vs. 62.5±10.9 kg, p=0.002), higher pre-pregnancy BMI (30.2±6.8 kg/m2 vs. 22.9±4.3 kg/m2, p=0.0003), and lower gestational weight gain (11.4±6.2 kg vs. 16.0±4.7 kg, p=0.01). Diabetic women with shoulder dystocia were more likely to deliver before completion of the 38th week of gestation (30.8% vs. 5.7%, p=0.02) and had a higher incidence of 1st and 2nd stage perineal tears compared with the non-diabetic group (23.1% vs. 0%, p=0.02). There were two cases of symphysis pubis dehiscence in non-diabetic women. Children of diabetic mothers had a significantly higher birth weight (4,425.4±561.6 g vs. 4,006.9±452.8 g, p=0.03). Children of diabetic mothers with dystocia were at significantly higher risk of peripartum injuries (92.3% vs. 45.7%). A significant difference was observed in the percentage of brachial plexus palsy (61.5% vs. 17.1%). Children of diabetic women experiencing shoulder dystocia were more frequently affected by Erb's brachial plexus palsy and respiratory disturbances. These children had an increased likelihood of birth weights above the 90th percentile (not necessarily reaching 4,000 g) compared to children born to non-diabetic mothers. Shoulder dystocia in women with

Anatomy of the clitoris.

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O'Connell, Helen E; Sanjeevan, Kalavampara V; Hutson, John M

2005-10-01

We present a comprehensive account of clitoral anatomy, including its component structures, neurovascular supply, relationship to adjacent structures (the urethra, vagina and vestibular glands, and connective tissue supports), histology and immunohistochemistry. We related recent anatomical findings to the historical literature to determine when data on accurate anatomy became available. An extensive review of the current and historical literature was done. The studies reviewed included dissection and microdissection, magnetic resonance imaging (MRI), 3-dimensional sectional anatomy reconstruction, histology and immunohistochemical studies. The clitoris is a multiplanar structure with a broad attachment to the pubic arch and via extensive supporting tissue to the mons pubis and labia. Centrally it is attached to the urethra and vagina. Its components include the erectile bodies (paired bulbs and paired corpora, which are continuous with the crura) and the glans clitoris. The glans is a midline, densely neural, non-erectile structure that is the only external manifestation of the clitoris. All other components are composed of erectile tissue with the composition of the bulbar erectile tissue differing from that of the corpora. The clitoral and perineal neurovascular bundles are large, paired terminations of the pudendal neurovascular bundles. The clitoral neurovascular bundles ascend along the ischiopubic rami to meet each other and pass along the superior surface of the clitoral body supplying the clitoris. The neural trunks pass largely intact into the glans. These nerves are at least 2 mm in diameter even in infancy. The cavernous or autonomic neural anatomy is microscopic and difficult to define consistently. MRI complements dissection studies and clarifies the anatomy. Clitoral pharmacology and histology appears to parallel those of penile tissue, although the clinical impact is vastly different. Typical textbook descriptions of the clitoris lack detail and

Automated electrohysterographic detection of uterine contractions for monitoring of pregnancy: feasibility and prospects.

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Muszynski, C; Happillon, T; Azudin, K; Tylcz, J-B; Istrate, D; Marque, C

2018-05-08

Preterm birth is a major public health problem in developed countries. In this context, we have conducted research into outpatient monitoring of uterine electrical activity in women at risk of preterm delivery. The objective of this preliminary study was to perform automated detection of uterine contractions (without human intervention or tocographic signal, TOCO) by processing the EHG recorded on the abdomen of pregnant women. The feasibility and accuracy of uterine contraction detection based on EHG processing were tested and compared to expert decision using external tocodynamometry (TOCO) . The study protocol was approved by local Ethics Committees under numbers ID-RCB 2016-A00663-48 for France and VSN 02-0006-V2 for Iceland. Two populations of women were included (threatened preterm birth and labour) in order to test our system of recognition of the various types of uterine contractions. EHG signal acquisition was performed according to a standardized protocol to ensure optimal reproducibility of EHG recordings. A system of 18 Ag/AgCl surface electrodes was used by placing 16 recording electrodes between the woman's pubis and umbilicus according to a 4 × 4 matrix. TOCO was recorded simultaneously with EHG recording. EHG signals were analysed in real-time by calculation of the nonlinear correlation coefficient H 2 . A curve representing the number of correlated pairs of signals according to the value of H 2 calculated between bipolar signals was then plotted. High values of H 2 indicated the presence of an event that may correspond to a contraction. Two tests were performed after detection of an event (fusion and elimination of certain events) in order to increase the contraction detection rate. The EHG database contained 51 recordings from pregnant women, with a total of 501 contractions previously labelled by analysis of the corresponding tocographic recording. The percentage recognitions obtained by application of the method based on coefficient H 2 was

Pituitary stalk interruption syndrome presenting as short stature: a case report.

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Ram, Nanik; Ali, Syed Ahsan; Hussain, Syed Zubair

2014-12-19

Pituitary stalk interruption syndrome is a rare congenital abnormality of the pituitary that is responsible for anterior pituitary deficiency. It is characterized by a classic triad of interrupted pituitary stalk, absent or ectopic posterior pituitary, and anterior pituitary hypoplasia or aplasia. Clinical presentation varies according to age. In adults it presents as short stature and anterior pituitary deficiency. Without early diagnosis and treatment, mortality and morbidity in these patients is high. Early diagnosis and treatment of this rare disease can prevent permanent short statue of the patient. We report the first case of pituitary stalk interruption syndrome from Pakistan. A 17-year-old Pakistani young man presented with short stature and underdeveloped secondary sexual characters. His siblings and parents were healthy, with normal height. An examination showed his blood pressure was 90/60 mmHg, and his height, weight, and body mass index were 142 cm, 34.5 kg, and 17.10 kg/m2, respectively. He had no hair growth on his face, axilla, or pubis. His testes were between 1 and 2 mL in size, with a 4 cm-at-stretch micropenis. His lab investigations showed that his thyroid stimulating hormone (TSH) was 8.58 uIU/mL (0.4 to 4.2), his free thyroid hormone level FT4 was 0.46 ng/dL (0.89 to 1.76), his prolactin was 21.1 ng/mL (3.0 to 14.7), and his baseline cortisol was 0.30 ug/dL (4.3 to 22.4). His cortisol level after 60 minutes of cosyntropin injection was 3.5 ug/dL (4.3 to 22.4), his insulin like growth factor IGF-1 was 31.56 ng/mL (247.3 to 481.7), his testosterone level was under 2.5 ng/dL (2 to 800), his follicle stimulating hormone FSH was 0.41 uIU/mL (0.0 to 10.0), and his leutinizing hormone LH was under 0.1 uIU/mL (1.2 to 7.8). His bone age was 10 years according to the Greulich and Pyle method, as shown by X-rays. The results from his pituitary magnetic resonance imaging scan were consistent with pituitary stalk interruption syndrome. We describe a young

[Application of temporary balloon blocking technique in bone tumors surgery under the aid of CT angiography].

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Fang, Cheng; Hu, Yongcheng; Huang, Hongchao; Xia, Qun; Chen, Xiaopeng; Yuan, Binbin; He, Xin; Wang, Peng

2014-10-01

To study the value of CT angiography (CTA) in the surgical treatment of bone tumors with the temporary balloon blocking technique. A retrospective analysis was made on the clinical data of 36 bone tumor patients between April 2008 and October 2013. There were 22 males and 14 females, aged from 25 to 83 years (mean, 46 years). The tumor located at the sacrococcygeal region in 17 cases, at the ilium in 12 cases, at the pubis in 5 cases, and at the proximal femur in 2 cases. Before surgery, CTA was performed to measure the external diameter of aortaventralis and arteria iliac communis, and the distance between the low renal artery and the abdominal aortic bifurcation as well as mark the anatomical relationship between the low renal artery, the abdominal aortic bifurcation and bony landmarks of vertebral body. According to these data, suitable balloon was chosen and the balloon positioning was guided in the surgery to completely excise tumor assisted by balloon blocking technique. The CTA results showed that the external diameter of aortaventralis and arteria iliaca communis was (1.545 ± 0.248) cm and (1.060 ± 0.205) cm respectively, and the distance between the low renal artery and the abdominal aortic bifurcation was (10.818 ± 1.165) cm. The three-dimensional reconstruction showed that the opening of the low renal artery was mainly located at L1 (16/36, 44.4%) and the abdominal aortic bifurcation mainly located at L4 (22/36, 61.1%). Effective block of abdomial aorta was performed; the blood pressure obviously increased in 3 cases after balloon inflation, and pulse of the left dorsal artery of the foot decreased in 1 case after removal of balloon, which were relieved after expectant treatment. The operation time was 118-311 minutes; the intraoperative blood loss was 200-1800 mL, 21 patients were given blood transfusion, and the amount of blood transfusion was 400-1200 mL; and the aortic clamping time was 40-136 minutes. All patients were followed up 5-44 months

Reliability of a new method for measuring coronal trunk imbalance, the axis-line-angle technique.

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Zhang, Rui-Fang; Liu, Kun; Wang, Xue; Liu, Qian; He, Jia-Wei; Wang, Xiang-Yang; Yan, Zhi-Han

2015-12-01

Accurate determination of the extent of trunk imbalance in the coronal plane plays a key role in an evaluation of patients with trunk imbalance, such as patients with adolescent idiopathic scoliosis. An established, widely used practice in evaluating trunk imbalance is to drop a plumb line from the C7 vertebra to a key reference axis, the central sacral vertical line (CSVL) in full-spine standing anterioposterior radiographs, and measuring the distance between them, the C7-CSVL. However, measuring the CSVL is subject to intraobserver differences, is error-prone, and is of poor reliability. Therefore, the development of a different way to measure trunk imbalance is needed. This study aimed to describe a new method to measure coronal trunk imbalance, the axis-line-angle technique (ALAT), which measures the angle at the intersection between the C7 plumb line and an axis line drawn from the vertebral centroid of the C7 to the middle of the superior border of the symphysis pubis, and to compare the reliability of the ALAT with that of the C7-CSVL. A prospective study at a university hospital was used. The patient sample consisted of sixty-nine consecutively enrolled men and women patients, aged 10-18 years, who had trunk imbalance defined as C7-CSVL longer than 20 mm on computed full-spine standing anterioposterior radiographs. Data were analyzed to determine the correlation between C7-CSVL and ALAT measurements and to determine intraobserver and interobserver reliabilities. Using a picture archiving and communication system, three radiologists independently evaluated trunk imbalance on the 69 computed radiographs by measuring the C7-CSVL and by measuring the angle determined by the ALAT. Data were analyzed to determine the correlations between the two measures of trunk imbalance, and to determine intraobserver and interobserver reliabilities of each of them. Overall results from the measurements by the C7-CSVL and the ALAT were significantly moderately correlated

1,000 consecutive cases of laser-assisted liposuction and suction-assisted lipectomy managed with local anesthesia.

Science.gov (United States)

Chia, Christopher T; Theodorou, Spero J

2012-08-01

Advances in suction-assisted lipectomy (SAL) include improved instrumentation, better understanding of fluid dynamics, and an improved concept of appropriate indications. The tumescent technique uses subcutaneous injection of isotonic fluid containing vasoconstrictive and analgesic agents and is proved to be safe, with low morbidity and mortality rates. Laser-assisted liposuction (LAL) using local infiltration of an anesthetic and no general anesthesia or sedation has been developed, with claims of fat destruction and skin tightening. This study aimed to review 1,000 consecutive cases of LAL and SAL performed with the patient under local anesthesia and to determine whether this represents a safe technique with few complications. During a period of 22 months, 581 consecutive patients (486 females and 95 males) underwent 1,000 LAL/SAL operations, 545 of whom had multiple procedures performed. None of the patients had a body mass index (BMI) higher than 30 kg/m2. The patients ranged in age from 18 to 62 years. The fat aspirate ranged from 50 to 1,400 ml. Patients were given an oral sedative, an antibiotic, and an analgesic. Ringer's lactate solution containing lidocaine and epinephrine was injected into the subcutaneous space. The 1,064-nm and/or 1,320-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used for laser lipolysis followed by SAL using standard and/or power-assisted liposuction (PAL) cannulas. The treated areas included the neck, triceps, male breast, midback, flanks, axilla, abdomen, mons pubis, thighs, presacrum, and knees. No patient was administered intravenous sedation or general anesthesia. The average number of areas treated was 1.8, and no major complications or mortalities were observed. There were three burns, two infections, one hematoma, and one seroma. A total of 73 secondary procedures were performed (7.3%). No tertiary procedures were required. For appropriately selected patients, comparable results can be obtained with an excellent

VULVAR CANCER – A CASE REPORT

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Špela Smrkolj

2018-02-01

Full Text Available Background: Malignant vulvar lesions arise from premalignant vulvar intraepithelial neoplasm (VIN and occur only rarely (3–4 % of all malignancies of the female genital organs, especially in the menopause. They are associated with human papillomavirus infection. If the change is found sufficiently early and if it is properly treated, the prognosis is favourable. Methods and patients: We present a case of a 60-year-old multiparous postmenopausal woman with recurrence of the vulvar cancer. In May 1995 vulvar biopsy revealed VIN III. In February 2006 she was examined at the Oncology Institute because of expansive lesions which covered the entire area of external genitals from clitoris to the anus. On 7th March, 2006 vulvectomy with broad safety margins and right-sided lymphadenectomy were made. Histological di- agnosis revealed a well-differentiated invasive squamous cell carcinoma (FIGO II, grade I; postoperative radiotherapy followed. In February 2007, suspicious lesions reoccurred in the external genital area, the smear was negative. In December 2007 histological diagnosis of recurrent squamous cancer was made. On 7th October, 2008 the patient was admitted to the Department of Gynecology, University Medical Centre, Ljubljana. Abdominal computed tomography showed a widespread vulvar cancer, T4 in appearance, suspicious lymph nodes in the pre-sacral area and suspicious left inguinal lymph node. Metastases to the liver were not confirmed. On 28th October, 2008 total Brunschwig operation was performed (pelvic exenteration of the bladder, uterus, pelvic lymph nodes, rectum and radical vulvectomy with resection of both ramus ossis pubis, anus praeter and transposition of skin-muscle flap (m. rectus abdominis. The interdisciplinary operation, which lasted 9 hours and blood loss was 6 litres, involved gynaecologists, a urologist, a plastic surgeon, and an oncology surgeon. The histological diagnosis of a 27 × 24 cm large preparation was a moderately

S-08: Kronik Pelvik Ağrı Sebebi Olarak İliopsoas Sendromu: Bir Kadın Futbolcuda Tanıda Gecikmenin ve Başarılı Tedavisinin Tartışılması

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Şeyhmus Kaplan

2017-03-01

Full Text Available AMAÇ Bu olgudaki amacımız bir kadın futbolcuda kronik pelvik ağrı sebebi olarak tespit edilen, egzersiz ve kinesiotape uygulaması ile başarılı tedavi edilen iliopsoas sendromu olgusunu sunmak ve tanıdaki gecikmenin sebeplerini tartışmaktır.OLGUSon 1 yıldır sağ kasık bölgesinde ağrı şikayeti olan 26 yaşında, 8 yıldır aktif futbol sporu yapan bayan hasta, çeşitli kliniklerde üreter taşı, inguinal herni, non-spesifik alt bel ağrısı ve osteitis pubis ön tanıları ile değerlendirilmiş. Yapılan muayene, laboratuvar ve görüntüleme incelemelerinde ağrıyı açıklayacak bir sorun tespit edilmemiş. Son olarak jinekoloji kliniğinde kronik pelvik ağrı tanısı konarak, analjezik ve oral kontraseptif tedavi denenmiş. Verilen tedaviye cevap vermeyen hasta, spor hekimliği bölümüne refere edilmiş. Hastada tek taraflı (sağ kasık ağrısı, uzun süre oturduktan sonra kalktığında dik olabilmede zorluk ve bazen bu şikayetlerine eklenen alt bel ağrısı yakınmaları vardı. Bilateral alt ekstemite kuvvet muayenesi, tendon refleksleri normal olarak tespit edildi. Muayene bulguları: sağ iliopsoas kas trasesinde insersiyoya yakın bölgede derin palpasyonda hassasiyet, belde lordoz artışı, sol pelvik antero-superior tilt, sol kalçada piriformis trasesinde hassasiyet, sağda daha belirgin olmak üzere bilateral pozitif Thomas testi, sağ kalçada tüm yönlere doğru eklem hareket açıklığının son derecelerinde azalma. Kan, idrar, konvansiyonel grafi, USG ve MR incelemelerinde hastanın şikayetlerini açıklayacak patolojik bir sorun tespit edilemedi. İliopsoas sendromu tanısı konuldu. Tedavide günlük germe egzersizleri önerildi ve beşer gün aralarla kinesiotape uygulaması yapıldı (Resim 1. Ağrı düzeyi Vizüel Analog Skala (VAS skoru ile değerlendirildi. Dördüncü seanstan sonra ağrının tamamen ortadan kalkması ile tedavi sonlandırıldı. Tedavinin bitiminden üç ay sonra

Variabilidad de la presión intrabdominal en pacientes sometidos a abdominoplastia Intrabdominal pressure variability in patients under abdominoplasty procedure

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S. Mercedes

2009-12-01

Full Text Available Realizamos un estudio prospectivo, descriptivo, clínico-quirúrgico y aleatorio sobre 100 pacientes sometidos a abdominoplastia por 15 cirujanos distintos en el Hospital Salvador B. Gautier y el Centro de Cirugía Plástica y Especialidades Santo Domingo, de la República Dominicana, a lo largo de un periodo de 5 meses, Julio y Agosto de 2003 y de Julio a Septiembre de 2004. Medimos la presión intrabdominal (PIA de forma estandarizada mediante cateterismo vesical, vaciando la vejiga urinaria e introduciendo 100 ml de solución salina al 0,9%. La medición se hizo en una columna de agua graduada en centímetros que tenía como punto cero la sínfisis del pubis, antes y durante la intervención en posición plana y flexionando el tronco a 45 grados y entre 12 a 24 horas después del procedimiento quirúrgico, en posición flexionada. Correlacionamos los valores obtenidos con parámetros tales como: diámetro de la plicatura, índice de la masa corporal, frecuencias cardiaca y respiratoria. Las 100 pacientes del estudio fueron de sexo femenino. Por edades, 47 tenían entre 30 y 39 años de edad, 34 tenían 40 años o más, 18 tenían entre 20 y 29 años y solo 1 era menor de 20 años. Del total, 66 pacientes tenían antecedentes de cirugía abdominal, destacando los procedimientos ginecológicos. Había también 75 pacientes con sobrepeso o algún grado de obesidad. El diámetro de la plicatura muscular realizada osciló entre los 8 y los 10 cm en el 70% de los casos. Demostramos variaciones de la PIA medida en el preoperatorio, intraoperatorio y postoperatorio, tanto en posición plana como flexionada, así como que el aumento de la PIA se produce con mayor frecuencia en pacientes que presentan sobrepeso u obesidad.A randomised, prospective, descriptive study was realized in 100 patient who had an abdominoplasty procedure by one of 15 different surgeons at the Salvador B. Gautier Hospital and the Centro de Cirugía Plástica y Especialidades

Hemipelvectomia: experiência do Hospital Erasto Gaertner com 32 casos em 10 anos Hemipelvectomy: Erasto Gaertner Hospital's experiences with 32 cases in 10 years

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Rosyane Rena de Freitas

2010-01-01

age was 37.94 years. Eight cases showed involvement of the neurovascular bundle: 3 were located in the iliac and extended to the thigh, 2 were in the acetabulum and extended to the thigh and 3 were in the acetabulum and pubis. One involved the iliac-femoral vessels: one in the pubic ramus. Seven cases of chondrosarcoma and 4 cases of Ewing's sarcoma represented the majority. Eight underwent external hemipelvectomy and 24 underwent internal hemipelvectomy (11 were type I; 4 were type II; 2 were type II + III; 3 were type III and 4 were type IV. Of these 24 cases, 13 were without reconstruction, 10 were with a fibular graft and 1 was with an iliac-femoral vein and artery prosthesis. Twenty-six surgeries were curative and 6 palliative. There were 14 deaths. Survival of 2 and 5 years were seen in 11 and 10 cases, respectively. Six cases have less than 2 years of surgery. Three cases were lost during follow-up. CONCLUSION: The study shows the experiences of an exemplary oncology service, specializing in highly complex surgical treatment.

P-19: Rektus Femoris'te Heterotopik Ossifikasyon

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Bilgehan Öztop

2017-03-01

Full Text Available GİRİŞ: Myositis Ossifikans(MO iskelet kası,ciltaltı dokusu ve tendona yakın fibröz dokularda oluşan benign heterotopik kemik formasyonudur. Heterotopik ossifikasyon(HO nörojenik heterotopik ossifikasyon, travmatik heterotopik ossifikasyon, miyozitis ossifikans progresiva olarak genelde üç grupta incelenir[1].Travmatik form özellikle sporcularda posterior uyluk kaslarında ve jokeylerde adduktor longus tendonunun osifikasyonuna bağlı olarak ‘binici kemiği’ şeklinde ortaya çıkabilir.Heterotopik ossifikasyon genellikle travmadan 1-4 ay sonra görülürken,birkaç yıl sonra da gelişebilir[2].Muayenede ağrı,eklem sertliği ile birlikte;nörovasküler yapılara kompresyon gözlenmektedir.Semptomlar sıklıkla lezyonun matürleşmesinden sonra azalır.Tanıda görüntüleme yöntemleri;özellikle malignensilerden ayırmak için yardımcıdır.Tipik patern sınırları belirgin,periferi yüksek dansiteli,merkezi düşük dansiteli kitledir.HO tedavi seçenekleri arasında eklem hareket açıklığının korunması,ilaç tedavisi,radyoterapi ve cerrahi eksizyonu yer almaktadır.Fizyoterapi,asetik asit iyontoforez,magnezyum ve etidronate disodyumun tedavide efektif olduğu bildirilmiştir[3].Bifosfonatlar ve non-steroid antienflamatuar ilaçlar (özellikle indometazinerken dönem tedavide ve profilakside fayda göstermektedir.Cerrahi rezeksiyon maturasyon tamamlandıktan sonra uygulanabilir.Bu hastalık sıklıkla travmaya bağlı diğer hastalıklarla karışabilmektedir.Biz de bir hastamızla bu konuyu sizlere tekrar hatırlatmak istedik.METOD-BULGULAR: Otuzüç yaşında erkek hasta spor hekimliği polikliniğine 3 aydır geçmeyen kalça ağrısı ile başvurdu.Öyküsünde haftada 3 gün 1 saat bisiklete bindiğini ve haftada 2 gün futbol maçı yaptığını belirten hasta,4 ay önce bisikletten düştüğünü belirtti.Dış merkezde osteitis pubis tanısıyla fizik tedavi gören hastanın,muayenesinde iç rotasyon k

Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography: case control study and evaluation of interobserver agreement Características anatômicas e funcionais do assoalho pélvico em nulíparas avaliadas por ultrassonografia tridimensional endovaginal: estudo caso-controle e avaliação da confiabilidade interobservador

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Sthela Maria Murad-Regadas

2013-03-01

Full Text Available PURPOSE: To determine anatomical and functional pelvic floor measurements performed with three-dimensional (3-D endovaginal ultrasonography in asymptomatic nulliparous women without dysfunctions detected in previous dynamic 3-D anorectal ultrasonography (echo defecography and to demonstrate the interobserver reliability of these measurements. METHODS: Asymptomatic nulliparous volunteers were submitted to echo defecography to identify dynamic dysfunctions, including anatomical (rectocele, intussusceptions, entero/sigmoidocele and perineal descent and functional changes (non-relaxation or paradoxical contraction of the puborectalis muscle in the posterior compartment and assessed with regard to the biometric index of levator hiatus, pubovisceral muscle thickness, urethral length, anorectal angle, anorectal junction position and bladder neck position with the 3-D endovaginal ultrasonography. All measurements were compared at rest and during the Valsalva maneuver, and perineal and bladder neck descent was determined. The level of interobserver agreement was evaluated for all measurements. RESULTS: A total of 34 volunteers were assessed by echo defecography and by 3-D endovaginal ultrasonography. Out of these, 20 subjects met the inclusion criteria. The 14 excluded subjects were found to have posterior dynamic dysfunctions. During the Valsalva maneuver, the hiatal area was significantly larger, the urethra was significantly shorter and the anorectal angle was greater. Measurements at rest and during the Valsalva maneuver differed significantly with regard to anorectal junction and bladder neck position. The mean values for normal perineal descent and bladder neck descent were 0.6 cm and 0.5 cm above the symphysis pubis, respectively. The intraclass correlation coefficient ranged from 0.62-0.93. CONCLUSIONS: Functional biometric indexes, normal perineal descent and bladder neck descent values were determined for young asymptomatic nulliparous women