scholarly journals Polarized Dermoscopy Facilitates Diagnosis and Treatment of Plantar Pseudohirsutism

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Sody Naimer
Keyword(s):  
Soft Tissue ◽  
Complete Resolution ◽  
Direct Contact ◽  
Foreign Bodies ◽  
Three Dimensional ◽  
Tissue Reaction ◽  
Hypodermic Needle ◽  
Mild Case ◽  
Case Presentation ◽  
Common Causes

Background. Plantar cutaneous conditions are the most common causes of foot discomfort limiting ambulation. Identification of indwelling foreign bodies is greatly facilitated by dermoscopy, allowing early detection of the character of the underlying pathological etiology. Furthermore, polarized dermoscopy provides ideal conditions of illumination and three- dimensional visualization of the involved site, without direct contact with the cutaneous surface. This unprecedented report describes its implementation for a solitary hair implanted into plantar skin.  Case Presentation. A patient presented with localized plantar discomfort diagnosed as a soft tissue reaction to an embedded single human hair, folded and rooted inside the epidermis. Under magnified vision the phenomenon was characterized, the hair was extracted, the source was manipulated with a hypodermic needle and the lesion was removed with ensuing complete resolution. Conclusions. Previous reports of hair slivers embedded inside the skin were attributed to barbers or animal grooming and the treatment was dictated by the severity of the complications. In this relatively mild case the intervention was greatly facilitated by therapeutic dermoscopy. Therapeutic dermoscopy is advocated for use to evaluate and treat many diverse body surfaces, especially the plantar skin as it raises the likelihood of successful treatment of embedded foreign bodies.  Precisely how a single hair may become lodged into normal plantar skin remains to be explained

scholarly journals Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Niels Hammer ◽  
Ulrich Hirschfeld ◽  
Hendrik Strunz ◽  
Michael Werner ◽  
Thomas Wolfskämpf ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Three Dimensional ◽  
Triangular Fibrocartilage Complex ◽  
Soft Tissue Reconstruction ◽  
Case Presentation ◽  
Complex Anatomy ◽  
Radiocarpal Joint ◽  
Tissue Reconstruction ◽  
Triangular Fibrocartilage ◽  
Magnetic Resonance Imaging Mri

Introduction. The triangular fibrocartilage complex (TFCC) provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This feasibility study aimed at developing a workup for soft-tissue reconstruction using clinical imaging, to verify these results in retrospective patient data. Methods. Microcomputed tomography (μ-CT), 3 T magnetic resonance imaging (MRI), and plastination were used to visualize the TFCC in cadaveric specimens applying segmentation-based 3D reconstruction. This approach further trialed the MRI dataset of a patient with minor radiological TFCC alterations but persistent pain. Results. TFCC reconstruction was impossible using μ-CT only but feasible using MRI, resulting in an appreciation of its substructures, as seen in the plastinates. Applying this approach allowed for visualizing a Palmer 2C lesion in a patient, confirming ex postum the arthroscopy findings, being markedly different from MRI (Palmer 1B). Discussion. This preliminary study showed that image-based TFCC reconstruction may help to identify pathologies invisible in standard MRI. The combined approach of μ-CT, MRI, and plastination allowed for a three-dimensional appreciation of the TFCC. Image quality and time expenditure limit the approach’s usefulness as a diagnostic tool.

scholarly journals Accuracy and Reproducibility of Facial Measurements of Digital Photographs and Wrapped Cone Beam Computed Tomography (CBCT) Photographs

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 757
Author(s):  
Maged Sultan Alhammadi ◽  
Abeer Abdulkareem Al-mashraqi ◽  
Rayid Hussain Alnami ◽  
Nawaf Mohammad Ashqar ◽  
Omar Hassan Alamir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Cone Beam Computed Tomography ◽  
High Reliability ◽  
Three Dimensional ◽  
Cone Beam ◽  
Cross Sectional ◽  
Facial Profile ◽  
Digital Photographs ◽  
Gonial Angle

The study sought to assess whether the soft tissue facial profile measurements of direct Cone Beam Computed Tomography (CBCT) and wrapped CBCT images of non-standardized facial photographs are accurate compared to the standardized digital photographs. In this cross-sectional study, 60 patients with an age range of 18–30 years, who were indicated for CBCT, were enrolled. Two facial photographs were taken per patient: standardized and random (non-standardized). The non-standardized ones were wrapped with the CBCT images. The most used soft tissue facial profile landmarks/parameters (linear and angular) were measured on direct soft tissue three-dimensional (3D) images and on the photographs wrapped over the 3D-CBCT images, and then compared to the standardized photographs. The reliability analysis was performed using concordance correlation coefficients (CCC) and depicted graphically using Bland–Altman plots. Most of the linear and angular measurements showed high reliability (0.91 to 0.998). Nevertheless, four soft tissue measurements were unreliable; namely, posterior gonial angle (0.085 and 0.11 for wrapped and direct CBCT soft tissue, respectively), mandibular plane angle (0.006 and 0.0016 for wrapped and direct CBCT soft tissue, respectively), posterior facial height (0.63 and 0.62 for wrapped and direct CBCT soft tissue, respectively) and total soft tissue facial convexity (0.52 for both wrapped and direct CBCT soft tissue, respectively). The soft tissue facial profile measurements from either the direct 3D-CBCT images or the wrapped CBCT images of non-standardized frontal photographs were accurate, and can be used to analyze most of the soft tissue facial profile measurements.

Congenital hyperinsulinism due to compound heterozygous mutations in ABCC8 responsive to diazoxide therapy

2020 ◽  
Vol 33 (5) ◽  
pp. 671-674
Author(s):  
Tashunka Taylor-Miller ◽  
Jayne Houghton ◽  
Paul Munyard ◽  
Yadlapalli Kumar ◽  
Clinda Puvirajasinghe ◽  
...  
Keyword(s):  
Insulin Secretion ◽  
Compound Heterozygous ◽  
Congenital Hyperinsulinism ◽  
Β Cells ◽  
Pancreatic Β Cells ◽  
Newborn Period ◽  
Case Presentation ◽  
Male Baby ◽  
Common Causes ◽  
Compound Heterozygous Mutations

AbstractBackgroundCongenital hyperinsulinism (CHI), a condition characterized by dysregulation of insulin secretion from the pancreatic β cells, remains one of the most common causes of hyperinsulinemic, hypoketotic hypoglycemia in the newborn period. Mutations in ABCC8 and KCNJ11 constitute the majority of genetic forms of CHI.Case presentationA term macrosomic male baby, birth weight 4.81 kg, born to non-consanguineous parents, presented on day 1 of life with severe and persistent hypoglycemia. The biochemical investigations confirmed a diagnosis of CHI. Diazoxide was started and progressively increased to 15 mg/kg/day to maintain normoglycemia. Sequence analysis identified compound heterozygous mutations in ABCC8 c.4076C>T and c.4119+1G>A inherited from the unaffected father and mother, respectively. The mutations are reported pathogenic. The patient is currently 7 months old with a sustained response to diazoxide.ConclusionsBiallelic ABCC8 mutations are known to result in severe, diffuse, diazoxide-unresponsive hypoglycemia. We report a rare patient with CHI due to compound heterozygous mutations in ABCC8 responsive to diazoxide.

scholarly journals The concept of “Four Walls, Two Poles” in the lesions of the thalamus and ganglion regions: case report and literature review

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haiyang Yang ◽  
Gang Bai ◽  
Yongli Zhang ◽  
Guolong Chen ◽  
Lei Duan ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Literature Review ◽  
Surgical Resection ◽  
Three Dimensional ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Surgical Results ◽  
Case Presentation ◽  
Operation Process ◽  
Thalamic Glioma

Abstract Background There are few articles about the surgical techniques of thalamic glioma and the lesions in the basal ganglia area. According to three existing cases and the literature review (Twelve articles were summarized which mainly described the surgical techniques), we discuss the surgical characteristics of lesions of the thalamus and basal ganglia area and summarize the relevant surgical skills. Case presentation Of the three cases, two were thalamic gliomas and one was brain abscess in basal ganglia. According to the three-dimensional concept of the “Four Walls, Two Poles”, lesions of the thalamus and basal ganglia were surgically removed, and the operative effect was analysed by relevant surgical techniques. Surgical resection of the lesions of the thalamus and basal ganglia area according to the three-dimensional concept of the “Four Walls, Two Poles” has achieved good surgical results. Relevant surgical techniques, such as the use of retractors, the use of aspirators, the choice of surgical approaches, and the haemostasis strategy, also played an important role in the operation process. Conclusions In the presented three cases the three-dimensional concept of the “Four Walls, Two Poles” allowed for safe surgical resection of lesions of the thalamus and basal ganglia.

Soft tissue abnormalities in Wassel Type VI radial polydactyly: a detailed anatomical study

2021 ◽  
Vol 46 (4) ◽  
pp. 352-359
Author(s):  
Susumu Saito ◽  
Itaru Tsuge ◽  
Hiroki Yamanaka ◽  
Naoki Morimoto
Keyword(s):  
Soft Tissue ◽  
Three Dimensional ◽  
Anatomical Study ◽  
Metacarpophalangeal Joint ◽  
Abductor Pollicis Brevis ◽  
Level Of Evidence ◽  
Thenar Muscle ◽  
Pulley System ◽  
Radial Deviation ◽  
Tissue Abnormalities

Wassel VI radial polydactyly is associated with metacarpal adduction and radial deviation of the metacarpophalangeal joint of the ulnar duplicate. The soft tissue abnormalities responsible for these deformities were characterized using preoperative multi-planar three-dimensional ultrasound and intraoperative observation in four patients. In all patients, the abductor pollicis brevis and superficial head of the flexor pollicis brevis inserted into the radial first metacarpal, whereas the adductor pollicis and deep head of the flexor pollicis brevis inserted into the ulnar thumb. Aberrant location of the flexor pollicis longus and absence of the A1 pulley system was associated with severe radial deviation. An additional superficial thenar muscle along the ulnar metacarpal was associated with minimal metacarpal adduction. Uneven forces on the ulnar duplicate could be associated with these characteristic deformities and joint instability. Knowledge of these abnormalities allows better planning of surgery and further insight into this rare radial polydactyly configuration. Level of evidence: II

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