scholarly journals Preoperative Endovascular Embolisation of the Symptomatic Hemangioma in 7th Thoracic Vertebrae: Case Report

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Igor Sekulic ◽  
Aleksandar Jovanovski ◽  
Jelena Stevanovic ◽  
Jelena Boskovic-Sekulic ◽  
Dragan Dulovic ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Surgical Intervention ◽  
Intraoperative Complications ◽  
Mass Effect ◽  
The Body ◽  
Thoracic Vertebrae ◽  
Vertebral Hemangioma ◽  
Worldwide Population ◽  
Magnetic Resonance Imaging Mri ◽  
Control Angiography

Abstract Although, as asymptomatic, they appear in about 10- 12% of the worldwide population, vertebrae hemangiomas are symptomatic in about 0.9-1.2% of all the cases. We showed the case of the symptomatic hemangioma in the 7th thoracic vertebrae in 67 year old patient, that was successfully preoperative embolised. Magnetic resonance imaging (MRI) detected the tumor in the body of 7th vertebrae with mass effect on the anterior aspect of the spinal cord. Multidetector computed tomography (MDCT) imaging describes this tumor as hemangioma that is in the body of the 7th vertebrae and in the both pedicules. We performed selective and supraselective spinal angiography which showed pathological vascularisation of the tumor, and then the tumor was embolised. The control angiography detected the reduction of the tumor blood vessels, as a sign of the successful embolisation. Ten days after embolisation, the patient went through corporectomia of the Th7 and the stabilization of the thoracic spine was performed. Intraoperative blood transfusion in our patient was 930 mL, while expected blood transfusion during the surgical intervention without preoperative embolisation is about 1600 mL. Method of choice in conditions with neurological compressive symptoms caused by vertebral hemangioma is surgery for the decompression of the nerve structures. Embolisation of aggressive vertebral hemangioma is recommended and preoperatively performed for the intraoperative hemorrhage reduction and decreasing of intraoperative complications.

scholarly journals A totally extraperitoneal approach for endoscopic resection of a congenital prepubic sinus through the pubic symphysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Masahiro Fukuhara ◽  
Shun Onishi ◽  
Yusuke Yonemura ◽  
Tomoe Sato ◽  
Satoshi Tsutsumi ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Intraoperative Complications ◽  
Pubic Symphysis ◽  
Complete Resection ◽  
Rectus Abdominis ◽  
The Body ◽  
Preperitoneal Space ◽  
Extraperitoneal Approach ◽  
Totally Extraperitoneal ◽  
Good Visibility

Abstract Background A congenital prepubic sinus (CPS) is a rare congenital anomaly in which a duct remnant extends from the skin opening near the pubic symphysis to various parts and the lesions are mostly located in the preperitoneal space. The totally extraperitoneal (TEP) approach is an operational method that provides a good field of view for the preperitoneal space. We report the CPS through the pubic symphysis in which complete resection was achieved by a TEP approach. TEP approach was minimally invasive and achieved satisfactory cosmetic outcome. Case presentation We herein report the case of a 13-year-old boy with a fistula opening near the dorsal penis. He was admitted to our hospital due to fever and lower abdominal pain. Abdominal ultrasonography and computed tomography revealed an abscess inside a fistula lumen on the posterior surface of the rectus abdominis muscles in the midline of the lower abdomen. Under a diagnosis of CPS, which was located in the preperitoneal space, endoscopic resection was performed by a totally extraperitoneal approach. After making an umbilical incision, the rectus abdominis muscle was excised outward to expose the preperitoneal space. A single-port system was placed in the preperitoneal space. Three 5-mm-port trocars were inserted. As the preperitoneal cavity was expanded, a sinus connecting to the pubic symphysis was confirmed. The pubic symphysis did not connect with the bladder. Because the fistula was penetrated with the pubic symphysis, the remaining caudal fistula was removed from the body surface with a small spindle-shaped incision around the fistula opening. Finally, the sinus was completely resected, with confirmation from both the cranial side and dorsal side of the pubic symphysis. We were able to perform complete resection of the CPS with good visibility and without any peritoneal damage. There were no intraoperative complications. His postoperative course was uneventful during the 1-year follow-up. Conclusions The TEP approach may be feasible for the resection of a CPS and may allow safe and secure resection due to good visibility, even in pediatric patients.

scholarly journals Classification of Shoulder X-ray Images with Deep Learning Ensemble Models

2021 ◽  
Vol 11 (6) ◽  
pp. 2723
Author(s):  
Fatih Uysal ◽  
Fırat Hardalaç ◽  
Ozan Peker ◽  
Tolga Tolunay ◽  
Nil Tokgöz
Keyword(s):  
Deep Learning ◽  
Performance Test ◽  
The Body ◽  
Test Accuracy ◽  
Cohen’S Kappa ◽  
X Ray ◽  
Cohen's Kappa ◽  
Auc Value ◽  
Magnetic Resonance Imaging Mri ◽  
Fully Connected

Fractures occur in the shoulder area, which has a wider range of motion than other joints in the body, for various reasons. To diagnose these fractures, data gathered from X-radiation (X-ray), magnetic resonance imaging (MRI), or computed tomography (CT) are used. This study aims to help physicians by classifying shoulder images taken from X-ray devices as fracture/non-fracture with artificial intelligence. For this purpose, the performances of 26 deep learning-based pre-trained models in the detection of shoulder fractures were evaluated on the musculoskeletal radiographs (MURA) dataset, and two ensemble learning models (EL1 and EL2) were developed. The pre-trained models used are ResNet, ResNeXt, DenseNet, VGG, Inception, MobileNet, and their spinal fully connected (Spinal FC) versions. In the EL1 and EL2 models developed using pre-trained models with the best performance, test accuracy was 0.8455, 0.8472, Cohen’s kappa was 0.6907, 0.6942 and the area that was related with fracture class under the receiver operating characteristic (ROC) curve (AUC) was 0.8862, 0.8695. As a result of 28 different classifications in total, the highest test accuracy and Cohen’s kappa values were obtained in the EL2 model, and the highest AUC value was obtained in the EL1 model.

Magnetic Resonance Imaging in the Diagnosis of Disruption of the Posterior Tibial Tendon

Foot & Ankle ◽  
1987 ◽  
Vol 8 (3) ◽  
pp. 144-147 ◽  
Author(s):  
Ian J. Alexander ◽  
Kenneth A. Johnson ◽  
Thomas H. Berquist
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissues ◽  
Diagnostic Technique ◽  
Clinical Findings ◽  
The Body ◽  
Posterior Tibial Tendon ◽  
Resonance Imaging ◽  
Posterior Tibial ◽  
Magnetic Resonance Imaging Mri

Magnetic resonance imaging (MRI), a useful technique of studying soft tissues of the body, can be very effective in assessing the integrity of tendons. Usually a patient with a complete tear of the posterior tibial tendon has characteristic physical findings. In the patient presented, MRI demonstrated a complete disruption of the posterior tibial tendon, despite the absence of the commonly associated clinical findings. In view of the difficulties encountered with attempted tenography of the completely torn posterior tibial tendon, MRI provides a sensitive alternative diagnostic technique.

scholarly journals When the Blood Hits Your Brain: The Neurotoxicity of Extravasated Blood

2021 ◽  
Vol 22 (10) ◽  
pp. 5132
Author(s):  
Jesse A. Stokum ◽  
Gregory J. Cannarsa ◽  
Aaron P. Wessell ◽  
Phelan Shea ◽  
Nicole Wenger ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Surgical Intervention ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Critical Factor ◽  
Mass Effect ◽  
Direct Role ◽  
Scientific Curiosity ◽  
Clot Removal ◽  
Clinical Literature ◽  
The Central Nervous System

Hemorrhage in the central nervous system (CNS), including intracerebral hemorrhage (ICH), intraventricular hemorrhage (IVH), and aneurysmal subarachnoid hemorrhage (aSAH), remains highly morbid. Trials of medical management for these conditions over recent decades have been largely unsuccessful in improving outcome and reducing mortality. Beyond its role in creating mass effect, the presence of extravasated blood in patients with CNS hemorrhage is generally overlooked. Since trials of surgical intervention to remove CNS hemorrhage have been generally unsuccessful, the potent neurotoxicity of blood is generally viewed as a basic scientific curiosity rather than a clinically meaningful factor. In this review, we evaluate the direct role of blood as a neurotoxin and its subsequent clinical relevance. We first describe the molecular mechanisms of blood neurotoxicity. We then evaluate the clinical literature that directly relates to the evacuation of CNS hemorrhage. We posit that the efficacy of clot removal is a critical factor in outcome following surgical intervention. Future interventions for CNS hemorrhage should be guided by the principle that blood is exquisitely toxic to the brain.

Congenital Heart Disease and Childhood Adjustment

1971 ◽  
Vol 2 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Edward T. Auer ◽  
Audrey G. Senturia ◽  
Moisy Shopper ◽  
Ralph L. Biddy
Keyword(s):  
Body Image ◽  
Surgical Intervention ◽  
Intellectual Functioning ◽  
Emotional Disturbances ◽  
The Body ◽  
Psychiatric Clinic ◽  
Control Group ◽  
Significant Difference ◽  
Figure Drawings ◽  
Childhood Adjustment

This report deals with the findings from a study of twenty-eight children, all of whom had ventricular septal defects and were studied by the same cardiovascular team. One-half of the group had a surgical procedure for correction of the defect. The study investigated three problems in children with ventricular septal defect ( VSD). (1) Do children with surgical intervention for VSD show greater impairment of intellectual functioning than non-operated children? (2) Do children with surgical intervention show greater emotional disturbance than non-operated children? (3) Do children with surgical intervention show greater alteration of body image than do non-operated children? Data were collected using questionnaires, family interviews, subject interviews, medical records, school reports, physicians' reports and Human Figure Drawings, both inside and outside the body. The findings conclude that ( a) operated children do demonstrate significantly more impairment of intellectual functioning; ( b) there was no significant difference in the incidence of emotional disturbances between the two groups but that these twenty-eight children with VSD were more similar emotionally to children in a psychiatric clinic group than in a control group; and ( c) the only indication of altered body image was found in the greater frequency with which bones were drawn by the operated group.

scholarly journals Reconfigurable MRI coil technology can substantially reduce RF heating at the tips of bilateral deep brain stimulation implants

2018 ◽  
Author(s):  
Laleh Golestanirad ◽  
Boris Keil ◽  
Sean Downs ◽  
John Kirsch ◽  
Behzad Elahi ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Temperature Rise ◽  
Substantial Reduction ◽  
The Body ◽  
Rf Heating ◽  
Coil System ◽  
Body Coil ◽  
Magnetic Resonance Imaging Mri ◽  
Deep Brain

AbstractPatients with deep brain stimulation (DBS) implants can significantly benefit from magnetic resonance imaging (MRI) examination, however, access to MRI is restricted in this patients because of safety concerns due to RF heating of the leads. Recently we introduced a patient-adjustable reconfigurable MRI coil system to reduce the SAR at the tip of deep brain stimulation implants during MRI at 1.5T. A simulation study with realistic models of single (unilateral) DBS leads demonstrated a substantial reduction in the local SAR up to 500-fold could be achieved using the coil system compared to quadrature birdcage coils. Many patients however, have bilateral DBS implants and the question arises whether the rotating coil system can be used in for them. This work reports the results of phantom experiments measuring the temperature rise at the tips of bilateral DBS implants with realistic trajectories extracted from postoperative CT images of 10 patients (20 leads in total). A total of 200 measurements were performed to record temperature rise at the tips of the leads during 2 minutes of scanning with the coil rotated to cover all accessible rotation angles. In all patients, we were able to find an optimum coil rotation angle and reduced the heating of both left and right leads to a level below the heating produced by the body coil. An average heat reduction of 65% was achieved for bilateral leads. Reconfigurable coil technology introduces a promising approach for imaging of patients with DBS implants.

scholarly journals Unusual Site for a White Nodule on the Palatine Tonsil: Presentation, Differential Diagnosis, and Discussion

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ashwag Yagoub Aloyouny
Keyword(s):  
Differential Diagnosis ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Fungal Infections ◽  
The Body ◽  
Palatine Tonsil ◽  
Unusual Site ◽  
Case Presentation ◽  
Lymphoepithelial Cysts ◽  
Malignant Lesions

Introduction. Palatine tonsils are part of the mucosa-associated lymphoid tissue, located in the oropharyngeal region. Although these tissues protect the body from foreign intruders, they are more prone to infections due to their anatomical structure and location. For instance, the differential diagnosis of a white lesion on the palatine tonsil can range from benign to malignant lesions. Oral lymphoepithelial cysts commonly arise as painless, yellowish nodules on the floor of the mouth and the ventral or lateral surface of the tongue. Case Presentation. This paper presents a rare case of an unusual site of a lymphoepithelial cyst (LEC) in the oral cavity. The lesion was located in the tonsil of a 20-year-old woman with a chief complaint of a painless, white lump in the back of the mouth for nine months. Discussion. The differential diagnosis of a white lesion on the palatine tonsil is caused by several factors, such as bacterial, viral, and fungal infections; trauma; stones; cysts; abscess; or cancer. In this case, both the clinical presentation and extra- and intraoral examinations were highly associated with LEC. Oral LEC etiopathogenesis is uncertain, and several theories have been proposed to discuss the causes of LEC. In addition, oral LEC could be monitored without surgical intervention if the nodule is asymptomatic. Conclusion. We emphasize the importance of a thorough clinical examination of oral and oropharyngeal lesions, which are usually neglected.

scholarly journals SAT-249 Polyarticular Osteoarthritis: A Disabling Manifestation of Acromegaly

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Azkia Khan ◽  
Hashim Ejaz ◽  
Vijaykumar Sekar ◽  
Sofia Syed
Keyword(s):  
Pituitary Adenoma ◽  
Endocrine System ◽  
Mass Effect ◽  
Free Testosterone ◽  
The Body ◽  
Medical Attention ◽  
Serum Prolactin ◽  
Oral Glucose ◽  
Patient Reported ◽  
Hands And Feet

Abstract Background Acromegaly is a slow-onset rare endocrinopathy that is characterized by chronic overproduction of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). Excess GH and IGF-1 levels lead to insulin resistance, which is implicated in most of the complications associated with acromegaly. We present a case of acromegaly, wherein the patient presented with worsening polyarthralgia and decreasing mobility. As the patient was undergoing workup for rapidly progressing osteoarthritis, the internist became suspicious of patient’s changing physical appearance. Case A 53-year-old man with medical history of diabetes mellitus and hypertension was referred to endocrine clinic on account of high IGF-1 levels, 909 ng/ml (normal: 37-245 ng/ml). He was seeking medical attention because of rapidly progressing polyarthralgia and stiffness for the last two years. His symptoms were intensifying despite use of non-steroidal anti-inflammatory drugs and intra-articular steroid injections. Imaging revealed severe degenerative changes and narrowing of joint space in bilateral hip, knee and glenohumeral joints. Internist observed that the patient was exhibiting stigmata of acromegaly such as enlargement of hands and feet, prognathism and dental space widening. Patient reported headaches, blurry vision, sleep apnea, dysphagia and right ear exostosis. Colonoscopy revealed hyperplastic polyps. Repeat IGF- 1 levels were 910 ng/ml (Normal: 37-245 ng/ml). Oral glucose tolerance test showed failure of suppression of GH. Serial GH levels were 4.50, 5.08, 6.74, 5.81 and 5.21 ng/ml (Normal: 0.01- 0.97 ng/ml). Tests for other endocrinopathies revealed the following results: serum prolactin 4 ng/ml (Normal <18 ng/ml), serum cortisol 7.9 ug/dl (Normal: 6-27 ug/dl), 24 hour urine cortisol 23mcg/24 hours (Normal: 3.5-45 mcg/24 hours), serum TSH 2.25 uIU/ml (Normal: 0.34- 3 uIU/ml), serum T4 level 0.7 ng/dl (Normal: 0.6-1.6 ng/dl) and serum T3 level 144.9ng/dl (Normal: 87-178 ng/dl). Serum total and free testosterone levels were 111 ng/dl (Normal: 240-950 ng/dl) and 3.89 ng/dl (Normal: 4.06-15.6 ng/dl) respectively and were suggestive of hypogonadism. MRI Brain showed 12x10x8mm pituitary adenoma. He was referred for transsphenoidal surgery for resection of pituitary adenoma. Conclusion Polyarticular osteoarthritis is an early manifestation of acromegaly. Systemic diseases associated with acromegaly are the primary reason for which most patients seek medical attention. It is important to look for coexisting endocrinopathies whenever the diagnosis of acromegaly is established, since mass effect of pituitary adenoma can wreak havoc on the endocrine system of the body. High index of suspicion, early diagnosis and prompt treatment are the key to reverse some but not all comorbid conditions associated with acromegaly.

The Imaginal Ecdysis of Blowflies. The Control of Cuticuar Hardening and Darkening

1962 ◽  
Vol 39 (3) ◽  
pp. 395-412
Author(s):  
C. B. COTTRELL
Keyword(s):  
Blood Transfusion ◽  
Critical Period ◽  
Body Wall ◽  
The Body ◽  
Internal Organs ◽  
Active Factor

1. Blood transfusion experiments show that normal hardening and darkening at the imaginal ecdysis of CaUiphora erythrocephala (Meigen) is brought about by the release into the blood of an active factor. Introduction of this factor into a newly emerged fly some 35 min. prior to the time at which it would normally be released is sufficient to prevent expansion. 2. The factor is normally released some 45 min. before the appearance of the first signs of darkening and between 3 and 15 min. after the fly has reached conditions suitable for expansion, that is at about the time of initiation of air-pumping. 3. Decapitation at emergence will prevent the initiation of normal hardening and darkening but not of secondary darkening. Evidently the head is concerned in the release or the control of the release of the blood-borne darkening factor. 4. The critical period for the prevention of normal hardening and darkening by decapitation lies between 3 and 15 min. after the fly has reached conditions suitable for expansion. 5. Isolated abdomina behave in a manner similar to decapitated flies but their reactions are complicated by secondary darkening associated with damage. 6. Flies deprived of their abdomina will expand at least partially but the rate of their hardening and darkening is reduced. 7. Damage reactions resembling secondary darkening in digging flies are more extensive after damage to internal organs such as the gut than to superficial organs such as the body wall. 8. Allowing for the effects of secondary darkening it is possible to demonstrate the occurrence of the blood-borne darkening factor by means of ligatures placed at emergence between the thorax and the abdomen. Under these conditions only the head and thorax exhibit normal darkening.

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