Palatoschisis, Schizophrenia and Hypocalcaemia: Phenotypic Expression of 22q11.2 Deletion Syndrome (DiGeorge Syndrome) in an Adult

22q11.2 deletion syndrome typically presents with congenital cardiac anomalies, immunodeficiencies and hypoparathyroidism. However, clinical findings vary greatly. We present the case of a 56-year-old man, with a history of cleft palate and schizophrenia, who was newly diagnosed with 22q11.2 deletion syndrome during an episode of hypocalcaemia. The syndrome is caused by developmental abnormalities of the embryonic pharyngeal arch system. Treatment of hypocalcaemia with oral calcium and vitamin D is usually sufficient.

Anatomical organization of aortic arch variation with embryological basis and clinical application

Introduction: The variation in the aortic arch is well known and it has been demonstrated by number of researchers. Changes involved in the development of aortic arch system such as regression, retention or reappearance result in the variation in branching pattern of aortic arch. Variations of the branches of aortic arch are due to alteration of branchial arch arteries during embryonic period. The most common classical branching pattern of the aortic arch in humans comprises of three great vessels, which includes Brachiocephalic trunk, Left Common Carotid artery and Left Subclavian artery. Aim: The study is to determine the embryological basis correlating with clinical application and surgical procedures. Materials and Methods: A study was conducted in 50 formalin fixed cadaveric hearts, during a period of two years. In the routine dissection for 1st MBBS and also museum specimens we encountered 3variations in the branches of arch of aorta. Results: The variations in aortic arch branching pattern were observed in 4 cadaveric hearts (8%). Conclusion: The wide spectrum of variation in the human aortic arch and its branches offer valuable information to catheterize in endovascular surgery for diagnostic and surgical procedures in the thorax, head and neck regions. KEY WORDS: Aortic Arch (AA), Left Common Carotid (LCCA), Left Subclavian (LSA), Brachiocephalic Trunk (BCT), left vertebral artery(LVA).

Comparison of Anterior only and Combined Anterior and Posterior Approach in Treating Lumbosacral Tuberculosis

A combined anterior and posterior (AP) surgical approach is a popular treatment modality of lumbosacral tuberculosis, but it is often traumatic and complicated. The present study aims to find whether the anterior only approach with the ARCH plate system is less invasive than the AP approach in treating lumbosacral tuberculosis. The ARCH plate system is an innovative anatomic lumbosacral anterior multi-directional locking plate system which was devised with due consideration to the anatomic features of the lumbosacral spine and irregular destruction of involved vertebral endplates. In this retrospective study, 32 patients with lumbosacral tuberculosis underwent surgeries via either the anterior only approach (ARCH group, 18 patients) using the ARCH system or the conventional combined anterior and posterior approach (AP group, 14 patients). American Spinal Injury Association (ASIA) scores, Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI), bone union status, ESR, CRP, intervertebral foraminal height between L5 and S1, the vertical height between the anterior upper edge of L5 and S1 vertebral body, lumbosacral angle, and the physiological lordosis of between L1 and S1 from both groups were recorded and compared. All patients were followed up for at least two years. The average duration of operation, blood loss, and length of hospital admission of the ARCH group (154.6 min, 361.1 ml&18.3days) was significantly smaller and shorter(p < 0.001, p < 0.001 & p = 0.008) that those of the AP group(465.5 min, 814.3 ml & 24.6days). The ODI score(p = 0.08, 0.471, 0.06, 0.07, 0.107), the VAS score(p = 0.099, 0.249, 0.073, 0.103, 0.273), the intervertebral foraminal height between L5 and S1(p = 0.826, 0.073, 0.085), L5-S1 height(p = 0.057, 0.234, 0.094), lumbosacral angle(p = 0.052, 0.242, 0.825), and L5-S1 lordosis(p = 0.146, 0.129, 0.053) of both groups showed no significant difference in any of the time points. The anterior only approach using the ARCH system is as effective as the combined anterior and posterior approach and is less traumatic in treating lumbosacral tuberculosis.

Impacts of temperature on the stress-strain state of aerial braces of arch systems

Introduction. In landmark buildings, floorings and roofs are performed as vault and arch systems. For accommodation of horizontal forces in the arches, aerial braces are used. Aerial braces of an arch system are a tie made of wrought iron with a cross-sectional area from 10 to 50 cm2. In the scientific and technical literature, information on aerial braces is extremely poor. Materials and methods. To assess the impacts of temperature deformations on the bearing strength of the aerial braces, a computational analysis was performed. On the basis of data on standard structural schemes of the landmark buildings, the characteristic length of aerial braces was taken into account. Averaged climatic data calculated on the basis of weather observations for the period 1988–2017 for 13 climatic regions of Russia were analysed. Since the data on the temperature of the closure of the distance piece system are irrevocably missing, two variants of the outdoor temperature were considered for the installation of the aerial braces: zero and the maximum summer temperature. Results. Calculations were carried out and the strain arising in the aerial braces at the corresponding temperature elongation values obtained under recognition of the different temperatures of arch system closure was determined. Totally 78 temperature graphs were obtained and analysed for different climate areas, with different closure temperatures of arched systems. Conclusions. It was found out that, for the assessment of the impacts of temperature deformation on the bearing capacity of aerial braces, the actual temperature of the arch system closure is decisive. The safety factor of the bearing strength of aerial braces of arch systems for most climatic zones exceeds 50 % and can reach 92 %. At the same time, for two areas with significant negative temperatures in the winter period, the utilization ratio of aerial braces can reach 0.6–0.63. The maximum temperature elongation of aerial braces with a length of 6 m does not exceed 3 mm in case of mounting at the maximum summer temperature and 2 mm at the zero point.

Type door rigid frame - pile arch system characteristics and disaster prevention application in thermodynamics

The construction of mountain roads often promotes the occurrence of landslides, and poses a serious threat to the safety of driving and the geological environment. This paper introduces a new type of road landslide area anti-sliding structure based on thermal factors. The type door rigid frame-pile arch system, it is mainly composed of three parts: the gate type anti-slide pile, the reinforced concrete arch plate, and the mouth shaped guard pier. Its characteristics are: door-type anti-slide pile role is to resist the landslide thrust and the main road as a support structure; reinforced concrete arch between the plate as the door-type anti-slide pile and pile retaining force transmission member, active play arch structure compression high strength, can change the mechanical properties of stress paths, so that the lateral landslide sliding force to reduce; shaped mouth guard pier to control the deformation and solid slope, and enhance the overall stability of the system. The FLAC3D simulation results show that the stress distribution of arch plate is more uniform, with the increase of the sliding force, the stress in the arch foot and the lower part of the arch plate increases rapidly, which accords with the principle of soil arching. At the same time, the contact beam gradually works, The landslide thrust is transmitted to the front row of piles. The stress of the rear row of piles increases more than that of the front row of piles. The stress of the upper part of the beam increases more than that of the lower part of the beam. The overall trend is more and more gentle.

Vascular ring, an uncommon presentation of BRUE in newborns

Vascular rings are a group of anomalies caused by abnormal embryologic development of the branchial arch system. They can lead to variable degrees of respiratory problems or feeding difficulties by forming a complete or partial ring compressing the trachea, the bronchi, and the oesophagus. Vascular rings not being so common, a missed diagnosis is much more common. Hence a high degree of suspicion along with appropriate imaging study is required to make a diagnosis. This case report describes an uncommon acute presentation of a vascular ring in newborn as a brief resolved unexplained event (BRUE).

Double Aortic Arch – A Case Study

Double aortic arch (DAA) is one of the 2 most common forms of vascular ring, a class of congenital anomalies of the aortic arch system in which the trachea and esophagus are completely encircled by connected segments of the aortic arch and its branches. The aim of this study is to describe a case of DAA in a middle aged person. A 40 year old male came to outdoor patient department with cough and breathlessness since childhood which was diagnosed earlier as bronchial asthma, cold allergy, and dust allergy. The final diagnosis DAA was made after CT angiogram. Establishing a diagnosis of DAA in a middle aged person requires thorough understanding and clinical skills in performing steps.Cardiovasc. j. 2017; 10(1): 91-93