RESUMO
Geosynthetic clay liners (GCLs) are mostly used as flow barriers in landfills and waste containments due to their low hydraulic conductivity to prevent the leachate from reaching the environment. The self-healing and swell-shrink properties of soft clays (expansive soils) such as bentonite enable them as promising materials for the GCL core layers. However, it is important to modify their physico-chemical properties in order to overcome the functional limitations of GCL under different hydraulic conditions. In the present study, locally available black cotton soil (BCS) is introduced in the presence of an anionic polymer named carboxymethyl cellulose (CMC) as an alternative to bentonite to enhance the hydraulic properties of GCL under different compositions. The modified GCL is prepared by stitching the liner with an optimum percentage of CMC along with various percentages of BCS mixed with bentonite. Hydraulic conductivity tests were performed on the modified GCL using the flexi-wall permeameter. The results suggest that the lowest hydraulic conductivity of 4.58 × 10-10 m/s is obtained when 25% of BCS is blended with bentonite and an optimum 8% CMC and further addition of BCS results in the reduction of the hydraulic conductivity.
Assuntos
Bentonita , Eliminação de Resíduos , Bentonita/química , Argila , Solo , Metilcelulose , Eliminação de Resíduos/métodos , Carboximetilcelulose SódicaRESUMO
Knowledge about distribution of dissolved plumes and their influencing factors is essential for risk assessment and remediation of light non-aqueous phase liquid contamination in groundwater. Present study deals with the applicability of numerical model for simulating various hydro-geological scenarios considering non-uniform source distribution at a petroleum contaminated site in Chennai, India. The complexity associated with the hydrogeology of the site has limited scope for on-site quantification of petroleum pipeline spillage. The change in fuel composition under mass-transfer limited conditions was predicted by simultaneously comparing deviations in aqueous concentrations and activity coefficients (between Raoult's law and analytical approaches). The effects of source migration and weathering on the dissolution of major soluble fractions of petroleum fuel were also studied in relation to the apparent change in their activity coefficients and molar fractions. The model results were compared with field observations and found that field conditions were favourable for biodegradation, especially for the aromatic fraction (benzene and toluene (nearly 95% removal), polycyclic aromatic hydrocarbons (up to 65% removal) and xylene (nearly 45% removal). The results help to differentiate the effect of compositional non-ideality from rate-limited dissolution towards tailing of less soluble compounds (alkanes and trimethylbenzene). Although the effect of non-ideality decreased with distance from the source, the assumption of spatially varying residual saturation could effectively illustrate post-spill scenario by estimating the consequent decrease in mass transfer rate.
Assuntos
Água Subterrânea/química , Modelos Teóricos , Petróleo/análise , Hidrocarbonetos Policíclicos Aromáticos/química , Poluentes Químicos da Água/química , Biodegradação Ambiental , Poluição Ambiental/análise , Índia , Movimentos da Água , Poluentes Químicos da Água/análiseRESUMO
OBJECTIVE: The purpose of this study is to understand the epidemiology, clinical features, behavior, and the prognostic factors that influence the outcome of intracranial meningiomas in children. METHODS: Thirty-one patients with age less than 18 years who underwent surgery for intracranial meningiomas during the period of at 1988-2012 at Voluntary Health Services Hospital, Chennai, India were studied. These formed 3.7 % of the total 831 cases of intracranial meningiomas operated at the institute. RESULTS: The study group included 22 (71 %) males and 9 (29 %) females. The mean age of presentation was 15 years, with the youngest being 9 months old. Two (6 %) had evidence of neurofibromatosis type 2 (NF2). The most common symptoms at presentation were seizures in 11 (35.5 %), weakness of limbs in 11 (35.5 %), and raised intracranial pressure in 10 (32 %). Convexity meningiomas were seen in 16 (51 %) and skull base in 15(49 %). Multiple meningiomas was seen in two (6 %) of the patients and intraventricular location was found in one patient (3 %). Two (6 %) had evidence of NF2. Gross total excision was achieved in 26 (83 %) and subtotal excision in 5 (17 %). WHO grade I was found in 20 (64 %) and higher grade was seen in 11 (36 %). The mean follow-up was 46.2 months. Recurrence was seen in 20 patients (64 %). In patients with higher grade or with recurrence resurgery and radiotherapy was given. Three (9 %) had multiple recurrences. On a mean follow-up of 46.2 months, 25 patients (81 %) were neurologically intact, 5 (16 %) were having moderated disability, and 1 (3 %) patient died. CONCLUSIONS: Childhood meningiomas are uncommon lesions with a slight male predominance. They can have a varied clinical presentation. Higher grade is found more frequently compared with adults. Gross total resection is the goal and in higher grade meningiomas radiotherapy helps as a good adjuvant. Though the rate of recurrence is high, resurgery and radiotherapy gives a good outcome.
Assuntos
Neoplasias Meníngeas/terapia , Meningioma/terapia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Neoplasias Meníngeas/radioterapia , Neoplasias Meníngeas/cirurgia , Meningioma/radioterapia , Meningioma/cirurgia , Radioterapia Adjuvante , Fatores Sexuais , Taxa de Sobrevida , Resultado do TratamentoRESUMO
OBJECTIVE: The aim of the present study was to determine the anti-ulcer activity of a methanol extract of Bauhinia purpurea leaf (MEBP). MATERIALS AND METHODS: MEBP was administered at doses of 100, 500 and 1,000 mg/kg and its effects on acute toxicity, absolute ethanol- and indomethacin-induced gastric ulceration, and pyloric ligation tests in rats were investigated. RESULTS: At a dose of 5,000 mg/kg, MEBP did not cause any signs of toxicity in rats when given orally. Oral administration of MEBP exerted anti-ulcer activity (p < 0.05) in all models tested. However, a dose-dependent protection was observed only in the indomethacin-induced gastric ulceration model. Histological studies supported the observed anti-ulcer activity of MEBP. In the pyloric ligation assay, MEBP significantly increased gastric wall mucus secretion (p < 0.05), but did not affect the acidity of the gastric contents. CONCLUSION: MEBP exhibited anti-ulcer activity, which could be due to the presence of flavonoids, saponins or other polyphenols, thereby validating the traditional use of B. purpurea in the treatment of ulcers.
Assuntos
Bauhinia , Fármacos Gastrointestinais/farmacologia , Extratos Vegetais/farmacologia , Úlcera/tratamento farmacológico , Animais , Relação Dose-Resposta a Droga , Fármacos Gastrointestinais/administração & dosagem , Fármacos Gastrointestinais/uso terapêutico , Indometacina/farmacologia , Masculino , Metanol/química , Omeprazol/farmacologia , Extratos Vegetais/administração & dosagem , Extratos Vegetais/química , Extratos Vegetais/uso terapêutico , Folhas de Planta , Ratos , Ratos Sprague-Dawley , Úlcera Gástrica/induzido quimicamenteRESUMO
BACKGROUND: Increased incidence of fungal infection has been reported globally in the recent years. Fungal infection of the central nervous system remains one of the most difficult diseases to treat and requires multi-modality intensive therapeutic strategies. MATERIALS AND METHODS: Retrospective analysis of case records of patients with confirmed skull base fungal granuloma treated at a tertiary hospital between 1988-2008. An attempt was made to stage the extent of skull base fungal granuloma based on neuroimaging, operative findings and course of the disease on serial follow-up. RESULTS: Thirty-three patients with skull base fungal granuloma were treated surgically during the study period. The mean age at presentation was 33.2 years and diabetes was a major predisposing factor. Eight patients expired in the first two months following surgical intervention due to flare-up of the disease. Eighteen patients who underwent grossly total excision had a mean progression-free survival (PFS) of 43 months and seven patients with subtotal excision had a mean PFS of 23 months. Better survival probability was noted in those patients who underwent total excision at surgery and received complete course of amphotericin. CONCLUSION: Total surgical excision with complete course of antimycotic drug therapy increases PFS. A better antimycotic drug with less toxicity and high efficacy with fungicidal property can make a difference in the outcomes of the disease.
Assuntos
Infecções Fúngicas do Sistema Nervoso Central/cirurgia , Granuloma/cirurgia , Base do Crânio/patologia , Adolescente , Adulto , Idoso , Infecções Fúngicas do Sistema Nervoso Central/complicações , Diabetes Mellitus/terapia , Intervalo Livre de Doença , Feminino , Seguimentos , Granuloma/complicações , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Adulto JovemRESUMO
INTRODUCTION: Temporal contusions are common in patients with head injuries and require close monitoring due to the propensity of these patients to deteriorate rapidly and fatally. This study attempts to introduce a radiological grading system for temporal lobe contusions and analyse its prognostic value so as to better identify patients at risk of deterioration. METHODS: The study was conducted as a cross-sectional observational study from April 2011-March 2017 on 42 patients with temporal lobe contusion. Each patients was graded according to the proposed system from a minimum of four to a maximum of 13 and then further grouped in three grades - grade 1 (score = 4), grade 2 (score 5-7) and grade 3 (score > 7) - and their clinical course was closely observed. RESULTS: The minimum and maximum scores observed were four and 11 respectively. The proposed grading system has statistically significant correlation to the Glasgow Coma Scale (p-value < 0.05). All patients in grade 1 (17) could be managed conservatively, while all those in grade 3 (five) needed immediate surgical intervention. Of 20 patients in grade 2, 11 had a score of 5-6 and did not require surgery, whereas nine patients had a score of seven and of these eight required delayed surgical intervention. This correlation was statistically significant (p-value < 0.05). CONCLUSION: The proposed temporal lobe contusion grading system is a good radiological tool to predict the clinical course of patients and thereby identify patients at higher risk of delayed deterioration.
Assuntos
Contusão Encefálica/diagnóstico por imagem , Traumatismos Craniocerebrais/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
OBJECTIVE: To study the course, relationships, branches and possible anomalies of the vertebral artery in the suboccipital region in adult Indian cadavers. MATERIALS AND METHODS: Twenty-one suboccipital segment vertebral artery specimens from embalmed, Indian adult cadavers were dissected and studied. Dissection was performed using microsurgical instruments and was carried out from the skin up to the vertebral artery in layers. The course, relationships and the branches of the vertebral artery were studied and measurements were taken using Vernier calipers. The readings obtained were corroborated with the measurements derived from the digital images using a computer. OBSERVATIONS: All the vertebral arteries had a tortuous course and were covered with rich venous plexuses. None of the specimens had an anomalous course. The artery was divided into a vertical segment (Vv) between C2 and C1 vertebra and a horizontal segment (Vh) from the C1 transverse foramina to its dural entry. The mean diameter of the artery was 4.8 mm. The shortest distance of Vv segment from the dural tube was 16.1 mm, and the distance from the C2 ganglion was 7.2 mm. The average length of the Vv segment was 15 mm and the average length of the Vh segment was 35.6 mm. The average of the shortest distance between the vertebral artery and the midline was 13.4 mm. CONCLUSION: The vertebral artery has a tortuous course and is prone to accidental iatrogenic injury, which can result in devastating neurological sequelae depending on contralateral vertebral artery flow. A thorough anatomical knowledge of this segment is essential for the surgeon who intends to operate in this area.
Assuntos
Microcirurgia/métodos , Osso Occipital/cirurgia , Artéria Vertebral/cirurgia , Adulto , Cadáver , Craniotomia/métodos , HumanosRESUMO
Flavonoids which were reported as having many pharmacological activities, antimicrobial, antioxidant, cytotoxic, chemoprevention activities and they possess strong antiproliferative effects related to inhibition of cell cycle progression and apoptosis induction. On the basis of this Thespesia populnea (L.) Sol. Ex Correa (Family-Malvaceae) was selected and it is having the major composition of flavonoids and the antibacterial activity of methanolic extract of Thespesia populnea flowers was investigated by agar well diffusion method. Furthermore our phytochemical studies indicated that methanolic extract of Thespesia populnea flowers contains flavonoids, alkaloids, tannins and anthroquinone glycosides. Moreover the individual components were identified by thin layer chromatography and Rf value was compared with standard flavonoid quercetin. The total phenolic and flavonoid content studies were also quantified. The bacteria used for antibacterial study were Shigella flexneri (NCIM 4924), Rhodococcus terrae (NCIM 5126), Escherichiae coli (ATCC 11775), Streptococcus faecalis (NCIB 2406), Klebsiella pneumoniae (ATCC 13883),Brevibacterium luteum (NCIM 2923), Micrococcus flavum (NCIM 2376), Proteus mirabilis (NCIB 8268), Bacillus licheniformis (NCIM 2468), Micrococcus luteus (ATCC 2984), Flavobacterium devorans (NCIM 2581), Shigella sonei(ATCC 29930), Shigella boydii (ATCC 8700) and Shigella dysentriae (ATCC 13313).According to our results in the lowest tested concentration of 62.5 microg/ml and 125mug/ml 7.2% of the plant extract were active, 5% active in the concentration of 250 microg/ml, 75.7% active in the concentration of 500 microg/ml and 92.8% active at the concentration of 1000 microg/ml in a dose dependent manner.
Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Flavonoides/farmacologia , Flores/química , Malvaceae/química , Fenóis/farmacologia , Alcaloides/isolamento & purificação , Alcaloides/farmacologia , Antraquinonas/isolamento & purificação , Antraquinonas/farmacologia , Antibacterianos/química , Cromatografia Líquida de Alta Pressão , Flavonoides/isolamento & purificação , Glicosídeos/isolamento & purificação , Glicosídeos/farmacologia , Testes de Sensibilidade Microbiana , Fenóis/isolamento & purificação , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Taninos/isolamento & purificação , Taninos/farmacologiaRESUMO
The Achanta Lakshmipathi Neurosurgical Center (ALNC) and Post Graduate Institute of Neurological Surgery is a private teaching neurosurgical institution located in the VHS (Voluntary Health Services) Hospital Chennai. It has been a leader and trendsetter among the private academic neurosurgical training institutions, and because of its unique legacy, has influenced the progress of Neurosurgery in India. The center was the second neurosurgical Institute to be created by Prof. B Ramamurthi and has trained neurosurgeons in the unique ALNC school of Neurosurgery. The Institute has grown to become a centre of excellence in microsurgery, and spinal surgery and has become a training centre for neurosurgery since 1985. The unique humanitarian aspects of the Voluntary Health Services Hospital helped in bringing the best of Neurosurgery to all strata of society. Forty years after its inception, the ALNC continues its delivery of excellence in clinical neurosurgery and academics.
Assuntos
Neurocirurgiões/tendências , Neurocirurgia/educação , Neurocirurgia/tendências , Procedimentos Neurocirúrgicos/tendências , Academias e Institutos/tendências , Humanos , Índia , Internato e Residência/tendênciasRESUMO
OBJECTIVES: The objectives of study was to 1) Describe relevant surgical anatomy in defining and accessing the lateral recess for placement of electrode, 2) Propose a working classification for grades of Flocculus; 3) To determine if different grades of cerebellar flocculus effects placement of ABI electrode and subjective outcomes in implantees. METHODS: Our study was a prospective study, and comprised of cohort of 12 patients who underwent ABI surgery via retrosigmoid approach between 1 Jan 2012 to 31 Dec 2014. All children with congenital profound sensorineural hearing loss with either absent cochlea or cochlear nerve were included in the study. Relevant anatomy was noted. We also noted down the difficulty encountered during the placement of ABI electrode. Auditory perception and speech intelligibility was scored post operatively for 1 year. RESULTS: Cerebellar flocculus was divided into 4 grades depending on the morphology of cerebellar flocculus. It was noted that Grade 3 & 4 flocculus (Group B) had difficult ABI electrode placement in comparison to Grade 1 & 2 flocculus (Group A). The subjective outcomes of Group A was better than Group B. However the p value was not statistically significant. CONCLUSION: Cerebellar flocculus can be graded depending on morphology and size. Flocculus of higher grades can make the placement of ABI electrodes difficult and adversely effects the postoperative subjective outcomes.
Assuntos
Implante Auditivo de Tronco Encefálico/métodos , Percepção Auditiva/fisiologia , Cerebelo/fisiologia , Inteligibilidade da Fala/fisiologia , Percepção da Fala/fisiologia , Adolescente , Implantes Auditivos de Tronco Encefálico , Criança , Pré-Escolar , Nervo Coclear/anormalidades , Feminino , Humanos , Masculino , Estudos Prospectivos , Resultado do TratamentoRESUMO
The extent of dissolution of petroleum hydrocarbon fuels into groundwater depends greatly on fuel composition. Petroleum fuels can consist of thousands of compounds creating different interactions within the non-aqueous phase liquid (NAPL), thereby affecting the relative dissolution of the components and hence a groundwater plume's composition over long periods. Laboratory experiments were conducted to study the variability in the effective solubilities and activity coefficients for common constituents of gasoline fuels (benzene, toluene, p-xylene and 1,2,4-trimethylbenzene) (BTX) in matrices with an extreme range of molar volumes and chemical affinities. Four synthetic mixtures were investigated comprising BTX with the bulk of the NAPL mixtures made up of either, ethylbenzene (an aromatic like BTX with similar molar volume); 1,3,5-trimethylbenzene (an aromatic with a greater molar volume); n-hexane (an aliphatic with a low molar volume); and n-decane (an aliphatic with a high molar volume). Equilibrium solubility values for the constituents were under-predicted by Raoult's law by up to 30% (higher experimental concentrations) for the mixture with n-hexane as a filler and over-predicted by up to 12% (lower experimental concentrations) for the aromatic mixtures with ethylbenzene and 1,3,5-trimethylbenzene as fillers. Application of PP-LFER (poly-parameter linear free energy relationship) model for non-ideal mixtures also resulted in poor correlation between experimentally measured and predicted concentrations, indicating that differences in chemical affinities can be the major cause of deviation from ideal behavior. Synthetic mixtures were compared with the dissolution behavior of fresh and naturally weathered unleaded gasoline. The presence of lighter aliphatic components in the gasoline had a profound effect on estimating effective solubility due to chemical affinity differences (estimated at 0.0055 per percentage increase in the molar proportion of aliphatic) as well as reduced molar volumes (estimated at -0.0091 in the activity coefficient per unit increase in molar volume, mL/mol). Previously measured changes in activity coefficients due to natural weathering of 0.25 compares well to 0.27 calculated here based on changes in the chemical affinity and molar volumes. The study suggests that the initial estimation of the composition of a fuel is crucial in evaluating dissolution processes due to ideal and non-ideal dissolution, and in predicting long term dissolution trends and the longevity of NAPL petroleum plume risks.
Assuntos
Gasolina , Poluentes Químicos da Água/química , Benzeno/química , Derivados de Benzeno/química , Gasolina/análise , Água Subterrânea , Hexanos/química , Solubilidade , Tolueno/química , Poluentes Químicos da Água/análise , Xilenos/químicaRESUMO
OBJECT: Confusion exists regarding the term giant spinal schwannoma. There are a variety of nerve sheath tumors that, because of their size and extent, justify the label "giant schwannoma." The authors propose a classification system for spinal schwannomas as a means to define these giant lesions. The classification is confined to tumors that are essentially intraspinal, with or without extraspinal components. Lesions that erode the vertebral bodies (VBs) and extend posteriorly and laterally into the myofascial planes are classified as giant "invasive" spinal schwannomas. METHODS: The records of patients with giant invasive spinal schwannoma were analyzed. The radiological features, operative approaches, and intraoperative findings were noted. Ten patients with giant invasive tumors were surgically treated over the last 8 years. Six patients were male. Erosion of the posterior surface of the VBs was the diagnostic finding demonstrated on plain x-ray films. Magnetic resonance imaging delineated the extent of the tumors and helped in preoperative planning. Radical excision of the tumors in multiple stages was possible in eight of the 10 patients. Dural reconstruction was required in four patients. All patients required fusion, and an additional stabilization procedure was undertaken in three patients. CONCLUSIONS: The authors conclude that giant invasive schwannomas are uncommon lesions and propose a new classification system. Because of their locally "invasive" nature and extension in all directions, careful preoperative planning of the surgical approach is very important. Although radical excision is possible and promises good results, recurrences may occur and multiple surgical procedures may be required.
Assuntos
Neurilemoma/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Adolescente , Adulto , Dura-Máter/cirurgia , Feminino , Humanos , Laminectomia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Neurilemoma/diagnóstico , Neurilemoma/diagnóstico por imagem , Dispositivos de Fixação Ortopédica , Radiografia , Fusão Vertebral , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Terminologia como AssuntoRESUMO
Some novel benzoxazolylethoxypiperidones have been synthesized and their antibacterial activity against streptococcus faecalis, bacillus subtilis, escherichia coli, staphylococcus aureus aand pseudomonas aeruginosa and antifungal activity against Candida-6, Candida albicans, Aspergillus niger, Candida-51 and Aspergillus flavus were evaluated. Compounds 37, 38 and 39 exerted potent in vitro antibacterial activity against Streptococcus faecalis while compounds 40 and 41 exhibited potent in vitro antifungal activity against Candida-51.
Assuntos
Antibacterianos/síntese química , Antifúngicos/síntese química , Benzoxazóis/síntese química , Piperidinas/síntese química , Antibacterianos/farmacologia , Antifúngicos/farmacologia , Benzoxazóis/farmacologia , Candida/efeitos dos fármacos , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Piperidinas/farmacologia , Relação Estrutura-AtividadeRESUMO
A simple, precise and rapid reversed-phase HPLC method was developed for the simultaneous estimation of acetaminophen, ibuprofen and chlorzoxazone in formulations. The method was carried out on a Kromasil(R) C(8) column using a mixture of 0.2% triethylamine:acetonitrile (adjusted to pH 3.2 using dilute orthophosphoric acid), and detection was carried out at 215 nm using ketoprofen as internal standard. All these drugs showed linearity in the range of 2-10 mug ml(-1), and limits of quantification was found to be 10, 50 and 20 ng ml(-1) for acetaminophen, ibuprofen and chlorzoxazone, respectively.
RESUMO
A simple, precise and accurate high performance liquid chromatography (HPLC) method was developed for the simultaneous estimation of metformin with gliclazide and glipizide present in multicomponent dosage forms. The method was carried out on Inertsil C(18) column. A mobile phase composed of acetonitrile-water containing camphor sulphonic acid (adjusted to pH 7 using 0.1 N sodium hydroxide; 75 mM) at a flow rate of 1 ml min(-1) was used for the separation. Detection was carried out at 225 nm. Tolbutamide was used as internal standard. Validation of the developed HPLC method was carried out.
Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Hipoglicemiantes/análise , Metformina/análise , Química Farmacêutica , Gliclazida/análise , Glipizida/análise , Controle de Qualidade , Padrões de Referência , Reprodutibilidade dos TestesRESUMO
A simple, precise and accurate HPLC method was developed for the simultaneous estimation of phenyl-propanolamine HCl, guaiphenesin and diphenylpyraline HCl in syrup. The method was carried out on a Shimpak C8 column with a mobile phase consisting of acetonitrile-triethylamine (pH adjusted to 3.5 using orthophosphoric acid; 0.5%), (35:65, v/v) at a flow rate of 1.2 ml min(-1). Detection was carried out at 210 nm. Diphenhydramine was used as internal standard. The validation of the method was also carried out.
Assuntos
Guaifenesina/análise , Fenilpropanolamina/análise , Piperidinas/análise , Cromatografia Líquida de Alta PressãoRESUMO
BACKGROUND: Difficulty in proper visualization of the upper thoracic spine in plain radiographs allows for injuries at this level to be missed, especially in a busy trauma center. This window of error is increased when the patient presents with no symptoms or signs of neurologic or spinal involvement, as upper thoracic dislocations commonly present early. CASE DESCRIPTION: The authors report a 19-year-old girl who developed progressive paraparesis 18 hours following initial presentation with a scalp avulsion injury. Imaging revealed a complete dislocation at T1-T2, with cord compression. Emergency surgical decompression and reconstruction of her spinal column was performed with a 360-degree stabilization. There was immediate neurologic improvement and on follow-up the patient is neurologically normal. CONCLUSIONS: The case highlights the difficulty in visualization of the upper thoracic spine in routine radiographs taken in a casualty setting. Treating physicians should have a low threshold for investigation of cervico-thoracic dislocations. The possibility of a delayed progressive dislocation should be kept in mind when dealing with injuries with a potential for spinal injury.
Assuntos
Luxações Articulares/complicações , Luxações Articulares/diagnóstico por imagem , Paraparesia/etiologia , Traumatismos da Coluna Vertebral/complicações , Vértebras Torácicas/lesões , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Radiografia Torácica , Couro Cabeludo/lesões , Compressão da Medula Espinal , Centros de TraumatologiaRESUMO
BACKGROUND: Meningiomas are generally solid tumors and are easily diagnosed by CT scans and MRI scans. Rarely are these tumors associated with cysts that can cause a confusion in the pre- and intraoperative diagnosis. Cysts associated with meningiomas may be intratumoral or peritumoral. METHODS: The authors conducted a retrospective study of the seventeen meningiomas, out of a total number of 232, which were associated with cysts. The cysts were classified based on their relationship to the tumor. The patients' sex, age group, location of the tumor, and pathological type of tumor were also analyzed. RESULTS: The 17 cases of cystic meningioma formed 7.3% of the meningiomas seen between 1984 and 1993. Eleven of these were intratumoral and 6 peritumoral. One case had both intra- and peritumoral cysts. The tumors were found mostly in the fourth and fifth decades of life. Histologically, all the peritumoral cysts except one were associated with meningotheliomatous meningiomas. Tumors with peritumoral cysts were more common in males. Intratumoral cysts, more common in females, were angioblastic or meningotheliomatous on histopathology. Only one case was an anaplastic meningioma. CONCLUSION: Cysts associated with meningiomas, although uncommon, are certainly not rare. The peritumoral and the intratumoral cysts form distinct subtypes needing separate consideration. Cystic meningiomas are only rarely malignant.
Assuntos
Cistos , Neoplasias Meníngeas/patologia , Meningioma/patologia , Adulto , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
Metallic artifacts in magnetic resonance (MR) imaging occur mostly in patients who have received an implant at surgery. Similar artifacts are now increasingly recognized in patients in whom high-speed drills have been used. A 15-year-old male with neurofibromatosis 2 had undergone excision of acoustic neurofibroma on the left 1.5 years prior to the present admission. MR imaging to evaluate the acoustic neurofibroma on the right showed a metallic artifact at the site of the previous surgery. Computed tomography did not show any evidence of metal debris. The artifact was probably caused by metallic dust or debris from a high-speed drill during the first surgery. We suggest that care should be taken to prevent deposition of such debris in the operative field to prevent this complication.