Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 41
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
J Craniofac Surg ; 31(3): e233-e236, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31895847

RESUMO

To evaluate the ability of the maxillary sinus membrane to produce bone after internal sinus lifting and implant placement without adding exogenous bone graft, and to assess the quality of bone that has been produced 6 months postoperatively.In this retrospective study, 10 subjects who underwent maxillary sinus floor lifting and met the inclusion criteria were selected and then subdivided into: Group-A underwent internal sinus elevation and placement of implants without the use of bone graft and Group-B underwent classical internal sinus lifting and placement of bovine bone particles and then placement of the implant as a control group. Radiofrequency analysis (RFA) values for measuring the Implant Stability Quotient (ISQ) of all implants were measured by Osstell device. CBCT was performed involving linear measurements of the site of sinus lifting for both groups.High RFA values demonstrating excellent biomechanical stability were observed in Group-A compared to Group-B at 6 months postoperatively. Group-A showed a median of ISQ value;78 (8), 77(12), 79(3.5) and 77(4.50). Group-A was significantly higher in ISQ values than Group-B, which showed median and interquartile range (IQR) of ISQ value of [51(12.50), 54(14.50), 55(9), and 55(7.50)]. However, the amount of bone available in group B was significantly higher than group A; [3.5 mm (0.75) and 3.8 mm (0.69)].Internal sinus lifting without bone graft has the ability of bone formation by osteogenic potential of the sinus membrane. Nevertheless, the high quality of bone being produced is of high importance for the success of an implant without the need for an exogenous bone graft. The newly formed bone was significantly of a better quality in Group-A. Thus, it is recommended to perform internal sinus lifting, without adding bone graft material and allow the osteogenic potential of the maxillary sinus membrane to produce its own osteogenic cells.


Assuntos
Implantes Dentários , Seio Maxilar/diagnóstico por imagem , Membranas/diagnóstico por imagem , Animais , Bovinos , Implantação Dentária Endo-Óssea , Humanos , Seio Maxilar/cirurgia , Osteogênese , Estudos Retrospectivos , Levantamento do Assoalho do Seio Maxilar
2.
BMC Anesthesiol ; 19(1): 124, 2019 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288737

RESUMO

BACKGROUND: Surgical cricothyroidotomy is a last resort in patients with an anticipated difficult airway, but without any guarantee of success. Identification of the cricothyroid membrane may be the key to successful cricothyrotomy. Ultrasonographic identification of the cricothyroid membrane has been reported to be more useful than the conventional palpation technique. However, ultrasonographic identification techniques are not yet fully characterized. CASE PRESENTATION: A 28-year-old man with hemophilia and poor adherence to medication. He was brought to the emergency department with a large cervical hematoma and respiratory difficulty. An otolaryngologist decided to insert a tracheal tube to maintain his airway. However, emergent laryngoscopy indicated an anticipated difficult airway. A backup plan that included awake intubation by the anesthesiologists and surgical cricothyroidotomy by an otolaryngologist was devised. The cricothyroid membrane could not be identified by palpation but was detected by ultrasonographic identification with a longitudinal approach. Awake fiberoptic intubation was successfully performed. CONCLUSIONS: In this case, the cricothyroid membrane could be identified using the longitudinal approach but not the transverse approach. It may be ideal to know which ultrasound technique can be applied for each patient.


Assuntos
Cartilagem Cricoide/diagnóstico por imagem , Hematoma/complicações , Intubação Intratraqueal/métodos , Membranas/diagnóstico por imagem , Cartilagem Tireóidea/diagnóstico por imagem , Adulto , Manuseio das Vias Aéreas/métodos , Hematoma/etiologia , Hemofilia A/complicações , Humanos , Masculino , Pescoço/irrigação sanguínea , Síndrome do Desconforto Respiratório do Adulto/etiologia , Síndrome do Desconforto Respiratório do Adulto/terapia , Ultrassonografia
3.
Nucl Med Commun ; 40(2): 153-158, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30531407

RESUMO

INTRODUCTION: Dynamic inhalation scintigraphy (DIS) with technetium-99m-diethylenetriamine-pentaacetate aerosol is a useful nuclear medicine procedure for staging and monitoring the damage of alveolocapillary membrane. The e-cigarette is a new popular smoking device producing vapor from the nicotine solution. Many studies have shown that e-cigarettes appear to be safer than smoking, but there are still debates to what extent e-cigarettes are less harmful than smoking.In this prospective, self-controlled study, we compared DIS results among volunteers smoking an e-cigarette and their results after they returned to traditional cigarette smoking for a week. PARTICIPANTS AND METHODS: We included 24 healthy volunteers into this study who regularly used e-cigarette containing at least 10 mg nicotine/ml. We performed baseline DIS study in volunteers with e-cigarette smoking and then we asked them to return to traditional cigarette smoking for a week. Conventional respiration tests were also measured. We statistically analyzed the effect of traditional cigarette on clinical parameters and pulmonary clearance of the radiopharmacon. RESULTS: There was no significant change in the parameters of peak expiratory flow rate and Tiffeneau-Pinelli index respiration tests; forced vital capacity and forced expiratory volume in 1 s slightly decreased (P<0.05), whereas the exhaled CO and COHb levels were significantly higher at traditional cigarette use (P<0.0001), and increased in every case. The pulmonary clearance was significantly faster at traditional cigarette smoking compared with e-cigarette use (P<0.0001). CONCLUSION: On the basis of our results, we suppose that e-cigarette smoking is less harmful to the lung function than a traditional cigarette, and it can be recommended to heavy smokers who are unable to stop smoking.


Assuntos
Capilares/efeitos dos fármacos , Capilares/diagnóstico por imagem , Sistemas Eletrônicos de Liberação de Nicotina , Alvéolos Pulmonares/irrigação sanguínea , Alvéolos Pulmonares/diagnóstico por imagem , Fumar/efeitos adversos , Produtos do Tabaco/efeitos adversos , Adulto , Feminino , Voluntários Saudáveis , Humanos , Masculino , Membranas/diagnóstico por imagem , Membranas/efeitos dos fármacos , Pessoa de Meia-Idade , Alvéolos Pulmonares/efeitos dos fármacos , Ventilação Pulmonar , Cintilografia , Adulto Jovem
4.
Am J Emerg Med ; 36(11): 2078-2084, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30025948

RESUMO

BACKGROUND: Prior to the anticipated difficult airway, the emergency physician commonly palpates the neck to identify the presumed location of the cricothyroid membrane (CTM). In the event of a "cannot-intubate, cannot­oxygenate" airway, precise CTM localization is vital to the success of a cricothyrotomy and hence, the patient's survival. OBJECTIVE: This narrative review will summarize the prospective studies evaluating CTM identification. It will demonstrate the inaccuracy of the classically used landmark palpation technique. It will then describe the use of ultrasound (US) as a superior tool for CTM identification, illustrate the technique itself, and propose its implementation in the pre-intubation checklist for the anticipated difficult airway. DISCUSSION: Evidence demonstrates that physicians are not sufficiently accurate in palpating the CTM in both cadavers and volunteers in a stable non-emergent setting. In preparing for a real-time intubation, this fine motor task would be more difficult to achieve. Moreover, this particular patient group may often exhibit difficult airway features. US has been demonstrated to be superior for locating the CTM than landmark palpation across body habitus, gender, and failed airway simulations. This technique carries a short learning curve even without prior airway US experience, along with a high retention rate. An illustrative tutorial is provided. CONCLUSION: Emergency physicians may apply this US technique for CTM localization in preparation for an anticipated difficult airway. However, since this technique takes longer than landmark palpation, using US is not recommended once already in the midst of a failed airway situation.


Assuntos
Manuseio das Vias Aéreas/métodos , Membranas/diagnóstico por imagem , Palpação , Ultrassonografia , Cartilagem Cricoide/diagnóstico por imagem , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Cartilagem Tireóidea/diagnóstico por imagem , Fatores de Tempo
5.
Arch. Soc. Esp. Oftalmol ; 93(4): 169-173, abr. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-173113

RESUMO

OBJETIVOS: Evaluar la posible asociación entre el uso de análogos de prostaglandinas (AP) y el desarrollo de membrana epirretinal (MER) en pacientes con glaucoma. MÉTODO: Mediante el método comparativo se realizó un diseño retrospectivo de casos y controles. Se compararon pacientes que presentaban glaucoma y, a su vez, MER y que utilizaban una mayor proporción de AP con un grupo control de pacientes que presentaban glaucoma pero sin MER. El diagnóstico de MER ha sido realizado mediante un examen clínico y un estudio de tomografía de coherencia óptica. RESULTADOS: La edad media de los casos ha sido de 77 años, con DE de 8,68 (IC 95%: 74,3-79,4) y la de los controles de 63 años, con DE de 16,6 (IC 95%: 70,1-78,5). El 50% de los casos (n = 26) estaba compuesto por hombres y el otro 50% eran mujeres (n = 26), mientras que para los controles el 25,4% eran hombres (n = 16) y el 74,6% eran mujeres (n = 47). El 59,6% de los casos (n = 31) y el 60,3% de los controles (n = 38) fueron tratados con AP. No se ha observado ninguna diferencia de colocación de AP entre ambos grupos (p = 0,939). CONCLUSIONES: En este trabajo no hemos podido demostrar si existe asociación entre el uso de AP y el desarrollo de MER


OBJECTIVES: To determine whether patients with glaucoma and epiretinal membrane (ERM) use a greater proportion of prostaglandin analogues (PA) than a control group of patients with glaucoma without ERM. METHOD: A retrospective study of cases and controls was conducted in order to determine whether patients with glaucoma and ERM used a greater proportion of PA than a control group of patients with glaucoma without ERM. The diagnosis of de ERM was made by clinical examination and optical coherence tomography. RESULTS: The mean age of the cases was 77 years (SD: 8.68; 95% CI: 74.3-79.4), compared to the controls with 63 years (SD: 16.6; 95% CI: 70.1-78.5). The cases included 50% (n = 26) men and 50% women (n=26), whereas in the controls 25.4% (n = 16) of the cases were men and 74.6% (n = 47) women. PA treatment was used in 59.6% (n = 31) and 60.3% (n = 38) of the cases and controls, respectively. There was no statistically significant difference in PA use between the 2 groups (P = .939). CONCLUSIONS: In this study, an association between the use of AP and the development of ERM could not be demonstrated


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Prostaglandinas Sintéticas/uso terapêutico , Glaucoma/diagnóstico , Glaucoma/tratamento farmacológico , Estudos de Casos e Controles , Membranas/diagnóstico por imagem , Acuidade Visual , Prostaglandinas Sintéticas/efeitos adversos , Estudos Retrospectivos , Macula Lutea/lesões , Tomografia de Coerência Óptica/métodos
6.
Hand (N Y) ; 12(2): 145-149, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28344525

RESUMO

Background: Radial head fractures can be associated with soft tissue injuries of the forearm and wrist. The Essex-Lopresti injury can lead to significant morbidity, especially if the diagnosis is not made acutely. Better identification of such injuries is needed to allow optimal surgical treatment and prevent long-term sequelae. We used magnetic resonance imaging (MRI) to correlate the degree of soft tissue injuries with radial head fractures. Methods: Sixteen pairs of forearms with an associated radial head fracture in 15 patients prospectively underwent an MRI within 2 weeks of their injury. MRI findings were correlated with fracture type, associated soft tissue injury, and presence of symptomatic wrist pain. Results: According to the modified Mason classification, there were 8 type I, 5 type II, and 3 type III radial head fractures. Wrist pain was reported in 8 of 16 extremities, and 2 had associated wrist pathology, including an acute scaphoid fracture in 1 patient and a preexisting stage II scapholunate advanced collapse (SLAC) wrist in another patient. The MRI findings included an elbow effusion in all 16 patients, edema in the proximal third of the radius in 15 extremities, which extended to the middle third in 3 extremities, edema of the interosseous membrane (IOM) in 5 extremities, and edema of the soft tissues including the supinator and/or pronator quadratus in 13 extremities. Conclusions: Eighty percent of patients with edema of the IOM had associated wrist pain. Soft tissue injuries of the forearm did not correlate with the severity of the radial head fracture.


Assuntos
Traumatismos do Antebraço/diagnóstico por imagem , Fraturas do Rádio/diagnóstico por imagem , Lesões dos Tecidos Moles/diagnóstico por imagem , Adulto , Idoso , Edema/diagnóstico por imagem , Feminino , Traumatismos do Antebraço/terapia , Fixação de Fratura/métodos , Humanos , Imagem por Ressonância Magnética , Masculino , Membranas/diagnóstico por imagem , Pessoa de Meia-Idade , Traumatismo Múltiplo/diagnóstico por imagem , Traumatismo Múltiplo/terapia , Estudos Prospectivos , Fraturas do Rádio/terapia , Lesões dos Tecidos Moles/terapia , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Punho/terapia , Adulto Jovem
7.
Curr Probl Diagn Radiol ; 45(6): 380-391, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26433812

RESUMO

Crests, bands, chords, and membranes can be seen within the different cardiac chambers, with variable clinical significance. They can be incidental or can have clinical implications by causing hemodynamic disturbance. It is crucial to know the morphology and orientation of normal structures, aberrant or accessory muscles, and abnormal membranes to diagnose the hemodynamic disturbance associated with them. Newer generation computed tomographic scanners and faster magnetic resonance imaging sequences offer high spatial and temporal resolution allowing for acquisition of high resolution images of the cardiac chambers improving identification of small internal structures, such as papillary muscles, muscular bands, chords, and membranes. They also help in identification of other associated complications, malformations, and provide a road map for treatment. In this article, we review cross-sectional cardiac imaging findings of normal anatomical variants and distinctive imaging features of pathologic bands, chords, or membranes, which may produce significant hemodynamic changes and clinical symptomatology.


Assuntos
Diagnóstico por Imagem/métodos , Coração/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Tendões/diagnóstico por imagem , Eletrocardiografia , Humanos , Imagem por Ressonância Magnética , Membranas/diagnóstico por imagem , Tomografia Computadorizada por Raios X
8.
Echocardiography ; 31(2): E58-9, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24138092

RESUMO

The left atrial appendage (LAA) is a blind-ending, complex structure distinct from the body of the left atrium and is sometimes regarded as a minor extension of the atrium. However, it should routinely be evaluated as part of a transesophageal echocardiographic examination. In this study we describe the presence of a nonobstructive membrane traversing the cavity of the LAA, found incidentally on transesophageal echocardiography.


Assuntos
Apêndice Atrial/anormalidades , Apêndice Atrial/diagnóstico por imagem , Ecocardiografia/métodos , Comunicação Interatrial/diagnóstico por imagem , Adulto , Humanos , Masculino , Membranas/anormalidades , Membranas/diagnóstico por imagem , Doenças Raras/diagnóstico por imagem
9.
Eur J Orthop Surg Traumatol ; 24(7): 1095-100, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24337440

RESUMO

Evidence from a recent cadaveric study has revealed that the thickness of the distal interosseous membrane (DIOM) of the forearm shows substantial individual variations, and a thick fibrous tissue known as the distal oblique bundle (DOB) was found in 40% specimens in the study. Another cadaveric study revealed that greater stability of the distal radioulnar joint (DRUJ) was obtained in a group with DOB following ulnar shortening than in a group without DOB. Thus, the presence of DOB influences the condition of DIOM and the ability of DIOM to provide stability to the compromised DRUJ. In the present study, we carried out a preoperative morphological evaluation of DIOM using ultrasound (US) and compared the US findings with intraoperative findings in order to investigate the efficacy and the meanings of this US evaluation. A total of 14 patients with various diseases or injuries of the distal forearm requiring corrective surgery were enrolled. The mean values of DIOM thickness as measured by US evaluation correlated well with those measured intraoperatively. The sensitivity of US evaluation in confirming presence of DOB was 80% when the presence of DOB bundle was judged by DIOM thickness. In addition, 4 of 5 patients with chronic DRUJ instability showed no DOB. This study suggested that US can be a useful tool in evaluating DIOM and for detecting the presence of DOB and may provide helpful information regarding DRUJ instability.


Assuntos
Membranas/anatomia & histologia , Rádio (Anatomia)/anatomia & histologia , Ulna/anatomia & histologia , Articulação do Punho/anatomia & histologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Membranas/diagnóstico por imagem , Pessoa de Meia-Idade , Rádio (Anatomia)/diagnóstico por imagem , Ulna/diagnóstico por imagem , Ultrassonografia , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/cirurgia
11.
Cardiovasc J Afr ; 23(4): e1-2, 2012 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-22614699

RESUMO

The left atrial appendage (LAA) is a blind-ending, complex structure distinct from the body of the left atrium and is sometimes regarded as a minor extension of the atrium. However, it should routinely be analysed as part of a transoesophageal echocardiographic examination. In this study we describe the presence of a non-obstructive membrane traversing the cavity of the LAA, found incidentally on transoesophageal echocardiography.


Assuntos
Apêndice Atrial/ultraestrutura , Fibrilação Atrial/diagnóstico por imagem , Ecocardiografia Transesofagiana , Trombose/etiologia , Idoso , Fibrilação Atrial/complicações , Diagnóstico Diferencial , Cardiopatias/diagnóstico por imagem , Cardiopatias/etiologia , Humanos , Masculino , Membranas/diagnóstico por imagem , Trombose/diagnóstico por imagem
12.
Biomaterials ; 32(35): 9159-67, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21872327

RESUMO

Aseptic loosening is a major cause of failure of total hip arthroplasty (THA). Macrophage apoptosis in interface membrane has been proved to play an important role in the pathogenesis of aseptic loosening. The purpose of current study was to identify the apoptotic mechanism of macrophages in the interface membrane of aseptic loosening. We collected periprosthetic interface membrane from 23 patients undergoing the revision operations for aseptic loosening of hip joint prostheses. To serve as the control group, samples of capsule were collected from 18 patients undergoing the primary hip arthroplasties for osteoarthritis (OA). The ultrastructure of interface membrane was examined by transmission electron microscopy (TEM), and in situ apoptotic macrophage identification was performed by TUNEL staining. Furthermore, using immunohistochemical methods we investigated the expression of some apoptosis-related markers such as inducible nitric oxide synthase (iNOS), peroxynitrite (ONOO(-)), cleaved caspase-3/4/8/9, cytochrome c, glucose regulated protein 78 (GRP78), and growth arrest and DNA damage-inducible gene 153 (GADD153) in macrophages. These markers were regarded as apoptotic inducers or specific indicators of different apoptotic pathways such as death receptor pathway, mitochondrial pathway and endoplasmic reticulum (ER) stress pathway. TEM showed that a great deal of wear debris was phagocytosed by macrophages, which displayed morphological changes characteristic of apoptosis. The results of TUNEL staining demonstrated that there were more apoptotic macrophages in interface membrane. The expression levels of iNOS, ONOO(-), cleaved caspase-3/4/8/9, cytochrome c, GRP78 and GADD153 in macrophages in interface membrane were significantly higher than those in the control samples (p < 0.05). Our results suggest that death receptor pathway, mitochondria/cytochrosome c caspase-dependent pathway and ER stress pathway are involved in the process of macrophage apoptosis. A therapeutic target to modulate the apoptotic pathways in macrophages may be a strategy to prevent and treat aseptic loosening.


Assuntos
Apoptose , Prótese de Quadril , Macrófagos/citologia , Falha de Prótese , Transdução de Sinais , Adulto , Idoso , Biomarcadores/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Marcação In Situ das Extremidades Cortadas , Macrófagos/metabolismo , Masculino , Membranas/diagnóstico por imagem , Membranas/patologia , Membranas/ultraestrutura , Pessoa de Meia-Idade , Modelos Biológicos , Cuidados Pré-Operatórios , Radiografia , Raios X
13.
J Cereb Blood Flow Metab ; 30(9): 1608-18, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20424634

RESUMO

[(11)C]PBR28, a radioligand targeting the translocator protein (TSPO), does not produce a specific binding signal in approximately 14% of healthy volunteers. This phenomenon has not been reported for [(11)C]PK11195, another TSPO radioligand. We measured the specific binding signals with [(3)H]PK11195 and [(3)H]PBR28 in brain tissue from 22 donors. Overall, 23% of the samples did not generate a visually detectable specific autoradiographic signal with [(3)H]PBR28, although all samples showed [(3)H]PK11195 binding. There was a marked reduction in the affinity of [(3)H]PBR28 for TSPO in samples with no visible [(3)H]PBR28 autoradiographic signal (K(i)=188+/-15.6 nmol/L), relative to those showing normal signal (K(i)=3.4+/-0.5 nmol/L, P<0.001). Of this latter group, [(3)H]PBR28 bound with a two-site fit in 40% of cases, with affinities (K(i)) of 4.0+/-2.4 nmol/L (high-affinity site) and 313+/-77 nmol/L (low-affinity site). There was no difference in K(d) or B(max) for [(3)H]PK11195 in samples showing no [(3)H]PBR28 autoradiographic signal relative to those showing normal [(3)H]PBR28 autoradiographic signal. [(3)H]PK11195 bound with a single site for all samples. The existence of three different binding patterns with PBR28 (high-affinity binding (46%), low-affinity binding (23%), and two-site binding (31%)) suggests that a reduction in [(11)C]PBR28 binding may not be interpreted simply as a reduction in TSPO density. The functional significance of differences in binding characteristics warrants further investigation.


Assuntos
Acetamidas/metabolismo , Encéfalo/diagnóstico por imagem , Neurite (Inflamação)/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Piridinas/metabolismo , Receptores de GABA/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Autorradiografia , Sítios de Ligação , Ligação Competitiva/efeitos dos fármacos , Química Encefálica , Radioisótopos de Carbono , Feminino , Humanos , Imuno-Histoquímica , Isoquinolinas , Masculino , Membranas/diagnóstico por imagem , Membranas/metabolismo , Pessoa de Meia-Idade , Proteínas do Tecido Nervoso/análise , Proteínas do Tecido Nervoso/metabolismo , Ensaio Radioligante , Bancos de Tecidos
14.
Scand J Gastroenterol ; 45(2): 226-34, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-19958053

RESUMO

OBJECTIVE: Budd-Chiari syndrome (BCS) is characterized by an obstruction of hepatic venous outflow. Membranous obstruction of the inferior vena cava (IVC) is a curable cause of primary BCS but is very rare in Western Europe. To date, there is only very limited information on membranous BCS in the Western world. We here report the diagnosis and management of five Caucasian patients with membranous BCS. MATERIAL AND METHODS: Out of 23 patients with BCS diagnosed between 2004 and 2007 we identified five with a membranous web of the IVC. Diagnostic evaluation of BCS included laboratory tests, ultrasound Doppler imaging, CT and MRI. RESULTS: The clinical presentation of membranous BCS was heterogeneous. The time frame from first clinical symptoms to diagnosis ranged from 3 weeks to 60 years. Liver cirrhosis was misdiagnosed in 4/5 patients. CT did not establish the correct diagnosis of membranous BCS in any of our patients. In contrast, abdominal Doppler ultrasonography showed collaterals and a web in the IVC which was confirmed by Doppler-MRI and hepatovenography. Four patients underwent interventional treatment with balloon dilatation of short-segment venous stenoses or complete occlusions. Therapy was successful: in all cases it resulted in a normalized extrahepatic blood flow and reduction of spleen size. CONCLUSIONS: Membranous BCS may be underdiagnosed in Caucasians. Doppler ultrasound should be used as the initial diagnostic procedure for membranous BCS. Although CT is considered the "gold standard" in addition to angiography, it could not detect membranous obliteration in our cases. Patients can be effectively treated by interventional endovascular therapy.


Assuntos
Síndrome de Budd-Chiari/diagnóstico , Síndrome de Budd-Chiari/etnologia , Grupo com Ancestrais do Continente Europeu , Adulto , Síndrome de Budd-Chiari/terapia , Cateterismo , Feminino , Humanos , Masculino , Membranas/diagnóstico por imagem , Membranas/cirurgia , Pessoa de Meia-Idade , Stents , Resultado do Tratamento , Ultrassonografia , Veia Cava Inferior/diagnóstico por imagem , Adulto Jovem
15.
J Hand Surg Am ; 34(4): 685-91, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19345871

RESUMO

PURPOSE: An earlier anatomic study described five ligamentous components in the interosseous membrane of the forearm (central band, accessory band, distal oblique bundle, proximal oblique cord, and dorsal oblique accessory cord) and provided their precise location of attachment. In the present study, we investigated in vivo length changes of these five ligaments during forearm rotation to understand the function of each ligament. METHODS: We acquired computed tomographies of nine forearms from seven healthy volunteers for 3 rotation positions: maximum pronation, neutral position, and maximum supination. We created 3-dimensional models of the radius, ulna, and the 5 ligaments by combining osseous images and anatomic data of ligament attachment. We calculated 3-dimensional ligament lengths between attachments during forearm rotation using a markerless bone registration technique. We also examined relationships between the axis of forearm rotation and each ligament. RESULTS: The distal 3 ligaments (central band, accessory band, and distal oblique bundle) had little change in length during forearm rotation, with their ulnar attachments located almost on the axis of forearm rotation. The 2 proximal ligaments (proximal oblique cord and dorsal oblique accessory cord) changed substantially in length, with their attachments out of the course of the axis. CONCLUSIONS: The distal 3 ligaments of the interosseous membrane are essentially isometric stabilizers of the forearm. The distal oblique bundle in the distal membranous portion may stabilize the distal radioulnar joint in 40% of human subjects who have this ligament.


Assuntos
Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/fisiologia , Antebraço/diagnóstico por imagem , Antebraço/fisiologia , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Ligamentos Articulares/diagnóstico por imagem , Ligamentos Articulares/fisiologia , Membranas/diagnóstico por imagem , Membranas/fisiologia , Pronação/fisiologia , Supinação/fisiologia , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Fenômenos Biomecânicos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Modelos Teóricos , Adulto Jovem
18.
Surg Radiol Anat ; 28(6): 606-19, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17061033

RESUMO

A discrete membranous layer, "stratum membranosum", in human subcutaneous tissue is classically described as confined to the lower anterior abdominal wall and perineum and referred to as Scarpa's and Colles' fasciae, respectively. Evidence for its existence elsewhere in the body is scanty and therefore the present study was undertaken. Dissection of six embalmed adult cadavers, along with ultrasound imaging on four living subjects, were carried out to determine the existence, topography, and thickness of the membranous layer of superficial fascia in different regions of the body. In all six cadavers, a continuous layer of fibrous membrane in the superficial fascia was found consistently in all the dissected regions of the body and was also confirmed by ultrasonography. The arrangement and thickness of this membranous layer varied according to body region, body surface, and gender. It was thicker in the lower than in the upper extremity, on the posterior than anterior aspect of the body, and in females than in males. The mean thickness of the membranous layer ranged from 39 to 189 mum, being thickest in the leg and thinnest over the dorsum of the hand. The membranous layer was observed to have two or even three components in regions such as the breast, back, thigh, and arm and was seen to split, forming special compartments around subcutaneous major veins of upper and lower extremities, with fibrous septa extending to attach to the vessel wall. Functionally, the membranous superficial fascia may play a role in the integrity of the skin and support for subcutaneous structures particularly veins, by ensuring their patency. Understanding the topographic anatomy of this fascial layer may help explain body-contour deformities and provide the anatomic basis for surgical correction.


Assuntos
Tela Subcutânea/anatomia & histologia , Tela Subcutânea/diagnóstico por imagem , Parede Abdominal/anatomia & histologia , Parede Abdominal/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Dorso/anatomia & histologia , Dorso/diagnóstico por imagem , Pesos e Medidas Corporais/estatística & dados numéricos , Cadáver , Tecido Conjuntivo/anatomia & histologia , Tecido Conjuntivo/diagnóstico por imagem , Feminino , Humanos , Extremidade Inferior/anatomia & histologia , Extremidade Inferior/diagnóstico por imagem , Masculino , Membranas/anatomia & histologia , Membranas/diagnóstico por imagem , Pessoa de Meia-Idade , Pescoço/anatomia & histologia , Pescoço/diagnóstico por imagem , Fatores Sexuais , Parede Torácica/anatomia & histologia , Parede Torácica/diagnóstico por imagem , Ultrassonografia , Extremidade Superior/anatomia & histologia , Extremidade Superior/diagnóstico por imagem
19.
Folia Morphol (Warsz) ; 65(1): 15-21, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16783730

RESUMO

Despite intensive research in the anatomical sciences for the last two centuries, some structures of the human body still remain controversial or incompletely described. We describe a new membranous fascial anatomical entity, which we refer to as the iliolumbar membrane (ILM). During the 2004-2005 academic semesters at the American University of the Caribbean School of Medicine we dissected 40 human cadavers fixed in formalin-alcohol-phenol solution. Iliolumbar membrane is a thick connective tissue structure, deep to the skin, originating from the fibres of the thoracolumbar fascia at the lateral border of the erector spinae. It runs inferior to the superior border of the iliac crest, lateral to the posterior superior iliac spine, overlying the iliac crest at the level of the 4th lumbar vertebra. Iliolumbar membrane terminates within subcutaneous fat, where it divides into multiple layers. All cadavers showed considerable variation in the blending of the membrane's multiple layers with the subcutaneous fat. However, all specimens consistently showed a uniform appearance of ILM at the point of origin. Iliolumbar membrane could be demonstrated objectively by ultrasound examination with a frequency of 7.5 MHz and also with a Stryker endoscope. A hypothesis is put forth, conjecturing that this new structure may have relevance in creating a natural barrier between the musculature of the back and the muscles of the gluteal region, similar to Scarpa's fascia of the anterior abdominal wall.


Assuntos
Dorso/anatomia & histologia , Ílio/anatomia & histologia , Ligamentos Articulares/anatomia & histologia , Vértebras Lombares/anatomia & histologia , Membranas/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Dorso/diagnóstico por imagem , Cadáver , Fáscia/anatomia & histologia , Fáscia/diagnóstico por imagem , Feminino , Humanos , Ligamentos Articulares/diagnóstico por imagem , Masculino , Membranas/diagnóstico por imagem , Pessoa de Meia-Idade , Ultrassonografia
20.
Ann Thorac Surg ; 82(1): 322-3, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16798243

RESUMO

Total anomalous pulmonary venous connection is rarely associated with a supramitral ring. This condition should be suspected in any infant having total anomalous pulmonary venous connection with obstruction to the pulmonary venous return. Preoperative echocardiography is usually successful in detecting the lesion. The Shumaker and King repair for total anomalous pulmonary venous connection is most appropriate for such composite lesions as it enables the surgeon to identify the membrane and excise it easily and completely. We report one such case.


Assuntos
Estenose da Valva Mitral/congênito , Valva Mitral/anormalidades , Veias Pulmonares/anormalidades , Anormalidades Múltiplas/diagnóstico por imagem , Anormalidades Múltiplas/cirurgia , Veias Braquiocefálicas/anormalidades , Veias Braquiocefálicas/cirurgia , Cardiomegalia/etiologia , Ponte Cardiopulmonar , Permeabilidade do Canal Arterial/diagnóstico por imagem , Permeabilidade do Canal Arterial/cirurgia , Insuficiência de Crescimento/etiologia , Parada Cardíaca Induzida , Comunicação Interatrial/diagnóstico por imagem , Comunicação Interatrial/cirurgia , Humanos , Hipotermia Induzida , Lactente , Membranas/anormalidades , Membranas/diagnóstico por imagem , Membranas/cirurgia , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Estenose da Valva Mitral/etiologia , Estenose da Valva Mitral/cirurgia , Veias Pulmonares/diagnóstico por imagem , Veias Pulmonares/cirurgia , Ultrassonografia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA