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Posterior Aspect (posterior + aspect)
Selected AbstractsEccrine poroma of the heelINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2000Harvey Lemont A 67-year-old African,American woman had a tender red nodule on the posterior aspect of her left heel of 20 years' duration. The lesion had initially grown quickly to its present size, but subsequently remained unchanged through the years. No previous history of trauma to the area could be elicited. The lesion was not tender or painful, although the patient related some recent discomfort when wearing shoes with high heel counters. Examination revealed a soft, multilobulated, skin-colored nodule, measuring approximately 1.1 cm at its greatest diameter ( Fig. 1), with a rim space or moat ( Fig. 2) surrounding the lesion. Biopsy of the lesion demonstrated a uniform proliferation of basaloid cells exhibiting a sharp demarcation between the adjacent normal epidermis ( Fig. 3). No horn cysts were present. The papillary dermis demonstrated multiple ectatic blood vessels ( Fig. 4) which may be responsible for its reddish appearance. Figure 1 Multilobulated,. red, granulating lesion on the posterior heel Figure 2 Note. the characteristic ,,moat'' surrounding the lesion Figure 3 Biopsy. reveals a proliferation of uniformly small cuboidal cells sharply demarcated from the adjacent normal epidermal cells Figure 4 Ectatic. vessel dilatation most likely responsible for the reddish color of the lesion [source] Sonographic guidance for electron boost planning after breast-conserving surgeryJOURNAL OF CLINICAL ULTRASOUND, Issue 7 2004Antje Warszawski MD Abstract Purpose This study was conducted to determine the feasibility of using sonography for electron boost planning in breast cancer treatment and to define the factors that influence the accuracy and reproducibility of this technique. Patients and Methods Seventy-seven patients underwent 102 sonographic examinations after breast-conserving surgery and before and after radiotherapy. The size of the electron boost field was defined by measuring the postoperative cavity. Reproducibility of the sonographic findings was investigated in 25 of the patients who were examined before and after radiotherapy (at a total dose of 46,50.4 Gy). Depth (distance from the skin surface to the posterior aspect of the postoperative cavity) was measured, and sonographic appearance of the postoperative cavity was evaluated. Type of surgical procedure, time elapsed since surgery, use of systemic therapy, menopausal status, breast size, and radiation dose were investigated for their influence on sonographic appearance and visualization of the postoperative cavity. Results The postoperative cavity was well visualized in 78% of patients and visualized with some difficulty in 22%. In all but 5 patients, it was hypoechoic and inhomogeneous. The mean depth of the postoperative cavity after radiotherapy was 27 ± 4 mm. Smaller breast (p < 0.001) and younger age (p < 0.05) were associated with decreased visibility of the postoperative cavity. Sonographic appearance was the same before and after radiotherapy, but the mean difference in postoperative cavity depth between the 2 measurements was 2 mm (range, 0,4 mm). In 43/77 (56%) of the patients, changes in electron energy or in field size were required after sonographic measurement. Conclusion Sonography is a useful and reproducible means of electron boost planning, helping to avoid underdosage of the postoperative cavity and overdosage of normal tissue. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 32:333,337, 2004 [source] Sonographic measurement of the fetal cerebellum, cisterna magna, and cavum septum pellucidum in normal fetuses in the second and third trimesters of pregnancyJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2003Selami Serhatlioglu MD Abstract Purpose Absence of the cavum septum pellucidum (CSP), the cisterna magna (CM), or both, and enlargement of either or both structures are associated with various central nervous system malformations. In an effort to determine normal sizes and relationships between these cranial structures, we measured the CSP and CM in normal fetuses in the second and third trimesters of pregnancy using transabdominal sonography. Methods Women with uncomplicated pregnancies and normal singleton fetuses between 16 and 38 weeks' menstrual age were included in this prospective study. The width and anteroposterior (AP) diameters of the CSP were measured on the transverse transventricular plane, and the AP diameter of the CM was measured on the transcerebellar plane from the posterior aspect of the cerebellar vermis to the inner edge of the cranium. The transverse and AP diameters of the cerebellum were also measured. In addition, we measured the biparietal diameters (BPDs). Results In total, 130 women participated; 64 were examined in their second trimester and 66 in their third trimester. The mean age of the women was 27.4 ± 4.8 years (range, 18,38 years), and the mean menstrual age of the fetuses was 26.9 ± 6.7 weeks (range, 16,38 weeks). The mean BPD was 66.8 ± 18.7 mm (range, 30,96 mm). The mean width and AP diameter of the CSP and the mean AP diameter of the CM differed significantly between the second and third trimesters (p < 0.001). All measured parameters correlated significantly with menstrual age and BPD. Conclusions In normal fetuses, the CSP and CM should be visible on transabdominal sonography between 16 and 38 weeks' menstrual age. Because abnormalities in these cranial structures may be indicative of central nervous system malformations, the availability of mean sonographic measurements from normal fetuses should be helpful in determining the need for additional testing in fetuses with abnormal measurements. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:194,200, 2003 [source] Evaluation of cryoprobe deployment precision with body surface and in situ templatesBJU INTERNATIONAL, Issue 12 2008Keegan L. Maxwell OBJECTIVE To evaluate the precision of cryoprobe targeting with a surface template, an in situ template (on the target organ), or a combined approach. MATERIALS AND METHODS Fourteen participants placed five 17 G cryoprobes into porcine kidneys in a laparoscopic trainer using a surface template (group 1), an in situ template (group 2) or a combination of the two templates (group 3). The distance from the ideal probe placement was measured both on the anterior and posterior aspect of the kidney. The sequence of attempts was randomized. The distances were compared across the three groups using anova with the adjustment for multiple comparisons. RESULTS The mean distance from the ideal probe placement was 1.58 cm (anterior) and 1.81 cm (posterior) in group 1, 0.05 cm and 0.39 cm in group 2, and 0.07 cm and 0.22 cm in group 3, respectively. The placement of the probes was significantly more accurate in groups 2 (P < 0.001 anteriorly and P < 0.002 posteriorly) and 3 (P = 0.001 anteriorly and P < 0.001 posteriorly) compared with group 1. There was no significant difference between groups 2 and 3. CONCLUSION In this in vitro model, the use of internal or combined internal and external templates allows for significantly more precise deployment of 17-G cryoprobes than a standard external template alone. [source] Malignant changes in a giant orbital keratoacanthoma developing over 25 yearsACTA OPHTHALMOLOGICA, Issue 2 2000Ghassan A. Alyahya ABSTRACT. Purpose: To report a patient with a history over 25 years of a slowly growing, large, invasive crateriform tumour filling the anterior part of the orbit. Methods: A 61-year-old male presented with a large tumour of the left orbit. Exenteration was performed with subsequent histological analysis of the excised mass. Results: The main tumour showed the characteristic features of a keratoacanthoma. However, the posterior aspect of the tumour disclosed the morphology of a squamous cell carcinoma. Six months later, the patient presented with metastases to lymph nodes, lung and mediastinal tissue. A leukemoid reaction was diagnosed by fine needle biopsy. Conclusion: The giant variety of keratoacanthoma may fail to regress and can transform into a squamous cell carcinoma. In our patient, the development of a chronic lymphoid leukemia raises the possibility that it may be the underlying cause for the transformation of the posterior part of the keratoacanthoma into a frank squamous cell carcinoma. [source] A rare case of recessive dystrophic epidermolysis bullosa and verruciform xanthomaCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 1 2009S. D. Orpin Summary A 33-year-old man with recessive dystrophic epidermolysis bullosa presented with a 3-month history of an enlarging mass within scarring on the posterior aspect of the right shoulder. The clinical appearance of the mass with an almost cobbled, verrucous surface, and its rapid evolution suggested the development of a squamous cell carcinoma (SCC) in a chronically scarred site. Histopathological examination of a biopsy taken from the lesion subsequently revealed it to be a verruciform xanthoma. This case shows that benign phenomena can mimic SCC and underlines the need for a biopsy to be taken promptly. [source] Suicide-related perforating injury of globe with nail gunCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2005Marc Rofail MB BS Abstract A case is reported of nail gun injury due to suicide attempt involvingboth orbits, frontal lobe and abdomen, which resulted in an unusualposterior perforation of the left globe. Injury was inflicted witha total of eight nails. Three nails entered the left orbit, oneof which perforated the posterior aspect of the left globe. Onenail entered the right orbit involving the optic nerve and crossedthe midline to finish in the left sphenoid sinus. Three nails enteredthe frontal lobe near the midline and the final nail pierced theleft lobe of the liver. The left eye underwent primary repair, lensectomyand vitrectomy with silicone oil and achieved a visual acuity of 6/60,3 months post removal of oil with sutured posterior chamberintraocular lens. The right eye suffered traumatic optic neuropathyand currently has a visual acuity of 6/36 due to senilecataract formation. No other serious sequelae resulted from theother injuries and the patient has recovered from his episode ofdepression. [source] Anatomic study of the prechiasmatic sulcus and its surgical implicationsCLINICAL ANATOMY, Issue 6 2010Bharat Guthikonda Abstract To address a lack of anatomical descriptions in the literature regarding the prechiasmatic sulcus, we conducted an anatomical study of this sulcal region and discuss its clinical relevance to cranial base surgery. Our systematic morphometric analysis includes the variable types of chiasmatic sulcus and a classification schema that has surgical implications. We examined the sulcal region in 100 dry skulls; bony relationships measured included the interoptic distance, sulcal length/width, planum sphenoidale length, and sulcal angle. The varied anatomy of the prechiasmatic sulcii was classified as four types in combinations of wide to narrow, steep to flat. Its anterior border is the limbus sphenoidale at the posterior aspect of the planum sphenoidale. The sulcus extends posteriorly to the tuberculum sellae and laterally to the posteromedial aspect of each optic strut. Averages included an interoptic distance (19.3 ± 2.4 mm), sulcal length (7.45 ± 1.27 mm), planum sphenoidale length (19 ± 2.35 mm), and sulcal angle (31 ± 14.2 degrees). Eighteen percent of skulls had a chiasmatic ridge, a bony projection over the chiasmatic sulcus. The four types of prechiasmatic sulcus in our classification hold potential surgical relevance. Near the chiasmatic ridge, meningiomas may be hidden from the surgeon's view during a subfrontal or pterional approach. Preoperative evaluation by thin-cut CT scans of this region can help detect this ridge. Clin. Anat. 23:622,628, 2010. © 2010 Wiley-Liss, Inc. [source] Topographical anatomy of Spiegel's lobe and its adjacent organs in mid-term fetuses: Its implication on the development of the lesser sac and adult morphology of the upper abdomenCLINICAL ANATOMY, Issue 6 2010Si Eun Hwang Abstract At 8,16 weeks of gestation, Spiegel's lobe of the caudate lobe appears as a sac-like herniation of the liver parenchyma between the inferior vena cava and ductus venosus or Arantius' duct. In 5 of 11 fetuses at 20,30 weeks of gestation, we found that an external notch was formed into the posterior aspect of the caudate lobe by a peritoneal fold containing the left gastric artery. This notch appeared to correspond to that observed in adults, which is usually seen at the antero-inferior margin of the lobe after rotation of the lobe along the horizontal or transverse axis. However, the notch did not accompany two of the three fetuses in which the left hepatic artery originated from the left gastric artery. Notably, until 9,10 weeks of gestation, the inferior and left part of Spiegel's lobe rode over the hepatoduodenal ligament and protruded medially into the lesser sac (bursa omentalis) behind the stomach. Thus, the fetal Winslow's foramen was located at the "superior" side of the ligament. However, as seen in adults, the protruding Spiegel's lobe was located at the posterior side of the lesser omentum. Therefore, a hypothetical rotation along the transverse axis in the later stages of development seems necessary to explain this repositioning. Considering that Spiegel's lobe develops faster than surrounding structures, it is likely that the lesser sac resulting from the rotation of the gastrointestinal tract, which actively contributes to facilitate the growth of the Spiegel lobe. Clin. Anat. 23:712,719, 2010. © 2010 Wiley-Liss, Inc. [source] | ||||||||||