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Medial Side (medial + side)
Selected AbstractsA case of erythema elevatum diutinum associated with breast carcinomaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2005Fikriye Yilmaz MD A 53-year-old woman diagnosed with invasive ductal-type breast carcinoma was referred to our clinic with red,purple lesions on the hands and legs. She had neither pruritus nor pain. The first lesion developed on the dorsal hand. In the following days, new lesions appeared on the extensor surface of the legs. The patient had been treated with modified radical mastectomy and three courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy. Dermatologic examination revealed reddish-violaceous papules and plaques ranging from a few millimeters to 2 cm in diameter, bilaterally located on the dorsal hands, especially over the metacarpophalangeal and interphalangeal joints (Fig. 1). Multiple red,purple, circumscribed papules and plaques of various diameters were observed bilaterally over the shins (Fig. 2). The largest of these plaques showed an annular configuration. The nails showed distal subungual keratosis and yellow discoloration. The rest of the physical examination was normal. Figure 1. Violaceous papules and plaques on the dorsal hands Figure 2. Red,purple, circumscribed, papules and plaques over the shins A biopsy taken from the medial side of the shin revealed a predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (Fig. 3). Figure 3. Predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (hematoxylin and eosin stain, ×100) Complete blood count, routine biochemical tests and fasting lipids, serologic tests of bacterial and viral agents, serum electrophoresis, and serologic profiles for autoimmune connective tissue diseases revealed normal results. Mycologic examination of nail clippings did not show any evidence of fungal infection. In the light of our clinical and histopathologic findings, a diagnosis of erythema elevatum diutinum was made, and the patient was given topical clobetasol propionate therapy. Complete clearance was achieved in 3 weeks (Fig. 4). After six courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy, and radiotherapy, no recurrence of erythema elevatum diutinum lesions was observed. Figure 4. Healed lesion 3 weeks after high-potency topical glucocorticoids [source] Variations in the normal anatomy of the collateral ligaments of the human elbow jointJOURNAL OF ANATOMY, Issue 3 2000K. S. BECKETT The variations which occur in the medial and lateral ligament complexes of the elbow were investigated. These occurred frequently with the standard appearances occurring in no more than half the specimens on the medial side and one quarter of those on the lateral side. Surgeons who regularly perform elbow arthroplasty must be aware of these considerations, especially with the introduction of unconstrained prostheses which rely upon the ligament complex for their postoperative stability. [source] Embryonic development of Galloisiana yuasai Asahina, with special reference to external morphology (Insecta: Grylloblattodea)JOURNAL OF MORPHOLOGY, Issue 2 2005Toshiki Uchifune Abstract The embryogenesis of Grylloblattodea, one of the most primitive of the polyneopteran orders, is described using Galloisiana yuasai with special reference to external morphology. The egg membranes are characterized by an endochorion crossed by numerous vertical aeropyles and a fairly thin vitelline membrane, features shared by Mantophasmatodea. The inner layer formation is of the fault type. Serosal elements in the amnioserosal fold differentiate into hydropylar cells, to function in water absorption together with specialized amniotic structures, i.e., an amniotic strand and a thickened amnion. The germ band is of the short germ type. The germ band immerses deep into the yolk after its full elongation along the egg surface, and in this respect blastokinesis closely resembles that of Mantophasmatodea. The embryological features, i.e., those on egg membranes and blastokinesis, may suggest a closer affinity of Grylloblattodea and Mantophasmatodea. Appendages, ectodermal invaginations, and sternal and pleural sclerites are discussed in the light of serial homology, to provide a new basis for elucidating the insect body plan. Appendages are divided into the proximal coxopodite and distal telopodite, the former being divided further into the subcoxa and coxa. Subcoxal and coxal elements are identified in the mandible as well as in the abdominal appendages. The subcoxa is divided into the epimeron and episternum by the pleural suture in thoracic segments. Likewise, in the abdominal segments the subcoxa is divided into two, although the homologs of the epimeron and episternum are not sclerotized, and in the labial segment the subcoxal derivative or the postmentum is divided into the submentum and mentum. Two coxal endites bulge out from the medial side of the gnathal appendages. The mandibular molar and incisor, maxillary lacinia and galea, and labial glossa and paraglossa are serially homologous with each other. In the thoracic segments the original embryonic sternum or "protosternum" is largely replaced by subcoxal elements, and merely remains as a small anterior presternum and a posterior spinasternum. A major part of the venter is represented by the derivatives of the episternum such as an extensive basisternum, katepisternum, and trochantin and the medial element of the epimeron. The pleuron is derived from the episternal elements or the anepisternum and preepisternum, which bears a spiracle in the mesothorax and metathorax, and the lateral element of the epimeron. The homolog of the preepisternum in the prothorax is the cervical sclerite, but with no spiracle developed. A median ventral invagination arises in the thoracic segments as a spina, and the homolog of the spina develops into the eversible sac in the first abdominal segment. J. Morphol. © 2005 Wiley-Liss, Inc. [source] Single-bundle posterior cruciate ligament reconstruction with remnant preservation: lateral versus medial-sided augmentation techniqueORTHOPAEDIC SURGERY, Issue 1 2009Jin-zhong Zhao MD Objective:, To compare the results of lateral versus medial-sided augmentation techniques in single-bundle posterior cruciate ligament (PCL) reconstruction with remnant preservation. Methods:, Forty-two cases of isolated chronic PCL ruptures were reconstructed in a single-bundle manner with remnant preservation. The patients were randomly separated into two groups: in the medial-sided augmentation (MSA) group the graft passed through the medial side of the remnant and in the lateral-sided augmentation (LSA) group it passed through the lateral side. Results:, Nineteen patients in the MSA group and 17 in the LSA group were followed up for a minimum of 2 years. At the final follow-up, the average side-to-side differences in posterior laxity were 1.6 ± 1.2 mm and 1.5 ± 1.3 mm respectively in the MSA and LSA groups. According to the International Knee Documentation Committee (IKDC) scale, patient numbers graded as normal, nearly normal and abnormal were 14 (73.7%), 4 (21.1%), and 1 (5.3%) in the MSA group, and 13 (76.5%), 3 (17.6%), and 1 (5.9%) in the LSA group. The IKDC subjective scores were 93.1 ± 3.8 and 92.6 ± 4.1, the Lysholm scores were 95.0 ± 4.6 and 93.7 ± 4.2, and the Tegner scores were 5.4 ± 0.9 and 5.6 ± 0.7 respectively in the MSA and LSA groups. Statistical analysis showed no significant differences between the MSA and the LSA group regarding all subjective and objective results. Conclusion:, In single-bundle PCL reconstruction with remnant preservation, similar subjective and objective results can be obtained with MSA and LSA techniques. [source] Necrosis of the long process of the incus following stapes surgery: New anatomical observations,,THE LARYNGOSCOPE, Issue 4 2009Imre Gerlinger MD Abstract Objectives/Hypothesis: The most frequent complication (generally recognized during revision procedures) following seemingly successful stapedotomies and stapedectomies is necrosis of the long process of the incus. This is currently ascribed to a malcrimped stapes prosthesis or to a compromised blood supply of the incus. The two-point fixation can cause a mucosal injury with a resulting toxic reaction, and also osteoclastic activity. An important aspect in the engineering of ideal stapes prostheses is that they should be fixed circularly to the long process of the incus with appropriate strength. The objective of this study was to compare current knowledge relating to the blood supply of the ossicular chain with the present authors' observations on cadaver incudes. Most of the papers dealing with this issue appeared in the mid-20th century. Methods: The published data were compared with the authors' findings gained from photodocumentation on 100 cadaver incudes. The photos were taken with a Canon EOS 20 digital camera (Canon, Inc., Lake Success, NY) with a 5:1 macro-objective. The long processes of the incudes were examined from four directions under a Leica surface-analyzing microscope (Leica Microsystems GmbH, Wetzlar, Germany). Results: Analysis of the positions of the entrances of the feeding arteries (nutritive foramina) on the incudes revealed 1-4 nutritive foramina on the long processes of 48% (24) of the left-sided incudes and 56% (28) of the right-sided incudes. The positions of these foramina differed, however, from those previously described in the literature. They were mostly located not on the medial side of the incus body or on the short process or on the cranial third of the long processes, but antero-medially, mostly on the middle or cranial third. In 48% of all the incudes examined, an obvious foramen was not observed either in the body or in the long process of the incus. No relationship was discerned between the chronological age of the incus specimens and the numbers and/or locations of the nutritive foramina. In each case, the opening of the foramen was the beginning of a tunnel running obliquely and medially upward through the corticalis of the long process of the incus. The foramina are thought to be capable of ensuring a richer blood supply between the surface and the inside of the long process, allowing the arteries to run in and out. Conclusions: These observations indicate that conclusions drawn from classical anatomical works appear to need reconsideration. The present authors consider that the reason for the necrosis of the long process of the incus is not a compromised blood supply, except in some exceptional anatomical situations. They discuss the possible reasons why malcrimping may lead to necrosis of the long process of the incus. To prevent such malcrimping, attention is paid to the new generation of prostheses. Laryngoscope, 2009 [source] Late reactions to the patch-test preparations para-phenylenediamine and epoxy resin: a prospective multicentre investigation of the German Contact Dermatitis Research GroupBRITISH JOURNAL OF DERMATOLOGY, Issue 4 2006U. Hillen Summary Background Late patch-test reactions, developing at day (D) 7 or later have been described for several allergens. Late reactions may reflect patch-test sensitization. Para-phenylenediamine (PPD) and epoxy resins (ER) are potent allergens and therefore may potentially induce patch-test sensitization. Up to now, there has been no prospective study on the frequency of late reactions in routine patch testing with these allergens. Objectives To assess the frequency of late reactions to PPD and ER. Patients/methods In 1748 patients PPD (PPD-base, 1% pet.) and ER [based on diglycidylether of bisphenol A (DGEBA, 1% pet.)], and in 812 patients, nickel sulphate (5% pet.) were removed from the test panel of the standard series and applied on the medial side of the upper arm. Patch-test occlusion time was 24 h in 588 (PPD and ER) and 241 patients (nickel sulphate), respectively, and 48 h in 1160 (PPD and ER) and 571 (nickel sulphate) patients, respectively. Patch tests were read on D1,3 and D2,3, respectively; additional late readings were performed on D7, D14 and D21 after patch-test application. Patients who were not able to return for all scheduled late readings were telephoned on D7, D14 or D21, and questioned about a reaction at the test sites. Patients were instructed to perform daily self-examination from D4 onwards and to return immediately to the clinic if a reaction at the upper arm became visible. Results Data of 1428 patients (ER and PPD) and 638 patients (nickel) were evaluable. In 25 patients (1·8%), patch tests became positive not before D7, among them 21 reactions to PPD (1·5%) and four reactions to ER (0·3%). In five of seven patients, repeated patch tests with PPD disclosed patch-test sensitization as the cause of the late reaction. All late reactions, except for one, occurred in patients in whom patch tests were applied for 48 h. No late reactions were seen with nickel sulphate. Conclusions PPD (1% pet.) elicited late reactions in 1·5% of routine patch tests, the majority of them probably being caused by patch-test sensitization. Therefore, the German Contact Dermatitis Research Group decided to remove PPD 1% pet. from the German standard series and to take efforts to optimize the patch-test conditions of PPD. One way to optimize PPD testing could be to reduce the exposure of PPD 1% to 24 h. Alternatively the patch-test concentration of PPD might be reduced. [source] Ultrasonographic Investigation of the Effect of Inguinal Compression on the Cross-sectional Area of the Femoral VeinACADEMIC EMERGENCY MEDICINE, Issue 1 2008Jin-Tae Kim MD Abstract Objectives:, The reverse Trendelenburg position increases the cross-sectional area (CSA) of the femoral vein, making it easier to cannulate, although this position is potentially harmful in hypovolemic patients. The authors hypothesized that compression above the femoral vein increases the CSA of the femoral vein during emergency cannulation. Methods:, Ultrasound was used to measure the CSA of the femoral vein of 20 healthy volunteers. The following five measurements were made inferior to the inguinal crease: 1) in the horizontal supine position (control), 2) with inguinal compression 2 cm above the inguinal crease (at the point of arterial pulsation and its medial side), 3) in the Trendelenburg position 15°, 4) in the Trendelenburg position 15° plus inguinal compression, and 5) in the reverse Trendelenburg position 15°. Results:, Femoral vein CSA was increased by 35% by inguinal compression in the horizontal supine position (p < 0.001) and was decreased by the Trendelenburg position (p < 0.001). However, inguinal compression increased the CSA by 66% in the Trendelenburg position (p < 0.001). The reverse Trendelenburg position also increased the CSA of the femoral vein by 50% (p < 0.001). Conclusions:, Inguinal compression presents an alternative method for increasing the CSA of the femoral vein for venous catheterization in normal patients. [source] Relationship between formation of the femoral bicondylar angle and trochlear shape: Independence of diaphyseal and epiphyseal growthAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 4 2006C. Tardieu Abstract During hominin evolution, an increase in the femoral bicondylar angle was the initial change that led to selection for protuberance of the lateral trochlear lip and the elliptical profile of the lateral condyle. No correlation is found during ontogeny between the degree of femoral obliquity and of the prominence of the lateral trochlear lip. Might there be a relationship with the elliptical profile of the lateral condyle? On intact femoral diaphyses of juvenile humans and great apes, we compared the anteroposterior length of the lateral and medial sides of the distal metaphysis. The two diaphyseal pillars remain equal during postnatal growth in great apes, while the growth of the lateral pillar far exceeds that of the medial pillar in humans. Increase in bicondylar angle is correlated with disproportionate anteroposterior lengthening of the lateral pillar. The increased anteroposterior length of the lateral side of the metaphysis would contribute to increasing the radius of the curvature of the lateral condyle, but not to the projection of the lateral trochlear lip. The similar neonatal and adult femoro-patellar joint shape in humans prompted an assessment of the similarity during growth of the entire neonatal and adult epiphyses. We showed that the entire epiphysis undergoes drastic changes in proportions during postnatal growth. Finally, we emphasize the need to distinguish the cartilaginous phenotype and the ossified phenotype of the distal femoral epiphysis (and of any epiphysis) during postnatal growth. This crucial distinction applies to most postcranial bones, for they almost all develop following the process of endochondral ossification. Am J Phys Anthropol, 2006. © 2006 Wiley-Liss, Inc. [source] | |||||||||||||