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Proximal Portion (proximal + portion)
Selected AbstractsCarcinoma of the gall-bladder associated with primary sclerosing cholangitis and ulcerative colitisDIGESTIVE ENDOSCOPY, Issue 1 2000Mitsuru Seo A 64-year-old Japanese male was admitted to Fukuoka University Hospital to undergo further examination for an elevated ,-glutamyltransferase (,-GTP) level. Endoscopic retrograde cholangiography (ERC) showed dilatation of the intrahepatic bile duct and stenosis of the proximal portion of the common bile duct. No abnormality was found in the gall-bladder. Since the fecal occult blood test was positive, sigmoidoscopy and a barium enema were performed. Sigmoidoscopy showed a hyperemic and hemorrhagic mucosa in the rectum, but a barium enema study did not show any abnormal findings in the entire colon. We diagnosed the patient to have primary sclerosing cholangitis (PSC) and ulcerative proctitis based on these radiological and endoscopic findings. Bloody stool and fever occurred 4 months after the first admission. The patient's colitis extended to the entire colon. Because of the failure of corticosteroid therapy, a subtotal colectomy was performed. Given that a mass was intraoperatively palpable in the gall-bladder, a cholecystectomy was simultaneously performed. In the whole resected colon, diffuse ulcerations and mucosal islands were found. Grossly, a flat polypoid lesion, measuring 2 cm in diameter, was found in the fundus of the resected gall-bladder. Sections of this lesion in the gall-bladder revealed cystic atypical glands and some atypical cell clusters invading the subserosa. The present case suggests that careful observations are needed for patients with ulcerative colitis who have an elevated ,-GTP level even if the colitis is limited to the distal colon and the serum alkaline phosphatase level is normal. [source] Childhood bullous pemphigoid: a case report and 10-year follow upINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2007Ana María Sáenz MD, Assist. Bullous pemphigoid (BP) is a very rare acquired immunbullous disease in children and infants. We report the case of a 15-month-old boy referred to our service with multiple tense bullae located predominantly on the trunk, neck and proximal portion of the limbs. Palms, soles and oral mucosa were also affected. Histopathologic and immunopathologic features were characterized with bullous pemphigoid. The patient responded well to systemic steroids, with improvement of his condition. After a 10-year follow up the patient was no longer suffering from the disease. [source] Persistent sciatic vessels associated with an arteriovenous malformationJOURNAL OF ANATOMY, Issue 3 2001ZELIHA KURTO The sciatic artery is the major arterial supply to the lower limb bud at an early embryological stage. It primarily originates from the dorsal root of the umbilical artery. After the 22 mm embryological stage, the sciatic artery involutes and the femoral artery system develops as the major inflow source to the lower limb. In the adult, remnants of the sciatic artery persist as the proximal portion of the inferior gluteal artery, the popliteal and peroneal arteries (Williams et al. 1989). It is suggested that either failure in development of the femoral system or failure in regression of the sciatic artery results in persistence of this artery (Arey, 1965). We report a rare example of persistent sciatic artery (PSA) accompanied by arterio-arterial and arteriovenous anastomoses. [source] Transpulmonary Stenting of Both Pulmonary Arteries with a Surgical Access through Redo SternotomyJOURNAL OF CARDIAC SURGERY, Issue 4 2009Yacine Aggoun M.D. He developed 21 months later stenosis at the origin of both pulmonary arteries. The conventional interventional catheterization approaches were not available due to femoral vein thrombosis and severe transient complete atrioventricular block due to the manipulations to catheterize the left pulmonary artery. The stenoses were treated by implant of stents using a surgical access to the proximal portion of a Contegra valved conduit (Medtronic, Inc., Minneapolis, MN, USA) by sternotomy. [source] Ultrastructure of the spermatid of Caprimulgus europaeus Linnaeus 1758, the European nightjar (Aves; Caprimulgidae), with phylogenetic implicationsJOURNAL OF MORPHOLOGY, Issue 10 2006Sandro Tripepi Abstract The sperm of Caprimulgus europaeus is typical of other nonpasserines in many respects. Features shared with Paleognathae and Galloanserae are the conical acrosome, shorter than the nucleus; the presence of a perforatorium and endonuclear canal; the presence of a proximal as well as distal centriole; the elongate midpiece with mitochondria grouped around a central axis (here maximally six mitochondria in ,10 tiers); and the presence of a fibrous or amorphous sheath around the principal piece of the axoneme. A major (apomorphic) difference from paleognaths and galloanserans is the short distal centriole, the midpiece being penetrated for most of its length by the axoneme and for only a very short proximal portion by the centriole. Nonpasserines differ from paleognaths in that the latter have a transversely ribbed fibrous sheath, whereas in nonpasserines it is amorphous, as in Caprimulgus, or absent. The absence of an annulus is an apomorphic feature of Caprimulgus, apodiform, psittaciform, gruiform, and passerine sperm, homoplastic in at least some of these. In contrast to passerines, in Caprimulgus the cytoplasmic microtubules in the spermatid are restricted to a transient longitudinal manchette. The structure of the spermatid and spermatozoon is consistent with placement of the Caprimulgidae near the Psittacidae, but is less supportive of close proximity to the Apodidae, from DNA,DNA hybridization and some other analyses. J. Morphol. © 2006 Wiley-Liss, Inc. [source] Distal sensory nerve conduction of the superficial peroneal nerve: New method and its clinical applicationMUSCLE AND NERVE, Issue 5 2001Shin J. Oh MD Abstract The superficial peroneal nerve subserves sensation on the entire surface of the dorsum of the foot, except in small areas. All previously reported techniques for evaluating nerve conduction along this nerve tested a proximal portion of the nerve. We report a new method for evaluating sensory nerve conduction of the four branches of the distal superficial peroneal nerve. Two branches to the second and third toes of the medial dorsal cutaneous nerve and two branches to the fourth and fifth toes of the intermediate dorsal cutaneous nerve were studied orthodromically and antidromically in 37 feet of 21 normal volunteers using surface stimulating and recording electrodes and with a distance of 10 cm between the stimulating and recording electrodes. Maximum nerve conduction velocities (NCV) ranged from 41.8 to 46.9 m/s, and mean response amplitude ranged from 6.5 to 7.6 ,V with the orthodromic technique. Values for NCV were almost identical when elicited by antidromic and orthodromic techniques, but response amplitudes were higher with the antidromic technique. Mean amplitudes of the distal superficial peroneal nerve were about 50% of the proximal superficial peroneal, and the conduction velocity in the distal superficial peroneal was slower than that in the proximal superficial peroneal nerve, by 8,14 m/s. In seven cases, distal superficial peroneal neuropathy was confirmed with this technique: two with proper digital neuropathy, two with medial dorsal cutaneous neuropathy, and three with intermediate dorsal cutaneous neuropathy. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 689,694, 2001 [source] Management of retinoblastoma with proximal optic nerve enhancement on MRI at diagnosisPEDIATRIC BLOOD & CANCER, Issue 4 2008Saro H. Armenian DO Abstract Background In North America, retinoblastoma rarely presents with gross clinical evidence of tumor involving the optic nerve. Extent of microscopic tumor infiltration into the postlaminar optic nerve is a significant risk factor for metastasis, especially if there is tumor at the cut end. Due to poor outcomes in patients with metastatic disease, historical treatment for patients with clinical evidence of extraocular optic nerve involvement has included upfront enucleation followed by aggressive adjuvant chemotherapy. Additional orbital irradiation is advocated for individuals with optic nerve involvement at the surgical margin. Little is known about the role of neoadjuvant therapy in the setting of orbital optic nerve enhancement on magnetic resonance imaging (MRI) at diagnosis. Methods A retrospective review of consecutive retinoblastoma cases at Childrens Hospital Los Angeles over a 3-year period (2004,2006) found to have gadolinium contrast enhancement in the proximal portion of optic nerve on MRI at diagnosis. Results Nine patients fit the inclusion criteria. Two had secondary glaucoma of a sufficient degree to cause an enlarged eye (buphthalmos). Median age at presentation was 17 months (2,36 months). All patients received neoadjuvant chemotherapy prior to enucleation. Only two received external beam radiation. All are disease-free with a median follow-up of 22 months (12,41 months). Conclusions Neoadjuvant chemotherapy is well tolerated prior to enucleation of retinoblastoma-containing eyes associated with contrast enhancement of the proximal optic nerve on MRI at diagnosis. Such an approach may be used to decrease intensity or duration of chemotherapy and need for external beam radiation. Pediatr Blood Cancer 2008;51:479,484. © 2008 Wiley-Liss, Inc. [source] Morphological Changes in the Chicken Ductus Arteriosi During Closure at HatchingTHE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 8 2008Candace Belanger Abstract The chicken embryo has two functioning ductus arteriosi (DA) during development. These blood vessels connect the pulmonary arteries to the descending aorta providing a right-to-left shunt of blood away from the nonrespiring lungs and to the systemic circuit and chorioallanotic membrane. The DA consists of two distinct tissue types along its length, a muscular proximal portion and an elastic distal portion. During hatching, the DA must close for proper separation of systemic and pulmonary circulation. We examined the morphological changes of the chicken DA before, during, and after hatching. Occlusion of the proximal DA began during external pipping and was complete at hatching. Anatomical remodeling began as early as external pipping with fragmentation of the internal elastic lamina and smooth muscle actin appearing in the neointimal zone. By day 2 posthatch, the proximal DA lumen was fully occluded by endothelial cells and smooth muscle actin positive cells. In contrast, the distal DA was not fully occluded by day 2 posthatch. Increases in Po2 of the blood serves as the main stimulus for closure of the mammalian DA. The responsiveness of the chicken proximal DA to oxygen increased during hatching, peaking during external pipping. This peak correlated with an increase in blood gas Po2 and the initial occlusion of the vessel. The distal portion remained unresponsive to oxygen throughout hatching. In conclusion, the chicken DA begins to close during external pipping when arterial Po2 increases and vessel tone is most sensitive to oxygen. Anat Rec, 291:1007,1015, 2008. © 2008 Wiley-Liss, Inc. [source] Inferring adaptation within shape diversity of the humerus of subterranean rodent CtenomysBIOLOGICAL JOURNAL OF THE LINNEAN SOCIETY, Issue 2 2010FRANCISCO STEINER-SOUZA In subterranean rodents of the genus Ctenomys, excavation activity can be carried out with the claws and forelimbs (scratch-digging) as well as with the skull and incisor teeth (skull-tooth digging). Within the forelimb myoskeletal system, the humerus is a main bone concentrating a large number of muscles and bearing tensions during excavation. The genus Ctenomys is considered primarily a scratch-digger and secondarily a skull-tooth digger. We analysed the humerus (N = 165) of four species of Ctenomys from southern Brazil, in areas ranging from the soft soils of the first lines of coastal dunes (Ctenomys flamarioni, Ctenomys minutus), through the sandy fields of the coastal plains (Ctenomys minutus, Ctenomys lami), on to the hard soils of the southern pampas ,gaúchos' fields (Ctenomys torquatus). The differences in the form (size + shape) were quantified using geometric morphometrics methods and interpreted in the light of myological descriptions. As expected from a phylogenetic and ecological point of view, C. flamarioni had the most divergent shape and larger size among the species analysed, showing a more slender humerus, especially in the head region, than C. lami, C. minutus, and C. torquatus. Crossing the osteology data with the qualitative observations of the musculature, it was possible to detect large differences in the proximal portion of the humerus that could be related to the insertion of important extension muscles of the pectoral,shoulder joints, which could increase force. The comparison of shape differences between the three closely-related species (C. lami, C. minutus, and C. torquatus) revealed unexpected patterns because C. lami was the species phenetically more distant from C. flamarioni and not C. torquatus as expected from ecological data and phylogenetic relationships. A two-step adaptive path to humeral shapes better fit to digging is postulated where the deltoid crest and epicondylar crest increases precede an articular surface area increase. The absence of sexual dimorphism in C. torquatus is discussed with regard to the optimal size required to dig in hard soils. © 2010 The Linnean Society of London, Biological Journal of the Linnean Society, 2010, 100, 353,367. [source] Expression of receptor tyrosine kinases epidermal growth factor receptor and HER-2/neu in synovial sarcoma,CANCER, Issue 4 2005Dafydd G. Thomas M.D., Ph.D. Abstract BACKGROUND Synovial sarcomas are high-grade soft tissue neoplasms often characterized by a biphasic spindle and epithelioid cell morphology. The majority of synovial sarcomas harbor a specific chromosomal translocation in which the proximal portion of the SYT gene at chromosome 18q11 is fused to the distal portion of one of several duplicated SSX genes (most notably SSX1 and SSX2) at chromosome Xp11. SYT/SSX1 translocations are seen in nearly three times as many synovial sarcomas as SYT/SSX2 translocations. Although the SYT/SSX2 fusion is usually associated with the monophasic disease pattern, the SYT/SSX1 fusion is present in tumors with biphasic or monophasic patterns. The SYT/SSX1 fusion gene is associated with more aggressive tumor growth and poor outcome. Despite advances in the therapy of local disease, distant metastasis remains the predominant cause of death. Accordingly, there is a need for alternate therapies, such as those recently developed against the receptor tyrosine kinases, such as epidermal growth factor receptor (EGFR) and HER-2/neu. METHODS Archival specimens of synovial sarcoma (n = 38) representing 30 patients were assessed for EGFR and HER-2/neu protein expression by standard immunohistochemical techniques. To validate the immunohistochemistry results, quantitative real-time polymerase chain reaction (Q-PCR) assays using either fresh and/or archival material was performed. The presence of gene amplification was determined by chromogenic in-situ hybridization. RESULTS EGFR and HER-2/neu protein were detected by immunohistochemistry in 21 of 38 (55.3%) and 20 of 38 (52.6%) synovial specimens, respectively. EGFR immunoreactivity showed a granular and membranous pattern, whereas HER-2/neu immunoreactivity demonstrated only a membrane pattern. Coexpression was observed in 13 of 38 specimens (34.2%). HER-2/neu expression by immunohistochemistry in synovial sarcomas was restricted to tumors with the SYT/SSX1 translocations. Of 6 specimens with SSX2 translocation, none (0%) showed HER-2/neu immunoreactivity and 1 (17%) demonstrated EGFR expression. Q-PCR demonstrated the presence of mRNA for EGFR and HER-2/neu in 19 of 30 specimens (63.3%) and 22 of 30 specimens (73.3%), respectively. EGFR and HER-2/neu were expressed at low concentrations compared with the expression of glyceraldehyde 3-phosphate dehydrogenase (GAPDH). No evidence of gene amplification was observed. CONCLUSIONS EGFR and HER-2/neu are expressed in the majority of patients with SYT/SSX1 synovial sarcomas, albeit at low levels. Treatment with tyrosine kinase inhibitors may represent appropriate alternate therapy for these patients. Cancer 2005. © 2005 American Cancer Society. [source] Gender-Related Differences in Coronary Artery Dimensions: A Volumetric AnalysisCLINICAL CARDIOLOGY, Issue 2 2010Jennifer A. Dickerson MD Abstract Background Women consistently have poorer revascularization outcomes and more coronary vascular complications compared to men. This has been attributed to smaller coronary arteries, though limited data exist to support this assumption. Hypothesis By using volumetric data obtained from multidetector cardiovascular computed tomography (CCT), we sought to determine to what extent gender influences coronary artery dimensions and test the hypothesis that women would have smaller coronary dimensions even after normalizing for body surface area and cardiac mass. Methods CCT examinations completed on a 64-slice scanner were identified from a university cardiovascular database. Data sets from 50 women and 44 men without coronary artery disease were selected for analysis. Cross-sectional areas of proximal and distal segments of the left anterior descending (LAD), circumflex (LCx), and right coronary artery (RCA) were measured, blinded to patient gender. Measurements were compared using 2-sample t tests and linear regression analysis techniques accounting for body surface area (BSA) and left ventricular (LV) mass. Results Analysis of cross-sectional coronary artery areas, unadjusted for BSA and LV mass showed smaller coronary artery size in women compared to men in the proximal portion of both the LAD (P = .01) and RCA (P = .002), but no significant difference in the remaining coronary segments. Conclusion Gender significantly impacts proximal LAD and RCA size. Differences in coronary artery dimensions may explain some, but not all excess gender-related risk with coronary artery revascularization, underscoring the importance of considering multiple contributing factors. Copyright © 2010 Wiley Periodicals, Inc. [source] Renal sexual segment of the ground skink, Scincella laterale (Reptilia, Squamata, Scincidae),JOURNAL OF MORPHOLOGY, Issue 1 2005David M. Sever Abstract Mature squamates possess hypertrophied regions of the distal urinary ducts, the renal sexual segment (RSS). The RSS is believed to provide seminal fluid that mixes with sperm and is released into the female cloaca during coitus. This study is the first to describe ultrastructure of the RSS in a lizard collected throughout the active season. The species examined, Scincella laterale, represents the largest family (Scincidae: 1,200 species) of lizards. Although sperm are present in the posterior ductus deferens of male S. laterale throughout the year, an annual spermatogenic cycle occurs that results in spermiation in spring, coinciding with maximum development of the RSS. Female S. laterale may possess stored sperm in vaginal crypts from March,May and large oviductal eggs April,June. Thus, the correlation between mating and RSS activity observed in other squamates is also found in S. laterale. Cytologically, the active RSS consists of columnar cells with numerous apical, electron-dense secretory vacuoles which are released by an apocrine process. The granules stain positively for proteins with bromphenol blue and react with PAS for neutral carbohydrates. After the mating season the RSS undergoes recrudescence and the electron-dense granules are replaced by a mucoid secretion that characterizes more proximal portions of the nephric tubules throughout the year. Little variation in ultrastructure of the RSS occurs between S. laterale and Cnemidophorus lemniscatus (Teiidae), the only other lizard in which seasonal variation of the RSS has been studied using similar methods. Females exhibit differentiation similar to that of males in the distal urinary tubules, but to a lesser degree. This is only the second such report for female squamates, and the differentiation of the region in females is proposed to result from adrenal androgens. J. Morphol. Published 2005 Wiley-Liss, Inc. [source] | |||||||||||||