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Sample records for clinical cerebrovascular anatomy

  1. Chromosomes and clinical anatomy.

    PubMed

    Gardner, Robert James McKinlay

    2016-07-01

    Chromosome abnormalities may cast light on the nature of mechanisms whereby normal anatomy evolves, and abnormal anatomy arises. Correlating genotype to phenotype is an exercise in which the geneticist and the anatomist can collaborate. The increasing power of the new genetic methodologies is enabling an increasing precision in the delineation of chromosome imbalances, even to the nucleotide level; but the classical skills of careful observation and recording remain as crucial as they always have been. Clin. Anat. 29:540-546, 2016. © 2016 Wiley Periodicals, Inc. PMID:26990310

  2. Cerebral blood flow: Physiologic and clinical aspects

    SciTech Connect

    Wood, J.H.

    1987-01-01

    This book contains 46 chapters divided among nine sections. The section titles are: Historical Perspectives; Cerebrovascular Anatomy; Cerebrovascular Physiology; Methods of Clinical Measurement; Experimental Methods; Imaging of Cerebral Circulation; Cerebrovascular Pathophysiology; Cerebrovascular Pharmacology; and Surgical and Interventional Augmentation.

  3. Principles and Clinical Application of Dual-energy Computed Tomography in the Evaluation of Cerebrovascular Disease

    PubMed Central

    Hsu, Charlie Chia-Tsong; Kwan, Gigi Nga Chi; Singh, Dalveer; Pratap, Jit; Watkins, Trevor William

    2016-01-01

    Dual-energy computed tomography (DECT) simultaneously acquires images at two X-ray energy levels, at both high- and low-peak voltages (kVp). The material attenuation difference obtained from the two X-ray energies can be processed by software to analyze material decomposition and to create additional image datasets, namely, virtual noncontrast, virtual contrast also known as iodine overlay, and bone/calcium subtraction images. DECT has a vast array of clinical applications in imaging cerebrovascular diseases, which includes: (1) Identification of active extravasation of iodinated contrast in various types of intracranial hemorrhage; (2) differentiation between hemorrhagic transformation and iodine staining in acute ischemic stroke following diagnostic and/or therapeutic catheter angiography; (3) identification of culprit lesions in intra-axial hemorrhage; (4) calcium subtraction from atheromatous plaque for the assessment of plaque morphology and improved quantification of luminal stenosis; (5) bone subtraction to improve the depiction of vascular anatomy with more clarity, especially at the skull base; (6) metal artifact reduction utilizing virtual monoenergetic reconstructions for improved luminal assessment postaneurysm coiling or clipping. We discuss the physical principles of DECT and review the clinical applications of DECT for the evaluation of cerebrovascular diseases. PMID:27512615

  4. Principles and Clinical Application of Dual-energy Computed Tomography in the Evaluation of Cerebrovascular Disease.

    PubMed

    Hsu, Charlie Chia-Tsong; Kwan, Gigi Nga Chi; Singh, Dalveer; Pratap, Jit; Watkins, Trevor William

    2016-01-01

    Dual-energy computed tomography (DECT) simultaneously acquires images at two X-ray energy levels, at both high- and low-peak voltages (kVp). The material attenuation difference obtained from the two X-ray energies can be processed by software to analyze material decomposition and to create additional image datasets, namely, virtual noncontrast, virtual contrast also known as iodine overlay, and bone/calcium subtraction images. DECT has a vast array of clinical applications in imaging cerebrovascular diseases, which includes: (1) Identification of active extravasation of iodinated contrast in various types of intracranial hemorrhage; (2) differentiation between hemorrhagic transformation and iodine staining in acute ischemic stroke following diagnostic and/or therapeutic catheter angiography; (3) identification of culprit lesions in intra-axial hemorrhage; (4) calcium subtraction from atheromatous plaque for the assessment of plaque morphology and improved quantification of luminal stenosis; (5) bone subtraction to improve the depiction of vascular anatomy with more clarity, especially at the skull base; (6) metal artifact reduction utilizing virtual monoenergetic reconstructions for improved luminal assessment postaneurysm coiling or clipping. We discuss the physical principles of DECT and review the clinical applications of DECT for the evaluation of cerebrovascular diseases. PMID:27512615

  5. Professional Storytelling in Clinical Dental Anatomy Teaching

    ERIC Educational Resources Information Center

    Kieser, Jules; Livingstone, Vicki; Meldrum, Alison

    2008-01-01

    The aim of the present work was to see if storytelling in a clinical dental anatomy course would increase student satisfaction. We enhanced teaching by spontaneous storytelling in problem-based learning, in half of the third-year dentistry class. At the end of the course, we administered an anonymous questionnaire to the students in the class,…

  6. Guidelines for Standard Photography in Gross and Clinical Anatomy

    ERIC Educational Resources Information Center

    Barut, Cagatay; Ertilav, Hakan

    2011-01-01

    Photography has a widespread usage in medicine and anatomy. In this review, authors focused on the usage of photography in gross and clinical anatomy. Photography in gross and clinical anatomy is not only essential for accurate documentation of morphological findings but also important in sharing knowledge and experience. Photographs of cadavers…

  7. Clinical anatomy of the subserous layer: An amalgamation of gross and clinical anatomy.

    PubMed

    Yabuki, Yoshihiko

    2016-05-01

    The 1998 edition of Terminologia Anatomica introduced some currently used clinical anatomical terms for the pelvic connective tissue or subserous layer. These innovations persuaded the present author to consider a format in which the clinical anatomical terms could be reconciled with those of gross anatomy and incorporated into a single anatomical glossary without contradiction or ambiguity. Specific studies on the subserous layer were undertaken on 79 Japanese women who had undergone surgery for uterine cervical cancer, and on 26 female cadavers that were dissected, 17 being formalin-fixed and 9 fresh. The results were as follows: (a) the subserous layer could be segmentalized by surgical dissection in the perpendicular, horizontal and sagittal planes; (b) the segmentalized subserous layer corresponded to 12 cubes, or ligaments, of minimal dimension that enabled the pelvic organs to be extirpated; (c) each ligament had a three-dimensional (3D) structure comprising craniocaudal, mediolateral, and dorsoventral directions vis-á-vis the pelvic axis; (d) these 3D-structured ligaments were encoded morphologically in order of decreasing length; and (e) using these codes, all the surgical procedures for 19th century to present-day radical hysterectomy could be expressed symbolically. The establishment of clinical anatomical terms, represented symbolically through coding as demonstrated in this article, could provide common ground for amalgamating clinical anatomy with gross anatomy. Consequently, terms in clinical anatomy and gross anatomy could be reconciled and compiled into a single anatomical glossary. Clin. Anat. 29:508-515, 2016. © 2015 Wiley Periodicals, Inc. PMID:26621479

  8. Spinal Cord Anatomy and Clinical Syndromes.

    PubMed

    Diaz, Eric; Morales, Humberto

    2016-10-01

    We review the anatomy of the spinal cord, providing correlation with key functional and clinically relevant neural pathways, as well as magnetic resonance imaging. Peripherally, the main descending (corticospinal tract) and ascending (gracilis or cuneatus fasciculi and spinothalamic tracts) pathways compose the white matter. Centrally, the gray matter can be divided into multiple laminae. Laminae 1-5 carry sensitive neuron information in the posterior horn, and lamina 9 carries most lower motor neuron information in the anterior horn. Damage to the unilateral corticospinal tract (upper motor neuron information) or gracillis-cuneatus fasciculi (touch and vibration) correlates with ipsilateral clinical findings, whereas damage to unilateral spinothalamic tract (pain-temperature) correlates with contralateral clinical findings. Damage to commissural fibers correlates with a suspended bilateral "girdle" sensory level. Autonomic dysfunction is expected when there is bilateral cord involvement. PMID:27616310

  9. Professional storytelling in clinical dental anatomy teaching.

    PubMed

    Kieser, Jules; Livingstone, Vicki; Meldrum, Alison

    2008-01-01

    The aim of the present work was to see if storytelling in a clinical dental anatomy course would increase student satisfaction. We enhanced teaching by spontaneous storytelling in problem-based learning, in half of the third-year dentistry class. At the end of the course, we administered an anonymous questionnaire to the students in the class, consisting of 12 questions that students had to answer on a Likert scale of 1-5. An overall satisfaction score was obtained and we used a linear mixed model to compare differences in satisfaction between the two groups, with "group" as the fixed effect. We also conducted an exploratory factor analysis of the responses to investigate whether there were distinct constructs within the data. Overall satisfaction is high, with students "with stories" having higher satisfaction than those "without stories." The former group consistently gives higher satisfaction scores, regardless of which question is being asked. Factor analysis provides evidence that storytelling nurtures reflective learning, while students work on their clinical anatomy problems. PMID:19177386

  10. Guyon Canal: The Evolution of Clinical Anatomy

    PubMed Central

    Maroukis, Brianna L.; Ogawa, Takeshi; Rehim, Shady A.; Chung, Kevin C.

    2016-01-01

    The eponym “Guyon canal” refers to the ulnar tunnel at the wrist that was named after the French surgeon Jean Casimir Félix Guyon who first described this space in 1861. After Guyon’s discovery, clinicians have focused their interest on symptoms caused by compression of structures occupying this canal (later named ulnar tunnel syndrome, or Guyon syndrome). However disagreement and confusion persisted over the correct anatomical boundaries and terminology used to describe the ulnar tunnel. Through anatomical investigation and evolving clinical case studies, the current understanding of the anatomy of the ulnar tunnel was established. This article examines the evolution of the anatomical description of the ulnar tunnel and its relevant clinical associations, and casts light on the life and contributions of Jean Casimir Félix Guyon. PMID:25446410

  11. Perceptions of Anatomy: Critical Components in the Clinical Setting

    ERIC Educational Resources Information Center

    Lazarus, Michelle D.; Chinchilli, Vernon M.; Leong, Shou Ling; Kauffman, Gordon L., Jr.

    2012-01-01

    The evolution in undergraduate medical school curricula has significantly impacted anatomy education. This study investigated the perceived role of clinical anatomy and evaluated perceptions of medical students' ability to apply anatomical knowledge in the clinic. The aim of this study was to develop a framework to enhance anatomical educational…

  12. Clinical Vignettes Improve Performance in Anatomy Practical Assessment

    ERIC Educational Resources Information Center

    Ikah, December S. K.; Finn, Gabrielle M.; Swamy, Meenakshi; White, Pamela M.; McLachlan, John C.

    2015-01-01

    Although medical curricula now adopt an integrated teaching approach, this is not adequately reflected in assessment of anatomy knowledge and skills. In this study, we aimed to explore the impact of the addition of clinical vignette to item stems on students' performance in anatomy practical examinations. In this study, 129 undergraduate medical…

  13. Teaching of clinical anatomy in rheumatology: a review of methodologies.

    PubMed

    Torralba, Karina D; Villaseñor-Ovies, Pablo; Evelyn, Christine M; Koolaee, R Michelle; Kalish, Robert A

    2015-07-01

    Clinical anatomy may be defined as anatomy that is applied to the care of the patient. It is the foundation of a well-informed physical examination that is so important in rheumatologic practice. Unfortunately, there is both documented and observed evidence of a significant deficiency in the teaching and performance of a competent musculoskeletal examination at multiple levels of medical education including in rheumatology trainees. At the Annual Meeting of the American College of Rheumatology in Boston, MA, that took place in November 2014, a Clinical Anatomy Study Group met to share techniques of teaching clinical anatomy to rheumatology fellows, residents, and students. Techniques that were reviewed included traditional anatomic diagrams, hands-on cross-examination, cadaver study, and musculoskeletal ultrasound. The proceedings of the Study Group section are described in this review. PMID:26037454

  14. The Weak Relationship between Anatomy Competence and Clinical Skills in Junior Medical Students

    ERIC Educational Resources Information Center

    Schoeman, Scarpa; Chandratilake, Madawa

    2012-01-01

    In modern curricula, the early integration of anatomy and clinical skills education at undergraduate level is seen as important. However, the direct relationship between medical students' competence in anatomy, and their clinical proficiency during early undergraduate years, has scarcely been studied. In this study, the marks for anatomy and…

  15. Surgical Clinical Correlates in Anatomy: Design and Implementation of a First-Year Medical School Program

    ERIC Educational Resources Information Center

    Haubert, Lisa M.; Jones, Kenneth; Moffatt-Bruce, Susan D.

    2009-01-01

    Medical students state the need for a clinically oriented anatomy class so to maximize their learning experience. We hypothesize that the first-year medical students, who take the Surgical Clinical Correlates in Anatomy program, will perform better than their peers in their anatomy course, their surgical clerkships and ultimately choose surgical…

  16. Normal feline brain: clinical anatomy using magnetic resonance imaging.

    PubMed

    Mogicato, G; Conchou, F; Layssol-Lamour, C; Raharison, F; Sautet, J

    2012-04-01

    The purpose of this study was to provide a clinical anatomy atlas of the feline brain using magnetic resonance imaging (MRI). Brains of twelve normal cats were imaged using a 1.5 T magnetic resonance unit and an inversion/recovery sequence (T1). Fourteen relevant MRI sections were chosen in transverse, dorsal, median and sagittal planes. Anatomic structures were identified and labelled using anatomical texts and Nomina Anatomica Veterinaria, sectioned specimen heads, and previously published articles. The MRI sections were stained according to the major embryological and anatomical subdivisions of the brain. The relevant anatomical structures seen on MRI will assist clinicians to better understand MR images and to relate this neuro-anatomy to clinical signs. PMID:21919951

  17. Clinical anatomy of the internal oblique muscle.

    PubMed

    Ramasastry, S S; Granick, M S; Futrell, J W

    1986-01-01

    In recent years microvascular free tissue transfer has become a well accepted reconstructive technique. The current trend in flap research seems to be the development of more refined flaps to meet specific needs with minimal donor site morbidity. The internal oblique muscle provides a broad, thin, well-vascularized flap which is ideally suited for restoration of contour with excellent aesthetic results. In addition, the iliac crest may be raised in continuity based on the same vascular pedicle, i.e. the deep circumflex iliac vessels. The purpose of this article is to describe the anatomic details necessary for the clinical application of this versatile flap. Thirty specimens of the internal oblique muscle flap were dissected and studied using Microfil injection techniques, including xerograms. In about 80 percent of the flaps, a single ascending branch of the deep circumflex iliac artery (DCIA) enters the undersurface of the muscle, arborizing within the muscle. In the remaining 20 percent, two or three branches enter the muscle separately, originating on the DCIA. The arc of rotation extends into the ipsilateral groin for coverage of exposed femoral vessels, along the pubis and the anterior perineum. The length of the vascular pedicle is to 6 to 7 cm and the vessel diameter is 2.0 to 3.0 mm, making the flap suitable for free tissue transfer. PMID:2935630

  18. The clinical anatomy of the conal artery.

    PubMed

    Loukas, Marios; Patel, Swetal; Cesmebasi, Alper; Muresian, Horia; Tubbs, R Shane; Spicer, Diane; Dabrowski, Marek

    2016-04-01

    Coronary arteries have been extensively described and recognized by gross anatomic studies. However, in the clinical setting, the recognition of the conal artery is essential during coronary angiography, as well as certain congenital heart conditions such as tetralogy of Fallot. In order to provide a complete anatomic and physiologic correlation of the actual incidence and distribution of the conal artery we examined 300 formalin fixed hearts with gross dissections and 300 coronary angiograms. The conal artery was identified in all hearts examined and five main patterns were recognized. In Type A (193, 32.1%), the conal artery arose as a branch of the right coronary artery (RCA); in Type B (96, 16%), the conal artery arose from the common coronary ostium with the RCA; in Type C (242, 40.3%), the conal artery took origin from the right aortic sinus as an independent artery; in Type D (48, 8%), multiple conal arteries were present and arose from the RCA as separate branches (32, 66.6%), from a common ostium with the RCA (8, 16.6%) or from the aortic sinus (8, 16.6%); in Type E (22, 3.6%), the conal artery arose as a branch of the right ventricular branch (17, 2.8%) or acute marginal artery (5, 0.8%). The relative prevalence of the five patterns as well as the morphology and the topography of the conal artery varied significantly with the degree of coronary luminal stenosis (as observed during angiography) and also with the degree of hypertrophied ventricular wall (as observed during gross dissections). Clin. Anat. 29:371-379, 2016. © 2014 Wiley Periodicals, Inc. PMID:25255889

  19. Digital tomosynthesis: technique modifications and clinical applications for neurovascular anatomy

    SciTech Connect

    Maravilla, K.R.; Murry, R.C. Jr.; Diehl, J.; Suss, R.; Allen, L.; Chang, K.; Crawford, J.; McCoy, R.

    1984-09-01

    Digital tomosynthesis studies (DTS) using a linear tomographic motion can provide good quality clinical images when combined with subtraction angiotomography. By modifying their hardware system and the computer software algorithms, the authors were able to reconstruct tomosynthesis images using an isocentric rotation (IR) motion. Applying a combination of linear tomographic and IR techniques in clinical cases, they performed DTS studies in six patients, five with aneurysms and one with a hypervascular tumor. The results showed detailed definitions of the pathologic entities and the regional neurovascular anatomy. Based on this early experience, DTS would seem to be a useful technique for the preoperative surgical planning of vascular abnormalities.

  20. Clinical anatomy of the canine brain using magnetic resonance imaging.

    PubMed

    Leigh, Edmund J; Mackillop, Edward; Robertson, Ian D; Hudson, Lola C

    2008-01-01

    The purpose of this study was to produce an magnetic resonsnce (MR) image atlas of clinically relevant brain anatomy and to relate this neuroanatomy to clinical signs. The brain of a large mixed breed dog was imaged in transverse, sagittal, and dorsal planes using a 1.5 T MR unit and the following pulse sequences: Turbo (fast) spin echo (TSE) T2, T1, and T2- weighted spatial and chemical shift-encoded excitation sequence. Relevant neuroanatomic structures were identified using anatomic texts, sectioned cadaver heads, and previously published atlases. Major subdivisions of the brain were mapped and the neurologic signs of lesions in these divisions were described. TSE T2-weighted images were found to be the most useful for identifying clinically relevant neuroanatomy. Relating clinical signs to morphology as seen on MR will assist veterinarians to better understand clinically relevant neuroanatomy in MR images. PMID:18418990

  1. Effectiveness of a Shortened, Clinically Engaged Anatomy Course for Physician Assistant Students

    ERIC Educational Resources Information Center

    Rizzolo, Lawrence J.; Rando, William C.; O'Brien, Michael K.; Garino, Alexandria; Stewart, William B.

    2011-01-01

    There is little consensus among programs that train physician assistants (PAs) regarding how much time should be devoted to the study of anatomy, what should be included, or how it should be taught. Similar concerns led us to redesign anatomy for medical students and introduce clinically engaged anatomy, an approach designed in collaboration with…

  2. Midface: Clinical Anatomy and Regional Approaches with Injectable Fillers.

    PubMed

    Cotofana, Sebastian; Schenck, Thilo L; Trevidic, Patrick; Sykes, Jonathan; Massry, Guy G; Liew, Steven; Graivier, Miles; Dayan, Steve; de Maio, Mauricio; Fitzgerald, Rebecca; Andrews, J Todd; Remington, B Kent

    2015-11-01

    The clinical approach towards the midface is one of the most important interventions for practitioners when treating age-related changes of the face. Currently a plethora of procedures are used and presented. However, few of these approaches have been validated or passed review board assigned evaluations. Therefore, it is the aim of this work to establish a guideline manual for practitioners for a safe and effective mid-face treatment based on the most current concepts of facial anatomy. The latter is based on the 5-layered structural arrangement and its understanding is the key towards the favoured outcome and for minimizing complications. PMID:26441102

  3. Reverse Radial Artery Flap Perforator Anatomy and Clinical Applications.

    PubMed

    White, Colin P; Steve, Anna K; Buchel, Edward W; Hayakawa, Thomas E; Morris, Steven F

    2016-09-01

    The pedicled reverse radial forearm flap is a well-known option for the treatment of a variety of soft tissue wounds including dorsal hand wounds. We document the number, emerging diameter, length from origin, course, and location of all perforators of the radial artery in a series of 6 fresh human cadavers after whole body lead oxide and gelatin injection to confirm and comprehensively document the anatomy of the radial artery perforators. This data provide an anatomic basis for a modification to the reversed radial forearm flap used to decrease venous congestion in the postoperative period. Two case reports are presented to provide clinical demonstration of the importance of this modification. PMID:26678105

  4. Determination of Clinically Relevant Content for a Musculoskeletal Anatomy Curriculum for Physical Medicine and Rehabilitation Residents

    ERIC Educational Resources Information Center

    Lisk, Kristina; Flannery, John F.; Loh, Eldon Y.; Richardson, Denyse; Agur, Anne M. R.; Woods, Nicole N.

    2014-01-01

    To address the need for more clinical anatomy training in residency education, many postgraduate programs have implemented structured anatomy courses into their curriculum. Consensus often does not exist on specific content and level of detail of the content that should be included in such curricula. This article describes the use of the Delphi…

  5. Design and Development of a New Facility for Teaching and Research in Clinical Anatomy

    ERIC Educational Resources Information Center

    Greene, John Richard T.

    2009-01-01

    This article discusses factors in the design, commissioning, project management, and intellectual property protection of developments within a new clinical anatomy facility in the United Kingdom. The project was aimed at creating cost-effective facilities that would address widespread concerns over anatomy teaching, and support other activities…

  6. The Case Anatomical Knowledge Index (CAKI): A Novel Method Used to Assess Anatomy Content in Clinical Cases

    ERIC Educational Resources Information Center

    Banda, Sekelani S.

    2009-01-01

    There are concerns in the literature that the use of case-based teaching of anatomy could be compromising the depth and scope of anatomy learned by students in a problem-based learning curriculum. Poor selection of clinical cases that are used as vehicles for teaching/learning anatomy may be the root problem because some clinical cases do not…

  7. ISI values and interhemispheric differences in patients with ischemic cerebrovascular disease; correlations with clinical and angiographic findings

    SciTech Connect

    Mosmans, P.C.; Veering, M.M.; Jonkman, E.J.

    1986-01-01

    Xenon 133 inhalation CBF studies of one hundred patients with ischemic cerebrovascular disease in the territory of the carotid artery were compared in an attempt to gain more insight into the collateral capacity, especially in those with a stenosis or occlusion of one of the major arteries. Asymmetry of the ISI values for the two hemispheres was expressed as a ratio. High ratios (greater ISI asymmetries) were found for patients with an occlusion of the internal carotid or middle cerebral artery, especially--but not exclusively--those with the more severe clinical symptoms. It also appeared that even when the patient is in a good clinical condition, an elevated ratio reflects insufficiency of the collateral supply to the affected side. The ISI values for individual patients seem to be less useful, partly due to the variable age dependency of this flow parameter.

  8. Clinical and Radiological Classification of the Jawbone Anatomy in Endosseous Dental Implant Treatment

    PubMed Central

    Kubilius, Marius

    2013-01-01

    ABSTRACT Objectives The purpose of present article was to review the classifications suggested for assessment of the jawbone anatomy, to evaluate the diagnostic possibilities of mandibular canal identification and risk of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone, as well as to suggest new classification system of the jawbone anatomy in endosseous dental implant treatment. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandible; mandibular canal; alveolar nerve, inferior; anatomy, cross-sectional; dental implants; classification. The search was restricted to English language articles, published from 1972 to March 2013. Additionally, a manual search in the major anatomy and oral surgery books were performed. The publications there selected by including clinical and human anatomy studies. Results In total 109 literature sources were obtained and reviewed. The classifications suggested for assessment of the jawbone anatomy, diagnostic possibilities of mandibular canal identification and risk of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone were discussed. New classification system of the jawbone anatomy in endosseous dental implant treatment based on anatomical and radiologic findings and literature review results was suggested. Conclusions The classification system proposed here based on anatomical and radiological jawbone quantity and quality evaluation is a helpful tool for planning of treatment strategy and collaboration among specialists. Further clinical studies should be conducted for new classification validation and reliability evaluation. PMID:24422030

  9. Lower Face: Clinical Anatomy and Regional Approaches with Injectable Fillers.

    PubMed

    Braz, André; Humphrey, Shannon; Weinkle, Susan; Yee, G Jackie; Remington, B Kent; Lorenc, Z Paul; Yoelin, Steve; Waldorf, Heidi A; Azizzadeh, Babak; Butterwick, Kimberly J; de Maio, Mauricio; Sadick, Neil; Trevidic, Patrick; Criollo-Lamilla, Gisella; Garcia, Philippe

    2015-11-01

    The use of injectable fillers enables facial sculpting through treatment of volume depletion and modeling of facial contours. Injectable fillers are among the most frequently performed minimally invasive cosmetic procedures.However, treatment of the lower third of the face can be challenging and requires expertise in facial anatomy. In this article, the authors provide a comprehensive review of the anatomy of the lower third of the face, highlighting danger zones. In addition, the authors describe their preferred approach and detailed technique used in the treatment of each specific area, namely the jawline, prejowl sulcus, melomental folds, and lips. PMID:26441104

  10. Sinus Anatomy

    MedlinePlus

    ... ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... ANATOMY > Sinus Anatomy Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ...

  11. The Anatomical Basis of Clinical Practice: An Anatomy Learning Programme

    ERIC Educational Resources Information Center

    Travill, A. A.

    1977-01-01

    In an attempt to optimize medical students' enthusiasm to learn rather than to be taught, an anatomy learning program has been introduced into an evolving medical curriculum at Queen's University in Ontario. It uses a course guide, slide presentation, prosection by senior students, and peer-directed group tutorials. Surgical and radiological…

  12. Body Painting as a Tool in Clinical Anatomy Teaching

    ERIC Educational Resources Information Center

    McMenamin, Paul G.

    2008-01-01

    The teaching of human anatomy has had to respond to significant changes in medical curricula, and it behooves anatomists to devise alternative strategies to effectively facilitate learning of the discipline by medical students in an integrated, applied, relevant, and contextual framework. In many medical schools, the lack of cadaver dissection as…

  13. The thoracolumbar fascia: anatomy, function and clinical considerations

    PubMed Central

    Willard, F H; Vleeming, A; Schuenke, M D; Danneels, L; Schleip, R

    2012-01-01

    In this overview, new and existent material on the organization and composition of the thoracolumbar fascia (TLF) will be evaluated in respect to its anatomy, innervation biomechanics and clinical relevance. The integration of the passive connective tissues of the TLF and active muscular structures surrounding this structure are discussed, and the relevance of their mutual interactions in relation to low back and pelvic pain reviewed. The TLF is a girdling structure consisting of several aponeurotic and fascial layers that separates the paraspinal muscles from the muscles of the posterior abdominal wall. The superficial lamina of the posterior layer of the TLF (PLF) is dominated by the aponeuroses of the latissimus dorsi and the serratus posterior inferior. The deeper lamina of the PLF forms an encapsulating retinacular sheath around the paraspinal muscles. The middle layer of the TLF (MLF) appears to derive from an intermuscular septum that developmentally separates the epaxial from the hypaxial musculature. This septum forms during the fifth and sixth weeks of gestation. The paraspinal retinacular sheath (PRS) is in a key position to act as a ‘hydraulic amplifier’, assisting the paraspinal muscles in supporting the lumbosacral spine. This sheath forms a lumbar interfascial triangle (LIFT) with the MLF and PLF. Along the lateral border of the PRS, a raphe forms where the sheath meets the aponeurosis of the transversus abdominis. This lateral raphe is a thickened complex of dense connective tissue marked by the presence of the LIFT, and represents the junction of the hypaxial myofascial compartment (the abdominal muscles) with the paraspinal sheath of the epaxial muscles. The lateral raphe is in a position to distribute tension from the surrounding hypaxial and extremity muscles into the layers of the TLF. At the base of the lumbar spine all of the layers of the TLF fuse together into a thick composite that attaches firmly to the posterior superior iliac spine

  14. Hypertension and cerebrovascular damage.

    PubMed

    Veglio, Franco; Paglieri, Cristina; Rabbia, Franco; Bisbocci, Daniela; Bergui, Mauro; Cerrato, Paolo

    2009-08-01

    Hypertension is the most important modifiable factor for cerebrovascular disease. Stroke and dementia are growing health problems that have considerable social and economical consequences. Hypertension causes brain lesions by several mechanisms predisposing to lacunar infarctions, leucoaraiosis, and white matter changes as well as to intracerebral haemorrhages. These parenchymal damages determine evident or silent neurological alterations that often precede the onset of cognitive decline. It is important to recognize cerebrovascular disease and, above all, to correlate typical lesions to hypertension. Antihypertensive therapy has shown clinical benefits in primary and secondary prevention of stroke. These drugs represent important instruments against cerebrovascular disease but their effects on cognition are still matter of debate. Cerebral parenchymal and functional damages have to be considered together to make medical intervention more incisive. PMID:19100549

  15. The Student's Dilemma, Liver Edition: Incorporating the Sonographer's Language into Clinical Anatomy Education

    ERIC Educational Resources Information Center

    Hall, M. Kennedy; Mirjalili, S. Ali; Moore, Christopher L.; Rizzolo, Lawrence J.

    2015-01-01

    Anatomy students are often confused by multiple names ascribed to the same structure by different clinical disciplines. Increasingly, sonography is being incorporated into clinical anatomical education, but ultrasound textbooks often use names unfamiliar to the anatomist. Confusion is worsened when ultrasound names ascribed to the same structure…

  16. The Development of Clinical Reasoning Skills: A Major Objective of the Anatomy Course

    ERIC Educational Resources Information Center

    Elizondo-Omana, Rodrigo E.; Lopez, Santos Guzman

    2008-01-01

    Traditional medical school curricula have made a clear demarcation between the basic biomedical sciences and the clinical years. It is our view that a comprehensive medical education necessarily involves an increased correlation between basic science knowledge and its clinical applications. A basic anatomy course should have two main objectives:…

  17. Bridging the gap between basic and clinical sciences: A description of a radiological anatomy course.

    PubMed

    Torres, Anna; Staśkiewicz, Grzegorz J; Lisiecka, Justyna; Pietrzyk, Łukasz; Czekajlo, Michael; Arancibia, Carlos U; Maciejewski, Ryszard; Torres, Kamil

    2016-05-01

    A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images requires the practitioner to not only hone certain technical skills, but to command an excellent knowledge of sectional anatomy and an understanding of the pathophysiology of the examined areas as well. Yet throughout many medical curricula there is often a large gap between traditional anatomy coursework and clinical training in imaging techniques. The authors present a radiological anatomy course developed to teach sectional anatomy with particular emphasis on ultrasonography and computed tomography, while incorporating elements of medical simulation. To assess students' overall opinions about the course and to examine its impact on their self-perceived improvement in their knowledge of radiological anatomy, anonymous evaluation questionnaires were provided to the students. The questionnaires were prepared using standard survey methods. A five-point Likert scale was applied to evaluate agreement with statements regarding the learning experience. The majority of students considered the course very useful and beneficial in terms of improving three-dimensional and cross-sectional knowledge of anatomy, as well as for developing practical skills in ultrasonography and computed tomography. The authors found that a small-group, hands-on teaching model in radiological anatomy was perceived as useful both by the students and the clinical teachers involved in their clinical education. In addition, the model was introduced using relatively few resources and only two faculty members. Anat Sci Educ 9: 295-303. © 2015 American Association of Anatomists. PMID:26599321

  18. Anatomy of the Gynecomastia Tissue and Its Clinical Significance

    PubMed Central

    Blau, Mordecai; Hazani, Ron

    2016-01-01

    Background: Gynecomastia is a very common entity in men, and several authors estimate that approximately 50% to 70% of the male population has palpable breast tissue. Much has been published with regard to the etiology, diagnosis, and treatment of gynecomastia. However, the anatomy of the gynecomastia tissue remains elusive to most surgeons. Purpose: The purpose of this article was to define the shape and consistency of the glandular tissue based on the vast experience of the senior author (MB). Patients and Methods: Between the years 1980 and 2014, a total of 5124 patients have been treated for gynecomastia with surgical excision, liposuction, or a combination of both. A total of 3130 specimens were collected with 5% of the cases being unilateral. Results: The specimens appear to have a unifying shape of a head, body, and tail. The head is semicircular in shape and is located more medially toward the sternum. The majority of the glandular tissue consists of a body located immediately deep to the nipple areolar complex. The tail appears to taper off of the body more laterally and toward the insertion of the pectoralis major muscle onto the humerus. Conclusions: This large series of gynecomastia specimens demonstrates a unique and unifying finding of a head, body, and tail. Understanding the anatomy of the gynecomastia gland can serve as a guide to gynecomastia surgeons to facilitate a more thorough exploration and subsequently sufficient gland excision. PMID:27622122

  19. Design and development of a new facility for teaching and research in clinical anatomy.

    PubMed

    Greene, John Richard T

    2009-01-01

    This article discusses factors in the design, commissioning, project management, and intellectual property protection of developments within a new clinical anatomy facility in the United Kingdom. The project was aimed at creating cost-effective facilities that would address widespread concerns over anatomy teaching, and support other activities central to the university mission-namely research and community interaction. The new facilities comprise an engaging learning environment and were designed to support a range of pedagogies appropriate to the needs of healthcare professionals at different stages of their careers. Specific innovations include integrated workstations each comprising of a dissection table, with removable top sections, an overhead operating light, and ceiling-mounted camera. The tables incorporate waterproof touch-screen monitors to display images from the camera, an endoscope or a database of images, videos, and tutorials. The screens work independently so that instructors can run different teaching sessions simultaneously and students can progress at different speeds to suit themselves. Further, database access is provided from within an integrated anatomy and pathology museum and display units dedicated to the correlation of cross-sectional anatomy with medical imaging. A new functional neuroanatomy modeling system, called the BrainTower, has been developed to aid integration of anatomy with physiology and clinical neurology. Many aspects of the new facility are reproduced within a Mobile Teaching Unit, which can be driven to hospitals, colleges, and schools to provide appropriate work-based education and community interaction. PMID:19217068

  20. Clinical anatomy and biomechanics of the ankle in dance.

    PubMed

    Russell, Jeffrey A; McEwan, Islay M; Koutedakis, Yiannis; Wyon, Matthew A

    2008-01-01

    The ankle is an important joint to understand in the context of dance because it is the connection between the leg and the foot that establishes lower extremity stability. Its function coordinates with the leg and foot and, thus, it is crucial to the dancer's ability to perform. Furthermore, the ankle is one of the most commonly injured body regions in dance. An understanding of ankle anatomy and biomechanics is not only important for healthcare providers working with dancers, but for dance scientists, dance instructors, and dancers themselves. The bony architecture, the soft tissue restraints, and the locomotive structures all integrate to allow the athletic artistry of dance. Yet, there is still much research to be carried out in order to more completely understand the ankle of the dancer. PMID:19618582

  1. Integration of Medical Imaging Including Ultrasound into a New Clinical Anatomy Curriculum

    ERIC Educational Resources Information Center

    Moscova, Michelle; Bryce, Deborah A.; Sindhusake, Doungkamol; Young, Noel

    2015-01-01

    In 2008 a new clinical anatomy curriculum with integrated medical imaging component was introduced into the University of Sydney Medical Program. Medical imaging used for teaching the new curriculum included normal radiography, MRI, CT scans, and ultrasound imaging. These techniques were incorporated into teaching over the first two years of the…

  2. VARK Learning Preferences and Mobile Anatomy Software Application Use in Pre-Clinical Chiropractic Students

    ERIC Educational Resources Information Center

    Meyer, Amanda J.; Stomski, Norman J.; Innes, Stanley I.; Armson, Anthony J.

    2016-01-01

    Ubiquitous smartphone ownership and reduced face-to-face teaching time may lead to students making greater use of mobile technologies in their learning. This is the first study to report on the prevalence of mobile gross anatomy software applications (apps) usage in pre-clinical chiropractic students and to ascertain if a relationship exists…

  3. Evidence-Based Decision about Test Scoring Rules in Clinical Anatomy Multiple-Choice Examinations

    ERIC Educational Resources Information Center

    Severo, Milton; Gaio, A. Rita; Povo, Ana; Silva-Pereira, Fernanda; Ferreira, Maria Amélia

    2015-01-01

    In theory the formula scoring methods increase the reliability of multiple-choice tests in comparison with number-right scoring. This study aimed to evaluate the impact of the formula scoring method in clinical anatomy multiple-choice examinations, and to compare it with that from the number-right scoring method, hoping to achieve an…

  4. VARK learning preferences and mobile anatomy software application use in pre-clinical chiropractic students.

    PubMed

    Meyer, Amanda J; Stomski, Norman J; Innes, Stanley I; Armson, Anthony J

    2016-05-01

    Ubiquitous smartphone ownership and reduced face-to-face teaching time may lead to students making greater use of mobile technologies in their learning. This is the first study to report on the prevalence of mobile gross anatomy software applications (apps) usage in pre-clinical chiropractic students and to ascertain if a relationship exists between preferred learning styles as determined by the validated VARK(©) questionnaire and use of mobile anatomy apps. The majority of the students who completed the VARK questionnaire were multimodal learners with kinesthetic and visual preferences. Sixty-seven percent (73/109) of students owned one or more mobile anatomy apps which were used by 57 students. Most of these students owned one to five apps and spent less than 30 minutes per week using them. Six of the top eight mobile anatomy apps owned and recommended by the students were developed by 3D4Medical. Visual learning preferences were not associated with time spent using mobile anatomy apps (OR = 0.40, 95% CI 0.12-1.40). Similarly, kinesthetic learning preferences (OR = 1.88, 95% CI 0.18-20.2), quadmodal preferences (OR = 0.71, 95% CI 0.06-9.25), or gender (OR = 1.51, 95% CI 0.48-4.81) did not affect the time students' spent using mobile anatomy apps. Learning preferences do not appear to influence students' time spent using mobile anatomy apps. Anat Sci Educ 9: 247-254. © 2015 American Association of Anatomists. PMID:26109371

  5. Ultrasonography-Based Thyroidal and Perithyroidal Anatomy and Its Clinical Significance

    PubMed Central

    Ha, Eun Ju; Lee, Jeong Hyun

    2015-01-01

    Ultrasonography (US)-guided procedures such as ethanol ablation, radiofrequency ablation, laser ablation, selective nerve block, and core needle biopsy have been widely applied in the diagnosis and management of thyroid and neck lesions. For a safe and effective US-guided procedure, knowledge of neck anatomy, particularly that of the nerves, vessels, and other critical structures, is essential. However, most previous reports evaluated neck anatomy based on cadavers, computed tomography, or magnetic resonance imaging rather than US. Therefore, the aim of this article was to elucidate US-based thyroidal and perithyroidal anatomy, as well as its clinical significance in the use of prevention techniques for complications during the US-guided procedures. Knowledge of these areas may be helpful for maximizing the efficacy and minimizing the complications of US-guided procedures for the thyroid and other neck lesions. PMID:26175574

  6. Ultrasonography-Based Thyroidal and Perithyroidal Anatomy and Its Clinical Significance.

    PubMed

    Ha, Eun Ju; Baek, Jung Hwan; Lee, Jeong Hyun

    2015-01-01

    Ultrasonography (US)-guided procedures such as ethanol ablation, radiofrequency ablation, laser ablation, selective nerve block, and core needle biopsy have been widely applied in the diagnosis and management of thyroid and neck lesions. For a safe and effective US-guided procedure, knowledge of neck anatomy, particularly that of the nerves, vessels, and other critical structures, is essential. However, most previous reports evaluated neck anatomy based on cadavers, computed tomography, or magnetic resonance imaging rather than US. Therefore, the aim of this article was to elucidate US-based thyroidal and perithyroidal anatomy, as well as its clinical significance in the use of prevention techniques for complications during the US-guided procedures. Knowledge of these areas may be helpful for maximizing the efficacy and minimizing the complications of US-guided procedures for the thyroid and other neck lesions. PMID:26175574

  7. Nasal Anatomy

    MedlinePlus

    ... Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult ... Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure Statement Printer Friendly ...

  8. Meta-Evaluation in Clinical Anatomy: A Practical Application of Item Response Theory in Multiple Choice Examinations

    ERIC Educational Resources Information Center

    Severo, Milton; Tavares, Maria A. Ferreira

    2010-01-01

    The nature of anatomy education has changed substantially in recent decades, though the traditional multiple-choice written examination remains the cornerstone of assessing students' knowledge. This study sought to measure the quality of a clinical anatomy multiple-choice final examination using item response theory (IRT) models. One hundred…

  9. An explorative learning approach to teaching clinical anatomy using student generated content.

    PubMed

    Philip, Christo T; Unruh, Kenneth P; Lachman, Nirusha; Pawlina, Wojciech

    2008-01-01

    Translating basic sciences into a clinical framework has been approached through the implementation of various teaching techniques aimed at using a patient case scenario to facilitate learning. These techniques present students with a specific patient case and lead the students to discuss physiological processes through analysis of provided data supported by independent learning and research. However, no literature exists that describes a reverse teaching methodology in which students are given disease diagnosis and then asked to construct a patient case. This article discusses an explorative learning approach introduced in the gross anatomy course in which students were asked to use clinical skills and reasoning to create a patient case. The online knowledge-sharing portal utilizing MediaWiki provided a necessary base for students in completing their task. Teams were given 4 weeks to complete their written online project with weekly feedback provided by 3rd year teaching assistants using the Wiki discussion page. A survey was performed to assess competence regarding a patient write up and oral presentation. Skills that the teams acquired through the completion of this project will benefit future patient interactions. This project also emphasized and reinforced the importance of effective communication, leadership, and teamwork. This study shows that a clinical anatomy project that incorporates explorative learning can be an effective way of introducing students to the skills needed for patient write ups and oral presentations. Furthermore this approach to learning allows students to excel during their clinical years and to correlate anatomy to clinical diagnoses. PMID:19177391

  10. [Clinical and tomographic aspects of hemorrhagic cerebrovascular disease associated with hypertensive crisis in adults under 50 years of age].

    PubMed

    Arismendi-Morillo, G J; Fernández-Abreu, M; Añez-Moreno, R E

    2000-09-01

    The purpose of this study was to analyze both the clinical and tomographic aspects of the hemorrhagic cerebrovascular disease (HCd), associated with hypertensive crisis in adults under 50 years of age. Forty six patients, who were not under anticoagulant therapy, were not using illegal drugs, who had not a cerebral tumor disease, and who had neither arteriovenous malformations nor past traumatic episodes, were studied. Seventy eight percent of the patients had preexisted arterial hypertension, 30% of them had at least a previous emergency for a hypertensive crisis. Mortality for intracerebral hematoma (ICH) and for subarachnoid hemorrhage (SAH) was 21% and 23% respectively. In 68% of the cases, ICH was located in the deep structures of the brain. Asymmetric ventricular system, compression or the absence of mesencephalic cisterna were significantly associated (p > 0.01; p > 0.001 respectively) with higher mortality. There was not a significant difference between the deceased and the survivors in relation with their systolic and diastolic arterial pressure on admission to the emergency unit. A significant positive relation was found between the severity of the injury (percentage of patients with an Scale Coma Glasgow < or = 8 points) and the mortality percentage for the type of HCd (r = 0.81 for ICH; p < 0.001, r = 0.98 for SAH; p < 0.001). Age and a low Scale Coma Glasgow score on the admission, represent unfavorable prognostic factors. Due to the different criteria used to evaluate the tomographic characteristics of intracerebral hematomas, comparisons of the present results with other findings can be difficult. PMID:11029832

  11. A comprehensive clinical review of maxillary sinus floor elevation: anatomy, techniques, biomaterials and complications.

    PubMed

    Danesh-Sani, Seyed Amir; Loomer, Peter M; Wallace, Stephen S

    2016-09-01

    Several systematic reviews have shown that maxillary sinus augmentation is a predictable and effective procedure for augmentation of an atrophic posterior maxilla. However, we know of no reviews that have covered all the clinical aspects. We searched the PubMed, EMBASE, Cinhal, and Cochrane databases up to January 2015 to select relevant studies that cover the different objectives of this review, including the anatomy of the maxillary sinus, surgical techniques, biomaterials used in the sinus augmentation, and potential complications. PMID:27235382

  12. Clinical Evaluation of Effects of Chronic Resveratrol Supplementation on Cerebrovascular Function, Cognition, Mood, Physical Function and General Well-Being in Postmenopausal Women—Rationale and Study Design

    PubMed Central

    Evans, Hamish Michael; Howe, Peter Ranald Charles; Wong, Rachel Heloise Xiwen

    2016-01-01

    Background: This methodological paper presents both a scientific rationale and a methodological approach for investigating the effects of resveratrol supplementation on mood and cognitive performance in postmenopausal women. Postmenopausal women have an increased risk of cognitive decline and dementia, which may be at least partly due to loss of beneficial effects of estrogen on the cerebrovasculature. We hypothesise that resveratrol, a phytoestrogen, may counteract this risk by enhancing cerebrovascular function and improving regional blood flow in response to cognitive demands. A clinical trial was designed to test this hypothesis. Method: Healthy postmenopausal women were recruited to participate in a randomised, double-blind, placebo-controlled (parallel comparison) dietary intervention trial to evaluate the effects of resveratrol supplementation (75 mg twice daily) on cognition, cerebrovascular responsiveness to cognitive tasks and overall well-being. They performed the following tests at baseline and after 14 weeks of supplementation: Rey Auditory Verbal Learning Test, Cambridge Semantic Memory Battery, the Double Span and the Trail Making Task. Cerebrovascular function was assessed simultaneously by monitoring blood flow velocity in the middle cerebral arteries using transcranial Doppler ultrasound. Conclusion: This trial provides a model approach to demonstrate that, by optimising circulatory function in the brain, resveratrol and other vasoactive nutrients may enhance mood and cognition and ameliorate the risk of developing dementia in postmenopausal women and other at-risk populations. PMID:27005658

  13. The Dorello canal: historical development, controversies in microsurgical anatomy, and clinical implications.

    PubMed

    Kshettry, Varun R; Lee, Joung H; Ammirati, Mario

    2013-03-01

    Interest in studying the anatomy of the abducent nerve arose from early clinical experience with abducent palsy seen in middle ear infection. Primo Dorello, an Italian anatomist working in Rome in the early 1900s, studied the anatomy of the petroclival region to formulate his own explanation of this pathological entity. His work led to his being credited with the discovery of the canal that bears his name, although this structure had been described 50 years previously by Wenzel Leopold Gruber. Renewed interest in the anatomy of this region arose due to advances in surgical approaches to tumors of the petroclival region and the need to explain the abducent palsies seen in trauma, intracranial hypotension, and aneurysms. The advent of the surgical microscope has allowed more detailed anatomical studies, and numerous articles have been published in the last 2 decades. The current article highlights the historical development of the study of the Dorello canal. A review of the anatomical studies of this structure is provided, followed by a brief overview of clinical considerations. PMID:23451716

  14. From college to clinic: reasoning over memorization is key for understanding anatomy.

    PubMed

    Miller, Sue Ann; Perrotti, William; Silverthorn, Dee U; Dalley, Arthur F; Rarey, Kyle E

    2002-04-15

    Anatomy and physiology are taught in community colleges, liberal arts colleges, universities, and medical schools. The goals of the students vary, but educators in these diverse settings agree that success hinges on learning concepts rather than memorizing facts. In this article, educators from across the postsecondary educational spectrum expand on several points: (1) There is a problem with student perception that anatomy is endless memorization, whereas the ability to manage information and use reasoning to solve problems are ways that professionals work. This misperception causes students to approach the subject with the wrong attitude. (2) The process of learning to use information is as important as the concepts themselves. Using understanding to explain and make connections is a more useful long-term lesson than is memorization. Anatomy should be presented and learned as a dynamic basis for problem solving and for application in the practice and delivery of quality health care. (3) Integration of form and function must be explicit and universal across all systems. (4) Using only models, images, audiovisuals, or computers cannot lead students to the requisite reasoning that comes from investigative dissection of real tissue. (5) Some undergraduate courses require students to memorize excessive musculoskeletal detail. (6) Learning tissue biology is a particular struggle for medical students who have no background from an undergraduate course. (7) Medical professors and students see benefits when students have taken undergraduate courses in anatomy, histology, and physiology. If medical schools suggest these electives to applicants, medical students might arrive better prepared and, thus, be able to learn clinical correlations more efficiently in the limited allocated time of medical school curricula. PMID:12001213

  15. Differential properties of Van der Pol — Duffing mathematical model of cerebrovascular haemodynamics based on clinical measurements

    NASA Astrophysics Data System (ADS)

    Parshin, D. V.; Ufimtseva, I. V.; Cherevko, A. A.; Khe, A. K.; Orlov, K. Yu; Krivoshapkin, A. L.; Chupakhin, A. P.

    2016-06-01

    The present paper discusses the method of identification (diseased/healthy) human cerebral vessels by using of mathematical model. Human cerebral circulation as a single tuned circuit, which consists of blood flow, elastic vessels and elastic brain gel tissue is under consideration. Non linear Van der Pol-Duffing equation is assumed as mathematical model of cerebrovascular circulation. Hypothesis of vascular pathology existence in some position of blood vessel, based on mathematical model properties for this position is formulated. Good reliability of hypothesis is proved statistically for 7 patients with arterial aneurysms.

  16. Spatial Abilities of Expert Clinical Anatomists: Comparison of Abilities between Novices, Intermediates, and Experts in Anatomy

    ERIC Educational Resources Information Center

    Fernandez, Ruth; Dror, Itiel E.; Smith, Claire

    2011-01-01

    Spatial ability has been found to be a good predictor of success in learning anatomy. However, little research has explored whether spatial ability can be improved through anatomy education and experience. This study had two aims: (1) to determine if spatial ability is a learned or inherent facet in learning anatomy and (2) to ascertain if there…

  17. Clinical Significance of Cerebrovascular Biomarkers and White Matter Tract Integrity in Alzheimer Disease: Clinical correlations With Neurobehavioral Data in Cross-Sectional and After 18 Months Follow-ups.

    PubMed

    Wu, Ming-Kung; Lu, Yan-Ting; Huang, Chi-Wei; Lin, Pin-Hsuan; Chen, Nai-Ching; Lui, Chun-Chung; Chang, Wen-Neng; Lee, Chen-Chang; Chang, Ya-Ting; Chen, Sz-Fan; Chang, Chiung-Chih

    2015-07-01

    Cerebrovascular risk factors and white matter (WM) damage lead to worse cognitive performance in Alzheimer dementia (AD). This study investigated WM microstructure using diffusion tensor imaging in patients with mild to moderate AD and investigated specific fiber tract involvement with respect to predefined cerebrovascular risk factors and neurobehavioral data prediction cross-sectionally and after 18 months. To identify the primary pathoanatomic relationships of risk biomarkers to fiber tract integrity, we predefined 11 major association tracts and calculated tract specific fractional anisotropy (FA) values. Eighty-five patients with AD underwent neurobehavioral assessments including the minimental state examination (MMSE) and 12-item neuropsychiatric inventory twice with a 1.5-year interval to represent major outcome factors. In the cross-sectional data, total cholesterol, low-density lipoprotein, vitamin B12, and homocysteine levels correlated variably with WM FA values. After entering the biomarkers and WM FA into a regression model to predict neurobehavioral outcomes, only fiber tract FA or homocysteine level predicted the MMSE score, and fiber tract FA or age predicted the neuropsychiatric inventory total scores and subdomains of apathy, disinhibition, and aberrant motor behavior. In the follow-up neurobehavioral data, the mean global FA value predicted the MMSE and aberrant motor behavior subdomain, while age predicted the anxiety and elation subdomains. Cerebrovascular risk biomarkers may modify WM microstructural organization, while the association with fiber integrity showed greater clinical significance to the prediction of neurobehavioral outcomes both cross-sectionally and longitudinally. PMID:26181568

  18. Clinical Structural Anatomy of the Inferior Pyramidal Space Reconstructed Within the Cardiac Contour Using Multidetector-Row Computed Tomography.

    PubMed

    Mori, Shumpei; Fukuzawa, Koji; Takaya, Tomofumi; Takamine, Sachiko; Ito, Tatsuro; Fujiwara, Sei; Nishii, Tatsuya; Kono, Atsushi K; Yoshida, Akihiro; Hirata, Ken-Ichi

    2015-07-01

    Although many studies have described the detailed anatomy of the inferior pyramidal space, it may not be easy for cardiologists who have few chances to study cadaveric hearts to understand the correct morphology of the structure. The inferior pyramidal space is the part of extracardiac fibro-adipose tissue wedging between the 4 cardiac chambers from the diaphragmatic surface of the heart. Many cardiologists have interests in pericardial adipose tissue, but the inferior pyramidal space seems to have been neglected. A number of important structures, including the coronary sinus, atrioventricular node, atrioventricular nodal artery, membranous septum, muscular atrioventricular sandwich (previously called the "muscular atrioventricular septum"), atrial septum, ventricular septum, aortic valvar complex, mitral valvar attachment, and tricuspid valvar attachment are associated with the inferior pyramidal space. We previously revealed its 3-dimensional live anatomy using multidetector-row computed tomography. Moreover, the 3-dimensional understanding of the anatomy in association with the cardiac contour is important from the viewpoints of clinical cardiac electrophysiology. The purpose of this article is to demonstrate extended findings regarding the clinical structural anatomy of the inferior pyramidal space, which was reconstructed in combination with the cardiac contour using multidetector-row computed tomography, and discuss the clinical implications of the findings. PMID:25884276

  19. The Integrated Clinical Anatomy Program at Alfaisal University: An Innovative Model of Teaching Clinically Applied Functional Anatomy in a Hybrid Curriculum

    ERIC Educational Resources Information Center

    Yaqinuddin, Ahmed; Ikram, Muhammad Faisal; Zafar, Muhammad; Eldin, Nivin Sharaf; Mazhar, Muhammad Atif; Qazi, Sadia; Shaikh, Aftab Ahmed; Obeidat, Akef; Al-Kattan, Khaled; Ganguly, Paul

    2016-01-01

    Anatomy has historically been a cornerstone in medical education regardless of specialty. It is essential for physicians to be able to perform a variety of tasks, including performing invasive procedures, examining radiological images, performing a physical examination of a patient, etc. Medical students have to be prepared for such tasks, and we…

  20. The Anatomy of Learning Anatomy

    ERIC Educational Resources Information Center

    Wilhelmsson, Niklas; Dahlgren, Lars Owe; Hult, Hakan; Scheja, Max; Lonka, Kirsti; Josephson, Anna

    2010-01-01

    The experience of clinical teachers as well as research results about senior medical students' understanding of basic science concepts has much been debated. To gain a better understanding about how this knowledge-transformation is managed by medical students, this work aims at investigating their ways of setting about learning anatomy.…

  1. Topology and hemodynamics of the cortical cerebrovascular system

    PubMed Central

    Hirsch, Sven; Reichold, Johannes; Schneider, Matthias; Székely, Gábor; Weber, Bruno

    2012-01-01

    The cerebrovascular system continuously delivers oxygen and energy substrates to the brain, which is one of the organs with the highest basal energy requirement in mammals. Discontinuities in the delivery lead to fatal consequences for the brain tissue. A detailed understanding of the structure of the cerebrovascular system is important for a multitude of (patho-)physiological cerebral processes and many noninvasive functional imaging methods rely on a signal that originates from the vasculature. Furthermore, neurodegenerative diseases often involve the cerebrovascular system and could contribute to neuronal loss. In this review, we focus on the cortical vascular system. In the first part, we present the current knowledge of the vascular anatomy. This is followed by a theory of topology and its application to vascular biology. We then discuss possible interactions between cerebral blood flow and vascular topology, before summarizing the existing body of the literature on quantitative cerebrovascular topology. PMID:22472613

  2. Use of Clinical Anatomy Resources by Musculoskeletal Outpatient Physiotherapists in Australian Public Hospitals: A Cross-Sectional Study

    PubMed Central

    Davies, Tilman M.; Cornwall, Jon

    2015-01-01

    ABSTRACT Purpose: To investigate how musculoskeletal outpatient physiotherapists in public hospitals interact with and perceive clinical anatomy resources in the workplace. Method: This cross-sectional study used a postal survey sent to musculoskeletal outpatient physiotherapists in 64 Australian public hospitals. Survey questions examined demographics, qualifications, experience, types of resources used, whether resources meet requirements, and what improvements could be made to current resources. Results: A total of 193 physiotherapists responded (75% response rate; 60% female), of whom 49% were age 35 years or younger; 67% had only an undergraduate qualification, and 37% had practised for 5 years or less. More experienced physiotherapists used resources significantly less frequently ([odds ratio]=1.35; 95% CI, 1.17–1.57), and we found no significant associations between preference for online versus printed resources and age, sex, qualifications, or experience. Trends included less experienced physiotherapists identifying the absence of online access as a barrier to resource use and provision of improved online facilities as necessary to improve access to clinical anatomy resources. Conclusion: Results indicate distinct trends in physiotherapists' use of clinical anatomy resources, including a desire for improved online resource access on the part of less experienced physiotherapists. The findings are relevant to hospital outpatient clinics, particularly those that employ less experienced physiotherapists. PMID:26839457

  3. Cerebrovascular Dysfunction in Preeclamptic Pregnancies

    PubMed Central

    Hammer, Erica S.; Cipolla, Marilyn J.

    2016-01-01

    Preeclampsia is a hypertensive, multi-system disorder of pregnancy that affects several organ systems, including the maternal brain. Cerebrovascular dysfunction during preeclampsia can lead to cerebral edema, seizures, stroke and potentially maternal mortality. This review will discuss the effects of preeclampsia on the cerebrovasculature that may adversely affect the maternal brain, including cerebral blood flow (CBF) autoregulation and blood-brain barrier disruption, and the resultant clinical outcomes including posterior reversible encephalopathy syndrome (PRES) and maternal stroke. Potential long-term cognitive outcomes of preeclampsia and the role of the cerebrovasculature are also reviewed. PMID:26126779

  4. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy.

    PubMed

    Jiaravuthisan, Michael M; Sasseville, Denis; Vender, Ronald B; Murphy, Francis; Muhn, Channy Y

    2007-07-01

    Psoriasis is a chronic skin disease that affects millions of people throughout the world. Even though cutaneous signs and symptoms are the most common clinical manifestations, the nails can be involved in up to 50% of cases, and their involvement remains an important yet often overlooked aspect of the disease. There is a broad spectrum of nail dystrophies associated with psoriasis, ranging from the common pitting and loosening of the nail plate to the less frequent discoloration and splinter hemorrhages seen in the nail bed. This article discusses the normal anatomy and embryology of the nail unit as well as the current understanding of the pathogenesis of the disease. It also provides an extensive review of the existing literature with respect to psoriatic nail therapy. Although there have been many recent advances in the treatment of the cutaneous form of the disease-most notably in the field of immunotherapies-the options for nail psoriasis are far more limited. While a number of treatment alternatives currently exist for nail disease, the general paucity of clear evidence regarding these choices often makes it difficult to select the most efficient, safe, and optimal treatment for the patient. Even though the current literature has shown some support for the use of topical, intralesional, radiation, systemic, and combination therapies for nail psoriasis, the available studies lack sufficient power to extrapolate a standardized therapeutic regimen. Therefore, until better-documented evidence validating the treatment options emerges within the literature, clinicians and patients are left with a vague and relatively unproven approach to psoriatic nail disease. PMID:17572277

  5. Larynx Anatomy

    MedlinePlus

    ... e.g. -historical Searches are case-insensitive Larynx Anatomy Add to My Pictures View /Download : Small: 648x576 ... View Download Large: 2700x2400 View Download Title: Larynx Anatomy Description: Anatomy of the larynx; drawing shows the ...

  6. Pharynx Anatomy

    MedlinePlus

    ... e.g. -historical Searches are case-insensitive Pharynx Anatomy Add to My Pictures View /Download : Small: 720x576 ... View Download Large: 3000x2400 View Download Title: Pharynx Anatomy Description: Anatomy of the pharynx; drawing shows the ...

  7. Vulva Anatomy

    MedlinePlus

    ... e.g. -historical Searches are case-insensitive Vulva Anatomy Add to My Pictures View /Download : Small: 720x634 ... View Download Large: 3000x2640 View Download Title: Vulva Anatomy Description: Anatomy of the vulva; drawing shows the ...

  8. Inferior Phrenic Arteries and Their Branches, Their Anatomy and Possible Clinical Importance: An Experimental Cadaver Study

    PubMed Central

    Gürses, İlke Ali; Gayretli, Özcan; Kale, Ayşin; Öztürk, Adnan; Usta, Ahmet; Şahinoğlu, Kayıhan

    2015-01-01

    Background: Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepatocellular carcinoma. If the carcinoma is advanced or the main arterial supply, the hepatic artery, is occluded, extrahepatic collateral arteries may develop. Both, right and left inferior phrenic arteries (RIPA and LIPA) are the most frequent and important among these collaterals. However, the topographic anatomy of these arteries has not been described in detail in anatomy textbooks, atlases and most previous reports. Aims: To investigate the anatomy and branching patterns of RIPA and LIPA on cadavers and compare our results with the literature. Study Design: Descriptive study. Methods: We bilaterally dissected 24 male and 2 female cadavers aged between 49 and 88 years for this study. Results: The RIPA and LIPA originated as a common trunk in 5 cadavers. The RIPA originated from the abdominal aorta in 13 sides, the renal artery in 2 sides, the coeliac trunk in 1 side and the left gastric artery in 1 side. The LIPA originated from the abdominal aorta in 9 sides and the coeliac trunk in 6 sides. In 6 cadavers, the ascending and posterior branches of the LIPA had different sources of origin. Conclusion: As both the RIPA and LIPA represent the half of all extrahepatic arterial collaterals to hepatocellular carcinomas, their anatomy gains importance not only for anatomists but interventional radiologists as well. PMID:26167344

  9. Pedagogical Tools to Address Clinical Anatomy and Athletic Training Student Learning Styles

    ERIC Educational Resources Information Center

    Mazerolle, Stephanie; Yeargin, Susan

    2010-01-01

    Context: A thorough knowledge of anatomy is needed in four of the six domains of athletic training: prevention, injury/condition recognition, immediate care, and treatment/rehabilitation. Students with a solid foundation can achieve competency in these specific domains. Objective: To provide educators with pedagogical tools to promote a deeper…

  10. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications

    PubMed Central

    Vleeming, A; Schuenke, M D; Masi, A T; Carreiro, J E; Danneels, L; Willard, F H

    2012-01-01

    This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections. A historical overview is presented on pelvic and especially SIJ research, followed by a general functional anatomical overview of the pelvis. In specific sections, the development and maturation of the SIJ is discussed, and a description of the bony anatomy and sexual morphism of the pelvis and SIJ is debated. The literature on the SIJ ligaments and innervation is discussed, followed by a section on the pathology of the SIJ. Pelvic movement studies are investigated and biomechanical models for SIJ stability analyzed, including examples of insufficient versus excessive sacroiliac force closure. PMID:22994881

  11. Dural arteriovenous fistulas of the hypoglossal canal: systematic review on imaging anatomy, clinical findings, and endovascular management.

    PubMed

    Spittau, Björn; Millán, Diego San; El-Sherifi, Saad; Hader, Claudia; Singh, Tejinder Pal; Motschall, Edith; Vach, Werner; Urbach, Horst; Meckel, Stephan

    2015-04-01

    Dural arteriovenous fistulas (DAVFs) of the hypoglossal canal (HCDAVFs) are rare and display a complex angiographic anatomy. Hitherto, they have been referred to as various entities (for example, "marginal sinus DAVFs") solely described in case reports or small series. In this in-depth review of HCDAVF, the authors describe clinical and imaging findings, as well as treatment strategies and subsequent outcomes, based on a systematic literature review supplemented by their own cases (120 cases total). Further, the involved craniocervical venous anatomy with variable venous anastomoses is summarized. Hypoglossal canal DAVFs consist of a fistulous pouch involving the anterior condylar confluence and/or anterior condylar vein with a variable intraosseous component. Three major types of venous drainage are associated with distinct clinical patterns: Type 1, with anterograde drainage (62.5%), mostly presents with pulsatile tinnitus; Type 2, with retrograde drainage to the cavernous sinus and/or orbital veins (23.3%), is associated with ocular symptoms and may mimic cavernous sinus DAVF; and Type 3, with cortical and/or perimedullary drainage (14.2%), presents with either hemorrhage or cervical myelopathy. For Types 1 and 2 HCDAVF, transvenous embolization demonstrates high safety and efficacy (2.9% morbidity, 92.7% total occlusion). Understanding the complex venous anatomy is crucial for planning alternative approaches if standard transjugular access is impossible. Transarterial embolization or surgical disconnection (morbidity 13.3%-16.7%) should be reserved for Type 3 HCDAVFs or lesions with poor venous access. A conservative strategy could be appropriate in Type 1 HCDAVF for which spontaneous regression (5.8%) may be observed. PMID:25415064

  12. [The influence of segmental lumbosacral anatomy restoration on clinical outomes in the operative treatment of the isthmic spondylolisthesis].

    PubMed

    Pankowski, Rafał; Smoczyński, Andrzej; Jaskólski, Dawid; Rocławski, Marek; Samson, Lucjan; Piotrowski, Maciej

    2008-01-01

    The influence of lumbosacral spine segmental anatomy restoration on the outcome of the operative treatment of isthmic spondylolisthesis was taken into evaluation. A series of 55 patients (29 males and 26 females) was examined. The long-term follow up period exceeded 3 years. The Oswestry Disability Questionaire was used to evaluate the objective clinical condition of the patients, while for the subjective assessment an analog pain score and the two questions survey concerning the evaluation of success of the operative treatment and a possible agreement to a following operation if necessary were used. The presence of neurological radical symptoms was evaluated. The radiological assessment was consisted of the evaluation of the degree of spondylolisthesis, the angle of lumbosacral lordosis, the height of the interbody space and intervertebral foramen. In conclusions, the proper spine anatomy restoration had the influence on the improvement of the outcome of operative treatment of isthmic spondylolisthesis. A metal cage usage for the anterior interbody fusion of lumbar spine in the operative treatment of isthmic spondylolisthesis enables long-lasting proper anatomical relations of the fused segment. PMID:19241885

  13. Eye Anatomy

    MedlinePlus

    ... News About Us Donate In This Section Eye Anatomy en Español email Send this article to a ... You at Risk For Glaucoma? Childhood Glaucoma Eye Anatomy Five Common Glaucoma Tests Glaucoma Facts and Stats ...

  14. Paraganglioma Anatomy

    MedlinePlus

    ... e.g. -historical Searches are case-insensitive Paraganglioma Anatomy Add to My Pictures View /Download : Small: 648x576 ... View Download Large: 2700x2400 View Download Title: Paraganglioma Anatomy Description: Paraganglioma of the head and neck; drawing ...

  15. Tooth anatomy

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/002214.htm Tooth anatomy To use the sharing features on this page, ... upper jawbone is called the maxilla. Images Tooth anatomy References Lingen MW. Head and neck. In: Kumar ...

  16. Heart Anatomy

    MedlinePlus

    ... Incredible Machine Bonus poster (PDF) The Human Heart Anatomy Blood The Conduction System The Coronary Arteries The ... of the Leg Vasculature of the Torso Heart anatomy illustrations and animations for grades K-6. Heart ...

  17. Endocannabinoids in cerebrovascular regulation.

    PubMed

    Benyó, Zoltán; Ruisanchez, Éva; Leszl-Ishiguro, Miriam; Sándor, Péter; Pacher, Pál

    2016-04-01

    The cerebral blood flow is tightly regulated by myogenic, endothelial, metabolic, and neural mechanisms under physiological conditions, and a large body of recent evidence indicates that inflammatory pathways have a major influence on the cerebral blood perfusion in certain central nervous system disorders, like hemorrhagic and ischemic stroke, traumatic brain injury, and vascular dementia. All major cell types involved in cerebrovascular control pathways (i.e., smooth muscle, endothelium, neurons, astrocytes, pericytes, microglia, and leukocytes) are capable of synthesizing endocannabinoids and/or express some or several of their target proteins [i.e., the cannabinoid 1 and 2 (CB1 and CB2) receptors and the transient receptor potential vanilloid type 1 ion channel]. Therefore, the endocannabinoid system may importantly modulate the regulation of cerebral circulation under physiological and pathophysiological conditions in a very complex manner. Experimental data accumulated since the late 1990s indicate that the direct effect of cannabinoids on cerebral vessels is vasodilation mediated, at least in part, by CB1 receptors. Cannabinoid-induced cerebrovascular relaxation involves both a direct inhibition of smooth muscle contractility and a release of vasodilator mediator(s) from the endothelium. However, under stress conditions (e.g., in conscious restrained animals or during hypoxia and hypercapnia), cannabinoid receptor activation was shown to induce a reduction of the cerebral blood flow, probably via inhibition of the electrical and/or metabolic activity of neurons. Finally, in certain cerebrovascular pathologies (e.g., subarachnoid hemorrhage, as well as traumatic and ischemic brain injury), activation of CB2 (and probably yet unidentified non-CB1/non-CB2) receptors appear to improve the blood perfusion of the brain via attenuating vascular inflammation. PMID:26825517

  18. PET in Cerebrovascular Disease

    PubMed Central

    Powers, William J.; Zazulia, Allyson R.

    2010-01-01

    SYNOPSIS Investigation of the interplay between the cerebral circulation and brain cellular function is fundamental to understanding both the pathophysiology and treatment of stroke. Currently, PET is the only technique that provides accurate, quantitative in vivo regional measurements of both cerebral circulation and cellular metabolism in human subjects. We review normal human cerebral blood flow and metabolism and human PET studies of ischemic stroke, carotid artery disease, vascular dementia, intracerebral hemorrhage and aneurysmal subarachnoid hemorrhage and discuss how these studies have added to our understanding of the pathophysiology of human cerebrovascular disease. PMID:20543975

  19. Psoas Major: a case report and review of its anatomy, biomechanics, and clinical implications

    PubMed Central

    Sajko, Sandy; Stuber, Kent

    2009-01-01

    A 25-year-old male professional hockey player with right sided hip pain was diagnosed with myofascopathy of the right psoas major and rectus femoris. The patient maintained a conservative treatment regimen and was prescribed a four week active strengthening program. The program progressed from resisted concentric exercise to eccentric abduction/adduction exercises along with balance training, core stabilizing and endurance exercises in the first two weeks. In the final two weeks the program progressed to include sport specific exercises. At three weeks the patient was able to participate in non-contact practice and was clear for full contact at five weeks. The anatomy, biomechanics, and function of the psoas major muscle are discussed as is its influence on lumbar spine stability. Evidence-based evaluation and management strategies for psoas dysfunction are presented. PMID:20037696

  20. Computed and conventional arthrotomography of the glenohumeral joint: normal anatomy and clinical experience

    SciTech Connect

    Deutsch, A.L.; Resnick, D.; Mink, J.H.; Berman, J.L.; Cone, R.O. III; Resnik, C.S.; Danzig, L.; Guerra, J. Jr.

    1984-12-01

    The glenohumeral joint was studied in 25 cadavers and 136 patients using computed arthrotomography (CAT) and conventional arthrotomography (AT) to assess shoulder instability. Cadaver shoulders were injected with air or latex, sectioned with a band saw, and normal articular anatomy outlined. CAT was performed in 81 patients and characterized the glenoid labrum as normal, abnormal, or detached. Hill-Sachs defects were seen in 20 out of 29 patients with anterior labral abnormalities, while bicipital tendon abnormalities were evident on CAT in 6. Of 55 patients who had AT, the status of the labrum was clarified in 13 of the 16 patients who had surgery or arthroscopy. Both methods can characterize the labrum; however, CAT is more comprehensive and appears ideal for both detection of Hill-Sachs defects and imaging the bicipital tendon. CAT requires less technical expertise and radiation than AT and is tolerated better by patients in pain.

  1. Educational impact of a clinical anatomy workshop on 1st-year orthopedic and rheumatology fellows in Mexico City.

    PubMed

    Saavedra, M A; Villaseñor-Ovies, P; Harfush, L A; Navarro-Zarza, J E; Canoso, J J; Cruz-Domínguez, P; Vargas, A; Hernández-Díaz, C; Chiapas-Gasca, K; Camacho-Galindo, J; Alvarez-Nemegyei, J; Kalish, R A

    2016-05-01

    We aim to study the educational impact of a clinical anatomy workshop in 1st-year orthopedic and rheumatology fellows. First-year rheumatology fellows (N = 17) and a convenience sample of 1st-year orthopedic fellows (N = 14) from Mexico City in the 9th month of training participated in the study. The pre- and the post- workshop tests included the same 20 questions that had to be answered by identification or demonstration of relevant anatomical items. The questions, arranged by anatomical regions, were asked in five dynamic stations. Overall, the 31 participants showed an increase of correct answers, from a median of 6 (range 1 to 12) in the pre-workshop test, to a median of 14 (range 7 to 19) in the post-workshop test. In the pre-workshop test, the correct median answers were 7 (range 2 to 12) in the orthopedic fellows and 5 (range 1 to 10) in the rheumatology fellows (p = 0.297). Corresponding scores in the post-workshop were 15 (range 10 to 19) and 12 (range 7 to 18) (p = 0.026) showing a significant difference favoring the orthopedic group. Our clinical anatomy workshop was efficacious, in the short term, as a teaching instrument for 1st-year orthopedic and rheumatology fellows. The post-workshop scores, although significantly improved in both groups, particularly in the orthopedic fellows, were still suboptimal. Further refinements of our workshop might yield better results. PMID:26400643

  2. Decision Making for Borderline Cases in Pass/Fail Clinical Anatomy Courses: The Practical Value of the Standard Error of Measurement and Likelihood Ratio in a Diagnostic Test

    ERIC Educational Resources Information Center

    Severo, Milton; Silva-Pereira, Fernanda; Ferreira, Maria Amelia

    2013-01-01

    Several studies have shown that the standard error of measurement (SEM) can be used as an additional “safety net” to reduce the frequency of false-positive or false-negative student grading classifications. Practical examinations in clinical anatomy are often used as diagnostic tests to admit students to course final examinations. The aim of this…

  3. Clinical characteristics of congenital cervical atresia based on anatomy and ultrasound: a retrospective study of 32 cases

    PubMed Central

    2014-01-01

    Background To explore the clinical characteristics of congenital cervical atresia. Methods This retrospective analysis included 32 cases of congenital cervical atresia treated from March 1984 to September 2010. The anatomic location, ultrasonic features, surgical treatments, and outcomes were recorded. Results Based on clinical characteristics observed during preoperative ultrasound and intraoperative exploration, congenital cervical atresia was divided into four types. Type I (n?=?22/32, 68.8%) is incomplete cervical atresia. Type II (n?=?5/32, 15.6%) defines a short and solid cervix with a round end; the structure lacked uterosacral and cardinal ligament attachments to the lower uterine body. Type III (n?=?2/32, 6.3%) is complete cervical atresia, in which the lowest region of the uterus exhibited a long and solid cervix. Type IV (n?=?3/32, 9.4%) defines the absence of a uterine isthmus, in which no internal os was detected, and a blind lumen was found under the uterus. Conclusions Observations of clinical characteristics of congenital cervical atresia based on the anatomy and ultrasound may inform diagnosis and treatment strategy. PMID:24555664

  4. Role of transcranial Doppler in cerebrovascular disease.

    PubMed

    Kulkarni, Amit A; Sharma, Vijay K

    2016-01-01

    Transcranial Doppler (TCD) is the only noninvasive modality for the assessment of real-time cerebral blood flow. It complements various anatomic imaging modalities by providing physiological-flow related information. It is relatively cheap, easily available, and can be performed at the bedside. It has been suggested as an essential component of a comprehensive stroke centre. In addition to its importance in acute cerebrovascular ischemia, its role is expanding in the evaluation of cerebral hemodynamics in various disorders of the brain. The "established" clinical indications for the use of TCD include cerebral ischemia, sickle cell disease, detection of right-to-left shunts, subarachnoid hemorrhage, periprocedural or surgical monitoring, and brain death. We present the role of TCD in acute cerebrovascular ischemia, sonothrombolysis, and intracranial stenosis. PMID:27625245

  5. Cerebrovascular autoregulation: lessons learned from spaceflight research.

    PubMed

    Blaber, Andrew P; Zuj, Kathryn A; Goswami, Nandu

    2013-08-01

    This review summarizes our current understanding of cerebral blood flow regulation with exposure to microgravity, outlines potential mechanisms associated with post-flight orthostatic intolerance, and proposes future directions for research and linkages with cerebrovascular disorders found in the general population. It encompasses research from cellular mechanisms (e.g. hind limb suspension: tissue, animal studies) to whole body analysis with respect to understanding human responses using space analogue studies (bed rest, parabolic flight) as well as data collected before, during, and after spaceflight. Recent evidence indicates that cerebrovascular autoregulation may be impaired in some astronauts leading to increased susceptibility to syncope upon return to a gravitational environment. The proposed review not only provides insights into the mechanisms of post-flight orthostatic intolerance, but also increases our understanding of the mechanisms associated with pathophysiological conditions (e.g. unexplained syncope) with clinical applications in relation to postural hypotension or intradialytic hypotension. PMID:23132388

  6. Anatomy of the Facial Nerve at the Condylar Area: Measurement Study and Clinical Implications

    PubMed Central

    Yang, Hun-Mu; Yoo, Young-Bok

    2014-01-01

    The aim of this study was to elucidate the detailed anatomy of the facial nerve (FN) at the condylar area to helping physicians preventing the iatrogenic trauma on the nerve. We dissected 25 specimens of the embalmed Korean cadavers (13 males and 2 females; mean age 76.9 years). The FN course at the condylar was examined, and the location of the FN branches was measured with superficial standards. The trunks of the FN emerged in the condylar area as one trunk, two trunks, and a loop or plexiform in 36%, 12%, and 52% areas, respectively. The zygomatic branch (Zbr) of FN passed over the tragus-alar line 23 mm anterior to the tragus (Tg) in most of the cases. The Zbr passed over the vertical line 2 cm anterior to the Tg through the area about 6 to 20 mm inferior to the Tg. Regardless of careful approach techniques to the condylar area, the FN could be damaged by a careless manipulation. Any reference landmarks could not guarantee the safety during the approach to the condylar area because more than half of the cases present the complicated branching type in the front of the Tg. PMID:25379533

  7. Mastoid emissary vein: anatomy and clinical relevance in plastic & reconstructive surgery.

    PubMed

    Kim, Leo K P; Ahn, Chris S; Fernandes, Antonio E L

    2014-06-01

    The mastoid emissary vein (MEV) is an anatomical structure with limited description in the literature and its importance is even less recognized in the plastic surgical field. Investigations in its anatomy and physiology have described its anthropological significance in transition to bipedalism and preferential intracranial venous flow into the vertebral plexus in the upright man. Inadvertant injury of vessels of this size pose a significant problem due not only to difficulty with haemostasis but also from their bidirectional flow and close proximity to the sigmoid sinus where cases of thromboembolism have been described. Recognition of this common anatomical structure and how to manage bleeding from the vessel it is important for the surgeon operating in this area and even more so for the craniofacial surgeon who operates on complex craniosynostotic patients where the MEV may be the sole dominant drainage pathway of the brain. We conducted a study on 106 cadaveric dry skull specimens looking at the incidence, position and caliber of mastoid emissary foramina. 83.7% of skulls were found to have at least one foramen with a mean diameter of 1.64 mm and the largest specimen measuring 7 mm. PMID:24713148

  8. Other cerebrovascular occlusive disease.

    PubMed

    Camargo, Erica C S; Schaefer, Pamela W; Singhal, Aneesh B

    2016-01-01

    In this chapter we review the optimal imaging modalities for subacute and chronic stroke. We discuss the utility of computed tomography (CT) and multimodal CT imaging. Further, we analyze the importance of specific magnetic resonance imaging sequences, such as diffusion-weighted imaging for acute ischemic stroke, T2/fluid-attenuated inversion recovery for subacute and chronic stroke, and susceptibility imaging for detection of intracranial hemorrhages. Different ischemic stroke mechanisms are reviewed, and how these imaging modalities may aid in the determination of such. Further, we analyze how topographic patterns in ischemic stroke may provide important clues to the diagnosis, in addition to the temporal evolution of the stroke. Lastly, specific cerebrovascular occlusive diseases are reviewed, with emphasis on the optimal imaging modalities and their findings in each condition. PMID:27432673

  9. An Interactive Method for Teaching Anatomy of the Human Eye for Medical Students in Ophthalmology Clinical Rotations

    ERIC Educational Resources Information Center

    Kivell, Tracy L.; Doyle, Sara K.; Madden, Richard H.; Mitchell, Terry L.; Sims, Ershela L.

    2009-01-01

    Much research has shown the benefits of additional anatomical learning and dissection beyond the first year of medical school human gross anatomy, all the way through postgraduate medical training. We have developed an interactive method for teaching eye and orbit anatomy to medical students in their ophthalmology rotation at Duke University…

  10. Integer anatomy

    SciTech Connect

    Doolittle, R.

    1994-11-15

    The title integer anatomy is intended to convey the idea of a systematic method for displaying the prime decomposition of the integers. Just as the biological study of anatomy does not teach us all things about behavior of species neither would we expect to learn everything about the number theory from a study of its anatomy. But, some number-theoretic theorems are illustrated by inspection of integer anatomy, which tend to validate the underlying structure and the form as developed and displayed in this treatise. The first statement to be made in this development is: the way structure of the natural numbers is displayed depends upon the allowed operations.

  11. The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic

    PubMed Central

    de Gara, C. J.; Karmali, S.

    2014-01-01

    Abstract. Weight recidivism in bariatric surgery failure is multifactorial. It ranges from inappropriate patient selection for primary surgery to technical/anatomic issues related to the original surgery. Most bariatric surgeons and centers focus on primary bariatric surgery while weight recidivism and its complications are very much secondary concerns. Methods. We report on our initial experience having established a dedicated weight recidivism and revisional bariatric surgery clinic. A single surgeon, dedicated nursing, dieticians, and psychologist developed care maps, goals of care, nonsurgical candidate rules, and discharge planning strategies. Results. A single year audit (2012) of clinical activity revealed 137 patients, with a mean age 49 ± 10.1 years (6 years older on average than in our primary clinic), 75% of whom were women with BMI 47 ± 11.5. Over three quarters had undergone a vertical band gastroplasty while 15% had had a laparoscopic adjustable gastric band. Only 27% of those attending clinic required further surgery. As for primary surgery, the role of the obesity expert clinical psychologist was a key component to achieving successful revision outcomes. Conclusion. With an exponential rise in obesity and a concomitant major increase in bariatric surgery, an inevitable increase in revisional surgery is becoming a reality. Anticipating this increase in activity, Alberta Health Services, Alberta, Canada, has established a unique and dedicated clinic whose early results are promising. PMID:24672540

  12. [Ischemic cerebrovascular accidents in childhood].

    PubMed

    Pascual Pascual, S I; Pascual Castroviejo, I; Vélez, A

    1988-04-01

    Authors review 53 children, aged 0 to 14 years, affected with cerebrovascular ischemic strokes. Largest aetiological groups were: a) congenital heart disease, 16 patients; b) arteritis of unknown cause, 11; c) idiopathic arterial occlusion without arteritis images on angiography, 7; d) moyamoya disease, 6; and d) local or systemic infections, 5. The mode of onset was as completed stroke in 72% and stroke in evolution in 24%. After acute stage 17.6% of patients presented other definitive strokes, 11.7% suffered only transient ischemic strokes (TIA), and 4% reversible ischemic neurologic deficits (RIND). Mean follow-up was 4.36 years, 9.8% of patients died, 11.8% recovered completely and 52.9% improved after initial stroke. Poor global evolution was associated with heart disease (p less than 0.05) and with onset of strokes before age 2 (p less than 0.05). Most important sequelae, besides motor impairment, were epilepsy (49%) and mental retardation (50% got less than IQ 80). Late epilepsy was associated with seizures at onset (p less than 0.05). Clinical factors of adverse mental development were: a) seizures at onset, b) late epilepsy and c) stroke before age 2. 66% of cases had two or more arterial lesions in the same or in different arterial trees. Therefore, embolic and arteritic factors probably play an important role in infancy and childhood stroke. PMID:3400936

  13. Non-ionizing radiofrequency electromagnetic waves traversing the head can be used to detect cerebrovascular autoregulation responses

    NASA Astrophysics Data System (ADS)

    Oziel, M.; Hjouj, M.; Gonzalez, C. A.; Lavee, J.; Rubinsky, B.

    2016-02-01

    Monitoring changes in non-ionizing radiofrequency electromagnetic waves as they traverse the brain can detect the effects of stimuli employed in cerebrovascular autoregulation (CVA) tests on the brain, without contact and in real time. CVA is a physiological phenomenon of importance to health, used for diagnosis of a number of diseases of the brain with a vascular component. The technology described here is being developed for use in diagnosis of injuries and diseases of the brain in rural and economically underdeveloped parts of the world. A group of nine subjects participated in this pilot clinical evaluation of the technology. Substantial research remains to be done on correlating the measurements with physiology and anatomy.

  14. Non-ionizing radiofrequency electromagnetic waves traversing the head can be used to detect cerebrovascular autoregulation responses

    PubMed Central

    Oziel, M.; Hjouj, M.; Gonzalez, C. A.; Lavee, J.; Rubinsky, B.

    2016-01-01

    Monitoring changes in non-ionizing radiofrequency electromagnetic waves as they traverse the brain can detect the effects of stimuli employed in cerebrovascular autoregulation (CVA) tests on the brain, without contact and in real time. CVA is a physiological phenomenon of importance to health, used for diagnosis of a number of diseases of the brain with a vascular component. The technology described here is being developed for use in diagnosis of injuries and diseases of the brain in rural and economically underdeveloped parts of the world. A group of nine subjects participated in this pilot clinical evaluation of the technology. Substantial research remains to be done on correlating the measurements with physiology and anatomy. PMID:26898944

  15. Surgical approach in primary total hip arthroplasty: anatomy, technique and clinical outcomes

    PubMed Central

    Petis, Stephen; Howard, James L.; Lanting, Brent L.; Vasarhelyi, Edward M.

    2015-01-01

    Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of technical intricacies allow safe and efficient femoral and acetabular reconstruction when using each approach. Hip dislocation, abductor insufficiency, fracture and nerve injury are complications of THA, although their relative risk varies by approach. Numerous clinical trials have sought to elicit differences in patient-reported outcomes, complication rates and return to function among the surgical approaches. This review outlines some of the technical pearls of performing a THA through either a direct anterior, direct lateral or posterior approach. A literature review outlines the impact of surgical approach on clinical outcomes and clinically relevant complication rates. PMID:25799249

  16. Anatomy of the cardiac nervous system with clinical and comparative morphological implications.

    PubMed

    Kawashima, Tomokazu

    2011-03-01

    Unlike autonomic nervous preservation in other surgeries for improving patient quality of life, autonomic cardiac nervous system (ACNS) preservation has been neglected in cardiovascular surgery because of technical difficulties and other unsolved issues. Because such ACNS preservation in cardiovascular surgery is anticipated in the future, detailed anatomical investigation of the human ACNS is required. Therefore, we have conducted morphological studies of the ACNS from macroscopic, clinical, and evolutionary anatomical viewpoints. In this study, I review detailed anatomical studies of the human ACNS together with their clinical implications. In addition, the evolutionary comparative anatomical significance of primate ACNS is also summarized to help understand and translate the findings of functional experiments to humans. These integrated findings will be the subject of a future study unifying molecular embryological and anatomical findings to clarify cardiac functions based on functional animal experiments, clinical applications such as improving surgery techniques and individual order-made surgery in cardiac surgery, and for future evaluation in regenerative medicine. PMID:21116884

  17. An Explorative Learning Approach to Teaching Clinical Anatomy Using Student Generated Content

    ERIC Educational Resources Information Center

    Philip, Christo T.; Unruh, Kenneth P.; Lachman, Nirusha; Pawlina, Wojciech

    2008-01-01

    Translating basic sciences into a clinical framework has been approached through the implementation of various teaching techniques aimed at using a patient case scenario to facilitate learning. These techniques present students with a specific patient case and lead the students to discuss physiological processes through analysis of provided data…

  18. Traumatic Extensor Tendon Injuries to the Hand: Clinical Anatomy, Biomechanics, and Surgical Procedure Review.

    PubMed

    Colzani, Giulia; Tos, Pierluigi; Battiston, Bruno; Merolla, Giovanni; Porcellini, Giuseppe; Artiaco, Stefano

    2016-04-01

    The extensor apparatus is a complex muscle-tendon system that requires integrity or optimal reconstruction to preserve hand function. Anatomical knowledge and the understanding of physiopathology of extensor tendons are essential for an accurate diagnosis of extensor tendon injuries (ETIs) of the hand and wrist, because these lesions are complex and commonly observed in clinical practice. A careful clinical history and assessment still remain the first step for the diagnosis, followed by US and MR to confirm the suspect of ETI or to investigate some doubtful conditions and rule out associate lesions. During last decades the evolution of surgical techniques and rehabilitative treatment protocol led to gradual improvement in clinical results of ETI treatment and surgical repair. Injury classification into anatomical zones and the evaluation of the characteristics of the lesions are considered key points to select the appropriate treatment for ETI. Both conservative and surgical management can be indicated in ETI, depending on the anatomical zone and on the characteristics of the injuries. As a general rule, an attempt of conservative treatment should be performed when the lesion is expected to have favorable result with nonoperative procedure. Many surgical techniques have been proposed over the time and with favorable results if the tendon injury is not underestimated and adequately treated. Despite recent research findings, a lack of evidence-based knowledge is still observed in surgical treatment and postoperative management of ETI. Further clinical and biomechanical investigations would be advisable to clarify this complex issue. PMID:27616821

  19. Advances in understanding of mammalian penile evolution, human penile anatomy and human erection physiology: Clinical implications for physicians and surgeons

    PubMed Central

    Hsieh, Cheng-Hsing; Liu, Shih-Ping; Hsu, Geng-Long; Chen, Heng-Shuen; Molodysky, Eugen; Chen, Ying-Hui; Yu, Hong-Jeng

    2012-01-01

    Summary Recent studies substantiate a model of the tunica albuginea of the corpora cavernosa as a bi-layered structure with a 360° complete inner circular layer and a 300° incomplete outer longitudinal coat spanning from the bulbospongiosus and ischiocavernosus proximally and extending continuously into the distal ligament within the glans penis. The anatomical location and histology of the distal ligament invites convincing parallels with the quadrupedal os penis and therefore constitutes potential evidence of the evolutionary process. In the corpora cavernosa, a chamber design is responsible for facilitating rigid erections. For investigating its venous factors exclusively, hemodynamic studies have been performed on both fresh and defrosted human male cadavers. In each case, a rigid erection was unequivocally attainable following venous removal. This clearly has significant ramifications in relation to penile venous surgery and its role in treating impotent patients. One deep dorsal vein, 2 cavernosal veins and 2 pairs of para-arterial veins (as opposed to 1 single vein) are situated between Buck’s fascia and the tunica albuginea. These newfound insights into penile tunical, venous anatomy and erection physiology were inspired by and, in turn, enhance clinical applications routinely encountered by physicians and surgeons, such as penile morphological reconstruction, penile implantation and penile venous surgery. PMID:22739749

  20. The place of surface anatomy in the medical literature and undergraduate anatomy textbooks.

    PubMed

    Azer, Samy A

    2013-01-01

    The aims of this review were to examine the place of surface anatomy in the medical literature, particularly the methods and approaches used in teaching surface and living anatomy and assess commonly used anatomy textbooks in regard to their surface anatomy contents. PubMed and MEDLINE databases were searched using the following keywords "surface anatomy," "living anatomy," "teaching surface anatomy," "bony landmarks," "peer examination" and "dermatomes". The percentage of pages covering surface anatomy in each textbook was calculated as well as the number of images covering surface anatomy. Clarity, quality and adequacy of surface anatomy contents was also examined. The search identified 22 research papers addressing methods used in teaching surface anatomy, 31 papers that can help in the improvement of surface anatomy curriculum, and 12 anatomy textbooks. These teaching methods included: body painting, peer volunteer surface anatomy, use of a living anatomy model, real time ultrasound, virtual (visible) human dissector (VHD), full body digital x-ray of cadavers (Lodox(®) Statscan(®) images) combined with palpating landmarks on peers and the cadaver, as well as the use of collaborative, contextual and self-directed learning. Nineteen of these studies were published in the period from 2006 to 2013. The 31 papers covered evidence-based and clinically-applied surface anatomy. The percentage of surface anatomy in textbooks' contents ranged from 0 to 6.2 with an average of 3.4%. The number of medical illustrations on surface anatomy varied from 0 to 135. In conclusion, although there has been a progressive increase in publications addressing methods used in teaching surface anatomy over the last six to seven years, most anatomy textbooks do not provide students with adequate information about surface anatomy. Only three textbooks provided a solid explanation and foundation of understanding surface anatomy. PMID:23650274

  1. New Clinically Feasible 3T MRI Protocol to Discriminate Internal Brain Stem Anatomy.

    PubMed

    Hoch, M J; Chung, S; Ben-Eliezer, N; Bruno, M T; Fatterpekar, G M; Shepherd, T M

    2016-06-01

    Two new 3T MR imaging contrast methods, track density imaging and echo modulation curve T2 mapping, were combined with simultaneous multisection acquisition to reveal exquisite anatomic detail at 7 canonical levels of the brain stem. Compared with conventional MR imaging contrasts, many individual brain stem tracts and nuclear groups were directly visualized for the first time at 3T. This new approach is clinically practical and feasible (total scan time = 20 minutes), allowing better brain stem anatomic localization and characterization. PMID:26869471

  2. [The blood vessels of the posterior cranial fossa. anatomy, pathophysiology, clinic--a survey (author's transl)].

    PubMed

    Helms, J

    1978-04-20

    Pathophysiology and tomography of the blood vessels of the posterior cranial fossa gain clinical interest in treatment of diseases of the inner ear, complications of middle ear inflammations, tumors of the pyramid and cerebello-pontine angle. Numerous variations in the arterial venous system restrict neuroradiological procedures. Techniques to treat a thrombosis of the sinuses were developed 50 years ago. Surgical procedures to remove glomus tumors of the pyramid could be improved by new anatomical and surgical experiences. Unilateral neck dissection occasionally alters the blood flow in the sinuses of the posterior cranial fossa causing serious complications. PMID:350206

  3. Anatomy and embryology of umbilicus in newborns: a review and clinical correlations.

    PubMed

    Hegazy, Abdelmonem A

    2016-09-01

    Umbilicus is considered a mirror of the abdomen in newborns. Despite its importance, the umbilicus has been stated in literature and textbooks as discrete subjects with many body systems, such as the urinary, digestive, and cardiovascular ones. This article aimed to address the basic knowledge of the umbilicus in relation to clinical disorders under one integrated topic to aid physicians and surgeons in assessing newborns and infants. The umbilicus appears as early as the fourth week of fetal life when the folding of the embryonic plate occurs. The umbilicus appears initially as a primitive umbilical ring on the ventral aspect of the body. The primitive umbilicus contains the connecting stalk, umbilical vessels, vitelline duct and vessels, allantois, and loop of the intestine. Changes occur to form the definitive cord, which contains three umbilical vessels, namely, "one vein and two arteries," embedded in Wharton's jelly. After birth, the umbilical vessels inside the body obliterate and gradually form ligaments. Congenital disorders at the umbilicus include herniation, bleeding, and discharge of mucous, urine, or feces. Some of these disorders necessitate emergent surgical interference, whereas others may be managed conservatively. The umbilicus has many embryological remnants. Thus, the umbilicus is prone to various clinical disorders. Detecting these disorders as early as possible is essential to prevent or minimize possible complications. PMID:27473223

  4. Cerebrovascular Complications After Heart Transplantation

    PubMed Central

    Alejaldre, Aída; Delgado-Mederos, Raquel; Santos, Miguel Ángel; Martí-Fàbregas, Joan

    2010-01-01

    Neurological complications in orthotopic heart transplantation represent a major cause of morbidity and mortality despite successful transplantation. The most frequent perioperative neurological complications are delirium or encephalopathy. In this period cerebrovascular complication ranges between 5-11%. After the perioperative period, the 5-year stroke risk after cardiac transplantation is 4.1%. In a retrospective study conducted with 314 patients who underwent cardiac transplantation, it was found that 20% of cerebrovascular complications occurred within the first two weeks after transplantation, while 80% occurred in the late postoperative phase. Of these, ischemic stroke is the most common subtype. In the perioperative periode, hemodynamic instability, cardiac arrest, extracorporeal circulation over 2 hours, prior history of stroke, and carotid stenosis greater than 50% have been reported to be risk factors for the occurrence of cerebrovascular complications. Perioperative cerebrovascular complications are associated with higher mortality and poor functional outcome at one year follow-up. After the perioperative period, the only factor that has been significantly associated with an increased risk of cerebrovascular complications is a history of prior stroke, either ischemic or hemorrhagic. Other associated factors include unknown atrial fibrillation, septic emboli from endocarditis, cardiac catheterization and perioperative hemodynamic shock. According to the TOAST etiologic classification, the most prevalent etiologic subtype of ischemic stroke is undetermined cause. PMID:21804780

  5. Aquaporin-4 and Cerebrovascular Diseases.

    PubMed

    Chu, Heling; Huang, Chuyi; Ding, Hongyan; Dong, Jing; Gao, Zidan; Yang, Xiaobo; Tang, Yuping; Dong, Qiang

    2016-01-01

    Cerebrovascular diseases are conditions caused by problems with brain vasculature, which have a high morbidity and mortality. Aquaporin-4 (AQP4) is the most abundant water channel in the brain and crucial for the formation and resolution of brain edema. Considering brain edema is an important pathophysiological change after stoke, AQP4 is destined to have close relation with cerebrovascular diseases. However, this relation is not limited to brain edema due to other biological effects elicited by AQP4. Till now, multiple studies have investigated roles of AQP4 in cerebrovascular diseases. This review focuses on expression of AQP4 and the effects of AQP4 on brain edema and neural cells injuries in cerebrovascular diseases including cerebral ischemia, intracerebral hemorrhage and subarachnoid hemorrhage. In the current review, we pay more attention to the studies of recent years directly from cerebrovascular diseases animal models or patients, especially those using AQP4 gene knockout mice. This review also elucidates the potential of AQP4as an excellent therapeutic target. PMID:27529222

  6. Aquaporin-4 and Cerebrovascular Diseases

    PubMed Central

    Chu, Heling; Huang, Chuyi; Ding, Hongyan; Dong, Jing; Gao, Zidan; Yang, Xiaobo; Tang, Yuping; Dong, Qiang

    2016-01-01

    Cerebrovascular diseases are conditions caused by problems with brain vasculature, which have a high morbidity and mortality. Aquaporin-4 (AQP4) is the most abundant water channel in the brain and crucial for the formation and resolution of brain edema. Considering brain edema is an important pathophysiological change after stoke, AQP4 is destined to have close relation with cerebrovascular diseases. However, this relation is not limited to brain edema due to other biological effects elicited by AQP4. Till now, multiple studies have investigated roles of AQP4 in cerebrovascular diseases. This review focuses on expression of AQP4 and the effects of AQP4 on brain edema and neural cells injuries in cerebrovascular diseases including cerebral ischemia, intracerebral hemorrhage and subarachnoid hemorrhage. In the current review, we pay more attention to the studies of recent years directly from cerebrovascular diseases animal models or patients, especially those using AQP4 gene knockout mice. This review also elucidates the potential of AQP4as an excellent therapeutic target. PMID:27529222

  7. The pterygopalatine ganglion and its role in various pain syndromes: from anatomy to clinical practice.

    PubMed

    Piagkou, Maria; Demesticha, Theano; Troupis, Theodore; Vlasis, Konstantinos; Skandalakis, Panayiotis; Makri, Aggeliki; Mazarakis, Antonios; Lappas, Dimitrios; Piagkos, Giannoulis; Johnson, Elizabeth O

    2012-06-01

    The postsynaptic fibers of the pterygopalatine or sphenopalatine ganglion (PPG or SPG) supply the lacrimal and nasal glands. The PPG appears to play an important role in various pain syndromes including headaches, trigeminal and sphenopalatine neuralgia, atypical facial pain, muscle pain, vasomotor rhinitis, eye disorders, and herpes infection. Clinical trials have shown that these pain disorders can be managed effectively with sphenopalatine ganglion blockade (SPGB). In addition, regional anesthesia of the distribution area of the SPG sensory fibers for nasal and dental surgery can be provided by SPGB via a transnasal, transoral, or lateral infratemporal approach. To arouse the interest of the modern-day clinicians in the use of the SPGB, the advantages, disadvantages, and modifications of the available methods for blockade are discussed.▪ PMID:21956040

  8. Periocular anterior adnexal anatomy and clinical adnexal examination of the adult Asian elephant (Elephas maximus).

    PubMed

    Wong, Michael A; Isaza, Ramiro; Cuthbert, J Kelly; Brooks, Dennis E; Samuelson, Don A

    2012-12-01

    Formalin preserved ocular-associated anterior adnexa tissues from five necropsied Asian elephants (Elephas maximus) were dissected with attention to the palpebrae, conjunctiva, nictitating membranes, nasolacrimal ducts, and periocular glandular tissues. Gross and histologic examination revealed that lacrimal and tarsal glands were not present. Evidence of the lacrimal drainage apparatus, including lacrimal punctae or any remnant of lacrimal sacs, was also absent. In contrast, well-developed sebaceous glands associated with accessory hairs along the palpebrae were exceptionally abundant. Mixed-secreting accessory lacrimal glands were noted in the deep stroma posterior to the tarsus of both palpebrae and the gland of the nictitating membrane. Apparently, the Asian elephant has developed a novel tear system in the absence of lacrimal and tarsal (meibomian) glands. Clinical examinations and bacterial cultures of the visible periocular tissues were performed on eight living adult Asian elephants to confirm the postmortem anatomic findings and provide guidance to the clinician during examination of the elephant conjunctiva. PMID:23272346

  9. Ankle syndesmosis injuries: anatomy, biomechanics, mechanism of injury, and clinical guidelines for diagnosis and intervention.

    PubMed

    Lin, Cheng-Feng; Gross, Michael L; Weinhold, Paul

    2006-06-01

    Syndesmosis injuries are rare, but very debilitating and frequently misdiagnosed. The purpose of this clinical commentary is to review the mechanisms of syndesmotic injuries, clinical examination methods, diagnosis, and management of the injuries. Cadaveric studies of the syndesmosis and deltoid ligaments are also reviewed for further understanding of stress transmission and the roles of different structures in stabilizing the distal syndesmosis. External rotation and excessive dorsiflexion of the foot on the leg have been reported as the most common mechanisms of injury. The injury is most often incurred by individuals who participate in skiing, football, soccer, and other sport activities played on turf. The external rotation and squeeze tests are reliable tests to detect this injury. The ability of imaging studies to assist in an accurate diagnosis may depend on the severity of the injury. The results of cadaveric studies indicate the importance of the deltoid ligament in maintaining stability of the distal tibiofibular syndesmosis and the congruency of the ankle mortise. Intervention programs with early rigid immobilization and pain relief strategies, followed by strengthening and balance training are recommended. Heel lift and posterior splint intervention can be used to avoid separation of the distal syndesmosis induced by excessive dorsiflexion of the ankle joint. Application of a rigid external device should be used with caution to prevent medial-lateral compression of the leg superior to the ankle mortise, thereby inducing separation of the distal syndesmosis articulation. Surgical intervention is an option when a complete tear of the syndesmotic ligaments is present or when fractures are observed. PMID:16776487

  10. Human papillomavirus infection in the oromaxillofacial area: Clinical anatomy and histological considerations.

    PubMed

    Ilea, Aranka; Boşca, Bianca; MiclĂuş, Viorel; Rus, Vasile; BĂbţan, Anida Maria; CÂmpian, Radu Septimiu

    2015-11-01

    Clinical manifestations of human papillomavirus (HPV) infection in the head and neck can range from benign lesions, which are the most frequent, to malignant lesions. The prevalence of head and neck cancer is increasing, despite currently decreasing trends in known risk factors such as smoking and alcohol use. A new patient profile has appeared in recent practice: most frequently a middle-aged male patient who does not smoke or drink alcohol, is sexually active (possibly having multiple partners), and presents with oral or cervicofacial lesions requiring diagnosis and treatment. Another risk factor that should be considered in these patients is HPV infection. The association of oral potentially malignant disorders (OPMD) with HPV is a challenge for the medical practitioner. The gold standard for diagnosis is histopathological examination, which can also yield evidence suggesting HPV infection. Determination of the viral genotype provides additional data for assessing the oncological risk of an HPV infection. Treatment of these patients is aimed at removing the lesions, in association or not with antiviral treatment and recurrence control. PMID:26331491

  11. In search of clinical truths: equine and comparative studies of anatomy.

    PubMed

    Latorre, R; Rodríguez, M J

    2007-05-01

    The importance of correlating anatomical studies with diagnostic and therapeutic approaches in practice has long been recognised. Such studies in the horse have, until recently, lagged behind this discipline in human medicine and surgery. Clinical techniques by which this correlation is achieved include radiography, ultrasound, computed tomography and magnetic resonance imaging. This review presents published literature on the subject and, in addition, describes the part played by plastination, a recently developed technique for the preservation of biological specimens. In this, tissue fluids and part of the lipids are replaced by certain polymers yielding specimens that can be handled without gloves, do not smell or decay, and even retain microscopic properties of the original sample. The technique has proved to be a useful tool to correct previously presented anatomical descriptions and is one now favoured by human surgeons. Studies of the horse employing this technique include those of the temporomandibular joint and tarsus. The aim of the review is to stimulate further correlations of anatomical structure and equine medical and surgical procedures, thereby advancing knowledge and understanding in practice and teaching. PMID:17520979

  12. The anatomy of clinical decision-making in multidisciplinary cancer meetings

    PubMed Central

    Soukup, Tayana; Petrides, Konstantinos V.; Lamb, Benjamin W.; Sarkar, Somita; Arora, Sonal; Shah, Sujay; Darzi, Ara; Green, James S. A.; Sevdalis, Nick

    2016-01-01

    Abstract In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable. The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision. This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons. We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis. The exploratory factor analysis produced 4 factors, labeled “Holistic and Clinical inputs” (patient views, psychosocial aspects, patient history, comorbidities, oncologists’, nurses’, and surgeons’ inputs), “Radiology” (radiology results, radiologists’ inputs), “Pathology” (pathology results, pathologists’ inputs), and “Meeting Management” (meeting chairs’ and coordinators’ inputs). A negative cross-loading was observed from surgeons’ input on the fourth factor with a follow-up analysis showing negative correlation (r = −0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001). Hawthorne effect is the main limitation of the study. The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient profile and contributions to case review by all core

  13. A rare combination of atypical cerebral vascular anatomy.

    PubMed

    Koleilat, Issam; Eidt, John

    2015-10-01

    A 57-year-old woman presented with neurologic deficits consistent with a cerebrovascular accident. Her workup demonstrated the simultaneous occurrence of three uncommon cerebrovascular congenital anomalies in a single patient: (1) persistent trigeminal artery, (2) persistent fetal origin of the posterior cerebral artery and (3) bilateral occurrence of the vertebral arteries terminating in the posterior inferior cerebellar arteries. These persistent fetal cerebrovascular anatomic variants are reviewed and the clinical relevance discussed. PMID:25414171

  14. Movement Disorders Following Cerebrovascular Lesions in Cerebellar Circuits

    PubMed Central

    Choi, Seong-Min

    2016-01-01

    Cerebellar circuitry is important to controlling and modifying motor activity. It conducts the coordination and correction of errors in muscle contractions during active movements. Therefore, cerebrovascular lesions of the cerebellum or its pathways can cause diverse movement disorders, such as action tremor, Holmes’ tremor, palatal tremor, asterixis, and dystonia. The pathophysiology of abnormal movements after stroke remains poorly understood. However, due to the current advances in functional neuroimaging, it has recently been described as changes in functional brain networks. This review describes the clinical features and pathophysiological mechanisms in different types of movement disorders following cerebrovascular lesions in the cerebellar circuits. PMID:27240809

  15. Movement Disorders Following Cerebrovascular Lesions in Cerebellar Circuits.

    PubMed

    Choi, Seong-Min

    2016-05-01

    Cerebellar circuitry is important to controlling and modifying motor activity. It conducts the coordination and correction of errors in muscle contractions during active movements. Therefore, cerebrovascular lesions of the cerebellum or its pathways can cause diverse movement disorders, such as action tremor, Holmes' tremor, palatal tremor, asterixis, and dystonia. The pathophysiology of abnormal movements after stroke remains poorly understood. However, due to the current advances in functional neuroimaging, it has recently been described as changes in functional brain networks. This review describes the clinical features and pathophysiological mechanisms in different types of movement disorders following cerebrovascular lesions in the cerebellar circuits. PMID:27240809

  16. Stroke atlas: a 3D interactive tool correlating cerebrovascular pathology with underlying neuroanatomy and resulting neurological deficits.

    PubMed

    Nowinski, W L; Chua, B C

    2013-02-01

    Understanding stroke-related pathology with underlying neuroanatomy and resulting neurological deficits is critical in education and clinical practice. Moreover, communicating a stroke situation to a patient/family is difficult because of complicated neuroanatomy and pathology. For this purpose, we created a stroke atlas. The atlas correlates localized cerebrovascular pathology with both the resulting disorder and surrounding neuroanatomy. It also provides 3D display both of labeled pathology and freely composed neuroanatomy. Disorders are described in terms of resulting signs, symptoms and syndromes, and they have been compiled for ischemic stroke, hemorrhagic stroke, and cerebral aneurysms. Neuroanatomy, subdivided into 2,000 components including 1,300 vessels, contains cerebrum, cerebellum, brainstem, spinal cord, white matter, deep grey nuclei, arteries, veins, dural sinuses, cranial nerves and tracts. A computer application was developed comprising: 1) anatomy browser with the normal brain atlas (created earlier); 2) simulator of infarcts/hematomas/aneurysms/stenoses; 3) tools to label pathology; 4) cerebrovascular pathology database with lesions and disorders, and resulting signs, symptoms and/or syndromes. The pathology database is populated with 70 lesions compiled from textbooks. The initial view of each pathological site is preset in terms of lesion location, size, surrounding surface and sectional neuroanatomy, and lesion and neuroanatomy labeling. The atlas is useful for medical students, residents, nurses, general practitioners, and stroke clinicians, neuroradiologists and neurologists. It may serve as an aid in patient-doctor communication helping a stroke clinician explain the situation to a patient/family. It also enables a layman to become familiarized with normal brain anatomy and understand what happens in stroke. PMID:23859169

  17. To Quiz or Not to Quiz: Formative Tests Help Detect Students at Risk of Failing the Clinical Anatomy Course

    ERIC Educational Resources Information Center

    Azzi, Alain J.; Ramnanan, Christopher J.; Smith, Jennifer; Dionne, Éric; Jalali, Alireza

    2015-01-01

    Through a modified team-based learning (TBL) in the anatomy pre-clerkship curriculum, formative evaluations are utilized in the University of Ottawa Faculty of Medicine to assess and predict students' outcomes on summative examinations. The purpose of this study was to determine the efficiency of formative assessments to predict student's…

  18. The neuropathology and cerebrovascular mechanisms of dementia.

    PubMed

    Raz, Limor; Knoefel, Janice; Bhaskar, Kiran

    2016-01-01

    The prevalence of dementia is increasing in our aging population at an alarming rate. Because of the heterogeneity of clinical presentation and complexity of disease neuropathology, dementia classifications remain controversial. Recently, the National Plan to address Alzheimer’s Disease prioritized Alzheimer’s disease-related dementias to include: Alzheimer’s disease, dementia with Lewy bodies, frontotemporal dementia, vascular dementia, and mixed dementias. While each of these dementing conditions has their unique pathologic signature, one common etiology shared among all these conditions is cerebrovascular dysfunction at some point during the disease process. The goal of this comprehensive review is to summarize the current findings in the field and address the important contributions of cerebrovascular, physiologic, and cellular alterations to cognitive impairment in these human dementias. Specifically, evidence will be presented in support of small-vessel disease as an underlying neuropathologic hallmark of various dementias, while controversial findings will also be highlighted. Finally, the molecular mechanisms shared among all dementia types including hypoxia, oxidative stress, mitochondrial bioenergetics, neuroinflammation, neurodegeneration, and blood–brain barrier permeability responsible for disease etiology and progression will be discussed. PMID:26174330

  19. Clinical benefits of visualization of airway anatomy and manipulation of the endotracheal tube cuff with the GlideScope in the morbidly obese patient during tracheotomy.

    PubMed

    Hartman, Michael T; Lang, John

    2009-12-01

    Inadvertent deflation of the endotracheal tube cuff during a tracheotomy can complicate the surgical procedure, especially in a morbidly obese patient. Also, the anesthesia provider may lose control of the airway, with the inability to reintubate in case of airway edema, airway secretions, or airway fire. The use of the GlideScope video laryngoscope (Verathon Inc, Bothell, Washington) in the morbidly obese patient undergoing a tracheotomy has clinical benefits. This device allowed the visualization of the airway anatomy in 2 patients and the manipulation of the punctured endotracheal tube cuff in one case. PMID:20108730

  20. Non-invasive evaluation of culprit lesions by PET imaging: shifting the clinical paradigm away from resultant anatomy toward causative physiology

    PubMed Central

    Bengel, Frank M.

    2014-01-01

    Although coronary angiography is the gold standard for assessing coronary artery disease (CAD), there is at best a weak correlation between degree of stenosis and the risk of developing cardiac events. Plaque rupture is the most common type of plaque complication, accounting for about 70% of fatal acute myocardial infarctions or sudden coronary deaths. Recently, the feasibility of 18F-fluoride PET/CT in the evaluation of atherosclerotic lesions was assessed. Radionuclide techniques allow non-invasive biologic assessment of atherosclerotic plaques. This may help to further shift the clinical paradigm in coronary disease away from anatomy toward causative physiology and biology. PMID:25610799

  1. [Gender difference in cerebrovascular disease].

    PubMed

    Ikawa, Fusao; Kato, Yoko; Kobayashi, Shoutai

    2015-04-01

    We discuss about the gender difference of cerebrovascular disease according to the data of Japan Standard Stroke Registry Study. The male proportion was dominant in cerebrovascular disease except for subarachnoid hemorrhage(SAH). According to the data of Ministry of Health, Labour and Welfare, age-adjusted death rate in cerebral infarction and intracerebral hemorrhage were higher in male than in female, however, in SAH the rate was no different between male and female. The incidence of SAH is higher in women than in men, but this gender difference emerges not earlier than age 59. Most cases of SAH were occurring in the ages ranging from 50's in male and 70's in female. The total male-to-female ratio was approximately 1:2. The female proportion was dominant in older patients. PMID:25936150

  2. Imaging Inflammation in Cerebrovascular Disease.

    PubMed

    Gounis, Matthew J; van der Marel, Kajo; Marosfoi, Miklos; Mazzanti, Mary L; Clarençon, Frédéric; Chueh, Ju-Yu; Puri, Ajit S; Bogdanov, Alexei A

    2015-10-01

    Imaging inflammation in large intracranial artery pathology may play an important role in the diagnosis of and risk stratification for a variety of cerebrovascular diseases. Looking beyond the lumen has already generated widespread excitement in the stroke community, and the potential to unveil molecular processes in the vessel wall is a natural evolution to develop a more comprehensive understanding of the pathogenesis of diseases, such as ICAD and brain aneurysms. PMID:26351362

  3. Carpal Ligament Anatomy and Biomechanics.

    PubMed

    Pulos, Nicholas; Bozentka, David J

    2015-08-01

    A fundamental understanding of the ligamentous anatomy of the wrist is critical for any physician attempting to treat carpal instability. The anatomy of the wrist is complex, not only because of the number of named structures and their geometry but also because of the inconsistencies in describing these ligaments. The complex anatomy of the wrist is described through a review of the carpal ligaments and their effect on normal carpal motion. Mastery of this topic facilitates the physician's understanding of the patterns of instability that are seen clinically. PMID:26205699

  4. Cerebrovascular stenoses with cerebral infarction in a child with Williams syndrome.

    PubMed

    Ardinger, R H; Goertz, K K; Mattioli, L F

    1994-07-01

    We report on a patient with Williams syndrome who suffered a cerebrovascular accident. Clinical evaluation demonstrated the presence of carotid and cerebral arterial stenoses. We believe these lesions led to acute cerebrovascular ischemia and a non-hemorrhagic cerebral infarction. It is possible the stenoses were exacerbated by a vasculitis. The stenoses were identified by both invasive and noninvasive imaging studies. These studies may have a role in the evaluation of persons with Williams syndrome. PMID:8074144

  5. To quiz or not to quiz: Formative tests help detect students at risk of failing the clinical anatomy course.

    PubMed

    Azzi, Alain J; Ramnanan, Christopher J; Smith, Jennifer; Dionne, Éric; Jalali, Alireza

    2015-01-01

    Through a modified team-based learning (TBL) in the anatomy pre-clerkship curriculum, formative evaluations are utilized in the University of Ottawa Faculty of Medicine to assess and predict students' outcomes on summative examinations. The purpose of this study was to determine the efficiency of formative assessments to predict student's performance on summative examinations, during the first two semesters of medical school. Formative assessments included multiple-choice quizzes (MCQ) for each laboratory session and a practical midterm examination (MIDTERM), while the summative assessment corresponded to the final practical examination (FINAL). A moderate correlation between MCQs and FINAL (r = 0.353 and 0.301, respectively), and strong correlation between MIDTERM and FINAL assessments (r = 0.688 and 0.610, respectively) were found in the first two semesters. The MIDTERM-FINAL correlations were enhanced for students who scored under 61% in the MIDTERM (r = 0.887 and 0.717, respectively). Despite limitations, mostly related to particularities of the used tests, the analysis revealed an efficient method to identify students at risk of failing the FINAL in a TBL-based anatomy program. Future developments include the elaboration of strategies to predict and support those underperforming students. PMID:25227111

  6. Symptomatic Epilepsies due to Cerebrovascular Diseases

    PubMed Central

    Dakaj, Nazim; Shatri, Nexhat; Isaku, Enver; Zeqiraj, Kamber

    2014-01-01

    Introduction: Cerebro-vascular diseases (CVD) are the leading cause of symptomatic epilepsies. This study aims to investigate: a) Frequency of epilepsy in patients with CVD; b) Correlation of epilepsy with the type of CVD (ischemic and hemorrhage) and with age. Methodology: It is analyzed medical documentation of 816 hospitalized patients with CVD in the clinic of Neurology in University Clinical Center (UCC) during the period January - December 2010. The study included data on patients presenting with epileptic seizures after CVD, and those with previously diagnosed epilepsy, are not included in the study. The diagnosis of CVD, are established in clinical neurological examination and the brain imaging (computer tomography and magnetic resonance imaging). The diagnosis of epilepsy is established by the criteria of ILAE (International League against Epilepsy) 1983, and epileptic seizures are classified according to the ILAE classification, of 1981. Results: Out of 816 patients with CVD, 692 were with ischemic stroke and 124 with hemorrhage. From 816 patients, epileptic seizures had 81 (10%), of which 9 patients had been diagnosed with epilepsy earlier and they are not included in the study. From 72 (99%) patients with seizures after CVD 25 (33%) have been with ischemia, whereas 47 (67%) with hemorrhage. Conclusion: CVD present fairly frequent cause of symptomatic epilepsies among patients treated in the clinic of Neurology at UCC (about 10%). The biggest number of patients with epilepsy after CVD was with intracerebral hemorrhage. PMID:25685086

  7. Evolution of a multidisciplinary cerebrovascular center: lessons learned.

    PubMed

    Hui, Ferdinand K; Spiotta, Alejandro M; Katzan, Irene; Manno, Edward M; Masaryk, Thomas J; Rasmussen, Peter A

    2012-03-01

    The Cerebrovascular Center at the Cleveland Clinic is an integrated, multidisciplinary center comprising vascular neurologists, neurointensivists, physiatrists, open and endovascular neurosurgeons, interventional neurologists and interventional neuroradiologists administered through a single financial center with unified governance and leadership. This report describes the history and evolution of the center from conceptualization to the present, as well as outlining lessons learned in the formation and maturation of the group. PMID:21990440

  8. Normal Pancreas Anatomy

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Pancreas Anatomy Add to My Pictures View /Download : Small: ... 1586x1534 View Download Large: 3172x3068 View Download Title: Pancreas Anatomy Description: Anatomy of the pancreas; drawing shows ...

  9. Normal Female Reproductive Anatomy

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Reproductive System, Female, Anatomy Add to My Pictures View /Download : Small: ... Reproductive System, Female, Anatomy Description: Anatomy of the female reproductive system; drawing shows the uterus, myometrium (muscular outer layer ...

  10. Thymus Gland Anatomy

    MedlinePlus

    ... historical Searches are case-insensitive Thymus Gland, Adult, Anatomy Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Thymus Gland, Adult, Anatomy Description: Anatomy of the thymus gland; drawing shows ...

  11. Molecular imaging of cerebrovascular lesions.

    PubMed

    Chalouhi, Nohra; Jabbour, Pascal; Magnotta, Vincent; Hasan, David

    2014-04-01

    Inflammation is a key component in the pathogenesis of cerebrovascular lesions. Two agents have emerged as promising possibilities for imaging cerebrovascular lesions. These agents are ferumoxytol and myeloperoxidase (MPO)-specific paramagnetic magnetic resonance (MR) contrast agent. Ferumoxytol is an iron oxide nanoparticle coated by a carbohydrate shell that is used in MRI studies as an inflammatory marker as it is cleared by macrophages. Ferumoxytol-enhanced MRI allows noninvasive assessment of the inflammatory status of cerebral aneurysms and arteriovenous malformations and, possibly, may differentiate "unstable" lesions that require early intervention from "stable" lesions that can be safely observed. Several pilot studies have also suggested that MPO-specific paramagnetic MR contrast agent, di-5-hydroxytryptamide of gadopentetate dimeglumine, may allow imaging of inflammation in the wall of saccular aneurysms in animal models. However, studies in human subjects have yet to be performed. In this paper, we review current data regarding ferumoxytol-enhanced MRI and MPO-specific paramagnetic MR contrast agent and discuss current and future applications. PMID:24323714

  12. Regulatory Anatomy

    PubMed Central

    2015-01-01

    This article proposes the term “safety logics” to understand attempts within the European Union (EU) to harmonize member state legislation to ensure a safe and stable supply of human biological material for transplants and transfusions. With safety logics, I refer to assemblages of discourses, legal documents, technological devices, organizational structures, and work practices aimed at minimizing risk. I use this term to reorient the analytical attention with respect to safety regulation. Instead of evaluating whether safety is achieved, the point is to explore the types of “safety” produced through these logics as well as to consider the sometimes unintended consequences of such safety work. In fact, the EU rules have been giving rise to complaints from practitioners finding the directives problematic and inadequate. In this article, I explore the problems practitioners face and why they arise. In short, I expose the regulatory anatomy of the policy landscape. PMID:26139952

  13. Thermography in Occlusive Cerebrovascular Diseases

    PubMed Central

    Mawdsley, C.; Samuel, E.; Sumerling, M. D.; Young, G. B.

    1968-01-01

    Cooling of the skin over the medial supraorbital region in 80% of patients who have an occlusion or severe stenosis of a carotid artery can be demonstrated by facial thermography. Minor stenotic lesions in the carotid arteries do not produce characteristic thermographic changes, while thermography is of no help in the diagnosis of vertebrobasilar arterial disease. Thermographic changes suggestive of carotid arterial lesions are found occasionally in patients whose angiograms are normal, owing to variations in the size of the frontal sinuses, or factors such as fever or inflammatory lesions. It is suggested that facial thermography is of value in the preliminary investigation of patients with occlusive cerebrovascular disease. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6 PMID:5676953

  14. Clinical Evaluation of Positioning Verification Using Digital Tomosynthesis and Bony Anatomy and Soft Tissues for Prostate Image-Guided Radiotherapy

    SciTech Connect

    Yoo, Sua Wu, Q. Jackie; Godfrey, Devon; Yan Hui; Ren Lei; Das, Shiva; Lee, William R.; Yin Fangfang

    2009-01-01

    Purpose: To evaluate on-board digital tomosynthesis (DTS) for patient positioning vs. two-dimensional (2D) radiography and three-dimensional cone beam (CBCT). Methods and Materials: A total of 92 image sessions from 9 prostate cancer patients were analyzed. An on-board image set was registered to a corresponding reference image set. Four pairs of image sets were used: digitally reconstructed radiographs vs. on-board orthogonal paired radiographs for the 2D method, coronal-reference DTS vs. on-board coronal DTS for the coronal-DTS method, sagittal-reference DTS vs. on-board sagittal DTS for the sagittal-DTS method, and planning CT vs. CBCT for the CBCT method. The registration results were compared. Results: The systematic errors in all methods were <1 mm/1{sup o}. When registering the bony anatomy, the mean vector difference was 0.21 {+-} 0.11 cm between 2D and CBCT, 0.11 {+-} 0.08 cm between CBCT and coronal DTS, and 0.14 {+-} 0.07 cm between CBCT and sagittal DTS. The correlation between CBCT to DTS was stronger (coefficient = 0.92-0.95) than the correlation between 2D and CBCT or DTS (coefficient = 0.81-0.83). When registering the soft tissue, the mean vector difference was 0.18 {+-} 0.11 cm between CBCT and coronal DTS and 0.29 {+-} 0.17 cm between CBCT and sagittal DTS. The correlation coefficient of CBCT to sagittal DTS and to coronal DTS was 0.84 and 0.92, respectively. Conclusion: DTS could provide equivalent results to CBCT when the bony anatomy is used as landmarks for prostate image-guided radiotherapy. For soft tissue-based positioning verification, coronal DTS produced equivalent results to CBCT, but sagittal DTS alone was insufficient. DTS could allow for comparable soft tissue-based target localization with faster scanning time and a lower imaging dose compared with CBCT.

  15. Assessment and Imaging of the Cerebrovascular Glycocalyx.

    PubMed

    Haeren, Roel Hubert Louis; van de Ven, Steffi Elisabeth Maria; van Zandvoort, Marcus Anna Maria Jacobus; Vink, Hans; van Overbeeke, Jacobus Johannes; Hoogland, Govert; Rijkers, Kim

    2016-01-01

    The glycocalyx is a gel-like layer lining the luminal surface of the endothelium. The glycocalyx exerts an important barrier role because it prevents exposure of plasma components to the endothelial surface. Disruption of the glycocalyx by local inflammation or ischemia results in decreased glycocalyx thickness which is associated with a number of vascular diseases. The cerebrovascular glycocalyx has sparsely been studied, but is of great interest because of its potential role in cerebrovascular disease. In this review, we describe all existing techniques to visualize the glycocalyx and designate techniques that may be suitable for studying the cerebrovascular glycocalyx. A total of seven imaging techniques are discussed thoroughly, including transmission electron microscopy, intravital microscopy, micro-particle image velocimetry, confocal laser scanning microscopy, two-photon laser scanning microscopy, orthogonal polarization spectral imaging and sidestream dark field/oblique imaging. Measurement of serum concentrations of glycocalyx-specific constituents is another method for glycocalyx analysis. Also, we have reviewed the methods of glycocalyx analysis by using these imaging techniques. So far, the cerebrovascular glycocalyx has only been studied in vitro. However, other cerebral microcirculatory properties have been studied in vivo. This suggests that the cerebrovascular glycocalyx can be studied in vivo by using some of the described techniques, when specific software is subjoined to the analysis. In conclusion, we have summarized techniques available for glycocalyx assessment, and explained the significance and technical possibilities regarding cerebrovascular glycocalyx visualization. Cerebrovascular glycocalyx assessment would add valuable information to our understanding of the pathophysiology of cerebrovascular disease. Moreover, as a part of the blood-brain barrier, more knowledge on the cerebrovascular glycocalyx may lead to better understanding of

  16. Cerebrovascular neurosurgery in evolution: the endovascular paradigm.

    PubMed

    Sorkin, Grant C; Dumont, Travis M; Eller, Jorge L; Mokin, Maxim; Snyder, Kenneth V; Levy, Elad I; Siddiqui, Adnan H; Hopkins, L Nelson

    2014-02-01

    Endovascular technique represents an important, minimally invasive approach to treating cerebrovascular disease. In this article, we discuss the origins of endovascular neurosurgery as a discipline in the context of important technical milestones, evidence-based medicine, and future cerebrovascular neurosurgical training. Cerebrovascular neurosurgery has seen a steady, convergent evolution toward the surgeon capable of seamless incorporation of open and endovascular approaches to any complex vascular disease affecting the central nervous system. Neurosurgery must assume the leadership role in the multidisciplinary neurovascular team. PMID:24402487

  17. Brain imaging changes associated with risk factors for cardiovascular and cerebrovascular disease in asymptomatic patients.

    PubMed

    Friedman, Joseph I; Tang, Cheuk Y; de Haas, Hans J; Changchien, Lisa; Goliasch, Georg; Dabas, Puneet; Wang, Victoria; Fayad, Zahi A; Fuster, Valentin; Narula, Jagat

    2014-10-01

    Reviews of imaging studies assessing the brain effects of vascular risk factors typically include a substantial number of studies with subjects with a history of symptomatic cardiovascular or cerebrovascular disease and/or events, limiting our ability to disentangle the primary brain effects of vascular risk factors from those of resulting brain and cardiac damage. The objective of this study was to perform a systematic review of brain changes from imaging studies in patients with vascular risk factors but without clinically manifest cardiovascular or cerebrovascular disease or events. The 77 studies included in this review demonstrate that in persons without symptomatic cardiovascular, cerebrovascular, or peripheral vascular disease, the vascular risk factors of hypertension, diabetes mellitus, obesity, hyperlipidemia, and smoking are all independently associated with brain imaging changes before the clinical manifestation of cardiovascular or cerebrovascular disease. We conclude that the identification of brain changes associated with vascular risk factors, before the manifestation of clinically significant cerebrovascular damage, presents a window of opportunity wherein adequate treatment of these modifiable vascular risk factors may prevent the development of irreversible deleterious brain changes and potentially alter patients' clinical course. PMID:25323165

  18. On the Anatomy of Understanding

    ERIC Educational Resources Information Center

    Wilhelmsson, Niklas; Dahlgren, Lars Owe; Hult, Hakan; Josephson, Anna

    2011-01-01

    In search for the nature of understanding of basic science in a clinical context, eight medical students were interviewed, with a focus on their view of the discipline of anatomy, in their fourth year of study. Interviews were semi-structured and took place just after the students had finished their surgery rotations. Phenomenographic analysis was…

  19. Prospective Screening for Blunt Cerebrovascular Injuries

    PubMed Central

    Miller, Preston R.; Fabian, Timothy C.; Croce, Martin A.; Cagiannos, Catherine; Williams, J. Scott; Vang, Meng; Qaisi, Waleed G.; Felker, Richard E.; Timmons, Shelly D.

    2002-01-01

    Objective To prospectively examine outcomes associated with an aggressive screening protocol for blunt cerebrovascular injury (BCVI), and to compare the accuracy of computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) versus conventional angiography with respect to BCVI diagnosis. Summary Background Data In the past 5 years, BCVI (carotid and vertebral arteries) has been recognized with increasing frequency. Initial studies described blunt carotid injuries and their associated morbidity, while more recent reports have established the devastating potential of blunt vertebral injuries. It has been suggested that early diagnosis and anticoagulation will improve outcomes and that less-invasive diagnostic techniques than conventional angiography are desirable for screening. However, there are neither established screening criteria nor studies comparing optimal diagnostic modalities. Methods The screened population included all patients with cervical spine fractures, LeFort II or III facial fractures, Horner’s syndrome, skull base fractures involving the foramen lacerum, neck soft tissue injury, or neurological abnormalities unexplained by intracranial injuries. Patients underwent screening with four-vessel cerebral angiography. During the first half of the study, patients also underwent helical CTA. Selected patients during this same period underwent MRA. At the time of diagnosis, anticoagulant or antiplatelet therapy was instituted unless clinically contraindicated. Results of this screening protocol were compared to a previously published cohort with cerebrovascular injuries (1995–1999) from the authors’ institution. Results Two hundred sixteen patients were screened over a 2-year period (3.5% of all blunt trauma admissions). Angiography identified 24 patients with carotid artery injuries (CAI) and 43 patients with vertebral artery injuries (VAI) for an overall screening yield of 29%. While the incidence of CAI remained similar between

  20. The persistent trigeminal artery: development, imaging anatomy, variants, and associated vascular pathologies.

    PubMed

    Meckel, Stephan; Spittau, Bjoern; McAuliffe, William

    2013-01-01

    The persistent trigeminal artery (PTA) is the most common and most cephalad-located embryological anastomosis between the developing carotid artery and vertebrobasilar system to persist into adulthood. As such, it is frequently reported as an incidental finding in computed tomography angiography and magnetic resonance angiography studies. Here, we review the embryology, anatomy, and angiographic imaging findings, including important variants of this commonly encountered cerebrovascular anomaly (reported incidence of PTA/PTA variants ranges from 0.1% to 0.76%). Further, the aim is to present the range of associated arterial anomalies or syndromes, as well as pathologies that are associated with a PTA: aneurysms, trigeminal cavernous fistulas, and trigeminal nerve compression. Besides summarizing the risks and clinical presentation of such pathologies, their management is discussed with endovascular strategies mostly being the primary choice for aneurysms and trigeminal cavernous fistulas. Symptomatic trigeminal nerve compression can be treated with microvascular decompression surgery. As an illustrative example, a case of a trigeminal cavernous fistula on a PTA variant is included, mainly to emphasize the importance of understanding the variant anatomy for treatment planning in such pathologies. Finally, recommendations on how to manage patients with PTA-associated vascular pathologies are advanced. PMID:22170080

  1. Interprofessional Education in Gross Anatomy: Experience with First-Year Medical and Physical Therapy Students at Mayo Clinic

    ERIC Educational Resources Information Center

    Hamilton, Steven S.; Yuan, Brandon J.; Lachman, Nirusha; Hellyer, Nathan J.; Krause, David A.; Hollman, John H.; Youdas, James W.; Pawlina, Wojciech

    2008-01-01

    Interprofessional education (IPE) in clinical practice is believed to improve outcomes in health care delivery. Integrating teaching and learning objectives through cross discipline student interaction in basic sciences has the potential to initiate interprofessional collaboration at the early stages of health care education. Student attitudes and…

  2. Cerebrovascular disease in ageing and Alzheimer's disease.

    PubMed

    Love, Seth; Miners, J Scott

    2016-05-01

    Cerebrovascular disease (CVD) and Alzheimer's disease (AD) have more in common than their association with ageing. They share risk factors and overlap neuropathologically. Most patients with AD have Aβ amyloid angiopathy and degenerative changes affecting capillaries, and many have ischaemic parenchymal abnormalities. Structural vascular disease contributes to the ischaemic abnormalities in some patients with AD. However, the stereotyped progression of hypoperfusion in this disease, affecting first the precuneus and cingulate gyrus, then the frontal and temporal cortex and lastly the occipital cortex, suggests that other factors are more important, particularly in early disease. Whilst demand for oxygen and glucose falls in late disease, functional MRI, near infrared spectroscopy to measure the saturation of haemoglobin by oxygen, and biochemical analysis of myelin proteins with differential susceptibility to reduced oxygenation have all shown that the reduction in blood flow in AD is primarily a problem of inadequate blood supply, not reduced metabolic demand. Increasing evidence points to non-structural vascular dysfunction rather than structural abnormalities of vessel walls as the main cause of cerebral hypoperfusion in AD. Several mediators are probably responsible. One that is emerging as a major contributor is the vasoconstrictor endothelin-1 (EDN1). Whilst there is clearly an additive component to the clinical and pathological effects of hypoperfusion and AD, experimental and clinical observations suggest that the disease processes also interact mechanistically at a cellular level in a manner that exacerbates both. The elucidation of some of the mechanisms responsible for hypoperfusion in AD and for the interactions between CVD and AD has led to the identification of several novel therapeutic approaches that have the potential to ameliorate ischaemic damage and slow the progression of neurodegenerative disease. PMID:26711459

  3. Anatomy of the Eye

    MedlinePlus

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Anatomy of the Eye En Español Read in Chinese External (Extraocular) Anatomy Extraocular Muscles: There are six muscles that are ...

  4. Clinical neuroimaging

    SciTech Connect

    Theodore, W.H.

    1988-01-01

    This book contains chapters on neuroimaging. Included are the following chapters: diagnostic neuroimaging in stroke, position emission tomography in cerebrovascular disease: clinical applications, and neuroradiologic work-up of brain tumors.

  5. Innovative Interventional and Imaging Registries: Precision Medicine in Cerebrovascular Disorders

    PubMed Central

    Liebeskind, David S.

    2015-01-01

    Background Precision medicine in cerebrovascular disorders may be greatly advanced by the use of innovative interventional and imaging-intensive registries. Registries have remained subsidiary to randomized controlled trials, yet vast opportunities exist to leverage big data in stroke. Summary This overview builds upon the rationale for innovative, imaging-intensive interventional registries as a pivotal step in realizing precision medicine for several cerebrovascular disorders. Such enhanced registries may serve as a model for expansion of our translational research pipeline to fully leverage the role of phase IV investigations. The scope and role of registries in precision medicine are considered, followed by a review on the history of stroke and interventional registries, data considerations, critiques or barriers to such initiatives, and the potential modernization of registry methods into efficient, searchable, imaging-intensive resources that simultaneously offer clinical, research and educational added value. Key Messages Recent advances in technology, informatics and endovascular stroke therapies converge to provide an exceptional opportunity for registries to catapult further progress. There is now a tremendous opportunity to deploy registries in acute stroke, intracranial atherosclerotic disease and carotid disease where other clinical trials leave questions unanswered. Unlike prior registries, imaging-intensive and modernized methods may leverage current technological capabilities around the world to efficiently address key objectives and provide added clinical, research and educational value. PMID:26600792

  6. Illustrated Imaging Essay on Congenital Heart Diseases: Multimodality Approach Part I: Clinical Perspective, Anatomy and Imaging Techniques

    PubMed Central

    Belaval, Vinay; Gadabanahalli, Karthik; Raj, Vimal; Shah, Sejal

    2016-01-01

    Rapid evolution in technology in the recent years has lead to availability of multiple options for cardiac imaging. Availability of multiple options of varying capability, poses a challenge for optimal imaging choice. While new imaging choices are added, some of the established methods find their role re-defined. State of the art imaging practices are limited to few specialist cardiac centres, depriving many radiologists and radiologist in-training of optimal exposure to the field. This presentation is aimed at providing a broad idea about complexity of clinical problem, imaging options and a large library of images of congenital heart disease. Some emphasis is made as to the need of proper balance between performing examination with technical excellence in an ideal situation against the need of the majority of patients who are investigated with less optimal resources. Cases of congenital cardiac disease are presented in an illustrative way, showing imaging appearances in multiple modalities, highlighting specific observations in given instance. PMID:27376034

  7. Through-knee amputation for a patient with proximal femur focal deficiency and tibial hemimelia: surgical anatomy and clinical implications.

    PubMed

    Lloyd, Selvyn; Rashid, Abdul Halim Abd; Das, Srijit; Ibrahim, Sharaf

    2014-03-01

    Tibial hemimelia is a rare anomaly of unknown etiology. This condition can occur sporadically or may have a familial inheritance. It is characterized by deficiency of the tibia with a relatively intact fibula. The anomaly may be unilateral or bilateral. We report a case of a 2-year-old girl who presented with right lower limb deformity since birth. She was diagnosed with proximal femur focal deficiency with absence of the ipsilateral tibia. She presented with a shorter right lower limb and a deformed foot. She was treated with a through-knee amputation. Anatomical dissection of the amputated limb was carried out to verify the anomalies. The dissection showed that the distal phalanx of the great toe was trifid. The anatomical and clinical significance of this interesting case is discussed. PMID:24158808

  8. Illustrated Imaging Essay on Congenital Heart Diseases: Multimodality Approach Part I: Clinical Perspective, Anatomy and Imaging Techniques.

    PubMed

    Bhat, Venkatraman; Belaval, Vinay; Gadabanahalli, Karthik; Raj, Vimal; Shah, Sejal

    2016-05-01

    Rapid evolution in technology in the recent years has lead to availability of multiple options for cardiac imaging. Availability of multiple options of varying capability, poses a challenge for optimal imaging choice. While new imaging choices are added, some of the established methods find their role re-defined. State of the art imaging practices are limited to few specialist cardiac centres, depriving many radiologists and radiologist in-training of optimal exposure to the field. This presentation is aimed at providing a broad idea about complexity of clinical problem, imaging options and a large library of images of congenital heart disease. Some emphasis is made as to the need of proper balance between performing examination with technical excellence in an ideal situation against the need of the majority of patients who are investigated with less optimal resources. Cases of congenital cardiac disease are presented in an illustrative way, showing imaging appearances in multiple modalities, highlighting specific observations in given instance. PMID:27376034

  9. NIRS-based noninvasive cerebrovascular regulation assessment

    NASA Astrophysics Data System (ADS)

    Miller, S.; Richmond, I.; Borgos, J.; Mitra, K.

    2016-03-01

    Alterations to cerebral blood flow (CBF) have been implicated in diverse neurological conditions, including mild traumatic brain injury, microgravity induced intracranial pressure (ICP) increases, mild cognitive impairment, and Alzheimer's disease. Near infrared spectroscopy (NIRS)-measured regional cerebral tissue oxygen saturation (rSO2) provides an estimate of oxygenation of the interrogated cerebral volume that is useful in identifying trends and changes in oxygen supply to cerebral tissue and has been used to monitor cerebrovascular function during surgery and ventilation. In this study, CO2-inhalation-based hypercapnic breathing challenges were used as a tool to simulate CBF dysregulation, and NIRS was used to monitor the CBF autoregulatory response. A breathing circuit for the selective administration of CO2-compressed air mixtures was designed and used to assess CBF regulatory responses to hypercapnia in 26 healthy young adults using non-invasive methods and real-time sensors. After a 5 or 10 minute baseline period, 1 to 3 hypercapnic challenges of 5 or 10 minutes duration were delivered to each subject while rSO2, partial pressure of end tidal CO2 (PETCO2), and vital signs were continuously monitored. Change in rSO2 measurements from pre- to intrachallenge (ΔrSO2) detected periods of hypercapnic challenges. Subjects were grouped into three exercise factor levels (hr/wk), 1: 0, 2:>0 and <10, and 3:>10. Exercise factor level 3 subjects showed significantly greater ΔrSO2 responses to CO2 challenges than level 2 and 1 subjects. No significant difference in ΔPETCO2 existed between these factor levels. Establishing baseline values of rSO2 in clinical practice may be useful in early detection of CBF changes.

  10. Anatomy Education in Namibia: Balancing Facility Design and Curriculum Development

    ERIC Educational Resources Information Center

    Wessels, Quenton; Vorster, Willie; Jacobson, Christian

    2012-01-01

    The anatomy curriculum at Namibia's first, and currently only, medical school is clinically oriented, outcome-based, and includes all of the components of modern anatomical sciences i.e., histology, embryology, neuroanatomy, gross, and clinical anatomy. The design of the facilities and the equipment incorporated into these facilities were directed…

  11. Cerebrovascular ischemic events in wind instrument players.

    PubMed

    Evers, S; Altenmüller, E; Ringelstein, E B

    2000-09-26

    Two cases of ischemic stroke due to carotid artery dissection occurring during wind instrument playing, probably caused by increased intrathoracic and subsequent intrapharyngeal pressure, are presented. A review of the literature revealed three similar patients with other types of cerebrovascular events, such as paradoxical cerebral embolism due to a patent foramen ovale and spinal epidural hematoma during trumpet playing. PMID:10994010

  12. Frank Netter's legacy: Interprofessional anatomy instruction.

    PubMed

    Niekrash, Christine E; Copes, Lynn E; Gonzalez, Richard A

    2015-01-01

    Several medical schools have recently described new innovations in interprofessional interactions in gross anatomy courses. The Frank H. Netter MD School of Medicine at Quinnipiac University in Hamden, CT has developed and implemented two contrasting interprofessional experiences in first-year medical student gross anatomy dissection laboratories: long-term, informal visits by pathologists' assistant students who work with the medical students to identify potential donor pathologies, and a short-term, formal visit by fourth-year dental students who teach craniofacial anatomy during the oral cavity dissection laboratory. A survey of attitudes of participants was analyzed and suggest the interprofessional experiences were mutually beneficial for all involved, and indicate that implementing multiple, contrasting interprofessional interactions with different goals within a single course is feasible. Two multiple regression analyses were conducted to analyze the data. The first analysis examined attitudes of medical students towards a pathologists' assistant role in a health care team. The question addressing a pathologists' assistant involvement in the anatomy laboratory was most significant. The second analysis examined attitudes of medical students towards the importance of a good foundation in craniofacial anatomy for clinical practice. This perceived importance is influenced by the presence of dental students in the anatomy laboratory. In both instances, the peer interprofessional interactions in the anatomy laboratory resulted in an overall positive attitude of medical students towards pathologists' assistant and dental students. The consequences of these interactions led to better understanding, appreciation and respect of the different professionals that contribute to a health care team. PMID:26014811

  13. Anatomy Comic Strips

    ERIC Educational Resources Information Center

    Park, Jin Seo; Kim, Dae Hyun; Chung, Min Suk

    2011-01-01

    Comics are powerful visual messages that convey immediate visceral meaning in ways that conventional texts often cannot. This article's authors created comic strips to teach anatomy more interestingly and effectively. Four-frame comic strips were conceptualized from a set of anatomy-related humorous stories gathered from the authors' collective…

  14. Anatomy: Spotlight on Africa

    ERIC Educational Resources Information Center

    Kramer, Beverley; Pather, Nalini; Ihunwo, Amadi O.

    2008-01-01

    Anatomy departments across Africa were surveyed regarding the type of curriculum and method of delivery of their medical courses. While the response rate was low, African anatomy departments appear to be in line with the rest of the world in that many have introduced problem based learning, have hours that are within the range of western medical…

  15. Anatomy comic strips.

    PubMed

    Park, Jin Seo; Kim, Dae Hyun; Chung, Min Suk

    2011-01-01

    Comics are powerful visual messages that convey immediate visceral meaning in ways that conventional texts often cannot. This article's authors created comic strips to teach anatomy more interestingly and effectively. Four-frame comic strips were conceptualized from a set of anatomy-related humorous stories gathered from the authors' collective imagination. The comics were drawn on paper and then recreated with digital graphics software. More than 500 comic strips have been drawn and labeled in Korean language, and some of them have been translated into English. All comic strips can be viewed on the Department of Anatomy homepage at the Ajou University School of Medicine, Suwon, Republic of Korea. The comic strips were written and drawn by experienced anatomists, and responses from viewers have generally been favorable. These anatomy comic strips, designed to help students learn the complexities of anatomy in a straightforward and humorous way, are expected to be improved further by the authors and other interested anatomists. PMID:21634024

  16. Risk of Cerebrovascular Events in Pneumoconiosis Patients

    PubMed Central

    Chuang, Chieh-Sen; Ho, Shang-Chang; Lin, Cheng-Li; Lin, Ming-Chia; Kao, Chia-Hung

    2016-01-01

    Abstract Pneumoconiosis is a parenchymal lung disease that develops through the inhalation of inorganic dust at work. Cerebrovascular and cardiovascular events are leading causes of mortality and adult disability worldwide. This retrospective cohort study investigated the association between pneumoconiosis, and cerebrovascular and cardiovascular events by using a nationwide population-based database in Taiwan. The data analyzed in this study was retrieved from the Taiwan National Health Insurance Research Database. We selected 6940 patients with pneumoconiosis from the database as our study cohort. Another 27,760 patients without pneumoconiosis were selected and matched with those with pneumoconiosis according to age and sex as the comparison cohort. We used univariate and multivariate Cox proportional-hazard regression analyses to determine the association between pneumoconiosis and the risk of cerebrovascular and cardiovascular events after adjusting for medical comorbidities. After adjustment for age, sex, and comorbidities, the patients with pneumoconiosis exhibited a significantly higher incidence of ischemic stroke (hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.05–1.24) than did those without pneumoconiosis. The incidence of hemorrhagic stroke was higher, but not significant, in the pneumoconiosis patients (HR 1.20, 95% CI 0.99–1.46). No statistically significant differences were observed between the pneumoconiosis and nonpneumoconiosis groups in acute coronary syndrome (HR 1.10, 95% CI 0.95–1.26). The findings of this study reveal an association between pneumoconiosis and a higher risk of cerebrovascular events after adjustment for comorbidities. Healthcare providers should control the related risk factors for primary prevention of stroke in pneumoconiosis patients. PMID:26945404

  17. Anatomy in a Modern Medical Curriculum

    PubMed Central

    Turney, BW

    2007-01-01

    Anatomy in undergraduate education has been in decline for many years. Some suggest that it has fallen below a safe level. Balances between detail and safety, and assimilation and application of anatomy have yet to be established as the methods of teaching undergo another metamorphosis. For doctors, the human body is the focus of investigation and intervention on a daily basis; for this reason, the study of anatomy in some form will continue to be essential to safe medical practice. It is necessary for core knowledge of anatomy to be assimilated by all doctors in order to practice and communicate safely. It may be true that most doctors do not need to dissect a cadaver or study a prosection in order to practice, but if it can improve their understanding of what they do and why they do it, this surely has to be of benefit both for the safety of the patient and satisfaction of the doctor as a professional. Integration of newer teaching modalities and modern technology will encourage interest and retention of anatomical knowledge and its clinical relevance. Anatomy has a promising future in postgraduate specialist and surgical training. Detailed knowledge should be integrated into specialist training when it is clinically relevant allowing specialists of the future to practice safely and accurately and also to provide a strong base for future clinical developments. PMID:17346399

  18. Medical student participation in surface anatomy classes.

    PubMed

    Aggarwal, R; Brough, H; Ellis, H

    2006-10-01

    Surface anatomy is an integral part of medical education and enables medical students to learn skills for future medical practice. In the past decade, there has been a decline in the teaching of anatomy in the medical curriculum, and this study seeks to assess the attitudes of medical students to participation in surface anatomy classes. Consequently, all first year medical students at the Guy's, King's and St Thomas's Medical School, London, were asked to fill in an anonymous questionnaire at the end of their last surface anatomy session of the year. A total of 290 medical students completed the questionnaires, resulting in an 81.6% response rate. The students had a mean age of 19.6 years (range 18-32) and 104 (35.9%) of them were male. Seventy-six students (26.2%) were subjects in surface anatomy tutorials (60.5% male). Students generally volunteered because no one else did. Of the volunteers, 38.2% would rather not have been subjects, because of embarrassment, inability to make notes, or to see clearly the material being taught. Female medical students from ethnic minority groups were especially reluctant to volunteer to be subjects. Single-sex classes improved the volunteer rate to some extent, but not dramatically. Students appreciate the importance of surface anatomy to cadaveric study and to future clinical practice. Computer models, lectures, and videos are complementary but cannot be a substitute for peer group models, artists' models being the only alternative. PMID:16302232

  19. Student Perspectives of Imaging Anatomy in Undergraduate Medical Education

    ERIC Educational Resources Information Center

    Machado, Jorge Americo Dinis; Barbosa, Joselina Maria Pinto; Ferreira, Maria Amelia Duarte

    2013-01-01

    Radiological imaging is gaining relevance in the acquisition of competencies in clinical anatomy. The aim of this study was to evaluate the perceptions of medical students on teaching/learning of imaging anatomy as an integrated part of anatomical education. A questionnaire was designed to evaluate the perceptions of second-year students…

  20. A Minimally Invasive Approach to Undergraduate Anatomy Teaching

    ERIC Educational Resources Information Center

    Gogalniceanu, Petrut; Madani, Hardi; Paraskeva, Paraskevas A.; Darzi, Ara

    2008-01-01

    Anatomy is one of the cornerstones of medical education. Unfortunately, sufficient evidence has accumulated to suggest a worldwide decline in the resources and time allocated to its teaching. Integration of anatomy with clinical medicine has been frequently advocated as the solution to this academic crisis. Consequently, new ways of harnessing…

  1. Student-Directed Fresh Tissue Anatomy Course for Physician Assistants

    ERIC Educational Resources Information Center

    McBride, Jennifer M.; Drake, Richard L.

    2011-01-01

    Healthcare providers in all areas and levels of education depend on their knowledge of anatomy for daily practice. As educators, we are challenged with teaching the anatomical sciences in creative, integrated ways and often within a condensed time frame. This article describes the organization of a clinical anatomy course with a peer taught…

  2. Contributing Mechanisms of Aortic Atheroma in Ischemic Cerebrovascular Disease.

    PubMed

    Kong, Qi; Ma, Xin

    2015-12-01

    In recent years, the correlation between aortic atheroma (AA) and the occurrence and recurrence of ischemic cerebrovascular disease (ICVD) has attracted much attention, but the contributory mechanisms remain controversial. This review analyzes related research on the roles of AA in ICVD, and demonstrates the correlation between the formation and development of AA and abnormal metabolism, inflammation, hemodynamic changes, and other contributory factors. The presence of complex aortic plaque (CAP) in the ascending aorta and aortic arch increases the risk of cerebral embolism and degree of injury, while the association between CAP in the descending aorta and cerebral embolism remains ambiguous. AA also functions as an indicator of atherosclerosis burden as well as hypercoagulability, which may further increase the risk of ICVD. Further study on the relationship of AA to ICVD will improve diagnosis and treatment in clinical practice. PMID:26522269

  3. Skull Base Anatomy.

    PubMed

    Patel, Chirag R; Fernandez-Miranda, Juan C; Wang, Wei-Hsin; Wang, Eric W

    2016-02-01

    The anatomy of the skull base is complex with multiple neurovascular structures in a small space. Understanding all of the intricate relationships begins with understanding the anatomy of the sphenoid bone. The cavernous sinus contains the carotid artery and some of its branches; cranial nerves III, IV, VI, and V1; and transmits venous blood from multiple sources. The anterior skull base extends to the frontal sinus and is important to understand for sinus surgery and sinonasal malignancies. The clivus protects the brainstem and posterior cranial fossa. A thorough appreciation of the anatomy of these various areas allows for endoscopic endonasal approaches to the skull base. PMID:26614826

  4. Building the Body: Active Learning Laboratories that Emphasize Practical Aspects of Anatomy and Integration with Radiology

    ERIC Educational Resources Information Center

    Zumwalt, Ann C.; Lufler, Rebecca S.; Monteiro, Joseph; Shaffer, Kitt

    2010-01-01

    Active learning exercises were developed to allow advanced medical students to revisit and review anatomy in a clinically meaningful context. In our curriculum, students learn anatomy two to three years before they participate in the radiology clerkship. These educational exercises are designed to review anatomy content while highlighting its…

  5. Does Spatial Ability Help the Learning of Anatomy in a Biomedical Science Course?

    ERIC Educational Resources Information Center

    Sweeney, Kevin; Hayes, Jennifer A.; Chiavaroli, Neville

    2014-01-01

    A three-dimensional appreciation of the human body is the cornerstone of clinical anatomy. Spatial ability has previously been found to be associated with students' ability to learn anatomy and their examination performance. The teaching of anatomy has been the subject of major change over the last two decades with the reduction in time spent…

  6. Comparison of a Gross Anatomy Laboratory to Online Anatomy Software for Teaching Anatomy

    ERIC Educational Resources Information Center

    Mathiowetz, Virgil; Yu, Chih-Huang; Quake-Rapp, Cindee

    2016-01-01

    This study was designed to assess the grades, self-perceived learning, and satisfaction between occupational therapy students who used a gross anatomy laboratory versus online anatomy software (AnatomyTV) as tools to learn anatomy at a large public university and a satellite campus in the mid-western United States. The goal was to determine if…

  7. Anatomy of the Eye

    MedlinePlus

    ... Examinations, Adults Patient Eye Examinations, Children Refractive Errors Scientists in the Laboratory Visual Acuity Testing Anatomy of the Eye × Warning message Automatic fallback to the cURL connection method kicked in to handle the request. Result code ...

  8. Anatomy and art.

    PubMed

    Laios, Konstantinos; Tsoukalas, Gregory; Karamanou, Marianna; Androutsos, George

    2013-01-01

    Leonardo da Vinci, Jean Falcon, Andreas Vesalius, Henry Gray, Henry Vandyke Carter and Frank Netter created some of the best atlases of anatomy. Their works constitute not only scientific medical projects but also masterpieces of art. PMID:24640589

  9. Anatomy of the Brain

    MedlinePlus

    ... our existence. It controls our personality, thoughts, memory, intelligence, speech and understanding, emotions, senses, and basic body functions, as well as how we function in our environment. The diagrams below show brain anatomy, or the various parts of the brain, ...

  10. Cerebrovascular pathology during the progression of experimental Alzheimer's disease.

    PubMed

    Giannoni, Patrizia; Arango-Lievano, Margarita; Neves, Ines Das; Rousset, Marie-Claude; Baranger, Kévin; Rivera, Santiago; Jeanneteau, Freddy; Claeysen, Sylvie; Marchi, Nicola

    2016-04-01

    Clinical and experimental evidence point to a possible role of cerebrovascular dysfunction in Alzheimer's disease (AD). The 5xFAD mouse model of AD expresses human amyloid precursor protein and presenilin genes with mutations found in AD patients. It remains unknown whether amyloid deposition driven by these mutations is associated with cerebrovascular changes. 5xFAD and wild type mice (2 to 12months old; M2 to M12) were used. Thinned skull in vivo 2-photon microscopy was used to determine Aβ accumulation on leptomeningeal or superficial cortical vessels over time. Parenchymal microvascular damage was assessed using FITC-microangiography. Collagen-IV and CD31 were used to stain basal lamina and endothelial cells. Methoxy-XO4, Thioflavin-S or 6E10 were used to visualize Aβ accumulation in living mice or in fixed brain tissues. Positioning of reactive IBA1 microglia and GFAP astrocytes at the vasculature was rendered using confocal microscopy. Platelet-derived growth factor receptor beta (PDGFRβ) staining was used to visualize perivascular pericytes. In vivo 2-photon microscopy revealed Methoxy-XO4(+) amyloid perivascular deposits on leptomeningeal and penetrating cortical vessels in 5xFAD mice, typical of cerebral amyloid angiopathy (CAA). Amyloid deposits were visible in vivo at M3 and aggravated over time. Progressive microvascular damage was concomitant to parenchymal Aβ plaque accumulation in 5xFAD mice. Microvascular inflammation in 5xFAD mice presented with sporadic FITC-albumin leakages at M4 becoming more prevalent at M9 and M12. 3D colocalization showed inflammatory IBA1(+) microglia proximal to microvascular FITC-albumin leaks. The number of perivascular PDGFRβ(+) pericytes was significantly decreased at M4 in the fronto-parietal cortices, with a trend decrease observed in the other structures. At M9-M12, PDGFRβ(+) pericytes displayed hypertrophic perivascular ramifications contiguous to reactive microglia. Cerebral amyloid angiopathy and

  11. Simultaneous cerebrovascular and cardiovascular responses during presyncope

    NASA Technical Reports Server (NTRS)

    Bondar, R. L.; Kassam, M. S.; Stein, F.; Dunphy, P. T.; Fortney, S.; Riedesel, M. L.

    1995-01-01

    BACKGROUND AND PURPOSE: Presyncope, characterized by symptoms and signs indicative of imminent syncope, can be aborted in many situations before loss of consciousness occurs. The plasticity of cerebral autoregulation in healthy humans and its behavior during this syncopal prodrome are unclear, although systemic hemodynamic instability has been suggested as a key factor in the precipitation of syncope. Using lower body negative pressure (LBNP) to simulate central hypovolemia, we previously observed falling mean flow velocities (MFVs) with maintained mean arterial blood pressure (MABP). These findings, and recent reports suggesting increased vascular tone within the cerebral vasculature at presyncope, cannot be explained by the classic static cerebral autoregulation curve; neither can they be totally explained by a recent suggestion of a rightward shift in this curve. METHODS: Four male and five female healthy volunteers were exposed to presyncopal LBNP to evaluate their cerebrovascular and cardiovascular responses by use of continuous acquisition of MFV from the right middle cerebral artery with transcranial Doppler sonography, MABP (Finapres), and heart rate (ECG). RESULTS: At presyncope, MFV dropped on average by 27.3 +/- 14% of its baseline value (P < .05), while MABP remained at 2.0 +/- 27% above its baseline level. Estimated cerebrovascular resistance increased during LBNP. The percentage change from baseline to presyncope in MFV and MABP revealed consistent decreases in MFV before MABP. CONCLUSIONS: Increased estimated cerebrovascular resistance, falling MFV, and constant MABP are evidence of an increase in cerebral vascular tone with falling flow, suggesting a downward shift in the cerebral autoregulation curve. Cerebral vessels may have a differential sensitivity to sympathetic drive or more than one type of sympathetic innervation. Future work to induce dynamic changes in MABP during LBNP may help in assessing the plasticity of the cerebral autoregulation

  12. Oral anatomy laboratory examinations in a physical therapy program.

    PubMed

    Fabrizio, Philip A

    2013-01-01

    The process of creating and administering traditional tagged anatomy laboratory examinations is time consuming for instructors and limits laboratory access for students. Depending on class size and the number of class, sections, creating, administering, and breaking down a tagged laboratory examination may involve one to two eight-hour days. During the time that a tagged examination is being created, student productivity may be reduced as the anatomy laboratory is inaccessible to students. Further, the type of questions that can be asked in a tagged laboratory examination may limit student assessment to lower level cognitive abilities and may limit the instructors' ability to assess the students' understanding of anatomical and clinical concepts. Anatomy is a foundational science in the Physical Therapy curriculum and a thorough understanding of anatomy is necessary to progress through the subsequent clinical courses. Physical therapy curricula have evolved to reflect the changing role of physical therapists to primary caregivers by introducing a greater scope of clinical courses earlier in the curriculum. Physical therapy students must have a thorough understanding of clinical anatomy early in the education process. However, traditional anatomy examination methods may not be reflective of the clinical thought processes required of physical therapy students. Traditional laboratory examination methods also reduce student productivity by limiting access during examination set-up and breakdown. To provide a greater complexity of questions and reduced overall laboratory time required for examinations, the Physical Therapy Program at Mercer University has introduced oral laboratory examinations for the gross anatomy course series. PMID:23225627

  13. [Daily life activities following cerebrovascular infarct].

    PubMed

    Pradat-Diehl, Pascale; Peskine, Anne

    2006-09-15

    Cerebro-vascular disease is the first cause of handicap in France. Disabilities in daily life activities are due to motor, visual and cognitive impairments following a stroke. Difficulties arise while grooming, getting dressed, eating, moving around ... the WHO presents with a new classification of functioning, that has been followed by a recent law in France. The aim is to place the handicapped citizen in daily life and not just to list his/her deficiencies. Rehabilitation after stroke has to establish functional objectives early so as to include daily life goals in re-education. PMID:17002070

  14. Teaching Anatomy in the XXI Century: New Aspects and Pitfalls

    PubMed Central

    Papa, Veronica; Vaccarezza, Mauro

    2013-01-01

    Anatomy has historically been a cornerstone in medical education regardless of nation, racial background, or medical school system. By learning gross anatomy, medical students get a first “impression” about the structure of the human body which is the basis for understanding pathologic and clinical problems. Although the importance of teaching anatomy to both undergraduate and postgraduate students remains undisputed, there is currently a relevant debate concerning methods of anatomy teaching. In the past century, dissection and lectures were its sole pedagogy worldwide. Recently, the time allocated for anatomy teaching was dramatically reduced to such an extent that some suggest that it has fallen below an adequate standard. Traditional anatomy education based on topographical structural anatomy taught in lectures and gross dissection classes has been replaced by a multiple range of study modules, including problem-based learning, plastic models or computer-assisted learning, and curricula integration. “Does the anatomical theatre still have a place in medical education?” And “what is the problem with anatomic specimens?” We endeavor to answer both of these questions and to contribute to the debate on the current situation in undergraduate and graduate anatomy education. Doctors without anatomy are like moles.They work in the dark and the work of their hands are mounds. Friedrich TiedemannThe foundation of the study of the art of operating must be laid in the dissecting room. Robert Liston PMID:24367240

  15. Computerized Grading of Anatomy Laboratory Practical Examinations

    ERIC Educational Resources Information Center

    Krippendorf, Beth B.; Bolender, David L.; Kolesari, Gary L.

    2008-01-01

    At the Medical College of Wisconsin, a procedure was developed to allow computerized grading and grade reporting of laboratory practical examinations in the Clinical Human Anatomy course. At the start of the course, first year medical students were given four Lists of Structures. On these lists, numbered items were arranged alphabetically; the…

  16. Occult endocrine dysfunction in patients of cerebrovascular accident

    PubMed Central

    Kumar, K. V. S. Hari; Kumar, Sandeep; Ahmad, Faiz M. H.

    2016-01-01

    Background: Cerebrovascular disorders are common conditions leading to significant morbidity and mortality in the population. Occult endocrine disorders also contribute to the morbidity and we studied the prevalence of endocrine dysfunction in patients of cerebrovascular accident (CVA). Materials and Methods: We evaluated 30 patients of CVA (aged 18-75, admission within 72 h of symptoms and positive neuroimaging) in this prospective, observational study. All subjects were assessed clinically and biochemically for hormonal dysfunction at admission and for mortality at the end of 1 month. The patients were divided into two groups: Group 1 (infarct, n = 20) and Group 2 (hemorrhage, n = 10) and the data were analyzed with appropriate statistical tests using GraphPad Prism Software, version 6. Results: The study participants (24M:6F) had a mean age of 60.7 ± 11.4 years and body weight of 67.2 ± 11.4 kg. Fourteen out of 30 patients showed results consistent with an endocrine disorder, including sick euthyroid syndrome (SES) and central hypothyroidism (n = 10), secondary hypogonadism (n = 3), subclinical hypothyroidism (n = 1), and growth hormone (GH) deficiency in two patients. The endocrine conditions did not differ significantly between both the groups and nine out of 30 patients succumbed to their illness within 1 month. None of the hormonal parameters studied, could predict the 30 day mortality. Conclusion: Endocrine disorders are common in acute stage of CVA and commonest finding is a SES. Hormonal dysfunction did not differ based on the etiology of the CVA. Long-term follow-up is essential to understand the morbidity contributed by the hormonal alterations. PMID:27011637

  17. Strangulation injuries in children. Part 2. Cerebrovascular hemodynamics.

    PubMed

    Hanigan, W C; Aldag, J; Sabo, R A; Rose, J; Aaland, M

    1996-01-01

    The cerebrovascular hemodynamics were recorded in two children with comparable hypoxic-ischemic injuries after strangulation. Monitoring was initiated within 13 hours of injury and continued for at least 38 hours. The profile included continuous measurements of cortical regional cerebral blood flow (rCBF) with a subdural thermal diffusion probe, intracranial pressure, mean arterial pressure, and expired CO2 tension. Data sets were obtained every 15 minutes or every 5 minutes during epochs of hyperventilation and inotropic support. Arterial CO2 and oxygen content and pH and, in the second patient, cardiac output (and cardiac index) were determined every 3 to 6 hours. Both children showed cortical hyperemia with a gradual rise of rCBF during the study; neither child showed elevated intracranial pressure. Mean CO2 reactivities were 1.8 and 2.1 mL/100 g/minute/mm Hg, with gradual elevations during the study. Mean cerebrovascular resistances were 0.7 and 0.9 mL/100 g/minute/mm Hg, respectively. Dissociative vasoparalysis with loss of autoregulation and preservation of CO2 reactivity was observed in both children. In the second child, during two periods of hyperventilation, an inverse steal occurred with rCBF indirectly related to expired CO2 tension; the rCBF was not related to changes in cardiac output or cardiac index. Neurologic outcome was not related to mean levels of rCBF, CPP, and CO2 reactivity, or clinical dissociative vasoparalysis. Lower initial and mean values of rCBF and an inverse steal after hyperventilation were associated with a poor outcome in the second patient. PMID:8577003

  18. Cardiovascular and Cerebrovascular Control on Return from ISS

    NASA Technical Reports Server (NTRS)

    Hughson, Richard Lee; Shoemaker, Joel Kevin; Blaber, Andrew Philip; Arbeille, Philippe; Greaves, Danielle Kathleen

    2008-01-01

    Cardiovascular and Cerebrovascular Control on Return from ISS (CCISS) will study the effects of long-duration spaceflight on crew members' heart functions and their blood vessels that supply the brain. Learning more about the cardiovascular and cerebrovascular systems could lead to specific countermeasures that might better protect future space travelers. This experiment is collaborative with the Canadian Space Agency.

  19. A Non-Invasive Method to Assess Cerebral Perfusion Pressure in Geriatric Patients with Suspected Cerebrovascular Disease

    PubMed Central

    Deng, Nan; He, Peng; Qin, Chunchang; Yang, Deyu; Li, Zhiwei; Xie, Peng

    2015-01-01

    Background Cerebral perfusion pressure (CPP) can adversely impact cerebrovascular hemodynamics but cannot be practically measured in most clinical settings. Here, we aimed to establish a representative mathematical model for CPP in geriatric patients with suspected cerebrovascular disease. Methods A total of 100 patients (54 males and 46 females between 60–80 years of age) with suspected cerebrovascular disease and no obvious cerebrovascular stenosis were selected for invasive CPP monitoring via catheterization of the middle segment of the common carotid arteries and openings of the vertebral arteries bilaterally. Curves were function-fitted using MATLAB 7.0, and data was statistically processed by SPSS 20.0. Results MATLAB 7.0 constructed eighth-order Fourier functions that fit all recorded CPP curves. Since the coefficients of the 100 functions were significantly different, all functions were standardized to derive one representative function. By manipulating the heart rate and maximum/minimum CPP of the representative function, estimated CPP curves can be constructed for patients with differing heart rates, intracranial pressures (ICPs) and blood pressures. Conclusions CPP can be well-modeled through an eighth-order Fourier function that can be constructed from a patient’s brachial artery blood pressure (BABP), ICP and heart rate. This function is representative of geriatric patients with cerebrovascular disease and can be used in the future study of cerebral hemodynamics. PMID:25789855

  20. [Resistance to antiplatelet drugs in patients with cerebrovascular disorders].

    PubMed

    Suslina, Z A; Tanashian, M M; Domashenko, M A

    2011-01-01

    This review concerns clinical and laboratory resistance to antiplatelet drugs (aspirin and clopidogrel) in patients with cerebrovascular disorders. Results of certain clinical trials showed that laboratory resistance to antiaggregants is associated with recurrent thromboembolic vascular events. The commonest causes of aspirin resistance are production of arachidonic acid metabolites via the lipoxygenase pathway, poor compliance with the treatment, polymorphism of the genes encoding for cyclooxygenase and glycoprotein (GP) IIb/IIIa, endothelial dysfunction. The causes of clopidogrel resistance include inadequate doses of the drug, its low absorption, poor compliance with the treatment, polymorphism of ADP receptors, GP IIb/IIIa and cytochrome P450 genes, acute coronary syndrome and stroke, metabolic syndrome. Therapeutic efficacy of antiaggregants can be improved by increasing their doses, using membranotropic agents, correcting endothelial dysfunction, etc. Because the apparent variability of antiplatelet drug resistance is currently due to the use of different test-systems by different authors, the evaluation of individual sensitivity to a given drug showing laboratory resistance and the choice of alternative therapy are thus far possible only in the framework of clinical studies. Large-scale prospective multicenter trials of antiplatelet drug resistance are needed along with research for better understanding mechanisms of individual platelet sensitivity and resistance to antiaggregants and developing efficacious methods for their correction. PMID:21901881

  1. The Drosophila anatomy ontology

    PubMed Central

    2013-01-01

    Background Anatomy ontologies are query-able classifications of anatomical structures. They provide a widely-used means for standardising the annotation of phenotypes and expression in both human-readable and programmatically accessible forms. They are also frequently used to group annotations in biologically meaningful ways. Accurate annotation requires clear textual definitions for terms, ideally accompanied by images. Accurate grouping and fruitful programmatic usage requires high-quality formal definitions that can be used to automate classification and check for errors. The Drosophila anatomy ontology (DAO) consists of over 8000 classes with broad coverage of Drosophila anatomy. It has been used extensively for annotation by a range of resources, but until recently it was poorly formalised and had few textual definitions. Results We have transformed the DAO into an ontology rich in formal and textual definitions in which the majority of classifications are automated and extensive error checking ensures quality. Here we present an overview of the content of the DAO, the patterns used in its formalisation, and the various uses it has been put to. Conclusions As a result of the work described here, the DAO provides a high-quality, queryable reference for the wild-type anatomy of Drosophila melanogaster and a set of terms to annotate data related to that anatomy. Extensive, well referenced textual definitions make it both a reliable and useful reference and ensure accurate use in annotation. Wide use of formal axioms allows a large proportion of classification to be automated and the use of consistency checking to eliminate errors. This increased formalisation has resulted in significant improvements to the completeness and accuracy of classification. The broad use of both formal and informal definitions make further development of the ontology sustainable and scalable. The patterns of formalisation used in the DAO are likely to be useful to developers of other

  2. Chronic cerebrovascular dysfunction after traumatic brain injury.

    PubMed

    Jullienne, Amandine; Obenaus, Andre; Ichkova, Aleksandra; Savona-Baron, Catherine; Pearce, William J; Badaut, Jerome

    2016-07-01

    Traumatic brain injuries (TBI) often involve vascular dysfunction that leads to long-term alterations in physiological and cognitive functions of the brain. Indeed, all the cells that form blood vessels and that are involved in maintaining their proper function can be altered by TBI. This Review focuses on the different types of cerebrovascular dysfunction that occur after TBI, including cerebral blood flow alterations, autoregulation impairments, subarachnoid hemorrhage, vasospasms, blood-brain barrier disruption, and edema formation. We also discuss the mechanisms that mediate these dysfunctions, focusing on the cellular components of cerebral blood vessels (endothelial cells, smooth muscle cells, astrocytes, pericytes, perivascular nerves) and their known and potential roles in the secondary injury cascade. © 2016 Wiley Periodicals, Inc. PMID:27117494

  3. Cysticercosis and cerebrovascular disease: a review.

    PubMed Central

    Del Brutto, O H

    1992-01-01

    Ischaemic cerebrovascular disease is a relatively common but under-recognised complication of neurocysticercosis. It is usually caused by inflammatory occlusion of the arteries at the base of the brain secondary to cysticercotic arachnoiditis. In most cases, the involved vessels are of small diameter and the neurological picture is limited to a lacunar syndrome secondary to a small cerebral infarct. However, large infarcts related to the occlusion of the middle cerebral artery or even the internal carotid artery have also been reported in this setting. CT and CSF examination usually support the cause-and-effect relationship between neurocysticercosis and the cerebral infarct by showing abnormalities compatible with cysticercotic arachnoiditis. An accurate diagnosis of this condition is important since early treatment with steroids is advised to ameliorate the subarachnoid inflammatory reaction which may cause recurrent cerebral infarcts. PMID:1583508

  4. Chronic obstructive pulmonary disease and cerebrovascular disease: A comprehensive review.

    PubMed

    Lahousse, Lies; Tiemeier, Henning; Ikram, M Arfan; Brusselle, Guy G

    2015-11-01

    Along with the aging population, the public health burden of cerebrovascular disease is increasing. Cerebral small vessel disease and accumulation of brain pathology associate with cognitive decline and can lead to clinical outcomes, such as stroke and dementia. Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory disease among elderly. The quality of life and prognosis of patients with COPD is greatly determined by the presence of comorbidities including stroke and cognitive impairment. Despite the clinical relevance of cerebral small vessel disease, stroke and (vascular) cognitive impairment in patients with COPD, literature is scarce and underlying mechanisms are unknown. The aim of the present review is therefore to summarize current scientific knowledge, to provide a better understanding of the interplay between COPD and the aging brain and to define remaining knowledge gaps. This narrative review article 1) overviews the epidemiology of cerebral small vessel disease, stroke and cognitive impairment in patients with COPD; 2) discusses potential underlying mechanisms including aging, smoking, systemic inflammation, vasculopathy, hypoxia and genetic susceptibility; and 3) highlights areas requiring further research. PMID:26342840

  5. Learning Anatomy Enhances Spatial Ability

    ERIC Educational Resources Information Center

    Vorstenbosch, Marc A. T. M.; Klaassen, Tim P. F. M.; Donders, A. R. T.; Kooloos, Jan G. M.; Bolhuis, Sanneke M.; Laan, Roland F. J. M.

    2013-01-01

    Spatial ability is an important factor in learning anatomy. Students with high scores on a mental rotation test (MRT) systematically score higher on anatomy examinations. This study aims to investigate if learning anatomy also oppositely improves the MRT-score. Five hundred first year students of medicine ("n" = 242, intervention) and…

  6. Anatomy for Biomedical Engineers

    ERIC Educational Resources Information Center

    Carmichael, Stephen W.; Robb, Richard A.

    2008-01-01

    There is a perceived need for anatomy instruction for graduate students enrolled in a biomedical engineering program. This appeared especially important for students interested in and using medical images. These students typically did not have a strong background in biology. The authors arranged for students to dissect regions of the body that…

  7. The Anatomy Puzzle Book.

    ERIC Educational Resources Information Center

    Jacob, Willis H.; Carter, Robert, III

    This document features review questions, crossword puzzles, and word search puzzles on human anatomy. Topics include: (1) Anatomical Terminology; (2) The Skeletal System and Joints; (3) The Muscular System; (4) The Nervous System; (5) The Eye and Ear; (6) The Circulatory System and Blood; (7) The Respiratory System; (8) The Urinary System; (9) The…

  8. Anatomy of the Honeybee

    ERIC Educational Resources Information Center

    Postiglione, Ralph

    1977-01-01

    In this insect morphology exercise, students study the external anatomy of the worker honeybee. The structures listed and illustrated are discussed in relation to their functions. A goal of the exercise is to establish the bee as a well-adapted, social insect. (MA)

  9. Illustrated Speech Anatomy.

    ERIC Educational Resources Information Center

    Shearer, William M.

    Written for students in the fields of speech correction and audiology, the text deals with the following: structures involved in respiration; the skeleton and the processes of inhalation and exhalation; phonation and pitch, the larynx, and esophageal speech; muscles involved in articulation; muscles involved in resonance; and the anatomy of the…

  10. [Comprehensive therapy of cerebral and cerebrovascular decompensation (author's transl)].

    PubMed

    Hofmann, G

    1980-06-01

    Many psychiatric syndroms in older age are based on cerebral and cerebrovascular decompensation. Diagnosis of metabolic dysfunction or vascular dysregulation--leading to cerebral decompensation--and their therapy is of greater importance than immediate therapy of psychiatric syndroms. We use Strophantin therapy, hemodilation, stabilization of blood pressure, antidiabetics combined with mild sedation by low dose neuroleptics. After achieving metabolic and cerebrovascular equilibrium we start more or less specific psychiatric syndrom therapy like antidepressants. PMID:6109459

  11. [Nuts, cardio and cerebrovascular risks. A Spanish perspective].

    PubMed

    Nus, Meritxell; Ruperto, Mar; Sánchez-Muniz, Francisco J

    2004-06-01

    Nuts have been included in human diets for ages. They are very appreciated and used as a central component of sweets and desserts. However, during the last decades, scientific interest in those foods has increased enormously as many epidemiologic studies show protective effects of nut consumption on coronary heart disease in different population groups. To date, many clinical trials have analyzed the positive effects of nuts consumption (almond, walnut, pistachio, Macadamia nut, and pecan) on the lipid profile, decreasing total and low density lipoproteins (LDL) cholesterol. However, whether these effects are only due to their fatty acid composition or to any other bioactive compounds, such as tocopherols, phytosterols and phytoestrogens, it is still unknown. This paper, aims to review comparative composition aspects of nuts, such as the positive effects on body weight, lipoprotein metabolism, and protection against cardiovascular and cerebrovascular diseases. The inclusion of 25 g/day of nuts, mainly raw, into a prudent diet seems to be recommended. Further investigations, as actual information is still scarce, in order to dilucidate the relationship between nuts consumption and vascular diseases are proposed. PMID:15586681

  12. Anatomy and physiology of genital organs - women.

    PubMed

    Graziottin, Alessandra; Gambini, Dania

    2015-01-01

    "Anatomy is destiny": Sigmund Freud viewed human anatomy as a necessary, although not a sufficient, condition for understanding the complexity of human sexual function with a solid biologic basis. The aim of the chapter is to describe women's genital anatomy and physiology, focusing on women's sexual function with a clinically oriented vision. Key points include: embryology, stressing that the "female" is the anatomic "default" program, differentiated into "male" only in the presence of androgens at physiologic levels for the gestational age; sex determination and sex differentiation, describing the interplay between anatomic and endocrine factors; the "clitoral-urethral-vaginal" complex, the most recent anatomy reading of the corpora cavernosa pattern in women; the controversial G spot; the role of the pelvic floor muscles in modulating vaginal receptivity and intercourse feelings, with hyperactivity leading to introital dyspareunia and contributing to provoked vestibulodynia and recurrent postcoital cystitis, whilst lesions during delivery reduce vaginal sensations, genital arousability, and orgasm; innervation, vessels, bones, ligaments; and the physiology of women's sexual response. Attention to physiologic aging focuses on "low-grade inflammation," genital and systemic, with its impact on women sexual function, especially after the menopause, if the woman does not or cannot use hormone replacement therapy. PMID:26003238

  13. Learning of Musculoskeletal Ligament Stress Testing in a Gross Anatomy Laboratory

    ERIC Educational Resources Information Center

    Krause, David A.; Youdas, James W.; Hollman, John H.

    2011-01-01

    Human anatomy in physical therapy programs is a basic science course serving as a foundation for subsequent clinical courses. Integration of anatomy with a clinical emphasis throughout a curriculum provides opportunities for reinforcement of previously learned material. Considering the human cadaver laboratory as a fixed cost to our program, we…

  14. [Anatomy of the skull].

    PubMed

    Pásztor, Emil

    2010-01-01

    The anatomy of the human body based on a special teleological system is one of the greatest miracles of the world. The skull's primary function is the defence of the brain, so every alteration or disease of the brain results in some alteration of the skull. This analogy is to be identified even in the human embryo. Proportions of the 22 bones constituting the skull and of sizes of sutures are not only the result of the phylogeny, but those of the ontogeny as well. E.g. the age of the skeletons in archaeological findings could be identified according to these facts. Present paper outlines the ontogeny and development of the tissues of the skull, of the structure of the bone-tissue, of the changes of the size of the skull and of its parts during the different periods of human life, reflecting to the aesthetics of the skull as well. "Only the human scull can give me an impression of beauty. In spite of all genetical colseness, a skull of a chimpanzee cannot impress me aesthetically"--author confesses. In the second part of the treatise those authors are listed, who contributed to the perfection of our knowledge regarding the skull. First of all the great founder of modern anatomy, Andreas Vesalius, then Pierre Paul Broca, Jacob Benignus Winslow are mentioned here. The most important Hungarian contributors were as follow: Sámuel Rácz, Pál Bugát or--the former assistant of Broca--Aurél Török. A widely used tool for measurement of the size of the skull, the craniometer was invented by the latter. The members of the family Lenhossék have had also important results in this field of research, while descriptive anatomy of the skull was completed by microsopical anatomy thanks the activity of Géza Mihálkovits. PMID:21661257

  15. Human ocular anatomy.

    PubMed

    Kels, Barry D; Grzybowski, Andrzej; Grant-Kels, Jane M

    2015-01-01

    We review the normal anatomy of the human globe, eyelids, and lacrimal system. This contribution explores both the form and function of numerous anatomic features of the human ocular system, which are vital to a comprehensive understanding of the pathophysiology of many oculocutaneous diseases. The review concludes with a reference glossary of selective ophthalmologic terms that are relevant to a thorough understanding of many oculocutaneous disease processes. PMID:25704934

  16. Executions and scientific anatomy.

    PubMed

    Dolezal, Antonín; Jelen, Karel; Stajnrtova, Olga

    2015-12-01

    The very word "anatomy" tells us about this branch's connection with dissection. Studies of anatomy have taken place for approximately 2.300 years already. Anatomy's birthplace lies in Greece and Egypt. Knowledge in this specific field of science was necessary during surgical procedures in ophthalmology and obstetrics. Embalming took place without public disapproval just like autopsies and manipulation with relics. Thus, anatomical dissection became part of later forensic sciences. Anatomical studies on humans themselves, which needed to be compared with the knowledge gained through studying procedures performed on animals, elicited public disapprobation and prohibition. When faced with a shortage of cadavers, anatomists resorted to obtaining bodies of the executed and suicide victims - since torture, public display of the mutilated body, (including anatomical autopsy), were perceived as an intensification of the death penalty. Decapitation and hanging were the main execution methods meted out for death sentences. Anatomists preferred intact bodies for dissection; hence, convicts could thus avoid torture. This paper lists examples of how this process was resolved. It concerns the manners of killing, vivisection on people in the antiquity and middle-ages, experiments before the execution and after, vivifying from seeming death, experiments with galvanizing electricity on fresh cadavers, evaluating of sensibility after guillotine execution, and making perfect anatomical preparations and publications during Nazism from fresh bodies of the executed. PMID:26859596

  17. Cerebrovascular Reactivity in Young Subjects with Sleep Apnea

    PubMed Central

    Buterbaugh, John; Wynstra, Charles; Provencio, Natalie; Combs, Daniel; Gilbert, Michael; Parthasarathy, Sairam

    2015-01-01

    Study Objectives: Regional brain alterations may be involved in the pathogenesis and adverse consequences of obstructive sleep apnea (OSA). The objectives for the current study were to (1) determine cerebrovascular reactivity in the motor areas that control upper airway musculature in patients with OSA, and (2) determine whether young patients with OSA have decreased cerebrovascular reactivity in response to breath holding. Design: Case-control study. Setting: Academic center. Participants: Twelve subjects with OSA (age 24–42 y; apnea-hypopnea index 17; interquartile range [IQR] 9, 69 per hour) and control subjects (n = 10; age 29–44 y; AHI 2; IQR 1, 3 per hour). Measurements and Results: Subjects underwent blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) while awake, swallowing, and breath holding. In subjects with OSA, during swallowing, there was less activity in the brainstem than in controls (P = 0.03) that remained reduced after adjusting for cortical motor strip activity (P = 0.036). In OSA subjects, brain regions of increased cerebrovascular reactivity (38; IQR 17, 96 cm3) was smaller than that in controls (199; IQR 5, 423 cm3; P = 0.01). In OSA subjects, brain regions of decreased cerebrovascular reactivity during breath hold was greater (P = 0.01), and the ratio of increased-to-decreased brain regions was lower than that of controls (P = 0.006). Adjustment for cerebral volumes, body mass index, and white matter lesions did not change these results substantively. Conclusions: In patients with obstructive sleep apnea (OSA), diminished change in brainstem activity during swallowing and reduced cerebrovascular reactivity may contribute to the etiopathogenesis and adverse cerebrovascular consequences, respectively. We speculate that decreased cerebral auto-regulation may be causative of gray matter loss in OSA. Citation: Buterbaugh J, Wynstra C, Provencio N, Combs D, Gilbert M, Parthasarathy S. Cerebrovascular reactivity in

  18. [Epidemiology of cerebrovascular disease in Spain].

    PubMed

    Brea, Angel; Laclaustra, Martín; Martorell, Esperanza; Pedragosa, Angels

    2013-01-01

    In Spain, cerebrovascular disease (CVD) is a very common cause of morbidity and hospitalization. They are the second leading cause of mortality in the general population, and the first in women. They also constitute a very high social spending, which is estimated to increase in coming years, due to the aging of our population. Data from the Hospital Morbidity Survey of the National Statistics Institute recorded, in 2011, 116,017 strokes and 14,933 transient ischemic attacks, corresponding, respectively, to an incidence of 252 and 32 events per 100,000 people. In 2002, the cost of hospitalization for each stroke was estimated at €3,047. The amount of total cost health care throughout the life of a stroke patient is calculated at €43,129. Internationally, the direct costs of stroke constitute 3% of national health spending, this being similar amount in different countries around us. Hypertension was the cardiovascular risk factor (CVRF) more prevalent in both ischemic and hemorrhagic strokes, followed by dyslipidemia and diabetes mellitus. Peripheral arterial disease and hypertension were more frequently associated with atherothrombotic events, atrial fibrillation with cardioembolic strokes, and obesity and high blood pressure to lacunar infarcts. In Spain, as showing several studies, we are far from optimal control of CVRF, especially in secondary prevention of stroke. According to the ICTUSCARE study, achieving recommended values was 17.6% in the case of hypertension, 29.8% in LDL-cholesterol, 74.9% of smoking, and 50.2% in diabetes mellitus. In this review, we analyze in detail the epidemiology, prevention and costs originated by CVD. PMID:24238835

  19. Landmark papers in cerebrovascular neurosurgery 2015.

    PubMed

    Moore, Justin M; Griessenauer, Christoph J; Gupta, Raghav; Adeeb, Nimer; Patel, Apar S; Ogilvy, Christopher S; Thomas, Ajith J

    2016-09-01

    The management of cerebrovascular disease has advanced considerably in 2015. Five randomized control trials have firmly established the role of endovascular thrombectomy for ischemic strokes due to large vessel occlusion. The randomized trial of intraarterial treatment for acute ischemic stroke (MR CLEAN) (Berkhemer et al. NEJM 2015;372:11-20) was the first of a series on the topic. There was a total of 5 randomized controlled trials published showing benefit in terms of functional outcomes at 90days for mechanical thrombectomy including the Endovascular Therapy for Ischemic stroke with perfusion-imaging selection (EXTEND IA) (Campbell et al. NEJM 2015;372:1009-18), the Randomized assessment of rapid endovascular treatment of ischemic stroke (ESCAPE) (Goyal et al. NEJM 2015;372:1019-30) trials, the stent-retriever thrombectomy after IV t-PA is t-PA alone in stroke (SWIFT-PRIME) (Saver et al. NEJM 2015;372:2285-95), and the thrombectomy within 8h after symptom onset in Ischemic stroke (REVASCAT) trial (Jovin et al. NEJM 2015; 372:2296-306). Six-year results from randomized controlled Barrow Ruptured Aneurysm Trial (BRAT) found no significant difference in functional outcomes in patients ruptured aneurysms treated surgically clippings versus endovascular treatment (Spetzler et al. JNS 2015;123:609-17. The 10-year results of the International Subarachnoid Aneurysm trial (ISAT) reported similar mortality rates and good functional outcomes between clipped and coiled patients (Molyneux et al. Lancet 2015;385:691-7). We also discuss the impact of genome wide sequencing studies in familial aneurysms, the largest publication on stent assisted coiling and flow diverter for aneurysms and noteworthy papers relevant to Moyamoya and cavernous malformations (Yang et al. Neurosurgery 2015;77:241-7). PMID:27366977

  20. Cerebrovascular disease as the initial clinical presentation of haematological disorders.

    PubMed

    Arboix, A; Besses, C

    1997-01-01

    We describe 14 patients (mean age 57 years) in whom stroke or TIA was the presenting manifestation of a haematologic disorder. Twelve patients had an ischaemic stroke and 2 a haemorrhagic stroke. This group represented 1.27% (14/1,099) of the total number of patients with first-ever stroke diagnosed from 1986 to 1992 at our institution, accounted for 1.32% (12/906) of all brain infarcts and 1.03% (2/193) of all haemorrhagic strokes, and was the most common aetiology (25%) of ischaemic stroke of unusual cause. Haematological disorders included essential thrombocythaemia (6), polycythaemia vera (1), smoker's polycythaemia (1), thrombotic thrombocytopenic purpura (1), IgA lambda myeloma (1), acute lymphoblastic leukaemia (1), Waldenström's macroglobulinaemia (1), chronic granulocytic leukaemia (1) and IgG lambda myeloma (1). Stroke subtypes included definitive cerebral infarct (10), TIA (2), parenchymal haemorrhage (1) and spontaneous subdural haematoma (1). Vascular territories in ischaemic stroke were the carotid in 7 patients, the vertebrobasilar in 1 and undetermined in 4. Mean follow-up was 40 months (range, 1-96 months). The mortality rate was 18.7%. PMID:9208259

  1. Cerebrovascular regulation, exercise, and mild traumatic brain injury

    PubMed Central

    Meehan, William P.; Iverson, Grant L.; Taylor, J. Andrew

    2014-01-01

    A substantial number of people who sustain a mild traumatic brain injury report persistent symptoms. Most common among these symptoms are headache, dizziness, and cognitive difficulties. One possible contributor to sustained symptoms may be compromised cerebrovascular regulation. In addition to injury-related cerebrovascular dysfunction, it is possible that prolonged rest after mild traumatic brain injury leads to deconditioning that may induce physiologic changes in cerebral blood flow control that contributes to persistent symptoms in some people. There is some evidence that exercise training may reduce symptoms perhaps because it engages an array of cerebrovascular regulatory mechanisms. Unfortunately, there is very little work on the degree of impairment in cerebrovascular control that may exist in patients with mild traumatic brain injury, and there are no published studies on the subacute phase of recovery from this injury. This review aims to integrate the current knowledge of cerebrovascular mechanisms that might underlie persistent symptoms and seeks to synthesize these data in the context of exploring aerobic exercise as a feasible intervention to treat the underlying pathophysiology. PMID:25274845

  2. Who Is Repeating Anatomy? Trends in an Undergraduate Anatomy Course

    ERIC Educational Resources Information Center

    Schutte, Audra F.

    2016-01-01

    Anatomy courses frequently serve as prerequisites or requirements for health sciences programs. Due to the challenging nature of anatomy, each semester there are students remediating the course (enrolled in the course for a second time), attempting to earn a grade competitive for admissions into a program of study. In this retrospective study,…

  3. Ultrasound techniques in the evaluation of the mediastinum, part 2: mediastinal lymph node anatomy and diagnostic reach of ultrasound techniques, clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography

    PubMed Central

    Jenssen, Christian; Annema, Jouke Tabe; Clementsen, Paul; Cui, Xin-Wu; Borst, Mathias Maximilian

    2015-01-01

    Ultrasound imaging has gained importance in pulmonary medicine over the last decades including conventional transcutaneous ultrasound (TUS), endoscopic ultrasound (EUS), and endobronchial ultrasound (EBUS). Mediastinal lymph node (MLN) staging affects the management of patients with both operable and inoperable lung cancer (e.g., surgery vs. combined chemoradiation therapy). Tissue sampling is often indicated for accurate nodal staging. Recent international lung cancer staging guidelines clearly state that endosonography should be the initial tissue sampling test over surgical staging. Mediastinal nodes can be sampled from the airways [endobronchial ultrasound combined with transbronchial needle aspiration (EBUS-TBNA)] or the esophagus [endoscopic ultrasound fine needle aspiration (EUS-FNA)]. EBUS and EUS have a complementary diagnostic yield and in combination virtually all MLNs can be biopsied. Additionally endosonography has an excellent yield in assessing granulomas in patients suspected of sarcoidosis. The aim of this review in two integrative parts is to discuss the current role and future perspectives of all ultrasound techniques available for the evaluation of mediastinal lymphadenopathy and mediastinal staging of lung cancer. A specific emphasis will be on learning mediastinal endosonography. Part 1 deals with an introduction into ultrasound techniques, MLN anatomy and diagnostic reach of ultrasound techniques and part 2 with the clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography. PMID:26623120

  4. [Pandora's box of anatomy].

    PubMed

    Weinberg, Uri; Reis, Shmuel

    2008-05-01

    Physicians in Nazi Germany were among the first to join the Nazi party and the SS, and were considered passionate and active supporters of the regime. Their actions included development and implementation of the racial theory thus legitimizing the development of the Nazi genocide plan, leadership and execution of the sterilization and euthanasia programs as well as atrocious human experimentation. Nazi law allowed the use of humans and their remains in research institutions. One of the physicians whose involvement in the Nazi regime was particularly significant was Eduard Pernkopf. He was the head of the Anatomy Institute at the University of Vienna, and later became the president of the university. Pernkopf was a member of the Nazi party, promoted the idea of "racial hygiene", and in 1938, "purified" the university from all Jews. In Pernkopfs atlas of anatomy, the illustrators expressed their sympathy to Nazism by adding Nazi symbols to their illustrations. In light of the demand stated by the "Yad Vashem" Institute, the sources of the atlas were investigated. The report, which was published in 1998, determined that Pernkopfs Anatomy Institute received almost 1400 corpses from the Gestapo's execution chambers. Copies of Pernkopfs atlas, accidentally exposed at the Rappaport School of Medicine in the Technion, led to dilemmas concerning similar works with a common background. The books initiated a wide debate in Israel and abroad, regarding ethical aspects of using information originated in Nazi crimes. Moreover, these findings are evidence of the evil to which science and medicine can give rise, when they are captured as an unshakable authority. PMID:18770971

  5. Dynamic estimation of three-dimensional cerebrovascular deformation from rotational angiography

    SciTech Connect

    Zhang Chong; Villa-Uriol, Maria-Cruz; De Craene, Mathieu; and others

    2011-03-15

    Purpose: The objective of this study is to investigate the feasibility of detecting and quantifying 3D cerebrovascular wall motion from a single 3D rotational x-ray angiography (3DRA) acquisition within a clinically acceptable time and computing from the estimated motion field for the further biomechanical modeling of the cerebrovascular wall. Methods: The whole motion cycle of the cerebral vasculature is modeled using a 4D B-spline transformation, which is estimated from a 4D to 2D+t image registration framework. The registration is performed by optimizing a single similarity metric between the entire 2D+t measured projection sequence and the corresponding forward projections of the deformed volume at their exact time instants. The joint use of two acceleration strategies, together with their implementation on graphics processing units, is also proposed so as to reach computation times close to clinical requirements. For further characterizing vessel wall properties, an approximation of the wall thickness changes is obtained through a strain calculation. Results: Evaluation on in silico and in vitro pulsating phantom aneurysms demonstrated an accurate estimation of wall motion curves. In general, the error was below 10% of the maximum pulsation, even in the situation when substantial inhomogeneous intensity pattern was present. Experiments on in vivo data provided realistic aneurysm and vessel wall motion estimates, whereas in regions where motion was neither visible nor anatomically possible, no motion was detected. The use of the acceleration strategies enabled completing the estimation process for one entire cycle in 5-10 min without degrading the overall performance. The strain map extracted from our motion estimation provided a realistic deformation measure of the vessel wall. Conclusions: The authors' technique has demonstrated that it can provide accurate and robust 4D estimates of cerebrovascular wall motion within a clinically acceptable time, although it

  6. Resident perceptions of anatomy education: a survey of medical school alumni from two different anatomy curricula and multiple medical specialties.

    PubMed

    Bohl, Michael A; Gest, Thomas R

    2011-01-01

    In 2004, the University of Michigan Medical School reduced its gross anatomy curriculum. To determine the effect of this reduction on resident perceptions of their clinical preparedness, we surveyed alumni that included residents from the original and new shortened curricula. A Likert-scale survey was sent to four classes of alumni. Respondents were compared in old curriculum (OC) and new curriculum (NC) groups, surgical specialty (SS) and nonsurgical specialty (NS) groups, and subgroups of SS and NS were compared for differences between OC and NC. Mean response scores were compared using independent samples T-tests. As a single population (n = 110), respondents felt their anatomy education prepared them well for residency, that a more robust anatomy curriculum would be helpful, that dissection was important to their residency preparation, and that a 4th year anatomy elective was effective in expanding their anatomy education and preparing them for residency. No significant difference existed between OC and NC groups, neither as a whole nor as SS and NS subgroups. The SS group felt dissection was more important to their residency preparation than the NS group (P = 0.001) and that a more robust anatomy curriculum would have better prepared them for residency (P = 0.001). Thirty percent of SS respondents who did not take a 4th year elective commented that they wish they had. Fourth year anatomy electives were highly valued by residents, and respondents felt that they should be offered to students as a way of revisiting anatomy following the 1st year of clinical training. PMID:21381214

  7. How Much Anatomy Is Enough?

    ERIC Educational Resources Information Center

    Bergman, Esther M.; Prince, Katinka J. A. H.; Drukker, Jan; van der Vleuten, Cees P. M.; Scherpbier, Albert J. J. A.

    2008-01-01

    Innovations in undergraduate medical education, such as integration of disciplines and problem based learning, have given rise to concerns about students' knowledge of anatomy. This article originated from several studies investigating the knowledge of anatomy of students at the eight Dutch medical schools. The studies showed that undergraduate…

  8. Health Instruction Packages: Cardiac Anatomy.

    ERIC Educational Resources Information Center

    Phillips, Gwen; And Others

    Text, illustrations, and exercises are utilized in these five learning modules to instruct nurses, students, and other health care professionals in cardiac anatomy and functions and in fundamental electrocardiographic techniques. The first module, "Cardiac Anatomy and Physiology: A Review" by Gwen Phillips, teaches the learner to draw and label…

  9. The quail anatomy portal.

    PubMed

    Ruparelia, Avnika A; Simkin, Johanna E; Salgado, David; Newgreen, Donald F; Martins, Gabriel G; Bryson-Richardson, Robert J

    2014-01-01

    The Japanese quail is a widely used model organism for the study of embryonic development; however, anatomical resources are lacking. The Quail Anatomy Portal (QAP) provides 22 detailed three-dimensional (3D) models of quail embryos during development from embryonic day (E)1 to E15 generated using optical projection tomography. The 3D models provided can be virtually sectioned to investigate anatomy. Furthermore, using the 3D nature of the models, we have generated a tool to assist in the staging of quail samples. Volume renderings of each stage are provided and can be rotated to allow visualization from multiple angles allowing easy comparison of features both between stages in the database and between images or samples in the laboratory. The use of JavaScript, PHP and HTML ensure the database is accessible to users across different operating systems, including mobile devices, facilitating its use in the laboratory.The QAP provides a unique resource for researchers using the quail model. The ability to virtually section anatomical models throughout development provides the opportunity for researchers to virtually dissect the quail and also provides a valuable tool for the education of students and researchers new to the field. DATABASE URL: http://quail.anatomyportal.org (For review username: demo, password: quail123). PMID:24715219

  10. Radiological sinonasal anatomy

    PubMed Central

    Alrumaih, Redha A.; Ashoor, Mona M.; Obidan, Ahmed A.; Al-Khater, Khulood M.; Al-Jubran, Saeed A.

    2016-01-01

    Objectives: To assess the prevalence of common radiological variants of sinonasal anatomy among Saudi population and compare it with the reported prevalence of these variants in other ethnic and population groups. Methods: This is a retrospective cross-sectional study of 121 computerized tomography scans of the nose and paranasal sinuses of patients presented with sinonasal symptoms to the Department of Otorhinolarngology, King Fahad Hospital of the University, Khobar, Saudi Arabia, between January 2014 and May 2014. Results: Scans of 121 patients fulfilled inclusion criteria were reviewed. Concha bullosa was found in 55.4%, Haller cell in 39.7%, and Onodi cell in 28.9%. Dehiscence of the internal carotid artery was found in 1.65%. Type-1 and type-2 optic nerve were the prevalent types. Type-II Keros classification of the depth of olfactory fossa was the most common among the sample (52.9%). Frontal cells were found in 79.3%; type I was the most common. Conclusions: There is a difference in the prevalence of some radiological variants of the sinonasal anatomy between Saudi population and other study groups. Surgeon must pay special attention in the preoperative assessment of patients with sinonasal pathology to avoid undesirable complications. PMID:27146614

  11. Engineering theranostic nanovehicles capable of targeting cerebrovascular amyloid deposits.

    PubMed

    Agyare, Edward K; Jaruszewski, Kristen M; Curran, Geoffry L; Rosenberg, Jens T; Grant, Samuel C; Lowe, Val J; Ramakrishnan, Subramanian; Paravastu, Anant K; Poduslo, Joseph F; Kandimalla, Karunya K

    2014-07-10

    Cerebral amyloid angiopathy (CAA) is characterized by the deposition of amyloid beta (Aβ) proteins within the walls of the cerebral vasculature with subsequent aggressive vascular inflammation leading to recurrent hemorrhagic strokes. The objective of the study was to develop theranostic nanovehicles (TNVs) capable of a) targeting cerebrovascular amyloid; b) providing magnetic resonance imaging (MRI) contrast for the early detection of CAA; and c) treating cerebrovascular inflammation resulting from CAA. The TNVs comprised of a polymeric nanocore made from Magnevist (MRI contrast agent) conjugated chitosan. The nanocore was also loaded with cyclophosphamide (CYC), an immunosuppressant shown to reduce the cerebrovascular inflammation in CAA. Putrescine modified F(ab')2 fragment of anti-amyloid antibody, IgG4.1 (pF(ab')24.1) was conjugated to the surface of the nanocore to target cerebrovascular amyloid. The average size of the control chitosan nanoparticles (conjugated with albumin and are devoid of Magnevist, CYC, and pF(ab')24.1) was 164±1.2 nm and that of the TNVs was 239±4.1 nm. The zeta potential values of the CCNs and TNVs were 21.6±1.7 mV and 11.9±0.5 mV, respectively. The leakage of Magnevist from the TNVs was a modest 0.2% over 4 days, and the CYC release from the TNVs followed Higuchi's model that describes sustained drug release from polymeric matrices. The studies conducted in polarized human microvascular endothelial cell monolayers (hCMEC/D3) in vitro as well as in mice in vivo have demonstrated the ability of TNVs to target cerebrovascular amyloid. In addition, the TNVs provided contrast for imaging cerebrovascular amyloid using MRI and single photon emission computed tomography. Moreover, the TNVs were shown to reduce pro-inflammatory cytokine production by the Aβ challenged blood brain barrier (BBB) endothelium more effectively than the cyclophosphamide alone. PMID:24735640

  12. Aspirin failure in patients presenting with acute cerebrovascular ischaemia.

    PubMed

    Halawani, Saeed H M; Williams, David J P; Adefurin, Abiodun; Webster, John; Greaves, Michael; Ford, Isobel

    2011-08-01

    Aspirin is the most commonly used antiplatelet drug for prevention of ischaemic stroke. In order to determine the prevalence and nature of aspirin failure, we studied 51 adults admitted with suspected ischaemic stroke and already prescribed daily aspirin. Within 48 hours (h) of onset, blood and urine samples were collected to assess platelet aggregation, activation and aspirin response by a range of methods. All tests were then repeated on a second sample taken 24 h after witnessed administration of 75 mg or 150 mg aspirin. At entry to the study, incomplete response to aspirin, measured by arachidonic acid (AA)-stimulated platelet aggregation, was found in 43% of patients. Following in-hospital aspirin administration, there was a significant decrease in AA-aggregation (p=0.001) suggesting poor adherence to therapy prior to admission. However, residual aggregation (10-15%) persisted in 11 subjects - suggesting alternative causes. In incomplete responders on admission, platelet aggregation with adenosine diphosphate (ADP) was significantly higher compared with responders (p<0.05) but there were no significant differences in collagen aggregation, platelet fibrinogen binding or P-selectin expression, plasma von Willebrand factor, fibrinogen, high-sensitivity C-reactive protein, or the urinary metabolite, 11-dehydro-TxB2. Incomplete platelet inhibition is common around the time of acute cerebrovascular ischaemic events in patients prescribed aspirin. Up to 50% of these observations appear due to incomplete adherence to aspirin therapy. Intervention studies are required to determine the clinical relevance of measured platelet response to aspirin in terms of outcome, and the effectiveness of improved pharmacotherapy for stroke prevention. PMID:21544317

  13. Impact of breath holding on cardiovascular respiratory and cerebrovascular health.

    PubMed

    Dujic, Zeljko; Breskovic, Toni

    2012-06-01

    Human underwater breath-hold diving is a fascinating example of applied environmental physiology. In combination with swimming, it is one of the most popular forms of summer outdoor physical activities. It is performed by a variety of individuals ranging from elite breath-hold divers, underwater hockey and rugby players, synchronized and sprint swimmers, spear fishermen, sponge harvesters and up to recreational swimmers. Very few data currently exist concerning the influence of regular breath holding on possible health risks such as cerebrovascular, cardiovascular and respiratory diseases. A literature search of the PubMed electronic search engine using keywords 'breath-hold diving' and 'apnoea diving' was performed. This review focuses on recent advances in knowledge regarding possibly harmful physiological changes and/or potential health risks associated with breath-hold diving. Available evidence indicates that deep breath-hold dives can be very dangerous and can cause serious acute health problems such a collapse of the lungs, barotrauma at descent and ascent, pulmonary oedema and alveolar haemorrhage, cardiac arrest, blackouts, nitrogen narcosis, decompression sickness and death. Moreover, even shallow apnoea dives, which are far more frequent, can present a significant health risk. The state of affairs is disturbing as athletes, as well as recreational individuals, practice voluntary apnoea on a regular basis. Long-term health risks of frequent maximal breath holds are at present unknown, but should be addressed in future research. Clearly, further studies are needed to better understand the mechanisms related to the possible development or worsening of different clinical disorders in recreational or competitive breath holding and to determine the potential changes in training/competition regimens in order to prevent these adverse events. PMID:22574634

  14. Objective cardiac markers and cerebrovascular lesions in Indian seniors.

    PubMed

    Charles, Stephanie H; Tow, Amanda C; Verghese, Joe

    2014-09-01

    Cardiovascular risk factors are implicated in cerebrovascular disease, resulting in cognitive impairment. This study investigated the relationship between objective cardiac markers and cerebral changes in older Indian adults with and without dementia. Dementia patients with major electrocardiographic (EKG) abnormalities were 8.19 times more likely to have evidence of stroke on magnetic resonance imaging (MRI) compared with patients with no EKG abnormalities (p<.05). The relationship between major EKG abnormalities and stroke on MRI was not significant for patients without dementia. Objective cardiac markers may identify MRI cerebrovascular lesions in patients with dementia, and thus guide neuroimaging allocation in resource-poor areas. PMID:25107661

  15. Effects of Dietary Nitrates on Systemic and Cerebrovascular Hemodynamics

    PubMed Central

    Curry, Bryan H.; Adams, Richard G.; Asadi, M. Sadegh; Millis, Richard M.; Haddad, Georges E.

    2013-01-01

    Cerebral blood flow dysregulation is often associated with hypertension. We hypothesized that a beetroot juice (BRJ) treatment could decrease blood pressure and cerebrovascular resistance (CVR). We subjected 12 healthy females to control and BRJ treatments. Cerebrovascular resistance index (CVRI), systolic blood pressure (SBP), total vascular resistance (TVR), and the heart rate-systolic pressure product (RPP) measured at rest and at two exercise workloads were lower after the BRJ treatment. CVRI, SBP, and RPP were lower without a lower TVR at the highest exercise level. These findings suggest improved systemic and cerebral hemodynamics that could translate into a dietary treatment for hypertension. PMID:24455404

  16. Methodological inaccuracies in clinical aortic valve severity assessment: insights from computational fluid dynamic modeling of CT-derived aortic valve anatomy

    NASA Astrophysics Data System (ADS)

    Traeger, Brad; Srivatsa, Sanjay S.; Beussman, Kevin M.; Wang, Yechun; Suzen, Yildirim B.; Rybicki, Frank J.; Mazur, Wojciech; Miszalski-Jamka, Tomasz

    2016-04-01

    Aortic stenosis is the most common valvular heart disease. Assessing the contribution of the valve as a portion to total ventricular load is essential for the aging population. A CT scan for one patient was used to create one in vivo tricuspid aortic valve geometry and assessed with computational fluid dynamics (CFD). CFD simulated the pressure, velocity, and flow rate, which were used to assess the Gorlin formula and continuity equation, current clinical diagnostic standards. The results demonstrate an underestimation of the anatomic orifice area (AOA) by Gorlin formula and overestimation of AOA by the continuity equation, using peak velocities, as would be measured clinically by Doppler echocardiography. As a result, we suggest that the Gorlin formula is unable to achieve the intended estimation of AOA and largely underestimates AOA at the critical low-flow states present in heart failure. The disparity in the use of echocardiography with the continuity equation is due to the variation in velocity profile between the outflow tract and the valve orifice. Comparison of time-averaged orifice areas by Gorlin and continuity with instantaneous orifice areas by planimetry can mask the errors of these methods, which is a result of the assumption that the blood flow is inviscid.

  17. Browsing Software of the Visible Korean Data Used for Teaching Sectional Anatomy

    ERIC Educational Resources Information Center

    Shin, Dong Sun; Chung, Min Suk; Park, Hyo Seok; Park, Jin Seo; Hwang, Sung Bae

    2011-01-01

    The interpretation of computed tomographs (CTs) and magnetic resonance images (MRIs) to diagnose clinical conditions requires basic knowledge of sectional anatomy. Sectional anatomy has traditionally been taught using sectioned cadavers, atlases, and/or computer software. The computer software commonly used for this subject is practical and…

  18. A Cross-Cultural Comparison of Anatomy Learning: Learning Styles and Strategies

    ERIC Educational Resources Information Center

    Mitchell, Barry S.; Xu, Qin; Jin, Lixian; Patten, Debra; Gouldsborough, Ingrid

    2009-01-01

    Cultural influences on anatomy teaching and learning have been investigated by application of a questionnaire to medical students in British and Chinese Medical Schools. Results from the responses from students of the two countries were analyzed. Both groups found it easier to understand anatomy in a clinical context, and in both countries,…

  19. Neuroimaging Assessment of Cerebrovascular Reactivity in Concussion: Current Concepts, Methodological Considerations, and Review of the Literature

    PubMed Central

    Ellis, Michael J.; Ryner, Lawrence N.; Sobczyk, Olivia; Fierstra, Jorn; Mikulis, David J.; Fisher, Joseph A.; Duffin, James; Mutch, W. Alan C.

    2016-01-01

    Concussion is a form of traumatic brain injury (TBI) that presents with a wide spectrum of subjective symptoms and few objective clinical findings. Emerging research suggests that one of the processes that may contribute to concussion pathophysiology is dysregulation of cerebral blood flow (CBF) leading to a mismatch between CBF delivery and the metabolic needs of the injured brain. Cerebrovascular reactivity (CVR) is defined as the change in CBF in response to a measured vasoactive stimulus. Several magnetic resonance imaging (MRI) techniques can be used as a surrogate measure of CBF in clinical and laboratory studies. In order to provide an accurate assessment of CVR, these sequences must be combined with a reliable, reproducible vasoactive stimulus that can manipulate CBF. Although CVR imaging currently plays a crucial role in the diagnosis and management of many cerebrovascular diseases, only recently have studies begun to apply this assessment tool in patients with concussion. In order to evaluate the quality, reliability, and relevance of CVR studies in concussion, it is important that clinicians and researchers have a strong foundational understanding of the role of CBF regulation in health, concussion, and more severe forms of TBI, and an awareness of the advantages and limitations of currently available CVR measurement techniques. Accordingly, in this review, we (1) discuss the role of CVR in TBI and concussion, (2) examine methodological considerations for MRI-based measurement of CVR, and (3) provide an overview of published CVR studies in concussion patients. PMID:27199885

  20. Cerebrovascular function and cognition in childhood: a systematic review of transcranial doppler studies

    PubMed Central

    2014-01-01

    Background The contribution of cerebrovascular function to cognitive performance is gaining increased attention. Transcranial doppler (TCD) is portable, reliable, inexpensive and extremely well tolerated by young and clinical samples. It enables measurement of blood flow velocity in major cerebral arteries at rest and during cognitive tasks. Methods We systematically reviewed evidence for associations between cognitive performance and cerebrovascular function in children (0-18 years), as measured using TCD. A total of 2778 articles were retrieved from PsychInfo, Pubmed, and EMBASE searches and 25 relevant articles were identified. Results Most studies investigated clinical groups, where decreased blood flow velocities in infants were associated with poor neurological functioning, and increased blood flow velocities in children with Sickle cell disease were typically associated with cognitive impairment and lower intelligence. Studies were also identified assessing autistic behaviour, mental retardation and sleep disordered breathing. In healthy children, the majority of studies reported cognitive processing produced lateralised changes in blood flow velocities however these physiological responses did not appear to correlate with behavioural cognitive performance. Conclusion Poor cognitive performance appears to be associated with decreased blood flow velocities in premature infants, and increased velocities in Sickle cell disease children using TCD methods. However knowledge in healthy samples is relatively limited. The technique is well tolerated by children, is portable and inexpensive. It therefore stands to make a valuable contribution to knowledge regarding the underlying functional biology of cognitive performance in childhood. PMID:24602446

  1. Pleura space anatomy

    PubMed Central

    Charalampidis, Charalampos; Youroukou, Andrianna; Lazaridis, George; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Papaiwannou, Antonis; Karavergou, Anastasia; Tsakiridis, Kosmas; Katsikogiannis, Nikolaos; Sarika, Eirini; Kapanidis, Konstantinos; Sakkas, Leonidas; Korantzis, Ipokratis; Lampaki, Sofia; Zarogoulidis, Konstantinos

    2015-01-01

    The pleural cavity is the potential space between the two pleurae (visceral and parietal) of the lungs. The pleurae are serous membranes which fold back onto themselves to form a two-layered membranous structure. The thin space between the two pleural layers is known as the pleural cavity and normally contains a small amount of pleural fluid. There are two layers; the outer pleura (parietal pleura) is attached to the chest wall and the inner pleura (visceral pleura) covers the lungs and adjoining structures, via blood vessels, bronchi and nerves. The parietal pleurae are highly sensitive to pain, while the visceral pleura are not, due to its lack of sensory innervation. In the current review we will present the anatomy of the pleural space. PMID:25774304

  2. The Anatomy of Galaxies

    NASA Astrophysics Data System (ADS)

    D'Onofrio, Mauro; Rampazzo, Roberto; Zaggia, Simone; Longair, Malcolm S.; Ferrarese, Laura; Marziani, Paola; Sulentic, Jack W.; van der Kruit, Pieter C.; Laurikainen, Eija; Elmegreen, Debra M.; Combes, Françoise; Bertin, Giuseppe; Fabbiano, Giuseppina; Giovanelli, Riccardo; Calzetti, Daniela; Moss, David L.; Matteucci, Francesca; Djorgovski, Stanislav George; Fraix-Burnet, Didier; Graham, Alister W. McK.; Tully, Brent R.

    Just after WWII Astronomy started to live its "Golden Age", not differently to many other sciences and human activities, especially in the west side countries. The improved resolution of telescopes and the appearance of new efficient light detectors (e.g. CCDs in the middle eighty) greatly impacted the extragalactic researches. The first morphological analysis of galaxies were rapidly substituted by "anatomic" studies of their structural components, star and gas content, and in general by detailed investigations of their properties. As for the human anatomy, where the final goal was that of understanding the functionality of the organs that are essential for the life of the body, galaxies were dissected to discover their basic structural components and ultimately the mystery of their existence.

  3. Mechanisms of Heart Block after Transcatheter Aortic Valve Replacement – Cardiac Anatomy, Clinical Predictors and Mechanical Factors that Contribute to Permanent Pacemaker Implantation

    PubMed Central

    Young Lee, Mark; Chilakamarri Yeshwant, Srinath; Chava, Sreedivya; Lawrence Lustgarten, Daniel

    2015-01-01

    Transcatheter aortic valve replacement (TAVR) has emerged as a valuable, minimally invasive treatment option in patients with symptomatic severe aortic stenosis at prohibitive or increased risk for conventional surgical replacement. Consequently, patients undergoing TAVR are prone to peri-procedural complications including cardiac conduction disturbances, which is the focus of this review. Atrioventricular conduction disturbances and arrhythmias before, during or after TAVR remain a matter of concern for this high-risk group of patients, as they have important consequences on hospital duration, short- and long-term medical management and finally on decisions of device-based treatment strategies (pacemaker or defibrillator implantation). We discuss the mechanisms of atrioventricular disturbances and characterise predisposing factors. Using validated clinical predictors, we discuss strategies to minimise the likelihood of creating permanent high-grade heart block, and identify factors to expedite the decision to implant a permanent pacemaker when the latter is unavoidable. We also discuss optimal pacing strategies to mitigate the possibility of pacing-induced cardiomyopathy. PMID:26835105

  4. Subjective and objective knowledge and decisional role preferences in cerebrovascular patients compared to controls

    PubMed Central

    Riechel, Christina; Alegiani, Anna Christina; Köpke, Sascha; Kasper, Jürgen; Rosenkranz, Michael; Thomalla, Götz; Heesen, Christoph

    2016-01-01

    Background Risk knowledge and active role preferences are important for patient involvement in treatment decision-making and adherence. Although knowledge about stroke warning signs and risk factors has received considerable attention, objective knowledge on secondary prevention and further self-esteem subjective knowledge have rarely been studied. The aim of our study was to investigate knowledge and treatment decisional role preferences in cerebrovascular patients compared to controls. Methods We performed a survey on subjective and objective stroke risk knowledge and autonomy preferences in cerebrovascular patients from our stroke outpatient clinic (n=262) and from pedestrians on the street taken as controls during a “World Stroke Day” (n=274). The questionnaire includes measures for knowledge and decisional role preferences from previously published questionnaires and newly developed measures, for example, subjective knowledge, revealed on a visual analog scale. Results The overall stroke knowledge was low to moderate, with no differences between patients and controls. Knowledge about secondary prevention was particularly low. Only 10%–15% of participants correctly estimated the stroke absolute risk reduction potential of aspirin. The medical data interpretation competence was moderate in both groups. Age and basic mathematical and statistical understanding (numeracy) were the only independent predictors of objective stroke knowledge, whereas previous stroke had no impact on stroke knowledge. However, patients were thought to be better informed than controls. Approximately 60% of both patients and controls claimed to prefer a shared decision-making approach in treatment decisions. Conclusion The level of stroke risk knowledge in patients with cerebrovascular diseases was as low as in randomly selected pedestrians, although patients felt better informed. Both groups preferred involvement in treatment decision-making. We conclude that educational concepts

  5. [Surgery without anatomy?].

    PubMed

    Stelzner, F

    2016-08-01

    Anatomy is the basis of all operative medicine. While this branch of scientific medicine is frequently not explicitly mentioned in surgical publications, it is nonetheless quintessential to medical education. In the era of video sequences and digitized images, surgical methods are frequently communicated in the form of cinematic documentation of surgical procedures; however, this occurs without the help of explanatory drawings or subtexts that would illustrate the underlying anatomical nomenclature, comment on fine functionally important details or even without making any mention of the surgeon. In scientific manuscripts color illustrations frequently appear in such overwhelming quantities that they resemble long arrays of trophies but fail to give detailed explanations that would aid the therapeutic translation of the novel datasets. In a similar fashion, many anatomy textbooks prefer to place emphasis on illustrations and photographs while supplying only a paucity of explanations that would foster the understanding of functional contexts and thus confuse students and practitioners alike. There is great temptation to repeat existing data and facts over and over again, while it is proportionally rare to make reference to truly original scientific discoveries. A number of examples are given in this article to illustrate how discoveries that were made even a long time ago can still contribute to scientific progress in current times. This includes the NO signaling molecules, which were first described in 1775 but were only discovered to have a pivotal role as neurotransmitters in the function of human paradoxical sphincter muscles in 2012 and 2015. Readers of scientific manuscripts often long for explanations by the numerous silent coauthors of a publication who could contribute to the main topic by adding in-depth illustrations (e. g. malignograms, evolution and involution of lymph node structures). PMID:27251482

  6. Immunotherapy of cerebrovascular amyloidosis in a transgenic mouse model.

    PubMed

    Lifshitz, Veronica; Weiss, Ronen; Benromano, Tali; Kfir, Einat; Blumenfeld-Katzir, Tamar; Tempel-Brami, Catherine; Assaf, Yaniv; Xia, Weiming; Wyss-Coray, Tony; Weiner, Howard L; Frenkel, Dan

    2012-02-01

    Cerebrovascular amyloidosis is caused by amyloid accumulation in walls of blood vessel walls leading to hemorrhagic stroke and cognitive impairment. Transforming growth factor-β1 (TGF-β1) expression levels correlate with the degree of cerebrovascular amyloid deposition in Alzheimer's disease (AD) and TGF-β1 immunoreactivity in such cases is increased along the cerebral blood vessels. Here we show that a nasally administered proteosome-based adjuvant activates macrophages and decreases vascular amyloid in TGF-β1 mice. Animals were nasally treated with a proteosome-based adjuvant on a weekly basis for 3 months beginning at age 13 months. Using magnetic resonance imaging (MRI) we found that while control animals showed a significant cerebrovascular pathology, proteosome-based adjuvant prevents further brain damage and prevents pathological changes in the blood-brain barrier. Using an object recognition test and Y-maze, we found significant improvement in cognition in the treated group. Our findings support the potential use of a macrophage immunomodulator as a novel approach to reduce cerebrovascular amyloid, prevent microhemorrhage, and improve cognition. PMID:21371785

  7. Cerebrovascular contributions to aging and Alzheimer's disease in Down syndrome.

    PubMed

    Wilcock, Donna M; Schmitt, Frederick A; Head, Elizabeth

    2016-05-01

    Down syndrome (DS) is a common cause of intellectual disability and is also associated with early age of onset of Alzheimer's disease (AD). Due to an extra copy of chromosome 21, most adults over 40years old with DS have beta-amyloid plaques as a result of overexpression of the amyloid precursor protein. Cerebrovascular pathology may also be a significant contributor to neuropathology observed in the brains of adults with DS. This review describes the features of cardiovascular dysfunction and cerebrovascular pathology in DS that may be modifiable risk factors and thus targets for interventions. We will describe cerebrovascular pathology, the role of co-morbidities, imaging studies indicating vascular pathology and the possible consequences. It is clear that our understanding of aging and AD in people with DS will benefit from further studies to determine the role that cerebrovascular dysfunction contributes to cognitive health. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. PMID:26593849

  8. Lesions of nucleus tractus solitarii globally impair cerebrovascular autoregulation

    SciTech Connect

    Ishitsuka, T.; Iadecola, C.; Underwood, M.D.; Reis, D.J.

    1986-08-01

    The authors studied the effects of acute bilateral electrolytic lesions of the nucleus tractus solitarii (NTS) on regional cerebral blood flow (rCBF) and its autoregulation in rats anesthetized, paralyzed, and artificially ventilated. rCBF or regional cerebral glucose utilization (rCGU) was measured 30 min after NTS lesions, by the UC-iodoantipyrine technique or 2-deoxyglucose method, respectively. Cerebrovascular autoregulation was assessed in groups of 4-5 rats at three levels of arterial pressure (AP):90, 125, and 140 mmHg. AP was lowered by hemorrhage or elevated by intravenous infusion of phenylephrine. NTS lesions did not alter rCBF at 125 mmHg but resulted in loss of autoregulation. In contrast, lesions of the cuneate nucleus or transection of the baroreceptor afferents did not alter autoregulation. NTS lesions did not affect the reactivity of the cerebrovascular bed to hypercarbia or hypocarbia nor the rCGU in any brain regions. They conclude that lesions of the NTS impair cerebrovascular autoregulation. The effect is not due to changes in metabolism, nonspecific effects of the lesions, vasoparalysis, or interruption of the baroreceptor reflex arch. Neural pathways originating in or passing through the NTS can regulate the cerebrovascular autoregulation of the entire brain.

  9. The anatomy of clinical decision-making in multidisciplinary cancer meetings: A cross-sectional observational study of teams in a natural context.

    PubMed

    Soukup, Tayana; Petrides, Konstantinos V; Lamb, Benjamin W; Sarkar, Somita; Arora, Sonal; Shah, Sujay; Darzi, Ara; Green, James S A; Sevdalis, Nick

    2016-06-01

    In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable.The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision.This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons.We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis.The exploratory factor analysis produced 4 factors, labeled "Holistic and Clinical inputs" (patient views, psychosocial aspects, patient history, comorbidities, oncologists', nurses', and surgeons' inputs), "Radiology" (radiology results, radiologists' inputs), "Pathology" (pathology results, pathologists' inputs), and "Meeting Management" (meeting chairs' and coordinators' inputs). A negative cross-loading was observed from surgeons' input on the fourth factor with a follow-up analysis showing negative correlation (r = -0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001).Hawthorne effect is the main limitation of the study.The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient profile and contributions to case review by all core disciplines. Evidence of dual-task interference was

  10. [The French lessons of anatomy].

    PubMed

    Bouchet, Alain

    2003-01-01

    The "Lessons of Anatomy" can be considered as a step of Medicine to Art. For several centuries the exhibition of a corpse's dissection was printed on the title-page of published works. Since the seventeenth century, the "Lessons of Anatomy" became a picture on the title-page in order to highlight the well-known names of the european anatomists. The study is limited to the French Lessons of Anatomy found in books or pictures after the invention of printing. PMID:14626253

  11. The Vulnerability of Vessels Involved in the Role of Embolism and Hypoperfusion in the Mechanisms of Ischemic Cerebrovascular Diseases

    PubMed Central

    2016-01-01

    Accurate definition and better understanding of the mechanisms of stroke are crucial as this will guide the effective care and therapy. In this paper, we review the previous basic and clinical researches on the causes or mechanisms of ischemic cerebrovascular diseases (ICVD) and interpret the correlation between embolism and hypoperfusion based on vascular stenosis and arterial intimal lesions. It was suggested that if there is no embolus (dynamic or in situ emboli), there might be no cerebral infarction. Three kinds of different clinical outcomes of TIA were theoretically interpreted based on its mechanisms. We suppose that there is a correlation between embolism and hypoperfusion, and which mechanisms (hypoperfusion or hypoperfusion induced microemboli) playing the dominant role in each type of ICVD depends on the unique background of arterial intimal lesions (the vulnerability of vessels). That is to say, the vulnerability of vessels is involved in the role of embolism and hypoperfusion in the mechanisms of ischemic cerebrovascular diseases. This inference might enrich and provide better understandings for the underlying etiologies of ischemic cerebrovascular events. PMID:27314040

  12. Chronic Pancreatitis Correlates With Increased Risk of Cerebrovascular Disease

    PubMed Central

    Wong, Tuck-Siu; Liao, Kuan-Fu; Lin, Chi-Ming; Lin, Cheng-Li; Chen, Wen-Chi; Lai, Shih-Wei

    2016-01-01

    Abstract The aim of this study is to explore whether there is a relationship between chronic pancreatitis and cerebrovascular disease in Taiwan. Using the claims data of the Taiwan National Health Insurance Program, we identified 16,672 subjects aged 20 to 84 years with a new diagnosis of chronic pancreatitis from 2000 to 2010 as the chronic pancreatitis group. We randomly selected 65,877 subjects aged 20 to 84 years without chronic pancreatitis as the nonchronic pancreatitis group. Both groups were matched by sex, age, comorbidities, and the index year of diagnosing chronic pancreatitis. The incidence of cerebrovascular disease at the end of 2011 was measured. The multivariable Cox proportional hazards regression model was used to measure the hazard ratio (HR) and 95% confidence interval (CI) for cerebrovascular disease risk associated with chronic pancreatitis and other comorbidities. The overall incidence of cerebrovascular disease was 1.24-fold greater in the chronic pancreatitis group than that in the nonchronic pancreatitis group (14.2 vs. 11.5 per 1000 person-years, 95% CI = 1.19–1.30). After controlling for confounding factors, the adjusted HR of cerebrovascular disease was 1.27 (95% CI = 1.19–1.36) for the chronic pancreatitis group as compared with the nonchronic pancreatitis group. Woman (adjusted HR = 1.41, 95% CI = 1.31–1.51), age (every 1 year, HR = 1.04, 95% CI = 1.04–1.05), atrial fibrillation (adjusted HR = 1.23, 95% CI = 1.02–1.48), chronic kidney disease (adjusted HR = 1.48, 95% CI = 1.31–1.67), chronic obstructive pulmonary disease (adjusted HR = 1.27, 95% CI = 1.16–1.40), diabetes mellitus (adjusted HR = 1.82, 95% CI = 1.72–1.92), hypertension (adjusted HR = 1.66, 95% CI = 1.56–1.76), and peripheral atherosclerosis (adjusted HR = 1.26, 95% CI = 1.06–1.51) were other factors significantly associated with cerebrovascular disease. Chronic pancreatitis is

  13. Mutational anatomy of an HIV-1 protease variant conferring cross-resistance to protease inhibitors in clinical trials. Compensatory modulations of binding and activity.

    PubMed

    Schock, H B; Garsky, V M; Kuo, L C

    1996-12-13

    Site-specific substitutions of as few as four amino acids (M46I/L63P/V82T/I84V) of the human immunodeficiency virus type 1 (HIV-1) protease engenders cross-resistance to a panel of protease inhibitors that are either in clinical trials or have recently been approved for HIV therapy (Condra, J. H., Schleif, W. A., Blahy, O. M. , Gadryelski, L. J., Graham, D. J., Quintero, J. C., Rhodes, A., Robbins, H. L., Roth, E., Shivaprakash, M., Titus, D., Yang, T., Teppler, H., Squires, K. E., Deutsch, P. J., and Emini, E. A. (1995) Nature 374, 569-571). These four substitutions are among the prominent mutations found in primary HIV isolates obtained from patients undergoing therapy with several protease inhibitors. Two of these mutations (V82T/I84V) are located in, while the other two (M46I/L63P) are away from, the binding cleft of the enzyme. The functional role of these mutations has now been delineated in terms of their influence on the binding affinity and catalytic efficiency of the protease. We have found that the double substitutions of M46I and L63P do not affect binding but instead endow the enzyme with a catalytic efficiency significantly exceeding (110-360%) that of the wild-type enzyme. In contrast, the double substitutions of V82T and I84V are detrimental to the ability of the protease to bind and, thereby, to catalyze. When combined, the four amino acid replacements institute in the protease resistance against inhibitors and a significantly higher catalytic activity than one containing only mutations in its active site. The results suggest that in raising drug resistance, these four site-specific mutations of the protease are compensatory in function; those in the active site diminish equilibrium binding (by increasing Ki), and those away from the active site enhance catalysis (by increasing kcat/KM). This conclusion is further supported by energy estimates in that the Gibbs free energies of binding and catalysis for the quadruple mutant are quantitatively

  14. Hallux Rigidus: Relevant Anatomy and Pathophysiology.

    PubMed

    Lucas, Douglas E; Hunt, Kenneth J

    2015-09-01

    Hallux rigidus is a painful condition of the great toe characterized by restriction of the metatarsophalangeal joint arc of motion and progressive osteophyte formation. Precise cause of hallux rigidus remains under debate. Anatomic variations and historical, clinical, and radiographic findings have been implicated in the development and progression of hallux rigidus. Radiologic findings associated with hallux rigidus include metatarsal head osteochondral defects, altered metatarsal head morphology, and an elevated hallux interphalangeus angle measure. Associated historical findings include a positive family history and history of trauma to the joint. An understanding of relevant anatomy and pathophysiology is essential during the approach to hallux rigidus treatment. PMID:26320553

  15. OLFACTION: ANATOMY, PHYSIOLOGY AND BEHAVIOR

    EPA Science Inventory

    The anatomy, physiology and function of the olfactory system are reviewed, as are the normal effects of olfactory stimulation. It is speculated that olfaction may have important but unobtrusive effects on human behavior.

  16. Integrating Radiology and Anatomy Teaching in Medical Education in the UK--The Evidence, Current Trends, and Future Scope.

    PubMed

    Heptonstall, N B; Ali, T; Mankad, K

    2016-04-01

    This review article presents the current evidence of the importance of integrating radiology and anatomy in medical education in the UK, a recommendation by a number of key anatomy, education, and radiology organizations. Current evidence highlights that on average only 5% of total teaching time in medical education is dedicated to radiology. Often, radiology teaching does not adequately fulfill students' learning needs and potentially leaves them underprepared for medical practice. Benefits of integrating radiology and anatomy include improved clinical application of anatomy, an increase in student's interest in anatomy, and ultimately improved radiological interpretation. Various modalities exist for the integration of radiology and anatomy, facilitated by the vast portability of radiological images. It appears that combining radiological resources with traditional anatomy teaching methodology in a blended approach is most beneficial. PMID:26970390

  17. Surgical Anatomy of the Eyelids.

    PubMed

    Sand, Jordan P; Zhu, Bovey Z; Desai, Shaun C

    2016-05-01

    Slight alterations in the intricate anatomy of the upper and lower eyelid or their underlying structures can have pronounced consequences for ocular esthetics and function. The understanding of periorbital structures and their interrelationships continues to evolve and requires consideration when performing complex eyelid interventions. Maintaining a detailed appreciation of this region is critical to successful cosmetic or reconstructive surgery. This article presents a current review of the anatomy of the upper and lower eyelid with a focus on surgical implications. PMID:27105794

  18. Current Perspectives on the Beneficial Role of Ginkgo biloba in Neurological and Cerebrovascular Disorders

    PubMed Central

    Nash, Kevin M.; Shah, Zahoor A.

    2015-01-01

    Ginkgo biloba extract is an alternative medicine available as a standardized formulation, EGb 761®, which consists of ginkgolides, bilobalide, and flavonoids. The individual constituents have varying therapeutic mechanisms that contribute to the pharmacological activity of the extract as a whole. Recent studies show anxiolytic properties of ginkgolide A, migraine with aura treatment by ginkgolide B, a reduction in ischemia-induced glutamate excitotoxicity by bilobalide, and an alternative antihypertensive property of quercetin, among others. These findings have been observed in EGb 761 as well and have led to clinical investigation into its use as a therapeutic for conditions such as cognition, dementia, cardiovascular, and cerebrovascular diseases. This review explores the therapeutic mechanisms of the individual EGb 761 constituents to explain the pharmacology as a whole and its clinical application to cardiovascular and neurological disorders, in particular ischemic stroke. PMID:26604665

  19. High-intensity interval exercise and cerebrovascular health: curiosity, cause, and consequence

    PubMed Central

    Lucas, Samuel J E; Cotter, James D; Brassard, Patrice; Bailey, Damian M

    2015-01-01

    Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimize health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This review critiques the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. We highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimize exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the aging brain have the potential to prevent stroke and associated neurovascular diseases. PMID:25833341

  20. Essential role for smooth muscle BK channels in alcohol-induced cerebrovascular constriction

    NASA Astrophysics Data System (ADS)

    Liu, Pengchong; Xi, Qi; Ahmed, Abu; Jaggar, Jonathan H.; Dopico, Alejandro M.

    2004-12-01

    Binge drinking is associated with increased risk for cerebrovascular spasm and stroke. Acute exposure to ethanol at concentrations obtained during binge drinking constricts cerebral arteries in several species, including humans, but the mechanisms underlying this action are largely unknown. In a rodent model, we used fluorescence microscopy, patch-clamp electrophysiology, and pharmacological studies in intact cerebral arteries to pinpoint the molecular effectors of ethanol cerebrovascular constriction. Clinically relevant concentrations of ethanol elevated wall intracellular Ca2+ concentration and caused a reversible constriction of cerebral arteries (EC50 = 27 mM; Emax = 100 mM) that depended on voltage-gated Ca2+ entry into myocytes. However, ethanol did not directly increase voltage-dependent Ca2+ currents in isolated myocytes. Constriction occurred because of an ethanol reduction in the frequency (-53%) and amplitude (-32%) of transient Ca2+-activated K+ (BK) currents. Ethanol inhibition of BK transients was caused by a reduction in Ca2+ spark frequency (-49%), a subsarcolemmal Ca2+ signal that evokes the BK transients, and a direct inhibition of BK channel steady-state activity (-44%). In contrast, ethanol failed to modify Ca2+ waves, a major vasoconstrictor mechanism. Selective block of BK channels largely prevented ethanol constriction in pressurized arteries. This study pinpoints the Ca2+ spark/BK channel negative-feedback mechanism as the primary effector of ethanol vasoconstriction.

  1. The role of cerebrovascular disease when there is concomitant Alzheimer disease.

    PubMed

    Vemuri, Prashanthi; Knopman, David S

    2016-05-01

    Cerebrovascular Pathologies (CVP) are the most common co-existent pathologies observed in conjunction with Alzheimer disease. CVP rarely exists in isolation in later life, and CVP most likely plays a supporting role, rather than a sole leading role, in the pathogenesis of dementia. Our goal is to illustrate CVP's role using neuroimaging biomarkers. First, we discuss the frequency of CVP and present data from population-based Mayo Clinic Study of Aging. Here, we used a novel metric for identifying individuals with cerebrovascular imaging abnormalities (that we designate as "V+") and present the frequency of V-/V+ in the context of absence and presence of β-amyloid elevation (designated A-/A+). Next, we discuss the contribution of CVP to neurodegeneration and use hippocampal volume loss over time in a subset of participants categorized as A-V-, A-V+, A+V-, A+V+. Lastly, we discuss the contribution of CVP to cognitive impairment and conclude with the considerations for design of future studies. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. PMID:26408957

  2. Pharmacologically targeted NMDA receptor antagonism by NitroMemantine for cerebrovascular disease

    PubMed Central

    Takahashi, Hiroto; Xia, Peng; Cui, Jiankun; Talantova, Maria; Bodhinathan, Karthik; Li, Wenjun; Holland, Emily A.; Tong, Gary; Piña-Crespo, Juan; Zhang, Dongxian; Nakanishi, Nobuki; Larrick, James W.; McKercher, Scott R.; Nakamura, Tomohiro; Wang, Yuqiang; Lipton, Stuart A.

    2015-01-01

    Stroke and vascular dementia are leading causes of morbidity and mortality. Neuroprotective therapies have been proposed but none have proven clinically tolerated and effective. While overstimulation of N-methyl-d-aspartate-type glutamate receptors (NMDARs) is thought to contribute to cerebrovascular insults, the importance of NMDARs in physiological function has made this target, at least in the view of many in ‘Big Pharma,’ ‘undruggable’ for this indication. Here, we describe novel NitroMemantine drugs, comprising an adamantane moiety that binds in the NMDAR-associated ion channel that is used to target a nitro group to redox-mediated regulatory sites on the receptor. The NitroMemantines are both well tolerated and effective against cerebral infarction in rodent models via a dual allosteric mechanism of open-channel block and NO/redox modulation of the receptor. Targeted S-nitrosylation of NMDARs by NitroMemantine is potentiated by hypoxia and thereby directed at ischemic neurons. Allosteric approaches to tune NMDAR activity may hold therapeutic potential for cerebrovascular disorders. PMID:26477507

  3. Elevated adiponectin prevents HIV protease inhibitor toxicity and preserves cerebrovascular homeostasis in mice.

    PubMed

    Dasuri, Kalavathi; Pepping, Jennifer K; Fernandez-Kim, Sun-Ok; Gupta, Sunita; Keller, Jeffrey N; Scherer, Philipp E; Bruce-Keller, Annadora J

    2016-06-01

    HIV protease inhibitors are key components of HIV antiretroviral therapies, which are fundamental in the treatment of HIV infection. However, the protease inhibitors are well-known to induce metabolic dysfunction which can in turn escalate the complications of HIV, including HIV associated neurocognitive disorders. As experimental and epidemiological data support a therapeutic role for adiponectin in both metabolic and neurologic homeostasis, this study was designed to determine if increased adiponectin could prevent the detrimental effects of protease inhibitors in mice. Adult male wild type (WT) and adiponectin-overexpressing (ADTg) mice were thus subjected to a 4-week regimen of lopinavir/ritonavir, followed by comprehensive metabolic, neurobehavioral, and neurochemical analyses. Data show that lopinavir/ritonavir-induced lipodystrophy, hypoadiponectinemia, hyperglycemia, hyperinsulinemia, and hypertriglyceridemia were attenuated in ADTg mice. Furthermore, cognitive function and blood-brain barrier integrity were preserved, while loss of cerebrovascular markers and white matter injury were prevented in ADTg mice. Finally, lopinavir/ritonavir caused significant increases in expression of markers of brain inflammation and decreases in synaptic markers in WT, but not in ADTg mice. Collectively, these data reinforce the pathophysiologic link from metabolic dysfunction to loss of cerebrovascular and cognitive homeostasis; and suggest that preservation and/or replacement of adiponectin could prevent these key aspects of HIV protease inhibitor-induced toxicity in clinical settings. PMID:26912411

  4. Outcomes of a Rotational Dissection System in Gross Anatomy

    ERIC Educational Resources Information Center

    Marshak, David W.; Oakes, Joanne; Hsieh, Pei-Hsuan; Chuang, Alice Z.; Cleary, Leonard J.

    2015-01-01

    At the University of Texas Houston Medical School, a rotational dissection system was introduced to improve coordination between the Gross Anatomy and the Introduction to Clinical Medicine (ICM) courses. Six students were assigned to each cadaver and divided into two teams. For each laboratory, one team was assigned to dissect and the other to…

  5. Development of a Synergistic Case-Based Micro anatomy Curriculum

    ERIC Educational Resources Information Center

    McBride, Jennifer M.; Prayson, Richard A.

    2008-01-01

    This paper discusses the development of an interactive approach to teaching and assessing a micro anatomy curriculum in an innovative medical school program. As an alternative to lectures and labs, students are engaged in interactive seminars focused on discussion of clinical and research-based cases matched with normal histology and pathology…

  6. Anatomy of an incident

    DOE PAGESBeta

    Cournoyer, Michael E.; Trujillo, Stanley; Lawton, Cindy M.; Land, Whitney M.; Schreiber, Stephen B.

    2016-03-23

    A traditional view of incidents is that they are caused by shortcomings in human competence, attention, or attitude. It may be under the label of “loss of situational awareness,” procedure “violation,” or “poor” management. A different view is that human error is not the cause of failure, but a symptom of failure – trouble deeper inside the system. In this perspective, human error is not the conclusion, but rather the starting point of investigations. During an investigation, three types of information are gathered: physical, documentary, and human (recall/experience). Through the causal analysis process, apparent cause or apparent causes are identifiedmore » as the most probable cause or causes of an incident or condition that management has the control to fix and for which effective recommendations for corrective actions can be generated. A causal analysis identifies relevant human performance factors. In the following presentation, the anatomy of a radiological incident is discussed, and one case study is presented. We analyzed the contributing factors that caused a radiological incident. When underlying conditions, decisions, actions, and inactions that contribute to the incident are identified. This includes weaknesses that may warrant improvements that tolerate error. Measures that reduce consequences or likelihood of recurrence are discussed.« less

  7. Penile embryology and anatomy.

    PubMed

    Yiee, Jenny H; Baskin, Laurence S

    2010-01-01

    Knowledge of penile embryology and anatomy is essential to any pediatric urologist in order to fully understand and treat congenital anomalies. Sex differentiation of the external genitalia occurs between the 7th and 17th weeks of gestation. The Y chromosome initiates male differentiation through the SRY gene, which triggers testicular development. Under the influence of androgens produced by the testes, external genitalia then develop into the penis and scrotum. Dorsal nerves supply penile skin sensation and lie within Buck's fascia. These nerves are notably absent at the 12 o'clock position. Perineal nerves supply skin sensation to the ventral shaft skin and frenulum. Cavernosal nerves lie within the corpora cavernosa and are responsible for sexual function. Paired cavernosal, dorsal, and bulbourethral arteries have extensive anastomotic connections. During erection, the cavernosal artery causes engorgement of the cavernosa, while the deep dorsal artery leads to glans enlargement. The majority of venous drainage occurs through a single, deep dorsal vein into which multiple emissary veins from the corpora and circumflex veins from the spongiosum drain. The corpora cavernosa and spongiosum are all made of spongy erectile tissue. Buck's fascia circumferentially envelops all three structures, splitting into two leaves ventrally at the spongiosum. The male urethra is composed of six parts: bladder neck, prostatic, membranous, bulbous, penile, and fossa navicularis. The urethra receives its blood supply from both proximal and distal directions. PMID:20602076

  8. Anatomy of trisomy 18.

    PubMed

    Roberts, Wallisa; Zurada, Anna; Zurada-ZieliŃSka, Agnieszka; Gielecki, Jerzy; Loukas, Marios

    2016-07-01

    Trisomy 18 is the second most common aneuploidy after trisomy 21. Due to its multi-systemic defects, it has a poor prognosis with a 50% chance of survival beyond one week and a <10% chance of survival beyond one year of life. However, this prognosis has been challenged by the introduction of aggressive interventional therapies for patients born with trisomy 18. As a result, a review of the anatomy associated with this defect is imperative. While any of the systems can be affected by trisomy 18, the following areas are the most likely to be affected: craniofacial, musculoskeletal system, cardiac system, abdominal, and nervous system. More specifically, the following features are considered characteristic of trisomy 18: low-set ears, rocker bottom feet, clenched fists, and ventricular septal defect. Of particular interest is the associated cardiac defect, as surgical repairs of these defects have shown an improved survivability. In this article, the anatomical defects associated with each system are reviewed. Clin. Anat. 29:628-632, 2016. © 2016 Wiley Periodicals, Inc. PMID:27087248

  9. LAMBL’S EXCRESCENCES: ASSOCIATION WITH CEREBROVASCULAR DISEASE AND PATHOGENESIS

    PubMed Central

    Roldan, Carlos A.; Schevchuck, Oleksandr; Tolstrup, Kirsten; Roldan, Paola C.; Macias, Leonardo; Qualls, Clifford R.; Greene, Ernest R.; Hayek, Reyaad; Charlton, Gerald; Sibbitt, Wilmer L.

    2015-01-01

    Background Lambl’s excrescences (LEx) are detected by transesophageal echocardiography (TEE) and are characterized as thin, elongated, and hypermobile structures located at the leaflets’ coaptation point of the heart valves. The association of LEx with cerebrovascular disease (CVD) is still undefined and yet patients with LEx and suspected CVD receive unproven effective antiplatelet or anticoagulant therapy or even undergo valve surgery. Also, the association of LEx with aging and atherogenic, inflammatory, or thrombogenic parameters has not been reported. Methods 77 patients with systemic lupus erythematosus (SLE) (71 women, age 37±12 years) and 26 age-and-sex matched healthy controls (22 women, age 34±11 years) prospectively underwent routine history and physical exam, transcranial Doppler, brain MRI, transesophageal echocardiography (TEE), carotid duplex, and clinical and laboratory evaluations of atherogenesis, inflammation, platelet activity, coagulation, and fibrinolysis. Subjects without stroke/TIA on enrollment (with and without LEx) had a median follow-up of 57 months. Results On enrollment, 33 (43%) of 77 patients had CVD manifested as acute stroke/TIA (23 patients), cerebromicroembolism by transcranial Doppler (17 patients), or cerebral infarcts by MRI (14 patients). Mitral or aortic valve LEx were equally frequent in healthy controls (46%) as in patients with and without any CVD (39% and 43%), stroke/TIA (35% and 43%), cerebromicroembolism (41% and 42%), or cerebral infarcts (36% and 43%) (all p≥0.72). Also, other mechanisms for CVD other than LEx such as Libman-Sacks vegetations, patent foramen ovale or interatrial septal aneurysm, aortic or carotid atherosclerosis, or thrombogenesis were found in ≥94% of patients with CVD. In addition, 36 subjects with and 44 without LEx had similar low incidence of stroke/TIA [1(1.3%) and 2(2.5%), respectively, p=1.0] during follow-up. Finally, LEx were not associated with aging, atherogenic risk factors

  10. Resident Perceptions of Anatomy Education: A Survey of Medical School Alumni from Two Different Anatomy Curricula and Multiple Medical Specialties

    ERIC Educational Resources Information Center

    Bohl, Michael A.; Gest, Thomas R.

    2011-01-01

    In 2004, the University of Michigan Medical School reduced its gross anatomy curriculum. To determine the effect of this reduction on resident perceptions of their clinical preparedness, we surveyed alumni that included residents from the original and new shortened curricula. A Likert-scale survey was sent to four classes of alumni. Respondents…