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Nicola Romano, Margherita Federici, Antonio Castaldi
The human body has 12 pairs of cranial nerves that control motor and sensory functions of the head and neck. The anatomy of cranial nerves is complex and its knowledge is crucial to detect pathological alterations in case of nervous disorders. Therefore, it is necessary to know the most frequent pathologies that may involve cranial nerves and recognize their typical characteristics of imaging. Cranial nerve dysfunctions may be the result of pathological processes of the cranial nerve itself or be related to tumors, inflammation, infectious processes, or traumatic injuries of adjacent structures...
March 15, 2019: Insights Into Imaging
Joseph Khoury, Irina Selezneva, Sergei Pestov, Vadim Tarassov, Artem Ermakov, Andrey Mikheev, Mikhail Lazov, Sean R Kirkpatrick, Dmitry Shashkov, Alexandre Smolkov
Polyetheretherketone (PEEK) is an alternative to metallic implants and a material of choice in many applications, including orthopedic, spinal, trauma, and dental. While titanium (Ti) and Ti-alloys are widely used in many intraosseous implants due to its biocompatibility and ability to osseointegrate, negatives include stiffness which contributes to shear stress, radio-opacity, and Ti-sensitivity. Many surgeons prefer to use PEEK due to its biocompatibility, similar elasticity to bone, and radiolucency, however, due to its inert properties, it fails to fully integrate with bone...
December 2019: Bioactive Materials
Patrick K O'Callaghan, Kyle Freeman, Leah C Davis, Robert F Murphy
A 9-year-old boy sustained an ulnohumeral dislocation with a medial epicondyle fracture and experienced incomplete post-traumatic median nerve palsy in addition to post-traumatic stiffness following closed reduction and cast immobilization. When his motor palsy and stiffness did not improve, MRI and ultrasound were obtained, which demonstrated entrapment of the median nerve in an osseous tunnel at the fracture site, compatible with type 2 median nerve entrapment. Subsequently, the patient underwent surgery to mobilize the medial epicondyle and free the median nerve, resulting in improved range of motion, near complete restoration of motor function, and complete restoration of sensory function in the median nerve distribution within 6 months of surgery...
March 13, 2019: Skeletal Radiology
Chien-Hung Lin, Kun-Yu Wu, Clement Kuen-Huang Chen, Chien-Feng Li, Tsyh-Jyi Hsieh
Intraosseous myoepithelial carcinoma is an extremely rare type of bone tumor that most often presents in the long tubular bones, but also occurs in small tubular bones and the axial skeleton. We report the radiographic images and complete magnetic resonance (MR) features of a 44-year-old male with right knee pain of 7 months' duration. The radiographic findings and convention MR images indicated a giant cell tumor of the bone. The dynamic contrast-enhanced images showed a patent with the early wash-in and early wash-out usually noted in a giant cell tumor of the bone...
March 13, 2019: Skeletal Radiology
Steven G Schauer, Jason F Naylor, Michael D April, Andrew D Fisher, Cord W Cunningham, Jessie Renee D Fernandez, Brian P Shreve, Vikhyat S Bebarta
BACKGROUND: Peripheral intravenous (IV) cannulation is often difficult to obtain in a patient with hemorrhagic shock, delaying the appropriate resuscitation of critically ill patients. Intraosseous (IO) access is an alternative method. To date, few data exist on use of this procedure by ground forces in Afghanistan. Here, we compare patient characteristics and concomitant interventions among patients undergoing IO access versus those undergoing IV access only. METHODS: We obtained data from the Prehospital Trauma Registry (PHTR)...
2019: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Kazuki Sakakura, Yasunobu Nakai, Go Ikeda, Masanari Shiigai, Noriyuki Watanabe, Kazuya Uemura, Alexander Zaboronok, Eiichi Ishikawa, Akira Matsumura
BACKGROUND: Dural arteriovenous fistulae (dAVF) of the anatomically complex anterior condylar confluence (ACC) are often examined by computed tomography (CT) angiography and conventional angiography before treatment. Contrasted vessels often overlap with skull bones in enhanced CT and make it difficult to detect the shunt point of dAVF. Bone subtraction CT angiography (BSCTA) can overcome this limitation and allow for superior imaging of dAVF that may help to find an alternative access for catheterization...
March 8, 2019: World Neurosurgery
James M Burgert, Arthur D Johnson, Joseph C O'Sullivan, Wayne J Blalock, Brent C Duffield, Brian P Albright, Cory C Herzog, Matthew S Moore, Katelyn S Dempster, Japeth W Rauch
INTRODUCTION: Limited prospective data exist regarding epinephrine's controversial role in managing traumatic cardiac arrest (TCA). This study compared the maximum concentration (Cmax), time to maximum concentration (Tmax), plasma concentration over time, return of spontaneous circulation (ROSC), time to ROSC, and odds of ROSC of epinephrine administered by the endotracheal (ETT), intraosseous (IO), and intravenous (IV) routes in a swine TCA model. METHODS: Forty-nine Yorkshire-cross swine were assigned to seven groups: ETT, tibial IO (TIO), sternal IO (SIO), humeral IO (HIO), IV, CPR with defibrillation (CPRD), and CPR only...
February 23, 2019: American Journal of Emergency Medicine
Mats Eriksson, Anders Larsson, Miklós Lipcsey, Gunnar Strandberg
BACKGROUND: Intraosseous (IO) access is a recommended method when venous access cannot be rapidly established in an emergency. Experimental data suggest that major hemorrhage and catecholamine administration both reduce bone marrow blood flow. We studied the uptake of gentamicin as a tracer substance administered IO following adrenaline administration in hemorrhagic shock and in cardiac arrest. METHODS: Twenty anesthetized pigs underwent hemorrhage corresponding to 50% of the blood volume...
March 8, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
F Buček, M Komzák, R Hart
PURPOSE OF THE STUDY The authors in their study compare the knee joint kinematics in patients before and after medial unicompartmental knee arthroplasty (UKA) and in the group of healthy volunteers. This study aims to confirm or reject the hypothesis that UKA preserves the physiological knee joint kinematics. MATERIAL AND METHODS In the course of 2015 and 2016 a total of 20 patients with grade III-IV medial knee joint osteoarthritis and 20 healthy volunteers were included in the study. In the first group of patients the standard Oxford™ unicompartmental knee prosthesis was implanted using kinematic navigation and the reference data were collected before and after the knee joint replacement...
2019: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Marion Wiegele, Thomas Hamp, Johannes Gratz, Eleonore Pablik, Eva Schaden
Rotational thromboelastometry is recommended to guide haemostatic therapy in trauma-related coagulopathy. In the case of unsuccessful venepuncture, intraosseous access allows immediate administration of drugs and volume replacement. Feasibility of rotational thromboelastometry from intraosseous blood has not yet been investigated in humans. We performed rotational thromboelastometry and standard coagulation assays from intraosseous and intravenous blood samples in 19 volunteers and 4 patients undergoing general anaesthesia...
March 6, 2019: Scientific Reports
Fritjof Kreher, Alexander Zeller, Christian Krettek, Ralph Gaulke
BACKGROUND: Arthrodesis can be considered the fastest and safest surgical treatment for degenerative destruction of the proximal interphalangeal joint. For this procedure, a variety of surgical strategies have been described. Protocols for compression arthrodesis by intraosseous wiring are known to have the best outcomes. Biomechanical effects of reinforcing the arthrodesis using Kirschner wires have been controversially discussed. PURPOSE: This study aims to compare these two procedures with respect to primary stability under physiological stress in vitro...
February 2019: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Erik Näslund, Lars-Göran Lindberg, Iréne Lund, Lui Näslund-Koch, Agneta Larsson, Robert Frithiof
Photoplethysmography performed on the peripheral extremities or the earlobes cannot always provide sufficiently rapid and accurate calculation of arterial oxygen saturation. The purpose of this study was to evaluate a novel photoplethysmography prototype to be fixed over the sternum. Our hypotheses were that arterial oxygen saturation can be determined from an intraosseous photoplethysmography signal from the sternum and that such monitoring detects hypoxemia faster than pulse oximetry at standard sites. Sixteen healthy male volunteers were subjected to incremental hypoxemia using different gas mixtures with decreasing oxygen content...
February 25, 2019: Journal of Clinical Monitoring and Computing
Elena Marie Loschan, Padhraig O'Loughlin, Christian Krettek, Ralph Gaulke
BACKGROUND/AIM: In extensive soft tissue injury, primary internal fracture fixation is not always possible and external fixation for primary immobilization plays an important role. The aim of this study was to compare the accuracy of freehand technique and of a target device for retrograde calcaneotibial fixation in an uninjured bone and an unstable ankle fracture. MATERIALS AND METHODS: The calcaneotibial fixation was performed randomly by an experienced surgeon utilizing either a freehand drilling technique or a novel targeting device in four human cadavers before and after producing a bimalleolar ankle fracture...
March 2019: In Vivo
Huizhi Liu, Xiaojing Chang, Hua Shang, Feng Li, Huandi Zhou, Xiaoying Xue
BACKGROUND: Primary intraosseous cavernous hemangiomas (PICHs) of the skull are extremely rare. To date, diffuse cranial hemangioma of skull has not been reported. In cancer patients, it is often misdiagnosed as metastasis. CASE PRESENTATION: Here, we presented a case of a 50-year-old female patient suffering from slightly headache who received breast cancer modified radical mastectomy in 2004, computed tomography and magnetic resonance imaging findings revealed abnormal lesions of diffuse skull which were misdiagnosed as skull metastasis, and the relevant literatures were also reviewed...
February 25, 2019: BMC Cancer
Molly Rideout, William Raszka
Introduction: Volume depletion is a common problem in pediatrics. Interns need to be able to recognize critical illness such as hypovolemic shock, obtain access, and manage complications. This simulation case involves a child with hypovolemic shock who requires intraosseous (IO) needle placement. While designed for subinterns in pediatrics, it is relevant for clerkship students and interns in family medicine and emergency medicine. Methods: In this case, a 3-year-old child presents with vomiting, diarrhea, and lethargy, and is in hypovolemic shock...
March 16, 2018: MedEdPORTAL Publications
Moo Soung Park, Mi Young Eo, Hoon Myoung, Soung Min Kim, Jong Ho Lee
Background: Osteomyelitis is an intraosseous inflammatory disease characterized by progressive inflammatory osteoclasia and ossification. The use of quantitative analysis to assist interpretation of osteomyelitis is increasingly being considered. The objective of this study was to perform early diagnosis of osteomyelitis on digital panoramic radiographs using basic functions provided by picture archiving and communication system (PACS), a program used to show radiographic images. Methods: This study targeted a total of 95 patients whose symptoms were confirmed as osteomyelitis under clinical, radiologic, pathological diagnosis over 11 years from 2008 to 2017...
December 2019: Maxillofacial Plastic and Reconstructive Surgery
Milla Jousi, Markus B Skrifvars, Annika Nelskylä, Giuseppe Ristagno, Alexey Schramko, Jouni Nurmi
INTRODUCTION: Screening and correcting reversible causes of cardiac arrest (CA) are an essential part of cardiopulmonary resuscitation (CPR). Point-of-care (POC) laboratory analyses are used for screening pre-arrest pathologies, such as electrolyte disorders and acid-base balance disturbances. The aims of this study were to compare the intraosseous (IO), arterial and central venous POC values during CA and CPR and to see how the CPR values reflect the pre-arrest state. METHODS: We performed an experimental study on 23 anaesthetised pigs...
February 20, 2019: Resuscitation
Ji-Gang Wang, Jingwei Liu, Bing He, Ling Gao, Lijuan Zhang, Jihua Liu
PURPOSE: Diffuse tenosynovial giant cell tumor (TGCT) of the temporomandibular joint (TMJ) is rare. The aim of the present study was to summarize the clinical, radiologic, and pathologic features of this tumor. MATERIALS AND METHODS: Nine cases of TGCT in the TMJ region were examined. All available radiologic and pathologic documents were carefully reviewed. These cases were grouped into 3 types according to the radiologic features: bone-centered type, intraosseous type, and soft tissue type...
January 29, 2019: Journal of Oral and Maxillofacial Surgery
Thomas S Roukis
Although open reduction and internal fixation for treating displaced intra-articular calcaneal fractures remain common, difficulty obtaining and maintaining both calcaneal morphology and subtalar articular surface reduction remain. In addition, open approaches induce a significant risk of wound-healing complications. For this reason, closed manipulation to restore calcaneal morphology, intra-osseous fracture reduction, and rigid locked nail fixation was developed and validated for clinical use. Conversion to an immediate primary or delayed reconstructive subtalar joint arthrodesis using the same instrumentation remains unique to this system...
April 2019: Clinics in Podiatric Medicine and Surgery
Juliana Martínez Rodríguez, Sandra J Renou, María B Guglielmotti, Daniel G Olmedo
High density polyethylene (HDPE) is a synthetic biomaterial used as a three-dimensional scaffold for bone defect reconstruction. Reports differ with regard to its biological response, particularly its osteoconductive capacity. The aim of the present work was to histologically and histomorphometrically evaluate tissue response to porous HDPE. An in vivo study was conducted in rat tibia to evaluate osteogenic capacity, angiogenesis, inflammatory response, and the presence of multinucleated giant cells 14 and 60 days post-biomaterial implantation...
February 19, 2019: Journal of Biomaterials Science. Polymer Edition
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