Chronic radiodermatitis following cardiac catheterisation: a report of two cases and a brief review of the literature.
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Cardiac angiography produces one of the highest radiation exposures of any commonly used diagnostic x ray procedure. Recently, serious radiation induced skin injuries have been reported after repeated therapeutic interventional procedures using prolonged fluoroscopic imaging. Two male patients, aged 62 and 71 years, in whom chronic radiodermatitis developed one to two years after two consecutive cardiac catheterisation procedures are reported. Both patients had undergone lengthy procedures using prolonged fluoroscopic guidance in a limited number of projections. The resulting skin lesions were preceded, in one case, by an acute erythema and took the form of a delayed pigmented telangiectatic, indurated, or ulcerated plaque in the upper back or below the axilla whose site corresponded to the location of the x ray tube during cardiac catheterisation. Cutaneous side effects of radiation exposure result from direct damage to the irradiated tissue and have known thresholds. The diagnosis of radiation induced skin injury relies essentially on clinical and histopathological findings, location of skin lesions, and careful medical history. Interventional cardiologists should be aware of this complication, because chronic radiodermatitis may result in painful and resistant ulceration and eventually in squamous cell carcinoma. (+info)
Can nuchal cord cause transient increased nuchal translucency thickness?
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When detected in a first trimester scan, an increased thickness of nuchal translucency (NT) may be associated with chromosomal, cardiac or genetic disorders. However, less attention has been devoted to the outcome of those fetuses who have confirmed normal anatomies and karyotyping, but have abnormal first trimester scans. Thus, a challenging new issue is how to counsel such cases of transient increased NT in which the translucency rapidly vanishes with no evidence of other underlying abnormalities. Two cases of transient increased thickness of NT are reported. In both, a nuchal cord was ultrasonographically demonstrated and a thorough work-up revealed chromosomally and anatomically normal fetuses. The pathophysiological theories behind these observations and their significance are discussed. Based on these observations, we suggest that transvaginal sonography combined with Doppler flow studies should be utilized for the presize detection of cord patterns to accomplish the work-up in cases of increased NT. (+info)
Evaluation of an intervention to reduce sun exposure in children: design and baseline results.
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The Kidskin Study is a 5-year intervention study (1995-1999) involving 1,776 5- and 6-year-old children attending 33 primary schools in Perth, Western Australia. The aim of the study is to design, implement, and evaluate an intervention to reduce sun exposure in young children. There are three study groups: a control group, a "moderate intervention" group, and a "high intervention" group. The control schools receive the standard Western Australian health education curriculum, while the moderate and high intervention schools receive a specially designed curricular intervention. In addition, children in the high intervention group receive program materials over the summer holidays, when exposure is likely to be highest, and are offered sun-protective swimwear at low cost. The main outcome measure is the number of nevi on the back. Other outcomes include nevi on the chest (boys only), face, and arms, levels of suntanning, degree of freckling, and sun-related behaviors. At baseline, the three groups were similar with respect to nevi and freckling after adjustment for observer and month of observation. Sun exposure was slightly higher in the high intervention group. The groups were also similar with respect to most potential confounders, although they differed with respect to Southern European ethnicity and parental education. (+info)
A study of motoneuron groups and motor columns of the human spinal cord.
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Eight normal human spinal cords were studied for motoneuron (Mn) groups and columns. Spinal segments (C1 to Coc.) were identified and embedded in paraffin wax. Serial cross sections were cut at 25 microm and stained by cresyl violet. Cross-sectional profiles of the spinal cord were traced for each segmental level and the outlines of the various Mn groups superimposed. These charts (maps) were used to examine intra and intersegmental changes in the relative positions of the columns. An attempt was made to provide topographical picture of Mn groups of individual segments. In the cervical region neuronal groups were more numerous but smaller and less distinct, while in the lumbosacral region they were fewer, larger and at many levels better circumscribed. The average number of Mn groups at any segmental level was 3-4 and never exceeded 5. C4, C5, C6, C7, L4, L5 and S1 contained numerous Mn groups. Maximum intrasegmental changes were noted at C3, C4, C7, T1, and S2, while at C5, C6, all thoracic, L1 L2 and L3, the pattern was constant throughout the segment. Eleven motor columns were traced in the human spinal cord. Column 1 belonged to the medial division and columns 2-11 to the lateral division of the ventral grey horn. Columns 1 and 2 were the most extensive as they were traceable from the lower medulla to S3 segment. Columns 3-8 were confined to cervical segments (including T1), while columns 9-11 were traced in lumbosacral segments. In general, motor columns followed a definite mode for their appearance and disappearance. Many of them showed rotation from a dorsal to a ventromedial direction. (+info)
The unilateral and bilateral control of motor unit pairs in the first dorsal interosseous and paraspinal muscles in man.
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1. The discharges of two motor units were identified in an intrinsic hand muscle (first dorsal interosseous, FDI) or an axial muscle (lumbar paraspinals, PSP) in ten healthy subjects. Each motor unit was situated in the homologous muscle on either side of the body (bilateral condition) or in the same muscle (ipsilateral condition). The relationship between the times of discharge of the two units was determined using coherence analysis. 2. Motor unit pairs in the ipsilateral FDI showed significant coherence over the frequency bands 1-10 Hz and 12-40 Hz. Motor units in the ipsilateral PSP were significantly coherent below 5 Hz. In contrast there was no significant coherence at any frequency up to 100 Hz in the bilateral FDI condition and only a small but significant band of coherence below 2 Hz in the bilateral PSP condition. 3. Common drive to motor units at frequencies of < 4 Hz was assessed by cross-correlation of the instantaneous frequencies of the motor units. A significantly higher coefficient was found in the ipsilateral FDI, ipsi- and bilateral PSP compared with shifted, unrelated data sets. This was not the case for the bilateral FDI condition. 4. The presence of higher frequency coherence ( > 10 Hz) in the ipsilateral FDI condition and its absence in ipsilateral PSP is consistent with a more direct and influential cortical supply to the intrinsic hand muscles compared with the axial musculature. The presence of low frequency drives (< 4 Hz) in the bilateral PSP condition and its absence in the bilateral FDI condition is consistent with a bilateral drive to axial, but not distal, musculature by the motor pathways responsible for this oscillatory input. (+info)
Investigation of trunk and extremity movement associated with passive head turning in newborns.
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BACKGROUND AND PURPOSE: Physical therapist examination of pediatric clients or clients with neurological conditions often includes the observation of stereotypical movement patterns such as the asymmetrical tonic neck reflex and righting reactions. The purpose of this study was to investigate whether extremity and trunk responses to passive head turning could be documented in newborn infants. SUBJECTS AND METHODS: Forty-two newborns with no known medical problems were videotaped within 5 days of birth while an investigator turned their heads left and right. Videotapes were stopped at 5-second intervals to record the direction of head turn with the rest of the body obscured. A second investigator recorded trunk and extremity position with the head obscured. RESULTS: The direction of head turning affected upper- and lower-extremity position, with extension stronger on the face side. The direction of trunk convexity was also affected by head position, with the trunk convex to the side to which the face was turned. CONCLUSION AND DISCUSSION: Extremity responses and trunk responses to passive head turning can be documented corresponding to patterns reported for the asymmetrical tonic neck reflex and righting reflexes in neonates with no known medical problems more frequently than would occur by chance. (+info)
Genome-wide scan for body composition in pigs reveals important role of imprinting.
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The role of imprinting in body composition was investigated in an experimental cross between Chinese Meishan pigs and commercial Dutch pigs. A whole-genome scan revealed significant evidence for five quantitative trait loci (QTL) affecting body composition, of which four were imprinted. Imprinting was tested with a statistical model that separated the expression of paternally and maternally inherited alleles. For back fat thickness, a paternally expressed QTL was found on Sus scrofa chromosome 2 (SSC2), and a Mendelian-expressed QTL was found on SSC7. In the same region of SSC7, a maternally expressed QTL affecting muscle depth was found. Chromosome 6 harbored a maternally expressed QTL on the short arm and a paternally expressed QTL on the long arm, both affecting intramuscular fat content. The individual QTL explained from 2% up to 10% of the phenotypic variance. The known homologies to human and mouse did not reveal positional candidate genes. This study demonstrates that testing for imprinting should become a standard procedure to unravel the genetic control of multifactorial traits. (+info)
Spinal cord stimulation for treatment of failed back surgery syndrome--two case reports.
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Severe, persistent back pain following back surgery is often referred to as Failed Back Surgery Syndrome (FBSS). Conservative measures such as physiotherapy, back strengthening exercises, transcutaneous electrical nerve stimulation and epidural steroids may be inadequate to alleviate pain. Spinal Cord Stimulators were implanted into two patients suffering from FBSS. Both patients responded successfully to spinal cord stimulation with reduction of pain and disability. (+info)