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摘要:Objectives: The purpose of this work was to determine the dimensions of CFA before the birth of the deep thigh artery, describe the mode of termination of the CFA, search for CFA collaterals, and describe the anatomical variations of the CFA. Methodology: This was a prospective study conducted at the Anatomy Laboratory of the Faculty of Medicine and Odonto-Stomatology of Bamako. CFA arteries of 12 fresh corpses of adults include 9 men and 3 women. A total of 24 CFA arteries were dissected and photographed. Results: The mean length of CFA was 50.9 ± 12.55 mm (range: 31 and 93 mm). Its average diameter was 9.12 ± 1.17 mm (range: 7 and 12 mm). In 70.83%, the CFA artery ended without any particularity. There was 29.17% anatomic variation in the CFA termination mode. The CFA divided into 3 branches (trifurcation) in 25%. The 3 branches were in 20.83%, the FS and a common core to LFCA and AQ; in 4.17%, they were the SFA, the DFA and the MFCA. In 4.17%, it divided into 4 branches which are: the SFA, the DFA, the MFCA and a common core to QA and LFCA. The CFA gave as collateral: circumflex superficial iliac artery in 22 cases (91.67%), superficial epigastric artery in 19 cases (79.17%), upper external pudendal artery in 20 cases (83.33%), and lower external pudendal artery in 14 cases (58.33%). We noted in our series 9 anatomical variations at the collateral level of the CFA or 37.5%. The CFA gave birth to the following branches: the MFCA in 4 cases or 16.67%, the LFCA in 1 case or 4.17%, the QA in 1 case or 4.17%, and a common core to the QA and LFCA in 3 cases or 12.5%. Conclusion: The length of CFA is important. The variations of CFA are frequent and important to know in clinical and surgical practice....
摘要:Objectives: The purpose of this work was to measure the dimensions of the femoral veins, to describe the affluent and the variations of the femoral veins. Methodology: Twenty-four femoral veins of 12 fresh adult cadavers were dissected and photographed. Results: The diameter of the superficial, deep and common femoral veins was respectively 8.75 mm; 7.60 mm and 13.95 mm. The common femoral vein was 80.70 mm long. At the level of the superficial vein, the modal disposition was noted in 79.17%; as anatomical variations, it was split in 2 cases, the presence of a collateral canal in 1 case and in 2, and it received a quadricipital muscle vein. At the level of the deep femoral vein, the modal disposition was noted in 16.67%, and the anatomical variations were noted in 83.33% where it received no affluent in the femoral trine. The modal disposition was noted in 91.67% at the level of the mode of birth of the common femoral vein, in 16.67% at the level of its tributaries. The anatomical variations were noted in 8.33% in the mode of birth of the femoral vein, in 83.33% in which the common femoral vein received, in addition to the large saphenous vein, other tributaries, the most frequent of which were the quadricipital veins and the circumflex femoral veins. Conclusion: The diameter of the femoral veins is important. The main tributaries of the common femoral vein are GVS, VQ and circumflex femoral veins. The femoral variations are numerous and important to know to avoid a possible misdiagnosis in case of their thrombosis....
摘要:It has been well documented that acute pancreatitis and diabetic ketoacidosis (DKA) co-occur, and both of them present either as a cause or result of the other [ href="#ref1">1] [ href="#ref2">2]. Recently, hypertriglyceridemia has been reported to co-occur as well [ href="#ref3">3] [ href="#ref4">4]; the involvement of acute adrenalitis in the setting of acute pancreatitis and DKA has not been reported. We report a case of sudden death due to diabetic ketoacidosis, acute pancreatitis and acute adrenalitis in a 37-year-old female. She was found unresponsive and breathless in bed by her mother at their residence. At the time of the autopsy, both lungs were expanded and sigmoid diverticulosis was discovered on gross examination. Histology of the pancreas and the adrenal glands revealed acute inflammation despite appearing normal upon gross examination. The postmortem toxicology report showed high levels of acetone (12 mg/dL) in the postmortem blood and extremely high levels of glucose (>500 mg/dL) in the postmortem vitreous fluid. This is the first reported case of fatal diabetic ketoacidosis co-occurring with acute pancreatitis and acute adrenalitis....
摘要:Sudden cardiac death (SCD) generally refers to sudden cardiovascular death of a person with or without pre-existing heart disease. This is a retrospective study conducted at the Department of Anatomy and Pathological Cytology at Aristide Le Dantec Hospital in Senegal. This study covers a period of 7 years from January 1st, 2000 to December 31st, 2006. During this 7-year period we collected 235 cases of sudden cardiovascular death out of a total of 3717 forensic autopsies, representing a frequency of 6.32%. Sudden cardiovascular deaths accounted for 75.3% of all 312 sudden deaths. 96.1% were black compared to 3.9% Caucasians. The average age of the patients was 46.86 years with extremes ranging from 17 to 86 years. The most affected age group was between 50 - 59 years old, representing 23.4% of the cases. The sex ratio was 4.3 in favour of men. Men aged 50 - 59 were the most affected, while women were more affected in the 20 - 29 age group. Cardiomyopathies constituted 54.9% with 90% of dilated cardiomyopathies of which 75% were male and 10% of hypertrophic cardiomyopathies more frequent also in men. Valvulopathies came in 3rd position with 3.4% of the cases and in 75% of the cases they were poly-valvulopathies. Atherosclerosis was incriminated in 2.5% of the cases and aortic localization was the most represented. Aortic dissection was implicated in 6 cases out of 235 or 2.5%. It was isolated in 4 cases (without other cardiac conditions), and in the other 2 cases it was accompanied by other cardiac lesions including hypertrophy, pericarditis and endocarditis. The other causes found were interauricular communication (n = 1) and pericarditis (n = 2). Sudden cardiovascular death is a major global public health problem. The lack of epidemiological data on sudden death in Africa motivated our work, which led us to note that 75.3% of all sudden deaths in adults were of cardiovascular origin....
摘要:This paper is a critical review of the newly published second edition of “Developmental Juvenile Osteology” by C. Cunningham, L. Scheuer and S. Black. It is extensively illustrated by Angela Christie portraying the developing human skeleton at varying stages of juvenile growth. A chapter on the dentition omits mention of attritional wear or identifies caries restorative materials. Despite an extensive bibliography, failure to provide reference sources detracts from an incomparable source of developmental skeletal enlightenment....
摘要:Objectives: To investigate the effect of electrical stimulation of different anatomical variations of sacral surface on early recovery of urinary continence after radical prostatectomy. Methods: Twenty of 53 consecutive patients who underwent prostatectomy by a single surgeon were enrolled in this study. Ten patients were prospectively randomized to two groups; five patients in Sacral foramena stimulation group received postoperative surface electrical stimulation of sacral foramina area while five patients in control group did not received any electrical stimulation. Selection of remaining ten patients depended on sacral hiatus anatomical variations, assessed by plan X-rays. Of the ten patients, five patients with sacral hiatus subtotals were grouped under SHS1 while 5 patients with sacral hiatus totals were grouped as SHS2. Electrical stimulation for each group began 7 days after catheter removal, thrice a week for 8 weeks. Each of the 24 treatment sessions for each group composed of 20 minutes for sacral electrical stimulation. Continence was evaluated at baseline, 4 and 8 weeks using the 24-hour pad test and according to the incontinence section of the International Continence Society questionnaire. Results: After 2 weeks of treatment, the mean leakage weight was comparable between SFS group and SHS1 group while it was significantly lowered in SHS2 as compared to SFS and SHS1 groups. Comparing mean leakage weight at 8 weeks revealed further significant reduction in SHS2 group than in SFS and SHS1 groups. Moreover, percentage of continent patients was highest in SHS2 group after 8 weeks of treatment followed by SHS1, SFS and control respectively. Conclusions: Electrical stimulation of sacral hiatus surface area may provide better stimulation for sacral nerve than sacral foramena surface area and appears to be effective treatment for early recovery of urinary continence after radical prostatectomy....
摘要:Heterotopic ossification (HO) is the abnormal, non-neoplastic presence of lamellar bone in soft tissue. The ectopic formation of lamellar bone in non-osseus tissues secondary to traumatic injuries of the spinal cord or the brain is defined as Neurogenic HO. The pathophysiology of HO is not clear. But several theories like overactive humoral mechanisms after fracture healing, imbalance of pro-osteoinductive and anti-osteoinductive mediators located on the soft tissues and gene mutations in such as bone morphogenetic proteins-4 (BMP-4) are proposed. Casualty factors leading to increased risk of HO include older age, blast mechanism of injury, location of injury and traumatic brain injury. The aim of this paper is to demonstrate a case of HO located in the brain without history of trauma or any other risk factors....
摘要:The “facial composite” is one of the major fields in the forensic science that helps the criminal investigators to carry out their investigation process. The survey conducted by United States Law Enforcement Agencies confirms that 80% of the law enforcement agencies use computer automated composite systems whereas Sri Lanka is still far behind in the process of facial composite with lot of inefficiencies in the current manual process. Hence this research introduces a novel approach for the manual facial composite process, while eliminating the inefficiencies of the manual procedure in Sri Lanka. In order to overcome this situation, this study introduces an automated image processing based software solution with 2D facial feature templates targeting the Sri Lankan population. Thus, this was the first ever approach that creates the 2D facial feature templates by incorporating both medically defined indexes and relevant aesthetic aspects. Hence, this research study is comprised of two separate analyses on anthropometric indices and facial feature shapes which were carried out targeting the local population. Subsequently, several evaluation techniques were utilized to evaluate this methodology where we obtained an overall success rate as 70.19%. The ultimate goal of this research study is to provide a system to the law enforcement agencies in order to carry out an efficient and effective facial composite process which can lead to increase the success rate of suspect identification....
摘要:Blunt cardiac rupture is a characteristic of high death rates and rapid death process. But sometimes it is hard to find out the cause of cardiac rupture of traumatized patients, especially when it relates the relationship between injury and disease. In the 2 cases reported herein, both of the 2 patients had pre-existent cardiac pathological changes when suffered from traumatic injury. Our aim is to evaluate autopsy findings from a medicolegal point of view, and offer our proposals on how to deal with this sort of cases....
摘要:An adult human skull was discovered in a college osteological collection presenting with two Inca bones. Inca bones or interparietal (supernumerary) bones are rarely seen among dry human skulls. Their frequency of presentation is much less than that of sutural or Wormian bones. Inca bones or interparietal (supernumerary) bones are accepted as normal variants most often found in the occipitoparietal region of the skull. Their characteristic shape, a triangle, resembles a monument design of the Inca tribe of South America and Latin America. The significance of the presence of these variants is that Inca bones or interparietal bones may be mistaken for a skull fracture. They may also be very useful in forensic identification of an unknown individual....
摘要:In forensic pathology, it is always indispensable to determine burn wound vitality or age to accurately assess the relationship between death and any burn wounds. Subsequently, the determination of wound age is a definitive and still cutting-edge subject in forensic pathology. Therefore, deep second-degree burn injuries were induced in a group of mice. At 7, 12, 17, 21 and 28 days post-burn, burn wound specimens were histomorphologically differentiated and compared with normal intact skin using H&E stain. The study revealed that the burn wound during healing process was usually incorporated of infiltration of inflammatory cells, granulation tissue formation and epithelialization within 7 - 12 days post-burn. Then, the surface of burn wound was partially ulcerated in association with epidermal necrosis, dermal disorganization and degeneration of the sebaceous gland 17 - 21 days post-burn. Finally, the regenerated skin retained the structure of normal skin at 28th day post-burn. Our study demonstrated that the histopathological changes of burn wounds involved deep dermis, and the pathological changes occurred at distinctive time phases were almost different in comparing to regular intact skin. Such age estimation of burn wounds is important when a cadaver or a burnt body has many burns of diverse times, especially in criminal cases....
摘要:We report a case of skin and soft tissue infection, peritonitis and bacteriemia in a 51-year-old drug abuse male. His wife found him lifeless lying on the kitchen floor at his residence. At the time of autopsy, multiple skin ulcers with deep soft tissue infection and peritonitis were found on gross examination. Cultures of postmortem blood and a swab of soft tissue were positive for Shewanella putrefaciens, a gram-negative bacterium that had been isolated from many foods, sewage and fresh and salt water. This is the first reported case in the United States of fatal skin and soft tissue infection, peritonitis and bacteremia caused by this micro-organism....
摘要:Drowning still remains one of the most difficult diagnoses in forensic pathology because macroscopic and microscopic autopsy findings are unspecific. An ideal diagnostic marker for drowning still needs to be developed, but some authors have recently studied SP-A as a marker of asphyxiation and drowning. The aim of this study is to compare the histopathological features and the SP-A immunohistochemical expression in lung tissue in the case of drowning with those determined by other causes to discriminate between cadaver submersion and drowning....
摘要:This study evaluated the comparison of premortem and postmortem diagnoses of trauma cases that died during treatment and then autopsied. We had analyzed the autopsy reports of forensic deaths retrospectively which occurred between 2013 and 2014. The cases that died because of trauma and which had complete medical reports were included the study. Totally 626 cases were autopsied and 307 cases records were examined from them. The mean age was found to be 28.11. According the treatment period, it was detected that 116 (37.8%) cases died within the first 24 hours. Discrepancies between premortem and postmortem diagnoses were determined in 20.6% of cases. 5.9% had a main diagnostic discrepancy and 14.7% were of second lethal diagnoses. The discrepancies were observed mostly in the multiple injury cases. In our study, diagnostic discrepancy rate was higher in multiple injury cases especially who died by explosion. When clinicians focus on the treatment according to their main diagnosis, they overlook the fatal injuries in other parts of the body. This study shows that autopsy is the most reliable method for the confirmation of the clinical diagnosis in trauma patients. Therefore, particularly surgery physicians should compare the results of the autopsy diagnoses to their own diagnosis....
摘要:The aim of the present work was to investigate the exposure to the medical and industrial toxic chemicals. The research was carried out on hair, nail and blood samples in a panel of 40 healthy volunteers aged 7 to 77 with an average of 45 ± 19 years (18 women (45%) and 22 men (55%)). All of these individuals had not received medication for at least 1 year, including antibiotics and psychotropic. This study was realized from July 2013 to March 2014 in Beijing, China. The method for an accurate and reliable screening of medical and an industrial toxic chemical was based on detection and assay by ultra-high performance liquid chromatography with UV detection type of diode arrays. Also more than 10,000 toxic molecules commonly found in western industrial countries were screened by coupling gas chromatography and mass spectrometry. The main results indicate that the molecules analyzed are mainly antibiotic (Gentamycine and Tobramycine), antidepressant (Amitriptylin and its metabolites), narcotic (MDMA and Clonitazene), ingredient in cosmetics (Benzenediol and Benzoic acid), insecticide (Carbamate derivative), ketamine, chlorhexidine and phthalate derivatives. There are no detailed documented baseline data of the analysis of medical and Industrial toxic pollutants in hair, nail and blood samples in Beijing; however, this study should be completed on samples from other provinces of China. This study is the first of its kind. Therefore, further studies should be conducted in other cities and provinces of China to be compared with each other....
摘要:Background: In forensic science the identification of a human is based on three important factors: Age, Sex and Stature. Bones are an important tool for it and among human bones the pelvis and the skull are the most reliable source for sex determination. In the absence of complete pelvis, mandi-ble becomes the important source for sex determination since mandible is the most durable and movable part of skull that can resist postmortem changes. The present study is conducted to assess the accuracy and role of few metric and morphological parameters in determination of the sex of dry adult human mandible of North Indian origin. Material & Methods: The Study is conducted on 50 dry intact human adult mandibles of North Indian origin. The metric parameters i.e. bigonial breadth, bicondylar breadth are measured with a Vernier Calliper by two observers. Non-metric parameters being observed are the morphological features like gonion flaring, muscular markings and shape of angle of symphysis menti. Result & Conclusion: It is concluded that bigonial breadth and bicondylar breadth exhibit the sexual dimorphism. Morphological Parameters: Gonion flaring, muscular markings and shape of angle of symphysis menti also demonstrate the sexual dimorphism. These parameters taken together may determine the sex of adult human mandibles. The present study shows that the mandible is an important tool in the determination of gender with high accuracy....
摘要:In Japan, most sudden deaths occurring during bathing happen in the winter, and predominantly to elderly people. One can infer a relation to physical conditions that are specific to aging. Atrial fibrillation, an arrhythmia, increases with age. This study examined histological changes in the pulmonary vein myocardial sleeves of sudden bathtub death victims and compared them with those of control individuals. We investigated 35 sudden deaths that occurred during bathing and 34 accidental deaths or deaths caused by diseases unrelated to cardiopathies. Pulmonary veins were excised cross-sectionally from the hilar side to the venoatrial junction. Then they were stained with hematoxylin and eosin, resorcin-fuchsin van Gieson, and Congo-red stains. Amyloid deposits in the pulmonary vein myocardial sleeves, as well as the range and severity of scarring, were graded microscopically on a scale of 0-3. In the sudden bathtub death victims, severe scarring was found in the myocardial sleeves of the four pulmonary veins (mean score, 2.0), which was significantly different (p < 0.05) from the control subjects (mean score, 1.4). Cardiomegaly was found in 28 out of the autopsied individuals. In subjects with cardiomegaly, the mean value of pulmonary vein myocardial sleeve scarring was 2.1. In subjects without cardiomegaly, the mean value was 1.8. Comparison revealed that cardiomegaly was associated significantly with scarring progression and degeneration of the myocardial sleeves. Scarring of the pulmonary vein myocardial sleeves was more advanced in victims of sudden bathtub death than in controls without heart disease. Elderly people with scarring of the pulmonary vein myocardial sleeves are likely to develop degenerative variations in their intra-atrial excitation conduction. These results demonstrate that taking hot baths might induce supraventricular arrhythmias such as atrial fibrillation....
摘要:In today's research driven society, it has become commonplace for institutions to rely upon DNA and RNA extraction techniques to help obtain genomic data from old specimens. Generally, specimens are preserved for future gross examination and/or teaching. Using histological examination of specimens from museum jars from the Pathology Department at the Indiana University School of Medicine, the sequential and chronological degradation of DNA and RNA has been studied. We examined gross specimens from 1920 to 2000. We evaluated histologic preservation of kidney, liver, heart, lung, spleen, uterus and brain for nuclear structure in these samples. Nuclear preservation was based on amount of nuclei per microscopic field and the crispness of the nuclear membrane and internal features. The nuclei in high lipid tissues such as the brain were found to degrade at a quicker rate than dense tissues such as the heart and uterus. Our study has shown that specimens preserved beyond fifty years were likely to have little to no nuclei left, thus indicating that there was little to no DNA and RNA remaining. This technique of histologic evaluation is an important finding and a general guideline which may save research institutions from the expensive process of DNA and RNA extraction....
摘要:Chlormequat is a quaternary ammonium and choline chlorinated derivated is used as plant growth regulating agent. There are very few documented cases of poisoning in humans. We reported a case of non-fatal suicide attempt by chlormequat in France. A 34-year-old woman was admitted to hospital after deliberate consumption of plant growth regulator, C5 SUN, containing chlormequat chloride (460 g/L) and choline chloride (320 g/L). Immediately, she developed symptoms of respiratory distress and a cardiac massage was begun by her father. In this case report, we described the method for an accurate and reliable screening of chlormequat which was based on the combination of Target Analysis powerful software and a high performance TOF-MS (Impact HD from Bruker). After forced diuresis, the kinetic of elimination of chlormequat is biphasic: vascular phase diffusion (half-life of 5.6 hr) followed by a phase of free elimination (half-life of 16.2 h). Although chlormequat poisoning is clinically similar to that observed with anticholinesterase compounds, chlormequat chloride is not an acetylcholinesterase inhibitor. Chlormequat seems to be a weak substrat competitor for cholinesterase leading to acetylcholine accumulation and prolonged depolarization in muscular junction. Cardiac massage, artificial respiration and forced diuresis have significantly improved the prognosis of our patient....
摘要:The retroesophageal right subclavian artery may be associated with multiple neurovascular variations, which may impact various cervicothoracic surgeries. During the dissection of 27 cadavers, the authors detected a retroesophageal right subclavian artery in old man arising from distal aortic arch, crossed ventrally by left recurrent laryngeal nerve and dorsally by thoracic duct. On the right side, the aberrant subclavian artery was associated with nonrecurrent laryngeal nerve crossing a large tortuous inferior thyroid artery at multiple intersection points. Importantly, the nonrecurrent laryngeal nerve gave rise to extra laryngeal branch passing over Zuckerkandl's tubercle of thyroid gland before its termination into the larynx. The relationships of the aberrant subclavian artery in the present case to thoracic duct, recurrent and nonrecurrent laryngeal nerves may have clinical relevance to various operations such as thyroidectomy, esophagectomy and surgical correction of the aberrant vessel. Therefore, these relationships should be well known by surgeons for prevention of iatrogenic damage of essential neurovascular structures during various surgeries....
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