May-Thurner syndrome causing venous thromboembolism in a young female with Sturge weber syndrome and connective tissue disease

May-Thurner syndrome (MTS) is a rare condition characterized by the compression of the left common iliac vein by the overlying right common iliac artery. It is a unique causal reason for development of deep venous thrombosis (DVT) and pulmonary embolism (PE). Young females developing DVT should be examined and investigated with details as triggers can include trauma, pregnancy, autoimmunity. In this case report we report a case of a young female who had Sturge Weber Syndrome, and how a left hip pain was diagnosed as DVT which led to diagnosis of an underlying MTS and autoimmune trigger for her hypercoagulable state

Anatomical eponyms — unloved names in medical terminology

Uniform international terminology is a fundamental issue of medicine. Names of various organs or structures have developed since early human history. The first proper anatomical books were written by Hippocrates, Aristotle and Galen. For this reason the modern terms originated from Latin or Greek. In a modern time the terminology was improved in particular by Vasalius, Fabricius and Harvey. Presently each known structure has internationally approved term that is explained in anatomical or histological terminology. However, some elements received eponyms, terms that incorporate the surname of the people that usually describe them for the first time or studied them (e.g., circle of Willis, follicle of Graff, fossa of Sylvious, foramen of Monro, Adamkiewicz artery). Literature and historical hero also influenced medical vocabulary (e.g. Achilles tendon and Atlas). According to various scientists, all the eponyms bring colour to medicine, embed medical traditions and culture to our history but lack accuracy, lead of confusion, and hamper scientific discussion. The current article presents a wide list of the anatomical eponyms with their proper anatomical term or description according to international anatomical terminology. However, since different eponyms are used in various countries, the list could be expanded

Venous Interventions: From Lower-Limb Deep Vein Thrombosis to May-Thurner Syndrome and Budd-Chiari Syndrome

Over the past decade, there have been great innovations in the diagnosis of venous disorder since the introduction of dual-source computed tomography (DSCT) in 2006. It provides fast and reliable diagnosis of deep vein thrombosis (DVT) with the capability of full leveling of thrombus burden and allows early endovascular interventions with pharmacomechanical aspiration thrombectomy (PMAT) being performed aiming to reduce the post-thrombotic syndrome (PTS) and improve quality of life. The newly introduced ultrafast clot removal system, in patients who failed with PMAT, AngioJet, and EKOS, aids in rapid restoration of venous flow and decline of venous hypertension to mitigate the valve damage. Percutaneous transluminal angioplasty (PTA) and stenting yield high technical success rate of 93–96% and a promising short-term 1-year and 2-year patency of around 93% and 75–79%, respectively, for symptomatic May-Thurner syndrome (MTS). Based on the cumulative endovascular treatment experience in over 2000 cases in Xizou, China, some relevant precipitating factors are addressed, and a new classification of subtypes have been proposed to guide the proper selection of endovascular management of Budd-Chiari syndrome (BCS)

Bringing Dicynodonts Back to Life: Paleobiology and Anatomy of a New Emydopoid Genus from the Upper Permian of Mozambique

Dicynodontia represent the most diverse tetrapod group during the Late Permian. They survived the Permo-Triassic extinction and are central to understanding Permo-Triassic terrestrial ecosystems. Although extensively studied, several aspects of dicynodont paleobiology such as, neuroanatomy, inner ear morphology and internal cranial anatomy remain obscure. Here we describe a new dicynodont (Therapsida, Anomodontia) from northern Mozambique: Niassodon mfumukasi gen. et sp. nov. The holotype ML1620 was collected from the Late Permian K5 formation, Metangula Graben, Niassa Province northern Mozambique, an almost completely unexplored basin and country for vertebrate paleontology. Synchrotron radiation based micro-computed tomography (SRµCT), combined with a phylogenetic analysis, demonstrates a set of characters shared with Emydopoidea. All individual bones were digitally segmented allowing a 3D visualization of each element. In addition, we reconstructed the osseous labyrinth, endocast, cranial nerves and vasculature. The brain is narrow and the cerebellum is broader than the forebrain, resembling the conservative, "reptilian-grade" morphology of other non-mammalian therapsids, but the enlarged paraflocculi occupy the same relative volume as in birds. The orientation of the horizontal semicircular canals indicates a slightly more dorsally tilted head posture than previously assumed in other dicynodonts. In addition, synchrotron data shows a secondary center of ossification in the femur. Thus ML1620 represents, to our knowledge, the oldest fossil evidence of a secondary center of ossification, pushing back the evolutionary origins of this feature. The fact that the specimen represents a new species indicates that the Late Permian tetrapod fauna of east Africa is still incompletely known.Mozambique (Ministério dos Recursos Minerais), National Geographic Society, TAP airlines and other anonymous patrons, financial support from DESY through the I-20110184 EC project

Six surgical cases

The following Case records are primarily of diseased individuals rather than of the diseases which they demonstrate, and the procedure of their study may be said to lie mainly in bedside investigation. In all cases, as far as circumstances allow, pre- operative examination, with daily observation, is the rule, operation is attended, and the patient is observed and the local condition examined from day to day, and the effects of treatment noted. In the records of cases, many details of little import are necessarily omitted. The system of case - taking as used in the class of Morbid Anatomy is re-applied to clinical material, but whereas pathological material was described, and the findings corelated with the Clinical History, in these cases the diseased patient is described, and the findings corelated with the underlying Pathology. Every clinical surgical subject has an associated pathology, and clinical surgery is inseparable from Pathology. On an understanding of the underlying pathology in each in- dividual case rests the whole question of surgical procedure. This pathology as Professor J. Macewen* has said, "is not the "dead pathology of the post -mortem room, but the living path- ology of our bodies, and the cells of which they are composed, "in their efforts to ward off, and repair the damage caused by, "injury and disease." In these Case Reports, the underlying pathology is kept in mind, and, where possible, the Commentary attempts to corelate the disease manifestations and the path- ology, although in some cases the pathology can only be estim- ated by clinical methods of examination. It is doubtful if any disease, including inflammations and injuries, can be regarded strictly from the surgical aspect, as every disease can be regarded from the medical standpoint, either in aetiology or treatment. In all cases a systematic medical examination was carried out, and the importance of previous disease and family history are stressed. These cases represent a variety of diseases and defor- mities, as met with in the course of general surgical practice. In their discussion, particularly in differential diagnosis, other similar cases and conditions are discussed and recorded, and this in itself makes the taking of Surgical Cases of general value. Certain of the Cases have been observed periodically, as they have reported at the Wards, during a period up to 18 months from the date of their admission, when the cases were originally studied. Progress notes are thus appended. A follow -up of a case is of the utmost value. A disease process is only partly observed during the patient's stay in hospital, and future observation leads to an estimation of the morbid process at work, and demonstrates the effect of treatment

Studies of the laser thermal probe in cardiovascular disease

The initial use of optical fibres to transmit laser energy intravascularly was accompanied by a high rate of perforations and the production of inadequate vascular channels when used for recanalisation. The laser thermal probe - in which all laser energy is converted into heat by a metal cap at the tip of the fibre, prior to tissue application - was one of the earliest modifications designed to overcome these problems. The studies in this thesis were concerned with the application of the laser thermal probe to percutaneous peripheral and coronary artery angioplasty and His bundle ablation. In vitro studies were commenced in March 1987 when the first (argon) laser generator was installed in the cardiac catheterisation laboratory at Guy's Hospital and these were followed by clinical studies in three groups of patients: nine with peripheral artery occlusions, three with coronary artery stenoses and four with supraventricular arrhythmias using either argon or Nd-YAG energies. Suggestions that enhanced safety might be possible with on-line monitoring and/or control of the probe temperature were studied by recording the temperature responses in simulated circulations at flow rates observed clinically. The highly variable temperatures recorded in blood indicate that these measures are unlikely to contribute to improvements in either efficacy or clinical safety. An earlier report of successful peripheral artery recanalisation using the laser thermal probe was confirmed in the patients studied here, though a learning curve was evident. Coronary laser angioplasty had also been performed in a few patients with a similar device but without as much success. A more flexible "over the wire" laser probe was assessed here, first in cadaver coronary arteries and then in three patients undergoing coronary angioplasty. The lack of success seen with this laser thermal probe relates to the considerable differences found between peripheral and coronary arteries: percutaneous accessibility, vessel size and the susceptibility to thermal injury being the most important. These aspects and subsequent developments in coronary laser angioplasty are discussed further. The final chapter considers a hitherto new area for laser thermal probe application the interruption of arrhythmia circuits. Cadaver and electrophysiological studies indicated that ablation of the bundle of His might be possible with this device - without the need for a general anaesthetic. The course of the first patient ever to undergo this procedure is described, as well as the implications for percutaneous His bundle ablation using other energy sources

Osteology, relationships and paleoecology of a new Arctic hadrosaurid (Dinosauria: ornithopoda) from the Prince Creek formation of Northern Alaska

Thesis (Ph.D.) University of Alaska Fairbanks, 2014The Liscomb Bonebed (LBB), found in the early Maastrichtian Prince Creek Formation of northern Alaska, is the single most productive site for the Arctic dinosaurs in either hemisphere. From the LBB, thousands of bones representing at least hundreds of individuals of a saurolophine hadrosaur have been collected, but they have not been previously described and their taxonomic status remains unresolved. In part, this stems from the fact that most material comes from individuals approximately one-half to onefourth of adult size. Another long-standing question concerns whether dinosaurs in the Prince Creek Formation overwintered in the paleo-Arctic or migrated elsewhere (presumably south) to escape prolonged darkness and cold. Here, I attempt to determine the taxonomic status of the LBB hadrosaurs using three semi-independent methods: 1) geometric morphometric analysis; 2) comparative morphological analysis; and 3) cladistic analysis. An important component of this work also includes an ontogenetic study of the growth patterns of the genus Edmontosaurus, to which this material has been previously referred, in order to better understand ontogenetic variation within the Alaskan taxon. My results indicate the Alaskan taxon is a new species of the widespread genus Edmontosaurus. For the first time, the Alaskan taxon is described in detail, making it the best known polar dinosaur to date. My cladistic analysis suggests a possible biogeographic scenario in which the common ancestor of Edmontosaurus and Shantungosaurus originated in eastern Eurasia and then dispersed by the Campanian to North America via a land corridor in the area of present day Alaska. Finally, I used a novel method involving strontium isotope geochemistry to test the migration hypothesis of the new species of Alaskan Edmontosaurus. I measured strontium in tooth enamel of Edmontosaurus and a putative non-migratory species (Troodon) using LA-MC-ICP-MS. My results suggest diagenesis had not significantly altered the signal and that Alaskan Edmontosaurus likely did not migrate during approximately the last four months of life. My results lend further support for the existence of a distinct, early Maastrichtian polar dinosaur fauna known as the Paanaqtat Province

Two early Cretaceous fossils document transitional stages in Alvarezsaurian dinosaur evolution

Highly specialized animals are often difficult to place phylogenetically. The Late Cretaceous members of Alvarezsauria represent such an example, having been posited as members of various theropod lineages, including birds [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11]. A 70-million-year ghost lineage exists between them and the Late Jurassic putative alvarezsaurian Haplocheirus [12], which preserves so few derived features that its membership in Alvarezsauria has recently been questioned [13]. If Haplocheirus is indeed an alvarezsaurian, then the 70-million-year gap between Haplocheirus and other alvarezsaurians represents the longest temporal hiatus within the fossil record of any theropod subgroup [14]. Here we report two new alvarezsaurians from the Early Cretaceous of Western China that document successive, transitional stages in alvarezsaurian evolution. They provide further support for Haplocheirus as an alvarezsaurian and for alvarezsaurians as basal maniraptorans. Furthermore, they suggest that the early biogeographic history of the Alvarezsauria involved dispersals from Asia to other continents. The new specimens are temporally, morphologically, and functionally intermediate between Haplocheirus and other known alvarezsaurians and provide a striking example of the evolutionary transition from a typical theropod forelimb configuration (i.e., the relatively long arm and three-digit grasping hand of typical tetanuran form in early-branching alvarezsaurians) to a highly specialized one (i.e., the highly modified and shortened arm and one-digit digging hand of Late Cretaceous parvicursorines such as Linhenykus [1, 15]). Comprehensive analyses incorporating data from these new finds show that the specialized alvarezsaurian forelimb morphology evolved slowly and in a mosaic fashion during the Cretaceous