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Hands & Feet
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
White hard papules or nodules containing calcium (cutaneous calcinosis, see p. 199) can occur on the fingers or dorsum of the hand in patients with scleroderma or dermatomyositis. The diagnosis can be confirmed by X-ray. Gout results in tophi (deposits of uric acid crystals, associated with joint deformity). A ganglion is a synovial cyst associated with the wrist joint.
Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Ganglion cysts are benign bone lesions containing mucous material. They can be intra-articular, extra-articular, intra-osseous and periosteal. They are most common around the wrist and hand. Internal septations may or may not be present. MRI features are T1 low to intermediate signal, T2 high signal and high signal on protein density sequences. Periosteal new bone formation is a feature of periosteal ganglia rather than an intraosseous ganglion cyst.
Central Nervous System
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
These tumors comprise neoplastic ganglion cells alone (gangliocytoma) or in association with neoplastic glial cells (ganglioglioma). Most patients are under 30 years of age, and a great majority present with seizure. The primary treatment for both tumors is surgery. Radiotherapy is now usually withheld from these lesions, which are regarded as WHO Class 1, even if resection is incomplete. However, anaplastic transformation may occur in the glial component, when the outcome becomes much more sinister and treatment more aggressive. As described earlier, a significant proportion of these tumors harbor BRAF mutations and/or other mutations that activate MAPK signaling. The response to targeting this pathway in these patients is under investigation, with initial promising data.65,66
The Role of Nervous System and Immune System in Herpes Zoster Ophthalmicus Dissemination and Laterality – Current Views
Published in Ocular Immunology and Inflammation, 2023
Yue Li, Louis Tong, Chrystie Quek, Yun Feng
Natural infection with VZV leads to a very early release of type I interferon (IFN) in the bloodstream, and IFN-α is also locally transmitted to varicella lesions through plasmacytoid dendritic cells. While IFNs are important in the immune response to VZV, they are not part of the key immune mechanism. On the other hand, T lymphocytes have a protective effect against VZV. The detection of T cells 3 days after the occurrence of the varicella rash may be an exhibition of how T cells rapidly respond to the primary VZV infection and promote more rapid clearance of rash and viremia. In addition, the response of VZV-specific CD4 + T cells was inversely correlated with the severity of the disease and the level of viremia. VZV-specific CD8 + T cells are also induced during the natural infection.18 After the primary infection of VZV, it is likely that it remains dormant in sensory ganglia found symmetrically on both sides of the body. These ganglia contain cell nuclei of sensory nerves that supply the skin.18
Bilateral peroneal nerve palsy secondary to prolonged sitting in an adolescent patient
Published in International Journal of Neuroscience, 2022
Şükran Güzel, Selin Ozen, Sacide Nur Coşar
External nerve compression is the most common mechanism of peroneal palsy reported in children [1,6]. In one case series, 10 of 17 cases were related to external nerve compression due to casting, traction, taping and strapping. All but one of these cases were unilateral [4]. Positional habitudes can also cause PNP, including sitting cross legged, squatting and lying [7]. Simultaneous compression by a bed or chair, as in this case, may cause bilateral nerve palsies. Likewise, the slim body habitus of the patient may have been a predisposing factor for the development of PNP [2]. Peroneal palsies arising from trauma or nerve entrapment are less common in childhood; bony exostoses, hemangiomas, synovial cysts and intraneural ganglion cysts may cause nerve entrapment [8,9]. An intraneural ganglion cyst is a rare disease of adulthood, and is even rarer in children. Typically, neural cysts present with symptoms of knee or proximal leg pain. A history of knee trauma and examination findings of a palpable mass in the lateral aspect of the knee are common. Tinel’s sign may be elicited in the same region [10]. In the present case, as there was bilateral peroneal nerve involvement, no history of trauma, no palpable mass in the lower extremity, nor tenderness, and a negative Tinel’s test, a differential diagnosis of inraneural ganglion cyst was excluded. As a result, no further imaging was deemed necessary to rule out a diagnosis of an intraneural ganglion cyst.
Cross-sectional representations of the central nervous system in Pirogov’s “Ice Anatomy”
Published in Journal of the History of the Neurosciences, 2022
Boleslav Lichterman, Douglas J. Lanska
For his atlas, Pirogov had dissected frozen heads in three directions into multiple “disks” from three to five inches thick. In some cases, he also dissected frozen brains after the cranial vault was removed (Pirogoff 1859, 1). He “tried to review the position and topography of all parts of brain with saw cuts in three directions” (Pirogoff 1859, 1). He boasted that, although the brain had been dissected by many authors since Vesalius, “if I am not mistaken, nobody never ever pictured and described the cranium and brain dissected into such thin and such numerous layers [as I did]” (Pirogoff 1859, 1). As he elaborated, In descriptive brain anatomy, [serial] sections were introduced long ago, but nobody, as far as I know, presented them with such sequences [with narrow sections in all three anatomical planes] as in my atlas. It seems useful to have a clear idea on the order and gradual changes of different structures in consecutive saw cuts [i.e., sections of the brain]. This is especially important for the study of the topography of [basal] ganglia. (Pirogov 1860, 401)