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Experimental Methodology
Published in Donna J. Clemons, Jennifer L. Seeman, The Laboratory GUINEA PIG, 2016
Donna J. Clemons, Jennifer L. Seeman
Firmly restrain the guinea pig and place on a firm surface.Grasp the nape of the neck with the thumb and forefinger.Clean the area with an antiseptic.Insert the needle (22 to 30 gauge) at the base of the skin fold between the thumb and forefinger (Figure 49).Slowly withdraw the plunger. If blood is seen in the needle hub, withdraw the needle and reinsert into skin fold.Inject the compound with a steady motion. More than one site should be used if the injection volume is very large.
Neuroendocrine disease
Published in Philip E. Harris, Pierre-Marc G. Bouloux, Endocrinology in Clinical Practice, 2014
Clinical features may relate primarily to the somatic overgrowth engendered by elevated GH and IGF-I levels, to the size of the tumor itself, and/or due to symptoms of associated hypopituitarism. Key features of the condition relate to the somatic overgrowth that results in the characteristic symptoms (Table 1.12) and signs (Table 1.13) of acromegaly. Frequently, the features can best be appreciated by retrospective comparison of the patient’s photographs (Figure 1.22). Thickening of the skin is a cardinal physical sign. This thickening can be objectively demonstrated by the measurement of heel pad thickness on x-ray. As a result, venipuncture is often difficult. Skin cuts tend to heal quickly. Patients frequently describe excessive sweating and greasy skin. Skin tags are a common feature, particularly in the axilla and around the nape of the neck. Glossomegaly is also a cardinal sign. The glossomegaly can interfere with mastication that is exacerbated by prognathism and dental malocclusion.
Breech presentation
Published in Leroy C Edozien, The Labour Ward Handbook, 2010
You must see the nape of the neck before proceeding with delivery of the head. After an assistant has gently lifted the leg almost to the vertical, deliver with forceps. Caution: doing this prematurely could hyperextend the neck and cause damage to the cervical spinal cord.Use the Mauriceau–Smellie–Veit manoeuvre if delivery is imminent and there is no time to apply forceps.If the head fails to engage, the baby may be allowed to hang for up to 1 minute until the nuchal line is visible (Burns–Marshall technique). Suprapubic pressure can also be applied to guide the head into the pelvis.
Encephalitis lethargica in Peru
Published in Journal of the History of the Neurosciences, 2021
Santiago Stucchi-Portocarrero, Miguel Humberto Tomas-Miranda
The fifth case presented also belongs to the 1926 Espejo-Tamayo thesis. The situation revolved around a 32-year-old man who, in March 1923, “suffered from an intense emotion” and “a violent pain in the neck,” which later spread “to the nape of the neck and the occipital region on the same side and part of the back” (Espejo-Tamayo 1926, 125). Four days later, the patient’s right arm “was abruptly oscillating,” and three days later, “the myoclonic movement had extended to the left arm.” In April, he also presented “abrupt and rhythmic movements of the abdomen” (Espejo-Tamayo 1926, 125). In May, he was hospitalized, and on examination, it was found that “the myoclonic jerking of the nape and neck was quite noticeable.” On the other hand, the author noted, “the forearms never reach complete muscular relaxation; they retain a manifest hypertonic state” (Espejo-Tamayo 1926, 126). Wassermann’s reaction was negative. According to Espejo-Tamayo, this was undoubtedly a case of encephalitis with an algesic-myoclonic presentation, whose anatomical compromise lies in the striatum. The patient finally recovered and was discharged.
The perversion of language: Jules Baillarger on aphasia, the lateralization of speech, and the Baillarger-Jackson principle
Published in Journal of the History of the Neurosciences, 2021
The last case cited by Baillarger had been reported by Étienne Rufz de Lavison (1806–1884), a physician and herpetologist from the French colony of Martinique and a member of the Anthropological Society. Rufz reported the case of a woman who had been rendered hemiplegic and aphasic from a cerebral infarction caused by the bite of a fer-de-lance, a viper common to Martinique.25Cerebral infarction following envenomation is an uncommon but well-described occurrence. The venom damages the cerebral arterial wall, causing thrombosis, and it also has a procoagulant effects. For a case of Broca’s aphasia following envenomation, see Paul, Paul, and Sandeep Puri (2014). For a case of Wernicke’s aphasia from the same cause, see Polo et al. (2002). The clinical evolution of Rufz’s patient was unusual. The patient’s weakness improved after treatment with emetics, compresses to the nape of the neck, and vapor baths, but the aphasia persisted. As Rufz wrote, [S]he was returned to her master [sic]. I learnt that upon arrival at the plantation, having learnt that her man had sought other lovers, she was taken by an excess of jealousy during which all were astonished to hear her speak very distinctly. Then, as she became calm, the mutism returned. (Rufz 1859, 70)
Axillary sentinel node biopsy in prone position for melanomas on the upper back or nape
Published in Journal of Plastic Surgery and Hand Surgery, 2019
Lutz Kretschmer, Simin Hellriegel, Naciye Cevik, Franziska Hartmann, Kai-Martin Thoms, Michael P. Schön
If SLNs are located in the axilla, the SLNB will traditionally be performed with the patient lying in the supine position. Many melanomas, however, are located on the upper back, on the cranial part of the shoulder or the nape of the neck. In these cases, scattered radiation can significantly hinder the search for radioactive lymph nodes. This is because the gamma probe needs to be simultaneously pointed at the SLNs and the radioactively labeled primary tumor site. In order to facilitate the search for SLNs in these situations, we have performed axillary SLNB in the prone position since 2008 [4]. Prone positioning of patients with melanomas of the upper back, shoulder or nape changes the orientation of the gamma probe during SLNB, thereby moving the primary tumor region out of the gamma probe’s focus.