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Orthopaedics and musculoskeletal system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
Acute osteomyelitis is due to blood-borne infection and is situated at the metaphyses at the entrance of the nutrient artery. X-ray changes do not appear for a week after the onset of illness. The most common causative organism is Staphylococcus aureus, followed by Streptococcus pyogenes. Treatment should be commenced with penicillin and cloxacillin in combination because of the possibility of penicillin-resistant staphylococci.
Pediatric Imaging in General Radiography
Published in Christopher M. Hayre, William A. S. Cox, General Radiography, 2020
Allen Corrall, Joanna Fairhurst
Intramembranous ossification starts early in fetal life and is the process particularly responsible for plates of bone such as the bones of the skull. Endochondral ossification (replacement of cartilage ‘chondro’ by bone ‘ossify’) also usually starts in the fetus by development of the cartilaginous template from mesenchymal cells (cells that can differentiate into osteoblasts and chondrocytes). Invasion of chondroblasts helps the template grow in length and width and by the end of the process the beginnings of the medullary cavity develop. A nutrient artery forms and pierces the perichondrium (the perichondrium becomes the periosteum), and the increased blood supply stimulates perichondrium to specialize into bone cells to form a collar of bone (the periosteum). The spongy bone of the diaphysis starts to form and is eventually replaced by compact bone.
Innervation of Vasa Nervorum
Published in Geoffrey Burnstock, Susan G. Griffith, Nonadrenergic Innervation of Blood Vessels, 2019
Kumud K. Dhital, Otto Appenzeller
The origin of nutrient arteries is consistent for any particular nerve, but the exact takeoff from the main artery, their number, size, and length vary considerably between species and are usually asymmetric on the two sides of the body.11,21-23 The length of these extraneural arteries in man varies from 5 to 15 mm, although a length of 25 mm has been reported for branches of the radial artery supplying the median nerve in the forearm.19 The variability in the length of nutrient arteries implies that long segments of the main nerve trunk may be without external blood supply, but the circulation to these segments is maintained by descending intraneural vessels. It is thought that the size of the first nutrient artery, or group of nutrient vessels determines, the size and number of subsequent arteries along the nerve.19
Surgical Management of Haemophilic Pseudotumors: Experience in a Developing Country
Published in Journal of Investigative Surgery, 2019
Yu He, Xi Zhou, Haomin Cui, Guixing Qiu, Xisheng Weng, Baozhong Zhang, Yong Liu
Irradiation might be beneficial for unresectable pseudotumors and the remaining capsule but not for a first choice.4,21 Aspiration is not considered a safe method because of relapse, fistulization, and infection.10,11 Embolization alone has only a temporary effect, so it should be performed as a preoperative preparation approximately 2 weeks before surgery.4,22 Surgery after arterial embolization to reduce the vascularization is an effective method that can shrink pseudotumors and reduce complications during surgery. This technology may be restricted to use in cases of an uncertain nutrient artery to the mass. Panotopoulos et al. demonstrated that embolization was unnecessary if bleeding events were controlled easily.14 We did not use this method in our patients because of controlled bleeding and economic concerns.
The Impact of Sorafenib in Combination with Intermittent Hepatic Arterial Infusion Chemotherapy for Unresectable Hepatocellular Carcinoma with Major Vascular Invasion
Published in Cancer Investigation, 2022
Masaki Kaibori, Hideyuki Matsushima, Morihiko Ishizaki, Hisashi Kosaka, Kosuke Matsui, Miyuki Nakatani, Shuji Kariya, Takashi Yamaguchi, Katsunori Yoshida, Kengo Yoshii, Mitsugu Sekimoto
In our phase I study, we determined the maximum tolerated dose and the recommended phase II dose. Thus, CDDP 30 mg/m2 was administered by 30-min intra-arterial infusion on days 1, 8 and 15, with once-daily oral administration of sorafenib 400 mg. CDDP-powder (DDP-H, IA-call®, Nipponkayaku, Japan) and physiologic saline (50 ml) were mixed in a 50-ml syringe (Figure 1). The CDDP-saline suspension was administered via intra-arterial infusion using a hepatic arterial infusion port that was inserted into an HCC nutrient artery under X-ray fluoroscopy. Dose reduction or discontinuation of sorafenib and/or HAIC was performed depending on the incidence of adverse events.
Rare inherited coagulation disorders in young children in Oman
Published in Pediatric Hematology and Oncology, 2022
Surekha Tony, Roshan Mevada, Abdulhakim Al Rawas, Yasser Wali, Mohamed Elshinawy
Bone cysts, one of the rare complications of hypo/afibrinogenemia, frequently appear in the contiguity of the cortex or trabeculae in the diaphysis of long bones, particularly the femora, tibiae, and humeri, and should be considered in patients who suffer recurrent unexplained pains of the extremities.36 Intraosseous hemorrhage, usually at the entrance of the nutrient artery, causes intraosseous cysts. Large cysts, especially in weight bearing bones, may cause pathological fractures.37 Whole body MRI might be useful to evaluate the lesions.