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SBA Questions
Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
An ultrasound is performed on a 30-year-old woman who presented with lower abdominal pain and a dark brown vaginal discharge. This shows an intrauterine gestational sac with no obvious fetal pole but with a yolk sac and an inhomogeneous left adnexal mass measuring 40 mm in diameter and a small echoic fluid in the pouch of Douglas. A diagnosis of a heterotopic pregnancy is made from these findings. What would be the best approach to the management of this patient who is haemodynamically stable?Expectant managementHyperosmolar injection of the adnexal mass with potassium chlorideLaparoscopic surgical removalMethotrexate – local injection in the adnexal massMethotrexate – systemic
Nervous System
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Mark T. Butt, Alys Bradley, Robert Sills
Neuronal heterotopia refers to groups of neurons that appear normal individually but are present in an abnormal site or arrangement. Dysplasia is a term that has been used to describe this abnormality/malformation, which is believed to be due to altered migration during development, but heterotopia or ectopia appears to be more accepted. Neuronal heterotopias are well recognized in humans (Harding and Copp 2008) but rarely encountered (or perhaps just rarely recognized) in laboratory animals.
Paediatrics
Published in Dave Maudgil, Anthony Watkinson, The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
Dave Maudgil, Anthony Watkinson
The following are associated with Chiari II malformation. True or false? Lacunar skull.Beaked tectum of midbrain.Cerebral heterotopia.Colpocephaly.Holoprosencephaly.
“A Space Where Queer Is Normalized”: The Online World and Fanfictions as Heterotopias for WLW
Published in Journal of Homosexuality, 2022
Heterotopias have varied forms but several principles in common. Specifically, they are places that play with societies normative constructions of time and space. Foucault (1986) explains: “heterotopias are most often linked to slices in time-which is to say that they open onto what might be termed, for the sake of symmetry, heterochronies.” (p. 26); this can take the form of “eternal” time found in cemeteries or museums or “temporal” time located in carnivals of traveling fairgrounds. In general (literal), “technologies … shrink our notions of time and space” (Seargeant & Tagg, 2014, p. 1). Specifically, for the online world, time and distance between geographical spaces no longer exists in a physical sense. “The plasticity of time within new media and emerging real-time technologies remove the temporal boundaries of the actual world.” (Rymarczuk & Derksen, 2014). Moreover, time in the online world can be both eternal and temporal. For instance, articles and comments can be posted and immediately deleted hence implying temporality; however, texts may be recycled, tagged, or uncovered after deletion, hence inferring eternality.
Towards a science-based testing strategy to identify maternal thyroid hormone imbalance and neurodevelopmental effects in the progeny—part III: how is substance-mediated thyroid hormone imbalance in pregnant/lactating rats or their progeny related to neurodevelopmental effects?
Published in Critical Reviews in Toxicology, 2022
M. Sue Marty, Ursula G. Sauer, Alex Charlton, Rashin Ghaffari, Davy Guignard, Nina Hallmark, Bethany R. Hannas, Sylvia Jacobi, Heike-Antje Marxfeld, Stephanie Melching-Kollmuss, Larry P. Sheets, Daniel Urbisch, Philip A. Botham, Bennard van Ravenzwaay
The ECETOC T4 TF extracted all thyroid- and brain-related data from the selected studies. Depending on the study considered, thyroid-related parameters included (1) maternal and/or offspring serum T4, T3, TSH, fT4, and/or free T3 (fT3); (2) maternal and/or offspring thyroid weight and histopathology; and (3) offspring brain T4 and T3 (see Li et al. 2019 and Marty et al. 2021 for technical challenges related to the measurement of thyroid-related parameters). Neurodevelopmental parameters included in the selected studies covered motor activity, acoustic startle response, cognitive function, hearing function, findings from the functional observational battery (https://www.ecfr.gov/current/title-40/chapter-I/subchapter-R/part-798/subpart-G/section-798.6050 [accessed 2022 August]), detailed clinical observations as well as brain histopathology and morphometry. These parameters are included in TG-conforming developmental toxicity studies (Table 1(B)). Further brain-related parameters, that have not (yet) been standardised for adoption in TG-conforming studies, included electrophysiology, periventricular heterotopia and gene expression. Heterotopias are clusters of ectopic neurons in the brain indicative of altered neuronal migration; they have been observed in rats and humans and are associated with neurodevelopmental disorders like epilepsy and learning disabilities (Goodman and Gilbert 2007; Gilbert et al. 2014; O’Shaughnessy et al. 2019).
Extraovarian juvenile granulosa cell tumor in a prepubertal child: novel location of a rare tumor
Published in Pediatric Hematology and Oncology, 2020
İdil Rana User, Burak Ardıçlı, Bilgehan Yalçın, Diclehan Orhan, Eren Müngen, Nursun Özcan, Saniye Ekinci
There are several theories regarding origin of sex cord stromal cells including coelomic epithelium, mesenchyme, mesonephros and their combinations.1 Possible explanation for an extragonadal sex cord stromal tumor depends on these embryologic origin theories. The presence of misplaced sex cord stromal cells, ectopic ovarian tissue or accessory supernumerary ovary can be the underlying mechanisms. Similar to the presence of germ cell tumors in central nervous system, mediastinum and sacrococcygeal region, abnormal migration of cells to gonadal ridge can explain extragonadal locations of sex cord stromal tumors.4 Most of the extragonadal sex cord stromal tumor cases were located adjacent to ovaries such as broad ligament, fallopian tubes, pelvic side wall, retroperitoneum, adrenal gland and intestinal mesentery.2 McCluggage et al. reported incidentally detected extraovarian microscopic proliferations of sex cord cells similar to adult granulosa cell tumor. They speculate that these cells may represent heterotopic embryonic rests due to aberrant migration.5 Another possibility is the presence of ectopic ovarian tissue rather than cell clusters. Teratoma arising from ectopic ovary have been reported.6 In our case, tumor was located in suprarenal fossa adjacent to adrenal gland and ovaries were in normal locations without tumoral invasion. The exact origin of tumor in our patient whether an ectopic ovary or abnormally located cell proliferations still remains unknown.