China
Africa
Explore chapters and articles related to this topic
Attachment, temperament and the development of self-attachment
Published in Ajay Sharma, Helen Cockerill, Lucy Sanctuary, Mary Sheridan's From Birth to Five Years, 2021
Ajay Sharma, Helen Cockerill, Lucy Sanctuary
Early precursors of self-awareness are seen in infants' awareness of others and interest in them. By 4 months of age, infants begin to show social interest in others and initiate vocal and gestural interactions with them. From 7 to 9 months, they search visually for their parents and from 9 to 12 months establish joint attention to share their interests, indicating that they have a sense of separation from others. By the middle of the second year, they recognise that a mirror image is a self-reflection, not a playmate, and on noticing a mark on their face, they try to remove it from their face and not from the mirror.
Fetal echocardiography
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Caroline K. Lee, Erik C. Michelfelder, Gautam K. Singh
The first step in the evaluation of the fetal heart is to establish fetal position within the maternal abdomen (vertex, breech, transverse, supine, prone) and to establish fetal left and right sides. From a transverse section of the fetal abdomen, visceral situs is assessed by demonstrating the relative position of the stomach, hepatic vessels, abdominal aorta, and inferior vena cava (IVC). Normal abdominal situs (situs solitus) is characterized by the stomach bubble on the fetal left side, liver with hepatic vessels on the right side, abdominal aorta to the left of the fetal spine, and IVC to the right of the fetal spine and slightly anterior to the aorta (Fig. 3). In situs inversus, there is a mirror-image arrangement of these organs and vessels. Situs ambiguous denotes when neither situs solitus nor inversus is present; this is also referred to as heterotaxy and is commonly associated with complex congenital heart defects and splenic abnormalities (asplenia or polysplenia).
Transplantation Tolerance, Microchimerism, and the Two-Way Paradigm
Published in Thomas F. Kresina, Immune Modulating Agents, 2020
Thomas E. Starzl, Anthony J. Demetris, Noriko Murase, Massimo Trucco, Angus W. Thomson, Abdul S. Rao, John J. Fung
It also was proposed that bone marrow and organ transplantation were, in fact, mirror images, resulting from the drastically different treatment strategies [4,42]. This contention has been supported by reports describing a trace residual population of recipient leukocytes in essentially all human bone marrow recipients, who previously were thought to have complete donor cell chimerism (Figure 1D) [53,54].
Patient-Specific Orbital Implants Vs. Pre-Formed Implants for Internal Orbital Reconstruction
Published in Seminars in Ophthalmology, 2023
Daphna Landau Prat, Said Massarwa, Assa Zohar, Ayelet Priel, Oded Sagiv, Ofira Zloto, Guy J. Ben Simon
Callahan et al., Prabhu et al., and Dave et al. all demonstrated good results with relatively low-cost PSI.3,11,12 Chen et al. recently observed that the process of creating a projected 3D mirror image may not reflect natural bony anatomy since patients may not have native symmetry of their orbits.4 Interestingly, Callahan et al. designed two versions of each implant, the first based upon an estimation of the restored abnormal orbit and the second based upon the intact contralateral orbit mirrored to the abnormal laterality. Those authors concluded that the mirrored intact side yielded a more anatomically consistent result. Several brands of PSI are relatively expensive compared to PFI, but it is likely that PSI prices will become lower with advancing technologies and manufacturing techniques. Chen et al. described successful utilization of porous-polyethylene PSI in nine patients, also modeled after the contralateral orbits.4 The implants were secured with titanium screw fixation, with good results. Those authors stated that this technique is particularly useful in patients with prior unsuccessful repair. In 2020, Chepurnyi et al. compared polyetheretherketone PSI with pre-bent titanium plates and conventional plates and demonstrated higher clinical efficacy in the PSI group.13,14 Taken together, all of these case series described a favorable outcome with a good anatomic result, and unanimously advocated the use of personalized implants in oculofacial surgery.
S1P in the development of atherosclerosis: roles of hemodynamic wall shear stress and endothelial permeability
Published in Tissue Barriers, 2021
Christina M Warboys, Peter D Weinberg
Why, then, is there disagreement about these findings? The first controversy concerns the location of lesions and hence the direction of transport that is important. Anichkov1 and many subsequent groups5 examining disease in hypercholesterolaemic animals found that the lesions occur must frequently in a triangular area on the downstream lip of aortic branch ostia. Elevated uptake of circulating macromolecules was found in the same region, consistent with excessive uptake being the rate-liming factor.1,6,7 However, when lesions were examined in human postmortem specimens, the mirror image pattern was observed: lesions occurred least frequently in these regions and instead occurred at the sides and upstream of branch points. Since the disease-free regions rather than the disease-prone ones were thought to have high permeability, it was postulated that it was reduced transport out of the wall, into the lumen, of material made or modified in the wall that caused disease.8 HDL transport would be a good candidate for this material.
An interesting case of narrow QRS tachycardia with rightward axis
Published in Acta Cardiologica, 2019
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Kartik Sambaturu, Ajitkumar Valaparambil
A 30-year-old gentleman got admitted with sudden onset regular fast palpitation (Panel A). The treating physician administered 6 mg of IV adenosine and the tachycardia terminated (Panel B). The tachycardia is regular with narrow QRS, rightward QRS axis and the lack of progression of R-wave in the precordial leads from V1 to V6. The rhythm strip shows a P-wave on the T-wave and QRS alternans followed by tachycardia termination with a P-wave. Termination of tachycardia with P-wave is less likely with atrial tachycardia and QRS alternans at a rate of <180 bpm favours Atrioventricular (AV) re-entry. Rightward QRS axis during the tachycardia along with negative QRS in lead I and aVR suggest either limb lead (left arm–right arm) reversal or cardiac malposition. The lack of R-wave progression from V1 to V6 favours mirror image dextrocardia. Surface ECG (panel C) after termination of the tachycardia showed sinus rhythm, prolonged PR interval, right ward P-wave axis with negative P-wave in lead I, rightward QRS axis and lack of R-wave progression in the precordial leads suggesting the diagnosis of mirror image dextrocardia. A chest X ray PA view (panel D) showed elevated left dome of diaphragm and fundal gas shadow below the right dome of diaphragm suggesting situs inversus. The base to apex cardiac axis was to the right suggesting dextrocardia. Hence, this happened to be a case of situs inversus with mirror image dextrocardia presenting as regular long RP tachycardia likely due to orthodromic AV re-entry.