ABSTRACT
This case report presents a 65-year-old woman with multiple complications during a revision tracheotomy including subcutaneous emphysema and a pneumothorax. Management of her airway was complicated by a history of recurrent follicular B-cell lymphoma associated with extensive cervical lymphadenopathy. We detail the importance of heightened clinical awareness and the use of intraoperative safety adjuncts when performing revision tracheostomies.
Subject(s)
Pneumothorax , Subcutaneous Emphysema , Humans , Female , Aged , Tracheostomy/adverse effects , Tracheotomy/adverse effects , Subcutaneous Emphysema/etiology , Chronic Disease , Pneumothorax/etiologyABSTRACT
We report a case of a 63-year-old male who presented with synchronous pT1N1 p16-positive squamous cell carcinoma (SCC) of the left tonsil and pT4N0 p16-negative SCC of the left tongue.
Subject(s)
Carcinoma, Squamous Cell , Head and Neck Neoplasms , Oropharyngeal Neoplasms , Papillomavirus Infections , Tongue Neoplasms , Male , Humans , Middle Aged , Papillomavirus Infections/complications , Carcinoma, Squamous Cell/pathology , Tongue/pathology , Oropharyngeal Neoplasms/pathology , PapillomaviridaeABSTRACT
We report a case of a 6-month-old male that presented with wound dehiscence, in part due to mechanical tongue trauma, following bilateral cleft lip repair. A silastic sheeting dressing with retention sutures was uniquely fashioned to decrease wound tension and protect the surgical site from patient interference. This solution may potentially be used in similar circumstances.
Subject(s)
Cleft Lip , Cleft Palate , Craniocerebral Trauma , Humans , Male , Infant , Cleft Lip/surgery , Surgical Wound Dehiscence/etiology , Surgical Wound Dehiscence/surgery , Postoperative Complications , Blindness/complications , Craniocerebral Trauma/complications , Cleft Palate/surgery , Cleft Palate/complicationsABSTRACT
The cortico-basal ganglia-thalamo-cortical loop is one of the fundamental network motifs in the brain. Revealing its structural and functional organization is critical to understanding cognition, sensorimotor behaviour, and the natural history of many neurological and neuropsychiatric disorders. Classically, this network is conceptualized to contain three information channels: motor, limbic and associative1-4. Yet this three-channel view cannot explain the myriad functions of the basal ganglia. We previously subdivided the dorsal striatum into 29 functional domains on the basis of the topography of inputs from the entire cortex5. Here we map the multi-synaptic output pathways of these striatal domains through the globus pallidus external part (GPe), substantia nigra reticular part (SNr), thalamic nuclei and cortex. Accordingly, we identify 14 SNr and 36 GPe domains and a direct cortico-SNr projection. The striatonigral direct pathway displays a greater convergence of striatal inputs than the more parallel striatopallidal indirect pathway, although direct and indirect pathways originating from the same striatal domain ultimately converge onto the same postsynaptic SNr neurons. Following the SNr outputs, we delineate six domains in the parafascicular and ventromedial thalamic nuclei. Subsequently, we identify six parallel cortico-basal ganglia-thalamic subnetworks that sequentially transduce specific subsets of cortical information through every elemental node of the cortico-basal ganglia-thalamic loop. Thalamic domains relay this output back to the originating corticostriatal neurons of each subnetwork in a bona fide closed loop.
Subject(s)
Basal Ganglia/cytology , Cerebral Cortex/cytology , Neural Pathways , Neurons/cytology , Thalamus/cytology , Animals , Basal Ganglia/anatomy & histology , Cerebral Cortex/anatomy & histology , Male , Mice , Mice, Inbred C57BL , Thalamus/anatomy & histologyABSTRACT
The basolateral amygdalar complex (BLA) is implicated in behaviors ranging from fear acquisition to addiction. Optogenetic methods have enabled the association of circuit-specific functions to uniquely connected BLA cell types. Thus, a systematic and detailed connectivity profile of BLA projection neurons to inform granular, cell type-specific interrogations is warranted. Here, we apply machine-learning based computational and informatics analysis techniques to the results of circuit-tracing experiments to create a foundational, comprehensive BLA connectivity map. The analyses identify three distinct domains within the anterior BLA (BLAa) that house target-specific projection neurons with distinguishable morphological features. We identify brain-wide targets of projection neurons in the three BLAa domains, as well as in the posterior BLA, ventral BLA, posterior basomedial, and lateral amygdalar nuclei. Inputs to each nucleus also are identified via retrograde tracing. The data suggests that connectionally unique, domain-specific BLAa neurons are associated with distinct behavior networks.
