Bilateral spontaneous tenodesis of the long head of the biceps at the bicipital groove with massive rotator cuff tear on a 103-year-old female cadaver: the natural evolution of the human shoulder?

During a dissection on a 103-year-old female cadaver, a bilateral spontaneous tenodesis of the long head of the biceps (LHB) with massive rotator cuff tear was discovered at the bicipital groove. Neer et al. have introduced the term of cuff-tear arthropathy to define severe disorganization of the glenohumeral joint with collapse of the humeral head that occurs following some massive tears of the rotator cuff, and we found this aspect during our dissection. The tendon of the LHB is a well-known source of shoulder pain, and the majority of degenerative changes in the LHB are associated with pathology of the rotator cuff. When there are complete rotator cuff tears and a rupture of the LHB, the ineluctable evolution of the shoulder is the ascension of the humeral head and the creation of a neoarticulation like in our case. This aspect is an acromial acetabulization as described roentgenographically by Hamada et al.

[Necrotizing fasciitis and cellulitis of the upper limb resulting from centipede bite: two case reports]. / Dermohypodermite bactérienne et phlegmon du membre supérieur par morsure de scolopendre: à propos de deux cas.

Centipede bites occurring in tropical countries are rare, however vigilance must be exercised during activities in the open air and dwellings should be checked in the event of rain. The bite is very painful and can be accompanied by generalised signs. An initial wound disinfection and a check of antitetanus vaccination status is all that is usually needed to ensure an uneventful outcome. There are however, rare cases where local toxicity and a bacterial super-infection, often with Gram+ cocci, can lead to a cellulitis or even necrotizing fasciitis of the hand. The diagnosis of a centipede bite can be made by the double marks made by the fangs. Wound debridement and antibiotics led to a good outcome in both our cases.

Bilateral variation of the pectoralis minor muscle discovered during practical dissection.

We describe a case of an original insertion of the pectoralis minor on the coracohumeral ligament, supraspinatus tendon and the capsule of the glenohumeral joint. This variation has been described in anatomy textbooks since the nineteenth century. The peculiarity of this case is that the right shoulder presented type 2 and the left type 1 of the three varieties described by Le Double in 1897. Le Double (1843-1913) was a French anatomist who wrote a treaty on anatomical variations, in particular those of the muscle. Lately, only three publications have reported this variation in anatomic studies. Some authors have described the rotator cuff syndrome caused by this variation and an ultrasound study has demonstrated a frequency of 9.57% for the detection of this variation. It is possible to try and find this variation while investigating in order to diagnose impingement, through ultrasound, CT arthrography or MRI. We believe that this variation should be taken into consideration by surgeons during surgical procedures and arthroscopy.

Percutaneous transthoracic needle biopsy of the lung: review of 612 lesions.

PURPOSE: The results and complications of 651 pulmonary fine-needle aspiration biopsies (FNABs) were reviewed. The number of needle passes and needle size were correlated to pneumothorax and chest tube placement rates. MATERIALS AND METHODS: FNAB of the lung was performed on 651 occasions in 612 patients with 18- to 22-gauge Franseen needles. Diagnostic rates were calculated. The number of needle passes performed and needle size used were evaluated for their association with pneumothorax and subsequent chest tube placement. RESULTS: Diagnostic accuracy was 94% with sensitivity for malignancy of 95%. Positive and negative predictive values were 99.5% and 90%, respectively. Pneumothorax occurred in 26.9% of patients with 9.2% requiring chest tube placement. Increasing numbers of needle passes and larger needle sizes did not increase the rates of pneumothorax or chest tube placement. CONCLUSIONS: FNAB of the lung has excellent diagnostic rates and remains the procedure of choice for diagnosing pulmonary lesions. This large study contradicts perceptions that pneumothorax and chest tube placement rates decrease with thinner needles and fewer passes.

Complications of laparoscopic cholecystectomy and their interventional radiologic management.

Cholelithiasis and cholecystitis are encountered throughout the world and are responsible for the majority of cholecystectomies performed. Treatment has traditionally consisted of open cholecystectomy, but laparoscopic cholecystectomy is currently a popular alternative. Laparoscopic cholecystectomy offers several benefits over the open procedure, but it also has its own set of complications. Complications include those of laparoscopy (abdominal wall bleeding, omental bleeding, abdominal vessel injury, retroperitoneal vessel injury, gastrointestinal perforation, bladder perforation, solid visceral injury, and infection) and those of cholecystectomy (gallbladder fossa bleeding, bile duct injury, bile leakage, and infection). The literature suggests that the total complication rate for the laparoscopic procedure compares favorably with that of the open procedure, but this may apply only to surgeons who have accomplished numerous laparoscopic procedures and not to those who have just completed a training course and are performing their first few procedures. With the growing success of the laparoscopic procedure, it is essential that the radiologist be knowledgeable about the radiographic manifestations and interventional radiologic management of potential complications, since the radiologist can significantly affect patient care.

Prostatic urethroplasty with balloon catheter as a nonsurgical alternative for benign prostatic hyperplasia.

Prostatic urethroplasty with a balloon catheter is an easy procedure to perform, but certain guidelines must be followed to avoid complications. This procedure will reduce the overall treatment cost of benign prostatic hyperplasia significantly. Preliminary results range from 70% to 85% symptomatic improvement or resolution of the prostatism symptoms. Its recurrence rate is still not known, but a small one is expected. Nevertheless, because of the noninvasiveness, low cost, and simplicity of the procedure, it potentially could be repeated, if necessary. This procedure is one that when it is done in combination with another specialist, in this case a urologist, the patient will benefit by the use of the expertise of both the urologist's knowledge of the disease of the urinary system and the interventional radiologist's skills with catheters and guide wires.

Renal pseudotumor due to aberrant renal capsular artery supplying normal spleen.

A renal pseudotumor caused by a small portion of normal spleen receiving blood supply from a renal capsular artery is described. CT with nonselective enhancement and liver/spleen scan may fail to delineate this previously unreported finding. CT angiography, however, can establish the diagnosis. The consideration of this situation in the differential diagnosis may help avoid costly additional workup.

Prenatal diagnosis of agenesis of the corpus callosum.

The prenatal sonographic findings in seven cases of agenesis of the corpus callosum (AGCC) are reported. Findings that suggest AGCC on standard transverse views of the fetal cranium are emphasized. All seven cases demonstrated ventricular abnormalities including four fetuses (57%) who demonstrated laterally displaced lateral ventricles and/or disproportionate enlargement of the occipital horns. Two additional fetuses demonstrated a large midline fluid collection, representing a dilated third ventricle. The remaining case demonstrated atypical findings of a septated periventricular cystic mass. Following birth, additional malformations were found in 5 of the 7 fetuses (71%), including one fetus with trisomy 8. We conclude that AGCC can be suggested on the basis of prenatal sonographic findings and that awareness of typical findings should permit more frequent detection of this anomaly in utero. Due to the frequency of concurrent anomalies, identification of AGCC should initiate a careful search for additional malformations.

Horner syndrome occurring as a complication of chest tube placement.

A case of Horner syndrome occurring secondary to the high insertion of a chest tube is reported. Horner syndrome from this cause can easily be avoided. The tip of the chest tube should be kept at or below the third posterior rib unless the clinical situation dictates otherwise.

[Effects of zinc sulfate on limbic motor epilepsy induced by kainic acid]. / Effetti del solfato di zinco sull'epilessia motoria limbica indotta da acido kainico.

In the present study the Authors have investigated the effects of chronic pretreatment with injections of Zn++ sulphate solution on kainic acid induced epilepsy, to verify wether or not Zn++ is able to change the epileptiform pattern induced by kainic acid infection. Results obtained show that Zn++ do not produce any significant change in the experimental parameters by us study.