brief and concise on radiological anatomy of retroperitoneum
includes topic like pararenal space,perirenal space,fascial plane,retroperitoneum hematoma and sign of mass origin
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
2. • Retroperitoneum
• Pararenal spaces
• Perirenal spaces
• Interfascial planes
• Retroperitoneal hematoma
• Retroperitoneal mass
• Identification of organ of origin
3. Retroperitoneum
• The retroperitoneum is the part of the abdominal cavity that lies
between the posterior parietal peritoneum and anterior to the
transversalis fascia.
• It is divided into three spaces by the perirenal fascia (Fascia's of
Gerota and Zukerkandl) and is best visualized using CT or MRI .The
Three spaces are:
– anterior pararenal space
– perirenal space
– posterior pararenal space
4.
5.
6. BOUNDARIES OF RETROPERITINEUM
Retroperitoneum is bounded
• anteriorly by the posterior parietal peritoneum,
• posteriorly by the transversalis fascia
• extends craniocaudally from the diaphragm to the pelvic brim.
7. INTRAPERITONEAL AND RETROPERITONEAL
ORGAN
Major Intraperitoneal Organ Secondary Retroperitoneal Organ Primary Retroperitoneal Organ
Stomach Duodenum 2nd and3rdpart Kidney
Liver and gall bladder Pancreas: head,neck and body Adrenal gland
spleen Ascending and descending colon Ureter
Duodenum 1st part Upper rectum Aorta
Tail of pancreas Inferior venacava
Jejunum , ileum, appendix Lower rectum
Transverse and sigmoid colon Anal canal
8. Anterior Pararenal Space
Boundaries
– Anteriorly: post parietal peritoneum
– Posteriorly: ARF[anterior renal fascia]
– Contents: Ascending and descending colon, duodenum, pancreas
– Continuous across midline, with root of small bowel mesentery and
inferiorly with perirenal, posterior pararenal and prevesical spaces
9.
10. Posterior Para renal Space
Boundaries
– Anteriorly: PRF[posterior renal fascia] and lateral conal fascia.
– Posteriorly: transversalis fascia.
– Open laterally to flank and inferiorly to pelvis
– Contents: Fat (no visceral organs)
11. Posterior Para renal Space
• Continues anterolaterally into the properitoneal fat,the
extraperitoneal fat of the anterior abdominal wall.
12.
13. Peri Renal Space
Boundaries
• Superior - open to bare area of liver and contiguous with
mediastinum.
• Medial – anterior and posterior renal fascia fuse
• Lateral - ARF, PRF fuse to form lateroconal fascia
• Inferior - ARF & PRF converge blend about 8 cm below kidney
14.
15.
16. Contents of Perirenal Space
• Kidney, proximal collecting system, adrenal gland,
• Renal vasculature
• Lymphatics
• Bridging septa
20. Interfascial Plane
These interfascial planes are represented by
- Retromesenteric
- Retrorenal
- Lateroconal interfascial plane,
- Combined interfascial planes
21.
22. • The retromesenteric, retrorenal, and lateroconal planes are potential
routes of interfascial communication between the retroperitoneal
spaces.
• Retroperitoneal hemorrhage or rapidly expanding fluid collections can
spread via these interfascial connections.
23. • Retro mesenteric - between anterior pararenal and perinephric
spaces contiguous across midline and laterally with retro renal and
lateral conal space.
• Retro renal - between perinephric and posterior pararenal spaces·
• Lateral conal
– Combined fascial plane continues into pelvis anterolateral to psoas
muscle.
– Allowing pathway to pelvis.
– Trifurcation of 3 planes - anterioposterior location is variable
24.
25. The Retromesenteric plane
• Expansile plane located between the anterior pararenal space and
perirenal space
27. The lateroconal interfascial plane
Between layers of the LCF[lateroconal fascia]. It communicates with
the RMP[retromesenteric plane] and RRP[retrorenal plane] at the fascial
trifurcation.
28. • formed by the inferior blending
of the RMP[retro mesenteric
plane] and RRP[retrorenal plane]
. It continues into the pelvis.
The combined interfascial plane
29. The fascial trifurcation
• The point at which the RMP[retromesenteric plane], RRP[retrorenal
plane], and LCF[lateroconal fascia] planes communicate mutually
37. Zone I
Mandates exploration for both penetrating and blunt injury because of the
high likelihood of major vascular injury in this area.
Zone II
Injury to the renal vessels or parenchyma and mandates exploration for
penetrating trauma.
A nonexpanding stable hematoma resulting from a blunt trauma mechanism
is better left unexplored.
Zone III
• Penetrating trauma mandates exploration
• Blunt trauma are usually with pelvic fractures management is based
external fixation or angiographic embolization
38. Goals of Imaging in Retroperitoneal
Hemorrhage
• To identify the retroperitoneal hemorrhage, it’s location and possible
source
• To assess its relative stability on the basis of the size and presence [or
absence] of active extravasation of intravascular contrast material
39. Retroperitoneal hemorrhages & fluid
collections
• Below the kidneys, the retroperitoneal spaces- a single space with
direct contiguity between the anterior and posterior portions.
• Retroperitoneal hemorrhage or fluid spread from the abdominal
retroperitoneum into the extraperitoneal pelvis along the anterior
and posterior perirenal fasciae, which combine to form the fascial
plane in the iliac fossa.
40. • Superiorly , the perirenal fasciae are attached to the diaphragm.
• On the right side, the bare area of the liver is directly connected to
the anterior pararenal space.
Therefore , hepatic lacerations involving the bare area of the liver can
be a source of retroperitoneal hemorrhage.
44. Identification of the Organ of Origin
• Some radiologic signs that are helpful in determining tumor origin
include
– the “beak sign,”
– the “phantom (invisible) organ sign,”
– the “embedded organ sign,” and
– the “prominent feeding artery sign”
45. Beak sign
• When a mass deforms the edge of an adjacent organ into a “beak”
shape, it is likely that the mass arises from that organ (beak sign).
• On the other hand, an adjacent organ with dull edges suggests that
the tumor compresses the organ but does not arise from it
46. Phantom (Invisible) Organ Sign
• When a large mass arises from a small organ, the organ sometimes
becomes undetectable. This is known as the phantom organ sign.
• However, false-positive findings do exist, as in cases of huge
retroperitoneal sarcomas that involve other small organs such as the
adrenal gland.
47. Embedded Organ Sign
• When a tumor compresses an adjacent plastic organ (eg,
gastrointestinal tract, inferior vena cava) that is not the organ of origin,
the organ is deformed into a crescent shape.
• In contrast, when part of an organ appears to be embedded in the
tumor , the tumor is in close contact with the organ and the contact
surface is typically sclerotic with desmoplastic reaction.
• When the embedded organ sign is present, it is likely that the tumor
originates from the involved organ.
48.
49. Prominent Feeding Artery Sign
• Hypervascular masses are often supplied by feeding arteries that are
prominent enough to be visualized at CT or MR imaging, a finding that
provides an important key to understanding the origin of the mass.
50. “CT angiogram sign” or “floating aorta sign”
• Retroperitoneal masses arising posterior to the aorta can insinuate
between the aorta and the vertebral column and displace the aorta
anteriorly; and hence the term floating aorta sign.