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Persistent mullerian duct syndrome  [cached]
Renu Divya,Rao B,Ranganath K,Namitha
Indian Journal of Radiology and Imaging , 2010,
Abstract: Persistent Mullerian duct syndrome (PMDS) is a rare form of internal male pseudohermaphroditism in which Mullerian duct derivatives are seen in a male patient. This syndrome is characterized by the persistence of Mullerian duct derivatives (i.e. uterus, cervix, fallopian tubes and upper two thirds of vagina) in a phenotypically and karyotypically male patient. In this article we present the USG and MRI features of a case of PMDS with bilateral cryptorchidism and left sided inguinal hernia, containing the uterus and fallopian tubes.
Patent arterial duct
Jonathan T Forsey, Ola A Elmasry, Robin P Martin
Orphanet Journal of Rare Diseases , 2009, DOI: 10.1186/1750-1172-4-17
Abstract: The arterial duct is an essential fetal structure and only becomes abnormal if it remains open after the neonatal period. Persistence of the arterial duct has been defined as continued patency in term infants older than 3 months [1]. It can be defined by combining both the clinical features and anatomical measurements acquired from echocardiogram as small, moderate or large and by configuration on angiogram, as described by Krichenko et al. [2].Isolated patent arterial duct is found in around 1 in 2000 full term infants, constituting nearly 10% of all congenital heart disease [3] and is the second most common congenital heart defect [4]. The overall incidence in infants born prematurely is 8 per 1000 live births with extremely high incidence of ductal patency in low birth weight infants [1]. Siassi et al. [5] reported that the incidence of patent arterial duct was 21% in a prospective study on 150 preterm infants with low birth weight. However, spontaneous delayed closure of the arterial duct occurred in 79% of their patients who survived the immediate neonatal period. The majority of reports show that there is a higher incidence in females, with a female to male ratio of ~2:1. Studies have revealed recurrence rates of between 1–5% among siblings of individuals with isolated patent arterial duct [6-10]. There are case reports which have shown much higher recurrence rates in individual families, suggesting different inheritance patterns in these families [11]. The familial occurrence of patent arterial duct is uncommon. An epidemiology paper from Carleton covering the period between 1941–58 found only 41 families where the same cardiac defect occurred in two family members and of these only 17 had patent arterial duct [12].Most patients are asymptomatic (when the duct is small). In a moderate-to-large duct, the patency of the arterial duct is recognised on detection of the characteristic continuous heart murmur. Often termed a "machinery murmur", this is typically lo
Hemihaematometra with persistent undeveloped Wolffian duct.  [cached]
Saharan S,Parulekar S
Journal of Postgraduate Medicine , 1993,
Abstract: A case of hemihaematometra in a non-communicating rudimentary horn of the uterus in a 14 year old girl is presented. Exploratory laparotomy revealed a persistent undeveloped Wolffian duct. This is the second case in world literature where a persistent mesonephric duct without any development is reported.
Persistent müllerian duct syndrome
Prakash Neeraj,Khurana Anuj,Narula Bhawna
Indian Journal of Pathology and Microbiology , 2009,
Abstract: Persistent Müllerian duct syndrome (PMDS) is a rare form of male pseudohermaphroditism characterized by the presence of the M llerian duct structures in an otherwise phenotypically as well as genotypically normal male. We report a case of 40-year-old cryptorchid male who was clinically diagnosed as seminoma in the undescended abdominal testis. A diagnosis of PMDS was made on histological evaluation subsequent to abdominal orchidectomy.
Clinical Outcome of Intra-Arterial Embolization for Treatment of Patients with Pelvic Trauma  [PDF]
M. W. Barentsz,E. P. A. Vonken,J. A. van Herwaarden,L. P. H. Leenen,W. P. Th. M. Mali,M. A. A. J. van den Bosch
Radiology Research and Practice , 2011, DOI: 10.1155/2011/935484
Abstract: Purpose. To analyse the technical success of pelvic embolization in our institution and to assess periprocedural hemodynamic status and morbidity/mortality of all pelvic trauma patients who underwent pelvic embolization. Methods. A retrospective analysis of patients with a pelvic fracture due to trauma who underwent arterial embolization was performed. Clinical data, pelvic radiographs, contrast-enhanced CT-scans, and angiographic findings were reviewed. Subsequently, the technical success and peri-procedural hemodynamic status were evaluated and described. Results. 19 trauma patients with fractures of the pelvis underwent arterial embolization. Initially, 10/19 patients (53%) were hemodynamically unstable prior to embolization. Technical success of embolization was 100%. 14/19 patients (74%) were stable after embolization, and treatment success was high as 74%. Conclusion. Angiography with subsequent embolization should be performed in patients with a pelvic fracture due to trauma and hemodynamic instability, after surgical intervention or with a persistent arterial blush indicative of an active bleeding on CT. 1. Introduction Trauma is one of the leading causes of death in patients under the age of 45 years [1]. Pelvic fractures occur in 4.0%–9.3% of patients with blunt trauma [2, 3]. These fractures should be considered severe, since mortality in these patients is high, ranging from 5.6% to 15.0% [2–8]. The mortality rate of hemodynamically unstable patient with pelvic fractures is even higher and ranges from 40% to 60% [5, 9–12]. Pelvic hemorrhage may originate from bone or vascular lesions. Venous bleeding occurs from the pelvic soft tissue, fracture ends, or the pelvic venous plexus. Arterial bleedings occur due to direct vascular laceration and are more frequently present in hemodynamically unstable patients [13, 14]. Management of hemodynamically unstable patients is aimed at controlling the venous and/or the arterial bleeding. Angiography and subsequent embolization can control arterial bleeding, while pelvic packing and external fixation encompass the current management of venous bleeding and bleeding from fracture sites. In the literature, specific indications for these treatment options remain controversial. The presence of contrast extravasation on a contrast-enhanced computed tomography (CT) scan is a strong predictor of an arterial bleeding [15–18]. This can indicate injury to a specific artery in the pelvis region. With this localisation of injury provided by CT angiography, an interventional radiologist can actively search for the
Persistent Current in Normal Metals  [PDF]
Pritiraj Mohanty
Physics , 1999, DOI: 10.1002/(SICI)1521-3889(199911)8:7/9<549::AID-ANDP549>3.0.CO
Abstract: We discuss the recent experiments on persistent current in metallic rings in the backdrop of low temperature decoherence. The observed size of the persistent current, typically on the order of the Thouless energy, $ e/\tau_D$, is much larger than the theoretical results, obtained with or without electron interaction. In considering the phenomenology of both decoherence and persistent current, usually observed in similar systems, we argue towards a dynamic role played by decoherence in the generation of a persistent current. A field-induced phase shift from near-equilibrium high-frequency fluctuations---which otherwise gives rise to decoherence---under certain conditions of periodicity and asymmetry due to disorder, is argued to induce a steady state diffusion current on the order of $e/\tau_D$, comparable to the observed persistent current.
Persistent Umbilical Discharge from an Omphalomesenteric Duct Cyst Containing Gastric Mucosa  [PDF]
Kanimozhi Tamilselvan,Arunodaya Mohan,Sarah Cheslyn-Curtis,Michael Eisenhut
Case Reports in Pediatrics , 2012, DOI: 10.1155/2012/482185
Abstract: Umbilical discharge in infancy is often attributed to infection or an umbilical granuloma. It is important to investigate if such a discharge is due to an underlying congenital abnormality because corrective surgical intervention may then be required. We present the first case of an infant with a persistent umbilical discharge from an omphalomesenteric duct cyst. The discharge was associated with periumbilical dermatitis. The dermatitis was most likely due to irritation of the skin by gastric acid produced by the ectopic gastric mucosa contained in the omphalomesenteric duct cyst. Both discharge and dermatitis resolved after surgical removal of the cyst. 1. Introduction Umbilical disorders can result from failure of an embryologic process. Basic understanding of the anatomy and embryology is necessary to identify and treat umbilical disorders. The omphalomesenteric duct (OMD) appears at the beginning of embryonic life as a long, tubular structure that connects the midgut to the yolk sac. The OMD normally regresses during the 5th?9th weeks of fetal development, leaving a solid cord that runs from the ileum to the umbilicus. If the lumen of the OMD has not completely disappeared at birth, various abnormalities can result including a fistula between the ileum and the umbilicus, an omphalomesenteric duct sinus emerging from the umbilicus and blind ending, a cyst representing a remnant of a patent segment of the OMD, a diverticulum whose enteric portion is patent, that is, Meckel’s diverticulum, or an umbilical polyp [1]. Approximately two percent of the population may have an OMD remnant, and the commonest variant is an asymptomatic Meckel’s diverticulum. We present the case of an umbilical cyst lined with gastric mucosa discharging from the umbilicus through a sinus with fistula. 2. Case Report A 6-month-old female infant had presented five times to medical services since birth with a history of discharge from the umbilicus. On days 2 and 4, she presented with bleeding from the umbilical stump, which was managed with a pressure dressing. At 2 weeks of age, she attended a general practitioner surgery with discharge of watery liquid from the umbilicus, and it was treated like an umbilical granuloma with silver nitrate application. She came to the paediatric assessment unit of the local district general hospital at 3 weeks of age because of ongoing discharge. The periumbilical skin area appeared raw with features of a chemical dermatitis. An umbilical swab was taken and treatment with oral flucloxacillin commenced. The child presented again with ongoing
Case Report - Intestinal prolapse through a persistent omphalomesenteric duct causing small-bowel obstruction
G Pauleau, D Commandeur, C Andro, X Chapellier
South African Journal of Surgery , 2012,
Abstract: Persistent omphalomesenteric duct as a cause of small-bowel obstruction is an exceptional finding. A neonate presented with occlusion due to intestinal prolapse through a persistent omphalomesenteric duct. Remnants of the duct were successfully resected, and the postoperative course was uneventful. We discuss the presentation of omphalomesenteric duct and its management.
Persistent undeveloped mesonephric duct (a case report).  [cached]
Parulekar S
Journal of Postgraduate Medicine , 1990,
Abstract: The mesonephric duct may fail to develop, resulting in congenital absence of the kidney and ureter. A unique case of persistence of the mesonephric duct without development into the kidney and ureter is presented.
Current Ablation Strategies for Persistent and Long-Standing Persistent Atrial Fibrillation  [PDF]
Konstantinos P. Letsas,Michael Efremidis,Charalampos Charalampous,Spyros Tsikrikas,Antonios Sideris
Cardiology Research and Practice , 2011, DOI: 10.4061/2011/376969
Abstract: Atrial fibrillation (AF) is associated with an increased risk of cardiac and overall mortality. Restoration and maintenance of sinus rhythm is of paramount importance if it can be accomplished without the use of antiarrhythmic drugs. Catheter ablation has evolved into a well-established treatment option for patients with symptomatic, drug-refractory AF. Ablation strategies which target the pulmonary veins are the cornerstone of AF ablation procedures, irrespective of the AF type. Ablation strategies in the setting of persistent and long-standing persistent AF are more complex. Many centers follow a stepwise ablation approach including pulmonary vein antral isolation as the initial step, electrogram-based ablation at sites exhibiting complex fractionated atrial electrograms, and linear lesions. Up to now, no single strategy is uniformly effective in patients with persistent and long-standing persistent AF. The present study reviewed the efficacy of the current ablation strategies for persistent and long-standing persistent AF. 1. Introduction Atrial fibrillation (AF) is associated with a 2-fold risk of cardiac and overall mortality [1]. Restoration and maintenance of sinus rhythm is of paramount importance if it can be accomplished without the use of antiarrhythmic drugs [2]. Catheter ablation of AF has been widely accepted as an important therapeutic modality for the treatment of patients with symptomatic AF, refractory or intolerant to at least one class I or III antiarrhythmic medication [3–5]. Previous studies have clearly demonstrated the superiority of catheter ablation over antiarrhythmic drug treatment, even in patients with persistent AF [6–11]. The recently published ESC guidelines state that ablation of persistent symptomatic AF that is refractory to antiarrhythmic therapy should be considered a treatment option (class IIa, level of evidence B) [5]. In addition, catheter ablation of AF may also be considered in patients with symptomatic long-standing persistent AF refractory to antiarrhythmic drugs (class IIb, level of evidence C) [5]. Following the work of Ha?ssaguerre et al.[12], catheter ablation of paroxysmal AF aiming at electrical pulmonary vein isolation (PVI) results in maintenance of sinus rhythm in 60 to 85% of patients [13, 14]. On the contrary, PVI is considered insufficient to eliminate persistent or long-standing persistent AF (more that one year) leading to significantly lower success rate of this method [3, 4, 15, 16]. Substrate modification is usually required in the setting of persistent and long-standing persistent AF [15,
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