link CDHA

http://learningradiology.com/
http://www.ctisus.org/tf/
http://spinwarp.ucsd.edu/NeuroWeb/
http://uhrad.com/
http://www.medicalheaven.com/category/radiology/
Ovid: trang hay ID: buco1 pass: medi14
http://radquiz.com/
http://www.neuroradiologyportal.com/

N.H.T.N

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Upperultrasound

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Part 1

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Nguồn: chunggiavien

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Kayser Fleischer ring

 

Nguồn: internet

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Foix-Chavany-Marie syndrome

Foix-Chavany-Marie syndrome, also known as bilateral anterior opercular syndrome is a partial paralysis of the face, pharynx and jaw caused by a loss of blood supply in a specific region of the brain. It was described in 1926 by Charles Foix, Jean Alfred Émile Chavany and Julien Marie in the Revue Neurologique.[1] As a characteristic, there is no paralysis of upper or lower limbs and those affected can still make involuntary movement like smiling, eating or blinking eyes.

A case of Foix-Chavany-Marie syndrome and crossed aphasia after right corona radiata infarction with history of left hemispheric infarction

Foix-Chavany-Marie syndrome (FCMS) is a syndrome that presents facio-pharyngo-glosso-masticatory diplegia with automatic voluntary dissociation. Its most common etiology is stroke in the regions of bilateral opercula. We described a 75-year-old woman with FCMS and crossed aphasia. She had cerebral infarction of left middle cerebral artery territory 23 years before. At that time she had transient right hemiparesis, but no aphasia. This time, she suddenly became mute and was brought to our hospital. Neurological examination revealed severe weakness in her bilateral lower face, pharynx, tongue, and sternocleidomastoideus. She had no weakness of limbs. Her listening comprehension was moderately disturbed and handwriting was paragraphic. Her emotional facial movement was maintained despite of disturbed volitional facial movement. CT scan disclosed fresh infarction at the right corona radiata and old infarction at the left middle cerebral artery territory. In this patient, lesions at the left operculum and right corona radiata with the preserved right operculum gave rise to FCMS. This implies following possibilities: 1) the corticobulbar tract and corticospinal tract run separately at the corona radiata, 2) volitional and emotional tracts of facial movement run separately at the corona radiata. It was demonstrated that FCMS is not always caused by bilateral operculum lesions. Our patient did not show aphasia after the first stroke including left language area, but became severely aphasic after the right corona radiata infarction. Simultaneous occurrence of FCMS and aphasia after corona radiata lesion suggested that the corticobulbar tract and a tract that conducts linguistic information are running adjacently in the corona radiata. Our case suggested that restricted corona radiata lesion may cause severe subcortical aphasia and in case of additional contralateral corticobulbar tract lesion, severe dysarthria may occur.

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A 79-year-old woman with a history of prior right frontal infarction presented with sudden inability to speak (figure, A). Examination revealed anarthria, yet intact comprehension, writing, and limb function (video). Voluntary tongue, swallowing, and mouth movements were absent, while cough and swallow reflexes were preserved (video). An acute left hemispheric ischemic stroke causing Foix-Chavany-Marie syndrome (FCMS) was diagnosed, and IV recombinant tissue plasminogen activator was administered. Left frontal infarction was confirmed on MRI

Figure (A) CT scan without contrast showing area of old right-sided infarct encompassing the frontoparietal opercular cortex; (B) diffusion-weighted MRI with restricted diffusion in the left precentral gyrus

Nguồn: internet

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(Do thầy Minh hỏi lúc sáng)

Extramedullary Hematopoiesis: Breathtaking and Hair-Raising

To the Editor: Thoracic masses due to extramedullary hematopoiesis are rare, occurring most often in patients with thalassemia or congenital hemolytic anemia.1 The masses usually cause no symptoms but can cause pleural effusion or hemothorax. Here, we describe a patient with respiratory insufficiency caused by large, hematopoietic thoracic masses. 

A 51-year-old woman with type III congenital dyserythropoietic anemia2 (diagnosed in 1971, with lifelong anemia) was referred to our clinic in December 1998 because of exertional dyspnea and respiratory insufficiency. In 1980, a routine radiograph of the chest had shown a small, right-sided thoracic mass; biopsy had revealed extramedullary hematopoiesis. In November 1998, the patient had had bilateral pleural effusions and was treated with thoracentesis and pleurodesis. 

At referral, when her condition was clinically stable, she had persistent hypercapnia and severely restrictive lung function (forced vital capacity, 0.84 liter; forced expiratory volume in one second, 0.66 liter) Her hemoglobin concentration was 7.6 g per deciliter. Radiographs and computed tomographic (CT) scans of the chest showed large paravertebral masses that deformed and stretched the lower-lobe bronchi in both lungs (Figure 1A). The right mass measured 17 by 12 cm, and the left 15 by 12 cm. A single-photon-emission CT (SPECT) scan of the bone marrow obtained after injection of technetium-99m sulfur colloid revealed accumulation of the radionuclide in both masses. Superimposition of the SPECT image of the bone marrow on the CT scan of the chest confirmed that the thoracic masses contained hematopoietic cells. The bone marrow scan also showed enlargement of the liver and spleen and accumulation of hematopoietic cells in the extremities, the sternum, the ribs, and the skull. This accumulation caused an extreme "hair-on-end" phenomenon on the radiograph of the skull (Figure 1B).

Extramedullary hematopoiesis can be treated with frequent blood transfusions to limit the hematopoietic stimulus. In addition, hydroxyurea therapy has been reported to decrease the size of masses of hematopoietic cells and to relieve spinal cord compression,3 as well as to reduce the size of cutaneous masses.4 We treated our patient with blood transfusions and hydroxyurea (500 mg twice daily). During a four-month treatment period, her clinical condition gradually improved, her forced vital capacity and forced expiratory volume in one second increased,4 her blood gas values normalized, and the thoracic masses decreased slightly in size. 

Extramedullary hematopoiesis has been reported in an asymptomatic patient with type II congenital dyserythropoietic anemia.5 Our patient had respiratory insufficiency due to paravertebral extramedullary hematopoiesis, and treatment with blood transfusions and hydroxyurea resulted in a satisfactory clinical, functional, and radiologic response

Nguồn: nejm

L.Y.

cách rửa phổi ... heo

1. trước tiên người ta sẽ rửa phổi bằng nước muối

khi rửa xả nước vào các phế quản phổi thật kỹ

3-4 lần như thế

bóp khô

2. sau đó xắt nhỏ

bắt chảo không lên đun cho thật nóng

cho phổi đã xắt vào đảo qua lại vài lần

lấy xuống rửa nước muối cho thật sạch rồi bóp khô

làm khoảng 2-3 lần

3. đập gừng bỏ vào nấu nước cho sôi

cho phổi vào nấu khoảng 15 phút nhắc xuống

4. bóp phổi với nước gừng lạnh (lấy gừng nấu khi nãy hoặc gừng mới)

làm khoảng 3 lần

=>phổi đã được rửa sạch

* có thể bỏ qua bước 3, 4 nếu nấu phổi heo chung với gừng

phổi heo thường để nấu canh với cải trắng phơi khô hoặc củ sen, rong biển

ăn ngon phải biết

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CT trong TBMMN

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Đây là bài của thầy Nam (Nội thần kinh)

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Phân giai đoạn carcinom đường mật ngoài gan

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Nguồn: thientuong.summerhost.info

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khai trương

Chào mừng ngày thành lập blog linh tinh

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