RESUMEN
Chronic groin pain, often as a consequence from surgery, is a challenge from both a diagnostic and treatment standpoint. Interventional therapy is often attempted.Genitofemoral nerve block can be used for the diagnosis and treatment of groin pain. Classically, this nerve is blocked blindly at the level of the pubic tubercle, or more recently, with ultrasound. We present a novel technique to blocking the genitofemoral nerve in males using an anterior approach with computed tomographic guidance.
Asunto(s)
Conducto Inguinal , Bloqueo Nervioso/métodos , Manejo del Dolor/métodos , Tomografía Computarizada por Rayos X , Nervio Femoral , Genitales Masculinos/inervación , Humanos , Conducto Inguinal/inervación , MasculinoRESUMEN
BACKGROUND: Ex utero intrapartum treatment (EXIT) procedures have emerged as a viable option for potentially life-saving procedures in fetuses with predicted airway compromise at birth. The ability to maintain maternal-fetal uteroplacental perfusion allows for prolonged procedures in a stable fetal hemodynamic environment thereby avoiding neonatal hypoxemia or sequelae of an emergent tracheostomy. CASE: A 26-year-old female presents with a 20-week ultrasound and subsequent magnetic resonance imaging demonstrating severe fetal micrognathia (jaw index below the 5th percentile), glossoptosis, polyhydramnios, absence of a gastric bubble, and suspected microtia concerning for Treacher Collins syndrome. An EXIT procedure was completed with successful intrapartum endotracheal intubation with a flexible fiber-optic bronchoscope through a laryngeal mask airway. CONCLUSION: This case represents the first EXIT procedure completed at Naval Medical Center San Diego. Although this case is unique, the clinical skills and coordination of care required to perform this procedure are exemplified in our daily practice of stabilizing, transporting, and definitively treating our wounded warriors. The ability to work in coordination across multiple armed services to provide the EXIT procedure to our military families, for potentially life-saving procedures, is a true testament to the current state of Military Medicine.
Asunto(s)
Anomalías Múltiples/diagnóstico , Microtia Congénita/diagnóstico , Glosoptosis/diagnóstico , Intubación Intratraqueal , Micrognatismo/terapia , Periodo Periparto , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Micrognatismo/diagnóstico , Embarazo , Ultrasonografía PrenatalRESUMEN
Nostoc punctiforme strain Pasteur Culture Collection (PCC) 73102, a sequenced filamentous cyanobacterium capable of nitrogen fixation, is used as a model organism for characterization of bioenergetic processes during nitrogen fixation in Nostoc. A protocol for isolating thylakoid membranes was developed to examine the biochemical and biophysical aspects of photosynthetic electron transfer. Thylakoids were isolated from filaments of N. punctiforme by pneumatic pressure-drop lysis. The activity of photosynthetic enzymes in the isolated thylakoids was analysed by measuring oxygen evolution activity, fluorescence spectroscopy and electron paramagnetic resonance spectroscopy. Electron transfer was found functional in both PSII and PSI. Electron transfer measurements in PSII, using diphenylcarbazide as electron donor and 2,6-dichlorophenolindophenol as electron acceptor, showed that 80% of the PSII centres were active in water oxidation in the final membrane preparation. Analysis of the membrane protein complexes was made by 2D gel electrophoresis, and identification of representative proteins was made by mass spectrometry. The ATP synthase, several oligomers of PSI, PSII and the NAD(P)H dehydrogenase (NDH)-1L and NDH-1M complexes, were all found in the gels. Some differences were noted compared with previous results from Synechocystis sp. PCC 6803. Two oligomers of PSII were found, monomeric and dimeric forms, but no CP43-less complexes. Both dimeric and monomeric forms of Cyt b(6)/f could be observed. In all, 28 different proteins were identified, of which 25 are transmembrane proteins or membrane associated ones.