322 research outputs found

    Iatrogenic encephalocele: a rare complication of vacuum extraction delivery

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    Vacuum extraction is a frequently used form of assisted vaginal delivery. Here we describe a child who was born by vacuum extraction delivery. Days after the birth, a frontal swelling, which was thought to be a caput succedaneum, enlarged. Imaging revealed an iatrogenic encephalocele with a large subcutaneous CSF collection. Surgical reconstruction was performed. A parasagittal dura defect was closed. There was no involvement of the superior sagittal sinus. To our knowledge, encephalocele is an infrequent complication of vacuum extraction delivery, rarely described in literature. The child had a good recovery after the operation, without neurologic deficits

    4QMMT - The Problem of the Epilogue

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    The main focus of this study is the epilogue of 4QMMT (4QMiqsat Ma aseh ha-Torah), a text of obscure genre containing a halakhic section found in cave 4 at Qumran. In the official edition published in the series Discoveries of the Judaean Desert (DJD X), the extant document was divided by its editors, Elisha Qimron and John Strugnell, into three literary divisions: Section A) the calendar section representing a 364-day solar calendar, Section B) the halakhot, and Section C) an epilogue. The work begins with text critical inspection of the manuscripts containing text from the epilogue (mss 4Q397, 4Q398, and 4Q399). However, since the relationship of the epilogue to the other sections of the whole document 4QMMT is under investigation, the calendrical fragments (4Q327 and 4Q394 3-7, lines 1-3) and the halakhic section also receive some attention, albeit more limited and purpose oriented. In Ch. 2, after a transcription of the fragments of the epilogue, a synopsis is presented in order to evaluate the composite text of the DJD X edition in light of the evidence provided by the individual manuscripts. As a result, several critical comments are offered, and finally, an alternative arrangement of the fragments of the epilogue with an English translation. In the following chapter (Ch. 3), the diversity of the two main literary divisions, the halakhic section and the epilogue, is discussed, and it is demonstrated that the author(s) of 4QMMT adopted and adjusted the covenantal pattern known from biblical law collections, more specifically Deuteronomy. The question of the genre of 4QMMT is investigated in Ch. 4. The final chapter (Ch. 5) contains an analysis of the use of Scripture in the epilogue. In a close reading, both the explicit citations and the more subtle allusions are investigated in an attempt to trace the theology of the epilogue. The main emphases of the epilogue are covenantal faithfulness, repentance and return. The contents of the document reflect a grave concern for the purity of the cult in Jerusalem, and in the epilogue Deuteronomic language and expressions are used to convince the readers of the necessity of a reformation. The large number of late copies found in cave 4 at Qumran witness the significance of 4QMMT and the continuous importance of the Jerusalem Temple for the Qumran community.TM Hanne von Weissenbergin väitöskirja käsittelee Kuolleen meren rannalta, läheltä Qumranin raunioita löydettyä n. 2000 vuotta vanhaa juutalaista tekstiä, jonka suomenkielinen nimi on Tooran määräyksiä. Kansainvälisessä Qumran-tutkimuksessa teksti tunnetaan paremmin koodinimellä 4QMMT. Vaikka teksti löydettiin jo 1950-luvulla, sen virallinen tekstieditio julkaistiin vasta vuonna 1994. Populaarimediassa teksti on tullut tunnetuksi ennen kaikkea tekstin epävirallisten, ns. "piraattijulkaisujen" aikaansaamien tekijänoikeusoikeudenkäyntien vuoksi. Aikaisemmassa Qumran-tutkimuksessa on esitetty, että Tooran määräyksiä olisi ajanlaskumme taitteen tienoilla Kuolleen meren rannalla asuneen Qumranin yhteisön perustajan, Vanhurskauden opettajan, Jerusalemin papistolle kirjoittama kirje. Lajikritiikki ja tekstin vertailu von Weissenbergin tutkimuksessa muihin tuon ajan juutalaisiin kirjeteksteihin kuitenkin osoittaa että tekstissä ei esiinny riittävästi henkilökohtaisen kirjeen piirteitä, jotta tällainen tulkinta olisi uskottava. Itse asiassa von Weissenbergin tarkastelu on osoittanut, ettei teksti sisällä juuri lainkaan Qumranin yhteisölle tyypillistä sanastoa tai teologisia piirteitä, ja on mahdollista, että teksti on alunperin syntynyt yhteisön ulkopuolella. Lukuisien kopioiden löytyminen Qumranilta merkitsee siitä huolimatta sitä, että teksti on ollut yhteisön ajattelulle merkittävä. Tooran määräyksiä-tekstissä on kaksi osaa, ns. lakiosa ja ns. epilogi, jotka poikkeavat toisistaan kirjalliselta tyyliltään. Tekstin ensimmäisten julkaisijoiden mukaan Tooran määräyksiä-tekstistä oli säilynyt kuusi käsikirjoitusta, mutta von Weissenbergin paleografinen analyysi osoittaa, että käsikirjoituksia onkin seitsemän. Von Weissenberg esittää myös useita parannuksia tekstin lukutapoihin, uuden rekonstruktion sekä itsenäisen käännöksen tekstin epilogi-osasta. Väitöskirjassa tehty rakenneanalyysi ja epilogissa käytettyjen Vanhan testamentin sitaattien analyysi osoittaa, että yksi tekstin keskeisistä teemoista on Israelin kansan liitto Jumalan kanssa ja uskollisuus tälle liitolle. Tämä näkyy sekä tekstin rakenteessa, joka soveltaa Vanhan testamentin lakiteksteistä ja muinaisitämaisista sopimusteksteistä tuttua liittokaavaa, että siinä miten epilogissa tulkitaan 5. Mooseksen kirjan liittoteologista ainesta. Epilogi kehottaa lukijoita kääntymykseen ja liittoon palaamiseen. Uskollisuus liitolle toteutuu noudattamalla tekstin lakiosassa esitettyä laintulkintaa

    Acute hydrocephalus in a child with a third ventricle arachnoid cyst and coincidental enteroviral meningitis

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    We present a 2.5-year-old child suffering from acute hydrocephalus. First, the child was diagnosed with aseptic viral meningitis. The PCR of the cerebrospinal fluid (CSF) was positive for enterovirus. Subsequently, MRI revealed that the hydrocephalus was caused by a cyst in the third ventricle. During ventriculoscopy, the cyst had all aspects of an arachnoid cyst. An endoscopic fenestration and partial removal of the cyst was performed, combined with a ventriculocisternostomy. The coincidental finding of viral meningitis and a third ventricle arachnoid cyst in a patient with acute hydrocephalus has, to our knowledge, not been described in literature before. If there is a relation between the enteroviral meningitis, the arachnoid cyst (possibly causing a pre-existing subclinical hydrocephalus) and the rapidly evolving neurological deterioration, remains speculative. Proposed mechanisms, by which the viral meningitis could accelerate the disease process, are slight brain swelling or increased CSF production. This rare combination of diagnoses could also be coincidental

    The application of fluorescence techniques in meningioma surgery-a review

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    Surgical resections of meningiomas, the most common intracranial tumor in adults, can only be curative if radical resection is achieved. Potentially, the extent of resection could be improved, especially in complex and/or high-grade meningiomas by fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA), indocyanine green (ICG), or fluorescein. This review aims to summarize and evaluate these fluorescence-guided meningioma surgery techniques. PubMed and Embase were searched for relevant articles. Additionally, we checked reference lists for further studies. Forty-eight articles were included in the final analysis. 5-ALA fluoresced with varying sensitivity and selectivity in meningiomas and in invaded bone and dura mater. Although ICG was mainly applied for video angiography, one report shows tumor fluorescence 18-28 h post-ICG injection. Lastly, the use of fluorescein could aid in the identification of tumor remnants; however, detection of dural tail is highly questionable. Fluorescence-guided meningioma surgery should be a reliable, highly specific, and sensitive technique. Despite numerous studies reporting the use of fluorescent dyes, currently, there is no evidence that these tools improve the radical resection rate and long-term recurrence-free outcome in meningioma surgery without neurological deficits. Evidence regarding the effectiveness and increased safety of resection after the application of these fluorophores is currently lacking. Future research should focus on the development of a meningioma-targeted, highly sensitive, and specific fluorophore.</p
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