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jcrmhscasereports · 2 years
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COMPLETE PENOSCROTAL TRANSPOSITION WITH MULTIPLE CONGENITAL MALFORMATIONS by Jafari B. Lutavi in Journal of Clinical Case Reports Medical Images and Health Sciences  
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SUMMARY
Penoscrotal transposition (PST) is an extremely rare congenital anomaly of the external genitalia, characterized by malposition of the penis in relation to the scrotum. PST can be either complete or incomplete according to the positional exchanges between the penis and scrotum and both forms of PST are generally linked with hypospadias. Incomplete transposition is the common form of this entity and the penis lies in the middle of the scrotum, but complete transposition, the scrotum almost entirely covers the penis, which emerges from the perineum. Both forms are most often associated with a wide variety of other anomalies. We describe a case of a newborn with complete PST, with other associated malformations.
BACKGROUND
Penoscrotal transposition (PST) is a rare anomaly of the external genitalia, characterized by malposition of the penis in relation to the scrotum1,2,3. PST can be defined as either complete or incomplete according to the positional exchanges between the penis and scrotum and both forms of PST are generally linked with hypospadias. Incomplete transposition is the common form of this entity and the penis lies in the middle of the scrotum, but in complete transposition, the scrotum almost entirely covers the penis, which emerges from the perineum1. PST was first reported by Appleby in 1923. Patients with PST often have accompanying urological abnormalities, such as chordee, hypospadias, and vesicoureteric reflux4.
The etiology and embryological sequence abnormalities that occur in PST is still unclear. The genital tubercle and the labioscrotal swellings are the embryological origins of the penis and scrotum, respectively. During normal embryonic development, in the 9th–11th week, the scrotal swellings migrate infero-medially and fuse in the midline caudal to the genital tubercle that forms the penis by the 12th week of gestation. This is usually achieved under the influence of androgens and poor response or absence of androgens results in abnormal migration  of the scrotal swellings3. Somoza et al suggested that an abnormal positioning of the genital tubercle at the 6th gestation week (GA) concerning the scrotal swellings or a defective gubernaculum leads to PST2.
Complete penoscrotal transposition (CPST) is frequently characterized by major and often life-threatening anomalies involving the urogenital, cardiovascular, gastrointestinal, and skeletal systems2. Common genital anomalies include hypospadias and chordee, and 100% of cases have a renal defect.
CASE PRESENTATION
A gravida 5, para 1, living 1 with 3 abortions woman aged 27 years was referred from Mwananyamara Referral Regional Hospital and admitted to Obstetrics and Gynecology department at Muhimbili National Hospital- Mloganzila. She has a referral diagnosis of antepartum hemorrhage and severe oligohydramnious at GA of 30 weeks 2 days. She had three previous pregnancy loses: 1st and 2nd loses both at 12 weeks GA with 6 months between the loses; her 3rd loss was 2 years after she had a term healthy baby by normal delivery.
She had no histories of phenotypic genetic abnormalities in their families, illicit drug use, cigarette or alcohol consumption, no chemical, radiation exposure, or any chronic illness. She is married, and is a university graduate, working as a transportation officer. She attended antenatal clinic (ANC) five times and all her laboratory work-up such as blood count indices, blood grouping, urinalysis, stool examination, and microscopy, and fasting blood sugar were normal. She was HIV negative and blood film for malaria parasites came back negative. Record of the ultrasound scan taken at 6th -week gestation indicates early multiple pregnancy (two gestational sacs seen) and the next scan performed at 27th weeks GA show a normal single fetus with no anomaly. She was given iron and folic acid supplements, received Tetanus Toxoid vaccine twice, sulfadoxine-pyrimethamine (SP) tables twice as part of intermittent preventive therapy for malaria and she was dewormed using Mebendazole. With her history of pregnancy loss and complaints of abdominal cramps, she had been kept on bed rest at home from 16th week of gestation as recommended by her obstetrician at Mwananyamala Hospital.
After she was brought to our hospital she had active vagina bleeding. A bed side ultrasound revealed placenta previa grade 3 and she was planned for emergency hysterotomy. She delivered a male baby, 1750 gm, who did not initiate spontaneous breathing after birth. The baby was initially resuscitated with a bag and mask before intubation at age 5 minutes. He was assigned an Apgar score of 3, 1, 4 at 1st, 5th and 10th minute respectively. On examination, baby had severe pallor, occipital-frontal circumference – 29cm, communicating anterior and posterior fontanelle, low set ears, short neck, wide-spaced nipples, undescended testes (empty scrotum), inverted genitals (CPST) with hypospadias (Figure 1), rectal atresia, prominent heel, and bilateral talipes equinovarus.
https://jmedcasereportsimages.org/wp-content/uploads/2022/10/fig-1-2.jpg
Figure 1: (a) shows a horizontal view of complete penoscrotal transposition and (b) shows an oblique view of complete penoscrotal transposition.
DISCUSSION
Penoscrotal transposition (PST) is a congenital urogenital anomaly described first in 1923 by Appleby. The embryological sequence responsible for this malformation remains unclear; however, it has been suggested that an abnormal positioning of the genital tubercle in relation to the scrotal swellings during the critical fourth to the fifth week of gestation could affect the migration of the scrotal swellings2. In this case report, there is a complete exchange of position with the scrotum located superior to the penis, which is inferior to scrotum. (Figures 1(a) and 1(b)). Also, there presents a spiral and hypoplastic penis crooked toward the anal position. Ayamba et al reported the same findings whereby noticed complete transposition of the external genitalia with cryptorchidism, hypoplastic penis from the perineum just above the blind anal position, and caudal to the scrotum3. Somoza et al also noted at birth a newborn has a complete transposition of the external genitalia, a 3.5-cm-long, hypospadic, and hypoplasic penis arose from the perineum, just above the anus and beneath a normal scrotum1–3,5.
CPST is often characterized by major associated malformations. Our baby had also other multiple physical abnormalities such as short neck, low set ears and talipes equinovarus. Unfortunately, due to our limited resources, we could not complete imaging of internal organs. Previous reports of CPST have also noted presence of other malformation with 100% occurrence of renal anomalies. For example, Parida et al had noted major renal anomalies in the form of agenesis, horseshoe kidney, ectopic and dysplastic kidney, obstructive uropathy, and hydronephrosis. Other systemic abnormalities are mental retardation, anorectal malformations, central nervous system, skeletal and cardiological defects5.  In our case, we did not perform imaging to detect renal anomalies, but literature suggests most likely there were there. The detection of CPST should warrant careful clinical evaluation to rule out other anomalies.
Although some reported a family history and genetic basis for the incidence of PST6, we did not find any evidence of positive family history of phenotypic abnormalities. When associated with severe hypospadias, penoscrotal transposition necessitates a staged surgical repair for physiological and psychological reasons.
Our newborn required advanced resuscitation at birth, likely due to hypoxia in utero as a result of significant blood loss (placenta previa grade 3). This is supported by the findings that baby was very pale at birth. However, we cannot rule out the possibility of other anomalies such as fatal cardiac anomalies which are incompatible with life1,5.
OUTCOME
The newborn was transferred to the neonatal intensive care unit for further treatment and passed on after 4 hours. No any radiological or laboratory investigation were completed within this time.
LEARNING POINTS/TAKE HOME MESSAGES
Strengthening of antenatal care services in a primary health facility is a key for positive outcome of pregnancy. This is by early detection of abnormal development of fetus in utero by early ultrasound
Referring hospitals in low-income settings should be strengthened with well knowledgeable personnel (radiographers) and modern equipment. As we have notice in this case even a placenta praevia was detected after being received in a tertiary hospital despite the woman being scanned in late 2nd
There is a need of strengthening neonatal ICU by ensuring bedside radiological equipment’s is available also other ICU equipment’s are enough. As we have seen no any radiological investigation done to the baby due to the fact that the baby was in critical condition but based on critical care knowledge and experience this could possible by bedside equipment.
Learning culture must be strengthened in our institute; if we had good learning culture radiological investigations would have been done to the dead baby for learning purpose to detect if there is any other internal congenital anomaly and other cause of death to this newborn
PATIENT’S PERSPECTIVE
Am so thankful for the services I receive from all hospitals and I declare to have no any experience of having an abnormal baby in my family and even my husband’s family. This is my first time to give birth a newborn with congenital malformation and i wondered the way it was not even discovered early during the antenatal period. Also, I promise to attend the clinic early for the next pregnancy and follow all instructions that i will be given by health care providers for the sake of the good health of herself and next baby.  Am so happy about this publication because it will help other doctors to identify the condition and treat it accordingly also for those who are in learning schools will learn more about this condition.
Competing interests: None.
Patient consent: Obtained
For more information: https://jmedcasereportsimages.org/about-us/
For more submission : https://jmedcasereportsimages.org/
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courtjester69420 · 1 year
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Silly as fuck to have a body part called the gubernaculum. What’s next, the corpus jokesum?? Fuck off
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amunvulcan · 3 years
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Fortuna (Latin: Fortūna, equivalent to the Greek goddess Tyche) is the goddess of fortune and the personification of luck in Roman religion who, largely thanks to the Late Antique author Boethius, remained popular through the Middle Ages until at least the Renaissance. The blindfolded depiction of her is still an important figure in many aspects of today's Italian culture, where the dichotomy fortuna / sfortuna (luck / unluck) plays a prominent role in everyday social life, also represented by the very common refrain "La [dea] fortuna è cieca" (latin Fortuna caeca est; "Luck [goddess] is blind").
Fortuna is often depicted with a gubernaculum (ship's rudder), a ball or Rota Fortunae (wheel of fortune, first mentioned by Cicero) and a cornucopia (horn of plenty). She might bring good or bad luck: she could be represented as veiled and blind, as in modern depictions of Lady Justice, except that Fortuna does not hold a balance. Fortuna came to represent life's capriciousness. She was also a goddess of fate: as Atrox Fortuna, she claimed the young lives of the princeps Augustus' grandsons Gaius and Lucius, prospective heirs to the Empire.[1] (In antiquity she was also known as Automatia.)[2]
Fortuna's father was said to be Jupiter and like him, she could also be bountiful (Copia). As Annonaria she protected grain supplies. June 11 was consecrated to her: on June 24 she was given cult at the festival of Fors Fortuna.[4][5] Fortuna's name seems to derive from Vortumna (she who revolves the year).[citation needed]
Roman writers disagreed whether her cult was introduced to Rome by Servius Tullius[6] or Ancus Marcius.[7] The two earliest temples mentioned in Roman Calendars were outside the city, on the right bank of the Tiber (in Italian Trastevere). The first temple dedicated to Fortuna was attributed to the Etruscan Servius Tullius, while the second is known to have been built in 293 BC as the fulfilment of a Roman promise made during later Etruscan wars.[8] The date of dedication of her temples was 24 June, or Midsummer's Day, when celebrants from Rome annually floated to the temples downstream from the city. After undisclosed rituals they then rowed back, garlanded and inebriated.[9] Also Fortuna had a temple at the Forum Boarium. Here Fortuna was twinned with the cult of Mater Matuta (the goddesses shared a festival on 11 June), and the paired temples have been revealed in the excavation beside the church of Sant'Omobono: the cults are indeed archaic in date.[10] Fortuna Primigenia of Praeneste was adopted by Romans at the end of 3rd century BC in an important cult of Fortuna Publica Populi Romani (the Official Good Luck of the Roman People) on the Quirinalis outside the Porta Collina.[11] No temple at Rome, however, rivalled the magnificence of the Praenestine sanctuary.
Fortuna's identity as personification of chance events was closely tied to virtus (strength of character). Public officials who lacked virtues invited ill-fortune on themselves and Rome: Sallust uses the infamous Catiline as illustration – "Truly, when in the place of work, idleness, in place of the spirit of measure and equity, caprice and pride invade, fortune is changed just as with morality".[12]
An oracle at the Temple of Fortuna Primigena in Praeneste used a form of divination in which a small boy picked out one of various futures that were written on oak rods. Cults to Fortuna in her many forms are attested throughout the Roman world. Dedications have been found to Fortuna Dubia (doubtful fortune), Fortuna Brevis (fickle or wayward fortune) and Fortuna Mala (bad fortune).
Fortuna is found in a variety of domestic and personal contexts. During the early Empire, an amulet from the House of Menander in Pompeii links her to the Egyptian goddess Isis, as Isis-Fortuna.[13] She is functionally related to the god Bonus Eventus,[14] who is often represented as her counterpart: both appear on amulets and intaglio engraved gems across the Roman world. In the context of the early republican period account of Coriolanus, in around 488 BC the Roman senate dedicated a temple to Fortuna on account of the services of the matrons of Rome in saving the city from destruction.[15] Evidence of Fortuna worship has been found as far north as Castlecary, Scotland[16] and an altar and statue can now be viewed at the Hunterian Museum in Glasgow.[17]
The earliest reference to the Wheel of Fortune, emblematic of the endless changes in life between prosperity and disaster, is from 55 BC.[18] In Seneca's tragedy Agamemnon, a chorus addresses Fortuna in terms that would remain almost proverbial, and in a high heroic ranting mode that Renaissance writers would emulate:
O Fortune, who dost bestow the throne's high boon with mocking hand, in dangerous and doubtful state thou settest the too exalted. Never have sceptres obtained calm peace or certain tenure; care on care weighs them down, and ever do fresh storms vex their souls. ... great kingdoms sink of their own weight, and Fortune gives way ‘neath the burden of herself. Sails swollen with favouring breezes fear blasts too strongly theirs; the tower which rears its head to the very clouds is beaten by rainy Auster. ... Whatever Fortune has raised on high, she lifts but to bring low. Modest estate has longer life; then happy he whoe’er, content with the common lot, with safe breeze hugs the shore, and, fearing to trust his skiff to the wider sea, with unambitious oar keeps close to land.[19]
Ovid's description is typical of Roman representations: in a letter from exile[20] he reflects ruefully on the “goddess who admits by her unsteady wheel her own fickleness; she always has its apex beneath her swaying foot.”
Fortuna did not disappear from the popular imagination with the ascendancy of Christianity.[21] Saint Augustine took a stand against her continuing presence, in the City of God: "How, therefore, is she good, who without discernment comes to both the good and to the bad?...It profits one nothing to worship her if she is truly fortune... let the bad worship her...this supposed deity".[22] In the 6th century, the Consolation of Philosophy, by statesman and philosopher Boethius, written while he faced execution, reflected the Christian theology of casus, that the apparently random and often ruinous turns of Fortune's Wheel are in fact both inevitable and providential, that even the most coincidental events are part of God's hidden plan which one should not resist or try to change. Fortuna, then, was a servant of God,[23] and events, individual decisions, the influence of the stars were all merely vehicles of Divine Will. In succeeding generations Boethius' Consolation was required reading for scholars and students. Fortune crept back into popular acceptance, with a new iconographic trait, "two-faced Fortune", Fortuna bifrons; such depictions continue into the 15th century.[24]
The ubiquitous image of the Wheel of Fortune found throughout the Middle Ages and beyond was a direct legacy of the second book of Boethius's Consolation. The Wheel appears in many renditions from tiny miniatures in manuscripts to huge stained glass windows in cathedrals, such as at Amiens. Lady Fortune is usually represented as larger than life to underscore her importance. The wheel characteristically has four shelves, or stages of life, with four human figures, usually labeled on the left regnabo (I shall reign), on the top regno (I reign) and is usually crowned, descending on the right regnavi (I have reigned) and the lowly figure on the bottom is marked sum sine regno (I have no kingdom). Medieval representations of Fortune emphasize her duality and instability, such as two faces side by side like Janus; one face smiling the other frowning; half the face white the other black; she may be blindfolded but without scales, blind to justice. She was associated with the cornucopia, ship's rudder, the ball and the wheel. The cornucopia is where plenty flows from, the Helmsman's rudder steers fate, the globe symbolizes chance (who gets good or bad luck), and the wheel symbolizes that luck, good or bad, never lasts.
Fortuna lightly balances the
orb
of sovereignty between thumb and finger in a Dutch painting of
ca
1530 (
Musée des Beaux-Arts de Strasbourg
)
Fortune would have many influences in cultural works throughout the Middle Ages. In Le Roman de la Rose, Fortune frustrates the hopes of a lover who has been helped by a personified character "Reason". In Dante's Inferno (vii.67-96), Virgil explains the nature of Fortune, both a devil and a ministering angel, subservient to God. Boccaccio's De Casibus Virorum Illustrium ("The Fortunes of Famous Men"), used by John Lydgate to compose his Fall of Princes, tells of many where the turn of Fortune's wheel brought those most high to disaster, and Boccaccio essay De remedii dell'una e dell'altra Fortuna, depends upon Boethius for the double nature of Fortuna. Fortune makes her appearance in Carmina Burana (see image). The Christianized Lady Fortune is not autonomous: illustrations for Boccaccio's Remedii show Fortuna enthroned in a triumphal car with reins that lead to heaven.[25]
Fortuna also appears in chapter 25 of Machiavelli's The Prince, in which he says Fortune only rules one half of men's fate, the other half being of their own will. Machiavelli reminds the reader that Fortune is a woman, that she favours a strong, ambitious hand, and that she favours the more aggressive and bold young man than a timid elder. Monteverdi's opera L'incoronazione di Poppea features Fortuna, contrasted with the goddess Virtue. Even Shakespeare was no stranger to Lady Fortune:
When in disgrace with Fortune and men's eyes I all alone beweep my outcast state...
Ignatius J Reilly, the protagonist in the famous John Kennedy Toole novel A Confederacy of Dunces, identifies Fortuna as the agent of change in his life. A verbose, preposterous medievalist, Ignatius is of the mindset that he does not belong in the world and that his numerous failings are the work of some higher power. He continually refers to Fortuna as having spun him downwards on her wheel of luck, as in “Oh, Fortuna, you degenerate wanton!”
In astrology the term Pars Fortuna represents a mathematical point in the zodiac derived by the longitudinal positions of the Sun, Moon and Ascendant (Rising sign) in the birth chart of an individual. It represents an especially beneficial point in the horoscopic chart. In Arabic astrology, this and similar points are called Arabian Parts.
Al-Biruni (973 – 1048), an 11th-century mathematician, astronomer, and scholar, who was the greatest proponent of this system of prediction, listed a total of 97 Arabic Parts, which were widely used for astrological consultations.
Aspects[edit]
Lady Fortune in a
Boccaccio
manuscript
Sculpture of Fortuna,
Vienna
La Fortune
by
Charles Samuel
(1894), Collection
King Baudouin Foundation
Fortuna Annonaria brought the luck of the harvest
Fortuna Belli the fortune of war
Fortuna Primigenia directed the fortune of a firstborn child at the moment of birth
Fortuna Virilis ("Luck in men"), a woman's luck in marriage[26]
Fortuna Redux brought one safely home
Fortuna Respiciens the fortune of the provider
Fortuna Muliebris the luck of a woman.
Fortuna Victrix brought victory in battle
Fortuna Augusta the fortune of the emperor[27]
Fortuna Balnearis the fortune of the baths.[27]
Fortuna Conservatrix the fortune of the Preserver[28]
Fortuna Equestris fortune of the Knights.[28]
Fortuna Huiusce Diei fortune of the present day.[28]
Fortuna Obsequens fortune of indulgence.[28]
Fortuna Privata fortune of the private individual.[28]
Fortuna Publica fortune of the people.[28]
Fortuna Romana fortune of Rome.[28]
Fortuna Virgo fortune of the virgin.[28]
Fortuna Faitrix the fortune of life
Pars Fortuna
Fortuna Barbata the fortune of adolescents becoming adults[29]
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alastor-nemesis · 3 years
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Gubernaculum | Repo Jazz | Splitting The Atom
"Gubernaculum | Repo Jazz | Splitting The Atom" https://splittingatom.bandcamp.com/album/gubernaculum
A little thing I cooked up with my friends.
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kirby-the-gorb · 6 years
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the first one says “anatomy of a kirb”, I was playing with the text tool today :p it turned out kind of a mess though
fun fact: the gubernaculum is a real thing, included at my partner’s request. kirby probably doesn’t actually have one tho.
drawn in drawing desk for iOS (on sketch desk)
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soumal · 6 years
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01: When it comes to those important words/terms you just can’t get into your head, try looking up their etymologies i.e. the origin of the word. The root is almost always either the latin/greek/french/etc equivalent or a description of the word’s function/position/etc. This really helped me with memorising and understanding a lot of anatomy - for example, Gubernaculum (a peritoneal attachment to the gonads) : 
gubernāculum n (genitive gubernāculī); second declension
the steering-oar, helm, rudder
management
The gubernaculum steers and guides the developing testes into their adult positions.
02: When first learning a difficult concept, go slow, hella slow. Break down and simplify learning points as much as possible and don’t worry about spending too much time on it initially. Once you’ve got it - REVISIT regularly.
03: Nuts. Eat them. Protein is satiating and they’re hands down the best study snack + your skin will thank you later (Vit E wut wut). Literally munch on them throughout your sessions if you want to avoid getting up to eat all the time. (DON’T DO THIS WITH BRAZIL NUTS - have only 2 a day of these max)
04: If you’re pulling an all nighter (don’t recommend these but anyway) and you’re starting to drop off, the obvious thing is to get up and move but also talk. If anyone is still awake, have a quick conversation or talk outloud to yourself. Outline what you’ll be doing tomorrow/ bullet point what you were just reading - pretend your a lecturer, use hand gestures etc. This will activate as many parts of your brain as possible.
05: Story acronyms. If you have a process or profile to learn, break it down into a few steps/components then create a very short anecdote, (no more than a sentence)cally, where each word starts with the letter of the first step, for example (this works esp well for cramming) :
William And Inel Vay-K-ed (vaycayed i.e. went on vacation ¬.¬) Enroute Redding
Warfarin Antithrombin Inhibits Vitamin K Epoxide Reductase etc
Don’t worry if it’s utter nonsense - it’s for those times when you can’t find a neat abbreviation and need something memorable.
06: Watch movies/shows that are either a) very study orientated (I don’t mean school-setting k-dramas) or b) are super calming, slice-of-life types with lots of pretty scenery like uh Ghibli movies. This kinda stuff always motivates the heck out of me for some reason esp this one.
07: Write in Blue. Research suggests it improves recall memory. This helped me somewhat when annotating lecture slides but I think I noticed the effects most when I was writing rough notes to check retention.
08: Watch those around you. Sit near someone who is really on it (not everyday though, that might weird them out) - big motivator. If not, you’ll likely feel like an idiot if you don’t get on with it as well.
09: Year 3 (/third grade) spelling test classic - Look, Cover, Write: Works every time - especially with revision guides. Make notes then chuck em (erm I mean recycle obvs). These aren’t meant to be organised or aes at all. They’re rough and ugly and purely for recall.
Can’t really think of anymore atm so that’s all folks.
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referencedailynews · 3 years
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Anambra Guber: Civil Society Condemn INEC’s Silence On Alleged $4m Bribe To Compromise Election
Anambra Guber: Civil Society Condemn INEC’s Silence On Alleged $4m Bribe To Compromise Election
A Civil Society Organization known as Save Nigeria Movement, SNM, has berated the Independent National Electoral Commission, INEC, over allegations that some of its top officials have received a $4million bribe to compromise the Anambra governorship election.The group claimed that INEC was working in favour of a particular candidate to win the gubernaculum election.SNM convener, Rev Solomon…
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mbimphblog · 3 years
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ON A NEW NEMATODE METAQUIMPERIA CHAUHANI N. Sp. FROM FRESH WATER FISH BAGARIUS BAGARIUS (HAM.)|UTTAR PRADESH JOURNAL OF ZOOLOGY
At Lucknow, Metaquimperia chauhan in sp. was discovered in the intestine of the freshwater fish Bagarius bagarius (Ham). Caudal papillae (4 pairs preanal and 5 pairs postanal), a tiny gubernaculum, and the absence of anal papillae separate it from other species.
Please see the link :- http://mbimph.com/index.php/UPJOZ/article/view/1006
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mytheslegendes · 3 years
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En ce jour, les romains fêtaient Fortuna, la déesse de la fortune et la personnification de la chance. Fortuna est souvent représentée avec un gubernaculum (gouvernail de navire), une boule ou Rota Fortunae (roue de la fortune, mentionnée pour la première fois par Cicéron) et une corne d'abondance (corne d'abondance). Elle pourrait porter chance ou malchance : elle pourrait être représentée comme voilée et aveugle, comme dans les représentations modernes de Dame Justice, sauf que Fortuna ne tient pas la balance. Fortuna en est venu à représenter les caprices de la vie. Elle était aussi une déesse du destin : en tant qu'Atrox Fortuna, elle a coûté la vie aux petits-fils du princeps Auguste, Gaius et Lucius, futurs héritiers de l'Empire. #calendrier #mythologie #mythe #legende #rome #fortuna https://www.instagram.com/p/CQfbvcfJCJ6/?utm_medium=tumblr
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I was tagged by @contrivedcoincidences6
1. What’s the best compliment you’ve ever received?
When I first went away to university, I was dealing with a lot of things and going through a bout of depression.  My youngest brother (10 years younger than me), was apparently really looking forward to my visit home over the Christmas holidays but I was too down and blue, in my own head, to notice.  Anyway, towards the end of the vacation, I found him crying in his room.  He was devastated that I was going back so soon and that we didn’t spend a lot of time together doing fun things.  So while I felt (and continue to feel) horrible about that, it still stands out as a huge moment for me in my life.  I would say that he gave me the best compliment that day because I don’t know if I ever really noticed until that time how much I really meant to him and how much he enjoyed spending time with me.  (I’m tearing up again just thinking of it....anyway, it’s a happy story.  He ended up drawing things for me that I posted on my door and walls...and yes John, I still have them.) 
2. Do you have any siblings? (If not tell me about someone who is like a sibling)
Yup, I am one of 6 (5 younger siblings)....4 of my siblings are twins but I have claimed John as my twin the day he was born. 
3. If you could have actually witnessed one cool event what would it have been?
Does the truth about all the gillovny fuckery count?  In which case, that (specifically to be a fly on the wall for an epic moment).
4. If you could only eat one meal for the rest of your life what meal would that be?
Does ice cream count as a meal?  (I’ve had it as one many times before.)
5. Your preferred superpower?
hmmm...I could cheat and say Rogue’s power to sample them all, but it would suck not to be able to touch anyone.  Having the ability to fly might make my fear of heights a thing of the past.   Honestly, the first thing that came to mind was invisibility (along with the line from the guy who could turn invisible, but only when no one was looking at him, in Mystery Men).  Maybe incredible strength and healing so that I can keep with with my super siblings. 
6. What is on your mind most of the time?
All the stuff that I have to do as well as anxiety about never being able to get it done.  (That or things that I’ve said or done in the past that I can’t stop beating myself up over.)
7. What’s your favorite txf fanfiction! (Link??)
Now that’s mean...how could I possibly choose?  I’ve recently been on an AU kick, so some of those fics include Au Café Pequod saga by @sunflowerseedsandscience, One Week at Quantico  by @crossedbeams, and then basically anything by Prufrock’s love, such as A Moment in the Sun, Paracelsus, and (the one I’ve probably read the most from this author) Hiraeth .  (Sorry about not including the links...Prufrock’s Love’s fics are on gossamer while the others are on AO3).
8. What is a cause you care about? (Maybe give us info so we can look into it!)
Basically anything that has to do with kids.  Covenant House in Toronto (provides 24/7 crisis care for homeless youth and many other services), Sick Kids Hospital, education, etc.  Personally, I want to work on prevention of metabolic syndrome.  (While our health care is great in many ways, very little attention is spent on prevention of chronic illnesses and I want to work to change that.)
9. Who is your hero?
There are many and for different reasons.  My great-grandmother (who lived I Poland during both world wars), my grandmothers (both of whom were independent in their own ways), GA (for obvious reasons), Neil deGrasse Tyson (who incidentally had an interesting thing to say on heroes and role models here:  https://www.youtube.com/watch?v=LijswPL3LQ8), and the great Clara Hughes.  
10. What is your favorite word?
My favourite words to say are probably “gubernaculum” (an anatomical term) and “coquelicot” (the French word for poppy), but because they are kind of quirky and fun to say.
I asked my dying grandmother this one day (my sisters looked at me as if this was the weirdest thing I’ve ever done in my life).  Her response was my favourite though.  “No.”  I think that that is a good word that I don’t use enough.
11. What is a song I should listen to?
I love soundtrack music.  A couple of examples that come to mind include “The Battle” from the Narnia soundtrack, the Lord of the Rings soundtrack (especially these two bits: when the beacon is lit, paired with the scenery of the mountains, etc; and when the people of Rohan charge the field right after the King gave that epic speech...the ride of the Rohirrim), and finally, my fav bit of X files soundtrack, called Threnody in X (which was from FTF....that part where they are driving in Texas after those tanker trucks and the music just grows and swells).
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angingerton · 8 years
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The word of the day is gubernaculum.
In other news, i'm so tired of repro/GU studying. I don't want to fail this test simply because this stuff is boringgg. Well, I already knew OB/GYN wasn't for me.
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ao3feed-janto · 7 years
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The Boy
read it on the AO3 at http://ift.tt/2sFu3Rf
by gubernaculum
Secrets never stay that way.
Words: 2091, Chapters: 1/1, Language: English
Fandoms: Torchwood, Highlander: The Series
Rating: Mature
Warnings: Graphic Depictions Of Violence
Categories: M/M
Characters: Jack Harkness, Ianto Jones, Gwen Cooper, Original Characters
Relationships: Jack Harkness/Ianto Jones
read it on the AO3 at http://ift.tt/2sFu3Rf
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ao3feed-doctorwho · 5 years
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The Wedding II
read it on the AO3 at http://bit.ly/2DYgQua
by gubernaculum
A purely fluffy piece centered around my original character relationships
Words: 2967, Chapters: 1/1, Language: English
Series: Part 15 of The Namesakes
Fandoms: Highlander: The Series, Torchwood
Rating: Not Rated
Warnings: Creator Chose Not To Use Archive Warnings
Categories: M/M
read it on the AO3 at http://bit.ly/2DYgQua
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cancersfakianakis1 · 7 years
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Ectopic nephrogenic rests in children: A series of 13 cases in a single institution
Abstract
Purpose
Ectopic nephrogenic rests (ENR) are extremely rare, and their diagnosis and treatment have not yet been standardized. Our study aimed to analyze the clinical and pathological features of ENR in children and explore the optimal methods for diagnosis and treatment.
Methods
A retrospective, single-center, case series study of 13 children with ENR was performed. Clinical manifestations, work-up, pathological features, and treatment methods were analyzed, and the postoperative status was evaluated at follow-up.
Results
The study cohort included seven males and six females aged 1/4–19 months, who were divided into two subgroups: group 1 (pure ENR, cases 1–3) and group 2 (ENR associated with teratoma, cases 4–13). The patients commonly presented with a painless mass or an incidental finding in surgery. The ENR were detected in the lumbosacral and sacrococcygeal region (five cases), retroperitoneal area (five cases), testis (one case), gubernaculum testis (one case), and stomach (one case). Radiological findings showed a mixed-density mass or a mixed-signal-intensity lesion in group 2. All the patients underwent surgical resection, and all except two were event-free in a follow-up period of 2–154 months. Case 8 showed recurrence, and extended surgery was performed. Case 7 developed metastases and received chemotherapy.
Conclusions
ENR are rare among children and have no specific clinical manifestations, lab tests, and radiological features. Different treatment strategies may be adopted based on the diagnosis. Complete resection can generally be achieved, and the prognosis is excellent in most cases. However, relapse or metastasis may occur in a small subset of patients. Close follow-up is mandatory to detect recurrence and metastasis early.
http://ift.tt/2C4N9U8
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udrugecom-blog · 7 years
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HUMANITARNA UDRUGA GUBERNACULUM, Zagreb, Ilica 158
HUMANITARNA UDRUGA GUBERNACULUM, Zagreb, Ilica 158
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Anatomy and histology of the scrotal ligament in adults: inconsistency and variability of the gubernaculum testis
Abstract
Purpose
The anatomy of gubernaculum testis (GT) is often discussed; however, the postnatal anatomy of the GT or scrotal ligament (SL) is rarely described. Hence, we performed an anatomical and histological study to analyze histologically the structures between testis and scrotum.
Methods
We performed anatomical dissections on 25 human fresh cadavers’ testes. Each testis was removed with its envelopes and macroscopically analyzed. Then samples were included for histological study. Finally, they were analyzed under microscope, looking for attachments between testis, epididymis and scrotal envelopes.
Results
The absence of proximal and distal attachment was found in 56.0% of cases. Looking at the proximal attachment of the SL, the main one found is the epididymal attachment (28.0%), whereas no cases of testis attachment was found. Distally, there are more variations with scrotal attachment (12%) and cremaster attachment (12.0%). We found a significant prevalence of multiple adherences in 16.0% of cases too. Finally, in 15 cases (57.7%) an attachment is present between testis and epididymis, as it is commonly described.
Conclusions
In the majority of cases there is no attachment of the lower pole of the testis and epididymis and these structures remain free. So it seems that the SL disappears with aging. Moreover, there is not only one kind of ligamentous attachment, but a high variability of attachments at the lower pole of the testiculo-epididymal structure. When it exists, this structure is never a real ligament and it seems more appropriate to use the term “attachments”.
from #ORL-Sfakianakis via xlomafota13 on Inoreader http://ift.tt/2v9VIO1
from OtoRhinoLaryngology - Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2f0eMrG
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