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Sample records for acute optic neuritis

  1. Optic neuritis

    Retro-bulbar neuritis; Multiple sclerosis - optic neuritis; Optic nerve - optic neuritis ... The exact cause of optic neuritis is unknown. The optic nerve carries visual information from your eye to the brain. The nerve can swell when ...

  2. Bilateral optic neuritis in acute human immunodeficiency virus infection

    Larsen, M; Toft, P.B.; Bernhard, P;

    1998-01-01

    PURPOSE: To report a case of acute viral disease accompanied by bilateral optic neuritis with substantial paraclinical evidence that human immunodeficiency virus was the causative agent. METHODS: Clinical and paraclinical examination. Magnetic resonance imaging. RESULTS: Virus and antibody titers...... as well as reverse lymphocytosis were consistent with acute infection by the human immunodeficiency virus-1. CONCLUSIONS: Human immunodeficiency virus infection should be considered in the differential diagnosis of acute optic neuritis...

  3. Optic Neuritis

    Mary Caitlin Dooley

    2010-01-01

    Demyelinating optic neuritis is the most common cause of unilateral painful visual loss in the United States. Although patients presenting with demyelinating optic neuritis have favorable long-term visual prognosis, optic neuritis is the initial clinical manifestation of multiple sclerosis in 20% of patients. The Optic Neuritis Treatment Trial (ONTT) has helped stratify the risk of developing multiple sclerosis after the first episode of optic neuritis based on abnormal findings on brain MRI....

  4. Optic neuritis

    Optic neuritis is inflammation of the optic nerve. It may cause sudden, reduced vision in the affected eye. ... The exact cause of optic neuritis is unknown. The optic nerve carries visual information from your eye to the brain. The nerve can swell when ...

  5. Optic neuritis

    Sørensen, Torben Lykke; Roed, H; Sellebjerg, F

    2004-01-01

    To study the involvement of the chemokine receptor CXCR3 and its ligands (CXCL9/Mig, CXCL10/IP-10, CXCL11/ITAC) in optic neuritis (ON).......To study the involvement of the chemokine receptor CXCR3 and its ligands (CXCL9/Mig, CXCL10/IP-10, CXCL11/ITAC) in optic neuritis (ON)....

  6. 25-Hydroxyvitamin D levels in acute monosymptomatic optic neuritis

    Pihl-Jensen, Gorm; Frederiksen, Jette Lautrup

    2015-01-01

    Optic neuritis (ON) is a common first symptom of MS and only few studies have thus far investigated vitamin D at this early stage of MS. The objectives of the study were to examine total 25-hydroxyvitamin D levels (25HVITDL) in patients in acute (A) ON and to determine whether 25HVITD levels in AON...... AON. 25HVITDL was significantly associated with CSF leukocyte count, but not ON severity. The study indicates a possible role of vitamin D in the early stages of MS, but does not support the use of 25HVITDL as a predictor of MS development in acute ON....

  7. Effector and regulatory T cells in patients with acute optic neuritis

    Tsakiri, Anna; Kjærsgaard, Erik; Grigoriadis, Nikolaos; Svane, Inge Marie; Frederiksen, Jette L

    2012-01-01

    Optic neuritis (ON) is an autoimmune acute demyelinating disease of the optic nerve and may occur in patients with confirmed multiple sclerosis (MS) or as a clinically isolated syndrome. T lymphocytes play a central role in the pathogenesis of MS. The phenotype of different T cell subsets is...

  8. Systemic T-cell activation in acute clinically isolated optic neuritis

    Roed, Hanne; Frederiksen, Jette; Langkilde, Annika Reynberg; Sørensen, Torben Lykke; Lauritzen, Martin; Sellebjerg, Finn

    We examined untreated 60 patients with acute monosymptomatic optic neuritis (ON). Patients examined early after onset showed increased expression of HLA-DR and CD45R0 on CD4 and CD8 T cells. Expression of HLA-DR on CD4 T cells was higher in patients without IgG oligoclonal bands. Expression of HL...

  9. A double-blind, randomized trial of IV immunoglobulin treatment in acute optic neuritis

    Roed, H.G; Langkilde, Annika Reynberg; Sellebjerg, F; Lauritzen, M; Bang, P; Morup, A; Frederiksen, J.L.

    2005-01-01

    OBJECTIVE: To investigate if IV immunoglobulin (IVIG) treatment in the acute phase of optic neuritis (ON) could improve visual outcome and reduce MRI disease activity 6 months after onset of ON. METHODS: Sixty-eight patients with ON were randomized within 4 weeks from onset of symptoms. Thirty...... treatment groups during follow-up. CONCLUSIONS: There was no effect of IV immunoglobulin (IVIG) on long-term visual function following acute optic neuritis, nor was there an effect of IVIG treatment in reducing latency on visual evoked potentials and thus preserving function of axons of the optic nerve......-four patients were randomized to IVIG 0.4 g/kg body wt, and 34 patients were randomized to placebo. Infusions were given at days 0, 1, 2, 30, and 60. Contrast sensitivity, visual acuity, and color vision were measured at baseline and after 1 week, 1 month, and 6 months. Pattern reversal visual evoked potential...

  10. New treatments for Optic Neuritis

    Optic neuritis is used as a general term for any acute optic neuropathy caused by inflammation, and in a more specific sense, to refer to the optic neuropathy that occurs in patients with multiple sclerosis. The latter disease, often called demyelinating neuritis, occurs most often in women, is usually retrobulbar, is accompanied by pain with eye movements, and generally recovers spontaneously. For patients with no prior history of neurological disease, the 10-year risk of second demyelinating event after an initial attack of optic neuritis is 38%. This risk is greater in patients who have demyelinating plaques present on brain magnetic resonance imaging. The Optic Neuritis Treatment Trial showed no benefit of corticosteroid therapy on visual acuity, measured six months after an attack of neuritis. However, at one month there was more rapid improvement acuity in patients treated with intravenous steroids. Long-term treatment with interferon, an immunosuppressive agent, has been shown to reduce the rate of demyelinating events and plaque accumulation measured by magnetic resonance imaging. A new drug, natalizumab, has also been shown to reduce the formation of new demyelinating plaques in patients with multiple sclerosis. Unfortunately, treatment with interferon and natalizumab has resulted in progressive multifocal leukoencephalopathy, a rare and fatal opportunistic viral infection of the brain, in 3/5000 patients. Despite this tragic setback, the advent of new drug therapies has brightened the prognosis for patients with multiple sclerosis. (author)

  11. Cortical neuroplasticity in patients recovering from acute optic neuritis

    Korsholm, Kirsten; Madsen, Kristoffer Hougaard; Frederiksen, Jette L.;

    2008-01-01

    geniculate and Visual Cortical neuroplasticity during recovery. Moreover, inferences from the fourth model can be extended to the general Population of patients recovering from ON. In Conclusion, we present a method of accommodating subject-specific differences between patients with acute ON by inclusion of...... timepoint. in the third and fourth models the four examination timepoints were not modelled explicitly, but entered vicariously through the associated changes in the HMD for each subject that marked their individual recovery. The results show that the third and fourth models were more sensitive to...

  12. Optic nerve magnetisation transfer ratio after acute optic neuritis predicts axonal and visual outcomes.

    Yejun Wang

    Full Text Available Magnetisation transfer ratio (MTR can reveal the degree of proton exchange between free water and macromolecules and was suggested to be pathological informative. We aimed to investigate changes in optic nerve MTR over 12 months following acute optic neuritis (ON and to determine whether MTR measurements can predict clinical and paraclinical outcomes at 6 and 12 months. Thirty-seven patients with acute ON were studied within 2 weeks of presentation and at 1, 3, 6 and 12 months. Assessments included optic nerve MTR, retinal nerve fibre layer (RNFL thickness, multifocal visual evoked potential (mfVEP amplitude and latency and high (100% and low (2.5% contrast letter acuity. Eleven healthy controls were scanned twice four weeks apart for comparison with patients. Patient unaffected optic nerve MTR did not significantly differ from controls at any time-point. Compared to the unaffected nerve, affected optic nerve MTR was significantly reduced at 3 months (mean percentage interocular difference = -9.24%, p = 0.01, 6 months (mean = -12.48%, p<0.0001 and 12 months (mean = -7.61%, p = 0.003. Greater reduction in MTR at 3 months in patients was associated with subsequent loss of high contrast letter acuity at 6 (ρ = 0.60, p = 0.0003 and 12 (ρ = 0.44, p = 0.009 months, low contrast letter acuity at 6 (ρ = 0.35, p = 0.047 months, and RNFL thinning at 12 (ρ = 0.35, p = 0.044 months. Stratification of individual patient MTR time courses based on flux over 12 months (stable, putative remyelination and putative degeneration predicted RNFL thinning at 12 months (F(2,32 = 3.59, p = 0.02. In conclusion, these findings indicate that MTR flux after acute ON is predictive of axonal degeneration and visual disability outcomes.

  13. DIFFERENTIAL DIAGNOSIS OF OPTIC NEURITIS

    Zoric Lepsa

    2013-12-01

    Full Text Available Abstract: Optic neuritis is inflammation of the optic nerve, which in a single or repeated attacks can severely and permanently damage visual function. Errors in diagnostic are daily and usually occur because of incomplete diagnostic procedure performed. This manuscript presents a series of 19 patients reffered with optic neuritis diagnosis. The diagnosis was confirmed in 15, while four had other changes in the optic nerve or macula. We analyzed the diagnostic specificity of the basic parameters of optic neuritis diagnosis and afferent pupillary defect showed the highest sensitivity. The spectrum of differential diagnoses is shown within this finding. Optic neuritis diagnosis should be established carefully, using usual and available diagnostic methods in ophthalmologic and neurological practice, and if necessary, refer patients to neuro-ophthalmologist, as well as to electrophysiological evaluation and other methods that help fifferentiate disease.

  14. Optic Nerve Sheath Meningioma Masquerading as Optic Neuritis

    Alroughani, R.; Behbehani, R

    2016-01-01

    Optic neuritis is a common presentation of demyelinating disorders such as multiple sclerosis. It typically presents with acute painful monocular vision loss, whereas chronic optic neuropathy can be caused by compressive lesions along the anterior visual pathway, genetic, toxic, or nutritional causes. We report an unusual presentation mimicking optic neuritis, which was subsequently diagnosed as optic nerve sheath meningioma (ONSM). Misinterpretation of white matter lesions on MRI of brain an...

  15. Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla

    Nielsen, Kirsten; Rostrup, Egill; Frederiksen, Jette L.;

    2006-01-01

    OBJECTIVE:: We sought to assess whether magnetic resonance imaging (MRI) at 3.0 T detects more brain lesions in acute optic neuritis (ON) than MRI at 1.5 T. MATERIALS AND METHODS:: Twenty-eight patients with acute ON were scanned at both field-strengths using fast-fluid-attenuated inversion recov...

  16. Current options for the treatment of optic neuritis

    Pula JH

    2012-07-01

    Full Text Available John H Pula,1 Christopher J MacDonald21Division of Neuro-ophthalmology, University of Illinois College of Medicine at Peoria, Peoria; 2University of Illinois College of Medicine at Urbana-Champaign, Champaign, IL, USAAbstract: Optic neuritis can be defined as typical (associated with multiple sclerosis, improving independent of steroid treatment, or atypical (not associated with multiple sclerosis, steroid-dependent improvement. Causes of atypical optic neuritis include connective tissue diseases (eg, lupus, vasculitis, sarcoidosis, or neuromyelitis optica. In this manuscript, updated treatment options for both typical and atypical optic neuritis are reviewed. Conventional treatments, such as corticosteroids, therapeutic plasma exchange, and intravenous immunoglobulin therapy are all discussed with commentary regarding evidence-based outcomes. Less commonly used treatments and novel purported therapies for optic neuritis are also reviewed. Special scenarios in the treatment of optic neuritis – pediatric optic neuritis, acute demyelinating encephalomyelitis, and optic neuritis occurring during pregnancy – are specifically examined.Keywords: optic neuritis, optic neuropathy, treatment, neuroophthalmology

  17. Optic Nerve Sheath Meningioma Masquerading as Optic Neuritis

    R. Alroughani

    2016-01-01

    Full Text Available Optic neuritis is a common presentation of demyelinating disorders such as multiple sclerosis. It typically presents with acute painful monocular vision loss, whereas chronic optic neuropathy can be caused by compressive lesions along the anterior visual pathway, genetic, toxic, or nutritional causes. We report an unusual presentation mimicking optic neuritis, which was subsequently diagnosed as optic nerve sheath meningioma (ONSM. Misinterpretation of white matter lesions on MRI of brain and the failure to image the optic nerves at the time of acute loss of vision led to the misdiagnosis of optic neuritis in this case. A comprehensive accurate history and ordering the appropriate imaging modality remain paramount in diagnosing progressive visual deterioration.

  18. 25-Hydroxyvitamin D levels in acute monosymptomatic optic neuritis: relation to clinical severity, paraclinical findings and risk of multiple sclerosis.

    Pihl-Jensen, Gorm; Frederiksen, Jette Lautrup

    2015-07-01

    Optic neuritis (ON) is a common first symptom of MS and only few studies have thus far investigated vitamin D at this early stage of MS. The objectives of the study were to examine total 25-hydroxyvitamin D levels (25HVITDL) in patients in acute (A) ON and to determine whether 25HVITD levels in AON (1) predict risk of RRMS and (2) are associated with visual tests of ON severity. A cross-sectional study was conducted of mean 25HVITDL differences between ON (n = 164) and MS (n = 948) patients and of prevalence of 25HVITDL deficiency (vitamin D in the early stages of MS, but does not support the use of 25HVITDL as a predictor of MS development in acute ON. PMID:25929657

  19. Acute brachial neuritis following influenza vaccination

    Shaikh, Maliha Farhana; Baqai, Tanya Jane; Tahir, Hasan

    2012-01-01

    Brachial neuritis following vaccination is an uncommon but clinically important presentation of severe shoulder and arm pain associated with globally reduced range of movement. It may be confused with the more common diagnoses of rotator cuff pathology, adhesive capsulitis (frozen shoulder), shoulder arthritis or cervical spondylosis. We present a case of acute brachial neuritis, which posed a clinical diagnostic challenge to emergency, acute medical and rheumatology clinicians.

  20. Neuritis óptica inflamatoria Inflammatory optic neuritis

    T. Ayuso

    2009-08-01

    Full Text Available La neuritis óptica inflamatoria (NO es la causa más frecuente de pérdida visual aguda en adultos jóvenes. Aunque el pronóstico visual es excelente en la mayoría de los casos, muchos pacientes desarrollarán otra patología como esclerosis múltiple en la evolución posterior. La historia natural de la NO ha sido estudiada en múltiples trabajos en los últimos años; uno de los más importantes es el Optic Neuritis Treatment Trial. La Resonancia Magnética tiene un papel fundamental en el diagnóstico etiológico de la NO y en la predicción del riesgo de conversión a esclerosis múltiple. Recientemente se han incorporado nuevas técnicas exploratorias como la tomografia de coherencia óptica, útil para el diagnóstico y pronóstico; se han identificado biomarcadores séricos que ayudan en el diagnóstico de otras patologías de naturaleza autoinmune que producen NO. Un mejor conocimiento de los datos clínicos y exploratorios de la NO típica permitirá un estudio diagnóstico más rápido y certero. El tratamiento de la NO con esteroides debe ser individualizado teniendo en cuenta que no modifican el pronóstico a largo plazo y en pacientes con alto riesgo de conversión a esclerosis múltiple debe plantearse terapia inmunomoduladora. Este trabajo revisa los datos existentes en la literatura referentes a las manifestaciones clínicas, el diagnóstico etiológico y diferencial y tratamiento de la NO inflamatoria.Inflammatory Optic Neuritis (ON is the most frequent cause of acute visual loss in young adults. Although the visual prognosis is excellent in the majority of cases, many patients develop pathology, such as multiple sclerosis, in its subsequent evolution. The natural history of ON has been studied in numerous works in recent years; one of the most important of which is Optic Neuritis Treatment Trial. Magnetic Resonance plays a fundamental role in the etiological diagnosis of ON and in predicting the risk of conversion into

  1. MRI in Optic Neuritis: Structure, Function, Interactions

    Fuglø, Dan

    2011-01-01

    Optic neuritis (ON) is an acute inflammatory demyelinating condition of the optic nerve characterised by transient visual loss and eye pain. ON is the presenting symptom in 20% of patients with multiple sclerosis (MS) and the 15 year risk of developing MS after ON is about 50%. Decline in vision...... resonance imaging (MRI), and the visual evoked potential (VEP) continues to show a delayed P100 indicating persistent demyelination. The explanation for this apparent discrepancy between structure and function could be due to either a redundancy in the visual pathways so that some degree of signal loss...

  2. Acute Sciatic Neuritis following Lumbar Laminectomy

    Foad Elahi

    2014-01-01

    Full Text Available It is commonly accepted that the common cause of acute/chronic pain in the distribution of the lumbosacral nerve roots is the herniation of a lumbar intervertebral disc, unless proven otherwise. The surgical treatment of lumbar disc herniation is successful in radicular pain and prevents or limits neurological damage in the majority of patients. Recurrence of sciatica after a successful disc surgery can be due to many possible etiologies. In the clinical setting we believe that the term sciatica might be associated with inflammation. We report a case of acute sciatic neuritis presented with significant persistent pain shortly after a successful disc surgery. The patient is a 59-year-old female with complaint of newly onset sciatica after complete pain resolution following a successful lumbar laminectomy for acute disc extrusion. In order to manage the patient’s newly onset pain, the patient had multiple pain management visits which provided minimum relief. Persistent sciatica and consistent physical examination findings urged us to perform a pelvic MRI to visualize suspected pathology, which revealed right side sciatic neuritis. She responded to the electrical neuromodulation. Review of the literature on sciatic neuritis shows this is the first case report of sciatic neuritis subsequent to lumbar laminectomy.

  3. Review of the optic neuritis treatment trial

    The Optic Neuritis Treatment Trial (ONTT) is a multicenter controlled clinical trial. The primary objective of this trial is to assess the efficacy of corticosteroids in the treatment of optic neuritis. Treatment with intravenous methylprednisolone resulted in a more rapid return of the visual function to normal. Oral prednisone alone was associated with a significantly increased risk of recurrent optic neuritis. The trial also provided invaluable information about the clinical profile of optic neuritis and its relationship to Multiple Sclerosis (MS). At 6 months after the initial optic neuritis attack, a 12-month follow-up of patients was begun and the data collected during this period indicated that visual acuity was more than 20/20 in 69%, 20/40 in 93%, and 20/200 or less in only 3% of the patients. The risk of MS within 10 years after the first episode of optic neuritis was 56% among patients who were found to have had one or more characteristic white-matter lesions at baseline, as compared to only 22% for patients who had no observable lesions at baseline. (author)

  4. Ipsilateral Uveitis and Optic Neuritis in Multiple Sclerosis

    Eric Thouvenot

    2012-01-01

    Full Text Available Background. Uveitis is 20 times more frequent in multiple sclerosis (MS patients than in the general population. Methods. A retrospective study of local multiple sclerosis (n=700 and uveitis cohorts (n=450 described the ophthalmological and neurological characteristics of patients with multiple sclerosis and uveitis. Results. Uveitis and multiple sclerosis were associated in seven patients. The time intervals between diagnoses of MS and uveitis ranged from 6 months to 15 years. Analysis of the patients’ characteristics revealed that multiple sclerosis was associated with an older age of onset than usually expected, that is, 39 years. Uveitis was bilateral in three cases and mainly posterior (5/10. Five patients presented with acute optic neuritis (two in one eye and three in both eyes. All eyes presenting with acute optic neuritis were also affected by uveitis (P=0.02, though not simultaneously. Conclusion. The ipsilateral association between optic neuritis and uveitis in this series of patients with multiple sclerosis may suggest a reciprocal potentiation between optic neuritis and uveitis in multiple sclerosis.

  5. Pituitary Apoplexy Presented with Optic Neuritis

    Mahsa Owji

    2013-07-01

    Full Text Available The patient is a 40-years-old woman presented with visual loss in the right eye since two days ago. The patient complained of headache with gradual onset in the right parietal area since 2 years ago. The headache pattern did not alter.The left eye was normal but the vision in the right eye was 50 cm finger counting. Marcus Gunn pupil could be observed during swinging-flashlight test in the right eye. According to these findings, the first diagnosis was optic neuritis which was corroborated with visual evoked potential (the latency of P100 was 122. According to magnetic resonance imaging (MRI, there was a big cystic tumor in sella turcica extended to the suprasellar region (Figure 1-A. It had a large liquid component. Optic chiasm was under pressure and was displaced (Figure 1-B. A faint enhancement was seen after the injection (Figure 1-C.The patient was operated with the transnasal-transsphenoidal approach. Blood and fibrin were among the small monomorphic round cells andfibro-connective tissue of the pituitary gland. Considering the bleeding inside the pituitary tumor, the final diagnosis was pituitary apoplexy. After recovery from the operation the symptoms were removed.Pituitary apoplexy presents with headache, loss of vision, ophthalmoplegia, and mental alterations which is caused by infarction or sudden bleeding inside the pituitary tumor.1In our review of literature, 3 patients afflicted with pituitary apoplexy presented with optic neuritis were reported.In a study conducted by Petersen et al., all three patients referred to them suffered from unilateral visual loss and headache. They were examined with the early diagnosis of optic neuritis. After taking a Brain Computerized tomography (CT scan, pituitary adenoma together with the formation of cyst were detected in patients. After transsphenoidal adenomectomy, the patient regained full vision. Therefore, the correct diagnosis of these patients, who had been incorrectly diagnosed with

  6. Post-Plasmodium vivax malaria cerebellar ataxia and optic neuritis: A new form of delayed cerebellar ataxia or cerebellar variant of acute disseminated encephalomyelitis?

    Gaurav M Kasundra

    2015-01-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is commonly seen after viral and bacterial infections, immunization, and Plasmodium falciparum (PF malaria. Plasmodium vivax (PV rarely causes ADEM. We report a 14-year-old female patient who presented with acute onset bilateral cerebellar ataxia and optic neuritis, 2 weeks after recovery from PV. Magnetic resonance imaging showed bilateral cerebellar hyperintensities suggestive of ADEM. No specific viral etiology was found on cerebrospinal fluid examination. Patient responded well to treatment without any sequelae. Thus, PV too is an important cause of ADEM along with PF. Two of the previously reported cases had co-infection with falciparum malaria. The only other two reported cases, as also this patient, are from Asia. A geographical or racial predisposition needs to be evaluated. Also, a possibility of post-PV delayed cerebellar ataxia, which is classically described post-PF infection, may be considered as it may be clinically, radiologically, and prognostically indistinguishable from a milder presentation of ADEM.

  7. Current options for the treatment of optic neuritis

    Pula JH; MacDonald CJ

    2012-01-01

    John H Pula,1 Christopher J MacDonald21Division of Neuro-ophthalmology, University of Illinois College of Medicine at Peoria, Peoria; 2University of Illinois College of Medicine at Urbana-Champaign, Champaign, IL, USAAbstract: Optic neuritis can be defined as typical (associated with multiple sclerosis, improving independent of steroid treatment), or atypical (not associated with multiple sclerosis, steroid-dependent improvement). Causes of atypical optic neuritis include connective tissue di...

  8. Visual Function following Treatment of Optic Neuritis

    Majid Abrishami

    2008-12-01

    Full Text Available

    PURPOSE: To evaluate changes in different aspects of visual function including visual acuity, visual field, contrast sensitivity, colour vision and stereopsis in patients with optic neuritis before and after medical intervention. METHODS: In a noncomparative interventional case series on 31 eyes of 30 patients with optic neuritis, the following aspects of visual function were compared before and after treatment. Medical intervention was conducted following the Optic Neuritis Treatment Trial (ONTT guidelines. Visual function was assessed by evaluating changes in visual acuity, visual field (Goldmann in all patients and automated in some patients, contrast sensitivity using Cambridge low contrast grating, colour vision using Ishihara plates and stereopsis using Titmus stereoacuity test. RESULTS: Visual acuity was significantly lower (3/10 in the affected eyes than unaffected eyes (8/10 [P < 0.001]. Contrast sensitivity was also significantly better in the unaffected eyes. Mean stereoacuity was 310 sec/arc. The visual field impairment was also significantly higher than that of the unaffected eye and also normal population sample. Weak deutan defects were present in 60% of the patients. After medical treatment, visual acuity, visual field defects, contrast sensitivity, colour and stereopsis were significantly improved

  9. Optic neuritis: Experience from a south Indian demyelinating disease registry

    Lekha Pandit

    2012-01-01

    Full Text Available Background: Natural history of optic neuritis (OPN has not been studied in India. Aim: To study consecutive patients with optic neuritis as the initial manifestation of the neurologic disease and with disease duration of 3 or more years registered in the Mangalore Demyelinating Disease Registry. Materials and Methods: The study included 59 patients with a primary diagnosis of optic neuritis (confirmed by either an ophthalmologist or a neurologist or both. All the patients were investigated and followed-up in the clinic. Results: During the follow-up of the 59 patients, 29 (49% patients developed multiple sclerosis (MS; 3 (5% patients neuromyelitis optica (NMO; and 13 (22% patients chronic relapsing inflammatory optic neuritis (CRION, while the remaining 14 (24% did not either progress or relapse, monophasic OPN. An initial abnormal magnetic resonance imaging predicted conversion to MS in all 7 patients who had imaging at onset. Patients with NMO were left with significant residual visual loss distinguishing NMO from MS. In this large series of patients with CRION, nearly 50% of patients had deterioration in vision while steroids were being tapered. Long-term immunosuppression was essential for maintaining good visual outcome in both NMO and CRION. Conclusions: Optic neuritis in India appears similar to that in the West with nearly 50% developing MS in the long term.

  10. Early Onset Optic Neuritis Following Measles-Rubella Vaccination

    Siamak Moradian

    2008-12-01

    Full Text Available

    PURPOSE: To report two cases of optic neuritis with onset less than 24 hours following measles-rubella (MR vaccination. CASE REPORT: Two teenage patients developed acute optic neuritis 6 to 7 hours after MR booster vaccination. The first patient demonstrated bilateral papillitis and severe visual loss but improved significantly with pulse intravenous steroid therapy with methylprednisolone 500 mg/day. The second patient had unilateral retrobulbar optic neuritis and demonstrated excellent visual recovery without intervention. CONCLUSION: Acute optic neuritis is a rare complication of MR vaccination and may occur early after immunization.

  1. Unusual Presentation of Unilateral Isolated Probable Lyme Optic Neuritis.

    Burakgazi, Ahmet Z; Henderson, Carl S

    2016-01-01

    Optic neuritis (ON) is one of the most common manifestations of central nervous system involvement caused by various etiologies. Lyme ON is an exceedingly rare ocular manifestation of Lyme disease (LD) and only a few cases have been published in the literature. Lyme ON is very rare but should be included in the differential diagnosis in unexplained cases, particularly in Lyme endemic areas. Careful and detailed examination and investigation are warranted to make the diagnosis. We report this case to increase awareness of clinicians to include Lyme disease in differential diagnosis of ON for unexplained cases of ON. Herein we present a unique case with a unilateral ON caused by LD along with pre- and posttreatment findings and literature review. PMID:26953086

  2. Visual pathway abnormalities were found in most multiple sclerosis patients despite history of previous optic neuritis

    Stella Maris Costa Castro

    2013-07-01

    Full Text Available Objective It was to investigate visual field (VF abnormalities in a group of multiple sclerosis (MS patients in the remission phase and the presence of magnetic resonance imaging (MRI lesions in the optic radiations. Methods VF was assessed in 60 participants (age range 20-51 years: 35 relapsing-remitting MS patients [20 optic neuritis (+, 15 optic neuritis (-] and 25 controls. MRI (3-Tesla was obtained in all patients. Results Visual parameters were abnormal in MS patients as compared to controls. The majority of VF defects were diffuse. All patients except one had posterior visual pathways lesions. No significant difference in lesion number, length and distribution was noted between patients with and without history of optic neuritis. One patient presented homonymous hemianopsia. Conclusion Posterior visual pathway abnormalities were found in most MS patients despite history of previous optic neuritis.

  3. Functional MRI Examination of Visual Pathways in Patients with Unilateral Optic Neuritis

    The relations between brain areas involved in vision were explored in 8 patients with unilateral acute optic neuritis using functional magnetic resonance imaging (f MRI) and diffusion tensor imaging (DTI). In all patients monocular stimulation of affected and unaffected eye elicited significantly different activation foci in the primary visual cortex (V1), whereas the foci evoked in the middle temporal visual area (area V5) were similar in size and in delay of blood-oxygen-level-dependent response. DTI analysis documented lower white matter anisotropy values and reduced fibre reconstruction in the affected compared with the unaffected optic nerves. The preserved activation of area V5 observed in all our patients is an interesting finding that suggests the notion of a different sensitivity of the optic pathways to inflammatory changes.

  4. Transgenic inhibition of astroglial NF-κB protects from optic nerve damage and retinal ganglion cell loss in experimental optic neuritis

    Brambilla Roberta

    2012-09-01

    Full Text Available Abstract Background Optic neuritis is an acute, demyelinating neuropathy of the optic nerve often representing the first appreciable symptom of multiple sclerosis. Wallerian degeneration of irreversibly damaged optic nerve axons leads to death of retinal ganglion cells, which is the cause of permanent visual impairment. Although the specific mechanisms responsible for triggering these events are unknown, it has been suggested that a key pathological factor is the activation of immune-inflammatory processes secondary to leukocyte infiltration. However, to date, there is no conclusive evidence to support such a causal role for infiltrating peripheral immune cells in the etiopathology of optic neuritis. Methods To dissect the contribution of the peripheral immune-inflammatory response versus the CNS-specific inflammatory response in the development of optic neuritis, we analyzed optic nerve and retinal ganglion cells pathology in wild-type and GFAP-IκBα-dn transgenic mice, where NF-κB is selectively inactivated in astrocytes, following induction of EAE. Results We found that, in wild-type mice, axonal demyelination in the optic nerve occurred as early as 8 days post induction of EAE, prior to the earliest signs of leukocyte infiltration (20 days post induction. On the contrary, GFAP-IκBα-dn mice were significantly protected and showed a nearly complete prevention of axonal demyelination, as well as a drastic attenuation in retinal ganglion cell death. This correlated with a decrease in the expression of pro-inflammatory cytokines, chemokines, adhesion molecules, as well as a prevention of NAD(PH oxidase subunit upregulation. Conclusions Our results provide evidence that astrocytes, not infiltrating immune cells, play a key role in the development of optic neuritis and that astrocyte-mediated neurotoxicity is dependent on activation of a transcriptional program regulated by NF-κB. Hence, interventions targeting the NF-κB transcription

  5. Functional MRI of the visual cortex and visual testing in patients with previous optic neuritis

    Langkilde, Annika Reynberg; Frederiksen, J.L.; Rostrup, Egill; Larsson, H.B.W.

    2002-01-01

    activated area and the signal change following ON, and compared the results with results of neuroophthalmological testing. We studied nine patients with previous acute ON and 10 healthy persons served as controls using fMRI with visual stimulation. In addition to a reduced activated volume, patients showed...... a reduced blood oxygenation level dependent (BOLD) signal increase and a greater asymmetry in the visual cortex, compared with controls. The volume of visual cortical activation was significantly correlated to the result of the contrast sensitivity test. The BOLD signal increase correlated......The volume of cortical activation as detected by functional magnetic resonance imaging (fMRI) in the visual cortex has previously been shown to be reduced following optic neuritis (ON). In order to understand the cause of this change, we studied the cortical activation, both the size of the...

  6. Functional MRI of the visual cortex and visual testing in patients with previous optic neuritis

    Langkilde, Annika Reynberg; Frederiksen, J.L.; Rostrup, Egill; Larsson, H.B.W.

    2002-01-01

    significantly to both the results of the contrast sensitivity test and to the Snellen visual acuity. Our results indicate that fMRI is a useful method for the study of ON, even in cases where the visual acuity is severely impaired. The reduction in activated volume could be explained as a reduced neuronal input......The volume of cortical activation as detected by functional magnetic resonance imaging (fMRI) in the visual cortex has previously been shown to be reduced following optic neuritis (ON). In order to understand the cause of this change, we studied the cortical activation, both the size of the...... activated area and the signal change following ON, and compared the results with results of neuroophthalmological testing. We studied nine patients with previous acute ON and 10 healthy persons served as controls using fMRI with visual stimulation. In addition to a reduced activated volume, patients showed...

  7. Occurrence of Optic Neuritis and Cervical Cord Schwannoma with Charcot-Marie-Tooth Type 4B1 Disease

    Scott, Patrick; Bruwer, Zandre; Al-Kharusi, Khalsa; Meftah, Douja; Al-Murshedi, Fathiya

    2016-01-01

    Charcot-Marie-Tooth neuropathy type 4B1 (CMT4B1) disease is a rare subtype of CMT4 with reported association of facial weakness, vocal cord paresis, chest deformities, and claw hands. We report the unusual occurrence of optic neuritis and cervical cord schwannoma in a male individual with confirmed CMT4B1 disease. Sequencing of the MTMR2 gene revealed a novel nonsense homozygous mutation c.1768C>T (p.Gln590*). The mutation was identified in affected relatives of the proband and a second, apparently unrelated, family. The rare association of optic neuritis or schwannoma with genetically confirmed CMT1A has been individually observed, but never with recessive CMT. To the best of our knowledge, the occurrence of optic neuritis and cervical cord schwannoma in the same patient has never been reported with any form of CMT including CMT4B1. In similar cases, we recommend immediate medical attention to rule out the possibility of schwannomas in patients with all demyelinating CMT subtypes in case of the development of focal neurological signs or acute worsening of clinical status. PMID:27162595

  8. Occurrence of Optic Neuritis and Cervical Cord Schwannoma with Charcot-Marie-Tooth Type 4B1 Disease.

    Scott, Patrick; Bruwer, Zandre; Al-Kharusi, Khalsa; Meftah, Douja; Al-Murshedi, Fathiya

    2016-05-01

    Charcot-Marie-Tooth neuropathy type 4B1 (CMT4B1) disease is a rare subtype of CMT4 with reported association of facial weakness, vocal cord paresis, chest deformities, and claw hands. We report the unusual occurrence of optic neuritis and cervical cord schwannoma in a male individual with confirmed CMT4B1 disease. Sequencing of the MTMR2 gene revealed a novel nonsense homozygous mutation c.1768C>T (p.Gln590*). The mutation was identified in affected relatives of the proband and a second, apparently unrelated, family. The rare association of optic neuritis or schwannoma with genetically confirmed CMT1A has been individually observed, but never with recessive CMT. To the best of our knowledge, the occurrence of optic neuritis and cervical cord schwannoma in the same patient has never been reported with any form of CMT including CMT4B1. In similar cases, we recommend immediate medical attention to rule out the possibility of schwannomas in patients with all demyelinating CMT subtypes in case of the development of focal neurological signs or acute worsening of clinical status. PMID:27162595

  9. Optic neuritis in a case after gamma knife radiosurgery for relapsed pituitary adenoma

    The purpose of this study was to report a case of optic neuritis after gamma knife radiosurgery for pituitary adenoma. A 41-year-old woman presented with impaired vision in both eyes since 5 days before. She had received surgery for pituitary tumor 5 years before. She was treated by gamma knife radiosurgery for relapse of tumor 50 days before. Her corrected visual acuity was 0.5 right and 0.6 left. She had abnormal color sense. Flicker fusion frequency was decreased in both eyes. Both eyes showed enlarged blind spot and relative scotoma in the superior sector. Magnetic resonance imaging (MRI) showed enhanced signal in the optic nerve sheath. These findings led to the diagnosis of optic neuritis. Pulsed corticosteroid therapy was followed by improved vision of 1.2 in either eye. She has been doing well for 18 months until present. This case illustrates that optic neuritis may develop after gamma knife radiosurgery. (author)

  10. Relationship between serum bilirubin levels and optic neuritis

    DENG Juan; LIANG Xue-mei; ZHANG Xiu-lan; LING Shi-qi; YANG Ting-ting; LI Min; PENG Fu-hua

    2013-01-01

    Background Bilirubin is the end product of heme catabolism and has strong antioxidant properties.Serum bilirubin levels are reported to be reduced in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO).The pathophysiology of optic neuritis (ON) resembles that of MS; however,the role of endogenous bilirubin in ON is unclear.The aim of this study is to measure serum bilirubin levels in patients with ON,and to investigate the correlation between ON and serum antioxidant status of bilirubin.Methods Serum levels of bilirubin were measured in 42 patients with ON,50 patients with multiple sclerosis (MS),48 patients with neuromyelitis optica (NMO) and 48 healthy control subjects.Results Serum total bilirubin (Tbil),direct bilirubin (Dbil) and indirect bilirubin (Ibil) levels in patients with ON were significantly lower than those in the healthy controls.However,no statistical significance was found between levels in the ON and MS,ON and NMO,and MS and NMO groups.In patients with ON,serum Tbil,Dbil,and Ibil levels were lower in those with recurrence or those with ON for a longer duration (>1 year).Moreover,Tbil,Dbil,and Ibil concentrations were lower in patients with papillitis than in those with retrobulbar type ON,but the differences were not statistically significant.Conclusions Low antioxidant status may exist in patients with ON.But serum levels of Tbil,Dbil,and Ibil did not correlate with clinical presentations,such as recurrence,duration of disease and subtypes of ON.Low antioxidant status already existed in MS or NMO patients before systemic symptoms appeared.

  11. Retrobulbar optic neuritis and meningoencephalitis following progressive outer retinal necrosis due to CMV in a patient with AIDS.

    Park, K H; Bang, J H; Park, W B; Kim, H B; Kim, N J; Ahn, J K; Chang, K H; Oh, M D; Choe, K W

    2008-10-01

    We report on a 34-year-old male patient with AIDS who developed retrobulbar optic neuritis and meningoencephalitis following bilateral progressive outer retinal necrosis (PORN) caused by cytomegalovirus (CMV). This case documents the presumed association of PORN with retrobulbar optic neuritis, and CMV meningoencephalitis in an AIDS patient. PMID:18574556

  12. MRI findings and correlative study of MRI and visual evoked potentials in optic neuritis

    Objective: To investigate the effective MRI sequences and describe the correlation between MRI and visual evoked potential (VEP) in diagnosing optic neuritis. Methods: One hundred and fifty-four eyes with visual impairment of 98 patients with diagnoses of optic neuritis, papillitis, multiple sclerosis and Devic's disease underwent MRI and VEP examination. The MRI findings were analyzed and correlated with VEP results and clinical presentation by using X2 test, wilco xon test and Kappa test. Results Out of the 154 sick eyes, 56 eyes presented thickened optic nerves, 76 eyes had normal diameter of the optic nerve, and 22 eyes had thin optic nerves. A total of 132 optic nerves showed abnormally high signal in STIR sequences, including involvement of intraocular segment in 7, intraorbital segment in 1.35, intracanalicular segment in 109, intracranial segment in 97, optic chiasm in 56, and optic tract in 23. A total of 54 patients underwent postcontrast MRI. Seventy-four optic nerves of 87 eyes showed enhancement. Among the 196 eyes of 98 patients, 132 eyes presented visual impairment and simultaneous abnormal MR signal of the optic nerve, and 26 eyes had both normal vision and normal MR signal of optic nerve. The consistency of MRI findings and vision status was 80. 61% (Kappa 0.453,P1-weighted MR sequence combined with fat- suppression are helpful in diagnosis of optic neuritis. VEP is helpful in diagnosing optic neuritis and in finding subclinical visual problem. The MRI combined with VEP could improve the diagnostic accuracy of optic neuritis. (authors)

  13. Permeability of the blood-brain barrier predicts conversion from optic neuritis to multiple sclerosis

    Cramer, Stig P; Modvig, Signe; Simonsen, Helle Juhl;

    2015-01-01

    permeability of the blood-brain barrier in normal-appearing white matter of patients with multiple sclerosis and here, for the first time, we present a study on the capability of blood-brain barrier permeability in predicting conversion from optic neuritis to multiple sclerosis and a direct comparison with...... cerebrospinal fluid markers of inflammation, cellular trafficking and blood-brain barrier breakdown. To this end, we applied dynamic contrast-enhanced magnetic resonance imaging at 3 T to measure blood-brain barrier permeability in 39 patients with monosymptomatic optic neuritis, all referred for imaging as...... part of the diagnostic work-up at time of diagnosis. Eighteen healthy controls were included for comparison. Patients had magnetic resonance imaging and lumbar puncture performed within 4 weeks of onset of optic neuritis. Information on multiple sclerosis conversion was acquired from hospital records 2...

  14. HLA typing in acute optic neuritis

    Frederiksen, J L; Madsen, H O; Ryder, L P;

    1997-01-01

    frequency of HLA-DR15 was significantly increased in patients with ON + CDMS (52%) and ON (47%) compared with control subjects (31%). The frequency of HLA-DR17 was almost equal in the ON + CDMS (18%), ON (23%), and control (23%) groups. The frequencies of HLA-DQA-1B (55% in ON + CDMS, 58% in ON) and HLA......-DQB-1B (49% in ON + CDMS, 59% in ON) were significantly increased compared with control subjects (41%, HLA-DQA-1B; 37%, HLA-DQB-1B). Brain MRI was abnormal in 48 of 56 examined patients with ON + CDMS and in 64 of 120 examined patients with ON (P < .001). In contrast, the frequencies of HLA alleles did...... not differ between patients with and without demyelinating lesions. However, patients with ON and normal MRI findings did not show association with HLA-DR15. CONCLUSIONS: The frequencies of alleles were similar in patients with ON and ON + CDMS, confirming that they are not 2 immunogenetically...

  15. Human Rabies with Initial Manifestations that Mimic Acute Brachial Neuritis and Guillain-Barré Syndrome

    Rima El-Abassi; Maury, Joaquin S.; Craver, Randall D.; Lenay Santana-Gould; Austin J. Sumner; Enrique Segura-Palacios; Edward C. Mader Jr

    2012-01-01

    Introduction Human rabies can be overlooked in places where this disease is now rare. Its diagnosis is further confused by a negative history of exposure (cryptogenic rabies), by a Guillain-Barré syndrome (GBS) type of presentation, or by symptoms indicating another diagnosis, eg, acute brachial neuritis (ABN). Case presentation A 19-year-old Mexican, with no past health problems, presented with a two-day history of left shoulder, arm, and chest pain. He arrived in Louisiana from Mexico five ...

  16. Myelitis and optic neuritis induced by a long course of etanercept in a patient with rheumatoid arthritis

    Yokoyama, Waka; Takada, Kazuki; Miyasaka, Nobuyuki; Kohsaka, Hitoshi

    2014-01-01

    A 64-year-old woman presented with an acute onset of myelitis and optic neuritis after 47 months of etanercept use for rheumatoid arthritis. Etanercept was discontinued and pulse methylprednisolone therapy (1000 mg/day for 3 days) was started, followed by a quick and complete resolution. Demyelination associated with antitumor necrosis factor agents, reported to develop mostly from 1 week to 12 months after the initiation of the agents, could develop after a few years and thus warrants vigilant monitoring. PMID:25085953

  17. Neither retinal nor brain atrophy can be shown in patients with isolated unilateral optic neuritis at the time of presentation

    Kallenbach, Klaus; Sander, Birgit; Tsakiri, Anna; Wanscher, Benedikte; Fuglø, Dan; Larsen, Michael; Larsson, Henrik; Frederiksen, Jette L

    2011-01-01

    BACKGROUND: Acute monosymptomatic optic neuritis (ON) may be the earliest manifestation of multiple sclerosis (MS). Atrophy has been shown to be a prominent feature of MS with great impact on disability. OBJECTIVES: The objectives of this study were to evaluate retinal and brain atrophy and...... were calculated based on MRI. Additionally, visual evoked potentials (VEPs) were recorded. RESULTS: Neither OCT measurements nor brain volume measures revealed signs of localized or generalized atrophy in patients compared with healthy volunteers. Stratification of patients into high risk based on the...

  18. Lymphocyte Proliferation Response to S Antigen in Patients with Uveitis and Optic Neuritis

    PeixianRen; XiuzhenYan

    1995-01-01

    Purpose:To evaluate the autoimmunity which may play a major role in the etiolo-gy of certain forms of uveitis and optic neuritis.Methods:lymphocyte proliferation response to retinal soluble antigen in vitro by gy of certain forms of uveitis and optic neuritis.Methods:Lymphocyte proliferation response toretinal soluble antigen in vitro by incoperation3H-thymidine withDNA was tested in 115patients with anterior u-veitis,posterior/pan-uveitis,optic neuritis,and 50volunteers with unrelated diseases such as congenital ptosis,strabismus,or completely healthy persons as control.Results:The positive rate of lymphocyte stimulation was34%(18/53)in anteri-or uveitis,41.5%(17/41)in posterior/pan-uveitis,and57.1%(12/21)in optic euritis,The results in the experimental groups were significantly different from those of the control group(x2=14.76,P<0.05,x2=19.14P<0.005,x2=26.38,P<0.005,respectively).Conclusion:The autoimmunity plays a role in the patogenesis in certain forms of uveitis and optic neuritis,Such immune responses may be secondary to the expo-sition or release of retinal antigens by various causes,leading to activation or augmentation of meager or low-affinity S antigen specific lymphocytes which may preexist in the circulation and starting the pathogenic autoimmune process.Eye Science 1995;11:120-123.

  19. Optic neuritis caused by canine distemper virus in a Jack Russell terrier

    Richards, Tara R.; Whelan, Nick C.; Pinard, Chantale L.; Alcala, Fernanda Castillo; Wolfe, Katheryn C.

    2011-01-01

    An atypical case of canine distemper (CD) was diagnosed in a vaccinated healthy adult dog. The patient was presented circling, seizuring, and blind. Postmortem examination resulted in a diagnosis of CD. Optic neuritis was diagnosed, a finding not previously described in the context of CD virus infection presenting solely with neurological signs.

  20. Tumor necrosis factor alpha gene polymorphism in multiple sclerosis and optic neuritis

    Fugger, L; Morling, N; Sandberg-Wollheim, M; Ryder, L P; Svejgaard, A

    1990-01-01

    The NcoI tumor necrosis factor (TNF alpha) polymorphism was studied in relapsing/remitting multiple sclerosis and monosymptomatic optic neuritis. The frequency of the NcoI marker phenotypes did not differ between healthy controls and the two disease groups. No extra or missing DNA fragments were ...

  1. Aquaporin 4 antibody [NMO Ab] status in patients with severe optic neuritis in India.

    Ambika, Selvakumar; Balasubramanian, Mahalakshmi; Theresa, Lily; Veeraputhiran, Akila; Arjundas, Deepak

    2015-12-01

    Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system that causes attacks of optic neuritis and transverse myelitis. The discovery of a specific serum marker for NMO-IgG antibody [aquaporin 4 antibody/AQP4 Ab] has revolutionised the treatment of demyelinating diseases. Severe vision loss can be seen in optic neuritis (ON) associated with both multiple sclerosis (MS) and NMO. Identifying this antibody in optic neuritis patients can help us to establish the likelihood of these patients developing NMO (Jarius et al. Neurol Sci 298:158-162, 2010). It is important to differentiate these two entities as the treatment strategies of MS and NMO are different. To the best of our knowledge, there is no published literature regarding the importance of identifying this antibody in severe optic neuritis in Indian patients. Hence we decided to screen our severe optic neuritis patients for this AQP4 Ab. To investigate the presence of aquaporin 4 antibody and determine its prognostic value for visual and neurological outcome, in patients with bilateral and recurrent [severe] ON without any previous neurological manifestations presenting to a neuro-ophthalmology clinic in India. Single centre, prospective study. 40 patients (27 female patients and 13 male) with severe optic neuritis [patients with no visual improvement by 4 weeks from onset of vision loss] who presented either as recurrent attacks or as bilateral and severe optic neuritis between January 2010 and June 2011 were enrolled. Clinical features, visual outcome and sequential neurological events were compared between the seropositive and the seronegative groups. Aquaporin 4 antibodies were detected from serum using ELISA technique and IIF technique. Presence of this antibody in the serum was considered to be seropositive status and patients who did not have this antibody were considered seronegatives. AQP4 antibodies were detected in 8 of the 40 patients with severe ON (20 %).The

  2. Detection of optic nerve atrophy following a single episode of unilateral optic neuritis by MRI using a fat-saturated short-echo fast FLAIR sequence

    We describe an MRI technique for quantifying optic nerve atrophy resulting from a single episode of unilateral optic neuritis. We imaged 17 patients, with a median time since onset of optic neuritis of 21 months (range 3-81 months), using a coronal-oblique fat-saturated short-echo fast fluid-attenuated inversion-recovery (sTE fFLAIR) sequence. The mean cross-sectional area of the intraorbital portion of the optic nerves was calculated by a blinded observer from five consecutive 3 mm slices from the orbital apex forwards using a semiautomated contouring technique and compared with data from 16 controls. The mean optic nerve area was 11.2mm2 in the affected eye of the patients, 12.9mm2 in the contralateral eye (P = 0.006 compared to the affected eye) and 12.8mm2 in controls (P = 0.03 compared to the affected eyes). There was a significant negative correlation between disease duration and the size of the affected optic nerve (r = -0.59, P = 0.012). The measurement coefficient of variation was 4.8 %. The sTE fFLAIR sequence enables measurement of optic nerve area with sufficient reproducibility to show optic nerve atrophy following a single episode of unilateral optic neuritis. The correlation of increasing optic nerve atrophy with disease duration would be consistent with ongoing axonal loss in a persistently demyelinated lesion, or Wallerian degeneration following axonal damage during the acute inflammatory phase. (orig.)

  3. Inner Nuclear Layer Thickening Is Inversley Proportional to Retinal Ganglion Cell Loss in Optic Neuritis

    Kaushik, Megha; Wang, Chen Yu; Barnett, Michael H; Garrick, Raymond; Parratt, John; GRAHAM, STUART L.; Sriram, Prema; Yiannikas, Con; Klistorner, Alexandr

    2013-01-01

    Aim To examine the relationship between retinal ganglion cell loss and changes in the inner nuclear layer (INL) in optic neuritis (ON). Methods 36 multiple sclerosis (MS) patients with a history of ON and 36 age and sex-matched controls underwent Optical Coherence Tomography. The paramacular retinal nerve fiber layer (RNFL), combined ganglion cell and inner plexiform layers (GCL/IPL) and inner nuclear layer (INL) thickness were measured at 36 points around the fovea. To remove inter-subject v...

  4. Experimental Optic Neuritis Induced by a Demyelinating Strain of Mouse Hepatitis Virus▿

    Shindler, Kenneth S.; Kenyon, Lawrence C; Dutt, Mahasweta; Hingley, Susan T.; Sarma, Jayasri Das

    2008-01-01

    Optic neuritis (ON), an inflammatory demyelinating optic nerve disease, occurs in multiple sclerosis (MS). Pathological mechanisms and potential treatments for ON have been studied via experimental autoimmune MS models. However, evidence suggests that virus-induced inflammation is a likely etiology triggering MS and ON; experimental virus-induced ON models are therefore required. We demonstrate that MHV-A59, a mouse hepatitis virus (MHV) strain that causes brain and spinal cord inflammation a...

  5. Efficacy of vision restoration therapy after optic neuritis (VISION study: study protocol for a randomized controlled trial

    Schinzel Johann

    2012-06-01

    Full Text Available Abstract Background Optic neuritis is a frequent manifestation of multiple sclerosis. Visual deficits range from a minor impairment of visual functions through to complete loss of vision. Although many patients recover almost completely, roughly 35% of patients remain visually impaired for years, and therapeutic options for those patients hardly exist. Vision restoration therapy is a software-based visual training program that has been shown to improve visual deficits after pre- and postchiasmatic injury. The aim of this pilot study is to evaluate whether residual visual deficits after past or recent optic neuritis can be reduced by means of vision restoration therapy. Methods/design A randomized, controlled, patient- and observer-blinded clinical pilot study (VISION study was designed to evaluate the efficacy of vision restoration therapy in optic neuritis patients. Eighty patients with a residual visual deficit after optic neuritis (visual acuity ≤0.7 and/or scotoma will be stratified according to the time of optic neuritis onset (manifestation more than 12 months ago (40 patients, fixed deficit versus manifestation 2 to 6 months ago (40 patients, recent optic neuritis, and randomized into vision restoration therapy arm or saccadic training arm (control intervention. Patients will be instructed to complete a computer-based visual training for approximately 30 minutes each day for a period of 6 months. Patients and evaluators remain blinded to the treatment allocation throughout the study. All endpoints will be analyzed and P-values  Discussion If vision restoration therapy is shown to improve visual function after optic neuritis, this method might be a first therapeutic option for patients with incomplete recovery from optic neuritis. Trial registration NCT01274702

  6. Flupirtine as Neuroprotective Add-On Therapy in Autoimmune Optic Neuritis

    Sättler, Muriel B.; Williams, Sarah K.; Neusch, Clemens; Otto, Markus; Pehlke, Jens R.; Bähr, Mathias; Diem, Ricarda

    2008-01-01

    Multiple sclerosis (MS) is a common inflammatory disease of the central nervous system that results in persistent impairment in young adults. During chronic progressive disease stages, there is a strong correlation between neurodegeneration and disability. Current therapies fail to prevent progression of neurological impairment during these disease stages. Flupirtine, a drug approved for oral use in patients suffering from chronic pain, was used in a rat model of autoimmune optic neuritis and...

  7. Parent and medical professional willingness to enroll children in a hypothetical pediatric optic neuritis treatment trial

    Amy eWaldman

    2011-11-01

    Full Text Available The Optic Neuritis Treatment Trial and subsequent studies have had a tremendous impact on the treatment and prognosis of optic neuritis and multiple sclerosis in adults. The results of these studies have been extrapolated to children; however, pediatric data are sparse. Using the method of prospective preference assessment, the willingness of parents and medical professionals to enroll children in a hypothetical Pediatric Optic Neuritis Treatment Trial was assessed using a mock consent form and questionnaire. A 3-arm trial was proposed: 1 intravenous corticosteroids, 2 high-dose oral corticosteroids, and 3 an oral placebo. The forms were completed by 198 parents and 49 physicians. After reviewing the hypothetical scenario, trial design, risks and benefits, and alternatives to the study, 21% of parents would enroll their children in the trial whereas 98% of medical professionals would enroll their patients. With medical professional recommendation, 43% of parents would enroll their children. The manner in which this hypothetical trial was presented to parents, specifically with respect to the recommendation of their child’s health care team, influenced a parent’s willingness to participate.

  8. Current and future potential of retinal optical coherence tomography in multiple sclerosis with and without optic neuritis.

    Balk, Lisanne J; Petzold, Axel

    2014-01-01

    Multiple sclerosis (MS) is a disorder characterized by inflammation and neuroaxonal degeneration. The latter is held responsible for the irreversible disability in patients with MS. The eye is a unique window into the brain. With the advent of optical coherence tomography, accurate quantification of retinal layer thickness has become feasible. Neuroaxonal degeneration affecting the retinal layers is structurally and functionally related to pathology in the visual pathways, which is most severe following MS optic neuritis. This is relevant to recognize because MS optic neuritis may mask the subtle thinning of retinal layers associated with global CNS atrophy, which is also related to more global loss of neurological function. Taken together, optical coherence tomography stands at the brink of becoming a validated imaging biomarker for monitoring neurodegeneration in MS and to provide end points for clinical trials. PMID:24832034

  9. Bilateral optic neuritis in a 26-year-old man with common variable immunodeficiency: a case report

    Palao-Duarte Susana

    2011-07-01

    Full Text Available Abstract Introduction Common variable immunodeficiency encompasses a group of heterogeneous conditions linked by a lack of immunoglobulin production and primary antibody failure. Although primary immunodeficiencies are typically characterized by recurrent infections, autoimmune manifestations have increasingly been recognized. Neurological complications are extremely rare and to the best of our knowledge optic neuritis has not been described previously. We report the case of a patient with common variable immunodeficiency who developed loss of vision secondary to bilateral optic neuritis. Case presentation A 26-year-old Caucasian man with a diagnosis of common variable immunodeficiency presented to our facility with loss of vision secondary to bilateral optic neuritis. Results of a thorough study for infectious, neoplastic and autoimmune diseases were negative. Our patient was treated with intravenous methylprednisolone with almost complete improvement and he remained asymptomatic at a 12-month follow-up. Conclusions Bilateral optic neuritis should be added to the list of autoimmune disorders related to common variable immunodeficiency. If a patient with common variable immunodeficiency experiences loss of vision, the possibility of bilateral optic neuritis should be considered as rapid initiation of high-dose corticosteroids may improve visual recovery.

  10. Optic neuritis and retinal ganglion cell loss in a chronic murine model of multiple sclerosis

    KennethS.Shindler

    2011-08-01

    Full Text Available Multiple sclerosis (MS and its animal model experimental autoimmune encephalomyelitis (EAE are neurodegenerative diseases with characteristic inflammatory demyelination in the central nervous system, including the optic nerve. Neuronal and axonal damage is considered to be the main cause of long-term disability in patients with MS. Neuronal loss, including retinal ganglion cell (RGC apoptosis in eyes with optic neuritis, also occurs in EAE. However, there is significant variability in the clinical course and level of neuronal damage in MS and EAE. The current studies examine the mechanisms and kinetics of RGC loss in C57BL/6 mice immunized with myelin oligodendrocyte glycoprotein to induce a chronic EAE disease. Clinical progression of EAE was scored daily and vision was assessed by optokinetic responses. At various time points, RGCs were counted and optic nerves were examined for inflammatory cell infiltration. Almost all EAE mice develop optic neuritis by day 15 post-immunization; however, RGC loss is delayed in these mice. No RGC loss is detected 25 days post-immunization, whereas RGC numbers in EAE mice significantly and progressively decrease compared to controls from 35-50 days post-immunization. The delayed time course of RGC loss is in stark contrast to that reported in relapsing EAE, as well as in rats with chronic EAE. Results suggest that different clinical disease courses of optic nerve inflammation may trigger distinct mechanisms of neuronal damage, or RGCs in different rodent strains may have variable resistance to neuronal degeneration.

  11. Analysis of Fundus Photography and Fluorescein Angiography in Nonarteritic Anterior Ischemic Optic Neuropathy and Optic Neuritis

    Kim, Min Kyung

    2016-01-01

    Purpose We evaluated fundus and fluorescein angiography (FAG) findings and characteristics that can help distinguish nonarteritic anterior ischemic optic neuropathy (NAION) from optic neuritis (ON). Methods Twenty-three NAION patients and 17 ON with disc swelling patients were enrolled in this study. We performed fundus photography and FAG. The disc-swelling pattern, hyperemia grade, presence of splinter hemorrhages, cotton-wool spots, artery/vein ratio and degree of focal telangiectasia were investigated. The FAG findings for each patient were compared with respect to the following features: the pattern of disc leakage in the early phase, arteriovenous (artery/vein) transit time (second), and the presence and pattern of the filling delay. Results Cotton-wool spots, focal telangiectasia, and venous congestion were more common in the affected eyes of NAION patients. Upon FAG, 76.5% of the patients in the ON group exhibited normal choroidal circulation. However, 56.5% of patients in the NAION group demonstrated abnormal filling defects, such as peripapillary, generalized, or watershed zone filling delays. Conclusions Fundus findings, including cotton-wool spots, focal telangiectasia, and venous congestion in the affected eye, may be clues that can be used to diagnose NAION. In addition, choroidal insufficiencies on FAG could be also helpful in differentiating NAION from ON. PMID:27478356

  12. Bilateral monosymptomatic optic neuritis following Mycoplasma pneumoniae infection: A case report and literature review

    Wei-Yu Chiang

    2014-01-01

    Full Text Available Herein, we report the clinical findings, treatment choice, and clinical course of a rare case of Mycoplasma pneumoniae (M. pneumoniae infection with the sole manifestation of optic neuritis (ON. To the best of our knowledge, this is the first case presenting monosymptomatic visual loss without papillitis, neurological symptoms, and abnormal findings on brain imaging. Related articles about ON after M. pneumoniae infection were reviewed to summarize the clinical presentation, possible mechanisms, clinical survey, treatment, and prognosis of this condition. We propose that a Mycoplasma profile is necessary in children who present with ON, especially when this condition is accompanied by prodromal symptoms of the respiratory tract infection.

  13. A reassessment of the risk of multiple sclerosis developing in patients with optic neuritis after extended follow-up.

    Francis, D A; Compston, D A; Batchelor, J R; McDonald, W I

    1987-01-01

    One hundred and one of 146 patients presenting with isolated idiopathic optic neuritis, previously reviewed in 1978, were reassessed clinically, and retyped for HLA antigens and Factor B alleles, after a mean follow-up of 11.6 years. Fifty eight patients (57%) had developed multiple sclerosis at the time of reassessment in the present study, of whom 51 (88%) had clinically definite disease. This compared with 40% of the original group, in 1978, of whom 62% then had clinically definite multiple sclerosis. When the life-table method of analysis was used, the probability of developing multiple sclerosis was 75%, 15 years after the initial episode of optic neuritis. The frequencies of HLA-DR2 and the recently defined D-region antigen, DQw1, were significantly increased in patients with isolated optic neuritis and those who subsequently developed multiple sclerosis compared with normal controls, but neither allele appears to influence progression from optic neuritis to multiple sclerosis. Patients with optic neuritis who were HLA-DR3 positive had an increased risk for the development of multiple sclerosis (RR = 2.8) and this risk was further enhanced when DR3 occurred in combination with DR2 (RR = 6.7). The overall increased risk of developing multiple sclerosis for patients with this combination was 26 times that for the normal population. When the patients' original tissue-typing was considered BT 101 no longer influenced conversion of optic neuritis to multiple sclerosis. This may partly be explained by improved methods of tissue-typing, since not all BT 101 patients were subsequently found to be positive for HLA-DR2 or HLA-DQw1 and vice versa and by extended follow-up as multiple sclerosis conversion in HLA-DR2 negative individuals increased with time. All 101 patients were typed for Factor B alleles. No significant differences in frequencies were found between individuals with isolated optic neuritis or those who progressed to multiple sclerosis compared with the

  14. Successful treatment of bilateral visual loss caused by HIV-associated optic neuritis

    Claire Cullen

    2011-12-01

    Full Text Available Optic neuritis is not an uncommon diagnosis in HIV-infected patients, but it is rarely idiopathic. We report a case of a young HIV-infected woman who developed optic neuritis as her presenting manifestation of HIV infection. She had initially experienced sudden-onset right-sided painful visual loss; the left eye had become involved within days. Bilateral swollen discs were apparent on fundoscopy. Investigations were performed for meningitis (including bacterial, cryptococcal, tuberculous and syphilitic types, auto-immune diseases, toxoplasma, rubella, cytomegalovirus, viral hepatitis, HTLV-1/2, HIV-1/2 and syphilis. The only positive result was a reactive HIV enzyme-linked immunosorbent assay. The CD4 count was 85 cells/µl. A post-contrast magnetic resonance imaging scan of the brain illustrated enhancement of the optic nerves. Treatment was 3 days of intravenous methylprednisolone 1 g daily, followed by 11 days of oral prednisone 60 mg daily. Highly active antiretroviral therapy was initiated after 2 weeks. Vision improved from day 6 after commencement of steroid therapy, with ongoing recovery at 5 months.

  15. ICAL AND MISDIAGNOSED CASE OF OPTIC NEURITIS IN A YOUNG FEMALE

    Inderjit

    2014-02-01

    Full Text Available AIM: To report an atypical and misdiagnosed case of optic neuritis in a young female. METHOD: 26 year healthy female was referred to the Regional Institute of Ophthalmology, Amritsar with the diagnosis of angle closure glaucoma both eyes. Patient was on 2% pilocarpine eye drops q.i.d and tablet acetazolamide 250 mg BD. On examination, visual acuity was 2/60 OD and 1/60 OS. Near vision was 6/36 OU. There was no circumcorneal congestion OU, no corneal edema OU, though anterior chamber was shallow OS >OD with pin pointed non-reacting pupil OU. IOP 14.6mm Hg OD and17.3mm Hg OS. Gonioscopically open angle grade 2. IOP and gonioscopy were repeated after pupil dilatation with tropicamide, findings were consistent with the previous ones. Fundoscopy showed bilateral disc edema with hyperemia and normal foveal reflex. Color vision was defective .Low vision prevented a conclusive perimetry. ONTT protocol was given, on the basis of decreased visual acuity, abnormal color vision, headache, disc changes, open angle and a normal MRI. Patient’s vision improved to 6/6 OD 6/9 OS in thirteen days. CONCLUSIONS: Bilateral optic neuritis is rare and an atypical presentation can be misdiagnosed as angle closure glaucoma in presence of severe headache, OU visual loss and shallow anterior chamber

  16. Recovery from optic neuritis: an ROI-based analysis of LGN and visual cortical areas

    Korsholm, Kirsten; Madsen, Kristoffer Hougaard; Frederiksen, Jette L; Skimminge, Arnold Jesper Møller; Lund, Torben

    2007-01-01

    Optic neuritis (ON) is the first clinical manifestation in approximately 20% of patients with multiple sclerosis (MS). The inflammation and demyelination of the optic nerve are characterized by symptomatic visual impairment and retrobulbar pain, and associated with decreased visual acuity......, decreased colour and contrast sensitivity, delayed visual evoked potentials and visual field defects. Spontaneous recovery of vision typically occurs within weeks or months after onset, depending on the resolution of inflammation, remyelination, restoration of conduction in axons which persist demyelinated...... and neuronal plasticity in the cortical and subcortical visual pathways. To assess where recovery takes place along the visual pathway, visual activation was studied in the lateral geniculate nucleus (LGN), the main thalamic relay nucleus in the visual pathway and in three areas of the visual cortex...

  17. Effects of minocycline on apoptosis and neuronal changes in retinal ganglion cells from experimental optic neuritis rats

    Jing Zhang

    2008-01-01

    BACKGROUND: Minocycline, a tetracycline derivative, is neuroprotective in models of various neurological diseases.OBJECTIVE: To investigate the effects of minocycline on retinal ganglion cells (RGCs) in rats with optic neuritis, and to compare with the effects of methylprednisolone.DESIGN, TIME AND SETTING: This neuropathology controlled study was performed at the First Affiliated Hospital, Chongqing Medical University, China in May 2007.MATERIALS: A total of 22 female Wistar rats were randomly assigned into a normal control group (n = 5) and an experimental group (n = 17). The experimental group was composed of a model subgroup (n = 7), a minocycline subgroup (n = 5), and a methylprednisolone subgroup (n = 5). Minocycline was supplied by Sigma, USA.METHODS: Antigen homogenate made from guinea pig spinal cord and complete Freund adjuvant was used to induce autoimmune encephalomyelitis, which could induce demyelinated optic neuritis models. Rats in the minocycline subgroup were intraperitoneally injected with minocycline (45 mg/kg) daily from day 8 following autoimmunity. Rats in the methylprednisolone subgroup were intraperitoneally injected with methylprednisolone (20 mg/kg) daily from day 8 following autoimmunity.MAIN OUTCOME MEASURES: On day 18 after autoimmunity induction, pathological changes in the optic nerve were observed by hematoxylin-eosin staining. The percentage area of axons in the transverse section of the optic nerve was measured by Bielschowsky staining. Apoptosis of RGCs was detected by TUNEL.RESULTS: Under an optical microscope, the optic nerve in rats with demyelinated optic neuritis showed a vacuole-like structure of fibers, irregular swelling of the axons, and infiltration of a large quantity of inflammatory cells. With an electron microscope, the optic nerve presented with vacuole-like structures in the axons, a small percentage area of axons in the transverse section, loose myelin sheaths, and microtubules and microfilaments disappeared. The

  18. Neuritis vestibularis

    Hansen, S.; Caye-Thomasen, P.; Boesen, J.;

    2008-01-01

    Vestibular neuritis is the second most common cause of peripheral vestibular vertigo. Its assumed cause is a reactivation of herpes simplex virus type 1 infection. Methylprednisolone significantly improves the recovery of peripheral vestibular function in patients with vestibular neuritis. Clinical...... studies suggest that specific vestibular exercises improve vestibulo-spinal and vestibulo-ocular compensation in patients with vestibular neuritis. This review discusses the above and comments etiology, epidemiology, pathophysiology, diagnostic procedures and differential diagnosis Udgivelsesdato: 2008/5/19...

  19. The socioeconomic consequences of optic neuritis with and without multiple sclerosis

    Jennum, P; Frederiksen, J L; Wanscher, B;

    2012-01-01

    OBJECTIVES: Optic neuritis (ON) often precedes multiple sclerosis (MS). MS is associated with a significant socioeconomic burden. However, the burden of ON with and without MS before and after its diagnosis has never been calculated. METHODS: Using complete national records from the Danish Nation...... for the individual patient and for society. Productivity losses are a far more important economic factor than health sector costs....... Patient Registry (1998-2006), we identified 1677 patients with ON and compared them with 6708 randomly selected citizens matched for age, sex and geography. A societal perspective is taken towards the cost analyses. Costs included in the analysis are those of the health sector, including all contacts...... with primary and secondary sectors, and the use and costs of drugs. Productivity losses included labour supply and income. All social transfer payments were also calculated. RESULTS: Patients with ON had higher rates of contact with healthcare services, medication use and income from employment, all of which...

  20. Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient

    Juanarita Jaafar; Wan Hazabbah Wan Hitam; Raja Azmi Mohd Noor

    2012-01-01

    A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye and 6/120 (pinhole 3/60) in the left eye. Anterior segment in both eyes was unremarkable. Funduscopy showed bilateral optic disc swelling with presence of multiple foci of choroiditis in the peripheral retina. The vitreous and retinal vessels were normal. Chest radiography was normal. CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis. This patient was managed with infectious disease team. She was started on HAART and anti-TB treatment was continued. She completed anti-TB treatment after 9 months without any serious side effects. During follow up the visual acuity in both eyes was not improved. However, funduscopy showed resolving of disc swelling and choroiditis following treatment.

  1. Bilateral optic neuritis in a child diagnosed with Gd-enhanced MR imaging using fat-suppression technique

    Okamoto, K.; Ogawa, R.; Furusawa, T.; Sakai, K. [Dept. of Radiology, Niigata Univ. School of Medicine, Niigata (Japan); Ito, J.; Tokiguchi, S. [Dept. of Radiology, Niigata University School of Dentistry (Japan); Takagi, M. [Dept. of Ophthalmology, Niigata Univ. School of Medicine (Japan)

    1999-05-01

    A 4-year-old boy developed bilateral optic neuritis. Although precise neuro-ophthalmological evaluation was difficult, the diagnosis was made with gadolinium-enhanced MR imaging using fat-suppression technique in the initial stage of the disease. Enhancement and enlargement of the intraorbital and intracanalicular optic nerve were demonstrated bilaterally as well as protrusion of the optic nerve head. The disease responded dramatically to intravenous steroid therapy. The etiologies in children usually differ from those in adolescent and adult patients. (orig.) With 1 fig., 13 refs.

  2. Normal-appearing white matter in optic neuritis and multiple sclerosis: a comparative proton spectroscopy study

    We investigated neurochemical abnormalities in the normal-appearing white matter (NAWM) on MRI of patients with optic neuritis (ON) and compared them to those of patients with multiple sclerosis (MS). Patients with ON (42) were classified into three groups according to abnormalities on brain MRI. Patients with MS (55) were devided in two groups: relapsing remitting MS (RRMS) and secondary progressive MS (SPMS). All patients underwent MRI of the brain and localised proton magnetic resonance spectroscopy (MRS) of NAWM. The results were compared to those of 15 controls. Patients with MS had significant abnormalities compared with controls and with patients with ON. Patients with RRMS and those with ON had comparable MRS parameters, while patients with SPMS had significant spectroscopic abnormalities in comparison with controls, but also with patients with RRMS. These changes consisted of a decrease in N -acetylaspartate, a neuronal marker, which may reflect axonal dysfunction and/or loss. MRS abnormalities were detected in 14 patients with ON (27 %). The main abnormalities consisted of a decrease in N -acetylaspartate, an increase in choline-containing compounds at long echo times, and the presence of free lipid peaks at short echo times. MRS of the NAWM on MRI may prove useful for detecting neurochemical brain abnormalities in ON not visible on MRI. (orig.)

  3. Study of MRI using short inversion time inversion recovery (STIR) sequences of cases with retrobulbar neuritis

    Eleven cases of retrobulbar neuritis were evaluated with MRI using short inversion time inversion recovery (STIR) sequences, which demonstrated the edematous and demyelinated lesions as hyperintense areas. Five of 6 cases in the acute phase showed hyperintense areas in the affected optic nerves. Three cases of multiple sclerosis in remission still demonstrated the hyperintense areas. MRI using STIR sequences provides very useful images for the diagnosis, pathogenesis, and evaluation of retrobulbar neuritis therapy. (author)

  4. Devic's disease before Devic: Bilateral optic neuritis and simultaneous myelitis in a young woman (1874).

    Jarius, S; Wildemann, B

    2015-11-15

    Neuromyelitis optica (NMO, Devic's disease) is an often severely disabling disorder of the central nervous system (CNS) which mainly affects the optic nerves and spinal cord. NMO was long considered a clinical subform of multiple sclerosis (MS). In 2004, however, Lennon and colleagues described a novel autoantibody in NMO which targets aquaporin-4, the most abundant water channel in the CNS, and which was later shown to be directly pathogenic. This has led to the recognition of NMO as a distinct disease entity in its own right. While the history of 'classical' MS has been extensively studied, only little is known about the early history of NMO. The term neuromyelitis optica was coined in 1894 by Eugène Devic (1858-1930) and Fernand Gault (1873-1936), who were the first to provide a systematic description of that disorder. Here we re-present a very early description of a case of NMO by a Polish physician, Adolf Wurst, which appeared in 1876 in Przegląd Lekarski, one of the oldest Polish medical journals. This report predates Devic and Gault's seminal work on NMO by more than two decades. The patient, a 30-year-old woman, subacutely developed simultaneous bilateral optic neuritis with papilloedema and bilateral blindness and transverse myelitis with severe paraparesis, anaesthesia, and bladder and bowel dysfunction. At last follow-up, one year after onset, she had recovered except for a residual spastic gait and some visual deficit on the right side. Of note, this is the first known case of NMO in a Caucasian patient ever reported outside Western Europe. PMID:26303625

  5. Changes in the retinal veins in acute optic neuritis

    Engell, T; Sellebjerg, F; Jensen, C

    1999-01-01

    retinae (PR) and 2 had venous sheathing (VS). Probable MS was found in 15 patients without prior symptoms of MS. One had PR and VS, and 2 had VS. Twenty patients had mono-symptomatic ON, none had retinal changes. CONCLUSION: Changes of the retinal veins should alert the clinician to a probable diagnosis...

  6. Early anisotropy changes in the corpus callosum of patients with optic neuritis

    Bester, M.; Ding, X.Q.; Holst, B.; Fiehler, J. [University Medical Center Hamburg-Eppendorf, Department of Neuroradiology, Hamburg (Germany); Heesen, C.; Schippling, S.; Martin, R. [University Medical Center Hamburg-Eppendorf, Department of Neuroradiology, Hamburg (Germany); University Medical Center Hamburg-Eppendorf, Institute for Neuroimmunology and Clinical MS Research, Hamburg (Germany)

    2008-07-15

    Optic neuritis (ON) and any other early manifestation of multiple sclerosis (MS) are referred to as clinically isolated syndrome (CIS) as long as MS is suspected. In this prospective study we aimed to determine whether diffusion tensor imaging (DTI) could quantify structural changes in patients with early MS. A total of 24 patients and 15 control subjects were prospectively followed by clinical examinations and MRI. the main inclusion criterion was presentation with ON. Patients underwent serial MRI scans: MRI1 (baseline, n=24), MRI2 (mean 6.6 months, n=24), MRI3 (mean 13.0 months, n=14), MRI4 (mean 39.4 months, n=5). Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were derived from DTI. Four regions of interest (ROIs) were defined in normal-appearing white matter (NAWM). In the temporal course FA decreased in the genu of the callosal body (GCC) from MRI1 to MRI4 (P=0.005) and in the splenium of the callosal body (SCC) (P=0.006). Patients already had lower FA values in the SCC (P<0.01) on MRI1 compared with the controls. Patients had lower FA values in the GCC (P<0.01) starting from MRI2. Patients with definite MS on follow-up (n=9) showed a correlation between FA in the SCC and time (r=-0.40, P=0.004), whereas patients without progression did not. Our findings suggest that the corpus callosum is an early site for development of anisotropy changes in MS patients with ON. There seems to be a primary FA decrease in all patients with ON that only deteriorates in the group developing definite MS. (orig.)

  7. Application of immunosuppressant facilitates the therapy of optic neuritis combined with Sj(o)gren's syndrome

    Li Hongyang; Liu Zihao; Gong Yan; Jiang Zhaocai; Zhang Yixin; Dai Yanli; Zhang Yan

    2014-01-01

    Background Optic neuritis (ON) is often the first symptom of multiple sclerosis (MS) and neuromyelitis optica (NMO) while there has been very little research reported on ON combined with Sj(o)gren's syndrome (SS).The aim of this study is to provide different treatments and services for and NMO patients combined with SS.Methods Twenty-seven patients with ON combined SS were divided into two groups:corticosteroid group (C group,methylprednisolone sodium succinate,14 patients) and corticosteroid+ immunosuppressant group (C+I group,leflunomide,13 patients).ON relapse times in 1 year after treatment,number of patients who relapsed to NMO/MS in 1 years,visual acuity and retina nerve fiber layer (RNFL) thickness were measured.Mann Whitney-Wilcoxon test was used to compare continuous variables and Chi-square test or Fisher's exact test was to compare proportions.Results ON combined with SS patients had higher incidence rates in middle-aged women who have binocular damage and heavier visual function damage or when there is an easy relapse,and the patients are often hormone dependent.The patients are more likely anti-aquaporin-4 IgG seropositive (70.4%).They are liable to form a centrocecal scotoma and tubular vision.The times of relapse decreased in patients who used immunosuppressant,and a significant difference was found between immunosuppressant and non-immunosuppressant groups in visual acuity recovery during 6-month followup period (P <0.05); however,the RNFL thickness at the four quadrants was not significantly different.Conclusions The effect of immunosuppressant plus corticosteroid on the early onset of ON combined with SS was to provide ON remedy and to prevent recurrence in clinics.This study provides a significant reference for the prevention and treatment of ON on the basis of immunosuppressant and corticosteroid.

  8. Early anisotropy changes in the corpus callosum of patients with optic neuritis

    Optic neuritis (ON) and any other early manifestation of multiple sclerosis (MS) are referred to as clinically isolated syndrome (CIS) as long as MS is suspected. In this prospective study we aimed to determine whether diffusion tensor imaging (DTI) could quantify structural changes in patients with early MS. A total of 24 patients and 15 control subjects were prospectively followed by clinical examinations and MRI. the main inclusion criterion was presentation with ON. Patients underwent serial MRI scans: MRI1 (baseline, n=24), MRI2 (mean 6.6 months, n=24), MRI3 (mean 13.0 months, n=14), MRI4 (mean 39.4 months, n=5). Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were derived from DTI. Four regions of interest (ROIs) were defined in normal-appearing white matter (NAWM). In the temporal course FA decreased in the genu of the callosal body (GCC) from MRI1 to MRI4 (P=0.005) and in the splenium of the callosal body (SCC) (P=0.006). Patients already had lower FA values in the SCC (P<0.01) on MRI1 compared with the controls. Patients had lower FA values in the GCC (P<0.01) starting from MRI2. Patients with definite MS on follow-up (n=9) showed a correlation between FA in the SCC and time (r=-0.40, P=0.004), whereas patients without progression did not. Our findings suggest that the corpus callosum is an early site for development of anisotropy changes in MS patients with ON. There seems to be a primary FA decrease in all patients with ON that only deteriorates in the group developing definite MS. (orig.)

  9. Idiopathic Brachial Neuritis

    Gonzalez-Alegre, Pedro; Recober, Ana; Kelkar, Praful

    2002-01-01

    Idiopathic brachial neuritis is a well defined clinical condition that most commonly affects young adults, seen usually by primary care physicians, neurologists or orthopaedic surgeons. Its onset is characterized by acute, aching shoulder pain lasting a few days to weeks, followed by progressive shoulder girdle and upper extremity weakness and atrophy, with a slow but progressive recovery of motor function over 6 to 18 months. Its early recognition can help avoid unnecessary and potentially h...

  10. Severe optic neuritis in a patient with combined neuromyelitis optica spectrum disease and primary Sjögren’s syndrome: a case report

    Tan Petrina

    2012-11-01

    Full Text Available Abstract Introduction Optic neuritis, although uncommon, can be the initial presentation of Sjögren’s syndrome. Coexisting Sjögren’s syndrome has also been reported with neuromyelitis optica spectrum disorder. This case report highlights the association between the two diseases and the importance of rheumatological and neurological evaluations in patients with such diagnoses. Distinction of neuromyelitis optica with coexisting connective tissue disease has both prognostic and therapeutic significance for the patient. Case presentation We report a case of a 56-year-old Chinese woman who presented with bilateral asymmetric visual loss secondary to optic neuritis. She was subsequently found to be seropositive for neuromyelitis optica immunoglobulin G (NMO-IgG (anti-aquaporin-4 antibody and was diagnosed with neuromyelitis optica spectrum disorder. She also fulfilled the international criteria for Sjögren’s syndrome. Despite initial high dose immunosuppressive therapy, she failed to regain vision in one eye. Conclusion Patients presenting with optic neuritis and severe visual loss should be screened for neuromyelitis optica and treated appropriately. Neuromyelitis optica has been associated with systemic autoimmune diseases, in particular Sjögren’s syndrome, and current evidence indicates that they are two distinct entities. We recommend that both diagnoses be considered in cases of optic neuritis with severe visual loss.

  11. Imidazol-1-ylethylindazole Voltage-Gated Sodium Channel Ligands Are Neuroprotective during Optic Neuritis in a Mouse Model of Multiple Sclerosis

    Browne, Lorcan; Lidster, Katie; Al-Izki, Sarah; Clutterbuck, Lisa; Posada, Cristina; Chan, A. W. Edith; Riddall, Dieter; Garthwaite, John; Baker, David; Selwood, David L.

    2014-01-01

    A series of imidazol-1-ylethylindazole sodium channel ligands were developed and optimized for sodium channel inhibition and in vitro neuroprotective activity. The molecules exhibited displacement of a radiolabeled sodium channel ligand and selectivity for blockade of the inactivated state of cloned neuronal Nav channels. Metabolically stable analogue 6 was able to protect retinal ganglion cells during optic neuritis in a mouse model of multiple sclerosis.

  12. Imidazol-1-ylethylindazole voltage gated sodium (Nav) channel ligands are neuroprotective during optic neuritis in a mouse model of multiple sclerosis.

    Browne, L.; Lidster, K.; Al-Izki, S.; Clutterbuck, L.; Posada, C.; Chan, A. E.; Riddall, D.; Garthwaite, J; Baker, D; Selwood, D. L.

    2014-01-01

    A series of imidazol-1-ylethyl)indazole sodium channel ligands were developed and optimized for sodium channel inhibition and in vitro neuroprotective activity. The molecules exhibited displacement of the radiolabelled sodium channel ligand and selectivity for blockade of the inactivated state of cloned neuronal Nav channels. A metabolically stable analogue 6 (CFM6104) was able to protect retinal ganglion cells during optic neuritis in a mouse model of multiple sclerosis.

  13. Altered intrinsic regional spontaneous brain activity in patients with optic neuritis: a resting-state functional magnetic resonance imaging study

    Shao Y

    2015-12-01

    Full Text Available Yi Shao,1,* Feng-Qin Cai,2,* Yu-Lin Zhong,1 Xin Huang,1,3 Ying Zhang,1 Pei-Hong Hu,1 Chong-Gang Pei,1 Fu-Qing Zhou,2 Xian-Jun Zeng2 1Department of Ophthalmology, 2Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, 3Department of Ophthalmology, First People’s Hospital of Jiujiang, Jiujiang, People’s Republic of China *These authors contributed equally to this work Objective: To investigate the underlying regional homogeneity (ReHo in brain-activity deficit in patients with optic neuritis (ON and its relationship with behavioral performance.Materials and methods: In total, twelve patients with ON (four males and eight females and twelve (four males and eight females age-, sex-, and education-matched healthy controls underwent resting-state functional magnetic resonance imaging scans. The ReHo method was used to assess the local features of spontaneous brain activity. Correlation analysis was used to explore the relationship between the observed mean ReHo values of the different brain areas and the visual evoked potential (VEP in patients with ON.Results: Compared with the healthy controls, patients with ON showed lower ReHo in the left cerebellum, posterior lobe, left middle temporal gyrus, right insula, right superior temporal gyrus, left middle frontal gyrus, bilateral anterior cingulate cortex, left superior frontal gyrus, right superior frontal gyrus, and right precentral gyrus, and higher ReHo in the cluster of the left fusiform gyrus and right inferior parietal lobule. Meanwhile, we found that the VEP amplitude of the right eye in patients with ON showed a positive correlation with the ReHo signal value of the left cerebellum posterior lobe (r=0.701, P=0.011, the right superior frontal gyrus (r=0.731, P=0.007, and the left fusiform gyrus (r=0.644, P=0.024. We also found that the VEP latency of the right eye in ON showed a positive correlation with the ReHo signal value of the right insula (r=0.595, P=0

  14. Roles of Treg/Th17 Cell Imbalance and Neuronal Damage in the Visual Dysfunction Observed in Experimental Autoimmune Optic Neuritis Chronologically.

    Liu, Yuanyuan; You, Caiyun; Zhang, Zhuhong; Zhang, Jingkai; Yan, Hua

    2015-12-01

    Optic neuritis associated with multiple sclerosis and its animal model, experimental autoimmune optic neuritis (EAON), is characterized by inflammation, T cell activation, demyelination, and neuronal damage, which might induce permanent vision loss. Elucidating the chronological relationship among the features is critical for treatment of demyelinating optic neuritis. EAON was induced in C57BL/6 mice immunized with myelin oligodendrocyte glycoprotein subcutaneously, and visual function was assessed by flash-visual evoked potential (F-VEP) at days 7, 11, 14, 19, 23, 28 post-immunization. Retinal ganglion cell (RGC) apoptosis was measured by terminal-deoxynucleotidyl transferase-mediated nick-end labeling. Demyelination and axonal damage were verified with myelin basic protein (MBP) and β-amyloid precursor protein staining, respectively. Real-time polymerase chain reaction quantified IL-17, IL-1β, TGF-β, FoxP3, IL-6, and IL-10 mRNA expression in the optic nerve, as well as FoxP3 and IL-17 staining. Systemic changes of Th17 and Treg cells were tested by flow cytometry in spleen. F-VEP latency was prolonged at 11 days and peaked at 23 days commensurate with demyelination. However, F-VEP amplitude was reduced at 11 days, preceding axon damage, and was exacerbated at 23 days when a peak in RGC apoptosis was detected. Th17 cells up-regulated as early as 7 days and peaked at 11 days, while Treg cells down-regulated inversely compared to Th17 cells change as verified by IL-17 and FoxP3 expression; spleen cell samples were slightly different, demonstrating marked changed at 14 days. Treg/Th17 cell imbalance in the optic nerve precedes and may initiate neuronal damage of axons and RGCs. These changes are commensurate with the appearances of visual dysfunction reflected in F-VEP and hence may offer a novel therapeutic avenue for vision preservation. PMID:26318182

  15. Anti-aquaporin-4 IgG in patients presenting with unilateral optic neuritis: A cohort study

    Masoud Etemadifar

    2012-01-01

    Full Text Available Background: Optic neuritis (ON can be the first presentation of multiple sclerosis (MS or neuromyelitis optica (NMO. Anti-aquaporin-4 IgG (AQP4 IgG is a highly specific and moderately sensitive biomarker for NMO. This study was designed to assess the rate of seropositivity for AQP4 IgG, and the short-term outcome of patients presenting with single isolated ON (SION. Methods: A cohort of 41 consecutive patients experiencing severe (< 20 / 200 SION (not fulfilling the diagnostic criteria for MS or NMO, was prospectively recruited. Blood sampling was carried out immediately after the diagnosis of ON, and AQP4 IgG was tested qualitatively, using an indirect immunofluorescence kit. After clinical and paraclinical investigations, all the patients were followed up for a short-term period of at least 18 months. Results: The seroprevalence among the initial ON patients was 9.7% (4 / 41. The short-term conversion rate to MS and NMO was estimated to be about 7.3 and 4.9%, respectively. The conversion rate to NMO in initially seropositive patients was greater than that for the whole cohort [2 / 4 (50% vs. 2 / 41 (4.9%; P = 0.035; Odds ratio: 19.5, 95% confidence interval: 1.73 to 219.50]. Conclusion: AQP4 IgG seropositive SION patients were more likely to develop NMO in comparison to the total SION population. Further studies, with a longer follow-up period and larger sample sizes are warranted to assess the clinical and prognostic value of assessing AQP4 IgG in SION.

  16. 25-hydroxyvitamin D concentrations in patients with optic neuritis as a clinically isolated syndrome and healthy controls

    Masoud Etemadifar

    2012-01-01

    Full Text Available Objectives: The onset of multiple sclerosis in the majority of the cases occurs as a clinically isolated syndrome (CIS. We sought to assess serum levels of 25-hydroxyvitamin D (25-OHD in CIS patients and healthy controls. Methods: In this cross-sectional study 40 patients (36 women and 4 men with CIS manifesting as a single isolated optic neuritis and 40 Age- and sex-matched healthy controls (35 women and 5 men were enrolled between late October 2010 and early March 2011. General vitamin D deficiency was defined as serum 25-OHD levels of lower than 20 ng/ml and was classified as mild (15 < 25-OHD <20 ng/ml, moderate (8 < 25-OHD <15 ng/ml, and severe (25-OHD <8 ng/ml. Results: We found no difference in the median interquartile range [IQR] between CIS patients and controls (17.95 [10.40-29.13] vs. 17.00 [12.25-31.00]; P=0.57. However, when stratified by the levels of deficiency, among CIS patients a significantly higher proportion had severe vitamin D deficiency in comparison to healthy controls (20% vs. 2.5%; P=0.034. Nevertheless, the frequency of general (62.5% vs. 60%, P=0.82, mild (25% vs. 30%, P=0.80, and moderate (17.5% vs. 27.5%, P=0.42 vitamin D deficiency were not different between the two groups. Conclusions: Our findings do not indicate any significant difference of serum 25-OHD between CIS patients and healthy controls. However, in our series severe vitamin D deficiency was more frequent among CIS patients.

  17. Optic neuritis: a 5-year follow-up study of Chinese patients based on aquaporin-4 antibody status and ages.

    Zhou, Huanfen; Zhao, Shuo; Yin, Dongfang; Chen, Xiaofei; Xu, Quangang; Chen, Tingjun; Li, Xiaoyan; Wang, Junqing; Li, Hongyang; Peng, Chunxia; Lin, Dahe; Wei, Shihui

    2016-07-01

    Little work has been performed on the long-term outcome of optic neuritis (ON) according to the status of aquaporin-4 antibody (AQP4-Ab) and long-term prognosis in older patients in China. This study retrospectively analyzed medical records in a cohort of Chinese patients with 5-year follow-up according to AQP4-Ab status and ages from January 2009 to December 2010. The clinical features, laboratory findings and risk factors for prognosis were analyzed. A total of 128 ON patients were included, 66.4 % of whom were female. The median age at onset was 36.8 years (range 18-73). Serum AQP4-Ab was positive in 45 (35.2 %) patients, with greater frequency in the female, bilateral, and recurrent ON groups (48.2, 42.5 and 53.6 %, respectively). Seropositive AQP4-Ab ON patients had worse visual recovery compared to seronegative patients (p = 0.033). The average and four quadrants of retinal nerve fiber layer (RNFL) thickness were significantly thinner in the seropositive group than in the seronegative group (p transverse myelitis (TM) episode were ocular pain and recurrence within 1 year. The older patients had worse visual outcome after the first episode of ON than the younger patients (p = 0.007). However, the two groups did not differ significantly with regard to prevalence of AQP4-Ab, long-term visual recovery and the risk of developing to NMO/MS. PMID:27159992

  18. Frequency and prognostic impact of antibodies to aquaporin-4 in patients with optic neuritis

    Jarius, Sven; Frederiksen, Jette Lautrup Battistini; Waters, Patrick; Paul, Friedemann; Akman-Demir, Gulsen; Marignier, Romain; Franciotta, Diego; Ruprecht, Klemens; Kuenz, Bettina; Rommer, Paulus; Kristoferitsch, Wolfgang; Wildemann, Brigitte; Vincent, Angela

    Antibodies to aquaporin-4 (AQP4-Ab) are found in 60-80% of patients with neuromyelitis optica (NMO), a severely disabling inflammatory CNS disorder of putative autoimmune aetiology, which predominantly affects the optic nerves and spinal cord.......Antibodies to aquaporin-4 (AQP4-Ab) are found in 60-80% of patients with neuromyelitis optica (NMO), a severely disabling inflammatory CNS disorder of putative autoimmune aetiology, which predominantly affects the optic nerves and spinal cord....

  19. Frequency and prognostic impact of antibodies to aquaporin-4 in patients with optic neuritis

    Jarius, Sven; Frederiksen, Jette Lautrup Battistini; Waters, Patrick;

    2010-01-01

    Antibodies to aquaporin-4 (AQP4-Ab) are found in 60-80% of patients with neuromyelitis optica (NMO), a severely disabling inflammatory CNS disorder of putative autoimmune aetiology, which predominantly affects the optic nerves and spinal cord.......Antibodies to aquaporin-4 (AQP4-Ab) are found in 60-80% of patients with neuromyelitis optica (NMO), a severely disabling inflammatory CNS disorder of putative autoimmune aetiology, which predominantly affects the optic nerves and spinal cord....

  20. Management of optic neuritis and impact of clinical trials: an international survey

    Biousse, Valérie; Calvetti, Olivier; Drews-Botsch, Carolyn D;

    2009-01-01

    more frequently presented to ophthalmologists, and were subsequently referred to neurologists or subspecialists. Evaluation and management of ON varied among countries, mostly because of variations in healthcare systems, imaging access, and local guidelines. A brain MRI was obtained for 70-80% of ON...... countries, steroids were often prescribed to improve visual outcome or to decrease the long-term risk of multiple sclerosis. INTERPRETATION: Although recent clinical trials have changed the management of acute ON around the world, many neurologists and ophthalmologists do not evaluate and treat acute ON...... patients according to the best evidence from clinical research. This confirms that evaluation of the impact of major clinical trials ("translational T2 clinical research") is essential when assessing the effects of interventions designed to improve quality of care....

  1. MRI texture heterogeneity in the optic nerve predicts visual recovery after acute optic neuritis

    Yunyan Zhang

    2014-01-01

    Conclusions: Tissue heterogeneity may be a potential measure of functional outcome in ON patients and advanced analysis of the texture in standard MRI could provide insights into mechanisms of injury and recovery in patients with similar disorders.

  2. Structural Alterations of Segmented Macular Inner Layers in Aquaporin4-Antibody-Positive Optic Neuritis Patients in a Chinese Population.

    Chunxia Peng

    Full Text Available This study aimed to analyse the structural injury of the peripapillary retinal nerve fibre layer (pRNFL and segmented macular layers in optic neuritis (ON in aquaporin4-antibody (AQP4-Ab seropositivity(AQP4-Ab-positiveON patients and in AQP4-Ab seronegativity (AQP4-Ab-negative ON patients in order to evaluate their correlations with the best-corrected visual acuity (BCVA and the value of the early diagnosis of neuromyelitis optica (NMO.This is a retrospective, cross-sectional and control observational study.In total, 213 ON patients (291 eyes and 50 healthy controls (HC (100 eyes were recruited in this study. According to a serum AQP4-Ab assay, 98 ON patients (132 eyes were grouped as AQP4-Ab-positive ON and 115 ON patients (159 eyes were grouped as AQP4-Ab-negative ON cohorts. All subjects underwent scanning with spectralis optical coherence tomography (OCT and BCVA tests. pRNFL and segmented macular layer measurements were analysed.The pRNFL thickness in AQP4-Ab-positive ON eyes showed a more serious loss during 0-2 months (-27.61μm versus -14.47 μm and ≥6 months (-57.91μm versus -47.19μm when compared with AQP4-Ab-negative ON eyes. AQP4-Ab-positive ON preferentially damaged the nasal lateral pRNFL. The alterations in the macular ganglion cell layer plus the inner plexiform layer (GCIP in AQP4-Ab-positive ON eyes were similar to those in AQP4-Ab-negative ON eyes. AQP4-Ab-positive ON eyes had entirely different injury patterns in the inner nuclear layer (INL compared with AQP4-Ab-negative ON eyes during the first 6 months after the initial ON attack. These differences were as follows: the INL volume of AQP4-Ab-positive ON eyes had a gradual growing trend compared with AQP4-Ab-negative ON eyes, and it increased rapidly during 0-2 months, reached its peak during 2-4 months, and then decreased gradually. The pRNFL and GCIP in AQP4-Ab-positive ON eyes had positive correlations with BCVA. When the pRNFL thickness decreased to 95%CI (50.77

  3. Adding Papillomacular Bundle Measurements to Standard Optical Coherence Tomography Does Not Increase Sensitivity to Detect Prior Optic Neuritis in Patients with Multiple Sclerosis

    Laible, Mona; Jarius, Sven; Schmidt-Bacher, Annette; Platten, Michael; Haas, Jürgen

    2016-01-01

    Purpose To improve the detection of retinal nerve fiber layer (RNFL) thinning in multiple sclerosis (MS), a special peripapillary ring scanning algorithm (N-site RNFL, N-RNFL) was developed for spectral domain optical coherence tomography (SD-OCT). In contrast to the standard protocol (ST-RNFL) scanning starts nasally, not temporally, and provides an additional sector of analysis, the papillomacular bundle (PMB). We aimed to ascertain whether the temporal RNFL differs between the two techniques, whether N-RNFL is more sensitive than ST-RNFL to detect previous optic neuritis (ON), and whether analyzing the PMB adds additional sensitivity. Furthermore, we investigated whether RNFL is associated with disease severity and/or disease duration. Methods We conducted a cross-sectional case-control study of 38 patients with MS, of whom 24 had a history of ON, and 40 healthy controls (HC). Subjects with ON within the previous 6 months were excluded. Records included clinical characteristics, visual evoked potentials (VEP), and SD-OCT in both techniques. Results In a total of 73 evaluable MS eyes, temporal N-RNFL was abnormal in 17.8%, temporal ST-RNFL in 19.2%, and the PMB-RNFL in 21.9%. In ON eyes, the sensitivity of temporal N-RNFL and ST-RNFL did not differ significantly (37.0%/33.3%, p = 0.556). The sensitivity of VEP was 85.2%. RNFL thickness was associated with disease severity in all eyes, with and without a history of ON, and with disease duration. Conclusion The two OCT techniques detected previous ON with similar sensitivity, but the sensitivity of VEPs was superior to that of both N-RNFL and ST-RNFL. Our results indicate that the widely used ST-RNFL technique is appropriate for peripapillary RNFL measurements in MS patients. PMID:27171375

  4. Comparison of 3D double inversion recovery and 2D STIR FLAIR MR sequences for the imaging of optic neuritis: pilot study

    Hodel, Jerome; Bocher, Anne-Laure; Pruvo, Jean-Pierre; Leclerc, Xavier [Hopital Roger Salengro, Department of Neuroradiology, Lille (France); Outteryck, Olivier; Zephir, Helene; Vermersch, Patrick [Hopital Roger Salengro, Department of Neurology, Lille (France); Lambert, Oriane [Fondation Ophtalmologique Rothschild, Department of Neuroradiology, Paris (France); Benadjaoud, Mohamed Amine [Radiation Epidemiology Team, Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Villejuif (France); Chechin, David [Philips Medical Systems, Suresnes (France)

    2014-12-15

    We compared the three-dimensional (3D) double inversion recovery (DIR) magnetic resonance imaging (MRI) sequence with the coronal two-dimensional (2D) short tau inversion recovery (STIR) fluid-attenuated inversion recovery (FLAIR) for the detection of optic nerve signal abnormality in patients with optic neuritis (ON). The study group consisted of 31 patients with ON (44 pathological nerves) confirmed by visual-evoked potentials used as the reference. MRI examinations included 2D coronal STIR FLAIR and 3D DIR with 3-mm coronal reformats to match with STIR FLAIR. Image artefacts were graded for each portion of the optic nerves. Each set of MR images (2D STIR FLAIR, DIR reformats and multiplanar 3D DIR) was examined independently and separately for the detection of signal abnormality. Cisternal portion of optic nerves was better delineated with DIR (p < 0.001), while artefacts impaired analysis in four patients with STIR FLAIR. Inter-observer agreement was significantly improved (p < 0.001) on 3D DIR (κ = 0.96) compared with STIR FLAIR images (κ = 0.60). Multiplanar DIR images reached the best performance for the diagnosis of ON (95 % sensitive and 94 % specific). Our study showed a high sensitivity and specificity of 3D DIR compared with STIR FLAIR for the detection of ON. These findings suggest that the 3D DIR sequence may be more useful in patients suspected of ON. (orig.)

  5. Idiopathic brachial neuritis in a child: A case report and review of the literature

    Shikha Jain; Girish Chandra Bhatt; Nirendra Rai; Bhavna Dhingra Bhan

    2014-01-01

    Brachial neuritis is a rare disease in children, affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. We report a case of idiopathic brachial plexus neuritis in a 2³-year-old female child admitted with acute respiratory distress and given antibiotic therapy following which she developed weakness of the left hand. She was diagnosed as a case of idiopathic brachial plexus neuritis and was given supportive care. Although, the association wit...

  6. Effects of vitamin D on retinal nerve fiber layer in vitamin D deficient patients with optic neuritis: Preliminary findings of a randomized, placebo-controlled trial

    Mehri Salari

    2015-01-01

    Full Text Available Background: There is accumulating evidence for a possible protective role of vitamin D in the development and disease course of multiple sclerosis. Whether vitamin D is also effective in treating patients with optic neuritis (ON is not known. The aim of this study was to evaluate the effect of oral vitamin D on the thickness of retinal nerve fiber layer (RNFL in vitamin D deficient patients with ON by optical coherence tomography. Materials and Methods: A Phase II placebo-controlled randomized clinical trial conducted between July 2011 and November 2012 included 52 patients with confirmed unilateral ON aged 15-38 years and low serum 25-hydroxyvitamin D levels. The main outcome measures were changes in thickness of RNFL and macula 6 months after treatment. Patients were randomly allocated to receive 6 months of treatment with adding either 50,000 IU/week vitamin D or placebo. Results: In the 27 patients treated with vitamin D, the mean (standard deviation [SD] thickness of RNFL decreased from 111.3 (18.9 μm at baseline to 91.4 (13.3 at the end of study period (P 0.05. Average thickness of RNFL at the end of trial did not differ between groups. Conclusion: Adding vitamin D to routine disease therapy had no significant effect on the thickness of RNFL or macula in patients with ON. This trial is registered on www.clinicaltrials.gov (ID NCT01465893.

  7. Disturbed spontaneous brain-activity pattern in patients with optic neuritis using amplitude of low-frequency fluctuation: a functional magnetic resonance imaging study

    Huang X

    2015-12-01

    Full Text Available Xin Huang,1,2,* Feng-Qin Cai,3,* Pei-Hong Hu,1 Yu-Lin Zhong,1 Ying Zhang,1 Rong Wei,1 Chong-Gang Pei,1 Fu-Qing Zhou,3 Yi Shao1 1Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, First Affiliated Hospital of Nanchang University, Nanchang, 2Department of Ophthalmology, First People’s Hospital of Jiujiang, Jiujiang, 3Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China *These authors contributed equally to this work Objective: To use the amplitude of low-frequency fluctuation (ALFF technique to investigate the local features of spontaneous brain activity in optic neuritis (ON and their relationship with behavioral performance.Materials and methods: Twelve patients with ON (four male, eight female and twelve age-, sex-, and education status-matched healthy controls (HCs (four male, eight female underwent resting-state functional magnetic resonance imaging (rs-fMRI scans. The ALFF technique was used to assess local features of spontaneous brain activity. Correlation analysis was used to explore the relationship between the observed mean ALFF values of the different areas and visual evoked potentials (VEPs in patients with ON.Results: Compared with HCs, patients with ON had significantly decreased ALFF values in the posterior and anterior lobes of the right cerebellum, right putamen, right inferior frontal gyrus, right insula, right supramarginal gyrus, right inferior parietal lobule, left medial frontal gyrus, left superior temporal gyrus, bilateral anterior cingulate/medial frontal gyrus, and bilateral precuneus, and significantly increased ALFF values in the posterior lobes of the left and right cerebellum, right inferior temporal gyrus, right inferior temporal/fusiform gyrus, left parahippocampal gyrus, left fusiform gyrus, left calcarine fissure, left inferior parietal lobule, and left cuneus. We found negative correlations between the mean ALFF signal

  8. HLA typing in acute optic neuritis. Relation to multiple sclerosis and magnetic resonance imaging findings

    Frederiksen, J.L.; Madsen, H.O.; Ryder, L.P.;

    1997-01-01

    frequency of HLA-DR15 was significantly increased in patients with ON + CDMS (52%) and ON (47%) compared with control subjects (31%). The frequency of HLA-DR17 was almost equal in the ON + CDMS (18%), ON (23%), and control (23%) groups. The frequencies of HLA-DQA-1B (55% in ON + CDMS, 58% in ON) and HLA......-DQB-1B (49% in ON + CDMS, 59% in ON) were significantly increased compared with control subjects (41%, HLA-DQA-1B; 37%, HLA-DQB-1B). Brain MRI was abnormal in 48 of 56 examined patients with ON + CDMS and in 64 of 120 examined patients with ON (P < .001). In contrast, the frequencies of HLA alleles did...... not differ between patients with and without demyelinating lesions. However, patients with ON and normal MRI findings did not show association with HLA-DR15. CONCLUSIONS: The frequencies of alleles were similar in patients with ON and ON + CDMS, confirming that they are not 2 immunogenetically...

  9. A double-blind, randomized trial of IV immunoglobulin treatment in acute optic neuritis

    Roed, H.G; Langkilde, Annika Reynberg; Sellebjerg, F;

    2005-01-01

    -four patients were randomized to IVIG 0.4 g/kg body wt, and 34 patients were randomized to placebo. Infusions were given at days 0, 1, 2, 30, and 60. Contrast sensitivity, visual acuity, and color vision were measured at baseline and after 1 week, 1 month, and 6 months. Pattern reversal visual evoked potential...

  10. White and Gray Matter Volume Changes and Correlation with Visual Evoked Potential in Patients with Optic Neuritis: A Voxel-Based Morphometry Study.

    Huang, Xin; Zhang, Qiang; Hu, Pei-Hong; Zhong, Yu-Lin; Zhang, Ying; Wei, Rong; Xu, Ting-Ting; Shao, Yi; fMRI Study Group, And Oculopathy

    2016-01-01

    BACKGROUND The aim of this study was to investigate potential morphological alterations of gray and white matter in patients with optic neuritis (ON) and their relationship with behavioral performance, using voxel-based morphometry (VBM). MATERIAL AND METHODS Twelve (4 males, 8 females) patients with ON and 12 (4 males, 8 females) age-, sex-, and education-matched healthy controls (HCs) underwent magnetic resonance imaging (MRI). Imaging data were analyzed using two-sample t tests to identify group differences in gray and white matter volume (GMV, WMV). Correlation analysis was used to explore relationships between observed GMV and WMV of different areas and visual evoked potential (VEP) in ON. RESULTS Compared with HCs, ON patients had: significantly decreased GMV in the left postcentral gyrus, left inferior frontal gyrus, left anterior cingulate, left and right middle frontal gyrus, and right inferior parietal lobule; decreased WMV in the left middle frontal gyrus, right superior frontal gyrus, left precentral gyrus and right inferior parietal lobule; and increased WMV in the left fusiform gyrus and left inferior parietal lobule. VEP latency of the right eye in ON correlated positively with WMV signal value of the left fusiform gyrus (r=0.726, p=0.008), and negatively with GMV signal value of the right inferior parietal lobule (r=-0.611, p=0.035). Duration of ON correlated negatively with WMV signal value of the right superior frontal gyrus (r=-0.662, p=0.019), while best-corrected visual acuity (VA) of the right eye correlated negatively with WMV signal value of the left middle frontal gyrus (r=-0.704, p=0.011). CONCLUSIONS These results suggest significant brain involvement in ON, which may reflect the underlying pathologic mechanism. Correlational results demonstrate that VEP in ON is closely associated with WMV and GMV atrophy in many brain regions. PMID:27045330

  11. Brain Tissue Volumes and Perfusion Change with the Number of Optic Neuritis Attacks in Relapsing Neuromyelitis Optica: A Voxel-Based Correlation Study.

    Carlos A Sánchez-Catasús

    Full Text Available Recent neuroimaging studies show that brain abnormalities in neuromyelitis optica (NMO are more frequent than earlier described. Yet, more research considering multiple aspects of NMO is necessary to better understand these abnormalities. A clinical feature of relapsing NMO (RNMO is that the incremental disability is attack-related. Therefore, association between the attack-related process and neuroimaging might be expected. On the other hand, the immunopathological analysis of NMO lesions has suggested that CNS microvasculature could be an early disease target, which could alter brain perfusion. Brain tissue volume changes accompanying perfusion alteration could also be expected throughout the attack-related process. The aim of this study was to investigate in RNMO patients, by voxel-based correlation analysis, the assumed associations between regional brain white (WMV and grey matter volumes (GMV and/or perfusion on one side, and the number of optic neuritis (ON attacks, myelitis attacks and/or total attacks on the other side. For this purpose, high resolution T1-weighted MRI and perfusion SPECT imaging were obtained in 15 RNMO patients. The results showed negative regional correlations of WMV, GMV and perfusion with the number of ON attacks, involving important components of the visual system, which could be relevant for the comprehension of incremental visual disability in RNMO. We also found positive regional correlation of perfusion with the number of ON attacks, mostly overlapping the brain area where the WMV showed negative correlation. This provides evidence that brain microvasculature is an early disease target and suggests that perfusion alteration could be important in the development of brain structural abnormalities in RNMO.

  12. Neurodegeneration in Autoimmune Optic Neuritis Is Associated with Altered APP Cleavage in Neurons and Up-Regulation of p53.

    Sabine Herold

    Full Text Available Multiple Sclerosis (MS is a chronic autoimmune inflammatory disease of the central nervous system (CNS. Histopathological and radiological analysis revealed that neurodegeneration occurs early in the disease course. However, the pathological mechanisms involved in neurodegeneration are poorly understood. Myelin oligodendrocyte glycoprotein (MOG-induced experimental autoimmune encephalomyelitis (EAE in Brown Norway rats (BN-rats is a well-established animal model, especially of the neurodegenerative aspects of MS. Previous studies in this animal model indicated that loss of retinal ganglion cells (RGCs, the neurons that form the axons of the optic nerve, occurs in the preclinical phase of the disease and is in part independent of overt histopathological changes of the optic nerve. Therefore, the aim of this study was to identify genes which are involved in neuronal cell loss at different disease stages of EAE. Furthermore, genes that are highly specific for autoimmune-driven neurodegeneration were compared to those regulated in RGCs after optic nerve axotomy at corresponding time points. Using laser capture micro dissection we isolated RNA from unfixed RGCs and performed global transcriptome analysis of retinal neurons. In total, we detected 582 genes sequentially expressed in the preclinical phase and 1150 genes in the clinical manifest EAE (P 1.5. Furthermore, using ingenuity pathway analysis (IPA, we identified amyloid precursor protein (APP as a potential upstream regulator of changes in gene expression in the preclinical EAE but neither in clinical EAE, nor at any time point after optic nerve transection. Therefore, the gene pathway analysis lead to the hypothesis that altered cleavage of APP in neurons in the preclinical phase of EAE leads to the enhanced production of APP intracellular domain (AICD, which in turn acts as a transcriptional regulator and thereby initiates an apoptotic signaling cascade via up-regulation of the target gene p

  13. Unilateral Optic Neuropathy and Acute Angle-Closure Glaucoma following Snake Envenomation

    Osman Okan Olcaysu

    2015-01-01

    Full Text Available Purpose. We aimed to describe a unique case in which a patient developed unilateral optic neuritis and angle-closure glaucoma as a result of snake envenomation. Case Report. Approximately 18 hours after envenomation, a 67-year-old female patient described visual impairment and severe pain in her left eye (LE. The patient’s best corrected visual acuity was 10/10 in the RE and hand motion in the LE. Cranial magnetic resonance imaging showed signs of neuropathy in the left optic nerve. In the LE, corneal haziness, closure of the iridocorneal angle, and mild mydriasis were observed and pupillary light reflex was absent. Intraocular pressure was 25 mmHg and 57 mmHg in the RE and LE, respectively. The patient was diagnosed with acute angle-closure glaucoma in the LE. Optic neuropathy was treated with intravenous pulse methylprednisolone. Left intraocular pressure was within normal range starting on the fourth day. One month after the incident, there was no sign of optic neuropathy; relative afferent pupillary defect and optic nerve swelling disappeared. Conclusions. Patients with severe headache and visual loss after snake envenomation must be carefully examined for possible optic neuropathy and angle-closure glaucoma. Early diagnosis and treatment of these cases are necessary to prevent permanent damage to optic nerves.

  14. Idiopathic brachial neuritis in a child: A case report and review of the literature.

    Jain, Shikha; Bhatt, Girish Chandra; Rai, Nirendra; Bhan, Bhavna Dhingra

    2014-01-01

    Brachial neuritis is a rare disease in children, affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. We report a case of idiopathic brachial plexus neuritis in a 2½-year-old female child admitted with acute respiratory distress and given antibiotic therapy following which she developed weakness of the left hand. She was diagnosed as a case of idiopathic brachial plexus neuritis and was given supportive care. Although, the association with antibiotic therapy in this case could be incidental, indeed it is intriguing and requires further studies. PMID:25624937

  15. Idiopathic brachial neuritis in a child: A case report and review of the literature

    Shikha Jain

    2014-01-01

    Full Text Available Brachial neuritis is a rare disease in children, affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. We report a case of idiopathic brachial plexus neuritis in a 2³-year-old female child admitted with acute respiratory distress and given antibiotic therapy following which she developed weakness of the left hand. She was diagnosed as a case of idiopathic brachial plexus neuritis and was given supportive care. Although, the association with antibiotic therapy in this case could be incidental, indeed it is intriguing and requires further studies.

  16. 视神经炎的MRI表现及与视觉诱发电位的相关性研究%MRI findings and correlative study of MRI and visual evoked potentials in optic neuritis

    燕飞; 李静; 王振常; 刘守斌; 张晓君

    2008-01-01

    Objective To investigate the effective MRI sequences and describe the correlation between MRI and visual evoked potential(VEP)in diagnosing optic neuritis.Methods One hundred and fifty-four eyes with visual impairment of 98 patients with diagnoses of optic neuritis,papillitis,multiple sclerosis and Devic's disease underwent MRI and VEP examination. The MRI findings were analyzed and correlated with VEP results and clinical presentation by using x2 test,wilcoxon test and Kappa test.Results Out of the 154 sick eyes.56 eyes presented thickened optic nerves.76 eyes had normal diameter of the optic nerve,and 22 eyes had thin optic nerves.A total of 132 optic nerves showed abnormally high signal in STIR sequences.including involvement of intraocular segment in 7,intraorbitsl segment in 135,intracanalicular segment in 109,intracranial segment in 97,optic chiasm in 56,and optic tract in 23.A total of 54 patients underwent postcontrast MRI. Seventy-four optic nerves of 87 eyes showed enhancement.Among the 196 eyes of 98 patients,132 eyes presented visual impairment and simultaneous abnormal MR signal of the optic nerve.and 26 eyes had both normal vision and normal MR signal of optic nerve.The consistency of MRI findings and vision status was 80.61%(Kappa=0.453,P<0.01).Among the 175 eyes with VEP results.129 eyes had visual loss with simultaneous VEP abnormalities,and 30 eyes had both normal vision and normal VEP results.The consistency of VEP and vision status was 90.86%(Kappa=0.731,P<0.01).Among the 175 eyes with VEP results,117 eyes had abnormal MR signal of the optic nerve and simultaneous abnormal VEP,and 24 eyes had both normal MR signal of the optic nerve and normal VEP.The consistency of MRI findings and VEP was 80.57%(Kappa=0.460,P<0.01).Conclusion STIR sequence and gadolinium-enhanced T1-weighted MR sequence combined with fatsuppression are helpful in diagnosis of optic neuritis.VEP is helpful in diagnosing optic neuritis and in finding subclinical visual

  17. Acute Disseminated Encephalomyelitis

    Kambiz Sotoudeh

    Full Text Available Acute disseminated encephalomyelitis (ADEM is an acute, inflammatory, monophasic, demyelinating and immune-mediated disorder of central nervous system; occurs mostly in children after systemic viral infections or vaccinations. Acute polysymptomatic neurologic signs such as encephalopathy, paralysis of limbs, cranial nerve involvement, ataxia and optic neuritis are common manifestations. Brain magnetic resonance imaging study is essential for diagnosis and enabling prompt diagnosis and treatment. Evidence of multifocal lesions of demyelination in subcortical white matter are seen. They are usually bilateral and asymmetrical. Treatment optins have included steroids, immunoglobulins, and plasmapheresis. ADEM is treatable and prognosis is good.

  18. 鼠神经生长因子联合甲基强的松龙治疗急性球后视神经炎的临床研究%The investigation the therapeutic effects of combined mouse nerve growth factor and methylprednisolone on acute retrobulbar neuritis

    陆君华; 马吴波; 赵茂竹

    2013-01-01

    目的 探讨鼠神经生长因子(NGF)联合甲基强的松龙治疗急性球后视神经炎(ARN)临床疗效.方法 对44例(64只眼)ARN患者治疗后的资料进行总结分析.结果 鼠NGF联合甲基强的松龙治疗后患者的视力、视野、P-VEP均有不同程度改善.治疗组有效率为93.5%,对照组有效率为69.6%.治疗组疗效优于对照组(P<0.05).结论 鼠NGF联合甲基强的松龙为ARN的治疗提供了有效方法.%Objective To Investigate the therapeutic efficacy of mouse nerve growth factor combined with methylprednisolone on acute retrobulbar neuritis (ARN).Methods To summarize and analyze the data of 44 cases (64 eyes) of acute retrobulbar neuritis that were treated with mouse nerve growth factor combined with methylprednisolone.Results After treatment,the VA,VF and P-VEP are all improved.The rate of improvement was 93.5 %,which was significantly better than the improvement rate of 69.6% in the control group (P <0.05).Conclusion Combination ofnerve growth factor and methylprednisolone is a superior treatment for acute retrobulbar neuritis than steroids alone.

  19. Isolated Unilateral Brachial Neuritis of the Phrenic Nerve (Parsonage-Turner Syndrome) in a Marathon Runner With Exertional Dyspnea

    Weng, Modern; Fidel, Constance

    2010-01-01

    Parsonage-Turner syndrome, or acute brachial neuritis/plexitis, is a rare condition that should be included in the differential diagnosis of any athlete who presents with antecedent flulike symptoms, with progression to significant neuropathic pain, followed by profound weakness in the affected upper extremity. In rare cases, the main presenting symptom of this condition may be dyspnea on exertion secondary to an isolated unilateral brachial neuritis of the phrenic nerve.

  20. Inflammatory Cytokines Are Involved in Focal Demyelination in Leprosy Neuritis.

    Andrade, Priscila Ribeiro; Jardim, Márcia Rodrigues; da Silva, Ana Caroline Costa; Manhaes, Paula Saraiva; Antunes, Sérgio Luiz Gomes; Vital, Robson; Prata, Rhana Berto da Silva; Petito, Rafael Braga; Pinheiro, Roberta Olmo; Sarno, Euzenir Nunes

    2016-03-01

    Mycobacterium leprae (ML) infection causes nerve damage that often leads to permanent loss of cutaneous sensitivity and limb deformities, but understanding of the pathogenesis of leprous neuropathy that would lead to more effective treatments is incomplete. We studied reactional leprosy patients with (n = 9) and without (n = 8) acute neuritis. Nerve conduction studies over the course of the reactional episode showed the findings of demyelination in all patients with neuritis. Evaluation of patient sera revealed no correlation of the presence of antibodies against gangliosides and the clinical demyelination. In nerve biopsies of 3 patients with neuritis, we identified tumor necrosis factor (TNF), TNF receptors, and TNF-converting enzyme in Schwann cells (SCs) using immunofluorescence. To elucidate immunopathogenetic mechanisms, we performed experiments using a human SC line. ML induced transmembrane TNF and TNF receptor 1 expression in the SCs; TNF also induced interleukin (IL) -: 6 and IL-8 production by the SCs; and ML induced IL-23 secretion, indicating involvement of this previously unrecognized factor in leprosy nerve damage. These data suggest that ML may contribute to TNF-mediated inflammation and focal demyelination by rendering SCs more sensitive to TNF within the nerves of patients with leprous neuropathy. PMID:26888306

  1. Brachial neuritis following a corticosteroid injection.

    Robinson, Matthew; Fulcher, Mark

    2014-01-01

    This report presents a case of brachial neuritis following a subacromial corticosteroid injection. The patient developed an anterior interosseous neuropathy shortly after the injection, with no other trigger being identified. This neuropathy has unfortunately not shown any sign of recovery at 2 years. The authors propose that corticosteroid injection be added to the list of possible triggering events of brachial neuritis and highlight the frequent use of oral corticosteroids in its treatment. (1) The injection of local anaesthetic and corticosteroid should be considered as a potential trigger for brachial neuritis. (2) Brachial neuritis should be considered in the differential diagnosis for patients presenting with severe arm pain and weakness. (3) The nerves originating from the upper trunk of the brachial plexus are most commonly affected. (4) The anterior interosseous nerve is involved in one-third of cases. PMID:24596414

  2. Brachial neuritis following a corticosteroid injection

    Robinson, Matthew; Fulcher, Mark

    2014-01-01

    This report presents a case of brachial neuritis following a subacromial corticosteroid injection. The patient developed an anterior interosseous neuropathy shortly after the injection, with no other trigger being identified. This neuropathy has unfortunately not shown any sign of recovery at 2 years. The authors propose that corticosteroid injection be added to the list of possible triggering events of brachial neuritis and highlight the frequent use of oral corticosteroids in its treatment....

  3. Distribution of autoimmune antibodies and clinical features in 54 cases with recurrent optic neuritis%复发性视神经炎54例临床特点及自身免疫抗体的分布

    王颖云; 魏世辉; 范珂; 闫洪欣; 张译心; 戴艳丽

    2013-01-01

    目的 观察复发性视神经炎的临床特点以及自身免疫抗体(水通道蛋白4抗体和血清抗核抗体)的分布.方法 收集2010年10月至2012年4月间在解放军总医院神经眼科住院诊治的复发性视神经炎患者54例的临床资料,回顾分析其一般临床特点,统计其水通道蛋白4抗体(AQP4-Ab)(36例)和血清抗核抗体(ANAs)的阳性率,并与相关文献数据分析比较.结果 男女比例1∶2.6,发病年龄平均30.3岁;病程50d~20年,发病次数2~8次.病程中最差视力(矫正后)在0.1以下者44例,占81.5%.ANAs阳性率22.2% (12/54),AQP4-Ab阳性率27.8% (10/36);颅脑和/或脊髓核磁异常者占48.0% (24/50);脑脊液异常70.0% (16/23).结论 复发性视神经炎多发于青壮年,视力损害较重,自身免疫抗体(AQP4-Ab和ANAs)阳性率较视神经脊髓炎及复发性长节段横贯性脊髓炎略低,中枢神经系统影像检查对其诊治有重要价值.%ObJective To investigate the clinical features and seroprevalence of autoimmune antibodies (aquaporin-4 antibodies,AQP4-Ab and antinuclear antibodies,ANAs) in patients with recurrent optic neuritis (RON).Methods Fifty-four RON patients who were in-hospital in Ophthalmology Department of PLA from October 2010 to April 2012 were enrolled in the study.The general clinical features and statistic the positive rate of AQP4-Ab and ANAs were analyzed retrospectively,and the relative data in other studies were compared.Results The ratio of male to female was 1:2.6 and the average age of onset was 30.3 years old.The recurrent attacks of optic neuritis were 2 to 8 times during 50 days to 20 years.There were 44 patients (81.5%) who had ever appeared the lowest visual acuity (corrected) of <0.1 in the course of disease.The rate of seropositive ANAs was 22.2% (12/54) while 27.8% (10/36) for AQP4-Ab.The 48.0% (24/50) cases were abnormal in Brain and/or spinal cord MRI and 70.0% (16/23) in CSF.Conclusions RON is more appeared in

  4. The clinical outcomes of idiopathic optic neuritis with no light perception in 21 eyes%特发性视神经炎无光感21只眼临床观察

    李学晶; 童绎; 张守康

    2012-01-01

    目的 观察特发性视神经炎(IDON)无光感眼的治疗情况及预后.方法 回顾性系列病例研究.临床病例来自中国中医科学院眼科医院2003年8月至2011年4月住院患者.观察17例(21只眼)IDON无光感患者经糖皮质激素冲击并配合其他药物治疗后出现光感时间、最佳矫正视力、视觉诱发电位(VEP)等情况,至少随访3个月.结果 21只眼无光感时间1.0 ~90.0 d,除1只眼90.0 d外,余20只眼平均无光感时间(12.5±10.6)d.治疗后14只眼(66.7%)部分恢复视力,出现光感的时间为治疗后2.0 ~25.0 d,平均(9.9±7.9)d.出院时最佳矫正视力为1只眼手动,2只眼指数,1只眼0.01,3只眼0.02,2只眼0.025,1只眼0.04,1只眼0.06,1只眼0.15,1只眼0.6,1只眼1.0.治疗前未见VEP波形者10只眼,治疗后5只眼出现P100波,但仍潜时延迟、振幅低;3只眼复查无波形;2只眼未行VEP复查.治疗前可见VEP波形者11只眼,治疗后8只眼VEP波形改善,2只眼VEP波形消失;1只眼未行VEP检查.随访时除1只眼视力提高外,其余眼视力稳定.结论 对就诊时无光感的视神经炎患者,不应放弃治疗;不能通过无光感时间的长短、出现光感时间的早晚和是否有VEP波形来评估视力预后.%Objective To evaluate the treatment outcomes of idiopathic optic neuritis with no light perception in 21 eyes.Methods This is a retrospective study.The hospital data of 17 patients (21 eyes)with idiopathic optic neuritis whose visual acuity were no light perception from August 2003 to April 2011 were retrospectively analyzed.These patients were treated with steroid pulse and other drugs.The clinical features,the time of appearance light perception,the best corrected visual acuity and VEP were measured.The follow-up was at least three months.Results Before the treatment,the average time of occurring no light perception were 1.0 ~ 90.0 days,except 1 eye was 90.0 days while the other 20 eyes was (12.5 ±10.6)days.After the

  5. [Demyelinating diseases in children with acute neurological symptoms].

    Olofsson, Isa Amalie; Skov, Liselotte; Miranda, Maria Jose

    2015-12-01

    Demyelinating diseases in children is a broad group of illnesses, which affect the central nervous system. Demyelinating diseases can be monophasic or chronic and comprise acute disseminated encephalomyelitis, optic neuritis, transverse myelitis, multiple sclerosis and neuromyelitis optica. Demyelinating diseases are rare, but it is important for the physician to recognize these diseases, as well as to understand the differential diagnoses. This review summarizes the current knowledge of demyelinating disorders in children, focusing on an approach to diagnosis and management. PMID:26651911

  6. 38 CFR 4.123 - Neuritis, cranial or peripheral.

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Neuritis, cranial or....123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss of... the scale provided for injury of the nerve involved, with a maximum equal to severe,...

  7. Dimethyl Fumarate Ameliorates Lewis Rat Experimental Autoimmune Neuritis and Mediates Axonal Protection.

    Kalliopi Pitarokoili

    Full Text Available Dimethyl fumarate is an immunomodulatory and neuroprotective drug, approved recently for the treatment of relapsing-remitting multiple sclerosis. In view of the limited therapeutic options for human acute and chronic polyneuritis, we used the animal model of experimental autoimmune neuritis in the Lewis rat to study the effects of dimethyl fumarate on autoimmune inflammation and neuroprotection in the peripheral nervous system.Experimental autoimmune neuritis was induced by immunization with the neuritogenic peptide (amino acids 53-78 of P2 myelin protein. Preventive treatment with dimethyl fumarate given at 45 mg/kg twice daily by oral gavage significantly ameliorated clinical neuritis by reducing demyelination and axonal degeneration in the nerve conduction studies. Histology revealed a significantly lower degree of inflammatory infiltrates in the sciatic nerves. In addition, we detected a reduction of early signs of axonal degeneration through a reduction of amyloid precursor protein expressed in axons of the peripheral nerves. This reduction correlated with an increase of nuclear factor (erythroid derived 2-related factor 2 positive axons, supporting the neuroprotective potential of dimethyl fumarate. Furthermore, nuclear factor (erythroid derived 2-related factor 2 expression in Schwann cells was only rarely detected and there was no increase of Schwann cells death during EAN.We conclude that immunomodulatory and neuroprotective dimethyl fumarate may represent an innovative therapeutic option in human autoimmune neuropathies.

  8. 实验性自身免疫性脑脊髓炎小鼠模型视神经炎发病机制:与辅助性T细胞亚群的关系%Correlation analysis of pathogenesis of optic neuritis with helper T cell subsets in a mouse experimental autoimmune encephalomyelitis model

    姚汉云; 文芳; 董新宇

    2014-01-01

    BACKGROUND:More and more evidence have shown that autoimmune-induced inflammatory demyelinating mostly leads to optic neuritis that is quite an early manifestation of multiple sclerosis, but whether the pathogenesis of optic neuritis in experimental autoimmune encephalomyelitis (EAE) mice is correlated with helper T cellsubsets has rarely been reported. OBJECTIVE:To analyze the correlation between pathogenesis of optic neuritis of mouse EAE model with helper T cellsubsets. METHODS:The mice were injected intraperitoneal y Bordetel a pertussis to establish EAE models. Then, the animal models were subjected to immunization for 11, 15, 19 days, respectively. Mice undergoing intraperitoneal injection of normal saline served as controls (adjuvant group). RESULTS AND CONCLUSION:Compared with the adjuvant group, the protein expression of interleukin 4 in the optic nerve decreased in the 19-day immunization group (P  结果与结论:酶联免疫吸附检测显示,与佐剂组相比,免疫后19 d组视神经白细胞介素4蛋白含量降低(P<0.05);免疫后11,15 d组视神经白细胞介素17蛋白含量升高(P<0.05);免疫后15,19 d组视神经干扰素γ蛋白含量升高(P <0.05);免疫后11,15,19 d组视神经Foxp3蛋白含量显著降低(P <0.05)。实时PCR检测显示,与佐剂组相比,免疫后11,15,19 d组视神经中干扰素γ、Foxp3 mRNA表达降低(P<0.05), RORt mRNA表达升高;免疫后15,19 d组视神经中白细胞介素4,白细胞介素17,T-beat mRNA表达升高(P<0.05)。免疫后19 d组GATA3 mRNA表达降低(P<0.05)。结果证实,实验性自身免疫性脑脊髓炎小鼠模型视神经炎的发生发展可能受到Foxp3和调节性T细胞表达减少的影响,免疫后早期白细胞介素17可能介导对炎症损伤,发病高峰期干扰素γ可能使炎症损伤程度加重。

  9. Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla

    Nielsen, Kirsten; Rostrup, Egill; Frederiksen, Jette L;

    2006-01-01

    field strength. RESULTS:: Scans at 3.0 T showed a significantly increase in number of lesions detected on FLAIR images (P = 0.002) relative to scanning at 1.5 T. MPRAGE proved to be suitable for detecting enhancing lesions in ON. CONCLUSION:: The MRI protocol at 3.0 T was more sensitive to hyperintense...

  10. Establishing a cat model of acute optic nerve injury

    2007-01-01

    BACKGROUND: In order to investigate the progress in optic nerve injury and the following regeneration and repair, many kinds of animal models of optic nerve injury have been established, such as models of acute and chronic ocular hypertension, compression, amputating wound, ischemia reperfusion or hypoxia,intravitreal injection of excitatory amino acids, etc. However, most of these models are established by squeezing intraorbital optic nerve, and suitable for ophthalmology, and there are fewer models suitable for the acute cranial contusion in neurosurgery.OBJECTIVE: To observe the changes of optic nerve after acute injury, and the characteristics of methods for establishing model of acute optic nerve injury in cats.DESIGN: A complete randomized grouping and controlled animal trial.SETTING: Department of Neurosurgery, General Hospital of Ji'nan Military Area Command of Chinese PLA.MATERIALS: Twenty-eight healthy adult cats, common degree, either sex, weighing 2.0 - 3.5 kg, were provided by the animal experimental center of Fudan University. The cats were randomly divided into control group (n =3) and model group (n =25), and 5 cats in the model group were observed at 6 hours and 1,3, 7 and 14 days after injury respectively. JX-2000 biological signal processing system (Department of Physiology, Second Military Medical University of Chinese PLA, Shanghai); Inverted phase contrast microscope (Olympus); Axioplan 2 imaging microgram analytical system (Labsystems).METHODS: The experiments were carried out in the Department of Neurosurgery, General Hospital of Jinan Military Area Command of Chinese PLA from June 2004 to June 2005. The cats in the model groups were made into models of acute optic nerve injury: The cats were anesthetized, then the limbs were fixed in a lateral recumbent position. Pterion approach in human was imitated, the operative incision was made along the line between lateral canthus and tragus, and it could be seen deep along the skull base that white

  11. Cauda Equina Neuritis: A Chronic Idiopathic Polyneuritis in Two Horses

    Rousseaux, C. G.; Futcher, K. G.; Clark, E G; Naylor, J M

    1984-01-01

    Two cases of cauda equina neuritis are compared and contrasted. Neurological deficits of the tail and perineum were noted and functional deficits were seen in gait, urination, defecation and cranial nerve function. Lesions consisted of nonsuppurative inflammation of the nerve trunks and proliferation of the perineurium of the cauda equina. Cranial nerve involvement in one case supported a diagnosis of polyneuritis equi rather than cauda equina neuritis. The possible etiologies and pathogenesi...

  12. Establishing a cat model of acute optic nerve injury

    2007-01-01

    BACKGROUND: In order to investigate the progress in optic nerve injury and the following regeneration and repair, many kinds of animal models of optic nerve injury have been established, such as models of acute and chronic ocular hypertension, compression, amputating wound, ischemia reperfusion or hypoxia,intravitreal injection of excitatory amino acids, etc. However, most of these models are established by squeezing intraorbital optic nerve, and suitable for ophthalmology, and there are fewer models suitable for the acute cranial contusion in neurosurgery.OBJECTIVE: To observe the changes of optic nerve after acute injury, and the characteristics of methods for establishing model of acute optic nerve injury in cats.DESIGN: A complete randomized grouping and controlled animal trial.SETTING: Department of Neurosurgery, General Hospital of Ji'nan Military Area Command of Chinese PLA.MATERIALS: Twenty-eight healthy adult cats, common degree, either sex, weighing 2.0 - 3.5 kg, were provided by the animal experimental center of Fudan University. The cats were randomly divided into control group (n =3) and model group (n =25), and 5 cats in the model group were observed at 6 hours and 1,3, 7 and 14 days after injury respectively. JX-2000 biological signal processing system (Department of Physiology, Second Military Medical University of Chinese PLA, Shanghai); Inverted phase contrast microscope (Olympus); Axioplan 2 imaging microgram analytical system (Labsystems).METHODS: The experiments were carried out in the Department of Neurosurgery, General Hospital of Jinan Military Area Command of Chinese PLA from June 2004 to June 2005. The cats in the model groups were made into models of acute optic nerve injury: The cats were anesthetized, then the limbs were fixed in a lateral recumbent position. Pterion approach in human was imitated, the operative incision was made along the line between lateral canthus and tragus, and it could be seen deep along the skull base that white

  13. Unilateral Acute Anterior Ischemic Optic Neuropathy in a Patient with an Already Established Diagnosis of Bilateral Optic Disc Drusen

    Ziya Ayhan; Aylin Yaman; Meltem Söylev Bajin; Osman Saatci, A

    2015-01-01

    Optic disc drusen (ODD) are calcific deposits that form in the optic nerve head secondary to abnormalities in axonal metabolism and degeneration. Anterior ischemic optic neuropathy, central retinal artery, and vein occlusion are among the rare vascular complications of disc drusen. We reported the clinical course of a 51-year-old patient with a unilateral acute nonarteritic anterior ischemic optic neuropathy (NAION) who received the diagnosis of bilateral optic disc drusen five years earlier ...

  14. Therapeutic Approach to the Management of Pediatric Demyelinating Disease: Multiple Sclerosis and Acute Disseminated Encephalomyelitis.

    Brenton, J Nicholas; Banwell, Brenda L

    2016-01-01

    Acquired pediatric demyelinating diseases manifest acutely with optic neuritis, transverse myelitis, acute disseminated encephalomyelitis, or with various other acute deficits in focal or polyfocal areas of the central nervous system. Patients may experience a monophasic illness (as in the case of acute disseminated encephalomyelitis) or one that may manifest as a chronic, relapsing disease [e.g., multiple sclerosis (MS)]. The diagnosis of pediatric MS and other demyelinating disorders of childhood has been facilitated by consensus statements regarding diagnostic definitions. Treatment of pediatric MS has been modeled after data obtained from clinical trials in adult-onset MS. There are now an increasing number of new therapeutic agents for MS, and many will be formally studied for use in pediatric patients. There are important efficacy and safety concerns regarding the use of these therapies in children and young adults. This review will discuss acute management as well as chronic immunotherapies in acquired pediatric demyelination. PMID:26496907

  15. Treatment for idiopathic and hereditary neuralgic amyotrophy (brachial neuritis) (Review)

    Alfen, N. van; Engelen, B.G.M. van; Hughes, R.A.

    2009-01-01

    BACKGROUND: Neuralgic amyotrophy (also know as Parsonage-Turner syndrome or brachial plexus neuritis) is a distinct peripheral nervous system disorder characterised by episodes (attacks) of extreme neuropathic pain and rapid multifocal weakness and atrophy in the upper limbs. Neuralgic amyotrophy ha

  16. Acute Posterior Ischemic Optic Neuropathy Mimicking Posterior Cerebral Artery Stroke Visualized by 3-Tesla MRI

    Tilman Menzel

    2012-11-01

    Full Text Available Acute ischemic lesions of the posterior optic nerve and optic tract can produce a variety of visual field defects. A 71-year-old woman presented with acute hemianopia, which led to rt-PA thrombolysis for suspected posterior cerebral artery ischemia. 3-Tesla cMRI, however, revealed the cause to be an acute posterior ischemic optic neuropathy. Cases like this may be more common than thought and quite regularly overlooked in clinical practice, especially when there is no high-resolution MRI available. This case strengthens the importance of repeat MR imaging in patients with persistent visual field defects.

  17. Acute Posterior Ischemic Optic Neuropathy Mimicking Posterior Cerebral Artery Stroke Visualized by 3-Tesla MRI

    Menzel, Tilman; Kern, Rolf; Griebe, Martin; Hennerici, Michael; Fatar, Marc

    2012-01-01

    Acute ischemic lesions of the posterior optic nerve and optic tract can produce a variety of visual field defects. A 71-year-old woman presented with acute hemianopia, which led to rt-PA thrombolysis for suspected posterior cerebral artery ischemia. 3-Tesla cMRI, however, revealed the cause to be an acute posterior ischemic optic neuropathy. Cases like this may be more common than thought and quite regularly overlooked in clinical practice, especially when there is no high-resolution MRI avai...

  18. Ocular perfusion pressure and hemodynamics analysis in non-arteritic anterior ischemic optic neuropathy and idiopathic optic neuritis%非炎性前部缺血性视神经病变和特发性视神经炎眼灌注压与眼部血流动力学研究

    王欣玲; 李雪姣; 阎启昌

    2014-01-01

    Objective To compare the Ocular perfusion pressure (OPP) and ocular hemodynamics of patients with non-arteritic anterior ischemic optic neuropathy (NAION) and idiopathic optic neuritis (ION),and analyze their relationship with fixation features.Methods It was a retrospective case study.Data were collected in patients with NAION and ION who were treated in Department of Ophthalmology,the Fourth Affiliated Hospital,China Medical University from March 2011 to May 2013.OPP and ocular hemodynamics were analyzed,as well as the ages,gender,and systemic diseases after these patients were divided as the central fixation group and the extra-central fixation one on the basis of ocular fixation features.The reason making the differences were thought over.Results There were 21 NAION cases (21 eyes,14 for central fixation and 7 for extra-central fixation) and 21 ION ones (21 eyes,8 for central fixation and 13 for extra-central fixation).The peak systolic velocity (PSV) of posterior ciliary artery (PCA) and central retinal artery (CRA) were significantly decreased in the NAION group comparing with the ION group in central fixation eyes (t =12.49,P =0.00; t =14.25,P =0.00).In the extra-central fixation eyes,the sitting mean artery pressure (MAP) of brachial artery and OPP were significantly increased in the NAION group,and the PSV of PCA and CRA were significantly decreased in the NAION group (t =6.41,P =0.02; t =5.66,P =0.03; t =8.47,P =0.01; t =11.32,P =0.00).However,the PSV of PCA and CRA were significantly decreased in the NAION group when the fixation features were excluded from the classification criteria and all kinds of vision was regarded totally as central fixation vision (t =5.81,P =0.02; t =9.20,P =0.00).Conclusions The fixation features of NAION and ION eyes can be classified as central fixation and extra-central fixation.The comparisons of OPP and ocular hemodynamics should be classified according to the fixation features.%目的 比较非炎性前部缺血性视神

  19. Specific vestibular exercises in the treatment of vestibular neuritis

    Komazec Zoran; Lemajić Slobodanka N.

    2004-01-01

    Introduction Vestibular neuritis rapidly damages unilateral vestibular periphery, inducing severe balance disorders. In most cases, such vestibular imbalance is gradually restored to within the normal level after clinical therapies. This successive clinical recovery occurs due to regeneration of vestibular periphery and/or accomplishment of central vestibular compensation. Rehabilitation The program of vestibular rehabilitation presents a major achievement in the field of treatment of balance...

  20. Optical coherence tomography of the optic nerve head detects acute changes in intracranial pressure.

    Anand, Aashish; Pass, Anastas; Urfy, Mian Z; Tang, Rosa; Cajavilca, Christian; Calvillo, Eusebia; Suarez, Jose I; Venkatasubba Rao, Chethan P; Bershad, Eric M

    2016-07-01

    We aimed to determine if there are measurable objective changes in the optic nerve head (ONH) immediately after cerebrospinal fluid (CSF) drainage in a prospective case-series of five patients undergoing a clinically indicated lumbar puncture (LP) for diagnosis of idiopathic intracranial hypertension. A Cirrus high-definition optical coherence tomography machine (Carl Zeiss Meditec, Dublin, CA, USA) was used to acquire images in the lateral decubitus position. Optic disc cube and high-definition line raster scans centered on the ONH were obtained immediately before and after draining CSF, while the patient maintained the lateral decubitus position. Measured parameters included retinal nerve fiber layer (RNFL) thickness, peripapillary retinal pigment epithelium/Bruch's membrane (RPE/BM) angulation, transverse neural canal diameter (NCD) and the highest vertical point of the internal limiting membrane from the transverse diameter (papillary height). The mean (±standard deviation) opening and closing CSF pressures were 34.3±11.8 and 11.6±3.3cmH2O, respectively. Mean RNFL thickness (pre LP: 196±105μm; post LP: 164±77μm, p=0.1) and transverse NCD (pre LP: 1985±559μm; post LP: 1590±228μm, p=2.0) decreased in all subjects, but with non-significant trends. The RPE/BM angle (mean change: 5.8±2.0degrees, p=0.003) decreased in all subjects. A decrease in papillary height was seen in three of five subjects (mean: pre LP: 976±275μm; post LP: 938±300μm, p=0.9). Our results show a measurable, objective change in the ONH after acute lowering of the lumbar CSF pressure, suggesting a direct link between the lumbar subarachnoid space and ONH regions, and its potential as a non-invasive method for monitoring intracranial pressures. PMID:26898579

  1. Diffusion MR Imaging of Postoperative Bilateral Acute Ischemic Optic Neuropathy

    Kannan, Anusha; Srinivasan, Sivasubramanian [Khoo Teck Puat Hospital, Singapore (Singapore)

    2012-09-15

    We read with great interest, the case report on ischemic optic neuropathy (1). We would like to add a few points concerning the blood supply of the optic nerve and the correlation with the development of post-operative ischemic neuropathy. Actually, the perioperative or post-operative vision loss (postoperative ischemic neuropathy) is most likely due to ischemic optic neuropathy. Ischemic optic neuropathy (2) is classified as an anterior ischemic optic neuropathy (AION) and posterior ischemic optic neuropathy (PION). This classification is based on the fact that blood supply (2) to the anterior segment of the optic nerve (part of the optic nerve in the scleral canal and the optic disc) is supplied by short posterior ciliary vessels or anastamotic ring branches around the optic nerve. The posterior part of the optic canal is relatively less perfused, and is supplied by ophthalmic artery and central fibres are perfused by a central retinal artery. So, in the post-operative period, the posterior part of the optic nerve is more vulnerable for ischemia, especially, after major surgeries (3), one of the theories being hypotension or anaemia (2) and resultant decreased perfusion. The onset of PION is slower than the anterior ischemic optic neuropathy. AION on the other hand, is usually spontaneous (idiopathic) or due to arteritis, and is usually sudden in its onset. The reported case is most likely a case of PION. The role of imaging, especially the diffusion weighted magnetic resonance imaging, is very important because the ophthalmoscopic findings in early stages of PION is normal, and it may delay the diagnosis. On the other hand, edema of the disc is usually seen in the early stages of AION.

  2. An autopsy case of acute multiple sclerosis with multifocal low density areas in the cerebral white matter on CT scans

    A 34-year-old woman presented with urination difficulty and consciousness disturbance, followed by persistent neurologic findings, such as semicomatose mental status and bilateral optic neuritis, and monophasic clinical course. Cranial CT showed multifocal low density areas in cerebral white matter. The patient was clinically diagnosed as having acute disseminated encephalomyelitis. She died of sepsis four months later. Autopsy revealed multifocal large demyelinating lesions confined to the cerebral white matter, shown as low density areas on CT scans, and demyelinating plaques scattered in the optic nerves and chiasm, and cerebral peduncle. The final diagnosis was acute multiple sclerosis. The CT appearance of multifocal low density areas was most likely due to demyelinating lesions causing edema and tissue necrosis. (Namekawa, K.)

  3. Concurrent acute disseminated encephalomyelitis and Guillain-Barré syndrome in a child

    Isha S Deshmukh

    2015-01-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM and Guillain-Barrι syndrome (GBS are distinct demyelinating disorders that share an autoimmune pathogenesis and prior history of viral infection or vaccination. Our patient is a 10 years with acute flaccid paralysis, quadriparesis (lower limbs affected more than upper limbs, generalized areflexia and urinary retention. He had difficulty in speech and drooling of saliva. He also presented with raised intracranial pressure with papilledema; then bilateral optic neuritis developed during the later course of illness. Based on the temporal association and exclusion of alternative etiologies, diagnosis of the association between ADEM and GBS was made. Electro-diagnosis (electromyography-nerve conduction velocity and magnetic resonance imaging study supported our diagnosis. He improved remarkably after treatment with intravenous immunoglobulin and intravenous methylprednisolone.

  4. Brachial Plexus Neuritis Associated With Streptococcus agalactiae Infection: A Case Report

    Seo, Yu Jung; Lee, Yu Jin; Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young

    2014-01-01

    Brachial plexus neuritis is reportedly caused by various factors; however, it has not been described in association with Streptococcus agalactiae. This is a case report of a patient diagnosed with brachial plexus neuritis associated with pyogenic arthritis of the shoulder. A 57-year-old man visited the hospital complaining of sudden weakness and painful swelling of the left arm. The diagnosis was pyogenic arthritis of the left shoulder, and the patient was treated with open irrigation and deb...

  5. Acute optic nerve sheath fenestration with the free-electron laser

    Shen, Jin-Hui; Casagrande, Vivien A.; Joos, Karen M.; Shetlar, Debra J.; Robinson, Richard D.; Head, William S.; Mavity-Hudson, Julia A.; Nunnally, Amy H.

    1999-06-01

    Purpose: To determine if the free electron laser (FEL) energy can be delivered to a small space to perform optic nerve sheath fenestration with minimal acute nerve damage. Methods: A 530 mm hollow waveguide probe was designed. Optic nerve sheath fenestration (1.0 mm diameter) was performed in 8 rabbits using either the FEL (4 eyes, 6.45mm, 10 Hz, 2 mJ) or a knife (4 eyes). Within 2 hours following surgery, the animals were perfused with aldehyde fixative. The integrity of the optic nerve and glial response at the site of fenestration were evaluated on tissue selections with H&E, and antibodies to S100β or GFAP. Results: Surgery using the FEL probe was found to be technically superior to the knife. The glial reaction was limited to a zone adjacent to the fenestration and was similar in both the FEL and knife incisions. Conclusions: The FEL appears capable of efficiently performing an optic nerve sheath fenestration in a small space with minimal acute damage. Both the FEL and knife incisions result in a rapid glial response at the site of fenestration even when optic nerve integrity is not compromised.

  6. Devic's Disease (Neuromyelitis optical)

    We present a case report about a young woman initially treated as having multiple sclerosis, who relapsed with serious visual impairment. Devic's disease is a demyelinating disorder that presents as transverse myelitis associated with optic neuritis, typically bilateral. Multiple sclerosis is in fact the main differential diagnosis

  7. Visual recovery from optic atrophy following acute optic neuropathy in the fellow eye

    Kemal Örnek; Nurgül Örnek

    2012-01-01

    The left eye of a 65-year-old male was blind due to optic atrophy and only seeing eye had also dry type age-related macular degeneration. An anterior ischemic optic neuropathy developed in the better seeing eye. Vision recovered in the blind eye in a short time after losing the better eye. Gaining some vision in a blind eye may be an adaptation of visual pathway in such patients.

  8. Thalidomide prolongs experimental autoimmune neuritis in Lewis rats.

    Zhu, J; Deng, G M; Diab, A; Zwingenberger, K; Bakhiet, M; Link, H

    1998-10-01

    Thalidomide is reported to have immunomodulatory and anti-inflammatory effects, which have led to its use in the treatment of a number of immune-mediated disorders, including leprosy, discoid lupus and Behcet's disease, and to prevent immunological rejection phenomena following skin and bone marrow grafts. Experimental autoimmune neuritis (EAN) is a CD4+ T-cell-mediated demyelinating autoimmune disease, which represents an animal model for the study of the immunopathogenesis and immunotherapy of Guillain-Barré syndrome (GBS) in humans. We examined the effect of thalidomide in Lewis rats with EAN, which was induced by immunization with bovine peripheral nerve myelin (BPM) and complete Freund's adjuvant (CFA). Thalidomide prolonged clinical EAN when given at a dose of 200 mg/kg/day by gavage. This clinical effect was associated with increased numbers of inflammatory cells in sciatic nerve sections and elevated numbers of interferon-gamma (IFN-gamma) mRNA-expressing cells among lymph node mononuclear cells from thalidomide-treated EAN rats on day 17 postimmunization, i.e. at the peak of clinical EAN. The finding that thalidomide prolongs clinical EAN is in agreement with the clinical polyneuropathy reported in patients receiving treatment with thalidomide and limits its clinical usefulness. PMID:9790310

  9. Specific vestibular exercises in the treatment of vestibular neuritis

    Komazec Zoran

    2004-01-01

    Full Text Available Introduction Vestibular neuritis rapidly damages unilateral vestibular periphery, inducing severe balance disorders. In most cases, such vestibular imbalance is gradually restored to within the normal level after clinical therapies. This successive clinical recovery occurs due to regeneration of vestibular periphery and/or accomplishment of central vestibular compensation. Rehabilitation The program of vestibular rehabilitation presents a major achievement in the field of treatment of balance disorders. Vestibular compensation is associated with central sensory reintegration and bilaterally equalizes the vestibular tonus over a period of time. Material and methods In this retrospective study of a series of cases authors present their results in 58 patients undergoing a program of vestibular rehabilitation. Patients were divided into two groups. Thirty patients were in group I, and 28 in group II. Specific vestibular exercises were conducted in group I, and non-specific exercises in group II. Analysis of effects of vestibular compensation was made due electronystagmography. Results Results were satisfactory in both groups of patients. Absence of spontaneous nystagmus was detected in 83.3% of patients in group I (specific vestibular exercises and in 53.5% of patients in group II (non-specific exercises, with an average treatment time of up to 2 months. Harmonization of pendular stimulation was detected in 83.3% and 60.7% of patients in groups I and II, respectively. Conclusion Early physiotherapeutic vestibular rehabilitation supports the vestibular compensation mechanism. At the same time vestibular rehabilitation may prevent panic disorder caused by hyperventilation syndrome.

  10. Idiopathic brachial plexus neuritis after laparoscopic treatment of endometriosis: a complication that may mimic position-related brachial plexus injury.

    Minas, Vasileios; Aust, Thomas

    2013-01-01

    We report the case of a 37-year-old woman who developed idiopathic brachial plexus neuritis, also referred to as Parsonage-Turner syndrome, after laparoscopic excision of endometriosis. The differential diagnosis between this non-position-related neuritis and brachial plexus injury is discussed. The aim of this report was to raise awareness on this distressing postoperative complication. PMID:24183278

  11. Clinical Study on the Wrist-Ankle Acupuncture Treatment for 30 Cases of Diabetic Peripheral Neuritis

    2006-01-01

    Objective: To study the mechanisms of wrist-ankle acupuncture for prevention and treatment of diabetic peripheral neuritis. Methods: Ninety cases of diabetic peripheral neuritis were randomly divided into 3groups, and treated respectively with wrist-ankle acupuncture, body-acupuncture, and the western routine medical treatment, with 30 cases in each of the groups; and therapeutic effects and laboratory results compared. Results: It is proved that the therapeutic effects of the wrist-ankle acupuncture group and body acupuncture group were significantly superior to those of the control group, with no significant differences between the former two groups. Conclusion: Wrist-ankle acupuncture has the actions of improving the metabolisms of blood sugar and blood-lipid, lowering down blood viscosity, and restoring the functions of peripheral nerve cells, thus giving definite therapeutic effects for diabetic peripheral neuritis.

  12. Brachial Plexus Neuritis Associated With Streptococcus agalactiae Infection: A Case Report.

    Seo, Yu Jung; Lee, Yu Jin; Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young

    2014-08-01

    Brachial plexus neuritis is reportedly caused by various factors; however, it has not been described in association with Streptococcus agalactiae. This is a case report of a patient diagnosed with brachial plexus neuritis associated with pyogenic arthritis of the shoulder. A 57-year-old man visited the hospital complaining of sudden weakness and painful swelling of the left arm. The diagnosis was pyogenic arthritis of the left shoulder, and the patient was treated with open irrigation and debridement accompanied by intravenous antibiotic therapy. S. agalactiae was isolated from a wound culture, and an electrodiagnostic study showed brachial plexopathy involving the left upper and middle trunk. Nine weeks after onset, muscle strength improved in most of the affected muscles, and an electrodiagnostic study showed signs of reinnervation. In conclusion, S. agalactiae infection can lead to various complications including brachial plexus neuritis. PMID:25229037

  13. Surgical treatment of type I neuritis in a teenage boy with borderline tuberculoid leprosy

    Christiane Salgado Sette

    2015-04-01

    Full Text Available Exacerbation of the immune response against Mycobacterium leprae can lead to neuritis, which is commonly treated via immunosuppression with corticosteroids. Early neurolysis may be performed concurrently, especially in young patients with a risk of functional sequelae. We report the case of a young patient experienced intense pain in the left elbow one year after the treatment of tuberculoid-tuberculoid leprosy. The pain was associated with paresthesias in the ulnar edge and left ulnar claw. After evaluation, the diagnosis was changed to borderline tuberculoid leprosy accompanied with neuritis of the left ulnar nerve. Early neurolysis resulted in rapid reduction of the pain and recovery of motor function.

  14. Acupuncture in the rehabilitation of patients with radiation fibrosis ans secondary neuritis

    Acupuncture application experience as effective method of rehabilitation of patients with radiation fibrosis and neuritis is presented. Acupuncture results are more efficient in patients with treatment course after irradiation not more than 3 years, that is why its inclusion in the complex of medicaleasures of presentive treatment of patients with delayed radiation injuries should be considered advisable

  15. Optical Coherence Tomography Findings of the Acute Exudative Polymorphous Vitelliform Maculopathy.

    Brasil, Oswaldo Ferreira Moura; Vianna, Raul Nunes Galvarro; Moraes, Remo Turchetti

    2010-03-01

    The optical coherence tomography (OCT) findings of a 26-year-old HIV-positive male with acute exudative polymorphous vitelliform maculopathy were described. His with best-corrected visual acuity at the presentation of the disease was 20/25 in the right eye and 20/30 in the left eye. Fundus examination showed bilateral yellowish subretinal lesions arranged in a honeycombed pattern throughout the posterior pole in both eyes. OCT scans on the topography of these lesions showed well-defined hyporeflective spaces that occasionally merged, limited superiorly by the retinal pigment epithelium and inferiorly by a hypereflective tissue that could correspond to Bruch's membrane. Sub-sensory fluid was found in both maculas. PMID:20337319

  16. Brachial Neuritis With Phrenic Nerve Involvement in a Patient With a Possible Connective Tissue Disease

    Subash, Meera; Patel, Gaurav; Welker, John; Nugent, Kenneth

    2014-01-01

    Background. Brachial neuritis (BN) is a rare inflammatory condition of peripheral nerves, usually involving the cervicobrachial plexus. These patients present with sudden onset of shoulder and arm pain that evolves into muscle weakness and atrophy.. Case Report. A 33-year-old woman presented with a 1-month history of diffuse pain in her thorax. She had no trauma or inciting incident prior to the onset of this pain and was initially treated for muscle spasms. The patient was seen in the emerge...

  17. Unusual association of epidemic dropsy with brachial neuritis and palatal palsy.

    Sahoo, Sushama; Bandyopadhyay, Arindam; Mahapatra, Nepal Chandra

    2013-05-01

    Epidemic dropsy (ED) results from accidental ingestion of adulterated mustard oil with argemone oil. Chief organs involved in this disease are heart, subcutaneous tissue, eyes and kidneys. Nervous system involvement is very rare. Objective manifestation of neurological involvement is even rarer. The authors report two cases from the same family, who were victims of epidemic dropsy along with their parents. One of them showed objective neurologic involvement in the form of brachial neuritis and another showed palatal palsy. PMID:22231775

  18. Thymic epithelium determines a spontaneous chronic neuritis in Icam1(tm1Jcgr)NOD mice.

    Meyer zu Horste, Gerd; Mausberg, Anne K; Cordes, Steffen; El-Haddad, Houda; Partke, Hans-Joachim; Leussink, Verena I; Roden, Michael; Martin, Stephan; Steinman, Lawrence; Hartung, Hans-Peter; Kieseier, Bernd C

    2014-09-15

    The NOD mouse strain spontaneously develops autoimmune diabetes. A deficiency in costimulatory molecules, such as B7-2, on the NOD genetic background prevents diabetes but instead triggers an inflammatory peripheral neuropathy. This constitutes a shift in the target of autoimmunity, but the underlying mechanism remains unknown. In this study, we demonstrate that NOD mice deficient for isoforms of ICAM-1, which comediate costimulatory functions, spontaneously develop a chronic autoimmune peripheral neuritis instead of diabetes. The disease is transferred by CD4(+) T cells, which infiltrate peripheral nerves together with macrophages and B cells and are autoreactive against peripheral myelin protein zero. These Icam1(tm1Jcgr)NOD mice exhibit unaltered numbers of regulatory T cells, but increased IL-17-producing T cells, which determine the severity, but not the target specificity, of autoimmunity. Ab-mediated ICAM-1 blockade triggers neuritis only in young NOD mice. Thymic epithelium from Icam1(tm1Jcgr)NOD mice features an altered expression of costimulatory molecules and induces neuritis and myelin autoreactivity after transplantation into nude mice in vivo. Icam1(tm1Jcgr)NOD mice exhibit a specifically altered TCR repertoire. Our findings introduce a novel animal model of chronic inflammatory neuropathies and indicate that altered expression of ICAM-1 on thymic epithelium shifts autoimmunity specifically toward peripheral nerves. This improves our understanding of autoimmunity in the peripheral nervous system with potential relevance for human diseases. PMID:25108020

  19. Parsonage-Turner Syndrome rather than Zoster Neuritis?

    Gariani, Karim; Magistris, Michel R; Mathieu R Nendaz

    2011-01-01

    We report the case of an 86-year-old man with acute left shoulder pain, followed by left limb monoparesis and a herpetic rash on the left upper limb and thoracic region. This situation presented a diagnostic challenge because of the simultaneity of symptoms attributable to Parsonage-Turner syndrome and herpes zoster neuropathy. A detailed clinical history, physical examination and electroneuromyography were essential to distinguish the neurological structures involved and to ascertain the dia...

  20. Parsonage-Turner Syndrome rather than Zoster Neuritis

    Karim Gariani

    2011-07-01

    Full Text Available We report the case of an 86-year-old man with acute left shoulder pain, followed by left limb monoparesis and a herpetic rash on the left upper limb and thoracic region. This situation presented a diagnostic challenge because of the simultaneity of symptoms attributable to Parsonage-Turner syndrome and herpes zoster neuropathy. A detailed clinical history, physical examination and electroneuromyography were essential to distinguish the neurological structures involved and to ascertain the diagnosis.

  1. Characterization of rat model of acute anterior uveitis using optical coherence tomography angiography

    Choi, Woo June; Pepple, Kathryn L.; Zhi, Zhongwei; Wang, Ruikang K.

    2015-03-01

    Uveitis, or ocular inflammation, is a cause of severe visual impairment. Rodent models of uveitis are powerful tools used to investigate the pathological mechanisms of ocular inflammation and to study the efficacy of new therapies prior to human testing. In this paper, we report the utility of spectral-domain optical coherence tomography (SD-OCT) angiography in characterizing the inflammatory changes induced in the anterior segment of a rat model of uveitis. Acute anterior uveitis (AAU) was induced in two rats by intravitreal injection of a killed mycobacterial extract. One of them received a concurrent periocular injection of steroids to model a treatment effect. OCT imaging was performed prior to inflammation induction on day 0 (baseline), and 2 days post-injection (peak inflammation). Baseline and inflamed images were compared. OCT angiography identified swelling of the cornea, inflammatory cells in the anterior and posterior chambers, a fibrinous papillary membrane, and dilation of iris vessels in the inflamed eyes when compared to baseline images. Steroid treatment was shown to prevent the changes associated with inflammation. This is a novel application of anterior OCT imaging in animal models of uveitis, and provides a high resolution, in vivo assay for detecting and quantifying ocular inflammation and the response to new therapies.

  2. Swept-Source Optical Coherence Tomography Detecting Intraoperative Acute Descemet's Fold Formation

    Yu Ichioka

    2016-07-01

    Full Text Available Background: To present an intraoperative acute Descemet’s fold formation using swept-source optical coherence tomography (SS-OCT imaging. Case Report: A 67-year-old man complaining of reduced visual acuity in the left eye. A 25-gauge pars plana vitrectomy combined with phacoemulsification cataract surgery was performed to remove the vitreomacular traction. When hydro-sealing was performed, striae rapidly spread in the cornea. SS-OCT B-scan images performed on postoperative day 1 revealed a wavy Descemet’s membrane that might correspond to Descemet’s folds. Pairs of hypo- and hyperreflective narrow lesions running from the wavy Descemet’s membrane to almost half of the thickness of the whole cornea were observed. En face OCT imaging clearly showed the stromal fold, which continuously spread from the Descemet’s fold. Conclusion: The stromal fold might be due to the focal bulge of the stroma posteriorly caused by the rapid volume increase of the stroma which could push Descemet’s membrane posteriorly, thereby forming a wavy Descemet’s membrane layer.

  3. Acute Retinal Pigment Epitheliitis: Spectral Domain Optical Coherence Tomography, Fluorescein Angiography, and Autofluorescence Findings

    Tuğba Aydoğan

    2015-01-01

    Full Text Available A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes’ best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF was slightly increased. Spectral domain optical coherence tomography (SD-OCT showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL. One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease.

  4. An unusual cause of optic neuritis:rickettsiosis disease

    Loukil Hanen; Snoussi Mouna; Frikha Faten; Ben Salah Raida; Jallouli Moez; ChérifYosra; ElAoud Sahar; Marzouk Sameh; Bahloul Zouhir

    2014-01-01

    Optic neuritis (ON) may be associated to a range of autoimmune or infectious diseases. We report herein a case of ON induced by Rickettsia conorii. A 53-year-old woman presented with a recent decrease in visual acuity and headache. ON was diagnosed on the basis of ophthalmologic examination and flash visual evoked potentials. Etiological investigation made in our department eliminated first autoimmune disorders (vasculitis and connective tissue diseases). Rickettsial optic neuritis was confirmed by detection of specific antibodies in serum and the negativity of other serologic tests. An association between corticosteroids and cyclines was prescribed with improvement of visual acuity.

  5. Quantification of Optic Disc Edema during Exposure to High Altitude Shows No Correlation to Acute Mountain Sickness

    Willmann, Gabriel, 1977-; Fischer, M. Dominik; Schatz, Andreas; Schommer, Kai; Messias, Andre; Zrenner, Eberhart; Bartz-Schmidt, Karl U.; Gekeler, Florian

    2011-01-01

    Background The study aimed to quantify changes of the optic nerve head (ONH) during exposure to high altitude and to assess a correlation with acute mountain sickness (AMS). This work is related to the Tuebingen High Altitude Ophthalmology (THAO) study. Methodology/Principal Findings A confocal scanning laser ophthalmoscope (cSLO, Heidelberg Retina Tomograph, HRT3®) was used to quantify changes at the ONH in 18 healthy participants before, during and after rapid ascent to high altitude (4559 ...

  6. Optic radiation damage in multiple sclerosis is associated with visual dysfunction and retinal thinning - an ultrahigh-field MR pilot study

    Sinnecker, Tim [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Asklepios Fachklinikum Teupitz, Department of Neurology, Teupitz (Germany); Oberwahrenbrock, Timm; Zimmermann, Hanna; Ramien, Caren; Brandt, Alexander U. [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Metz, Imke; Brueck, Wolfgang [University Medicine Goettingen, Institute of Neuropathology, Goettingen (Germany); Pfueller, Caspar F.; Doerr, Jan [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Clinical and Experimental Multiple Sclerosis Research Center, Berlin (Germany); Harms, Lutz; Ruprecht, Klemens [Charite - Universitaetsmedizin Berlin, Clinical and Experimental Multiple Sclerosis Research Center, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Department of Neurology, Berlin (Germany); Hahn, Katrin [Charite - Universitaetsmedizin Berlin, Department of Neurology, Berlin (Germany); Niendorf, Thoralf [Max Delbrueck Center for Molecular Medicine, Berlin Ultrahigh Field Facility (B.U.F.F), Berlin (Germany); Charite - Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Experimental and Clinical Research Center, Berlin (Germany); Paul, Friedemann [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Clinical and Experimental Multiple Sclerosis Research Center, Berlin (Germany); Charite - Universitaetsmedizin Berlin, Department of Neurology, Berlin (Germany); Charite - Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Experimental and Clinical Research Center, Berlin (Germany); Wuerfel, Jens [Charite - Universitaetsmedizin Berlin, NeuroCure Clinical Research Center, Berlin (Germany); Max Delbrueck Center for Molecular Medicine, Berlin Ultrahigh Field Facility (B.U.F.F), Berlin (Germany); University Medicine Goettingen, Institute of Neuroradiology, Goettingen (Germany)

    2015-01-15

    To investigate posterior visual pathway damage in multiple sclerosis using ultrahigh-field magnetic resonance imaging (MRI) at 7 Tesla (7 T), and to determine its correlation with visual disability and retinal fibre layer (RNFL) damage detectable by optic coherence tomography (OCT). We studied 7 T MRI, OCT, functional acuity contrast testing (FACT), and visually evoked potentials (VEP, n = 16) in 30 patients (including 26 relapsing-remitting MS and four clinically isolated syndrome patients) and 12 healthy controls to quantify RNFL thickness, optic radiation lesion volume, and optic radiation thickness. Optic radiation lesion volume was associated with thinning of the optic radiation (p < 0.001), delayed VEP (p = 0.031), and visual disability indicated by FACT (p = 0.020). Furthermore, we observed an inverse correlation between optic radiation lesion volume and RNFL thickness (p < 0.001), including patients without previous optic neuritis (p < 0.001). Anterior visual pathway damage, but also (subclinical) optic radiation integrity loss detectable by 7 T MRI are common findings in MS that are mutually affected. Given the association between optic radiation damage, visual impairment, and increased VEP latency in this exploratory study of a limited sample size, clinicians should be aware of acute lesions within the optic radiation in patients with (bilateral) visual disturbances. (orig.)

  7. Optic radiation damage in multiple sclerosis is associated with visual dysfunction and retinal thinning - an ultrahigh-field MR pilot study

    To investigate posterior visual pathway damage in multiple sclerosis using ultrahigh-field magnetic resonance imaging (MRI) at 7 Tesla (7 T), and to determine its correlation with visual disability and retinal fibre layer (RNFL) damage detectable by optic coherence tomography (OCT). We studied 7 T MRI, OCT, functional acuity contrast testing (FACT), and visually evoked potentials (VEP, n = 16) in 30 patients (including 26 relapsing-remitting MS and four clinically isolated syndrome patients) and 12 healthy controls to quantify RNFL thickness, optic radiation lesion volume, and optic radiation thickness. Optic radiation lesion volume was associated with thinning of the optic radiation (p < 0.001), delayed VEP (p = 0.031), and visual disability indicated by FACT (p = 0.020). Furthermore, we observed an inverse correlation between optic radiation lesion volume and RNFL thickness (p < 0.001), including patients without previous optic neuritis (p < 0.001). Anterior visual pathway damage, but also (subclinical) optic radiation integrity loss detectable by 7 T MRI are common findings in MS that are mutually affected. Given the association between optic radiation damage, visual impairment, and increased VEP latency in this exploratory study of a limited sample size, clinicians should be aware of acute lesions within the optic radiation in patients with (bilateral) visual disturbances. (orig.)

  8. Acute brachial plexus neuritis%急性臂丛神经炎

    张功林; 章鸣

    2006-01-01

    急性臂丛神经炎是一种少见病,但人们往往认识不足,在早期,易被误诊为神经根型颈椎病或胸廓出口综合征.为了提高对本病的认识,降低误诊和漏诊率,本文就急性臂丛神经炎的诊断、鉴别诊断与治疗进行综述.

  9. Fiber optic probe enabled by surface-enhanced Raman scattering for early diagnosis of potential acute rejection of kidney transplant

    Chi, Jingmao; Chen, Hui; Tolias, Peter; Du, Henry

    2014-06-01

    We have explored the use of a fiber-optic probe with surface-enhanced Raman scattering (SERS) sensing modality for early, noninvasive and, rapid diagnosis of potential renal acute rejection (AR) and other renal graft dysfunction of kidney transplant patients. Multimode silica optical fiber immobilized with colloidal Ag nanoparticles at the distal end was used for SERS measurements of as-collected urine samples at 632.8 nm excitation wavelength. All patients with abnormal renal graft function (3 AR episodes and 2 graft failure episodes) who were clinically diagnosed independently show common unique SERS spectral features in the urines collected just one day after transplant. SERS-based fiber-optic probe has excellent potential to be a bedside tool for early diagnosis of kidney transplant patients for timely medical intervention of patients at high risk of transplant dysfunction.

  10. Neurological complications of acute multifocal placoid pigment epitheliopathy.

    Brownlee, W J; Anderson, N E; Sims, J; Pereira, J A

    2016-09-01

    Acute multifocal placoid pigment epitheliopathy (AMPPE) is an autoimmune chorioretinal disease that can be complicated by neurological involvement. There is limited information on this potentially treatable condition in the neurological literature. The objective of this patient series is to describe the neurological complications of AMPPE. We retrospectively identified patients with neurological complications of AMPPE seen at Auckland Hospital between 2008 and 2013 and summarised cases in the literature between 1976 and 2013. We identified five patients with neurological complications of AMPPE at Auckland Hospital and 47 reported patients. These patients demonstrated a spectrum of neurological involvement including isolated headache, stroke or transient ischaemic attack, seizures, venous sinus thrombosis, optic neuritis, sensorineural hearing loss and peripheral vestibular disorder. We propose criteria to define AMPPE with neurological complications. A cerebrospinal fluid (CSF) lymphocytosis in a patient with isolated headache may predict the development of cerebrovascular complications of AMPPE. Patients with cerebrovascular complications of AMPPE have a poor prognosis with high rates of death and neurological disability among survivors. Predictors of poor outcome in those who develop neurological complications of AMPPE are a relapsing course, generalised seizures and multifocal infarction on MRI. All patients with neurological complications of AMPPE, including headache alone, should be investigated with an MRI brain and CSF examination. Patients with focal neurological symptoms should receive intravenous (IV) methylprednisolone followed by a tapering course of oral steroids for at least 3months. Patients with AMPPE and an isolated headache with a CSF pleocytosis should be treated with oral steroids. PMID:27183958

  11. OPTICAL IMAGING OF LIPOPOLYSACCHARIDE-INDUCED OXIDATIVE STRESS IN ACUTE LUNG INJURY FROM HYPEROXIA AND SEPSIS

    Sepehr, Reyhaneh; Audi, Said H.; Maleki, Sepideh; Staniszewski, Kevin; EIS, ANNIE L.; Konduri, Girija G.; Ranji, Mahsa

    2013-01-01

    Reactive oxygen species (ROS) have been implicated in the pathogenesis of many acute and chronic pulmonary disorders such as acute lung injury (ALI) in adults and bronchopulmonary dysplasia (BPD) in premature infants. Bacterial infection and oxygen toxicity, which result in pulmonary vascular endothelial injury, contribute to impaired vascular growth and alveolar simplification seen in the lungs of premature infants with BPD. Hyperoxia induces ALI, reduces cell proliferation, causes DNA damag...

  12. Neuronal apoptosis and neurofilament protein expression in the lateral geniculate body of cats following acute optic nerve injuries

    2007-01-01

    BACKGROUND: The visual pathway have 6 parts, involving optic nerve, optic chiasm, optic tract, lateral geniculate body, optic radiation and cortical striatum area. Corresponding changes may be found in these 6 parts following optic nerve injury. At present, studies mainly focus on optic nerve and retina, but studies on lateral geniculate body are few.OBJECTIVE: To prepare models of acute optic nerve injury for observing the changes of neurons in lateral geniculate body, expression of neurofilament protein at different time after injury and cell apoptosis under the optical microscope, and for investigating the changes of neurons in lateral geniculate body following acute optic nerve injury.DESIGN: Completely randomized grouping design, controlled animal experiment.SETTING: Department of Neurosurgery, General Hospital of Ji'nan Military Area Command of Chinese PLA.MATERIALS: Twenty-eight adult healthy cats of either gender and common grade, weighing from 2.0 to 3.5 kg, were provided by the Animal Experimental Center of Fudan University. The involved cats were divided into 2 groups according to table of random digit: normal control group (n =3) and model group (n =25). Injury 6 hours, 1, 3, 7 and 14 days five time points were set in model group for later observation, 5 cats at each time point. TUNEL kit (Bohringer-Mannheim company)and NF200& Mr 68 000 mouse monoclonal antibody (NeoMarkers Company) were used in this experiment.METHODS: This experiment was carried out in the Department of Neurosurgery, General Hospital of Ji'nan Military Area Command of Chinese PLA between June 2004 and June 2005. ① The cats of model group were developed into cat models of acute intracranial optic nerve injury as follows: The anesthetized cats were placed in lateral position. By imitating operation to human, pterion approach was used. An incision was made at the joint line between outer canthus and tragus, and deepened along cranial base until white optic nerve via optic nerve pore

  13. RAD001 (everolimus) attenuates experimental autoimmune neuritis by inhibiting the mTOR pathway, elevating Akt activity and polarizing M2 macrophages.

    Han, Ranran; Gao, Juan; Zhai, Hui; Xiao, Jinting; Ding, Ya'nan; Hao, Junwei

    2016-06-01

    Guillain-Barre' syndrome (GBS) is an acute, postinfectious, immune-mediated, demyelinating disease of peripheral nerves and nerve roots. As a classical animal model of GBS, experimental autoimmune neuritis (EAN) has become well-accepted. Additionally, the potent immune modulation exerted by mammalian target of rapamycin (mTOR) inhibitors has been used to treat cancers and showed beneficial effects. Here we demonstrate that the mTOR inhibitor RAD001 (everolimus) protected rats from the symptoms of EAN, as shown by decreased paralysis, diminished inflammatory cell infiltration, reductions in demyelination of peripheral nerves and improved nerve conduction. Furthermore, RAD001 shifted macrophage polarization toward the protective M2 phenotype and modified the inflammatory milieu by downregulating the production of pro-inflammatory cytokines including IFN-γ and IL-17as well as upregulating the release of anti-inflammatory cytokines such as IL-4 and TGF-β. Amounts of the mTOR downstream targets p-P70S6K and p-4E-BP1 in sciatic nerves decreased, whereas the level of its upstream protein p-Akt was elevated. This demonstrated that RAD001 inhibited the mTOR pathway and encouraged the expression of p-Akt, which led to M2 macrophage polarization, thus improved the outcome of EAN in rats. Consequently, RAD001 exhibits strong potential as a therapeutic strategy for ameliorating peripheral poly-neuropathy. PMID:27063582

  14. CSF abnormalities can be predicted by VEP and MRI pathology in the examination of optic neuritis

    Vinter, Matilda Degn; Nielsen, Signe Modvig; Larsson, Henrik B W;

    2012-01-01

    be valuable in the evaluation of patients with ON. We analyzed CSF findings in patients referred with ON in the context of MRI and visual evoked potential (VEP) pathology. We assessed the possible contributory role of a lumbar puncture and weigh this against disadvantages of the procedure. Between February...... causes of their symptoms and patients with >3 months between onset and tests were excluded. All files were reviewed retrospectively. CSF leukocytes and the IgG index were elevated in 33 and 41 %, respectively, and OCBs were detected in 61 % of patients. CSF abnormalities correlated strongly with VEP...

  15. Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient

    Jaafar, Juanarita; Hitam, Wan Hazabbah Wan; Noor, Raja Azmi Mohd

    2012-01-01

    A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye a...

  16. Brachial Neuritis With Phrenic Nerve Involvement in a Patient With a Possible Connective Tissue Disease.

    Subash, Meera; Patel, Gaurav; Welker, John; Nugent, Kenneth

    2014-01-01

    Background. Brachial neuritis (BN) is a rare inflammatory condition of peripheral nerves, usually involving the cervicobrachial plexus. These patients present with sudden onset of shoulder and arm pain that evolves into muscle weakness and atrophy.. Case Report. A 33-year-old woman presented with a 1-month history of diffuse pain in her thorax. She had no trauma or inciting incident prior to the onset of this pain and was initially treated for muscle spasms. The patient was seen in the emergency room multiple times and was treated with several courses of antibiotics for pneumonia on the basis of clinical symptoms and abnormal x-rays. The pleuritic chest pain persisted for at least 4 months, and the patient was eventually admitted for worsening pain and dyspnea. On physical examination, crackles were heard at both lung bases, and chest inspection revealed increased expansion in the upper thorax but poor expansion of the lower thorax and mild paradoxical respiration. "Sniff" test revealed no motion of the left hemidiaphragm and reduced motion on the right hemidiaphragm. Her computed tomography scan revealed bilateral atelectasis, more severe at the left base. She reported no symptoms involving her joints or skin or abdomen. Her presentation and clinical course are best explained by BN with a bilateral diaphragmatic weakness. However, she had a positive ANA, RF, anti-RNP antibody, and anti SS-A. Conclusion. Patients with BN can present with diffuse thoracic pain, pleuritic chest pain, and diaphragmatic weakness. Our patient may represent a case of connective tissue disease presenting with brachial plexus neuritis. PMID:26425609

  17. Optical Coherence Tomography Analysis of Attenuated Plaques Detected by Intravascular Ultrasound in Patients with Acute Coronary Syndromes

    Takashi Kubo

    2011-01-01

    Full Text Available Background. Recent intravascular ultrasound (IVUS studies have demonstrated that hypoechoic plaque with deep ultrasound attenuation despite absence of bright calcium is common in acute coronary syndrome. Such “attenuated plaque” may be an IVUS characteristic of unstable lesion. Methods. We used optical coherence tomography (OCT in 104 patients with unstable angina to compare lesion characteristics between IVUS-detected attenuated plaque and nonattenuated plaque. Results. IVUS-detected attenuated plaque was observed in 41 (39% patients. OCT-detected lipidic plaque (88% versus 49%, <0.001, thin-cap fibroatheroma (48% versus 16%, <0.001, plaque rupture (44% versus 11%, <0.001, and intracoronary thrombus (54% versus 17%, <0.001 were more often seen in IVUS-detected attenuated plaques compared with nonattenuated plaques. Conclusions. IVUS-detected attenuated plaque has many characteristics of unstable coronary lesion. The presence of attended plaque might be an important marker of lesion instability.

  18. A case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis

    Nathalie Puche

    2010-09-01

    Full Text Available Nathalie Puche1, Olivier Offret1, Jean-Antoine Bernard1, Francine Behar-Cohen1,21Department of Ophthalmology, Hotel Dieu de Paris, AP-HP, Université Paris Descartes; 2Inserm UMRS872, Physiopathology of Ocular Diseases: Therapeutic Innovations, Centre de Recherche des Cordeliers, Université Paris Descartes, Paris, FrancePurpose: To report the time course of retinal morphologic changes in a patient with acute retinal pigment epithelitis (ARPE using spectral domain optical coherence tomography (SD-OCT.Methods: A 30-year old man was referred for blurred vision of his right eye after five days that appeared suddenly 15 days after recovery from a flu-like syndrome. SD-OCT was performed immediately, followed by fluorescein and infracyanine angiography at eight days and then at three weeks.Results: At presentation, a bubble of sub-macular deposit was observed on the right macula with central golden micronodules in a honeycomb pattern. SD-OCT showed an “anterior dislocation” of all the retinal layers up to the inner/outer segment (IS/OS line and irregular deposits at the OS level together with thickening of the retinal pigment epithelial (RPE layer. As visual acuity increased, eight days later, the OCT showed reduction of the sub-retinal deposits and an abnormal hyperflectivity of the sub-retinal and RPE layers was observed. The patient showed a positive serology for picornavirus.Discussion: The acute SD-OCT sections of this patient with ARPE were compared with histological sections of a 35 day old Royal College of Surgeons rat. Similar findings could be observed, with preservation of the IS/OS line and accumulation of debris at the OS level, suggesting that ARPE symptoms could result from a transient phagocytic dysfunction of the RPE at the fovea, inducing reversible accumulation of undigested OS. Picornaviruses comprising enterovirus and coxsachievirus described as being associated with acute chorioretinitis. In this case, it was responsible for

  19. Marked Mydriasis and Neuritis Nervi Optici Associated with Galactorrhea Following Citalopram Treatment: A Case Report and Discussion

    Koch, Horst J.; Heike Zellmer

    2011-01-01

    We report the case of a 25-year-old women suffering from major depression who was treated with citalopram for several weeks with doses between 20 mg and 60 mg. She gradually developed marked mydriasis within 2 months after treatment and subsequently neuritis nervi optici. Moreover, abrupt galactorrhea occurred after 2 months of treatment. All neuro-ophthalmological, neurophysiological, clinical laboratory, and neuroradiological diagnostic efforts did not reveal an underlying organic pathophys...

  20. Epidemiology and clinical findings associated with enteroviral acute flaccid paralysis in Pakistan

    Angez Mehar; Shaukat Shahzad; Sharif Salmaan; Masroor Muhammad; Naeem Asif; Zaidi Sohail Z; Saeed Mohsan; Khan Anis

    2007-01-01

    Abstract Background Enteroviruses are among the most common viruses infecting humans worldwide and they are associated with diverse clinical syndromes. Acute flaccid paralysis (AFP) is a clinical manifestation of enteroviral neuropathy, transverse myelitis, Guillian-Barre Syndrome, Traumatic neuritis and many other nervous system disorders. The objective of this study was to understand the role of Non-Polio Enteroviruses (NPEV) towards this crippling disorder. Methods Stool specimens of 1775 ...

  1. Neuromyelitis optica IgG in the cerebrospinal fluid induces astrocytopathy in optic nerve

    Soelberg, Kerstin; Lillevang, Søren Thue; Mørch, Marlene;

    Background: Serum immunoglobulin G targeting the astrocyte water channel aquaporin-4 (AQP4) in the central nervous system (CNS) is a biomarker for neuromyelitis optica spectrum disease (NMOSD). Optic neuritis (ON) is believed to be immune-mediated and is associated with AQP4-IgG in NMOSD-ON. The...

  2. Acute changes associated with electrode insertion measured with optical coherence microscopy

    Hammer, Daniel X.; Lozzi, Andrea; Boretsky, Adam; Agrawal, Anant; Welle, Cristin G.

    2016-03-01

    Despite advances in functional neural imaging, penetrating microelectrodes provide the most direct interface for the extraction of neural signals from the nervous system and are a critical component of many high degree-of-freedom braincomputer interface devices. Electrode insertion is a traumatic event that elicits a complex neuroinflammatory response. In this investigation we applied optical coherence microscopy (OCM), particularly optical coherence angiography (OCA), to characterize the immediate tissue response during microelectrode insertion. Microelectrodes of varying dimension and footprint (one-, two-, and four-shank) were inserted into mouse motor cortex beneath a window after craniotomy surgery. The microelectrodes were inserted in 3-4 steps at 15-20°, with approximately 250 μm linear insertion distance for each step. Before insertion and between each step, OCM datasets were collected, including for quantitative capillary velocimetry. A cohort of control animals without microelectrode insertion was also imaged over a similar time period (2-3 hours). Mechanical tissue deformation was observed in all the experimental animals. The quantitative angiography results varied across animals, and were not correlated with device dimensions. In some cases, localized flow drop-out was observed in a small region surrounding the electrode, while in other instances a global disruption in flow occurred, perhaps as a result of large vessel compression caused by mechanical pressure. OCM is a tool that can be used in various neurophotonics applications, including quantification of the neuroinflammatory response to penetrating electrode insertion.

  3. Twenty-eight Cases of Neuritis of Lateral Cutaneous Nerve of Thigh Treated by Acupuncture and Point-Injection

    廖明扬

    2001-01-01

    @@Neuritis of lateral cutaneous nerve of thigh, also called meralgia paresthetica, is a commonly encountered disease in clinical practice. The author has treated 28 cases of meralgia paresthetica since 1996 by acupuncture plus point-injection with satisfactory results. A report follows. Clinical Data Among the 28 cases, 13 were male and 15 female. Their age ranged from 24 to 72 years, most of the patients being 35 to 50 years; the duration of illness varied from one month to ten years and 6 cases were affected on left side, 8 cases on right side and 14 cases on both sides.

  4. Trealment of rats with experimental allergic neuritis using high dose immunoglobulin

    2000-01-01

    Objective To investigate the therapeutic potential of high-dase immunoglobulin (HIG) in experimental allergic neuritis (FAN) to provide a theoretical basis of its clinical use in the treatment of human inflammatory emyelinating neuropathies. Methods Female Lewis rats were induced to EAN,and divided into experimental and control groups. The rats were treated with either 0.3 g/kg.day-1 of IgG oran equivalent volume of 0.15 rnoVL glycine. Clinicst,electrophysiologic,and histologic evaluations were carried out in a blind fashion. Results Clinically, rars treated with fgG had significantly less severe symptoms (P<0.001) and slower progression (P<0.001) than controls. Electrophysiologically, the mean conduction latency of the experimental group was significantly shorter than controls (P<0.05).Histologically,rats treated with lgG prepared from normal Lewis rats had a significantly lower percentage of damyelinated fibem (P=0.01)and total abnormal fibers (P<0.001) than ontrels,Statistically,clinicat, electrophysiologic and moqrphologic data were all significantly correlated. Concluslons The EAN animal model is reliable for observation of HIG effects, and useful to provide data for clinical work. HIG has a significant therapeutic effect in EAN when given soon after disease onset. Itcan reduce clincal disease severity and decrease the number of demyelinated fibers as well as the number of total abnormal fibers. For the current corntroversy over whether HIG is effective, the results of this research support the clinical use of HIG in human damyelinating neuropathy.

  5. 急性臂丛神经炎一例%Acute brachial neuritis: a report of 1 case

    张功林; 章鸣; 蔡国荣; 王顺炳

    2006-01-01

    患者,男,36岁.因突发性肩部严重疼痛4 h急诊入院,患者主诉无明显诱因右肩部突发性严重疼痛以致从熟睡中痛醒,自行口服数片止痛药难以奏效,无法入睡,终因疼痛难忍急来就诊.

  6. Detection of retinal blood vessel changes in multiple sclerosis with optical coherence tomography

    Bhaduri, Basanta; Nolan, Ryan M.; Shelton, Ryan L.; Pilutti, Lara A.; Motl, Robert W.; Moss, Heather E.; Pula, John H.; Boppart, Stephen A.

    2016-01-01

    Although retinal vasculitis is common in multiple sclerosis (MS), it is not known if MS is associated with quantitative abnormalities in retinal blood vessels (BVs). Optical coherence tomography (OCT) is suitable for examining the integrity of the anterior visual pathways in MS. In this paper we have compared the size and number of retinal blood vessels in patients with MS, with and without a history of optic neuritis (ON), and control subjects from the cross-sectional retinal images from OCT...

  7. In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients with Acute Coronary Syndrome by Intravascular Optical Coherence Tomography

    Jia, Haibo; Abtahian, Farhad; Aguirre, Aaron D; Lee, Stephen; Chia, Stanley; Lowe, Harry; Kato, Koji; Yonetsu, Taishi; Vergallo, Rocco; Hu, Sining; Tian, Jinwei; Lee, Hang; Park, Seung-Jung; Jang, Yang-Soo; Raffel, Owen C.; Mizuno, Kyoichi; Uemura, Shiro; Itoh, Tomonori; Kakuta, Tsunekazu; Choi, So-Yeon; Dauerman, Harold L.; Prasad, Abhiram; Toma, Catalin; McNulty, Iris; Zhang, Shaosong; Yu, Bo; Fuster, Valentine; Narula, Jagat; Virmani, Renu; Jang, Ik-Kyung

    2013-01-01

    Objectives To characterize the morphological features of plaque erosion and calcified nodule in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Background Plaque erosion and calcified nodule have not been systematically investigated in vivo. Methods One hundred and twenty-six patients with ACS who had undergone pre-intervention OCT imaging were included. The culprit lesions were classified as plaque rupture (PR), erosion (OCT-erosion), calcified nodule (OCT-CN), or others using a new set of diagnostic criteria for OCT. Results The incidences of PR, OCT-erosion, and OCT-CN were 43.7%, 31.0%, and 7.9%, respectively. Patients with OCT-erosion were the youngest compared with those with PR and OCT-CN (53.8±13.1 years vs. 60.6±11.5 years, 65.1±5.0 years, p=0.005). Compared with patients with PR, presentation with non-ST-segment elevation ACS (NSTE-ACS) was more common in patients with OCT-erosion (61.5% vs. 29.1%, p=0.008) and OCT-CN (100% vs. 29.1%, p<0.001). OCT-erosion had a lower frequency of lipid plaque (43.6% vs. 100%, p<0.001), thicker fibrous cap (169.3±99.1 μm vs. 60.4±16.6 μm, p<0.001), and smaller lipid arc (202.8±73.6° vs. 275.8±60.4°, p<0.001) than PR. The diameter stenosis was least severe in OCT-erosion followed by OCT-CN and PR (55.4±14.7% vs. 66.1±13.5% vs. 68.8±12.9%, p<0.001). Conclusions OCT is a promising modality for identifying OCT-erosion and OCT-CN in vivo. OCT-erosion is a frequent finding in patients with ACS, especially in those with NSTE-ACS and younger patients. OCT-CN is the least common etiology for ACS and is more common in older patients. PMID:23810884

  8. Optics

    Fincham, W H A

    2013-01-01

    Optics: Ninth Edition Optics: Ninth Edition covers the work necessary for the specialization in such subjects as ophthalmic optics, optical instruments and lens design. The text includes topics such as the propagation and behavior of light; reflection and refraction - their laws and how different media affect them; lenses - thick and thin, cylindrical and subcylindrical; photometry; dispersion and color; interference; and polarization. Also included are topics such as diffraction and holography; the limitation of beams in optical systems and its effects; and lens systems. The book is recommen

  9. Algorithm early diagnosis optic nevritis

    M. S. Kasimova

    2013-01-01

    Full Text Available Purpose: Evaluate the diagnostic value of specific methods of investigation for the early diagnosis of patients with optic neuritis (ON.Methods: 75 patients with ON were included into the study. Everyone were examined using static perimetry, optical coherence tomography of the optic nerve and thickness of peripapillary nerve fiber layer, visual evoked potentials to flash and pattern types.Results. In the early stage of defining the method was static perimetry (sensitivity 94 %, followed in descending order VEP and OCT (sensitivity 87 % and 84 % and MRI of the brain and orbits (sensitivity 82 %.Conclusion: VEP, static perimetry, MRI of the brain and orbits, as well as OCT allow establishing inflammation of the optic nerve at the early stages of the disease. Complex application of these methods revealed ON to 97 % of cases.

  10. Optics

    Fincham, W H A

    2013-01-01

    Optics: Eighth Edition covers the work necessary for the specialization in such subjects as ophthalmic optics, optical instruments and lens design. The text includes topics such as the propagation and behavior of light; reflection and refraction - their laws and how different media affect them; lenses - thick and thin, cylindrical and subcylindrical; photometry; dispersion and color; interference; and polarization. Also included are topics such as diffraction and holography; the limitation of beams in optical systems and its effects; and lens systems. The book is recommended for engineering st

  11. 综合疗法治疗股外侧皮神经炎78例%Seventy-eight cases of lateral femoral cutaneous neuritis treated with Comprehensive therapy

    王红; ZHANG Nan

    2011-01-01

    @@ The author had treated 78 cases of lateral femoral cutaneous neuritis by surrounding electroacupuncture, pricking puncture with dermal needle and cupping from June 2005 to June 2010.It is reported as follows.

  12. Prevalence, dynamics, and biochemical predictors of optic nerve remyelination after methanol-induced acute optic neuropathy: a 2-year prospective study in 54 patients

    Nurieva, O.; Kotíková, K.; Urban, P.; Pelclová, D.; Petřík, V.; Navrátil, Tomáš; Zakharov, S.

    2016-01-01

    Roč. 147, č. 1 (2016), s. 239-249. ISSN 0026-9247 Institutional support: RVO:61388955 Keywords : methanol optic neuropathy * visual evoked potentials * remyelination Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.222, year: 2014

  13. Demyeliniserende sygdom hos børn med akutte neurologiske symptomer

    Olofsson, Isa Amalie; Skov, Liselotte; Miranda, Maria Jose

    2015-01-01

    Demyelinating diseases in children is a broad group of illnesses, which affect the central nervous system. Demyelinating diseases can be monophasic or chronic and comprise acute disseminated encephalomyelitis, optic neuritis, transverse myelitis, multiple sclerosis and neuromyelitis optica...

  14. Demyeliniserende sygdom hos børn med akutte neurologiske symptomer

    Olofsson, Isa Amalie; Skov, Liselotte; Miranda, Maria Jose

    2016-01-01

    Demyelinating diseases in children is a broad group of illnesses, which affect the central nervous system. Demyelinating diseases can be monophasic or chronic and comprise acute disseminated encephalomyelitis, optic neuritis, transverse myelitis, multiple sclerosis and neuromyelitis optica...

  15. Factors predicting optic nerve axonal degeneration after methanol-induced acute optic neuropathy: a 2-year prospective study in 54 patients

    Zakharov, S.; Nurieva, O.; Kotíková, K.; Urban, P.; Navrátil, Tomáš; Pelclová, D.

    2016-01-01

    Roč. 147, č. 1 (2016), s. 251-261. ISSN 0026-9247 Institutional support: RVO:61388955 Keywords : methanol optic neuropathy * visual evoked potentials * axonal degeneration Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.222, year: 2014

  16. Altered intrinsic regional spontaneous brain activity in patients with optic neuritis: a resting-state functional magnetic resonance imaging study

    Shao Y; Cai FQ; Zhong YL; Huang X; Zhang Y; Hu PH; Pei CG; Zhou FQ; Zeng XJ

    2015-01-01

    Yi Shao,1,* Feng-Qin Cai,2,* Yu-Lin Zhong,1 Xin Huang,1,3 Ying Zhang,1 Pei-Hong Hu,1 Chong-Gang Pei,1 Fu-Qing Zhou,2 Xian-Jun Zeng2 1Department of Ophthalmology, 2Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, 3Department of Ophthalmology, First People’s Hospital of Jiujiang, Jiujiang, People’s Republic of China *These authors contributed equally to this work Objective: To investigate the underlying regional homogeneity (ReHo) in brain...

  17. Altered intrinsic regional spontaneous brain activity in patients with optic neuritis: a resting-state functional magnetic resonance imaging study

    Shao, Yi

    2015-01-01

    Yi Shao,1,* Feng-Qin Cai,2,* Yu-Lin Zhong,1 Xin Huang,1,3 Ying Zhang,1 Pei-Hong Hu,1 Chong-Gang Pei,1 Fu-Qing Zhou,2 Xian-Jun Zeng2 1Department of Ophthalmology, 2Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, 3Department of Ophthalmology, First People’s Hospital of Jiujiang, Jiujiang, People’s Republic of China *These authors contributed equally to this work Objective: To investigate the underlying regional homogeneity (Re...

  18. Cerebrospinal fluid levels of nitric oxide metabolites predict response to methylprednisolone treatment in multiple sclerosis and optic neuritis

    Sellebjerg, F; Giovannoni, G; Hand, A; Madsen, H.O.; Jensen, C.V.; Garred, P

    The role of nitric oxide (NO) in multiple sclerosis (MS) is not clear. We found increased cerebrospinal fluid concentrations of the NO degradation products nitrate (NO(x)) in clinically definite MS but not in clinically isolated syndromes. High CSF concentrations of NO(x) correlated with long att...

  19. EVALUATION OF OPTIC NERVE SHEATH DIAMETER MEASUREME NT AND OPTIC FUNDI EXAMINATION DONE IN ED TO DETERMINE THE RAISED INTRACRANIAL PRESSURE IN ADULTS IN ACUTE TRA UMA SETTING

    Bhavesh

    2013-03-01

    Full Text Available ABSTRACT: Study objective: The objective of the present study is to determine whether a bedside ultrasonographic measurement of optic nerve s heath diameter and optic fundus examination can accurately predict the computed tomog raphic (CT findings of elevated intracranial pressure in adult head injury patients i n the emergency department (ED. METHODS: We conducted a prospective, blinded observational st udy on adult ED patients with suspected intracranial injury with possible elevated intracranial pressure. Exclusion criteria were age younger than 18 years or obvious ocular tr auma. All patients underwent fundus examination by a single examiner immediate and afte r 6 hours of admission. Using a 7.5-MHz ultrasonographic probe on the closed eyelids, a singl e optic nerve sheath diameter was measured 3 mm behind the globe in each eye. A mean binocular optic nerve sheath diameter greater than 5.00 mm was considered abnormal. Cranial CT findings of shift, edema, or effacement s uggestive of elevated intracranial pressure were used to evaluate optic nerve sheath dia meter accuracy. RESULTS: 200 patients were studied during the study period of 2 years from 2011-2012. Average age was 38 years, and mean Glasgow Coma Scale score was 9. 22 patients wi th an optic nerve sheath diameter of 5.6 mm or more had CT findings that correlated with elev ated intracranial pressure. The sensitivity for the ultrasonography in detecting elevated intrac ranial pressure was 100% (95% confidence interval [CI] 68% to 100% and specificity was 63% (9 5% CI 50% to 76%. Fundus examination in these 22 patients found to have poor correlation with the CT findings of elevated intracranial pressure with low sensitivity of 64% (95% confidence interval [CI] 56% to 80% and specificity of only 64% (95% CI 50% to 76%. CONCLUSION: Bedside ED optic nerve sheath diameter ultrasonography has potential as a sensitive screenin g test for elevated intracranial pressure in adult head injury

  20. Acute Cocaine Induces Fast Activation of D1 Receptor and Progressive Deactivation of D2 Receptor Strial Neurons: In Vivo Optical Microprobe [Ca2+]i Imaging

    Cocaine induces fast dopamine increases in brain striatal regions, which are recognized to underlie its rewarding effects. Both dopamine D1 and D2 receptors are involved in cocaine's reward but the dynamic downstream consequences of cocaine effects in striatum are not fully understood. Here we used transgenic mice expressing EGFP under the control of either the D1 receptor (D1R) or the D2 receptor (D2R) gene and microprobe optical imaging to assess the dynamic changes in intracellular calcium ([Ca2+]i ) responses (used as marker of neuronal activation) to acute cocaine in vivo separately for D1R- versus D2R-expressing neurons in striatum. Acute cocaine (8 mg/kg, i.p.) rapidly increased [Ca2+]i in D1R-expressing neurons (10.6 ± 3.2%) in striatum within 8.3 ± 2.3 min after cocaine administration after which the increases plateaued; these fast [Ca2+]i increases were blocked by pretreatment with a D1R antagonist (SCH23390). In contrast, cocaine induced progressive decreases in [Ca2+]i in D2R-expressing neurons (10.4 ± 5.8%) continuously throughout the 30 min that followed cocaine administration; these slower [Ca2+]i decreases were blocked by pretreatment with a D2R antagonist (raclopride). Since activation of striatal D1R-expressing neurons (direct-pathway) enhances cocaine reward, whereas activation of D2R expressing neurons suppresses it (indirect-pathway) (Lobo et al., 2010), this suggests that cocaine's rewarding effects entail both its fast stimulation ofD1R (resulting in abrupt activation of direct-pathway neurons) and a slower stimulation of D2R (resulting in longer-lasting deactivation of indirect-pathway neurons). We also provide direct in vivo evidence of D2R and D1R interactions in the striatal responses to acute cocaine administration.

  1. Sight-threatening optic neuropathy is associated with paranasal lymphoma

    Takahiko Hayashi

    2010-03-01

    Full Text Available Takahiko Hayashi1, Ken Watanabe2, Yukio Tsuura3, Gengo Tsuji4, Shingo Koyama4, Jun Yoshigi4, Naoko Hirata1, Shin Yamane1, Yasuhito Iizima5, Shigeo Toyota6, Satoshi Takeuchi11Department of Ophthalmology, Yokosuka Kyosai Hospital, Japan; 2Department of Hematology, Graduate School of Medicine, Tokyo Medical and Dental University, Japan; 3Department of Pathology, Yokosuka Kyosai Hospital, Japan; 4Department of Radiology, Yokosuka Kyosai Hospital, Japan; 5Department of Ophthalmology, Yokohama City University, Japan; 6Department of Internal Medicine, Yokosuka Kyosai Hospital, JapanAbstract: Malignant lymphoma around the orbit is very rare. We present a rare case of optic neuropathy caused by lymphoma. A 61-year-old Japanese woman was referred to our hospital for evaluation of idiopathic optic neuropathy affecting her right eye. The patient was treated with steroid pulse therapy (methyl-predonisolone 1 g daily for 3 days with a presumed diagnosis of idiopathic optic neuritis. After she had been switched to oral steroid therapy, endoscopic sinus surgery had been performed, which revealed diffuse large B cell lymphoma of the ethmoidal sinus. Although R-CHOP therapy was immediately started, prolonged optic nerve compression resulted in irreversible blindness. Accordingly, patients with suspected idiopathic optic neuritis should be carefully assessed when they show a poor response, and imaging of the orbits and brain should always be done for initial diagnosis because they may have compression by a tumor.Keywords: optic neuropathy, malignant lymphoma, paranasal lymphoma, rhinogenic optic neuropathy

  2. Optical spectroscopy investigation of peptides issued from the AML1-ETO–E-protein complex relevant to acute myeloid leukemia

    Porumb, H.

    2008-01-01

    The expression of AML1-ETO, resulting from the t(8; 21) chromosomal translocation causes 15% of acute myeloid leukaemias. The NHR2 region of ETO, bearing the motif LxxLL, is involved in the oligomerisation of the AML1-ETO. “Peptide NHR2” is one of the objects of the present investigation. The TAFH region of ETO may recruit AML1-ETO to transcription activators, such as E-protein. “Peptide TAFH” is another object of the present investigation. TAFH interacts with E-protein through the AD1 domain...

  3. Optical coherence tomography based microangiography for quantitative monitoring of structural and vascular changes in a rat model of acute uveitis in vivo: a preliminary study

    Choi, Woo June; Pepple, Kathryn L.; Zhi, Zhongwei; Wang, Ruikang K.

    2015-01-01

    Uveitis models in rodents are important in the investigation of pathogenesis in human uveitis and the development of appropriate therapeutic strategies for treatment. Quantitative monitoring of ocular inflammation in small animal models provides an objective metric to assess uveitis progression and/or therapeutic effects. We present a new application of optical coherence tomography (OCT) and OCT-based microangiography (OMAG) to a rat model of acute anterior uveitis induced by intravitreal injection of a killed mycobacterial extract. OCT/OMAG is used to provide noninvasive three-dimensional imaging of the anterior segment of the eyes prior to injection (baseline) and two days post-injection (peak inflammation) in rats with and without steroid treatments. OCT imaging identifies characteristic structural and vascular changes in the anterior segment of the inflamed animals when compared to baseline images. Characteristics of inflammation identified include anterior chamber cells, corneal edema, pupillary membranes, and iris vasodilation. In contrast, no significant difference from the control is observed for the steroid-treated eye. These findings are compared with the histology assessment of the same eyes. In addition, quantitative measurements of central corneal thickness and iris vessel diameter are determined. This pilot study demonstrates that OCT-based microangiography promises to be a useful tool for the assessment and management of uveitis in vivo.

  4. Vestibular perception following acute unilateral vestibular lesions.

    Sian Cousins

    Full Text Available Little is known about the vestibulo-perceptual (VP system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO and VP function in 25 patients with vestibular neuritis (VN acutely (2 days after onset and after compensation (recovery phase, 10 weeks. Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2 and velocity steps of 90°/s (acceleration 180°/s(2. We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of

  5. Acute Bronchitis

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  6. Neuromyelitis optica antibody in Leber hereditary optic neuropathy: case report

    Luciano Mesquita Simão

    2012-08-01

    Full Text Available Neuromyelitis optica antibody (or aquaporin-4 antibody is a well stablished serum marker associated to high-risk neuromyelitis optica syndrome that presents as an inflammatory demyelinating disease characterized by the occurrence of bilateral and simultaneous optic neuritis without complete visual recovery or it occurs as an isolated episode of transverse myelitis accompanied by longitudinally extensive spinal cord lesions. On the other hand, Leber hereditary optic neuropathy is a primarily hereditary disorder that affects all tissues of the body and its clinical presentation is tissue-specific for the optic nerve and, eventually, it might reach the spinal cord. Overlapping clinical features of neuromyelitis optica and Leber hereditary optic neuropathy may suggest common target organ diseases. The case report described herein emphasizes the coexistence of serum markers of both diseases, and suggests that further investigation of this challenging clinical presentation is warranted to confirm or rule out this association.

  7. Acute Pancreatitis and Pregnancy

    ... Acute Pancreatitis > Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  8. Labyrinthitis and Vestibular Neuritis

    ... Mention “VEDA” to receive a 15% discount. Paid Advertisement Disclaimer Information on this website is not intended to be used for medical diagnosis or treatment. VEDA does not specifically endorse any product or service advertised on this site. VEDA is ...

  9. Optical coherence tomography evaluation of retinal nerve fiber layer in longitudinally extensive transverse myelitis

    Frederico C. Moura

    2011-02-01

    Full Text Available OBJECTIVE: To compare optical coherence tomography (OCT measurements on the retinal nerve fiber layer (RNFL of healthy controls and patients with longitudinally extensive transverse myelitis (LETM without previous optic neuritis. METHOD: Twenty-six eyes from 26 patients with LETM and 26 control eyes were subjected to automated perimetry and OCT for comparison of RNFL measurements. RESULTS: The mean deviation values from perimetry were significantly lower in patients with LETM than in controls (p<0.0001. RNFL measurements in the nasal quadrant and in the 3-o'clock segment were significantly smaller in LETM eyes than in controls. (p=0.04 and p=0.006, respectively. No significantly differences in other RNFL measurements were found. CONCLUSION: Patients with LETM may present localized RNFL loss, particularly on the nasal side of the optic disc, associated with slight visual field defects, even in the absence of previous episodes of optic neuritis. These findings emphasize the fact that patients with LETM may experience attacks of subclinical optic nerve damage.

  10. Bronchitis - acute

    ... sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflammation in the main passages ... present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a ...

  11. Bronchitis - acute

    Acute bronchitis is swelling and inflammation in the main passages that carry air to the lungs. The swelling narrows ... makes it harder to breathe. Another symptom of bronchitis is a cough. Acute means the symptoms have ...

  12. Acute Bronchitis

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  13. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline) addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingest...

  14. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline) addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion....

  15. Acute pancreatitis

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  16. Acute pancreatitis

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  17. Damage to the optic chiasm in myelin oligodendrocyte glycoprotein-experimental autoimmune encephalomyelitis mice.

    Herrera, Sheryl L; Palmer, Vanessa L; Whittaker, Heather; Smith, Blair Cardigan; Kim, Annie; Schellenberg, Angela E; Thiessen, Jonathan D; Buist, Richard; Del Bigio, Marc R; Martin, Melanie

    2014-01-01

    Optic chiasm lesions in myelin oligodendrocyte glycoprotein (MOG)-experimental autoimmune encephalomyelitis (EAE) mice were characterized using magnetic resonance imaging (MRI) and validated using electron microscopy (EM). MR images were collected from 3 days after induction to remission, approximately 20 days after induction. Hematoxylin and eosin, solochrome cyanin-stained sections, and EM images were obtained from the optic chiasms of some mice approximately 4 days after disease onset when their scores were thought to be the highest. T2-weighted imaging and apparent diffusion coefficient map hyperintensities corresponded to abnormalities in the optic chiasms of EAE mice. Mixed inflammation was concentrated at the lateral surface. Degeneration of oligodendrocytes, myelin, and early axonal damage were also apparent. A marked increase in chiasm thickness was observed. T2-weighted and diffusion-weighted MRI can detect abnormalities in the optic chiasms of MOG-EAE mice. MRI is an important method in the study of this model toward understanding optic neuritis. PMID:25520558

  18. Optic nerve oxygen tension

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T;

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide.......To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  19. Normal levels of cerebrospinal fluid hypocretin-1 and daytime sleepiness during attacks of relapsing-remitting multiple sclerosis and monosymptomatic optic neuritis

    Knudsen, S; Jennum, P J; Korsholm, K;

    2008-01-01

    There is emerging evidence that multiple sclerosis (MS), the hypothalamic sleep-wake regulating neuropeptide hypocretin-1 (hcrt-1) and the sleep disorder narcolepsy may be connected. Thus, the major pathophysiological component of narcolepsy is lack of hcrt-1. Dysfunction of the hypocretin system...

  20. Disturbed spontaneous brain-activity pattern in patients with optic neuritis using amplitude of low-frequency fluctuation: a functional magnetic resonance imaging study

    Shao, Yi

    2015-01-01

    Xin Huang,1,2,* Feng-Qin Cai,3,* Pei-Hong Hu,1 Yu-Lin Zhong,1 Ying Zhang,1 Rong Wei,1 Chong-Gang Pei,1 Fu-Qing Zhou,3 Yi Shao1 1Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, First Affiliated Hospital of Nanchang University, Nanchang, 2Department of Ophthalmology, First People’s Hospital of Jiujiang, Jiujiang, 3Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China *These a...

  1. Disturbed spontaneous brain-activity pattern in patients with optic neuritis using amplitude of low-frequency fluctuation: a functional magnetic resonance imaging study

    Huang X; Cai FQ; Hu PH; Zhong YL; Zhang Y; Wei R; Pei CG; Zhou FQ; Shao Y

    2015-01-01

    Xin Huang,1,2,* Feng-Qin Cai,3,* Pei-Hong Hu,1 Yu-Lin Zhong,1 Ying Zhang,1 Rong Wei,1 Chong-Gang Pei,1 Fu-Qing Zhou,3 Yi Shao1 1Department of Ophthalmology, Jiangxi Province Clinical Ophthalmology Institute, First Affiliated Hospital of Nanchang University, Nanchang, 2Department of Ophthalmology, First People’s Hospital of Jiujiang, Jiujiang, 3Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China *These authors contr...

  2. Cerebrospinal fluid levels of chitinase 3-like 1 and neurofilament light chain predict multiple sclerosis development and disability after optic neuritis

    Modvig, S; Degn, M; Roed, H; Sørensen, Torben Lykke; Larsson, Hbw; Langkilde, Ar; Frederiksen, Jl; Sellebjerg, F

    evaluation. 18.6% were interviewed by phone. Cox regression, multiple regression and Spearman correlation analyses were used. RESULTS: Forty-six (53.5%) developed clinically definite MS (CDMS) during follow-up. In a multivariate model MRI (p=0.0001), chitinase 3-like 1 (p=0.0033) and age (p=0.0194) combined...... predicted CDMS best. Neurofilament light-chain predicted long-term disability by the multiple sclerosis severity scale (p=0.0111) and nine-hole-peg-test (p=0.0202). Chitinase-3-like-1 predicted long-term cognitive impairment by the paced auditory serial addition test (p=0.0150). CONCLUSION: Neurofilament...... light-chain and chitinase-3-like-1 were significant predictors of long-term physical and cognitive disability. Furthermore, chitinase-3-like-1 predicted CDMS development. Thus, these molecules hold promise as clinically valuable biomarkers after ON as a first demyelinating event....

  3. Acute pancreatitis

    ... page: //medlineplus.gov/ency/article/000287.htm Acute pancreatitis To use the sharing features on this page, ... fatty foods after the attack has improved. Outlook (Prognosis) Most cases go away in a week. However, ...

  4. Acute Pericarditis

    ... Sugar Control Helps Fight Diabetic Eye Disease Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... cancer, or heart surgery, the fluid is blood. Causes Acute pericarditis usually results from infection or other ...

  5. Acute dyspnea

    Radiodiagnosis is applied to determine the causes of acute dyspnea. Acute dyspnea is shown to aggravate the course of pulmonary diseases (bronchial asthma, obstructive bronchitis, pulmonary edema, throboembolism of pulmonary arteries etc) and cardiovascular diseases (desiseas of myocardium). The main tasks of radiodiagnosis are to determine volume and state of the lungs, localization and type of pulmonary injuries, to verify heart disease and to reveal concomitant complications

  6. Bronchitis (acute)

    Wark, Peter

    2008-01-01

    Acute bronchitis, with transient inflammation of the trachea and major bronchi, affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.A third of people may have longer-term symptoms or recurrence.

  7. Acute myelogenous leukemia (AML) - children

    Acute myelogenous leukemia - children; AML; Acute myeloid leukemia - children; Acute granulocytic leukemia - children; Acute myeloblastic leukemia - children; Acute non-lymphocytic leukemia (ANLL) - children

  8. Brachial Plexopathy due to Myeloid Sarcoma in a Patient With Acute Myeloid Leukemia After Allogenic Peripheral Blood Stem Cell Transplantation.

    Ha, Yumi; Sung, Duk Hyun; Park, Yoonhong; Kim, Du Hwan

    2013-04-01

    Myeloid sarcoma is a solid, extramedullary tumor comprising of immature myeloid cells. It may occur in any organ; however, the invasion of peripheral nervous system is rare. Herein, we report the case of myeloid sarcoma on the brachial plexus. A 37-year-old woman with acute myelogenous leukemia achieved complete remission after chemotherapy. One year later, she presented right shoulder pain, progressive weakness in the right upper extremity and hypesthesia. Based on magnetic resonance images (MRI) and electrophysiologic study, a provisional diagnosis of brachial plexus neuritis was done and hence steroid pulse therapy was carried out. Three months later the patient presented epigastric pain. After upper gastrointestinal endoscopy, myeloid sarcoma of gastrointestinal tract was confirmed pathologically. Moreover, 18-fluoride fluorodeoxyglucose positron emission tomography showed a fusiform shaped mass lesion at the brachial plexus overlapping with previous high signal lesion on the MRI. Therefore, we concluded the final diagnosis as brachial plexopathy due to myeloid sarcoma. PMID:23705126

  9. Acute Cocaine Induces Fast Activation of D1 Receptor and Progressive Deactivation of D2 Receptor Strial Neurons: In Vivo Optical Microprobe [Ca(superscript)2+]subscript)i Imaging

    Du, C.; Luo, Z.; Volkow, N.D.; Heintz, N.; Pan, Y.; Du, C.

    2011-09-14

    Cocaine induces fast dopamine increases in brain striatal regions, which are recognized to underlie its rewarding effects. Both dopamine D1 and D2 receptors are involved in cocaine's reward but the dynamic downstream consequences of cocaine effects in striatum are not fully understood. Here we used transgenic mice expressing EGFP under the control of either the D1 receptor (D1R) or the D2 receptor (D2R) gene and microprobe optical imaging to assess the dynamic changes in intracellular calcium ([Ca{sup 2+}]{sub i} ) responses (used as marker of neuronal activation) to acute cocaine in vivo separately for D1R- versus D2R-expressing neurons in striatum. Acute cocaine (8 mg/kg, i.p.) rapidly increased [Ca{sup 2+}]{sub i} in D1R-expressing neurons (10.6 {+-} 3.2%) in striatum within 8.3 {+-} 2.3 min after cocaine administration after which the increases plateaued; these fast [Ca{sup 2+}]{sub i} increases were blocked by pretreatment with a D1R antagonist (SCH23390). In contrast, cocaine induced progressive decreases in [Ca{sup 2+}]{sub i} in D2R-expressing neurons (10.4 {+-} 5.8%) continuously throughout the 30 min that followed cocaine administration; these slower [Ca{sup 2+}]{sub i} decreases were blocked by pretreatment with a D2R antagonist (raclopride). Since activation of striatal D1R-expressing neurons (direct-pathway) enhances cocaine reward, whereas activation of D2R expressing neurons suppresses it (indirect-pathway) (Lobo et al., 2010), this suggests that cocaine's rewarding effects entail both its fast stimulation ofD1R (resulting in abrupt activation of direct-pathway neurons) and a slower stimulation of D2R (resulting in longer-lasting deactivation of indirect-pathway neurons). We also provide direct in vivo evidence of D2R and D1R interactions in the striatal responses to acute cocaine administration.

  10. Investigating Tissue Optical Properties and Texture Descriptors of the Retina in Patients with Multiple Sclerosis.

    Boglárka Enikő Varga

    Full Text Available To assess the differences in texture descriptors and optical properties of retinal tissue layers in patients with multiple sclerosis (MS and to evaluate their usefulness in the detection of neurodegenerative changes using optical coherence tomography (OCT image segmentation.38 patients with MS were examined using Stratus OCT. The raw macular OCT data were exported and processed using OCTRIMA software. The enrolled eyes were divided into two groups, based on the presence of optic neuritis (ON in the history (MSON+ group, n = 36 and MSON- group, n = 31. Data of 29 eyes of 24 healthy subjects (H were used as controls. A total of seven intraretinal layers were segmented and thickness as well as optical parameters such as contrast, fractal dimension, layer index and total reflectance were measured. Mixed-model ANOVA analysis was used for statistical comparisons.Significant thinning of the retinal nerve fiber layer (RNFL, ganglion cell/inner plexiform layer complex (GCL+IPL and ganglion cell complex (GCC, RNFL+GCL+IPL was observed between study groups in all comparisons. Significant difference was found in contrast in the RNFL, GCL+IPL, GCC, inner nuclear layer (INL and outer plexiform layer when comparing MSON+ to the other groups. Higher fractal dimension values were observed in GCL+IPL and INL layers when comparing H vs. MSON+ groups. A significant difference was found in layer index in the RNFL, GCL+IPL and GCC layers in all comparisons. A significant difference was observed in total reflectance in the RNFL, GCL+IPL and GCC layers between the three examination groups.Texture and optical properties of the retinal tissue undergo pronounced changes in MS even without optic neuritis. Our results may help to further improve the diagnostic efficacy of OCT in MS and neurodegeneration.

  11. Detection of early glial responses in the retina,optic nerve and optic chiasm in acute ocular hypertension rat model%急性眼压升高所致视网膜、视神经及视交叉胶质细胞的早期反应

    张绍丹; 李维义; 王雯倩; 黄萍; 王宁利; 张纯

    2012-01-01

    胞的反应,增生的胶质细胞表达神经前体细胞的标志物.视网膜与视神经和视交叉的改变在时间上具有一定的同步性.%Background Glial cells perform specialized function in many aspects of the development,homeostasis,and function of neurons.Retinal ganglion cells (RGCs)and glia interactions are critically important in glaucomatous neurodegeneration.However,the precise mechanisms of glial activation and ganglion cells damage are still remained unclear. Objective This study was to assess the early responses of glial cells in the retina,optic nerve and optic chiasm in rat models of acute high intraocular pressure (IOP),and to examine the expression of nestin,a neuronal progenitor marker,in the reactive glias. Methods Acute high IOP of 110 mmHg was induced in the right eyes of 6 clean adult female Wistar rats by infusing normal saline solution into the anterior chamber for 60 minutes.Three normal matched Wistar rats were used as controls.The rats were sacrificed by overanaesthesia and sections of retina,optic nerve and optic chiasm were collected on 3 days and 7 days after the injection.Rat retina was examined by Nissl staining to illustrate the gross structure changes.Loss of axons of RGCs in the optic nerve was assessed by immunostaining of β Ⅲ-tubulin.Double labeling of glia] fibrillary acidic protein (GFAP) and nestin was performed in sections of retina,optic nerve and optic chiasm to evaluate the glial responses.The use of the animals complied with Statement of Animal Ethic Committee of Peking University Third Hospital. Results In control rats,GFAP-positive glial cells were observed in the retina,optic nerve and optic chiasm,where only weak positive response for nestin was noticed.Three days after acute IOP elevation,thickness of inner plexus form layer was significantlydecreased in comparison with the control rats.A loss of 46% RGCs was found in the rats with ocular hypertension.Obvious increase of GFAP expression was

  12. Optics/Optical Diagnostics Laboratory

    Federal Laboratory Consortium — The Optics/Optical Diagnostics Laboratory supports graduate instruction in optics, optical and laser diagnostics and electro-optics. The optics laboratory provides...

  13. The Diagnostic Accuracy of Truncal Ataxia and HINTS as Cardinal Signs for Acute Vestibular Syndrome

    Carmona, Sergio; Martínez, Carlos; Zalazar, Guillermo; Moro, Marcela; Batuecas-Caletrio, Angel; Luis, Leonel; Gordon, Carlos

    2016-01-01

    The head impulse, nystagmus type, test of skew (HINTS) protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS). The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests, and negative MRI) and the rest with stroke: 32 in the posterior inferior cerebellar artery (PICA) territory (positive HINTS findings, positive MRI) and 10 in the anterior inferior cerebellar artery (AICA) territory (variable findings and grade 3 ataxia, positive MRI). Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture. When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38), 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient’s age. Grade 2–3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2–3 Ataxia) had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate. PMID:27551274

  14. The Diagnostic Accuracy of Truncal Ataxia and HINTS as Cardinal Signs for Acute Vestibular Syndrome.

    Carmona, Sergio; Martínez, Carlos; Zalazar, Guillermo; Moro, Marcela; Batuecas-Caletrio, Angel; Luis, Leonel; Gordon, Carlos

    2016-01-01

    The head impulse, nystagmus type, test of skew (HINTS) protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS). The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests, and negative MRI) and the rest with stroke: 32 in the posterior inferior cerebellar artery (PICA) territory (positive HINTS findings, positive MRI) and 10 in the anterior inferior cerebellar artery (AICA) territory (variable findings and grade 3 ataxia, positive MRI). Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture. When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38), 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient's age. Grade 2-3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2-3 Ataxia) had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate. PMID:27551274

  15. Acute pancreatitis

    Al Mofleh Ibrahim

    1997-01-01

    Full Text Available The past few years have witnessed a tremendous progress in our knowledge regarding the pathogenesis, diagnosis, prognostic evaluation and classification of acute pancreatitis. The role of ischemia, lysosomal enzymes, oxygen free radicals, polymorphnuclear cells-byproducts and inflammatory mediators in the pathogenesis of pancreatic necrosis and multiple organ failure has been emphasized. Furthermore, the recent knowledge about agents infecting pancreatic necrosis, routes of infection, bacteriological examination of fine needle aspirate and appropriate antibiotics have changed the concept of acute pancreatitis. New diagnostic tests such as rapid urinary trypsinogen-2 test and inflammatory mediators including polymorphnuclear elastase, C-reactive protein and interleukin-6 contribute to early diagnosis, prognostic evaluation and initiation of an appropriate therapy.

  16. Comprehensive evaluation of peripheral nerve regeneration in the acute healing phase using tissue clearing and optical microscopy in a rodent model.

    Yookyung Jung

    Full Text Available Peripheral nerve injury (PNI, a common injury in both the civilian and military arenas, is usually associated with high healthcare costs and with patients enduring slow recovery times, diminished quality of life, and potential long-term disability. Patients with PNI typically undergo complex interventions but the factors that govern optimal response are not fully characterized. A fundamental understanding of the cellular and tissue-level events in the immediate postoperative period is essential for improving treatment and optimizing repair. Here, we demonstrate a comprehensive imaging approach to evaluate peripheral nerve axonal regeneration in a rodent PNI model using a tissue clearing method to improve depth penetration while preserving neural architecture. Sciatic nerve transaction and end-to-end repair were performed in both wild type and thy-1 GFP rats. The nerves were harvested at time points after repair before undergoing whole mount immunofluorescence staining and tissue clearing. By increasing the optic depth penetration, tissue clearing allowed the visualization and evaluation of Wallerian degeneration and nerve regrowth throughout entire sciatic nerves with subcellular resolution. The tissue clearing protocol did not affect immunofluorescence labeling and no observable decrease in the fluorescence signal was observed. Large-area, high-resolution tissue volumes could be quantified to provide structural and connectivity information not available from current gold-standard approaches for evaluating axonal regeneration following PNI. The results are suggestive of observed behavioral recovery in vivo after neurorrhaphy, providing a method of evaluating axonal regeneration following repair that can serve as an adjunct to current standard outcomes measurements. This study demonstrates that tissue clearing following whole mount immunofluorescence staining enables the complete visualization and quantitative evaluation of axons throughout

  17. 中医护理干预在面神经炎病患治疗中的应用*%Application of TCM Nursing Intervention in Patients with Facial Neuritis

    张朝平; 高小林; 黄丹

    2013-01-01

      目的:探讨中医护理干预措施在面神经炎患者中的应用效果。方法:80例面神经炎患者按照随机数字法分为治疗组和对照组,对照组40例患者给予常规的护理,治疗组40例患者在常规的护理基础上给予中医护理干预措施,观察两组的临床治疗效果。结果:总有效率治疗组为87.5%,对照组为68.5%,治疗组明显高于对照组(P<0.05);治疗后抑郁状况评分治疗组较对照组改善更加显著,且组间比较,差异有统计学意义(P<0.05)。结论:面神经炎患者实施中医护理干预措施能够有效的提高其临床治疗效果,并改善患者抑郁的状态。%Objective: To investigate the efficacy of TCM nursing intervention measures in patients with facial neuritis. Methods: 80 cases of patients with facial neuritis were randomly divided into treatment and control groups. 40 patients in con-trol group were given routine nursing and the 40 patients in treatment group were given routine nursing as well as TCM nurs-ing intervention measures. The efficacy of the two groups was observed. Results: The total effective rate was 87.5% and 68.5% respectively in treatment and control groups, the clinical effect in treatment group was obviously higher than in the control group (P<0.05); after treatment, the depression score in treatment group were lower than that of control group, with significant difference (P<0.05). Conclusion: TCM nursing intervention measures can effectively improve the clinical treatment ef-fect in patients with facial neuritis, and improve the depression.

  18. Acute abdomen

    Acute abdomen may be connected with the injury of one of the internal organs, injury of large blood vessels, with the spreading of pains from some other area. It may also be a manifestation of systemic disease or poisoning. The main purposes of radiodiagnosis are: determination of the cause of clinical syndrome; determination of the localization and spreading of pathological changes in abdominal organs; finding out the character of complications. If the data of the ordinary roentgenological investiagtion and isn't complete, the computer tomography of abdominal and pelvic cavities is needed

  19. [Acute myocarditis].

    Combes, Alain

    2013-05-01

    Myocarditis is defined as inflammation of the myocardium accompanied by myocellular necrosis. Acute myocarditis must be considered in patients who present with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackievirus and adenovirus being the most frequently viruses responsible for the disease. Treatment of myocarditis remains largely supportive, since immunosuppression has not been proven to be beneficial for acute lymphocytic myocarditis. Trials of antiviral therapies, or immunostimulants such as interferons, suggest a potential therapeutic role but require further investigation. Lastly, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. In this setting, ECMO should be the first-line mechanical assistance. For highly unstable patients, a Mobile Cardiac Assistance Unit, that rapidly travels to primary care hospitals with a portable ECMO system and hooks it up before refractory multiorgan failure takes hold, is the preferred option. PMID:23789482

  20. RECURRENT SEASONAL ACUTE PSYCHOSIS

    Agarwal, Vivek

    1999-01-01

    Acute psychoses have been reported to occur more frequently in summer. This is a report of seasonal recurrence of acute psychosis in a patient. This case report emphasizes towards the biological etiology of acute psychoses.

  1. Acute cerebellar ataxia

    Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA ... Acute cerebellar ataxia in children, especially younger than age 3, may occur several weeks after an illness caused by a virus. ...

  2. Magnetic resonance imaging in optic nerve lesions with multiple sclerosis

    Magnetic resonance imaging (MRI) of the optic nerve was performed in 10 patients with multiple sclerosis (MS) using short inversion time inversion recovery (STIR) pulse sequences, and the results were compared with the visual evoked potentials (VEP). The 10 patients had optic neuritis in the chronic or remitting phase together with additional symptoms or signs allowing a diagnosis of clinically definite or probable MS. Sixteen optic nerves were clinically affected and 4 were unaffected. MRI was performed using a 0.5 tesla supeconducting unit, and multiple continuous 5 mm coronal and axial STIR images were obtained. A lesion was judged to be present if a focal or diffuse area of increased signal intensity was detectd in the optic nerve. In VEP, a delay in peak latency or no P 100 component was judged to be abnormal. With regard to the clinically affected optic nerves, MRI revealed a region of increased signal intensity in 14/16 (88%) and the VEP was abnormal in 16/16 (100%). In the clinically unaffected optic nerves, MRI revealed an increased signal intensity in 2/4 (50%). One of these nerves had an abnormal VEP and the other had a VEP latency at the upper limit of normal. The VEP was abnormal in 1/4 (25%). In the clinically affected optic nerves, the degree of loss of visual acuity was not associated with the longitudinal extent of the lesions shown by MRI. The mean length was 17.5 mm in optic nerves with a slight disturbance of visual acuity and 15.0 mm in nerves with severe visual loss. MRI using STIR pulse sequences was found to be almost as sensitive as VEP in detecting both clinically affected and unaffected optic nerve lesions in patients with MS, and was useful in visualizing the location or size of the lesions. (author)

  3. Optic glioma

    Glioma - optic; Optic nerve glioma; Juvenile pilocytic astrocytoma; Brain cancer - optic glioma ... Optic gliomas are rare. The cause of optic gliomas is unknown. Most optic gliomas are slow-growing ...

  4. Acute Myopericarditis Mimicking Acute Myocardial Infarction

    Seval İzdeş; Neriman Defne Altıntaş; Gülin Karaaslan; Recep Uygun; Abdulkadir But

    2011-01-01

    Acute coronary syndromes among young adults are relatively low when compared with older population in the intensive care unit. Electrocardiographic abnormalities mimicking acute coronary syndromes may be caused by non-coronary syndromes and the differential diagnosis requires a detailed evaluation. We are reporting a case of myopericarditis presenting with acute ST elevation and elevated cardiac enzymes simulating acute coronary syndrome. In this case report, the literature is reviewed to dis...

  5. Photoreceptor atrophy in acute zonal occult outer retinopathy

    Zibrandtsen, N.; Munch, I.C.; Klemp, K.;

    2006-01-01

    Purpose: To assess retinal morphology in acute zonal occult outer retinopathy (AZOOR). Methods: Three patients with a normal ophthalmoscopic fundus appearance, a history of photopsia, and visual field loss compatible with AZOOR were examined using optical coherence tomography, automated perimetry...

  6. Visual functional changes during acute elevation of intraocular pressure

    Tian-De SHOU

    2006-01-01

    Glaucoma is closely related to elevation of intraocular pressure (IOP). Many studies have done on the effect of chronic elevation of IOP on the retina and optic nerve, but less attention was paid to the effect of acute elevated IOP. Here we briefly review experimental studies on functional changes of the visual system from the retina to the visual cortex under acute elevated IOP condition, which is similar to that of acute primary angle-closure glaucoma.

  7. Effect observation of Zengshisan on optic atrophy%增视散对视神经萎缩的疗效观察

    2001-01-01

    @@1 Subject and methods 1.1 Subject On the basis of diagnosis criterion of optic atrophy from the bock Pratical Ophthalonlogy,we selecte 82 inpatients of outpatients from January 1997 to December 2000,total 116 eyes. Except for any frontoptomein agents that influence reversion of VA for example transparent interstitial turbid of refraction,there were 49 males and 33 femals aging from 10 to 62 years old with an average of 37 years and the course from 15 days to 6 years with the mean of 4.5 months.According to etiological factor,40 eyes trauma caused by trauma,25 eyes caused by optic neuritis,14 eyes caused by hyperpyrexia,10 eyes caused by avascular disease of optic disc,16 eyes caused by glaucoma,11 eyes caused by pigmentary retinopathy.

  8. Acute abdomen

    The book first presents the anatomy and physiology of the abdomen and continues with chapters discussing clinical and laboratory aspects and a suitable order of diagnostic examinations with reference to the acute processes, explaining the diagnostic tools: ultrasonography, radiography including angiography and CT, tapping techniques and endoscopy together with their basic principles, examination techniques, and diagnosis. One chapter presents a complete survey of the processes involving the entire abdomen - as e.g. peritonitis, ileus, abdominal trauma, intraperitoneal hemorrage. This chapter profoundly discusses the diagnostics and therapies including emergency measures and surgery. Problems requiring consultation among varous specialists, in internal medicine, gynecology, urology, or pediatrics, are discussed in great detail. Information for the anesthetist is given for cases of emergency. More than one third of the book is devoted to organ-specific information, dicussing the pathogenesis, diagnostics, and therapy of the oesophagus, stomach, large and small intestine, bile ducts, pankreas, liver, spleen, and the abdominal vessels and the abdominal wall. (orig.) With 153 figs., 90 tabs

  9. Acute pancreatitis

    A prospective study was performed on the relationship of CT findings to the clinical course of 148 patients with acute pancreatitis. The type of pancreatic inflammation seen on CT was classified into six categories based on an overall assessment of size, contour and density of the gland, and peripancreatic abnormalities. The majority (94%) of patients in whom CT showed mild pancreatic changes (grades A, B and C) had two or less positive clinical indicaters of severe pancreatitis (Ranson's signs). In contrast, 92% of patients in whom CT showed more severe changes of pancreatitis (grades D, E or F) had three or more positive signs. The nine patients who died with pancreatitis-related complications were in grades D, E or F. We wish to draw attention to a CT appearance which we have called 'fat islets' (low density intrapancreatic or peripancreatic areas, the contents of which approach fat in attenuation values); there was a strong correlation between this appearance and subsequent infection. (author). 24 refs.; 7 figs.; 4 tabs

  10. Acute chylous peritonitis due to acute pancreatitis

    2012-01-01

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of “chyle” occurs rapidly, the patient may present with signs of peritonitis. Preoperative...

  11. Acute arterial occlusion - kidney

    ... arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury ...

  12. Acute Pancreatitis in Children

    ... a feeding tube or an IV to prevent malnutrition and improve healing. Does my child have to ... intestines. Can my child die from acute pancreatitis? Death from acute pancreatitis is quite rare in children– ...

  13. Diagnosing and Treating Acute Bronchitis

    ... Lung Disease Lookup > Acute Bronchitis Diagnosing and Treating Acute Bronchitis It is important to get your questions about ... Symptoms that last a few weeks How Is Acute Bronchitis Diagnosed? Healthcare providers diagnose acute bronchitis by asking ...

  14. An Isolated Bee Sting Involving Multiple Cranial Nerves

    Alireza Majidi; Mohammadreza Maleki Verki; Fatemeh Rasooli; Arash Forouzan; Hassan Motamed

    2013-01-01

    Hymenoptera stings are self-limiting events or due to allergic reactions. Sometimes envenomation with Hymenoptera can cause rare complications such as acute encephalopathy, peripheral neuritis, acute renal failure, nephrotic syndrome, silent myocardial infarction, rhabdomyolysis, conjunctivitis, corneal infiltration, lens subluxation, and optic neuropathy. The mechanism of peripheral nervous system damage is not clearly known. In our studied case after bee sting on face between the eyebrows w...

  15. Metformin induced acute pancreatitis

    Alsubaie, Sadeem; Almalki, Mussa H.

    2013-01-01

    Acute pancreatitis frequently presents with abdomen pain but may presents with various skin manifestations as rash and rarely, pancreatic panniculitis. Metformin, one of the most effective and valuable oral hypoglycemic agents in the biguanide class was linked to acute pancreatitis in few cases. Here, we report a case of metformin induce acute pancreatitis in young healthy man with normal renal function.

  16. Acute mastoiditis in children

    Anthonsen, Kristian; Høstmark, Karianne; Hansen, Søren;

    2013-01-01

    Conservative treatment of acute otitis media may lead to more complications. This study evaluates changes in incidence, the clinical and microbiological findings, the complications and the outcome of acute mastoiditis in children in a country employing conservative guidelines in treating acute ot...

  17. Recurrent acute renal failure

    Satish, S.; Rajesh, R.; Kurian, G.; Seethalekshmi, N. V.; Unni, M.; Unni, V. N.

    2010-01-01

    While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare. We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

  18. Management Of Acute Migraine

    Mehndiratta M

    2002-01-01

    Full Text Available Pharmacotherapy for migraine involves treatment for the acute attack as well as using long-term prophylaxis in order to reduce the frequency and severity of the attacks. Based on severity, there are a number of drugs available to treat the acute attacks. For mild to moderate attacks, analgesics, NSAIDs and Ergotamine are effective but severe attacks may need Dihydroergotamine (DHE or a triptan. Sumatriptan and the second generation triptans have revolutionized the acute treatment of migraine. Early and appropriate treatment holds the key to successful therapy of the acute attack. This article discusses the various acute treatment options available.

  19. Optic atrophy and cerebral infarcts caused by methanol intoxication: MRI

    We present the MRI findings of cerebral and optic pathway damage in the acute and subacute stages of methanol intoxication. In the acute stage, CT and MRI showed bilateral haemorrhagic necrosis of the corpus striatum and infarcts in the anterior and middle cerebral arterial territories. MRI in the subacute stage demonstrated atrophy of the optic chiasm and prechiasmatic optic nerves in addition to the cerebral infarcts. The patient survived, with total blindness. (orig.)

  20. Acute loss of consciousness.

    Tristán, Bekinschtein; Gleichgerrcht, Ezequiel; Manes, Facundo

    2015-01-01

    Acute loss of consciousness poses a fascinating scenario for theoretical and clinical research. This chapter introduces a simple yet powerful framework to investigate altered states of consciousness. We then explore the different disorders of consciousness that result from acute brain injury, and techniques used in the acute phase to predict clinical outcome in different patient populations in light of models of acute loss of consciousness. We further delve into post-traumatic amnesia as a model for predicting cognitive sequels following acute loss of consciousness. We approach the study of acute loss of consciousness from a theoretical and clinical perspective to conclude that clinicians in acute care centers must incorporate new measurements and techniques besides the classic coma scales in order to assess their patients with loss of consciousness. PMID:25702218

  1. Skin biopsies in the evaluation of atypical optic neuropathies.

    Bielory, L; Kupersmith, M; Warren, F; Bystryn, J; Frohman, L

    1993-01-01

    Patients with atypical clinical presentations of common optic neuropathies such as optic neuritis (ON), anterior ischemic optic neuropathy (AION), or optic neuropathy of unknown etiology (UON) are difficult to distinguish from inflammatory autoimmune optic neuropathy (AON) which is typically associated with a poor visual prognosis, unless treated with high doses of corticosteroids and/or immunosuppressive agents. The authors retrospectively evaluated 34 patients [AON (n = 12); AION (n = 5); ON (n = 9); UON (n = 8)] with visual loss which deteriorated over weeks to months or followed an atypical course, for the presence of immunological markers suggestive of AON. These markers included serological testing for antiphospholipid (APA) and antinuclear (ANA) antibodies, and evaluation of histopathologic and immunofluorescent staining of skin biopsies. All patients underwent a skin biopsy. Four of the 12 patients with AON had urticarial cutaneous lesions which revealed leukocytoclastic and/or lymphohistiocytic vasculitis. Seven of the remaining eight AON patients had skin biopsies of non-lesional skin which revealed immunoreactant deposition. Seven of the 21 skin biopsies obtained from the non-AON patients had findings of vacuolization or mild perivascular infiltration of lymphocytes (n = 5) and immunofluorescent deposits (n = 2). Abnormal skin biopsies (92%;p = 0.0009) and circulating APA (82%; p = 0.013) were common in AON patients while ANA was not statistically increased in AON patients (p = 0.06) when compared to the remaining patients as a whole. AON patients typically demonstrate evidence of systemic autoimmune involvement, as manifested by cutaneous abnormalities such as urticarial vasculitis and/or immunoreactant deposition and circulating APA. These may serve as markers for identifying AON patients who may be treated with immunomodulatory agents. PMID:22822778

  2. Acute pancreatitis in acute viral hepatitis

    2007-01-01

    AIM: To elucidate the frequency and characteristics of pancreatic involvement in the course of acute (nonfulminant) viral hepatitis.METHODS: We prospectively assessed the pancreatic involvement in patients with acute viral hepatitis who presented with severe abdomimanl pain.RESULTS: We studied 124 patients with acute viral hepatitis, of whom 24 presented with severe abdominal pain. Seven patients (5.65%) were diagnosed to have acute pancreatitis. All were young males. Five patients had pancreatitis in the first week and two in the fourth week after the onset of jaundice. The pancreatitis was mild and all had uneventful recovery from both pancreatitis and hepatitis on conservative treatment.The etiology of pancreatitis was hepatitis E virus in 4,hepatitis A virus in 2, and hepatitis B virus in 1 patient.One patient had biliary sludge along with HEV infection.The abdominal pain of remaining seventeen patients was attributed to stretching of Glisson's capsule.CONCLUSION: Acute pancreatitis occurs in 5.65% of patients with acute viral hepatitis, it is mild and recovers with conservative management.

  3. Acute chylous peritonitis due to acute pancreatitis.

    Georgiou, Georgios K; Harissis, Haralampos; Mitsis, Michalis; Batsis, Haralampos; Fatouros, Michalis

    2012-04-28

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of "chyle" occurs rapidly, the patient may present with signs of peritonitis. Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation, appendicitis or visceral ischemia. Less than 100 cases of acute chylous peritonitis have been reported. Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis. This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis, and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis. The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer, since, due to hypertriglyceridemia, serum amylase values appeared within the normal range. Moreover, abdominal computed tomography imaging was not diagnostic for pancreatitis. Following abdominal lavage and drainage, the patient was successfully treated with total parenteral nutrition and octreotide. PMID:22563182

  4. Acute chylous peritonitis due to acute pancreatitis

    Georgios K Georgiou; Haralampos Harissis; Michalis Mitsis; Haralampos Batsis; Michalis Fatouros

    2012-01-01

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse.The development of chylous ascites is usually a chronic process mostly involving malignancy,trauma or surgery,and symptoms arise as a result of progressive abdominal distention.However,when accumulation of "chyle" occurs rapidly,the patient may present with signs of peritonitis.Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation,appendicitis or visceral ischemia.Less than 100 cases of acute chylous peritonitis have been reported.Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis.This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis,and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis.The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer,since,due to hypertriglyceridemia,serum amylase values appeared within the normal range.Moreover,abdominal computed tomography imaging was not diagnostic for pancreatitis.Following abdominal lavage and drainage,the patient was successfully treated with total parenteral nutrition and octreotide.

  5. Relapsing Devic′s disease in a child

    Gokcen Gokce

    2013-01-01

    Full Text Available Neuromyelitis optica (NMO also named Devic′s disease is an acute demyelinating disorder that primarily affects the spinal cord and optic nerves. NMO can occur rarely in children but pediatric NMO cases need specific consideration owing to possible poor visual and motor outcome. In this case report, a NMO case of a 10-year-old girl with bilateral optic neuritis, cerebral, and spinal cord involvement is presented.

  6. Dynamic contrast-enhanced quantitative perfusion measurement of the brain using T-1-weighted MRI at 3T

    Larsson, H.B.W.; Hansen, A.E.; Berg, H.K.;

    2008-01-01

    Purpose: To develop a method for the measurement of brain perfusion based on dynamic contrast-enhanced T-1-weighted MR imaging. Materials and Methods: Dynamic imaging of the first pass of a bolus of a paramagnetic contrast agent was performed using a 3T whole-body magnet and a T-1-weighted fast...... field echo sequence. The input function was obtained from the internal carotid artery. An initial T-1 measurement was performed in order to convert the MR signal to concentration of the contrast agent. Pixelwise and region of interest (ROI)based calculation of cerebral perfusion (CBF) was performed...... using Tikhonov's procedure of deconvolution. Seven patients with acute optic neuritis and two patients with acute stroke were investigated. Results: The mean perfusion value for ROIs in gray matter was 62 mL/100g/min and 21 mL/100g/min in white matter in patients with acute optic neuritis. The perfusion...

  7. Leber Hereditary Optic Neuropathy

    Kopishinskaya S.V.

    2014-06-01

    Full Text Available Leber optic neuropathy is mitochondrial neurodegenerative disease manifested by progressive visual deterioration due to optic nerve atrophy. It is most frequently manifested in young people aged from 18 to 30, male patients prevailing. The disease is characterized by maternal inheritance, and the inheritance of a feature discontinues in men. In 95% cases Leber hereditary optic neuropathology is due to one of three known mitochondrial DNA mutations, its type being important in relation to the disease prognosis. The disease course has a number of succeeding stages: preclinical, acute and chronic (atrophic. The disease diagnosis is based on the characteristic clinical presentation of sequential impairment of both eyes forming central scotoma, the analysis of family history and detection of specific mutations. The present clinical observation illustrates the difficulties in Leber disease diagnosis.

  8. Acute renal failure associated with nonfulminant acute viral hepatitis A

    Sarawgi, S.; Gupta, A. K.; Arora, D S; Jasuja, S.

    2008-01-01

    Hepatitis A runs a benign course in children, but may have atypical presentations in adults. Very rarely acute renal failure complicates nonfulminant hepatitis A. We report a patient with nonfulminant acute viral hepatitis A with multiorgan involvement. Patient had biopsy proven acute interstitial nephritis, acute pancreatitis, acute myocarditis and required hemodialysis for 6 weeks.

  9. Drug-induced acute myopia following chlorthalidone treatment

    Mahesh G; Giridhar A; Saikumar S; Fegde Sachin

    2007-01-01

    We report a case of sudden loss of vision due to the development of acute myopia after the intake of chlorthalidone used for treating systemic hypertension. Clinically this was associated with ciliary spasm, shallow peripheral choroidal effusion and retinal striae at the macula with increase in macular thickness seen on optical coherence tomography. All these findings were reversed completely once the drug was discontinued. Development of acute myopia should be kept in mind as an adverse effe...

  10. Imaging of acute pancreatitis

    Merkle, Elmar M.; Goerich, Johannes [Department of Radiology, University Hospitals of Ulm, Steinhoevel Strasse 9, 89075 Ulm (Germany)

    2002-08-01

    Acute pancreatitis is defined as an acute inflammatory process of the pancreas with variable involvement of peripancreatic tissues or remote organ systems. This article reports the current classification, definition and terminology, epidemiology and etiology, pathogenesis and pathological findings, clinical and laboratory findings, and finally imaging findings of acute pancreatitis with emphasis on cross-sectional imaging modalities such as ultrasound, computed tomography, and magnetic resonance imaging. (orig.)

  11. Streptococcal acute pharyngitis

    2014-01-01

    Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci) is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-s...

  12. Acute generalized exanthematous pustulosis

    K.S. Dhillon

    2012-10-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a rare reaction pattern with a typical morphology and a short clinical course that in majority of cases is related to medication administration. It is an acute pustular eruption with unique clinical features, a rapid clinical course and a typical histopathology. Herein, we report the case of a patient with acute generalized exanthematous pustulosis for its classical presentation.

  13. Acute recurrent polyhydramnios

    Rode, Line; Bundgaard, Anne; Skibsted, Lillian;

    2007-01-01

    Acute recurrent polyhydramnios is a rare occurrence characterized by a poor fetal outcome. This is a case report describing a 34-year-old woman presenting with acute recurrent polyhydramnios. Treatment with non-steroidal anti-inflammatory drugs (NSAID) and therapeutic amniocenteses was initiated...... an enzyme-linked immunosorbent assay. As in normal pregnancies, amniotic prolactin levels decreased by 80% from highest to lowest value in this case of resolving acute recurrent polyhydramnios....

  14. Management Of Acute Migraine

    Mehndiratta M

    2002-01-01

    Pharmacotherapy for migraine involves treatment for the acute attack as well as using long-term prophylaxis in order to reduce the frequency and severity of the attacks. Based on severity, there are a number of drugs available to treat the acute attacks. For mild to moderate attacks, analgesics, NSAIDs and Ergotamine are effective but severe attacks may need Dihydroergotamine (DHE) or a triptan. Sumatriptan and the second generation triptans have revolutionized the acute treatment of migra...

  15. Atrial fibrillation (acute onset)

    Lip, Gregory Y. H.; Watson, Timothy

    2008-01-01

    Acute atrial fibrillation is rapid, irregular, and chaotic atrial activity of less than 48 hours' duration. It resolves spontaneously within 24 to 48 hours in over 50% of people. In this review we have included studies on patients with onset up to 7 days previously. Risk factors for acute atrial fibrillation include increasing age, CVD, alcohol abuse, diabetes, and lung disease.Acute atrial fibrillation increases the risk of stroke and heart failure.

  16. Mixed phenotype acute leukemia

    Ye Zixing; Wang Shujie

    2014-01-01

    Objective To highlight the current understanding of mixed phenotype acute leukemia (MPAL).Data sources We collected the relevant articles in PubMed (from 1985 to present),using the terms "mixed phenotype acute leukemia","hybrid acute leukemia","biphenotypic acute leukemia",and "mixed lineage leukemia".We also collected the relevant studies in WanFang Data base (from 2000 to present),using the terms "mixed phenotype acute leukemia" and "hybrid acute leukemia".Study selection We included all relevant studies concerning mixed phenotype acute leukemia in English and Chinese version,with no limitation of research design.The duplicated articles are excluded.Results MPAL is a rare subgroup of acute leukemia which expresses the myeloid and lymphoid markers simultaneously.The clinical manifestations of MPAL are similar to other acute leukemias.The World Health Organization classification and the European Group for Immunological classification of Leukaemias 1998 cdteria are most widely used.MPAL does not have a standard therapy regimen.Its treatment depends mostly on the patient's unique immunophenotypic and cytogenetic features,and also the experience of individual physician.The lack of effective treatment contributes to an undesirable prognosis.Conclusion Our understanding about MPAL is still limited.The diagnostic criteria have not been unified.The treatment of MPAL remains to be investigated.The prognostic factor is largely unclear yet.A better diagnostic cdteria and targeted therapeutics will improve the therapy effect and a subsequently better prognosis.

  17. Analysis of images of acute human and animal leukaemia

    This research thesis first proposes a review of the development of stereology: historical backgrounds, basic principles. It discusses the choices regarding instrumentation: Coulter counter (principle and theory), quantitative analysis of particles, image analyser (optical microscope, epidiascope, scanners, detection, electronic pencil, computers, programming and data processing system), and stereo-logical parameters. The author then reports the stereo-logical study of acute human leukaemia: definition, classification, determination of spherical particle size distribution, lympho-blast size distributions. He reports the comparative study of rat L 5222 leukaemia and Brown Norway rat acute myelocytic leukaemia, and discusses their relationship with acute human leukaemia

  18. Acute myopericarditis masquerading as acute myocardial infarction

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  19. Leukocytosis in acute stroke

    Kammersgaard, L P; Jørgensen, H S; Nakayama, H;

    1999-01-01

    Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...

  20. Poznan acute Astronomical Observatory

    Murdin, P.

    2000-11-01

    This Poznan acute Astronomical Observatory is a unit of the Adam Mickiewicz University, located in Poznan acute, Poland. From its foundation in 1919, it has specialized in astrometry and celestial mechanics (reference frames, dynamics of satellites and small solar system bodies). Recently, research activities have also included planetary and stellar astrophysics (asteroid photometry, catalysmic b...

  1. Acute Otitis Media

    A Joshan

    2000-07-01

    Full Text Available Acute Otitis Media is a common problem of childhood. It is characterized by otalgia, fever, irritability, anorexia and vomiting or diarrhea. Diagnosis is most often made by pneumatic otoscopy. Acute Otitis Media is mostly caused by S.pneumonia or H.influenza there are sensitive to penicillins.

  2. Acute kidney injury.

    Lang, Joanna; Zuber, Kim; Davis, Jane

    2016-04-01

    Acute kidney injury (AKI) complicates up to 20% of all hospital admissions. Responding to the increase in admissions, complications, mortality, morbidity, and cost of AKI, Kidney Disease: Improving Global Outcomes convened an expert panel to study the issue, review the literature, and publish guidelines to evaluate and treat patients with AKI in the acute setting. This article reviews those guidelines. PMID:27023656

  3. Acute dysautonomia following mumps.

    Mathuranath P

    1999-04-01

    Full Text Available Pure acute or subacute dysautonomia is a rare entity. Its etiology is as yet unknown. However, majority of these cases have a preceding viral infection such as herpes simplex, infectious mononucleosis, rubella or coxsackie B. A unique patient in whom acute dysautonomia followed mumps is reported.

  4. Acute dysautonomia following mumps.

    Mathuranath P; Duralpandian J; Kishore A

    1999-01-01

    Pure acute or subacute dysautonomia is a rare entity. Its etiology is as yet unknown. However, majority of these cases have a preceding viral infection such as herpes simplex, infectious mononucleosis, rubella or coxsackie B. A unique patient in whom acute dysautonomia followed mumps is reported.

  5. Optic Coherence Tomography Findings in Relapsing-remitting Multiple Sclerosis Patients of the Northwest of Iran

    Sasan Andalib

    2013-07-01

    Full Text Available Background: Optical coherence tomography (OCT is a simple, high-resolution technique to quantify the thickness of retinal nerve fiber layer (RNFL and macula volume, which provide an indirect measurement of axonal damage in multiple sclerosis (MS. This study aimed to evaluate OCT finding in relapsing-remitting MS patients of the northwest of Iran and compare them with a normal control group.Methods: In a cross-sectional, descriptive, analytic study, 60 patients with MS as case group and 60 patients as controls were studied. Total macular volume (TMV and retinal nerve fiber layer (RNFL in perioptic disk area (3.4 millimeter around the disk and macula was measured using Stratus 3000 in circular form. These findings were compared between the two groups and their relationship with the duration and severity of MS [based on Expanded Disability Status Scale (EDSS] and history of optic neuritis were evaluated.Results: In total, 35 men and 85 women with a mean age of 34.8 years were evaluated. The mean RNFL in MS patients were 231.9 and 233.1 micrometers in right and left eyes; while they were 246.7 and 250.4 micrometers in right and left eyes of healthy subjects, respectively. This difference in thickness of RNFL in total measure and all quadrants around the optic disk and TMV between case and control groups was analytically meaningful (P = 0.001 and P = 0.001 for right and left eyes, respectively. The mean thickness of RNFL in patients with optic neuritis was significantly lower than other patients in right and left eyes (P = 0.042 and P = 0.005. There was a significant correlation between most of OCT findings and the MS disease duration and EDSS.Conclusion: Findings of the present study in the northwest of Iran buttress the idea that RNFL thickness can be greatly affected by MS. Our results also indicate that this effect is associated with ON and MS duration and severity.

  6. Acute corneal hydrops in keratoconus

    Prafulla K Maharana

    2013-01-01

    Full Text Available Acute corneal hydrops is a condition characterized by stromal edema due to leakage of aqueous through a tear in descemet membrane. The patient presents with sudden onset decrease in vision, photophobia, and pain. Corneal thinning and ectasias combined with trivial trauma to the eye mostly by eye rubbing is considered as the underlying cause. With conservative approach self-resolution takes around 2 to 3 months. Surgical intervention is required in cases of non-resolution of corneal edema to avoid complications and for early visual rehabilitation. Intracameral injection of air or gas such as perflouropropane is the most common surgical procedure done. Recent investigative modality such as anterior segment optical coherence tomography is an extremely useful tool for diagnosis, surgical planning, and postoperative follow up. Resolution of hydrops may improve the contact lens tolerance and visual acuity but most cases require keratoplasty for visual rehabilitation.

  7. Acute methanol toxicity in minipigs

    Dorman, D.C.; Dye, J.A.; Nassise, M.P.; Ekuta, J.; Bolon, B.

    1993-01-01

    The pig has been proposed as a potential animal model for methanol-induced neuro-ocular toxicosis in humans because of its low liver tetrahydrofolate levels and slower rate of formate metabolism compared to those of humans. To examine the validity of this animal model, 12 4-month-old female minipigs (minipig YU) were given a single oral dose of water or methanol at 1.0, 2.5, or 5.0 g/kg body wt by gavage (n = 3 pigs/dose). Dose-dependent signs of acute methanol intoxication, which included mild CNS depression, tremors, ataxia, and recumbency, developed within 0.5 to 2.0 hr, and resolved by 52 hr. Methanol- and formate-dosed pigs did not develop optic nerve lesions, toxicologically significant formate accumulation, or metabolic acidosis. Based on results following a single dose, female minipigs do not appear to be overtly sensitive to methanol and thus may not be a suitable animal model for acute methanol-induced neuroocular toxicosis.

  8. Acute appendicitis caused by acute myeloid leukemia

    Zhang, Shanxiang; Chen, Shaoxiong

    2014-01-01

    Key Clinical Message A case of appendiceal involvement by acute myeloid leukemia (AML) in an adult with recent history of AML transformed from myelodysplastic syndrome (MDS) was presented. Being aware of this rare presentation in particular in a patient with history of MDS and/or AML is important for prompt clinical diagnosis and management.

  9. Bilateral acute visual loss from Rathke's cleft cyst apoplexy in a patient with dengue fever

    Ana Cláudia De Franco Suzuki

    2014-10-01

    Full Text Available Hemorrhagic complications of optic pathway diseases are extremely rare causes of acute visual loss associated with dengue fever. In this paper we report a patient presenting with dengue fever and bilateral acute visual loss caused by chiasmal compression due to Rathke's cleft cyst apoplexy. Considering the importance of early diagnosis and treatment to visual recovery, apoplexy of sellar and suprasellar tumors should be considered in the differential diagnosis of patients with acute visual loss and dengue fever.

  10. Bilateral acute visual loss from Rathke's cleft cyst apoplexy in a patient with dengue fever

    Ana Cláudia De Franco Suzuki; Rafael Barbosa de Araújo; Eduardo Cunha de Souza; Mário Luiz Ribeiro Monteiro

    2014-01-01

    Hemorrhagic complications of optic pathway diseases are extremely rare causes of acute visual loss associated with dengue fever. In this paper we report a patient presenting with dengue fever and bilateral acute visual loss caused by chiasmal compression due to Rathke's cleft cyst apoplexy. Considering the importance of early diagnosis and treatment to visual recovery, apoplexy of sellar and suprasellar tumors should be considered in the differential diagnosis of patients with acute visual lo...

  11. Modern optics

    Guenther, B D

    2015-01-01

    Modern Optics is a fundamental study of the principles of optics using a rigorous physical approach based on Maxwell's Equations. The treatment provides the mathematical foundations needed to understand a number of applications such as laser optics, fiber optics and medical imaging covered in an engineering curriculum as well as the traditional topics covered in a physics based course in optics. In addition to treating the fundamentals in optical science, the student is given an exposure to actual optics engineering problems such as paraxial matrix optics, aberrations with experimental examples, Fourier transform optics (Fresnel-Kirchhoff formulation), Gaussian waves, thin films, photonic crystals, surface plasmons, and fiber optics. Through its many pictures, figures, and diagrams, the text provides a good physical insight into the topics covered. The course content can be modified to reflect the interests of the instructor as well as the student, through the selection of optional material provided in append...

  12. ERCP in acute pancreatitis

    Jijo V Cherian; Joye Varghese Selvaraj; Rajesh Natrayan; Jayanthi Venkataraman

    2007-01-01

    BACKGROUND:The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of acute pancreatitis has evolved over years since its introduction in 1968. Its importance in diagnosing the etiology of pancreatitis has steadily declined with the advent of less invasive diagnostic tools. The therapeutic implications of ERCP in acute pancreatitis are many fold and are directed towards management of known etiological factors or its related complications. This article highlights the current status of ERCP in acute pancreatitis. DATA SOURCES:An English literature search using PubMed database was conducted on ERCP in acute pancreatitis, the etiologies and complications of pancreatitis amenable to endotherapy and other related subjects, which were reviewed. RESULTS: ERCP serves as a primary therapeutic modality for management of biliary pancreatitis in speciifc situations, pancreatitis due to microlithiasis, speciifc types of sphincter of Oddi dysfunction, pancreas divisum, ascariasis and malignancy. In recurrent acute pancreatitis and smoldering pancreatitis it has a deifnite therapeutic utility. Complications of acute pancreatitis including pancreatic-duct disruptions or leaks, benign pancreatic-lfuid collections and pancreatic necrosis can be beneifcially dealt with. Intraductal ultrasound and pancreatoscopy during ERCP are useful in detecting pancreatic malignancy. CONCLUSIONS:The role of ERCP in acute pancreatitis is predominantly therapeutic and occasionally diagnostic. Its role in the management continues to evolve and advanced invasive procedures should be undertaken only in centers dedicated to pancreatic care.

  13. Acute pancreatitis; Pancreatite aigue

    Mehdi, M.; Deutsch, J.P.; Arrive, L.; Ayadi, K.; Ladeb, M.F.; Tubiana, J.M. [Centre Hospitalier Universitaire Saint-Antoine, 75 - Paris (France)

    1996-12-31

    The diagnosis of acute pancreatitis is based on clinical examination and basic laboratory tests. The main role of sonography in acute pancreatitis is to evaluate gallstones and small fluid collections. However, sonography is frequently difficult due to intestinal ileus related to pancreatitis. CT is indicated early in the clinical course of acute severe pancreatitis when the diagnosis is uncertain or when complications such as abscess, hemorrhage, or necrosis, are suspected. In addition, CT may be used to assess the prognosis and follow-up of patients. (authors). 20 refs., 12 figs., 4 tabs.

  14. Acute oncological emergencies.

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  15. Acute genital ulcers

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-01

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on...

  16. Acute acalculous cholecystitis complicating chemotherapy for acute myeloblastic leukemia

    Olfa Kassar

    2015-01-01

    Full Text Available Acute acalculous cholecystitis is a rare complication in the treatment of acute myeloblastic leukemia. Diagnosis of acute acalculous cholecystitis remains difficult during neutropenic period. We present two acute myeloblastic leukemia patients that developed acute acalculous cholecystitis during chemotherapy-induced neutropenia. They suffered from fever, vomiting and acute pain in the epigastrium. Ultrasound demonstrated an acalculous gallbladder. Surgical management was required in one patient and conservative treatment was attempted in the other patient. None treatment measures were effective and two patients died. Acute acalculous cholecystitis is a serious complication in neutropenic patients. Earlier diagnosis could have expedited the management of these patients.

  17. Neurite óptica bilateral após infecção viral por dengue: relato de casos Bilateral optic neuritis after dengue viral infection: case report

    Ricardo Evangelista Marrocos de Aragão; Ieda Maria Alexandre Barreira; Livia Nogueira Costa Lima; Leonardo Portela Rabelo; Felipe Bezerra Alves Pereira

    2010-01-01

    Dengue é uma doença viral transmitida pelos mosquitos Aedes aegypti e Aedes albopictus. Apresenta distribuição geográfica bastante ampla, sendo epidêmica em alguns países. A apresentação clínica depende da idade e do estado imunológico do paciente, podendo se apresentar de forma assintomática como, dengue clássica, hemorrágica e até como choque. Têm sido descritas muitas manifestações oculares, entretanto, poucos relatos de manifestações neurológicas causada por dengue. Relatamos dois casos d...

  18. Nutrition, Inflammation, and Acute Pancreatitis

    Max Petrov

    2013-01-01

    Acute pancreatitis is acute inflammatory disease of the pancreas. Nutrition has a number of anti-inflammatory effects that could affect outcomes of patients with pancreatitis. Further, it is the most promising nonspecific treatment modality in acute pancreatitis to date. This paper summarizes the best available evidence regarding the use of nutrition with a view of optimising clinical management of patients with acute pancreatitis.

  19. Engineering Optics

    Iizuka, Keigo

    2008-01-01

    Engineering Optics is a book for students who want to apply their knowledge of optics to engineering problems, as well as for engineering students who want to acquire the basic principles of optics. It covers such important topics as optical signal processing, holography, tomography, holographic radars, fiber optical communication, electro- and acousto-optic devices, and integrated optics (including optical bistability). As a basis for understanding these topics, the first few chapters give easy-to-follow explanations of diffraction theory, Fourier transforms, and geometrical optics. Practical examples, such as the video disk, the Fresnel zone plate, and many more, appear throughout the text, together with numerous solved exercises. There is an entirely new section in this updated edition on 3-D imaging.

  20. Organophosphorus poisoning (acute)

    Eddleston, Michael; Singh, Surjit; Buckley, Nick

    2007-01-01

    Acetylcholinesterase inhibition by organophosphorus pesticides or nerve gases can cause acute parasympathetic system dysfunction, muscle weakness, seizures, coma, and respiratory failure. Prognosis depends on the dose and relative toxicity of the specific compound, as well as pharmacokinetic factors.

  1. Organophosphorus poisoning (acute)

    Blain, Peter G

    2011-01-01

    Acetylcholinesterase inhibition by organophosphorus pesticides or organophosphate nerve agents can cause acute parasympathetic system dysfunction, muscle weakness, seizures, coma, and respiratory failure. Prognosis depends on the dose and relative toxicity of the specific compound, as well as pharmacokinetic factors.

  2. Acute respiratory distress syndrome

    ... chap 33. Lee WL, Slutsky AS. Acute hypoxemic respiratory failure and ARDS. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: ...

  3. Acute lymphoblastic leukemia (ALL)

    Jeha S, Pui CH. Clinical manifestations and treatment of acute lymphoblastic leukemia in children. In: Hoffman R, Benz EJ Jr, Silberstein LE, Weitz JI, Anastasi J, eds. Hematology: Basic Principles and Practice. 6th ed. ...

  4. Acute Mesenteric Ischemia

    ... 2 Diabetes, Heart Disease a Dangerous Combo Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... surgery is needed. Acute mesenteric ischemia has multiple causes. The most common are Arterial embolism Arterial thrombus ...

  5. Acute respiratory distress syndrome

    ... chap 33. Lee WL, Slutsky AS. Acute hypoxemic respiratory failure and ARDS. In: Broaddus VC, Mason RJ, Ernst ... A.M. Editorial team. Related MedlinePlus Health Topics Respiratory Failure Browse the Encyclopedia A.D.A.M., Inc. ...

  6. Acute mountain sickness

    High altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edema ... Acute mountain sickness is caused by reduced air pressure and lower oxygen levels at high altitudes. The faster you ...

  7. Acute interstitial pneumonia

    The paper refers to a 71 year-old patient, to who is diagnosed acute interstitial pneumonia; with square of 20 days of evolution of cough dry emetizant, fever, general uneasiness, migraine, progressive dyspnoea and lost of weight

  8. Acute genital ulcers.

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-01

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers. PMID:24473429

  9. Acute liver failure

    Larsen, Fin Stolze; Bjerring, Peter Nissen

    2011-01-01

    Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these.......Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these....

  10. Feigning Acute Intermittent Porphyria

    Rania Elkhatib; Modupe Idowu; Gregory S. Brown; Jaber, Yasmeen M.; Reid, Matthew B.; Cheryl Person

    2014-01-01

    Acute intermittent porphyria (AIP) is an autosomal dominant genetic defect in heme synthesis. Patients with this illness can have episodic life-threatening attacks characterized by abdominal pain, neurological deficits, and psychiatric symptoms. Feigning this illness has not been reported in the English language literature to date. Here, we report on a patient who presented to the hospital with an acute attack of porphyria requesting opiates. Diligent assessment of extensive prior treatment r...

  11. Acute management of stones

    Jung, Helene; Osther, Palle J S

    2015-01-01

    INTRODUCTION: Stone management is often conservative due to a high spontaneous stone passage rate or non-symptomatic calyceal stones that do not necessarily require active treatment. However, stone disease may cause symptoms and complications requiring urgent intervention. MATERIAL AND METHODS......: In this review, we update latest research and current recommendations regarding acute management of stones, with particular focus on imaging, pain management, active stone interventions, medical expulsive therapy, and urolithiasis in pregnancy and childhood. RESULTS: Acute stone management should be planned...

  12. Acute lymphocytic Leukemia masquerading as acute osteomyelitis

    Two children each developed a focal destructive bone lesion accompanied by intermittent fever, swelling, tenderness and elevated ESR. Blood counts were normal; bone marrow aspiration showed acute leukemia. The bone lesions healed in both patients after anti-leukemic therapy. We suggest that the similar roentgenographic appearance of osteomyelitis, bone infarction and focal destructive lesions in leukemia probably reflects a common, basically ischemic process of bone. (orig.)

  13. Acute Myeloid Leukemia Presenting as Acute Appendicitis

    Sherri Rauenzahn

    2013-01-01

    Full Text Available Appendicitis in leukemic patients is uncommon but associated with increased mortality. Additionally, leukemic cell infiltration of the appendix is extremely rare. While appendectomy is the treatment of choice for these patients, diagnosis and management of leukemia have a greater impact on remission and survival. A 59-year-old Caucasian female was admitted to the surgical service with acute right lower quadrant pain, nausea, and anorexia. She was noted to have leukocytosis, anemia, and thrombocytopenia. Abdominal imaging demonstrated appendicitis with retroperitoneal and mesenteric lymphadenopathy for which she underwent laparoscopic appendectomy. Peripheral smear, bone marrow biopsy, and surgical pathology of the appendix demonstrated acute myeloid leukemia (AML with nonsuppurative appendicitis. In the setting of AML, prior cases described the development of appendicitis with active chemotherapy. Of these cases, less than ten patients had leukemic infiltration of the appendix, leading to leukostasis and nonsuppurative appendicitis. Acute appendicitis with leukemic infiltration as the initial manifestation of AML has only been described in two other cases in the literature with an average associated morbidity of 32.6 days. The prompt management in this case of appendicitis and AML resulted in an overall survival of 185 days.

  14. Radiation Recall Phenomenon Secondary to Bevacizumab in a Patient with Pancreatic Cancer

    Muhammad Wasif Saif; Jorge Ramos; Jonathan Knisely

    2008-01-01

    Radiation recall is an acute inflammatory reaction in an area that has been previously irradiated that is incited by a pharmacologic agent [1]. Reactions associated with gemcitabine include dermatitis, optic neuritis, brainstem radionecrosis, colitis, and lymphangitis [2, 3, 4]. In the treatment of pancreatic cancer, gemcitabine has been implicated in radiation recall manifested as myositis in two case reports [5, 6]. Gemcitabine linked radiation recall has also resulted in gastritis and duod...

  15. Serious unexpected sinus infection discovered by CT scanning for presumed neurological disease.

    Swift, A C; Gill, G. V.

    1994-01-01

    Serious infection in the paranasal sinuses may present with symptoms suggestive of neurological disease and thus lead to delay in the diagnosis and subsequent treatment. We present three such cases in whom the initial diagnoses had been acute optic neuritis, a posterior communicating aneurysm and an intracranial space occupying lesion. The fourth patient had meningitis but the paranasal sinuses had not initially been considered as a possible source of infection. The current methods of diagnos...

  16. Applied optics

    The 1988 progress report, of the Applied Optics laboratory, of the (Polytechnic School, France), is presented. The optical fiber activities are focused on the development of an optical gyrometer, containing a resonance cavity. The following domains are included, in the research program: the infrared laser physics, the laser sources, the semiconductor physics, the multiple-photon ionization and the nonlinear optics. Investigations on the biomedical, the biological and biophysical domains are carried out. The published papers and the congress communications are listed

  17. Acute bronchial asthma.

    Grover, Sudhanshu; Jindal, Atul; Bansal, Arun; Singhi, Sunit C

    2011-11-01

    Acute asthma is the third commonest cause of pediatric emergency visits at PGIMER. Typically, it presents with acute onset respiratory distress and wheeze in a patient with past or family history of similar episodes. The severity of the acute episode of asthma is judged clinically and categorized as mild, moderate and severe. The initial therapy consists of oxygen, inhaled beta-2 agonists (salbutamol or terbutaline), inhaled budesonide (three doses over 1 h, at 20 min interval) in all and ipratropium bromide and systemic steroids (hydrocortisone or methylprednisolone) in acute severe asthma. Other causes of acute onset wheeze and breathing difficulty such as pneumonia, foreign body, cardiac failure etc. should be ruled out with help of chest radiography and appropriate laboratory investigations in first time wheezers and those not responding to 1 h of inhaled therapy. In case of inadequate response or worsening, intravenous infusion of magnesium sulphate, terbutaline or aminophylline may be used. Magnesium sulphate is the safest and most effective alternative among these. Severe cases may need ICU care and rarely, ventilatory support. PMID:21769523

  18. Optical interconnects

    Chen, Ray T

    2006-01-01

    This book describes fully embedded board level optical interconnect in detail including the fabrication of the thin-film VCSEL array, its characterization, thermal management, the fabrication of optical interconnection layer, and the integration of devices on a flexible waveguide film. All the optical components are buried within electrical PCB layers in a fully embedded board level optical interconnect. Therefore, we can save foot prints on the top real estate of the PCB and relieve packaging difficulty reduced by separating fabrication processes. To realize fully embedded board level optical

  19. Optical fibres

    Geisler, J; Boutruche, J P

    1986-01-01

    Optical Fibers covers numerous research works on the significant advances in optical fibers, with particular emphasis on their application.This text is composed of three parts encompassing 15 chapters. The first part deals with the manufacture of optical fibers and the materials used in their production. The second part describes optical-fiber connectors, terminals and branches. The third part is concerned with the major optoelectronic components encountered in optical-communication systems.This book will be of value to research scientists, engineers, and patent workers.

  20. Nonlinear optics

    Boyd, Robert W

    2013-01-01

    Nonlinear Optics is an advanced textbook for courses dealing with nonlinear optics, quantum electronics, laser physics, contemporary and quantum optics, and electrooptics. Its pedagogical emphasis is on fundamentals rather than particular, transitory applications. As a result, this textbook will have lasting appeal to a wide audience of electrical engineering, physics, and optics students, as well as those in related fields such as materials science and chemistry.Key Features* The origin of optical nonlinearities, including dependence on the polarization of light* A detailed treatment of the q

  1. Optical Micromachining

    1998-01-01

    Under an SBIR (Small Business Innovative Research) with Marshall Space Flight Center, Potomac Photonics, Inc., constructed and demonstrated a unique tool that fills a need in the area of diffractive and refractive micro-optics. It is an integrated computer-aided design and computer-aided micro-machining workstation that will extend the benefits of diffractive and micro-optic technology to optical designers. Applications of diffractive optics include sensors and monitoring equipment, analytical instruments, and fiber optic distribution and communication. The company has been making diffractive elements with the system as a commercial service for the last year.

  2. The Clinical Efficacy Observation About The Treatment of Facial Neuritis With The Electroacupuncture Combining Microwave and The Intermediate Frequency-Pulse Electrotherapy%电针结合微波、中频脉冲电治疗面神经炎60例临床疗效观察

    袁红玲; 李剑虹; 谢金金

    2013-01-01

    Objective:To observe the clinical efficacy about the treatment of facial neuritis with the electroacupuncture combining microwave and the intermediate frequency-pulse electrotherapy. Methods: (1) Acupoint of electroacupuncture: Yangbai, Sibai, Jiache, Dicang, Taiyang, Quanliao, Hegu, etc. Connected the electronic-acupression instrument, choose the dilatational wave, electri-fied and remained the needle about 30min. (2) Intermediate frequency-pulse electrotherapy:Neuri-tis prescription, the intensity was making the muscle bounce slightly and the patients can tolerate for the degree, each time was 20min. (3) Microwave(millimeter waves):Using the cyclo-radiator to irradiate stylomastoid foramen for 20min each time and 1time a day. A period of treatment was 14 days. After a course of treatment patients could rest for 1-2 days. Results:The therapy of patients with facial neuritis was 60 cases, 51 cases were cured, 8 cases were improved, 1 case was invalid, the cure rate was 85%, the total effective rate was 98.3%. Conclusion:The treatment of facial neuri-tis with the electroacupuncture combining microwave and the intermediate frequency-pulse electro-therapy has the exact efficacy, so it is worth clinical promotion.%  目的:观察电针加微波、中频脉冲电治疗面神经炎的疗效.方法:(1)电针:取阳白、四白、颊车、地仓、太阳、颧髎、合谷等,接通电针仪,选用疏密波,通电、留针30分钟;(2)中频脉冲电疗:神经炎处方,强度以肌肉轻微跳动、患者能耐受为度,每次20分钟;(3)微波(毫米波):采用圆形辐射器照射耳后茎乳孔处,每次20分钟,1次/d,14天为一个疗程,疗程间休息1-2天.结果:治疗面神经炎病人60例,其中治愈51例,好转8例,无效1例,治愈率85%,总有效率98.3%.结论:电针结合微波、中频脉冲电治疗面神经炎疗效确切,值得临床推广.

  3. Treatment of acute pancreatitis

    Al-Mofleh Ibrahim

    1998-01-01

    Full Text Available There is no specific treatment for acute pancreatitis. Majority of patients with acute pancreatitis respond to medical therapy. Supportive measures and close observations represent the cornerstone of the medical therapy. Failure to respond to medical treatment may indicate choledocholithiasis or infected necrosis. Endoscopic papillotomy with stone retrieval is beneficial in patients with severe biliary pancreatitis. Image-guided fine needle aspiration and bacteriological examination of aspirate is reliable in detecting infection and deliniating causative pathogen. Surgical debridement is the method of choice for treatment of infected necrosis. In contrast, in pancreatic abscess, surgery is preserved for those, who do not respond to percutaneous drainage combined with antibiotics. The benefit of antisecretory and antiproteolytic agents is debatable. A combination of antioxidants, calcium channel antagonists and antibiotics may play a major role in the treatment of acute pancreatitis in the future.

  4. Acute acalculous cholecystitis.

    Barie, Philip S; Eachempati, Soumitra R

    2003-08-01

    Acute cholecystitis can develop without gallstones in critically ill or injured patients. However, the development of acute acalculous cholecystitis is not limited to surgical or injured patients, or even to the intensive care unit. Diabetes, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, and shock or cardiac arrest have been associated with acute acalculous cholecystitis. Children may also be affected, especially after a viral illness. The pathogenesis of acute acalculous cholecystitis is a paradigm of complexity. Ischemia and reperfusion injury, or the effects of eicosanoid proinflammatory mediators, appear to be the central mechanisms, but bile stasis, opioid therapy, positive-pressure ventilation, and total parenteral nutrition have all been implicated. Ultrasound of the gallbladder is the most accurate diagnostic modality in the critically ill patient, with gallbladder wall thickness of 3.5 mm or greater and pericholecystic fluid being the two most reliable criteria. The historical treatment of choice for acute acalculous cholecystitis has been cholecystectomy, but percutaneous cholecystostomy is now the mainstay of therapy, controlling the disease in about 85% of patients. Rapid improvement can be expected when the procedure is performed properly. The mortality rates (historically about 30%) for percutaneous and open cholecystostomy appear to be similar, reflecting the severity of illness, but improved resuscitation and critical care may portend a decreased risk of death. Interval cholecystectomy is usually not indicated after acute acalculous cholecystitis in survivors; if the absence of gallstones is confirmed and the precipitating disorder has been controlled, the cholecystostomy tube can be pulled out after the patient has recovered. PMID:12864960

  5. Acute pancreatitis: Manifestation of acute HIV infection in an adolescent

    Bitar, Anas; Altaf, Muhammad; Sferra, Thomas J.

    2012-01-01

    Summary Background: Pancreatitis in the pediatric age group is not as common as in adults. Etiologies are various and differ from those in adults. Although infectious etiology accounts for a significant number of cases of pancreatitis, acute infection with Human Immunodeficiency Virus (HIV) was rarely reported as a possible etiology for acute pancreatitis in adults. Acute pancreatitis has never been reported as a presenting manifestation of acute HIV infection in children. Case Report: We des...

  6. Acute acalculous cholecystitis

    Fox, M.S.; Wilk, P.J.; Weissmann, H.S.; Freeman, L.M.; Gliedman, M.L.

    1984-07-01

    Sixty-eight patients with acute acalculous cholecystitis were reviewed. The results of history and physical examinations were usually nondiagnostic. IDA cholescintigraphy (93 per cent accuracy rate) was the only reliable diagnostic modality. The results of oral cholecystography, intravenous cholangiography and ultrasonography were considerably less reliable. One-half of the patients had gangrenous cholecystitis. Cholecystectomy was the preferred operation with an over-all mortality of 9 per cent. IDA cholescintigraphy is an important new modality for the diagnosis of acute acalculous cholecystitis which, in the past, has often been difficult to diagnose.

  7. Congenital acute megakaryocytic leukemia

    N B Mathur

    2011-01-01

    Full Text Available Congenital leukemia (CL is an extremely rare disorder in the newborn, significant proportion of which is of myeloid origin, primarily of M4 or M5 morphology. As compared to pediatric leukemia, CL is a more aggressive disease. Acute myeloid leukemia (AML-M7 or acute megakaryocytic leukemia is a rare type of AML with an incidence of 0.5 per million per year. Median age of presentation is 6 years, and children may present with a broad variety of symptoms including low-grade fever, diarrhea, easy bruising, failure to gain weight and life-threatening conditions.

  8. Acute Gynecologic Disorders.

    Donaldson, Carolyn K

    2015-11-01

    Premenopausal women with acute pelvic pain comprise a significant percentage of patients who present to the emergency room. Etiologies can be gynecologic, urologic, gastrointestinal, or vascular. Signs and symptoms are often nonspecific and overlapping. The choice of imaging modality is determined by the clinically suspected differential diagnosis. Ultrasound (US) is the preferred imaging modality for suspected obstetric or gynecologic disorders. CT is more useful when gastrointestinal or urinary tract pathology is likely. MR imaging is rarely used in the emergent setting, except to exclude appendicitis in pregnant women. This article presents a comprehensive review of imaging of acute gynecologic disorders. PMID:26526439

  9. Acute calcific retropharyngeal tendinitis

    Acute calcific tendinitis results from the deposition of calcium hydroxyapatite crystals in peri articular muscular attachments. It usually develops in extremities, most often in shoulders and hips. Although the incidence is much lower, it has been reported to occur in the neck region, where it involves the tendons insertion of the longs colli muscle. We present a case of acute neck pain caused by a calcareous deposition in the tendon of the longs colli muscle, producing inflammation. We describe the clinical and radiologic features (plain radiography, CT,MRI) associated with this entire. (Author) 7 refs

  10. Acute myocardial infarct imaging

    A brief review is presented of radiopharmaceuticals used for imaging acute myocardial infarction and instrumentation using the rectilinear scanner and the scintillation camera. Clinical experience indicates that myocardial imaging with /sup 99 m/Tc pyrophosphate is a useful adjunct to the electrocardiogram and serum enzyme activity in managing patients with myocardial infarction. The technique allows rapid diagnosis, accurate localization, and an estimate of the size of acute infarcts. It can also be used to document infarct extension and in association with myocardial perfusion imaging can help differentiate fresh from old myocardial infarction

  11. Applied optics and optical design

    Conrady, A E

    2011-01-01

    ""For the optical engineer it is an indispensable work."" - Journal, Optical Society of America""As a practical guide this book has no rival."" - Transactions, Optical Society""A noteworthy contribution,"" - Nature (London)Part I covers all ordinary ray-tracing methods, together with the complete theory of primary aberrations and as much of higher aberration as is needed for the design of telescopes, low-power microscopes and simple optical systems. Chapters: Fundamental Equations, Spherical Aberration, Physical Aspect of Optical Images, Chromatic Aberration, Design of Achromatic Object-Glass

  12. Loperamide-Induced Acute Pancreatitis

    Halla Vidarsdottir; Hanna Vidarsdottir; Pall Helgi Moller; Einar Stefan Bjornsson

    2013-01-01

    Acute pancreatitis is a common disease leading to hospitalizations, most often caused by gallstones or alcohol. We present a case of a patient diagnosed with acute pancreatitis considered to be due to loperamide treatment for diarrhea.

  13. Causes of acute bronchitis (image)

    ... the respiratory system that leads into the lungs. Acute bronchitis has a sudden onset and usually appears after ... and the production of thick yellow mucus. If acute bronchitis occurs because of a bacterial infection antibiotics are ...

  14. Drug-induced acute pancreatitis

    Eland, I.A.

    2008-01-01

    textabstractAcute pancreatitis is an inflammatory disease of the pancreas with sudden onset. The severity of acute pancreatitis may vary from mild to life threatening. There are many risk factors for acute pancreatitis, among which gallstones and alcohol abuse are most widely known. Drugs are considered as potential risk factors for acute pancreatitis, but have received relatively little attention in the medical literature. In this thesis, several epidemiological studies were performed to ass...

  15. Lung Injury in Acute Pancreatitis

    Raffaele Pezzilli; Lara Bellacosa; Cristina Felicani

    2009-01-01

    Most knowledge has been accumulated on the mechanisms involved in the development of distant organ injuries during the course of severe acute pancreatitis. Among the various distant organ dysfunctions, both the development of acute lung injury and acute respiratory distress syndrome represent serious complications. In the following paragraphs the pathophysiological mechanisms capable of determining lung injury during the course of acute pancreatitis will be reviewed. Pancreatic Enzymes and...

  16. Acute Intermittent Porphyria (AIP)

    ... sold as Panhematin ® , from Recordati Rare Diseases. Most hospitals do not stock it. Therefore the pharmacy must be notified at the time the patient’s ... the Acute Porphyrias - Clarification of Testing Results** Important Update ... & Immunology, University Hospital of Wales, for assistance in the preparation of ...

  17. Acute hemiplegia in childhood

    Okuno, Takehiko; Takao, Tatsuo; Itoh, Masatoshi; Konishi, Yukuo; Nakano, Shozo (Kyoto Univ. (Japan). Faculty of Medicine)

    1983-04-01

    The results of CT in 100 patients with acute hemiplegia in childhood are reported here. The etiology was various: 2 patients had infratentorial brain tumors, 56 had cerebral vascular diseases, 3 had head injuries, 16 had intracranial infectious diseases, one had postinfectious encephalomyelitis, one had multiple sclerosis, 2 had epilepsy, and the diagnosis of 19 were unknown. Eleven patients had a normal CT and a good prognosis. As for the type of onset, there were patients of type 1 with fever and 42 with convulsions and unconsciousness; those of type 2 with convulsions and unconsciousness were 12, and those of type 3 without fever and convulsions were 46. This classification is assumed to be useful, as the type of onset is characteristic of the etiology. Six patients were diagnosed correctly by repeated examinations, although the first CT did not reveal any remarkable findings. Capsular infarction, occlusion of the posterior cerebral artery in acute hemiplegia in childhood, abnormal findings of the internal capsule, thalamus, and midbrain in a patient with postinfectious encephalomyelitis, and a diffuse low density in the CT of the unilateral hemisphere in the patients with acute encephalopathy and acute hemiplegia of an obscure origin have been found after the introduction of computerized tomography.

  18. Childhood Acute Lymphoblastic Leukemia

    Pui, Ching-Hon; Yang, Jun J; Hunger, Stephen P;

    2015-01-01

    PURPOSE: To review the impact of collaborative studies on advances in the biology and treatment of acute lymphoblastic leukemia (ALL) in children and adolescents. METHODS: A review of English literature on childhood ALL focusing on collaborative studies was performed. The resulting article was...

  19. Acute cough in adults

    Jochen W L Cals; Nick A Francis

    2010-01-01

    @@ A healthy, non-smoking 54 year old woman consults with a severe acute cough. It started two weeks ago with symptoms of a common cold, but she is worried about its duration and would like something to "clear it up. "

  20. Acute radiation disease

    Features of clinical trends in acute period of radiation disease at personnel who suffered from Chernobyl accident are considered. The main attention is paid to the results of 10 year observation of organs, systems and metabolic processes in patients. Used therapeutic, rehabilitation and preventive actions in stationary, ambulatory and sanatorium - health resort stages are described

  1. [Acute pancreatitis and pregnancy].

    Scollo, P; Licitra, G

    1993-12-01

    Aetiologic factors (gallstones, hyperlipidemia I-IV, hypertriglyceridaemia) make their occurrence, mainly, in the third trimester of gestation. Two cases of acute pancreatitis in pregnancy are described; in both cases patients referred healthy diet, no habit to smoke and no previous episode of pancreatitis. An obstructive pathology of biliary tract was the aetiologic factor. Vomiting, upper abdominal pain are aspecific symptoms that impose a differential diagnosis with acute appendicitis, cholecystitis and obstructive intestinal pathology. Laboratory data (elevated serum amylase and lipase levels) and ultrasonography carry out an accurate diagnosis. The management of acute pancreatitis is based on the use of symptomatic drugs, a low fat diet alternated to the parenteral nutrition when triglycerides levels are more than 28 mmol/L. Surgical therapy, used only in case of obstructive pathology of biliary tract, is optimally collected in the third trimester or immediately after postpartum. Our patients, treated only medically, delivered respectively at 38th and 40th week of gestation. Tempestivity of diagnosis and appropriate therapy permit to improve prognosis of a pathology that, although really associated with pregnancy, presents high maternal mortality (37%) cause of complications (shock, coagulopathy, acute respiratory insufficiency) and fetal (37.9%) by occurrence of preterm delivery. PMID:8139793

  2. Drug-induced acute pancreatitis

    I.A. Eland

    2003-01-01

    textabstractAcute pancreatitis is an inflammatory disease of the pancreas with sudden onset. The severity of acute pancreatitis may vary from mild to life threatening. There are many risk factors for acute pancreatitis, among which gallstones and alcohol abuse are most widely known. Drugs are consid

  3. Acute pancreatitis and Cushing's syndrome.

    Clague, H W; B. Warren; Krasner, N.

    1984-01-01

    A case of acute necrotizing pancreatitis in a 53-year-old man with an ectopic adrenocorticotrophin (ACTH) producing bronchial carcinoma is described. The aetiology of acute pancreatitis in relation to steroid therapy and malignancy is discussed and it is suggested that excess endogenous steroid production may also cause acute pancreatitis.

  4. Gadolinium induced recurrent acute pancreatitis.

    Blasco-Perrin, H; Glaser, B; Pienkowski, M; Peron, J M; Payen, J L

    2013-01-01

    Acute pancreatitis is a sudden swelling and inflammation of the pancreas. The two most common causes are alcohol use and biliary stones. Drug-induced acute pancreatitis are rare (1.4-2%). In this present study, we present a case of recurrent acute pancreatitis induced by a specific magnetic-resonance-imaging (MRI) contrast agent called gadobenate dimeglumine. PMID:23395575

  5. Optical computing.

    Stroke, G. W.

    1972-01-01

    Applications of the optical computer include an approach for increasing the sharpness of images obtained from the most powerful electron microscopes and fingerprint/credit card identification. The information-handling capability of the various optical computing processes is very great. Modern synthetic-aperture radars scan upward of 100,000 resolvable elements per second. Fields which have assumed major importance on the basis of optical computing principles are optical image deblurring, coherent side-looking synthetic-aperture radar, and correlative pattern recognition. Some examples of the most dramatic image deblurring results are shown.

  6. Geometrical Optics

    Lindlein, Norbert; Leuchs, Gerd

    This chapter shall discuss the basics and the applications of geometrical optical methods in modern optics. Geometrical optics has a long tradition and some ideas are many centuries old. Nevertheless, the invention of modern personal computers which can perform several million floating-point operations in a second also revolutionized the methods of geometrical optics and so several analytical methods lost importance whereas numerical methods such as ray tracing became very important. Therefore, the emphasis in this chapter is also on modern numerical methods such as ray tracing and some other systematic methods such as the paraxial matrix theory.

  7. Acute pyelonephritis in ER

    Giovanni Volpicelli

    2007-10-01

    Full Text Available Symptoms and signs of acute pyelonephritis sometimes are subtle and emergency physicians attending overcrowded and busy institutions could easily miss the right diagnosis. The presence of a renal damage is decisive in the therapeutic choice. Aims of our study are: 1 to assess prevalence of renal damage in patients presenting to our ED with symptoms and signs of primary urinary tract infection (UTI; 2 to evaluate the reliability of such symptoms and signs in predicting a renal damage; 3 to assess accuracy of the contrast enhanced ultrasound (CEUS in the ED diagnosis of renal damage due to acute uncomplicated pyelonephritis. We studied 54 patients with suspected UTI. Each patient underwent clinical examination, routine blood and urine sampling and conventional renal ultrasound (US. 23 patients had confirmation of acute primary UTI, and performed renal magnetic resonance (MR to rule out renal parenchymal involvement. In 16 patients (69,6% one or more parenchymal lesions were visualized at MR, and diagnosis of acute uncomplicated pyelonephritis was confirmed (group A. The other 7 patients had a diagnosis of UTI without renal involvement (group B. Some of 23 patients presented with few atypical symptoms. Lumbar pain was the most frequent symptom (n = 21, without a statistically significant difference between group A and B (P 0,958; p = 0,328. No other symptom or sign has demonstrated statistically valid in predicting the renal involvement. Renal US was positive in only 3 patients of group A (18,7%. During this first part of our study, CEUS was performed in a limited number of patients (n = 8, and in 7 examinations data were concordant with MR. In conclusion, analysis of our preliminary data confirms that a distinction between patients with different extension of the UTI is not possible through the simple clinical examination and routine tests. CEUS is very promising and its routine employment in the ED could simplify the diagnostic practice in

  8. QUANTUM OPTICS. Universal linear optics.

    Carolan, Jacques; Harrold, Christopher; Sparrow, Chris; Martín-López, Enrique; Russell, Nicholas J; Silverstone, Joshua W; Shadbolt, Peter J; Matsuda, Nobuyuki; Oguma, Manabu; Itoh, Mikitaka; Marshall, Graham D; Thompson, Mark G; Matthews, Jonathan C F; Hashimoto, Toshikazu; O'Brien, Jeremy L; Laing, Anthony

    2015-08-14

    Linear optics underpins fundamental tests of quantum mechanics and quantum technologies. We demonstrate a single reprogrammable optical circuit that is sufficient to implement all possible linear optical protocols up to the size of that circuit. Our six-mode universal system consists of a cascade of 15 Mach-Zehnder interferometers with 30 thermo-optic phase shifters integrated into a single photonic chip that is electrically and optically interfaced for arbitrary setting of all phase shifters, input of up to six photons, and their measurement with a 12-single-photon detector system. We programmed this system to implement heralded quantum logic and entangling gates, boson sampling with verification tests, and six-dimensional complex Hadamards. We implemented 100 Haar random unitaries with an average fidelity of 0.999 ± 0.001. Our system can be rapidly reprogrammed to implement these and any other linear optical protocol, pointing the way to applications across fundamental science and quantum technologies. PMID:26160375

  9. Severe Acute Pancreatitis in Pregnancy

    Bahiyah Abdullah

    2015-01-01

    Full Text Available This is a case of a pregnant lady at 8 weeks of gestation, who presented with acute abdomen. She was initially diagnosed with ruptured ectopic pregnancy and ruptured corpus luteal cyst as the differential diagnosis. However she then, was finally diagnosed as acute hemorrhagic pancreatitis with spontaneous complete miscarriage. This is followed by review of literature on this topic. Acute pancreatitis in pregnancy is not uncommon. The emphasis on high index of suspicion of acute pancreatitis in women who presented with acute abdomen in pregnancy is highlighted. Early diagnosis and good supportive care by multidisciplinary team are crucial to ensure good maternal and fetal outcomes.

  10. Lagrangian optics

    Lakshminarayanan, Vasudevan; Thyagarajan, K

    2002-01-01

    Ingeometrical optics, light propagation is analyzed in terms of light rays which define the path of propagation of light energy in the limitofthe optical wavelength tending to zero. Many features oflight propagation can be analyzed in terms ofrays,ofcourse, subtle effects near foci, caustics or turning points would need an analysis based on the wave natureoflight. Allofgeometric optics can be derived from Fermat's principle which is an extremum principle. The counterpart in classical mechanics is of course Hamilton's principle. There is a very close analogy between mechanics ofparticles and optics oflight rays. Much insight (and useful results) can be obtained by analyzing these analogies. Asnoted by H. Goldstein in his book Classical Mechanics (Addison Wesley, Cambridge, MA, 1956), classical mechanics is only a geometrical optics approximation to a wave theory! In this book we begin with Fermat's principle and obtain the Lagrangian and Hamiltonian pictures of ray propagation through various media. Given the ...

  11. Acute Coronary Events

    Arbab-Zadeh, Armin; Nakano, Masataka; Virmani, Renu; Fuster, Valentin

    2012-01-01

    In the United States alone, more than 400,000 Americans die annually from coronary artery disease and more than 1,000,000 suffer acute coronary events, i.e., myocardial infarction and sudden cardiac death.1 Considering the aging of our population and increasing incidence of diabetes and obesity, the morbidity from coronary artery disease, and its associated costs, will place an increasing, substantial burden on our society.2 Between 2010 and 2030, total direct medical costs spent in the US for cardiovascular diseases are projected to triple from 273 to 818 billion dollars.2 Although effective treatments are available and considerable efforts are ongoing to identify new strategies for the prevention of coronary events, predicting such events in an individual has been challenging.3 In hopes of improving our ability to determine the risk of coronary events, it is prudent to review our knowledge of factors that lead to acute coronary events. PMID:22392862

  12. Vision and vision-related outcome measures in multiple sclerosis

    Balcer, Laura J; Miller, David H; Reingold, Stephen C;

    2015-01-01

    to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting......Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple...... of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes...

  13. Acute pancreatitis in pregnancy

    Pitchumoni, Capecomorin S; Yegneswaran, Balaji

    2009-01-01

    Acute pancreatitis (AP) is a rare event in pregnancy, occurring in approximately 3 in 10 000 pregnancies. The spectrum of AP in pregnancy ranges from mild pancreatitis to serious pancreatitis associated with necrosis, abscesses, pseudocysts and multiple organ dysfunction syndromes. Pregnancy related hematological and biochemical alterations influence the interpretation of diagnostic tests and assessment of severity of AP. As in any other disease associated with pregnancy, AP is associated wit...

  14. Streptococcal acute pharyngitis

    Lais Martins Moreira Anjos

    2014-07-01

    Full Text Available Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-streptococcal glomerulonephritis. Symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Cough, coryza, conjunctivitis, and diarrhea are uncommon, and their presence suggests a viral cause. A diagnosis of pharyngitis is supported by the patient's history and by the physical examination. Throat culture is the gold standard for diagnosing streptococcus pharyngitis. However, it has been underused in public health services because of its low availability and because of the 1- to 2-day delay in obtaining results. Rapid antigen detection tests have been used to detect S. pyogenes directly from throat swabs within minutes. Clinical scoring systems have been developed to predict the risk of S. pyogenes infection. The most commonly used scoring system is the modified Centor score. Acute S. pyogenes pharyngitis is often a self-limiting disease. Penicillins are the first-choice treatment. For patients with penicillin allergy, cephalosporins can be an acceptable alternative, although primary hypersensitivity to cephalosporins can occur. Another drug option is the macrolides. Future perspectives to prevent streptococcal pharyngitis and post-infection systemic complications include the development of an anti-Streptococcus pyogenes vaccine.

  15. Acute ischemic cerebral attack

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  16. Minocycline for Acute Neuroprotection

    Elewa, Hazem F.; Hilali, Hend; Hess, David C.; Machado, Livia S.; Fagan, Susan C.

    2006-01-01

    Minocycline is a widely used tetracycline antibiotic. It has been used for decades in the treatment of various gram-positive and gram-negative infections. More recently, minocycline has been shown to have neuroprotective properties in different animal models of acute neurological injury. As a neuroprotective agent, minocycline has the potential to be superior to most of the previously tried agents. In addition to its high blood-brain barrier penetration, minocycline is also a safe compound co...

  17. Myopathy in acute hypothyroidism.

    Kung, A. W.; Ma, J T; Yu, Y L; Wang, C. C.; Woo, E K; Lam, K.S.; Huang, C Y; Yeung, R T

    1987-01-01

    Hypothyroid myopathy has so far been reported in long standing cases of hypothyroidism. We describe two adult patients with myopathy associated with acute transient hypothyroidism. Both presented with severe muscle aches and cramps, stiffness and spasms. Muscle enzymes were markedly elevated and electromyography in one patient showed myopathic features. Histological changes were absent in muscle biopsy, probably because of the short duration of metabolic disturbance. The myopathy subsided pro...

  18. Myopathy in acute hypothyroidism

    Kung, AWC; Ma, JTC; Yu, YL

    1987-01-01

    Hypothyroid myopathy has so far been reported in long standing cases of hypothyroidism. We describe two adult patients with myopathy associated with acute transient hypothyroidism. Both presented with severe muscle aches and cramps, stiffness and spasms. Muscle enzymes were markedly elevated and electromyography in one patient showed myopathic features. Histological changes were absent in muscle biopsy, probably because of the short duration of metabolic disturbance. The myopathy subsided pro...

  19. Acute Myocardial Infarction 19922001

    Robert Schmitz

    2005-01-01

    Heart disease is the leading cause of hospitalization and death in the United States among persons age 65 and older. Acute myocardial infarction (AMI), more commonly known as heart attack, accounted for more than 321,000 hospitalizations among Medicare beneficiaries in 2001. This report presents trends in AMI hospitalization, readmission, and mortality rates from 1992 through 2001 among Medicare fee-for-service beneficiaries across various demographic groups.

  20. Acute oesophageal necrosis syndrome

    Garas, George; Wou, Constance; Sawyer, Joseph; Amygdalos, Iakovos; Gould, Stuart

    2011-01-01

    An 89-year-old woman with a known hiatus hernia presented to the accident and emergency department with acute onset epigastric pain. CT of the thorax and abdomen revealed a large hiatus hernia with mesentero-axial volvulus but no evidence of strangulation. A large aneurysmal aortic arch and descending aorta were visible with associated mural thrombus. As the pain was worsening, following discussion with the patient, the decision to operate was taken. The hiatus hernia was successfully reduced...

  1. Epidemiology and clinical findings associated with enteroviral acute flaccid paralysis in Pakistan

    Angez Mehar

    2007-02-01

    Full Text Available Abstract Background Enteroviruses are among the most common viruses infecting humans worldwide and they are associated with diverse clinical syndromes. Acute flaccid paralysis (AFP is a clinical manifestation of enteroviral neuropathy, transverse myelitis, Guillian-Barre Syndrome, Traumatic neuritis and many other nervous system disorders. The objective of this study was to understand the role of Non-Polio Enteroviruses (NPEV towards this crippling disorder. Methods Stool specimens of 1775 children, aged less than 15 years, suffering from acute flaccid paralysis were collected after informed consent within 14 days of onset of symptoms during January 2003 to September 2003. The specimens were inoculated on RD and L20B cells using conventional tube cell culture while micro-neutralization test was used to identify the non-polio enterovirus (NPEV serotypes. Detailed clinical information and 60-days follow-up reports were analyzed for NPEV-associated AFP cases. Results NPEV were isolated from 474 samples. The male to female ratio was 1.4:1. The isolation of NPEV decreased significantly with the increase in age. Cases associated with fever at the onset of NPEV-associated AFP were found to be 62%. The paralysis was found asymmetrical in 67% cases, the progression of paralysis to peak within 4 days was found in 72% cases and residual paralysis after 60 days of paralysis onset was observed in 39% cases associated with NPEV. A clinical diagnosis of Guillian-Barre syndrome was made in 32% cases. On Microneutralization assay, echo-6 (13% and coxsackievirus B (13% were the most commonly isolated serotypes of NPEV along with E-7, E-13, E-11, E-4 and E-30. The isolates (n = 181 found untypable by the antiserum pools were confirmed as NPEV by PCR using Pan-Enterovirus primers. Conclusion The present study suggests that NPEV are a dominant cause of AFP and different serotypes of NPEV are randomly distributed in Pakistan. The untypable isolates need further

  2. Acute tubulointerstitial nephritis.

    Ulinski, Tim; Sellier-Leclerc, Anne-Laure; Tudorache, Elena; Bensman, Albert; Aoun, Bilal

    2012-07-01

    Acute tubulointerstitial nephritis (TIN) is a frequent cause of acute renal failure, characterised by the presence of inflammatory cell infiltrate in the interstitium of the kidney. Immuno-allergic reaction to certain medications, mainly non-steroidal anti-inflammatory drugs and antibiotics are by far the most important etiology for TIN today, but other situations such as infections, toxins, and vasculitis are known to induce TIN. Incidence of TIN is increasing, probably due to prescription habits and NSAID overuse, representing 3-7% of acute kidney injury in biopsies in children. Avoidance of the causal substance and rapid steroid therapy are hallmarks for patient care, but spontaneous initial recovery is very frequent and the general prognosis seems satisfactory. However, development of chronic TIN, without response to steroid or other immunosuppressive treatment, is possible. As the largest part of TIN is secondary to certain drugs, clear indications in particular for NSAID or antibiotics should be respected to reduce the number of TIN cases. PMID:21638156

  3. Acute puerperal uterine inversion

    Objective: To determine the frequency, causes, clinical presentations, management and maternal mortality associated with acute puerperal inversion of the uterus. Materials and Methods: All the patients who developed acute puerperal inversion of the uterus either in or outside the JPMC were included in the study. Patients of chronic uterine inversion were not included in the present study. Abdominal and vaginal examination was done to confirm and classify inversion into first, second or third degrees. Results: 57036 deliveries and 36 acute uterine inversions occurred during the study period, so the frequency of uterine inversion was 1 in 1584 deliveries. Mismanagement of third stage of labour was responsible for uterine inversion in 75% of patients. Majority of the patients presented with shock, either hypovolemic (69%) or neurogenic (13%) in origin. Manual replacement of the uterus under general anaesthesia with 2% halothane was successfully done in 35 patients (97.5%). Abdominal hysterectomy was done in only one patient. There were three maternal deaths due to inversion. Conclusion: Proper education and training regarding placental delivery, diagnosis and management of uterine inversion must be imparted to the maternity care providers especially to traditional birth attendants and family physicians to prevent this potentially life-threatening condition. (author)

  4. Perioperative acute renal failure.

    Mahon, Padraig

    2012-02-03

    PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

  5. Levels of Acute Phase Reactants in Patients with Acute Brucellosis

    Mehmet Uluğ

    2010-08-01

    Full Text Available Objective: Infection, tissue damage, immunologic reactions and the inflammatory process rapidly cause a systemic response in the organism, generally termed as acute phase response. The aim of this study was to evaluate the levels of acute phase reactants such as C-reactive protein (CRP, ferritin and fibrinogen in patients with acute brucellosis.Methods: This study was carried out in 48 patients (27 female, 21 male with acute brucellosis who were followed at the Departments of Infectious Diseases and Neurology, between April 2007 and August 2008, and in 42 healthy controls (22 female, 20 male.Results: Serum albumin levels significantly decreased (p<0.001, whereas CRP and ferritin levels significantly increased (p<0.001 and p=0.03 in patients with acute brucellosis.Conclusions: It was concluded that serum levels of CRP and ferritin increased, while albumin decreased in patients with acute brucellosis.

  6. Optical holography

    Collier, Robert

    2013-01-01

    Optical Holography deals with the use of optical holography to solve technical problems, with emphasis on the properties of holograms formed with visible light. Topics covered include the Fourier transform, propagation and diffraction, pulsed-laser holography, and optical systems with spherical lenses. A geometric analysis of point-source holograms is also presented, and holograms and hologram spatial filters formed with spatially modulated reference waves are described. This book is comprised of 20 chapters and begins with an introduction to concepts that are basic to understanding hologr

  7. Acute appendicitis mistaken as acute rejection in renal transplant recipients.

    Talwalkar N; Javali D; Venkatesh K; Iyer S; Venkatesh M; Joshi U

    1994-01-01

    Case histories of 2 renal transplant recipients are reported who had presenting features of fever, leukocytosis and pain/tenderness over right iliac fossa and were diagnosed to be due to acute appendicitis rather than more commonly suspected acute rejection episode which has very similar features. Diagnosis of acute appendicitis was suspected on the basis of rectal examination and later confirmed by laparotomy. The purpose of this communication is to emphasize the need for proper diagnosis in...

  8. A focus on acute cholecystitis and acute cholangitis

    Massimo Sartelli; Cristian Tranà

    2012-01-01

    Biliary infections are very common intra-abdominal infections. Laparoscopic cholecystectomy for acute cholecystitis and endoscopic retrograde management of acute cholangitis play important roles in the treatment of biliary infections. Also antimicrobial therapy is nevertheless important in the overall management of biliary infections. A multidisciplinary team of physicians, including surgeons trained in laparoscopic techniques, interventional gastroenterologists, and interventional radiologists may improve outcomes of patients with biliary infections. This review focuses the clinical presentation, diagnosis, and state of the art management of acute cholecystitis and acute cholangitis.

  9. Optical Spectroscopy

    Thyrhaug, Erling

    The work presented in this thesis is broadly concerned with how complexation reactions and molecular motion can be characterized with the standard techniques in optical spectroscopy. The thesis aims to show a relatively broad range of methods for probing physico-chemical properties in fluorophore...... information about chemical equilibria, kinetics and molecular motion by monitoring changes in optical properties of the system. The five presented research projects are largely unrelated to each other both in aim and in what property is probed, however they are all connected in that they are fluorophore...... containing systems and are characterized using techniques in optical spectroscopy. Of the standard techniques in optical spectroscopy, particular attention has been paid to those based on time-resolved measurements and polarization, which is reflected in the experiment design in the projects. Not all of the...

  10. Optical twisters

    Daria, Vincent R.; Palima, Darwin; Glückstad, Jesper

    2010-01-01

    and linearly scaled towards no phase singularity at the centre of the beam. At the focal volume, we show that our beam forms an intensity distribution that can be accurately described as an "optical twister" as it propagates in the forward direction. Unlike LG beams, an optical twister can have...... minimal changes in radius but with a scalable OAM. Furthermore, we characterize the OAM in terms of its capacity to introduce spiral motion on particles trapped along its orbit. We also show that our "optical twister" maintains a high concentration of photons at the focus even as the topological charge is...... increased. Such beams can be applied to fundamental studies of light and atoms such as in quantum entanglement of the OAM, toroidal traps for cold atoms and for optical manipulation of microscopic particles....

  11. Quantum optics

    Andersen, Ulrik Lund

    2013-01-01

    Further sensitivity improvements are required before advanced optical interferometers will be able to measure gravitational waves. A team has now shown that introducing quantum squeezing of light may help to detect these elusive waves....

  12. Quantum optics

    Andersen, Ulrik Lund

    2013-01-01

    Further sensitivity improvements are required before advanced optical interferometers will be able to measure gravitational waves. A team has now shown that introducing quantum squeezing of light may help to detect these elusive waves.......Further sensitivity improvements are required before advanced optical interferometers will be able to measure gravitational waves. A team has now shown that introducing quantum squeezing of light may help to detect these elusive waves....

  13. The Effect of Intravitreal Bevacizumab in Patients with Acute Central Serous Chorioretinopathy

    Lim, Ji Won; Ryu, Su Jeong; Shin, Min Cheol

    2010-01-01

    Purpose To evaluate the effect of intravitreal bevacizumab injection (IVBI) in acute central serous chorioretinopathy (CSC) patients. Methods Patients with acute CSC received IVBI (1.25 mg/0.05 mL) or observation by randomization. Twelve eyes in each group completed 6 months of regular follow-up and were ultimately included in this study. Each patient was assessed using best corrected visual acuity measurements, fluorescein angiography, and optical coherence tomography at baseline and had reg...

  14. On obesity in acute pancreatitis

    Segersvärd, Ralf

    2005-01-01

    Over-nutrition is one of today s most visible public health problems. Currently over 40% of the Swedish population is either overweight or obese. Acute pancreatitis (AP) is an acute inflammatory process of the pancreas with variable involvement of regional tissues and/or remote organ systems. The morbidity and mortality associated with acute pancreatitis is largely determined by the involvement of distant organs such as the liver and lung and by the development of organ fail...

  15. Acute otitis media in children

    Cherpillod J

    2011-01-01

    Jacques CherpillodEar, Nose and Throat Department, Childrens’ University Hospital, Lausanne, SwitzerlandDate of preparation: 6th March 2011Conflict of interest: None declaredClinical question: What is the best treatment for acute otitis media in children?Results: Watchful waiting, followed by amoxicillin treatment, if necessary, is the best first-line treatment for acute otitis media in children aged six months or older.Keywords: acute otitis media, antibiotics, watchful waitin

  16. ACUTE PSYCHOTIC DISORDER AND HYPOGLYCEMIA

    Singh, S.K.; Agrawal, J.K.; Srivastava, A.S.; Bhardwaj, V.K.; Bose, B. Sarat

    1994-01-01

    A variable array of neuroglycopenic symptoms are frequently encountered in the hypoglycemic stage, but acute psychotic disorders are quite rare. A fifty five year old female presented with an acute psychosis following oral sulfonylurea induced hypoglycemia without preceding features of adrenomedullary stimulation. This case report suggests that an acute and transient psychotic disorder may be an important neuroglycopenic feature and its early recognition protects the patient from severe hypog...

  17. Nutrition Support in Acute Pancreatitis

    Orestis Ioannidis; Athina Lavrentieva; Dimitrios Botsios

    2008-01-01

    The management of acute pancreatitis differs according to its severity. Approximately 75% of patients with acute pancreatitis have mild disease with a mortality rate below 1%. Mortality increases up to 20% if the disease progresses to its severe necrotizing form and, in the most severe cases, mortality can increase to 30-40%. Severe acute pancreatitis is usually accompanied by systemic inflammatory response syndrome (SIRS) which results in hypermetabolism with prominent protein catabolism. Ac...

  18. Application of psychological care clinical pathway in the rehabilitation of patients with facial neuritis%心理护理临床路径在面神经炎患者中的应用

    谭晓雪

    2013-01-01

    Objective To investigate the efficacy of psychological care clinical pathway on the rehabilitation of patients with facial ncuritis.Methods Analysis from 74 cases of hospitalized patients with facial neuritis in neurology from January 2010 to August 2012.They were randomly divided into the path group and control group,37 cases for each.The control group was treated with conventional care,while the path group received the clinical path of psychological care on the basis of conventional care.Anxiety and severity of depression of patients in the first day to hospital,the second day,and discharge from hospital,length of stay,hospital costs,patients' satisfaction,efficacy and other key indicators were observed and compared between the two groups.Results As compared with the control group,the path group had significantly lower in the anxiety score of the discharged day (43.60 ± 9.32),depression (32.91 ± 4.04),hospital stay (18.9 ± 3.9 days),hospital costs(4325.12 ± 706.9 (¥)),and the difference between the two groups was significantly difference (t =6.757,22.320,8.569,3.253,respectively ; P < 0.01).And the patients' satisfaction (94.59%),treatment effect (97.30%),and health education knowledge score (92.1 ± 6.4) in the path group were significantly higher than that in the control group (x2 =5.232,16.207,respectively; t =13.068 ; P < 0.05).Conclusions Using psychological care clinical path mode to strengthen the psychological care of patients with facial paralysis,can improve the patients with adverse psychological state,promote disease recovery,reduce hospitalization costs,and shorter hospital stay,improve patients' satisfaction,and so on.Standardization and procedures of the clinical path of psychological care,patients can get the best care services and health education effect,while enhancing the nurses' professional knowledge level and job satisfaction.%目的 探索心理护理临床路径在面神经炎患者康复中的应用效果.方法 2010年1

  19. Diarrheal Diseases - Acute and Chronic

    ... and drinking contaminated or raw foods and beverages. Screening/Diagnosis Most episodes of acute diarrhea resolve quickly without antibiotic therapy and with simple dietary modifications. See a ...

  20. Computer tomography in acute pyelonephritis

    Triller, J.; Scheidegger, J.; Terrier, F.

    1983-07-01

    Computer tomography of the kidneys was performed on 30 patients with acute renal infections (acute suppurative pyelonephritis, acute renal abscess, infected cyst, pyelonephrosis, calculus perforation, retroperitoneal abscess). Computer tomography provided more accurate information concerning the extent of the renal and extra-renal inflammatory process than did the urogram or sonogram. This may significantly affect the choice of treatment, particularly concerning the use of drugs or of surgery. Angiography and retrograde pyelography may be used in selected cases, especially where there is a suspicion of acute bacterial nephritis, renal vein thrombosis or ureteric obstruction.

  1. [Acute abdomen in gynecology].

    von Hugo, R; Meyer, B; Loos, W; Dirmeier, H

    1988-09-01

    The aim of the present study is, to describe the morbidity and mortality of 196 patients with an acute abdominal condition who underwent surgery at the Department of Gynecology and Obstetrics of the TU Munich between 1982 and 1986. This is a percentage of 2.7 of all 7,167 operations carried out during this period. 118 of these patients had an extrauterine pregnancy and were therefore excluded from the study. The second group of 79 patients, mostly with inflammatory diseases, were analyzed. In most of these cases the acute abdominal condition was caused by a tuboovarian abscess (48.1%), followed by peritonitis because of a bowel-disease (11.4%). 6 patients suffered from an abscessing endometritis due to a caesarean section with sepsis in 5 cases. A generalized peritonitis occurred in 5 cases and was treated with a planned relaparatomy with lavage. 63% of the patients had no complications within 28 days after operation, 13% developed a subileus; in 7% a relaparatomy was necessary. 6% of the patients had problems of wound-healing. One patient with stomach-cancer died 3 weeks after the operation because of a fulminant lung-embolism. Thus the mortality rate was 1.5%. A further 27% were treated at the intensive care-unit and 18% needed artificial respiration. The average postoperative period of hospitalisation was 15 days. In comparison, patients with elective operations remained 13 days. The morbidity and mortality of patients due to surgery of an acute abdominal condition was relatively small; postoperative complications could be well treated in all cases and is probably the result of a positive and early indication for surgical intervention. PMID:3181709

  2. Acute liver failure

    Bernal, William; Lee, William M; Wendon, Julia;

    2015-01-01

    Over the last three decades acute liver failure (ALF) has been transformed from a rare and poorly understood condition with a near universally fatal outcome, to one with a well characterized phenotype and disease course. Complex critical care protocols are now applied and emergency liver...... transplantation (ELT) is an established treatment option. These improvements in care are such that the majority of patients may now be expected to survive (Fig. 1). Key features of the condition have changed dramatically over time, with a remarkable fall in the incidence of cerebral edema and intracranial...

  3. Feedlot Acute Interstitial Pneumonia.

    Woolums, Amelia R

    2015-11-01

    Acute interstitial pneumonia (AIP) of feedlot cattle is a sporadically occurring respiratory condition that is often fatal. Affected cattle have a sudden onset of labored breathing. There is no confirmed effective treatment of feedlot AIP; however, administration of antibiotics effective against common bacterial respiratory pathogens and nonsteroidal anti-inflammatory drugs, especially aspirin, has been recommended. Protective strategies are not well defined, but efforts to limit dust exposure and heat stress; to ensure consistent formulation, mixing, and delivery of feed; and to identify and treat infectious respiratory disease in a timely manner may decrease rates of feedlot AIP. PMID:26253266

  4. Diagnosis of acute neuropathies

    Crone, Clarissa; Krarup, Christian

    2007-01-01

    Acute and subacute polyneuropathies present diagnostic challenges since many require prompt initiation of treatment in order to limit axonal degeneration and since an exact and detailed diagnosis is a prerequisite for making the correct choice of treatment. It is for instance of utmost importance...... to recognize whether the underlying pathological changes are due to demyelination or to axonal degeneration and electrodiagnostic tests can thus in most cases contribute considerably to the securing of an exact diagnosis. The specific and characteristic electrophysiological findings in the different...

  5. Acute traumatic patellar dislocation.

    Duthon, V B

    2015-02-01

    Inaugural traumatic patellar dislocation is most often due to trauma sustained during physical or sports activity. Two-thirds of acute patellar dislocations occur in young active patients (less than 20 years old). Non-contact knee sprain in flexion and valgus is the leading mechanism in patellar dislocation, accounting for as many as 93% of all cases. The strong displacement of the patella tears the medial stabilizing structures, and notably the medial patellofemoral ligament (MPFL), which is almost always injured in acute patellar dislocation, most frequently at its femoral attachment. Lateral patellar glide can be assessed with the knee in extension or 20° flexion. Displacement by more than 50% of the patellar width is considered abnormal and may induce apprehension. Plain X-ray and CT are mandatory to diagnose bony risk factors for patellar dislocation, such as trochlear dysplasia or increased tibial tubercle-trochlear groove distance (TT-TG), and plan correction. MRI gives information on cartilage and capsulo-ligamentous status for treatment planning: free bodies or osteochondral fracture have to be treated surgically. If patellar dislocation occurs in an anatomically normal knee and osteochondral fracture is ruled out on MRI, non-operative treatment is usually recommended. PMID:25592052

  6. Semiconductor Optics

    Klingshirn, Claus F

    2012-01-01

    This updated and enlarged new edition of Semiconductor Optics provides an introduction to and an overview of semiconductor optics from the IR through the visible to the UV, including linear and nonlinear optical properties, dynamics, magneto and electrooptics, high-excitation effects and laser processes, some applications, experimental techniques and group theory. The mathematics is kept as elementary as possible, sufficient for an intuitive understanding of the experimental results and techniques treated. The subjects covered extend from physics to materials science and optoelectronics. Significantly updated chapters add coverage of current topics such as electron hole plasma, Bose condensation of excitons and meta materials. Over 120 problems, chapter introductions and a detailed index make it the key textbook for graduate students in physics. The mathematics is kept as elementary as possible, sufficient for an intuitive understanding of the experimental results and techniques treated. The subjects covered ...

  7. Optical memory

    Mao, Samuel S; Zhang, Yanfeng

    2013-07-02

    Optical memory comprising: a semiconductor wire, a first electrode, a second electrode, a light source, a means for producing a first voltage at the first electrode, a means for producing a second voltage at the second electrode, and a means for determining the presence of an electrical voltage across the first electrode and the second electrode exceeding a predefined voltage. The first voltage, preferably less than 0 volts, different from said second voltage. The semiconductor wire is optically transparent and has a bandgap less than the energy produced by the light source. The light source is optically connected to the semiconductor wire. The first electrode and the second electrode are electrically insulated from each other and said semiconductor wire.

  8. Acute necrotizing pancreatitis in rats

    B. van Ooijen (Baan)

    1988-01-01

    textabstractThe specific aim of the present study was to investigate whether eicosanoids play a role in acute necrotizing pancreatitis. Because of the limited number of patients with acute pancreatitis admitted to the hospital each year, as well as the practical difficulties encountered in studying

  9. Sugar intolerance complicating acute gastroenteritis.

    Evans-Jones, G; McDowell, H P

    1986-01-01

    Sugar intolerance occurred in 31 of 200 children admitted to hospital with acute gastroenteritis. In 28 this was transient and settled rapidly, but in the remaining three it indicated a more serious and persistent problem. The most important predisposing factor was viral infection, in particular with rotavirus. The current regimen for the management of sugar intolerance complicating acute gastroenteritis at this hospital is outlined.

  10. INFLAMMATION AND ACUTE PHASE RESPONSE

    Farah Aziz Khan

    2010-10-01

    Full Text Available Inflammation caused by infection takes place by the cooperative cascade of cytokines and leukocytes. Tumor necrosis factor, interlukin-1, and interlukin-6 play important roles as proinflammatory cytokines to mediate local inflammation and activate other inflammatory cells e.g. neutrophils, monocytes, and macrophages. At least 15 different low molecular weight cytokine are secreted by activated leukocytes and are responsible for triggering acute phase response in the form of fever, leukocytosis, increased secretion of adreno corticotropic hormones, and production of acute phase proteins. Acute phase proteins are produced in liver under the influence of cytokines, which through blood stream passes to the site of inflammation and kill the pathogens by opsonization and activating complement pathways. The changes in the concentrations of positive acute-phase proteins and negative acute-phase proteins are due to the changes in their production by liver. Three of the best known acute phase proteins are C-reactive protein, serum anyloid A, and haptoglobin. Some disease states are casually related to acute phase proteins. C-reactive protein mediated compliment activation has a key role in some forms of tissue alteration such as cardiac infarction. Elevated S amyloid A levels are seen in chronic arthritis and tuberculosis. Other acute phase proteins show more moderate rise, usually less than fivefold.

  11. Acute brain hemorrhage in dengue

    Somsri Wiwanitkit; Viroj Wiwanitkit

    2014-01-01

    Dengue is a tropical arboviral infection that can have severe hemorrhagic complication.Acute brain hemorrhage in dengue is rare and is a big challenge in neurosurgery.To perform surgery for management of acute brain hemorrhage in dengue is a controversial issue.Here, the authors try to summarize the previous reports on this topic and compare neurosurgery versus conservative management.

  12. Reflective optics

    Korsch, Dietrich

    1991-01-01

    This is the first book dedicated exclusively to all-reflective imaging systems. It is a teaching tool as well as a practical design tool for anyone who specializes in optics, particularly for those interested in telescopes, infrared, and grazing-incidence systems. The first part of the book describes a unified geometric optical theory of all-reflective imaging systems (from near-normal to grazing incidence) developed from basic principles. The second part discusses correction methods and a multitude of closed-form solutions of well-corrected systems, supplemented with many conventional and unc

  13. Quantum optics

    The 1988 progress report of the Quantum Optics laboratory (Polytechnic School, France) is presented. The research program is focused on the behavior of dense and dilute materials submitted to short and high-intensity light radiation fields. Nonlinear optics techniques, with time and spatial resolution, are developed. An important research activity concerns the investigations on the interactions between the photon beams and the inhomogeneous or composite materials, as well as the artificial microstructures. In the processes involving molecular beams and surfaces, the research works on the photophysics of surfaces and the molecule-surface interactions, are included

  14. Statistical optics

    Goodman, Joseph W

    2015-01-01

    This book discusses statistical methods that are useful for treating problems in modern optics, and the application of these methods to solving a variety of such problems This book covers a variety of statistical problems in optics, including both theory and applications.  The text covers the necessary background in statistics, statistical properties of light waves of various types, the theory of partial coherence and its applications, imaging with partially coherent light, atmospheric degradations of images, and noise limitations in the detection of light. New topics have been introduced i

  15. Acute pneumonia in a fire-eater.

    Dell' Omo, M; Murgia, N; Chiodi, M; Giovenali, P; Cecati, A; Gambelunghe, A

    2010-01-01

    Fire-eater's lung, an acute exogenous lipoid pneumonia, is caused when street performers accidentally inhale pyrofluids. We report the case of a young fire-eater who, 12 hours after inhaling an iso-alkanebased pyrofluid, developed fever, dyspnoea, dry cough and intense right chest pain. Radiographic signs of pneumonia emerged two days later. Computed tomography (CT) scans visualized an irregular area of parenchymal consolidation with an air bronchiologram and peripheral ground-glass opacities in the right middle lobe. The diagnostic work-up included microbiological and lung function tests, optic fibre bronchoscopy and an in-depth cyto-immunological analysis of bronchoalveolar lavage fluid. Symptoms gradually improved over a few days. A CT scan one month later showed the thickened parenchymal area in the right middle lobe had almost completely disappeared. PMID:21244782

  16. Optical coherence tomography and indocyanine green angiography findings in acute syphilitic posterior placoid choroidopathy: case report Achados da tomografia de coerência óptica e angiografia com indocianina verde na coroidopatia placóide posterior aguda sifilítica: relato de caso

    Daniel Meira-Freitas

    2009-12-01

    Full Text Available The optical coherence tomography (OCT and indocyanine green angiography (ICGA findings of a 58-year-old male with acute syphilitic posterior placoid chorioretinitis are reported herein. Best-corrected visual acuity was 20/150 in the right eye (OD and 20/30 in the left eye (OS at presentation. On funduscopy, there was a central subretinal placoid yellowish lesion in OD. VDRL and serum FTA-ABS were positive. OCT showed increased reflectance and thickening of the subfoveal RPE-choriocapillaris complex corresponding to the lesion in OD. ICGA revealed a hypofluorescent spot corresponding to the lesion in OD and confluent small dots extending to periphery, without any correspondence in fundus examination. The same dots were also seen in OS, even though no lesions could be observed clinically. Intravenous ceftriaxone 2 g daily was given for 10 days. One month after the first visit, visual acuity improved to 20/30 and marked improvement of the lesion was seen. OCT was normal in both eyes at the final visit.Relatamos aqui os achados da tomografia de coerência óptica (OCT e angiografia com indocianina verde (ICGA de um paciente masculino de 58 anos com a coroidopatia placóide posterior aguda sifilítica. A acuidade visual corrigida na apresentação foi de 20/150 no olho direito (OD e 20/30 no olho esquerdo (OE. A fundoscopia evidenciou lesão sub-retiniana placóide amarelada central no OD. As sorologias VDRL e FTA-ABS foram positivas. OCT evidenciou aumento de refletividade subfoveal e espessamento do complexo EPR-coriocapilar correspondente à lesão do OD. ICGA revelou hipofluorescência local correspondente à lesão do OD e pequenos pontos confluentes que se estendiam para a periferia, sem qualquer correspondência na fundoscopia. O mesmo também foi visto no OE, embora nenhuma lesão pode ser observada clinicamente. Ceftriaxona 2 g intravenosa diária foi administrada durante 10 dias. Um mês após a primeira visita, a acuidade visual do OD foi

  17. Radiologic diagnosis of acute appendicitis

    Sixty-six cases of acute appendicitis were proved by surgery during the period from May 1969 to May 1971. The present study was designated to elucidate the findings of roentgen examination in acute appendicitis. The results obtained were summarized as follows: 1. Over 90 percent of cases of acute appendicitis showed significant radiographic findings. 2. Distension and fluid level in cecum and terminal ileum were disclosed approximately 75 percent of cases. It believe diagnostically significant in acute appendicitis. 3. About 10 percent of cases were found extra-alimentary free air. 4. The roentgen findings of the fluid interposed between colonic contents and frank stripesin the right lower quadrant was another interesting findings to suspect acute appendicitis

  18. Imaging diagnosis of acute appendicitis

    The nontraumatic acute abdomen is one of the most common presentation to the emergency room, with appendicitis being one of the most common causes of the acute abdomen. Up to 30 % of patients suspected of having acute appendicitis will present with atypical signs and symptoms. There are many conditions that imitate acute appendicitis. The percentage of unnecessary appendectomies that result from a clinical false-positive diagnosis of appendicitis. The use of computed tomography (CT) before planned surgery has decreased the negative appendicectomy rate for patients with suspected acute appendicitis. Recognition of the typical and atypical CT signs of appendicitis is important to optimize the diagnosis yield of the examination. Visualization of an appendix with normal characteristics is the most important finding to exclude appendicitis. (author)

  19. Nutrition Support in Acute Pancreatitis

    Orestis Ioannidis

    2008-07-01

    Full Text Available The management of acute pancreatitis differs according to its severity. Approximately 75% of patients with acute pancreatitis have mild disease with a mortality rate below 1%. Mortality increases up to 20% if the disease progresses to its severe necrotizing form and, in the most severe cases, mortality can increase to 30-40%. Severe acute pancreatitis is usually accompanied by systemic inflammatory response syndrome (SIRS which results in hypermetabolism with prominent protein catabolism. Acute malnutrition, commonly observed in patients with acute pancreatitis, is associated with immunological disturbances, septic complications and delayed healing of surgical wounds, and may lead to multiorgan dysfunction or failure syndrome (MODS or MOFS and increased morbidity and mortality [1].

  20. Radiological aspects of acute abdomen

    This work demonstrates the main roentgen signs of the most common causes of acute abdomen, through some cases chosen from H.N.M.D. Roentgen Department-Learning Register. First, we will show the normal roentgen anatomy of the abdomen. Then, we will discuss about the basic roentgen routine of acute abdomen and some technical changes depending on the suspected illness, the clinical conditions of the patient and certain roentgen findings. Finally, we will show the most important roentgen signs of the most familiar effects accurate abdomen, putting emphasis on the next things: intestinal obstructions, peritonitis, acute cholecustitis, acute pancreatitis, acute appendicitis, subphrenic abscesses, toxic megacolon of ulcerative retocolitis, gastric or duodenal ulcer perforation and renal colic. (author)

  1. [Bacteriostatic shock in acute purulent pyelonephritis].

    Arbuliev, M G; Arbuliev, K M; Gadzhiev, D P

    2002-01-01

    Fifty-seven patients with acute purulent pyelonephritis (APP) complicated by bacteriotoxic shock (BTS) were treated in Daghestan Medical Academy's urological clinic from 1982 to 1999. The condition was primarily caused by acute occlusion of the urinary tracts. The first step of the treatment was aimed at the recovery of normal hemodynamics. As early as the first hours of BTS, plasma- and hemosorption, hemodialysis, hemodialysis were made. If the patients got better, they were operated to remove the obstruction for urine flow (epicystostomy, nephrostomy). 28 recent cases received adjuvant laser therapy--irradiation of the cavitary renal system and blood. This was performed via light guide inserted into the renal pelvis through the nephrostomic drainage. The guide was connected with the He-Ne optic quantum generator AFL-1. Laser procedure lasted for 8-12 min, a course consisted of 7-8 procedures. Later, laser beam was also directed to the biologically active points corresponding to pyelonephritis. Normalization of renal function and T, B immunity was faster in patients exposed to laser radiation. Lethality in this group was lower. PMID:12180052

  2. Acute aortic intramural hematoma

    Bae, Oh Keun; Choi, Yo Won; Kim, Kwon Hyung; Jeon, Seok Chol; Park, Choong Kee; Seo, Heung Suk; Hahm, Chang Kok [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-02-01

    To evaluate the radiologic findings of acute intramural hematoma of the aorta, and the clinical follow up thereof. Among 34 cases confirmed clinically and radiologically as aortic dissection, and analysis was carried out based on 15 cases in which intramural hematoma without false lumen was demonstrated, on initial CT, 12 cases of in which follow up CT was used and five cases involving an aortogram. Elements such as the shape of the thickened aortic wall, ulcer-like intimal defects, and intimal calcification were examined. Changes in these elements were also examined on follow-up CT. DeBackey types 1 and 3 accounted for one and 14 cases, respectively. Initial precontrast CT demonstrated continuous, crescentic high attenuation areas along the wall of the descending aorta. In postcontrast scans, the crescentic areas were of relatively lower-attenuation and appeared along the aorta wall. Displaced intimal calcifications were seen in nine of fifteen patients. There was no intimal flap on all five aortogram, while aortic wall thickening and atherosclerotic change were demonstrated in four cases and in one case, respectively. Focal ulcers were seen in three cases. Ulcer-like intimal defects were demonstrated in a total of eleven cases (eight on CT, two on aortogram, and one on both). In ten of the twelve cases seen on follow up CT, the thickness of the intramural hematoma was seen to be reduced. Among the 15 cases, the operation was performed in two cases, and the remaining 13 received conservative treatment. In ten cases observed for more than twelve months, a recurrence of symptoms did not occur. Eccentric aortic wall thickening in patients who complain of acute chest pain is the result of acute aortic dissection with intramural hematoma, or a penetrating atherosclerotic ulcer of the aorta. The later may be differentiated from the former by the presence of on ulcer-like intimal defect. When both diseases are limited to the descending aorta, conservative treatment may

  3. Acute aortic intramural hematoma

    To evaluate the radiologic findings of acute intramural hematoma of the aorta, and the clinical follow up thereof. Among 34 cases confirmed clinically and radiologically as aortic dissection, and analysis was carried out based on 15 cases in which intramural hematoma without false lumen was demonstrated, on initial CT, 12 cases of in which follow up CT was used and five cases involving an aortogram. Elements such as the shape of the thickened aortic wall, ulcer-like intimal defects, and intimal calcification were examined. Changes in these elements were also examined on follow-up CT. DeBackey types 1 and 3 accounted for one and 14 cases, respectively. Initial precontrast CT demonstrated continuous, crescentic high attenuation areas along the wall of the descending aorta. In postcontrast scans, the crescentic areas were of relatively lower-attenuation and appeared along the aorta wall. Displaced intimal calcifications were seen in nine of fifteen patients. There was no intimal flap on all five aortogram, while aortic wall thickening and atherosclerotic change were demonstrated in four cases and in one case, respectively. Focal ulcers were seen in three cases. Ulcer-like intimal defects were demonstrated in a total of eleven cases (eight on CT, two on aortogram, and one on both). In ten of the twelve cases seen on follow up CT, the thickness of the intramural hematoma was seen to be reduced. Among the 15 cases, the operation was performed in two cases, and the remaining 13 received conservative treatment. In ten cases observed for more than twelve months, a recurrence of symptoms did not occur. Eccentric aortic wall thickening in patients who complain of acute chest pain is the result of acute aortic dissection with intramural hematoma, or a penetrating atherosclerotic ulcer of the aorta. The later may be differentiated from the former by the presence of on ulcer-like intimal defect. When both diseases are limited to the descending aorta, conservative treatment may

  4. Optical metrology

    Gåsvik, Kjell J

    2003-01-01

    New material on computerized optical processes, computerized ray tracing, and the fast Fourier transform, Bibre-Bragg sensors, and temporal phase unwrapping.* New introductory sections to all chapters.* Detailed discussion on lasers and laser principles, including an introduction to radiometry and photometry.* Thorough coverage of the CCD camera.

  5. Diophantine Optics

    Rouan, D.

    2016-09-01

    What I call Diophantine optics is the exploitation in optics of some remarkable algebraic relations between powers of integers. The name comes from Diophantus of Alexandria, a greek mathematician, known as the father of algebra. He studied polynomial equations with integer coefficients and integer solutions, called diophantine equations. Since constructive or destructive interferences are playing with optical path differences which are multiple integer (odd or even) of λ/2 and that the complex amplitude is a highly non-linear function of the optical path difference (or equivalently of the phase), one can understand that any Taylor development of this amplitude implies powers of integers. This is the link with Diophantine equations. We show how, especially in the field of interferometry, remarkable relations between powers of integers can help to solve several problems, such as achromatization of a phase shifter or deep nulling efficiency. It appears that all the research that was conducted in this frame of thinking, relates to the field of detection of exoplanets, a very active domain of astrophysics today.

  6. Optical electronics

    Javan, A.

    1976-01-01

    The development of an optical diode consisting of a metal-dielectric-metal junction in which the high-speed electric conduction process occurs due to quantum mechanical electron tunneling across the dielectric barrier is briefly reviewed. Potential applications of the diode are discussed.

  7. Acute pancreatitis in pregnancy

    Capecomorin S Pitchumoni; Balaji Yegneswaran

    2009-01-01

    Acute pancreatitis (AP) is a rare event in pregnancy,occurring in approximately 3 in 10 000 pregnancies.The spectrum of AP in pregnancy ranges from mild pancreatitis to serious pancreatitis associated with necrosis, abscesses, pseudocysts and multiple organ dysfunction syndromes. Pregnancy related hematological and biochemical alterations influence the interpretation of diagnostic tests and assessment of severity of AP. As in any other disease associated with pregnancy, AP is associated with greater concerns as it deals with two lives rather than just one as in the nonpregnant population. The recent advances in clinical gastroenterology have improved the early diagnosis and effective management of biliary pancreatitis. Diagnostic studies such as endoscopic ultrasound,magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography and therapeutic modalities that include endoscopic sphincterotomy, biliary stenting, common bile duct stone extraction and laparoscopic cholecystectomy are major milestones in gastroenterology. When properly managed AP in pregnancy does not carry a dismal prognosis as in the past.

  8. Massive acute arsenic poisonings.

    Lech, Teresa; Trela, Franciszek

    2005-07-16

    Arsenic poisonings are still important in the field of toxicology, though they are not as frequent as about 20-30 years ago. In this paper, the arsenic concentrations in ante- and post-mortem materials, and also forensic and anatomo-pathological aspects in three cases of massive acute poisoning with arsenic(III) oxide (two of them with unexplained criminalistic background, in which arsenic was taken for amphetamine and one suicide), are presented. Ante-mortem blood and urine arsenic concentrations ranged from 2.3 to 6.7 microg/ml, respectively. Post-mortem tissue total arsenic concentrations were also detected in large concentrations. In case 3, the contents of the duodenum contained as much as 30.1% arsenic(III) oxide. The high concentrations of arsenic detected in blood and tissues in all presented cases are particularly noteworthy in that they are very rarely detected at these concentrations in fatal arsenic poisonings. PMID:15939162

  9. Acute coagulopathy of trauma

    Johansson, P I; Ostrowski, S R

    2010-01-01

    Acute coagulopathy of trauma predicts a poor clinical outcome. Tissue trauma activates the sympathoadrenal system resulting in high circulating levels of catecholamines that influence hemostasis dose-dependently through immediate effects on the two major compartments of hemostasis, i.......e., the circulating blood and the vascular endothelium. There appears to be a dose-dependency with regards to injury severity and the hemostatic response to trauma evaluated in whole blood by viscoelastic assays like thrombelastography (TEG), changing from normal to hypercoagulable, to hypocoagulable and finally......, is an evolutionary developed response that counterbalances the injury and catecholamine induced endothelial activation and damage. Given this, the rise in circulating catecholamines in trauma patients may favor a switch from hyper- to hypocoagulability in the blood to keep the progressively more procoagulant...

  10. Acute human schistosomiasis mansoni

    Ana Rabello

    1995-04-01

    Full Text Available The acute schistosomiasis is the toxemic disease that follow the Schistosoma cercariae active penetration trough screen in the immunologicaly naive vertebrate host. The clinical picture starts two to eight weeks after the first contact with the contaminated water. Susceptible patients present a syndrome comprising fever, diarrhea, toxemia and hepatosplenomegaly. Diagnosis is based on epidemiological and clinical features, presence of Schistosoma eggs in the feces, enlargement of abdominal lymph nodes by ultrasonography and by detection of high antibodies levels against the antigen keyhole limpet haemocyanin. Different rates of cure have been observed with specific medication and for the most severe clinical presentations the use of steroids reduces the systemic and allergic manifestations.

  11. [Acute retinal necrosis].

    Lucke, K; Reinking, U; el-Hifnawi, E; Dennin, R H; Laqua, H

    1988-12-01

    The authors report on three patients with acute retinal necrosis who were treated with the virostatic agent Acyclovir and who underwent vitreoretinal surgery with silicone oil filling for total retinal detachment. In two eyes the retina was reattached, but useful vision was only preserved in one patient. Titers from blood and the vitreous, as well as microscopic findings in retinal biopsies, support the view that the necrosis is caused by a herpes simplex virus infection. After therapy with Acyclovir was instituted no further progression on the necrosis was observed. However, the development of retinal detachment could not be prevented. Early diagnosis and antiviral therapy are essential to improve the otherwise poor prognosis in this rare syndrome. PMID:3221657

  12. Perioperative acute kidney injury

    Calvert Stacey

    2012-07-01

    Full Text Available Abstract Acute kidney injury (AKI is a serious complication in the perioperative period, and is consistently associated with increased rates of mortality and morbidity. Two major consensus definitions have been developed in the last decade that allow for easier comparison of trial evidence. Risk factors have been identified in both cardiac and general surgery and there is an evolving role for novel biomarkers. Despite this, there has been no real change in outcomes and the mainstay of treatment remains preventive with no clear evidence supporting any therapeutic intervention as yet. This review focuses on definition, risk factors, the emerging role of biomarkers and subsequent management of AKI in the perioperative period, taking into account new and emerging strategies.

  13. Acute Methylenedioxypyrovalerone Toxicity.

    Froberg, Blake A; Levine, Michael; Beuhler, Michael C; Judge, Bryan S; Moore, Philip W; Engebretsen, Kristin M; Mckeown, Nathanael J; Rosenbaum, Christopher D; Young, Amy C; Rusyniak, Daniel E

    2015-06-01

    The objective of this study was to characterize the acute clinical effects, laboratory findings, complications, and disposition of patients presenting to the hospital after abusing synthetic cathinone. We conducted a retrospective multicenter case series of patients with synthetic cathinone abuse by searching for the terms bath salts, MDPV, methylenedioxypyrovalerone, mephedrone, methcathinone, methylone, methedrone, and cathinone within the "agent" field of a national clinical toxicology database (ToxIC). The medical records of these patients were obtained and abstracted by investigators at each study site. Patients with confirmatory testing that identified a synthetic cathinone in either blood or urine were included in the series. Patients who had either an undetectable synthetic cathinone test or no confirmatory testing were excluded. A data abstraction sheet was used to obtain information on each patient. We entered data into an Excel spreadsheet and calculated descriptive statistics. We identified 23 patients with confirmed synthetic cathinone exposure--all were positive for methylenedioxyprovalerone (MDPV). Eighty-three percent were male and 74 % had recreational intent. The most common reported clinical effects were tachycardia (74 %), agitation (65 %), and sympathomimetic syndrome (65 %). Acidosis was the most common laboratory abnormality (43 %). Seventy-eight percent of patients were treated with benzodiazepines and 30 % were intubated. Ninety-six percent of patients were hospitalized and 87 % were admitted to the ICU. The majority (61 %) of patients was discharged home but 30 % required inpatient psychiatric care. There was one death in our series. The majority of patients presenting to the hospital after abusing MDPV have severe sympathomimetic findings requiring hospitalization. A number of these patients require inpatient psychiatric care after their acute presentation. PMID:25468313

  14. Color vision versus pattern visual evoked potentials in the assessment of subclinical optic pathway involvement in multiple sclerosis

    Fatih C Gundogan

    2013-01-01

    Full Text Available Background: Optic pathway involvement in multiple sclerosis is frequently the initial sign in the disease process. In most clinical applications, pattern visual evoked potential (PVEP is used in the assessment of optic pathway involvement. Objective: To question the value of PVEP against color vision assessment in the diagnosis of subclinical optic pathway involvement. Materials and Methods: This prospective, cross-sectional study included 20 multiple sclerosis patients without a history of optic neuritis, and 20 healthy control subjects. Farnsworth-Munsell (FM 100-Hue testing and PVEPs to 60-min arc and 15-min arc checks by using Roland-Consult RetiScan® system were performed. P 100 amplitude, P 100 latency in PVEP and total error scores (TES in FM 100-Hue test were assessed. Results: Expanded Disability Status Scale score and the time from diagnosis were 2.21 ± 2.53 (ranging from 0 to 7 and 4.1 ± 4.4 years. MS group showed significantly delayed P 100 latency for both checks (P 0.05 for all. 14 MS patients (70% had an increased TESs in FM-100 Hue, 11 (55% MS patients had delayed P 100 latency and 9 (45% had reduced P 100 amplitude. The areas under the ROC curves were 0.944 for FM-100 Hue test, 0.753 for P 100 latency, and 0.173 for P 100 amplitude. Conclusions: Color vision testing seems to be more sensitive than PVEP in detecting subclinical visual pathway involvement in MS.

  15. Acute appendicitis mistaken as acute rejection in renal transplant recipients.

    Talwalkar N

    1994-01-01

    Full Text Available Case histories of 2 renal transplant recipients are reported who had presenting features of fever, leukocytosis and pain/tenderness over right iliac fossa and were diagnosed to be due to acute appendicitis rather than more commonly suspected acute rejection episode which has very similar features. Diagnosis of acute appendicitis was suspected on the basis of rectal examination and later confirmed by laparotomy. The purpose of this communication is to emphasize the need for proper diagnosis in patient with such presentation; otherwise wrong treatment may be received.

  16. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction

    Andreas; Kumar; Rodrigo; Bagur; Patrick; Béliveau; Jean-Michel; Potvin; Pierre; Levesque; Nancy; Fillion; Benoit; Tremblay; éric; Larose; Valérie; Gaudreault

    2014-01-01

    A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause.

  17. 光学相干断层成像评价植入不同药物洗脱架后的血管愈合情况%Evaluation by optical coherence tomography of vascular healing after drug-eluting stents implantation in acute myocardial infarction

    范春雨; Kim Jung-Sun; Kim Tae-Hoon; 吕吉元

    2011-01-01

    目的 应用光学相干断层成像(OCT)比较急性心肌梗死(AMI)患者植入不同药物洗脱支架(DES)后的新生内膜覆盖和支架贴壁情况以评估血管愈合.方法 49例AMI患者植入不同DES后9个月时进行OCT检查.其中20个雷帕霉素药物洗脱支架(SES,Cypher),12个紫杉醇药物洗脱支架(PES,Taxus)和17个雷帕霉素衍生物药物洗脱支架(ZES,Endeavor).每隔1 mm评估OCT横断面影像每个支架柱的新生内膜覆盖和贴壁情况,同时观察每个支架内的血栓发生情况.结果 总计对12 378个支架柱进行了分析.SES的新生内膜增生最少,新生内膜厚度:SES(77±60)μm、PES(153±82)μm、ZES(265±130)μm,且新生内膜增生面积百分比最低,SES(10±8)%、PES(19±8)%、ZES28±9)%,但SES和PES有更多未被新生内膜覆盖的支架柱,SES(15.1±16)%、PES(7.1±10)%、ZES(0.6±1.5)%,且贴壁不良支架柱的发生率也高于ZES,SES(3.8±7.2)%、PES(2.1±4.4)%、ZES(0±0)%,而有完全新生内膜覆盖的支架比例以ZES为高,SES 5%、PES33.3%、ZES 82.4%.血栓的发生率SES和PES高于ZFS,SES 34%、PES 33%、ZES 6%.结论 AMI患者植入不同类型DES后,其支架的新生内膜覆盖程度和贴壁不良的发生率是显著不同的,因此DES的类型可能影响了AMI血栓性病变的血管愈合过程.%Objective To compare neointimal coverage and stent malapposition after DESs implantation in patients with acute myocardial infarction using optical coherence tomography (OCT).Methods OCT was analyzed at 9-month after DESs implantation in 49 AMI patients [20 sirolimus eluting stent (SES, Cypher), 12 paclitaxel eluting stent (PES, Taxus) and 17 zotarolimus eluting stent (ZES,Endeavor)].Neointimal thickness and strut apposition were measured at each stent strut and every 1 mm corss section.Presence of thrombus was observed in each stent.Results In total, 12 378 stent struts were analyzed.SES had the least neointimal thickness (SES 77 ±60 μm vs PES 153 ±82 μ,m vs ZES

  18. Diffractive Optical Elements for Dynamic Optical Coupling

    2003-01-01

    Diffractive optical elements such as the complementary Dammann gratings are incorporated for dynamic optical fiber splitting and combining. Experimental results of 1×8 dynamic optical couplings are presented.

  19. Diffractive Optical Elements for Dynamic Optical Coupling

    Changhe Zhou; Xin Zhao; Liren Liu

    2003-01-01

    Diffractive optical elements such as the complementary Dammann gratings are incorporated for dynamic optical fiber splitting and combining. Experimental results of 1′8 dynamic optical couplings are presented.

  20. [Latest advances in acute pancreatitis].

    de-Madaria, Enrique

    2015-09-01

    The present article analyses the main presentations on acute pancreatitis at Digestive Disease Week 2015. Arterial pseudoaneurysm is an uncommon complication of acute pancreatitis (incidence 0.7%) and mortality from this cause is currently anecdotal. Diabetes mellitus has little impact on the clinical course of acute pancreatitis, unlike cirrhosis, which doubles the risk of mortality. Intake of unsaturated fat could be associated with an increased severity of acute pancreatitis and is a confounding factor in studies evaluating the relationship between obesity and morbidity and mortality. PET-CT (positron emission tomography-computed tomography) could be a non-invasive tool to detect infection of collections in acute pancreatitis. Peripancreatic fat necrosis is less frequent than pancreatic fat necrosis and is associated with a better clinical course. If the clinical course is poor, increasing the calibre of the percutaneous drains used in the treatment of infected necrosis can avoid surgery in 20% of patients. The use of low molecular-weight heparin in moderate or severe pancreatitis could be associated with a better clinical course, specifically with a lower incidence of necrosis. In acute recurrent pancreatitis, simvastatin is a promising drug for prophylaxis of new episodes of acute pancreatitis. Nutritional support through a nasogastric tube does not improve clinical course compared with oral nutrition. PMID:26520203

  1. Optical sorting due to optical binding

    Karásek, Vítězslav; Zemánek, Pavel

    Bellingham: SPIE, 2013, 881027:1-8. ISSN 0277-786X. [Optical Trapping and Optical Micromanipulation /10./. San Diego (US), 25.08.2013-29.08.2013] R&D Projects: GA ČR GPP205/12/P868 Institutional support: RVO:68081731 Keywords : optical binding * optical sorting * particles * optical trapping * bessel beam s * code division multiplexing * numerical simuklations Subject RIV: BH - Optics, Masers, Laser s

  2. [Cerebrolysin for acute ischemic stroke].

    iganshina, L E; Abakumova, T R

    2013-01-01

    The review discusses existing evidence of benefits and risks of cerebrolysin--a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue with proposed neuroprotective and neurotrophic properties, for acute ischemic stroke. The review presents results of systematic search and analysis of randomised clinical trials comparing cerebrolysin with placebo in patients with acute ischemic stroke. Only one trial was selected as meeting quality criteria. No difference in death and adverse events between cerebrolysin and placebo was established. The authors conclude about insufficiency of evidence to evaluate the effect of cerebrolysin on survival and dependency in people with acute ischemic stroke. PMID:23805635

  3. Cerebrogenic tachyarrhythmia in acute stroke

    A S Praveen Kumar

    2012-01-01

    Full Text Available The electrocardiac abnormalities following acute stroke are frequent and seen in both ischemic and hemorrhagic stroke. The changes seen in electrocardiogram (ECG consist of repolarization abnormalities such as ST elevation, ST depression, negative T waves, and QT prolongation. Among tachyarrhythmias, atrial fibrillation is the most common and occurrence of focal atrial tachycardia is very rare though any cardiac arrhythmias can follow acute stroke. We report a case of focal atrial tachycardia following acute ischemic stroke in 50-year-old female without structural heart disease, and their mechanisms and clinical implications.

  4. Applied optics and optical engineering v.9

    Shannon, Robert

    1983-01-01

    Applied Optics and Optical Engineering, Volume IX covers the theories and applications of optics and optical engineering. The book discusses the basic algorithms for optical engineering; diffraction gratings, ruled and holographic; and recording and reading of information on optical disks. The text also describes the perfect point spread function; the multiple aperture telescope diffraction images; and the displays and simulators. Ophthalmic optics, as well as the canonical and real-space coordinates used in the theory of image formation are also encompassed. Optical engineers and students tak

  5. Pharmacotherapy of Acute Lung Injury and Acute Respiratory Distress Syndrome

    Raghavendran, Krishnan; Pryhuber, Gloria S.; Chess, Patricia R.; Davidson, Bruce A.; Paul R. Knight; Notter, Robert H.

    2008-01-01

    Acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) are characterized by rapid-onset respiratory failure following a variety of direct and indirect insults to the parenchyma or vasculature of the lungs. Mortality from ALI/ARDS is substantial, and current therapy primarily emphasizes mechanical ventilation and judicial fluid management plus standard treatment of the initiating insult and any known underlying disease. Current pharmacotherapy for ALI/ARDS is not optimal, a...

  6. Acute Legionella pneumophila infection masquerading as acute alcoholic hepatitis

    Hunter, Jonathan Michael; Chan, Julian; Reid, Angeline Louise; Tan, Chistopher

    2013-01-01

    A middle-aged man had deteriorated rapidly in hospital after being misdiagnosed with acute alcoholic hepatitis. Acute Legionnaires disease (Legionellosis) was subsequently diagnosed on rapid antigen urinary testing and further confirmed serologically. This led to appropriate antibiotic treatment and complete clinical resolution. Physicians caring for patients with alcohol-related liver disease should consider Legionella pneumophila in their differential diagnosis even with a paucity of respir...

  7. Optic nerve atrophy

    Optic atrophy; Optic neuropathy ... There are many causes of optic atrophy. The most common is poor blood flow. This is called ischemic optic neuropathy. The problem most often affects older adults. ...

  8. Foveated optics

    Bryant, Kyle R.

    2016-05-01

    Foveated imaging can deliver two different resolutions on a single focal plane, which might inexpensively allow more capability for military systems. The following design study results provide starting examples, lessons learned, and helpful setup equations and pointers to aid the lens designer in any foveated lens design effort. Our goal is to put robust sensor in a small package with no moving parts, but still be able to perform some of the functions of a sensor in a moving gimbal. All of the elegant solutions are out (for various reasons). This study is an attempt to see if lens designs can solve this problem and realize some gains in performance versus cost for airborne sensors. We determined a series of design concepts to simultaneously deliver wide field of view and high foveal resolution without scanning or gimbals. Separate sensors for each field of view are easy and relatively inexpensive, but lead to bulky detectors and electronics. Folding and beam-combining of separate optical channels reduces sensor footprint, but induces image inversions and reduced transmission. Entirely common optics provide good resolution, but cannot provide a significant magnification increase in the foveal region. Offsetting the foveal region from the wide field center may not be physically realizable, but may be required for some applications. The design study revealed good general guidance for foveated optics designs with a cold stop. Key lessons learned involve managing distortion, telecentric imagers, matching image inversions and numerical apertures between channels, reimaging lenses, and creating clean resolution zone splits near internal focal planes.

  9. Fiber optic monitoring device

    Samborsky, James K.

    1993-01-01

    A device for the purpose of monitoring light transmissions in optical fibers comprises a fiber optic tap that optically diverts a fraction of a transmitted optical signal without disrupting the integrity of the signal. The diverted signal is carried, preferably by the fiber optic tap, to a lens or lens system that disperses the light over a solid angle that facilitates viewing. The dispersed light indicates whether or not the monitored optical fiber or system of optical fibers is currently transmitting optical information.

  10. An optical modulator

    Thévenaz, Luc; Dainesi, Paolo

    2003-01-01

    An optical modulator is arranged to compensate for the thermo-optical modulating effects induced by charge-injection based phase modulators. It comprises first modulator means (3), that receive optical radiation (11, 21), direct it along an optical path, apply a first predetermined optical phase modulation by the injection of free charges into the optical path, and output optical radiation (13, 22) so modulated. Compensator means (4) apply, to optical radiation output from (13, 22), or to be ...

  11. Acute stroke imaging research roadmap

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Koehrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Warach, Steven

    2008-01-01

    The recent "Advanced Neuroimaging for Acute Stroke Treatment" meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (

  12. Acute Theophylline Intoxication: Case Report

    Zehra Baykal Tutal

    2016-01-01

    Full Text Available Theophylline is an efficient bronchodilatator, which is used in the treatment of the disease such like Chronic Obstructive Pulmoner Disease (COPD neonatal apnea, bradycardial syndrome. Blood levels of theophylline above 15 ug/ml have risk of intoxication. Acute and chronic intoxication can be seen. Nausea, vomitin, agitation, palpitation and metabolic abnormalities such as, hyperglisemia, hypokalemia, impairment in acid base equilibrium and leukocytosis can be seen in acute theophylline intoxication. Acute theophylline intoxications can result life threatening situations such as convulsions, ventricular arrhythmias and death. Theophylline intoxications are often iatrogenic. In this case, the clinical course of a patient with COPD who took theophylline with the intention of suicide attempt is to mentioned and discussion of diagnosis, treatment and clinical course of acute theophylline intoxication was to aimed.

  13. Pipazethate--acute childhood poisoning.

    da Silva, O A; Lopez, M

    1977-01-01

    A previously healthy child who who had accidentally ingested an unknown quantity of 20-mg tablets of pipazethate developed severe acute poisoning with neurologic, metabolic, and cardiovascular disturbances. She recovered with symptomatic and supportive therapy. PMID:589958

  14. Thrombolysis in Acute Cerebrovascular Disease

    刘泽霖

    2003-01-01

    @@ Large-scale trials have shown that thrombolytic therapy reduces mortality and preserves left ventricular function in patients with acute myocardial infarction (AMI). That's a rationale for the use of thrombolytic agents in the management of ischemic stroke.

  15. Acute myelogenous leukemia (AML) -- children

    ... Leung WH, Pounds S, Cao X, e t al. Definition of cure in childhood acute myeloid leukemia. Cancer . ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  16. [Ascites and acute kidney injury].

    Piano, Salvatore; Tonon, Marta; Angeli, Paolo

    2016-07-01

    Ascites is the most common complication of cirrhosis. Ascites develops as a consequence of an abnormal splanchnic vasodilation with reduction of effecting circulating volume and activation of endogenous vasoconstrictors system causing salt and water retention. Patients with ascites have a high risk to develop further complications of cirrhosis such as hyponatremia, spontaneous bacterial peritonitis and acute kidney injury resulting in a poor survival. In recent years, new studies helped a better understanding of the pathophysiology of ascites and acute kidney injury in cirrhosis. Furthermore, new diagnostic criteria have been proposed for acute kidney injury and hepatorenal syndrome and a new algorithm for their management has been recommended with the aim of an early diagnosis and treatment. Herein we will review the current knowledge on the pathophysiology, diagnosis and treatment of ascites and acute kidney injury in patients with cirrhosis and we will identify the unmet needs that should be clarified in the next years. PMID:27571467

  17. ANTICOAGULANTS IN ACUTE CORONARY SYNDROME

    I. A. Latfullin; A. A. Podolskaya

    2016-01-01

    Clinical efficacy of unfractionated and low molecular heparins in acute coronary syndrome is discussed. New synthetic heparin derivative fondaparinux (Arixtra) is focused. Author’s brief experience of fondaparinux clinical implementation is presented.

  18. Polyhydramnios and acute renal failure

    Hamilton, D. V.; Kelly, Moira B.; Pryor, J. S.

    1980-01-01

    Acute renal failure secondary to ureteric obstruction is described in a primigravida with twin gestation and polyhydramnios. Relief of the obstruction occurred on drainage of the liquor and return to normal renal function following delivery.

  19. Prognosis of Acute Transverse Myelitis

    J Gordon Millichap; John J Millichap

    2014-01-01

    Investigators at Children's Hospital of Chongqing Medical University, China, reviewed children diagnosed with acute transverse myelitis (ATM) between 1995 and 2008 and selected 39 patients diagnosed according to the new Johns Hopkins Consortium criteria.

  20. Acute ischemic cerebral attack

    Franco-Garcia Samir

    2010-12-01

    Full Text Available The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violent death in the world and the first of disability. Many risk factors favor the presentation of these events and some of them are susceptible of modification and therfore are objetives of primary prevention just as the control of diabetes, hypertension and the practice of healthy habits of life. The advances in the knowledge of the physiopatology, had taken to sustantial change in the nomenclature and management of ischemic ACS. Within these changes it was substituted the term cerebrovascular accident fo acute stroke, making emphasis in the key rol of a timely management with goals of time similiar to the acute coronary syndrome. It was redefined the time of acute ischemic attack to a one hour. Once stablished the cerebrovascular attack the semiology of symtoms with frecuency will led us make a topographic diagnosis of the in injury that joined to the cerebral TAC will allow us to exclude an hemorragic event and to start the treatment. In the management of these patients its essential the coordination of the differents teams of work, from the early recognition of symtoms on the part of patients andthe family, the rapid activation and response of emergency systems and the gearing of health care institutions. Are pillars of treatment: the abcde of reanimatiion, to avoid the hiperpirexis, the seizures, the hipoglicemy, the hiperglicemy, to achieve the thrombolysis in the first three hours of the begining of symtoms, to use antiplatelets, antithrombotic profilaxis

  1. Acute Respiratory Distress Syndrome.

    Yadam, Suman; Bihler, Eric; Balaan, Marvin

    2016-01-01

    Acute respiratory distress syndrome (ARDS) is a serious inflammatory disorder with high mortality. Its main pathologic mechanism seems to result from increased alveolar permeability. Its definition has also changed since first being described according to the Berlin definition, which now classifies ARDS on a severity scale based on PaO2 (partial pressure of oxygen, arterial)/FIO2 (fraction of inspired oxygen) ratio. The cornerstone of therapy was found to be a low tidal volume strategy featuring volumes of 6 to 8 mL per kg of ideal body weight that has been shown to have decreased mortality as proven by the ARDSnet trials. There are other areas of treatment right now that include extracorporeal membrane oxygenation, as well for severe refractory hypoxemia. Other methods that include prone positioning for ventilation have also shown improvements in oxygenation. Positive end-expiratory pressure with lung recruitment maneuvers has also been found to be helpful. Other therapies that include vasodilators and neuromuscular agents are still being explored and need further studies to define their role in ARDS. PMID:26919679

  2. Acute subdural empyema

    The patient, a 19-year-old male, began suffering from severe headache, vomiting, and high fever. Two days later the patient was admitted in a semicomatose state and with left hemiplegia. Nuchal rigidity and choked disc were not noticed. WBC count was 12,500/mm3. CT scan disclosed marked swelling of the right cerebral hemisphere with midline shift. Except for a small lucent space in the parafalcial region, no extracerebral collection was noted in either pre- or post-contrast scans. Plain craniograms showed clouding of the left frontal, ethmoidal, and sphenoidal sinuses. Carotid angiography revealed prolongation of the circulation time and stenosis of the supraclinoidal portion of the right carotid artery. Right fronto-parietal decompressive craniectomy was performed. Subdural empyema was found and evacuated. Curettage and drainage of the empyema in the paranasal sinuses were also done. A bone defect 4 mm in diameter was detected on the medial-upper wall of the left frontal sinus. The causative organism was confirmed as α-Streptococcus. Both systemic and local antibiotics were administered and the patient recovered well and was discharged without any neurological deficit. The authors emphasized that cerebral angiography is necessary for its accurate diagnosis of subdural empyema in its acute stage and that emergency intracranial and rhino-otological operations should be concomitantly performed. (author)

  3. Acute pain transfusion reaction.

    Hardwick, Jody; Osswald, Michael; Walker, Daniel

    2013-11-01

    A 34-year-old woman with a diagnosis of hemophagocytic lymphohistocytosis (HLH) received a double umbilical cord blood transplantation following a myeloablative chemotherapy preparative regimen with busulfan and cyclophosphamide. HLH is a rare, potentially fatal hematologic disorder characterized by the overactivation of histocytes and T lymphocytes, leading to organ infiltration and acute illness. On day 25 post-transplantation, the patient required a platelet transfusion for a platelet count of 6,000 per ml (normal range = 150,000-450,000 per ml). The patient's blood type prior to the cord blood transplantation was B positive and, although both umbilical cord blood donors were O positive, the patient was still B positive per blood bank testing on that day. Although the recipient of an allogenic stem cell transplantation will eventually become the blood type of the donor, the time for this process to occur varies for each person. That process must be monitored by the blood bank for the purpose of cross-matching blood products to decrease hemolysis as much as possible. The patient was premedicated with the facility's standard for platelet transfusions: acetaminophen 650 mg and diphenhydramine 25 mg about 30 minutes prior to the platelet transfusion. PMID:24161631

  4. Acute diarrhea in children

    Radlović Nedeljko

    2015-01-01

    Full Text Available Acute diarrhea (AD is the most frequent gastroenterological disorder, and the main cause of dehydration in childhood. It is manifested by a sudden occurrence of three or more watery or loose stools per day lasting for seven to 10 days, 14 days at most. It mainly occurs in children until five years of age and particularly in neonates in the second half-year and children until the age of three years. Its primary causes are gastrointestinal infections, viral and bacterial, and more rarely alimentary intoxications and other factors. As dehydration and negative nutritive balance are the main complications of AD, it is clear that the compensation of lost body fluids and adequate diet form the basis of the child’s treatment. Other therapeutic measures, except antipyretics in high febrility, antiparasitic drugs for intestinal lambliasis, anti-amebiasis and probiotics are rarely necessary. This primarily regards uncritical use of antibiotics and intestinal antiseptics in the therapy of bacterial diarrhea. The use of antiemetics, antidiarrhetics and spasmolytics is unnecessary and potentially risky, so that it is not recommended for children with AD.

  5. [Acute gastrointestinal bleeding].

    Baumbach, Robert; Faiss, Siegbert; Cordruwisch, Wolfgang; Schrader, Carsten

    2016-04-01

    Acute gastrointestinal bleeding is a common major emergency (Internal medical or gastroenterological or medical), approximately 85 % of which occur in the upper GI tract. It is estimated that about a half of upper GI bleeds are caused by peptic ulcers. Upper GI bleeds are associated with more severe bleeding and poorer outcomes when compared to middle or lower GI bleeds. Prognostic determinants include bleeding intensity, patient age, comorbid conditions and the concomitant use of anticoagulants. A focused medical history can offer insight into the bleeding intensity, location and potential cause (along with early risk stratification). Initial measures should focus on rapid assessment and resuscitation of unstable patients. The oesophagogastroduodenoscopy (OGD) is the gold standard method for localizing the source of bleeding and for interventional therapy. Bleeding as a result of peptic ulcers is treated endoscopically with mechanical and / or thermal techniques in combination with proton pump inhibitor (PPI) therapy. When variceal bleeding is suspected, pre-interventional use of vasopressin analogues and antibiotic therapies are recommended. Endoscopically, the first line treatment of esophageal varices is endoscopic ligature therapy, whereas that for gastric varices is the use of Histoacryl injection sclerotherapy. When persistent and continued massive hemorrhage occurs in a patient with known or suspected aortic disease the possibility of an aorto-enteric fistula must be considered. PMID:27078246

  6. Acute pancreatitis following paracetamol overdose

    Fernandes, Roland

    2009-01-01

    A 17-year-old woman presented with acute abdominal pain and vomiting 3 h after she attempted to commit suicide by ingesting 30×500 mg paracetamol tablets. The woman was found to have a raised amylase level, and a CT scan confirmed the diagnosis of acute pancreatitis. According to the Naranjo adverse drug reaction probability scale, it is likely that the pancreatitis was induced by the paracetamol ingestion. A literature search reported 36 cases of pancreatitis following excessive doses of par...

  7. Prognostic Indicators in Acute Pancreatitis

    2003-01-01

    Several approaches have been used in an attempt to predict the severity and prognosis of attacks of acute pancreatitis. The Ranson and Glasgow criteria include a variety of simple laboratory parameters that are measured on admission and again within 48 h. They are the most widely used indices in clinical practice. The Acute Physiological and Chronic Health Evaluation II system is more complicated, but can be applied to a wide variety of conditions, especially in intensive care settings. The u...

  8. The acute respiratory distress syndrome

    Modrykamien, Ariel M.; Gupta, Pooja

    2015-01-01

    The acute respiratory distress syndrome (ARDS) is a major cause of acute respiratory failure. Its development leads to high rates of mortality, as well as short- and long-term complications, such as physical and cognitive impairment. Therefore, early recognition of this syndrome and application of demonstrated therapeutic interventions are essential to change the natural course of this devastating entity. In this review article, we describe updated concepts in ARDS. Specifically, we discuss t...

  9. Biomarkers in Acute Lung Injury

    Bhargava, Maneesh; Wendt, Chris

    2012-01-01

    Acute Respiratory Distress Syndrome (ARDS) and Acute Lung Injury (ALI) result in high permeability pulmonary edema causing hypoxic respiratory failure with high morbidity and mortality. As the population ages, the incidence of ALI is expected to rise. Over the last decade, several studies have identified biomarkers in plasma and bronchoalveolar lavage fluid providing important insights into the mechanisms involved in the pathophysiology of ALI. Several biomarkers have been validated in subjec...

  10. Cerebrogenic tachyarrhythmia in acute stroke

    A S Praveen Kumar; Babu, E; D K Subrahmanyam

    2012-01-01

    The electrocardiac abnormalities following acute stroke are frequent and seen in both ischemic and hemorrhagic stroke. The changes seen in electrocardiogram (ECG) consist of repolarization abnormalities such as ST elevation, ST depression, negative T waves, and QT prolongation. Among tachyarrhythmias, atrial fibrillation is the most common and occurrence of focal atrial tachycardia is very rare though any cardiac arrhythmias can follow acute stroke. We report a case of focal atrial tachycardi...

  11. Amebiasis presenting as acute appendicitis.

    Andrade, Javier E; Mederos, Raul; Rivero, Haidy; Sendzischew, Morgan A; Soaita, Mauela; Robinson, Morton J; Sendzischew, Harry; Danielpour, Payman

    2007-11-01

    Amebiasis presenting as acute appendicitis is extremely rare. The case of a 38-year-old Hispanic man who presented to the hospital with symptoms and signs suggestive of acute appendicitis is reported. He underwent laparoscopic appendectomy and the pathologic examination of the appendix revealed multiple trophozoites of Entamoeba histolytica. The patient was treated postoperatively with metronidazole for amebiasis, and follow-up stool studies showed no sign of residual infection. The patient has remained asymptomatic. PMID:17984748

  12. Acute Echinococcosis: a Case Report

    Di Comite, Gabriele; Dognini, Giuseppina; Gaiera, Giovanni; Ieri, Rossella; Praderio, Luisa

    2000-01-01

    We report the case of a 69-year-old man with acute pulmonary echinococcosis. A computed tomographic scan of the thorax revealed the presence of multiple nodules in both lungs, and laboratory tests showed eosinophilia and the presence of antibodies against Echinococcus granulosus. Therapy with albendazole led to resolution of the pulmonary nodules and a normalization of the white cell count. To our knowledge this is the first described case of acute echinococcosis, as the diagnosis of this dis...

  13. Enteroviruses in Acute Myocardial Infarction

    A Gholoobi; MS Nabavinia; T Mohamadpoor; MS Alavi; Z Meshkat

    2012-01-01

    Background: Human enteroviruses (EVs) may have a role as a possible risk factor in the pathogenesis of MI. The aim of this study was to evaluate the presence of enterovirus genomic RNA in peripheral blood samples of patients with acute myocardial infarction (MI). Methods: We investigated the presence of enterovirus genomic RNA in the peripheral blood of 115 patients with acute MI hospitalized in the Coronary Care Unit of Imam Reza and Ghaem University Hospitals (Mashhad, Iran) by RT-PCR using...

  14. Acute pancreatitis complicating severe dengue

    Vishakha Jain; O P Gupta; Tarun Rao; Siddharth Rao

    2014-01-01

    Dengue is an arthropod borne viral infection endemic in tropical and subtropical continent. Severe dengue is life threatening. Various atypical presentations of dengue have been documented. But we present a rare and fatal complication of severe dengue in form of acute pancreatitis. A 27-year-old male had presented with severe dengue in decompensated shock and with pain in abdomen due to pancreatitis. The pathogenesis of acute pancreatitis in dengue is not clearly understood, but various mecha...

  15. Pizotifen relieves acute migraine symptoms

    A.S.M. Kamrul Huda

    2008-01-01

    Full Text Available To The Editor: Various pharmacological agents are used for the treatment of migraine. In the last five years, various drug companies in Bangladesh have been marketing pizotifen as a preventive treatment of all types of migraine. Pizotifen is a serotonin antagonist acting mainly at the 5-HT1, 5-HT2A and 5HT2C receptors. It also has some activity as an antihistamine (1. Pizotifen is a well-established preventative therapy of migraine. I would like to report my own experience in using pizotifen in treating the acute attacks of migraine. Pizotifen was prescribed as acute therapy in 11 patients, 6 females (4 had migraine without aura and 2 had migraine with aura and 5 males (all had migraine without aura. Three female and 5 male patients, who had migraine without aura, reported no beneficial effect of pizotifen as treatment for the acute attacks. Three female patients (two with migraine with aura and one with migraine without aura had their headache relieved by use of pizotifen as treatment for the acute attacks. This is an initial observation about the effectiveness of pizotifen as acute therapy in migraine. However, this could be simply a placebo affect. Nevertheless, it will be worth exploring the role of pizotifen as a therapeutic agent for acute attacks of migraine by conducting well-designed randomized, controlled studies.

  16. Medical management of hereditary optic neuropathies

    ChiaraLa Morgia

    2014-07-01

    Full Text Available Hereditary optic neuropathies are diseases of the optic nerve. The most common are mitochondrial hereditary optic neuropathies, i.e. the maternally inherited Leber’s Hereditary Optic Neuropathy (LHON and Dominant Optic Atrophy (DOA. They both share a mitochondrial pathogenesis that leads to the selective loss of retinal ganglion cells and axons, in particular of the papillo-macular bundle. Typically, LHON is an acute/subacute loss of central vision associated with impairment of color vision and swelling of retinal nerve fibers followed by optic atrophy. DOA, instead, is characterized by a childhood-onset and slowly progressive loss of central vision, worsening over the years, leading to optic atrophy. The diagnostic workup includes neuro-ophthalmologic evaluation and genetic testing of the three most common mitochondrial DNA mutations affecting complex I (11778/ND4, 3460/ND1 and 14484/ND6 for LHON and sequencing of the nuclear gene OPA1 for DOA. Therapeutic strategies are limited including agents that bypass the complex I defect and exert an antioxidant effect (idebenone. Further strategies are aimed at stimulating compensatory mitochondrial biogenesis. Gene therapy is also a promising venue that still needs to be validated.

  17. Acute Reversible Mania as a Presenting Feature Of Vitamin B12 Deficiency

    Kumar S

    2004-01-01

    Full Text Available Vitamin B12 deficiency usually presents with hematological or neuropsychiatric manifestations. The common clinical presentations include pernicious anemia, myelopathy (Subacute combined degeneration of the cord, myeloneuropathy, optic atrophy, dementia and psychosis. An uncommon manifestation of Vitamin B12 deficiency-acute onset mania-in a 25-years old man that responded to treatment is reported. Relevant literature is also reviewed.

  18. Acute Reversible Mania as a Presenting Feature Of Vitamin B12 Deficiency

    Kumar S

    2004-01-01

    Vitamin B12 deficiency usually presents with hematological or neuropsychiatric manifestations. The common clinical presentations include pernicious anemia, myelopathy (Subacute combined degeneration of the cord), myeloneuropathy, optic atrophy, dementia and psychosis. An uncommon manifestation of Vitamin B12 deficiency-acute onset mania-in a 25-years old man that responded to treatment is reported. Relevant literature is also reviewed.

  19. Contemporary Management of Acute Biliary Pancreatitis

    Orhan Ozkan

    2014-01-01

    Acute biliary pancreatitis is one of the major causes of acute pancreatitis.Gallstones, biliary sludge and microlithiasis, especially in pancreatitis without detectable reason, can be the cause of acute pancreatitis. Acute biliary pancreatitis has many controversions in the literature, and its classification and guidelines are being updated very frequently. Atlanta classifications which determine the definitions and guidelines about acute pancreatitis were renewed and published in 2013. It ha...

  20. Cloud optics

    Kokhanovsky, A

    2006-01-01

    Clouds affect the climate of the Earth, and they are an important factor in the weather. Therefore, their radiative properties must be understood in great detail. This book summarizes current knowledge on cloud optical properties, for example their ability to absorb, transmit, and reflect light, which depends on the clouds' geometrical and microphysical characteristics such as sizes of droplets and crystals, their shapes, and structures. In addition, problems related to the image transfer through clouds and cloud remote sensing are addressed in this book in great detail. This book can be an im

  1. Optical coupling

    Bock, J J [Jet Propulsion Laboratory, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Gundersen, J [Department of Physics, University of Miami, Coral Gables, FL 33146 (United States); Lee, A T [Department of Physics, University of California, Berkeley CA 94720 Physics Division, Lawrence Berkeley National Laboratory, Berkeley CA 94720 (United States); Richards, P L [Department of Physics, University of California, Berkeley CA 94720 (United States); Wollack, E, E-mail: James.Bock@jpl.nasa.go, E-mail: gunder@physics.miami.ed, E-mail: Adrian.Lee@berkeley.ed, E-mail: Richards@cosmology.berkeley.ed, E-mail: Edward.j.wollack@nasa.go [Observational Cosmology Laboratory, NASA/GSFC, Greenbelt, MD 20771 (United States)

    2009-03-01

    This paper describes contributions to the CMBpol Technology Study Workshop concerning optical coupling structures. These are structures in or near the focal plane which convert the free space wave to a superconducting microstrip on a SI wafer, or to the waveguide input to a HEMT receiver. In addition to an introduction and conclusions by the editor, this paper includes independent contributions by Bock on 'Planar Antenna-Coupled Bolometers for CMB Polarimetry', by Gunderson and Wollack on 'Millimeter-Wave Platlet Feeds', and by Lee on 'Multi-band Dual-Polarization Lens-coupled Planar Antennas for Bolometric CMB polarimetry.'

  2. Topiramate-induced angle closure with acute myopia, macular striae

    S Natesh

    2010-01-01

    Full Text Available Topiramate is a sulfamate-substituted monosaccharide used in the treatment of seizures, and prophylaxis of migraine. A number of ocular side-effects have been described with use of topiramate, like bilateral angle closure, acute myopia and macular striae. Ultrasound biomicroscopy (UBM clinches the diagnosis after ruling out other causes of shallow anterior chamber. Previous studies have not demonstrated internal limiting membrane folds presenting as macular striae. We report a case of topiramate-induced acute myopia with angle closure and macular striae in a young adult. This is the first report wherein striae formation after low doses of topiramate and their resolution have been documented by Optical Coherence Tomography (OCT.

  3. EDITORIAL: Optical orientation Optical orientation

    SAME ADDRESS *, Yuri; Landwehr, Gottfried

    2008-11-01

    priority of the discovery in the literature, which was partly caused by the existence of the Iron Curtain. I had already enjoyed contact with Boris in the 1980s when the two volumes of Landau Level Spectroscopy were being prepared [2]. He was one of the pioneers of magneto-optics in semiconductors. In the 1950s the band structure of germanium and silicon was investigated by magneto-optical methods, mainly in the United States. No excitonic effects were observed and the band structure parameters were determined without taking account of excitons. However, working with cuprous oxide, which is a direct semiconductor with a relative large energy gap, Zakharchenya and his co-worker Seysan showed that in order to obtain correct band structure parameters, it is necessary to take excitons into account [3]. About 1970 Boris started work on optical orientation. Early work by Hanle in Germany in the 1920s on the depolarization of luminescence in mercury vapour by a transverse magnetic field was not appreciated for a long time. Only in the late 1940s did Kastler and co-workers in Paris begin a systematic study of optical pumping, which led to the award of a Nobel prize. The ideas of optical pumping were first applied by Georges Lampel to solid state physics in 1968. He demonstrated optical orientation of free carriers in silicon. The detection method was nuclear magnetic resonance; optically oriented free electrons dynamically polarized the 29Si nuclei of the host lattice. The first optical detection of spin orientation was demonstrated by with the III-V semiconductor GaSb by Parsons. Due to the various interaction mechanisms of spins with their environment, the effects occurring in semiconductors are naturally more complex than those in atoms. Optical detection is now the preferred method to detect spin alignment in semiconductors. The orientation of spins in crystals pumped with circularly polarized light is deduced from the degree of circular polarization of the recombination

  4. Acute disseminated encephalomyelitis.

    Murthy J

    2002-07-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is an uncommon inflammatory demyelinating disease of the central nervous system. The true incidence of the disease in India is undetermined and is likely to be more frequent than reported, as the common antecedent events, exanthematous fevers and Semple antirabies vaccination, which predispose to ADEM, are still prevalent. The existing evidence suggests that ADEM results from a transient autoimmune response towards myelin or other self-antigens, possibly via molecular mimicry, or by non-specific activation of auto-reactive T cell clones. ADEM is a monophasic illness with favourable long-term outcome. Involvement of neuroaxis is variable and can be diffuse or multifocal and site restricted. Magnetic resonance imaging (MRI is highly sensitive in detecting white matter lesions and the lesions described are rather extensive and subcortical in location. Involvement of the deep gray matter, particularly basal ganglia, is more frequent. Oligoclonal bands in CSF are usually absent. No therapy has been established by controlled trials in ADEM. Use of high-dose methylprednisolone, plasma exchange, and IVIG are based on the analogy of the pathogenesis of ADEM with that of multiple sclerosis (MS. Differentiation of ADEM from the first attack of MS is important from prognostic as well as therapeutic point of view. However, in the absence of biological marker, at times differentiation of ADEM from the initial presentation of MS may not be possible even by combination of clinical, CSF analysis, and MRI. This differentiation is more relevant to India where the incidence of MS is low.

  5. Activation and Regulation of Hemostasis in Acute Liver Failure and Acute Pancreatitis

    Lisman, Ton; Porte, Robert J.

    2010-01-01

    Acute liver failure and acute pancreatitis are accompanied by substantial changes in the hemostatic system. In acute liver failure, defective synthesis of coagulation factors and intravascular activation of coagulation results in thrombocytopenia and reduced levels of proteins involved in coagulatio

  6. Acute liver failure and acute kidney injury: Definitions, prognosis, and outcome

    Włodzimirow, K.A.

    2013-01-01

    The objective of this thesis was to investigate definitions, prognostic indicators and their association with adverse events, mainly mortality for acute liver failure (ALF), acute-on-chronic liver failure (ACLF) and acute kidney injury (AKI).

  7. Review: Acute phase reaction and acute phase proteins

    GRUYS E.; TOUSSAINT M.J.M.; NIEWOLD T.A.; KOOPMANS S.J.

    2005-01-01

    A review of the systemic acute phase reaction with major cytokines involved, and the hepatic metabolic changes,negative and positive acute phase proteins (APPs) with function and associated pathology is given. It appears that APPs represent appropriate analytes for assessment of animal health. Whereas they represent non-specific markers as biological effect reactants,they can be used for assessing nutritional deficits and reactive processes, especially when positive and negative acute phase variables are combined in an index. When such acute phase index is applied to separate healthy animals from animals with some disease, much better results are obtained than with single analytes and statistically acceptable results for culling individual animals may be reached.Unfortunately at present no cheap, comprehensive and easy to use system is available for assessing various acute phase proteins in serum or blood samples at the same time. Protein microarray or fluid phase microchip technology may satisfy this need;and permit simultaneous analysis of numerous analytes in the same small volume sample and enable integration of information derived from systemic reactivity and nutrition with disease specific variables. Applying such technology may help to solve health problems in various countries not only in animal husbandry but also in human populations.

  8. Optical interconnect assembly

    Laughlin, Daric; Abel, Philip

    2015-06-09

    An optical assembly includes a substrate with a first row of apertures and a second row of apertures. A first optical die includes a first plurality of optical transducer elements and is mounted on the substrate such that an optical signal interface of each transducer element is aligned with an aperture of the first row of optical apertures. A second optical die includes a second plurality of optical transducer elements and is mounted on the substrate such that an optical signal interface of each of the second plurality of optical transducer elements is aligned with an aperture of the second row of optical apertures. A connector configured to mate with the optical assembly supports a plurality of optical fibers. A terminal end of each optical fiber protrudes from the connector and extends into one of the apertures when the connector is coupled with the optical assembly.

  9. EDITORIAL: Optical orientation Optical orientation

    SAME ADDRESS *, Yuri; Landwehr, Gottfried

    2008-11-01

    priority of the discovery in the literature, which was partly caused by the existence of the Iron Curtain. I had already enjoyed contact with Boris in the 1980s when the two volumes of Landau Level Spectroscopy were being prepared [2]. He was one of the pioneers of magneto-optics in semiconductors. In the 1950s the band structure of germanium and silicon was investigated by magneto-optical methods, mainly in the United States. No excitonic effects were observed and the band structure parameters were determined without taking account of excitons. However, working with cuprous oxide, which is a direct semiconductor with a relative large energy gap, Zakharchenya and his co-worker Seysan showed that in order to obtain correct band structure parameters, it is necessary to take excitons into account [3]. About 1970 Boris started work on optical orientation. Early work by Hanle in Germany in the 1920s on the depolarization of luminescence in mercury vapour by a transverse magnetic field was not appreciated for a long time. Only in the late 1940s did Kastler and co-workers in Paris begin a systematic study of optical pumping, which led to the award of a Nobel prize. The ideas of optical pumping were first applied by Georges Lampel to solid state physics in 1968. He demonstrated optical orientation of free carriers in silicon. The detection method was nuclear magnetic resonance; optically oriented free electrons dynamically polarized the 29Si nuclei of the host lattice. The first optical detection of spin orientation was demonstrated by with the III-V semiconductor GaSb by Parsons. Due to the various interaction mechanisms of spins with their environment, the effects occurring in semiconductors are naturally more complex than those in atoms. Optical detection is now the preferred method to detect spin alignment in semiconductors. The orientation of spins in crystals pumped with circularly polarized light is deduced from the degree of circular polarization of the recombination

  10. Diagnosis of acute necrotizing pancreatitis and acute hemorrhagic pancreatitis in 5 severe acute pancreatitis by plain computed tomography

    The diagnosis of acute pancreatitis is still mainly based on the clinical signs and symptoms of patients. In a prospective study of 64 patients with acute pancreatitis, computed tomography (CT) findings were correlated with the clinical types of acute pancreatitis. We were able to correctly diagnose 3 acute necrotizing pancreatitis with autopsy and 2 acute hemorrhagic pancreatitis by plain CT about 48 hours after onset. At present, CT about 48 hours after onset seems to be the most accurate method for the early detection of necrotizing, hemorrhagic and edematous forms of acute pancreatitis. (author)

  11. Acute dengue myositis with rhabdomyolysis and acute renal failure

    Acharya Sourya

    2010-01-01

    Full Text Available Dengue is an acute mosquito-borne infection caused by dengue viruses from the genus flavivirus. Neurologic complications have been attributed chiefly to metabolic alterations and to focal and sometimes massive intracranial haemorrhages, but anecdotal cases and limited case series have indicated the possibility of viral CNS and skeletal muscle invasion causing encephalitis and myositis. We present a case of a 40-year-old male who presented with severe dengue myositis resulting in quadriparesis, respiratory failure and acute renal failure with red urine. His elevated serum creatine kinase (CK, serum and urine myoglobin levels justified rhabdomyolysis as the cause of acute renal failure. A muscle biopsy revealed inflammatory myositis. He required ventilator support for respiratory failure and was treated conservatively. This case highlights the severe and persistent muscle involvement in dengue which is a rarity.

  12. Pathogenesis of acute lung injury in severe acute pancreatitis

    SHI Lei; YUE Yuan; ZHANG Mei; PAN Cheng-en

    2005-01-01

    Objective:To study the pathogenesis of acute lung injury in severe acute pancreatitis (SAP). Methods:Rats were sacrificed at 1, 3, 5, 6, 9 and 12 h after establishment of inducing model. Pancreas and lung tissues were obtained for pathological study, microvascular permeability and MPO examination. Gene expressions of TNF-α and ICAM-1 in pancreas and lung tissues were detected by RT-PCR. Results:After inducing SAP model, the injury degree of the pancreas and the lung increased gradually, accompanied with gradually increased MPO activity and microvascular permeability. Gene expressions of TNF-α and ICAM-1 in pancreas rose at 1 h and reached peak at 7 h. Relatively, their gene expressions in the lungs only rose slightly at 1 h and reached peak at 9-12 h gradually. Conclusion:There is an obvious time window between SAP and lung injury, when earlier protection is beneficial to prevent development of acute lung injury.

  13. The acute abdomen in childhood

    The acute abdomen in childhood demands early diagnosis for the sake of appropriate and early therapy. A high number of differential diagnosis in the assessment of acute abdominal pain and problems, as well as different causes of diseases in different age of the children, make a partition with respect to the age of the children considerable. A partition in diseases, which are leading to acute abdominal pain in neonates, in toddlers and small infants and in schoolchildren makes sense. In older schoolchildren and adolescents also diseases of the grown up generation are possible as a cause of acute abdominal pain. The lack of compliance (cooperation and communication) in small children obstructs clinical and radiological assessment and elucidates the necessity of knowledge of causes of acute abdominal pain as much as possible. A lot of patience and experience are mandatory in the evaluation of small children and therefore make a dedicated, trained and experienced stuff necessary. A dedicated paediatric radiologist will find a safe and proper technique, and in cooperation with the referring clinician the necessary decision for therapy will be made. (orig.)

  14. Echography in appendicitis acute diagnosis

    Over an 18-month period, high resolution ultrasound was used to assess 220 patients with doubtful clinical diagnosis of acute appendicitis. The ultrasonographic findings were correlated with the surgical results and the pathological results in 115 cases, and with clinical follow-up in the rest. This technique has been found to be effective in the diagnosis of acute appendicitis, with a sensitivity of 90.4%, and similar specificity and reliability (90.2%). The positive predictive value of the test was 89% and the negative predictive value, 91%. The ultrasonographic criteria applied for the diagnosis of acute appendicitis was the detection of an understood appendix measuring over 6 mm. All cases with perforation were correctly diagnosed as acute appendicitis. The observation of an accumulation of fluid pooled in DIF in patients with ultrasonographic findings suggestive of appendicitis points to a diagnosis of perforation or complicated (gangrenous) appendicitis. A relationship between complicated appendicitis and the detection of appendicoliths within the enlarged appendix was also observed. The results obtained demonstrate that high resolution ultrasound is indicated in the diagnosis of acute appendicitis in all cases in which the clinical findings are doubtful

  15. Ultrasonographic diagnosis of acute appendicitis

    Acute appendicitis is the most common surgical disease of acute abdomen, But the diagnosis of acute appendicitis is often difficult, and not in frequently, operation for appendicitis is performed only to find a normal appendix. Various radiological examinations have been proposed to improve diagnostic accuracy of appendicitis. The purpose of this study was to improve the diagnostic accuracy of appendicitis, and to decline negative exploration. High resolution real time ultrasonographical examination using graded compression was performed in 57 consecutive patients who were clinically suspected of appendicitis. Autors analysed ultrasonographical, surgical, and clinical follow up findings. The results were are follows: 1. Ultrasonographical finding of acute appendicitis was visualization of appendix as a tubular structure with one bline end, or target phenomenon. 2. Hypoechoic area over the appendix was thought to be a sign of periappendiceal abscess. 3. The sensitivity of US diagnosis of acute appendicitis in this study was 92.8% with a specificity of 93.1%. The overall accuracy was 93.0%. 4. In control group of 50 individuals, the abnormal appendix was not visualized. 5. In cases of clinically suspected appendicitis, the US evaluation with graded compression technique is very accurate and effective examination.

  16. Acute childhood leukemia: Nursing care

    Modern therapy for childhood acute leukemia has provided a dramatically improved prognosis over that of just 30 years ago. In the early 1960's survival rates for acute lymphocytic leukemia (ALL) and acute myelogenous leukemia (AML) were 4% and 3%, respectively. By the 1980's survival rates had risen to 72% for all and 25% to 40% for AML. Today, a diagnosis of all carries an 80% survival rate and as high as a 90% survival rate for some low-risk subtypes. Such high cure rates depend on intense and complex, multimodal therapeutic protocols. Therefore, nursing care of the child with acute leukemia must meet the demands of complicated medical therapies and balance those with the needs of a sick child and their concerned family. An understanding of disease process and principles of medical management guide appropriate and effective nursing interventions. Leukemia is a malignant disorder of the blood and blood- forming organs (bone marrow, lymph nodes and spleen). Most believe that acute leukemia results from a malignant transformation of a single early haematopoietic stem cell that is capable of indefinite self-renewal. These immature cells of blasts do not respond to normal physiologic stimuli for differentiation and gradually become the predominant cell in the bone marrow

  17. [Acute and subacute chemical pneumonitis].

    Andujar, P; Nemery, B

    2009-10-01

    Acute or subacute chemical-induced lung injury is rarely compound specific and is most often caused by an accidental occupational, domestic or environmental exposure to an inhaled chemical agent. The industrial disaster that happened in Bhopal in 1984, accidental poisoning with chlorine and petroleum hydrocarbons and also vesicant gases used during conflicts, are specific examples. Rarely, a chemical agent can cause lung damage by being ingested and reaching the lung through the systemic circulation (for example accidental or deliberate paraquat ingestion). Household accidents should not be underestimated. An important cause of household accidents is chlorine inhalation resulting from mixing bleach with acids such as the scale removers used to clean toilets. Chemical agents can provoke direct and/or indirect damage to the respiratory tract. The acute or subacute clinical manifestations resulting from inhalation of chemical agents are very varied and include inhalation fevers, acute non-cardiogenic pulmonary oedema, adult respiratory distress syndrome, reactive airways dysfunction syndrome and acute or subacute pneumonitis. The site and the severity of chemical-induced respiratory damage caused by inhaled chemical agents depend mainly on the nature and the amount of the agent inhaled. The immediate and long-term prognosis and possible sequelae are also variable. This review excludes infectious or immunologically induced acute respiratory diseases. PMID:19953031

  18. The optical communications reference

    DeCusatis, Casimer

    2009-01-01

    Extracting key information from Academic Press's range of prestigious titles in optical communications, this reference gives the R&D optical fiber communications engineer a quick and easy-to-grasp understanding of the current state of the art in optical communications technology, together with some of the underlying theory, covering a broad of topics: optical waveguides, optical fibers, optical transmitters and receivers, fiber optic data communication, optical networks, and optical theory. With this reference, the engineer will be up-to-speed on the latest developments in no-time. <

  19. Advances in nonlinear optics

    Chen, Xianfeng; Zeng, Heping; Guo, Qi; She, Weilong

    2015-01-01

    This book presents an overview of the state of the art of nonlinear optics from weak light nonlinear optics, ultrafast nonlinear optics to electro-optical theory and applications. Topics range from the fundamental studies of the interaction between matter and radiation to the development of devices, components, and systems of tremendous commercial interest for widespread applications in optical telecommunications, medicine, and biotechnology.

  20. [Pharmacological treatment of acute cough].

    Småbrekke, Lars; Melbye, Hasse

    2009-05-14

    Acute cough may cause considerable distress for patients with upper airway infections, and is a symptom commonly presented to doctors. We wanted to assess the evidence basis for pharmacological treatment of this condition. Predefined terms (MeSH and Emtree) and free text were used to search PubMed and Embase for double-blind randomized trials, reviews and guidelines. Little evidence supports the use of guaifenesine, bromhexine and acetylcysteine for acute cough associated with upper airway infections. Likewise, there is insufficient evidence to decide whether noscapine, codeine and ehylmorphine are beneficial for acute cough on this indication. Well-designed randomized controlled trials with valid outcomes are needed to document possible benefits of treatment. Treatment with codeine or ethylmorphine may be at the expense of adverse effects, abuse or dependence. PMID:19448753

  1. Antibiotics for acute maxillary sinusitis

    Ahovuo-Saloranta, Anneli; Borisenko, Oleg V; Kovanen, Niina;

    2008-01-01

    antibiotics from different classes for acute maxillary sinusitis in adults. We included trials with clinically diagnosed acute sinusitis, whether or not confirmed by radiography or bacterial culture. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened search results, extracted......BACKGROUND: Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care. OBJECTIVES: We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes are the...... most effective. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2007, Issue 3); MEDLINE (1950 to May 2007) and EMBASE (1974 to June 2007). SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing antibiotics with placebo or...

  2. Unilateral acute idiopathic maculopathy. 1991.

    Yannuzzi, Lawrence A; Jampol, Lee M; Rabb, Maurice F; Sorenson, John A; Beyrer, Charles; Wilcox, Lloyd M

    2012-02-01

    This is a report of nine patients who experienced sudden, severe, unilateral central vision loss following a flulike illness. Each patient had an exudative detachment of the macula. All patients experienced a spontaneous resolution of the acute macular manifestations with near-complete recovery of vision. A characteristic "bull's-eye" appearance in the macula persisted. The acute manifestations of the disorder did not recur in any of the patients during the period of follow-up. The constellation of findings was suggestive of an inflammatory disease of the retinal pigment epithelium, but a specific causative agent could not be identified. The acute clinical and angiographic features, the natural course, and the residual pigment epithelial derangement were not consistent with any previously described disorder. PMID:22451959

  3. Management of Acute Skin Trauma

    Joel W. Beam

    2010-01-01

    @@ Acute skin trauma (ie, abrasions, avulsions, blisters, incisions, lacerations, and punctures) is common among individuals involved in work, recreational, and athletic activities. Appropriate management of these wounds is important to promote healing and lessen the risk of cross-contamination and infection. Wound management techniques have undergone significant changes in the past 40 years but many clinicians continue to manage acute skin trauma with long-established, traditional techniques (ie, use of hydrogen peroxide, adhesive strips/patches, sterile gauze, or no dressing) that can delay healing and increase the risk of infection. The purpose of this review is to discuss evidence-based cleansing, debridement, and dressing techniques for the management of acute skin trauma.

  4. Surgical treatment of acute pancreatitis

    Klose, K.J.; Neher, M.; Kuhn, F.P.; Kuemmerle, F.; Thelen, M.

    1983-03-31

    The diagnosis of acute pancreatitis is based on anamnestic, clinical and chemical data. Ultrasound and computed tomography permit direct visualisation of the pancreas and establish the diagnosis. In cases of haemorrhagic-necrotising pancreatitis they demonstrate the extent of morphological changes and permit exclusion of other causes of an acute abdomen. The imaging methods support indications for operation in cases of subtotal or total parenchymatous necrosis and in pancreatic abscesses. Conservative expectant approaches in patients with severe clinical course and slight morphological changes as well as in agreement of clinical and morphological findings are facilitated. Complete demonstration of parenchymatous and peripancreatic necroses furnishes useful additional information for total extirpation. Gallstone disease can be demonstrated or excluded preoperatively. Since introduction of ultrasound and computed tomography for the diagnosis of acute pancreatitis a marked diminution of early surgical intervention and delayed operation has been achieved.

  5. Plasma cytokines in acute stroke

    Christensen, Hanne Krarup; Boysen, Gudrun; Christensen, Erik;

    2011-01-01

    months later plasma levels of interleukin 1 beta (IL-1beta), tumor necrosis factor alpha (TNF-alpha), interleukin-1 receptor antagonist (IL-1RA), interleukin 6 (IL-6), interleukin 10 (IL-10), soluble tumor necrosis factor receptor 1 (sTNF-R1), and soluble tumor necrosis factor receptor 2 (sTNF-R2) were......GOALS: The aim of this study was to test the relations between plasma cytokines and the clinical characteristics, course, and risk factors in acute stroke. PATIENTS AND METHODS: The analysis was based on 179 patients with acute stroke included within 24 hours of stroke onset. On inclusion and 3...

  6. Acute kidney injury in children.

    Merouani, A; Flechelles, O; Jouvet, P

    2012-04-01

    Acute kidney injury (AKI) affects 5% of critically ill hospitalized children and is a risk factor for increased morbidity and mortality. The current review focuses on new definitions of acute kidney injury, standardized to reflect the entire spectrum of the disease, as well as on ongoing research to identify early biomarkers of kidney injury. Its also provides an overview of current practice and available therapies, with emphasis on new strategies for the prevention and pharmacological treatment of diarrhea-associated hemolytic uremic syndrome. Furthermore, a decision-making algorithm is presented for the use of renal replacement therapies in critically ill children with AKI. PMID:22495187

  7. Acute silicosis with bilateral pneumothorax.

    Srivastava, G N; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-01-01

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of acute silicosis as bilateral pneumothorax. PMID:24862410

  8. Biliary acute pancreatitis: a review

    Osvaldo M. Tiscomia; Susana Hamamura; Enriqueta S. de Lehmann; Graciela Otero; Hipólito Waisman; Patricia Tiscornia-Wasserman; Simmy Bank

    2000-01-01

    @@INTRODUCTION It is axiomatic that the most effective and soundly based plan of treatment of any disorder is one aimed at the mechanism or mechanisms responsible for its development[1]. This basic notion, coupled with recent reports[2- 11] in which, surprisingly there is a total lack of reference to the probable involvement of autonomic-arc-reflexes in the physiopathogenesis of biliary acute pancreatitis have prompted this presentation. Undoubtedly, this disease entity has numerous causes, an obscure physiopathology, few effective remedies, and, often, an unpredictable outcome. At the turn of the century, Opie[12,13] brought to light the association between gallstone migration and acute pancreatitis.

  9. Acute hemorrhagic edema of infancy

    Sultan Ecer Menteş; Mustafa Taşkesen; Selahattin Katar; M.Emin Günel; Sedat Akdeniz

    2009-01-01

    Acute hemorrhagic edema of infancy is a rare form of leukocytoclastic vasculitis. Mostly it appears under three years of age and is characterized by purpuric skin lesions, fever and edema. A three years-old boy, who has cough and coryzea was admitted to our clinic for fever and red spots on legs and arms. In physical examination; ecimotic skin lesions on right ear, face, arms, dorsal of the hands, buttocks, legs and dorsal of the feet were found. In the laboratory tests acute phase reactants ...

  10. Therapeutic hypothermia for acute stroke

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter

    2003-01-01

    directly related to stroke severity and outcome, and fever after stroke is associated with substantial increases in morbidity and mortality. Normalisation of temperature in acute stroke by antipyretics is generally recommended, although there is no direct evidence to support this treatment. Despite its...... obvious therapeutic potential, hypothermia as a form of neuroprotection for stroke has been investigated in only a few very small studies. Therapeutic hypothermia is feasible in acute stroke but owing to serious side-effects--such as hypotension, cardiac arrhythmia, and pneumonia--it is still thought of...

  11. Acute phase protein response during acute ruminal acidosis in cattle

    Danscher, A. M.; Thoefner, M. B.; Heegaard, Peter M. H.;

    2011-01-01

    The aim of the study was to describe the acute phase protein and leukocyte responses in dairy heifers during acute, oligofructose-induced ruminal acidosis. The study included 2 trials involving oral oligofructose overload (17g/kg BW) to nonpregnant Danish Holstein heifers. Trial 1 included 12...... performed.Heifers receiving oligofructose developed a profound ruminal and systemic acidosis (in Trial 1 and 2 lowest ruminal pH was 4.3±0.2 and 3.8±0.02, respectively, and minimum SBE was −9.3±4.1 and −8.9±2.8, respectively). In Trial 1, SAA concentrations were higher than baseline concentrations on all...... than control heifers at 18 and 24h after overload (max. 13.7±4.3 billions/L). Feeding had no effect on plasma fibrinogen concentrations or WBC in Trial 1.Acute ruminal and systemic acidosis caused by oligofructose overload resulted in distinct acute phase protein and leukocyte responses in dairy...

  12. Septo-Optic Dysplasia

    ... Enhancing Diversity Find People About NINDS NINDS Septo-Optic Dysplasia Information Page Synonym(s): De Morsier's Syndrome Table ... being done? Clinical Trials Organizations What is Septo-Optic Dysplasia? Septo-optic dysplasia (SOD) is a rare ...

  13. Fiber optics engineering

    Azadeh, Mohammad

    2009-01-01

    Covering fiber optics from an engineering perspective, this text emphasizes data conversion between electrical and optical domains. Techniques to improve the fidelity of this conversion (from electrical to optical domain, and vice versa) are also covered.

  14. Optical data latch

    Vawter, G. Allen

    2010-08-31

    An optical data latch is formed on a substrate from a pair of optical logic gates in a cross-coupled arrangement in which optical waveguides are used to couple an output of each gate to an photodetector input of the other gate. This provides an optical bi-stability which can be used to store a bit of optical information in the latch. Each optical logic gate, which can be an optical NOT gate (i.e. an optical inverter) or an optical NOR gate, includes a waveguide photodetector electrically connected in series with a waveguide electroabsorption modulator. The optical data latch can be formed on a III-V compound semiconductor substrate (e.g. an InP or GaAs substrate) from III-V compound semiconductor layers. A number of optical data latches can be cascaded to form a clocked optical data shift register.

  15. Fiber optic multiplex optical transmission system

    Bell, C. H. (Inventor)

    1977-01-01

    A multiplex optical transmission system which minimizes external interference while simultaneously receiving and transmitting video, digital data, and audio signals is described. Signals are received into subgroup mixers for blocking into respective frequency ranges. The outputs of these mixers are in turn fed to a master mixer which produces a composite electrical signal. An optical transmitter connected to the master mixer converts the composite signal into an optical signal and transmits it over a fiber optic cable to an optical receiver which receives the signal and converts it back to a composite electrical signal. A de-multiplexer is coupled to the output of the receiver for separating the composite signal back into composite video, digital data, and audio signals. A programmable optic patch board is interposed in the fiber optic cables for selectively connecting the optical signals to various receivers and transmitters.

  16. Glucose Effect in the Acute Porphyrias

    ... You are here Home Diet and Nutrition The glucose effect in acute porphyrias The disorders Acute Intermittent ... are treated initially with the administration of carbohydrate/glucose. This therapy has its basis in the ability ...

  17. Infectious mononucleosis presenting as bilateral acute dacryocystitis.

    Atkinson, P L; Ansons, A M; Patterson, A.

    1990-01-01

    A case of infectious mononucleosis presenting as bilateral acute dacryocystitis in a 7-year-old girl is reported. Acute dacryocystitis is uncommon in this age group, and an underlying systemic illness should be suspected particularly when it is bilateral.

  18. General Information about Adult Acute Myeloid Leukemia

    ... Treatment Childhood AML Treatment Research Adult Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Myeloid Leukemia Go to Health Professional Version Key Points Adult ...

  19. Treatment Option Overview (Adult Acute Lymphoblastic Leukemia)

    ... Treatment Childhood AML Treatment Research Adult Acute Lymphoblastic Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Lymphoblastic Leukemia Go to Health Professional Version Key Points Adult ...

  20. Treatment Option Overview (Adult Acute Myeloid Leukemia)

    ... Treatment Childhood AML Treatment Research Adult Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Myeloid Leukemia Go to Health Professional Version Key Points Adult ...