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Sample records for akinetic mutism

  1. [Rare consciousness disturbances in toxicological practice: akinetic mutism, somnambulism, locked-in syndrome, and psychogenic coma].

    Science.gov (United States)

    Ciszowski, Krzysztof; Mietka-Ciszowska, Aneta

    2013-01-01

    The toxicity of xenobiotics can result inrare disorders of consciousness, such as akinetic mutism and somnambulism as well as syndromes mimicking consciousness disturbances, such as locked-in syndrome and psychogenic coma. Akinetic mutism is a condition characterized by a lack of spontaneous movements and little or no vocalization. Somnambulism include performing of complex motor activity in an automatic manner during deep sleep, without any awareness of its execution. The locked-in syndrome is a state with quadriplegia coexisting with cranial nerves palsies and mutism, but with fully preserved consciousness. Psychogenic coma is a condition in which the patient has preserved level of consciousness and awareness, but does not communicate with theenvironment and does not exhibit the external manifestations of consciousness. This paper presents the etiology, clinical characteristics, as well as diagnostic and therapeutic issues for the above syndromes. PMID:24466703

  2. Akinetic Mutism Following Bilateral Anterior Cerebral Artery Territory Infarction Due to Aneurysm: A Case Report

    Directory of Open Access Journals (Sweden)

    Zeynep Özözen Ayas

    2014-04-01

    Full Text Available BACKGROUND AND PURPOSE: Bilateral anterior cerebral artery (ACA territory infarction is rare localization in stroke which should always prompt a search for an anterior communicating artery (ACoA aneurysm. The common neurological manifestations are contralateral weakness predominate in the lower extremite, behavior disturbance, motor inertia, muteness, incontinence, grasp reflex, diffuse rigidity, akinetic mutism. CASE DESCRIPTION: We describe a 38-year-old woman presented with a left sided hemiparesia and decrease of speech for last days. She was a smoker and morbide obese. She had no any diagnosed disease. Her neurological examination had weakness of left extremites affected leg more than the arm and akinetic mutism like as no spontaneously speech and move and grasp reflex. CT showed bilateral ACA infarction which included cingulate gyrus, the right side more than left and subarachnoid hemorrhage in the interhemispheric fissure. MRI angiography showed the appearance of AcoA aneurysm. CONCLUSION: We report a patient with bilateral infarction in the ACA which a rare localization and clinicians must be alert to exist AcoA aneurysm which may bleed, different symptoms and signs like as akinetic mutism, primitive reflexes.

  3. Selective mutism - resources

    Science.gov (United States)

    Resources - selective mutism ... The following organizations are good resources for information on selective mutism : American Speech-Language-Hearing Association -- www.asha.org/public/speech/disorders/selectivemutism.htm Selective Mutism and ...

  4. Mesoproterozoic Archaeoellipsoides: akinetes of heterocystous cyanobacteria

    Science.gov (United States)

    Golubic, S.; Sergeev, V. N.; Knoll, A. H.

    1995-01-01

    The genus Archaeoellipsoides Horodyski & Donaldson comprises large (up to 135 micrometers long) ellipsoidal and rod-shaped microfossils commonly found in silicified peritidal carbonates of Mesoproterozoic age. Based on morphometric and sedimentary comparisons with the akinetes of modern bloom-forming Anabaena species, Archaeoellipsoides is interpreted as the fossilized remains of akinetes produced by planktic heterocystous cyanobacteria. These fossils set a minimum date for the evolution of derived cyanobacteria capable of marked cell differentiation, and they corroborate geochemical evidence indicating that atmospheric oxygen levels were well above 1% of present day levels 1,500 million years ago.

  5. Cerebellar mutism: review of the literature

    DEFF Research Database (Denmark)

    Gudrunardottir, Thora; Sehested, Astrid; Juhler, Marianne;

    2011-01-01

    Cerebellar mutism is a common complication of posterior fossa surgery in children. This article reviews current status with respect to incidence, anatomical substrate, pathophysiology, risk factors, surgical considerations, treatment options, prognosis and prevention....

  6. Cerebellar mutism: review of the literature

    DEFF Research Database (Denmark)

    Gudrunardottir, Thora; Sehested, Astrid; Juhler, Marianne;

    2011-01-01

    Cerebellar mutism is a common complication of posterior fossa surgery in children. This article reviews current status with respect to incidence, anatomical substrate, pathophysiology, risk factors, surgical considerations, treatment options, prognosis and prevention.......Cerebellar mutism is a common complication of posterior fossa surgery in children. This article reviews current status with respect to incidence, anatomical substrate, pathophysiology, risk factors, surgical considerations, treatment options, prognosis and prevention....

  7. Deciphering the mechanisms against oxidative stress in developing and mature akinetes of the cyanobacterium Aphanizomenon ovalisporum.

    Science.gov (United States)

    Kaplan-Levy, Ruth N; Hadas, Ora; Sukenik, Assaf

    2015-07-01

    Cells of filamentous cyanobacteria of the orders Nostocales and Stigonematales can differentiate into dormant forms called akinetes. Akinetes play a key role in the survival, abundance and distribution of the species, contributing an inoculum for their perennial blooms. In the cyanobacterium Aphanizomenon ovalisporum, potassium deficiency triggers the formation of akinetes. Here we present experimental evidence for the production of reactive oxygen species (ROS) during akinete development in response to potassium deficiency. The function of ROS as a primer signal for akinete differentiation was negated. Nevertheless, akinetes acquired protective mechanisms against oxidative damage during their differentiation and maintained them as they matured, giving akinetes advantages enabling survival in harsh conditions.

  8. Selective Mutism: Treating the Silent Child

    Science.gov (United States)

    Shott, Elizabeth F.; Warren, Mary Ellen

    2011-01-01

    Infant mental health specialists are increasingly expected to treat complex mental health disorders in very young children. Selective mutism is an anxiety disorder which can lead to functional impairment across home, preschool, and community settings. The authors share their experiences with Keylah, a preschooler with significant social anxiety…

  9. Potassium deficiency triggers the development of dormant cells (akinetes) in Aphanizomenon ovalisporum (Nostocales, Cyanoprokaryota)(1).

    Science.gov (United States)

    Sukenik, Assaf; Kaplan-Levy, Ruth N; Viner-Mozzini, Yehudit; Quesada, Antonio; Hadas, Ora

    2013-06-01

    Akinetes are spore-like nonmotile cells that differentiate from vegetative cells of filamentous cyanobacteria from the order Nostocales. They play a key role in the survival and distribution of these species and contribute to their perennial blooms. Various environmental factors were reported to trigger the differentiation of akinetes including light intensity and quality, temperature, and nutrient deficiency. Here, we report that deprivation of potassium ion (K(+) ) triggers akinete development in the cyanobacterium Aphanizomenon ovalisporum. Akinetes formation is initiated 3 d-7 d after an induction by K(+) depletion, followed by 2-3 weeks of a maturation process. Akinete formation occurs within a restricted matrix of environmental conditions such as temperature, light intensity or photon flux. Phosphate is essential for akinete maturation and P-limitation restricts the number of mature akinetes. DNA replication is essential for akinete maturation and akinete development is limited in the presence of Nalidixic acid. While our results unequivocally demonstrated the effect of K(+) deficiency on akinete formation in laboratory cultures of A. ovalisporum, this trigger did not cause Cylindrospermopsis raciborskii to produce akinetes. Anabaena crassa however, produced akinetes upon potassium deficiency, but the highest akinete concentration was achieved at conditions that supported vegetative growth. It is speculated that an unknown internal signal is associated with the cellular response to K(+) deficiency to induce the differentiation of a certain vegetative cell in a trichome into an akinete. A universal stress protein that functions as mediator in K(+) deficiency signal transduction cascade, may communicate between the lack of K(+) and akinete induction.

  10. Factors Affecting the Germination of Akinetes of Nodularia spumigena (Cyanobacteriaceae)

    OpenAIRE

    Huber, Ann L.

    1985-01-01

    Nutritional and physical factors which influence the germination of akinetes of Nodularia spumigena (Cyanobacteriaceae) were examined. Low concentrations of phosphorus (45 μM, inhibited germination. Salinities of >20‰ were inhibitory to germination. Optimum temperatures were 22°C or greater. Germination did not take place in the dark, but only very low light intensities (0.5 microeinstein m−2 s−1) were necessary to initiate germination. Red light (620 to 665 nm) was required. More than 24 h o...

  11. Selective Serotonin Reuptake Inhibitors for Treatment of Selective Mutism

    Directory of Open Access Journals (Sweden)

    Mazlum Çöpür

    2012-03-01

    Full Text Available Some authors suggest that selective mutism should be considered as a variant of social phobia or a disorder in the obsessive-compulsive spectrum. Recent studies indicate that pharmacological treatments may be effective in the treatment of selective mutism. In this article, four cases who were treated with citalopram and escitalopram are presented. The results indicate that the drugs were well tolerated, and the level of social and verbal interactions improved significantly. These findings have shown that citalopram and escitalopram can be considered in medication of selective mutism; nevertheless, it is essential that research be done with more cases than previous ones, in order to prove their accuracy

  12. A CARD-FISH protocol for the identification and enumeration of cyanobacterial akinetes in lake sediments.

    Science.gov (United States)

    Ramm, Jessica; Lupu, Achsa; Hadas, Ora; Ballot, Andreas; Rücker, Jacqueline; Wiedner, Claudia; Sukenik, Assaf

    2012-10-01

    Akinetes are the dormant cells of Nostocales (cyanobacteria) that enable the organisms to survive harsh environmental conditions while resting in bottom sediments. The germination of akinetes assists the dispersal and persistence of the species. The assessment of the akinete pool in lake sediments is essential to predict the bloom formation of the Nostocales population. We present here the implementation of an improved catalysed reporter deposition (CARD)-fluorescence in situ hybridization (FISH) protocol to assist the identification and quantification of akinetes in sediment samples. Several 16S rRNA gene oligonucleotide probes were evaluated for labelling akinetes of various species of Anabaena, Aphanizomenon and Cylindrospermopsis. Akinetes of all the taxa studied were successfully labelled and could be easily detected by their bright fluorescence signal. The probes' specificity was tested with 32 strains of different taxa. All six Cylindrospermopsis raciborskii strains were labelled with a specific probe for its 16S rRNA gene. A more general probe labelled 73% of the Anabaena and Aphanizomenon strains. The counting data of field samples obtained with CARD-FISH and the regular light microscopy approach did not differ significantly, confirming the suitability of both methods. The CARD-FISH approach was found to be less time-consuming because of better visibility of akinetes.

  13. Selective Mutism: Practice and Intervention Strategies for Children

    Science.gov (United States)

    Hung, Shu-Lan; Spencer, Michael S.; Dronamraju, Rani

    2012-01-01

    The onset of selective mutism (SM) is usually between the ages of three and five years, when the children first go to preschool. However, these children are most commonly referred for treatment between the ages of six and 11, when they are entering the elementary school system. Early detection and early intervention is suggested for effective SM…

  14. Assessment and Treatment of Selective Mutism with English Language Learners

    Science.gov (United States)

    Mayworm, Ashley M.; Dowdy, Erin; Knights, Kezia; Rebelez, Jennica

    2015-01-01

    Selective mutism (SM) is a type of anxiety disorder that involves the persistent failure to speak in contexts where speech is typically expected (e.g., school), despite speaking in other contexts (e.g., home). Research on the etiology and treatment of SM is limited, as it is a rare disorder and few clinical trials evaluating SM interventions have…

  15. Comorbidity and Family Factors Associated with Selective Mutism

    OpenAIRE

    Brian A. Buzzella; Jill Ehrenreich-May; Pincus, Donna B.

    2011-01-01

    Recent findings suggest that Selective Mutism (SM) is best conceptualized as a childhood anxiety disorder and that oppositional behavior may or may not be a significant part of the clinical picture. Twenty-nine mothers of children with SM and 28 mothers of children who did not meet diagnostic criteria for any Axis I disorder (a community comparison group) completed parental self-report questionnaires and clinician-rated interviews assessing anxiety and oppositional behavior, parental psychopa...

  16. The Sounds of Silence: Language, Cognition, and Anxiety in Selective Mutism

    Science.gov (United States)

    Manassis, Katharina; Tannock, Rosemary; Garland, E. Jane; Minde, Klaus; McInnes, Alison; Clark, Sandra

    2007-01-01

    Objectives: To determine whether oral language, working memory, and social anxiety differentiate children with selective mutism (SM), children with anxiety disorders (ANX), and normal controls (NCs) and explore predictors of mutism severity. Method: Children ages 6 to 10 years with SM (n = 44) were compared with children with ANX (n = 28) and NCs…

  17. Viability of dried vegetative trichomes, formation of akinetes and heterocysts and akinete germination in some blue-green algae under water stress.

    Science.gov (United States)

    Agrawal, S C; Singh, V

    1999-01-01

    Almost all dried vegetative trichomes ofAnabaena iyengarii, Westiellopsis prolifica andNostochopsis lobatus died within 1 h, while those ofOscillatoria acuminata retained viability to some extent for 1 d under similar storage conditions. The viability of dried vegetative trichomes ofO. acuminata decreased about equally on storage at 20 degrees C in the light or in the dark, but dropped rapidly at 12 and 0 degrees C in the dark. Vegetative trichomes ofA. iyengarii, N. lobatus andW. prolifica were more sensitive to frost than those ofO. acuminata, and this correlated with their low resistance to desiccation because both types of exposure involved osmotic stress. Both dried and wet akinetes ofA. iyengarii, W. prolifica andN. lobatus were about equally viable when stored at 20 degrees C in the light or the dark or at 12 and 0 degrees C in the dark, but their germination ability decreased on storage at 0 degrees C. The water stress imposed on growing vegetative trichomes either in high-agar media or in NaCl-supplemented liquid media reduced the survival ofO. acuminata trichomes, decreased or totally suppressed akinete and heterocyst formation and akinete germination inA. iyengarii, W. prolifica andN. lobatus. The sensitivity decreased in the sequenceA. iyengarii green algae was more sensitive to physiological water stress than their formation. In all of them, akinetes formed under water stress were equally viable as those formed under normal conditions. Trichomes ofO. acuminata became broader when grown in 0.5-0.8 mol/L NaCl-supplemented media, probably due to polyol accumulation, and they also developed a thin sheath-like structure. PMID:18461490

  18. Selective mutism and temperament: the silence and behavioral inhibition to the unfamiliar.

    Science.gov (United States)

    Gensthaler, Angelika; Khalaf, Sally; Ligges, Marc; Kaess, Michael; Freitag, Christine M; Schwenck, Christina

    2016-10-01

    Behavioral inhibition (BI) is a suspected precursor of selective mutism. However, investigations on early behavioral inhibition of children with selective mutism are lacking. Children aged 3-18 with lifetime selective mutism (n = 109), social phobia (n = 61), internalizing behavior (n = 46) and healthy controls (n = 118) were assessed using the parent-rated Retrospective Infant Behavioral Inhibition (RIBI) questionnaire. Analyses showed that children with lifetime selective mutism and social phobia were more inhibited as infants and toddlers than children of the internalizing and healthy control groups, who displayed similar low levels of behavioral inhibition. Moreover, behavioral inhibition was higher in infants with lifetime selective mutism than in participants with social phobia according to the Total BI score (p = 0.012) and the Shyness subscale (p lifetime diagnosis of selective mutism. Results yield first evidence of the recently hypothesized temperamental origin of selective mutism. Children at risk should be screened for this debilitating child psychiatric condition.

  19. Survival of akinetes (resting-state cells of cyanobacteria) in low earth orbit and simulated extraterrestrial conditions.

    Science.gov (United States)

    Olsson-Francis, Karen; de la Torre, Rosa; Towner, Martin C; Cockell, Charles S

    2009-12-01

    Cyanobacteria are photosynthetic organisms that have been considered for space applications, such as oxygen production in bioregenerative life support systems, and can be used as a model organism for understanding microbial survival in space. Akinetes are resting-state cells of cyanobacteria that are produced by certain genera of heterocystous cyanobacteria to survive extreme environmental conditions. Although they are similar in nature to endospores, there have been no investigations into the survival of akinetes in extraterrestrial environments. The aim of this work was to examine the survival of akinetes from Anabaena cylindrica in simulated extraterrestrial conditions and in Low Earth Orbit (LEO). Akinetes were dried onto limestone rocks and sent into LEO for 10 days on the ESA Biopan VI. In ground-based experiments, the rocks were exposed to periods of desiccation, vacuum (0.7×10(-3) kPa), temperature extremes (-80 to 80°C), Mars conditions (-27°C, 0.8 kPa, CO(2)) and UV radiation (325-400 nm). A proportion of the akinete population was able to survive a period of 10 days in LEO and 28 days in Mars simulated conditions, when the rocks were not subjected to UV radiation. Furthermore, the akinetes were able to survive 28 days of exposure to desiccation and low temperature with high viability remaining. Yet long periods of vacuum and high temperature were lethal to the akinetes. This work shows that akinetes are extreme-tolerating states of cyanobacteria that have a practical use in space applications and yield new insight into the survival of microbial resting-state cells in space conditions.

  20. Spino-Cerebellar Degeneration, Hormonal Disorder, Hypogonadism, Deaf Mutism and Mental Deficiency

    Science.gov (United States)

    Sylvester, P. E.

    1972-01-01

    Post mortem examinations were done on two adult siblings (one female and one male) who had been clinically described as suffering from mental handicap, deaf mutism, ataxia, hypogonadism, and hormonal disorders. (DB)

  1. Consensus paper on post-operative pediatric cerebellar mutism syndrome

    DEFF Research Database (Denmark)

    Gudrunardottir, Thora; Morgan, Angela T; Lux, Andrew L;

    2016-01-01

    INTRODUCTION: Confusion has surrounded the description of post-operative mutism and associated morbidity in pediatric patients with cerebellar tumors for years. The heterogeneity of definitions and diagnostic features has hampered research progress within the field, and to date, no international......-operative pediatric CMS" was formed, preliminary recommendations for diagnostic and follow-up procedures were created, two working groups on a new scoring scale and risk prediction and prevention were established, and areas were identified where further information is needed. DISCUSSION: The consensus process...... was motivated by desire to further research and improve quality of life for pediatric brain tumor patients. The Delphi rounds identified relevant topics and established basic agreement, while face-to-face engagement helped resolve matters of conflict and refine terminology. The new definition is intended...

  2. Comorbidity and Family Factors Associated with Selective Mutism

    Directory of Open Access Journals (Sweden)

    Brian A. Buzzella

    2011-01-01

    Full Text Available Recent findings suggest that Selective Mutism (SM is best conceptualized as a childhood anxiety disorder and that oppositional behavior may or may not be a significant part of the clinical picture. Twenty-nine mothers of children with SM and 28 mothers of children who did not meet diagnostic criteria for any Axis I disorder (a community comparison group completed parental self-report questionnaires and clinician-rated interviews assessing anxiety and oppositional behavior, parental psychopathology, and family factors with hypothesized relationships with childhood anxiety. Findings suggested that children with SM experienced more anxiety than those in the community comparison group, with significantly higher levels of social anxiety, rumination, and physical symptoms reported. Mothers of children with SM reported greater monitoring of their children's activities, but they did not significantly differ from community comparison group mothers on reports of other parenting behaviors. Such findings may have important implications for guiding family involvement in psychosocial interventions.

  3. The Cerebellar Mutism Syndrome and Its Relation to Cerebellar Cognitive Function and the Cerebellar Cognitive Affective Disorder

    Science.gov (United States)

    Wells, Elizabeth M.; Walsh, Karin S.; Khademian, Zarir P.; Keating, Robert F.; Packer, Roger J.

    2008-01-01

    The postoperative cerebellar mutism syndrome (CMS), consisting of diminished speech output, hypotonia, ataxia, and emotional lability, occurs after surgery in up to 25% of patients with medulloblastoma and occasionally after removal of other posterior fossa tumors. Although the mutism is transient, speech rarely normalizes and the syndrome is…

  4. The Importance of a Team Approach in Working Effectively with Selective Mutism: A Case Study

    Science.gov (United States)

    Borger, Gary W.; Bartley, Dana L.; Armstrong, Norma; Kaatz, Debra; Benson, Dave

    2007-01-01

    Selective Mutism (SM) in children and adolescents is characterized by a persistent failure to speak in certain social situations including at school or with friends despite the ability to speak and comprehend language. Not due to a specific communication disorder, SM is actually a pervasive psychological problem that lies along the continuum of…

  5. The Teachers' Role in the Assessment of Selective Mutism and Anxiety Disorders

    Science.gov (United States)

    Martinez, Yvonne J.; Tannock, Rosemary; Manassis, Katharina; Garland, E. Jane; Clark, Sandra; McInnes, Alison

    2015-01-01

    Selective mutism (SM) is a childhood disorder characterized by failure to speak in social situations, despite there being an expectation to speak and the capacity to do so. There has been a focus on elucidating the differences between SM and anxiety disorder (ANX) in the recent literature. Although children with SM exhibit more symptoms at school…

  6. Assessing Spoken Language Competence in Children with Selective Mutism: Using Parents as Test Presenters

    Science.gov (United States)

    Klein, Evelyn R.; Armstrong, Sharon Lee; Shipon-Blum, Elisa

    2013-01-01

    Children with selective mutism (SM) display a failure to speak in select situations despite speaking when comfortable. The purpose of this study was to obtain valid assessments of receptive and expressive language in 33 children (ages 5 to 12) with SM. Because some children with SM will speak to parents but not a professional, another purpose was…

  7. Selective Mutism: A Team Approach to Assessment and Treatment in the School Setting

    Science.gov (United States)

    Ponzurick, Joan M.

    2012-01-01

    The school nurse plays a pivotal role in the assessment and treatment of selective mutism (SM), a rare disorder found in elementary school children. Due to anxiety, children with SM do not speak in uncomfortable situations, primarily the school setting. Diagnosis of SM is often missed in the formative years because the child does speak at home.…

  8. Examination of a Social Problem-Solving Intervention to Treat Selective Mutism

    NARCIS (Netherlands)

    O'Reilly, M.F.; McNally, D.; Sigafoos, J.; Lancioni, G.E.; Green, V.A.; Edrisinha, C.; Machalicek, W.A.; Sorrells, A.; Didden, H.C.M.

    2008-01-01

    The authors examined the use of a social problem-solving intervention to treat selective mutism with 2 sisters in an elementary school setting. Both girls were taught to answer teacher questions in front of their classroom peers during regular classroom instruction. Each girl received individualized

  9. Rapid response of long-standing, treatment-resistant non-catatonic mutism in paranoid schizophrenia with single ECT session

    Directory of Open Access Journals (Sweden)

    Mansoor Ahmad Dar

    2014-01-01

    Full Text Available Context: Mutism is a common manifestation of catatonia, but mutism due to other forms of psychopathology and neurological disorders have also been described. Although not common, long-standing mutism has also been a feature of non-catatonic schizophrenia and traditionally responds less to conventional therapies. Case Report: We describe a rare case of paranoid schizophrenia presenting with continuous mutism for about 4 years. This 26-year-old male had symptoms of schizophrenia without catatonia. After failed trial of adequate pharmacotherapy and psychological intervention and considering his level of dysfunction, he was started on electroconvulsive therapy (ECT. To our surprise, he improved with a single session of ECT while he was on concurrent pharmacotherapy. We also discuss the possible explanation for this rapid effect of ECT in such clinical presentation. To our knowledge, this is the first case of non-catatonic mutism of schizophrenia of this long duration responding so promptly to ECT, although there are other reports as well in literature, but multiple ECT sessions were applied in those cases. Conclusion: Non-catatonic mutism is perhaps presenting as a cultural variant in this part of the world and whenever encountered, ECT should be an option. Further research should be carried out to validate this idea.

  10. A Selective Mutism Arising from First Language Attrition, Successfully Treated with Paroxetine-CBT Combination Treatment.

    Science.gov (United States)

    Serra, Agostino; Di Mauro, Paola; Andaloro, Claudio; Maiolino, Luigi; Pavone, Piero; Cocuzza, Salvatore

    2015-10-01

    After immersion in a foreign language, speakers often have difficulty retrieving native-language words and may experience a decrease in its proficiency, this phenomenon, in the non-pathological form, is known as first language attrition. Self-perception of this low native-language proficiency and apprehension occurring when speaking is expected and, may sometimes lead these people to a state of social anxiety and, in extreme forms, can involve the withholding of speech as a primitive tool for self-protection, linking them to selective mutism. We report an unusual case of selective mutism arising from first language attrition in an Italian girl after attending a two-year "German language school", who successfully responded to a paroxetine-cognitive behavioral treatment (CBT) combination treatment. PMID:26508972

  11. Contributions to the functional morphology of caudate skulls: kinetic and akinetic forms.

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    Natchev, Nikolay; Handschuh, Stephan; Lukanov, Simeon; Tzankov, Nikolay; Naumov, Borislav; Werneburg, Ingmar

    2016-01-01

    A strongly ossified and rigid skull roof, which prevents parietal kinesis, has been reported for the adults of all amphibian clades. Our μ-CT investigations revealed that the Buresch's newt (Triturus ivanbureschi) possess a peculiar cranial construction. In addition to the typical amphibian pleurokinetic articulation between skull roof and palatoquadrate associated structures, we found flexible connections between nasals and frontals (prokinesis), vomer and parasphenoid (palatokinesis), and between frontals and parietals (mesokinesis). This is the first description of mesokinesis in urodelans. The construction of the skull in the Buresch's newts also indicates the presence of an articulation between parietals and the exocipitals, discussed as a possible kind of metakinesis. The specific combination of pleuro-, pro-, meso-, palato-, and metakinetic skull articulations indicate to a new kind of kinetic systems unknown for urodelans to this date. We discuss the possible neotenic origin of the skull kinesis and pose the hypothesis that the kinesis in T. ivanbureschi increases the efficiency of fast jaw closure. For that, we compared the construction of the skull in T. ivanbureschi to the akinetic skull of the Common fire salamander Salamandra salamandra. We hypothesize that the design of the skull in the purely terrestrial living salamander shows a similar degree of intracranial mobility. However, this mobility is permitted by elasticity of some bones and not by true articulation between them. We comment on the possible relation between the skull construction and the form of prey shaking mechanism that the species apply to immobilize their victims.

  12. Phase-sensitive optical coherence tomography-based vibrometry using a highly phase-stable akinetic swept laser source

    Science.gov (United States)

    Applegate, Brian E.; Park, Jesung; Carbajal, Esteban; Oghalai, John S.

    2015-12-01

    Phase-sensitive Optical Coherence Tomography (PhOCT) is an emerging tool for in vivo investigation of the vibratory function of the intact middle and inner ear. PhOCT is able to resolve micron scale tissue morphology in three dimensions as well as measure picometer scale motion at each spatial position. Most PhOCT systems to date have relied upon the phase stability offered by spectrometer detection. On the other hand swept laser source based PhOCT offers a number of advantages including balanced detection, long imaging depths, and high imaging speeds. Unfortunately the inherent phase instability of traditional swept laser sources has necessitated complex user developed hardware/software solutions to restore phase sensitivity. Here we present recent results using a prototype swept laser that overcomes these issues. The akinetic swept laser is electronically tuned and precisely controls sweeps without any mechanical movement, which results in high phase stability. We have developed an optical fiber based PhOCT system around the akinetic laser source that had a 1550 nm center wavelength and a sweep rate of 140 kHz. The stability of the system was measured to be 4.4 pm with a calibrated reflector, thus demonstrating near shot noise limited performance. Using this PhOCT system, we have acquired structural and vibratory measurements of the middle ear in a mouse model, post mortem. The quality of the results suggest that the akinetic laser source is a superior laser source for PhOCT with many advantages that greatly reduces the required complexity of the imaging system.

  13. Phase-sensitive optical coherence tomography-based vibrometry using a highly phase-stable akinetic swept laser source

    Energy Technology Data Exchange (ETDEWEB)

    Applegate, Brian E.; Park, Jesung; Carbajal, Esteban [Department of Biomedical Engineering, Texas A& M University, College Station, Texas (United States); Oghalai, John S. [Department of Otolaryngology - Head and Neck Surgery, Stanford University, Stanford, California (United States)

    2015-12-31

    Phase-sensitive Optical Coherence Tomography (PhOCT) is an emerging tool for in vivo investigation of the vibratory function of the intact middle and inner ear. PhOCT is able to resolve micron scale tissue morphology in three dimensions as well as measure picometer scale motion at each spatial position. Most PhOCT systems to date have relied upon the phase stability offered by spectrometer detection. On the other hand swept laser source based PhOCT offers a number of advantages including balanced detection, long imaging depths, and high imaging speeds. Unfortunately the inherent phase instability of traditional swept laser sources has necessitated complex user developed hardware/software solutions to restore phase sensitivity. Here we present recent results using a prototype swept laser that overcomes these issues. The akinetic swept laser is electronically tuned and precisely controls sweeps without any mechanical movement, which results in high phase stability. We have developed an optical fiber based PhOCT system around the akinetic laser source that had a 1550 nm center wavelength and a sweep rate of 140 kHz. The stability of the system was measured to be 4.4 pm with a calibrated reflector, thus demonstrating near shot noise limited performance. Using this PhOCT system, we have acquired structural and vibratory measurements of the middle ear in a mouse model, post mortem. The quality of the results suggest that the akinetic laser source is a superior laser source for PhOCT with many advantages that greatly reduces the required complexity of the imaging system.

  14. Phase-sensitive optical coherence tomography-based vibrometry using a highly phase-stable akinetic swept laser source

    International Nuclear Information System (INIS)

    Phase-sensitive Optical Coherence Tomography (PhOCT) is an emerging tool for in vivo investigation of the vibratory function of the intact middle and inner ear. PhOCT is able to resolve micron scale tissue morphology in three dimensions as well as measure picometer scale motion at each spatial position. Most PhOCT systems to date have relied upon the phase stability offered by spectrometer detection. On the other hand swept laser source based PhOCT offers a number of advantages including balanced detection, long imaging depths, and high imaging speeds. Unfortunately the inherent phase instability of traditional swept laser sources has necessitated complex user developed hardware/software solutions to restore phase sensitivity. Here we present recent results using a prototype swept laser that overcomes these issues. The akinetic swept laser is electronically tuned and precisely controls sweeps without any mechanical movement, which results in high phase stability. We have developed an optical fiber based PhOCT system around the akinetic laser source that had a 1550 nm center wavelength and a sweep rate of 140 kHz. The stability of the system was measured to be 4.4 pm with a calibrated reflector, thus demonstrating near shot noise limited performance. Using this PhOCT system, we have acquired structural and vibratory measurements of the middle ear in a mouse model, post mortem. The quality of the results suggest that the akinetic laser source is a superior laser source for PhOCT with many advantages that greatly reduces the required complexity of the imaging system

  15. Selective Mutism

    Science.gov (United States)

    ... background history is gathered, as well as an educational history review, hearing screening, oral-motor examination, parent/caregiver interview, and a speech and language evaluation. The educational history review seeks information on: academic reports parent/teacher ...

  16. Dopamine transporter single-photon emission computerized tomography supports diagnosis of akinetic crisis of parkinsonism and of neuroleptic malignant syndrome.

    Science.gov (United States)

    Martino, G; Capasso, M; Nasuti, M; Bonanni, L; Onofrj, M; Thomas, A

    2015-04-01

    Akinetic crisis (AC) is akin to neuroleptic malignant syndrome (NMS) and is the most severe and possibly lethal complication of parkinsonism. Diagnosis is today based only on clinical assessments yet is often marred by concomitant precipitating factors. Our purpose is to evidence that AC and NMS can be reliably evidenced by FP/CIT single-photon emission computerized tomography (SPECT) performed during the crisis. Prospective cohort evaluation in 6 patients. In 5 patients, affected by Parkinson disease or Lewy body dementia, the crisis was categorized as AC. One was diagnosed as having NMS because of exposure to risperidone. In all FP/CIT, SPECT was performed in the acute phase. SPECT was repeated 3 to 6 months after the acute event in 5 patients. Visual assessments and semiquantitative evaluations of binding potentials (BPs) were used. To exclude the interference of emergency treatments, FP/CIT BP was also evaluated in 4 patients currently treated with apomorphine. During AC or NMS, BP values in caudate and putamen were reduced by 95% to 80%, to noise level with a nearly complete loss of striatum dopamine transporter-binding, corresponding to the "burst striatum" pattern. The follow-up re-evaluation in surviving patients showed a recovery of values to the range expected for Parkinsonisms of same disease duration. No binding effects of apomorphine were observed. By showing the outstanding binding reduction, presynaptic dopamine transporter ligand can provide instrumental evidence of AC in Parkinsonism and NMS.

  17. Absence of Nails, Deaf-mutism, Seizures, and Intellectual Disability: A Case Report.

    Science.gov (United States)

    Nair, Lal Devayanivasudevan; Sagayaraj, Benjamin; Kumar, Radha

    2015-04-01

    Seizures coexists in children with intellectual disability and are often attributed to neural dysfunction associated with it. Often a careful clinical examination will unravel many diagnostic pointers as in this 8-year-old child with global development delay, deaf-mutism and moderate intellectual disability (mental retardation) who presented with seizures in the emergency department. General examination revealed dysmorphic features like anonychia, low set ears, long philtrum, large lower lips and abnormal dermatoglyphics with features of osteodystrophy on radiology. She was diagnosed as a case of DOORS syndrome, an extremely rare genetic condition affecting the TCA cycle, with just over 40 cases reported, worldwide till date, since its first description in 1961. Her genetic analysis did not reveal the common TBC1D24 mutation in 16p13.3 resulting often from substitutions affecting the arginine at position 242, in spite of all classical clinical features associated with it, suggesting genetic heterogeneity in DOORS syndrome. Though four year follow-up revealed changes in seizure pattern, there was no optic atrophy, change in IQ or peripheral nerve problem. This probably suggests that children with typical clinical features and TBC1D24 mutations may have more progressive deterioration than those without it and newer molecular techniques may identify unexplained phenotypic expressions. PMID:26023614

  18. Absence of Nails, Deaf-mutism, Seizures, and Intellectual Disability: A Case Report

    Science.gov (United States)

    Sagayaraj, Benjamin; Kumar, Radha

    2015-01-01

    Seizures coexists in children with intellectual disability and are often attributed to neural dysfunction associated with it. Often a careful clinical examination will unravel many diagnostic pointers as in this 8-year-old child with global development delay, deaf-mutism and moderate intellectual disability (mental retardation) who presented with seizures in the emergency department. General examination revealed dysmorphic features like anonychia, low set ears, long philtrum, large lower lips and abnormal dermatoglyphics with features of osteodystrophy on radiology. She was diagnosed as a case of DOORS syndrome, an extremely rare genetic condition affecting the TCA cycle, with just over 40 cases reported, worldwide till date, since its first description in 1961. Her genetic analysis did not reveal the common TBC1D24 mutation in 16p13.3 resulting often from substitutions affecting the arginine at position 242, in spite of all classical clinical features associated with it, suggesting genetic heterogeneity in DOORS syndrome. Though four year follow-up revealed changes in seizure pattern, there was no optic atrophy, change in IQ or peripheral nerve problem. This probably suggests that children with typical clinical features and TBC1D24 mutations may have more progressive deterioration than those without it and newer molecular techniques may identify unexplained phenotypic expressions. PMID:26023614

  19. Behavioral and emotional adjustment, family functioning, academic performance, and social relationships in children with selective mutism.

    Science.gov (United States)

    Cunningham, Charles E; McHolm, Angela; Boyle, Michael H; Patel, Sejal

    2004-11-01

    This study addressed four questions which parents of children with selective mutism (SM) frequently ask: (1) Is SM associated with anxiety or oppositional behavior? (2) Is SM associated with parenting and family dysfunction? (3) Will my child fail at school? and (4) Will my child make friends or be teased and bullied? In comparison to a sample of 52 community controls, 52 children with SM were more anxious, obsessive, and prone to somatic complaints. In contrast, children with SM were less oppositional and evidenced fewer attentional difficulties at school. We found no group differences in family structure, economic resources, family functioning, maternal mood difficulties, recreational activities, or social networks. While parents reported no differences in parenting strategies, children with SM were described as less cooperative in disciplinary situations. The academic (e.g., reading and math) and classroom cooperative skills of children with SM did not differ from controls. Parents and teachers reported that children with SM had significant deficits in social skills. Though teachers and parents rated children with SM as less socially assertive, neither teachers nor parents reported that children with SM were victimized more frequently by peers. PMID:15482497

  20. Identifying Treatment Response of Sertraline in a Teenager with Selective Mutism using Electrophysiological Neuroimaging

    Science.gov (United States)

    Eugene, Andy R.; Masiak, Jolanta

    2016-01-01

    Background Selective Mutism is described as the inability to verbally express oneself in anxiety provoking social situations and may result in awkward social interactions in school-aged children. In this case-report we present the baseline electrophysiological neuroimaging results and after treatment with Sertraline for 6-weeks. Methods A 20-channel EEG event-related potential recording was acquired during an internal voice task at baseline prior to the initiation of 50mg of Sertraline and then repeated 6-weeks after treatment with Sertraline. EEG signals were processed for movement, eye-blink, and muscle artifacts and ERP signal averaging was completed. ERPs were analyzed using Standard Low Resolution Brain Electromagnetic Tomography (sLORETA). Results At baseline, Sertraline increased the neuronal activation in the middle temporal gyrus and the anterior cingulate gyrus from baseline in the patient following 6-weeks of treatment. Conclusion Our findings suggest that electrophysiological neuroimaging may provide a creative approach for personalizing medicine by providing insight to the pharmacodynamics of antidepressants. PMID:27468379

  1. Childhood disintegrative disorder with seasonal total mutism: A rare clinical presentation.

    Science.gov (United States)

    Shirazi, Elham; Hosseinpoor, Sara; Mirhosseini, Seyyed Mohammad Mahdy; Bidaki, Reza

    2016-01-01

    Childhood disintegrative disorder (CDD) is a rare autistic-like clinical condition with unknown etiology, in that previously acquired age-appropriate language, social and adaptive abilities deteriorate significantly in 2-10-year-old healthy children, although physical and neurological evaluations display no observable abnormality. Our case is a 22-year-old female born of a consanguineous marriage, with the appearance of CDD symptoms in her fifth year of age following normal mental and physical development during her initial four years of life. Without any precipitating factor, she gradually lost her language abilities, social relational skills, affectionate behavior, adaptive capacities, peer play and meaningful interest in her surrounding, friends and family members over a period of 4 years, reaching a plateau in her ninth year of age. The unique special clinical symptom in this case is a seasonal total mutism, which after the beginning of her CDD symptoms is revealing every year covering the spring. As no additional physical or psychological change accompanies her total seasonal speech loss, it cannot be attributed to any mental condition known as having a seasonal pattern. Because in the literature CDD is presented mostly as case reports with lacking of advanced research data, describing any new case is recommended to improve the knowledge about this rare condition, especially if it displays some new unusual signs, not reported till now. PMID:27069898

  2. Mutismo cerebelar transitório: relato de dois casos Transitory cerebellar mutism: report of two cases

    Directory of Open Access Journals (Sweden)

    JOSÉ ALBERTO GONÇALVES DA SILVA

    1999-12-01

    Full Text Available Relatamos dois casos de mutismo observados após ressecção de tumores do cerebelo em duas crianças do sexo feminino, tratando-se, no primeiro caso de meduloblastoma, e no segundo, de astrocitoma juvenil. Em ambas havia lesão pré-operatória de nervos bulbares. A fisiopatogenia do mutismo envolve fatores anatômicos, vasculares e emocionais. As características essenciais do mutismo cerebelar são discutidas com base em revisão da literatura.We present two cases of mutism observed after resection of tumors of the cerebellum, in two children of the feminine sex, being in the first case of medulloblastoma and in the second of juvenile astrocytoma. In both patients there was pre-operative lesion of low cranial nerves. The pathophysiology of the mutism involves anatomical, vascular and emotional factors, being its essential characteristics discussed with base in revision of the literature.

  3. Children Who are Anxious in Silence: A Review on Selective Mutism, the New Anxiety Disorder in DSM-5.

    Science.gov (United States)

    Muris, Peter; Ollendick, Thomas H

    2015-06-01

    Selective mutism (SM) is a relatively rare childhood disorder characterized by a consistent failure to speak in specific settings (e.g., school, social situations) despite speaking normally in other settings (e.g., at home). The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists SM among the anxiety disorders. This makes sense as the current review of the literature confirms that anxiety is a prominent symptom in many children suffering from this condition. Further, research on the etiology and treatment of SM also corroborates the conceptualization of SM as an anxiety disorder. At the same time, critical points can be raised regarding the classification of SM as an anxiety disorder. We explore a number of such issues in this review. Recommendations for dealing with this diagnostic conundrum are made for psychologists, psychiatrists, and other mental health workers who face children with SM in clinical practice, and directions for future research are highlighted.

  4. Children of Few Words: Relations Among Selective Mutism, Behavioral Inhibition, and (Social) Anxiety Symptoms in 3- to 6-Year-Olds

    OpenAIRE

    Muris, Peter; Hendriks, Eline; Bot, Suili

    2015-01-01

    Children with selective mutism (SM) fail to speak in specific public situations (e.g., school), despite speaking normally in other situations (e.g., at home). The current study explored the phenomenon of SM in a sample of 57 non-clinical children aged 3–6 years. Children performed two speech tasks to assess their absolute amount of spoken words, while their parents completed questionnaires for measuring children’s levels of SM, social anxiety and non-social anxiety symptoms as well as the tem...

  5. Eficiência da correção endoventricular com patch em pacientes com grande área acinética pós-infarto do miocárdio e severa disfunção ventricular Efficacy of endoventricular patch plasty in large postinfarction akinetic scar and severe left ventricular dysfunction

    Directory of Open Access Journals (Sweden)

    Gustavo Calado de Aguiar RIBEIRO

    2002-03-01

    Full Text Available OBJETIVO: Verificar a eficiência da técnica de plastia endoventricular com patch circular nos casos com grande área acinética causada por infarto agudo do miocárdio prévio no ventrículo esquerdo e com severa depressão da função ventricular. CASUÍSTICA E MÉTODOS: Este estudo evoluiu resultados hemodinâmicos da plastia endoventricular com patch circular em pacientes com grande área acinética (9 casos e grande área discinética (11 casos e ambos apresentando severa depressão ventricular (fração de ejeção PURPOSE: Efficacy of endoventricular patch plasty in large postinfarction akinetic scar and severe left ventricular dysfunction. METHODS: This study evaluated clinical and hemodynamic results of endoventricular circular patch plasty in patients with either large akinetic scar (n=9 or large dyskinetic scar (n=11 and depressed left ventricular function (ejection fraction < 35%. The difference between akinetic and dyskinetic left ventricular aneurysms was diagnosed by gated radionuclide ventriculography. Groups were comparable for symptons and by echocardiography and by hemodynamic before and after the surgery. RESULTS: Results showed an early improvement in New York Heart Association functional class. Statistically (the Student t test an improvement occurred in left ventricle ejection fraction (from 25 ± 0.8% to 39 ± 1.6% in akinetic patients and from 27 ± 0.7% to 41 ± 1.6% in dyskinetic patients, decreased of capillary wedge pressure (20 ± 1.2 mmHg to 12 ± 1.2 mmHg in akinetics and 17 ± 0,5 mmHg to 11 ± 0.9 mmHg in dyskinetics patients, decrease end-diastolic volume index (226 ± 11 ml to 115 ± 7,8 ml in akinetics and 209 ± 11ml to 96 ± 5ml in dyskinetics and end-systolic volume index (176 ± 9.2 ml to 77 ± 6.2 ml in akinetics and 160 ± 10ml to 66 ± 2ml in dyskinetics patients. Overall operative mortality was 10% (2 cases in akinetic group = 22.2%. CONCLUSION: We find that endoventricular circular patch plasty

  6. 小脑性缄默与儿童髓母细胞瘤%Cerebellar mutism and childhood medulloblastoma

    Institute of Scientific and Technical Information of China (English)

    梁云梅; 吕燕松; 张金; 任思其; 呙芳

    2015-01-01

    目的:探讨小脑性缄默(CM)与髓母细胞瘤(MB)复发及原发肿瘤位置的相关性。方法回顾性分析2011年11月至2015年4月收治的114例3岁以上MB患儿的临床资料。结果114例患儿中,男77例、女37例,初次发病中位年龄84.7月(36.4~184.7月),其中48例为复发病例。22例发生CM,发生率为19.3%(22/114);其中非复发及复发MB患儿CM发生率分别为19.7%(13/66)及18.8%(9/48),二者间差异无统计学意义(P=0.899);原发肿瘤位于第四脑室者的CM发生率17.6%(9/51),小脑蚓部为7.1%(1/14),第四脑室及小脑蚓部同时受累者21.4%(3/14),第四脑室合并其他部位受累者45.5%(5/11),小脑蚓部合并其他部位受累者50.0%(4/8),非第四脑室及小脑蚓部受累者无CM发生。CM发生率在原发肿瘤位置累及第四脑室和/或小脑蚓部与未累及第四脑室和/或小脑蚓部患儿间的差异有统计学意义(P=0.039)。结论 CM发生与MB患儿复发无相关性。原发肿瘤侵犯第四脑室和/或小脑蚓部者易发生CM。%Objective To investigate the relationships among cerebellar mutism (CM), relapsed medulloblastoma (MB) and the primary tumor location.MethodsA retrospective analysis was conducted in 114 children over 3 years old with MB from November 2011 to April 2015.ResultsThe median onset age was 84.7 months (36.4 to 184.7 months) in 114 children with MB (77 boys and 37 girls), of whom there were 48 cases of recurrence. There were twenty two cases of CM and the overall incidence of CM was 19.3% (22/114). The incidence of CM was 19.7% (13/66) in non-recurrent cases and 18.8% (9/48) in recur-rent cases, and there was no signiifcant difference between two groups (P=0.899). The incidence of CM was 17.6% (9/51) in cas-es with primary tumor in the fourth ventricle, 7.1% (1/14) in cases with primary tumor in the cerebellar vermis, 21.4% (3/14) in cases with primary tumor in both fourth ventricle and cerebellar vermis, 45.5% (5/11) in

  7. Children of Few Words: Relations Among Selective Mutism, Behavioral Inhibition, and (Social) Anxiety Symptoms in 3- to 6-Year-Olds.

    Science.gov (United States)

    Muris, Peter; Hendriks, Eline; Bot, Suili

    2016-02-01

    Children with selective mutism (SM) fail to speak in specific public situations (e.g., school), despite speaking normally in other situations (e.g., at home). The current study explored the phenomenon of SM in a sample of 57 non-clinical children aged 3-6 years. Children performed two speech tasks to assess their absolute amount of spoken words, while their parents completed questionnaires for measuring children's levels of SM, social anxiety and non-social anxiety symptoms as well as the temperament characteristic of behavioral inhibition. The results indicated that high levels of parent-reported SM were primarily associated with high levels of social anxiety symptoms. The number of spoken words was negatively related to behavioral inhibition: children with a more inhibited temperament used fewer words during the speech tasks. Future research is necessary to test whether the temperament characteristic of behavioral inhibition prompts children to speak less in novel social situations, and whether it is mainly social anxiety that turns this taciturnity into the psychopathology of SM.

  8. 儿童后颅窝术后小脑性缄默综合征的临床分析%Clinical studies of cerebellar mutism syndrome after posterior fossa surgery in children

    Institute of Scientific and Technical Information of China (English)

    朱晓锋; 王增亮; 刘源; 吉文玉; 秦虎; 柳琛; 汪永新

    2016-01-01

    目的:探讨儿童后颅窝术后并发小脑性缄默综合征的相关危险因素及其发病机制。方法回顾性分析本院神经外科自2004年1月至2014年12月收治的16例继发小脑性缄默综合征患儿临床资料,分析其临床特征及危险因素,结合文献探讨其发病机制。结果16例患儿中,因后颅窝病变行手术治疗14例,保守治疗2例,经保守治疗的2例和14例术后患儿均继发不同程度的小脑性缄默综合征并伴有其他神经功能障碍,于术后2~6 d 出现缄默,持续约2周至3个月不等,大部分患儿缄默好转后仍有持续1~3个月的语言障碍。结论儿童后颅窝病变,特别是大型小脑蚓部肿瘤术后,易发生小脑性缄默综合征,有一定的潜伏期,预后良好。%Objetive To investigate the child after posterior fossa lesions postoperative cerebellar mut-ism syndrome related risk factors and pathogenesis.Methods A retrospective analysis was made on 16 cases of secondary cerebellar mutism syndrome treated in Department of Neurosurgery in our hospital from Jan 2004 to Dec 2014.The clinical features and risk factors were analyzed and the pathogenesis of literature were investiga-ted.Results Due to posterior fossa lesions underwent surgery 14 cases,2 cases of conservative treatment,con-servative treatment of 2 patients and 14 cases of postoperative patients were secondary to varying degrees of cer-ebellar mutism syndrome and associated with other neurological disorders appeared silent in 2 ~6 days after sur-gery,which lasted about 2 weeks to 3 months to still continue the language barrier after 1 ~3 months of silence most of the children improved.Conclusions Children with fossa lesions,especially large tumor surgery cere-bellar vermis,are more likely to suffer from cerebellar mutism syndrome prone.There is a certain incubation pe-riod,but with favourable prognosis.

  9. Serial MRI in early Creutzfeldt-Jacob disease with a point mutation of prion protein at codon 180

    International Nuclear Information System (INIS)

    We report a 66-year-old woman with histologically diagnosed Creutzfeld-Jacob disease (CJD), followed with MRI from an early clinical stage. MRI demonstrated expansion of the high cortical signal on T2-weighted images, which differs from previous MRI reports of CJD. This patient followed an atypical clinical course: 16 months had passed before she developed akinetic mutism, and periodic sharp waves had not been detected on EEG after 2 years in spite of her akinetic mutism. Brain biopsy showed primary spongiform changes in the grey matter, and a point mutation of the prion protein gene at codon 180 was discovered using polymerase chain reaction direct sequencing and Tth 111 I cutting. This is the first case with the point mutation of the codon 180 variant with an atypical clinical course and characteristic MRI findings. (orig.)

  10. Diffusion MR imaging in sporadic Creutzfeldt-Jakob disease

    Directory of Open Access Journals (Sweden)

    Burcak Cakir Pekoz

    2014-08-01

    Full Text Available Creutzfeldt-Jakob disease (CJD is a rare dementing disease and is thought to caused by a prion. It is characterized by rapidly progressive dementia, ataxia, myoclonus, akinetic mutism and eventual death. Brain biopsy or autopsy is required for a definitive diagnosis of CJD. Diffusion-weighted imaging became an important tool for early diagnosis of CJD because of the high sensitivity. We present 59-year-old female patient diagnosed as sporadic CJD with typical MR imagings. [Cukurova Med J 2014; 39(4.000: 880-883

  11. Atypical Parkinsonism Revealing a Late Onset, Rigid and Akinetic Form of Huntington's Disease

    OpenAIRE

    Benti, R.; Ciammola, A.; Mencacci, N.; Poletti, B.; Sassone, J.; Silani, V.

    2011-01-01

    Huntington's disease (HD) is a rare hereditary neurodegenerative disorder characterized in over 90 percent of cases by chorea as the presenting motor symptom. We report a 54-year-old male who presented with Parkinsonism as the initial symptom of the disease. Genetic analysis revealed expansion of 40 CAG repeats, and brain MRI showed both severe caudate nuclei and cortical atrophy. Single-photon emission computed tomography (SPECT) imaging of the dopamine transporter showed nigrostriatal pathw...

  12. Atypical Parkinsonism Revealing a Late Onset, Rigid and Akinetic Form of Huntington's Disease

    Directory of Open Access Journals (Sweden)

    A. Ciammola

    2011-01-01

    Full Text Available Huntington's disease (HD is a rare hereditary neurodegenerative disorder characterized in over 90 percent of cases by chorea as the presenting motor symptom. We report a 54-year-old male who presented with Parkinsonism as the initial symptom of the disease. Genetic analysis revealed expansion of 40 CAG repeats, and brain MRI showed both severe caudate nuclei and cortical atrophy. Single-photon emission computed tomography (SPECT imaging of the dopamine transporter showed nigrostriatal pathway degeneration. Here, we also describe his 2 years of clinical followup after ensuing dopaminergic stimulation.

  13. Bruxism Associated with Anoxic Encephalopathy: Successful Treatment with Baclofen

    Directory of Open Access Journals (Sweden)

    A. Bruce Janati

    2013-01-01

    Full Text Available Introduction. Bruxism is a movement disorder characterized by grinding and clenching of the teeth. Etiology of bruxism can be divided into three groups: psychosocial factors, peripheral factors, and pathophysiological factors. Methods. The clinical investigation was conducted at King Khaled Hospital in Hail, Saudi Arabia, in 2012. Results. A 16-year-old Saudi female was brought to the hospital in a comatose state and with generalized convulsive seizures secondary to acute anoxic encephalopathy. In the third week of hospitalization, while still in a state of akinetic mutism, she developed incessant bruxism which responded favorably to a GABA receptor agonist (baclofen. Conclusion. Our data support the hypothesis that bruxism emanates from imbalance or dysregulation of the neurotransmitter system. Larger scale studies will be needed to confirm this hypothesis.

  14. The First Report of a Patient with Probable Variant Creutzfeldt-Jakob Disease in Turkey

    Directory of Open Access Journals (Sweden)

    Demet Özbabalık Adapınar

    2011-12-01

    Full Text Available Variant Creutzfeldt-Jakob disease (vCJD was first reported in the UK in 1996. Here, we report the first Turkish case of vCJD. A 47-year-old man, who has never lived outside of Turkey and had had no transfusion, was admitted to the University Hospital with speech disorder, cognitive decline and ataxia following depression, irritability, and personality change. The immunoassay of the 14-3-3 protein in the cerebrospinal fluid was negative. Brain magnetic resonance imaging revealed high-signal lesions involving the bilateral caudate and lentiform nucleus on T2- and diffusion-weighted imaging. The patient developed akinetic mutism 10 months after disease onset. The clinical presentation and neuroimaging findings were compatible with the vCJD cases reported since 1996 and met the World Health Organization’s case definition for probable vCJD.

  15. 开颅术后缄默症%Postoperative Mutism after Craniotomy

    Institute of Scientific and Technical Information of China (English)

    吴明灿; 张志文; 刘建雄; 闵杰; 余辉; 罗国才

    2004-01-01

    目的探讨开颅术后缄默症的发病机理及预防和预后.方法回顾性分析开颅术后缄默症7例.结果幕下手术5例,幕上2例,其中肿瘤5例,外伤2例,出现缄默症的时间为术后1~7天,平均2.7天,持续时间6~67天,平均25.4天.结论开颅术后缄默症可能与手术、外伤、颅内感染等诸多因素致齿状核-丘脑-大脑皮质两侧言语通路中断有关.

  16. Speech Rate as a Sticky Switch: A Multiple Lesion Case Analysis of Mutism and Hyperlalia

    Science.gov (United States)

    Braun, Claude M. J.; Dumont, Mathieu; Duval, Julie; Hamel-Hebert, Isabelle

    2004-01-01

    Though it has long been known on the basis of clinical associations and serendipitous observation that speech rate is related to mood and psychomotor baseline, it is less known that speech rate is also related to libido and to immune function. We make the case for a bipolar phenomenon of ''psychic tonus,'' encompassing all these dimensions. The…

  17. Tumour type and size are high risk factors for the syndrome of "cerebellar" mutism and subsequent dysarthria

    NARCIS (Netherlands)

    C.E. Catsman-Berrevoets (Coriene); H.R. van Dongen (Hugo); D. Paz y Geuze; P.F. Paquier; M.H. Lequin (Maarten); P.G.H. Mulder (Paul)

    1999-01-01

    textabstractOBJECTIVE: "Cerebellar mutis" and subsequent dysarthria (MSD) is a documented complication of posterior fossa surgery in children. In this prospective study the following risk factors for MSD were assessed: type, size and site of the tumour; hydrocephalus at

  18. Different patterns of cardiac sympathetic denervation in tremor-type compared to akinetic-rigid-type Parkinson's disease: molecular imaging with ¹²³I-MIBG.

    Science.gov (United States)

    Chiaravalloti, A; Stefani, A; Tavolozza, M; Pierantozzi, M; Di Biagio, D; Olivola, E; Di Pietro, B; Stampanoni, M; Danieli, R; Simonetti, G; Stanzione, P; Schillaci, O

    2012-12-01

    The aim of this study was to evaluate the correlation between the clinical motor phenotypes of Parkinson's disease (PD) and ¹²³I-MIBG myocardial uptake. In total, 53 patients with PD [31 males and 22 females, mean age 62±10 years; 19 Hoehn & Yahr (H&Y) stage 1, 9 stage 1.5, 15 stage 2 and 10 at stage 3] were examined and subdivided into different clinical forms on the basis of dominance of resting tremor (n=19, TDT) and bradykinesia plus rigidity (n=34, ART). This status was correlated with the semi-quantitative analysis of ¹²³I-MIBG myocardial uptake. An age-matched control group of 18 patients was recruited (8 males and 10 females, mean age 62.4±16.3 years). ¹²³I-MIBG myocardial uptake significantly correlated with disease duration in early (r²=0.1894; P=0.0028) and delayed images (r²=0.1795; P=0.0037) in PD patients, while no correlation was found when considering age at examination, UPDRS III motor examination section score and H&Y score. PD patients showed a reduced ¹²³I-MIBG myocardial uptake compared to the control group in early (P=0.0026) and delayed images (P=0.0040), and ¹²³I-MIBG myocardial uptake was significantly lower in delayed images in TDT patients compared with ART patients (P=0.0167). A decrease was detected in the heart-to-mediastinum (H/M) ratio in delayed images compared to that of the early images in TDT patients (P=0.0040) and in the whole PD population (P=0.0012), while no differences were found in ART patients (P=0.1043). The results of the present study revealed that the cardiac sympathetic system is more severely impaired in TDT than in ART patients and ¹²³I-MIBG molecular imaging has the potential help in improving therapeutic planning in these patients. PMID:23023866

  19. Stereotypic Movements in Case of Sporadic Creutzfeldt-Jakob Disease: Possible Role of Anti-NMDA Receptor Antibodies

    Directory of Open Access Journals (Sweden)

    Michelle Molina

    2012-12-01

    Full Text Available Sporadic Creutzfeldt-Jakob disease (sCJD and anti-NMDA receptor antibody encephalitis (NMDAE can both produce a rapidly progressive dementia with resulting state of catatonia or akinetic mutism. Both are associated with movement disorders. In published case series, myoclonus appears to be the most frequent movement disorder in sCJD, while stereotypic, synchronized, one-cycle-per-second movements such as arm or leg elevation, jaw opening, grimacing, head turning, and eye deviation are seen in NMDAE. We report a case of a 59-year-old woman with rapidly worsening cognitive disturbance leading to a nearly catatonic state interrupted by stereotypic movements. sCJD was diagnosed via periodic sharp wave complexes on EEG as well as cerebrospinal fluid (CSF 14-3-3 and tau protein elevation. Characteristic movement disorder of NMDAE was present in absence of ovarian mass or CSF pleiocytosis. Given prior case reports of presence of anti-NMDA receptor antibodies in sCJD, we propose that the movement disorder in this case was caused by anti-NMDA receptor antibodies whose formation was secondary to neuronal damage from prion disease. It is important to consider sCJD even in cases that have some clinical features suggestive of NMDAE.

  20. Panencephalopathic Creutzfeldt-Jakob disease with distinct pattern of prion protein deposition in a patient with D178N mutation and homozygosity for valine at codon 129 of the prion protein Gene.

    Science.gov (United States)

    Marcon, Gabriella; Indaco, Antonio; Di Fede, Giuseppe; Suardi, Silvia; Finato, Nicoletta; Moretti, Valentino; Micoli, Sandro; Fociani, Paolo; Zerbi, Pietro; Pincherle, Alessandro; Redaelli, Veronica; Tagliavini, Fabrizio; Giaccone, Giorgio

    2014-03-01

    Prion diseases include sporadic, acquired and genetic forms linked to mutations of the prion protein (PrP) gene (PRNP). In subjects carrying the D178N PRNP mutation, distinct phenotypes can be observed, depending on the methionine/valine codon 129 polymorphism. We present here a 53-year-old woman with D178N mutation in the PRNP gene and homozygosity for valine at codon 129. The disease started at age 47 with memory deficits, progressive cognitive impairment and ataxia. The clinical picture slowly worsened to a state of akinetic mutism in about 2 years and the disease course was 6 years. The neuropathologic examination demonstrated severe diffuse cerebral atrophy with neuronal loss, spongiosis and marked myelin loss and tissue rarefaction in the hemispheric white matter, configuring panencephalopathic Creutzfeldt-Jakob disease. PrP deposition was present in the cerebral cortex, basal ganglia and cerebellum with diffuse synaptic-type pattern of immunoreactivity and clusters of countless, small PrP deposits, particularly evident in the lower cortical layers, in the striatum and in the molecular layer of the cerebellum. Western blot analysis showed the presence of type 1 PrP(Sc) (Parchi classification). These findings underline the clear-cut distinction between the neuropathological features of Creutzfeldt-Jakob disease associated with D178N PRNP mutation and those of fatal familial insomnia.

  1. A case of Creutzfeldt-Jakob disease: diagnostic dilemmas of a rapidly fatal disease

    Directory of Open Access Journals (Sweden)

    Mirza M. Baig

    2013-10-01

    Full Text Available Creutzfeldt-Jakob disease (CJD is a rapidly progressive and ultimately fatal disorder of the central nervous system. It occurs worldwide with an incidence of 0.5-1 new case per million population per year. No specific treatment is available and management is limited to supportive care. Autopsy or biopsy provides a definitive diagnosis. Because of the transmissible nature of the disease and hesitancy of patients/family members to give consent for biopsy, numerous challenges in confirming the clinical diagnosis are faced by healthcare professionals. We report a case of 66-year-old male who was hospitalized due to hip fracture following a fall. Acute mental status changes followed the surgical fixation of hip fracture which triggered neurologic work up. This finally revealed suspicion and confirmation of CJD. Patient had progressive cognitive decline with akinetic mutism during further hospital stay and was later discharged home with hospice. Shorter thereafter he died at home. This case demonstrates the importance of keeping an open mind towards possibility of CJD when faced with esoteric neurologic presentations. Also this case provides insight into challenges in quarantine and sterilization of surgical instruments when these patients go through major surgeries.

  2. Tc-99m-bicisate (ECD)-brain-SPECT in rapidly progressive dementia

    International Nuclear Information System (INIS)

    We present a 61-year-old male patient with progressive dementia. A brain SPECT with Tc-99m-bicisate was performed for confirmation of clinically suspected Alzheimer-dementia. At the time of the SPECT-investigation marked apraxia and aphasia besides severe dementia were present. Electrophysiological as well as anatomical neuroimaging findings showed non-diagnostic alterations. SPECT revealed distinct perfusion defects, which made Alzheimer Dementia unlikely. The further course of the patient was determined by rapidly progressive deterioration with development of akinetic mutism. Thereafter, increased levels of neuron-specific enolase as well as 14-3-3 proteins were found in the cerebro-spinal fluid (CSF). The patient finally died with signs of cerebral decortication. Due to the clinical course and the CSF-findings the patient's final diagnosis was Creutzfeld-Jakob-disease, nevertheless no autopsy was performed. The presented case report underscores the clinical utility of perfusion brain SPECT in the differential diagnosis of dementias. (orig.)

  3. Fairystory »through the looking-glass« of psychoanalysis – fairystory as a therapeutic method for speach and language pathology treatment of selective mutism

    OpenAIRE

    Rovan, Katja

    2013-01-01

    This diploma paper deals with fairystory as adult literature which is transferred to the child through the 'art of narrating' of adults. It is reflected through the concept of psychoanalysis tracing analogies with fiction and spirituality. That spirituality which freed itself from the bonds of religious institutions and began comparing its own intelligence with intuitive intelligence of the sacred scriptures. Fairystory as apocalyptical literature aims at the ontological status of ambivalenc...

  4. Le banquier central, du mutisme à la communication permanente : la tonalité du discours de la B.C.E. et son impact

    OpenAIRE

    Mickaël Clévenot; Ludovic Desmedt; Matthieu Llorca

    2010-01-01

    Nous proposons une études théorique et empirique de l'influence du discours de la BCE à travers l'analyse des éditoriaux des bulletins mensuels. Le résultat principal est que le discours n'a qu'une influence très relative sur les variables réelles et dès qu'on réintègre les taux, l'influence du discours disparaît. Le discours apparaît donc juste comme enregistrant la conjoncture et accompagnant l'évolution des taux. Le discours en tant que tel n'a pas de réel impact en dehors du fait qu'il es...

  5. Novel mutation of the PRNP gene of a clinical CJD case

    Directory of Open Access Journals (Sweden)

    Collinge John

    2006-11-01

    Full Text Available Abstract Background Transmissible spongiform encephalopathies (TSEs, a group of neurodegenerative diseases, are thought to be caused by an abnormal isoform of a naturally occurring protein known as cellular prion protein, PrPC. The abnormal form of prion protein, PrPSc accumulates in the brain of affected individuals. Both isoforms are encoded by the same prion protein gene (PRNP, and the structural changes occur post-translationally. Certain mutations in the PRNP gene result in genetic TSEs or increased susceptibility to TSEs. Case presentation A 70 year old woman was admitted to the hospital with severe confusion and inability to walk. Relatives recognized memory loss, gait and behavioral disturbances over a six month period prior to hospitalization. Neurological examination revealed Creutzfeldt-Jakob disease (CJD related symptoms such as incontinence, Babinski sign and myoclonus. EEG showed periodic sharp waves typical of sporadic CJD and cerebrospinal fluid analysis (CSF was positive for the presence of the 14-3-3-protein. As the disease progressed the patient developed akinetic mutism and died in the tenth month after onset of the disease symptoms. Unfortunately, no autopsy material was available. PRNP sequencing showed the occurrence of a point mutation on one allele at codon 193, which is altered from ACC, coding for a threonine, to ATC, encoding an isoleucine (T193I. Conclusion Here we report a novel mutation of the PRNP gene found in an elderly female patient resulting in heterozygosity for isoleucine and threonine at codon 193, in which normally homozygosity for threonine is expected (T193. The patient presented typical clinical symptoms of CJD. EEG findings and the presence of the 14-3-3 protein in the CSF, contributed to CJD diagnosis, allowing the classification of this case as a probable CJD according to the World Health Organization (WHO accepted criteria.

  6. Tc-99m-bicisate (ECD)-brain-SPECT in rapidly progressive dementia; Hirn-SPECT mit Tc-99m-Bicisat (ECD) bei rasch progredientem dementiellen Syndrom

    Energy Technology Data Exchange (ETDEWEB)

    Marienhagen, J.; Eilles, C. [Regensburg Univ. (Germany). Abt. fuer Nuklearmedizin; Weingaertner, U.; Blaha, L. [Bezirkskrankenhaus Mainkofen (Germany). Psychiatrische Klinik; Zerr, I.; Poser, S. [Goettingen Univ. (Germany). Klinik und Poliklinik fuer Neurologie

    1999-07-01

    We present a 61-year-old male patient with progressive dementia. A brain SPECT with Tc-99m-bicisate was performed for confirmation of clinically suspected Alzheimer-dementia. At the time of the SPECT-investigation marked apraxia and aphasia besides severe dementia were present. Electrophysiological as well as anatomical neuroimaging findings showed non-diagnostic alterations. SPECT revealed distinct perfusion defects, which made Alzheimer Dementia unlikely. The further course of the patient was determined by rapidly progressive deterioration with development of akinetic mutism. Thereafter, increased levels of neuron-specific enolase as well as 14-3-3 proteins were found in the cerebro-spinal fluid (CSF). The patient finally died with signs of cerebral decortication. Due to the clinical course and the CSF-findings the patient's final diagnosis was Creutzfeld-Jakob-disease, nevertheless no autopsy was performed. The presented case report underscores the clinical utility of perfusion brain SPECT in the differential diagnosis of dementias. (orig.) [German] Wir berichten ueber einen 61jaehrigen Patienten mit progredientem dementiellen Syndrom, der unter der Verdachtsdiagnose einer Demenz vom Alzheimer-Typ (DAT) zur Hirn-SPECT-Untersuchung mit TC-99m-Bicisat (ECD) vorgestellt wurde. Zum Untersuchungszeitpunkt bestanden neben dem Vollbild einer Demenz eine ausgepraegte Apraxie und Aphasie bei unspezifischen Veraenderungen im EEG sowie der neuroradiologischen Bildgebung. In der Hirn-SPECT-Untersuchung fanden sich fuer eine DAT untypische ausgedehnte, vorwiegend rechtshemisphaerische Perfusionsstoerungen. Im weiteren Verlauf rasche Progredienz des Krankheitsbildes mit Entwicklung eines akinetischen Mutismus sowie Nachweis erhoehter Werte der neuronspezifischen Enolase und des 14-3-3-Proteins im Liquor. Der Patient verstarb schliesslich unter dem Bild einer Decortication. Aufgrund des klinischen Verlaufs sowie der Liquorbefunde wurde, da eine autoptische Befundsicherung

  7. [Gerstmann-Sträussler-Scheinker syndrome with a Pro102Leu mutation in the prion protein gene and atypical MRI findings, hyperthermia, tachycardia, and hyperhidrosis].

    Science.gov (United States)

    Imaiso, Y; Mitsuo, K

    1998-01-01

    A 64-year-old Japanese woman with Gerstmann-Sträussler-Scheinker syndrome (GSS) is reported. She was admitted to our hospital for progressive amnesia, twitching of the right upper limb, and difficulty in speaking and walking for 5 months. Physical examination revealed a fever, tachycardia, and hyperhidrosis without any evidence of inflammation or infection. Neurological examinations demonstrated dementia, frontal lobe signs, and spontaneous myoclonus. She developed akinetic mutism 4 months later. The levels of neuron-specific enolase and 14-3-3 protein were elevated in the cerebrospinal fluid, and serial EEG showed periodic synchronous discharges. DNA analysis of the prion protein gene revealed a Pro102Leu mutation and therefore she was diagnosed as GSS102. Head MRI showed abnormal high signal intensity by T2 weighted image in bilateral caudate nuclei, putamen, frontal lobes, and white matter around the posterior horn of lateral ventricles at admission, and extension to global cerebral cortex and diffuse deep white matter with marked atrophy of bilateral frontal and cerebellar cortices 4 months later. In 123I-IMP SPECT study, uptake of RI decreased slightly only in left frontal region at admission, but decreased markedly in bilateral frontal region 4 months later. Analysis of autonomic function (analysis of noradrenarine in plasma and urine, coefficient of variation of R-R intervals before and after giving atenolol, Aschner's eyeball pressure test, intracutaneous atropine and adrenaline injection test) revealed sympathetic hyperactivity but normal parasympathetic activity. This is a very rare case of GSS102 with atypical MRI findings and clinical features like Creutzfeldt-Jakob disease rather than GSS102, presenting hyperthermia, tachycardia, and hyperhidrosis caused presumably by sympathetic hyperactivity as well as fatal familial insomnia. Therefore it is suggested that some factors besides the codon mutation in the prion protein gene may influence clinical

  8. Sporadic Creutzfeldt-Jakob disease with focal findings: caveats to current diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Edward C. Mader

    2013-02-01

    Full Text Available The clinical diagnosis of Creutzfeldt-Jakob disease (CJD is largely based on the 1998 World Health Organization diagnostic criteria. Unfortunately, rigid compliance with these criteria may result in failure to recognize sporadic CJD (sCJD, especially early in its course when focal findings predominate and traditional red flags are not yet present. A 61-year-old man presented with a 3-week history of epilepsia partialis continua (jerking of the left upper extremity and a 2-week history of forgetfulness and left hemiparesis; left hemisensory neglect was also detected on admission. Repeated brain magnetic resonance imaging (MRI showed areas of restricted diffusion in the cerebral cortex, initially on the right but later spreading to the left. Electroencephalography (EEG on hospital days 7, 10, and 14 showed right-sided periodic lateralized epileptiform discharges. On day 20, the EEG showed periodic sharp wave complexes leading to a diagnosis of probable sCJD and subsequently to definite sCJD with brain biopsy. Neurological decline was relatively fast with generalized myoclonus and akinetic mutism developing within 7 weeks from the onset of illness. CJD was not immediately recognized because of the patient’s focal/lateralized manifestations. Focal/lateralized clinical, EEG, and MRI findings are not uncommon in sCJD and EEG/MRI results may not be diagnostic in the early stages of sCJD. Familiarity with these caveats and with the most current criteria for diagnosing probable sCJD (University of California San Francisco 2007, MRI-CJD Consortium 2009 will enhance the ability to recognize sCJD and implement early safety measures.

  9. Consciousness.

    Science.gov (United States)

    Zeman, A

    2001-07-01

    Consciousness is topical, for reasons including its renewed respectability among psychologists, rapid progress in the neuroscience of perception, memory and action, advances in artificial intelligence and dissatisfaction with the dualistic separation of mind and body. Consciousness is an ambiguous term. It can refer to (i) the waking state; (ii) experience; and (iii) the possession of any mental state. Self-consciousness is equally ambiguous, with senses including (i) proneness to embarrassment in social settings; (ii) the ability to detect our own sensations and recall our recent actions; (iii) self-recognition; (iv) the awareness of awareness; and (v) self-knowledge in the broadest sense. The understanding of states of consciousness has been transformed by the delineation of their electrical correlates, of structures in brainstem and diencephalon which regulate the sleep-wake cycle, and of these structures' cellular physiology and regional pharmacology. Clinical studies have defined pathologies of wakefulness: coma, the persistent vegetative state, the 'locked-in' syndrome, akinetic mutism and brain death. Interest in the neural basis of perceptual awareness has focused on vision. Increasingly detailed neuronal correlates of real and illusory visual experience are being defined. Experiments exploiting circumstances in which visual experience changes while external stimulation is held constant are tightening the experimental link between consciousness and its neural correlates. Work on unconscious neural processes provides a complementary approach. 'Unperceived' stimuli have detectable effects on neural events and subsequent action in a range of circumstances: blindsight provides the classical example. Other areas of cognitive neuroscience also promise experimental insights into consciousness, in particular the distinctions between implicit and explicit memory and deliberate and automatic action. Overarching scientific theories of consciousness include

  10. [A 57-year-old woman with gait disturbance, headache, character change, convulsion, and coma].

    Science.gov (United States)

    Takubo, H; Satoh, S; Mori, H; Tsukahara, M; Suda, K; Imai, H; Mizuno, Y

    1995-07-01

    discharged for out patient follow up, however, she developed a convulsion which was followed by loss of consciousness, and was admitted again to our service. She had never gained consciousness after this episode, and remained in the state of akinetic mutism. Follow-up CT and MRI did not show much change, although the area of high signal density lesions slightly enlarged on June 1, 1993. Her clinical course was complicated by drug induced bone marrow suppression and nephrotic syndrome. She expired on September 8, 1993 after developing sudden drop of blood pressure and bradycardia.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:7612389

  11. Basal hyperaemia is the primary abnormality of perfusion in Takotsubo cardiomyopathy

    DEFF Research Database (Denmark)

    Christensen, Thomas Emil; Ahtarovski, Kiril Aleksov; Bang, Lia Evi;

    2015-01-01

    AIMS: Takotsubo cardiomyopathy (TTC) is characterized by acute completely reversible regional left ventricle (LV) akinesia and decreased tracer uptake in the akinetic region on semi-quantitative perfusion imaging. The latter may be due to normoperfusion of the akinetic mid/apical area and basal...

  12. Increasing Verbal Behavior of a Student Who Is Selectively Mute

    Science.gov (United States)

    Beare, Paul; Torgerson, Colleen; Creviston, Cindy

    2008-01-01

    "Selective mutism" is the term used to describe a disorder in which a person speaks only in restricted stimulus situations. Examination of single-subject research concerning selective mutism reveals the most popular and successful interventions to instate speech involve a combination of behavior modification procedures. The present research…

  13. [Functional pathophysiology of consciousness].

    Science.gov (United States)

    Jellinger, Kurt A

    2009-01-01

    from important somatic and sensory pathways and acts as a control system of neuronal activities of the cerebral cortex. The principal function of the ARAS is to focus our alertness on specific stimuli or internal processes, which run via complex neuronal cell groups and numerous neurotransmitters that influence various aspects of consciousness and wakefulness. Stimulation of the ARAS produces an arousal reaction as the electric correlate of consciousness; its destruction causes coma and related states. The highest level are cortical (prefrontal and association) networks for recognition, motor activity, longterm memory and attention, the left hemisphere being considered as the dominant one. Different levels of consciousness are distinguished: 1. hyperalertness, 2. alertness (normal state of wakefulness), 3. somnolence or lethargy, 4. obtundation with tendency to fall asleep, 5. stupor, 6. coma and its subtypes, like akinetic mutism, apallic syndrome or persistent vegative state, locked-in syndrome, delirium, and catatonia. They are caused by damages in various functional levels of the brain, by psychogenic factors or experimentally, and are accompanied by characteristic neurological and psychiatric disorders. The relevant morphological lesions can be detected by electrophysiological and imaging studies. The bases of functional anatomy and pathophysiology of consciousness, its cognitive aspects and its major disorders, their causes and functional substrates with reference to sleep and both spontaneous and iatrogenic disorders of consciousness are critically summarized.

  14. [Functional pathophysiology of consciousness].

    Science.gov (United States)

    Jellinger, Kurt A

    2009-01-01

    from important somatic and sensory pathways and acts as a control system of neuronal activities of the cerebral cortex. The principal function of the ARAS is to focus our alertness on specific stimuli or internal processes, which run via complex neuronal cell groups and numerous neurotransmitters that influence various aspects of consciousness and wakefulness. Stimulation of the ARAS produces an arousal reaction as the electric correlate of consciousness; its destruction causes coma and related states. The highest level are cortical (prefrontal and association) networks for recognition, motor activity, longterm memory and attention, the left hemisphere being considered as the dominant one. Different levels of consciousness are distinguished: 1. hyperalertness, 2. alertness (normal state of wakefulness), 3. somnolence or lethargy, 4. obtundation with tendency to fall asleep, 5. stupor, 6. coma and its subtypes, like akinetic mutism, apallic syndrome or persistent vegative state, locked-in syndrome, delirium, and catatonia. They are caused by damages in various functional levels of the brain, by psychogenic factors or experimentally, and are accompanied by characteristic neurological and psychiatric disorders. The relevant morphological lesions can be detected by electrophysiological and imaging studies. The bases of functional anatomy and pathophysiology of consciousness, its cognitive aspects and its major disorders, their causes and functional substrates with reference to sleep and both spontaneous and iatrogenic disorders of consciousness are critically summarized. PMID:19573504

  15. Anxiety and Depression Association of America

    Science.gov (United States)

    ... Guidelines Scientific Council Special Interest Groups Child & Adolescent Anxiety SIG Peer Consultation OCD & Related Disorders SIG Peer Consultation Selective Mutism SIG Peer Consultation Social Anxiety SIG Peer Consultation Professional Opportunities: Jobs and Fellowships ...

  16. STUDY ABOUT THE INCIDENCE OF HEARING-SPEAKING DISORDERS IN A POPULATION WITH MENTAL DEFICIENCY

    Directory of Open Access Journals (Sweden)

    Ioana Mihaela Tomulescu

    2003-01-01

    Full Text Available This study is about the incidence of hearing-speaking disorders in a population with mental deficiency. We studied 596 children interned in Neurology and Psychiatry Clinical Hospital of Oradea during the 1999 - 2001 period. In 596 children, 393 presented different types of mental deficiency. The most frequent disorders observed are hearing loss or deafness, deaf-mutism, mutism and speaking retardation. Also, we related an increased frequency in rural area and in group of children with severe mental deficiency.

  17. Absence of Neurobehavioral Disturbance in a Focal Lesion of the Left Paracentral Lobule

    Directory of Open Access Journals (Sweden)

    T. Imamura

    1992-01-01

    Full Text Available The case of a right-handed woman with an infarcation confined to the left paracentral lobule and sparing the supplementary motor area (SMA is reported. She presented with a right leg monoplegia and displayed no mutism. The absence of any associated neurobehavioral disturbances (mutism, forced grasping, reduced spontaneous arm activity or aphasia raises the possibility that the left SMA has discrete neurobehavioral functions.

  18. WAARDENBURG SYNDROME TYPE II: A CASE REPORT

    OpenAIRE

    Santosh Kumar; Sunil Kumar; Anand

    2014-01-01

    Waardenburg syndrome is a rare syndrome, characterized by lateral displacement of the medial canthi combined with dystopia of the lacrimal punctum and blepharophimosis, prominent broad nasal root, hypertrichosis of the medial part of the eyebrows, white forelock, heterochromia iridis, and deaf mutism. A four months old girl with waardenburg syndrome type II, who had the characterstic features of the syndrome, is reported.

  19. Transient Stuttering in Catatonic Bipolar Patients

    Directory of Open Access Journals (Sweden)

    Anthony B. Joseph

    1991-01-01

    Full Text Available Two cases of transient stuttering occurring in association with catatonia and bipolar disorder are described. Affective decompensation has been associated with lateralized cerebral dysfunction, and it is hypothesized that in some bipolar catatonic patients a concomitant disorder of the lateralization of language function may lead to a variety of clinical presentations including aphasia, mutism, and stuttering.

  20. Catatonia in Autism: A Distinct Subtype?

    Science.gov (United States)

    Ghaziuddin, M.; Quinlan, P.; Ghaziuddin, N.

    2005-01-01

    Catatonia is a life-threatening disorder characterized by motor abnormalities, mutism, and disturbances of behaviour, which is increasingly being diagnosed in persons with autism. In this report, we describe the presentation and course of catatonia in an adolescent with autism who responded to electroconvulsive therapy (ECT). The illness started…

  1. Cannabis Induced Periodic Catatonia: A Case Report

    Science.gov (United States)

    Bajaj, Vikrant; Pathak, Prashant; Mehrotra, Saurabh; Singh, Vijender; Govil, Sandeep; Khanna, Aman

    2011-01-01

    Catatonia is a syndrome of specific motor abnormalities closely associated with disorders in mood, affect, thought and cognition. The principal signs of the disorder are mutism, immobility, negativism, posturing, stereotypy and echo phenomena. Catatonia is commonly seen in various psychiatric disorders, neurological disorders and certain medical…

  2. Major Depression in a Small Group of Adults with Down Syndrome.

    Science.gov (United States)

    Myers, Beverly A.; Pueschel, Siegfried M.

    1995-01-01

    The clinical histories and treatment of 9 individuals with Down syndrome and major depression are presented, as are clinical characteristics of an additional 13 individuals. Vegetative symptoms of disinterest, withdrawal, mutism, psychomotor retardation, decreased appetite, and insomnia were prominent. Preoccupations with suicide, death,…

  3. Iodine deficiency, thyroid function and hearing deficit: a review

    NARCIS (Netherlands)

    Boonstra, A.; MacKenzie, I.

    2013-01-01

    Iodine deficiency affects an estimated 241 million school-aged children in the world. Little is known about iodine deficiency in relation to auditory function, except for the fact that deaf-mutism is one of the features of cretinism. In the present review, we documented the scientific knowledge on t

  4. Establishing Vocal Verbalizations in Mute Mongoloid Children.

    Science.gov (United States)

    Buddenhagen, Ronald G.

    Behavior modification as an attack upon the problem of mutism in mongoloid children establishes the basis of the text. Case histories of four children in a state institution present the specific strategy of speech therapy using verbal conditioning. Imitation and attending behavior, verbal chaining, phonetic theory, social reinforcement,…

  5. Huntington Disease: A Case Study of Early Onset Presenting as Depression

    Science.gov (United States)

    Duesterhus, Pia; Schimmelmann, Benno Graf; Wittkugel, Oliver; Schulte-Markwort, Michael

    2004-01-01

    Huntington disease is a dominantly inherited, neurodegenerative disease characterized by choreiform movement disturbances and dementia, usually with adult onset. The rare juvenile-onset Huntington disease differs from the adult phenotype. A case presenting twice, at age 10 with all the signs of a major depression and age 14 with mutism and…

  6. Narrative Counseling for Professional School Counselors

    Science.gov (United States)

    Nafziger, Jacinta; DeKruyf, Lorraine

    2013-01-01

    This article introduces narrative counseling concepts and techniques for professional school counselors. The authors provide a case study of narrative school counseling with an elementary student struggling with selective mutism. Examples also demonstrate how a narrative approach could be used at elementary, middle, and high school levels within…

  7. Identification of valid housekeeping genes for quantitative RT-PCR analysis of cardiosphere-derived cells preconditioned under hypoxia or with prolyl-4-hydroxylase inhibitors

    OpenAIRE

    TAN, Suat Cheng; Carolyn A Carr; Yeoh, Kar Kheng; Schofield, Christopher J.; Davies, Kay E.; Clarke, Kieran

    2011-01-01

    Infarction irreversibly damages the heart, with formation of an akinetic scar that may lead to heart failure. Endogenous cardiac stem cells (CSCs) are a promising candidate cell source for restoring lost tissue and thereby preventing heart failure. CSCs may be isolated in vitro, via the formation of cardiospheres, to give cardiosphere-derived cells (CDCs). Although qRT-PCR analyses of CDCs have been performed, no justification for the selection of the housekeeping gene has been published. Her...

  8. Huntington's disease: effect of cysteamine, a somatostatin-depleting agent.

    Science.gov (United States)

    Shults, C; Steardo, L; Barone, P; Mohr, E; Juncos, J; Serrati, C; Fedio, P; Tamminga, C A; Chase, T N

    1986-08-01

    Somatostatin levels in the basal ganglia are elevated in Huntington's disease. A controlled therapeutic trial of the somatostatin-depleting agent, cysteamine, was therefore conducted in five patients, including one with the rigid-akinetic form. Maximum tolerated dosage for 2 weeks produced no consistent change in extrapyramidal or dementia scores. Somatostatin concentrations were not significantly altered in plasma or CSF. Growth hormone levels, on the other hand, more than doubled, suggesting a functionally significant decrease in central somatostatin levels. PMID:2874527

  9. Accuracy of subjective and objective handwriting assessment for differentiating Parkinson's disease from tremulous subjects without evidence of dopaminergic deficits (SWEDDs): an FP-CIT-validated study.

    Science.gov (United States)

    Bajaj, N P S; Wang, L; Gontu, V; Grosset, D G; Bain, P G

    2012-11-01

    Handwriting examinations are commonly performed in the analysis of tremor and Parkinson's disease (PD). We analyzed the accuracy of subjective and objective assessment of handwriting samples for distinguishing 27 PD cases, 22 with tremulous PD, and five with akinetic-rigid PD, from 39 movement-disorder patients with normal presynaptic dopamine imaging (subjects without evidence of dopamine deficiency or SWEDDs; 31 with dystonic tremor (DT), six indeterminate tremor syndrome, one essential tremor, one vascular parkinsonism). All handwriting analysis was performed blind to clinical details. Subjective classification was made as: (1) micrographia, (2) normal, or (3) macrographia. In addition, a range of objective metrices were measured on standardized handwriting specimens. Subjective assessments found micrographia more frequently in PD than SWEDDs (p = 0.0352) and in akinetic-rigid than tremulous PD (p = 0.0259). Macrographia was predominantly seen in patients with dystonic tremor and not other diagnoses (p = 0.007). Micrographia had a mean sensitivity of 55 % and specificity of 84 % for distinguishing PD from SWEDDs and mean sensitivity of 90 % and specificity of 55 % for distinguishing akinetic-rigid PD from tremulous PD. Macrographia had a sensitivity of 26 % and specificity of 96 % for distinguishing DT from all other diagnoses. The best of the objective metrices increased sensitivity for the distinction of SWEDDs from PD with a reduction in specificity. We conclude that micrographia is more indicative of PD than SWEDDs and more characteristic of akinetic-rigid than tremulous PD. In addition, macrographia strongly suggests a diagnosis of dystonic tremor. PMID:22532169

  10. Electroconvulsive therapy as a treatment for refractory neuropsychiatric lupus with catatonia: three case studies and literature review.

    Science.gov (United States)

    Bica, B E R G; Moro, A L D; Hax, V; Nicol, N A; Campos, G S; Rivera, L M S; da Costa, A F C; Xavier, R M; Monticielo, O A

    2015-10-01

    Neuropsychiatric disorders associated with systemic lupus erythematosus are very common. Treatment generally consists of glucocorticoids and immunosuppressive therapy; however, some cases are unresponsive. Electroconvulsive therapy (ECT) is a recognized treatment modality in psychiatry and is an option for refractory cases of neuropsychiatric lupus. This report describes three cases of neuropsychiatric lupus that improved with ECT after failure of antipsychotics and immunosuppressive therapy. All cases met DSM-5 criteria for catatonia (case 1: agitation, stereotypies, and grimacing; case 2: stupor, mutism, and grimacing; case 3: agitation, mutism, and stereotypies); therefore, ECT was indicated. This case series shows that ECT can be a therapeutic option in patients with neuropsychiatric lupus, especially when associated with catatonia and unresponsive to conventional treatment.

  11. Syndrome Keratitis-Ichtyosis-Deafness (KID) chez un enfant togolais issu d'un mariage consanguin

    OpenAIRE

    Kombaté, Koussak; Saka, Bayaki; Landoh, Dadja Essoya; Mouhari-Toure, Abass; Akakpo, Séfako; Belei, Eric; Gnassingbé, Wanguena; Djibril, Mohaman Awalou; Tchangaï-Walla, Kissem; Pitché, Palokinam

    2015-01-01

    Le syndrome KID est une affection génétique rare associant kératite, ichtyose et surdité. Nous rapportons un cas dont la surdité s'est compliquée de mutisme chez un enfant togolais issu d'un mariage consanguin.Il s'agissait d'une fillette de 9 ans admise en dermatologie pour une peau sèche et une kératodermie palmoplantaire évoluant depuis l'enfance, une surdité sévère et un mutisme total évoluant depuis la naissance. Il n'y avait pas d'histoire familiale connue de syndrome KID. Les parents d...

  12. Catatonic schizophrenia: an international comparative study.

    Science.gov (United States)

    Chandrasena, R

    1986-04-01

    Thirty-five hospitalized catatonic schizophrenic patients from Sri Lanka were compared with 22 patients in the U.K. and 13 in Canada. The phenomenology was established using the Present State Examination. Results suggest that ethnicity, chronicity of illness and reception of neuroleptic treatment may influence the lower prevalence of catatonic symptoms among the U.K. and Canadian schizophrenics. Onset of illness appears to be among young adults and mutism, stupor, mannerisms, stereotypes and negativism were the common catatonic symptoms observed.

  13. Catatonic syndrome associated with lead intoxication: a case report

    OpenAIRE

    Modabbernia, Mohammad Jafar; Mirsafa, Ali Reza; Modabbernia, Amirhossein; Pilehroodi, Farhad; Shirazi, Maryam

    2009-01-01

    Introduction Little is known about catatonia associated with lead intoxication. Case presentation A retired printing house worker man presented with one week history of refusal to eat and mutism. He was treated with possible diagnosis of catatonia with administration of Lorazepam 3 mg P.O. daily. Significant improvement occurred after 48 hours. In further examinations, there was no evidence of physical and mental disorders while impairment in neuropsychiatry test, identification of Dohle body...

  14. WAARDENBURG SYNDROME TYPE II: A CASE REPORT

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    Santosh Kumar

    2014-10-01

    Full Text Available Waardenburg syndrome is a rare syndrome, characterized by lateral displacement of the medial canthi combined with dystopia of the lacrimal punctum and blepharophimosis, prominent broad nasal root, hypertrichosis of the medial part of the eyebrows, white forelock, heterochromia iridis, and deaf mutism. A four months old girl with waardenburg syndrome type II, who had the characterstic features of the syndrome, is reported.

  15. Prevalence of goitre among school going children in urban area of Dehradun

    OpenAIRE

    Utkarsh Sharma; Janmejai Prasad Sharma; Arti Sharma; Alok Kumar; Navin Shukla

    2015-01-01

    Background: Iodine is an important micro-nutrient required for human nutrition. Iodine Deficiency Disorders (IDDs) are one of the major world-wide public health problems of today which causes wide spectrum of disabilities. It includes impairment of reproductive functions, lowering of IQ levels in school age children, goiter, deaf mutism, mental defects, weakness and paralysis of muscles as well as lesser degree of physical dysfunction. Methods: Selection of population: The school children...

  16. A MORPHOMETRIC ANALYSIS OF FOURTH VENTRICAL OF HUMAN CADAVERIC BRAIN BY PLASTINATION

    OpenAIRE

    Akbari V J; Saiyad S S; Pandya A M; Solanki S V; Dangar K P

    2011-01-01

    The fourth ventricle enlarges in various conditions like hydrocephalus, dementias, mutism etc. So, it is necessary to know the normal range of dimensions of forth ventricle. Present study was conducted at anatomy Dept. P.D.U. medical college, Rajkot, Gujarat during October 2009 to October 2010. The casts of ventricular system of 20 formalinized cadaveric human brains were prepared after injecting epoxyresin+hardener (BOND TITE) mixture. From the cast, measurements of height (from upper end of...

  17. Can Autism Spectrum Disorders and Social Anxiety Disorders Be Differentiated by the Social Responsiveness Scale in Children and Adolescents?

    Science.gov (United States)

    Cholemkery, Hannah; Mojica, Laura; Rohrmann, Sonja; Gensthaler, Angelika; Freitag, Christine M.

    2014-01-01

    Autism spectrum disorder (ASD) as well as social phobia (SP), and selective mutism (SM) are characterised by impaired social interaction. We assessed the validity of the Social Responsiveness Scale (SRS) to differentiate between ASD, and SP/SM. Raw scores were compared in 6-18 year old individuals with ASD (N = 60), SP (N = 38), SM (N = 43), and…

  18. Quadrigeminal plate lipoma presenting with Psychosis: A case ‎report with review of literature

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    Sourav Das

    2015-12-01

    Full Text Available A young patient who presented with headache followed by positive and negative symptoms of psychosis and mutism was sent for the MRI of brain. MRI revealed a lipoma in the quardrigeminal area. We hypothesized that the neuro-vascular encasement of structures located at the upper dorsal midbrain by the lipoma caused the symptoms. A review of the current literature of quadrigeminal lipoma cases with presenting symptoms is provided. Lipoma in quardrigeminal area could give rise to symptoms of psychosis.

  19. Dobutamine stress echocardiographyin distinguishing ischemic from nonischemic dilated cardiomyopathy

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    Miloradović Vladimir

    2005-01-01

    Full Text Available Introduction The aim of this study was to evaluate the diagnostic accuracy of dobutamine stress echocardiography for detection of coronary artery disease in patients with dilated cardiomyopathy. Detection of regional wall motion abnormalities at rest does not reliably distinguish ischemic from nonischemic cardiomyopathy. Material and methods To distinguish between ischemic and nonischemic dilated cardiomyopathy (DCM, we studied 50 patients with left ventricular dysfunction (20 ischemic and 30 nonischemic, detected by coronary angiography using dobutamine stress echocardiography. Echocardiographic images were obtained at baseline, low and paek dose of dobutamine. Rest and stress left ventricular wall motion scores were derived from analysis of regional wall motion. Results Dobutamine infusion was terminated after achievement of the target heart rate or maximal protocol dose in 16 (80% patients with ischemic heart disease and in 23 (73.3% patients with nonischemic heart disease. At rest, there were more normal segments (p<0.001 and a trend toward more akinetic segments (p, not significant per ischemic than per nonischemic DCM patients. However, either at rest or with low-dose dobutamine, individual data largely overlapped. At peak dose, in ischemic DCM, regional contraction worsened in many normal or dyssinergic regions at rest (in some cases after inprovement with low-dose dobutamine; in contrast, in nonischemic DCM, further mild impovement was observed in a variable number of left ventricular areas. Thus, with peak-dose dobutamine, more akinetic and less normal segments were present per ishemic than per nonischemic DCM patient (both, p<0.001. A value of six or more akinetic segments was 90% sensitive and 98% specific for ischemic DCM. Conclusions Our data show that analysis of regional contraction by dobutamine stress echocardiography can distinguish between.

  20. Occurrence and trends of selected nutrients, other chemical constituents, diatoms, and cyanobacteria in bottom sediment, Lake Maxinkuckee, northern Indiana

    Science.gov (United States)

    Juracek, Kyle E.

    2015-01-01

    Bottom-sediment cores collected in 2013 were used to investigate the recent and predevelopment (pre-1863) occurrence of selected nutrients (total nitrogen and total phosphorus), carbon, 39 trace elements, diatoms, cyanobacterial akinetes, and 3 radionuclides in the bottom sediment of Lake Maxinkuckee, a kettle lake in northern Indiana. Total nitrogen concentrations in the recent sediment (since about 1970) were variable with no consistent trend indicated. Total phosphorus concentrations in the recent sediment generally were uniform from about 1970 to about 2000 and indicated consistent inputs to the lake during that time. Subsequently, the history of total phosphorus deposition apparently was obscured by postdepositional upward diffusion.

  1. A Review of Treatment Options for Progressive Supranuclear Palsy.

    Science.gov (United States)

    Stamelou, Maria; Höglinger, Günter

    2016-07-01

    Progressive supranuclear palsy (PSP) is an atypical parkinsonian condition characterized by a symmetric akinetic-rigid syndrome, early falls, supranuclear gaze palsy, and a frontotemporal behavioral syndrome. The typical phenotype is termed Richardson's syndrome, but numerous other phenotypes have been described. The pathophysiology of PSP is not fully understood, but dysfunction of the tau protein seems to play a central role. Despite exciting new knowledge on the pathophysiology of PSP, there is still no highly effective symptomatic or disease-modifying treatment. We review the evidence on pharmacotherapy and experimental therapies in PSP and provide levels of recommendation for the off-label use of commonly used drugs in this disorder. PMID:27222018

  2. Consultation Dilemma Catatonia in a Patient with Prior TBI: MentaI or Medical Disorder?

    Science.gov (United States)

    Khalafian, Andrey; Dukes, Charles; Tucker, Phebe

    2015-08-01

    Mr. R, a 27 year old Hispanic male with history of traumatic brain injury (TBI) over ten years prior but no psychiatric history, presents to the psychiatric consultation service with recent onset of mutism, psychotic behavior and new diagnosis of epilepsy. The differential diagnosis is broad and includes both medical and psychiatric causes: post-ictal state, non-convulsive status epilepticus, delirium due to metabolic conditions, drugs, catatonia, conversion disorder, major depression with psychotic features, new onset schizophrenia or a combination of these possible diagnoses. We explore different medical causes that can present with symptoms of catatonia, as it is crucial to rule out a possible treatable medical cause.

  3. Malignant Catatonia

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    Ayca Ozkul

    2010-12-01

    Full Text Available Catatonia is a syndrome characterized by mutism, immobility, negativism, stereotypy, mannerisms, echophenomena, perseveration and passive obedience. The underlying causes can be psychiatric or may be associated with general medical status or neurological diseases. Additionally catatonia has two subtypes as malignant and nonmalignant catatonia. Main symptoms of malignant catatonia are hyperthermia and autonomic symptoms such as tachycardia, tachypnea and hyperhidrosis. It is important to make the diagnosis as early as possible for an appropriate medical treatment. Clinicians should be aware of the fatal outcome of the disease.

  4. Pour une typologie des formes de reformulation dans des prises en charge d'enfant en diachronie

    OpenAIRE

    Pouder, Marie-Christine

    2005-01-01

    Court article fait d'après le poster présenté au Colloque. Les thérapies d'enfants mettent en relation des locuteurs adultes experts et des enfants souvent à la limite du mutisme, en retard sur le plan du développement langagier. Le suivi en diachronie de ce genre de situation montre que parmi les "moteurs" de progression de l'interaction adulte / enfant, les procédés de répétition avec reformulation ou de reprise avec répétition partielle ou totale jouent un rôle important à certains mome...

  5. Clinical and imaging characteristics of 16 patients with autoimmune neuronal synaptic encephalitis

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    N Kamble

    2015-01-01

    Conclusions: All patients with anti-VGKC, anti-NMDA and anti-TPO antibody positivity presented with a triad of behavioral changes, impaired cognition and seizures. Mutism was a predominant symptom in patients with an anti-NMDA antibody positivity, which may help in the early identification of this disorder. MRI brain showed changes restricted to limbic structures in anti-NMDA and anti-VGKC antibody positivity. An early diagnosis and treatment of autoimmune encephalitis is essential for a better outcome and for prevention of long-term sequel.

  6. Potential for intracranial movements in pterosaurs.

    Science.gov (United States)

    Prondvai, Edina; Osi, Attila

    2011-05-01

    Based on comparative anatomical, morphological, and phylogenetic considerations the potential of pterosaurs for cranial kinesis is assessed. Our investigation shows that whereas skeletally mature derived pterodactyloids have completely fused, rigid and doubtlessly akinetic skulls, skeletally immature derived pterodactyloids and more basal pterosaurs possess key features in the morphology of their otic and basal joints that are suggestive of cranial kinesis, namely streptostyly. In addition, pterosaurs exhibit an evolutionarily informative trend in the degree of cranial ossification, where it is low in most nonpterodactyloids (here named bifenestratans), intermediate in Rhamphorhynchus and Archaeopterodactyloidea, and high in derived pterodactyloids. Incomplete fusion could also indicate loose connections between skull elements. However, another crucial anatomical requirement of a kinetic skull, the permissive kinematic linkage is absent in all pterosaurian taxa. The fact, that the presence of permissive kinematic linkages in the skull is also a prerequisite of all types of cranial kinesis, provides hard evidence that all members of Pterosauria had akinetic skulls. Thus, the presence of the morphological attributes indicative of intracranial movements in some pterosaurs must be explained on grounds other than real potential for cranial kinesis. It could either be of mechanical or ontogenetic importance, or both. Alternatively, it might be considered as the morphological remnant of a real, kinetic skull possessed by the diapsid ancestors of pterosaurs.

  7. Fungal parasitism: life cycle, dynamics and impact on cyanobacterial blooms.

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    Mélanie Gerphagnon

    Full Text Available Many species of phytoplankton are susceptible to parasitism by fungi from the phylum Chytridiomycota (i.e. chytrids. However, few studies have reported the effects of fungal parasites on filamentous cyanobacterial blooms. To investigate the missing components of bloom ecosystems, we examined an entire field bloom of the cyanobacterium Anabaena macrospora for evidence of chytrid infection in a productive freshwater lake, using a high resolution sampling strategy. A. macrospora was infected by two species of the genus Rhizosiphon which have similar life cycles but differed in their infective regimes depending on the cellular niches offered by their host. R. crassum infected both vegetative cells and akinetes while R. akinetum infected only akinetes. A tentative reconstruction of the developmental stages suggested that the life cycle of R. crassum was completed in about 3 days. The infection affected 6% of total cells (and 4% of akinètes, spread over a maximum of 17% of the filaments of cyanobacteria, in which 60% of the cells could be parasitized. Furthermore, chytrids may reduce the length of filaments of Anabaena macrospora significantly by "mechanistic fragmentation" following infection. All these results suggest that chytrid parasitism is one of the driving factors involved in the decline of a cyanobacteria blooms, by direct mortality of parasitized cells and indirectly by the mechanistic fragmentation, which could weaken the resistance of A. macrospora to grazing.

  8. A tautology in the classification of generalized non-convulsive epileptic seizures.

    Science.gov (United States)

    Seino, M; Fujiwara, T; Miyakoshi, M; Yagi, K

    1980-01-01

    Five patients with the Lennox-Gastaut syndrome who have shown generalized nonconvulsive seizures were presented. The seizure manifestations which occurred spontaneously were documented by simultaneous recording and analyzed in terms of clinical and electroencephalographic correlates. According to the diagnostic criteria of the International Classification, it was possible, on the one hand, to regard them as "atypical complex absences" in which the impairment of consciousness is accompanied by other symptoms, which tend to dominate the clinical picture. They were: hypotonic, hypertonic, myoclonic and akinetic components, respectively. On the other hand, if we give a special weight to the accompanying symptoms, it is entirely possible that they are at the same time diagnosed atonic, axial tonic, bilateral myoclonic and akinetic seizures. The initial impairment of consciousness is common to all the seizure manifestations, and the ictal and interictal EEG expressions are not of diagnostic significance. A question arises as to whether two different nomenclatures were arbitrarily given to a unique ictal manifestation or not as far as the generalized non-convulsive seizures were concerned.

  9. Posterior Fossa Syndrome

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    Serhan Kupeli

    2014-08-01

    Full Text Available Posterior fossa syndrome is defined as the temporary and complete loss of speech after posterior fossa surgery which is not related to cerebellar hemorrhage, infection of the cerebellum, degenerative or neoplastic diseases of the cerebellum. In this review, we aimed to outline the incidence of posterior fossa syndrome, to define the risk factors for posterior fossa syndrome, to describe accompanying neurobehavioural and psychologic problems and to speculate about the etiologic mechanisms. The diagnosis of medulloblastoma and midline location of the tumor are important risk factors for the development of posterior fossa syndrome. These findings support the hypothesis that temporary ischemia and edema due to retracted and largely manipulated dentate nuclei and superior cerebellar pedincles may be the cause of mutism. Informing the family and the patient about the posterior fossa syndromemust be a component of the preoperative interview and patients who developed posterior fossa syndrome should be followed for accompanying neurobehavioural and psychologic problems even after mutism improved. [Archives Medical Review Journal 2014; 23(4.000: 636-657

  10. Parkinson's disease severity and motor subtype influence physical capacity components

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    Marcelo Pinto Pereira

    2013-09-01

    Full Text Available The severity of Parkinson's disease (PD and PD's motor subtypes influence the components of physical capacity. The aim of this study was to investigate the impact of both PD severity and motor subtype in the performance of these components. Thirty-six PD patients were assigned into four groups: Tremor (TD initial and TD mild, akinetic-rigid (AR initial, and AR mild. Patients' strength, balance, coordination, mobility and aerobic capacity were evaluated and groups were compared using a two-way ANOVA (severity and subtype as factors. AR presents a poorer performance than TD in almost all tests. Also this performance was worsened with the advance of the disease in AR, contrary to TD. We conclude that AR and TD subgroups are different about their performance on physical capacity components, moreover, this performance worsens with the advance of the disease of the AR group, but not for TD.

  11. Sedimentation and occurrence and trends of selected nutrients, other chemical constituents, and cyanobacteria in bottom sediment, Clinton Lake, northeast Kansas, 1977-2009

    Science.gov (United States)

    Juracek, Kyle E.

    2011-01-01

    A combination of available bathymetric-survey information and bottom-sediment coring was used to investigate sedimentation and the occurrence of selected nutrients (total nitrogen and total phosphorus), organic and total carbon, 25 trace elements, cyanobacterial akinetes, and the radionuclide cesium-137 in the bottom sediment of Clinton Lake, northeast Kansas. The total estimated volume and mass of bottom sediment deposited from 1977 through 2009 in the conservation (multi-purpose) pool of the reservoir was 438 million cubic feet and 18 billion pounds, respectively. The estimated sediment volume occupied about 8 percent of the conservation-pool, water-storage capacity of the reservoir. Sedimentation in the conservation pool has occurred about 70 percent faster than originally projected at the time the reservoir was completed. Water-storage capacity in the conservation pool has been lost to sedimentation at a rate of about 0.25 percent annually. Mean annual net sediment deposition since 1977 in the conservation pool of the reservoir was estimated to be 563 million pounds per year. Mean annual net sediment yield from the Clinton Lake Basin was estimated to be 1.5 million pounds per square mile per year. Typically, the bottom sediment sampled in Clinton Lake was at least 99 percent silt and clay. The mean annual net loads of total nitrogen and total phosphorus deposited in the bottom sediment of Clinton Lake were estimated to be 1.29 million pounds per year and 556,000 pounds per year, respectively. The estimated mean annual net yields of total nitrogen and total phosphorus from the Clinton Lake Basin were 3,510 pounds per square mile per year and 1,510 pounds per square mile per year, respectively. Throughout the history of Clinton Lake, total nitrogen concentrations in the deposited sediment generally were uniform and indicated consistent inputs to the reservoir over time. Likewise, total phosphorus concentrations in the deposited sediment generally were uniform

  12. Depression in schizophrenia.

    Science.gov (United States)

    Becker, R E

    1988-12-01

    Depressive syndromes that occur during the course of schizophrenia are not clearly understood but have important implications for the treatment of the schizophrenic patient. In this review of the literature on depression secondary to schizophrenia, the author notes that lack of tested diagnostic criteria has led to a misunderstanding of its relatively high frequency and its association with poor outcome features such as impaired psychosocial functioning, schizophrenic relapse, and suicide. Differential diagnosis, including ruling out akinetic depression, is essential, he believes, partly because the concept of schizophrenic depression as postpsychotic is not supported by evidence. Clinical management must address such increased risk factors as relapse and suicide, but evidence indicates that secondary depression in schizophrenia does not respond to antidepressant medication. PMID:3068116

  13. Ecological distribution of harmful epiphytic Oscillatoriales in Alexandria coast, Egypt, with special reference to DNA identification

    Institute of Scientific and Technical Information of China (English)

    Amany Abdel Hamid Ismael; Eman Abdel Razak Mohamed; Mostafa Mohamed El-Sheikh; Wafaa Hassan Hegazy

    2014-01-01

    Objective: To identify the potentially harmful epiphytic Oscillatoriales species and follow up their distribution along Alexandria coast. Methods: Samples were collected bimonthly from April 2009 to February 2010 at three sites along Alexandria coast. Both morphological and molecular analyses were used for identifying the dominant species.Results:Five species belonging to two families were identified; Oscillatoria acutissima, Oscillatoria nigroviridis, Oscillatoria sp., Lyngbya majuscule and Phormidium formosum. Their cell density ranged from 103 to 126X103 filament g-1 fresh weight macroalgae. The morphological study of the dominant species, Oscillatoria sp. (Oscillatoria sp. W1) showed much similarity withPlanktothrix agardhii with no heterocysts and akinetes, while molecular ananlysis (16S rDNA) clustered the species in the same group with Anabaena sp.Conclusions:The 16S rDNA genes are not suitable for identifying Oscillatoriales during the present study and another molecular method should be used instead.

  14. Diagnosis of a Strangulated Laparoscopic Incisional Hernia with Point-of-Care Ultrasonography

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    Argintaru, Niran

    2015-05-01

    Full Text Available The use of point-of-care ultrasound for the diagnosis of bowel obstructions and hernias is becoming increasingly common in the emergency department (ED. Using a relatively rare case of an incisional port hernia, we demonstrate the ultrasound findings of a strangulated hernia causing a partial small bowel obstruction. A 46-year-old female presented four days following a laparoscopic surgery complaining of abdominal pain, nausea and lack of bowel movements. There was a palpable mass in the left lower quadrant under the 12mm trocar port incision. ED point-of-care ultrasound revealed herniated akinetic loops of bowel through her laparoscopy incision. This is the first case report to describe the use of point-of-care ultrasound for the diagnosis of a strangulated incisional port hernia at the bedside. [West J Emerg Med. 2015;16(3:450–452.

  15. [Perioperative Management of PD Patients].

    Science.gov (United States)

    Reichmann, H

    2016-07-01

    Both patients and caregivers but also treating physicians are concerned about complications along with surgical interventions. A major problem is abrupt cessation of anti-Parkinson medication, which leads to manifold disturbances, sometimes even to an akinetic crisis. There are several means to guarantee continuous dopaminergic stimulation even in patients that are not allowed to take medication orally before they undergo surgery. Amongst others rectally applied levodopa, amantadine infusions, and especially the use of a rotigotine patch are good means to overcome oral intake. Perioperative management is important due to the fact that in Germany alone each year more than 10 000 PD patients undergo surgery. Main reasons for this are fractures, but also elective interventions. Further emergency situations that cause treatment as an inpatient are psychosis, motoric disability, but also pneumonia and cardiovascular disturbances. In contrast PD patients suffer less often from cancer. PMID:27276074

  16. Pharmacological profile of the abeorphine 201-678, a potent orally active and long lasting dopamine agonist

    Energy Technology Data Exchange (ETDEWEB)

    Jaton, A.L.; Giger, R.K.A.; Vigouret, J.M.; Enz, A.; Frick, W.; Closse, A.; Markstein, R.

    1986-01-13

    The central dopaminergic effects of an abeorphine derivative 201-678 were compared to those of apomorphine and bromocriptine in different model systems. After oral administration, this compound induced contralateral turning in rats with 6-hydroxydopamine induced nigral lesions and exhibited strong anti-akinetic properties in rats with 6-hydroxydopamine induced hypothalamic lesions. It decreased dopamine metabolism in striatum and cortex, but did not modify noradrenaline and serotonin metabolism in the rat brain. 201-678 counteracted the in vivo increase of tyrosine hydroxylase activity induced by ..gamma..-butyrolactone. In vitro it stimulated DA-sensitive adenylate cyclase and inhibited acetylcholine release from rat striatal slices. This compound had high affinity for /sup 3/H-dopamine and /sup 3/H-clonidine binding sites. These results indicate that 201-678 is a potent, orally active dopamine agonist with a long duration of action. Furthermore it appears more selective than other dopaminergic drugs. 29 references, 5 figures, 3 tables.

  17. Neuroimaging studies of striatum in cognition Part II: Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Alexandru eHanganu

    2015-10-01

    Full Text Available In recent years a gradual shift in the definition of Parkinson’s disease (PD has been established, from a classical akinetic-rigid movement disorder to a multi-system neurodegenerative disease. While the pathophysiology of PD is complex and goes much beyond the nigro-striatal degeneration, the striatum has been shown to be responsible for many cognitive functions. Patients with PD develop impairments in multiple cognitive domains and the PD model is probably the most extensively studied regarding striatum dysfunction and its influence on cognition. Up to 40% of PD patients present cognitive impairment even in the early stages of disease development. Thus understanding the key patterns of striatum and connecting regions’ influence on cognition will help develop more specific approaches to alleviate cognitive impairment and slow down its decline. This review focuses on the contribution of neuroimaging studies in understanding how striatum impairment affects cognition in PD.

  18. Caracterización citomorfomérica de Anabaena circinalis (Cyanophyta en una proliferación masiva en el embalse Paso de Las Piedras (Provincia de Buenos Aires, Argentina Cytomorphometric characterization of Anabaena circinalis (Cyanophyta from a bloom in the lake Embalse Paso de las Piedras (Buenos Aires Province, Argentina

    Directory of Open Access Journals (Sweden)

    Gimena Argañaraz Bonini

    2005-07-01

    . Our results suggest that 1 it is possible to characterise individuals of A. circinalis growing in eutrophic condition, by using statistical parameters of the vegetative cells dimensions, 2 the criterion based on akinete morphology should not be used for characterization given the no maturation of akinetes in eutrophic conditions and the trend to morphological uniformity between the vegetative cells and immature akinetes, and 3 spherical heterocyst and vegetative cells can be discriminated by size but not by shape, whereas both can be differentiated from ovoidal akinetes. The variance analysis of the length of vegetative cells indicates all trichomes belong to the same species.

  19. Clinical features of progressive supranuclear palsy in 105 Chinese patients

    Institute of Scientific and Technical Information of China (English)

    Jing Hou; Ruibiao Guo; Tong Chen; Xiaohong Zhang; Weiping Wu; Zhenfu Wang

    2011-01-01

    OBJECTIVE: To thoroughly investigate clinical characteristics of progressive supranuclear palsy (PSP) in a Chinese population.METHODS: Computer-based online searches through China National Knowledge Infrastructure and Weipu Periodical Database were performed to collect case reports of PSP published between 1980 and 2009. Clinical characteristics were analyzed.RESULTS: A total of 58 studies comprising 105 patients (76 males and 29 females) were included. All cases were sporadic and free of family history. The mean age at onset was 60.6 ± 9.1 years, and the mean course from onset of symptoms to diagnosis was 3.4 ± 2.4 years. The male-to-female ratio was approximately 3: 1. Onset was characterized by akinetic-rigid features and accounted for 34.3% of all cases, followed by early postural instability (25.5%), pseudobulbar palsy (9.8%), cognitive impairment (9.8%), and vertical supranuclear ophthalmoplegia (7.8%). With disease progression, vertical supranuclear ophthalmoplegia was reported in 95.1% of cases, followed by akinetic-rigid features (83.3%), pseudobulbar palsy (82.4%), axial dystonia (75.5%), cognitive impairment (72.5%), and early postural instability (69.6%). A total of 70.5% of patients exhibited abnormal electroencephalograms, and 21.4% exhibited mild abnormalities in cerebrospinal fluid. Brain CT scanning results of 37 patients showed 37.8% with midbrain and concurrent cerebral hemisphere atrophy, and 5.4% and 24.3% with midbrain and cerebral hemisphere atrophy, respectively. Brain MRI scanning results of 55 patients revealed a total of 16.4% patients with midbrain atrophy, 23.6% with midbrain and concurrent cerebral hemisphere atrophy, 32.7% with cerebral hemisphere atrophy, and 11% with brainstem atrophy. The percentage of midbrain atrophy revealed by MRI was greater than by CT. All 11 patients subjected to Mini-Mental State Examination scored < 23. A total of 10 patients underwent brain electrophysiological examination, and 80% presented with

  20. Transient stress cardiomyopathies in the elderly: Clinical & Pathophysiologic considerations

    Institute of Scientific and Technical Information of China (English)

    Michael A Chen

    2012-01-01

    Transient stress-induced cardiomyopathies have been increasingly recognized and while rare,they tend to affect elderly women more than other demographic groups.One type,often called tako-tsubo cardiomyopathy (TTC),is typically triggered by significant emotional or physical stress and is associated with chest pain,electrocardiogram (ECG) changes and abnormal cardiac enzymes.Significant left ventricular regional wall motion abnormalities usually include an akinetic "ballooning" apex with normal or hyperdynamic function of the base.A second type,often called neurogenic stunned myocardium,typically associated with subarachnoid hemorrhage,also usually presents with ECG changes and positive enzymes,but the typical wall motion abnormalities seen include normal basal and apical left ventricular contraction with akinesis of the mid-cavity in a circumferential fashion.The pathophysiology,clinical care and typical courses,are reviewed.

  1. A prospective study of freezing of gait with early Parkinson disease in Chinese patients.

    Science.gov (United States)

    Zhang, Hongbo; Yin, Xifan; Ouyang, Zhiyuan; Chen, Jing; Zhou, Shenghua; Zhang, Changguo; Pan, Xin; Wang, Shiliang; Yang, Junxiang; Feng, Yaoyao; Yu, Ping; Zhang, Qiangchun

    2016-06-01

    This study investigated the risk factors for freezing of gait (FOG) in the early stage of Parkinson disease in China, using a sample of 248 patients who were followed for 3 years. Part III of the Unified Parkinson Disease Rating Scale and the modified Hoehn-Yahr grading scale were used to evaluate the severity of motor symptoms. Nonmotor symptoms were assessed using the Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale (HAMD), and Non-Motor Symptoms Scale (NMSS). The end-point was the presence of FOG at the end of follow-up; patients with FOG were classified as freezers. The risk factors for FOG were analyzed at the end of the first, second, and third years after baseline. There were 40 freezers (16.13%) 1 year later, 98 (39.52%) 2 years later, and 128 (51.61%) 3 years later. FOG 3 years later was associated with the following variables: depression (P = 0.003), older age, living in the countryside, lower education, akinetic-rigid style, lower limbs as site of onset, early use of levodopa, higher daily dose of levodopa, and not using amantadine or selegiline and dopamine receptor agonists (P Early use of amantadine, selegiline, and dopamine receptor agonists was negatively related to FOG (P onset (OR = 4.772, P = 0.008), not using dopamine receptor agonists (OR = 0.031, P Parkinson disease were more likely to experience FOG if: they were older, or from the countryside; had an akinetic-rigid style, anxiety, or higher NMSS scores; they used levodopa early or did not use amantadine or selegiline; their lower limbs were the site of onset; or they had more severe motor disability or higher HAMD scores at baseline. PMID:27368041

  2. Detection of viable myocardium by low dose of dobutamine cine MR imaging in miniswine

    Institute of Scientific and Technical Information of China (English)

    陆敏杰; 赵世华; 韦云青; 王诚; 蒋世良; 黄连军; 张岩; 牟峰; 孟亮; 阮英峁

    2003-01-01

    Objective To evaluate the diagnostic value of dobutamine stress magnetic resonance imaging (MRI) for myocardial viability. Methods Ten male miniswines underwent left ventriculography and coronary angiography, followed by stenosis of the left circumflex coronary artery (LCX) using ameroid constrictor. More than one month later, left ventriculography and coronary angiography were performed again, followed by cine-MRI at rest and during stress with incremental dose of dobutamine 5-20 μg·kg-1·min-1. Traditional and/or breath-hold cine-MRI were used to evaluate regional left ventricular wall motion, corresponding to basal, midventricular and apical short-axis tomograms. Regional wall motion score index (WMSI) was calculated.The miniswines were finally sacrificed for pathological examination. Triphenyl tetrazolium chloride (TTC) delineated myocardial infarction. Microscopy was used to identify myocardial cellular changes. Results One pig died, one pig suffered from aneurysm and another showed no negative findings. The other seven pigs were found with hypokinetic (n=4) or akinetic (n=3) myocardial regions related to stenosed LCX. Their mean WMSI at rest for the lateral and posteroinferior walls (ischemic regions) of the left ventricle was 2.27±0.32, as compared with 1.00±0.00 (P0.05). The pathologic examination showed viable myocardium at the ischemic regions. ConclusionLow-dose dobutamine (5μg·kg-1·min-1) recovers hypokinetic or akinetic myocardial regions, and dobutamine stress MRI can be used to detect myocardial viability.

  3. THE INFLUENCE OF LONG-TERM THERAPY WITH PERINDOPRIL ON THE HEART INOTROPIC FUNCTION IN PATIENTS WITH CHRONIC POSTINFARCTION ANEURISM

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    I. G. Fomina

    2006-01-01

    Full Text Available Aim. To study the influence of long-term therapy with perindopril on the heart inotropic function in patients with chronic postinfarction aneurism. Material and methods. 21 patients suffering ischemic heart disease with postinfarction cardiosclerosis, chronic aneurism of left ventricle and chronic heart failure of functional class III-IV according to NYHA were observed. All patients took perindopril, 2-4 mg daily. Before and after 6 months of therapy myocardial contractile function of left and right ventricles was studied by balanced radioventriculography with segmental and phase analysis of histogram. Results. In patients with chronic postinfarction aneurism significant structural and functional abnormalities were revealed: reduction of left ventricular ejection fraction up to 17,8 ± 3,2 %, the same for right ventricular up to 22,1±4,4 %, their considerable dilation with reduction of filling and expulsion velocity. After 6 months of therapy with  perindopril  improvement of clinic status of patients, tendency towards  increase of both ventricles general ejection fraction, enlargement of maximal filling velocity and filling velocity during 1/3 of diastole as well as tendency to reduction of both ventricles end diastolic and systolic volumes were registered. In left ventricle there were normokinetic zones in 35 (21% segments, hypokinetic zones in 24 (14%, akinetic zones in 54 (32% and dyskinetic zones in 17 (10% segments. In right ventricle there were normokinetic zones in 45 (27% segments, hypokinetic zones in 62(37%, akinetic zones in 54 (32% and dyskinetic zones in 7 (4% segments. After 6 months of therapy with perindopril tendency towards improvement of local myocardial contractility was registered. Conclusion. In patients with chronic postinfarction aneurism deterioration of general and local myocardial contractility were registered. Accurate link between left ventricle local myocardial contractility and localization of aneurism were

  4. Paleobiology of the Mesoproterozoic Billyakh Group, Anabar Uplift, northern Siberia

    Science.gov (United States)

    Sergeev, V. N.; Knoll, A. H.; Grotzinger, J. P.

    1995-01-01

    Silicified peritidal carbonates of the Mesoproterozoic Kotuikan and Yusmastakh Formations, Anabar Uplift, northeastern Siberia, contain exceptionally well-preserved microfossils. The assemblage is dominated by ellipsoidal akinetes of nostocalean cyanobacteria (Archaeoellipsoides) and problematic spheroidal unicells (Myxococcoides); both are allochthonous and presumably planktonic. The assemblage also includes distinctive mat-forming scytonematacean and entophysalidacean cyanobacteria, diverse short trichomes interpreted as cyanobacterial hormogonia or germinated akinetes, rare longer trichomes, and several types of colonial unicells. Although many taxa in the Kotuikan-Yusmastakh assemblage are long-ranging prokaryotes, the overall character of the assemblage is distinctly Mesoproterozoic, with its major features shared by broadly coeval floras from Canada, China, India, and elsewhere in Siberia. Microfossils also occur in middle to inner shelf shales of the Ust'-Il'ya and lower Kotuikan Formations. Leiosphaerid acritarchs (up to several hundred microns in diameter) characterize this facies. As in other Mesoproterozoic acritarch assemblages, acanthomorphic and other complex forms that typify Neoproterozoic assemblages are absent. The combination in Billyakh assemblages of exceptional preservation and low eukaryotic diversity supports the hypothesis that nucleated organisms diversified markedly near the Mesoproterozoic-Neoproterozoic boundary. The assemblages also demonstrate the antiquity of cyanobacteria capable of cell differentiation and suggest the importance of both changing peritidal substrates and evolving eukaryotes in determining stratigraphic patterns of Proterozoic prokaryotes. The permineralized assemblage contains 33 species belonging to 17 genera. Ten new species or new combinations are proposed: Archaeoellipsoides costatus n. sp., A. elongatus n. comb., A. dolichos n. comb., A. minor n. nom., A. crassus n. comb., A. major n. comb., A. bactroformis n

  5. Macrochaete gen. nov. (Nostocales, Cyanobacteria), a taxon morphologically and molecularly distinct from Calothrix.

    Science.gov (United States)

    Berrendero Gómez, Esther; Johansen, Jeffrey R; Kaštovský, Jan; Bohunická, Markéta; Čapková, Kateřina

    2016-08-01

    Historically, the genus Calothrix included all noncolonial, tapered, heterocytous filaments within the cyanobacteria. However, recent molecular phylogenies show that "Calothrix" defined in this sense represents five distinct clades. The type species of Calothrix is marine, with solitary basal heterocytes, no akinetes, and distal ends tapering abruptly into short hairs. We examined the morphology and phylogeny of 45 tapering cyanobacteria in the Rivulariaceae, including freshwater and marine representatives of both Calothrix (35 strains) and its sister taxon Rivularia (10 strains). The marine Calothrix fall into two lineages, but we lack the generitype and so cannot identify the clade corresponding to the type species. The freshwater and soil Calothrix fall into the C. parietina clade and are characterized by having a basal heterocyte, no akinetes, and gradual tapering-but not into a long hyaline hair. Macrochaete gen. nov. is a freshwater taxon sister to the Calothrix lineages but clearly separated from Rivularia. The species in this genus differ morphologically from Calothrix by their ability to produce two heteromorphic basal heterocytes and specific secondary structures of the 16S-23S ITS. An additional feature present in most species is the presence of a distal, long hyaline hair, but this character has incomplete penetrance due to its expression only under specific environmental conditions (low phosphate), and in one species appears to be lost. We recognize three species: M. psychrophila (type species) from cold environments (high mountains, Antarctica), M. santannae from wet walls of subtropical South America, and M. lichenoides, a phycobiont of lichens from Europe. PMID:27136320

  6. Multi-Modal Ultra-Widefield Imaging Features in Waardenburg Syndrome

    Science.gov (United States)

    Choudhry, Netan; Rao, Rajesh C.

    2015-01-01

    Background Waardenburg syndrome is characterized by a group of features including; telecanthus, a broad nasal root, synophrys of the eyebrows, piedbaldism, heterochromia irides, and deaf-mutism. Hypopigmentation of the choroid is a unique feature of this condition examined with multi-modal Ultra-Widefield Imaging in this report. Material/Methods Report of a single case. Results Bilateral symmetric choroidal hypopigmentation was observed with hypoautofluorescence in the region of hypopigmentation. Fluorescein angiography revealed a normal vasculature, however a thickened choroid was seen on Enhanced-Depth Imaging Spectral-Domain OCT (EDI SD-OCT). Conclusion(s) Choroidal hypopigmentation is a unique feature of Waardenburg syndrome, which can be visualized with ultra-widefield fundus autofluorescence. The choroid may also be thickened in this condition and its thickness measured with EDI SD-OCT. PMID:26114849

  7. Mutation Identification in A 5-Generation Pedigree with Autosomal Dominant Retinitis Pigmentosa

    Institute of Scientific and Technical Information of China (English)

    滕云; 田虹; 王慧; 胡晓峰; 王嵬; 陈燕; 杨真荣

    2003-01-01

    An extended 5-generation family has been investigated in which 32 of the 111 familymembers were diagnosed as having retinitis pigmentosa (RP). The proband was a 58-year old malein whom night-blindness was first observed in early childhood, with almost loss of vision by 52years of age. The symptoms observed in other family members included night-blindness, impairedvision and visual field loss. Dementia, digital abnormalities, deaf-mutism and mental retardationwere variously diagnosed in a number of individuals with RP. The affected and unaffected familymembers were tested for mutations in a range of candidate genes. The 8 exons of three candidategenes have been analyzed by polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP) and DNA sequencing techniques. A novel mutation was identified in the rhodopsingene at codon 52 of exon 1 (TTC-TAC) that resulted in a substitution of Phe to Tyr.

  8. [Catatonia in the elderly].

    Science.gov (United States)

    Chiba, Yuhei; Odawara, Toshinari

    2013-10-01

    Catatonia is a syndrome characterized by mutism, stupor, immobility, negativism, posturing, stereotypy, and echophenomena. Not only patients with schizophrenia, but also patients with general medical disease, mood disorder, and substance-related disorder exhibit catatonia. In the patients with catatonia, it is recommended to examine whether they have a general medical disease. We present two catatonic elder patients. Case 1 exhibited catatonia with vascular dementia, and was revealed to have anti-phospholipid antibody syndrome. Case 2 exhibited catatonia with dementia with Lewy bodies, and was revealed to have Hashimoto's encephalopathy. The first recommended treatment for catatonia is benzodiazepines. In case of benzodiazepine resistance or malignant catatonia, it should be considered electroconvulsive therapy, but it needs to be carefully implemented for elder patients.

  9. Renal Failure in Dementia with Lewy Bodies Presenting as Catatonia

    Directory of Open Access Journals (Sweden)

    Robert Fekete

    2013-01-01

    Full Text Available Catatonia, originally described by Karl Kahlbaum in 1874, may be regarded as a set of clinical features found in a subtype of schizophrenia, but the syndrome may also stem from organic causes including vascular parkinsonism, brain masses, globus pallidus lesions, metabolic derangements, and pharmacologic agents, especially first generation antipsychotics. Catatonia may include paratonia, waxy flexibility (cerea flexibilitas, stupor, mutism, echolalia, and catalepsy (abnormal posturing. A case of catatonia as a result of acute renal failure in a patient with dementia with Lewy bodies is described. This patient recovered after intravenous fluid administration and reinstitution of the atypical dopamine receptor blocking agent quetiapine, but benzodiazepines and amantadine are additional possible treatments. Recognition of organic causes of catatonia leads to timely treatment and resolution of the syndrome.

  10. Electroconvulsive therapy for catatonia in juvenile neuropsychiatric lupus.

    Science.gov (United States)

    Leon, T; Aguirre, A; Pesce, C; Sanhueza, P; Toro, P

    2014-09-01

    Neuropsychiatric manifestations are serious and frequent complications of systemic lupus erythematous (SLE). Catatonia is a neuropsychiatric disorder characterized by motor disturbance (including waxy flexibility and catalepsy), stupor, excitement, negativism, mutism, echopraxia and echolalia. Catatonia associated with SLE has been only rarely reported, especially in children. Here we present a case of a 14-year-old patient encountered in consultation-liaison psychiatry who presented catatonia associated with SLE. Her catatonia was refractory to treatment with pulse methylprednisolone, intravenous cyclophosphamide and rituximab. The patient responded to a combined therapy of electroconvulsive therapy and benzodiazepines. The present case suggests that although rarely reported, catatonia seen in the background of SLE should be promptly identified and treated to reduce the morbidity.

  11. Nothing new under the sun: post-traumatic stress disorders in the ancient world.

    Science.gov (United States)

    Abdul-Hamid, Walid Khalid; Hughes, Jamie Hacker

    2014-01-01

    Herodotus' account of the Athenian spear carrier Epizelus' psychogenic mutism following the Marathon Wars is usually cited as the first documented account of post-traumatic stress disorders in historical literature. This paper describes much earlier accounts of post combat disorders that were recorded as occurring in Mesopotamia (present day Iraq) during the Assyrian dynasty (1300-609 BC). The descriptions in this paper include many symptoms of what we would now identify in current diagnostic classification systems as post-traumatic stress disorders; including flashbacks, sleep disturbance and low mood. The Mesopotamians explain the disorder in terms of spirit affliction; the spirit of those enemies whom the patient had killed during battle causing the symptoms. PMID:25577928

  12. Avant-propos

    Directory of Open Access Journals (Sweden)

    Jacques-Emmanuel Bernard

    2003-09-01

    Full Text Available En évoquant les grottes de Lascaux, Fernand Braudel s’interrogeait : pourquoi, à l’heure où naît le premier art des hommes, la Méditerranée est-elle silencieuse en quelque sorte ? S’occuperait-elle d’autre chose ? Vivrait-elle autrement ? Le miracle y serait-il, en Orient, le développement décisif des langages parlés ? Le mutisme méditerranéen… On ne pourrait rêver plus beau paradoxe pour ouvrir un numéro de Babel sur les rhétoriques enfantées par la Mère Méditerranée- pour faire allusion...

  13. Il bisogno dell’origine e l’orrore del mutismo. Alcune note sulla questione dell’origine del linguaggio verbale umano more philosophico

    Directory of Open Access Journals (Sweden)

    Delio Salottolo

    2013-06-01

    Full Text Available In this essay we analyze more philosophico the impact of the research on the origin of human verbal language. Starting from suggestions deriving from the work of Agamben and Lévi-Strauss, two discontinuists, we face a double contradiction. The first relates to the inability to define the birth date of human language and of human world. This consideration makes us suspect that behind the passion for this issue there is a hidden need. The second concerns the mix of fascinans and tremendum linked to human mutism, which suggests, from the dominator point of view, an attitude to human animalization, and, from the dominated point of view, a form of resistance or survival instinct. Under these lenses we will read the enfant sauvage by Itard and the Foe by Coetzee. Finally we will discuss the issue of the need for origin as modern mankind melancholia and as unresolved tension towards the future.

  14. Catatonia from its creation to DSM-V: Considerations for ICD.

    Science.gov (United States)

    Fink, Max

    2011-07-01

    Catatonia was delineated only as a type of schizophrenia in the many American Psychiatric Association DSM classifications and revisions from 1952 until 1994 when "catatonia secondary to a medical condition" was added. Since the 1970s the diagnosis of catatonia has been clarified as a syndrome of rigidity, posturing, mutism, negativism, and other motor signs of acute onset. It is found in about 10% of psychiatric hospital admissions, in patients with depressed and manic mood states and in toxic states. It is quickly treatable to remission by benzodiazepines and by ECT. The DSM-V revision proposes catatonia in two major diagnostic classes, specifiers for 10 principal diagnoses, and deletion of the designation of schizophrenia, catatonic type. This complex recommendation serves no clinical or research purpose and confuses treatment options. Catatonia is best considered in the proposed ICD revision as a unique syndrome of multiple forms warranting a single unique defined class similar to that of delirium.

  15. Functional Neurological Symptom Disorder: Mismanagement, Misdiagnosis, Chronic Cough Following Sexual Abuse: A Rare Case Report.

    Science.gov (United States)

    Bidaki, Reza; Zarepur, Ehsan; Akrami, Maryam; Mohammad, Mohammad

    2016-01-01

    Objective Conversion disorder (CD) is a mental disorder in which patient displays neurological symptoms such as blindness, mutism, paralysis and seizure. It starts when our mind converts our mental stress into a physical symptom. A 15-year-old single white female with chronic cough, which had begun 5 months ago, was brought to our clinic. She had no history of hospitalization. His daily cough was without sputum production or fever, rhinorrhea and stopped during sleep. There was no recent exposure to tobacco smoke or a person with a chronic productive cough. Laboratory tests were normal. She had engaged 4 months ago. Doing sex during engagement is prohibited in her culture but and had anal sex, because of her spouse's trend. Psychotherapy was done and complete recovery was accomplished. PMID:27247590

  16. Functional Neurological Symptom Disorder: Mismanagement, Misdiagnosis, Chronic Cough Following Sexual Abuse: A Rare Case Report

    Science.gov (United States)

    BIDAKI, Reza; ZAREPUR, Ehsan; AKRAMI, Maryam; Mohammad, Mohammad

    2016-01-01

    Objective Conversion disorder (CD) is a mental disorder in which patient displays neurological symptoms such as blindness, mutism, paralysis and seizure. It starts when our mind converts our mental stress into a physical symptom. A 15-year-old single white female with chronic cough, which had begun 5 months ago, was brought to our clinic. She had no history of hospitalization. His daily cough was without sputum production or fever, rhinorrhea and stopped during sleep. There was no recent exposure to tobacco smoke or a person with a chronic productive cough. Laboratory tests were normal. She had engaged 4 months ago. Doing sex during engagement is prohibited in her culture but and had anal sex, because of her spouse’s trend. Psychotherapy was done and complete recovery was accomplished. PMID:27247590

  17. Transtorno de humor bipolar: diversas apresentações de uma mesma doença Bipolar mood disorder: different occurrences of the same disease

    Directory of Open Access Journals (Sweden)

    Audrey Regina Magalhães Braga

    2008-04-01

    Full Text Available O presente relato tem por objetivo acompanhar a evolução de um caso que se apresentou como mutismo seletivo e evoluiu para transtorno de humor bipolar e chamar atenção para a diversidade de sintomas possíveis no transtorno de humor. Em geral, o mutismo seletivo tem início na idade pré-escolar, porém os sintomas chamam mais atenção na idade escolar. A importância do diagnóstico e tratamento precoces reside na prevenção das complicações, tais como distúrbios no desenvolvimento social e acadêmico e na auto-estima, além da possibilidade de evolução para outros transtornos de ansiedade. O transtorno de humor bipolar é uma doença mental caracterizada por variações extremas no humor. Na criança, prejudica o crescimento emocional e seu desenvolvimento. É confundido com transtorno de déficit de atenção/hiperatividade e transtornos de comportamento, tais como transtorno de conduta e desafiador opositivo. A paciente do sexo feminino, quando avaliada, estava com 5 anos e 9 meses de idade. Concluiu-se o diagnóstico como mutismo seletivo. Foi indicada psicoterapia, com orientações aos pais e à escola, e iniciado o uso de inibidores seletivos de recaptação da serotonina, com boa resposta aos sintomas de ansiedade, mas passou a apresentar piora significativa do comportamento. Foi levantada a hipótese diagnóstica de transtorno de humor bipolar de início precoce. Medicada com estabilizador, apresentou adequação na terceira medicação e evolução satisfatória. O mutismo seletivo, considerado um transtorno de ansiedade na infância, pode ser pródromo para outros quadros psiquiátricos na infância. Há necessidade que os pediatras, médicos que primeiro acessam essas crianças, assim como os psiquiatras da infância, estejam atentos à riqueza de sintomas que pode dar seguimento ao quadro.The purpose of the present case report is to follow the evolution of a child who presented selective mutism and evolved into bipolar

  18. Diagnostic pitfalls in Parkinson's disease: case report Dificuldades diagnósticas na doença de Parkinson: relato de caso

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    Flávio Augusto Sekeff-Sallem

    2007-06-01

    Full Text Available Parkinson's disease (PD is characterized by resting tremor, rigidity and bradykinesia. In 80% of cases, the disorder begins with upper limb resting tremor. However, there are some presenting atypical features that make the diagnosis even more difficult and intriguing. The disorder can have its onset below 40 years old, characterizing early-onset parkinsonism, which differential diagnosis possibilities are varied. Atypical presentations include a pure akinetic-rigid syndrome, the initial manifestations occurring in the lower limbs, and pain as the most important or sole manifestation. These atypical features are unusual, but can be seen in clinical practice. We present a 37 years old woman with early-onset parkinsonism beginning with an akinetic-rigid syndrome in the lower limbs whose first symptom was left leg pain, which diagnosis was made after 4 years of onset and after 16 referrals to several experts in different fields. We discuss these atypical features and the diagnostic pitfalls in PD.A doença de Parkinson (DP caracteriza-se pela tríade de tremor, rigidez e bradicinesia. Em cerca de 80% dos casos inicia-se com tremor em membros superiores. Entretanto, certas atipias na apresentação desta entidade tornam seu diagnóstico ainda mais desafiador. A doença pode iniciar-se abaixo dos 40 anos de idade, caracterizando o parkinsonismo de início precoce. Apresentações atípicas incluem uma síndrome rígido-acinética pura, as manifestações inaugurais ocorrendo em membros inferiores, e uma síndrome dolorosa podendo ser um sintoma inicial proeminente ou o único sintoma. Estas atipias, apesar de infreqüentes, são encontradas na prática clínica diária. Discutimos estas características atípicas ao apresentarmos uma paciente de 37 anos com quadro rígido-acinético de instalação precoce, iniciado em membros inferiores, cujo sintoma predominante era dor, cujo diagnóstico somente foi feito após 4 anos do início e após 16 avalia

  19. A new fossil from the Jurassic of Patagonia reveals the early basicranial evolution and the origins of Crocodyliformes.

    Science.gov (United States)

    Pol, Diego; Rauhut, Oliver W M; Lecuona, Agustina; Leardi, Juan M; Xu, Xing; Clark, James M

    2013-11-01

    Extant crocodylians have a limited taxonomic and ecological diversity but they belong to a lineage (Crocodylomorpha) that includes basal and rather generalized species and a highly diverse clade, Crocodyliformes. The latter was among the most successful groups of Mesozoic tetrapods, both in terms of taxonomic and ecological diversity. Crocodyliforms thrived in terrestrial, semiaquatic, and marine environments, and their fossil diversity includes carnivorous, piscivorous, insectivorous, and herbivorous species. This remarkable ecological and trophic diversity is thought only to occur in forms with a completely akinetic skull, characterized by a functionally integrated and tightly sutured braincase-quadrate-palate complex. However, the patterns of evolutionary change that led to the highly modified skull of crocodyliforms and that likely enabled their diversification remain poorly understood. Herein, a new basal crocodylomorph from the Late Jurassic of Patagonia is described, Almadasuchus figarii gen. et sp. nov. The new taxon is known from a well-preserved posterior region of the skull as well as other craniomandibular and postcranial remains. Almadasuchus figarii differs from all other crocodylomorphs in the presence of six autapomorphic features, including the presence of a large lateral notch on the upper temporal bar, an otic shelf of the squamosal that is wider than long, a deep subtriangular concavity on the posterolateral surface of the squamosal, and an elongated pneumatopore on the ventral surface of the quadrate. Phylogenetic analysis focused on the origin of Crocodyliformes places Almadasuchus as the sister group of Crocodyliformes, supported by synapomorphic features of the skull (e.g. subtriangular basisphenoid, absence of basipterygoid process, absence of a sagittal ridge on the frontal, and a flat anterior skull roof with an ornamented dorsal surface). New braincase information provided by Almadasuchus and other crocodylomorphs indicates that most of

  20. Nonlanguage disorders of speech reflect complex neurologic apparatus.

    Science.gov (United States)

    Valenstein, E

    1975-09-01

    The mute or nearly mute patient who is alert and has good understanding of speech and a right hemiparesis could have Broca's aphasia, akinesia of speech (transcortical motor aphasia), or aphemia. The patient who has Broca's aphasia does not write well, and his speech does not improve greatly with repetition. The speech of a patient with akinesia of speech improves with repetition. The aphemic patient writes normally, but his speech does not improve with repetition. The mute patient whose eyes are open but who is poorly responsive and moves little or not at all could be an akinetic mute (with either a cingulate or a thalamomesencephalic lesion) or have a locked-in syndrome. The latter is diagnosed by asking the patient to look up and down or to open and close his eyes. If he obeys these commands, the physician questions him using a code of eye movement responses. If the patient fails to respond at all, he is an akinetic mute; intense stimulation may result in speech or movement. If the patient is drowsy and has third nerve involvement, the lesion is in the thalamomesencephalic reticular formation. If the patient appears alert and has episodes of agitation, he probably has bilateral lesions in the gyri cinguli. Patients with weakness of the bulbar musculature (facial, palatal, and tongue weakness and dysphonia) may have either upper motor neuron or lower motor neuron lesions. Only bilateral upper motor neuron lesions produce permanent dysarthria. As a typical example, a patient has a transient left hemiparesis with dysarthria and almost completely recovers. Later, however, a right hemiparesis develops and the patient experiences severe bilateral facial weakness, drooling, dysphagia, and severe dysarthria. The absence of atrophy of the bulbar musculature, a hyperactive jaw jerk and gag reflex and, sometimes, inappropriate laughing or crying episodes indicate that the lesion is located above the medulla in the corticobulbar tracts. Flaccid paralysis, absence of the jaw

  1. Diagnosis and treatment of infratentorial rosette forming glioneuronal tumors%幕下菊形团形成型胶质神经元肿瘤的诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    张忠; 王永志; 季玉陈; 陈宝师

    2015-01-01

    Objective To summarize clinical, imaging and pathological characteristics of the infratentorial rosette-forming glioneuronal tumor for improving the understanding of the disease. Methods Clinical data of 4 patients with surgically and pathologically verified rosette-forming glioneuronal tumor were analyzed retrospectively. The tumors were resected by micro-craniotomy via sub-occipital midline approach. Results Total removal was achieved in 3 patients and nearly total resection in 1. Mutism and ataxia occurred in 1 patient and diplopia in 1. All the patients were followed up for 6 to 24 months, no relapse was observed. The diplopia disappeared but there was no improvement in mutism. Conclusions The rosette-forming glioneuronal tumor is a rare benign tumor. Surgical resection is the most common treatment. Postoperative irradiation or chemotherapy is not recommended but further long-term follow-up is necessary.%目的:总结幕下菊形团形成型胶质神经元肿瘤的临床、影像、病理学特征,旨在提高对该病的认识。方法回顾性分析经手术及病理证实4例菊形团形成型胶质神经元肿瘤病人的临床资料,均在显微镜下行枕下后正中开颅切除肿瘤。结果全切3例,近全切1例。术后1例出现缄默伴共济失调,1例复视。随访6~24个月,均未见复发。复视症状消失,缄默症状无明显改善。结论菊形团形成型胶质神经元肿瘤是一种罕见的良性肿瘤。手术切除肿瘤是常见的治疗方式,术后一般不推荐放化疗,但应该长期随访。

  2. [Long-term prognostic factors in Parkinson's disease (author's transl)].

    Science.gov (United States)

    Guillard, A; Chastang, C

    1978-05-01

    Acturial methods are used to study the correlation between the initial condition and early therapeutic results, and the present condition of 164 parkinsonian patients treated with L. dopa for 4 to 8 years. There is an ineluctable deterioration in motility. There is a lower risk in patients who are autonomous and only slightly akinetic at the beginning of treatment. Intellectual deterioration is seen in some patients only. The risk factors are: males, the clinical forms of Parkinson's disease in which tremor is not predominant, onset of the disease before 60 years of age, and depression and transitory psychotic disorders during the first year of treatment. This deterioration appears 3 to 5 years after starting dopatherapy, which could be the cause. Life expectancy is still reduced by the disease at the present time. It is longer in patients in whom the disease started with isolated tremors, absence of Babinski's sign, and no loss of autonomy, and those in whom a good initial therapeutic result was obtained. PMID:725403

  3. Myall Lakes - Isotope dating of short term environmental changes in a coastal lake system - Anthropogenic pressures causing blue-green algae outbreaks in a national park

    International Nuclear Information System (INIS)

    Full text: The Myall Lakes system, 50 km North of Newcastle, Australia, is a barrier lake system covering 10,000ha, and is brackish (ranging from Oligohaline to Mesohaline under the Venice System classification). The Myall Lakes system is far less disturbed than similar coastal lakes, and as an important migratory bird habitat, they are protected under the RAMSAR agreement. They are also fully encompassed by the Myall Lakes National Park, declared in 1972, and are important to the local tourism and fisheries industries. Only two small streams provide freshwater input therefore water-retention time is of concern, because any changes to nutrient regimes, or pollution in the catchment affecting the Lakes, may take a long time to be corrected. In recent summers a series of cyanobacteria blooms have occurred which may indicate that human activities such as agriculture and recreational boating and fishing are affecting the Myall Lakes. Four sediment cores, up to 95cm long, were collected and sub-sampled for trace elements, palynological assemblages, sediment grain size and organic/carbonate content. Lead-210 (210Pb) was used to determine sedimentation rates and construct a chronology. Fossilised algal remains, specifically the akinetes of cyanobacteria, were used to estimate previous algal populations in the lake system. This technique has the potential to be an important tool in not only historical environmental reconstruction but also in catchment management. Results indicate that there have been cyclical fluctuations in the populations of aquatic plants and algae throughout recent history. (author)

  4. Systematic mutation analysis of KIAA0767 and KIAA1646 in chromosome 22q-linked periodic catatonia

    Directory of Open Access Journals (Sweden)

    Gawlik Micha

    2005-10-01

    Full Text Available Abstract Background Periodic catatonia is a familial subtype of schizophrenia characterized by hyperkinetic and akinetic episodes, followed by a catatonic residual syndrome. The phenotype has been evaluated in two independent genome-wide linkage scans with evidence for a major locus on chromosome 15q15, and a second independent locus on chromosome 22qtel. Methods In the positional and brain-expressed candidate genes KIAA0767 and KIAA1646, we searched for variants in the complete exons and adjacent splice-junctions as well as in parts of the 5'- and 3'-untranslated regions by means of a systematic mutation screening in individuals from chromosome 22q-linked pedigrees. Results The mutation scan revealed 24 single nucleotide polymorphisms, among them two rare codon variants (KIAA0767: S159I; KIAA1646: V338G. However, both were neither found segregating with the disease in the respective pedigree nor found at a significant frequency in a case-control association sample. Conclusion Starting from linkage signals at chromosome22qtel in periodic catatonia, we screened two positional brain-expressed candidate genes for genetic variation. Our study excludes genetic variations in the coding and putative promoter regions of KIAA0767 and KIAA1646 as causative factors for periodic catatonia.

  5. Cellular responses in the cyanobacterial symbiont during its vertical transfer between plant generations in the Azolla microphylla symbiosis.

    Science.gov (United States)

    Zheng, Weiwen; Bergman, Birgitta; Chen, Bin; Zheng, Siping; Guan, Xiong; Xiang, Guan; Rasmussen, Ulla

    2009-01-01

    The nitrogen-fixing symbiosis between cyanobacteria and the water fern Azolla microphylla is, in contrast to other cyanobacteria-plant symbioses, the only one of a perpetual nature. The cyanobacterium is vertically transmitted between the plant generations, via vegetative fragmentation of the host or sexually within megasporocarps. In the latter process, subsets of the cyanobacterial population living endophytically in the Azolla leaves function as inocula for the new plant generations. Using electron microscopy and immunogold-labeling, the fate of the cyanobacterium during colonization and development of the megasporocarp was revealed. On entering the indusium chamber of the megasporocarps as small-celled motile cyanobacterial filaments (hormogonia), these differentiated into large thick-walled akinetes (spores) in a synchronized manner. This process was accompanied by cytoplasmic reorganizations and the release of numerous membrane vesicles, most of which contained DNA, and the formation of a highly structured biofilm. Taken together the data revealed complex adaptations in the cyanobacterium during its transition between plant generations. PMID:19076717

  6. Palaeobiology of Mesoproterozoic Salkhan Limestone, Semri Group, Rohtas, Bihar, India: Systematics and significance

    Indian Academy of Sciences (India)

    Mukund Sharma

    2006-02-01

    Mesoproterozoic (∼1600 Ma old) Salkhan Limestone (Semri Group)of the Vindhyan Supergroup, exposed in Rohtas district of Bihar,India,preserves an abundant and varied ancient microbial assemblage.These microfossils are recorded in three distinctly occurring cherts viz.,bedded chert, stromatolitic chert and cherty stromatolites.27 morphoforms belonging to 14 genera and 21 species have been recognized.Six unnamed forms are also described. The microbial assemblage,almost exclusively composed of the remnants of cyanobacteria,is dominated by entophysalidacean members and short trichomes and can be termed as ‘typical Meso-proterozoic microbiotas ’.The assemblage includes characteristic mat-forming scytonematacean and entophysalidacean cyanobacteria. Eoentophysalis is the dominant organism in the assemblage. Ellipsoidal akinetes of nostocalean cyanobacteria (Archaeollipsoides) and spherical unicells also occur;both are distinct from mat forming assemblage,allochthonous and possibly planktic.Co-occurrence of the microbiotas and precipitates is related to the depositional environment of the Mesoproterozoic tidal flats with high carbonate saturation.

  7. DHA improves cognition and prevents dysfunction of entorhinal cortex neurons in 3xTg-AD mice.

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    Dany Arsenault

    Full Text Available Defects in neuronal activity of the entorhinal cortex (EC are suspected to underlie the symptoms of Alzheimer's disease (AD. Whereas neuroprotective effects of docosahexaenoic acid (DHA have been described, the effects of DHA on the physiology of EC neurons remain unexplored in animal models of AD. Here, we show that DHA consumption improved object recognition (↑12%, preventing deficits observed in old 3xTg-AD mice (↓12%. Moreover, 3xTg-AD mice displayed seizure-like akinetic episodes, not detected in NonTg littermates and partly prevented by DHA (↓50%. Patch-clamp recording revealed that 3xTg-AD EC neurons displayed (i loss of cell capacitance (CC, suggesting reduced membrane surface area; (ii increase of firing rate versus injected current (F-I curve associated with modified action potentials, and (iii overactivation of glutamatergic synapses, without changes in synaptophysin levels. DHA consumption increased CC (↑12% and decreased F-I slopes (↓21%, thereby preventing the opposite alterations observed in 3xTg-AD mice. Our results indicate that cognitive performance and basic physiology of EC neurons depend on DHA intake in a mouse model of AD.

  8. Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease

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    Yvette M. Bordelon

    2011-01-01

    Full Text Available We assessed degree of Parkinson disease motor symptom improvement with medication among subjects enrolled in an ongoing, population-based study in Central California. The motor section of the unified Parkinson disease rating scale (UPDRS was performed on subjects in both OFF and ON medication states, and difference between these scores was used as an indicator of symptomatic benefit. Higher OFF minus ON scores correlated with more severe baseline symptoms. There was equivalent improvement on the motor UPDRS scale for subjects divided according to medication classes used: levodopa alone 7.3 points, levodopa plus other medications 8.5 points, and dopamine agonists but not levodopa 6.1 points. In addition, there was no difference in the magnitude of improvement when subjects were divided according to Parkinson disease subtype, defined as tremor dominant, akinetic-rigid, or mixed. In this community-based sample, these values are within the range of a clinically important difference as defined by previous studies.

  9. Assessment of the role of sutures in a lizard skull: a computer modelling study.

    Science.gov (United States)

    Moazen, Mehran; Curtis, Neil; O'Higgins, Paul; Jones, Marc E H; Evans, Susan E; Fagan, Michael J

    2009-01-01

    Sutures form an integral part of the functioning skull, but their role has long been debated among vertebrate morphologists and palaeontologists. Furthermore, the relationship between typical skull sutures, and those involved in cranial kinesis, is poorly understood. In a series of computational modelling studies, complex loading conditions obtained through multibody dynamics analysis were imposed on a finite element model of the skull of Uromastyx hardwickii, an akinetic herbivorous lizard. A finite element analysis (FEA) of a skull with no sutures revealed higher patterns of strain in regions where cranial sutures are located in the skull. From these findings, FEAs were performed on skulls with sutures (individual and groups of sutures) to investigate their role and function more thoroughly. Our results showed that individual sutures relieved strain locally, but only at the expense of elevated strain in other regions of the skull. These findings provide an insight into the behaviour of sutures and show how they are adapted to work together to distribute strain around the skull. Premature fusion of one suture could therefore lead to increased abnormal loading on other regions of the skull causing irregular bone growth and deformities. This detailed investigation also revealed that the frontal-parietal suture of the Uromastyx skull played a substantial role in relieving strain compared with the other sutures. This raises questions about the original role of mesokinesis in squamate evolution.

  10. An exquisitely preserved troodontid theropod with new information on the palatal structure from the Upper Cretaceous of Mongolia

    Science.gov (United States)

    Tsuihiji, Takanobu; Barsbold, Rinchen; Watabe, Mahito; Tsogtbaatar, Khishigjav; Chinzorig, Tsogtbaatar; Fujiyama, Yoshito; Suzuki, Shigeru

    2014-02-01

    Troodontidae is a clade of small-bodied theropod dinosaurs. A new troodontid, Gobivenator mongoliensis gen. et sp. nov., is described based on the most complete skeleton of a Late Cretaceous member of this clade presently known, from the Campanian Djadokhta Formation in the central Gobi Desert. G. mongoliensis is different from other troodontids in possessing a pointed anterior end of the fused parietal and a fossa on the surangular in front of the posterior surangular foramen. The skull was superbly preserved in the specimen and provides detailed information of the entire configuration of the palate in Troodontidae. Overall morphology of the palate in Gobivenator resembles those of dromaeosaurids and Archaeopteryx, showing an apparent trend of elongation of the pterygoid process of the palatine and reduction of the pterygopalatine suture toward the basal Avialae. The palatal configuration suggests that the skull of Gobivenator would have been akinetic but had already acquired prerequisites for later evolution of cranial kinesis in birds, such as the loss of the epipterygoid and reduction in contact areas among bones.

  11. Molecular phylogenetics of emydine turtles: taxonomic revision and the evolution of shell kinesis.

    Science.gov (United States)

    Feldman, Chris R; Parham, James Ford

    2002-03-01

    The 10 extant species of emydine turtles represent an array of morphological and ecological forms recognizable and popular among scientists and hobbyists. Nevertheless, the phylogenetic affinities of most emydines remain contentious. Here, we examine the evolutionary relationships of emydine turtles using 2092 bp of DNA encoding the mitochondrial genes cyt b, ND4, and adjacent tRNAs. These data contain 339 parsimony informative characters that we use to erect hypotheses of relationships for the Emydinae. Both maximum parsimony and maximum likelihood methods yield a monophyletic Emydinae in which all but three nodes are well resolved. Emys orbicularis, Emydoidea blandingii, and Clemmys marmorata form a monophyletic clade, as do the species of Terrapene. Clemmys muhlenbergii and Clemmys insculpta form a third monophyletic group that may be sister to all other emydines. Clemmys guttata is problematic and probably related to Terrapene. Based on this phylogeny, and previous molecular work on the group, we suggest the following taxonomic revisions: (1) Clemmys should be restricted to a single species, C. guttata. (2) Calemys should be resurrected for C. muhlenbergii and C. insculpta. (3) Emys should be expanded to include three species: E. orbicularis, E. blandingii, and E. marmorata. Furthermore, our analyses show that neither kinetic-shelled nor akinetic-shelled emydines form monophyletic groups. Therefore, shell kinesis was either independently gained in Emys and Terrapene or secondarily lost in E. marmorata and C. guttata. Parsimony, paleontological evidence, and the multiple origins of shell kinesis in related turtle lineages (especially geoemydines) support the independent origin of plastral kinesis.

  12. Off-Pump Coronary Bypass Grafting Causing Stunned Myocardium

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    Feridoun Sabzi

    2015-10-01

    Full Text Available The term “stunned myocardium” refers to abnormalities in the myocardial function following reperfusion and is common in on-pump coronary artery bypass grafting (CABG and is exceedingly rare in off- pump CABG. A 53-year-old man presented with unstable angina due to the severe stenosis of the left anterior descending coronary artery (LAD and the obtuse marginal. Laboratory findings and Chest X-ray revealed nothing abnormal. The intraoperative course was uneventful. The patient left the operating room without any inotropic support. Six hours later, however, he developed low cardiac output .At exploration, cardiac tamponade was excluded and flowmetry showed that the graft had adequate function. Cardiac enzymes were normal. High-dose adrenalin and Dobutamine were administrated and an intra-aortic balloon pump was used. After hemodynamic stabilization, the patient left the Intensive Care Unit without an intra-aortic balloon pump and inotropic support. On the fifth postoperative day, coronary angiography showed patent grafts and correct anastomotic sites. On the seventh postoperative day, the akinetic lateral wall of the left ventricle changed to dyskinesia. Finally after hospital discharge on the thirtieth postoperative day, an echocardiogram showed normal left ventricular function without regional wall motion abnormalities

  13. Longitudinal strain is a marker of microvascular obstruction and infarct size in patients with acute ST-segment elevation myocardial infarction.

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    Loïc Bière

    Full Text Available OBJECTIVES: We assessed the value of speckle tracking imaging performed early after a first ST-segment elevation myocardial infarction (STEMI in order to predict infarct size and functional recovery at 3-month follow-up. METHODS: 44 patients with STEMI who underwent revascularization within 12 h of symptom onset were prospectively enrolled. Echocardiography was performed 3.9 ± 1.2 days after myocardial reperfusion, assessing circumferential (CGS, radial (RGS, and longitudinal global (GLS strains. Late gadolinium-enhanced cardiac magnetic imaging (CMR, for assessing cardiac function, infarct size, and microvascular obstruction (MVO, was conducted 5.6 ± 2.5 days and 99.4 ± 4.6 days after myocardial reperfusion. RESULTS: GLS was evaluable in 97% of the patients, while CGS and RGS could be assessed in 85%. Infarct size significantly correlated with GLS (R = 0.601, p-6.0% within the infarcted area exhibited 96% specificity and 61% sensitivity for predicting the persistence of akinesia (≥ 3 segments at 3-month follow-up. CONCLUSIONS: Speckle-tracking strain imaging performed early after a STEMI is easy-to-use as a marker for persistent akinetic territories at 3 months. In addition, GLS correlated significantly with MVO and final infarct size, both parameters being relevant post-MI prognostic factors, usually obtained via CMR.

  14. Brain Perfusion in Corticobasal Syndrome with Progressive Aphasia

    Directory of Open Access Journals (Sweden)

    Yoshitake Abe

    2016-04-01

    Full Text Available Background: Brain perfusion may differ between patients with corticobasal syndrome (CBS with and without aphasia. Methods: Twenty-six (9 males and 17 females; mean age 76 ± 5.3 years patients with CBS were enrolled in the study. Brain MRI and single-photon emission computed tomography were performed in all subjects. Language was evaluated using the Standard Language Test of Aphasia. The patients were divided into two subgroups according to the presence or absence of progressive aphasia. Differences in the regional cerebral blood flow (rCBF between the two groups were detected based on voxel-by-voxel group analysis using Statistical Parametric Mapping 8. Results: All patients exhibited asymmetric motor symptoms and signs, including limb apraxia, bradykinesia, and akinetic rigidity. Of 26 patients, 9 had a clinically obvious language disturbance, characterized as nonfluent aphasia. Almost all CBS patients with aphasia exhibited cortical atrophy predominantly in the left frontal and temporal lobes with widening of the Sylvian fissure on MRI. The rCBF in the left middle frontal gyrus differed significantly between CBS patients with and without aphasia. Conclusion: CBS patients with aphasia exhibit motor symptoms predominantly on the right side and cortical atrophy mainly in the left perisylvian cortices. In particular, left frontal dysfunction might be related to nonfluent aphasia in CBS.

  15. Postharvest treatment of fresh fruit from California with methyl bromide for control of light brown apple moth (Lepidoptera: Tortricidae).

    Science.gov (United States)

    Walse, Spencer S; Myers, Scott W; Liu, Yong-Biao; Bellamy, David E; Obenland, David; Simmons, Greg S; Tebbets, Steve

    2013-06-01

    Methyl bromide (MB) chamber fumigations were evaluated for postharvest control of light brown apple moth, Epiphyas postvittana (Walker) (Lepidoptera: Tortricidae), in fresh fruit destined for export from California. To simulate external feeding, larvae were contained in gas-permeable cages and distributed throughout loads of peaches, plums, nectarines (all Prunus spp.), apples (Malus spp.), raspberries (Rubus spp.), or grapes (Vitis spp.). Varying the applied MB dose and the differential sorption of MB by the loads resulted in a range of exposures, expressed as concentration x time cross products (CTs) that were verified by gas-chromatographic quantification of MB in chamber headspace over the course of each fumigation. CTs > or = 60 and > or = 72 mg liter(-1) h at 10.0 +/- 0.5 and 15.6 +/- 0.5 degrees C (x +/- s, average +/- SD), respectively, yielded complete mortality of approximately 6,200 larvae at each temperature. These confirmatory fumigations corroborate E. postvittana mortality data for the first time in relation to measured MB exposures and collectively comprise the largest number of larval specimens tested to date. In addition, akinetic model of MB sorption was developed for the quarantine fumigation of fresh fruit based on the measurement of exposures and how they varied across the fumigation trials. The model describes how to manipulate the applied MB dose, the load factor, and the load geometry for different types of packaged fresh fruit so that the resultant exposure is adequate for insect control.

  16. Dopamine imbalance in Huntington's Disease: a mechanism for the lack of behavioral flexibility

    Directory of Open Access Journals (Sweden)

    Jane Y Chen

    2013-07-01

    Full Text Available Dopamine (DA plays an essential role in the control of coordinated movements. Alterations in DA balance in the striatum lead to pathological conditions such as Parkinson’s and Huntington’s diseases (HD. HD is a progressive, invariably fatal neurodegenerative disease caused by a genetic mutation producing an expansion of glutamine repeats and is characterized by abnormal dance-like movements (chorea. The principal pathology is the loss of striatal and cortical projection neurons. Changes in brain DA content and receptor number contribute to abnormal movements and cognitive deficits in HD. In particular, during the early hyperkinetic stage of HD, DA levels are increased whereas expression of DA receptors is reduced. In contrast, in the late akinetic stage, DA levels are significantly decreased and resemble those of a Parkinsonian state. Time-dependent changes in DA transmission parallel biphasic changes in glutamate synaptic transmission and may enhance alterations in glutamate receptor-mediated synaptic activity. In this review, we focus on neuronal electrophysiological mechanisms that may lead to some of the motor and cognitive symptoms of HD and how they relate to dysfunction in DA neurotransmission. Based on clinical and experimental findings, we propose that some of the behavioral alterations in HD, including reduced behavioral flexibility, may be caused by altered DA modulatory function. Thus, restoring DA balance alone or in conjunction with glutamate receptor antagonists could be a viable therapeutic approach.

  17. Juvenile Huntington's disease confirmed by genetic examination in twins Doença de Huntington juvenil confirmada por exame genético em gêmeas

    Directory of Open Access Journals (Sweden)

    GILBERTO LEVY

    1999-09-01

    Full Text Available Early-onset Huntington's disease (HD occurs in approximately 10% of HD's cases. We report juvenile HD in phenotypically identical twins, evaluated by history, clinical and neurologic examination, mini-mental state examination, blood laboratory exams, cerebrospinal fluid examination, skull computed tomography, and genetic examination for HD. Patients had the akinetic-rigid variety (Westphal variant of the disease and paternal inheritance. The laboratory workup confirmed the clinical diagnosis of HD, which adds this report to the rare cases of HD in twins reported in the literature.Doença de Huntington (DH de início precoce ocorre em aproximadamente 10% dos casos de DH. Relatamos DH juvenil em gêmeas fenotipicamente idênticas, avaliadas por história, exames clínico e neurológico, mini-exame do estado mental, exames de sangue, exame do líquido cefalorraquidiano, tomografia computadorizada de crânio e exame genético para DH. As pacientes apresentavam a variedade rígido-acinética (variante de Westphal da doença e herança paterna. A avaliação laboratorial confirmou o diagnóstico clínico de DH, acrescentando-se este relato aos raros casos de DH em gêmeos relatados na literatura.

  18. Quantitative assessment of left ventricular systolic wall thickening using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kristensen, Thomas S. [Department of Radiology, Diagnostic Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: tskaarup@yahoo.com; Kofoed, Klaus F. [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: kkofoed@dadlnet.dk; Moller, Daniel V. [Department of Cardiology, Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: DVEGA@gmx.net; Ersboll, Mads [Department of Cardiology, Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: ersboell@stud.ku.dk; Kuehl, Tobias [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: tobiaskh@gmail.com; Recke, Peter von der [Department of Radiology, Diagnostic Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: peter.von.der.recke@rh.regionh.dk; Kober, Lars [Department of Cardiology, Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: lk@heart.dk; Nielsen, Michael B. [Department of Radiology, Diagnostic Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: mbn@dadlnet.dk; Kelbaek, Henning [Department of Cardiology, Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: henning.kelbaek@rh.regionh.dk

    2009-10-15

    Background: Multidetector computed tomography (MDCT) of the heart provides both anatomical and functional information. The objective of this study was to evaluate the accuracy of quantitative assessment of left ventricular contractile function in relation to two-dimensional transthoracic echocardiography (TTE). Materials and methods: Sixty-four patients with known or suspected coronary artery disease underwent ECG-gated 64-slice MDCT and TTE. Regional left ventricular contractile function was measured by percent systolic wall thickening (SWT) in 16 myocardial segments using MDCT, and compared with visual evaluation of wall motion score (WMS) by TTE. Global SWT by MDCT was calculated as the mean SWT of all myocardial segments and compared with wall motion index (WMI) by TTE. Results: Eight hundred and eleven segments (81%) were classified as normokinetic, 142 (14%) as hypokinetic, 41 (4%) as akinetic and 5 (0.5%) as dyskinetic by TTE. A significant inverse linear trend was found between regional SWT by MDCT and WMS by TTE (p < 0.001). Sensitivity and specificity for the identification of regional abnormalities of contractile function were 76% and 78%, respectively. A linear correlation between global SWT by MDCT and WMI by TTE was found (r = -0.8, p < 0.001). Sensitivity and specificity for the identification of WMI > 1.5 using global SWT was 91% and 94%, respectively. Conclusion: Quantification of systolic wall thickening by MDCT provides functional information, which is well correlated to visual assessment of global left ventricular contractile function by TTE.

  19. The usefulness of SPECT and MRI in the diagnosis of atypical parkinsonian syndromes

    International Nuclear Information System (INIS)

    Clinico-pathological studies have shown that only three out of four patients with parkinsonism have idiopathic Parkinson's disease. In patients with so-called Parkinson plus syndrome, the degeneration in the brain is more widespread and the variety of neurological signs greater than in Parkinson's disease. The differentiation of these syndromes from Parkinson's disease can be difficult. Single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRl) can be of value in the differential diagnosis of parkinsonism. We present three patients with atypical parkinsonism in whom MRI and SPECT with β-CIT and epidepride was performed in addition to the clinical evaluation. The three patients all had a rapidly developing symmetric akinetic-rigid syndrome that responded poorly to levodopa. MRI showed findings regarded as typical for multiple system atrophy in two patients, but only nonspecific findings in the third patient. SPECT with β-CIT showed a pronounced bilateral and relatively symmetric reduction in the striatal dopaminergic activity in all patients. SPECT with epidepride showed a clearly reduced striatal D2-receptor binding bilaterally in only one of the patients. In patients with atypical parkinsonism, MRI and SPECT with β-CIT and epidepride can give valuable support to the clinical diagnosis of a Parkinson plus syndrome

  20. The usefulness of SPECT and MRI in the diagnosis of atypical parkinsonian syndromes; Diagnostisk nytte av SPECT- og MR-undersoekelse ved atypisk parkinsonisme

    Energy Technology Data Exchange (ETDEWEB)

    Skogseid, I.M.; Gerdts, R.; Nyberg-Hansen, R.; Rootwelt, K.; Bakke, S.J

    2001-07-01

    Clinico-pathological studies have shown that only three out of four patients with parkinsonism have idiopathic Parkinson's disease. In patients with so-called Parkinson plus syndrome, the degeneration in the brain is more widespread and the variety of neurological signs greater than in Parkinson's disease. The differentiation of these syndromes from Parkinson's disease can be difficult. Single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRl) can be of value in the differential diagnosis of parkinsonism. We present three patients with atypical parkinsonism in whom MRI and SPECT with {beta}-CIT and epidepride was performed in addition to the clinical evaluation. The three patients all had a rapidly developing symmetric akinetic-rigid syndrome that responded poorly to levodopa. MRI showed findings regarded as typical for multiple system atrophy in two patients, but only nonspecific findings in the third patient. SPECT with {beta}-CIT showed a pronounced bilateral and relatively symmetric reduction in the striatal dopaminergic activity in all patients. SPECT with epidepride showed a clearly reduced striatal D{sub 2}-receptor binding bilaterally in only one of the patients. In patients with atypical parkinsonism, MRI and SPECT with {beta}-CIT and epidepride can give valuable support to the clinical diagnosis of a Parkinson plus syndrome.

  1. Accuracy of Dobutamine Stress Echocardiography in Detecting Recovery of Contractile Reserve after Revascularization of Ischemic Myocardium

    Directory of Open Access Journals (Sweden)

    Abas Ali karimi

    2007-09-01

    Full Text Available Background: This study was designed to investigate the accuracy of dobutamine stress echocardiography (DSE in detecting the post-revascularization recovery rate of contractile reserve (CR in ischemic myocardium. Methods: A total of 112 segments from seven patients with low ejection fraction (<35% and coronary artery disease were evaluated with DSE one week before and 12 weeks after coronary artery bypass graft surgery (CABG. Sensitivity, specificity, and positive and negative predictive values of DSE for detecting the recovery rate of CR were calculated based upon their standard definition and were presented with 95% confidence intervals (CI. Results: The mean baseline left ventricular ejection fraction was 31±4%, which reached 35±7% after CABG unremarkably. The recovery rates of resting function and CR were 18.2% and 50% for hypokinetic and 15.6% and 24.1 for akinetic segments respectively. Specificity, sensitivity, and positive and negative predictive values of DSE for detecting the recovery of CR were 83% (CI=69-97, 89% (CI=83-96, 94% (CI = 88-99, and 73 % (CI = 55-88, respectively. Conclusion: Despite acceptable sensitivity, specificity, and positive predictive value, DSE has a relatively lower negative predictive value for detecting the recovery of CR in ischemic myocardium and, consequently, the full extent of myocardial viability. Further sensitive techniques may, therefore, be needed to provide complementary information regarding long-term functional outcome.

  2. Responses of a rice-field cyanobacterium Anabaena siamensis TISTR-8012 upon exposure to PAR and UV radiation.

    Science.gov (United States)

    Rastogi, Rajesh P; Incharoensakdi, Aran; Madamwar, Datta

    2014-10-15

    The effects of PAR and UV radiation and subsequent responses of certain antioxidant enzymatic and non-enzymatic defense systems were studied in a rice field cyanobacterium Anabaena siamensis TISTR 8012. UV radiation resulted in a decline in growth accompanied by a decrease in chlorophyll a and photosynthetic efficiency. Exposure of cells to UV radiation significantly affected the differentiation of vegetative cells into heterocysts or akinetes. UV-B radiation caused the fragmentation of the cyanobacterial filaments conceivably due to the observed oxidative stress. A significant increase of reactive oxygen species in vivo and DNA strand breaks were observed in UV-B exposed cells followed by those under UV-A and PAR radiation, respectively. The UV-induced oxidative damage was alleviated due to an induction of antioxidant enzymatic/non-enzymatic defense systems. In response to UV irradiation, the studied cyanobacterium exhibited a significant increase in antioxidative enzyme activities of superoxide dismutase, catalase and peroxidase. Moreover, the cyanobacterium also synthesized some UV-absorbing/screening substances. HPLC coupled with a PDA detector revealed the presence of three compounds with UV-absorption maxima at 326, 331 and 345 nm. The induction of the biosynthesis of these UV-absorbing compounds was found under both PAR and UV radiation, thus suggesting their possible function as an active photoprotectant.

  3. Chronic manganese toxicity due to substance abuse in Turkish patients

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    Ayhan Koksal

    2012-01-01

    Full Text Available Background: Manganese toxicity may lead to a levodopa-resistant akinetic-rigid syndrome. Pathological changes occur mostly in the pallidium and stratium. Materials and Methods: We report seven patients with a new form of chronic manganese toxicity due to long-term intravenous use of a solution consisting of ephedrine, acetylsalicylic acid and potassium permanganate as a psycho-stimulant, popularly known as "Russian Cocktail". Results: The age of the patients ranged between 19 and 31 years, and the duration of substance abuse was between nine and 106 months. The onset of symptoms from first use ranged seven to 35 months. The initial symptom was impaired speech followed by gait disturbance and bradykinesia. In addition to these symptoms, choreic movements, ataxia presenting as backward falls and dystonia were also seen. Serum and urine samples revealed high levels of manganese. Hyperintense lesions on T1-weighted magnetic resonance imaging were seen in bilateral basal ganglia and brainstem, dentate nuclei, features consistent with manganese intoxication. Conclusion: Manganese toxicity, which may cause a distinctive irreversible neurodegenerative disorder, can be seen frequently with "Russian Cocktail" abuse, a substance which can be accessed very easily and at a low cost.

  4. 中国淡水水体常见束丝藻种类的形态及生理特性研究%MORPHOLOGICAL AND PHYSIOLOGICAL CHARACTERISTICS AND COMMON APHANIZOMENON TYPES IN CHINESE WATER BODIES

    Institute of Scientific and Technical Information of China (English)

    吴忠兴; 曾波; 李仁辉; 宋立荣

    2012-01-01

    our laboratory had shown that three types of Aphanizomenon, A. Flos-aquae, A. Gracile and A. Issatschenkoi, were the most common strains in Chinese freshwater bodies. Due to the limitation of samples and knowledge, however, the physiological characters were not compared in the three-type strains so far. Therefore, in order to further explore their knowledge and investigate the bloom-forming mechanism in Aphanizomenon, in the present study, their morphological and physiological characteristics, including the ratio of length and width in vegetative cell, heterocyst and akinete, growth rate, pigment composition, photosynthetic O2 evolution, and the electron transport rate (ETR), were compared in A. Flos-aquae, A. Gracile and A. Issatschenkoi. The results indicated that some morphological differences were found in the frequency distributions for length/width ratios of vegetative cells, heterocyst, and akinetes. Among them, the most sig nificant difference was found in the akinetes, suggesting that the length/ width ratios of akinetes could be regarded as a taxonomic unit in the genus Aphanizomenon. Moreover, physiological differences were also showed in three types of Aphanizomenon. Compared with the strains of A. Flos-aquae and A. Issatschenkoi, the strains of A. Gracile displayed higher PC contents. However, the strains of A. Gracile showed significantly lower chlorophyll a, carotenoid contents, maximum photosynthesis (Pm), apparent photosynthetic efficiency (a), and maximal electron transport rates (ETRmax) in comparison with the other strains of Aphanizomenon. It suggested that the strain of A. Gracile showed lower competitive abilities in photosynthesis when compared with the strains of A. Flos-aquae and A. Issatschenkoi. In addition, similar physiological features, such as the value of Pm and ETRmax, pigment contents and specific growth rate (μ), were found in A. Flos-aquae and A. Issatschenkoi. These data suggested that the three morphological strains of

  5. Stress-induced cardiomyopathy (Takotsubo – broken heart and mind?

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    Redfors B

    2013-04-01

    Full Text Available Björn Redfors, Yangzhen Shao, Elmir Omerovic Department of Molecular and Clinical Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden Abstract: Stress-induced cardiomyopathy (SIC, also known as Takotsubo cardiomyopathy, is characterized by severe but potentially reversible regional left ventricular wall motion abnormalities, ie, akinesia, in the absence of explanatory angiographic evidence of a coronary occlusion. The typical pattern is that of an akinetic apex with preserved contractions in the base, but other variants are also common, including basal or midmyocardial akinesia with preserved apical function. The pathophysiology of SIC remains largely unknown but catecholamines are believed to play a pivotal role. The diverse array of triggering events that have been linked to SIC are arbitrarily categorized as either emotional or somatic stressors. These categories can be considered as different elements of a continuous spectrum, linked through the interface of neurology and psychiatry. This paper reviews our current knowledge of SIC, with focus on the intimate relationship between the brain and the heart. Keywords: stress-induced cardiomyopathy, takotsubo cardiomyopathy, catecholamine, cerebral injury, emotional stress, somatic stress

  6. Role of early audiological screening and intervention

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    Isha Preet Tuli

    2012-01-01

    Full Text Available Objectives: The aim of our study is to find out whether early identification and intervention prevents severe linguistic and communication delays, minimizing the need for more elaborate rehabilitation during the school years. Design and Study Sample: A Cross-sectional study was carried out on one hundred and eleven children with documented deaf-mutism presenting at the Department of Oto-Rhino-Laryngology in two different geographical regions of India. Detailed history, clinical and audiological assessment along with assessment of the language and communication skills according to American Speech Language Hearing Association (ASHA guidelines was done. Results: The children were predominantly male, of low socio-economic background, presented for rehabilitation, mostly after the age of six years. They commonly had more than 70dBHL (decibel hearing level hearing threshold. The study found that the children who presented early for diagnosis and hearing aid usage had better response to rehabilitation. Conclusion: It is important that hearing loss be detected at an early age and amplification should be introduced as early as possible once there has been a diagnosis of a hearing loss. So that early intervention can have an impact on speech and language development. Without concurrent follow-up program, identification of hearing loss early in children is meaningless.

  7. Clinical manifestations of Waardenburg syndrome in a male adolescent in Mali, West Africa.

    Science.gov (United States)

    Imperato, Pascal James; Imperato, Gavin H

    2015-02-01

    Waardenburg syndrome (WS) is a genetic disorder of which there are four distinct types. These four types are differentiated by the physical defects which they produce. Presented here is the case of a 13-year-old boy with WS Type I who was observed and physically assessed in Mali, West Africa in 1969. His physical findings included a bright blue coloring to the irises of the eyes, profound sensorineural deafness, mutism, dystopia canthorum (lateral displacement of the inner canthi of the eyes), broad nasal root, bushy eyebrows, and scaphoid deformities of the supraorbital portions of the frontal bone. Because family members were not available for interviews or physical examinations, it was not possible to determine if this patient was suffering from a congenital form of the disorder or from a spontaneous mutation. Given the patient's then location in a remote rural area of Mali where electricity was absent, it was not possible to perform additional diagnostic tests. The patient described here is the first with WS in Mali, West Africa to have been medically observed and evaluated and later documented in the medical literature. A second case of the syndrome in Mali was described in the medical literature in 2011 in an 18-month-old infant who did not have sensorineural hearing loss, but who did have a bilateral cleft lip. An historical overview of WS is presented along with details concerning the characteristics of the four types of the disorder. PMID:25224968

  8. The 7q11.23 Microduplication Syndrome: A Clinical Report with Review of Literature.

    Science.gov (United States)

    Abbas, Elham; Cox, Devin M; Smith, Teri; Butler, Merlin G

    2016-09-01

    We report a 14-year-old adolescent girl with selective mutism (SM) and a 7q11.23 microduplication detected by chromosomal microarray (CMA) analysis and reviewed the literature from 18 published clinical reports. Our patient had specific phobias, SM, extreme anxiety, obesity, cutis marmorata, and a round appearing face with a short neck and over folded ears. We reviewed the published clinical, cognitive, behavioral, and cytogenetic findings grouped by speech and language delay, growth and development, craniofacial, clinical, and behavior and cognitive features due to the 7q11.23 microduplication. This microduplication syndrome is characterized by speech delay (91%), social anxiety (42%), attention deficit hyperactivity disorder (ADHD, 37%), autism spectrum disorder (29%), and separation anxiety (13%). Other findings include abnormal brain imaging (80%), congenital heart and vascular defects (54%), and mild intellectual disability (38%). We then compared the phenotype with Williams-Beuren syndrome (WBS) which is due to a deletion of the same chromosome region. Both syndromes have abnormal brain imaging, hypotonia, delayed motor development, joint laxity, mild intellectual disability, ADHD, autism, and poor visuospatial skills but opposite or dissimilar findings regarding speech and behavioral patterns, cardiovascular problems, and social interaction. Those with WBS are prone to have hyperverbal speech, lack of stranger anxiety, and supravalvular aortic stenosis while those with the 7q11.23 microduplication have speech delay, SM, social anxiety, and are prone to aortic dilatation. PMID:27617154

  9. Special medical conditions associated with catatonia in the internal medicine setting: hyponatremia-inducing psychosis and subsequent catatonia.

    Science.gov (United States)

    Novac, Andrei A; Bota, Daniela; Witkowski, Joanne; Lipiz, Jorge; Bota, Robert G

    2014-01-01

    Diagnosis and treatment of catatonia in the psychiatry consultation service is not infrequent. Usually, the patient either presents to the Emergency Department or develops catatonia on the medical floor. This condition manifests with significant behavioral changes (from mildly decreased speech output to complete mutism) that interfere with the ability to communicate. After structural brain disorders are excluded, one of the diagnoses that always should be considered is catatonia. However, the causes of catatonia are numerous, ranging from psychiatric causes to a plethora of medical illnesses. Therefore, it is not surprising that there are many proposed underlying mechanisms of catatonia and that controversy persists about the etiology of specific cases.There are only 6 reports of hyponatremia-induced catatonia and psychosis in the literature. Here, we present the case of a 30-year-old woman with catatonia and psychosis induced by hyponatremia, and we use this report to exemplify the multitude of biologic causes of catatonia and to propose a new way to look at the neuroanatomical basis of processing, particularly the vertical processing systems we believe are involved in catatonia.

  10. Catatonia in patients with autism: prevalence and management.

    Science.gov (United States)

    Mazzone, Luigi; Postorino, Valentina; Valeri, Giovanni; Vicari, Stefano

    2014-03-01

    Although recent studies have shown that catatonia can occur in patients with autism spectrum disorders (ASDs), the overlap of the behavioral features between these disorders raises many diagnostic challenges. In fact, in clinical practice it is common to misinterpret catatonic symptoms, including mutism, stereotypic speech, repetitive behaviors, echolalia, posturing, mannerisms, purposeless agitation and rigidity, as features of ASDs. The current medical treatment algorithm for catatonia in ASDs recommends the use of benzodiazepines. Electroconvulsive therapy (ECT) is indicated when patients are unresponsive, or insufficiently responsive, to benzodiazepines. Other pharmacological options are also described for the treatment of catatonic patients resistant to benzodiazepines and ECT, and there is evidence for the effectiveness of a psychological treatment, co-occurring with medical treatments, in order to support the management of these patients. In this article we provide a summary of studies exploring catatonia in ASDs and our clinical experience in the management and treatment of this syndrome through the presentation of three brief case studies. Moreover, we review the mechanisms underlying symptoms of catatonia in ASDs, as well as the diagnostic challenges, providing an outline for the management and treatment of this syndrome in this clinical population.

  11. Wax on, wax off: a rare case of catatonia.

    Science.gov (United States)

    Greenberg, Karen; D'Ambrosio, Michael; Liebman, Kenneth M; Veznedaroglu, Erol

    2014-10-01

    Catatonia was first described by a German psychiatrist, Karl Kahlbaum, in 1874. It is a behavioral syndrome marked by an inability to move normally, which can occur in the context of many underlying general medical and psychiatric disorders. A wide variety of neurologic, metabolic, drug-induced, and psychiatric causes of catatonia have been reported. We present a unique case of late onset catatonia in a 56-year-old man with no prior medical or psychiatric history initially presenting with stroke-like symptoms. The patient was awake and alert, with spontaneous eye opening, but completely nonverbal and not following any commands. Specifically, the patient demonstrated stupor, catalepsy, mutism, and negativism. After extensive emergency department testing, including negative computed tomography head, negative magnetic resonance imaging brain, negative electroencephalogram, and normal laboratory results, the patient was diagnosed with new-onset bipolar disorder with depressive features presenting as catatonia. Recognizing catatonia is important because it may be caused or exacerbated by treatment of the underlying disorder. Failure to institute treatment early in the course of catatonia is associated with a poor prognosis.

  12. Antiretroviral treatment induced catatonia in 16-year-old boy

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    Anand Lingeswaran

    2014-01-01

    Full Text Available We present a 16-year-old boy, who had presented to us with catatonic features of mutism, withdrawal, passive negativism, grimacing, gesturing, echopraxia, and excitement of 5 days duration while taking antiretroviral therapy (ART for a period of 2 years. He had history of birth asphyxia and acquired HIV infection from his father when the same syringe and needle was used on both of them in a medical setting where the father and son had consulted for treatment of pyrexia of unknown origin. He was the eldest of a three children family in which the biologic father had acquired HIV through extramarital sexual contact with HIV-infected sex workers but was unaware of his HIV positive status till our patient, the 16-year-old was admitted and treated for pulmonary tuberculosis at 14 years of age. The boy′s mother had only acquired HIV after having three children with the HIV-positive husband, thus leaving the other two children HIV negative. The catatonia completely resolved within 2 days after the ART was withheld, and risperidone 1 mg twice a day was prescribed. This case highlights the risks of ART and breach of universal precautions.

  13. Dysgraphia in patients with primary lateral sclerosis: a speech-based rehearsal deficit?

    Science.gov (United States)

    Zago, S; Poletti, B; Corbo, M; Adobbati, L; Silani, V

    2008-01-01

    The present study aims to demonstrate that errors when writing are more common than expected in patients affected by primary lateral sclerosis (PLS) with severe dysarthria or complete mutism, independent of spasticity. Sixteen patients meeting Pringle's et al. [34] criteria for PLS underwent standard neuropsychological tasks and evaluation of writing. We assessed writing abilities in spelling through dictation in which a set of words, non-words and short phrases were presented orally and by composing words using a set of preformed letters. Finally, a written copying task was performed with the same words. Relative to controls, PLS patients made a greater number of spelling errors in all writing conditions, but not in copy task. The error types included: omissions, transpositions, insertions and letter substitutions. These were equally distributed on the writing task and the composition of words with a set of preformed letters. This pattern of performance is consistent with a spelling impairment. The results are consistent with the concept that written production is critically dependent on the subvocal articulatory mechanism of rehearsal, perhaps at the level of retaining the sequence of graphemes in a graphemic buffer. In PLS patients a disturbance in rehearsal opportunity may affect the correct sequencing/assembly of an orthographic representation in the written process.

  14. Anxiety disorders in children%儿童的焦虑障碍

    Institute of Scientific and Technical Information of China (English)

    张劲松

    2015-01-01

    儿童的焦虑障碍是常见的精神障碍,常与躯体症状或躯体疾病相伴随,总体的终生患病率较高.儿童焦虑障碍主要包括分离性焦虑障碍、恐惧性焦虑障碍、社交性焦虑障碍、广泛性焦虑障碍、惊恐障碍和选择性缄默.现主要介绍上述5种焦虑障碍的流行病学、病因与病理机制、常见临床表现、评估、治疗和预后.%Child anxiety disorders are among the common mental health disorders,often with physical symptoms or physical disorders.The life time prevalence is relative high.Child anxiety disorders mainly include in subtype as separation anxiety,specific phobia,social anxiety disorder,panic disorder and selective mutism.In this paper,the prevalence rate of the above 5 subtypes,etiology,clinic manifestation,treatment and outcome were introduced.

  15. The 7q11.23 Microduplication Syndrome: A Clinical Report with Review of Literature.

    Science.gov (United States)

    Abbas, Elham; Cox, Devin M; Smith, Teri; Butler, Merlin G

    2016-09-01

    We report a 14-year-old adolescent girl with selective mutism (SM) and a 7q11.23 microduplication detected by chromosomal microarray (CMA) analysis and reviewed the literature from 18 published clinical reports. Our patient had specific phobias, SM, extreme anxiety, obesity, cutis marmorata, and a round appearing face with a short neck and over folded ears. We reviewed the published clinical, cognitive, behavioral, and cytogenetic findings grouped by speech and language delay, growth and development, craniofacial, clinical, and behavior and cognitive features due to the 7q11.23 microduplication. This microduplication syndrome is characterized by speech delay (91%), social anxiety (42%), attention deficit hyperactivity disorder (ADHD, 37%), autism spectrum disorder (29%), and separation anxiety (13%). Other findings include abnormal brain imaging (80%), congenital heart and vascular defects (54%), and mild intellectual disability (38%). We then compared the phenotype with Williams-Beuren syndrome (WBS) which is due to a deletion of the same chromosome region. Both syndromes have abnormal brain imaging, hypotonia, delayed motor development, joint laxity, mild intellectual disability, ADHD, autism, and poor visuospatial skills but opposite or dissimilar findings regarding speech and behavioral patterns, cardiovascular problems, and social interaction. Those with WBS are prone to have hyperverbal speech, lack of stranger anxiety, and supravalvular aortic stenosis while those with the 7q11.23 microduplication have speech delay, SM, social anxiety, and are prone to aortic dilatation.

  16. Management of developmental speech and language disorders. Part 2: acquired conditions.

    Science.gov (United States)

    O'Hare, Anne

    2016-03-01

    Many children who present with these acquired impairments of communication have a clear preceding event such as an acquired brain injury from a road traffic accident. Children often respond differently in this situation to adult presentations. They may have a period of mutism when the prognosis might look poor and yet they subsequently make rapid progress and recover speech. They have greater potential for neural plasticity and language recovery, although they often have persisting difficulties in oral and written language. Alternatively, there may be a presentation with a paroxysmal event such as a seizure or a period of depressed consciousness, and the unusual behaviour that may accompany dysphasia and dysarthria may be misinterpreted in the child, whereas for the adult with the more common 'stroke-like' presentation, it would be immediately considered. Rarely the aphasia/dysphasia may itself be the paroxysmal event where actually recognising that the child's disrupted communication is the basis of any observed behaviours can be the greater challenge.

  17. A MORPHOMETRIC ANALYSIS OF FOURTH VENTRICAL OF HUMAN CADAVERIC BRAIN BY PLASTINATION

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    Akbari V J

    2011-04-01

    Full Text Available The fourth ventricle enlarges in various conditions like hydrocephalus, dementias, mutism etc. So, it is necessary to know the normal range of dimensions of forth ventricle. Present study was conducted at anatomy Dept. P.D.U. medical college, Rajkot, Gujarat during October 2009 to October 2010. The casts of ventricular system of 20 formalinized cadaveric human brains were prepared after injecting epoxyresin+hardener (BOND TITE mixture. From the cast, measurements of height (from upper end of impression of superior medullary valum to obex and breadth (at the level of lateral recesses of 4th ventricle were taken by vernier caliper. The data was analyzed statistically and was compared with the data obtained from radiological methods. In present study, the mean height of fourth ventricle 2.29 cm (range 1.9-2.7cm, S.D. 0.30 and mean breadth 2.38 cm (range 1.75-3 cm, S.D. 0.44. Present data differs significantly from data of radiological studies, which could be due to different methodologies, whereas the radiological methods are indirect and two dimensional; the present study with cast gives direct and three dimensional results without distorting the dimensions of fourth ventricle. [National J of Med Res 2011; 1(2.000: 48-50

  18. CASE REPORT OF NEUROLEPTIC MALIGNANT SYNDROME WITH RISING BLOOD SUGAR

    Institute of Scientific and Technical Information of China (English)

    WANG Hong-xing; LV Qiu-lin; WANG Zu-cheng; HUANG Ji-zhong; XU He-ding; WEN Hui; CHEN Jun; QIAO Song; NI Xiao-dong

    2007-01-01

    Objective To report one case of neuroleptic malignant syndrome (NMS) with raising blood sugar. Methods The patient was studied clinically with biochemistry, white blood cells, psychiatric symptoms,and creatine phosphokinase (CPK) observations. Results The male patient with a history of taking antipsychotics more 30 years and his age of onset was about 20 years. He had severe muscular rigidity, altered consciousness and autonomic disturbance associated with elevation of serum CPK levels ( max 3755 U/L) and leucocytosis ( max 13.3 × 109/L ) , especially granular leukocytosis( max 90% ) and lymphocytopenia (min 8% ). In addition, high blood sugar emerged along with the variation of white blood cells ( max 9. 0 mmol/L). Conclusion The manifestations of the patient was in conformity with those of the NMS. The patient had catatonic signs such as mutism,drinking difficulty, etc. and excess of saliva. Developmental observation with CPK and white blood cells is able to reveal the severity level of NMS. Raising blood sugar should be also monitoring item.

  19. Iodine deficiency disorders.

    Science.gov (United States)

    Elliott, T C

    1987-01-01

    Iodine deficiency disorder (IDD) affects 800 million people in the world, yet iodine supplementation is one of the most cost-effective nutritional interventions known. Iodine is incorporated into thyroid hormones, necessary for regulating metabolic rate, growth, and development of the brain and nervous system. IDD may appear as goiter in adults, usually not a serious problem, or in cretinism in children, which is marked by severe mental and physical retardation, with irreversible hearing and speech defects and either deaf-mutism, squint and paralysis, or stunting and edema. Children supplemented by age 1 or 2 can sometimes be helped. Foods contain variable amounts of iodine dependent on the soil where they are grown, hence mountainous and some inland regions have high goiter and IDD incidence. There are also goitrogenic foods, typically those of the cabbage family. Diagnosis is clinical or by blood tests for thyroid hormone levels and ratios. Finger-stick methods are available. Prevention of IDD is simple with either iodized salt or flour, iodinated central water supplies, injectable or oral iodine-containing oil. All cost about $.04 per person per year, except injections, which cost about $1 per person, but have the advantage that they could be combined with immunizations. Local problems with supplements are loss of iodine in salt with storage in tropics, and local production of cheaper uniodinated salt. Emphasis should be given to pregnant women and young children. There is no harm in giving pregnant women iodine injections in 2nd or 3rd trimester. PMID:12343033

  20. A novel de novo mutation in ATP1A3 and childhood-onset schizophrenia.

    Science.gov (United States)

    Smedemark-Margulies, Niklas; Brownstein, Catherine A; Vargas, Sigella; Tembulkar, Sahil K; Towne, Meghan C; Shi, Jiahai; Gonzalez-Cuevas, Elisa; Liu, Kevin X; Bilguvar, Kaya; Kleiman, Robin J; Han, Min-Joon; Torres, Alcy; Berry, Gerard T; Yu, Timothy W; Beggs, Alan H; Agrawal, Pankaj B; Gonzalez-Heydrich, Joseph

    2016-09-01

    We describe a child with onset of command auditory hallucinations and behavioral regression at 6 yr of age in the context of longer standing selective mutism, aggression, and mild motor delays. His genetic evaluation included chromosomal microarray analysis and whole-exome sequencing. Sequencing revealed a previously unreported heterozygous de novo mutation c.385G>A in ATP1A3, predicted to result in a p.V129M amino acid change. This gene codes for a neuron-specific isoform of the catalytic α-subunit of the ATP-dependent transmembrane sodium-potassium pump. Heterozygous mutations in this gene have been reported as causing both sporadic and inherited forms of alternating hemiplegia of childhood and rapid-onset dystonia parkinsonism. We discuss the literature on phenotypes associated with known variants in ATP1A3, examine past functional studies of the role of ATP1A3 in neuronal function, and describe a novel clinical presentation associated with mutation of this gene. PMID:27626066

  1. Afebrile Neuroleptic Malignant Syndrome associated with Fluphenazine decanoate: A case report

    Directory of Open Access Journals (Sweden)

    Marzieh Assareh

    2010-06-01

    Full Text Available "nNeuroleptic Malignant Syndrome (NMS is unusual but could be a lethal reaction associated with neuroleptic drugs. It occurs in almost 0.07-2.2% of patients under treatment with neuroleptics. There are some medical treatments that may also be helpful for its treatment, including dopamine agonists, muscle relaxants, and electroconvulsive therapy (ECT. We present this case to alert the clinicians to the potential for inducing afebrile NMS. Our case is a 41-year-old man with a history of schizophrenia showing signs and symptoms in accordance with NMS, 2 weeks after receiving one dose of 12.5 mg fluphenazine decanoate, abruptly following the 3rdsession of ECT. The patient presented with decreased level of consciousness, muscular rigidity, waxy flexibility, mutism ,generalized tremor, sever diaphoresis and tachycardia which progressed during the previous 24 h. Laboratory data indicated primarily leukocytosis, an increasing level of creatinine phosphokinase and hypokalemia during the next 72h. In patients receiving antipsychotics, any feature of NMS should carefully be evaluated whether it is usual or unusual particularly in patients receiving long acting neuroleptics.

  2. Prevalence of goitre among school going children in urban area of Dehradun

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    Utkarsh Sharma

    2015-01-01

    Full Text Available Background: Iodine is an important micro-nutrient required for human nutrition. Iodine Deficiency Disorders (IDDs are one of the major world-wide public health problems of today which causes wide spectrum of disabilities. It includes impairment of reproductive functions, lowering of IQ levels in school age children, goiter, deaf mutism, mental defects, weakness and paralysis of muscles as well as lesser degree of physical dysfunction. Methods: Selection of population: The school children in age group of 6-18 years from both the sexes were screened from SGRR Schools of different locations at Dehradun, after taking approval from principal and the parents. Results: The prevalence of goitre among school going children was 5%. Prevalence of goitre among female was 6.4% compare to male were 4.1%. There was significant association found between prevalence of goitre and vegetarian diet. In pre pubertal age (11-14 years maximum (7.6% cases of goitre were seen. A significant association of goitre with pallor was also observed Conclusion: The sustained efforts in implementing the guidelines of National Iodine Deficiency Disorders Control Programme (NIDDCP have been able to reduce the prevalence of goitre in Uttrakhand state. In spite of reduction in prevalence over years, goitre continues to be a major public health problem in the state. [Int J Res Med Sci 2015; 3(1.000: 198-200

  3. Management of developmental speech and language disorders. Part 2: acquired conditions.

    Science.gov (United States)

    O'Hare, Anne

    2016-03-01

    Many children who present with these acquired impairments of communication have a clear preceding event such as an acquired brain injury from a road traffic accident. Children often respond differently in this situation to adult presentations. They may have a period of mutism when the prognosis might look poor and yet they subsequently make rapid progress and recover speech. They have greater potential for neural plasticity and language recovery, although they often have persisting difficulties in oral and written language. Alternatively, there may be a presentation with a paroxysmal event such as a seizure or a period of depressed consciousness, and the unusual behaviour that may accompany dysphasia and dysarthria may be misinterpreted in the child, whereas for the adult with the more common 'stroke-like' presentation, it would be immediately considered. Rarely the aphasia/dysphasia may itself be the paroxysmal event where actually recognising that the child's disrupted communication is the basis of any observed behaviours can be the greater challenge. PMID:25990500

  4. Olmsted syndrome: report of a case with study of the cellular proliferation in keratoderma.

    Science.gov (United States)

    Requena, L; Manzarbeitia, F; Moreno, C; Izquierdo, M J; Pastor, M A; Carrasco, L; Fariña, M C; Martín, L

    2001-12-01

    Olmsted syndrome is a rare disorder that consists of sharply marginated keratoderma of the palms and soles, constriction of digits and toes that may result in spontaneous amputation of the distal phalanges, hyperkeratotic plaques around the body orifices, onychodystrophy, and other less common cutaneous and extracutaneous anomalies. Although some patients had other affected family members, most cases of Olmsted syndrome seem to be of sporadic occurrence. We describe a patient with the characteristic features of Olmsted syndrome. The symptoms consisted of diffuse transgrediens palmoplantar keratoderma and keratotic plaques around the mouth and nose. Our patient also had the associated anomalies of hyperhidrosis of the palms and soles and congenital deaf-mutism. Histopathologic study of the keratoderma demonstrated epidermal hyperplasia with acanthosis, papillomatosis, and orthokeratotic hyperkeratosis. Immunohistochemical study showed more basal and suprabasal keratinocytes of the epidermis with immunoreactivity for Ki-67 marker when compared with the keratinocytes of the epidermis of the adjacent non-involved skin. These results support the notion that Olmsted syndrome is a hyperproliferative disorder of the epidermis. PMID:11801792

  5. Global aphasia as a predictor of mortality in the acute phase of a first stroke

    Directory of Open Access Journals (Sweden)

    F F Oliveira

    2011-01-01

    Full Text Available OBJECTIVE: To establish whether vascular aphasic syndromes can predict stroke outcomes. METHOD: Thirty-seven adults were evaluated for speech and language within 72 hours after a single first-ever ischemic brain lesion, in blind association to CT and/or MR. RESULTS: Speech or language disabilities were found in seven (87.5% of the eight deceased patients and twenty-six (89.7% of the twenty-nine survivors. Global aphasia was identified in eleven patients, all with left hemisphere lesions (nine mute; five deceased, consisting on a risk factor for death in the acute stroke phase (ρ=0.022. Age (z=1.65; ρ>0.09, thrombolysis (ρ=0.591, infarct size (ρ=0.076 and side (ρ=0.649 did not significantly influence survival. Absence of aphasia did not predict a better evolution, regardless of the affected hemisphere. Prevalence of cardiovascular risk factors was similar for all patient groups. CONCLUSION: Global aphasia in acute stroke can adversely affect prognosis, translated into impairment of dominant perisylvian vascular territories, with mutism as an important semiological element.

  6. Complete clinical recovery of a central pontine and extrapontine myelinolysis delayed onset in a child with acute myeloblastic leukemia.

    Science.gov (United States)

    Yilmaz, D; Karapinar, B; Balkan, C; Ay, Y; Kavakli, K

    2011-02-01

    Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated with the demyelination of extrapontine areas of the central nervous system. It typically occurs 0.5-7 days after a rapid increment in serum Na level in hyponatremic patients and may lead to death. A 2.5-year-old child with a diagnosis of acute myeloblastic leukemia developed febril neutropenia, diarrhea, gastrointestinal hemorrhage followed by pulmonary aspergillosis. He could not tolerate enteral nutrition. He was given broad spectrum antibiotics and antifungal treatment. Laboratory tests showed electrolyte abnormalities including hyponatremia, hypokalemia and hypophosphatemia in a chronic course. Twenty three days after a rapid correction of hyponatremia (16 mEq/L/24 h) he revealed flask quadriparesis, disphagia, mutism, irregular respiratory pattern and loss of cough and gag reflex. Cranial magnetic resonance showed central pontine and extrapontine myelinolysis. He required mechanical ventilation and then he regained his neurologic functions. He completed chemotherapy protocol and underwent hematopoietic stem cell transplantation. After 2.5 years of the occurrence of CPM he is in completely normal physical and neurological status. CPM is a very severe but rare disorder in children with underlying disease. In the presence of multiple etiologic factors it may reveal a delayed onset and optimum outcome can be seen even in the severe clinical presentation with adequate intensive support.

  7. Coexistence of protease sensitive and resistant prion protein in 129VV homozygous sporadic Creutzfeldt–Jakob disease: a case report

    Directory of Open Access Journals (Sweden)

    Rodríguez-Martínez Ana B

    2012-10-01

    Full Text Available Abstract Introduction The coexistence of different molecular types of classical protease-resistant prion protein in the same individual have been described, however, the simultaneous finding of these with the recently described protease-sensitive variant or variably protease-sensitive prionopathy has, to the best of our knowledge, not yet been reported. Case presentation A 74-year-old Caucasian woman showed a sporadic Creutzfeldt–Jakob disease clinical phenotype with reactive depression, followed by cognitive impairment, akinetic-rigid Parkinsonism with pseudobulbar syndrome and gait impairment with motor apraxia, visuospatial disorientation, and evident frontal dysfunction features such as grasping, palmomental reflex and brisk perioral reflexes. She died at age 77. Neuropathological findings showed: spongiform change in the patient’s cerebral cortex, striatum, thalamus and molecular layer of the cerebellum with proteinase K-sensitive synaptic-like, dot-like or target-like prion protein deposition in the cortex, thalamus and striatum; proteinase K-resistant prion protein in the same regions; and elongated plaque-like proteinase K-resistant prion protein in the molecular layer of the cerebellum. Molecular analysis of prion protein after proteinase K digestion revealed decreased signal intensity in immunoblot, a ladder-like protein pattern, and a 71% reduction of PrPSc signal relative to non-digested material. Her cerebellum showed a 2A prion protein type largely resistant to proteinase K. Genotype of polymorphism at codon 129 was valine homozygous. Conclusion Molecular typing of prion protein along with clinical and neuropathological data revealed, to the best of our knowledge, the first case of the coexistence of different protease-sensitive prion proteins in the same patient in a rare case that did not fulfill the current clinical diagnostic criteria for either probable or possible sporadic Creutzfeldt–Jakob disease. This highlights the

  8. Correlation with neuropsychological assessment and SPM analysis of brain perfusion SPECT in patients with progressive supranuclear palsy

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Young Jin; Kang, Do Young; Park, Kyung Won; Kim, Jae Woo [School of Medicine, Dong-A University, Busan (Korea, Republic of)

    2004-07-01

    Progressive supranuclear palsy (PSP) is a degenerative condition of unknown aetiology that produces an akinetic-rigid form of parkinsonism characterised by early falls, dementia and abnormalities of extraocular movements. The patterns of decreased regional cerebral blood flow and cognitive impairment in PSP compared with normal control have been insufficiently investigated and a limited number of studies have been performed. We evaluated clinical symptoms, functional neuroimaging study using Tc-99m HMPAO SPECT and neuropsychological profiles in patients with PSP. Eleven patients with PSP diagnosed by the clinical criteria of National Institute of Neurological Disorders and Stroke and the Society for PSP (NINDS-SPSP) (mean age: 70.5{+-}5.6 years, educational period: 4.5{+-}4.7 years) and age-matched 10 healthy control subjects (mean age: 68.1{+-}4.5 years, educational period: 6.5{+-}4.1 years) participated in this study were participated. All patients were given a neurologic examination, brain MRI and cerebral perfusion SPECT using Tc-99m HMPAO. We concomittently evaluated several cognitive profiles using the Seoul Neuropsychological Screening Battery. SPM analysis of the SPECT image showed significant perfusion deficits in the left inferior frontal gyrus, left caudate nucleus, left middle frontal gyrus and cingulate gyrus in the patients with PSP compared with age-matched healthy control (uncorrected p<0.01). On neuropsychological assessment, cognitive deficits on verbal and visual memory, word fluency and frontal executive functions were prominent in most patients with PSP compared with healthy control subjects. Our findings suggest that measurement of regional cerebral blood flow by perfusion SPECT and voxel-based SPM analysis with neuropsychological assessment are useful to understanding the correlation between perfusion deficits and abnormal cognitive profiles in patients with PSP.

  9. USE OF THREE-COMPONENT LEVODOPA (LEVODOPA/CARBIDOPA/ENTACAPONE TO CORRECT NOCTURNAL SYMPTOMS OF PARKINSON,S DISEASE

    Directory of Open Access Journals (Sweden)

    T. K. Kulua

    2015-01-01

    Full Text Available Objective: to describe a clinical case of late-stage Parkinson’s disease (PD with nocturnal symptoms and fluctuations and to present successful experience in using the three-component drug Stalevo (levodopa/carbidopa/entacapone as a single dose prior to sleep. Patient V. aged 72 years took medical advice at the Department of Neurology, Russian Medical Academy of Postgraduate Education, for complaints of constrained movements, inability to turn in bed independently, painful muscle cramps, light sleep with nocturnal awakenings, and frequent (5–6 times urinations at night. The first symptoms of the disease appeared 12 years ago when the patient began to notice sluggishness, altered handwriting, and clumsiness during small movements of the right hand. By taking into account symptoms (obvious nocturnal akinesia, overactive bladder, sleep disorders, and cramps and the results of his examination, the patient was diagnosed with the akinetic-rigid form of PD (4 Hoehn-Yarh scores. Therapy was corrected as follows: the dose of amantadine remained the same (300 mg; its last administration is recommended to be at 16:00; the daily dose of levodopa was 700 mg; that of levodopa/benserazide was 550 mg/day (1 tablet × 3/4 tablet × 1 tablet. The evening intake of levodopa was changed for that of the three-component drug Stalevo (levodopa 150 mg/ carbidopa 37.5 mg/entacapone 200 mg. Results. After 3 months, the patient was observed to have significant health improvement: reduced nocturnal and morning akinesia, better gait, a considerably smaller number of nocturnal urinations (less than once per night, regression of painful calf muscle cramps, and improved sleep. Conclusion. The three-component drug Stalevo (levodopa/carbidopa/entacapone is effective in treating late-stage PD. Its use as a single dose before going to bed has led to regressive nocturnal symptoms, better sleep, and lower motor fluctuations. 

  10. Correlation with neuropsychological assessment and SPM analysis of brain perfusion SPECT in patients with progressive supranuclear palsy

    International Nuclear Information System (INIS)

    Progressive supranuclear palsy (PSP) is a degenerative condition of unknown aetiology that produces an akinetic-rigid form of parkinsonism characterised by early falls, dementia and abnormalities of extraocular movements. The patterns of decreased regional cerebral blood flow and cognitive impairment in PSP compared with normal control have been insufficiently investigated and a limited number of studies have been performed. We evaluated clinical symptoms, functional neuroimaging study using Tc-99m HMPAO SPECT and neuropsychological profiles in patients with PSP. Eleven patients with PSP diagnosed by the clinical criteria of National Institute of Neurological Disorders and Stroke and the Society for PSP (NINDS-SPSP) (mean age: 70.5±5.6 years, educational period: 4.5±4.7 years) and age-matched 10 healthy control subjects (mean age: 68.1±4.5 years, educational period: 6.5±4.1 years) participated in this study were participated. All patients were given a neurologic examination, brain MRI and cerebral perfusion SPECT using Tc-99m HMPAO. We concomittently evaluated several cognitive profiles using the Seoul Neuropsychological Screening Battery. SPM analysis of the SPECT image showed significant perfusion deficits in the left inferior frontal gyrus, left caudate nucleus, left middle frontal gyrus and cingulate gyrus in the patients with PSP compared with age-matched healthy control (uncorrected p<0.01). On neuropsychological assessment, cognitive deficits on verbal and visual memory, word fluency and frontal executive functions were prominent in most patients with PSP compared with healthy control subjects. Our findings suggest that measurement of regional cerebral blood flow by perfusion SPECT and voxel-based SPM analysis with neuropsychological assessment are useful to understanding the correlation between perfusion deficits and abnormal cognitive profiles in patients with PSP

  11. A transitional snake from the Late Cretaceous period of North America.

    Science.gov (United States)

    Longrich, Nicholas R; Bhullar, Bhart-Anjan S; Gauthier, Jacques A

    2012-08-01

    Snakes are the most diverse group of lizards, but their origins and early evolution remain poorly understood owing to a lack of transitional forms. Several major issues remain outstanding, such as whether snakes originated in a marine or terrestrial environment and how their unique feeding mechanism evolved. The Cretaceous Coniophis precedens was among the first Mesozoic snakes discovered, but until now only an isolated vertebra has been described and it has therefore been overlooked in discussions of snake evolution. Here we report on previously undescribed material from this ancient snake, including the maxilla, dentary and additional vertebrae. Coniophis is not an anilioid as previously thought a revised phylogenetic analysis of Ophidia shows that it instead represents the most primitive known snake. Accordingly, its morphology and ecology are critical to understanding snake evolution. Coniophis occurs in a continental floodplain environment, consistent with a terrestrial rather than a marine origin; furthermore, its small size and reduced neural spines indicate fossorial habits, suggesting that snakes evolved from burrowing lizards. The skull is intermediate between that of lizards and snakes. Hooked teeth and an intramandibular joint indicate that Coniophis fed on relatively large, soft-bodied prey. However, the maxilla is firmly united with the skull, indicating an akinetic rostrum. Coniophis therefore represents a transitional snake, combining a snake-like body and a lizard-like head. Subsequent to the evolution of a serpentine body and carnivory, snakes evolved a highly specialized, kinetic skull, which was followed by a major adaptive radiation in the Early Cretaceous period. This pattern suggests that the kinetic skull was a key innovation that permitted the diversification of snakes.

  12. Morphology and Elemental Composition of Recent and Fossil Cyanobacteria

    Science.gov (United States)

    SaintAmand, Ann; Hoover, Richard B.; Jerman, Gregory; Rozanov, Alexei Yu.

    2005-01-01

    Cyanobacteria (cyanophyta, cyanoprokaryota, and blue-green algae) are an ancient, diverse and abundant group of photosynthetic oxygenic microorganisms. Together with other bacteria and archaea, the cyanobacteria have been the dominant life forms on Earth for over 3.5 billion years. Cyanobacteria occur in some of our planets most extreme environments - hot springs and geysers, hypersaline and alkaline lakes, hot and cold deserts, and the polar ice caps. They occur in a wide variety of morphologies. Unlike archaea and other bacteria, which are typically classified in pure culture by their physiological, biochemical and phylogenetic properties, the cyanobacteria have historically been classified based upon their size and morphological characteristics. These include the presence or absence of heterocysts, sheath, uniseriate or multiseriate trichomes, true or false branching, arrangement of thylakoids, reproduction by akinetes, binary fission, hormogonia, fragmentation, presence/absence of motility etc. Their antiquity, distribution, structural and chemical differentiation, diversity, morphological complexity and large size compared to most other bacteria, makes the cyanobacteria ideal candidates for morphological biomarkers in returned Astromaterials. We have obtained optical (nomarski and phase contrast)/fluorescent (blue and green excitation) microscopy images using an Olympus BX60 compound microscope and Field Emission Scanning Electron Microscopy images and EDAX elemental compositions of living and fossil cyanobacteria. The S-4000 Hitachi Field Emission Scanning Electron Microscope (FESEM) has been used to investigate microfossils in freshly fractured interior surfaces of terrestrial rocks and the cells, hormogonia, sheaths and trichomes of recent filamentous cyanobacteria. We present Fluorescent and FESEM Secondary and Backscattered Electron images and associated EDAX elemental analyses of recent and fossil cyanobacteria, concentrating on representatives of the

  13. Identification by [{sup 99m}Tc]ECD SPECT of anterior cingulate hypoperfusion in progressive supranuclear palsy, in comparison with Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Varrone, Andrea [University Federico II, Biostructure and Bioimaging Institute, National Research Council/Department of Biomorphological and Functional Sciences, Napoli (Italy); Karolinska Hospital, Department of Clinical Neuroscience, Psychiatry Section, Stockholm (Sweden); Pagani, Marco; Salmaso, Dario [National Research Council, Institute of Cognitive Sciences and Technologies, Rome and Padua (Italy); Salvatore, Elena; Amboni, Marianna; De Michele, Giuseppe; Filla, Alessandro; Barone, Paolo [University Federico II, Department of Neurological Sciences, Napoli (Italy); Sansone, Valeria; Pappata, Sabina; Salvatore, Marco [University Federico II, Biostructure and Bioimaging Institute, National Research Council/Department of Biomorphological and Functional Sciences, Napoli (Italy); Nobili, Flavio [University of Genoa, Clinical Neurophysiology, Department of Endocrinological and Metabolic Sciences, Genoa (Italy)

    2007-07-15

    Progressive supranuclear palsy (PSP) is an akinetic-rigid syndrome that can be difficult to differentiate from Parkinson's disease (PD), particularly at an early stage. [{sup 99m}Tc]ethyl cysteinate dimer (ECD) SPECT could represent a widely available tool to assist in the differential diagnosis. In this study we used voxel-based analysis and Computerised Brain Atlas (CBA)-based principal component analysis (PCA) of [{sup 99m}Tc]ECD SPECT data to test whether: (1) specific patterns of rCBF abnormalities can differentiate PSP from controls and PD; (2) networks of dysfunctional brain regions can be found in PSP vs controls and PD. Nine PD patients, 16 PSP patients and ten controls were studied with [{sup 99m}Tc]ECD SPECT using a brain-dedicated device (Ceraspect). Voxel-based analysis was performed with statistical parametric mapping. PCA was applied to volume of interest data after spatial normalisation to CBA. The voxel-based analysis showed hypoperfusion of the anterior cingulate and medial frontal cortex in PSP compared with controls and PD. In PSP patients the rCBF impairment extended to the pre-supplementary motor area and prefrontal cortex, areas involved in executive function and motor networks. Compared with PSP patients, PD patients showed a mild rCBF decrease in associative visual areas which could be related to the known impairment of visuospatial function. The PCA identified three principal components differentiating PSP patients from controls and/or PD patients that included groups of cortical and subcortical brain regions with relatively decreased (cingulate cortex, prefrontal cortex and caudate) or increased (parietal cortex) rCBF, representing distinct functional networks in PSP. Anterior cingulate hypoperfusion seems to be an early, distinct brain abnormality in PSP as compared with PD. (orig.)

  14. Bee Venom Alleviates Motor Deficits and Modulates the Transfer of Cortical Information through the Basal Ganglia in Rat Models of Parkinson's Disease.

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    Nicolas Maurice

    Full Text Available Recent evidence points to a neuroprotective action of bee venom on nigral dopamine neurons in animal models of Parkinson's disease (PD. Here we examined whether bee venom also displays a symptomatic action by acting on the pathological functioning of the basal ganglia in rat PD models. Bee venom effects were assessed by combining motor behavior analyses and in vivo electrophysiological recordings in the substantia nigra pars reticulata (SNr, basal ganglia output structure in pharmacological (neuroleptic treatment and lesional (unilateral intranigral 6-hydroxydopamine injection PD models. In the hemi-parkinsonian 6-hydroxydopamine lesion model, subchronic bee venom treatment significantly alleviates contralateral forelimb akinesia and apomorphine-induced rotations. Moreover, a single injection of bee venom reverses haloperidol-induced catalepsy, a pharmacological model reminiscent of parkinsonian akinetic deficit. This effect is mimicked by apamin, a blocker of small conductance Ca2+-activated K+ (SK channels, and blocked by CyPPA, a positive modulator of these channels, suggesting the involvement of SK channels in the bee venom antiparkinsonian action. In vivo electrophysiological recordings in the substantia nigra pars reticulata (basal ganglia output structure showed no significant effect of BV on the mean neuronal discharge frequency or pathological bursting activity. In contrast, analyses of the neuronal responses evoked by motor cortex stimulation show that bee venom reverses the 6-OHDA- and neuroleptic-induced biases in the influence exerted by the direct inhibitory and indirect excitatory striatonigral circuits. These data provide the first evidence for a beneficial action of bee venom on the pathological functioning of the cortico-basal ganglia circuits underlying motor PD symptoms with potential relevance to the symptomatic treatment of this disease.

  15. The Smallest Known Genomes of Multicellular and Toxic Cyanobacteria: Comparison, Minimal Gene Sets for Linked Traits and the Evolutionary Implications

    Science.gov (United States)

    Stucken, Karina; John, Uwe; Cembella, Allan; Murillo, Alejandro A.; Soto-Liebe, Katia; Fuentes-Valdés, Juan J.; Friedel, Maik; Plominsky, Alvaro M.; Vásquez, Mónica; Glöckner, Gernot

    2010-01-01

    Cyanobacterial morphology is diverse, ranging from unicellular spheres or rods to multicellular structures such as colonies and filaments. Multicellular species represent an evolutionary strategy to differentiate and compartmentalize certain metabolic functions for reproduction and nitrogen (N2) fixation into specialized cell types (e.g. akinetes, heterocysts and diazocytes). Only a few filamentous, differentiated cyanobacterial species, with genome sizes over 5 Mb, have been sequenced. We sequenced the genomes of two strains of closely related filamentous cyanobacterial species to yield further insights into the molecular basis of the traits of N2 fixation, filament formation and cell differentiation. Cylindrospermopsis raciborskii CS-505 is a cylindrospermopsin-producing strain from Australia, whereas Raphidiopsis brookii D9 from Brazil synthesizes neurotoxins associated with paralytic shellfish poisoning (PSP). Despite their different morphology, toxin composition and disjunct geographical distribution, these strains form a monophyletic group. With genome sizes of approximately 3.9 (CS-505) and 3.2 (D9) Mb, these are the smallest genomes described for free-living filamentous cyanobacteria. We observed remarkable gene order conservation (synteny) between these genomes despite the difference in repetitive element content, which accounts for most of the genome size difference between them. We show here that the strains share a specific set of 2539 genes with >90% average nucleotide identity. The fact that the CS-505 and D9 genomes are small and streamlined compared to those of other filamentous cyanobacterial species and the lack of the ability for heterocyst formation in strain D9 allowed us to define a core set of genes responsible for each trait in filamentous species. We presume that in strain D9 the ability to form proper heterocysts was secondarily lost together with N2 fixation capacity. Further comparisons to all available cyanobacterial genomes covering

  16. The Effect of Sleep and Wakefulness Disorders on Cognitive Function in Parkinson's Disease

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    Rustambek Matmurodov

    2015-03-01

    Full Text Available Objective: To clarify clinical features of sleep disorders in patients with Parkinson’s disease (PD and their effect on cognitive function and emotional-personal sphere. Material and methods: The study involved 62 patients with PD (33 men and 29 women mean age 47.8+7.1 years. The control group consisted of 20 patients without Parkinsonism matching by age and sex. The diagnosis of PD was established by criteria A.Hughes. Patients underwent an extended neuropsychological study with qualitative and quantitative analysis. To determine cognitive disorders, we used neuropsychological tests. Results: 49 patients (79,3% had sleep disorders. In the structure of sleep disorders: 29 (59.2% patients had insomnia and 11 (22.4% patients – parasomnia and 9 (18.4% - hypersomnia. In a control group, numbers were 4.5 times less. The analysis showed that the structure of sleep disorders correlates with the form of PD. So, insomnia is more rapidly met in akinetic-rigid form (55.5%, whereas hypersomnia is presented in mixed form. Patients with insomnia present 35% of predement cognitive impairment and 34% of dementia (66.7% of mild degree dementia and 33.3% moderate dementia severity. Whereas, in patients with hypersomnia 35% of predement cognitive impairment, 60% of dementia (54.6% and 45.4% were observed. Among patients with permanent drowsiness 32.4% of predement cognitive impairment and 58.4% of dementia (44.8% and 55.2% were diagnosed. Dementia (65.4% was observed more in patients with sudden sleep (42,8% and 57.2%. Conclusion: sleep and wakefulness disorders depend not only on the severity of motor symptoms, but also depend on the emotional and cognitive state.

  17. Studies on 201Th myocardial scintiscanning

    International Nuclear Information System (INIS)

    The diagnostical evidence of myocardial scintiscanning with thallium-201 was tested on 98 patients with coronary heart disease. 2 mCi thallium-201 were injected into an arm vene and then scintigrams of the heart were registered partly with a scanner, partly with a gamma camera in several views. The healthy myocardium was found in the thallium-201-scintigram to be a rather homogeneous, horeshoe-shaped activity pattern with intramyocardial activity differences of up to 20% of the maximal thallium-201-activity above the myocard which can be declared to be physiological. In dependency on the local blood flow conditions, thallium-201 is stored only in the healthy, but not in the ischaemic or infarcted myocardium. In the scintigram, these regions are seen as regions with reduced radioactivity. A comparison of the localisation of the infarction in the scintigram with those in the electrocardiagram and coronary angiogram showed a good congrucucy. Scintigrams taken at different times after the infarction brought a decrease in the number of diagnosed storage failures, from 90% to 68% in infarctions older than 6 weeks. A scintigraphical differentiation between fresh and old infarctions was not possible. In cases of angiographically established coronary heart disease without infarction, pathological storage reductions were observed. By comparing the findings obtained by scintiscanning with the results of laevocardiography it was seen that hypokinetic regions in the thallium-201-myocardial scintigram showed in only 6% of the cases a pathological storage defect; akinetic, dyskinetic, and aneurysmatic regions, however, were seen in 65% of the cases as clear activity reductions or failures. (orig./MG)

  18. Impaired sense of smell in a Drosophila Parkinson's model.

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    Simone Poddighe

    Full Text Available Parkinson's disease (PD is one of the most common neurodegenerative disease characterized by the clinical triad: tremor, akinesia and rigidity. Several studies have suggested that PD patients show disturbances in olfaction at the earliest onset of the disease. The fruit fly Drosophila melanogaster is becoming a powerful model organism to study neurodegenerative diseases. We sought to use this system to explore olfactory dysfunction, if any, in PINK1 mutants, which is a model for PD. PINK1 mutants display many important diagnostic symptoms of the disease such as akinetic motor behavior. In the present study, we describe for the first time, to the best of our knowledge, neurophysiological and neuroanatomical results concerning the olfactory function in PINK1 mutant flies. Electroantennograms were recorded in response to synthetic and natural volatiles (essential oils from groups of PINK1 mutant adults at three different time points in their life cycle: one from 3-5 day-old flies, from 15-20 and from 27-30 days. The results obtained were compared with the same age-groups of wild type flies. We found that mutant adults showed a decrease in the olfactory response to 1-hexanol, α-pinene and essential oil volatiles. This olfactory response in mutant adults decreased even more as the flies aged. Immunohistological analysis of the antennal lobes in these mutants revealed structural abnormalities, especially in the expression of Bruchpilot protein, a marker for synaptic active zones. The combination of electrophysiological and morphological results suggests that the altered synaptic organization may be due to a neurodegenerative process. Our results indicate that this model can be used as a tool for understanding PD pathogensis and pathophysiology. These results help to explore the potential of using olfaction as a means of monitoring PD progression and developing new treatments.

  19. 我国蓝藻水华的发生机理、危害及防控利用研究进展%Advances in Mechanism of the Occurrence, Hazard, and Prevention/Control Utilization of Cyanophytic Blooms in China

    Institute of Scientific and Technical Information of China (English)

    李媛; 张家卫; 魏杰; 赵文

    2015-01-01

    近些年蓝藻水华的大规模爆发不仅危害了水产养殖业,而且严重影响了人类日常生活、供水、旅游业等。主要介绍了蓝藻水华爆发的内在因素(假空泡、类胡萝卜素、厚壁孢子、细胞壁等)及外在因素(营养物质、温度、微量元素、滤食性鱼类等)。阐述了蓝藻水华对生产、生态和生活造成的危害,归纳总结了蓝藻水华防控的化学、物理、生物等方法。最后描述了蓝藻水华的有效利用并提出其研究中存在的问题。%In recent years, a large scale of cyanophytic blooms not only harms aquaculture, but also seriously affected daily life, water supply, tourism etc.This paper mainly introduces the internal factors ( pseudobacuoles, carotenoid, akinetes, cytoderm etc.) and external factors ( nutrient substance, temperature, trace element, filter feeding fish etc.) of the outbreak of cyanophytic blooms;elaborates the harms of cyanophytic blooms to the production, ecology, and life;and sum up chemical, physical, and biological methods to prevent and control the cyanophyte; finally de-scribes the effective utilization of cyanophytic blooms, and puts forward the existing problems in the research.

  20. Critical appraisal of the role of davunetide in the treatment of progressive supranuclear palsy

    Directory of Open Access Journals (Sweden)

    Gozes I

    2012-02-01

    Full Text Available Michael Gold1, Stefan Lorenzl2, Alistair J Stewart1, Bruce H Morimoto1, David R Williams3, Illana Gozes1,41Allon Therapeutics Inc, Vancouver, BC, Canada; 2Interdisciplinary Center for Palliative Medicine, Munich University Hospital Klinikum Grosshadern, Munich, Germany; 3Van Cleef/Roet Centre for Nervous Diseases, Monash University, Melbourne, Australia; 4The Dr Diana and Zelman Elton (Elbaum Laboratory for Molecular Neuroendocrinology, The Lily and Avraham Gildor Chair for the Investigation of Growth Factors, The Adams Super Center for Brain Studies, and the Department of Human Molecular Genetics and Biochemistry, School of Neuroscience, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelAbstract: Progressive supranuclear palsy (PSP is a rare neurodegenerative disease characterized by the accumulation of tau protein aggregates in the basal ganglia, brainstem and cerebral cortex leading to rapid disease progression and death. The neurofibrillary tangles that define the neuropathology of PSP are comprised of aggregated 4R tau and show a well-defined distribution. Classically, PSP is diagnosed by symptoms that include progressive gait disturbance, early falls, vertical ophthalmoparesis, akinetic-rigid features, prominent bulbar dysfunction and fronto-subcortical dementia. There are currently no effective therapies for the treatment of this rapidly degenerating and debilitating disease. Davunetide is a novel neuroprotective peptide that is thought to impact neuronal integrity and cell survival through the stabilization of microtubules. Preclinical activity in models of tauopathy has been translated to clinical studies, demonstrating pharmacologic activity that has supported further development. Davunetide's efficacy and tolerability are being tested in a placebo-controlled study in PSP patients, making it the most advanced drug candidate in this indication. This review examines the disease characteristics of PSP, the rationale for

  1. The smallest known genomes of multicellular and toxic cyanobacteria: comparison, minimal gene sets for linked traits and the evolutionary implications.

    Directory of Open Access Journals (Sweden)

    Karina Stucken

    Full Text Available Cyanobacterial morphology is diverse, ranging from unicellular spheres or rods to multicellular structures such as colonies and filaments. Multicellular species represent an evolutionary strategy to differentiate and compartmentalize certain metabolic functions for reproduction and nitrogen (N(2 fixation into specialized cell types (e.g. akinetes, heterocysts and diazocytes. Only a few filamentous, differentiated cyanobacterial species, with genome sizes over 5 Mb, have been sequenced. We sequenced the genomes of two strains of closely related filamentous cyanobacterial species to yield further insights into the molecular basis of the traits of N(2 fixation, filament formation and cell differentiation. Cylindrospermopsis raciborskii CS-505 is a cylindrospermopsin-producing strain from Australia, whereas Raphidiopsis brookii D9 from Brazil synthesizes neurotoxins associated with paralytic shellfish poisoning (PSP. Despite their different morphology, toxin composition and disjunct geographical distribution, these strains form a monophyletic group. With genome sizes of approximately 3.9 (CS-505 and 3.2 (D9 Mb, these are the smallest genomes described for free-living filamentous cyanobacteria. We observed remarkable gene order conservation (synteny between these genomes despite the difference in repetitive element content, which accounts for most of the genome size difference between them. We show here that the strains share a specific set of 2539 genes with >90% average nucleotide identity. The fact that the CS-505 and D9 genomes are small and streamlined compared to those of other filamentous cyanobacterial species and the lack of the ability for heterocyst formation in strain D9 allowed us to define a core set of genes responsible for each trait in filamentous species. We presume that in strain D9 the ability to form proper heterocysts was secondarily lost together with N(2 fixation capacity. Further comparisons to all available cyanobacterial

  2. Case series of eosinophilic meningoencephalitis from South India

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    Parameswaran K

    2006-01-01

    Full Text Available Eosinophilic meningoencephalitis (EM is a rare type of meningoencephalitis. The objective of this report is to describe a series of EM identified in a specific geographic area over a short period of time. Materials and Methods: This series of cases are described from a neurological center in Central Kerala occuring in the period between February 2004 and June 2006. Results: During this period we had identified ten patients (eight males and two females with EM. Their mean age was 37.1 years (range 15-60 years. Main symptomatologies were fever, severe headache, body pain, abdominal pain and arthralgia. One patient was in akinetic rigid state with coma. All patients had peripheral eosinophilia. The cerebrospinal fluid (CSF of all patients showed eosinophilic pleocytosis. The mean CSF white cell count was 588 cells. CSF differential count showed 50-70% eosinophils. CSF glucose levels were normal but proteins were markedly raised (mean CSF protein was 180 mg/dl. MRI brain showed T2 hyperintensities diffusely in periventricular white matter in the comatose patient. Contrast enhanced CT scan of the brain was normal in others. All eight male patients gave history of eating "raw flesh of Monitor Lizard" (Iguana some three to fourteen days prior to the onset of symptoms. There was no such history for the female patients. Considering the history of exposure and eosinophilic meningitis we suspected a meningoencephalitis with Angiostrongylus cantonensis and treated them with albendazole, steroid and other supportive measures. All of them recovered. Conclusion: Eosinophilic meningitis (EM is a rare condition and in this locality, a CNS infection with Agiostrongylus cantonensis is highly likely. AC is a parasite in monitor lizard. Human infection occurs from consumption of uncooked flesh or blood of infected lizards. Physicians need to maintain a high index of suspicion and enquire for any exposure to uncooked meat or blood of monitor lizard when faced with EM

  3. Parkinson subtype-specific Granger-causal coupling and coherence frequency in the subthalamic area.

    Science.gov (United States)

    Florin, Esther; Pfeifer, Johannes; Visser-Vandewalle, Veerle; Schnitzler, Alfons; Timmermann, Lars

    2016-09-22

    Previous work on Parkinson's disease (PD) has indicated a predominantly afferent coupling between affected arm muscle activity and electrophysiological activity within the subthalamic nucleus (STN). So far, no information is available indicating which frequency components drive the afferent information flow in PD patients. Non-directional coupling e.g. by measuring coherence is primarily established in the beta band as well as at tremor frequency. Based on previous evidence it is likely that different subtypes of the disease are associated with different connectivity patterns. Therefore, we determined coherence and causality between local field potentials (LFPs) in the STN and surface electromyograms (EMGs) from the contralateral arm in 18 akinetic-rigid (AR) PD patients and 8 tremor-dominant (TD) PD patients. During the intraoperative recording, patients were asked to lift their forearm contralateral to the recording side. Significantly more afferent connections were detected for the TD patients for tremor-periods and non-tremor-periods combined as well as for only tremor periods. Within the STN 74% and 63% of the afferent connections are associated with coherence from 4-8Hz and 8-12Hz, respectively. However, when considering only tremor-periods significantly more afferent than efferent connections were associated with coherence from 12 to 20Hz across all recording heights. No difference between efferent and afferent connections is seen in the frequency range from 4 to 12Hz for all recording heights. For the AR patients, no significant difference in afferent and efferent connections within the STN was found for the different frequency bands. Still, for the AR patients dorsal of the STN significantly more afferent than efferent connections were associated with coherence in the frequency range from 12 to 16Hz. These results provide further evidence for the differential pathological oscillations and pathways present in AR and TD Parkinson patients. PMID:27393252

  4. Differences in striatal dopamine transporter density between tremor dominant and non-tremor Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kaasinen, Valtteri; Kinos, Maija; Joutsa, Juho [University of Turku and Turku University Hospital, Division of Clinical Neurosciences, Turku (Finland); University of Turku and Turku University Hospital, Turku PET Centre, Turku (Finland); Seppaenen, Marko [University of Turku and Turku University Hospital, Turku PET Centre, Turku (Finland); University of Turku and Turku University Hospital, Department of Clinical Physiology and Nuclear Medicine, Turku (Finland); Noponen, Tommi [University of Turku and Turku University Hospital, Department of Clinical Physiology and Nuclear Medicine, Turku (Finland)

    2014-10-15

    Parkinson's disease (PD) can manifest with a tremor-dominant or a non-tremor (akinetic-rigid) phenotype. Although the tremor-dominant subtype may show a better prognosis, there is limited information on the phenotypic differences regarding the level of striatal dopamine transmission. The present study investigated striatal dopamine transporter (DAT) binding characteristics in a large sample of patients with and without tremor. [{sup 123}I]FP-CIT SPECT scans of 231 patients with a clinical diagnosis of PD and abnormal FP-CIT binding (157 with tremor, 74 without tremor) and 230 control patients with normal FP-CIT binding (148 with tremor, 82 without tremor) were analysed using an automated region-of-interest analysis of the scans (BRASS). Specific striatal binding ratios were compared between phenotypes and groups using age, sex, and symptom duration, predominant side of symptoms, dopaminergic medications and scanner as covariates. Patients with PD had 28.1 - 65.0 % lower binding in all striatal regions compared to controls (p < 0.001). The mean FP-CIT caudate nucleus uptake and the left caudate nucleus uptake were higher in PD patients with tremor than in PD patients without tremor (mean 9.0 % higher, left 10.5 % higher; p < 0.05), whereas there were no differences between tremor and non-tremor control patients. No significant effects of tremor on DAT binding were observed in the anterior or posterior putamen. The motor phenotype is associated with the extent of caudate dopamine terminal loss in PD, as dopamine function is relatively more preserved in tremor patients. Symptom type is related to caudate dopamine function only in association with Parkinsonian dopaminergic degeneration, not in intact dopamine systems in patients with non-PD tremor. (orig.)

  5. Síndrome de Cotard asociado a Trastorno Depresivo Mayor con síntomas catatónicos. Informe de caso / Cotard Syndrome Associated to Major Depressive Disorder with Catatonic Symptoms. Case report / Síndrome de Cotard associada ao transtorno depressivo maior com sintomas catatônicos. Relato de caso

    Directory of Open Access Journals (Sweden)

    Daniel Mauricio Torrado-Arenas

    2015-07-01

    Full Text Available Introduction: Catatonia is a neuropsychiatric syndrome with abnormal postures, mutism and stupor. Colombia has a prevalence of 11.4% of psychiatric patients. Objective: To discuss the clinical curse of a 34-year-old woman with major depressive disorder that presents to emergency department with nihilistic delirium and catatonic symptoms. Case presentation: A young woman with history of unipolar major depression with psychotic features was hospitalized nine months ago. She was medicated with a pharmacological treatment she did not remember. At admission, the patient had three days of bizarre behavior, mutism and negativism. Paraclinics and brain computer tomography did not report any abnormality or changes. Treatment began with benzodiazepine, which achieved full remission of catatonic symptoms. After this, she developed anhedonia, sadness and nihilistic delusions and was considered as a relapse of a previous depressive episode from nine months ago, associated with Cotard’s syndrome. Sertraline was added with gradual increase to 100mg and 5mg of olanzapine, getting a complete remission of psychotic and mood symptoms. Discussion: Affective disorders are most common cause of catatonia. There has already been a history of similar reports, but in few times these three entities were associated; this is the first case reported in Hospital Universitario de Santander, with informed consent. Conclusions: It is unusual for a depressed patient to present denial delusions and catatonic symptoms simultaneously; therefore this case is unusual and may contribute to literature. The catatonic symptoms make it difficult to explore other mental spheres, though they may be secondary to a medical condition, therefore, it is essential to dismiss organic pathologies and give initial treatment, so we can discover the underlying etiopsychopathology. [Torrado-Arenas DM, Santos-Gutiérrez KE, Ruiz-Higuera SM, Zabala-Arias LM, Niño-García JA. Síndrome de Cotard

  6. Children with 7q11.23 duplication syndrome: psychological characteristics.

    Science.gov (United States)

    Mervis, Carolyn B; Klein-Tasman, Bonita P; Huffman, Myra J; Velleman, Shelley L; Pitts, C Holley; Henderson, Danielle R; Woodruff-Borden, Janet; Morris, Colleen A; Osborne, Lucy R

    2015-07-01

    To begin to delineate the psychological characteristics associated with classic 7q11.23 duplication syndrome (duplication of the classic Williams syndrome region; hereafter classic Dup7), we tested 63 children with classic Dup7 aged 4-17 years. Sixteen toddlers aged 18-45 months with classic Dup7 and 12 adults identified by cascade testing also were assessed. For the child group, median General Conceptual Ability (similar to IQ) on the Differential Ability Scales-II was 85.0 (low average), with a range from severe disability to high average ability. Median reading and mathematics achievement standard scores were at the low average to average level, with a range from severe impairment to high average or superior ability. Adaptive behavior was considerably more limited; median Scales of Independent Behavior-Revised Broad Independence standard score was 62.0 (mild impairment), with a range from severe adaptive impairment to average adaptive ability. Anxiety disorders were common, with 50.0% of children diagnosed with Social Phobia, 29.0% with Selective Mutism, 12.9% with Separation Anxiety Disorder, and 53.2% with Specific Phobia. In addition, 35.5% were diagnosed with Attention Deficit/Hyperactivity Disorder and 24.2% with Oppositional Defiant Disorder or Disruptive Behavior Disorder-Not Otherwise Specified. 33.3% of the children screened positive for a possible Autism Spectrum Disorder and 82.3% were diagnosed with Speech Sound Disorder. We compare these findings to previously reported results for children with Williams syndrome and argue that genotype/phenotype studies involving the Williams syndrome region offer important opportunities to understand the contribution of genes in this region to common disorders affecting the general population. PMID:25900101

  7. The story of iodine deficiency: An international challenge in nutrition

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    Hetzel, B.S.

    1989-01-01

    Iodine deficiency is a risk factor for the growth and development of up to 800 million people living in iodine deficient environments throughout the world. The effects on growth and development, called the iodine deficiency disorders (IDD), comprise goiter, stillbirths and miscarriages, neonatal and juvenile thyroid deficiency, dwarfism, mental defects, deaf mutism, and spastic weakness and paralysis, as well as lesser degrees of loss of physical and mental function. All these effects are due to inadequate thyroid hormone production because iodine is an essential constituent of the thyroid hormone. In the West, IDD has been largely eliminated by the addition of iodine to the diet through iodized salt or through changes in food distribution and technology. IDD still persists in certain areas of Europe where these dietary changes have not occurred. In the Third World, IDD is a major problem in many countries with large populations, such as China, India, Indonesia, Nigeria, and Zaire. In these and other Third World countries, IDD is a significant barrier to social and economic progress which can be removed by correction of the deficiency. This book shows that elimination of iodine deficiency is feasible within the next decade, only requiring a modest financial and technical effort from the West. Part 1 reviews IDD in man and animals. Part 2 discusses the control of iodine deficiency disorders through iodine supplementation, and considers action at the national and international level. Part 3 presents a global review of the status of IDD control. There is a brief conclusion on the way forward to successful control programs.

  8. World War I psychoneuroses: hysteria goes to war.

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    Tatu, Laurent; Bogousslavsky, Julien

    2014-01-01

    During the First World War, military physicians from the belligerent countries were faced with soldiers suffering from psychotrauma with often unheard of clinical signs, such as camptocormia. These varied clinical presentations took the form of abnormal movements, deaf-mutism, mental confusion, and delusional disorders. In Anglo-Saxon countries, the term 'shell shock' was used to define these disorders. The debate on whether the war was responsible for these disorders divided mobilized neuropsychiatrists. In psychological theories, war is seen as the principal causal factor. In hystero-pithiatism, developed by Joseph Babinski (1857-1932), trauma was not directly caused by the war. It was rather due to the unwillingness of the soldier to take part in the war. Permanent suspicion of malingering resulted in the establishment of a wide range of medical experiments. Many doctors used aggressive treatment methods to force the soldiers exhibiting war neuroses to return to the front as quickly as possible. Medicomilitary collusion ensued. Electrotherapy became the basis of repressive psychotherapy, such as 'torpillage', which was developed by Clovis Vincent (1879-1947), or psychofaradism, which was established by Gustave Roussy (1874-1948). Some soldiers refused such treatments, considering them a form of torture, and were brought before courts-martial. Famous cases, such as that of Baptiste Deschamps (1881-1953), raised the question of the rights of the wounded. Soldiers suffering from psychotrauma, ignored and regarded as malingerers or deserters, were sentenced to death by the courts-martial. Trials of soldiers or doctors were also held in Germany and Austria. After the war, psychoneurotics long haunted asylums and rehabilitation centers. Abuses related to the treatment of the Great War psychoneuroses nevertheless significantly changed medical concepts, leading to the modern definition of 'posttraumatic stress disorder'.

  9. Medulloblastoma in children: Prognostic factors and predictors of outcome

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    Girish Menon

    2006-01-01

    Full Text Available Objective: To determine the relative contributions of clinical, radiological and histopatholgical predictors of survival in children with medulloblastoma (MB and to compare it with their adult counterparts. Materials and Methods: Retrospective case record analyses of 79 children (< 16 y operated after Jan. 1990, who have completed at least 5 y of follow-up. The following variables were assessed by bivariate analysis: age, CT scan location of the lesion, brainstem invasion, extent of excision, histological subtype. Statistical analysis was performed using Chi-square test, Fischers test and Student′s t test. Results: Near-total to total excision could be achieved in 59 (74.6% cases. Twenty-three patients (29.11% required CSF diversion procedures. Histopathology revealed features of classical medulloblastoma in 63.2%, thermoplastic variant in 11% and glial differentiation in 25.3% of cases. Postoperative mutism was seen in 14 (17.72% patients. All patients received adjuvant therapy. On follow-up, 34 patients were found to have posterior fossa recurrence and four patients were re-operated. An additional 17% of patients were found to have either spinal or supratentorial metastasis on follow-up. The overall 5-year recurrence-free survival rate was 19 (24.05%. Mortality was recorded in 23 patients and nearly 29 patients who were severely disabled on follow-up were referred to terminal care centres. Conclusion: In spite of recent advances in management, children with medulloblastoma still carry a poor prognosis. We observed poor outcome in children below 7 y of age. Vermian location had a better outcome in adults but not in children. Desmoplastic variant was observed to be a significant prognostic factor in paediatric, group while brain stem invasion carried poor prognosis for both.

  10. Síndrome neuroléptica maligna: relato de caso com recorrência associada ao uso de olanzapina Neuroleptic malignant syndrome: case report of a recurrence related to olanzapine

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    RICARDO A. HANEL

    1998-12-01

    Full Text Available A síndrome neuroléptica maligna (SNM consiste em reação idiossincrática a neurolépticos, provavelmente relacionada a bloqueio dos receptores dopaminérgicos nos gânglios da base, sendo por isso também conhecida como síndrome da deficiência aguda de dopamina.A SNM é caracterizada por hiperpirexia, alteração do nível de consciência, hipertonia, disfunção autonômica e insuficiência respiratória, podendo ainda ser encontrados rabdomiólise e leucocitose. O haloperidol é a droga mais frequentemente associada à síndrome. Relatamos o caso de um paciente de 30 anos que apresentou SNM em duas ocasiões diferentes, a primeira delas relacionada ao uso de haloperidol e clorpromazina e a segunda relacionada ao uso de olanzapina, fato este sem menção anterior na literatura indexada.The neuroleptic malignant syndrome (NMS consists in an idiosyncratic reaction to neuroleptic drugs, probably related to a blockage of dopamine receptors in basal ganglia. Research criteria for diagnosing NMS from DSM-IV require severe rigidity and fever accompanied by 2 of 10 minor features including diaphoresis, dysphagia, tremor, incontinence, altered mentation, mutism, tachycardia, elevated or labile blood pressure, leukocytosis and elevation of creatine phosphokinase. From a clinical point of view, the NMS may range a large spectrum of presentations. Haloperidol is the most frequent drug associated with this syndrome. We report the case of a 30 year-old man who developed NMS at two different occasions, the first related to haloperidol and chlorpromazine and the second related to olanzapine, to our knowledge without previous mention in the indexed literature.

  11. Neuroleptic intolerance in patients with anti-NMDAR encephalitis

    Science.gov (United States)

    Lejuste, Florian; Thomas, Laure; Picard, Géraldine; Desestret, Virginie; Ducray, François; Rogemond, Veronique; Psimaras, Dimitri; Antoine, Jean-Christophe; Delattre, Jean-Yves; Groc, Laurent; Leboyer, Marion

    2016-01-01

    Objective: To precisely describe the initial psychiatric presentation of patients with anti-NMDA receptor (NMDAR) antibodies encephalitis (anti-NMDAR encephalitis) to identify potential clues enhancing its early diagnosis. Methods: We retrospectively studied the French Reference Centre medical records of every adult patient with anti-NMDAR encephalitis to specify the patients' initial psychiatric symptoms leading to hospitalization in a psychiatric department and the reasons underlying the diagnosis of anti-NMDAR encephalitis. Results: The medical records of 111 adult patients were reviewed. Psychiatric features were the initial presentation in 65 patients (59%). Among them, several psychiatric manifestations were observed, including visual and auditory hallucinations (n = 26, 40%), depression (n = 15, 23%), mania (n = 5, 8%), acute schizoaffective episode (n = 15, 23%), and eating disorder or addiction (n = 4; 6%). Forty-five patients (40% of total cohort) were first hospitalized in a psychiatric institution (91% women), with a median duration of stay of 9 days (range 0.25–239 days). Among them, 24 patients (53%) had associated discreet neurologic signs at the first evaluation, while 17 additional patients (38%) developed neurologic signs within a few days. Twenty-one patients (47%) were transferred to a medical unit for a suspicion of antipsychotic intolerance characterized by high temperature, muscle rigidity, mutism or coma, and biological results suggesting rhabdomyolysis. Conclusions: Several psychiatric presentations were observed in patients with anti-NMDAR encephalitis, although none was specific; however, patients, mostly women, also had discreet neurologic signs that should be carefully assessed as well as signs of antipsychotic intolerance that should raise suspicion for anti-NMDAR encephalitis. PMID:27606355

  12. Neuroleptic intolerance in patients with anti-NMDAR encephalitis

    Science.gov (United States)

    Lejuste, Florian; Thomas, Laure; Picard, Géraldine; Desestret, Virginie; Ducray, François; Rogemond, Veronique; Psimaras, Dimitri; Antoine, Jean-Christophe; Delattre, Jean-Yves; Groc, Laurent; Leboyer, Marion

    2016-01-01

    Objective: To precisely describe the initial psychiatric presentation of patients with anti-NMDA receptor (NMDAR) antibodies encephalitis (anti-NMDAR encephalitis) to identify potential clues enhancing its early diagnosis. Methods: We retrospectively studied the French Reference Centre medical records of every adult patient with anti-NMDAR encephalitis to specify the patients' initial psychiatric symptoms leading to hospitalization in a psychiatric department and the reasons underlying the diagnosis of anti-NMDAR encephalitis. Results: The medical records of 111 adult patients were reviewed. Psychiatric features were the initial presentation in 65 patients (59%). Among them, several psychiatric manifestations were observed, including visual and auditory hallucinations (n = 26, 40%), depression (n = 15, 23%), mania (n = 5, 8%), acute schizoaffective episode (n = 15, 23%), and eating disorder or addiction (n = 4; 6%). Forty-five patients (40% of total cohort) were first hospitalized in a psychiatric institution (91% women), with a median duration of stay of 9 days (range 0.25–239 days). Among them, 24 patients (53%) had associated discreet neurologic signs at the first evaluation, while 17 additional patients (38%) developed neurologic signs within a few days. Twenty-one patients (47%) were transferred to a medical unit for a suspicion of antipsychotic intolerance characterized by high temperature, muscle rigidity, mutism or coma, and biological results suggesting rhabdomyolysis. Conclusions: Several psychiatric presentations were observed in patients with anti-NMDAR encephalitis, although none was specific; however, patients, mostly women, also had discreet neurologic signs that should be carefully assessed as well as signs of antipsychotic intolerance that should raise suspicion for anti-NMDAR encephalitis.

  13. [Regional ventricular function at rest during exercise before and after bypass surgery (author's transl)].

    Science.gov (United States)

    Bussmann, W D; Mayer, V; Kober, G; Kaltenbach, M

    1978-06-01

    In 9 patients with coronary heart disease isovolumetric contractility indices and ejection phase parameters were measured simultaneously, using an angiographic catheter with a manometer at the tip (Millar). Regional wall motion at rest, after leg raising and during physical exercise (bicycle ergometer) was analyzed applying the hemiaxis method. Five weeks after aortocoronary bypass surgery the same examinations were repeated. Preoperatively left ventricular enddiastolic pressure (LVEDP) increased from 21 to 37 mm Hg following leg raising. The velocity mean of fiber shortening (Vcf) and of regional fiber shortening in the anterior wall decreased significantly.--All patients discontinued physical exercise due to angina pectoris. LVEDP increased from 21 to 39 mm Hg. Large hypokinetic and akinetic areas developed especially in the anterior wall. Velocity of fiber shortening of the anterior wall decreased from 1.43 to 0.76/s. Enddiastolic volume remained unchanged while endsystolic volume increased significantly. In six patients with patent grafts surgery had a beneficial effect. Comparing angiograms at rest no significant changes were found. After leg raising and physical exercise, however, marked improvement in ventricular function occurred, compared to the preoperative performance. All 6 patients were exercised without complaints at a load of 100 watts for 8 minutes. Velocity of fiber shortening in the anterior wall increased significantly from 0.76 to 2.56/s, mean Vcf from 1.11 to 2.12 circ/s, max dP/dt from 2302 to 4280 mm Hg/s and Vpm from 27.8 to 55.7/s. Functional improvement in individual wall segments amounted to 500% in the mean. Ejection fraction increased from 54 to 76%. Enddiastolic volume remained unchanged while endsystolic volume decreased from 67 to 33 ml/1.37 m2 (p less than 0.002). In three patients the bypass occluded or myocardial infarction occurred intraoperatively. Postoperative findings at rest and during exercise were unchanged as compared to

  14. Fossils of Cyanobacteria in CI1 Carbonaceous Meteorites: Implications to Life on Comets, Europa and Enceladus

    Science.gov (United States)

    Hoover, Richard B.

    2011-10-01

    Environmental (ESEM) and Field Emission Scanning Electron Microscopy (FESEM) investigations of the internal surfaces of the CI1 Carbonaceous Meteorites have yielded images of large complex filaments. The filaments have been observed to be embedded in freshly fractured internal surfaces of the stones. They exhibit recognizable features (e.g., the size and size ranges of the internal cells and their location and arrangement within sheaths) that are diagnostic of known genera and species of filamentous trichomic cyanobacteria and other trichomic prokaryotes (such as filamentous sulfur bacteria). ESEM and FESEM studies of living and fossil cyanobacteria show features similar to the filaments found in the meteorites -- uniseriate and multiseriate, branched or unbranched, isodiametric or tapered, polarized or unpolarized filaments with trichomes encased within thin or thick external sheaths. Some of the filaments found in the CI1 meteorites also exhibit specialized cells and structures used by cyanobacteria for reproduction (baeocytes, akinetes and hormogonia), nitrogen fixation (basal, intercalary or apical heterocysts), attachment (pili or fimbriae) or indicative of oscillatoria type locomotion (escaped or coiling hormogonia and flattened and coiled empty sheaths). Energy dispersive X-ray Spectroscopy (EDS) studies indicate that the Orgueil meteorite filaments are typically carbon-rich sheaths infilled with magnesium sulfate and other minerals characteristic of the CI1 carbonaceous meteorites. However, the size, structure, detailed morphological characteristics and chemical compositions of the meteorite filaments are not consistent with known species of abiotic minerals. The nitrogen content of the meteorite filaments are almost always below the detection limit of the EDS detector. EDS analysis of living and dead biological materials (e.g., filamentous cyanobacteria; bacteria, mummy and mammoth hair and tissues, and fossils of cyanobacteria, trilobites and insects in

  15. Principal stages in evolution of precambrian organic world: Communication 2. The late proterozoic

    Science.gov (United States)

    Sergeev, V. N.; Semikhatov, M. A.; Fedonkin, M. A.; Vorob'eva, N. G.

    2010-12-01

    A new suggested model outlining the evolution of the organic world from the mid-Early Proterozoic (˜2.0 Ga) to the Early Cambrian is based on data characterizing the relevant chert-embedded and compression-preserved organic-walled microbiotas, impressions of soft-bodied multicellular organisms, and biomarkers. Critical analysis of overall paleontological data resulted in the distinguishing of seven successive assemblages of Proterozoic micro- and macrofossils. Being of global geographic range, the assemblages correspond to the major stages in evolution of the organic world and typify global units which are termed the Labradorian (˜2.0-1.65 Ga), Anabarian (1.65-1.2 Ga), Turukhanian (1.2-1.03 Ga), Uchuromayan (1.03-0.85 Ga), Yuzhnouralian (0.85-0.635 Ga), Amadeusian (0.635-0.56 Ga), and Belomorian (0.56-0.535 Ga). Characteristic of the Labradorian unit are microfossil assemblages of the Gunflint type including remains of morphologically bizarre prokaryotic microorganisms: star-like Eoastrion, umbrella-shaped Kakabekia, dumbbell-shaped Xenothrix, and some others. Fine-grained siliciclastic deposits of the same age yield the oldest remains of millimeter-sized eukaryotes: spherical to ribbon-like Chuaria and Tawuia. Microfossils prevailing in shallow-water carbonate facies of the Anabarian unit are akinetes of nostocalean cyanophyceae Archaeoellipsoides and entophysalidacean cyanobacteria Eoentophysalis, whereas acanthomorphic acritarchs Tappania and Shuiyousphaeridium dominate the assemblages of open-shelf facies, where they are associated with the first-found rare macroscopic multicellular fossils Horodyskia. The distinguishing feature of the next Turukhanian unit is the first occurrence of filamentous red alga Bangiomorpha and the stalked cyanobacterium Polybessurus. The Uchuromayan unit is characterized by the appearance and worldwide radiation of structurally complicated eukaryotic microorganisms, primarily of acanthomorphic acritarchs Trachyhystrichosphaera and

  16. Clinical profile of parkinsonism and Parkinson's disease in Lagos, Southwestern Nigeria

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    Ojo Oluwadamilola O

    2010-01-01

    Full Text Available Abstract Background Current data on the pattern of parkinsonism and Parkinson's disease in Nigerians are sparse. This database was designed to document the clinical profile of PD in Nigerians, and compare this to prior observations. Methods A database of patients presenting to the Neurology out-patients clinic of the Lagos University Teaching Hospital was established in October 1996. Demographic and clinical data at presentation (disease stage using Hoehn and Yahr scale; 'off' state severity on the Unified Parkinson's disease Rating Scale were documented for patients diagnosed with parkinsonism between October 1996 and December 2006. Cases were classified as Parkinson's disease or secondary parkinsonism (in the presence of criteria suggestive of a secondary aetiology. Results The hospital frequency of parkinsonism (over a 2-year period, and relative to other neurologic disorders was 1.47% (i.e. 20/1360. Of the 124 patients with parkinsonism, 98 (79.0% had PD, while 26 (21.0% had secondary parkinsonism. Mean age (SD at onset of PD (61.5 (10.0 years was slightly higher than for secondary parkinsonism (57.5 (14.0 years (P = 0.10. There was a male preponderance in PD (3.3 to 1 and secondary parkinsonism (2.7 to 1, while a positive family history of parkinsonism was present in only 1.02% (1/98 of PD. There was a modestly significant difference in age at onset (SD of PD in men (60.3 (10.4 compared to women (65.2 (7.9 (T = 2.08; P = 0.04. The frequency of young onset PD (≤ 50 years was 16.3% (16/98. The mean time interval from onset of motor symptoms to diagnosis of PD was 24.6 ± 26.1 months with majority presenting at a median 12 months from onset. On the H&Y scale, severity of PD at presentation was a median 2.0 (range 1 to 4. PD disease subtype was tremor-dominant in 31 (31.6%, mixed 54 (55.1% and akinetic-rigid 14 (14.3%. Hypertension was present as a co-morbidity in 20 (20.4%, and diabetes in 6 (6.12%. Conclusions The clinical profile of PD in

  17. [What is impaired consciousness? Revisiting impaired consciousness as psychiatric concept].

    Science.gov (United States)

    Kanemoto, Kousuke

    2004-01-01

    For decades, psychiatrists have considered that concepts of impaired consciousness in the study of psychiatry were inconsistent with those applied in the field of neurology, in which the usefulness of the concept of consciousness has long been seriously doubted. Gloor concluded that the concept of consciousness does not further the understanding of seizure mechanisms or brain function, which is the current representative opinion of most epileptologists. Loss of consciousness tends to be reduced to aggregates of individual impairments of higher cognitive functions, and the concept of consciousness is preferably avoided by neurologists by assigning various behavioral disturbances during disturbed consciousness to particular neuropsychological centers. In contrast, psychiatrists, especially those in Europe, are more likely to include phenomena involving problems related to phenomenological intentionality in impaired consciousness. For the present study, we first divided consciousness into vigilance and recursive consciousness, and then attempted to determine what kind of impaired consciousness would be an ideal candidate to represent pure disturbance of recursive consciousness. Then, 4 patients, 1 each with pure amnestic states followed immediately by complex partial seizures, an akinetic mutistic state caused by absence status, and mental diplopia as a manifestation of postictal psychosis, as well as a patient with Alzheimer's disease who gracefully performed Japanese tea ceremony, were studied. Based on our findings, we concluded that impaired consciousness as a generic term in general medicine does not indicate any unitary entity corresponding to some well-demarcated physiological function or constitute a base from which recursive consciousness emerges as a superstructure. From that, we stressed that a pure form of impairment of recursive consciousness could occur without the impaired consciousness named generically in general medicine. Second, following

  18. Mineralized Remains of Morphotypes of Filamentous Cyanobacteria in Carbonaceous Meteorites

    Science.gov (United States)

    Hoover, Richard B.

    2005-01-01

    The quest for conclusive evidence of microfossils in meteorites has been elusive. One difficulty arises from the fact than many abiotic or inorganic microstructures, mineral grains, and coating artifacts can mimic the smaller representatives of the microbial world that possess very simple morphologies (unicellular cocci or bacilli). However, there exist a wide variety of large, filamentous trichomic prokaryotic microorganisms (cyanobacteria and sulfur bacteria) with sufficiently well known and complex morphologies that they can be recognized and are known to be of unquestionable biogenic origin. The taphonomic modes of fossilization and their of their life habits and processes frequently result in distinctive chemical biosignatures associated with carbonization, silicification, calcification, phosphatization and metal-binding properties of their cell-walls, trichomes, sheaths and extracellular polymeric substances (EPS). Strong differences of mineral concentrations in closely associated and visibly differentiated cellular microstructures provide strong evidence of biogenicity. This evidence is further enhanced by the detection of recognizable and distinct microstructures (e.g., uniseriate or multiseriate filaments, trichomes, sheaths, cells of proper sizes and size distributions) and growth characteristics (e.g., basal or apical cells, true or false branching of trichomes, tapered or uniform filaments, robust or thin sheaths) and reproductive and nitrogen fixation habits (e.g., baeocytes, hormogonia, akinetes and heterocysts), Microfossils of cyanobacteria and cyanobacterial mats and stromatolites have been recognized a described from many of the most ancient rocks on Earth. The crucial problem lies in developing valid protocols and methodologies for establishing that the putative microfossils are truly indigenous and not merely recent microbial contaminants. During the past several years, we have conducted Field Emission Scanning Electron Microscopy (FESEM

  19. Assessment of regional left ventricular function by Dual Source Computed Tomography: Interobserver variability and validation to laevocardiography

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    Pflederer, T. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail: tobiaspflederer@web.de; Ho, K.T. [Department of Cardiology, Tan Tock Seng Hospital (Singapore)], E-mail: contact@ttsh.com.sg; Anger, T. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail: thomas.anger@uk-erlangen.de; Kraehner, R. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail: robert.kraehner@uk-erlangen.de; Ropers, D. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail: dieter.ropers@uk-erlangen.de; Muschiol, G. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail: gerd.muschiol@uk-erlangen.de; Renz, A. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail: alexandra.renz@uk-erlangen.de; Daniel, W.G. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail: werner.daniel@uk-erlangen.de; Achenbach, S. [Department of Internal Medicine 2 (Cardiology), University of Erlangen (Germany)], E-mail: stephan.achenbach@uk-erlangen.de

    2009-10-15

    Objective: Assessment of left ventricular function is possible in contrast-enhanced cardiac CT data sets. However, rapid ventricular motion especially in systole can lead to artifacts. Dual Source Computed Tomography (DSCT) has high temporal resolution which effectively limits motion artifact. We therefore assessed the accuracy of DSCT to detect regional left ventricular wall motion abnormalities in comparison to invasive cine angiocardiography. Methods: We analyzed DSCT data sets of 50 patients (39 male, 11 female, mean age: 61 {+-} 10 years) which were acquired after intravenous injection of 55-70 mL contrast agent (rotation time: 330 ms, collimation: 2 mm x 64 mm x 0.6 mm, 120 kV, 380 mAs, ECG-correlated tube current modulation). 10 data sets consisting of transaxial slices with a slice thickness of 1.5 mm, an increment of 1.0 mm and a matrix of 256 x 256 pixels were reconstructed at 10 time instants during the cardiac cycle (0-90% in 10% increments). The data sets were analyzed visually by two independent readers, using standard left ventricular planes, concerning regional wall motion abnormalities. DSCT was verified in a blinded fashion against cine ventriculography performed during cardiac catheterization (RAO and LAO projection), using a 7-segment model. Analysis was performed on a per-patient (presence of at least one hypo-, a- or dyskinetic segment) and on a per-segment basis. Results: Concerning the presence of a wall motion abnormality, the two observers agreed in 340/350 segments (97%) and 48/50 patients (96%). In invasive cine angiocardiography, 22 of 50 patients displayed at least one segment with abnormal contraction. To detect these patients, DSCT showed a sensitivity of 95% (21/22), specificity of 96% (27/28), positive predictive value of 95% and negative predictive value of 96%. Out of a total of 350 left ventricular segments, 66 segments had abnormal contraction in cine angiocardiography (34 hypokinetic, 26 akinetic, 6 dyskinetic). For detection

  20. IMPULSIVE-COMPULSIVE DISORDERS IN PARKINSON'S DISEASE. CLINICAL CASES

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    N. V. Fedorova

    2015-01-01

    Full Text Available Objective – a description of clinical cases of impulsive­compulsive disorders in Parkinson,s disease. The first clinical case. Patient N., 75 years old, suffering for 15 years from Parkinson,s disease, akinetic­rigid form of the disease, stage 4 by Hyun–Yar. Since 2009, he received levodopa/carbidopa 250/25 mg 5 times/day (daily dose of 1250 mg of levodopa; pramipexole 3.5 mg per day (daily dose 3.5 mg, amantadine sulfate 100 mg 5 times/day (daily dose 500 mg. While taking antiparkinsonian drugs the patient developed behavioral disorders such as dopamine disregulatory syndrome combined with punding, hypersexuality and compulsive shopping accompanied by visual hallucinations. The total equivalent dose of levodopa was 1600 mg per day. The second clinical case. Patient R., 52 years old, suffers from Parkinson,s disease about 5 years, a mixed form. She complained of slowness of movement, tremor in her left hand, sleep disturbances, poor mood. The clinic was appointed piribedil 50 mg 3 times per day. Despite the fact that the patient took only one of dopaminergic drugs in a therapeutic daily dose, she developed impulsive­compulsive disorder as hyper­ sexuality, compulsive shopping and binge eating. Results. In the first clinical case for correction of behavioral disorders in patients with Parkinson,s disease levodopa/carbidopa dose was reduced to 750 mg per day (3/4 Tab. 4 times a day; added to levodopa/benserazide dispersible 100 mg morning and levodopa/benserazide 100 mg before sleep (total dose of levodopa of 950 mg per day. Amantadine sulfate and pramipexole were canceled. It was added to the therapy of atypical neuroleptic clozapine dose 6,25 mg overnight. After 3 months marked improvement, regressed visual hallucina­ tions, improved family relationships, background mood became more stable. The patient continue to sing karaoke, but this hobby has be­ come less intrusive. In the second clinical event correction impulsive

  1. Ballistic Protons and Microwave-induced Water Solitons in Bioenergetic Transformations

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    Reuven Tirosh

    2006-09-01

    Full Text Available Active streaming (AS of liquid water is considered to generate and overcomepressure gradients, so as to drive cell motility and muscle contraction by hydrauliccompression. This idea had led to reconstitution of cytoplasm streaming and musclecontraction by utilizing the actin-myosin ATPase system in conditions that exclude acontinuous protein network. These reconstitution experiments had disproved a contractileprotein mechanism and inspired a theoretical investigation of the AS hypothesis, aspresented in this article. Here, a molecular quantitative model is constructed for a chemicalreaction that might generate the elementary component of such AS within the pure waterphase. Being guided by the laws of energy and momentum conservation and by the physicalchemistry of water, a vectorial electro-mechano-chemical conversion is considered, asfollows: A ballistic H+ may be released from H2O-H+ at a velocity of 10km/sec, carrying akinetic energy of 0.5 proton*volt. By coherent exchange of microwave photons during 10-10sec, the ballistic proton can induce cooperative precession of about 13300 electrically-polarized water molecule dimers, extending along 0.5 μm. The dynamic dimers rearrangealong the proton path into a pile of non-radiating rings that compose a persistent rowing-likewater soliton. During a life-time of 20 msec, this soliton can generate and overcome amaximal pressure head of 1 kgwt/cm2 at a streaming velocity of 25 μm/sec and intrinsicpower density of 5 Watt/cm3. In this view, the actin-myosin ATPase is proposed to catalyzestereo-specific cleavage of H2O-H+ , so as to generate unidirectional fluxes of ballisticprotons and water solitons along each actin filament. Critical requirements and evidentialpredictions precipitate consistent implications to the physical chemistry of water, enzymatichydrolysis and synthesis of ATP, trans-membrane signaling, intracellular transport, cellmotility, intercellular interaction, and associated

  2. [What is impaired consciousness? Revisiting impaired consciousness as psychiatric concept].

    Science.gov (United States)

    Kanemoto, Kousuke

    2004-01-01

    For decades, psychiatrists have considered that concepts of impaired consciousness in the study of psychiatry were inconsistent with those applied in the field of neurology, in which the usefulness of the concept of consciousness has long been seriously doubted. Gloor concluded that the concept of consciousness does not further the understanding of seizure mechanisms or brain function, which is the current representative opinion of most epileptologists. Loss of consciousness tends to be reduced to aggregates of individual impairments of higher cognitive functions, and the concept of consciousness is preferably avoided by neurologists by assigning various behavioral disturbances during disturbed consciousness to particular neuropsychological centers. In contrast, psychiatrists, especially those in Europe, are more likely to include phenomena involving problems related to phenomenological intentionality in impaired consciousness. For the present study, we first divided consciousness into vigilance and recursive consciousness, and then attempted to determine what kind of impaired consciousness would be an ideal candidate to represent pure disturbance of recursive consciousness. Then, 4 patients, 1 each with pure amnestic states followed immediately by complex partial seizures, an akinetic mutistic state caused by absence status, and mental diplopia as a manifestation of postictal psychosis, as well as a patient with Alzheimer's disease who gracefully performed Japanese tea ceremony, were studied. Based on our findings, we concluded that impaired consciousness as a generic term in general medicine does not indicate any unitary entity corresponding to some well-demarcated physiological function or constitute a base from which recursive consciousness emerges as a superstructure. From that, we stressed that a pure form of impairment of recursive consciousness could occur without the impaired consciousness named generically in general medicine. Second, following

  3. Surgical considerations for ′intrinsic′ brainstem gliomas: Proposal of a modification in classification

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    Mehta V

    2009-01-01

    Full Text Available Background: Brainstem gliomas are highly heterogeneous tumors both in their clinical manifestation and in their pathology. Despite significant advances in the surgery for brainstem gliomas many aspects of this pathology are still unclear Objective: To evaluate the clinical, radiological and surgical outcome of 40 focal ′intrinsic′ brainstem gliomas and propose a surgical strategy-oriented classification. Materials and Methods: A total of 40 focal ′intrinsic′ ("expanding variety" tumors have been operated over a period of 8.5-years (January 1998-June 2007. Our criteria included patients with (1 well-defined gadolinium enhancing tumor; (2 relatively long duration of symptoms (> six months and (3 good neurological functional status and independent for all activities of daily living. The cutoff size of 2 cm was not rigidly adhered to. Results: The ′intrinsic′ brainstem tumors were classified into three types: Expanding, diffuse infiltrative and pure ventral varieties. Only patients with expanding variety of brainstem gliomas were subjected to surgery, mean age 19.2 years (range 4-55 years and male to female ration mean: 3:2. The tumor location included pons (n=19, midbrain (n=13 and medulla (n=8. Surgical approaches included midline suboccipital (n=28, retromastoid (n=7, subtemporal (n=3 and supracerebellar-infratentorial (n=2. Thirty-two cases with ′diffuse infiltrative′ and ′pure ventral′ variety were given radiotherapy only. Histology pathology revealed pilocytic variety (n=10, Grade II (n=17 and Grade III (n=13. There was one death in the surgical series (due to aspiration. Complications included meningitis (n=2, wound infection (n=1, chest infection (n=5 and transient mutism (n=1. Follow-up ranged from 3-68 months. Overall, 36 improved /remained same and three worsened in their clinical status at the time of discharge. Conclusion: The surgical management of intrinsic brainstem tumors presents a surgical challenge; radical

  4. Enfermedad de Creutzfeldt-Jakob por RMI: alteración cortical como signo temprano de la enfermedad Creutzfeldt-Jakob disease by MRI: Cortical alteration as early sign disease

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    María Fernanda Markarian

    2008-12-01

    Full Text Available Se estudió por RMI un paciente de 59 años con diagnóstico probable de Enfermedad de Creutzfeldt-Jakob desde el inicio de sus síntomas. El paciente comienza con un cuadro de leve deterioro cognitivo. En una primera resonancia en secuencias FLAIR se visualiza hiperintensidad cortical a predomino de hemisferio izquierdo, no observándose en FSE T 2. Se hace más significativa en nueva resonancia en FLAIR y Difusión, con aparición de hiperintensidad en cabeza de ambos caudados y rápido deterioro cognitivo, alteraciones visuales, aparición de signos piramidales y extrapiramidales, convulsiones y mioclonias y mutismo. Con la acentuación de las alteraciones corticales -y en los ganglios de la base en una tercera resonancia-, el paciente trasforma su ECG de ritmo lento a un ritmo de punta-onda bifásico y trifásico. A 3 meses de la primera resonancia, nuevas imágenes muestran atrofia e importante hiperintensidad cortical y en ganglios de la base. En conclusión, las secuencias FLAIR y Difusión serían más sensibles que las secuencias T2 en la detección del aumento de intensidad de señal en la corteza cerebral, siendo un indicio diagnóstico temprano de la enfermedad de Creutzfeld-Jakob.A 59-year-old man with probable Creutzfeldt-Jakob disease was studied from early symptoms. The patients manifested mild cognitive impairment. The first magnetic resonance showed hiperintense signal cortical abnormalities in FLAIR sequence predominantly in left hemisphere, FSE T2 no showed abnormalities. In other resonance those abnormities were more significative and appeared head of the caudate nucleus abnormalities in FLAIR and Diffusion-weighted, the patients began with rapidly progressing impairment, visual disturbance, pyramidal and extrapyramidal signs, seizures, myoclonus and mutism. The third resonance revealed cortical and basal ganglia high signal intensity abnormalities and the patient transformed slowing EEG to biphasic and triphasic sharp

  5. Characterization of Behavioral and Image of Completely Unilaterally Lesioned Parkinson Rat Model%完全毁损型偏侧帕金森病大鼠模型的行为及影像特征

    Institute of Scientific and Technical Information of China (English)

    王志忠; 姚昊; 欧阳小辉; 何宝明; 张婷

    2011-01-01

    profound loss of sensorimotor, analogous to severely rigid-akinetic terminal stage of human disease.

  6. Reconstrução fisiológica do ventrículo esquerdo: o conceito de máxima redução ventricular e mínima resposta inflamatória Physiologic left ventricular reconstruction: the concept of maximum ventricular reduction and minimum inflammatory reaction

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    Walter J. Gomes

    2004-12-01

    induce a chronic myocardial inflammatory reaction. We report on a modification of the ventricular reconstruction technique that eliminates the need of intraventricular patches and the use of synthetic material. METHOD: Eleven consecutive patients presenting with left ventricular aneurysms, evolving to functional class III and IV of the New York Heart Association, underwent direct left ventricular reconstruction surgery without the use of intraventricular patches or prosthetic strips. RESULTS: There was no operative mortality or need of mechanical circulatory support. The postoperative hospital stay ranged from 4 to 7 days (average 5.3 ± 1.1 days. The serial echocardiogram control showed reduction of the left ventricular diastolic diameter (from 69.0± 7.5 mm preoperatively to 62.6 ± 5.1 mm postoperatively. The left ventricular ejection fraction increased from 47.3% ± 6.6% to 56.3% ±10.5%. One-year follow-up revealed eight patients in functional class I and three in class II. CONCLUSION: This technique, with elimination of prosthetic materials, could contribute to an improvement of the clinical results in patients who undergo left ventricular reconstruction, providing virtual elimination of left ventricular akinetic areas and potentially attenuating the long-term myocardial chronic inflammatory reaction.

  7. Tratamento cirúrgico dos aneurismas de ventrículo esquerdo e isquemia coronária

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    Danton R. da Rocha LOURES

    1997-04-01

    reconstruction and their effects on morphology, ventricular function, symptomatic state and longevity. This study was designed to evaluate the cases of left ventricular aneurysm relating the main surgical indications and treatment and the patients' symptomatic state before and after operation. The study involves 12 patients with left ventricular aneurysm, nine males, mean age 60 years, whose main indications for surgery were angina (58% and angina plus congestive heart failure (42%. Ventricular cineangiograms revealed an akinetic/dyskinetic segment in 92% of patients, apical or anteroapical aneurysm in 83% and coronary artery disease in 100%, affecting 3 or more vessels in 75%, the left anterior descending artery was most affected (29%. The ejection fraction ranged from 32% to 66%. All patients underwent coronary artery bypass grafting, nine had left ventricular aneurysmectomy, seven through linear closure and 2 through geometric reconstruction. The cardiopulmonary bypass and aortic cross-clamp mean time was 96 and 50 minutes for linear closure and 180 and 86 for geometric reconstruction. The main complications after surgery were low cardiac output and atrial fibrillation (16%. Hospital mortality rate was 16%. Patients have a mean follow up of 15 months, survival rate is 75%, those surgically treated for CHF are in class II and 89% are angina-free. These improvements in quality of life provide justification for aneurysmectomy.

  8. Are lichens and cyanobacteria suitable candidates to test the theory of lithopanspermia?

    Science.gov (United States)

    de La Torre Noetzel, Rosa; Martinez Frías, Jesús; Mateo-Martí, Eva; Sanchez Iñigo, Francisco Javier; García Sancho, Leopoldo; Horneck, Gerda

    2010-05-01

    Lichens, endolithic- and endoevaporitic communities of cyanobacteria and bacteria has been exposed to real- and simulated space conditions to demonstrate likelihood of the lithopanspermia hypothesis, that postulates a viable transport of microorganisms between planets by means of meteorites, i.e. impact expelled rocks from a planets surface, which serve as vehicles for spreading living material from one planet or solar system to another (Nicholson et al. 2000, Benardini et al. 2003, Cockell 2008, Horneck et al. 2008, Valtonen et al. 2009). Three experiments (LICHENS, Foton M2 mission, 2005, and LITHOPANSPERMIA, Foton-M3 satellite, 2007), have been performed in space, the first two on a short mission, onboard of Biopan of the Foton-M satellite recoverable capsule, and the third one in a long-term mission on the Expose facility of the ISS to test the survival of prokaryotic- and eukaryotic symbiotic organisms in relation to lithopanspermia. The first two experiments allowed for the first time the demonstration- and intercomparison of the high survival capacity of eukaryotic- and prokaryotic symbiotic organisms in space (the epilithic lichen species Rhizocarpon geographicum and Xanthoria elegans, endoevaporitic microbial communities, epilithic microbial communities with cyanobacterial akinetes of Anabaena, and a vagrant lichen species, Aspicilia fruticulosa). Exposure to different UV-conditions of a low Earth orbit (LEO, 300 km) were performed: solar extraterrestrial UV radiation, Mars simulated UV-climate, UV-B radiation and PAR, space vacuum at 10-6 mbar, microgravity and temperatures between -23°C and +16°C. To check the resistance of the selected organisms to space before these missions, space simulation experiments were performed at INTA (Spasolab) and DLR (Institute of Aerospace Medicine), which were decisive to show the high survival capacity of these species to space vacuum (10-4 - 10-6 mbar), space UV radiation (200-400 nm) and extreme temperatures. The

  9. Dobutamine cine magnetic resonance imaging after myocardial infarction; Cine Risonanza Magnetica con dobutamina dopo infarto del miocardio

    Energy Technology Data Exchange (ETDEWEB)

    Giovagnoni, A.; Ligabue, G.; Romagnoli, R. [Modena Univ., Modena (Italy). Scienze Radiologiche, Dipt. di Medicina Interna; Reggio Emilia Univ., Reggio Emilia (Italy). Cattedra di Cardiologia; Rossi, R.; Muia, N.; Modena, M.G. [Modena Univ., Modena (Italy). Dipt. di Scienze Mediche, Oncologiche e Radiologiche; Reggio Emilia Univ. (Italy). Dipt. di Scienze Mediche, Oncologiche e Radiologiche

    1999-12-01

    Dobutamine Cine MRI is a new diagnostic imaging technique in the pretreatment (revascularization) assessment of myocardial infarction patients. In this issue are reported the result of a comparative study of the diagnostic yield of dobutamine Cine MRI with that of stress echocardiography in the assessment of viable myocardium. A new method for analysis of Cine MR images, employing digital subtraction, aimed at decreasing subjectivity in the quantitative assessment of myocardial wall thickening. Twenty-six patients (21 men and 5 women) with a history of myocardial infarction who were scheduled for revascularization were submitted to stress echocardiography and dobutamine Cine MRI to evaluate contractile recovery of the segments considered akinetic or hypo kinetic at baseline echocardiography. Dobutamine was administered in growing doses (5, 10, 15{gamma}/kg/min). 16 segments of the left ventricle in each patient were considered. In the 416 segments studied, it was found that 307 normo kinetic, 64 scarred and 45 viable segments with stress echocardiography, versus 302 normo kinetic, 83 scarred and 31 viable segments with dobutamine MRI. Three months after revascularization 15 patients were examined to check contractile recovery of the segments considered as viable. Echocardiography had 79% sensitivity and 97% specificity, while Cine MRI had 96% and 86%, respectively. In patients with anteroseptal wall myocardial infarction stress echocardiography had 75% sensitivity and 97% specificity. Echocardiography permits to distinguish viable myocardium and scarred myocardial tissue with good sensitivity and specificity, but Cine MRI performs better. Cine MRI has much higher sensitivity than stress echocardiography and thus makes the technique of choice to evaluate viable myocardium in these sites. The digital subtraction technique is as accurate as manual measurements, but reduces the error rate and permits quicker evaluation, particularly in subendocardial thickening

  10. [Catatonia: resurgence of a concept. A review of the international literature].

    Science.gov (United States)

    Pommepuy, N; Januel, D

    2002-01-01

    Catatonia was first described in 1874 by Kahlbaum as being a cyclic disease mixing motor features and mood variations. Because most cases ended in dementia, Kraepelin recognized catatonia as a form of dementia praecox and Bleuler included it within his wide group of schizophrenias. This view influenced the psychiatric practice for more than 70 years. But catatonia was recently reconsidered and this because of the definition of more precise diagnosis criteria, the discovery of a striking association with mood disorders, and the emphasis on effective therapeutics. Peralta et al empirically developed a performant diagnostic instrument with the 11 most discriminant signs among catatonic features. Diagnostic threshold is three or more signs with sensitivity of 100% and specificity of 99%. These signs are: immobility/stupor (extreme passivity, marked hypokinesia); mutism (includes inaudible whisper); negativism (resistance to instructions, contrary comportment to whose asked); oppositionism, other called gegenhalten (resistance to passive movement which increases with the force exerted); posturing (patient adopts spontaneously odd postures); catalepsy (patient retains limb positions passively imposed during examination; waxy flexibility); automatic obedience (exaggerated co-operation to instructed movements); echo phenomena (movements, mimic and speech of the examiner are copied with modification and amplifications); rigidity (increased muscular tone); verbigeration (continuous and directionless repetition of single words or phrases); withdrawal/refusal to eat or drink (turning away from examiner, no eye contact, refusal to take food or drink when offered). Using this diagnostic tool, prevalence of catatonic syndrome appears to be close to 8% of psychiatric admissions. Other signs are also common but less specific: staring, ambitendance, iterations, stereotypes, mannerism, overactivity/excitement, impulsivity, combativeness. Some authors complete this description by

  11. Microsurgical anatomy and clinical application of infratentorial supracerebellar keyhole approach%小脑幕下小脑上锁孔入路的显微解剖研究及其初步临床应用

    Institute of Scientific and Technical Information of China (English)

    兰青; 朱玉辐; 贡志刚

    2009-01-01

    and pineal region,based on the individualized imaging features.Results Only the central group bridging veins on the cerebellum tentorial surface needed to be sacrificed under infratentorial supracerebellar keyhole approach,and other vessels could be preserved well The distance between the bridging veins of beth left and right medial group could reach (35±6) mm when they were fully dissected,thus offering enough surgical space for applying this keyhole approach.When the culmen of cerebellum was retracted,the pineal body,Galen vein and its tributary,quadrigeminal bodies,even trochlear nerve could be observed.When the underlayer choroid of the third ventricular roof was dissected medially and inferiorly to the posterior choroidal artery,the posterior third ventricle could be reached.If the tentorium of cerebellum was cut open between the straight sinus and the lateral sinus,the surgical field could be enlarged anteriorly and superiorly to the longitudinal fissure region above the tentorium.Eight of the 11 pineal region tumors sized 2 -5 cm in diameter were totally removed,and 3 were subtotally resected.For one case,posterior cranial fossa decompression and ventriculoperitoneal shunt were performed postoperatively.Another one patient suffered from transient mutism and steady fixation after surgery.Other patients had no adverse effect.Conclusions Infratentorial supracerebellar keyhole approach can be applied for removing the pineal region minors without interfering the adjacent deep venous system,and can enter the third ventricle in a nearly non-traumatic way.If necessary the tentorium can be cut open to expose supra-tentorial structures.It can be regarded as a better choice for surgeries in this region.

  12. Total allowable concentrations of monomeric inorganic aluminum and hydrated aluminum silicates in drinking water.

    Science.gov (United States)

    Willhite, Calvin C; Ball, Gwendolyn L; McLellan, Clifton J

    2012-05-01

    toxicity is also manifest in the hematopoietic system as an erythropoietin-resistant microcytic hypochromic anemia. Signs of Al toxicity in the central nervous system (speech difficulty to total mutism to facial grimacing to multifacial seizures and dyspraxia) are related to Al accumulation in the brain and these symptoms can progress to frank encephalopathy. There are four groups of people at elevated risk of systemic Al intoxication after repeated ingestion of monomeric Al salts: the preterm infant, the infant with congenital uremia and children and adults with kidney disease. There is a dose-dependent increase in serum and urinary Al in people with compromised renal function, and restoration of renal function permits normal handling of systemically absorbed Al and resolution of Al bone disease. Clinical experience with 960 mg/day of Al(OH)(3) (~5 mg Al/kg-day) given by mouth over 3 months to men and women with compromised renal function found subclinical reductions in hemoglobin, hematocrit and serum ferritin. Following adult males and females with reduced kidney function found that ingestion of Al(OH)(3) at 2.85 g/day (~40 mg/kg-day Al) over 7 years increased bone Al, but failed to elicit significant bone toxicity. There was one report of DNA damage in cultured lymphocytes after high AlCl(3) exposure, but there is no evidence that ingestion of common inorganic Al compounds presents an increased carcinogenic risk or increases the risk for adverse reproductive or developmental outcomes. A number of studies of Al exposure in relation to memory in rodents have been published, but the results are inconsistent. At present, there is no evidence to substantiate the hypothesis that the pathogenesis of Alzheimer's Disease is caused by Al found in food and drinking water at the levels consumed by people living in North America and Western Europe. Attapulgite (palygorskite) has been used for decades at oral doses (recommended not to exceed two consecutive days) of 2,100

  13. Stem Cell Therapy for Congestive Heart Failure

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    Gunduz E

    2011-01-01

    engraft in sufficient numbers to differentiate to the cardiac myocytes and restore functionality in these akinetic areas. Hematopoietic stem cells consist can differentiate to skeletal and myocardial cells when cultured under appropriate conditions [4]. Strauer et al [5] reported that intracoronary bone marrow stem cell therapy improves ventricular performance, quality of life and survival in patients with chronic heart failure. Hamano et al [6] showed in 5 patients that autologous bone marrow cells can be injected safely during a by-pass operation into areas of ischemic myocardium. Brehm et al [7] have treated 23 patients with acute cardiac infarction using autologous mononuclear bone marrow cells. Ozbaran et al [8] transplanted peripheral blood stem cells into areas of injury with open-heart surgery in six patients with ischemic cardiomyopathy. There are also meta-analysis on ongoing clinical trials performed. Abdel-Latif et al [9] described a statistically significant improvement in ejection fraction, reduction in infarct size and left ventricular end-systolic volume in 18 patients treated with either unseparated bone marrow cells, bone marrow mesenchymal and mobilized peripheral blood cells. Martin-Rendon et al ­­ focused on 13 randomized studies encompassing 811 participants on bone marrow therapy for post acute infarction. Improvement in LVEF, decrease in left ventricular and systolic and end diastolic volumes and infarct size were observed. The reason for choice of intravenous route was being the standard way of giving hematopoietic stem cells by hematologists. We tried to decide the availibility of this route for indications other than hematological diseases. Although trapping of stem cells in the pulmonary vascular bed is a drawback of intravenous route and the question of whether the patient would have been more benefited by intracoronary or intramyocardial route remains unanswered, we think intravenous route may still have some role according to our own