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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. 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.

  3. Effects of UV-light and γ-rays on the survival, akinete formation and akinete germination in Stigeoclonium pascheri

    International Nuclear Information System (INIS)

    The damage produced by UV light to any of the three different stages of the life cycle of the parent generation of the green alga S. pascheri, i.e. akinetes, germinating akinetes and vegetative cells, remained up to the stage of germination of akinetes of the first generation and no deleterious effect was reported thereafter. Lower doses of γ-rays (25-75 Gy) increased the percentage germination of akinetes and germinating akinetes of parent generation. The percentage germination of akinetes, germinating akinetes, survival of colonies originated from vegetative cells and sporulation of cells of the parent generation decreased with doses increasing from 100 to 300 Gy. The γ-induced effect on any of the three different stages was not transferred to the subsequent stage of algal generation. (author). 3 tabs., 21 refs

  4. 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....

  5. Selective mutism – approaches and support

    OpenAIRE

    Zabukovec, Tina

    2013-01-01

    In the theoretical part of this diploma work, we explore the history of the disorder known as selective mutism through its present-day definition and diagnostic criteria. As the exact reason for the development of selective mutism still isn’t known, we look at different possible origins of the disorder based on various theories and learn its characteristics. Next up, we point out the elements of support and assistance that professional workers in school can offer, with an emphasis on understa...

  6. 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…

  7. 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...

  8. 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

  9. Carbon assimilation and accumulation of cyanophycin during the development of dormant cells (akinetes in the cyanobacterium Aphanizomenon ovalisporum

    Directory of Open Access Journals (Sweden)

    Assaf Sukenik

    2015-09-01

    Full Text Available Akinetes are spore-like non-motile 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. Here we demonstrate variations in cellular ultrastructure during akinete formation concomitant with accumulation of cyanophycin; a copolymer of aspartate and arginine that forms storage granules. Cyanophycin accumulation is initiated in vegetative cells few days post exposure to akinete inducing conditions. This early-accumulated cyanophycin pool in vegetative cells disappeared as a nearby cell differentiates to an akinete and stores large pool of cyanophycin. During the akinete maturation, the cyanophycin pool is further increased and comprise up to 2% of the akinete volume. The cellular pattern of photosynthetic activity during akinete formation was study by a nano-metric scale secondary ion mass spectrometry (NanoSIMS analysis of 13C-enriched cultures. Quantitative estimation of carbon assimilation in vegetative cells and akinetes (filament-attached and free indicates that vegetative cells maintained their basal activity while differentiating akinetes gradually reduced their activity. Mature free akinetes practically lost their photosynthetic activity although small fraction of free akinetes were still photosynthetically active. Additional 13C pulse chase experiments indicated rapid carbon turnover during akinete formation and de novo synthesis of cyanophycin in vegetative cells 4 days post induction of akinete differentiation.

  10. Too Anxious to Speak? The Implications of Current Research into Selective Mutism for Educational Psychology Practice

    Science.gov (United States)

    Cleave, Hayley

    2009-01-01

    Selective Mutism is a low incidence disorder but has considerable impact on the school system when it occurs. Over the last decade several research articles have been published which have challenged the understanding of the aetiology of Selective Mutism. Current perceptions about the aetiology of Selective Mutism are considered in order to inform…

  11. Selective mutism: more than social anxiety?

    Science.gov (United States)

    Yeganeh, Robin; Beidel, Deborah C; Turner, Samuel M

    2006-01-01

    This study investigated the relationship between selective mutism (SM), social phobia (SP), oppositionality, and parenting styles. Twenty-one children with SP, 21 children with SM and SP, and 21 normal children ages 7-15, and the mother of each child, participated in an assessment of psychopathological factors potentially related to SM. Children with SM did not endorse higher levels of social anxiety than did children with SP, although clinicians gave higher severity ratings to those who had both disorders. In addition, although a dimensional measure of oppositionality (Eyberg Child Behavior Inventory) did not reveal group differences, there were significantly more diagnoses of oppositional defiant disorder among children with SM (29%) in comparison to children with SP alone (5%). With respect to parenting styles, there were no significant differences among parents of children with SM and the other groups, except that children with SP reported significantly less warmth/acceptance from parents than normal children. These data replicate previous findings that children with SM do not report greater social anxiety than other children with a SP diagnosis. Furthermore, they suggest that oppositional behaviors may be part of the clinical presentation of a subset of children with SM. PMID:16421889

  12. Augmented Self-Modeling as an Intervention for Selective Mutism

    Science.gov (United States)

    Kehle, Thomas J.; Bray, Melissa A.; Byer-Alcorace, Gabriel F.; Theodore, Lea A.; Kovac, Lisa M.

    2012-01-01

    Selective mutism is a rare disorder that is difficult to treat. It is often associated with oppositional defiant behavior, particularly in the home setting, social phobia, and, at times, autism spectrum disorder characteristics. The augmented self-modeling treatment has been relatively successful in promoting rapid diminishment of selective mutism…

  13. 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...... and follow-up. METHODS: Consensus was obtained using the modified nominal group technique, involving four rounds of online Delphi questionnaires interspersed with a structured consensus conference with lectures, group work, and open discussion sessions. RESULTS: A new, proposed definition of "post...

  14. 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...

  15. 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

  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. Abnormal gait sequence in locomotion after atropine treatment of catecholamine-deficient akinetic rats.

    OpenAIRE

    Pellis, S M; Pellis, V C; Chesire, R M; Rowland, N; Teitelbaum, P

    1987-01-01

    Excessive, abnormal locomotion occurs after a high dose (25-50 mg/kg) of atropine sulfate to rats already akinetic due to catecholamine deficiency from intraventricular administration of 6-hydroxydopamine. This abnormal locomotion involves an abnormal gait sequence [right (R) hindleg (H), left (L) foreleg (F), LH, RF] instead of the normal gait sequence (RH, RF, LH, LF). In such animals atropine progressively (i) decreases hindleg step size, (ii) decreases arching of the trunk, and (iii) incr...

  18. 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)

  19. 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.

  20. Treating Youths with Selective Mutism with an Alternating Design of Exposure-Based Practice and Contingency Management

    Science.gov (United States)

    Vecchio, Jennifer; Kearney, Christopher A.

    2009-01-01

    Selective mutism is a severe childhood disorder involving failure to speak in public situations in which speaking is expected. The present study examined 9 youths with selective mutism treated with child-focused, exposure-based practices and parent-focused contingency management via an alternating treatments design. Broadband measures of…

  1. 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…

  2. The use of medication in selective mutism: a systematic review.

    Science.gov (United States)

    Manassis, Katharina; Oerbeck, Beate; Overgaard, Kristin Romvig

    2016-06-01

    Despite limited evidence, selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) are used to reduce symptoms of selective mutism (SM) in children unresponsive to psychosocial interventions. We review existing evidence for the efficacy of these medications, limitations of the literature, and resulting treatment considerations. Bibliographic searches were conducted in Medline, Embase, PsycInfo, Web of Science and Cochrane up to June 2015. Two reviewers independently sought studies of children with SM as primary psychiatric diagnosis, which reported response to medication treatment. Abstracts were limited to those reporting original data. Two reviewers independently assessed the ten papers reporting on >2 subjects regarding study design, key results, and limitations. Heterogeneity of designs mandated a descriptive summary. Symptomatic improvement was found for 66/79 children treated with SSRIs and 4/4 children treated with phenelzine. Only 3/10 studies had unmedicated comparison groups and only two were double-blinded. This review may be affected by publication bias, missed studies, and variability of outcome measures in included studies. Although there is some evidence for symptomatic improvement in SM with medication, especially SSRIs, it is limited by small numbers, lack of comparative trials, lack of consistent measures, and lack of consistent reporting on tolerability. The clinician must weigh this paucity of evidence against the highly debilitating nature of SM, and its adverse effects on the development of those children whose progress with psychosocial interventions is limited or very slow. Studies of optimal dosage and timing of medications in relation to psychosocial treatments are also needed. PMID:26560144

  3. 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…

  4. 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

  5. Evaluation of Children with Selective Mutism and Social Phobia: A Comparison of Psychological and Psychophysiological Arousal

    Science.gov (United States)

    Young, Brennan J.; Bunnell, Brian E.; Beidel, Deborah C.

    2012-01-01

    Although children with social phobia (SP) and selective mutism (SM) present similarly in a clinical setting, it remains unclear whether children with SM are unable to speak due to overwhelming anxiety, or whether withholding speech functions as an avoidance mechanism. A total of 35 children (ages 5-12 years) with either SM (n = 10), SP (n = 11),…

  6. Behavioral Intervention to Treat Selective Mutism across Multiple Social Situations and Community Settings

    Science.gov (United States)

    Lang, Russell; Regester, April; Mulloy, Austin; Rispoli, Mandy; Botout, Amanda

    2011-01-01

    We evaluated a behavioral intervention for a 9-year-old girl with selective mutism. The intervention consisted of role play and video self-modeling. The frequency of spoken initiations, responses to questions, and communication breakdowns was measured during three social situations (i.e., ordering in a restaurant, meeting new adults, and playing…

  7. 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…

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. An auditory-neuroscience perspective on the development of selective mutism

    Directory of Open Access Journals (Sweden)

    Yael Henkin

    2015-04-01

    Full Text Available Selective mutism (SM is a relatively rare psychiatric disorder of childhood characterized by consistent inability to speak in specific social situations despite the ability to speak normally in others. SM typically involves severe impairments in social and academic functioning. Common complications include school failure, social difficulties in the peer group, and aggravated intra-familial relationships. Although SM has been described in the medical and psychological literatures for many years, the potential underlying neural basis of the disorder has only recently been explored. Here we explore the potential role of specific auditory neural mechanisms in the psychopathology of SM and discuss possible implications for treatment.

  13. Cerebellar mutism syndrome and its relation to cerebellar cognitive and affective function: Review of the literature

    Directory of Open Access Journals (Sweden)

    Yildiz Ozlem

    2010-01-01

    Full Text Available Tumors of the cerebellum and brainstem account for half of all brain tumors in children. The realization that cerebellar lesions produce clinically relevant intellectual disability makes it important to determine whether neuropsychological abnormalities occur in long-term survivors of pediatric cerebellar tumors. Little is known about the neurobehavioral sequale resulting specifically from the resection of these tumors in this population. We therefore reviewed neuropsychological findings associated with postoperative cerebellar mutism syndrome and discuss the further implications for cerebellar cognitive function.

  14. Ties of silence - Family lived experience of selective mutism in identical twins.

    Science.gov (United States)

    Albrigtsen, Vårin; Eskeland, Benedicte; Mæhle, Magne

    2016-04-01

    This article is based on an in-depth interview with a pair of twins diagnosed with selective mutism and their parents 2 years after recovery. Selective mutism (SM) is a rare disorder, and identical twins sharing the condition are extremely rare. The twins developed SM simultaneously during their first year of school. The treatment and follow-up they received for several years are briefly described in this article. The interview explored the children's and their parents' narratives about the origin of the condition, the challenges it entailed in their daily lives, and what they found helpful in the treatment they were offered. In the interview, the children conveyed experiences that even the parents were unaware of and revealed examples of daily life-traumas for which they were unable to obtain support and help. The whole family was trapped in the silence. The twins and their parents emphasized different aspects in terms of what they believed were helpful. The implications of these findings for our understanding and treatment of children with SM are discussed, as well as the potential of service user involvement in child and adolescent mental health research. PMID:26092264

  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. 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

  17. 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

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

    Directory of Open Access Journals (Sweden)

    Elham Shirazi

    2016-01-01

    Full Text Available 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.

  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. 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.

  1. Global Gene Expression Patterns of Nostoc punctiforme in Steady-State Dinitrogen-Grown Heterocyst-Containing Cultures and at Single Time Points during the Differentiation of Akinetes and Hormogonia▿ †

    OpenAIRE

    Campbell, Elsie L.; Summers, Michael L.; Christman, Harry; Martin, Miriam E.; Meeks, John C.

    2007-01-01

    The vegetative cells of the filamentous cyanobacterium Nostoc punctiforme can differentiate into three mutually exclusive cell types: nitrogen-fixing heterocysts, spore-like akinetes, and motile hormogomium filaments. A DNA microarray consisting of 6,893 N. punctiforme genes was used to identify the global transcription patterns at single time points in the three developmental states, compared to those in ammonium-grown time zero cultures. Analysis of ammonium-grown cultures yielded a transcr...

  2. 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...

  3. 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

  4. A girl with tuberous sclerosis complex presenting with severe epilepsy and electrical status epilepticus during sleep, and with high-functioning autism and mutism.

    Science.gov (United States)

    Pacheva, Iliyana; Panov, Georgi; Gillberg, Christopher; Neville, Brian

    2014-06-01

    Most patients with tuberous sclerosis complex (TSC) suffer from epilepsy, and many have cognitive and behavioral problems like severe intellectual disability, autism, and hyperactivity. Only rare patients with TSC and autism have a normal intelligence quotient. We report a 13-year-old girl with definite TSC who had early-onset severe epilepsy, autistic behavior, and moderate developmental delay. By school age, however, she had normal intelligence; her intelligence quotient was at least 70 based on a Stanford-Binet test that she refused to complete. She showed good reading, writing, and language comprehension skills, and the special abilities of hyperlexia, hypermnesia, and hypercalculia. However, she did not speak. Criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and her Childhood Autism Rating Scale score of 36 indicated mild to moderate autism. She had severe electroencephalographic abnormalities: hypsarrhythmia, multifocal or generalized epileptiform discharges, and electrical status epilepticus during sleep, with a continuous left temporal focus. Magnetic resonance imaging showed many cortical tubers in all brain lobes, and subependymal nodules. We discuss possible explanations for her lack of speech. Considered as speech apraxia, her mutism could be either a symptom of her TSC or a component of her autism. Another possibility is that long-lasting electrical status epilepticus during sleep led to her autistic behavior and language arrest. Still another possibility is that a disinhibited mammalian target of rapamycin (mTOR) pathway was at the root of all of her neuropsychiatric symptoms. PMID:24968009

  5. Prolonged abulia following putaminal hemorrhage.

    Science.gov (United States)

    Nagaratnam, N; Fanella, S; Gopinath, S; Goodwin, A

    2001-01-01

    Abulia, akinetic mutism, and other conditions causing reduced activity and slowness are a continuum of severity of behavior. Unilateral lesions usually cause transient symptoms. This article describes a patient with prolonged abulia lasting 12 weeks after aspontaneous left putaminal hemorrhage. He developed seizures that could be a contributing factor. The pathophysiologic mechanisms are discussed. PMID:17903806

  6. 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.)

  7. Disorders of diminished motivation.

    Science.gov (United States)

    Marin, Robert S; Wilkosz, Patricia A

    2005-01-01

    Disorders of diminished motivation occur frequently in individuals with traumatic brain injury. Motivation is an ever-present, essential determinant of behavior and adaptation. The major syndromes of diminished motivation are apathy, abulia, and akinetic mutism. Depending on their etiology, disorders of diminished motivation may be a primary clinical disturbance, a symptom of another disorder, or a coexisting second disorder. This article presents a biopsychosocial approach to the assessment and management of motivational impairments in patients with traumatic brain injury. The recognition and differential diagnosis of disorders of diminished motivation, as well as the mechanism and clinical pathogenesis, are discussed. PMID:16030444

  8. 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...

  9. 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.

  10. 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.

  11. 'Chasing the dragon': new knowledge for an old practice.

    Science.gov (United States)

    Cordova, Juan P; Balan, Sabish; Romero, Jorge; Korniyenko, Aleksandr; Alviar, Carlos L; Paniz-Mondolfi, Alberto; Jean, Raymonde

    2014-01-01

    Heroin administration by "chasing the dragon," whereby the user places freebase heroin on aluminum foil, heats it below with a flame, and inhales the pyrolysate through a straw, can be associated with the rare development of a delayed-onset spongiform leukoencephalopathy. We report the case of a 46-year-old woman with a psychiatric diagnosis of depression and heroin dependence by "chasing the dragon" admitted with features of altered mental status and later development of catatonia, abulia, and akinetic mutism. A brain magnetic resonance image evidenced bilateral symmetric high-signal lesions in the white matter of the cerebrum and cerebellum on T2-weighted images compatible with toxic leukoencephalopathy. The patient's condition resolved after a hospital stay of 2 months with supportive treatment. Acute onset of neurobehavioral changes, including confusion, apathy, and cerebellar signs in a person with exposure to heroin, should prompt one to consider toxic leukoencephalopathy as a cause of presentation. PMID:21519216

  12. A twelve-year follow-up study on a case of early-onset parkinsonism preceding clinical manifestation of Gaucher disease.

    Science.gov (United States)

    Machaczka, Maciej; Arce, Martin Paucar; Rucinska, Malgorzata; Yoshitake, Takashi; Kehr, Jan; Jurczak, Wojciech; Skotnicki, Aleksander B; Månsson, Jan-Erik; Tylki-Szymanska, Anna; Svenningsson, Per

    2012-01-01

    Mutations in the glucocerebrosidase gene (GBA1) cause Gaucher disease (GD) and are the most common genetic risk factor for the development of Parkinson's disease (PD). Here, we present a 12-year follow-up study of a male with GD and PD (diagnosed 24years ago), which PD preceded the clinical manifestation of GD by 12years. The patient is a compound heterozygote for mutations c.115+1G>A and c.1226A>G (IVS2 + 1/N370S) in the GBA1 gene. Imiglucerase had a beneficial effect on GD, but not on PD. Treatment with L-dopa and other PD drugs showed temporary efficacy but 2years later significant wearing-off phenomenon and dyskinesias appeared. Unilateral pallidotomy was performed with transient benefit. Cognitive decline appeared later and developed in to akinetic mutism. A lumbar puncture was performed to characterize the biochemical profile of cerebrospinal fluid (CSF). Analyses of monoamine metabolites levels in the CSF, determined by reverse-phase high-performance liquid chromatography, revealed remarkably low levels of all studied monoamine metabolites (HVA, DOPAC, 5-HIAA, MHPG). These data indicate that PD associated with GBA1 mutations may not only affect dopaminergic neurons, but also noradrenergic and serotonergic neurons. Of note, normal levels of P-tau, total tau and β-amyloid (1-42) were detected on ELISA assay. Thus, the cognitive decline, akinetic mutism and moderate cortical atrophy found on the CT scan were not paralleled by any changes of dementia markers in CSF. This single case study extends the follow-up period and adds novel CSF information; however additional data on other patients with both PD and GD may help put our observations in its ultimate proper context. PMID:23430873

  13. [Comparison of 2 depression scales and their relationship with negative and akinetic symptoms in stabilized schizophrenic patients].

    Science.gov (United States)

    Langlois-Thery, S; Dollfus, S; Lesieur, P; Petit, M

    1994-01-01

    Since the Bleuler's early writings, studies in schizophrenia have often shown a frequent occurrence of depression in the context of schizophrenia and also its implications for the morbidity and mortality of schizophrenic patients. The wide variability in the prevalence of depression (between 7 to 70% in post-psychotic period) is due in part to the difficulty in clearly separating depressive symptoms from akinesia induced by neuroleptic or negative symptoms and to the lack of a valid assessment of depressive symptoms in schizophrenic patients. Under these conditions, a better understanding of depressive symptomatology in schizophrenia seems to be necessary to go further in this area of research with clinical and therapeutical purposes. The "Echelle de Ralentissement Dépressif" (ERD, Widlöcher, 1983) was studied in a sample of 53 schizophrenic patients to determinate whether ERD composed of three subscores (motor, ideic and subjective) could be able to evaluate the subjective depressive symptomatology and whether its measure would be independent of negative symptoms or akinesia. Pearson's correlations and correlations with variables partialled out were used to compare ERD to Montgomery and Asberg Depression Rating Scale (MADRS, 1979) and to establish their relationship with Positive And Negative Syndrome Scale (PANSS< Kay, 1987) and an Extrapyramidal Symptom Rating Scale (ESRS, Chouinard & Ross-Chouinard, 1980). Fifty three in or outpatients (35 males and 18 females, mean age +/- standard deviation = 38.26 +/- 9.82) were evaluated in a stable condition (i.e., when the psychotic symptomatology and the neuroleptic treatment have been stabilized since 4 weeks). According to DESM III-R criteria, 49 patients met the diagnosis of schizophrenia (2 schizoaffective disorders and 2 schizophreniform disorders).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7828511

  14. 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

  15. 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

  16. 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.

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

    Science.gov (United States)

    M Baig, Mirza; Phillips, Martin

    2013-10-01

    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. PMID:24470960

  18. Atypical parkinsonism of Japan: amyotrophic lateral sclerosis-parkinsonism-dementia complex of the Kii peninsula of Japan (Muro disease): an update.

    Science.gov (United States)

    Kuzuhara, Shigeki; Kokubo, Yasumasa

    2005-08-01

    An update of the endemic parkinsonism-dementia complex (PDC) frequently associated with amyotrophic lateral sclerosis (ALS) in the high prevalence ALS focus of the Kii peninsula of Japan is presented. The initial symptom was parkinsonian gait or hypobulia/amnesia, which was followed by akinesia, rigidity, occasional tremor, bradyphrenia, abulia and amnesia, and finally by akinetic mutism. In several years, most of the patients developed ALS symptoms such as muscle atrophy, bulbar palsy, and upper motor neuron signs. Magnetic resonance imaging and computed tomography of the brain showed marked atrophy of the temporal and frontal lobes and the cerebral blood flow reduction on single-photon emission computed tomography. Marked loss of nerve cells associated with abundant neurofibrillar tangles (NFTs) in the entire central nervous system, most predominantly in the brainstem and temporal lobe was characteristic. Concomitant ALS pathology involving the upper and lower motor neurons was common, and senile plaques were absent in most cases. NFTs consisted of twisted tubules on electron microscopy. Western blot of tau protein showed three bands consisting of six tau isoforms, similar to those of Alzheimer's disease. A family history of ALS/PDC was recorded in more than 70% of patients, but no abnormal mutation or polymorphism was found in the genes of SOD1, tau, and apolipoprotein E. Familial nature and continuing morbidity of Kii ALS/PDC suggest that genetic factors may be more likely in its pathogenesis. PMID:16092099

  19. 5-fluorouracil-induced leukoencephalopathy in patients with breast cancer.

    Science.gov (United States)

    Choi, S M; Lee, S H; Yang, Y S; Kim, B C; Kim, M K; Cho, K H

    2001-06-01

    The purpose of this study is to determine the characteristic clinical features, radiologic findings, and precipitating and prognostic factors in the patients with breast cancer and with 5-Fluorouracil (5-FU)-induced leukoencephalopathy. We reviewed the medical records of six breast cancer patients who developed leukoencephalopathy after chemotherapy which included 5-FU and also evaluated thorough neurological examinations including mini-mental status examination, cerebrospinal fluid studies, brain images and brain biopsies. Six patients exhibited slowly progressing neurologic symptoms characterized by the impairment of cognitive function, abulia, ataxic gait, and/or akinetic mutism. None of the patients had any specific causes or etiologic factors for leukoencephalopathy. Brain MRI in all patients showed diffuse periventricular white matter changes in the T2-weighted MR image. Brain biopsy in Patient 1 showed fragmented axonal fiber and minimally deprived myelination with many scattered macrophages. Five patients who treated with steroids at the onset of neurological symptoms showed clinical improvement, regardless of their age, sex, the pathology and stage of breast cancer, or the total dosage of chemotherapeutic agents. We conclude that leukoencephalopathy in these cases could be attributable to 5-FU neurotoxicity and suggest that the administration of steroids might be the treatment of choice. PMID:11410695

  20. 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.)

  1. 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...

  2. 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...

  3. 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.

  4. Magnetic resonance-guided laser interstitial thermal therapy: report of a series of pediatric brain tumors.

    Science.gov (United States)

    Tovar-Spinoza, Zulma; Choi, Hoon

    2016-06-01

    OBJECTIVE Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a novel, minimally invasive treatment that has multiple advantages in pediatric use and broad applicability for different types of lesions. Here, the authors report the preliminary results of the first series of pediatric brain tumors treated with MRgLITT at Golisano Children's Hospital in Syracuse, New York. METHODS Pediatric brain tumors treated with MRgLITT between February 2012 and August 2014 at Golisano Children's Hospital were evaluated retrospectively. Medical records, radiological findings, surgical data, complications, and results of tumor volumetric analyses were reviewed. The Visualase thermal laser system (Medtronic) was used in all MRgLITT procedures. RESULTS This series included 11 patients with 12 tumors (pilocytic astrocytoma, ependymoma, medulloblastoma, choroid plexus xanthogranuloma, subependymal giant cell astrocytoma, and ganglioglioma). A single laser and multiple overlapping ablations were used for all procedures. The mean laser dose was 10.23 W, and the mean total ablation time was 68.95 seconds. The mean initial target volume was 6.79 cm(3), and the mean immediate post-ablation volume was 7.86 cm(3). The mean hospital stay was 3.25 days, and the mean follow-up time was 24.5 months. Tumor volume decreased in the first 3 months after surgery (n = 11; p = 0.007) and continued to decrease by the 4- to 6-month followup (n = 11; mean volume 2.61 cm(3); p = 0.009). Two patients experienced post-ablation complications: transient right leg weakness in one patient, and transient hemiparesis, akinetic mutism, and eye movement disorder in the other. CONCLUSIONS Magnetic resonance-guided laser interstitial thermal therapy is an effective first- or second-line treatment for select pediatric brain tumors. Larger multiinstitutional clinical trials are necessary to evaluate its use for different types of lesions to further standardize practices. PMID:26849811

  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. [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

  7. 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

  8. 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…

  9. 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...

  10. 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.

  11. 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.

  12. 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…

  13. 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,…

  14. 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

  15. 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…

  16. Role of Cerebellum in Fine Speech Control in Childhood: Persistent Dysarthria after Surgical Treatment for Posterior Fossa Tumour

    Science.gov (United States)

    Morgan, A. T.; Liegeois, F.; Liederkerke, C.; Vogel, A. P.; Hayward, R.; Harkness, W.; Chong, K.; Vargha-Khadem, F.

    2011-01-01

    Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen…

  17. Morphological traits in nitrogen fixing heterocytous cyanobacteria: possible links between morphology and eco-physiology.

    Czech Academy of Sciences Publication Activity Database

    Pinto, P. D.; Kust, Andreja; Devercelli, M.; Kozlíková-Zapomělová, Eliška

    2016-01-01

    Roč. 764, č. 1 (2016), s. 271-281. ISSN 0018-8158 R&D Projects: GA ČR(CZ) GA14-18067S Institutional support: RVO:60077344 Keywords : traits * heterocyte * akinete * shape * size * phytoplankton Subject RIV: DA - Hydrology ; Limnology Impact factor: 2.275, year: 2014

  18. 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...

  19. Mode of presentation of patients of dissociative (conversion) disorder at the armed forces institute of mental health

    International Nuclear Information System (INIS)

    To determine the mode of presentation of dissociative disorders presenting at Armed Forces Institute of Mental Health. Study Design: Cross sectional study. Place and Duration of Study: The study was conducted at the Armed Forces Institute of Mental Health (AFIMH) Rawalpindi from 1st June 2013 to 31st August 2013. Patients and Methods: Fifty four patients of dissociative disorders were included in the study by using consecutive non-probability sampling. Category of presentation of dissociative disorders in the participants was determined by the primary mode of presentation and by using international classification of diseases (ICD)-10 diagnostic guidelines. Results: The commonest type of presentation of dissociative disorders was mutism (40.7%), possession state (18.5%), pseudo fits (12.9%) followed by paraparesis (9.2%). Conclusion: Predominantly the patients presented with mutism (dissociative motor disorder). (author)

  20. WAARDENBURG SYNDROME TYPE II: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    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.

  1. 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…

  2. 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...

  3. Classic Pick's disease type with ubiquitin-positive and tau-negative inclusions: case report Doença de Pick do tipo clássico com inclusão de ubiquitina positiva e proteína tau negativa: relato de caso

    OpenAIRE

    Paulo Roberto de Brito-Marques; Roberto Vieira de Mello; Luciano Montenegro

    2001-01-01

    We report on a patient presenting Pick's disease similar to the one reported by Pick in 1892, with ubiquitin-positive and tau-negative inclusions. His diagnosis was made on the basis of clinical (language disturbance and behavioural disorders), neuropsychological (progressive aphasia of the expression type and late mutism), neuroimaging with magnetic resonance (bilateral frontal and temporal lobes atrophy) and brain single photon emission computed tomography (frontal and temporal lobes hypope...

  4. ON THE EROTIC-LIRIC POSSESSION OR THE WORD SILENCE IN ANTÓNIO FRANCO ALEXANDRE POETRY

    Directory of Open Access Journals (Sweden)

    Paulo Ricardo Braz de Sousa

    2012-04-01

    Full Text Available The work of the Portuguese poet António Franco Alexandre has been read in various ways. Nevertheless, the interest in its reception is a very recurrent topic. The present paper intends to discuss how the eroticism is linked with the António Franco Alexandre’s poetry and how the Idea of mutism is associated with this anlysis, elucidating the erotic possession is­sue as an image of the act of reading. 

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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...

  7. 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...

  8. Chronic catatonia with obsessive compulsive disorder symptoms treated with lorazepam, memantine, aripiprazole, fluvoxamine and neurosurgery

    OpenAIRE

    Mukai, Yuki; Two, Aimee; Jean-Baptiste, Michel

    2011-01-01

    Catatonia is a syndrome with protean manifestations and multiple aetiologies. In this report, the authors describe the case of a young woman who presented for care after a 13-year period of catatonia-like symptoms, including mutism, refusal to eat and persistent neck flexion. Medical management included placement of a percutaneous endoscopic gastric tube for nutritional support. A thorough medical investigation later revealed the presence of a cervical spine haemangioma that was treated surgi...

  9. Successful management of a postinfarction left ventricular rupture using a sutureless technique with concomitant myocardial revascularization.

    Science.gov (United States)

    Kalangos, A; Panos, A; Chatelain, P; Vala, D; Fromage, P; Faidutti, B

    1997-01-01

    We present a case of left ventricular (LV) rupture that occurred on the second day after inferolateral myocardial infarction (MI). An aggressive diagnostic approach with rapid coronary angiography prior to surgical repair provides a benefit characterized postoperatively by complete recovery of myocardial contractility in the akinetic infarcted area. We believe that coronary artery disease associated with subacute ventricular rupture may, in fact, be better investigated and simultaneously treated under a protocol of early surgical repair. PMID:9591179

  10. Unusual Combination of Total Occlusion of Left Main Coronary Artery and Heart Failure with Pulmonary Hemosiderosis: Case Report

    OpenAIRE

    Elayda, Macarthur A.; Mathur, Virendra S.; Hall, Robert J.

    1983-01-01

    A case of total occlusion of the left main coronary artery, congestive heart failure, and pulmonary hemosiderosis in a 54-year-old man is reported. Cardiac catheterization showed total occlusion of the left main coronary artery, subtotal occlusion of the right coronary artery, severely deranged hemodynamics, and an akinetic left ventricle except for a hypokinetic posterobasal segment. A radionuclide left ventricular performance study revealed an ejection fraction of 0.16 with diffuse biventri...

  11. 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

  12. 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

  13. 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...

  14. Dobutamine stress echocardiographyin distinguishing ischemic from nonischemic dilated cardiomyopathy

    Directory of Open Access Journals (Sweden)

    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.

  15. Primary progressive aphasia as the initial manifestation of corticobasal degeneration. A "three in one " syndrome?

    Science.gov (United States)

    Ioannides, Panos; Karacostas, Dimitris; Hatzipantazi, Maria; Ioannis, Milonas

    2005-01-01

    In 1994, the term "Pick complex" was proposed to indicate significant clinical and pathological overlapping between primary progressive aphasia, frontal lobe dementia and corticobasal degeneration. We report the case of a 60-year-old man, who initially presented progressive non-fluent aphasia with orofacial apraxia, and subsequently, over a period of 3 years, developed mutism, pathological laughter, extrapyramidal rigidity, dystonia, alien hand syndrome and bulbar signs. An extensive haematological, immunological and biochemical work up was normal. The results of neuroimaging studies and neuropsychological tests, along with the clinical evolution, finally led us to the ?three in one? diagnosis, supporting the concept of Pick complex. PMID:16324238

  16. Evaluation and management of the child with speech delay.

    Science.gov (United States)

    Leung, A K; Kao, C P

    1999-06-01

    A delay in speech development may be a symptom of many disorders, including mental retardation, hearing loss, an expressive language disorder, psychosocial deprivation, autism, elective mutism, receptive aphasia and cerebral palsy. Speech delay may be secondary to maturation delay or bilingualism. Being familiar with the factors to look for when taking the history and performing the physical examination allows physicians to make a prompt diagnosis. Timely detection and early intervention may mitigate the emotional, social and cognitive deficits of this disability and improve the outcome. PMID:10392594

  17. Bilateral anterior choroidal artery infarction presenting with progressive somnolence.

    Science.gov (United States)

    van Son, Brechtje; Vandevenne, Jan; Viaene, Pieter

    2014-09-01

    A 55-year-old woman was admitted with a 3 days history of increasing lethargy with bradyphrenia and apathy. She progressively developed severe somnolence with marked abulia, right hemiparesis, right hemianopsia, and pseudobulbar palsy. Brain magnetic resonance imaging showed the rare image of bilateral acute anterior choroidal artery infarction. Pseudobulbar mutism and in rare cases abulia have been described in acute anterior choroidal artery infarction contralateral to an older lesion in mirror position. Although neurologic deterioration is not infrequent in anterior choroidal artery territory infarcts, the absence of focal neurologic signs on admission is rare and did not raise suspicion of acute stroke. PMID:25106836

  18. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Screening for health: Tunisia

    International Nuclear Information System (INIS)

    Imagine the distress for everyone involved when it becomes apparent that a child is mentally disabled, especially if the condition could have been avoided. Thyroid deficiency in newborn babies can lead to varying degrees of mental retardation or intellectual impairment and, in severe cases, can lead to deaf mutism. For the person affected and their family, life will never be normal and yet the condition can be treated effectively if it is detected within the first few days of life. Radioimmunoassay (RIA) is a simple, cost effective diagnostic technique. (IAEA)

  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. From juvenile parkinsonism to encephalitis lethargica, a new phenotype of post-streptococcal disorders: case report.

    Science.gov (United States)

    Beleza, Pedro; Soares-Fernandes, João; Jordão, Maria J; Almeida, Fátima

    2008-11-01

    We report the case of a 16-year-old boy presented with a mild akinetic-rigid parkinsonism shortly after a post-streptococcal infection. After stopping corticoids, he had a rapid neurological deterioration to a fatal encephalitis lethargica-like syndrome. Serum analysis demonstrated consistently elevated anti-streptolysin-O. This case illustrates a new severe phenotype in the spectrum of the post-streptococcal disorders. This etiology should be considered in the differential diagnosis of a movement disorder with a rapid detrimental evolution. PMID:18221898

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

    OpenAIRE

    N. V. Fedorova; Nikitina, A. V.

    2015-01-01

    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...

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  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. 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

  9. Avant-propos

    OpenAIRE

    Bernard, Jacques-Emmanuel

    2013-01-01

    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...

  10. Avant-propos

    OpenAIRE

    Jacques-Emmanuel Bernard

    2003-01-01

    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......

  11. 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...

  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. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. [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

  19. 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

  20. Detection of viable myocardium by low dose dobutamine cine MRI: experimental study in pigs

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic value of dobutamine stress magnetic resonance imaging (MR) for myocardial viability. Methods: Mini swine (n = 10) underwent left ventriculography and coronary angiography, followed by stenosis of the left circumflex coronary artery (LCX) using aneroid constrictor. More than 1 month later left ventriculography and coronary angiography were performed again, followed by cine-MR at rest and during stress with incremental dose of dobutamine 5-20 μg · kg-1 · min-1. Traditional and/or breath-hold cine-MR were used to evaluate regional left ventricular wall motion, corresponding to basal, mid ventricular and apical short-axis tomograms. Regional wall motion score index (WMSI) was calculated. Mini swine were finally sacrificed for pathological examination. Triphenyl tetrazolium chloride (TTC) assessed myocardial infarction. Microscopy was used to identify myocardial cellular changes. Results: One pig died, 1 pig suffered from aneurysm and another 1 showed negative findings. The other 7 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 postero-inferior walls (ischemic regions) of the left ventricle was 2.27 +- 0.32 compared with 1.00 +- 0.00 (x2 = 106.27, P 2 = 20.57, P -1·min-1. However, the mean WMSI at the dose of dobutamine 10 and 20 μg·kg-1·min-1 was 1.70 +- 0.76, 1.75 +- 0.83, respectively, compared with the mean WSCI at rest (x2=3.25 versus 2.33, P > 0.05). The pathologic examination showed viable myocardium at the ischemic regions. Conclusion: Low dose dobutamine (5 μg·kg-1·min-1) can recover hypokinetic or akinetic myocardial regions, Dobutamine stress MR can detect myocardial viability

  1. 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

  2. Altered energy metabolism after myocardial infarction assessed by 31P-MR-spectroscopy in humans

    International Nuclear Information System (INIS)

    The value of 31P-magnetic resonance spectroscopy (MRS) as a possible tool to distinguish viable from non-viable tissue after myocardial infarction was analysed in humans. Fifteen patients 3 weeks after anterior myocardial infarction were studied with breath-hold cine MRI and 3D-CSI MRS (1.5 T system). 31P-spectra were obtained from infarcted as well as non-infarcted myocardium (voxel size 25 cm3 each). Gold standard for viability was recovery of regional function, as determined by a control MRI 6 months after revascularization. Ten age-matched healthy volunteers served as control group. No significant difference was found between the phosphocreatine to adenosinetriphosphate (PCr/ATP) ratio of volunteers (SD 1.72±0.31) and non-infarcted septal myocardium of patients. Cine MRI demonstrated recovery of regional function in 10 patients, i. e. 10 patients showed viable and 5 non-viable myocardium. In viable myocardium, the PCr/ATP ratio was 1.47±0.38 (non-significant vs volunteers; p>0.05). In the 5 patients with akinetic myocardium, PCr peaks could not be detected. Therefore, calculation of PCr/ATP ratios was not possible. However, a significant reduction of the ATP signal-to-noise ratio (SNR) was observed (2.92±0.73 vs 6.68±0.80; patients vs volunteers; p<0.05). The SNR of ATP of akinetic regions may predict recovery of function after revascularization in patients with myocardial infarction. (orig.)

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  5. [Depressive symptoms and negative symptoms during schizophrenia].

    Science.gov (United States)

    Dollfus, S; Langlois, S; Assouly-Besse, F; Petit, M

    1995-06-01

    Taking into account the wellknown frequency of depressive and extrapyramidal symptoms in schizophrenia and the rare studies about their evolution, several questions can be raised: How do these different symptoms move? Are there specific characters of each of them? First, stability of negative symptoms evaluated by the Scale for the Assessment of Negative Symptoms (SANS) was studied among 57 schizophrenic patients at admission and at discharge. The course of negative symptoms was compared to that of depressive MADRS (Montgomery et Asberg Depression Rating Scale) and akinetic symptoms (Extrapyramidal Symptom Rating Scale). All the subscores of the SANS decreased significantly but 4 items belonging to the affective flattening subscale and one item belonging to the alogia subscale did not vary significantly, showing the necessity of taking into account the individual items of the SANS rather than the subscale scores to evaluate the course of negative symptoms. Changes in all the SANS subscores except the alogia and anhedonia subscores were associated with variations in scores of other scales. Correlations between the changes of negative symptoms and the changes of depressive symptoms showed the necessity to do more specific scales, for example, scales for depression in schizophrenia. Langlois-Théry et al. (1994) evaluated among 53 schizophrenic patients stabilized with neuroleptic treatment, depressive symptomatology with Echelle de Ralentissement Dépressif (ERD, Widlöcher, 1983) and MADRS, negative symptomatology (Positive and Negative Syndrome Scale) and akinesia (ESRS), to determinate whether ERD composed of 3 subscores (motor, ideic and subjective) could be able to evaluate the depressive symptomatology, independently of the measures of negative and akinetic symptomatology.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7628337

  6. 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

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

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    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

  8. Effectiveness of Teaching in Expressive Arts Therapy-Emotionally Traumatized Preschool Children

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    Chen I Ju

    2014-05-01

    Full Text Available In recent years, the numbers of single parent families, skipped-generation education families and high-risk families are increasing year by year, and therefore, the proportion of preschool children from dysfunctional families are also increasing, wherein, these preschool children must face multiple pressures in the external environment, hence, it needs to pay special attention to life adjustment issues of these traumatized preschool children.Kepner (1995 revealed that traumatic preschool childhood experiences coexisted with existing traumatic environments, while observing it from the viewpoint of development; preschool children’s physical, mental and learning capabilities were completely affected. The primary system in the preschool childhood trauma cases was self-enclosed, supportless and helpless; thereby, they might find themself living in constant states of loneliness and hopelessness (Martin, 2009. If preschool childhood trauma was maintained over a considerable period, it could affect the personal development and self-functions as well as social relationships.The cases of preschool children abuse are getting more and more due to the reasons of parental separations, bereavements, skipped-generation educations, witnessing acts of domestic violence; and in general, these preschool children desire to be loved, therefore, these traumatized preschool children will exhibit various degrees of life adjustment problems in different ways, and some of them may eager to show off their abilities, try to please others, and some are very quiet or cringe in front of others, some are very unstable, and some have aggressive tendencies, or have a lower level of learning motivation, or even, some are inveterate liars, etc. (McConnell, 2002.The expressive arts therapy group introduced in this study aimed at older students of kindergartens affiliated to the elementary schools who belonged to emotionally traumatized preschool children with selective mutism and

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

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    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

  10. Nonlanguage disorders of speech reflect complex neurologic apparatus.

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    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

  11. 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

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

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    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

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

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    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.

  14. [An acute severe heat stroke patient showing abnormal diffuse high intensity of the cerebellar cortex in diffusion weighted image: a case report].

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    Fujioka, Yusuke; Yasui, Keizo; Hasegawa, Yasuhiro; Takahashi, Akira; Sobue, Gen

    2009-10-01

    A 47-year-old man was admitted to the hospital because of general convulsion, loss of consciousness and hyperthermia. A diagnosis of acute heat stroke was made clinically and neuroradiologically. As the consciousness level ameliorated, he developed severe abulia and mutism, then cerebellar ataxic syndrome (viz. truncal ataxia, hypermetria, ataxic speech and nystagmus). An MRI (diffusion weighted image; DWI) disclosed abnormal diffuse high signal intensity of the cerebellar cortex with reduced apparent diffusion coefficient (ADC). Two months later after the onset, truncal ataxia and dysarthria significantly improved, while dysmetria of the extremities rather worsened. At that time, the abnormal signal intensity of the cerebellar cortex disappeared, and the cerebellum became atrophic. The cerebellar blood flow was significantly decreased on brain SPECT (99mTc-ECD). The abnormal DWI signal intensity of the cerebellar cortex in the present patient may represent the cytotoxic edema of Purkinje cells resulting from heat stroke-related hyperthermia It is essential to repeat MRI examination for cerebellar pathology and to obtain better insight into sequelae in patients with acute heat stroke. Protirelin tartrate seemed to be valid for improvement of abulia in the present patient. Further study is indicated. PMID:19999144

  15. [Bilateral caudate head infarcts].

    Science.gov (United States)

    Kuriyama, N; Yamamoto, Y; Akiguchi, I; Oiwa, K; Nakajima, K

    1997-11-01

    We reported a 67-year-old woman with bilateral caudate head infarcts. She developed sudden mutism followed by abulia. She was admitted to our hospital 2 months after ictus for further examination. She showed prominent abulia and was inactive, slow and apathetic. Spontaneous activity and speech, immediate response to queries, spontaneous word recall and attention and persistence to complex programs were disturbed. Apparent motor disturbance, gait disturbance, motor aphasia, apraxia and remote memory disturbance were not identified. She seemed to be depressed but not sad. Brain CT and MRI revealed bilateral caudate head hemorrhagic infarcts including bilateral anterior internal capsules, in which the left lesion was more extensive than right one and involved the part of the left putamen. These infarct locations were thought to be supplied by the area around the medial striate artery including Heubner's arteries and the A1 perforator. Digital subtraction angiography showed asymptomatic right internal carotid artery occlusion. She bad had hypertension, diabetes mellitus and atrial fibrillation and also had a left atrium with a large diameter. The infarcts were thought to be caused by cardioembolic occlusion to the distal portion of the left internal carotid artery. Although some variations of vasculature at the anterior communicating artery might contribute to bilateral medial striate artery infarcts, we could not demonstrate such abnormalities by angiography. Bilateral caudate head infarcts involving the anterior internal capsule may cause prominent abulia. The patient did not improve by drug and rehabilitation therapy and died suddenly a year after discharge. PMID:9503974

  16. Bilateral caudate infarct--a case report.

    Science.gov (United States)

    Lim, J K; Yap, K B

    1999-07-01

    Caudate strokes comprise only a small proportion of all subtypes of strokes. Bilateral caudate infarcts are even rarer and only a few cases have been reported in the literature. We report an 86-year-old woman with bilateral caudate infarcts. She had no past medical history of note. She presented with headache for several days and drowsiness on day of admission. Clinical examination revealed abulia, inability to comprehend or verbalize (acute mutism), right-sided neglect and right-sided hemiparesis. Computed tomographic (CT) scan brain revealed decreased attenuation in both heads of both caudate nuclei with extension across the anterior limb of both internal capsules to involve the lentiform nuclei. Echocardiography showed aortic valve sclerosis, mild mitral and aortic regurgitation and normal left ventricular function. Carotid ultrasound revealed mild stenosis of proximal right internal carotid and left distal common carotid and adjacent proximal internal carotid arteries. She showed initial improvement in the first week, but subsequently had a progressive downward course despite rehabilitation and died 44 days after her stroke. A patient with bilateral caudate infarcts is likely to have poor prognosis for rehabilitation and survival. PMID:10561773

  17. 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

  18. [Recovery of consciousness: process-oriented approach].

    Science.gov (United States)

    Gusarova, S B

    2014-01-01

    Traditionally psychological neurorehabilitation of neurosurgical patients is provided subject to availability of clear consciousness and minimal potential to communicate verbally. Cognitive and emotional disorders, problems in social adaptation, neurotic syndromes are normally targets in such cases. We work with patients having survived severe brain damage being in different states of consciousness: vegetative state, minimal state of consciousness, mutism, confusion, posttraumatic Korsaroff syndrom. Psychologist considers recovery of consciousness as the target besides traditional tasks. Construction of communication with patient is central part of such job, where the patient remains unable to contact verbally, yet it is impossible to consider potential aphasia. This is a non-verbal "dialogue" with patient created by psychologist with gradual development and involving other people and objects of environment. Inline with modern neuroscientific achievements demonstrating ability to recognize by patients with severe brain injury (A. Owen, S. Laureys, M. Monti, M. Coleman, A. Soddu, M. Boly and others) we base upon psychological science, on psychotherapeutic approaches containing instruments inevitable to work with patients in altered states of consciousness and creation of non-verbal communication with patient (Jung, Reich, Alexander, Lowen, Keleman, Arnold and Amy Mindell, S. Tomandl, D. Boadella, A. Längle, P. Levin etc). This article will include 15 years of experience to apply Process-oriented approach by A. Mindell to recovery of consciousness of neurosurgical patients based on work with "minimal signals" (micro moves, breath, mimic reactions etc.), principle of feedback, psychosomatic resonance, empathy. PMID:24761599

  19. 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.

  20. 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

  1. 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.

  2. Speech and language delay in children.

    Science.gov (United States)

    McLaughlin, Maura R

    2011-05-15

    Speech and language delay in children is associated with increased difficulty with reading, writing, attention, and socialization. Although physicians should be alert to parental concerns and to whether children are meeting expected developmental milestones, there currently is insufficient evidence to recommend for or against routine use of formal screening instruments in primary care to detect speech and language delay. In children not meeting the expected milestones for speech and language, a comprehensive developmental evaluation is essential, because atypical language development can be a secondary characteristic of other physical and developmental problems that may first manifest as language problems. Types of primary speech and language delay include developmental speech and language delay, expressive language disorder, and receptive language disorder. Secondary speech and language delays are attributable to another condition such as hearing loss, intellectual disability, autism spectrum disorder, physical speech problems, or selective mutism. When speech and language delay is suspected, the primary care physician should discuss this concern with the parents and recommend referral to a speech-language pathologist and an audiologist. There is good evidence that speech-language therapy is helpful, particularly for children with expressive language disorder. PMID:21568252

  3. A 33-month-old with fever and altered mental status.

    Science.gov (United States)

    Lautz, Andrew J; Jenssen, Brian; McGuire, Jennifer; St Geme, Joseph W

    2015-01-01

    A 33-month-old girl presented with 3 days of fever and 1 day of multiple paroxysmal episodes of screaming with apparent unresponsiveness, flexed lower extremities, clenched hands, and upward eye deviation. These events lasted seconds to a minute at a time and occurred only during sleep. She slept peacefully between episodes and was easily awakened. She had a history of mild speech delay and mild intermittent asthma but was otherwise healthy. She was tired-appearing and fussy on examination with dry mucous membranes, but her examination was otherwise normal. A complete blood count with differential and serum levels of sodium, potassium, chloride, and calcium were normal, but her bicarbonate level was 12 mmol/L. Her fingerstick glucose level was 69 mg/dL. Urine dipstick was notable for large ketones, and a urine drug screen was normal. Cerebrospinal fluid examination yielded 2 white blood cells and 1040 red blood cells/mm(3) with normal chemistries. A computed tomography (CT) scan of her head was unremarkable, and an abdominal ultrasound demonstrated no evidence of intussusception. Over the course of her hospitalization, these paroxysmal episodes persisted, and she subsequently developed mutism, right-sided weakness, and difficulty swallowing liquids. Here we present her case, diagnostic evaluation, and ultimate diagnosis. PMID:25489012

  4. Using human extra-cortical local field potentials to control a switch

    Science.gov (United States)

    Kennedy, Philip; Andreasen, Dinal; Ehirim, Princewill; King, Brandon; Kirby, Todd; Mao, Hui; Moore, Melody

    2004-06-01

    Individuals with profound paralysis and mutism require a communication channel. Traditional assistive technology devices eventually fail, especially in the case of amyotrophic lateral sclerosis (ALS) subjects who gradually become totally locked-in. A direct brain-to-computer interface that provides switch functions can provide a direct communication channel to the external world. Electroencephalographic (EEG) signals recorded from scalp electrodes are significantly degraded due to skull and scalp attenuation and ambient noise. The present system using conductive skull screws allows more reliable access to cortical local field potentials (LFPs) without entering the brain itself. We describe an almost locked-in human subject with ALS who activated a switch using online time domain detection techniques. Frequency domain analysis of his LFP activity demonstrates this to be an alternative method of detecting switch activation intentions. With this brain communicator system it is reasonable to expect that locked-in, but cognitively intact, humans will always be able to communicate. Financial disclosure. Authors PK and DA may derive some financial gain from the sale of this device. A patent has been applied under US and international law: 10/675,703.

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. Viability of dried filaments, survivability and reproduction under water stress, and survivability following heat and UV exposure in Lyngbya martensiana, Oscillatoria agardhii, Nostoc calcicola, Hormidium fluitans, Spirogyra sp. and Vaucheria geminata

    International Nuclear Information System (INIS)

    The aim of our study was to determine how long and to what extent Lyngbya martensiana, Oscillatoria agardhii, Nostoc calcicola, Hormidium fluitans and Vaucheria geminata tolerate dry storage at different temperatures, UV-light radiation and water stress imposed by growing them on media with a high agar content and/or in NaCl-containing liquid media. Dried vegetative filaments of Spirogyra sp., Vaucheria geminata and Nostoc calcicola died within 0,5, 1 and 4 h, respectively; those of Hormidium fluitans, Oscillatoria agardhii and Lyngbya martensiana retained viability for 3, 5 and 10 d, respectively. L. martensiana and O. agardhii tolerated 0.8 mol/L NaCl. The resistance to desiccation in L. martensiana and O. agardhii exhibited similar dependence as that to frost, to heat and UV light. The water stress imposed on growing algae either on high-agar solid media or in NaCl-containing liquid media reduced hormogonium formation in L. martensiana and O. agardhii; hetero-cyst and akinete formation in N. calcicola and fragmentation in H. fluitans. In all studied algae the stress reduced at various levels the survival of vegetative parts. Generally, algal body form and composition rather than habitats seem to decide primarily the level of resistance against various stress conditions

  10. 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)

  11. 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.

  12. 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

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

    Directory of Open Access Journals (Sweden)

    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. 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.

  15. Changes in the phase and amplitude images in the rehabilitation phase after myocardial infarction

    International Nuclear Information System (INIS)

    A studing involving patients with completed myocardial infarction, who underwent a 3-week exercise program at a cardiocirculatory rehabilitation center in Southern Hungary, is described. Infarctions were confirmed by the typical clinical and ECG signs and symptoms as well as by 201-T1 imaging at rest. Patients with normal 201-T1 activity distribution were excluded. Three ECG-gated equilibrium radionuclide studies were performed in each case: The first was done on the first day of rehabilitation (at a mean post-infarction interval of 1.5 months); the second study was scheduled 3 weeks after the first on completion of the exercise program and the last 9 weeks after the first (on an outpatient basis). From April 25, 1983 to September 9, 1983 a total of 25 patients were investigated. Of these, 9 had normal 201-T1 images. Of the remaining 16, 9 showed no significant changes of the phase and amplitude images. In 2 cases dyskinesia was found to have been replaced by akinesia, and in another 3 akinesia was replaced by hypokinesia. By contrast, 2 previously akinetic patients became dyskinetic. We expect to increase our patient material to at least 50 cases by the end of 1983 and would like to present our results, illustrating them by some typical examples. (Author)

  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. Corticobasal degeneration: clinical characteristics and multidisciplinary therapeutic approach in 26 patients.

    Science.gov (United States)

    Shehata, Hatem S; Shalaby, Nevin M; Esmail, Eman H; Fahmy, Ebtesam

    2015-09-01

    Corticobasal syndrome (CBS) is a sporadic tauopathy that manifests by a various combination of motor and cognitive deficits, which makes its diagnosis challenging. Treatment of CBS is symptomatic and based on evidence from other similar disorders due to the lack of studies on CBS. The aim of the study was to investigate low-frequency repetitive transcranial magnetic stimulation (rTMS) as a therapeutic tool in CBS. Twenty-six patients with clinically evident CBS according to Cambridge criteria were followed for 12-18 months while receiving low-frequency rTMS combined with pharmacological, rehabilitation treatment and botulinum toxin injection. The majority of patients are manifested with akinetic-rigid syndrome and cognitive dysfunction. There was improvement of the UPDRS and quality of life after 3 months of therapeutic interventions (P < 0.001 and <0.05, respectively). No significant deterioration in cognitive functions was detected over the study period. There was a significant reduction of caregiver burden after 3 months of interventions (P < 0.01); this improvement was maintained up to 18 months. Cognitive dysfunction is a frequent manifestation of CBS. CBS patients can benefit from multidisciplinary therapeutic approach employing low-frequency rTMS. PMID:25917399

  18. 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

  19. 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.

  20. Determination of left ventricular wall motility injury by factor analysis in patients with advanced ischemic heart disease

    International Nuclear Information System (INIS)

    Left ventricular phase and amplitude images (Fourier analysis, PAI) and factor analysis images (FAI) from gated radionuclide ventriculography were obtained in 235 patients after myocardial infarction (MI) and in 44 patients with well documented ischemic heart disease (IHD) in order to assess areas of regional left ventricular motility injury (LVMI). The sensitivity of FAI for LVMI detection was higher than with PAI (36.3% vs 22.7% in patients without MI; 76.6% vs 68% in those after anterior MI; and 53.2% vs 31.9% after posterior MI, respectively). In 2.9% of all patients PAI were unclear due to small time activity amplitudes and heart rate irregularity, whereas FAI could be easily assessed. Significantly decreased left ventricular ejection fraction was observed predominantly after anterior MI in connection with distinct signs of LVMI in a large area of anterior wall or in the anteroseptal and/or apical region. Areas of LVMI could be sharply delineated in FAI; however, in contrast to PAI, FAI is unable to distinguish between dyskinetic and akinetic regions. The use of both PAI and FAI is recommended for more detailed detection of regional LVMI in patients with IHD. (orig.)

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

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    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. Brain Perfusion in Corticobasal Syndrome with Progressive Aphasia

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    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.

  3. Prevalence of ischemia by quantitative thallium-201 scintigraphy in patients with ventricular tachycardia or fibrillation inducible by programmed stimulation

    International Nuclear Information System (INIS)

    The prevalence of exercise-induced ischemia was determined by thallium-201 (TI-201) scintigraphic criteria in patients with ventricular tachycardia (VT) or ventricular fibrillation (VF) inducible by programmed electrical stimulation. Thirty-eight patients (age 57 +/- 19 years), of whom 87% had angiographic coronary artery disease, underwent quantitative TI-201 exercise scintigraphy within 14 days of invasive electrophysiologic testing. The mean rest ejection fraction was 38 +/- 9%. Eighty percent of patients had 1 or more regions with akinetic or dyskinetic wall motion. Thallium-201 scan segments were scored as normal or containing redistribution defects or mild or severe persistent defects. Only 4 patients (10%) had only redistribution defects and 9 (24%) had both redistribution defects and persistent defects; 32 of 38 patients (84%) had 1 or more persistent defects, of which 26 had at least 1 severe, persistent defect (more than 50% reduction in TI-201 activity). Patients with and without exercise-induced VT had a similar prevalence of redistribution. Redistribution defect prevalence was similar in patients with polymorphic VT (3 of 13) and monomorphic VT (10 of 25) during programmed electrical stimulation (difference not significant). Thus, patients with VT or VF induced by programmed ventricular stimulation have extensive TI-201 scintigraphic abnormalities on exercise scintigrams, predominantly those suggesting scar, with associated severe regional wall motion abnormalities at rest

  4. Evaluation of viability of infarcted myocardium by low dose dobutamine stress echocardiography. Comparison with exercise stress 201Tl myocardial scintigraphy

    International Nuclear Information System (INIS)

    Exercise stress 201Tl myocardial single-photon emission computed tomography (SPECT) is recognized to be a excellent method for identifying viability after myocardial infarction, but it is expensive and needs a longer time for data acquisition than echocardiography. We therefore performed this study to evaluate the effectiveness of low dose (5-10 μg/kg/min) dobutamine stress echocardiography (DSE) in 30 patients (61±8 years old: 24 men and 6 women) within 4 weeks after myocardial infarction in identifying viable myocardium, compared to results obtained by SPECT. Defining an akinetic or dyskinetic segment obtained by rest echocardiography as a definite infarct area, altogether 96 segments out of 716 segments were shown to be infarct areas. Of these, 75 (78%) segments were identified as viable by DSE, and 77 (80%) by SPECT. Only 2 segments were shown to be discrepant on DSE and SPECT. Subsequently, the sensitivity, specificity and accuracy rates for DSE were 96%, 100% and 96%, respectively. In conclusion, DSE is as effective and useful as SPECT in the evaluation of viability after myocardial infarction. (author)

  5. 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.

  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. ST segment elevation after myocardial infarction: Viability or ventricular dysfunction? Comparison with myocardial scintigraphy

    International Nuclear Information System (INIS)

    The detection of viable myocardium after myocardial infarction is an important indication for revascularization. We compared exercise-induced ST segment elevation with reversibility at Thallium-201 SPECT scintigraphy and regional wall motion assessment by ventriculography. Thirty two patients with previous myocardial infarction and with left ventricular ejection fraction of < 50% were studied. Patients underwent coronary angiography and Thallium-201 SPECT scintigraphy with re-injection protocol before and after coronary artery bypass graft surgery. Group I comprised 11 patients with ST segment elevation during treadmill stress testing. Group II comprised 21 patients without ST segment elevation. Minimal or moderate hypokinesis was present in 2 patients of Group I and in 4 patients of Group II. Nine patients of Group I and 17 patients of Group II had severe hypokinetic, akinetic or dyskinetic myocardium. Scintigraphy revealed reversibility in the myocardial infarction area in 4 patients from Group I (36.4%) and 11 (52.4%) patients from Group II. Improvement in perfusion after coronary artery bypass grafting was observed in 4 patients from Group I and 8 patients from Group II. Sensitivity, specificity, accuracy, and positive and negative predictive values of ST segment elevation were 33.3, 70.6, 55.2, 44.5 and 60% respectively. It was concluded that exercise-induced ST segment elevation after myocardial infarction is present more frequently in cases of severe regional myocardial dysfunction. (author)

  8. Evaluation of myocardial viability using sequential dual-isotope single photon emission tomography imaging with rest Tl-201/stress Tc-99m tetrofosmin in the prediction of wall motion recovery after revascularization

    International Nuclear Information System (INIS)

    In patients with coronary artery disease (CAD), differentiation between severely ischemic but potentially viable myocardium and irreversibly infarcted tissue is clinically important, particularly when revascularization procedures are considered. Although thallium (Tl) cardiac imaging has been shown to be a good tool for investigating myocardial viability in CAD, this tracer shows physical limitations, such as a low photon energy and long half-life. We assessed the results of a rest Tl-201/stress Tc-99m tetrofosmin protocol in subjects with prior anterior myocardial infarction. All of the patients had an akinetic or dyskinetic area and more than 75% stenosis in the left anterior descending artery. All of the patients underwent revascularization after the examination. We evaluated the improvement in wall motion after revascularization using the centerline method with contrast left ventricular angiography. Fourteen patients showed reversible defects with the rest Tl-201/stress Tc-99m tetrofosmin protocol or in additional Tl-201 24 h redistribution images. All 14 patients showed a significant improvement in wall motion after revascularization. Dual-isotope rest Tl-201/stress Tc-99m tetrofosmin single photon emission tomography data, acquired separately, may give fast and complete information about myocardial perfusion during stress and at rest, and on about myocardial viability. (author)

  9. 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 10000ha, 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)

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

    Directory of Open Access Journals (Sweden)

    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

  11. [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

  12. 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.

  13. Evaluation of left ventricular contractility in anterior old myocardial infarction using MRI

    International Nuclear Information System (INIS)

    Currently, interventional therapy is often performed for coronary artery disease. Therefore accurate diagnosis of myocardial viability is indispensable. One diagnostic method is measurement of systolic myocardial wall thickening. In the present study, we evaluated myocardial viability in terms of segmental wall thickening using MRI. We performed spin-echo MRI and cine MRI using the double oblique method in 20 patients with anterior old myocardial infarction to obtain the left ventricular long-axis view and four-chamber view. We found a good correlation (r=0.84) between the left ventricular long-axis view and four-chamber view. We found a good correlation (r=0.84) between the left ventricular ejection fraction and the mean percentage wall thickening. Wall thickening of the infarcted myocardium was classified into three patterns (hypokinesis, akinesis and dyskinesis). Akinetic segments were further divided into two classes: one where the wall was unchanged throughout systole and diastole, and the other where thickening was delayed after systole. The segments with delayed contraction showed accumulation of fluorine-18-labeled fluorodeoxyglucose (FDG) by positron emission tomography (PET) or normalized wall motion after PTCA. Therefore, we considered that the segment showing delayed contraction was visible, even if a constant defect was evident on the 201Tl scintigram. In conclusion, analysis of wall thickening using MRI is very useful for evaluating left ventricular contractility and viability. (author)

  14. 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

  15. An experimental animal model of chronic myocardial hibernation: comparative study of cine-MR, myocardial single photon emission computed tomography and pathology

    International Nuclear Information System (INIS)

    Objective: To establish the chronic low-flow myocardial hibernation animal model in pigs, and to assess the diagnostic value for myocardial hibernation by using various imaging methods. Methods: A total of 13 miniswine (30-40 kg) were used. All animals underwent general anesthesia and orotracheal intubation while the animals were mechanically ventilated. Under sterile conditions, left ventriculography and coronary angiography were performed by introduction of catheter into the right femoral artery. Further, a left anterolateral thoracotomy was performed in the third intercostal space. The proximal LCX was dissected free to allow placement of an ameroid constrictor. More than 1 month later, left ventriculography and coronary angiography were performed again, followed by cine-MRI at rest and during stress with low-dose of dobutamine (5μg·kg-1·min-1), respectively. 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. At the same time 99mTc-MIBI myocardial SPECT was performed at rest and during nitroglycerin administration, respectively. All animals were finally sacrificed for pathological examination. Triphenyl tetrazolium chloride (TTC) staining was used to assess the myocardial infarction. Electron microscopy was used to identify myocardial cellular changes characteristic of hibernating myocardium. Results: Three pigs died during surgery or within two weeks after surgery. One pig died of anesthesia during SPECT examination, 1 pig suffered from aneurysm, and another one pig showed negative findings. The other 7 pigs were found with hypokinetic (n=4) or akinetic (n=3) myocardial regions related to stenosed LCX (70%-99%). Resting cine-MRI demonstrated decreased regional motion of the lateral and posteroinferior walls (ischemic regions) of the left ventricle (n=7), compared with the nonischemic

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

    Directory of Open Access Journals (Sweden)

    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.

  17. The idiot's dreams: rêverie in child psychotherapy.

    Science.gov (United States)

    Arfelli, Patrizia

    2008-03-01

    When exploring the frontier of the "border" cases, that is treating severely damaged patients, either by organic pathologies or by severe physical traumas or even by catastrophic emotional events, the classical technique is often forsaken to pioneer new trails, and we may utilize intersubjective actions. Some of these actions may occur very directly and suddenly, only later revealing their meaning in the après coup; others, on the contrary, may be the result of a not always easy or painless choice; in either case, these actions can have a great therapeutic meaning. I ventured to follow one such trail, together with the child I am going to speak of in this paper: the little "idiot" (as he used to name himself). He was suffering from an extremely severe phonologic disorder, which allowed him to utter only inarticulate noises; yet, a rich and deep internal world peeped out in the sessions, a world imprisoned but not completely annihilated by mutism. For many months, I have been trying to lend my voice to this world, by agreeing to narrate "my own" dreams within the play that was taking place in the sessions: in other words, I have tried to make use of my rêverie and capacity of identification in order to express the awful anxieties connected with the child's impossibility to communicate and to be understood: that is, with his huge loneliness. This work of "translation" did not take place with interpretation dresses, but as a repeated narration of dreams and nightmares, apparently mine yet, actually, deeply belonging to him. In this way a first step has been taken towards the raise of trust and hope of being understood, an indispensable requirement for him to finally get-after many years of work-to express himself and to make himself understood. PMID:18301373

  18. 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

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

    International Nuclear Information System (INIS)

    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

  20. Two different motor systems are needed to generate human speech.

    Science.gov (United States)

    Holstege, Gert; Subramanian, Hari H

    2016-06-01

    Vocalizations such as mews and cries in cats or crying and laughter in humans are examples of expression of emotions. These vocalizations are generated by the emotional motor system, in which the mesencephalic periaqueductal gray (PAG) plays a central role, as demonstrated by the fact that lesions in the PAG lead to complete mutism in cats, monkeys, as well as in humans. The PAG receives strong projections from higher limbic regions and from the anterior cingulate, insula, and orbitofrontal cortical areas. In turn, the PAG has strong access to the caudal medullary nucleus retroambiguus (NRA). The NRA is the only cell group that has direct access to the motoneurons involved in vocalization, i.e., the motoneuronal cell groups innervating soft palate, pharynx, and larynx as well as diaphragm, intercostal, abdominal, and pelvic floor muscles. Together they determine the intraabdominal, intrathoracic, and subglottic pressure, control of which is necessary for generating vocalization. Only humans can speak, because, via the lateral component of the volitional or somatic motor system, they are able to modulate vocalization into words and sentences. For this modulation they use their motor cortex, which, via its corticobulbar fibers, has direct access to the motoneurons innervating the muscles of face, mouth, tongue, larynx, and pharynx. In conclusion, humans generate speech by activating two motor systems. They generate vocalization by activating the prefrontal-PAG-NRA-motoneuronal pathway, and, at the same time, they modulate this vocalization into words and sentences by activating the corticobulbar fibers to the face, mouth, tongue, larynx, and pharynx motoneurons. J. Comp. Neurol. 524:1558-1577, 2016. © 2015 Wiley Periodicals, Inc. PMID:26355872

  1. Twelve clinically significant points in medulloblastoma

    International Nuclear Information System (INIS)

    Though medulloblastoma is the most common malignant brain tumor during childhood, only 80 newly-diagnosed tumors develos every year, as the annual incidence is extremely rare with an occurrence of 0.5 per 100,000 children younger than 15-year-old and of 0.7 per 100,000 for the entire population. Images obtained of medulloblastoma are characterized by a round heterogeously-enhanced mass in or adjacent to the VIth ventricle. Objectives of surgical treatment are the maximum resectioning of the main mass and the relief of the obstructive hydrocephalus. Cerebellar mutism occurs a few days after one fourth of medulloblastoma surgery, and lasts approximately for 50 days followed by subsequent dysarthria. Pathological subtypes include classic medulloblastoma, desmoplastic/nodular medulloblastoma, medulloblastoma with extensive nodularity, large cell/anaplastic medulloblastoma, all corresponding to World Health Organization (WHO) grade IV. According to age, residual tumor size, and disseminated staging, patients are divided into average-risk group, high-risk group, or baby-medulloblastoma after surgery. Standard treatment in average-risk group includes 23.4-Gy cranio-spinal irradiation (CSI) with posterior boost followed by chemotherapy consisting of cisplatin (CDDP), alkylating agents, and vincristine. Patients in high-risk group receive over 36-Gy CSI with boost radiotherapy to nodular lesions before, concomitantly with, or followed by dose-intensity chemotherapy. In cases with gross total removal, or desmoplastic/nodular pathology radiotherapy for patients younger than 3-year-old are often delayed until they turn 3-year-old, and are able to survive for long time by appropriate chemotherapy alone. Adolescent survivors with childhood medulloblastoma have a number of late adverse effects regarding another neoplasm, neuro-cognitive function, endocrine activity, cardiovascular organs, and skeletal system. Comprehensive follow-up and support system are mandatory. (author)

  2. 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.

  3. Validation of a novel classification model of psychogenic nonepileptic seizures by video-EEG analysis and a machine learning approach.

    Science.gov (United States)

    Magaudda, Adriana; Laganà, Angela; Calamuneri, Alessandro; Brizzi, Teresa; Scalera, Cinzia; Beghi, Massimiliano; Cornaggia, Cesare Maria; Di Rosa, Gabriella

    2016-07-01

    The aim of this study was to validate a novel classification for the diagnosis of PNESs. Fifty-five PNES video-EEG recordings were retrospectively analyzed by four epileptologists and one psychiatrist in a blind manner and classified into four distinct groups: Hypermotor (H), Akinetic (A), Focal Motor (FM), and with Subjective Symptoms (SS). Eleven signs and symptoms, which are frequently found in PNESs, were chosen for statistical validation of our classification. An artificial neural network (ANN) analyzed PNES video recordings based on the signs and symptoms mentioned above. By comparing results produced by the ANN with classifications given by examiners, we were able to understand whether such classification was objective and generalizable. Through accordance metrics based on signs and symptoms (range: 0-100%), we found that most of the seizures belonging to class A showed a high degree of accordance (mean±SD=73%±5%); a similar pattern was found for class SS (80% slightly lower accordance was reported for class H (58%±18%)), with a minimum of 30% in some cases. Low agreement arose from the FM group. Seizures were univocally assigned to a given class in 83.6% of seizures. The ANN classified PNESs in the same way as visual examination in 86.7%. Agreement between ANN classification and visual classification reached 83.3% (SD=17.8%) accordance for class H, 100% (SD=22%) for class A, 83.3% (SD=21.2%) for class SS, and 50% (SD=19.52%) for class FM. This is the first study in which the validity of a new PNES classification was established and reached in two different ways. Video-EEG evaluation needs to be performed by an experienced clinician, but later on, it may be fed into ANN analysis, whose feedback will provide guidance for differential diagnosis. Our analysis, supported by the ML approach, showed that this model of classification could be objectively performed by video-EEG examination. PMID:27208925

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

    International Nuclear Information System (INIS)

    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. [123I]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. 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

  6. Identification by [99mTc]ECD SPECT of anterior cingulate hypoperfusion in progressive supranuclear palsy, in comparison with Parkinson's disease

    International Nuclear Information System (INIS)

    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. [99mTc]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 [99mTc]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 [99mTc]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.)

  7. Prevalence and clinical significance of residual myocardial ischemia 2 weeks after uncomplicated non-Q wave infarction: a prospective natural history study

    International Nuclear Information System (INIS)

    Despite having smaller infarct size and better left ventricular function, patients with non-Q wave myocardial infarction (NQMI) appear to have an unexpectedly high long-term mortality that is ultimately comparable to that of patients with Q-wave myocardial infarction (QMI). Patients with NQMI may lose their initial prognostic advantage because there is more viable tissue in the perfusion zone of the infarct-related vessel, rendering myocardium more prone to reinfarction. We tested this hypothesis in a prospective study of 241 consecutive patients 65 years of age or younger with acute uncomplicated myocardial infarction confirmed by creatine kinase levels (MB fraction). All patients received customary care and none underwent thrombolytic therapy or emergency angioplasty. Predischarge coronary angiography, radionuclide ventriculography, 24 hr Holter monitoring, and quantitative thallium-201 scintigraphy during treadmill exercise were performed 10 +/- 3 days after infarction. Infarcts were designated as QMI (n = 154) or NQMI (n = 87) by accepted criteria applied to serial electrocardiograms obtained on days 1, 2, 3, and 10. The baseline Norris coronary prognostic index, angiographic jeopardy scores, and prevalence of Lown grade ventricular arrhythmias were similar between groups despite evidence for less necrosis with NQMI vs QMI, reflected by lower peak creatine kinase levels (520 vs 1334 IU/liter; p = .0001, 4 hr sampling), higher resting left ventricular ejection fraction (53% vs 46%; p = .0001), fewer akinetic or dyskinetic segments (1.2 vs 2.4; p = .0001), and fewer persistent 201Tl defects in the infarct zone. Patients with NQMI also had more patent infarct-related vessels and a shorter time from onset of infarction to peak creatine kinase level

  8. 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)

  9. 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.

  10. 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.)

  11. Disease-specific longevity of impulse generators in deep brain stimulation and review of the literature.

    Science.gov (United States)

    van Riesen, Christoph; Tsironis, Georg; Gruber, Doreen; Klostermann, Fabian; Krause, Patricia; Schneider, Gerd Helge; Kupsch, Andreas

    2016-06-01

    Deep brain stimulation (DBS) represents an established and internationally approved therapy for movement disorders. In the present retrospective analysis, we evaluated disease-specific longevity of dual channel impulse generators (IPG) used in different movement disorders. We correlated the battery lifetime with electrical stimulation settings, "total electrical energy delivered" (TEED), stimulation modi (monopolar, double monopolar and bipolar) and targets. Specifically, we reviewed the longevity and stimulation settings of 464 IPGs implanted between 1996 until 2011 in a single university center. Disease entities comprised Parkinson's disease (PD, n = 257), dystonia (n = 130) and essential tremor (ET, n = 50). Further subanalyses aimed at assessing differential longevity in different subtypes of PD and dystonia. The main finding relates to longer IPG longevity in ET (thalamic DBS) and PD (subthalamic DBS) vs. dystonia (pallidal DBS; 71.9 ± 6.7 vs. 51.5 ± 2.3 vs. 37 ± 2 months). In PD the tremor-dominant type was associated with a significant shorter battery survival than in the akinetic-rigid type without tremor or the "balanced" type with tremor, bradykinesia and rigidity (38.8 ± 3.9 vs. 53.6 ± 3.4 vs. 58.8 ± 4.1 months), while there were no significant differences in longevity between the subtypes of dystonia. Frequency, amplitude, pulse widths and TEED correlated inversely with battery lifetime. Pallidal DBS in dystonia is associated with a shorter lifetime of IPGs than subthalamic or thalamic DBS for PD or ET. The present results may contribute to the rapidly evolving refinement of DBS devices. Future studies that assess energy consumption both in patients with and without IPG replacement could help to avoid potential underestimation of longevity of IPGs. PMID:27198700

  12. 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.

  13. 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.

  14. 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.

  15. 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.)

  16. [Event-related desynchronization and Parkinson disease. Importance in the analysis of the phase of preparation for movement].

    Science.gov (United States)

    Defebvre, L; Derambure, P; Bourriez, J L; Destée, A; Guieu, J D

    1999-02-01

    This study was aimed at determining the spatiotemporal distribution of event-related desynchronization (ERD) during self-paced voluntary movement in order to establish the interest of this method for the analysis of movement programming in Parkinson's disease. Desynchronization of mu rhythm was recorded 2 s before to 0.5 s after right then left self-paced voluntary wrist flexions from 11 leads covering the primary sensorimotor cortex (central), supplementary motor area (frontocentral) and parietal cortex (parietocentral). Recordings were obtained from ten control subjects, ten patients treated for Parkinson's disease (bilateral symptoms) and 20 patients presenting with right or left hemiparkinsonism before and after chronic administration of L-dopa. In the control group, ERD started over the contralateral primary sensorimotor cortex 1,750 ms before movement and was bilateral just before performance of the movement. In both treated and de novo Parkinson's disease groups, decrease in ERD latency (1,000 to 1,250 ms before movement) was only observed when movements were performed with the akinetic hand and corresponded to a decrease in motor cortical activity. This confirmed that programming of movement is affected in Parkinson's disease. Earlier ERD with central ipsilateral distribution were also observed, suggesting that other cortical areas might be activated to compensate for dysfunction of movement programming and to increase the level of cortical activity required for performance of the movement. The administration of L-dopa to de novo hemiparkinsonians patients resulted in increased ERD latency over contralateral and ipsilateral central areas. As in the treated Parkinson's disease group, frontocentral ERD could also be recorded. L-dopa would thus partially restore the affected motor programmation and modulate cortical activation in both supplementary motor area and primary motor cortex, the later receiving more afferences from basal ganglia. PMID:10093819

  17. 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

  18. 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

  19. Case series of eosinophilic meningoencephalitis from South India

    Directory of Open Access Journals (Sweden)

    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

  20. 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

  1. 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. 

  2. New Perspective on Parkinsonism in Frontotemporal Lobar Degeneration

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    Hee Kyung Park

    2013-04-01

    Full Text Available Frontotemporal dementia (FTD is the second most common type of presenile dementia. Three clinical prototypes have been defined; behavioral variant FTD, semantic dementia, and progressive nonfluent aphasia. Progressive supranuclear palsy, corticobasal degeneration, and motor neuron disease may possess clinical and pathological characteristics that overlap with FTD, and it is possible that they may all belong to the same clinicopathological spectrum. Frontotemporal lobar degeneration (FTLD is a clinicopathological syndrome that encompasses a heterogenous group of neurodegenerative disorders. Owing to the advancement in the field of molecular genetics, diagnostic imaging, and pathology, FTLD has been the focus of great interest. Nevertheless, parkinsonism in FTLD has received relatively less attention. Parkinsonism is found in approximately 20–30% of patients in FTLD. Furthermore, parkinsonism can be seen in all FTLD subtypes, and some patients with familial and sporadic FTLD can present with prominent parkinsonism. Therefore, there is a need to understand parkinsonism in FTLD in order to obtain a better understanding of the disease. With regard to the clinical characteristics, the akinetic rigid type of parkinsonism has predominantly been described. Parkinsonism is frequently observed in familial FTD, more specifically, in FTD with parkinsonism linked to chromosome 17q (FTDP-17. The genes associated with parkinsonism are microtubule associated protein tau (MAPT, progranulin (GRN or PGRN, and chromosome 9 open reading frame 72 (C9ORF72 repeat expansion. The neural substrate of parkinsonism remains to be unveiled. Dopamine transporter (DAT imaging revealed decreased uptake of DAT, and imaging findings indicated atrophic changes of the basal ganglia. Parkinsonism can be an important feature in FTLD and, therefore, increased attention is needed on the subject.

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

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    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

  4. 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

  5. Role of I-MIBG cardiac scintigraphy in diagnosing Parkinson's disease: a case study

    International Nuclear Information System (INIS)

    Full text: A 49-year-old male presented with a two year history of progressively worsening akinetic rigid syndrome. After a number of non-specific findings on PET, MRI and CT scans of the brain, a clinical diagnosis was made of Parkinson's disease, and treatment with Sinemet was commenced. The patient's symptoms, however, were not sufficiently relieved and a change in medication was considered. However, after much persistence from the patient and his family in seeking a number of neurological opinions, a 12J[-metaiodobenzylguanidine (MIBG) cardiac study was requested to attempt to confirm the diagnosis of Parkinson's disease. The patient's medication was ceased for seven days prior to the study, and the patient was pre-treated with IO ml of potassium iodide one hour prior to '231-MIBG administration, to protect the thyroid. 185MBq of '231MIBG was administered intravenously and planar and SPECT images of the chest were acquired at fifteen minutes and three hours post injection. A heart-to-mediastinum (H-to-M) ratio was calculated at both fifteen minutes and three hours post injection, to quantify the cardiac uptake of the tracer. The images demonstrated reduced uptake on the early images (H-to-M ratio of 0.75 [normal value - 1.52]) and further reduced uptake on the delayed images (H-to-M ratio of 0.68). This reduced cardiac uptake is associated with Parkinson's disease, and provided sufficient evidence to confirm the initial clinical suspicion. As a result, the patient's medication dosage is currently being reviewed, with more invasive therapies being considered.

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

    Science.gov (United States)

    Maurice, Nicolas; Deltheil, Thierry; Melon, Christophe; Degos, Bertrand; Mourre, Christiane; Amalric, Marianne; Kerkerian-Le Goff, Lydia

    2015-01-01

    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. PMID:26571268

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

    Science.gov (United States)

    Maurice, Nicolas; Deltheil, Thierry; Melon, Christophe; Degos, Bertrand; Mourre, Christiane

    2015-01-01

    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. PMID:26571268

  8. 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

    Directory of Open Access Journals (Sweden)

    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

  9. Neurological Effects of Acute Carbon Monoxide Poisoning in Children

    Directory of Open Access Journals (Sweden)

    Coskun YARAR

    2009-11-01

    Full Text Available Carbon monoxide poisoning (COP is one of the most common causes of mortality and morbidity due to poisoning in all over the world. Although the incidence of COP has not been known exactly in the childhood, almost one-third of CO exposures occurred in children. The data regarding COP in children are inconclusive. Children may be more vulnerable to CO exposure than adults as a result of their high respiration and metabolic rates, high oxygen metabolism, and immature central nervous system. Recent researches proposed new theories about neurological effects of CO toxicity. The clinical presentations associated acute COP may be various and nonspecific. Unrecognized CO exposure may lead to significant morbidity and mortality. CO exposed children often become symptomatic earlier, and recover more rapidly, than similarly CO exposed adults. Mild clinical signs and symptoms associated with COP are headache, dizziness, weakness, lethargy, and myalgia; however, severe signs and symptoms such as blurred vision, syncope, convulsion, coma, cardiopulmonary arrest and death can also accompany with COP. Neurologic manifestations can include altered mental status at different degrees, neck stiffness, tremor, ataxia, and positive Babinski's sign. Delayed neurologic sequels (DNS of COP might be seen in children like adults. DNS symptoms and signs in children include memory problems, mental retardation, mutism, fecal and urinary incontinence, motor deficits, facial palsy, psychosis, chronic headache, seizures, and epilepsy. After CO exposure children must be cared to detect and treat DNS. Although hyperbaric oxygen therapy (HBOT is reported to prevent development of DNS, its indications, application duration and procedures are controversial in both of the children and adults. Although their predictive values are limited, exposing to CO more than eight hours and suffering from CO-induced coma, cardiac arrest, lactic acidosis, high COHb levels, and pathologic findings

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  11. 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

  12. Ultrasound-mediated stimulation of microbubbles after acute myocardial infarction and reperfusion ameliorates left-ventricular remodelling in mice via improvement of borderzone vascularization.

    Directory of Open Access Journals (Sweden)

    Jonas Dörner

    Full Text Available AIMS: Post-infarction remodelling (PIR determines left-ventricular (LV function and prognosis after myocardial infarction. The aim of this study was to evaluate transthoracic ultrasound-mediated microbubble stimulation (UMS as a novel gene- and cell-free therapeutic option after acute myocardial infarction and reperfusion (AMI/R in mice. METHODS AND RESULTS: For myocardial delivery of UMS, a novel therapeutic ultrasound-system (TIPS, Philips Medical and commercially available microbubbles (BR1, Bracco Suisse SA were utilized in a closed-chest mouse model. UMS was performed as myocardial post-conditioning (PC on day four after 30 minutes of coronary occlusion and reperfusion. LV-morphology, as well as global and regional function were measured repeatedly with reconstructive 3-dimensional echocardiography applying an additional low-dose dobutamine protocol after two weeks. Scar size was quantified by means of histomorphometry. A total of 41 mice were investigated; 17 received PC with UMS. Mean ejection fraction (EF prior UMS was similar in both groups 53%±10 (w/o UMS and 53%±14 (UMS, p = 0.5, reflecting comparable myocardial mass at risk 17%±8 (w/o UMS, 16%±13 (UMS, p = 0.5. Two weeks after AMI/R, mice undergoing UMS demonstrated significantly better global LV-function (EF = 53%±7 as compared to the group without PC (EF = 39%±11, p<0.01. The fraction of akinetic myocardial mass was significantly lower among mice undergoing UMS after AMI/R [27%±10 (w/o UMS, 13%±8 (UMS, p<0.001]. Our experiments showed a fast onset of transient, UMS-induced upregulation of vascular-endothelial and insulin-like growth factor (VEGF-a, IGF-1, as well as caveolin-3 (Cav-3. The mice undergoing PC with UMS after AMI/R showed a significantly lower scar size. In addition, the microvascular density was significantly higher in the borderzone of UMS-treated animals. CONCLUSION: UMS following AMI/R ameliorates PIR in mice via up-regulation of VEGF-a, IGF

  13. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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. 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.

  18. 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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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

  20. Clinical value of gated 99Tcm-MIBI SPECT for assessment of left ventricular function in patients with left ventricular aneurysms

    International Nuclear Information System (INIS)

    Objective: To validate the accuracy of quantitative gated SPECT (QGS) in assessing EDV, ESV and LVEF in patients with left ventricular aneurysms (LVA), using MRI as a reference. Furthermore, the correlations between the number of segments with severe perfusion defects, size of LVA and the differences of left ventricular volumes and LVEF were explored.Methods Sixty-nine patients (62 males and 7 females; mean age, (56 ± 10) years) with LVA were examined using gated 99Tcm-MIBI SPECT (G-SPECT) (8 frames/cardiac cycle) at rest and MRI (25 frames/cardiac cycle) at (4 ± 3) d. All the data were retrospectively reviewed. EDV, ESV, LVEF and wall thickening (WT) scores were calculated using QGS. The size of LVA was defined by the number of akinetic or dyskinetic segments with WT =3, and the segments with severe perfusion defects (activity ≤ 30%) were analyzed using quantitative perfusion SPECT (QPS) with a 17-segment model. EDV, ESV and LVEF were obtained using the Simpson's rule from MR images. A paired t test, analysis of variance and χ2 test were used to analyze the data obtained from G-SPECT and MRI. Pearson correlation coefficients (r) and Bland-Altman analysis were applied to assess the strength of the agreement,and standard error of estimate (SEE) was calculated. Results: According to the number of segments with severe perfusion defects, patients were divided into Group 1 (≤ 2 segments, n =25), Group 2 (3-4 segments, n=16) and Group 3 (≥ 5 segments, n=28). Correlation was good for all parameters (r =0.83-0.95, all P<0.001) in all groups,except for LVEF in Group 3 (r=0.64, SEE =8%, P<0.001). Compared with MRI, EDV in Group 1 was underestimated by G-SPECT ((174±44) ml vs (161 ±43) ml, t=-2.60, P<0.05), while the other parameters in Groups 1 and 2 had no significant difference (Group 1, t=-1.63, -1.26 for ESV and LVEF; Group 2, t=-0.62, 0.48, -2.07 for EDV, ESV and LVEF, respectively, all P>0.05). In Group 3, EDV ((217 ± 68) ml vs (196±55) ml, t=2.99, P

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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

  3. 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

  4. Stem Cell Therapy for Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    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