Sample records for autonomic nerve tumour

  1. Malignant peripheral nerve sheath tumour of the bladder associated with neurofibromatosis I.

    LENUS (Irish Health Repository)

    O'Brien, Julie


    Neurofibromatosis is a hamartomatous disorder of autonomic peripheral nerve sheaths associated with peripheral nerve sheath tumours. Most tumours are neurofibromas; however, the genitourinary system is rarely involved. We present a rare case of a nerve sheath tumour of the bladder in a young patient, which was discovered to be malignant.

  2. Intraoral myxoid nerve sheath tumour

    NARCIS (Netherlands)

    Schortinghuis, J; Hille, JJ; Singh, S


    A case of an intraoral myxoid nerve sheath tumour of the dorsum of the tongue in a 73-year-old Caucasian male is reported. This case describes the oldest patient with this pathology to date. Immunoperoxidase staining for neuronspecific enolase (NSE) and epithelial membrane antigen (EMA) expression d

  3. Solitary fibrous tumour of the vagus nerve. (United States)

    Scholsem, Martin; Scholtes, Felix


    We describe the complete removal of a foramen magnum solitary fibrous tumour in a 36-year-old woman. It originated on a caudal vagus nerve rootlet, classically described as the 'cranial' accessory nerve root. This ninth case of immunohistologically confirmed cranial or spinal nerve SFT is the first of the vagus nerve.

  4. Cardiac autonomic nerve distribution and arrhythmia

    Institute of Scientific and Technical Information of China (English)

    Quan Liu; Dongmei Chen; Yonggang Wang; Xin Zhao; Yang Zheng


    OBJECTIVE: To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia.DATA RETRIEVAL: A computer-based retrieval was performed for papers examining the distribution of cardiac autonomic nerves, using "heart, autonomic nerve, sympathetic nerve, vagus nerve, nerve distribution, rhythm and atrial fibrillation" as the key words.SELECTION CRITERIA: A total of 165 studies examining the distribution of cardiac autonomic nerve were screened, and 46 of them were eventually included.MAIN OUTCOME MEASURES: The distribution and characteristics of cardiac autonomic nerves were observed, and immunohistochemical staining was applied to determine the levels of tyrosine hydroxylase and acetylcholine transferase (main markers of cardiac autonomic nerve distribution). In addition, the correlation between cardiac autonomic nerve distribution and cardiac arrhythmia was investigated.RESULTS: Cardiac autonomic nerves were reported to exhibit a disordered distribution in different sites, mainly at the surface of the cardiac atrium and pulmonary vein, forming a ganglia plexus. The distribution of the pulmonary vein autonomic nerve was prominent at the proximal end rather than the distal end, at the upper left rather than the lower right, at the epicardial membrane rather than the endocardial membrane, at the left atrium rather than the right atrium, and at the posterior wall rather than the anterior wall. The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution, and the distribution density of autonomic nerves was determined using a computer-aided morphometric analysis system.CONCLUSION: The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the

  5. A rare case of malignant peripheral nerve sheath tumour

    Directory of Open Access Journals (Sweden)

    Anita Harry, Nirankumar Samuel, Vigil TD


    Full Text Available Malignant Peripheral Nerve Sheath Tumours are tumours of ectomesenchymal origin often originating from major nerves or their nerve sheaths, they are commonly found in patients with neurofibromatosis-1 though sporadic cases have been reported. We report a rare sporadic case of MPNST in a 20 year old patient arising from the spinal accessory nerve.

  6. Malignant peripheral nerve sheath tumour of penis. (United States)

    Kaur, J; Madan, R; Singh, L; Sharma, D N; Julka, P K; Rath, G K; Roy, S


    Malignant peripheral nerve sheath tumour (MPNST) is a rare variety of soft tissue sarcoma that originates from Schwann cells or pluripotent cells of neural crest origin. They have historically been difficult tumours to diagnose and treat. Surgery is the mainstay of treatment with a goal to achieve negative margins. Despite aggressive surgery and adjuvant therapy, the prognosis of patients with MPNST remains poor. MPNST arising from penis is a very rare entity; thus, it presents a diagnostic and therapeutic challenge. We present a case of penile MPNST in a 38-year-old man in the absence of neurofibromatosis treated with surgery followed by post-operative radiotherapy to a dose of 60 Gray in 30 fractions and adjuvant chemotherapy with ifosfamide and adriamycin.

  7. Acute GI bleeding by multiple jejunal gastrointestinal autonomic nerve tumour associated with neurofibromatosis type I Urgencia quirúrgica por sangrado intestinal debido a tumor intestinal de nervios autónomos asociados a neurofibromatosis tipo I

    Directory of Open Access Journals (Sweden)

    M. Keese


    Full Text Available We describe a surgical emergency due to GI-bleeding caused by gastrointestinal autonomic nerve tumours (GANT's in a patient with von Recklinghausen's disease. A 72 year old female patient with von Recklinghausen's disease was admitted with maelena. Endoscopy showed no active bleeding in the stomach and the colon. Therefore an angio-CT-scan was performed which revealed masses of the proximal jejunum as source of bleeding. Laparotomy was indicated and a 20 cm segment of jejunum which carried multiple extraluminal tumours was resected. The source of the bleeding was a 2 cm tumour which had eroded the mucosal surface. Immunohistologically, evidence of neuronal differentiation could be shown in the spindle-formed cells with positive staining for C-Kit (CD 117, CD 34, and a locally positive staining for synaptophysine and S100. This case report illustrates the association between neurofibromatosis and stromal tumours and should alert surgeons and gastroenterologist about gastrointestinal manifestations in patients with von Recklinghausen's disease.Se describe una urgencia quirúrgica por sangrado intestinal debido a tumor gastrointestinal de nervios autónomos (GANT asociado a enfermedad de von Recklinghausen. Una mujer de 72 años con neurofibromatosis fue ingresada con signos de melena. La endoscopia digestiva alta y baja fue negativa. Se indicó TAC con contraste que advirtió tumores yeyunales como causa del sangrado. Se realizó laparotomía y resección de un segmento de 20 cm de yeyuno que incluía varios tumores. La causa del sangrado activo fue lesión en mucosa intestinal por erosión tumoral. El análisis por inmunohistoquímica de la pieza mostró diferenciación neuronal, con células fusiformes con tinción positiva para el C-Kit (CD 117, CD 34. Esta nota clínica pone de manifiesto la asociación entre la neurofibromatosis y los tumores estromales y debe alertar a gastroenterólogos y cirujanos sobre las posibles manifestaciones

  8. Malignant Peripheral Nerve Sheath Tumour of the Maxilla

    Directory of Open Access Journals (Sweden)

    Puja Sahai


    Full Text Available A 38-year-old man was diagnosed with malignant peripheral nerve sheath tumour of the maxilla. He was treated with total maxillectomy. Histopathological examination of the resected specimen revealed a close resection margin. The tumour was of high grade with an MIB-1 labelling index of almost 60%. At six weeks following the surgery, he developed local tumour relapse. The patient succumbed to the disease at five months from the time of diagnosis. The present report underlines the locally aggressive nature of malignant peripheral nerve sheath tumour of the maxilla which necessitates an early therapeutic intervention. A complete resection with clear margins is the most important prognostic factor for malignant peripheral nerve sheath tumour in the head and neck region. Adjuvant radiotherapy may be considered to improve the local control. Future research may demarcate the role of targeted therapy for patients with malignant peripheral nerve sheath tumour.

  9. Morphologic Changes in Autonomic Nerves in Diabetic Autonomic Neuropathy

    Directory of Open Access Journals (Sweden)

    Heung Yong Jin


    Full Text Available Diabetic neuropathy is one of the major complications of diabetes, and it increases morbidity and mortality in patients with both type 1 diabetes mellitus (T1DM and type 2 diabetes mellitus (T2DM. Because the autonomic nervous system, for example, parasympathetic axons, has a diffuse and wide distribution, we do not know the morphological changes that occur in autonomic neural control and their exact mechanisms in diabetic patients with diabetic autonomic neuropathy (DAN. Although the prevalence of sympathetic and parasympathetic neuropathy is similar in T1DM versus T2DM patients, sympathetic nerve function correlates with parasympathetic neuropathy only in T1DM patients. The explanation for these discrepancies might be that parasympathetic nerve function was more severely affected among T2DM patients. As parasympathetic nerve damage seems to be more advanced than sympathetic nerve damage, it might be that parasympathetic neuropathy precedes sympathetic neuropathy in T2DM, which was Ewing's concept. This could be explained by the intrinsic morphologic difference. Therefore, the morphological changes in the sympathetic and parasympathetic nerves of involved organs in T1DM and T2DM patients who have DAN should be evaluated. In this review, evaluation methods for morphological changes in the epidermal nerves of skin, and the intrinsic nerves of the stomach will be discussed.

  10. Thoracic malignant peripheral nerve sheath tumour mimicking a pleural tumour: a rare pedunculated appearance

    Energy Technology Data Exchange (ETDEWEB)

    Komori, Masahiro [Department of Radiology, National Kyushu Cancer Centre, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395 (Japan); Department of Radiology, Munakata Medical Association Hospital, 1201-1 Taguma, Munakata 811-3431 (Japan); Yabuuchi, Hidetake; Kuroiwa, Toshiro [Department of Radiology, National Kyushu Cancer Centre, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395 (Japan); Nagatoshi, Yoshihisa [Department of Paediatrics, National Kyushu Cancer Centre, Fukuoka (Japan); Ichinose, Yukito [Department of Thoracic Surgery, National Kyushu Cancer Centre, Fukuoka (Japan); Hachitanda, Yoichi [Department of Pathology, National Kyushu Cancer Centre, Fukuoka (Japan)


    A malignant peripheral nerve sheath tumour (MPNST) generally occurs in adults and often in patients with neurofibromatosis-1 (NF-1). We present a rare case of a huge thoracic MPNST arising from the intercostal nerve in a 12-year-old girl without NF-1. In addition to the unusual occurrence in a child without NF-1, MRI demonstrated a unique pedunculated appearance mimicking a pleural tumour. In this report, we present the CT and MRI findings of our case, together with the histopathological findings, and review previous reports. (orig.)

  11. MRI of intraspinal nerve sheath tumours presenting with sciatica

    Energy Technology Data Exchange (ETDEWEB)

    Loke, T.K.L.; Chan, C.S. [United Christian Hospital (Hong Kong). Dept. of Diagnostic Radiology; Ma, H.T.G. [St Teresa`s Hospital, Kowloon (Hong Kong). MRI and CT scanning Dept.; Ward, S.C.; Metreweli, C. [Prince of wales Hospital, New Territories (Hong Kong). Dept. of Diagnostic Radiology


    The magnetic resonance imaging (MRI) characteristics of 14 intraspinal nerve sheath tumours (NST) presenting with sciatica were reviewed. The group comprised seven schwannomas, six neurofibromas and one perineuroma. The tumours were either iso- or hypointense with respect to spinal cord on T1-weighted (T1W) images; almost all tumours were hyperintense compared with spinal cord on T2-weighted (T2W) images. The tumours were all detectable on unenhanced T1 W images. Nine NST were scanned following Gadolinium-Diethylenetriamine penta acetic acid (DTPA) injection and all showed intense enhancement. This aids differentiation from sequestrated disc fragments. Tumours were more likely to show homogeneous enhancement unless they were recurrent tumours. Rim enhancement occurs more commonly in schwannomas and this can be used to differentiate these from neurofibromas. It is estimated that on unenhanced images, schwannomas cannot be distinguished from neurofibromas. Four tumours occurred at T1 1-T12. There was poor correlation of the site of the lesion with the clinical findings. It is recommended that the MRI studies in patients with sciatica should include the lower thoracic region especially if no protruded disc was found in the lumbar region. 15 refs., 4 figs.

  12. Feline cutaneous nerve sheath tumours: histological features and immunohistochemical evaluations. (United States)

    Mandara, M T; Fabriani, E; Pavone, S; Pumarola, M


    Feline cutaneous nerve sheath tumours (CNSTs) are uncommonly reported in the skin, since they are underestimated relative to the more common spindle cell tumours of soft tissue. In this study, 26 nerve sheath tumours selected from 337 skin neoplasms of cats were examined. Histologically, they were classified into malignant (MPNSTs) and benign tumours (BPNSTs) based on degree of cellular atypia and polymorphism as well as mitotic rate and diffuse necrosis. CPNSTs were tipically characterised by Antoni A pattern, in some cases associated with Antoni B pattern. In the malignant peripheral nerve sheath tumours (MPNSTs) the polymorphism was marked, while it was mild to moderate in the benign forms (BPNSTs). In the MPNSTs the mitotic activity was generally higher than in the BPNSTs. In five cases, including three MPNSTs and two BPNSTs, there were multinucleated giant cells. Necrotic foci occurred in a BPNST and in two MPNSTs, while osseous/chondroid metaplasia was found in two cases. Immunohistochemically, all the tumours showed a marked diffuse vimentin expression. S-100 protein was expressed in 17 cases, including 81.8% of BPNSTs and 57.14% of MPNSTs. Twenty-five tumours expressed NSE and twenty-four cases showed immunoreaction for laminin. Thirteen tumours were positive for GFAP, while five tumours were positive for SMA. PGP 9.5 expression was detected in all cases, except for two MPNSTs. NGFR was expressed in eleven cases, including four MPNSTs and seven BPNSTs. Ki67 was expressed in twenty tumours without any relationship with morphologic malignancy of the neoplasm. In this case series we confirmed neoplastic spindloid cells with wavy cytoplasm arranged in compact areas, with occasional nuclear palisading or whirls, and interchanged with loosely arranged areas, as the morphological features supporting a diagnosis of CPNST. A constant concurrent expression of vimentin, NSE, and laminin might confirm the diagnosis of PNST in the absence of clear S-100 protein

  13. Cardiac Autonomic Nerve Stimulation in the Treatment of Heart Failure


    Kobayashi, Mariko; Massiello, Alex; Karimov, Jamshid H.; Van Wagoner, David R.; Fukamachi, Kiyotaka


    Research on the therapeutic modulation of cardiac autonomic tone by electrical stimulation has yielded encouraging early clinical results. Vagus nerve stimulation has reduced the rates of morbidity and sudden death from heart failure, but therapeutic vagus nerve stimulation is limited by side effects of hypotension and bradycardia. Sympathetic nerve stimulation that has been implemented in the experiment may exacerbate the sympathetic-dominated autonomic imbalance. In contrast, concurrent sti...

  14. Malignant peripheral nerve sheath tumour: An elusive diagnosis

    Directory of Open Access Journals (Sweden)

    Patil Karthikeya


    Full Text Available Malignant peripheral nerve sheath tumour (MPNST also termed as spindle cell malignancy of the peripheral nerve Schwann cells or neurogenic sarcoma, represents approximately 10% of all soft tissue sarcomas. This tumour is usually found in the lower extremities and only 10-12% of all lesions occur in the head and neck region, which makes it a rare entity. The diagnosis of MPNST has been described as one of the most difficult and elusive diagnosis in the soft tissue diseases because of its non-specific presentation both clinically and histopathologically. This was overcome by the use of immunohistochemistry. A case of MPNST of the left maxillary antrum in a 45 -year -old male patient is reported.

  15. Magnetic resonance imaging of peripheral nerve tumours in the upper extremity

    DEFF Research Database (Denmark)

    Nilsson, Jessica; Sandberg, Kristina; Søe Nielsen, Niels;


    extremity. Medical records of 19 patients (20 MRI examinations) with 29 histopathologically verified benign nerve tumours were examined retrospectively. In 12/20 cases MRI suggested a correct diagnosis of the type of nerve tumour. An additional 3/20 cases had an uncertain diagnosis, but nerve relations...

  16. Malignant Peripheral Nerve Sheath Tumour: CT and MRI Findings

    Directory of Open Access Journals (Sweden)

    Massimiliano Sperandio


    Full Text Available Malignant peripheral nerve sheath tumour (MPNST is extremely rare malignancy in the general population, occurring more frequently in patients with Neurofibromatosis type 1 (NF1. In the literature five cases of MPNST arising from the parapharyngeal space (PPS in patients without neurofibromatosis have been reported. We report imaging techniques in a patient with MPNST in the PPS, who had neither a family history nor sign of NF1. Computed tomography (CT scan and magnetic resonance imaging (MRI were performed for a correct therapeutic planning. CT and MRI findings were correlated with hystopathological diagnosis.

  17. Malignant peripheral nerve cell sheath tumour of the upper lip: a rare case

    Directory of Open Access Journals (Sweden)

    Joseph Ward


    Full Text Available We present the case of a malignant peripheral nerve sheath tumour (MPNST that developed on the upper lip of an 86 year old woman. MPNSTs are highly aggressive sarcomas that very rarely occur in the face. We know of no other reported cases of a malignant peripheral nerve sheath tumour arising from the upper lip.

  18. Excellent response of malignant peripheral nerve sheath tumour of retroperitoneum to radiation therapy (United States)

    Akhavan, Ali; Binesh, Fariba; Ghannadi, Fazlollah; Navabii, Hossein


    Malignant peripheral nerve sheath tumours are high-grade sarcomas originating from Schwann cells or nerve sheath cells. Most of these tumours are associated with major nerves of the body wall and extremities. The lower extremity and the retroperitoneum are the most common sites. Surgery is the cornerstone of treatment, however, radiation therapy is usually used as an adjuvant treatment. In this paper we present a 57-year-old Iranian woman with malignant peripheral nerve sheath tumour of retroperitoneum who was operated subtotally and then underwent radiation therapy which led to disappearance of all gross residual disease. PMID:23257269

  19. Sciatica due to malignant nerve sheath tumour of sciatic nerve in the thigh.

    Directory of Open Access Journals (Sweden)

    Sharma R


    Full Text Available Malignant peripheral nerve sheath tumour (MPNST is a rare malignant neoplasm arising from the supportive non-neural component of the peripheral nerves. An unusual case of pain and weakness of the foot and calf muscles due to a giant MPNST of the sciatic nerve in the posterior compartment of the thigh is presented. The patient was already investigated as a case of sciatica due to a lumbar disc disease with a negative magnetic resonance imaging and then unsuccessfully operated elsewhere twice, with a misdiagnosis of tarsal tunnel syndrome. Neurosurgical referral prompted a diagnostic magnetic resonance study of the thigh, revealing the lesion, which was completely excised microsurgically with total relief in the pain and partial improvement in the weakness and sensations in the sole of the foot.

  20. Impaired Pten expression in human malignant peripheral nerve sheath tumours.

    Directory of Open Access Journals (Sweden)

    Maren Bradtmöller

    Full Text Available Malignant peripheral nerve sheath tumours (MPNST are aggressive sarcomas that develop in about 10% of patients with the genetic disease neurofibromatosis type 1 (NF1. Molecular alterations contributing to MPNST formation have only partially been resolved. Here we examined the role of Pten, a key regulator of the Pi3k/Akt/mTOR pathway, in human MPNST and benign neurofibromas. Immunohistochemistry showed that Pten expression was significantly lower in MPNST (n=16 than in neurofibromas (n=16 and normal nervous tissue. To elucidate potential mechanisms for Pten down-regulation or Akt/mTOR activation in MPNST we performed further experiments. Mutation analysis revealed absence of somatic mutations in PTEN (n=31 and PIK3CA (n=38. However, we found frequent PTEN promotor methylation in primary MPNST (11/26 and MPNST cell lines (7/8 but not in benign nerve sheath tumours. PTEN methylation was significantly associated with early metastasis. Moreover, we detected an inverse correlation of Pten-regulating miR-21 and Pten protein levels in MPNST cell lines. The examination of NF1-/- and NF1+/+Schwann cells and fibroblasts showed that Pten expression is not regulated by NF1. To determine the significance of Pten status for treatment with the mTOR inhibitor rapamycin we treated 5 MPNST cell lines with rapamycin. All cell lines were sensitive to rapamycin without a significant correlation to Pten levels. When rapamycin was combined with simvastatin a synergistic anti-proliferative effect was achieved. Taken together we show frequent loss/reduction of Pten expression in MPNST and provide evidence for the involvement of multiple Pten regulating mechanisms.

  1. Malignant peripheral nerve sheath tumours in inherited disease

    Directory of Open Access Journals (Sweden)

    Evans D


    Full Text Available Abstract Background Malignant peripheral nerve sheath tumours (MPNST are rare tumours known to occur at high frequency in neurofibromatosis 1 (NF1, but may also occur in other cancer prone syndromes. Methods The North West Regional Genetic Register covers a population of 4.1 million and was interrogated for incidence of MPNST in 12 cancer prone syndromes. Age, incidence and survival curves were generated for NF1. Results Fifty two of 1254 NF1 patients developed MPNST, with MPNST also occurring in 2/181 cases of schwannomatosis and 2/895 NF2 patients. Three cases were also noted in TP53 mutation carriers. However, there were no cases amongst 5727BRCA1/2 carriers and first degree relatives, 2029 members from Lynch syndrome families, nor amongst 447 Familial Adenomatous Polyposis, 202 Gorlin syndrome, nor 87 vHL cases. Conclusion MPNST is associated with schwannomatosis and TP53 mutations and is confirmed at high frequency in NF1. It appears to be only increased in NF2 amongst those that have been irradiated. The lifetime risk of MPNST in NF1 is between 9–13%.

  2. Autonomic and sensory nerve dysfunction in primary biliary cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Katalin Keresztes; Ildikó Istenes; Aniko Folhoffer; Peter L Lakatos; Andrea Horvath; Timea Csak; Peter Varga; Peter Kempler; Ferenc Szalay


    AIM: Cardiovascular autonomic and peripheral sensory neuropathy is a known complication of chronic alcoholic and non-alcoholic liver diseases. We aimed to assess the prevalence and risk factors for peripheral sensory nerve and autonomic dysfunction using sensitive methods in patients with primary biliary cirrhosis (PBC).METHODS: Twenty-four AMA M2 positive female patients with clinical, biochemical and histological evidence of PBC and 20 age matched healthy female subjects were studied.Five standard cardiovascular reflex tests and 24-h heart rate variability (HRV) analysis were performed to define autonomic function. Peripheral sensory nerve function on median and peroneal nerves was characterized by current perception threshold (CPT), measured by a neuroselective diagnostic stimulator (Neurotron, Baltimore, MD).RESULTS: Fourteen of 24 patients (58%) had at least one abnormal cardiovascular reflex test and thirteen (54%)had peripheral sensory neuropathy. Lower heart rate response to deep breathing (P = 0.001), standing (P = 0.03)and Valsalva manoeuvre (P = 0.01), and more profound decrease of blood pressure after standing (P = 0.03) was found in PBC patients than in controls. As a novel finding we proved that both time domain and frequency domain parameters of 24-h HRV were significantly reduced in PBC patients compared to controls. Each patient had at least one abnormal parameter of HRV. Lower CPT values indicated hyperaesthesia as a characteristic feature at peroneal nerve testing at three frequencies (2000 Hz: P = 0.005;250 Hz: P = 0.002; 5 Hz: P = 0.004) in PBC compared to controls. Correlation of autonomic dysfunction with the severity and duration of the disease was observed. Lower total power of HRV correlated with lower CPT values at median nerve testing at 250 Hz (P = 0.0001) and at 5 Hz (P = 0.002), as well as with those at peroneal nerve testing at 2000 Hz (P = 0.01).CONCLUSION: Autonomic and sensory nerve dysfunctions are frequent in PBC. Twenty

  3. Non-cell-autonomous driving of tumour growth supports sub-clonal heterogeneity. (United States)

    Marusyk, Andriy; Tabassum, Doris P; Altrock, Philipp M; Almendro, Vanessa; Michor, Franziska; Polyak, Kornelia


    Cancers arise through a process of somatic evolution that can result in substantial sub-clonal heterogeneity within tumours. The mechanisms responsible for the coexistence of distinct sub-clones and the biological consequences of this coexistence remain poorly understood. Here we used a mouse xenograft model to investigate the impact of sub-clonal heterogeneity on tumour phenotypes and the competitive expansion of individual clones. We found that tumour growth can be driven by a minor cell subpopulation, which enhances the proliferation of all cells within a tumour by overcoming environmental constraints and yet can be outcompeted by faster proliferating competitors, resulting in tumour collapse. We developed a mathematical modelling framework to identify the rules underlying the generation of intra-tumour clonal heterogeneity. We found that non-cell-autonomous driving of tumour growth, together with clonal interference, stabilizes sub-clonal heterogeneity, thereby enabling inter-clonal interactions that can lead to new phenotypic traits.

  4. Plexiform malignant peripheral nerve sheath tumour of infancy and childhood of the index finger : Surgical treatment

    NARCIS (Netherlands)

    Meek, Marcel F.; Wolf, Rinze; Coert, J. Henk; Hoekstra, Harald J.; Nicolai, Jean-Philippe A.


    We describe a rare case of plexiform malignant peripheral nerve sheath tumour (MPNST) of infancy and childhood in a 3.5-year-old girl. The tumour was located in the proximal phalanx of the left index finger. After initial excisions and a ray amputation, exarticulation of the third and fourth rays wa

  5. Accuracy and complications of CT-guided core needle biopsy of peripheral nerve sheath tumours

    Energy Technology Data Exchange (ETDEWEB)

    Pianta, Marcus; Chock, Eric; Schlicht, Stephen [St Vincent' s Hospital, Fitzroy, VIC (Australia); McCombe, David [St Vincent' s Hospital and Victorian Hand Surgery Associates, Victoria (Australia)


    This single-centre study retrospectively reviews the complications in patients that have occurred following peripheral nerve sheath tumour biopsy, and assesses whether there is an association with biopsy technique or underlying lesion characteristics. 41 consecutive core needle biopsies of proven peripheral nerve sheath tumours over a 2-year period in a tertiary teaching hospital were reviewed. Patient demographics and symptoms, tumour characteristics and radiological appearances were recorded. Biopsy and surgical histology were correlated, and post-biopsy and surgical complications analyzed. 41 biopsies were performed in 38 patients. 68 % schwannomas, 24 % neurofibromas and 7 % malignant peripheral nerve sheath tumours. Biopsy histology correlated with surgery in all cases. 71 % of lesions were surgically excised. 60 % of patients reported pain related to their lesion. Following the biopsy, 12 % reported increased pain, which resolved in all cases. Pain exacerbation was noted in tumours smaller in size, more superficial and in closer proximity of the biopsy needle tip to the traversing nerve. Number of biopsy needle passes was not associated with an increased incidence of procedure-related pain. Core biopsy of a suspected peripheral nerve sheath tumour may be performed safely before excisional surgery to confirm lesion histology and assist prognosis. There is excellent correlation between core biopsy and excised surgical specimen histology. The most common complication of pain exacerbation is seen in a minority and is temporary, and more likely with smaller, more superficial lesions and a closer needle-tip to traversing nerve distance during biopsy. (orig.)

  6. Gastrointestinal autonomic nerve tumors:A surgical point of view

    Institute of Scientific and Technical Information of China (English)

    Anton Stift; Josef Friedl; Michael Gnant; Friedrich Herbst; Raimund Jakesz; Etienne Wenzl


    AIM: Gastrointestinal autonomic nerve tumors are uncommon stromal tumors of the intestinal tract. Their histological appearance is similar to that of other gastrointestinal stromal tumors. We report two cases and performed an analysis of the literature by comparing our findings with the available case reports in the medical literature.METHODS: Two patients were admitted with abdominal tumor masses. One occurred in the stomach with large multiple liver metastases and the second originated in Meckel's diverticulum. The latter site has never been reported previously. Both patients underwent surgery. In one patient gastrectomy, right liver resection and colon transversum resection were performed to achieve aggressive tumor debulking. In the other patient the tumor bearing diverticulum was removed.RESULTS: Postoperative recovery of both patients was uneventful. Histological examination, immunohistochemical analysis and electron microscopy revealed the diagnosis of a gastrointestinal autonomic nerve tumor. The patient with the tumor in Meckel's diverticulum died 6 mo after surgery because of pneumonia. The patient with liver metastases have been alive 13 years after initial tumor diagnosis and 7 years after surgery with no evidence of tumor progression. In light of our results, we performed a thorough comparison with available literature reports.CONCLUSION: Radical surgical resection of gastrointestinal autonomic nerve tumors seems to be the only available curative approach to date, and long term survival is possible even in large metastasized tumors.ACKNOWLEDGMENTWe thank Christine Brostjan, PhD for critical review of the manuscript.


    Directory of Open Access Journals (Sweden)

    Sampath Kumar


    Full Text Available Malignant nerve sheath tumours [syn : Neurogenic sarcoma , Neuro fibro sarcoma] comprise approximately 5% of all soft tissue sarcomas. Only 8to15% of these tumours arises in Head and neck region. Commonest sites in head and neck region a re lateral skull base or along the course of cranial nerves. These tumours in sino nasal region are extreme rare. In this article we report a rare case of low grade MPNST. The tumour was resected by medial maxillectomy via modified Denker extended maxillar y anterior antrostomy , resected tumour Histopathological examination and immunohistochemistry study reported as low grade MPNST and negative for s - 100 protein. Patient was relieved from symptoms and followed for 18 months.

  8. Atypical inguinal malignant peripheral nerve sheath tumour with arteriovenous fistula of the left femoral nerve in a child

    Energy Technology Data Exchange (ETDEWEB)

    Melloni, Pietro; Veintemillas, Maite [Corporacio Sanitaria Parc Tauli, Unitat de Diagnostic per Imatge d' Alta Tecnologia, Barcelona (Spain); Olsina, Gustavo; Oliva, Eulalia; Garcia-Continente, Gemma [Capio Hospital General de Catalunya, Servei de Diagnostic per la Imatge, Barcelona (Spain); Garcia-Hernandez, Felip [Capio Hospital General de Catalunya, Servei de Anatomia Patalogica, Barcelona (Spain)


    We report a 9-year-old girl who developed a malignant peripheral nerve sheath tumour (MPNST) with an arteriovenous fistula arising from the left femoral nerve and adjacent to the iliofemoral vessels in the ipsilateral groin, but without infiltrating them. We describe the MRI and MRA findings. Although MPNST is relatively well known and widely studied, the location of this mass is unique in a child. The mass was surgically removed. (orig.)

  9. Facial nerve damage in the treatment of tumours of the parotid gland

    Energy Technology Data Exchange (ETDEWEB)

    Rampling, R.; Catterall, M. (Hammersmith Hospital, London (UK). M.R.C. Cyclotron Unit)


    The treatment of malignant parotid gland tumours by either surgery or X-radiotherapy alone results in unacceptably high rates of local recurrence. This has led to a combined management, with radiation given either before or after surgery. In the best series this gives an 85% control rate but with severence of the facial nerve in a high proportion of cases. Fast neutron therapy was given for much more advanced tumours and gave the same control rate. Where the facial nerve had been damaged by the tumour, paralysis was lessened substantially in four of nine cases. However neutrons were the apparent course of damage to the nerve in three cases. Two of these had previously received surgery and X-ray therapy.

  10. An atypical peripheral nerve sheath tumour with pseudoglandular architecture in a dog. (United States)

    Volmer, Christelle; Caplier, Laura; Reyes-Gomez, Edouard; Huet, Hélène; Owen, Roger A; Fontaine, Jean-Jacques


    This case describes a subcutaneous soft tissue tumour in a German Shepherd dog. Histologically, the lesion was characterized by proliferating ovoid cells, loosely arranged in a collagenous to myxoid stroma, and by numerous pseudoglandular structures lined by neoplastic cells. Immunohistochemically, neoplastic cells were labelled with vimentin, glial fibrillary acidic protein and S100 antibodies, but not with cytokeratin, desmin and smooth muscle actin antibodies. Ultrastructurally, neoplastic cells were characterized by numerous mitochondria surrounded by endoplasmic reticulum and contained few secondary lysosomes. This tumour was diagnosed as a subcutaneous peripheral nerve sheath tumour (PNST) with pseudoglandular architecture. This case illustrates the morphological diversity of PNST and provides new insight into the differential diagnosis of cutaneous tumours of similar morphology in the dog.

  11. TRPM8 mechanism of autonomic nerve response to cold in respiratory airway

    Directory of Open Access Journals (Sweden)

    Wang Cong-Yi


    Full Text Available Abstract Breathing cold air without proper temperature exchange can induce strong respiratory autonomic responses including cough, airway constriction and mucosal secretion, and can exacerbate existing asthma conditions and even directly trigger an asthma attack. Vagal afferent fiber is thought to be involved in the cold-induced respiratory responses through autonomic nerve reflex. However, molecular mechanisms by which vagal afferent fibers are excited by cold remain unknown. Using retrograde labeling, immunostaining, calcium imaging, and electrophysiological recordings, here we show that a subpopulation of airway vagal afferent nerves express TRPM8 receptors and that activation of TRPM8 receptors by cold excites these airway autonomic nerves. Thus activation of TRPM8 receptors may provoke autonomic nerve reflex to increase airway resistance. This putative autonomic response may be associated with cold-induced exacerbation of asthma and other pulmonary disorders, making TRPM8 receptors a possible target for prevention of cold-associated respiratory disorders.

  12. Effects of pigment epithelium derived factor (PEDF) on malignant peripheral nerve sheath tumours (MPNSTs). (United States)

    Demestre, Maria; Terzi, Menderes Yusuf; Mautner, Victor; Vajkoczy, Peter; Kurtz, Andreas; Piña, Ana Luisa


    Neurofibromatosis type 1 (NF1) is an inherited genetic disease affecting 1 in 3,500 individuals. A prominent feature of NF1 is the formation of benign tumours of the peripheral nerve sheath (neurofibromas). However, these can become malignant and form highly metastatic malignant peripheral nerve sheath tumours (MPNST), which are usually fatal despite aggressive surgery, chemotherapy, and radiotherapy. Recent studies have shown that pigment epithelium-derived factor (PEDF) can induce differentiation and inhibit angiogenesis in several kinds of tumours. The present study was designed to determine the in vitro and in vivo effects of PEDF on MPNST angiogenesis and tumour growth. PEDF inhibited proliferation and augmented apoptosis in S462 MPNST cells after 48 h of treatment in culture. In xenografts of S462 MPNST cells in athymic nude mice, PEDF suppressed MPNST tumour burden, due mainly to inhibition of angiogenesis. These results demonstrate for the first time inhibitory effects of PEDF on the growth of human MPNST via induction of anti-angiogenesis and apoptosis. Our results suggest that PEDF could be a novel approach for future therapeutic purposes against MPNST.

  13. Malignant peripheral nerve sheath tumour (MPNST) of mandible: solving the perplexity. (United States)

    Patel, Shilpa; Pathak, Jigna; Dekate, Kamlesh; Mohanty, Neeta


    We present an extremely rare case of malignant peripheral nerve sheath tumour (MPNST) in a 30-year-old woman without associated neurofibromatosis 1. The patient presented with an 8 cm×4 cm lesion extending from 46 to the retro molar region involving the ramus of the right mandible associated with regional paraesthesia. Incisional biopsy revealed spindle cells with vesicular nuclei arranged in fascicles leading to a diagnosis of spindle cell lesion. Posterior segmental mandibulectomy was performed under general anaesthesia. On excisional biopsy, a definitive diagnosis of low-grade MPNST was established on the basis of immunohistochemistry. The patient was then lost to follow-up.

  14. Autonomic nerve development contributes to prostate cancer progression. (United States)

    Bauman, John; McVary, Kevin


    In a significant translational study, Magnon et al. investigated the role that the autonomic nervous system plays in the development and spread of prostate cancer in both mice and human models. The study shows different roles for both branches of the autonomic nervous system, with the sympathetic system promoting early stages of tumorigenesis, and the parasympathetic system promoting cancer dissemination. This information could lead to important new foundations for treatment, therapies and management of prostate cancer.

  15. [Techniques of autonomic nerve preservation in laparoscopic radical resection for rectal cancer]. (United States)

    Wei, Hongbo; Zheng, Zongheng


    Pelvic autonomic nerve is a three-dimensional structure surrounding the rectum. There are several key points related to nerve injury during laparoscopic radical resection for rectal cancer. Hypogastric nerve has close relation with the upper and middle part of the rectum. Combined with S2-S4 pelvic splanchnic nerve, hypogastric nerve forms pelvic plexus. Incorrect operation in pelvic parietal peritoneum during dissection of upper rectum will lead to nerve injury. When performing dissection of inferior mesenteric artery, bilateral nerve tracts should be pushed to posterior abdominal wall and anterior fascia of the abdominal aorta should be well protected to avoid nerve injury. Pelvic plexus fibers located lateral to the rectum of pelvic floor, as well as neurovascular bundle closed to Denonvillier's fascia, also have close relations with nerve injury. Dissection of either lateral or anterior wall of rectum should be performed behind the Denonvillier's fascia and in front of the proper fascia of rectum. Sharp dissection should be performed closed to the mesorectum to protect branches of pelvic plexus.

  16. Germline and somatic NF1 mutations in sporadic and NF1-associated malignant peripheral nerve sheath tumours

    NARCIS (Netherlands)

    Bottillo, Irene; Ahiquist, Terje; Brekke, Helge; Danielsen, Stine A.; van den Berg, Eva; Mertens, Fredrik; Lothe, Ragnhild A.; Dallapiccola, Bruno


    Malignant peripheral nerve sheath tumours (MPNSTs) are a malignancy occurring with increased frequency in patients with neurofibromatosis type 1 (NF1). In contrast to the well-known spectrum of germline NF1 mutations, the information on somatic mutations in MPNSTs is limited. In this study, we scree

  17. Malignant peripheral nerve sheath tumours in neurofibromatosis type 1: MRI supports the diagnosis of malignant plexiform neurofibroma

    Energy Technology Data Exchange (ETDEWEB)

    Mautner, V.F. [Department of Neurology, Klinikum Nord Hamburg, Langenhorner Chaussee 560, 22419, Hamburg (Germany); Friedrich, R.E. [Department of Maxillofacial Surgery, Universitaetsklinikum Eppendorf, Hamburg (Germany); Deimling, A. von [Department of Neuropathology, Charite, Berlin (Germany); Hagel, C. [Department of Neuropathology, Universitaetsklinikum Eppendorf, Hamburg (Germany); Korf, B. [Center for Human Genetics, Harvard Institutes of Medicine, Boston, MA (United States); Knoefel, M.T. [Department of Surgery, Universitaetsklinikum Eppendorf, Hamburg (Germany); Wenzel, R.; Fuensterer, C. [MRI-Institute Hamburg Othmarschen, Hamburg (Germany)


    Plexiform neurofibroma (PNF) is a typical feature of neurofibromatosis 1 (NF1). About 10% of patients with NF1 develop malignant peripheral nerve-sheath tumours (MPNST), usually arising from PNF, and this is the major cause of poor survival. A better prognosis can be achieved if the tumours are diagnosed at an early stage. Our objective was to establish MRI criteria for MPNST and to test their usefulness in detecting early malignant change in PNF. MRI was performed on 50 patients with NF1 and nerve-sheath tumours, of whom seven had atypical pain, tumour growth or neurological deficits indicative of malignancy; the other 43 were asymptomatic. On MRI all seven symptomatic patients had inhomogeneous lesions, due to necrosis and haemorrhage and patchy contrast enhancement. In one patient, the multiplicity of confluent tumours with inhomogeneous areas in addition to central lesions did not allow exclusion of malignancy. Only three of the 43 asymptomatic patients had comparable changes; the other 40 patients had tumours being of relatively homogeneous structure on T1- and T2-weighted images before and after contrast enhancement. All three asymptomatic patients with inhomogeneous lesions were shown to have MPNST. (orig.)

  18. Malignant peripheral nerve sheath tumour (MPNST): the clinical implications of cellular signalling pathways. (United States)

    Katz, Daniela; Lazar, Alexander; Lev, Dina


    Malignant peripheral nerve sheath tumour (MPNST) is a rare malignancy accounting for 3-10% of all soft tissue sarcomas. Most MPNSTs arise in association with peripheral nerves or deep neurofibromas and may originate from neural crest cells, although the specific cell of origin is uncertain. Approximately half of MPNSTs occur in the setting of neurofibromatosis type 1 (NF1), an autosomal dominant disorder with an incidence of approximately one in 3500 persons; the remainder of MPNSTs develop sporadically. In addition to a variety of clinical manifestations, approximately 8-13% of NF1 patients develop MPNSTs, which are the leading cause of NF1-related mortality. Surgical resection is the mainstay of MPNST clinical management. However, because of invasive growth, propensity to metastasise, and limited sensitivity to chemotherapy and radiation, MPNST has a guarded to poor prognosis. Five-year survival rates of only 20-50% indicate an urgent need for improved therapeutic approaches. Recent work in this field has identified several altered intracellular signal transduction cascades and deregulated tyrosine kinase receptors, posing the possibility of personalised, targeted therapeutics. However, expanded knowledge of MPNST molecular pathobiology will be needed to meaningfully apply such approaches for the benefit of afflicted patients.

  19. Prognostic relevance of FDG PET in patients with neurofibromatosis type-1 and malignant peripheral nerve sheath tumours

    Energy Technology Data Exchange (ETDEWEB)

    Brenner, Winfried; Buchert, Ralph; Clausen, Malte [University Medical Center Hamburg-Eppendorf, Department of Nuclear Medicine, Hamburg (Germany); Friedrich, Reinhard E.; Mautner, Victor F. [University Medical Center Hamburg-Eppendorf, Department of Oral and Maxillofacial Surgery, Hamburg (Germany); Gawad, Karim A. [University Medical Center Hamburg-Eppendorf, Department of General, Visceral and Thoracic Surgery, Hamburg (Germany); Hagel, Christian [University Medical Center Hamburg-Eppendorf, Institute of Neuropathology, Hamburg (Germany); Deimling, Andreas von [Charite Universitaetsmedizin, Department of Neuropathology, Berlin (Germany); Wit, Maike de [University Medical Center Hamburg-Eppendorf, Department of Medicine II, Hamburg (Germany)


    In patients with neurofibromatosis type-1 (NF1) and malignant peripheral nerve sheath tumours (MPNSTs), survival rates are low and time to death is often less than 2 years. However, there are patients with a more favourable prognosis who develop metastases rather late or not at all. Since histopathology and tumour grading are not well correlated with prognosis, we aimed to evaluate the potential of {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG PET) for prediction of patient outcome in MPNST. FDG PET was performed in 16 patients with NF1 and MPNSTs. Standardised uptake values (SUVs) were calculated for each tumour and correlated to tumour grade and patient outcome in terms of survival or death. Three patients with tumour grade II had an SUV <3. None of these patients developed metastases or died during a follow-up of 41-62 months. Thirteen patients with tumour grades II and III had an SUV >3. Only one of these patients is still alive after 20 months; the remaining 12 died within 4-33 months. SUV predicted long-term survival with an accuracy of 94%, compared with 69% for tumour grade. In Kaplan-Meier survival analysis, patients with an SUV >3 had a significantly shorter mean survival time, 13 months, than patients with an SUV <3, in whom the mean survival time was 52 months. Tumour grading did not reveal differences in survival time (15 vs 12 months). Tumour SUV obtained by FDG PET was a significant parameter for prediction of survival in NF1 patients with MPNSTs while histopathological tumour grading did not predict outcome. (orig.)

  20. The subdiaphragmatic part of the phrenic nerve - morphometry and connections to autonomic ganglia. (United States)

    Loukas, Marios; Du Plessis, Maira; Louis, Robert G; Tubbs, R Shane; Wartmann, Christopher T; Apaydin, Nihal


    Few anatomical textbooks offer much information concerning the anatomy and distribution of the phrenic nerve inferior to the diaphragm. The aim of this study was to identify the subdiaphragmatic distribution of the phrenic nerve, the presence of phrenic ganglia, and possible connections to the celiac plexus. One hundred and thirty formalin-fixed adult cadavers were studied. The right phrenic nerve was found inferior to the diaphragm in 98% with 49.1% displaying a right phrenic ganglion. In 22.8% there was an additional smaller ganglion (right accessory phrenic ganglion). The remaining 50.9% had no grossly identifiable right phrenic ganglion. Most (65.5% of specimens) exhibited plexiform communications with the celiac ganglion, aorticorenal ganglion, and suprarenal gland. The left phrenic nerve inferior to the diaphragm was observed in 60% of specimens with 19% containing a left phrenic ganglion. No accessory left phrenic ganglia were observed. The left phrenic ganglion exhibited plexiform communications to several ganglia in 71.4% of specimens. Histologically, the right phrenic and left phrenic ganglia contained large soma concentrated in their peripheries. Both phrenic nerves and ganglia were closely related to the diaphragmatic crura. Surgically, sutures to approximate the crura for repair of hiatal hernias must be placed above the ganglia in order to avoid iatrogenic injuries to the autonomic supply to the diaphragm and abdomen. These findings could also provide a better understanding of the anatomy and distribution of the fibers of that autonomic supply.

  1. Survival in Malignant Peripheral Nerve Sheath Tumours: A Comparison between Sporadic and Neurofibromatosis Type 1-Associated Tumours

    Directory of Open Access Journals (Sweden)

    D. E. Porter


    As the survival rate in the NF group was dependant on tumour volume, routine screening of these patients with FDG PET and/or MRI may be warranted, thereby staging and controlling them at the earliest possible opportunity.

  2. Effects of expression ways and traits of anger emotion on autonomic nerve in the emotion recovery stage

    Institute of Scientific and Technical Information of China (English)



    Objective To explore the effects of expression ways and traits of anger emotion on autonomic nerve in the emotion recovery stage.Methods The 48 healthy undergraduate students were recruited as subjects,who were

  3. The Anticonvulsant Effect of Transcutaneous Auricular Vagus Nerve Stimulation is Associated with Balancing the Autonomic Dysfunction in Rats

    Directory of Open Access Journals (Sweden)

    Wei He


    Full Text Available Objective: The present study aims to investigate whether the anticonvulsant effect of transcutaneous auricular vagus nerve stimulation is associated with balancing the autonomic dysfunction in rats.

  4. Part and Parcel of the Cardiac Autonomic Nerve System: Unravelling Its Cellular Building Blocks during Development

    Directory of Open Access Journals (Sweden)

    Anna M. D. Végh


    Full Text Available The autonomic nervous system (cANS is essential for proper heart function, and complications such as heart failure, arrhythmias and even sudden cardiac death are associated with an altered cANS function. A changed innervation state may underlie (part of the atrial and ventricular arrhythmias observed after myocardial infarction. In other cardiac diseases, such as congenital heart disease, autonomic dysfunction may be related to disease outcome. This is also the case after heart transplantation, when the heart is denervated. Interest in the origin of the autonomic nerve system has renewed since the role of autonomic function in disease progression was recognized, and some plasticity in autonomic regeneration is evident. As with many pathological processes, autonomic dysfunction based on pathological innervation may be a partial recapitulation of the early development of innervation. As such, insight into the development of cardiac innervation and an understanding of the cellular background contributing to cardiac innervation during different phases of development is required. This review describes the development of the cANS and focuses on the cellular contributions, either directly by delivering cells or indirectly by secretion of necessary factors or cell-derivatives.

  5. The Effect of Levetiracetam Therapy on the Autonomous Nerve System in Epilepsy Patients

    Directory of Open Access Journals (Sweden)

    Kazim Ekmekci


    Full Text Available Aim: It was aimed to research the effects of levetiracetam on some autonomic functions by comparing autonomous nerve system tests in epilepsy patients using levetiracetam monotherapy with the tests of the healthy volunteers who don’t use drug.   Material and Method: Fourty-one patients diagnosed with partial epilepsy using levetiracetam were included in this study. Control group was selected from 35 healthy volunteers who don’t have epilepsy. RR interval variation (RRIV, valsalva, and tilt tests were applied to patient and control groups in order to assess the autonomous nerve system functions. Results: No statistically-significant differences were found in the results of RRIV, valsalva, and tilt tests in patients in comparison with the control group (p>0.05. No statistical significances weren’t also observed when the results of upright position and the postural blood pressure changes were compared with the control group (p>0.05. Discussion: Our findings had shown that using levetiracetam therapy had no effect on the responses of heart rate and blood pressure in epilepsy patients.

  6. Tumour Necrosis Factor α Enhances CCL2 and ICAM-1 Expression in Peripheral Nerve Microvascular Endoneurial Endothelial Cells

    Directory of Open Access Journals (Sweden)

    Kelly A. Langert


    Full Text Available Recruitment and trafficking of autoreactive leucocytes across the BNB (blood–nerve barrier is an early pathological insult in GBS (Guillain-Barré syndrome, an aggressive autoimmune disorder of the PNS (peripheral nervous system. Whereas the aetiology and pathogenesis of GBS remain unclear, pro-inflammatory cytokines, including TNFα (tumour necrosis factor α, are reported to be elevated early in the course of GBS and may initiate nerve injury by activating the BNB. Previously, we reported that disrupting leucocyte trafficking in vivo therapeutically attenuates the course of an established animal model of GBS. Here, PNMECs (peripheral nerve microvascular endothelial cells that form the BNB were harvested from rat sciatic nerves, immortalized by SV40 (simian virus 40 large T antigen transduction and subsequently challenged with TNFα. Relative changes in CCL2 (chemokine ligand 2 and ICAM-1 (intercellular adhesion molecule 1 expression were determined. We report that TNFα elicits marked dose- and time-dependent increases in CCL2 and ICAM-1 mRNA and protein content and promotes secretion of functional CCL2 from immortalized and primary PNMEC cultures. TNFα-mediated secretion of CCL2 promotes, in vitro, the transendothelial migration of CCR2-expressing THP-1 monocytes. Increased CCL2 and ICAM-1 expression in response to TNFα may facilitate recruitment and trafficking of autoreactive leucocytes across the BNB in autoimmune disorders, including GBS.

  7. Uterine autonomic nerve innervation plays a crucial role in regulating rat uterine mast cell functions during embryo implantation. (United States)

    Yuan, Xue-Jun; Huang, Li-Bo; Qiao, Hui-Li; Deng, Ze-Pei; Fa, Jing-Jing


    To explore the potential mechanism of how uterine innervations would affect the uterine mast cell (MC) population and functions during the periimplantation. We herein first examined the consequence of uterine neurectomy on embryo implantation events. We observed that amputation of autonomic nerves innervating the uterus led to on-time implantation failure in rats. Exploiting MC culture and ELISA approaches, we then further analyzed the effect of neurectomy on cellular histamine levels and its release from uterine MCs, to elucidate the relation of the autonomic nerves and local cellular immunity in the uterine during early pregnancy. We observed that disconnection of autonomic nerve innervation significantly increased the population of uterine MCs. Most interestingly, these increased number of uterine MCs in neuroectomized rats contained a much reduced cellular level of histamine. Our subsequent challenge experiments revealed that uterine MCs in nerve amputated rats exhibited enhanced histamine releasing rate in response to substance P and antiIgE, suggesting loss of nerve innervation in the uterus not only increases the population of uterine MCs, but also facilitates the release of histamine from MCs, thus subsequently interfere with the normal implantation process. Collectively, our findings provide a new line of evidence supporting the concept that immune-neuro-endocrine network plays important role during pregnancy establishment and maintenance.

  8. Cancer Pain Control for Advanced Cancer Patients by Using Autonomic Nerve Pharmacopuncture

    Directory of Open Access Journals (Sweden)

    Hwi-joong Kang


    Full Text Available Objectives: The purpose of this study is to report a case series of advanced cancer patients whose cancer pain was relieved by using autonomic nerve pharmacopuncture (ANP treatment. ANP is a subcutaneous injection therapy of mountain ginseng pharmacopuncture (MGP along the acupoints on the spine (Hua-Tuo-Jia-Ji-Xue; 0.5 cun lateral to the lower border of the spinous processes of vertebrae to enhance the immune system and to balance autonomic nerve function. Methods: Patients with three different types of cancer (gastric cancer, lung cancer, colon cancer with distant metastases with cancer pain were treated with ANP. 1 mL of MGP was injected into the bilateral Hua-Tuo-Jia-Ji-Xue on the T1-L5 sites (total 12 ─ 20 mL injection of each patient’s dorsum by using the principle of symptom differentiation. During ANP treatment, the visual analogue scale (VAS for pain was used to assess their levels of cancer pain; also, the dosage and the frequency of analgesic use were measured. Results: The cancer pain levels of all three patients improved with treatment using ANP. The VAS scores of the three patients decreased as the treatment progressed. The dosage and the frequency of analgesics also gradually decreased during the treatment period. Significantly, no related adverse events were found. Conclusion: ANP has shown benefit in controlling cancer pain for the three different types of cancer investigated in this study and in reducing the dosage and the frequency of analgesics. ANP is expected to be beneficial for reducing cancer pain and, thus, to be a promising new treatment for cancer pain.

  9. Histological modifications of the rat prostate following transection of somatic and autonomic nerves

    Directory of Open Access Journals (Sweden)

    Rosaura Diaz


    Full Text Available It is known that hormones influence significantly the prostate tissue. However, we reported that mating induces an increase in androgen receptors, revealing a neural influence on the gland. These data suggested that somatic afferents (scrotal and genitofemoral nerves and autonomic efferents (pelvic and hypogastric nerves could regulate the structure of the prostate. Here we assessed the role of these nerves in maintaining the histology of the gland. Hence, afferent or efferent nerves of male rats were transected. Then, the ventral and dorsolateral regions of the prostate were processed for histology. Results showed that afferent transection affects prostate histology. The alveoli area decreased and increased in the ventral and dorsolateral prostate, respectively. The epithelial cell height increased in both regions. Efferent denervation produced dramatic changes in the prostate gland. The tissue lost its configuration, and the epithelium became scattered and almost vanished. Thus, afferent nerves are responsible for spinal processes pertaining to the trophic control of the prostate, activating its autonomic innervation. Hence, our data imply that innervation seems to be synergic with hormones for the healthy maintenance of the prostate. Thus, it is suggested that some prostate pathologies could be due to the failure of the autonomic neural pathways regulating the gland.Sabe-se que os hormônios influenciam significativamente o tecido prostático. Entretanto, nós demonstramos que o acasalamento induz um aumento nos receptores androgênicos, revelando uma influência neural sobre a glândula. Esses dados sugerem que os aferentes somáticos (nervos escrotal e genito-femural e os eferentes autonômicos (nervos pélvicos e hipo-gástricos poderiam regular a estrutura da próstata. Neste trabalho, avaliou-se a função destes nervos na manutenção da histologia da glândula. Dessa forma, os nervos aferentes e eferentes de ratos machos foram

  10. {sup 18}F-FDG PET/CT for detection of malignant peripheral nerve sheath tumours in neurofibromatosis type 1: tumour-to-liver ratio is superior to an SUV{sub max} cut-off

    Energy Technology Data Exchange (ETDEWEB)

    Salamon, Johannes [University Medical Centre Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); University Hospital Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Veldhoen, Simon [University Medical Centre Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); University Medical Centre Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Apostolova, Ivayla [Otto-von-Guericke University, Department of Radiology and Nuclear Medicine, Magdeburg (Germany); Bannas, Peter; Yamamura, Jin; Herrmann, Jochen; Adam, Gerhard; Derlin, Thorsten [University Medical Centre Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Friedrich, Reinhard E. [University Medical Centre Hamburg-Eppendorf, Department of Oral and Maxillofacial Surgery, Hamburg (Germany); Mautner, Victor F. [University Medical Centre Hamburg-Eppendorf, Department of Neurology, Hamburg (Germany)


    To evaluate the usefulness of normalising intra-tumour tracer accumulation on {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) to reference tissue uptake for characterisation of peripheral nerve sheath tumours (PNSTs) in neurofibromatosis type 1 (NF1) compared with the established maximum standardised uptake value (SUVmax) cut-off of >3.5. Forty-nine patients underwent FDG PET/CT. Intra-tumour tracer uptake (SUVmax) was normalised to three different reference tissues (tumour-to-liver, tumour-to-muscle and tumour-to-fat ratios). Receiver operating characteristic (ROC) analyses were used out to assess the diagnostic performance. Histopathology and follow-up served as the reference standard. Intra-tumour tracer uptake correlated significantly with liver uptake (r{sub s} = 0.58, P = 0.016). On ROC analysis, the optimum threshold for tumour-to-liver ratio was >2.6 (AUC = 0.9735). Both the SUVmax cut-off value of >3.5 and a tumour-to-liver ratio >2.6 provided a sensitivity of 100 %, but specificity was significantly higher for the latter (90.3 % vs 79.8 %; P = 0.013). In patients with NF1, quantitative {sup 18}F-FDG PET imaging may identify malignant change in neurofibromas with high accuracy. Specificity could be significantly increased by using the tumour-to-liver ratio. The authors recommend further evaluation of a tumour-to-liver ratio cut-off value of >2.6 for diagnostic intervention planning. (orig.)

  11. Effect of intracranial hypertension on cerebral hemorrhage induced autonomic nerve imbalance

    Institute of Scientific and Technical Information of China (English)

    Xuelong Jin; Wenli Jing; Fengxia Yan; Zhaoqiang Zhang; Fengjun Lü; Shuiqing Jing; Na Sun; Kazushige Mizoguchi


    BACKGROUND: Cerebral hemorrhage can cause the imbalance of nerve function, whereas its mechanism and main impact factors are still not quite clear.OBJECTIVE: To explore the rules about the changes of intracranial pressure in brainstem hemorrhage and internal capsule hemorrhage, and analyze the role of intracranial hypertension in the changes of nerve function caused by cerebral hemorrhage.DESIGN: A self-controlled trial.SETTING: Department of Physiology, Tianjin Medical University.MATERIALS: Sixty-five healthy male Japanese white rabbits with long ears (1.5-1.8 kg) were supplied and fed by the Department of Animal Experiment of Tianjin Medical University. The RM6240B biological signal collecting and processing system was used.METHODS: The experiments were conducted in the Department of Physiology, Tianjin Medical University from August 2001 to May 2006. ① The rabbits were anesthetized, then fixed onto the brain stereotaxic apparatus, and afterwards fenestration on skull and intubation to lateral ventricle were performed. The dynamic changes of intracranial pressure were monitored continuously. Rabbits were infused with autologous arterial blood (0.3 mL) into midbrain corpora quadrigemina inferior colliculus to induce model of acute brainstem hemorrhage; models of internal capsule hemorrhage were established by infusing autologous arterial blood into internal capsule. ② The dynamic intracranial pressures under the above conditions were recorded continuously with the RM6240B biological signal collecting and processing system. ③ An animal model of persistent intracranial hypertension was established by infusion of physiologic saline into lateral ventricle. ④ The changes of the intensity of autonomic nerve discharge were analyzed, using the biological signal collecting and processing system before and after hemorrhage and under persistent intracranial hypertension. ⑤ Ten animal models of internal capsule hemorrhage and 10 of brainstem hemorrhage were selected

  12. Biphasic effects of orexin-A on autonomic nerve activity and lipolysis. (United States)

    Shen, Jiao; Tanida, Mamoru; Yao, Jia-Fei; Niijima, Akira; Nagai, Katsuya


    Previously, we showed that orexin-A, a 33-aa peptide, influences renal sympathetic nerve activity. Because the autonomic nervous system plays an important role in the regulation of lipid metabolism, we investigated the in vivo effects of orexin-A on the sympathetic nerve activity innervating white adipose tissue (WAT-SNA) and lipolysis. We found that intracerebroventricular (icv) administration of orexin-A at doses of 1 microg/rat and 10 ng/rat elevated and suppressed WAT-SNA, respectively. The effect of the high dose of orexin-A (1 microg/rat) was eliminated by pretreatment with diphenhydramine hydrochloride, a histamine H(1) receptor antagonist. In contrast, the effect of the low dose of orexin-A (10 ng/rat) was suppressed by thioperamide maleate salt, a histamine H(3) receptor antagonist. Moreover, icv administration of 1 microg/rat and 10 ng/rat of orexin-A increased and decreased the levels of plasma free fatty acids (FFAs), respectively. The effect of 1 microg/rat of orexin-A on plasma FFA was eliminated by propranolol hydrochloride, a beta-adrenergic receptor blocker, and also by diphenhydramine. The effect of orexin-A at dose of 10 ng/rat disappeared by pretreatment with atropine sulfate, a muscarinic receptor blocker, and thioperamide maleate salt. Our results suggest that high doses of orexin-A may regulate the lipolytic processes in adipose tissue through facilitation of the sympathetic nervous system, which is driven by histamine neurons through the H(1) receptor, and that the beta(3)-receptor may be involved in this enhanced lipolytic response. Low doses of orexin-A, on the other hand, may lower lipolysis by suppressing sympathetic nerve activity via the H(3)-receptor, and the muscarinic receptor may be related to this response.

  13. Vagus nerve stimulation: state of the art of stimulation and recording strategies to address autonomic function neuromodulation (United States)

    Guiraud, David; Andreu, David; Bonnet, Stéphane; Carrault, Guy; Couderc, Pascal; Hagège, Albert; Henry, Christine; Hernandez, Alfredo; Karam, Nicole; Le Rolle, Virginie; Mabo, Philippe; Maciejasz, Paweł; Malbert, Charles-Henri; Marijon, Eloi; Maubert, Sandrine; Picq, Chloé; Rossel, Olivier; Bonnet, Jean-Luc


    Objective. Neural signals along the vagus nerve (VN) drive many somatic and autonomic functions. The clinical interest of VN stimulation (VNS) is thus potentially huge and has already been demonstrated in epilepsy. However, side effects are often elicited, in addition to the targeted neuromodulation. Approach. This review examines the state of the art of VNS applied to two emerging modulations of autonomic function: heart failure and obesity, especially morbid obesity. Main results. We report that VNS may benefit from improved stimulation delivery using very advanced technologies. However, most of the results from fundamental animal studies still need to be demonstrated in humans.

  14. Evaluation of distal symmetric polyneuropathy: the role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review). (United States)

    England, J D; Gronseth, G S; Franklin, G; Carter, G T; Kinsella, L J; Cohen, J A; Asbury, A K; Szigeti, K; Lupski, J R; Latov, N; Lewis, R A; Low, P A; Fisher, M A; Herrmann, D; Howard, J F; Lauria, G; Miller, R G; Polydefkis, M; Sumner, A J


    Distal symmetric polyneuropathy (DSP) is the most common variety of neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyneuropathy. A literature review using MEDLINE, EMBASE, Science Citation Index, and Current Contents was performed to identify the best evidence regarding the evaluation of polyneuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based on the level of evidence. (1) Autonomic testing may be considered in the evaluation of patients with polyneuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic neuropathy (Level B) and distal small fiber sensory polyneuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). (2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected amyloid neuropathy, mononeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyneuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). (3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyneuropathy.

  15. Cancer-related Fatigue in Patients with Advanced Cancer Treated with Autonomic Nerve Pharmacopuncture. (United States)

    Park, Ji-hye; Jeon, Hyung-jun; Kang, Hwi-joong; Jeong, In-Sook; Cho, Chong-kwan; Yoo, Hwa-seung


    The purpose of this study was to observe the effects of autonomic nerve pharmacopuncture (ANP) treatment on cancer-related fatigue (CRF) in patients with advanced cancer. This observational case study was conducted at the East West Cancer Center of Daejeon University's Dunsan Korean Medical Hospital. Two patients were observed. One patient was diagnosed with left thymic cancer metastatic to the left pleura. The other patient had terminal-stage cervical cancer with iliac bone and lumbar 5 metastases. We injected mountain ginseng pharmacopuncture (MGP) into acupoints alongside the spine (Hua-Tuo-Jia-Ji-Xue, EX B2). We examined the patients for CRF using the Korean version of the Revised Piper Fatigue Scale (RPFS-K), which is a self-assessment tool. The scores on the RPFS-K for both patients tended to decrease during the treatment. Laboratory findings, including hematological changes, were also checked. Liver and renal function tests showed that the treatment was safe. Although further large-population studies are necessary, this case study suggests that ANP has a favorable effect on CRF in patients with advanced cancer.

  16. Development of rat tibia innervation: colocalization of autonomic nerve fiber markers with growth-associated protein 43. (United States)

    Gajda, Mariusz; Litwin, Jan A; Tabarowski, Zbigniew; Zagólski, Olaf; Cichocki, Tadeusz; Timmermans, Jean-Pierre; Adriaensen, Dirk


    Development of autonomic innervation of the tibia was investigated in rat fetuses on gestational days (GD) 17-21 and in juvenile animals on postnatal days (PD) 1-28. Double immunofluorescence combined with confocal microscopy was applied to study colocalization of neuronal growth- associated protein 43 (GAP-43) and panneuronal marker protein gene product 9.5 (PGP) with markers of the autonomic nervous system: neuropeptide Y (NPY) and dopamine beta-hydroxylase (DbetaH) for adrenergic, as well as vasoactive intestinal polypeptide (VIP) and vesicular acetylcholine transporter (VAChT) for cholinergic fibers. The first GAP-43-immunoreactive (GAP-IR) nerve fibers were seen on GD17 in the perichondrium of the proximal epiphysis. Further GAP- and PGP-IR innervation appeared in the perichondrium/periosteum of the diaphysis and in the distal epiphysis (GD19), then in the bone marrow and in the intercondylar eminence (GD21). On PD1, NPY-IR and DbetaH-IR fibers appeared within the diaphyseal periosteum and on PD4 within the bone marrow. From PD14, GAP-43 immunoreactivity of NPY-positive fibers decreased. From PD7 on, NPY-IR fibers were observed in cartilage canals of both epiphyses and in the intercondylar eminence. In secondary ossification centers, NPY-IR fibers were seen from PD10, and in the bone marrow of the epiphyses from PD14. First VIP-IR and VAChT-IR fibers were observed on PD4 within the periosteum, bone marrow and patellar ligament. From PD10 on, VIP-positive fibers were seen in the intercondylar eminence, and from PD14 in secondary ossification centers. GAP-43 proved to be superior to PGP 9.5 as marker of growing nerve fibers, mostly due to its earlier appearance. The presence of specific nerve fibers may suggest possible involvement of autonomic innervation in regulation of bone development.

  17. The Anticonvulsant Effect of Transcutaneous Auricular Vagus Nerve Stimulation is Associated with Balancing the Autonomic Dysfunction in Rats

    Institute of Scientific and Technical Information of China (English)

    Wei He; Xiao-Yu Wang; Hong Shi; Yang-Shuai Su; Xiang-Hong Jing; Bing Zhu


    Objective: The present study aims to investigate whether the anticonvulsant effect of transcutaneous auricular vagus nerve stimulation is associated with balancing the autonomic dysfunction in rats. Methods: Healthy adult male Sprague-Dawley rats were anesthetized with an intraperitoneal injection of 10%urethane. Seizures were evoked by intraperitoneal injection of pentylenetetrazol (PTZ, 60 mg/kg). Femoral vein catheterization was performed for injection of sympathetic agonist and antagonists. Bipolar globe silver electrodes were utilized for epidural EEG recording. Three needles were inserted separately in subcutaneous muscles of left anterior limb, right anterior limb, and left hind limb to record ECG signals. ta-VNS was performed at auricular concha. Results: In comparison with preictal state, the mean heart rate (HR) increased slightly during epileptic seizures (P<0.05). In comparison with ictal state, the mean HR decreased a little at postictal state (P<0.05). When continuous epileptic seizures in EEG traces occurred (in ictal state), vein injection of propranolol hydrochloride (sympathetic antagonist) suppressed the epileptic seizures. When epileptic seizures occurred rarely (in postictal state), vein injection of adrenaline hydrochloride (sympathetic agonist) exacerbated the epileptic seizures. In comparison with pre-stimulation, the integral of EEG traces after ta-VNS decreased (P<0.05), the mean HR decreased (P<0.05), and the high power (HF) of HRV increased (P<0.05) after ta-VNS. Conclusion: The results showed that autonomic dysfunction occurred in epileptic rats characterized by enhanced sympathetic nerve activity. Epileptic seizures in EEG traces decreased, HR decreased and HF increased after ta-VNS, which indicated that ta-VNS may suppress epileptic seizures via balancing the autonomic dysfunction.

  18. Effect of Shensong Yangxin on the Progression of Paroxysmal Atrial Fibrillation is Correlated with Regulation of Autonomic Nerve Activity (United States)

    Zhao, Hong-Yi; Zhang, Shu-Di; Zhang, Kai; Wang, Xi; Zhao, Qing-Yan; Zhang, Shu-Juan; Dai, Zi-Xuan; Qian, Yong-Sheng; Zhang, You-Jing; Wei, Hao-Tian; Tang, Yan-Hong; Huang, Cong-Xin


    Background: Shensong Yangxin (SSYX), a traditional Chinese herbal medicine, has long been used clinically to treat arrhythmias in China. However, the mechanism of SSYX on atrial fibrillation (AF) is unknown. In this study, we tested the hypothesis that the effect of SSYX on the progression of paroxysmal AF is correlated with the regulation of autonomic nerve activity. Methods: Eighteen mongrel dogs were randomly divided into control group (n = 6), pacing group (n = 6), and pacing + SSYX group (n = 6). The control group was implanted with pacemakers without pacing; the pacing group was implanted with pacemakers with long-term intermittent atrial pacing; the pacing + SSYX group underwent long-term intermittent atrial pacing and SSYX oral administration. Results: Compared to the pacing group, the parameters of heart rate variability were lower after 8 weeks in the pacing + SSYX group (low-frequency [LF] component: 20.85 ± 3.14 vs. 15.3 ± 1.89 ms2, P = 0.004; LF component/high-frequency component: 1.34 ± 0.33 vs. 0.77 ± 0.15, P dogs in the pacing group had more episodes and longer durations of AF than that in the pacing + SSYX group. SSYX markedly inhibited the increase in sympathetic nerves and upregulation of tumor necrosis factor-alpha and interleukin-6 expression in the pacing + SSYX group. Furthermore, SSYX suppressed the decrease of acetylcholine and α7 nicotinic acetylcholine receptor protein induced by long-term intermittent atrial pacing. Conclusions: SSYX substantially prevents atrial electrical remodeling and the progression of AF. These effects of SSYX may have association with regulating the imbalance of autonomic nerve activity and the cholinergic anti-inflammatory pathway. PMID:28091409

  19. [{sup 18}F]FDG PET/CT in the diagnosis of malignant peripheral nerve sheath tumours in neurofibromatosis type-1

    Energy Technology Data Exchange (ETDEWEB)

    Warbey, Victoria S.; O' Doherty, Michael J. [King' s College London, Clinical PET Centre, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Ferner, Rosalie E. [King' s College London, Department of Neurology, Guy' s and St Thomas' Hospitals NHS Foundation Trust, London (United Kingdom); Dunn, Joel T. [King' s College London, Clinical PET Centre, Division of Imaging Sciences, Guy' s, King' s and St Thomas' School of Medicine, London (United Kingdom); Calonje, Eduardo [Guy' s and St Thomas' Hospitals NHS Foundation Trust, Department of Dermatopathology, London (United Kingdom)


    The detection of malignant peripheral nerve sheath tumours (MPNSTs) in patients with neurofibromatosis 1 (NF1) remains a clinical challenge. The purpose of this study was to evaluate the use of [{sup 18}F]2-fluoro-2-deoxy-d-glucose PET/CT (FDG PET/CT with early and delayed imaging) in patients with symptomatic neurofibromas, to revalidate current cut-off values for identification of malignant change within neurofibromas and to examine the relationship between SUV and tumour grade. Patients with symptomatic neurofibromas underwent FDG PET/CT imaging at 90 and 240 min. Semiquantitative analysis using maximum standardized uptake value (SUVmax) was performed and correlated with histology. In 69 patients, 85 lesions were identified for analysis, including 10 atypical neurofibromas and 21 MPNSTs. Sensitivity of FDG PET/CT in diagnosing NF1-associated MPNST was 0.97 (95% CI 0.81-0.99) and the specificity was 0.87 (CI 0.74-0.95). There was a significant difference in SUVmax between early and delayed imaging and in SUVmax between tumours identified as benign and malignant on PET/CT. There was also a significant difference in SUVmax between tumour grades. FDG PET/CT is a highly sensitive and specific imaging modality for the diagnosis of MPNST in NF1 patients. We recommend performing early (90 min) and delayed imaging at 4 h for accurate lesion characterization and using a cut-off SUVmax of 3.5 on delayed imaging to achieve maximal sensitivity. (orig.)

  20. Imaging of sacral tumours

    Energy Technology Data Exchange (ETDEWEB)

    Gerber, S.; Ollivier, L.; Brisse, H.; Neuenschwander, S. [Institut Curie, Department of Radiology, Paris (France); Leclere, J. [Institut Gustave Roussy, Department of Radiology, Villejuif (France); Vanel, D. [The Rizzoli Institute, Department of Radiology, Bologna (Italy); Missenard, G. [Institut Gustave Roussy, Comite de pathologie tumorale de l' appareil locomoteur, Villejuif (France); Pinieux, G. de [CHRU de Tours, Department of Pathology, Hopital Trousseau, Tours (France)


    All components of the sacrum (bone, cartilage, bone marrow, meninges, nerves, notochord remnants, etc.) can give rise to benign or malignant tumours. Bone metastases and intraosseous sites of haematological malignancies, lymphoma and multiple myeloma are the most frequent aetiologies, while primary bone tumours and meningeal or nerve tumours are less common. Some histological types have a predilection for the sacrum, especially chordoma and giant cell tumour. Clinical signs are usually minor, and sacral tumours are often discovered in the context of nerve root or pelvic organ compression. The roles of conventional radiology, CT and MRI are described and compared with the histological features of the main tumours. The impact of imaging on treatment decisions and follow-up is also reviewed. (orig.)

  1. Evaluation of intratumoural heterogeneity on {sup 18}F-FDG PET/CT for characterization of peripheral nerve sheath tumours in neurofibromatosis type 1

    Energy Technology Data Exchange (ETDEWEB)

    Salamon, Johannes; Derlin, Thorsten; Bannas, Peter; Busch, Jasmin D.; Herrmann, Jochen; Adam, Gerhard [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Bockhorn, Maximilian [University Medical Center Hamburg-Eppendorf, Department of General, Visceral and Thoracic Surgery, Hamburg (Germany); Hagel, Christian [University Medical Center Hamburg-Eppendorf, Institute of Neuropathology, Hamburg (Germany); Friedrich, Reinhard E. [University Medical Center Hamburg-Eppendorf, Department of Oral and Maxillofacial Surgery, Hamburg (Germany); Mautner, Victor F. [University Medical Center Hamburg-Eppendorf, Department of Neurology, Hamburg (Germany)


    The aim of the study was to evaluate the potential usefulness of intratumoural tracer uptake heterogeneity on {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT as compared to a cut-off maximum standardized uptake value (SUV{sub max}) for characterization of peripheral nerve sheath tumours (PNSTs) in neurofibromatosis type 1 (NF1). Fifty patients suffering from NF1 were examined by {sup 18}F-FDG PET/CT. Intralesional tracer uptake was analysed qualitatively and semi-quantitatively by measuring the mean and maximum SUV. Uptake heterogeneity was graded qualitatively using a three-point scale and semi-quantitatively by calculating an SUV-based heterogeneity index (HI{sub SUV}). Cohen's {kappa} was used to determine inter- and intra-rater agreement. Histopathological evaluation and clinical as well as radiological follow-up examinations served as the reference standards. A highly significant correlation between the degree of intratumoural uptake heterogeneity on {sup 18}F-FDG PET and malignant transformation of PNSTs was observed (p < 0.0001). Semi-quantitative HI{sub SUV} was significantly higher in malignant PNSTs (MPNSTs) than in benign tumours (p = 0.0002). Both intralesional heterogeneity and SUV{sub max} could be used to identify malignant tumours with a sensitivity of 100 %. Cohen's {kappa} was 0.86 for inter-rater agreement and 0.88 for intra-rater agreement on heterogeneity. MPNSTs in patients with NF1 demonstrate considerable intratumoural uptake heterogeneity on {sup 18}F-FDG PET/CT. Assessment of tumour heterogeneity is highly reproducible. Both tumour heterogeneity and a cut-off SUV{sub max} may be used to sensitively identify malignant PNSTs, but the specificity is higher for the latter. A combination of both methods leads to a non-significant improvement in diagnostic performance. (orig.)

  2. Intra-SA-nodal pacemaker shifts induced by autonomic nerve stimulation in the dog. (United States)

    Goldberg, J M


    Pacemaker shifts in the canine heart were inferred during stimulation of thoracic cardiac nerves and following norepinephrine from changes in the initial site of activation of bipolar electrodes sutured over the rostral, middle, and caudal regions of the sinus node, over the internodal pathways, and His bundle. During control periods, pacemaker activity was localized within the sinoatrial (SA) node 87% of the time, with the middle electrode most frequently showing initial activation. Stimulation of the right-sympathetic nerves enhanced sinus node pacemaker dominance, shifting it rostrally within the node. Right-vagal stimulation shifted the pacemaker caudally within the SA node, to nonnodal sites, and to the lower atrioventricular node and His bundle. Left-sympathetic stimulation shifted the pacemaker caudally within the sinus node and enhanced pacemaker activity in the vicinity of the internodal pathway electrodes and His bundle. Dispersion of pacemaker activity was particularly apparent during stimulation of the ventrolateral cervical cardiac nerve. Stimulation of the left-vagal nerves produced effects similar to those of the left-sympathetic nerves. Norepinephrine enhanced pacemaker activity particularly in the rostral region of the sinus node. Slight shifts in pacemaker activity within the sinus node produced changes in pattern of atrial excitation.

  3. Early-onset multisystem degeneration with central motor, autonomic and optic nerve disturbances: unusual Riley-Day syndrome or new clinical entity? (United States)

    Schnitzler, A; Witte, O W; Kunesch, E; Freund, H J; Benecke, R


    We report a 21-year-old woman presenting with a slowly progressive tetraparesis, optic nerve atrophy on both sides, and autonomic disturbances since early childhood. The patient has been carefully followed up for 5 years with clinical and ancillary investigations. The results and the time course strongly suggest an underlying degenerative syndrome affecting parts of three major systems: autonomic, motor and visual. Some symptoms resemble familial dysautonomia (FD, Riley-Day syndrome), however, hallmarks of FD, such as absence of fungiform papillae of the tongue, abnormal reaction on intradermal histamine injection, absent tendon reflexes, are missing, and central motor disturbances have not been described in FD. We consider this syndrome a slowly progressive multisystemic degeneration with two unusual hitherto unreported features: the combination of affected systems (autonomic and motor systems, optic nerves), and the early onset.

  4. [Autonomic neuropathies]. (United States)

    Siepmann, T; Penzlin, A I; Illigens, B M W


    Autonomic neuropathies are a heterogeneous group of diseases that involve damage of small peripheral autonomic Aδ- and C-fibers. Causes of autonomic nerve fiber damage are disorders such as diabetes mellitus and HIV-infection. Predominant symptoms of autonomic neuropathy are orthostatic hypotension, gastro-intestinal problems, urogenital dysfunction, and cardiac arrhythmia, which can severely impair the quality of life in affected patients. Furthermore, autonomic neuropathies can be induced by autoimmune diseases such as acute inflammatory demyelinating polyneuropathy, hereditary disorders such as the lysosomal storage disorder Fabry disease and hereditary sensory and autonomic neuropathies, as well as certain toxins and drugs.

  5. Autonomic nerves versus prostaglandins in the control of rat and rabbit testicular capsular contractions in vivo and in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Hargrove, J.L.; Ellis, L.C.


    The tonus and rate of spontaneous contractions measured in vivo from the tunica albuginea of rabbit testes were augmented by epinephrine, acetylcholine and prostaglandin (PG)F/sub 2 alpha/. Neither reserpine, dibenamine nor atropine decreased autorhythmic contractility. Indomethacin injections ip significantly decreased the mean amplitude of testicular contractions. This treatment effaced motility in two of eleven preparations. Injections of 5,8,11,14-eicosatetraynoic acid (TYA) did not significantly decrease the amplitude of contraction. Electrical stimulation of the spermatic artery (site of the spermatic nerve) in rabbits and in rats failed to alter testicular tonus or motility. The above evidence suggests that local factors such as PGs may contribute more to smooth muscle activity in the tunica albuginea of rabbit testes than do autonomic nerves. The rhythmical contractions observed in vivo, however, continued in the presence of indomethacin in the bathing medium, and may not require stimulation by PGs for their origination. Rat testes, unlike rabbit testes, did not contract rhythmically in vivo. Isolated rat testes contracted in response to administered PGF/2 alpha/, while PGE/sub 1/ abolished the induced contraction. Such modulators of muscular tonus feasibly could alter intratesticular pressure for the intact animal.

  6. Perivascular nerve fiber α-synuclein regulates contractility of mouse aorta: a link to autonomic dysfunction in Parkinson's disease. (United States)

    Marrachelli, Vannina G; Miranda, Francisco J; Alabadí, José A; Milán, Miguel; Cano-Jaimez, Marifé; Kirstein, Martina; Alborch, Enrique; Fariñas, Isabel; Pérez-Sánchez, Francisco


    Parkinson's disease and other neurodegenerative disorders associated to changes in alpha-synuclein often result in autonomic dysfunction, most of the time accompanied by abundant expression of this synaptic protein in peripheral autonomic neurons. Given that expression of alpha-synuclein in vascular elements has been previously reported, the present study was undertaken to determine whether alpha-synuclein directly participates in the regulation of vascular responsiveness. We detected by immunohistochemistry perivascular nerve fibers containing alpha-synuclein in the aorta of mice while aortic endothelial cells and muscular fibers themselves did not exhibit detectable levels of this protein. To assess the effect of alpha-synuclein on vascular reactivity, aortic ring preparations obtained from alpha-synuclein-deficient knockout mice and from transgenic mice overexpressing human wild-type alpha-synuclein under the control of the tyrosine hydroxylase-promoter were mounted and equilibrated in organ baths for isometric tension recording. Lack of alpha-synuclein did not modify the relaxant responses to the endothelium-dependent (acetylcholine) and -independent (sodium nitroprusside) vasodilators, but resulted in a greater than normal norepinephrine-induced vasoconstriction along with a lowered response to dopamine, suggesting potential presynaptic changes in dopamine and norepinephrine releases in knockout mice. Overexpression of alpha-synuclein in TH-positive fibers resulted in complex abnormal responses, characterized by lowered acetylcholine-induced relaxation and lowered norepinephrin-induced contraction. Taken together, our data show for the first time that alpha-synuclein is present in sympathetic fibers supplying the murine aorta and provide evidence that changes in alpha-synuclein levels in perivascular fibers play a physiological role in the regulation of vascular function.

  7. Autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J


    The diagnosis of autonomic neuropathy is often difficult to establish, since clinical symptoms generally appear late in the course of the disease, and may be non-specific. A number of recently developed quantifiable and reproducible autonomic nerve function tests are reviewed, with emphasis on th...

  8. EZH2-miR-30d-KPNB1 pathway regulates malignant peripheral nerve sheath tumour cell survival and tumourigenesis. (United States)

    Zhang, Pingyu; Garnett, Jeannine; Creighton, Chad J; Al Sannaa, Ghadah Abbas; Igram, Davis R; Lazar, Alexander; Liu, Xiuping; Liu, Changgong; Pollock, Raphael E


    Malignant peripheral nerve sheath tumours (MPNSTs), which develop sporadically or from neurofibromatosis, recur frequently with high metastatic potential and poor outcome. The polycomb group protein enhancer of zeste homologue 2 (EZH2) is an important regulator for various human malignancies. However, the function of EZH2 in MPNSTs is unknown. Here we report that the EZH2-miR-30d-KPNB1 signalling pathway is critical for MPNST tumour cell survival in vitro and tumourigenicity in vivo. Up-regulated EZH2 in MPNST inhibits miR-30d transcription via promoter binding activity, leading to enhanced expression of the nuclear transport receptor KPNB1 that is inhibited by miR-30d targeting of KPNB1 3' UTR region. Furthermore, inhibition of EZH2 or KPNB1, or miR-30d over-expression, induces MPNST cell apoptosis in vitro and suppresses tumourigenesis in vivo. More importantly, forced over-expression of KPNB1 rescues MPNST cell apoptosis induced by EZH2 knockdown. Immunohistochemical analyses show that EZH2 and KPNB1 over-expression is observed in human MPNST specimens and is negatively associated with miR-30d expression. Our findings identify a novel signalling pathway involved in MPNST tumourigenesis, and also suggest that EZH2-miR-30d-KPNB1 signalling represents multiple potential therapeutic targetable nodes for MPNST.

  9. Gross anatomical study on the human myocardial bridges with special reference to the spatial relationship among coronary arteries, cardiac veins, and autonomic nerves. (United States)

    Watanabe, Yuko; Arakawa, Takamitsu; Kageyama, Ikuo; Aizawa, Yukio; Kumaki, Katsuji; Miki, Akinori; Terashima, Toshio


    Coronary arteries are frequently covered by cardiac muscles. This arrangement is termed a myocardial bridge. Previous studies have shown that myocardial bridges can cause myocardial ischemic diseases or cardiac arrhythmia, but the relevant pathogenic mechanisms remain unknown. We examined 60 hearts from Japanese cadavers macroscopically to clarify the spatial relationships among coronary arteries, cardiac veins and autonomic nerves. We found 86 myocardial bridges in 47 hearts from the 60 cadavers examined (78.3%). Next, we dissected out nine hearts with myocardial bridges in detail under the operating microscope. We found no additional branches of coronary arteries on the myocardial bridge surfaces. However, the cardiac veins, which usually accompany the coronary arteries, ran independently on the myocardial bridge surfaces in the same region. Cardiac autonomic nerves comprised two rami: one was associated with the coronary artery under the myocardial bridge and the other ran on the surface of the bridge. Such spatial relationships among the coronary arteries, cardiac veins and cardiac autonomic nerves at the myocardial bridges are quite similar to those in mouse embryo hearts.

  10. Evaluation of cardiac autonomic nerves by iodine-123 metaiodobenzylguanidine scintigraphy and ambulatory electrocardiography in patients after arterial switch operations

    Energy Technology Data Exchange (ETDEWEB)

    Sakurai, Hajime; Maeda, Masanobu; Miyahara, Ken [Shakaihoken Chukyo Hospital, Nagoya (Japan)] [and others


    The autonomic cardiac nerves reach the heart after passing through the vicinity of the aortic root and the pulmonary trunk. The arterial switch operation (ASO) completely transects the ascending aorta and the pulmonary trunk. Therefore, this surgical procedure virtually denerves the heart. Cardiac sympathetic denervation and reinnervation were evaluated in patients after ASO using iodine-123 metaiodobenzylguanidine (MIBG) myocardial scintigraphy and parasympathetic denervation and reinnervation using ambulatory electrocardiography [Holter electrocardiogram (ECG)]. MIBG scintigraphy was performed in 14 patients who underwent ASO (ASO group) and 3 patients who underwent other open heart surgery (control group). All patients in the ASO group underwent the operation in the neonatal or infantile period. Planar and single photon emission computed tomography (SPECT) images of the myocardium were obtained. Defect score was determined by the SPECT images as a semi-quantitative index. The mean interval between ASO and MIBG scintigraphy was 25.6{+-}14.6 months. Holter ECG was also performed in 14 patients in the ASO group and 19 age-matched normal children. The Holter ECGs were plotted on a Lorenz plot. The H index, which is related to vagal tone for the cardiovascular system, was calculated from the R-R intervals. The mean interval between the ASO and Holter ECG was 8.3{+-}9.7 months. MIBG scintigraphy in the control group demonstrated an almost normal homogeneous tracer uptake, but showed extremely reduced tracer uptake and significantly higher defect score in the ASO group. The extent and degree of the reduction of MIBG uptake improved with time after the ASO. The heart-to-mediastinum MIBG count ratio tended to increase with time. The H index of the ASO group was lower than that of normal children (<12 months: Control group 0.0280{+-}0.0068 vs ASO group 0.0219{+-}0.0083), and gradually increased with time (1-3 years: 0.0470{+-}0.0157 vs 0.0314{+-}0.0124). (author)

  11. Protein expression of BIRC5, TK1, and TOP2A in malignant peripheral nerve sheath tumours--A prognostic test after surgical resection. (United States)

    Kolberg, Matthias; Høland, Maren; Lind, Guro E; Ågesen, Trude H; Skotheim, Rolf I; Hall, Kirsten Sundby; Mandahl, Nils; Smeland, Sigbjørn; Mertens, Fredrik; Davidson, Ben; Lothe, Ragnhild A


    No consensus treatment regime exists beyond surgery for malignant peripheral nerve sheath tumours (MPNST), and the purpose of the present study was to find new approaches to stratify patients with good and poor prognosis and to better guide therapeutic intervention for this aggressive soft tissue cancer. From a total of 67 MPNSTs from Scandinavian patients with and without neurofibromatosis type 1, 30 MPNSTs were investigated by genome-wide RNA expression profiling and 63 MPNSTs by immunohistochemical (IHC) analysis, and selected genes were submitted to analyses of disease-specific survival. The potential drug target genes survivin (BIRC5), thymidine kinase 1 (TK1), and topoisomerase 2-alpha (TOP2A), all encoded on chromosome arm 17q, were up-regulated in MPNST as compared to benign neurofibromas. Each of them was found to be independent prognostic markers on the gene expression level, as well as on the protein level. A prognostic profile was identified by combining the nuclear expression scores of the three proteins. For patients with completely resected tumours only 15% in the high risk group were alive after two years, as compared to 78% in the low risk group. In conclusion, we found a novel protein expression profile which identifies MPNST patients with inferior prognosis even after assumed curative surgery. The tested proteins are drug targets; therefore the expression profile may provide predictive information guiding the design of future clinical trials. Importantly, as the effect is seen on the protein level using IHC, the biomarker panel can be readily implemented in routine clinical testing.

  12. Peripheral injury of pelvic visceral sensory nerves alters GFRa (GDNF family receptor alpha localization in sensory and autonomic pathways of the sacral spinal cord

    Directory of Open Access Journals (Sweden)

    Shelley Lynne Forrest


    Full Text Available GDNF (glial cell line-derived neurotrophic factor, neurturin and artemin use their co-receptors (GFRα1, GFRα2 and GFRα3, respectively and the tyrosine kinase Ret for downstream signalling. In rodent dorsal root ganglia (DRG most of the unmyelinated and some myelinated sensory afferents express at least one GFRα. The adult function of these receptors is not completely elucidated but their activity after peripheral nerve injury can facilitate peripheral and central axonal regeneration, recovery of sensation, and sensory hypersensitivity that contributes to pain. Our previous immunohistochemical studies of spinal cord and sciatic nerve injuries in adult rodents have identified characteristic changes in GFRα1, GFRα2 or GFRα3 in central spinal cord axons of sensory neurons located in dorsal root ganglia. Here we extend and contrast this analysis by studying injuries of the pelvic and hypogastric nerves that contain the majority of sensory axons projecting to the pelvic viscera (e.g., bladder and lower bowel. At 7 d, we detected some effects of pelvic but not hypogastric nerve transection on the ipsilateral spinal cord. In sacral (L6-S1 cord ipsilateral to nerve injury, GFRα1-immunoreactivity (IR was increased in medial dorsal horn and CGRP-IR was decreased in lateral dorsal horn. Pelvic nerve injury also upregulated GFRα1- and GFRα3-IR terminals and GFRα1-IR neuronal cell bodies in the sacral parasympathetic nucleus that provides the spinal parasympathetic preganglionic output to the pelvic nerve. This evidence suggests peripheral axotomy has different effects on somatic and visceral sensory input to the spinal cord, and identifies sensory-autonomic interactions as a possible site of post-injury regulation.

  13. The autonomic laboratory (United States)

    Low, P. A.; Opfer-Gehrking, T. L.


    The autonomic nervous system can now be studied quantitatively, noninvasively, and reproducibly in a clinical autonomic laboratory. The approach at the Mayo Clinic is to study the postganglionic sympathetic nerve fibers of peripheral nerve (using the quantitative sudomotor axon reflex test [QSART]), the parasympathetic nerves to the heart (cardiovagal tests), and the regulation of blood pressure by the baroreflexes (adrenergic tests). Patient preparation is extremely important, since the state of the patient influences the results of autonomic function tests. The autonomic technologist in this evolving field needs to have a solid core of knowledge of autonomic physiology and autonomic function tests, followed by training in the performance of these tests in a standardized fashion. The range and utilization of tests of autonomic function will likely continue to evolve.

  14. Calretinin-immunoreactive nerves in the uterus, pelvic autonomic ganglia, lumbosacral dorsal root ganglia and lumbosacral spinal cord. (United States)

    Papka, R E; Collins, J; Copelin, T; Wilson, K


    Nerves containing the calcium-binding protein calretinin have been reported in several organs but not in female reproductive organs and associated ganglia. This study was undertaken to determine if nerves associated with the uterus contain calretinin and the source(s) of calretinin-synthesizing nerves in the rat (are they sensory, efferent, or both?). Calretinin-immunoreactive nerves were present in the uterine horns and cervix where they were associated with arteries, uterine smooth muscle, glands, and the epithelium. Calretinin-immunoreactive terminals were apposed to neurons in the paracervical ganglia; in addition, some postganglionic neurons in this ganglion were calretinin positive. Calretinin perikarya were present in the lumbosacral dorsal root ganglia, no-dose ganglia, and lumbosacral spinal cord. Retrograde axonal tracing, utilizing Fluorogold injected into the uterus or paracervical parasympathetic ganglia, revealed calretinin-positive/Fluorogold-labeled neurons in the dorsal root and nodose ganglia. Also, capsaicin treatment substantially reduced the calretinin-positive fibers in the uterus and pelvic ganglia, thus indicating the sensory nature of these fibers. The presence of calretinin immunoreactivity identifies a subset of nerves that are involved in innervation of the pelvic viscera and have origins from lumbosacral dorsal root ganglia and vagal nodose ganglia. Though the exact function of calretinin in these nerves is not currently known, calretinin is likely to play a role in calcium regulation and their function.

  15. Understanding the surgical pitfalls in total mesorectal excision : Investigating the histology of the perirectal fascia and the pelvic autonomic nerves

    NARCIS (Netherlands)

    Kraima, A. C.; West, N. P.; Treanor, D.; Magee, D. R.; Bleys, R. L A W; Rutten, H. J T; Van De Velde, C. J H; Quirke, P.; Deruiter, M. C.


    Aim Excellent understanding of fasciae and nerves surrounding the rectum is necessary for total mesorectal excision (TME). However, fasciae anterolateral to the rectum and surrounding the low rectum are still poorly understood. We studied the perirectal fascia enfolding the extraperitoneally located

  16. [Changes in autonomic nerve function during the normal menstrual cycle measured by the coefficient of variation of R-R intervals]. (United States)

    Kondo, M; Hirano, T; Okamura, Y


    The purpose of this study was to determine if there is a change in autonomic nerve function during the menstrual cycle. The subjects were 20 females (average age 26.1 years +/- 4.6) with a normal menstrual cycle. The coefficient of variation of R-R intervals (CV R.R) was measured to investigate autonomic function in the menstrual, follicular, ovulatory, luteal, and premenstrual phases. Average CV R-R for all phases was 5.2 +/- 1.9%. And the CV R-R tended to be lower in those in their 30s than in those in their 20s. And no noticeable difference was seen in the CV R-R among the 5 phases of the menstrual cycle. On the other hand, the CV R-R of 11 females with premenstrual syndrome was low in the ovulatory, luteal and premenstrual phases. These results, which provide basic data for clinical use, suggest the following. (1) The age of subjects should be taken into consideration. (2) Changes in the CV R-R during the menstrual cycle are negligible. (3) However, in those showing symptoms associated with the menstrual cycle such as premenstrual syndrome, changes during the menstrual cycle should be taken into account. At the same time psychological changes in the subjects were evaluated by the following tests: Cornell Medical Index, Taylor's manifest anxiety scale, and Zung's self-rating depression scale. The results of these tests did not vary significantly during the menstrual cycle.

  17. Prostate cancer progression attributed to autonomic nerve development: Potential for therapeutic prevention of localized and metastatic disease



    In a study recently published in Science, Magnon et al. show that both the sympathetic and parasympathetic components of the autonomic nervous system play an integral part in the development and dissemination of prostate cancer (PCa). Inhibition of the sympathetic nervous system (SNS) and disruption of the adrenergic receptors, specifically Ardβ2, resulted in the prevention of primary PCa tumor development in mice. The authors found that inhibition of the SNS is only successful in preventing ...

  18. Autonomic markers of emotional processing: skin sympathetic nerve activity in humans during exposure to emotionally-charged images

    Directory of Open Access Journals (Sweden)

    Rachael eBrown


    Full Text Available The sympathetic innervation of the skin primarily subserves thermoregulation, but the system has also been commandeered as a means of expressing emotion. While it is known that the level of skin sympathetic nerve activity (SSNA is affected by anxiety, the majority of emotional studies have utilized the galvanic skin response as a means of inferring increases in SSNA. The purpose of the present study was to characterize the changes in SSNA when showing subjects neutral or emotionally-charged images from the International Affective Picture System. Skin sympathetic nerve activity was recorded via tungsten microelectrodes inserted into cutaneous fascicles of the common peroneal nerve in ten subjects. Neutral images, positively-charged images (erotica or negatively-charged images (mutilation were presented in blocks of fifteen images of a specific type, each block lasting two minutes. Images of erotica or mutilation were presented in a quasi-random fashion, each block following a block of neutral images. Both images of erotica or images of mutilation caused significant increases in SSNA, but the increases in SSNA were greater for mutilation. The increases in SSNA were often coupled with sweat release and cutaneous vasoconstriction, however, these markers were not always consistent with the SSNA increases. We conclude that SSNA, comprising cutaneous vasoconstrictor and sudomotor activity, increases with both positively-charged and negatively-charged emotional images. Measurement of SSNA provides a more comprehensive assessment of sympathetic outflow to the skin than does the use of sweat release alone as a marker of emotional processing.

  19. Anatomical basis for pelvic autonomic nerve preservation in total mesorectal excision of adult male%全直肠系膜切除术中保留男性盆腔自主神经的解剖基础

    Institute of Scientific and Technical Information of China (English)

    刘念; 林谋斌; 张浩波; 陆兴生; 吕克之; 尹路


    Objective To study the pelvic fascia related to pelvic autonomic nerve and detect the anatomical localization of pelvic autonomic nerve by marker in adult male.Methods Twelve pelvises of adult male harvested from cadavers were studied by dissection.Results Hypogastric nerve was embedded in the posterior leaf of the visceral pelvic fascia.Pelvic plexus was situated between vesicohypogastric fascia and visceral fascia.Pelvic nerve branch of seminal vesicle and prostate was located at the anterolateral part of Denonvilliers fascia.Sacral promontory,ureter,junction of Denonvilliers fascia,visceral fascia and seminal vesicle could be regarded as anatomical markers for pelvic autonomic nerve.Conclusion The anatomical characteristics of pelvic autonomic nerve can be used for protecting and isolating pelvic autonomic nerve in total mesorectal excision of adult male.%目的 探讨成年男性盆腔自主神经的筋膜层次及其解剖标记,明确全直肠系膜切除术中保留男性盆腔自主神经的解剖基础.方法 对12具男性尸体盆腔(24侧半盆腔)进行解剖.结果 盆腔自主神经走行筋膜层次为:腹下神经走行于脏筋膜后叶内,盆丛位于膀胱腹下筋膜与脏筋膜间,精囊前列腺分支位于Denonvilliers筋膜前侧方.骶骨岬、输尿管、Denonvilliers筋膜与脏筋膜交汇处、精囊腺等都可作为男性盆腔自主神经定位标记.结论 男性盆腔自主神经的筋膜层次和解剖标记可用于男性全直肠系膜切除术中盆腔自主神经的定位和保护.

  20. Prostate cancer progression attributed to autonomic nerve development: potential for therapeutic prevention of localized and metastatic disease. (United States)

    Fernández, Elena V; Price, Douglas K; Figg, William D


    In a study recently published in Science, Magnon et al. show that both the sympathetic and parasympathetic components of the autonomic nervous system play an integral part in the development and dissemination of prostate cancer (PCa). Inhibition of the sympathetic nervous system (SNS) and disruption of the adrenergic receptors, specifically Ardβ 2, resulted in the prevention of primary PCa tumor development in mice. The authors found that inhibition of the SNS is only successful in preventing murine tumor development if completed early enough, and the parasympathetic nervous system (PNS) predominates in later stages of PCa. Inhibition of the PNS by way of the cholinergic receptor, muscarinic 1 (Chrm1), caused mice to develop less metastases to the pelvic lymph nodes, intestines, and bones. A PCa progression scheme has been outlined where initial tumor engraftment is controlled by the SNS but then becomes less prominent than the PNS, which promotes metastasis. The investigators showed the dependence of the autonomic nervous system on development of PCa and present opportunities for prevention; further studies are needed to confirm these results in humans.

  1. Origin and central projections of rat dorsal penile nerve: possible direct projection to autonomic and somatic neurons by primary afferents of nonmuscle origin. (United States)

    Núñez, R; Gross, G H; Sachs, B D


    Cell number, size, and somatotopic arrangement within the spinal ganglia of the cells of origin of the rat dorsal penile nerve (DPN), and their spinal cord projections, were studied by loading the proximal stump of the severed DPN with horseradish peroxidase (HRP). The DPN sensory cells were located entirely in the sixth lumbar (L6) dorsal root ganglia (DRG), in which a mean of 468 +/- 78 cells per side were observed, measuring 26.7 +/- 0.8 microns in their longest axis (range 10-65 microns) and distributed apparently randomly within the ganglia. Within the spinal cord, no retrograde label was found, i.e., no motoneurons were labeled, indicating that in the rat the DPN is formed exclusively of sensory nerve fibers. Although labeled fibers entered the cord only through L6, transganglionically transported HRP was evident in all spinal segments examined, i.e., T13-S2. Labeled fibers projected along the inner edge of the dorsal horn (medial pathway) throughout their extensive craniosacral distribution. However, laminar distribution varied with spinal segment. In the dorsal horn, terminals or preterminal axons were found in the dorsal horn marginal zone (lamina I), the substantia gelatinosa (lamina II), the nucleus proprius (laminae III and IV--the most consistent projection), Clarke's column (lamina VI), and the dorsal gray commissure. In the ventral horn, terminals were found in lamina VII and lamina IX. Label apposed to cell somas and dendrites in lamina VII may represent direct primary afferent projections onto sympathetic autonomic neurons. In lamina IX, labeled terminals delineated the somas and dendrites of cells that appeared to be motoneurons. This is the first description of an apparently monosynaptic contact onto motoneurons by a primary afferent of nonmuscle origin.

  2. The effect of end-to-side nerve anastomosis of autonomic nerve to somatic nerve on the donor nerve and its functions%内脏神经-体神经端侧吻合对供体神经及其功能的影响

    Institute of Scientific and Technical Information of China (English)

    董传江; 谢宗兰; 张路生; 范哲奇; 吴朝; 董自强


    Objective Using neural morphology and electromyography technology to study the effect of end-to-side nerve anastomosis of autonomic nerve to somatic nerve on the donor nerve and its functions.Methods Twenty-four young adult male Sprague-Dawley rats [mean weight (230 ± 28) g] were randomly divided into 2 groups:group A,control group (n =12);group B,end-to-side anastomosis group (n =12).In group A only a L3-L6 laminectomy was performed,and in group B the distal end of left L6 ventral root (L6VR) was sutured in an end-to-side fashion to Left L4 ventral root (L6VR).All rats' left tibialis anterior muscle electromyogram (EMG) was recorded at 4th,12th,and 24th week after operation.At 24th week after operation,the rats were sacrificed.The left L4 nerve segment In control group,and the left L4 nerve segment distal to the anastomosis site in end-to-side anastomosis group were resected and stained with toluidine blue for nerve fiber count.The L4 nerve innervated tibialis anterior muscle wet weight was measured,and hematoxylin and eosin (HE) staining was used to observe muscle morphology.Results At 4th and 12th week after operation,the denervation EMG changes to varying degrees were observed,and returned to normal at 24th week.The average number of myelinated axons of the left L4VR at 24th week after operation in end-to-side anastomosis group and control group was 1 043 ± 212 and 1 039 ± 205,respectively.At 24th week there were no significant differences in muscle morphology between the two groups (P > 0.05).The muscle wet weights in two groups were (0.666 ± 0.043) g and (0.670 ± 0.050) g respectively with the difference being not significant between the two groups (P > 0.05).Conclusion End-to-side anastomosis shows no adverse effect on the donor nerve and donor nerve innervated muscle function.%目的 利用神经形态学、肌电图技术检测内脏神经-体神经端侧吻合对供体神经及其功能影响.方法 选用24只成年雄性SD大鼠(230~250 g)

  3. Differential Patterns and Determinants of Cardiac Autonomic Nerve Dysfunction during Endotoxemia and Oral Fat Load in Humans.

    Directory of Open Access Journals (Sweden)

    Dan Ziegler

    Full Text Available The autonomic nervous system (ANS plays an important role in regulating the metabolic homeostasis and controlling immune function. ANS alterations can be detected by reduced heart rate variability (HRV in conditions like diabetes and sepsis. We determined the effects of experimental conditions mimicking inflammation and hyperlipidemia on HRV and heart rate (HR in relation to the immune, metabolic, and hormonal responses resulting from these interventions. Sixteen lean healthy subjects received intravenous (i.v. low-dose endotoxin (lipopolysaccharide [LPS], i.v. fat, oral fat, and i.v. glycerol (control for 6 hours, during which immune, metabolic, hormonal, and five HRV parameters (pNN50, RMSSD, low-frequency (LF and high-frequency (HF power, and LF/HF ratio were monitored and energy metabolism and insulin sensitivity (M-value were assessed. LPS infusion induced an increase (AUC in HR and LF/HF ratio and decline in pNN50 and RMSSD, while oral fat resulted in elevated HR and a transient (hours 1-2 decrease in pNN50, RMSSD, and HF power. During LPS infusion, ΔIL-1ra levels and ΔIL-1ra and ΔIL-1ß gene expression correlated positively with ΔLF/HF ratio and inversely with ΔRMSSD. During oral fat intake, ΔGLP-1 tended to correlate positively with ΔHR and inversely with ΔpNN50 and ΔRMSSD. Following LPS infusion, lipid oxidation correlated positively with HR and inversely with pNN50 and RMSSD, whereas HRV was not related to M-value. In conclusion, suppression of vagal tone and sympathetic predominance during endotoxemia are linked to anti-inflammatory processes and lipid oxidation but not to insulin resistance, while weaker HRV changes in relation to the GLP-1 response are noted during oral fat NCT01054989.

  4. Differential Patterns and Determinants of Cardiac Autonomic Nerve Dysfunction during Endotoxemia and Oral Fat Load in Humans (United States)

    Ziegler, Dan; Strom, Alexander; Strassburger, Klaus; Nowotny, Bettina; Zahiragic, Lejla; Nowotny, Peter J.; Carstensen-Kirberg, Maren; Herder, Christian; Szendroedi, Julia; Roden, Michael


    The autonomic nervous system (ANS) plays an important role in regulating the metabolic homeostasis and controlling immune function. ANS alterations can be detected by reduced heart rate variability (HRV) in conditions like diabetes and sepsis. We determined the effects of experimental conditions mimicking inflammation and hyperlipidemia on HRV and heart rate (HR) in relation to the immune, metabolic, and hormonal responses resulting from these interventions. Sixteen lean healthy subjects received intravenous (i.v.) low-dose endotoxin (lipopolysaccharide [LPS]), i.v. fat, oral fat, and i.v. glycerol (control) for 6 hours, during which immune, metabolic, hormonal, and five HRV parameters (pNN50, RMSSD, low-frequency (LF) and high-frequency (HF) power, and LF/HF ratio) were monitored and energy metabolism and insulin sensitivity (M-value) were assessed. LPS infusion induced an increase (AUC) in HR and LF/HF ratio and decline in pNN50 and RMSSD, while oral fat resulted in elevated HR and a transient (hours 1-2) decrease in pNN50, RMSSD, and HF power. During LPS infusion, ΔIL-1ra levels and ΔIL-1ra and ΔIL-1ß gene expression correlated positively with ΔLF/HF ratio and inversely with ΔRMSSD. During oral fat intake, ΔGLP-1 tended to correlate positively with ΔHR and inversely with ΔpNN50 and ΔRMSSD. Following LPS infusion, lipid oxidation correlated positively with HR and inversely with pNN50 and RMSSD, whereas HRV was not related to M-value. In conclusion, suppression of vagal tone and sympathetic predominance during endotoxemia are linked to anti-inflammatory processes and lipid oxidation but not to insulin resistance, while weaker HRV changes in relation to the GLP-1 response are noted during oral fat load. Trial Registration NCT01054989 PMID:25893426

  5. Autoimmune autonomic disorders. (United States)

    Mckeon, Andrew; Benarroch, Eduardo E


    Autoimmune autonomic disorders occur because of an immune response directed against sympathetic, parasympathetic, and enteric ganglia, autonomic nerves, or central autonomic pathways. In general, peripheral autoimmune disorders manifest with either generalized or restricted autonomic failure, whereas central autoimmune disorders manifest primarily with autonomic hyperactivity. Some autonomic disorders are generalized, and others are limited in their anatomic extent, e.g., isolated gastrointestinal dysmotility. Historically, these disorders were poorly recognized, and thought to be neurodegenerative. Over the last 20 years a number of autoantibody biomarkers have been discovered that have enabled the identification of certain patients as having an autoimmune basis for either autonomic failure or hyperactivity. Peripheral autoimmune autonomic disorders include autoimmune autonomic ganglionopathy (AAG), paraneoplastic autonomic neuropathy, and acute autonomic and sensory neuropathy. AAG manifests with acute or subacute onset of generalized or selective autonomic failure. Antibody targeting the α3 subunit of the ganglionic-type nicotinic acetylcholine receptor (α3gAChR) is detected in approximately 50% of cases of AAG. Some other disorders are characterized immunologically by paraneoplastic antibodies with a high positive predictive value for cancer, such as antineuronal nuclear antibody, type 1 (ANNA-1: anti-Hu); others still are seronegative. Recognition of an autoimmune basis for autonomic disorders is important, as their manifestations are disabling, may reflect an underlying neoplasm, and have the potential to improve with a combination of symptomatic and immune therapies.

  6. Sensitivity Analysis of Vagus Nerve Stimulation Parameters on Acute Cardiac Autonomic Responses: Chronotropic, Inotropic and Dromotropic Effects (United States)

    Ojeda, David; Le Rolle, Virginie; Romero-Ugalde, Hector M.; Gallet, Clément; Bonnet, Jean-Luc; Henry, Christine; Bel, Alain; Mabo, Philippe; Carrault, Guy; Hernández, Alfredo I.


    Although the therapeutic effects of Vagus Nerve Stimulation (VNS) have been recognized in pre-clinical and pilot clinical studies, the effect of different stimulation configurations on the cardiovascular response is still an open question, especially in the case of VNS delivered synchronously with cardiac activity. In this paper, we propose a formal mathematical methodology to analyze the acute cardiac response to different VNS configurations, jointly considering the chronotropic, dromotropic and inotropic cardiac effects. A latin hypercube sampling method was chosen to design a uniform experimental plan, composed of 75 different VNS configurations, with different values for the main parameters (current amplitude, number of delivered pulses, pulse width, interpulse period and the delay between the detected cardiac event and VNS onset). These VNS configurations were applied to 6 healthy, anesthetized sheep, while acquiring the associated cardiovascular response. Unobserved VNS configurations were estimated using a Gaussian process regression (GPR) model. In order to quantitatively analyze the effect of each parameter and their combinations on the cardiac response, the Sobol sensitivity method was applied to the obtained GPR model and inter-individual sensitivity markers were estimated using a bootstrap approach. Results highlight the dominant effect of pulse current, pulse width and number of pulses, which explain respectively 49.4%, 19.7% and 6.0% of the mean global cardiovascular variability provoked by VNS. More interestingly, results also quantify the effect of the interactions between VNS parameters. In particular, the interactions between current and pulse width provoke higher cardiac effects than the changes on the number of pulses alone (between 6 and 25% of the variability). Although the sensitivity of individual VNS parameters seems similar for chronotropic, dromotropic and inotropic responses, the interacting effects of VNS parameters provoke

  7. 特发性室早气阴两虚证患者自主神经功能的变化%Changes of Autonomic Nerve Function in Premature Ventricular Contraction Beats Patients with Deficiency of both Qi and Yin

    Institute of Scientific and Technical Information of China (English)

    阮小芬; 王肖龙; 张一乐; 徐燕; 龚菊芬; 吴昉怡


    目的 探讨气阴两虚证室早患者自主神经功能变化的特点.方法 与30例健康对照组相比较,分析41例室早患者自主神经功能各项指标变化,及室早、中医证候与自主神经功能的相关性.结果 室早组患者的SDANN、rMSSD、PNN50显著降低,室早患者中医证候积分与rMSSD、PNN50显著负相关.结论 气阴两虚证室早患者存在迷走神经功能显著降低及交感神经功能亢进,室早临床症状产生与迷走神经功能低下相关.%Objective: To observe the characteristics of autonomic nerve function in premature ventricular contraction beats(PVC) patients. Methods: Compared with 30 healthy controls,the autonomic nervous function of 41 cases PVC patients and the relationship between ventricular premature, the clinical symptoms and autonomic nervous function were analysed. Results: SDANN, rMSSD, and PNN50 were significantly lower in patients with PVC. TCM syndrome and rMSSD, PNN50 was significantly negative correlation. Conclusions: The vagus nerve function are decreased and the sympathetic nerve functionin is hyperthyroidism in PVC patients of both deficiency qi and Yin. clinical symptoms have associated with the vagus nerve function.

  8. 心电图对功能性心血管疾病自主神经功能评价的意义%Significance of electrocardiogram in the evaluation of the autonomic nerve function in functional cardiovascular disease

    Institute of Scientific and Technical Information of China (English)

    刘丽萍; 王成


    Autonomic nervous system(ANS) activity plays an important role in the pathogenesis of cardiovascular disease,including organic cardiovascular disease(such as hypertension,coronary artery disease,etc) and functional cardiovascular disease (such as vasovagal syncope,postural orthostatic tachycardia syndrome,etc).Many methods was used to evaluate ANS function.Heart rate variability is a widely accepted method to assess cardiac autonomic nerve function.Autonomic nervous affected cardiac action potential and let electrocardiogram changes.Through the sympathetic and parasympathetic neurotransmitters which acting on the corresponding receptors.Electrocardiogram changes reflects autonomic nervous function.Present researches suggest that electrocardiogram has an important significance in the evaluation of autonomic nerve function in functional cardiovascular disease.%自主神经系统对心血管疾病的发生发展起重要调节作用,包括器质性心血管疾病(如高血压、冠状动脉粥样硬化性心脏病等)及功能性心血管疾病(如血管迷走性晕厥、体位性心动过速综合征等).评估自主神经功能的方法有很多,心率变异性分析是公认的评估心脏自主神经功能的方法.自主神经系统通过交感神经和副交感神经作用于相应受体,影响心肌动作电位导致心电图变化.因此,心电图能反映心脏自主神经功能变化,对功能性心血管疾病的自主神经功能评估具有重要意义.

  9. Regulating autonomic nerve system:a new field of anti-inflammatory therapy for cardiovascular diseases%调节自主神经系统:心血管疾病抗炎治疗的新领域

    Institute of Scientific and Technical Information of China (English)

    马度芳; 姜萍; 杨金龙; 李晓


    The role of chronic inflammation and autonomic neuropathy in the crucial underlying process con -tributing to the initiation and the progression of various cardiovascular diseases is well established .It is well known that the immune system is innervated by the autonomic nervous system , and the inflammatory reaction and immune reaction are re-gulated by the autonomic nerve system .Vagus nerve depresses inflammatory reaction via cholinergic anti-inflammatory path-way (CAP), while sympathetic nervous system has bidirectional regulation of pro-inflammation and anti-inflammation, which are affected by several factors such as the concentration of neurotransmitters or types of receptors .In this paper , we reviewed different effects of CAP and sympathetic nervous system on cardiovascular inflammatory reaction .Activation of CAP and regaining normal sympathetic function will improve the chronic inflammation in the process of cardiovascular disea -ses.Low-toxic and selective α7nAchR agonist is expected to be applied in cardiovascular diseases to alleviate chronic in -flammation .

  10. Expression and Significance of MMP-9 and TIMP-1 in Malignant Peripheral Nerve Sheath Tumours%MMP-9及TIMP-1在恶性外周神经鞘膜瘤中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    齐云飞; 牟英君; 裴丽霞


    目的 探讨恶性外周神经鞘膜瘤(malignant peripheral nerve sheath tumours,MPNST)中基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)及组织金属蛋白酶抑制剂-1(tissue inhibitor of metalloproteinase-1,TIMP-1)的表达与病理分级、转移及预后的关系.方法 采用免疫组化S-P法检测MPNST中MMP-9及TIMP-1表达.结果 共检测了58例MPNST,其中MMP-9阳性表达率为89.7%(52/58),TIMP-1阳性表达率是60.3%(35/58).MMP-9蛋白酶的表达与病理学分级、转移率呈正相关,与术后生存率呈负相关;而TIMP-1则相反.结论 MMP-9、TIMP-1与MPNST病理学分级、转移及术后生存期有关,可作为判断恶性外周神经鞘膜瘤恶性程度及预后的可靠指标,为其治疗提供参考价值.

  11. The study on the function of gastrointestinal autonomic nerve in reflux esophagitis patients%反流性食管炎患者胃肠道自主神经功能研究

    Institute of Scientific and Technical Information of China (English)

    赵威; 王瑞峰; 孙晓红; 方秀才; 王智凤; 朱丽明; 柯美云


    Objective To explore the features of autonomic nerve function in reflux esophagitis (RE) patients, and the role of abnormal function in the pathogenesis of RE. Methods Twenty RE patients (RE group) and 18 healthy controls (HS group) all underwent heart rate variability (HRV) with meal stimulation to test the function of autonomic nerve. At same time, the endoscopic Los Angeles (LA) Classification, RE symptom score, Gastroesophageal reflux disease-health related quality of life (GERD-HRQL), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were evaluated in the RE patients. Of those, 12 RE patients were re-examined the function of autonomic never after 2 to 4 months [mean (3.7±0.8) months] of proton pump inhibitors (PPI) treatment. Results In fasting state, the sympathetic activity was higher in RE group than in HS group, while the parasympathetic activity was lower in HS group (P=0.022 and 0.034). Postprandial, the trend of autonomic functional change was the same in RE group and HS group. Postprandial, the sympathetic activity was negatively correlated with symptom score in RE patients; however, the parasympathetic activity was positively correlated with RE symptom score. The influence of meal on the balance of sympathetic and parasympathetic was negatively correlated with RE symptom score (r=-0.48, P=0.022). The influence of meal on the parasympathetic nerve was positively correlated with RE symptom score and GERD-HRQL score. After PPI treatments, RE symptom score, GERD-HRQL score, SAS score and SDS score were all significantly decreased in RE patients. There was no significant difference in autonomic nerve function before and after PPI treatment. Conclusions There is abnormal autonomic nerve function in RE patients, characterized by higher sympathetic activity and lower parasympathetic activity in fasting state. The autonomic nerve function is correlated with RE symptom score. The abnormal autonomic nerve function may be one of the causes

  12. Do sensory calcitonin gene-related peptide nerve fibres in the rat pelvic plexus supply autonomic neurons projecting to the uterus and cervix? (United States)

    Houdeau, E; Barranger, E; Rossano, B


    Sensory nerve fibres containing calcitonin gene-related peptide (CGRP) innervate neurons of the paracervical ganglion (PCG) in the female rat pelvic plexus. We have combined retrograde tracing with immunocytochemistry to investigate whether CGRP-immunoreactive (-IR) fibres supply neurons targeting the genital tract. Of the total neurons projecting to either the uterine horns or the cervix, 38 and 41% received CGRP-IR innervation, respectively. All these neurons displayed choline acetyltransferase-IR, thus are cholinergic. They were found throughout the PCG and other pelvic plexus ganglia, namely accessory ganglia (AG) and hypogastric plexus (HP). Pelvic nerve section showed that afferent fibres in these nerves provided most of the CGRP-IR fibres supplying uterine- or cervical-related neurons in the PCG/AG, none in HP. It is suggested that such sensory-motor network may provide a local pathway for reflex control of genital tract activity, acting through cholinergic nerve projections.

  13. Plasticity of autonomic nerves: differential effects of long-term guanethidine sympathectomy on the sensory innervation of the rat uterus during maturation. (United States)

    Brauer, M M; Lincoln, J; Milner, P; Sarner, S; Blundell, D; Passaro, M; Corbacho, A; Burnstock, G


    The sensory nerves, containing substance P and calcitonin gene-related peptide, and noradrenaline-containing sympathetic nerves of the rat uterus were analyzed following long-term sympathectomy with guanethidine in prepubertal (four weeks), young adult (eight weeks) and fully adult animals (18 weeks). Immunohistochemical and histochemical methods were used in association with nerve density measurements and biochemical assays. The main findings were as follows: (1) long-term guanethidine treatment completely abolished the noradrenergic innervation of the uterine horn and parametrial tissue and markedly reduced the tissue levels of noradrenaline in both regions at the three ages analysed; (2) in the uterine horn guanethidine treatment had no effect on the tissue levels of either calcitonin gene-related peptide or substance P or on the density of calcitonin gene-related peptide-containing nerves, at any of the three ages studied; (3) in the parametrial tissue increased levels of calcitonin gene-related peptide were observed at 8 and 18 weeks of age, together with a significant increase in the density of calcitonin gene-related peptide-containing nerves. Substance P levels showed a transient increase in this tissue at eight weeks. In conclusion, long-term sympathectomy with guanethidine resulted in an increase in calcitonin gene-related peptide and substance P in sensory nerves in the parametrial tissue, but not in the uterine horn. The changes in the parametrial tissue only occurred after puberty. It is suggested that sensory nerves in the uterine horn may be less responsive to sympathetic denervation since loss of sympathetic nerves occurs as part of a normal physiological process during pregnancy in this region.

  14. Peripheral nerve lengthening as a regenerative strategy

    Institute of Scientific and Technical Information of China (English)

    Kenneth M.Vaz; Justin M.Brown; Sameer B.Shah


    Peripheral nerve injury impairs motor, sensory, and autonomic function, incurring substantial ifnancial costs and diminished quality of life. For large nerve gaps, proximal lesions, or chronic nerve injury, the prognosis for recovery is particularly poor, even with autografts, the current gold standard for treating small to moderate nerve gaps. In vivo elongation of intact proximal stumps towards the injured distal stumps of severed peripheral nerves may offer a promising new strategy to treat nerve injury. This review describes several nerve lengthening strategies, in-cluding a novel internal ifxator device that enables rapid and distal reconnection of proximal and distal nerve stumps.

  15. Anatomical basis and main points of pelvic autonomic nerve preserving in proctectomy%直肠切除术中保留盆腔内脏神经的解剖学基础及要点

    Institute of Scientific and Technical Information of China (English)

    马国龙; 王毅; 梁小波


    目的:了解盆腔内脏神经的走行及与盆腔筋膜的关系,寻找安全的操作平面,减少直肠癌手术中对内脏神经的损伤。方法通过解剖12例人骨盆标本,观察盆腔内脏神经的走向分布及与筋膜间隙的关系。结果腹下神经全程走行于骶前筋膜内,下腹下丛走行于盆壁层筋膜内,并于直肠2点及10点处(截石位)在多个平面交叉穿入 Denonvilliers 筋膜汇入泌尿生殖血管束, Denonvilliers筋膜内存在横行的神经交通支。结论直肠后方及侧方的手术操作平面在直肠固有筋膜与骶前筋膜之间靠近直肠固有筋膜一侧,在直肠前方的手术操作应注意保护直肠2点及10点位置的泌尿生殖神经血管束及Denonvillers筋膜内的神经交通支。%Objective To elucidate the course of pelvic autonomic nerves and its relationship with pelvic fascia in order to identify the safe plane to reduce the damage of pelvic autonomic nerves in total mesorectaI excision(TME). Methods The course and distribution of pelvic autonomic nerves were observed and their relationship with pelvic interfascial space was examined through the anatomy of 12 adult pelvic specimens. Results The entire course of hypogastric nerves ran within the anterior sacral fascia and the inferior hypogastric plexus ran within parietal fascia. Inferior hypogastric plexus crossed the fusion line of Denonvilliers fascia and parietal fascia in the 10 o′clock and 2 o′clock directions of the rectum, and joined urogenital vessel bundle finally. Laterigrade traffic nerves could be found in Denonvilliers fascia. Conclusion The safe plane should be chosen between rectal proper fascia and anterior sacral fascia near rectal proper fascia in posterior dissection and lateral dissection of rectum. More attention should be paid to protect the nervovascular bundle in the 10 o′clock and 2 o′clock directions of rectum and traffic nerve within Denonvilliers fascia in anterior

  16. Effects of Expression Ways and Traits of Anger Emotion on Autonomic Nerve in the Emotion Recovery Stage%愤怒表达方式及特质对情绪恢复期自主神经的影响

    Institute of Scientific and Technical Information of China (English)

    詹向红; 乔明琦; 张惠云; 刘胜利; 杨雪; 徐玮玮


    Objective To explore the effects of expression ways and traits of anger emotion on autonomic nerve in the emotion recovery stage.Methods The 48 healthy undergraduate students were recruited as subjects,who were assigned to four groups,i.e.,anger-out of high trait group,anger-in of high trait group,anger-out of low trait group,anger-in of low trait group,12 in each group.The changes of autonomic nerve in emotion recovery stage [mainly including heart rate (HR),finger pulse volume (FPV),heart rate variability (HRV),and galvanic skin response (GSR)] were observed in an experimental paradigm processed dynamically by emotion induction (by watching movie clips) and emotion regulation (by phraseology clewing and regulating body reaction to anger).Results In the emotion recovery stage all increased data of vegetative reactions decreased in the four groups.The decrease extent of HR,FPV,and GSR was lower in the anger-in groups than that in the anger-out groups (P <0.05).The HRV showed a decreasing trend,but with no statistical significance (P >0.05).The decrease extent of HR was lower in the low-anger groups than in the high-anger group (P <0.05).Conclusions Both expression ways and traits of anger exerted influence on the autonomic nerve in the emotion recovery stage.The former influenced more broadly.The influence of anger-in on the autonomic nerve would be more sustainable.%目的 探讨愤怒表达方式和特质对情绪恢复期自主神经的影响.方法 以48名在校健康大学生作为被试,分为高特质发怒、高特质郁怒、低特质发怒、低特质郁怒4组,每组12名.采用情绪诱发(观看电影片段)和情绪调节(按语词提示调节对愤怒刺激的反应)动态加工的试验范式,研究情绪恢复期自主神经的变化,主要包括心率(heart rate,HR)、手指脉搏血容(finger pulse volume,FPV)、心率变异性(heart rate variability,HRV)及皮肤电反应(galvanic skin response,GSR).结果 在情绪恢复期,4组被试

  17. 腹腔镜保留盆腔自主神经的直肠癌根治术技术要领%Techniques of autonomic nerve preservation in laparoscopic radical resection for rectal cancer

    Institute of Scientific and Technical Information of China (English)

    卫洪波; 郑宗珩


    Pelvic autonomic nerve is a three-dimensional structure surrounding the rectum. There are several key points related to nerve injury during laparoscopic radical resection for rectal cancer. Hypogastric nerve has close relation with the upper and middle part of the rectum. Combined with S2-S4 pelvic splanchnic nerve, hypogastric nerve forms pelvic plexus. Incorrect operation in pelvic parietal peritoneum during dissection of upper rectum will lead to nerve injury. When performing dissection of inferior mesenteric artery, bilateral nerve tracts should be pushed to posterior abdominal wall and anterior fascia of the abdominal aorta should be well protected to avoid nerve injury. Pelvic plexus fibers located lateral to the rectum of pelvic floor, as well as neurovascular bundle closed to Denonvillier′s fascia, also have close relations with nerve injury. Dissection of either lateral or anterior wall of rectum should be performed behind the Denonvillier′s fascia and in front of the proper fascia of rectum. Sharp dissection should be performed closed to the mesorectum to protect branches of pelvic plexus.%盆腔自主神经丛是一个立体的结构,包裹于直肠周围。在腹腔镜直肠癌手术中,有多个容易造成神经损伤的关键点。腹下神经与直肠中上段关系密切,来自骶2至骶4的盆内脏神经与腹下神经共同组成盆腔神经丛;游离直肠上段时,如错误进入盆筋膜壁层之后,则可能会将神经层掀起,造成神经损伤或离断。游离肠系膜下动脉时,应将动脉双侧可见的神经束尽量推向后腹壁,注意避免切开腹主动脉前筋膜,以免损伤神经。盆底深部直肠侧方的盆腔神经丛纤维和靠近Denonvilliers筋膜的血管神经束这两个部位也是容易受损伤的关键点,在游离直肠侧壁及前壁时,可在Denonvilliers筋膜后方、直肠固有筋膜前方进行,紧贴直肠系膜锐性离断,保护由盆腔神经丛发出的支配其他器官的分支。

  18. Gastric Calcifying Fibrous Tumour

    Directory of Open Access Journals (Sweden)

    Tan Attila


    Full Text Available Intramucosal gastric tumours are most commonly found to be gastrointestinal stromal tumours or leiomyomas (smooth muscle tumours; however, a variety of other uncommon mesenchymal tumours can occur in the stomach wall. A rare benign calcifying fibrous tumour is reported and the endoscopic appearance, ultrasound findings and morphology are documented. A review of the literature found only two similar cases.

  19. 愤怒情志表达方式及特质对自主神经的影响%Effect of expression and trait of anger emotion on autonomic nerve

    Institute of Scientific and Technical Information of China (English)

    詹向红; 刘胜利; 江虹; 乔明琦; 张惠云; 潘芳; 杨雪; 徐玮玮


    Objective: To explore the effects of expression and trait of anger emotion on autonomic nerve. Methods:The subjects enrolled were screened from the health college students. The changes of autonomic nerve were researched in an experimental paradigm processed dynamically by emotion induction (by watching movie clips) and emotion regulation (by phraseology clewing and regulating body reaction to anger). Results: The increased extent of heart rate, finger pulse volume, heart rate variability, galvanic skin reflex in the anger-ont groups was higher than that in the anger-in groups(P=0.025, 0.028, 0.014,0.047). The skin temperature of the subjects increased when the anger expression of them in the high-trait anger group were suppressed (P=0.032). Conclusion: ①The extent of sympathetic nerve of the subjects activated by anger-out was more obvious than that by anger-in. ②There was the interaction between trait anger and anger expression.%目的:探讨愤怒情志表达方式和特质对自主神经的影响.方法:以健康在校大学生48人为被试,采用情绪诱发(观看电影片段)和情绪调节(按语词提示调节对愤怒刺激的反应)动态加工的实验范式,研究自主神经的变化.结果:发怒时心率(HR)、手脂脉搏血容(FPV)、心率变异性(HRV)、皮肤电(GSR)增幅大于郁怒(P=0.025,0.028,0.014,0.047);高特质怒在抑制情绪表达时皮肤温度升高(P=0.032).结论:①发怒时对交感神经的激活程度高于郁怒;②特质怒与愤怒表达方式间存在交互作用.

  20. 自主神经在电针“肾俞”穴利尿效应中的作用%The Role of Autonomic Nerve on Diuretic Response Induced by Acupuncturing “Shen-Shu” Point

    Institute of Scientific and Technical Information of China (English)

    马正行; 蔡乃真; 单敏初


    -05)。结论①针刺兔“肾俞”穴可引起肾交感神经系统活动加强和迷走神经传入纤维放电加强,但迷走传出活动无明显变化;②肾交感神经传出纤维放电增加,不但不能促进肾泌尿功能,而且对尿量和尿钠排出量的增加起抑制或推迟作用;③针刺“肾俞”穴后迷走神经传入纤维放电增加可能通过血浆AVP浓度降低和抑制肾交感传出纤维兴奋活动导致利尿和利钠效应。%Objective To observe the activities of autonomic nerve and to elucidate its role on diuretic response induced by acupuncturing “Shen-Shu” Point. Methods 38 anesthetized rabbits were divided into 5 groups: Group A, discharge of efferent fibers of renal nerve observed (DERN) (n=6); Group B, discharge of afferent fibers of renal nerve observed (DARN) (n=11); Group C, discharge of afferent fibers of cervical vagus nerve observed (n=6); Group D, amount of urine with denervation of bilateral cervical vagus nerve observed (n=6); Group E, heart rate variability observed (n=9). Results The duration of spontaneous discharge of efferent fiber plexus of renal nerve (Ti), the ratio of duration of discharge /cycle of discharge (Ti/Ti+Te) and the peak of accumulative curve of discharge were all gradually increased after acupuncturing “Shen-Shu” Point, and maintained at high levels for 60~120 minutes after withdrawing the needles. The frequency of discharge of efferent fibers of renal nerves was gradually increased and maintained at high level for 30~90 minutes after withdrawing the needles. The frequency of discharge of afferent fiber of vagus nerve was gradually increased after acupuncturing “Shen-Shu” Point and maintained at high level for 90~120 minutes after withdrawing the needles. All these reached the highest levels 90 minute after withdrawing the needles. The amount of urine after acupuncturing “Shen-Shu” Point in the rabbits with denervation of bilateral vagus was not

  1. [Influence of beta block and autonomic nerve block on the recovery time of the sinus node in sick sinus syndrome and carotid sinus syndrome]. (United States)

    Brignole, M; Sartore, B; Barra, M; Menozzi, C; Monducci, I; Bertulla, A


    In order to evaluate the relative role of the automatic nervus system and of the intrinsic electrophysiologic properties on the sinus node function, we measured the corrected sinus node recovery time before and after autonomic nervous system blockade in 24 patients. Fourteen had a sick sinus syndrome, five had a carotid sinus syncope, two had syncope of unknown origin associated with bradycardia. Beta blockade was obtained by infusing metoprolol intravenously at a dosage of 0.2 mg/kg; complete automatic blockade was achieved by further i.v. administration of atropine at a dosage of 0.04 mg/kg. After beta blockade, the corrected sinus node recovery time increased in patients with sick sinus syndrome and intrinsic slow heart rate, whereas it decreased in patients with carotid sinus syncope or with syncope and bradycardia. In patients with sick sinus syndrome and normal intrinsic heart rate the response was variable. A positive direct correlation was found between the changes of the corrected sinus node recovery time induced by beta blockade and those induced by autonomic blockade; that is, both either prolonged or shortened the corrected sinus node recovery time. The changes of the corrected sinus node recovery time after beta blockade alone were inversely correlated with the intrinsic heart rate. We conclude that patients with intrinsic depression of the sinus node have an increased sympathetic tone.

  2. Neurophysiological approach to disorders of peripheral nerve

    DEFF Research Database (Denmark)

    Crone, Clarissa; Krarup, Christian


    Disorders of the peripheral nerve system (PNS) are heterogeneous and may involve motor fibers, sensory fibers, small myelinated and unmyelinated fibers and autonomic nerve fibers, with variable anatomical distribution (single nerves, several different nerves, symmetrical affection of all nerves...... methods including nerve conduction studies and electromyography used in the study of patients suspected of having a neuropathy and the significance of the findings are discussed in detail and more novel and experimental methods are mentioned. Diagnostic considerations are based on a flow chart classifying...

  3. Clinical anatomy study of autonomic nerve anterior to the lumbar%腰椎前路手术相关自主神经的解剖及临床意义

    Institute of Scientific and Technical Information of China (English)

    陆声; 徐永清; 师继红; 丁自海; 李忠华; 钟世镇


    Objective The anatomical and histological characteristics of the autonomic nerve anterior to the lumbar are to study,in aiming to clarify anatomical basis for an ejaculation-preserving approach in the minimally invasive lumbar surgery.Methods The lumbar retroperitoneal region of 10 male cadavers was dissected and analyzed.The parietal peritoneum anterior to the abdominal aorta, iliac artery and lumbar spine was incised and dissection bilaterally.The main goal of these dissections was to understand the anatomic relations of autonomic nerves and analyzed a series of sections of paraffin-embedded preortic and para-aortic tissues,exposing the anatomic relations between nervous structure and the covering fasciae.Results The major part of the superior hypogastric plexus(SHP)was found slighted shifted to the left,with principal mass resting on the left common iliac artery.The main trunk of the SHP was situated in the triangle region before the distal abdominal aorta and its bifurcation plane.There were 7 cases (70%) situated at L5S1 intervertebral disc level and 3 cases(30%) situated at the sacral promontory level.The main trunk of the SHP situated on the left side of sacral promontory were found in 4 cases(40%).The other cases (60%) were situated on the left side of the midline of sacral promontory.These retroperitoneal structures appeared to be separated from the overlying fatty mass by a distinguishable loose connective tissue plane.Microscopic analysis of preaortic and para-aortic tissues conftrms the plane of separation.thus the nerve fiber plane exist as an independent plane.Conclusion According to the character of automatic nerve in front of lumbar, the peritoneum should be incised from right side in the transperitoneal approach.The nerve fiber fascia anterior to the aortic and sacral promontory can be mobilized as a whole to preserve the autonomic nerve.%目的 对腰椎前方的自主神经进行解剖和组织学观察,提出避免导致逆行射精的自主神

  4. 鼻腔自主神经临床解剖研究——鼻内镜下高能量聚焦超声治疗变应性鼻炎的靶点选择%Clinical anatomical study of nasal autonomic nerve-obtaining target points for the treatment of allergic rhinitis by blocking nasal autonomic nerve with high intensity focused ultrasound under nasal endoscope

    Institute of Scientific and Technical Information of China (English)

    李强; 杨盈坡; 安伟


    Objective:To provide anatomical references for the treatment of allergic rhinitis by blocking nasal autonomic nerve with high intensity focused ultrasound under nasal endoscope.Methods:Ten (20 sides) adult head specimens sawn in midline sagittal were choosen,posterosuperior medial nasal branch and posterosuperior lateral nasal branch of sphenopalatine nerve as well as posteroinferior nasal nerve were anatomized under microscope to study and research their branches and ramification and to measure the distance from point of posterosuperior medial nasal branch started from nasal septum to superior border of choana and nasal bottom,the distance from posterosuperior lateral nasal branch in medial surface of middle turbinate to midpoint of inferior border of middle turbinate and the distance from point of posteroinferior nasal nerve reaching at inferior turbinate to posterior border of inferior turbinate.Results:(1)Posterosuperior medial nasal branch of sphenopalatine nerve disturbed on the nasal septum from backward and upward to forward and downward;the route approximated straight line and reverse-parabola line.The nerves in 10 sides disturbed on surface of nasal septum as a main never,all reaching the bottom of nasal septum from anterior-middle segment of nasal septum.The nerves in 8 sides disturbed on surface of nasal septum as two main never branches,the branch near nasal bottom(inferior branch) reaching the bottom of nasal septum from anterior-middle segment of nasal septum(two sides was destroyed when anatomized).The distances were (9.04 ± 1.51) mm(inferior branch) and (15.76 ±2.17) mm(superior branch) to superior border of choana,(18.95 ± 2.69)mm(inferior branch) and (23.39 ± 2.42) mm(superior branch)to nasal bottom.(2)Posterosuperior lateral nasal branch of spheno-palatine nerve distributed on medial surface of middle turbinate,and moved from posterior segment of superior border of middle turbinate,travelled slantingly and reached posterior segment of middle

  5. 自主神经功能检测对体位性心动过速综合征的诊断价值%Diagnostic Value of Autonomic Nerve Function Tests for Postural Orthastatic Tachycardia Syndrome

    Institute of Scientific and Technical Information of China (English)

    朱露璐; 张凤文; 张清友; 金红芳; 杜军保


    目的 探讨自主神经功能检测对体位性心动过速综合征(POTS)的诊断价值.方法 对POTS患儿26例和健康儿童20例分别测定其瓦式(Valsalva )比值、深呼吸心率差、30 s最长RR间期/15 s最短RR 间期(30/15)比值、卧立位血压差等自主神经功能及12 导联同步体表心电图(12 ECG)QT间期离散度(QTd)、P波离散度(Pd)水平的变化.采用SPSS 13.0软件进行统计学分析.结果 POTS患儿Valsalva比值、深呼吸心率差与健康对照组比较[Valsalva比值:(1.08±0.06) vs (1.22±0.03); 深呼吸心率差:(9.7±1.7) 次·min-1 vs (18.3±1.6)次·min-1] 均明显降低,差异均有统计学意义(t=5.86、11.34,Pa0.05).结论 POTS患儿自主神经明显受损,Valsalva比值、深呼吸心率差、QTd可作为诊断POTS的一种新方法.%Objective To explore the diagnostic value of autonomic nerve function tests for children with postural orthastatic tachycardia syndrome (POTS). Methods Cardiovascular autonomic nerve function tests, including response index of Valsalva maneuver, heart rate change with deep respiration, 30: 15 postural ratio, postural change of blood pressure, the variation of QT interval dispersion (QTd) and P - wave dispersion (Pd) of 12 - lead simultaneous body surface electrocardiogram were performed in POTS group including 26 cases of POTS and healthy control group including 20 cases of healthy children. The data were analyzed by SPSS 13.0 software. Results Index of Valsalva maneuver ratio and heart rate change with deep respiration of POTS children were significantly lower than those of healthy subjects [ Valsalva maneuver index: ( 1.08 ± 0.06) vs ( 1.22 ± 0.03 ); heart rate change with deep respiration: ( 9.7 ± 1.7 ) times per min vs ( 18.3 ± 1.6 ) times per min,Pa < 0.05 ]. In addition, compared with the healthy control group, maximal QT interval (QTmax), minimal QT interval (QTmin) and QTd prolonged (Pa < 0.01 ), maximal QT corrected for heart rate (QTcmax) and QT

  6. Nerve biopsy (United States)

    Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site may be sore for a few days ...

  7. Targeting tumour Cell Plasticity

    Institute of Scientific and Technical Information of China (English)

    Elizabeth D. WILLIAMS


    @@ Her research is focused on understanding the mechanisms of tumour progression and metastasis, particularly in uro-logical carcinomas (bladder and prostate). Tumour cell plasticity, including epithelial-mesenchymal transition, is a cen-tral theme in Dr Williams' work.

  8. Orbital tumours and tumour-like lesions: exploring the armamentarium of multiparametric imaging. (United States)

    Purohit, Bela S; Vargas, Maria Isabel; Ailianou, Angeliki; Merlini, Laura; Poletti, Pierre-Alexandre; Platon, Alexandra; Delattre, Bénédicte M; Rager, Olivier; Burkhardt, Karim; Becker, Minerva


    Although the orbit is a small anatomical space, the wide range of structures present within it are often the site of origin of various tumours and tumour-like conditions, both in adults and children. Cross-sectional imaging is mandatory for the detection, characterization, and mapping of these lesions. This review focuses on multiparametric imaging of orbital tumours. Each tumour is reviewed in relation to its clinical presentation, compartmental location, imaging characteristics, and its histological features. We herein describe orbital tumours as lesions of the globe (retinoblastoma, uveal melanoma), optic nerve sheath complex (meningioma, optic nerve glioma), conal-intraconal compartment (hemangioma), extraconal compartment (dermoid/epidermoid, lacrimal gland tumours, lymphoma, rhabdomysarcoma), and bone and sinus compartment (fibrous dysplasia). Lesions without any typical compartmental localization and those with multi-compartment involvement (veno-lymphatic malformation, plexiform neurofibroma, idiopathic orbital pseudotumour, IgG4 related disease, metastases) are also reviewed. We discuss the role of advanced imaging techniques, such as MR diffusion-weighted imaging (DWI), diffusion tensor imaging, fluoro-2-deoxy-D-glucose positron emission tomography CT (FDG-PET CT), and positron emission tomography MRI (MRI PET) as problem-solving tools in the evaluation of those orbital masses that present with non-specific morphologic imaging findings. Main messages/Teaching points • A compartment-based approach is essential for the diagnosis of orbital tumours. • CT and MRI play a key role in the work-up of orbital tumours. • DWI, PET CT, and MRI PET are complementary tools to solve diagnostic dilemmas. • Awareness of salient imaging pearls and diagnostic pitfalls avoids interpretation errors.

  9. Acupuncture Effect and Central Autonomic Regulation

    Directory of Open Access Journals (Sweden)

    Qian-Qian Li


    Full Text Available Acupuncture is a therapeutic technique and part of traditional Chinese medicine (TCM. Acupuncture has clinical efficacy on various autonomic nerve-related disorders, such as cardiovascular diseases, epilepsy, anxiety and nervousness, circadian rhythm disorders, polycystic ovary syndrome (PCOS and subfertility. An increasing number of studies have demonstrated that acupuncture can control autonomic nerve system (ANS functions including blood pressure, pupil size, skin conductance, skin temperature, muscle sympathetic nerve activities, heart rate and/or pulse rate, and heart rate variability. Emerging evidence indicates that acupuncture treatment not only activates distinct brain regions in different kinds of diseases caused by imbalance between the sympathetic and parasympathetic activities, but also modulates adaptive neurotransmitter in related brain regions to alleviate autonomic response. This review focused on the central mechanism of acupuncture in modulating various autonomic responses, which might provide neurobiological foundations for acupuncture effects.

  10. Pharmacology of airway afferent nerve activity

    Directory of Open Access Journals (Sweden)

    Carr Michael J


    Full Text Available Abstract Afferent nerves in the airways serve to regulate breathing pattern, cough, and airway autonomic neural tone. Pharmacologic agents that influence afferent nerve activity can be subclassified into compounds that modulate activity by indirect means (e.g. bronchial smooth muscle spasmogens and those that act directly on the nerves. Directly acting agents affect afferent nerve activity by interacting with various ion channels and receptors within the membrane of the afferent terminals. Whether by direct or indirect means, most compounds that enter the airspace will modify afferent nerve activity, and through this action alter airway physiology.

  11. Nerve plane-sparing radical hysterectomy: a simplified technique of nerve-sparing radical hysterectomy for invasive cervical cancer

    Institute of Scientific and Technical Information of China (English)

    LI Bin; LI Wei; SUN Yang-chun; ZHANG Rong; ZHANG Gong-yi; YU Gao-zhi; WU Ling-ying


    Background In order to simplify the complicated procedure of nerve-sparing radical hysterectomy, a novel technique characterized by integral preservation of the autonomic nerve plane has been employed for invasive cervical cancer. The objective of this study was to introduce the nerve plane-sparing radical hysterectomy technique and compare its efficacy and safety with that of nerve-sparing radical hysterectomy.Methods From September 2006 to August 2010, 73 consecutive patients with International Federation of Gynecology and Obstetrics stage IB to IIA cervical cancer underwent radical hysterectomy with two different nerve-sparing approaches. Nerve-sparing radical hysterectomy was performed for the first 16 patients (nerve-sparing radical hysterectomy group). The detailed autonomic nerve structures were identified and separated by meticulous dissection during this procedure. After January 2008, the nerve plane-sparing radical hysterectomy procedure was developed and performed for the next 57 patients (nerve plane-sparing radical hysterectomy group). During this modified procedure, the nerve plane (meso-ureter and its extension) containing most of the autonomic nerve structures was integrally preserved. The patients' clinicopathologic characteristics, surgical parameters, and outcomes of postoperative bladder function were compared between the two groups.Conclusion Nerve plane-sparing radical hysterectomy Is a reproducible and simplified modification of nerve-sparing radical hysterectomy, and may be preferable to nerve-sparing radical hysterectomy for treatment of early-stage invasive cervical cancer.

  12. Clinical value of pelvic autonomic nerve preservation during laparoscopic surgery for low rectal cancer%腹腔镜下低位直肠癌手术中保留盆腔自主神经的临床价值

    Institute of Scientific and Technical Information of China (English)

    侯雷; 刘志满; 张学敏; 赵明明


    AIM:To observe the function of pelvic autonomic nerve preservation (PANP) during laparoscopic surgery for low rectal cancer.METHODS:Seventy-six elderly patients who underwent laparoscopic surgery for low rectal cancer were included in this study.These patients were divided into either an observation group (n =40) or a control group (n =36).The observation group underwent PANP,while the control group did not undergo PANP.After treatment,the short-term and long-term micturition function was observed.In addition,a three-year follow-up was performed,and the quality of life was scored at the last follow-up.RESULTS:The percentage of patients who had improved short-term and long-term micturition function was significantly higher in the observation group than in the control group (17.50% vs 47.22%,0% vs 5.56%,both P < 0.05).Psychological state (SAS,SDS) and self esteem (SES) scores were significantly better in the observation group than in the control group (36.64 + 4.27 vs 42.37 + 4.35,32.84 + 3.21 vs 39.43 + 3.92,24.45 +4.20 vs 18.54 + 3.20,all P < 0.01).CONCLUSION:PANP during laparoscopic surgery for low rectal cancer can improve micturition function and patient's quality of life.%目的:观察腹腔镜下低位直肠癌手术中保留盆腔自主神经(pelvic autonomic nerve,PANP)的作用,方法:对76例腹腔镜下中低位直肠癌手术进行回顾性临床研究,其中40例PANP(观察组),36例非PANP(对照组).观察两组近期、远期排尿情况,同时对患者进行了为期3年的临床随访,并在最后一次随访时进行生活质量评分调查.结果:观察组患者近期、远期排尿功能的恢复均好于对照组(17.50% vs 47.22%,0% vs5.56%,P<0.05).心理状态[焦虑自评量表(self-rating anxietyscale)、抑郁量表(self-ratingdepression scale)]、自尊评价(self esteem)等相关生活质量评分,观察组亦显著好于对照组(36.64±4.27 vs 42.37±4.35,32.84±3.21 vs 39.43±3.92,24.45±4.20 vs 18.54±3.20,

  13. Atypical teratoid/rhabdoid tumour in sella turcica in an adult. (United States)

    Arita, K; Sugiyama, K; Sano, T; Oka, H


    Although atypical teratoid rhabdoid tumours preferentially arise in the posterior fossa of infants, we encountered a 56 year old woman with an atypical teratoid rhabdoid tumour located in the sella. She presented with right abducent and oculomotor nerve paresis. Magnetic resonance imaging demonstrated an intrasellar tumour impinging on the right cavernous sinus. Microscopically, the tumour was composed of cells with rhabdoid features; we observed atypia, eccentric nuclei, and intracytoplasmic inclusion bodies. The Ki-67 labeling index was around 30%. The tumour cells were positive for vimentin, epithelial membrane antigen, and neurofilament, but negative for INI1. Despite extended local brain and whole-spine irradiation she died of neural axis dissemination.

  14. To Explore the Nerve EMG in Patients With Autonomic Neuropathy and Early Diabetic Peripheral Neuropathy%浅析自主神经病变及早期糖尿病周围神经的神经肌电图情况

    Institute of Scientific and Technical Information of China (English)



    Objective To study the nerve electromyography in patients with early diabetes mellitus and autonomic neuropathy.Methods 164 patients with diabetes research, on their median nerve, common peroneal nerve, tibial nerve motor nerve and the conduction velocity of median and peroneal, sural sensory nerve conduction velocity (SCV), median nerve F wave, H-reflex of tibial nerve and sympathetic skin response (SSR) for detection and analysis.Results The incidence of H reflex and SSR abnormality was higher in all patients, the more serious the patient's condition, the higher the abnormal probability.Conclusion The early stage of diabetes peripheral neuropathy can be judged by detecting the H-relfex of tibial nerve. The abnormal SSR is very important indicators, combined with nerve electromyography can have better judgment to the patient's illness.%目的:研究分析早期糖尿病和自主神经病变患者的神经肌电图情况。方法根据我院164例糖尿病患者进行研究,对正中神经、腓总神经、胫神经运动神经传导速度和正中、腓浅、腓肠感觉神经传导速度(SCV)、正中神经F波、胫神经H反射及交感神经皮肤反应(SSR)等进行检测和分析。结果全部患者的H反射和SSR异常发生率较高,患者病情越严重,其异常几率越高。结论糖尿病早期周围神经病变可以通过检测胫神经H反射来进行判断,SSR异常是重要指标,结合神经肌电图能够对患者的病情有较好的判断。

  15. Autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J


    In order to elucidate the physiological significance of autonomic neuropathy in juvenile diabetics, cardiovascular, hormonal and metabolic functions have been investigated in three groups of juvenile diabetics: One group had no signs of neuropathy, one group had presumably slight autonomic...... neuropathy (reduced beat-to-beat variation in heart rate during hyperventilation) and one group had clinically severe autonomic neuropathy, defined by presence of orthostatic hypotension. In all three experimental situations we found sympathetic dysfunction causing cardiovascular and/or hormonal...... maladjustments in patients with autonomic neuropathy. Regarding metabolic functions we found normal responses to graded exercise and insulin-induced hypoglycemia in patients with autonomic neuropathy in spite of blunted catecholamine responses, suggesting increased sensitivity of glycogen stores and adipose...

  16. Autonomic Regulation of Splanchnic Circulation

    Directory of Open Access Journals (Sweden)

    Kathleen A Fraser


    Full Text Available The role of the autonomic nervous system in circulatory regulation of the splanchnic organs (stomach, small intestine, colon, liver, pancreas and spleen is reviewed. In general, the sympathetic nervous system is primarily involved in vasoconstriction, while the parasympathetic contributes to vasodilation. Vasoconstriction in the splanchnic circulation appears to be mediated by alpha-2 receptors and vasodilation by activation of primary afferent nerves with subsequent release of vasodilatory peptides, or by stimulation of beta-adrenergic receptors. As well, an important function of the autonomic nervous system is to provide a mechanism by which splanchnic vascular reserve can be mobilized during stress to maintain overall cardiovascular homeostasis.

  17. Effect of laparoscopic rectal-carcinoma surgery with pelvic autonomic nerve preservation on the urinary and sexual functions of male patients%腹腔镜下直肠癌手术保留盆腔自主神经对男性排尿及性功能的影响

    Institute of Scientific and Technical Information of China (English)

    郑逸川; 陈小勋; 黄克伟


    目的:研究腹腔镜下直肠癌手术保留盆腔自主神经对男性排尿及性功能的影响。方法:回顾性分析我院2010年1月至2012年12月接受腹腔镜下直肠癌根治术80例患者,其中观察组的40例患者接受腹腔镜下直肠癌根治术,并保留盆腔自主神经;对照组的40例患者只接受腹腔镜下直肠癌根治术,不保留自主神经。比较两组患者排尿功能及性功能恢复情况。结果:观察组术后排尿功能障碍、性功能障碍与对照组比较差异均有统计学意义(P<0.05),保留自主神经后排尿功能和性功能障碍的发生率更低。结论:腹腔镜下直肠癌手术保留盆腔自主神经有利于患者及时恢复,并有效减轻患者痛苦,提高患者的生存质量。%To study effects of laparoscopic rectal -carcinoma surgery with pelvic autonomic nerve preservation on the urinary and sexual functions of male patients.Methods:80 patients having received laparo-scopic rectal-carcinoma surgery in our hospital from January 2010 to December 2012 were selected and divided into two groups,with 40 patients in the observation group preserving pelvic autonomic nerve and the other 40 ones in the control group not.The urinary function and sexual function recovery of the two groups were compared.Results:Differences in the urinary function and sexual function recovery rate of the two groups were statistically significant (P<0.05 ),with lower incidence rate of urinary and sexual dysfunction in the pelvic autonomic nerve preservation group.Conclusion:Laparoscopic rectal-carcinoma surgery with pelvic autonomic nerve preservation is conducive to pa-tients’recovery in time,and can effectively alleviate the suffering of patients while improve the life quality of patients.

  18. Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study. (United States)

    Tuite, Gerald F; Polsky, Ethan G; Homsy, Yves; Reilly, Margaret A; Carey, Carolyn M; Parrish Winesett, S; Rodriguez, Luis F; Storrs, Bruce B; Gaskill, Sarah J; Tetreault, Lisa L; Martinez, Denise G; Amankwah, Ernest K


    OBJECTIVE Xiao et al. and other investigators have studied an intradural somatic-to-autonomic (e.g., L-5 to S3-4) nerve transfer as a method to create a reflex arc to allow bladder emptying in response to cutaneous stimulation (the Xiao procedure). In previous clinical studies of patients with spinal dysraphism who underwent the Xiao procedure, high success rates (70%-85%) were reported for the establishment of a "skin-CNS-bladder" reflex arc that allows spontaneous, controlled voiding in children with neurogenic bladder dysfunction. However, many of these studies did not use blinded observers, did not have control groups, and/or featured only limited follow-up durations. METHODS A randomized, prospective, double-blind trial was initiated in March 2009, enrolling children with myelomeningocele (MM), lipomyelomeningocele (LMM), and neurogenic bladder dysfunction who were scheduled for spinal cord detethering (DT) for the usual indications. At the time of DT, patients were randomized between 2 arms of the study: half of the patients underwent a standard spinal cord DT procedure alone (DT group) and half underwent DT as well as the Xiao procedure (DT+X group). Patients, families, and study investigators, all of whom were blinded to the surgical details, analyzed the patients' strength, sensory function, mobility, voiding, and urodynamic bladder function before surgery and at regular intervals during the 3-year follow-up. RESULTS Twenty patients were enrolled in the study: 10 underwent only DT and the other 10 underwent DT+X. The addition of the Xiao procedure to spinal cord DT resulted in longer operative times (p = 0.024) and a greater chance of wound infection (p = 0.03). Patients in both treatment arms could intermittently void or dribble small amounts of urine (Xiao procedure than in the patients who did not. No patient in either treatment arm was continent of urine before, during, or after the study. CONCLUSIONS Patients with MM and LMM who underwent the Xiao

  19. Biochemistry of neuroendocrine tumours. (United States)

    de Herder, Wouter W


    Several circulating or urinary tumour markers can be used for the diagnosis and follow-up of functioning and clinically non-functioning neuroendocrine tumours of the pancreatic islet cells and intestinal tract. Among the specific tumour markers are serotonin and its metabolites--e.g. 5-hydroxyindoleacetic acid (5-HIAA)--in carcinoid tumours and the carcinoid syndrome, insulin and its precursors or breakdown products in insulinoma, and gastrin in gastrinoma. Plasma vasointestinal polypeptide (VIP) determinations have been used in the diagnosis of VIPoma, plasma glucagon for glucagonoma, and serum somatostatin for somatostatinoma. Among the tumour-non-specific markers are: chromogranins, neuron-specific enolase (NSE), alpha-subunits of the glycoprotein hormones, catecholamines, pancreatic polypeptide (PP), ghrelin and adrenomedullin.

  20. Comparative anatomy of the autonomic nervous system. (United States)

    Nilsson, Stefan


    This short review aims to point out the general anatomical features of the autonomic nervous systems of non-mammalian vertebrates. In addition it attempts to outline the similarities and also the increased complexity of the autonomic nervous patterns from fish to tetrapods. With the possible exception of the cyclostomes, perhaps the most striking feature of the vertebrate autonomic nervous system is the similarity between the vertebrate classes. An evolution of the complexity of the system can be seen, with the segmental ganglia of elasmobranchs incompletely connected longitudinally, while well developed paired sympathetic chains are present in teleosts and the tetrapods. In some groups the sympathetic chains may be reduced (dipnoans and caecilians), and have yet to be properly described in snakes. Cranial autonomic pathways are present in the oculomotor (III) and vagus (X) nerves of gnathostome fish and the tetrapods, and with the evolution of salivary and lachrymal glands in the tetrapods, also in the facial (VII) and glossopharyngeal (IX) nerves.

  1. Hereditary sensory and autonomic neuropathies. (United States)

    Auer-Grumbach, Michaela


    Hereditary sensory and autonomic neuropathies (HSN/HSAN) are clinically and genetically heterogeneous disorders of the peripheral nervous system that predominantly affect the sensory and autonomic neurons. Hallmark features comprise not only prominent sensory signs and symptoms and ulcerative mutilations but also variable autonomic and motor disturbances. Autosomal dominant and autosomal recessive inheritance has been reported. Molecular genetics studies have identified disease-causing mutations in 11 genes. Some of the affected proteins have nerve-specific roles but underlying mechanisms have also been shown to involve sphingolipid metabolism, vesicular transport, structural integrity, and transcription regulation. Genetic and functional studies have substantially improved the understanding of the pathogenesis of the HSN/HSAN and will help to find preventive and causative therapies in the future.

  2. Peripheral autonomic neuropathy: diagnostic contribution of skin biopsy. (United States)

    Donadio, Vincenzo; Incensi, Alex; Giannoccaro, Maria Pia; Cortelli, Pietro; Di Stasi, Vitantonio; Pizza, Fabio; Jaber, Masen Abdel; Baruzzi, Agostino; Liguori, Rocco


    Skin biopsy has gained widespread use for the diagnosis of somatic small-fiber neuropathy, but it also provides information on sympathetic fiber morphology. We aimed to ascertain the diagnostic accuracy of skin biopsy in disclosing sympathetic nerve abnormalities in patients with autonomic neuropathy. Peripheral nerve fiber autonomic involvement was confirmed by routine autonomic laboratory test abnormalities. Punch skin biopsies were taken from the thigh and lower leg of 28 patients with various types of autonomic neuropathy for quantitative evaluation of skin autonomic innervation. Results were compared with scores obtained from 32 age-matched healthy controls and 25 patients with somatic neuropathy. The autonomic cutoff score was calculated using the receiver operating characteristic curve analysis. Skin biopsy disclosed a significant autonomic innervation decrease in autonomic neuropathy patients versus controls and somatic neuropathy patients. Autonomic innervation density was abnormal in 96% of patients in the lower leg and in 79% of patients in the thigh. The abnormal findings disclosed by routine autonomic tests ranged from 48% to 82%. These data indicate the high sensitivity and specificity of skin biopsy in detecting sympathetic abnormalities; this method should be useful for the diagnosis of autonomic neuropathy, together with currently available routine autonomic testing.

  3. Bilateral Malignant Brenner Tumour

    Directory of Open Access Journals (Sweden)

    Nasser D Choudhary, S.Manzoor Kadri, Ruby Reshi, S. Besina, Mansoor A. Laharwal, Reyaz tasleem, Qurrat A. Chowdhary


    Full Text Available Bilateral malignant Brenner tumour ofovary is extremely rate. A case ofmalignant Brenner tumourinvolving both the ovaries with mctastasis to mesentery in a 48 year femalc is presented. Grosslyo'arian masses were firm with soft areas, encapsulated and having bosselated external surfaces.Cut sections showed yellowish white surface with peripheral cysts (in both tumours. Microscopyrevealed transitional cell carcinoma with squamoid differentiation at places. Metastatic deposits werefound in the mesentery. Endometrium showed cystic glandular hyperplasia.

  4. Extraskeletal Ewing’s Sarcoma Arising from the Sciatic Nerve: A Diagnostic Challenge

    Directory of Open Access Journals (Sweden)

    Aadhar Sharma


    Full Text Available Ewing’s sarcoma is a common bone tumour of childhood but is a rare occurrence in individuals over 20 years of age. Few cases are reported as originating from peripheral nerves. We present an unusual case of extraosseous Ewing’s sarcoma originating from the sciatic nerve in a 66-year-old patient which had the clinical hallmarks of a benign nerve sheath tumour. Following discussion at a multidisciplinary meeting, excision biopsy of the suspected benign nerve sheath tumour was planned. At operation, the mass had malignant features. Histology confirmed the presence of Ewing’s sarcoma. Due to the morbidity of nerve resection, radiotherapy and chemotherapy were commenced. Ewing’s sarcoma is known to mimic benign pathologies. In this case there were subtle signs of a malignant process in the form of unremitting pain. It is vital to keep in mind the less common tumours that can affect the peripheral nervous system in such cases.

  5. Trigeminal neuralgia and facial nerve paralysis

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [IPOFG, Department of Radiology, Lisbon (Portugal)


    The trigeminal nerve is the largest of the cranial nerves. It provides sensory input from the face and motor innervation to the muscles of mastication. The facial nerve is the cranial nerve with the longest extracranial course, and its main functions include motor innervation to the muscles of facial expression, sensory control of lacrimation and salivation, control of the stapedial reflex and to carry taste sensation from the anterior two-thirds of the tongue. In order to be able adequately to image and follow the course of these cranial nerves and their main branches, a detailed knowledge of neuroanatomy is required. As we are dealing with very small anatomic structures, high resolution dedicated imaging studies are required to pick up normal and pathologic nerves. Whereas CT is best suited to demonstrate bony neurovascular foramina and canals, MRI is preferred to directly visualize the nerve. It is also the single technique able to detect pathologic processes afflicting the nerve without causing considerable expansion such as is usually the case in certain inflammatory/infectious conditions, perineural spread of malignancies and in very small intrinsic tumours. Because a long course from the brainstem nuclei to the peripheral branches is seen, it is useful to subdivide the nerve in several segments and then tailor the imaging modality and the imaging study to that specific segment. This is particularly true in cases where topographic diagnosis can be used to locate a lesion in the course of these nerves. (orig.)

  6. Hereditary sensory autonomic neuropathy and anaesthesia - a case report

    Directory of Open Access Journals (Sweden)

    Nandini Dave


    Full Text Available The hereditary sensory and autonomic neuropathies are a rare group of disorders characterized by progressive loss of function that predominantly affects the peripheral sensory nerves. Autonomic dysfunction is present to a variable degree and can have several implications for anaesthesia. We report the case of a patient with Hereditary sensory and autonomic neuropathy who was posted for a below knee amputation and discuss the anaesthesia management.

  7. Effect of different anesthesia methods in laparoscopic pelvic autonomic nerve reserved surgery on the sexual function of patients with colorectal cancer%不同麻醉方法对腹腔镜盆腔植物神经保留术直肠癌患者性功能影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    余叶挺; 陈天勇; 丁可峰; 关天容


    目的:对不同麻醉方法对腹腔镜盆腔植物神经保留术直肠癌患者性功能影响进行分析。方法:选取2010年11月至2013年11月在我院进行腹腔镜盆腔植物神经保留术直肠癌手术男性患者62例,随机进行分组,单纯组患者30例,单纯进行气管插管全麻;联合组患者32例,在常规气管插管全麻基础上联合硬膜外神经阻滞麻醉,观察两组患者术后性功能情况进行分析。结果:联合组患者阴茎勃起功能障碍发生比例、排尿功能障碍及射精功能障碍发生比例均明显优于单纯组患者,差异性显著,具有统计学意义(P<0.05)。62例患者无一例因麻醉操作导致发生严重不良反应和全脊髓麻醉等严重不良后果。结论:腹腔镜盆腔植物神经保留术直肠癌患者在全麻基础上联合硬膜外神经阻滞麻醉可有效的降低术后射精功能障碍、排尿困难及勃起功能障碍等情况的发生,改善患者的生活质量,安全性较高,可依据患者进行应用和开展。%Objectives:To analyze the effect of different anesthesia methods in laparoscopic pelvic autonom-ic nerve reserved surgery on the sexual function of patients with colorectal cancer.Methods:The 62 colorectal cancer patients having received laparoscopic pelvic autonomic nerve reserved surgery in our hospital from November 2010 to November 2013 were randomly divided into two groups:simple group of 30 patients to receive simple endo-tracheal intubation;joint group of 32 patients to receive epidural nerve block anesthesia on the basis of conventional general anesthesia.The postoperative sexual functions of the two groups were compared.Results:The incidence rates of erectile dysfunction,voiding dysfunction and ejaculatory dysfunction in the joint group were significantly bet-ter than that of the signal group,with a statistically significant difference (P<0.05 ).There was no case of serious adverse consequences caused

  8. Autonomic Modification of Intestinal Smooth Muscle Contractility (United States)

    Montgomery, Laura E. A.; Tansey, Etain A.; Johnson, Chris D.; Roe, Sean M.; Quinn, Joe G.


    Intestinal smooth muscle contracts rhythmically in the absence of nerve and hormonal stimulation because of the activity of pacemaker cells between and within the muscle layers. This means that the autonomic nervous system modifies rather than initiates intestinal contractions. The practical described here gives students an opportunity to observe…

  9. Sperm protein 17 is expressed in human nervous system tumours

    Directory of Open Access Journals (Sweden)

    Frezza Eldo E


    Full Text Available Abstract Background Human sperm protein 17 (Sp17 is a highly conserved protein that was originally isolated from a rabbit epididymal sperm membrane and testis membrane pellet. It has recently been included in the cancer/testis (CT antigen family, and shown to be expressed in multiple myeloma and ovarian cancer. We investigated its immunolocalisation in specimens of nervous system (NS malignancies, in order to establish its usefulness as a target for tumour-vaccine strategies. Methods The expression of Sp17 was assessed by means of a standardised immunohistochemical procedure [(mAb/antigen MF1/Sp17] in formalin-fixed and paraffin embedded surgical specimens of NS malignancies, including 28 neuroectodermal primary tumours (6 astrocytomas, 16 glioblastoma multiforme, 5 oligodendrogliomas, and 1 ependymoma, 25 meningeal tumours, and five peripheral nerve sheath tumours (4 schwannomas, and 1 neurofibroma,. Results A number of neuroectodermal (21% and meningeal tumours (4% were found heterogeneously immunopositive for Sp17. None of the peripheral nerve sheath tumours was immunopositive for Sp17. The expression pattern was heterogeneous in all of the positive samples, and did not correlate with the degree of malignancy. Conclusion The frequency of expression and non-uniform cell distribution of Sp17 suggest that it cannot be used as a unique immunotherapeutic target in NS cancer. However, our results do show the immunolocalisation of Sp17 in a proportion of NS tumour cells, but not in their non-pathological counterparts. The emerging complex function of Sp17 makes further studies necessary to clarify the link between it and immunopositive cells.

  10. Post-treatment complications of soft tissue tumours

    Energy Technology Data Exchange (ETDEWEB)

    Shapeero, L.G. [Department of Radiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Bone and Soft Tissue Program, United States Military Cancer Institute, 6900 Georgia Ave, NW, Washington, DC 20307 (United States)], E-mail:; De Visschere, P.J.L.; Verstraete, K.L. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Poffyn, B. [Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Forsyth, R. [Department of Pathology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Sys, G. [Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Uyttendaele, D. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)


    subcutaneous and cutaneous tissue and the majority of seromas were evident at the first follow-up study. Although seromas after resection and external beam therapy resolved with time, seromas after additional brachytherapy persisted. Inflammatory changes in muscle and cutaneous and subcutaneous tissue after resection alone disappeared by the second follow-up study, whereas these changes after radiotherapy resolved months to years after treatment. Fourteen of 51 patients showed MR findings of chronic muscular atrophy, predominantly located in the lower extremity. Heterotopic ossification was seen in three patients after resection and amputation without radiotherapy. Except for one patient with aggressive fibromatosis, bone and nerve complications occurred in patients with soft tissue malignancy. Twelve patients had osteoporosis. Six patients sustained fractures in irradiated osteoporotic bone of the lower extremity, and one patient had a vertebral fracture in radiographically normal but irradiated bone. In addition, one patient was found to have a medullary infarct in an irradiated femur. In nerve entrapment, DCE-MRI demonstrated the rapidly enhancing recurrent tumour or non-enhancing fibrosis surrounding the slowly enhancing nerve. T1- and T2-weighted MR images displayed the acute and chronic sequelae of nerve entrapment and nerve transection with denervation as T2-hyperintense acute muscle atrophy or T1-hypertense chronic fatty muscular atrophy with decrease in muscle volume. Conclusion: This study suggests a possible relationship between types of treatment of soft tissue tumours and subsequent complications. Postoperative radiotherapy was associated with a significant number of patients with seromas, muscle, cutaneous and subcutaneous inflammation, and fractures. Incomplete or difficult surgery resulted in residual or recurrent tumours and heterotopic ossification. Muscle atrophy and nerve entrapment were related to both treatments (resection alone or radiotherapy after

  11. Parallel evolution of tumour subclones mimics diversity between tumours. (United States)

    Martinez, Pierre; Birkbak, Nicolai Juul; Gerlinger, Marco; McGranahan, Nicholas; Burrell, Rebecca A; Rowan, Andrew J; Joshi, Tejal; Fisher, Rosalie; Larkin, James; Szallasi, Zoltan; Swanton, Charles


    Intratumour heterogeneity (ITH) may foster tumour adaptation and compromise the efficacy of personalized medicine approaches. The scale of heterogeneity within a tumour (intratumour heterogeneity) relative to genetic differences between tumours (intertumour heterogeneity) is unknown. To address this, we obtained 48 biopsies from eight stage III and IV clear cell renal cell carcinomas (ccRCCs) and used DNA copy-number analyses to compare biopsies from the same tumour with 440 single tumour biopsies from the Cancer Genome Atlas (TCGA). Unsupervised hierarchical clustering of TCGA and multi-region ccRCC samples revealed segregation of samples from the same tumour into unrelated clusters; 25% of multi-region samples appeared more similar to unrelated samples than to any other sample originating from the same tumour. We found that the majority of recurrent DNA copy number driver aberrations in single biopsies were not present ubiquitously in late-stage ccRCCs and were likely to represent subclonal events acquired during tumour progression. Such heterogeneous subclonal genetic alterations within individual tumours may impair the identification of robust ccRCC molecular subtypes classified by distinct copy number alterations and clinical outcomes. The co-existence of distinct subclonal copy number events in different regions of individual tumours reflects the diversification of individual ccRCCs through multiple evolutionary routes and may contribute to tumour sampling bias and impact upon tumour progression and clinical outcome.

  12. Percutaneous renal tumour biopsy. (United States)

    Delahunt, Brett; Samaratunga, Hemamali; Martignoni, Guido; Srigley, John R; Evans, Andrew J; Brunelli, Matteo


    The use of percutaneous renal tumour biopsy (RTB) as a diagnostic tool for the histological characterization of renal masses has increased dramatically within the last 30 years. This increased utilization has paralleled advances in imaging techniques and an evolving knowledge of the clinical value of nephron sparing surgery. Improved biopsy techniques using image guidance, coupled with the use of smaller gauge needles has led to a decrease in complication rates. Reports from series containing a large number of cases have shown the non-diagnostic rate of RTB to range from 4% to 21%. Re-biopsy has been shown to reduce this rate, while the use of molecular markers further improves diagnostic sensitivity. In parallel with refinements of the biopsy procedure, there has been a rapid expansion in our understanding of the complexity of renal cell neoplasia. The 2013 Vancouver Classification is the current classification for renal tumours, and contains five additional entities recognized as novel forms of renal malignancy. The diagnosis of tumour morphotype on RTB is usually achievable on routine histology; however, immunohistochemical studies may be of assistance in difficult cases. The morphology of the main tumour subtypes, based upon the Vancouver Classification, is described and differentiating features are discussed.

  13. Autonomous Search

    CERN Document Server

    Hamadi, Youssef; Saubion, Frédéric


    Decades of innovations in combinatorial problem solving have produced better and more complex algorithms. These new methods are better since they can solve larger problems and address new application domains. They are also more complex which means that they are hard to reproduce and often harder to fine-tune to the peculiarities of a given problem. This last point has created a paradox where efficient tools are out of reach of practitioners. Autonomous search (AS) represents a new research field defined to precisely address the above challenge. Its major strength and originality consist in the

  14. Radiotherapy for jugulo-tympanic paragangliomas (Glomus jugulare tumours)

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, P.D.; Johnson, A.P.; Whitton, A.C.


    Parasympathetic paraganglia are found in the region of the jugular bulb, in association with the tympanic branch of the glossopharyngeal nerve and the auricular branch of the vagus. The name commonly applied to these structures is 'glomus jugulare'. Tumours arising from these paraganglia (paragangliomas or glomus jugulare tumours) are usually histologically benign but locally destructive. They may involve the middle ear, the temporal bone, or the jugular foramen, and may extend into the neck or cranium. Very occasionally they are malignant and metastasise (Taylor et al., 1965). The clinical features of these tumours and the techniques for their diagnosis are well established, but treatment remains controversial. Radiotherapy has been the preferred treatment at St. Bartholomew's Hospital, London, and sixty cases seen at this hospital between 1942 and 1982 are reviewed here.

  15. Raman microspectroscopy for visualization of peripheral nerves (United States)

    Minamikawa, Takeo; Harada, Yoshinori; Koizumi, Noriaki; Takamatsu, Tetsuro


    The peripheral nervous system plays an important role in motility, sensory, and autonomic functions of the human body. Preservation of peripheral nerves in surgery is essential for improving quality of life of patients. To preserve peripheral nerves, detection of ne peripheral nerves that cannot be identi ed by human eye or under white light imaging is necessary. In this study, we sought to provide a proof-of-principle demonstration of a label-free detection technique of peripheral nerve tissues against adjacent tissues that employs spontaneous Raman microspectroscopy. A line-illumination confocal Raman microscope was used for the experiment. A laser operating at the wavelength of 532 nm was used as an excitation laser light. We obtained Raman spectra of peripheral nerve, brous connective tissue, skeletal muscle, blood vessel, and adipose tissue of Wistar rats, and extracted speci c spectral features of peripheral nerves and adjacent tissues. By applying multivariate image analysis, peripheral nerves were clearly detected against adjacent tissues without any preprocessing neither xation nor staining. These results suggest the potential of the Raman spectroscopic observation for noninvasive and label-free nerve detection, and we expect this method could be a key technique for nerve-sparing surgery.

  16. Facial nerve neurinoma presenting as middle cranial fossa and cerebellopontine angle mass : a case report.

    Directory of Open Access Journals (Sweden)

    Devi B


    Full Text Available Facial nerve neurinomas are rare. The tumours arising from the geniculate ganglion may grow anteriorly and superiorly and present as a mass in the middle cranial fossa. Only a few cases of facial nerve neurinomas presenting as middle cranial fossa mass have so far been reported. These tumours present with either long standing or intermittent facial palsy along with cerebellopontine angle syndrome.

  17. Peptide receptor radionuclide therapy with {sup 90}Y/{sup 177}Lu-labelled peptides for inoperable head and neck paragangliomas (glomus tumours)

    Energy Technology Data Exchange (ETDEWEB)

    Puranik, Ameya D.; Kulkarni, Harshad R.; Singh, Aviral; Baum, Richard P. [Zentralklinik Bad Berka, THERANOSTICS Centre for Molecular Radiotherapy and Molecular Imaging, ENETS Center of Excellence, Bad Berka (Germany)


    Head and neck paragangliomas (HNPGLs) are rare tumours arising from autonomic nervous system ganglia. Although surgery offers the best chance of complete cure, there is associated morbidity due to the crucial location of these tumours. Radiotherapy arrests tumour growth and provides symptomatic improvement, but has long-term consequences. These tumours express somatostatin receptors (SSTR) and hence peptide receptor radionuclide therapy (PRRT) is now a treatment option. We assessed the molecular, morphological and clinical responses of inoperable HNPGLs to PRRT. Nine patients with inoperable HNPGL assessed between June 2006 and June 2014 were included. Four patients had a solitary lesion, four had multifocal involvement and one had distant metastases (bone and lungs). The patients were treated with PRRT using {sup 90}Y/{sup 177}Lu-labelled peptides after positive confirmation of SSTR expression on {sup 68}Ga-DOTATOC PET/CT. All patients received two to four courses of PRRT. Subsequent serial imaging with {sup 68}Ga-DOTATOC PET/CT was carried out every 6 months to assess response to treatment. Clinical (symptomatic) response was also assessed. Based on molecular response (EORTC) criteria, four of the nine patients showed a partial molecular response to treatment seen as significant decreases in SUV{sub max}, accompanied by a reduction in tumour size. Five patients showed stable disease on both molecular and morphological criteria. Six out of nine patients were symptomatic at presentation with manifestations of cranial nerve involvement, bone destruction at the primary site and metastatic bone pain. Molecular responses were correlated with symptomatic improvement in four out of these six patients; while two patients showed small reductions in tumour size and SUV{sub max}. The three asymptomatic patients showed no new lesions or symptomatic worsening. PRRT was effective in all patients, with no disease worsening seen, either in the form of neurological symptoms or


    Directory of Open Access Journals (Sweden)

    Premalatha Pidakala


    Full Text Available BACKGROUND Tumours of central nervous system (CNS are of varied histogenesis and show divergent lines of differentiation and morphological features. These tumours show specific predilection for age and sex groups, more commonly than of tumours of other systems. Though tumours of glial tissue are more common, other tumours of neural, ependymal and meningeal origin are not uncommon. Metastatic disease is the common encounter in elderly. Tumour diagnosis is not always straight forward as many non-neoplastic lesions and reactive proliferations mimic tumours. Immunohistochemistry may help in problematic cases and thus can be used as an adjuvant tool in the diagnosis of such cases in addition to the routine histopathological staining methods. An accurate histological diagnosis is of extreme importance in these sites as exact diagnosis helps in proper management and favourable clinical outcome. MATERIAL & METHODS This study is on a retrospective and prospective basis in our institution from January 2011 to January, 2016. Our institute is a tertiary care center attached to a medical college catering to the needs of a rural based population. During this period, a total of 717 central nervous system tumour specimens were received and diagnosed based on examination of Haematoxylin and Eosin stained sections of formalin fixed and paraffin embedded specimens. Immunohistochemical markers (IHC were applied in selective cases for an accurate diagnosis and a number of rare cases were diagnosed based on morphology and IHC marker studies. RESULTS Age and sex incidence and anatomic distribution of various tumours were studied. In adults, meningiomas occurred most frequently in the present study followed by nerve sheath tumours, astrocytomas, metastatic deposits, glioblastomas and pituitary adenomas. Embryonal tumours occurred frequently in children. Other rare tumours identified are amyloidogenic pituitary adenoma, central neurocytoma, glioneuronal tumour with

  19. Malignant salivary gland tumours

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, S.H. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Oral Pathology)


    The most frequent malignant salivary gland tumours are the mucoepidermoid tumour, adenoid cystic carcinoma and adenocarcinoma. The major salivary glands and the minor glands of the mouth and upper respiratory tract may potentially develop any of these malignant lesions. Malignant lesions most frequently present as a palpable mass and tend to enlarge more rapidly than benign neoplasms. Pain, paresthesia, muscle paralysis and fixation to surrounding tissue are all ominous signs and symptoms. The only reliable means of differential diagnosis of these lesions is biopsy and histologic analysis. Therapy involves surgery or a combination of surgery and radiation therapy. The ultimate prognosis is governed by the intrinsic biologic behaviour of the neoplasms, the extent of disease and adequate clinical therapy.

  20. Skull base tumours

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Instituto Portugues de Oncologia Francisco Gentil, Servico de Radiologia, Rua Professor Lima Basto, 1093 Lisboa Codex (Portugal)], E-mail:


    With the advances of cross-sectional imaging radiologists gained an increasing responsibility in the management of patients with skull base pathology. As this anatomic area is hidden to clinical exam, surgeons and radiation oncologists have to rely on imaging studies to plan the most adequate treatment. To fulfil these endeavour radiologists need to be knowledgeable about skull base anatomy, about the main treatment options available, their indications and contra-indications and needs to be aware of the wide gamut of pathologies seen in this anatomic region. This article will provide a radiologists' friendly approach to the central skull base and will review the most common central skull base tumours and tumours intrinsic to the bony skull base.

  1. Diabetic autonomic neuropathy. (United States)

    Freeman, Roy


    Diabetes mellitus is the commonest cause of an autonomic neuropathy in the developed world. Diabetic autonomic neuropathy causes a constellation of symptoms and signs affecting cardiovascular, urogenital, gastrointestinal, pupillomotor, thermoregulatory, and sudomotor systems. Several discrete syndromes associated with diabetes cause autonomic dysfunction. The most prevalent of these are: generalized diabetic autonomic neuropathy, autonomic neuropathy associated with the prediabetic state, treatment-induced painful and autonomic neuropathy, and transient hypoglycemia-associated autonomic neuropathy. These autonomic manifestations of diabetes are responsible for the most troublesome and disabling features of diabetic peripheral neuropathy and result in a significant proportion of the mortality and morbidity associated with the disease.

  2. Cutaneous nerve entrapment syndrome

    Institute of Scientific and Technical Information of China (English)



    The cutaneous nerve entrapment syndrome is named that, the cutaneous nerve's functional disorder caused by some chronic entrapment, moreover appears a series of nerve's feeling obstacle,vegetative nerve function obstacle, nutrition obstacle, even motor function obstacle in various degree.

  3. Nerve biopsy (image) (United States)

    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  4. Vagus Nerve Stimulation (United States)

    Vagus nerve stimulation Overview By Mayo Clinic Staff Vagus nerve stimulation is a procedure that involves implantation of a device that stimulates the vagus nerve with electrical impulses. There's one vagus nerve on ...

  5. Ulnar nerve dysfunction (United States)

    Neuropathy - ulnar nerve; Ulnar nerve palsy; Mononeuropathy; Cubital tunnel syndrome ... neuropathy occurs when there is damage to the ulnar nerve. This ... syndrome may result. When damage destroys the nerve covering ( ...

  6. Surgical anatomy of the retroperitoneal spaces, Part IV: retroperitoneal nerves. (United States)

    Mirilas, Petros; Skandalakis, John E


    We present surgicoanatomical topographic relations of nerves and plexuses in the retroperitoneal space: 1) six named parietal nerves, branches of the lumbar plexus: iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, femoral. 2) The sacral plexus is formed by the lumbosacral trunk, ventral rami of S1-S3, and part of S4; the remainder of S4 joining the coccygeal plexus. From this plexus originate the superior gluteal nerve, which passes backward through the greater sciatic foramen above the piriformis muscle; the inferior gluteal nerve also courses through the greater sciatic foramen, but below the piriformis; 3) sympathetic trunks: right and left lumbar sympathetic trunks, which comprise four interconnected ganglia, and the pelvic chains; 4) greater, lesser, and least thoracic splanchnic nerves (sympathetic), which pass the diaphragm and join celiac ganglia; 5) four lumbar splanchnic nerves (sympathetic), which arise from lumbar sympathetic ganglia; 6) pelvic splanchnic nerves (nervi erigentes), providing parasympathetic innervation to the descending colon and pelvic splanchna; and 7) autonomic (prevertebral) plexuses, formed by the vagus nerves, splanchnic nerves, and ganglia (celiac, superior mesenteric, aorticorenal). They include sympathetic, parasympathetic, and sensory (mainly pain) fibers. The autonomic plexuses comprise named parts: aortic, superior mesenteric, inferior mesenteric, superior hypogastric, and inferior hypogastric (hypogastric nerves).

  7. The nature of the autonomic dysfunction in multiple system atrophy (United States)

    Parikh, Samir M.; Diedrich, Andre; Biaggioni, Italo; Robertson, David


    The concept that multiple system atrophy (MSA, Shy-Drager syndrome) is a disorder of the autonomic nervous system is several decades old. While there has been renewed interest in the movement disorder associated with MSA, two recent consensus statements confirm the centrality of the autonomic disorder to the diagnosis. Here, we reexamine the autonomic pathophysiology in MSA. Whereas MSA is often thought of as "autonomic failure", new evidence indicates substantial persistence of functioning sympathetic and parasympathetic nerves even in clinically advanced disease. These findings help explain some of the previously poorly understood features of MSA. Recognition that MSA entails persistent, constitutive autonomic tone requires a significant revision of our concepts of its diagnosis and therapy. We will review recent evidence bearing on autonomic tone in MSA and discuss their therapeutic implications, particularly in terms of the possible development of a bionic baroreflex for better control of blood pressure.

  8. Nerve Regeneration Should Be Highly Valued in the Treatment of Diabetic Peripheral Neuropathy

    Institute of Scientific and Technical Information of China (English)

    LIANG Xiao-chun


    @@ Diabetic peripheral neuropathy (DPN) is the most common chronic complication of the long-term complications of diabetes, affecting up to 90% of patients during the progress of the disease. Many parts of the nerve system, including the sensory nerves, motor nerves and autonomic nerves, can be affected, leading to various clinical features. DPN leads not only to a great degree of mutilation and death but also to the occurrence and development of other long-term complications in diabetics.

  9. Vaginal haemangioendothelioma: an unusual tumour.

    LENUS (Irish Health Repository)

    Mohan, H


    Vaginal tumours are uncommon and this is a particularly rare case of a vaginal haemangioendothelioma in a 38-year-old woman. Initial presentation consisted of symptoms similar to uterovaginal prolapse with "something coming down". Examination under anaesthesia demonstrated a necrotic anterior vaginal wall tumour. Histology of the lesion revealed a haemangioendothelioma which had some features of haemangiopericytoma. While the natural history of vaginal haemangioendothelioma is uncertain, as a group, they have a propensity for local recurrence. To our knowledge this is the third reported case of a vaginal haemangioendothelioma. Management of this tumour is challenging given the paucity of literature on this tumour. There is a need to add rare tumours to our "knowledge bank" to guide management of these unusual tumours.

  10. Primary bone tumours in infants

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Beluffi, G.; Cohen, D.H.; Padovani, J.; Tamaela, L.; Azouz, M.; Bale, P.; Martin, H.C.; Nayanar, V.V.; Arico, M.


    Ten cases of primary bone tumours in infants (1 osteosarcoma, 3 Ewing's sarcoma, 1 chondroblastoma and 5 angiomastosis) are reported. All cases of angiomatosis showed characteristic radiographic findings. In all the other tumours the X-ray appearances were different from those usually seen in older children and adolescents. In the auhtors' opinion the precise diagnosis of malignant bone tumours in infancy is very difficult as no characteristic X-ray features are present in this age period.

  11. LET-painting increases tumour control probability in hypoxic tumours. (United States)

    Bassler, Niels; Toftegaard, Jakob; Lühr, Armin; Sørensen, Brita Singers; Scifoni, Emanuele; Krämer, Michael; Jäkel, Oliver; Mortensen, Lise Saksø; Overgaard, Jens; Petersen, Jørgen B


    LET-painting was suggested as a method to overcome tumour hypoxia. In vitro experiments have demonstrated a well-established relationship between the oxygen enhancement ratio (OER) and linear energy transfer (LET), where OER approaches unity for high-LET values. However, high-LET radiation also increases the risk for side effects in normal tissue. LET-painting attempts to restrict high-LET radiation to compartments that are found to be hypoxic, while applying lower LET radiation to normoxic tissues. Methods. Carbon-12 and oxygen-16 ion treatment plans with four fields and with homogeneous dose in the target volume, are applied on an oropharyngeal cancer case with an identified hypoxic entity within the tumour. The target dose is optimised to achieve a tumour control probability (TCP) of 95% when assuming a fully normoxic tissue. Using the same primary particle energy fluence needed for this plan, TCP is recalculated for three cases assuming hypoxia: first, redistributing LET to match the hypoxic structure (LET-painting). Second, plans are recalculated for varying hypoxic tumour volume in order to investigate the threshold volume where TCP can be established. Finally, a slight dose boost (5-20%) is additionally allowed in the hypoxic subvolume to assess its impact on TCP. Results. LET-painting with carbon-12 ions can only achieve tumour control for hypoxic subvolumes smaller than 0.5 cm(3). Using oxygen-16 ions, tumour control can be achieved for tumours with hypoxic subvolumes of up to 1 or 2 cm(3). Tumour control can be achieved for tumours with even larger hypoxic subvolumes, if a slight dose boost is allowed in combination with LET-painting. Conclusion. Our findings clearly indicate that a substantial increase in tumour control can be achieved when applying the LET-painting concept using oxygen-16 ions on hypoxic tumours, ideally with a slight dose boost.

  12. A novel internal fixator device for peripheral nerve regeneration. (United States)

    Chuang, Ting-Hsien; Wilson, Robin E; Love, James M; Fisher, John P; Shah, Sameer B


    Recovery from peripheral nerve damage, especially for a transected nerve, is rarely complete, resulting in impaired motor function, sensory loss, and chronic pain with inappropriate autonomic responses that seriously impair quality of life. In consequence, strategies for enhancing peripheral nerve repair are of high clinical importance. Tension is a key determinant of neuronal growth and function. In vitro and in vivo experiments have shown that moderate levels of imposed tension (strain) can encourage axonal outgrowth; however, few strategies of peripheral nerve repair emphasize the mechanical environment of the injured nerve. Toward the development of more effective nerve regeneration strategies, we demonstrate the design, fabrication, and implementation of a novel, modular nerve-lengthening device, which allows the imposition of moderate tensile loads in parallel with existing scaffold-based tissue engineering strategies for nerve repair. This concept would enable nerve regeneration in two superposed regimes of nerve extension--traditional extension through axonal outgrowth into a scaffold and extension in intact regions of the proximal nerve, such as that occurring during growth or limb-lengthening. Self-sizing silicone nerve cuffs were fabricated to grip nerve stumps without slippage, and nerves were deformed by actuating a telescoping internal fixator. Poly(lactic co-glycolic) acid (PLGA) constructs mounted on the telescoping rods were apposed to the nerve stumps to guide axonal outgrowth. Neuronal cells were exposed to PLGA using direct contact and extract methods, and they exhibited no signs of cytotoxic effects in terms of cell morphology and viability. We confirmed the feasibility of implanting and actuating our device within a sciatic nerve gap and observed axonal outgrowth following device implantation. The successful fabrication and implementation of our device provides a novel method for examining mechanical influences on nerve regeneration.


    Directory of Open Access Journals (Sweden)

    Prathima Gujjaru


    Full Text Available BACKGROUND Brain neoplasms occur at all ages and account for around 2-3 percent of all deaths in adults. In children, the frequency increases to more than twenty percent. In children, it forms the second most common type of malignancy. Most of the tumours encountered are not related to any identifiable risk factors except for irradiation and some hereditary syndromes like subependymal giant cell astrocytoma, glioblastoma multiforme, cerebellar haemangioblastoma, meningioma, Schwannoma of 7 th cranial nerve. Gliomas constitute fifty percent of the brain tumours and sixty percent of all gliomas are glioblastoma multiforme. Meningiomas constitute twenty percent and cerebral metastasis is seen in fifteen percent of the cases. Seventy percent of supratentorial tumours are found in adults and seventy percent of brain tumours in children are infratentorial. The three common tumours of cerebellum are medulloblastoma, haemangioblastoma and juvenile pilocytic astrocytoma. Brain tumours are space occupying lesions and cause compression and destruction of adjacent structures, brain oedema (Peritumoural tissue, infarction and ischaemia of brain by compressing/infiltrating cerebral blood vessels, obstruction of CSF flow causing hydrocephalus, and rise in intracranial pressure with herniations. Tumours can undergo ischaemic necrosis and necrotic tumours tend to bleed. Brain tumours generally do not metastasise. Schwannoma and meningioma are benign tumours. Medulloblastoma of childhood may have drop metastasis via CSF. A sincere effort has been put in this study to identify the incidence of each variety of brain tumour among the fifty confirmed and identified cases of brain tumours. METHODS The age range of the cases in present study was 5-72 years with a mean age of occurrence of 44.11 years and the peak age group affected were in the 3 rd and 4 th decades. Cerebral hemisphere was the commonest site for intracranial tumours. RESULT In the present study, fifty

  14. The effects of TME with preserving pelvic autonomic nerve on sexual and urinary function of male%保留盆腔自主神经对男性直肠癌TME术后性功能和排尿功能的影响

    Institute of Scientific and Technical Information of China (English)

    王亚国; 钱军


    目的:观察保留盆腔自主神经(pelvic autonomic nerve preservation,PANP)的全直肠系膜切除术(total mesorectal excision,TME)对男性直肠癌患者术后性功能及排尿功能的影响.方法:将行直肠癌根治术的108例男性患者,根据不同的手术方式分为TME+PANP组(56例)和TME组(52例),并对2组患者术后的性功能(包括勃起功能和射精功能)及排尿障碍发生率和局部复发率进行比较.结果:TME+PANP组与TME组患者术后勃起功能障碍发生率分别为32.1%和78.8%,射精功能障碍发生率分别为35.7%和78.8%,排尿障碍发生率分别为26.8%和82.7%,2组差异均有统计学意义(P0.05).结论:PANP+TME在不增加肿瘤局部复发率的同时,能有效降低男性患者术后排尿和性功能障碍的发生率.%Objective: To investigate the effects of total mesorectal excision (TME) with pelvic autonomic nerve preservation (PANP) on sexual and urinary function of male. Methods: One hundred and eight cases with radical resection for rectal carcinoma were divided into PANP and TME group (56 cases) plus TME group (52 cases) according to different operative techniques. Sexual dysfunction, urination disorder rates and local recurrence rates were compared. Results: Erectile dysfunction, ejaculation disorder and urination dysfunction rates of TME plus PANP group and TME group were 32. 1% and 78. 8% ,35. 7% and 78. 8% and 26. 8% and 82. 7% , respectively, which differences had statistical significance ( P 0. 05) . Conclusions:TME with PANP can effectively reduce the local recurrence and the sexual and urinary dysfunction rates.

  15. Autonomic nervous system and immune system interactions. (United States)

    Kenney, M J; Ganta, C K


    The present review assesses the current state of literature defining integrative autonomic-immune physiological processing, focusing on studies that have employed electrophysiological, pharmacological, molecular biological, and central nervous system experimental approaches. Central autonomic neural networks are informed of peripheral immune status via numerous communicating pathways, including neural and non-neural. Cytokines and other immune factors affect the level of activity and responsivity of discharges in sympathetic and parasympathetic nerves innervating diverse targets. Multiple levels of the neuraxis contribute to cytokine-induced changes in efferent parasympathetic and sympathetic nerve outflows, leading to modulation of peripheral immune responses. The functionality of local sympathoimmune interactions depends on the microenvironment created by diverse signaling mechanisms involving integration between sympathetic nervous system neurotransmitters and neuromodulators; specific adrenergic receptors; and the presence or absence of immune cells, cytokines, and bacteria. Functional mechanisms contributing to the cholinergic anti-inflammatory pathway likely involve novel cholinergic-adrenergic interactions at peripheral sites, including autonomic ganglion and lymphoid targets. Immune cells express adrenergic and nicotinic receptors. Neurotransmitters released by sympathetic and parasympathetic nerve endings bind to their respective receptors located on the surface of immune cells and initiate immune-modulatory responses. Both sympathetic and parasympathetic arms of the autonomic nervous system are instrumental in orchestrating neuroimmune processes, although additional studies are required to understand dynamic and complex adrenergic-cholinergic interactions. Further understanding of regulatory mechanisms linking the sympathetic nervous, parasympathetic nervous, and immune systems is critical for understanding relationships between chronic disease

  16. A case of fibrolipomatous hamartoma of the median nerve with macrodactyly

    Directory of Open Access Journals (Sweden)

    Sathish Arakeri


    Full Text Available Fibrolipomatous hamartoma of nerve is a tumor-like lipomatous process principally involving affecting young persons. The median nerve is most commonly affectedinvolved. The lesion is characterized by a soft slowly growing mass, surrounding and infiltrating major nerves and their branches. It may cause symptoms of compression neuropathy and is associated with macrodactyly in one third of cases. Here, we present a case of Fibrolipomatous hamartoma of nerve in the wrist of a young man arising from median nerve. Debulking of the tumour was performed.

  17. Tumours in the Small Bowel

    Directory of Open Access Journals (Sweden)

    N. Kurniawan


    Full Text Available Small bowel tumours are rare and originate from a wide variety of benign and malignant entities. Adenocarcinomas are the most frequent primary malignant small bowel tumours. Submucosal tumours like gastrointestinal stromal tumours (GIST or neuroendocrine tumours (NET may show a central umbilication, pathologic vessels, bridging folds or an ulceration of the overlying mucosa. These signs help to differentiate them from harmless bulges caused by impression from outside, e.g. from other intestinal loops. Sarcomas of the small bowel are rare neoplasias with mesenchymal origin, sometimes presenting as protruding masses. Benign tumours like lipoma, fibrolipoma, fibroma, myoma, and heterotopias typically present as submucosal masses. They cannot be differentiated endoscopically from those with malignant potential as GIST or NET. Neuroendocrine carcinomas may present with diffuse infiltration, which may resemble other malignant tumours. The endoscopic appearance of small bowel lymphomas has a great variation from mass lesions to diffuse infiltrative changes. Melanoma metastases are the most frequent metastases to the small bowel. They may be hard to distinguish from other tumours when originating from an amelanotic melanoma.

  18. Intraspinal tumours in the Kenya African. (United States)

    Ruberti, R F; Carmagnani, A L


    Thirty-one cases of intraspinal tumours in the African have been described, with age, sex incidence, frequency, site and histopathology shown. Intraspinal tumours in this series are compared with the larger series. Extradural and intramedullary tumours together with cervical spine tumours appear to be more frequent in this series. There is a high incidence of dumbell tumours in the neurinomas. Sarcomas are the most common type of tumours and mainly affect the thoracic spine.

  19. Unusual tumours of the lung. (United States)

    Wright, E S; Pike, E; Couves, C M


    Unusual lung tumors are not simply pathological curiosities. They demonstrate features of major significance in diagnosis, treatment, and prognosis. Six of these tumours are discussed: (1) Carcinosarcoma is rarely found in the lung. The histogenis of the lesion is unclear and the prognosis is poor. (2) Only three cases of pleomorphic adenoma have previously been described. Differentiation from other "mixed tumours" of the lung is essential. (3) A rare case of bronchial adenoma producing ectopic ACTH is described. Early recognition of these polypeptide hormone-secreting tumours is stressed. (4) Oat cell carcinoma with the myasthenic (Eaton-Lambert) syndrome shows the clinical features which should permit early tumour diagnosis. The hazards of muscle relaxants must be recognized. (5) Prostatic carcinoma with endobronchial metastases is is discussed. The importance of localization of the primary tumour is emphasized. (6) An example of double primary carcinoma is presented. The rarity of this finding may be related to the poor prognosis of patients with bronchogenesis carcinoma.

  20. Normal and pathological findings for the facial nerve on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Al-Noury, K., E-mail: [Department of Otolaryngology, King Abdulaziz University, Jeddah (Saudi Arabia); Lotfy, A. [Radiology Department, King Abdulaziz University Hospital and International Medical Centre, Jeddah (Saudi Arabia)


    Aim: To demonstrate the enhanced radiological anatomy and common pathological conditions of the facial nerve by using magnetic resonance imaging (MRI). Materials and methods: A retrospective review of the MRI findings of the facial nerve of 146 patients who visited a tertiary academic referral center was conducted. Results: The radiological anatomy of the facial nerve was well illustrated using MRI, as were most of the common pathological conditions of the facial nerve. Conclusions: Enhancement of the facial nerve in MRI should be correlated with the clinical data. Normal individuals can show enhancement of the tympanic or vertical segments of the facial nerve. Enhancement of the labyrinthine portion of the nerve is almost diagnostic of Bell's palsy. No specific enhancement patterns were observed for tumours or for infections of the middle or external ear. A larger population study is required for the accurate assessment of facial nerve enhancement in multiple sclerosis patients.

  1. Autonomic Nervous System Disorders (United States)

    Your autonomic nervous system is the part of your nervous system that controls involuntary actions, such as the beating of your heart ... breathing and swallowing Erectile dysfunction in men Autonomic nervous system disorders can occur alone or as the result ...

  2. Primary vertebral tumours in children

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Beluffi, G.; Masel, J.; Diard, F.; Ferrari-Ciboldi, F.; Le Dosseur, P.; Labatut, J.


    20 cases of primary benign and malignant bone tumours in children were reported. The most common tumours were Ewing's sarcoma, aneurismal bone cyst, benign osteoblastoma and osteoid osteoma. Some rare primary bone tumours in children (osteochondroma, chondroblastoma 6F, primary lymphoma of bone and neurofibromatosis with unusual cervical spinal changes) were also reported. The authors believe that radiographic findings together with clinical history and clinical examination may yield a high percentage of accurate diagnoses. Although microscopy is essential in the final diagnosis, the microscopic report should be also accepted with caution.

  3. [Trigeminal autonomic cephalgias]. (United States)

    Maximova, M Yu; Piradov, M A; Suanova, E T; Sineva, N A


    Review of literature on the trigeminal autonomic cephalgias are presented. Trigeminal autonomic cephalgias are primary headaches with phenotype consisting of trigeminal pain with autonomic sign including lacrimation, rhinorrhea and miosis. Discussed are issues of classification, pathogenesis, clinical picture, diagnosis, differential diagnosis and treatment of this headache. Special attention is paid to cluster headache, paroxysmal hemicrania, SUNCT syndrome, hemicrania continua.

  4. Nervous System and Intracranial Tumour Incidence by Ethnicity in England, 2001-2007: A Descriptive Epidemiological Study.

    Directory of Open Access Journals (Sweden)

    Edward J Maile

    Full Text Available There is substantial variation in nervous system and intracranial tumour incidence worldwide. UK incidence data have limited utility because they group these diverse tumours together and do not provide data for individual ethnic groups within Blacks and South Asians. Our objective was to determine the incidence of individual tumour types for seven individual ethnic groups.We used data from the National Cancer Intelligence Network on tumour site, age, sex and deprivation to identify 42,207 tumour cases. Self-reported ethnicity was obtained from the Hospital Episode Statistics database. We used mid-year population estimates from the Office for National Statistics. We analysed tumours by site using Poisson regression to estimate incidence rate ratios comparing non-White ethnicities to Whites after adjustment for sex, age and deprivation.Our study showed differences in tumour incidence by ethnicity for gliomas, meningiomas, pituitary tumours and cranial and paraspinal nerve tumours. Relative to Whites; South Asians, Blacks and Chinese have a lower incidence of gliomas (p<0.01, with respective incidence rate ratios of 0.68 (confidence interval: 0.60-0.77, 0.62 (0.52-0.73 and 0.58 (0.41-0.83. Blacks have a higher incidence of meningioma (p<0.01 with an incidence rate ratio of 1.29 (1.05-1.59 and there is heterogeneity in meningioma incidence between individual South Asian ethnicities. Blacks have a higher incidence of pituitary tumours relative to Whites (p<0.01 with an incidence rate ratio of 2.95 (2.37-3.67. There is heterogeneity in pituitary tumour incidence between individual South Asian ethnicities.We present incidence data of individual tumour types for seven ethnic groups. Current understanding of the aetiology of these tumours cannot explain our results. These findings suggest avenues for further work.

  5. The Heidelberg classification of renal cell tumours

    NARCIS (Netherlands)

    Kovacs, G; Akhtar, M; Beckwith, BJ; Bugert, P; Cooper, CS; Delahunt, B; Eble, JN; Fleming, S; Ljungberg, B; Medeiros, LJ; Moch, H; Reuter, VE; Ritz, E; Roos, G; Schmidt, D; Srigley, [No Value; Storkel, S; VandenBerg, E; Zbar, B


    This paper presents the conclusions of a workshop entitled 'Impact of Molecular Genetics on the Classification of Renal Cell Tumours', which was held in Heidelberg in October 1996, The focus on 'renal cell tumours' excludes any discussion of Wilms' tumour and its variants, or of tumours metastatic t

  6. Primary optic nerve sheath meningioma

    Energy Technology Data Exchange (ETDEWEB)

    Jeremic, Branislav [International Atomic Energy Agency, Vienna (Austria); Pitz, Susanne (eds.) [University Eye Hospital, Mainz (Germany)


    Optic nerve sheath meningioma (ONSM) is a rare tumour. Cases are usually separated into primary ONSM, which arises either intraorbitally or, less commonly, intracanalicularly, and secondary ONSM, which arises intracranially and subsequently invades the optic canal and orbit. This is the first book to cover all important aspects of the diagnosis and treatment of primary ONSM. After a general introduction, individual chapters discuss the clinical presentation, clinical examination and diagnosis, imaging, and histology. Treatment options are then addressed in detail, with special emphasis on external beam radiation therapy, and in particular stereotactic fractionated radiation therapy. The latter has recently produced consistently good results and is now considered the emerging treatment of choice for the vast majority of patients with primary ONSM. This well-illustrated book will prove invaluable to all practitioners who encounter primary ONSM in their clinical work. (orig.)

  7. Soft tissue tumours: imaging strategy

    Energy Technology Data Exchange (ETDEWEB)

    Brisse, Herve J. [Institute Curie, Department of Radiology, Paris (France); Orbach, Daniel [Institute Curie, Department of Paediatric Oncology, Paris (France); Klijanienko, Jerzy [Institute Curie, Department of Pathology, Paris (France)


    Vascular tumours and malformations, fibrous and fibrohistiocytic tumours and pseudotumours are the most common benign soft-tissue masses observed in children, and can be treated conservatively. Rhabdomyosarcomas are the most frequent malignant tumours, accounting for about half of soft tissue sarcomas. A child referred for a soft-tissue mass should ideally be managed by a multidisciplinary team and primary excision should be proscribed until a definite diagnosis has been established. Clinical examination, conventional radiography and US with Doppler represent the first-line examinations and are sometimes sufficient to make a diagnosis. In all other situations, MRI is mandatory to establish the aggressiveness and extension of the tumour. This technique provides the relevant data to guide the decision regarding tissue sampling. (orig.)

  8. Dual pathology proximal median nerve compression of the forearm.

    LENUS (Irish Health Repository)

    Murphy, Siun M


    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.

  9. MRI characteristics of midbrain tumours

    Energy Technology Data Exchange (ETDEWEB)

    Sun, B. [Chinese Academy of Medical Science, Beijing (China). Neurosurgical Inst.]|[Department of Neuroradiology, Beijing Tiantan Hospital (China); Wang, C.C.; Wang, J. [Chinese Academy of Medical Science, Beijing (China). Neurosurgical Inst.


    We diagnosed 60 cases of midbrain tumours by MRI between 1993 to 1997. There were 39 males and 21 females, aged 2-64 years, mean 25.6 years. We found 38 patients with true intramedullary midbrain tumours, 11 predominantly in the tectum, 20 in the tegmentum and 7 with a downward extension to the pons; there were 7 within the cerebral aqueduct. There were 22 patients with infiltrating midbrain tumours extending from adjacent structures, 11 cases each from the thalamus and pineal region. All patients received surgical treatment. Gross total resection was achieved in 42 cases, subtotal (> 75 %) resection in 18. Pathological diagnoses included 16 low-grade and 15 high-grade astrocytomas; 5 oligodendroastrocytomas; 2 ependymomas; 11 glioblastomas; and 11 pineal parenchymal or germ-cell tumours. Midbrain tumours are a heterogeneous group of neoplasms, with wide variation in clinical and MRI features, related to the site and type of tumour. MRI not only allows precise analysis of their growth pattern, but also can lead to a correct preoperative diagnosis in the majority of cases. (orig.) (orig.) With 3 figs., 3 tabs., 19 refs.

  10. Tumour markers in gastrointestinal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lamerz, R.


    For non-endocrine gastrointestinal tumours the following tumour markers are of clinical interest: For esophageal cancer CEA (sensitivity, s: 40-60%) and SCC (squamous cell carcinoma antigen, x: 20-50%); for gastric cancer CEA (s: 30-40%) as well as CA 19-9 (s: 30-40%) because of complementary results (additive s: 50-60); for hepatocellular cancer AFP (first choice, s: 70-90%; second choice CA 19-9, s: 50-70%); for cholangiocellular cancer CA 19-9 (s: 40-70%); for secondary liver cancer in general CEA; for biliary tract cancer CA 19-9 (s: 40-70%) as well as for excretory pancreatic cancer (s: 70-90%); for colorectal cancer CEA (s: 40-70%) as a first choice marker, and CA 19-9 (s: 20-60%) as a second choice marker, and for anal cancer SCC. The frequency of tumour marker determinations depends on follow-up care recommendations for different tumour diseases (e.g. 1-3 monthly during the 1st and 2nd postoperative year, following chemotherapy courses, on change of therapy, on restaging and at unclear alteration of the clinical state). Tumour markers are only valuable adjuncts to the medical care of tumour patients and therefore useless as solitary findings or on missing therapeutic consequence.

  11. Transcutaneous cervical vagal nerve stimulation modulates cardiac vagal tone and tumor necrosis factor-alpha

    DEFF Research Database (Denmark)

    Brock, C; Brock, B; Aziz, Q


    The vagus nerve is a central component of cholinergic anti-inflammatory pathways. We sought to evaluate the effect of bilateral transcutaneous cervical vagal nerve stimulation (t-VNS) on validated parameters of autonomic tone and cytokines in 20 healthy subjects. 24 hours after t...

  12. 腹腔镜与开腹直肠癌根治术保留盆腔自主神经对男性排尿及性功能影响的对比研究%The comparative study of urinary and sexual function after laparoscopic and open radical resection of rectal carcinoma withpelvic autonomic nerve preservation in males

    Institute of Scientific and Technical Information of China (English)

    郭炜; 王昭顺; 郭澎; 孙军席; 刘铁


    Objective:To evaluate the urinary and sexual functions after pelvic autonomic never preserving in laparoscopic radical resection for rectal cancer in male patients. Methods:Retrospective analysis was made on clinical data of 210 male patients with rectal cancer during 2007 to 2010. They were divided into two groups ( laparoscopic group, n = 96; open group, n = 114 ). Results: The urinary disorder rates, effective disorder rates and ejaculation disorder rates of laparoscopic group were 10.42%, 13.54% and 19.79% ,while values of open group were 18.42% ,25.43% and 29.82%. The difference between them was statistically significant( P <0.05 ). Conclusions: The laparoscopic radical resection with pelvic autonomic nerve preservation can effectively reduce the incidence of urinary dysfunction and sexual dysfunction after operation ,and improve patients'quality of life after operation.%目的:探讨腹腔镜直肠癌根治术保留盆腔自主神经对男性患者术后排尿及性功能的影响.方法:回顾分析2007~2010年为96例男性直肠癌患者施行腹腔镜手术的临床资料,总结其对患者术后排尿及性功能的影响,并与114例开腹手术对比.结果:腹腔镜组术后排尿功能障碍率10.42%,勃起功能障碍率13.54%,射精功能障碍率19.79%;开腹组分别为18.42%,25.43%,29.82%,两组差异均有统计学意义(P<0.05).结论:腹腔镜直肠癌根治术保留盆腔自主神经可有效降低男性患者术后排尿功能及性功能障碍的发生率,提高患者的生活质量.

  13. Activities of autonomic neurotransmitters in meibomian gland tissues are associated with menopausal dry eye

    Institute of Scientific and Technical Information of China (English)

    Lianxiang Li; Dongling Jin; Jinsheng Gao; Liguang Wang; Xianjun Liu; Jingzhang Wang; Zhongxin Xu


    The secretory activities of meibomian glands are regulated by the autonomic nervous system. The change in density and activity of autonomic nerves in meibomian glands during menopause play an important role in the pathogenesis of dry eye. In view of this, we established a dry eye rat model by removing the bilateral ovaries. We used neuropeptide Y and vasoactive intestinal polypeptide as markers of autonomic neurotransmitters. Our results showed that the concentration of estradiol in serum significantly decreased, the density of neuropeptide Y immunoreactivity in nerve fibers significantly increased, the density of vasoactive intestinal polypeptide immunoreactivity in nerve fibers significantly decreased, and the ratio of vasoactive intestinal polypeptide/neuropeptide Y positive staining significantly decreased. These results suggest that a decrease in ovary activity may lead to autonomic nervous system dysfunction, thereby affecting the secretory activity of the meibomian gland, which participates in sexual hormone imbalance-induced dry eye.

  14. 腹腔镜下保留盆腔自主神经平面根治性子宫切除术的初步临床研究%Preliminary clinical study of laparoscopic pelvic autonomic nerve-plane sparing radical hysterectomy

    Institute of Scientific and Technical Information of China (English)

    卢艳; 姚德生; 莫凌昭; 李菲; 潘忠勉


    目的 探讨保留盆腔自主神经平面的腹腔镜下根治性子宫切除术的技术要点、可行性及其对降低术后膀胱功能障碍的作用.方法 将2010年1月至2011年5月30例宫颈癌患者分为两组,一组(15例)根据盆腔自主神经的标志性结构行保留“神经平面”法,于腹腔镜下保留盆腔自主神经的根治性子宫切除术(LNSRH),另一组(15例)行腹腔镜下根治性子宫切除术(LRH)作为对照.结果 LNSRH组15例患者中2例因出血较多保留单侧神经,1例为ⅡA期选择性保留病灶对侧盆腔神经,其余成功保留了双侧神经.全组30例患者均顺利完成手术,LNSRH组的手术时间为(301.8±47.6) min,长于LRH组的(178.3±17.0) min(P <0.05).术中出血量、术后肠道恢复时间、切除盆腔淋巴结的数目、宫旁和阴道切除范围两组比较差异无统计学意义(P>0.05).术后LNSRH组的住院时间为(10.9±2.0)d,明显少于LRH组的(15.1±0.8)d(P<0.05).LNSRH组术后拔除尿管的平均时间为(10.8±3.2)d,明显短于LRH组的(17.4±3.2)d(P <0.05).随访3~19个月,全组无复发和转移病例.结论 LNSRH在技术上安全、可行,可明显减少术后膀胱功能障碍,既不降低根治性标准,又有利于患者术后恢复及生活质量提高.%Objective To study the feasibility of laparoscopic pelvic autonomic nerve-plane sparing radical hysterectomy (LN-SRH) technique and its effect on decreasing postoperative bladder dysfunction. Methods From February 2010 to May 2011, 30 consecutive patients with cervical cancer were divided into LNSRH group and laparoscopic radical hysterectomy (LRH) group. We performed 15 LNSRH with the fascia space dissection technique and according to the basic anatomic landmarks of pelvic autonomic nerves and the operating time, operating bleeding and the postoperative recovery of bladder function were assayed. The other 15 patients were in control group under LRH. Results In LNSRH group, 2 cases reserved

  15. Ganglioneuromas involving the hypoglossal nerve and the vagus nerve in a child: Surgical difficulties. (United States)

    Bakshi, Jaimanti; Mohammed, Abdul Wadood; Lele, Saudamini; Nada, Ritambra


    Ganglioneuromas are benign tumors that arise from the Schwann cells of the autonomic nervous system. They are usually seen in the posterior mediastinum and the paraspinal retroperitoneum in relation to the sympathetic chain. In the head and neck, they are usually related to the cervical sympathetic ganglia or to the ganglion nodosum of the vagus nerve or the hypoglossal nerve. We describe what we believe is the first reported case of multiple ganglioneuromas of the parapharyngeal space in which two separate cranial nerves were involved. The patient was a 10-year-old girl who presented with a 2-year history of a painless and slowly progressive swelling on the left side of her neck and a 1-year history hoarseness. She had no history of relevant trauma or surgery. Intraoperatively, we found two tumors in the left parapharyngeal space-one that had arisen from the hypoglossal nerve and the other from the vagus nerve. Both ganglioneuromas were surgically removed, but the affected nerves had to be sacrificed. Postoperatively, the patient exhibited hypoglossal nerve and vocal fold palsy, but she was asymptomatic. In addition to the case description, we discuss the difficulties we faced during surgical excision.


    Directory of Open Access Journals (Sweden)

    Senthilvel Arumugam


    Full Text Available Wilms’ tumour also called as nephroblastoma is a malignant renal neoplasm of childhood that arises from remnant of immature kidney. About 80% of Wilms’ tumour cases occur before age 5 with a median age of 3.5 years. But adult Wilms’ tumour can occur at any age from 16 to 70 years, the median age in young adult is around 24. CASE REPORT A 16-year-old girl came with history of mass right abdomen, which she noticed for 1 week duration; no urinary symptoms. Her recent blood pressure was 140/90 mmHg. Per abdomen a 10 x 9 cm mass palpable in the right lumbar region, surface smooth, firmto-hard in consistency, non-tender, well defined, no bruit. Urine routine examination was normal; urine culture was sterile; renal and liver function tests were within normal limits; Sr. calcium 9.5 mg/dL. CT abdomen plain and contrast showed a 10 x 9 cm heterodense lesion equivocal with renal cell carcinoma and angiomyolipoma. MR angiogram was done. It showed well-defined encapsulated heterointense mass of size 12 x 8 x 7cm, IVC and bilateral renal vein normal. Since findings were inconclusive, we did a CT-guided biopsy and report came as feature positive for small round cell tumour. Hence, proceeded with right radical nephrectomy. The final histopathology report came as Wilms’ tumour spindle cell variant. Margins clear and ureter not involved. She was then started on adjuvant chemotherapy Inj. Vincristine 2 mg weekly for 27 weeks. She is on regular followup now. CONCLUSION Wilms’ tumour should be considered in a patient who presents with a renal mass with or without loin pain, haematuria especially in young adults. Every attempt should be made to differentiate it from renal cell carcinoma. The outcome for adult Wilms’ tumour is steadily improving with current multimodality treatment approach.

  17. Cystic change in primary paediatric optic nerve sheath meningioma. (United States)

    Narayan, Daniel; Rajak, Saul; Patel, Sandy; Selva, Dinesh


    Primary optic nerve sheath meningiomas (PONSM) are rare in children. Cystic meningiomas are an uncommon subgroup of meningiomas. We report a case of paediatric PONSM managed using observation alone that underwent cystic change and radiological regression. A 5-year-old girl presented with visual impairment and proptosis. Magnetic resonance (MR) imaging demonstrated a PONSM. The patient was left untreated and followed up with regular MR imaging. Repeat imaging at 16 years of age showed the tumour had started to develop cystic change. Repeat imaging at 21 years of age showed the tumour had decreased in size.

  18. Tumour banking: the Spanish design. (United States)

    Morente, M M; de Alava, E; Fernandez, P L


    In the last decade the technical advances in high throughput techniques to analyze DNA, RNA and proteins have had a potential major impact on prevention, diagnosis, prognosis and treatment of many human diseases. Key pieces in this process, mainly thinking about the future, are tumour banks and tumour bank networks. To face these challenges, diverse suitable models and designs can be developed. The current article presents the development of a nationwide design of tumour banks in Spain based on a network of networks, specially focusing on its harmonization efforts mainly regarding technical procedures, ethical requirements, unified quality control policy and unique sample identification. We also describe our most important goals for the next years. This model does not correspond to a central tumour bank, but to a cooperative and coordinated network of national and regional networks. Independently from the network in which it is included, sample collections reside in their original institution, where it can be used for further clinical diagnosis, teaching and research activities of each independent hospital. The herein described 'network of networks' functional model could be useful for other countries and/or international tumour bank activities.

  19. Carpal tunnel syndrome caused by a giant cell tumour of the flexor tendon sheath. (United States)

    Meek, Marcel F; Sheikh, Zahid A; Quinton, David N


    A 76-year-old woman developed right carpal tunnel syndrome after being conservatively treated for tenosynovitis of the flexor tendons with associated mild carpal tunnel syndrome. A magnetic resonance imaging scan showed a tumour in the carpal tunnel. Re-exploration showed that the median nerve was being compressed by a giant cell tumour of the flexor tendon sheaths. Appropriate imaging is advised in patients with additional findings (such as swelling) or in patients with secondary carpal tunnel syndrome and incomplete response to conservative treatment, to exclude a space-occupying lesion.

  20. Improvement of sciatic nerve regeneration using laminin-binding human NGF-beta.

    Directory of Open Access Journals (Sweden)

    Wenjie Sun

    Full Text Available BACKGROUND: Sciatic nerve injuries often cause partial or total loss of motor, sensory and autonomic functions due to the axon discontinuity, degeneration, and eventual death which finally result in substantial functional loss and decreased quality of life. Nerve growth factor (NGF plays a critical role in peripheral nerve regeneration. However, the lack of efficient NGF delivery approach limits its clinical applications. We reported here by fusing with the N-terminal domain of agrin (NtA, NGF-beta could target to nerve cells and improve nerve regeneration. METHODS: Laminin-binding assay and sustained release assay of NGF-beta fused with NtA (LBD-NGF from laminin in vitro were carried out. The bioactivity of LBD-NGF on laminin in vitro was also measured. Using the rat sciatic nerve crush injury model, the nerve repair and functional restoration by utilizing LBD-NGF were tested. FINDINGS: LBD-NGF could specifically bind to laminin and maintain NGF activity both in vitro and in vivo. In the rat sciatic nerve crush injury model, we found that LBD-NGF could be retained and concentrated at the nerve injury sites to promote nerve repair and enhance functional restoration following nerve damages. CONCLUSION: Fused with NtA, NGF-beta could bind to laminin specifically. Since laminin is the major component of nerve extracellular matrix, laminin binding NGF could target to nerve cells and improve the repair of peripheral nerve injuries.

  1. Pitfalls in colour photography of choroidal tumours. (United States)

    Schalenbourg, A; Zografos, L


    Colour imaging of fundus tumours has been transformed by the development of digital and confocal scanning laser photography. These advances provide numerous benefits, such as panoramic images, increased contrast, non-contact wide-angle imaging, non-mydriatic photography, and simultaneous angiography. False tumour colour representation can, however, cause serious diagnostic errors. Large choroidal tumours can be totally invisible on angiography. Pseudogrowth can occur because of artefacts caused by different methods of fundus illumination, movement of reference blood vessels, and flattening of Bruch's membrane and sclera when tumour regression occurs. Awareness of these pitfalls should prevent the clinician from misdiagnosing tumours and wrongfully concluding that a tumour has grown.

  2. Pitfalls in colour photography of choroidal tumours (United States)

    Schalenbourg, A; Zografos, L


    Colour imaging of fundus tumours has been transformed by the development of digital and confocal scanning laser photography. These advances provide numerous benefits, such as panoramic images, increased contrast, non-contact wide-angle imaging, non-mydriatic photography, and simultaneous angiography. False tumour colour representation can, however, cause serious diagnostic errors. Large choroidal tumours can be totally invisible on angiography. Pseudogrowth can occur because of artefacts caused by different methods of fundus illumination, movement of reference blood vessels, and flattening of Bruch's membrane and sclera when tumour regression occurs. Awareness of these pitfalls should prevent the clinician from misdiagnosing tumours and wrongfully concluding that a tumour has grown. PMID:23238442

  3. Preoperative shunts in thalamic tumours.

    Directory of Open Access Journals (Sweden)

    Goel A


    Full Text Available Thirty one patients with thalamic glioma underwent a pre-tumour resection shunt surgery. The procedure was uneventful in 23 patients with relief from symptoms of increased intracranial pressure. Eight patients worsened after the procedure. The level of sensorium worsened from excessively drowsy state to unconsciousness in seven patients. Three patients developed hemiparesis, 4 developed paresis of extra-ocular muscles and altered pupillary reflexes, and 1 developed incontinence of urine and persistent vomiting. Alteration in the delicately balanced intracranial pressure and movements in the tumour and vital adjacent brain areas could be the probable cause of the worsening in the neurological state in these 8 patients. On the basis of these observations and on review of literature, it is postulated that the ventricular dilatation following an obstruction in the path of the cerebrospinal fluid flow by a tumour could be a natural defense phenomenon of the brain.

  4. Tumour endothelial cells in high metastatic tumours promote metastasis via epigenetic dysregulation of biglycan (United States)

    Maishi, Nako; Ohba, Yusuke; Akiyama, Kosuke; Ohga, Noritaka; Hamada, Jun-ichi; Nagao-Kitamoto, Hiroko; Alam, Mohammad Towfik; Yamamoto, Kazuyuki; Kawamoto, Taisuke; Inoue, Nobuo; Taketomi, Akinobu; Shindoh, Masanobu; Hida, Yasuhiro; Hida, Kyoko


    Tumour blood vessels are gateways for distant metastasis. Recent studies have revealed that tumour endothelial cells (TECs) demonstrate distinct phenotypes from their normal counterparts. We have demonstrated that features of TECs are different depending on tumour malignancy, suggesting that TECs communicate with surrounding tumour cells. However, the contribution of TECs to metastasis has not been elucidated. Here, we show that TECs actively promote tumour metastasis through a bidirectional interaction between tumour cells and TECs. Co-implantation of TECs isolated from highly metastatic tumours accelerated lung metastases of low metastatic tumours. Biglycan, a small leucine-rich repeat proteoglycan secreted from TECs, activated tumour cell migration via nuclear factor-κB and extracellular signal–regulated kinase 1/2. Biglycan expression was upregulated by DNA demethylation in TECs. Collectively, our results demonstrate that TECs are altered in their microenvironment and, in turn, instigate tumour cells to metastasize, which is a novel mechanism for tumour metastasis. PMID:27295191

  5. Endocrine tumors associated with the vagus nerve. (United States)

    Varoquaux, Arthur; Kebebew, Electron; Sebag, Fréderic; Wolf, Katherine; Henry, Jean-François; Pacak, Karel; Taïeb, David


    The vagus nerve (cranial nerve X) is the main nerve of the parasympathetic division of the autonomic nervous system. Vagal paragangliomas (VPGLs) are a prime example of an endocrine tumor associated with the vagus nerve. This rare, neural crest tumor constitutes the second most common site of hereditary head and neck paragangliomas (HNPGLs), most often in relation to mutations in the succinate dehydrogenase complex subunit D (SDHD) gene. The treatment paradigm for VPGL has progressively shifted from surgery to abstention or therapeutic radiation with curative-like outcomes. Parathyroid tissue and parathyroid adenoma can also be found in close association with the vagus nerve in intra or paravagal situations. Vagal parathyroid adenoma can be identified with preoperative imaging or suspected intraoperatively by experienced surgeons. Vagal parathyroid adenomas located in the neck or superior mediastinum can be removed via initial cervicotomy, while those located in the aortopulmonary window require a thoracic approach. This review particularly emphasizes the embryology, molecular genetics, and modern imaging of these tumors.

  6. Heart Rate Changes in Response to Mechanical Pressure Stimulation of Skeletal Muscles Are Mediated by Cardiac Sympathetic Nerve Activity (United States)

    Watanabe, Nobuhiro; Hotta, Harumi


    Stimulation of mechanoreceptors in skeletal muscles such as contraction and stretch elicits reflexive autonomic nervous system changes which impact cardiovascular control. There are pressure-sensitive mechanoreceptors in skeletal muscles. Mechanical pressure stimulation of skeletal muscles can induce reflex changes in heart rate (HR) and blood pressure, although the neural mechanisms underlying this effect are unclear. We examined the contribution of cardiac autonomic nerves to HR responses induced by mechanical pressure stimulation (30 s, ~10 N/cm2) of calf muscles in isoflurane-anesthetized rats. Animals were artificially ventilated and kept warm using a heating pad and lamp, and respiration and core body temperature were maintained within physiological ranges. Mechanical stimulation was applied using a stimulation probe 6 mm in diameter with a flat surface. Cardiac sympathetic and vagus nerves were blocked to test the contribution of the autonomic nerves. For sympathetic nerve block, bilateral stellate ganglia, and cervical sympathetic nerves were surgically sectioned, and for vagus nerve block, the nerve was bilaterally severed. In addition, mass discharges of cardiac sympathetic efferent nerve were electrophysiologically recorded. Mechanical stimulation increased or decreased HR in autonomic nerve-intact rats (range: −56 to +10 bpm), and the responses were negatively correlated with pre-stimulus HR (r = −0.65, p = 0.001). Stimulation-induced HR responses were markedly attenuated by blocking the cardiac sympathetic nerve (range: −9 to +3 bpm, p mechanical stimulation increased, or decreased the frequency of sympathetic nerve activity in parallel with HR (r = 0.77, p = 0.0004). Furthermore, the changes in sympathetic nerve activity were negatively correlated with its tonic level (r = −0.62, p = 0.0066). These results suggest that cardiac sympathetic nerve activity regulates HR responses to muscle mechanical pressure stimulation and the direction of HR


    LENUS (Irish Health Repository)

    Raza, Kazim


    SOLITARY PARAGANGLIOMA OF THE HYPOGLOSSAL NERVE:: Case Report BACKGROUND AND IMPORTANCE:: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumour are discussed with literature review. CLINICAL PRESENTATION:: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left sided tongue wasting. On examination there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2cm x 2cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral sub occipital craniotomy was carried out in the sitting position. The hypoglossal nerve appeared to be enlarged and the jugular foramen was normal. Complete surgical debulking of the tumour was not attempted due to its vascular nature. The nerve was decompressed and neuropathology confirmed a low grade paraganglioma arising from the hypoglossal nerve. The patient is scheduled to receive stereotactic radiation for further management. CONCLUSION:: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focussed on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted in the MRI scan, a pre-operative angiogram should be performed with a view for embolisation.We decompressed the hypoglossal canal and achieved a good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumours and regular follow up with MRI scans.


    LENUS (Irish Health Repository)


    SOLITARY PARAGANGLIOMA OF THE HYPOGLOSSAL NERVE:: Case Report BACKGROUND AND IMPORTANCE:: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumour are discussed with literature review. CLINICAL PRESENTATION:: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left sided tongue wasting. On examination there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2cm x 2cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral sub occipital craniotomy was carried out in the sitting position. The hypoglossal nerve appeared to be enlarged and the jugular foramen was normal. Complete surgical debulking of the tumour was not attempted due to its vascular nature. The nerve was decompressed and neuropathology confirmed a low grade paraganglioma arising from the hypoglossal nerve. The patient is scheduled to receive stereotactic radiation for further management. CONCLUSION:: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focussed on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted in the MRI scan, a pre-operative angiogram should be performed with a view for embolisation.We decompressed the hypoglossal canal and achieved a good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumours and regular follow up with MRI scans.

  9. Semi-Autonomous Systems Laboratory (United States)

    Federal Laboratory Consortium — Vision The Semi-Autonomous Systems Lab focuses on developing a comprehensive framework for semi-autonomous coordination of networked robotic systems. Semi-autonomous...

  10. Semi-Autonomous Systems Laboratory (United States)

    Federal Laboratory Consortium — VisionThe Semi-Autonomous Systems Lab focuses on developing a comprehensive framework for semi-autonomous coordination of networked robotic systems. Semi-autonomous...

  11. Nerve conduction velocity (United States)

    ... to measure the speed of the nerve signals. Electromyography (recording from needles placed into the muscles) is ... Often, the nerve conduction test is followed by electromyography (EMG). In this test, needles are placed into ...

  12. Common peroneal nerve dysfunction (United States)

    ... toe-out movements Tests of nerve activity include: Electromyography (EMG, a test of electrical activity in muscles) Nerve ... Peroneal neuropathy. In: Preston DC, Shapiro BE, eds. Electromyography and Neuromuscular Disorders . 3rd ed. Philadelphia, PA: Elsevier; ...

  13. Follicular infundibulum tumour presenting as cutaneous horn

    Directory of Open Access Journals (Sweden)

    Jayaraman M


    Full Text Available Tumour of follicular infundibulum is an organoid tumour with a plate like growth attached to the epidermis with connection from the follicular epithelium. We are reporting such a case unusually presenting as cutaneous horn.

  14. Testing for autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J


    Autonomic neuropathy is a common complication in long-term diabetes, about 30% of the patients showing measurable signs of autonomic dysfunction after 10 years duration of disease. The diagnosis is often difficult to establish because clinical symptoms generally occur late in the course...

  15. Computer-aided hepatic tumour ablation

    CERN Document Server

    Voirin, D; Amavizca, M; Leroy, A; Letoublon, C; Troccaz, J; Voirin, David; Payan, Yohan; Amavizca, Miriam; Leroy, Antoine; Letoublon, Christian; Troccaz, Jocelyne


    Surgical resection of hepatic tumours is not always possible. Alternative techniques consist in locally using chemical or physical agents to destroy the tumour and this may be performed percutaneously. It requires a precise localisation of the tumour placement during ablation. Computer-assisted surgery tools may be used in conjunction to these new ablation techniques to improve the therapeutic efficiency whilst benefiting from minimal invasiveness. This communication introduces the principles of a system for computer-assisted hepatic tumour ablation.

  16. Primary brain tumours in adults. (United States)

    Ricard, Damien; Idbaih, Ahmed; Ducray, François; Lahutte, Marion; Hoang-Xuan, Khê; Delattre, Jean-Yves


    Important advances have been made in the understanding and management of adult gliomas and primary CNS lymphomas--the two most common primary brain tumours. Progress in imaging has led to a better analysis of the nature and grade of these tumours. Findings from large phase 3 studies have yielded some standard treatments for gliomas, and have confirmed the prognostic value of specific molecular alterations. High-throughput methods that enable genome-wide analysis of tumours have improved the knowledge of tumour biology, which should lead to a better classification of gliomas and pave the way for so-called targeted therapy trials. Primary CNS lymphomas are a group of rare non-Hodgkin lymphomas. High-dose methotrexate-based regimens increase survival, but the standards of care and the place of whole-brain radiotherapy remain unclear, and are likely to depend on the age of the patient. The focus now is on the development of new polychemotherapy regimens to reduce or defer whole-brain radiotherapy and its delayed complications.

  17. The Physics of Nerves

    CERN Document Server

    Heimburg, Thomas


    The accepted model for nerve pulse propagation in biological membranes seems insufficient. It is restricted to dissipative electrical phenomena and considers nerve pulses exclusively as a microscopic phenomenon. A simple thermodynamic model that is based on the macroscopic properties of membranes allows explaining more features of nerve pulse propagation including the phenomenon of anesthesia that has so far remained unexplained.

  18. FDG uptake, a surrogate of tumour hypoxia?

    NARCIS (Netherlands)

    Dierckx, Rudi Andre; de Wiele, Christophe Van


    Introduction Tumour hyperglycolysis is driven by activation of hypoxia-inducible factor-1 (HIF-1) through tumour hypoxia. Accordingly, the degree of 2-fluro-2-deoxy-D-glucose (FDG) uptake by tumours might indirectly reflect the level of hypoxia, obviating the need for more specific radiopharmaceutic

  19. Melanotic neuroectodermal tumour of the pineal region

    Energy Technology Data Exchange (ETDEWEB)

    Gorhan, C.; Soto-Ares, G.; Pruvo, J.P. [Dept. of Neuroradiology, Hopital Roger Salengro, CHRU Lille, Lille (France); Ruchoux, M.M. [Dept. of Neuropathology, Hopital Roger Salengro, CHRU Lille (France); Blond, S. [Dept. of Neurosurgery, Hopital Roger Salengro, CHRU Lille (France)


    We describe CT and MR findings in a 23-month-old infant with a melanotic neuroectodermal tumour of the pineal gland. The tumour has been stereotactically biopsied and surgically resected. The pathological diagnosis was made on the resected piece. Embryology of the pineal gland and the histology of melanotic neuroectodermal tumour of infancy are discussed. (orig.)

  20. Imaging of salivary gland tumours

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Y.Y.P.; Wong, K.T.; King, A.D. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong (Hong Kong); Ahuja, A.T. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong (Hong Kong)], E-mail:


    Salivary gland neoplasms account for <3% of all tumors. Most of them are benign and parotid gland is the commonest site. As a general rule, the smaller the involved salivary gland, the higher is the possibility of the tumor being malignant. The role of imaging in assessment of salivary gland tumour is to define intra-glandular vs. extra-glandular location, detect malignant features, assess local extension and invasion, detect nodal metastases and systemic involvement. Image guided fine needle aspiration cytology provides a safe means to obtain cytological confirmation. For lesions in the superficial parotid and submandibular gland, ultrasound is an ideal tool for initial assessment. These are superficial structures accessible by high resolution ultrasound and FNAC which provides excellent resolution and tissue characterization without a radiation hazard. Nodal involvement can also be assessed. If deep tissue extension is suspected or malignancy confirmed on cytology, an MRI or CT is mandatory to evaluate tumour extent, local invasion and perineural spread. For all tumours in the sublingual gland, MRI should be performed as the risk of malignancy is high. For lesions of the deep lobe of parotid gland and the minor salivary glands, MRI and CT are the modalities of choice. Ultrasound has limited visualization of the deep lobe of parotid gland which is obscured by the mandible. Minor salivary gland lesions in the mucosa of oral cavity, pharynx and tracheo-bronchial tree, are also not accessible by conventional ultrasound. Recent study suggests that MR spectroscopy may differentiate malignant and benign salivary gland tumours as well as distinguishing Warthin's tumor from pleomorphic adenoma. However, its role in clinical practice is not well established. Similarly, the role of nuclear medicine and PET scan, in imaging of parotid masses is limited. Sialography is used to delineate the salivary ductal system and has limited role in assessment of tumour extent.

  1. A comparison of one hundred and fifty consecutive parotidectomies for tumours and inflammatory disease. (United States)

    Moody, A B; Avery, C M; Taylor, J; Langdon, J D


    The demographic profile and complications are compared and contrasted for 150 consecutive parotidectomies. All patients were under the care of one surgeon (JDL) over a twenty-year period (1977-1997). The case records and contemporaneous database were analysed retrospectively. 111 (74%) procedures were performed for tumours and 39 (26%) for inflammatory disease. The incidence of unexpected permanent facial nerve palsy was 1.8% in the tumour group and zero in the inflammatory group. The overall unexpected palsy rate was 1.3%. Transient paralysis was more common in the inflammatory group than the tumour group (61.5% compared with 33.3%, P<0.02) and was more likely to be panfacial (48.7% compared with 17.1%, P<0.0002). The overall incidence of Frey's syndrome was less than 20% and both salivary fistulae and sialocoeles were infrequent.

  2. Health-related quality of life in patients with skull base tumours.

    LENUS (Irish Health Repository)

    Kelleher, M O


    The objective of the investigation was to report on the health-related quality of life (HRQoL) of patients diagnosed with skull base tumours using the Short Form Health Survey questionnaire (SF-36). Those patients suffering with vestibular schwannoma were examined to determine the effect facial nerve function had on their quality of life. It took place at the tertiary referral centre at the Department of Clinical Neurosciences, Western General Hospital, Edinburgh. A prospective study of 70 consecutive patients was taken, who harboured the following tumours: 54 vestibular schwannomas, 13 meningiomas, two haemangioblastomas and one hypoglossal schwannoma. Patients were interviewed using the short form 36 (SF-36) questionnaire. Facial nerve function was assessed in those patients who had vestibular schwannomas. The entire cohort of live skull base patients were assessed after a median follow-up time of 38.4 months. Patients with vestibular schwannoma treated conservatively with interval MRI had a quality of life similar to t he normal population. Those who underwent surgery had a significant difference in two of the SF-36 domains. No statistically significant correlation was found at final assessment between the degree of facial nerve functioning and any of the domains of SF-36. Patients with non-vestibular tumours had an impaired HRQoL in seven of the eight domains. Patients with skull base tumours have a significant impairment of their HRQoL. A conservative policy of follow up with interval MRI for patients with small vestibular schwannomas may therefore be more appropriate to preserve their HRQoL. Facial nerve outcome has little influence on quality of life in vestibular schwannoma patients.

  3. A case of hereditary sensory autonomic neuropathy type IV

    Directory of Open Access Journals (Sweden)

    G P Prashanth


    Full Text Available Hereditary sensory autonomic neuropathy type IV (HSAN -IV, also known as congenital insensitivity to pain with anhidrosis, is a very rare condition that presents in infancy with anhidrosis, absence of pain sensation and self -mutilation. Developmental delay and mental retardation are usually present. Ultrastructural study of the peripheral nerves demonstrates loss of the unmyelinated and small myelinated fibers. We here report a 8 year -old boy with HSAN IV with typical clinical features where the diagnosis was supported by nerve biopsy findings. However, our case was unusual since mental development was normal.

  4. Tumours of the fetal body: a review

    Energy Technology Data Exchange (ETDEWEB)

    Avni, Fred E.; Massez, Anne; Cassart, Marie [University Clinics of Brussels - Erasme Hospital, Department of Medical Imaging, Brussels (Belgium)


    Tumours of the fetal body are rare, but lesions have been reported in all spaces, especially in the mediastinum, the pericardial space, the adrenals, the kidney, and the liver. Lymphangioma and teratoma are the commonest histological types encountered, followed by cardiac rhabdomyoma. Adrenal neuroblastoma is the commonest malignant tumour. Imaging plays an essential role in the detection and work-up of these tumours. In addition to assisting clinicians it also helps in counselling parents. Most tumours are detected by antenatal US, but fetal MRI is increasingly used as it brings significant additional information in terms of tumour extent, composition and complications. (orig.)

  5. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;


    -oxygenase inhibitor, indomethacin, which indicates that prostaglandin metabolism plays a role. Laboratory studies suggest that carbonic anhydrase inhibitors might be useful for medical treatment of optic nerve and retinal ischemia, potentially in diseases such as glaucoma and diabetic retinopathy. However, clinical...... at similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human...... glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen...

  6. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;


    at similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human...... glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen......-oxygenase inhibitor, indomethacin, which indicates that prostaglandin metabolism plays a role. Laboratory studies suggest that carbonic anhydrase inhibitors might be useful for medical treatment of optic nerve and retinal ischemia, potentially in diseases such as glaucoma and diabetic retinopathy. However, clinical...

  7. Immunomodulation by the autonomic nervous system: therapeutic approach for cancer, collagen diseases, and inflammatory bowel diseases. (United States)

    Abo, Toru; Kawamura, Toshihiko


    The distribution of leukocytes is regulated by the autonomic nervous system in humans and animals. The number and function of granulocytes are stimulated by sympathetic nerves whereas those of lymphocytes are stimulated by parasympathetic nerves. This is because granulocytes bear adrenergic receptors, but lymphocytes bear cholinergic receptors on the surface. These regulations may be beneficial to protect the body of living beings. However, when the autonomic nervous system deviates too much to one direction, we fall victim to certain diseases. For example, severe physical or mental stress --> sympathetic nerve activation --> granulocytosis --> tissue damage, including collagen diseases, inflammatory bowel diseases, and cancer. If we introduce the concept of immunomodulation by the autonomic nervous system, a new approach for collagen diseases, inflammatory bowel diseases, and even cancer is raised. With this approach, we believe that these diseases are no longer incurable.

  8. Autonomous surveillance for biosecurity. (United States)

    Jurdak, Raja; Elfes, Alberto; Kusy, Branislav; Tews, Ashley; Hu, Wen; Hernandez, Emili; Kottege, Navinda; Sikka, Pavan


    The global movement of people and goods has increased the risk of biosecurity threats and their potential to incur large economic, social, and environmental costs. Conventional manual biosecurity surveillance methods are limited by their scalability in space and time. This article focuses on autonomous surveillance systems, comprising sensor networks, robots, and intelligent algorithms, and their applicability to biosecurity threats. We discuss the spatial and temporal attributes of autonomous surveillance technologies and map them to three broad categories of biosecurity threat: (i) vector-borne diseases; (ii) plant pests; and (iii) aquatic pests. Our discussion reveals a broad range of opportunities to serve biosecurity needs through autonomous surveillance.

  9. Direct Interaction between Autonomic Nerves and the Immune System (United States)


    enhancement, propranolol for beta-adrenergic blockade, and phentolamine for alpha- adrenergic blockade. Cholinergic agents were not examined due to the...Table III), The alpha blocker phentolamine also caused partial inhibition of the agonist response, and in the case of NE, was additive with propranolol...effect which was blocked by propranolol (beta blocker) but not phentolamine (alpha blocker). "Further analysis showed that beta2-stimulation with

  10. 20.7 Peripheral nerve disease

    Institute of Scientific and Technical Information of China (English)


    930394 A1—10 year follow—up study of 82cases of methamidophos induced delayedpolyneuropathy.Z1HENG Rongyuan (郑荣远),etal.Neurol Dept,Wenzhou Med Coll.325000.Chin J Industr Hyg & Occupat Dis 1992;10(6):344—347.A1—10 year follow—up study of 82 cases ofmethamidophos induced delayed polyneuropathywas reported.82 cases were classified into threetypes:motor (36.6%),sensory—motor (61%)and Guillain-Barre syndrome (2.4%).As awhole,the sensory disturbances disappearedwithin 2—3 months;the autonomic nerve func-tional disorder vanished within 3—6 months;

  11. An Electerophisioligic Study Of Autonomic Nervous System In Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Noorolahi Moghaddam H


    Full Text Available Autonomic nervous system dysfunction in diabetics can occur apart from peripheral sensorimotor polyneuropathy and sometimes leads to complaints which may be diagnosed by electrodiagnostic methods. Moreover glycemic control of these patients may prevent such a complications."nMaterials and Methods: 30 diabetic patients were compared to the same number of age and sex-matched controls regarding to electrophysiologic findings of autonomic nervous system. Symptoms referable to autonomic disorder including nightly diarrhea, dizziness, urinary incontinence, constipation, nausea, and mouth dryness were recorded in all diabetic patients. Palmar and plantar SSR and expiration to inspiration ratio (E: I and Valsalva ratio were recorded in all diabetics and control individuals by electromyography device. In addition NCS was performed on two sensory and two motor nerves in diabetic patients."nResults: There was no relation between age of diabetics and abnormal D: I ratio, Valsalva ratio and degree of electrophysiologic autonomic impairment. Also no relation between peripheral sensorimotor polyneuropathy and electrophysiologic autonomic impairment was found. Plantar SSR was absent in 80% of diabetics with orthostatic hypotension (p~ 0.019. Palmar and plantar SSR were absent in many diabetics in comparison to control group (for palmar SSR p~ 0.00 and for plantar SSR p< 0.015. There was no relation between diabetes duration since diagnosis and electrophysiologic autonomic impairment."nConclusion: According to the above mentioned findings diabetic autonomic neuropathy develops apart from peripheral sensorimotor polyneuropathy and probably with different mechanisms. Remarkable absence of palmar SSR in diabetics with orthostatic hypotension can be due to its sympathetic origin. Absence of any relation between diabetes duration and electrophysiologic autonomic impairment can be due to late diagnosis of type 2 diabetes or no pathophysiologic relation between chronic

  12. Tumour targeting with systemically administered bacteria.

    LENUS (Irish Health Repository)

    Morrissey, David


    Challenges for oncology practitioners and researchers include specific treatment and detection of tumours. The ideal anti-cancer therapy would selectively eradicate tumour cells, whilst minimising side effects to normal tissue. Bacteria have emerged as biological gene vectors with natural tumour specificity, capable of homing to tumours and replicating locally to high levels when systemically administered. This property enables targeting of both the primary tumour and secondary metastases. In the case of invasive pathogenic species, this targeting strategy can be used to deliver genes intracellularly for tumour cell expression, while non-invasive species transformed with plasmids suitable for bacterial expression of heterologous genes can secrete therapeutic proteins locally within the tumour environment (cell therapy approach). Many bacterial genera have been demonstrated to localise to and replicate to high levels within tumour tissue when intravenously (IV) administered in rodent models and reporter gene tagging of bacteria has permitted real-time visualisation of this phenomenon. Live imaging of tumour colonising bacteria also presents diagnostic potential for this approach. The nature of tumour selective bacterial colonisation appears to be tumour origin- and bacterial species- independent. While originally a correlation was drawn between anaerobic bacterial colonisation and the hypoxic nature of solid tumours, it is recently becoming apparent that other elements of the unique microenvironment within solid tumours, including aberrant neovasculature and local immune suppression, may be responsible. Here, we consider the pre-clinical data supporting the use of bacteria as a tumour-targeting tool, recent advances in the area, and future work required to develop it into a beneficial clinical tool.

  13. Autonomic involvement in Parkinson's disease: pathology, pathophysiology, clinical features and possible peripheral biomarkers. (United States)

    Cersosimo, Maria G; Benarroch, Eduardo E


    Autonomic nervous system involvement occurs at early stages in both Parkinson's disease (PD) and incidental Lewy body disease (ILBD), and affects the sympathetic, parasympathetic, and enteric nervous systems (ENS). It has been proposed that alpha-synuclein (α-SYN) pathology in PD has a distal to proximal progression along autonomic pathways. The ENS is affected before the dorsal motor nucleus of the vagus (DMV), and distal axons of cardiac sympathetic nerves degenerate before there is loss of paravertebral sympathetic ganglion neurons. Consistent with neuropathological findings, some autonomic manifestations such as constipation or impaired cardiac uptake of norepinephrine precursors, occur at early stages of the disease even before the onset of motor symptoms. Biopsy of peripheral tissues may constitute a promising approach to detect α-SYN neuropathology in autonomic nerves and a useful early biomarker of PD.

  14. Pupil cycle time and early autonomic involvement in ocular leprosy. (United States)

    Karaçorlu, M A; Sürel, Z; Cakiner, T; Hanyaloğlu, E; Saylan, T; Mat, C


    Ocular complications of leprosy patients often develop insidiously and with few if any symptoms. This study involves measurement of the pupil cycle time (PCT) to evaluate the autonomic nerve system of the iris to determine the presence of subclinical intraocular involvement. The study included 19 lepromatous (LL), 19 borderline lepromatous (BL), and five borderline tuberculoid (BT) leprosy patients and involved 25 healthy volunteers, 10 patients with pulmonary tuberculosis and eight with Duhring disease. The PCT was measured in these groups. In all leprosy groups included in the study the PCT was higher than in the control groups. Moreover, the PCT of the leprosy patients without any intraocular involvement was higher than in the controls. These results show that in the ophthalmic examination of leprosy patients without any symptoms the fact that autonomic nerve system of the eye is affected by the leprosy can often be determined by measuring the PCT.

  15. Inflammatory myofibroblastic tumour of maxilla

    Directory of Open Access Journals (Sweden)

    Deshingkar S


    Full Text Available Inflammatory myofibroblastic tumour (IMT is a biologically controversial entity that was originally described as non-neoplastic lesion in the lungs and designated initially as inflammatory pseudotumour. The lesion has recently been recognized to occur at various sites but rarely affects head and neck region. Controversies still exist regarding its reactive versus neoplastic nature. The lesion has a potential for recurrence, persistent local growth, progression to frank sarcoma and metastasis. Hence IMT can best be regarded as a low-grade sarcoma. A case of a 30-year-old female with swelling in the right maxilla and associated ophthalmic manifestations is discussed here. Contribution of immunohistochemistry for diagnosis of IMT is emphasized. Additional cytogenetic studies of this highly enigmatic and minimally studied tumour are warranted.

  16. Desmoplastic small round cell tumour

    Energy Technology Data Exchange (ETDEWEB)

    Tan, T.H.L. [North District Hospital, Fanling, Kowloon (Hong Kong). Radiology Department; Ong, K.L. [Prince of Wales Hospital, Shatin, Kowloon (Hong Kong). Accident and Emergency Department; Au, Y.M.C. [Princess Margarete Hospital, Kowloon, (Hong Kong). Department of Radiology


    The present report describes a rare case of primary desmoplastic small cell tumour of the recto-sigmoid colon with hepatic metastases and lymphadenopathy. There are no pathognomonic radiological features and often their features overlap with other diseases including lymphoma. Histology is necessary to confirm this diagnosis. Unfortunately despite aggressive therapy, the prognosis for this disease is poor. Copyright (1998) Blackwell Science Pty Ltd 8 refs., 1 fig.

  17. Reconstructive options in pelvic tumours

    Directory of Open Access Journals (Sweden)

    Mayilvahanan N


    Full Text Available Background: Pelvic tumours present a complex problem. It is difficult to choose between limb salvage and hemipelvectomy. Method: Forty three patients of tumours of pelvis underwent limb salvage resection with reconstruction in 32 patients. The majority were chondrosarcomas (20 cases followed by Ewing sarcoma. Stage II B was the most common stage in malignant lesions and all the seven benign lesions were aggressive (B3. Surgical margins achieved were wide in 31 and marginal in 12 cases. Ilium was involved in 51% of cases and periacetabular involvement was seen in 12 patients. The resections done were mostly of types I &II of Enneking′s classification of pelvic resection. Arthrodesis was attempted in 24 patients. Customized Saddle prosthesis was used in seven patients and no reconstruction in 12 patients. Adjuvant chemotherapy was given to all high-grade malignant tumours, combined with radiotherapy in 7 patients. Results: With a mean follow up of 48.5 months and one patient lost to follow up, the recurrence rate among the evaluated cases was 16.6%. Oncologically, 30 patients were continuously disease free with 7 local recurrences and 4 deaths due to disseminated disease and 2 patients died of other causes. During the initial years, satisfactory functional results were achieved with prosthetic replacement. Long-term functional result of 36 patients who were alive at the time of latest follow up was satisfactory in 75% who underwent arthrodesis and in those where no reconstruction was used. We also describe a method of new classification of pelvic resections that clarifies certain shortcomings of the previous systems of classification. Conclusion: Selection of a procedure depends largely on the patient factors, the tumour grade, the resultant defect and the tissue factors. Resection with proper margins gives better functional and oncological results

  18. Inherited autonomic neuropathies. (United States)

    Axelrod, Felicia B; Hilz, Max J


    Inherited autonomic neuropathies are a rare group of disorders associated with sensory dysfunction. As a group they are termed the "hereditary sensory and autonomic neuropathies" (HSAN). Classification of the various autonomic and sensory disorders is ongoing. In addition to the numerical classification of four distinct forms proposed by Dyck and Ohta (1975), additional entities have been described. The best known and most intensively studied of the HSANs are familial dysautonomia (Riley-Day syndrome or HSAN type III) and congenital insensitivity to pain with anhidrosis (HSAN type IV). Diagnosis of the HSANs depends primarily on clinical examinations and specific sensory and autonomic assessments. Pathologic examinations are helpful in confirming the diagnosis and in differentiating between the different disorders. In recent years identification of specific genetic mutations for some disorders has aided diagnosis. Replacement or definitive therapies are not available for any of the disorders so that treatment remains supportive and directed toward specific symptoms.

  19. Imaging the trigeminal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Radiology Department, Instituto Portugues de Oncologia Francisco Gentil, Centro de Lisboa, Rua Prof. Lima Basto, 1093, Lisboa (Portugal)], E-mail:; Casselman, Jan [Department of Radiology, A. Z. St Jan Brugge and A. Z. St Augustinus Antwerpen Hospitals (Belgium)


    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  20. Notch as a tumour suppressor. (United States)

    Nowell, Craig S; Radtke, Freddy


    The Notch signalling cascade is an evolutionarily conserved pathway that has a crucial role in regulating development and homeostasis in various tissues. The cellular processes and events that it controls are diverse, and continued investigation over recent decades has revealed how the role of Notch signalling is multifaceted and highly context dependent. Consistent with the far-reaching impact that Notch has on development and homeostasis, aberrant activity of the pathway is also linked to the initiation and progression of several malignancies, and Notch can in fact be either oncogenic or tumour suppressive depending on the tissue and cellular context. The Notch pathway therefore represents an important target for therapeutic agents designed to treat many types of cancer. In this Review, we focus on the latest developments relating specifically to the tumour-suppressor activity of Notch signalling and discuss the potential mechanisms by which Notch can inhibit carcinogenesis in various tissues. Potential therapeutic strategies aimed at restoring or augmenting Notch-mediated tumour suppression will also be highlighted.

  1. Autonomous Star Tracker Algorithms

    DEFF Research Database (Denmark)

    Betto, Maurizio; Jørgensen, John Leif; Kilsgaard, Søren


    Proposal, in response to an ESA R.f.P., to design algorithms for autonomous star tracker operations.The proposal also included the development of a star tracker breadboard to test the algorithms performances.......Proposal, in response to an ESA R.f.P., to design algorithms for autonomous star tracker operations.The proposal also included the development of a star tracker breadboard to test the algorithms performances....

  2. Autonomic cardiac innervation


    Hasan, Wohaib


    Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targe...

  3. Pupil cycle time and early autonomic involvement in ocular leprosy.


    Karaçorlu, M A; Sürel, Z; Cakiner, T; Hanyaloğlu, E; Saylan, T; MAT, C.


    Ocular complications of leprosy patients often develop insidiously and with few if any symptoms. This study involves measurement of the pupil cycle time (PCT) to evaluate the autonomic nerve system of the iris to determine the presence of subclinical intraocular involvement. The study included 19 lepromatous (LL), 19 borderline lepromatous (BL), and five borderline tuberculoid (BT) leprosy patients and involved 25 healthy volunteers, 10 patients with pulmonary tuberculosis and eight with Duhr...

  4. Reconstruction of the distal radio-ulnar joint with a prosthesis of the distal ulna in the treatment of a recurrent giant cell tumour. (United States)

    Kotrych, Daniel; Zyluk, Andrzej; Walaszek, Ireneusz; Bohatryrewicz, Andrzej


    We present a case of 35-year old left-handed woman with recurrent giant-cell tumour affecting 1/4 of the distal part of the left ulna, with associated ulnar nerve involvement. After resection of the tumour and 1 cm of the ulnar nerve, the distal ulna was reconstructed with an individually designed and matched prosthesis, followed by ulnar nerve reconstruction. At 12 months follow-up the patients was free of pain, had excellent recovery of ulnar nerve function, satisfactory wrist range of motion and moderately impaired function of the left hand (DASH score 42). She returned to her original work in the office. We believe that restoration of the anatomy of the distal forearm after en block resection of the distal ulna is desirable in young, active patients, and that the prosthesis we used provides a good anatomical framework for the recovery of the function of the wrist.


    Zhilyaev, S Yu; Moskvin, A N; Platonova, T F; Demchenko, I T


    The activation of autonomic afferents (achieved through the vagus nerve (VN) electrical stimulation) on CNS O2 toxicity and cardiovascular function was investigated. In conscious rabbits at 5 ATA 02, prodromal signs of CNS O2 toxicity and convulsion latency were determined with and without vagus nerve (VN) stimulation. EEG, ECG and respiration were also recorded. In rabbits at 5 ATA, sympathetic overdrive and specific patterns on the EEG (synchronization of slow-waves), ECG (tachycardia) and respiration (respiratory minute volume increase) preceded motor convulsions. Vagus nerve stimulation increased parasympathetic component of autonomic drive and significantly delayed prodromal signs of oxygen toxicity and convulsion latency. Autonomic afferent input to the brain is a novel target for preventing CNS toxicity in HBO2.

  6. Organ-specific activation of the gastric branch of the efferent vagus nerve by ghrelin in urethane-anesthetized rats. (United States)

    Habara, Hiromi; Hayashi, Yujiro; Inomata, Norio; Niijima, Akira; Kangawa, Kenji


    Ghrelin plays multiple physiological roles such as growth hormone secretion and exerting orexigenic actions; however, its physiological roles in the electrical activity of autonomic nerves remain unclear. Here, we investigated the effects of human ghrelin on several autonomic nerve activities in urethane-anesthetized rats using an electrophysiological method. Intravenous injection of ghrelin at 3 μg/kg significantly and transiently potentiated the efferent activity of the gastric vagus nerve; however, it did not affect the efferent activity of the hepatic vagus nerve. The activated response to ghrelin in the gastric efferent vagus nerve was not affected by the gastric afferent vagotomy, suggesting that this effect was not induced via the gastric afferent vagus nerve. Ghrelin did not affect the efferent activity of the brown adipose tissue, adrenal gland sympathetic nerve, and the renal sympathetic nerve. In addition, rectal temperature and the plasma concentrations of norepinephrine, corticosterone, and renin were also not changed by ghrelin. These findings demonstrate that ghrelin stimulates the gastric efferent vagus nerve in an organ-specific manner without affecting the gastric afferent vagus nerve and that ghrelin does not acutely affect the efferent basal activity of the sympathetic nerve in rats.

  7. Mechanisms of disease in hereditary sensory and autonomic neuropathies. (United States)

    Rotthier, Annelies; Baets, Jonathan; Timmerman, Vincent; Janssens, Katrien


    Hereditary sensory and autonomic neuropathies (HSANs) are a clinically and genetically heterogeneous group of disorders of the PNS. Progressive degeneration, predominantly of sensory and autonomic neurons, is the main pathological feature in patients with HSAN, and causes prominent sensory loss and ulcerative mutilations in combination with variable autonomic and motor disturbances. Advances in molecular genetics have enabled identification of disease-causing mutations in 12 genes, and studies on the functional effects of these mutations are underway. Although some of the affected proteins--such as nerve growth factor and its receptor--have obvious nerve-specific roles, others are ubiquitously expressed proteins that are involved in sphingolipid metabolism, vesicular transport, transcription regulation and structural integrity. An important challenge in the future will be to understand the common molecular pathways that result in HSANs. Unraveling the mechanisms that underlie sensory and autonomic neurodegeneration could assist in identifying targets for future therapeutic strategies in patients with HSAN. This Review highlights key advances in the understanding of HSANs, including insights into the molecular mechanisms of disease, derived from genetic studies of patients with these disorders.

  8. Malignant tumours of the kidney: imaging strategy

    Energy Technology Data Exchange (ETDEWEB)

    Smets, Anne M. [Academic Medical Center, Department of Radiology G1, Amsterdam (Netherlands); Kraker, Jan de [Paediatric Oncology-Academic Medical Center, Amsterdam (Netherlands)


    Primitive malignant renal tumours comprise 6% of all childhood cancers. Wilms tumour (WT) or nephroblastoma is the most frequent type accounting for more than 90%. Imaging alone cannot differentiate between these tumours with certainty but it plays an important role in screening, diagnostic workup, assessment of therapy response, preoperative evaluation and follow-up. The outcome of WT after therapy is excellent with an overall survival around 90%. In tumours such as those where the outcome is extremely good, focus can be shifted to a risk-based stratification to maintain excellent outcome in children with low risk tumours while improving quality of life and decreasing toxicity and costs. This review will discuss the imaging issues for WT from the European perspective and briefly discuss the characteristics of other malignant renal tumours occurring in children and new imaging techniques with potential in this matter. (orig.)

  9. Movement disorders caused by brain tumours.

    Directory of Open Access Journals (Sweden)

    Bhatoe H


    Full Text Available Movement disorders are uncommon presenting features of brain tumours. Early recognition of such lesions is important to arrest further deficit. We treated seven patients with movement disorders secondary to brain tumours over a period of seven years. Only two of these were intrinsic thalamic tumours (astrocytomas while the rest were extrinsic tumours. The intrinsic tumours were accompanied by hemichorea. Among the extrinsic tumours, there was one pituitary macroadenoma with hemiballismus and four meningiomas with parkinsonism. Symptoms were unilateral in all patients except one with anterior third falcine meningioma who had bilateral rest tremors. There was relief in movement disorders observed after surgery. Imaging by computed tomography or magnetic resonance imaging is mandatory in the evaluation of movement disorders, especially if the presentation is atypical, unilateral and/or accompanied by long tract signs.

  10. [Adenomatoid tumour of the adrenal gland]. (United States)

    Bandier, Philippe Claus; Hansen, Alastair; Thorelius, Lars


    An adenomatoid tumour in the right suprarenal gland was discovered during clinical cancer staging of a 73-year-old woman. Adenomatoid tumours in the suprarenal glands are rare and are most often found incidentally. A definitive diagnosis is made on the basis of histology since imaging methods are non-specific. Differential diagnoses comprise malignant vascular neoplasm or adenocarcinoma. Immunohistochemistry or electron microscopy allows uncomplicated distinction between these tumours. In general, it is recommended to obtain biopsies from suprarenal processes.

  11. An unusual presentation of a glomus tumour.

    LENUS (Irish Health Repository)

    Nugent, N


    Glomus tumours are benign, soft tissue tumours, usually of fingertips. Classically they present with severe pain, temperature sensitivity and localised tenderness. The diagnosis is often delayed due to sometimes non-specific symptoms and rarity of the disorder. While usually a clinical diagnosis, imaging may be necessary for diagnosis and localisation. We present a case of glomus tumour of the fingertip with an unusual history.

  12. Ex-vivo HRMAS of adult brain tumours: metabolite quantification and assignment of tumour biomarkers.

    NARCIS (Netherlands)

    Wright, A.J.; Fellows, G.A.; Griffiths, J.R.; Wilson, M.; Bell, B.A.; Howe, F.A.


    BACKGROUND: High-resolution magic angle spinning (HRMAS) NMR spectroscopy allows detailed metabolic analysis of whole biopsy samples for investigating tumour biology and tumour classification. Accurate biochemical assignment of small molecule metabolites that are "NMR visible" will improve our inter

  13. Autonomous Evolutionary Information Systems

    Institute of Scientific and Technical Information of China (English)


    Traditional information systems are passive, i.e., data orknowledge is created , retrieved, modified, updated, and deleted only in response to operations issued by users or application programs, and the systems only can execute queries or t ransactions explicitly submitted by users or application programs but have no ab ility to do something actively by themselves. Unlike a traditional information system serving just as a storehouse of data or knowledge and working passively a ccording to queries or transactions explicitly issued by users and application p rograms, an autonomous evolutionary information system serves as an autonomous a nd evolutionary partner of its users that discovers new knowledge from its datab ase or knowledge-base autonomously, cooperates with its users in solving proble m s actively by providing the users with advices, and has a certain mechanism to i mprove its own state of “knowing” and ability of “working”. This paper semi nall y defines what is an autonomous evolutionary information system, explain why aut onomous evolutionary information systems are needed, and presents some new issue s, fundamental considerations, and research directions in design and development of autonomous evolutionary information systems.

  14. Autonomic disturbances in narcolepsy. (United States)

    Plazzi, Giuseppe; Moghadam, Keivan Kaveh; Maggi, Leonardo Serra; Donadio, Vincenzo; Vetrugno, Roberto; Liguori, Rocco; Zoccoli, Giovanna; Poli, Francesca; Pizza, Fabio; Pagotto, Uberto; Ferri, Raffaele


    Narcolepsy is a clinical condition characterized mainly by excessive sleepiness and cataplexy. Hypnagogic hallucinations and sleep paralysis complete the narcoleptic tetrad; disrupted night sleep, automatic behaviors and weight gain are also usual complaints. Different studies focus on autonomic changes or dysfunctions among narcoleptic patients, such as pupillary abnormalities, fainting spells, erectile dysfunction, night sweats, gastric problems, low body temperature, systemic hypotension, dry mouth, heart palpitations, headache and extremities dysthermia. Even if many studies lack sufficient standardization or their results have not been replicated, a non-secondary involvement of the autonomic nervous system in narcolepsy is strongly suggested, mainly by metabolic and cardiovascular findings. Furthermore, the recent discovery of a high risk for overweight and for metabolic syndrome in narcoleptic patients represents an important warning for clinicians in order to monitor and follow them up for their autonomic functions. We review here studies on autonomic functions and clinical disturbances in narcoleptic patients, trying to shed light on the possible contribute of alterations of the hypocretin system in autonomic pathophysiology.

  15. Prognosis of Brain Tumours with Epilepsy



    The prognosis of 560 patients with a clinical and CT diagnosis of intrinsic supratentorial brain tumour was examined retrospectively at the Department of Neurosciences, Walton Hospital, Liverpool, England.

  16. Elevated tumour marker: an indication for imaging?

    LENUS (Irish Health Repository)

    McMahon, Colm J


    INTRODUCTION: The purpose of this study was to evaluate the utility of imaging examinations in patients with elevated tumour markers when (a) the tumour marker is not validated for as a primary diagnostic test; (b) the patient had no personal history of cancer and (c) the patient had no other imaging indication. MATERIALS AND METHODS: Patients without known cancer who had abnormal carcinoembryonic antigen, CA19-9, CA125 and\\/or CA15-3 serology over a one-year period were included. A retrospective medical record review was performed to assess the number of these cases who underwent imaging because of \\'elevated tumour marker\\' in the absence of a clinical indication for imaging. The number and result of these imaging studies were evaluated. RESULTS: Eight hundred and nineteen patients were included. Of those, 25 patients (mean age: 67.8 [range 41-91] y), were imaged to evaluate: \\'elevated tumour marker\\'. They underwent 29 imaging studies (mean [+\\/-standard deviation (SD)] per patient = 1.2 [+\\/-0.4]), and had 42 elevated tumour marker serology tests (mean [+\\/-SD] per patient = 1.7 [+\\/-0.7]). Four patients had >1 imaging test. No patient had an imaging study which diagnosed a malignancy or explained the elevated tumour marker. CONCLUSION: The non-judicious use of tumour markers can prompt further unnecessary investigations including imaging. In this study, there was no positive diagnostic yield for imaging performed for investigation of \\'elevated tumour marker\\'. \\'Elevated tumour marker\\

  17. 腹腔镜下保留盆腔自主神经直肠癌根治术对冲洗液及血清中黏附分子、术后脏器功能的影响%Effect of pelvic autonomic nerve preservation in Iaparoscopic radical resection of rectal car-cinoma on adhesion molecules in washing fluid and serum as well as postoperative organ function

    Institute of Scientific and Technical Information of China (English)

    李超; 姚立彬; 孟松; 时林森; 王辉; 朱孝成


    目的::研究腹腔镜下保留盆腔自主神经直肠癌根治术对冲洗液及血清中黏附分子、术后脏器功能的影响。方法:选择2013年5月~2015年12月在本院接受全腹腔镜下直肠系膜切除术的86例直肠癌患者进行回顾性分析,37例患者在术中保留盆腔自主神经、纳入 A 组,49例患者在术中未保留盆腔自主神经、纳入B组。术后当天,测定血清肿瘤标志物、黏附分子的含量以及腹腔冲洗液中黏附分子的含量;术后1个月时,评估尿流动力学指标。结果:术后当天,A组患者血清中癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原125(CA125)、糖类抗原724(CA724)、细胞间黏附分子-1(ICAM-1)、血管细胞黏附分子-1(VCAM-1)、CD44v6、骨桥蛋白(OPN)的含量以及腹腔冲洗液中 ICAM-1、VCAM-1、CD44v6、OPN的含量均显著低于B组,血清和腹腔冲洗液中 E-钙黏蛋白(E-cadherin)的含量显著高于B组;术后1个月时,A组患者最大尿流率(QMax)、最大膀胱逼尿肌收缩压(PdetMax)、排尿量均显著高于B组,残余尿量显著低于 B组。结论:腹腔镜下直肠癌根治术中保留盆腔自主神经能够减少黏附分子的释放、降低术后排尿功能障碍的发生风险,具有积极的临床应用价值。%[ABSTRACT]Objective:To study the effect of pelvic autonomic nerve preservation in laparoscopic radical resection of rec-tal carcinoma on adhesion molecules in washing fluid and serum as well as postoperative organ function.Methods:86 patients with rectal carcinoma who received laparoscopic total mesorectal excision in our hospital between May 2013 and December 2015 were retrospectively analyzed,37 patients were with intraoperative pelvic autonomic nerve preservation and included in group A,and 49 patients were without intraoperative pelvic autonomic nerve preservation and included in group B.The same day after operation,the levels of tumor markers and adhesion molecules in serum as

  18. Autonomic Modulation by Electrical Stimulation of the Parasympathetic Nervous System: An Emerging Intervention for Cardiovascular Diseases. (United States)

    He, Bo; Lu, Zhibing; He, Wenbo; Huang, Bing; Jiang, Hong


    The cardiac autonomic nervous system has been known to play an important role in the development and progression of cardiovascular diseases. Autonomic modulation by electrical stimulation of the parasympathetic nervous system, which increases the parasympathetic activity and suppresses the sympathetic activity, is emerging as a therapeutic strategy for the treatment of cardiovascular diseases. Here, we review the recent literature on autonomic modulation by electrical stimulation of the parasympathetic nervous system, including vagus nerve stimulation, transcutaneous auricular vagal stimulation, spinal cord stimulation, and ganglionated plexi stimulation, in the treatment of heart failure, atrial fibrillation, and ventricular arrhythmias.

  19. Transcutaneous cervical vagal nerve stimulation modulates cardiac vagal tone and tumor necrosis factor-alpha. (United States)

    Brock, C; Brock, B; Aziz, Q; Møller, H J; Pfeiffer Jensen, M; Drewes, A M; Farmer, A D


    The vagus nerve is a central component of cholinergic anti-inflammatory pathways. We sought to evaluate the effect of bilateral transcutaneous cervical vagal nerve stimulation (t-VNS) on validated parameters of autonomic tone and cytokines in 20 healthy subjects. 24 hours after t-VNS, there was an increase in cardiac vagal tone and a reduction in tumor necrosis factor-α in comparison to baseline. No change was seen in blood pressure, cardiac sympathetic index or other cytokines. These preliminary data suggest that t-VNS exerts an autonomic and a subtle antitumor necrosis factor-α effect, which warrants further evaluation in larger controlled studies.

  20. Surgical treatment of extra-abdominal desmoid tumours (aggressive fibromatoses). (United States)

    Higaki, S; Tateishi, A; Ohno, T; Abe, S; Ogawa, K; Iijima, T; Kojima, T


    Extra-abdominal desmoid tumours (EADT) are benign lesions but difficult to cure because of their infiltrative nature and tendency to recur. Among many treatments recommended in the past, wide excision has been successful, even in difficult cases. We have analyzed retrospectively 41 cases of histologically confirmed EADTs. A total of 98 operations were performed on these patients: 29 wide excisions on 22 patients, 52 intra-lesional excisions with wide margins on 16 patients, and 17 incomplete excisions on 3 patients. One patient, with intra-pelvic lesions, died of a massive haemorrhage 3 days after surgery. Forty patients were followed from between 3 and 29 years. One, who had a multicentric EADT for 21 years, died from the disease. The significant factors concerning local recurrence after wide procedures were an unsatisfactory initial wide local excision, disease affecting 4 or more muscles and the invasive nature of the recurrences. We recommend wide local excision of these tumours in all anatomical areas that allow this procedure. When major nerves and vessels are involved, we recommend an intralesional excision with wide margins in order to preserve limb function. Radiation therapy should be confined to cases in which wide local procedures are not feasible. Overall, 37 of our patients (90%) were cured of the disease, 2 had their disease controlled, and 2 died.

  1. 腹腔镜自主神经保护的直肠癌根治术对女性性功能的影响%Effect of sexual function after pelvic autonomic nerve preservation of laparoscopic radical resection on for rectal in female patients

    Institute of Scientific and Technical Information of China (English)

    姚寒晖; 朱志强; 宁忠良; 梁伟; 张善家


    目的 探讨腹腔镜自主神经保护对女性直肠癌根治术患者的性功能保护价值.方法 回顾性分析100例女性中低位直肠癌患者分别行腹腔镜保盆腔自主神经手术(L-PANP,n=50)和开腹保盆腔自主神经手术(O-PANP,n=50)的临床资料,采用电话问卷调查的方式依据女性性功能指标量表(FSFI)中的内容量化患者在术后6、12个月的性功能情况,评估两种手术方式对女性患者性功能的影响.结果 100例均顺利完成手术,无中转开腹,且患者均康复出院,术后随访1年以上者95例:L-PANP组48例,O-PANP组47例.术后6个月性功能变化情况(性兴奋、性高潮、性交痛、性满意度指标),L-PANP组各型术式均优于O-PANP组同型术式,差异有统计学意义(P<0.05);术后12个月L-PANP的Ⅰ型及Ⅱ型术式优于O-PANP组同型术式患者(P<0.05),但两组行Ⅲ型术式差异无统计学意义.结论 在不增加局部复发率的前提下,L-PANP对女性患者性功能的保护优于O-PANP,提高患者术后生存质量.%To evaluate the protection of sexual function after laparoscopic radical resection with pelvic autonomic nerve preservation ( PANP ) for rectal cancer in female patients. Methods Prospectively 100 female patients with middle or low rectal cancer were divided into two groups( L-PANP,n = 50;O-PANP,n =50 ). The radicalism and safety of L-PANP surgery were analyzed and the effects on sexual function between the two groups assessed by erectile and ejaculation function study. Results Patients of L-PANP group had difference in those of 0-PANP group for six month PANP surgery( P <0. 05 ). Patients of subtypes I and II of L-PANP surgery had better sexual( sexual excitement, orgasm, pain disorder and sexual satisfaction ) than those of the same subtype of O-PANP surgery for twelve months, and there were no difference in patients of subtype M PANP surgery. Conclusion Compared with O-PANP surgery, L-PANP surgery without any increase in relapse

  2. 肥胖儿童心脏自主神经变化特征及有氧运动的干预作用%The characteristics of cardiac autonomic nerve changes and the intervention effect of aerobic exercises in obese children

    Institute of Scientific and Technical Information of China (English)

    王国祥; 刘殿玉


    : SDNN and LPNN50 in experimental group were significantly lower than those in control group ( P < 0. 01 ); in experimental group, SDNN and LPNN 50 after exercise were significantly higher than those before exercise ( P < 0. 05 ) . Conclusion: Compared with normal children, the children with simple obesity have heart rate variability, which mainly appears as the decrease of activity of pneumogastrie nerve; aerobic exercise can improve the autonomic nervous activity of children with simple obesity.

  3. Imaging the hypoglossal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Pedro [Department of Radiology, Centro Hospitalar de Lisboa Central-Hospital de Sao Jose, Rua Jose Antonio Serrano, 1150-199 Lisboa Codex (Portugal)], E-mail:


    The hypoglossal nerve is a pure motor nerve. It provides motor control to the intrinsic and extrinsic tongue muscles thus being essential for normal tongue movement and coordination. In order to design a useful imaging approach and a working differential diagnosis in cases of hypoglossal nerve damage one has to have a good knowledge of the normal anatomy of the nerve trunk and its main branches. A successful imaging evaluation to hypoglossal diseases always requires high resolution studies due to the small size of the structures being studied. MRI is the preferred modality to directly visualize the nerve, while CT is superior in displaying the bony anatomy of the neurovascular foramina of the skull base. Also, while CT is only able to detect nerve pathology by indirect signs, such as bony expansion of the hypoglossal canal, MRI is able to visualize directly the causative pathological process as in the case of small tumors, or infectious/inflammatory processes affecting the nerve. The easiest way to approach the study of the hypoglossal nerve is to divide it in its main segments: intra-axial, cisternal, skull base and extracranial segment, tailoring the imaging technique to each anatomical area while bearing in mind the main disease entities affecting each segment.

  4. Suprascapular nerve palsy. (United States)

    Moskowitz, E; Rashkoff, E S


    Isolated traumatic suprascapular nerve palsy without associated fracture is a rare occurrence. Localized segmental muscle atrophy limited to the supraspinatus and infraspinatus muscles associated with weakness in initiating abduction and in external rotation of the shoulder should suggest the diagnosis. Electromyography will confirm the diagnosis by excluding nerve root and brachial plexus involvement with denervation potentials limited to the supraspinatus and infraspinatus muscles.

  5. Granular cell tumour of the neurohypophysis: a rare sellar tumour with specific radiological and operative features.

    LENUS (Irish Health Repository)

    Aquilina, K


    Symptomatic granular cell tumours of the neurohypophysis are rare sellar lesions. Preoperative prediction of the diagnosis on the basis of radiological appearance is useful as these tumours carry specific surgical difficulties. This is possible when the tumour arises from the pituitary stalk, rostral to a normal pituitary gland. This has not been emphasized previously.

  6. Simple Autonomous Chaotic Circuits (United States)

    Piper, Jessica; Sprott, J.


    Over the last several decades, numerous electronic circuits exhibiting chaos have been proposed. Non-autonomous circuits with as few as two components have been developed. However, the operation of such circuits relies on the non-ideal behavior of the devices used, and therefore the circuit equations can be quite complex. In this paper, we present two simple autonomous chaotic circuits using only opamps and linear passive components. The circuits each use one opamp as a comparator, to provide a signum nonlinearity. The chaotic behavior is robust, and independent of nonlinearities in the passive components. Moreover, the circuit equations are among the algebraically simplest chaotic systems yet constructed.

  7. Biological and artificial nerve conduit for repairing peripheral nerve defect

    Institute of Scientific and Technical Information of China (English)

    Xuetao Xie; Changqing Zhang


    OBJECTIVE: Recently, with the development of biological and artificial materials, the experimental and clinical studies on application of this new material-type nerve conduit for treatment of peripheral nerve defect have become the hotspot topics for professorial physicians.DATA SOURCES: Using the terms "nerve conduits, peripheral nerve, nerve regeneration and nerve transplantation" in English, we searched Pubmed database, which was published during January 2000 to June 2006, for the literatures related to repairing peripheral nerve defect with various materials. At the same time, we also searched Chinese Technical Scientific Periodical Database at the same time period by inputting" peripheral nerve defect, nerve repair, nerve regeneration and nerve graft" in Chinese.STUDY SELECTION: The materials were firstly selected, and literatures about study on various materials for repairing peripheral nerve defect and their full texts were also searched. Inclusive criteria: nerve conduits related animal experiments and clinical studies. Exclusive criteria: review or repetitive studies.DATA EXTRACTION: Seventy-nine relevant literatures were collected and 30 of them met inclusive criteria and were cited.DATA SYNTHESTS: Peripheral nerve defect, a commonly seen problem in clinic, is difficult to be solved. Autogenous nerve grafting is still the gold standard for repairing peripheral nerve defect, but because of its application limitation and possible complications, people studied nerve conduits to repair nerve defect. Nerve conduits consist of biological and artificial materials.CONCLUSION: There have been numerous reports about animal experimental and clinical studies of various nerve conduits, but nerve conduit, which is more ideal than autogenous nerve grafting, needs further clinical observation and investigation.

  8. [Pain of the trigeminal nerve as the first symptom of a metastasis from an oesohaguscarcinoma in Meckel's cave - case report]. (United States)

    Mewes, H; Schroth, I; Deinsberger, W; Böker, D K


    Pain in all three divisions of the trigeminal nerve is in over 65% of all cases the first symptom of a tumour in Meckel's cave. Tumors in this location make up only 0,5% of all intracranial tumours. The most common are trigeminal schwannomas and meningeomas. A metastases as a cause of trigeminal pain is a rare description in the literature so far. We describe a patient with trigeminal pain and a tumour in Meckels's cave shown in the MRI, who were operated in our department. The histological examination of the tumour resulted in the diagnosis of metastatic carcinoma of an until then unknown oesophaguscarcinoma. - Although metastatic tumours are rare, we could show with our case, that they have to be included in differential dignostic considerations.

  9. Overview of the Autonomic Nervous System (United States)

    ... be reversible or progressive. Anatomy of the autonomic nervous system The autonomic nervous system is the part of ... organs they connect with. Function of the autonomic nervous system The autonomic nervous system controls internal body processes ...

  10. [sup 123]I-MIBG myocardial scintigraphy in diabetic patients. Association with autonomic neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Hoshi, Hiroaki; Ohnishi, Takashi; Jinnouchi, Seishi; Futami, Shigemi; Watanabe, Katsushi; Nakatsuru, Kuninobu; Toshimori, Toshitaka; Matsukura, Shigeru (Miyazaki Medical Coll., Kiyotake (Japan))


    [sup 123]I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy was performed in 20 diabetic patients (NIDDM) and 8 control subjects to investigate the association between clinical autonomic nerve dysfunction and myocardial accumulation of MIBG. We used coefficient variance of R-R interval (CV[sub R-R]) as a index of the autonomic neuropathy and categorized diabetes into two groups (CV[sub R-R][>=]2.0: non-autonomic neuropathy. CV[sub R-R]<2.0: autonomic neuropathy). In planar imaging studies, heart to mediastinum MIBG uptake ratio (H/M) was calculated on both early and delayed images. The washout ratio of [sup 123]I-MIBG in the heart (%WR) was also obtained using myocardial tracer activity on the both images. Mean value of these indices in diabetic group did not reveal any significant difference with the value in the control group. On the SPECT images, low uptake was observed in the posterior-inferior wall with normal uptake of [sup 201]Tl in diabetic patients with non-autonomic neuropathy. These areas extended in patients with autonomic neuropathy. The mean value of count ratio of posterior-interior to anterior wall (posterior-inferior/anterior ratio: PI/A) in the diabetic autonomic neuropathy group was significantly higher than in the control group on the both early and delayed images. And the mean value of regional %WR in the posterior-inferior wall calculated by the both MIBG SPECT images was significantly higher in the non-autonomic neuropathy group than in the control group. In the diabetic patients, retention mechanism of [sup 123]I-MIBG was considered to be involved at an early stage without autonomic nerve dysfunction clinically. As autonomic neuropathy progressed severely, uptake mechanism was also supposed to be involved. Therefore, [sup 123]I-MIBG myocardial scintigraphy was useful for early detection of cardiac sympathetic nervous dysfunction in diabetic patients. (author).

  11. Epithelial tumours of the lacrimal gland

    DEFF Research Database (Denmark)

    von Holstein, Sarah Linéa; Coupland, Sarah E; Briscoe, Daniel;


    Epithelial tumours of the lacrimal gland represent a large spectrum of lesions with similarities in clinical signs and symptoms but with different biological behaviour and prognosis. They are rare, but with aggressive malignant potential. Tumours of the lacrimal gland may present with swelling of...

  12. Percutaneously implanted markers in peripheral lung tumours

    DEFF Research Database (Denmark)

    Persson, G.F.; Josipovic, Mirjana; Nygaard, Ditte Eklund;


    A letter to the editor is presented which is concerned with research which investigated percutaneously implanted markers in peripheral lung tumours and their complications.......A letter to the editor is presented which is concerned with research which investigated percutaneously implanted markers in peripheral lung tumours and their complications....

  13. Thermal resistance in a spontaneous murine tumour. (United States)

    Maher, J; Urano, M; Rice, L; Suit, H D


    Resistance to subsequent hyperthermia as a result of prior heating was investigated using a spontaneous murine tumour implanted into the feet of C3H/Sed mice. Tumours were treated by immersing the tumour-bearing foot into a constant-temperature hot water bath set at 45.5 degrees C and were given single and split doses of heat. Response was assessed using a tumour-growth time assay. Three aspects of thermally-induced resistance were particularly considered: the time course of development and decay; the importance of the magnitude of the priming dose and the influence of the size of the tumour at the time of treatment. Substantial resistance was induced in this tumour by short priming doses at 45.5 degrees C, rising rapidly 1-2 days after the first treatment and then starting to decay. There was no significant difference in the kinetics of thermal resistance induced in tumours treated at 4mm and those treated at 8 mm in size, although the large tumours were more sensitive to single doses of heat. Increasing the magnitude of the priming dose of heat resulted in an increase in the magnitude of resistance to the second dose. The results of this study are compared with results of similar studies in this and other laboratories using murine normal tissues and cells in culture. Possible clinical implications are considered.

  14. Skull metastasis from rectal gastrointestinal stromal tumours. (United States)

    Gil-Arnaiz, Irene; Martínez-Trufero, Javier; Pazo-Cid, Roberto Antonio; Felipo, Francesc; Lecumberri, María José; Calderero, Verónica


    Gastrointestinal stromal tumours (GIST) are the most common mesenchymal neoplasm of the gastrointestinal tract. Rectum localisation is infrequent for these neoplasms, accounting for about 5% of all cases. Distant metastases of GIST are also rare. We present a patient with special features: the tumour is localised in rectum and it has an uncommon metastatic site, the skull, implying a complex differential diagnosis approach.

  15. Occurrence studies of intracranial tumours

    Energy Technology Data Exchange (ETDEWEB)

    Larjavaara, S.


    Intracranial tumours are a histopathologically heterogeneous group of tumours. This thesis focused on three types of intracranial tumours; gliomas, meningiomas and vestibular schwannomas (VS). The main objectives of the dissertation were to estimate the occurrence of intracranial tumours by different subtypes, and to assess the validity and completeness of the cancer registry data. The specific aims of the publications were to evaluate the validity of reported incidence rates of meningioma cases, to describe the trends of VS incidence in four Nordic countries, and to define the anatomic distribution of gliomas and to investigate their location in relation to mobile phone use. Completeness of meningioma registration was examined by comparing five separate sources of information, and by defining the frequencies of cases reported to the Finnish Cancer Registry (FCR). Incidence trends of VS were assessed in the four Nordic countries over a twenty-one-year period (1987 - 2007) using cancer registry data. The anatomic site of gliomas was evaluated using both crude locations in the cerebral lobes and, in more detail, a three-dimensional (3D) distribution in the brain. In addition, a study on specific locations of gliomas in relation to the typical position of mobile phones was conducted using two separate approaches: a case-case and a case-specular analysis. The thesis was based on four sets of materials. Data from the international Interphone study were used for the studies on gliomas, while the two other studies were register-based. The dataset for meningiomas included meningioma cases from the FCR and four clinical data sources in Tampere University Hospital (neurosurgical clinic, pathology database, hospital discharge register and autopsy register). The data on VS were obtained from the national cancer registries of Denmark, Finland, Norway and Sweden. The coverage of meningiomas was not comprehensive in any of the data sources. The completeness of FCR was

  16. Autonomous Hexapod Spider Robot

    DEFF Research Database (Denmark)

    Pandey, Nisha; Pandey, Bishwajeet; Hussain, Dil muhammed Akbar


    of a hexapod robot. It is controlled through Arduino-unoR3 based SSC servo control module. Servos of torque 2.5kg-cm are used in robot to show different working movements including back and forth movement and sitting posture. Another trending technology i.e. Bluetooth is used to control autonomous feature...

  17. Experimental Autonomous Vehicle Systems

    DEFF Research Database (Denmark)

    Ravn, Ole; Andersen, Nils Axel


    The paper describes the requirements for and a prototype configuration of a software architecture for control of an experimental autonomous vehicle. The test bed nature of the system is emphasised in the choice of architecture making re-configurability, data logging and extendability simple...

  18. Autonomous component carrier selection

    DEFF Research Database (Denmark)

    Garcia, Luis Guilherme Uzeda; Pedersen, Klaus; Mogensen, Preben


    in local areas, basing our study case on LTE-Advanced. We present extensive network simulation results to demonstrate that a simple and robust interference management scheme, called autonomous component carrier selection allows each cell to select the most attractive frequency configuration; improving...

  19. Autonomous Forest Fire Detection

    NARCIS (Netherlands)

    Breejen, E. den; Breuers, M.; Cremer, F.; Kemp, R.A.W.; Roos, M.; Schutte, K.; Vries, J.S. de


    Forest fire detection is a very important issue in the pre-suppression process. Timely detection allows the suppression units to reach the fire in its initial stages and this will reduce the suppression costs considerably. The autonomous forest fire detection principle is based on temporal contrast

  20. Nerve Damage (Diabetic Neuropathies) (United States)

    ... normally. A woman may have difficulty with arousal, lubrication, or orgasm. Sweat Glands Autonomic neuropathy can affect ... performed in people with diabetes. Comprehensive foot care programs can reduce amputation rates by 45 to 85 ...

  1. Changes in nerve microcirculation following peripheral nerve compression

    Institute of Scientific and Technical Information of China (English)

    Yueming Gao; Changshui Weng; Xinglin Wang


    Following peripheral nerve compression, peripheral nerve microcirculation plays important roles in regulating the nerve microenvironment and neurotrophic substances, supplying blood and oxygen and maintaining neural conduction and axonal transport. This paper has retrospectively analyzed the articles published in the past 10 years that addressed the relationship between peripheral nerve compression and changes in intraneural microcirculation. In addition, we describe changes in different peripheral nerves, with the aim of providing help for further studies in peripheral nerve microcirculation and understanding its protective mechanism, and exploring new clinical methods for treating peripheral nerve compression from the perspective of neural microcirculation.

  2. Pituitary adenylatecyclase-activating polypeptide-immunoreactive nerve fibers in the rat epiglottis and pharynx. (United States)

    Kano, Mitsuhiro; Shimizu, Yoshinaka; Suzuki, Yujiro; Furukawa, Yusuke; Ishida, Hiroko; Oikawa, Miho; Kanetaka, Hiroyasu; Ichikawa, Hiroyuki; Suzuki, Toshihiko


    The distribution of pituitary adenylatecyclase-activating polypeptide-immunoreactive (PACAP-IR) nerve fibers was studied in the rat epiglottis and pharynx. PACAP-IR nerve fibers were located beneath the mucous epithelium, and occasionally penetrated the epithelium. These nerve fibers were abundant on the laryngeal side of the epiglottis and in the dorsal and lateral border region between naso-oral and laryngeal parts of the pharynx. PACAP-IR nerve fibers were also detected in taste buds within the epiglottis and pharynx. In addition, many PACAP-IR nerve fibers were found around acinar cells and blood vessels. The double immunofluorescence method demonstrated that distribution of PACAP-IR nerve fibers was similar to that in CGRP-IR nerve fibers in the epithelium and taste bud. However, distributions of PACAP-IR and CGRP-IR nerve fibers innervating mucous glands and blood vessels were different. The retrograde tracing method also demonstrated that PACAP and CGRP were co-expressed by vagal and glossopharyngeal sensory neurons innervating the pharynx. These findings suggest that PACAP-IR nerve fibers in the epithelium and taste bud of the epiglottis and pharynx which originate from the vagal and glossopharyngeal sensory ganglia include nociceptors and chemoreceptors. The origin of PACAP-IR nerve fibers which innervate mucous glands and blood vessels may be the autonomic ganglion.

  3. Cancer-associated-fibroblasts and tumour cells: a diabolic liaison driving cancer progression. (United States)

    Cirri, Paolo; Chiarugi, Paola


    Several recent papers have now provided compelling experimental evidence that the progression of tumours towards a malignant phenotype does not depend exclusively on the cell-autonomous properties of cancer cells themselves but is also deeply influenced by tumour stroma reactivity, thereby undergoing a strict environmental control. Tumour microenvironmental elements include structural components such as the extracellular matrix or hypoxia as well as stromal cells, either resident cells or recruited from circulating precursors, as macrophages and other inflammatory cells, endothelial cells and cancer-associated fibroblasts (CAFs). All these elements synergistically play a specific role in cancer progression. This review summarizes our current knowledge on the role of CAFs in tumour progression, with a particular focus on the biunivocal interplay between CAFs and cancer cells leading to the activation of the epithelial-mesenchymal transition programme and the achievement of stem cell traits, as well as to the metabolic reprogramming of both stromal and cancer cells. Recent advances on the role of CAFs in the preparation of metastatic niche, as well as the controversial origin of CAFs, are discussed in light of the new emerging therapeutic implications of targeting CAFs.

  4. The ‘Pantie' Tumour

    Directory of Open Access Journals (Sweden)

    Silada Kanokrungsee


    Full Text Available We present a case of radiation-associated angiosarcoma. A 67-year-old Thai woman was diagnosed with endometrium carcinoma stage IC and was treated with surgery and radiations. Ten years later, she presented with a gradually enlarging mass on the pubic area, in the shape of a pair of panties. Skin biopsy of lesions confirmed angiosarcoma. The diagnosis was radiation-associated angiosarcoma. She was treated with chemotherapy due to unresectable tumour. The chemotherapy was started with paclitaxel 70 mg/m2 every 2 weeks. After completing the fifth cycle of paclitaxel, the lesion was markedly decreased in size and the symptoms previously described were also completely resolved.

  5. Motion compensation for robotic lung tumour radiotherapy in remote locations: A personalised medicine approach (United States)

    Ionescu, Clara M.; Copot, Cosmin; Verellen, Dirk


    The purpose of this work is to integrate the concept of patient-in-the-closed-loop application with tumour treatment of cancer-diagnosed patients in remote areas. The generic closed loop control objective is effective synchronisation of the radiation focus to the movement of a lung tissue tumour during actual breathing of the patient. This is facilitated by accurate repositioning of a robotic arm manipulator, i.e. we emulate the Cyberknife Robotic Radiosurgery system. Predictive control with disturbance filter is used in this application in a minimalistic model design. Performance of the control structure is validated by means of simulation using real recorded breathing patterns from patients measured in 3D space. Latency in communication protocol is taken into account, given telerobotics involve autonomous operation of a robot interacting with a human being in different location. Our results suggest that the proposed closed loop control structure has practical potential to individualise the treatment and improves accuracy by at least 15%.

  6. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

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


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

  7. Degenerative Nerve Diseases (United States)

    Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical ...

  8. Diabetes and nerve damage (United States)

    Diabetic neuropathy; Diabetes - neuropathy; Diabetes - peripheral neuropathy ... In people with diabetes, the body's nerves can be damaged by decreased blood flow and a high blood sugar level. This condition is ...

  9. Diabetic Nerve Problems (United States)

    ... at the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get ... you change positions quickly Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. ...

  10. Damaged axillary nerve (image) (United States)

    Conditions associated with axillary nerve dysfunction include fracture of the humerus (upper arm bone), pressure from casts or splints, and improper use of crutches. Other causes include systemic disorders that cause neuritis (inflammation of ...

  11. Sacral nerve stimulation. (United States)

    Matzel, K E; Stadelmaier, U; Besendörfer, M


    The current concept of recruiting residual function of an inadequate pelvic organ by electrostimulation involves stimulation of the sacral spinal nerves at the level of the sacral canal. The rationale for applying SNS to fecal incontinence was based on clinical observations of its effect on bowel habits and anorectal continence function in urologic patients (increased anorectal angulation and anal canal closure pressure) and on anatomic considerations: dissection demonstrated a dual peripheral nerve supply of the striated pelvic floor muscles that govern these functions. Because the sacral spinal nerve site is the most distal common location of this dual nerve supply, stimulating here can elicit both functions. Since the first application of SNS in fecal incontinence in 1994, this technique has been improved, the patient selection process modified, and the spectrum of indications expanded. At present SNS has been applied in more than 1300 patients with fecal incontinence limited.

  12. Compression of the median nerve in the proximal forearm by a giant lipoma: A case report

    Directory of Open Access Journals (Sweden)

    O'Toole Greg A


    Full Text Available Abstract Background Compression of the median nerve by a tumour in the elbow and forearm region is rare. We present a case of neuropathy of the median nerve secondary to compression by giant lipoma in the proximal forearm. Case presentation A 46-year-old man presented with a six month history of gradually worsening numbness and paresthesia on the palmar aspect of the left thumb and thenar eminence. Clinical examination reveals a hypoaesthesia in the median nerve area of the left index and thumb compared to the contralateral side. Electromyography showed prolonged sensory latency in the distribution of the median nerve corresponding to compression in the region of the pronator teres (pronator syndrome. Radiological investigations were initially reported as normal. Conservative treatment for one month did not result in any improvement. Surgical exploration was performed and a large intermuscular lipoma enveloped the median nerve was found. A complete excision of the tumour was performed. Postoperative revaluation the X-ray of the elbow was seen to demonstrate a well-circumscribed mass in the anterior aspect of the proximal forearm. At follow-up, 14 months after surgery, the patient noted complete return of the sensation and resolution of the paresthesia. Conclusion In case of atypical findings or non frequent localization of nerve compression, clinically interpreted as an idiopathic compression, it is recommended to make a pre-operative complementary Ultrasound or MRI study.

  13. Conjoined lumbosacral nerve roots

    Directory of Open Access Journals (Sweden)

    Atila Yılmaz


    Full Text Available Lumbosacral nerve root anomalies are a rare group ofcongenital anatomical anomalies. Various types of anomaliesof the lumbosacral nerve roots have been documentedin the available international literature. Ttheseanomalies may consist of a bifid, conjoined structure, ofa transverse course or of a characteristic anastomizedappearance. Firstly described as an incidental findingduring autopsies or surgical procedures performed forlumbar disk herniations and often asymptomatic, lumbosacralnerve root anomalies have been more frequentlydescribed in the last years due to the advances made inradiological diagnosis.

  14. MRI of pineal region tumours: relationship between tumours and adjacent structures

    Energy Technology Data Exchange (ETDEWEB)

    Satoh, H. [Hiroshima University, School of Medicine (Japan). Dept. of Neurosurgery; Uozumi, T. [Hiroshima University, School of Medicine (Japan). Dept. of Neurosurgery; Kiya, K. [Dept. of Neurosurgery, Hiroshima Prefectural Hospital, Hiroshima (Japan); Kurisu, K. [Hiroshima University, School of Medicine (Japan). Dept. of Neurosurgery; Arita, K. [Hiroshima University, School of Medicine (Japan). Dept. of Neurosurgery; Sumida, M. [Hiroshima University, School of Medicine (Japan). Dept. of Neurosurgery; Ikawa, F. [Dept. of Neurosurgery, Hiroshima Prefectural Hospital, Hiroshima (Japan)


    A variety of tumours may arise in the pineal region; accurate diagnosis is important in the selection of treatment and prognosis. A retrospective analysis of the MRI studies of 25 patients with pathologically proven pineal region tumours was performed, focused on the relationship between the tumour and neighbouring structures. Compression of the tectal plate was classified as expansive or invasive, and compression of the corpus callosum as inferior, anterior or posterior. In 10 of the 14 patients (71 %) with germ cell tumours tectal compression was of the invasive type; 8 patients (57 %) had multiple tumours and in 13 (93 %) the tumour margins were irregular. Teratomas were readily diagnosed because of characteristic heterogeneous signal intensity. Pineal cell tumours were differentiated from germ cell tumours by their rounded shape, solid nature, sharp margins, and expansive type of tectal compression. Meningiomas were characterised by their falcotentorial attachments, posterior callosal compression, and a low-intensity rim on T2-weighted images. Gd-DTPA injection enabled clear demonstration of the site and extent of tumour spread and was useful in differentiating cystic and solid components. The appearances described, while not pathognomonic, are helpful in the differential diagnosis of pineal region tumours, and valuable in planning appropriate treatment. (orig.). With 4 figs., 6 tabs.

  15. Electrophysiology of autonomic neuromuscular transmission involving ATP. (United States)

    Sneddon, P


    Electrophysiological investigations of autonomic neuromuscular transmission have provided great insights into the role of ATP as a neurotransmitter. Burnstock and Holman made the first recordings of excitatory junction potentials (e.j.p.s) produced by sympathetic nerves innervating the smooth muscle of the guinea-pig vas deferens. This led to the identification of ATP as the mediator of e.j.p.s in this tissue, where ATP acts as a cotransmitter with noradrenaline. The e.j.p.s are mediated solely by ATP acting on P2X(1) receptors leading to action potentials and a rapid phasic contraction, whilst noradrenaline mediates a slower, tonic contraction which is not dependent on membrane depolarisation. Subsequent electrophysiological studies of the autonomic innervation of smooth muscles of the urogenital, gastrointestinal and cardiovascular systems have revealed a similar pattern of response, where ATP mediates a fast electrical and mechanical response, whilst another transmitter such as noradrenaline, acetylcholine, nitric oxide or a peptide mediates a slower response. The modulation of junction potentials by a variety of pre-junctional receptors and the mechanism of inactivation of ATP as a neurotransmitter will also be described.

  16. Acute Pancreatitis Secondary to Pancreatic Neuroendocrine Tumours

    Directory of Open Access Journals (Sweden)

    Grinó P


    Full Text Available CONTEXT: Pancreatic neoplasms are an uncommon aetiology of acute pancreatitis. Pancreatic neuroendocrine tumours are a rare subgroup of pancreatic neoplasms. CASE REPORT: We report on three patients having acute pancreatitis secondary to pancreatic neuroendocrine tumours, one of them with severe pancreatitis, and review the published cases up to now. Only 22 patients with acute pancreatitis secondary to pancreatic neuroendocrine tumours have been reported (including the present cases. Most of these cases were of non-functioning neoplasms and the course of the pancreatitis tended to be mild. In the most recent reports and in the present cases, the initial diagnostic method was CT scan. Less than half had metastases when the tumour was diagnosed and mortality from these neoplasms reached approximately 50%. CONCLUSIONS: Pancreatic neuroendocrine tumours can cause acute pancreatitis even in patients under 50 years of age. On many occasions, the tumours are non-functioning; therefore, acute pancreatitis may be the first clinical symptom. Consequently, faced with acute pancreatitis of unknown origin, a non-functioning neuroendocrine tumour should be ruled out.

  17. Mechanisms of tumour escape from immune surveillance

    Directory of Open Access Journals (Sweden)

    Lisiecka Urszula


    Full Text Available The progressive growth and spread of tumour cells in the form of metastases requires an interaction of healthy host cells, such as endothelial cells, fibroblasts, and other cells of mesenchymal origin with immune cells taking part in innate and adaptive responses within the tumour lesion and entire body. The host cells interact with tumour cells to create a dynamic tumour microenvironment, in which healthy cells can both positively and negatively influence the growth and spread of the tumour. The balance of cellular homeostasis and the effect of substances they secrete on the tumour microenvironment determine whether the tumour has a tendency to grow or disappear, and whether the cells remain within the lesion or are capable of metastasis to other regions of the body. Intercellular interactions also determine the tumour’s susceptibility to radiation or other types of cancer treatment. They may also be a rational explanation for differences in treatment outcomes, in which some metastases regress and others progress in response to the same treatment method.

  18. Oncogenic extracellular vesicles in brain tumour progression

    Directory of Open Access Journals (Sweden)

    Esterina eD'Asti


    Full Text Available The brain is a frequent site of neoplastic growth, including both primary and metastatic tumours. The clinical intractability of many brain tumours and their distinct biology are implicitly linked to the unique microenvironment of the central nervous system (CNS and cellular interactions within. Among the most intriguing forms of cellular interactions is that mediated by membrane-derived extracellular vesicles (EVs. Their biogenesis (vesiculation and uptake by recipient cells serves as a unique mechanism of intercellular trafficking of complex biological messages including the exchange of molecules that cannot be released through classical secretory pathways, or that are prone to extracellular degradation. Tumour cells produce EVs containing molecular effectors of several cancer-related processes such as growth, invasion, drug resistance, angiogenesis, and coagulopathy. Notably, tumour-derived EVs (oncosomes also contain oncogenic proteins, transcripts, DNA and microRNA (miR. Uptake of this material may change properties of the recipient cells and impact the tumour microenvironment. Examples of transformation-related molecules found in the cargo of tumour-derived EVs include the oncogenic epidermal growth factor receptor (EGFRvIII, tumour suppressors (PTEN and oncomirs (miR-520g. It is postulated that EVs circulating in blood or cerebrospinal fluid (CSF of brain tumour patients may be used to decipher molecular features (mutations of the underlying malignancy, reflect responses to therapy or molecular subtypes of primary brain tumours (e.g. glioma or medulloblastoma. It is possible that metastases to the brain may also emit EVs with clinically relevant oncogenic signatures. Thus EVs emerge as a novel and functionally important vehicle of intercellular communication that can mediate multiple biological effects. In addition, they provide a unique platform to develop molecular biomarkers in brain malignancies.

  19. Mobile Autonomous Humanoid Assistant (United States)

    Diftler, M. A.; Ambrose, R. O.; Tyree, K. S.; Goza, S. M.; Huber, E. L.


    A mobile autonomous humanoid robot is assisting human co-workers at the Johnson Space Center with tool handling tasks. This robot combines the upper body of the National Aeronautics and Space Administration (NASA)/Defense Advanced Research Projects Agency (DARPA) Robonaut system with a Segway(TradeMark) Robotic Mobility Platform yielding a dexterous, maneuverable humanoid perfect for aiding human co-workers in a range of environments. This system uses stereo vision to locate human team mates and tools and a navigation system that uses laser range and vision data to follow humans while avoiding obstacles. Tactile sensors provide information to grasping algorithms for efficient tool exchanges. The autonomous architecture utilizes these pre-programmed skills to form human assistant behaviors. The initial behavior demonstrates a robust capability to assist a human by acquiring a tool from a remotely located individual and then following the human in a cluttered environment with the tool for future use.

  20. Anatomical study of sciatic nerve and common peroneal nerve compression

    Institute of Scientific and Technical Information of China (English)

    Mingzhao Jia; Qing Xia; Jinmin Sun; Qiang Zhou; Weidong Wang


    BACKGROUND: Many diseases of the common peroneal nerve are a result of sciatic nerve injury. The present study addresses whether anatomical positioning of the sciatic nerve is responsible for these injuries. OBJECTIVE: To analyze anatomical causes of sciatic nerve and common peroneal nerve injury by studying the relationship between the sciatic nerve and piriformis. DESIGN, TIME AND SETTING: Observe and measure repeatedly. The experiment was conducted in the Department of Anatomy, Tianjin Medical College between January and June 2005. MATERIALS: Fifty-two adult cadavers 33 males and 19 females, with a total of 104 hemispheres, and fixed with formaldehyde, were provided by Tianjin Medical College and Tianjin Medical University. METHODS: A posterior cut was made from the lumbosacral region to the upper leg, fully exposing the piriformis and path of the sciatic nerve. MAIN OUTCOME MEASURES: (1) Anatomical characteristics of the tibial nerve and common peroneal nerve. (2) According to different areas where the sciatic nerve crosses the piriformis, the study was divided into two types--normal and abnormal. Normal is considered to be when the sciatic nerve passes through the infrapiriform foramen. Remaining pathways are considered to be abnormal. (3) Observe the relationship between the suprapiriform foramen, infrapiriform foramen, as well as the superior and inferior space of piriformis. RESULTS: (1) The nerve tract inside the common peroneal nerve is smaller and thinner, with less connective tissue than the tibial nerve. When pathological changes or variations of the piriformis, or over-abduction of the hip joint, occur, injury to the common peroneal nerve often arises due to blockage and compression. (2) A total of 76 hemispheres (73.08%) were normal, 28 were abnormal (26.92%). The piriformis can be injured, and the sciatic nerve can become compressed, when the hip joint undergoes intorsion, extorsion, or abduction. (3) The structures between the infrapiriform and

  1. Carcinoid tumour of the middle ear

    LENUS (Irish Health Repository)

    Baig, Salman


    A case of middle ear mass in a young female from Ireland is described, who presented with left ear hearing loss and intermittent bloody discharge from the same ear. Examination under microscope revealed occlusive polyp in the left ear and a biopsy had been taken under general anaesthesia. Histopathology report described an adenoma \\/ carcinoid tumour of the middle ear confirmed by positive immunohistochemical staining. CT temporal bones revealed the extension of the disease. The patient underwent left tympanotomy and excision of the tumour. In general, these tumours are regarded as benign but may be mistaken for adenocarcinomas because of their histological heterogenecity.

  2. Autonomous Undersea Observations (United States)


    less expensive sensor systems for a variety of applications, including measurement of physical characteristics of the ocean, threat detection, and...multiple autonomous environmental sensors within an acoustic modem-based infrastructure capable of communicating to and from the sensors and to and...networks, and telesonar with high speed platforms. This effort is concentrating on the development and demonstration of the two modem- based sensors . We

  3. Autonomous robotic sweeper


    Kržišnik, Domen


    There is already a wide range of personal/domestic robots on the market capable of performing various tasks. We haven't however been able to find any commercially available robots designed for effectively performing the task of backyard sweeping. This thesis presents the process and end result of planning, assembly and programming of an autonomous robot, capable of performing the above mentioned task. We first analyze robots with similar functions, including robotic vacuum cleaners and lawn m...

  4. Autonomic neuropathy-in its many guises-as the initial manifestation of the antiphospholipid syndrome. (United States)

    Schofield, Jill R


    Autonomic disorders have previously been described in association with the antiphospholipid syndrome. The present study aimed to determine the clinical phenotype of patients in whom autonomic dysfunction was the initial manifestation of the antiphospholipid syndrome and to evaluate for autonomic neuropathy in these patients. This was a retrospective study of 22 patients evaluated at the University of Colorado who were found to have a disorder of the autonomic nervous system as the initial manifestation of antiphospholipid syndrome. All patients had persistent antiphospholipid antibody positivity and all patients who underwent skin biopsy were found to have reduced sweat gland nerve fiber density suggestive of an autonomic neuropathy. All patients underwent an extensive evaluation to rule out other causes for their autonomic dysfunction. Patients presented with multiple different autonomic disorders, including postural tachycardia syndrome, gastrointestinal dysmotility, and complex regional pain syndrome. Despite most having low-titer IgM antiphospholipid antibodies, 13 of the 22 patients (59%) suffered one or more thrombotic event, but pregnancy morbidity was minimal. Prothrombin-associated antibodies were helpful in confirming the diagnosis of antiphospholipid syndrome. We conclude that autonomic neuropathy may occur in association with antiphospholipid antibodies and may be the initial manifestation of the syndrome. Increased awareness of this association is important, because it is associated with a significant thrombotic risk and a high degree of disability. In addition, anecdotal experience has suggested that antithrombotic therapy and intravenous immunoglobulin therapy may result in significant clinical improvement in these patients.

  5. Nature's Autonomous Oscillators (United States)

    Mayr, H. G.; Yee, J.-H.; Mayr, M.; Schnetzler, R.


    Nonlinearity is required to produce autonomous oscillations without external time dependent source, and an example is the pendulum clock. The escapement mechanism of the clock imparts an impulse for each swing direction, which keeps the pendulum oscillating at the resonance frequency. Among nature's observed autonomous oscillators, examples are the quasi-biennial oscillation and bimonthly oscillation of the Earth atmosphere, and the 22-year solar oscillation. The oscillations have been simulated in numerical models without external time dependent source, and in Section 2 we summarize the results. Specifically, we shall discuss the nonlinearities that are involved in generating the oscillations, and the processes that produce the periodicities. In biology, insects have flight muscles, which function autonomously with wing frequencies that far exceed the animals' neural capacity; Stretch-activation of muscle contraction is the mechanism that produces the high frequency oscillation of insect flight, discussed in Section 3. The same mechanism is also invoked to explain the functioning of the cardiac muscle. In Section 4, we present a tutorial review of the cardio-vascular system, heart anatomy, and muscle cell physiology, leading up to Starling's Law of the Heart, which supports our notion that the human heart is also a nonlinear oscillator. In Section 5, we offer a broad perspective of the tenuous links between the fluid dynamical oscillators and the human heart physiology.

  6. Trigeminal autonomic cephalalgias. (United States)

    Eller, M; Goadsby, P J


    The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders characterised by lateralized symptoms: prominent headache and ipsilateral cranial autonomic features, such as conjunctival injection, lacrimation and rhinorrhea. The TACs are: cluster headache (CH), paroxysmal hemicrania (PH), short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short-lasting neuralgiform headache attacks with cranial autonomic features (SUNA) and hemicrania continua (HC). Their diagnostic criteria are outlined in the International Classification of Headache Disorders, third edition-beta (ICHD-IIIb). These conditions are distinguished by their attack duration and frequency, as well as response to treatment. HC is continuous and by definition responsive to indomethacin. The main differential when considering this headache is chronic migraine. Other TACs are remarkable for their short duration and must be distinguished from other short-lasting painful conditions, such as trigeminal neuralgia and primary stabbing headache. Cluster headache is characterised by exquisitely painful attacks that occur in discrete episodes lasting 15-180 min a few times a day. In comparison, PH occurs more frequently and is of shorter duration, and like HC is responsive to indomethacin. SUNCT/SUNA is the shortest duration and highest frequency TAC; attacks can occur over a hundred times every day.


    Directory of Open Access Journals (Sweden)

    Arvind L.


    Full Text Available PURPOSE: To evaluate ocular manifestations and visual field changes in patients with Sellar and Suprasellar Tumours. METHODS: Fifty patients with Sellar and Suprasellar tumours underwent a complete ophthalmic assessment and visual field analysis using the Humphrey Field Analyzer 30 - 2 program. Visual acuity, duration of symptoms, optic nerve head changes, pattern of visual field defects was noted. RESULTS: 50 patients including 15 male and 35 female subjects with mean age of 35.1±9.9 years and CT/MRI proven Suprasellar tumours 70% pituitary adenoma and 30% craniopharyngiomas were included. 70% cases presented with headache 80% with diminution of vision only 10% with hypothyroidism 50% with abnormal pupillary reaction including RAPD and anisocoria. Mean visual acuity at presentation was 0.46 log MAR . Of 100 eyes, 45 patients (90% had visual field defects including temporal defects in 35 patients (70%, non - specific defects in 4 patients (20% and 1patient (10% without any defect. Optic nerve head changes note d and 5 patients (25% presented with partial optic atrophy and 10 presented with established papilloedema. Visual field outcomes are correlated with duration of symptoms, optic nerve head changes at presentation and CT/ MRI findings. CONCLUSION: Visual fi eld defects were present in two thirds of patients at presentation. An overall deterioration in vision and visual fields was noted before surgical resection. A correlation was found between the duration of symptoms, MRI/ CT scan reports and visual field, s ignifying the importance in early diagnosis of neurological lesions on the basis of ophthalmic examination .

  8. Diagnostic pitfall: Adenoid cystic carcinoma of the tongue presenting as an isolated hypoglossal nerve palsy, case report and literature review

    Directory of Open Access Journals (Sweden)

    Wee Hide Elfrida


    In malignancies that have a propensity for PI such as ACC, patients may present atypically with nerve palsies. In infiltrative lesions, the primary tumour may not be evident on magnetic resonance imaging. Therefore, to achieve a diagnosis, a high index of suspicion is required. When the diagnosis is in question, deep biopsy and positron emission tomography may be useful.

  9. Regional tumour glutamine supply affects chromatin and cell identity. (United States)

    Højfeldt, Jonas W; Helin, Kristian


    Limited perfusion of solid tumours produces a nutrient-deprived tumour core microenvironment. Low glutamine levels in the tumour core are now shown to lead to reduced levels of α-ketoglutarate and decreased histone demethylase activity, thereby promoting a less differentiated and more therapy-resistant state of the tumour cells.

  10. Symptoms and time to diagnosis in children with brain tumours

    DEFF Research Database (Denmark)

    Klitbo, Ditte Marie; Nielsen, Rine; Illum, Niels Ove;


    Clinical symptoms in brain tumours in children are variable at onset and diagnosis is often delayed. Symptoms were investigated with regard to brain tumour localisation, prediagnostic symptomatic intervals and malignancy.......Clinical symptoms in brain tumours in children are variable at onset and diagnosis is often delayed. Symptoms were investigated with regard to brain tumour localisation, prediagnostic symptomatic intervals and malignancy....

  11. Interactions of human monocytes with TMVs (tumour-derived microvesicles). (United States)

    Baj-Krzyworzeka, Monika; Baran, Jarosław; Szatanek, Rafał; Mytar, Bożenna; Siedlar, Maciej; Zembala, Marek


    The tumour microenvironment represents a dynamic complex milieu, which includes tumour cells, cells of the immune system and other (cellular and non-cellular) components. The role of these particular 'puzzle pieces' may change substantially due to their mutual interactions. The present review concerns different opinions on interactions that occur between monocytes, tumour cells and TMVs (tumour-derived microvesicles).

  12. Small gap anastomosis to repair peripheral nerve rupture using a nerve regeneration chamber constructed by scissoring and sleeve jointing autologous epineurium

    Institute of Scientific and Technical Information of China (English)

    Peiji Wang; Zhongliang Zhou; Qirong Dong


    A number of studies have shown how to eliminate the misorientated docking of the peripheral nerve bundle in the traditional epineurium or perineudum anastomosis, thus avoiding neuroma formation and axonal outgrowth from the coaptation sites, and seriously hindering neural function recovery. Based on the "peripheral nerve selective regeneration theory", this experiment was designed to investigate the feasibility and benefits of a new small gap anastomosis repairing peripheral nerve rupture, by scissoring and sleeve jointing an autologous epineurium. In the proximal stump of the nerve, a 1 mm-long epineurium was annularly separated and removed, while a 3 mm-long epineurium was longitudinally incised in the distal stump after the epineurium was dissociated from proximal to distal. The epineuria of the two stumps and the longitudinal incision were sutured, leaving a 2 mm gap between the two nerve stumps. Results show that the experimental rats quickly recovered autonomic activities, and there were minimal adhesions at the outer surface of the epineurial tube to the surrounding tissue. The morphologic changes to the sciatic nerve showed that connective tissue hyperplasia of the small gaps was significantly reduced, and nerve fibers were arranged orderly. No such changes were observed in the neurorrhaphy in situ group. Thus, the experiment confirmed that the new small gap anastomosis to repair peripheral nerve rupture by scissoring and sleeve jointing autologous epineurium is feasible, and that it is superior to epineurium neurorrhaphy in situ.

  13. Dog sciatic nerve gap repaired by artificial tissue nerve graft

    Institute of Scientific and Technical Information of China (English)

    GU Xiaosong; ZHANG Peiyun; WANG Xiaodong; DING Fei; PENG Luping; CHENG Hongbing


    The feasibility of repairing dog sciatic nerve damage by using a biodegradable artificial tissue nerve graft enriched with neuroregenerating factors is investigated. The artificial nerve graft was implanted to a 30 mm gap of the sciatic nerve damage in 7 dogs. The dogs with the same nerve damage that were repaired by interposition of the autologous nerve or were given no treatment served as control group 1 or 2, respectively. The observations include gross and morphological observations, immune reaction, electrophysiological examination, fluorescence tracing of the neuron formation and the number of the neurons at the experimental sites, etc. Results showed that 6 months after the implantation of the graft, the regenerated nerve repaired the damage of the sciatic nerve without occurrence of rejection and obvious inflammatory reaction in all 7 dogs, and the function of the sciatic nerve recovered with the nerve conduction velocity of (23.91±11.35)m/s. The regenerated neurons and the forming of axon could be observed under an electron microscope. This proves that artificial tissue nerve graft transplantation can bridge the damaged nerve ends and promote the nerve regeneration.

  14. Repair of sciatic nerve defects using tissue engineered nerves*

    Institute of Scientific and Technical Information of China (English)

    Caishun Zhang; Gang Lv


    In this study, we constructed tissue-engineered nerves with acel ular nerve al ografts in Sprague-Dawley rats, which were prepared using chemical detergents-enzymatic digestion and mechanical methods, in combination with bone marrow mesenchymal stem cel s of Wistar rats cultured in vitro, to repair 15 mm sciatic bone defects in Wistar rats. At postoperative 12 weeks, electrophysiological detection results showed that the conduction velocity of regenerated nerve after repair with tis-sue-engineered nerves was similar to that after autologous nerve grafting, and was higher than that after repair with acel ular nerve al ografts. Immunohistochemical staining revealed that motor endplates with acetylcholinesterase-positive nerve fibers were orderly arranged in the middle and superior parts of the gastrocnemius muscle;regenerated nerve tracts and sprouted branches were connected with motor endplates, as shown by acetylcholinesterase histochemistry combined with silver staining. The wet weight ratio of the tibialis anterior muscle at the affected contralateral hind limb was similar to the sciatic nerve after repair with autologous nerve grafts, and higher than that after repair with acel ular nerve al ografts. The hind limb motor function at the affected side was significantly improved, indicating that acel ular nerve al ografts combined with bone marrow me-senchymal stem cel bridging could promote functional recovery of rats with sciatic nerve defects.

  15. Pineal anlage tumour - a rare entity with divergent histology. (United States)

    Ahuja, Arvind; Sharma, Mehar Chand; Suri, Vaishali; Sarkar, Chitra; Sharma, B S; Garg, Ajay


    Pineal anlage tumour is a rare tumour of the pineal gland that is not listed in the 2007 World Health Organization classification of tumours of the central nervous system. Pineal anlage has been defined as a primary pineal tumour with both neuroepithelial and ectomesenchymal differentiation but without endodermal differentiation. We report a pineal anlage tumour in a 4-month-old boy, the youngest patient reported with this rare tumour, with a brief review of the literature. Clinicians and neuropathologists should be aware of this entity as it is likely to be misdiagnosed as a teratoma or a melanocytic tumour of the central nervous system.

  16. Localized hypertrophic neuropathy of the sciatic nerve in children: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Roux, Adrien; Treguier, Catherine; Bruneau, Bertrand; Marin, Franck; Gandon, Yves; Gauvrit, Jean-Yves [University Hospital, Department of Radiology, Hopital Sud, 16 Boulevard de Bulgarie, BP 90347, Rennes cedex 2 (France); Riffaud, Laurent [University Hospital, Department of Pediatric Neurosurgery, Hopital Sud, Rennes (France); Violas, Philippe [University Hospital, Department of Pediatric Surgery, Hopital Sud, Rennes (France); Michel, Anne [University Hospital, Department of Neurological Functional Explorations, Hopital Sud, Rennes (France)


    Localized hypertrophic neuropathy (LHN) of the sciatic nerve in children is a rare condition characterized by a painless neurological deficit in the sciatic nerve territory. To demonstrate the role of MRI using a specific protocol and describe the primary findings in LHN. Imaging in four children (age 2 years to 12 years) is presented. All children presented with lower limb asymmetry. Three had a steppage gait. LHN was confirmed by electrophysiological studies and by MRI of the whole sciatic nerve with a dedicated protocol covering the lumbar spine and the lower limb. There were four direct MRI findings: (1) linear and focal hypertrophy with progressive enlargement of a peripheral nerve or plexus diameter, (2) abnormal hyperintensity of the nerve on T2-weighted images, (3) preserved fascicular configuration, and (4) variable enhancement after intravenous gadolinium administration. In addition there were atrophy and fatty infiltration of innervated muscles. MRI was helpful for determining the extent of lesions and in excluding peripheral nerve compression or tumour. MRI of the whole sciatic nerve is the method of choice for diagnosing LHN of the sciatic nerve. (orig.)

  17. Serum tumour markers in malignant mesothelioma

    Directory of Open Access Journals (Sweden)

    Rao Pallavi


    Full Text Available Malignant mesothelioma is a rare malignancy of the body cavities with dismal prognosis. It has been a diagnostic dilemma for years with many clinical and pathological mimics. Discovery of a reliable tumour marker will definitely be of value in screening individuals with a history of asbestos exposure, diagnosis, treatment and follow up of malignant mesothelioma. Many tumour markers have been studied and speculatively associated with the malignant mesothelioma, but much still needs to be proven.

  18. Diagnosis and treatment of bronchopulmonary neuroendocrine tumours

    DEFF Research Database (Denmark)

    Tabaksblat, Elizaveta Mitkina; Langer, Seppo W; Knigge, Ulrich;


    Bronchopulmonary neuroendocrine tumours (BP-NET) are a heterogeneous population of neoplasms with different pathology, clinical behaviour and prognosis compared to the more common lung cancers. The management of BP-NET patients is largely based on studies with a low level of evidence and extrapol...... and extrapolation of data obtained from more common types of neuroendocrine tumours. This review reflects our view of the current state of the art of diagnosis and treatment of patients with BP-NET....

  19. 'Pseudo-Alzheimer's' and primary brain tumour.


    O'Mahony, D; Walsh, J. B.; Coakley, D.


    Primary brain tumour may present in the elderly purely as a dementing illness before the onset or detection of sensorimotor neurological symptoms or signs. Although neurological examination may indicate no definite signs, close attention to accepted DSM-IIIR and NINCDS-ADRDA diagnostic criteria for primary degenerative dementia and 'probable' Alzheimer's disease respectively will suggest a process other than a degenerative one. This was the case in two patients with primary brain tumour prese...

  20. Autonomic disorders in multiple sclerosis. (United States)

    Lensch, E; Jost, W H


    Multiple sclerosis is an inflammatory disease leading to disseminated lesions of the central nervous system resulting in both somatomotor and autonomic disturbances. These involve the central centers of the autonomic nervous system, as well as the automatic control and pathway systems. All autonomic functions may be disordered individually or in combined form. There is no other disease with a clinical picture so multifaceted. Besides cardiovascular dysfunctions disorders of bladder and rectum have become apparent. Somatomotor and autonomic disturbances occur with similar frequency; however the focused exam often heavily favors somatomotor symptoms. Autonomic disturbances should primarily be taken into account on history taking and clinical examination. Individual diagnosis and treatment is a secondary feature. Impairments of the autonomic nervous systems in multiple sclerosis are frequently overlooked.

  1. Autonomic Disorders in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    E. Lensch


    Full Text Available Multiple sclerosis is an inflammatory disease leading to disseminated lesions of the central nervous system resulting in both somatomotor and autonomic disturbances. These involve the central centers of the autonomic nervous system, as well as the automatic control and pathway systems. All autonomic functions may be disordered individually or in combined form. There is no other disease with a clinical picture so multifaceted. Besides cardiovascular dysfunctions disorders of bladder and rectum have become apparent. Somatomotor and autonomic disturbances occur with similar frequency; however the focused exam often heavily favors somatomotor symptoms. Autonomic disturbances should primarily be taken into account on history taking and clinical examination. Individual diagnosis and treatment is a secondary feature. Impairments of the autonomic nervous systems in multiple sclerosis are frequently overlooked.

  2. Neuromuscular ultrasound of cranial nerves. (United States)

    Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S


    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

  3. Brain tumour-associated status epilepticus. (United States)

    Goonawardena, Janindu; Marshman, Laurence A G; Drummond, Katharine J


    We have reviewed the scant literature on status epilepticus in patients with brain tumours. Patients with brain tumour-associated epilepsy (TAE) appear less likely to develop status epilepticus (TASE) than patients with epilepsy in the general population (EGP) are to develop status epilepticus (SEGP). TASE is associated with lesions in similar locations as TAE; in particular, the frontal lobes. However, in contrast to TAE, where seizures commence early in the course of the disease or at presentation, TASE is more likely to occur later in the disease course and herald tumour progression. In marked contrast to TAE, where epilepsy risk is inversely proportional to Word Health Organization tumour grade, TASE risk appears to be directly proportional to tumour grade (high grade gliomas appear singularly predisposed). Whilst anti-epileptic drug (AED) resistance is more common in TAE than EGP (with resistance directly proportional to tumour grade and frontal location), TASE appears paradoxically more responsive to simple AED regimes than either TAE or SEGP. Although some results suggest that mortality may be higher with TASE than with SEGP, it is likely that (as with SEGP) the major determinant of mortality is the underlying disease process. Because all such data have been derived from retrospective studies, because TASE and SEGP are less common than TAE and EGP, and because TASE and SEGP classification has often been inconsistent, findings can only be considered preliminary: multi-centre, prospective studies are required. Whilst preliminary, our review suggests that TASE has a distinct clinical profile compared to TAE and SEGP.

  4. Consensus on biomarkers for neuroendocrine tumour disease (United States)

    Oberg, Kjell; Modlin, Irvin M; De Herder, Wouter; Pavel, Marianne; Klimstra, David; Frilling, Andrea; Metz, David C; Heaney, Anthony; Kwekkeboom, Dik; Strosberg, Jonathan; Meyer, Timothy; Moss, Steven F; Washington, Kay; Wolin, Edward; Liu, Eric; Goldenring, James


    Management of neuroendocrine neoplasia represents a clinical challenge because of its late presentation, lack of treatment options, and limitations in present imaging modalities and biomarkers to guide management. Monoanalyte biomarkers have poor sensitivity, specificity, and predictive ability. A National Cancer Institute summit, held in 2007, on neuroendocrine tumours noted biomarker limitations to be a crucial unmet need in the management of neuroendocrine tumours. A multinational consensus meeting of multidisciplinary experts in neuroendocrine tumours assessed the use of current biomarkers and defined the perquisites for novel biomarkers via the Delphi method. Consensus (at >75%) was achieved for 88 (82%) of 107 assessment questions. The panel concluded that circulating multianalyte biomarkers provide the highest sensitivity and specificity necessary for minimum disease detection and that this type of biomarker had sufficient information to predict treatment effectiveness and prognosis. The panel also concluded that no monoanalyte biomarker of neuroendocrine tumours has yet fulfilled these criteria and there is insufficient information to support the clinical use of miRNA or circulating tumour cells as useful prognostic markers for this disease. The panel considered that trials measuring multianalytes (eg, neuroendocrine gene transcripts) should also identify how such information can optimise the management of patients with neuroendocrine tumours. PMID:26370353

  5. Myeloid cells in tumour-immune interactions. (United States)

    Kareva, Irina; Berezovskaya, Faina; Castillo-Chavez, Carlos


    Despite highly developed specific immune responses, tumour cells often manage to escape recognition by the immune system, continuing to grow uncontrollably. Experimental work suggests that mature myeloid cells may be central to the activation of the specific immune response. Recognition and subsequent control of tumour growth by the cells of the specific immune response depend on the balance between immature (ImC) and mature (MmC) myeloid cells in the body. However, tumour cells produce cytokines that inhibit ImC maturation, altering the balance between ImC and MmC. Hence, the focus of this manuscript is on the study of the potential role of this inhibiting mechanism on tumour growth dynamics. A conceptual predator-prey type model that incorporates the dynamics and interactions of tumour cells, CD8(+) T cells, ImC and MmC is proposed in order to address the role of this mechanism. The prey (tumour) has a defence mechanism (blocking the maturation of ImC) that prevents the predator (immune system) from recognizing it. The model, a four-dimensional nonlinear system of ordinary differential equations, is reduced to a two-dimensional system using time-scale arguments that are tied to the maturation rate of ImC. Analysis shows that the model is capable of supporting biologically reasonable patterns of behaviour depending on the initial conditions. A range of parameters, where healing without external influences can occur, is identified both qualitatively and quantitatively.

  6. Catecholamines and diabetic autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J


    In diabetic patients with autonomic neuropathy plasma noradrenaline concentration, used as an index of sympathetic nervous activity, is low. This decrease is, however, only found in patients with a long duration of diabetes with clinically severe autonomic neuropathy. This apparent insensitivity...... of plasma catecholamine measurements is not due to changes in the clearance of catecholamines in diabetic autonomic neuropathy. The physiological responses to infused adrenaline and to noradrenaline are enhanced, for noradrenaline mainly cardiovascular responses. Adrenoceptors (alpha and beta adrenoceptors...

  7. Perfusion imaging of parotid gland tumours: usefulness of arterial spin labeling for differentiating Warthin's tumours

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Hiroki; Watanabe, Haruo [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Kanematsu, Masayuki [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Gifu University Hospital, High-level Imaging Diagnosis Center, Gifu (Japan); Kajita, Kimihiro [Gifu University Hospital, High-level Imaging Diagnosis Center, Gifu (Japan); Mizuta, Keisuke; Aoki, Mitsuhiro [Gifu University School of Medicine, Department of Otolaryngology, Gifu (Japan); Okuaki, Tomoyuki [Philips Healthcare, Tokyo (Japan)


    To assess prospectively the efficacy of arterial spin labelling (ASL) against conventional and diffusion-weighted (DW) MR imaging for differentiating parotid gland tumours. We included 10 pleomorphic adenomas, 12 Warthin's tumours, and nine malignant tumours of the parotid glands. Only tumours larger than 10 mm were included in this study. All parotid gland tumours underwent T1-weighted, T2-weighted, DW, and ASL imaging. Tumour-to-parotid gland signal intensity ratios (SIRs) and apparent diffusion coefficients (ADCs) of solid components were correlated with these pathologies. SIRs on T2-weighted images and ADCs were higher in pleomorphic adenomas than in Warthin's tumours (p <.01) and malignant tumours (p <.01). SIRs on ASL were higher in Warthin's tumours than in pleomorphic adenomas (p <.01) and malignant tumours (p <.05). Az value of SIRs on ASL for differentiating Warthin's tumours from the other pathologies was 0.982. The sensitivity, specificity, and accuracy of SIRs on ASL for the diagnosis of Warthin's tumours at an optimal SIR threshold of over 8.70 were 91.7 %, 94.7 %, and 93.5 %, respectively. ASL with SIR measurements could non-invasively evaluate tumour blood flow of parotid gland tumours and differentiate Warthin's tumours from pleomorphic adenomas and malignant tumours. (orig.)

  8. Systemic and non-systemic vasculitis affecting the peripheral nerves. (United States)

    Finsterer, J


    Vasculitis affecting the peripheral nerves predominantly manifests as subacute, progressive, asymmetric sensorimotor polyneuropathy or mononeuritis multiplex, and more rarely as painful mononeuropathy, pure sensory neuropathy, neuropathy of the cranial nerves, plexopathy, or as autonomic neuropathy. Vasculitic neuropathy may occur isolated or non-isolated (systemic) together with involvement of other organs. Systemic vasculitis with involvement of the peripheral nerves is further subdivided into primary (Takayasu syndrome, giant cell arteritis, classical panarteritis nodosa, thrombangitis obliterans, Kawasaki disease, Churg-Strauss syndrome, Wegener granulomatosis, cryoglobulinemic vasculitis, Behcet disease, microscopic polyangitis, Schoenlein Henoch purpura) or secondary systemic vasculitis (autoimmune connective tissue diseases, vasculitis from infection, sarcoidosis, malignancy, drugs, radiation, or diabetes). In addition to routine laboratory investigations and nerve conduction studies, nerve biopsy is essential for diagnosing the condition and to delineate it from differentials, although its sensitivity is only approximately 60%. Therapy of non-viral vasculitic neuropathy is based on corticosteroids and cyclophosphamide alone or in combination. Additional options include azathioprine, methotrexate, mycophenolate mofetil, or rituximab. In single cases immunoglobulins, immunoadsorbtion, or plasma exchange have been successfully applied. In case of virus-associated vasculitis interferon-alpha plus lamivudine or ribaverin may be beneficial.

  9. A 41-year-old man with polyarthritis and severe autonomic neuropathy

    Directory of Open Access Journals (Sweden)

    Matthew E Bourcier


    Full Text Available Matthew E Bourcier, Aaron I VinikEastern Virginia Medical School, Norfolk, VA, USAAbstract: Orthostasis due to autonomic neuropathy can cause severe debilitation and prove refractory to treatment. This report describes a case of severe sympathetic and parasympathetic autonomic dysfunction as a consequence of acetylcholine receptor antibodies and Sjogren’s syndrome. Symptomatic management, plasma fluid expanders, and IVIG therapy failed to offer a salutary response to the condition. Etanercept therapy provided improvement of the orthostasis and autonomic function measured as high and low frequency respiratory effects on heart rate variability as well as enhancement of skin blood flow using Laser Doppler. It would be of considerable interest to determine the effectiveness of etanercept in other autoimmune neuropathies.Keywords: autonomic neuropathy, etanercept, IntraEpidermal Nerve Fibers (IENF, acetylcholine receptor antibodies, laser doppler skin blood flow, orthostasis

  10. Jam avoidance with autonomous systems

    CERN Document Server

    Tordeux, Antoine


    Many car-following models are developed for jam avoidance in highways. Two mechanisms are used to improve the stability: feedback control with autonomous models and increasing of the interaction within cooperative ones. In this paper, we compare the linear autonomous and collective optimal velocity (OV) models. We observe that the stability is significantly increased by adding predecessors in interaction with collective models. Yet autonomous and collective approaches are close when the speed difference term is taking into account. Within the linear OV models tested, the autonomous models including speed difference are sufficient to maximise the stability.

  11. Robotics and Autonomous Systems Laboratory (United States)

    Federal Laboratory Consortium — FUNCTION: Provides an environment for developing and evaluating intelligent software for both actual and simulated autonomous vehicles. Laboratory computers provide...

  12. Disease mechanisms in hereditary sensory and autonomic neuropathies. (United States)

    Verpoorten, Nathalie; De Jonghe, Peter; Timmerman, Vincent


    Inherited peripheral neuropathies are common monogenically inherited diseases of the peripheral nervous system. In the most common variant, i.e., the hereditary motor and sensory neuropathies, both motor and sensory nerves are affected. In contrast, sensory abnormalities predominate or are exclusively present in hereditary sensory and autonomic neuropathies (HSAN). HSAN are clinically and genetically heterogeneous and are subdivided according to mode of inheritance, age of onset and clinical evolution. In recent years, 6 disease-causing genes have been identified for autosomal dominant and recessive HSAN. However, vesicular transport and axonal trafficking seem important common pathways leading to degeneration of sensory and autonomic neurons. This review discusses the HSAN-related genes and their biological role in the disease mechanisms leading to HSAN.

  13. Exophytic benign mixed epithelial stromal tumour of the kidney: case report of a rare tumour entity

    Directory of Open Access Journals (Sweden)

    Küster Jens


    Full Text Available Abstract Background Mixed epithelial and stromal tumour (MEST represents a recently described benign composite neoplasm of the kidney, which predominantly affects perimenopausal females. Most tumours are benign, although rare malignant cases have been observed. Case report A 47-year-old postmenopausal female presented to the urologist with flank pain. A CT scan of the abdomen showed a 30-mm-in-diameter uniform mass adjacent to the pelvis of the left kidney. Surgical exploration showed a tumour arising from the lower anterior hilus of the left kidney. The tumour could be excised by preserving the kidney. By intraoperative frozen section the tumour showed characteristic features of MEST with epithelial-covered cysts embedded in an "ovarian-like" stroma. Additional immunohistochemistry investigations showed expression for hormone receptors by the stromal component of the tumour. Discussion MEST typically presents in perimenopausal women as a primarily cystic mass. Commonly, the tumour arises from the renal parenchyma or pelvis. The tumour is composed of an admixture of cystic and sometimes more solid areas. The stromal cells typically demonstrate an ovarian-type stroma showing expression for the estrogen and progesterone receptors. Conclusion MEST represents a distinctive benign tumour entity of the kidney, which affects perimenopausal woman. The tumour should be distinguished from other cystic renal neoplasms. By imaging studies it is difficult to distinguish between a benign or malignant nature of the tumour. Thus, intraoperative frozen section is necessary for conservative surgery, since the overall prognosis is favourable and renal function can be preserved in most cases.

  14. [Peripheral facial nerve palsy]. (United States)

    Pons, Y; Ukkola-Pons, E; Ballivet de Régloix, S; Champagne, C; Raynal, M; Lepage, P; Kossowski, M


    Facial palsy can be defined as a decrease in function of the facial nerve, the primary motor nerve of the facial muscles. When the facial palsy is peripheral, it affects both the superior and inferior areas of the face as opposed to central palsies, which affect only the inferior portion. The main cause of peripheral facial palsies is Bell's palsy, which remains a diagnosis of exclusion. The prognosis is good in most cases. In cases with significant cosmetic sequelae, a variety of surgical procedures are available (such as hypoglossal-facial anastomosis, temporalis myoplasty and Tenzel external canthopexy) to rehabilitate facial aesthetics and function.

  15. Autonomous mobile robot teams (United States)

    Agah, Arvin; Bekey, George A.


    This paper describes autonomous mobile robot teams performing tasks in unstructured environments. The behavior and the intelligence of the group is distributed, and the system does not include a central command base or leader. The novel concept of the Tropism-Based Cognitive Architecture is introduced, which is used by the robots in order to produce behavior transforming their sensory information to proper action. The results of a number of simulation experiments are presented. These experiments include worlds where the robot teams must locate, decompose, and gather objects, and defend themselves against hostile predators, while navigating around stationary and mobile obstacles.

  16. Guidelines for the management of gastroenteropancreatic neuroendocrine tumours (including bronchopulmonary and thymic neoplasms). Part II-specific NE tumour types

    DEFF Research Database (Denmark)

    Oberg, Kjell; Astrup, Lone Bording; Eriksson, Barbro;


    Part II of the guidelines contains a description of epidemiology, histopathology, clinical presentation, diagnostic procedure, treatment, and survival for each type of neuroendocrine tumour. We are not only including gastroenteropancreatic tumours but also bronchopulmonary and thymic neuroendocrine...... tumours. These guidelines essentially cover basic knowledge in the diagnosis and management of the different forms of neuroendocrine tumour. We have, however, tried to give more updated information about the epidemiology and histopathology, which is essential for the clinical management of these tumours....

  17. Bilateral eventration of sciatic nerve

    Directory of Open Access Journals (Sweden)

    T Sharma


    Full Text Available During routine dissection of a 60 years male cadaver, it was observed that the two divisions of sciatic nerve were separate in the gluteal region on both the sides with the tibial nerve passing below the piriformis and the common peroneal nerve piercing the piriformis muscle. The abnormal passage of the sciatic nerve (SN, the common peroneal nerve (CPN, and the tibial nerve (TN, either through the piriformis or below the superior gemellus may facilitate compression of these nerves. Knowledge of such patterns is also important for surgeons dealing with piriformis syndrome which affects 5-6% of patients referred for the treatment of back and leg pain. A high division may also account for frequent failures reported with the popliteal block. Keywords: eventration, piriformis muscle, piriformis syndrome, sciatic nerve

  18. Tumors of the optic nerve

    DEFF Research Database (Denmark)

    Lindegaard, Jens; Heegaard, Steffen


    A variety of lesions may involve the optic nerve. Mainly, these lesions are inflammatory or vascular lesions that rarely necessitate surgery but may induce significant visual morbidity. Orbital tumors may induce proptosis, visual loss, relative afferent pupillary defect, disc edema and optic...... atrophy, but less than one-tenth of these tumors are confined to the optic nerve or its sheaths. No signs or symptoms are pathognomonic for tumors of the optic nerve. The tumors of the optic nerve may originate from the optic nerve itself (primary tumors) as a proliferation of cells normally present...... in the nerve (e.g., astrocytes and meningothelial cells). The optic nerve may also be invaded from tumors originating elsewhere (secondary tumors), invading the nerve from adjacent structures (e.g., choroidal melanoma and retinoblastoma) or from distant sites (e.g., lymphocytic infiltration and distant...

  19. Nerve Injuries of the Upper Extremity (United States)

    ... nerves do both of these things. Injury to nerves that carry motor signals causes some amount of weakness. Pain : This is frequently a symptom after nerve injury. The pain present after a nerve injury ...

  20. MicroRNA Regulation of Brain Tumour Initiating Cells in Central Nervous System Tumours

    Directory of Open Access Journals (Sweden)

    Neha Garg


    Full Text Available CNS tumours occur in both pediatric and adult patients and many of these tumours are associated with poor clinical outcome. Due to a paradigm shift in thinking for the last several years, these tumours are now considered to originate from a small population of stem-like cells within the bulk tumour tissue. These cells, termed as brain tumour initiating cells (BTICs, are perceived to be regulated by microRNAs at the posttranscriptional/translational levels. Proliferation, stemness, differentiation, invasion, angiogenesis, metastasis, apoptosis, and cell cycle constitute some of the significant processes modulated by microRNAs in cancer initiation and progression. Characterization and functional studies on oncogenic or tumour suppressive microRNAs are made possible because of developments in sequencing and microarray techniques. In the current review, we bring recent knowledge of the role of microRNAs in BTIC formation and therapy. Special attention is paid to two highly aggressive and well-characterized brain tumours: gliomas and medulloblastoma. As microRNA seems to be altered in the pathogenesis of many human diseases, “microRNA therapy” may now have potential to improve outcomes for brain tumour patients. In this rapidly evolving field, further understanding of miRNA biology and its contribution towards cancer can be mined for new therapeutic tools.

  1. High division of sciatic nerve

    Directory of Open Access Journals (Sweden)

    Tripti Shrivastava


    Results: In all except two cadavers, the nerve divided at the apex of the popliteal fossa. In two cadavers the sciatic nerve divided bilaterally in the upper part of thigh. Conclusion: The high division presented in this study can make popliteal nerve blocks partially ineffective. The high division of sciatic nerve must always be borne in mind as they have important clinical implications. [Int J Res Med Sci 2014; 2(2.000: 686-688

  2. Possible role of the histaminergic system in autonomic and cardiovascular responses to neuropeptide Y. (United States)

    Tanida, Mamoru; Shen, Jiao; Nagai, Katsuya


    Previous studies have demonstrated that neuropeptide Y (NPY) affects blood pressure (BP) in anesthetized rats. Here, we examined the effects of the third cerebral ventricular (3CV) injection of various doses of NPY on renal sympathetic nerve activity (RSNA) and BP in anesthetized rats. 3CV injection of NPY suppressed RSNA and BP in a dose-dependent manner. Moreover, suppressing effects of NPY on RSNA and BP were eliminated by lateral cerebral ventricular (LCV) preinjection of thioperamide, an antagonist of histaminergic H3-receptor, not diphenhydramine, an antagonist of histaminergic H1-receptor. In addition, 3CV injection of NPY accelerated gastric vagal nerve activity (GVNA) and inhibited brown adipose tissue sympathetic nerve activity (BAT-SNA) of anesthetized rats, and lowered brown adipose tissue temperature (BAT-T) of conscious rats. Thus, these evidences suggest that central NPY affects autonomic nerves containing RSNA, GVNA or BAT-SNA, and BP by mediating central histaminergic H3-receptors.

  3. 3D-FT MRI of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Girard, N. (Neuroradiology, Hopital Nord, 13 Marseille (France)); Raybaud, C. (Neuroradiology, Hopital Nord, 13 Marseille (France)); Poncet, M. (Neuroradiology, Hopital Nord, 13 Marseille (France))


    Contrast-enhanced 3D-FT MRI of the intrapetrous facial nerve was obtained in 38 patients with facial nerve disease, using a 1.0 T magnet and fast gradient-echo acquisition sequences. Contiguous millimetric sections were obtained, which could be reformatted in any desired plane. Acutely ill patients, were examined within the first 2 months, included: 24 with Bell's palsy and 6 with other acute disorders (Herpes zoster, trauma, neuroma, meningeal metastasis, middle ear granuloma). Six patients investigated more than a year after the onset of symptoms included 3 with congenital cholesteatoma, 2 with neuromas and one with a chronic Bell's palsy. The lesion was found incidentally in two cases (a suspected neurofibroma and a presumed drop metastasis from an astrocytoma). Patients with tumours had nodular, focally-enhancing lesions, except for the leptomeningeal metastasis in which the enhancement was linear. Linear, diffuse contrast enhancement of the facial nerve was found in trauma, and in the patient with a middle ear granuloma. Of the 24 patients with an acute Bell's palsy 15 exhibited linear contrast enhancement of the facial nerve. Three of these were lost to follow-up, but correlation of clinical outcome and contrast enhancement showed that only 4 of the 11 patients who made a complete recovery and all 10 patients with incomplete recovery demonstrated enhancement. Possible explanations for these findings are suggested by pathological data from the literature. 3D-FT imaging of the facial nerve thus yields direct information about the of the nerve condition and defines the morphological abnormalities. It can also demonstrate contrast enhancement which seems to have some prognostic value in acute idiopathic Bell's palsy. (orig.)

  4. Learning for Autonomous Navigation (United States)

    Angelova, Anelia; Howard, Andrew; Matthies, Larry; Tang, Benyang; Turmon, Michael; Mjolsness, Eric


    Robotic ground vehicles for outdoor applications have achieved some remarkable successes, notably in autonomous highway following (Dickmanns, 1987), planetary exploration (1), and off-road navigation on Earth (1). Nevertheless, major challenges remain to enable reliable, high-speed, autonomous navigation in a wide variety of complex, off-road terrain. 3-D perception of terrain geometry with imaging range sensors is the mainstay of off-road driving systems. However, the stopping distance at high speed exceeds the effective lookahead distance of existing range sensors. Prospects for extending the range of 3-D sensors is strongly limited by sensor physics, eye safety of lasers, and related issues. Range sensor limitations also allow vehicles to enter large cul-de-sacs even at low speed, leading to long detours. Moreover, sensing only terrain geometry fails to reveal mechanical properties of terrain that are critical to assessing its traversability, such as potential for slippage, sinkage, and the degree of compliance of potential obstacles. Rovers in the Mars Exploration Rover (MER) mission have got stuck in sand dunes and experienced significant downhill slippage in the vicinity of large rock hazards. Earth-based off-road robots today have very limited ability to discriminate traversable vegetation from non-traversable vegetation or rough ground. It is impossible today to preprogram a system with knowledge of these properties for all types of terrain and weather conditions that might be encountered.

  5. Towards autonomous vehicular clouds

    Directory of Open Access Journals (Sweden)

    Stephan Olariu


    Full Text Available The dawn of the 21st century has seen a growing interest in vehicular networking and its myriad potential applications. The initial view of practitioners and researchers was that radio-equipped vehicles could keep the drivers informed about potential safety risks and increase their awareness of road conditions. The view then expanded to include access to the Internet and associated services. This position paper proposes and promotes a novel and more comprehensive vision namely, that advances in vehicular networks, embedded devices and cloud computing will enable the formation of autonomous clouds of vehicular computing, communication, sensing, power and physical resources. Hence, we coin the term, autonomous vehicular clouds (AVCs. A key feature distinguishing AVCs from conventional cloud computing is that mobile AVC resources can be pooled dynamically to serve authorized users and to enable autonomy in real-time service sharing and management on terrestrial, aerial, or aquatic pathways or theaters of operations. In addition to general-purpose AVCs, we also envision the emergence of specialized AVCs such as mobile analytics laboratories. Furthermore, we envision that the integration of AVCs with ubiquitous smart infrastructures including intelligent transportation systems, smart cities and smart electric power grids will have an enormous societal impact enabling ubiquitous utility cyber-physical services at the right place, right time and with right-sized resources.

  6. Disorders of the lower cranial nerves

    Directory of Open Access Journals (Sweden)

    Josef Finsterer


    Full Text Available Lesions of the lower cranial nerves (LCN are due to numerous causes, which need to be differentiated to optimize management and outcome. This review aims at summarizing and discussing diseases affecting LCN. Review of publications dealing with disorders of the LCN in humans. Affection of multiple LCN is much more frequent than the affection of a single LCN. LCN may be affected solely or together with more proximal cranial nerves, with central nervous system disease, or with nonneurological disorders. LCN lesions have to be suspected if there are typical symptoms or signs attributable to a LCN. Causes of LCN lesions can be classified as genetic, vascular, traumatic, iatrogenic, infectious, immunologic, metabolic, nutritional, degenerative, or neoplastic. Treatment of LCN lesions depends on the underlying cause. An effective treatment is available in the majority of the cases, but a prerequisite for complete recovery is the prompt and correct diagnosis. LCN lesions need to be considered in case of disturbed speech, swallowing, coughing, deglutition, sensory functions, taste, or autonomic functions, neuralgic pain, dysphagia, head, pharyngeal, or neck pain, cardiac or gastrointestinal compromise, or weakness of the trapezius, sternocleidomastoid, or the tongue muscles. To correctly assess manifestations of LCN lesions, precise knowledge of the anatomy and physiology of the area is required.

  7. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    Kiilgaard, Jens Folke; Pedersen, D B; Eysteinsson, T


    The authors have previously reported that carbonic anhydrase inhibitors such as acetazolamide and dorzolamide raise optic nerve oxygen tension (ONPO(2)) in pigs. The purpose of the present study was to investigate whether timolol, which belongs to another group of glaucoma drugs called beta block...

  8. Desmoplastic nested spindle cell tumours and nested stromal epithelial tumours of the liver. (United States)

    Misra, Sunayana; Bihari, Chhagan


    Desmoplastic nested spindle cell tumour of liver (DNSTL), nested stromal-epithelial tumour (NSET) and calcifying nested stromal-epithelial tumour (CNSET) are recently described entities with similar morphology, immunohistochemistry and molecular genetics. These are rare entities with only three large case series described till date. These tumours commonly present in the paediatric age group. NSETs, in addition have been described to be associated with ectopic adrenocorticotropic hormone (ACTH) production and Cushingoid features. It is important to discuss this rare group of tumours with a low malignant potential as the most common radiological differential diagnosis is hepatoblastoma, which has a relatively poorer prognosis. Thus, a pathologist needs to keep this entity in mind, so as to offer a correct histological diagnosis.

  9. Progress of peripheral nerve repair

    Institute of Scientific and Technical Information of China (English)



    Study on repair of peripheral nerve injury has been proceeding over a long period of time. With the use of microsurgery technique since 1960s,the quality of nerve repair has been greatly improved. In the past 40 years, with the continuous increase of surgical repair methods, more progress has been made on the basic research of peripheral nerve repair.

  10. Imaging the ocular motor nerves.

    NARCIS (Netherlands)

    Ferreira, T.; Verbist, B.M.; Buchem, M. van; Osch, T. van; Webb, A.


    The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic reso

  11. Giant Sporadic Low Grade Malignant Peripheral Nerve Sheath (MPNST) of Left Thigh. (United States)

    Nikumbh, Dhiraj B; Suryawanshi, K H; Dravid, N V; Patil, T B; Rokade, C M


    Malignant Peripheral Nerve Sheath Tumours (MPNST) are rare spindle- cell sarcomas which are derived from the schwann cells or the pleuripotent cells of the neural crest. MPNSTs are usually located in the peripheral nerve trunk roots, extremities and in the head and neck region. These tumours may arise as sporadic variants or in patients with neurofibromatosis1 (NF1). The estimated incidence of MPNSTs in the patients with NF1is 2-5% as compared to a 0.001% incidence in the general population. Herein, we are reporting a case of a giant sporadic (NF1 independent) low grade MPNST of the left thigh in 65 year female patient, which had a good prognosis.

  12. Nerve growth factor and injured peripheral nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Endong Shi; Bingchen Wang; Qingshan Sun


    Nerve growth factor (NGF) exhibits many biological activities, such as supply of nutrients, neuroprotection, and the generation and rehabilitation of injured nerves. The neuroprotective and neurotrophic qualities of NGF are generally recognized. NGF may enhance axonal regeneration and myelination of peripheral nerves, as well as cooperatively promote functional recovery of injured nerves and limbs. The clinical efficacy of NGF and its therapeutic potentials are reviewed here. This paper also reviews the latest NGF research developments for repairing injured peripheral nerve, thereby providing scientific evidence for the appropriate clinical application of NGF.

  13. Proportionality and Autonomous Weapons Systems

    NARCIS (Netherlands)

    van den Boogaard, J.


    Given the swift technologic development, it may be expected that the availability of the first truly autonomous weapons systems is fast approaching. Once they are deployed, these weapons will use artificial intelligence to select and attack targets without further human intervention. Autonomous weap

  14. Autonomous Learner Model Resource Book (United States)

    Betts, George T.; Carey, Robin J.; Kapushion, Blanche M.


    "Autonomous Learner Model Resource Book" includes activities and strategies to support the development of autonomous learners. More than 40 activities are included, all geared to the emotional, social, cognitive, and physical development of students. Teachers may use these activities and strategies with the entire class, small groups, or…

  15. Synergic anti-tumour effect of B7.1 gene modified tumour vaccine combined with allicin for murine bladder tumour

    Institute of Scientific and Technical Information of China (English)

    WANG Jian; LIN Li-guo; LIU Jian-jun; LIU Xin-guang; HE Cheng-wei; HE Hui-juan; WU ping; HUANG Ping-ping; CHEN Xiao-wen; DONG Zhong; WU Xiu-dong


    @@ In the previous study, we found that B7.1 gene transduction failed to induce sufficient anti-tumour response when it is used as a tumour vaccine. It is necessary to develop immunity by a combination of appropriate cytokines to stimulate effective tumour immunity in a therapeutic setting.

  16. Targeting the tumour microenvironment in ovarian cancer. (United States)

    Hansen, Jean M; Coleman, Robert L; Sood, Anil K


    The study of cancer initiation, growth, and metastasis has traditionally been focused on cancer cells, and the view that they proliferate due to uncontrolled growth signalling owing to genetic derangements. However, uncontrolled growth in tumours cannot be explained solely by aberrations in cancer cells themselves. To fully understand the biological behaviour of tumours, it is essential to understand the microenvironment in which cancer cells exist, and how they manipulate the surrounding stroma to promote the malignant phenotype. Ovarian cancer is the leading cause of death from gynaecologic cancer worldwide. The majority of patients will have objective responses to standard tumour debulking surgery and platinum-taxane doublet chemotherapy, but most will experience disease recurrence and chemotherapy resistance. As such, a great deal of effort has been put forth to develop therapies that target the tumour microenvironment in ovarian cancer. Herein, we review the key components of the tumour microenvironment as they pertain to this disease, outline targeting opportunities and supporting evidence thus far, and discuss resistance to therapy.

  17. Tumour-host dynamics under radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Placeres Jimenez, Rolando, E-mail: [Departamento de Fi' sica, Universidade Federal de Sao Carlos, Sao Carlos - SP (Brazil); Ortiz Hernandez, Eloy [Centre of Medicine and Complexity, Medical University Carlos J. Finlay, Carretera Central s/n, Camagueey (Cuba)


    Highlight: > Tumour-host interaction is modelled by Lotka-Volterra equations. > A brief review of the motion integral and analysis of linear stability is presented. > Radiotherapy is introduced into the model, using a periodic Dirac delta function. > A two-dimensional logistic map is derived from the modified Lotka-Volterra model. > It is shown that tumour can be controlled by a correct selection of therapy strategy. - Abstract: Tumour-host interaction is modelled by the Lotka-Volterra equations. Qualitative analysis and simulations show that this model reproduces all known states of development for tumours. Radiotherapy effect is introduced into the model by means of the linear-quadratic model and the periodic Dirac delta function. The evolution of the system under the action of radiotherapy is simulated and parameter space is obtained, from which certain threshold of effectiveness values for the frequency and applied doses are derived. A two-dimensional logistic map is derived from the modified Lotka-Volterra model and used to simulate the effectiveness of radiotherapy in different regimens of tumour development. The results show the possibility of achieving a successful treatment in each individual case by employing the correct therapeutic strategy.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND Pituitary gland is known as the “Master Gland” of the body as it controls majority of the endocrine glands of the body. Embryologically, they are formed by two parts. There are two types of malignancies encountered namely adenomas and carcinomas. Vast majority of the neoplasms located in the sella turcica are benign pituitary adenomas derived from adenohypophyseal cells. The aim is to study the pituitary malignancies. METHODS The sample size included 100 cases of intra-cranial neoplasms that turned in the Department of Medicine in KVG Medical College, Sullia and different local private hospitals of Sullia and Mangalore. RESULTS Pituitary tumours comprised 6(6% of all the tumour studies. They occurred maximally in the age above 14 years. Tumours showed a male predominance. All the tumours were located in pituitary fossa. Principal presenting complaint was visual disturbance. Microscopically, the tumour was composed of small polyhedral to round cells with a uniform darkly staining round nucleus and scant eosinophilic cytoplasm. The cells formed papillary structures or were arranged in a trabecular pattern. CONCLUSION There is a male predominance in this study and the percentage of cases was found to be less in this region of Karnataka

  19. Evolutionary Autonomous Health Monitoring System (EAHMS) Project (United States)

    National Aeronautics and Space Administration — For supporting NASA's Robotics, Tele-Robotics and Autonomous Systems Roadmap, we are proposing the "Evolutionary Autonomous Health Monitoring System" (EAHMS) for...

  20. Pathology of the vestibulocochlear nerve

    Energy Technology Data Exchange (ETDEWEB)

    De Foer, Bert [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Kenis, Christoph [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Van Melkebeke, Deborah [Department of Neurology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Vercruysse, Jean-Philippe [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Somers, Thomas [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Pouillon, Marc [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Offeciers, Erwin [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Casselman, Jan W. [Department of Radiology, AZ Sint-Jan AV Hospital, Ruddershove 10, Bruges (Belgium); Consultant Radiologist, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium); Academic Consultent, University of Ghent (Belgium)], E-mail:


    There is a large scala of pathology affecting the vestibulocochlear nerve. Magnetic resonance imaging is the method of choice for the investigation of pathology of the vestibulocochlear nerve. Congenital pathology mainly consists of agenesis or hypoplasia of the vestibulocochlear nerve. Tumoral pathology affecting the vestibulocochlear nerve is most frequently located in the internal auditory canal or cerebellopontine angle. Schwannoma of the vestibulocochlear nerve is the most frequently found tumoral lesion followed by meningeoma, arachnoid cyst and epidermoid cyst. The most frequently encountered pathologies as well as some more rare entities are discussed in this chapter.


    Directory of Open Access Journals (Sweden)

    Uma Devi


    Full Text Available OBJECTIVE: To study incidence age distribution of benign and malignant ovarian tu mours in general population. METHODS AND MATERIAL : To study 120 patients with ovarian tumours in Govt . general hospital during June 2003 and June 2005. RESULTS: Clinical and pathological evaluation of all ovarian tumours was done and incidence, age distrib ution of various benign and malignant ovarian neoplasms were tabulated and compared with other studies. CONCLUSIONS: Most common ovarian tumours are benign tumours and serous cystadenoma is the commonest benign tumour and S erous cystadeno carcinoma is the most common malignant tumour.

  2. Cardiovascular autonomic neuropathy and subclinical cardiovascular disease in normoalbuminuric type 1 diabetic patients

    DEFF Research Database (Denmark)

    Mogensen, Ulrik Madvig; Jensen, Tonny; Køber, Lars


    Cardiovascular autonomic neuropathy (CAN) is associated with increased mortality in diabetes. Since CAN often develops in parallel with diabetic nephropathy as a confounder, we aimed to investigate the isolated impact of CAN on cardiovascular disease in normoalbuminuric patients. Fifty......-six normoalbuminuric, type 1 diabetic patients were divided into 26 with (+) and 30 without (-) CAN according to tests of their autonomic nerve function. Coronary artery plaque burden and coronary artery calcium score (CACS) were evaluated using computed tomography. Left ventricular function was evaluated using...... with increased CACS, subclinical left ventricular dysfunction, and increased pulse pressure. In conclusion, CAN in normoalbuminuric type 1 diabetic patients is associated with distinct signs of subclinical cardiovascular disease....

  3. MRI of intracranial germ cell tumours

    Energy Technology Data Exchange (ETDEWEB)

    Sumida, M. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Uozumi, T. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Kiya, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Mukada, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Arita, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Kurisu, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Sugiyama, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Onda, J. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Satoh, H. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Ikawa, F. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan); Migita, K. [Dept. of Neurosurgery, Hiroshima Univ. School of Medicine, Hiroshima (Japan)


    We reviewed MRI findings in proven intracranial germ cell tumours in 22 cases, 12 of whom received Gd-DTPA. On T1-weighted images, the signal intensity of the tumour parenchyma was moderately low in 19 cases and isointense in 3; on T2-weighted images, it was high in all cases. Regions of different intensity thought to be cysts were found in 17 (77 %): 7 of 12 patients with germinoma (58 %) and in all other cases. Of the 13 patients with pineal lesions T1-weighted sagittal images showed the aqueduct to be obstructed in 5, stenotic in 7 and normal in 1. Strong contrast enhancement was observed in all 12 cases. Of the 14 patients with suprasellar lesions, 5 were found to have an intrasellar extension, and in 3 of these, the normal pituitary gland, which could be distinguished from the tumour, was displaced anteriorly. Ten patients (45 %) had multiple lesions. (orig.)

  4. Autoimmune pancreatitis mimicking Klatskin tumour on radiology. (United States)

    Hadi, Yousaf Bashir; Sohail, Abdul Malik Amir Humza; Haider, Zishan


    Autoimmune pancreatitis (AIP) is categorised into two distinct types, AIP type 1 and 2. Although there can be multisystem involvement, rarely, the cholangitis associated with AIP can present radiologically in a manner similar to that of Klatskin tumour. We present the case of a 65-year-old man who was almost misdiagnosed with a Klatskin tumour because of the similarity in radiological features of the two aforementioned clinical entities. The patient presented with a history of jaundice, pruritus and abdominal pain, and work up showed deranged liver function tests, elevated cancer antigen 19-9 levels and positive antinuclear antibodies. CT scan of the abdomen showed findings suggestive of Klatskin tumour but due to diffuse enlargement of the pancreas and surrounding low-attenuation halo found on a closer review, a diagnosis of AIP was performed. The patient was started on standard corticosteroid therapy and responded well, with complete resolution of the radiological findings.

  5. Progesterone and peripheral nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Fei Fan; Haichao Li; Yuwei Wang; Yanglin Zheng; Lianjun Jia; Zhihui Wang


    OBJECTIVE: To explore the effect of progesterone on peripheral nerve regeneration.DATA SOURCES: An online search of Medline and OVID databases was under taken to identify articles about progesterone and peripheral nerve regeneration published in English between January 1990 and June 2004 by using the keywords of "peripheral nerve, injury, progesterone, regeneration".STUDY SELECTION: The data were primarily screened, those correlated with progesterone and peripheral nerve regeneration were involved, and their original articles were further searched, the repetitive studies or reviews were excluded.DATA EXTRACTION: Totally 59 articles about progesterone and peripheral nerve regeneration were collected, and 26 of them were involved, the other 33 excluded ones were the repetitive studies or reviews.DATA SYNTHESIS: Recent researches found that certain amount of progesterone could be synthetized in peripheral nervous system, and the expression of progesterone receptor could be found in sensory neurons and Schwann cells. After combined with the receptor, endogenous and exogenous progesterone can accelerate the formation of peripheral nerve myelin sheath, also promote the axonal regeneration.CONCLUSION: Progesterone plays a role in protecting neurons, increasing the sensitivity of nerve tissue to nerve growth factor, and accelerating regeneration of nerve in peripheral nerve regeneration, which provides theoretical references for the treatment of demyelinated disease and nerve injury, as well as the prevention of neuroma, especially that the in vivo level of progesterone should be considered for the elderly people accompanied by neuropathy and patients with congenital luteal phase defect, which is of positive significance in guiding the treatment.

  6. Autonomous Gaussian Decomposition

    CERN Document Server

    Lindner, Robert R; Murray, Claire E; Stanimirović, Snežana; Babler, Brian L; Heiles, Carl; Hennebelle, Patrick; Goss, W M; Dickey, John


    We present a new algorithm, named Autonomous Gaussian Decomposition (AGD), for automatically decomposing spectra into Gaussian components. AGD uses derivative spectroscopy and machine learning to provide optimized guesses for the number of Gaussian components in the data, and also their locations, widths, and amplitudes. We test AGD and find that it produces results comparable to human-derived solutions on 21cm absorption spectra from the 21cm SPectral line Observations of Neutral Gas with the EVLA (21-SPONGE) survey. We use AGD with Monte Carlo methods to derive the HI line completeness as a function of peak optical depth and velocity width for the 21-SPONGE data, and also show that the results of AGD are stable against varying observational noise intensity. The autonomy and computational efficiency of the method over traditional manual Gaussian fits allow for truly unbiased comparisons between observations and simulations, and for the ability to scale up and interpret the very large data volumes from the up...

  7. Transanal minimally invasive surgery (TAMIS) approach for large juxta-anal gastrointestinal stromal tumour. (United States)

    Wachter, Nicolas; Wörns, Marcus-Alexander; Dos Santos, Daniel Pinto; Lang, Hauke; Huber, Tobias; Kneist, Werner


    Gastrointestinal stromal tumours (GISTs) are rarely found in the rectum. Large rectal GISTs in the narrow pelvis sometimes require extended abdominal surgery to obtain free resection margins, and it is a challenge to preserve sufficient anal sphincter and urogenital function. Here we present a 56-year-old male with a locally advanced juxta-anal non-metastatic GIST of approximately 10 cm in diameter. Therapy with imatinib reduced the tumour size and allowed partial intersphincteric resection (pISR). The patient underwent an electrophysiology-controlled nerve-sparing hybrid of laparoscopic and transanal minimally invasive surgery (TAMIS) in a multimodal setting. The down-to-up approach provided sufficient dissection plane visualisation and allowed the confirmed nerve-sparing. Lateroterminal coloanal anastomosis was performed. Follow-up showed preserved urogenital function and good anorectal function, and the patient remains disease-free under adjuvant chemotherapy as of 12 months after surgery. This report suggests that the TAMIS approach enables extraluminal high-quality oncological and function-preserving excision of high-risk GISTs.

  8. Transanal minimally invasive surgery (TAMIS approach for large juxta-anal gastrointestinal stromal tumour

    Directory of Open Access Journals (Sweden)

    Nicolas Wachter


    Full Text Available Gastrointestinal stromal tumours (GISTs are rarely found in the rectum. Large rectal GISTs in the narrow pelvis sometimes require extended abdominal surgery to obtain free resection margins, and it is a challenge to preserve sufficient anal sphincter and urogenital function. Here we present a 56-year-old male with a locally advanced juxta-anal non-metastatic GIST of approximately 10 cm in diameter. Therapy with imatinib reduced the tumour size and allowed partial intersphincteric resection (pISR. The patient underwent an electrophysiology-controlled nerve-sparing hybrid of laparoscopic and transanal minimally invasive surgery (TAMIS in a multimodal setting. The down-to-up approach provided sufficient dissection plane visualisation and allowed the confirmed nerve-sparing. Lateroterminal coloanal anastomosis was performed. Follow-up showed preserved urogenital function and good anorectal function, and the patient remains disease-free under adjuvant chemotherapy as of 12 months after surgery. This report suggests that the TAMIS approach enables extraluminal high-quality oncological and function-preserving excision of high-risk GISTs.

  9. The utility of the Golgi-Cox method in the morphological characterization of the autonomic innervation in the rat heart. (United States)

    Gómez-Villalobos, M J; Gordillo, Aurora Calvo; López, José Rubicel Hernández; Flores, Gonzalo


    The autonomic innervation in the heart is predominantly by postganglionic, parasympathetic, and sympathetic neurons, which are organized in a plexus of ganglions into the heart. The knowledge of the density, distribution, location, morphology, and intrinsic connection of this system that constitute the heart autonomic innervation is limited and controversial. Methods that provide clear information in this field are desirable. A widely used method to study the morphology of the nerve cells in the central nervous system (CNS) is used in this study to characterize the autonomic innervation in rat hearts. The method consisted of impregnation of the fresh whole heart of 12 adult male Wistar rats with the Golgi-Cox stain for 30 days, after which they were incubated in 30% sucrose solution for 2-3 days and then were sectioned (200 microm) with a vibratome. The tissues were mounted on gelatin-covered slides and analyzed by using the Sholl method under light microscopy adapted to a camera lucida. The results clearly show a distribution of the ganglion plexuses in the epicardium, myocardium, and endocardium, joined by an extensive network of nerve fibers in the four cardiac chambers. We also identified and characterized the morphology of an isolated cardiac nerve cell. As results similar to that in the CNS, the Golgi-Cox method is a simple, efficient, and an accessible tool to study the autonomic innervation in the rat heart and provides a good resolution of the morphology of the plexuses of the ganglions and nerve fibers.

  10. Mobile Intelligent Autonomous Systems

    Directory of Open Access Journals (Sweden)

    Jitendra R. Raol


    Full Text Available Mobile intelligent autonomous systems (MIAS is a fast emerging research area. Although it can be regarded as a general R&D area, it is mainly directed towards robotics. Several important subtopics within MIAS research are:(i perception and reasoning, (ii mobility and navigation,(iii haptics and teleoperation, (iv image fusion/computervision, (v modelling of manipulators, (vi hardware/software architectures for planning and behaviour learning leadingto robotic architecture, (vii vehicle-robot path and motionplanning/control, (viii human-machine interfaces for interaction between humans and robots, and (ix application of artificial neural networks (ANNs, fuzzy logic/systems (FLS,probabilistic/approximate reasoning (PAR, Bayesian networks(BN and genetic algorithms (GA to the above-mentioned problems. Also, multi-sensor data fusion (MSDF playsvery crucial role at many levels of the data fusion process:(i kinematic fusion (position/bearing tracking, (ii imagefusion (for scene recognition, (iii information fusion (forbuilding world models, and (iv decision fusion (for tracking,control actions. The MIAS as a technology is useful for automation of complex tasks, surveillance in a hazardousand hostile environment, human-assistance in very difficultmanual works, medical robotics, hospital systems, autodiagnosticsystems, and many other related civil and military systems. Also, other important research areas for MIAScomprise sensor/actuator modelling, failure management/reconfiguration, scene understanding, knowledge representation, learning and decision-making. Examples ofdynamic systems considered within the MIAS would be:autonomous systems (unmanned ground vehicles, unmannedaerial vehicles, micro/mini air vehicles, and autonomousunder water vehicles, mobile/fixed robotic systems, dexterousmanipulator robots, mining robots, surveillance systems,and networked/multi-robot systems, to name a few.Defence Science Journal, 2010, 60(1, pp.3-4,

  11. Ex-vivo HRMAS of adult brain tumours: metabolite quantification and assignment of tumour biomarkers

    Directory of Open Access Journals (Sweden)

    Wilson M


    Full Text Available Abstract Background High-resolution magic angle spinning (HRMAS NMR spectroscopy allows detailed metabolic analysis of whole biopsy samples for investigating tumour biology and tumour classification. Accurate biochemical assignment of small molecule metabolites that are "NMR visible" will improve our interpretation of HRMAS data and the translation of NMR tumour biomarkers to in-vivo studies. Results 1D and 2D 1H HRMAS NMR was used to determine that 29 small molecule metabolites, along with 8 macromolecule signals, account for the majority of the HRMAS spectrum of the main types of brain tumour (astrocytoma grade II, grade III gliomas, glioblastomas, metastases, meningiomas and also lymphomas. Differences in concentration of 20 of these metabolites were statistically significant between these brain tumour types. During the course of an extended 2D data acquisition the HRMAS technique itself affects sample analysis: glycine, glutathione and glycerophosphocholine all showed small concentration changes; analysis of the sample after HRMAS indicated structural damage that may affect subsequent histopathological analysis. Conclusions A number of small molecule metabolites have been identified as potential biomarkers of tumour type that may enable development of more selective in-vivo 1H NMR acquisition methods for diagnosis and prognosis of brain tumours.

  12. Early onset hereditary sensory autonomic neuropathy type I and not leprosy

    Directory of Open Access Journals (Sweden)

    Pande Sushil


    Full Text Available Hereditary sensory autonomic neuropathies (HSAN are rare forms of chronic neuropathies in children, which lead to severe complications like foot ulcers, mutilations, fractures and deformities. We report an eight years old female who presented with nonhealing perforating ulcer over anterior sole, resorption of terminal portion of right middle finger and hyperhidrosis over back since two years of age. Deep tendon reflexes were absent in lower legs but were preserved in upper limbs. Nerve conduction studies and nerve biopsy confirmed the diagnosis of HSAN, Type I. Early diagnosis of hereditary sensory neuropathy led to significant reduction in morbidity and hence improvement in the quality of life in our patient.

  13. How to express tumours using membrane systems

    Institute of Scientific and Technical Information of China (English)

    Miguel A. Gutiérrez-Naranjo; Mario J. Pérez-Jiménez; Agustín Riscos-Nú(n)ez; Francisco J. Romero-Campero


    In this paper we discuss the potential usefulness of membrane systems as tools for modelling tumours. The approach is followed both from a macroscopic and a microscopic point of view. In the first case, one considers the tumour as a growing mass of cells,focusing on its external shape. In the second case, one descends to the microscopic level, studying molecular signalling pathways that are crucial to determine if a cell is cancerous or not. In each of these approaches we work with appropriate variants of membrane systems.

  14. [Surgical treatment of children with hepatic tumours

    DEFF Research Database (Denmark)

    Rasmussen, A.; Kvist, N.; Kirkegaard, P.;


    INTRODUCTION: In this paper we review the results of surgical treatment of children with hepatic tumours. MATERIALS AND METHODS: The study comprises 33 children who have undergone lever resection or liver transplantation since 1990. 26 patients had hepatoblastoma, 3 had hepatocellular carcinoma, 2......%). There was no difference in survival dependent on the type of resection, and there was no impact of the extension of tumour growth at the time of diagnosis. CONCLUSION: The combination of neoadjuvant chemotherapy followed by liver resection or liver transplantation is the treatment of choice in all children...

  15. High dose radiotherapy for pituitary tumours

    Energy Technology Data Exchange (ETDEWEB)

    Mead, K.W. (Queensland Radium Inst., Herston (Australia))


    The results of treatment of 120 pituitary tumours are presented. Based on this experience operable chromophobe adenomas are now treated with 5,000 rads in 4 weeks and inoperable ones receive an additional central dose to 7,500 rads. Pituitary Cushing's tumours are given 10,000 rads in 5 weeks using small fields and acromegalics 5,000 rads to the whole sella and 7,500 to its lower half. The absence of complications at these dose levels is attributed to the use of small fields and the precise application of treatment.

  16. Coordinated regulation of myeloid cells by tumours. (United States)

    Gabrilovich, Dmitry I; Ostrand-Rosenberg, Suzanne; Bronte, Vincenzo


    Myeloid cells are the most abundant nucleated haematopoietic cells in the human body and are a collection of distinct cell populations with many diverse functions. The three groups of terminally differentiated myeloid cells - macrophages, dendritic cells and granulocytes - are essential for the normal function of both the innate and adaptive immune systems. Mounting evidence indicates that the tumour microenvironment alters myeloid cells and can convert them into potent immunosuppressive cells. Here, we consider myeloid cells as an intricately connected, complex, single system and we focus on how tumours manipulate the myeloid system to evade the host immune response.

  17. Stochastic Gompertz model of tumour cell growth. (United States)

    Lo, C F


    In this communication, based upon the deterministic Gompertz law of cell growth, a stochastic model in tumour growth is proposed. This model takes account of both cell fission and mortality too. The corresponding density function of the size of the tumour cells obeys a functional Fokker--Planck equation which can be solved analytically. It is found that the density function exhibits an interesting "multi-peak" structure generated by cell fission as time evolves. Within this framework the action of therapy is also examined by simply incorporating a therapy term into the deterministic cell growth term.

  18. Sertoliform cystadenoma: a rare benign tumour of the rete testis

    Directory of Open Access Journals (Sweden)

    Bremmer Felix


    Full Text Available Abstract Sertoliform cystadenoma of the rete testis represents an uncommon benign tumour. They appear in patients from 26 to 62 years of age. We describe a case of a 66-year-old man with a tumour in the area of the epididymal head. The tumour markers were not increased. Under the assumption of a malignant testicular tumour an inguinal orchiectomy was performed. The cut surface of this tumour was of grey/white color and showed small cysts. The tumour consisted of two compartments. The epithelial like tumour cells showed a sertoliform growth pattern and cystic dilatations. In between the tumour cells repeatedly actin expressing sclerotic areas could be recognized as the second tumour component. Proliferative activity was not increased. Immunohistochemically the tumour cells were positiv for inhibin, S-100, and CD 99. Alpha feto protein (AFP, human chorionic gonadotropin (ß-HCG and placental alkaline phosphatase (PLAP as well as synaptophysin, epithelial membrane antigene (EMA, and BCL-2 were not expressed. As far as we know this is the sixth reported case of this tumour. Because of the benign nature of this tumour the correct diagnosis is important for the intra- and postoperative management. Here we present a case of this rare tumour and discuss potential differential diagnosis. Virtual Slides The virtual slide(s for this article can be found here:

  19. Coupled modeling of tumour angiogenesis, tumour growth,and blood perfusion

    Institute of Scientific and Technical Information of China (English)


    This paper proposes a more realistic mathematical simulation method to investigate the dynamic process of tumour angio-genesis by fully coupling the vessel growth,tumour growth and associated blood perfusion.The tumour growth and angiogenesis are coupled by the chemical microenvironment and the cell-matrix interaction.The haemodynamic calculation is carried out on the new vasculature,and an estimation of vessel collapse is made according to the wall shear stress criterion.The results are consistent with phy...

  20. Autonomous software: Myth or magic?

    CERN Document Server

    Allan, Alasdair; Saunders, Eric S


    We discuss work by the eSTAR project which demonstrates a fully closed loop autonomous system for the follow up of possible micro-lensing anomalies. Not only are the initial micro-lensing detections followed up in real time, but ongoing events are prioritised and continually monitored, with the returned data being analysed automatically. If the ``smart software'' running the observing campaign detects a planet-like anomaly, further follow-up will be scheduled autonomously and other telescopes and telescope networks alerted to the possible planetary detection. We further discuss the implications of this, and how such projects can be used to build more general autonomous observing and control systems.

  1. Tissue engineering and peripheral nerve regeneration (III) -- Sciatic nerve regeneration with PDLLA nerve guide

    Institute of Scientific and Technical Information of China (English)


    The biodegradation rate and biocompatibility of poly(d, l -lactide) (PDLLA) in vivo were evaluated. The aim of this study was to establish a nerve guide constructed by the PDLLA with 3-D microenvironment and to repair a 10 mm of sciatic nerve gap in rats. The process of the nerve regeneration was investigated by histological assessment, electrophysiological examination, and determination of wet weight recovery rate of the gastrocnemius muscle. After 3 weeks, the nerve guide had changed from a transparent to an opaque status. The conduit was degraded and absorbed partly and had lost their strength with breakage at the 9th week of postoperation. At the conclusion of 12 weeks, proximal and distal end of nerves were anastomosed by nerve regeneration and the conduit vanished completely. The results suggest that PDLLA conduits may serve for peripheral nerve regeneration and PDLLA is a sort of hopeful candidate for tissue engineering.

  2. Optic nerve hypoplasia

    Directory of Open Access Journals (Sweden)

    Savleen Kaur


    Full Text Available Optic nerve hypoplasia (ONH is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65% than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED.

  3. Vagus Nerve and Vagus Nerve Stimulation, a Comprehensive Review: Part III. (United States)

    Yuan, Hsiangkuo; Silberstein, Stephen D


    Vagus nerve stimulation (VNS) is currently undergoing multiple trials to explore its potential for various clinical disorders. To date, VNS has been approved for the treatment of refractory epilepsy and depression. It exerts antiepileptic or antiepileptogenic effect possibly through neuromodulation of certain monoamine pathways. Beyond epilepsy, VNS is also under investigation for the treatment of inflammation, asthma, and pain. VNS influences the production of inflammatory cytokines to dampen the inflammatory response. It triggers the systemic release of catecholamines that alleviates the asthma attack. VNS induces antinociception by modulating multiple pain-associated structures in the brain and spinal cord affecting peripheral/central nociception, opioid response, inflammation process, autonomic activity, and pain-related behavior. Progression in VNS clinical efficacy over time suggests an underlying disease-modifying neuromodulation, which is an emerging field in neurology. With multiple potential clinical applications, further development of VNS is encouraging.

  4. [Biotherapy of neuroendocrine tumours of the gastrointestinal tract and pancreas

    DEFF Research Database (Denmark)

    Hansen, C.P.; Knigge, U.


    Biotherapy of hormonal symptoms and tumour growth is a mainstay in the therapy of metastatic neuroendocrine tumours of the gastrointestinal tract and pancreas. Symptomatic relief can be achieved by somatostatin analogues and interferon, either alone or in combination. The effect on tumour growth...... is less convincing although a stabilization of disease is recorded in almost 50% of patients. Interferon treatment should mainly be considered for tumours with a low proliferation index Udgivelsesdato: 2008/6/9...


    Directory of Open Access Journals (Sweden)



    Full Text Available Phosphaturic mesenchymal tumour is a tumour that can involve bone or soft tissue. This is a rare tumour and is known to be associated with osteomalasia. This is caused by tumour induced expression of fibroblastic growth factor (FGF23. We present a case of PMT in a 72 year old female patient who was diagnosed with osteomalasia due to nutritional deficiency of vitamin D and was appropriately treated but later presented with a mass in her foot.

  6. Carcinoid Klatskin tumour: A rare cause of obstructive jaundice. (United States)

    Khuroo, Suhail; Rashid, Arshad; Bali, Rajandeep Singh; Mushtaque, Majid; Khuroo, Farzana


    Carcinoid tumours of the extrahepatic biliary ducts represent an extremely rare cause of bile duct obstruction. We report a case of obstructive jaundice secondary to carcinoid tumour arising at the hilar confluence. Resection of the primary tumour was done and the patient is doing well on follow-up. This case demonstrated that surgery offers the only potential cure for biliary carcinoid and aggressive surgical therapy should be the preferred treatment in cases of potentially resectable biliary tumours.

  7. Organisation of autonomic nervous structures in the small intestine of chinchilla (Chinchilla laniger, Molina). (United States)

    Nowak, E


    Using histochemical, histological and immunocytochemical methods, organisation of the autonomic nerve structures in small intestine of chinchilla was investigated. Myenteric plexus was localised between circular and longitudinal layers of the smooth muscles. Forming network nodes, the small autonomic, cholinergic ganglia were linked with the bundles of nerve fibres. Adrenergic structures were visible as specific varicose, rosary-like fibres forming bundles of parallel fibres connecting network nodes. Structures of the submucosal plexus formed a finer network than those of the myenteric plexus. Moreover, in 'whole-mount' specimens, fibres forming thick perivascular plexuses were also observed. Immunocytochemical studies confirmed the cholinergic and adrenergic character of the investigated structures. VAChT-positive neurones were found only in myenteric plexus, and numerous VAChT-positive and DBH-positive fibres were found in both plexuses.

  8. MR diffusion imaging of human intracranial tumours

    DEFF Research Database (Denmark)

    Krabbe, K; Gideon, P; Wagn, P;


    We used MRI for in vivo measurement of brain water self-diffusion in patients with intracranial tumours. The study included 28 patients (12 with high-grade and 3 with low-grade gliomas, 7 with metastases, 5 with meningiomas and 1 with a cerebral abscess). Apparent diffusion coefficients (ADC) wer...

  9. Imaging biomarkers in primary brain tumours

    Energy Technology Data Exchange (ETDEWEB)

    Lopci, Egesta; Chiti, Arturo [Humanitas Clinical and Research Center, Nuclear Medicine Department, Rozzano, MI (Italy); Franzese, Ciro; Navarria, Pierina; Scorsetti, Marta [Humanitas Clinical and Research Center, Radiosurgery and Radiotherapy, Rozzano, MI (Italy); Grimaldi, Marco [Humanitas Clinical and Research Center, Radiology, Rozzano, MI (Italy); Zucali, Paolo Andrea; Simonelli, Matteo [Humanitas Clinical and Research Center, Medical Oncology, Rozzano, MI (Italy); Bello, Lorenzo [Humanitas Clinical and Research Center, Neurosurgery, Rozzano, MI (Italy)


    We are getting used to referring to instrumentally detectable biological features in medical language as ''imaging biomarkers''. These two terms combined reflect the evolution of medical imaging during recent decades, and conceptually comprise the principle of noninvasive detection of internal processes that can become targets for supplementary therapeutic strategies. These targets in oncology include those biological pathways that are associated with several tumour features including independence from growth and growth-inhibitory signals, avoidance of apoptosis and immune system control, unlimited potential for replication, self-sufficiency in vascular supply and neoangiogenesis, acquired tissue invasiveness and metastatic diffusion. Concerning brain tumours, there have been major improvements in neurosurgical techniques and radiotherapy planning, and developments of novel target drugs, thus increasing the need for reproducible, noninvasive, quantitative imaging biomarkers. However, in this context, conventional radiological criteria may be inappropriate to determine the best therapeutic option and subsequently to assess response to therapy. Integration of molecular imaging for the evaluation of brain tumours has for this reason become necessary, and an important role in this setting is played by imaging biomarkers in PET and MRI. In the current review, we describe most relevant techniques and biomarkers used for imaging primary brain tumours in clinical practice, and discuss potential future developments from the experimental context. (orig.)

  10. The role of methylation in urological tumours

    NARCIS (Netherlands)

    Heijden, A.G. van der


    Alterations in DNA methylation have been described in human cancer for more than thirty years now. Since the last decade DNA methylation gets more and more important in cancer research. In this review the different alterations of DNA methylation are discussed in testicular germ cell tumours, Wilms't

  11. Bone scintigraphy (B S) in testicle tumours

    Energy Technology Data Exchange (ETDEWEB)

    Braga, F.J.H.N.; Arbex, M.A.; Souza, J.F.; Haddad, J. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina


    Full text. Testicle tumours are not very frequent and radiotherapy has an important role in the cure of many patients. The detection of metastases is not an easy task and we do not know any study concerning B S in the search for bone metastases in such cases. We studied 28 patients (8-52 years old) with proven testicle tumours by means of 99 m Tc-M D P (750 MBq intravenously). Images were obtained 2 h after. B S was normal in 21 studies. In 7 evaluations the only abnormality we found was variable but diffuse involvement of the iliac bone on the same side as the affected testicle. Five out of these patients showed important uptake of M D P (4 seminoma and 1 epididymoma) and the 2 others showed moderate uptake of the radio pharmaceutical (2 seminoma). Metastases were confirmed by biopsy. Testicle tumour metastases are known to occur through the lymphatic drainage which goes to the iliac lymph node chain and this makes our findings very logical. The scintigraphic aspect of the affected iliac bone is characteristic and makes it possible to imagine an `iliac sign` for such cases. Early detection of metastases is very important because of radiotherapy efficacy and B S may play an important role in such cases. Testicle tumour metastases should be thought of when this scintigraphic aspect is seen. Differential diagnosis is Paget`s Disease

  12. Analysis of nanoparticle delivery to tumours (United States)

    Wilhelm, Stefan; Tavares, Anthony J.; Dai, Qin; Ohta, Seiichi; Audet, Julie; Dvorak, Harold F.; Chan, Warren C. W.


    Targeting nanoparticles to malignant tissues for improved diagnosis and therapy is a popular concept. However, after surveying the literature from the past 10 years, only 0.7% (median) of the administered nanoparticle dose is found to be delivered to a solid tumour. This has negative consequences on the translation of nanotechnology for human use with respect to manufacturing, cost, toxicity, and imaging and therapeutic efficacy. In this article, we conduct a multivariate analysis on the compiled data to reveal the contributions of nanoparticle physicochemical parameters, tumour models and cancer types on the low delivery efficiency. We explore the potential causes of the poor delivery efficiency from the perspectives of tumour biology (intercellular versus transcellular transport, enhanced permeability and retention effect, and physicochemical-dependent nanoparticle transport through the tumour stroma) as well as competing organs (mononuclear phagocytic and renal systems) and present a 30-year research strategy to overcome this fundamental limitation. Solving the nanoparticle delivery problem will accelerate the clinical translation of nanomedicine.

  13. Molecular mechanisms for tumour resistance to chemotherapy. (United States)

    Pan, Shu-Ting; Li, Zhi-Ling; He, Zhi-Xu; Qiu, Jia-Xuan; Zhou, Shu-Feng


    Chemotherapy is one of the prevailing methods used to treat malignant tumours, but the outcome and prognosis of tumour patients are not optimistic. Cancer cells gradually generate resistance to almost all chemotherapeutic drugs via a variety of distinct mechanisms and pathways. Chemotherapeutic resistance, either intrinsic or acquired, is caused and sustained by reduced drug accumulation and increased drug export, alterations in drug targets and signalling transduction molecules, increased repair of drug-induced DNA damage, and evasion of apoptosis. In order to better understand the mechanisms of chemoresistance, this review highlights our current knowledge of the role of altered drug metabolism and transport and deregulation of apoptosis and autophagy in the development of tumour chemoresistance. Reduced intracellular activation of prodrugs (e.g. thiotepa and tegafur) or enhanced drug inactivation by Phase I and II enzymes contributes to the development of chemoresistance. Both primary and acquired resistance can be caused by alterations in the transport of anticancer drugs which is mediated by a variety of drug transporters such as P-glycoprotein (P-gp), multidrug resistance associated proteins, and breast cancer resistance protein. Presently there is a line of evidence indicating that deregulation of programmed cell death including apoptosis and autophagy is also an important mechanism for tumour resistance to anticancer drugs. Reversal of chemoresistance is likely via pharmacological and biological approaches. Further studies are warranted to grasp the full picture of how each type of cancer cells develop resistance to anticancer drugs and to identify novel strategies to overcome it.

  14. Gastrointestinal stromal tumour presenting as gastroduodenal intussusception.

    LENUS (Irish Health Repository)

    Wilson, Mark H


    Gastroduodenal intussusception secondary to gastrointestinal stromal tumour is a very rare cause for intestinal obstruction. The diagnosis of this condition can be challenging, as symptoms are often non-specific and intermittent. This article reports a case where the diagnosis was made preoperatively with abdominal imaging and was treated by a combination of endoscopic reduction and laparoscopic resection.

  15. Granular cell tumour of the urinary bladder

    Directory of Open Access Journals (Sweden)

    Christoph von Klot


    Full Text Available With only 16 cases reported in the literature, the mostly benign granular cell tumour of the urinary bladder is exceptionally rare. We present the case of a 68-year old patient with one of these lesions demonstrating our histological findings including several immunohistochemical stainings used to differentiate between other more common entities.

  16. SIRTF autonomous star tracker (United States)

    van Bezooijen, Roelof W. H.


    Two redundant AST-301 autonomous star trackers (AST) serve as the primary attitude sensors for JPL's space infrared telescope facility (SIRTF). These units, which employ a 1553B interface to output their attitude quaternions and uncertainty at a 2 Hz rate, provide a 1 σaccuracy of better than 0.18, 0.18, and 5.1 arcsec about their X, Y, and Z axes, respectively. This is a factor 5.5 better than the accuracy of the flight-proven AST-201 from which the trackers were derived. To obtain this improvement, the field of view (FOV) was reduced to 5 by 5 degrees, the accurate Tycho-1 and ACT catalogs were used for selecting the 71,830 guide stars, star image centroiding was improved to better than 1/50th of a pixel, and optimal attitude estimation was implemented. In addition, the apparent direction to each guide star in the FOV is compensated for proper motion, parallax, velocity aberration, and optical distortion. The AST-301 employs autonomous time-delayed integration (TDI) to achieve image motion compensation (IMC) about its X axis that prevents accuracy degradation, even at rates of 2.1 deg/s, making it actually suitable for use on spinning spacecraft. About the Y axis, a software function called "image motion accommodation" (IMA) processes smeared images to maximize the signal to noise ratio of the resulting synthetic images, which enables robust and accurate tracking at rates tested up to 0.42 deg/s. The AST-301 is capable of acquiring its attitude anywhere in the sky in less than 3 seconds with a 99.98% probability of success, without requiring any a priori attitude knowledge. Following a description of the 7.1 kg AST-301, its operation and IMA, the methodology for translating the night sky test data into performance numbers is presented, while, in addition, the results of tests used to measure alignment stability over temperature are included.

  17. [Electrical nerve stimulation for plexus and nerve blocks]. (United States)

    Birnbaum, J; Klotz, E; Bogusch, G; Volk, T


    Despite the increasing use of ultrasound, electrical nerve stimulation is commonly used as the standard for both plexus and peripheral nerve blocks. Several recent randomized trials have contributed to a better understanding of physiological and clinical correlations. Traditionally used currents and impulse widths are better defined in relation to the distance between needle tip and nerves. Commercially available devices enable transcutaneous nerve stimulation and provide new opportunities for the detection of puncture sites and for training. The electrically ideal position of the needle usually is defined by motor responses which can not be interpreted without profound anatomical knowledge. For instance, interscalene blocks can be successful even after motor responses of deltoid or pectoral muscles. Infraclavicular blocks should be aimed at stimulation of the posterior fascicle (extension). In contrast to multiple single nerve blocks, axillary single-shot blocks more commonly result in incomplete anaesthesia. Blockade of the femoral nerve can be performed without any nerve stimulation if the fascia iliaca block is used. Independently of the various approaches to the sciatic nerve, inversion and plantar flexion are the best options for single-shot blocks. Further clinical trials are needed to define the advantages of stimulating catheters in continuous nerve blocks.

  18. Tumour and tumour-like lesions of the patella - a multicentre experience

    Energy Technology Data Exchange (ETDEWEB)

    Singh, J.; James, S.L.; Davies, A.M. [The Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Kroon, H.M. [Leiden University Medical Centre, Department of Radiology, C-2-S, P. O Box 9600, Leiden (Netherlands); Woertler, K. [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Anderson, S.E. [Knochentumor- Referenzzentrum der Schweizerischen Gesellschaft fuer Pathologie, Basel (Switzerland)


    Fifty-nine cases of lesions presenting in the patella were identified after review of the databases of four European bone tumour registries. Of the 59 cases, 46% were non neoplastic, 39% were benign and 15% were malignant. The commonest benign neoplasm was giant cell tumour (GCT) (11 cases). Younger patients were more likely to have a benign neoplasm. Lesions in patients less than 40 years of age included giant cell tumour, chondroblastoma, aneurysmal bone cyst (ABC), osteomyelitis, osteoid osteoma and solitary bone cyst. In patients older than 40 years, the following were common lesions: intra-osseous gout, metastasis and intra-osseous ganglion. Expansion of the patella with thinning of cortex was seen more commonly in GCT and brown tumour in hyperparathyroidism. There was associated soft tissue extension in gout and malignant lesions. (orig.)

  19. 腹腔镜与开腹保留盆腔自主神经全直肠系膜切除术对老年男性直肠癌患者排尿功能和性功能障碍的影响研究%A comparative study of laparoscopic and open surgery for colorectal cancer pelvic autonomic nerve preser-vation radical surgery on the urinary function and sexual dysfunction in elderly male patients

    Institute of Scientific and Technical Information of China (English)

    邬祖立; 叶文


    Objectives:To observe the effect of laparoscopic and open radical pelvic autonomic nerve pres-ervation colorectal cancer surgery on the urinary function and male sexual function of elderly patients.Methods:A total of 90 elderly male patients with colorectal cancer in our hospital from January 2010 to June 2013 were selected, and divided according to the different surgeries,39 cases using open surgery and 51 cases using laparoscopic surger-y.Patients in both groups received Mesangial full rectal excision surgery and pelvic autonomic nerve preservation (TME +PANP).The postoperative catheter removal time,urine output of after 2 weeks and after three months, maximum flow rate,residual urine volume,and the erection and ejaculation function of two groups of patients,be-fore and 3 months after operation were recorded and comparatively analyzed.Results:For patients in the open sur-gery group,the incidence of voiding dysfunction two weeks after was higher than that in the laparoscopic surgery group,with statistically significant difference (open surgery group of 30.7%,laparoscopic surgery group of 9.8%;t =8.69,P =0.015).The differences between the two groups in terms of urine output after two weeks was of no statistical significance (open surgery group of 326 ±33.1mL,laparoscopic surgery group of 323 ±32.9mL;t =1.31,P =0.814).The catheter pull out of time,maximum flow rate,residual urine of the laparoscopic group were 2.6 ±0.8d,29.8 ±3.2mL/s,and 15.8 ±3.6mL respectively,better than the open surgery group,which were 5.1 ±0.9d,22.2 ±3.1mL/s and 23.1 ±3.8mL.The difference was statistically significant (catheter pull out of time:t =8.69,P =0.015;maximum flow rate:t =5.67,P =0.042;residual urine:t =5.93,P =0.038).3 months after surgery,the incidence of voiding dysfunction,urine output,maximum flow rate and residual urine of the lapa-roscopic group were 5.9%,324 ±32.6mL,29.0 ±3.2mL/s and 16.1 ±3.3mL,better than the open surgery group of 5.1%,321 ±32.2mL,26.2 ±3.4m

  20. Framework for Autonomous Optimization Project (United States)

    National Aeronautics and Space Administration — Phoenix Integration and MIT propose to create a novel autonomous optimization tool and application programming interface (API). The API will demonstrate the ability...

  1. Cranial Autonomic Symptoms in Migraine

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available Cranial autonomic symptoms (CAS in patients with migraine and cluster headaches (CH were characterized and compared in a prospective study of consecutive patients attending a headache clinic at Taipei Veterans General Hospital, Taiwan.

  2. Autonomic Function in Neurodegenerative Diseases

    DEFF Research Database (Denmark)

    Sørensen, Gertrud Laura; Jennum, Poul Jørgen


    , which includes the cardiac centre and controls autonomic functions, and therefore autonomic dysfunction may be experienced early in the disease course. Sleep disturbances are also common non-motor complications of PD, and therefore PD patients undergo polysomnography at the Danish Center for Sleep......Neurodegenerative diseases are highly debilitating and often lead to severe morbidity and even death. Parkinson’s disease (PD) is the second most common neurodegenerative disease after Alzheimer’s disease. According to the Braak staging study, the progressionof PD starts in the medulla oblongata...... Medicine to assess the sleep disturbances. The aim of this PhD dissertation was to: 1) Develop a method to investigate autonomic changes during sleep in neurodegenerative diseases, and apply this method on PD, iRBD and narcolepsy patients to evaluate the autonomic function in these diseases. 2) Validate...

  3. Improved classification, diagnosis and prognosis of canine round cell tumours

    NARCIS (Netherlands)

    Cangul, Taci


    As the name suggests, canine round cell tumour (RCTs) are composed of cells with a round morphology. There is some discrepancy amongst authors as to which tumours belong to this category, but most designate lymphomas, melanomas, plasmacytomas, transmissible venereal tumours (TVTs), histiocytomas, an

  4. [Malignant germinal tumours of the mediastinum: diagnosis and treatment]. (United States)

    Lemarié, E


    Mediastinal germinal tumours are composed of tissues resembling those that follow one another during embryo development, by differentiation of the primordial and extraembryonic layers. Such practice separates the mature teratomas (benign), seminomas and non-seminomatous germinal tumours (NSGT). Platin-based chemotherapy has shattered the prognosis of such tumours.

  5. Tumour suppressor genes in sporadic epithelial ovarian cancer

    DEFF Research Database (Denmark)

    Liu, Ying; Ganesan, Trivadi S


    of the evolution of tumour progression. A major focus of research has been to identify tumour suppressor genes implicated in sporadic ovarian cancer over the past decade. Several tumour suppressor genes have been identified by strategies such as positional cloning and differential expression display. Further...

  6. Relevance of high-dose chemotherapy in solid tumours

    NARCIS (Netherlands)

    Nieboer, P; de Vries, EGE; Mulder, NH; van der Graaf, WTA


    Drug resistance is a major problem in the treatment of solid tumours. Based on a steep dose-response relationship for especially alkylating agents on tumour cell survival, high-dose chemotherapy was considered of interest for the treatment of solid tumours. Results of phase 1 and 2 studies with high

  7. Renal space-occupying solid growth of uncertain tumour status in metastasising tumour of the testicles

    Energy Technology Data Exchange (ETDEWEB)

    Engelhard, K.; Sarmiento-Garcia, G.; Worlicek, H.


    On the basis of a particular case of 'atypical' hypernephroma the main differential diagnosis of solid renal masses are described with reference to the basis disease: testicle tumour causing metastasis. The problems of determining the dignity of the disease by methods of sonography, pyelogram and CT are pointed out as well as the differences between those characteristics of the said tumour revealed by X-ray diagnosis and the known characteristics of substantial kidney deformations as described in medical literature.

  8. Influence of cosmetics on emotional, autonomous, endocrinological, and immune reactions. (United States)

    Pössel, P; Ahrens, S; Hautzinger, M


    Recent findings indicate that cosmetics increase positive valence of emotions and thereby influence the autonomous nerve system. Other studies showed the effects of emotions on the endocrinological and the immune system. Based on this preliminary conclusion, the aim of the present study was to prove whether cosmetics are able to decrease the level of the stress hormone cortisol and strengthen the immune system. Four slides of made up or unvarnished women each, integrated in another 16 slides each of equivalent valence and arousal, were presented to 60 women. During stimulus presentation, subjective (valence), autonomous (heart rate), endocrinological (salivary cortisol) as well as immunological reactions [secretory immunoglobulin A (sIgA)] were recorded. As expected subjective ratings concerning the slides of made up women reported more positive valence than those concerning unvarnished women. Furthermore, heart rate decreased under presentation of made up women, which indicates the positive influence of these slides on the autonomous nerve system. Furthermore, in half of the volunteers a decrease of cortisol and an increase of sIgA level while presenting the made up women was measurable in contrast to the presentation of unvarnished women. Maybe this is due to a short presentation time and the endocrinological as well as the immune system can be hardly influenced that quick. Another explanation could be that the volunteers were in part so called psychophysiological non-responders who show no reaction to emotional stimuli in the endocrinological and the immune system. It has to be considered that only the influence of visual stimuli and not the influence of social care (e.g. positive statements of other, etc.), which is normally connected with the use of cosmetics, was assessed, so that these delineated positive results show the lower limit of cosmetic effects.

  9. Prophylactic Anticonvulsants in patients with brain tumour

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, P.A. [Depts. of Oncology and Clinical Neurosciences, Univ. of Calgary, Calgary, Alberta (Canada); Tom Baker Cancer Centre, Calgary, Alberta (Canada); Weaver, S. [Depts. of Neurology and Medicine, Albany Medical College, Albany, New York (United States); Fulton, D. [Dept. of Radiation Oncology, Cross Cancer Institute and Dept. of Medicine/Neurology, Univ. of Alberta, Edmonton, Alberta (Canada)


    We conducted a clinical trial to determine if prophylactic anticonvulsants in brain tumour patients (without prior seizures) reduced seizure frequency. We stopped accrual at 100 patients on the basis of the interim analysis. One hundred newly diagnosed brain tumour patients received anticonvulsants (AC Group) or not (No AC Group) in this prospective randomized unblinded study. Sixty patients had metastatic, and 40 had primary brain tumours. Forty-six (46%) patients were randomized to the AC Group and 54 (54%) to the No AC Group. Median follow-up was 5.44 months (range 0.13 -30.1 months). Seizures occurred in 26 (26%) patients, eleven in the AC Group and 15 in the No AC Group. Seizure-free survivals were not different; at three months 87% of the AC Group and 90% of the No AC Group were seizure-free (log rank test, p=0.98). Seventy patients died (unrelated to seizures) and survival rates were equivalent in both groups (median survival = 6.8 months versus 5.6 months, respectively; log rank test, p=0.50). We then terminated accrual at 100 patients because seizure and survival rates were much lower than expected; we would need {>=}900 patients to have a suitably powered study. These data should be used by individuals contemplating a clinical trial to determine if prophylactic anticonvulsants are effective in subsets of brain tumour patients (e.g. only anaplastic astrocytomas). When taken together with the results of a similar randomized trial, prophylactic anticonvulsants are unlikely to be effective or useful in brain tumour patients who have not had a seizure. (author)


    Energy Technology Data Exchange (ETDEWEB)

    Lindner, Robert R.; Vera-Ciro, Carlos; Murray, Claire E.; Stanimirović, Snežana; Babler, Brian [Department of Astronomy, University of Wisconsin, 475 North Charter Street, Madison, WI 53706 (United States); Heiles, Carl [Radio Astronomy Lab, UC Berkeley, 601 Campbell Hall, Berkeley, CA 94720 (United States); Hennebelle, Patrick [Laboratoire AIM, Paris-Saclay, CEA/IRFU/SAp-CNRS-Université Paris Diderot, F-91191 Gif-sur Yvette Cedex (France); Goss, W. M. [National Radio Astronomy Observatory, P.O. Box O, 1003 Lopezville, Socorro, NM 87801 (United States); Dickey, John, E-mail: [University of Tasmania, School of Maths and Physics, Private Bag 37, Hobart, TAS 7001 (Australia)


    We present a new algorithm, named Autonomous Gaussian Decomposition (AGD), for automatically decomposing spectra into Gaussian components. AGD uses derivative spectroscopy and machine learning to provide optimized guesses for the number of Gaussian components in the data, and also their locations, widths, and amplitudes. We test AGD and find that it produces results comparable to human-derived solutions on 21 cm absorption spectra from the 21 cm SPectral line Observations of Neutral Gas with the EVLA (21-SPONGE) survey. We use AGD with Monte Carlo methods to derive the H i line completeness as a function of peak optical depth and velocity width for the 21-SPONGE data, and also show that the results of AGD are stable against varying observational noise intensity. The autonomy and computational efficiency of the method over traditional manual Gaussian fits allow for truly unbiased comparisons between observations and simulations, and for the ability to scale up and interpret the very large data volumes from the upcoming Square Kilometer Array and pathfinder telescopes.

  11. [Autonomic peripheral neuropathy]. (United States)

    Adams, David; Cauquil, Cecile; Lozeron, Pierre


    The mechanisms of dysautonomic disturbances are varied and mostly acquired. They can result from lesions of sympathetic or parasympathetic vegetative fibers located in the peripheral contingent, or in the somatic contingent by demyelination or axonal loss; or more rarely by cellular bodies in the sympathetic or parasympathetic ganglia. Several chronic peripheral neuropathies can be associated with dysautonomia. Only some causes need to be known because they can be clinically significant. Dysautonomia may be seen during chronic acquired neuropathies but also acute or subacute ones. The most frequent cause in the world is the dysautonomia of the diabetes; it affects all the systems; the cardiovascular dysfunction has an impact on the prognosis for survival when it is severe. Hereditary autonomic neuropathies are rare; they can declare themselves very early during the Riley-Day syndrome or very late during amyloid polyneuropathies due to transthyretin gene mutation. The diagnosis can be confirmed by molecular biology. The dysautonomia is frequent and often severe. These neuropathies justify symptomatic treatment to improve quality of life. For some of them, a specific treatment can be proposed to treat the causal affection to try to stop the progression of the disease.

  12. Is paramecium swimming autonomic? (United States)

    Bandyopadhyay, Promode R.; Toplosky, Norman; Hansen, Joshua


    We seek to explore if the swimming of paramecium has an underlying autonomic mechanism. Such robotic elements may be useful in capturing the disturbance field in an environment in real time. Experimental evidence is emerging that motion control neurons of other animals may be present in paramecium as well. The limit cycle determined using analog simulation of the coupled nonlinear oscillators of olivo-cerebellar dynamics (ieee joe 33, 563-578, 2008) agrees with the tracks of the cilium of a biological paramecium. A 4-motor apparatus has been built that reproduces the kinematics of the cilium motion. The motion of the biological cilium has been analyzed and compared with the results of the finite element modeling of forces on a cilium. The modeling equates applied torque at the base of the cilium with drag, the cilium stiffness being phase dependent. A low friction pendulum apparatus with a multiplicity of electromagnetic actuators is being built for verifying the maps of the attractor basin computed using the olivo-cerebellar dynamics for different initial conditions. Sponsored by ONR 33.

  13. Cardiovascular, hormonal and metabolic responses to graded exercise in juvenile diabetics with and without autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J; Galbo, H; Christensen, N J


    Thirteen juvenile diabetics were studied in order to determine if decreased beat-to-beat variation during deep respiration, indicating abnormal autonomic nerve function, imply that cardiovascular, hormonal and metabolic responses are impaired. Patients with decreased beat-to-beat variation had...... to be more heavily stressed during exercise to reach a certain heart rate or catecholamine level. The relation between other metabolic and hormonal response is discussed....

  14. Diabetes and cardiac autonomic neuropathy: Clinicalmanifestations, cardiovascular consequences, diagnosisand treatment

    Institute of Scientific and Technical Information of China (English)

    Akif Serhat Balcloglu; Haldun Müderrisoglu


    Cardiac autonomic neuropathy (CAN) is a frequentchronic complication of diabetes mellitus with potentiallylife-threatening outcomes. CAN is caused by theimpairment of the autonomic nerve fibers regulatingheart rate, cardiac output, myocardial contractility, cardiacelectrophysiology and blood vessel constriction anddilatation. It causes a wide range of cardiac disorders,including resting tachycardia, arrhythmias, intraoperativecardiovascular instability, asymptomatic myocardialischemia and infarction and increased rate of mortalityafter myocardial infarction. Etiological factors associatedwith autonomic neuropathy include insufficient glycemiccontrol, a longer period since the onset of diabetes,increased age, female sex and greater body mass index.The most commonly used methods for the diagnosisof CAN are based upon the assessment of heart ratevariability (the physiological variation in the time intervalbetween heartbeats), as it is one of the first findings inboth clinically asymptomatic and symptomatic patients.Clinical symptoms associated with CAN generally occurlate in the disease process and include early fatigue andexhaustion during exercise, orthostatic hypotension,dizziness, presyncope and syncope. Treatment is basedon early diagnosis, life style changes, optimization ofglycemic control and management of cardiovascular riskfactors. Medical therapies, including aldose reductaseinhibitors, angiotensin-converting enzyme inhibitors,prostoglandin analogs and alpha-lipoic acid, have beenfound to be effective in randomized controlled trials.The following article includes the epidemiology, clinicalfindings and cardiovascular consequences, diagnosis,and approaches to prevention and treatment of CAN.

  15. RNF43 is a tumour suppressor gene mutated in mucinous tumours of the ovary. (United States)

    Ryland, Georgina L; Hunter, Sally M; Doyle, Maria A; Rowley, Simone M; Christie, Michael; Allan, Prue E; Bowtell, David D L; Gorringe, Kylie L; Campbell, Ian G


    Mucinous carcinomas represent a distinct morphological subtype which can arise from several organ sites, including the ovary, and their genetic characteristics are largely under-described. Exome sequencing of 12 primary mucinous ovarian tumours identified RNF43 as the most frequently somatically mutated novel gene, secondary to KRAS and mutated at a frequency equal to that of TP53 and BRAF. Further screening of RNF43 in a larger cohort of ovarian tumours identified additional mutations, with a total frequency of 2/22 (9%) in mucinous ovarian borderline tumours and 6/29 (21%) in mucinous ovarian carcinomas. Seven mutations were predicted to truncate the protein and one missense mutation was predicted to be deleterious by in silico analysis. Six tumours had allelic imbalance at the RNF43 locus, with loss of the wild-type allele. The mutation spectrum strongly suggests that RNF43 is an important tumour suppressor gene in mucinous ovarian tumours, similar to its reported role in mucinous pancreatic precancerous cysts.

  16. Immunohistochemical detection of tumour cell proliferation and intratumoural microvessel density in canine malignant mammary tumours

    Directory of Open Access Journals (Sweden)

    Sennazli Gulbin


    Full Text Available The objective of this study was to investigate the correlation between different histological types and grades of canine malignant mammary tumours, tumour cell proliferation and their angiogenic activity using immunohistochemical markers. Mammary tissue samples from 47 bitches with mammary cancer were evaluated. The expression of cellular proliferation marker Ki-67 and endothelial marker Von Willebrand’s factor (vWF were immunohistochemically demonstrated. The tumours with the highest Ki-67 and vWF expressions were found to share similar histomorphological features. Simple solid carcinoma had the highest levels of Ki-67, vWF, and higher histological grade while complex carcinomas, osteosarcomas, and carcinosarcomas had the lowest ones. The differences between the expressions of Ki-67 and vWF in different tumour types were considered to be of great importance in determination of biological behaviour and prognosis of these tumours. This study is one of the few studies that evaluate these differences among the subtypes of malignant canine mammary tumours

  17. Acellular nerve allograft promotes selective regeneration

    Institute of Scientific and Technical Information of China (English)

    Haili Xin; Guanjun Wang; Xinrong He; Jiang Peng; Quanyi Guo; Wenjing Xu


    Acellular nerve allograft preserves the basilar membrane tube and extracellular matrix, which pro-motes selective regeneration of neural defects via bridging. In the present study, a Sprague Dawley rat sciatic nerve was utilized to prepare acellular nerve allografts through the use of the chemical extraction method. Subsequently, the allograft was transplanted into a 10-mm sciatic nerve defect in Wistar rats, while autologous nerve grafts from Wistar rats served as controls. Compared with autologous nerve grafts, the acellular nerve allografts induced a greater number of degenerated nerve fibers from sural nerves, as well as a reduced misconnect rate in motor fibers, fewer acetyl-choline esterase-positive sural nerves, and a greater number of carbonic anhydrase-positive senso-ry nerve fibers. Results demonstrated that the acellular nerve allograft exhibited significant neural selective regeneration in the process of bridging nerve defects.

  18. 口服补液盐、健康教育和自主神经锻炼对儿童体位性心动过速综合征的疗效分析%Efficacy of oral saline plus health education and autonomic nerve exercise on the treatment of postural orthostatic tachycardia syndrome in children

    Institute of Scientific and Technical Information of China (English)

    刘平; 陈铮; 李晶


    Objective To compare the efficacy of oral rehydration salts(ORS),health education and autonomic nervous activity training with health education and autonomic nervous activity training on children with postural orthostatic tachycardia syndrome (POTS).Methods Fifty-two children with POTS based on head-up test or head-up tilt test were divided into ORS treatment group and conventional treatment group.ORS treatment group included 33 children,and they received ORS and health education and autonomic nervous activity training therapy.Conventional treatment group included 19 children who received health education and autonomic nervous activity training therapy only.Telephone follow-ups were made after the therapy for 1-3 months.The contents of follow-up were the compliance of ORS treatment,the implementation of health education and POTS related symptom frequency.Results 1.The compliance of doctor's advice in ORS treatment group was better than that in the conventional treatment group.2.There was no significant difference in the symptom scores before therapy between ORS treatment group and conventional treatment group [(6 ± 3) scores in ORS treatment group vs (5 ± 3) scores in conventional treatment group,t =0.799,P > 0.05].After 1 to 3 months therapy,the symptom scores were significantly lowered in both groups.The symptom scores in ORS treatment group was lower than those of the conventional treatment group[(2 ± 1) scores in ORS treatment group vs(3 ± 1)scores in conventional treatment,t =-2.189,P < 0.05].3.If the therapy was determined to be effective when the symptom scores decreased by at least 2 scores,the effective rate in ORS treatment group was significantly higher than that of the conventional treatment group(78.8% in ORS treatment group vs 42.1% in conventional treatment group,x2 =7.169,P < 0.01).Conclusions The efficacy of ORS,health education and autonomic nervous activity training therapy is better than that of the health education and autonomic

  19. Gland-preserving robotic surgery for benign submandibular gland tumours: a comparison between robotic and open techniques. (United States)

    Yang, Tsung-Lin; Ko, Jenq-Yuh; Lou, Pei-Jen; Wang, Cheng-Ping; Hsiao, Tzu-Yu


    Benign tumours of the submandibular gland are usually treated surgically. Gland-preserving techniques, which can be used to completely remove the tumour, preserve the function of the gland and reduce complications, but conventional open operations result in obvious scars on the neck. We aimed to investigate the feasibility and efficacy of gland-preserving robotic surgery using a hairline approach. We compared robotic with open techniques for gland-preserving operations to remove benign tumours of the submandibular gland. Patients were matched for age and sex (4 in each group). All patients in the robotic surgery group had their tumours removed successfully through hairline approaches. No patient had operative complications or postoperative functional nerve deficit, and an aesthetically pleasing outcome was achieved by concealing the scars within the hairline. Robotic operations took longer than open operations. No recurrence was noted during follow-up. Gland-preserving robotic surgery is a feasible alternative to conventional techniques and has potential advantages for safety and aesthetic outcome.

  20. Electrostimulation and morphologic study of the nerves to the bone marrow of the albino rat. (United States)

    DePace, D M; Webber, R H


    The innervation of the bone marrow of the albino rat was investigated by electrostimulation and morphological methods. Stimulation of the lumbar sympathetic trunks resulted in the release of reticulocytes and neutrophils into the circulating blood. The effects of stimulation on other cell types in the bone marrow could not be definitely established. It was concluded that the nerve fibers to the bone marrow were distributed to the arteries. It is postulated that the transmitter substance released at the autonomic nerve endings may have an effect upon the permeability of the venous sinusiods and the mobility of the blood cells in the marrow parenchyma resulting in their release into the circulating blood.

  1. Pulmonary tumours in the Netherlands : focus on temporal trends in histology and stage and on rare tumours

    NARCIS (Netherlands)

    de Jong, W. K.; Schaapveld, M.; Blaauwgeers, J. L. G.; Groen, H. J. M.


    Background: Recent temporal trends in histology and stage of pulmonary tumours in the Netherlands were studied. The incidence of rare pulmonary tumours was determined. Methods: All tumours originating from the trachea, bronchus and lung recorded in the Netherlands Cancer Registry were included. Base

  2. Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin (United States)

    Borovikova, Lyudmila V.; Ivanova, Svetlana; Zhang, Minghuang; Yang, Huan; Botchkina, Galina I.; Watkins, Linda R.; Wang, Haichao; Abumrad, Naji; Eaton, John W.; Tracey, Kevin J.


    Vertebrates achieve internal homeostasis during infection or injury by balancing the activities of proinflammatory and anti-inflammatory pathways. Endotoxin (lipopolysaccharide), produced by all gram-negative bacteria, activates macrophages to release cytokines that are potentially lethal. The central nervous system regulates systemic inflammatory responses to endotoxin through humoral mechanisms. Activation of afferent vagus nerve fibres by endotoxin or cytokines stimulates hypothalamic-pituitary-adrenal anti-inflammatory responses. However, comparatively little is known about the role of efferent vagus nerve signalling in modulating inflammation. Here, we describe a previously unrecognized, parasympathetic anti-inflammatory pathway by which the brain modulates systemic inflammatory responses to endotoxin. Acetylcholine, the principle vagal neurotransmitter, significantly attenuated the release of cytokines (tumour necrosis factor (TNF), interleukin (IL)-1β, IL-6 and IL-18), but not the anti-inflammatory cytokine IL-10, in lipopolysaccharide-stimulated human macrophage cultures. Direct electrical stimulation of the peripheral vagus nerve in vivo during lethal endotoxaemia in rats inhibited TNF synthesis in liver, attenuated peak serum TNF amounts, and prevented the development of shock.

  3. Ovarian Steroid Cell Tumour: Correlation of Histopathology with Clinicopathologic Features

    Directory of Open Access Journals (Sweden)

    Ghazala Mehdi


    Full Text Available Ovarian steroid cell tumours (not otherwise specified are rare neoplasms of the ovary and are classified under lipid cell tumours. Their diagnosis can be considered as one of exclusion. Histopathologically, the tumour should carefully be evaluated for microscopic features of malignancy, but it is essential for the clinician and the pathologist to remember that in these tumours, pathologically benign histomorphology does not exclude the possibility of clinically malignant behaviour. Our case study focuses on the comparative findings in a postmenopausal female diagnosed with an ovarian steroid tumour (not otherwise specified. A careful correlation between clinical and surgical evaluation and microscopic analysis is necessary, as is a regular followup.

  4. Oral and maxillofacial tumours in children: a review. (United States)

    Sato, M; Tanaka, N; Sato, T; Amagasa, T


    This retrospective review presents our experience of oral and maxillofacial tumours in children. The subjects were 250 children under the age of 15 years (out of a total of 2747 patients with oral and maxillofacial tumours), who were treated after histopathological confirmation of their diagnoses during the 28 years 1965-92. Diagnosis, incidence, and age at presentation were the main outcome measures and the results showed that 232 patients (93%) had benign tumours and 18 (7%) were malignant. The most common benign tumour was haemangioma (n = 69) and the most common malignant tumour sarcoma (n = 14). The most common odontogenic tumour was odontoma (n = 47) and non-odontogenic tumour ossifying fibroma (n = 5). The most common site of soft tissue tumours was the tongue (n = 65) and of bony tumours the mandible (n = 62). About a third of the tumours developed in patients between the ages of 6 and 11 years. Most of the angiomas developed in patients less than 6 years old, and most of the ameloblastomas in those over 12 years of age. Children accounted for 55% of patients with lymphangoma, 41% of those with odontoma, and 22% of those with haemangioma. It is concluded that most of these lesions were probably developmental malformations rather than neoplasms, and that the definition of oral and maxillofacial tumours in children should be reconsidered.

  5. Perinatal tumours: the contribution of radiology to management

    Energy Technology Data Exchange (ETDEWEB)

    Donoghue, Veronica; Ryan, Stephanie; Twomey, Eilish [Children' s University Hospital, Radiology Department, Dublin (Ireland)


    A formal classification does not exist and they are probably best classified by their location. Overall the most common neoplasms are - Extracranial teratoma - Neuroblastoma - Soft-tissue tumours - Brain tumours - Leukaemia - Renal tumours - Liver tumours - Retinoblastoma. The prognosis is generally poor, although there are some exceptions such as congenital neuroblastoma and hepatoblastoma. These tumours have a tendency to regress and have a benign clinical course despite a clear malignant histological picture. Other tumours, though histologically benign, may be fatal because of their size and location. Large benign masses may cause airway or cardiovascular compromise and death. Others may cause significant mass effect preventing normal organ development. As normal embryonic cells have a high mitotic rate it is not surprising that perinatal tumours may have a rapid growth rate and become enormous in size. (orig.)

  6. Primary Malignant Neuroendocrine Tumour of Pleura: First Case Report

    Directory of Open Access Journals (Sweden)

    Anirban Das


    Full Text Available Metastatic tumours of pleura are the most common malignant tumours causing malignant pleural effusion. Lungs are the most common primary sites. Primary pleural tumours are rarely seen and diffuse malignant mesothelioma is the most common malignant tumour of pleura. Primary malignant neuroendocrine tumour of pleura is not reported in the literature. Here, we report a rare case of primary malignant neuroendocrine tumour of pleura in a fifty-two-year-old, nonsmoker female who presented with right-sided pleural effusion and ipsilateral, dull aching chest pain. Clinical presentations of inflammatory lesions like tuberculous pleuritis and benign and malignant neoplasms of pleura are indistinguishable; hence, fluid cytology, pleural biopsy, and immunohistochemistry are necessary for exact tissue diagnosis of the tumours, which is mandatory for correct treatment and prognostic assessment.

  7. Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical Consideration (United States)

    Ali, Nurayub Mohd; Azizan, Nornazirah; Zakaria, Andee Dzulkarnaen; Rahman, Mohd Ramzisham Abdul


    We present a case of 16-year-old male, who was referred from private centre for dyspnoea, fatigue, and orthopnea. The chest radiograph revealed complete opacification of left chest which was confirmed by computed tomography as a large left mediastinal mass measuring 14 × 15 × 18 cm. The diagnostic needle core biopsy revealed mixed germ cell tumour with possible combination of embryonal carcinoma, yolk sac, and teratoma. After 4 cycles of neoadjuvant BEP regime, there was initial response of tumour markers but not tumour bulk. Instead of classic median sternotomy or clamshell incision, posterolateral approach with piecemeal manner was chosen. Histology confirmed mixed germ cell tumour with residual teratomatous component without yolk sac or embryonal carcinoma component. Weighing 3.5 kg, it is one of the largest mediastinal germ cell tumours ever reported. We describe this rare and gigantic intrathoracic tumour and discuss the spectrum of surgical approach and treatment of this exceptional tumour.

  8. Integrated Motion Planning and Autonomous Control Technology for Autonomous ISR Project (United States)

    National Aeronautics and Space Administration — SSCI and MIT propose to design, implement and test a comprehensive Integrated Mission Planning & Autonomous Control Technology (IMPACT) for Autonomous ISR...

  9. Sympathetic preganglionic efferent and afferent neurons mediated by the greater splanchnic nerve in rabbit (United States)

    Torigoe, Yasuhiro; Cernucan, Roxana D.; Nishimoto, Jo Ann S.; Blanks, Robert H. I.


    As a part of the study of the vestibular-autonomic pathways involved in motion sickness, the location and the morphology of preganglionic sympathetic neurons (PSNs) projecting via the greater splanchnic nerve were examined. Retrograde labeling of neurons was obtained by application of horseradish peroxidase to the cut end of the greater splanchnic nerve. Labeled PSNs were found, ipsilaterally, within the T1 to T11 spinal cord segments, with the highest density of neurons in T6. Most PSNs were located within the intermediolateral column, but a significant portion also occurred within the lateral funiculus, the intercalated region, and the central autonomic area; the proportion of labeling between the four regions depended on the spinal cord segment.

  10. 17beta-estradiol modulates baroreflex sensitivity and autonomic tone of female rats. (United States)

    Saleh, T M; Connell, B J


    The following experiments examine the role of estrogen as a central modulator of autonomic tone and baroreflex sensitivity in the female rat. Female Sprague-Dawley rats were ovariectomized and then supplemented daily for 7 days with a fixed dose of estrogen (5 microg/kg; sc) to produce a stable level of estrogen similar to that present at proestrous (17 pg/ml). The rats were then anaesthetized with sodium thiobutabarbital (100 mg/kg) and instrumented to record blood pressure, heart rate and both vagal and renal efferent nerve activities. The sensitivity of the cardiac baroreflex was tested using intravenous injection of multiple doses of either phenylephrine hydrochloride or sodium nitroprusside. Estrogen-supplemented female rats exhibited a significantly enhanced BRS as compared to male rats from a previous study (0.78 vs. 0.5). Furthermore, bolus injection of estrogen (1x10(-2) mg/kg; iv) in estrogen-supplemented female rats produced a significant increase in vagal nerve activity and a significant decrease in renal nerve activity which together resulted in a further enhancement of the BRS (0.78 vs. 2.4). Injection of the selective estrogen receptor antagonist, ICI 182,780, into nucleus ambiguus and the intrathecal space of the spinal cord blocked the respective changes in parasympathetic and sympathetic nerve activities indicating that intravenously administered estrogen modulates baseline autonomic tone via the activation of central estrogen receptors.

  11. The role of the autonomic nervous system in Tourette Syndrome

    Directory of Open Access Journals (Sweden)

    Jack eHawksley


    Full Text Available Tourette Syndrome (TS is a neurodevelopmental disorder, consisting of multiple involuntary movements (motor tics and one or more vocal (phonic tics. It affects up to one percent of children worldwide, of whom about one third continue to experience symptoms into adulthood. The central neural mechanisms of tic generation are not clearly understood, however recent neuroimaging investigations suggest impaired cortico-striato-thalamo-cortical activity during motor control. In the current manuscript, we will tackle the relatively under-investigated role of the peripheral autonomic nervous system, and its central influences, on tic activity. There is emerging evidence that both sympathetic and parasympathetic nervous activity influences tic expression. Pharmacological treatments which act on sympathetic tone are often helpful: for example, Clonidine (an alpha-2 adrenoreceptor agonist is often used as first choice medication for treating TS in children due to its good tolerability profile and potential usefulness for co-morbid attention-deficit and hyperactivity disorder. Clonidine suppresses sympathetic activity, reducing the triggering of motor tics. A general elevation of sympathetic tone is reported in patients with TS compared to healthy people, however this observation may reflect transient responses coupled to tic activity. Thus the presence of autonomic impairments in patients with TS remains unclear. Effect of autonomic afferent input to cortico-striato-thalamo-cortical circuit will be discussed schematically. We additionally review how TS is affected by modulation of central autonomic control through biofeedback and Vagus Nerve Stimulation (VNS. Biofeedback training can enable a patient to gain voluntary control over covert physiological responses by making these responses explicit. Electrodermal biofeedback training to elicit a reduction in sympathetic tone has a demonstrated association with reduced tic frequency. VNS, achieved through an

  12. The hypoxic tumour microenvironment and metastatic progression. (United States)

    Subarsky, Patrick; Hill, Richard P


    The microenvironment of solid tumours contains regions of poor oxygenation and high acidity. Growing evidence from clinical and experimental studies points to a fundamental role for hypoxia in metastatic progression. Prolonged hypoxia increases genomic instability, genomic heterogeneity, and may act as a selective pressure for tumour cell variants. Hypoxia can also act in an epigenetic fashion, altering the expression of genes. Hypoxia-induced changes in gene expression alter non-specific stress responses, anaerobic metabolism, angiogenesis, tissue remodeling, and cell-cell contacts. Experimental studies have demonstrated that inhibition of proteins involved in these processes can modify metastasis formation, suggesting a causal role in metastatic progression. Recent advances in high-throughput screening techniques have allowed identification of many hypoxia-induced genes that are involved in the processes associated with metastasis. Here we review the epigenetic control of gene expression by the hypoxic microenvironment and its potential contribution to metastatic progression.

  13. SPECT/CT and tumour imaging

    Energy Technology Data Exchange (ETDEWEB)

    Abikhzer, Gad [Rambam Health Care Campus, Department of Nuclear Medicine, Haifa (Israel); Keidar, Zohar [Rambam Health Care Campus, Department of Nuclear Medicine, Haifa (Israel); Technion - Israel Institute of Technology, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa (Israel)


    Scintigraphic techniques are sensitive imaging modalities in the diagnosis and follow-up of cancer patients providing the functional and metabolic activity characteristics of the tumour. Hybrid SPECT/CT improves the diagnostic accuracy of these well-established imaging techniques by precise anatomical localization and characterization of morphological findings, differentiation between foci of physiological and pathological tracer uptake, resulting in a significant impact on patient management and more definitive interpretations. The use of SPECT/CT has been studied in a variety of applications in tumour imaging which are reviewed in this article. By combining functional and anatomical information in a single imaging session, SPECT/CT has become a one-stop cancer imaging modality. (orig.)

  14. Nasopharyngeal carcinoma presented as cavernous sinus tumour. (United States)

    Moona, Mohammad Shafi; Mehdi, Itrat


    A 32 year Libyan male presented with the complaints of headache and diplopia. He was diagnosed with a cavernous sinus meningioma on the basis of MRI findings but no initial biopsy was taken. Depending on the radiologic diagnosis the patient was treated with gamma knife surgery twice, abroad. During follow up he developed left ear deafness and left cervical lymph adenopathy. An ENT evaluation with biopsy from the nasopharynx and cervical lymph node was taken. The histopathologic diagnosis of the resected tumour showed a nasopharyngeal carcinoma with cervical lymph node metastasis (poorly differentiated lympho-epithelial carcinoma). The cavernous sinus tumour which was initially treated as a meningioma was in fact metastasis from the nasopharyngeal carcinoma, making this an interesting and rare occurrence.

  15. Tumour Debulking for Esophageal Cancer - Thermal Modalities

    Directory of Open Access Journals (Sweden)

    David Fleischer


    Full Text Available Esophageal cancer usually is discovered at a late stage and curative therapy seldom is possible. The prognosis is poor and most therapy is palliative. Endoscopic therapy commonly is employed; two common treatments involve thermal modalities. The Nd:YAG laser has been employed for 10 years and is effective in relieving obstruction in approximately 90% of cases. Re-ohstruction usually occurs in two to three months and repeat treatment may be necessary. Limitations to laser use include the fact that equipment is expensive and there are technical restrictions. An alternative thermal modality is the bipolar coagulation tumour probe which employs bipolar electrocoagulation. It is less expensive and, if the tumour is circumferential, tends to be easier to use. (It should not be used if the cancer is noncircumferential. The advantages and limitations of each modality are addressed.

  16. Electrochemotherapy for rat implanted liver tumour

    Institute of Scientific and Technical Information of China (English)


    @@ The most common interventional therapies for liver cancer at present include transcatheter hepatic arterial chemoembolization (TACE),1 percutaneous ethanol injection2 and radiofrequency ablation,3 but all these therapies have some intrinsic disadvantages. Since the advent of electrochemo- therapy (EChT), it has been accepted as a safe and effective therapy for malignant tumors4,5 There are only a few experimental studies reporting the use of EChT in the treatment of liver cancer in the foreign medical literature.6-8 However, there have been some clinical studies, and even fewer reports of experimental studies on EChT for liver cancer in China. We used a rat implanted liver cancer animal model to monitor changes in tumour size, tumour necrosis, cellular apoptosis, expression of peripheral immunological markers (IL-2, sIL-2R, IL-6 and TNF-α) and survival.

  17. Peptide receptor radionuclide therapy of neuroendocrine tumours. (United States)

    Brabander, Tessa; Teunissen, Jaap J M; Van Eijck, Casper H J; Franssen, Gaston J H; Feelders, Richard A; de Herder, Wouter W; Kwekkeboom, Dik J


    In the past decades, the number of neuroendocrine tumours that are detected is increasing. A relative new and promising therapy for patients with metastasised or inoperable disease is peptide receptor radionuclide therapy (PRRT). This therapy involves an infusion of somatostatin analogues linked to radionuclides like Yttrium-90 or Lutetium-177. Objective response rates are reported in 15-35%. Response rates may vary between type of tumour and radionuclide. Besides the objective response rate, overall survival and progression free survival increase significantly. Also, the quality of life improves as well. Serious side-affects are rare. PRRT is usually well tolerated, also in patients with extensive metastasised disease. Recent studies combined PRRT with other types of therapies. Unfortunately no randomised trials comparing these strategies are available. In the future, more research is needed to evaluate the best therapy combinations or sequence of therapies.

  18. Metastatic carcinoid tumour with spinal cord compression. (United States)

    Scott, Si; Antwi-Yeboah, Y; Bucur, Sd


    Carcinoid tumours are rare with an incidence of 5.25/100,000. They predominantly originate in the gastrointestinal tract (50-60%) or bronchopulmonary system (25-30%). Common sites of metastasis are lymph nodes, liver, lungs and bone. Spinal metastasis are rare, but has been reported in patients with symptoms of spinal cord compression including neurological deficits. We report a rare case of carcinoid metastasis with spinal cord compression, in a 63-year-old man, presenting with a one-year history of back pain without any neurological symptoms. The patient underwent a two-level decompressive laminectomy of T10 and T11 as well as piecemeal tumour resection. Post-operatively the patient made a good recovery without complications.

  19. COX-2, VEGF and tumour angiogenesis.

    LENUS (Irish Health Repository)

    Toomey, D P


    Epidemiological evidence suggests a protective effective of regular NSAID use against developing cancer. Cyclooxygenase-2, a target of NSAIDs, is upregulated in many cancers and has been associated with increased VEGF production and angiogenesis. Angiogenesis is the formation of new vessels from existing vasculature and as an essential process for tumour development represents an important therapeutic target. Following an extensive review of the literature this article details the current knowledge on the role of COX-2 in tumorigenesis focusing on its relationship to angiogenesis and VEGF production by tumour cells. While COX-2 is clearly detrimental to prognosis and NSAIDs have a beneficial effect, the possibility of COX-2 independent effects being partly or wholly responsible for this benefit cannot be excluded.

  20. Endometrial stromal sarcoma: a rare tumour

    Directory of Open Access Journals (Sweden)

    Amrit Pal Kaur


    Full Text Available Endometrial stromal sarcomas (ESS are rare endometrial tumours arising from stroma of endometrium i.e. connective tissue of endometrium rather than glands. Usually a pre-operative diagnosis is difficult. Total abdominal hysterectomy with bilateral salpingo-oophorectomy is main line of treatment. Adjuvant hormone therapy in the form of progesterones, GnRH analogues, aromatase inhibitors are effective for prevention of recurrences as these tumours are invariably positive for oestrogen & progesterone receptors. Surgical excision, radiotherapy, hormone therapy are recommended for recurrences. We report a 52 yrs widow with undifferentiated endometrial stromal sarcoma weighing 3.75 kg with a short history of 3 months diagnosed only after histopathology. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 276-278

  1. Autonomous Landing on Moving Platforms

    KAUST Repository

    Mendoza Chavez, Gilberto


    This thesis investigates autonomous landing of a micro air vehicle (MAV) on a nonstationary ground platform. Unmanned aerial vehicles (UAVs) and micro air vehicles (MAVs) are becoming every day more ubiquitous. Nonetheless, many applications still require specialized human pilots or supervisors. Current research is focusing on augmenting the scope of tasks that these vehicles are able to accomplish autonomously. Precise autonomous landing on moving platforms is essential for self-deployment and recovery of MAVs, but it remains a challenging task for both autonomous and piloted vehicles. Model Predictive Control (MPC) is a widely used and effective scheme to control constrained systems. One of its variants, output-feedback tube-based MPC, ensures robust stability for systems with bounded disturbances under system state reconstruction. This thesis proposes a MAV control strategy based on this variant of MPC to perform rapid and precise autonomous landing on moving targets whose nominal (uncommitted) trajectory and velocity are slowly varying. The proposed approach is demonstrated on an experimental setup.

  2. [De novo tumours of renal transplants]. (United States)

    Hétet, J F; Rigaud, J; Dorel-Le Théo, M; Láuté, F; Karam, G; Blanchet, P


    Kidney cancer occurs rarely and late in renal transplants. The lack of grafts and the increasing age of the cadaver donors are likely to result in an increasing number of such cancers. To date, the treatment of choice is the transplant removal. Nevertheless partial nephrectomy may be discussed in selected cases. Ultrasonographic screening should allow detection of low volume tumours suitable for partial nephrectomy. Alternative techniques (radiofrequency, cryoablation) are to be assessed in such patients.

  3. Autonomous mobile robots: Vehicles with cognitive control

    Energy Technology Data Exchange (ETDEWEB)

    Meystel, A.


    This book explores a new rapidly developing area of robotics. It describes the state-of-the-art intelligence control, applied machine intelligence, and research and initial stages of manufacturing of autonomous mobile robots. A complete account of the theoretical and experimental results obtained during the last two decades together with some generalizations on Autonomous Mobile Systems are included in this book. Contents: Introduction; Requirements and Specifications; State-of-the-art in Autonomous Mobile Robots Area; Structure of Intelligent Mobile Autonomous System; Planner, Navigator; Pilot; Cartographer; Actuation Control; Computer Simulation of Autonomous Operation; Testing the Autonomous Mobile Robot; Conclusions; Bibliography.

  4. Ultrasonographic Evaluation of Peripheral Nerves. (United States)

    Ali, Zarina S; Pisapia, Jared M; Ma, Tracy S; Zager, Eric L; Heuer, Gregory G; Khoury, Viviane


    There are a variety of imaging modalities for evaluation of peripheral nerves. Of these, ultrasonography (US) is often underused. There are several advantages of this imaging modality, including its cost-effectiveness, time-efficient assessment of long segments of peripheral nerves, ability to perform dynamic maneuvers, lack of contraindications, portability, and noninvasiveness. It can provide diagnostic information that cannot be obtained by electrophysiologic or, in some cases, magnetic resonance imaging studies. Ideally, the neurosurgeon can use US as a diagnostic adjunct in the preoperative assessment of a patient with traumatic, neoplastic, infective, or compressive nerve injury. Perhaps its most unique use is in intraoperative surgical planning. In this article, a brief description of normal US nerve anatomy is presented followed by a description of the US appearance of peripheral nerve disease caused by trauma, tumor, infection, and entrapment.

  5. Tumour exosome integrins determine organotropic metastasis. (United States)

    Hoshino, Ayuko; Costa-Silva, Bruno; Shen, Tang-Long; Rodrigues, Goncalo; Hashimoto, Ayako; Tesic Mark, Milica; Molina, Henrik; Kohsaka, Shinji; Di Giannatale, Angela; Ceder, Sophia; Singh, Swarnima; Williams, Caitlin; Soplop, Nadine; Uryu, Kunihiro; Pharmer, Lindsay; King, Tari; Bojmar, Linda; Davies, Alexander E; Ararso, Yonathan; Zhang, Tuo; Zhang, Haiying; Hernandez, Jonathan; Weiss, Joshua M; Dumont-Cole, Vanessa D; Kramer, Kimberly; Wexler, Leonard H; Narendran, Aru; Schwartz, Gary K; Healey, John H; Sandstrom, Per; Labori, Knut Jørgen; Kure, Elin H; Grandgenett, Paul M; Hollingsworth, Michael A; de Sousa, Maria; Kaur, Sukhwinder; Jain, Maneesh; Mallya, Kavita; Batra, Surinder K; Jarnagin, William R; Brady, Mary S; Fodstad, Oystein; Muller, Volkmar; Pantel, Klaus; Minn, Andy J; Bissell, Mina J; Garcia, Benjamin A; Kang, Yibin; Rajasekhar, Vinagolu K; Ghajar, Cyrus M; Matei, Irina; Peinado, Hector; Bromberg, Jacqueline; Lyden, David


    Ever since Stephen Paget's 1889 hypothesis, metastatic organotropism has remained one of cancer's greatest mysteries. Here we demonstrate that exosomes from mouse and human lung-, liver- and brain-tropic tumour cells fuse preferentially with resident cells at their predicted destination, namely lung fibroblasts and epithelial cells, liver Kupffer cells and brain endothelial cells. We show that tumour-derived exosomes uptaken by organ-specific cells prepare the pre-metastatic niche. Treatment with exosomes from lung-tropic models redirected the metastasis of bone-tropic tumour cells. Exosome proteomics revealed distinct integrin expression patterns, in which the exosomal integrins α6β4 and α6β1 were associated with lung metastasis, while exosomal integrin αvβ5 was linked to liver metastasis. Targeting the integrins α6β4 and αvβ5 decreased exosome uptake, as well as lung and liver metastasis, respectively. We demonstrate that exosome integrin uptake by resident cells activates Src phosphorylation and pro-inflammatory S100 gene expression. Finally, our clinical data indicate that exosomal integrins could be used to predict organ-specific metastasis.

  6. [Epidemiology and risk factors of testicular tumours]. (United States)

    Kozłowski, Piotr; Starosławska, Elżbieta; Szumiło, Justyna; Jankiewicz, Małgorzata; Kozłowska, Magdalena; Burdan, Franciszek


    Testicular tumours are rare neoplasms, which most commonly affects men aged 25 to 35 years. Among young adult males it is the most common cause of testicular swelling. In recent decades, the number of cases of testicular tumours has greatly increased. The most significant predisposing factors are cryptorchidism and some endocrine disorders, especially increased levels of gonadotropins and female sex hormones. Testicular trauma, inguinal hernia, extreme values of body mass index (BMI), high-calorie diet rich in dairy products as well as high social status are also regarded as risk factors. Furthermore, some chromosomal abnormalities like increased number of chromosomes 7, 8. 12, 21 and X, loss of chromosomes 4, 5, 11, 13, 18, or Y, mutation in the gene Xq27; as well as multiplied copy of the gene i(12p) are associated with tumor development. It has been proven that high testosterone levels and regular physical activity may prevent testicular tumours. Since one of the first sign the lesion is often a lump or swelling of the testis and the appearance of abnormal structure in the scrotum routine testicular self-examination seems to be important in early detection. In all suspected cases an immediate ultrasound examination of both testicles is highly recommended. It is also advised to conduct a computerized tomography (CT) and a positron emission tomography (PET) scan for staging of the tumor to select the best mode of treatment.

  7. Imatinib treatment for gastrointestinal stromal tumour (GIST). (United States)

    Lopes, Lisandro F; Bacchi, Carlos E


    Gastrointestinal stromal tumour (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. GISTs are believed to originate from intersticial cells of Cajal (the pacemaker cells of the gastrointestinal tract) or related stem cells, and are characterized by KIT or platelet-derived growth factor receptor alpha (PDGFRA) activating mutations. The use of imatinib has revolutionized the management of GIST and altered its natural history, substantially improving survival time and delaying disease progression in many patients. The success of imatinib in controlling advanced GIST led to interest in the neoadjuvant and adjuvant use of the drug. The neoadjuvant (preoperative) use of imatinib is recommended to facilitate resection and avoid mutilating surgery by decreasing tumour size, and adjuvant therapy is indicated for patients at high risk of recurrence. The molecular characterization (genotyping) of GISTs has become an essential part of the routine management of the disease as KIT and PDGFRA mutation status predicts the likelihood of achieving response to imatinib. However, the vast majority of patients who initially responded to imatinib will develop tumour progression (secondary resistance). Secondary resistance is often related to secondary KIT or PDGFRA mutations that interfere with drug binding. Multiple novel tyrosine kinase inhibitors may be potentially useful for the treatment of imatinib-resistant GISTs as they interfere with KIT and PDGFRA receptors or with the downstream-signalling proteins.

  8. Role of liver nerves and adrenal medulla in glucose turnover of running rats

    DEFF Research Database (Denmark)

    Sonne, B; Mikines, K J; Richter, Erik;


    Sympathetic control of glucose turnover was studied in rats running 35 min at 21 m X min-1 on the level. The rats were surgically liver denervated, adrenodemedullated, or sham operated. Glucose turnover was measured by primed constant infusion of [3-3H]glucose. At rest, the three groups had ident...... and duration, hepatic glycogenolysis and glucose production are not influenced by the autonomic liver nerves but are enhanced by circulating epinephrine....

  9. The natural history of disappearing bone tumours and tumour-like conditions

    Energy Technology Data Exchange (ETDEWEB)

    Yanagawa, Takashi; Watanabe, Hideomi; Shinozaki, Tetsuya; Ahmed, Adel Refaat; Shirakura, Kenji; Takagishi, Kenji


    We describe 27 cases of bone tumours or tumour-like lesions where there was spontaneous regression. The follow-up period was 2.8-16.7 years (average, 7.0 years). Fourteen of these cases were no longer visible on plain radiographs. Histological diagnosis included exostosis, eosinophilic granuloma, fibrous dysplasia, fibrous cortical defect, non-ossifying fibroma, osteoid osteoma and bone island. Most cases began to reduce in adolescence or earlier, although sclerotic type lesions showed their regression in older patients. All lesions thought to be eosinophilic granuloma began to regress after periods of less than 3 months, while the duration of the other lesions showed wide variation (1-74 months). As resolution of the lesions took between 2 and 79 months (mean, 25.0 {+-} 20.3 months) we consider that the most likely mechanism was recovery of normal skeletal growth control. In exostosis with fracture, alteration of vascular supply may contribute to growth arrest, but not to subsequent remodelling stage. In inflammatory-related lesions such as eosinophilic granuloma, cessation of inflammation may be the mechanism of growth arrest, whilst temporary inflammation may stimulate osteogenic cells engaged in remodeling. In the sclerotic type, growth arrest is a less probable mechanism. Necrosis within the tumour and/or local changes in hormonal control, plus remodelling of the sclerotic area takes longer. Knowledge of the potential for spontaneous resolution may help in management of these tumour and tumour-like lesions of bone. Yanagawa, T. et al. (2001)

  10. Evaluating the agreement between tumour volumetry and the estimated volumes of tumour lesions using an algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Laubender, Ruediger P. [German Cancer Consortium (DKTK), Heidelberg (Germany); University Hospital Munich - Campus Grosshadern, Institute of Medical Informatics, Biometry, and Epidemiology (IBE), Munich (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany); Lynghjem, Julia; D' Anastasi, Melvin; Graser, Anno [University Hospital Munich - Campus Grosshadern, Institute for Clinical Radiology, Munich (Germany); Heinemann, Volker; Modest, Dominik P. [University Hospital Munich - Campus Grosshadern, Department of Medical Oncology, Munich (Germany); Mansmann, Ulrich R. [University Hospital Munich - Campus Grosshadern, Institute of Medical Informatics, Biometry, and Epidemiology (IBE), Munich (Germany); Sartorius, Ute; Schlichting, Michael [Merck KGaA, Darmstadt (Germany)


    To evaluate the agreement between tumour volume derived from semiautomated volumetry (SaV) and tumor volume defined by spherical volume using longest lesion diameter (LD) according to Response Evaluation Criteria In Solid Tumors (RECIST) or ellipsoid volume using LD and longest orthogonal diameter (LOD) according to World Health Organization (WHO) criteria. Twenty patients with metastatic colorectal cancer from the CIOX trial were included. A total of 151 target lesions were defined by baseline computed tomography and followed until disease progression. All assessments were performed by a single reader. A variance component model was used to compare the three volume versions. There was a significant difference between the SaV and RECIST-based tumour volumes. The same model showed no significant difference between the SaV and WHO-based volumes. Scatter plots showed that the RECIST-based volumes overestimate lesion volume. The agreement between the SaV and WHO-based relative changes in tumour volume, evaluated by intraclass correlation, showed nearly perfect agreement. Estimating the volume of metastatic lesions using both the LD and LOD (WHO) is more accurate than those based on LD only (RECIST), which overestimates lesion volume. The good agreement between the SaV and WHO-based relative changes in tumour volume enables a reasonable approximation of three-dimensional tumour burden. (orig.)

  11. Adipose derived stem cells and nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Alessandro Faroni; Richard JP Smith; Adam J Reid


    Injuries to peripheral nerves are common and cause life-changing problems for patients along-side high social and health care costs for society. Current clinical treatment of peripheral nerve injuries predominantly relies on sacriifcing a section of nerve from elsewhere in the body to pro-vide a graft at the injury site. Much work has been done to develop a bioengineered nerve graft, precluding sacriifce of a functional nerve. Stem cells are prime candidates as accelerators of re-generation in these nerve grafts. This review examines the potential of adipose-derived stem cells to improve nerve repair assisted by bioengineered nerve grafts.

  12. Nanofibrous nerve conduit-enhanced peripheral nerve regeneration. (United States)

    Jiang, Xu; Mi, Ruifa; Hoke, Ahmet; Chew, Sing Yian


    Fibre structures represent a potential class of materials for the formation of synthetic nerve conduits due to their biomimicking architecture. Although the advantages of fibres in enhancing nerve regeneration have been demonstrated, in vivo evaluation of fibre size effect on nerve regeneration remains limited. In this study, we analyzed the effects of fibre diameter of electrospun conduits on peripheral nerve regeneration across a 15-mm critical defect gap in a rat sciatic nerve injury model. By using an electrospinning technique, fibrous conduits comprised of aligned electrospun poly (ε-caprolactone) (PCL) microfibers (981 ± 83 nm, Microfiber) or nanofibers (251 ± 32 nm, Nanofiber) were obtained. At three months post implantation, axons regenerated across the defect gap in all animals that received fibrous conduits. In contrast, complete nerve regeneration was not observed in the control group that received empty, non-porous PCL film conduits (Film). Nanofiber conduits resulted in significantly higher total number of myelinated axons and thicker myelin sheaths compared to Microfiber and Film conduits. Retrograde labeling revealed a significant increase in number of regenerated dorsal root ganglion sensory neurons in the presence of Nanofiber conduits (1.93 ± 0.71 × 10(3) vs. 0.98 ± 0.30 × 10(3) in Microfiber, p regeneration. These results could provide useful insights for future nerve guide designs.

  13. Autonomous underwater riser inspection tool

    Energy Technology Data Exchange (ETDEWEB)

    Camerini, Claudio; Marnet, Robson [Petrobras SA, (Brazil); Freitas, Miguel; Von der Weid, Jean Pierre [CPTI/PUC-Rio, Rio de Janeiro, (Brazil); Artigas Lander, Ricardo [EngeMOVI, Curitiba, (Brazil)


    The detection of damage on the riser is a serious concern for pipeline companies. Visual examinations by remotely operated vehicle (ROV) are presently carried out to detect the defects but this process has limitations and is expensive. This paper presents the development of a new tool to ensure autonomous underwater riser inspection (AURI) that uses the riser itself for guidance. The AURI, which is autonomous in terms of control and power supply, is equipped with several cameras that perform a complete visual inspection of the riser with 100 % coverage of the external surface of the riser. The paper presents the detailed characteristics of the first AURI prototype, describes its launching procedure and provides the preliminary test results from pool testing. The results showed that the AURI is a viable system for autonomous riser inspection. Offshore tests on riser pipelines are scheduled to be performed shortly.

  14. Nanoparticle-blood interactions: the implications on solid tumour targeting. (United States)

    Lazarovits, James; Chen, Yih Yang; Sykes, Edward A; Chan, Warren C W


    Nanoparticles are suitable platforms for cancer targeting and diagnostic applications. Typically, less than 10% of all systemically administered nanoparticles accumulate in the tumour. Here we explore the interactions of blood components with nanoparticles and describe how these interactions influence solid tumour targeting. In the blood, serum proteins adsorb onto nanoparticles to form a protein corona in a manner dependent on nanoparticle physicochemical properties. These serum proteins can block nanoparticle tumour targeting ligands from binding to tumour cell receptors. Additionally, serum proteins can also encourage nanoparticle uptake by macrophages, which decreases nanoparticle availability in the blood and limits tumour accumulation. The formation of this protein corona will also increase the nanoparticle hydrodynamic size or induce aggregation, which makes nanoparticles too large to enter into the tumour through pores of the leaky vessels, and prevents their deep penetration into tumours for cell targeting. Recent studies have focused on developing new chemical strategies to reduce or eliminate serum protein adsorption, and rescue the targeting potential of nanoparticles to tumour cells. An in-depth and complete understanding of nanoparticle-blood interactions is key to designing nanoparticles with optimal physicochemical properties with high tumour accumulation. The purpose of this review article is to describe how the protein corona alters the targeting of nanoparticles to solid tumours and explains current solutions to solve this problem.

  15. Discrimination of paediatric brain tumours using apparent diffusion coefficient histograms

    Energy Technology Data Exchange (ETDEWEB)

    Bull, Jonathan G.; Clark, Christopher A. [UCL Institute of Child Health, Imaging and Biophysics Unit, London (United Kingdom); Saunders, Dawn E. [Great Ormond Street Hospital for Children NHS Trust, Department of Radiology, London (United Kingdom)


    To determine if histograms of apparent diffusion coefficients (ADC) can be used to differentiate paediatric brain tumours. Imaging of histologically confirmed tumours with pre-operative ADC maps were reviewed (54 cases, 32 male, mean age 6.1 years; range 0.1-15.8 years) comprising 6 groups. Whole tumour ADC histograms were calculated; normalised for volume. Stepwise logistic regression analysis was used to differentiate tumour types using histogram metrics, initially for all groups and then for specific subsets. All 6 groups (5 dysembryoplastic neuroectodermal tumours, 22 primitive neuroectodermal tumours (PNET), 5 ependymomas, 7 choroid plexus papillomas, 4 atypical teratoid rhabdoid tumours (ATRT) and 9 juvenile pilocytic astrocytomas (JPA)) were compared. 74% (40/54) were correctly classified using logistic regression of ADC histogram parameters. In the analysis of posterior fossa tumours, 80% of ependymomas, 100% of astrocytomas and 94% of PNET-medulloblastoma were classified correctly. All PNETs were discriminated from ATRTs (22 PNET and 4 supratentorial ATRTs) (100%). ADC histograms are useful in differentiating paediatric brain tumours, in particular, the common posterior fossa tumours of childhood. PNETs were differentiated from supratentorial ATRTs, in all cases, which has important implications in terms of clinical management. (orig.)

  16. Gas House Autonomous System Monitoring (United States)

    Miller, Luke; Edsall, Ashley


    Gas House Autonomous System Monitoring (GHASM) will employ Integrated System Health Monitoring (ISHM) of cryogenic fluids in the High Pressure Gas Facility at Stennis Space Center. The preliminary focus of development incorporates the passive monitoring and eventual commanding of the Nitrogen System. ISHM offers generic system awareness, adept at using concepts rather than specific error cases. As an enabler for autonomy, ISHM provides capabilities inclusive of anomaly detection, diagnosis, and abnormality prediction. Advancing ISHM and Autonomous Operation functional capabilities enhances quality of data, optimizes safety, improves cost effectiveness, and has direct benefits to a wide spectrum of aerospace applications.

  17. The Bering Autonomous Target Detection

    DEFF Research Database (Denmark)

    Jørgensen, John Leif; Denver, Troelz; Betto, Maurizio


    An autonomous asteroid target detection and tracking method has been developed. The method features near omnidirectionality and focus on high speed operations and completeness of search of the near space rather than the traditional faint object search methods, employed presently at the larger...... telescopes. The method has proven robust in operation and is well suited for use onboard spacecraft. As development target for the method and the associated instrumentation the asteroid research mission Bering has been used. Onboard a spacecraft, the autonomous detection is centered around the fully...

  18. Discerning non-autonomous dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Clemson, Philip T.; Stefanovska, Aneta, E-mail:


    Structure and function go hand in hand. However, while a complex structure can be relatively safely broken down into the minutest parts, and technology is now delving into nanoscales, the function of complex systems requires a completely different approach. Here the complexity clearly arises from nonlinear interactions, which prevents us from obtaining a realistic description of a system by dissecting it into its structural component parts. At best, the result of such investigations does not substantially add to our understanding or at worst it can even be misleading. Not surprisingly, the dynamics of complex systems, facilitated by increasing computational efficiency, is now readily tackled in the case of measured time series. Moreover, time series can now be collected in practically every branch of science and in any structural scale—from protein dynamics in a living cell to data collected in astrophysics or even via social networks. In searching for deterministic patterns in such data we are limited by the fact that no complex system in the real world is autonomous. Hence, as an alternative to the stochastic approach that is predominantly applied to data from inherently non-autonomous complex systems, theory and methods specifically tailored to non-autonomous systems are needed. Indeed, in the last decade we have faced a huge advance in mathematical methods, including the introduction of pullback attractors, as well as time series methods that cope with the most important characteristic of non-autonomous systems—their time-dependent behaviour. Here we review current methods for the analysis of non-autonomous dynamics including those for extracting properties of interactions and the direction of couplings. We illustrate each method by applying it to three sets of systems typical for chaotic, stochastic and non-autonomous behaviour. For the chaotic class we select the Lorenz system, for the stochastic the noise-forced Duffing system and for the non-autonomous

  19. Discerning non-autonomous dynamics (United States)

    Clemson, Philip T.; Stefanovska, Aneta


    Structure and function go hand in hand. However, while a complex structure can be relatively safely broken down into the minutest parts, and technology is now delving into nanoscales, the function of complex systems requires a completely different approach. Here the complexity clearly arises from nonlinear interactions, which prevents us from obtaining a realistic description of a system by dissecting it into its structural component parts. At best, the result of such investigations does not substantially add to our understanding or at worst it can even be misleading. Not surprisingly, the dynamics of complex systems, facilitated by increasing computational efficiency, is now readily tackled in the case of measured time series. Moreover, time series can now be collected in practically every branch of science and in any structural scale-from protein dynamics in a living cell to data collected in astrophysics or even via social networks. In searching for deterministic patterns in such data we are limited by the fact that no complex system in the real world is autonomous. Hence, as an alternative to the stochastic approach that is predominantly applied to data from inherently non-autonomous complex systems, theory and methods specifically tailored to non-autonomous systems are needed. Indeed, in the last decade we have faced a huge advance in mathematical methods, including the introduction of pullback attractors, as well as time series methods that cope with the most important characteristic of non-autonomous systems-their time-dependent behaviour. Here we review current methods for the analysis of non-autonomous dynamics including those for extracting properties of interactions and the direction of couplings. We illustrate each method by applying it to three sets of systems typical for chaotic, stochastic and non-autonomous behaviour. For the chaotic class we select the Lorenz system, for the stochastic the noise-forced Duffing system and for the non-autonomous the

  20. Does the autonomic nervous system contribute to the initiation and progression of prostate cancer? (United States)

    Ventura, Sabatino; Evans, Bronwyn A


    In the July 12 issue of Science magazine, researchers from the Albert Einstein College of Medicine, the Mount Sinai School of Medicine, the Durham VA Medical Centre and Duke University published an elegant study demonstrating that the sympathetic nervous system, acting through β2 and β3-adrenoceptors in the prostate, plays an important role in the initiation of prostate cancer, while the parasympathetic nervous system plays a role in the dissemination of tumour metastases via M1 muscarinic receptors. These findings are significant because they indicate that receptors associated with the autonomic nervous system may be viable targets for prostate cancer therapy.

  1. Epstein-Barr virus-associated smooth muscle tumour presenting as a parasagittal brain tumour. (United States)

    Ibebuike, K E; Pather, S; Emereole, O; Ndolo, P; Kajee, A; Gopal, R; Naidoo, S


    Dural-based brain tumours, apart from meningiomas, are rare. Epstein-Barr virus (EBV)-associated smooth muscle tumor (SMT) is a documented but rare disease that occurs in immunocompromized patients. These tumours may be located at unusual sites including the brain. We present a 37-year-old patient, positive for the human immunodeficiency virus (HIV), who was admitted after generalized tonic-clonic seizures. MRI and CT scan revealed a dural-based brain tumour, intraoperatively thought to be a meningioma, but with an eventual histological diagnosis of EBV-SMT. Clinically the patient was well postoperatively with a Glasgow coma scale score of 15/15 and no focal neurologic deficit. This case confirms the association between EBV and SMT in patients with HIV/acquired immunodeficiency syndrome (AIDS). It also highlights the need to include EBV-SMT in the differential diagnosis of intracranial mass lesions in patients with HIV/AIDS.

  2. Sensory nerve conduction studies in neuralgic amyotrophy. (United States)

    van Alfen, Nens; Huisman, Willem J; Overeem, S; van Engelen, B G M; Zwarts, M J


    Neuralgic amyotrophy is a painful, episodic peripheral nerve disorder localized to the brachial plexus. Sensory symptoms occur in 80% of the patients. We assessed the frequency of abnormalities in sensory nerve conduction studies of the lateral and medial antebrachial cutaneous, radial sensory, median sensory, and ulnar sensory nerves in 112 patients. Sensory nerve conduction studies showed abnormalities in nerves, even when the nerve was clinically affected. The lateral and medial antebrachial cutaneous nerves were most often abnormal, in 15% and 17% of nerves. No correlation with the presence or localization of clinical deficits was found. Brachial plexus sensory nerve conduction studies seem to be of little diagnostic value in neuralgic amyotrophy. Our findings also indicate that some sensory lesions may be in the nerve roots instead of the plexus. An examination of normal sensory nerve conduction studies does not preclude neuralgic amyotrophy as a diagnosis.

  3. Autonomic dysfunction in cirrhosis and portal hypertension

    DEFF Research Database (Denmark)

    Dümcke, Christine Winkler; Møller, Søren


    Liver cirrhosis and portal hypertension are frequently associated with signs of circulatory dysfunction and peripheral polyneuropathy, which includes defects of the autonomic nervous system. Autonomic dysfunction, which is seen in both alcoholic and non-alcoholic liver cirrhosis and increases...

  4. Platelet-activating factor receptor (PAF-R-dependent pathways control tumour growth and tumour response to chemotherapy

    Directory of Open Access Journals (Sweden)

    Rohde Ciro BS


    Full Text Available Abstract Background Phagocytosis of apoptotic cells by macrophages induces a suppressor phenotype. Previous data from our group suggested that this occurs via Platelet-activating factor receptor (PAF-R-mediated pathways. In the present study, we investigated the impact of apoptotic cell inoculation or induction by a chemotherapeutic agent (dacarbazine, DTIC on tumour growth, microenvironmental parameters and survival, and the effect of treatment with a PAF-R antagonist (WEB2170. These studies were performed in murine tumours: Ehrlich Ascitis Tumour (EAT and B16F10 melanoma. Methods Tumour growth was assessed by direct counting of EAT cells in the ascitis or by measuring the volume of the solid tumour. Parameters of the tumour microenvironment, such as the frequency of cells expressing cyclo-oxygenase-2 (COX-2, caspase-3 and galectin-3, and microvascular density, were determined by immunohistochemistry. Levels of vascular endothelium growth factor (VEGF and prostaglandin E2 (PGE2 were determined by ELISA, and levels of nitric oxide (NO by Griess reaction. PAF-R expression was analysed by immunohistochemistry and flow cytometry. Results Inoculation of apoptotic cells before EAT implantation stimulated tumour growth. This effect was reversed by in vivo pre-treatment with WEB2170. This treatment also reduced tumour growth and modified the microenvironment by reducing PGE2, VEGF and NO production. In B16F10 melanoma, WEB2170 alone or in association with DTIC significantly reduced tumour volume. Survival of the tumour-bearing mice was not affected by WEB2170 treatment but was significantly improved by the combination of DTIC with WEB2170. Tumour microenvironment elements were among the targets of the combination therapy since the relative frequency of COX-2 and galectin-3 positive cells and the microvascular density within the tumour mass were significantly reduced by treatment with WEB2170 or DTIC alone or in combination. Antibodies to PAF-R stained

  5. Intracranial melanocytic meningeal tumours and melanosis oculi: case report and literature review

    Directory of Open Access Journals (Sweden)

    Doglietto Francesco


    Full Text Available Abstract Background Melanocytic meningeal tumours are rare extra-axial neoplasms of the nervous system, with only three reported cases in the cavernous sinus. Herein we describe for the first time the association of ocular melanosis and multiple intracranial melanocytic meningeal tumours, with the presenting lesion being in the cavernous sinus. The importance of this association is discussed together with the diagnostic and therapeutic challenges of the case. Case presentation A 20-year-old man presented with a left sixth cranial nerve deficit; general examination documented only congenital melanosis of the homolateral eye. MRI examination showed a space occupying lesion in the left cavernous sinus, which was followed conservatively for 2 years, until a new space occupying lesion was evident at the level of the right frontal convexity: both lesions presented with neuroradiological characteristics suggestive of melanin content. The frontal convexity lesion was removed: intraoperatively the dura was markedly and diffusely melanotic. Histological examination documented a melanocytic meningeal tumour, with a proliferative index of 3 %. The patient underwent 3D-Conformal Radiation Therapy on the lesion of the cavernous sinus (total dose 5040 cGy, with initial tumour reduction. Three years later, due to a symptomatic growth, he underwent partial removal of the lesion in the cavernous sinus. Histological examination was unchanged. He then received adjuvant Temozolomide with Low Dose Fractionated Radiation Therapy (LD-FRT. Due to further disease progression cisplatin plus fotemustine were administered, concomitant with LD-FRT: after two cycles MRI documented significant disease regression. After a period of apparent disease control, the patient presented with persistent cough and evidence of multiple thoracic metastases, which lead to his death, seven years after presentation. Conclusions Intracranial melanocytic meningeal tumours are challenging

  6. Functional assessment of sciatic nerve reconstruction : Biodegradable poly (DLLA-epsilon-CL) nerve guides versus autologous nerve grafts

    NARCIS (Netherlands)

    Meek, MF; Dijkstra, [No Value; Den Dunnen, WFA; Ijkema-Paassen, J; Schakenraad, JM; Gramsbergen, A; Robinson, PH


    The aim of this study was to compare functional nerve recovery after reconstruction with a biodegradable p(DLLA-epsilon-CL) nerve guide filled with modified denatured muscle tissue (MDMT), or an autologous nerve graft. We evaluated nerve recovery using walking track analysis (measurement of the scia

  7. Sensory nerve function and auto-mutilation after reconstruction of various gap lengths with nerve guides and autologous nerve grafts

    NARCIS (Netherlands)

    den Dunnen, WFA; Meek, MF


    The aim of this study was to evaluate sensory nerve recovery and auto-mutilation after reconstruction of various lengths of nerve gaps in the sciatic nerve of the rat, using different techniques. Group 4, in which the longest nerve gap (15 mm) was reconstructed with a thin-walled p(DL-lactide-y-capr


    Directory of Open Access Journals (Sweden)



    Full Text Available CONTEXT Bronchial asthma is a chronic inflammatory disorder of the airways affecting people of all ages. It is manifested physiologically by a wide spread narrowing of the air passages , which may be relieved spontaneously or as a result of therapy and clinically by paroxysms of dyspnea , cough and wheezing. Airways are richly innervated by autonomic nervous system which plays a part in the control and their secretion. They regulate many aspects of airw ays’ physiology such as smooth muscle , mucus secretions , blood flow , micro vascular permeability and the migration and release of inflammatory cells. These effects are due to the release of neurotransmitters from autonomic nerves. MATERIAL AND METHODS: The present work was undertaken in 50 cases of bronchial asthma attending medical OPD and indoor and they were randomly selected without any bias of age and sex. Criteria for grading of severity of asthma were determined by clinical & Peak expiratory Flow Rat e [PEFR]. A complete general and systemic examination was carried out and they were specifically examined in detail for signs of autonomic dysfunction employing the standard “Ewing - Clarke” battery of five tests for cardiovascular autonomic functions. Three tests were used for parasympathetic function - 1.Heart rate response to Valsalva maneuver 2. Heart rate variation during deep breathing 3. Immediate Heart rate response to standing . And two tests were used for sympathetic function - 1. Blood pressure respon se to standing 2.Blood pressure response to sustained handgrip . OBSERVATIONS: In the present study , 32 patients (64% were tested positive for autonomic dysfunction out of 50 cases. Maximum number of cases 17(94.44% out of 18 with autonomic dysfunction had severe asthma. 15(46.87% out of 32 cases with autonomic dysfunction had mild - moderate asthma. Thus there was an increase in autonomic dysfunction with increased severity of asthma (p<0.001 highly significant. CONCLUSION

  9. Neuroprotective Effect of Natural Products on Peripheral Nerve Degeneration: A Systematic Review. (United States)

    Araújo-Filho, Heitor G; Quintans-Júnior, Lucindo J; Barreto, André S; Almeida, Jackson R G S; Barreto, Rosana S S; Quintans, Jullyana S S


    Peripheral nerve injury (PNI) is a serious public health problem that is linked with motor, sensory and autonomic deficits. Given the fact that this type of disorder leads to a decreased quality of life in most patients and adherence of available drugs is limited and have adverse effects, we investigated the efficacy of natural products in a PNI model. The search terms plants, medicinal, nerve regeneration, nerve crush, sciatic nerve as well as MeSH terms or free-text words were used to retrieve English language articles in PubMed, Scopus, Web of Science and LILACS published until July 2015. After sciatic nerve crush, natural products have improved significantly motor performance, sensory function and electrical conductance measured over weeks. Among the pharmacological targets suggested by the action of natural products, there were citations on the activation of the antiapoptotic signaling pathway, modulation in the expression of pro-inflammatory cytokines and neurotrophic factors. The systematic review provides scientific evidence that natural products are pharmacologically effective in the treatment of PNI such as sciatic nerve crush.

  10. Schwannomatosis of the sciatic nerve

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Tetsuji; Maruyama, Shigeki; Mizuno, Kosaku [Dept. of Orthopaedic Surgery, Kobe University School of Medicine (Japan)


    A 52-year-old woman with schwannomatosis in the left sciatic nerve is presented. The patient had no stigmata of neurofibromatosis (NF) type 1 or 2. Cutaneous or spinal schwannomas were not detected. Magnetic resonance (MR) imaging of the sciatic nerve revealed more than 15 tumors along the course of the nerve. Histological examination revealed schwannomas consisting of Antoni A and B areas. Immunohistochemical study showed most cells reacting intensely for S-100 protein. The patient underwent conservative follow-up treatment due to the minimal symptoms. The relationship of the disease with NF-2 and plexiform schwannoma is discussed. (orig.)

  11. Pulsation-limited oxygen diffusion in the tumour microenvironment (United States)

    Milotti, Edoardo; Stella, Sabrina; Chignola, Roberto


    Hypoxia is central to tumour evolution, growth, invasion and metastasis. Mathematical models of hypoxia based on reaction-diffusion equations provide seemingly incomplete descriptions as they fail to predict the measured oxygen concentrations in the tumour microenvironment. In an attempt to explain the discrepancies, we consider both the inhomogeneous distribution of oxygen-consuming cells in solid tumours and the dynamics of blood flow in the tumour microcirculation. We find that the low-frequency oscillations play an important role in the establishment of tumour hypoxia. The oscillations interact with consumption to inhibit oxygen diffusion in the microenvironment. This suggests that alpha-blockers–a class of drugs used to treat hypertension and stress disorders, and known to lower or even abolish low-frequency oscillations of arterial blood flow –may act as adjuvant drugs in the radiotherapy of solid tumours by enhancing the oxygen effect.

  12. Autonomous Duffing-Holmes Type Chaotic Oscillator

    DEFF Research Database (Denmark)

    Tamaševičius, A.; Bumelienė, S.; Kirvaitis, R.


    We have designed and built a novel Duffing type autonomous 3rd-order chaotic oscillator. In comparison with the common non-autonomous DuffingHolmes type oscillator the autonomous circuit has an internal positive feedback loop instead of an external periodic drive source. In addition...

  13. CAAD: Computer Architecture for Autonomous Driving


    Liu, Shaoshan; Tang, Jie; Zhang, Zhe; Gaudiot, Jean-Luc


    We describe the computing tasks involved in autonomous driving, examine existing autonomous driving computing platform implementations. To enable autonomous driving, the computing stack needs to simultaneously provide high performance, low power consumption, and low thermal dissipation, at low cost. We discuss possible approaches to design computing platforms that will meet these needs.

  14. New insights into the pathology of Parkinson's disease: does the peripheral autonomic system become central? (United States)

    Probst, A; Bloch, A; Tolnay, M


    Recent studies in aged, neurologically unimpaired subjects have pointed to a specific induction site of the pathological process of Parkinson's disease (PD) in the region of the dorsal glossopharyngeus-vagus complex as well as in the anterior olfactory nucleus. From the lower brainstem, the disease process would then pursue an ascending course and involve more rostral brainstem areas, limbic structures, and eventually the cerebral cortex. One barrier to the acceptance of the caudal medullary structures as the induction site of PD pathology is that not all parts of the nervous system have been investigated for the presence of PD-associated lesions in cases of early asymptomatic PD. Using alpha-synuclein immunostaining, we investigated the brain, the sacral, and thoracic autonomic nuclei of the spinal cord as well as several components of the peripheral autonomic nervous system in a autopsy cohort of 98 neurologically unimpaired subjects aged 64 or more. Our data indicate that the autonomic nuclei of the spinal cord and the peripheral autonomic nervous system belong to the most constantly and earliest affected regions next to medullary structures and the olfactory nerves in neurologically unimpaired older individuals, thus providing a pathological basis for early premotor autonomic dysfunctions at a prodromal stage of PD.

  15. Objects as Temporary Autonomous Zones

    Directory of Open Access Journals (Sweden)

    Tim Morton


    Full Text Available From Hakim Bey's instructions on creating temporary autonomous zones we see an oscillation "between performance art and politics, circus clowning and revolution." In this essay Tim Morton discusses anarchist politics as, "the creation of fresh objects in a reality without a top or a bottom object, or for that matter a middle object."

  16. Objects as Temporary Autonomous Zones


    Tim Morton


    From Hakim Bey's instructions on creating temporary autonomous zones we see an oscillation "between performance art and politics, circus clowning and revolution." In this essay Tim Morton discusses anarchist politics as, "the creation of fresh objects in a reality without a top or a bottom object, or for that matter a middle object."

  17. Hazard Map for Autonomous Navigation

    DEFF Research Database (Denmark)

    Riis, Troels

    This dissertation describes the work performed in the area of using image analysis in the process of landing a spacecraft autonomously and safely on the surface of the Moon. This is suggested to be done using a Hazard Map. The correspondence problem between several Hazard Maps are investigated fu...

  18. Autonomous vertical profiler data management

    Digital Repository Service at National Institute of Oceanography (India)

    Afzulpurkar, S.; Navelkar, G.S.; Desa, E.S.; Madhan, R.; Dabholkar, N; Prabhudesai, S.P.; Mascarenhas, A.A

    The Autonomous Vertical Profiler (AVP), developed at NIO [1] [2], collects position and water column data over a period of 3 days and transmits through a satellite modem which is collated and stored on a PC. Data includes GPS positions, water column...

  19. Designing Assessment for Autonomous Learning (United States)

    Hay, Marie; Mathers, Lucy


    This paper aims to disseminate and evaluate an autonomous learning framework developed through collaborative research with first- and second-year undergraduate students at De Montfort University. Central to the framework is the involvement of students in the assessment of their peers and themselves using dialogue about the assessment and feedback…

  20. Computing architecture for autonomous microgrids (United States)

    Goldsmith, Steven Y.


    A computing architecture that facilitates autonomously controlling operations of a microgrid is described herein. A microgrid network includes numerous computing devices that execute intelligent agents, each of which is assigned to a particular entity (load, source, storage device, or switch) in the microgrid. The intelligent agents can execute in accordance with predefined protocols to collectively perform computations that facilitate uninterrupted control of the .

  1. Autonomic dysreflexia: a medical emergency (United States)

    Bycroft, J; Shergill, I; Choong, E; Arya, N; Shah, P


    Autonomic dysreflexia is an important clinical diagnosis that requires prompt treatment to avoid devastating complications. The condition may present itself to all members of medical and surgical specialties, who may not be accustomed to treating it. It is the clinician's responsibility to have a basic understanding of the pathophysiology of the condition and the simple steps required to treat it. PMID:15811886

  2. Trigeminal autonomic cephalalgia as a presenting feature of Neuromyelitis Optica: "A rare combination of two uncommon disorders". (United States)

    Mathew, Thomas; Nadimpally, Uday Shanker; Sarma, G R K; Nadig, Raghunandan


    Neuromyelitis Optica (NMO) can have atypical presentations like hiccups, vomiting, etc. which is classically described as the area postrema syndrome. Here we report a case of a 39 year old male patient who presented with features of Trigeminal Autonomic Cephalalgia (TAC). MRI spine showed long segment myelitis. Diagnosis of NMO was confirmed by a positive Anti aquaporin 4 antibody assay. TACs are a rare group of headache disorders characterized by severe unilateral headache in the V1 distribution of the trigeminal nerve and autonomic symptoms. This presentation in NMO is hitherto unreported in literature.

  3. Neurodevelopment. Parasympathetic neurons originate from nerve-associated peripheral glial progenitors. (United States)

    Dyachuk, Vyacheslav; Furlan, Alessandro; Shahidi, Maryam Khatibi; Giovenco, Marcela; Kaukua, Nina; Konstantinidou, Chrysoula; Pachnis, Vassilis; Memic, Fatima; Marklund, Ulrika; Müller, Thomas; Birchmeier, Carmen; Fried, Kaj; Ernfors, Patrik; Adameyko, Igor


    The peripheral autonomic nervous system reaches far throughout the body and includes neurons of diverse functions, such as sympathetic and parasympathetic. We show that the parasympathetic system in mice--including trunk ganglia and the cranial ciliary, pterygopalatine, lingual, submandibular, and otic ganglia--arise from glial cells in nerves, not neural crest cells. The parasympathetic fate is induced in nerve-associated Schwann cell precursors at distal peripheral sites. We used multicolor Cre-reporter lineage tracing to show that most of these neurons arise from bi-potent progenitors that generate both glia and neurons. This nerve origin places cellular elements for generating parasympathetic neurons in diverse tissues and organs, which may enable wiring of the developing parasympathetic nervous system.

  4. Stroma and extracellular matrix proteins in canine tumours



    In this thesis, studies on temporal and spatial changes in stromal cells and extracellular matrix (ECM) molecules in canine gastrointestinal (GIT) tumours and canine transmissible venereal (CTVT) tumours are described. The mechanisms involved in the phenotypic transformation of fibroblasts to myofibroblasts, and ECM changes were investigated. We found that the myofibroblast is the most common stromal cell in canine GIT epithelial tumours and most likely originated from pre-existing fibroblast...

  5. The challenges of detecting circulating tumour cells in sarcoma


    Tellez-Gabriel, M.; Brown, H K; Young, R.; Heymann, M. F.; Heymann, D


    International audience; Sarcomas are a heterogenous group of malignant neoplasms of mesenchymal origin, many of which have a propensity to develop distant metastases. Cancer cells that have escaped from the primary tumour are able to invade into surrounding tissues, to intravasate into the bloodstream to become Circulating Tumour Cells (CTCs), and are responsible for the generation of distant metastases. Due to the rarity of these tumours and the absence of specific markers expressed by sarco...

  6. Impaired autonomic regulation of resistance arteries in mice with low vascular endothelial growth factor or upon vascular endothelial growth factor trap delivery

    DEFF Research Database (Denmark)

    Storkebaum, Erik; Ruiz de Almodovar, Carmen; Meens, Merlijn;


    BACKGROUND: Control of peripheral resistance arteries by autonomic nerves is essential for the regulation of blood flow. The signals responsible for the maintenance of vascular neuroeffector mechanisms in the adult, however, remain largely unknown. METHODS AND RESULTS: Here, we report that VEGF( ...

  7. Factors that influence peripheral nerve regeneration

    DEFF Research Database (Denmark)

    Krarup, Christian; Archibald, Simon J; Madison, Roger D


    median nerve lesions (n = 46) in nonhuman primates over 3 to 4 years, a time span comparable with such lesions in humans. Nerve gap distances of 5, 20, or 50mm were repaired with nerve grafts or collagen-based nerve guide tubes, and three electrophysiological outcome measures were followed: (1) compound...

  8. Clinical significance of suprascapular nerve mobilization. (United States)

    Bodily, Kale D; Spinner, Robert J; Shin, Alexander Y; Bishop, Allen T


    The anatomy of the suprascapular nerve is important to surgeons when focal nerve lesions necessitate surgical repair. Recent experience with a patient who had a complete suprascapular nerve lesion in the retroclavicular region (combined with axillary and musculocutaneous nerve lesions) is presented to illustrate that successful direct nerve repair is possible despite resection of a neuroma. Specifically, we found that neurolysis and mobilization of the suprascapular nerve and release of the superior transverse scapular ligament provided the necessary nerve length to achieve direct nerve repair after the neuroma was removed. A combined supraclavicular and infraclavicular approach to the suprascapular nerve provided excellent visualization, especially in the retroclavicular region. Postoperatively, the patient recovered complete shoulder abduction and external rotation with the direct repair, an outcome uncommonly achieved with interpositional grafting. Based on our operative experience, we set out to quantify the length that the suprascapular nerve could be mobilized with neurolysis. Mobilization of the nerve and release of the superior transverse scapular ligament generated an average of 1.6 cm and 0.7 cm of extra nerve length respectively, totaling 2.3 cm of additional usable nerve length overall. The ability to expose the suprascapular nerve in the retroclavicular/infraclavicular region and to mobilize the suprascapular nerve for possible direct repair has not been previously emphasized and is clinically important. This surgical approach and technique permits direct nerve repair after resection of a focal neuroma in the retroclavicular or infraclavicular region, thus avoiding interpositional grafting, and improving outcomes.

  9. Tumour Heterogeneity: The Key Advantages of Single-Cell Analysis (United States)

    Tellez-Gabriel, Marta; Ory, Benjamin; Lamoureux, Francois; Heymann, Marie-Francoise; Heymann, Dominique


    Tumour heterogeneity refers to the fact that different tumour cells can show distinct morphological and phenotypic profiles, including cellular morphology, gene expression, metabolism, motility, proliferation and metastatic potential. This phenomenon occurs both between tumours (inter-tumour heterogeneity) and within tumours (intra-tumour heterogeneity), and it is caused by genetic and non-genetic factors. The heterogeneity of cancer cells introduces significant challenges in using molecular prognostic markers as well as for classifying patients that might benefit from specific therapies. Thus, research efforts for characterizing heterogeneity would be useful for a better understanding of the causes and progression of disease. It has been suggested that the study of heterogeneity within Circulating Tumour Cells (CTCs) could also reflect the full spectrum of mutations of the disease more accurately than a single biopsy of a primary or metastatic tumour. In previous years, many high throughput methodologies have raised for the study of heterogeneity at different levels (i.e., RNA, DNA, protein and epigenetic events). The aim of the current review is to stress clinical implications of tumour heterogeneity, as well as current available methodologies for their study, paying specific attention to those able to assess heterogeneity at the single cell level. PMID:27999407

  10. Isolation and identification of marine fish tumour (odontoma) associated bacteria

    Institute of Scientific and Technical Information of China (English)

    Ramalingam Vijayakumar; Kuzhanthaivel Raja; Vijayapoopathi Singaravel; Ayyaru Gopalakrishnan


    Objective: To identify fish tumour associated bacteria. Methods: The marine fish Sphyraena jello with odontoma was collected from in Tamil Nadu (Southeast India), and tumour associated bacteria were isolated. Then the isolated bacteria were identified based on molecular characters. Results: A total of 4 different bacterial species were isolated from tumour tissue. The bacterial species were Bacillus sp., Pontibacter sp., Burkholderia sp. and Macrococcus sp., and the sequences were submitted in DNA Data Bank of Japan with accession numbers of AB859240, AB859241, AB859242 and AB859243 respectively. Conclusions: Four different bacterial species were isolated from Sphyraena jello, but the role of bacteria within tumour needs to be further investigated.

  11. 3D Multiscale Modelling of Angiogenesis and Vascular Tumour Growth

    KAUST Repository

    Perfahl, H.


    We present a three-dimensional, multiscale model of vascular tumour growth, which couples nutrient/growth factor transport, blood flow, angiogenesis, vascular remodelling, movement of and interactions between normal and tumour cells, and nutrient-dependent cell cycle dynamics within each cell. We present computational simulations which show how a vascular network may evolve and interact with tumour and healthy cells. We also demonstrate how our model may be combined with experimental data, to predict the spatio-temporal evolution of a vascular tumour.

  12. Salivary gland tumours in a Mexican sample. A retrospective study. (United States)

    Ledesma-Montes, C; Garces-Ortiz, M


    Salivary gland tumours are an important part of the Oral and Maxillofacial Pathology, unfortunately, only few studies on these tumours have been done in Latin-American population. The aim of this study was to compare demographic data on salivary gland tumours in a Mexican sample with those previously published from Latin American and non-Latin American countries. All cases of salivary gland tumours or lesions diagnosed in our service were reviewed. Of the reviewed cases,67 were confirmed as salivary gland tumours. Out of these 64.2% were benign neoplasms, 35.8% were malignant and a slight female predominance (56.7%) was found. The most common location was palate followed by lips and floor of the mouth. Mean age for benign tumours was 40.6 years with female predominance (60.5%). Mean age for malignant tumours was 41 years and female predominance was found again. Palate followed by retromolar area were the usual locations. Pleomorphic adenoma (58.2%), mucoepidermoid carcinoma (17.9%) and adenoid cystic carcinoma (11.9%) were the more frequent neoplasms. All retromolar cases were malignant and all submandibular gland tumours were benign. We found a high proportion of salivary gland neoplasms in children. Our results showed that differences of the studied tumours among our sample and previously reported series exist. These differences can be related to race and geographical location.

  13. Abducens nerve enhancement demonstrated by multiplanar reconstruction of contrast-enhanced three-dimensional MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hosoya, T.; Adachi, M.; Sugai, Y. [Dept. of Radiology, Yamagata University School of Medicine (Japan); Yamaguchi, K.; Yamaguchi, K. [Dept. of Ophthalmology, Yamagata University School of Medicine (Japan); Kato, T. [3. Dept. of Internal Medicine, Yamagata University School of Medicine (Japan)


    We describe contrast enhancement of the cisternal portion of the abducens nerve and discuss its clinical significance. We examined 67 patients with ophthalmoplegia using contrast-enhanced 3-dimensional (3D) MRI with multiplanar reconstruction along the nerves and found 16 patients (ten men, six women), aged 10-73 years (mean 34.4 years), with contrast enhancement of the abducens nerve. Of the 36 patients who had an abducens palsy, 14 (39 %) showed contrast enhancement. In the 16 patients, 23 abducens nerves enhanced; 13 were symptomatic and 10 asymptomatic at the time. The causes were disseminated tumour (1), an inflammatory process (3), trauma (2), ischaemia (2) and autoimmune diseases (8), such as the Miller Fisher syndrome, acute ophthalmoparesis, polyneuropathy and multiple sclerosis. Abducens and/or oculomotor nerve enhancement was the only abnormality on MRI in the patients with traumatic or ischaemic neuropathy or autoimmune diseases. There were 14 patients who recovered fully within 1-6 months after treatment, and resolution of the enhancement correlated well with recovery. (orig.)

  14. The feasibility of a brain tumour website

    DEFF Research Database (Denmark)

    Piil, K; Jakobsen, J; Juhler, M


    PURPOSE: Patients with a high-grade glioma (HGG) and their caregivers have imminent and changing informational and supportive care needs. The purpose of this study was to investigate the feasibility and safety of a Danish brain tumour website (BTW) in patients with HGG and their caregivers. We...... and 2) a sample of patients with HGG (n = 9) and their caregivers (n = 8) interviewed three months after being introduced to the BTW. RESULTS: The BTW was accessed from 131 different Danish towns and cities, and from ten different countries. The website had 637 unique users. The interviews identified...

  15. Poly(DL-lactide-epsilon-caprolactone) nerve guides perform better than autologous nerve grafts

    NARCIS (Netherlands)

    DenDunnen, WFA; VanderLei, B; Schakenraad, JM; Stokroos, [No Value; Blaauw, E; Pennings, AJ; Robinson, PH; Bartels, H.


    The aim of this study was to compare the speed and quality of nerve regeneration after reconstruction using a biodegradable nerve guide or an autologous nerve graft. We evaluated nerve regeneration using light microscopy, transmission electron microscopy and morphometric analysis. Nerve regeneration

  16. Imaging of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Veillon, F. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France)], E-mail:; Ramos-Taboada, L.; Abu-Eid, M. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France); Charpiot, A. [Service d' ORL, Hopital de Hautepierre, 67098 Strasbourg Cedex (France); Riehm, S. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France)


    The facial nerve is responsible for the motor innervation of the face. It has a visceral motor function (lacrimal, submandibular, sublingual glands and secretion of the nose); it conveys a great part of the taste fibers, participates to the general sensory of the auricle (skin of the concha) and the wall of the external auditory meatus. The facial mimic, production of tears, nasal flow and salivation all depend on the facial nerve. In order to image the facial nerve it is mandatory to be knowledgeable about its normal anatomy including the course of its efferent and afferent fibers and about relevant technical considerations regarding CT and MR to be able to achieve high-resolution images of the nerve.

  17. GRP nerves in pig antrum

    DEFF Research Database (Denmark)

    Holst, J J; Poulsen, Steen Seier


    We extracted gastrin-releasing peptide (GRP) and its C-terminal decapeptide corresponding to 6.4 and 6.8 pmol/g from pig antrum mucosa. By immunohistochemistry GRP was localized to mucosal, submucosal, and myenteric nerve fibers. A few nerve cell bodies were also identified. Using isolated perfused...... pig antrum with intact vagal innervation, we found concomitant, atropine-resistant release of GRP and gastrin during electrical stimulation of the vagal nerves. Intra-arterial GRP at 10(-11)-10(-10) mol/l caused up to fivefold, dose-dependent increases in gastrin secretion; higher doses were less...... response to GRP and abolished the effect of vagal stimulation. The available evidence strongly suggests that GRP nerves are responsible for the stimulatory vagal effects on gastrin secretion in the pig....

  18. Insulin Pump Therapy Is Associated with Lower Rates of Retinopathy and Peripheral Nerve Abnormality (United States)

    Zabeen, Bedowra; Craig, Maria E.; Virk, Sohaib A.; Pryke, Alison; Chan, Albert K. F.; Cho, Yoon Hi; Benitez-Aguirre, Paul Z.; Hing, Stephen; Donaghue, Kim C.


    Objective To compare rates of microvascular complications in adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI). Research Design and Methods Prospective cohort of 989 patients (aged 12–20 years; diabetes duration >5 years) treated with CSII or MDI for >12 months. Microvascular complications were assessed from 2000–14: early retinopathy (seven-field fundal photography), peripheral nerve function (thermal and vibration threshold testing), autonomic nerve abnormality (heart rate variability analysis of electrocardiogram recordings) and albuminuria (albumin creatinine ratio/timed overnight albumin excretion). Generalized estimating equations (GEE) were used to examine the relationship between treatment and complications rates, adjusting for socio-economic status (SES) and known risk factors including HbA1c and diabetes duration. Results Comparing CSII with MDI: HbA1C was 8.6% [70mmol/mol] vs. 8.7% [72 mmol/mol]) (p = 0.7), retinopathy 17% vs. 22% (p = 0.06); microalbuminuria 1% vs. 4% (p = 0.07), peripheral nerve abnormality 27% vs. 33% (p = 0.108) and autonomic nerve abnormality 24% vs. 28% (p = 0.401). In multivariable GEE, CSII use was associated with lower rates of retinopathy (OR 0.66, 95% CI 0.45–0.95, p = 0.029) and peripheral nerve abnormality (OR 0.63, 95% CI 0.42–0.95, p = 0.026), but not albuminuria (OR 0.46, 95% CI 0.10–2.17, p = 0.33). SES was not associated with any of the complication outcomes. Conclusions In adolescents, CSII use is associated with lower rates of retinopathy and peripheral nerve abnormality, suggesting an apparent benefit of CSII over MDI independent of glycemic control or SES. PMID:27050468

  19. Insulin Pump Therapy Is Associated with Lower Rates of Retinopathy and Peripheral Nerve Abnormality.

    Directory of Open Access Journals (Sweden)

    Bedowra Zabeen

    Full Text Available To compare rates of microvascular complications in adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII versus multiple daily injections (MDI.Prospective cohort of 989 patients (aged 12-20 years; diabetes duration >5 years treated with CSII or MDI for >12 months. Microvascular complications were assessed from 2000-14: early retinopathy (seven-field fundal photography, peripheral nerve function (thermal and vibration threshold testing, autonomic nerve abnormality (heart rate variability analysis of electrocardiogram recordings and albuminuria (albumin creatinine ratio/timed overnight albumin excretion. Generalized estimating equations (GEE were used to examine the relationship between treatment and complications rates, adjusting for socio-economic status (SES and known risk factors including HbA1c and diabetes duration.Comparing CSII with MDI: HbA1C was 8.6% [70mmol/mol] vs. 8.7% [72 mmol/mol] (p = 0.7, retinopathy 17% vs. 22% (p = 0.06; microalbuminuria 1% vs. 4% (p = 0.07, peripheral nerve abnormality 27% vs. 33% (p = 0.108 and autonomic nerve abnormality 24% vs. 28% (p = 0.401. In multivariable GEE, CSII use was associated with lower rates of retinopathy (OR 0.66, 95% CI 0.45-0.95, p = 0.029 and peripheral nerve abnormality (OR 0.63, 95% CI 0.42-0.95, p = 0.026, but not albuminuria (OR 0.46, 95% CI 0.10-2.17, p = 0.33. SES was not associated with any of the complication outcomes.In adolescents, CSII use is associated with lower rates of retinopathy and peripheral nerve abnormality, suggesting an apparent benefit of CSII over MDI independent of glycemic control or SES.

  20. Multimodal therapy for synergic inhibition of tumour cell invasion and tumour-induced angiogenesis

    Directory of Open Access Journals (Sweden)

    Muehlenweg Bernd


    Full Text Available Abstract Background Squamous cell carcinoma of the head and neck (SCCHN are highly invasive tumours with frequent local and distant recurrence. Metastasis formation requires degradation of the extracellular matrix, which is fulfilled by membrane-associated proteases such as the urokinase plasminogen activator (uPA. WX-UK1 is a competitive active site inhibitor of the protease function of uPA that impairs on the capacity of tumour cells to invade in vitro. Methods In the present study, effects of combinations of WX-UK1 with matrix metalloprotease inhibitors (MMP, galardin® and cyclooxygenase-2 (COX-2, celecoxib® inhibitors on tumour cell proliferation, invasion, and angiogenesis induction were evaluated. Matrigel invasion chambers and a spheroid co-cultivation model with human fibroblast served to determine the invasive potential of both FaDu (SCCHN and HeLa (cervical carcinoma cells, each treated with combinations of Celecoxib®, Galardin®, and WX-UK1. Results Blocking of single protease systems resulted in a significant 50% reduction of tumour cell invasion using WX-UK1, while the triple combination was even more effective with 80% reduction of invasion. Additionally, a sprouting assay with HUVEC was used to test the anti-angiogenetic potential of the triple combination, resulting in a 40% decrease in the sprouting rate. Conclusions A combined approach targeting different families of proteases and cyclooxygenases represents a promising adjuvant therapy.

  1. Utility of positron emission tomography for tumour surveillance in children with neurofibromatosis type 1

    Energy Technology Data Exchange (ETDEWEB)

    Moharir, Mahendranath [Hospital for Sick Children, Division of Neurology, Ontario (Canada); London, Kevin [Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney (Australia); Howman-Giles, Robert [University of Sydney, Discipline of Imaging, Faculty of Medicine, Sydney (Australia); North, Kathryn [Children' s Hospital at Westmead, Institute for Neuroscience and Muscle Research, Sydney, NSW (Australia)


    There is little consensus regarding optimal surveillance of optic pathway glioma (OPG) and plexiform neurofibroma (PNF) in childhood neurofibromatosis type 1 (NF1). {sup 18}F-2-Fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) is employed in the surveillance of adult PNFs; but its utility has neither been specifically studied in children with PNFs nor in children with OPG. Review of PET/CT studies was performed in NF1 children with OPG or PNF. FDG-avidity of tumours was semi-quantitatively analysed and graded by calculating the maximum standardised uptake value (SUV{sub max}) [grade 1: <3 (low), grade 2: >3-<4 (intermediate), grade 3: >4 (intense)]. Eighteen children (ten girls; median age: 8.5-years) had PET/CT. Nineteen OPGs were imaged. The SUV{sub max} could be measured in 16. Ten were grade 1 and three each were grade 2 and grade 3. FDG-avidity reduced from grade 3 to grade 1 in two symptomatic OPGs following chemotherapy and this was associated with clinical improvement. PET/CT diagnosed symptomatic OPGs with a sensitivity of 0.625 [95% confidence interval (CI): 0.259-0.897] and specificity of 0.875 (95% CI: 0.466-0.993). Sixteen PNFs were imaged. Twelve were grade 1 and two each were grade 2 and grade 3. The two grade 3 PNFs were confirmed malignant peripheral nerve sheath tumours. PET/CT diagnosed malignant transformation with a sensitivity of 1.0 (95% CI: 0.197-1.0) and specificity of 0.857 (95% CI: 0.561-0.974). PET/CT may contribute useful information to the surveillance of OPG in childhood NF1 - particularly to identify progressive, symptomatic tumours. As in adults, PET/CT is useful for the detection of malignant transformation in PNFs in children with NF1. (orig.)

  2. Large Extremity Peripheral Nerve Repair (United States)


    human amnion membrane and periosteal autograft on tendon healing: experimental study in rabbits. J Hand Surg Eur Vol 2010;35:262e8. 674 N.G. Fairbairn...SE, Hunter DA. Functional evaluation of complete sciatic, peroneal, and posterior tibial nerve lesions in the rat. Plast Reconstr Surg. 1989;83:129...complete sciatic, peroneal, and posterior tibial nerve lesions in the rat. Plastic and reconstructive surgery. 1989 Jan;83(1):129-38. PubMed PMID: 2909054

  3. Autonomic computing enabled cooperative networked design

    CERN Document Server

    Wodczak, Michal


    This book introduces the concept of autonomic computing driven cooperative networked system design from an architectural perspective. As such it leverages and capitalises on the relevant advancements in both the realms of autonomic computing and networking by welding them closely together. In particular, a multi-faceted Autonomic Cooperative System Architectural Model is defined which incorporates the notion of Autonomic Cooperative Behaviour being orchestrated by the Autonomic Cooperative Networking Protocol of a cross-layer nature. The overall proposed solution not only advocates for the inc

  4. Experiences in Benchmarking of Autonomic Systems (United States)

    Etchevers, Xavier; Coupaye, Thierry; Vachet, Guy

    Autonomic computing promises improvements of systems quality of service in terms of availability, reliability, performance, security, etc. However, little research and experimental results have so far demonstrated this assertion, nor provided proof of the return on investment stemming from the efforts that introducing autonomic features requires. Existing works in the area of benchmarking of autonomic systems can be characterized by their qualitative and fragmented approaches. Still a crucial need is to provide generic (i.e. independent from business, technology, architecture and implementation choices) autonomic computing benchmarking tools for evaluating and/or comparing autonomic systems from a technical and, ultimately, an economical point of view. This article introduces a methodology and a process for defining and evaluating factors, criteria and metrics in order to qualitatively and quantitatively assess autonomic features in computing systems. It also discusses associated experimental results on three different autonomic systems.

  5. MRI of intracranial germ-cell tumours

    Energy Technology Data Exchange (ETDEWEB)

    Liang, L.; Korogi, Y.; Sugahara, T.; Ikushima, I.; Shigematsu, Y.; Okuda, T.; Takahashi, M. [Department of Radiology, Kumamoto University School of Medicine (Japan); Kochi, M.; Ushio, Y. [Department of Neurosurgery, Kumamoto University School of Medicine (Japan)


    Abstract. Our aim was to review the MRI appearances of primary intracranial germ-cell tumours (GCT). We reviewed the MRI studies of 32 patients: 19 with germinomas, five with teratomas, one with an embryonal carcinoma, five with mixed and two with malignant nongerminomatous GCT. Eleven were in the pineal region, 12 suprasellar, five in the both sites, two in the basal ganglia and two in the corpus callosum. Contrast-enhanced images were available for 27 patients. The solid parts of GCT were nearly isointense with grey matter on both T1- and T2-weighted images. In seven patients with nongerminomatous GCT high-signal components were found on T1-weighted images, representing haemorrhage, high-protein fluid or fat. Cystic components were detected in 17 of 27 patients; eight germinomas and all nine nongerminomatous GCT had cysts. The solid components of germinomas enhanced homogeneously in eight cases and heterogeneously in 10, while all nongerminomatous GCT showed heterogeneous enhancement. MRI features tumours can facilitate correct diagnosis of GCT, including histological subtypes. (orig.)

  6. Targeted therapy of gastrointestinal stromal tumours

    Institute of Scientific and Technical Information of China (English)

    Ashish Jakhetiya; Pankaj Kumar Garg; Gaurav Prakash; Jyoti Sharma; Rambha Pandey; Durgatosh Pandey


    Gastrointestinal stromal tumours(GISTs) are mesen-chymal neoplasms originating in the gastrointestinal tract, usually in the stomach or the small intestine, and rarely elsewhere in the abdomen. The malignant potential of GISTs is variable ranging from small lesions with a benign behaviour to fatal sarcomas. The majo-rity of the tumours stain positively for the CD-117(KIT) and discovered on GIST-1(DOG-1 or anoctamin 1) expression, and they are characterized by the presence of a driver kinase-activating mutation in either KIT or platelet-derived growth factor receptor α. Although surgery is the primary modality of treatment, almost half of the patients have disease recurrence following surgery, which highlights the need for an effective adjuvant therapy. Traditionally, GISTs are considered chemotherapy and radiotherapy resistant. With the advent of targeted therapy(tyrosine kinase inhibitors), there has been a paradigm shift in the management of GISTs in the last decade. We present a comprehensive review of targeted therapy in the management of GISTs.

  7. Comprehensive molecular portraits of human breast tumours. (United States)


    We analysed primary breast cancers by genomic DNA copy number arrays, DNA methylation, exome sequencing, messenger RNA arrays, microRNA sequencing and reverse-phase protein arrays. Our ability to integrate information across platforms provided key insights into previously defined gene expression subtypes and demonstrated the existence of four main breast cancer classes when combining data from five platforms, each of which shows significant molecular heterogeneity. Somatic mutations in only three genes (TP53, PIK3CA and GATA3) occurred at >10% incidence across all breast cancers; however, there were numerous subtype-associated and novel gene mutations including the enrichment of specific mutations in GATA3, PIK3CA and MAP3K1 with the luminal A subtype. We identified two novel protein-expression-defined subgroups, possibly produced by stromal/microenvironmental elements, and integrated analyses identified specific signalling pathways dominant in each molecular subtype including a HER2/phosphorylated HER2/EGFR/phosphorylated EGFR signature within the HER2-enriched expression subtype. Comparison of basal-like breast tumours with high-grade serous ovarian tumours showed many molecular commonalities, indicating a related aetiology and similar therapeutic opportunities. The biological finding of the four main breast cancer subtypes caused by different subsets of genetic and epigenetic abnormalities raises the hypothesis that much of the clinically observable plasticity and heterogeneity occurs within, and not across, these major biological subtypes of breast cancer.

  8. Influence of autonomic nerve system on early recurrence of atrial fibrillation after radiofrequency ablation of paroxysmal atrial fibrillation%射频消融术后心脏自主神经的变化对房颤早期复发的影响

    Institute of Scientific and Technical Information of China (English)

    孙亚娟; 石亚君; 王晋丽; 赵月香; 郭红阳; 王玉堂; 单兆亮


    目的:通过心率变异性分析,探讨左房环肺静脉消融术对自主神经系统的影响及其与心房颤动(房颤)早期复发的关系.方法:阵发性房颤患者90例,均接受CARTO指导下左房环肺静脉电隔离射频消融术.在术前3d及术后3d进行12导联动态心电图(Holter)监测,根据术后随访结果将患者分为房颤复发组(n=38例)和无复发组(n =52例).并记录两组的平均心率(MeanlHR),心率变异性(heart rate variability,HRV)分析,包括时域指标SDNN、SDANN、rMSSD、PNN50,频域指标W、LF、HF、LF/HF,进行比较.结果:90例患者均达到肺静脉电隔离.术后反应迷走神经及交感神经张力的指标均显著降低;在无复发组,反应迷走神经张力的HF降低更显著,LF/HF升高,其它HRV指标均显著降低;在复发组,MeanHR升高,反应交感神经张力的LF显著降低,LF/HF降低.结论:降低迷走神经张力,可能会抑制阵发性房颤患者左房环肺静脉消融术后的早期复发.%AIM:To investigate the relationship between autonomic nervous system (ANS) and early recurrence of atrial fibrillation (AF) after left atrium circumferential pulmonary vein ablation.METHODS:A total of 90 patients with paroxysmal AF underwent circumferential pulmonary vein ablation using CARTO system.All patients underwent 24-h ambulatory Holter monitoring and heart rate variability (HRV) analysis 3 days before and after the ablation.Patients were divided into recurrence group (n =38) and nonrecurrence group (n =52) based on the postoperative Holter results,symptoms and electrocardiogram.The average heart rate (mean HR),time domain indexes (such as SDNN,SDANN,rMSSD,PNN50)and frequency domain index (such as W,LF,HF,LF/HF) of the two groups were compared.RESULTS:Electrical isolation of the pulmonary veins was achieved in all 90 patients.The parameters indicated parasympathetic and sympathetic activities decreased significantly after ablation in both groups.In non-recurrence group

  9. Autonomic skin responses in females with Fabry disease

    DEFF Research Database (Denmark)

    Møller, Anette Torvin; Bach, Flemming W.; Feldt-Rasmussen, Ulla;


    Fabry disease is a genetic lysosomal disorder with dysfunction of the lysosomal enzyme alpha-galactosidase A causing accumulation of glycolipids in multiple organs including the nervous system and with neuropathy as a prominent manifestation. Neurological symptoms include pain and autonomic dysfu...... response to iontophoresis of acetylcholine (p = 0.04) and a smaller capsaicin-induced flare compared to controls. These findings suggest that female patients both have an impaired C-fiber function and local abnormalities in blood vessels and sweat glands......., and the cold pressor test; and (3) cutaneous blood flow following capsaicin. The vasoconstrictor response to inspiratory gasp was increased in Fabry patients compared to controls (p = 0.03), while the response to cold and mental stress did not change. Female patients with Fabry disease had a reduced sweat...... dysfunction. This study examined peripheral autonomic nerve function in 19 female patients with Fabry disease and 19 sex and age-matched controls by measuring (1) sweat production following acetylcholine challenge; (2) the sympathetically mediated vasoconstrictor responses to inspiratory gasp, stress...

  10. Perturbed autonomic nervous system function in metabolic syndrome. (United States)

    Tentolouris, Nicholas; Argyrakopoulou, Georgia; Katsilambros, Nicholas


    The metabolic syndrome is characterized by the clustering of various common metabolic abnormalities in an individual and it is associated with increased risk for the development of type 2 diabetes and cardiovascular diseases. Its prevalence in the general population is approximately 25%. Central fat accumulation and insulin resistance are considered as the common denominators of the abnormalities of the metabolic syndrome. Subjects with metabolic syndrome have autonomic nervous system dysfunction characterized by predominance of the sympathetic nervous system in many organs, i.e. heart, kidneys, vasculature, adipose tissue, and muscles. Sympathetic nervous system activation in metabolic syndrome is detected as increased heart rate and blood pressure, diminished heart rate variability, baroreceptor dysfunction, enhanced lipolysis in visceral fat, increased muscle sympathetic nerve activity, and high urine or plasma catecholamine concentrations as well as turnover rates. The augmented sympathetic activity in individuals with metabolic syndrome worsens prognosis of this high-risk population. The mechanisms linking metabolic syndrome with sympathetic activation are complex and not clearly understood. Whether sympathetic overactivity is involved in the development of the metabolic syndrome or is a consequence of it remains to be elucidated since data from prospective studies are missing. Intervention studies have demonstrated that the autonomic disturbances of the metabolic syndrome may be reversible.


    Institute of Scientific and Technical Information of China (English)


    Objective To study the therapeutical effects of crossing anastomosis of nerve on the peripheral and central nerve injuries.Methods Twelve kinds of central and peripheral nerve disorders and their complications were treated with 11 kinds of crossing anastomosis of nerve bundles near the innervated organs. After nerve injury and repair, somatosensory evoked potentials (SEPs) and horseradish peroxidase (HRP) retrograde tracing studies were used to investigate the rabbit's nerve function and morphology.Results The ulcers of all patients healed. Sensation, voluntary movement, and joint function recovered. Four weeks after the anastomosis of distal stump of radialis superficialis nerve and median nerve, pain sensation regained and SEPs appeared. HRP retrograde tracing studies demonstrated sensory nerve ending of medial nerve formed new connection with the body of neuron.Conclusion Crossing anastomosis of nerve is an effective method to treat peripheral and central nerve injuries.

  12. Comparison of nerve graft integration after segmentar resection versus epineural burying in crushed rat sciatic nerves

    Directory of Open Access Journals (Sweden)

    Cunha Marco Túlio Rodrigues da


    Full Text Available The aim of the present paper is to compare and correlate the take of nerve segments in a severely crushed nerve. Forty adult Wistar rats had their right sciatic nerve by a "Péan-Murphy" forceps for 40 minutes. In Group 1 (n=20, a segmentar serection in the crushed sciatic nerve was made. A sural nerve segment from the opposite hindpaw was placed in the gap. In Group 2 (n=20, a lontudinal insision in the epineurium of the lesioned sciatic nerve was made. A sural nerve segment was buried underneath the epineurium. The crushed sciatic nerves undergone Wallerian degeneration and endoneurial fibrosis. Sciatic nerves from Group 2 had significant better histological aspects than those from Group 1. Sural nerve grafts presented better degrees of regeneration than crushed sciatic nerves. Sural nerve grafts from Group 2 (burying method integrated as well as those from Group 1 (segmentar resection.

  13. Clinical use of nerve conduits in peripheral-nerve repair : Review of the literature

    NARCIS (Netherlands)

    Meek, MF; Coert, JH


    The use of nerve conduits has evolved from a previous experimental idea to a clinical reality over the last ten years. An overview of the literature on the clinical use of nerve conduits in peripheral-nerve repair is presented.

  14. (Non-invasive evaluation of the cardiac autonomic nervous system by PET)

    Energy Technology Data Exchange (ETDEWEB)


    The proposed research addresses the development, validation and application of cardiac PET imaging techniques to characterize the autonomic nervous system of the heart. PET technology has significantly matured over the last two decades. Instrument design, image processing and production of radiochemical compounds have formed an integrative approach to provide a powerful and novel imaging modality for the quantitative in vivo evaluation of the autonomic nervous system of the heart. Animal studies using novel tracers for the sympathetic and parasympathetic nerve terminals will be employed to characterize the functional integrity of nerve terminals. This work will be complemented by the development of agents which bind to postsynaptic receptor sites. The combined evaluation of presynaptic and postsynaptic neuronal function will allow a unique characterization of neuronal function. Initial development in animal studies will be followed by feasibility studies in humans. These studies are designed to test sophisticated imaging protocols in the human heart and validate the scintigraphic findings with independent markers of autonomic innervation. Subsequent clinical application in various cardiac diseases is expected to provide new insights into the neuropathophysiology of the heart.

  15. Chaotic neurodynamics for autonomous agents. (United States)

    Harter, Derek; Kozma, Robert


    Mesoscopic level neurodynamics study the collective dynamical behavior of neural populations. Such models are becoming increasingly important in understanding large-scale brain processes. Brains exhibit aperiodic oscillations with a much more rich dynamical behavior than fixed-point and limit-cycle approximation allow. Here we present a discretized model inspired by Freeman's K-set mesoscopic level population model. We show that this version is capable of replicating the important principles of aperiodic/chaotic neurodynamics while being fast enough for use in real-time autonomous agent applications. This simplification of the K model provides many advantages not only in terms of efficiency but in simplicity and its ability to be analyzed in terms of its dynamical properties. We study the discrete version using a multilayer, highly recurrent model of the neural architecture of perceptual brain areas. We use this architecture to develop example action selection mechanisms in an autonomous agent.

  16. Cardiovascular autonomic neuropathy in diabetes

    DEFF Research Database (Denmark)

    Spallone, Vincenza; Ziegler, Dan; Freeman, Roy


    in type 2 diabetes. CAN is a risk marker of mortality and cardiovascular morbidity, and possibly a progression promoter of diabetic nephropathy. Criteria for CAN diagnosis and staging are: 1. one abnormal cardio-vagal test identifies possible or early CAN; 2. at least two abnormal cardio-vagal tests....... diagnosis of CAN clinical forms, 2. detection and tailored treatment of CAN clinical correlates (e.g. tachycardia, OH, nondipping, QT interval prolongation), 3. risk stratification for diabetic complications and cardiovascular morbidity and mortality, and 4. modulation of targets of diabetes therapy......Cardiovascular Autonomic Neuropathy (CAN) Subcommittee of Toronto Consensus Panel on Diabetic Neuropathy worked to update CAN guidelines, with regard to epidemiology, clinical impact, diagnosis, usefulness of CAN testing, and management. CAN is the impairment of cardiovascular autonomic control...

  17. Autonomous Industrial Mobile Manipulation (AIMM)

    DEFF Research Database (Denmark)

    Hvilshøj, Mads; Bøgh, Simon; Nielsen, Oluf Skov


    Purpose - The purpose of this paper is to provide a review of the interdisciplinary research field Autonomous Industrial Mobile Manipulation (AIMM), with an emphasis on physical implementations and applications. Design/methodology/approach - Following an introduction to AIMM, this paper investiga......Purpose - The purpose of this paper is to provide a review of the interdisciplinary research field Autonomous Industrial Mobile Manipulation (AIMM), with an emphasis on physical implementations and applications. Design/methodology/approach - Following an introduction to AIMM, this paper...... investigates the missing links and gaps between the research and developments efforts and the real-world application requirements, in order to bring the AIMM technology from laboratories to manufacturing environments. The investigation is based on 12 general application requirements for robotics......; sustainability, configuration, adaptation, autonomy, positioning, manipulation and grasping, robot-robot interaction, human-robot interaction, process quality, dependability, and physical properties. Findings - The concise yet comprehensive review provides both researchers (academia) and practitioners (industry...

  18. Alterations of monocarboxylate transporter densities during hypoxia in brain and breast tumour cells

    DEFF Research Database (Denmark)

    Cheng, Chang; Edin, Nina F Jeppesen; Lauritzen, Knut H;


    Tumour cells are characterized by aerobic glycolysis, which provides biomass for tumour proliferation and leads to extracellular acidification through efflux of lactate via monocarboxylate transporters (MCTs). Deficient and spasm-prone tumour vasculature causes variable hypoxia, which favours...

  19. Biology-Inspired Autonomous Control (United States)


    of, and perhaps will not be tolerated in, manmade critical systems. Although this paper does not directly address questions of ethics associated...political, ethical , and moral issues associated with the use of autonomous systems in warfare will be debated long after the technology hurdles to...accessible discussion on the interplay of biochemistry, genetics and embryology in animal evolution; Wagner, 2005 describes biological concepts of

  20. Autonomous spacecraft rendezvous and docking (United States)

    Tietz, J. C.; Almand, B. J.

    A storyboard display is presented which summarizes work done recently in design and simulation of autonomous video rendezvous and docking systems for spacecraft. This display includes: photographs of the simulation hardware, plots of chase vehicle trajectories from simulations, pictures of the docking aid including image processing interpretations, and drawings of the control system strategy. Viewgraph-style sheets on the display bulletin board summarize the simulation objectives, benefits, special considerations, approach, and results.