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Sample records for bilateral pallidal stimulation

  1. Pallidal stimulation for segmental dystonia: long term follow up of 11 consecutive patients.

    Science.gov (United States)

    Sensi, Mariachiara; Cavallo, Michele A; Quatrale, Rocco; Sarubbo, Silvio; Biguzzi, Sara; Lettieri, Cristian; Capone, Jay G; Tugnoli, Valeria; Tola, Maria Rosaria; Eleopra, Roberto

    2009-09-15

    Pallidal stimulation is a convincing and valid alternative for primary generalized dystonia refractory to medical therapy or botulinum toxin. However, the clinical outcome reported in literature is variable most likely because of heterogeneity DBS techniques employed and /or to clinical dystonic pattern of the patients who undergo surgery. In this study, we report the long term follow up of a homogeneous group of eleven subjects affected by segmental dystonia who were treated with bilateral stimulation of the Globus Pallidus pars interna (GPi) from the years 2000 to 2008. All the patients were evaluated, before surgery and at 6-12-24-36 months after the treatment, in accordance with the Burke Fahn Marsden Dystonia Rating Scale (BFMDRS). Our study indicates that DBS promotes an early and significant improvement at 6 months with an even and a better outcome later on. The analysis of specific sub items of the BFMDRS revealed an earlier and striking benefit not only as far as segmental motor function of the limbs but also for the complex cranial functions like face, (eyes and mouth), speech and swallowing, differently from results reported in primary generalized dystonia. Deep Brain Stimulation of GPi should be considered a valid indication for both generalized and segmental dystonia when other therapies appear ineffective.

  2. Comparison of weight gain and energy intake after subthalamic versus pallidal stimulation in Parkinson's disease.

    Science.gov (United States)

    Sauleau, Paul; Leray, Emmanuelle; Rouaud, Tiphaine; Drapier, Sophie; Drapier, Dominique; Blanchard, Sophie; Drillet, Gwenolla; Péron, Julie; Vérin, Marc

    2009-10-30

    To compare body mass index (BMI) and daily energy intake (DEI) after subthalamic versus pallidal deep brain stimulation (DBS). Weight gain following DBS in Parkinson's disease patients remains largely unexplained and no comparison of subthalamic and pallidal (GPi) stimulation has yet been performed. BMI and DEI, dopaminergic drug administration and motor scores were recorded in 46 patients with PD before STN (n = 32) or GPi (n = 14) DBS and 3 and 6 months after. At M6, BMI had increased by an average of 8.4% in the STN group and 3.2% in the GPi group. BMI increased in 28 STN and 9 GPi patients. This increase was significantly higher in the STN group (P weight gain, inadequately explained by motor improvement or reduced dopaminergic drug dosage, occurred in subthalamic DBS patients. The difference between groups suggests additional factors in the STN group, such as homeostatic control center involvement.

  3. Bilateral pallidal deep brain stimulation in idiopathic dystonic camptocormia

    Directory of Open Access Journals (Sweden)

    Ravi Yadav

    2015-01-01

    Conclusions: In this report, we have shown the efficacy of GPi DBS in the treatment of drug refractory dystonia associated camptocormia. Although only reported for PD associated camptocormia, evaluation for truncal extensor myopathy is mandatory in these cases also to achieve a good outcome.

  4. Exploiting pallidal plasticity for stimulation in Parkinson’s disease

    Science.gov (United States)

    Lourens, Marcel A. J.; Schwab, Bettina C.; Nirody, Jasmine A.; Meijer, Hil G. E.; van Gils, Stephan A.

    2015-04-01

    Objective. Continuous application of high-frequency deep brain stimulation (DBS) often effectively reduces motor symptoms of Parkinson’s disease patients. While there is a growing need for more effective and less traumatic stimulation, the exact mechanism of DBS is still unknown. Here, we present a methodology to exploit the plasticity of GABAergic synapses inside the external globus pallidus (GPe) for the optimization of DBS. Approach. Assuming the existence of spike-timing-dependent plasticity (STDP) at GABAergic GPe-GPe synapses, we simulate neural activity in a network model of the subthalamic nucleus and GPe. In particular, we test different DBS protocols in our model and quantify their influence on neural synchrony. Main results. In an exemplary set of biologically plausible model parameters, we show that STDP in the GPe has a direct influence on neural activity and especially the stability of firing patterns. STDP stabilizes both uncorrelated firing in the healthy state and correlated firing in the parkinsonian state. Alternative stimulation protocols such as coordinated reset stimulation can clearly profit from the stabilizing effect of STDP. These results are widely independent of the STDP learning rule. Significance. Once the model settings, e.g., connection architectures, have been described experimentally, our model can be adjusted and directly applied in the development of novel stimulation protocols. More efficient stimulation leads to both minimization of side effects and savings in battery power.

  5. Selective peripheral denervation : comparison with pallidal stimulation and literature review

    NARCIS (Netherlands)

    Contarino, Maria Fiorella; Van den Munckhof, Pepijn; Tijssen, Marina A. J.; de Bie, Rob M. A.; Bosch, D. Andries; Schuurman, P. Richard; Speelman, Johannes D.

    2014-01-01

    Patients with cervical dystonia who are non-responders to Botulinum toxin qualify for surgery. Selective peripheral denervation (Bertrand's procedure, SPD) and deep brain stimulation of the globus pallidus (GPi-DBS) are available surgical options. Although peripheral denervation has potential advant

  6. Weight Gain following Pallidal Deep Brain Stimulation: A PET Study

    OpenAIRE

    Sauleau, Paul; Drapier, Sophie; Duprez, Joan; Houvenaghel, Jean-François; Dondaine, Thibaut; Haegelen, Claire; Drapier, Dominique; Jannin, Pierre; Robert, Gabriel; Le Jeune, Florence; Vérin, Marc

    2016-01-01

    The mechanisms behind weight gain following deep brain stimulation (DBS) surgery seem to be multifactorial and suspected depending on the target, either the subthalamic nucleus (STN) or the globus pallidus internus (GPi). Decreased energy expenditure following motor improvement and behavioral and/or metabolic changes are possible explanations. Focusing on GPi target, our objective was to analyze correlations between changes in brain metabolism (measured with PET) and weight gain following GPi...

  7. Weight Gain following Pallidal Deep Brain Stimulation: A PET Study.

    Science.gov (United States)

    Sauleau, Paul; Drapier, Sophie; Duprez, Joan; Houvenaghel, Jean-François; Dondaine, Thibaut; Haegelen, Claire; Drapier, Dominique; Jannin, Pierre; Robert, Gabriel; Le Jeune, Florence; Vérin, Marc

    2016-01-01

    The mechanisms behind weight gain following deep brain stimulation (DBS) surgery seem to be multifactorial and suspected depending on the target, either the subthalamic nucleus (STN) or the globus pallidus internus (GPi). Decreased energy expenditure following motor improvement and behavioral and/or metabolic changes are possible explanations. Focusing on GPi target, our objective was to analyze correlations between changes in brain metabolism (measured with PET) and weight gain following GPi-DBS in patients with Parkinson's disease (PD). Body mass index was calculated and brain activity prospectively measured using 2-deoxy-2[18F]fluoro-D-glucose PET four months before and four months after the start of GPi-DBS in 19 PD patients. Dopaminergic medication was included in the analysis to control for its possible influence on brain metabolism. Body mass index increased significantly by 0.66 ± 1.3 kg/m2 (p = 0.040). There were correlations between weight gain and changes in brain metabolism in premotor areas, including the left and right superior gyri (Brodmann area, BA 6), left superior gyrus (BA 8), the dorsolateral prefrontal cortex (right middle gyrus, BAs 9 and 46), and the left and right somatosensory association cortices (BA 7). However, we found no correlation between weight gain and metabolic changes in limbic and associative areas. Additionally, there was a trend toward a correlation between reduced dyskinesia and weight gain (r = 0.428, p = 0.067). These findings suggest that, unlike STN-DBS, motor improvement is the major contributing factor for weight gain following GPi-DBS PD, confirming the motor selectivity of this target.

  8. Pallidal deep brain stimulation in a 5-year-old child with dystonic storm: case report.

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    Aydin, Sabri; Abuzayed, Bashar; Uysal, Serap; Unver, Olcay; Uzan, Mustafa; Mengi, Murat; Kizilkilic, Osman; Hanci, Murat

    2013-01-01

    A 5-year-old child had a medical history of epilepsy and a newly presented mental retardation with a life-threatening dystonic storm. Neuroimagings showed bilateral calcification of the pallidum. Several treatment modalities were performed, but the symptoms showed no significant improvement. The patient was operated on in order to place a deep brain stimulation (DBS) targeting bilateral globus pallidum internus (GPi). The dystonia showed a remarkable improvement after surgery, with 81% reduction of dystonia severity after 15 months. To our best knowledge, this is the youngest patient mentioned in the literature to be treated with DBS, which was also life-saving in this case.

  9. Efficacy and safety of pallidal stimulation in primary dystonia: results of the Spanish multicentric study

    OpenAIRE

    Valldeoriola, Francesc; Regidor, Ignacio; Mínguez-Castellanos, Adolfo; Lezcano, Elena; García-Ruiz, Pedro; Rojo, Ana; Salvador, Antonio; Castro, Alfonso; Grandas, Francisco; Martí, Maria José; Martínez-Martín, Pablo; Kulisevsky, Jaime; Relova, Luis; Rumià, Jordi; Cámara, Ana

    2009-01-01

    Abstract We report the results of a prospective, multicenter study with open-label, blinded, as well as self-assessed evaluations to investigate the efficacy and safety of bilateral GPi DBS in patients with primary dystonia. Twenty-four patients from ten different hospitals were included and followed for one year. Clinical assessments were done through blinded scoring of video recordings, open-label evaluations, and self-assessment scales. One year after surgery, baseline motor sco...

  10. Improvement of both dystonia and tics with 60 Hz pallidal deep brain stimulation.

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    Hwynn, Nelson; Tagliati, Michele; Alterman, Ron L; Limotai, Natlada; Zeilman, Pamela; Malaty, Irene A; Foote, Kelly D; Morishita, Takashi; Okun, Michael S

    2012-09-01

    Deep brain stimulation has been utilized in both dystonia and in medication refractory Tourette syndrome. We present an interesting case of a patient with a mixture of disabling dystonia and Tourette syndrome whose coexistent dystonia and tics were successfully treated with 60 Hz-stimulation of the globus pallidus region.

  11. Dystonia in neurodegeneration with brain iron accumulation : outcome of bilateral pallidal stimulation

    NARCIS (Netherlands)

    Timmermann, L.; Pauls, K. A. M.; Wieland, K.; Jech, R.; Kurlemann, G.; Sharma, N.; Gill, S. S.; Haenggeli, C. A.; Hayflick, S. J.; Hogarth, P.; Leenders, K. L.; Limousin, P.; Malanga, C. J.; Moro, E.; Ostrem, J. L.; Revilla, F. J.; Santens, P.; Schnitzler, A.; Tisch, S.; Valldeoriola, F.; Vesper, J.; Volkmann, J.; Woitalla, D.; Peker, S.

    2010-01-01

    Neurodegeneration with brain iron accumulation encompasses a heterogeneous group of rare neurodegenerative disorders that are characterized by iron accumulation in the brain. Severe generalized dystonia is frequently a prominent symptom and can be very disabling, causing gait impairment, difficulty

  12. Amnesia Associated with Bilateral Hippocampal and Bilateral Basal Ganglia Lesions in Anoxia with Stimulant Use

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    Haut, Marc W.; Hogg, Jeffery P.; Marshalek, Patrick J.; Suter, Blair C.; Miller, Liv E.

    2017-01-01

    We report a case of a 55-year-old man with ischemic lesions of the bilateral hippocampus and bilateral basal ganglia following a myocardial infarction during an episode of multiple drug use with subsequent anoxia requiring resuscitation. He presented for a neuropsychological evaluation with an anterograde amnesia for both explicit and procedural memory. There are two main points to this case, the unique aspects of the bilateral multifocal lesions and the functional, cognitive impact of these lesions. We hypothesize that his rare focal bilateral lesions of both the hippocampus and basal ganglia are a result of anoxia acting in synergy with his stimulant drug use (cocaine and/or 3,4-methylenedioxy-methamphetamine). Second, his unique lesions produced an explicit and implicit/procedural anterograde amnesia. PMID:28228745

  13. Deep brain stimulation of pallidal versus subthalamic for patients with Parkinson's disease: a meta-analysis of controlled clinical trials

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    Xu F

    2016-06-01

    Full Text Available Fan Xu,1 Wenbin Ma,2 Yongmin Huang,1 Zhihai Qiu,1 Lei Sun11Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, People’s Republic of China; 2Department of Neurology, Binzhou Medical University Hospital, Binzhou, Shandong, People’s Republic of ChinaBackground: Parkinson's disease (PD is a common neurodegenerative disorder that affects many people every year. Deep brain stimulation (DBS is an effective nonpharmacological method to treat PD motor symptoms. This meta-analysis was conducted to evaluate the efficacy of subthalamic nucleus (STN-DBS versus globus pallidus internus (GPi-DBS in treating advanced PD.Methods: Controlled clinical trials that compared STN-DBS to GPi-DBS for short-term treatment of PD in adults were researched up to November 2015. The primary outcomes were the Unified Parkinson’s Disease Rating Scale Section (UPDRS III score and the levodopa-equivalent dosage (LED after DBS. The secondary outcomes were the UPDRS II score and the Beck Depression Inventory (BDI score.Results: Totally, 13 studies containing 1,148 PD patients were included in this meta-analysis to compare STN-DBS versus GPi-DBS. During the off-medication state, the pooled weighted mean difference (WMD of UPDRS III and II scores were −2.18 (95% CI =−5.11 to 0.74 and −1.96 (95% CI =−3.84 to −0.08, respectively. During the on-medication state, the pooled WMD of UPDRS III and II scores were 0.15 (95% CI =−1.14 to 1.44 and 1.01 (95% CI =0.12 to 1.89, respectively. After DBS, the pooled WMD of LED and BDI were −254.48 (95% CI =−341.66 and 2.29 (95% CI =0.83 to 3.75, respectively.Conclusion: These results indicate that during the off-medication state, the STN-DBS might be superior to GPi-DBS in improving the motor function and activities of daily living for PD patients; but during the on-medication state, the opposite result is observed. Meanwhile, the STN-DBS is superior at reducing

  14. Unilateral pallidotomy versus bilateral subthalamic nucleus stimulation in PD - A comparison of neuropsychological effects

    NARCIS (Netherlands)

    Smeding, HMM; Esselink, RAJ; Schmand, B; Koning-Haanstra, M; Nijhuis, [No Value; Wijnalda, EM; Speelman, J.D.

    2005-01-01

    Objective To compare the cognitive and behavioural effects of unilateral pallidotomy and bilateral subthalamic nucleus (STN) stimulation. Methods After baseline examination 34 patients were randomly assigned to unilateral pallidotomy ( 4 left-sided, 10 right-sided) or bilateral STN stimulation ( n=

  15. Ultrasound-guided bilateral continuous sciatic nerve blocks with stimulating catheters for postoperative pain relief after bilateral lower limb amputations*.

    NARCIS (Netherlands)

    Geffen, G.J. van; Scheuer, M.; Müller, A.; Garderniers, J.; Gielen, M.J.M.

    2006-01-01

    The performance of continuous bilateral sciatic nerve blocks under ultrasonographic control using stimulating catheters is described in a 4-year-old child with VACTERL syndrome. Ultrasound showed an abnormal vascular and nerve supply to the lower limbs. The use of ultrasound guidance made successful

  16. Response of SI cortex to ipsilateral, contralateral and bilateral flutter stimulation in the cat

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    Favorov Oleg

    2005-04-01

    Full Text Available Abstract Background While SII cortex is considered to be the first cortical stage of the pathway that integrates tactile information arising from both sides of the body, SI cortex is generally not considered as a region in which neuronal response is modulated by simultaneous stimulation of bilateral (and mirror-image skin sites. Results Optical intrinsic signal imaging was used to evaluate the response of SI and SII in the same hemisphere to 25 Hz sinusoidal vertical skin displacement stimulation ("skin flutter" applied contralaterally, ipsilaterally, and bilaterally (simultaneously to the central pads of the forepaws. A localized increase in absorbance in both SI and SII occurred in response to both contralateral and bilateral flutter stimulation. Ipsilateral flutter stimulation evoked a localized increase in absorbance in SII, but little or no change in SI absorbance. In the forepaw representational region of SI, however, bilateral stimulation of the central pads evoked a response substantially smaller (approximately 30–35% smaller than the response to flutter stimulation of the contralateral central pad. Conclusion The finding that the response of SI cortex to bilateral central pad flutter stimulation is substantially smaller than the response evoked by a contralateral flutter stimulus, together with the recently published observation that a region located posteriorly in SII responds with a substantially larger response to a bilateral flutter stimulus than the response evoked from the contralateral central pad, lead us to propose that the SI activity evoked by contralateral skin stimulation is suppressed/inhibited (via corticocortical connections between SII and SI in the same hemisphere by the activity a simultaneous ipsilateral skin stimulus evokes in posterior SII.

  17. Bilateral adaptive deep brain stimulation is effective in Parkinson's disease

    NARCIS (Netherlands)

    Little, Simon; Beudel, Martijn; Zrinzo, Ludvic; Foltynie, Thomas; Limousin, Patricia; Hariz, Marwan; Neal, Spencer; Cheeran, Binith; Cagnan, Hayriye; Gratwicke, James; Aziz, Tipu Z.; Pogosyan, Alex; Brown, Peter

    2016-01-01

    Introduction & objectives Adaptive deep brain stimulation (aDBS) uses feedback from brain signals to guide stimulation. A recent acute trial of unilateral aDBS showed that aDBS can lead to substantial improvements in contralateral hemibody Unified Parkinson's Disease Rating Scale (UPDRS) motor score

  18. Bimanual force coordination in Parkinson's disease patients with bilateral subthalamic deep brain stimulation.

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    Stacey L Gorniak

    Full Text Available OBJECTIVE: Studies of bimanual actions similar to activities of daily living (ADLs are currently lacking in evaluating fine motor control in Parkinson's disease patients implanted with bilateral subthalamic deep brain stimulators. We investigated basic time and force characteristics of a bimanual task that resembles performance of ADLs in a group of bilateral subthalamic deep brain stimulation (DBS patients. METHODS: Patients were evaluated in three different DBS parameter conditions off stimulation, on clinically derived stimulation parameters, and on settings derived from a patient-specific computational model. Model-based parameters were computed as a means to minimize spread of current to non-motor regions of the subthalamic nucleus via Cicerone Deep Brain Stimulation software. Patients were evaluated off parkinsonian medications in each stimulation condition. RESULTS: The data indicate that DBS parameter state does not affect most aspects of fine motor control in ADL-like tasks; however, features such as increased grip force and grip symmetry varied with the stimulation state. In the absence of DBS parameters, patients exhibited significant grip force asymmetry. Overall UPDRS-III and UPDRS-III scores associated with hand function were lower while patients were experiencing clinically-derived or model-based parameters, as compared to the off-stimulation condition. CONCLUSION: While bilateral subthalamic DBS has been shown to alleviate gross motor dysfunction, our results indicate that DBS may not provide the same magnitude of benefit to fine motor coordination.

  19. Response of SII cortex to ipsilateral, contralateral and bilateral flutter stimulation in the cat

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    Favorov Oleg

    2005-02-01

    Full Text Available Abstract Background A distinctive property of SII is that it is the first cortical stage of the somatosensory projection pathway that integrates information arising from both sides of the body. However, there is very little known about how inputs across the body mid-line are processed within SII. Results Optical intrinsic signal imaging was used to evaluate the response of primary somatosensory cortex (SI and SII in the same hemisphere to 25 Hz sinusoidal vertical skin displacement stimulation ("skin flutter" applied contralaterally, ipsilaterally, and bilaterally to the central pads of the forepaws. A localized increase in absorbance in both SI and SII was evoked by both contralateral and bilateral flutter stimulation. Ipsilateral flutter stimulation evoked a localized increase in absorbance in SII, but not in SI. The SII region that responded with an increase in absorbance to ipsilateral stimulation was posterior to the region in which absorbance increased maximally in response to stimulation of the contralateral central pad. Additionally, in the posterior SII region that responded maximally to ipsilateral stimulation of the central pad, bilateral central pad stimulation approximated a linear summation of the SII responses to independent stimulation of the contralateral and ipsilateral central pads. Conversely, in anterior SII (the region that responded maximally to contralateral stimulation, bilateral stimulation was consistently less than the response evoked from the contralateral central pad. Conclusions The results indicate that two regions located at neighboring, but distinctly different A-P levels of the anterior ectosylvian gyrus process input from opposite sides of the body midline in very different ways. The results suggest that the SII cortex, in the cat, can be subdivided into at least two functionally distinct regions and that these functionally distinct regions demonstrate a laterality preference within SII.

  20. Hypomania with hypersexuality following bilateral anterior limb stimulation in obsessive-compulsive disorder.

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    Chang, Chun-Hung; Chen, Shin-Yuan; Hsiao, Yi-Ling; Tsai, Sheng-Tzung; Tsai, Hsin-Chi

    2010-06-01

    This 28-year-old Chinese man was referred for deep brain stimulation (DBS) evaluation for an 8-year history of refractory obsessive-compulsive disorder. After the patient had signed an informed consent, the authors implanted DBS leads. Hypomania with hypersexuality was noted on stimulation at Contact 2 and became aggravated with a higher voltage (> or = 3 V) during chronic bilateral DBS. After the voltage was decreased to 1 V, the patient's hypomanic symptoms subsided and his libido returned to baseline.

  1. Unilateral occipital nerve stimulation for bilateral occipital neuralgia: a case report and literature review

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    Liu, Aijun; Jiao, Yongcheng; Ji, Huijun; Zhang, Zhiwen

    2017-01-01

    Objectives The aim of this study is to present a case of successful relief of bilateral occipital neuralgia (ON) using unilateral occipital nerve stimulation (ONS) and to discuss the possible underlying mechanisms. Materials and methods We present the case of a 59-year-old female patient with severe bilateral ON treated with unilateral ONS. We systematically reviewed previous studies of ONS for ON, discussing the possible mechanisms of ONS in the relief of ON. Results The patient reported complete pain relief after consistent unilateral ONS during the follow-up period. The underlying mechanisms may be linked to the relationship between pain and several brain regions, including the pons, midbrain, and periaqueductal gray. Conclusion ONS is an effective and safe option for treating ON. Future studies will be required to clarify the mechanisms by which unilateral occipital stimulation provided relief for bilateral neuralgia in this case. PMID:28176938

  2. Neuropsychological effects of bilateral STN stimulation in Parkinson disease - A controlled study

    NARCIS (Netherlands)

    Smeding, HMM; Koning-Haanstra, M; Schuurman, PR; Nijssen, P; van Laar, T; Schmand, B; Speelman, J.D.

    2006-01-01

    Objective: To evaluate the cognitive and behavioral effects of bilateral subthalamic nucleus (STN) stimulation in patients with Parkinson disease (PD). Methods: The authors included 103 patients; 99 patients were evaluated 6 months after surgery. A control group of 39 patients with PD was formed and

  3. Unilateral pallidotomy versus bilateral subthalamic nucleus stimulation in PD - A randomized trial

    NARCIS (Netherlands)

    Esselink, RAJ; de Bie, RMA; de Haan, RJ; Lenders, MWPM; Nijssen, PCG; Staal, MJ; Smeding, HMM; Schuurman, PR; Bosch, DA; Speelman, J.D.

    2004-01-01

    Objective: To compare the efficacy of unilateral pallidotomy and bilateral subthalamic nucleus (STN) stimulation in patients with advanced Parkinson disease (PD) in a randomized, observer-blind, multicenter trial. Methods: Thirty-four patients with advanced PD were randomly assigned to have unilater

  4. Unilateral pallidotomy versus bilateral subthalamic nucleus stimulation in PD: a randomized trial.

    NARCIS (Netherlands)

    Esselink, R.A.J.; Bie, R.M. de; Haan, R.J. de; Lenders, M.W.; Nijssen, P.C.; Staal, M.J.; Smeding, H.M.; Schuurman, P.R.; Bosch, D.A.; Speelman, J.D.

    2004-01-01

    OBJECTIVE: To compare the efficacy of unilateral pallidotomy and bilateral subthalamic nucleus (STN) stimulation in patients with advanced Parkinson disease (PD) in a randomized, observer-blind, multicenter trial. METHODS: Thirty-four patients with advanced PD were randomly assigned to have unilater

  5. A Short Term Therapy Approach to Processing Trauma: Art Therapy and Bilateral Stimulation

    Science.gov (United States)

    Tripp, Tally

    2007-01-01

    This article describes a dynamic, short-term art therapy approach that has been developed for the treatment of trauma related disorders. Using a modified Eye Movement Desensitization and Reprocessing (EMDR) protocol with alternating tactile and auditory bilateral stimulation, associations are rapidly brought to conscious awareness and expressed in…

  6. The effects of bilateral electric and bimodal electric--acoustic stimulation on language development.

    Science.gov (United States)

    Nittrouer, Susan; Chapman, Christopher

    2009-09-01

    There is no doubt that cochlear implants have improved the spoken language abilities of children with hearing loss, but delays persist. Consequently, it is imperative that new treatment options be explored. This study evaluated one aspect of treatment that might be modified, that having to do with bilateral implants and bimodal stimulation. A total of 58 children with at least one implant were tested at 42 months of age on four language measures spanning a continuum from basic to generative in nature. When children were grouped by the kind of stimulation they had at 42 months (one implant, bilateral implants, or bimodal stimulation), no differences across groups were observed. This was true even when groups were constrained to only children who had at least 12 months to acclimatize to their stimulation configuration. However, when children were grouped according to whether or not they had spent any time with bimodal stimulation (either consistently since their first implant or as an interlude to receiving a second) advantages were found for children who had some bimodal experience, but those advantages were restricted to language abilities that are generative in nature. Thus, previously reported benefits of simultaneous bilateral implantation early in a child's life may not extend to generative language. In fact, children may benefit from a period of bimodal stimulation early in childhood because low-frequency speech signals provide prosody and serve as an aid in learning how to perceptually organize the signal that is received through a cochlear implant.

  7. Impairments of motor-cortex responses to unilateral and bilateral direct current stimulation in schizophrenia.

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    Hasan, Alkomiet; Bergener, Theresa; Nitsche, Michael A; Strube, Wolfgang; Bunse, Tilmann; Falkai, Peter; Wobrock, Thomas

    2013-01-01

    Transcranial direct current stimulation (tDCS) is a non-invasive stimulation technique that can be applied to modulate cortical activity through induction of cortical plasticity. Since various neuropsychiatric disorders are characterized by fluctuations in cortical activity levels (e.g., schizophrenia), tDCS is increasingly investigated as a treatment tool. Several studies have shown that the induction of cortical plasticity following classical, unilateral tDCS is reduced or impaired in the stimulated and non-stimulated primary motor cortices (M1) of patients with schizophrenia. Moreover, an alternative, bilateral tDCS setup has recently been shown to modulate cortical plasticity in both hemispheres in healthy subjects, highlighting another potential treatment approach. Here we present the first study comparing the efficacy of unilateral tDCS (cathode left M1, anode right supraorbital) with simultaneous bilateral tDCS (cathode left M1, anode right M1) in patients with schizophrenia. tDCS-induced cortical plasticity was monitored by investigating motor-evoked potentials induced by single-pulse transcranial magnetic stimulation applied to both hemispheres. Healthy subjects showed a reduction of left M1 excitability following unilateral tDCS on the stimulated left hemisphere and an increase in right M1 excitability following bilateral tDCS. In schizophrenia, no plasticity was induced following both stimulation paradigms. The pattern of these results indicates a complex interplay between plasticity and connectivity that is impaired in patients with schizophrenia. Further studies are needed to clarify the biological underpinnings and clinical impact of these findings.

  8. Impairments of motor-cortex responses to unilateral and bilateral direct current stimulation in schizophrenia

    Directory of Open Access Journals (Sweden)

    Alkomiet eHasan

    2013-10-01

    Full Text Available Transcranial direct current stimulation (tDCS is a non-invasive stimulation technique that can be applied to modulate cortical activity through induction of cortical plasticity. Since various neuropsychiatric disorders are characterised by fluctuations in cortical activity levels (e.g. schizophrenia, tDCS is increasingly investigated as a treatment tool. Several studies have shown that the induction of cortical plasticity following classical, unilateral tDCS is reduced or impaired in the stimulated and non-stimulated primary motor cortices (M1 of schizophrenia patients. Moreover, an alternative, bilateral tDCS setup has recently been shown to modulate cortical plasticity in both hemispheres in healthy subjects, highlighting another potential treatment approach. Here we present the first study comparing the efficacy of unilateral tDCS (cathode left M1, anode right supraorbital with simultaneous bilateral tDCS (cathode left M1, anode right M1 in schizophrenia patients. tDCS-induced cortical plasticity was monitored by investigating motor-evoked potentials induced by single-pulse transcranial magnetic stimulation applied to both hemispheres. Healthy subjects showed a reduction of left M1 excitability following unilateral tDCS on the stimulated left hemisphere and an increase in right M1 excitability following bilateral tDCS. In schizophrenia, no plasticity was induced following both stimulation paradigms. The pattern of these results indicates a complex interplay between plasticity and connectivity that is impaired in schizophrenia patients. Further studies are needed to clarify the biological underpinnings and clinical impact of these findings.

  9. The Effects of Bilateral Electric and Bimodal Electric—Acoustic Stimulation on Language Development

    OpenAIRE

    2009-01-01

    There is no doubt that cochlear implants have improved the spoken language abilities of children with hearing loss, but delays persist. Consequently, it is imperative that new treatment options be explored. This study evaluated one aspect of treatment that might be modified, that having to do with bilateral implants and bimodal stimulation. A total of 58 children with at least one implant were tested at 42 months of age on four language measures spanning a continuum from basic to generative i...

  10. Unilateral occipital nerve stimulation for bilateral occipital neuralgia: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Liu A

    2017-01-01

    Full Text Available Aijun Liu, Yongcheng Jiao, Huijun Ji, Zhiwen Zhang Department of Neurosurgery, First Affiliated Hospital of PLA General Hospital, Beijing, People’s Republic of China Objectives: The aim of this study is to present a case of successful relief of bilateral occipital neuralgia (ON using unilateral occipital nerve stimulation (ONS and to discuss the possible underlying mechanisms. Materials and methods: We present the case of a 59-year-old female patient with severe bilateral ON treated with unilateral ONS. We systematically reviewed previous studies of ONS for ON, discussing the possible mechanisms of ONS in the relief of ON. Results: The patient reported complete pain relief after consistent unilateral ONS during the follow-up period. The underlying mechanisms may be linked to the relationship between pain and several brain regions, including the pons, midbrain, and periaqueductal gray. Conclusion: ONS is an effective and safe option for treating ON. Future studies will be required to clarify the mechanisms by which unilateral occipital stimulation provided relief for bilateral neuralgia in this case. Keywords: occipital neuralgia, neuromodulation, peripheral nerve stimulation

  11. Asymmetric pallidal neuronal activity in patients with cervical dystonia

    Directory of Open Access Journals (Sweden)

    Christian KE eMoll

    2014-02-01

    Full Text Available The origin of asymmetric clinical manifestation of symptoms in patients suffering from cervical dystonia (CD is hitherto poorly understood. Dysregulated neuronal activity in the basal ganglia has been suggested to have a role in the pathophysiology of CD. Here, we re-assessed the question to what extent relative changes occur in the direct versus indirect basal ganglia pathway in CD, whether these circuit changes are lateralized, and how these alterations relate to CD symptoms. To this end, we recorded ongoing single cell and local field potential (LFP activity from the external (GPe and internal pallidal segment (GPi of thirteen CD patients undergoing microelectrode-guided stereotactic surgery for deep brain stimulation in the GPi. We compared pallidal recordings from CD patients operated under local anaesthesia (LA with those obtained in CD patients operated under general anaesthesia (GA. In awake patients, mean GPe discharge rate (52 Hz was lower than that of GPi (72 Hz. Mean GPi discharge ipsilateral to the side of head turning was higher than contralateral and correlated with torticollis symptom severity. Lateralized differences were absent at the level of the GPe and in recordings from patients operated under GA. Furthermore, in the GPi of CD patients there was a subpopulation of theta-oscillatory cells with unique bursting characteristics. Power and coherence of GPe- and GPi-LFPs were dominated by a theta peak and also exhibited band-specific interhemispheric differences. Strong cross-frequency coupling of low-gamma amplitude to theta phase was a feature of pallidal LFPs recorded under LA, but not GA. These results indicate that CD is associated with an asymmetric pallidal outflow. Based on the finding of symmetric neuronal discharges in the GPe, we propose that an imbalanced interhemispheric direct pathway gain may be involved in CD pathophysiology.

  12. Results by motor cortex stimulation in treatment of focal dystonia, Parkinson's disease and post-ictal spasticity. The experience of the Italian Study Group of the Italian Neurosurgical Society.

    Science.gov (United States)

    Pagni, C A; Albanese, A; Bentivoglio, A; Broggi, G; Canavero, S; Cioni, B; Rose, M D; Simone, C D; Franzini, A; Lavano, A; Landi, A; Meglio, M; Modugno, M; Romanelli, L; Romito, L M; Sturiale, C; Valzania, F; Zeme, S; Zenga, F

    2008-01-01

    Extradural motor cortex stimulation has been employed in cases of Parkinson's disease (PD), fixed dystonia (FD) and spastic hemiparesis (SH) following cerebral stroke. Symptoms of PD are improved by EMCS: results were evaluated on the basis of the UPDRS and statistically analysed. In PD EMCS is less efficacious than bilateral subthalamic nucleus (STN) stimulation, but it may be safely employed in patients not eligible for deep brain stimulation (DBS). The most rewarding effect is the improvement, in severely affected patients, of posture and gait. FD, unresponsive to bilateral pallidal stimulation, has been relieved by EDMS. In SH reduction of spasticiy by EMCS allows improvement of the motor function.

  13. Change of the melanocortin system caused by bilateral subthalamic nucleus stimulation in Parkinson's disease.

    Science.gov (United States)

    Escamilla-Sevilla, F; Pérez-Navarro, M J; Muñoz-Pasadas, M; Sáez-Zea, C; Jouma-Katati, M; Piédrola-Maroto, G; Ramírez-Navarro, A; Mínguez-Castellanos, A

    2011-10-01

    OBJECTIVES - Determine whether bilateral subthalamic nucleus stimulation (STN-DBS) in Parkinson's disease (PD) is associated with an increase in neuropeptide Y (NPY) and/or resistance to inhibition by leptin in relation to post-surgery weight gain. MATERIALS AND METHODS - This prospective study included 20 patients who underwent bilateral STN-DBS and 17 who refused surgery. Data were obtained at baseline, 3 and 6 months on neurological and nutritional status, including determination of body mass index (BMI) and serum NPY and leptin levels. RESULTS -  NPY and leptin levels changed over time, with a distinct pattern. The BMI increase at 6 months was greater in the surgical group (5.5 ± 6.3% vs 0.5 ± 3.5%; P = 0.035). Medical group exhibited a reduction in leptin level (-2.0 ± 4.3 ng/ml) and a consequent increase in NPY level (72.4 ± 58.7 pmol/ml). However, STN-DBS patients showed an increase in leptin (3.1 ± 5.0 ng/ml; P = 0.001 vs medical group) and also in NPY (12.1 ± 53.6 pmol/ml; P = 0.022 vs medical group) levels, which suggests resistance to inhibition by leptin. Rise in NPY level correlated with higher stimulation voltages. CONCLUSIONS -  Bilateral STN-DBS causes disruption of the melanocortin system, probably related to diffusion of the electric current to the hypothalamus. This mechanism may in part explain the weight gain of patients with PD after surgery.

  14. Global perception depends on coherent work of bilateral visual cortices: Transcranial magnetic stimulation (TMS) studies

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xin; HAN ShiHui

    2007-01-01

    Previous research suggests that the right and left hemispheres dominate global and local perception of hierarchical patterns, respectively. The current work examined whether global perception of hierarchical stimuli requires coherent work of bilateral visual cortices using transcranial magnetic stimulation(TMS). Subjects discriminated global or local properties of compound letters in Experiment 1. Reaction times were recorded when single-pulse real TMS or sham TMS was delivered over the left or right visual cortex. While a global precedence effect (i.e., faster responses to global than local targets and stronger global-to-local interference than the reverse) was observed, TMS decreased global-to-local interference whereas increased local-to-global interference. Experiment 2 ruled out the possibility that the effects observed in Experiment 1 resulted from perceptual learning. Experiment 3 used compound shapes and observed TMS effect similar to that in Experiment 1. Moreover, TMS also slowed global RTs whereas speeded up local RTs in Experiment 3. Finally, the TMS effects observed in Experiments 1 and 3 did not differ between the conditions when TMS was applied over the left and right hemispheres. The results support a coherence hypothesis that global perception of compound stimuli depends upon the coherent work of bilateral visual cortices.

  15. Global perception depends on coherent work of bilateral visual cortices:Transcranial magnetic stimulation (TMS) studies

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Previous research suggests that the right and left hemispheres dominate global and local perception of hierarchical patterns, respectively. The current work examined whether global perception of hierarchi-cal stimuli requires coherent work of bilateral visual cortices using transcranial magnetic stimulation (TMS). Subjects discriminated global or local properties of compound letters in Experiment 1. Reaction times were recorded when single-pulse real TMS or sham TMS was delivered over the left or right visual cortex. While a global precedence effect (i.e., faster responses to global than local targets and stronger global-to-local interference than the reverse) was observed, TMS decreased global-to-local interference whereas increased local-to-global interference. Experiment 2 ruled out the possibility that the effects observed in Experiment 1 resulted from perceptual learning. Experiment 3 used compound shapes and observed TMS effect similar to that in Experiment 1. Moreover, TMS also slowed global RTs whereas speeded up local RTs in Experiment 3. Finally, the TMS effects observed in Experiments 1 and 3 did not differ between the conditions when TMS was applied over the left and right hemispheres. The results support a coherence hypothesis that global perception of compound stimuli depends upon the co-herent work of bilateral visual cortices.

  16. Visual imagery influences brain responses to visual stimulation in bilateral cortical blindness.

    Science.gov (United States)

    de Gelder, Beatrice; Tamietto, Marco; Pegna, Alan J; Van den Stock, Jan

    2015-11-01

    Mental imagery is a powerful mechanism that may facilitate visual perception as well as compensate for it. The role of V1 in mental imagery is still a matter of debate. Our goal here was to investigate whether visual imagery was still possible in case of bilateral V1 destruction behaviorally evidenced by total clinical blindness and if so, whether it might boost residual visual perception. In a factorial fMRI design, faces, scenes or scrambled images were presented while a rare patient with cortical blindness over the whole visual field due to bilateral V1-lesions (TN) was instructed to imagine either an angry person or a neutral object (tree). The results show that visual imagery of a person activates frontal, parietal and occipital brain regions similar to control subjects and hence suggest that V1 is not necessary for visual imagery. In addition, the combination of visual stimulation and visual imagery of socio-emotional stimuli triggers activation in superior parietal lobule (SPL) and ventromedial (vmPFC) and dorsolateral prefrontal cortex (DLPFC). Finally, activation during residual vision, visual imagery and their interaction overlapped in the SPL, arguing for a central role of feeling in V1-independent vision and imagery.

  17. Preventing long-lasting fear recovery using bilateral alternating sensory stimulation: A translational study.

    Science.gov (United States)

    Wurtz, H; El-Khoury-Malhame, M; Wilhelm, F H; Michael, T; Beetz, E M; Roques, J; Reynaud, E; Courtin, J; Khalfa, S; Herry, C

    2016-05-03

    Posttraumatic stress disorder (PTSD) is a highly debilitating and prevalent psychological disorder. It is characterized by highly distressing intrusive trauma memories that are partly explained by fear conditioning. Despite efficient therapeutic approaches, a subset of PTSD patients displays spontaneous recurrence of traumatic memories after successful treatment. The development of animal behavioral models mimicking the individual variability in treatment outcome for PTSD patients represent therefore an important challenge as it allows for the identification of predicting factors of resilience or susceptibility to relapse. However, to date, only few animal behavioral models of long-lasting fear recovery have been developed and their predictive validity has not been tested directly. The objectives of this study were twofold. First we aimed to develop a simple animal behavioral model of long-lasting fear recovery based on auditory cued fear conditioning and extinction learning, which recapitulates the heterogeneity of fear responses observed in PTSD patients after successful treatment. Second we aimed at testing the predictive validity of our behavioral model and used to this purpose a translational approach based (i) on the demonstration of the efficiency of Eye Movement Desensitization and Reprocessing (EMDR) therapy to reduce conditioned fear responses in PTSD patients and (ii) on the implementation in our behavioral model of an electrical bilateral alternating stimulation of the eyelid which mimics the core feature of EMDR. Our data indicate that electrical bilateral alternating stimulation of the eyelid during extinction learning alleviates long-lasting fear recovery of conditioned fear responses and dramatically reduces inter-individual variability. These results demonstrate the face and predictive validity of our animal behavioral model and provide an interesting tool to understand the neurobiological underpinnings of long-lasting fear recovery.

  18. Bilateral Transcranial Magnetic Stimulation of the Prefrontal Cortex reduces cocaine intake: a pilot study.

    Directory of Open Access Journals (Sweden)

    Corinna Bolloni

    2016-08-01

    Full Text Available Background: Chronic cocaine consumption is associated to a decrease in mesolimbic dopamine transmission that maintains drug intake. Transcranial Magnetic Stimulation (TMS is gaining reliability a useful therapeutic tool in drug addiction since it can modulate cortico-limbic activity resulting in reduction of drug craving. Aims: In the present study we investigated the therapeutic effect of bilateral TMS of prefrontal cortex (PFC in reducing cocaine intake, in a sample of treatment-seeking patients with current cocaine use disorder (DSM-V. Methods: 10 cocaine addicts (DSM-V were randomly assigned to the active or sham stimulation protocol in a double-blind experimental design. Twelve repetitive TMS (rTMS sessions were administered 3 times a week for 4 weeks at 100% of motor threshold, over bilateral PFC. Cocaine intake (ng/mg was assessed by hair analysis at baseline (before treatment, T0, after one month (end of treatment, T1, 3 (T2 and 6 (T3 months later. All subjects received psychological support weekly. Results: The two-way ANOVA for repeated measures did not show a significant effect of the interaction between time and treatment (F4,32= 0.35; p=.87. Despite that result indicated no difference in the effect of the two conditions (active vs sham along time, a decreasing trend in cocaine consumption in active TMS group (F3,23=3.42; p=.04 vs sham (F3,15=1.88; p=.20 was observed when we performed exploratory analysis with time as factor . Indeed, Post-hoc comparisons showed a significant reduction in the amount of cocaine detected from the onset to three months later (T0-T2; p=.02 and to the end of treatment (T0-T3; p=.01 in addicts from the active group. Conclusions: Bilateral rTMS of PFC at 10 Hz did not show a significant effect on cocaine intake compared to sham. However, a long-term reduction in cocaine intake in active TMS treated patients was observed when we considered the time as factor. Further studies are required to confirm these

  19. Image-guided preoperative prediction of pyramidal tract side effect in deep brain stimulation: proof of concept and application to the pyramidal tract side effect induced by pallidal stimulation.

    Science.gov (United States)

    Baumgarten, Clement; Zhao, Yulong; Sauleau, Paul; Malrain, Cecile; Jannin, Pierre; Haegelen, Claire

    2016-04-01

    Deep brain stimulation of the medial globus pallidus (GPm) is a surgical procedure for treating patients suffering from Parkinson's disease. Its therapeutic effect may be limited by the presence of pyramidal tract side effect (PTSE). PTSE is a contraction time-locked to the stimulation when the current spreading reaches the motor fibers of the pyramidal tract within the internal capsule. The objective of the study was to propose a preoperative predictive model of PTSE. A machine learning-based method called PyMAN (PTSE model based on artificial neural network) accounting for the current used in stimulation, the three-dimensional electrode coordinates and the angle of the trajectory, was designed to predict the occurrence of PTSE. Ten patients implanted in the GPm have been tested by a clinician to create a labeled dataset of the stimulation parameters that trigger PTSE. The kappa index value between the data predicted by PyMAN and the labeled data was 0.78. Further evaluation studies are desirable to confirm whether PyMAN could be a reliable tool for assisting the surgeon to prevent PTSE during the preoperative planning.

  20. Effects of contact location and voltage amplitude on speech and movement in bilateral subthalamic nucleus deep brain stimulation.

    Science.gov (United States)

    Tripoliti, Elina; Zrinzo, Ludvic; Martinez-Torres, Irene; Tisch, Stephen; Frost, Eleanor; Borrell, Ellie; Hariz, Marwan I; Limousin, Patricia

    2008-12-15

    Subthalamic nucleus deep brain stimulation (STN-DBS) is particularly effective in improving limb symptoms in Parkinson's disease. However, speech shows a variable response. Contact site and amplitude of stimulation have been suggested as possible factors influencing speech. In this double blind study, we assessed 14 patients post bilateral STN-DBS, without medication. Six conditions were studied in random order as follows: stimulation inside the STN at low voltage (2 V) and at high voltage (4 V); above the STN at 2 V and at 4 V, at usual clinical parameters, and off-stimulation. The site of stimulation was defined on the postoperative stereotactic MRI data. Speech protocol consisted of the assessment of intelligibility of the dysarthric speech, maximum sustained phonation, and a 1-minute monologue. Movement was assessed using the UPDRS-III. Stimulation at 4 V significantly reduced the speech intelligibility (P = 0.004) independently from the site of stimulation. Stimulation at 4 V significantly improved the motor function. Stimulation inside the nucleus was significantly more effective than outside the nucleus (P = 0.0006). The significant improvement in movement coupled with significant deterioration in speech intelligibility when patients are stimulated inside the nucleus at high voltage indicates a critical role for electrical stimulation parameters in speech motor control.

  1. Body weight gain in patients with bilateral deep brain stimulation for dystonia.

    Science.gov (United States)

    Wolf, Marc E; Capelle, Hans-Holger; Lütjens, Götz; Ebert, Anne D; Hennerici, Michael G; Krauss, Joachim K; Blahak, Christian

    2016-03-01

    In patients with Parkinson's disease, significant weight gain following chronic deep brain stimulation (DBS) has been reported. Recently, relevant weight gain could be demonstrated also following subthalamic nucleus DBS in patients with primary cervical dystonia. Prospective analyses of body weight changes following DBS in patients with dystonia, however, have not been published so far. We aimed to analyse the changes of body weight following DBS in patients with dystonia. The body mass index (BMI) of 17 consecutive patients with segmental or generalised dystonia (mean age 54.6 ± 16.1 years) treated with bilateral DBS of the globus pallidus internus (GPi) (n = 14) or the thalamic ventral intermediate nucleus (n = 3) was measured preoperatively (pre-OP) and at three follow-up (FU) time points post-DBS surgery (FU1 = 7 months, FU2 = 17 months, FU3 = 72 months). All patients benefited from marked improvement in their dystonia. The mean BMI pre-OP (SD) was 22.5 (±3.7) kg/m(2) and increased stepwise to 24.0 (±3.3) kg/m(2) at FU1, 24.4 (±3.7) kg/m(2) at FU2 and 24.9 (±3.7) kg/m(2) at FU3 (p weight gain, in particular during the first 6 months post-OP. This probably is a result of improvement of dystonic motor symptoms and recovery of eating dysfunction rather than a target-specific phenomenon.

  2. Modulation of nutritional state in Parkinsonian patients with bilateral subthalamic nucleus stimulation.

    Science.gov (United States)

    Guimarães, Joana; Matos, Eduarda; Rosas, Maria José; Vieira-Coelho, Augusta; Borges, Nuno; Correia, Flora; Vaz, Rui; Garrett, Carolina

    2009-12-01

    Chronic bilateral subthalamic stimulation (DBS-STN) provides considerable clinical benefits in Parkinson disease patients, with improvement in primary symptoms and resolution of side effects of chronic pharmacological treatment. Apart from its therapeutic effects on PD symptoms, DBS-STN also appears to induce weight gain, which may itself induce critical metabolic disorders and limit the benefits of surgery. No data are available in literature showing the efficacy of a nutritional intervention to prevent rapid and/or excessive weight gain after DBSSTN. Fifty-seven PD patients were included in this study and were divided into two groups: Group 1 comprised 16 patients with a nutritional intervention immediately after surgery (1 week after); Group 2 comprised 41 patients with a nutritional intervention in a later period after surgery (mean time of 2.5 ± 1.6 years). Weight, body mass index (BMI), percentage of fat mass, levodopa daily dose (LDD) and part III of the Unified Parkinson's disease rating scale (UPDRS) were studied before and after an individualized and structured nutritional intervention. Three months after nutritional intervention, Group 1 had a mean BMI (24.1 ± 2.99), that was not significantly different (p = 0.114) from BMI before intervention, with stability of the weight and in percentage of fat mass. In Group 2 all the patients gained weight, reaching to 13.17 ± 10%; a total of 63% of patients became overweight (BMI 25 kg/m(2)). Three months after nutritional intervention, Group 2 had a mean BMI (24.80 ± 2.45) that was significantly (p = 0.03) different from BMI before intervention (26.75 ± 2.99), although percentage of fat mass was higher in women. With this study, we have conclude that nutritional intervention adequate to patient-age, disease characteristics, medical therapy with L-dopa and physical activity, is effective incontrolling weight after DBS-STN surgery.

  3. Plasticity Induced by Intermittent Theta Burst Stimulation in Bilateral Motor Cortices Is Not Altered in Older Adults

    Directory of Open Access Journals (Sweden)

    Daina S. E. Dickins

    2015-01-01

    Full Text Available Numerous studies have reported that plasticity induced in the motor cortex by transcranial magnetic stimulation (TMS is attenuated in older adults. Those investigations, however, have focused solely on the stimulated hemisphere. Compared to young adults, older adults exhibit more widespread activity across bilateral motor cortices during the performance of unilateral motor tasks, suggesting that the manifestation of plasticity might also be altered. To address this question, twenty young (65 years underwent intermittent theta burst stimulation (iTBS whilst attending to the hand targeted by the plasticity-inducing procedure. The amplitude of motor evoked potentials (MEPs elicited by single pulse TMS was used to quantify cortical excitability before and after iTBS. Individual responses to iTBS were highly variable, with half the participants showing an unexpected decrease in cortical excitability. Contrary to predictions, however, there were no age-related differences in the magnitude or manifestation of plasticity across bilateral motor cortices. The findings suggest that advancing age does not influence the capacity for, or manifestation of, plasticity induced by iTBS.

  4. Plasticity Induced by Intermittent Theta Burst Stimulation in Bilateral Motor Cortices Is Not Altered in Older Adults.

    Science.gov (United States)

    Dickins, Daina S E; Sale, Martin V; Kamke, Marc R

    2015-01-01

    Numerous studies have reported that plasticity induced in the motor cortex by transcranial magnetic stimulation (TMS) is attenuated in older adults. Those investigations, however, have focused solely on the stimulated hemisphere. Compared to young adults, older adults exhibit more widespread activity across bilateral motor cortices during the performance of unilateral motor tasks, suggesting that the manifestation of plasticity might also be altered. To address this question, twenty young (65 years) underwent intermittent theta burst stimulation (iTBS) whilst attending to the hand targeted by the plasticity-inducing procedure. The amplitude of motor evoked potentials (MEPs) elicited by single pulse TMS was used to quantify cortical excitability before and after iTBS. Individual responses to iTBS were highly variable, with half the participants showing an unexpected decrease in cortical excitability. Contrary to predictions, however, there were no age-related differences in the magnitude or manifestation of plasticity across bilateral motor cortices. The findings suggest that advancing age does not influence the capacity for, or manifestation of, plasticity induced by iTBS.

  5. Unilateral pallidotomy versus bilateral subthalamic nucleus stimulation in Parkinson's disease: one year follow-up of a randomised observer-blind multi centre trial.

    NARCIS (Netherlands)

    Esselink, R.A.J.; Bie, R.M. de; Haan, R.J. de; Steur, E.N.; Beute, G.N.; Portman, A.T.; Schuurman, P.R.; Bosch, D.A.; Speelman, J.D.

    2006-01-01

    Background. To investigate whether STN stimulation is more efficacious than unilateral pallidotomy in advanced Parkinson's disease (PD) one year after surgery. Method. Thirty-four patients with advanced PD were randomly assigned to unilateral pallidotomy or bilateral STN stimulation. Outcome measure

  6. Unilateral pallidotomy versus bilateral subthalamic nucleus stimulation in Parkinson's disease : one year follow-up of a randomised observer-blind multi centre trial

    NARCIS (Netherlands)

    Esselink, R. A. J.; de Bie, R. M. A.; de Haan, R. J.; Steur, E. N. H. J.; Beute, G. N.; Portman, A. T.; Schuurman, P. R.; Bosch, D. A.; Speelman, J.D.

    2006-01-01

    Background. To investigate whether STN stimulation is more efficacious than unilateral pallidotomy in advanced Parkinson's disease (PD) one year after surgery. Method. Thirty-four patients with advanced PD were randomly assigned to unilateral pallidotomy or bilateral STN stimulation. Outcome measure

  7. Efficacy of bilateral repetitive transcranial magnetic stimulation for negative symptoms of schizophrenia : results of a multicenter double-blind randomized controlled trial

    NARCIS (Netherlands)

    Dlabac-de Lange, J. J.; Bais, L.; van Es, F. D.; Visser, B. G. J.; Reinink, E.; Bakker, B.; van den Heuvel, E. R.; Aleman, A.; Knegtering, H.

    2015-01-01

    Background. Few studies have investigated the efficacy of repetitive transcranial magnetic stimulation (rTMS) treatment for negative symptoms of schizophrenia, reporting inconsistent results. We aimed to investigate whether 10 Hz stimulation of the bilateral dorsolateral prefrontal cortex during 3 w

  8. Reduced pallidal output causes dystonia

    Directory of Open Access Journals (Sweden)

    Atsushi eNambu

    2011-11-01

    Full Text Available Dystonia is a neurological disorder characterized by sustained or repetitive involuntary muscle contractions and abnormal postures. In the present article, we will introduce our recent electrophysiological studies in hyperkinetic transgenic mice generated as a model of DYT1 dystonia and in a human cervical dystonia patient, and discuss the pathophysiology of dystonia on the basis of these electrophysiological findings. Recording of neuronal activity in the awake state of DYT1 dystonia model mice revealed reduced spontaneous activity with bursts and pauses in both internal (GPi and external (GPe segments of the globus pallidus. Electrical stimulation of the primary motor cortex evoked responses composed of excitation and subsequent long-lasting inhibition, the latter of which was never observed in normal mice. In addition, somatotopic arrangements were disorganized in the GPi and GPe of dystonia model mice. In a human cervical dystonia patient, electrical stimulation of the primary motor cortex evoked similar long-lasting inhibition in the GPi and GPe. Thus, reduced GPi output may cause increased thalamic and cortical activity, resulting in the involuntary movements observed in dystonia.

  9. Parkinson's disease patients with bilateral subthalamic deep brain stimulation gain weight.

    Science.gov (United States)

    Macia, Frédéric; Perlemoine, Caroline; Coman, Irène; Guehl, Dominique; Burbaud, Pierre; Cuny, Emmanuel; Gin, Henri; Rigalleau, Vincent; Tison, François

    2004-02-01

    Weight, body mass index (BMI) and energy expenditure/energy intake (EE/EI) was studied in 19 Parkinson's disease (PD) patients after subthalamic deep brain stimulation (STN-DBS) versus 14 nonoperated ones. Operated patients had a significant weight gain (WG, + 9.7 +/- 7 kg) and BMI increase (+ 4.7 kg/m2). The fat mass was higher after STN-DBS. Resting EE (REE; offdrug/ON stimulation) was significantly decreased in STN-DBS patients, while their daily energy expenditure (DEI) was not significantly different. A significant correlation was found among WG, BMI increase, and pre-operative levodopa-equivalent daily dose, their reduction after STN-DBS, and the differential REE related to stimulation and the REE in the offdrug/OFF stimulation condition. In conclusion, STN-DBS in PD induces a significant WG associated with a reduction in REE without DEI adjustment.

  10. Bilateral Repetitive Transcranial Magnetic Stimulation Combined with Intensive Swallowing Rehabilitation for Chronic Stroke Dysphagia: A Case Series Study

    Directory of Open Access Journals (Sweden)

    Ryo Momosaki

    2014-03-01

    Full Text Available The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56-80 years; interval between onset of stroke and treatment: 24-37 months with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS, Modified Mann Assessment of Swallowing Ability (MMASA, Functional Oral Intake Scale (FOIS, laryngeal elevation delay time (LEDT and Repetitive Saliva-Swallowing Test (RSST on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients.

  11. Bilateral Repetitive Transcranial Magnetic Stimulation Combined with Intensive Swallowing Rehabilitation for Chronic Stroke Dysphagia: A Case Series Study

    Science.gov (United States)

    Momosaki, Ryo; Abo, Masahiro; Kakuda, Wataru

    2014-01-01

    The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS) combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56–80 years; interval between onset of stroke and treatment: 24–37 months) with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS), Modified Mann Assessment of Swallowing Ability (MMASA), Functional Oral Intake Scale (FOIS), laryngeal elevation delay time (LEDT) and Repetitive Saliva-Swallowing Test (RSST) on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients. PMID:24803904

  12. 双耳刺激听觉训练%Auditory Training with Bilateral Stimulation

    Institute of Scientific and Technical Information of China (English)

    张莉; 梁巍

    2015-01-01

    双耳刺激为听障儿童口语康复提供先决条件,通过刺激获得双耳聆听技能更有助于听障儿童语言学习。本文介绍了双耳刺激的类型与形式,并针对听障儿童接受双耳刺激后听觉训练方案及随班就读后的康复指导要点进行了介绍。%Binaural stimulation provides a prerequisite of oral rehabilitation for hearing-impaired children and binaural listening skills will help children's language development.The article introduces the type of binaural stimulation, auditory training emphasis and some guidances for inclusive education.

  13. Bilateral repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Y.Q. Zhang

    2015-03-01

    Full Text Available There has been concern regarding the use of controversial paradigms for repetitive transcranial magnetic stimulation (rTMS to manage treatment-resistant depression (TRD. This meta-analysis assessed the efficacy of bilateral rTMS compared with unilateral and sham rTMS in patients with TRD. PubMed, Embase, CENTRAL, PsycINFO, Web of Science, EAGLE and NTIS databases were searched to identify relevant studies, and randomized controlled trials (RCTs on bilateral rTMS for TRD patients were included. The response was defined as the primary outcome, and remission was the secondary outcome. Ten RCTs that included 634 patients met the eligibility criteria. The risk ratio (RRs of both the primary and secondary outcomes of bilateral rTMS showed non-significant increases compared to unilateral rTMS (RR=1.01, P=0.93; odds ratio [OR]=0.77, P=0.22. Notably, the RR of the primary bilateral rTMS outcome was significantly increased compared to that for sham rTMS (RR=3.43, P=0.0004. The results of our analysis demonstrated that bilateral rTMS was significantly more effective than sham rTMS but not unilateral rTMS in patients with TRD. Thus, bilateral rTMS may not be a useful paradigm for patients with TRD.

  14. Neuropsychological and psychiatric assessments following bilateral deep brain stimulation of the subthalamic nucleus in Japanese patients with Parkinson's disease.

    Science.gov (United States)

    Aono, Michitaka; Iga, Jun-Ichi; Ueno, Shu-Ichi; Agawa, Masahito; Tsuda, Toshio; Ohmori, Tetsuro

    2014-09-01

    The physical benefits of subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) patients are well documented, but the mental benefits are uncertain, particularly in Japanese patients. This study evaluated the clinical and neuropsychological characteristics before and after STN-DBS surgery in Japanese PD patients. PD patients (n=13, age 67.0 ± 7.8 years) were evaluated pre-surgery (baseline) and at 1 and 6 months post-surgery by two trained psychiatrists. The motor symptoms were assessed by the Unified Parkinson's Disease Rating Scale (UPDRS) motor score. The neuropsychological and psychiatric tests performed were the Mini-Mental State Examination, the Wisconsin Card Sorting Test (WCST), the Verbal Fluency Test (VFT), the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale (HAM-A). The UPDRS motor score (pscore (p=0.004) showed significant improvement at 1 month post-surgery, but a significant decline was observed in the WCST total error (p=0.005) and the semantic VFT score (pscore was maintained, and the scores on the neuropsychological and psychiatric tests had returned to baseline. Although bilateral STN-DBS did not appear to have long-term effects on neuropsychological and psychiatric outcomes, the microlesion effects associated with STN-DBS appear to increase the risk of transient cognitive and psychiatric complications. These complications should be monitored by careful observation of neurological and psychiatric symptoms.

  15. The ABC of tDCS: Effects of Anodal, Bilateral and Cathodal Montages of Transcranial Direct Current Stimulation in Patients with Stroke—A Pilot Study

    Directory of Open Access Journals (Sweden)

    A. Fusco

    2013-01-01

    Full Text Available Transcranial direct current stimulation (tDCS is a noninvasive technique that is emerging as a prospective therapy for different neurologic disorders. Previous studies have demonstrated that anodal and cathodal stimulation can improve motor performance in terms of dexterity and manual force. The objective of this study was to determine whether different electrodes’ setups (anodal, cathodal, and simultaneous bilateral tDCS provide different motor performance and which montage was more effective. As secondary outcome, we have asked to the patients about their satisfaction, and to determine if the bilateral tDCS was more uncomfortable than unilateral tDCS. Nine patients with stroke in subacute phase were enrolled in this study and randomly divided in three groups. Our results showed that tDCS was an effective treatment if compared to Sham stimulation (. In particular, anodal stimulation provided the higher improvement in terms of manual dexterity. Cathodal stimulation seemed to have a little effect in terms of force improvement, not observed with other setups. Bipolar stimulation seemed to be the less effective. No significant differences have been noted for the different set-ups for patients’ judgment. These results highlight the potential efficacy of tDCS for patients with stroke in subacute phase.

  16. The ABC of tDCS: Effects of Anodal, Bilateral and Cathodal Montages of Transcranial Direct Current Stimulation in Patients with Stroke—A Pilot Study

    Science.gov (United States)

    Fusco, A.; De Angelis, D.; Morone, G.; Maglione, L.; Paolucci, T.; Bragoni, M.; Venturiero, V.

    2013-01-01

    Transcranial direct current stimulation (tDCS) is a noninvasive technique that is emerging as a prospective therapy for different neurologic disorders. Previous studies have demonstrated that anodal and cathodal stimulation can improve motor performance in terms of dexterity and manual force. The objective of this study was to determine whether different electrodes' setups (anodal, cathodal, and simultaneous bilateral tDCS) provide different motor performance and which montage was more effective. As secondary outcome, we have asked to the patients about their satisfaction, and to determine if the bilateral tDCS was more uncomfortable than unilateral tDCS. Nine patients with stroke in subacute phase were enrolled in this study and randomly divided in three groups. Our results showed that tDCS was an effective treatment if compared to Sham stimulation (P = 0.022). In particular, anodal stimulation provided the higher improvement in terms of manual dexterity. Cathodal stimulation seemed to have a little effect in terms of force improvement, not observed with other setups. Bipolar stimulation seemed to be the less effective. No significant differences have been noted for the different set-ups for patients' judgment. These results highlight the potential efficacy of tDCS for patients with stroke in subacute phase. PMID:23365790

  17. The Missouri River Scaphirhynchus albus (pallid sturgeon) effects analysis

    Science.gov (United States)

    Jacobson, Robert B.

    2016-08-05

    The Missouri River Pallid Sturgeon Effects Analysis (EA) was designed to assess how Missouri River management has affected—and may affect—the endangered Scaphirhynchus albus (pallid sturgeon) population. The EA emerged from the recognition that the direction and focus of the Missouri River Recovery Program would benefit from an updated, thorough evaluation of what is known, what is not known, and what needs to be known for effective actions. This fact sheet documents the steps in the EA process and the four core reports, culminating in the 2016 integrative report.

  18. Short and long term effects of left and bilateral repetitive transcranial magnetic stimulation in schizophrenia patients with auditory verbal hallucinations: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Leonie Bais

    Full Text Available BACKGROUND: Repetitive transcranial magnetic stimulation of the left temporo-parietal junction area has been studied as a treatment option for auditory verbal hallucinations. Although the right temporo-parietal junction area has also shown involvement in the genesis of auditory verbal hallucinations, no studies have used bilateral stimulation. Moreover, little is known about durability effects. We studied the short and long term effects of 1 Hz treatment of the left temporo-parietal junction area in schizophrenia patients with persistent auditory verbal hallucinations, compared to sham stimulation, and added an extra treatment arm of bilateral TPJ area stimulation. METHODS: In this randomized controlled trial, 51 patients diagnosed with schizophrenia and persistent auditory verbal hallucinations were randomly allocated to treatment of the left or bilateral temporo-parietal junction area or sham treatment. Patients were treated for six days, twice daily for 20 minutes. Short term efficacy was measured with the Positive and Negative Syndrome Scale (PANSS, the Auditory Hallucinations Rating Scale (AHRS, and the Positive and Negative Affect Scale (PANAS. We included follow-up measures with the AHRS and PANAS at four weeks and three months. RESULTS: The interaction between time and treatment for Hallucination item P3 of the PANSS showed a trend for significance, caused by a small reduction of scores in the left group. Although self-reported hallucination scores, as measured with the AHRS and PANAS, decreased significantly during the trial period, there were no differences between the three treatment groups. CONCLUSION: We did not find convincing evidence for the efficacy of left-sided rTMS, compared to sham rTMS. Moreover, bilateral rTMS was not superior over left rTMS or sham in improving AVH. Optimizing treatment parameters may result in stronger evidence for the efficacy of rTMS treatment of AVH. Moreover, future research should consider

  19. [A Case of Left Vertebral Artery Aneurysm Showing Evoked Potentials on Bilateral Electrode by the Left Vagus Nerve Stimulation to Electromyographic Tracheal Tube].

    Science.gov (United States)

    Kadoya, Tatsuo; Uehara, Hirofumi; Yamamoto, Toshinori; Shiraishi, Munehiro; Kinoshita, Yuki; Joyashiki, Takeshi; Enokida, Kengo

    2016-02-01

    Previously, we reported a case of brainstem cavernous hemangioma showing false positive responses to electromyographic tracheal tube (EMG tube). We concluded that the cause was spontaneous respiration accompanied by vocal cord movement. We report a case of left vertebral artery aneurysm showing evoked potentials on bilateral electrodes by the left vagus nerve stimulation to EMG tube. An 82-year-old woman underwent clipping of a left unruptured vertebral artery-posterior inferior cerebellar artery aneurysm. General anesthesia was induced with remifentanil, propofol and suxamethonium, and was maintained with oxygen, air, remifentanil and propofol. We monitored somatosensory evoked potentials, motor evoked potentials, and electromyogram of the vocal cord. When the manipulation reached brainstem and the instrument touched the left vagus nerve, evoked potentials appeared on bilateral electrodes. EMG tube is equipped with two electrodes on both sides. We concluded that the left vagus nerve stimulation generated evoked potentials of the left laryngeal muscles, and they were simultaneously detected as potential difference between two electrodes on both sides. EMG tube is used to identify the vagus nerve. However, it is necessary to bear in mind that each vagus nerve stimulation inevitably generates evoked potentials on bilateral electrodes.

  20. Inhibition of the reinstatement of morphine-induced place preference in rats by high-frequency stimulation of the bilateral nucleus accumbens

    Institute of Scientific and Technical Information of China (English)

    MA Yu; CHEN Ning; WANG Hui-min; Meng Fan-gang; ZHANG Jian-guo

    2013-01-01

    Background Opiate addiction remains intractable in a large percentage of patients,and relapse is the biggest hurdle to recovery.Many studies have identified a central role of the nucleus accumbens (NAc) in addiction.Deep brain stimulation (DBS) has the advantages of being reversible,adjustable,and minimally invasive,and it has become a potential neurobiological intervention for addiction.The purpose of our study was to investigate whether high-frequency DBS in the NAc effectively attenuates the reinstatement of morphine seeking in morphine-primed rats.Methods A morphine-dependent group of rats was given increasing doses of morphine during conditioned place preference training.A control group of rats was given equal volumes of saline.After the establishment of this model,withdrawal syndromes were precipitated in these two groups by administering naloxone,and the differences in withdrawal symptoms between the groups were analyzed.Electrodes for DBS were implanted in the bilateral shell of the NAc in the experimental group.The rats were stimulated daily in the NAc for 5 hours per day over 30 days.Changes in the conditioned place preference test and withdrawal symptoms in the rats were investigated and place navigation studies were performed using the Morris water maze.The data were assessed statistically with one-way analysis of variance (ANOVA) followed by Tukey's tests for multiple post hoc comparisons.Results High-frequency stimulation of the bilateral NAc prevented the morphine-induced reinstatement of morphine seeking in the conditioned place preference test.The time spent in the white compartment by rats following 30 days of DBS ((268.25±25.07) seconds) was not significantly different compared with the time spent in the white compartment after relapse was induced by morphine administration ((303.29±34.22) seconds).High-frequency stimulation of the bilateral NAc accelerated the innate decay of drug craving in morphine-dependent rats without significantly

  1. The Role of Alternating Bilateral Stimulation in Establishing Positive Cognition in EMDR Therapy: A Multi-Channel Near-Infrared Spectroscopy Study

    Science.gov (United States)

    Amano, Tamaki; Toichi, Motomi

    2016-01-01

    Eye movement desensitisation and reprocessing (EMDR) is a standard method for treating post-traumatic stress disorder. EMDR treatment consists of desensitisation and resource development and installation (RDI) stages. Both protocols provide a positive alternating bilateral stimulation (BLS). The effect of desensitisation with BLS has been elucidated. However, a role for BLS in RDI remains unknown. Therefore, it is important to measure feelings as subjective data and physiological indicators as objective data to clarify the role of BLS in RDI. RDI was administered to 15 healthy volunteer subjects who experienced pleasant memories. Their oxygenated haemoglobin concentration ([oxy-Hb]), a sensitive index of brain activity, was measured from the prefrontal cortex (PFC) to the temporal cortex using multi-channel near-infrared spectroscopy during recall of a pleasant memory with or without BLS. The BLS used was alternating bilateral tactile stimulation with a vibration machine. The psychological evaluation suggested that RDI was successful. The results showed that, compared with non-BLS conditions, accessibility was increased and subjects were more relaxed under BLS conditions. A significant increase in [oxy-Hb] was detected in the right superior temporal sulcus (STS), and a decrease in the wide bilateral areas of the PFC was observed in response to BLS. The significant BLS-induced activation observed in the right STS, which is closely related to memory representation, suggests that BLS may help the recall of more representative pleasant memories. Furthermore, the significant reduction in the PFC, which is related to emotion regulation, suggests that BLS induces relaxation and comfortable feelings. These results indicate an important neural mechanism of RDI that emotional processing occurred rather than higher cognitive processing during this stage. Considering the neuroscientific evidence to date, BLS in RDI may enhance comfortable feelings about pleasant memories

  2. Effects of Seismic Air Guns on Pallid Sturgeon and Paddlefish.

    Science.gov (United States)

    Popper, Arthur N; Carlson, Thomas J; Gross, Jackson A; Hawkins, Anthony D; Zeddies, David; Powell, Lynwood; Young, John

    2016-01-01

    Pallid sturgeon and paddlefish were placed at different distances from a seismic air gun array to determine the potential effects on mortality and nonauditory body tissues from the sound from a single shot. Fish were held 7 days postexposure and then necropsied. No fish died immediately after sound exposure or over the postexposure period. Statistical analysis of injuries showed no differences between the experimental and control animals in either type or severity of injuries. There was also no difference in injuries between fish exposed closest to the source compared with those exposed furthest from the source.

  3. Efficacy and safety of bilateral continuous theta burst stimulation (cTBS for the treatment of chronic tinnitus: design of a three-armed randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Plontke Stefan K

    2009-08-01

    Full Text Available Abstract Background Tinnitus, the perception of sound and noise in absence of an auditory stimulus, has been shown to be associated with maladaptive neuronal reorganization and increased activity of the temporoparietal cortex. Transient modulation of tinnitus by repetitive transcranial magnetic stimulation (rTMS indicated that these areas are critically involved in the pathophysiology of tinnitus and suggested new treatment strategies. However, the therapeutic efficacy of rTMS in tinnitus is still unclear, individual response is variable, and the optimal stimulation area disputable. Recently, continuous theta burst stimulation (cTBS has been put forward as an effective rTMS protocol for the reduction of pathologically enhanced cortical excitability. Methods 48 patients with chronic subjective tinnitus will be included in this randomized, placebo controlled, three-arm trial. The treatment consists of two trains of cTBS applied bilaterally to the secondary auditory cortex, the temporoparietal associaction cortex, or to the lower occiput (sham condition every working day for four weeks. Primary outcome measure is the change of tinnitus distress as quantified by the Tinnitus Questionnaire (TQ. Secondary outcome measures are tinnitus loudness and annoyance as well as tinnitus change during and after treatment. Audiologic and speech audiometric measurements will be performed to assess potential side effects. The aim of the present trail is to investigate effectiveness and safety of a four weeks cTBS treatment on chronic tinnitus and to compare two areas of stimulation. The results will contribute to clarify the therapeutic capacity of rTMS in tinnitus. Trial registration The trial was registered with the clinical trials register of http://www.clinicaltrials.gov (NCT00518024.

  4. Development of conceptual ecological models linking management of the Missouri River to pallid sturgeon population dynamics

    Science.gov (United States)

    Jacobson, Robert B.; Parsley, Michael J.; Annis, Mandy L.; Colvin, Michael E.; Welker, Timothy L.; James, Daniel A.

    2015-01-01

    This report documents the process of developing and refining conceptual ecological models (CEMs) for linking river management to pallid sturgeon (Scaphirhynchus albus) population dynamics in the Missouri River. The refined CEMs are being used in the Missouri River Pallid Sturgeon Effects Analysis to organize, document, and formalize an understanding of pallid sturgeon population responses to past and future management alternatives. The general form of the CEMs, represented by a population-level model and component life-stage models, was determined in workshops held in the summer of 2013. Subsequently, the Missouri River Pallid Sturgeon Effects Analysis team designed a general hierarchical structure for the component models, refined the graphical structure, and reconciled variation among the components and between models developed for the upper river (Upper Missouri & Yellowstone Rivers) and the lower river (Missouri River downstream from Gavins Point Dam). Importance scores attributed to the relations between primary biotic characteristics and survival were used to define a candidate set of working dominant hypotheses about pallid sturgeon population dynamics. These CEMs are intended to guide research and adaptive-management actions to benefit pallid sturgeon populations in the Missouri River.

  5. Functional interaction between right parietal and bilateral frontal cortices during visual search tasks revealed using functional magnetic imaging and transcranial direct current stimulation.

    Directory of Open Access Journals (Sweden)

    Amanda Ellison

    Full Text Available The existence of a network of brain regions which are activated when one undertakes a difficult visual search task is well established. Two primary nodes on this network are right posterior parietal cortex (rPPC and right frontal eye fields. Both have been shown to be involved in the orientation of attention, but the contingency that the activity of one of these areas has on the other is less clear. We sought to investigate this question by using transcranial direct current stimulation (tDCS to selectively decrease activity in rPPC and then asking participants to perform a visual search task whilst undergoing functional magnetic resonance imaging. Comparison with a condition in which sham tDCS was applied revealed that cathodal tDCS over rPPC causes a selective bilateral decrease in frontal activity when performing a visual search task. This result demonstrates for the first time that premotor regions within the frontal lobe and rPPC are not only necessary to carry out a visual search task, but that they work together to bring about normal function.

  6. Novel single-nucleotide polymorphism markers confirm successful spawning of endangered pallid sturgeon in the upper Missouri River Basin

    Science.gov (United States)

    Eichelberger, Jennifer S.; Braaten, P. J.; Fuller, D. B.; Krampe, Matthew S.; Heist, Edward J.

    2014-01-01

    Spawning of the federally endangered Pallid Sturgeon Scaphirhynchus albus is known to occur in the upper Missouri River basin, but progeny from natural reproductive events have not been observed and recruitment to juvenile or adult life stages has not been documented in recent decades. Identification of Pallid Sturgeon progeny is confounded by the fact that Shovelnose Sturgeon S. platorynchus occurs throughout the entire range of Pallid Sturgeon and the two species are essentially indistinguishable (morphometrically and meristically) during early life stages. Moreover, free embryos of sympatric Paddlefish Polyodon spathula are very similar to the two sturgeon species. In this study, three single-nucleotide polymorphism (SNP) assays were employed to screen acipenseriform free embryos and larvae collected from the upper Missouri River basin in 2011, 2012, and 2013. A mitochondrial DNA SNP discriminates Paddlefish from sturgeon, and specific multilocus genotypes at two nuclear DNA SNPs occurred in 98.9% of wild adult Pallid Sturgeon but only in 3% of Shovelnose Sturgeon sampled in the upper Missouri River. Individuals identified as potential Pallid Sturgeon based on SNP genotypes were further analyzed at 19 microsatellite loci for species discrimination. Out of 1,423 free embryos collected over 3 years of sampling, 971 Paddlefish, 446 Shovelnose Sturgeon, and 6 Pallid Sturgeon were identified. Additionally, 249 Scaphirhynchus spp. benthic larvae were screened, but no Pallid Sturgeon were detected. These SNP markers provide an efficient method of screening acipenseriform early life stages for the presence of Pallid Sturgeon in the Missouri River basin. Detection of wild Pallid Sturgeon free embryos in the upper Missouri and Yellowstone rivers supports the hypothesis that the failure of wild Pallid Sturgeon to recruit to the juvenile life stage in the upper Missouri River basin is caused by early life stage mortality rather than by lack of successful spawning.

  7. Science information to support Missouri River Scaphirhynchus albus (pallid sturgeon) effects analysis

    Science.gov (United States)

    Jacobson, Robert B.; Parsley, Michael J.; Annis, Mandy L.; Colvin, Michael E.; Welker, Timothy L.; James, Daniel A.

    2016-01-26

    The Missouri River Pallid Sturgeon Effects Analysis (EA) was commissioned by the U.S. Army Corps of Engineers to develop a foundation of understanding of how pallid sturgeon (Scaphirhynchus albus) population dynamics are linked to management actions in the Missouri River. The EA consists of several steps: (1) development of comprehensive, conceptual ecological models illustrating pallid sturgeon population dynamics and links to management actions and other drivers; (2) compilation and assessment of available scientific literature, databases, and models; (3) development of predictive, quantitative models to explore the system dynamics and population responses to management actions; and (4) analysis and assessment of effects of system operations and actions on species’ habitats and populations. This report addresses the second objective, compilation and assessment of relevant information.

  8. Effects of Acclimation on Poststocking Dispersal and Physiological Condition of Age-1 Pallid Sturgeon

    Energy Technology Data Exchange (ETDEWEB)

    Oldenburg, Eric W.; Guy, Christopher S.; Cureton, Eli S.; Webb, Molly H.; Gardner, William M.

    2011-03-28

    A propagation program for pallid sturgeon Scaphirhynchus albus in the upper Missouri River was implemented by the U. S. Fish and Wildlife Service in 1997. Preliminary research indicated that many hatchery-reared pallid sturgeon were experiencing significant downstream poststocking dispersal, negatively affecting their recruitment. Therefore, the objective of this study was to evaluate the effects of acclimation to flow and site-specific physicochemical water conditions on poststocking dispersal and physiological condition of age-1 pallid sturgeon. Fish from three acclimation treatments were radio-tagged, released at two locations (Missouri River and Marias River), and monitored using passive telemetry stations. Marias treatment was acclimated to flow and site-specific physicochemical conditions, Bozeman treatment was acclimated to flow only, and traditional treatment had no acclimation (reared under traditional protocol). During both years fish released in the Missouri River dispersed less than fish released in the Marias River. In 2005, Marias treatment dispersed less and nearly twice as many fish remained in the Missouri River reach than traditional treatment. In 2006, pallid sturgeon dispersed similarly among treatments and fish remaining in the Missouri River reach were similar among all treatments. Differences in poststocking dispersal between years may be related to fin curl. Fin curl was present in all fish in 2005 and 27% of the fish in 2006. Pallid sturgeon from all treatments in both years had a greater affinity for the lower reaches of the Missouri River than the upper reaches. Thus, habitat at release site influenced poststocking dispersal more than acclimation treatment. No difference was observed in relative growth rate among treatments in 2006. However, acclimation to flow (i.e., exercise conditioning) may reduce liver fat content. Acclimation conditions used in this study may not benefit pallid sturgeon unless physiological maladies are present

  9. Missouri River Scaphirhynchus albus (pallid sturgeon) effects analysis—Integrative report 2016

    Science.gov (United States)

    Jacobson, Robert B.; Annis, Mandy L.; Colvin, Michael E.; James, Daniel A.; Welker, Timothy L.; Parsley, Michael J.

    2016-07-15

    The Missouri River Pallid Sturgeon Effects Analysis was designed to carry out three components of an assessment of how Missouri River management has affected, and will affect, population dynamics of endangered Scaphirhynchus albus (pallid sturgeon): (1) collection of reliable scientific information, (2) critical assessment and synthesis of available data and analyses, and (3) analysis of the effects of actions on listed species and their habitats. This report is a synthesis of the three components emphasizing development of lines of evidence relating potential future management actions to pallid sturgeon population dynamics. We address 21 working management hypotheses that emerged from an expert opinion-based filtering process.The ability to quantify linkages from abiotic changes to pallid sturgeon population dynamics is compromised by fundamental information gaps. Although a substantial foundation of pallid sturgeon science has been developed during the past 20 years, our efforts attempt to push beyond that understanding to provide predictions of how future management actions may affect pallid sturgeon responses. For some of the 21 hypotheses, lines of evidence are limited to theoretical deduction, inference from sparse empirical datasets, or expert opinion. Useful simulation models have been developed to predict the effects of management actions on survival of drifting pallid sturgeon free embryos in the Yellowstone and Upper Missouri River complex (hereafter referred to as the “upper river”), and to assess the effects of flow and channel reconfigurations on habitat availability in the Lower Missouri River, tributaries, and Mississippi River downstream of Gavins Point Dam (hereafter referred to as the “lower river”). A population model also has been developed that can be used to assess sensitivity of the population to survival of specific life stages, assess some hypotheses related to stocking decisions, and explore a limited number of management

  10. Ecological requirements for pallid sturgeon reproduction and recruitment in the Missouri River—Annual report 2013

    Science.gov (United States)

    Delonay, Aaron J.; Jacobson, Robert B.; Chojnacki, Kimberly A.; Braaten, Patrick J.; Buhl, Kevin J.; Eder, Brandon L; Elliott, Caroline M.; Erwin, Susannah O.; Fuller, David B.; Haddix, Tyler M.; Ladd, Hallie L.A.; Mestl, Gerald E.; Papoulias, Diana M.; Rhoten, Jason C.; Wesolek, Christopher J.; Wildhaber, Mark L.

    2016-01-20

    The Comprehensive Sturgeon Research Project is a multiyear, multiagency collaborative research framework developed to provide information to support pallid sturgeon recovery and Missouri River management decisions. The project strategy integrates field and laboratory studies of pallid sturgeon reproductive ecology, early life history, habitat requirements, and physiology. The project scope of work is developed annually with collaborating research partners and in cooperation with the U.S. Army Corps of Engineers, Missouri River Recovery—Integrated Science Program. The research consists of several interdependent and complementary tasks that engage multiple disciplines.

  11. Fish and chips? Implanted transmitters help map the endangered pallid sturgeon

    Science.gov (United States)

    Chojnacki, Kimberly; DeLonay, Aaron

    2011-01-01

    With a flattened snout, long slender tail and rows of bony plates lining its body, the pallid sturgeon (Scaphirhynchus albus) has a unique, almost pre-historic, appearance. This endangered fish is native to the muddy, free-flowing waters of the Missouri River.

  12. Laboratory evaluation of effects of early life-stage exposure to selenium on pallid and shovelnose sturgeon

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Endangered pallid sturgeon and congeneric shovelnose sturgeon found in the lower Platte River, NE and elsewhere in the Missouri River basin have elevated tissue...

  13. Development of working hypotheses linking management of the Missouri River to population dynamics of Scaphirhynchus albus (pallid sturgeon)

    Science.gov (United States)

    Jacobson, Robert B.; Parsley, Michael J.; Annis, Mandy L.; Colvin, Michael E.; Welker, Timothy L.; James, Daniel A.

    2016-01-20

    This report documents a process of filtering of hypotheses that relate Missouri River Scaphirhynchus albus (pallid sturgeon) population dynamics to management actions including flow alterations, channel reconfigurations, and pallid sturgeon population augmentation. The filtering process was a partnership among U.S. Geological Survey, U.S. Army Corps of Engineers, and U.S. Fish and Wildlife Service to contribute to the Missouri River Recovery Management Plan process. The objective of the filtering process was to produce a set of hypotheses with high relevance to pallid sturgeon population dynamics and decision making on the Missouri River. The Missouri River Pallid Sturgeon Effects Analysis team filtered hundreds of potential hypotheses implicit in conceptual ecological models to develop a set of 40 candidate dominant hypotheses that were identified by experts as being important in pallid sturgeon population dynamics. Using a modified Delphi process and additional expert opinion, the team reduced this set of hypotheses to 23 working dominant hypotheses. We then matched the 23 hypotheses with management actions that could influence the biotic outcomes, resulting in as many as 176 potential effects between management actions and pallid sturgeon in the Missouri River. This number was consolidated to a candidate set of 53 working management hypotheses because some management actions applied to multiple life stages of the pallid sturgeon. We used an additional round of expert surveys to identify a set of 30 working management hypotheses. Finally, the set of working management hypotheses was filtered by the U.S. Army Corps of Engineers, Missouri River Recovery Program for actions that were within the agency’s authority and jurisdiction. This round resulted in a set of 21 hypotheses for initial modeling of linkages from management to pallid sturgeon population responses.

  14. Ecological requirements for pallid sturgeon reproduction and recruitment in the Missouri River—A synthesis of science, 2005 to 2012

    Science.gov (United States)

    Delonay, Aaron J.; Chojnacki, Kimberly A.; Jacobson, Robert B.; Albers, Janice L.; Braaten, Patrick J.; Bulliner, Edward A.; Elliott, Caroline M.; Erwin, Susannah O.; Fuller, David B; Haas, Justin D.; Ladd, Hallie L.A.; Mestl, Gerald E.; Papoulias, Diana M.; Wildhaber, Mark L.

    2016-01-20

    This report is intended to synthesize the state of the scientific understanding of pallid sturgeon ecological requirements to provide recommendations for future science directions and context for Missouri River restoration and management decisions. Recruitment of pallid sturgeon has been low to non-existent throughout its range. Emerging understanding of the genetic structure of pallid sturgeon populations sets a broad framework for species and river management decisions, including decisions about managing the future genetic diversity of the species, but also decisions about where and what type of river restoration actions will be effective for subpopulations of this highly migratory species. Adult pallid sturgeon may migrate hundreds of kilometers (km) to spawn and their progeny may disperse even greater distances downstream as drifting free embryos. As a result of their complex life history pallid sturgeon naturally exploit a wide range of habitats during their life cycles. The construction of dams and reservoirs has fragmented habitats and may have shifted Missouri River subpopulations downstream. Research has not identified one primary biological or ecological constraint that appears to limit populations of the pallid sturgeon. With the present (2013) state of knowledge many life stages and life-stage transitions cannot be ruled out as contributing to recruitment failure.

  15. Population viability analysis of Lower Missouri River shovelnose sturgeon with initial application to the pallid sturgeon

    Science.gov (United States)

    Bajer, P.G.; Wildhaber, M.L.

    2007-01-01

    Demographic models for the shovelnose (Scaphirhynchus platorynchus) and pallid (S. albus) sturgeons in the Lower Missouri River were developed to conduct sensitivity analyses for both populations. Potential effects of increased fishing mortality on the shovelnose sturgeon were also evaluated. Populations of shovelnose and pallid sturgeon were most sensitive to age-0 mortality rates as well as mortality rates of juveniles and young adults. Overall, fecundity was a less sensitive parameter. However, increased fecundity effectively balanced higher mortality among sensitive age classes in both populations. Management that increases population-level fecundity and improves survival of age-0, juveniles, and young adults should most effectively benefit both populations. Evaluation of reproductive values indicated that populations of pallid sturgeon dominated by ages ≥35 could rapidly lose their potential for growth, particularly if recruitment remains low. Under the initial parameter values portraying current conditions the population of shovelnose sturgeon was predicted to decline by 1.65% annually, causing the commercial yield to also decline. Modeling indicated that the commercial yield could increase substantially if exploitation of females in ages ≤12 was highly restricted.

  16. Ecological requirements for pallid sturgeon reproduction and recruitment in the Missouri River—Annual report 2014

    Science.gov (United States)

    Delonay, Aaron J.; Chojnacki, Kimberly A.; Jacobson, Robert B.; Braaten, Patrick J.; Buhl, Kevin J.; Elliott, Caroline M.; Erwin, Susannah O.; Faulkner, Jacob D.A.; Candrl, James S.; Fuller, David B.; Backes, Kenneth M.; Haddix, Tyler M.; Rugg, Matthew L.; Wesolek, Christopher J.; Eder, Brandon L.; Mestl, Gerald E.

    2016-03-16

    The Comprehensive Sturgeon Research Project is a multiyear, multiagency collaborative research framework developed to provide information to support pallid sturgeon recovery and Missouri River management decisions. The project strategy integrates field and laboratory studies of sturgeon reproductive ecology, early life history, habitat requirements, and physiology. The project scope of work is developed annually with collaborating research partners and in cooperation with the U.S. Army Corps of Engineers, Missouri River Recovery Program–Integrated Science Program. The project research consists of several interdependent and complementary tasks that involve multiple disciplines.The project research tasks in the 2014 scope of work emphasized understanding of reproductive migrations and spawning of adult pallid sturgeon and hatch and drift of larvae. These tasks were addressed in three hydrologically and geomorphologically distinct parts of the Missouri River Basin: the Lower Missouri River downstream from Gavins Point Dam, the Upper Missouri River downstream from Fort Peck Dam and downstream reaches of the Milk River, and the Lower Yellowstone River. The project research is designed to inform management decisions related to channel re-engineering, flow modification, and pallid sturgeon population augmentation on the Missouri River and throughout the range of the species. Research and progress made through this project are reported to the U.S. Army Corps of Engineers annually. This annual report details the research effort and progress made by the Comprehensive Sturgeon Research Project during 2014.

  17. Motor pathway excitability in ATP13A2 mutation carriers: a transcranial magnetic stimulation study.

    NARCIS (Netherlands)

    Zittel, S.; Kroeger, J.; Vegt, J.P.M. van der; Siebner, H.R.; Bruggemann, N.; Ramirez, A.; Behrens, M.I.; Gerloff, C.; Baumer, T.; Klein, C.; Munchau, A.

    2012-01-01

    OBJECTIVE: To describe excitability of motor pathways in Kufor-Rakeb syndrome (PARK9), an autosomal recessive nigro-striatal-pallidal-pyramidal neurodegeneration caused by a mutation in the ATP13A2 gene, using transcranial magnetic stimulation (TMS). METHODS: Five members of a Chilean family with an

  18. Bilateral vanished testes diagnosed with a single blood sample showing very high gonadotropins (follicle-stimulating hormone and luteinizing hormone) and very low inhibin B

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Petersen, Bodil Laub; Kvist, Kolja;

    2011-01-01

    Objective. In boys with cryptorchidism median serum values of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are higher and median serum values of inhibin B lower than in normal controls. Serum values of inhibin B reflect the state of germinative epithelium in cryptorchid testes....

  19. Short and Long Term Effects of Left and Bilateral Repetitive Transcranial Magnetic Stimulation in Schizophrenia Patients with Auditory Verbal Hallucinations : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Bais, Leonie; Vercammen, Ans; Stewart, Roy; van Es, Frank; Visser, Bert; Aleman, Andre; Knegtering, Henderikus

    2014-01-01

    Background: Repetitive transcranial magnetic stimulation of the left temporo-parietal junction area has been studied as a treatment option for auditory verbal hallucinations. Although the right temporo-parietal junction area has also shown involvement in the genesis of auditory verbal hallucinations

  20. A randomized double-blind crossover trial comparing subthalamic and pallidal deep brain stimulation for dystonia

    DEFF Research Database (Denmark)

    Schjerling, Lisbeth; Hjermind, Lena E; Jespersen, Bo;

    2013-01-01

    ratings were assessed by using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and video recordings. Quality of life was evaluated by using questionnaires (36-item Short Form Health Survey). Supplemental Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) scores were assessed for patients...

  1. Neurophysiological modulation of the subthalamic nucleus by pallidal stimulation in Parkinson's disease

    OpenAIRE

    Sterio, D; Rezai, A; Mogilner, A.; Zonenshayn, M; Gracies, J; Kathirithamby, K; Beric, A.

    2002-01-01

    Objectives: Current models of basal ganglia dysfunction in Parkinson's disease suggest a pivotal role of subthalamic nucleus (STN) hyperactivity. There is a direct excitatory output to the globus pallidus internus (GPi), which in turn hyperinhibits the motor thalamus and leads to a lack of cortical facilitation. The model, however, does not address the reciprocal influence of GPi on STN activity.

  2. 双侧丘脑底核慢性电刺激治疗原发性帕金森病%Treatment of idiopathic Parkinson's disease with chronic electronic deep brain stimulation of bilateral subthalamic nucleus

    Institute of Scientific and Technical Information of China (English)

    骆承章; 曹胜武; 赵春生

    2013-01-01

    Objective To evaluate the surgical approaches and clinical efficacy of electronic deep brain stimulation(DBS) in bilateral subthalamic nucleus (STN) for the treatment of Parkinson's disease.Methods Fourteen patients with idiopathic Parkinson's disease were treated with chronic electronic bilateral subthalamic nucleus deep brain stimulation(STN-DBS).The target was established by cranial magnetic resonance(MRI) and intraoperative microelectrode recording(MER).The patients were followed up for 6 months to 8 years.The outcomes of motor symptoms and medication dose in the 6th month after surgery were analyzed.Results The Unified Parkinson's Disease Rating Scale (UPDRS) motor score was significantly improved in the 6th month after surgery (P<0.05).The UPDRS motor score was improved on an average by 41.8% under on-status and 51.6% under offstatus.Patients were able to gain a better life quality by a long-term stimulation parameters and medication dose adjustment.The medication dose was reduced averagely by 55.6% in the 6th month after surgery.Conclusion The bilateral subthalamic nucleus stimulation is an effective method for the treatment of idiopathic Parkinson's disease.%目的 探讨双侧丘脑底核-脑深部电刺激(STN-DBS)治疗原发性帕金森病(PD)的手术方法及临床疗效.方法 采用头颅核磁共振及术中微电极记录电生理技术明确靶点定位,对14例原发性PD患者行STN-DBS手术.随访6个月-8年,评估手术对患者运动症状的改善及术后6个月患者服药剂量减少情况.结果 术后6个月患者统一用帕金森评分量表(UPDRS),运动检查评分有明显改善(P<0.05):“开”状态下平均改善率为41.8%,“关”状态下平均改善率为51.6%.患者术后通过调整刺激参数及药物剂量,均能获得满意的生活质量.于术后6个月左右评估,患者服用抗帕金森药物剂量平均减少55.6% (P<0.05).结论 STN-DBS术治疗原发性PD疗效确切.

  3. Migrations and swimming capabilities of endangered pallid sturgeon (Scaphirhynchus albus) to guide passage designs in the fragmented Yellowstone River

    Science.gov (United States)

    Braaten, P. J.; Elliott, Caroline M.; Rhoten, Jason C.; Fuller, D. B.; McElroy, Brandon J.

    2015-01-01

    Fragmentation of the Yellowstone River is hypothesized to preclude recruitment of endangered Scaphirhynchus albus (pallid sturgeon) by impeding upstream spawning migrations and access to upstream spawning areas, thereby limiting the length of free-flowing river required for survival of early life stages. Building on this hypothesis, the reach of the Yellowstone River affected by Intake Diversion Dam (IDD) is targeted for modification. Structures including a rock ramp and by-pass channel have been proposed as restoration alternatives to facilitate passage. Limited information on migrations and swimming capabilities of pallid sturgeon is available to guide engineering design specifications for the proposed structures. Migration behavior, pathways (channel routes used during migrations), and swimming capabilities of free-ranging wild adult pallid sturgeon were examined using radiotelemetry, and complemented with hydraulic data obtained along the migration pathways. Migrations of 12–26% of the telemetered pallid sturgeon population persisted to IDD, but upstream passage over the dam was not detected. Observed migration pathways occurred primarily through main channel habitats; however, migrations through side channels up to 3.9 km in length were documented. The majority of pallid sturgeon used depths of 2.2–3.4 m and mean water velocities of 0.89–1.83 m/s while migrating. Results provide inferences on depths, velocities, and habitat heterogeneity of reaches successfully negotiated by pallid sturgeon that may be used to guide designs for structures facilitating passage at IDD. Passage will provide connectivity to potential upstream spawning areas on the Yellowstone River, thereby increasing the likelihood of recruitment for this endangered species.

  4. Bilateral ankle edema with bilateral iritis.

    Science.gov (United States)

    Kumar, Sunil

    2007-07-01

    I report two patient presented to me with bilateral symmetrical ankle edema and bilateral acute iritis. A 42-year-old female of Indian origin and 30-year-old female from Somalia both presented with bilateral acute iritis. In the first patient, bilateral ankle edema preceded the onset of bilateral acute iritis. Bilateral ankle edema developed during the course of disease after onset of ocular symptoms in the second patient. Both patients did not suffer any significant ocular problem in the past, and on systemic examination, all clinical parameters were within normal limit. Lacrimal gland and conjunctival nodule biopsy established the final diagnosis of sarcoidosis in both cases, although the chest x-rays were normal.

  5. An innovative intervention for the treatment of cognitive impairment–Emisymmetric bilateral stimulation improves cognitive functions in Alzheimer’s disease and mild cognitive impairment: an open-label study

    Directory of Open Access Journals (Sweden)

    Guerriero F

    2015-09-01

    Full Text Available Fabio Guerriero,1–3 Emanuele Botarelli,3 Gianni Mele,3 Lorenzo Polo,3 Daniele Zoncu,3 Paolo Renati,3,4 Carmelo Sgarlata,1 Marco Rollone,2 Giovanni Ricevuti,1,2 Niccolo Maurizi,1 Matthew Francis,1 Mariangela Rondanelli,5 Simone Perna,5 Davide Guido,2,6 Piero Mannu3 1Department of Internal Medicine and Medical Therapy, Section of Geriatrics, University of Pavia, Pavia, Italy; 2Agency for Elderly People Services, Santa Margherita Hospital, Pavia, Italy; 3Ambra Elektron, Italian Association of Biophysics for the Study of Electromagnetic Fields in Medicine, 4Alberto Sorti Research Institute, Medicine and Metamolecular Biology, Turin, Italy; 5Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, 6Department of Public Health, Experimental and Forensic Medicine, Biostatistics and Clinical Epidemiology Unit, University of Pavia, Pavia, Italy Background and aims: In the last decade, the development of different methods of brain stimulation by electromagnetic fields (EMF provides a promising therapeutic tool for subjects with impaired cognitive functions. Emisymmetric bilateral stimulation (EBS is a novel and innovative EMF brain stimulation, whose working principle is to introduce very weak noise-like stimuli through EMF to trigger self-arrangements in the cortex of treated subjects, thereby improving cognitive faculties. The aim of this pilot study was to investigate in patients with cognitive impairment the effectiveness of EBS treatment with respect to global cognitive function, episodic memory, and executive functions. Methods: Fourteen patients with cognitive decline (six with mild cognitive impairment and eight with Alzheimer’s disease underwent three EBS applications per week to both the cerebral cortex and auricular-specific sites for a total of 5 weeks. At baseline, after 2 weeks and 5 weeks, a neuropsychological assessment was performed through mini–mental state

  6. Neuropsychological and quality of life assessment in patients with Parkinson's disease submitted to bilateral deep brain stimulation in the subthalamic nucleus

    Directory of Open Access Journals (Sweden)

    Alessandra Shenandoa Heluani

    Full Text Available ABSTRACT Deep brain stimulation (DBS has been widely used to control motor symptoms and improve quality of life in patients with Parkinsons disease (PD. Recently, DBS in the subthalamic nucleus (STN has become the preferred target for patients with mixed motor symptoms. Despite resultant motor and quality of life improvements, the procedure has been associated with cognitive decline, mainly in language skills, and also with psychiatric symptoms. Objective: To evaluate the influence of DBS in the STN on cognition, mood and quality of life. Methods: We studied 20 patients with PD submitted to DBS in the STN from May 2008 to June 2012 with an extensive battery of cognitive tests including memory, language, praxis, executive functions and attention assessments; the Parkinson's Disease Quality of Life Questionnaire (PDQ-39; and the Hospital Anxiety and Depression Scale (HAD, were applied both before and after the surgery. Data was analyzed using SPSS version 17.0 and results compared using the paired Student's t test. Results: A total of 20 patients with pre and post-operative assessments were included. A statistically significant improvement was found in total score and on subscales of mobility, activities of daily living and emotional well-being from the PDQ-39 (P=0.009, 0.025, 0.001 and 0.034, respectively. No significant difference was found on the cognitive battery or mood scale. Conclusion: DBS in the SNT improved quality of life in PD with no negative impact on cognitive skills and mood.

  7. An innovative intervention for the treatment of cognitive impairment–Emisymmetric bilateral stimulation improves cognitive functions in Alzheimer’s disease and mild cognitive impairment: an open-label study

    Science.gov (United States)

    Guerriero, Fabio; Botarelli, Emanuele; Mele, Gianni; Polo, Lorenzo; Zoncu, Daniele; Renati, Paolo; Sgarlata, Carmelo; Rollone, Marco; Ricevuti, Giovanni; Maurizi, Niccolo; Francis, Matthew; Rondanelli, Mariangela; Perna, Simone; Guido, Davide; Mannu, Piero

    2015-01-01

    Background and aims In the last decade, the development of different methods of brain stimulation by electromagnetic fields (EMF) provides a promising therapeutic tool for subjects with impaired cognitive functions. Emisymmetric bilateral stimulation (EBS) is a novel and innovative EMF brain stimulation, whose working principle is to introduce very weak noise-like stimuli through EMF to trigger self-arrangements in the cortex of treated subjects, thereby improving cognitive faculties. The aim of this pilot study was to investigate in patients with cognitive impairment the effectiveness of EBS treatment with respect to global cognitive function, episodic memory, and executive functions. Methods Fourteen patients with cognitive decline (six with mild cognitive impairment and eight with Alzheimer’s disease) underwent three EBS applications per week to both the cerebral cortex and auricular-specific sites for a total of 5 weeks. At baseline, after 2 weeks and 5 weeks, a neuropsychological assessment was performed through mini–mental state examination, free and cued selective reminding tests, and trail making test. As secondary outcomes, changes in behavior, functionality, and quality of life were also evaluated. Results After 5 weeks of standardized EBS therapy, significant improvements were observed in all neurocognitive assessments. Mini–mental state examination score significantly increased from baseline to end treatment (+3.19, P=0.002). Assessment of episodic memory showed an improvement both in immediate and delayed recalls (immediate recall =+7.57, P=0.003; delayed recall =+4.78, P<0.001). Executive functions significantly improved from baseline to end stimulation (trail making test A −53.35 seconds; P=0.001). Of note, behavioral disorders assessed through neuropsychiatric inventory significantly decreased (−28.78, P<0.001). The analysis concerning the Alzheimer’s disease and mild cognitive impairment group confirmed a significant improvement of

  8. Bilateral Duane syndrome and bilateral aniridia.

    Science.gov (United States)

    Khan, Arif O; Aldahmesh, Mohammad

    2006-06-01

    Duane retraction syndrome has been reported in association with structural abnormalities of the eye, including epibulbar dermoid, keratoconus, iris dysplasia, heterochromia iridis, persistent fetal vasculature, cataract, choroidal coloboma, microphthalmia, and optic nerve dysplasia. A novel association, that of bilateral Duane syndrome with bilateral aniridia, is the subject of this report.

  9. Effects of Exposure to the Sound from Seismic Airguns on Pallid Sturgeon and Paddlefish.

    Science.gov (United States)

    Popper, Arthur N; Gross, Jackson A; Carlson, Thomas J; Skalski, John; Young, John V; Hawkins, Anthony D; Zeddies, David

    2016-01-01

    This study examined the effects of exposure to a single acoustic pulse from a seismic airgun array on caged endangered pallid sturgeon (Scaphirhynchus albus) and on paddlefish (Polyodon spathula) in Lake Sakakawea (North Dakota, USA). The experiment was designed to detect the onset of physiological responses including minor to mortal injuries. Experimental fish were held in cages as close as 1 to 3 m from the guns where peak negative sound pressure levels (Peak- SPL) reached 231 dB re 1 μPa (205 dB re 1 μPa2·s sound exposure level [SEL]). Additional cages were placed at greater distances in an attempt to develop a dose-response relationship. Treatment and control fish were then monitored for seven days, euthanized, and necropsied to determine injuries. Necropsy results indicated that the probability of delayed mortality associated with pulse pressure following the seven day monitoring period was the same for exposed and control fish of both species. Exposure to a single pulse from a small air gun array (10,160 cm3) was not lethal for pallid sturgeon and paddlefish. However, the risks from exposure to multiple sounds and to sound exposure levels that exceed those reported here remain to be examined.

  10. Bilateral orbital cavernous haemangiomas.

    OpenAIRE

    Fries, P D; Char, D. H.

    1988-01-01

    Simultaneous bilateral orbital lesions are rare. The differential diagnosis includes orbital pseudotumour, metastasis, leukaemia, lymphoma, Wegener's granulomatosis, and neurofibromatosis. We report what we believe to be the first case of bilateral orbital cavernous haemangiomas.

  11. Bilateral otogenic cerebellar abscesses.

    Directory of Open Access Journals (Sweden)

    Nadkarni T

    1993-01-01

    Full Text Available An unusual presentation of bilateral otogenic cerebellar abscesses observed in two of our patients is reported. Both gave a history of otorrhoea, fever, headache, vomiting and had bilateral cerebellar signs and conductive hearing loss. The abscesses were detected on computerised tomography. X-rays revealed bilateral mastoiditis. The therapy followed was excision of abscesses, mastoidectomy and antibiotic therapy.

  12. Development of a community-level forecasting model for pallid and shovelnose sturgeon and associated chub species in the lower Missouri River

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Produce a fish community model that can be used to predict joint population growth rates of shovelnose and pallid sturgeon and associated chub species.

  13. Distribution of iron in the parrot brain: conserved (pallidal) and derived (nigral) labeling patterns.

    Science.gov (United States)

    Roberts, T F; Brauth, S E; Hall, W S

    2001-12-01

    The distribution of iron in the brain of a vocal learning parrot, the budgerigar (Melopsittacus undulatus), was examined using iron histochemistry. In mammals, iron is a highly specific stain for the dorsal and ventral pallidal subdivision as well as specific cell groups in the brainstem, including the substantia nigra pars reticulata [Neuroscience 11 (1984) 595-603]. The purpose of this study was to compare the distribution of iron in the mammalian and avian brain focusing on pallidal and nigral cell groups. The results show that in the avian brain, iron stains oligodendrocytes, neurons and the neuropil. Cell staining changes dramatically along the rostrocaudal axis, with neuronal labeling confined to regions caudal to the thalamus and oligodendrocyte labeling denser in regions rostral to the dorsal thalamus. Many sensory forebrain regions contain appreciable iron labeling, including telencephalic vocal control nuclei. The dorsal and ventral subdivision of the avian pallidum, along with the basal ganglia component of the vocal control circuit, the magnicellular nucleus of the lobus parolfactorius, stain heavily for iron. Several brainstem regions, including nucleus rotundus, the medial spiriform nucleus (SpM), the principle nucleus of the trigeminal nerve, nucleus laminaris and scattered cell groups throughout the isthmus and pontine reticular formation stain intensely for iron. Within SpM neuronal labeling is more intense in the medial division while oligodendrocyte labeling is more intense in the lateral division. surprisingly no nigral iron staining was observed. Our results imply that iron is a conserved marker for the pallidum in birds and mammals, but that patterns of nigral staining have diverged in birds and mammals. Differences in iron staining patterns between birds and mammals may also reflect the relatively greater importance of the collothalamic visual pathways, pretectal-cerebellar pathways and specialized vocal learning circuitry in avian sensory

  14. Heterochronic bilateral ectopic pregnancy after ovulation induction.

    Science.gov (United States)

    Zhu, Bo; Xu, Gu-feng; Liu, Yi-feng; Qu, Fan; Yao, Wei-miao; Zhu, Yi-min; Gao, Hui-juan; Zhang, Dan

    2014-08-01

    Ectopic pregnancy is identified with the widely-applied assisted reproductive technology (ART). Bilateral ectopic pregnancy is a rare form of ectopic pregnancy which is difficult to be diagnosed at the pre-operation stage. In this paper, we presented an unusual case of heterochronic bilateral ectopic pregnancy after stimulated intrauterine insemination (IUI), where there has been a delay of 22 d between the diagnoses of the two ectopic pregnancies. Literature was reviewed on the occurrence of bilateral ectopic pregnancy during the past four years in the MEDLINE database. We found 16 cases of bilateral ectopic pregnancy reported since 2008, and analyzed the characteristics of those cases of bilateral ectopic pregnancy. We emphasize that ovulation induction and other ARTs may increase the risk of bilateral ectopic pregnancy. Because of the difficulty in identification of bilateral ectopic pregnancy by ultrasonography, the clinician should be aware that the treatment of one ectopic pregnancy does not preclude the occurrence of a second ectopic pregnancy in the same patient and should pay attention to the intra-operation inspection of both side fallopian tubes in any ectopic pregnancy case.

  15. Activity of identified wrist-related pallidal neurons during step and ramp wrist movements in the monkey.

    Science.gov (United States)

    Hamada, I; DeLong, M R; Mano, N

    1990-12-01

    1. The activity of globus pallidus (GP) neurons (n = 1,117) was studied in two monkeys to reexamine the relation of neuronal activity to movement type (slow vs. fast) while they performed both a visually guided step and ramp wrist tracking task. To select neurons specifically related to wrist movements, we employed both a somatosensory examination of individual body parts and a statistical analysis of the strength of temporal coupling of neuronal discharges to active wrist movement. 2. Neuronal responses to somatosensory stimulation were studied in 1,000 high-frequency GP neurons, of which 686 exhibited clear responses to manipulation of body parts. Of the latter, 336 responded to passive manipulation of forelimb joints and 58 selectively to passive flexion or extension of the wrist. 3. In the external segment of GP (GPe), most neurons responding to passive wrist movement were found to be clustered in four to five adjacent, closely positioned (separated by 200 microns) tracks in single coronal planes. The clusters were irregular in shape with a maximal width of 800-1,000 microns. Separate clusters of neurons responsive to passive wrist movement were identified in planes 3 mm apart in one monkey and in planes 500 microns apart in the other. Multiple clusters of neurons were also found for neurons responsive to joints other than the wrist. These findings suggest a more discrete and complex representation of individual joints in the primate GP than previously conceived. 4. During the performance of the wrist flexion and extension task, 92 neurons showed clear and consistent changes in activity. For these neurons we measured, with a statistical method on a trial-by-trial basis, the strength of temporal coupling between the onset of active wrist movement and the onset of change in neuronal discharge rate. Fifteen neurons showed changes in activity time-locked to the onset of active wrist movement. 5. Twelve pallidal neurons were classified as "wrist-related" based on

  16. Bilateral ekstrauterin graviditet

    DEFF Research Database (Denmark)

    Kirkegaard, Ida; Kruse, Christina

    2009-01-01

    Bilateral tubal pregnancies are extremely rare and they are usually found after assisted reproductive techniques have been applied. A rare case of bilateral tubal pregnancy after natural conception, occurring in a woman without any predisposing factors for ectopic pregnancy, is presented....... The condition was diagnosed during laparoscopic surgery, and she was optimally treated with conservative tubal surgery. A short review of the literature is provided and discussed along with the clinical features, diagnostic difficulties and treatment options of bilateral tubal pregnancy. Udgivelsesdato: 2009...

  17. Acanthocytosis, retinitis pigmentosa, and pallidal degeneration: a report of three patients, including the second reported case with hypoprebetalipoproteinemia (HARP syndrome).

    Science.gov (United States)

    Orrell, R W; Amrolia, P J; Heald, A; Cleland, P G; Owen, J S; Morgan-Hughes, J A; Harding, A E; Marsden, C D

    1995-03-01

    We describe an example of a variant of Hallervorden-Spatz disease, characterized by hypoprebeta-lipoproteinemia, acanthocytosis, retinitis pigmentosa, and pallidal degeneration (HARP syndrome), in an 18-year-old woman who presented with longstanding intellectual subnormality, night blindness, and a 2-year history of orobuccolingual dystonia causing dysarthria and dysphagia. Investigation showed acanthocytosis and hypoprebetalipoproteinemia, and electroretinograms were typical of tapetoretinal degeneration. T2-weighted MRI showed decreased signal intensity in the pallidal nuclei with central hyperintensity, constituting the "eye-of-the-tiger" sign. The patient's sister and mother have a similar lipid disorder but no retinal or neurologic disease. We also report two patients with clinical and radiologic features similar to those of the patient with HARP syndrome but who had normal lipid studies. These various combinations of components of HARP syndrome may be caused by several distinct genetic diseases or may represent variable manifestations of a contiguous gene defect.

  18. Ecological Requirements for Pallid Sturgeon Reproduction and Recruitment in the Lower Missouri River: A Research Synthesis 2005-08

    Science.gov (United States)

    DeLonay, Aaron J.; Jacobson, Robert B.; Papoulias, Diana M.; Simpkins, Darin G.; Wildhaber, Mark L.; Reuter, Joanna M.; Bonnot, Tom W.; Chojnacki, Kimberly A.; Korschgen, Carl E.; Mestl, Gerald E.; Mac, Michael J.

    2009-01-01

    This report provides a synthesis of results obtained between 2005 and 2008 from the Comprehensive Sturgeon Research Program, an interagency collaboration between the U.S. Geological Survey, Nebraska Game and Parks Commission, U.S. Fish and Wildlife Service, and the U.S. Army Corps of Engineers' Missouri River Recovery - Integrated Science Program. The goal of the Comprehensive Sturgeon Research Program is to improve fundamental understanding of reproductive ecology of the pallid sturgeon with the intent that improved understanding will inform river and species management decisions. Specific objectives include: *Determining movement, habitat-use, and reproductive behavior of pallid sturgeon; *Understanding reproductive physiology of pallid sturgeon and relations to environmental conditions; *Determining origin, transport, and fate of drifting pallid sturgeon larvae, and evaluating bottlenecks for recruitment of early life stages; *Quantifying availability and dynamics of aquatic habitats needed by pallid sturgeon for all life stages; and *Managing databases, integrating understanding, and publishing relevant information into the public domain. Management actions to increase reproductive success and survival of pallid sturgeon in the Lower Missouri River have been focused on flow regime, channel morphology, and propagation. Integration of 2005-08 Comprehensive Sturgeon Research Program research provides insight into linkages among flow regime, re-engineered channel morphology, and pallid sturgeon reproduction and survival. The research approach of the Comprehensive Sturgeon Research Program integrates opportunistic field studies, field-based experiments, and controlled laboratory studies. The field study plan is designed to explore the role of flow regime and associated environmental cues using two complementary approaches. An upstream-downstream approach compares sturgeon reproductive behavior between an upstream section of the Lower Missouri River with highly

  19. Compensation following bilateral vestibular damage

    Directory of Open Access Journals (Sweden)

    Bill J Yates

    2011-12-01

    Full Text Available Bilateral loss of vestibular inputs affects far fewer patients than unilateral inner ear damage, and thus has been understudied. In both animal subjects and human patients, bilateral vestibular hypofunction (BVH produces a variety of clinical problems, including impaired balance control, inability to maintain stable blood pressure during postural changes, difficulty in visual targeting of images, and disturbances in spatial memory and navigational performance. Experiments in animals have shown that nonlabyrinthine inputs to the vestibular nuclei are rapidly amplified following the onset of BVH, which may explain the recovery of postural stability and orthostatic tolerance that occurs within 10 days. However, the loss of the vestibulo-ocular reflex and degraded spatial cognition appear to be permanent in animals with BVH. Current concepts of the compensatory mechanisms in humans with BVH are largely inferential, as there is a lack of data from patients early in the disease process. Translation of animal studies of compensation for BVH into therapeutic strategies and subsequent application in the clinic is the most likely route to improve treatment. In addition to physical therapy, two types of prosthetic devices have been proposed to treat individuals with bilateral loss of vestibular inputs: those that provide tactile stimulation to indicate body position in space, and those that deliver electrical stimuli to branches of the vestibular nerve in accordance with head movements. The relative efficacy of these two treatment paradigms, and whether they can be combined to facilitate recovery, is yet to be ascertained.

  20. [Hemorrhagic bilateral renal angiomyolipoma].

    Science.gov (United States)

    Benjelloun, Mohamed; Rabii, Redouane; Mezzour, Mohamed Hicham; Joual, Abdenbi; Bennani, Saâd; el Mrini, Mohamed

    2003-09-01

    Renal angiomyolipoma is a rare benign tumour, often associated with congenital diseases especially de Bourneville's tuberous sclerosis. Bilateral angiomyolipoma is exceptional. The authors report a case of bilateral renal angiomyolipoma in a 33-year-old patient presenting with haemorrhagic shock. In the light of this case and a review of the literature, the authors discuss the diagnostic and therapeutic aspects of this disease.

  1. Bilateral microform cleft lip

    OpenAIRE

    Pace, David; Attard Montalto, Simon; Grech, Victor E.

    2006-01-01

    Microform cleft lip (MCL), also called congenital healed cleft lip or cleft lip "frustré", is a rare congenital anomaly. MCL has been described as having the characteristic appearance of a typical cleft lip which has been corrected in utero. We present a girl with bilateral microform cleft lip associated with a preauricular sinus and bilateral camptodactyly.

  2. Bilateral assymetric epidural hematoma

    Directory of Open Access Journals (Sweden)

    Edmundo Luis Rodrigues Pereira

    2015-01-01

    Full Text Available Background: Acute bilateral extradural hematoma is a rare presentation of head trauma injury. In sporadic cases, they represent 0.5-10% of all extradural hematomas. However, higher mortality rates have been reported in previous series. Case Description: The authors described the case of a 28-year-old male presenting head injury, comatose, Glasgow Coma Scale of 6, anisocoric pupils without puppilary light reflex. Computed tomography showed asymmetric bilateral epidural hematomas, effacement of the lateral ventricles and sulci, midline shift and a bilateral skull fracture reaching the vertex. Surgical evacuation was performed with simultaneous hematoma drainage. Patient was discharged on the 29 th postoperative day with no neurological deficit. Conclusion: The correct approach on bilateral epidural hematomas depends on the volume, moment of diagnosis, and neurological deficit level. Simultaneous drainage of bilateral hematomas has been demonstrated to be an effective technique for it, which soon decreases the intracranial pressure and promotes an efficient resolution to the neurological damage.

  3. Remote-sensing of Riverine Environments Utilized by Spawning Pallid Sturgeon Using a Suite of Hydroacoustic Tools and High-resolution DEMs

    Science.gov (United States)

    Elliott, C. M.; Jacobson, R. B.; DeLonay, A. J.; Braaten, P. J.

    2013-12-01

    The pallid sturgeon (Scaphirynchus albus) inhabits sandy-bedded rivers in the Mississippi River basin including the Missouri and Lower Yellowstone Rivers and has experienced decline generally associated with the fragmentation and alteration of these river systems. Knowledge gaps in the life history of the pallid sturgeon include lack of an understanding of conditions needed for successful reproduction and recruitment. We employed hydroacoustic tools to investigate habitats utilized by spawning pallid sturgeon in the Missouri River in Missouri, Kansas, Iowa, and Nebraska, and the Yellowstone River in Montana and North Dakota USA from 2008-2013. Reproductive pallid sturgeon were tracked to suspected spawning locations by field crews using either acoustic or radio telemetry, a custom mobile mapping application, and differential global positioning systems (DGPS). Female pallid sturgeon were recaptured soon after spawning events to validate that eggs had been released. Habitats were mapped at presumed spawning and embryo incubation sites using a multibeam echosounder system (MBES), sidescan sonar, acoustic Doppler current profiler, an acoustic camera and either a real-time kinematic global positioning system (RTK GPS) or DGPS. High-resolution DEM's and velocimetric maps were gridded from at a variety of scales from 0.10 to 5 meters for characterization and visualization at spawning and presumed embryo incubation sites. Pallid sturgeon spawning sites on the Missouri River are deep (6-8 meters) and have high current velocities (>1.5 meters per second). These sites are also characterized by high turbidity and high rates of bedload sediment transport in the form of migrating sand dunes. Spawning on the channelized Lower Missouri River occurs on or adjacent to coarse angular bank revetment or bedrock. Collecting biophysical information in these environmental conditions is challenging, and there is a need to characterize the substrate and substrate condition at a scale

  4. Pregnancy following bilateral salpingectomy

    DEFF Research Database (Denmark)

    Oturai, Annette Bang

    2008-01-01

    This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy...... was unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy Udgivelsesdato: 2008/4/21...

  5. Bilateral Control - Operational enhancements

    OpenAIRE

    Altınışık, Ahmet; Altinisik, Ahmet

    2006-01-01

    A succinct definition of the word bilateral is having two sides [1]. In robotics the term bilateral control is used to define the specific interaction of two systems by means of position and/or force. Bilateral systems are composed of two sides named master and slave side. The aim of such an arrangement is such that position command dictated by master side is followed by a slave side, and at the same time the force sensation of the remote environment experienced by slave is transferred to the...

  6. Staged bilateral carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Engell, Hans Christian

    1986-01-01

    In a series of 56 staged bilateral carotid endarterectomies, new neurologic symptoms developed in 5% and 20% following the first and second procedure, respectively. All complications were transient or minor. The incidence of postendarterectomy hypertension was significantly higher following...

  7. Echinoderms have bilateral tendencies.

    Science.gov (United States)

    Ji, Chengcheng; Wu, Liang; Zhao, Wenchan; Wang, Sishuo; Lv, Jianhao

    2012-01-01

    Echinoderms take many forms of symmetry. Pentameral symmetry is the major form and the other forms are derived from it. However, the ancestors of echinoderms, which originated from Cambrian period, were believed to be bilaterians. Echinoderm larvae are bilateral during their early development. During embryonic development of starfish and sea urchins, the position and the developmental sequence of each arm are fixed, implying an auxological anterior/posterior axis. Starfish also possess the Hox gene cluster, which controls symmetrical development. Overall, echinoderms are thought to have a bilateral developmental mechanism and process. In this article, we focused on adult starfish behaviors to corroborate its bilateral tendency. We weighed their central disk and each arm to measure the position of the center of gravity. We then studied their turning-over behavior, crawling behavior and fleeing behavior statistically to obtain the center of frequency of each behavior. By joining the center of gravity and each center of frequency, we obtained three behavioral symmetric planes. These behavioral bilateral tendencies might be related to the A/P axis during the embryonic development of the starfish. It is very likely that the adult starfish is, to some extent, bilaterian because it displays some bilateral propensity and has a definite behavioral symmetric plane. The remainder of bilateral symmetry may have benefited echinoderms during their evolution from the Cambrian period to the present.

  8. Altered pallido-pallidal synaptic transmission leads to aberrant firing of globus pallidus neurons in a rat model of Parkinson's disease.

    Science.gov (United States)

    Miguelez, Cristina; Morin, Stéphanie; Martinez, Audrey; Goillandeau, Michel; Bezard, Erwan; Bioulac, Bernard; Baufreton, Jérôme

    2012-11-15

    The pattern of activity of globus pallidus (GP) neurons is tightly regulated by GABAergic inhibition. In addition to extrinsic inputs from the striatum (STR-GP) the other source of GABA to GP neurons arises from intrinsic intranuclear axon collaterals (GP-GP). While the contribution of striatal inputs has been studied, notably its hyperactivity in Parkinson's disease (PD), the properties and function of intranuclear inhibition remain poorly understood. Our objective was therefore to test the impact of chronic dopamine depletion on pallido-pallidal transmission. Using patch-clamp whole-cell recordings in rat brain slices, we combined electrical and optogenetic stimulations with pharmacology to differentiate basic synaptic properties of STR-GP and GP-GP GABAergic synapses. GP-GP synapses were characterized by activity-dependent depression and insensitivity to the D(2) receptor specific agonist quinpirole and STR-GP synapses by frequency-dependent facilitation and quinpirole modulation. Chronic dopamine deprivation obtained in 6-OHDA lesioned animals boosted the amplitude of GP-GP IPSCs but did not modify STR-GP transmission and increased the amplitude of miniature IPSCs. Replacement of calcium by strontium confirmed that the quantal amplitude was increased at GP-GP synapses. Finally, we demonstrated that boosted GP-GP transmission promotes resetting of autonomous activity and rebound-burst firing after dopamine depletion. These results suggest that GP-GP synaptic transmission (but not STR-GP) is augmented by chronic dopamine depletion which could contribute to the aberrant GP neuronal activity observed in PD.

  9. Sperm-cell ultrastructure of North American sturgeons. IV. The pallid sturgeon (Scaphirhynchus albus Forbes and Richardson, 1905)

    Science.gov (United States)

    DiLauro, M.N.; Walsh, R.A.; Peiffer, M.; Bennett, R.M.

    2001-01-01

    Sperm-cell morphology and ultrastructure in the pallid sturgeon (Scaphirhynchus albus) were examined using transmission and scanning electron microscopy. Metrics and structure were compared with similar metrics obtained from other published descriptions of sturgeon sperm cells. General morphology was found to be similar to that of sperm cells of the white (Acipenser transmontanus), lake (A. fulvescens), stellate (A. stellatus), Chinese (A. sinensis), Russian (A. gueldenstaedti colchicus), and shortnose (A. brevirostrum) sturgeons, which all shared a gradual tapering of the nuclear diameter from posterior to anterior, unlike that of the Atlantic sturgeon (A. oxyrhynchus). The sperm cell of the pallid sturgeon was similar in size to that of the Atlantic sturgeon, being only slightly larger. The sperm cell of the pallid sturgeon differed from those of other sturgeons chiefly in the acrosomal region, where the posterolateral projections (PLP) have the shape of an acute triangle and are arranged in a spiral about the longitudinal axis of the cell. The PLP were longer than those of other sturgeons, being twice the length of those of the Atlantic sturgeon and 58% longer than those of the lake sturgeon. Also, in cross section the acrosome had the shape of a hollow cone rather than the cap of an oak tree acorn, as was found in ultrastructural studies of other sturgeons. In addition, we were able to confirm that the structural arrangement of the distal centriole of the midpiece is identical with that of the proximal centriole: nine sets of microtubular triplets around the periphery of the centriole. This information is of potential use to fishery biologists, forensic biologists, zoologists, reproductive physiologists, taxonomists, evolutionary biologists, and aquaculturists.

  10. Escleritis posterior bilateral Bilateral posterior scleritis

    Directory of Open Access Journals (Sweden)

    A. Zurutuza

    2011-08-01

    Full Text Available La escleritis posterior es un proceso inflamatorio de la parte posterior de la esclera. Su prevalencia es muy baja y el diagnóstico puede resultar complicado por la ausencia de signos oculares externos. Es más frecuente en mujeres. Cuando aparece en pacientes jóvenes no suele tener otras patologías asociadas, pero en mayores de 55 años hasta un tercio de los casos tienen relación con alguna enfermedad sistémica, sobre todo la artritis reumatoide. El diagnóstico de esta patología puede requerir un abordaje multidisciplinar y la colaboración de oftalmólogos con neurólogos, internistas o reumatólogos. En este artículo se describe un caso de escleritis posterior bilateral idiopática.Posterior scleritis is an inflammatory process of the posterior part of the sclera. Its prevalence is very low and its diagnosis can be complicated due to the absence of external ocular signs. It is more frequent in women. In young patients it does not usually have other associated pathologies, but in those over 55 years nearly one-third of the cases have a relation with some systemic disease, above all rheumatoid arthritis. The diagnosis of this pathology can require a multidisciplinary approach and the collaboration of ophthalmologists with neurologists, internists or rheumatologists. This article describes a case of idiopathic bilateral posterior scleritis.

  11. Bilaterally Incarcerated Morgagni Hernia

    Directory of Open Access Journals (Sweden)

    Zuhal Demirhan Yananli

    2013-06-01

    Full Text Available Morgagni hernia is a rare congenital diaphragmatic hernia. It is seen rarely bilaterally. Patients are usually asymptomatic. Therefore, diagnosis may be delayed until adulthood. Significant morbidity can occur in case complications arise and diagnosis is delayed. The patient, a 74 year-old female, presented in this article, was admitted to the emergency department with abdominal pain, vomiting, and shortness of breath. The plain abdominal radiograph of the patient revealed bowel obstruction and suspicious appearence in favor of the diaphragmatic hernia on both sides of the sternum. Computed tomography revealed bilaterally incarcerated Morgagni hernia with strangulated omentum in the right side of the sternum and a part of colon in the left side of sternum. Incarcerated organs were withdrawn to peritoneal cavity and defects of hernia were sutured primarily on laparatomy. Because bilateral incarcerated Morgagni hernia can be seen rarely, this case was reported.

  12. Bilateral inferior turbinate osteoma

    Science.gov (United States)

    Sahemey, R.; Warfield, A.T.; Ahmed, S.

    2016-01-01

    Osteomas are the most common benign osteoclastic tumours of the paranasal sinuses. However, nasal cavity and turbinate osteomas are extremely rare. Only nine middle turbinate, three inferior turbinate and one inferior turbinate osteoma cases have been reported to date. The present case report describes the management and follow-up of symptomatic bilateral inferior turbinate osteoma. A 60-year-old female presented with symptoms of bilateral nasal obstruction and right-sided epiphora. Radiological investigation found hypertrophic bony changes involving both inferior turbinates. The patient was managed successfully by endoscopic inferior turbinectomies in order to achieve a patent airway, with no further recurrence of tumour after 3 months postoperatively. To the best of our knowledge, this is the first reported case of bilateral inferior turbinate osteoma. We describe a safe and minimally invasive method of tumour resection, which has a better cosmetic outcome compared with other approaches. PMID:27534890

  13. Bilateral Primary Intraocular Lymphoma

    Directory of Open Access Journals (Sweden)

    Mehrdad Karimi

    2011-01-01

    Full Text Available Purpose: To report a case of bilateral primary intraocular lymphoma. Case report: A 33-year-old man presented with bilateral blurred vision since two years ago. Examination revealed large keratic precipitates, anterior chamber reaction, posterior subcapsular cataracts, and vitreous infiltration. After a short trial of topical and periocular steroids, diagnostic 25-gauge pars plana vitrectomy was performed and cytologic evaluation of the aspirate confirmed a diagnosis of intraocular lymphoma. The patient was subsequently managed with intravitreal methotrexate in both eyes and responded favorably. Central nervous system workup for lymphoma was negative. Conclusion: Primary intraocular lymphoma should be considered in young adults suffering from chronic recalcitrant panuveitis.

  14. Bilateral Naevus Of OTA

    Directory of Open Access Journals (Sweden)

    Ahmad Qazi Masood

    2001-01-01

    Full Text Available Naevus of Ota is a type of dermal melanocytic naevus characterized by extensive blue patch of dermal melanocytic pigmentation of the sclera and the skin adjacent to the eye. The condition is usually unilateral. Here we report a patient with bilateral naevus of Ota in view of the rarity of this condition.

  15. Bilateral cochlear implantation: current concepts, indications, and results.

    Science.gov (United States)

    Basura, Gregory J; Eapen, Rose; Buchman, Craig A

    2009-12-01

    The optimal treatment for bilateral hearing loss continues to evolve as cochlear implant (CI) and hearing aid technologies advance, as does our understanding of the central auditory system. Ongoing discussions continue on the validity and feasibility of bilateral CI in terms of performance, justification of need, medical/surgical safety concerns, and economics. The purpose of this review article is to provide an update on the advantages and disadvantages of bilateral CI and to provide a discussion on timing (simultaneous vs. sequential), technology (bimodal vs. binaural) and feasibility. Binaural advantages are found in both adult and pediatric bilateral CI recipients, the greatest being the head shadow effect and improvements in localization and loudness summation. This theoretically offers an advantage over their unilateral implanted counterparts in terms of improved sound localization and enhanced speech perception under noisy conditions. Most investigators agree that bilateral stimulation during critical periods of development is paramount for optimizing auditory functioning in children. Currently, bilateral CI is widely accepted as a safe and effective means of bilateral auditory stimulation.

  16. Economic Diplomacy in Africa: The Impact of Regional Integration versus Bilateral Diplomacy on Bilateral Trade

    DEFF Research Database (Denmark)

    Afesorgbor, Sylvanus Kwaku

    The paper examines the impact of two main instruments of economic diplomacy — regional integration and commercial diplomacy on export flows among African states. We test whether there is any evidence of a trade-off or complementary interaction between these two instruments in trade facilitation. We...... compare the effects of these two instruments of economic diplomacy on bilateral trade by employing a gravity model for 45 African states over the period 1980-2005. The results show that bilateral diplomatic exchange is a relatively more significant determinant of bilateral exports among African states...... compared to regional integration. We also find a nuanced interaction between these two instruments of economic diplomacy: the trade–stimulating effect of diplomatic exchange is less pronounced among African countries that shared membership of the same regional bloc. Generally, this could mean...

  17. Application of non-lethal stable isotope analysis to assess feeding patterns of juvenile pallid sturgeon Scaphirhynchus albus: a comparison of tissue types and sample preservation methods

    Science.gov (United States)

    Andvik, R.T.; VanDeHey, J.A.; Fincel, M.J.; French, William E.; Bertrand, K.N.; Chipps, Steven R.; Klumb, R.A.; Graeb, B.D.S.

    2010-01-01

    Traditional techniques for stable isotope analysis (SIA) generally require sacrificing animals to collect tissue samples; this can be problematic when studying diets of endangered species such as the pallid sturgeon Scaphirhynchus albus. Our objectives were to (i) determine if pectoral fin tissue (non-lethal) could be a substitute for muscle tissue (lethal) in SIA of juvenile pallid sturgeon, and (ii) evaluate the influence of preservation techniques on stable isotope values. In the laboratory, individual juvenile pallid sturgeon were held for up to 186 day and fed chironomids, fish, or a commercially available pellet diet. Significant, positive relationships (r² ≥ 0.8) were observed between fin and muscle tissues for both δ15N and δ13C; in all samples isotopes were enriched in fins compared to muscle tissue. Chironomid and fish based diets of juvenile pallid sturgeon were distinguishable for fast growing fish (0.3 mm day−1) using stable δ15N and δ13C isotopes. Frozen and preserved fin tissue δ15N isotopes were strongly related (r2 = 0.89) but δ13C isotopes were weakly related (r2 = 0.16). Therefore, freezing is recommended for preservation of fin clips to avoid the confounding effect of enrichment by ethanol. This study demonstrates the utility of a non-lethal technique to assess time integrated food habits of juvenile pallid sturgeon and should be applicable to other threatened or endangered species.

  18. Visual Basic, Excel-based fish population modeling tool—The pallid sturgeon example

    Science.gov (United States)

    Moran, Edward H.; Wildhaber, Mark L.; Green, Nicholas S.; Albers, Janice L.

    2016-02-10

    The model presented in this report is a spreadsheet-based model using Visual Basic for Applications within Microsoft Excel (http://dx.doi.org/10.5066/F7057D0Z) prepared in cooperation with the U.S. Army Corps of Engineers and U.S. Fish and Wildlife Service. It uses the same model structure and, initially, parameters as used by Wildhaber and others (2015) for pallid sturgeon. The difference between the model structure used for this report and that used by Wildhaber and others (2015) is that variance is not partitioned. For the model of this report, all variance is applied at the iteration and time-step levels of the model. Wildhaber and others (2015) partition variance into parameter variance (uncertainty about the value of a parameter itself) applied at the iteration level and temporal variance (uncertainty caused by random environmental fluctuations with time) applied at the time-step level. They included implicit individual variance (uncertainty caused by differences between individuals) within the time-step level.The interface developed for the model of this report is designed to allow the user the flexibility to change population model structure and parameter values and uncertainty separately for every component of the model. This flexibility makes the modeling tool potentially applicable to any fish species; however, the flexibility inherent in this modeling tool makes it possible for the user to obtain spurious outputs. The value and reliability of the model outputs are only as good as the model inputs. Using this modeling tool with improper or inaccurate parameter values, or for species for which the structure of the model is inappropriate, could lead to untenable management decisions. By facilitating fish population modeling, this modeling tool allows the user to evaluate a range of management options and implications. The goal of this modeling tool is to be a user-friendly modeling tool for developing fish population models useful to natural resource

  19. Visual Basic, Excel-based fish population modeling tool - The pallid sturgeon example

    Science.gov (United States)

    Moran, Edward H.; Wildhaber, Mark L.; Green, Nicholas S.; Albers, Janice L.

    2016-02-10

    The model presented in this report is a spreadsheet-based model using Visual Basic for Applications within Microsoft Excel (http://dx.doi.org/10.5066/F7057D0Z) prepared in cooperation with the U.S. Army Corps of Engineers and U.S. Fish and Wildlife Service. It uses the same model structure and, initially, parameters as used by Wildhaber and others (2015) for pallid sturgeon. The difference between the model structure used for this report and that used by Wildhaber and others (2015) is that variance is not partitioned. For the model of this report, all variance is applied at the iteration and time-step levels of the model. Wildhaber and others (2015) partition variance into parameter variance (uncertainty about the value of a parameter itself) applied at the iteration level and temporal variance (uncertainty caused by random environmental fluctuations with time) applied at the time-step level. They included implicit individual variance (uncertainty caused by differences between individuals) within the time-step level.The interface developed for the model of this report is designed to allow the user the flexibility to change population model structure and parameter values and uncertainty separately for every component of the model. This flexibility makes the modeling tool potentially applicable to any fish species; however, the flexibility inherent in this modeling tool makes it possible for the user to obtain spurious outputs. The value and reliability of the model outputs are only as good as the model inputs. Using this modeling tool with improper or inaccurate parameter values, or for species for which the structure of the model is inappropriate, could lead to untenable management decisions. By facilitating fish population modeling, this modeling tool allows the user to evaluate a range of management options and implications. The goal of this modeling tool is to be a user-friendly modeling tool for developing fish population models useful to natural resource

  20. Bilateral matrix-exponential distributions

    DEFF Research Database (Denmark)

    Bladt, Mogens; Esparza, Luz Judith R; Nielsen, Bo Friis

    2012-01-01

    In this article we define the classes of bilateral and multivariate bilateral matrix-exponential distributions. These distributions have support on the entire real space and have rational moment-generating functions. These distributions extend the class of bilateral phasetype distributions of [1]...

  1. Bilateral chronic subdural hematoma

    DEFF Research Database (Denmark)

    Andersen-Ranberg, Nina Christine; Poulsen, Frantz Rom; Bergholt, Bo

    2017-01-01

    OBJECTIVE Bilateral chronic subdural hematoma (bCSDH) is a common neurosurgical condition frequently associated with the need for retreatment. The reason for the high rate of retreatment has not been thoroughly investigated. Thus, the authors focused on determining which independent predictors...... are associated with the retreatment of bCSDH with a focus on surgical laterality. METHODS In a national database of CSDHs (Danish Chronic Subdural Hematoma Study) the authors retrospectively identified all bCSDHs treated in the 4 Danish neurosurgical departments over the 3-year period from 2010 to 2012....... Univariate and multivariate analyses were performed to determine the relationship between retreatment of bCSDH and clinical, radiological, and surgical variables. RESULTS Two hundred ninety-one patients with bCSDH were identified, and 264 of them underwent unilateral (136 patients) or bilateral (128 patients...

  2. Bilateral tibial hemimelia I.

    Science.gov (United States)

    Suganthy, J; Rassau, Marina; Koshi, Rachel; Battacharjee, Suranjan

    2007-05-01

    Congenital absence of tibia is a rare anomaly. We report a case of bilateral tibial hemimelia born to phenotypically normal parents. The two amputated legs with tibial dysplasia obtained from a 3-year-old boy were studied by radiography and anatomical dissection. The radiological evaluation revealed a normal hip joint. The lower end of femur was normal without any bifurcation, shortening or bowing. Fibula was present on both legs and there was no sign of bowing or doubling. Both right and left tibiae were absent. In addition, on the right side, five tarsal bones, two metatarsals and the corresponding digital rays were absent. On the left side, three tarsal bones were absent. Dissection of the amputated segments showed the presence of extensor digitorum longus, peroneus tertius, peroneus longus and brevis, gastrocnemius, and soleus. Following bilateral knee disarticulation the patient was fitted with prosthesis and is doing well.

  3. [Spontaneous bilateral Petit hernia].

    Science.gov (United States)

    Fontoura, Rodrigo Dias; Araújo, Emerson Silveira de; Oliveira, Gustavo Alves de; Sarmenghi Filho, Deolindo; Kalil, Mitre

    2011-01-01

    Petit's lumbar hernia is an uncommon defect of the posterior abdominal wall that represents less than 1% of all abdominal wall hernias. It is more often unilateral and founded in young females, rarely containing a real herniated sac. There are two different approaches to repair: laparoscopy and open surgery. The goal of this article is to report one case of spontaneous bilateral lumbar Petit's hernia treated with open surgery.

  4. Bilateral lunate intraosseous ganglia

    Energy Technology Data Exchange (ETDEWEB)

    Pablos, J.M. [Department of Radiology, Hospital San Juan de Dios, Seville (Spain); Valdes, J.C. [Department of Radiology, Cemedi, Seville (Spain); Gavilan, F. [Department of Pathology, Hospital Universitario Virgen del Rocio, Seville (Spain)

    1998-12-01

    An intraosseous ganglion is a relatively uncommon, benign, cyst-like lesion that occurs in young and middle-aged adults. Most commonly seen adjacent to the hip, ankle, knee, or wrist, they are histologically identical to their soft tissue counterparts. A review of the literature revealed only two previously reported examples of bilateral symmetrical ganglia of the lunate bones. (orig.) With 3 figs., 10 refs.

  5. Ischemic Bilateral Opercular Syndrome

    OpenAIRE

    Aysel Milanlioglu; Mehmet Nuri Aydın; Alper Gökgül; Mehmet Hamamcı; Mehmet Atilla Erkuzu; Temel Tombul

    2013-01-01

    Opercular syndrome, also known as Foix-Chavany-Marie syndrome, is a paralysis of the facial, pharyngeal, masticatory, tongue, laryngeal, and brachial muscles. It is a rare cortical form of pseudobulbar palsies caused by vascular insults to bilateral operculum. Its clinical presentations include anarthria, weakness of voluntary muscles involving face, tongue, pharynx, larynx, and masticatory muscles. However, autonomic reflexes and emotional activities of these structures are preserved. In the...

  6. Bilateral akillesseneruptur hos nyretransplanterede

    DEFF Research Database (Denmark)

    Skovgaard, D; Feldt-Rasmussen, B F; Nimb, L

    1996-01-01

    Increased incidence of tendinitis and tendon ruptures is reported in recipients of a kidney transplant. Two cases of bilateral achilles tendon rupture after minimal trauma are described. Tendon ruptures are more frequent in individuals with kidney disease in dialysis or after transplantation...... compared with patients receiving other organ transplantations. It is therefore more likely that tendon ruptures are related to metabolic changes associated with kidney disease rather than with transplantation or with glucocorticoid treatment per se. Clinical symptoms of achilles tendinitis should...

  7. 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

    2002-10-01

    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.

  8. Dynamic stereotypic responses of basal ganglia neurons to subthalamic nucleus high frequency stimulation in the parkinsonian primate

    Directory of Open Access Journals (Sweden)

    Anan eMoran

    2011-04-01

    Full Text Available Deep brain stimulation in the subthalamic nucleus (STN is a well-established therapy for patients with severe Parkinson‟s disease (PD; however, its mechanism of action is still unclear. In this study we explored static and dynamic activation patterns in the basal ganglia during high frequency macro-stimulation of the STN. Extracellular multi-electrode recordings were performed in primates rendered parkinsonian using 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Recordings were preformed simultaneously in the STN and the globus pallidus externus and internus. Single units were recorded preceding and during the stimulation. During the stimulation, STN mean firing rate dropped significantly, while pallidal mean firing rates did not change significantly. The vast majority of neurons across all three nuclei displayed stimulation driven modulations, which were stereotypic within each nucleus but differed across nuclei. The predominant response pattern of STN neurons was somatic inhibition. However, most pallidal neurons demonstrated synaptic activation patterns. A minority of neurons across all nuclei displayed axonal activation. Temporal dynamics were observed in the response to stimulation over the first 10 seconds in the STN and over the first 30 seconds in the pallidum. In both pallidal segments, the synaptic activation response patterns underwent delay and decay of the magnitude of the peak response due to short term synaptic depression. We suggest that during STN macro stimulation the STN goes through a functional ablation as its upper bound on information transmission drops significantly. This notion is further supported by the evident dissociation between the stimulation driven pre-synaptic STN somatic inhibition and the post-synaptic axonal activation of its downstream targets. Thus, basal ganglia output maintains its firing rate while losing the deleterious effect of the STN. This may be a part of the mechanism leading to the beneficial

  9. Effects of unilateral and bilateral deep brain stimulation of nucleus accumbens on heroin-seeking behavior in serf-administration rats%单双侧脑深部电刺激伏核对大鼠海洛因觅药行为的影响

    Institute of Scientific and Technical Information of China (English)

    郭烈美; 周洪语; 王冉; 钟志宏; 徐纪文; 江基尧; 周文华; 张富强; 唐甩恩

    2013-01-01

    Objective To investigate the effects of unilateral or bilateral deep brain stimulation (DBS) of nucleus accumbens (NAc) on heroin-seeking behaviors in self-administration rats elicited by conditioned cues or small dose of heroin.Methods Self-administration rat models of relapsing in heroin were established with fixed ration program (FR1),and then,the rats were randomly divided into 5 groups:control group,sham stimulation group,left DBS group,right DBS group and bilateral DBS group.The concentric bipolar microelectrodes were implanted unilaterally/bilaterally into the core of NAc in rats of DBS groups.After 5 days recovery,the rats were given a 1-hour-long high frequency electrical stimulation (square pulse and frequency:130 Hz; current intensity:150 μA; pulse width:100 μs) for 7 days during the extinction phase.Heroin-seeking behaviors were elicited by conditioned cues or small dose of heroin,and their differences between groups were compared through the times of active nose-poke responses.Results In the reinstatement induced by conditioned cues and small dose of heroin,significant differences on the active nose-poke responses of rats were noted between each two groups (P<0.05); both the right DBS group and bilateral DBS group showed significant differences of active nose-poke responses as compared with the control group,the sham stimulation group and the left DBS group (P<0.05),while no significant difference was obsvred between the right DBS group and the bilateral DBS group (P>0.05).Conclusion The right or bilateral DBS of NAc core can significantly reduce the heroin-seeking behaviors elicited by conditioned cues and small dose of heroin in self-administration rats,and the right DBS of NAc can obtain almost the same effects of bilateral DBS.%目的 观察单侧和双侧脑深部电刺激(DBS)伏核核心部对条件性线索和小剂量海洛因诱导大鼠海洛因觅药行为的影响,探讨DBS治疗药物成瘾的单双侧靶点选取问题. 方法

  10. Bilateral optic neuropathy with bilateral putaminal lesions: a case report.

    Science.gov (United States)

    Togawa, Jumpei; Ohi, Takekazu

    2015-01-01

    Bilateral optic neuropathy with bilateral putaminal lesions may be caused by methanol or cyanide poisoning or mitochondrial disorders including Leber hereditary optic neuropathy and Leigh syndrome. We report the case of a 34-year-old Japanese man who developed bilateral visual loss 5 days after the development of gastrointestinal symptoms. Magnetic resonance imaging of the brain on admission revealed high-intensity signal areas in the bilateral putamina on diffusion-weighted and T2-weighted images as well as a high-intensity signal area in the left middle cerebellar peduncle that had been identified 3 years previously. We diagnosed bilateral optic neuropathy with bilateral putaminal lesions caused by preceding infection-triggered demyelination. We administered methylprednisolone, but his vision did not recover.

  11. Ischemic Bilateral Opercular Syndrome

    Directory of Open Access Journals (Sweden)

    Aysel Milanlioglu

    2013-01-01

    Full Text Available Opercular syndrome, also known as Foix-Chavany-Marie syndrome, is a paralysis of the facial, pharyngeal, masticatory, tongue, laryngeal, and brachial muscles. It is a rare cortical form of pseudobulbar palsies caused by vascular insults to bilateral operculum. Its clinical presentations include anarthria, weakness of voluntary muscles involving face, tongue, pharynx, larynx, and masticatory muscles. However, autonomic reflexes and emotional activities of these structures are preserved. In the present case, an 81-year-old male presented with acute onset of anarthria with difficulties in chewing, speaking, and swallowing that was diagnosed with opercular syndrome.

  12. Ischemic bilateral opercular syndrome.

    Science.gov (United States)

    Milanlioglu, Aysel; Aydın, Mehmet Nuri; Gökgül, Alper; Hamamcı, Mehmet; Erkuzu, Mehmet Atilla; Tombul, Temel

    2013-01-01

    Opercular syndrome, also known as Foix-Chavany-Marie syndrome, is a paralysis of the facial, pharyngeal, masticatory, tongue, laryngeal, and brachial muscles. It is a rare cortical form of pseudobulbar palsies caused by vascular insults to bilateral operculum. Its clinical presentations include anarthria, weakness of voluntary muscles involving face, tongue, pharynx, larynx, and masticatory muscles. However, autonomic reflexes and emotional activities of these structures are preserved. In the present case, an 81-year-old male presented with acute onset of anarthria with difficulties in chewing, speaking, and swallowing that was diagnosed with opercular syndrome.

  13. Comparison of weight changes following unilateral and staged bilateral STN DBS for advanced PD

    OpenAIRE

    Lee, Eric M; Kurundkar, Ashish; Cutter, Gary R.; Huang, He; Guthrie, Barton L.; Watts, Ray L; Walker, Harrison C.

    2011-01-01

    Unilateral and bilateral subthalamic nucleus deep brain stimulation (STN DBS) in Parkinson's disease (PD) result in weight gain in the initial postoperative months, but little is known about the changes in weight following unilateral and staged bilateral STN DBS over longer time intervals. A case–control comparison evaluated weight changes over 2 years in 43 consecutive unilateral STN DBS patients, among whom 25 elected to undergo staged bilateral STN DBS, and 21 age-matched and disease sever...

  14. Bilateral accessory thoracodorsal artery.

    Science.gov (United States)

    Natsis, Konstantinos; Totlis, Trifon; Tsikaras, Prokopios; Skandalakis, Panagiotis

    2006-09-01

    The subscapular artery arises from the third part of the axillary artery and gives off the circumflex scapular and the thoracodorsal arteries. Although anatomical variations of the axillary artery are very common, the existence of a unilateral accessory thoracodorsal artery has been described in the literature only once. There are no reports of bilateral accessory thoracodorsal artery, in the literature. In the present study, a bilateral accessory thoracodorsal artery, originating on either side of the third part of the axillary artery, is described in a 68-year-old female cadaver. All the other branches of the axillary artery had a typical origin, course, distribution and termination. This extremely rare anatomical variation apart from the anatomical importance also has clinical significance for surgeons in this area. Especially, during the dissection or mobilization of the latissimus dorsi that is partly used for coverage problems in many regions of the body and also in dynamic cardiomyoplasty, any iatrogenic injury of this accessory artery may result in ischemia and functional loss of the graft.

  15. Bilateral Antepartum Mastitis

    Directory of Open Access Journals (Sweden)

    Peyman Alibeigi

    2010-12-01

    Full Text Available Antepartum mastitis is a rare condition, whereas postpartum orlactation mastitis is a common problem. This report introducesa case of complicated bilateral antepartum mastitis, which wastreated successfully by drain insertion and antibiotic therapy.The patient was a 23-year-old woman in the 23rd week of herfirst pregnancy. Her chief complaint was progressive swelling,redness and radicular pain in both breasts, which had beenstarted gradually from the 18th week of pregnancy. The patientwas admitted to hospital, and received oral and intravenous antibioticsempirically, which was not effective. The patient wastreated by drainage and oral antibiotic therapy. Based on theapproaches employed and the outcomes achieved it is suggestedthat early surgical insertion in the presence of fluid collection inantepartum mastitis will shorten hospitalization and course ofintravenous antibiotic therapy.Iran J Med Sci 2010; 35(4: 327-330.

  16. [Bilateral cochlear implantation].

    Science.gov (United States)

    Kronenberg, Jona; Migirov, Lela; Taitelbaum-Swead, Rikey; Hildesheimer, Minka

    2010-06-01

    Cochlear implant surgery became the standard of care in hearing rehabilitation of patients with severe to profound sensorineural hearing loss. This procedure may alter the lives of children and adults enabling them to integrate with the hearing population. In the past, implantation was performed only in one ear, despite the fact that binaural hearing is superior to unilateral, especially in noisy conditions. Cochlear implantation may be performed sequentially or simultaneously. The "sensitive period" of time between hearing loss and implantation and between the two implantations, when performed sequentially, significantly influences the results. Shorter time spans between implantations improve the hearing results after implantation. Hearing success after implantation is highly dependent on the rehabilitation process which includes mapping, implant adjustments and hearing training. Bilateral cochlear implantation in children is recommended as the proposed procedure in spite of the additional financial burden.

  17. Idiopathic Bilateral Bloody Tearing

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    Emrullah Beyazyıldız

    2015-01-01

    Full Text Available Bloody tear is a rare and distinct clinic phenomenon. We report a case presenting with the complaint of recurrent episodes of bilateral bloody tearing. A 16-year-old girl presented to our clinic with complaint of bloody tearing in both eyes for 3 months. Bloody tearing was not associated with her menses. A blood-stained discharge from the punctum was not observed during the compression of both nasolacrimal ducts. Nasolacrimal passage was not obstructed. Imaging studies such as dacryocystography and gradient-echo magnetic resonance imaging (MRI of nasolacrimal canal were normal. Intranasal endoscopic evaluation was normal. We collected samples from bloody tears two times and pathological examination was performed. Pathological analysis showed lots of squamous cells and no endometrial cells; dysplastic cells were found. Further evaluations for underlying causes were unremarkable. No abnormalities were found in ophthalmologic, radiologic, and pathologic investigations. This condition is likely a rare abnormality and the least recognized aetiology for the idiopathic phenomenon.

  18. Bilateral acute corneal calcification.

    Science.gov (United States)

    Freddo, T F; Leibowitz, H M

    1985-04-01

    A 38-year-old man with brittle, juvenile onset diabetes mellitus and bilateral severe dry eyes with recurrent corneal ulcers developed atypical band-shaped calcifications of both corneas during a 24-hour period. Serum calcium, phosphate, and carbon dioxide levels all were within normal limits. The patient was mildly uremic but was not in renal failure. When EDTA chelation failed to clear the deposits, partial keratectomies were performed in both eyes and the specimens were examined by light and electron microscopy, including energy dispersive x-ray analysis. Microscopic studies revealed an atypical calcific keratopathy which involved neither Bowman's layer nor the most superficial stromal lamellae. The deposits were confined to deeper lamellae in the anterior stroma and by electron microscopy were composed of extracellular crystalline aggregates. Energy dispersive x-ray analysis of these aggregates confirmed the presence of calcium and phosphate. Corneal dessication appeared to be a major contributing factor in the rapid formation of these deposits.

  19. A stochastic bioenergetics model based approach to translating large river flow and temperature in to fish population responses: the pallid sturgeon example

    Science.gov (United States)

    Wildhaber, Mark L.; Dey, Rima; Wikle, Christopher K.; Moran, Edward H.; Anderson, Christopher J.; Franz, Kristie J.

    2015-01-01

    In managing fish populations, especially at-risk species, realistic mathematical models are needed to help predict population response to potential management actions in the context of environmental conditions and changing climate while effectively incorporating the stochastic nature of real world conditions. We provide a key component of such a model for the endangered pallid sturgeon (Scaphirhynchus albus) in the form of an individual-based bioenergetics model influenced not only by temperature but also by flow. This component is based on modification of a known individual-based bioenergetics model through incorporation of: the observed ontogenetic shift in pallid sturgeon diet from marcroinvertebrates to fish; the energetic costs of swimming under flowing-water conditions; and stochasticity. We provide an assessment of how differences in environmental conditions could potentially alter pallid sturgeon growth estimates, using observed temperature and velocity from channelized portions of the Lower Missouri River mainstem. We do this using separate relationships between the proportion of maximum consumption and fork length and swimming cost standard error estimates for fish captured above and below the Kansas River in the Lower Missouri River. Critical to our matching observed growth in the field with predicted growth based on observed environmental conditions was a two-step shift in diet from macroinvertebrates to fish.

  20. Resposta do ACTH plasmático ao estímulo com CRH ou CRH + desmopressina em pacientes com síndrome de Cushing ACTH- dependente submetidos a cateterismo bilateral simultâneo dos seios petrosos inferiores Response of plasmatic ACTH to CRH or combined CRH/desmopressin stimulation in patients with ACTHdependent Cushing's syndrome submitted to simultaneous bilateral petrosal sinuses sampling

    Directory of Open Access Journals (Sweden)

    Daniella Maria Carneiro do Rêgo

    2007-12-01

    Full Text Available OBJETIVO: Comparar a resposta do ACTH plasmático após estímulo com CRH ou CRH + desmopressina em pacientes com síndrome de Cushing ACTH-dependente que realizaram cateterismo bilateral simultâneo dos seios petrosos inferiores. MATERIAIS E MÉTODOS: O procedimento foi realizado em 21 pacientes - 14 mulheres e 7 homens - com síndrome de Cushing ACTH-dependente no período de janeiro de 1998 a dezembro de 2003. Após a cateterização de ambos os seios petrosos, amostras de sangue para ACTH foram colhidas, simultaneamente, nos seios petrosos e veia periférica, tanto no estado basal como após três e cinco minutos da administração de CRH humano (100 mg (6 pacientes ou CRH + desmopressina (100 mg + 10 mg (15 pacientes. RESULTADOS: Aos três minutos, houve aumento percentual do ACTH tanto no grupo CRH (257,77 ± 240,36 no seio petroso direito e 718,78 ± 1.358,82 no seio petroso esquerdo [média ± desvio-padrão] como no grupo CRH + desmopressina (1.263,35 ± 1.842,91 no seio petroso direito [p = 0,06] e 583,93 ± 1.020,03 no seio petroso esquerdo [p = 0,83]. Aos cinco minutos houve declínio percentual do ACTH no grupo do CRH (181,07 ± 217,39 no seio petroso direito e 188,25 ± 270,15 no seio petroso esquerdo e aumento progressivo no grupo do CRH + desmopressina (1.365,29 ± 1.832,31 no seio petroso direito [p = 0,03] e 866,43 ± 1.431,72 no seio petroso esquerdo [p = 0,11]. Nos três pacientes com secreção ectópica não houve gradiente. CONCLUSÃO: A estimulação combinada CRH + desmopressina induziu maior produção de ACTH em adenomas corticotróficos em comparação ao CRH, o que pode melhorar a sensibilidade diagnóstica deste procedimento.OBJECTIVE: To compare the responses of plasmatic ACTH to CRH or combined CRH/desmopressin stimulation in patients with ACTH-dependent Cushing's syndrome submitted to simultaneous, bilateral inferior petrosal sinuses sampling. MATERIALS AND METHODS: The procedure was performed in 21 patients - 14

  1. Silicosis with bilateral spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Fotedar Sanjay

    2010-01-01

    Full Text Available Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax.The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

  2. Pediatric isolated bilateral iliac aneurysm.

    Science.gov (United States)

    Chithra, R; Sundar, R Ajai; Velladuraichi, B; Sritharan, N; Amalorpavanathan, J; Vidyasagaran, T

    2013-07-01

    Aneurysms are rare in children. Isolated iliac artery aneurysms are very rare, especially bilateral aneurysms. Pediatric aneurysms are usually secondary to connective tissue disorders, arteritis, or mycotic causes. We present a case of a 3-year-old child with bilateral idiopathic common iliac aneurysms that were successfully repaired with autogenous vein grafts.

  3. Bilateral bi-cephalic tDCS with two active electrodes of the same polarity modulates bilateral cognitive processes differentially [corrected].

    Directory of Open Access Journals (Sweden)

    Elise Klein

    Full Text Available Transcranial direct current stimulation (tDCS is an innovative method to explore the causal structure-function relationship of brain areas. We investigated the specificity of bilateral bi-cephalic tDCS with two active electrodes of the same polarity (e.g., cathodal on both hemispheres applied to intraparietal cortices bilaterally using a combined between- and within-task approach. Regarding between-task specificity, we observed that bilateral bi-cephalic tDCS affected a numerical (mental addition but not a control task (colour word Stroop, indicating a specific influence of tDCS on numerical but not on domain general cognitive processes associated with the bilateral IPS. In particular, the numerical effect of distractor distance was more pronounced under cathodal than under anodal stimulation. Moreover, with respect to within-task specificity we only found the numerical distractor distance effect in mental addition to be modulated by direct current stimulation, whereas the effect of target identity was not affected. This implies a differential influence of bilateral bi-cephalic tDCS on the recruitment of different processing components within the same task (number magnitude processing vs. recognition of familiarity. In sum, this first successful application of bilateral bi-cephalic tDCS with two active electrodes of the same polarity in numerical cognition research corroborates the specific proposition of the Triple Code Model that number magnitude information is represented bilaterally in the intraparietal cortices.

  4. Paresia diafragmática bilateral idiopática Idiopathic bilateral diaphragmatic paresis

    Directory of Open Access Journals (Sweden)

    Mônica Corso Pereira

    2006-10-01

    Full Text Available Relata-se o caso de um paciente com dispnéia intensa ao se deitar, em que foram excluídas doenças pulmonares, neuromusculares ou cardíacas, cuja investigação revelou paresia diafragmática bilateral. Um sinal chave para o diagnóstico foi a evidência de respiração paradoxal com o doente em decúbito supino. Havia piora da oxigenação e da capacidade vital forçada com a mudança da posição ortostática para supina. A fluoroscopia ortostática foi normal. A pressão inspiratória máxima estava muito reduzida. A estimulação elétrica transcutânea do diafragma foi normal, e a eletroestimulação do nervo frênico mostrou ausência de resposta, permitindo o diagnóstico de paresia bilateral do diafragma.We report the case of a patient with severe dyspnea upon reclining. Lung disease, neuromuscular disorders and heart disease were ruled out. However, during the course of the investigation, bilateral diaphragmatic paresis was discovered. A key sign leading to the diagnosis was evidence of paradoxical respiration in the dorsal decubitus position. When the patient was moved from the orthostatic position to the dorsal decubitus position, oxygenation and forced vital capacity worsened. The orthostatic fluoroscopy was normal. Maximal inspiratory pressure was severely reduced. The responses to transcutaneous electric stimulation of the diaphragm were normal. However, electric stimulation of the phrenic nerve produced no response, leading to the diagnosis of bilateral diaphragmatic paresis.

  5. Traumatic bilateral hip dislocation with bilateral sciatic nerve palsy

    Institute of Scientific and Technical Information of China (English)

    Ajay Pal Singh; Amarjit Singh Sidhu; Arun Pal Singh

    2010-01-01

    Bilateral hip dislocation rarely occurs.In this paper, a case of bilateral hip dislocation associated with bilateral sciatic nerve palsy resulted from a road traffic acci-dent is reported.Both hips were emergently reduced under general anaesthesia.Acetabular reconstruction was done bilaterally due to the unstable hips.The patient subsequently developed heterotopic ossification and avascular necrosis on the left hip and underwent total hip arthroplasty.The sciatic nerve on the right side achieved complete recovery but that on the left side only partly recovered and was aug-mented by tendon transfer.Such injuries are serious and one should be aware of the complications because they can resurface and so patients should be followed up for a long time.To the best of our knowledge, this kind of injury has not been reported in the English .language literature.

  6. Associations of Unilateral Whisker and Olfactory Signals Induce Synapse Formation and Memory Cell Recruitment in Bilateral Barrel Cortices: Cellular Mechanism for Unilateral Training Toward Bilateral Memory

    Science.gov (United States)

    Gao, Zilong; Chen, Lei; Fan, Ruicheng; Lu, Wei; Wang, Dangui; Cui, Shan; Huang, Li; Zhao, Shidi; Guan, Sudong; Zhu, Yan; Wang, Jin-Hui

    2016-01-01

    Somatosensory signals and operative skills learned by unilateral limbs can be retrieved bilaterally. In terms of cellular mechanism underlying this unilateral learning toward bilateral memory, we hypothesized that associative memory cells in bilateral cortices and synapse innervations between them were produced. In the examination of this hypothesis, we have observed that paired unilateral whisker and odor stimulations led to odorant-induced whisker motions in bilateral sides, which were attenuated by inhibiting the activity of barrel cortices. In the mice that showed bilateral cross-modal responses, the neurons in both sides of barrel cortices became to encode this new odor signal alongside the innate whisker signal. Axon projections and synapse formations from the barrel cortex, which was co-activated with the piriform cortex, toward its contralateral barrel cortex (CBC) were upregulated. Glutamatergic synaptic transmission in bilateral barrel cortices was upregulated and GABAergic synaptic transmission was downregulated. The associative activations of the sensory cortices facilitate new axon projection, glutamatergic synapse formation and GABAergic synapse downregulation, which drive the neurons to be recruited as associative memory cells in the bilateral cortices. Our data reveal the productions of associative memory cells and synapse innervations in bilateral sensory cortices for unilateral training toward bilateral memory. PMID:28018178

  7. Associations of unilateral whisker and olfactory signals induce synapse formation and memory cell recruitment in bilateral barrel cortices: cellular mechanism for unilateral training toward bilateral memory

    Directory of Open Access Journals (Sweden)

    Zilong Gao

    2016-12-01

    Full Text Available Somatosensory signals and operative skills learned by unilateral limbs can be retrieved bilaterally. In terms of cellular mechanism underlying this unilateral learning toward bilateral memory, we hypothesized that associative memory cells in bilateral cortices and synapse innervations between them were produced. In the examination of this hypothesis, we have observed that paired unilateral whisker and odor stimulations led to odorant-induced whisker motions in bilateral sides, which were attenuated by inhibiting the activity of barrel cortices. In the mice that showed bilateral cross-modal responses, the neurons in both sides of barrel cortices became to encode this new odor signal alongside the innate whisker signal. Axon projections and synapse formations from the barrel cortex, which was co-activated with the piriform cortex, toward its contralateral barrel cortex were upregulated. Glutamatergic synaptic transmission in bilateral barrel cortices was upregulated and GABAergic synaptic transmission was downregulated. The associative activations of the sensory cortices facilitate new axon projection, glutamatergic synapse formation and GABAergic synapse downregulation, which drive the neurons to be recruited as associative memory cells in the bilateral cortices. Our data reveals the productions of associative memory cells and synapse innervations in bilateral sensory cortices for unilateral training toward bilateral memory.

  8. Disrupted Auto-Activation, Dysexecutive and Confabulating Syndrome Following Bilateral Thalamic and Right Putaminal Stroke

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    Lieve De Witte

    2008-01-01

    Full Text Available Objective: Clinical, neuropsychological, structural and functional neuroimaging results are reported in a patient who developed a unique combination of symptoms after a bi-thalamic and right putaminal stroke. The symptoms consisted of dysexecutive disturbances associated with confabulating behavior and auto-activation deficits. Background: Basal ganglia and thalamic lesions may result in a variety of motor, sensory, neuropsychological and behavioral syndromes. However, the combination of a dysexecutive syndrome complicated at the behavioral level with an auto-activation and confabulatory syndrome has never been reported. Methods: Besides clinical and neuroradiological investigations, an extensive set of standardized neuropsychological tests was carried out. Results: In the post-acute phase of the stroke, a dysexecutive syndrome was found in association with confabulating behavior and auto-activation deficits. MRI showed focal destruction of both thalami and the right putamen. Quantified ECD SPECT revealed bilateral hypoperfusions in the basal ganglia and thalamus but no perfusion deficits were found at the cortical level. Conclusion: The combination of disrupted auto-activation, dysexecutive and confabulating syndrome in a single patient following isolated subcortical damage renders this case exceptional. Although these findings do not reveal a functional disruption of the striato-ventral pallidal-thalamic-frontomesial limbic circuitry, they add to the understanding of the functional role of the basal ganglia in cognitive and behavioral syndromes.

  9. Bilateral, independent juvenile nasopharyngeal angiofibroma

    DEFF Research Database (Denmark)

    Mørkenborg, Marie-Louise; Frendø, M; Stavngaard, T;

    2015-01-01

    BACKGROUND: Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originating...... from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning...... embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated. CONCLUSION: This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting with bilateral...

  10. Bilateral Olecranon Tophaceous Gout Bursitis

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    Güzelali Özdemir

    2017-01-01

    Full Text Available In this case, we present a patient with the diagnosis of bilateral olecranon tophaceous gout. After the surgical treatment, there was no limitation of range of motion or wound problem at 6th month control.

  11. Bilateral Morgagni Hernia in Adult

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    Ali Celik

    2014-03-01

    Full Text Available       Morgagni hernia is a congenital anterior diaphragma hernias. Although it generally seen in childhood and on the right side, rarely seen bilaterally and adult. Computarize tomography is helpful in diagnosis for this lesions asymptomatic in adult. In this article, bilaterally morgagni hernia diagnosed a sixty-five year old male patient looked for due to dyspne was presented.

  12. Bilateral sarkoidose i glandula parotis

    DEFF Research Database (Denmark)

    Hahn, Pernille; Krogdahl, Annelise; Godballe, Christian

    2012-01-01

    We describe an unusual case of sarcoidosis in which the patient presented with a bilateral swelling of the parotid salivary glands and no other manifestation of the disease. Sarcoidosis is a multisystem granulomatous disorder of unknown cause in which there may be multiple exocrine involvement......, including the salivary glands. This case emphasises the importance of including sarcoidosis in the differential diagnosis of bilateral parotid swelling....

  13. CETA - BILATERAL TRADE AGREEMENT BETWEEN THE EU AND CANADA

    Directory of Open Access Journals (Sweden)

    Ludmila Borta

    2014-04-01

    Full Text Available The international trade for wide world countries in the means more growth, more jobs and access on more products at competitive prices. The European Union is a major economy and an important trading partner for many countries and regions in the world. To stimulate growth and to create jobs in the Union, this economy has concluded multilateral trade agreement (under the World Trade Organisation and a number of bilateral (preferential trade agreements. The aim of this paper is to present an example of fully elimination of tariffs and tariff lines under a bilateral trade agreement. In this case, we have analysed Comprehensive Economic and Trade Agreement (CETA negotiated by the European Union and Canada. For both sides of Atlantic, the CETA is supposed to bring the solution for today's issues concerning the important trading aspects and, also, to facilitate the EU-Canada bilateral trade by creating competition.

  14. Eye muscle proprioception is represented bilaterally in the sensorimotor cortex

    DEFF Research Database (Denmark)

    Balslev, Daniela; Albert, Neil B; Miall, Chris

    2011-01-01

    The cortical representation of eye position is still uncertain. In the monkey a proprioceptive representation of the extraocular muscles (EOM) of an eye were recently found within the contralateral central sulcus. In humans, we have previously shown a change in the perceived position of the right...... the proprioceptive representation for the left and the right eye separately. Data were acquired while passive eye movement was used to stimulate EOM proprioceptors in the absence of a motor command. We also controlled for the tactile stimulation of the eyelid by removing from the analysis voxels activated by eyelid...... touch alone. For either eye, the brain area commonly activated by passive and active eye movement was located bilaterally in the somatosensory area extending into the motor and premotor cytoarchitectonic areas. We suggest this is where EOM proprioception is processed. The bilateral representation...

  15. Bilateral zeta functions and their applications

    OpenAIRE

    Shibukawa, Genki

    2011-01-01

    We introduce a new type of multiple zeta functions, which we call bilateral zeta functions, analogous to the Barnes zeta functions. The bilateral zeta function is a periodic function and shares certain basic properties of Barnes zeta function. Especially, we prove that the bilateral zeta function has a nice Fourier series expansion and the Barnes zeta function can be expressed as a finite sum of bilateral zeta functions. By these properties of the bilateral zeta functions, We obtain simple pr...

  16. Paralisia facial bilateral Bilateral facial paralysis: a case report

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1976-03-01

    Full Text Available É apresentado um caso de diplegia facial surgida após meningite meningocócica e infecção por herpes simples. Depois de discutir as diversas condições que o fenômeno pode apresentar-se, o autor inclina-se por uma etiologia herpética.A case of bilateral facial paralysis following meningococcal meningitis and herpes simplex infection is reported. The author discusses the differential diagnosis of bilateral facial nerve paralysis which includes several diseases and syndromes and concludes by herpetic aetiology.

  17. Bilateral spontaneous hemotympanum: Case report

    Directory of Open Access Journals (Sweden)

    Economou Nicolas C

    2006-10-01

    Full Text Available Abstract Background The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. Case presentation A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. Conclusion Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder.

  18. Facilitating access to emotions: neural signature of EMDR stimulation.

    Directory of Open Access Journals (Sweden)

    Deborah Herkt

    Full Text Available Eye Movement Desensitisation and Reprocessing (EMDR is a method in psychotherapy effective in treating symptoms of posttraumatic stress disorder. The client attends to alternating bilateral visual, auditory or sensory stimulation while confronted with emotionally disturbing material. It is thought that the bilateral stimulation as a specific element of EMDR facilitates accessing and processing of negative material while presumably creating new associative links. We hypothesized that the putatively facilitated access should be reflected in increased activation of the amygdala upon bilateral EMDR stimulation even in healthy subjects.We investigated 22 healthy female university students (mean 23.5 years with fMRI. Subjects were scanned while confronted with blocks of disgusting and neutral picture stimuli. One third of the blocks was presented without any additional stimulation, one third with bilateral simultaneous auditory stimulation, and one third with bilateral alternating auditory stimulation as used in EMDR.Contrasting disgusting vs. neutral picture stimuli confirmed the expected robust effect of amygdala activation for all auditory stimulation conditions. The interaction analysis with the type of auditory stimulation revealed a specific increase in activation of the right amygdala for the bilateral alternating auditory stimulation. Activation of the left dorsolateral prefrontal cortex showed the opposite effect with decreased activation.We demonstrate first time evidence for a putative neurobiological basis of the bilateral alternating stimulation as used in the EMDR method. The increase in limbic processing along with decreased frontal activation is in line with theoretical models of how bilateral alternating stimulation could help with therapeutic reintegration of information, and present findings may pave the way for future research on EMDR in the context of posttraumatic stress disorder.

  19. Bilateral familial nevus of Ota.

    Science.gov (United States)

    Goyal, Sunali; Uwaydat, Sami H; Phillips, Paul H; Schaefer, G Bradley

    2014-12-01

    Nevus of Ota is a benign congenital melanocytic lesion found most commonly in people of Asian ancestry. It is associated with an increased risk of glaucoma and uveal melanomas. Most cases are sporadic and unilateral. We present the first reported case of a brother and sister with familial, bilateral nevus of Ota.

  20. Spontaneous bilateral quadriceps tendon rupture.

    Science.gov (United States)

    Vigneswaran, N; Lee, K; Yegappan, M

    2007-11-01

    Spontaneous bilateral quadriceps tendon ruptures are uncommon. We present a 30-year-old man with end-stage renal failure, who sustained this injury, and subsequently had surgical repair of both tendons on separate occasions. He has since regained full range of movement of both knees.

  1. Bilateral breast in brothers - abreast

    Directory of Open Access Journals (Sweden)

    Altamash Mohammed Yusuf Shaikh

    2013-01-01

    Full Text Available Gynecomastia is a common occurrence in pubertal age group, and is physiological in up to 65 percent of cases. When occurs in the family it should be investigated in order not to miss on a treatable etiology. Two brothers within the same family, presenting with bilateral gynecomastia of different causes and requiring different treatment are presented.

  2. Bilateral acetabular fracture without trauma

    OpenAIRE

    De Rosa, M. A.; G. Maccauro; D’Arienzo, M.

    1999-01-01

     In the absence of trauma fracture of the acetabulum is an extremely rare injury. We describe a 70 year old man who spontaneously developed fractures in both acetabulae due to bony insufficiency. It was successfully treated by bilateral total hip replacement.

  3. Sensitivity of shovelnose sturgeon (Scaphirhynchus platorynchus) and pallid sturgeon (S. albus) early life stages to 3,3',4,4',5-pentachlorobiphenyl and 2,3,7,8-tetrachlorodibenzo-P-dioxin exposure.

    Science.gov (United States)

    Buckler, Justin; Candrl, James S; McKee, Michael J; Papoulias, Diana M; Tillitt, Donald E; Galat, David L

    2015-06-01

    Concern exists that polychlorinated biphenyls (PCBs) may be contributing to the current decline of shovelnose sturgeon (Scaphirhynchus platorynchus) and the US federally endangered pallid sturgeon (Scaphirhynchus albus). Waterborne exposures with newly fertilized eggs were used to assess developmental and morphological effects of 2 of the most potent aryl hydrocarbon receptor (AhR) agonists, 3,3',4,4',5-pentachlorobiphenyl (PCB-126) and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), on early life stage shovelnose and pallid sturgeon. No dose-related effects of PCB-126 were observed on percent development or hatch in either species at concentrations as high as 1711 ng/g egg. Effects of TCDD on percent development were not assessed in shovelnose sturgeon. However, percent development was not affected by TCDD in pallid sturgeon, and percent hatch was unaffected by TCDD doses as high as 60 ng/g egg to 81 ng/g egg in either species. Morphological pathologies such as yolk sac edema and craniofacial deformities were typical of AhR agonist exposure and were similar in both species. Calculated PCB-126 50% lethal dose (LD50, 95% fiducial limits) values were 196 ng/g egg (188-203 ng/g) for shovelnose and 159 ng/g egg (122-199 ng/g) for pallid sturgeon. Likewise, calculated TCDD LD50 values were 13 ng/g egg (11-15 ng/g) for shovelnose and 12 ng/g egg (10-14 ng/g) for pallid sturgeon. These LD50 values are among the highest recorded in early life stage fish, suggesting that early life stage Scaphirhynchus sturgeon may be comparatively insensitive to AhR agonists.

  4. Bilateral pallidotomy for generalized dystonia Palidotomia bilateral para distonias generalizadas

    Directory of Open Access Journals (Sweden)

    Hélio A. G. Teive

    2001-06-01

    Full Text Available OBJECTIVE: To evaluate the efficacy and safety of bilateral pallidotomies in five patients with generalized dystonia. BACKGROUND: Generalized dystonias are frequently a therapeutic challenge, with poor responses to pharmacological treatment. GPi (globus pallidus internus pallidotomies for Parkinson's disease ameliorate all kinds of dyskinesias/dystonia, and recent studies reported a marked improvement of refractory dystonias with this procedure. METHODS: Five patients with generalized dystonias refractory to medical treatment were selected; one posttraumatic and four idiopathic. The decision to perform bilateral procedures was based on the predominant axial involvement in these patients. Dystonia severity was assessed with the Burke-Fahn-Marsden Dystonia Scale (BFM. Simultaneous procedures were performed in all but one patient, who had a staged procedure. They were reevaluated with the same scale (BFM by an unblinded rater at 1, 2, 3, 30, 60, 90, 120 and 180 days post-operatively. RESULTS: The four patients with idiopathic dystonia showed a progressive improvement up to three months; the patient with posttraumatic dystonia relapsed at three months. One patient had a marked improvement, being able to discontinue all the medications. A mean decrease in the BFM scores of 52,58% was noted. One patient had a trans-operative motor seizure followed by a transient hemiparesis secondary to rack hemorrhage; other was lethargic up to three days after the procedure. CONCLUSIONS: Our results show that bilateral GPi pallidotomies may be a safe and effective approach to medically refractory generalized dystonias; it can also be speculated that the posttraumatic subgroup may not benefit with this procedure.As distonias generalizadas são freqüentemente um desafio terapêutico, com pobres respostas aos tratamentos farmacológicos. As cirurgias estereotáxicas, como a palidotomia, têm sido utilizadas com êxito no tratamento da doença de Parkinson e estudos

  5. Immediate Sequential Bilateral Cataract Surgery

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte

    2015-01-01

    The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...... performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery...

  6. Bilateral Lhermitte-Duclos disease

    Directory of Open Access Journals (Sweden)

    Bozbuga Mustafa

    2010-01-01

    Full Text Available Lhermitte-Duclos disease (LDD is a pathologic entity with progrediating, diffuse hypertrophy chiefly of the stratum granulosum of the cerebellum. Typically LDD is a unilateral lesion of the cerebellum or in vermis. Here we report a case of LDD with bilateral lesions of cerebellar hemispheres managed surgically. A 28-year-old woman presented with one-year history of progressive headache, nausea, vomiting, and blurred vision. Neurologic examination revealed a bilateral mild papilledema, mild dysmetria, and dysdiadochokinesia. The cerebellar lesions caused moderate mass effect in posterior fossa with hydrocephalus, and Chiari type I malformation. We performed the suboccipital-retrosigmoid approach, and removed completely the left intracerebellar mass. Symptoms related to elevated intracranial pressure disappeared in a short period postoperatively.

  7. Bilateral collicular interaction: modulation of auditory signal processing in frequency domain.

    Science.gov (United States)

    Cheng, L; Mei, H-X; Tang, J; Fu, Z-Y; Jen, P H-S; Chen, Q-C

    2013-04-01

    In the ascending auditory pathway, the inferior colliculus (IC) receives and integrates excitatory and inhibitory inputs from a variety of lower auditory nuclei, intrinsic projections within the IC, contralateral IC through the commissure of the IC and the auditory cortex. All these connections make the IC a major center for subcortical temporal and spectral integration of auditory information. In this study, we examine bilateral collicular interaction in the modulation of frequency-domain signal processing of mice using electrophysiological recording and focal electrical stimulation. Focal electrical stimulation of neurons in one IC produces widespread inhibition and focused facilitation of responses of neurons in the other IC. This bilateral collicular interaction decreases the response magnitude and lengthens the response latency of inhibited IC neurons but produces an opposite effect on the response of facilitated IC neurons. In the frequency domain, the focal electrical stimulation of one IC sharpens or expands the frequency tuning curves (FTCs) of neurons in the other IC to improve frequency sensitivity and the frequency response range. The focal electrical stimulation also produces a shift in the best frequency (BF) of modulated IC (ICMdu) neurons toward that of electrically stimulated IC (ICES) neurons. The degree of bilateral collicular interaction is dependent upon the difference in the BF between the ICES neurons and ICMdu neurons. These data suggest that bilateral collicular interaction is a part of dynamic acoustic signal processing that adjusts and improves signal processing as well as reorganizes collicular representation of signal parameters according to the acoustic experience.

  8. Bilateral Collicular Interaction: Modulation of Auditory Signal Processing in Amplitude Domain

    Science.gov (United States)

    Fu, Zi-Ying; Wang, Xin; Jen, Philip H.-S.; Chen, Qi-Cai

    2012-01-01

    In the ascending auditory pathway, the inferior colliculus (IC) receives and integrates excitatory and inhibitory inputs from many lower auditory nuclei, intrinsic projections within the IC, contralateral IC through the commissure of the IC and from the auditory cortex. All these connections make the IC a major center for subcortical temporal and spectral integration of auditory information. In this study, we examine bilateral collicular interaction in modulating amplitude-domain signal processing using electrophysiological recording, acoustic and focal electrical stimulation. Focal electrical stimulation of one (ipsilateral) IC produces widespread inhibition (61.6%) and focused facilitation (9.1%) of responses of neurons in the other (contralateral) IC, while 29.3% of the neurons were not affected. Bilateral collicular interaction produces a decrease in the response magnitude and an increase in the response latency of inhibited IC neurons but produces opposite effects on the response of facilitated IC neurons. These two groups of neurons are not separately located and are tonotopically organized within the IC. The modulation effect is most effective at low sound level and is dependent upon the interval between the acoustic and electric stimuli. The focal electrical stimulation of the ipsilateral IC compresses or expands the rate-level functions of contralateral IC neurons. The focal electrical stimulation also produces a shift in the minimum threshold and dynamic range of contralateral IC neurons for as long as 150 minutes. The degree of bilateral collicular interaction is dependent upon the difference in the best frequency between the electrically stimulated IC neurons and modulated IC neurons. These data suggest that bilateral collicular interaction mainly changes the ratio between excitation and inhibition during signal processing so as to sharpen the amplitude sensitivity of IC neurons. Bilateral interaction may be also involved in acoustic

  9. Bilateral cleft lip nasal deformity

    Directory of Open Access Journals (Sweden)

    Singh Arun

    2009-01-01

    Full Text Available Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it′s management both at the time of cleft lip repair

  10. Amelogenesis imperfecta with bilateral nephrocalcinosis.

    Science.gov (United States)

    Poornima, P; Katkade, Shashikant; Mohamed, Roshan Noor; Mallikarjuna, Rachappa

    2013-05-24

    A 12-year-old patient presented with a severe delay of eruption in permanent maxillary and mandibular incisors. On examination, there was over-retained primary teeth and delayed eruption of permanent teeth. Retained primary teeth showed light yellow discolouration whereas permanent teeth were distinct yellow with thin or little enamel. Subsequent imaging revealed all the premolars except maxillary left first premolar showed signs of intra-alveolar coronal resorption, nephrocalcinosis with bilateral multiple calculi and small papillary tip calcifications, marked increase in alkaline phosphatase. Subsequent dental treatment for restoring the functional and aesthetic requirement followed by appropriate treatment for renal problem was undertaken.

  11. Bilateral zosteriform extragenital lichen sclerosus.

    Science.gov (United States)

    Kumar, Piyush; Jha, Abhijeet Kumar; Mallik, Sambeet Kumar; Raihan, Mohammed

    2014-01-01

    A 35-year-old man presented with asymptomatic eruption on both forearms and lower aspects of the legs for 6 months. The lesions first appeared on his inner aspects of the wrist, the dorsal surface of the hands, and legs and progressed to involve proximal aspects of the extremities. There was no significant past history. On examination, multiple pearly white papules and depigmented atrophic plaques were found bilaterally on the flexors of the arms and the extensors of the legs. The lesions were arranged in a linear manner, following the lines of Blaschko (Figures 1 and 2). The surface of the atrophic plaques was notable for prominent telangiectasia, giving an erythematous appearance. The genitalia, oral cavity, palms, and soles were spared. Systemic examination was noncontributory. Lichen striatus and extragenital lichen sclerosus (ELS) were considered the differential diagnosis. Clinically, the age of the patient, the absence of scaling, and the presence of atrophic plaques and telangiectasia were in favor of ELS. A punch biopsy from an atrophic plaque was performed, and it revealed hyperkeratosis, atrophic epidermis, basal layer vacuolar degeneration, mild lymphocytic infiltration in the dermis, edema, and homogenization of collagen of the upper portion of the dermis (Figures 3 and Figure 4). Histopathologic findings were consistent with lichen sclerosus. A diagnosis of bilateral zosteriform ELS was made.

  12. Danish Exports and Danish Bilateral Aid

    DEFF Research Database (Denmark)

    Hansen, Henrik; Rand, John

    Danish bilateral development assistance is aimed at reducing poverty in the partner countries. Even so, bilateral assistance may have secondary, or knock-on, effects, which are beneficial for Denmark. An important secondary effect is the prospect of increased export from Denmark to the partner...... countries. This Evaluation Study presents an econometric analysis of Danish exports to 144 countries over the period from 1981 to 2010. The analysis is based on the gravity model of bilateral trade; a structural model developed over decades and now the central model in analyses of bilateral trade flows...... and trade policies. The main result of the study is that Danish bilateral aid has a positive and statistically significant impact on Danish exports to the recipient countries. Bilateral development assistance may affect exports through several channels. Three of the main channels are direct aid tying...

  13. New Curious Bilateral q-Series Identities

    Directory of Open Access Journals (Sweden)

    Frédéric Jouhet

    2012-10-01

    Full Text Available By applying a classical method, already employed by Cauchy, to a terminating curious summation by one of the authors, a new curious bilateral q-series identity is derived. We also apply the same method to a quadratic summation by Gessel and Stanton, and to a cubic summation by Gasper, respectively, to derive a bilateral quadratic and a bilateral cubic summation formula.

  14. [Our experience with bilateral cochlear implantation].

    Science.gov (United States)

    Carmel, Eldar; Taitelbaum-Swead, Ricky; Migirov, Lela; Hildesheimer, Minka; Kronenberg, Jona

    2008-03-01

    Cochlear implantation is a standard method of hearing rehabilitation among patients with severe to profound bilateral sensorineural hearing loss. In recent years there have been an increasing number of studies showing superior hearing with bilateral cochlear implantation in comparison with a unilateral procedure. In this study we present our experience with 15 patients, children and adults, who had bilateral cochlear implant surgery. Speech perception test results demonstrated a hearing benefit in bilateral cochlear implantation in comparison with a unilateral device, mainly by improvement in the identification of speech in noise tests.

  15. Bilateral theta-burst TMS to influence global gestalt perception.

    Directory of Open Access Journals (Sweden)

    Bernd Ritzinger

    Full Text Available While early and higher visual areas along the ventral visual pathway in the inferotemporal cortex are critical for the recognition of individual objects, the neural representation of human perception of complex global visual scenes remains under debate. Stroke patients with a selective deficit in the perception of a complex global Gestalt with intact recognition of individual objects - a deficit termed simultanagnosia - greatly helped to study this question. Interestingly, simultanagnosia typically results from bilateral lesions of the temporo-parietal junction (TPJ. The present study aimed to verify the relevance of this area for human global Gestalt perception. We applied continuous theta-burst TMS either unilaterally (left or right or bilateral simultaneously over TPJ. Healthy subjects were presented with hierarchically organized visual stimuli that allowed parametrical degrading of the object at the global level. Identification of the global Gestalt was significantly modulated only for the bilateral TPJ stimulation condition. Our results strengthen the view that global Gestalt perception in the human brain involves TPJ and is co-dependent on both hemispheres.

  16. Bilateral theta-burst TMS to influence global gestalt perception.

    Science.gov (United States)

    Ritzinger, Bernd; Huberle, Elisabeth; Karnath, Hans-Otto

    2012-01-01

    While early and higher visual areas along the ventral visual pathway in the inferotemporal cortex are critical for the recognition of individual objects, the neural representation of human perception of complex global visual scenes remains under debate. Stroke patients with a selective deficit in the perception of a complex global Gestalt with intact recognition of individual objects - a deficit termed simultanagnosia - greatly helped to study this question. Interestingly, simultanagnosia typically results from bilateral lesions of the temporo-parietal junction (TPJ). The present study aimed to verify the relevance of this area for human global Gestalt perception. We applied continuous theta-burst TMS either unilaterally (left or right) or bilateral simultaneously over TPJ. Healthy subjects were presented with hierarchically organized visual stimuli that allowed parametrical degrading of the object at the global level. Identification of the global Gestalt was significantly modulated only for the bilateral TPJ stimulation condition. Our results strengthen the view that global Gestalt perception in the human brain involves TPJ and is co-dependent on both hemispheres.

  17. A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

    Directory of Open Access Journals (Sweden)

    Gultekin Gulbahar

    2015-01-01

    Full Text Available First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

  18. Bilateral metachronous breast cancer with bilateral recurrences: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Hyun; Sohn, Yu Mee [Dept. of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Kim, Eun Kyung [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-05-15

    The incidence of bilateral breast cancer has been reported to range from 0.4% to 14%, and it increases gradually as a result of improved early detection capabilities and longer survival times. We report a rare case where the bilateral breast cancers occurred as a metachronous bilateral breast cancer with bilateral recurrences, detected by mammography, and the rapid growth of tumor that manifested as microcalcification and skin thickening within 3 months.

  19. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation

    OpenAIRE

    Rajendra Nehete; Anita Nehete; Sandeep Singla; Harshad Adhav

    2012-01-01

    In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally s...

  20. Bilateral Saccadic Eye Movements and Tactile Stimulation, but Not Auditory Stimulation, Enhance Memory Retrieval

    Science.gov (United States)

    Nieuwenhuis, Sander; Elzinga, Bernet M.; Ras, Priscilla H.; Berends, Floris; Duijs, Peter; Samara, Zoe; Slagter, Heleen A.

    2013-01-01

    Recent research has shown superior memory retrieval when participants make a series of horizontal saccadic eye movements between the memory encoding phase and the retrieval phase compared to participants who do not move their eyes or move their eyes vertically. It has been hypothesized that the rapidly alternating activation of the two hemispheres…

  1. Bilateral saccadic eye movements and tactile stimulation, but not auditory stimulation, enhance memory retrieval

    NARCIS (Netherlands)

    Nieuwenhuis, S.; Elzinga, B.M.; Ras, P.H.; Berends, F.; Duijs, P.; Samara, Z.; Slagter, H.A.

    2013-01-01

    Recent research has shown superior memory retrieval when participants make a series of horizontal saccadic eye movements between the memory encoding phase and the retrieval phase compared to participants who do not move their eyes or move their eyes vertically. It has been hypothesized that the rapi

  2. Concurrent bilateral ectopic pregnancy: a rarity

    Directory of Open Access Journals (Sweden)

    Prabhleen Kaur

    2015-08-01

    Full Text Available Bilateral ectopic pregnancy is a rare twin gestation with only a few cases reported in the literature. We report a 30 year old woman without any high risk factor for ectopic pregnancy, who had concurrent bilateral ectopic pregnancy. A 30 year old female presented to the Gynecology emergency department complaining of vaginal bleeding and abdominal pain. The presumptive diagnosis of ruptured left sided ectopic pregnancy was made on basis of clinical findings and ultrasound finings. An emergency laparotomy was done revealed a hemoperitoneum of 1.5 liters, a ruptured left tubal pregnancy with active bleeding and right tubal un-ruptured ectopic was found. A bilateral salpingectomy was performed. Histopathology confirmed presence of chorionic villi in both tubes. In theory, laparoscopic salpingostomy is the best surgical approach in bilateral tubal pregnancy. However, bilateral salpingectomy may be necessary when both tubes are extensively damaged or are actively bleeding. Successful pregnancies have been reported after conservative surgical treatment of bilateral ectopic, but the risk of recurrence is high. Our decision for an emergency laparotomy followed by bilateral salpingectomy was based on the fact that the patient presented with acute abdomen and was haemodynamically unstable and there was extensive bilateral tubal damage. As the incidence of ectopic pregnancies is increasing concurrently with the incidences of pelvic inflammatory disease and use of assisted fertility techniques; it may be that these and ldquo;rare ectopics and rdquo; will become less uncommon. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1197-1199

  3. Acral osteolysis in bilateral compartment syndrome

    Directory of Open Access Journals (Sweden)

    Iram Saeed

    2008-08-01

    Full Text Available Carpal tunnel syndrome is a common neurological condition with rare yet potentially serious cutaneous and skeletal complications. We present a case of mutilating/ulcerating bilateral carpal tunnel syndrome in a 63 year old female. Radiographs showed symmetrical acral osteolysis in the index and middle fingers distal phalanges bilaterally. Carpal tunnel decompressions provided symptomatic relief.

  4. Bilateral locked facets in the thoracic spine

    NARCIS (Netherlands)

    M.H.A. Willems; Braakman, R. (Reinder); B. van Linge (Bert)

    1984-01-01

    textabstractTwo cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets. Bilateral locked facets are very uncommon in the thoracic spine.

  5. Simultaneous and spontaneous bilateral quadriceps tendons rupture.

    Science.gov (United States)

    Celik, Evrim Coşkun; Ozbaydar, Mehmet; Ofluoglu, Demet; Demircay, Emre

    2012-07-01

    Simultaneous and spontaneous bilateral quadriceps tendon rupture is an uncommon injury that is usually seen in association with multiple medical conditions and some medications. We report a case of simultaneous and spontaneous bilateral quadriceps tendon rupture that may be related to the long-term use of a statin.

  6. Spontaneous bilateral adrenal hemorrhage following cholecystectomy.

    Science.gov (United States)

    Dahan, Meryl; Lim, Chetana; Salloum, Chady; Azoulay, Daniel

    2016-06-01

    Postoperative bilateral adrenal hemorrhage is a rare but potentially life-threatening complication. This diagnosis is often missed because the symptoms and laboratory results are usually nonspecific. We report a case of bilateral adrenal hemorrhage associated with acute primary adrenal insufficiency following laparoscopic cholecystectomy. The knowledge of this uncommon complication following any abdominal surgery allows timey diagnosis and rapid treatment.

  7. Bilateral zeta functions and their applications

    CERN Document Server

    Shibukawa, Genki

    2011-01-01

    We introduce a new type of multiple zeta functions, which we call bilateral zeta functions, analogous to the Barnes zeta functions. The bilateral zeta function is a periodic function and shares certain basic properties of Barnes zeta function. Especially, we prove that the bilateral zeta function has a nice Fourier series expansion and the Barnes zeta function can be expressed as a finite sum of bilateral zeta functions. By these properties of the bilateral zeta functions, We obtain simple proofs of some formulas, for example the reflection formula for the multiple gamma function, the inversion formula of the Dedekind eta function, Ramanujan's formula, Fourier expansion of the Barnes zeta function and multiple Iseki's formula.

  8. Bilateral movement training and stroke motor recovery progress: a structured review and meta-analysis.

    Science.gov (United States)

    Cauraugh, James H; Lodha, Neha; Naik, Sagar K; Summers, Jeffery J

    2010-10-01

    The purpose was to conduct a structured review and meta-analysis to determine the cumulative effect of bilateral arm training on motor capabilities post stroke. Forty-eight stroke studies were selected from three databases with 25 comparisons qualifying for inclusion in our meta-analysis. We identified and coded four types of bilateral arm interventions with 366 stroke patients. A random effects model using the standardized mean difference technique determined a large and significant effect size (0.734; SE=0.125), high fail-safe N (532), and medium variability in the studies (I(2)=63%). Moderator variable analysis on the type of bilateral training revealed two large and significant effects: (a) BATRAC (0.842; SE=0.155) and (b) coupled bilateral and EMG-triggered neuromuscular stimulation (1.142; SE=0.176). These novel findings provide strong evidence supporting bilateral arm training with the caveat that two coupled protocols, rhythmic alternating movements and active stimulation, are most effective.

  9. Movement disorders induced by deep brain stimulation.

    Science.gov (United States)

    Baizabal-Carvallo, José Fidel; Jankovic, Joseph

    2016-04-01

    Deep brain stimulation represents a major advance in the treatment of several types of movement disorders. However, during stimulation new movement disorders may emerge, thus limiting the positive effects of this therapy. These movement disorders may be induced by: 1) stimulation of the targeted nucleus, 2) stimulation of surrounding tracts and nuclei, and 3) as a result of dose adjustment of accompanying medications, such as reduction of dopaminergic drugs in patients with Parkinson's disease. Various dyskinesias, blepharospasm, and apraxia of eyelid opening have been described mainly with subthalamic nucleus stimulation, whereas hypokinesia and freezing of gait have been observed with stimulation of the globus pallidus internus. Other deep brain stimulation-related movement disorders include dyskinesias associated with stimulation of the globus pallidus externus and ataxic gait as a side effect of chronic bilateral stimulation of the ventral intermediate nucleus of thalamus. These movement disorders are generally reversible and usually resolved once the stimulation is reduced or turned off. This, however, typically leads to loss of benefit of the underlying movement disorder which can be re-gained by using different contacts, changing targets or stimulation parameters, and adjusting pharmacological therapy. New and innovative emerging technologies and stimulation techniques may help to prevent or overcome the various deep brain stimulation-induced movement disorders. In this review we aim to describe the clinical features, frequency, pathophysiology, and strategies for treatment of these iatrogenic movement disorders.

  10. Sound localization ability of young children with bilateral cochlear implants.

    NARCIS (Netherlands)

    Beijen, J.W.; Snik, A.F.M.; Mylanus, E.A.M.

    2007-01-01

    OBJECTIVE: To evaluate the benefit of bilateral cochlear implantation in young children. STUDY DESIGN: Clinical trial comparing a group of bilaterally implanted children with a group of unilaterally implanted children. SETTING: Tertiary referral center. PATIENTS: Five bilaterally implanted children

  11. Bilateral optic neuropathy in acute cryptococcal meningitis

    Institute of Scientific and Technical Information of China (English)

    Qi Zhe Ngoo; Li Min Evelyn Tai; Wan Hazabbah Wan Hitam; John Tharakan

    2016-01-01

    We reported a case of cryptococcal meningitis presenting with bilateral optic neuropathy in an immunocompetent patient. A 64-year-old Malay gentleman with no medical comorbidities presented with acute bilateral blurring of vision for a week, which was associated with generalised throbbing headache and low grade fever. He also had som-nolence and altered consciousness. Visual acuity in both eyes was no perception of light with poor pupillary reflexes. Extraocular muscle movements were normal. Anterior segments were unremarkable bilaterally. Fundoscopy revealed bilateral optic disc swelling. CT scan of the brain showed multifocal infarct, but no meningeal enhancement or mass. Cerebrospinal fluid opening pressure was normal, while its culture grew Cryptococcus neoformans. A diagnosis of cryptococcal meningitis with bilateral optic neuropathy was made. Patient was treated with a six-week course of intravenous flu-conazole and started concomitantly on a fortnight's course of intravenous amphotericin B. After that, his general condition improved, but there was still no improvement in his visual acuity. On reviewing at two months post-initiation of treatment, fundi showed bilateral optic atrophy. Bilateral optic neuropathy secondary to cryptococcal meningitis was rare. The prognosis was guarded due to the sequelae of optic atrophy. Anti-fungal medication alone may not be sufficient to manage this condition. However, evidence for other treatment modalities is still lacking and further clinical studies are required.

  12. Bilateral Petit’s Triangle Hernia

    Directory of Open Access Journals (Sweden)

    Sanjay Kumar Bhasin, Arshad Bashir Khan, Sanjay Sharma

    2006-07-01

    Full Text Available Lumbar traingle hernia that occurs through lumbar triangles is very rare type of hernia. Only about 300 cases havebeen reported till date. Bilateral Petit’s triangle hernia find further rarity and the case under reference is probably thefirst ever reported case of Primary bilateral Petit’s triangle hernia. The present case is of a 46 years old married,multigravida female who presented with 1 year duration of LBA and subsequently notice of swelling both sides oflow back. FNAC revealed lipoma and on exploration it turned out to be rarest extra peritoneal bilateral Petit’s trianglehernia, fat as contents.

  13. Properties of bilateral spinocerebellar activation of cerebellar cortical neurons

    Directory of Open Access Journals (Sweden)

    Pontus eGeborek

    2014-10-01

    Full Text Available We aimed to explore the cerebellar cortical inputs from two spinocerebellar pathways, the spinal border cell-component of the ventral spinocerebellar tract (SBC-VSCT and the dorsal spinocerebellar tract (DSCT, respectively, in the sublobule C1 of the cerebellar posterior lobe. The two pathways were activated by electrical stimulation of the contralateral lateral funiculus (coLF and the ipsilateral LF (iLF at lower thoracic levels. Most granule cells in sublobule C1 did not respond at all but part of the granule cell population displayed high-intensity responses to either coLF or iLF stimulation. As a rule, Golgi cells and Purkinje cell simple spikes responded to input from both LFs, although Golgi cells could be more selective. In addition, a small population of granule cells responded to input from both the coLF and the iLF. However, in these cases, similarities in the temporal topography and magnitude of the responses suggested that the same axons were stimulated from the two LFs, i.e. that the axons of individual spinocerebellar neurons could be present in both funiculi. This was also confirmed for a population of spinal neurons located within known locations of SBC-VSCT neurons and dorsal horn DSCT neurons. We conclude that bilateral spinocerebellar responses can occur in cerebellar granule cells, but the VSCT and DSCT systems that provide the input can also be organized bilaterally. The implications for the traditional functional separation of VSCT and DSCT systems and the issue whether granule cells primarily integrate functionally similar information or not are discussed.

  14. Hierarchical stochastic modeling of large river ecosystems and fish growth across spatio-temporal scales and climate models: the Missouri River endangered pallid sturgeon example

    Science.gov (United States)

    Wildhaber, Mark L.; Wikle, Christopher K.; Moran, Edward H.; Anderson, Christopher J.; Franz, Kristie J.; Dey, Rima

    2017-01-01

    We present a hierarchical series of spatially decreasing and temporally increasing models to evaluate the uncertainty in the atmosphere – ocean global climate model (AOGCM) and the regional climate model (RCM) relative to the uncertainty in the somatic growth of the endangered pallid sturgeon (Scaphirhynchus albus). For effects on fish populations of riverine ecosystems, cli- mate output simulated by coarse-resolution AOGCMs and RCMs must be downscaled to basins to river hydrology to population response. One needs to transfer the information from these climate simulations down to the individual scale in a way that minimizes extrapolation and can account for spatio-temporal variability in the intervening stages. The goal is a framework to determine whether, given uncertainties in the climate models and the biological response, meaningful inference can still be made. The non-linear downscaling of climate information to the river scale requires that one realistically account for spatial and temporal variability across scale. Our down- scaling procedure includes the use of fixed/calibrated hydrological flow and temperature models coupled with a stochastically parameterized sturgeon bioenergetics model. We show that, although there is a large amount of uncertainty associated with both the climate model output and the fish growth process, one can establish significant differences in fish growth distributions between models, and between future and current climates for a given model.

  15. Extensive Bilateral Naevus Comedonicus Exacerbating During Pregnancy

    Directory of Open Access Journals (Sweden)

    Rao M.V

    1999-01-01

    Full Text Available Naevus comedonicus is a rare developmental anomaly of the pilosebaceous apparatus. It occurred bilaterally in a 23 year old pregnant woman. She noted exacerbations during two pregnancies, hitherto unreported in the literature.

  16. FLOWING BILATERAL FILTER: DEFINITION AND IMPLEMENTATIONS

    Directory of Open Access Journals (Sweden)

    Maxime Moreaud

    2015-06-01

    Full Text Available The bilateral filter plays a key role in image processing applications due to its intuitive parameterization and its high quality filter result, smoothing homogeneous regions while preserving the edges of the objects. Considering the image as a topological relief, seeing pixel intensities as peaks and valleys, we introduce a way to control the tonal weighting coefficients, the flowing bilateral filter, reducing "halo" artifacts typically produced by the regular bilateral filter around a large peak surrounded by two valleys of lower values. In this paper we propose to investigate exact and approximated versions of CPU and parallel GPU (Graphical Processing Unit based implementations of the regular and flowing bilateral filter using the NVidia CUDA API. Fast implementations of these filters are important for the processing of large 3D volumes up to several GB acquired by x-ray or electron tomography.

  17. Bilateral areolar and periareolar pityriasis versicolor.

    Science.gov (United States)

    Sárdy, Miklós; Korting, Hans Christian; Ruzicka, Thomas; Wolff, Hans

    2010-08-01

    An adolescent boy presented with isolated, symmetrical, bilateral areolar and periareolar pityriasis versicolor. This extremely rare condition should be considered in the differential diagnosis of light brown patches on the areolae.

  18. Genetics of Infantile Bilateral Striatal Necrosis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-09-01

    Full Text Available The gene mutation causing autosomal recessive infantile bilateral striatal necrosis (IBSN was identified in eight consanguineous Israeli Bedouin families, in a study at Schneider Children’s Medical Center, Petah Tikva, Israel, and other centers.

  19. Bilateral giant juvenile fibroadenoma of breasts

    Directory of Open Access Journals (Sweden)

    Mukhopadhyay Madhumita

    2009-01-01

    Full Text Available An 11-year-old girl with rapidly enlarging bilateral breast lumps is reported. It was diagnosed as a case of juvenile fibroadenoma following fine needle aspiration cytology and confirmed on histopathological examination of the excised specimens.

  20. BILATERAL TESSIER CLEFT 3: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Utpal

    2014-06-01

    Full Text Available Tessier cleft 3 is a very rare congenital anomaly, (2 especially the bilateral form. Very few cases have been reported worldwide. (1,2 I report a case of bilateral Tessier cleft 3 presenting at the age of three months with clefts extending from philtral regions, undermining the nasal alar bases to the medial canthal areas bilaterally. There were bilateral complete alveolar clefts with mild protrusion of the pre-maxilla, but the rest of the maxilla including the palate was not involved. Surgical correction was started at the age of three months and completed at the age of one and half years in three stages. There was no intra-operative or postoperative complications and the final result was satisfactory.

  1. THE EUROPEAN UNION’S BILATERAL APPROACH

    Directory of Open Access Journals (Sweden)

    Ludmila BORTA

    2014-12-01

    Full Text Available The EU is a world economic power and a major trading partner for most countries. All the time, this region has been interested and has acted towards a free and fair trade. The decrease and even the elimination of tariff and non-tariff barriers in the world trade are among the main objectives of the EU strategy for international trade. At the moment, the elusive outcome of the WTO Doha Round has led to the proliferation of bilateral trade agreements worldwide. Although the EU remains committed to further development of the multilateral trading system, however, the EU still has appealed also to the development of bilateral trade relations. The aim of this paper is to illustrate the current bilateral dimension of the common commercial policy of the EU. In conclusion, to describe this bilateral approach of the EU we are using one word, namely “diversity”.

  2. Sequential presentation of bilateral Brown syndrome.

    Science.gov (United States)

    Sekeroğlu, Hande Taylan; Türkçüoğlu, Peykan; Sanaç, Ali Şefik; Sener, Emin Cumhur

    2012-04-01

    Brown syndrome, characterized by a limitation of elevation in adduction and positive forced duction testing, is usually unilateral but occurs bilaterally in 10% of all cases. It may present as a congenital condition in one eye and develop in the other eye with no apparent cause. We present a case of bilateral Brown syndrome in which the right eye became involved within 1 year of surgery on the left eye for congenital Brown syndrome.

  3. Clinical subgroups in bilateral Meniere disease

    OpenAIRE

    2016-01-01

    Meniere disease (MD) is a heterogeneous clinical condition characterized by sensorineural hearing loss, episodic vestibular symptoms and tinnitus associated with several comorbidities such as migraine or autoimmune disorders (AD). The frequency of bilateral involvement may range from 5-50% and it depends on the duration of the disease. We have performed a two-step cluster analysis in 398 patients with bilateral MD to identify the best predictors to define clinical subgroups with a potential d...

  4. Bilateral anophthalmia with septo-optic dysplasia

    Directory of Open Access Journals (Sweden)

    Manisha Jana

    2010-01-01

    Full Text Available Bilateral anophthalmia is a rare entity and association with septo-optic dysplasia is an even rare condition. The condition is characterized by absent eyeballs in the presence of eyelids, conjunctiva or lacrimal apparatus. Though anophthalmia can be diagnosed clinically, imaging plays a crucial role in delineating the associated anomalies. In addition, often clinical anophthalmia may prove to be severe microphthalmia on imaging. We describe the imaging findings in an infant with bilateral anophthalmia and septo-optic dysplasia.

  5. Electrical stimulation for epilepsy: stimulation of hippocampal foci.

    Science.gov (United States)

    Velasco, F; Velasco, M; Velasco, A L; Menez, D; Rocha, L

    2001-01-01

    Subacute and chronic continuous electrical stimulation at the epileptic focus in the hippocampus or parahippocampal cortex at 130 Hz, 0.21-1.0 ms, 2.5-3.5 V (about 200-300 microA) induces a decrease in focal EEG epileptic interictal activity and also in the occurrence of clinical seizures. This may represent an alternative for the treatment of temporal lobe seizures originated in bilateral independent temporal lobe foci or occurring in patients where one is uncertain whether memory deficit might result from ablative procedures.

  6. EFFECT OF NEUROMUSCULAR REEDUCATION IN BILATERAL FACIAL PALSY ON PATIENT WITH GBS

    Directory of Open Access Journals (Sweden)

    Sanjiv Kumar, MPT, PhD

    2014-04-01

    Full Text Available Background: Bilateral facial palsy is a rare entity and remains to be a challenging case to diagnose and manage which has the major impact on the physical and social aspect of the affected individual. Objective: The aim of the report is to determine the role of neuromuscular reeducation in restoration of function in person with Guillain Barre Syndrome present with facial diplegia. Case report: We report the case of 23 year male presenting with history of deviation of mouth to the right side, followed by bilateral facial involvement and latter distal symmetrical involvement of bilateral upper and lower limb. The facial diplegia was managed by PNF and Electrical stimulation. Conclusions: Neuromuscular reeducation is an effective intervention for restoration of function after facial diplegia.

  7. Bilateral Keratectasia 34 Years after Corneal Transplant

    Directory of Open Access Journals (Sweden)

    Xavier Valldeperas

    2010-07-01

    Full Text Available We report the clinical findings of a patient with severe bilateral keratectasia 34 years after a penetrating keratoplasty (PK in both eyes. An otherwise healthy 67-year-old man complained of deterioration of the eyesight in both eyes over the last 6 months. The patient was diagnosed with bilateral keratoconus at the age of 32 years, and he underwent a bilateral PK. At presentation, visual acuity was 20/200 in the right eye and light perception in the left eye. A Pentacam pachymetric map revealed a central pachymetry of 720 µm in the right eye and of 710 µm in the left eye, as well as an average paracentral pachymetry of 436 and 270 µm in the 9-mm zone in the right and the left eye, respectively. Corneal topography revealed bilateral irregular and asymmetric bowing with generalized steepening and high corneal power. We describe a case of bilateral keratectasia 34 years after PK in a patient who was originally diagnosed with bilateral keratoconus.

  8. MODERN VIEWS ON BILATERAL BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Ye. A. Fesik

    2014-01-01

    Full Text Available Presented modern literature data on the features of the pathogenesis, course, clinical and morphological expression and tumor characteristics, parameters and nodal metastasis of hematogenous bilateral breast cancer. Highlight the results of domestic and foreign studies in recent years to determine the prognostic factors and recurrence of synchronous and metachronous bilateral breast cancer. It was revealed that the frequency of bilateral breast tumor lesions varies widely, ranging from 0.1 to 20%, with metachronous tumors recorded significantly higher (69.6% than the synchronous (22.7%. The probability of occurrence of metachronous breast cancer is higher in women with a family history, as well as if they have a gene mutation BRCA-1. Found that the most common histological type of breast tumor with bilateral lesions is invasive ductal. However, the incidence of invasive lobular cancer and non-invasive lobular cancer is slightly higher among synchronous bilateral cancer compared with unilateral disease. Studies have shown that in a double-sided synchronous breast cancer tumor, as a rule, has a lower degree of differentiation, and the higher the expression level of estrogen receptors and progesterone receptors. Relevance of the issue because the identification of patterns in the study of lymphatic and hematogenous features bilateral metastasis of mammary tumors provides a basis for speculation about the differences in the progression of neoplastic disease in these groups and is a cause for further detailed research in this area to identify and evaluate the prognosis and also the choice of tactics of such patients.

  9. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation.

    Science.gov (United States)

    Nehete, Rajendra; Nehete, Anita; Singla, Sandeep; Adhav, Harshad

    2012-01-01

    In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally symmetric and aesthetically superior to the osteoplastic reconstruction. The technical details are discussed, and the long term functional and aesthetic results are presented.

  10. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation

    Directory of Open Access Journals (Sweden)

    Rajendra Nehete

    2012-01-01

    Full Text Available In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally symmetric and aesthetically superior to the osteoplastic reconstruction. The technical details are discussed, and the long term functional and aesthetic results are presented.

  11. Transcranial direct current stimulation: electrode montage in stroke.

    Science.gov (United States)

    Mahmoudi, Hooman; Borhani Haghighi, Afshin; Petramfar, Peyman; Jahanshahi, Sepehr; Salehi, Zahra; Fregni, Felipe

    2011-01-01

    Neurophysiological and computer modelling studies have shown that electrode montage is a critical parameter to determine the neuromodulatory effects of transcranial direct current stimulation (tDCS). We tested these results clinically by systematically investigating optimal tDCS electrode montage in stroke. Ten patients received in a counterbalanced and randomised order the following conditions of stimulation (i) anodal stimulation of affected M1 (primary motor cortex) and cathodal stimulation of unaffected M1 ('bilateral tDCS'); (ii) anodal stimulation of affected M1 and cathodal stimulation of contralateral supraorbital area ('anodal tDCS'); (iii) cathodal stimulation of unaffected M1 and anodal stimulation of contralateral supraorbital area ('cathodal tDCS'); (iv) anodal stimulation of affected M1 and cathodal stimulation of contralateral deltoid muscle ('extra-cephalic tDCS') and (v) sham stimulation. We used the Jebsen-Taylor Test (JTT) as a widely accepted measure of upper limb function. Bilateral tDCS, anodal tDCS and cathodal tDCS were shown to be associated with significant improvements on the JTT. Placing the reference electrode in an extracephalic position and use of sham stimulation did not induce any significant effects. This small sham controlled cross-over clinical trial is important to provide additional data on the clinical effects of tDCS in stroke and for planning and designing future large tDCS trials in patients with stroke.

  12. Bilateral agenesis of the anterior cruciate ligament: MRI evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Bedoya, Maria A.; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Radiology Department, Philadelphia, PA (United States); McGraw, Michael H. [Hospitalof theUniversityof Pennsylvania, Divisionof Orthopaedics, Philadelphia, PA (United States); Wells, Lawrence [The Children' s Hospital of Philadelphia, Division of Orthopaedics, Philadelphia, PA (United States)

    2014-09-15

    Bilateral agenesis of the anterior cruciate ligament (ACL) is extremely rare. We describe a 13-year-old girl who presented with bilateral knee pain without history of trauma; she has two family members with knee instability. Magnetic resonance imaging showed bilateral absence of the ACL, and medial posterior horn meniscal tears. Bilateral arthroscopic partial meniscectomy and anterior cruciate ligament reconstruction was performed. (orig.)

  13. Comparison of weight changes following unilateral and staged bilateral STN DBS for advanced PD.

    Science.gov (United States)

    Lee, Eric M; Kurundkar, Ashish; Cutter, Gary R; Huang, He; Guthrie, Barton L; Watts, Ray L; Walker, Harrison C

    2011-09-01

    Unilateral and bilateral subthalamic nucleus deep brain stimulation (STN DBS) in Parkinson's disease (PD) result in weight gain in the initial postoperative months, but little is known about the changes in weight following unilateral and staged bilateral STN DBS over longer time intervals. A case-control comparison evaluated weight changes over 2 years in 43 consecutive unilateral STN DBS patients, among whom 25 elected to undergo staged bilateral STN DBS, and 21 age-matched and disease severity matched PD controls without DBS. Regression analyses incorporating age, gender, and baseline weight in case or control were conducted to assess weight changes 2 years after the initial unilateral surgery. Unilateral STN DBS and staged bilateral STN DBS patients gained 3.9 ± 2.0 kg and 5.6 ± 2.1 kg versus their preoperative baseline weight (P weight gain in staged bilateral STN DBS patients versus unilateral patients, we found no evidence for an equivalent or synergistic increase in body weight following placement of the second DBS electrode.

  14. Clinical subgroups in bilateral Meniere disease

    Directory of Open Access Journals (Sweden)

    Lidia Frejo

    2016-10-01

    Full Text Available Meniere disease (MD is a heterogeneous clinical condition characterized by sensorineural hearing loss, episodic vestibular symptoms and tinnitus associated with several comorbidities such as migraine or autoimmune disorders (AD. The frequency of bilateral involvement may range from 5-50% and it depends on the duration of the disease. We have performed a two-step cluster analysis in 398 patients with bilateral MD to identify the best predictors to define clinical subgroups with a potential different etiology to improve the phenotyping of bilateral MD and to develop new treatments. We have defined five clinical variants in bilateral MD. Group 1 is the most frequently found, includes 46% of patients, and is defined by metachronic hearing loss without migraine and without AD. Group 2 is found in 17% of patients, and it is defined by synchronic hearing loss without migraine or AD. Group 3, with 13% of patients, is characterized by familial MD, while group 4, that includes 12% of patients, is associated by the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by AD. This approach can be helpful in selecting patients for genetic and clinical research. However, further studies will be required to improve the phenotyping in these clinical variants for a better understanding of the diverse etiological factors contributing to bilateral MD.

  15. In vivo trial results of a novel ultrasonic cough stimulator

    Directory of Open Access Journals (Sweden)

    Jennifer C. Nitz, PhD, MPhty, BPhty

    2012-12-01

    Full Text Available The aims of these double-blind in-vivo trials of a prototype ultrasonic cough stimulator (CoughStim™ were to establish (1 whether ultrasound (US stimulation can be safely used to stimulate a cough, (2 the most efficient US frequency and power parameters to reliably stimulate a cough, (3 whether single- or dual-sided stimulation is more effective, and (4 whether a cough can be stimulated in adults unable to cough on demand. Fifteen nondisabled volunteers (18–59 yr and seven volunteers unable to cough on demand (85–102 yr were recruited. Stimulation was applied to the neck unilaterally at eight frequencies and two power levels and bilaterally at two frequencies and three power levels. Vital signs were monitored during testing with no adverse responses. CoughStim stimulated a cough in all nondisabled subjects, 80% of subjects at 0.58 MHz and 9 W unilaterally and 75% of subjects at 0.58 MHz and 6 W bilaterally. Of the subjects unable to cough, 71 percent responded to bilateral stimuli (0.54 MHz and 6 W with a strong cough. The CoughStim regularly and safely produced a moderately strong cough response in subjects with or without ability to cough and produced this effect without causing undue discomfort.

  16. Studies on the clinical significance of pallidal high intensity of T{sub 1}-weighted MR imaging in patients with liver cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Morino, Koutaro [Gifu Univ. (Japan). School of Medicine

    1997-03-01

    We investigated the clinical significances of signals in cirrhotic patients with special relation to subclinical hepatic encephalopathy. MRI was carried out in 30 patients with liver cirrhosis in the abscence of hepatic encephalopathy greater than grade II, and in 20 healthy subjects. Signal intensity of the globus pallidus was standardized to GP index. GP index=100 x (signal intensity of the globus pallidus - signal intensity of the putamen)/(signal intensity of the globus pallidus + signal intensity of the putamen). Normal value of GP index obtained in healthy subjects was -0.66{approx}4.70. Twenty seven of 30 cirrhotic patients showed GP index higher than the normal range. GP index correlated significantly with the blood manganese concentration. This observation suggested that the pallidal high intensity signals were brought about by the deposition of Mn in the globus pallidus. GP index correlated significantly with the central conduction time (CCT) measured by somatosensory evoked potentials. GP index and CCT may reflect the similar pathophysiological changes of the brain in patients with liver cirrhosis. Multivariate analysis revealed that GP index was explained well by the presence of portal systemic shunts and by preceding histories of hepatic encephalopathy but not by the present grade of the liver parenchymal damage. For the earlier diagnosis of subclinical hepatic encephalopathy, GP index showed an excellent parameter similar to those of somatosensory evoked potentials and psychometric tests. GP index is favorable than electrophysiological methods in terms of its non-invasiveness to the patients and simplicity of the examination technique. (K.H.)

  17. The Effectiveness of Bilateral Cochlear Implants for Severe-to-Profound Deafness in Children : A Systematic Review

    NARCIS (Netherlands)

    Sparreboom, Marloes; van Schoonhoven, Jelmer; van Zanten, Bert G. A.; Scholten, Rob J. P. M.; Mylanus, Emmanuel A. M.; Grolman, Wilko; Maat, Bert

    2010-01-01

    Objective: To assess the clinical effectiveness of bilateral cochlear implantation compared with unilateral cochlear implantation alone or with a contralateral hearing aid (bimodal stimulation), in children with severe-to-profound hearing loss. Recently, the National Institute for Health and Clinica

  18. Bilateral sensory deprivation of trigeminal afferent fibers on corticomotor control of human tongue musculature: A preliminary study

    DEFF Research Database (Denmark)

    Kothari, Mohit; Baad-Hansen, Lene; Svensson, Peter

    2016-01-01

    Background: Transcranial magnetic stimulation (TMS) has demonstrated changes in motor evoked potentials (MEPs) in human limb muscles following modulation of sensory afferent inputs. Objective: The aim of the present study was to determine whether bilateral local anaesthesia (LA) of the lingual ne...

  19. [Bilateral pheochromocytoma: laparoscopic surgery in 2 cases].

    Science.gov (United States)

    Lam, J; Castillo, O; Bravo, J; Henríquez, R; Tagle, F

    2001-01-01

    Laparoscopic adrenalectomy, if done by skilled surgeons, is now the first choice for treating most adrenal tumors, including bilateral pheochromocytoma. We report two women, aged 35 and 34 years old, with bilateral adrenal pheochromocytoma successfully excised by laparoscopic surgery. Both had severe hypertension, high urinary catecholamine values (epinephrine + norepinephrine: 528 and 1083 ug/24 h) and bilateral adrenal tumors at CT scan. After 4 weeks of doxazosin treatment, a laparoscopic transperitoneal adrenalectomy was done (Gugner's technique), with surgical times of 7 and 5 hours respectively. Both patients received hydrocortisone and only the second one required one unit of packed cells. Postoperative evolution was uneventful and both patients were discharged at the fifth postoperative day. At two months of follow up, both patients are asymptomatic and normotensive.

  20. Prognosis of synchronous bilateral breast cancer

    DEFF Research Database (Denmark)

    Holm, Marianne; Tjønneland, Anne; Balslev, Eva

    2014-01-01

    Currently, no consistent evidence-based guidelines for the management of synchronous bilateral breast cancer (SBBC) exist and it is uncertain how presenting with SBBC affects patients' prognosis. We conducted a review of studies analyzing the association between SBBC and prognosis. The studies...... that reported adjusted effect measures were included in meta-analyses of effect of bilaterality on breast cancer mortality. From 57 initially identified records 17 studies from 11 different countries including 8,050 SBBC patients were included. The quality of the studies varied but was generally low with small...... sample sizes, and lack of consistent, detailed histo-pathological information. When doing meta-analysis on the subgroup of studies that provided adjusted effect estimates on breast cancer mortality (nine studies including 3,631 SBBC cases), we found that bilaterality in itself had a negative impact...

  1. Langerhans Cell Histiocytosis in Bilateral Mastoid Cavity

    Directory of Open Access Journals (Sweden)

    Kazım Bozdemir

    2013-01-01

    Full Text Available A 39-year-old male was admitted to our clinic with symptoms of headache, dizziness, nausea, otalgia, otorrhea, tinnitus, and hearing loss in both ears for 3 weeks. Physical examination revealed edema in the tympanic membrane and external ear canal, and pain by palpation in the mastoid area bilaterally. There was no nystagmus, and the rest of the physical examination was otherwise normal. Temporal bone high resolution computed tomography (CT showed a lesion causing erosion in the mastoid cortex, tegmen tympani, ossicles, and in the bone covering the sigmoid sinus bilaterally. There was also erosion in the superior semicircular canal and petrous bone on the left side. Cortical mastoidectomy was performed under general anesthesia. Histopathologic examination of the tissue revealed Langerhans cell histiocytosis (LCH. In this paper a case with LCH, presenting with bilateral mastoid involvement which has been rarely reported in the literature, is discussed with the existing literature.

  2. Growth Stimulants

    OpenAIRE

    Matthews, Nyle J.

    1989-01-01

    A tiny pellet inserted under the skin of a calf's ear may increase weight gains as much as 15 to 20 percent. This same result would take years to accomplish through breeding and selection. These tiny pellets are growth stimulants. They are made of hormones that are constructed to slowly release minute amounts into the blood stream that stimulate the animal to produce natural body hormones. One of these hormones is a growth hormone. It regulates the rate of growth of the animal. Increasing the...

  3. Bilateral Meckel's cave amyloidoma: a case report.

    Science.gov (United States)

    Gültaşli, N; van den Hauwe, L; Bruneau, M; D'Haene, N; Delpierre, I; Balériaux, D

    2012-05-01

    Primary solitary amyloidoma of Meckel's cave is rare, and a bilateral location is even more rare. To the best of our knowledge, only 12 cases in the literature have described such a primary lesion, including one case of bilateral involvement of Meckel's cave. We report here on the case of a 57-year-old woman presenting with pseudotumor masses involving both Meckel's caves and responsible for trigeminal neuropathy. The final diagnosis of amyloidoma was made on the basis of histological examination of surgical biopsy specimens.

  4. [Bilateral choroidal osteoma--a case report].

    Science.gov (United States)

    Jędrychowska-Jamborska, Justyna; Kulig-Stochmal, Agnieszka; Markiewicz, Anna; Jakubowska, Barbara; Romanowska-Dixon, Bożena

    2014-01-01

    Choroidal osteoma is a an extremely rare (especially located bilaterally), benign, intraocular tumor, the type of choristoma. It occurs between 2-3 decades of life, women are particularly vulnerable. The main complication in 1/3 cases is a subretinal neovascularization which may cause bleeding. The gradually progressive decalcification develops within the tumour over time, which causes atrophy of the retinal pigment epithelium and Bruch's membrane deformity. The article presents a case of a 26-year-old woman with bilateral choroidal osteoma complicated by subretinal hemorrhage; the diagnosis was based on clinical examination (biomicroscopy and indirect ophthalmoscopy) as well as specialised tests including: ultrasonography, optical coherence tomography, and fluorescein angiography.

  5. Bilateral Renal Mass-Renal Disorder: Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ozlem Tiryaki

    2013-01-01

    Full Text Available A 30-year-old woman has presented complaining of weakness and fatigue to her primary care physician. The renal sonography is a routine step in the evaluation of new onset renal failure. When the renal masses have been discovered by sonography in this setting, the functional imaging may be critical. We reported a case about bilateral renal masses in a young female patient with tuberculosis and renal insufficiency. Magnetic resonance (MR has revealed the bilateral renal masses in patient, and this patient has been referred to our hospital for further management. The patient’s past medical and surgical history was unremarkable.

  6. Sudden bilateral hearing loss after organophosphate inhalation

    OpenAIRE

    Dundar, Mehmet Akif; Derin, Serhan; Aricigil, Mitat; Eryilmaz, Mehmet Akif

    2016-01-01

    Sudden bilateral hearing loss are seen rarely and the toxic substance exposure constitutes a small part of etiology. A Fifty-eight-year-old woman admitted to our clinic with sudden bilateral hearing loss shortly after chlorpyrifos-ethyl exposure. Otolaryngologic examination findings were normal. The patient had 40 dB sensorineural hearing loss (SNHL) on the right ear and 48 dB SNHL on the left ear. Additional diagnostic tests were normal. The conventional treatment for sudden hearing loss was...

  7. Bilateral accessory cleidohyoid in a human cadaver

    Directory of Open Access Journals (Sweden)

    Stark ME

    2009-10-01

    Full Text Available During routine anatomical dissection of the infrahyoid region, a muscle was found bilaterally originating from the sternal end of clavicle and inserting into the hyoid bone. The muscle coursed parallel and lateral to the sternohyoid muscle. The muscle was found in the presence of an intact omohyoid, thus being classified as an accessory cleidohyoid (cleidohyoideus accessorius muscle. While other authors have reported the presence of a unilateral cleidohyoideus accessorius muscle, to our knowledge this is the first case of a bilateral cleidohyoideus accessorius muscle in the medical literature. Anatomical variations of the infrahyoid muscles may have functional, diagnostic, surgical and pathological implications.

  8. Isolated Bilateral Congenital Iris Sphincter Agenesis

    Directory of Open Access Journals (Sweden)

    Aparna Rao

    2011-01-01

    Full Text Available Purpose. We herein report a patient with bilateral congenital total iris sphincter agenesis with no other abnormality detected on systemic examination. Methods. A 24-year-old laborer presented to us for a routine checkup with complaint of photophobia and inability to work under sunlight. Examination revealed bilateral absence of sphincter and 6.5 mm pupil in both eyes in the undilated state. Results. Accommodation was poor in both eyes. Systemic examination was within normal limits. He was prescribed bifocal photochromic glasses for constant wear. Conclusions. Congenital sphincter agenesis can occur in an isolated form without systemic abnormalities which can be managed conservatively.

  9. A spatiotemporal analysis of gait freezing and the impact of pedunculopontine nucleus stimulation

    Science.gov (United States)

    Cole, Michael H.; Graepel, Cara L.; Hyam, Jonathan A.; Jenkinson, Ned; Brittain, John-Stuart; Coyne, Terry J.; Silburn, Peter A.; Aziz, Tipu Z.; Kerr, Graham; Brown, Peter

    2012-01-01

    Gait freezing is an episodic arrest of locomotion due to an inability to take normal steps. Pedunculopontine nucleus stimulation is an emerging therapy proposed to improve gait freezing, even where refractory to medication. However, the efficacy and precise effects of pedunculopontine nucleus stimulation on Parkinsonian gait disturbance are not established. The clinical application of this new therapy is controversial and it is unknown if bilateral stimulation is more effective than unilateral. Here, in a double-blinded study using objective spatiotemporal gait analysis, we assessed the impact of unilateral and bilateral pedunculopontine nucleus stimulation on triggered episodes of gait freezing and on background deficits of unconstrained gait in Parkinson’s disease. Under experimental conditions, while OFF medication, Parkinsonian patients with severe gait freezing implanted with pedunculopontine nucleus stimulators below the pontomesencephalic junction were assessed during three conditions; off stimulation, unilateral stimulation and bilateral stimulation. Results were compared to Parkinsonian patients without gait freezing matched for disease severity and healthy controls. Pedunculopontine nucleus stimulation improved objective measures of gait freezing, with bilateral stimulation more effective than unilateral. During unconstrained walking, Parkinsonian patients who experience gait freezing had reduced step length and increased step length variability compared to patients without gait freezing; however, these deficits were unchanged by pedunculopontine nucleus stimulation. Chronic pedunculopontine nucleus stimulation improved Freezing of Gait Questionnaire scores, reflecting a reduction of the freezing encountered in patients’ usual environments and medication states. This study provides objective, double-blinded evidence that in a specific subgroup of Parkinsonian patients, stimulation of a caudal pedunculopontine nucleus region selectively improves gait

  10. The effect of bilateral adrenal demedullation on vascular reactivity and blood pressure in spontaneously hypertensive rats.

    Science.gov (United States)

    Borkowski, K. R.; Quinn, P.

    1983-01-01

    Bilateral adrenal demedullation of juvenile spontaneously hypertensive rats attenuated, but did not prevent, the development of hypertension. Neither did it affect the subsequent vascular reactivity to phenylephrine though it significantly reduced the vascular effects of sympathetic nerve stimulation. Demedullation of adult spontaneously hypertensive rats did not alter blood pressure, but did attenuate the pressor responses to both alpha-adrenoceptor agonists and sympathetic nerve stimulation. In acutely demedullated adult rats, vascular reactivity to sympathetic nerve stimulation, but not to exogenous amines, could be restored by slow i.v. infusion of adrenaline in a dose-dependent manner. The results support a possible facilitatory role for adrenaline in sympathetic neurotransmitter release, both during the development of genetic hypertension and in vascular responses to sympathetic nerve stimulation. PMID:6640199

  11. Synchronous bilateral breast carcinoma in a 50-year-old man with 45,X/46,XY mosaic karyotype: report of a case.

    Science.gov (United States)

    Franceschini, Gianluca; D'Alba, Pierfrancesco; Costantini, Melania; Magistrelli, Andrea; Belli, Paolo; Mulè, Antonino; Coco, Claudio; Picciocchi, Aurelio

    2006-01-01

    We report a case of synchronous bilateral breast cancer in a patient with ambiguous external genitalia attributed to a 45,X/46,XY mosaicism. To our knowledge, this represents the first such case ever to be reported. Mammography, ultrasonography, computed tomography, and magnetic resonance imaging all showed bilateral suspicious breast masses with microcalcifications. There were no radiological findings of muscle invasion or axillary lymphadenopathy. The patient was successfully treated by bilateral radical modified mastectomy followed by external irradiation and adjuvant endocrine therapy. Histological examination revealed a bilateral ductal carcinoma in situ, with a cribriform and papillary pattern and microfoci of infiltrating ductal carcinoma. The hormonal profile revealed high levels of follicle-stimulating hormone and luteinizing hormone, and low levels of testosterone. Testicular sonography revealed small hypoechoic testicles with bilateral microlithiasis. This case shows that 45,X/46,XY men may have an increased risk of breast cancer and must be followed up carefully.

  12. Therapeutic electrical stimulation for spasticity: quantitative gait analysis.

    Science.gov (United States)

    Pease, W S

    1998-01-01

    Improvement in motor function following electrical stimulation is related to strengthening of the stimulated spastic muscle and inhibition of the antagonist. A 26-year-old man with familial spastic paraparesis presented with gait dysfunction and bilateral lower limb spastic muscle tone. Clinically, muscle strength and sensation were normal. He was considered appropriate for a trial of therapeutic electrical stimulation following failed trials of physical therapy and baclofen. No other treatment was used concurrent with the electrical stimulation. Before treatment, quantitative gait analysis revealed 63% of normal velocity and a crouched gait pattern, associated with excessive electromyographic activity in the hamstrings and gastrocnemius muscles. Based on these findings, bilateral stimulation of the quadriceps and anterior compartment musculature was performed two to three times per week for three months. Repeat gait analysis was conducted three weeks after the cessation of stimulation treatment. A 27% increase in velocity was noted associated with an increase in both cadence and right step length. Right hip and bilateral knee stance motion returned to normal (rather than "crouched"). No change in the timing of dynamic electromyographic activity was seen. These findings suggest a role for the use of electrical stimulation for rehabilitation of spasticity. The specific mechanism of this improvement remains uncertain.

  13. Bilateral Facial Nerve Palsy: A Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Sohil Pothiawala

    2012-01-01

    Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological investigation for evaluation of the underlying cause and specific further management as relevant.

  14. [Congenital lumbar hernia and bilateral renal agenesis].

    Science.gov (United States)

    Barrero Candau, R; Garrido Morales, M

    2007-04-01

    We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia.

  15. Bilateral chylothorax, chylopericardium and chylous ascitis

    Directory of Open Access Journals (Sweden)

    Anil Kashyap

    2011-01-01

    Full Text Available Non-Hodgkin′s lymphoma (NHL can commonly present as chylothorax and rarely as chylopericardium. Here we are presenting a case of a 21-years-old female with bilateral chylothorax, chylopericardium and chylous ascites all together finally diagnosed to have NHL as the etiology. To the best of our knowledge, it has been reported very infrequently.

  16. Bilateral duplication of the internal auditory canal

    Energy Technology Data Exchange (ETDEWEB)

    Weon, Young Cheol; Kim, Jae Hyoung; Choi, Sung Kyu [Seoul National University College of Medicine, Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si (Korea); Koo, Ja-Won [Seoul National University College of Medicine, Department of Otolaryngology, Seoul National University Bundang Hospital, Seongnam-si (Korea)

    2007-10-15

    Duplication of the internal auditory canal is an extremely rare temporal bone anomaly that is believed to result from aplasia or hypoplasia of the vestibulocochlear nerve. We report bilateral duplication of the internal auditory canal in a 28-month-old boy with developmental delay and sensorineural hearing loss. (orig.)

  17. Bilateral eyelid edema : Cutis laxa or blepharochalasis?

    NARCIS (Netherlands)

    Braakenburg, A; Nicolai, JPA

    2000-01-01

    A 59-year-old woman with massive bilateral edema of the upper and lower eyelids is presented. The edema occurred suddenly and without provocation. No cause could be identified despite a multitude of examinations. Initially the patient was diagnosed as having blepharochalasis, but later skin biopsy s

  18. Bilateral Diabetic Papillopathy and Metabolic Control

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit;

    2010-01-01

    -six patients with type 1 diabetes. METHODS: Review of clinical, photographic, and clinical chemistry records from a large diabetology and ophthalmology unit between 2001 and 2008. MAIN OUTCOME MEASURES: Simultaneous, bilateral diabetic papillopathy. RESULTS: The mean follow-up was 4.9 years. During 10 020...

  19. Bilateral carpal tunnel syndrome in Graves' disease.

    Science.gov (United States)

    Manganelli, P; Pavesi, G; Salaffi, F

    1987-01-01

    Carpal tunnel syndrome (CTS) may be associated with endocrinopathies, such as hypothyroidism and acromegaly. A direct relationship between CTS and hyperthyroidism has recently been suggested. We now report a case in which bilateral CTS developed after treatment of Graves' disease, thus, questioning the possibility of a relationship between these two disease processes.

  20. Bilateral synchronous rupture of the quadriceps tendon.

    LENUS (Irish Health Repository)

    Ellanti, P

    2012-09-01

    Bilateral simultaneous rupture of the quadriceps tendon is a rare entity. They are often associated with degenerative changes of the tendons and predisposing conditions such as diabetes or excessive steroid use. They most commonly tend to occur in patients of 40 years of age or older.

  1. ANAESTHETIC MANAGEMENT OF BILATERAL PHEOCHROMOCYTOM A

    OpenAIRE

    Joginder Pal; Veena; Ranjana; Gurmeet Kaur; Anju

    2012-01-01

    A 27 year old female patient with bilateral pheochrom ocytoma presented with hypertension. Confirmation of diagnosis was done by CT scan and raised 24 hour urinary vanillylmandelic acid levels. Preoperative BP was co ntrolled with prazosin, labetolol, indapamide and clonidine. The anaesthetic technique used was general anaesthesia with epidural analgesia.

  2. ANAESTHETIC MANAGEMENT OF BILATERAL PHEOCHROMOCYTOM A

    Directory of Open Access Journals (Sweden)

    Joginder Pal

    2012-11-01

    Full Text Available A 27 year old female patient with bilateral pheochrom ocytoma presented with hypertension. Confirmation of diagnosis was done by CT scan and raised 24 hour urinary vanillylmandelic acid levels. Preoperative BP was co ntrolled with prazosin, labetolol, indapamide and clonidine. The anaesthetic technique used was general anaesthesia with epidural analgesia.

  3. Fetal goiter and bilateral ovarian cysts

    DEFF Research Database (Denmark)

    Lassen, Pernille; Sundberg, Karin; Juul, Anders

    2008-01-01

    A unique case of fetal goiter accompanied by bilateral ovarian cysts in a mother treated with methimazole for Graves'disease is reported. The abnormal findings were detected by ultrasound at 31 weeks of gestation. Umbilical fetal blood sampling revealed elevated serum TSH, normal concentrations o...

  4. "Ostrich sign" indicates bilateral vertebral artery dissection.

    Science.gov (United States)

    Rose, David Z; Husain, M Rizwan

    2012-11-01

    Vertebral artery dissections (VADs) comprise about 2% of ischemic strokes and can be associated with trauma, chiropractic manipulation, motor vehicle collisions, whiplash, amusement park rides, golfing, and other motion-induced injuries to the neck. We present a case of bilateral extracranial VAD as a complication of conducting an orchestra. To our knowledge, this has not been documented in the literature. Conceivably, vigorous neck twisting in an inexperienced, amateur conductor may place excessive rotational forces upon mobile portions of the verterbral arteries, tear the intima, deposit subintimal blood that extends longitudinally, and cause neck pain and/or posterior fossa ischemic symptoms. Magnetic resonance angiography examinations of axially oriented slices of bilateral VADs resemble the face of an ostrich. This observation is similar to the "puppy sign," in which bilateral internal carotid artery dissections resemble the face of a dog. Craniocervical dissections of either the carotid or vertebral arteries have the potential to form an aneurysm, cause artery-to-artery embolism, or completely occlude the parent artery, resulting in an ischemic stroke. Because bilateral VADs in axial magnetic resonance angiographic sections stand out like the eyes of an ostrich, and because the fast identification of VADs is so critical, we eponymize this image the "ostrich sign."

  5. Fast and Provably Accurate Bilateral Filtering.

    Science.gov (United States)

    Chaudhury, Kunal N; Dabhade, Swapnil D

    2016-06-01

    The bilateral filter is a non-linear filter that uses a range filter along with a spatial filter to perform edge-preserving smoothing of images. A direct computation of the bilateral filter requires O(S) operations per pixel, where S is the size of the support of the spatial filter. In this paper, we present a fast and provably accurate algorithm for approximating the bilateral filter when the range kernel is Gaussian. In particular, for box and Gaussian spatial filters, the proposed algorithm can cut down the complexity to O(1) per pixel for any arbitrary S . The algorithm has a simple implementation involving N+1 spatial filterings, where N is the approximation order. We give a detailed analysis of the filtering accuracy that can be achieved by the proposed approximation in relation to the target bilateral filter. This allows us to estimate the order N required to obtain a given accuracy. We also present comprehensive numerical results to demonstrate that the proposed algorithm is competitive with the state-of-the-art methods in terms of speed and accuracy.

  6. Severe Hyperkalemia and Bilateral Adrenal Metastasis

    Directory of Open Access Journals (Sweden)

    Michael Nagler

    2009-01-01

    Full Text Available Adrenal metastases are a common finding in metastatic lung and breast cancer. Often there are no clinical symptoms suggesting them. In this paper, we present a case of a 66-year-old man with metastatic lung cancer suffering from severe hyperkaliemia due to hypoaldosteronism as a result of bilateral adrenal metastasis.

  7. Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review

    Directory of Open Access Journals (Sweden)

    Sultan Şevik Eliçora

    2015-01-01

    Full Text Available Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis.

  8. Economic Diplomacy in Africa: The Impact of Regional Integration versus Bilateral Diplomacy on Bilateral Trade

    OpenAIRE

    Afesorgbor, Sylvanus Kwaku

    2016-01-01

    The paper examines the impact of two main instruments of economic diplomacy — regional integration and commercial diplomacy on export flows among African states. We test whether there is any evidence of a trade-off or complementary interaction between these two instruments in trade facilitation. We compare the effects of these two instruments of economic diplomacy on bilateral trade by employing a gravity model for 45 African states over the period 1980-2005. The results show that bilateral d...

  9. One-stage clipping of bilateral middle cerebral artery aneurysms via the bilateral pterional keyhole approach.

    Science.gov (United States)

    Maruyama, Keisuke; Kurita, Hiroki; Yamaguchi, Ryuichi; Noguchi, Akio; Shiokawa, Yoshiaki

    2013-01-01

    Five patients aged 55 to 73 years (mean 63 years) underwent one-stage clipping for unruptured aneurysms in the bilateral middle cerebral arteries (mean size 4.5 mm, range 2 to 7 mm) via the bilateral pterional keyhole approach in our institute. Important points are as follows: the head is affixed with no rotation; one side manipulation is started 5 minutes after the other side to avoid conflict of surgical instruments; a 5-cm curvilinear skin incision is made inside the hairline and pterional keyhole craniotomy is made bilaterally using 2 burr holes; the whole operating table is rotated 15 degrees to one side to facilitate the microsurgical trans-sylvian approach and aneurysm clipping; the operating table is rotated to the other side for the contralateral procedure; and particular care is taken to avoid bilateral brain injury. This approach provided minimum but sufficient working space required for trans-sylvian dissection. Aneurysm neck clipping was safely performed in a mean operation time of 5 hours 17 minutes. No complications occurred and satisfactory cosmetic results were obtained in all patients. Postoperative neuroimaging studies exhibited bilateral complete clipping with minimal intracranial air content and minimum consequences of brain retraction. One-stage clipping via the pterional keyhole approach is a safe and effective therapeutic option for small bilateral aneurysms.

  10. Metabotropic glutamate receptor 7 modulates the rewarding effects of cocaine in rats: involvement of a ventral pallidal GABAergic mechanism.

    Science.gov (United States)

    Li, Xia; Li, Jie; Peng, Xiao-Qing; Spiller, Krista; Gardner, Eliot L; Xi, Zheng-Xiong

    2009-06-01

    The metabotropic glutamate receptor 7 (mGluR7) has received much attention as a potential target for the treatment of epilepsy, major depression, and anxiety. In this study, we investigated the possible involvement of mGluR7 in cocaine reward in animal models of drug addiction. Pretreatment with the selective mGluR7 allosteric agonist N,N'-dibenzyhydryl-ethane-1,2-diamine dihydrochloride (AMN082; 1-20 mg/kg, i.p.) dose-dependently inhibited cocaine-induced enhancement of electrical brain-stimulation reward and intravenous cocaine self-administration under both fixed-ratio and progressive-ratio reinforcement conditions, but failed to alter either basal or cocaine-enhanced locomotion or oral sucrose self-administration, suggesting a specific inhibition of cocaine reward. Microinjections of AMN082 (1-5 microg/microl per side) into the nucleus accumbens (NAc) or ventral pallidum (VP), but not dorsal striatum, also inhibited cocaine self-administration in a dose-dependent manner. Intra-NAc or intra-VP co-administration of 6-(4-methoxyphenyl)-5-methyl-3-pyridin-4-ylisoxazolo[4,5-c]pyridin-4(5H)-one (MMPIP, 5 microg/microl per side), a selective mGluR7 allosteric antagonist, significantly blocked AMN082's action, suggesting an effect mediated by mGluR7 in these brain regions. In vivo microdialysis demonstrated that cocaine (10 mg/kg, i.p.) priming significantly elevated extracellular DA in the NAc or VP, while decreasing extracellular GABA in VP (but not in NAc). AMN082 pretreatment selectively blocked cocaine-induced changes in extracellular GABA, but not in DA, in both naive rats and cocaine self-administration rats. These data suggest: (1) mGluR7 is critically involved in cocaine's acute reinforcement; (2) GABA-, but not DA-, dependent mechanisms in the ventral striatopallidal pathway appear to underlie AMN082's actions; and (3) AMN082 or other mGluR7-selective agonists may be useful in the treatment of cocaine addiction.

  11. Bilateral cerebellar activation in unilaterally challenged essential tremor

    Directory of Open Access Journals (Sweden)

    Marja Broersma

    2016-01-01

    Conclusions: Our results expand on previous findings of bilateral cerebellar involvement in ET. We have identified specific areas in the bilateral somatomotor regions of the cerebellum: lobules V, VI and VIII.

  12. Bilateral internal auditory canal gangliogliomas mimicking neurofibromatosis Type II

    Directory of Open Access Journals (Sweden)

    Kristopher G Hooten

    2016-01-01

    Conclusion: This is the first reported case of bilateral IAC/CPA gangliogliomas. When evaluating bilateral IAC/CPA lesions with unusual imaging characteristics, ganglioglioma should be included in the differential diagnosis.

  13. Tratamiento conservador en pacientes con retinoblastoma bilateral

    Directory of Open Access Journals (Sweden)

    Juan C. Suárez

    2008-11-01

    Full Text Available OBJETIVO: comparar el tratamiento convencional del retinoblastoma bilateral, usado hasta hace algunos años, consistente en radioterapia o enucleación bilateral, con el tratamiento conservador actual que incluye termoterapia transpupilar (TTT o TTT/quimioterapia al menos en un ojo, en niños con diagnóstico de retinoblastoma bilateral. DISEÑO: estudio retrospectivo descriptivo. MUESTRA: 20 pacientes con diagnóstico de retinoblastoma bilateral que consultaron al Hospital Universitario San Vicente de Paúl, de Medellín, Colombia, entre 1997 y 2007. MÉTODO: se hizo enucleación del ojo con el tumor de mayor tamaño. En el otro ojo se hizo tratamiento con TTT, con el láser diodo (810 nm, spot amplio, solo o combinado con otras terapias. RESULTADOS: se dividió a los pacientes en dos grupos: 16 pacientes (32 ojos en el grupo 1 tratados conservadoramente y 4 pacientes (8 ojos en el grupo 2 con tratamiento convencional. El rango de edad fue de 1-72 meses en el grupo 1 y de 1-12 meses en el grupo 2. El tiempo de seguimiento fue de 7-67 meses para el grupo 1 y de 13-73 meses para el grupo 2. En el grupo 1 se hizo enucleación de 16 ojos (50%, radioterapia externa de uno (3,1%, quimioterapia más termoterapia de 5 (15,6% y quimioterapia más termoterapia más crioterapia de 10 (31,3%. En todos los pacientes se logró preservar al menos un ojo. En el grupo 2, se enuclearon 7 ojos (87,5% y se hizo radioterapia externa más enucleación en un paciente (12.5%. Además, todos los pacientes recibieron quimioterapia. CONCLUSIÓN: la terapia conservadora actual consistente en tratamiento local (termoterapia, crioterapia o braquiterapia y quimiorreducción permite preservar al menos un ojo y en algunos casos de los dos, muchas veces con buena agudeza visual, en niños con retinoblastoma bilateral; se evitan así la enucleación bilateral y la radioterapia externa usada en el tratamiento convencional con todos sus efectos secundarios. La enucleación contin

  14. Hypertension after bilateral kidney irradiation in young and adult rats

    Energy Technology Data Exchange (ETDEWEB)

    Jongejan, H.T.; van der Kogel, A.J.; Provoost, A.P.; Molenaar, J.C.

    1987-09-01

    The mechanism of a rise in blood pressure after kidney irradiation is unclear but most likely of renal origin. We have investigated the role of the renin-angiotensin system and dietary salt restriction in the development of systolic hypertension after bilateral kidney irradiation in young and adult rats. Three to 12 months after a single X-ray dose of 7.5 or 12.5 Gy to both kidneys of young and adult rats, the systolic blood pressure (SBP) and plasma renin concentration (PRC) were measured regularly. A single X-ray dose of 12.5 Gy caused a moderate rise in SBP and a slight reduction in PRC in both young and adult rats. A dose of 7.5 Gy did not significantly alter the SBP or PRC during the follow-up period of 1 year. In a second experiment, the kidneys of young rats received an X-ray dose of 20 Gy. Subsequently, rats were kept on a standard diet (110 mmol sodium/kg) or a sodium-poor diet (10 mmol sodium/kg). On both diets, SBP started to rise rapidly 3 months after kidney irradiation. Sodium balance studies carried out at that time revealed an increased sodium retention in the irradiated rats compared to controls on the same diet. In rats on a low sodium intake, there was neither a delay nor an alleviation in the development of hypertension. Compared to controls, the PRC tended to be lower in irradiated rats up to 4 months after irradiation. Subsequently, malignant hypertension developed in all 20 Gy rats, resulting in pressure natriuresis, stimulating the renin-angiotensin system. Our findings indicated that hypertension after bilateral kidney irradiation was not primarily the result of an activation of the renin-angiotensin system. Although there were some indications that sodium retention played a role, dietary sodium restriction did not influence the development of hypertension.

  15. Recurrence of bilateral herpes simplex virus keratitis following bimatoprost use

    Directory of Open Access Journals (Sweden)

    Kothari Mihir

    2006-01-01

    Full Text Available A 76-year-old man presented with features of bilateral herpes simplex virus (HSV keratitis. It was found to be recurrence of bilateral HSV keratitis following the use of Bimatoprost eye drops for uncontrolled intraocular pressure in a case of bilateral primary open-angle glaucoma.

  16. Bilateral Severe Ectropion and Mature Cataract in Lamellar Ichthyosis

    Directory of Open Access Journals (Sweden)

    Intiyaz A. Lone, Reyaz A. Untoo, Sheikh S. Ahmad

    2004-07-01

    Full Text Available Lamellar ichthyosis is a rare, autosomal recessive, genetically heterogeneous skin disorder causedby mutations in the transglutaminase-1 gene. Eye abnormalities include bilateral ectropion of lowerlids, chronic blepharitis and rarely cataract. A case of lamellar ichthyosis with bilateral lower lidectropion and bilateral mature cataract is hereby presented for its rarity.

  17. Bilateral plasticity of Vibrissae SII representation induced by classical conditioning in mice.

    Science.gov (United States)

    Debowska, Weronika; Liguz-Lecznar, Monika; Kossut, Malgorzata

    2011-04-01

    The somatosensory cortex in mice contains primary (SI) and secondary (SII) areas, differing in somatotopic precision, topographic organization, and function. The role of SII in somatosensory processing is still poorly understood. SII is activated bilaterally during attentional tasks and is considered to play a role in tactile memory and sensorimotor integration. We measured the plasticity of SII activation after associative learning based on classical conditioning, in which unilateral stimulation of one row of vibrissae was paired with a tail shock. The training consisted of three daily 10 min sessions, during which 40 pairings were delivered. Cortical activation driven by stimulation of vibrissae was mapped with 2-[(14)C]deoxyglucose (2DG) autoradiography 1 d after the end of conditioning. We reported previously that the conditioning procedure resulted in unilateral enlargement of 2DG-labeled cortical representation of the "trained" row of vibrissae in SI. Here, we measured the width and intensity of the labeled region in SII. We found that both measured parameters in SII increased bilaterally. The increase was observed in cortical layers II/III and IV. Apparently, plasticity in SII is not a simple reflection of changes in SI. It may be attributable to bilateral integrative role of SII, its lesser topographical specificity, and strong involvement in attentional processing.

  18. Bilateral Diabetic Papillopathy and Metabolic Control

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit;

    2010-01-01

    OBJECTIVE: The pathogenesis of diabetic papillopathy largely is unknown, but case reports suggest that it may follow rapidly improved metabolic control. The present study was designed to investigate this hypothesis. DESIGN: Retrospective case-control study. PARTICIPANTS: Two thousand sixty......-six patients with type 1 diabetes. METHODS: Review of clinical, photographic, and clinical chemistry records from a large diabetology and ophthalmology unit between 2001 and 2008. MAIN OUTCOME MEASURES: Simultaneous, bilateral diabetic papillopathy. RESULTS: The mean follow-up was 4.9 years. During 10 020...... patient-years of observation, bilateral diabetic papillopathy developed in 5 patients. During the year preceding this incident, all 5 patients had experienced a decrease in glycosylated hemoglobin A(1c) (HbA(1C)) at a maximum rate of -2.5 (mean) percentage points per quarter year, which was significantly...

  19. [Bilateral dependency and the minimal group paradigm].

    Science.gov (United States)

    Jin, N; Yamagishi, T; Kiyonari, T

    1996-06-01

    Two experiments examined the effect of illusion of control on in-group favoritism found in the minimal group situation (Tajfel, Billig, Bundy, & Flament, 1971). In bilateral dependency condition, each member made allocation decisions for in-group as well as out-group participants. It was exactly the same situation used in the original studies under the minimal group paradigm, and the subjects knew that their reward allocation too depended on others' decisions. In contrast, in unilateral dependency condition, the subjects made allocation decisions knowing that theirs were not dependent on others' decisions. In Experiment 1, an in-group bias in reward distribution was found in the bilateral dependency condition, but not in the unilateral condition. In Experiment 2, it was found that only those who felt illusion of control exhibited such an in-group bias. Results of the experiments therefore confirmed that illusion of control explained in-group favoritism, as Karp, Jin, Yamagishi, and Shinotsuka (1993) originally hypothesized.

  20. [Bilateral eye injuries by external transversal force].

    Science.gov (United States)

    Geidel, K; Schob, S; Unterlauft, J D; Wiedemann, P; Meier, P

    2016-12-14

    A 49-year-old female victim of violent crime with an acute bilateral loss of vision was referred to our hospital. The ophthalmological evaluation showed complete subconjunctival hemorrhage of both eyes, bilateral hemophthalmos and hypotonia of the left eye. These raised the suspicion of an occult scleral rupture. We immediately performed exploratory surgery and found a perforating scleral lesion of the left eye and a penetrating scleral lesion of the right eye. Furthermore, a small, cruciform wound was detected on the left temple. In cooperation with the department of radiology, the extraordinary injury pattern was reconstructed: a horizontal stab wound with perforation of the left eye and penetration of the right eye caused by a screwdriver. Visual rehabilitation necessitated further surgical interventions. Besides the intraoperative approach, immediate primary wound management within 100 h of trauma plays a pivotal role for long-term outcome.

  1. Sudden bilateral hearing loss after organophosphate inhalation.

    Science.gov (United States)

    Dundar, Mehmet Akif; Derin, Serhan; Aricigil, Mitat; Eryilmaz, Mehmet Akif

    2016-12-01

    Sudden bilateral hearing loss are seen rarely and the toxic substance exposure constitutes a small part of etiology. A Fifty-eight-year-old woman admitted to our clinic with sudden bilateral hearing loss shortly after chlorpyrifos-ethyl exposure. Otolaryngologic examination findings were normal. The patient had 40 dB sensorineural hearing loss (SNHL) on the right ear and 48 dB SNHL on the left ear. Additional diagnostic tests were normal. The conventional treatment for sudden hearing loss was performed. On the second week following organophosphate (OP) exposure the patient's hearing loss almost completely resolved. OP's are heavily used in agriculture and should be taken into consideration as an etiologic factor in sudden hearing loss.

  2. Bilateral akillesseneruptur efter behandling med ciprofloxacin

    DEFF Research Database (Denmark)

    Attarzadeh, Amir Pasha; Ryge, Camilla

    2013-01-01

    We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment with cipr......We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment...... with ciprofloxacin 500 mg twice daily and long-term treatment with prednisolon 10 mg once daily. This rare side effect caused by concurrent treatment with steroids and ciprofloxacin should be kept in mind. Any signs of tendinitis following this treatment should arouse the physicians' suspicion towards ciprofloxacin....

  3. [Bilateral acetabulum fracture after suffering sport trauma].

    Science.gov (United States)

    Trost, P; Kollersbeck, C; Pelitz, M; Walcher, T; Genelin, F

    2013-07-01

    This case study describes a 37-year-old male who suffered a bilateral transverse acetabulum fracture with a fracture of the posterior wall and a double-sided dorsal hip dislocation in combination with a left-sided femoral head fracture (Pipkin IV) while skiing in a "fun park". The accurate diagnosis and presurgical planning was made by means of a computed tomography (CT) scan and a subsequent 3D reconstruction. After a primarily executed shielded repositioning of the bilateral hip dislocationearly secondary and anatomical reconstruction of the double-sided acetabulum fracture was possible using the Kocher-Langenbeck approach. A consistent physiotherapy as well as rehabilitation finally led to a positive clinical result for the patient.

  4. Simultaneous bilateral patellar tendon rupture without

    Directory of Open Access Journals (Sweden)

    LU Hua-ding

    2012-04-01

    Full Text Available 【Abstract】There is a dearth of case reports de-scribing simultaneous bilateral patellar tendon ruptures in the medical literature. These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use. The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar ten-don ruptures without any history of systemic disease or steroidal medication. We repaired and reattached the rup-tured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement. One year after operation, the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag. The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event. Key words: Patella; Patellar ligament; Rupture; Ten-don injuries; Knee

  5. Bilateral hypoglossal schwannoma: a radiologic diagnosis.

    Science.gov (United States)

    Bektaş, Devrim; Caylan, Refik

    2004-01-01

    A 53-year-old woman presented with a complaint of a sore throat. Examination showed a left-sided atrophy of the tongue. Upon protrusion, the tongue deviated to the left, suggestive of a unilateral hypoglossal nerve palsy. Computed tomography revealed enlarged hypoglossal canals. Magnetic resonance imaging (MRI) demonstrated bilateral hypoglossal canal masses, with enhancement following gadolinium administration. Magnetic resonance angiography and MRI with fat suppression revealed nonvascular masses in both hypoglossal canals. Radiological diagnosis of bilateral hypoglossal nerve schwannoma was made and the patient was scheduled for MRI monitoring with six-month intervals. The size of the masses and the clinical manifestations remained unchanged during a two-year follow-up period.

  6. China-Pakistan Strengthen Bilateral Custom Cooperation

    Institute of Scientific and Technical Information of China (English)

    Guo Yan

    2008-01-01

    @@ Mr.Abdullah Yusuf,Secretary General/Chairman,Central Board Of Revenue of Pakistan,arrived Shenzhen on April 22 to meet with Mr.Sheng Guangzu,the Chinese Minister for Customs Administration for discussing the bilateral customs issues.During his two-day visit,China's Foreign Trade Magazine interviewed to Mr.Abdullah Yusuf in Beijing,he gave the high evaluation on this visit and China's great development in the recent years.

  7. [Bilateral pleural mesothelioma--case report].

    Science.gov (United States)

    Land, I; Knolle, H

    1990-08-01

    It is reported on the rare case of a 46-year-old female patient with a bilateral mesothelioma of the pleura without contact to asbest. Although the female was suspected in a malignant tumor and many diagnostic investigations were performed, diagnosis could be ensured morphologically only a short time before her death. Causes and development of mesothelioma, histological types, clinical symptoms and diagnostic procedures are described.

  8. Loss of heterozygosity in bilateral breast cancer.

    Science.gov (United States)

    Kollias, J; Man, S; Marafie, M; Carpenter, K; Pinder, S; Ellis, I O; Blamey, R W; Cross, G; Brook, J D

    2000-12-01

    Women who develop bilateral breast cancer at an early age are likely to harbour germline mutations in breast cancer susceptibility genes. The aim of this study was to test for concordant genetic changes in left and right breast cancer of young women (age < 50) with bilateral breast cancer that may suggest an inherited breast cancer predisposition. Microsatellite markers were used to test for loss of heterozygosity (LOH) in left and right tumours for 31 women with premenopausal bilateral breast cancer. Markers adjacent to or within candidate genes on 17p (p53), 17q (BRCA1), 13q (BRCA2), 11q (Ataxia Telangiectasia-ATM) and 3p (FHIT) were chosen. Mutational testing for BRCA1 and BRCA2 was performed for cases where blood was available. Concordant LOH in both left and right tumours was demonstrated for at least one of the markers tested in 16/31(54%) cases. Where allelic loss was demonstrated for both left and right breast cancer, the same allele was lost on each occasion. This may suggest a common mutational event. Four cases showed concordant loss of alleles in both left and right breast cancer at D17S791 (BRCA1). BRCA1 mutations were identified in two of these cases where blood was available. Four cases showed concordant LOH at D13S155 (BRCA2). Concordant LOH was further demonstrated in seven cases for D11S1778 (ATM) and four cases for D3S1300 (which maps to the FHIT gene), suggesting a possible role for these tumour suppressor genes in this subgroup of breast cancer patients. No concordant allelic loss was demonstrated for D17S786 suggesting that germline mutations in p53 are unlikely in such cases of bilateral breast cancer.

  9. A rare case of bilateral oral carcinoma

    Directory of Open Access Journals (Sweden)

    Sonia Behal

    2008-01-01

    Full Text Available Tobacco in different forms is an acknowledged etiologic factor in development of oral cancer. Due to the habit pattern, mostly a single malignant lesion develops. While multiple oral malignancies and second primaries are well reported in the literature, a truly bilateral oral malignancy seems to be a rare occurrence. We report such an occurrence in an individual with an unusual pattern of tobacco habit.

  10. Hypersexuality following bilateral thalamic infarction: case report

    OpenAIRE

    Mutarelli Eduardo G; Omuro Antonio M.P.; Adoni Tarso

    2006-01-01

    Hypersexuality is a rare but well recognized condition following brain injury. It has been described secondarily to dysfunction in the hypothalamus, the temporal and frontal lobes. We report a 63 year-old man that developed neuropsychological disturbances with hypersexuality as a prominent feature, disinhibition and moderate memory loss, hypersomnia and irritability after a bilateral paramedian thalamic infarction. A SPECT showed frontal hypoperfusion. We believe that these findings are expre...

  11. Bilateral germinoma of the basal ganglia.

    Science.gov (United States)

    Rossi, Andrea; Garrè, Maria Luisa; Ravegnani, Marcello; Nozza, Paolo; Abbruzzese, Arturo; Giangaspero, Felice; Tortori-Donati, Paolo

    2008-01-01

    Germinoma arising in the bilateral basal ganglia is exceedingly rare, with only five cases reported to date. Owing to non-specific clinical findings and the frequent presence of ill-defined abnormalities without a definite tumor mass on neuroimaging, the diagnosis can be difficult. We describe a case in which magnetic resonance spectroscopy (MRS) findings suggested a tumor and supported the decision to perform biopsy of the lesion.

  12. Bilateral Pseudoexfoliation Deposits on Intraocular Lens Implants

    OpenAIRE

    Elena Bonafonte Marquez; Sergio Bonafonte Royo

    2015-01-01

    We present a rare case of bilateral pseudoexfoliative deposits on both intraocular lens (IOL) implants in an 83-year-old woman with no other associated pathology, 5 years after cataract surgery. Pseudoexfoliation syndrome is the most common cause of secondary open-angle glaucoma worldwide and these deposits are usually found on the natural lens. The fact that pseudoexfoliative deposits have been found on IOL implants implies the need for a thorough examination in pseudophakic patients, for i...

  13. Bilateral accessory cleidohyoid in a human cadaver

    OpenAIRE

    Stark ME; Wu B; Bluth BE; Wisco JJ

    2009-01-01

    During routine anatomical dissection of the infrahyoid region, a muscle was found bilaterally originating from the sternal end of clavicle and inserting into the hyoid bone. The muscle coursed parallel and lateral to the sternohyoid muscle. The muscle was found in the presence of an intact omohyoid, thus being classified as an accessory cleidohyoid (cleidohyoideus accessorius) muscle. While other authors have reported the presence of a unilateral cleidohyoideus accessorius muscle, to our know...

  14. Erlotinib-related bilateral anterior uveitis

    Science.gov (United States)

    Ali, Kashif; Kumar, Indu; Usman-Saeed, Muniba; Usman Saeed, Muhammad

    2011-01-01

    The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors’ knowledge, this is the first case of erlotinib-related anterior uveitis. PMID:22694887

  15. A rare case of bilateral aspergillus endophthalmitis

    Directory of Open Access Journals (Sweden)

    Saurabh Gupta

    2015-12-01

    Full Text Available Aspergillus endophthalmitis is a devastating inflammatory condition of the intraocular cavities that may result in irreparable loss of vision and rapid destruction of the eye. Almost all cases in the literature have shown an identified source causing aspergillus endophthalmitis as a result of direct extension of disease. We present a rare case of bilateral aspergillus endophthalmitis. A 72-year-old woman with a history of diabetes mellitus, congenital Hirschsprung disease, and recent culture-positive candida pyelonephritis with hydronephrosis status post-surgical stent placement presented with difficulty opening her eyes. She complained of decreased vision (20/200 with pain and redness in both eyes – right worse then left. Examination demonstrated multiple white fungal balls in both retinas consistent with bilateral fungal endophthalmitis. Bilateral vitreous taps for cultures and staining were performed. Patient was given intravitreal injections of amphotericin B, vancomycin, ceftazidime, and started on oral fluconazole. Patient was scheduled for vitrectomy to decrease organism burden and to remove loculated areas of infection that would not respond to systemic antifungal agents. Four weeks after initial presentation, the fungal cultures revealed mold growth consistent with aspergillus. Patient was subsequently started on voriconazole and fluconazole was discontinued due to poor efficacy against aspergillus. Further workup was conducted to evaluate for the source of infection and seeding. Transthoracic cardiogram was unremarkable for any vegetation or valvular abnormalities. MRI of the orbits and sinuses did not reveal any mass lesions or bony destruction. CT of the chest was unremarkable for infection. Aspergillus endophthalmitis may occur because of one of these several mechanisms: hematogenous dissemination, direct inoculation by trauma, and contamination during surgery. Our patient's cause of bilateral endophthalmitis was through an

  16. Occipital seizures presenting with bilateral visual loss

    Directory of Open Access Journals (Sweden)

    Hadjikoutis S

    2003-01-01

    Full Text Available Transient visual loss may occur with occipital seizures as an ictal or post-ictal phenomenon. Its duration varies from less than one minute to days, or can be permanent. We describe a 61-year-old man presenting with headache, vomiting and bilateral visual loss. EEG revealed persistent spike discharge in the occipital lobes suggesting occipital seizures. His vision improved with carbamazepine.

  17. Bilateral Brodie's abscess at the proximal tibia.

    Science.gov (United States)

    Buldu, Halil; Bilen, Fikri Erkal; Eralp, Levent; Kocaoglu, Mehmet

    2012-08-01

    Brodie's abscess is a form of subacute osteomyelitis, which typically involves the metaphyses of the long tubular bones, particularly in the tibia. The diagnosis is usually made incidentally, as there are no accompanying symptoms or laboratory studies. Bilateral involvement at the proximal tibia is unusual. However, orthopaedic surgeons should be aware of this entity, as it may present without symptoms. Checking the contralateral limb for concomitant Brodie's abscess is recommended.

  18. Multilateral, regional and bilateral energy trade governance

    Energy Technology Data Exchange (ETDEWEB)

    Leal-Arcas, Rafael; Grasso, Costantino; Rios, Juan Alemany (Queen Mary Univ. of London (United Kingdom))

    2014-12-01

    The current international energy trade governance system is fragmented and multi-layered. Streamlining it for greater legal cohesiveness and international political and economic cooperation would promote global energy security. The current article explores three levels of energy trade governance: multilateral, regional and bilateral. Most energy-rich countries are part of the multilateral trading system, which is institutionalized by the World Trade Organization (WTO). The article analyzes the multilateral energy trade governance system by focusing on the WTO and energy transportation issues. Regionally, the article focuses on five major regional agreements and their energy-related aspects and examines the various causes that explain the proliferation of regional trade agreements, their compatibility with WTO law, and then provides several examples of regional energy trade governance throughout the world. When it comes to bilateral energy trade governance, this article only addresses the European Union’s (EU) bilateral energy trade relations. The article explores ways in which gaps could be filled and overlaps eliminated whilst remaining true to the high-level normative framework, concentrating on those measures that would enhance EU energy security.

  19. Diagnosis and management of bilateral nasolabial cysts

    Directory of Open Access Journals (Sweden)

    Rajkumar Parwani

    2013-01-01

    Full Text Available Nasolabial cysts are painless, submucosal, non-odontogenic jaw cysts presenting as soft tissue swellings in the maxillary anterior mucolabial fold lateral to midline, leading to elevation of nasal ala. Present case documents bilateral nasolabial cysts in a 69-year-old Asian female patient. In the present case, extraoral swelling of maxillary lip and elevation of nasal ala was observed on right side of the face. Intraorally, soft and fluctuant bilateral cysts were observed. Straw-colored fluid was aspirated from the right cyst. Radiographically, erosion of bone in a "cupping" fashion was observed in the region of left cyst. The cysts were enucleated using intraoral approach. Histopathology of the right-sided cyst revealed a cystic cavity lined by stratified squamous cells along with a few mucosal cells. At few places, stratified squamous and pseudostratified columnar epithelia with many cilia and goblet cells were also evident. Capsule was loosely arranged with fibrous tissue and chronic inflammatory infiltrate. Left-sided cystic specimen showed two or more layered stratified squamous lining epithelium with thin capsule. Diagnosis of bilateral nasolabial/nasoalveolar cysts was confirmed.

  20. High Performance, Three-Dimensional Bilateral Filtering

    Energy Technology Data Exchange (ETDEWEB)

    Bethel, E. Wes

    2008-06-05

    Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

  1. Bilateral ovarian fibroma associated with Gorlin syndrome

    Directory of Open Access Journals (Sweden)

    Shahnaz Aram

    2009-02-01

    Full Text Available

    • Gorlin syndrome (GS, also known as nevoid basal cell carcinoma syndrome (NBCCS, is a rare inherited multisystem disorder. This paper presents a 22-years-old Iranian woman with this syndrome whose past history was multiple keratocysts of maxillary bone. She was referred to gynecology clinic with the chief complaint of irregular menses and vaginal spotting. On examination, frontal bossing and hypertelorism were detected. Physical examination of genitalia disclosed bilateral adnexal masses. Pelvic ultrasound showed two solid, echogenous and calcified masses measuring 100*50*10 & 60*50*45 mm in the left and right ovaries, respectively. The patient underwent right oophorectomy and ovarian mass resection with preservation of intact ovarian tissue on the left side. On frozen and permanent histological sections, bilateral and calcified ovarian fibromas were diagnosed. Surprisingly, during the last follow-up one year after the surgery, we found that our patient was expecting a baby. It can be concluded that in the presence of bilateral and calcified ovarian fibromas, the possibility of GS should be considered. Accurate diagnosis is only possible with close attention to the familial and past medical history and physical examination. In these patients, careful follow up for detecting malignancies and other complications is highly recommended.
    • KEY WORDS: Gorlin syndrome, ovarian fibroma, multiple keratocysts.

  2. Gastric metastasis of bilateral breast cancer

    Science.gov (United States)

    Belaïd, Asma; Mghirbi, Fahmi; Béhi, Khalil; Doghri, Raoudha; Benna, Farouk

    2017-01-01

    Breast cancer is the most common malignancy in women. The most frequent metastatic sites are lung, bone, liver and brain. On the other hand, gastric metastases are rare. Synchronous bilateral breast cancer (SBBC) occurs rarely. Lobular carcinoma is the histological type most often associated with bilateral breast carcinomas and gastric metastases. We made a retrospective study including four patients followed in the Salah Azaiez Institute, for a bilateral breast cancer with gastric metastases. We analyzed the epidemiological, anatomoclinical and therapeutic particularities of this rare entity. Symptoms were unspecific. The diagnosis of gastric metastasis of the SBBC was confirmed by a histopathological examination of an endoscopic biopsy. The median age was 46.2 years (range, 36–51 years) and the median time until the gastric involvement was 19 months (range, 0–41 months). None of patients had a surgical treatment for the gastric location. All Patients received at least one line of chemotherapy and radiotherapy. Median survival following the detection of gastric involvement was 22 months (range, 1–56 months). Gastric metastases from breast cancer are rare and frequently associated with other distant metastasis. Symptoms are unspecific and endoscopy may not be contributive. Therefore, gastric involvement is underestimated. Lobular infiltrating carcinoma (LIC) is the most histological type incriminated in its occurrence. The supply of immunohistochemistry is crucial to distinguish between primary or metastatic gastric cancer. PMID:28280631

  3. Bilateral limbic system destruction in man

    Science.gov (United States)

    Feinstein, Justin S.; Rudrauf, David; Khalsa, Sahib S.; Cassell, Martin D.; Bruss, Joel; Grabowski, Thomas J.; Tranel, Daniel

    2010-01-01

    We report here a case study of a rare neurological patient with bilateral brain damage encompassing a substantial portion of the so-called “limbic system.” The patient, Roger, has been studied in our laboratory for over 14 years and the current article presents his complete neuroanatomical and neuropsychological profiles. The brain damage occurred in 1980 following an episode of herpes simplex encephalitis. The amount of destroyed neural tissue is extensive and includes bilateral damage to core limbic and paralimbic regions, including the hippocampus, amygdala, parahippocampal gyrus, temporal poles, orbitofrontal cortex, basal forebrain, anterior cingulate cortex, and insular cortex. The right hemisphere is more extensively affected than the left, although the lesions are largely bilateral. Despite the magnitude of his brain damage, Roger has a normal IQ, average to above average attention, working memory, and executive functioning skills, and very good speech and language abilities. In fact, his only obvious presenting deficits are a dense global amnesia and a severe anosmia and ageusia. Roger's case presents a rare opportunity to advance our understanding of the critical functions underlying the human limbic system, and the neuropsychological and neuroanatomical data presented here provide a critical foundation for such investigations. PMID:19763994

  4. High and low frequency stimulation of the subthalamic nucleus induce prolonged changes in subthalamic and globus pallidus neurons

    Directory of Open Access Journals (Sweden)

    Hagar eLavian

    2013-12-01

    Full Text Available High frequency stimulation (HFS of the subthalamic nucleus (STN is widely used to treat the symptoms of Parkinson’s disease but the mechanism of this therapy is unclear. Using a rat brain slice preparation maintaining the connectivity between the STN and one of its target nuclei, the globus pallidus (GP, we investigated the effects of high and low frequency stimulation (HFS 100 Hz, LFS 10 Hz on activity of single neurons in the STN and GP. Both HFS and LFS caused changes in firing frequency and pattern of subthalamic and pallidal neurons. These changes were of synaptic origin, as they were abolished by glutamate and GABA antagonists. Both HFS and LFS also induced a long-lasting reduction in firing frequency in STN neurons possibly contending a direct causal link between HFS and the outcome DBS. In the GP both HFS and LFS induced either a long-lasting depression, or less frequently, a long-lasting excitation. Thus, in addition to the intrinsic activation of the stimulated neurons, long-lasting stimulation of the STN may trigger prolonged biochemical processes.

  5. Bilateral eye irrigation: a simple and effective hands-free technique.

    Science.gov (United States)

    Wade, Ryckie G; Peacock, Duncan

    2014-08-01

    Bilateral chemical eye injuries are a common and important problem in the Emergency Department. Irrigation of both eyes can be time-consuming, so we present a novel, simple and cost-effective technique for hands-free bilateral eye irrigation. Modifications of a generic dual-lumen cannula adapter and fixation about the glabella allow sterile irrigation fluid to be delivered directly to the medial canthi of the contaminated eyes in a hands-free fashion. Our customized rig frees both the clinician(s) and patient, thus conferring benefits to both. Patients regain autonomy of movement to reposition themselves for comfort or to manipulate the eyelids for more effective irrigation. Clinicians are freed to tend to other tasks. By sharing this technique we hope to stimulate discussion on the safest and most effective method of irrigating chemically injured eyes and prompt the generation of comparable outcome data for the benefit of patients.

  6. [Hyperprogesteronism due to bilateral adrenal carcinomas in a cat with diabetes mellitus].

    Science.gov (United States)

    Quante, S; Sieber-Ruckstuhl, N; Wilhelm, S; Favrot, C; Dennler, M; Reusch, C

    2009-09-01

    An 8 year old male castrated Russian Blue cat with polyuria, polydipsia, polyphagia, abdominal enlargement, unkempt and easily epilated hair coat and abdominal alopecia is described. As a first step diabetes mellitus was diagnosed. Further work-up by ultrasonography revealed severe bilateral enlargement of the adrenal glands. Hypercortisolism was suspected and therefore ACTH stimulation test and dexamethasone suppression test were performed. In all samples cortisol concentrations were below the detection limit of the assay used. Various precursor hormones were measured and high progesterone concentrations were found. Histologically, the adrenal masses were characterised as bilateral adrenal carcinomas of the adrenal cortex. The case report demonstrates that adrenal gland tumors are also capable to secrete sex hormones instead of cortisol. Clinical signs of hyperprogesteronism are identical to those of hypercortisolism.

  7. Vascular changes caused by deep brain stimulation using double-dose gadolinium-enhanced brain MRI

    Institute of Scientific and Technical Information of China (English)

    Byeong Sam Choi; Yong Hwan Kim; Sang Ryong Jeon

    2014-01-01

    We retrospectively analyzed the clinical data of 32 patients with medically intractable idiopathic Parkinson’s disease who had undergone staged bilateral deep brain stimulation of the subtha-lamic nuclei from January 2007 to May 2011. The vascularture of the patients who received two deep brain stimulations was detected using double-dose gadolinium-enhanced brain MRI. The dimensions of straight sinus, superior sagittal sinus, ipsilateral internal cerebral vein in the tha-lamic branch and ipsilateral anterior caudate vein were reduced. These ifndings demonstrate that bilateral deep brain stimulation of the subthalamic nuclei affects cerebral venous blood lfow.

  8. Iatrogenic “buffalo chest” bilateral pneumothoraces following unilateral transbronchial lung biopsies in a bilateral lung transplant recipient

    Directory of Open Access Journals (Sweden)

    Leith Sawalha

    2015-01-01

    Full Text Available We present a 54 year old male patient who had a bilateral lung transplant sixteen years ago for Alpha-1 Antitrypsin Deficiency-related emphysema. He was referred for flexible bronchoscopy with transbronchial biopsies to evaluate new mild exertional dyspnea and worsening of his FEV1. Eight transbronchial biopsies were done from the right middle lobe and the right lower lobe. Post procedure he developed bilateral pneumothoces that required emergent bilateral pleural ‘pigtail’ catheters. To our knowledge, this is the first reported case of bilateral pneumothoraces that developed after a unilateral procedure in a bilateral lung transplant recipient relatively late after the transplant.

  9. Ceratite bilateral por Acanthamoeba: relato de caso Bilateral Acanthamoeba keratitis: case report

    Directory of Open Access Journals (Sweden)

    Wilson Nahmatallah Obeid

    2003-12-01

    Full Text Available A ceratite por Acanthamoeba é uma infecção ocular grave que, apesar dos recentes progressos no diagnóstico e tratamento, ainda provoca prolongada morbidade e perda da acuidade visual. Relatamos um caso de ceratite bilateral por Acanthamoeba em usuário de lentes de contato, que é o primeiro caso descrito na literatura brasileira.Acanthamoeba keratitis is a severe ocular infection which even with recent progress in diagnosis and treatment still causes long morbidity and loss of visual acuity. We describe a case of bilateral Acanthamoeba keratitis in a user of contact lenses, which is the first case discussed in Brazilian literature.

  10. Bilateral maculopathy associated with Pierre Robin sequence.

    Science.gov (United States)

    Witmer, Matthew T; Vasan, Ryan; Levy, Richard; Davis, Jessica; Chan, R V Paul

    2012-08-01

    Pierre Robin sequence has been associated with a number of ocular complications, including myopia, strabismus, Möbius syndrome, nasolacrimal duct obstruction, glaucoma, cataract, microphthalmos, coloboma of choroid, and retinal detachment. We report a 10-day-old boy who presented with micrognathia, glossoptosis, and cleft palate as well as multiple congenital anomalies. Ophthalmic examination was notable for bilateral maculopathy, with focal areas of retinal and retinal pigment epithelial atrophy. The association of Pierre Robin sequence and maculopathy has been reported only twice previously.

  11. Bilateral Pseudoexfoliation Deposits on Intraocular Lens Implants

    Directory of Open Access Journals (Sweden)

    Elena Bonafonte Marquez

    2015-01-01

    Full Text Available We present a rare case of bilateral pseudoexfoliative deposits on both intraocular lens (IOL implants in an 83-year-old woman with no other associated pathology, 5 years after cataract surgery. Pseudoexfoliation syndrome is the most common cause of secondary open-angle glaucoma worldwide and these deposits are usually found on the natural lens. The fact that pseudoexfoliative deposits have been found on IOL implants implies the need for a thorough examination in pseudophakic patients, for it could be the only sign of secondary glaucoma.

  12. Bilateral amaurosis caused by Salmonella enteritidis infection.

    Science.gov (United States)

    Cerovski, Branimir; Barisić, Nina; Vidović, Tomislav; Petricek, Igor; Cerovski, Jasenka

    2004-12-01

    The aim of this paper was to show the potential of Salmonella enteritidis infection to eventually result in visual impairment. A case of salmonellosis in a 6-year-old boy, caused by intake of a cake made from eggs infected with Salmonella enteritidis, is presented. Prolonged duration of the disease was followed by complete remission of neurologic complications and persistent amaurosis with bilateral optic nerve atrophy. A severe form of Salmonella enterocolitis with neurologic involvement can lead to optic nerve lesion with consequential loss of vision.

  13. Primary amenorrhea with bilateral endometriotic cysts.

    Science.gov (United States)

    Jabeen, Sadaqat; Raees, Mehnaz

    2015-05-01

    Primary amenorrhea is a common problem. Diagnosis is usually by going through systematic approach of history, examination and investigations. This case had bilateral large endometriotic cysts in the adnexal region. Uterus was normal sized with well-formed endometrium. She underwent laparotomy followed by drainage of endometriotic cysts, stripping and reconstruction of ovaries was performed. Patient was given a trial of combined oral contraceptive pills for two consecutive cycles to observe withdrawal bleeding, but it failed. Till now we are unable to find out such case in literature. Exact case of primary amenorrhea could not be found.

  14. Spontan bilateral ekstrauterin graviditet efter kejsersnit

    DEFF Research Database (Denmark)

    Petersen, Jesper Friis; Ekelund, Charlotte; Settnes, Annette

    2015-01-01

    contralateral tube. The woman was readmitted three weeks later and had an additional salpingectomy on behalf of an unrecognized tubal pregnancy. Considering the rising caesarean section rates clinicians need to be certain of no additional ectopic pregnancy while performing the primary operation.......We describe a rare case of bilateral tubal pregnancy following natural conception in a woman with no other known risk factor than two former caesarean sections. Intraabdominal adhesions following the caesarean sections complicated the salpingectomy thus diminishing certainty of a healthy...

  15. Panuveite bilateral simultânea

    OpenAIRE

    RAMALHO, M.; Coutinho, I; Pina, S.; Santos, C.; Pedrosa, C; Vaz, F.; Chang, N; Bernardo, M.

    2013-01-01

    Introdução Tem sido descrito um ressurgimento da sífilis desde o final da década de 90. Descrevem-se dois casos clínicos de um casal homossexual com panuveite bilateral sifilítica simultânea. Métodos O primeiro caso clinico é de um homem de 31 anos, homossexual, com antecedentes de Hepatite C desde há 7 anos e diagnóstico de VIH-1 realizado 3 meses antes no contexto de úlcera peniana, VDRL negativo na altura, tendo iniciado terapêutica anti-retroviral mês e meio antes. Apresentou-se ...

  16. Hypersexuality following bilateral thalamic infarction: case report.

    Science.gov (United States)

    Mutarelli, Eduardo G; Omuro, Antonio M P; Adoni, Tarso

    2006-03-01

    Hypersexuality is a rare but well recognized condition following brain injury. It has been described secondarily to dysfunction in the hypothalamus, the temporal and frontal lobes. We report a 63 year-old man that developed neuropsychological disturbances with hypersexuality as a prominent feature, disinhibition and moderate memory loss, hypersomnia and irritability after a bilateral paramedian thalamic infarction. A SPECT showed frontal hypoperfusion. We believe that these findings are expression of frontal-subcortical circuits dysfunction, particularly the orbitofrontal circuit, secondary to dorso medial thalamic infarction which probably plays a role in the determination of human sexual behavior. This case favors a thalamic modulation of frontal function.

  17. Bilateral pneumothoraces secondary to acupuncture therapy.

    Science.gov (United States)

    Nguyen, Theresa M; Roy, Neil K; Zlupko, George R

    2011-09-01

    Acupuncture is becoming increasingly popular in the United States for a wide variety of uses, ranging from the treatment of chronic back pain to aiding in addiction therapy. As this form of complementary and alternative medicine becomes more prevalent in certain areas of the country, it is of paramount importance that the emergency physician be familiar with its methods and potential complications. In general, acupuncture is perceived as fairly safe. However, it is not without risks or side effects. In this case report, we discuss the history, methods, and common complications of acupuncture in the context of a patient who presented to the Emergency Department (ED) with bilateral pneumothoraces secondary to acupuncture therapy.

  18. Espasmo hemifacial bilateral: relato de caso

    OpenAIRE

    Machado Flavia Costa Nunes; Fregni Felipe; Campos Cynthia Resende; Limongi João Carlos Papaterra

    2003-01-01

    Espasmo hemifacial bilateral é um distúrbio de movimento raro geralmente associado à compressão vascular dos nervos faciais. Caracteriza-se clinicamente por contrações assimétricas e assíncronas da musculatura facial e por longa latência entre a instalação dos movimentos em cada hemiface. Deve ser diferenciado de outras condições como blefaroespasmo, miocimia facial, tiques faciais, distonia oromandibular e espasmo hemimastigatório. O tratamento sintomático mais eficaz e menos invasivo consis...

  19. Bilateral generating functions and operational methods

    Energy Technology Data Exchange (ETDEWEB)

    Dattoli, G. [ENEA, Divisione Fisica Applicata, Centro Ricerche Frascati, Frascati, RM (Italy)

    2000-07-01

    Bilateral generating functions are those involving products of different types of polynomials. It is showed that operational methods offer a powerful tool to derive these families of generating functions. Cases relevant to products of Hermite and Laguerre, Hermite and Legendre ... polynomials and propose further extensions of the method are studied in this report. [Italian] Le funzioni generatrici bilaterali sono quelle che coinvolgono prodotti di tipi differenti di polinomi, si dimostra che i metodi operazionali offrono uno strumento potente per derivare queste nuove famiglie di funzioni speciali. Si studiano casi relativi a prodotti di polinomi di Hermite e Laguerre, Hermite e Legendre. Si propongono infine possibili estensioni del metodo.

  20. Bilateral Nasoalveolar Cyst Causing Nasal Obstruction

    Directory of Open Access Journals (Sweden)

    Uzeyir Yildizoglu

    2016-01-01

    Full Text Available Nasoalveolar cysts, which originate from epithelial remnants of nasolacrimal duct, are nonodontogenic soft tissue lesions of the upper jaw. These cysts are thought to be developmental and are presented with fullness in the upper lip and nose, swelling on the palate, and sometimes nasal obstruction. Because of cosmetic problems, they are often diagnosed at an early stage. These lesions are mostly revealed unilaterally but also can be seen on both sides. In this case report, a patient who complained of nasal obstruction and then diagnosed with bilateral nasoalveolar cysts and treated by sublabial excision is presented and clinical features and treatment approaches are discussed with the review of literature.

  1. Bilateral Nasoalveolar Cyst Causing Nasal Obstruction

    Science.gov (United States)

    Yildizoglu, Uzeyir; Polat, Bahtiyar; Durmaz, Abdullah

    2016-01-01

    Nasoalveolar cysts, which originate from epithelial remnants of nasolacrimal duct, are nonodontogenic soft tissue lesions of the upper jaw. These cysts are thought to be developmental and are presented with fullness in the upper lip and nose, swelling on the palate, and sometimes nasal obstruction. Because of cosmetic problems, they are often diagnosed at an early stage. These lesions are mostly revealed unilaterally but also can be seen on both sides. In this case report, a patient who complained of nasal obstruction and then diagnosed with bilateral nasoalveolar cysts and treated by sublabial excision is presented and clinical features and treatment approaches are discussed with the review of literature. PMID:27980871

  2. Connectivity pattern differences bilaterally in the cerebellum posterior lobe in healthy subjects after normal sleep and sleep deprivation: a resting-state functional MRI study

    Directory of Open Access Journals (Sweden)

    Liu XM

    2015-05-01

    Full Text Available Xuming Liu,1 Zhihan Yan,2 Tingyu Wang,1 Xiaokai Yang,1 Feng Feng,3 Luping Fan,1 Jian Jiang4 1Department of Radiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, 2Department of Radiology, The 2nd Affiliated Hospital of Wenzhou Medical University, Wenzhou, 3Peking Union Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 4Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China Objective: The aim of this study was to use functional magnetic resonance imaging (fMRI technique to explore the resting-state functional connectivity (rsFC differences of the bilaterial cerebellum posterior lobe (CPL after normal sleep (NS and after sleep deprivation (SD. Methods: A total of 16 healthy subjects (eight males, eight females underwent an fMRI scan twice at random: once following NS and the other following 24 hours’ SD, with an interval of 1 month between the two scans. The fMRI scanning included resting state and acupuncture stimulation. The special activated regions located during the acupuncture stimulation were selected as regions of interest for rsFC analysis. Results: Bilateral CPLs were positively activated by acupuncture stimulation. In the NS group, the left CPL showed rsFC with the bilateral CPL, bilateral frontal lobe (BFL, left precuneus and right inferior parietal lobule, while the right CPL showed rsFC with the bilateral temporal lobe, right cerebellum anterior lobe, right CPL, left frontal lobe, left anterior cingulate, right posterior cingulate, and bilateral inferior parietal lobule. In the SD group, the left CPL showed rsFC with the left posterior cingulate gyrus bilateral CPL, left precuneus, left precentral gyrus, BFL, and the left parietal lobe, while the right CPL showed rsFC with bilateral cerebellum anterior lobe, bilateral CPL, left frontal lobe and left temporal lobe. Compared with the NS group, the

  3. No Effects of Bilateral tDCS over Inferior Frontal Gyrus on Response Inhibition and Aggression.

    Directory of Open Access Journals (Sweden)

    Franziska Dambacher

    Full Text Available Response inhibition is defined as the capacity to adequately withdraw pre-planned responses. It has been shown that individuals with deficits in inhibiting pre-planned responses tend to display more aggressive behaviour. The prefrontal cortex is involved in both, response inhibition and aggression. While response inhibition is mostly associated with predominantly right prefrontal activity, the neural components underlying aggression seem to be left-lateralized. These differences in hemispheric dominance are conceptualized in cortical asymmetry theories on motivational direction, which assign avoidance motivation (relevant to inhibit responses to the right and approach motivation (relevant for aggressive actions to the left prefrontal cortex. The current study aimed to directly address the inverse relationship between response inhibition and aggression by assessing them within one experiment. Sixty-nine healthy participants underwent bilateral transcranial Direct Current Stimulation (tDCS to the inferior frontal cortex. In one group we induced right-hemispheric fronto-cortical dominance by means of a combined right prefrontal anodal and left prefrontal cathodal tDCS montage. In a second group we induced left-hemispheric fronto-cortical dominance by means of a combined left prefrontal anodal and right prefrontal cathodal tDCS montage. A control group received sham stimulation. Response inhibition was assessed with a go/no-go task (GNGT and aggression with the Taylor Aggression Paradigm (TAP. We revealed that participants with poorer performance in the GNGT displayed more aggression during the TAP. No effects of bilateral prefrontal tDCS on either response inhibition or aggression were observed. This is at odds with previous brain stimulation studies applying unilateral protocols. Our results failed to provide evidence in support of the prefrontal cortical asymmetry model in the domain of response inhibition and aggression. The absence of t

  4. Bilateral osteoarthritis of the trapeziometacarpal joint treated by bilateral tendon interposition arthroplasty

    NARCIS (Netherlands)

    Damen, A; vanderLei, B; Robinson, PH

    1997-01-01

    Twenty-four flexor carpi radialis (FCR) tendon interposition arthroplasties of the trapezium for bilateral trapeziometacarpal osteoarthritis were reviewed. Pain was reduced in all cases. Function was improved in all right hands and in 92% of the left hands. FCR tendon interposition arthroplasty for

  5. A spatiotemporal analysis of gait freezing and the impact of pedunculopontine nucleus stimulation

    OpenAIRE

    Thevathasan, Wesley; Cole, Michael H.; Graepel, Cara L.; Hyam, Jonathan A.; Jenkinson, Ned; Brittain, John-Stuart; Coyne, Terry J; Peter A Silburn; Aziz, Tipu Z.; Kerr, Graham; BROWN, Peter

    2012-01-01

    Gait freezing is an episodic arrest of locomotion due to an inability to take normal steps. Pedunculopontine nucleus stimulation is an emerging therapy proposed to improve gait freezing, even where refractory to medication. However, the efficacy and precise effects of pedunculopontine nucleus stimulation on Parkinsonian gait disturbance are not established. The clinical application of this new therapy is controversial and it is unknown if bilateral stimulation is more effective than unilatera...

  6. Effects of pedunculopontine nucleus area stimulation on gait disorders in Parkinson's disease.

    OpenAIRE

    Ferraye, Murielle; Debû, Bettina; Fraix, Valérie; Goetz, Laurent; Ardouin, Claire; Yelnik, Jérôme; Henry-Lagrange, Christelle; Seigneuret, Eric; Piallat, Brigitte; Krack, Paul; Le Bas, Jean-François; Benabid, Alim-Louis; Chabardès, Stephan; Pollak, Pierre

    2010-01-01

    International audience; Gait disturbances are frequent and disabling in advanced Parkinson's disease. These symptoms respond poorly to usual medical and surgical treatments but were reported to be improved by stimulation of the pedunculopontine nucleus. We studied the effects of stimulating the pedunculopontine nucleus area in six patients with severe freezing of gait, unresponsive to levodopa and subthalamic nucleus stimulation. Electrodes were implanted bilaterally in the pedunculopontine n...

  7. Bilateral Electrical Cataract: A Case Report

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    Selçuk Sızmaz

    2011-06-01

    Full Text Available To present a rare complication, such as bilateral cataracts, in a man who sustained a high-voltage electrical injury. A 35- year-old man was admitted with a complaint of decrease in visual acuity. He had a history of a contact with a power line carrying 30.000 volts of electricity while working at a construction site. Examination at a burn center revealed second-degree facial, neck and left foot burns. One month later, the patient underwent amputation of fourth and fifth toes of his left foot. During the next 6 months, he noted decreasing vision in both eyes. Ocular examination 1 year after the accident revealed that the patient’s visual acuity had deteriorated to 1/10 in both eyes. The cornea on the left eye showed superficial punctate opacities. The lenses in both eyes had anterior subcapsular cortical lens opacities and posterior subcapsular opacities. Uncomplicated bilateral phacoemulsification surgery with intraocular lens implantation was performed and the patient’s visual acuity returned to 10/10 in both eyes. We noted that the fundus remained normal in both eyes. Electrical cataracts are still a serious potential complication that may occur after electrical injury. Awareness of this by burn team members is important for providing optimal treatment to those who have suffered an electrical injury. (Turk J Ophthalmol 2011; 41: 197-9

  8. Anaesthetic consideration during laparoscopic bilateral simultaneous nephrectomy

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    Manisha P Modi

    2014-01-01

    Full Text Available Study Objective: To assess outcome from anaesthesia during laparoscopic bilateral simultaneous nephrectomy. Design: Retrospective study. Measurements: Preoperative Hb%, serum potassium, coagulation profile electrocardiography (ECG changes, 2D Echography, x-ray chest, haemodynamic changes, end-tidal carbon dioxide (EtCO 2 , fluid management and postoperative analgesia. Results: The mean age was 24.75 ± 14.35 years. The mean duration of surgery was 120 ± 80 minutes. The Hb%, serum creatinine and serum potassium were 9.4 ± 1.04%, 6.79 ± 4.91 meq/L and 3.61 ± 0.51 meq/L, respectively. Pulse rate mean blood pressure and EtCO 2 were recorded after creation of pneumoperitoneum and at 15, 30, 45 and after exsufflation of pneumoperitoneum. After pneumoperitoneum, there was increase in pulse rate, systolic blood pressure, diastolic blood pressure and EtCO 2 . After 30 minutes and throughout the surgery, these variables remained stable. Four patients required nitroglycerine infusion for intraoperative hypertention. Only one patient required packed cell volume (PCV transfusion and total intravenous fluid was 1 ± 0.5 L. At the time of exsufflation, there was decrease in pulse rate, systolic and diastolic blood pressure and EtCO 2 . Conclusion: Because of advancement in anaesthetic agents and muscle relaxant, there is safe outcome from anaesthesia during laparoscopic bilateral simultaneous nephrectomy.

  9. Bilateral high division of sciatic nerve

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    K. Shwetha

    2014-08-01

    Full Text Available Sciatic nerve is the thickest nerve in the body formed by the sacral plexus from L4 to S3 in the lesser pelvis. It emerges through the greater sciatic foramen below the piriformis and enter the gluteal region. Then the nerve passes on the back of the thigh and at the level of superior angle of popliteal fossa it terminates by dividing into tibial and common peroneal nerve. The knowledge of anatomical variations in the division of nerve is important for various surgical and anaesthetic procedures. During routine dissection in the department of anatomy, Mysore Medical College and Research Institute, Mysore, a rare bilateral high division of sciatic nerve was observed in a female cadaver aged about 40 years. In the present case there was bilateral high division of sciatic nerve. The nerve was seen dividing into two branches before it emerges through the greater sciatic foramen. The tibial nerve was entering the gluteal region below the piriformis muscle and common peroneal nerve was entering by piercing the piriformis. The knowledge of this variation is important as the nerve may get compressed with surrounding anatomical structures resulting in non discogenic sciatica. The awareness of variations is important for surgeons during various procedures like fracture, posterior dislocation of hip joint and hip joint replacement. The anatomical variations are important during deep intramuscular injections in gluteal region and also for anaesthetists during sciatic nerve block. [Int J Res Med Sci 2014; 2(4.000: 1785-1787

  10. A RARE CASE OF BILATERAL MICROSPHEREPHAKIA

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    Pandu

    2015-05-01

    Full Text Available Microspherophakia is rare bilateral congenital anamoly of the crystalline lens. The condition may be isolated , familial or it may be associated with systemic affections like Marfan's syndrome , Weil - Marchesani syndrome , hyperlysinemia and congenital rubella. Microspherophakia results in lenticular myopia , lens dislocation , usually inferiorly and inverse glaucoma. We present a case in a 8 year old child who presented with bilateral microspherophakia and anterior dislocation of lens of right eye. visual acuity in right eye was counting fingers close to face and i n left eye 6/60.IOP with perkins applanation tonometer was 30mmHg in right eye 22mmHg in left eye , cornea was hazy due to edema , anterior chamber was shallow in both eye patient was managed with emergency lens extraction of right eye and secondary ACIOL im plantation. Left eye was managed by laser peripheral iridotomy. IOP was within normal limits postoperatively in both eyes without any antiglaucoma medications. Postoperatively best corrected visual acuity in right was 6/18 and 6/9 in left eye.

  11. Unusual Bilateral Rim Fracture in Femoroacetabular Impingement

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    Claudio Rafols

    2015-01-01

    Full Text Available This is a report of one case of bilateral acetabular rim fracture in association with femoroacetabular impingement (FAI, which was treated with a hip arthroscopic procedure, performing a partial resection, a labral reinsertion, and a subsequential internal fixation with cannulated screws. Up to date, there are in the literature only two reports of rim fracture and “os acetabuli” in association with FAI. In the case we present, the pincer and cam resection were performed without complications; the technique used was published previously. With this technique the head of the screw lays hidden by the reattached labrum. We removed partially the fractured rim fragment and the internal fixation of the remaining portion was achieved with a screw. In the event of a complete resection of the fragment, it would have ended with a LCE angle of 18° and a high probability of hip instability. We believe that this bilateral case helps establish the efficacy and reproducibility of the technique described by Larson.

  12. Bilateral Pneumothoraces Following Central Venous Cannulation

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    F. Pazos

    2009-01-01

    Full Text Available We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax.

  13. Bilateral acute retinal necrosis after herpetic meningitis

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    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  14. [Synchronous bilateral breast cancer in a male].

    Science.gov (United States)

    García-Mejido, José Antonio; Delgado-Jiménez, Carmen; Gutiérrez-Palomino, Laura; Sánchez-Sevilla, Miguel; Iglesias-Bravo, Eva; Caballero-Fernández, Virginia

    2013-01-01

    antecedentes: el cáncer de mama en el hombre es una enfermedad con baja incidencia, que se reduce aún más cuando es bilateral sincrónica. Existen pocas publicaciones en los últimos años. Objetivo: establecer pautas para el tratamiento de este cáncer, aunque sea infrecuente. Caso clínico: paciente masculino de 75 años de edad, con tumores en ambas mamas, que se le resecaron completamente con exéresis de ganglios palpables. El estudio histopatológico informó que se trataba de un carcinoma ductal infiltrante no especificado. Se indicó tratamiento adyuvante con tamoxifeno y radioterapia; en la actualidad está libre de enfermedad. Conclusiones: el carcinoma mamario bilateral sincrónico en el varón es una enfermedad poco frecuente. Su tratamiento principal es la cirugía, de ahí la importancia del diagnóstico temprano. En la mayoría de los casos se requiere quimioterapia y radioterapia adyuvante porque suelen diagnosticarse en un estadio avanzado.

  15. Influence of unilateral weight on bilateral cyclograms

    Science.gov (United States)

    Pellicer Costa, Juan José; Dusza, Jacek J.

    2014-11-01

    The paper presents the results of gait parameters as a function of unilateral weight. The object of the research was a woman walking on a stationary surface and carrying in his hand weights from 0 to 15 kg. Her movement was recorded by 6 cameras recording the location of 34 markers placed at appropriate points in the body. 3D reconstruction was performed for each of the reflecting markers. Tested signals were changes in the value the joint angles of ankle, knee and hip. On the basis of about 6 cycles of movement of each load, a model for the average gait cycle was developed. The result of the experiments are graphs of changes the joint angles as a function of time, bilateral cyclograms, synchronized bilateral cyclograms and regression lines. The conclusion of the study is to determine how one-sided load affects gait asymmetry. Simple and easy to interpret method of presentation of results were also shown. Studies were conducted using VICON system.

  16. Clinical Subgroups in Bilateral Meniere Disease

    Science.gov (United States)

    Frejo, Lidia; Soto-Varela, Andres; Santos-Perez, Sofía; Aran, Ismael; Batuecas-Caletrio, Angel; Perez-Guillen, Vanesa; Perez-Garrigues, Herminio; Fraile, Jesus; Martin-Sanz, Eduardo; Tapia, Maria C.; Trinidad, Gabriel; García-Arumi, Ana María; González-Aguado, Rocío; Espinosa-Sanchez, Juan M.; Marques, Pedro; Perez, Paz; Benitez, Jesus; Lopez-Escamez, Jose A.

    2016-01-01

    Meniere disease (MD) is a heterogeneous clinical condition characterized by sensorineural hearing loss, episodic vestibular symptoms, and tinnitus associated with several comorbidities, such as migraine or autoimmune disorders (AD). The frequency of bilateral involvement may range from 5 to 50%, and it depends on the duration of the disease. We have performed a two-step cluster analysis in 398 patients with bilateral MD (BMD) to identify the best predictors to define clinical subgroups with a potential different etiology to improve the phenotyping of BMD and to develop new treatments. We have defined five clinical variants in BMD. Group 1 is the most frequently found, includes 46% of patients, and is defined by metachronic hearing loss without migraine and without AD. Group 2 is found in 17% of patients, and it is defined by synchronic hearing loss without migraine or AD. Group 3, with 13% of patients, is characterized by familial MD, while group 4, that includes 12% of patients, is associated by the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by AD. This approach can be helpful in selecting patients for genetic and clinical research. However, further studies will be required to improve the phenotyping in these clinical variants for a better understanding of the diverse etiological factors contributing to BMD. PMID:27822199

  17. Pre-interventional prognostic value of renal endocrine, hemodynamic and arteriographic parameters in hypertensive patients with uni- and bilateral renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Arlart, I.P.; Bargon, G.

    1982-02-01

    In order to improve pre-interventional prognosis of blood pressure normalization, in patients with angiographically proven uni- (n=75) and bilateral (n=38) renal artery stenosis, (RAS) evaluation of renal venous and peripheral renin activity including stimulative procedures and Saralasin-infusion-test was carried out. In addition selective renal arteriographic, hemodynamic and pharmacodynamic (133 xe-washout) investigations were performed. The data were correlated with operative results concerning response of blood pressure to surgical treatment in 54 patients with uni- and 30 patients with bilateral RAS. Our results suggest that a postoperative normalization of blood-pressure can only be expected if pre-interventional selective arteriograms reveal a normal vascular tree accompanied with normal cortical flow rates of both kidneys in uni- and bilateral RAS. Selective renin determinations, stimulative procedures of the renin-angiotensin system and application of angiotensin antagonists are only of value for selection of patients.

  18. The bilateral advantage for famous faces: interhemispheric communication or competition?

    Science.gov (United States)

    Baird, Lyndsay M; Burton, A Mike

    2008-04-01

    The bilateral advantage for the perception of famous faces was investigated using a redundant target procedure. In experiment 1 we compared simultaneous presentation of stimuli (a) bilaterally and (b) one above the other in the central field. Results showed a redundancy advantage, but only when faces were presented bilaterally. This result lends support to the notion of interhemispheric communication using cross-hemisphere representations. Experiment 2 examined the nature of such communication by comparing bilateral presentation of identical face images, with bilateral presentation of different images of the same person. When asked to make a familiar/unfamiliar face judgement, participants showed evidence for a redundancy advantage under both bilateral conditions. This suggests that the nature of the information shared in interhemispheric communication is abstract, rather than being tied to superficial stimulus properties.

  19. Unilateral versus Bilateral Instrumentation in Spinal Surgery: A Systematic Review

    OpenAIRE

    2015-01-01

    Study Design Systematic review. Clinical Questions (1) What is the comparative efficacy of unilateral instrumentation compared with bilateral instrumentation in spine surgery? (2) What is the safety of unilateral instrumentation compared with bilateral instrumentation in spine surgery? Methods Electronic databases and reference lists of key articles were searched up to September 30, 2014, to identify studies reporting the comparative efficacy and safety of unilateral versus bilateral instrume...

  20. Bilateral angiosarcoma of breast in a young lady

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    Sanjoy Roy

    2011-01-01

    Full Text Available We report a young lady with bilateral angiosarcoma of breast because of its rarity. A 29 year old unmarried female presented with bilateral breast lump. She underwent bilateral mastectomy with axillary dissection histopathology of which showed low grade angiosarcoma of left breast and high grade angiosarcoma of right breast. CT Thorax revealed right hilar and right mediastenal lymph nodes. She was treated with radiotherapy and chemotherapy postoperatively.

  1. Increased bilateral interactions in middle-aged subjects

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    Jolien eHeetkamp

    2014-01-01

    Full Text Available A hallmark of the age-related neural reorganization is that old vs. young adults execute typical motor tasks by a more diffuse neural activation pattern including stronger ipsilateral activation during unilateral tasks. Whether such changes in neural activation are present already at middle age and affect bimanual interactions is unknown. We compared the amount of associated activity, i.e., muscle activity and force produced by the non-task hand and motor evoked potentials (MEPs produced by magnetic brain stimulation between young (mean 24 y, n = 10 and middle-aged (mean 50 y, n = 10 subjects during brief unilateral (7 levels of % maximal voluntary contractions, MVC and bilateral contractions (4 x 7 levels of % MVC combinations, and during a 120-s-long MVC of sustained unilateral index finger abduction. During the force production the excitability of the ipsilateral (iM1 or contralateral (cM1 primary motor cortex was assessed. The associated activity in the ‘resting’ hand was ~2-fold higher in middle-aged (28% of MVC vs. young adults (11% of MVC during brief unilateral MVCs. After controlling for background muscle activity, MEPs in iM1 were similar in the two groups during brief unilateral contractions. At low (bilateral forces only, MEPs evoked in cM1 were 30% higher in the middle-aged vs. young adults. At the start of the sustained contraction, the associated activity was higher in the middle-aged vs. young subjects and increased progressively in both groups (30% vs. 15% MVC at 120 s, respectively. MEPs were greater at the start of the sustained contraction in middle-aged subjects but increased further during the contraction only in young adults. Under these experimental conditions, the data provide evidence for the reorganization of neural control of unilateral force production as early as age 50. Future studies will determine if the altered neural control of such inter-manual interactions are of functional significance.

  2. Increased bilateral interactions in middle-aged subjects.

    Science.gov (United States)

    Heetkamp, Jolien; Hortobágyi, Tibor; Zijdewind, Inge

    2014-01-01

    A hallmark of the age-related neural reorganization is that old versus young adults execute typical motor tasks by a more diffuse neural activation pattern including stronger ipsilateral activation during unilateral tasks. Whether such changes in neural activation are present already at middle age and affect bimanual interactions is unknown. We compared the amount of associated activity, i.e., muscle activity and force produced by the non-task hand and motor evoked potentials (MEPs) produced by magnetic brain stimulation between young (mean 24 years, n = 10) and middle-aged (mean 50 years, n = 10) subjects during brief unilateral (seven levels of % maximal voluntary contractions, MVCs) and bilateral contractions (4 × 7 levels of % MVC combinations), and during a 120-s-long MVC of sustained unilateral index finger abduction. During the force production, the excitability of the ipsilateral (iM1) or contralateral primary motor cortex (cM1) was assessed. The associated activity in the "resting" hand was ~2-fold higher in middle-aged (28% of MVC) versus young adults (11% of MVC) during brief unilateral MVCs. After controlling for the background muscle activity, MEPs in iM1 were similar in the two groups during brief unilateral contractions. Only at low (bilateral) forces, MEPs evoked in cM1 were 30% higher in the middle-aged versus young adults. At the start of the sustained contraction, the associated activity was higher in the middle-aged versus young subjects and increased progressively in both groups (30 versus 15% MVC at 120 s, respectively). MEPs were greater at the start of the sustained contraction in middle-aged subjects but increased further during the contraction only in young adults. Under these experimental conditions, the data provide evidence for the reorganization of neural control of unilateral force production as early as age 50. Future studies will determine if the altered neural control of such inter-manual interactions are of

  3. Bilateral Filtering using Modified Fuzzy Clustering for Image Denoising

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    G.Vijaya,

    2011-01-01

    Full Text Available This paper presents a novel bilateral filtering using weighed fcm algorithm based on Gaussian kernel unction for image manipulations such as segmentation and denoising . Our proposed bilateral filteringconsists of the standard bilateral filter and the original Euclidean distance is replaced by a kernel – induced distance in the algorithm. We have applied the proposed filtering for image denoising with both the impulse and Gaussian random noise, which achieves better results than the bilateral filtering based denoising approaches, the Perona-Maliks anisotropic diffusion filter, the fuzzy vector median filter and the Non-Local Means filter.

  4. Bilateral cerebral hemispheric infarction associated with sildenafil citrate (Viagra) use.

    Science.gov (United States)

    Kim, K-K; Kim, D G; Ku, Y H; Lee, Y J; Kim, W-C; Kim, O J; Kim, H S

    2008-03-01

    Sildenafil citrate (Viagra) is one of the frequently prescribed drugs for men with erectile dysfunction. We describe a 52-year-old man with bilateral middle cerebral artery (MCA) territory infarction after sildenafil use. He ingested 100 mg of sildenafil and about 1 h later, he complained of chest discomfort, palpitation and dizziness followed by mental obtundation, global aphasia and left hemiparesis. Brain magnetic resonance imaging documented acute bilateral hemispheric infarction, and cerebral angiography showed occluded bilateral MCA. Despite significant bilateral MCA stenosis and cerebral infarction, systemic hypotension persisted for a day. We presume that cerebral infarction was caused by cardioembolism with sildenafil use.

  5. Unilateral practice of a ballistic movement causes bilateral increases in performance and corticospinal excitability.

    Science.gov (United States)

    Carroll, Timothy J; Lee, Michael; Hsu, Marlene; Sayde, Janel

    2008-06-01

    It has long been known that practicing a task with one limb can result in performance improvements with the opposite, untrained limb. Hypotheses to account for cross-limb transfer of performance state that the effect is mediated either by neural adaptations in higher order control centers that are accessible to both limbs, or that there is a "spillover" of neural drive to the opposite hemisphere that results in bilateral adaptation. Here we address these hypotheses by assessing performance and corticospinal excitability in both hands after unilateral practice of a ballistic finger movement. Participants (n = 9) completed 300 practice trials of a ballistic task with the right hand, the aim of which was to maximize the peak abduction acceleration of the index finger. Practice caused a 140% improvement in right-hand performance and an 82% improvement for the untrained left hand. There were bilateral increases in the amplitude of responses to transcranial magnetic stimulation, but increased corticospinal excitability was not correlated with improved performance. There were no significant changes in corticospinal excitability or task performance for a control group that did not train (n = 9), indicating that performance testing for the left hand alone did not induce performance or corticospinal effects. Although the data do not provide conclusive evidence whether increased corticospinal excitability in the untrained hand is causally related to the cross-transfer of ballistic performance, the finding that ballistic practice can induce bilateral corticospinal adaptations may have important clinical implications for movement rehabilitation.

  6. Spectral analysis of bilateral or alternate-site kindling-induced afterdischarges in the rabbit hippocampi.

    Science.gov (United States)

    Tsuchiya, Komei; Kogure, Shinichi

    2012-09-01

    Kindling is one of the popular animal models of temporal lobe epilepsy. In the present study following the previous results obtained using unilateral hippocampal kindling (UK), we performed spectral analysis of bilateral or alternate-site kindling-induced afterdischarges (ADs) in the rabbit hippocampi. Eight and ten adult rabbits were used for bilateral kindling (BK) and alternate-site kindling (AK), respectively. Kindling stimuli consisted of a train of biphasic pulses (1ms duration each) of 50Hz for 1s, with suprathreshold intensity for AD. The stimulations were applied simultaneously to the bilateral hippocampi in the BK and were delivered to the right and left hippocampus once every 24h in the AK. Motor responses were classified into five stages according to the conventional criteria. All animals in BK as well as AK developed stage 5 convulsions. This contrasts to the result of UK (kindled: 50%; incomplete: 50%). We normalized power spectral density (PSD) and monitored the changes in the proportion of lower frequency band component (LFB: 0-9Hz) and the higher frequency band (HFB: 12-30Hz). BK animals showed a significantly large decrement (0.5 times, pkindling progression. Very strong positive correlations were found in both kindling animals. Chronological spectral analysis of seizure discharges, resulting in a pattern of LFB decrement accompanied by HFB increment, is a convenient tool to investigate epileptic disorders and diagnose epileptic states.

  7. The effects of competing trade regimes on bilateral trade flows: case of Serbia

    Directory of Open Access Journals (Sweden)

    Predrag Bjelić

    2012-12-01

    Full Text Available The aim of this paper is to investigate the effects of competing trade regimes on Serbian trade with its most significant (traditional partners, like European Union and CEFTA 2006 signatories, and other untraditional trade partners with favourable trade regime, like the USA. To this end, gravity model with bilateral and time effects is estimated by Hausman-Taylor AR(1 instrumental variable estimator, using panel data on bilateral trade between Serbia and its main trade partners during the period 2001-2010. The results indicate that overall level of development and difference in factor endowments stimulate Serbia’s exports, which is in accordance with theoretical foundation that inter-industry trade is predominant in exports of less developed countries. Moreover, competing trade regimes appear as important determinant of Serbia’s trade relations, whereas additional liberalization of trade regime with the USA as untraditional trade partner, even asymmetrical to Serbia’s favour, cannot divert trade flows from traditional partners in the long-run. This could mean that distance plays more prominent role in bilateral trade than the degree of liberalization of trade regimes in case of Serbia. The result could be due to the contemporaneous effects of trade preferences granted to Serbia by the EU and other CEFTA 2006 signatories, main trading partners of Serbia.

  8. Interocular symmetry analysis of bilateral eyes.

    Science.gov (United States)

    Li, Yi; Bao, Fang Jun

    2014-05-01

    The purpose of this study was to evaluate the interocular symmetry of several biometric parameters between both eyes. The symmetry between the right and left eye of 397 subjects in 14 biometric parameters, spherical equivalent of refractive error (SE), Jackson crossed cylinder power of refractive error astigmatism with axes at 90° and 180° (RJ0) and at 45° and 135° (RJ45), best-corrected visual acuity (BCVA), average corneal curvature (CC), Jackson crossed cylinder power of corneal astigmatism (CJ0 and CJ45), corneal asphericity coefficient (Q), intraocular pressure (IOP), central corneal thickness (CCT), axial length (AL), anterior chamber depth (ACD), lens thickness (LT) and vitreous chamber depth (VCD), was assessed by comparative data analysis. Aside from RJ0 (p = 0.00), RJ45 (p = 0.02) and Q (p = 0.00), the overall interocular differences of other biometric parameters between fellow eyes were not significant (p > 0.05). The interocular correlation and Bland-Altman plots showed a good agreement between fellow eyes in 14 biometric parameters. Correlations between interocular differences in SE and that in RJ0 (p = 0.03), CC (p = 0.00), AL (p = 0.00) and VCD (p = 0.00) were statistically significant. There were similar strong linear relationships between refractive error astigmatism vectors and corneal astigmatism vectors in bilateral eyes. There were negative correlations of RJ45 and CJ45 between bilateral eyes. A potentially clinically important interocular symmetry in SE, BCVA, CC, CJ0, CJ45, IOP, CCT, AL, ACD, LT and VCD is found in this research, while the differences of RJ0, RJ45 and Q between left and right eyes seem a bit large. The negative interocular relationships of RJ45 and CJ45 demonstrate moderate mirror symmetry exists among fellow eyes. High interocular symmetry in bilateral eyes may be helpful in intraocular lens power calculation, intraocular pressure evaluation, post-operative visual acuity and refraction

  9. Vagus Nerve Stimulation

    Science.gov (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 ...

  10. Bilateral pigmented villonodular synovitis of the knee

    Science.gov (United States)

    Shah, Samir H.; Porrino, Jack A.; Green, John R.; Chew, Felix S.

    2015-01-01

    Pigmented villonodular synovitis is a disorder resulting in a villous, nodular, or villonodular proliferation of the synovium, with pigmentation related to the presence of hemosiderin. These lesions are almost exclusively benign with rare reports of malignancy. Pigmented villonodular synovitis can occur in a variety of joints and at any age but most often occurs within the knee in the young adult. Pigmented villonodular synovitis is a rare disease entity, and bilateral synchronous or metachronous involvement of a joint is even more uncommon, with few reports previously described in the literature. We present a case of pigmented villonodular synovitis involving both the right and left knee in the same patient, with radiographic imaging, magnetic resonance imaging, photograph and video intraoperative imaging, and pathologic correlation. PMID:26649121

  11. Bilateral pigmented villonodular synovitis of the knee

    Directory of Open Access Journals (Sweden)

    Samir H. Shah

    2015-12-01

    Full Text Available Pigmented villonodular synovitis is a disorder resulting in a villous, nodular, or villonodular proliferation of the synovium, with pigmentation related to the presence of hemosiderin. These lesions are almost exclusively benign with rare reports of malignancy. Pigmented villonodular synovitis can occur in a variety of joints and at any age but most often occurs within the knee in the young adult. Pigmented villonodular synovitis is a rare disease entity, and bilateral synchronous or metachronous involvement of a joint is even more uncommon, with few reports previously described in the literature. We present a case of pigmented villonodular synovitis involving both the right and left knee in the same patient, with radiographic imaging, magnetic resonance imaging, photograph and video intraoperative imaging, and pathologic correlation.

  12. CASE OF BILATERAL ANTERIOR SEGMENT TUBERCULOSIS

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    Gopal Kishan

    2015-04-01

    Full Text Available Tuberculosis is an important cause of uveitis in our country. India has been declared the country with the highest tuberculosis burden with 25 % of the cases . (1 This is especially true in Andhra Pradesh and Telangana which have a high percentage of affected patients. However , tuberculous uveitis is usually a unilateral presen tation. We report a case of bilateral uveitis of tuberculous origin in a 55 year old woman. She presented with different tuberculous manifestations in the two eyes. While the RE showed non granulomatous uveitis with sclerosing keratitis , the LE showed gran ulomatous uveitis with mutton fat keratic precipitates. Systemic examination revealed an enlarged lymph node which was positive for tuberculosis on biopsy. She was hence diagnosed as extra pulmonary tuberculosis and was treated with ATT regimen. In this pa tient , uveitis was the initial manifestation and resulted in a systemic diagnosis.

  13. Bilateral adrenal hemorrhage in polycythemia vera

    Directory of Open Access Journals (Sweden)

    Shruti Bhandari

    2016-09-01

    Full Text Available Bilateral adrenal hemorrhage (BAH is a rare complication typically seen in critically ill patients, which can lead to acute adrenal insufficiency and death unless it is recognized promptly and treated appropriately. We describe the case of a 64-year-old man with polycythemia vera found to be unresponsive with fever, hypotension, tachycardia, and hypoglycemia. Electrocardiogram showed ST-elevation with elevated troponin, hemoglobin, prothrombin time, and partial thromboplastin time. He required aggressive ventilator and vasopressor support. Despite primary coronary intervention, he remained hypotensive. Random cortisol level was low. He received stress dose hydrocortisone with immediate hemodynamic stability. BAH was highly suspected and was confirmed by non-contrast abdominal computed tomography. Prompt recognition and timely initiated treatment remain crucial to impact the mortality associated with acute adrenal insufficiency.

  14. Framing effect following bilateral amygdala lesion.

    Science.gov (United States)

    Talmi, Deborah; Hurlemann, René; Patin, Alexandra; Dolan, Raymond J

    2010-05-01

    A paradigmatic example of an emotional bias in decision making is the framing effect, where the manner in which a choice is posed--as a potential loss or a potential gain--systematically biases an ensuing decision. Two fMRI studies have shown that the activation in the amygdala is modulated by the framing effect. Here, contrary to an expectation based on these studies, we show that two patients with Urbach-Wiethe (UW) disease, a rare condition associated with congenital, complete bilateral amygdala degeneration, exhibit an intact framing effect. However, choice preference in these patients did show a qualitatively distinct pattern compared to controls evident in an increased propensity to gamble, indicating that loss of amygdala function does exert an overall influence on risk-taking. These findings suggest either that amygdala does contribute to decision making but does not play a causal role in framing, or that UW is not a pure lesion model of amygdala function.

  15. Bilateral foveal retinoschisis accompanying unilateral peripheral retinoschisis

    Directory of Open Access Journals (Sweden)

    Nilufer Kocak

    2014-01-01

    Full Text Available X-linked juvenile retinoschisis is a rare hereditary retinal disease characterized by a tangential splitting of the neurosensory retina which may cause early-onset visual impairment. Existence of the retinal neurosensory layer splitting on cross-sectional images of optical coherance tomography (OCT and the absence of leakage on fluorescein angiography (FA help confirming the diagnosis. Such diagnostic tests are also helpful in determining the management of the disease. However, most of the retinoschisis cavities remain stable and rarely extend to the posterior pole, many authors suggest laser prophylaxis to avoid the potential risk of retinal detachment due to holes in the outer retinal layer. Herein, we report a case with bilateral foveal retinoschisis accompanying unilateral peripheral retinoschisis who was evaluated with detailed ophthalmologic examination. Visual acuity, fundoscopy, OCT, and FA remained stable in the second year of follow-up after prophylactic argon laser treatment.

  16. Rare cause of bilateral sudden deafness.

    Science.gov (United States)

    Vos, F I; Merkus, P; van Nieuwkerk, E B J; Hensen, E F

    2016-10-08

    In this paper, we describe the case of a 62-year-old female with recurring episodes of sudden deafness with vertigo and facial paresis. Within a month's time, this resulted in bilateral deafness and vestibular areflexia. Erroneously, the patient was diagnosed with sudden deafness of unknown origin and subsequently with neuroborreliosis (Lyme disease). The true diagnosis of relapsing polychondritis (RP) was revealed 9 months after initial presentation. The diagnostic delay is in part explained by the fact that, by definition, the disease has to relapse before the diagnosis can be made, but also by its pluriform clinical presentation. Timely identification of RP as the cause of this profound sensorineural hearing loss proved to be important. It was key in instigating adequate follow-up, and allowed for cochlear implantation before total cochlear obliteration, which might have hampered optimal hearing rehabilitation.

  17. An Unusual Case of Bilateral Granulomatous Mastitis

    Directory of Open Access Journals (Sweden)

    C. A. Pistolese

    2013-01-01

    Full Text Available Idiopathic granulomatous mastitis (IGM is an uncommon benign disorder of the breast. At clinical examination, IGM is characterized by an inflammatory process of the breast, usually unilateral. Possible clinical findings are palpable mass with erythematous skin, pain, sterile abscesses, fistula and nipple retraction. Mammography and ultrasound findings are not specific for IGM. Magnetic resonance imaging (MRI is a useful tool for the differential diagnosis; it is also necessary to delineate the exact extension of the disease and to plan the correct treatment. Final diagnosis is histological. We described an unusual case of IGM with bilateral involvement in a patient with history of pacemaker implantation and IGM typical clinical symptoms. Mammography, ultrasound, and MRI examinations were performed to identify the inflammatory disorder and to plan the correct therapy. Imaging features were correlated with final histological diagnosis of IGM.

  18. Bilateral Trade Flows and Income Distribution Similarity.

    Science.gov (United States)

    Martínez-Zarzoso, Inmaculada; Vollmer, Sebastian

    2016-01-01

    Current models of bilateral trade neglect the effects of income distribution. This paper addresses the issue by accounting for non-homothetic consumer preferences and hence investigating the role of income distribution in the context of the gravity model of trade. A theoretically justified gravity model is estimated for disaggregated trade data (Dollar volume is used as dependent variable) using a sample of 104 exporters and 108 importers for 1980-2003 to achieve two main goals. We define and calculate new measures of income distribution similarity and empirically confirm that greater similarity of income distribution between countries implies more trade. Using distribution-based measures as a proxy for demand similarities in gravity models, we find consistent and robust support for the hypothesis that countries with more similar income-distributions trade more with each other. The hypothesis is also confirmed at disaggregated level for differentiated product categories.

  19. Marfan Syndrome Presenting with Bilateral Retinal Detachment

    Directory of Open Access Journals (Sweden)

    Subrata Chakrabarti

    2014-02-01

    Full Text Available Marfan syndrome is an autosomal dominant systemic disorder of the connective tissue. Marfan syndrome affects most organs and tissues, especially the skeleton, lungs, eyes, heart, and the large blood vessels. Eye involvement may be in the form of retinal detachment which is a potentially dangerous manifestation for its sight threatening nature .We report a case where a 17 year old male developed sudden blindness due to spontaneous bilateral retinal detachment. Examination revealed features of Marfan syndrome and was stamped as a case of Marfan syndrome by Ghent criteria . The point to stress upon is that a young male developing spontaneous retinal detachment, a diagnosis of underlying Marfan syndrome should be kept in mind if appropriate clinical stigmata are present. [Natl J Med Res 2014; 4(1.000: 104-105

  20. Computed tomography findings in bilateral perinephric lymphangiomatosis

    Directory of Open Access Journals (Sweden)

    Hakeem Aijaz

    2010-01-01

    Full Text Available Perinephric lymphangioma is rare disorder that may be confused with various forms of renal cystic diseases and urinomas. In this disorder a developmental malformation results in failure of developing lymphatic tissue to establish normal communication with the rest of lymphatic system. Once there is restricted drainage of lymphatic fluid the lymphatic channels dilate to form cystic masses that may be unilocular or multilocular and may be seen unilaterally or bilaterally .This condition presents with various signs and symptoms or can be just an incidental finding which in presence of misleading clinical history may be confused with other diseases. CT scan with delayed cuts and USG guided aspiration with biochemical analysis of fluid will help us in arriving to final diagnosis.

  1. Computed tomography findings in bilateral perinephric lymphangiomatosis.

    Science.gov (United States)

    Hakeem, Aijaz; Gojwari, Tariq A; Reyaz, Sheikh; Rasool, Shubana; Shafi, Hakim; Mufti, Shahida

    2010-01-01

    Perinephric lymphangioma is rare disorder that may be confused with various forms of renal cystic diseases and urinomas. In this disorder a developmental malformation results in failure of developing lymphatic tissue to establish normal communication with the rest of lymphatic system. Once there is restricted drainage of lymphatic fluid the lymphatic channels dilate to form cystic masses that may be unilocular or multilocular and may be seen unilaterally or bilaterally .This condition presents with various signs and symptoms or can be just an incidental finding which in presence of misleading clinical history may be confused with other diseases. CT scan with delayed cuts and USG guided aspiration with biochemical analysis of fluid will help us in arriving to final diagnosis.

  2. Bilateral vision loss associated with radiofrequency exposure

    Directory of Open Access Journals (Sweden)

    Liu D

    2012-12-01

    Full Text Available Dianna Liu, Franz Marie Cruz, Prem S SubramanianWilmer Eye Institute, The Johns Hopkins School of Medicine, Baltimore, Maryland, USAAbstract: A 57-year-old otherwise healthy woman presented with painless binocular vision loss 1 week after direct application of radiofrequency energy to her orbits. She had no light perception bilaterally. Pupils were dilated and not reactive to light. Fundoscopic exam initially showed optic disc swelling in the right eye and a normal-appearing disc in the left eye. Magnetic resonance imaging of the brain and orbits showed gadolinium enhancement of both intraorbital optic nerves. She underwent a course of high-dose steroid treatment without recovery of vision. Optic discs were pale 11 weeks after injury. With exclusion of other possible causes, this represents a unique case of irreversible binocular optic nerve damage and blindness secondary to radiofrequency exposure.Keywords: optic neuropathy, blindness, radiofrequency, vision loss

  3. Bilaterally Weighted Patches for Disparity Map Computation

    Directory of Open Access Journals (Sweden)

    Laura Fernández Julià

    2015-03-01

    Full Text Available Visual correspondence is the key for 3D reconstruction in binocular stereovision. Local methods perform block-matching to compute the disparity, or apparent motion, of pixels between images. The simplest approach computes the distance of patches, usually square windows, and assumes that all pixels in the patch have the same disparity. A prominent artifact of the method is the "foreground fattening effet" near depth discontinuities. In order to find a more appropriate support, Yoon and Kweon introduced the use of weights based on color similarity and spatial distance, analogous to those used in the bilateral filter. This paper presents the theory of this method and the implementation we have developed. Moreover, some variants are discussed and improvements are used in the final implementation. Several examples and tests are presented and the parameters and performance of the method are analyzed.

  4. Bilateral diaphragmatic paralysis after kidney surgery.

    Science.gov (United States)

    Sozzo, S; Carratù, P; Damiani, M F; Falcone, V A; Palumbo, A; Dragonieri, S; Resta, O

    2012-06-01

    A 57-year-old woman underwent an enucleoresection of her right kidney angiomyolipoma. Two weeks later she was admitted to our hospital because of dyspnea at rest with orthopnea. The chest x-ray showed the elevation of both hemidiaphragms and the measurement of the sniff transdiaphragmatic pressure confirmed the diagnosis of bilateral diaphragmatic paralysis. A diaphragm paralysis can be ascribed to several causes, i.e. trauma, compressive events, inflammations, neuropathies, or it can be idiopathic. In this case, it was very likely that the patient suffered from post-surgery neuralgic amyotrophy. To our knowledge, there are only a few reported cases of neuralgic amyotrophy, also known as Parsonage-Turner Syndrome, which affects only the phrenic nerve as a consequence of a surgery in an anatomically distant site.

  5. [Bilateral ovarian Burkitt's lymphoma. A case presentation].

    Science.gov (United States)

    Briseño-Hernández, Andrés Alejandro; Quezada-López, Deissy Roxana; Castañeda-Chávez, Agar; Dassaejv Macías-Amezcua, Michel; Pintor-Belmontes, Julio Cesar

    2014-01-01

    Antecedentes: el linfoma de Burkitt es una forma agresiva de los linfomas no Hodgkin de células B que ocurre con mayor frecuencia en niños y adultos jóvenes; el linfoma de ovario puede aparecer como lesión primaria o, más comúnmente, como una metástasis. Las lesiones primarias de ovario son manifestaciones raras que corresponden a 0.5% de los linfomas no Hodgkin y 1.5% de los tumores de ovario. Caso clínico: paciente femenina de 31 años de edad, con debilidad generalizada, incapacidad para la marcha, disnea, hiporexia, fiebre, diaforesis, pérdida de 20 kg de peso, abdomen plano, con dolor abdominal; Ca125 610 U/mL. La tomografía computada abdominal mostró un gran tumor de aspecto sólido que afectaba a la cavidad pélvica derecha. Se extirparon los tumores ováricos bilaterales. Desde el punto de vista microscópico ambas lesiones muestran una imagen en "cielo estrellado" compuesta por un patrón de infiltrado monótono de linfocitos mezclada con macrófagos de citoplasma amplio y claro, abundantes mitosis atípicas, zonas de necrosis y hemorragia. La inmunohistoquímica reveló positividad para CDI0 y CD20, negativo con CD3, índice de proliferación Ki67 alto. Se diagnosticó linfoma tipo Burkitt bilateral de ovario. Conclusiones: el linfoma de Burkitt de ovario bilateral es poco frecuente, con variabilidad de presentación; el dolor abdominal y los tumores abdominales son lo más frecuente. El pronóstico a corto plazo de las pacientes es malo, por lo que es necesario conocer esta afección para poder establecer el diagnóstico temprano.

  6. Conscious attention, meditation, and bilateral information transfer.

    Science.gov (United States)

    Bob, Petr; Zimmerman, Elizabeth M; Hamilton, Elizabeth A; Sheftel, Jenna G; Bajo, Stephanie D; Raboch, Jiri; Golla, Megan; Konopka, Lukasz M

    2013-01-01

    Recent findings indicate that conscious attention is related to large-scale information integration of various brain regions, including both hemispheres, that enables integration of parallel distributed modalities of processed information. There is also evidence that the level of information transference related to integration or splitting among brain regions, and between hemispheres, establishes a certain level of efficiency of the information processing. The level of information transference also may have modulatory influences on attentional capacity that are closely linked to the emotional arousal and autonomic response related to a stimulus. These findings suggest a hypothesis that changes in conscious attention, specifically during meditation could be reflected in the autonomic activity as the left-right information transference calculated from bilateral electrodermal activity (EDA). With the aim to compare conscious attention during meditation with other attentional states (resting state, Stroop task, and memory task), we performed bilateral EDA measurement in 7 healthy persons during resting state, Stroop task, neurofeedback memory test, and meditation. The results indicate that the information transference (ie, transinformation) is able to distinguish those attentional states, and that the highest level of the transinformation has been found during attentional processing related to meditation, indicating higher level of connectivity between left and right sides. Calculations other than pointwise transinformation (PTI) performed on EDA records, such as mean skin conductance level or laterality index, were not able to distinguish attentional states. The results suggest that PTI may present an interesting method useful for the assessment of information flow, related to neural functioning, that in the case of meditation may reflect typical integrative changes in the autonomic nervous system related to brain functions and focused attentional processing.

  7. Bilateral adrenal histoplasmosis in an immunocompetent man Histoplasmose adrenal bilateral em um homem imunocompetente

    Directory of Open Access Journals (Sweden)

    Carlos Frederico Lopes Benevides

    2007-04-01

    Full Text Available Histoplasmosis is a fungal disease that is endemic in Brazil. It may present as chronic pulmonary infection or in disseminated form. Disseminated histoplasmosis frequently affects the adrenal gland; however, unilateral involvement in immunosuppressed patients is the usual presentation. We report a case of an elderly immunocompetent male with history of weight loss, fever and bilateral adrenal mass who was successfully treated with itraconazole.Histoplasmose é uma doença fúngica endêmica no Brasil que pode se apresentar como infecção pulmonar crônica ou na forma disseminada. A histoplasmose disseminada freqüentemente acomete a glândula adrenal; entretanto, ocorre mais em pacientes imunossuprimidos e de forma unilateral. Relatamos um caso de um homem idoso imunocompetente com história de perda de peso, febre e massa adrenal bilateral que foi tratada com itraconazol, com sucesso.

  8. Simultaneous bilateral shoulder and bilateral central acetabular fracture dislocation: What to do?

    Institute of Scientific and Technical Information of China (English)

    Hardik Sheth; Abhijeet Ashok Salunke; Ramesh Panchal; Jimmy Chokshi; G.I.Nambi; Saranjeet Singh; Amit Patel

    2016-01-01

    Musculoskeletal injuries following seizures have a high morbidity and mortality.These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations.We report a case of 72 years old male with simultaneous bilateral central acetabular fracture dislocation and bilateral posterior shoulder fracture dislocation secondary to an epileptic seizure.Present study highlights the significance of clinical suspicion and clinico-radiological evaluation for diagnosis of a rare injury following episode of seizures.Simultaneous fracture dislocation of all four limbs treated with a holistic approach can lead to a good functional recovery.Surgical management with open reduction and internal fixation is preferred and replacement arthroplasty should be reserved for cases with implant failure and elderly patients.

  9. Bilateral psoas and bilateral perinephric abscesses complicating acute pyelonephritis in pregnancy

    OpenAIRE

    2013-01-01

    Acute pyelonephritis complicates 1-2% of pregnancies and causes significant maternal and fetal morbidity and mortality. The diagnosis of renal tuberculosis (TB) is often delayed and commonly presents with sterile pyuria or along with other pyogenic organisms. We report a case where the diagnosis of renal TB was missed in a pregnant woman when she presented with acute pyelonephritis, septic shock, and acute renal failure. There was clinical recovery with antibiotics, but bilateral psoas and pe...

  10. Espasmo hemifacial bilateral: relato de caso Bilateral hemifacial spasm: case report

    Directory of Open Access Journals (Sweden)

    Flavia Costa Nunes Machado

    2003-03-01

    Full Text Available Espasmo hemifacial bilateral é um distúrbio de movimento raro geralmente associado à compressão vascular dos nervos faciais. Caracteriza-se clinicamente por contrações assimétricas e assíncronas da musculatura facial e por longa latência entre a instalação dos movimentos em cada hemiface. Deve ser diferenciado de outras condições como blefaroespasmo, miocimia facial, tiques faciais, distonia oromandibular e espasmo hemimastigatório. O tratamento sintomático mais eficaz e menos invasivo consiste em aplicações de toxina botulínica mas abordagem cirúrgica de descompressão microvascular é outra alternativa terapêutica. Relatamos o caso de homem de 70 anos com espasmo hemifacial bilateral e fazemos uma breve revisão da literatura.Bilateral hemifacial spasm (BHS is a rare focal movement disorder often associated with vascular compression of both facial nerves. The contractions are usually asymmetric and asynchronous. Typically, one side is affected first and there is a long but variable interval for the symptoms on the other side to occur. BHS must be differentiated from other conditions including blefarospasm, facial myokymia, facial tics, oromandibular dystonia, and hemimasticatory spasm. The most successful and non-invasive symtomatic treatment is botulinum toxin injections but microvascular decompression surgery is another therapeutic option. We report the case of a 70 years old man with bilateral hemifacial spasms and present a brief review of the literature.

  11. Bilateral congenital pseudoarthrosis of the clavicles in a newborn

    Science.gov (United States)

    Kalagiri, Ram R.; Hemingway, Martha; Beeram, Madhava R.

    2016-01-01

    Bilateral congenital pseudoarthrosis of the clavicles is extremely rare. We report a case of this entity presenting in the neonatal period. We highlight the importance of the differential diagnosis when clavicular fracture shows no evidence of healing or occurs bilaterally. PMID:27695169

  12. [Bilateral anterior uveiopapillitis, suspicious of Lyme disease--case report].

    Science.gov (United States)

    Nicula, Cristina; Nicula, D; Rusu, Ioana; Popescu, Raluca

    2013-01-01

    We present the case of a patient which associated bilateral anterior uveitis manifestations with those of bilateral anterior inflammatory optic neuropathy. We followed the evolution of the case under treatment and we discussed the differential diagnosis and the association of the two ocular pathologies.

  13. Bilateral ganglion cyst of the common peroneal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Pedrazzini, Massimo; Cusmano, Ferdinando; Armaroli, Sara; Pavone, Paolo [Institute of Radiology, University of Parma, Viale Gramsci 14, 43100 Parma (Italy); Pogliacomi, Francesco; Rinaldi, Elio [Institute of Clinical Orthopedics and Traumatology, University of Parma, Viale Gramsci 14, 43100 Parma (Italy)

    2002-11-01

    Ganglion cysts of the common peroneal nerve are rarely described in the literature and a bilateral lesion has not been previously reported. We present a case of a 41-year-old man with a bilateral cyst of the common peroneal nerve diagnosed with ultrasound and magnetic resonance imaging. (orig.)

  14. Bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei

    DEFF Research Database (Denmark)

    Kaldau, Niels Christian; Brorson, Stig; Jensen, Poul Einar

    2012-01-01

    We present a case of bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei, and review the literature on Candida osteomyelitis.......We present a case of bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei, and review the literature on Candida osteomyelitis....

  15. Effects of Bilateralism and the MFN Clause on International Trade

    DEFF Research Database (Denmark)

    Lampe, Markus

    2009-01-01

    This study contributes to a revised picture of nineteenth-century bilateralism. Employing a new disaggregated data set, it argues that bilateral treaties did not implement general free trade, but instead reduced tariffs unevenly through commodity-specific preferences, especially favoring manufact...

  16. Simultaneous Bilateral Transient Osteoporosis of the Hip without Pregnancy

    Directory of Open Access Journals (Sweden)

    Yasuaki Okada

    2016-01-01

    Full Text Available Transient osteoporosis of the hip (TOH is a rare disorder characterized by acute severe coxalgia and temporary osteopenia in the proximal femur. Although most cases were unilateral or staged bilateral TOH, some authors reported that the pregnant patients simultaneously had TOH in their bilateral hips. However, there has been no report of simultaneous bilateral TOH in the patient without pregnancy. A 25-year-old Japanese woman without pregnancy had acute simultaneous bilateral hip pain. Plain X-ray of the bilateral hips did not show a periarticular osteopenia. However, magnetic resonance image obtained one week after the onset demonstrated increased T2-weighted signal intensity and decreased T1-weighted signal intensity in the bilateral femoral heads. She was treated conservatively, and follow-up magnetic resonance image at seven weeks after the onset returned to normal bone marrow signal intensity. Her bilateral coxalgia subsided gradually. At one year after the onset, she had no sign of symptomatic flair. Our experience with this case indicates that recognizing the possibility of simultaneous bilateral TOH is important unless the patient is pregnant, and magnetic resonance image is predictable test to make a diagnosis of TOH, even in the absence of abnormal finding on plain X-ray.

  17. [Bilateral hyperplasia of the coronoid apophyses. A clinical case].

    Science.gov (United States)

    Parascandolo, S; Rusciano, A; Tamai, M; Morlino, M

    1993-03-01

    The authors report on the case of a young patient affected with bilateral hyperplasia of the coronoid apophyses, who presented a serious reduction of the mandibular excursion. Normal mouth opening was re-established by a bilateral osteotomy with endoral removal of the coronoid apophyses.

  18. Fast-track surgery for bilateral total knee replacement

    DEFF Research Database (Denmark)

    Husted, H; Troelsen, A; Otte, K S;

    2011-01-01

    Bilateral simultaneous total knee replacement (TKR) has been considered by some to be associated with increased morbidity and mortality. Our study analysed the outcome of 150 consecutive, but selected, bilateral simultaneous TKRs and compared them with that of 271 unilateral TKRs in a standardised...

  19. Hydrodynamic Simulations of Physical Aquatic Habitat Availability for Pallid Sturgeon in the Lower Missouri River, at Yankton, South Dakota, Kenslers Bend, Nebraska, Little Sioux, Iowa, and Miami, Missouri, 2006-07

    Science.gov (United States)

    Jacobson, Robert B.; Johnson, Harold E.; Dietsch, Benjamin J.

    2009-01-01

    The objective of this study was to assess the sensitivity of habitat availability in the Lower Missouri River to discharge variation, with emphasis on habitats that might support spawning of the endangered pallid sturgeon. We constructed computational hydrodynamic models for four reaches that were selected because of evidence that sturgeon have spawned in them. The reaches are located at Miami, Missouri (river mile 259.6-263.5), Little Sioux, Iowa (river mile 669.6-673.5), Kenslers Bend, Nebraska (river mile 743.9-748.1), and Yankton, South Dakota reach (river mile 804.8-808.4). The models were calibrated for a range of measured flow conditions, and run for a range of discharges that might be affected by flow modifications from Gavins Point Dam. Model performance was assessed by comparing modeled and measured water velocities. A selection of derived habitat units was assessed for sensitivity to hydraulic input parameters (drag coefficient and lateral eddy viscosity). Overall, model results were minimally sensitive to varying eddy viscosity; varying lateral eddy viscosity by 20 percent resulted in maximum change in habitat units of 5.4 percent. Shallow-water habitat units were most sensitive to variation in drag coefficient with 42 percent change in unit area resulting from 20 percent change in the parameter value; however, no habitat unit value changed more than 10 percent for a 10 percent variation in drag coefficient. Sensitivity analysis provides guidance for selecting habitat metrics that maximize information content while minimizing model uncertainties. To assess model sensitivities arising from topographic variation from sediment transport on an annual time scale, we constructed separate models from two complete independent surveys in 2006 and 2007. The net topographic change was minimal at each site; the ratio of net topographic change to water volume in the reaches at 95 percent exceedance flow was less than 5 percent, indicating that on a reach

  20. Bilateral sensory deprivation of trigeminal afferent fibres on corticomotor control of human tongue musculature: a preliminary study.

    Science.gov (United States)

    Kothari, M; Baad-Hansen, L; Svensson, P

    2016-09-01

    Transcranial magnetic stimulation (TMS) has demonstrated changes in motor evoked potentials (MEPs) in human limb muscles following modulation of sensory afferent inputs. The aim of this study was to determine whether bilateral local anaesthesia (LA) of the lingual nerve affects the excitability of the tongue motor cortex (MI) as measured by TMS. The effect on MEPs after bilateral LA of the lingual nerve was studied, while the first dorsal interosseous (FDI) muscle served as a control in ten healthy participants. MEPs were measured on the right side of the tongue dorsum in four different conditions: (i) immediately prior to anaesthesia (baseline), (ii) during bilateral LA block of the lingual nerve, (iii) after anaesthesia had subjectively subsided (recovery) and (iv) 3 h after bilateral lingual block injection. MEPs were assessed using stimulus-response curves in steps of 10% of motor threshold (T). Eight stimuli were given at each stimulus level. The amplitudes of the tongue MEPs were significantly influenced by the stimulus intensity (P < 0·001) but not by condition (P = 0·186). However, post hoc tests showed that MEPS were statistically significantly higher during bilateral LA block condition compared with baseline at T + 40%, T + 50% and T + 60% (P < 0·028) and also compared with recovery at T + 60% (P = 0·010) as well as at 3 h after injection at T + 50% and T + 60% (P < 0·029). Bilateral LA block of the lingual nerve seems to be associated with a facilitation of the corticomotor pathways related to the tongue musculature.

  1. Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman

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    K. H. Odubamowo

    2014-01-01

    Full Text Available Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days’ duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide. Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation.

  2. Leg Weakness Caused by Bilateral Piriformis Syndrome: A Case Report.

    Science.gov (United States)

    Moon, Hee Bong; Nam, Ki Yeun; Kwon, Bum Sun; Park, Jin Woo; Ryu, Gi Hyeong; Lee, Ho Jun; Kim, Chang Jae

    2015-12-01

    Piriformis syndrome (PS) is an uncommon neuromuscular disorder caused by the piriformis muscle (PM) compressing the sciatic nerve (SN). The main symptom of PS is sciatica, which worsens with certain triggering conditions. Because the pathophysiology is poorly understood, there are no definite diagnostic and therapeutic choices for PS. This case report presents a young woman who mainly complained of bilateral leg weakness. Electromyography revealed bilateral sciatic neuropathy and magnetic resonance imaging confirmed structural lesions causing entrapment of the bilateral SNs. After a laborious diagnosis of bilateral PS, she underwent PM releasing surgery. Few PS cases present with bilateral symptoms and leg weakness. Therefore, in such cases, a high level of suspicion is necessary for accurate and prompt diagnosis and treatment.

  3. Groin hernia subtypes are associated in patients with bilateral hernias

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Andresen, Kristoffer; Pommergaard, Hans-Christian;

    2015-01-01

    for a DIH. Females and males operated for a unilaterally indirect inguinal hernia (IIH) had HRs of 6.93 (CI 95% 3.66-13.11) and 1.89 (CI95% 1.24-2.88) for being contralaterally operated for an IIH. The same tendency was seen for femoral hernias. CONCLUSIONS: All hernia subtypes were bilaterally associated......BACKGROUND: To investigate the relation between groin hernia subtypes in patients operated for bilateral hernias. METHODS: With data from the Danish Hernia Database, we identified all patients operated for primary groin hernias from 1998 to 2012. Within this cohort all patients that were...... bilaterally operated were analyzed. Risk factors for bilateral groin hernia operation as well as the relationship between groin hernia subtypes bilaterally, were analyzed using multivariate Cox proportional hazards analysis and Kappa statistics. RESULTS: A total of 108, 775 persons with primary groin hernia...

  4. Visual and proprioceptive interaction in patients with bilateral vestibular loss

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    Nicholas J. Cutfield

    2014-01-01

    Full Text Available Following bilateral vestibular loss (BVL patients gradually adapt to the loss of vestibular input and rely more on other sensory inputs. Here we examine changes in the way proprioceptive and visual inputs interact. We used functional magnetic resonance imaging (fMRI to investigate visual responses in the context of varying levels of proprioceptive input in 12 BVL subjects and 15 normal controls. A novel metal-free vibrator was developed to allow vibrotactile neck proprioceptive input to be delivered in the MRI system. A high level (100 Hz and low level (30 Hz control stimulus was applied over the left splenius capitis; only the high frequency stimulus generates a significant proprioceptive stimulus. The neck stimulus was applied in combination with static and moving (optokinetic visual stimuli, in a factorial fMRI experimental design. We found that high level neck proprioceptive input had more cortical effect on brain activity in the BVL patients. This included a reduction in visual motion responses during high levels of proprioceptive input and differential activation in the midline cerebellum. In early visual cortical areas, the effect of high proprioceptive input was present for both visual conditions but in lateral visual areas, including V5/MT, the effect was only seen in the context of visual motion stimulation. The finding of a cortical visuo-proprioceptive interaction in BVL patients is consistent with behavioural data indicating that, in BVL patients, neck afferents partly replace vestibular input during the CNS-mediated compensatory process. An fMRI cervico-visual interaction may thus substitute the known visuo-vestibular interaction reported in normal subject fMRI studies. The results provide evidence for a cortical mechanism of adaptation to vestibular failure, in the form of an enhanced proprioceptive influence on visual processing. The results may provide the basis for a cortical mechanism involved in proprioceptive substitution

  5. Visual and proprioceptive interaction in patients with bilateral vestibular loss.

    Science.gov (United States)

    Cutfield, Nicholas J; Scott, Gregory; Waldman, Adam D; Sharp, David J; Bronstein, Adolfo M

    2014-01-01

    Following bilateral vestibular loss (BVL) patients gradually adapt to the loss of vestibular input and rely more on other sensory inputs. Here we examine changes in the way proprioceptive and visual inputs interact. We used functional magnetic resonance imaging (fMRI) to investigate visual responses in the context of varying levels of proprioceptive input in 12 BVL subjects and 15 normal controls. A novel metal-free vibrator was developed to allow vibrotactile neck proprioceptive input to be delivered in the MRI system. A high level (100 Hz) and low level (30 Hz) control stimulus was applied over the left splenius capitis; only the high frequency stimulus generates a significant proprioceptive stimulus. The neck stimulus was applied in combination with static and moving (optokinetic) visual stimuli, in a factorial fMRI experimental design. We found that high level neck proprioceptive input had more cortical effect on brain activity in the BVL patients. This included a reduction in visual motion responses during high levels of proprioceptive input and differential activation in the midline cerebellum. In early visual cortical areas, the effect of high proprioceptive input was present for both visual conditions but in lateral visual areas, including V5/MT, the effect was only seen in the context of visual motion stimulation. The finding of a cortical visuo-proprioceptive interaction in BVL patients is consistent with behavioural data indicating that, in BVL patients, neck afferents partly replace vestibular input during the CNS-mediated compensatory process. An fMRI cervico-visual interaction may thus substitute the known visuo-vestibular interaction reported in normal subject fMRI studies. The results provide evidence for a cortical mechanism of adaptation to vestibular failure, in the form of an enhanced proprioceptive influence on visual processing. The results may provide the basis for a cortical mechanism involved in proprioceptive substitution of vestibular

  6. Temporal lobe cortical electrical stimulation during the encoding and retrieval phase reduces false memories.

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    Paulo S Boggio

    Full Text Available A recent study found that false memories were reduced by 36% when low frequency repetitive transcranial magnetic stimulation (rTMS was applied to the left anterior temporal lobe after the encoding (study phase. Here we were interested in the consequences on a false memory task of brain stimulation throughout the encoding and retrieval task phases. We used transcranial direct current stimulation (tDCS because it has been shown to be a useful tool to enhance cognition. Specifically, we examined whether tDCS can induce changes in a task assessing false memories. Based on our preliminary results, three conditions of stimulation were chosen: anodal left/cathodal right anterior temporal lobe (ATL stimulation ("bilateral stimulation"; anodal left ATL stimulation (with a large contralateral cathodal electrode--referred as "unilateral stimulation" and sham stimulation. Our results showed that false memories were reduced significantly after the two active conditions (unilateral and bilateral stimulation as compared with sham stimulation. There were no significant changes in veridical memories. Our findings show that false memories are reduced by 73% when anodal tDCS is applied to the anterior temporal lobes throughout the encoding and retrieval stages, suggesting a possible strategy for improving certain aspects of learning.

  7. Neuromuscular Adaptations to Unilateral vs. Bilateral Strength Training in Women.

    Science.gov (United States)

    Botton, Cíntia E; Radaelli, Regis; Wilhelm, Eurico N; Rech, Anderson; Brown, Lee E; Pinto, Ronei S

    2016-07-01

    Botton, CE, Radaelli, R, Wilhelm, EN, Rech, A, Brown, LE, and Pinto, RS. Neuromuscular adaptations to unilateral vs. bilateral strength training in women. J Strength Cond Res 30(7): 1924-1932, 2016-Considering the bilateral deficit, the sum of forces produced by each limb in a unilateral condition is generally greater than that produced by them in a bilateral condition. Therefore, it can be speculated that performing unilateral strength exercises may allow greater training workloads and subsequently greater neuromuscular adaptations when compared with bilateral training. Hence, the purpose of this study was to compare neuromuscular adaptations with unilateral vs. bilateral training in the knee extensor muscles. Forty-three recreationally active young women were allocated to a control, unilateral (UG) or bilateral (BG) training group, which performed 2 times strength training sessions a week for 12 weeks. Knee extension one repetition maximum (1RM), maximal isometric strength, muscle electrical activity, and muscle thickness were obtained before and after the study period. Muscle strength was measured in unilateral (right + left) and bilateral tests. Both UG and BG increased similarly their unilateral 1RM (33.3 ± 14.3% vs. 24.6 ± 11.9%, respectively), bilateral 1RM (20.3 ± 6.8% vs. 28.5 ± 12.3%, respectively), and isometric strength (14.7 ± 11.3% vs. 13.1 ± 12.5%, respectively). The UG demonstrated greater unilateral isometric strength increase than the BG (21.4 ± 10.5% vs. 10.3 ± 11.1%, respectively) and only the UG increased muscle electrical activity. Muscle thickness increased similarly for both training groups. Neither group exhibited pretesting 1RM bilateral deficit values, but at post-testing, UG showed a significant bilateral deficit (-6.5 ± 7.8%) whereas BG showed a significant bilateral facilitation (5.9 ± 9.0%). Thus, performing unilateral or bilateral exercises was not a decisive factor for improving morphological adaptations and bilateral

  8. Bilateral Birdshot Retinochoroiditis and Retinal Astrocytoma

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    Sunil Mamtora

    2017-01-01

    Full Text Available Background. This case highlights the importance of recognising multiple pathologies within the eye which may not necessarily be linked. Both birdshot retinochoroiditis and astrocytoma are rare conditions. The case underlines the need for early identification and treatment of birdshot retinochoroiditis with steroids and disease modifying drugs. Astrocytoma in the absence of tuberous sclerosis is also uncommon. Case Presentation. A 36-year-old male presented with 3-month history of bilateral progressive flashing lights and floaters. He was systemically well with no significant past medical history. Fundal examination revealed retinal vasculitis and active creamy lesions in the choroid radiating from the optic nerve. In the supranasal periphery of the right eye there was a raised white, jagged lesion protruding into the vitreous. Fluorescein angiogram and indocyanine green showed marked venous vasculitis, hypofluorescence, and disc leakage in keeping with birdshot retinochoroiditis. The supranasal lesion features were in keeping with astrocytoma and this was thought to be a coincidental finding. Conclusions. Retinal astrocytoma may be present as an isolated ocular finding; however, patients must still be investigated for tuberous sclerosis which is the most common association. Birdshot retinochoroiditis typically responds well to steroid therapy, and disease modifying drugs should be considered as soon as possible.

  9. Bilateral Psoas Haematomata Complicating Renal Transplantation

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    Jacob A. Akoh

    2014-01-01

    Full Text Available Background. The challenge in managing patients undergoing renal transplantation is how to achieve optimum levels of anticoagulation to avoid both clotting and postoperative bleeding. We report a rare case of severe postoperative retroperitoneal bleeding including psoas haematomata complicating renal transplantation. Case Report. SM, a 55-year-old female, had a past history of aortic valve replacement, cerebrovascular event, and thoracic aortic aneurysm and was on long-term warfarin that was switched to enoxaparin 60 mg daily a week prior to her living donor transplantation. Postoperatively, she was started on a heparin infusion, but this was complicated by a large retroperitoneal bleed requiring surgical evacuation on the first postoperative day. Four weeks later, she developed features compatible with acute femoral neuropathy and a CT scan revealed bilateral psoas haematomata. Following conservative management, she made steady progress and was discharged home via a community hospital 94 days after transplantation. At her last visit 18 months after transplantation, she had returned to full fitness with excellent transplant function. Conclusion. Patients in established renal failure who require significant anticoagulation are at increased risk of bleeding that may involve prolonged hospitalisation and more protracted recovery and patients should be carefully counselled about this.

  10. Bilateral maculopathy following electrical burn: case report

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    Leandro Dario Faustino

    Full Text Available CONTEXT: Electrical burns are an important etiology in dealing with patients suffering from burns. In situations of extensive deep lesions of multiple organs and systems affecting young and economically active people, there is a need for expensive multidisciplinary treatment, with a high socioeconomic cost for the community. Among the permanent injuries that explain this high cost, eye injuries stand out, since they are widely disabling. Although rare, lesions of the posterior segment of the eye are associated with higher incidence of major sequelae, and thus deserve special attention for dissemination and discussion of the few cases observed.CASE REPORT: The authors report the case of a patient who suffered high-voltage electrical burns and presented bilateral maculopathy, which evolved with a need for a surgical approach to repair retinal detachment and permanent low visual acuity.CONCLUSION: This report highlights the rarity of the etiology of maculopathy and the need for campaigns for prevention not only of burns in general, but also especially of electrical burns.

  11. Rehabilitation for bilateral amputation of fingers

    Science.gov (United States)

    Stapanian, Martin A.; Stapanian, Adrienne M.P.; Staley, Keith E.

    2010-01-01

    We describe reconstructive surgeries, therapy, prostheses, and adaptations for a patient who experienced bilateral amputation of all five fingers of both hands through the proximal phalanges in January 1992. The patient made considerable progress in the use of his hands in the 10 mo after amputation, including nearly a 120% increase in the active range of flexion of metacarpophalangeal joints. In late 1992 and early 1993, the patient had "on-top plasty" surgeries, in which the index finger remnants were transferred onto the thumb stumps, performed on both hands. The increased web space and functional pinch resulting from these procedures made many tasks much easier. The patient and occupational therapists set challenging goals at all times. Moreover, the patient was actively involved in the design and fabrication of all prostheses and adaptations or he developed them himself. Although he was discharged from occupational therapy in 1997, the patient continues to actively find new solutions for prehension and grip strength 18 yr after amputation.

  12. Rehabilitation for bilateral amputation of fingers.

    Science.gov (United States)

    Stapanian, Martin A; Stapanian, Adrienne M P; Staley, Keith E

    2010-01-01

    We describe reconstructive surgeries, therapy, prostheses, and adaptations for a patient who experienced bilateral amputation of all five fingers of both hands through the proximal phalanges in January 1992. The patient made considerable progress in the use of his hands in the 10 mo after amputation, including nearly a 120% increase in the active range of flexion of metacarpophalangeal joints. In late 1992 and early 1993, the patient had "on-top plasty" surgeries, in which the index finger remnants were transferred onto the thumb stumps, performed on both hands. The increased web space and functional pinch resulting from these procedures made many tasks much easier. The patient and occupational therapists set challenging goals at all times. Moreover, the patient was actively involved in the design and fabrication of all prostheses and adaptations or he developed them himself. Although he was discharged from occupational therapy in 1997, the patient continues to actively find new solutions for prehension and grip strength 18 yr after amputation.

  13. Outcome of bilateral ureteroscopic retrieval of stones in a single session

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    Majid Mushtaque

    2012-01-01

    Conclusion: Bilateral same-session ureteroscopy is a safe and effective procedure in the management of bilateral ureteral stones. The results are comparable to unilateral or staged bilateral procedures.

  14. Early morbidity after simultaneous and staged bilateral total knee arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer Calov; Husted, Henrik;

    2015-01-01

    PURPOSE: The aim of this nationwide study was to investigate the early morbidity after bilateral simultaneous and staged total knee arthroplasty (TKA) in order to clarify potential benefits of a well-established fast-track regime. METHODS: The Danish National Patient Registry was searched for all...... bilateral simultaneous and staged TKA procedures from 2010 to 2011. The staged procedures were defined as two separate procedures done within 0-6 months or within 7-18 months. RESULTS: A total of 157 patients had bilateral simultaneous TKA, 346 patients had bilateral staged TKA within 0-6 months and 292...... simultaneous TKA versus three deaths (0.9 and 1.0 %) in each of the bilateral staged groups within 90 days of surgery (n.s.). The total readmission rate within 30 days of surgery was lower after bilateral simultaneous TKA (7 %, CI 4.0-12.0) and bilateral staged TKA within 0-6 months (9 %, CI 6.4-12.4) compared...

  15. Post-Traumatic Isolated Bilateral Sixth Nerve Palsy

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    Jain

    2016-03-01

    Full Text Available Introduction Here we discussed an unusual case of head injury with bilateral sixth nerve palsy without any other neurological deficit. A 40-year-old male was admitted with double vision after an episode of head injury. Case Presentation On examination bilateral lateral rectus palsy was present. No other positive finding recorded in general physical, neurological and ophthalmological examinations. Conclusions Bilaterality of the abducent nerve paralysis is uncommon. It is usually associated with major head injury with brain stem injury and associated neurological findings.

  16. Bilateral impacted femoral neck fracture in a renal disease patient

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    Pramod Devkota

    2013-01-01

    Full Text Available Spontaneous bilateral femoral neck facture in a renal disease patient is not common. We report a case of 47-year-old female patient with chronic renal failure and on regular hemodialysis for the past 5 years who sustained bilateral impacted femoral neck fracture without history of trauma and injury and refused any surgical intervention. The patient was mobilised on wheel chair one year after the fractures. The cause of the fracture and the literature review of the bilateral femoral neck fracture in renal disease are discussed.

  17. Haptic Manipulation of Deformable Objects in Hybrid Bilateral Teleoperation System

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    Juan Manuel Ibarra-Zannatha

    2007-01-01

    Full Text Available The aim of this work is the integration of a virtual environment containing a deformable object, manipulated by an open kinematical chain virtual slave robot, to a bilateral teleoperation scheme based on a real haptic device. The virtual environment of this hybrid bilateral teleoperation system combines collision detection algorithms, dynamical, kinematical and geometrical models with a position–position and/or force–position bilateral control algorithm, to produce on the operator side the reflected forces corresponding to the virtual mechanical interactions, through a haptic device. Contact teleoperation task over the virtual environment with a flexible object is implemented and analysed.

  18. Reduced 123I Ioflupane Binding in Bilateral Diabetic Chorea

    Science.gov (United States)

    Sato, Kenichiro; Hida, Ayumi; Kameyama, Masashi; Morooka, Miyako; Takeuchi, Sousuke

    2016-01-01

    Abstract We report a 64-year-old man with diabetic chorea whom we investigated with dopamine transporter SPECT, 18F FDG PET, 99mTc ethylcysteinate dimer (ECD) SPECT, and 123I metaiodobenzylguanidine (MIBG) scintigraphy. Dopamine transporter SPECT revealed reduced 123I ioflupane binding in the bilateral striatum. 18F FDG PET showed metabolic dysfunction in the bilateral striatum, as shown in earlier studies. 99mTc ECD SPECT revealed reduced brain perfusion in the bilateral caudate nucleus and putamen. 123I MIBG scintigraphy revealed no cardiac sympathetic nerve dysfunction. Our case suggests a possible nigrostriatal presynaptic dopaminergic involvement in diabetic chorea. PMID:26975011

  19. Spheniodal mucocele causing bilateral optic neuropathy and ophthalmoplegia

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    Ambika Selvakumar

    2014-01-01

    Full Text Available Sphenoid sinus mucocele comprises only 2% of all paranasal sinus mucoceles. In literature, there is a case report on sphenoidal mucocele causing bilateral optic neuropathy, with unilateral partial recovery and cranial nerve palsy, but we did not come across any literature with bilateral optic neuropathy and ophthalmoplegia together caused by spheno-ethmoidal mucocele. We present such a rare case of spheno-ethmoidal mucocele causing bilateral optic neuropathy and unilateral sixth nerve palsy who had postsurgery, unilateral good vision recovery, and complete resolution of sixth nerve palsy.

  20. Bilateral Ota nevus in a 15 years old patient

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    Savaş Öztürk

    2013-12-01

    Full Text Available Nevus of Ota is a dermal melanocytosis, clinically localizedon skin that is innervated by the first and secondbranches of the trigeminal nerve. It occurs almost entirelyin Asian people. The clinical manifestations are usuallyunilateral; only 5% of cases are bilateral. In this article,due to rarity of the case, a 15-year-old patient, who was diagnosedwith bilateral ota nevus, without having any dermatologicalcomplaints other than cosmetic appearenceand stains in her eyes and around was presented.Key words: Bilateral ota nevus, child, melanocytosis

  1. A 72-year-old patient with bilateral Maisonneuve fractures

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    Thomas Dienstknecht

    2012-07-01

    Full Text Available Maisonneuve fractures result from a disruption of the medial ankle structures and a proximal fibular fracture. Patient complaints can be misleading and there is a significant rate of delayed diagnosed injuries. We present a case of bilateral Maisonneuve fractures after a fall due to a syncopal collapse. A precise clinical examination led to this rare diagnosis. The injuries were treated with syndesmotic screw fixation, removal of hardware followed after 6 weeks. The patient was asymptomatic at threemonths follow up. Patients with bilateral injuries undergoing standard surgical treatment can gain full recovery, but high suspicion in clinical examination is needed to detect this uncommon bilateral injury.

  2. Espasmo hemifacial bilateral: relato de caso Bilateral hemifacial spasm: case report

    OpenAIRE

    Flavia Costa Nunes Machado; Felipe Fregni; Cynthia Resende Campos; João Carlos Papaterra Limongi

    2003-01-01

    Espasmo hemifacial bilateral é um distúrbio de movimento raro geralmente associado à compressão vascular dos nervos faciais. Caracteriza-se clinicamente por contrações assimétricas e assíncronas da musculatura facial e por longa latência entre a instalação dos movimentos em cada hemiface. Deve ser diferenciado de outras condições como blefaroespasmo, miocimia facial, tiques faciais, distonia oromandibular e espasmo hemimastigatório. O tratamento sintomático mais eficaz e menos invasivo consis...

  3. Ceratite bilateral por Acanthamoeba: relato de caso Bilateral Acanthamoeba keratitis: case report

    OpenAIRE

    Wilson Nahmatallah Obeid; Rogério de Araújo; Luiz Antonio Vieira; Marco Antonio Campos Machado

    2003-01-01

    A ceratite por Acanthamoeba é uma infecção ocular grave que, apesar dos recentes progressos no diagnóstico e tratamento, ainda provoca prolongada morbidade e perda da acuidade visual. Relatamos um caso de ceratite bilateral por Acanthamoeba em usuário de lentes de contato, que é o primeiro caso descrito na literatura brasileira.Acanthamoeba keratitis is a severe ocular infection which even with recent progress in diagnosis and treatment still causes long morbidity and loss of visual acuity. W...

  4. Luxatio erecta bilateral: um relato de caso Bilateral luxatio erecta, a case report

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    César Augusto Xavier Acosta

    2012-02-01

    Full Text Available O deslocamento inferior do ombro (luxatio erecta é uma lesão rara, acometendo aproximadamente 0,5% dos deslocamentos dessa articulação. A grande maioria desses casos ocorre unilateralmente. Em setembro de 2004, um homem de 43 anos chegou ao pronto-socorro do Hospital Universitário de Santa Maria (HUSM com queixa de dor bilateral no ombro e incapacidade de abaixar os braços, em consequência de uma queda com os braços abduzidos, enquanto desempenhava sua atividade laboral. Após o exame físico e radiológico constatou- se que o indivíduo apresentava uma luxação inferior bilateral dos ombros. O paciente foi então encaminhado ao bloco cirúrgico onde foi realizada redução incruenta das luxações sob anestesia através da técnica de tração e contra-tração. No dia seguinte recebeu alta com imobilização tipo Velpeau mantendo os ombros totalmente aduzidos e rotados internamente, com orientação de manter a imobilização por três semanas. Foi orientado também a realizar fisioterapia.Inferior shoulder dislocation (luxactio erecta is a rare lesion affecting approximately 0.5% of dislocations of this joint. The vast majority of these cases occur unilaterally. In September 2004, a 43 year old man was brought to the emergency room of the University Hospital of Santa Maria (HUSM complaining of bilateral shoulder pain and inability to lower the arms, as a result of a fall with the arms abducted, while carrying out work activities. After physical examination and radiological exams, it was found that the patient had a bilateral inferior shoulder dislocation. He was referred to the surgical ward and after intravenous sedation, both shoulders were reduced by closed reduction using the traction-countertraction maneuver. The patient was discharged the day after the reduction. Both arms were immobilized with a velpeau sling in total adduction and intrarotation, with instructions to maintain immobilization for three weeks. The patient was

  5. Modulation of physiological mirror activity with transcranial direct current stimulation over dorsal premotor cortex.

    Science.gov (United States)

    Beaulé, Vincent; Tremblay, Sara; Lafleur, Louis-Philippe; Ferland, Marie C; Lepage, Jean-François; Théoret, Hugo

    2016-11-01

    Humans have a natural tendency towards symmetrical movements, which rely on a distributed cortical network that allows for complex unimanual movements. Studies on healthy humans using rTMS have shown that disruption of this network, and particularly the dorsal premotor cortex (dPMC), can result in increased physiological mirror movements. The aim of the present set of experiments was to further investigate the role of dPMC in restricting motor output to the contralateral hand and determine whether physiological mirror movements could be decreased in healthy individuals. Physiological mirror movements were assessed before and after transcranial direct current stimulation (tDCS) over right and left dPMC in three conditions: bilateral, unilateral left and unilateral right stimulation. Mirror EMG activity was assessed immediately before, 0, 10 and 20 min after tDCS. Results show that physiological mirroring increased significantly in the hand ipsilateral to cathodal stimulation during bilateral stimulation of the dPMC, 10 and 20 min after stimulation compared to baseline. There was no significant modulation of physiological mirroring in the hand ipsilateral to anodal stimulation in the bilateral condition or following unilateral anodal or unilateral cathodal stimulation. The present data further implicate the dPMC in the control of unimanual hand movements and show that physiological mirroring can be increased but not decreased with dPMC tDCS.

  6. Bilateral versus unilateral thyroid eye disease

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    Mohsen Bahmani Kashkouli

    2011-01-01

    Full Text Available Aims: The aim of this study was to compare demographics, clinical manifestations, associated systemic and ocular factors, severity and activity of patients with unilateral thyroid eye disease (U-TED versus bilateral thyroid eye disease (B-TED. Materials and Methods: In a cross-sectional study, all patients with Graves′ hyperthyroidism and primary hypothyroidism seen in an endocrinology clinic were included from September 2003 to July 2006. Demographics, complete eye examination, severity score (NOSPECS, total eye score, and clinical activity score were recorded and compared in the B-TED and U-TED groups of patients. Results: From 851 patients with thyroid disorders, 303 (35.6% had TED. Thirty-two patients (32/ 303, 10.56% were found to have U-TED. Patients with U-TED (mean age 31.6 ± 11.6 years were significantly younger than patients with B-TED (mean age 37.7 ± 14.7 years. Monovariate analysis (Chi-square and independent sample t-test showed a significantly higher severity score in B-TED (U-TED 4.09±4.05, B-TED: 6.7±6.3; P= 0.002 and more activity score in B-TED (U-TED= 1.03±0.96, B-TED: 1.74±1.6, P= 0.001. However, multivariate analysis did not show any significant difference between the two groups in terms of age, gender, type of thyroid disease, duration of thyroid disease and TED, severity and activity of TED, smoking habit, and presentation of TED before or after the presentation of thyroid disease (0.1

  7. Mielolipoma adrenal bilateral em um cão Bilateral adrenal myelolipoma in a dog

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    Silvia de Araújo França

    2008-08-01

    Full Text Available O presente relato descreve um caso de mielolipoma adrenal bilateral em uma cadela Poodle de 13 anos de idade. O cão morreu por peritonite séptica aguda, decorrente de ulceração e perfuração intestinal por corpo estranho linear. O neoplasma foi achado incidentalmente durante a necropsia. Macroscopicamente, as adrenais estavam redondas e com volume e aumentados. Ao corte elas eram friáveis, vermelho-amarronzadas, intercaladas por áreas branco-amareladas levemente proeminentes. Histologicamente, extensas áreas do parênquima continham adipócitos bem diferenciados, células hematopoéticas e macrófagos com hemossiderina, achados característicos de mielolipoma adrenal.A case of bilateral adrenal myelolipoma in a 13-year-old female Poodle is reported. Acute septic peritonitis due to intestinal ulceration and perforation caused by a linear foreign body was the cause of death. The adrenal neoplasm was an incidental necropsy finding. The adrenal glands were grossly rounded, enlarged and friable, and had red-brownish parenchyma interwoven by slightly prominent white-yellowish foci. Histologically, the findings of differentiated adipocytes in large areas of the parenchyma, in association to hematopoietic cells and macrophages with hemosiderin were consistent with the diagnosis of adrenal myelolipoma.

  8. Delayed-onset bilateral abducens paresis after head trauma

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    Pravin Salunke

    2012-01-01

    Full Text Available Bilateral sixth nerve paresis following closed head injury, though rare, is a known entity. However, delayed-onset post-traumatic bilateral abducens paresis is extremely rare. We present two cases. The first patient had onset of bilateral abducens paresis 2 weeks after closed head injury and the second patient after 3 days. The cause in the former was detected to be chronic subdural hematoma and in the latter is speculated to be edema/ischemia due to injury to soft tissue structures housing these nerves. The delayed onset of bilateral abducens paresis following head injury may vary according to the cause. There may be another mechanism of injury apart from direct trauma. Though rare, it needs to be evaluated and may have a treatable cause like elevated intracranial pressure.

  9. Simultaneous bilateral fungal keratitis caused by different fungi.

    Directory of Open Access Journals (Sweden)

    Prajna Venkatesh

    2002-01-01

    Full Text Available Fungal keratitis is an important cause of corneal disease in the tropical world. We report a rare presentation of simultaneous bilateral corneal ulceration caused by different fungi.

  10. Pros and cons of immediately sequential bilateral cataract surgery (ISBCS).

    Science.gov (United States)

    Grzybowski, Andrzej; Wasinska-Borowiec, Weronika; Claoué, Charles

    2016-01-01

    Immediately sequential bilateral cataract surgery (ISBCS) is currently a "hot topic" in ophthalmology. There are well-documented advantages in terms of quicker visual rehabilitation and reduced costs. The risk of bilateral simultaneous endophthalmitis and bilateral blindness is now recognized to be minuscule with the advent of intracameral antibiotics and modern management of endophthalmitis. Refractive surprises are rare for normal eyes and with the use of optical biometry. Where a general anesthetic is indicated for cataract surgery, the risk of death from a second anesthetic is much higher than the risk of blindness. A widely recognized protocol from the International Society of Bilateral Cataract Surgeons needs to be adhered to if surgeons wish to start practicing ISBCS.

  11. Spontaneous Unruptured Bilateral Tubal Pregnancy: A Case Report

    Directory of Open Access Journals (Sweden)

    Nayereh Ghomian

    2015-11-01

    Full Text Available Bilateral spontaneous tubal ectopic pregnancy is the rarest form of extra uterine pregnancy. The diagnosis is usually made intraoperatively and levels of serum BHCG and ultrasound has not been useful in the diagnosis of bilateral tubal ectopic pregnancy. A 33-year-old woman with 8 weeks amenorrhea and sever lower abdominal pain was admitted. A transvaginal pelvic ultrasound revealed left adnexal mass and massive fluid collection in the pelvis and abdomen. The serum BHCG was 5,700 mIU/ml and in laparotomy bilateral unruptured tubal pregnancy was noted. Left salpingectomy and right salpingostomy were performed. The diagnosis of bilateral spontaneous tubal ectopic pregnancy is usually made intraoperatively. Both tubes at the time of surgery should be closely examined in order to prevent maternal morbidity and mortality.

  12. Application of the residue theorem to bilateral hypergeometric series

    Directory of Open Access Journals (Sweden)

    Wenchang Chu

    2007-12-01

    Full Text Available The application of the residue theorem to bilateral hypergeometric series identities is systematically reviewed by exemplifying three classes of summation theorems due to Dougall (1907, Jackson (1949, 1952 and Slater-Lakin (1953.

  13. Bilateral hematoma of sternocleidomastoid muscles. A case presentation.

    Directory of Open Access Journals (Sweden)

    Zoe Quintero Delgado

    2005-08-01

    Full Text Available Presentation of the case of an infant with bilateral congenital torticollis which development was followed by ultrasound. Homeopathy and physiotherapy were used for its treatment. This is an infrequent disease scarcely reported in medical literature.

  14. Stabilization of Bilateral Progressive Rheumatoid Corneal Melt with Infliximab

    Directory of Open Access Journals (Sweden)

    Sheelah F. Antao

    2012-01-01

    Results. A patient with rheumatoid arthritis presented with bilateral PUK following a 2-month history of ocular discomfort and redness. His systemic prednisolone (PDN and methotrexate (MTX were increased and, despite an initial favorable response, bilateral recurrent corneal perforations ensued. Both eyes underwent cyanoacrylate glue repair, amniotic membrane transplantation (AMT, and penetrating keratoplasty (PKP. Recurrence of the disease and bilateral perforations of the second PKP in both eyes prompted administration of intravenous infliximab immediately after the fourth PKP. The disease activity rapidly settled in both eyes, and at eighteen-month followup, after 12 infliximab infusions, the PUK remains quiescent with no further graft thinning or perforation. Conclusion. Infliximab can be used to arrest the progression of severe bilateral rheumatoid PUK in cases that are refractory to conventional treatment.

  15. Bilateral parotitis as the initial presentation of childhood sarcoidosis.

    Science.gov (United States)

    Banks, Gretchen C; Kirse, Daniel J; Anthony, Evelyn; Bergman, Simon; Shetty, Avinash K

    2013-01-01

    The differential diagnosis of bilateral parotid gland enlargement in children includes infectious, inflammatory, and neoplastic disorders. We present the case of a 13-year-old male who presented with a 5-week history of bilateral parotid swelling. On exam, both parotid glands were nontender, smooth, and diffusely enlarged. He had slightly elevated inflammatory markers, but other lab results were normal. A neck CT revealed symmetric enlargement of the parotid, submandibular, and sublingual glands. A chest CT revealed scattered peripheral pulmonary nodules and bilateral hilar adenopathy. A parotid gland biopsy showed multiple noncaseating granulomas with multinucleated giant cells surrounded by lymphocytes, consistent with the diagnosis of sarcoidosis. Special stains for acid-fast and fungal organisms were negative. Using this illustrative case, we discuss the differential diagnosis of bilateral salivary gland enlargement in children and review the etiology, diagnosis, clinical manifestations, and treatment of pediatric sarcoidosis.

  16. Effect of pediatric bilateral cochlear implantation on language development

    NARCIS (Netherlands)

    Boons, Tinne; Brokx, Jan; Frijns, Johan; Peeraer, Louis; Philips, Birgit; Vermeulen,; Wouters,; Wieringen, van

    2012-01-01

    Objective: To examine spoken language outcomes in children undergoing bilateral cochlear implantation compared with matched peers undergoing unilateral implantation. Design: Case-control, frequency-matched, retrospective cross-sectional multicenter study. Setting: Two Belgian and 3 Dutch cochlear im

  17. Bilateral Efforts in Seizing Opportunities for Better Relations

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    @@ General improvement of the Japan-ROK relations started after the end of the Cold War. Although the Japanese wrongdoings over the history-related issues have caused fluctuations in the bilateral relations, no substantial damage has occurred.

  18. Ultrasound Diagnosis of Bilateral Quadriceps Tendon Rupture After Statin Use

    Directory of Open Access Journals (Sweden)

    Nesselroade, Ryan D

    2010-09-01

    Full Text Available Simultaneous bilateral quadriceps tendon rupture is a rare injury. We report the case of bilateral quadriceps tendon rupture sustained with minimal force while refereeing a football game. The injury was suspected to be associated with statin use as the patient had no other identifiable risk factors.The diagnosis was confirmed using bedside ultrasound. [West J Emerg Med. 2010; 11(4:306-309.

  19. Amyad's hernia while reparing the bilateral inguinal hernia

    Directory of Open Access Journals (Sweden)

    Arif Aslaner

    2015-01-01

    Full Text Available Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  20. Bilateral sudden sensorineural hearing loss following unilateral temporal bone fracture.

    Science.gov (United States)

    Hunchaisri, Niran

    2009-06-01

    Temporal bone fractures usually cause unilateral sensorineural hearing loss (SNHL) by fracture that violated otic capsule of that side. Bilateral SNHL from unilateral temporal bone fracture were rarely seen. Labyrinthine concussion was considered to be the pathogenesis in these cases. This article reports an additional case of bilateral SNHL from unilateral temporal bone fracture but in a different pattern of SNHL which may result from an occlusion of the internal auditory artery.

  1. An unusual triad: Bilateral dilated odontoma, hypodontia and peg laterals

    Directory of Open Access Journals (Sweden)

    Alphy Alphonsa Sebastian

    2013-01-01

    The aim of this case report is to present a rare case of bilateral dilated odontoma affecting a microdontic permanent lateral incisor in a 30 year old female patient with hypodontia and peglateral teeth with its clinical, radiological and histological features, which has yet been not reported. Bilateral presence of dilated odontoma is not a common occurrence, although a single tooth involvement in each case has been reported in the literature.

  2. Endovascular treatment for bilateral vertebral arteriovenous fistulas in neurofibromatosis 1.

    Science.gov (United States)

    Siddhartha, W; Chavhan, Govind B; Shrivastava, Manish; Limaye, Uday S

    2003-12-01

    We report a rare case of a 36-year-old woman with neurofibromatosis 1 (NF1) with bilateral vertebro-vertebral arteriovenous fistulas. The patient presented with quadriparesis and had neck pain. Angiography revealed vertebral arteriovenous fistulas bilaterally with dilated epidural venous plexuses compressing the cervical cord resulting in quadriparesis. Endovascular treatment using coils and balloons resulted in successful occlusion of both fistulas. At 6-months postembolization, the patient had improved significantly and is now able to walk with support.

  3. A rare case of complete bilateral ophthalmoplegia and ptosis.

    Science.gov (United States)

    Hall, Daniel John; Bazaraa, Talal

    2014-01-01

    We describe the case of an 85-year-old gentleman admitted with bilateral ptosis and complete bilateral ocular paralysis. Initial differential diagnoses included myasthenia gravis, diabetic cranial neuropathy, an ischaemic event and possible occult neoplasm. Investigations did not support any of the differentials and Miller Fisher syndrome (MFS) was considered. Anti-GQ1b IgG antibody was positive, supporting the possibility of anti-ganglioside syndrome. This gentleman was treated with intravenous immunoglobulin (IVIG) and made a full recovery.

  4. Bilateral Facial Nerve Paralysis as First Presentation of Lung Cancer

    Directory of Open Access Journals (Sweden)

    Shadi Hamouri

    2016-11-01

    Full Text Available Leptomeningeal carcinomatosis is rare, and its precise incidence is unknown. It is associated with a wide spectrum of solid and hematological malignancies. To complicate its diagnosis, the clinical presentation of leptomeningeal carcinomatosis can be variable. We report a case of a 38-year-old male with bilateral facial nerve paralysis as first presentation of lung adenocarcinoma. To our knowledge, this is the only case describing bilateral facial nerve palsy as the first and only manifestation of lung adenocarcinoma.

  5. Bilateral Traumatic Anterior Dislocation of Shoulder – a rare entity

    Directory of Open Access Journals (Sweden)

    Yashavantha Kumar C

    2013-01-01

    Full Text Available Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislocation of shoulder without associated fracture in a 45 old women without any predisposing pathoanatomy.Case Report: A 45-year-old women presented to casualty with sudden onset of pain and restriction of movement in both shoulders fallowing trauma. Immediately post trauma she had severe pain and restriction of both shoulders. On examination arms were abducted and externally rotated. Bilateral shoulder movements were painful and restricted . There was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly. Radiological examination revealed bilateral anterior dislocation of the shoulders without any associated fractures. Closed reduction done by Milch technique after intraraticular lignocaine injection. MRI of bilateral shoulder showed no pathological lesion. Both shoulders were immobilized with a shoulder immobilizer for three weeks.Conclusion: Most of the bilateral shoulder dislocations are posterior type seen in seizure disorders. Bilateral traumatic anterior shoulder dislocations are rare and are seen as a result of unique mechanism of injury. In our case patient had a fall on her elbows causing forced extension. If diagnosed and treated promptly completely normal function of the shoulders can be restored.

  6. Prolapsed bilateral ureteroceles leading to intermittent outflow obstruction.

    LENUS (Irish Health Repository)

    Stunell, H

    2012-02-01

    A ureterocele refers to a cystic dilatation of the distal ureter. It may be unilateral or bilateral and may be associated with a duplex system in some cases. We present an unusual case where a young patient was found to have large bilateral ureteroceles which prolapsed into the urethra, causing intermittent incontinence and obstruction. We discuss the case and review the literature concerning this rare anomaly.

  7. Stage 4S Bilateral Adrenal Neuroblastoma in a Newborn

    Directory of Open Access Journals (Sweden)

    Rahul Gupta

    2014-02-01

    Full Text Available Stage 4S bilateral adrenal neuroblastoma presenting in the neonatal period is extremely rare. A 1-day-old male with 4S bilateral adrenal neuroblastoma complicated by marked hepatomegaly managed by chemotherapy is being reported. The provisional diagnosis of neuroblastoma was made in the fetal life during the last trimester of pregnancy. Cardiomyopathy due to doxorubicin cytotoxicity developed over ensuing years, which is being treated.

  8. Bilateral scleritis and sclerokeratitis associated with IgA nephropathy

    OpenAIRE

    Garza-Leon, Manuel; Flores, Diana; Alarcón-Galván, Gabriela; Sánchez-Martínez, Concepción

    2012-01-01

    Purpose The purpose of this study is to report a case of bilateral nodular scleritis in a patient with final diagnosis of IgA nephropathy. Methods This is an observational case report. Results A male patient, 42 years old, presented with a bilateral nodular scleritis and OD sclerokeratitis. He had a previous history of acute otitis media and developed posterior renal failure and arterial hypertension. Clinical and systemic findings suggest Wegener's granulomatosis. A kidney biopsy was perform...

  9. Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

    OpenAIRE

    Kaori Fujimoto; Miki Hiraoka; Shuichiro Inatomi; Hiroshi Ohguro

    2014-01-01

    Two female patients with histories of cancer who showed cryptogenic organizing pneumonia (COP) complications and bilateral anterior uveitis with hypopyon were examined. Both patients had suffered from COP and received intermitted systemic corticosteroid administration (SCA). The first patient, a 65-year-old woman with a history of breast cancer, showed bilateral uveitis with hypopyon. The topical corticosteroid treatment was ineffective. After SCA for the treatment of COP was started, the hyp...

  10. Bilateral ovarian fibromas in a young patient: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Shailja Puri Wahal

    2014-01-01

    Full Text Available Ovarian fibroma accounts for 4% of all ovarian tumors. The mean age of presentation is 48 years. Nearly 10% cases are seen in age less than 30 years. Bilateral fibromas occur in association with nevoid basal cell carcinoma syndrome (gorlin syndrome. We report a case of bilateral fibromas in a 22-year-old female patient with ascites without any evidence of nevoid basal cell carcinoma syndrome.

  11. Giant Bilateral Juvenile Fibroadenoma of the Breast in Prepubescent Girl.

    Science.gov (United States)

    Khan, Salma; Khan, Momna; Rafique, Sadia

    2015-10-01

    Juvenile fibroadenoma accounts for 4% of the total fibroadenomas. Giant juvenile fibroadenoma is found in only 0.5% of all fibroadenomas. The authors report a 10-year girl presenting with progressive enlargement of both breasts for one year. Based on clinical findings and Fine Needle Aspiration Cytology (FNAC), a diagnosis of bilateral giant juvenile fibroadenomas of breast was made. She underwent bilateral lumpectomy with breast conservation and made uneventful postoperative recovery.

  12. Amyad's hernia while reparing the bilateral inguinal hernia

    OpenAIRE

    Arif Aslaner; Tuğrul Çakır; Umut Rıza Gündüz; Burhan Mayir; Nurullah Bülbüller

    2015-01-01

    Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  13. Binaural integration abilities in bilateral cochlear implant user

    Institute of Scientific and Technical Information of China (English)

    Chie Obuchi; Masae Shiroma; Sayaka Ogane; Kimitaka Kaga

    2015-01-01

    Bilateral Cochlear implants (CIs) improved speech intelligibility, speech perception in background noise, and sound localization in quiet and noisy situations. However, it is unclear whether these advantages essentially result in binaural integration of acoustic stimuli from each ear. In this study, we investigated the effectiveness of binaural integration by bilateral CIs placement using binaural hearing tests and subjective auditory perceptual assessment. A 61-year-old bilateral CIs subject underwent the following four tests:the Japanese Hearing in Noise Test (HINT-J), the dichotic listening test (DLT), the Rapidly Alternating Speech Perception (RASP) test, and subjective auditory perceptual assessment. The HINT-J score was significantly higher for bilateral CIs than for a unilateral CI. However, DLT and the RASP test revealed contradictory results. Subjective auditory perceptual assessment revealed active and bright impressions for bilateral hearing, which were also noisy and strong compared with those for unilateral hearing. The results of this study revealed that bilateral CIs improved speech perception in background noise and an improved auditory impression, although the bilateral integration abilities were not improved. This was probably because the patient was required to combine information from the two ears into a single perception in DLT and the RASP test. More longitudinal data should be collected and analyzed in future studies to evaluate the long-term effects of bilateral CIs. Copyright © 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  14. Recurrent Bilateral Occipital Infarct with Cortical Blindness and Anton Syndrome

    OpenAIRE

    Kiu Kwong Yew; Sanihah Abdul halim; Ahmad Tajudin Liza-Sharmini; John Tharakan

    2014-01-01

    Bilateral cortical blindness and Anton syndrome, are most commonly caused by ischaemic stroke. In this condition, patients have loss of vision but deny their blindness despite objective evidence of visual loss. We report a case of a patient with multiple cardiovascular risk factors who developed recurrent bilateral occipital lobe infarct with Anton syndrome. A suspicion of this condition should be raised when the patient has denial of blindness in the presence of clinical and radiological evi...

  15. Bilateral keratocystic odontogenic tumor: A report of two cases.

    Science.gov (United States)

    Srivatsan, K S; Kumar, Vikas; Mahendra, Ashish; Singh, Preeti

    2014-01-01

    The designation "keratocyst" was used to describe any jaw cyst in which keratin was formed to a large extent. A rare incidence of bilateral mandibular cysts (odontogenic keratocysts) was related to third molar teeth. Herein, we report two cases of bilateral keratocystic odontogenic tumor in a 22-year-old male and 15-year-old female, which was diagnosed by a series of investigations and treated appropriately.

  16. Brain Stimulation Therapies

    Science.gov (United States)

    ... is preferred by many doctors, patients and families. Vagus Nerve Stimulation Vagus nerve stimulation (VNS) works through a device implanted under ... skin that sends electrical pulses through the left vagus nerve, half of a prominent pair of nerves that ...

  17. Feldspar, Infrared Stimulated Luminescence

    DEFF Research Database (Denmark)

    Jain, Mayank

    2014-01-01

    This entry primarily concerns the characteristics and the origins of infrared-stimulated luminescence in feldspars.......This entry primarily concerns the characteristics and the origins of infrared-stimulated luminescence in feldspars....

  18. An Overview of Stimulators

    OpenAIRE

    Mohd. Suhaib Kidwai; Mohd Maroof Siddiqui; Ahmad Nafees; Qazi saeed Ahmad

    2012-01-01

    This paper aims to bring forth the significance of stimulators , recent advancements in the field of stimulators and how electrical signals can be utilized for pain relief and to cure other diseases of human body ,by using stimulators. This paper aims to create awareness about stimulators and also focuses on their advantages as compared to theconventional medicine .Moreover,it also bring forth that how an electrical signal can be utilized for treating various human disorders and diseases.

  19. Sense of smell in patients with bilateral nasal polyposis

    Directory of Open Access Journals (Sweden)

    Savović Slobodan N.

    2004-01-01

    Full Text Available Introduction Sense of smell is susceptible to various changes, both in physiological and in numerous pathological conditions. Of quantitative disorders of smell, hyposmia and anosmia are quite common, whereas of qualitative disorders parosmia is most frequent. The aim of this paper was to examine impact of bilateral nasal polyposis on olfactory function. Material and methods The research was carried out at the Nose, Ear and Throat Clinic in Novi Sad. It included 80 examinees, 40 (20 male, 20 female with bilateral nasal polyposis, while 40 examinees belonged to the control group (20 male, 20 female without symptoms of nasal polyposes. Fortunato-Niccolini olfactometer was used for this examination. Results and discussion In patients with bilateral nasal polyposis the average perception threshold values for examined odors were 15.50 ccm of odorous air, while in the control group they were 10,20 ccm of odorous air. The average identification threshold values for examined odors in patients with bilateral nasal polyposis were 18.80 ccm of odorous air, while in the control group they were 13.55 ccm of scented air. T-test showed that values of both tresholds were statistically significantly higher (p< 0,01 in patients with bilateral nasal polyposis in relation to the control group. Conclusion Olfactory deficit in patients with bilateral nasal polyposis is explained by difficult or impossible passage of odors into the olfactory region.

  20. Bilateral Traumatic Globe Luxation with Optic Nerve Transection

    Directory of Open Access Journals (Sweden)

    Levent Tok

    2014-12-01

    Full Text Available Purpose: The purpose of this study was to document clinical findings and management of a patient with bilateral globe luxation and optic nerve transection. Materials and Methods: A 25-year-old female patient was admitted to the emergency department with bilateral traumatic globe luxation following a motor vehicle accident. Results: Visual acuity testing showed no light perception. The right pupil was dilated and bilaterally did not react to light. The globes were bilaterally intact. A computed tomography scan revealed Le Fort type II fractures, bilateral optic nerve transection and disruption of all extraocular muscles. The globes of the patient were bilaterally reduced into the orbit. However, the patient developed phthisis bulbi in the right eye at month 3. Conclusion: Globe luxation presents a dramatic clinical picture, and may lead to the development of severe complications due to the concomitance of complete optic nerve dissection and multiple traumas. Even if the luxated globe is repositioned into the orbit, there is still an increased risk of the development of phthisis due to ischemia.

  1. The effect of Hegu acupoint stimulation in dental acupuncture analgesia

    Directory of Open Access Journals (Sweden)

    Fransiskus Andrianto

    2007-03-01

    Full Text Available In daily life, dental treatments are often related with oral pain sensation which needs anesthesia procedures. Sometimes local anesthetics can not be used because patients have hypersensitive reaction or systemic diseases which may lead to complications. Stimulating acupoint, such as Hegu activates hypothalamus and pituitary gland to release endogenous opioid peptide substances that reduce pain sensitivity. The aim of the study was to determine Hegu acupoint stimulation effect on the pain sensitivity reduction in maxillary central incisor gingiva. The laboratory experimental research was conducted on 12 healthy male Wistar rats (3 months old, weights 150–200 grams. All rat samples received the same treatments and adapted within 1 month. The research was done in pre and post test control group design. 40-Volt electro-stimulation was done once on the maxillary central incisor gingiva prior to the bilateral Hegu acupoint stimulation, then followed by 3 times electro-stimulation with 3 minutes intervals. The pain scores were obtained based on the samples’ contraction in each electro-stimulation. The responses were categorized into 5 pain scores and statistically analyzed using Wilcoxon Test. The results showed that Hegu acupoint stimulation lowered the pain scores significantly (p < 0.05. Hegu acupoint stimulation could reduce the pain sensitivity in maxillary central incisor gingiva. Therefore, the use of acupuncture analgesia in dental pain management can be considered in the future.

  2. Transcranial direct current stimulation of the prefrontal cortex increases attention to visual target stimuli.

    Science.gov (United States)

    Vierheilig, Nina; Mühlberger, Andreas; Polak, Thomas; Herrmann, Martin J

    2016-10-01

    Both functional imaging or EEG studies and studies including neurological patients found the dorsolateral prefrontal cortex (dLPFC) to be an important brain area for the processing of emotion and attention. The aim of the present study was to investigate whether emotion and attention can be modulated through bilateral transcranial direct current stimulation (tDCS) of the dLPFC. Therefore, we measured electroencephalographic occipital (early posterior negativity, EPN) and parietal ERPs (late positive potential, LPP) during an emotional picture viewing paradigm with an additional attentional instruction while applying bilateral anodal and cathodal tDC-stimulation to the left and right dLPFC. Beyond the well-known emotion and attention effects for both EPN and LPP, we found that left cathodal/right anodal tDCS leads to increased LPP amplitudes to target stimuli. In contrast to our hypothesis bilateral tDCS over the dLPFC did not influence emotional processing.

  3. Technical recommendations for bilateral comparison in diagnosis radiology: part 1; Protocolo tecnico da comparacao bilateral em radiologia diagnostica: parte 1

    Energy Technology Data Exchange (ETDEWEB)

    Peixoto, J.G.P., E-mail: guilherm@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Almeida, C.E.V. de [Universidade do Estado do Rio de Janeiro (LCR/IBRAG/UERJ), Rio de Janeiro, RJ (Brazil). Lab. de Ciencias Radiologicas

    2015-07-01

    By data from www.datasus.gov.br, then need each diagnostic quality dissemination should be periodically verify, therefore the bilateral comparison between calibration laboratory will be mandatory to quality services guarantee. (author)

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

    DEFF Research Database (Denmark)

    Brock, C; Brock, B; Aziz, Q

    2016-01-01

    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...

  5. Subthalamic Nucleus Deep Brain Stimulation Changes Velopharyngeal Control in Parkinson's Disease

    Science.gov (United States)

    Hammer, Michael J.; Barlow, Steven M.; Lyons, Kelly E.; Pahwa, Rajesh

    2011-01-01

    Purpose: Adequate velopharyngeal control is essential for speech, but may be impaired in Parkinson's disease (PD). Bilateral subthalamic nucleus deep brain stimulation (STN DBS) improves limb function in PD, but the effects on velopharyngeal control remain unknown. We tested whether STN DBS would change aerodynamic measures of velopharyngeal…

  6. Bilateral connectivity in the somatosensory region using near-infrared spectroscopy (NIRS) by wavelet coherence

    Science.gov (United States)

    Fernandez Rojas, Raul; Huang, Xu; Ou, Keng-Liang

    2016-12-01

    Near-infrared spectroscopy (NIRS) has been used in medical imaging to obtain oxygenation and hemodynamic response in the cerebral cortex. This technique has been applied in cortical activation detection and functional connectivity in brain research. Despite some advances in functional connectivity, most of the studies have focused on the prefrontal cortex and little has been done to study the somatosensory region (S1). For that reason, the aim of our present study is to assess bilateral connectivity in the somatosensory region by using NIRS and noxious stimulation. Eleven healthy subjects were investigated using near-infrared spectroscopy during an acupuncture stimulation procedure to safely induce pain in subjects. A multiscale analysis based on wavelet transform coherence (WTC) was designed to assess the functional connectivity of corresponding channel pairs within the left and right s1 region. The cortical activation in the somatosensory region was higher after the acupuncture stimulation, which was consistent with similar studies. The coherence in time-frequency domain between homologous signals generated by contralateral channel pairs revealed two main periods (3.2 s and 12.8 s) with high coherence. Based on the WTC analysis, it was also found that the coherence increase in these periods was task-related. This study contributes to the research field to investigate cerebral hemodynamic response of pain perception using NIRS and demonstrates the use of wavelet transform as a method to investigate functional lateralization in the cerebral cortex.

  7. Bilateral naso labial cyst: report of two cases; Cisto nasolabial bilateral: relato de dois casos

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Rodrigo de; Haetinger, Rainer Guilherme [Hospital Beneficencia Portuguesa de Sao Paulo, SP (Brazil). Med Imagem; Sales, Marcelo Augusto Oliveira [Universidade Federal da Paraiba (UFPB), Joao Pessoa, PB (Brazil). Hospital Universitario Lauro Wanderley; Fonseca, Luciana Cardoso [Pontificia Universidade Catolica de Belo Horizonte, MG (Brazil). Faculdade de Odontologia; Cavalcanti, Marcelo Gusmao Paraiso [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Estomatologia]. E-mail: mgpcaval@usp.br

    2007-07-01

    The nasolabial cyst is defined as nonodontogenic soft tissue lesion, rare and with occurrence in sagittal plane, between midline and nasal cartilage. Because its soft tissue composition, there is no radiographic presentation in conventional radiographic examination, being indicated evaluation through computed tomography and magnetic resonance imaging. In the present study, two cases are discussed, being one in white female subject, 72-year-old, and other in a black male subject, 24-year-old. The authors discuss about relevant aspects related to differential diagnosis through computed tomography and magnetic resonance imaging, as well as atypical features founded in one of the cases, like bilateral occurrence with different signal intensity in magnetic resonance imaging and determinant factors for differential diagnosis of soft tissues pathologies of maxillofacial complex, as fissure cysts with central occurrence (sagittal cysts), as dermoid cysts, palatine and nasopalatine and lateral fissure cysts. (author)

  8. Different Perception of Musical Stimuli in Patients with Monolateral and Bilateral Cochlear Implants

    Directory of Open Access Journals (Sweden)

    Anton Giulio Maglione

    2014-01-01

    Full Text Available The aim of the present study is to measure the perceived pleasantness during the observation of a musical video clip in a group of cochlear implanted adult patients when compared to a group of normal hearing subjects. This comparison was performed by using the imbalance of the EEG power spectra in alpha band over frontal areas as a metric for the perceived pleasantness. Subjects were asked to watch a musical video clip in three different experimental conditions: with the original audio included (Norm, with a distorted version of the audio (Dist, and without the audio (Mute. The frontal EEG imbalance between the estimated power spectra for the left and right prefrontal areas has been calculated to investigate the differences among the two populations. Results suggested that the perceived pleasantness of the musical video clip in the normal hearing population and in the bilateral cochlear implanted populations has similar range of variation across the different stimulations (Norm, Dist, and Mute, when compared to the range of variation of video clip’s pleasantness for the monolateral cochlear implanted population. A similarity exists in the trends of the perceived pleasantness across the different experimental conditions in the mono- and bilaterally cochlear implanted patients.

  9. Secondary bilateral synchrony due to fronto-mesial lesions: an invasive recording study

    Directory of Open Access Journals (Sweden)

    CUKIERT ARTHUR

    1999-01-01

    Full Text Available Frontal lobe epilepsies may present difficulties in focus localization in the pre-operative work-up for epilepsy surgery. This is specially true in patients with normal MRIs. We report on a 16 years-old girl that started with seizures by the age of 8 years. They were brief nocturnal episodes with automatisms such as bicycling and boxing. Seizure frequency ranged from 4-10 per night. Scalp EEG showed few right frontal convexity spiking and intense secondary bilateral syncrhony (SBS. High resolution MRI directed to the frontal lobes was normal. Ictal SPECT suggested a right fronto-lateral focus. Ictal video-EEG showed no focal onset. She was submitted to invasive recordings after subdural plates implantation. Electrodes covered all the frontal convexity and mesial surface bilaterally. Ictal recordings disclosed stereotyped seizures starting from the right mesial frontal. Using a high-resolution tool to measure intra and interhemispheric latencies, the timing and direction of seizure spread from the right fronto-mesial region were studied. Motor strip mapping was performed by means of electrical stimulation. She was submitted to a right frontal lobe resection, 1.5 cm ahead of the motor strip and has been seizure free since surgery (8 months. Pathological examination found a 4 mm area of cortical dysplasia. Invasive studies are needed to allow adequate localization in patients with non-localizatory non-invasive work-up and may lead to excellent results in relation to seizures after surgery.

  10. Single-Session Radiofrequency Ablation of Bilateral Lung Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Palussiere, Jean, E-mail: palussiere@bergonie.org; Gomez, Fernando; Cannella, Matthieu; Ferron, Stephane; Descat, Edouard [Institut Bergonie, Department of Radiology, Regional Cancer Centre (France); Fonck, Marianne [Institut Bergonie, Department of Digestive Oncology (France); Brouste, Veronique [Institut Bergonie, Clinical and Epidemiological Research Unit (France); Avril, Antoine [Institut Bergonie, Department of Surgery (France)

    2012-08-15

    Purpose: This retrospective study examined the feasibility and efficacy of bilateral lung radiofrequency ablation (RFA) performed in a single session. Methods: From 2002-2009, patients with bilateral lung metastases were treated by RFA, where possible in a single session under general anesthesia with CT guidance. The second lung was punctured only if no complications occurred after treatment of the first lung. Five lung metastases maximum per patient were treated by RFA and prospectively followed. The primary endpoint was the evaluation of acute and delayed complications. Secondary endpoints were calculation of hospitalization duration, local efficacy, median survival, and median time to tumor progression. Local efficacy was evaluated on CT or positron emission tomography (PET) CT. Results: Sixty-seven patients were treated for bilateral lung metastases with RFA (mean age, 62 years). Single-session treatment was not possible in 40 due to severe pneumothoraces (n = 24), bilateral pleural contact (n = 14), and operational exclusions (n = 2). Twenty-seven (41%) received single-session RFA of lesions in both lungs for 66 metastases overall. Fourteen unilateral and four bilateral pneumothoraces occurred (18 overall, 66.7%). Unilateral (n = 13) and bilateral (n = 2) chest tube drainage was required. Median hospitalization was 3 (range, 2-8) days. Median survival was 26 months (95% confidence interval (CI), 19-33). Four recurrences on RFA sites were observed (4 patients). Median time to tumor progression was 9.5 months (95% CI, 4.2-23.5). Conclusions: Although performing single-session bilateral lung RFA is not always possible due to pneumothoraces after RFA of first lung, when it is performed, this technique is safe and effective.

  11. Safety of bilateral total knee arthroplasty in morbidly obese patients.

    Science.gov (United States)

    Madsen, Adam A; Taylor, Benjamin C; Dimitris, Craig; Hansen, Dane C; Steensen, Robert A; Gaines, Stephen T

    2014-03-01

    There has been an increase in the prevalence of morbid obesity and the demand for total knee arthroplasty (TKA). Physicians must help patients with bilateral knee arthritis to make informed decisions regarding whether to undergo staged, sequential, or simultaneous TKA. The purpose of this study was to evaluate the perioperative complications of 2-team simultaneous bilateral TKA in the morbidly obese. The authors performed a retrospective review of the records at a single tertiary hospital from 1997 to 2007 and identified 35 morbidly obese (body mass index [BMI] greater than 40 kg/m(2)) patients who had undergone unilateral TKA, as well as 42 morbidly obese and 79 nonobese (BMI less than 30 kg/m(2)) patients who underwent simultaneous bilateral TKA. Clinical, operative, and postoperative variables and complication rates were recorded. Clinical variables were similar between the morbidly obese TKA patients. The bilateral group had significantly increased operative times (132.4 vs 115.5 minutes; P<.01), intravenous fluids (2556.1 vs 2114.7 mL; P=.03), percentage transfused (64.2% vs 11.4%; P<.01), days in the hospital (3.6 vs 3.2 days; P=.03), and discharge rates to rehabilitation facility (72.7% vs 48.6%; P=.01). Major and minor complications were few and comparable, with the need for manipulation under anesthesia in unilateral TKA (11.4%; P=.04) as the only significant difference between groups, including when comparing bilateral nonobese TKAs with bilateral morbidly obese TKAs. The authors feel that morbidly obese patients may undergo 2-team simultaneous bilateral TKA after careful discussion regarding some of the differences in short-term outcomes.

  12. Altered resting-state functional connectivity in patients with chronic bilateral vestibular failure

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    Martin Göttlich

    2014-01-01

    Using whole brain resting-state connectivity analysis in BVF patients we show that enduring bilateral deficient or missing vestibular input leads to changes in resting-state connectivity of the brain. These changes in the resting brain are robust and task-independent as they were found in the absence of sensory stimulation and without a region-related a priori hypothesis. Therefore they may indicate a fundamental disease-related change in the resting brain. They may account for the patients' persistent deficits in visuo-spatial attention, spatial orientation and unsteadiness. The relation of increasing connectivity in the inferior parietal lobe, specifically SMG, to improvement of VOR during active head movements reflects cortical plasticity in BVF and may play a clinical role in vestibular rehabilitation.

  13. Bilateral external and internal pudendal veins embolization treatment for venogenic erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Daniel Lee, BBA, BS

    2017-03-01

    Full Text Available Erectile dysfunction (ED or impotence is estimated to affect around 20-30 million men in the United States (Rhoden et al, 2002. Vascular etiology is purported to be the most prevalent cause of ED in the elderly population, with venogenic ED being the most common subtype (Shafik et al, 2007; Rebonato et al, 2014. A patient, who developed severe venogenic ED, was referred to interventional radiology after ineffective pharmaceutical treatments. Selective embolization of bilateral external and internal pudendal veins was performed through accessing the deep dorsal vein of penis. Subsequent venogram verified successful embolization with stasis within the outflow of the deep dorsal vein of penis. Close to 6 weeks after the procedure, the patient purports to be able to achieve approximately 65% of full penile erection and complete penile erection with penile stimulation and 0.25 mL injection of alprostadil after 25 minutes.

  14. Tractography patterns of subthalamic nucleus deep brain stimulation.

    Science.gov (United States)

    Vanegas-Arroyave, Nora; Lauro, Peter M; Huang, Ling; Hallett, Mark; Horovitz, Silvina G; Zaghloul, Kareem A; Lungu, Codrin

    2016-04-01

    Deep brain stimulation therapy is an effective symptomatic treatment for Parkinson's disease, yet the precise mechanisms responsible for its therapeutic effects remain unclear. Although the targets of deep brain stimulation are grey matter structures, axonal modulation is known to play an important role in deep brain stimulation's therapeutic mechanism. Several white matter structures in proximity to the subthalamic nucleus have been implicated in the clinical benefits of deep brain stimulation for Parkinson's disease. We assessed the connectivity patterns that characterize clinically beneficial electrodes in Parkinson's disease patients, after deep brain stimulation of the subthalamic nucleus. We evaluated 22 patients with Parkinson's disease (11 females, age 57 ± 9.1 years, disease duration 13.3 ± 6.3 years) who received bilateral deep brain stimulation of the subthalamic nucleus at the National Institutes of Health. During an initial electrode screening session, one month after deep brain stimulation implantation, the clinical benefits of each contact were determined. The electrode was localized by coregistering preoperative magnetic resonance imaging and postoperative computer tomography images and the volume of tissue activated was estimated from stimulation voltage and impedance. Brain connectivity for the volume of tissue activated of deep brain stimulation contacts was assessed using probabilistic tractography with diffusion-tensor data. Areas most frequently connected to clinically effective contacts included the thalamus, substantia nigra, brainstem and superior frontal gyrus. A series of discriminant analyses demonstrated that the strength of connectivity to the superior frontal gyrus and the thalamus were positively associated with clinical effectiveness. The connectivity patterns observed in our study suggest that the modulation of white matter tracts directed to the superior frontal gyrus and the thalamus is associated with favourable clinical

  15. Firing patterns and correlations of spontaneous discharge of pallidal neurons in the normal and the tremulous 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine vervet model of parkinsonism.

    Science.gov (United States)

    Raz, A; Vaadia, E; Bergman, H

    2000-11-15

    To investigate the role of the basal ganglia in parkinsonian tremor, we recorded hand tremor and simultaneous activity of several neurons in the external and internal segments of the globus pallidus (GPe and GPi) in two vervet monkeys, before and after systemic treatment with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and development of parkinsonism with tremor of 5 and 11 Hz. In healthy monkeys, only 11% (20/174) of the GPe cells and 3% (1/29) of the GPi cells displayed significant 3-19 Hz oscillations. After MPTP treatment, 39% (107/271) of the GPe cells and 43% (26/61) of the GPi cells developed significant oscillations. Oscillation frequencies of single cells after MPTP treatment were bimodally distributed around 7 and 13 Hz. For 10% of the oscillatory cells that were recorded during tremor periods, there was a significant tendency for the tremor and neuronal oscillations to appear simultaneously. Cross-correlation analysis revealed a very low level of correlated activity between pallidal neurons in the normal state; 95.6% (477/499) of the pairs were not correlated, and oscillatory cross-correlograms were found in only 1% (5/499) of the pairs. After MPTP treatment, the correlations increased dramatically, and 40% (432/1080) of the cross-correlograms had significant oscillations, centered around 13-14 Hz. Phase shifts of the cross-correlograms of GPe pairs, but not of GPi, were clustered around 0 degrees. The results illustrate that MPTP treatment changes the pattern of activity and synchronization in the GPe and GPi. These changes are related to the symptoms of Parkinson's disease and especially to the parkinsonian tremor.

  16. Bilateral Ramsay Hunt syndrome in a diabetic patient

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    Goyal Amit

    2004-12-01

    Full Text Available Abstract Background Herpes zoster oticus accounts for about 10% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in immunocompromised patients, though incidence is very rare. Case presentation Diabetic male, 57 year old presented to us with bilateral facial palsy due to herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural hearing loss. Patient was treated with appropriate metabolic control, anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, glucocorticoids were not used in this patient. Significant improvement in hearing status and facial nerve functions were seen in this patient. Conclusions Herpes zoster causes severe infections in diabetic patients and can be a cause of bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in diabetic patients should be treated with appropriate metabolic control, NSAIDS and intravenous acyclovir, which we feel should be started at the earliest. Glucocorticoids should be avoided in diabetic patients.

  17. Directional bilateral filters for smoothing fluorescence microscopy images

    Directory of Open Access Journals (Sweden)

    Manasij Venkatesh

    2015-08-01

    Full Text Available Images obtained through fluorescence microscopy at low numerical aperture (NA are noisy and have poor resolution. Images of specimens such as F-actin filaments obtained using confocal or widefield fluorescence microscopes contain directional information and it is important that an image smoothing or filtering technique preserve the directionality. F-actin filaments are widely studied in pathology because the abnormalities in actin dynamics play a key role in diagnosis of cancer, cardiac diseases, vascular diseases, myofibrillar myopathies, neurological disorders, etc. We develop the directional bilateral filter as a means of filtering out the noise in the image without significantly altering the directionality of the F-actin filaments. The bilateral filter is anisotropic to start with, but we add an additional degree of anisotropy by employing an oriented domain kernel for smoothing. The orientation is locally adapted using a structure tensor and the parameters of the bilateral filter are optimized for within the framework of statistical risk minimization. We show that the directional bilateral filter has better denoising performance than the traditional Gaussian bilateral filter and other denoising techniques such as SURE-LET, non-local means, and guided image filtering at various noise levels in terms of peak signal-to-noise ratio (PSNR. We also show quantitative improvements in low NA images of F-actin filaments.

  18. Bilateral Traumatic Intracranial Hematomas and its Outcome: a Retrospective Study.

    Science.gov (United States)

    Pandey, Sharad; Sharma, Vivek; Singh, Kulwant; Pandey, Deepa; Sharma, Mukesh; Patil, Deepak Bhanudas; Shende, Neeraj; Chauhan, Richa Singh

    2017-02-01

    The objective of this study was to evaluate the age distribution, mode of injury, type of hematomas, and their surgical outcome in patients with bilateral traumatic head injuries. The present study included 669 cases of traumatic head injury who presented at the neurosurgery emergency out of which 94 cases had bilateral head injuries from the period of August 2009 to April 2014. The data from the hospital computerized database were retrospectively analysed. Cases of bilateral traumatic head injury included 94 patients out of which 88.29 % (n = 83) were males and 11.70 % (n = 11) were females. Commonest mode of injury was road traffic accident in 56.38 % (n = 53) followed by fall from height in 29.78 % (n = 28). In our study, 25.53 % patients had epidural hematoma (EDH) with intracerebral hematoma (ICH) or contusion (n = 24), followed by EDH with subarachnoid hemorrhage (SAH) in 18.08 % (n = 17). At the time of discharge, all those patients managed conservatively had good Glasgow outcome scale (GOS) while with surgical intervention 58 % patients had good GOS, 19 % had moderate disability, and 9 % remained with severe disability. In cases of bilateral hematomas, EDH is most common and should be managed in neurosurgical emergency. Other combinations of bilateral intracranial hematomas should be managed according to the surgical indication and serial CT imaging.

  19. Bilateral implantation in children with cochleovestibular nerve hypoplasia.

    Science.gov (United States)

    Oker, N; Loundon, N; Marlin, S; Rouillon, I; Leboulanger, N; Garabédian, E N

    2009-10-01

    To report on the outcomes of sequential bilateral cochlear implantation (CI) in children with inner ear malformation. The study design is a retrospective case study. The setting is a tertiary reference center. Two children presenting a profound bilateral congenital hearing loss with bilateral hypoplasia of the cochleovestibular nerves and hypoplasic external semicircular canal had a cochlear implant at respectively 16 months and 33 months. A second implant was proposed at respectively 17 and 20 months after the first implant. The main outcome measures are audiometry, perceptive results in closed and open set words (CSW and OSW) and oral production at follow-up. The first cochlear implant gave respectively mean thresholds at 60 dB and 70 dB. Bilateral CI showed mean threshold at respectively 40 dB and 55 dB. In case 1, perceptive assessment was 83% and 70% in respectively CSW and OSW with oral production and comprehension of sentences after 1 year follow-up. In case 2, the perceptive assessment showed no perceptive or linguistic evolution at 6 months follow-up. In cochleovestibular nerve hypoplasia, bilateral implantation could be discussed in cases of limited result after unilateral implant.

  20. Stimulation of contacts in ventral but not dorsal subthalamic nucleus normalizes response switching in Parkinson's disease.

    Science.gov (United States)

    Greenhouse, Ian; Gould, Sherrie; Houser, Melissa; Aron, Adam R

    2013-06-01

    Switching between responses is a key executive function known to rely on the frontal cortex and the basal ganglia. Here we aimed to establish with greater anatomical specificity whether such switching could be mediated via different possible frontal-basal-ganglia circuits. Accordingly, we stimulated dorsal vs. ventral contacts of electrodes in the subthalamic nucleus (STN) in Parkinson's patients during switching performance, and also studied matched controls. The patients underwent three sessions: once with bilateral dorsal contact stimulation, once with bilateral ventral contact stimulation, and once Off stimulation. Patients Off stimulation showed abnormal patterns of switching, and stimulation of the ventral contacts but not the dorsal contacts normalized the pattern of behavior relative to controls. This provides some of the first evidence in humans that stimulation of dorsal vs. ventral STN DBS contacts has differential effects on executive function. As response switching is an executive function known to rely on prefrontal cortex, these results suggest that ventral contact stimulation affected an executive/associative cortico-basal ganglia circuit.

  1. A Rare Devastating Complication of Lasik: Bilateral Fungal Keratitis

    Directory of Open Access Journals (Sweden)

    H. Taylan Sekeroglu

    2010-01-01

    Full Text Available Purpose. To report an unusual case of severe bilateral fungal keratitis following laser in situ keratomileusis (LASIK. Method. A 48-year-old man developed bilateral diffuse corneal infiltration two weeks after LASIK. The corneal scrapings revealed fungal filaments but cultures were negative. Results. The corneal ulceration was improved on the left eye whereas spontaneous perforation occurred and finally evisceration was needed on the right eye despite topical and systemic antifungal treatment. Conclusions. Fungal keratitis, especially with bilateral involvement, is a very rare and serious complication of LASIK surgery. Clinical suspicion is crucial because most of fungal keratitis are misdiagnosed as bacterial keratitis and can lead serious visual results, even eye loss.

  2. Catastrophic Antiphospholipid Syndrome Presenting as Bilateral Central Retinal Artery Occlusions

    Directory of Open Access Journals (Sweden)

    Steven S. Saraf

    2015-01-01

    Full Text Available A previously healthy 22-year-old African American woman presented with bilateral vision loss associated with headache. Her ocular examination was significant for bilateral retinal arterial “boxcarring,” retinal whitening, retinal hemorrhages, and cherry red spots. She was diagnosed with bilateral central retinal artery occlusions and was hospitalized due to concomitant diagnosis of stroke and hypercoagulable state. She was also found to be in heart failure and kidney failure. Rheumatology was consulted and she was diagnosed with catastrophic antiphospholipid syndrome in association with systemic lupus erythematosus. Approximately 7 months after presentation, the patient’s vision improved and remained stable at 20/200 and 20/80.

  3. Introduction of a Case of Bilateral Pheochromocytoma Tumor

    Directory of Open Access Journals (Sweden)

    M Zare

    2009-01-01

    Full Text Available Summary: Pheochromocytoma is an adrenal tumor characterized by symptoms of hypertension, headache, increased sweating, and tachycardia .In one third of patients, the tumor is discovered incidentally during radiological evaluation of the abdomen. In this article a case of bilateral pheochromocytoma is reported. The patient, a twelve years old boy, referred with complaints of headache, flushing, palpitation and blurring of vision. He had a blood pressure of 200/120 mmHg and after investigation, coarctation of aorta was excluded. On abdominal ultrasound, bilateral adrenal mass was diagnosed, followed by serial measurements of urinary vanillyl mandellic acid (VMA which was found to be elevated. Meta- Iodio benzyl glunidin (MIBG scan showed increased uptake in both adrenals. Patient underwent laparotomy and bilateral adrenalectomy with the diagnosis of pheochromocytoma. Pathologic report confirmed the diagnosis

  4. BILATERAL HYDRONEPHROSIS IN A SUGAR GLIDER (PETAURUS BREVICEPS).

    Science.gov (United States)

    Cusack, Lara; Schnellbacher, Rodney; Howerth, Elizabeth W; Jiménez, David A; Mayer, Joerg; Divers, Stephen

    2016-09-01

    An adult, intact male sugar glider ( Petaurus breviceps ) presented for acute caudal abdominal swelling. Treatment by the referring veterinarian included aspiration of urine from the swelling. On physical examination, mild depression, pale mucus membranes, and caudal abdominal swelling were noted. Focused ultrasonographic assessment revealed a fluid-filled caudal abdominal structure and subjective bladder wall thickening. The following day, the sugar glider was severely depressed. Hematology results included hypoglycemia, hyperkalemia, hyponatremia, and azotemia. Ultrasonography revealed bilateral hydronephrosis and hydroureter. Despite supportive care, the animal died. Postmortem examination confirmed bilateral ureteral dilation, renal petechial hemorrhage, and dilation of the right renal pelvis. Submucosal edema, hemorrhage, and lymphoplasmacytic infiltration of the urinary bladder, ureters, and renal pelvises were noted. Hyperplasia of the urinary bladder and ureteral epithelium, coupled with inflammation, may have caused functional obstruction leading to bilateral hydronephrosis and hydroureter. This is the first reported case of hydronephrosis in a marsupial.

  5. Surgical management of bilateral bronchiectases: results in 29 patients.

    Science.gov (United States)

    Aghajanzadeh, Manucher; Sarshad, Ali; Amani, Hosin; Alavy, Ali

    2006-06-01

    Bronchiectasis is a major cause of morbidity and mortality in developing countries. Staged bilateral segmental resection of the lungs is performed in selected patients. Our experience of surgical removal of 87 bilateral bronchiectases in 29 patients during an 11-year period was reviewed retrospectively. High-resolution computed tomography was performed preoperatively in all patients to locate the anatomic sites of bronchiectasis. The mortality and morbidity of the surgical procedure, clinical symptoms, age distribution, etiology, bacteriology, and operative procedures were analyzed. There were 22 males (76%) and 7 females (24%), aged 5 to 60 years, with a mean age of 30 years. Complications developed in 11 patients (38%); atelectasia was the most common (14%). There was one hospital death. Clinical symptoms disappeared in 19 (66%) patients, improved in 5 (17%), and were unchanged in 4 (14%). Staged bilateral resection for bronchiectases can be performed at any age with acceptable morbidity and mortality.

  6. Bilateral sudden sensorineural hearing loss in Staphylococcus aureus endocarditis.

    Science.gov (United States)

    Lau, Joanne Wai Ling; Ceranic, Borka; Harris, Robert; Timehin, Elwina

    2015-09-14

    This case highlights the diagnostic challenges in patients presenting with bilateral sudden sensorinueral hearing loss (SNHL). The aetiology of bilateral sudden SNHL may span several medical disciplines. Therefore, clinicians should be mindful of such presentations, and consider aetiologies beyond otological and neurological causes. We present a case of a previously healthy 51-year-old woman who presented with coryzal symptoms and sudden audiovestibular failure. Examination revealed fever, tachycardia, bilateral profound hearing loss and nystagmus. Following investigations, an initial working diagnosis of vasculitis was made. Later, blood cultures revealed methicillin-sensitive Staphylococcus aureus (MSSA) and a transoesophageal echocardiogram confirmed endocarditis. The patient made a good recovery, but the hearing loss was permanent and managed with a cochlear implant.

  7. Bilateral putaminal necrosis in a comatose patient with metabolic acidosis

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    Sudhir Kumar

    2016-01-01

    Full Text Available We present a case of acute-onset coma in a young woman, associated with metabolic acidosis, respiratory distress, and hypotension. Magnetic resonance imaging of the brain done on day 2 of admission showed features of bilateral putaminal necrosis. History of methanol ingestion, though not forthcoming at admission, was confirmed later after the patient regained consciousness. A final diagnosis of methyl alcohol toxicity resulting in severe metabolic acidosis, coma, and bilateral blindness was made. This case is reported to emphasize the point that the finding of bilateral putaminal necrosis in a patient with coma and metabolic acidosis is virtually diagnostic of methyl alcohol toxicity even in the absence of any positive history.

  8. Constipation following bilateral of internal iliac artery aneurysms

    Directory of Open Access Journals (Sweden)

    S Morita

    2012-09-01

    Full Text Available A 72-year-old man presented with constipation. He was hypertensive and suffered from chronic constipation. On arrival, the patient was fully conscious, and his vital signs were stable. He requested an enema because this treatment had proved effective in the past. On physical examination, a hard palpable mass was detected in the lower abdomen. Computed tomography was performed with contrast media. It revealed an abdominal aortic aneurysm (AAA and bilateral internal iliac artery aneurysms (IIAAs; the latter obstructing the sigmoid colon. We believe that this obstruction was the cause of constipation. The patient underwent Y-graft replacement for the treatment of the AAA and bilateral IIAAs. The surgery was successful, and constipation has not recurred since. As constipation is the most common digestive disorder in the general population, all physicians should be aware that chronic constipation can be caused by bilateral IIAAs.

  9. Permanent bilateral cortical blindness due to reversible posterior leukoencephalopathy syndrome.

    Science.gov (United States)

    Iwama, Mayumi; Takahashi, Hiroshi; Takagi, Ryo; Hiraoka, Miki

    2011-01-01

    Reversible posterior leukoencephalopathy syndrome (RPLS) is induced by acute cerebral edema. Its symptoms include seizures, headache, altered mental status, and visual disturbances. The clinical and radiological findings are usually transient. This report describes a case of RPLS resulting in bilateral total blindness. A 40-year-old man presented with lethargy and bilateral visual loss. He had a 20-year history of hypertension, but had never been treated. On presentation, the left eye was able to perceive light, but the right eye was not. Radiological examination showed diffuse edema in the brain, and ocular fundus examination revealed severe bilateral hypertensive retinopathy. Antihypertensive therapy improved the patient's general condition, including blood pressure. Radiological findings 5 months later showed resolution of most of the abnormal signal areas. However, total blindness had developed in both eyes by day 15, and two courses of pulsed corticosteroid therapy failed to restore the visual loss.

  10. Empirical Analysis of Xinjiang's Bilateral Trade: Gravity Model Approach

    Institute of Scientific and Technical Information of China (English)

    CHEN Xuegang; YANG Zhaoping; LIU Xuling

    2008-01-01

    Based on the basic trade gravity model and Xinjiang's practical situation, new explanatory variables (GDP,GDPpc and SCO) are introduced to build an extended trade gravity model fitting for Xinjiang's bilateral trade. Fromthe empirical analysis of this model, it is proposed that those three variables affect the Xinjiang's bilateral trade posi-tively. Whereas, geographic distance is found to be a significant factor influencing Xinjiang's bilateral trade negatively.Then, by the extended trade gravity model, this article analyzes the present trade situation between Xinjiang and itsmain trade partners quantitatively in 2004. The results indicate that Xinjiang cooperates with its most trade partnerssuccessfully in terms of present economic scale and developing revel. Xinjiang has established successfully trade part-nership with Central Asia, Central Europe and Eastern Europe, Western Europe, East Asia and South Asia. However,the foreign trade development with West Asia is much slower. Finally, some suggestions on developing Xinjiang's for-eign trade are put forward.

  11. Carcinoma bilateral do plexo coróide operado com sucesso Bilateral carcinoma of the choroid plexus operated successfully

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    Gilberto M. de Almeida

    1970-06-01

    Full Text Available Os autores não encontraram na literatura caso de carcinoma bilateral do plexo coróide operado com sucesso. O trabalho consta da apresentação de uma criança de 11 anos com carcinoma dos plexos coróides nos dois ventrículos laterais. São feitas considerações a respeito das dificuldades no diagnóstico, da importância dó estudo angiográfico completo e do tratamentoA case of bilateral carcinoma of the choroid plexus is reported. Bilateral carcinoma of the choroid plexus are very rare and the authors did not find in the literature a similar case operated sucessfully. The difficulties for dignosis are discussed. The possibility exists that in other cases with bilateral tumors a complete diagnosis is impossible if angiography is performed only in one side. Therefore, it is necessary to perform a bilateral angiographic study when a tumor of the choroid plexus is suspected. The surgical treatment and the mortality rate are also discussed.

  12. Sensory-motor transformations for speech occur bilaterally.

    Science.gov (United States)

    Cogan, Gregory B; Thesen, Thomas; Carlson, Chad; Doyle, Werner; Devinsky, Orrin; Pesaran, Bijan

    2014-03-01

    Historically, the study of speech processing has emphasized a strong link between auditory perceptual input and motor production output. A kind of 'parity' is essential, as both perception- and production-based representations must form a unified interface to facilitate access to higher-order language processes such as syntax and semantics, believed to be computed in the dominant, typically left hemisphere. Although various theories have been proposed to unite perception and production, the underlying neural mechanisms are unclear. Early models of speech and language processing proposed that perceptual processing occurred in the left posterior superior temporal gyrus (Wernicke's area) and motor production processes occurred in the left inferior frontal gyrus (Broca's area). Sensory activity was proposed to link to production activity through connecting fibre tracts, forming the left lateralized speech sensory-motor system. Although recent evidence indicates that speech perception occurs bilaterally, prevailing models maintain that the speech sensory-motor system is left lateralized and facilitates the transformation from sensory-based auditory representations to motor-based production representations. However, evidence for the lateralized computation of sensory-motor speech transformations is indirect and primarily comes from stroke patients that have speech repetition deficits (conduction aphasia) and studies using covert speech and haemodynamic functional imaging. Whether the speech sensory-motor system is lateralized, like higher-order language processes, or bilateral, like speech perception, is controversial. Here we use direct neural recordings in subjects performing sensory-motor tasks involving overt speech production to show that sensory-motor transformations occur bilaterally. We demonstrate that electrodes over bilateral inferior frontal, inferior parietal, superior temporal, premotor and somatosensory cortices exhibit robust sensory-motor neural

  13. Intermanual transfer and bilateral cortical plasticity is maintained in older adults after skilled motor training with simple and complex tasks

    Science.gov (United States)

    Dickins, Daina S. E.; Sale, Martin V.; Kamke, Marc R.

    2015-01-01

    Intermanual transfer refers to the phenomenon whereby unilateral motor training induces performance gains in both the trained limb and in the opposite, untrained limb. Evidence indicates that intermanual transfer is attenuated in older adults following training on a simple ballistic movement task, but not after training on a complex task. This study investigated whether differences in plasticity in bilateral motor cortices underlie these differential intermanual transfer effects in older adults. Twenty young (65 years) trained on a simple (repeated ballistic thumb abduction) and complex (sequential finger-thumb opposition) task in separate sessions. Behavioral performance was used to quantify intermanual transfer between the dominant (trained) and non-dominant (untrained) hands. The amplitude of motor-evoked potentials induced by single pulse transcranial magnetic stimulation was used to investigate excitability changes in bilateral motor cortices. Contrary to predictions, both age groups exhibited performance improvements in both hands after unilateral skilled motor training with simple and complex tasks. These performance gains were accompanied by bilateral increases in cortical excitability in both groups for the simple but not the complex task. The findings suggest that advancing age does not necessarily influence the capacity for intermanual transfer after training with the dominant hand. PMID:25999856

  14. Intermanual transfer and bilateral cortical plasticity is maintained in older adults after skilled motor training with simple and complex tasks.

    Science.gov (United States)

    Dickins, Daina S E; Sale, Martin V; Kamke, Marc R

    2015-01-01

    Intermanual transfer refers to the phenomenon whereby unilateral motor training induces performance gains in both the trained limb and in the opposite, untrained limb. Evidence indicates that intermanual transfer is attenuated in older adults following training on a simple ballistic movement task, but not after training on a complex task. This study investigated whether differences in plasticity in bilateral motor cortices underlie these differential intermanual transfer effects in older adults. Twenty young (65 years) trained on a simple (repeated ballistic thumb abduction) and complex (sequential finger-thumb opposition) task in separate sessions. Behavioral performance was used to quantify intermanual transfer between the dominant (trained) and non-dominant (untrained) hands. The amplitude of motor-evoked potentials induced by single pulse transcranial magnetic stimulation was used to investigate excitability changes in bilateral motor cortices. Contrary to predictions, both age groups exhibited performance improvements in both hands after unilateral skilled motor training with simple and complex tasks. These performance gains were accompanied by bilateral increases in cortical excitability in both groups for the simple but not the complex task. The findings suggest that advancing age does not necessarily influence the capacity for intermanual transfer after training with the dominant hand.

  15. Intermanual transfer and bilateral cortical plasticity is maintained in older adults after skilled motor training with simple and complex tasks

    Directory of Open Access Journals (Sweden)

    Daina S. E. Dickins

    2015-05-01

    Full Text Available Intermanual transfer refers to the phenomenon whereby unilateral motor training induces performance gains in both the trained limb and in the opposite, untrained limb. Evidence indicates that intermanual transfer is attenuated in older adults following training on a simple ballistic movement task, but not after training on a complex task. This study investigated whether differences in plasticity in bilateral motor cortices underlie these differential intermanual transfer effects in older adults. Twenty young (65 years trained on a simple (repeated ballistic thumb abduction and complex (sequential finger-thumb opposition task in separate sessions. Behavioral performance was used to quantify intermanual transfer between the dominant (trained and non-dominant (untrained hands. The amplitude of motor-evoked potentials (MEPs induced by single pulse transcranial magnetic stimulation (TMS was used to investigate excitability changes in bilateral motor cortices. Contrary to predictions, both age groups exhibited performance improvements in both hands after unilateral skilled motor training with simple and complex tasks. These performance gains were accompanied by bilateral increases in cortical excitability in both groups for the simple but not the complex task. The findings suggest that advancing age does not necessarily influence the capacity for intermanual transfer after training with the dominant hand.

  16. Bilateral Morgagni Hernia: A Unique Presentation of a Rare Pathology

    Directory of Open Access Journals (Sweden)

    Michael Leshen

    2016-01-01

    Full Text Available Morgagni hernia is an unusual congenital herniation of abdominal content through the triangular parasternal gaps of the anterior diaphragm. They are commonly asymptomatic and right-sided. We present a case of a bilateral Morgagni hernia resulting in delayed growth in a 10-month-old boy. The presentation was unique due to its bilateral nature and its symptomatic compression of the mediastinum. Diagnosis was made by 3D reconstructed CT angiogram. The patient underwent medical optimization until he was safely able to tolerate laparoscopic surgical repair of his hernia. Upon laparoscopy, the CT findings were confirmed and the hernia was repaired.

  17. Bilateral Morgagni Hernia: A Unique Presentation of a Rare Pathology.

    Science.gov (United States)

    Leshen, Michael; Richardson, Randy

    2016-01-01

    Morgagni hernia is an unusual congenital herniation of abdominal content through the triangular parasternal gaps of the anterior diaphragm. They are commonly asymptomatic and right-sided. We present a case of a bilateral Morgagni hernia resulting in delayed growth in a 10-month-old boy. The presentation was unique due to its bilateral nature and its symptomatic compression of the mediastinum. Diagnosis was made by 3D reconstructed CT angiogram. The patient underwent medical optimization until he was safely able to tolerate laparoscopic surgical repair of his hernia. Upon laparoscopy, the CT findings were confirmed and the hernia was repaired.

  18. Bilateral Control Using Master/Slave Simulator for Haptic Communication

    Science.gov (United States)

    Yokokura, Yuki; Katsura, Seiichiro; Ohishi, Kiyoshi

    A bilateral controller is used to transmit and share haptic information between a master system and a slave system. In a transmission system, the bilateral controller encounters problems in the event of data packet loss and/or disconnections. In this study, a master/slave simulator and environmental data memory are used to solve the problems. In the case of normal operation, the environmental data memory stores force data in a remote side. The control system is operated by the environmental data memory and master/slave simulator when the communication lines are disconnected.

  19. Cerebral potentials preceding unilateral and simultaneous bilateral finger movements.

    Science.gov (United States)

    Kristeva, R; Keller, E; Deecke, L; Kornhuber, H H

    1979-08-01

    Cerebral potentials preceding voluntary bilateral simultaneous finger movements were investigated in 19 right-handed young adult subjects, and were compared with unilateral right-sided finger m n the same experiment. With bilateral movements, the Bereitschaftspotential (BP) was not symmetrical or larger over the dominant hemisphere, but surprisingly, it was larger over the minor hemisphere. The BP averaged -3.66 microV (S.D. 1.96) over the left precentral region and -4.82 microV (S.D. 3.73) over the right precentral region in this condition. The difference was significant at 2P less than 0.01. This difference was pronounced in precentral leads but very small and almost missing in parietal leads. The pre-motion positivity (PMP) was well developed and even larger with bilateral than with unilateral (right-sides) movements. At the vertex it averaged +1.33 microV (S.D.4.16) with bilateral movements and only +0.15 microV (S.D. 1.42) with right-sided unilateral movements (2P less than 0.05). With bilateral movements the PMP could be observed in any record, but with unilateral movements it was missing at the left precentral lead, in accordance with previous publications (Deecke et al. 1969, 1976). The motor potential (MP), measured in a bipolar record from left and right precentral leads, was larger with unilateral (-1.25 microV, S.D. 1.33) than with bilateral movements (-0.36 microV, S.D. 0.92). Onset time differences of the BP preceding unilateral and bilateral movements were very small. However, there was a tendency towards earlier onset with unilateral than with bilateral movements (1031 msec, S.D. 358, as compared with 951 msec, S.D. 305). The averaged EMG revealed differences in movement onset. Muscular contraction tended to be earlier in the right than in the left m. flexor indicis in our right-handed subjects, on the average by 16 msec (S.D. 15). With unilateral right-sided movements, the left m. flexor indicis was not silent but showed an abortive mirror activity

  20. Double trouble: Bilateral cerebral involvement in Sturge-Weber syndrome

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    Narosha Adroos

    2015-03-01

    Full Text Available Sturge-Weber syndrome, also known as encephalotrigeminal angiomatosis or meningofacial angiomatosis, is characterised in its classical form by a congenital, usually unilateral, ‘portwine stain’ (capillary naevus on the face, convulsions, typical intracranial calcification and some degree of mental retardation and hemiparesis. The clinical correlation of intractable seizures with the presence of bilateral intracranial disease has management and prognostic implications, thus making the presence of bilateral disease an important factor to all those involved in the management of the child with Sturge-Weber syndrome.

  1. Bilateral nonunited femoral neck fracture in a child with osteopetrosis.

    Science.gov (United States)

    Steinwender, G; Hosny, G A; Koch, S; Grill, F

    1995-01-01

    We report a case of osteopetrosis with bilateral nonunited femoral neck and coxa vara in a 7-year-old boy. There was a history of traumatic transcervical left femoral neck fracture unsuccessfully treated by internal fixation. We performed a bilateral subtrochanteric valgus osteotomy. K-Wire fixation failed on the right side due to hardness of the bone. Finally, internal fixation with an angular plate after predrilling of the femoral neck offered stability. Bone union was achieved on both sides, resulting in full recovery of normal physical activity.

  2. Links between the Philippines and Spain: migration and bilateral relations

    Directory of Open Access Journals (Sweden)

    Rogelia Pe-Pua

    2005-01-01

    Full Text Available This paper analyses the implications which Spanish policy regarding foreign workers has on the living and working conditions of the Filipino community in Spain. The author pays special attention to bilateral relations between the Philippines and Spain in issues suchas Spanish investment in the Philippines, the trade balance between the two countries and labour relations. In conclusion the article considers the necessity of reaching a bilateral labour agreement which would be beneficial to both countries and which at the same time would improve the working conditions and the integration of Philippine nationals living in Spain.

  3. Bilateral hypoplasia of the internal carotid arteries with basilar aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Briganti, F.; Tortora, F.; Elefante, A. [Universita di Napoli Federico II, Dipartimento di Scienze Neurologiche, Cattedra di Neuroradiologia, 80131, Napoli (Italy); Maiuri, F. [Universita di Napoli Federico II, Department of Neurological Sciences, Neurosurgery Service, Napoli (Italy)

    2004-10-01

    We report a rare case of bilateral hypoplasia of the internal carotid arteries with an associated aneurysm of the basilar tip, studied by CT angiography, MR angiography and digital angiography. The patient became symptomatic with an episode of loss of consciousness, likely due to reduced blood perfusion. The other 20 reported cases of bilateral carotid hypoplasia (only four of which with an associated aneurysm) are reviewed. The findings of noninvasive procedures (including narrowing of the carotid canals on CT) may lead to a correct diagnosis before angiography is performed; they may also help to differentiate angiographic narrowing of the hypoplastic internal carotids from the string sign often observed in some acquired conditions. (orig.)

  4. Bilateral s-shaped kidneys: A rare congenital malformation

    Directory of Open Access Journals (Sweden)

    Nikhil Ranjan

    2015-01-01

    Full Text Available A bilateral S-shaped kidney is a rare anomaly in which both the kidneys are in their normal position, in contrast to the commonly reported S-shaped fusion anomaly, in which the contralateral kidney crosses the midline to fuse with opposite kidney leaving the ipsilateral renal fossa empty. Here we present the diagnosis and management of a case of bilateral S-shaped renal anomaly with associated left pelviureteric junction obstruction and nonfunctioning kidney and right renal stones. Left kidney was managed by open nephrectomy and right kidney by PNL.

  5. Fatal bilateral pneumothoraces following administration of aerosolised pentamidine.

    Science.gov (United States)

    Green, Alison; Milne, Nathan; Ong, Beng Beng

    2011-10-01

    Aerosolised pentamidine (AP) is used for prophylaxis against infection with Pneumocystis jiroveci (carinii), a significant cause of morbidity and mortality for people with human immunodeficiency virus (HIV). In this article we report a 55 year old man with HIV and a background history of asthma since childhood, who suffered respiratory arrest and died within an hour of commencing AP prophylaxis. Autopsy revealed bilateral pneumothoraces. Common side effects of AP therapy include bronchospasm and coughing. Pneumothorax has been reported in several cases. To our knowledge, this is the first reported fatality from bilateral pneumothoraces.

  6. Bilateral type of nevus of Ota presenting as agminated lentigines.

    Science.gov (United States)

    Kang, Hee Young; Kang, Won Hyoung

    2003-01-01

    We report a 30-year-old female patient with a history of hyperpigmented macules of the face since the age of 7 years. The clinical appearance, brown macules in multiple segmental or grouped patterns, was suggested to be agminated lentigines. However, histologic examination of the pigmented macule revealed scattered melanocytes within the dermis. We diagnosed this lesion as a bilateral type of nevus of Ota presenting as agminated lentigines. The differential diagnosis from acquired bilateral nevus of Ota-like macules was made.

  7. Recurrent Bilateral Occipital Infarct with Cortical Blindness and Anton Syndrome

    Directory of Open Access Journals (Sweden)

    Kiu Kwong Yew

    2014-01-01

    Full Text Available Bilateral cortical blindness and Anton syndrome, are most commonly caused by ischaemic stroke. In this condition, patients have loss of vision but deny their blindness despite objective evidence of visual loss. We report a case of a patient with multiple cardiovascular risk factors who developed recurrent bilateral occipital lobe infarct with Anton syndrome. A suspicion of this condition should be raised when the patient has denial of blindness in the presence of clinical and radiological evidence of occipital lobe injury. Management of this condition should focus on the underlying cause, in which our patient requires secondary stroke prevention and rehabilitation.

  8. A modified rat model of isolated bilateral pulmonary contusion

    OpenAIRE

    Wang, Shaohua; Ruan, Zheng; Jie ZHANG; ZHENG, JIN

    2012-01-01

    The aim of the present study was to create a feasible specific rat model of isolated bilateral pulmonary contusion (PC) and to evaluate the relationship between severity of hypoxemia and quantity of contusion lesions. Anesthetized rats were placed in a prone position. Injury energy ranging from 2.1 to 3.0 J was produced by a falling weight passed through a specially designed arched shield to the bilateral chest wall of rats. After injury (4 h), the contusion volume was measured using computer...

  9. Bilateral adrenal [corrected] nodules due to histoplasmosis in an elderly.

    Science.gov (United States)

    Carvalho, Flávio Pedreira de Freitas de; Curiati, José Antônio Esper; Mauad, Thaís; Incerti, Milena Mendes; Jacob Filho, Wilson

    2007-02-01

    We report a case history of an 84-year-old elderly male patient that presented with a clinical picture suggestive of adrenal failure and bilateral adrenal nodules detected by abdominal computed tomography. A fine needle-guided biopsy was inconclusive for achieving a final diagnosis. The patient died due to septic shock and the autopsy disclosed histoplasmosis with extensive bilateral necrosis of the adrenal glands. Although the adrenal involvement in chronic disseminated histoplasmosis has been described, there have been few reports of the infection being associated with adrenal insufficiency.

  10. Bilateral afrenal nodules due to histoplasmosis in an elderly

    Directory of Open Access Journals (Sweden)

    Flávio Pedreira de Freitas de Carvalho

    2007-02-01

    Full Text Available We report a case history of an 84-year-old elderly male patient that presented with a clinical picture suggestive of adrenal failure and bilateral adrenal nodules detected by abdominal computed tomography. A fine needle-guided biopsy was inconclusive for achieving a final diagnosis. The patient died due to septic shock and the autopsy disclosed histoplasmosis with extensive bilateral necrosis of the adrenal glands. Although the adrenal involvement in chronic disseminated histoplasmosis has been described, there have been few reports of the infection being associated with adrenal insufficiency.

  11. Bilateral renal infarction: an uncommon presentation of fibromuscular dysplasia.

    Science.gov (United States)

    Ayach, Taha; Kazory, Amir

    2013-12-01

    While fibromuscular dysplasia (FMD) is an established cause of secondary hypertension, its association with renal infarction is less well recognized. We report a middle-aged man who presented with complaints of loin pain and severe hypertension. Computed tomography angiography of the abdomen revealed bilateral renal infarction with multiple short-segment arterial dissection compatible with FMD in the absence of systemic vasculitis and other risk factors for thromboembolic events. Bilateral renal infarction complicating FMD is extremely rare and has so far been reported only in a handful of cases. Physicians encountering cases of otherwise unexplained renal infarction/ischemia need to be aware of this complication.

  12. Bilateral ectopic tubal pregnancy, following in vitro fertilisation (IVF.

    Directory of Open Access Journals (Sweden)

    Wojciech Grzybowski

    2010-01-01

    Full Text Available This is a case report of a 33 year-old-woman who underwent in vitro fertilization, because of primary infertility caused by fallopian tube factor. The patient underwent three trials of frozen embryo transfers (ET-CRYO. On the 26th day after the third probe of ET-CRYO she suffered from pelvic pain and vaginal bleeding. Transvaginal ultrasonographic scan revealed bilateral tubal ectopic pregnancy without fluid in the Douglas pouch and no gestational sac in the uterus. Laparoscopic bilateral salpingectomy was performed on the next day after admission. The postoperative course was uneventful.

  13. Bilateral lingual-facial trunk: anatomic and clinical implications.

    Science.gov (United States)

    Troupis, T; Michalinos, A; Kakisis, J; Natsis, K; Sofidis, G; Skandalakis, P

    2015-01-01

    Common origin of lingual and facial artery is a relatively frequent anatomic varia-tion. Instead, bilateral lingual-facial trunk has been described only sparsely in the literature. In this report authors describe and analyse a case of bilateral common lingual-facial trunk in the context of its anatomical, clinical and embryological implications. We also describe possible consequences in performance of elective and emergent surgical operations and modification in surgical techniques that should be considered. We believe that surgeons should be suspicious for this variation's existence and keep alternative solutions in their armentarium.

  14. Bilateral giant femoropopliteal artery aneurysms: a case report

    Directory of Open Access Journals (Sweden)

    Perdikides Theodossios P

    2008-04-01

    Full Text Available Abstract Introduction Popliteal artery aneurysms are the most common peripheral arterial aneurysms, and are frequently bilateral. Acute limb ischemia, rupture and compression phenomena can complicate these aneurysms when the diameter exceeds 2 cm. Case Presentation We report an 82-year-old male patient with two giant femoropopliteal aneurysms, 10.5 and 8.5 cm diameters, managed in our institution. Both aneurysms were resected and a polytetrafluoroethylene (PTFE femoropopliteal interposition graft was placed successfully. Management and literature review are discussed. Conclusion We believe this is the first report in the medical literature of bilateral giant femoropopliteal aneurysms.

  15. Bilateral macrostomia associated with aqueductal stenosis and glial heterotopias.

    Science.gov (United States)

    Pepe, Ernesto; Petricig, Paola; Peretta, Paola; Cinalli, Giuseppe

    2007-09-01

    We report on an Italian boy, born to normal and nonconsanguineous parents with a prenatal diagnosis of ventriculomegaly and subependymal glial heterotopias. At birth bilateral macrostomia was diagnosed without other evident facial anomalies. Magnetic resonance imaging (MRI) showed triventricular hydrocephalus and aqueductal stenosis and confirmed the nodules of glial heterotopia. The bilateral macrostomia was surgically corrected with the vermilion square flap method and W-plasty technique and follow up MRI at 6 months showed mild increase of ventricular dilatation without signs of active hydrocephalus. The association between macrostomia and hydrocephalus has been reported only in rare cases of complex malformative syndromes but never with isolated macrostomia.

  16. Recurrent bilateral occipital infarct with cortical blindness and anton syndrome.

    Science.gov (United States)

    Kwong Yew, Kiu; Abdul Halim, Sanihah; Liza-Sharmini, Ahmad Tajudin; Tharakan, John

    2014-01-01

    Bilateral cortical blindness and Anton syndrome, are most commonly caused by ischaemic stroke. In this condition, patients have loss of vision but deny their blindness despite objective evidence of visual loss. We report a case of a patient with multiple cardiovascular risk factors who developed recurrent bilateral occipital lobe infarct with Anton syndrome. A suspicion of this condition should be raised when the patient has denial of blindness in the presence of clinical and radiological evidence of occipital lobe injury. Management of this condition should focus on the underlying cause, in which our patient requires secondary stroke prevention and rehabilitation.

  17. Neuropsychiatric Outcome of an Adolescent Who Received Deep Brain Stimulation for Tourette's Syndrome

    Directory of Open Access Journals (Sweden)

    S. J. Pullen

    2011-01-01

    Full Text Available This case study followed one adolescent patient who underwent bilateral deep brain stimulation of the centromedian parafascicular complex (CM-Pf for debilitating, treatment refractory Tourette's syndrome for a period of 1.5 years. Neurocognitive testing showed no significant changes between baseline and follow-up assessments. Psychiatric assessment revealed positive outcomes in overall adaptive functioning and reduction in psychotropic medication load in this patient. Furthermore, despite significant baseline psychiatric comorbidity, this patient reported no suicidal ideation following electrode implantation. Deep brain stimulation is increasingly being used in children and adolescents. This case reports on the positive neurologic and neuropsychiatric outcome of an adolescent male with bilateral CM-Pf stimulation.

  18. Fascitis necrosante bilateral: a propósito de un caso Bilateral necrotizing fasciitis: case report

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    F. Fernández Gómez

    2011-06-01

    Full Text Available La fascitis necrosante es una enfermedad de origen infeccioso que afecta a la fascia muscular y progresa rápidamente. Para el manejo de este tipo de pacientes es clave un diagnóstico precoz y un tratamiento adecuado que combine antibioticoterapia y cirugía. Presentamos el caso de una paciente de 77 años de edad con diagnóstico de fascitis necrosante de presentación atípica por la bilateralidad de las lesiones, la ausencia de factores predisponentes y la presencia de un único germen causal.Necrotizing fasciitis is an infectious disease that involves muscular fascia and has a quickly progress. Early diagnosis and proper treatment that consists on antibiotic therapy and surgery are the key of patient management. We report the case of a 77 years old oman with necrotizing fasciitis diagnosis with atypical presentation due to bilateral skin lesions, lack of risk factors and only one germ as causal pathogen.

  19. Luxação glenoumeral anterior bilateral: caso clínico Bilateral anterior glenohumeral dislocation: clinical case

    Directory of Open Access Journals (Sweden)

    Luís Pires Silva

    2011-01-01

    Full Text Available A luxação glenoumeral anterior bilateral é uma ocorrência rara. Apresentamos um caso de luxação glenoumeral anterior bilateral com origem após uma queda da própria altura. O interesse desta publicação reside no fato de se tratar de uma raridade clínica com poucos casos descritos na literatura. Paciente do sexo feminino com 89 anos recorre ao serviço de urgência (SU após queda referindo dor intensa e incapacidade de mobilização de ambos os ombros. Ao exame objetivo apresentava sinais clínicos suspeitos de luxação glenoumeral anterior bilateral confirmados por radiografia. Ambas as luxações foram reduzidas no SU pela técnica de Milch modificada, com sucesso. Quando existe uma força simétrica e síncrona sobre os ombros e estes se apresentarem dolorosos e com limite funcional significativo, a suspeita de luxação glenoumeral bilateral, embora rara, é um diagnóstico diferencial a ter em conta.Bilateral anterior glenohumeral dislocation is a rare occurrence. We present a case of bilateral anterior glenohumeral dislocation caused by a fall. The interest in publishing this case is that this is a clinical rarity with few cases reported in the literature. An 89-year-old female patient was brought to the emergency department after a fall, complaining of intense pain in both shoulders and inability to move them. Objective examination showed clinical signs giving the suspicion of bilateral anterior glenohumeral dislocation, which was confirmed by x-ray imaging. Both dislocations were successfully reduced in the emergency department using the modified Milch technique. When a synchronous and symmetrical force has acted on both shoulders and these are painful with significant functional limitation, the suspicion of bilateral glenohumeral dislocation is a differential diagnosis to be considered, even though it is rare.

  20. [Late consequences of an early stimulation of the lateral hypothalamus on the acquisition and extinction of alimentary conditioning].

    Science.gov (United States)

    Velley, L; Cardo, B

    1976-04-26

    Male Sprague Dawley rats received at 13 days of age bilaterally implanted electrodes in lateral hypothalamus. At 15th and 16th days of age they underwent a total of 4 hrs imposed stimulation, according to a self-stimulation model of a 15 days animal. Electrodes were removed on the 17th day. Between the 42nd and 46th days, animals were tested in a skinnerian, alimentary reinforced task. In acquisition as well as in extinction behavior, early stimulated animals performed better than animals of the same age, implanted but non stimulated or non implanted.

  1. [Complete recovery from transient coma in bilateral paramedian thalamic infarctions].

    Science.gov (United States)

    Casado, J L; Arenas, C; Serrano, V; Moreno Rojas, A; Gil-Néciga, E; Gil-Peralta, A

    1995-01-01

    Bilateral paramedian thalamic infarcts (BPTI) can begin clinically with transient coma, after which symptoms of fluctuating hypersomnolence, irrational behaviour, or amnesic states may be observed. We present two patients with BPTI who began with coma, recovering spontaneously in under eight hours, with no accompanying symptoms.

  2. Non-union following bilateral simultaneos Ganz trochanteric osteotomy

    Directory of Open Access Journals (Sweden)

    Sean M. Dixon

    2010-01-01

    Full Text Available Between January 2003 and December 2004, 13 patients underwent bilateral resurfacing arthroplasty via a Ganz trochanteric osteotomy. This bilateral group was mobilised fully weight-bearing with crutches. During the same period 139 Ganz trochanteric osteoto-mies were performed for unilateral hip resurfacing. These patients were mobilised with crutches, weight-bearing up to 10 kg on the operated leg. Nine osteotomies (32% in the bilateral group subsequently developed a symptomatic non-union requiring revision of fixation. This compares with 10 patients (7% in the unilateral group. Applying the Fisher’s exact test, the difference reached significance (P=0.0004. In two patients a second revision was required to achieve union. In one patient, revision of trochanteric fixation precipitated a deep infection. Protected weight-bearing following a Ganz trochanteric osteotomy is important to the success of the procedure. Simultaneous bilateral hip arthroplasty through a Ganz approach should be avoided. If it is undertaken, we recommend that patients should be non weight-bearing for 6 weeks following surgery. Non-union following a Ganz trochanteric osteotomy for arthroplasty carries a significant morbidity.

  3. Radiotherapy for Langerhans Cell Histiocytosis of Bilateral Eyelids

    Science.gov (United States)

    Bourque, Jean-Marc; Lukovic, Jelena; Dar, A. Rashid

    2016-01-01

    Langerhans cell histiocytosis (LCH) is a rare disorder with numerous clinicopathological variants with differing clinical courses, treatment methods, and prognoses. We report one patient with atypical LCH of the bilateral lower eyelids and subsequent successful treatment with local radiation therapy. PMID:27004151

  4. Bilateral multiligament injury of knee caused by entangled dupatta.

    Science.gov (United States)

    Vaidya, Shrinand V; Mathesul, Ambarish A; Panghate, Atul N; Wade, Roshan; Sonawane, Dhiraj V

    2012-03-01

    We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.

  5. Bilateral multiligament injury of knee caused by entangled dupatta

    Directory of Open Access Journals (Sweden)

    Shrinand V Vaidya

    2012-01-01

    Full Text Available We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.

  6. Lyme disease presenting with bilateral facial nerve palsy.

    Science.gov (United States)

    Eng, G D

    1990-09-01

    Facial palsy bilateral, or recurrent, suggests a myriad of diagnostic possibilities. An 11-year-old boy is described whose diagnosis remained elusive for several months. Clinical evolution and subsequent laboratory studies confirmed that he had Lyme disease. Literature review suggests that this disorder is ubiquitous in its manifestations. The diagnosis should be remembered in unexplained neurologic disorders, particularly in cranial and peripheral neuropathies.

  7. Fast O(1) bilateral filtering using trigonometric range kernels

    CERN Document Server

    Chaudhury, Kunal Narayan; Unser, Michael

    2011-01-01

    It is well-known that spatial averaging can be realized (in space or frequency domain) using algorithms whose complexity does not depend on the size or shape of the filter. These fast algorithms are generally referred to as constant-time or O(1) algorithms in the image processing literature. Along with the spatial filter, the edge-preserving bilateral filter [bilateralFilter] involves an additional range kernel. This is used to restrict the averaging to those neighborhood pixels whose intensity are similar or close to that of the pixel of interest. The range kernel operates by acting on the pixel intensities. This makes the averaging process non-linear and computationally intensive, especially when the spatial filter is large. In this paper, we show how the O(1) averaging algorithms can be leveraged for realizing the bilateral filter in constant-time, by using trigonometric range kernels. This is done by generalizing the idea in [bilateralFilter_fast] of using polynomial range kernels. The class of trigonomet...

  8. Spanish Bilateral Initiatives for Education in Latin America

    Science.gov (United States)

    Cortina, Regina; Sanchez, Maria Teresa

    2007-01-01

    The research presented in this article concerns la Agencia Espanola de Cooperacion Internacional (Spanish Agency for International Cooperation--AECI) and its growing presence in Latin America since the late 1990s. The aim is to evaluate the transformative potential that bilateral funding can have on educational reform in the region. The article…

  9. North-South FDI and Bilateral Investment Treaties

    NARCIS (Netherlands)

    Falvey, R.; Foster-McGregor, N.

    2015-01-01

    Bilateral Investment Treaties (BITs) have become increasingly popular as a means of encouraging FDI from developed to developing countries. We adopt a matched difference-in-difference estimation to deal with the problem of endogeneity when estimating the effects of BITs on inward FDI. Our results in

  10. Differential ventilation with spontaneous respiration for bilateral emphysema.

    Science.gov (United States)

    Chakravarthy, Murali; Jawali, Vivek

    2007-06-01

    In patients with bilateral bullous disease and empyema in one lung, controlled ventilation may be hazardous and result in severe hypoxia. A 50-year-old man with bullous disease and thoracic empyema on the left side was operated on under general anesthesia with spontaneous respiration using differential lung ventilation.

  11. Bilateral Synchronous Ectopic Ethmoid Sinus Olfactory Neuroblastoma: A Case Report

    Science.gov (United States)

    Leon-Soriano, Elena; Alfonso, Carolina; Yebenes, Laura; Garcia-Polo, Julio; Lassaletta, Luis; Gavilan, Javier

    2016-01-01

    Patient: Male, 41 Final Diagnosis: Olfactory neuroblastoma Symptoms: Left nasal obstruction • occasional left epistaxis • headache Medication: None Clinical Procedure: Nasal endoscopic examination • neck palpation • CT • bilateral endoscopic resection • MRI • PET-CT • postoperative radiotherapy Specialty: Otolaryngology Objective: Unusual clinical course Background: Olfactory neuroblastoma (ONB), also known as esthesioneuroblastoma, is a rare malignant head and neck cancer thought to originate from the olfactory epithelium. It typically invades contiguous structures at presentation. We report a very rare case of multifocal and ectopic ONB. Case Report: A 41-year-old man presented with left nasal obstruction and occasional left epistaxis associated with headache. Endoscopic examination of the nasal cavities and computed tomography suggested bilateral polypoid masses. Histopathological diagnosis after endoscopic resection established bilateral olfactory neuroblastoma of the ethmoid sinuses. The patient received postoperative radiotherapy. He remains free of disease 4 years after treatment. Conclusions: To the best of our knowledge this is the second documented case of multifocal ectopic olfactory neuroblastoma. Clinicians should consider ONB in the differential diagnosis of bilateral synchronous nasal and paranasal masses to avoid delayed diagnosis. Endoscopic resection of ONB could be an option in selected cases. PMID:27097989

  12. Meningococcal meningitis presenting with bilateral deafness and ataxia.

    OpenAIRE

    Sandyk, R; Brennan, M J

    1984-01-01

    A 50-year-old man presented with bilateral deafness and ataxia of sudden onset and without constitutional symptoms or signs of meningeal irritation. He was subsequently proved to have meningococcal meningitis, and the deafness and ataxia resolved following appropriate antibiotic therapy.

  13. [Difficult respiratory management in a patient with bilateral giant bullae].

    Science.gov (United States)

    Fujita, Ayaka; Hashiba, Eiji; Takahira, Yoko; Kitayama, Masatou; Tubo, Toshihito; Hirota, Kazuyoshi

    2009-10-01

    We report a case of bilateral giant bullae in a patient with multiple traumas. He had his arm amputated at the shoulder because of a machine accident and admitted to our hospital. Chest X-ray showed right-sided pneumothorax with bilateral giant bullae. Trimming of the stump was performed immediately after the placement of a right chest tube. He gradually developed hypoxia and hypercapnia with acidemia during the operation because of atelectasis due to sputum. Postoperatively, enlargement of right giant bulla led to frequent respiratory failure and he received a bilateral bullectomy through a median sternotomy 3 weeks after the accident. It was difficult to ventilate him due to air leak from the bilateral bulla and SpO2 dropped to below 70% with 100% oxygen. We continued the operation with standby extracorporeal membrane oxygenator (ECMO). Although the operation was finished without ECMO finally, ECMO had better been kept ready during anethesia with giant bullae when life threatening complication may occur at any point.

  14. Bilateral acrometastasis in a case renal cell carcinoma

    Science.gov (United States)

    Vaishya, Raju; Vijay, Vipul; Vaish, Abhishek

    2014-01-01

    We present a unique case of bilateral skeletal metastasis below the knee in a patient with renal cell carcinoma. In this rarest of rare cases, bony metastases were the first presentation of a primary tumour. Incidentally, the primary tumour (renal cell carcinoma) involved the solitary kidney of the patient and the same patient also had coexisting carcinoma of the prostate. PMID:25368128

  15. Bayer bilateral denoising on TriMedia3270

    Science.gov (United States)

    Phelippeau, H.; Akil, M.; Dias Rodrigues, B.; Talbot, H.; Bara, S.

    2009-02-01

    Digital cameras are now commonly included in several digital devices such as mobile phones. They are present everywhere and have become the principal image capturing tool. Inherent to light and semiconductors properties, sensor noise [10] continues to be an important factor of image quality [12], especially in low light conditions. Removing the noise with mathematical solutions appears thus unavoidable to obtain an acceptable image quality. However, embedded devices are limited by processing capabilities and power consumption and thus cannot make use of the full range of complex mathematical noise removing solutions. The bilateral filter [6] appears to be an interesting compromise between implementation complexity and noise removing performances. Especially, the Bayer [5] bilateral filter proposed in [11] is well adapted for single sensor devices. In this paper, we simulate and optimize the Bayer bilateral filter execution on a common media-processor: the TM3270 [4] from the NXP Semiconductors TriMedia family. To do so we use the TriMedia Compilation System (TCS). We applied common optimization techniques (such as LUT, loop unrolling, convenient data type representation) as well as custom TriMedia operations. We finally propose a new Bayer bilateral filter formulation dedicated to the TM3270 architecture that yields an execution improvement of 99.6% compared to the naÃve version. This improvement results in real-time video processing at VGA resolution at the 350MHz clock rate.

  16. Partner countries for Dutch bilateral development assistance 1962-2015

    NARCIS (Netherlands)

    Kazimierczuk, A.; Dietz, A.J.; Vink, de N.

    2016-01-01

    The Netherlands has been an active supporter of international development aid. Dutch development cooperation started in response to Truman's 'Four point programme' announced in 1949. It began as technical assistance, channelled through multilateral channels. Bilateral aid started in 1962 and was int

  17. The impact of cultural distance on bilateral arm's length exports

    NARCIS (Netherlands)

    Slangen, A.H.L.; Beugelsdijk, S.; Hennart, J.-F.

    2011-01-01

    Prior studies have argued and regularly found that cultural distance is negatively related to bilateral export flows, which are the sum of arm’s length and intra-firm exports. However, these macro-level studies overlook the firm-level insights that arm’s length exports are a substitute for arm’s len

  18. BILGO: Bilateral greedy optimization for large scale semidefinite programming

    KAUST Repository

    Hao, Zhifeng

    2013-10-03

    Many machine learning tasks (e.g. metric and manifold learning problems) can be formulated as convex semidefinite programs. To enable the application of these tasks on a large-scale, scalability and computational efficiency are considered as desirable properties for a practical semidefinite programming algorithm. In this paper, we theoretically analyze a new bilateral greedy optimization (denoted BILGO) strategy in solving general semidefinite programs on large-scale datasets. As compared to existing methods, BILGO employs a bilateral search strategy during each optimization iteration. In such an iteration, the current semidefinite matrix solution is updated as a bilateral linear combination of the previous solution and a suitable rank-1 matrix, which can be efficiently computed from the leading eigenvector of the descent direction at this iteration. By optimizing for the coefficients of the bilateral combination, BILGO reduces the cost function in every iteration until the KKT conditions are fully satisfied, thus, it tends to converge to a global optimum. In fact, we prove that BILGO converges to the global optimal solution at a rate of O(1/k), where k is the iteration counter. The algorithm thus successfully combines the efficiency of conventional rank-1 update algorithms and the effectiveness of gradient descent. Moreover, BILGO can be easily extended to handle low rank constraints. To validate the effectiveness and efficiency of BILGO, we apply it to two important machine learning tasks, namely Mahalanobis metric learning and maximum variance unfolding. Extensive experimental results clearly demonstrate that BILGO can solve large-scale semidefinite programs efficiently.

  19. Bilateral Social Security Instruments Concluded between European Socialist Countries.

    Science.gov (United States)

    Popescu, Andrei

    1982-01-01

    Presents a review of existing bilateral treaties, conventions, and agreements in the field of social policy concluded between European socialist countries. It summarizes their basic principles, their social security provisions (old-age benefit, employment injury benefits, cash benefits for sickness and maternity), and the provisions concerning…

  20. Bilateral chondrolysis of the hip following liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Chechik, Ofir; Dekel, Samuel [Tel Aviv Sourasky Medical Center, Department of Orthopedic Surgery ' B' , Tel Aviv (Israel)]|[Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel)

    2009-03-15

    A 32-year-old woman with bilateral hip chondrolysis diagnosed 2 years following allogeneic liver transplantation is described. Severe osteoarthritis was demonstrated on physical examination, serial radiographs and magnetic resonance imaging. Only four cases of chondrolysis in solid organ recipients have been described in the literature. (orig.)