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Sample records for central pontine myelinolysis

  1. Central Pontine Myelinolysis: Report of Four Cases

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    Handan Akar

    2010-09-01

    Full Text Available Central pontine myelinolysis is a neurological disorder characterized by loss of myelin in the central pons as well as in the other parts of the brain like basal ganglia, lateral geniculate bodies, external and internal capsules, and cerebellum. We report the clinical and radiological findings of three patients with central pontine myelinolysis and one patient with both pontine and extrapontine myelinolysis.

  2. Central Pontine and Extrapontine Myelinolysis in Encephalitis

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    Suvrendu Sankar Kar

    2013-08-01

    Full Text Available A 15 years male presented with fever, convulsion, unconsciousness and dystonia of acute onset. He was investigated and treated. MRI brain shows central pontine and extrapontine myelinolysis. Osmotic injury, Wilson's disease and other possibilities were excluded by clinical findings with supportive investigations. Patient was improved satisfactorily with treatment. [Natl J Med Res 2013; 3(4.000: 420-421

  3. Central pontine myelinolysis after liver transplantation.

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    Estol, C J; Faris, A A; Martinez, A J; Ahdab-Barmada, M

    1989-04-01

    Eight adults and 3 children out of 85 patients who had neuropathologic examination after death following orthotopic liver transplantation showed central pontine myelinolysis (CPM). Four patients also had extrapontine myelinolysis. Eight patients had significant serum sodium changes. In 5, the fluctuation occurred perioperatively and 4 had a clinical picture consistent with CPM, although no patient had this as an antemortem diagnosis. We emphasize the role of hepatic dysfunction as a cause of CPM and recommend careful monitoring of electrolytes in the perioperative period of patients undergoing liver transplantation.

  4. Central pontine myelinolysis (CPM and extrapontine myelinolysis (EPM following concurrent chemoradiotherapy for nasopharyngeal carcinoma

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    Chen-Hui Chong

    2016-06-01

    Full Text Available Central pontine myelinolysis (CPM is a disease that may present with coma, quadriplegia, or no symptoms at all. It is an iatrogenic demyelinating disease caused most frequently by overzealous correction of chronic hyponatremia and excessive swings in serum osmolality. Lesions can also occur outside the pons as extrapontine myelinolysis (EPM. Herein we have reported a case of CPM and EPM in a patient after chemoradiotherapy for recurrent nasopharyngeal carcinoma.

  5. Cognitive and Emotional Dysfunction after Central Pontine Myelinolysis

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    Tatia M. C. Lee

    2003-01-01

    Full Text Available The case of a 67-year-old right-handed Chinese man with Central Pontine Myelinolysis [CPM] is described to illustrate the resulting cognitive and emotional disturbances. A comparison of the data in this report with that in published studies suggests that ethnicity does not seem to have much effect on the symptoms of CPM. Possible underlying neural-pathological mechanisms are discussed. This case further substantiates the speculation that the brainstem plays a role in higher cognitive processes and emotional regulation.

  6. Hypertensive Encephalopathy: Isolated Pons Involvement Mimicking Central Pontine Myelinolysis

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    Gamanagatti, S.; Subramanian, S. [India Institute of Medical Sciences, New Delhi (India)

    2006-09-15

    MRI of the brain was performed, and it demonstrated an isolated high signal on the T2 weighted and fluid attenuated inversion recovery sequences that involved only the central pons with sparing the periphery. There was no restricted diffusion on diffusion weighted imaging. The differential diagnosis included posterior reversible syndrome and central pontine myelinolysis; however, the blood sodium on admission was normal. The pathogenesis of HE is that the auto-regulatory mechanisms that control the cerebral blood flow are exceeded, resulting in hyper-perfusion. The consequent over-distension of the cerebral vessels, the breakdown of the blood brain barrier and ultimately, the extravasation of fluid into the interstitium all cause vasogenic edema. In most cases, the changes of hypertensive encephalopathy represent reversible vasogenic edema, which can be seen on T2-weighted images, and restricted diffusion is not seen on the diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) maps. Hypertensive encephalopathy that manifests as a reversible increased signal isolated to the pons on T2-weighted images is extremely uncommon. The differential diagnosis for such pontine T2 hyperintensity includes pontine glioma, ischemic and radiation changes (generally irreversible conditions), as well as central pontine myelinolysis (CPM) and demyelinating disorders such as multiple sclerosis, acute disseminated encephalomyelitis and rhomb-encephalitis. In CPM electrolyte imbalances provide a clue for the diagnosis, where as for glioma, there will be an expansion and mass effect. In conclusion, clinical recognition of brainstem HE may be difficult. The features of a lack of correlation between the severity of the radiological abnormality and the clinical status, combined with the rapid resolution following antihypertensive treatment, should suggest the diagnosis. It is important for the radiologist to be familiar with the imaging abnormalities of this life

  7. [Alcoholism and possible consequences for the central nerval system - pontine and extrapontine myelinolysis].

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    Niemann, T; Iranyi, A; Ott, H W

    2009-06-10

    The central pontine and extrapontine myelinolysis is an important entity in the neurology disorders in the context with alcohol abuse. Though often first based on clinical characteristics, the diagnosis can be often supported with radiologic imaging.

  8. Acute Psychosis as Main Manifestation of Central Pontine Myelinolysis

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    Mangala Gopal

    2017-01-01

    Full Text Available Central pontine myelinolysis (CPM is an acute demyelinating neurological disorder affecting primarily the central pons and is frequently associated with rapid correction of hyponatremia. Common clinical manifestations of CPM include spastic quadriparesis, dysarthria, pseudobulbar palsy, and encephalopathy of various degrees; however, coma, “locked-in” syndrome, or death can occur in most severe cases. Rarely, CPM presents with neuropsychiatric manifestations, such as personality changes, acute psychosis, paranoia, hallucinations, or catatonia, typically associated with additional injury to the brain, described as extrapontine myelinolysis (EPM. We present a patient with primarily neuropsychiatric manifestations of CPM, in the absence of focal neurologic deficits or radiographic extrapontine involvement. A 51-year-old female without significant medical history presented with dizziness, frequent falls, diarrhea, generalized weakness, and weight loss. Physical examination showed no focal neurological deficits. Laboratory data showed severe hyponatremia, which was corrected rather rapidly. Subsequently, the patient developed symptoms of an acute psychotic illness. Initial brain magnetic resonance imaging (MRI was unremarkable, although a repeat MRI two weeks later revealed changes compatible with CPM. This case demonstrates that acute psychosis might represent the main manifestation of CPM, especially in early stages of the disease, which should be taken into consideration when assessing patients with acute abnormalities of sodium metabolism.

  9. Acute Psychosis as Main Manifestation of Central Pontine Myelinolysis

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    Gopal, Mangala; Patel, Harsh

    2017-01-01

    Central pontine myelinolysis (CPM) is an acute demyelinating neurological disorder affecting primarily the central pons and is frequently associated with rapid correction of hyponatremia. Common clinical manifestations of CPM include spastic quadriparesis, dysarthria, pseudobulbar palsy, and encephalopathy of various degrees; however, coma, “locked-in” syndrome, or death can occur in most severe cases. Rarely, CPM presents with neuropsychiatric manifestations, such as personality changes, acute psychosis, paranoia, hallucinations, or catatonia, typically associated with additional injury to the brain, described as extrapontine myelinolysis (EPM). We present a patient with primarily neuropsychiatric manifestations of CPM, in the absence of focal neurologic deficits or radiographic extrapontine involvement. A 51-year-old female without significant medical history presented with dizziness, frequent falls, diarrhea, generalized weakness, and weight loss. Physical examination showed no focal neurological deficits. Laboratory data showed severe hyponatremia, which was corrected rather rapidly. Subsequently, the patient developed symptoms of an acute psychotic illness. Initial brain magnetic resonance imaging (MRI) was unremarkable, although a repeat MRI two weeks later revealed changes compatible with CPM. This case demonstrates that acute psychosis might represent the main manifestation of CPM, especially in early stages of the disease, which should be taken into consideration when assessing patients with acute abnormalities of sodium metabolism.

  10. Central Pontine Myelinolysis Induced by Alcohol Withdrawal: A Case Report

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    2017-01-01

    Central pontine myelinolysis (CPM) is a demyelinating disorder characterized by the loss of myelin in the center of the basis pons, and is mainly caused by the rapid correction of hyponatremia. We report the case of a young woman who presented with gait disturbance and alcohol withdrawal, and who was eventually diagnosed with CPM. Generally, the cause and pathogenesis of CPM in chronic alcoholics remain unclear. In this cases, the CPM may be unrelated to hyponatremia or its correction. However, it is possible that the osmotic pressure changes due to refeeding syndrome after alcohol withdrawal was the likely cause in this case. This case illustrates the need for avoiding hasty, and possibly incomplete diagnoses, and performing more intensive test procedures to ensure a correct diagnosis.

  11. Central pontine myelinolysis secondary to hypokalaemic nephrogenic diabetes insipidus.

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    Davenport, C; Liew, A; Vic Lau, P; Smith, D; Thompson, C J; Kearns, G; Agha, A

    2010-01-01

    Central pontine myelinolysis (CPM) has been described in alcoholic patients and in the aftermath of rapid correction of chronic hyponatraemia. We describe a case of CPM occurring secondary to nephrogenic diabetes insipidus (DI), which developed as a consequence of severe hypokalaemia. A 63-year-old man with alcohol dependence was admitted to hospital with severe pulmonary sepsis and type 1 respiratory failure. On admission, he had euvolaemic hyponatraemia of 127 mmol/L, consistent with a syndrome of inappropriate antidiuretic hormone secondary to his pneumonia. Following admission, his plasma potassium dropped from 3.2 to a nadir of 2.3 mmol/L. Mineralocorticoid excess, ectopic adrenocorticotrophic hormone production and other causes of hypokalaemia were excluded. The hypokalaemia provoked significant hypotonic polyuria and a slow rise in plasma sodium to 161 mmol/L over several days. Plasma glucose, calcium and creatinine were normal. The polyuria did not respond to desmopressin, and subsequent correction of his polyuria and hypernatraemia after normalization of plasma potassium confirmed the diagnosis of nephrogenic DI due to hypokalaemia. The patient remained obtunded, and the clinical suspicion of osmotic demyelination was confirmed on magnetic resonance imaging. The patient remained comatose and passed away 10 days later. This is the first reported case of nephrogenic DI resulting in the development of CPM, despite a relatively slow rise in plasma sodium of less than 12 mmol/L/24 h. Coexisting alcohol abuse, hypoxaemia and hypokalaemia may have contributed significantly to the development of CPM in this patient.

  12. Central pontine myelinolysis secondary to hypokalaemic nephrogenic diabetes insipidus.

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    Davenport, C

    2010-01-01

    Central pontine myelinolysis (CPM) has been described in alcoholic patients and in the aftermath of rapid correction of chronic hyponatraemia. We describe a case of CPM occurring secondary to nephrogenic diabetes insipidus (DI), which developed as a consequence of severe hypokalaemia. A 63-year-old man with alcohol dependence was admitted to hospital with severe pulmonary sepsis and type 1 respiratory failure. On admission, he had euvolaemic hyponatraemia of 127 mmol\\/L, consistent with a syndrome of inappropriate antidiuretic hormone secondary to his pneumonia. Following admission, his plasma potassium dropped from 3.2 to a nadir of 2.3 mmol\\/L. Mineralocorticoid excess, ectopic adrenocorticotrophic hormone production and other causes of hypokalaemia were excluded. The hypokalaemia provoked significant hypotonic polyuria and a slow rise in plasma sodium to 161 mmol\\/L over several days. Plasma glucose, calcium and creatinine were normal. The polyuria did not respond to desmopressin, and subsequent correction of his polyuria and hypernatraemia after normalization of plasma potassium confirmed the diagnosis of nephrogenic DI due to hypokalaemia. The patient remained obtunded, and the clinical suspicion of osmotic demyelination was confirmed on magnetic resonance imaging. The patient remained comatose and passed away 10 days later. This is the first reported case of nephrogenic DI resulting in the development of CPM, despite a relatively slow rise in plasma sodium of less than 12 mmol\\/L\\/24 h. Coexisting alcohol abuse, hypoxaemia and hypokalaemia may have contributed significantly to the development of CPM in this patient.

  13. Therapy of central pontine myelinolysis following living donor liver transplantation: Report of three cases

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    Zhong-Wei Zhang; Yan Kang; Li-Jing Deng; Chuan-Xing Luo; Yan Zhou; Xin-Sheng Xue; Dong Wang; Wan-Hong Yin

    2009-01-01

    We analyzed the clinical manifestations and experiences of diagnosing and treating central pontine myelinolysis following living donor liver transplantation. The clinical data of three patients with central pontine myelinolysis following living donor liver transplantation from January 2005 to November 2007 were retrospectively analyzed at the West China Hospital, Sichuan University, China.The three patients developed hyponatremia prior to surgery. Case 1 suffered locked-in syndrome following surgery, and received a large dose of gamma globulin,and subsequently recovered. Case 2 was in a coma for three days, and received hyperbaric chamber treatment.This patient remained in a mild coma for six months following surgery. Case 3 developed consciousness disturbances, gradually went into a coma following surgery, and died due to pulmonary infection. Central pontine myelinolysis is a severe complication in patients following living donor liver transplantation. Largedose gamma globulin treatment, as well as hyperbaric oxygen, might be effective therapeutic methods.

  14. Central Pontine and Extrapontine Myelinolysis: The Great Masquerader—An Autopsy Case Report

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    Sajish Jacob

    2014-01-01

    Full Text Available Central pontine myelinolysis is a demyelinating disorder characterized by the loss of myelin in the center of the basis pontis usually caused by rapid correction of chronic hyponatremia. The clinical features vary depending on the extent of involvement. Demyelination can occur outside the pons as well and diagnosis can be challenging if both pontine and extrapontine areas are involved. We herein report a case of myelinolysis involving pons, lateral geniculate bodies, subependymal region, and spinal cord. To the best of our knowledge, this case represents the second case of spinal cord involvement in osmotic demyelination syndrome and the first case of involvement of thoracic region of spinal cord.

  15. Wernicke′s encephalopathy and central pontine myelinolysis in hyperemesis gravidarum

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    Panee Sutamnartpong

    2013-01-01

    Full Text Available A pregnant woman, who had been suffering from hyperemesis gravidarum, presented with alteration of consciousness, ocular nystagmus and ataxia. Magnetic Resonance Imaging of the brain showed typical findings of Wernicke′s encephalopathy and central pontine myelinolysis. The clinical features responded dramatically to thiamine supplementation.

  16. Possible causes of central pontine myelinolysis after liver transplantation

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    Jun Yu; Shu-Sen Zheng; Ting-Bo Liang; Yan Shen; Wei-Lin Wang; Qing-Hong Ke

    2004-01-01

    AIM: To sum up the clinical characteristics of patients with central pontine myelinolysis (CPM) after orthotopic liver transplantation (OLT) and to document the possible causes of CPM.METHODS: Data of 142 patients undergoing OLT between January 1999 to May 2003 were analyzed retrospectively.Following risk factors during perioperation were analyzed in patients with and without CPM: primary liver disease,preoperative serum sodium level, magnesium level and plasma osmolality, fluctuation degree of serum sodium concentration, and immunosuppressive drug level, etc.RESULTS: A total of 13 (9.2%) neurologic symptoms appeared in 142 patients post-operation including 5 cases (3.5%) with CPM and 8 cases (5.6%) with cerebral hemorrhage or infarct. Two patients developing CPM after OLT had a hyponatremia history before operation (serum sodium<130 mmol/L), their mean serum sodium level was 130.6±5.54 mmol/L. The serum sodium level was significantly lower in CPM patients than in patients without neurologic complications or with cerebral hemorrhage/infarct (P<0.05).The increase in serum sodiumduring perioperative 48 h after OLT in patients with CPM was significantly greater than that in patients with cerebral hemorrhage/infarct but without neurologic complications (19.5±6.54 mmol/L, 10.1±6.43 mmol/L,4.5±4.34 mmol/L, respectively, P<0.05). Plasma osmolality was greatly increased postoperation in patients with CPM.Hypomagnesemia was noted in all patients perioperation,but there were no significant differences between groups.The duration of operation on patients with CPM was longer than that on others (492±190.05 min, P<0.05). Cyclosporin A (CsA) levels were normal in all patients, but there were significant differences between patients with or without neurologic complications (P<0.05).CONCLUSION: CPM may be more prevalent following liver transplantation. Although the diagnosis of CPM after OLT can be made by overall neurologic evaluations including magnetic resonance

  17. Magnetic resonance imaging of sequelae of central pontine myelinolysis in chronic alcohol abusers

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    Uchino, Akira; Kudo, Sho [Department of Radiology, Saga Medical School, 5-1-1 Nabeshima, 849-8501, Saga (Japan); Yuzuriha, Takefumi; Murakami, Masaru; Endoh, Koichi; Hiejima, Shigeto; Koga, Hiroshi [Center for Emotional and Behavional Disorders, Hizen National Hospital, 160 Mitsu, Higashisefuri, Kanzaki, 842-0192, Saga (Japan)

    2003-12-01

    Central pontine myelinolysis (CPM) is one of the serious neurological complications of alcoholism. This study evaluated magnetic resonance images of sequelae of CPM. Approximately 600 alcoholic patients were examined by a 1.0-T magnetic resonance imaging device, and 11 patients were retrospectively found to have a central pontine lesion, a presumed sequela of CPM. The lesions had various shapes and most were cavitary. In 3 of the 11 patients bilateral symmetrical oval lesions were faintly visible in the middle cerebellar peduncles. These middle cerebellar peduncular lesions were diagnosed as having Wallerian degeneration of the pontocerebellar tract secondary to CPM. (orig.)

  18. Central pontine and extrapontine myelinolysis that developed during alcohol withdrawal, without hyponatremia, in a chronic alcoholic.

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    An, Jae Young; Park, Sung Kyung; Han, Si Ryung; Song, In Uk

    2010-01-01

    Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are osmotic demyelination syndrome. A 45-year-old man with a history of alcoholism visited the ER with dysarthria and dysphagia for 2 days. These symptoms occurred 3 days after he had stopped drinking alcohol. The neurological symptoms progressed to anarthria, pseudobulbar palsy and gait disturbance. During admission, the electrolyte studies were within the normal range. Diffusion-weighted images revealed high signal intensities in the pons, thalamus and basal ganglia. Apparent diffusion coefficient image showed low signal intensities in the pontine lesion, but isosignal intensities in the extrapontine lesion. The symptoms gradually improved after 1 month with only conservative treatment. The 1 month-follow-up MRI showed significant reduction of the previous extrapontine lesions. These findings suggest that cytotoxic edema is central to the pathogenesis of CPM, but vasogenic edema plays an important role in the pathogenesis of EPM occurring during alcohol withdrawal.

  19. Central pontine myelinolysis presenting as isolated sixth nerve palsy in third trimester of pregnancy

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    Tushar Divakar Gosavi

    2015-01-01

    Full Text Available A 30-year-old primigravida presented with isolated left sixth nerve palsy at 38 weeks gestation. Her MRI showed a lesion consistent with central pontine myelinolysis (CPM. Extensive investigations did not reveal any secondary cause for the CPM. She recovered spontaneously in 2 weeks with complete resolution of her MRI changes. To our knowledge, this is the first report of CPM occurring in third trimester in the absence of identifiable secondary causes and of CPM presenting as an isolated sixth nerve palsy. We discuss the reported causes of CPM in pregnancy, possible pathophysiologic mechanisms involved and the anatomic basis of the unique clinical presentation of sixth nerve palsy in our case.

  20. A Case of Central Pontine Myelinolysis Caused by Hypophosphatemia Secondary to Refeeding Syndrome.

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    Yamashita, Chikara; Shigeto, Hiroshi; Maeda, Norihisa; Torii, Takako; Ohyagi, Yasumasa; Kira, Jun-Ichi

    2015-01-01

    Central pontine myelinolysis (CPM), which was originally considered to be the result of rapid correction of chronic hyponatremia, is not necessarily accompanied by hyponatremia or drastic changes in serum sodium level. Here, we report a case of an anorexic 55-year-old male with a history of pharyngo-laryngo-esophagogastrectomy, initially hospitalized with status epilepticus. Although his consciousness gradually recovered as we were controlling his convulsion, it deteriorated again with new onset of anisocoria, and magnetic resonance imaging (MRI) at this point revealed CPM. Rapid change of serum sodium or osmolarity, which is often associated with CPM, had not been apparent throughout his hospitalization. Instead, a review of the serum biochemistry test results showed that serum phosphate had drastically declined the day before the MRI first detected CPM. In this case, we suspect that hypophosphatemia induced by refeeding syndrome greatly contributed to the occurrence of CPM.

  1. A Case of Central Pontine Myelinolysis Caused by Hypophosphatemia Secondary to Refeeding Syndrome

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    Chikara Yamashita

    2015-10-01

    Full Text Available Central pontine myelinolysis (CPM, which was originally considered to be the result of rapid correction of chronic hyponatremia, is not necessarily accompanied by hyponatremia or drastic changes in serum sodium level. Here, we report a case of an anorexic 55-year-old male with a history of pharyngo-laryngo-esophagogastrectomy, initially hospitalized with status epilepticus. Although his consciousness gradually recovered as we were controlling his convulsion, it deteriorated again with new onset of anisocoria, and magnetic resonance imaging (MRI at this point revealed CPM. Rapid change of serum sodium or osmolarity, which is often associated with CPM, had not been apparent throughout his hospitalization. Instead, a review of the serum biochemistry test results showed that serum phosphate had drastically declined the day before the MRI first detected CPM. In this case, we suspect that hypophosphatemia induced by refeeding syndrome greatly contributed to the occurrence of CPM.

  2. A case of mistaken identity: alcohol withdrawal, schizophrenia, or central pontine myelinolysis?

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    Schneider P

    2012-02-01

    Full Text Available Paul Schneider1, Vicki A Nejtek2,3, Cheryl Hurd2,31Green Oaks Behavioral Health Care Services, Dallas, 2University of North Texas Health Science Center, Fort Worth, 3John Peter Smith Health Network, Fort Worth, Texas, USAAbstract: Demyelination is a hallmark of central pontine myelinolysis (CPM. Neuropsychiatric manifestations of this condition include weakness, quadriplegia, pseudobulbar palsy, mood changes, psychosis, and cognitive disturbances. These psychiatric symptoms are also associated with schizophrenia and alcohol withdrawal. Thus, it is clinically relevant to differentiate between CPM, schizophrenia, and alcohol withdrawal as the treatment and prognostic outcomes for each diagnosis are distinct. We present a series of events that led to a misdiagnosis of a patient admitted to the medical emergency center presenting with confusion, psychomotor agitation, and delirium who was first diagnosed with schizophrenia and alcohol withdrawal by emergency medical physicians and later discovered by the psychiatric consult team to have CPM. With a thorough psychiatric evaluation, a review of the laboratory results first showing mild hyponatremia (127 mmol/L, subsequent hypernatremia (154 mmol/L, and magnetic resonance brain imaging, psychiatrists concluded that CPM was the primary diagnosis underlying the observed neuropsychopathology. This patient has mild impairments in mood, cognition, and motor skills that remain 12 months after her emergency-center admission. This case report reminds emergency clinicians that abnormal sodium metabolism can have long-term and devastating psychopathological and neurological consequences. Differentiating between CPM, schizophrenia, and alcohol withdrawal using neuroimaging techniques and preventing the risks for CPM using slow sodium correction are paramount.Keywords: MRI, alcohol, schizophrenia, central pontine myelinolysis, hyponatremia

  3. Incidence and mechanism of central pontine myelinolysis based on analysis of MRI images and risk factors

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    Kondo, Masato [Akita Univ. (Japan). School of Medicine

    2000-02-01

    In this study, the incidence of central pontine myelinolysis (CPM)-like lesions on MRI images was studied in 1917 subjects, 1,500 of which were psychiatric patients and 417 were patients attending a brain health examination. The CPM-like lesions were first classified into four groups based on the characteristics of their MRI images: group 1 showed symmetrical lesions on both T1 low and T2 high images and were considered to be typical CPM; group 2 showed symmetrical high intensity lesions only on T2 images; group 3 had asymmetrical lesions only on T2 images; and group 4 had asymmetrical lesions on both T1 low and T2 high images. Furthermore, the relationships of each group with particular risk factors, such as alcoholism, hypertension, hyperlipidemia were statistically analysed. The cause of CPM-like features in the MRI images were discussed. Among our subjects, the incidence of CPM-like lesions was 3.8%, and that of group 1 was 1.2%. Significant correlations between group 1 and alcoholism, and group 3 and 4 with brain ischemic lesions were observed. A previous hypothesis that group 2 may be a premature state of CPM is not supported by our results. (author)

  4. Central pontine and extrapontine myelinolysis: from epileptic and other manifestations to cognitive prognosis.

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    Odier, Céline; Nguyen, Dang Khoa; Panisset, Michel

    2010-07-01

    The objective of this study is to review the presentation, outcome and aetiology of central pontine and extrapontine myelinolysis (CPEPM) in a tertiary hospital center. The study method is a case series and included identification of patients from University of Montreal Health Centre archives database (1995-2007). All diagnoses were confirmed by neuroimaging or brain autopsy. Twelve individuals (25-66 years old) presented heterogeneous manifestations. Co-morbidities included diabetes insipidus (n = 2), haemodialysis (n = 1), cirrhosis (n = 3), gastroenteritis (n = 2) and potomania (n = 1). Aetiologies included rapid correction of severe hyponatremia (n = 6)/acute hypernatremia (n = 1); immediate (n = 2) or remote (n = 1 with recurrent cirrhosis) orthotopic liver transplantation (OLT) with tacrolimus-induced immunosuppression (n = 3); and chronic alcoholism (n = 4, two with hyponatremia). Four individuals died acutely. Two were lost to follow-up. Six had good motor or cerebellar recovery. Neuropsychological evaluations (n = 5/6) revealed a subcortical/frontal dysfunction. Cognitive impairment represented the major remaining lasting sequel (n = 4). Three salient clinical syndromes were observed: (1) predominant cerebellar presentation in individuals with alcoholism (n = 4); (2) significant alteration of consciousness at presentation (n = 4), all resulting in death (OLT, n = 3); (3) seizures persisting after natremia correction (n = 2). Clinical presentation of CPEPM is heterogeneous and can even include seizures. Cognitive impairment should be screened as it is a significant factor limiting return to normal life.

  5. Severe hyponatraemia secondary to beer potomania complicated by central pontine myelinolysis.

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    Kelly, J; Wassif, W; Mitchard, J; Gardner, W N

    1998-01-01

    A case of severe hyponatraemia in a 56-year-old male alcohol misuser secondary to beer potomania is presented. In view of severe volume depletion and the patient's inability to drink, normal saline was cautiously infused. Despite initial improvement, he subsequently deteriorated neurologically. Magnetic resonance imaging demonstrated the classical lesion of central pontine myelinolysis (CPM). The rate of correction of plasma sodium was within limits normally considered safe. Beer potomania should be considered as a cause of hyponatraemia in alcohol misusers. Recognition is important as the electrolyte imbalance repairs simply with cessation of alcohol intake and institution of normal diet. Correction of chronic hyponatraemia by infusion of normal or hypertonic saline should not be attempted unless life-threatening neurological complications supervene. When the balance of risks favours correction, caution should be exercised, as CPM may occur. Although a rate of correction of plasma sodium of up to 10 mM per 24-hour period has been associated with a low risk of precipitating CPM, this case illustrates that a completely safe rate of correction probably cannot be defined.

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

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

    2011-02-01

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

  7. Central pontine myelinolysis in a chronic alcoholic: A clinical and brain magnetic resonance imaging follow-up

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    Dujmović Irena

    2013-01-01

    Full Text Available Introduction. Central pontine myelinolysis (CPM is a noninflammatory, demyelinating lesion usually localised in the basis pontis. Chronic alcoholism is frequently associated with this condition which may have a variable clinical outcome. Until now, brain magnetic resonance imaging (MRI follow-up in alcoholic CPM cases after alcohol withdrawal has been rarely described. Case report. We reported a 30- year-old male with a 12-year history of alcohol abuse, who presented with inability to stand and walk, nausea, vomiting and somnolence. Neurological examination revealed: impared fixation on lateral gaze, dysarthria, mild spastic quadriparesis, truncal and extremity ataxia, sock-like hypesthesia and moderate decrease in vibration sense in legs. Brain MRI showed a trident-shaped non-enhancing pontine lesion highly suggestive of CPM. After an eight-month alcoholfree follow-up period, the patient’s clinical status significantly improved, while the extent of MRI pontine lesion was merely slightly reduced. Conclusion. The presented case demonstrates that CPM in chronic alcoholics may have a benign clinical course after alcohol withdrawal, which is not necessarily associated with the reduction of lesions on brain MRI. [Projekat Ministarstva nauke Republike Srbije, br. 175031

  8. Cerebellar Ataxia with Complete Clinical Recovery and Resolution of MRI Lesions Related to Central Pontine Myelinolysis: Case Report and Literature Review

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    Cristina Dolciotti

    2010-12-01

    Full Text Available There are several reports of central pontine myelinolysis (CPM in a setting of malnutrition, alcoholism, and chronic debilitating illness associated with electrolyte abnormalities, especially hyponatremia. The cause of myelinolysis is still under debate, and, although osmotic effects are thought to be responsible in most cases, alternative pathological factors should be considered [King et al.: Am J Med Sci 2010;339:561–567]. We report a case of CPM in a patient with recent chemotherapy for colon cancer without electrolyte unbalance and otherwise unexplained causes. Moreover, the present case is an example of the unusual clinical ataxic variant, followed by complete recovery without any specific treatment. The diagnosis was confirmed by MRI, which showed a characteristic hyperintense signal abnormality in the central part of the pons with an unaffected outer rim. One month later, we observed complete resolution of clinical and radiological symptoms.

  9. Sodium-reduced continuous venovenous hemodiafiltration (CVVHDF) for the prevention of central pontine myelinolysis (CPM) in hyponatremic patients scheduled for orthotopic liver transplantation.

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    Lenk, Marcus R; Kaspar, Michael

    2012-08-01

    Two patients in end-stage hepatic failure presented for orthotopic liver transplantation with longstanding severe hyponatremia (121 and 122 mmol/L). Both patients underwent liver transplantation with the concomitant use of continuous venovenous hemodiafiltration. Replacement and dialysate solutions were prepared individually to contain a sodium level that was individually considered safe with regard to the development of central pontine myelinolysis. The sodium increase in both patients was within the expected and planned limits despite a situation of mass transfusion. Both patients did well postoperatively and neither patient suffered neurological deficits.

  10. Central Pontine Myelinolysis

    Science.gov (United States)

    ... using water loss pills (diuretics), and women with eating disorders such as anorexia or bulimia. The risk for CPM is greater ... using water loss pills (diuretics), and women with eating disorders such as anorexia or bulimia. The risk for CPM is greater ...

  11. Central pontine myelinolysis with a hyperintense lesion in diffusion weighted MRI: overview by means of a case report; Zentrale pontine Myelinolyse mit hyperintenser Laesion im diffusionsgewichteten MRT: Uebersicht anhand eines Fallberichtes

    Energy Technology Data Exchange (ETDEWEB)

    Kuhn, J.; Bewermeyer, H. [Neurologische Klinik, Kliniken der Stadt Koeln gGmbH, Krankenhaus Merheim, Koeln (Germany); Harzheim, A. [Radiologische Klinik, Kliniken der Stadt Koeln gGmbH, Krankenhaus Merheim, Koeln (Germany)

    2005-07-01

    Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated with demyelination of other areas of the central nervous system (CNS). The etiology and pathogenesis of this disorder are still not fully understood. However, almost all cases of CPM are related to severe diseases or chronic alcoholism and occur in the setting of rapidly corrected serum hyponatremia and hypotonicity respectively. Depending on the involvement of other CNS structures, the clinical picture can vary considerably. Magnetic resonance imaging is the most sensitive investigation for the antemortem diagnosis of CPM, although the radiological findings lag behind and do not necessarily correlate with the clinical picture. Quite obviously diffusion-weighted imaging can be useful in the rapid diagnosis of CPM. This short review summarizes the current knowledge on the pathogenesis, clinical presentation, radiological findings, prognosis and therapeutic approaches of CPM. Characteristical clinical features and MR-findings including hyperintensity on diffusion-weighted images are illustrated by a typical case. (orig.)

  12. 脑桥中央髓鞘溶解症的临床特征及其康复预后%Clinical Features and Prognosis of Central Pontine Myelinolysis

    Institute of Scientific and Technical Information of China (English)

    杜晓霞; 宋鲁平; 徐建民; 何静杰; 孙蓉; 王强; 张通

    2011-01-01

    Objective To analyze the clinical features and prognosis of central pontine myelinolysis. Methods 20 cases with CPM diagnosed in last 10 years were reviewed and compared with those patients of foreign studies. Results 10 patients with hemoptysis were treated with hypophysin, which resulted in severe hyponatremia and osmotic myelinolysis. The main syndrom were dysarthria and dysphagia (secondary to corticobulbar fiber involvement), flaccid quadriparesis (as corticospinal tract involved) which later became spastic. The myelinolysis distrubuted symmetrically along the myelin disruption in the center basal, as well as independently in other brain areas (extrapontine myelinolysis or EPM), including the cerebellar and neocortical white/gray junctional areas, thalamus and striatum. Conclusion Supplement of sodium should be slower and more persistent for hyponatremia, the selection of drugs should be based on the patients' specific conditions.%目的 研究脑桥中央髓鞘溶解症(CPM)的临床特征、康复和预后.方法 回顾性分析并随访本院近10年确诊的CPM综合征患者20例,并与国外大型研究进行比较.结果与国外相比,国内应用垂体后叶素引起的渗透性髓鞘溶解综合征相对多见,并发脑桥外髓鞘溶解症(EPM)多见;主要在低钠血症快速纠正后2~10d内出现迅速进展的皮质延髓束或皮质脊髓束症候群.康复治疗可以改善症状,但严重构音障碍者语言功能改善差.结论CPM患者康复治疗有助于功能改善.应用垂体后叶素时注意监测电解质变化,低钠血症患者需严密监测、严格遵循补钠原则.

  13. Mielinólise pontina central e extra-pontina em paciente alcoolista sem distúrbios hidro-eletrolíticos: relato de caso Central pontine and extra-pontine myelinolysis in an alcoholic patient without electrolyte disturbances: case report

    Directory of Open Access Journals (Sweden)

    Francisco Manoel B. Germiniani

    2002-12-01

    Full Text Available A mielinólise pontina central (MPC e extra-pontina (MEP é enfermidade desmielinizante do encéfalo associada principalmente com a correção rápida da hiponatremia, que se manifesta principalmente por tetraparesia espástica e paralisia pseudo-bulbar. Existem na literatura poucos relatos de MPC/MEP em pacientes sem evidências de distúrbios hidro-eletrolíticos. Relatamos o caso de um paciente de 39 anos de idade, com história de alcoolismo intenso, com quadro de rápida evolução com tetraparesia espástica associada a paresia de diversos nervos cranianos, com exame de ressonância magnética demonstrando lesões compatíveis com MPC/MEP. Houve boa evolução clínica após tratamento com costicosteróide.Central pontine myelinolysis (CPM and extra-pontine myelinolysis (EPM are different presentations of a demyelinating disorder of the brain more commonly associated with rapid correction of hyponatremia, spastic tetraparesia and pseudo-bulbar palsy. There are in the literature a few cases of CPM/EPM in patients without electrolyte disturbances. We report the case of a 39 year-old man with severe alcoholism, who presented with spastic tetraparesis and palsy of several cranial nerves, associated with lesions in the magnetic resonance compatible with CPM/EPM. The patient had a good follow-up after pulse therapy with corticosteroids.

  14. 肝移植术后并发桥脑中央髓鞘溶解症三例%Central pontine myelinolysis following liver transplantation: clinical report of 3 cases

    Institute of Scientific and Technical Information of China (English)

    张中伟; 王文涛; 杨加印; 严律南; 康焰; 李波; 曾勇; 文天夫; 罗传兴

    2008-01-01

    Objective To summarize the clinical experience of central pontine myelin-olysis after liver transplantation. Methods The clinical data of 3 patients diagnosed as having central pontinemyelinolysis following liver transplantation were reviewed. Three patients had obviously preoperativehyponatremia, and the levels of serum sodium were separately 124, 119 and 119 mmol/L. The firstpatient with lock-in syndrome received large dosage of immunog lobulin; The second and the thirdpatients had coma, and the third patients received hyperbaric oxygen treatment. Results The levels ofserum sodium in 3 patients were risen sharply. The first patient had been recovery nearly after 3months, the second patient had been no return in 6 months, and the third patient was died frompulmonary infection. Conclusion Central pontine myelinolysis threatened the patients' life followingliver transplantation seriously.%目的 总结肝移植术后并发桥脑中央髓鞘溶解症(CPM)的诊治体会.方法 3例肝移植受者术后并发CPM,术前血清Na+明显偏低,分别为124 mmol/L、I 19 mmol/L和119 mmol/L,术后出现自主言语较少、自主动作变缓慢、吐词不清、昏迷等症状,经头颅磁共振(MRI)检查,例1主要表现为闭锁综合征,例2、3主要表现为昏迷.例I采取静脉给予大剂量丙种球蛋白治疗,例2采取高压氧治疗,例3未能进行针对性治疗.结果 3例患者术后均出现血钠快速升高,幅度达22~34mmol/L.例1术后随访3个月,基本恢复正常,但行动反应仍迟缓,肝功能正常.例2术后随访6个月,患者仍呈昏迷状态,肝功能良好.例3术后意识障碍逐渐加重,后死于肺部感染.结论CPM是肝移植术后的严重并发症,尚无有效的治疗方法 ,患者的预后差.

  15. Isolated extra pontine myelinolysis – a rare imaging appearance of osmotic demyelination syndrome

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    D. Rajitha

    2014-01-01

    Full Text Available Rapid correction of hyponatraemia leads to serious neurological complications, like osmotic demyelination syndrome (ODS. In ODS, magnetic resonance imaging (MRI often reveals features of pontine myelinolysis, that may occur in isolation or may, sometimes be associated with extrapontine myelinolysis. Isolated extrapontine myelinolysis is rare. We report the case of a 53-year-old lady brought to the emergency service with vomitings, and altered sensorium. She was found to have profound hyponatraemia (serum sodium 110 meq/L. Correction of hyponatremia was done with slow intravenous infusion of 3% sodium chloride. However, inadvertant, concomitant oral administration of salt led to overcorrection with serum sodium going upto 150 meq/L. She developed quadriplegia, depressed level of consciousness and respiratory failure and required ventilatory support. MRI brain showed features of isolated extrapontine myelinolysis.

  16. Bilateral internuclear ophthalmoplegia as first manifestation of extra pontine myelinolysis

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    Tushar Kanti Bandyopadhyay, Rudrajit Paul, Amit K Das, Rathindranath Sarkar

    2014-07-01

    Full Text Available Extrapontine myelinolysis (EPM is a rare clinical entity affecting anterior basal ganglia. This is one of the osmotic demyelination syndromes. It occurs due to rapid correction of hyponatremia and also rarely occurs in alcoholics. It generally presents with extrapyramidal symptoms. We here report a case of EPM in a 13 year old boy presenting with bilateral internuclear ophthalmoplegia and ptosis. The patient also had generalised weakness, but no psychiatric symptoms. The patient slowly recovered over six months. EPM can affect any age group, although the elderly are more likely to be affected due to frequent electrolyte abnormalities. Ocular movement disorders or brainstem signs are rarely reported in EPM. When present, it can create diagnostic confusion with multiple sclerosis. We believe this is the first report of this entity from India. The relevant literature regarding brainstem manifestations in myelinolysis syndromes is also discussed, along with the radiological findings.

  17. Alcoholism with central pontine demyelination: a case report

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    Rohit Arora

    2014-02-01

    Full Text Available Central pontine myelinolysis is a non-inflammatory demyelinating disease characterized by loss of myelin with relative neuron sparing, associated with rapid correction of hyponatremia and sometimes hypernatremia or chronic alcoholism. We are reporting a case of 52 year old male patient who was chronic alcoholic from past 20 years, presented to us with complaints of altered sensorium and dysarthria of 5 days duration .He was investigated and diagnosed as case of central pontine myelinosis associated with chronic alcoholism. [Int J Basic Clin Pharmacol 2014; 3(1.000: 230-232

  18. Extrapontine myelinolysis resulting in transient cortical blindness.

    Science.gov (United States)

    Langer, Jennifer E; Wilson, William G; Raghavan, Prashant; Rust, Robert S; Goodkin, Howard P

    2010-02-01

    Central pontine myelinolysis and extrapontine myelinolysis are characterized by symmetric demyelination subsequent to rapid shifts in serum osmolality. Described here is a novel case of transient cortical blindness in association with imaging features of extrapontine myelinolysis, which occurred in a child with carbamoyl phosphate synthetase deficiency after rapid correction of hyperammonemia. Serum sodium levels were within normal limits at presentation and throughout the period of ammonia correction. A potential pathogenic mechanism of osmotic demyelination in the setting of acute treatment for hyperammonemia in a patient with a urea cycle abnormality includes disruption of the blood-brain barrier and re-equilibration of organic osmolytes, particularly glutamine.

  19. Mielinólise pontina central após transplante hepático: o sódio é o único vilão? Relato de caso Mielinólisis pontina central después del transplante hepático: ¿es el sodio el único villano? Relato de caso Central pontine myelinolysis after liver transplantation: is sodium the only villain? Case report

    Directory of Open Access Journals (Sweden)

    Bruno Salomé de Morais

    2009-06-01

    transplante hepático y discutir su fisiopatología. RELATO DEL CASO: Paciente del sexo femenino, 29 años, sometida a transplante hepático debido a un fracaso hepático fulminante. En el postoperatorio, presentó un cuadro neurológico característico de Síndrome Locked In y lesiones compatibles con la mielinólisis pontina central a la resonancia nuclear magnética. La paciente no presentó oscilaciones exageradas del sodio plasmático, que es el ión frecuentemente acusado de ser el agente causador, y evolucionó con una mejoría significativa en algunas semanas. CONCLUSIONES: La mielinólisis pontina central tiene una etiología multifactorial, y una atención especial debe dársele al grupo de pacientes con mayor riesgo, tales como los sometidos a alteraciones abruptas de la natremia, transplantados de hígado, etilistas crónicos y desnutridos. Es importante reconocer, que los síndromes de desmielinización osmósticos pueden surgir en pacientes con niveles séricos de sodio bajo, normal o elevado, evidenciando la contribución de otros factores desencadenantes.BACKGROUND AND OBJECTIVES: Critically ill patients frequently develop neurologic symptoms, which frequently become a clinical challenge. Described approximately 50 years ago, pontine neuronal demyelination is a pathologic change associated with neurologic and psychiatric problems after liver transplantation. The objective of this report was to present a case of central pontine myelinolysis diagnosed after liver transplantation and to discuss its pathophysiology. CASE REPORT: A 29 years old female patient underwent liver transplantation for fulminant hepatic failure. Postoperatively, she developed neurologic symptoms characteristic of the Locked In Syndrome and the MRI showed changes compatible with central pontine myelinolysis. The patient did not develop dramatic changes in sodium plasma levels, which is frequently incriminated as the causal agent, and improved considerably within a few weeks. CONCLUSIONS

  20. Asymptomatic pontine and extra-pontine lesions in a patient with end-stage renal disease

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    Raj Kanwar Yadav

    2016-01-01

    Full Text Available Osmotic demyelination syndrome leading to central pontine/extra-pontine myelinolysis (CPM/EPM occurs mainly in patients with history of alcohol abuse, malnourishment, following liver transplantation and less commonly, in association with other systemic diseases. Asymptomatic CPM/EPM is rare. Patients with end-stage renal disease (ESRD who develop CPM/EPM are usually symptomatic with florid neurologic manifestations. Herein, we present a patient with ESRD on maintenance hemodialysis who was incidentally detected to have pontine and extra-pontine lesions suggestive of myelinolysis without any neurologic signs or symptoms.

  1. Medical image of the week: central pontine myelinolysis

    Directory of Open Access Journals (Sweden)

    Siddiqi TA

    2014-01-01

    Full Text Available A 38-year-old woman with history of alcohol abuse was admitted with generalized weakness, dehydration, alcoholic hepatitis, hyponatremia (serum sodium 116 mM/L, and cachexia (BMI 19 kg/m2. She developed hypoxemic respiratory failure after intravenous fluid resuscitation and required intubation and mechanical ventilation. Neurological exam revealed motor weakness, hyporeflexia, ataxia, and unsustained clonus. Neurology consultation was obtained and MRI revealed hyperintensity in the pons consistent with osmotic demyelination syndrome (1. Review of her records revealed her sodium level increased by 8 mM/L in first 6 hours of presentation, and then a slow increase of 4-6 mM/L daily to the normal range. She received nutritional support and aggressive physical therapy, and was discharged to skilled nursing facility after six weeks of hospitalization.

  2. Central and extrapontine myelinolysis in a patient in spite of a careful correction of hyponatremia.

    Science.gov (United States)

    Leens, C; Mukendi, R; Forêt, F; Hacourt, A; Devuyst, O; Colin, I M

    2001-03-01

    We report the case of a 54-year-old alcoholic female patient who was hospitalized for neurologic alterations along with a severe hyponatremia (plasma Na+: 97 mEq/l). She suffered from potomania and was given, a few days before admission, a thiazide diuretic for hypertension. A careful correction of plasma Na+ levels was initiated over a 48-hour period (rate of correction < 10 mEq/l/24h) in order to avoid brain demyelination. After a 2-day period of clinical improvement, her neurologic condition started to deteriorate. By the 5th day of admission, she became tetraplegic, presented pseudobulbar palsy, ataxia, strabism, extrapyramidal stiffness and clouding of consciousness. Scintigraphic and MRI investigations demonstrated pontine and extrapontine lesions associated with Gayet-Wernicke encephalopathy. After correction of ionic disorders (hyponatremia, hypokaliemia) and vitamin B (thiamine) deficiency, the patient almost completely recovered without notable disabilities. This case illustrates that profound hyponatremia, in a paradigm of slow onset, can be compatible with life. It also demonstrates that demyelinating lesions, usually considered as a consequence of a too fast correction of hyponatremia, may occur despite the strict observance of recent guidelines. There is increasing evidence to suggest that pontine swelling and dysfunction may sometimes occur in alcoholic patients even in absence of disturbance in plasma Na+ levels. It is therefore of importance, while managing a hyponatremic alcoholic patient, to identify additional risk factors (hypokaliemia, hypophosphoremia, seizure-induced hypoxemia, malnutrition with vitamin B deficiency) for brain demyelination and to correct them appropriately.

  3. [Extrapontine osmotic myelinolysis].

    Science.gov (United States)

    Silva, Federico A; Rueda-Clausen, Christian F; Ramírez, Fabián

    2005-06-01

    Extrapontine osmotic myelinolysis is a rare nervous system complication. Symptoms of this malady were presented during the clinical examination of a 49-year-old alcoholic male, who arrived at the hospital emergency room in a state of cardiorespiratory arrest. After resuscitation methods were applied, the patient was found in metabolic acidosis (pH 7.014) and was treated with sodium bicarbonate. Forty-eight hours later, sodium levels in the patient had risen from 142 to 174 mEq/l. During the period of clinical observation, the patient showed signs of cognitive impairment, disartria, bilateral amaurosis, hyporeflexia and right-half body hemiparesias. After 72 hours, computer tomography was applied; this showed a bilateral lenticular hypodensity with internal and external capsule compromise. One month later, when the patient was referred to another institution for rehabilitation, the patient showed cognitive impairment, bilateral optic atrophy, residual disartria, bradikynesia and double hemiparesia.

  4. Reconstructing production technology and distribution, using thin section petrography: A pilot study of Roman pottery production in the Pontine region, Central Italy

    NARCIS (Netherlands)

    Borgers, B.; Tol, G.; de Haas, T.

    2016-01-01

    This paper explores aspects of production and distribution of local Roman pottery from the Pontine region, Central Italy, based on ceramics recovered in surveys carried out within the ‘Minor Centres’ project. The aim of this project was to investigate the role of minor centres in local economies of

  5. Central amygdala lesions inhibit pontine nuclei acoustic reactivity and retard delay eyeblink conditioning acquisition in adult rats.

    Science.gov (United States)

    Pochiro, Joseph M; Lindquist, Derick H

    2016-06-01

    In delay eyeblink conditioning (EBC) a neutral conditioned stimulus (CS; tone) is repeatedly paired with a mildly aversive unconditioned stimulus (US; periorbital electrical shock). Over training, subjects learn to produce an anticipatory eyeblink conditioned response (CR) during the CS, prior to US onset. While cerebellar synaptic plasticity is necessary for successful EBC, the amygdala is proposed to enhance eyeblink CR acquisition. In the current study, adult Long-Evans rats received bilateral sham or neurotoxic lesions of the central nucleus of the amygdala (CEA) followed by 1 or 4 EBC sessions. Fear-evoked freezing behavior, CS-mediated enhancement of the unconditioned response (UR), and eyeblink CR acquisition were all impaired in the CEA lesion rats relative to sham controls. There were also significantly fewer c-Fos immunoreactive cells in the pontine nuclei (PN)-major relays of acoustic information to the cerebellum-following the first and fourth EBC session in lesion rats. In sham rats, freezing behavior decreased from session 1 to 4, commensurate with nucleus-specific reductions in amygdala Fos+ cell counts. Results suggest delay EBC proceeds through three stages: in stage one the amygdala rapidly excites diffuse fear responses and PN acoustic reactivity, facilitating cerebellar synaptic plasticity and the development of eyeblink CRs in stage two, leading, in stage three, to a diminution or stabilization of conditioned fear responding.

  6. Transient parkinsonism in isolated extrapontine myelinolysis

    NARCIS (Netherlands)

    Post, Bart; van Gool, W. A.; Tijssen, M. A. J.

    2009-01-01

    Extrapontine myelinolysis (EPM) is a rare cause of parkinsonism. In this case report, we describe a 63-year-old woman with parkinsonism due to EPM after correction of hyponatremia. During a 4-year follow-up, both the clinical features of parkinsonism and the changes on magnetic resonance imaging res

  7. CLIPPERS: chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. Review of an increasingly recognized entity within the spectrum of inflammatory central nervous system disorders.

    Science.gov (United States)

    Dudesek, A; Rimmele, F; Tesar, S; Kolbaske, S; Rommer, P S; Benecke, R; Zettl, U K

    2014-03-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently defined inflammatory central nervous system (CNS) disorder, prominently involving the brainstem and in particular the pons. The condition features a combination of clinical symptoms essentially referable to brainstem pathology and a characteristic magnetic resonance imaging (MRI) appearance with punctate and curvilinear gadolinium enhancement 'peppering' the pons. The radiological distribution is focused in the pons and adjacent rhombencephalic structures such as the cerebellar peduncles, cerebellum, medulla and the midbrain. While the lesion burden with a perivascular pattern is typically most dense in these pontine and peripontine regions, enhancing lesions may additionally extend into the spinal cord and supratentorial structures such as the thalamus, basal ganglia, capsula interna, corpus callosum and the cerebral white matter. Another core feature is clinical and radiological responsiveness to glucocorticosteroid (GCS)-based immunosuppression. As withdrawal of GCS treatment results commonly in disease exacerbation, long-term immunosuppressive therapy appears to be mandatory for sustained improvement. Diagnosis of CLIPPERS is challenging, and requires careful exclusion of alternative diagnoses. A specific serum or cerebrospinal fluid (CSF) biomarker for the disorder is currently not known. Pathogenesis of CLIPPERS remains poorly understood, and the nosological position of CLIPPERS has still to be established. Whether CLIPPERS represents an independent, actual new disorder or a syndrome that includes aetiologically heterogeneous diseases and/or their prestages remains a debated and not finally clarified issue. Clinicians and radiologists should be aware of this condition and its differential diagnoses, given that CLIPPERS constitutes a treatable condition and that patients may benefit from an early introduction of GCS ensued by long

  8. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): A lymphocytic reactive response of the central nervous system? A case report.

    Science.gov (United States)

    Wang, Xiaolin; Huang, Dehui; Huang, Xusheng; Zhang, Jiatang; Ran, Ye; Lou, Xin; Gui, Qiuping; Yu, Shengyuan

    2017-04-15

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroid (CLIPPERS) was first described in 2010. The characteristic clinical picture, radiological distribution and steroid response have been well-described in previous reports. However, the underlying pathogenesis and nosological position of CLIPPERS in the CNS require further investigation for the primary CNS lymphoma have been identified by autopsy subsequently. Here, we report a 51-year-old woman who was diagnosed with CLIPPERS but progressed to primary CNS lymphomatoid granulomatosis, which supports that CLIPPERS is not just an inflammatory CNS disorder.

  9. Centropontine myelinolysis related to refeeding syndrome in an adolescent suffering from anorexia nervosa.

    Science.gov (United States)

    Leroy, Sandrine; Gout, Ariel; Husson, Beatrice; de Tournemire, Renault; Tardieu, Marc

    2012-06-01

    Centropontine myelinolysis (CPM) is a rare neurologic disorder defined by symmetric demyelination in the central pons, mostly due to alcoholism, malnutrition, or water-electrolyte abnormalities. We report an unusual case of CPM likely due to hypophosphatemia, related to a refeeding syndrome in the context of mental anorexia. A 15-year-old girl with mental anorexia presented with hypophosphatemia in the following days of enteral refeeding, and then suffered from confusion, neurological signs, and typical MRI lesions of CPM. Hypophosphoremia may be considered as a causative agent in CPM related to refeeding syndrome. This clinical observation also highlights the importance of recognizing patients at high risk of refeeding syndrome to initiate a balanced nutrition with careful monitoring.

  10. Dystonias

    Science.gov (United States)

    ... a lack of oxygen to the brain, and neonatal brain hemorrhage), certain infections, reactions to certain drugs, ... NINDS Central Cord Syndrome Information Page NINDS Central Pain Syndrome Information Page NINDS Central Pontine Myelinolysis Information ...

  11. Zuogui pills for myelinolysis in a rat model of experimental autoimmune encephalomyelitis

    Institute of Scientific and Technical Information of China (English)

    Yongping Fan; Kelong Chen; Kangning Li; Jianping Zhou; Yan Shao; Hongyan Liu; Wenjing Yang

    2011-01-01

    Zuogui pills have been shown to attenuate the inflammatory reaction in a rat model of experimental autoimmune encephalomyelitis (EAE). The present study attempted to investigate the pathology underlying the influence of Zuogui pills on myelinolysis in EAE rats. Hematoxylin-eosin and Luxol fast blue staining showed that the myelinolysis foci in the cerebrum, cerebellum, brain stem, and the spinal cord of EAE rats were significantly decreased, along with serum myelin basic protein content following treatment with Zuogui pills.

  12. Patient with pontine warning syndrome and bilateral posterior internuclear ophthalmoplegia: case report

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    Su Li

    2010-06-01

    Full Text Available Abstract Background Capsular warning syndrome was first described in 1993, featured with repetitive episodes of motor and/or sensory dysfunction without cortical signs. Recently, it has been demonstrated that clinically typical capsular warning syndrome can be associated with pontine infarct and the term “pontine warning syndrome� was coined. Case Presentation A 54-year-old woman with a history of hypertension was seen with profound left-sided hemiplegia. She had had 3 episodes of left-sided weakness before complete hemiplegia. Her speech was slurred. Left central facial palsy and hemiglossoplegia were presented. Her left plantar response was extensor and bilateral posterior internuclear ophthalmoplegia was seen on neurologic examination. Biochemical tests revealed hyperglycemia and dyslipidemia on the next day. MRI demonstrated an acute right paramedian pontine infarct. The patient was commenced on oral clopidogrel, atorvastatin and acarbose. After 23 days of hospitalization, she was discharged with severe left hemiplegia. Conclusions 1 Pontine warning syndrome may be underestimated and understudied. 2 Posterior internuclear ophthalmoplegia is a rare clinical sign in cerebrovascular diseases, while it can help to locate a brainstem lesion rather than an internal capsular one. 3 Blood pressure lowing administration may be improper for patients with pontine warning syndrome.

  13. An extended chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids phenotype

    OpenAIRE

    Lane, Chris; Phadke, Rahul; Howard, Robin

    2014-01-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently described central nervous system inflammatory condition. In this case report we describe a patient initially with features consistent with this syndrome, who represented with seizures (not previously reported in this syndrome) and corresponding prominent cortical involvement on imaging (also not previously noted). Owing to diagnostic uncertainty, cerebral biopsy was performed...

  14. Musical hallucinations associated with pontine lacunar lesions.

    Science.gov (United States)

    Serby, Michael J; Hagiwara, Mari; O'Connor, Lisa; Lalwani, Anil K

    2013-01-01

    Three elderly patients experienced musical hallucinations (MH) in the context of hearing loss. In at least two of the cases, the onset was sudden. All three patients had pontine T2/FLAIR hyperintense foci on MR scan after the onset of the MH.

  15. A neurotological study of patients with pontine hyperintense lesions on T2 weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Toru; Tominaga, Satoru; Yukimasa, Akiko; Oku, Masaya; Sakagami, Masafumi [Hyogo Coll. of Medicine, Nishinomiya (Japan)

    2002-03-01

    Pontine hyperintense lesions seen on T2-weighted MRI were thought to be related to disequilibrium. Some of these lesions have a low signal on T1-weighted imaging, while others have an iso-signal. The purpose of this study was to clarify the relationship between neurological findings and pontine lesions detected by MRI. The subjects were 11 patients (6 males, 5 females; age range: 30 to 83 years [mean: 64.1 years]) with pontine hyperintense lesions identified on T2-weighted MRI. We compared the clinical signs and the MRI findings. Six of the patients had low-intensity areas on T1-weighted images, and the other 5 had iso-intensity areas. Six patients complained of vertigo, and 5 complained of dizziness. Eight complained of positionaly evoked disequilibrium. Positional nystagmus was seen in 4 patients. In 9 patients, abnormalities were found on the ENG test, including the saccadic eye movement test, ETT, and OKP. Numbness on the lips occurred in 2 patients, and cerebellar signs were present in 4. None of the patients had facial paralysis. Disequilibrium originating in the central nervous system was suggested in 10 patients. Clinical examinations revealed similar findings in patients with a low signal on T1-weighted MRI and those with an iso-signal. Our results indicate that pontine lesions identified by T2-weighted MRI cause vertigo or dizziness, and, in most cases, these lesions cause abnormal neurological or neurological abnormalities. (author)

  16. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): A case report and review of literature

    OpenAIRE

    Soma Madhan Reddy; Rahul Lath; Meenakshi Swain; Alok Ranjan

    2015-01-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently described inflammatory disease of central nervous system with distinct clinical and radiological features. The etiopathogenesis of this rare entity remains to be understood. The histopathological findings closely resemble chronic inflammatory diseases like sarcoidosis and malignancies like lymphoma. With advancements in serology, immunopathology and radiology CLIPPERS is iden...

  17. Chronic hepatitis B infection presenting with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): a case report

    OpenAIRE

    Weng, Ching-Fu; Chan, Ding-Cheng; Chen, Ya-Fang; Liu, Fei-Chih; Liou, Horng-Huei

    2015-01-01

    Introduction Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids is a brainstem disorder characterized by perivascular pathologic reaction with lymphocyte infiltration and leading to diplopia, facial palsy, dysarthria, and gait ataxia. It was thought to be an autoimmune disorder without distinct pathogenesis. Chronic hepatitis B virus infection has been proposed in correlation with autoimmune diseases, including central nervous system demyelinating di...

  18. Pontine hemorrhage in a patient with pheochromocytoma.

    Science.gov (United States)

    Scardigli, K; Biller, J; Brooks, M H; Cespedes, L E; Posniak, H V

    1985-02-01

    A 24-year-old woman with a two-year history of hypertension was hospitalized for coma and quadriplegia secondary to pontine hemorrhage. A seven-year history of intermittent severe headaches, diaphoresis, and anxiety together with persistent severe hypertension led to the diagnosis of pheochromocytoma. This unusual but devastating manifestation of pheochromocytoma illustrates the importance of excluding remedial forms of hypertension in young patients before initiating antihypertensive therapy.

  19. Evaluating the evidence surrounding pontine cholinergic involvement in REM sleep generation

    Directory of Open Access Journals (Sweden)

    Kevin P Grace

    2015-09-01

    Full Text Available Rapid eye movement (REM sleep - characterized by vivid dreaming, motor paralysis, and heightened neural activity - is one of the fundamental states of the mammalian central nervous system. Initial theories of rapid eye movement (REM sleep generation posited that induction of the state required activation of the ‘pontine REM sleep generator’ by cholinergic inputs. Here we review and evaluate the evidence surrounding cholinergic involvement in REM sleep generation. We submit that: (i the capacity of pontine cholinergic neurotransmission to generate REM sleep has been firmly established by gain-of-function experiments, (ii the function of endogenous cholinergic input to REM sleep generating sites cannot be determined by gain-of-function experiments; rather, loss-of-function studies are required, (iii loss-of-function studies show that endogenous cholinergic input to the PFT is not required for REM sleep generation, and (iv Cholinergic input to the pontine REM sleep generating sites serve an accessory role in REM sleep generation: reinforcing non-REM-to-REM sleep transitions making them quicker and less likely to fail.

  20. Evaluating the Evidence Surrounding Pontine Cholinergic Involvement in REM Sleep Generation.

    Science.gov (United States)

    Grace, Kevin P; Horner, Richard L

    2015-01-01

    Rapid eye movement (REM) sleep - characterized by vivid dreaming, motor paralysis, and heightened neural activity - is one of the fundamental states of the mammalian central nervous system. Initial theories of REM sleep generation posited that induction of the state required activation of the "pontine REM sleep generator" by cholinergic inputs. Here, we review and evaluate the evidence surrounding cholinergic involvement in REM sleep generation. We submit that: (i) the capacity of pontine cholinergic neurotransmission to generate REM sleep has been firmly established by gain-of-function experiments, (ii) the function of endogenous cholinergic input to REM sleep generating sites cannot be determined by gain-of-function experiments; rather, loss-of-function studies are required, (iii) loss-of-function studies show that endogenous cholinergic input to the PTF is not required for REM sleep generation, and (iv) cholinergic input to the pontine REM sleep generating sites serve an accessory role in REM sleep generation: reinforcing non-REM-to-REM sleep transitions making them quicker and less likely to fail.

  1. Control of breathing by interacting pontine and pulmonary feedback loops

    Directory of Open Access Journals (Sweden)

    Yaroslav I Molkov

    2013-02-01

    Full Text Available The medullary respiratory network generates respiratory rhythm via sequential phase switching, which in turn is controlled by multiple feedbacks including those from the pons and nucleus tractus solitarii; the latter mediates pulmonary afferent feedback to the medullary circuits. It is hypothesized that both pontine and pulmonary feedback pathways operate via activation of medullary respiratory neurons that are critically involved in phase switching. Moreover, the pontine and pulmonary control loops interact, so that pulmonary afferents control the gain of pontine influence of the respiratory pattern. We used an established computational model of the respiratory network (Smith et al. J. Neurophysiol. 2007 and extended it by incorporating pontine circuits and pulmonary feedback. In the extended model, the pontine neurons receive phasic excitatory activation from, and provide feedback to, medullary respiratory neurons responsible for the onset and termination of inspiration. The model was used to study the effects of: (1 vagotomy (removal of pulmonary feedback, (2 suppression of pontine activity attenuating pontine feedback, and (3 these perturbations applied together on the respiratory pattern and durations of inspiration (TI and expiration (TE. In our model: (a the simulated vagotomy resulted in increases of both TI and TE, (b the suppression of pontine-medullary interactions led to the prolongation of TI at relatively constant, but variable TE, and (c these perturbations applied together resulted in apneusis, characterized by a significantly prolonged TI. The results of modeling were compared with, and provided a reasonable explanation for, multiple experimental data. The characteristic changes in TI and TE demonstrated with the model may represent characteristic changes in the balance between the pontine and pulmonary feedback control mechanisms that may reflect specific cardio-respiratory disorders and diseases.

  2. Primary cerebello-pontine angle malignant melanoma : a case report.

    Directory of Open Access Journals (Sweden)

    Desai K

    2001-04-01

    Full Text Available A rare case of primary malignant melanoma in the cerebello-pontine angle, in a 17 year old girl is presented. The patient presented with one month history of headache, diplopia, facial asymmetry and ataxia. The computerised tomography (CT scan and magnetic resonance imaging (MRI revealed a large cerebello-pontine angle mass with features suggestive of a melanoma. The typical black coloured, solid and vascular melanoma was excised completely. Cerebello-pontine angle melanoma are extremely rare tumours with dismal long term outcome in majority of these cases.

  3. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS).

    Science.gov (United States)

    Pittock, Sean J; Debruyne, Jan; Krecke, Karl N; Giannini, Caterina; van den Ameele, Jelle; De Herdt, Veerle; McKeon, Andrew; Fealey, Robert D; Weinshenker, Brian G; Aksamit, Allen J; Krueger, Bruce R; Shuster, Elizabeth A; Keegan, B Mark

    2010-09-01

    The classification and pathological mechanisms of many central nervous system inflammatory diseases remain uncertain. In this article we report eight patients with a clinically and radiologically distinct pontine-predominant encephalomyelitis we have named 'chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids' (CLIPPERS). The patients were assessed clinically, radiologically and pathologically at Mayo Clinic, USA and Ghent University Hospital, Belgium from 1999 to 2009. Median follow-up duration from clinical onset was 22 months (range 7-144 months). Patients underwent extensive laboratory (serum and cerebrospinal fluid), radiological and pathological testing (conjunctival, transbronchial and brain biopsies) to search for causes of an inflammatory central nervous system disorder. All eight patients (five female, three male) presented with episodic diplopia or facial paresthesias with subsequent brainstem and occasionally myelopathic symptoms and had a favourable initial response to high dose glucocorticosteroids. All patients had symmetric curvilinear gadolinium enhancement peppering the pons and extending variably into the medulla, brachium pontis, cerebellum, midbrain and occasionally spinal cord. Radiological improvement accompanied clinical response to glucocorticosteroids. Patients routinely worsened following glucocorticosteroid taper and required chronic glucocorticosteroid or other immunosuppressive therapy. Neuropathology of biopsy material from four patients demonstrated white matter perivascular, predominantly T lymphocytic, infiltrate without granulomas, infection, lymphoma or vasculitis. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids is a definable, chronic inflammatory central nervous system disorder amenable to immunosuppressive treatment. The T cell predominant inflammatory pathology in affected central nervous system lesions and the clinical and radiological

  4. [CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids)].

    Science.gov (United States)

    Kan, Shinichi

    2016-09-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) has been recently identified as an inflammatory central nervous system (CNS) disorder. Punctate and curvilinear gadolinium enhancement (peppering) the pons is a characteristic magnetic resonance imaging (MRI) feature of CLIPPERS. Pathogenesis of this disorder remains unknown. A specific serum or cerebrospinal fluid biomarker for this disorder is currently unknown. Whether CLIPPERS is an actual new disease or just represents overlapping symptoms from multiple diseases is still debated. Many differential diagnoses exist even when using imaging as a tool. Pre-lymphoma states, such as grade I LYG (lymphomatoid granulomatosis) and sentinel lesions of primary CNS lymphoma are the most difficult to distinguish.

  5. An extended chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids phenotype.

    Science.gov (United States)

    Lane, Chris; Phadke, Rahul; Howard, Robin

    2014-06-25

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently described central nervous system inflammatory condition. In this case report we describe a patient initially with features consistent with this syndrome, who represented with seizures (not previously reported in this syndrome) and corresponding prominent cortical involvement on imaging (also not previously noted). Owing to diagnostic uncertainty, cerebral biopsy was performed revealing histology consistent with CLIPPERS, excluding other differentials. Following a further brainstem relapse, this patient was treated with high-dose steroids, subsequently switched to a tapering oral regime and now, azathioprine, a steroid-sparing agent. She remains well on this.

  6. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) with intracranial Epstein–Barr virus infection

    OpenAIRE

    Ma, Yue; Sun, Xiaolong; Li, Wen; Li, Yi; Kang, Tao; Yang, Xiai; Jiang, Wen

    2016-01-01

    Abstract Background: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory disorder in the central nervous system (CNS) with distinct clinical, radiological, and pathological features. The pathophysiology of CLIPPERS still remains unclear and the reports are quite few. Although the radiological lesions were reported to be located predominantly in the pons, brachium pontis, and cerebellum, other adjacent structures such as t...

  7. Cerebellar and pontine tegmental hypermetabolism in miller-fisher syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yu Kyrong; Kim, Ji Soo; Lee, Won Woo; Kim, Sang Eun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Miller Fisher syndrome (MFS) has been considered as a variant of Guillain-Barre syndrome (GBS), a type of acute immune neuropathies involving peripheral nerve system. Unlike GBS, presence of cerebellar type ataxia and supranuclear ophthalmioplesia in MFS suggests additional involvement of the central nervous system. To determine involvement of the central nervous system in MFS, we investigated the cerebral metabolic abnormalities in patients with MFS using FDG PET. Nine patients who were diagnosed as MFS based on acute ophthalmoplegia, ataxia, and areflexia without other identifiable causes participated in this study. In six patients, serum antibodies possibly related with symptom of MFS (anti- GQ1b or anti-GM1) were detected at the time of the study. With the interval of 25 26 days (range: 3-83 days) from the symptom on set, brain FDG PET were underwent in patients and compared with those from healthy controls. In group analysis comparing with healthy controls, FDG PET of patients revealed increased metabolism in the bilateral cerebellar hemispheres and vermis, and the thalamus. In contrast, the occipital cortex showed decreased metabolism. Individual analyses disclosed hypermetabolism in the cerebellar vermis or hemispheres in 5, and in the pontine tegmentum in 2 of the 9 patients. We also found that the cerebellar vermian hypermetabolism was inversely correlated with the interval between from the symptom on set to PET study. Moreover, follow-up PET of a patient demonstrated that cerebellar hypermetabolism decreased markedly with an improvement of the ophthalmoplegia and ataxia. These findings indicate an involvement of the central nervous system in MFS and suggest an antibody-associated acute inflammatory process as a mechanism of this disorder.

  8. Value of MRI for the diagnosis of pontine infarction%磁共振成像在脑桥梗死诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    殷雁; 金钰; 孙庆华; 尹琳

    2012-01-01

    目的 探讨脑桥梗死的临床与MRI特征.方法 回顾性分析96例脑桥梗死患者的临床资料,评估危险因素,分析临床与MRI特点.结果 首发临床表现复杂多样,96例患者中,头晕或眩晕79例(82.29%),肢体活动不便76例(79.17%),构音障碍54例(56.25%),中枢性面瘫49例(51.04%),感觉障碍31例(32.29%),中枢性舌瘫25例(26.04%)等表现最常见;多表现为病灶对侧的中枢性面瘫和(或)舌瘫合并肢体瘫和(或)无感觉障碍,而经典脑桥综合征3例(3.13%);病灶在脑桥上段21例(21.88%),中段62例(64.58%),下段13例(13.54%);腹内侧41例(42.71%),腹外侧22例(22.92%),中部16例(16.67%),背内侧11例(11.46%),背外侧6例(6.25%).结论 脑桥梗死常见临床表现为头晕或眩晕,肢体活动受限,构音障碍,中枢性面瘫,感觉障碍,中枢性舌瘫.交叉症状或体征在脑桥梗死患者中并不常见,经典的脑桥综合征病例少见.脑桥梗死以中段最常见,尤其是腹内侧.MRI对脑桥梗死的诊断有极其重要的意义.%Objective To study the clinical and MRI features of pontine infarction. Methods The clinical data about 96 patients with pontine infarction were retrospectively analyzed. Its risk factors were assessed. Clinical and MRI features of pontine infarction were analyzed. Results Among the 96 patients with different clinical manifestations, dizziness or vertigo was found in 79 (82. 29%),limb paralysis in 76(79. 17%) , barylalia in 54 (56. 25%) , central facial palsy in 49 (51. 04%), sensory disturbance in 31(32. 29%),central tongue palsy in 25(26.04%) respectively. Pontine infarction was usually manifested as contralateral central facial and/or tongue palsy accompanying limb paralysis and/or sensory disturbance. Three patients were diagnosed with classical pontine syndrome. Lesions were found in the upper,middle and lower pontine of 21(21. 88%) , 62(64. 58%) and 13(13. 54%)patients, respectively,and in the ventral

  9. Primary pontine hemorrhage. A clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Jun; Kagimoto, Hiroshi; Maeda, Masanobu; Soda, Takao [Shimane Prefectural Central Hospital, Izumo (Japan)

    2002-07-01

    We studied the relationship between outcome and clinical symptoms or CT findings of 34 cases with primary pontine hemorrhage diagnosed by CT scan from April 1994 to March 1999. This series comprised 19 males and 15 females ranging in age from 45 to 89 years with a mean of 67.1 years. According to their outcome at discharge, the cases were divided into 6 groups. Sixteen cases died within 2 weeks after onset (group AD), 4 cases died with complication in the chronic phase (group D), 3 cases were severely disabled to bed-ridden state (group C), 2 cases recovered to a daily life with wheelchair (group B), 4 cases recovered to a daily life with partial assistance (group A), and 5 cases showed a full recovery (group J). The factors significantly correlated with bed outcome are as follows: young age, consciousness disturbance, respiratory disturbance, tachycardia over 90 beats per minute, hyperthermia over 39 deg C, abnormal pupils, loss of oculocephalic reflex, tetraplegia, decerebrate rigidity, bilateral extension or over 30 mm transverse diameter of the hematoma. (author)

  10. Pontine tegmentum hematoma: report of a case with pure hemiplegia

    Directory of Open Access Journals (Sweden)

    MILAGRES ANTONIO CARLOS DE PÁDUA

    1998-01-01

    Full Text Available The authors report the case of a 50 year-old hypertensive male patient with a pontine hematoma. The clinical presentation was characterized by pure pyramidal deficit signs (no other signs or symptoms were present. A pure hemiplegia syndrome, although common in supratentorial lesions, is considered to be a rare event in pontine vascular lesions. The pathophysiologic mechanisms of these neurological findings are unclear. The exclusive involvement of the pyramidal tract in this case is likely due to a variation in the vascular anatomy of the pons but, in some cases, a vascular malformation may be the cause.

  11. Morphine-sensitive paroxysmal sympathetic storm in pontine intracerebral hemorrhage.

    Science.gov (United States)

    Ko, Sang-Bae; Kim, Chi Kyung; Lee, Seung-Hoon; Bae, Hee-Joon; Yoon, Byung-Woo

    2010-11-01

    Paroxysmal sympathetic storm (PSS) is a rare complication of severe traumatic brain injury or cerebrovascular disease. Various medications have been tried in patients with PSS, but the clinical responses of the patients were variable. We report a classic case of PSS after spontaneous pontine hemorrhage in which the patient's fluctuating blood pressure and body temperature were dramatically stabilized using morphine.

  12. Human pontine glioma cells can induce murine tumors

    NARCIS (Netherlands)

    Caretti, V.; Sewing, A.C.; Lagerweij, T.; Schellen, P.; Bugiani, M.; Jansen, M.H.; Vuurden, D.G. van; Navis, A.C.; Horsman, I.; Vandertop, W.P.; Noske, D.P.; Wesseling, P.; Kaspers, G.J.L.; Nazarian, J.; Vogel, H.; Hulleman, E.; Monje, M.; Wurdinger, T.

    2014-01-01

    Diffuse intrinsic pontine glioma (DIPG), with a median survival of only 9 months, is the leading cause of pediatric brain cancer mortality. Dearth of tumor tissue for research has limited progress in this disease until recently. New experimental models for DIPG research are now emerging. To develop

  13. Cerebellar diaschisis in pontine infractions: a report of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Yoshiyasu [Kagawa Medical School (Japan). Second Dept. of Internal Medicine; Ayada, Yoshihide [Kagawa Medical School (Japan). Second Dept. of Internal Medicine; Izumi, Yoshinari [Kagawa Medical School (Japan). Second Dept. of Internal Medicine; Ichihara, Sin-Ichiro [Kagawa Medical School (Japan). Second Dept. of Internal Medicine; Hosomi, Naohisa [Kagawa Medical School (Japan). Second Dept. of Internal Medicine; Ohkawa, Motoomi [Kagawa Medical School (Japan). Dept. of Radiology; Matsuo, Hirohide [Kagawa Medical School (Japan). Second Dept. of Internal Medicine

    1995-05-01

    We evaluate regional cerebral and cerebellar perfusion to prove the occurrence and follow the persistence of crossed cerebellar diaschisis in infratentorial pontine infarction. Six consecutive patients exhibiting mild hemiparetic symptoms or a heavy feeling in the head (mean age 65 years; four women, two men) and diagnosed as having pontine infarction by magnetic resonance imaging were sugjected to evaluation. Lesions due to infarction were located at the upper basis pontis in five partients and the upper tegmentum pontis in one, and medially at the paramedian portion in four and laterally in two. Regional cerebral and cerebellar perfusion was evaluated semiquantitatively by iodine-123 N-isopropyl-p-iodoamphetamine (IMP) single-photon emission tomography (SPET); this was done during the acute stage in five cases (mean time after onset: 0.7 months) and during the chronic stage in three (mean time after onset: 14.8 months) Significant asymmetry in cerebellar perfusion, which was reduced in the contralateral or ipsilateral cerebellar hemisphere, was demonstrated semiquantitatively in four cases during the acute stage and in one during the chronic stage, as compared with normal controls. This asymmetry continued to the chronic stage (6.5 and 33.0 months) in two cases, while no patient showed any significant asymmetries in cerebral perdusion in any region of interest in either SPET study. The pontine lesion may damage the pyramidal tract and corticocerebellar pathway, and interruption of the cerebrocerebellar pontine circuits may be regarded as the cause of the crossed cerebellar diaschisis observed in five of the six reported patients with pontine infarction. (orig.)

  14. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) after treatment for Hodgkin's lymphoma.

    Science.gov (United States)

    Mashima, Kyoko; Suzuki, Shigeaki; Mori, Takehiko; Shimizu, Toshihiko; Yamada, Satoshi; Hirose, Shigemichi; Okamoto, Shinichiro; Suzuki, Norihiro

    2015-12-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a rare central nervous system (CNS) disorder with distinct radiological features. However, CLIPPERS may mimic CNS lymphoma, and several cases in which CLIPPERS occurred premonitory to CNS lymphoma have been reported. We report a 31-year-old man presenting with progressive gait ataxia and the characteristic MRI features of CLIPPERS. He was diagnosed with stage II Hodgkin's lymphoma at the age of 15, and we considered the possibility of newly emerged CNS lymphoma occurring in the immunosuppressive condition after the treatment of Hodgkin's lymphoma. Histological findings showed no evidence of CNS lymphoma and the neurological symptoms were resolved by steroids. Although CLIPPERS developed in the reverse order in this case, CLIPPERS should be considered in different diagnosis for CNS lymphoma.

  15. What drives progressive motor deficits in patients with acute pontine infarction?

    Directory of Open Access Journals (Sweden)

    Jue-bao Li

    2015-01-01

    Full Text Available Progressive motor deficits are relatively common in acute pontine infarction and frequently associated with increased functional disability. However, the factors that affect the progression of clinical motor weakness are largely unknown. Previous studies have suggested that pontine infarctions are caused mainly by basilar artery stenosis and penetrating artery disease. Recently, lower pons lesions in patients with acute pontine infarctions have been reported to be related to progressive motor deficits, and ensuing that damage to the corticospinal tracts may be responsible for the worsening of neurological symptoms. Here, we review studies on motor weakness progression in pontine infarction and discuss the mechanisms that may underlie the neurologic worsening.

  16. Gasperini syndrome as clinical manifestation of pontine demyelination

    Directory of Open Access Journals (Sweden)

    Krasnianski M

    2009-09-01

    Full Text Available Abstract The Gasperini syndrome is a very rare brainstem disease characterized by the typical combination of ipsilateral lesions of the cranial nerves V-VII and dissociated contralateral hemihypesthesia, whereas both contralateral and ipsilateral hypacusis was described. Since the first description in 1912, only a few cases of this crossed brainstem syndrome were published so far. Pontine infarction and bleedings were the reported causes of the syndrome. Here we report a 44-year-old man with the classical Gasperini syndrome due to pontine demyelination in multiple sclerosis. The clinical findings were correlated with changes on MRI. The present case shows that classical crossed brainstem syndromes are topological terms not invariably associated with brainstem ischemia in particular vascular areas and may contribute to the differential diagnosis of peripheral facial nerve palsy.

  17. Right Sensory Alien Hand Phenomenon from a Left Pontine Hemorrhage

    OpenAIRE

    Rafiei, Nastaran; Chang, Gregory Youngnam

    2009-01-01

    Background Acute onset of a sensory alien hand phenomenon has been observed only from a supratentorial lesion involving the non-dominant hand, mostly from a right posterior cerebral artery infarction. A single acute vascular lesion resulting in a dominant hand sensory alien hand syndrome has not been previously documented. Case Report A 78-year old right-handed woman exhibited right sensory alien hand phenomenon from a left pontine hemorrhage. Disturbance of proprioceptive input and visuospat...

  18. [Xanthofibrogranulomatosis, pontine glioma, multiple nevocytic nevi and albinism (authors transl)].

    Science.gov (United States)

    Martin, U; Cremer, H; Klein, D; Kutzner, M

    1975-05-23

    A case of retroperitoneal fibrosis with ureter compression is reported. Clinical picture and course were determined by the presence of an additional tumor (astrospongoblastoma) of the pons. Extraretroperitoneal tissue changes found at post mortem examination were shown histologically to be foreign tissues of the same type deposited in the retroperitoneal space (disseminated xanthofibrogranuloma). Possible connections between the disseminated xanthofibrogranuloma, the pontine tumor and an albinism also present and multiple nevocytic nevi of the skin are discussed.

  19. Functionally-defined Therapeutic Targets in Diffuse Intrinsic Pontine Glioma

    Science.gov (United States)

    Grasso, Catherine S.; Tang, Yujie; Truffaux, Nathalene; Berlow, Noah E.; Liu, Lining; Debily, Marie-Anne; Quist, Michael J.; Davis, Lara E.; Huang, Elaine C.; Woo, Pamelyn J; Ponnuswami, Anitha; Chen, Spenser; Johung, Tessa B.; Sun, Wenchao; Kogiso, Mari; Du, Yuchen; Lin, Qi; Huang, Yulun; Hütt-Cabezas, Marianne; Warren, Katherine E.; Dret, Ludivine Le; Meltzer, Paul S.; Mao, Hua; Quezado, Martha; van Vuurden, Dannis G.; Abraham, Jinu; Fouladi, Maryam; Svalina, Matthew N.; Wang, Nicholas; Hawkins, Cynthia; Nazarian, Javad; Alonso, Marta M.; Raabe, Eric; Hulleman, Esther; Spellman, Paul T.; Li, Xiao-Nan; Keller, Charles; Pal, Ranadip; Grill, Jacques; Monje, Michelle

    2015-01-01

    Diffuse Intrinsic Pontine Glioma (DIPG) is a fatal childhood cancer. We performed a chemical screen in patient-derived DIPG cultures along with RNAseq analyses and integrated computational modeling to identify potentially effective therapeutic strategies. The multi-histone deacetylase inhibitor panobinostat demonstrated efficacy in vitro and in DIPG orthotopic xenograft models. Combination testing of panobinostat with histone demethylase inhibitor GSKJ4 revealed synergy. Together, these data suggest a promising therapeutic strategy for DIPG. PMID:25939062

  20. Pontine Stimulation Overcomes Developmental Limitations in the Neural Mechanisms of Eyeblink Conditioning

    Science.gov (United States)

    Freeman, John H., Jr; Rabinak, Christine A.; Campolattaro, Matthew M.

    2005-01-01

    Pontine neuronal activation during auditory stimuli increases ontogenetically between postnatal days (P) P17 and P24 in rats. Pontine neurons are an essential component of the conditioned stimulus (CS) pathway for eyeblink conditioning, providing mossy fiber input to the cerebellum. Here we examined whether the developmental limitation in pontine…

  1. Osmotic demyelination syndrome following slow correction of hyponatremia: Possible role of hypokalemia

    Directory of Open Access Journals (Sweden)

    Parvaiz A Koul

    2013-01-01

    Full Text Available A 47-year-old male presented with hyponatremia that was corrected slowly as per the recommended guidelines. The patient improved initially but went on to develop a quadriparesis with a locked-in state due to a central as well as extrapontine myelinolysis and subsequently succumbed to an intercurrent infective illness. The patient had associated hypokalemia. Hyponatremia can result in central pontine myelinolysis even when the electrolyte disorder is treated slowly, and the concomitant hypokalemia seems to play a contributory role in the pathogenesis of the neurological disorder.

  2. Tegmental pontine hemorrhages: clinical features and prognostic factors.

    Science.gov (United States)

    Lancman, M; Norscini, J; Mesropian, H; Bardeci, C; Bauso, T; Granillo, R

    1992-05-01

    We report six patients with partial, predominantly paramedian, tegmental pontine hemorrhages. Constant clinical manifestations consisted of: ipsilateral miosis, horizontal gaze paresis, lower motor neuron facial paresis, contralateral hemisensory loss and mild and transitory hemiparesis, dysarthria and mild or no compromise of consciousness. Five out of six were hypertensive. All patients survived with mild sequelae, oculomotor disturbances being the most persistent deficit. We found in our patients that a transverse diameter of less than 17 mm, unilaterality of the injury and absence of coma were the major indicators of a favorable outcome.

  3. Malignant melanoma of the cerebello-pontine angle region

    Directory of Open Access Journals (Sweden)

    F. Menezes Braga

    1989-12-01

    Full Text Available A case of malignant melanoma in the cerebello-pontine angle region is presented in a 72 years old female patient, who had neurological examination and CT scan suggestive of acoustic neuroma. The surgical finding and the histological examination provided the diagnosis. As a primary focus was not found on clinical examination and although autopsy was not carried out, there is a possibility of the diagnosis being a primary malignant melanoma in CNS. This specific location for this kind of tumor was found to be rare when literature is looked up.

  4. Solitary Fibrous Tumor of the Cerebello-Pontine Angle

    Science.gov (United States)

    Biggs, Nigel D.; Fagan, Paul A.; Turner, Jennifer J.; Doust, Bruce

    1999-01-01

    A case is presented of solitary fibrous tumor occurring in the cerebello-pontine angle. There have been only two other reported cases of a solitary fibrous tumors in this region. Imaging studies showed the tumor to be characteristic in shape and position of an acoustic tumor. However, at surgery the tumor was found to have a “rock hard” consistency. Solitary fibrous tumor differs from acoustic schwannoma and meningioma in its histopathological features and in this case, regrowth, after incomplete excision, was extremely rapid. ImagesFigure 2Figure 3Figure 4Figure 5Figure 6 PMID:17171119

  5. [Pontine cavernous angioma (cavernoma) with initial ENT manifestations].

    Science.gov (United States)

    Pino Rivero, V; González Palomino, A; Pantoja Hernández, C G; Trinidad Ruíz, G; Marqués Rebollo, L; Blasco Huelva, A

    2006-01-01

    We report the case of a 22 years old female who consulted us for facial parestesias, hearing loss in right ear and sudden tinnitus. Her audiometry showed an unilateral discreet sensorineural hipoacusia and the cranial IRM, a mass of 20 mm diameter in right pontine region and bulbus informed as cavernous angioma with signs of recent bleeding. The patient was sent to Neurosurgery but she refused the intervention. The risk of hemorrhage in the cavernomas is estimated at 0.25% to 1.6% per year and represents the main reason to advise a surgical treatment.

  6. German flooding of the Pontine Marshes in World War II.

    Science.gov (United States)

    Geissler, Erhard; Guillemin, Jeanne

    2010-03-01

    The German army's 1943 flooding of the Pontine Marshes south of Rome, which later caused a sharp rise in malaria cases among Italian civilians, has recently been described by historian Frank Snowden as a unique instance of biological warfare and bioterrorism in the European theater of war and, consequently, as a violation of the 1925 Geneva Protocol prohibiting chemical and biological warfare. We argue that archival documents fail to support this allegation, on several counts. As a matter of historical record, Hitler prohibited German biological weapons (BW) development and consistently adhered to the Geneva Protocol. Rather than biological warfare against civilians, the Wehrmacht used flooding, land mines, and the destruction of vital infrastructure to obstruct the Allied advance. To protect its own troops in the area, the German army sought to contain the increased mosquito breeding likely to be caused by the flooding. Italians returning to the Pontine Marshes after the German retreat in 1944 suffered malaria as a result of environmental destruction, which was banned by the 1899 and 1907 Hague Conventions and by subsequent treaties. In contrast, a state's violation of the Geneva Protocol, whether past or present, involves the use of germ weapons and, by inference, a state-level capability. Any allegation of such a serious violation demands credible evidence that meets high scientific and legal standards of proof.

  7. Can pontine trigeminal T2-hyperintensity suggest herpetic etiology of trigeminal neuralgia?

    Science.gov (United States)

    Russo, Carmela; Ugga, Lorenzo; Mazio, Federica; Capone, Elisa; D’Arco, Felice; Mankad, Kshitij; Caranci, Ferdinando; Marano, Enrico; Brunetti, Arturo

    2016-01-01

    Background Trigeminal neuralgia (TN) is usually classified into two different categories: idiopathic and secondary. We have investigated the frequency of brainstem pontine lesions in patients with idiopathic TN without multiple sclerosis (MS) or stroke, and their association with herpes zoster (HZ) infection. Methods Brain magnetic resonance imaging (MRI) studies of 28 patients with TN were retrospectively reviewed. Results We found seven patients with clinical suspicion of HZ infection and pontine T2 hyperintense lesions, associated with nerve atrophy in one case. Fifteen patients had a neurovascular conflict (NVC) without brainstem involvement, two of them associated with trigeminal atrophy, while four patients had only volumetric reduction of the nerve. In all patients MRI findings were ipsilateral to the side of TN. Conclusions Pontine T2 hyperintensities could be considered as a MRI sign of TN in patients without NVCs. This “trigeminal pontine sign” (TPS) is frequently found in association with herpetic infections. PMID:27942467

  8. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): A case report and review of literature.

    Science.gov (United States)

    Reddy, Soma Madhan; Lath, Rahul; Swain, Meenakshi; Ranjan, Alok

    2015-01-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently described inflammatory disease of central nervous system with distinct clinical and radiological features. The etiopathogenesis of this rare entity remains to be understood. The histopathological findings closely resemble chronic inflammatory diseases like sarcoidosis and malignancies like lymphoma. With advancements in serology, immunopathology and radiology CLIPPERS is identified as a distinct entity that differs considerably in its clinical presentation, immunopathology, radiological findings and response to steroids. We describe a case that presented to us with progressive quadriparesis and lower cranial nerve deficits whose radiological and pathological findings were consistent with CLIPPERS. The patient had a good outcome with long term immunosuppression.

  9. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Soma Madhan Reddy

    2015-01-01

    Full Text Available Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS is a recently described inflammatory disease of central nervous system with distinct clinical and radiological features. The etiopathogenesis of this rare entity remains to be understood. The histopathological findings closely resemble chronic inflammatory diseases like sarcoidosis and malignancies like lymphoma. With advancements in serology, immunopathology and radiology CLIPPERS is identified as a distinct entity that differs considerably in its clinical presentation, immunopathology, radiological findings and response to steroids. We describe a case that presented to us with progressive quadriparesis and lower cranial nerve deficits whose radiological and pathological findings were consistent with CLIPPERS. The patient had a good outcome with long term immunosuppression.

  10. Vesicular acetylcholine transporter-immunoreactive axon terminals enriched in the pontine nuclei of the mouse.

    Science.gov (United States)

    Tsutsumi, T; Houtani, T; Toida, K; Kase, M; Yamashita, T; Ishimura, K; Sugimoto, T

    2007-06-08

    Information to the cerebellum enters via many afferent sources collectively known as precerebellar nuclei. We investigated the distribution of cholinergic terminal-like structures in the mouse precerebellar nuclei by immunohistochemistry for vesicular acetylcholine transporter (VAChT). VAChT is involved in acetylcholine transport into synaptic vesicles and is regarded as a reliable marker for cholinergic terminals and preterminal axons. In adult male mice, brains were perfusion-fixed. Polyclonal antibodies for VAChT, immunoglobulin G-peroxidase and diaminobenzidine were used for immunostaining. In the mouse brain, immunoreactivity was seen in almost all major cholinergic cell groups including brainstem motoneurons. In precerebellar nuclei, the signal could be detected as diffusely beaded terminal-like structures. It was seen heaviest in the pontine nuclei and moderate in the pontine reticulotegmental nucleus; however, it was seen less in the medial solitary nucleus, red nucleus, lateral reticular nucleus, inferior olivary nucleus, external cuneate nucleus and vestibular nuclear complex. In particular, VAChT-immunoreactive varicose fibers were so dense in the pontine nuclei that detailed distribution was studied using three-dimensional reconstruction of the pontine nuclei. VAChT-like immunoreactivity clustered predominantly in the medial and ventral regions suggesting a unique regional difference of the cholinergic input. Electron microscopic observation in the pontine nuclei disclosed ultrastructural features of VAChT-immunoreactive varicosities. The labeled bouton makes a symmetrical synapse with unlabeled dendrites and contains pleomorphic synaptic vesicles. To clarify the neurons of origin of VAChT-immunoreactive terminals, VAChT immunostaining combined with wheat germ agglutinin-conjugated horseradish peroxidase retrograde labeling was conducted by injecting a retrograde tracer into the right pontine nuclei. Double-labeled neurons were seen bilaterally in the

  11. A quantitative evaluation of pontine atrophy by MR imaging in patients with spinocerebellar degeneration

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    Takeda, Hirotomo; Tsukamoto, Hiroshi; Kawaguchi, Hiroshi [St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    2000-04-01

    The purpose of this study is to evaluate if pontine measurement on MR images is capable of diagnosing spinocerebellar degeneration (SCD). The study population consists of 68 cases with SCD (34 males and 34 females with a mean age of 57.8 years ranging from 28 to 82 years) and 240 controls (120 males and 120 females with a mean age of 49.3 years ranging from 20 to 78 years). Patients with SCD were classified into three groups. Type I includes 23 cases with olivopontocerebellar atrophy (OPCA), 7 with spinocerebellar ataxia 2 (SCA2), one with SCA3, 3 with multiple system atrophy (MSA), and one with dentate-rubro-pallido-luysian atrophy (DRPLA) (total of 35 cases). Type II consists of 12 cases with late cortical cerebellar atrophy (LCCA) and 3 with SCA6 (total of 15 cases). The last group includes 18 cases with unclassified SCD. The pontine index was calculated using the following equation; transverse distance between bilateral trigeminal nerve root x AP distance of the pons between the pontine basilar sulcus and the median sulcus of the fourth ventricle. Measurement was performed at the level of the trigeminal nerve root on axial T1-weighted images. Pontine indexes were 699{+-}77.19 for the controls and 455{+-}134.23 for SCD groups (pERROR [Basic syntax error] in: <0ERROR [Basic syntax error] in:.0001; t-test). For SCD patients the pontine indexes were significantly Small for Type I in contrast to Type II (pERROR [Basic syntax error] in:<0ERROR [Basic syntax error] in:.001; t-test). Sensitivity of the Pontine indexes for SCD was 70.6% with a cutoff value of 540 (mean-2SD of controls). In agreement with the findings of the study it is proposed that the pontine index may be useful in diagnosis of SCD and OPCA in particular. (author)

  12. Reduced thalamic and pontine connectivity in Kleine-Levin syndrome

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    Maria eEngström

    2014-04-01

    Full Text Available The Kleine-Levin syndrome is a rare sleep disorder, characterized by exceptionally long sleep episodes. The neuropathology of the syndrome is unknown and treatment is often inadequate. The aim of the study was to improve understanding of the underlying neuropathology, related to cerebral networks, in Kleine-Levin syndrome during sleep episodes. One patient with Kleine-Levin syndrome and congenital nystagmus, was investigated by resting state functional Magnetic Resonance Imaging during both asymptomatic and hypersomnic periods. Fourteen healthy subjects were also investigated as control samples. Functional connectivity was assessed from seed regions of interest in the thalamus and the dorsal pons. Thalamic connectivity was normal in the asymptomatic patient whereas the connectivity between the brain stem, including dorsal pons, and the thalamus was diminished during hypersomnia. These results suggest that the patient’s nystagmus and hypersomnia might have their pathological origin in adjacent dorsal pontine regions. This finding provides additional knowledge of the cerebral networks involved in the neuropathology of this disabling disorder. Furthermore, these findings regarding a rare syndrome have broad implications and results could be of interest to researchers and clinicians in the whole field of sleep medicine.

  13. Pre-Clinical Models of Diffuse Intrinsic Pontine Glioma

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    Oren J Becher

    2015-07-01

    Full Text Available Diffuse Intrinsic Pontine Glioma (DIPG is a rare and incurable brain tumor that arises in the brainstem of children predominantly between the ages of six and eight. Its intricate morphology and involvement of normal pons tissue precludes surgical resection, and the standard of care today remains fractionated radiation alone. In the past 30 years, there have been no significant advances made in the treatment of DIPG. This is largely because we lack good models of DIPG and therefore have little biological basis for treatment. In recent years however, due to increased biopsy and acquisition of autopsy specimens, research is beginning to unravel the genetic and epigenetic drivers of DIPG. Insight gleaned from these studies has led to improvements in approaches to both model these tumors in the lab, as well as to potentially treat them in the clinic. This review will detail the initial strides towards modeling DIPG in animals, which included allograft and xenograft rodent models using non-DIPG glioma cells. Important advances in the field came with the development of in vitro cell and in vivo xenograft models derived directly from autopsy material of DIPG patients or from human embryonic stem cells. Lastly, we will summarize the progress made in the development of genetically engineered mouse models of DIPG. Cooperation of studies incorporating all of these modeling systems to both investigate the unique mechanisms of gliomagenesis in the brainstem and to test potential novel therapeutic agents in a preclinical setting will result in improvement in treatments for DIPG patients.

  14. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) with intracranial Epstein–Barr virus infection

    Science.gov (United States)

    Ma, Yue; Sun, Xiaolong; Li, Wen; Li, Yi; Kang, Tao; Yang, Xiai; Jiang, Wen

    2016-01-01

    Abstract Background: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory disorder in the central nervous system (CNS) with distinct clinical, radiological, and pathological features. The pathophysiology of CLIPPERS still remains unclear and the reports are quite few. Although the radiological lesions were reported to be located predominantly in the pons, brachium pontis, and cerebellum, other adjacent structures such as the white matter and spinal cord were very recently reported as involved regions in CLIPPERS. In this study, we report a case of CLIPPERS presenting with intracranial Epstein–Barr virus (EBV) infection and diffuse white matter involvement. Case summary: A 37-year-old male was diagnosed with mediastinal Hodgkin's lymphoma (lymphocyte predominance type) at the age of 26, and then obtained complete remission after treatment and remained free of relapse for 11 years. He was admitted with 7 months’ history of mental disorder, and 20 days’ history of gait and limb ataxia, dysphagia, and cough. The diagnosis of CLIPPERS was established based on the findings of punctate and nodular enhancing lesions in the bilateral pons, the basal ganglia, the mid-brain, the pontine brachium, and diffuse white matter in magnetic resonance imaging (MRI), together with CD3+ T-lymphocytic inflammatory infiltration in perivascular and parenchymal area revealed by bilateral parietal lobe brain biopsy. Also, our patient exhibited a good response to steroid therapy and remained free of relapse for 5 months. Importantly, we found intracranial Epstein–Barr virus infection in this patient. Conclusion: CLIPPERS might be an autoimmune disorder, and intracranial EBV-infection raises the possibility that EBV-associated autoimmunity is associated with CLIPPERS pathogenesis. PMID:27861371

  15. Wernicke′s encephalopathy following hyperemesis gravidarum

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    Sandeep Kantor

    2014-01-01

    Full Text Available Wernicke′s encephalopathy (WE is a potentially reversible yet serious neurological manifestation caused by vitamin B 1 (thiamine deficiency. It is commonly associated with heavy alcohol consumption. Other clinical associations are with hyperemesis gravidarum (HG, starvation, and prolonged intravenous feeding. Most patients present with the triad of ocular signs, ataxia, and confusion. It can be associated with life-threatening complication like central pontine myelinolysis (CPM. We report two cases of WE following HG, with two different outcomes.

  16. Rapid and fulminant leptomeningeal spread following radiotherapy in diffuse intrinsic pontine glioma.

    Science.gov (United States)

    Tinkle, Christopher L; Orr, Brent A; Lucas, John T; Klimo, Paul; Patay, Zoltan; Baker, Suzanne J; Broniscer, Alberto; Qaddoumi, Ibrahim

    2017-01-13

    A 4-year-old male presented with rapid-onset cranial nerve palsy and ataxia. Brain magnetic resonance imaging (MRI) revealed a pontine mass lesion with discordant conventional and advanced imaging. A stereotactic core biopsy revealed glioblastoma with immunostaining suggestive of histone H3K27M and TP53 mutation, consistent with diffuse intrinsic pontine glioma. MRI 3 months after radiotherapy revealed extensive new leptomeningeal metastatic disease involving both the supra- and infratentorial brain, as well as the imaged portion of the spine. Tissue procured at the time of needle biopsy has undergone striking in vivo expansion as an orthotopic xenograft.

  17. Rehabilitation for a Patient with Hemiplegia, Ataxia, and Cognitive Dysfunction Caused by Pontine Hemorrhage

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    Tetsuya Tsunoda

    2015-10-01

    Full Text Available Patients with pontine hemorrhage usually experience severe disturbances of consciousness, pupillary abnormalities, quadriparesis, and respiratory failure. However, little is known regarding cognitive dysfunction in patients with pontine hemorrhage. We report the case of a rehabilitation patient presenting with hemiplegia, ataxia, and cognitive dysfunction caused by a pontine hemorrhage. A 55-year-old, right-handed male suffered sudden onset of vertigo, dysarthria, and hemiplegia on the right side. He was diagnosed with brain stem hemorrhage, and conservative treatment was administered. The vertigo improved, but dysarthria, ataxia, hemiplegia, and gait disorder persisted. He was disoriented with respect to time and place and showed a poor attention span, impaired executive function, and reduced volition. A computed tomography revealed hematomas across the pons on both sides, but no lesions were obvious in the cerebellum and cerebrum. Single-photon emission tomography showed decreased perfusion in the brain stem, bilateral basal ganglia, and frontal and parietal lobes in the left hemisphere. The patient received exercise therapy and cognitive rehabilitation, and home modifications were performed to allow him to continue living at home under the supervision of his family. His symptoms improved, along with enhanced regional cerebral blood flow to the frontal and temporal lobes. These findings suggest that the pontine hemorrhage caused diaschisis resulting in secondary reduction of activity in the cerebral hemisphere and the occurrence of cortical symptoms. Therefore, rehabilitation is necessary, along with active instructions for the family members of patients with severe neurological deficits.

  18. Pontine glioma extending to the ipsilateral cavernous sinus and Meckel's cave: MR appearance.

    Science.gov (United States)

    Yuh, W T; Nguyen, H D; Mayr, N A; Follett, K A

    1992-01-01

    The authors describe an exophytic glioma of the pons that grew into the Meckel's cave and cavernous sinus in a 75-year-old man. Pontine gliomas should be included in the differential diagnosis of a hyperintense, complex cystic mass seen along the distribution of cranial nerve V.

  19. Clinical significance of pontine high signals identified on magnetic resonance imaging

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    Watanabe, Masaki; Takahashi, Akira (Nagoya Univ. (Japan). Faculty of Medicine); Arahata, Yutaka; Motegi, Yoshimasa; Furuse, Masahiro

    1993-07-01

    Spin-echo magnetic resonance imaging (MRI) was evaluated to 530 cases in order to investigate the clinical significance of pontine high signals. The subjects comprised 109 cases of pontine infarction with high signal on T[sub 2]-weighted image and low signal on T[sub 1]-weighted image (PI group), 145 of pontine high signal with high signal on T[sub 2]-weighted image but normal signal on T[sub 1]-weighted image (PH group) and 276 of age-matched control without abnormality either on T[sub 1] or T[sub 2]-weighted images (AC group). Subjective complaints such as vertigo-dizziness were more frequent in the PH group than in the PI group. In both PI and groups, periventricular hyperintensity as well as subcortical high signals in the supratentorium were more severe than in the AC group. These degrees were higher in the PI group than in the PH group. In conclusion, PH as well as PI may result from diffuse arteriosclerosis and PH is considered to be an early finding of pontine ischemia. (author).

  20. Wild rodents of Pontine Islands as bioindicators of environmental quality / I Roditori selvatici delle isole Pontine come bioindicatori della qualità ambientale

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    Luisa Anna Ieradi

    1992-07-01

    Full Text Available Abstract An investigation was performed in Pontine Islands (Ponza, Palmarola, Zannone within the researches performed in the Latium region aimed at locating risk and control areas using wild Rodents as bioindicators. Serological analyses and mutagenetic tests were applied on collected animals (Mus domesticus, Rattus norvegicus, Rattus rattus. Serological examinations show: positive sera (17.6% against Leptospira icterohaemorrhagiae only in mice and rats from Ponza; positive sera versus Rickettsia mooseri (7%, Toxoplasma gondii (7% and Leishmania donovani (12.5%; no antibodies against Hantaviruses were detected. Results obtained by the micronucleus test show that rodent populations from Pontine Islands may be considered as control for the environmental mutagenesis studies. Riassunto Il lavoro fa parte di un progetto di ricerca che ha lo scopo di individuare aree esposte a rischio e aree di controllo attraverso l'applicazione di un sistema integrato di indagini su Roditori selvatici utilizzati come bioindicatori. Test sierologici e di mutagenesi sono stati effettuati su Murini infestanti, raccolti nelle isole Pontine (Ponza, Palmarola, Zannone individuate come presumibili aree di controllo. Il test di agglutinazione microscopica (MAT ha evidenziato sieropositività nel 17% dei Murini raccolti a Ponza. Il test di immunofluorescenza indiretta per la ricerca delle agglutinine IgG per Hantaan virus, risultato negativo in tutti gli animali esaminati, è indicativo dell'assenza del virus nel territorio. I1 test di fissazione del complemento per la ricerca di anticorpi contro le Rickettsie ha mostrato una positività solo per Rickettsia mooseri in 2 R. norvegicus e 1 R. rattus di Ponza e 2 R. rattus di Palmarola. I risultati ottenuti con il test dei micronuclei evidenziano che nelle tre specie esaminate la frequenza media

  1. [Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) associated with swelling in the brainstem: a case report].

    Science.gov (United States)

    Tani, Hiroki; Nakajima, Hideto; Yamane, Kazushi; Ohnishi, Hiroyuki; Kimura, Fumiharu; Hanafusa, Toshiaki

    2014-01-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a rare central nervous system inflammatory disease characterized by the punctate gadolinium enhancement peppering the pons and the cerebellar peduncles as neuroimaging. We report the case of a 66-year-old woman who presented with CLIPPERS associated with swelling in the brainstem. She was hospitalized because of gait ataxia and consciousness disturbance. MRI of the brain showed FLAIR hyperintense lesions in the pons, cerebellar peduncles, cerebellum and the subcortical white matter lesion in the right occipital lobe with significant swelling in the brainstem. Diffusion-weighted MRI did not show an abnormal signal, indicating vasogenic edema. Post-contrast T1-weighted MRI showed enhanced area in the right occipital lobe and panctate gadolinium enhancement peppering brainstem. Treatment with steroids led to rapid improvement. However, she showed exacerbation of clinical and radiological findings during the tapering schedule of steroid. The biopsy from the occipital lobe revealed intense perivascular and parenchymal lymphocytic infiltrates composed of primarily T cells, B cells and macrophages. The patient was diagnosed with CLIPPERS, and treatment with increased dose of corticosteroid induced a clinical improvement. Previous reports well described a characteristic MRI finding of punctate enhancement peppering the pons. In addition, the pons and cerebellar peduncles swelling can occur in this disorder.

  2. Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids with a Significant Elevation of β-2 Microglobulin Levels.

    Science.gov (United States)

    Fujisawa, Naoaki; Oya, Soichi; Mori, Harushi; Matsui, Toru

    2015-11-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a relapsing-remitting disorder for which steroid administration is a key to control the progression. CLIPPERS can exhibit radiological features similar to malignant lymphoma, whose diagnosis is confounded by prior steroid administration. We report a case of CLIPPERS accompanied by abnormal elevation of β-2 microglobulin in the cerebrospinal fluid (CSF). A 62-year-old man started to experience numbness in all fingers of his left hand one year ago, which gradually extended to his body trunk and legs on both sides. Magnetic resonance imaging demonstrated numerous small enhancing spots scattered in his brain and spinal cord. CSF levels of β-2 microglobulin were elevated; although this often indicates central nervous system involvement in leukemia and lymphoma, the lesions were diagnosed as CLIPPERS based on the pathological findings from a biopsy specimen. We emphasize the importance of biopsy to differentiate between CLIPPERS and malignant lymphoma because the temporary radiological response to steroid might be the same in both diseases but the treatment strategies regarding the use of steroid are quite different.

  3. Pudendal but not tibial nerve stimulation inhibits bladder contractions induced by stimulation of pontine micturition center in cats.

    Science.gov (United States)

    Lyon, Timothy D; Ferroni, Matthew C; Kadow, Brian T; Slater, Richard C; Zhang, Zhaocun; Chang, Victor; Lamm, Vladimir; Shen, Bing; Wang, Jicheng; Roppolo, James R; de Groat, William C; Tai, Changfeng

    2016-02-15

    This study examined the possibility that pudendal nerve stimulation (PNS) or tibial nerve stimulation (TNS) inhibits the excitatory pathway from the pontine micturition center (PMC) to the urinary bladder. In decerebrate cats under α-chloralose anesthesia, electrical stimulation of the PMC (40 Hz frequency, 0.2-ms pulse width, 10-25 s duration) using a microelectrode induced bladder contractions >20 cmH2O amplitude when the bladder was filled to 60-70% capacity. PNS or TNS (5 Hz, 0.2 ms) at two and four times the threshold (2T and 4T) to induce anal or toe twitch was applied to inhibit the PMC stimulation-induced bladder contractions. Propranolol, a nonselective β-adrenergic receptor antagonist, was administered intravenously (1 mg/kg i.v.) to determine the role of sympathetic pathways in PNS/TNS inhibition. PNS at both 2T and 4T significantly (P contractions induced by PMC stimulation, while TNS at 4T facilitated the bladder contractions. Propranolol completely eliminated PNS inhibition and TNS facilitation. This study indicates that PNS, but not TNS, inhibits PMC stimulation-induced bladder contractions via a β-adrenergic mechanism that may occur in the detrusor muscle as a result of reflex activity in lumbar sympathetic nerves. Neither PNS nor TNS activated a central inhibitory pathway with synaptic connections to the sacral parasympathetic neurons that innervate the bladder. Understanding the site of action involved in bladder neuromodulation is important for developing new therapies for bladder disorders.

  4. Focal pontine lesions provide evidence that intrinsic functional connectivity reflects polysynaptic anatomical pathways.

    Science.gov (United States)

    Lu, Jie; Liu, Hesheng; Zhang, Miao; Wang, Danhong; Cao, Yanxiang; Ma, Qingfeng; Rong, Dongdong; Wang, Xiaoyi; Buckner, Randy L; Li, Kuncheng

    2011-10-19

    Intrinsic functional connectivity detected by functional MRI (fMRI) provides a useful but indirect approach to study the organization of human brain systems. An unresolved question is whether functional connectivity measured by resting-state fMRI reflects anatomical connections. In this study, we used the well-characterized anatomy of cerebrocerebellar circuits to directly test whether intrinsic functional connectivity is associated with an anatomic pathway. Eleven first-episode stroke patients were scanned five times during a period of 6 months, and 11 healthy control subjects were scanned three times within 1 month. In patients with right pontine strokes, the functional connectivity between the right motor cortex and the left cerebellum was selectively reduced. This connectivity pattern was reversed in patients with left pontine strokes. Although factors beyond anatomical connectivity contribute to fMRI measures of functional correlation, these results provide direct evidence that functional connectivity depends on intact connections within a specific polysynaptic pathway.

  5. Neurofibromatosis type 1 associated with vertebrobasilar dolichoectasia and pontine ischemic stroke.

    Science.gov (United States)

    Giannantoni, Nadia Mariagrazia; Broccolini, Aldobrando; Frisullo, Giovanni; Pilato, Fabio; Profice, Paolo; Morosetti, Roberta; Di Lella, Giuseppe; Zampino, Giuseppe; Della Marca, Giacomo

    2015-01-01

    Neurofibromatosis type 1 (NF1) is a heterogeneous, common, neurocutaneous disorder presenting different complications during a life span, including cerebrovascular dysplasia. To our knowledge this is the first reported case of NF1 associated with vertebrobasilar dolichoectasia and pontine ischemic stroke. We describe a 57-year-old man with NF1 who presented an acute onset right-sided facial palsy and hemiplegia, dysarthria, and gait imbalance. Magnetic resonance imaging showed an acute left paramedian pontine infarct and a hypoplastic right vertebral artery. Brain Computed Tomography Angiography revealed the occurrence of vertebrobasilar dolichoectasia. Co-occurrence of VBD and NF1 might not be merely casual and it may significantly heighten the mortality rate in this multisystem disorder. We suggest a possible role of VBD in the genesis of our patient's clinical-radiological features and prompt the early detection of asymptomatic arteriopathy in individuals with NF1 in order to ameliorate patients' quality of life and life expectancy.

  6. Visual hallucinations and pontine demyelination in a child: possible REM dissociation?

    Science.gov (United States)

    Vita, Maria Gabriella; Batocchi, Anna Paola; Dittoni, Serena; Losurdo, Anna; Cianfoni, Alessandro; Stefanini, Maria Chiara; Vollono, Catello; Della Marca, Giacomo; Mariotti, Paolo

    2008-12-15

    An 11 year-old-boy acutely developed complex visual and acoustic hallucinations. Hallucinations, consisting of visions of a threatening, evil character of the Harry Potter saga, persisted for 3 days. Neurological and psychiatric examinations were normal. Ictal EEG was negative. MRI documented 3 small areas of hyperintense signal in the brainstem, along the paramedian and lateral portions of pontine tegmentum, one of which showed post-contrast enhancement. These lesions were likely of inflammatory origin, and treatment with immunoglobulins was started. Polysomnography was normal, multiple sleep latency test showed a mean sleep latency of 8 minutes, with one sleep-onset REM period. The pontine tegmentum is responsible for REM sleep regulation, and contains definite "REM-on" and "REM-off" regions. The anatomical distribution of the lesions permits us to hypothesize that hallucinations in this boy were consequent to a transient impairment of REM sleep inhibitory mechanisms, with the appearance of dream-like hallucinations during wake.

  7. [Pure motor hemiplegia with ipsilateral lingual palsy caused by pontine infarction].

    Science.gov (United States)

    Aidi, S; el Alaoui Faris, M; Essalhi, M; Jiddane, M; Chkili, T

    1996-12-01

    A 36 year old diabetic man developed a pure motor hemiplegia (PMH) associated with an ipsilateral lingual palsy. Magnetic resonance imaging revealed a pontine infarct. Lingual palsies have never been reported in patients with PMH so far, but may be associated with other lacunar syndromes such as the "dysarthria-clumsy hand syndrome". This observation supports the hypothesis that corticohypoglossal pathways may have bilateral and assymetrical projections.

  8. Pontine stroke presenting as isolated facial nerve palsy mimicking Bell's palsy: a case report

    OpenAIRE

    Saluja Paramveer; Manandhar Lochana; Agarwal Rishi; Grandhi Bala

    2011-01-01

    Abstract Introduction Isolated facial nerve palsy usually manifests as Bell's palsy. Lacunar infarct involving the lower pons is a rare cause of solitary infranuclear facial paralysis. The present unusual case is one in which the patient appeared to have Bell's palsy but turned out to have a pontine infarct. Case presentation A 47-year-old Asian Indian man with a medical history of hypertension presented to our institution with nausea, vomiting, generalized weakness, facial droop, and slurred...

  9. Sleep Duration Varies as a Function of Glutamate and GABA in Rat Pontine Reticular Formation

    OpenAIRE

    Watson, Christopher J.; Lydic, Ralph; Baghdoyan, Helen A.

    2011-01-01

    The oral part of the pontine reticular formation (PnO) is a component of the ascending reticular activating system and plays a role in the regulation of sleep and wakefulness. The PnO receives glutamatergic and GABAergic projections from many brain regions that regulate behavioral state. Indirect, pharmacological evidence has suggested that glutamatergic and GABAergic signaling within the PnO alters traits that characterize wakefulness and sleep. No previous studies have simultaneously measur...

  10. Pontine Reticulospinal Projections in the Neonatal Mouse: Internal Organization and Axon Trajectories

    OpenAIRE

    Sivertsen, Magne Sand; Perreault, Marie-Claude; Glover, Joel C.

    2015-01-01

    We recently characterized physiologically a pontine reticulospinal (pRS) projection in the neonatal mouse that mediates synaptic effects on spinal motoneurons via parallel uncrossed and crossed pathways (Sivertsen et al. [2014] J Neurophysiol 112:1628–1643). Here we characterize the origins, anatomical organization, and supraspinal axon trajectories of these pathways via retrograde tracing from the high cervical spinal cord. The two pathways derive from segregated populations of ipsilaterally...

  11. Endoscopic endonasal transclival resection of a ventral pontine cavernous malformation: technical case report.

    Science.gov (United States)

    Gómez-Amador, Juan Luis; Ortega-Porcayo, Luis Alberto; Palacios-Ortíz, Isaac Jair; Perdomo-Pantoja, Alexander; Nares-López, Felipe Eduardo; Vega-Alarcón, Alfredo

    2016-10-21

    Brainstem cavernous malformations are challenging due to the critical anatomy and potential surgical risks. Anterolateral, lateral, and dorsal surgical approaches provide limited ventral exposure of the brainstem. The authors present a case of a midline ventral pontine cavernous malformation resected through an endoscopic endonasal transclival approach based on minimal brainstem transection, negligible cranial nerve manipulation, and a straightforward trajectory. Technical and reconstruction technique advances in endoscopic endonasal skull base surgery provide a direct, safe, and effective corridor to the brainstem.

  12. Case of primary pontine hemorrhage of the young adult followed by CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Mashiyama, Shoji; Higuchi, Hiroshi; Takahashi, Akira

    1985-01-01

    A case of primary pontine hemorrhage of the young was reported. He was 22 years of age, who did not have the history of hypertension. He suddenly noticed disturbance of skilled act of his right hand and speech disturbance. He was admitted to our clinic two days after the onset. Neurological examination revealed right facial palsy, disturbance of delicate movement of his right hand and slight dysarthria. Lumbar puncture, after six days from the onset, yielded watery clear cerebrospinal fluid containing 6/3 cells/mm/sup 3/, 27mg/dl of protein and 65.1 mg/dl of sugar. An opening pressure was 75 mmH/sub 2/O. The vertebral angiography revealed no evidence of mass lesion and vascular anomalies. CT scan demonstrated a pontine hematoma, the size of this hematoma sequentially enlarged in follow-up CT scan. His clinical symptoms were gradually aggravated, i.e. cerebellar sign, urinary disturbance and involuntary movement. Conservative therapy was performed and his symptoms gradually improved. The size of hematoma was reduced in follow-up CT scan. The genesis, diagnosis and treatment of primary pontine hemorrhage of the young were discussed. (author).

  13. Tegmental-type primary pontine hemorrhage with mesencephalic extension. Clinico-CT-anatomic correlations

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    Goto, Noboru; Ishikawa, Hiroshi; Kaneko, Mitsuo; Tanaka, Keisei

    1983-06-01

    In nine autopsy cases of tegmental-type primary pontine hemorrhage, two cases with a mesencephalic extension which was not accurately diagnosed symptomatologically, but which was clearly detected on CT films, were found. Correlative clinico-CT-anatomic reports on this kind of pontine hemorrhage have not been included in the literature. The two patients were both females, 73 and 53 years old. Both were hypertensive and under medical care. They showed disturbances of consciousness and respiration, pin-point pupils, fixed eyes in the midposition, right hemiplegia, right extensor plantar response, etc., but both responded well to painful stimuli on the left half of the body. CT examinations detected a continuous high-density area in the left-sided tegmentum of the pons and midbrain. They died 9 and 21 days later respectively. With the help of an electronic image analyser, a great volume of hematoma was measured in the postmortem brainstem in these cases (17 ml and 14 ml). Precise analyses of the correlations among clinical symptomatology, CT, and anatomical findings, and histological examinations were carried out in an attempt to find the pathogenesis of this disease. In the diagnosis of tegmental-type primary pontine hemorrhage, attention should be paid to a possible mesencephalic involvement as one of the modes of hematoma extension, although it may be rather rare.

  14. Pontine stroke presenting as isolated facial nerve palsy mimicking Bell's palsy: a case report

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    Saluja Paramveer

    2011-07-01

    Full Text Available Abstract Introduction Isolated facial nerve palsy usually manifests as Bell's palsy. Lacunar infarct involving the lower pons is a rare cause of solitary infranuclear facial paralysis. The present unusual case is one in which the patient appeared to have Bell's palsy but turned out to have a pontine infarct. Case presentation A 47-year-old Asian Indian man with a medical history of hypertension presented to our institution with nausea, vomiting, generalized weakness, facial droop, and slurred speech of 14 hours' duration. His physical examination revealed that he was conscious, lethargic, and had mildly slurred speech. His blood pressure was 216/142 mmHg. His neurologic examination showed that he had loss of left-sided forehead creases, inability to close his left eye, left facial muscle weakness, rightward deviation of the angle of the mouth on smiling, and loss of the left nasolabial fold. Afferent corneal reflexes were present bilaterally. MRI of the head was initially read as negative for acute stroke. Bell's palsy appeared less likely because of the acuity of his presentation, encephalopathy-like imaging, and hypertension. The MRI was re-evaluated with a neurologist's assistance, which revealed a tiny 4 mm infarct involving the left dorsal aspect of the pons. The final diagnosis was isolated facial nerve palsy due to lacunar infarct of dorsal pons and hypertensive encephalopathy. Conclusion The facial nerve has a predominant motor component which supplies all muscles concerned with unilateral facial expression. Anatomic knowledge is crucial for clinical localization. Bell's palsy accounts for around 72% of facial palsies. Other causes such as tumors and pontine infarcts can also present as facial palsy. Isolated dorsal infarct presenting as isolated facial palsy is very rare. Our case emphasizes that isolated facial palsy should not always be attributed to Bell's palsy. It can be a presentation of a rare dorsal pontine infarct as observed

  15. A case of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) in East Asia.

    Science.gov (United States)

    Tohge, Rie; Nagao, Masahiro; Yagishita, Akira; Matsubara, Shiro

    2012-01-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) syndrome is a clinically and radiologically distinct pontine-predominant perivascular neuroinflammation showing T lymphocyte infiltration. It is assumed to have an autoimmune or other inflammatory mediated pathogenesis. We report the first known case of CLIPPERS in East Asia, characterized by multiple punctate enhancement of the brainstem extending to the bilateral posterior limb of the internal capsule and caudal to the spinal cord conus. The patient had elevated IgE levels and a history of allergies, suggesting that lesions may arise from neuroinflammation in response to T lymphocyte infiltration into perivascular spaces.

  16. Symptomatic ependymal cysts of the perimesencephalic and cerebello-pontine angle cisterns.

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    Sharma, R R; Pawar, S J; Kharangate, P P; Delmendo, A

    2000-11-01

    Primary intracranial ependymal cysts are extremely rare. These are congenital, benign ependyma lined, commonly intraparenchymal and uncommonly extraparenchymal cysts in leptomeningeal location of variable size seen in the adult life. The authors report two cases of symptomatic ependymal cysts: one in the perimesencephalic cistern in a 10-month-old infant presenting with delayed mile stones and another in the cerebello-pontine cistern in a morbidly obese 35-year-old woman with known benign intracranial hypertension now presenting with hemifacial spasm. Neurosurgical intervention was curative in both cases. Interesting clinical, radiological and histological features are presented and discussed.

  17. Primary pontine gliobastoma multiforme: A case report and review of the literature

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    Baik, Ji Yeon; Baek, Hye Jin [Dept. of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan (Korea, Republic of); Moon, Jin Il; Cho, Soo Buem; Choi, Bo Hwa; Bae, Kyung Soo; Jeon, Kyung Nyeo [Dept. of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon (Korea, Republic of); Choi, Dae Seob; Shin, Hwa Seon [Dept. of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju (Korea, Republic of)

    2016-08-15

    Glioblastoma multiforme (GBM) most commonly occurs in the pons while it is rare in the brainstem. However, diagnosis of brainstem GBM can be difficult due to its rarity and nonspecific clinical manifestations. Herein, we presented a case of a 47-year-old female patient confirmed as primary pontine GBM by histopathological examination. This case highlights that GBM should be considered in the differential diagnosis of patients with a space-occupying lesion in the brainstem as well as the importance of a meticulous radiological review with clinical suspicion.

  18. Neuroradiological Features of Extrapontine Myelinolysis%脑桥外髓鞘溶解症的影像学特征

    Institute of Scientific and Technical Information of China (English)

    胡琦; 张存泰; 刘建; 江红; 舒红格; 康慧聪; 许峰; 刘晓艳; 朱遂强

    2013-01-01

    Objective To investigate the characteristics of the MRI and CT images of extrapontine myelinolysis(EPM). Methods Clinical and imaging data of 10 patients who suffered EPM after rapid correction of hyponatremia were analyzed. Hyponatremia in the 10 patients was caused by hypopituitarism in 3 cases,intravenous injection of hypophysin because of hemoptysis in 2 cases,hepatic cirrhosis complicated with gastrointestinal bleeding in 1 case,cavernous transformation of the portal vein complicated with gastrointestinal bleeding in 1 case, liver transplantation in 1 case, intestinal obstruction in 1 case and chronic diarrhea in 1 case. All the ten patients underwent conventional MRI scanning,including T1WI,T2WI and T2FLAIR sequences. Among them,CT scanning was performed in 3 patients,enhanced MRI in 3 cases,diffusion-weighted imaging(DWI) in 5 cases and proton magnetic resonance spectroscopy(1 H-MRS) in 1 case. Results MRI scanning showed demyelinating lesions in caudate nucleus in 8 cases,in lenticular nucleus in 8 cases,in thalamus in 5 cases,in temporal lobe in 3 cases,in parietal lobe in 3 cases, in frontal lobe in 2 cases and in occipital lobe in 1 case. Mesocephalon was concomitantly affected in 3 cases. Enhancement was not found in the 3 patients who underwent enhanced MRI. DWI performed on 5 patients showed high patchy signals which corresponded to the low or equal signal intensity on the ADC map. MRS imaging on only 1 patient showed the reduction in NAA signals and the ratio of NAA/Chol,normal Choi peak and unconspicuous Lac peak. CT scanning on 3 patients showed low signal intensities in the bilateral caudate nuclei and lentiform nuclei in only 1 patient and no lesions in the other two patients. Conclusion MRI is the examination of choice for EPM, which often shows the involved lesions in the basal ganglia, thalamus and cerebral lobes, low signal intensity on TlWI,high signal intensity on T2WI,rare mass effect and enhancement. False negative results were frequently

  19. Pontine tegmental cap dysplasia: developmental and cognitive outcome in three adolescent patients

    Directory of Open Access Journals (Sweden)

    Tortorella Gaetano

    2011-06-01

    Full Text Available Abstract Pontine Tegmental Cap Dysplasia (PTCD is a recently described, rare disorder characterized by a peculiar cerebellar and brainstem malformation. Nineteen patients have been reported to date, of which only one in the adolescent age, and data on the clinical, cognitive and behavioural outcome of this syndrome are scarce. Here we describe three adolescent patients with PTCD. All presented bilateral deafness and multiple cranial neuropathies, variably associated with skeletal, cardiac and gastro-intestinal malformations. Feeding and swallowing difficulties, that are often causative of recurrent aspiration pneumonias and death in the first years of life, completely resolved with age in all three patients. Neuropsychological assessment showed borderline to moderate cognitive impairment, with delay in adaptive functioning, visual-spatial and language deficits. Two of three patients also showed mild behavioural problems, although their overall socialization abilities were well preserved. Cochlear implantation in two patients significantly improved their relational and learning abilities. Fibre tractography confirmed the abnormal bundle of transversely oriented fibres forming the typical pontine "tegmental cap" and absence of decussation of the superior cerebellar peduncles, supporting the hypothesis that PTCD results from abnormal axonal guidance and/or migration. These data indicate that PTCD may have a favourable long-term outcome, with borderline cognitive deficit or even normal cognition and partially preserved speech.

  20. A clinico-radiological study on 254 cases of pontine high signals on magnetic resonance imaging in relation to brain stem semiology

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Masaki; Takahashi, Akira (Nagoya Univ. (Japan). Faculty of Medicine); Arahata, Yutaka; Motegi, Yoshimasa; Furuse, Masahiro

    1993-11-01

    A total of 254 patients who were proved to have pontine high intensity areas on T[sub 2]-weighted magnetic resonance imaging (MRI) were analyzed in relation to brain stem semiology. A comparative study on MRI and MR angiography was made between 254 patients with pontine high signals and 276 control cases showing no abnormality either on T[sub 1] or T[sub 2]-weighted images. Of the 254 patients, 62 had transient subjective complaints such as vertigo-dizziness. Supratentorial high signals, basilar artery tortuousness and vertebral artery asymmetry on MR angiography were seen more frequently in patients with pontine high signals than in the controls. In conclusion, pontine high signals may result from diffuse arteriosclerosis and MR angiography is considered to be a useful screening method. (author).

  1. Projections from the oral pontine reticular nucleus to the spinal cord of the mouse.

    Science.gov (United States)

    Liang, Huazheng; Watson, Charles; Paxinos, George

    2015-01-01

    The present study investigated projections of the mouse oral pontine reticular nucleus (PnO) to the spinal cord by (a) injecting a retrograde tracer fluoro-gold (FG) to the lumbar cord and (b) an anterograde tracer biotinylated dextran amine (BDA) to PnO. We found that PnO projects to the entire spinal cord with an ipsilateral predominance. PnO fibers mainly travel in the ipsilateral ventral funiculus in the entire cord, terminating in laminae 7-10 with a lower density of fibers and boutons in lower segments. A small number of fibers travel in the contralateral ventral funiculus in the cervical cord with a similar terminating pattern to the ipsilateral counterpart. The present study is the first demonstration of PnO fiber terminals in the mouse spinal cord. This pathway might be responsible for muscle atonia during REM sleep, but needs physiological research to confirm this.

  2. New insights on the petrology of submarine volcanics from the Western Pontine Archipelago (Tyrrhenian Sea, Italy)

    Science.gov (United States)

    Conte, A. M.; Perinelli, C.; Bianchini, G.; Natali, C.; Martorelli, E.; Chiocci, F. L.

    2016-11-01

    The Pontine Islands form a volcanic archipelago in the Tyrrhenian Sea. It consists of two edifices, the islands of Ponza, Palmarola and Zannone and the islands of Ventotene and Santo Stefano, respectively. The Archipelago developed during two main volcanic cycles in the Plio-Pleistocene: 1) the Pliocene episode erupted subalkaline, silica-rich volcanic units, which constitute the dominant products in the western edifice (Ponza and Zannone Islands); 2) the Pleistocene episode erupted more alkaline products, represented by evolved rocks (trachytes to peralkaline rhyolites) in the islands of Ponza and Palmarola and by basic to intermediate rocks in the eastern edifice (Ventotene and Santo Stefano Islands). In this paper we present new geochemical and petrological data from submarine rock samples collected in two oceanographic cruises and a scuba diving survey. The main result is the recovery of relatively undifferentiated lithotypes that provide further insights on the magmatic spectrum existing in the Pontine Archipelago, allowing modelling of the whole suite of rocks by fractional crystallization processes. New major and trace element data and thermodynamic constrains (by the software PELE) indicate the existence of three distinct evolutionary trends corresponding to a HK calcalkaline series in the Pliocene, followed by a transitional and then by a shoshonite series in the Pleistocene. In particular, the transitional series, so far overlooked in the literature, is required in order to explain the genesis of several peralkaline felsic rocks recognized in the Archipelago. On the whole, the new geochemical data i) confirm the orogenic signature of the suites, ii) allow to rule out an anatectic origin for both subalkaline and peralkaline rhyolites and iii) indicate highly heterogeneous mantle sources, due to crustal components variously recycled in the mantle via subduction.

  3. Pontine reticulospinal projections in the neonatal mouse: Internal organization and axon trajectories.

    Science.gov (United States)

    Sivertsen, Magne S; Perreault, Marie-Claude; Glover, Joel C

    2016-04-15

    We recently characterized physiologically a pontine reticulospinal (pRS) projection in the neonatal mouse that mediates synaptic effects on spinal motoneurons via parallel uncrossed and crossed pathways (Sivertsen et al. [2014] J Neurophysiol 112:1628-1643). Here we characterize the origins, anatomical organization, and supraspinal axon trajectories of these pathways via retrograde tracing from the high cervical spinal cord. The two pathways derive from segregated populations of ipsilaterally and contralaterally projecting pRS neurons with characteristic locations within the pontine reticular formation (PRF). We obtained estimates of relative neuron numbers by counting from sections, digitally generated neuron position maps, and 3D reconstructions. Ipsilateral pRS neurons outnumber contralateral pRS neurons by threefold and are distributed about equally in rostral and caudal regions of the PRF, whereas contralateral pRS neurons are concentrated in the rostral PRF. Ipsilateral pRS neuron somata are on average larger than contralateral. No pRS neurons are positive in transgenic mice that report the expression of GAD, suggesting that they are predominantly excitatory. Putative GABAergic interneurons are interspersed among the pRS neurons, however. Ipsilateral and contralateral pRS axons have distinctly different trajectories within the brainstem. Their initial spinal funicular trajectories also differ, with ipsilateral and contralateral pRS axons more highly concentrated medially and laterally, respectively. The larger size and greater number of ipsilateral vs. contralateral pRS neurons is compatible with our previous finding that the uncrossed projection transmits more reliably to spinal motoneurons. The information about supraspinal and initial spinal pRS axon trajectories should facilitate future physiological assessment of synaptic connections between pRS neurons and spinal neurons.

  4. Seizures after liver transplantation: a clinicopathologic study.

    Science.gov (United States)

    Estol, C J; Lopez, O; Brenner, R P; Martinez, A J

    1989-10-01

    We reviewed the clinical and neuropathologic findings in 21 patients who had seizures after orthotopic liver transplants. Tonic-clonic seizures were the most common seizure type. Six patients developed status epilepticus. In 9 patients, seizures occurred within 1 week following transplantation. We found CNS lesions that were probably responsible for the occurrence of seizures in most patients; some had more than 1 finding. Neuropathologic examination revealed ischemic or hemorrhagic strokes in 18 patients, central pontine myelinolysis in 5, and CNS infections in 5. Multiple metabolic abnormalities were a contributing factor to the onset of seizures in some patients.

  5. Difusion weighted imaging characteristics differentiate acute symptomatic cerebral microbleeds from silent microbleeds: An acute pontine microhemorrhage case presentation

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    Arda Yılmaz

    2015-04-01

    Full Text Available Cerebral microbleeds (CMBs on susceptibility weighted imaging (SWI have generally been considered to be silent. Recent reports indicated that, albeit it is a rarity, CMBs can cause acute focal neurological symptoms. Herein we present a patient who was admitted with cheiro-oral syndrome due to an acute izolated pontine microbleed. Combination of diffusion weighted imaging and SWI can be useful in the differentiation of acute symptomatic cerebral microbleeds from chronic ones.

  6. Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids with a Significant Elevation of β-2 Microglobulin Levels

    OpenAIRE

    Fujisawa, Naoaki; Oya, Soichi; Mori, Harushi; Matsui, Toru

    2015-01-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a relapsing-remitting disorder for which steroid administration is a key to control the progression. CLIPPERS can exhibit radiological features similar to malignant lymphoma, whose diagnosis is confounded by prior steroid administration. We report a case of CLIPPERS accompanied by abnormal elevation of β-2 microglobulin in the cerebrospinal fluid (CSF). A 62-year-old man started to expe...

  7. A case of bronchiectasis needing lung isolation for cerebello pontine angle tumor excision: Anesthetic challenges

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    C Srinivasan

    2016-01-01

    Full Text Available The main goals of neuroanesthesia are the maintenance of adequate cerebral perfusion pressure, avoidance of hypercarbia, hypoxemia, and to provide better brain relaxation. Providing anesthesia for a patient with bronchiectasis needing lung isolation for craniotomy can be challenging. A 56-year-old male patient, case of right lung bronchiectasis with a right cerebello pontine angle tumor underwent excision in the left lateral position. Since he had severe bronchiectasis of the right lung, we had isolated the right lung using right-sided double lumen tube to avoid spillage. Intraoperative split lung test was performed to assess the right lung contribution on carbon dioxide (CO 2 elimination and found that there was a significant contribution from the right lung. Hence, both lungs were ventilated to control CO 2 . The importance of lung isolation to prevent spillage and avoidance of one lung ventilation to control the arterial CO 2 are highlighted in this case report. By providing a balanced anesthetic keeping both, the neurosurgical and thoracic concerns are important for better postoperative outcome.

  8. Sleep duration varies as a function of glutamate and GABA in rat pontine reticular formation.

    Science.gov (United States)

    Watson, Christopher J; Lydic, Ralph; Baghdoyan, Helen A

    2011-08-01

    The oral part of the pontine reticular formation (PnO) is a component of the ascending reticular activating system and plays a role in the regulation of sleep and wakefulness. The PnO receives glutamatergic and GABAergic projections from many brain regions that regulate behavioral state. Indirect, pharmacological evidence has suggested that glutamatergic and GABAergic signaling within the PnO alters traits that characterize wakefulness and sleep. No previous studies have simultaneously measured endogenous glutamate and GABA from rat PnO in relation to sleep and wakefulness. The present study utilized in vivo microdialysis coupled on-line to capillary electrophoresis with laser-induced fluorescence to test the hypothesis that concentrations of glutamate and GABA in the PnO vary across the sleep/wake cycle. Concentrations of glutamate and GABA were significantly higher during wakefulness than during non-rapid eye movement sleep and rapid eye movement sleep. Regression analysis revealed that decreases in glutamate and GABA accounted for a significant portion of the variance in the duration of non-rapid eye movement sleep and rapid eye movement sleep episodes. These data provide novel support for the hypothesis that endogenous glutamate and GABA in the PnO contribute to the regulation of sleep duration.

  9. Diffuse intrinsic pontine glioma: is MRI surveillance improved by region of interest volumetry?

    Energy Technology Data Exchange (ETDEWEB)

    Riley, Garan T. [University Hospital of North Tees, Department of General Radiology, North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, Cleveland (United Kingdom); Armitage, Paul A.; Griffiths, Paul D. [University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Batty, Ruth; Connolly, Daniel J.A. [Sheffield Children' s NHS Foundation Trust, Department of Radiology, Sheffield (United Kingdom); Lee, Vicki [Sheffield Children' s NHS Foundation Trust, Department of Oncology, Sheffield (United Kingdom); McMullan, John [Sheffield Children' s NHS Foundation Trust, Department of Neurosurgery, Sheffield (United Kingdom)

    2014-08-21

    Paediatric diffuse intrinsic pontine glioma (DIPG) is noteworthy for its fibrillary infiltration through neuroparenchyma and its resultant irregular shape. Conventional volumetry methods aim to approximate such irregular tumours to a regular ellipse, which could be less accurate when assessing treatment response on surveillance MRI. Region-of-interest (ROI) volumetry methods, using manually traced tumour profiles on contiguous imaging slices and subsequent computer-aided calculations, may prove more reliable. To evaluate whether the reliability of MRI surveillance of DIPGs can be improved by the use of ROI-based volumetry. We investigated the use of ROI- and ellipsoid-based methods of volumetry for paediatric DIPGs in a retrospective review of 22 MRI examinations. We assessed the inter- and intraobserver variability of the two methods when performed by four observers. ROI- and ellipsoid-based methods strongly correlated for all four observers. The ROI-based volumes showed slightly better agreement both between and within observers than the ellipsoid-based volumes (inter-[intra-]observer agreement 89.8% [92.3%] and 83.1% [88.2%], respectively). Bland-Altman plots show tighter limits of agreement for the ROI-based method. Both methods are reproducible and transferrable among observers. ROI-based volumetry appears to perform better with greater intra- and interobserver agreement for complex-shaped DIPG. (orig.)

  10. The mechanism of noradrenergic alpha 1 excitatory modulation of pontine reticular formation neurons.

    Science.gov (United States)

    Stevens, D R; McCarley, R W; Greene, R W

    1994-11-01

    The alpha 1 adrenergic receptor occurs in all major divisions of the CNS and is thought to play a role in all behaviors influenced by norepinephrine (NE). In the medial pontine reticular formation (mPRF), the proposed site of adrenergic enhancement of startle responses (Davis, 1984), alpha 1 agonists excite most neurons (Gerber et al., 1990). We here report that alpha 1 excitation results from a reduction of a voltage- and calcium-dependent potassium current, not previously recognized as ligand-modulated. The calcium sensitivity is suggested by its antagonism with Mg2+, Cd2+, Ba2+, low concentrations of tetraethylammonium, and charybdotoxin. The voltage sensitivity of this conductance falls within the membrane potential range critical to action potential generation. Based on this voltage sensitivity, the change in repetitive firing characteristics may be predicted according to a mathematical model of the mPRF neuronal electrophysiology. The predicted response to a 50% decrease in the phenylephrine (PE)-sensitive conductance is similar to the observed responses, with respect to both the current response under voltage-clamp conditions and alterations of the AHP and frequency/current curve. In contrast, modeling a reduction of a voltage-insensitive leak current predicts none of these changes. Thus, the noradrenergic reduction of this current depolarizes the membrane, increases the likelihood of an initial response to depolarizing input, and increases firing rate during sustained depolarization in a manner consistent with an NE role as an excitatory neuromodulator of the mPRF.

  11. MICrocephaly, disproportionate pontine and cerebellar hypoplasia syndrome: A clinico-radiologic phenotype linked to calcium/calmodulin-dependent serine protein kinase gene mutation

    Directory of Open Access Journals (Sweden)

    Rashid Saleem

    2013-01-01

    Full Text Available MICrocephaly, disproportionate pontine and cerebellar hypoplasia (MICPCH syndrome, a rare X-linked disorder, generally seen in girls, is characterized by neurodevelopmental delay, microcephaly, and disproportionate pontine and cerebellar hypoplasia. It is caused by inactivating calcium/calmodulin-dependent serine protein kinase (CASK gene mutations. We report a 2-year-old girl with severe neurodevelopmental delay, microcephaly, minimal pontine hypoplasia, cerebellar hypoplasia, and normal looking corpus callosum, with whom the conventional cytogenetic studies turned out to be normal, and an array-comparative genomic hybridization (a-CGH analysis showed CASK gene duplication at Xp11.4. Our case highlights the importance of using clinico-radiologic phenotype to guide genetic investigation and it also confirms the role of a-CGH analysis in establishing the genetic diagnosis of MICPCH syndrome, when conventional cytogenetic studies are inconclusive.

  12. 脑桥梗死的临床特点及预后的相关性研究%Research of correlation between clinical manifestation and prognosis of pontine infarction

    Institute of Scientific and Technical Information of China (English)

    吕辉; 宋博; 许波; 袁海成; 许靖

    2015-01-01

    Objective To research risk factor, clinical manifestation, neuroimaging change and prognosis of pontine infarction.Methods A retrospective analysis was made on clinical data, including high risk factor, clinical manifestation, imaging examination and prognosis, of 100 patients with pontine infarction.Results High risk factors included hyperlipidaemia, hypertension, diabetes mellitus, and smoking. Atherosclerosis was the main pathogenesis. Main clinical manifestations included dizziness, central facial paralysis and acroparalysis in opposite of lesion, dysarthria, hemianesthesia, bulbar paralysis, nystagmus, diplopia, and disturbance of consciousness. Transverse lesion location of brain magnetic resonance imaging(MRI) showed 49 cases in ventromedial infarction group, 31 cases in ventrolateral infarcts group, 13 cases in tegmentum infraction group, and 7 cases in bilateral infarction group. Neurologic deficit symptoms were improved after 30 d of ventromedial and ventrolateral infarction onset, and the difference had statistical significance (P<0.01). Bilateral infarction group had higher modified Rankin scale (mRS) score than the other groups, and their difference had statistical significance (P<0.05). Conclusion Atherosclerosis is the main pathogenesis of pontine infarction patients. Dizziness, sensorimotor dysfunction, dysarthria, and bulbar paralysis are common clinical manifestations. Ventral branches are main onset location of pontine infarction. Different locations influence their prognosis.%目的 研究脑桥梗死的危险因素、临床表现、神经影像学改变及预后.方法 回顾性分析100例脑桥梗死患者的临床资料, 包括:高危因素、临床表现、影像学检查及预后.结果 高危因素:高脂血症、高血压、糖尿病、吸烟.主要病因为动脉粥样硬化.主要临床特点:眩晕、病灶对侧的中枢性面瘫和肢体瘫痪、构音障碍、偏身麻木、球麻痹、眼震、复视

  13. GABAergic Transmission in Rat Pontine Reticular Formation Regulates the Induction Phase of Anesthesia and Modulates Hyperalgesia Caused by Sleep Deprivation

    OpenAIRE

    Vanini, Giancarlo; Nemanis, Kriste; Baghdoyan, Helen A.; Lydic, Ralph

    2014-01-01

    The oral part of the pontine reticular formation (PnO) contributes to the regulation of sleep, anesthesia, and pain. The role of PnO GABA in modulating these states remains incompletely understood. The present study used time to Loss and time to Resumption of Righting Response (LoRR and RoRR) as surrogate measures of loss and resumption of consciousness. This study tested three hypotheses: (1) pharmacologically manipulating GABA levels in rat PnO alters LoRR, RoRR, and nociception; (2) propof...

  14. Living and dead benthic foraminiferal assemblages from bathyal environment in the Pontine Archipelago (Tyrrhenian Sea, Italy)

    Science.gov (United States)

    Di Bella, Letizia; Frezza, Virgilio; Ingrassia, Michela; Latino Chiocci, Francesco; Martorelli, Eleonora

    2016-04-01

    The western Pontine Archipelago (Tyrrhenian Sea, Italy), located about 30 km away from the Italian Peninsula, is composed of three volcanic islands (Ponza, Palmarola and Zannone). Sedimentological and micropaleontological characterization of the infralittoral and circalittoral zones in the Pontine Archipelago was already been studied, whereas it is lacking for deeper environments. The present study shows the preliminary micropaleontological results carried out on samples collected in the bathyal zone (at 500 mwd) in the Ventotene basin. Sediment samples, high resolution multibeam bathymetry, biological and video data were acquired in order to characterise both the morphological and biological features of study area, during the research cruise "BOLLE 2014" carried out on June 2014 aboard to the R/V Urania. Sediment samples were collected with a multi-corer, that allowed sampling of the upper decimetre of the sediments column. Successively, each core was sliced horizontally every 1 cm from the top to the bottom. For micropaleontological analyses, all samples were stained with Rose Bengal to distinguish living and dead assemblages. For each interval of the core all living specimens and 200 dead benthic foraminifera were classified and counted. Diversity index (α-Fisher, Shannon indices) and Faunal Density (specimens/gr) were calculated to define the structure of the assemblage. A variable number of living benthic foraminifera (Rose Bengal-stained) were found in all core-intervals (7-155 tests), with the Faunal Density ranging from 3 to 82 specimens/gr. A total of 77 species are recognised from living benthic foraminiferal assemblages, with a range of 4-31 species found in each core-interval. The α-Fisher index ranges between 3.88 and 43.45, whereas Shannon index shows a more limited variability (1.28-2.92). Among the living foraminifera, calcareous imperforate tests are very abundant, with percentages ranging between 33.3 and 100%; perforate species are subordinate

  15. Incontinência do choro e infarto protuberancial unilateral Incontinence of crying and unilateral pontine infarct

    Directory of Open Access Journals (Sweden)

    Ricardo de Oliveira-Souza

    1995-09-01

    Full Text Available O presente estudo trata do caso de um paciente que apresentou incontinência do choro e hemiplegia direita por infarto ventroprotuberancial paramediano detectado pela RNM. O caráter circunscrito da lesão foi endossado pela normalidade dos potenciais evocados sômato-sensitivos e auditivos de curta-latência. Os episódios de choro desapareceram poucos dias depois do início do tratamento com doses baixas de imipramina. Discutimos o choro e riso patológicos como forma de incontinência da mímica resultante de desconexão límbico-motora, enfatizando a impropriedade de incluí-los na síndrome pseudobulbar, uma vez que dependem de correlatos anatômicos e funcionais distintos.A 64-year-old man presented with pathologic crying and right hemiplegia due to a unilateral pontine infarct from probable branch disease of the basilar artery. The circumscribed nature of the lesion was supported by MRI and short-latency evoked potentials. The weeping spells ceased after a few days of imipramine in low doses. Pathologic laughing and crying can be viewed as a limbic-motor disconnection syndrome, in which the faciovocal motor system is released from forebrain afferents carrying information of emotional content. The inclusion of pathologic laughing and crying in the syndrome pseudobulbar palsy is inaccurate and misleading, since each is related to distinct functional and anatomic systems intrinsic to the human brainstem.

  16. Fear extinction memory consolidation requires potentiation of pontine-wave activity during REM sleep.

    Science.gov (United States)

    Datta, Subimal; O'Malley, Matthew W

    2013-03-06

    Sleep plays an important role in memory consolidation within multiple memory systems including contextual fear extinction memory, but little is known about the mechanisms that underlie this process. Here, we show that fear extinction training in rats, which extinguished conditioned fear, increased both slow-wave sleep and rapid-eye movement (REM) sleep. Surprisingly, 24 h later, during memory testing, only 57% of the fear-extinguished animals retained fear extinction memory. We found that these animals exhibited an increase in phasic pontine-wave (P-wave) activity during post-training REM sleep, which was absent in the 43% of animals that failed to retain fear extinction memory. The results of this study provide evidence that brainstem activation, specifically potentiation of phasic P-wave activity, during post-training REM sleep is critical for consolidation of fear extinction memory. The results of this study also suggest that, contrary to the popular hypothesis of sleep and memory, increased sleep after training alone does not guarantee consolidation and/or retention of fear extinction memory. Rather, the potentiation of specific sleep-dependent physiological events may be a more accurate predictor for successful consolidation of fear extinction memory. Identification of this unique mechanism will significantly improve our present understanding of the cellular and molecular mechanisms that underlie the sleep-dependent regulation of emotional memory. Additionally, this discovery may also initiate development of a new, more targeted treatment method for clinical disorders of fear and anxiety in humans that is more efficacious than existing methods such as exposure therapy that incorporate only fear extinction.

  17. Bioinformatics analysis of the molecular mechanism of diffuse intrinsic pontine glioma

    Science.gov (United States)

    Deng, Lei; Xiong, Pengju; Luo, Yunhui; Bu, Xiao; Qian, Suokai; Zhong, Wuzhao

    2016-01-01

    The present study aimed to elucidate key molecular mechanisms in the progression of diffuse intrinsic pontine glioma (DIPG). The gene expression profile GSE50021, which consisted of 35 pediatric DIPG samples and 10 normal brain samples, was downloaded from the Gene Expression Omnibus database. The differentially-expressed genes (DEGs) in the pediatric DIPG samples were identified. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and Reactome pathways of DEGs were enriched and analyzed. The protein-protein interaction (PPI) network of the DEGs was constructed and functional modules of the PPI network were disclosed using ClusterONE. A total of 679 DEGs (454 up- and 225 downregulated) were identified in the pediatric DIPG samples. DEGs were significantly enriched in various GO terms, and KEGG and Reactome pathways. The PPI network of upregulated (153 nodes and 298 connections) and downregulated (71 nodes and 124 connections) DEGs, and two crucial modules, were obtained. Downregulated genes in module 2, such as cholecystokinin (CCK), gastrin (GAST), adenylate cyclase 2 (brain) (ADCY2) and 5-hydroxytryptamine (serotonin) receptor 7 (HTR7), were significantly enriched in the calcium signaling pathway, the neuroactive ligand-receptor interaction pathway and in GO terms, such as the G-protein coupled receptor (GPCR) signaling pathway, while upregulated genes in module 1 were not enriched in any pathways or GO terms. CCK and GAST associated with the GPCR signaling pathway, HTR7 enriched in the neuroactive ligand-receptor interaction, and ADCY2 and HTR7 involved in the calcium signaling pathway may be key mechanisms playing crucial roles in the development and progression of DIPG.

  18. Neuronal Correlates of Cross-Modal Transfer in the Cerebellum and Pontine Nuclei

    Science.gov (United States)

    Campolattaro, Matthew M.; Kashef, Alireza; Lee, Inah; Freeman, John H.

    2011-01-01

    Cross-modal transfer occurs when learning established with a stimulus from one sensory modality facilitates subsequent learning with a new stimulus from a different sensory modality. The current study examined neuronal correlates of cross-modal transfer of Pavlovian eyeblink conditioning in rats. Neuronal activity was recorded from tetrodes within the anterior interpositus nucleus (IPN) of the cerebellum and basilar pontine nucleus (PN) during different phases of training. After stimulus pre-exposure and unpaired training sessions with a tone conditioned stimulus (CS), light CS, and periorbital stimulation unconditioned stimulus (US), rats received associative training with one of the CSs and the US (CS1-US). Training then continued on the same day with the other CS to assess cross-modal transfer (CS2-US). The final training session included associative training with both CSs on separate trials to establish stronger cross-modal transfer (CS1/CS2). Neurons in the IPN and PN showed primarily unimodal responses during pre-training sessions. Learning-related facilitation of activity correlated with the conditioned response (CR) developed in the IPN and PN during CS1-US training. Subsequent CS2-US training resulted in acquisition of CRs and learning-related neuronal activity in the IPN but substantially less little learning-related activity in the PN. Additional CS1/CS2 training increased CRs and learning-related activity in the IPN and PN during CS2-US trials. The findings suggest that cross-modal neuronal plasticity in the PN is driven by excitatory feedback from the IPN to the PN. Interacting plasticity mechanisms in the IPN and PN may underlie behavioral cross-modal transfer in eyeblink conditioning. PMID:21411647

  19. Off the beaten path: drug addiction and the pontine laterodorsal tegmentum.

    Science.gov (United States)

    Kohlmeier, Kristi A

    2013-01-01

    Drug addiction is a multileveled behavior controlled by interactions among many diverse neuronal groups involving several neurotransmitter systems. The involvement of brainstem-sourced, cholinergic neurotransmission in the development of addiction and in the persistent physiological processes that drive this maladaptive behavior has not been widely investigated. The major cholinergic input to neurons in the midbrain which are instrumental in assessment of reward and assignment of salience to stimuli, including drugs of abuse, sources from acetylcholine- (ACh-) containing pontine neurons of the laterodorsal tegmentum (LDT). Excitatory LDT input, likely cholinergic, is critical in allowing behaviorally relevant neuronal firing patterns within midbrain reward circuitry. Via this control, the LDT is positioned to be importantly involved in development of compulsive, addictive patterns of behavior. The goal of this review is to present the anatomical, physiological, and behavioral evidence suggesting a role of the LDT in the neurobiology underlying addiction to drugs of abuse. Although focus is directed on the evidence supporting a vital participation of the cholinergic neurons of the LDT, data indicating a contribution of noncholinergic LDT neurons to processes underlying addiction are also reviewed. While sparse, available information of actions of drugs of abuse on LDT cells and the output of these neurons as well as their influence on addiction-related behavior are also presented. Taken together, data from studies presented in this review strongly support the position that the LDT is a major player in the neurobiology of drug addiction. Accordingly, the LDT may serve as a future treatment target for efficacious pharmaceutical combat of drug addiction.

  20. Single- and Multivoxel Proton Spectroscopy in Pediatric Patients With Diffuse Intrinsic Pontine Glioma

    Energy Technology Data Exchange (ETDEWEB)

    Steffen-Smith, Emilie A. [Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland (United States); Venzon, David J. [Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Bent, Robyn S. [Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland (United States); Hipp, Sean J. [Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland (United States); Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland (United States); Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland (United States); Warren, Katherine E., E-mail: warrenk@mail.nih.gov [Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland (United States)

    2012-11-01

    Purpose: To determine the feasibility of two magnetic resonance spectroscopy (MRS) techniques for treating pediatric patients with diffuse intrinsic pontine gliomas (DIPGs) and to evaluate the relationship of metabolic profiles determined by each technique. Utility of each technique for improving patient management is also discussed. Methods and Materials: Children with DIPG (n = 36) were evaluated using single-voxel spectroscopy (SVS) and magnetic resonance spectroscopic imaging (MRSI) during the same imaging session. Patients were followed longitudinally (n = 150 total studies). Technical feasibility was defined by sufficient water and lipid suppression for detection of metabolites. Correlation of metabolic data obtained by SVS and MRSI was determined using the Spearman rank method. Metabolite ratios, including choline:N-acetyl-aspartate (Cho:NAA) and Cho:creatine (Cho:Cr), were obtained from SVS and MRSI. Results: SVS and MRSI acquisitions were feasible in >90% of studies. Maximum Cho:NAA and Cho:Cr from MRSI analysis were strongly associated with Cho:NAA and Cho:Cr obtained by SVS (r = 0.67 and 0.76, respectively). MRSI Cho:NAA values were more heterogeneous than Cho:Cr values within the same lesion, and a strong linear relationship between the range and maximum Cho:NAA values was observed. Conclusions: SVS and MRSI acquisitions were feasible, with a strong correlation in metabolic data. Both techniques may improve diagnostic evaluation and management of DIPG. SVS is recommended for global assessment of tumor metabolism before and after therapy. MRSI showed heterogeneous patterns of metabolic activity within these tumors and is recommended for planning and monitoring targeted therapies and evaluating nearby tissue for tumor invasion.

  1. Recurrent Hemorrhagic Venous Infarctions Caused by Thrombosis of a Pontine Developmental Venous Anomaly and Protein S Mutation.

    Science.gov (United States)

    Nakamura, Yuri; Takase, Kei-Ichiro; Matsushita, Takuya; Yoshimura, Satoshi; Yamasaki, Ryo; Murai, Hiroyuki; Kikuchi, Kazufumi; Kira, Jun-Ichi

    2016-11-01

    A 34-year-old man presented with an acute onset of upbeat nystagmus, slurred speech, and limb and truncal ataxias. The patient had a history of limb ataxia and gait disturbance previously treated as brainstem encephalitis with corticosteroids 3 years previously. Brain magnetic resonance imaging showed pontine developmental venous anomaly (DVA) and hemorrhagic infarction within the drainage territory of the DVA. Three months later, the patient exhibited recurrent limb ataxia, double vision, and numbness of the left side of the body. The brain magnetic resonance imaging revealed recurrent hemorrhagic venous infarction within the same territory of the pontine DVA. Laboratory tests disclosed a hypercoagulable state owing to a decrease of protein S activity despite the normal antigen level. Genetic testing indicated that the patient was a homozygous carrier of protein S Tokushima. The patient's severe disability remained unchanged in spite of treatment with anticoagulation therapy using warfarin. We propose that further research on hereditary coagulopathy be carried out in patients with recurrent episodes of DVA-related infarction.

  2. The AAA+ proteins Pontin and Reptin enter adult age: From understanding their basic biology to the identification of selective inhibitors

    Directory of Open Access Journals (Sweden)

    Pedro M Matias

    2015-05-01

    Full Text Available Pontin and Reptin are related partner proteins belonging to the AAA+ (ATPases Associated with various cellular Activities family. They are implicated in multiple and seemingly unrelated processes encompassing the regulation of gene transcription, the remodeling of chromatin, DNA damage sensing and repair, and the assembly of protein and ribonucleoprotein complexes, among others. The 2nd International Workshop on Pontin and Reptin took place at the Instituto de Tecnologia Química e Biológica António Xavier in Oeiras, Portugal on October 10-12, 2014, and reported significant new advances on the mechanisms of action of these two AAA+ ATPases. The major points under discussion were related to the mechanisms through which these proteins regulate gene transcription, their roles as co-chaperones, and their involvement in pathophysiology, especially in cancer and ciliary biology and disease. Finally, they may become anticancer drug targets since small chemical inhibitors were shown to produce anti-tumor effects in animal models.

  3. The AAA+ proteins Pontin and Reptin enter adult age: from understanding their basic biology to the identification of selective inhibitors.

    Science.gov (United States)

    Matias, Pedro M; Baek, Sung Hee; Bandeiras, Tiago M; Dutta, Anindya; Houry, Walid A; Llorca, Oscar; Rosenbaum, Jean

    2015-01-01

    Pontin and Reptin are related partner proteins belonging to the AAA+ (ATPases Associated with various cellular Activities) family. They are implicated in multiple and seemingly unrelated processes encompassing the regulation of gene transcription, the remodeling of chromatin, DNA damage sensing and repair, and the assembly of protein and ribonucleoprotein complexes, among others. The 2nd International Workshop on Pontin and Reptin took place at the Instituto de Tecnologia Química e Biológica António Xavier in Oeiras, Portugal on October 10-12, 2014, and reported significant new advances on the mechanisms of action of these two AAA+ ATPases. The major points under discussion were related to the mechanisms through which these proteins regulate gene transcription, their roles as co-chaperones, and their involvement in pathophysiology, especially in cancer and ciliary biology and disease. Finally, they may become anticancer drug targets since small chemical inhibitors were shown to produce anti-tumor effects in animal models.

  4. Role of MRI in the management of children with diffuse pontine tumors: a study of 15 patients and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Kornreich, Liora; Schwarz, Michael; Karmazyn, Boaz; Horev, Gadi [Schneider Children' s Medical Center of Israel, Department of Imaging, Petah Tiqva (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Cohen, Ian J.; Shuper, Avinoam; Yaniv, Issac [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Schneider Children' s Medical Center of Israel, Department of Hematology-Oncology, Petah Tiqva (Israel); Michovitz, Shalom [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Schneider Children' s Medical Center of Israel, Department of Neurosurgery, Petah Tiqva (Israel); Fenig, Eyal [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Rabin Medical Center,Beilinson Campus, Institute of Oncology, Radiotherapy Unit, Petah Tiqva (Israel)

    2005-09-01

    Pontine tumors carry the worst prognosis of all brain tumors. In most cases, the diagnosis is based solely on MR imaging, without biopsy. To describe the MR findings of pontine tumors at diagnosis and during follow-up and correlate those with prognosis and to assess the value of MR imaging in patient management compared to clinical evaluation. Ninety-one MR scans of 15 children with diffuse pontine tumors were reviewed at diagnosis and during follow-up. The parameters analyzed were as follows: tumor extent, area, and volume; encasement of the basilar artery; presence of exophytic component; necrosis; cysts; hydrocephalus; and intensity and enhancement. Findings were correlated to length of progression-free and overall survival. Trends of amelioration or worsening on imaging were compared with the clinical findings. Median length of progression-free survival was 10 months, and median survival was 20 months. Only hydrocephalus at presentation was associated with shorter progression-free survival (P=0.02). On the last examination of each patient, the craniocaudal diameter was significantly greater than at diagnosis (P=0.03). The concordance between the imaging and the clinical findings was good. MR is the mainstay for the diagnosis and management of pontine tumors. Cranial growth seems to be an ominous sign. However, the prognostic value of MR is limited. MR findings correlate well with the clinical examination. (orig.)

  5. Pontine and extrapontine osmotic myelinolysis after the syndrome of inappropriate secretion of antidiuretic hormone (SIADH associated with fluoxetine: case report Mielinólise osmótica pontina e extrapontina após a síndrome da secreção inapropriada de hormônio antidiurético associada com fluoxetina: relato de caso

    Directory of Open Access Journals (Sweden)

    Carlos Alexandre Twardowschy

    2007-09-01

    Full Text Available Osmotic demyelination syndrome (ODS may be precipitated by aggressive correction of a hypo or hyper-osmolar states. We describe the case of a 53-year-old woman that was started on fluoxetine 20 mg/day for depression and nine days later was found to have fluoxetine-induced syndrome of inappropriate secretion of antidiuretic hormone. After hyponatremia correction the mental status of the patient gradually improved, but subsequently she had intermittent difficulty in speaking, naming objects, memory deficits and psychomotor slowness. Magnetic resonance revealed bilateral symmetric hyperintense lesions in the basal ganglia, temporal lobe and hippocampal formation compatible with ODS. These symptoms gradually resolved and she was discharged home without any deficits. Two months later, a new image showed lesion in pons and the other lesions had disappeared. Fluoxetine therapy had never been related with a complication like that.A síndrome de desmielinização osmótica (SDO pode ser precipitada pela correção agressiva de um estado hiper ou hipoosmolar. Nós descrevemos o caso de mulher de 53 anos que havia iniciado o uso de fluoxetina 20 mg/dia para depressão e que nove dias depois foi diagnosticada como tendo síndrome da secreção inapropriada de hormônio antidiurético induzida por fluoxetina. Depois da correção da hiponatremia o estado mental da paciente gradualmente melhorou, mas subsequentemente ela apresentou dificuldade intermitente para fala e para nomear objetos, déficits de memória recente e lentidão psicomotora. Ressonância magnética revelou lesões hiperintensas bilaterais e simétricas na região dos gânglios da base, lobo temporal e hipocampo compatíveis com SDO. Estes sintomas gradualmente se resolveram e a paciente foi de alta sem qualquer déficit. Dois meses mais tarde uma nova imagem cerebral mostrou lesão na ponte e ausência das lesões antigas. Até onde sabemos a terapia com fluoxetina nunca foi relacionada a uma complicação tardia como esta.

  6. Role of Early Postradiation Magnetic Resonance Imaging Scans in Children With Diffuse Intrinsic Pontine Glioma

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Christine [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Kaushal, Aradhana, E-mail: kaushala@mail.nih.gov [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Hammoud, Dima A. [Radiology and Imaging Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Steffen-Smith, Emilie A.; Bent, Robyn [Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Citrin, Deborah; Camphausen, Kevin [Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States); Warren, Katherine E. [Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States)

    2012-07-15

    Purpose: To determine optimal timing of assessing postradiation radiographic response on magnetic resonance imaging (MRI) scans in pediatric patients with diffuse intrinsic pontine glioma (DIPG). Methods and Materials: Patients were treated on a prospective study at the National Cancer Institute (Protocol no. 06-C-0219) evaluating the effects of radiotherapy (RT). Standard RT was administered in standard fractionation over 6 weeks. Postradiation MRI scans were performed at 2 and 6-8 weeks. Results: Eleven patients with DIPG were evaluated. Median age was 6 years (range, 4-13 years). Patients were treated with external-beam RT to 55.8 Gy (n = 10) or 54 Gy (n = 1), with a gross tumor volume to planning target volume expansion of 1.8-2.0 cm. All patients received prescribed dose and underwent posttreatment MRI scans at 2 and 6-8 weeks. Pretreatment imaging revealed compression of fourth ventricle (n = 11); basilar artery encasement (n = 9); tumor extension outside the pons (n = 11); and tumor hemorrhage (n = 2). At the 2-week scan, basilar artery encasement improved in 7 of 9 patients, and extent of tumor was reduced in 5 of 11 patients. Fourth ventricle compression improved in 6 of 11 patients but worsened in 3 of 11 patients. Presumed necrosis was observed in 5 of 11 patients at 2 weeks and in 1 additional patient at 6-8 weeks. There was no significant difference in mean anteroposterior and transverse diameters of tumor between the 2- and 6-8-week time points. Six of 11 patients had increasing ventricular size, with no evidence of obstruction. Conclusions: There is no significant difference in tumor size of DIPG patients who have received standard RT when measured at 2 weeks vs. 6-8 weeks after RT. The majority of patients had the largest change in tumor size at the 2-week post-RT scan, with evolving changes documented on the 6-8-week scan. Six of 11 patients had progressive ventriculomegaly without obstruction, suggestive of communicating hydrocephalus. To the best

  7. Repetitive firing properties of medial pontine reticular formation neurones of the rat recorded in vitro.

    Science.gov (United States)

    Gerber, U; Greene, R W; McCarley, R W

    1989-03-01

    1. Intracellularly recorded neurones in nucleus reticularis pontis caudalis of the medial pontine reticular formation (mPRF) in the in vitro slice preparation were analysed for repetitive firing properties in response to intracellularly applied constant-current pulses. 2. Three neuronal classes were defined by this procedure: (1) non-burst neurones, which had only a non-burst firing pattern; (2) low-threshold burst neurones, which had either a low-threshold burst pattern or a non-burst pattern; (3) high-threshold burst neurones, which had either a high-threshold burst pattern or a non-burst pattern. 3. Histological characterization of electrophysiologically identified mPRF neurones with carboxyfluorescein showed no definite morphological difference between the first two classes. There was a trend for low-threshold burst neurones to have larger somata. 4. The low-threshold burst was generated by a slow calcium-dependent low-threshold spike, revealed in the presence of tetrodotoxin. The size of the low-threshold spike and thus the number of fast action potentials in the low-threshold burst was controlled by at least five factors including: activation; inactivation; amplitude of low-threshold conductance available to be activated; delayed outward conductance; and early transient outward conductance. 5. The non-burst pattern examined in both non-burst and low-threshold burst neurones appeared to be controlled primarily by one or more calcium-dependent potassium conductances sensitive to the removal of calcium and tetraethyl-ammonium. In the presence of tetrodotoxin (TTX), the addition of antagonists to calcium-dependent potassium current revealed a slow high-threshold calcium spike which was distinguished from the low-threshold spike by its threshold, lack of inactivation (at potentials negative to -40 mV) and insensitivity to Mg2+. A long-duration after-hyperpolarization (greater than 0.5 s) was not observed in any of these cells. 6. An early transient outward

  8. REM sleep modulation by perifornical orexinergic inputs to the pedunculo-pontine tegmental neurons in rats.

    Science.gov (United States)

    Khanday, M A; Mallick, B N

    2015-11-12

    Rapid eye movement sleep (REMS) is regulated by the interaction of the REM-ON and REM-OFF neurons located in the pedunculo-pontine-tegmentum (PPT) and the locus coeruleus (LC), respectively. Many other brain areas, particularly those controlling non-REMS (NREMS) and waking, modulate REMS by modulating these REMS-related neurons. Perifornical (PeF) orexin (Ox)-ergic neurons are reported to increase waking and reduce NREMS as well as REMS; dysfunction of the PeF neurons are related to REMS loss-associated disorders. Hence, we were interested in understanding the neural mechanism of PeF-induced REMS modulation. As a first step we have recently reported that PeF Ox-ergic neurons modulate REMS by influencing the LC neurons (site for REM-OFF neurons). Thereafter, in this in vivo study we have explored the role of PeF inputs on the PPT neurons (site for REM-ON neurons) for the regulation of REMS. Chronic male rats were surgically prepared with implanted bilateral cannulae in PeF and PPT and electrodes for recording sleep-waking patterns. After post-surgical recovery sleep-waking-REMS were recorded when bilateral PeF neurons were stimulated by glutamate and simultaneously bilateral PPT neurons were infused with either saline or orexin receptor1 (OX1R) antagonist. It was observed that PeF stimulation increased waking and decreased NREMS as well as REMS, which were prevented by OX1R antagonist into the PPT. We conclude that the PeF stimulation-induced reduction in REMS was likely to be due to inhibition of REM-ON neurons in the PPT. As waking and NREMS are inversely related, subject to confirmation, the reduction in NREMS could be due to increased waking or vice versa. Based on our findings from this and earlier studies we have proposed a model showing connections between PeF- and PPT-neurons for REMS regulation.

  9. Reptin and Pontin function antagonistically with PcG and TrxG complexes to mediate Hox gene control

    Science.gov (United States)

    Diop, Soda Balla; Bertaux, Karine; Vasanthi, Dasari; Sarkeshik, Ali; Goirand, Benjamin; Aragnol, Denise; Tolwinski, Nicholas S; Cole, Michael D; Pradel, Jacques; Yates, John R; Mishra, Rakesh K; Graba, Yacine; Saurin, Andrew J

    2008-01-01

    Pontin (Pont) and Reptin (Rept) are paralogous ATPases that are evolutionarily conserved from yeast to human. They are recruited in multiprotein complexes that function in various aspects of DNA metabolism. They are essential for viability and have antagonistic roles in tissue growth, cell signalling and regulation of the tumour metastasis suppressor gene, KAI1, indicating that the balance of Pont and Rept regulates epigenetic programmes critical for development and cancer progression. Here, we describe Pont and Rept as antagonistic mediators of Drosophila Hox gene transcription, functioning with Polycomb group (PcG) and Trithorax group proteins to maintain correct patterns of expression. We show that Rept is a component of the PRC1 PcG complex, whereas Pont purifies with the Brahma complex. Furthermore, the enzymatic functions of Rept and Pont are indispensable for maintaining Hox gene expression states, highlighting the importance of these two antagonistic factors in transcriptional output. PMID:18259215

  10. Proceedings of the diffuse intrinsic pontine glioma (DIPG) Toronto Think Tank: advancing basic and translational research and cooperation in DIPG.

    Science.gov (United States)

    Bartels, Ute; Hawkins, Cynthia; Vézina, Gilbert; Kun, Larry; Souweidane, Mark; Bouffet, Eric

    2011-10-01

    Diffuse intrinsic pontine glioma (DIPG) nearly exclusively affects children. The prognosis of DIPGs has remained grim despite more than three decades of clinical research and numerous clinical trials. More than 90% of the children with DIPG will succumb within 2 years of diagnosis. The tumor's incidence is still undefined, but data suggest 100-150 affected children annually in the US. The single proven effective treatment modality in DIPG remains radiation therapy. For the majority of patients however this treatment is only of transient effectiveness. Recent breakthroughs in the understanding of the molecular biology of DIPG have raised new hope and opened new avenues for therapeutic options. The advancement of basic and translational research and cooperation was the objective of the Toronto Think Tank, as new approaches are urgently needed.

  11. SLEEP AND GABA LEVELS IN THE ORAL PART OF RAT PONTINE RETICULAR FORMATION ARE DECREASED BY LOCAL AND SYSTEMIC ADMINISTRATION OF MORPHINE

    OpenAIRE

    Watson, Christopher J.; Lydic, Ralph; Baghdoyan, Helen A.

    2006-01-01

    Morphine, a μ-opioid receptor agonist, is a commonly prescribed treatment for pain. Although highly efficacious, morphine has many unwanted side effects including disruption of sleep and obtundation of wakefulness. One mechanism by which morphine alters sleep and wakefulness may be by modulating GABAergic signaling in brain regions regulating arousal, including the oral pontine reticular formation (PnO). This study used in vivo microdialysis in unanesthetized Sprague-Dawley rat to test the hy...

  12. Long-Term Outcome of Endonasal Transsphenoidal Approach for the Treatment of Pontine Cavernous Malformation: Case Report with 11 Years of Follow-Up.

    Science.gov (United States)

    Banczerowski, Péter; Czigléczki, Gábor; Gádor, Ildikó; Nyáry, István

    2016-05-01

    Ventromedial localized cavernous malformations in the pons pose a difficult problem because of their surgical access and the high risk of deleterious consequences due to damage of the surrounding tissues. We report an endonasal transsphenoidal approach for the treatment of ventromedial pontine cavernomas that also follows principles of optimal access known as the "two-point method" for the resection of cavernous malformations. A 31-year-old woman presented with sudden left hemiparesis, nausea, and headache. Radiologic findings demonstrated a ventral pontine cavernous malformation in the midline slightly extending to the right, together with signs of acute hemorrhage. Surgical intervention was performed, and the cavernoma was completely resected via a transnasal transsphenoidal approach. Cerebrospinal fluid (CSF) rhinorrhea that ensued postoperatively needed an additional reconstructive surgery using the same approach. No further CSF leakage was evident, and an 11-year follow-up examination revealed neither signs of neurologic deficit nor recurrence of the resected pontine cavernoma. The long-term outcome proves the effectiveness and safety of this novel surgical route in the treatment of ventromedial cavernous malformations in the pons.

  13. Motexafin-Gadolinium and Involved Field Radiation Therapy for Intrinsic Pontine Glioma of Childhood: A Children's Oncology Group Phase 2 Study

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, Kristin A., E-mail: bradley@humonc.wisc.edu [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Zhou Tianni [Department of Preventive Medicine, University of Southern California, Los Angeles, California (United States); McNall-Knapp, Rene Y. [Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (United States); Jakacki, Regina I. [Division of Pediatric Hematology/Oncology, Children' s Hospital of Pittsburgh, Pittsburgh, Pennsylvania (United States); Levy, Adam S. [Division of Pediatric Hematology/Oncology, Children' s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York (United States); Vezina, Gilbert [Department of Radiology, Children' s National Medical Center, George Washington University School of Medicine, Washington, DC (United States); Pollack, Ian F. [Department of Neurosurgery, Children' s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)

    2013-01-01

    Purpose: To evaluate the effects on 1-year event-free survival (EFS) and overall survival (OS) of combining motexafin and gadolinium (MGd), a potent radiosensitizer, with daily fractionated radiation therapy in children with newly diagnosed intrinsic pontine gliomas. Methods and Materials: Patients with newly diagnosed intrinsic pontine glioma were treated with MGd daily for 5 consecutive days each week, for a total of 30 doses. Patients received a 5- to 10-min intravenous bolus of MGd, 4.4 mg/kg/day, given 2 to 5 h prior to standard dose irradiation. Radiation therapy was administered at a daily dose of 1.8 Gy for 30 treatments over 6 weeks. The total dose was 54 Gy. Results: Sixty eligible children received MGd daily, concurrent with 6 weeks of radiation therapy. The estimated 1-year EFS was 18% {+-} 5%, and the estimated 1-year OS was 53% {+-} 6.5%. The most common grade 3 to 4 toxicities were lymphopenia, transient elevation of liver transaminases, and hypertension. Conclusions: Compared to historical controls, the addition of MGd to a standard 6-week course of radiation did not improve the survival of pediatric patients with newly diagnosed intrinsic pontine gliomas.

  14. Isolated Contralateral Sudden Sensorineural Hearing Loss: An Unusual Manifestation of Pontine Infarct

    OpenAIRE

    Eluvathingal Muttikkal, Thomas Jose; Kesser, Bradley W.; Mukherjee, Sugoto

    2014-01-01

    Unilateral, acute onset sensorineural hearing loss (“sudden sensorineural hearing loss” [SSNHL]) as an isolated event without other associated neurological deficits usually results from a lesion of the cochlea. Lesions in the ascending central auditory pathways cranial to the cochlear nucleus seldom result in unilateral hearing loss due to decussation of the central auditory pathways at multiple levels. We describe a patient with a tiny acute infarct in the right pons resulting in isolated ac...

  15. Isolated contralateral sudden sensorineural hearing loss: an unusual manifestation of pontine infarct.

    Science.gov (United States)

    Muttikkal, Thomas Jose Eluvathingal; Kesser, Bradley W; Mukherjee, Sugoto

    2014-09-01

    Unilateral, acute onset sensorineural hearing loss ("sudden sensorineural hearing loss" [SSNHL]) as an isolated event without other associated neurological deficits usually results from a lesion of the cochlea. Lesions in the ascending central auditory pathways cranial to the cochlear nucleus seldom result in unilateral hearing loss due to decussation of the central auditory pathways at multiple levels. We describe a patient with a tiny acute infarct in the right pons resulting in isolated acute onset left-sided SSHNL, without any other associated acute neurological deficits.

  16. Expanding the clinical, radiological and neuropathological phenotype of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS).

    Science.gov (United States)

    Simon, Neil G; Parratt, John D; Barnett, Michael H; Buckland, Michael E; Gupta, Ruta; Hayes, Michael W; Masters, Lynette T; Reddel, Stephen W

    2012-01-01

    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently described inflammatory disease of the CNS with a predilection for the hindbrain and responsive to immunotherapy. Five further cases are described with detailed pathology and long term evaluation. CLIPPERS does not represent a benign condition, and without chronic immunosuppression the disease may relapse. The radiological distribution is focused not only in the pons but also in the brachium ponti and cerebellum. Pontocerebellar atrophy occurred early, even in cases treated promptly. Significant cognitive impairment was seen in some cases and was associated with additional cerebral atrophy. The pathology included distinctive histiocytic as well as lymphocytic components and evidence of neuro-axonal injury. Additional subclinical systemic findings on investigation were identified. Relapse was associated with withdrawal of corticosteroids, and disability was least marked in cases where both the presentation and relapses were treated promptly. We propose that the title of the syndrome be amended to chronic lymphocytic inflammation with pontocerebellar perivascular enhancement responsive to steroids to more accurately reflect the distribution of the radiological findings.

  17. Morphologic Relationship between the Pontine Micturition Center and the Sympathetic Center in the Spinal Cord of the Rat

    Institute of Scientific and Technical Information of China (English)

    WU Xinhong; XIAO Chuanguo

    2005-01-01

    Summary: To study whether the sympathetic nerves coordinate with the parasympathetic nerves during micturition in the rat. We used antegrade neural tracing with biotinylated dextran amine (BDA) injected into the pontine micturition center (PMC) to label the terminals in the L6-S1 cord. Preganglionic parasympathetic neurons (PPNs) in the L6-S1 segment were labelled by retrograde transport of Fluorogold (FG) from the major pelvic ganglion (MPG).We detected retrograde neurons in L6-S1 using retrograde transport of horseradish peroxidase (HRP) from the intermediolateral cell column (IML) of the L1-L2 segment where sympathetic preganglionic neurons (SPNs) are located. Immunohistochemical methods showed that PPNs were identified to be choline acetyltransferase-immunoreactive (ChAT-IR). HRP-labelled neurons were not ChAT-IR and located dorsal to PPNs. BDA-labelled terminals were located mainly in the bilateral IML of L6-S1, some of which had synaptic contact with the HRP-labelled neurons. In addition, there were some wheat germ agglutinin-horseradish peroxidase (WGA-HRP) labelled terminals in the ipsilateral IML of the L1-L2 segment after WGA-HRP was microinjected into SPN. We conclude that PMC may control the preganglionic neurons of sympathetic nerves through the interneurons located dorsal to PPNs.

  18. Chemical Topography of Efferent Projections from the Median Preoptic Nucleus to Pontine Monoaminergic Cell Groups in the Rat

    Science.gov (United States)

    Zardetto-Smith, Andrea M.; Johnson, Alan Kim

    1995-01-01

    This study examined efferent output from the median preoptic nucleus (MNPO) to pontine noradrenergic and serotonergic cell groups using an anterograde tracing technique (Phaseolus vulgaris leucoagglutinin, PHA-L) combined with glucose oxidase immunocytochemistry to serotonin (5-HT) or to dopamine-beta-hydroxylase (DBH). Injections of PHA-L into the ventral MNPO resulted in moderate axonal labeling within the region of the B7 and B8 serotonergic groups in the dorsal raphe. PHA-L labeled fibers and punctate processes were observed in close apposition to many of the 5-HT immunoreactive neurons in these regions. In contrast, sparse terminal labeling was found within the B5 group in the raphe pontis nucleus, and only trace fiber labeling observed in the B3 and B6 groups. Efferents from the MNPO also provided moderate innervation to the A6 and A7 noradrenergic groups. PHA-L labeled punctate processes were found most frequently in close apposition to DBH-immunoreactive neurons at mid- to caudal levels of the locus coeruleus. Some labeled axons were also present within the A7 and A5 groups. Additionally, a close apposition between labeled MNPO efferents and 5-HT fibers within the lateral parabrachial nucleus was observed. The results indicate the MNPO provides a topographic innervation of monoaminergic groups in the upper brainstem.

  19. Central nervous system tuberculosis: MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kioumehr, F.; Dadsetan, M.R.; Rooholamini, S.A.; Au, A.

    1994-02-01

    The MRI findings of 18 proven cases of central nervous system (CNS) tuberculosis were reviewed; 10 patients were seropositive for HIV. All had medical, laboratory, or surgical proof of CNS tuberculosis. Eleven patients had meningitis, of whom two also had arachnoiditis. Five patients had focal intra-axial tuberculomas: four brain masses and one an intramedullary spinal lesion. Two patients had focal extra-axial tuberculomas: one in the pontine cistern, and one in the spine. In all 11 patients with meningitis MRI showed diffuse, thick, meningeal enhancement. All intraparenchymal tuberculomas showed low signal intensity on T2-weighted images and ring or nodular enhancement. The extra-axial tuberculomas had areas isointense or hypointense relative to normal brain and spinal cord on T2-weighted images. Although tuberculous meningitis cannot be differentiated from other meningitides on the basis of MR findings, intraparenchymal tuberculomas show characteristic T2 shortening, not found in most other space-occupying lesions. In the appropriate clinical setting, tuberculoma should be considered. (orig.)

  20. An unusual case of osmotic demyelination syndrome without electrolyte changes in a patient with diabetes

    Directory of Open Access Journals (Sweden)

    Shrikant S Kote

    2016-01-01

    Full Text Available Central pontine myelinolysis (CPM is a demyelinating disease of the pons which is also associated with the demyelination of extrapontine areas of the central nervous system. Although the aetiology and pathogenesis are unclear, CPM is usually associated with hyponatremia or its rapid correction. Malnutrition and chronic alcoholism are also the common underlying conditions. Herein, we report a rare presentation of ODS, secondary to hyperosmolar hyperglycaemic state. We observed a 37-year-old female with diabetes type 1 and hypertension who presented with ataxia, dysarthria and pseudobulbar effect which evolved over a duration of few weeks at home with no evidence of hyponatremia or its rapid correction and no history of alcohol abuse or malnutrition.

  1. [The re-introduction of malaria in the Pontine Marshes and the Cassino district during the end of World War II. Biological warfare or global war tactics?].

    Science.gov (United States)

    Sabbatani, Sergio; Fiorino, Sirio; Manfredi, Roberto

    2013-12-01

    After the fall of the Fascist regime on September 8, 1943, Italy was split into two parts: (i) the Southern regions where the King Victor Emanuel III and the military general staff escaped was under the control of English-American allied armies, and (ii) the northern regions comprising Lazio, Tuscany, Umbria, and Marche still under the control of the Germans. The German Wehrmacht, after suffering several defeats on Southern lines, established a new strengthened line of defence called the Gustav line, located south of Rome and crossing in the western portion the recently-drained Pontine Marshes. In his book published in 2006, Frank Snowden hypothesised that occupying German armies in 1943 had initiated a programme of re-flooding the Pontine plain as a biological warfare strategy to re-introduce malaria infection in the territories south of Rome, Such a plan was intended (i) to slow down the advance of English-American forces, and (ii) to punish Italians who abandoned their former allies. Other authors, including Annibale Folchi, Erhard Geissler, and Jeanne Guillemin, have disputed this hypothesis based on an analysis of recently-uncovered archive documents. What is not disputed is that the flooding of the Pontine and Roman plains in 1943 contributed to a severe malaria epidemic in 1944, which was associated with exceptionally high morbidity and mortality rates in the afflicted populations. Herein, we critically evaluate the evidence and arguments of whether the Wehrmacht specifically aimed to spread malaria as a novel biological warfare strategy in Italy during the Second World War. In our opinion, evidence for specific orders to deliberately spread malaria by the German army is lacking, although the strategy itself may have been considered by Nazis during the waning years of the war.

  2. Mesenchymal transition and PDGFRA amplification/mutation are key distinct oncogenic events in pediatric diffuse intrinsic pontine gliomas.

    Directory of Open Access Journals (Sweden)

    Stephanie Puget

    Full Text Available Diffuse intrinsic pontine glioma (DIPG is one of the most frequent malignant pediatric brain tumor and its prognosis is universaly fatal. No significant improvement has been made in last thirty years over the standard treatment with radiotherapy. To address the paucity of understanding of DIPGs, we have carried out integrated molecular profiling of a large series of samples obtained with stereotactic biopsy at diagnosis. While chromosomal imbalances did not distinguish DIPG and supratentorial tumors on CGHarrays, gene expression profiling revealed clear differences between them, with brainstem gliomas resembling midline/thalamic tumours, indicating a closely-related origin. Two distinct subgroups of DIPG were identified. The first subgroup displayed mesenchymal and pro-angiogenic characteristics, with stem cell markers enrichment consistent with the possibility to grow tumor stem cells from these biopsies. The other subgroup displayed oligodendroglial features, and appeared largely driven by PDGFRA, in particular through amplification and/or novel missense mutations in the extracellular domain. Patients in this later group had a significantly worse outcome with an hazard ratio for early deaths, ie before 10 months, 8 fold greater that the ones in the other subgroup (p = 0.041, Cox regression model. The worse outcome of patients with the oligodendroglial type of tumors was confirmed on a series of 55 paraffin-embedded biopsy samples at diagnosis (median OS of 7.73 versus 12.37 months, p = 0.045, log-rank test. Two distinct transcriptional subclasses of DIPG with specific genomic alterations can be defined at diagnosis by oligodendroglial differentiation or mesenchymal transition, respectively. Classifying these tumors by signal transduction pathway activation and by mutation in pathway member genes may be particularily valuable for the development of targeted therapies.

  3. Plaques of Nonstenotic Basilar Arteries with Isolated Pontine Infarction on Three-dimensional High Isotropic Resolution Magnetic Resonance Imaging

    Institute of Scientific and Technical Information of China (English)

    Xian-Jin Zhu; Wei-Jian Jiang; Lei Liu; Li-Bin Hu; Wu Wang; Zun-Jing Liu

    2015-01-01

    Background:There are few studies for evaluating plaque characteristics of nonstenotic basilar arteries (BA).Our aim was to determine entire BA plaques with a three-dimensional volumetric isotropic turbo spin-echo acquisition (VISTA) and investigate the differences between the patients with and without isolated pontine infarction (IPI).Methods:Twenty-four consecutive symptomatic patients with nonstenotic BA on time of flight magnetic resonance angiography (TOF MRA) were enrolled from China-Japan Friendship Hospital between January 2014 and December 2014.BA was classified as "normal" or"irregular" based on TOF MRA,and "normal wall","slight wall-thickening",and "plaque" based on three-dimensional VISTA images.Outcomes from MRA and VISTA were compared.Patients were categorized as IPI and non-IPI groups based on the diffusion-weighted imaging.Clinical and plaque characteristics were compared between the two groups.Results:A total of 1024 image slices including 311 (30.37%) plaque slices,427 (41.70%) slight wall-thickening slices,and 286 (27.93%) normal wall slices for the entire BA from 23 patients were finally included for analysis.VISTA images detected plaques in all the 9 (100%) irregular MRA patients and 7 of 14 (50%) normal MRA patients.IPI was found in 1 1 (47.83%) patients.Compared to non-IPI group,the IPI group had a higher percentage of plaque slices (P =0.001) and lower percentage of normal wall slices (P =0.014) than non-IPI group.Conclusions:Three-dimensional VISTA images enable detection of BA plaques not visualized by MRA.BA plaques could be found in both the IPI and non-IPI group.However,IPI group showed plaques more extensively in BA than the non-IPI group.

  4. GABAergic transmission in rat pontine reticular formation regulates the induction phase of anesthesia and modulates hyperalgesia caused by sleep deprivation.

    Science.gov (United States)

    Vanini, Giancarlo; Nemanis, Kriste; Baghdoyan, Helen A; Lydic, Ralph

    2014-07-01

    The oral part of the pontine reticular formation (PnO) contributes to the regulation of sleep, anesthesia and pain. The role of PnO γ-aminobutyric acid (GABA) in modulating these states remains incompletely understood. The present study used time to loss and time to resumption of righting response (LoRR and RoRR) as surrogate measures of loss and resumption of consciousness. This study tested three hypotheses: (i) pharmacologically manipulating GABA levels in rat PnO alters LoRR, RoRR and nociception; (ii) propofol decreases GABA levels in the PnO; and (iii) inhibiting GABA synthesis in the PnO blocks hyperalgesia caused by sleep deprivation. Administering a GABA synthesis inhibitor [3-mercaptopropionic acid (3-MPA)] or a GABA uptake inhibitor [nipecotic acid (NPA)] into rat PnO significantly altered LoRR caused by propofol. 3-MPA significantly decreased LoRR for propofol (-18%). NPA significantly increased LoRR during administration of propofol (36%). Neither 3-MPA nor NPA altered RoRR following cessation of propofol or isoflurane delivery. The finding that LoRR was decreased by 3-MPA and increased by NPA is consistent with measures showing that extracellular GABA levels in the PnO were decreased (41%) by propofol. Thermal nociception was significantly decreased by 3-MPA and increased by NPA, and 3-MPA blocked the hyperalgesia caused by sleep deprivation. The results demonstrate that GABA levels in the PnO regulate the time for loss of consciousness caused by propofol, extend the concept that anesthetic induction and emergence are not inverse processes, and suggest that GABAergic transmission in the PnO mediates hyperalgesia caused by sleep loss.

  5. Hox paralog group 2 genes control the migration of mouse pontine neurons through slit-robo signaling.

    Directory of Open Access Journals (Sweden)

    Marc J Geisen

    2008-06-01

    Full Text Available The pontine neurons (PN represent a major source of mossy fiber projections to the cerebellum. During mouse hindbrain development, PN migrate tangentially and sequentially along both the anteroposterior (AP and dorsoventral (DV axes. Unlike DV migration, which is controlled by the Netrin-1/Dcc attractive pathway, little is known about the molecular mechanisms guiding PN migration along the AP axis. Here, we show that Hoxa2 and Hoxb2 are required both intrinsically and extrinsically to maintain normal AP migration of subsets of PN, by preventing their premature ventral attraction towards the midline. Moreover, the migration defects observed in Hoxa2 and Hoxb2 mutant mice were phenocopied in compound Robo1;Robo2, Slit1;Slit2, and Robo2;Slit2 knockout animals, indicating that these guidance molecules act downstream of Hox genes to control PN migration. Indeed, using chromatin immunoprecipitation assays, we further demonstrated that Robo2 is a direct target of Hoxa2 in vivo and that maintenance of high Robo and Slit expression levels was impaired in Hoxa2 mutant mice. Lastly, the analysis of Phox2b-deficient mice indicated that the facial motor nucleus is a major Slit signaling source required to prevent premature ventral migration of PN. These findings provide novel insights into the molecular control of neuronal migration from transcription factor to regulation of guidance receptor and ligand expression. Specifically, they address the question of how exposure to multiple guidance cues along the AP and DV axes is regulated at the transcriptional level and in turn translated into stereotyped migratory responses during tangential migration of neurons in the developing mammalian brain.

  6. Hypofractionation vs Conventional Radiation Therapy for Newly Diagnosed Diffuse Intrinsic Pontine Glioma: A Matched-Cohort Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Janssens, Geert O., E-mail: g.janssens@rther.umcn.nl [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Jansen, Marc H. [Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam (Netherlands); Lauwers, Selmer J. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Nowak, Peter J. [Department of Radiation Oncology, Erasmus Medical Centre, Rotterdam (Netherlands); Oldenburger, Foppe R. [Department of Radiation Oncology, Academic Medical Centre, Amsterdam (Netherlands); Bouffet, Eric [Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto (Canada); Saran, Frank [Department of Pediatric Oncology, The Royal Marsden NHS Foundation Trust, Sutton (United Kingdom); Kamphuis-van Ulzen, Karin [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Lindert, Erik J. van [Department of Neurosurgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Schieving, Jolanda H. [Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Boterberg, Tom [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Kaspers, Gertjan J. [Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam (Netherlands); Span, Paul N.; Kaanders, Johannes H. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Gidding, Corrie E. [Department of Pediatric Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Hargrave, Darren [Department of Oncology, Great Ormond Street Hospital, London (United Kingdom)

    2013-02-01

    Purpose: Despite conventional radiation therapy, 54 Gy in single doses of 1.8 Gy (54/1.8 Gy) over 6 weeks, most children with diffuse intrinsic pontine glioma (DIPG) will die within 1 year after diagnosis. To reduce patient burden, we investigated the role of hypofractionation radiation therapy given over 3 to 4 weeks. A 1:1 matched-cohort analysis with conventional radiation therapy was performed to assess response and survival. Methods and Materials: Twenty-seven children, aged 3 to 14, were treated according to 1 of 2 hypofractionation regimens over 3 to 4 weeks (39/3 Gy, n=16 or 44.8/2.8 Gy, n=11). All patients had symptoms for {<=}3 months, {>=}2 signs of the neurologic triad (cranial nerve deficit, ataxia, long tract signs), and characteristic features of DIPG on magnetic resonance imaging. Twenty-seven patients fulfilling the same diagnostic criteria and receiving at least 50/1.8 to 2.0 Gy were eligible for the matched-cohort analysis. Results: With hypofractionation radiation therapy, the overall survival at 6, 9, and 12 months was 74%, 44%, and 22%, respectively. Progression-free survival at 3, 6, and 9 months was 77%, 43%, and 12%, respectively. Temporary discontinuation of steroids was observed in 21 of 27 (78%) patients. No significant difference in median overall survival (9.0 vs 9.4 months; P=.84) and time to progression (5.0 vs 7.6 months; P=.24) was observed between hypofractionation vs conventional radiation therapy, respectively. Conclusions: For patients with newly diagnosed DIPG, a hypofractionation regimen, given over 3 to 4 weeks, offers equal overall survival with less treatment burden compared with a conventional regimen of 6 weeks.

  7. Discrepant longitudinal volumetric and metabolic evolution of diffuse intrinsic Pontine gliomas during treatment: implications for current response assessment strategies

    Energy Technology Data Exchange (ETDEWEB)

    Loebel, U. [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Neuroradiology, Hamburg (Germany); St. Jude Children' s Research Hospital, Department of Diagnostic Imaging, Memphis, TN (United States); Hwang, S.; Edwards, A.; Patay, Z. [St. Jude Children' s Research Hospital, Department of Diagnostic Imaging, Memphis, TN (United States); Li, Y.; Li, X. [St. Jude Children' s Research Hospital, Department of Biostatistics, Memphis, TN (United States); Broniscer, A. [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Pediatrics, Memphis, TN (United States)

    2016-10-15

    Based on clinical observations, we hypothesized that in infiltrative high-grade brainstem neoplasms, such as diffuse intrinsic pontine glioma (DIPG), longitudinal metabolic evaluation of the tumor by magnetic resonance spectroscopy (MRS) may be more accurate than volumetric data for monitoring the tumor's biological evolution during standard treatment. We evaluated longitudinal MRS data and corresponding tumor volumes of 31 children with DIPG. We statistically analyzed correlations between tumor volume and ratios of Cho/NAA, Cho/Cr, and NAA/Cr at key time points during the course of the disease through the end of the progression-free survival period. By the end of RT, tumor volume had significantly decreased from the baseline (P <.0001) and remained decreased through the last available follow-up magnetic resonance imaging study (P =.007632). However, the metabolic profile of the tumor tissue (Cho/Cr, NAA/Cr, and Cho/NAA ratios) did not change significantly over time. Our data show that longitudinal tumor volume and metabolic profile changes are dissociated in patients with DIPG during progression-free survival. Volume changes, therefore, may not accurately reflect treatment-related changes in tumor burden. This study adds to the existing body of evidence that the value of conventional MRI metrics, including volumetric data, needs to be reevaluated critically and, in infiltrative tumors in particular, may not be useful as study end-points in clinical trials. We submit that advanced quantitative MRI data, including robust, MRS-based metabolic ratios and diffusion and perfusion metrics, may be better surrogate markers of key end-points in clinical trials. (orig.)

  8. Endogenous cholinergic input to the pontine REM sleep generator is not required for REM sleep to occur.

    Science.gov (United States)

    Grace, Kevin P; Vanstone, Lindsay E; Horner, Richard L

    2014-10-22

    Initial theories of rapid eye movement (REM) sleep generation posited that induction of the state required activation of the pontine subceruleus (SubC) by cholinergic inputs. Although the capacity of cholinergic neurotransmission to contribute to REM sleep generation has been established, the role of cholinergic inputs in the generation of REM sleep is ultimately undetermined as the critical test of this hypothesis (local blockade of SubC acetylcholine receptors) has not been rigorously performed. We used bilateral microdialysis in freely behaving rats (n = 32), instrumented for electroencephalographic and electromyographic recording, to locally manipulate neurotransmission in the SubC with select drugs. As predicted, combined microperfusion of D-AP5 (glutamate receptor antagonist) and muscimol (GABAA receptor agonist) in the SubC virtually eliminated REM sleep. However, REM sleep was not reduced by scopolamine microperfusion in this same region, at a concentration capable of blocking the effects of cholinergic receptor stimulation. This result suggests that transmission of REM sleep drive to the SubC is acetylcholine-independent. Although SubC cholinergic inputs are not majorly involved in REM sleep generation, they may perform a minor function in the reinforcement of transitions into REM sleep, as evidenced by increases in non-REM-to-REM sleep transition duration and failure rate during cholinergic receptor blockade. Cholinergic receptor antagonism also attenuated the normal increase in hippocampal θ oscillations that characterize REM sleep. Using computational modeling, we show that our in vivo results are consistent with a mutually excitatory interaction between the SubC and cholinergic neurons where, importantly, cholinergic neuron activation is gated by SubC activity.

  9. Three-year prognosis of first-ever primary pontine hemorrhage in a hospital-based registry.

    Science.gov (United States)

    Ye, Zusen; Huang, Xiaoya; Han, Zhao; Shao, Bei; Cheng, Jianhua; Wang, Zhen; Zhang, Zheng; Xiao, Meijuan

    2015-07-01

    Our aim was to evaluate the mortality rate of primary pontine hemorrhage (PPH) and to determine the factors related to the prognosis. Limited data exist on the long-term prognosis and determinants of death in patients with PPH in China. Our study analyzed consecutive cases of first-ever PPH from April 2007 to March 2011 in a hospital-based stroke registry. Mortality rates during 30 day and 3 year follow-ups were analyzed. We used the Kaplan-Meier method to estimate the event rates and binary logistic regression analysis, and Cox proportional hazard regression analysis to identify predictors of short-term and long-term prognosis, respectively. A total of 76 patients were identified, 44 (57.89%) were men. Both 30 day and 3 year overall mortalities in men were higher than women but this different was not statistically significant. Coma on admission, hematoma ⩾ 4 mL and a massive hemorrhage were significantly related to 30 day mortality of PPH. Multivariate Cox proportional hazard regression revealed that coma on admission (hazard ratio [HR] 2.18; 95% confidence interval [CI] 1.16-4.13; p = 0.02) and hematoma ⩾ 4 mL (HR 2.23; 95% CI 1.25-3.96; p = 0.01) were independent predictors of 3 year mortality. In conclusion, the short-term mortality rate and factors related to the prognosis of Chinese patients with PPH are similar to those reported for other populations. A low Glasgow coma scale score on admission and a large hematoma volume may be related to poor 3 year prognosis after PPH.

  10. Spinal projections from the lower brain stem in the cat as demonstrated by the horseradish peroxidase technique. II. Projections from the dorsolateral pontine tegmentum and raphe nuclei.

    Science.gov (United States)

    Tohyama, M; Sakai, K; Touret, M; Salvert, D; Jouvet, M

    1979-11-02

    The descending projections to the spinal cord arising from the dorsolateral pontine tegmentum and brain stem raphe nuclei have been investigated by means of the horseradish peroxidase (HRP) technique. Particular attention was taken to clarify the cells of origin and the funicular trajectory of these spinal projections. After injections of HRP into the spinal cord, a significant of HRP labeled neurons were observed in the following dorsolateral pontine tegmental structures: (1) an area ventral to the nucleus cuneiformis; (2) principal locus coeruleus; (3) locus coeruleus a; (4) locuse subcoeruleus; (5) Kölliker-Fuse nucleus; and (6) nucleus parabrachialis lateralis. As a rule, the projections are ipsilateral and descendaphe-spinal projections, we have demonstrated that the nucleus raphe dorsalis also sends axons to the cervical segment of the spinal cord. Furthermore, in accord with previous reports, HRP labeled cells were also identified in the nucleus raphe magnus, pallidus and obscurus, but not in the nucleus raphe centralis superior and pontis. On the whole the present study further clarified the organization of spinal projections from the dorsolateral pons and raphe nuclei and provided some additional anatomical data for the physiology of the tegmentospinal and raphe-spinal projections.

  11. The encephalopathy of sepsis.

    Science.gov (United States)

    Jackson, A C; Gilbert, J J; Young, G B; Bolton, C F

    1985-11-01

    Twelve fatal cases of encephalopathy associated with sepsis were examined in a ten-year retrospective study. The sources of infection and organisms isolated were variable. Six of the patients had focal neurologic signs; five had seizures. The level of consciousness varied from drowsiness to deep coma, and electroencephalograms revealed diffuse or multifocal abnormalities. Computed tomographic head scans and cerebrospinal fluid examinations were usually unremarkable. Eight patients had disseminated microabscesses in the brain at autopsy. Four patients had proliferation of astrocytes and microglia in the cerebral cortex, a feature associated with metabolic encephalopathies. Additional findings included cerebral infarcts, brain purpura, multiple small white matter hemorrhages, and central pontine myelinolysis. Although sepsis may cause encephalopathy by producing disturbances in cerebral synaptic transmission and cerebral energy production through a toxic mechanism, bacterial invasion of the brain with the formation of disseminated microabscesses is also an important cause.

  12. Neurologic complications of liver transplantation.

    Science.gov (United States)

    Martinez, A J; Estol, C; Faris, A A

    1988-05-01

    The clinical and neuropathologic findings of 55 adults and 30 children who received liver transplants were reviewed. Encephalopathy was the most common clinical neurologic syndrome and was usually caused by metabolic or anoxic causes. (Alzheimer type astrocytes were present in 73 per cent of patients, and evidence of diffuse hypoxic damage was present in 40 per cent of children and 25 per cent of adults.) Cerebrovascular lesions were a common finding with infarcts or hemorrhages present in 30 per cent of patients. CNS infections were documented in 34 per cent of patients. Seizures were present in a third of patients. Central pontine myelinolysis was present in 12 per cent of patients and was more common in adults than in children. Antemortem diagnosis of neurologic complications was more often based on clinical presentation rather than specific radiologic or laboratory tests.

  13. Functional neuroanatomy of the central noradrenergic system.

    Science.gov (United States)

    Szabadi, Elemer

    2013-08-01

    The central noradrenergic neurone, like the peripheral sympathetic neurone, is characterized by a diffusely arborizing terminal axonal network. The central neurones aggregate in distinct brainstem nuclei, of which the locus coeruleus (LC) is the most prominent. LC neurones project widely to most areas of the neuraxis, where they mediate dual effects: neuronal excitation by α₁-adrenoceptors and inhibition by α₂-adrenoceptors. The LC plays an important role in physiological regulatory networks. In the sleep/arousal network the LC promotes wakefulness, via excitatory projections to the cerebral cortex and other wakefulness-promoting nuclei, and inhibitory projections to sleep-promoting nuclei. The LC, together with other pontine noradrenergic nuclei, modulates autonomic functions by excitatory projections to preganglionic sympathetic, and inhibitory projections to preganglionic parasympathetic neurones. The LC also modulates the acute effects of light on physiological functions ('photomodulation'): stimulation of arousal and sympathetic activity by light via the LC opposes the inhibitory effects of light mediated by the ventrolateral preoptic nucleus on arousal and by the paraventricular nucleus on sympathetic activity. Photostimulation of arousal by light via the LC may enable diurnal animals to function during daytime. LC neurones degenerate early and progressively in Parkinson's disease and Alzheimer's disease, leading to cognitive impairment, depression and sleep disturbance.

  14. Morphological characteristics and clinical significance of transverse sinus drainage cerebellar pontine vein%横窦引流小脑桥静脉的形态特征及其临床意义

    Institute of Scientific and Technical Information of China (English)

    毕方; 张玉震; 李猛; 汪建军; 孙金龙

    2013-01-01

    目的 探讨横窦引流小脑桥静脉的形态特点及其临床意义.方法 运用显微解剖与铸型方法观察60例(120侧)成人头颅的湿标本与24例胎儿及幼儿脑静脉的血管铸型.结果 根据进入小脑幕位置的不同,小脑桥静脉可分成窦汇组、小脑幕组和岩部组;三组桥静脉数量相仿(P>0.05),桥静脉直径分别为(1.7±0.8) mm、(2.0±0.8) mm和(2.2±0.8) mm.窦汇组中,7%的标本没有小脑桥静脉;小脑幕组中,13%的标本没有桥静脉;显微解剖的标本每侧有超过1根岩部组小脑桥静脉.结论 在脑幕下手术,选择旁正中手术路径对小脑桥静脉损伤几率最小.%Objective To investigate the morphological characteristics and clinical significance of the transverse sinus drainage cerebellar pontine vein.Methods The microsurgical anatomy and casting method were utilized to observe the specimens of 60 cases(120 sides) adult cranial vascular cast and brain vein of 24 cases of fetal and infant.Results According to the different positions of cerebellar pontine vein going into the cerebellar tentorium,the pontine veins were divided into three groups of A(small pontine vein sinus),B(tentorial) and C(rock).The numbers of pontine veins of 3 groups were similar(P>0.05).The diameters of bridging vein were (1,7±0.8) mm,(2±0.8) mm and (2.2±0.8) mm for groups of A,B and C,respectively.Seven percent of the specimens in group A had no sinus of small pontine vein,13% of the specimens in group B had no pontine veins.More than 1 cerebellar pontine vein on each side of the microsurgical anatomy were seen in group C.Conclusion In supratentorial surgery,the probability of damaging the cerebellar pontine vein can be minimized when a paramedian operation aproach is selected.

  15. Pontine Tegmental Cap Dysplasia

    DEFF Research Database (Denmark)

    Herlin, Morten; Gammelgaard, Lise; Varvagiannis, Konstantinos

    2015-01-01

    Fast charging stations (FCS) will become an essential part of future transportation systems with an increasing number of electrical vehicles. However, since these FCS plugs have power ratings of up to 100 kW, serious stress caused by large number of FCS could threaten the stability of the main po...

  16. 基底动脉狭窄对孤立性脑桥梗死预后的预测作用研究%Basilar Artery Stenosis is an Independent Predictor of Poor Outcomes at Discharge in Patients with Isolated Pontine Infarction

    Institute of Scientific and Technical Information of China (English)

    鞠奕; 陈梅梅; 李娜; 赵性泉; 王春雪; 王拥军

    2012-01-01

    Objective To compare the clinical presentation, intracranial and extracranial artery stenosis, and the short-term outcomes in patients with basilar artery(BA) stenosis with those without BA stenosis, and to investigate the associations between BA stenosis and poor outcomes in the patients with isolated pontine infarction at discharge. Methods In this prospective study, we recruited patients who were hospitalized for isolated pontine infarction within 7 days of symptom onset from October 2007 to August 2008. We compared the differences in risk factors, clinical features, the baseline neurologic impairment and the outcomes at discharge in patients with and without BA stenosis. Results A total of 101 patients with isolated pontine infarction were included in this study. Differences in central facial palsy and dysphagia(P=0.008 and 0.002) were observed among the 2 groups(with and without moderate to severe BA stenosis/occlusion). When the 2 groups were compared, the neurological impairments on admission were more severe in patients with moderate to severe BA stenosis/occlusion than in patients without BA stenosis(P=0.002). Those with moderate to severe BA stenosis/occlusion had higher incidences of concomitant stenosis of intracranial and/or extracranial artery than those without BA stenosis(P=0.009). The multivariable logistic-regression analysis showed that the significant outcome differences between patients with and without moderate to severe BA stenosis/occlusion when adjusted for potential confounding factors(OR 2.7,95%I 1.07-7.02, P=0.04). Conclusions Patients of isolated pontine infarction with moderate to severe BA stenosis/occlusion had higher incidences of concomitant stenosis of other intracranial and/or extracranial artery. Moderate to severe BA stenosis/occlusion was an independent predictor for poor outcomes at discharge after stroke onset in patients with isolated pontine infarction.%目的 比较伴或不伴基底动脉狭窄的孤立性脑桥梗死

  17. Deployable centralizers

    Energy Technology Data Exchange (ETDEWEB)

    Grubelich, Mark C.; Su, Jiann-Cherng; Knudsen, Steven D.

    2017-02-28

    A centralizer assembly is disclosed that allows for the assembly to be deployed in-situ. The centralizer assembly includes flexible members that can be extended into the well bore in situ by the initiation of a gas generating device. The centralizer assembly can support a large load carrying capability compared to a traditional bow spring with little or no installation drag. Additionally, larger displacements can be produced to centralize an extremely deviated casing.

  18. In vitro drug response and efflux transporters associated with drug resistance in pediatric high grade glioma and diffuse intrinsic pontine glioma.

    Directory of Open Access Journals (Sweden)

    Susanna J E Veringa

    Full Text Available Pediatric high-grade gliomas (pHGG, including diffuse intrinsic pontine gliomas (DIPG, are the leading cause of cancer-related death in children. While it is clear that surgery (if possible, and radiotherapy are beneficial for treatment, the role of chemotherapy for these tumors is still unclear. Therefore, we performed an in vitro drug screen on primary glioma cells, including three DIPG cultures, to determine drug sensitivity of these tumours, without the possible confounding effect of insufficient drug delivery. This screen revealed a high in vitro cytotoxicity for melphalan, doxorubicine, mitoxantrone, and BCNU, and for the novel, targeted agents vandetanib and bortezomib in pHGG and DIPG cells. We subsequently determined the expression of the drug efflux transporters P-gp, BCRP1, and MRP1 in glioma cultures and their corresponding tumor tissues. Results indicate the presence of P-gp, MRP1 and BCRP1 in the tumor vasculature, and expression of MRP1 in the glioma cells themselves. Our results show that pediatric glioma and DIPG tumors per se are not resistant to chemotherapy. Treatment failure observed in clinical trials, may rather be contributed to the presence of drug efflux transporters that constitute a first line of drug resistance located at the blood-brain barrier or other resistance mechanism. As such, we suggest that alternative ways of drug delivery may offer new possibilities for the treatment of pediatric high-grade glioma patients, and DIPG in particular.

  19. ''Occult'' post-contrast signal enhancement in pediatric diffuse intrinsic pontine glioma is the MRI marker of angiogenesis?

    Energy Technology Data Exchange (ETDEWEB)

    Conway, Ashley E.; Reddick, Wilburn E.; Li, Yimei; Yuan, Ying; Glass, John O.; Baker, Justin N.; Kun, Larry E.; Broniscer, Alberto; Patay, Zoltan [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States)

    2014-05-15

    In diffuse intrinsic pontine gliomas (DIPG), subtracting pre-contrast from post-contrast T1-weighted images (T1WI) occasionally reveals subtle, ''occult'' enhancement. We hypothesized that this represents intravascular enhancement related to angiogenesis and hence that these tumors should have greater blood volume fractions than do non-enhancing tumors. We retrospectively screened MR images of 66 patients initially diagnosed with DIPG and analyzed pretreatment conventional and dynamic susceptibility contrast (DSC) perfusion MRI studies of 61 patients. To determine the incidence of occult enhancement, cerebral blood volume (CBV) values were compared in areas of occult enhancement (OcE), no enhancement (NE), and normal-appearing deep cerebellar white matter (DCWM). Tumors of 10 patients (16.4 %) had occult enhancement; those of 6 patients (9.8 %) had no enhancement at all. The average CBV in areas of occult enhancement was significantly higher than that in non-enhancing areas of the same tumor (P =.03), within DCWM in the same patient (P =.03), and when compared to anatomically paired/similar regions of interest (ROI) in patients with non-enhancing tumors (P =.005). Areas of OcE correspond to areas of higher CBV in DIPG, which may be an MRI marker for angiogenesis, but larger scale studies may be needed to determine its potential relevance to grading by imaging, treatment stratification, biopsy guidance, and evaluation of response to targeted therapy. (orig.)

  20. Projections from the cat posterior lateral hypothalamus to the ventral part of the oral pontine reticular nucleus contain a GABAergic component.

    Science.gov (United States)

    De La Roza, Carmen; Martínez-Mena, Juana; Sánchez-Valle, María Elena; Reinoso-Suárez, Fernando

    2004-09-10

    The posterior lateral hypothalamus (PLH) has long been considered crucial to normal wakefulness while the ventral part of the oral pontine reticular nucleus (vRPO) is involved in the generation and maintenance of rapid eye movement (REM) sleep. However, to date, there is no information on the ultrastructure or neurotransmitter content of the hypothalamo-reticular projection. In the present study, we examined the morphology and synaptic organization of PLH terminals in the vRPO using PLH injections of biotinylated dextran amine (BDA) as well as of wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP). Since some PLH neurons are GABAergic, we used a post-embedding immunogold technique to determine whether any anterogradely labeled terminals were GABA-immunopositive. Electron microscope analyses revealed a variety of ultrastructural features in the vRPO anterogradely labeled terminals. Although most labeled terminals (over 63%) formed symmetric synapses on vRPO somata and dendrites, others made asymmetric synapses on vRPO dendrites. The relative percentages of labeled terminals observed on large, medium and small diameter dendrites were 44.3 +/- 5.5%, 35.3 +/- 3.0% and 20.4 +/- 3.1%, respectively. Finally, post-embedding immunogold technique revealed that there are GABA-immunopositive and immunonegative components to this projection, indicating that GABA is one of the transmitters used by the PLH cells that project to the vRPO. Furthermore, most, if not all, of the GABA-labeled axon terminals formed symmetric synapsis. In conclusion, our results suggest that the PLH could modulate the physiological responses of vRPO neurons through a GABAergic pathway as well as by other inhibitory and/or excitatory pathways. Activation of the descending PLH GABAergic projection may inhibit the REM sleep-inducing neurons within the vRPO and thus contribute to the suppression of REM sleep activation during wakefulness.

  1. Synaptic interactions between perifornical lateral hypothalamic area, locus coeruleus nucleus and the oral pontine reticular nucleus are implicated in the stage succession during sleep-wakefulness cycle.

    Science.gov (United States)

    Tortorella, Silvia; Rodrigo-Angulo, Margarita L; Núñez, Angel; Garzón, Miguel

    2013-01-01

    The perifornical area in the posterior lateral hypothalamus (PeFLH) has been implicated in several physiological functions including the sleep-wakefulness regulation. The PeFLH area contains several cell types including those expressing orexins (Orx; also known as hypocretins), mainly located in the PeF nucleus. The aim of the present study was to elucidate the synaptic interactions between Orx neurons located in the PeFLH area and different brainstem neurons involved in the generation of wakefulness and sleep stages such as the locus coeruleus (LC) nucleus (contributing to wakefulness) and the oral pontine reticular nucleus (PnO) nucleus (contributing to REM sleep). Anatomical data demonstrated the existence of a neuronal network involving the PeFLH area, LC, and the PnO nuclei that would control the sleep-wake cycle. Electrophysiological experiments indicated that PeFLH area had an excitatory effect on LC neurons. PeFLH stimulation increased the firing rate of LC neurons and induced an activation of the EEG. The excitatory effect evoked by PeFLH stimulation in LC neurons was blocked by the injection of the Orx-1 receptor antagonist SB-334867 into the LC. Similar electrical stimulation of the PeFLH area evoked an inhibition of PnO neurons by activation of GABAergic receptors because the effect was blocked by bicuculline application into the PnO. Our data also revealed that the LC and PnO nuclei exerted a feedback control on neuronal activity of PeFLH area. Electrical stimulation of LC facilitated firing activity of PeFLH neurons by activation of catecholaminergic receptors whereas PnO stimulation inhibited PeFLH neurons by activation of GABAergic receptors. In conclusion, Orx neurons of the PeFLH area seem to be an important organizer of the wakefulness and sleep stages in order to maintain a normal succession of stages during the sleep-wakefulness cycle.

  2. GABA(A) receptors in the pontine reticular formation of C57BL/6J mouse modulate neurochemical, electrographic, and behavioral phenotypes of wakefulness.

    Science.gov (United States)

    Flint, RaShonda R; Chang, Theresa; Lydic, Ralph; Baghdoyan, Helen A

    2010-09-15

    Drugs that potentiate transmission at GABA(A) receptors are widely used to enhance sleep and to cause general anesthesia. The mechanisms underlying these effects are unknown. This study tested the hypothesis that GABA(A) receptors in the pontine reticular nucleus, oral part (PnO) of mouse modulate five phenotypes of arousal: sleep and wakefulness, cortical electroencephalogram (EEG) activity, acetylcholine (ACh) release in the PnO, breathing, and recovery time from general anesthesia. Microinjections into the PnO of saline (vehicle control), the GABA(A) receptor agonist muscimol, muscimol with the GABA(A) receptor antagonist bicuculline, and bicuculline alone were performed in male C57BL/6J mice (n = 33) implanted with EEG recording electrodes. Muscimol caused a significant increase in wakefulness and decrease in rapid eye movement (REM) and non-REM (NREM) sleep. These effects were reversed by coadministration of bicuculline. Bicuculline administered alone caused a significant decrease in wakefulness and increase in NREM sleep and REM sleep. Muscimol significantly increased EEG power in the delta range (0.5-4 Hz) during wakefulness and in the theta range (4-9 Hz) during REM sleep. Dialysis delivery of bicuculline to the PnO of male mice (n = 18) anesthetized with isoflurane significantly increased ACh release in the PnO, decreased breathing rate, and increased anesthesia recovery time. All drug effects were concentration dependent. The effects on phenotypes of arousal support the conclusion that GABA(A) receptors in the PnO promote wakefulness and suggest that increasing GABAergic transmission in the PnO may be one mechanism underlying the phenomenon of paradoxical behavioral activation by some benzodiazepines.

  3. Sleep and GABA levels in the oral part of rat pontine reticular formation are decreased by local and systemic administration of morphine.

    Science.gov (United States)

    Watson, C J; Lydic, R; Baghdoyan, H A

    2007-01-05

    Morphine, a mu-opioid receptor agonist, is a commonly prescribed treatment for pain. Although highly efficacious, morphine has many unwanted side effects including disruption of sleep and obtundation of wakefulness. One mechanism by which morphine alters sleep and wakefulness may be by modulating GABAergic signaling in brain regions regulating arousal, including the pontine reticular nucleus, oral part (PnO). This study used in vivo microdialysis in unanesthetized Sprague-Dawley rat to test the hypothesis that mu-opioid receptors modulate PnO GABA levels. Validation of the high performance liquid chromatographic technique used to quantify GABA was obtained by dialyzing the PnO (n=4 rats) with the GABA reuptake inhibitor nipecotic acid (500 microM). Nipecotic acid caused a 185+/-20% increase in PnO GABA levels, confirming chromatographic detection of GABA and demonstrating the existence of functional GABA transporters in rat PnO. Morphine caused a concentration-dependent decrease in PnO GABA levels (n=25 rats). Coadministration of morphine (100 microM) with naloxone (1 microM), a mu-opioid receptor antagonist, blocked the morphine-induced decrease in PnO GABA levels (n=5 rats). These results show for the first time that mu-opioid receptors in rat PnO modulate GABA levels. A second group of rats (n=6) was used to test the hypothesis that systemically administered morphine also decreases PnO GABA levels. I.v. morphine caused a significant (PPnO GABA levels relative to control i.v. infusions of saline. Finally, microinjections followed by 2 h recordings of electroencephalogram and electromyogram tested the hypothesis that PnO morphine administration disrupts sleep (n=8 rats). Morphine significantly (PPnO.

  4. Craniospinal irradiation with concurrent temozolomide for primary metastatic pediatric high-grade or diffuse intrinsic pontine gliomas. A first report from the GPOH-HIT-HGG Study Group

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, K.; Schlamann, A.; Pietschmann, S.; Kortmann, R.D. [University Medical Center Leipzig, Department of Radiation Oncology, Leipzig (Germany); Guckenberger, M. [University Medical Center Wuerzburg, Department of Radiation Oncology, Wuerzburg (Germany); Warmuth-Metz, M. [University Medical Center Wuerzburg, Department of Neuroradiology, Wuerzburg (Germany); Glueck, A. [Clinic for Radiation Oncology Schwabing, Muenchen (Germany); Wawer, A. [University Medical Center Muenchen Schwabing, Department of Pediatric Hematology and Oncology, Muenchen (Germany); Kramm, C.; Bueren, A.O. von [University Medical Center Goettingen, Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Goettingen (Germany)

    2014-04-15

    High-grade (HGG) and diffuse intrinsic pontine gliomas (DIPG) with primary metastatic spread are extremely rare and have a dismal prognosis. Analogous to simultaneous radiochemotherapy in non-metastatic HGG and DIPG, concurrent craniospinal irradiation (CSI) and metronomic temozolomide (metroTMZ) may represent a reasonable therapeutic approach. However, the antitumor efficacy and toxicity of this treatment still have to be investigated. Between March 2007 and December 2012, six children with primary metastatic HGG (n=4) or DIPG (n=2) received CSI and concurrent metroTMZ based on individual treatment recommendations and, in some cases, within the HIT-HGG 2007 multicenter trial. Outcome and treatment-related toxicities were evaluated. All patients received irradiation to the entire craniospinal axis (35.2 Gy, n=5; 36 Gy, n=1:) and 5 received a local boost to macroscopic tumor deposits. Simultaneously, metroTMZ (75 mg/m{sup 2}/day, n=5; 60 mg/m{sup 2}/day, n=1) was administered. Additionally, 1 patient received nimotuzumab once per week. Within a median follow-up of 10.0 months (range 6.5-18.7 months), all patients experienced disease progression and 5 patients died. Median progression-free survival was 4.0±0.8 months (range 2.4-10.7 months) and median overall survival was 7.6±3.5 months (range 4.0-17.6 months). Acute myelosuppression most severely limited application of this aggressive treatment strategy. Severe hematotoxicities (= grade 3) occurred in all patients and metroTMZ had to be interrupted or discontinued in 4 out of 6 cases. Concurrent CSI and metroTMZ might represent a feasible treatment approach for primary metastatic HGG and DIPG. On the basis of our experience, severe but manageable acute hematotoxicity has to be expected. An international effort is warranted to reassess the efficacy and toxicity of this approach within a prospective study. (orig.)

  5. Diffuse intrinsic pontine glioma treated with prolonged temozolomide and radiotherapy--results of a United Kingdom phase II trial (CNS 2007 04).

    Science.gov (United States)

    Bailey, S; Howman, A; Wheatley, K; Wherton, D; Boota, N; Pizer, B; Fisher, D; Kearns, P; Picton, S; Saran, F; Gibson, M; Glaser, A; Connolly, D J A; Hargrave, D

    2013-12-01

    Diffuse intrinsic pontine glioma (DIPG) has a dismal prognosis with no chemotherapy regimen so far resulting in any significant improvement over standard radiotherapy. In this trial, a prolonged regimen (21/28d) of temozolomide was studied with the aim of overcoming O(6)-methylguanine methyltransferase (MGMT) mediated resistance. Forty-three patients with a defined clinico-radiological diagnosis of DIPG received radiotherapy and concomitant temozolomide (75 mg/m(2)) after which up to 12 courses of 21d of adjuvant temozolomide (75-100mg/m(2)) were given 4 weekly. The trial used a 2-stage design and passed interim analysis. At diagnosis median age was 8 years (2-20 years), 81% had cranial nerve abnormalities, 76% ataxia and 57% long tract signs. Median Karnofsky/Lansky score was 80 (10-100). Patients received a median of three courses of adjuvant temozolomide, five received all 12 courses and seven did not start adjuvant treatment. Three patients were withdrawn from study treatment due to haematological toxicity and 10 had a dose reduction. No other significant toxicity related to temozolomide was noted. Overall survival (OS) (95% confidence interval (CI)) was 56% (40%, 69%) at 9 months, 35% (21%, 49%) at 1 year and 17% (7%, 30%) at 2 years. Median survival was 9.5 months (range 7.5-11.4 months). There were five 2-year survivors with a median age of 13.6 years at diagnosis. This trial demonstrated no survival benefit of the addition of dose dense temozolomide, to standard radiotherapy in children with classical DIPG. However, a subgroup of adolescent DIPG patients did have a prolonged survival, which needs further exploration.

  6. Environmental factors controlling the distribution of rhodoliths: An integrated study based on seafloor sampling, ROV and side scan sonar data, offshore the W-Pontine Archipelago

    Science.gov (United States)

    Sañé, E.; Chiocci, F. L.; Basso, D.; Martorelli, E.

    2016-10-01

    The effects of different environmental factors controlling the distribution of different morphologies, sizes and growth forms of rhodoliths in the western Pontine Archipelago have been studied. The analysis of 231 grab samples has been integrated with 68 remotely operated vehicle (ROV) videos (22 h) and a high resolution (sonar mosaic of the seafloor surrounding the Archipelago, covering an area of approximately 460 km2. Living rhodoliths were collected in approximately 10% of the grab samples and observed in approximately 30% of the ROV dives. The combination of sediment sampling, video surveys and acoustic facies mapping suggested that the presence of rhodoliths can be associated to the dishomogeneous high backscatter sonar facies and high backscatter facies. Both pralines and unattached branches were found to be the most abundant morphological groups (50% and 41% of samples, respectively), whereas boxwork rhodoliths were less common, accounting only for less than 10% of the total number of samples. Pralines and boxwork rhodoliths were almost equally distributed among large (28%), medium (36%) and small sizes (36%). Pralines generally presented a fruticose growth form (49% of pralines) even if pralines with encrusting-warty (36% of pralines) or lumpy (15% of pralines) growth forms were also present. Morphologies, sizes and growth forms vary mainly along the depth gradient. Large rhodoliths with a boxwork morphology are abundant at depth, whereas unattached branches and, in general, rhodoliths with a high protuberance degree are abundant in shallow waters. The exposure to storm waves and bottom currents related to geostrofic circulation could explain the absence of rhodoliths off the eastern side of the three islands forming the Archipelago.

  7. Dual Inhibition of PI3K/AKT and MEK/ERK Pathways Induces Synergistic Antitumor Effects in Diffuse Intrinsic Pontine Glioma Cells

    Directory of Open Access Journals (Sweden)

    Y. Linda Wu

    2017-04-01

    Full Text Available Diffuse intrinsic pontine glioma (DIPG is a devastating disease with an extremely poor prognosis. Recent studies have shown that platelet-derived growth factor receptor (PDGFR and its downstream effector pathway, PI3K/AKT/mTOR, are frequently amplified in DIPG, and potential therapies targeting this pathway have emerged. However, the addition of targeted single agents has not been found to improve clinical outcomes in DIPG, and targeting this pathway alone has produced insufficient clinical responses in multiple malignancies investigated, including lung, endometrial, and bladder cancers. Acquired resistance also seems inevitable. Activation of the Ras/Raf/MEK/ERK pathway, which shares many nodes of cross talk with the PI3K/AKT pathway, has been implicated in the development of resistance. In the present study, perifosine, a PI3K/AKT pathway inhibitor, and trametinib, a MEK inhibitor, were combined, and their therapeutic efficacy on DIPG cells was assessed. Growth delay assays were performed with each drug individually or in combination. Here, we show that dual inhibition of PI3K/AKT and MEK/ERK pathways synergistically reduced cell viability. We also reveal that trametinib induced AKT phosphorylation in DIPG cells that could not be effectively attenuated by the addition of perifosine, likely due to the activation of other compensatory mechanisms. The synergistic reduction in cell viability was through the pronounced induction of apoptosis, with some effect from cell cycle arrest. We conclude that the concurrent inhibition of the PI3K/AKT and MEK/ERK pathways may be a potential therapeutic strategy for DIPG.

  8. Synaptic interactions between perifornical lateral hypothalamic area, locus coeruleus nucleus and the oral pontine reticular nucleus are implicated in the stage succession during sleep-wakefulness cycle

    Directory of Open Access Journals (Sweden)

    Angel eNunez

    2013-11-01

    Full Text Available The perifornical area in the posterior lateral hypothalamus (PeFLH has been implicated in several physiological functions including the sleep-wakefulness regulation. The PeFLH area contains several cell types including those expressing orexins (Orx; also known as hypocretins, mainly located in the PeF nucleus. The aim of the present study was to elucidate the synaptic interactions between Orx neurons located in the PeFLH area and different brainstem neurons involved in the generation of wakefulness and sleep stages such as the locus coeruleus (LC nucleus (contributing to wakefulness and the oral pontine reticular nucleus (PnO nucleus (contributing to REM sleepAnatomical data demonstrated the existence of a neuronal network involving the PeFLH area, LC and the PnO nuclei that would control the sleep-wake cycle. Electrophysiological experiments indicated that PeFLH area had an excitatory effect on LC neurons. PeFLH stimulation increased the firing rate of LC neurons and induced an activation of the EEG. The excitatory effect evoked by PeFLH stimulation in LC neurons was blocked by the injection of the Orx-1 receptor antagonist SB-334867 into the LC. Similar electrical stimulation of the PeFLH area evoked an inhibition of PnO neurons by activation of GABAergic receptors because the effect was blocked by bicuculline application into the PnO. Our data also revealed that the LC and PnO nuclei exerted a feedback control on neuronal activity of PeFLH area. Electrical stimulation of LC facilitated firing activity of PeFLH neurons by activation of catecholaminergic receptors whereas PnO stimulation inhibited PeFLH neurons by activation of GABAergic receptors. In conclusion, Orx neurons of the PeFLH area seem to be an important organizer of the wakefulness and sleep stages in order to maintain a normal succession of stages during the sleep-wakefulness cycle.

  9. Silperisone: a centrally acting muscle relaxant.

    Science.gov (United States)

    Farkas, Sándor

    2006-01-01

    Silperisone is a tolperisone like organosilicon compound with centrally acting muscle relaxant properties. Studies in mice showed that silperisone may have less propensity to cause CNS depressant or motor side effects than tolperisone or other antispastic drugs. In cats and rats, silperisone was an effective suppressant of monosynaptic and polysynaptic spinal reflexes and decerebrate rigidity. Its suppressant effect on the spinal reflexes was also demonstrated in the isolated hemisected rat spinal cord in vitro. The in vivo potency and efficacy of silperisone by i.v administration were similar to those of tolperisone and eperisone. However, in cats by intraduodenal administration and in mice by oral administration its duration of action was much longer and its functional bioavailability much higher than of the other two drugs. With regard to its profile of actions silperisone was similar to tolperisone with minor differences. The most striking difference was in pontine facilitation and bulbar inhibition of the patellar reflex. Tolperisone depressed both, whereas silperisone inhibited only the former. The mechanism underlying the spinal reflex depressant effects of silperisone involves the blockade of voltage gated neuronal sodium and calcium channels leading to a decreased release of excitatory transmitter and reduced neuronal excitability. In addition, silperisone has potassium channel blocking effect, which is stronger than that of tolperisone. Silperisone is absorbed rapidly and is extensively metabolized in rats. However, its metabolism in dogs and particularly in humans is much less extensive. The elimination half-life of silperisone in humans is 12 to 16 h, so that it can be administered once or twice daily. Phase I clinical studies with silperisone at doses up to 150 mg/day failed to detect any adverse effects at plasma concentrations considered to be effective in the preclinical tests. These findings suggested that silperisone might be a useful antispastic

  10. Projections of medullary and pontine noradrenergic neurons to the horizontal limb of the nucleus of diagonal band in the rat.

    Science.gov (United States)

    Senatorov, V V; Renaud, L P

    1999-01-01

    Recent investigations in the rat have implicated a noradrenergic innervation to the horizontal nucleus of the diagonal band of Broca as a critical link in a neural circuit that conveys baroreceptor information centrally to inhibit the firing of vasopressin-secreting neurons in the hypothalamic supraoptic nucleus. In this study we used small intra-diagonal band injections of a retrograde tracer, rhodamine latex microspheres, in combination with tyrosine hydroxylase histochemistry to identify brainstem noradrenergic cells contributing to this innervation. In three cases where tracer injections were limited to the horizontal limb of the diagonal band, we observed 20-50 double-labelled neurons ipsilaterally in the dorsal part of the locus coeruleus (A6) and the caudal nucleus tractus solitarius (A2), and bilaterally in the caudal ventrolateral medulla (A1). Double-labelled neurons were also noted in the ventral tegmental area (dopaminergic A10 cell group). Although all major brainstem noradrenergic cell groups contribute fibers to the horizontal limb of the nucleus of diagonal band, data from physiological studies suggest that the noradrenergic A2 neurons in the nucleus tractus solitarius are the most likely pathway through which it receives this baroreceptor information.

  11. Central line infections - hospitals

    Science.gov (United States)

    ... infection; Central venous catheter - infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired ...

  12. Central Solenoid

    CERN Multimedia

    2002-01-01

    The Central Solenoid (CS) is a single layer coil wound internally in a supporting cylinder housed in the cryostat of the Liquid Argon Calorimeter. It was successfully tested at Toshiba in December 2000 and was delivered to CERN in September 2001 ready for integration in the LAr Calorimeter in 2003. An intermediate test of the chimney and proximity cryogenics was successfully performed in June 2002.

  13. Europa central

    Directory of Open Access Journals (Sweden)

    Karel BARTOSEK

    2010-02-01

    Full Text Available La investigación francesa continúa interesándose por Europa Central. Desde luego, hay límites a este interés en el ambiente general de mi nueva patria: en la ignorancia, producto del largo desinterés de Francia por este espacio después de la Segunda Guerra Mundial, y en el comportamiento y la reflexión de la clase política y de los medios de comunicación (una anécdota para ilustrar este ambiente: durante la preparación de nuestro coloquio «Refugiados e inmigrantes de Europa Central en el movimiento antifascista y la Resistencia en Francia, 1933-1945», celebrado en París en octubre de 1986, el problema de la definición fue planteado concreta y «prácticamente». ¡Y hubo entonces un historiador eminente, para quién Alemania no formaría parte de Europa Central!.

  14. Central pain.

    Science.gov (United States)

    Singh, Supreet

    2014-12-01

    Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. The topic addressed in this issue is central pain, a neuropathic pain syndrome caused by a lesion in the brain or spinal cord that sensitizes one's perception of pain. It is a debilitating condition caused by various diseases such as multiple sclerosis, strokes, spinal cord injuries, or brain tumors. Varied symptoms and the use of pharmacological medicines and nonpharmacological therapies will be addressed.

  15. central t

    Directory of Open Access Journals (Sweden)

    Manuel R. Piña Monarrez

    2007-01-01

    Full Text Available Dado que la Regresión Ridge (RR, es una estimación sesgada que parte de la solución de la regresión de Mínimos Cuadrados (MC, es vital establecer las condiciones para las que la distribución central t de Student que se utiliza en la prueba de hipótesis en MC, sea también aplicable a la regresión RR. La prueba de este importante resultado se presenta en este artículo.

  16. Role of basilar artery hypoplasia in patients with pontine penetrating artery infarction%基底动脉发育不全在脑桥穿支动脉梗死患者中的作用研究

    Institute of Scientific and Technical Information of China (English)

    张道培; 许予明; 张洪涛; 张淑玲

    2012-01-01

    目的 探讨基底动脉发育不全(BAH)与脑桥穿支动脉梗死的关系及其临床特点.方法 选择头颅MRI确诊的急性脑梗死患者328例,根据诊断分为BAH组27例和无BAH组301例.其中急性后循环穿支动脉梗死患者79例,通过头颅磁共振血管造影术评估基底动脉直径(BAH定义为直径<2 mm)、椎动脉V4段发育不全(V4AH)及胚胎大脑后动脉(FTP)情况.结果 BAH组后循环梗死、动脉发育不全(单侧V4AH、双侧V4AH、单侧FTP、双侧FTP、双侧V4AH和FTP)比例明显高于无BAH组(P<0.01).79例急性后循环穿支动脉梗死患者中,BAH 24例(30.4%),其中脑桥穿支动脉梗死15例(62.5%),后循环其他部位穿支动脉梗死9例(37.5%).在脑桥穿支动脉梗死患者中,合并BAH的比例明显高于未合并BAH的比例(62.5% vs 12.7%,P<0.01).结论 BAH与脑桥穿支动脉梗死的发生有密切关系,这些患者多合并V4AH和FTP.%Objective To study the relation between basilar artery hypoplasia(BAH) and pontine penetrating artery infarction and the clinical characteristics of BAH patients. Methods Three hundred and twenty-eight patients with acute cerebral infarction established by head MRI were divided into BAH group(n = 27) and non-BAH group(n = 301) according to their diagnosis. Basilar artery diameter (which was defined <2 mm according to BAH) , vertebral artery V4 hypoplasia (V4AH) and fetal type posterior(FTP) artery condition were assessed in 79 patients with acute posterior penetrating artery circulation ischemic stroke according to MRI. Results The proportions of posterior circulation ischemic stroke and the unilateral V4AH,bilateral V4AH,unilateral FTP,bilateral FTP, bilateral V4AH and FTP were significantly higher in BAH group than in non-BAH group(P<0. 01). Of the 79 patients with acute posterior circulation penetrating artery infarction,24(30. 4%)were diagnosed with BAH including 15(62. 5%) with pontine penetrating artery infarction and 9(37. 5

  17. 孤立性脑桥梗死形态学部位与急性期神经功能缺损进展的关系%Relationship between topographic location and neurological deterioration in acute isolated pontine infarction

    Institute of Scientific and Technical Information of China (English)

    黄如月; 张侠; 陈伟莉; 张顺开; 池丽芬; 林静; 黄双双

    2016-01-01

    Objective To discuss the relationship between topographic location and neurological deterioration (ND) in patients with acute isolated pontine infarction.Methods Two hundred and fifty-nine patients with acute isolated pontine infarction,collected in our hospital from January 2010 to August 2013 and identified by diffusion weighted imaging (DWI),were included for retrospective review.Patients were divided into two groups according to their clinical symptoms:patients with ND and patients without ND.According to neuroimaging of DWI,the topographic location of pontine infarction was divided into three types:the upper,middle and lower ones;and the correlations of ND with risk factors,laboratory examination results,clinical manifestations and different topographic locations were explored by statistical tests.Results Of 259 patients,27.4% (71) were diagnosed with ND;72.6% (188) were diagnosed without ND.Univariate analysis showed that there were no differences in laboratory test results,NIHSS scores and medications between the two groups (P>0.05);there were differences in female ratio (41 [57.7%] vs.82[43.6%]),smoking ratio (10[14.2%] vs.49[26.2%]),mean length of hospital stay ([22.72±7.01] d vs.[19.42±7.76] d),ratio of worse short-term clinical outcomes (56[78.87%] vs.64[34.04%]) and ratio of lower pontine infarction (31 [43.7%] vs.57[30.3%]) between the two groups (P<0.05).Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND (odds ratio=1.952,95% confidence interval=l.081-3.524,P=0.027).Conclusion Topographic location of lower pons lesions may be reliable predictor of ND in acute isolated pontine infarction.%目的 探讨孤立性脑桥梗死形态学部位与急性期神经功能缺损进展的关系. 方法 回顾性收集温州医科大学附属第三医院神经内科自2010年1月至2013年8月收治的经MRI证实的259例新发孤立性脑桥梗死患者的临床资料,按其临床是

  18. Movement disorders and the osmotic demyelination syndrome.

    Science.gov (United States)

    de Souza, Aaron

    2013-08-01

    With the advent of MRI, osmotic demyelination syndromes (ODS) are increasingly recognised to affect varied sites in the brain in addition to the classical central pontine lesion. Striatal involvement is seen in a large proportion of cases and results in a wide variety of movement disorders. Movement disorders and cognitive problems resulting from ODS affecting the basal ganglia may occur early in the course of the illness, or may present as delayed manifestations after the patient survives the acute phase. Such delayed symptoms may evolve over time, and may even progress despite treatment. Improved survival of patients in the last few decades due to better intensive care has led to an increase in the incidence of such delayed manifestations of ODS. While the outcome of ODS is not as dismal as hitherto believed - with the acute akinetic-rigid syndrome associated with striatal myelinolysis often responding to dopaminergic therapy - the delayed symptoms often prove refractory to medical therapy. This article presents a review of the epidemiology, pathophysiology, clinical features, imaging, and therapy of movement disorders associated with involvement of the basal ganglia in ODS. A comprehensive review of 54 previously published cases of movement disorders due to ODS, and a video recording depicting the spectrum of delayed movement disorders seen after recovery from ODS are also presented.

  19. Neurological complications in hyperemesis gravidarum.

    Science.gov (United States)

    Zara, Gabriella; Codemo, Valentina; Palmieri, Arianna; Schiff, Sami; Cagnin, Annachiara; Citton, Valentina; Manara, Renzo

    2012-02-01

    Hyperemesis gravidarum can impair correct absorption of an adequate amount of thiamine and can cause electrolyte imbalance. This study investigated the neurological complications in a pregnant woman with hyperemesis gravidarum. A 29-year-old pregnant woman was admitted for hyperemesis gravidarum. Besides undernutrition, a neurological examination disclosed weakness with hyporeflexia, ophthalmoparesis, multidirectional nystagmus and optic disks swelling; the patient became rapidly comatose. Brain MRI showed symmetric signal hyperintensity and swelling of periaqueductal area, hypothalamus and mammillary bodies, medial and posterior portions of the thalamus and columns of fornix, consistent with Wernicke encephalopathy (WE). Neurophysiological studies revealed an axonal sensory-motor polyneuropathy, likely due to thiamine deficiency or critical illness polyneuropathy. Sodium and potassium supplementation and parenteral thiamine were administered with improvement of consciousness state in a few days. WE evolved in Korsakoff syndrome. A repeat MRI showed a marked improvement of WE-related alterations and a new hyperintense lesion in the pons, suggestive of central pontine myelinolysis. No sign or symptom due to involvement of the pons was present.

  20. Central Cannabinoid Receptors Modulate Acquisition of Eyeblink Conditioning

    Science.gov (United States)

    Steinmetz, Adam B.; Freeman, John H.

    2010-01-01

    Delay eyeblink conditioning is established by paired presentations of a conditioned stimulus (CS) such as a tone or light, and an unconditioned stimulus (US) that elicits the blink reflex. Conditioned stimulus information is projected from the basilar pontine nuclei to the cerebellar interpositus nucleus and cortex. The cerebellar cortex,…

  1. Immunohistochemical distribution of Plexin A4 in the adult rat central nervous system

    Directory of Open Access Journals (Sweden)

    Claire-Anne Gutekunst

    2010-07-01

    Full Text Available PlexinA4 is the latest member to be identified of the plexin A subfamily, critical transducers of class 3 semaphorin signaling as co-receptors to neuropilins 1 and 2. Despite functional information regarding the role of PlexinA4 in development and guidance of specific neuronal pathways, little is known about its distribution in the adult central nervous system (CNS. Here we report an in depth immunohistochemical analysis of PlexinA4 expression in the adult rat CNS. PlexinA4 staining was present in neurons and fibers throughout the brain and spinal cord, including neocortex, hippocampus, lateral hypothalamus, red nucleus, facial nucleus and the mesencephalic trigeminal nucleus. PlexinA4 antibodies labeled fibers in the lateral septum, nucleus accumbens, several thalamic nuclei, substantia nigra pars reticulata, zona incerta, pontine reticular region, as well as in several cranial nerve nuclei. This constitutes the first detailed description of the topographic distribution of PlexinA4 in the adult CNS and will set the basis for future studies on the functional implications of PlexinA4 in adult brain physiology.

  2. Central bank Financial Independence

    OpenAIRE

    J.Ramon Martinez-Resano

    2004-01-01

    Central bank independence is a multifaceted institutional design. The financial component has been seldom analysed. This paper intends to set a comprehensive conceptual background for central bank financial independence. Quite often central banks are modelled as robot like maximizers of some goal. This perspective neglects the fact that central bank functions are inevitably deployed on its balance sheet and have effects on its income statement. A financially independent central bank exhibits ...

  3. NIDDK Central Repository

    Data.gov (United States)

    U.S. Department of Health & Human Services — The NIDDK Central Repository stores biosamples, genetic and other data collected in designated NIDDK-funded clinical studies. The purpose of the NIDDK Central...

  4. Central Neuropathic Pain Syndromes.

    Science.gov (United States)

    Watson, James C; Sandroni, Paola

    2016-03-01

    Chronic pain is common in patients with neurologic complications of a central nervous system insult such as stroke. The pain is most commonly musculoskeletal or related to obligatory overuse of neurologically unaffected limbs. However, neuropathic pain can result directly from the central nervous system injury. Impaired sensory discrimination can make it challenging to differentiate central neuropathic pain from other pain types or spasticity. Central neuropathic pain may also begin months to years after the injury, further obscuring recognition of its association with a past neurologic injury. This review focuses on unique clinical features that help distinguish central neuropathic pain. The most common clinical central pain syndromes-central poststroke pain, multiple sclerosis-related pain, and spinal cord injury-related pain-are reviewed in detail. Recent progress in understanding of the pathogenesis of central neuropathic pain is reviewed, and pharmacological, surgical, and neuromodulatory treatments of this notoriously difficult to treat pain syndrome are discussed.

  5. Central venous catheter - flushing

    Science.gov (United States)

    ... during cancer treatment Bone marrow transplant - discharge Central venous catheter - dressing change Peripherally inserted central catheter - flushing Sterile technique Surgical wound care - open Review Date 9/22/2016 Updated by: ...

  6. Magmatic (silicates/saline/sulfur-rich/CO2) immiscibility and zirconium and rare-earth element enrichment from alkaline magma chamber margins : Evidence from Ponza Island, Pontine Archipelago, Italy

    Science.gov (United States)

    Belkin, H.E.; de Vivo, B.; Lima, A.; Torok, K.

    1996-01-01

    Fluid inclusions were measured from a feldspathoid-bearing syenite xenolith entrained in trachyte from Ponza, one of the islands of the Pontine Archipelago, located in the Gulf of Gaeta, Italy. The feldspathoid-bearing syenite consists mainly of potassium feldspar, clinopyroxene, amphibole, biotite, titanite, manganoan magnetite, apatite with minor nosean, Na-rich feldspar, pyrrhotite, and rare cheralite. Baddeleyite and zirkelite occur associated with manganoan magnetite. Detailed electron-microprobe analysis reveals enrichments in REE, Y, Nb, U, Th as well as Cl and F in appropriate phases. Fluid inclusions observed in potassium feldspar are either silicate-melt or aqueous inclusions. The aqueous inclusions can be further classified as. (1) one-phase vapor, (2) two-phase (V + L) inclusions, vapor-rich inclusions with a small amount of CO2 in most cases; homogenization of the inclusions always occurred in the vapor phase between 359 and 424??C, salinities vary from 2.9 to 8.5 wt. % NaCl equivalent; and. (3) three-phase and multiphase inclusions (hypersaline/sulfur-rich aqueous inclusions sometimes with up to 8 or more solid phases). Daughter minerals dissolve on heating before vapor/liquid homogenization. Standardless quantitative scanning electron microscope X-ray fluorescence analysis has tentatively identified the following chloride and sulfate daughter crystals; halite, sylvite, glauberite. arcanite, anhydrite, and thenardite. Melting of the daughter crystals occurs between 459 and 536??C (54 to 65 wt. % NaCI equivalent) whereas total homogenization is between 640 and 755??C. The occurrence of silicate-melt inclusions and high-temperature, solute-rich aqueous inclusions suggests that the druse or miarolitic texture of the xenolith is late-stage magmatic. The xenolith from Ponza represents a portion of the peripheral magma chamber wall that has recorded the magmatic/hydrothermal transition and the passage of high solute fluids enriched in chlorides, sulfur, and

  7. 不同抗栓治疗对急性桥脑梗死患者预后影响%The effect on prognosis of acute pontine infarction patients treated with different antithrombotic therapies

    Institute of Scientific and Technical Information of China (English)

    吕燕华; 吴秀玲; 曹亦宾; 吕宪民; 庄严; 蒋立华; 王海英

    2013-01-01

    OBJECTIVE The purpose of the research was to explore the effect on prognosis of acute pontine infarction patients treated with different methods. METHODS It was a retrospective analysis of the pontine infarction patients treated consecutively in our department from October, 2008 to October, 2010. Patients were divided into two groups as heparin treatment group and antiplatelet treatment group. The scores of NIHSS, Mrs., and BI when firstly hospitalized were recorded, together with past medical history, potential causes of cerebral infarction, report of head CT and report of MRI. There were follow-up and scores after six months' treatment. All the data mentioned above were analyzed statistically. RESULTS The 2 groups were statistically similar in age, gender and past medical history, and causes of cerebral infarction. For the group treated with anticoagulation with heparin, the scores of NIHSS, mRS, BI before management were respectively 3.36 ± 3.26、 1.82 ± 1.04 and 75.45 ± 25.99; For the group treated with Antiplatelet, the scores were respectively 2.71 ± 3.09、 1.67 ± 1.02 and 81.28 ± 24.90, without statistical difference. After 6 months' treatment, the scores of NIHSS, mRS, BI for the anticoagulation with heparin group were 1.64 ± 2.32、 1.15 ± 0.83、 87.58 ± 16.58, while 1.69 ± 2.81、 0.94 ± 0.79 and 89.6 ± 18.20 for the Antiplatelet group. Compared with before, the scores of two groups both had a statistical difference. While there was no statistical difference between the scores of two groups after the treatments. CONCLUSION Both anticoagulation with heparin and antiplatelet have reliable curative effect on acute pontine infarction.%目的 探讨急性桥脑梗死患者不同治疗方法对预后的影响.方法 对2008年10月~2010年10月期间某科连续收治的急性桥脑梗死患者进行回顾性分析,根据治疗方法不同分为肝素抗凝治疗组和抗血小板治疗组,记录患者入院时NIHSS评分、mRS评分

  8. Central Laboratories Services

    Data.gov (United States)

    Federal Laboratory Consortium — The TVA Central Laboratories Services is a comprehensive technical support center, offering you a complete range of scientific, engineering, and technical services....

  9. Correlation of (18)F-FDG PET and MR Apparent Diffusion Coefficient (ADC) Histogram Metrics with Survival in Diffuse Intrinsic Pontine Glioma: A Report from the Pediatric Brain Tumor Consortium.

    Science.gov (United States)

    Zukotynski, Katherine; Vajapeyam, Sridhar; Fahey, Frederic H; Kocak, Mehmet; Brown, Douglas; Ricci, Kelsey; Onar-Thomas, Arzu; Fouladi, Maryam; Poussaint, Tina Young

    2017-03-30

    Rationale: To describe baseline (18)F-labeled 2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) voxel characteristics in pediatric diffuse intrinsic pontine glioma (DIPG) and to correlate these metrics with baseline magnetic resonance (MR) apparent diffusion coefficient (ADC) histogram metrics, progression-free survival (PFS) and overall survival (OS). Methods: Baseline brain FDG-PET and MR scans were obtained in 33 children from Pediatric Brain Tumor Consortium (PBTC) clinical DIPG trials. FDG-PET, post-gadolinium (PG) and ADC images were registered to baseline fluid attenuation inversion recovery (FLAIR) images. Three-dimensional regions of interest on FLAIR and PG images and FDG-PET and ADC histograms were generated. Metrics evaluated included peak number, skewness and kurtosis. Correlation between PET and ADC histogram metrics was evaluated. PET pixel values within the ROI for each tumor were plotted against ADC values. Association of these imaging markers with survival was described. Results: PET histograms were almost always unimodal (94% vs. 6% bimodal). None of the PET histogram parameters (skewness or kurtosis) had a significant association with PFS, although a higher PET PG skewness tended towards less favorable PFS (Hazard Ratio (95% CI)=3.48 (0.75, 16.28); P = 0.11). There was a significant association of higher ADC PG skewness with shorter PFS (Hazard Ratio (95% CI)=2.56 (1.11, 5.91); P = 0.028) and the suggestion that this also led to shorter OS (Hazard Ratio (95% CI)=2.18 (0.95, 5.04); P = 0.067). Higher ADC PG kurtosis tended towards shorter PFS (Hazard Ratio (95% CI)=1.30 (0.98, 1.74); P = 0.073). In a number of cases, PET and ADC pixel values were negatively correlated using the Pearson correlation coefficient. Further, the level of PET and ADC correlation was significantly positively associated with PFS; tumors with higher values of ADC-PET correlation had more favorable PFS (Hazard Ratio (95% CI)=0.17 (0.03, 0.89), P = 0

  10. Central Pain Syndrome

    Science.gov (United States)

    ... or hands. Central pain syndrome often begins shortly after the causative injury or damage, but may be delayed by months or even years, especially if it is related to post-stroke pain. × Definition Central pain syndrome is a neurological ...

  11. Central centrifugal cicatricial alopecia

    Directory of Open Access Journals (Sweden)

    Collin Blattner

    2013-01-01

    Full Text Available Central centrifugal cicatricial alopecia is a common cause of progressive permanent apical alopecia. This unique form of alopecia includes entities previously know as "hot comb alopecia," "follicular degeneration syndrome," "pseudopelade" in African Americans and "central elliptical pseudopelade" in Caucasians. The etiology appears to be multifactorial and the condition occurs in all races.

  12. Optimal central bank transparency

    NARCIS (Netherlands)

    van der Cruijsen, C.A.B.; Eijffinger, S.C.W.; Hoogduin, L.

    2008-01-01

    Should central banks increase their degree of transparency any further? We show that there is likely to be an optimal intermediate degree of central bank transparency. Up to this optimum more transparency is desirable: it improves the quality of private sector inflation forecasts. But beyond the opt

  13. Optimal central bank transparency

    NARCIS (Netherlands)

    van der Cruijsen, C.A.B.; Eijffinger, S.C.W.; Hoogduin, L.H.

    2010-01-01

    Should central banks increase their degree of transparency any further? We show that there is likely to be an optimal intermediate degree of central bank transparency. Up to this optimum more transparency is desirable: it improves the quality of private sector inflation forecasts. But beyond the opt

  14. The central peak revisited

    Energy Technology Data Exchange (ETDEWEB)

    Shirane, G.

    1995-10-27

    The central peak in SrTiO{sub 3} was first observed by Riste and his collaborators in 1971. This was one of the key discoveries leading to an understanding of the dynamics of phase transitions. The most recent discovery of two length scales in SrTiO{sub 3} motivated a reinvestigation of the soft phonon and associated central peak by neutron scattering. These recent experiments shed new light on the nature of the central peak. It is now well established to be strongly sample dependent and it originates from defects in bulk crystals.

  15. Imaging central pain syndromes.

    Science.gov (United States)

    Veldhuijzen, Dieuwke S; Greenspan, Joel D; Kim, Jong H; Coghill, Robert C; Treede, Rolf-Detlef; Ohara, Shinji; Lenz, Frederick A

    2007-06-01

    Anatomic, functional, and neurochemical imaging studies have provided new investigative tools in the study of central pain. High-resolution imaging studies allow for precise determination of lesion location, whereas functional neuroimaging studies measure pathophysiologic consequences of injury to the central nervous system. Additionally, magnetic resonance spectroscopy evaluates lesion-induced neurochemical changes in specific brain regions that may be related to central pain. The small number of studies to date precludes definitive conclusions, but the recent findings provide information that either supports or refutes current hypotheses and can serve to generate new ideas.

  16. Central nervous system resuscitation

    DEFF Research Database (Denmark)

    McIntosh, T K; Garde, E; Saatman, K E;

    1997-01-01

    Traumatic injury to the central nervous system induces delayed neuronal death, which may be mediated by acute and chronic neurochemical changes. Experimental identification of these injury mechanisms and elucidation of the neurochemical cascade following trauma may provide enhanced opportunities ...

  17. Central Asian Republic Info

    Data.gov (United States)

    US Agency for International Development — CAR Info is designed and managed by the Central Asian Republic Mission to fill in the knowledge and reporting gaps in existing agency systems for that Mission. It...

  18. Central nervous system

    Science.gov (United States)

    The central nervous system is composed of the brain and spinal cord. Your brain and spinal cord serve as the main "processing center" for your entire nervous system. They control all the workings of your body.

  19. Central nervous system resuscitation

    DEFF Research Database (Denmark)

    McIntosh, T K; Garde, E; Saatman, K E

    1997-01-01

    Traumatic injury to the central nervous system induces delayed neuronal death, which may be mediated by acute and chronic neurochemical changes. Experimental identification of these injury mechanisms and elucidation of the neurochemical cascade following trauma may provide enhanced opportunities...

  20. "Central Station" Londonis

    Index Scriptorium Estoniae

    2000-01-01

    Londoni galeriis Milch seitsme läti, leedu ja eesti kunstniku projekt "Central Station". Kuraatorid Lisa Panting, Sally Tallant. Eestist osalevad Hanno Soans (Catarina Campinoga koostöös valminud video), Kiwa, Kai Kaljo

  1. Central Station Design Options

    DEFF Research Database (Denmark)

    2011-01-01

    The purpose of EDISON Work Package 4.1 is the evaluation of possible Central (charging) Stations design options for making possible the public charging of Electric Vehicles (EVs). A number of scenarios for EVs are assessed, with special emphasis on the options of Fast Charging and Battery Swapping....... The work identifies the architecture, sizing and siting of prospective Central Stations in Denmark, which can be located at shopping centers, large car parking lots or gas stations. Central Stations are planned to be integrated in the Danish distribution grid. The Danish island of Bornholm, where a high.......g. due to vandalism, the charge supply circuit is disconnected. More electrical vehicles on the market are capable today of quick charging up to 50 kW power level. The feasibility of Central Stations with fast charging/swapping option, their capacity, design, costs and grid impact, as well as battery...

  2. Gangs in Central America

    Science.gov (United States)

    2008-10-17

    Citizen Security held in July 2008 indicated that Guatemala now has the second highest murder rate in Central America (roughly 45 per 100,000 people...training regional security forces.48 In recent years, the U.S. Southern Command has taken a leading role in discussing the problem of citizen security in...the results CRS-19 51 “Memo: The Merida Initiative and Citizen Security in Mexico and Central America,” Washington Office on Latin America, March 2008

  3. Outsourcing central banking

    DEFF Research Database (Denmark)

    Khoury, Sarkis Joseph; Wihlborg, Clas

    2005-01-01

    The literature on Currency Boards (CB) stops at the water edge in terms of dealing with the totality of the functions of a central bank. Monetary policy, and banking supervisioncan be "outsourced" in an open economy with substantial foreign direct investment (FDI)in the banking sector if political...... the feasibility of, and constraints on, outsourcing of central bank functions. A brief discussion of the Argentinian experience is used for contrast.Key words: Currency Board, Foreign Banks, Supervision, Regional Integration,outsourcing....

  4. Slow breathing and hypoxic challenge: cardiorespiratory consequences and their central neural substrates.

    Science.gov (United States)

    Critchley, Hugo D; Nicotra, Alessia; Chiesa, Patrizia A; Nagai, Yoko; Gray, Marcus A; Minati, Ludovico; Bernardi, Luciano

    2015-01-01

    Controlled slow breathing (at 6/min, a rate frequently adopted during yoga practice) can benefit cardiovascular function, including responses to hypoxia. We tested the neural substrates of cardiorespiratory control in humans during volitional controlled breathing and hypoxic challenge using functional magnetic resonance imaging (fMRI). Twenty healthy volunteers were scanned during paced (slow and normal rate) breathing and during spontaneous breathing of normoxic and hypoxic (13% inspired O2) air. Cardiovascular and respiratory measures were acquired concurrently, including beat-to-beat blood pressure from a subset of participants (N = 7). Slow breathing was associated with increased tidal ventilatory volume. Induced hypoxia raised heart rate and suppressed heart rate variability. Within the brain, slow breathing activated dorsal pons, periaqueductal grey matter, cerebellum, hypothalamus, thalamus and lateral and anterior insular cortices. Blocks of hypoxia activated mid pons, bilateral amygdalae, anterior insular and occipitotemporal cortices. Interaction between slow breathing and hypoxia was expressed in ventral striatal and frontal polar activity. Across conditions, within brainstem, dorsal medullary and pontine activity correlated with tidal volume and inversely with heart rate. Activity in rostroventral medulla correlated with beat-to-beat blood pressure and heart rate variability. Widespread insula and striatal activity tracked decreases in heart rate, while subregions of insular cortex correlated with momentary increases in tidal volume. Our findings define slow breathing effects on central and cardiovascular responses to hypoxic challenge. They highlight the recruitment of discrete brainstem nuclei to cardiorespiratory control, and the engagement of corticostriatal circuitry in support of physiological responses that accompany breathing regulation during hypoxic challenge.

  5. Malformação da transição crânio-vertebral como causa de síndrome do ângulo ponto-cerebelar: relato de dois casos Cerebello-pontine angle syndrome associated with cranio-vertebral malformation: report of two cases

    Directory of Open Access Journals (Sweden)

    Amauri Batista da Silva

    1972-03-01

    Full Text Available Os autores relatam dois casos de síndrome do ângulo ponto-cerebelar nos quais não havia neoplasia nessa região. Ambos os pacientes apresentavam uma associação de impressão basilar com síndrome de Arnold-Chiari. Após cirurgia descompressiva de fossa posterior os casos evoluiram favoravelmente com a diminuição progressiva dos sintomas neurológicos, restando apenas, no segundo paciente, certo grau de paralisia e de espasmo facial, à direita. São feitas considerações em tôrno das causas mais freqüentes da síndrome do ângulo ponto-cerebelar, bem como acêrca dos quadros clínicos mais usualmente encontrados em doentes que apresentam malformações da transição crânio-vertebral. Finalmente, os autores tecem breves considerações a respeito do possível mecanismo lesionai do VIII, do V e do VII nervos cranianos nos dois casos relatados.Two cases of cerebelo-pontine angle syndrome associated with basilar impression and Arnold-Chiari malformation are reported. In both cases neuroradiological studies and surgical exploration failled to demonstrate any space occupying lesion. After surgery the patients progressively recovered disapearing the neurological symptoms except for a slaight hemifacial spasm that remained in case 2. Clinical signs present in cerebello-pontine angle lesions and the occipito-cervical malformations are discussed. A possible mechanism to explain the association of both conditions is discussed.

  6. CENTRAL PLATEAU REMEDIATION

    Energy Technology Data Exchange (ETDEWEB)

    ROMINE, L.D.

    2006-02-01

    A systematic approach to closure planning is being implemented at the Hanford Site's Central Plateau to help achieve the goal of closure by the year 2035. The overall objective of Central Plateau remediation is to protect human health and the environment from the significant quantity of contaminated material that resulted from decades of plutonium production in support of the nation's defense. This goal will be achieved either by removing contaminants or placing the residual contaminated materials in a secure configuration that minimizes further migration to the groundwater and reduces the potential for inadvertent intrusion into contaminated sites. The approach to Central Plateau cleanup used three key concepts--closure zones, closure elements, and closure process steps--to create an organized picture of actions required to complete remediation. These actions were merged with logic ties, constraints, and required resources to produce an integrated time-phased schedule and cost profile for Central Plateau closure. Programmatic risks associated with implementation of Central Plateau closure were identified and analyzed. Actions to mitigate the most significant risks are underway while high priority remediation projects continue to make progress.

  7. The Naive Central Banker

    Directory of Open Access Journals (Sweden)

    Marcelo de Carvalho Griebeler

    2015-09-01

    Full Text Available There has been in some countries a trend of assigning other functions to central banks besides price stability. The most suggested function to be added to monetary authority’s obligations is to pursue economic growth or full employment. In this paper we characterize the behavior and analyse the optimal monetary policy of, what we call, a naive central banker. We describe the naive behavior as one that does face the inflation-unemployment trade-off, but it tries to minimize both variables simultaneously. Our findings, both under discretion and commitment, indicate that the naive central banker delivers lower expected inflation and inflation variance than the benchmark behavior whenever the economy is rigid enough. However, the degree of conservativeness also affects this result, such that the less conservative the naive policymaker, the more rigidity is necessary.

  8. SOCRATES Invades Central Europe

    Directory of Open Access Journals (Sweden)

    Joseph Slowinski

    1998-04-01

    Full Text Available The objective of this article is to explore the current reality faced by higher education students in Central and Eastern Europe and to draw out the implications of this current reality for policy makers in the future. In the article, I explore the influence of transnational corporations' training programs on education as it currently pertains to Central and Eastern European higher education and employment. In addition, multinational corporate entities exercise influence on European Union policy through the role of lobby organizations and activities. I explore the influence of these practices on education with an emphasis on the emerging importance of Western language skills. In addition, I focus on the European Union and its efforts to expand into Central and Eastern Europe in order to provide a focal point for analysis.

  9. Long-term complete remission in a patient with intravascular large B-cell lymphoma with central nervous system involvement

    Directory of Open Access Journals (Sweden)

    Sawada T

    2014-11-01

    Full Text Available Takeshi Sawada,1 Yasushi Omuro,1 Takeshi Kobayashi,2 Tunekazu Hishima,3 Fumiaki Koizumi,4 Yusuke Kanemasa,1 Tatsu Shimoyama,1 Eisaku Sasaki,1 Yoshiharu Maeda1 1Department of Chemotherapy, 2Department of Hematology, 3Department of Pathology, 4Department of Laboratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-ku, Tokyo, Japan Abstract: This report describes a patient with intravascular large B-cell lymphoma (IVLBCL with central nervous system involvement at the time of diagnosis who achieved complete remission for over 5 years in response to therapy. The patient, a 71 year-old woman, was previously healthy with the exception of taking verapamil for paroxysmal supraventricular tachycardia. She had presented with pyrexia and gradually progressive anemia. Brain magnetic resonance imaging revealed an infarct-like lesion in the pons, although no paralysis was observed. She was diagnosed with IVLBCL on the basis of random skin biopsy. After eight cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone therapy, abnormal laboratory data had normalized, and no pontine lesion was evident on magnetic resonance imaging without receiving any intrathecal chemotherapy. IVLBCL is associated with poor prognosis, particularly in patients with central nervous system involvement. Early initiation of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone therapy and drug interactions between anticancer agents and verapamil as a p-glycoprotein inhibitor were considered the possible reasons for favorable outcome in the present case. Keywords: intravascular large B-cell lymphoma, random skin biopsy, CNS involvement, rituximab, verapamil, blood–brain barrier

  10. Central Bank independence

    Directory of Open Access Journals (Sweden)

    Vasile DEDU

    2012-08-01

    Full Text Available In this paper we present the key aspects regarding central bank’s independence. Most economists consider that the factor which positively influences the efficiency of monetary policy measures is the high independence of the central bank. We determined that the National Bank of Romania (NBR has a high degree of independence. NBR has both goal and instrument independence. We also consider that the hike of NBR’s independence played an important role in the significant disinflation process, as headline inflation dropped inside the targeted band of 3% ± 1 percentage point recently.

  11. Several Centuries of Centrality

    OpenAIRE

    Roth, Dana L.

    2015-01-01

    As Carolyn Bertozzi mentioned in her inaugural editorial, the relationship of “Central Science” to “Chemistry” became popularized over 40 years ago with the publication of the first edition of Brown and LeMay’s Chemistry: The Central Science, now in its 13th edition. Yet as late as 2003, Prof. Sason Shaik at The Hebrew University claimed “popularization of chemistry remains scant.” He goes on to share [his] “own experience of popularizing chemistry by delivering the following universal messag...

  12. Glueballs A central mystery

    CERN Document Server

    Close, Francis Edwin

    2000-01-01

    Glueball candidates and qqbar mesons have been found to be produced with different momentum and angular dependences in the central region of pp collisions. This talk illustrates this phenomenon and explains the phi and t dependences of mesons with JPC = 0++,0-+, 1++, 2++ and 2-+. For production of 0++ and 2++ mesons the analysis reveals a systematic behaviour in the data that appears to distinguish between qqbar and non-qqbar or glueball candidates. An explanation is given for the absence of 0-+ glueball candidates in central production at present energies and the opportunity for their discovery at RHIC is noted.

  13. Glycinergic Pathways of the Central Auditory System and Adjacent Reticular Formation of the Rat.

    Science.gov (United States)

    Hunter, Chyren

    The development of techniques to visualize and identify specific transmitters of neuronal circuits has stimulated work on the characterization of pathways in the rat central nervous system that utilize the inhibitory amino acid glycine as its neurotransmitter. Glycine is a major inhibitory transmitter in the spinal cord and brainstem of vertebrates where it satisfies the major criteria for neurotransmitter action. Some of these characteristics are: uneven distribution in brain, high affinity reuptake mechanisms, inhibitory neurophysiological actions on certain neuronal populations, uneven receptor distribution and the specific antagonism of its actions by the convulsant alkaloid strychnine. Behaviorally, antagonism of glycinergic neurotransmission in the medullary reticular formation is linked to the development of myoclonus and seizures which may be initiated by auditory as well as other stimuli. In the present study, decreases in the concentration of glycine as well as the density of glycine receptors in the medulla with aging were found and may be responsible for the lowered threshold for strychnine seizures observed in older rats. Neuroanatomical pathways in the central auditory system and medullary and pontine reticular formation (RF) were investigated using retrograde transport of tritiated glycine to identify glycinergic pathways; immunohistochemical techniques were used to corroborate the location of glycine neurons. Within the central auditory system, retrograde transport studies using tritiated glycine demonstrated an ipsilateral glycinergic pathway linking nuclei of the ascending auditory system. This pathway has its cell bodies in the medial nucleus of the trapezoid body (MNTB) and projects to the ventrocaudal division of the ventral nucleus of the lateral lemniscus (VLL). Collaterals of this glycinergic projection terminate in the ipsilateral lateral superior olive (LSO). Other glycinergic pathways found were afferent to the VLL and have their origin

  14. Retiring the central executive.

    Science.gov (United States)

    Logie, Robert H

    2016-10-01

    Reasoning, problem solving, comprehension, learning and retrieval, inhibition, switching, updating, or multitasking are often referred to as higher cognition, thought to require control processes or the use of a central executive. However, the concept of an executive controller begs the question of what is controlling the controller and so on, leading to an infinite hierarchy of executives or "homunculi". In what is now a QJEP citation classic, Baddeley [Baddeley, A. D. (1996). Exploring the central executive. Quarterly Journal of Experimental Psychology, 49A, 5-28] referred to the concept of a central executive in cognition as a "conceptual ragbag" that acted as a placeholder umbrella term for aspects of cognition that are complex, were poorly understood at the time, and most likely involve several different cognitive functions working in concert. He suggested that with systematic empirical research, advances in understanding might progress sufficiently to allow the executive concept to be "sacked". This article offers an overview of the 1996 article and of some subsequent systematic research and argues that after two decades of research, there is sufficient advance in understanding to suggest that executive control might arise from the interaction among multiple different functions in cognition that use different, but overlapping, brain networks. The article concludes that the central executive concept might now be offered a dignified retirement.

  15. Central Nervous System Tuberculosis

    OpenAIRE

    Bano, Shahina; Chaudhary, Vikas; Yadav, Sachchidanand

    2012-01-01

    Central nervous system tuberculosis is a rare presentation of active tuberculosis and accounts for about 1% of cases (1). The three clinical categories include meningitis, intracranial tuberculomas, and spinal tuberculous arachnoiditis. We report a case of a young man who presented with active pulmonary tuberculosis in addition to tuberculous meningitis and the presence of numerous intracranial tuberculomas.

  16. Central venous line - infants

    Science.gov (United States)

    A central venous line (CVL) is a long, soft, plastic tube that is put into a large vein in the chest. WHY IS A CVL USED? A CVL is often put in when a baby cannot get a ... (MCC). A CVL can be used to give nutrients or medicines to a ...

  17. CMS Central Hadron Calorimeter

    OpenAIRE

    Budd, Howard S.

    2001-01-01

    We present a description of the CMS central hadron calorimeter. We describe the production of the 1996 CMS hadron testbeam module. We show the results of the quality control tests of the testbeam module. We present some results of the 1995 CMS hadron testbeam.

  18. Ecodesign in Central America

    NARCIS (Netherlands)

    Crul, M.R.M.

    2003-01-01

    This PhD thesis describes and analyses the change process started by the Ecodesign project in Central America, executed between 1998 and 2002. The project started using the concept and praxis developed in Europe. Nine ecodesign projects were performed in industry, and ecodesign was introduced to cou

  19. Central nervous system tuberculosis.

    Science.gov (United States)

    Torres, Carlos; Riascos, Roy; Figueroa, Ramon; Gupta, Rakesh K

    2014-06-01

    Tuberculosis (TB) has shown a resurgence in nonendemic populations in recent years and accounts for 8 million deaths annually in the world. Central nervous system involvement is one of the most serious forms of this infection, acting as a prominent cause of morbidity and mortality in developing countries. The rising number of cases in developed countries is mostly attributed to factors such as the pandemic of acquired immunodeficiency syndrome and increased migration in a globalized world. Mycobacterium TB is responsible for almost all cases of tubercular infection in the central nervous system. It can manifest in a variety of forms as tuberculous meningitis, tuberculoma, and tubercular abscess. Spinal infection may result in spondylitis, arachnoiditis, and/or focal intramedullary tuberculomas. Timely diagnosis of central nervous system TB is paramount for the early institution of appropriate therapy, because delayed treatment is associated with severe morbidity and mortality. It is therefore important that physicians and radiologists understand the characteristic patterns, distribution, and imaging manifestations of TB in the central nervous system. Magnetic resonance imaging is considered the imaging modality of choice for the study of patients with suspected TB. Advanced imaging techniques including magnetic resonance perfusion and diffusion tensor imaging may be of value in the objective assessment of therapy and to guide the physician in the modulation of therapy in these patients.

  20. Central Dogma Goes Digital.

    Science.gov (United States)

    Lin, Yihan; Elowitz, Michael B

    2016-03-17

    In this issue of Molecular Cell, Tay and colleagues (Albayrak et al., 2016) describe a new technique to digitally quantify the numbers of protein and mRNA in the same mammalian cell, providing a new way to look at the central dogma of molecular biology.

  1. Multicultural Central Asia.

    Science.gov (United States)

    Boyle, Eric D.

    This article addresses the multicultural aspect of Central Asia in response to the discussion on diversity in U.S. classrooms. Many areas of the world are more diverse than the U.S., and these areas experience successes and failures with many of the same issues the U.S. is currently struggling with. Comparing the U.S. diversity debate with similar…

  2. Channeling the Central Dogma.

    Science.gov (United States)

    Calabrese, Ronald L

    2014-05-21

    How do neurons and networks achieve their characteristic electrical activity, regulate this activity homeostatically, and yet show population variability in expression? In this issue of Neuron, O'Leary et al. (2014) address some of these thorny questions in this theoretical analysis that starts with the Central Dogma.

  3. Company activities - central region

    Energy Technology Data Exchange (ETDEWEB)

    Ayling, G.

    2007-06-15

    The first section of the article gives an overview of exploration and new developments in the field of gold, nickel, diamond and opal mining in central Queensland. The second part looks at coal, coal seam gas and petroleum exploration and development projects in the area. 1 fig.

  4. Testing for central symmetry

    NARCIS (Netherlands)

    Einmahl, John; Gan, Zhuojiong

    2016-01-01

    Omnibus tests for central symmetry of a bivariate probability distribution are proposed. The test statistics compare empirical measures of opposite regions. Under rather weak conditions, we establish the asymptotic distribution of the test statistics under the null hypothesis; it follows that they a

  5. Central areolar choroidal dystrophy.

    NARCIS (Netherlands)

    Boon, C.J.F.; Klevering, B.J.; Cremers, F.P.M.; Zonneveld-Vrieling, M.N.; Theelen, T.; Hollander, A.I. den; Hoyng, C.B.

    2009-01-01

    OBJECTIVE: To describe the clinical characteristics, follow-up data and molecular genetic background in a large group of patients with central areolar choroidal dystrophy (CACD). DESIGN: Retrospective case series study. PARTICIPANTS: One hundred three patients with CACD from the Netherlands. METHODS

  6. Induced, endogenous and exogenous centrality

    OpenAIRE

    Everett, Martin G.; Stephen P. Borgatti

    2010-01-01

    Centrality measures are based upon the structural position an actor has within the network. Induced centrality, sometimes called vitality measures, take graph invariants as an overall measure and derive vertex level measures by deleting individual nodes or edges and examining the overall change. By taking the sum of standard centrality measures as the graph invariant we can obtain measures which examine how much centrality an individual node contributes to the centrality of the other nodes in...

  7. Do Central Banks Need Capital?

    OpenAIRE

    Peter Stella

    1997-01-01

    Central banks may operate perfectly well without capital as conventionally defined. A large negative net worth, however, is likely to compromise central bank independence and interfere with its ability to attain policy objectives. If society values an independent central bank capable of effectively implementing monetary policy, recapitalization may become essential. Proper accounting practice in determining central bank profit or loss and rules governing the transfer of the central bank’s ope...

  8. Central simple Poisson algebras

    Institute of Scientific and Technical Information of China (English)

    SU Yucai; XU Xiaoping

    2004-01-01

    Poisson algebras are fundamental algebraic structures in physics and symplectic geometry. However, the structure theory of Poisson algebras has not been well developed. In this paper, we determine the structure of the central simple Poisson algebras related to locally finite derivations, over an algebraically closed field of characteristic zero.The Lie algebra structures of these Poisson algebras are in general not finitely-graded.

  9. Central corneal abscess.

    Science.gov (United States)

    van Bijsterveld, O P

    1976-05-01

    Central corneal abscess developed in the experimental animal after inoculation of biologically active staphylococcal strains in a paracentral epithelial lesion of the cornea. These abscesses did not ulcerate, developed only with high inocula, occurred more frequently in immunized rabbits. A serpiginous type of ulceration did not develop at the site of the initial epithelial lesion nor at any other place in the cornea. Histologically, the lesions consisted of densely packed polymorphonuclear leukocytes between the corneal lamellae.

  10. FNAL central email systems

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Jack; Lilianstrom, Al; Pasetes, Ray; Hill, Kevin; /Fermilab

    2004-10-01

    The FNAL Email System is the primary point of entry for email destined for an employee or user at Fermilab. This centrally supported system is designed for reliability and availability. It uses multiple layers of protection to help ensure that: (1) SPAM messages are tagged properly; (2) All mail is inspected for viruses; and (3) Valid mail gets delivered. This system employs numerous redundant subsystems to accomplish these tasks.

  11. Centrality Measures in Networks

    CERN Document Server

    Bloch, Francis; Tebaldi, Pietro

    2016-01-01

    We show that although the prominent centrality measures in network analysis make use of different information about nodes' positions, they all process that information in an identical way: they all spring from a common family that are characterized by the same simple axioms. In particular, they are all based on a monotonic and additively separable treatment of a statistic that captures a node's position in the network.

  12. Distributed Assessment of Network Centrality

    CERN Document Server

    Wehmuth, Klaus

    2011-01-01

    We propose a method for the Distributed Assessment of Network CEntrality (DANCE) in complex networks. DANCE attributes to each node a volume-based centrality computed using only localized information, thus not requiring knowledge of the full network topology. We show DANCE is simple, yet efficient, in assessing node centrality in a distributed way. Our proposal also provides a way for locating the most central nodes, again using only the localized information at each node. We also show that the node rankings based on DANCE's centrality and the traditional closeness centrality correlate very well. This is quite useful given the vast potential applicability of closeness centrality, which is however limited by its high computational costs. We experimentally evaluate DANCE against a state-of-the-art proposal to distributively assess network centrality. Results attest that DANCE achieves similar effectiveness in assessing network centrality, but with a significant reduction in the associated costs for practical ap...

  13. Central core disease

    Directory of Open Access Journals (Sweden)

    Jungbluth Heinz

    2007-05-01

    Full Text Available Abstract Central core disease (CCD is an inherited neuromuscular disorder characterised by central cores on muscle biopsy and clinical features of a congenital myopathy. Prevalence is unknown but the condition is probably more common than other congenital myopathies. CCD typically presents in infancy with hypotonia and motor developmental delay and is characterized by predominantly proximal weakness pronounced in the hip girdle; orthopaedic complications are common and malignant hyperthermia susceptibility (MHS is a frequent complication. CCD and MHS are allelic conditions both due to (predominantly dominant mutations in the skeletal muscle ryanodine receptor (RYR1 gene, encoding the principal skeletal muscle sarcoplasmic reticulum calcium release channel (RyR1. Altered excitability and/or changes in calcium homeostasis within muscle cells due to mutation-induced conformational changes of the RyR protein are considered the main pathogenetic mechanism(s. The diagnosis of CCD is based on the presence of suggestive clinical features and central cores on muscle biopsy; muscle MRI may show a characteristic pattern of selective muscle involvement and aid the diagnosis in cases with equivocal histopathological findings. Mutational analysis of the RYR1 gene may provide genetic confirmation of the diagnosis. Management is mainly supportive and has to anticipate susceptibility to potentially life-threatening reactions to general anaesthesia. Further evaluation of the underlying molecular mechanisms may provide the basis for future rational pharmacological treatment. In the majority of patients, weakness is static or only slowly progressive, with a favourable long-term outcome.

  14. West and Central Africa.

    Science.gov (United States)

    Lydie, N; Robinson, N J

    1998-01-01

    This article reviews scientific and other literature during the 1990s that links migration and mobility with the spread of sexually transmitted diseases (STDs), including HIV/AIDS. The focus is on key population groups linked to the spread of HIV and STDs in West and Central Africa: migrant laborers, truck drivers, itinerant traders, commercial sex workers (CSWs), and refugees. Countries with high emigration and immigration tend to have high levels of HIV infection, with the exception of Senegal. The main destination of immigrants are Senegal, Nigeria, and Cote d'Ivoire in West Africa and Cameroon, Congo, Gabon, and Congo in Central Africa. The risk of infection and the spread of HIV is variable among migrants. There is little in the literature that substantiates hypotheses about the strong association between migration and HIV-positive status. Information is needed on the duration, frequency of return visits, living conditions, sexual activities with multiple partners, and information before departure, along the routes, at final destination, and at the time of returns. Action-based research in five West African countries (Burkina Faso, Cote d'Ivoire, Mali, Niger, and Senegal) should produce results in late 1998. Comparable studies in Central Africa are unknown. Regional studies should be complemented by local studies. Prevention would benefit from studies on the relative size of these five population groups by geographic location.

  15. Central African Republic.

    Science.gov (United States)

    1986-02-01

    Focus in this discussion of the Central African Republic is on: geography; the people; history and political conditions; government; the economy; foreign relations; and relations with the US. The population of the Central African Republic totaled 2.7 million in 1985 with an annual growth rate of 2.8%. The infant mortality rate is 134/1000 with life expectancy at 49 years. The Central African Republic is at almost the precise center of Africa, about 640 km from the nearest ocean. More than 70% of the population live in rural areas. There are more than 80 ethnic groups, each with its own language. The precolonial history of the area was marked by successive waves of migration, of which little is known. These migrations are responsible for the complex ethnic and linguistic patterns today. United with Chad in 1906, it formed the Oubangui-Chari-Chad colony. In 1910, it became 1 of the 4 territories of the Federation of French Equatorial Africa, along with Chad, Congo, and Gabon. After World War II, the French Constitution of 1946 inaugurated the first of a series of reforms that led eventually to complete independence for all French territories in western and equatorial Africa. The nation became an autonomous republic within the newly established French Community on December 1, 1958, and acceded to complete independence as the Central Africa Republic on August 13, 1960. The government is made up of the executive and the judicial branches. The constitution and legislature remain suspended. All executive and legislative powers, as well as judicial oversight, are vested in the chief of state. The Central African Republic is 1 of the world's least developed countries, with an annual per capita income of $310. 85% of the population is engaged in subsistence farming. Diamonds account for nearly 1/3 of export earnings; the industrial sector is limited. The US terminated bilateral assistance programs in 1979, due to the human rights violations of the Bokassa regime, but modest

  16. Management of disease-modifying treatments in neurological autoimmune diseases of the central nervous system

    Science.gov (United States)

    Salmen, A; Gold, R; Chan, A

    2014-01-01

    sclerosis. Clinical and Experimental Immunology 2014, 175: 373–84. CLIPPERS: chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. Review of an increasingly recognized entity within the spectrum of inflammatory central nervous system disorders. Clinical and Experimental Immunology 2014, 175: 385–96. Requirement for safety monitoring for approved multiple sclerosis therapies: an overview. Clinical and Experimental Immunology 2014, 175: 397–407. Myasthenia gravis: an update for the clinician. Clinical and Experimental Immunology 2014, 175: 408–18. Cerebral vasculitis in adults: what are the steps in order to establish the diagnosis? Red flags and pitfalls. Clinical and Experimental Immunology 2014, 175: 419–24. Multiple sclerosis treatment and infectious issues: update 2013. Clinical and Experimental Immunology 2014, 175: 425–38. Diagnosis, pathogenesis and treatment of myositis: recent advances 2014, 175: 349–58. Neuromyelitis optica: clinical features, immunopathogenesis and treatment 2014, 176: 149–64. PMID:24358961

  17. Central venous catheter - dressing change

    Science.gov (United States)

    ... during cancer treatment Bone marrow transplant - discharge Central venous catheter - flushing Peripherally inserted central catheter - flushing Sterile technique Surgical wound care - open Review Date 9/17/2016 Updated by: ...

  18. Central effects of fingolimod.

    Science.gov (United States)

    Cruz, Vítor T; Fonseca, Joaquim

    2014-08-01

    Introduccion. El fingolimod, un modulador del receptor de la esfingosina-1-fosfato (S1P) dotado de un mecanismo de accion novedoso, fue el primer tratamiento oral aprobado para la esclerosis multiple remitente recurrente. Su union a los receptores S1P1 de los linfocitos promueve la retencion selectiva de los linfocitos T virgenes y de memoria central en los tejidos linfoides secundarios, lo que impide su salida hacia el sistema nervioso central (SNC). Asimismo, el fingolimod atraviesa con facilidad la barrera hematoencefalica, y diversos estudios le atribuyen un efecto neuroprotector directo en el SNC. Objetivo. Revisar la informacion disponible acerca de los efectos centrales del fingolimod. Desarrollo. El desequilibrio entre los procesos lesivos y reparadores constituye un reflejo de la desmielinizacion cronica, la degeneracion axonal y la gliosis, y parece contribuir a la discapacidad que la esclerosis multiple acarrea. La facilidad con la que el fingolimod atraviesa la barrera hematoencefalica le permite actuar directamente sobre los receptores S1P localizados en las celulas del SNC. Una vez en el interior del SNC, ocupa los receptores S1P de los oligodendrocitos y de sus celulas precursoras, de los astrocitos, los microgliocitos y las neuronas, fomentando la remielinizacion, la neuroproteccion y los procesos endogenos de regeneracion. La eficacia evidenciada en los ensayos clinicos concuerda con un mecanismo de accion que incluiria efectos directos sobre las celulas del SNC. Conclusiones. Los datos disponibles indican que la eficacia del fingolimod en el tratamiento de la esclerosis multiple se debe a su ambivalencia como molecula inmunomoduladora y moduladora directa de los receptores S1P del SNC. Tanto es asi que estudios recientes le atribuyen efectos neuroprotectores en varios modelos que suscitan expectativas en torno a su posible aplicacion terapeutica en la enfermedad de Alzheimer, el paludismo cerebral y el neuroblastoma, asi como en la neuroproteccion

  19. [Neurological diseases in the aged].

    Science.gov (United States)

    Kameyama, M

    1990-12-01

    In this paper, I described clinical and basic problems on neurology of the aged patients. These studies have been done in various institutions with many co-workers. 1) A PET study revealed some age differences on CBF, CMRO2, or CMRgl. But these results are not so rigid in which much of individual variations should be considered in interpretation. Calendar age is not always compatible to biological age. 2) Saccular aneurysms in the brain artery were found in 7.3% of 1200 routine autopsy series of the aged subjects. Aneurysms with external diameter exceeding 6 mm had been fatally ruptured in 14 (78%) of 18 subjects. 3) Variations of the pyramidal crossing are found responsible for bizarre clinical manifestations. Non-crossing component was more prominent in the right pyramidal tract; consequently, right pyramidal tracts including ventral and lateral one seemed to have more extensive representation in the spinal cord level. 4) I123-IMP SPECT study showed a reduced uptake in the area 4 or area 4-6 of the ALS patients. 5) I introduced a new simplified Wartenberg's maneuver, which is useful for detection of subtle pyramidal dysfunctions. 6) Cases with central pontine myelinolysis and those of paraneoplastic syndrome were presented with an emphasis on their patho-chemical mechanisms. 7) Lewis-Sumner syndrome showing multifocal persistent conduction block is not rare in the aged, in which we have already had some useful therapeutic methods. 8) Dementia complicated with neurodegenerative disease was discussed on its clinical and chemical features of mental disturbances. In ALS-dementia, CSF-homovanilic acid reduced significantly than in the control and L-dopa was effective in some patients. 9) Vascular and Alzheimer-type dementias were presented and discussed on their pathogenetic mechanism according to our recent studies with review of literature.

  20. [Central anticholinergic syndrome].

    Science.gov (United States)

    Fernández Urretavizcaya, P; Cenoz Osinaga, J C; Jáuregui Garía, M L; Gállego Culleré, J

    1991-10-01

    Two new cases of anticolinergic central syndrome are described. The first case, a 8 year old girl, suffered a severe encefalopathy after topical application of mydriatic cholirio as an aid in a rutine study of ocular refraction. The second case, 67 year old man presented a severe neurological picture after accidental intake of a silvester plantground (Atropa belladonna). His neurological condition returned quickly to normal whith administration of physostigmine. Differents aspects of the etiology, clinical picture and diagnosis are discussed with special emphasis in patients with delirium or acute confusional states. Finally, attention is drawn in the necessity of a properly use of anticholinergic drugs overcoat in aged or children.

  1. Central osteosclerosis with trichothiodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Wakeling, Emma L.; Brady, Angela F. [North West Thames Regional Genetics Service, Kennedy-Galton Centre, Level 8 V, North West London Hospitals NHS Trust, Watford Road, HAI 3UJ, Harrow, Middlesex (United Kingdom); Cruwys, Michele [Department of Paediatrics, Hillingdon Hospital, Hillingdon, Middlesex (United Kingdom); Suri, Mohnish [Clinical Genetics Service, City Hospital, Nottingham (United Kingdom); Aylett, Sarah E. [Neurosciences Unit, Great Ormond Street Hospital for Children NHS Trust, London (United Kingdom); Hall, Christine [Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London (United Kingdom)

    2004-07-01

    Trichothiodystrophy (TTD) is a rare, autosomal recessive, multisystem disorder associated with defects in nucleotide excision repair. We report a 7-year-old boy with TTD due to mutation in the XPD gene. The patient has classic features of this condition, including brittle, sulphur-deficient hair, ichthyosis, growth retardation and developmental delay. In addition, he has radiological evidence of progressive central osteosclerosis. Although similar radiological findings have previously been reported in a small number of patients, this association is not widely recognised. We review the radiological findings in this and other similar cases and discuss the natural history of these bony changes. (orig.)

  2. Centralized vs. De-centralized Multinationals and Taxes

    DEFF Research Database (Denmark)

    Nielsen, Søren Bo; Raimondos-Møller, Pascalis; Schjelderup, Guttorm

    2005-01-01

    The paper examines how country tax differences affect a multinational enterprise's choice to centralize or de-centralize its decision structure. Within a simple model that emphasizes the multiple conflicting roles of transfer prices in MNEs - here, as a strategic pre-commitment device and a tax...... manipulation instrument -, we show that (de-)centralized decisions are more profitable when tax differentials are (small) large.Keywords: Centralized vs. de-centralized decisions, taxes, MNEs.JEL-Classification: H25, F23, L23....

  3. Central centrifugal cicatricial alopecia.

    Science.gov (United States)

    Whiting, David A; Olsen, Elise A

    2008-01-01

    A progressive scarring alopecia of the central scalp is commonly seen in young to middle-aged females of African descent. It usually starts at the vertex or mid top of the scalp and gradually spreads centrifugally, hence, the unifying term of central centrifugal cicatricial alopecia. The clinical pattern is suggestive of female pattern alopecia, but a lack of follicular pores indicative of scarring is present. It can progress for years before slowly burning out. The etiology is unknown but genetic factors may be important. It is often associated with a history of traumatic hairstyling involving heat, traction, and chemicals. However, most patients of African descent without this disorder have similar styling habits. Nonetheless, avoidance of physical and chemical trauma to the scalp hair, the use of suitable shampoos and conditioners, and the encouragement of natural hairstyles may be helpful. Any infection should be treated. Topical or intralesional corticosteroids and systemic antibiotics may be useful and topical minoxidil should be tried with the hope of preventing further scarring and encouraging regrowth of recovering follicles. Current research into the etiology of this disorder will help to foster much-needed clinical trials of therapeutic agents.

  4. Central Sumatra enjoys success

    Energy Technology Data Exchange (ETDEWEB)

    Wongsosantiko, A.

    1977-05-02

    The Sihapas group contains the most prolific oil producing zones in the Central Sumatra Basin. It represents the transgressive, coarse clastic sequence deposited during the early Miocene. Some of these sandstone grade laterally into siltstones and shales of the Telisa Formation, believed to be a major source of rock for Central Sumatra oil. Recent exploratory wells drilled between the mountain front and coastal plain areas have provided more data for stratigraphic studies. These have resulted in subdivision of the lower Miocene transgressive sequence into discrete rock-stratigraphic units. The former Sihapas Formation has subsequently been elevated to group rank and now consists of several formations with the Duri Formation as the uppermost sand unit. This study covers Caltex's areas of operation, which includes the area between the Kampar River of the south, the Barumum River to the north, the Malacca Straits to the east, and the Barisan Mt. to the west. A basic map shows the regional scene, while a stratigraphic chart shows the lithology.

  5. en los pivotes centrales

    Directory of Open Access Journals (Sweden)

    Reynaldo Roque Rodés

    2005-01-01

    Full Text Available Se hace una revisión y comentarios sobre las ventajas y limitantes del empleo del LEPA (Low Enery Precision Aplication en los sistemas de riego de pivotes centrales. Estos sistemas o filosofía de manejo del agua para condiciones de escasez o mala calidad del líquido es una alternativa viable para la producción de alimentos. Introducida en la década del 80 en las planicies del sur de Texas, donde la alta evaporación del agua y la necesidad de regar grandes áreas con pivotes centrales obligaba a la búsqueda de una alternativa para incrementar al máximo la eficiencia de aplicación del riego. Aún en fase de estudio e introducción en Cuba para áreas específicas, puede ser una solución de incremento de los rendimientos de los cultivos, empleando menos agua y aguas con calidad limitada

  6. Centrality Measures in Urban Networks

    CERN Document Server

    Crucitti, P; Porta, S; Crucitti, Paolo; Latora, Vito; Porta, Sergio

    2005-01-01

    Centrality has revealed crucial for understanding the structural order of complex relational networks. Centrality is also relevant for various spatial factors affecting human life and behaviors in cities. We present a comprehensive study of centrality distributions over geographic networks of urban streets. Four different measures of centrality, namely closeness, betweenness, straightness and information, are compared over eighteen 1-square-mile samples of different world cities. Samples are represented by primal geographic graphs, i.e. valued graphs defined by metric rather than topologic distance where intersections are turned into nodes and streets into edges. The spatial behavior of centrality indexes over the networks is investigated graphically by means of colour-coded maps. The results indicate that a spatial analysis, that we term Multiple Centrality Assessment(MCA), grounded not a single but on a set of different centrality indices, allows an extended comprehension of the city structure, nicely captu...

  7. Orden monetario y bancos centrales Monetary order and Central Banks

    Directory of Open Access Journals (Sweden)

    Aglietta Michel

    1996-06-01

    Full Text Available Con el enfoque evolucionista e institucionalista de la economía de las convenciones francesa, este trabajo analiza el surgimiento histórico de la banca central y la creación institucional del 'arte de la banca central'. El artículo estudia los modelos formales del orden monetario, la banca libre y la banca central, y analiza los eventos históricos que llevaron a que el Banco de Inglaterra inventara el arte de manejar los bancos centrales en conjunción con el aprendizaje colectivo e institucional que lo hizo posible. Aglietta muestra que la banca central no es una creación del Estado sino una creación institucional endógena al sistema de mercado.With the evolutionist and institutionalist focus of the economics of the French conventions, this paper analyzes the historical rise of the central bank and the institutional creation of the 'art of the central bank'. The article studies formal models of the monetary order, free banking and the central bank, and analyzes the historie events that led to the Bank of England inventing the art of managing the central banks, in conjunction with the collective and institutional learning that made it possible. Aglietta shows that the central bank is not a creation of the State, but rather aninstitutional creation endogenous to the market system.

  8. UA1 central detector

    CERN Multimedia

    The UA1 central detector was crucial to understanding the complex topology of proton-antiproton events. It played a most important role in identifying a handful of Ws and Zs among billions of collisions. The detector was a 6-chamber cylindrical assembly 5.8 m long and 2.3 m in diameter, the largest imaging drift chamber of its day. It recorded the tracks of charged particles curving in a 0.7 Tesla magnetic field, measuring their momentum, the sign of their electric charge and their rate of energy loss (dE/dx). Atoms in the argon-ethane gas mixture filling the chambers were ionised by the passage of charged particles. The electrons which were released drifted along an electric field shaped by field wires and were collected on sense wires. The geometrical arrangement of the 17000 field wires and 6125 sense wires allowed a spectacular 3-D interactive display of reconstructed physics events to be produced.

  9. UA2 central calorimeter

    CERN Multimedia

    The UA2 central calorimeter measured the energy of individual particles created in proton-antiproton collisions. Accurate calibration allowed the W and Z masses to be measured with a precision of about 1%. The calorimeter had 24 slices like this one, each weighing 4 tons. The slices were arranged like orange segments around the collision point. Incoming particles produced showers of secondary particles in the layers of heavy material. These showers passed through the layers of plastic scintillator, generating light which was taken by light guides (green) to the data collection electronics. The amount of light was proportional to the energy of the original particle. The inner 23 cm of lead and plastic sandwiches measured electrons and photons; the outer 80 cm of iron and plastic sandwiches measured strongly interacting hadrons. The detector was calibrated by injecting light through optical fibres or by placing a radioactive source in the tube on the bottom edge.

  10. Pontine tegmentum hematoma: a case report with the "one-and-a-half "syndrome without pyramidal tract deficit Hematoma tegmentar pontino: relato de caso com a síndrome "one-and-a-half" e sem déficit piramidal

    Directory of Open Access Journals (Sweden)

    Dionísio Azevedo Jr

    1995-09-01

    Full Text Available The author reports the case of a 54-year-old male patient with a pontine hematoma and with the one-and-a-half syndrome, cerebellar ataxia and no signs of pyramidal tract involvement. The absence of involvement of the pyramidal tract in the case reported herein is likely due to variation in the vascular anatomy of the pons. The pathophysiologic mechanisms of the one-and-a-half syndrome and of the clinical findings recorded are discussed.O autor relata o caso de um paciente de sexo masculino de 54 anos com hematoma pontino que se manifestou por síndrome "one-and-a-half" e ataxia cerebelar mas sem sinais de acometimento do trato piramidal. A ausência de acometimento do trato piramidal é decorrente possivelmente de uma variação da anatomia vascular do segmento pontino do tronco cerebral. Os achados clínicos do caso e os mecanismos fisiopatológicos da síndrome "one-and-a-half" são discutidos.

  11. Central Disorders of Hypersomnolence

    Science.gov (United States)

    Khan, Zeeshan

    2015-01-01

    The central disorders of hypersomnolence are characterized by severe daytime sleepiness, which is present despite normal quality and timing of nocturnal sleep. Recent reclassification distinguishes three main subtypes: narcolepsy type 1, narcolepsy type 2, and idiopathic hypersomnia (IH), which are the focus of this review. Narcolepsy type 1 results from loss of hypothalamic hypocretin neurons, while the pathophysiology underlying narcolepsy type 2 and IH remains to be fully elucidated. Treatment of all three disorders focuses on the management of sleepiness, with additional treatment of cataplexy in those patients with narcolepsy type 1. Sleepiness can be treated with modafinil/armodafinil or sympathomimetic CNS stimulants, which have been shown to be beneficial in randomized controlled trials of narcolepsy and, quite recently, IH. In those patients with narcolepsy type 1, sodium oxybate is effective for the treatment of both sleepiness and cataplexy. Despite these treatments, there remains a subset of hypersomnolent patients with persistent sleepiness, in whom alternate therapies are needed. Emerging treatments for sleepiness include histamine H3 antagonists (eg, pitolisant) and possibly negative allosteric modulators of the gamma-aminobutyric acid-A receptor (eg, clarithromycin and flumazenil). PMID:26149554

  12. [MANAGEMENT OF CENTRAL HYPERSOMNIAS].

    Science.gov (United States)

    Dauvilliers, Yves; Lopez, Régis

    2016-06-01

    Central hypersomnias include narcolepsy type 1, type 2 and idiopathic hypersomnia with daytime sleepiness excessive in the foreground of the clinical symptoms. Despite major advances in our understanding of the mechanisms of the narcolepsy type 1 with a low level of hypocretin-1 in cerebrospinal fluid, its current management is only symptomatic. The current management is also only symptomatic for type 2 narcolepsy and idiopathic hypersomnia with an unknown pathophysiology. Treatment options may vary from a single drug targeting several symptoms or several drugs treating a specific symptom. The treatment of daytime sleepiness is based on modafinil in first intention. Other psychostimulants such as methylphenidate, pitolisant and exceptionally dextro-amfetamine may be considered. In narcolepsy type 1, antidepressants such as inhibitors of the reuptake of serotonin and noradrenaline will be considered to improve cataplexy. Sodium oxybate is an effective treatment on sleepiness, cataplexy and bad night sleep in narcolepsy. The management for other symptoms or comorbidities should be considered it necessary such as hallucinations, sleep paralysis, the disturbed nighttime sleep, unpleasant dreams, parasomnias, depressive symptoms, overweight/obesity, cardiovascular disease and obstructive sleep apnea syndrome. Important therapeutic perspectives are to be expected concerning new psychostimulant and anticataplectiques, but mainly on immune-based therapies administered as early as possible after disease onset and on hypocretin replacement therapy for patients with severe symptoms.

  13. y Banca Central

    Directory of Open Access Journals (Sweden)

    Ángel García Banchs

    2008-01-01

    Full Text Available Las teorías monetarias modernas, ortodoxas y heterodoxas, han pasado por alto el hecho de que posterior a la Segunda Guerra Mundial el mundo quedó dividido entre economías emisoras y receptoras de reservas, pasando el sistema monetario internacional desde entonces a ser completamente asimétrico. De allí que, desde el punto de vista teórico, señalemos la necesidad de tomar en cuenta si las economías emiten o no una moneda de reserva internacional, pues ello explicaría la existencia de diversas prácticas monetarias a nivel mundial. Este trabajo propone, y calcula, indicadores basados en datos provenientes de los balances de activos y pasivos de quince bancos centrales pertenecientes a Norteamérica, Suramérica, Europa y Asia. Los hallazgos con respecto a las diversas estructuras de activos y pasivos confirman la hipótesis acerca de la presencia de tales asimetrías. Se infiere en consecuencia que la política monetaria es menos flexible pero más influyente en las economías receptoras de reservas, y a la vez más flexible pero menos influyente en las economías emisoras. En pocas palabras, la exogeneidad de la tasa de interés de corto plazo es más débil en el caso de las economías receptoras de reservas las cuales se ven obligadas a acumular divisas y a procurar la estabilidad del tipo de cambio, debido a que sus monedas locales no son aceptadas en el exterior. Así, aunque la oferta crediticia es endógena en esas economías, las mismas no han sido capaces de librarse aún de la necesidad de mantener reservas monetarias en divisas extranjeras

  14. Dublin South Central (DSC)

    LENUS (Irish Health Repository)

    O'Gorman, Clodagh S M

    2010-12-01

    Children who appear healthy, even if they have one or more recognized cardiovascular risk factors, do not generally have outcomes of cardiovascular or other vascular disease during childhood. Historically, pediatric medicine has not aggressively screened for or treated cardiovascular risk factors in otherwise healthy children. However, studies such as the P-Day Study (Pathobiological Determinants of Atherosclerosis in Youth), and the Bogalusa Heart Study, indicate that healthy children at remarkably young ages can have evidence of significant atherosclerosis. With the increasing prevalence of pediatric obesity, can we expect more health problems related to the consequences of pediatric dyslipidemia, hypertriglyceridemia, and atherosclerosis in the future? For many years, medications have been available and used in adult populations to treat dyslipidemia. In recent years, reports of short-term safety of some of these medications in children have been published. However, none of these studies have detailed long-term follow-up, and therefore none have described potential late side-effects of early cholesterol-lowering therapy, or potential benefits in terms of reduction of or delay in cardiovascular or other vascular end-points. In 2007, the American Heart Association published a scientific statement on the use of cholesterol-lowering therapy in pediatric patients. In this review paper, we discuss some of the current literature on cholesterol-lowering therapy in children, including the statins that are currently available for use in children, and some of the cautions with using these and other cholesterol-lowering medications. A central tenet of this review is that medications are not a substitute for dietary and lifestyle interventions, and that even in children on cholesterol-lowering medications, physicians should take every opportunity to encourage children and their parents to make healthy diet and lifestyle choices.

  15. Central African Republic.

    Science.gov (United States)

    1989-11-01

    The Central African Republic contains 242,000 square miles, which rolling terrain almost 2000 feet above sea level. The climate is tropical, and it has a population of 2.8 million people with a 2.5% growth rate. There are more than 80 ethnic groups including Baya 34%, Banda 28%, Sara 10%, Mandja 9%, Mboum 9%, and M'Baka 7%. The religions are traditional African 35%, protestant 25%, Roman Catholic 25%, and Muslim 15%, and the languages are French and Sangho. The infant mortality rate is 143/1000, with expectancy at 49 years and a 40% literacy rate. The work force of 1 million is 70% agricultural, industry 6% and commerce and service 6% and government 3%. The government consists of a president assisted by cabinet ministers and a single party. Natural resources include diamonds, uranium, timber, gold, and oil, and major industries are beverages, textiles, and soap. Agricultural products feature coffee, cotton, peanuts, tobacco, food crops and livestock. Most of the population live in rural areas and most of the 80 ethnic groups have their own language. This is one of the world's least developed countries, with a per capita income of $375/year. The main problems with development are the poor transportation infrastructure, and the weak internal and international marketing systems. The US and various international organizations have aided in agriculture development, health programs, and family planning. US investment is mainly in diamond and gold mining, and although oil drilling has been successful it is not economically feasible at current prices.

  16. Central Hypothyroidism in Miniature Schnauzers

    NARCIS (Netherlands)

    Voorbij, Annemarie M W Y; Leegwater, Peter A J; Buijtels, Jenny J C W M; Daminet, Sylvie; Kooistra, Hans S

    2016-01-01

    BACKGROUND: Primary hypothyroidism is a common endocrinopathy in dogs. In contrast, central hypothyroidism is rare in this species. OBJECTIVES: The objective of this article is to describe the occurrence and clinical presentation of central hypothyroidism in Miniature Schnauzers. Additionally, the p

  17. Central presbycusis: an emerging view.

    Science.gov (United States)

    Gates, George A

    2012-07-01

    Age-related dysfunction of the central auditory system (central presbycusis) is common but rarely looked for by those who provide aural rehabilitation. Patients who complain of difficulty hearing in noise--the key symptom of central presbycusis--are generally disadvantaged with conventional rehabilitation. This symptom should be documented with commercially available speech-in-noise tests, which use materials that are uncomplicated to administer. Those patients who perform poorly on such tests should have a customized rehabilitation program aimed at optimizing their remaining communication abilities. Otolaryngologists who provide auditory rehabilitation may wish to consider expanding their practices to meet the communication needs of older patients with central presbycusis. Central presbycusis is an emerging area for basic and clinical research in auditory neurotology, particularly in the relation of cognitive dysfunction to impaired auditory processing.

  18. Centralized versus Decentralized Information Systems

    Science.gov (United States)

    Hugoson, Mats-Åke

    This paper brings into question whether information systems should be centralized or decentralized in order to provide greater support for different business processes. During the last century companies and organizations have used different approaches for centralization and decentralization; a simple answer to the question does not exist. This paper provides a survey of the evolution of centralized and decentralized approaches, mainly in a Nordic perspective. Based on critical reflections on the situation in the end of the century we can discuss what we can learn from history to achieve alignment between centralized and decentralized systems and the business structure. The conclusion is that theories, management and practice for decisions on centralization or decentralization of information systems must be improved. A conscious management and control of centralization /decentralization of IT support is a vital question in the company or the organization, and this is not a task that can be handled only by IT-specialists. There is a need for business oriented IT management of centralization/decentralization.

  19. Betweenness centrality profiles in trees

    CERN Document Server

    Fish, Benjamin; Turan, Gyorgy

    2016-01-01

    Betweenness centrality of a vertex in a graph measures the fraction of shortest paths going through the vertex. This is a basic notion for determining the importance of a vertex in a network. The k-betweenness centrality of a vertex is defined similarly, but only considers shortest paths of length at most k. The sequence of k-betweenness centralities for all possible values of k forms the betweenness centrality profile of a vertex. We study properties of betweenness centrality profiles in trees. We show that for scale-free random trees, for fixed k, the expectation of k-betweenness centrality strictly decreases as the index of the vertex increases. We also analyze worst-case properties of profiles in terms of the distance of profiles from being monotone, and the number of times pairs of profiles can cross. This is related to whether k-betweenness centrality, for small values of k, may be used instead of having to consider all shortest paths. Bounds are given that are optimal in order of magnitude. We also pre...

  20. Demographic tensions in Central America.

    Science.gov (United States)

    1986-08-01

    This discussion of Central America focuses on the rapid growth of its population, its stagnating economy, and those countries that are socioeconomically advanced. Between 1950-85 the population of Central America tripled, from 9.1 million to 26. 4 million, due to marked mortality declines and the absence of off-setting fertility declines. The distribution of Central Americas's growing populations sets its population growth apart from that of other developing regions. Currently, almost half of all Central Americans live in cities. Although the average growth rate for Central American countries has fallen and is expected to drop further, the decline does not counterbalance the effect of the absolute rise in population numbers. The average annual growth rate of more than 3% annually in the 1960s fell to about 2.6% in recent years, but this decline is due primarily to socioeconomically advanced Costa Rica and Panama. Central America's age structure further complicates the population crisis. About 43% of Central Americans are under the age of 15. When the increasingly larger young population group enters it reproductive years, the potential for future growth (albeit the falling rate of population increase) is unparalleled. UN population projections show the region's population at 40 million by the year 2000. The 1973 oil crisis began a downward spiral for the buoyant post World War II Central American economy. Between 1950-79, real per capita income growth in Central America doubled, with Central American economies growing an average of 5.3% annually. By the early 1980s, overseas markets of the trade-dependent countries of Central America had dried up due to protectionism abroad and slumping basic commodity prices. These and other factors plunged Central America into its current economic malaise of falling real per capita income, rising unemployment, curtailed export led economic growth, and a rising cost of living. In general, economic growth in Central America

  1. The Central Trigger Processor (CTP)

    CERN Multimedia

    Franchini, Matteo

    2016-01-01

    The Central Trigger Processor (CTP) receives trigger information from the calorimeter and muon trigger processors, as well as from other sources of trigger. It makes the Level-1 decision (L1A) based on a trigger menu.

  2. Payments and Central Bank Policy

    DEFF Research Database (Denmark)

    Korsgaard, Søren

    This thesis consists of three chapters. The rst, "Paying for Payments", examines the role of interchange fees in payment card networks. The second, "Bank Liquidity and the Interbank Market" (co-authored with Mikael Reimer Jensen), investigates how banks' liquidity holdings at the central bank a ect...... outcomes in the money market. The third, "Collateralized Lending and Central Bank Collateral Policy", considers the emergence of credit constraints under collateralized lending, and how central banks use collateral policy to mitigate these constraints. While the chapters can be read independently......, they share common themes. Each chapter is concerned with payments in one way or another, each is concerned with the e ciency of market outcomes, and, to the extent that there is scope for improving these outcomes, each discusses the appropriate role for policy, in particular central bank policy....

  3. Central cementifying fibroma of mandible

    Directory of Open Access Journals (Sweden)

    Joseph Edward

    2010-01-01

    Full Text Available Central cementifying fibroma is a rare non odontogenic tumor coming in the group of fibro osseouslesion, arising from periodontal ligament and is usually seen in tooth bearing area. It can affect boththe mandible and the maxilla, particularly the mandible. This bone tumour consists of highly cellular,fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum or both.Here we present a case of Central cementifying fibroma (recurrent in a 34 year old female.

  4. Inferring Centrality from Network Snapshots

    OpenAIRE

    Haibin Shao; Mehran Mesbahi; Dewei Li; Yugeng Xi

    2017-01-01

    The topology and dynamics of a complex network shape its functionality. However, the topologies of many large-scale networks are either unavailable or incomplete. Without the explicit knowledge of network topology, we show how the data generated from the network dynamics can be utilised to infer the tempo centrality, which is proposed to quantify the influence of nodes in a consensus network. We show that the tempo centrality can be used to construct an accurate estimate of both the propagati...

  5. CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY

    Energy Technology Data Exchange (ETDEWEB)

    BERGMAN, T. B.; STEFANSKI, L. D.; SEELEY, P. N.; ZINSLI, L. C.; CUSACK, L. J.

    2012-09-19

    THE CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY WAS CONDUCTED TO DEVELOP AN OPTIMAL SEQUENCE OF REMEDIATION ACTIVITIES IMPLEMENTING THE CERCLA DECISION ON THE CENTRAL PLATEAU. THE STUDY DEFINES A SEQUENCE OF ACTIVITIES THAT RESULT IN AN EFFECTIVE USE OF RESOURCES FROM A STRATEGIC PERSPECTIVE WHEN CONSIDERING EQUIPMENT PROCUREMENT AND STAGING, WORKFORCE MOBILIZATION/DEMOBILIZATION, WORKFORCE LEVELING, WORKFORCE SKILL-MIX, AND OTHER REMEDIATION/DISPOSITION PROJECT EXECUTION PARAMETERS.

  6. Controlling centrality in complex networks

    CERN Document Server

    Nicosia, Vincenzo; Romance, Miguel; Russo, Giovanni; Latora, Vito

    2011-01-01

    Spectral centrality measures allow to identify influential individuals in social groups, to rank Web pages by their popularity, and even to determine the impact of scientific researches. The centrality score of a node within a network crucially depends on the entire pattern of connections, so that the usual approach is to compute the node centralities once the network structure is assigned. We face here with the inverse problem, that is, we study how to modify the centrality scores of the nodes by acting on the structure of a given network. We prove that there exist particular subsets of nodes, called controlling sets, which can assign any prescribed set of centrality values to all the nodes of a graph, by cooperatively tuning the weights of their out-going links. We show that many large networks from the real world have surprisingly small controlling sets, containing even less than 5-10% of the nodes. These results suggest that rankings obtained from spectral centrality measures have to be considered with ex...

  7. Diagnóstico de tumores do ângulo ponto-cerebelar com o auxílio de técnicas de inteligência artificial A diagnostic model for cerebellum-pontine angle tumors using artificial intelligence techniques

    Directory of Open Access Journals (Sweden)

    FLÁVIO LEITÃO

    2000-03-01

    Full Text Available Trata-se de estudo multidisciplinar, cujo objetivo é a obtenção de modelo discriminatório entre diagnóstico de tumores do ângulo ponto-cerebelar (APC e de distúrbios otorrinolaringológicos. Presentemente, a realização de um acurado exame neurológico e/ou otorrinolaringológico é incapaz de firmar diagnóstico de tumor do APC, sem valer-se de exames radiológicos de alto custo (tomografia computadorizada, ressonância magnética. O modelo proposto foi obtido através da utilização de técnicas de inteligência artificial e apresentou bom nível de acurácia (88,4% no teste de novos casos, considerando-se apenas o exame clínico e sem o auxílio de exames radiológicos.We are concerned in this paper with learning classification procedures from known cases. More precisely, we provide a diagnostic model that discriminate between cerebellum-pontine angle (CPA tumors and otorhinolaryngological (ENT disorders. Usually, in order to distinguish between CPA tumors and ENT disorders one must perform clinical-neurological examination together with expensive radiological imagery (CT and MRI. The proposed model was obtained through artificial intelligence methods and presented a good accuracy level (88.4% when tested against new cases, considering only clinical examination without radiological imagery results.

  8. A molecular biology and phase II study of imetelstat (GRN163L) in children with recurrent or refractory central nervous system malignancies: a pediatric brain tumor consortium study.

    Science.gov (United States)

    Salloum, Ralph; Hummel, Trent R; Kumar, Shiva Senthil; Dorris, Kathleen; Li, Shaoyu; Lin, Tong; Daryani, Vinay M; Stewart, Clinton F; Miles, Lili; Poussaint, Tina Young; Stevenson, Charles; Goldman, Stewart; Dhall, Girish; Packer, Roger; Fisher, Paul; Pollack, Ian F; Fouladi, Maryam; Boyett, James; Drissi, Rachid

    2016-09-01

    Telomerase activation is critical in many cancers including central nervous system (CNS) tumors. Imetelstat is an oligonucleotide that binds to the template region of the RNA component of telomerase, inhibiting its enzymatic activity. We conducted an investigator-sponsored molecular biology (MB) and phase II study to estimate inhibition of tumor telomerase activity and sustained responses by imetelstat in children with recurrent CNS malignancies. In the MB study, patients with recurrent medulloblastoma, high-grade glioma (HGG) or ependymoma undergoing resection received one dose of imetelstat as a 2-h intravenous infusion at 285 mg/m(2), 12-24 h before surgery. Telomerase activity was evaluated in fresh tumor from surgery. Post-surgery and in the phase II study, patients received imetelstat IV (days 1 and 8 q21-days) at 285 mg/m(2). Imetelstat pharmacokinetic and pharmacodynamic studies were performed. Of two evaluable patients on the MB trial, intratumoral telomerase activity was inhibited by 95 % compared to baseline archival tissue in one patient and was inevaluable in one patient. Forty-two patients (40 evaluable for toxicity) were enrolled: 9 medulloblastomas, 18 HGG, 4 ependymomas, 9 diffuse intrinsic pontine gliomas. Most common grade 3/4 toxicities included thrombocytopenia (32.5 %), lymphopenia (17.5 %), neutropenia (12.5 %), ALT (7.5 %) and AST (5 %) elevation. Two patients died of intratumoral hemorrhage secondary to thrombocytopenia leading to premature study closure. No objective responses were observed. Telomerase inhibition was observed in peripheral blood mononuclear cells (PBMCs) for at least 8 days. Imetelstat demonstrated intratumoral and PBMC target inhibition; the regimen proved too toxic in children with recurrent CNS tumors.

  9. Rosette Central Configurations, Degenerate central configurations and bifurcations

    CERN Document Server

    Lei, Jinzhi

    2009-01-01

    In this paper we find a class of new degenerate central configurations and bifurcations in the Newtonian $n$-body problem. In particular we analyze the Rosette central configurations, namely a coplanar configuration where $n$ particles of mass $m_1$ lie at the vertices of a regular $n$-gon, $n$ particles of mass $m_2$ lie at the vertices of another $n$-gon concentric with the first, but rotated of an angle $\\pi/n$, and an additional particle of mass $m_0$ lies at the center of mass of the system. This system admits two mass parameters $\\mu=m_0/m_1$ and $\\ep=m_2/m_1$. We show that, as $\\mu$ varies, if $n> 3$, there is a degenerate central configuration and a bifurcation for every $\\ep>0$, while if $n=3$ there is a bifurcations only for some values of $\\epsilon$.

  10. Coverage centralities for temporal networks

    CERN Document Server

    Takaguchi, Taro; Yoshida, Yuichi

    2015-01-01

    Structure of real networked systems, such as social relationship, can be modeled as temporal networks in which each edge appears only at the prescribed time. Understanding the structure of temporal networks requires quantifying the importance of a temporal vertex, which is a pair of vertex index and time. In this paper, we define two centrality measures of a temporal vertex by the proportion of (normal) vertex pairs, the quickest routes between which can (or should) use the temporal vertex. The definition is free from parameters and robust against the change in time scale on which we focus. In addition, we can efficiently compute these centrality values for all temporal vertices. Using the two centrality measures, we reveal that distributions of these centrality values of real-world temporal networks are heterogeneous. For various datasets, we also demonstrate that a majority of the highly central temporal vertices are located within a narrow time window around a particular time. In other words, there is a bo...

  11. Coverage centralities for temporal networks*

    Science.gov (United States)

    Takaguchi, Taro; Yano, Yosuke; Yoshida, Yuichi

    2016-02-01

    Structure of real networked systems, such as social relationship, can be modeled as temporal networks in which each edge appears only at the prescribed time. Understanding the structure of temporal networks requires quantifying the importance of a temporal vertex, which is a pair of vertex index and time. In this paper, we define two centrality measures of a temporal vertex based on the fastest temporal paths which use the temporal vertex. The definition is free from parameters and robust against the change in time scale on which we focus. In addition, we can efficiently compute these centrality values for all temporal vertices. Using the two centrality measures, we reveal that distributions of these centrality values of real-world temporal networks are heterogeneous. For various datasets, we also demonstrate that a majority of the highly central temporal vertices are located within a narrow time window around a particular time. In other words, there is a bottleneck time at which most information sent in the temporal network passes through a small number of temporal vertices, which suggests an important role of these temporal vertices in spreading phenomena. Contribution to the Topical Issue "Temporal Network Theory and Applications", edited by Petter Holme.Supplementary material in the form of one pdf file available from the Journal web page at http://dx.doi.org/10.1140/epjb/e2016-60498-7

  12. Inferring Centrality from Network Snapshots

    Science.gov (United States)

    Shao, Haibin; Mesbahi, Mehran; Li, Dewei; Xi, Yugeng

    2017-01-01

    The topology and dynamics of a complex network shape its functionality. However, the topologies of many large-scale networks are either unavailable or incomplete. Without the explicit knowledge of network topology, we show how the data generated from the network dynamics can be utilised to infer the tempo centrality, which is proposed to quantify the influence of nodes in a consensus network. We show that the tempo centrality can be used to construct an accurate estimate of both the propagation rate of influence exerted on consensus networks and the Kirchhoff index of the underlying graph. Moreover, the tempo centrality also encodes the disturbance rejection of nodes in a consensus network. Our findings provide an approach to infer the performance of a consensus network from its temporal data. PMID:28098166

  13. CENTRAL MECHANISMS OF ACUPUNCTURE ANALGESIA

    Directory of Open Access Journals (Sweden)

    Eman S. Mansour

    2015-12-01

    Full Text Available Background: Acupuncture is an component of traditional Chinese medicine (TCM that has been used for three thousand years to treat diseases and relieve pain. Pain is found to be the most common reason for people to use acupuncture. Due to recent scientific findings, acupuncture treatment has been accepted worldwide. Numerous trials have been conducted especially in analgesia. The mechanisms of acupuncture analgesia has been widely investigated, however, the underlying mechanism still not clear. This article summarizes the central mechanisms of acupuncture analgesia and reviews recent studies on the topic. Method: We have focused on examining the recent literature on acupuncture analgesia. The central mechanisms of acupuncture analgesia and reviews recent studies on the topic. We focused on the studies related to central mechanisms of acupuncture analgesia from these aspects: (neurophysiology, neurochemistry and neuroanatomy. Result: The result revealed that acupuncture act on various parts of the central nervous system, including the spinal cord, brain stem, cerebral ganglia and cerebral cortex to alleviate pain. The central mechanisms underlying the effects of acupuncture include neurohumors and neurotransmitters, which are involved in analgesia. At spinal level, Spinal opioids, glutamate, norepinephrine and serotonin are the key elements acupuncture-induced analgesia. At brain level, Endogenous opioid peptides, limbic system play essential roles in mediating the analgesia. Conclusion: Acupuncture is an effective approach to pain management. There is good evidence in both experimental and clinical research that supports acupuncture efficacy in management of chronic pain through central nervous system. Acupuncture should be strongly used as a part of pain management plans. This work helps in improving our understanding of the scientific basis underlying acupuncture analgesia.

  14. Central Stars of Planetary Nebulae

    CERN Document Server

    Jones, David

    2016-01-01

    In this brief invited review, I will attempt to summarise some of the key areas of interest in the study of central stars of planetary nebulae which (probably) won't be covered by other speakers' proceedings. The main focus will, inevitably, be on the subject of multiplicity, with special emphasis on recent results regarding triple central star systems as well as wide binaries which avoid a common-envelope phase. Furthermore, in light of the upcoming release of Kepler's Campaign 11 data, I will discuss a few of the prospects from that data including the unique possibility to detect merger products.

  15. Central Libraries in Uncertain Times.

    Science.gov (United States)

    Kenney, Brian J.

    2001-01-01

    Discusses security and safety issues for public libraries, especially high-profile central facilities, in light of the September 11 terrorist attacks. Highlights include inspecting bags as patrons enter as well as exit; the need for security guidelines for any type of disaster or emergency; building design; and the importance of communication.…

  16. New Economy, Old Central Banks?

    NARCIS (Netherlands)

    Berk, Jan Marc

    2002-01-01

    Proponents of the so-called New Economy claim that it entails a structural change of the economy. Such a change, in turn, would require the central bank to rethink its monetary policy to the extent that traditional relationships between inf1ation and economic growth are no longer valid. But such a r

  17. Vulnerability in north- central Vietnam

    DEFF Research Database (Denmark)

    Casse, Thorkil; Milhøj, Anders; Nguyen, Thao Phuong

    2015-01-01

    This article examines changes in livelihood strategies in response to flooding. It does so on the basis of a household survey which was undertaken in three provinces in north central Vietnam. All households in the survey were regularly affected by flooding, but only poor households experience...

  18. Water Governance in Central Asia

    NARCIS (Netherlands)

    Djanibekov, Nodir; Assche, Van Kristof; Valentinov, Vladislav

    2016-01-01

    We develop a social systems theory perspective on Central Asian post-Socialist transition, placing particular emphasis on the coordination problems in transboundary water governance. The extensive Soviet water-energy infrastructure around the Amudarya and Syrdarya rivers required coordination, bu

  19. The Centrality of Ethical Leadership

    Science.gov (United States)

    Ehrich, Lisa C.; Harris, Jessica; Klenowski, Val; Smeed, Judy; Spina, Nerida

    2015-01-01

    Purpose: The central argument in this paper is that ethical school leadership is imperative in a context of increasing performance-driven accountability. The purpose of this paper is to focus on school principals' perceptions of how they understand ethical leadership and how they lead the ethical use of data. Design/Methodology/Approach: This…

  20. Learning and the central bank

    OpenAIRE

    Charles T. Carlstrom; Timothy S. Fuerst

    2001-01-01

    It is well known that sunspot equilibria may arise under an interest-rate operating procedure in which the central bank varies the nominal rate with movements in future inflation (a forward-looking Taylor rule). This paper demonstrates that these sunspot equilibria may be learnable in the sense of E-stability.

  1. The MEANING multilingual central repository

    NARCIS (Netherlands)

    Atserias, J.; Villarejo, L.; Rigau, G.; Agirre, E.; Carroll, J.; Magnini, B.; Vossen, P.

    2004-01-01

    This paper describes the first version of the Multilingual Central Repository, a lexical knowledge base developed in the framework of the MEANING project. Currently the MCR integrates into the EuroWordNet framework five local wordnets (including four versions of the English WordNet from Princeton),

  2. Copycats of the Central Himalayas

    NARCIS (Netherlands)

    P.A. Arora (Payal)

    2009-01-01

    textabstractThis case study highlights practices of a rarely documented group of neo-users of the Internet or newbies from Central Himalayas, serving as a catalyst for delving deeply into the act of ‘plagiarism’ in online learning By looking at such ‘learning’ practices away from schools, namely at

  3. Reduced central blood volume in cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Bendtsen, Flemming; Sørensen, T I

    1989-01-01

    for measuring the central blood volume. We have developed a method that enables us to determine directly the central blood volume, i.e., the blood volume in the heart cavities, lungs, and central arterial tree. In 60 patients with cirrhosis and 16 control subjects the central blood volume was assessed according...

  4. 27 CFR 9.75 - Central Coast.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Central Coast. 9.75... Central Coast. (a) Name. The name of the viticultural area described in this section is “Central Coast.” (b) Approved maps. The approved maps for determining the boundary of the Central Coast...

  5. 《关于国外渗透性脱髓鞘综合征部分文献之重新分析:反思》英文摘要与说明

    Institute of Scientific and Technical Information of China (English)

    张海鹏; 王荣明; 杨子军; 闫四梅; 陈萌; 崔松; 张力; 杜长生; 陈宗羡; 曾伏虎; 翟所鑫; 李玉清; 刘庆梅; 朱玉忠

    2015-01-01

    Objectives: To explore the main etiological factors of central pontine myelinolysis (CPM) and of the “osmotic demyelination syndrome(ODS)”that occurs after hepatic transplantation, to explore the differential diagnosing the manifestation consisting of dysarthria, dysphagia and quadriplegia presented after vomiting for a number of times, and to explore which fraction to be mainly involved by the “ODS”, what to be the pathological mechanism of the “ODS”, and how to prevent the “ODS”.Methods: Physiopathological principles are applied on the base of the clinical certificates, the diagnostic results differring from those in the case reports (that have been analyzed again by us).Results and Conclusions: It could be suggested that (1) CPM based mainly on alcoholism should result mainly from beriberi, as was mentioned by HUANG Ke-wei, the well-known Chinese neurologist, before or in 1960; (2) The coma secondary to hepatic transplantation could be often caused by Wernicke encephalopathy(WE, one of beriberi), which could be asscociated with the postoperative elevated corticosteroid or/and high-starch food for liver cirrhosis, which complicated by hepatic encephalopathy; (3)The case that was in 1995 reported by Kabeer et al, of possiblity of the earliest reported CPM due to cyclosporine, appeared to be the bilateral type of pontine lower paracentral hematal syndrome, a bilateral uncomplete Foville syndrome. It should be considerable whether an epileptic attack related to both cyclosporine and corticosteroid could result from reverible posterior leukoencephalopath syndrome with negative MRI owing to the effect of corticosteroid; (4) It is cerebral cortex that could be mainly involved by the “ODS” following a number of times of vomiting, of which one of evidences has been the 2 cases reported by Tomlinson et al in 1976.The kind of “ODS” following the encephalopathy of alkalosis yet without hypoxemic hypoxia, is possibly preventable not only if the

  6. Central venous line complications and tip detection

    OpenAIRE

    Ameneh Rezaee Gheshlaghi; Hamid Zamani Moghadam Dolu; Elham Pishbin; Maryam Salehi

    2015-01-01

    Central venous line is one of a creative instrument that saves human’s life in critical medical situation. Central venous line access is frequently involved in the disease management. It is used for rapid fluid therapy, transvenous pacemakers, infusion of some medications, hemodialysis or plasmapheresis and etc. Most of the emergency departments have some staffs that are trained for central venous line insertion but related complications occur during central venous line placement.Central veno...

  7. Is Central Asia really exsiccating?

    Science.gov (United States)

    Aizen, V. B.; Aizen, E. M.; Surazakov, A. B.

    2008-12-01

    At the end of 20th and the beginning of 21st century central Asia oases suffered from serious drought caused lack of water for agriculture, economy growth and population increase. However, people of this region always experienced lack of water for irrigation and fought a war over the rights to control river streams. The drying up of central Asian rivers is not a new phenomenon according to the ancient manuscripts. Thus, lets see about what has happened with the past century climate and water resources of central Asia using the long-term observational data. We analyzed data from more than 200 meteorological stations and stream gauges over the central Asia in elevation range from 25 m. b.s.l. to 4,000 m. a.s.l. to understand the last 100 years variability in climate and water resources, examining changes in the extreme and mean monthly air temperatures, precipitation and river runoff. The evaluation of seasonal snow and glacier's covered areas between 1970th and 2007th in central Asia derived from AVHRR, MODIS, Hexagon KH-9, Landsat ETM and ASTER data exhibit 15% reduction of the seasonal snow covered area and 10.1% of the glacier area. It has been found that during last twenty years the duration of snowmelt, from the date of maximum snow cover to date of its disappearance, reduced by 30 days and in 2007 was equal to 138 days in the central Asian mountains. The decrease of seasonal snow cover is not a linear process. The further decrease may be accelerated due to increase of rainfall instead of snowfall in early spring months at high elevations, and consequently a lesser heat expenditure for the snowmelt. The growth in summer air temperatures, especially observable since the 1970th, accompanied by increase of evapotranspiration and precipitation, notably in summer and autumn, and at high elevations over 3,000 m, and at the western peripheral mountain ridges. Average difference in the means of annual air temperatures for the two thirty-year periods before and after

  8. The Central Valley Hydrologic Model

    Science.gov (United States)

    Faunt, C.; Belitz, K.; Hanson, R. T.

    2009-12-01

    Historically, California’s Central Valley has been one of the most productive agricultural regions in the world. The Central Valley also is rapidly becoming an important area for California’s expanding urban population. In response to this competition for water, a number of water-related issues have gained prominence: conjunctive use, artificial recharge, hydrologic implications of land-use change, subsidence, and effects of climate variability. To provide information to stakeholders addressing these issues, the USGS made a detailed assessment of the Central Valley aquifer system that includes the present status of water resources and how these resources have changed over time. The principal product of this assessment is a tool, referred to as the Central Valley Hydrologic Model (CVHM), that simulates surface-water flows, groundwater flows, and land subsidence in response to stresses from human uses and from climate variability throughout the entire Central Valley. The CVHM utilizes MODFLOW combined with a new tool called “Farm Process” to simulate groundwater and surface-water flow, irrigated agriculture, land subsidence, and other key processes in the Central Valley on a monthly basis. This model was discretized horizontally into 20,000 1-mi2 cells and vertically into 10 layers ranging in thickness from 50 feet at the land surface to 750 feet at depth. A texture model constructed by using data from more than 8,500 drillers’ logs was used to estimate hydraulic properties. Unmetered pumpage and surface-water deliveries for 21 water-balance regions were simulated with the Farm Process. Model results indicate that human activities, predominately surface-water deliveries and groundwater pumping for irrigated agriculture, have dramatically influenced the hydrology of the Central Valley. These human activities have increased flow though the aquifer system by about a factor of six compared to pre-development conditions. The simulated hydrology reflects spatial

  9. Centrality in Interconnected Multilayer Networks

    CERN Document Server

    De Domenico, Manlio; Omodei, Elisa; Gómez, Sergio; Arenas, Alex

    2013-01-01

    Real-world complex systems exhibit multiple levels of relationships. In many cases, they require to be modeled by interconnected multilayer networks, characterizing interactions on several levels simultaneously. It is of crucial importance in many fields, from economics to biology, from urban planning to social sciences, to identify the most (or the less) influent nodes in a network. However, defining the centrality of actors in an interconnected structure is not trivial. In this paper, we capitalize on the tensorial formalism, recently proposed to characterize and investigate this kind of complex topologies, to show how several centrality measures -- well-known in the case of standard ("monoplex") networks -- can be extended naturally to the realm of interconnected multiplexes. We consider diagnostics widely used in different fields, e.g., computer science, biology, communication and social sciences, to cite only some of them. We show, both theoretically and numerically, that using the weighted monoplex obta...

  10. Centralized versus Decentralized Infrastructure Networks

    CERN Document Server

    Hines, Paul D H; Schläpfer, Markus

    2015-01-01

    While many large infrastructure networks, such as power, water, and natural gas systems, have similar physical properties governing flows, these systems tend to have distinctly different sizes and topological structures. This paper seeks to understand how these different size-scales and topological features can emerge from relatively simple design principles. Specifically, we seek to describe the conditions under which it is optimal to build decentralized network infrastructures, such as a microgrid, rather than centralized ones, such as a large high-voltage power system. While our method is simple it is useful in explaining why sometimes, but not always, it is economical to build large, interconnected networks and in other cases it is preferable to use smaller, distributed systems. The results indicate that there is not a single set of infrastructure cost conditions under which optimally-designed networks will have highly centralized architectures. Instead, as costs increase we find that average network size...

  11. A centralized audio presentation manager

    Energy Technology Data Exchange (ETDEWEB)

    Papp, A.L. III; Blattner, M.M.

    1994-05-16

    The centralized audio presentation manager addresses the problems which occur when multiple programs running simultaneously attempt to use the audio output of a computer system. Time dependence of sound means that certain auditory messages must be scheduled simultaneously, which can lead to perceptual problems due to psychoacoustic phenomena. Furthermore, the combination of speech and nonspeech audio is examined; each presents its own problems of perceptibility in an acoustic environment composed of multiple auditory streams. The centralized audio presentation manager receives abstract parameterized message requests from the currently running programs, and attempts to create and present a sonic representation in the most perceptible manner through the use of a theoretically and empirically designed rule set.

  12. The CDF Central Analysis Farm

    Energy Technology Data Exchange (ETDEWEB)

    Kim, T.H.; /MIT; Neubauer, M.; /UC, San Diego; Sfiligoi, I.; /Frascati; Weems, L.; /Fermilab; Wurthwein, F.; /UC, San Diego

    2004-01-01

    With Run II of the Fermilab Tevatron well underway, many computing challenges inherent to analyzing large volumes of data produced in particle physics research need to be met. We present the computing model within CDF designed to address the physics needs of the collaboration. Particular emphasis is placed on current development of a large O(1000) processor PC cluster at Fermilab serving as the Central Analysis Farm for CDF. Future plans leading toward distributed computing and GRID within CDF are also discussed.

  13. Central Nucleon-Nucleon Potential

    Science.gov (United States)

    Robilotta, M. R.

    2001-12-01

    The outer region of the NN interactions is dominated by the one pion exchange potential (OPEP), followed by the two-pion exchange potential (TPEP). Chiral calculations of the TPEP have been performed using either heavy baryon1 (HB) or relativistic2 perturbation theories. We compare the predictions from these two approaches for the dominant central interaction and show that they fail to agree by 25% ...

  14. Celtic Sites of Central Iberia

    Science.gov (United States)

    Pérez Gutiérrez, Manuel

    This chapter concerns the astronomy practiced by Celtic peoples in some parts of central Iberia, specifically the Vetton and Celtiberian peoples, inhabitants of the so-called Late Iron Age. The construction of some elements of religion or worship was perfectly determined by geometry, topography, and especially astronomy, because their spatial orientation occurs in locations of great interest for maintaining the local calendar. The maintenance of this calendar was probably the primary objective of some of the elements studied.

  15. Information from the central stores

    CERN Multimedia

    GS Department

    2010-01-01

    All items sold in the CERN shop (Bldg. 33) are now available in the central stores (Bldg. 73) and can be purchased on-line via EDH “Material Request” or at the “Emergency Desk” of the stores on the ground floor of Bldg. 73. These items are visible in the CERN catalogue under the “SCEM” codes beginning with 92. Department of General Infrastructure Services (GS) GS-SEM Group

  16. Central Asia, Physical Geography Handbook.

    Science.gov (United States)

    2007-11-02

    over 2,000 m) is not applicable to Central Asia, partly because the general hypsometric level of this region is high and unstable, as a consequence of...organic fossils in them, gastropods have been discovered. On the main territory of the Tarim massif, which evidently represented a weakly elevated...places seams of gypsum and rock salt, and, in a part to the west of the town of Aksu, also a bed of gray limestone with small fresh- water gastropods

  17. Central charges in regular mechanics

    CERN Document Server

    Cabo-Montes de Oca, Alejandro; Villanueva, V M

    1997-01-01

    We consider the algebra associated to a group of transformations which are symmetries of a regular mechanical system (i.e. system free of constraints). For time dependent coordinate transformations we show that a central extension may appear at the classical level which is coordinate and momentum independent. A cochain formalism naturally arises in the argument and extends the usual configuration space cochain concepts to phase space.

  18. Central hypersensitivity in chronic musculoskeletal pain.

    Science.gov (United States)

    Curatolo, Michele; Arendt-Nielsen, Lars

    2015-05-01

    Clinical research has consistently detected alteration in central pain processing leading to hypersensitivity. Most methods used in humans are reliable and have face validity to detect widespread central hypersensitivity. However, construct validity is difficult to investigate due to lack of gold standards. Reference values in the pain-free population have been generated, but need replication. Research on pain biomarkers that reflect specific central hypersensitivity processes is warranted. Few studies have analyzed the prognostic value of central hypersensitivity. Most medications acting at central level and some non-pharmacological approaches, including psychological interventions, are likely to attenuate central hypersensitivity.

  19. Central hypersensitivity in chronic musculoskeletal pain

    DEFF Research Database (Denmark)

    Curatolo, Michele; Arendt-Nielsen, Lars

    2015-01-01

    Clinical research has consistently detected alteration in central pain processing leading to hypersensitivity. Most methods used in humans are reliable and have face validity to detect widespread central hypersensitivity. However, construct validity is difficult to investigate due to lack of gold...... standards. Reference values in the pain-free population have been generated, but need replication. Research on pain biomarkers that reflect specific central hypersensitivity processes is warranted. Few studies have analyzed the prognostic value of central hypersensitivity. Most medications acting at central...... level and some non-pharmacological approaches, including psychological interventions, are likely to attenuate central hypersensitivity....

  20. CHINA AND ENERGY SECURITY IN CENTRAL ASIA

    OpenAIRE

    Guang, Pan

    2007-01-01

    This paper is divided into three parts: China’s energy policy and energy development strategy; Central Asia’s significance for China’s overseas energy development strategy; and Central Asia’s energy security and energy development.

  1. [Historical demography in the Central American isthmus].

    Science.gov (United States)

    Perez Brignoli, H

    1980-01-01

    The author reviews and evaluates sources of information on the demographic history of Central America. Past and present administrative, state, ecclesiastical, and genealogical sources are examined, and recent studies of various Central American countries are cited. A bibliography is provided

  2. Puente del Pedrido, tramo central

    Directory of Open Access Journals (Sweden)

    Torroja, Eduardo

    1962-02-01

    Full Text Available Planteada la necesidad de proceder a la ejecución del tramo central del puente en el Pasaje del Pedrido sobre la ría de Betanzos, y encontrándonos con que las armaduras para el mismo, que ya estaban acopiadas a pie de obra antes de la guerra, estaban totalmente no tuvimos inconveniente, puesto que habían de adquirirse de nuevo, en introducir algunas ligeras modificaciones sobre el proyecto anterior, a fin de reducir en lo posible el coste de la obra.

  3. Nonlocally Centralized Simultaneous Sparse Coding

    Institute of Scientific and Technical Information of China (English)

    雷阳; 宋占杰

    2016-01-01

    The concept of structured sparse coding noise is introduced to exploit the spatial correlations and nonlo-cal constraint of the local structure. Then the model of nonlocally centralized simultaneous sparse coding(NC-SSC)is proposed for reconstructing the original image, and an algorithm is proposed to transform the simultaneous sparse coding into reweighted low-rank approximation. Experimental results on image denoisng, deblurring and super-resolution demonstrate the advantage of the proposed NC-SSC method over the state-of-the-art image resto-ration methods.

  4. Inverting the central limit theorem

    CERN Document Server

    Navascues, Miguel; Villanueva, Ignacio

    2011-01-01

    The central limit theorem states that the sum of N independently distributed n-tuples of real variables (subject to appropriate normalization) tends to a multivariate gaussian distribution for large N. Here we propose to invert this argument: given a set of n correlated gaussian variables, we try to infer information about the structure of the discrete microscopic probability distributions whose convolution generated such a macroscopic behavior. The techniques developed along the article are applied to prove that the classical description of certain macroscopic optical experiments is infinitely more complex than the quantum one.

  5. Kalmanovitz y la banca central.

    OpenAIRE

    Maya M, Guillermo

    2011-01-01

    Salomón Kalmanovitz, Codirector del Banco de la República (B de la R) hasta enero de 2005, uno de los economistas colombianos más brillantes, publicó un libro titulado Ensayos sobre Banca Central, Comportamiento, Independencia e Historia (Norma, 2003). Si los estudiantes de economía de los años 70 y 80 estudiaron a un Kalmanovitz marxista, los estudiantes de hoy estudian a un economista ortodoxo y liberal, igualmente brillante. Kalmanovitz es un partidario de la independencia de la BC para la...

  6. Distributed trace using central performance counter memory

    Science.gov (United States)

    Satterfield, David L.; Sexton, James C.

    2013-01-22

    A plurality of processing cores, are central storage unit having at least memory connected in a daisy chain manner, forming a daisy chain ring layout on an integrated chip. At least one of the plurality of processing cores places trace data on the daisy chain connection for transmitting the trace data to the central storage unit, and the central storage unit detects the trace data and stores the trace data in the memory co-located in with the central storage unit.

  7. Capitalizing Central Banks: A Net Worth Approach

    OpenAIRE

    Alain Ize

    2005-01-01

    This paper provides a simple, quantitative, net worth-based, approach to assessing the need for central bank capital. It derives a concept of "core capital" (a function of the central bank's operating expenditures and the carrying cost of its international reserves) as the minimum capital needed by a central bank to ensure the credibility of its inflation target. The approach is illustrated with the published accounts of three loss-making central banks and selected accounting entries for a br...

  8. The European Central Bank and the Eurosystem

    OpenAIRE

    Carol C. Bertaut

    2002-01-01

    The Eurosystem comprises the European Central Bank at its center as well as the national central banks of the twelve countries currently participating in monetary union. The European Central Bank was established in July 1998, six months before the beginning of Stage Three of economic and monetary union. Although decisions regarding monetary policy are made centrally by the Governing Council of the Eurosystem, the operational aspects of monetary policy-including open market operations, adminis...

  9. Legal and actual central bank independence

    OpenAIRE

    Artha, I.K.D.S.; de Haan, J.

    2010-01-01

    Indicators of central bank independence (CBI) based on the interpretation central bank laws in place may not capture the actual independence of the central bank. This paper develops an indicator of actual independence of the Bank Indonesia (BI), the central bank of Indonesia, for the period 1953-2008 and compares it with a new legal CBI indicator based on Cukierman (1992). The indicator of actual independence captures institutional and economic factors that affect CBI. We find that before 199...

  10. Cetoacidosis alcohólica y complicaciones neurológicas reversibles de la hipofosfatemia Alcoholic ketoacidosis and reversible neurological complications due to hypophosphataemia

    Directory of Open Access Journals (Sweden)

    M.ª T. Fernández López

    2012-06-01

    hypophosphataemia, hypomagnesemia, hypocalcemia, hypokalemia, metabolic acidosis and respiratory alkalosis. Disturbance of consciousness in alcoholic patients is observed in several disorders, such drunkenness, Wernicke encephalopathy, alcohol withdrawal syndrome, central pontine myelinolysis, hepatic encephalopathy, hypoglucemia and electrolyte disorders.

  11. Central bank independence and inflation revisited

    NARCIS (Netherlands)

    Klomp, Jeroen; de Haan, Jakob

    2010-01-01

    We re-examine the relationship between central bank independence (CBI), proxied by the central bank governor's turnover rate and an indicator based on central bank laws in place, and inflation using a random coefficient model with the Hildreth-Houck estimator for more than 100 countries in the perio

  12. "Christofest" New Yorgi Central Parkis / Rael Artel

    Index Scriptorium Estoniae

    Artel, Rael, 1980-

    2004-01-01

    12. II 2005. a. avatakse Christo ja Jeanne-Claude'i keskkonnainstallatsioon "The Gates" New Yorgi Central Parkis. Paralleelselt toimub Metropolitan Muuseumis näitus "Christo and Jeanne-Claude : The Gates, Central Park, New York", kus eksponeeritakse Central Parki installatsiooni ettevalmistavaid materjale: joonistusi, diagramme, fotosid jne

  13. Precipitation chemistry in central Amazonia

    Science.gov (United States)

    Andreae, M. O.; Talbot, R. W.; Berresheim, H.; Beecher, K. M.

    1990-01-01

    Rain samples from three sites in central Amazonia were collected over a period of 6 weeks during the 1987 wet season and analyzed for ionic species and dissolved organic carbon. A continuous record of precipitation chemistry and amount was obtained at two of these sites, which were free from local or regional pollution, for a time period of over 1 month. The volume-weighted mean concentrations of most species were found to be about a factor of 5 lower during the wet season compared with previous results from the dry season. Only sodium, potassium, and chloride showed similar concentrations in both seasons. When the seasonal difference in rainfall amount is taken into consideration, the deposition fluxes are only slightly lower for most species during the wet season than during the dry season, again with the exception of chloride, potassium, and sodium. Sodium and chloride are present in the same ratio as in sea salt; rapid advection of air masses of marine origin to the central Amazon Basin during the wet season may be responsible for the observed higher deposition flux of these species. Statistical analysis suggests that sulfate is, to a large extent, of marine (sea salt and biogenic) origin, but that long-range transport of combustion-derived aerosols also makes a significant contribution to sulfate and nitrate levels in Amazonian rain. Organic acid concentrations in rain were responsible for a large fraction of the observed precipitation acidity; their concentration was strongly influenced by gas/liquid interactions.

  14. Glial involvement in trigeminal central sensitization

    Institute of Scientific and Technical Information of China (English)

    Yu-feng XIE

    2008-01-01

    Recent studies have indicated that trigeminal neurons exhibit central sensitization, an increase in the excitability of neurons within the central nervous system to the extent that a normally innocuous stimulus begins to produce pain after inflamma-tion or injury, and that glial activities play a vital role in this central sensitization. The involvement of glial cells in trigeminal central sensitization contains multiple mechanisms, including interaction with glutamatergic and purinergic receptors. A better understanding of the trigeminal central sensitization mediated by glial cells will help to find potential therapeutic targets and lead to developing new analge-sics for orofacial-specific pain with higher efficiency and fewer side-effects.

  15. Central Solenoid Insert Technical Specification

    Energy Technology Data Exchange (ETDEWEB)

    Martovetsky, Nicolai N [ORNL; Smirnov, Alexandre [ORNL

    2011-09-01

    The US ITER Project Office (USIPO) is responsible for the ITER central solenoid (CS) contribution to the ITER project. The Central Solenoid Insert (CSI) project will allow ITER validation the appropriate lengths of the conductors to be used in the full-scale CS coils under relevant conditions. The ITER Program plans to build and test a CSI to verify the performance of the CS conductor. The CSI is a one-layer solenoid with an inner diameter of 1.48 m and a height of 4.45 m between electric terminal ends. The coil weight with the terminals is approximately 820 kg without insulation. The major goal of the CSI is to measure the temperature margin of the CS under the ITER direct current (DC) operating conditions, including determining sensitivity to load cycles. Performance of the joints, ramp rate sensitivity, and stability against thermal or electromagnetic disturbances, electrical insulation, losses, and instrumentation are addressed separately and therefore are not major goals in this project. However, losses and joint performance will be tested during the CSI testing campaign. The USIPO will build the CSI that will be tested at the Central Solenoid Model Coil (CSMC) Test Facility at the Japan Atomic Energy Agency (JAEA), Naka, Japan. The industrial vendors (the Suppliers) will report to the USIPO (the Company). All approvals to proceed will be issued by the Company, which in some cases, as specified in this document, will also require the approval of the ITER Organization. Responsibilities and obligations will be covered by respective contracts between the USIPO, called Company interchangeably, and the industrial Prime Contractors, called Suppliers. Different stages of work may be performed by more than one Prime Contractor, as described in this specification. Technical requirements of the contract between the Company and the Prime Contractor will be covered by the Fabrication Specifications developed by the Prime Contractor based on this document and approved by

  16. 76 FR 22746 - Wiregrass Central Railway, LLC-Acquisition and Operation Exemption-Wiregrass Central Railroad...

    Science.gov (United States)

    2011-04-22

    ... Surface Transportation Board Wiregrass Central Railway, LLC--Acquisition and Operation Exemption--Wiregrass Central Railroad Company, Inc. Wiregrass Central Railway, LLC (WCR), a noncarrier, has filed a verified notice of exemption under 49 CFR 1150.31 to acquire from Wiregrass Central Railroad Company,...

  17. Central Exclusive Production at LHCb

    CERN Document Server

    McNulty, Ronan

    2016-01-01

    Central Exclusive Production (CEP) is a unique process at hadron machines in which particles are produced via colourless propagators. LHCb have measured the cross-sections for the CEP of vector mesons, $J/\\psi,\\psi(2S),\\Upsilon(1S),\\Upsilon(2S)$ and $\\Upsilon(3S)$, which are photo-produced. In the double pomeron exchange process, preliminary measurements have been made of $\\chi_{c0},\\chi_{c1}, \\chi_{c2}$ meson production while the first observations of the CEP of pairs of charmonia, $J/\\psi J/\\psi$ and $J/\\psi \\psi(2S)$, have been made and limits obtained on the pair production of other charmonia.

  18. Centralized Allocation in Multiple Markets

    DEFF Research Database (Denmark)

    Monte, Daniel; Tumennasan, Norovsambuu

    The problem of allocating indivisible objects to different agents, where each indi vidual is assigned at most one object, has been widely studied. Pápai (2000) shows that the set of strategy-proof, nonbossy, Pareto optimal and reallocation-proof rules are hierarchical exchange rules | generalizat......The problem of allocating indivisible objects to different agents, where each indi vidual is assigned at most one object, has been widely studied. Pápai (2000) shows that the set of strategy-proof, nonbossy, Pareto optimal and reallocation-proof rules are hierarchical exchange rules...... | generalizations of Gale's Top Trading Cycles mechanism. We study the centralized allocation that takes place in multiple markets. For example, the assignment of multiple types of indivisible objects; or the assignment of objects in successive periods. We show that the set of strategy-proof, Pareto efficient...

  19. CST-01-Central Standard Timing

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    薄如蝉翼名为CentralStandardTiming的工作室推出了E—ink材质代号为CST-01的手表,其厚度仅为0.8mm,号称全球最薄。一次充电10分钟便可连续使用15年。该手表屏幕由多层柔性材料构成。整体十分轻巧并且可弯曲,腕带则采用了柔性不锈钢材质。CST-01的预售价格为129美元。约合人民币800元,目前已经在著名的集资网站Kickstarter上创建项目。

  20. 类固醇激素反应性慢性淋巴细胞性炎症伴脑桥血管周围强化症一例临床及影像学分析%Clinical and imaging characteristics of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids: one case report

    Institute of Scientific and Technical Information of China (English)

    周雁; 崔丽英; 倪俊; 孙青; 彭斌; 魏妍平

    2013-01-01

    Objective Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently described brainstem-predominant inflammatory disorder responsive to steroids with characteristic magnetic resonance imaging(MRI) feature.There was no case report in China.The aim of this study was to characterize the clinical and imaging patterns of CLIPPERS for early diagnosis and treatment.Method Clinical and imaging data and therapeutic methods and following up after treatment of 1 patient diagnosed CLIPPERS were reviewed retrospectively.Results The patient presented with subacute weakness of the lower extremities,gait ataxia and facial numbness.Cerebellar ataxia and pyramidal signs were the main positive signs on neurological examinations.Brain MRI showed punctate gadolinium enhancement peppering the pons and cerebellar.Treatment with steroids led to rapid clinical improvement and marked resolution of MRI lesions which accorded with characteristics of CLIPPERS.Conclusions There are no characteristic clinical manifestations of CLIPPERS.Punctate gadolinium enhancement peppering the pons is the distinct magnetic resonance imaging feature which may suggest the clinical diagnosis of CLIPPERS.Early treatment with steroids can improve the prognosis.%目的 类固醇激素反应性慢性淋巴细胞性炎症伴脑桥血管周围强化症(CLIPPERS)是新近提出的一种激素治疗有效、以脑干受累为主、具有特征性影像改变的中枢神经系统炎症性病变,经检索,国内尚未见报道.我们报道1例,旨在提高认识,以利早期诊断和治疗.方法 回顾性分析l例CLIPPERS患者的临床、影像特点,以及治疗和预后随访情况.结果 该例患者临床表现为双下肢无力、行走不稳、头面部麻木,体检主要表现小脑体征和锥体束征,影像学显示双侧脑桥、小脑半球多发病变;增强扫描呈“胡椒粉”样斑点状或者线样强化,符合CLIPPERS的特点,激素

  1. Banco Central de Costa Rica

    Directory of Open Access Journals (Sweden)

    Sauter, Franz

    1963-06-01

    Full Text Available This new building is intended to house the various services of the Central Bank of Costa Rica. It has a prestressed concrete structure, and consists of a basement parking space for 105 vehicles, and nine storeys, providing altogether a floor surface of 12,000 ms2. The building rests on a ground area of 40 by 60 ms, and the main structure occupies 22 by 45 ms. This Bank is located in a district of narrow streets, but its main side overlooks a green open space, which will improve its visibility and appearance. The building structure is made up of a framework of prestressed beams and columns. The beams have been concreted at the site, and the joists, which are also prestressed, are factory made. This framework, at each floor level, constitutes the basis of a continuous slab, which renders the total structure exceedingly stiff. The main continuous girders span 11.22 ms spaces, and vary in cross section. The prestressing reinforcements consist of 6 Loeba type cables. This is an original design by Dr. Leonhardt, in which the cables are placed on three horizontal layers, of parabolic outline. Each cable is made up of 12 x 5.4 mm wires, with a breaking stress of 180 kg/mm2 The tensioning stress was 108 kg/mm2, and the total prestress load is 29,700 kgs. The cables run in corrugated metal tubes, and these were kept in precise position with the aid of distance pieces.El nuevo edificio, destinado a agrupar los servicios del Banco Central de Costa Rica, está constituido por una estructura de hormigón pretensado. El inmueble dispone de un sótano, estacionamiento propio para 105 vehículos y nueve plantas, con una superficie total de 12.000 metros cuadrados. Se asienta sobre una base de 40x60 m, donde se levanta un núcleo central de 22x45 metros. Está situado en un barrio de calles estrechas, pero tiene su fachada, principal frente a una zona verde que le proporcionará mayor categoría y visibilidad. La estructura se compone de una retícula de vigas

  2. ITER Central Solenoid Module Fabrication

    Energy Technology Data Exchange (ETDEWEB)

    Smith, John [General Atomics, San Diego, CA (United States)

    2016-09-23

    The fabrication of the modules for the ITER Central Solenoid (CS) has started in a dedicated production facility located in Poway, California, USA. The necessary tools have been designed, built, installed, and tested in the facility to enable the start of production. The current schedule has first module fabrication completed in 2017, followed by testing and subsequent shipment to ITER. The Central Solenoid is a key component of the ITER tokamak providing the inductive voltage to initiate and sustain the plasma current and to position and shape the plasma. The design of the CS has been a collaborative effort between the US ITER Project Office (US ITER), the international ITER Organization (IO) and General Atomics (GA). GA’s responsibility includes: completing the fabrication design, developing and qualifying the fabrication processes and tools, and then completing the fabrication of the seven 110 tonne CS modules. The modules will be shipped separately to the ITER site, and then stacked and aligned in the Assembly Hall prior to insertion in the core of the ITER tokamak. A dedicated facility in Poway, California, USA has been established by GA to complete the fabrication of the seven modules. Infrastructure improvements included thick reinforced concrete floors, a diesel generator for backup power, along with, cranes for moving the tooling within the facility. The fabrication process for a single module requires approximately 22 months followed by five months of testing, which includes preliminary electrical testing followed by high current (48.5 kA) tests at 4.7K. The production of the seven modules is completed in a parallel fashion through ten process stations. The process stations have been designed and built with most stations having completed testing and qualification for carrying out the required fabrication processes. The final qualification step for each process station is achieved by the successful production of a prototype coil. Fabrication of the first

  3. Performance contracting in central government in Denmark

    DEFF Research Database (Denmark)

    Kristiansen, Mads Bøge

    2015-01-01

    in organisational structure, tasks, culture and time with performance contracts is expected to affect the contract content, hypotheses on variation across agencies are deduced. The empirical basis of the paper is a study of all performance contracts between parent ministries and subordinate agencies in Danish......This paper looks into performance contracting in Danish central government. Management by Objectives and Results (MBOR) was adopted in central government in Denmark during the 1980s and early 1990s. In 1991, performance contracts between parent ministries and their agencies were introduced...... in Danish central government. Since their introduction, performance contracts have become central elements in the steering and management of agencies in central government in Denmark, and today they are nearly universally adopted in central government. In Denmark, the Ministry of Finance is responsible...

  4. Hirsch index as a network centrality measure

    CERN Document Server

    Campiteli, Monica G; Soles, Paulo R C; Soares, Leonardo H D; Kinouchi, Osame

    2010-01-01

    We study the h Hirsch index as a local node centrality measure for complex networks in general. The h index is compared with the Degree centrality (a local measure), the Betweenness and Eigenvector centralities (two non-local measures) in the case of a biological network (Yeast interaction protein-protein network) and a linguistic network (Moby Thesaurus II) as test environments. In both networks, the Hirsch index has poor correlation with Betweenness centrality but correlates well with Eigenvector centrality, specially for the more important nodes that are relevant for ranking purposes, say in Search Machine Optimization. In the thesaurus network, the h index seems even to outperform the Eigenvector centrality measure as evaluated by simple linguistic criteria.

  5. A matrix analysis of different centrality measures

    CERN Document Server

    Benzi, Michele

    2013-01-01

    Node centrality measures including degree, eigenvector, Katz and subgraph centralities are analyzed for both undirected and directed networks. We show how parameter-dependent measures, such as Katz and subgraph centrality, can be "tuned" to interpolate between degree and eigenvector centrality, which appear as limiting cases of the other measures. We interpret our finding in terms of the local and global influence of a given node in the graph as measured by graph walks of different length through that node. Our analysis gives some guidance for the choice of parameters in Katz and subgraph centrality, and provides an explanation for the observed correlations between different centrality measures and for the stability exhibited by the ranking vectors for certain parameter ranges. The important role played by the spectral gap of the adjacency matrix is also highlighted.

  6. Reduced central blood volume in cirrhosis

    DEFF Research Database (Denmark)

    Bendtsen, F; Henriksen, Jens Henrik Sahl; Sørensen, T I

    1989-01-01

    for measuring the central blood volume. We have developed a method that enables us to determine directly the central blood volume, i.e., the blood volume in the heart cavities, lungs, and central arterial tree. In 60 patients with cirrhosis and 16 control subjects the central blood volume was assessed according......The pathogenesis of ascites formation in cirrhosis is uncertain. It is still under debate whether the effective blood volume is reduced (underfilling theory) or whether the intravascular compartment is expanded (overflow theory). This problem has not yet been solved because of insufficient tools...... to the kinetic theory as the product of cardiac output and mean transit time of the central vascular bed. Central blood volume was significantly smaller in patients with cirrhosis than in controls (mean 21 vs. 27 ml/kg estimated ideal body weight, p less than 0.001; 25% vs. 33% of the total blood volume, p less...

  7. Market strategies for Central American dry beans.

    OpenAIRE

    Mertínez, Lourdes; Bernsten, Richard; Zamora, Miguel

    2004-01-01

    In the past few years, the dry bean sub-sector in CentralAmerica has witnessed many dynamic changes. Unless wefind ways to increase the competitiveness of the regionalbean sub-sector, Central American countries will likelyexperience significant negative social and economic impacts,especially since these countries are facing the challenge ofadjusting to new open markets, such as the Central AmericanFree Trade Agreement (CAFTA). Bean traders, retailers, andknowledgeable government official in C...

  8. Transpleural central venous catheter discovered during thoracotomy

    Directory of Open Access Journals (Sweden)

    Ashima Malhotra

    2014-01-01

    Full Text Available We report an uncommon complication of subclavian central venous catheterization, discovered at thoracotomy. The central venous catheter (CVC was placed by left infraclavicular route after induction of general anesthesia. CVC was secured after aspiration of blood and satisfactory central venous tracing. On thoracotomy, CVC was noticed to traverse the pleural cavity while the tracing was normal. CVC was thus removed consequent to which bleeding from each puncture site was noticed, that were secured surgically.

  9. The Centrality of Organization Design

    Directory of Open Access Journals (Sweden)

    Raymond E. Miles

    2012-05-01

    Full Text Available I am excited about this new journal focused on the subject of organization design. In my view, organization design is a central issue in the field of management. Designing an organization requires an understanding of strategy, as we pointed out some time ago (Miles & Snow, 1978. For example, if you want to be a prospector (a first-mover strategy, you have to design your firm to move quickly in new directions, which is likely to require that it be arranged so that various kinds of teams can interact across organizational units and levels. Designing an organization to follow a first-mover strategy also requires both an understanding of leadership and a commitment to the free flow of information throughout the organization. Leaders must understand how cross-functional teams pursue ideas and opportunities, and they must facilitate collaborative knowledge sharing to drive innovations that help the firm operate entrepreneurially. Because an organization is a complex, dynamic system, perhaps no other single topic is so deeply implanted at the core of management, organization theory, and organizational behavior as organization design. Moreover, organization design once was, and could be again, the topic of an ongoing dialogue between managers and academics focused on business organizations.

  10. Maximal switchability of centralized networks

    Science.gov (United States)

    Vakulenko, Sergei; Morozov, Ivan; Radulescu, Ovidiu

    2016-08-01

    We consider continuous time Hopfield-like recurrent networks as dynamical models for gene regulation and neural networks. We are interested in networks that contain n high-degree nodes preferably connected to a large number of N s weakly connected satellites, a property that we call n/N s -centrality. If the hub dynamics is slow, we obtain that the large time network dynamics is completely defined by the hub dynamics. Moreover, such networks are maximally flexible and switchable, in the sense that they can switch from a globally attractive rest state to any structurally stable dynamics when the response time of a special controller hub is changed. In particular, we show that a decrease of the controller hub response time can lead to a sharp variation in the network attractor structure: we can obtain a set of new local attractors, whose number can increase exponentially with N, the total number of nodes of the nework. These new attractors can be periodic or even chaotic. We provide an algorithm, which allows us to design networks with the desired switching properties, or to learn them from time series, by adjusting the interactions between hubs and satellites. Such switchable networks could be used as models for context dependent adaptation in functional genetics or as models for cognitive functions in neuroscience.

  11. Towards a centralized Grid Speedometer

    Energy Technology Data Exchange (ETDEWEB)

    Dzhunov, I. [CERN; Andreeva, J. [CERN; Fajardo, E.; Gutsche, O.; Luyckx, S.; Saiz, P. [CERN

    2014-01-01

    Given the distributed nature of the Worldwide LHC Computing Grid and the way CPU resources are pledged and shared around the globe, Virtual Organizations (VOs) face the challenge of monitoring the use of these resources. For CMS and the operation of centralized workflows, the monitoring of how many production jobs are running and pending in the Glidein WMS production pools is very important. The Dashboard Site Status Board (SSB) provides a very flexible framework to collect, aggregate and visualize data. The CMS production monitoring team uses the SSB to define the metrics that have to be monitored and the alarms that have to be raised. During the integration of CMS production monitoring into the SSB, several enhancements to the core functionality of the SSB were required, They were implemented in a generic way, so that other VOs using the SSB can exploit them. Alongside these enhancements, there were a number of changes to the core of the SSB framework. This paper presents the details of the implementation and the advantages for current and future usage of the new features in SSB.

  12. Towards a centralized Grid Speedometer

    CERN Document Server

    Gutsche, Oliver

    2013-01-01

    Given the distributed nature of the grid and the way CPU resources are pledged and scared around the globe, VOs are facing the challenge to monitor the use of these resources. For CMS and the operation of centralized workflows the monitoring of how many production jobs are running and pending in the Glidein WMS production pools is very important. The Dashboard SSB (Site Status Board) provides a very flexible framework to collect, aggregate and visualize data. The CMS production monitoring team uses the SSB to define the metrics that have to be monitored and the alarms that have to be set. During the integration of the CMS production monitoring into the SSB, several enhancements to the core functionality of the SSB were implemented; all in a generic way, so that other VOs using the SSB can use them as well. Alongside these enhancements, there were a few changes to the core of the SSB framework from which the CMS production team was able to benefit. We will present the details of the implementation and the adva...

  13. [Aniseikonia of central serous chorioretinopathy].

    Science.gov (United States)

    Hisada, H; Awaya, S

    1992-03-01

    Central serous chorioretinopathy (CRS) is one of the typical diseases that accompany micropsia. However very little is known about micropsia of CRS, because of the difficulty to measure "aniseikonia" in terms of micropsia. Aniseikonia in 65 cases of CRS was measured quantitatively by Awaya's New Aniseikonia Tests (NAT). The tests were performed at two different distances of 40 cm (visual angle: 6 degrees) and 20 cm (12 degrees) and under 4 meridians of the halfmoon on NAT, horizontal, 45 degrees, vertical and 135 degrees, respectively. The mean value of aniseikonia under each testing condition was as follows: 6 degrees horizontal -3.13%, 45 degrees -2.56%, vertical -2.13%, 135 degrees -2.57%, 12 degrees; horizontal -1.38%, 45 degrees -1.69%, vertical -1.84%, 135 degrees -1.50%. At 6 degrees aniseikonia is larger in the horizontal meridian than in the vertical with statistical significance (t-test, p less than 0.05), while at 12 degrees aniseikonia is smaller than at 6 degrees and shows no particular tendency in terms of meridian. The phenomenon observed at 6 degrees may be what is called "oriented metamorphopsia".

  14. Concept of the central clip

    DEFF Research Database (Denmark)

    Alegria-Barrero, Eduardo; Chan, Pak Hei; Foin, Nicolas

    2014-01-01

    -risk surgical population with severe mitral regurgitation (MR). METHODS AND RESULTS: Patients with severe MR (3 or 4+) and high operative risk (as defined by logistic EuroSCORE) refused for conventional mitral valve repair were considered for MitraClip(®). The procedure was performed under general anaesthesia...... with transoesophageal echocardiographic (TOE) guidance. Device success was defined as placement of one or more MitraClips(®) with a reduction of MR to ≤2+. Patients were followed up clinically and with TOE at one month and one year. From September 2009 to March 2012, 43 patients with severe MR with a mean age of 74.......8±10.7 years (30 males, 13 females; mean logistic EuroSCORE 24.1±11, mean LVEF 47.5±18.5%; mean±SD) were treated. Median follow-up was 385 days (104-630; Q1-Q3). Device implantation success was 93%. All patients were treated following the central clip concept: 52.5% of MR was degenerative in aetiology and 47...

  15. Central venous line complications and tip detection

    Directory of Open Access Journals (Sweden)

    Ameneh Rezaee Gheshlaghi

    2015-06-01

    Full Text Available Central venous line is one of a creative instrument that saves human’s life in critical medical situation. Central venous line access is frequently involved in the disease management. It is used for rapid fluid therapy, transvenous pacemakers, infusion of some medications, hemodialysis or plasmapheresis and etc. Most of the emergency departments have some staffs that are trained for central venous line insertion but related complications occur during central venous line placement.Central venous line might have some complications and complication follow-up should be considered. Thromboembolism and infection are two important medical complications. Arterial puncture, hematoma, pneumothorax and hemothorax are mechanical Central venous line complications. Chest X-ray and some other techniques should be used for detecting these complications.Central venous line tip misplace is a considerable problem for emergency department staffs, previously chest X-ray has been used for central venous line misplace detection. In some recent studies, contrast-enhanced ultrasonography and intravascular electrocardiography have been used for central venous line misplace.

  16. A global central banker competency model

    Directory of Open Access Journals (Sweden)

    David W. Brits

    2014-02-01

    Full Text Available Orientation: No comprehensive, integrated competency model exists for central bankers. Due to the importance of central banks in the context of the ongoing global financial crisis, it was deemed necessary to design and validate such a model.Research purpose: To craft and validate a comprehensive, integrated global central banker competency model (GCBCM and to assess whether central banks using the GCBCM for training have a higher global influence.Motivation for the study: Limited consensus exists globally about what constitutes a ‘competent’ central banker. A quantitatively validated GCBCM would make a significant contribution to enhancing central banker effectiveness, and also provide a solid foundation for effective people management.Research approach, design and method: A blended quantitative and qualitative research approach was taken. Two sets of hypotheses were tested regarding the relationships between the GCBCM and the training offered, using the model on the one hand, and a central bank’s global influence on the other.Main findings: The GCBCM was generally accepted across all participating central banks globally, although some differences were found between central banks with higher and lower global influence. The actual training offered by central banks in terms of the model, however, is generally limited to technical-functional skills. The GCBCM is therefore at present predominantly aspirational. Significant differences were found regarding the training offered.Practical/managerial implications: By adopting the GCBCM, central banks would be able to develop organisation-specific competency models in order to enhance their organisational capabilities and play their increasingly important global role more effectively.Contribution: A generic conceptual framework for the crafting of a competency model with evaluation criteria was developed. A GCBCM was quantitatively validated.

  17. Haemangiopericytoma of central nervous system

    Energy Technology Data Exchange (ETDEWEB)

    Borg, M.F.; Benjamin, C.S. [Auckland Hospital, Auckland (New Zealand). Dept. of Clinical Oncology

    1995-02-01

    The records of four patients presenting with a histological diagnosis of haemangiopericytoma of the central nervous system, in Auckland, New Zealand, between 1970 and 1990 were reviewed retrospectively, with the aim of determining the natural history of the disease and response to various treatment modalities. Three out of the four patients reviewed presented with primary cerebral disease and the fourth with a primary spinal cord tumour. All three cerebral primary patients were initially treated with local surgical excision. All three patients received radical radiotherapy following local recurrence. The first two patients remained disease-free locally although one patient developed a solitary liver metastasis 5 years after radiotherapy. The third patient was referred with multiple cerebral metastases and failed to respond to radiotherapy. The patient with the primary lesion in the spinal cord was treated with local excision followed by postoperative radiotherapy and remains disease-free 17 years after treatment. One patient failed to respond to chemotherapy, prescribed to treat a local recurrence adjacent to the previous radiotherapy field. This was successfully excised subsequently. The patient presenting with multiple cerebral metastases was the only patient to die of this disease. Results suggest that local recurrence is avoidable with adequate wide excision of the primary tumour followed by local radical radiotherapy. The role of chemotherapy remains controversial and no conclusion could be drawn regarding the role of palliative radiotherapy from this study. Active treatment and long-term follow-up are necessary because of the relative aggressiveness of this disease and the propensity for late relapses. 22 refs., 2 tabs., 6 figs.

  18. Tethyan evolution of central Asia

    Energy Technology Data Exchange (ETDEWEB)

    Sengor, A.M.C. (Instanbul Technical Univ. (Turkey))

    1990-05-01

    The study area extends from the eastern shores of the Caspian Sea in the west to the Helan Shan and Longmen Shan in the east and from about 40{degree}N parallel in the north to the neo-Tethyan sutures in the south, thus including what is called Middle Asia in the Soviet literature. In the region thus delineated lies the boundary between the largely late Paleozoic core of Asia (Altaids) and the Tethyside superorogenic complex. This boundary passes through continental objects that collided with nuclear Asia in the late Paleozoic to terminate its Altaid evolution. Subduction to the south of some of these had commenced before they collided (e.g., Tarim in the Kuen-Lun), in others later (e.g., South Ghissar area west of Pamirs). This subduction 1ed, in the late Paleozoic, to the opening of marginal basins, at least one of which may be partly extant (Tarim). Giant subduction accretion complexes of Paleozoic to earliest Triassic age dominate farther south in the basement of Turan (mainly in Turkmenian SSR) and in the Kuen-Lun/Nan Shan ranges. No discrete continental collisions or any continental basement in these regions could be unequivocally recognized contrary to most current interpretations. Magmatic arcs that developed along the southern margin of Asia in the late Paleozoic to early Mesozoic grew atop these subduction-accretion complexes and record a gradual southerly migration of magmatism through time. Subduction also dominated the northern margin of Gondwanaland between Iran and China in late Paleozoic time, although the record in Afghanistan and northwest Tibet is scrappy. It led to back-arc basin formation, which in Iran and Oman became neo-Tethys and, in at least parts of central Asia, the Waser-Mushan-Pshart/Banggong Co-Nu Jiang ocean. This ocean was probably connected with the Omani part of the neo-Tethys via the Sistan region.

  19. Digital data sets that describe aquifer characteristics of the Central Oklahoma aquifer in central Oklahoma

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This data set consists of digitized polygons of a constant hydraulic conductivity value for the Central Oklahoma aquifer in central Oklahoma. This area encompasses...

  20. Digital data sets that describe aquifer characteristics of the Central Oklahoma aquifer in central Oklahoma

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This data set consists of digitized water-level elevation contours for the Central Oklahoma aquifer in central Oklahoma. This area encompasses all or part of...

  1. Digital data sets that describe aquifer characteristics of the Central Oklahoma aquifer in central Oklahoma

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This data set consists of digitized aquifer boundaries created for a previously published report about the Central Oklahoma aquifer in central Oklahoma. This area...

  2. Digital data sets that describe aquifer characteristics of the Central Oklahoma aquifer in central Oklahoma

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This data set consists of digitized polygons of a constant recharge value for the Central Oklahoma aquifer in central Oklahoma. This area encompasses all or part of...

  3. Novel central nervous system drug delivery systems.

    Science.gov (United States)

    Stockwell, Jocelyn; Abdi, Nabiha; Lu, Xiaofan; Maheshwari, Oshin; Taghibiglou, Changiz

    2014-05-01

    For decades, biomedical and pharmaceutical researchers have worked to devise new and more effective therapeutics to treat diseases affecting the central nervous system. The blood-brain barrier effectively protects the brain, but poses a profound challenge to drug delivery across this barrier. Many traditional drugs cannot cross the blood-brain barrier in appreciable concentrations, with less than 1% of most drugs reaching the central nervous system, leading to a lack of available treatments for many central nervous system diseases, such as stroke, neurodegenerative disorders, and brain tumors. Due to the ineffective nature of most treatments for central nervous system disorders, the development of novel drug delivery systems is an area of great interest and active research. Multiple novel strategies show promise for effective central nervous system drug delivery, giving potential for more effective and safer therapies in the future. This review outlines several novel drug delivery techniques, including intranasal drug delivery, nanoparticles, drug modifications, convection-enhanced infusion, and ultrasound-mediated drug delivery. It also assesses possible clinical applications, limitations, and examples of current clinical and preclinical research for each of these drug delivery approaches. Improved central nervous system drug delivery is extremely important and will allow for improved treatment of central nervous system diseases, causing improved therapies for those who are affected by central nervous system diseases.

  4. Central Life Interests and Job Satisfaction.

    Science.gov (United States)

    Dubin, Robert; And Others

    Data on central life interests (CLI) and five aspects of job satisfaction were obtained in a sample of bluecollar males and two samples of clerical females. Both a multiple discriminant analysis and a bivariate analysis were performed. The results of these analyses showed that central life interest was significantly related to the total set of job…

  5. International Regulation of Central Arctic Ocean Fisheries

    NARCIS (Netherlands)

    Molenaar, E.J.

    2016-01-01

    Due in particular to the impacts of climate change, the adequacy of the international regulation of Central Arctic Ocean fisheries has come under increasing scrutiny in recent years. As shown in this article, however, international regulation of Central Arctic Ocean fisheries is by no means entirely

  6. An unusual Complication of Central Venous Cannulation

    Directory of Open Access Journals (Sweden)

    Ashvini Kumar

    2013-04-01

    Full Text Available Central venous catheter (CVC hub fracture is a rare complication of central venous cannulation. We report a case where catheter hub fracture was detected immediately after CVC insertion. Causes of catheter hub fracture and its complications are discussed.

  7. The Latino Experience in Central Falls

    Science.gov (United States)

    Holland, William R.

    2011-01-01

    Central Falls is, by far, the poorest community in Rhode Island. More than 40 percent of the children under 18 live in poverty, and 40 percent of that group live in severe poverty. At Central Falls High School, low-income Latino students have fallen behind their white counterparts, with shockingly low graduation, poor literacy, and low…

  8. Computing betweenness centrality in external memory

    DEFF Research Database (Denmark)

    Arge, Lars; Goodrich, Michael T.; Walderveen, Freek van

    2013-01-01

    Betweenness centrality is one of the most well-known measures of the importance of nodes in a social-network graph. In this paper we describe the first known external-memory and cache-oblivious algorithms for computing betweenness centrality. We present four different external-memory algorithms...

  9. Traveling Policies: Hijacked in Central Asia

    Science.gov (United States)

    Silova, Iveta

    2005-01-01

    Since the collapse of the Soviet Union, Central Asian education reform discourses have become increasingly similar to distinctive Western policy discourses traveling globally across national boundaries. Tracing the trajectory of "traveling policies" in Central Asia, this article discusses the way Western education discourses have been…

  10. China-Central Asia Power Cooperation Outlook

    Institute of Scientific and Technical Information of China (English)

    Luo

    2010-01-01

    After analyzing the basic information,distribution of energy resources and condition of power industry in Central Asia, the high feasibility for China to cooperate closely with Central Asia in transnational power interconnection, power investment and technology exchanges, etc. is studied. Furthermore, the forms, mechanisms, existing problems and suggestions for the improvement of current policies related to the power cooperation are proposed.

  11. An overview of CMS central hadron calorimeter

    CERN Document Server

    Katta, S

    2002-01-01

    The central hadron calorimeter for CMS detector is a sampling calorimeter with active medium as scintillator plates interleaved with brass absorber plates. It covers the central pseudorapidity region (¿ eta ¿<3.0). The design and construction aspects are reported. The status of construction and assembly of various subdetectors of HCAL are presented. (5 refs).

  12. The Cartan Matrix of a Centralizer Algebra

    Indian Academy of Sciences (India)

    Umesh V Dubey; Amritanshu Prasad; Pooja Singla

    2012-02-01

    The centralizer algebra of a matrix consists of those matrices that commute with it. We investigate the basic representation-theoretic invariants of centralizer algebras, namely their radicals, projective indecomposable modules, injective indecomposable modules, simple modules and Cartan matrices. With the help of our Cartan matrix calculations we determine their global dimensions. Many of these algebras are of infinite global dimension.

  13. Central bank independence and financial instability

    NARCIS (Netherlands)

    Klomp, J.G.; de Haan, J.

    2009-01-01

    It has been argued that central bank independence (CBI) may not only be beneficial for reaching the objective of price stability, but also for maintaining financial stability. Greater independence from external pressure implies that central banks are less politically constrained in acting to prevent

  14. A SCALED CENTRAL PATH FOR LINEAR PROGRAMMING

    Institute of Scientific and Technical Information of China (English)

    Ya-xiang Yuan

    2001-01-01

    Interior point methods are very efficient methods for solving large scale linear programming problems. The central path plays a very important role in interior point methods. In this paper we propose a new central path, which scales the variables. Thus it has the advantage of forcing the path to have roughly the same distance from each active constraint boundary near the solution.

  15. Traveling Policies: Hijacked in Central Asia

    Science.gov (United States)

    Silova, Iveta

    2005-01-01

    Since the collapse of the Soviet Union, Central Asian education reform discourses have become increasingly similar to distinctive Western policy discourses traveling globally across national boundaries. Tracing the trajectory of "traveling policies" in Central Asia, this article discusses the way Western education discourses have been hybridized…

  16. Central registry in psychiatry: A structured review

    Directory of Open Access Journals (Sweden)

    Jyoti Prakash

    2014-01-01

    Full Text Available Background: Central registry in psychiatry is being practiced in few countries and has been found useful in research and clinical management. Role of central registry has also expanded over the years. Materials and Methods: All accessible internet database Medline, Scopus, Embase were accessed from 1990 till date. Available data were systematically reviewed in structured manner and analyzed. Results: Central registry was found useful in epidemiological analysis, association studies, outcome studies, comorbidity studies, forensic issue, effective of medication, qualitative analysis etc., Conclusion: Central registry proves to be effective tool in quantitative and qualitative understanding of psychiatry practice. Findings of studies from central registry can be useful in modifying best practice and evidence based treatment in psychiatry.

  17. Central differences, Euler numbers and symbolic methods

    CERN Document Server

    Dowker, J S

    2013-01-01

    I relate some coefficients encountered when computing the functional determinants on spheres to the central differentials of nothing. In doing this I use some historic works, in particular transcribing the elegant symbolic formalism of Jeffery (1861) into central difference form which has computational advantages for Euler numbers, as discovered by Shovelton (1915). I derive sum rules for these, and for the central differentials, the proof of which involves an interesting expression for powers of sech x as multiple derivatives. I present a more general, symbolic treatment of central difference calculus which allows known, and unknown, things to be obtained in an elegant and compact fashion gaining, at no cost, the expansion of the powers of the inverse sinh, a basic central function. Systematic use is made of the operator 2 asinh(D/2). Umbral calculus is employed to compress the operator formalism. For example the orthogonality/completeness of the factorial numbers, of the first and second kinds, translates, ...

  18. Central station market development strategies for photovoltaics

    Science.gov (United States)

    1980-01-01

    Federal market development strategies designed to accelerate the market penetration of central station applications of photovoltaic energy system are analyzed. Since no specific goals were set for the commercialization of central station applications, strategic principles are explored which, when coupled with specific objectives for central stations, can produce a market development implementation plan. The study includes (1) background information on the National Photovoltaic Program, photovoltaic technology, and central stations; (2) a brief market assessment; (3) a discussion of the viewpoints of the electric utility industry with respect to solar energy; (4) a discussion of commercialization issues; and (5) strategy principles. It is recommended that a set of specific goals and objectives be defined for the photovoltaic central station program, and that these goals and objectives evolve into an implementation plan that identifies the appropriate federal role.

  19. Centrality and economic development in the Rijnland region: social and spatial concepts of centrality

    NARCIS (Netherlands)

    Van Nes, A.

    2007-01-01

    In urban research, spatial and social concepts of centrality are being distinguished. From a spatial point of view, metrical centrality implies that something is located in the middle of an area. However, metrical and topological centrality are not equivalent. In research where space syntax methods

  20. XNAT Central: Open sourcing imaging research data.

    Science.gov (United States)

    Herrick, Rick; Horton, William; Olsen, Timothy; McKay, Michael; Archie, Kevin A; Marcus, Daniel S

    2016-01-01

    XNAT Central is a publicly accessible medical imaging data repository based on the XNAT open-source imaging informatics platform. It hosts a wide variety of research imaging data sets. The primary motivation for creating XNAT Central was to provide a central repository to host and provide access to a wide variety of neuroimaging data. In this capacity, XNAT Central hosts a number of data sets from research labs and investigative efforts from around the world, including the OASIS Brains imaging studies, the NUSDAST study of schizophrenia, and more. Over time, XNAT Central has expanded to include imaging data from many different fields of research, including oncology, orthopedics, cardiology, and animal studies, but continues to emphasize neuroimaging data. Through the use of XNAT's DICOM metadata extraction capabilities, XNAT Central provides a searchable repository of imaging data that can be referenced by groups, labs, or individuals working in many different areas of research. The future development of XNAT Central will be geared towards greater ease of use as a reference library of heterogeneous neuroimaging data and associated synthetic data. It will also become a tool for making data available supporting published research and academic articles.

  1. Betweenness Centrality in Some Classes of Graphs

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Raghavan Unnithan

    2014-01-01

    Full Text Available There are several centrality measures that have been introduced and studied for real-world networks. They account for the different vertex characteristics that permit them to be ranked in order of importance in the network. Betweenness centrality is a measure of the influence of a vertex over the flow of information between every pair of vertices under the assumption that information primarily flows over the shortest paths between them. In this paper we present betweenness centrality of some important classes of graphs.

  2. Central Serous Chorioretinopathy after Solar Eclipse Viewing

    Directory of Open Access Journals (Sweden)

    Allie Lee

    2010-01-01

    Full Text Available Purpose: To report a case of central serous chorioretinopathy after solar eclipse viewing. Case Report: A middle-age man developed a sudden-onset unilateral scotoma after viewing a partial solar eclipse in Hong Kong. Fundus examination, fluorescein angiography, and optical coherence tomography showed features compatible with central serous chorioretinopathy. The patient was managed conservatively and reevaluated periodically. Serial optical coherence tomographic evaluations demonstrated an initial increase in the amount of subretinal fluid which spontaneously resolved 10 weeks after the onset of symptoms. Conclusion: This case demonstrates the possibility of development of central serous chorioretinopathy following solar eclipse viewing.

  3. [Functional anatomy of the central nervous system].

    Science.gov (United States)

    Krainik, A; Feydy, A; Colombani, J M; Hélias, A; Menu, Y

    2003-03-01

    The central nervous system (CNS) has a particular regional functional anatomy. The morphological support of cognitive functions can now be depicted using functional imaging. Lesions of the central nervous system may be responsible of specific symptoms based on their location. Current neuroimaging techniques are able to show and locate precisely macroscopic lesions. Therefore, the knowledge of functional anatomy of the central nervous system is useful to link clinical disorders to symptomatic lesions. Using radio-clinical cases, we present the functional neuro-anatomy related to common cognitive impairments.

  4. Central black hole masses of galaxies

    Institute of Scientific and Technical Information of China (English)

    樊军辉

    2003-01-01

    In this paper, the stellar velocity dispersions in the host galaxies are used to estimate the central black hole masses for a sample of elliptical galaxies. We find that the central black hole masses are in the range of 10(5.5-9.5) M(○). Based on the estimated masses in this paper and those by Woo & Urry (2002) and the measured host galaxy absolute magnitude,a relation, log(MBH/M(○)) = -(0.25 ± 4.3 × 10-3)MR + (2.98 4 0.208) is found for central black hole mass and the host galaxy magnitude. Some discussions are presented.

  5. Erroneous laboratory values obtained from central catheters.

    Science.gov (United States)

    Johnston, J B; Messina, M

    1991-01-01

    Serious analytic errors in potassium measurements have been identified in blood specimens obtained from newly inserted central catheters. Erroneous elevated readings have been related to interactions of chemistry analyzer electrodes and substances fixed to external and intraluminal walls of the central catheter. Anecdotal summaries of this phenomenon are presented to enable the nurse to recognize potential problems when sampling blood from central catheters. Studies were performed to determine the amount of flush necessary to clear the catheter of interfering residue. To eliminate this potentially hazardous occurrence, recommended flush volumes, nursing implications, and actions are described.

  6. Genetics Home Reference: central precocious puberty

    Science.gov (United States)

    ... difference in gene activation is caused by a phenomenon called genomic imprinting. Because only the copy of ... cause the disorder. When passed from parent to child, the condition is known as familial central precocious ...

  7. 1999 Yellow River Aerial Photos, Central Wisconsin

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The 25-mile stretch of the Yellow River adjacent to the Necedah National Wildlife Refuge in Central Wisconsin provides valuable habitat to numerous species of...

  8. Red wine, arterial stiffness and central hemodynamics.

    Science.gov (United States)

    Karatzi, Kalliopi; Papaioannou, Theodore G; Papamichael, Christos; Lekakis, John; Stefanadis, Christodoulos; Zampelas, Antonis

    2009-01-01

    Red wine is considered to reduce cardiovascular risk and decrease peripheral systolic and diastolic blood pressure. Central aortic pressures are often more sensitive clinical and prognostic factors than peripheral pressures, while arterial stiffness is an independent prognostic factor for cardiovascular events. Great efforts are being made to find natural sources of improving health. In order to clarify the mechanisms under which a widely used drink, like red wine, is affecting heart and vessels, we aimed to review the available data regarding the effects of red wine on arterial stiffness, wave reflections and central blood pressures. The effect of red wine on central hemodynamics has been poorly explored with divergent results. Possible consequences of acute and long-term intake on arterial stiffness, wave reflections and central pressures are not clear. This might make someone skeptical when suggesting the consumption of a glass of red wine, although its cardioprotective actions (when moderately consumed) are already shown from epidemiological studies.

  9. NCI Central Review Board Receives Accreditation

    Science.gov (United States)

    The Association for the Accreditation of Human Research Protection Programs has awarded the NCI Central Institutional Review Board full accreditation. AAHRPP awards accreditation to organizations demonstrating the highest ethical standards in clinical res

  10. Random walk centrality in interconnected multilayer networks

    CERN Document Server

    Solé-Ribalta, Albert; Gómez, Sergio; Arenas, Alex

    2015-01-01

    Real-world complex systems exhibit multiple levels of relationships. In many cases they require to be modeled as interconnected multilayer networks, characterizing interactions of several types simultaneously. It is of crucial importance in many fields, from economics to biology and from urban planning to social sciences, to identify the most (or the less) influential nodes in a network using centrality measures. However, defining the centrality of actors in interconnected complex networks is not trivial. In this paper, we rely on the tensorial formalism recently proposed to characterize and investigate this kind of complex topologies, and extend two well known random walk centrality measures, the random walk betweenness and closeness centrality, to interconnected multilayer networks. For each of the measures we provide analytical expressions that completely agree with numerically results.

  11. Central Gulf of Alaska Rockfish Permit Program

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The North Pacific Fishery Management Council adopted the Central Gulf of Alaska Rockfish Program (Rockfish Program) on June 14, 2010, to replace the expiring Pilot...

  12. California Black Rail - Central Delta [ds17

    Data.gov (United States)

    California Department of Resources — Results of taped-call black rail surveys of in-stream habitat within certain waterways in the central Sacramento / San Joaquin Delta during 1992 and 1993. TIME...

  13. Central Asian Snow Cover from Hydrometeorological Surveys

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Central Asian Snow Cover from Hydrometeorological Surveys data are based on observations made by personnel for three river basins: Amu Darya, Sir Darya, and...

  14. Legume Diversity Patterns in West Central Africa

    NARCIS (Netherlands)

    Estrella, de la M.; Mateo, M.A.; Wieringa, J.J.; Mackinder, B.; Munoz, J.

    2012-01-01

    Objectives - Species Distribution Models (SDMs) are used to produce predictions of potential Leguminosae diversity in West Central Africa. Those predictions are evaluated subsequently using expert opinion. The established methodology of combining all SDMs is refined to assess species diversity withi

  15. Childhood Central Nervous System Embryonal Tumors Treatment

    Science.gov (United States)

    ... Cord Tumors Treatment Childhood Astrocytomas Treatment Childhood Brain Stem Glioma ... Central nervous system (CNS) embryonal tumors may begin in embryonic (fetal) cells that remain in the brain after birth. ...

  16. NCPC Central Files Information System (CFIS)

    Data.gov (United States)

    National Capital Planning Commission — This dataset contains records from NCPC's Central Files Information System (CFIS), which is a comprehensive database of projects submitted to NCPC for design review...

  17. Central respiratory failure during acute organophosphate poisoning.

    Science.gov (United States)

    Carey, Jennifer L; Dunn, Courtney; Gaspari, Romolo J

    2013-11-01

    Organophosphate (OP) pesticide poisoning is a global health problem with over 250,000 deaths per year. OPs affect neuronal signaling through acetylcholine (Ach) neurotransmission via inhibition of acetylcholinesterase (AChE), leading to accumulation of Ach at the synaptic cleft and excessive stimulation at post-synaptic receptors. Mortality due to OP agents is attributed to respiratory dysfunction, including central apnea. Cholinergic circuits are integral to many aspects of the central control of respiration, however it is unclear which mechanisms predominate during acute OP intoxication. A more complete understanding of the cholinergic aspects of both respiratory control as well as neural modification of pulmonary function is needed to better understand OP-induced respiratory dysfunction. In this article, we review the physiologic mechanisms of acute OP exposure in the context of the known cholinergic contributions to the central control of respiration. We also discuss the potential central cholinergic contributions to the known peripheral physiologic effects of OP intoxication.

  18. Alluvial Boundary of California's Central Valley

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This digital dataset defines the extent of the alluvial deposits in the Central Valley of California and encompasses the contiguous Sacramento, San Joaquin, and...

  19. Shattering and Compressing Networks for Centrality Analysis

    CERN Document Server

    Sarıyüce, Ahmet Erdem; Kaya, Kamer; Çatalyürek, Ümit V

    2012-01-01

    Who is more important in a network? Who controls the flow between the nodes or whose contribution is significant for connections? Centrality metrics play an important role while answering these questions. The betweenness metric is useful for network analysis and implemented in various tools. Since it is one of the most computationally expensive kernels in graph mining, several techniques have been proposed for fast computation of betweenness centrality. In this work, we propose and investigate techniques which compress a network and shatter it into pieces so that the rest of the computation can be handled independently for each piece. Although we designed and tuned the shattering process for betweenness, it can be adapted for other centrality metrics in a straightforward manner. Experimental results show that the proposed techniques can be a great arsenal to reduce the centrality computation time for various types of networks.

  20. Earthquakes in Central California, 1980-1984

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — There have been many earthquake occurrences in central California. This set of slides shows earthquake damage from the following events: Livermore, 1980, Coalinga,...

  1. Veterans Affairs Central Cancer Registry (VACCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Veterans Affairs Central Cancer Registry (VACCR) receives and stores information on cancer diagnosis and treatment constraints compiled and sent in by the local...

  2. Miniaturized Airborne Imaging Central Server System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The innovation is a miniaturized airborne imaging central server system (MAICSS). MAICSS is designed as a high-performance-computer-based electronic backend that...

  3. Miniaturized Airborne Imaging Central Server System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The innovation is a miniaturized airborne imaging central server system (MAICSS). MAICSS is designed as a high-performance computer-based electronic backend that...

  4. Central Bank Transparency: Causes, Consequences and Updates

    OpenAIRE

    Nergiz Dincer; Barry Eichengreen

    2009-01-01

    We present updated estimates of central bank for 100 countries up through 2006 and use them to analyze both the determinants and consequences of monetary policy transparency in an integrated econometric framework. We establish that there has been significant movement in the direction of greater central bank transparency in recent years. Transparent monetary policy arrangements are more likely in countries with strong and stable political institutions. They are more likely in democracies, with...

  5. Economic Dimensions of Security in Central Asia

    Science.gov (United States)

    2006-01-01

    dollars worth of illegal or unregistered cash, most of it associated with narcotics trafficking and unreported remittances from migrant labor , is...Economic Dimensions of Security in Central Asia month on some construction sites.32 Remittances from legal migrant labor are part of the Central Asian...farms and construction sites,36 since they rarely have any le- gal standing. Also, income from migrant labor is usually barely suffi- cient to cover

  6. "Shadow Banking: Policy Challenges for Central Banks"

    OpenAIRE

    Moe, Thorvald Grung

    2014-01-01

    Central banks responded with exceptional liquidity support during the financial crisis to prevent a systemic meltdown. They broadened their tool kit and extended liquidity support to nonbanks and key financial markets. Many want central banks to embrace this expanded role as "market maker of last resort" going forward. This would provide a liquidity backstop for systemically important markets and the shadow banking system that is deeply integrated with these markets. But how much liquidity su...

  7. Central odontogenic fibroma of the simple type

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Eui Hwan; Lee, Sang Rae [Department of Oral and Maxillofacial Radiology, College of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    2002-12-15

    The central odontogenic fibroma is a rare benign neoplasm, and considered to be derived from the mesenchymal tissue of dental origin. It is a poorly defined tumor of the jawbones which has only been infrequently reported in the literature. We report a histologically proven case of simple-type central odontogenic fibroma, which affected the left canine-premolar region of the maxilla in a 52-year-old woman.

  8. Entrapment of guidewire during central venous catheterization

    Directory of Open Access Journals (Sweden)

    Tarun S.

    2016-07-01

    Full Text Available Central venous catheterization (CVC is common in the setting of ICU for various reasons like monitoring of CVP, fluid administration and vasopressor or drug infusions. Guidewires are routinely used in the Seldinger technique during central venous catheter placement CVC placement is not innocuous as numerous complications may occur, with varying frequency and severity. [Int J Res Med Sci 2016; 4(7.000: 3080-3081

  9. A handbook for solar central receiver design

    Energy Technology Data Exchange (ETDEWEB)

    Falcone, P.K.

    1986-12-01

    This Handbook describes central receiver technology for solar thermal power plants. It contains a description and assessment of the major components in a central receiver system configured for utility scale production of electricity using Rankine-cycle steam turbines. It also describes procedures to size and optimize a plant and discussed examples from recent system analyses. Information concerning site selection criteria, cost estimation, construction, and operation and maintenance is also included, which should enable readers to perform design analyses for specific applications.

  10. Midwifery education in Central-Eastern Europe.

    Science.gov (United States)

    Mivšek, Polona; Baškova, Martina; Wilhelmova, Radka

    2016-02-01

    Problems in midwifery in many Central-Eastern European countries are very similar; it is possible to speak about the evolving Central-Eastern model of midwifery care. The educational models of this region have a relatively strong theoretical part; however, there is an insufficient practical dimension. Theoretical part of midwifery education in the universities is relatively autonomous and is slowly changing the professional identity of graduates.

  11. Central Hemodynamics and Microcirculation in Critical Conditions

    Directory of Open Access Journals (Sweden)

    A. A. Kosovskikh

    2013-01-01

    Full Text Available Objective: to compare central hemodynamic and microcirculatory changes in critical conditions caused by different factors and to reveal their possible differences for a further differentiated approach to intensive therapy. Subjects and methods. The study covered 16 subjects with severe concomitant injury (mean age 41.96±2.83 years and 19 patients with general purulent peritonitis (mean age 45.34±2.16 years. Their follow-up was 7 days. The central hemodynamics was estimated by transpulmonary thermodilution using a Pulsion PiCCO Plus system (Pulsion Medical Systems, Germany. The microcirculatory bed was evaluated by cutaneous laser Doppler flowmetry using a LAKK-02 capillary blood flow laser analyzer (LAZMA Research-and-Production Association, Russian Federation. Results. The pattern of central hemodynamic and microcirculatory disorders varies with the trigger that has led to a critical condition. Central hemodynamics should be stabilized to ensure the average level of tissue perfusion in victims with severe concomitant injury. In general purulent peritonitis, microcirculatory disorders may persist even if the macrohemodynamic parameters are normal. Conclusion. The macrohemodynamic and microcirculatory differences obtained during the study suggest that a complex of intensive therapy should be differentiated and, if the latter is used, it is necessary not only to be based on the central hemodynamics, but also to take into consideration functional changes in microcirculation. Key words: severe concomitant injury, general purulent peritonitis, micro-circulation, central hemodynamics, type of circulation.

  12. Fast network centrality analysis using GPUs

    Directory of Open Access Journals (Sweden)

    Shi Zhiao

    2011-05-01

    Full Text Available Abstract Background With the exploding volume of data generated by continuously evolving high-throughput technologies, biological network analysis problems are growing larger in scale and craving for more computational power. General Purpose computation on Graphics Processing Units (GPGPU provides a cost-effective technology for the study of large-scale biological networks. Designing algorithms that maximize data parallelism is the key in leveraging the power of GPUs. Results We proposed an efficient data parallel formulation of the All-Pairs Shortest Path problem, which is the key component for shortest path-based centrality computation. A betweenness centrality algorithm built upon this formulation was developed and benchmarked against the most recent GPU-based algorithm. Speedup between 11 to 19% was observed in various simulated scale-free networks. We further designed three algorithms based on this core component to compute closeness centrality, eccentricity centrality and stress centrality. To make all these algorithms available to the research community, we developed a software package gpu-fan (GPU-based Fast Analysis of Networks for CUDA enabled GPUs. Speedup of 10-50× compared with CPU implementations was observed for simulated scale-free networks and real world biological networks. Conclusions gpu-fan provides a significant performance improvement for centrality computation in large-scale networks. Source code is available under the GNU Public License (GPL at http://bioinfo.vanderbilt.edu/gpu-fan/.

  13. Central auditory function of deafness genes.

    Science.gov (United States)

    Willaredt, Marc A; Ebbers, Lena; Nothwang, Hans Gerd

    2014-06-01

    The highly variable benefit of hearing devices is a serious challenge in auditory rehabilitation. Various factors contribute to this phenomenon such as the diversity in ear defects, the different extent of auditory nerve hypoplasia, the age of intervention, and cognitive abilities. Recent analyses indicate that, in addition, central auditory functions of deafness genes have to be considered in this context. Since reduced neuronal activity acts as the common denominator in deafness, it is widely assumed that peripheral deafness influences development and function of the central auditory system in a stereotypical manner. However, functional characterization of transgenic mice with mutated deafness genes demonstrated gene-specific abnormalities in the central auditory system as well. A frequent function of deafness genes in the central auditory system is supported by a genome-wide expression study that revealed significant enrichment of these genes in the transcriptome of the auditory brainstem compared to the entire brain. Here, we will summarize current knowledge of the diverse central auditory functions of deafness genes. We furthermore propose the intimately interwoven gene regulatory networks governing development of the otic placode and the hindbrain as a mechanistic explanation for the widespread expression of these genes beyond the cochlea. We conclude that better knowledge of central auditory dysfunction caused by genetic alterations in deafness genes is required. In combination with improved genetic diagnostics becoming currently available through novel sequencing technologies, this information will likely contribute to better outcome prediction of hearing devices.

  14. Dynamics-based centrality for directed networks

    Science.gov (United States)

    Masuda, Naoki; Kori, Hiroshi

    2010-11-01

    Determining the relative importance of nodes in directed networks is important in, for example, ranking websites, publications, and sports teams, and for understanding signal flows in systems biology. A prevailing centrality measure in this respect is the PageRank. In this work, we focus on another class of centrality derived from the Laplacian of the network. We extend the Laplacian-based centrality, which has mainly been applied to strongly connected networks, to the case of general directed networks such that we can quantitatively compare arbitrary nodes. Toward this end, we adopt the idea used in the PageRank to introduce global connectivity between all the pairs of nodes with a certain strength. Numerical simulations are carried out on some networks. We also offer interpretations of the Laplacian-based centrality for general directed networks in terms of various dynamical and structural properties of networks. Importantly, the Laplacian-based centrality defined as the stationary density of the continuous-time random walk with random jumps is shown to be equivalent to the absorption probability of the random walk with sinks at each node but without random jumps. Similarly, the proposed centrality represents the importance of nodes in dynamics on the original network supplied with sinks but not with random jumps.

  15. Community centrality and social science research.

    Science.gov (United States)

    Allman, Dan

    2015-12-01

    Community centrality is a growing requirement of social science. The field's research practices are increasingly expected to conform to prescribed relationships with the people studied. Expectations about community centrality influence scholarly activities. These expectations can pressure social scientists to adhere to models of community involvement that are immediate and that include community-based co-investigators, advisory boards, and liaisons. In this context, disregarding community centrality can be interpreted as failure. This paper considers evolving norms about the centrality of community in social science. It problematises community inclusion and discusses concerns about the impact of community centrality on incremental theory development, academic integrity, freedom of speech, and the value of liberal versus communitarian knowledge. Through the application of a constructivist approach, this paper argues that social science in which community is omitted or on the periphery is not failed science, because not all social science requires a community base to make a genuine and valuable contribution. The utility of community centrality is not necessarily universal across all social science pursuits. The practices of knowing within social science disciplines may be difficult to transfer to a community. These practices of knowing require degrees of specialisation and interest that not all communities may want or have.

  16. Making Central Banks Serve The Real Economy

    Directory of Open Access Journals (Sweden)

    Suleika Reiners

    2013-10-01

    Full Text Available The challenge is to redirect central bank money into the real economy and to the needs of society. If new money is issued to expand the productive capacity, there is no reason for inflation. Long-term financing could become available at an affordable price. Central bank money must not replace a sound tax system and the distribution of income and wealth, but complement them. The remaining task, apart from the financing of real needs, is the prevention of speculative asset price inflation. For this, central banks and regulators should install debt brakes for the financial sector. Furthermore, independent monetary policy calls for capital account management. It enables national central banks to find space for the conduct of their own policies in an interdependent global economy. Coordination between central banks and governments might increase as policies combine monetary, fiscal and regulatory facets. The future role of central banks should particularly lie in their insights regarding capital flows and leverage cycles and in their ability to create and withdraw money, depend­ing on economic conditions.

  17. Health challenges in Kazakhstan and Central Asia.

    Science.gov (United States)

    Adambekov, Shalkar; Kaiyrlykyzy, Aiym; Igissinov, Nurbek; Linkov, Faina

    2016-01-01

    The Central Asian region, which encompasses Kazakhstan, Uzbekistan, Tajikistan, Turkmenistan and Kyrgyzstan, is an interesting geographic region with a rich history dating back to the Silk Road, Mongol conquests and expansion of the Russian Empire. However, from a public health viewpoint, the Central Asian region is under-investigated, and many public health challenges exist, as countries of Central Asia inherited the centralised medical systems practiced in the Soviet Union, and are currently undergoing rapid transitions. A large number of low and middle-income countries around the world, including countries of Central Asia, face a double burden of chronic and infectious disease. This essay focuses on the exploration of the most important public health challenges in the Central Asian region, including limited scientific productivity, the double burden of chronic and infectious disease, the need for healthcare reform and the reduction in care variation. Central Asia has a large number of medical schools, medical centres, and emerging research institutes that can be used to foster a change in medical and public health practice in the region.

  18. Determinants of Central Adiposity among Iranian Population

    Directory of Open Access Journals (Sweden)

    Leila Azadbakht

    2013-03-01

    Full Text Available Background: Central obesity is one of the major public health problems. Recent studies have indicated that body fat distribution would be important in general health. Materials and Methods: The present study is a review of several studies which discuss the contributing factors of abdominal obesity, particulary in Iran. This study reviews 34 cross-sectional and interventional studies, which have been comducted during 1995-2012 and issued in English language. PubMed search engine and the related keywords were used to search the papers.Results: Breakfast skipping and also the sleep duration as well as the quality of diet are also associated with central adiposity. Dietary diversity score among Iranians can be related to abdominal adiposity. Fastfood consumption can increase the risk of central adiposity among young Iranian population. Red meat intake and food source of trans fat can increase the risk of central adiposity. Low quality diet with low amount of nutrients can increase the risk of central adiposity. Conclusion: Some behaviours such as sleep duration and eating breakfast can be associated with central adiposity among Iranians. Diet quality and dietary diversity score is also associated with this problem among Iranians.

  19. Market Information and Signaling in Central Bank Operations, or, How Often Should a Central Bank Intervene?

    OpenAIRE

    International Monetary Fund

    1997-01-01

    A central bank must decide on the frequency with which it will conduct open market operations and the variability in short-term money market that it will allow. The paper shows how the optimal operating procedure balances the value of attaining an immediate target and broadcasting the central bank's intentions against the informational advantages to the central bank of allowing the free play of market forces to reveal more of the information available to market participants.

  20. Central nervous system complications after liver transplantation.

    Science.gov (United States)

    Kim, Jeong-Min; Jung, Keun-Hwa; Lee, Soon-Tae; Chu, Kon; Roh, Jae-Kyu

    2015-08-01

    We investigated the diversity of central nervous system complications after liver transplantation in terms of clinical manifestations and temporal course. Liver transplantation is a lifesaving option for end stage liver disease patients but post-transplantation neurologic complications can hamper recovery. Between 1 January 2001 and 31 December 2010, patients who had undergone liver transplantation at a single tertiary university hospital were included. We reviewed their medical records and brain imaging data and classified central nervous system complications into four categories including vascular, metabolic, infectious and neoplastic. The onset of central nervous system complications was grouped into five post-transplantation intervals including acute (within 1 month), early subacute (1-3 months), late subacute (3-12 months), chronic (1-3 years), and long-term (after 3 years). During follow-up, 65 of 791 patients (8.2%) experienced central nervous system complications, with 30 occurring within 1 month after transplantation. Vascular etiology was the most common (27 patients; 41.5%), followed by metabolic (23; 35.4%), infectious (nine patients; 13.8%), and neoplastic (six patients). Metabolic encephalopathy with altered consciousness was the most common etiology during the acute period, followed by vascular disorders. An initial focal neurologic deficit was detected in vascular and neoplastic complications, whereas metabolic and infectious etiologies presented with non-focal symptoms. Our study shows that the etiology of central nervous system complications after liver transplantation changes over time, and initial symptoms can help to predict etiology.

  1. Dry needling - peripheral and central considerations.

    Science.gov (United States)

    Dommerholt, Jan

    2011-11-01

    Dry needling is a common treatment technique in orthopedic manual physical therapy. Although various dry needling approaches exist, the more common and best supported approach targets myofascial trigger points. This article aims to place trigger point dry needling within the context of pain sciences. From a pain science perspective, trigger points are constant sources of peripheral nociceptive input leading to peripheral and central sensitization. Dry needling cannot only reverse some aspects of central sensitization, it reduces local and referred pain, improves range of motion and muscle activation pattern, and alters the chemical environment of trigger points. Trigger point dry needling should be based on a thorough understanding of the scientific background of trigger points, the differences and similarities between active and latent trigger points, motor adaptation, and central sensitize application. Several outcome studies are included, as well as comments on dry needling and acupuncture.

  2. Retail Market Structure Development in Central Europe

    Directory of Open Access Journals (Sweden)

    Martin Machek

    2012-12-01

    Full Text Available This article is analyzing the trends and development in the retailing sector in Central Europe, namely in the Czech Republic, Hungary, Poland and Slovakia. These markets serve about 63 million inhabitants. The retail industry in Central Europe has changed dramatically in the last two decades, and has become a model for successful transformation of emerging markets. The retail market is highly concentrated and dominated by Western European retail chains. International retail chains are using all formats of modern distribution. This article is focusing on the development of hypermarkets, supermarkets and discount stores. Due to the international retail chains, Central European countries benefit from a dense network of modern shopping places; the intense competition of highly productive retailers contributes to the lower level of inflation rate because of the so-called Wal-Mart Effect. The constant pressure on prices influences the marketing strategies of both retailers and suppliers.

  3. Centralized rehabilitation after servere traumatic brain injury

    DEFF Research Database (Denmark)

    Engberg, Aase Worså; Liebach, Annette; Nordenbo, Annette Mosbæk

    2006-01-01

    OBJECTIVES: To present results from the first 3 years of centralized subacute rehabilitation after very severe traumatic brain injury (TBI), and to compare results of centralized versus decentralized rehabilitation. MATERIAL AND METHODS: Prospectively, the most severely injured group of adults from...... an uptake area of 2.4 million in Denmark were included at admission to a regional brain injury unit (BIU), on average 19 days after injury. Patients in the retrospective study used for comparison were randomly chosen from the national hospital register. RESULTS AND CONCLUSIONS: Out of 117 patients...... post-trauma was 0.29, and at 1 year 0.055 per 100,000 population. By comparison of 39 patients from the centralized unit injured in 2000-2003 with 21 patients injured in 1982, 1987 or 1992 and with similar PTA- and age distributions and male/female ratio, Glasgow Outcome Scale score at discharge...

  4. Angiotensin II during Experimentally Simulated Central Hypovolemia

    DEFF Research Database (Denmark)

    Jensen, Theo Walther; Olsen, Niels Vidiendal

    2016-01-01

    Central hypovolemia, defined as diminished blood volume in the heart and pulmonary vascular bed, is still an unresolved problem from a therapeutic point of view. The development of pharmaceutical agents targeted at specific angiotensin II receptors, such as the non-peptidergic AT2-receptor agonist...... of these agents in a hypovolemic setting. We argue that the latest debates on the effect of angiotensin II during hypovolemia might guide for future studies, investigating the effect of such agents during experimentally simulated central hypovolemia. The purpose of this review is to examine the role...... of angiotensin II during episodes of central hypovolemia. To examine this, we reviewed results from studies with three experimental models of simulated hypovolemia: head up tilt table test, lower body negative pressure, and hemorrhage of animals. A systemic literature search was made with the use of Pub...

  5. Central pain: definition, phisiopathology and therapy

    Directory of Open Access Journals (Sweden)

    Vincenzo Moschini

    2012-12-01

    Full Text Available Central pain is the expression of an injury and/or a primary or secondary dysfunction of the central nervous system.1 It is based on total or partial damage along the spinal-thalamic-cortical pathways and it may have cerebral or spinal origin. It has variable incidence according to its etiology: 8-10% in stroke patients, 30% in multiple sclerosis patients, 30-60% in paraplegic patients.2-3 At the spinal level, the most frequent causes are: traumatic injuries, cancer, plaques from multiple sclerosis, syringomyelia. In this review, we examine the main symptoms that contribute to confirm the diagnosis of central pain, neuropathic or thalamic. The presence of nerve injury, evaluated by neuroimaging and neurophysiological tests, allows us to complete the diagnostic picture.

  6. Generation of central exclusive final states

    CERN Document Server

    Lönnblad, Leif

    2016-01-01

    We present a scheme for the generation of central exclusive final states in the Pythia 8 program. The implementation allows for the investigation of higher order corrections to such exclusive processes as approximated by the initial-state parton shower in Pythia 8. To achieve this, the spin and colour decomposition of the initial-state shower has been worked out, in order to determine the probability that a partonic state generated from an inclusive sub-process followed by a series of initial-state parton splittings can be considered as an approximation of an exclusive colour- and spin-singlet process. We use our implementation to investigate effects of parton showers on some examples of central exclusive processes, and find sizeable effects on di-jet production, while the effects on e.g. central exclusive Higgs production are minor.

  7. Smart electromechanical systems the central nervous system

    CERN Document Server

    Kurbanov, Vugar

    2017-01-01

    This book describes approaches to solving the problems of developing the central nervous system of robots (CNSR) based on smart electromechanical systems (SEMS) modules, principles of construction of the various modules of the central nervous system and variants of mathematical software CNSR in control systems for intelligent robots. It presents the latest advances in theory and practice at the Russian Academy of Sciences. Developers of intelligent robots to solve modern problems in robotics are increasingly addressing the use of the bionic approach to create robots that mimic the complexity and adaptability of biological systems. These have smart electromechanical system (SEMS), which are used in various cyber-physical systems (CPhS), and allow the functions of calculation, control, communications, information storage, monitoring, measurement and control of parameters and environmental parameters to be integrated. The behavior of such systems is based on the information received from the central nervous syst...

  8. Centralized rehabilitation after servere traumatic brain injury

    DEFF Research Database (Denmark)

    Engberg, Aase Worså; Liebach, Annette; Nordenbo, Annette Mosbæk

    2006-01-01

    post-trauma was 0.29, and at 1 year 0.055 per 100,000 population. By comparison of 39 patients from the centralized unit injured in 2000-2003 with 21 patients injured in 1982, 1987 or 1992 and with similar PTA- and age distributions and male/female ratio, Glasgow Outcome Scale score at discharge......OBJECTIVES: To present results from the first 3 years of centralized subacute rehabilitation after very severe traumatic brain injury (TBI), and to compare results of centralized versus decentralized rehabilitation. MATERIAL AND METHODS: Prospectively, the most severely injured group of adults from...... an uptake area of 2.4 million in Denmark were included at admission to a regional brain injury unit (BIU), on average 19 days after injury. Patients in the retrospective study used for comparison were randomly chosen from the national hospital register. RESULTS AND CONCLUSIONS: Out of 117 patients...

  9. Central Venous Catheter-Related Hydrothorax

    Directory of Open Access Journals (Sweden)

    Se Hun Kim

    2015-11-01

    Full Text Available This report describes a case of 88-year-old women who developed central venous catheter-related bilateral hydrothorax, in which left pleural effusion, while right pleural effusion was being drained. The drainage prevented accumulation of fluid in the right pleural space, indicating that there was neither extravasation of infusion fluid nor connection between the two pleural cavities. The only explanation for bilateral hydrothorax in this case is lymphatic connections. Although vascular injuries by central venous catheter can cause catheter-related hydrothorax, it is most likely that the positioning of the tip of central venous catheter within the lymphatic duct opening in the right sub-clavian-jugular confluence or superior vena cava causes the catheter-related hydrothorax. Pericardial effusion can also result from retrograde lymphatic flow through the pulmonary lymphatic chains.

  10. Hydrogels for central nervous system therapeutic strategies.

    Science.gov (United States)

    Russo, Teresa; Tunesi, Marta; Giordano, Carmen; Gloria, Antonio; Ambrosio, Luigi

    2015-12-01

    The central nervous system shows a limited regenerative capacity, and injuries or diseases, such as those in the spinal, brain and retina, are a great problem since current therapies seem to be unable to achieve good results in terms of significant functional recovery. Different promising therapies have been suggested, the aim being to restore at least some of the lost functions. The current review deals with the use of hydrogels in developing advanced devices for central nervous system therapeutic strategies. Several approaches, involving cell-based therapy, delivery of bioactive molecules and nanoparticle-based drug delivery, will be first reviewed. Finally, some examples of injectable hydrogels for the delivery of bioactive molecules in central nervous system will be reported, and the key features as well as the basic principles in designing multifunctional devices will be described.

  11. Central functions of the orexinergic system

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yang Zhang; Lei Yu; Qian-Xing Zhuang; Jing-Ning Zhu; Jian-Jun Wang

    2013-01-01

    The neuropeptide orexin is synthesized by neurons exclusively located in the hypothalamus.However,these neurons send axons over virtually the entire brain and spinal cord and therefore constitute a unique central orexinergic system.It is well known that central orexin plays a crucial role in the regulation of various basic non-somatic and somatic physiological functions,including feeding,energy homeostasis,the sleep/wake cycle,reward,addiction,and neuroendocrine,as well as motor control.Moreover,the absence of orexin results in narcolepsy-cataplexy,a simultaneous somatic and non-somatic dysfunction.In this review,we summarize these central functions of the orexinergic system and associated diseases,and suggest that this system may hold a key position in somatic-non-somatic integration.

  12. 75 FR 14436 - Ameren Corporation, Illinois Power Company, Central Illinois Light Company, Central Illinois...

    Science.gov (United States)

    2010-03-25

    ... Energy Regulatory Commission Ameren Corporation, Illinois Power Company, Central Illinois Light Company, Central Illinois Public Service Company, Ameren Energy Resources Company, LLC, AmerenEnergy Resources Generating Company; Notice of Filing March 18, 2010. Take notice that on March 15, 2010, Ameren...

  13. The primary Maxillary Central Incisor in the Solitary Median Maxillary Central Incisor syndrome

    DEFF Research Database (Denmark)

    Kjaer, I; Balslev-Olesen, M

    2012-01-01

    Solitary Median Maxillary Central Incisor (SMMCI) is a developmental anomaly in the permanent dentition with one single central incisor in the maxilla, positioned exactly in the midline. This condition has been associated with extra- and intraoral malformations in the frontonasal segment of the c...

  14. Actual versus perceived central bank transparency: the case of the European Central Bank

    NARCIS (Netherlands)

    van der Cruijsen, C.; Eijffinger, S.

    2008-01-01

    Central banks have become more and more transparent about their monetary policy making process. In the central bank transparency literature the distinction between actual and perceived transparency is often lacking. However, as perceptions are crucial for the actions of economic agents this distinct

  15. What Can We Learn from 15,000 Teachers in Central Europe and Central Asia?

    Science.gov (United States)

    Temple, Charles

    2000-01-01

    Describes the "Reading and Writing for Critical Thinking Project" which has now sent more than 70 volunteer teacher educators into 20 countries across Central Europe and Central Asia to help teachers to try out methods that foster active learning and critical thinking. Discusses support for the project, teaching strategies introduced,…

  16. Central Bank Independence, Centralization of Wage Bargaining, Inflation and Unemployment - Theory and Some Evidence

    NARCIS (Netherlands)

    Cukierman, A.; Lippi, F.

    1998-01-01

    This paper proposes a conceptual framework to investigate the effects of central bank independence, of the degree of centralization of wage bargaining and of the interaction between those institutional variables, on real wages, unemployment and inflation, in a framework in which unions are averse to

  17. A History of the Central Limit Theorem

    CERN Document Server

    Fischer, Hans

    2011-01-01

    This study discusses the history of the central limit theorem and related probabilistic limit theorems from about 1810 through 1950. In this context the book also describes the historical development of analytical probability theory and its tools, such as characteristic functions or moments. The central limit theorem was originally deduced by Laplace as a statement about approximations for the distributions of sums of independent random variables within the framework of classical probability, which focused upon specific problems and applications. Making this theorem an autonomous mathematical

  18. Central nervous system involvement in diabetic neuropathy.

    Science.gov (United States)

    Selvarajah, Dinesh; Wilkinson, Iain D; Davies, Jennifer; Gandhi, Rajiv; Tesfaye, Solomon

    2011-08-01

    Diabetic neuropathy is a chronic and often disabling condition that affects a significant number of individuals with diabetes. Long considered a disease of the peripheral nervous system, there is now increasing evidence of central nervous system involvement. Recent advances in neuroimaging methods detailed in this review have led to a better understanding and refinement of how diabetic neuropathy affects the central nervous system. Recognition that diabetic neuropathy is, in part, a disease that affects the whole nervous system is resulting in a critical rethinking of this disorder, opening a new direction for further research.

  19. Simulating central forces in the classroom

    CERN Document Server

    Aguirregabiria, Juan M

    2015-01-01

    We describe the easy to customize and extend open source Java program Central force workbench that can be used in the classroom to simulate the motion of a particle (or a two-body system) under central forces. It may be useful to illustrate problems in which the analytical solution is not available as well as to help students to grasp a more intuitive understanding of the main features of this kind of problem and to realize the exceptional nature of the particular case of Newtonian (and harmonic) forces. We also include some suggestions on how to use the program as a pedagogical tool.

  20. Peripheral and central mechanisms of stress resilience

    Directory of Open Access Journals (Sweden)

    Madeline L. Pfau

    2015-01-01

    Full Text Available Viable new treatments for depression and anxiety have been slow to emerge, likely owing to the complex and incompletely understood etiology of these disorders. A budding area of research with great therapeutic promise involves the study of resilience, the adaptive maintenance of normal physiology and behavior despite exposure to marked psychological stress. This phenomenon, documented in both humans and animal models, involves coordinated biological mechanisms in numerous bodily systems, both peripheral and central. In this review, we provide an overview of resilience mechanisms throughout the body, discussing current research in animal models investigating the roles of the neuroendocrine, immune, and central nervous systems in behavioral resilience to stress.

  1. Betweenness Centrality : Algorithms and Lower Bounds

    CERN Document Server

    Kintali, Shiva

    2008-01-01

    One of the most fundamental problems in large scale network analysis is to determine the importance of a particular node in a network. Betweenness centrality is the most widely used metric to measure the importance of a node in a network. In this paper, we present a randomized parallel algorithm, lower bounds and an algebraic method for computing betweenness centrality of all nodes in a network. We prove that any path comparison based algorithm cannot compute betweenness of all nodes in less than O(nm) time.

  2. Central odontogenic fibroma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [School of Dentistry, Busan National University, Busan (Korea, Republic of)

    2011-06-15

    Central odontogenic fibroma is a rare odontogenic neoplasm that originates from odontogenic ectomesenchyme. Here, a case of central odontogenic fibroma in a 17-year-old male is reported. Since the present case showed a multilocular radiolucency with partially ill-defined border between the right mandibular condyle and the distal root of the right mandibular third molar, differential diagnosis involved a wide range of pathosis from benign lesions like ameoloblastic fibroma and odontogenic myxoma to more aggressive lesions such as desmoplastic fibroma, juvenile aggressive fibromatosis, or fibrosarcoma.

  3. Incoerenza temporale e indipendenza della banca centrale

    Directory of Open Access Journals (Sweden)

    Bruno Jossa

    2012-04-01

    Full Text Available According to the author, the emphasis authors currently tend to place on the 'surprise effect' in order to argue for the independence of central banks is to a large extent unjustified. The main arguments for the independence of a cen-tral bank are others: firstly, the opinion that governments are induced to in-cur excessive expenditure due to reasons highlighted by public choice theo-rists and, secondly, the idea that inflation arises in connection with social conflict. Additionally, this study makes it clear that 'time inconsistency' theory is far from being a new way of stating old ideas.  JEL Codes: E58Keywords:

  4. [Centralization in obstetrics: pros and cons].

    Science.gov (United States)

    Roemer, V M; Ramb, S

    1996-01-01

    Possible advantages and disadvantages of a general centralization of German obstetric facilities are analysed in the study. The need for centralization of risk cases, especially premature births (regionalization) is pointed out. Centralization appears appropriate, since every fifth maternity unit in Germany (19.78%) has 300 or fewer deliveries per year. This one fifth of perinatal clinics accounts for 6.3% of all deliveries (N = 49450). There are appreciable differences between the old and new federal states (Bundesländer): in the recently acceded federal states, 48.7% of all perinatal clinics have deliveries of 300 and less per year. This group of perinatal clinics accounts for 29% of all deliveries in the new federal states. We have carried out a survey of the mother's attitude to centralization: out of 416 patients in the Detmold women's hospital whose mean age was 29.0 +/- 4.2 years, 90.4% were not in favor of general centralization of obstetrics. 43% were also against a centralization of risk cases (regionalization). 75% of the women surveyed objected to centralized obstetrics because of the 'possible absence of the family', the 'possible absence of students and trainees' (44.9%), the 'unfamiliarity with staff and premises' (41.8%) and 'fear of anonymity' (44.5%). The majority of all women (84.1%) did not want to have a drive more than 20 km to an obstetrics center. Fear of 'delivery in a taxi'(78.6%), the 'fear that the husband will come too late to the delivery' (65.4%) and that the 'overall course of the delivery might not be adequate for reasons of time'. The presence of a pediatrics department in conjunction with the perinatal clinic was rated very positively (93%). It is concluded from the data and further juridical considerations that centralization of risk cases (regionalization) is indispensable in the near future and that somewhat more further into the future decentralization should be carried out by closing obstetrics departments with substantially

  5. The Boolean algebra and central Galois algebras

    Directory of Open Access Journals (Sweden)

    George Szeto

    2001-01-01

    Full Text Available Let B be a Galois algebra with Galois group G, Jg={b∈B∣bx=g(xb   for all   x∈B} for g∈G, and BJg=Beg for a central idempotent eg. Then a relation is given between the set of elements in the Boolean algebra (Ba,≤ generated by {0,eg∣g∈G} and a set of subgroups of G, and a central Galois algebra Be with a Galois subgroup of G is characterized for an e∈Ba.

  6. MRI of central nervous system anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Izawa, M.; Oikawa, A.; Matoba, A.

    1987-05-01

    MRI was very useful in the evaluation of congenital anomalies of central nervous system as well as other nervous system disease with three-dimensional spatial resolution. We had experienced MRI of central nervous system anomalies, demonstrated characterisitic findings in each anomaly. MRI is useful to observe the coronal, horizontal and sagittal images of the brain and spinal cord in order to discuss the etiological mechanisms of spinal dysraphysm and its associated anomalies. In case of spina bifida cystica MRI was available to decide operative indication for radical operation and tetherd cord developed from postoperative scar or accompanied intraspinal lesions.

  7. China-Central Asia Friendship Association Founded

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>The China-Central Asia Friendship Association(CCAFA) held its inaugural meeting in Beijing on December 18,2007. The CCAFA,founded at the initiation of the CPAFFC,is a national non-profit social organization with legal person status.It aims to further expand people-to-people contact between China and the five Central Asian countries,namely Kazakhstan,Kirghizstan,Tajikistan,Turkmenistan and Uzbekistan,enhance regional cooperation and deepen good-neighbourly relations so as to consolidate the social foundation for lasting friendship between China and these countries and promote common development.

  8. Ichthyofauna of the reservoirs of Central Vietnam

    Directory of Open Access Journals (Sweden)

    I. A. Stolbunov

    2012-01-01

    Full Text Available Species composition, distribution and abundance of fish in the pelagic and littoral zone of four reservoirs of Central Vietnam (Suoi Chau, Kam Lam, Da Ban and Suoi Dau were studied first. According to the research data the fish community of the reservoirs is represented by 43 species of 19 fish families.

  9. Central Asia: A New Great Game?

    Science.gov (United States)

    2007-11-02

    southward from civil war, or of revolutionary slogans hitting a chord with Iran’s own ethnic minorities, can only be met by economic investment and reliance...concern, both public and private, over the impact of radiation drifting into Kazakhstan has also been quite vocal .108 Chinese concerns about Central

  10. Quantum Central Processing Unit and Quantum Algorithm

    Institute of Scientific and Technical Information of China (English)

    王安民

    2002-01-01

    Based on a scalable and universal quantum network, quantum central processing unit, proposed in our previous paper [Chin. Phys. Left. 18 (2001)166], the whole quantum network for the known quantum algorithms,including quantum Fourier transformation, Shor's algorithm and Grover's algorithm, is obtained in a unitied way.

  11. Intracranial calcification in central diabetes insipidus.

    Science.gov (United States)

    Al-Kandari, Salwa Ramadan; Pandey, Tarun; Badawi, Mona H

    2008-01-01

    Intracranial calcification is a known but extremely rare complication of diabetes insipidus. To date, only 16 patients have been reported and all had the peripheral (nephrogenic) type of diabetes insipidus. We report a child with intracranial calcification complicating central diabetes insipidus. We also report a child with nephrogenic diabetes insipidus, and compare the patterns of intracranial calcification.

  12. Intracranial calcification in central diabetes insipidus

    Energy Technology Data Exchange (ETDEWEB)

    Al-Kandari, Salwa R. [Al Razi Hospital, Department of Clinical Radiology, Kuwait (Kuwait); Pandey, Tarun [Al Razi Hospital, Department of Clinical Radiology, Kuwait (Kuwait); University of Arkansas for Medical Sciences, Radiology Department, Little Rock, AR (United States); Badawi, Mona H. [Al-Adan Hospital, Department of Paediatrics, Kuwait (Kuwait)

    2008-01-15

    Intracranial calcification is a known but extremely rare complication of diabetes insipidus. To date, only 16 patients have been reported and all had the peripheral (nephrogenic) type of diabetes insipidus. We report a child with intracranial calcification complicating central diabetes insipidus. We also report a child with nephrogenic diabetes insipidus, and compare the patterns of intracranial calcification. (orig.)

  13. Workers' Central Life Interests and Job Performance.

    Science.gov (United States)

    Dubin, Robert; Champoux, Joseph E.

    Supervisors' ratings of individual industrial workers appear to be related to the central life interests (CLI) of the workers. The group of workers who had a job-oriented CLI received the highest ratings from their superivsors among the three CLI groups on Initiative and Application, Cooperation and Quantity of Work and were rated low on…

  14. Dust on UA1 central detector

    CERN Multimedia

    1982-01-01

    In March 1982 the central derector of UA1 was contaminated by dirt in the compressed air used for cooling during the bakeout of the beam pipe. The lengthy cleaning imposed a change of the collider schedule (Annual Report 1982 p. 114).

  15. Central serotonin metabolism and frequency of depression

    NARCIS (Netherlands)

    Praag, H.M. van; Haan, S. de

    1979-01-01

    Central serotonin (5-hydroxytryptamine; 5-HT) metabolism can be disturbed in a subgroup of patients with vital (endogenous, primary) depression. Presumably these disturbances do not result from the depression and have a predisposing rather than a causative relationship to it. This latter statement i

  16. Betweenness centrality patterns in random planar graphs

    CERN Document Server

    Lion, Benjamin

    2016-01-01

    Random planar graphs appear in a variety of context and it is important for many different applications to be able to characterize their structure. Local quantities fail to give interesting information and it seems that path-related measures are able to convey relevant information about the organization of these structures. In particular, nodes with a large betweenness centrality (BC) display non-trivial patterns, such as loops of very central nodes. We discuss briefly empirical results for different random planar graphs and we propose a toy model which allows us to discuss the condition for the emergence of non-trivial patterns such as central loops. This toy model is made of a star network with $N_b$ branches of size $n$ and links of weight $1$, superimposed to a loop at distance $\\ell$ from the center and with links of weight $w$. We estimate for this model the BC at the center and on the loop and we show that the loop can be more central than the origin if $w

  17. Gabapentin inhibits central sensitization during migraine

    Institute of Scientific and Technical Information of China (English)

    Yanbo Zhang; Guo Shao; Wei Zhang; Sijie Li; Jingzhong Niu; Dongmei Hu; Mingfeng Yang; Xunming Ji

    2013-01-01

    Peripheral and central sensitizations are phenomena that occur during migraine. The role of pentin, a migraine preventive drug, on central sensitization remains unclear. In this study, a rat model of migraine was established by electrical stimulation of the trigeminal ganglion, and the an-imals were given intragastric gabapentin. Changes in amino acid content in the cerebrospinal fluid and protein kinase C membrane translocation in the spinal trigeminal nucleus were examined to clarify the mechanisms underlying the efficacy of gabapentin in the treatment of central sensitization during migraine. Electrophysiology, liquid chromatography-mass spectrometry and western blot analysis results revealed that gabapentin reduces neuronal excitability in the spinal nucleus in the trigeminal nerve, decreases excitatory amino acid content and inhibits the activation of protein ki-nase C. This provides evidence that excitatory amino acids and protein kinase C are involved in the formation and maintenance of central sensitization during migraine. Gabapentin inhibits migraine by reducing excitatory amino acid content in the cerebrospinal fluid and inhibiting protein kinase C ac-tivation.

  18. Ferrobasalts from the Central Indian Ocean Basin

    Digital Repository Service at National Institute of Oceanography (India)

    Iyer, S.D.; Mukhopadhyay, R.; Popko, D.C.

    The occurrence of ferrobasalts recovered from the Central Indian Ocean Basin crust generated at the Southeast Indian Ridge during a phase of moderate to fast spreading accretion (approx 110-190 mm/yr, full rate) is reported. FeO (13-19%), and Ti...

  19. Universities and Knowledge Production in Central Europe

    Science.gov (United States)

    Kwiek, Marek

    2012-01-01

    The article discusses an East/West divide in Europe in university knowledge production. It argues that the communist and post-communist legacies in the four major Central European economies studied (Poland, Hungary, the Czech Republic and the Slovak Republic) matter substantially for educational and research systems. The differences in university…

  20. The central limit theorem and chaos

    Institute of Scientific and Technical Information of China (English)

    NIU Ying-xuan

    2009-01-01

    Let X be a compact metric space and f : X → X be a continuous map. This paper studies some relationships between stochastic and topological properties of dynamical systems.It is shown that if f satisfies the central limit theorem, then f is topologically ergodic and f is sensitively dependent on initial conditions if and only if f is neither minimal nor equicontinuous.

  1. Award Winning Communication Programs: Centrality or Confusion?

    Science.gov (United States)

    Beadle, Mary E.; Schmidt, Jacqueline J.

    1999-01-01

    Presents a post hoc analysis of peer-identified excellent departments at small colleges (5,000 or fewer undergraduates) to discover if they suffer from a lack of centrality. Hopes that this information may be used to help departments plan curriculum, develop evaluation methods, or write mission statements to strengthen existing programs or defend…

  2. Central African Security: Conflict in the Congo

    Science.gov (United States)

    2002-01-01

    Alliances mouvantes et conflits extraterritoriaux en Afrique Centrale. Paris: L’Hamarttan. Jean-Claude Willame, Banyarwanda et Banyamulenge: Violence...ethnique et gestion de l’identitaire au Kivu. Paris; L’Harmattan, 1997. Crawford Young, “Zaire: The Anatomy of a Failed State,” in David Birmingham & Phyllis

  3. Performance Management in Dutch Central Government

    NARCIS (Netherlands)

    Mol, Nico P.; Kruijf, de Johan A.M.

    2004-01-01

    This article investigates how and to what extent performance indicators in Dutch central government are actually embedded in performance management. In a case study encompassing 12 government organizations, the relevance of the indicators presented is analysed in three stages: (1) with respect to th

  4. Imaging of the fetal central nervous system

    NARCIS (Netherlands)

    Pistorius, L.R.

    2008-01-01

    Introduction : Ultrasound and MR imaging of the fetal central nervous system (CNS) develop at an ever-increasing rate. Theoretically, the two modalities should be synergistic, but a literature review revealed the difficulties of determining the merit of either technique and revealed gaps in our know

  5. Superficial siderosis in the central nervous system

    Energy Technology Data Exchange (ETDEWEB)

    Pythinen, J. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology; Paeaekkoe, E. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology; Ilkko, E. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology

    1995-02-01

    We describe a rare entity, superficial siderosis of the central nervous system, due to multiple small episodes of subarachnoid haemorrhage from any source. Non-specific neurological findings are associated with deposition of iron-containing pigments in the leptomeninges and superficial layers of the cortex. T2-weighted magnetic resonance imaging demonstrates characteristic low signal in the meninges. (orig.)

  6. Ablated tektite from the central Indian Ocean

    Digital Repository Service at National Institute of Oceanography (India)

    Glass, B.P.; Chapman, D.R.; ShyamPrasad, M.

    , if it originated in Southeast Asia, it must have had a very shallow trajectory (only a few degrees) and a velocity on the order of 7 km/s as it re-entered the atmosphere. The central Indian Ocean tektite is compositionally similar to high-magnesium (HMg...

  7. The ultimate determinants of central bank independence

    NARCIS (Netherlands)

    Eijffinger, S.C.W.; Schaling, E.

    1995-01-01

    Using a graphical method, a new way of determining the optimal degree of central bank conservativeness is developed in this paper. Unlike Lohmann (1992) and Rogoff (1985), we are able to express the upper and lower bounds of the interval containing the optimal degree of conservativeness in terms of

  8. Stochastic modelling of central heating systems

    DEFF Research Database (Denmark)

    Hansen, Lars Henrik

    1997-01-01

    and the degree Erhvervsforsker (a special Danish degree, equivalent to ``Industrial Ph.D.''). The thesis is mainly concerned with experimental design and system identification for individual components in water based central heating systems. The main contribution to this field is on the nonlinear dynamic...

  9. The Marstal Central Solar Heating Plant

    DEFF Research Database (Denmark)

    Heller, Alfred; Jochen, Dahm

    1999-01-01

    The central solar heating plant in Marstal is running since 1996 and has been monitored since. The resulting data from the plant is analysed and the plant performance evaluated. A TRNSYS-model (computersimulation) id prepared and validated based on the measured data from the plant. Acceptable good...

  10. Central Computer IMS Processing System (CIMS).

    Science.gov (United States)

    Wolfe, Howard

    As part of the IMS Version 3 tryout in 1971-72, software was developed to enable data submitted by IMS users to be transmitted to the central computer, which acted on the data to create IMS reports and to update the Pupil Data Base with criterion exercise and class roster information. The program logic is described, and the subroutines and…

  11. Radiologic placement of tunneled central venous catheter

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Seong Tae; Yang, Po Song; Yang, Dong Hunn; Kim, Ki Tae; Kim, Choon Yul; Shinn, Kyung Sub [The Catholic Univ. College of Medicine, Seoul (Korea, Republic of); Yun, Eun Joo [Korea Veterans Hospital, Seoul (Korea, Republic of)

    1996-01-01

    To evaluate the efficacy and safety of fluoroscopy-guided, radiologic placement of a tunneled central venous catheter into the superior vena cava (SVC). Thirty five patients underwent tunneled central venous catheter placement to facilitate long-term chemotherapy. They included 33 leukemic patients, one colon cancer patient, and one multiple myeloma patient. After confirming central venous patency with a injection of contrast media via the peripheral cephalic or basilic vein in the wrist joint, the subclavian vein was punctured under fluoroscopic guidance. A 7F double lumen TPN catheter was placed into the SVC through a subcutaneous tunnel in the anterior chest wall. Catheter placements were successful in all patients. The mean procedure time was 17.2minutes, mean fluooscopy time was 1.3minutes, mean number of punctures was 1.4, and mean volume of injhected contrast media was 43.5cc. Only two of all leukemic patients developed mild hematomas at the puncture site, but these soon resolved themselves. None of the patients developed pneumothorax or hemothorax. But late complications included local infection in two patients (6%) and thrombotic occlusion of the catheter in one (3%). The occluded catheter was successfully recanalized with Urokinase infusion. Fluoroscopy-guided, radiologic placement of a tunneled central venous catheter is an easy and safe method, and useful for patients requiring long-term venous access.

  12. Central Limit Theorem for Coloured Hard Dimers

    Directory of Open Access Journals (Sweden)

    Maria Simonetta Bernabei

    2010-01-01

    Full Text Available We study the central limit theorem for a class of coloured graphs. This means that we investigate the limit behavior of certain random variables whose values are combinatorial parameters associated to these graphs. The techniques used at arriving this result comprise combinatorics, generating functions, and conditional expectations.

  13. The quantum human central neural system.

    Science.gov (United States)

    Alexiou, Athanasios; Rekkas, John

    2015-01-01

    In this chapter we present Excess Entropy Production for human aging system as the sum of their respective subsystems and electrophysiological status. Additionally, we support the hypothesis of human brain and central neural system quantumness and we strongly suggest the theoretical and philosophical status of human brain as one of the unknown natural Dirac magnetic monopoles placed in the center of a Riemann sphere.

  14. Gravimetric maps of the Central African Republic

    Science.gov (United States)

    Albouy, J.; Godivier, R. (Principal Investigator)

    1982-01-01

    Gravimetric maps of the Central African Republic are described including a map of Bouguer anomalies at 1/1,000,000 in two sections (eastern sheet, western sheet) and a map, in color, of Bouguer anomalies at 1/2,000,000. Instrumentation, data acquisition, calibration, and data correction procedures are discussed.

  15. Primary Angiitis Of The Central Nervous System

    Directory of Open Access Journals (Sweden)

    Sundaram Meenakshi

    2001-01-01

    Full Text Available An unusual case of primary angiitis of central nervous system (PACNS presenting with headache, seizures and focal deficits is presented. Despite multiple lesions noted on brain MRI, definitive diagnosis required a brain biopsy. A high index of clinical suspicious and the utility of brain biopsy for diagnosis are emphasized.

  16. Hypersensitivity Responses in the Central Nervous System

    DEFF Research Database (Denmark)

    Khorooshi, Reza; Asgari, Nasrin; Mørch, Marlene Thorsen

    2015-01-01

    of pathology in neuromyelitis optica (NMO), a central nervous system (CNS) demyelinating disease where activated neutrophils infiltrate, unlike in MS. The most widely used model for MS, experimental autoimmune encephalomyelitis, is an autoantigen-immunized disease that can be transferred to naive animals...

  17. Interferons in the central nervous system

    DEFF Research Database (Denmark)

    Owens, Trevor; Khorooshi, Reza M. H.; Wlodarczyk, Agnieszka

    2014-01-01

    Interferons (IFNs) are implicated as an important component of the innate immune system influencing viral infections, inflammation, and immune surveillance. We review here the complex biological activity of IFNs in the central nervous system (CNS) and associated glial–immune interactions...

  18. THE LICHENS OF NORTH CENTRAL OKLAHOMA

    Directory of Open Access Journals (Sweden)

    DARVIN WENDELL KECK

    2006-12-01

    Full Text Available Over 1,000 specimens of lichens were collected at 78 collecting stations in 11 counties of North Central Oklahoma during 1959 and 1960. The objectives were to identify lichens collected in the area; to establish a record of lichen distribution for each county in the area; and to analyze the ecological relationships.

  19. Notes on Central Asian dragonflies (Insecta: Odonata)

    NARCIS (Netherlands)

    Schoorl Jr., J.W.

    2000-01-01

    New and old material from Central Asia is published. In total 38 species are recorded from various locations in this region. For the more interesting species notes and figures are provided. One probably new Ischnura species is briefly described, but not formally named. For a, possibly new, subspecie

  20. Notes on Central Asian dragonflies (Insecta: Odonata)

    OpenAIRE

    Schoorl Jr., J.W.

    2000-01-01

    New and old material from Central Asia is published. In total 38 species are recorded from various locations in this region. For the more interesting species notes and figures are provided. One probably new Ischnura species is briefly described, but not formally named. For a, possibly new, subspecies of Sympetrum sinaiticum Dumont, 1977, a short diagnosis with figures is provided.

  1. Larger foraminifera from Central Falcon (Venezuela)

    NARCIS (Netherlands)

    Gorter, Nettie E.; Vlerk, van der I.M.

    1931-01-01

    Dr. H. G. Kugler, chief geologist of the North Venezuelan Petroleum Company, at Puerto Cabello, entrusted us with the examination of a collection of larger foraminifera, selected from material collected by the geologists of this Company in Central Falcon. Dr. A. Senn kindly added material that had a

  2. Volkswagen Sets up Central Lab in BRICI

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ On June 2, Volkswagen Corp of Germany settled its Chinese central laboratory in Sinopec Beijing Research Institute of Chemical Industry (BRICI). This is the top-level lab of Volkswagen in Asia - Pacific region and it marks another close cooperation between Volkswagen Corp of Germany and Sinopec Corp.

  3. The Centrality of Engagement in Higher Education

    Science.gov (United States)

    Fitzgerald, Hiram E.; Bruns, Karen; Sonka, Steven T.; Furco, Andrew; Swanson, Louis

    2016-01-01

    The centrality of engagement is critical to the success of higher education in the future. Engagement is essential to most effectively achieving the overall purpose of the university, which is focused on the knowledge enterprise. Today's engagement is scholarly, is an aspect of learning and discovery, and enhances society and higher education.…

  4. Financial Stability and Central Bank Governance

    NARCIS (Netherlands)

    Koetter, Michael; Roszbach, Kasper; Spagnolo, Giancarlo

    2014-01-01

    The financial crisis has ignited a debate about the appropriate objectives and the governance structure of Central Banks. We use novel survey data to investigate the relation between these traits and banking system stability focusing in particular on their role in micro-prudential supervision. We fi

  5. Stone age transitions. Neolithisation in central Scandinavia

    Directory of Open Access Journals (Sweden)

    Helena Knutsson

    2003-01-01

    Full Text Available A summary of a series of individual research projects focused on the processes from the Mesolithic to the Late Neolithic in central Scandinavia. The projects were embeded in the "Coast to Coast project". The historicity in this process was emphasised.

  6. Fat graft myringoplasty in small central perforations

    Directory of Open Access Journals (Sweden)

    Chandni Sharma

    2014-01-01

    Full Text Available Background: Perforations of the tympanic membrane (TM are treated with various surgical techniques and materials. Although autologous temporalis fascia is the most common material used for the closure of TM perforations, however for a dry, small central perforation the fat graft myringoplasty (FM is a good alternative as it is a simple and cost-effective technique. Objectives: The aim of this study was to determine the efficacy of FM for repair of small central perforations. Suggestions for optimizing the outcome of FM are presented. Material and Methods: Twenty patients (10 males and 10 females who had uncomplicated dry small central perforation, which was confined to one quadrant of the pars tensa underwent FM. The outcome was evaluated after 1-week, 1-month, and 3 months. Results: After 3 months of follow-up, a closure rate of 80% was achieved. Mean preoperative air-bone (AB gap was 22.90 ± 6.54 dB and mean postoperative AB gap was 21.80 ± 6.28 dB. Mean improvement in AB gap postoperatively was 1.1 ± 2.63 dB. Conclusion: Fat graft myringoplasty, with its ease of technique and good graft uptake rate justifies its use in the closure of small dry central TM perforations.

  7. Clinical analysis and treatment of central pain due to headinjury

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@Central pain is induced by the involvement of the abnormal pain pathway due to diseases of the central nervous system. Central pain after brain trauma is common clinically, but it is often misdiagnosed and neglected because of lack of objective disturbances. We treated 20 cases of central pain after head injury by invigorating blood circulation and satisfactory result was obtained.

  8. A measure of centrality based on modularity matrix

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    In this paper, a kind of measure of structural centrality for networks, called modularity centrality, is introduced. This centrality index is based on the eigenvector belonging to the largest magnitude eigenvalue of modularity matrix. The measure is illustrated and compared with the standard centrality measures using a classic dataset. The statistical distribution of modularity centrality is investigated by con- sidering large computer generated graphs and two networks from the real world.

  9. A Climatology of Central American Gyres

    Science.gov (United States)

    Papin, P. P.; Griffin, K. S.; Bosart, L. F.; Torn, R. D.

    2012-12-01

    Monsoon gyres, commonly found over the western Pacific Ocean, are characterized by broad low-level cyclonic circulations that occur at a variety of spatial scales ranging from 1500-3000 km. Low-level cyclonic gyre circulations, while less frequent and occupying a smaller scale, have also been observed over Central America during the tropical cyclone (TC) season. A noteworthy gyre observed during the 2010 PREDICT field project served as a "collector" of TC Matthew and a source for TC Nicole. During October 2011, devastating flooding occurred in Guatemala and El Salvador when TD 12-E, embedded in a gyre circulation, made landfall on the Pacific coast of Central America. These gyre occurrences, their apparent links to TC activity, and their association with high-impact weather motivates this presentation. A preliminary analysis of Central American gyres suggests that their spatial scales vary between 1000-2000 km. These gyres also tend to be co-located with reservoirs of deep moisture that are characterized by high precipitable water values (>50 mm) and embedded deep convection on their southern and eastern sides. Catastrophic flooding can occur when gyre cyclonic circulations interact with the topography of Central America. A Central American gyre climatology including gyre frequency over the TC season and individual gyre duration will be presented. This climatology is then used to craft a gyre composite using previous gyre cases from 1980-2010. Particular attention will be given to the common synoptic and sub-synoptic scale features that precede and take place during gyre formation. This includes the role that intraseasonal and interannual circulations such as the Madden-Julian Oscillation (MJO) and El Nino-Southern Oscillation (ENSO) might play in gyre development. TC genesis events within gyre circulations will also be highlighted and examined further. Finally, the results of a September 2010 case study will be used to illustrate the impact that Central American

  10. THE ALLIANCE TRACHYNION DISTACHYAE RIVAS-MARTINEZ 1978 IN CENTRAL ITALYIN CENTRAL ITALY

    Directory of Open Access Journals (Sweden)

    M. DE SANCTIS

    2010-01-01

    Full Text Available The therophytic basiphilous vegetation of Central Italy has been generally framed in a single association Trifolio scabri- Hypochoeridetum achyrophori Biondi et al. 1997. We show that a considerable floristic variation exists inside Trifolio-Hypochoeridetum in Central Italy, and that it should be treated as a complex of no less than five different associations: Medicagini rigidulae-Trifolietum scabri Fanelli et al. hoc loco, Trifolio scabri-Hypochoeridetum achyrophori Biondi, Izco. Ballelli & Formica 1997 s.s, Hippocrepido siliquosae- Brachypodietum distachyi Fanelli et al. ad interim, Trigonello gladiatae-Brachypodietum distachyi Fanelli et al. hoc loc, Crucianello latifoliae-Hypochoeridetum achyrophori Filesi, Blasi, Di Marzio 1996. These associations are floristically and ecologically distinct, and show different geographical ranges in Central Italy. The great diversity of Trachynion distachyae in Central Italy is related to the widespread occurrence of limestone and calcareous alluvial rocks and to a climate with abundant winter and autumn rains very favourable to the development of winter annuals.

  11. On Central Extensions of Associative Dialgebras

    Science.gov (United States)

    Rakhimov, Isamiddin S.

    2016-03-01

    The concept of central extensions plays an important in constructing extensions of algebras. This technique has been successfully used in the classification problem of certain classes of algebras. In 1978 Skjelbred and Sund reduced the classification of nilpotent Lie algebras in a given dimension to the study of orbits under the action of automorphism group on the space of second degree cohomology of a smaller Lie algebra with coefficients in a trivial module. Then W. de Graaf applied the Skjelbred and Sund method to the classification problem of low-dimensional nilpotent Lie and associative algebras over some fields. The main purpose of this note is to establish elementary properties of central extensions of associative dialgebras and apply the above mentioned method to the classification of low dimensional nilpotent associative dialgebras.

  12. [Central nervous system malformations: neurosurgery correlates].

    Science.gov (United States)

    Jiménez-León, Juan C; Betancourt-Fursow, Yaline M; Jiménez-Betancourt, Cristina S

    2013-09-06

    Congenital malformations of the central nervous system are related to alterations in neural tube formation, including most of the neurosurgical management entities, dysraphism and craniosynostosis; alterations of neuronal proliferation; megalencefaly and microcephaly; abnormal neuronal migration, lissencephaly, pachygyria, schizencephaly, agenesis of the corpus callosum, heterotopia and cortical dysplasia, spinal malformations and spinal dysraphism. We expose the classification of different central nervous system malformations that can be corrected by surgery in the shortest possible time and involving genesis mechanisms of these injuries getting better studied from neurogenic and neuroembryological fields, this involves connecting innovative knowledge areas where alteration mechanisms in dorsal induction (neural tube) and ventral induction (telencephalization) with the current way of correction, as well as the anomalies of cell proliferation and differentiation of neuronal migration and finally the complex malformations affecting the posterior fossa and current possibilities of correcting them.

  13. Sheehan's syndrome with central diabetes insipidus.

    Science.gov (United States)

    Laway, Bashir Ahmad; Mir, Shahnaz Ahmad; Dar, Mohd Iqbal; Zargar, Abdul Hamid

    2011-03-01

    Sheehan's syndrome refers to the occurrence of hypopituitarism after delivery, usually preceded by postpartum hemorrhage. The condition still continues to be a common cause of hypopituitarism in developing countries like India. The disorder usually presents with anterior pituitary failure with preservation of posterior pituitary functions. Posterior pituitary dysfunction in the form of central diabetes insipidus is rare in patients with Sheehan's syndrome. We describe the clinical course of a young lady who after her sixth childbirth developed severe postpartum hemorrhage followed by development of panhypopituitarism which was confirmed by hormonal investigation and demonstration of empty sella on imaging. In addition, she developed Polyuria. The water deprivation test and response to vasopressin test results indicated central diabetes insipidus. She needed oral desmopressin on a continuous basis to control polyuria.

  14. Comprehensive management of presbycusis: central and peripheral.

    Science.gov (United States)

    Parham, Kourosh; Lin, Frank R; Coelho, Daniel H; Sataloff, Robert T; Gates, George A

    2013-04-01

    The prevailing otolaryngologic approach to treatment of age-related hearing loss (ARHL), presbycusis, emphasizes compensation of peripheral functional deficits (ie, hearing aids and cochlear implants). This approach does not address adequately the needs of the geriatric population, 1 in 5 of whom is expected to consist of the "old old" in the coming decades. Aging affects both the peripheral and central auditory systems, and disorders of executive function become more prevalent with advancing age. Growing evidence supports an association between age-related hearing loss and cognitive decline. Thus, to facilitate optimal functional capacity in our geriatric patients, a more comprehensive management strategy of ARHL is needed. Diagnostic evaluation should go beyond standard audiometric testing and include measures of central auditory function, including dichotic tasks and speech-in-noise testing. Treatment should include not only appropriate means of peripheral compensation but also auditory rehabilitative training and counseling.

  15. Centralized, Decentralized, and Hybrid Purchasing Organizations

    DEFF Research Database (Denmark)

    Bals, Lydia; Turkulainen, Virpi

    This paper addresses one of the focal issues in purchasing and supply management – global sourcing – from an organizational design perspective. In particular, we elaborate the traditional classification of global sourcing organization designs into centralized, decentralized, and hybrid models. We...... organization we can identify organization designs beyond the classical centralization-decentralization continuum. We also provide explanations for the observed organization design at GCC. The study contributes to research on purchasing and supply management as well as research on organization design....... illustrate with our empirical analysis on global sourcing organization design at Global Chemical Company (GCC, a pseudonym) that revisiting the conventional wisdom about global sourcing organization designs is required; by engaging in a detailed, subfirm level of analysis on the design of the purchasing...

  16. Association and Centrality in Criminal Networks

    DEFF Research Database (Denmark)

    Petersen, Rasmus Rosenqvist

    Network-based techniques are widely used in criminal investigations because patterns of association are actionable and understandable. Existing network models with nodes as first class entities and their related measures (e.g., social networks and centrality measures) are unable to capture...... and analyze the structural richness required to model and investigate criminal network entities and their associations. We demonstrate a need to rethink entity associations with one specific case (inspired by \\textit{The Wire}, a tv series about organized crime in Baltimore, United States) and corroborated...... by similar evidence from other cases. Our goal is to develop centrality measures for fragmented and non-navigational states of criminal network investigations. A network model with three basic first class entities is presented together with a topology of associations between network entities. We implement...

  17. Centralizers in simple locally finite groups

    Directory of Open Access Journals (Sweden)

    Mahmut Kuzucuoğlu

    2013-03-01

    Full Text Available This is a survey article on centralizers of finitesubgroups in locally finite, simple groups or LFS-groups as wewill call them. We mention some of the open problems aboutcentralizers of subgroups in LFS-groups and applications of theknown information about the centralizers of subgroups to thestructure of the locally finite group. We also prove thefollowing: Let $G$ be a countably infinite non-linear LFS-groupwith a Kegel sequence $mathcal{K}={(G_i,N_i | iinmathbf{N} }$. If there exists an upper bound for ${ |N_i| |iin mathbf{N} }$, then for any finite semisimplesubgroup $F$ in $G$ the subgroup $C_G(F$ has elements oforder $p_i$ for infinitely many distinct prime $p_i$. Inparticular $C_G(F$ is an infinite group. This answers Hartley'squestion provided that there exists a bound on ${ |N_i| | iin mathbf{N}$.

  18. Introduction to FAST central control system

    Science.gov (United States)

    Sun, Jinghai; Zhu, Lichun; Jiang, Zhiqian

    2016-07-01

    FAST is the largest single dish radio telescope in the world. During observation, part of spherical reflector forms paraboloid to the source direction, meanwhile the feed is placed to instant focus. The control of telescope is difficult and complicated. An autonomous central control system is designed and implemented for methodically and efficiently operation. The system connects and coordinates all subsystems including control, measurement and health monitoring for reflector, feed support and receiver respectively. The main functions are managing observation tasks, commanding subsystems, storing operating data, monitoring statuses and providing the uniform time standard. In this paper, the functions, software and hardware of FAST central control system are presented. The relative infrastructures such as power, network and control room arrangement are introduced.

  19. The segetal flora of the Central Poland

    Directory of Open Access Journals (Sweden)

    Aurelia U. Warcholińska

    2013-12-01

    Full Text Available In the paper a state and general characteristic of segetal flora of Central Poland is given. The segetal flora of the researched area consists 587 taxa. 127 (21,6% of them are on the list of threatened segetal plants. The studied flora was characterized by a high percentage of short-living plants (341 species - 58,1 %. Species of nature origin (apophytes constitute the dominant group (341 species - 58,1 %. Species of the archaeophytes group were frequently recorded (143 species - 24,4%. The most threatened species in the area of Central Poland are: Vaccaria hispanica (CR, Adonis flammea (CR, Coringia orientalis (CR, Thymelaea passerina (CR, Lythrum hyssopifolia (CR, Bupleurum rotundifolium (CR, Kickxia elatine (CR, Isolepis setacea (CR, Bromus arvensis (CR, Lolium temulentum (CR, L. remotum (CR.

  20. COOPERATION VS. COMPETITION IN CENTRAL ASIA

    Directory of Open Access Journals (Sweden)

    Veronica MIHALACHE

    2015-07-01

    Full Text Available The present study highlights the cooperation-competition ratio in the Central Asia region aiming at maintaining a force balance between Russia and China – as main state actors of the Shanghai Cooperation Organization (SCO, and avoiding the dominance of a state over the other member states of the Organization. Our paper attempts to identify the theoretical arguments that might render a better insight in this organization as a framework meant to mutually balance influence between Russia and China, with the purpose of reciprocally monitoring and limiting their power in a region considered the core of SCO – from a geographical point of view and from the point of view of the two powers’ interest. On the other hand, we should take into account that promoting multipolarity in the global politics is a common interest of China and Russia; both countries started to exclude, to various extents, the Western powers’ interests in Central Asia.