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Sample records for central pontine myelinolysis

  1. Central pontine myelinolysis

    Science.gov (United States)

    ... from one nerve to another. The most common cause of central pontine myelinolysis is a quick change in the body's sodium ... The nerve damage caused by central pontine myelinolysis is usually ... The disorder can cause serious long-term (chronic) disability.

  2. Central pontine myelinolysis.

    Science.gov (United States)

    Kiley, M A; King, M; Burns, R J

    1999-03-01

    Central pontine myelinolysis (CPM) was initially associated with alcoholism. Subsequently other factors, including rapid reversal of hyponatraemia and extreme serum hypoosmolality associated with severe burns, have been identified as other important factors in its pathogenesis. Extra-pontine lesions have also been described. CPM may be found at autopsy, either having been overlooked during life or as an incidental finding. Its precise incidence is not known but the ability to diagnose it during life has been helped by modern neuroimaging, particularly magnetic resonance imaging (MRI) of the brain stem. In the past the prognosis for CPM was thought to be invariably fatal. It is clear now that with the greater general awareness of the disorder and the ability to diagnose it during life that some degree of recovery is possible. However, the number who do recover and the degree of recovery is not known. We report a 40-year-old man who developed CPM presenting with quadriparesis and inability to speak and swallow. There were risk factors for CPM and the diagnosis was confirmed by MRI scanning. He made a complete recovery although he remains ataxic. We are reporting this case as we believe it is important to make clinicians aware of the potential for recovery of CPM. While no specific treatment has been shown to influence the degree and rate of recovery of the demyelination, the fact that the quadriplegia and bulbar paralysis can recover fully is of considerable importance. In particular, it means that when the diagnosis is made, complete and vigorous nursing and medical care is warranted. PMID:18639140

  3. Central Pontine and Extrapontine Myelinolysis in Encephalitis

    Directory of Open Access Journals (Sweden)

    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

  4. Central pontine myelinolysis: clinical presentation and radiologic findings

    International Nuclear Information System (INIS)

    Central pontine myelinolysis (CPM) is a neurologic disorder once thought to be uniformly fatal. With the introduction of CT and MRI there was an increasing number of reports on nonfatal cases of CPM. Nearly all reports on nonfata cases describe severe clinical syndromes with tetraparesis, bulbar palsy, and coma. We reviewed nine patients with CPM and compared the size of the pontine lesion on MRI and CT with the severity of clinical presentation. Clinical presentation of CPM was highly variable: The symptoms ranged from severe neurologic disorders to mild neurologic disturbances only. Two of nine patients died from CPM. The size of the pontine lesion did not correlate with the severity of the neurologic illness or the final outcome. Mild forms of CPM might be difficult to diagnose clinically. This applies even more for patients with underlying diseases such as Wernicke's encephalopathy, which in itself might cause a clinical picture similar to that of CPM. Central Pontine Myelinolysis is a major differential diagnosis in acute neurologic deterioration indicating pontine damage. Magnetic resonance imaging is the decisive diagnostic tool for CPM. (orig.)

  5. Rare association of central pontine myelinolysis with infantile tremor syndrome

    Directory of Open Access Journals (Sweden)

    Kalpana Datta

    2012-01-01

    Full Text Available Central pontine myelinolysis (CPM is an acute demyelination within the central basis pontis. Though exact mechanism is not known it is seen commonly with rapid correction of hyponatremia and also with pontine ischemia or infarction, demyelinating diseases, pontine neoplasm and different metabolic diseases. We report a rare association of CPM in a patient of Infantile Tremor Syndrom (ITS. ITS is a syndrome of tremor, mental and physical retardation, pigmentary changes of hair and skin and anemia in malnourished children. Though first reported in Indian subcontinent many identical cases were reported from around the world. Our case is a 15 month old child with generalized tremor, mild hepatosplenomegaly with features of grade II malnutrition including skin and hair changes. All the signs and symtoms of tremor improved after treatment with the World Health Organization (WHO protocol for protein energy malnutrition (PEM and administration of propranolol without any side effects.

  6. Central pontine myelinolysis secondary to cytomegalovirus hepatitis in a 10-month-old child

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    Tarhan, Cagla N.; Firat, Ali; Agildere, Muhtesem A. [Fevzi Cakmak Cad. 10. Sok. No:45, 06490 Bahcelievler, Ankara (Turkey); Otken, Arzu; Demirceken, Fulya [Sami Ulus Children' s Hospital, Department of Paediatrics, Ankara (Turkey)

    2003-01-01

    We present a 10-month-old child with central pontine myelinolysis (CPM) secondary to chronic active hepatitis due to cytomegalovirus (CMV) infection. A total of 35 paediatric cases of pontine and/or extrapontine myelinolysis are reported and, to our knowledge, CPM secondary to CMV hepatitis in an infant has not been previously reported. The MRI findings are highlighted. (orig.)

  7. Central pontine myelinolysis secondary to cytomegalovirus hepatitis in a 10-month-old child

    International Nuclear Information System (INIS)

    We present a 10-month-old child with central pontine myelinolysis (CPM) secondary to chronic active hepatitis due to cytomegalovirus (CMV) infection. A total of 35 paediatric cases of pontine and/or extrapontine myelinolysis are reported and, to our knowledge, CPM secondary to CMV hepatitis in an infant has not been previously reported. The MRI findings are highlighted. (orig.)

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

    International Nuclear Information System (INIS)

    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

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

    LENUS (Irish Health Repository)

    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.

  10. Central pontine and extrapontine myelinolysis: a systematic review.

    Science.gov (United States)

    Singh, T D; Fugate, J E; Rabinstein, A A

    2014-12-01

    The purpose was to perform a systematic review of studies on central pontine and extrapontine myelinolysis [forms of osmotic demyelination syndrome (ODS)] and define the spectrum of causes, risk factors, clinical and radiological presentations, and functional outcomes of this disorder. A thorough search of the literature was conducted using multiple databases (PubMed, Ovid Medline and Google) and bibliographies of key articles to identify all case series of adult patients with ODS published from 1959 to January 2013. Only series with five or more cases published in English were considered. Of the 2602 articles identified, 38 case series were included comprising a total of 541 patients who fulfilled our inclusion criteria. The most common predisposing factor was hyponatremia (78%) and the most common presentation was encephalopathy (39%). Favorable recovery occurred in 51.9% of patients and death in 24.8%. Liver transplant patients with ODS had a combined rate of death and disability of 77.4%, compared with 44.7% in those without liver transplantation (P < 0.001). ODS is found to have a good recovery in more than half of cases and its mortality has decreased with each passing decade. Favorable prognosis is possible in patients of ODS, even with severe neurological presentation. Further research is required to confirm the differences found in liver transplant recipients. PMID:25220878

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

    Institute of Scientific and Technical Information of China (English)

    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.

  12. Possible causes of central pontine myelinolysis after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    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

  13. 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.)

  14. Plasma exchange successfully treats central pontine myelinolysis after acute hypernatremia from intravenous sodium bicarbonate therapy

    OpenAIRE

    Chang, Kyung Yoon; Lee, In-Hee; Kim, Gi Jun; Cho, Kangwon; Park, Hoon Suk; Kim, Hyung Wook

    2014-01-01

    Background Osmotic demyelination syndrome (ODS) primarily occurs after rapid correction of severe hyponatremia. There are no proven effective therapies for ODS, but we describe the first case showing the successful treatment of central pontine myelinolysis (CPM) by plasma exchange, which occurred after rapid development of hypernatremia from intravenous sodium bicarbonate therapy. Case presentation A 40-year-old woman presented with general weakness, hypokalemia, and metabolic acidosis. The p...

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

    OpenAIRE

    Schneider P; Nejtek VA; Hurd CL

    2012-01-01

    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 associat...

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

    OpenAIRE

    Tushar Divakar Gosavi; Siew Ju See

    2015-01-01

    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 six...

  17. Central pontine myelinolysis with meticulous correction of hyponatraemia in chronic alcoholics.

    Science.gov (United States)

    Malhotra, Konark; Ortega, Luis

    2013-01-01

    Central pontine myelinolysis is a demyelinating disorder that arises due to osmolar disturbances in the cerebral microenvironment characterised by loss of the myelin sheath of neurons. The diffusion-weighting imaging sequence of MRI is the most sensitive diagnostic imaging modality for myelinolysis. The rapid correction of hyponatraemia by >20-25 mmol/L/48 h has been known for a long time as a prime cause of osmotic demyelination. Various other comorbidities in hyponatraemic patients are well known that can lead to osmotic demyelination such as alcoholism, hypoxaemia, severe liver disease, malignancy, burns, liver transplantation and malnutrition. Chronic alcohol abusers with additional liver disease and malnutrition have altered osmotic equilibrium at baseline that predisposes them to osmotic demyelination. We suggest a more cautious and meticulous approach should be followed in these patients to avoid the dreaded complication. PMID:23813514

  18. Acute psychosis with a favorable outcome as a complication of central pontine/extrapontine myelinolysis in a middle aged man

    OpenAIRE

    Gupta, Rishab; Balhara, Yatan Pal Singh; Sagar, Rajesh

    2012-01-01

    Central pontine myelinolysis is a demyelinating condition affecting the pons characterized by an acute progressive quadriplegia, dysarthria, dysphagia, and alterations of consciousness. Pathologic features include prominent demyelination in the central pons with sparing of axons and neurons. This condition is usually associated with systemic disorders such as hyponatremia, chronic alcoholism, liver failure, severe burns, malignant neoplasms, hemorrhagic pancreatitis, hemodialysis, and sepsis....

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

    Directory of Open Access Journals (Sweden)

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

    Science.gov (United States)

    Gosavi, Tushar Divakar; See, Siew Ju

    2015-01-01

    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. PMID:25745319

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Urinary incontinence a first presentation of central pontine myelinolysis: a case report.

    Science.gov (United States)

    Syed, Asmah Hassan; Shak, Joanna; Alsawaf, Ali

    2015-09-01

    An 84-year-old lady was treated for hyperosmolar hyperglycaemia with IV insulin, fluids and catheterisation for fluid balance monitoring. Trial without catheter failed as the patient complained of new-onset urinary incontinence and lack of awareness of bladder filling. In light of her breast cancer history, we excluded cauda equina. Ultrasound KUB showed an enlarged bladder. Whole-body MRI revealed a lesion in the pons which was highly suggestive of central pontine myelinolysis (CPM). Her electrolytes were normal throughout her admission; thus, the rapid fluctuation in osmolality, secondary to her hyperglycaemic state, was the likely cause of CPM. CPM has been reported secondary to hyperglycaemia; however, this is the first reported case of CPM presenting as urinary incontinence and loss of bladder sensation. PMID:26209689

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

    Science.gov (United States)

    Gosavi, Tushar Divakar; See, Siew Ju

    2015-01-01

    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. PMID:25745319

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

    Directory of Open Access Journals (Sweden)

    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

  6. A Rare Case of Central Pontine Myelinolysis in Overcorrection of Hyponatremia with Total Parenteral Nutrition in Pregnancy

    OpenAIRE

    Janga, Kalyana C.; Tazleem Khan; Ciril Khorolsky; Sheldon Greenberg; Priscilla Persaud

    2015-01-01

    A 42-year-old high risk pregnant female presented with hyponatremia from multiple causes and was treated with total parenteral nutrition. She developed acute hypernatremia due to the stage of pregnancy and other comorbidities. All the mechanisms of hyponatremia and hypernatremia were summarized here in our case report. This case has picture (graph) representation of parameters that led to changes in serum sodium and radiological findings of central pontine myelinolysis on MRI. In conclusion w...

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    International Nuclear Information System (INIS)

    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)

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

    OpenAIRE

    Dolciotti, Cristina; Nuti, Angelo; Cipriani, Gabriele; Borelli, Paolo; Baldacci, Filippo; Logi, Chiara; Bonuccelli, Ubaldo

    2010-01-01

    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 ...

  10. A Rare Case of Central Pontine Myelinolysis in Overcorrection of Hyponatremia with Total Parenteral Nutrition in Pregnancy.

    Science.gov (United States)

    Janga, Kalyana C; Khan, Tazleem; Khorolsky, Ciril; Greenberg, Sheldon; Persaud, Priscilla

    2015-01-01

    A 42-year-old high risk pregnant female presented with hyponatremia from multiple causes and was treated with total parenteral nutrition. She developed acute hypernatremia due to the stage of pregnancy and other comorbidities. All the mechanisms of hyponatremia and hypernatremia were summarized here in our case report. This case has picture (graph) representation of parameters that led to changes in serum sodium and radiological findings of central pontine myelinolysis on MRI. In conclusion we present a complicated case serum sodium changes during pregnancy and pathophysiological effects on serum sodium changes during pregnancy. PMID:26798530

  11. A Rare Case of Central Pontine Myelinolysis in Overcorrection of Hyponatremia with Total Parenteral Nutrition in Pregnancy

    Directory of Open Access Journals (Sweden)

    Kalyana C. Janga

    2015-01-01

    Full Text Available A 42-year-old high risk pregnant female presented with hyponatremia from multiple causes and was treated with total parenteral nutrition. She developed acute hypernatremia due to the stage of pregnancy and other comorbidities. All the mechanisms of hyponatremia and hypernatremia were summarized here in our case report. This case has picture (graph representation of parameters that led to changes in serum sodium and radiological findings of central pontine myelinolysis on MRI. In conclusion we present a complicated case serum sodium changes during pregnancy and pathophysiological effects on serum sodium changes during pregnancy.

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

    Science.gov (United States)

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

    2011-02-01

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

  13. 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.

  14. MRI of central pontine myelinolysis%桥脑中央髓鞘溶解症的MRI诊断

    Institute of Scientific and Technical Information of China (English)

    邹同恩; 嵇鸣; 苗华栋; 叶春涛

    2006-01-01

    目的 评价MR对桥脑中央髓鞘溶解症(central pontine myelinolysis,CPM)的诊断价值.方法 收集病例8例.主要病史:肝病史、酗酒、电解质紊乱等.扫描设备siemes magneton vision 1.5T超导MR,头线圈,RSE序列、FLAIR序列.MAGNETON PLUS螺旋CT扫描.2例在桥脑病灶处行MR单体素1H-MRS点解析波谱法(PRESS)检查.结果 MRI显示8例全部有阳性发现,其中桥脑病灶8例,丘脑、尾状核头部、内囊等处异常信号6例,信号呈长T1长T2信号.病灶显示率:FLAIR为100%,T2W为85%,T1W为50%.1H-MRS示:NAA降低,Cho升高,NAA/Cr比值降低,Cho/Cr比值稍高.CT显示阳性5例,阴性3例,阳性病例中双侧基底节、桥脑出现斑片状低密度灶4例、桥脑低密度1例.结论 MRI诊断价值明显优于CT,FLAIR序列对病灶显示尤为清楚,结合病史可明确诊断.1H-MRS无特异性,峰值可提示病灶部分组织学变化.

  15. [Case of neuromyelitis optica spectrum disorder associated with central pontine and extrapontine myelinolysis preceded by syndrome of inappropriate antidiuretic hormone secretion].

    Science.gov (United States)

    Sakai, Waka; Matsui, Naoko; Fujita, Koji; Izumi, Yuishin; Nishida, Yoshihiko; Takahashi, Toshiyuki; Kanbayashi, Takashi; Kaji, Ryuji

    2014-01-01

    A 36-year-old woman complained of general malaise. She presented with hyponatremia and plasma osmotic pressure was lower than urinary osmotic pressure. In addition, serum antidiuretic hormone level was higher than the measurement sensitivity. She was diagnosed with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). She fell into a coma despite correction of serum sodium level. Brain magnetic resonance imaging (MRI) revealed high signal intensities in the cerebral cortex, striatum, thalamus, hypothalamus, midbrain, and pons in fluid-attenuated inversion recovery images. Spinal MRI revealed a longitudinally extending lesion in the cervical cord. Serum sample was positive for anti-aquaporin-4 antibody, supporting the diagnosis of neuromyelitis optica spectrum disorder (NMOSD) combined with central pontine and extrapontine myelinolysis. In patients with NMOSD, the immune reaction can gradually cause destructive changes of the hypothalamus and lead to unstable ADH secretion in the absence of immunomodulatory treatment. PMID:25087556

  16. Central Pontine Myelinolysis

    Science.gov (United States)

    ... diuretics), and women with eating disorders such as anorexia or bulimia. The risk for CPM is greater ... to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce ...

  17. 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

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    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.)

  18. 脑桥中央髓鞘溶解症的临床和MRI特点(8例报告)%Clinical features and MRI analysis of central pontine myelinolysis and extrapontine myelinolysis:8 cases report

    Institute of Scientific and Technical Information of China (English)

    常颖; 高垚; 李欢; 严明兰

    2011-01-01

    Objective To investigate central pontine and extrapontine myelinolysis ( CPM and EPM) on etiology, clinical features, treatment, prognosis and magnetic resonance ( MR) imaging finding in acute stage and convalescence stage. Methods Retrospective analysis about 8 patients with diagnosis of central pontine and extrapontine myelinolysis ( CPM and EPM) on etiology, clinical features, prognosis, magnetic resonance imaging ( MRI) finding and curative effect. Results Overall 8 patients had primary disease. Patients showed different level of conscious disturbance, palsy and glosso-pharyngeal paralysis. 1 case had no correspondence clinical symptom. In 6 patients who had correspondence clinical symptom, initial MR imaging revealed a bilateral symmetry bat wing-shaped lesion within the basilar part of pons. 3 patients had cerebral ganglion and putamen abnormalities, which were consistent with extrapontine myelinolysis. The abnormalities in pontine were smaller in 1 -month follow-up in the 2 patients rechecked, which appeared hypo-intense in T, and hyper-intense in T2 on MRI, but the abnormalities in cerebral ganglion and putamen appeared hyper-intense in T, and T2 on MRI. Expect one with no clinical symptom and one case post liver transplantation, the other 6 cases were treated with glucocorticoids immediately after diagnosis was defined. All 6 cases were cured and could help themselves. Conclusion The hepatic function defect and chronic renal inadequacy might be associated with CPM and EPM. Glucocorticoid is effective for CPM and EPM. MRI is unquestionably superior to other detections in the diagnoses of CPM and EPM. The abnormal hyper-intense in T1 and T2 on MRI in cerebral ganglion and putamen appeared in convalescence were considered to be lipoid accumulate after myelinolysis.%目的 探讨脑桥中央髓鞘溶解症及脑桥外髓鞘溶解的发病原因、临床特点、治疗、疾病预后及急性期、恢复期MRI影像学特点.方法 对2002年~2006年吉林

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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

  5. Cerebral encephalopathy with extrapontine myelinolysis in a case of postpartum hypernatremia

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    Sonia Bhatia

    2014-01-01

    Full Text Available Extrapontine myelinolysis, a fairly common metabolic disorder, is associated with neurological complications. Central pontine and extrapontine myelinolysis are commonly recognized with rapid correction of sodium. Myelinolysis, however, has rarely been described with hypernatremia. We report a rare case of post-partum hypernatremic encephalopathy associated with serum sodium levels as high as 200 mEq/l on presentation. Although the serum sodium levels were brought down gradually, subsequent imaging showed progression of demyelination and deterioration of the neurological status.

  6. Cerebral encephalopathy with extrapontine myelinolysis in a case of postpartum hypernatremia

    OpenAIRE

    Sonia Bhatia; Abhay Kumar Kapoor; Anurag Sharma; Rajiv Gupta; Sushila Kataria

    2014-01-01

    Extrapontine myelinolysis, a fairly common metabolic disorder, is associated with neurological complications. Central pontine and extrapontine myelinolysis are commonly recognized with rapid correction of sodium. Myelinolysis, however, has rarely been described with hypernatremia. We report a rare case of post-partum hypernatremic encephalopathy associated with serum sodium levels as high as 200 mEq/l on presentation. Although the serum sodium levels were brought down gradually, subsequent im...

  7. [Central pontine myelinolysis--pathogenesis and review of the literature].

    Science.gov (United States)

    Kobayashi, I; Osawa, M; Murakami, H; Aikawa, T; Yamane, K; Takemiya, T; Maruyama, S; Tomonaga, M

    1983-08-01

    A 77-year-old, nonalcoholic man was admitted to the Omiya Red Cross Hospital with the complaint of fever and delirium state of two days' duration. Two months prior to admission he had had cough and sputum. Chest X-ray revealed honey comb lungs. Cultures of sputum revealed mycobacterium tuberculosis after eight weeks incubation. He had no liver disease in his past history. The patient appeared cachetic. His vital signs were as follows; temperature 38 degrees C, blood pressure 132/68 mmHg, with a pulse rate of 84/min. He was delirium and excited. Findings of the cranial, motor and sensory nerve examination were normal. Initial laboratory studies showed a serum sodium value of 133 mEq/l, potassium 4.5 mEq/l, chloride 98 mEq/l; a serum GOT value of 51 units, GPT 36 units; a total protein content of 7.8 g/dl and ESR rate of 87 mm/hr. Six days after admission, the patients' consciousness level began to stupor and nuchal rigidity was appeared. Spinal fluid examination revealed opening pressure 270 mm H2O, cell counts 720 (N 712, L 8)/cumm, sugar 57 mg/dl and protein 170 mg/dl. Spinal fluid cultures were positive in mycobacterium tuberculosis after eight weeks incubation. Laboratory studies showed a serum sodium value of 114 mEq/l, potassium 4.4 mEq/l, chloride 86 mEq/l, a serum osmorality (SeOs) 225 mOsm/l and urine osmorality (UOs) 958 mOsm/l.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6639805

  8. Medical image of the week: central pontine myelinolysis

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    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.

  9. [Pontine reversible leucopathy in an AIDS patient associated with highly active antiretroviral therapy (HAART): Report of one case].

    Science.gov (United States)

    Cartier, Luis; Matamala, José Manuel; Yáñez, Alonso

    2016-05-01

    Posterior reversible encephalopathy (PRES) is a condition characterized by T2 and FLAIR hyperintensities in magnetic resonance imaging (MRI) studies, localized preferentially in the occipital-parietal white matter regions. Pathological MRI images located in midbrain, pons, medulla and spinal cord, that could be asymptomatic, were recently included in this entity. These images are interpreted as vasogenic edema, which is caused by arterial hypertension or eclampsia, neurotoxicity related to immunosuppressive agents or chemotherapy, among other causes. We report a 25 years old asymptomatic male with AIDS, with normal blood pressure who after initiating highly active antiretroviral therapy (HAART) reported vertigo. The MRI showed a central pontine T2 hyperintensity with diffusion restriction, which was interpreted as a central pontine myelinolysis (CPM), but the lack of motor symptoms made improbable a real demyelination of the pons. The follow-up MRI revealed complete regression of the images. To our knowledge, this case could be the second report of a reversible leucopathy of the pons in a patient with AIDS, were the MRI images also simulated a CPM. This report extends the knowledge around the variability of the pathogenic interpretation of CPM images and their association with HAART. PMID:27552021

  10. Extrapontine myelinolysis presenting as acute parkinsonism

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    Ditchfield A

    2006-09-01

    Full Text Available Abstract Background Extrapontine myelinolysis presenting with extra pyramidal features suggestive of parkinsonism may be a challenging clinical syndrome. Clinicians should maintain their vigilance while correcting electrolyte imbalances, especially with associated co-morbidity. Case presentation A 41-year-old woman presented with acute parkinsonism like features while on a holiday. This followed slow correction of hyponatraemia after repeated vomiting. MRI changes were suggestive of Extrapontine myelinolysis(EPM. This case is at variance with four previous cases reported in the medical literature in that the patient made a full clinical recovery and the MR changes resolved with symptomatic support alone. Conclusion Extrapontine myelinolysis could make a complete recovery with symptomatic support alone. During hyponatraemia correction, rapid osmotic shifts of fluid that cause hypernatremia, causes myelinolysis rather than absolute serum sodium level. Even gradual correction of hyponatraemia can produce myelinolysis, especially with pre-existing malnourishment, alcoholism, drug misuse, Addison's disease and immuno-suppression. Pallidial sparing is typical of EPM in MRI scans.

  11. Cerebral bleeding, infarcts, and presumed extrapontine myelinolysis in hypernatraemic dehydration.

    Science.gov (United States)

    AlOrainy, I A; O'Gorman, A M; Decell, M K

    1999-02-01

    The neuroimaging findings in an infant with hypernatremic dehydration are presented. Brain parenchymal haemorrhage and extensive multiple infarcts were present in the acute stage. Follow-up CT showed bilateral, symmetrical changes presumed to indicate extrapontine myelinolysis in the thalamus and globus pallidus. MRI confirmed sparing of the pons. Only three previous cases of neuroimaging abnormalities due to hypernatraemia have been described in the radiological literature.

  12. 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.

  13. 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.

  14. BAER - brainstem auditory evoked response

    Science.gov (United States)

    ... a sign of hearing loss , multiple sclerosis , acoustic neuroma , or stroke. Abnormal results may also be due ... Butterworth-Heinemann; 2012:chap 32A. Read More Acoustic neuroma Central pontine myelinolysis Hearing loss Multiple sclerosis Stroke ...

  15. A Rare Association of Trigeminal Autonomic Cephalgia: Pontine Capillary Telangiectasia

    OpenAIRE

    Gocmen, Rahsan; Kurt, Erdal; Arslan, Sabina; Unal-Cevik, Isin; Karli Oguz, Kader; Tezer, F Irsel

    2015-01-01

    This report describes a case of pontine capillary telangiectasia in a 43-year-old woman with a clinical diagnosis of trigeminal autonomic cephalgia. The possible association with pontine capillary telangiectasia and trigeminal autonomic cephalgia is discussed.

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

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    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)

  17. Blepharospasm in a patient with pontine capillary telangiectasia

    OpenAIRE

    Gilbert, AL; Dillon, WP; Horton, JC

    2012-01-01

    Blepharospasm is rarely due to an identifiable etiology. In the majority of cases, imaging fails to reveal any structural lesion. Here we describe an otherwise healthy patient with blepharospasm who was found to have pontine capillary telangiectasia. We propose a potential association between blepharospasm and pontine capillary telangiectasia. © 2012 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.

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

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    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.

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

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    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. 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.

  2. 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)

  3. 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.

  4. 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

  5. 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.

  6. what drives progressive motor deifcits in patients with acute pontine infarction?

    Institute of Scientific and Technical Information of China (English)

    Jue-bao Li; Rui-dong Cheng; Liang Zhou; Wan-shun Wen; Gen-ying Zhu; Liang Tian; Xiang-ming Ye

    2015-01-01

    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 deifcits, and ensuing that damage to the corticospinal tracts may be respon-sible 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.

  7. 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

  8. Pontine Infarct Presenting with Atypical Dental Pain: A Case Report.

    Science.gov (United States)

    Goel, Rajat; Kumar, Sanjeev; Panwar, Ajay; Singh, Abhishek B

    2015-01-01

    Orofacial pain' most commonly occurs due to dental causes like caries, gingivitis or periodontitis. Other common causes of 'orofacial pain' are sinusitis, temporomandibular joint(TMJ) dysfunction, otitis externa, tension headache and migraine. In some patients, the etiology of 'orofacial pain' remains undetected despite optimal evaluation. A few patients in the practice of clinical dentistry presents with dental pain without any identifiable dental etiology. Such patients are classified under the category of 'atypical odontalgia'. 'Atypical odontalgia' is reported to be prevalent in 2.1% of the individuals. 'Atypical orofacial pain' and 'atypical odontalgia' can result from the neurological diseases like multiple sclerosis, trigeminal neuralgia and herpes infection. Trigeminal neuralgia has been frequently documented as a cause of 'atypical orofacial pain' and 'atypical odontalgia'. There are a few isolated case reports of acute pontine stroke resulting in 'atypical orofacial pain' and 'atypical odontalgia'. However, pontine stroke as a cause of atypical odontalgia is limited to only a few cases, hence prevalence is not established. This case is one, where a patient presented with acute onset atypical dental pain with no identifiable dental etiology, further diagnosed as an acute pontine infarct on neuroimaging. A 40 years old male presented with acute onset, diffuse teeth pain on right side. Dental examination was normal. Magnetic resonance imaging(MRI) of the brain had an acute infarct in right pons near the trigeminal root entry zone(REZ). Pontine infarct presenting with dental pain as a manifestation of trigeminal neuropathy, has rarely been reported previously. This stresses on the importance of neuroradiology in evaluation of atypical cases of dental pain. PMID:26464604

  9. 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…

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. Wine Glass Sign and Empty Delta Sign: A Rare Imaging Presentation of Postpartum Encephalopathy in Dehydration

    Science.gov (United States)

    Suprasanna, K.; Dudekula, Anees; Hegde, Madhav; Kory, Swetha

    2016-01-01

    Rapid correction of hyponatremia is a well-known cause of central pontine and extrapontine myelinolysis. But uncommonly seen and rarely reported in Hypernatraemia. We report a rare case presenting as postpartum psychosis, wherein imaging revealed myelinolysis of corticospinal tracts in wine glass distribution and empty delta sign due to cortical venous thrombosis. At follow-up 3 months later, revealed significant neurological improvement. Concurrance occurrence of this dual pathology is not been described, which in our case was due to high serum sodium levels at presentation and dehydration. PMID:27504377

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Pre-Clinical Models of Diffuse Intrinsic Pontine Glioma

    Directory of Open Access Journals (Sweden)

    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.

  18. Pontine capillary telangiectasia as visualized on MR imaging causing a clinical picture resembling basilar-type migraine: a case report

    OpenAIRE

    Beukers, R.J.; Roos, Y.B.W.E.M.

    2009-01-01

    A case of presumed pontine capillary telangiectasia in an 18-year-old woman with a clinical diagnosis of basilar-type migraine is reported. Since both are very rare diagnoses, this case provides some evidence to suggest that pontine capillary telangiectasia might cause a clinical picture resembling basilar-type migraine.

  19. Pontine capillary telangiectasia as visualized on MR imaging causing a clinical picture resembling basilar-type migraine: a case report

    NARCIS (Netherlands)

    R.J. Beukers; Y.B.W.E.M. Roos

    2009-01-01

    A case of presumed pontine capillary telangiectasia in an 18-year-old woman with a clinical diagnosis of basilar-type migraine is reported. Since both are very rare diagnoses, this case provides some evidence to suggest that pontine capillary telangiectasia might cause a clinical picture resembling

  20. Inhibition of the pontine Kölliker-Fuse nucleus reduces genioglossal activity elicited by stimulation of the retrotrapezoid chemoreceptor neurons.

    Science.gov (United States)

    Silva, Josiane N; Lucena, Elvis V; Silva, Talita M; Damasceno, Rosélia S; Takakura, Ana C; Moreira, Thiago S

    2016-07-22

    The Kölliker-Fuse (KF) region, located in the dorsolateral pons, projects to several brainstem areas involved in respiratory regulation, including the chemoreceptor neurons within the retrotrapezoid nucleus (RTN). Several lines of evidence indicate that the pontine KF region plays an important role in the control of the upper airways for the maintenance of appropriate airflow to and from the lungs. Specifically, we hypothesized that the KF region is involved in mediating the response of the hypoglossal motor activity to central respiratory chemoreflex activation and to stimulation of the chemoreceptor neurons within the RTN region. To test this hypothesis, we combined immunohistochemistry and physiological experiments. We found that in the KF, the majority of biotinylated dextran amine (BDA)-labeled axonal varicosities contained detectable levels of vesicular glutamate transporter-2 (VGLUT2), but few contained glutamic acid decarboxylase-67 (GAD67). The majority of the RTN neurons that were FluorGold (FG)-immunoreactive (i.e., projected to the KF) contained hypercapnia-induced Fos, but did not express tyrosine hydroxylase. In urethane-anesthetized sino-aortic denervated and vagotomized male Wistar rats, hypercapnia (10% CO2) or N-methyl-d-aspartate (NMDA) injection (0.1mM) in the RTN increased diaphragm (DiaEMG) and genioglossus muscle (GGEMG) activities and elicited abdominal (AbdEMG) activity. Bilateral injection of muscimol (GABA-A agonist; 2mM) into the KF region reduced the increase in DiaEMG and GGEMG produced by hypercapnia or NMDA into the RTN. Our data suggest that activation of chemoreceptor neurons in the RTN produces a significant increase in the genioglossus muscle activity and the excitatory pathway is dependent on the neurons located in the dorsolateral pontine KF region. PMID:27126558

  1. Acute correction of hyponatremia secondary to psychogenic polydipsia

    OpenAIRE

    Quinn, Coridon J.; Iyegha, Uroghupatei P.; Beilman, Greg J.; Cerra, Frank B.

    2012-01-01

    Summary Background: Psychogenic polydipsia is prevalent amongst psychiatric patients, but less common in the general population. Generally, hyponatremia ensues with complications of cerebral edema resulting in confusion, seizures, coma, and death. Rapid correction of serum sodium levels can lead to further complications of osmotic demyelination of neurons, e.g. central pontine myelinolysis. Case Report: We present a case of a 32-year-old male who presented with seizures while being treated at...

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Acute cerebellar ataxia in a child with transient pontine lesions demonstrated by MRI

    NARCIS (Netherlands)

    Groen, R.J.M.; Begeer, J H; Wilmink, J T; le Coultre, R

    1991-01-01

    A case of acute cerebellar ataxia with discrete signs of pyramidal and tegmental involvement is reported, several days after recovery from an upper respiratory infection of unknown etiology. Magnetic resonance imaging showed transient pontine lesions, disappearing in the convalescence phase. Laborat

  4. Diffusion-and T2-weighted MRI of the transverse pontine fibres in spinocerebellar degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, M.; Hosoya, T.; Yamaguchi, K. [Dept. of Radiology, Yamagata University School of Medicine (Japan); Kawanami, T.; Kato, T. [3. Dept. of Internal Medicine, Yamagata University School of Medicine (Japan)

    2000-11-01

    Because the transverse pontine fibres degenerate in some subtypes of spinocerebellar degeneration (SCD), demonstration of these fibres may be helpful for radiological diagnosis of SCD. Using multishot diffusion-weighted MRI, we attempted to find a way to show the transverse pontine fibres. We assessed the quality of demonstration of these fibres on DWI and of abnormal high signal in the pons and middle cerebellar peduncles on T2-weighted images. We examined evaluated 24 control subjects and 12 patients with SCD: two with sporadic olivopontocerebellar atrophy (OPCA), five with spinocerebellar ataxia type 1 (SCA1), two with SCA3, and three with SCA6. In all control subjects and patients with SCA6, we succeeded in demonstrating the transverse pontine fibres as clear low-signal bundles using DWI. In two patients with SCA3, these fibres were identified less distinctly. In contrast, in two patients with sporadic OPCA and in four of five patients with SCA1, the fibres were not identified. In both patients with sporadic OPCA, abnormal high-signal foci were seen in the base of the pons and middle cerebellar peduncles on T2-weighted images; no such foci were detected in any patient with SCA1, SCA3 or SCA6. DWI seems to be useful for demonstrating transverse pontine fibres. Abnormal high signal in the pons and middle cerebellar peduncles may provide a clue to differentiation of sporadic OPCA from other types of SCD. (orig.)

  5. Renshaw cells are inactive during motor inhibition elicited by the pontine microinjection of carbachol.

    Science.gov (United States)

    Morales, F R; Engelhardt, J K; Pereda, A E; Yamuy, J; Chase, M H

    1988-04-12

    The present study was undertaken to determine whether the postsynaptic inhibition of motoneurons that occurs following the pontine microinjection of carbachol in the decerebrate cat is due to the activity of Renshaw cells. Thirty-two out of 37 Renshaw cells (86%) were spontaneously active prior to the administration of carbachol, whereas only 2 out of 13 Renshaw cells (15%) discharged during carbachol-induced motor inhibition. In addition, discrete inhibitory synaptic potentials were observed in 33% of the Renshaw cells from which intracellular recordings were obtained after carbachol administration, indicating that these cells were actively inhibited. The finding that a population of Renshaw cells, which inhibit motoneurons, were themselves inhibited during a period of profound motoneuron inhibition was quite unexpected. These results support the conclusion that Renshaw cells are not the inhibitory interneurons that are responsible for the powerful inhibition of motoneurons that occurs following the pontine microinjection of carbachol. PMID:3380320

  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. 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...

  8. A comparative anatomical CT study of the vascular and nervous structures of the cerebello-pontine angle

    International Nuclear Information System (INIS)

    The arteries and veins of the cerebellopontine angle have been injected with a contrast medium permitting a precise anatomical reconnaissance of their topography and relations. These specimens have been explored by CT in order to define the opacified vessels and to differentiate them from the adjacent nervous tissue. Thus in CT it is possible to locate the cerebellar arteries, the petrous and medullo-pontine veins and the nerves of the cerebello-pontine angle. This study describes the normal appearance of the flocculus on CT and the criteria to distinguish the flocculus from the arteries and veins. Moreover it should contribute to the definition of the criteria of reliability of a CT diagnosis and its limits in the cerebello-pontine angle. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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

  10. 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 < 0.05) reduced the amplitude and area under the curve of the bladder 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. PMID:26676253

  11. 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.

  12. Pontine abscess with initial treatment failure following infectious endocarditis with Streptococcus salivarius.

    Science.gov (United States)

    Knudtzen, Fredrikke Christie; Lynge, Maja; Gaini, Shahin

    2015-01-01

    We present a case report of a 65-year-old man admitted to the department of infectious diseases on suspicion of meningitis with headache, fever and double vision. A cerebral MRI revealed a 17×30 mm pontine abscess with surrounding oedema. The patient had, 2 months prior to admission, been treated for Streptococcus salivarius aortic valve endocarditis. The abscess was not suitable for surgery, and the patient received multidrug antibiotic treatment for 4 weeks. The patient initially responded well clinically, but was readmitted 4 weeks after discontinuation of treatment, with headache and dizziness. A new cerebral MRI showed progression of the abscess. He received an additional 8 weeks of broad spectrum antibiotic treatment, followed by 12 weeks of oral treatment with pivampicillin. His symptoms resolved and a cerebral MRI at discontinuation of treatment showed regression of the abscess to 7.5 mm. PMID:26139646

  13. Reirradiation as part of a salvage treatment approach for progressive non-pontine pediatric high-grade gliomas: preliminary experiences from the German HIT-HGG study group

    OpenAIRE

    Müller, Klaus; Scheithauer, Heike; Pietschmann, Sophie; Hoffmann, Marion; Rössler, Jochen; Graf, Norbert; Baumert, Brigitta G.; Christiansen, Hans; Kortmann, Rolf-Dieter; Kramm, Christof M.; Bueren, Andre O. von

    2014-01-01

    Background and purpose: The aim of the present analysis was to assess the feasibility, toxicity, and the tumor control of reirradiation as a salvage treatment for progressive pediatric non-pontine high-grade gliomas (HGG). Patients and methods: The database of the Reference Center for Radiation Oncology of the German HIT (HIT = German acronym for brain tumor) treatment network for childhood brain tumors was screened for children who were reirradiated for progressive non-pontine HGG. Results: ...

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Motoneuron properties during motor inhibition produced by microinjection of carbachol into the pontine reticular formation of the decerebrate cat.

    Science.gov (United States)

    Morales, F R; Engelhardt, J K; Soja, P J; Pereda, A E; Chase, M H

    1987-04-01

    It is well established that cholinergic agonists, when injected into the pontine reticular formation in cats, produce a generalized suppression of motor activity (1, 3, 6, 14, 18, 27, 33, 50). The responsible neuronal mechanisms were explored by measuring ventral root activity, the amplitude of the Ia-monosynaptic reflex, and the basic electrophysiological properties of hindlimb motoneurons before and after carbachol was microinjected into the pontine reticular formation of decerebrate cats. Intrapontine microinjections of carbachol (0.25-1.0 microliter, 16 mg/ml) resulted in the tonic suppression of ventral root activity and a decrease in the amplitude of the Ia-monosynaptic reflex. An analysis of intracellular records from lumbar motoneurons during the suppression of motor activity induced by carbachol revealed a considerable decrease in input resistance and membrane time constant as well as a reduction in motoneuron excitability, as evidenced by a nearly twofold increase in rheobase. Discrete inhibitory postsynaptic potentials were also observed following carbachol administration. The changes in motoneuron properties (rheobase, input resistance, and membrane time constant), as well as the development of discrete inhibitory postsynaptic potentials, indicate that spinal cord motoneurons were postsynaptically inhibited following the pontine administration of carbachol. In addition, the inhibitory processes that arose after carbachol administration in the decerebrate cat were remarkably similar to those that are present during active sleep in the chronic cat. These findings suggest that the microinjection of carbachol into the pontine reticular formation activates the same brain stem-spinal cord system that is responsible for the postsynaptic inhibition of alpha-motoneurons that occurs during active sleep. PMID:3585456

  16. Pontine infarction caused by medial branch injury of the basilar artery as a rare complication of cisternal drain placement

    OpenAIRE

    Horiuchi, Tetsuyoshi; Yamamoto, Yasunaga; Kuroiwa, Masafumi; Rahmah, Nunung Nur; Hongo, Kazuhiro

    2012-01-01

    We present a rare complication of cisternal drain placement during aneurysm surgery. A ruptured anterior communicating artery aneurysm was clipped through a right pterional approach. A cisternal drain was inserted from the retro-carotid to the prepontine cistern. Postoperatively, a left-sided paresis of the upper extremity had developed. A CT brain scan revealed that the drain was located between the pons and the basilar artery, resulting in a pontine infarction. Vascular neurosurgeons should...

  17. Long-term control of large pontine arteriovenous malformation using gamma knife therapy: a review with illustrative case

    OpenAIRE

    Martin M Mortazavi; Patel, Daxa; Griessenauer, Christoph J.; Tubbs, R. Shane; Fisher, Winfield S

    2013-01-01

    Brain stem arteriovenous malformations (AVMs) are rare and their clinical management is controversial. A location in highly eloquent areas and a greater risk of radionecrosis are both serious issues for radiosurgery of this entity. We report a case of a pontine AVM treated successfully with gamma knife therapy. At 3 years angiographic follow-up, imaging demonstrated complete thrombosis and there were no new neurological deficits, and at 7 years clinical follow-up, the patient continued to be ...

  18. Mesenchymal Transition and PDGFRA Amplification/Mutation Are Key Distinct Oncogenic Events in Pediatric Diffuse Intrinsic Pontine Gliomas

    OpenAIRE

    Puget, Stephanie; Philippe, Cathy; Bax, Dorine A.; Job, Bastien; Varlet, Pascale; Junier, Marie-Pierre; Andreiuolo, Felipe; Carvalho, Dina; Reis, Ricardo; Guerrini-Rousseau, Lea; Roujeau, Thomas; Dessen, Philippe; Richon, Catherine; Lazar, Vladimir; Le Teuff, Gwenael

    2012-01-01

    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 supratentoria...

  19. 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.)

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

    Science.gov (United States)

    Srinivasan, C; Kurian, G P; Mariappan, R

    2016-01-01

    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 (CO2) elimination and found that there was a significant contribution from the right lung. Hence, both lungs were ventilated to control CO2. The importance of lung isolation to prevent spillage and avoidance of one lung ventilation to control the arterial CO2 are highlighted in this case report. By providing a balanced anesthetic keeping both, the neurosurgical and thoracic concerns are important for better postoperative outcome. PMID:27375400

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

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

    International Nuclear Information System (INIS)

    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.

  4. 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.

  5. Off the Beaten Path: Drug Addiction and the Pontine Laterodorsal Tegmentum

    Science.gov (United States)

    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. PMID:24959564

  6. 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.

  7. Induction of rapid eye movement sleep by the microinjection of nerve growth factor into the pontine reticular formation of the cat.

    Science.gov (United States)

    Yamuy, J; Morales, F R; Chase, M H

    1995-05-01

    Nerve growth factor is an endogenous protein which belongs to the neurotrophin family of trophic factors. According to the neurotrophic hypothesis, neurotrophins are synthetized by target tissues and regulate the survival and phenotype of their innervating neurons. Whereas these trophic molecules have been mainly thought to be involved in developmental processes, their existence in the central nervous system of the adult animal suggests that they may play a role in neuronal physiology. Recently, it has been reported that neurons that express messenger RNA for two neurotrophins, namely brain-derived neurotrophic factor and neurotrophin-3, are located medial to the locus coeruleus and ventral to the fourth ventricle. This area corresponds to the latero-dorsal tegmental nucleus, which contains cholinergic neurons that have been implicated in the generation of rapid eye movement sleep. In turn, the laterodorsal tegmental nucleus is reciprocally connected with the nucleus pontis oralis in the rostrodorsal pontine reticular formation, which is an area that is involved in the initiation of the physiological patterns of activity that define the state of rapid eye movement sleep. Scattered neurons in the nucleus pontis oralis express the low-affinity nerve growth factor receptor which also binds the other neurotrophins with similar affinity. In addition, neurons in the area of the nucleus pontis oralis have been reported to express a subtype of the neurotrophin high affinity receptors. These membrane receptors, independently or in combination with the low affinity receptors, have been proposed to mediate the delayed, long-term effects of neurotrophins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7637879

  8. Neurological complications following liver transplant: a pictorial review of radiological and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Kyung; Shin, Ji Hoon; Kim, Sang Joon; Lee, Deok Hee; Lee, Ho Kyu; Choi, Choong Gon; Suh, Dae Chul [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2005-07-15

    Neurological complications are a rare but important and significant source of information about morbidity and mortality in liver transplant patients. Based on the clinical and radiological findings of 21 patients, neurological complications were categorized into five main groups; focal hemorrhagic or occlusive complications (n=11); diffuse hypoxic-ischemic injury (n=3); hypertensive encephalopathy (n=1); central pontine or extra-pontine myelinolysis (n=4); and infection (n=2). Neurological manifestations varied according to the location of the lesion, although seizures were the most common manifestation. In this pictorial review, we illustrate the radiological findings, focusing on MR and CT images, of a spectrum of neurological complications following liver transplants, as well as their clinical correlations.

  9. 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.

  10. 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.

  11. Electrophysiological characterization of neurons in the dorsolateral pontine REM sleep induction zone of the rat: intrinsic membrane properties and responses to carbachol and orexins

    OpenAIRE

    Brown§, Ritchie E.; Winston, Stuart; Basheer, Radhika; Thakkar, Mahesh M.; McCarley, Robert W.

    2006-01-01

    Pharmacological, lesion and single-unit recording techniques in several animal species have identified a region of the pontine reticular formation (Subcoeruleus, SubC) just ventral to the locus coeruleus as critically involved in the generation of rapid-eye-movement (REM) sleep. However, the intrinsic membrane properties and responses of SubC neurons to neurotransmitters important ...

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

    International Nuclear Information System (INIS)

    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.)

  13. 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

  14. 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.

  15. Idiopathic pontine Streptococcus salivarius abscess in an immunocompetent patient: management lessons through case illustration and literature review.

    Science.gov (United States)

    Mandapat, Aimee Luna; Eddleman, Christopher S; Bissonnette, Mei Lin; Batjer, H Hunt; Zembower, Teresa R

    2011-12-01

    A 55-y-old woman with no previous medical history presented with a 3-day history of progressive headache, nausea, emesis, right-sided facial numbness, and right-sided extremity weakness. Serial magnetic resonance imaging demonstrated rapid enlargement of a left-sided ring-enhancing dorsal pontine lesion with an exophytic portion, raising concern for an abscess. A stereotactically guided left-sided retrosigmoid craniotomy for abscess incision and decompression was performed given the rapid progression of her neurological deficits. Streptococcus salivarius was isolated from the intra-operative samples. After an extensive evaluation, no source for the S. salivarius was identified. Solitary brainstem abscesses are uncommon intracranial infections with high morbidity and mortality. Patients can present with non-specific symptoms and often have no previous medical history. Since 1974, 40 patients with solitary brainstem abscess have survived to hospital discharge. We outline management strategies for solitary brainstem abscess based on a literature review of survivors. PMID:21756019

  16. 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

  17. Vasoactive intestinal polypeptide excites medial pontine reticular formation neurons in the brainstem rapid eye movement sleep-induction zone

    DEFF Research Database (Denmark)

    Kohlmeier, Kristi Anne; Reiner, P B

    1999-01-01

    Although it has long been known that microinjection of the cholinergic agonist carbachol into the medial pontine reticular formation (mPRF) induces a state that resembles rapid eye movement (REM) sleep, it is likely that other transmitters contribute to mPRF regulation of behavioral states. A key...... candidate is the peptide vasoactive intestinal polypeptide (VIP), which innervates the mPRF and induces REM sleep when injected into this region of the brainstem. To begin understanding the cellular mechanisms underlying this phenomenon, we examined the effects of VIP on mPRF cells using whole-cell patch...... conclude that VIP excites mPRF neurons by activation of a sodium current. This effect is mediated at least in part by G-protein stimulation of adenylyl cyclase, cAMP, and protein kinase A. These data suggest that VIP may play a physiological role in REM induction by its actions on mPRF neurons....

  18. Four-year follow-up study in a NF1 Boy with a focal pontine hamartoma

    Directory of Open Access Journals (Sweden)

    Parisi Pasquale

    2013-02-01

    Full Text Available Abstract Neurofibromatosis is a collective name for a group of genetic conditions in which benign tumours affect the nervous system. Type 1 is caused by a genetic mutation in the NF1 gene (OMIM 613113 and symptoms can vary dramatically between individuals, even within the same family. Some people have very mild skin changes, whereas others suffer severe medical complications. The condition usually appears in childhood and is diagnosed if two of the following are present: six or more café-au-lait patches larger than 1.5 cm in diameter, axillary or groin freckling, 2 or more Lisch nodules (small pigmented areas in the iris of the eye, 2 or more neurofibromas, optic pathway gliomas, bone dysplasia, and a first-degree family relative with Neurofibromatosis type 1. The pattern of inheritance is autosomal dominant, however, half of all NF1 cases are ‘sporadic’ and there is no family history. Neurofibromatosis type 1 is an extremely variable condition whose morbidity and mortality is largely dictated by the occurrence of the many complications that may involve any of the body systems. We describe a family affected by NF1 in whom genetic molecular analysis identified the same mutation in the son and father. Routine MRI showed pontine focal lesions in the eight-year-old son, though not in the father. We performed a four years follow-up study and at follow-up pontine hamartoma size remained unchanged in the son, and the father showed still no brain lesions, confirming thus an intra-familial phenotype variability.

  19. Four-year follow-up study in a NF1 boy with a focal pontine hamartoma.

    Science.gov (United States)

    Parisi, Pasquale; Persechino, Severino; Paolino, Maria Chiara; Nicita, Francesco; Torrente, Isabella; Bozzao, Alessandro; Villa, Maria Pia

    2013-01-01

    Neurofibromatosis is a collective name for a group of genetic conditions in which benign tumours affect the nervous system. Type 1 is caused by a genetic mutation in the NF1 gene (OMIM 613113) and symptoms can vary dramatically between individuals, even within the same family. Some people have very mild skin changes, whereas others suffer severe medical complications. The condition usually appears in childhood and is diagnosed if two of the following are present: six or more café-au-lait patches larger than 1.5 cm in diameter, axillary or groin freckling, 2 or more Lisch nodules (small pigmented areas in the iris of the eye), 2 or more neurofibromas, optic pathway gliomas, bone dysplasia, and a first-degree family relative with Neurofibromatosis type 1. The pattern of inheritance is autosomal dominant, however, half of all NF1 cases are 'sporadic' and there is no family history. Neurofibromatosis type 1 is an extremely variable condition whose morbidity and mortality is largely dictated by the occurrence of the many complications that may involve any of the body systems. We describe a family affected by NF1 in whom genetic molecular analysis identified the same mutation in the son and father. Routine MRI showed pontine focal lesions in the eight-year-old son, though not in the father. We performed a four years follow-up study and at follow-up pontine hamartoma size remained unchanged in the son, and the father showed still no brain lesions, confirming thus an intra-familial phenotype variability. PMID:23399325

  20. 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.

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

    International Nuclear Information System (INIS)

    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.)

  2. Magnetic resonance DTI in detection of secondary Wallerian degeneration in pyramidal tract of patients with pontine infarction%脑桥梗死锥体束继发Wallerian变性的磁共振扩散张量成像研究

    Institute of Scientific and Technical Information of China (English)

    张苗; 卢洁; 林起湘; 戎冬冬; 赵志莲; 马青峰; 舒妮; 贺永; 李坤成

    2012-01-01

    Objective To study the evolution of WD in pyramidal tract of patients with pontine infarction according to their magnetic resonance DTI and its relation with the recovery of nerve function. Methods Sixteen patients with pontine infarction, who underwent magnetic resonance DTI on days 7,15,30,90 and 180 respectively after onset of the disease,served as a patient group and 16 healthy subjects served as a control group. FA values were measured at the medullary bulb under the infarction area,at the cerebral peduncle,at the posterior limb of internal capsule,and at the anterior and posterior central gyrus cortex over the infarction area,respectively. Difference in FA values measured in the infarcted side and its opposite side at different time points was compared with that measured in those at different sites in control group. Results The FA values measured at the medullary bulb under the infarction area,at the cerebral peduncle,at the posterior limb of internal capsule,and at the anterior and posterior central gyrus cortex over the infarction area were lower, especially on day 15 after onset "of the disease in patient group than in control group,and then returned almost to their normal value on day 180 after onset of the disease. The rFA values on day 15 after onset of the disease were positively related with the Fugl-Meyer motor function scores measured on days 90 and 180 after onset of the disease. Conclusion DTI can detect early secondary WD in pyramidal tract of patients -with pontine infarction. Decreased FA value in the homolateral pyramidal tract of patients with early pontine infarction can predict their long-term recovery of motor function.%目的 应用磁共振扩散张量成像(DTI)研究脑桥梗死后锥体束继发Wallerian变性的演变过程与神经功能恢复的关系.方法 对16例脑桥梗死患者(病例组)于发病<7d、15 d、30 d、90 d和180 d进行DTI检查.另选16例正常志愿者作为对照组.测量梗死区下方的延髓、上

  3. Our first decade of experience in deep brain stimulation of the brainstem: elucidating the mechanism of action of stimulation of the ventrolateral pontine tegmentum.

    Science.gov (United States)

    Mazzone, Paolo; Vilela Filho, Osvaldo; Viselli, Fabio; Insola, Angelo; Sposato, Stefano; Vitale, Flora; Scarnati, Eugenio

    2016-07-01

    The region of the pedunculopontine tegmental nucleus (PPTg) has been proposed as a novel target for deep brain stimulation (DBS) to treat levodopa resistant symptoms in motor disorders. Recently, the anatomical organization of the brainstem has been revised and four new distinct structures have been represented in the ventrolateral pontine tegmentum area in which the PPTg was previously identified. Given this anatomical reassessment, and considering the increasing of our experience, in this paper we revisit the value of DBS applied to that area. The reappraisal of clinical outcomes in the light of this revisitation may also help to understand the consequences of DBS applied to structures located in the ventrolateral pontine tegmentum, apart from the PPTg. The implantation of 39 leads in 32 patients suffering from Parkinson's disease (PD, 27 patients) and progressive supranuclear palsy (PSP, four patients) allowed us to reach two major conclusions. The first is that the results of the advancement of our technique in brainstem DBS matches the revision of brainstem anatomy. The second is that anatomical and functional aspects of our findings may help to explain how DBS acts when applied in the brainstem and to identify the differences when it is applied either in the brainstem or in the subthalamic nucleus. Finally, in this paper we discuss how the loss of neurons in brainstem nuclei occurring in both PD and PSP, the results of intraoperative recording of somatosensory evoked potentials, and the improvement of postural control during DBS point toward the potential role of ascending sensory pathways and/or other structures in mediating the effects of DBS applied in the ventrolateral pontine tegmentum region. PMID:26865208

  4. [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.

  5. Reirradiation as part of a salvage treatment approach for progressive non-pontine pediatric high-grade gliomas: preliminary experiences from the German HIT-HGG study group

    International Nuclear Information System (INIS)

    The aim of the present analysis was to assess the feasibility, toxicity, and the tumor control of reirradiation as a salvage treatment for progressive pediatric non-pontine high-grade gliomas (HGG). The database of the Reference Center for Radiation Oncology of the German HIT (HIT = German acronym for brain tumor) treatment network for childhood brain tumors was screened for children who were reirradiated for progressive non-pontine HGG. We identified eight patients (WHO grade III: n = 5; WHO grade IV: n = 3) who underwent reirradiation between April 2006 and July 2012. Median age was 13.5 years at primary diagnosis and 14.8 years at first progression. All patients initially underwent surgery (incomplete resection, n = 7; biopsy, n = 1) followed by radiochemotherapy. Relapses occurred inside (n = 2), at the margin (n = 4), and outside of the preirradiated area (n = 2). In all patients, reirradiation was tolerated well without significant acute toxicity. Temporary clinical improvement and tumor regression on magnetic resonance imaging (MRI) following reirradiation was reported (n = 3). However, all patients finally died by disease progression. Median survival time was 26.2 months from initial diagnosis and 11.4 months after first progression. Median time interval between initial radiotherapy and first reirradiation was 9.0 months. In six patients, all macroscopic tumor deposits were reirradiated. In these patients, median progression-free (overall) survival from the start of reirradiation was 2.4 (4.6) months. Our analysis, although based on a limited patient number, suggests that reirradiation of progressive non-pontine HGG is feasible in children. Benefit in terms of quality of life and/or survival needs to be assessed in a prospective and ideally in a randomized manner

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

    Science.gov (United States)

    Puget, Stephanie; Philippe, Cathy; Bax, Dorine A; Job, Bastien; Varlet, Pascale; Junier, Marie-Pierre; Andreiuolo, Felipe; Carvalho, Dina; Reis, Ricardo; Guerrini-Rousseau, Lea; Roujeau, Thomas; Dessen, Philippe; Richon, Catherine; Lazar, Vladimir; Le Teuff, Gwenael; Sainte-Rose, Christian; Geoerger, Birgit; Vassal, Gilles; Jones, Chris; Grill, Jacques

    2012-01-01

    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. PMID:22389665

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. Central nervous system tuberculosis: MRI

    International Nuclear Information System (INIS)

    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.)

  13. Pseudoprogression in children, adolescents and young adults with non-brainstem high grade glioma and diffuse intrinsic pontine glioma.

    Science.gov (United States)

    Carceller, Fernando; Fowkes, Lucy A; Khabra, Komel; Moreno, Lucas; Saran, Frank; Burford, Anna; Mackay, Alan; Jones, David T W; Hovestadt, Volker; Marshall, Lynley V; Vaidya, Sucheta; Mandeville, Henry; Jerome, Neil; Bridges, Leslie R; Laxton, Ross; Al-Sarraj, Safa; Pfister, Stefan M; Leach, Martin O; Pearson, Andrew D J; Jones, Chris; Koh, Dow-Mu; Zacharoulis, Stergios

    2016-08-01

    Pseudoprogression (PsP) is a treatment-related phenomenon which hinders response interpretation. Its prevalence and clinical impact have not been evaluated in children/adolescents. We assessed the characteristics, risk factors and prognosis of PsP in children/adolescents and young-adults diagnosed with non-brainstem high grade gliomas (HGG) and diffuse intrinsic pontine gliomas (DIPG). Patients aged 1-21 years diagnosed with HGG or DIPG between 1995 and 2012 who had completed radiotherapy were eligible. PsP was assessed according to study-specific criteria and correlated with first-line treatment, molecular biomarkers and survival. Ninety-one patients (47 HGG, 44 DIPG) were evaluable. Median age: 10 years (range, 2-20). Eleven episodes of PsP were observed in 10 patients (4 HGG, 6 DIPG). Rates of PsP: 8.5 % (HGG); 13.6 % (DIPG). Two episodes of PsP were based on clinical findings alone; nine episodes had concurrent radiological changes: increased size of lesions (n = 5), new focal enhancement (n = 4). Temozolomide, MGMT methylation or H3F3A mutations were not found to be associated with increased occurrence of PsP. For HGG, 1-year progression-free survival (PFS) was 41.9 % no-PsP versus 100 % PsP (p = 0.041); differences in 1-year overall survival (OS) were not significant. For DIPG, differences in 1-year PFS and OS were not statistically significant. Hazard ratio (95 %CI) of PsP for OS was 0.551 (0.168-1.803; p = 0.325) in HGG; and 0.308 (0.107-0.882; p = 0.028) in DIPG. PsP occurred in both pediatric HGG and DIPG patients at a comparable rate to adult HGG. PsP was associated with improved 1-yr PFS in HGG patients. PsP had a protective effect upon OS in DIPG patients. PMID:27180091

  14. Osmotik Demiyelinizasyon Sendromu

    OpenAIRE

    Öztürk, F; SANCAK, R.; İNCESU, L.; BAYSAL, K.

    2010-01-01

    %/ Hyponatremia is the most common electrolyte disturbance seen in the hospitalized pa¬tients. Severe symptomatic hyponatremia (serum sodium concentration < 120 mmol per liter) may be associated with permanent brain damage or death. However, many authori¬ties have reported that rapid correction causes pontine and extrapontine myelinolysis. Therefore, the treatment of hyponatremia is controversial. We present a patient had a neurologic syndrome with clinical findigs typical of pontine and extr...

  15. 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.

  16. Central mechanisms II: pharmacology of brainstem pathways.

    Science.gov (United States)

    Bolser, D C

    2009-01-01

    Following systemic administration, centrally acting antitussive drugs are generally assumed to act in the brainstem to inhibit cough. However, recent work in humans has raised the possibility of suprapontine sites of action for cough suppressants. For drugs that may act in the brainstem, the specific locations, types of neurones affected, and receptor specificities of the compounds represent important issues regarding their cough-suppressant actions. Two medullary areas that have received the most attention regarding the actions of antitussive drugs are the nucleus of the tractus solitarius (NTS) and the caudal ventrolateral respiratory column. Studies that have implicated these two medullary areas have employed both microinjection and in vitro recording methods to control the location of action of the antitussive drugs. Other brainstem regions contain neurones that participate in the production of cough and could represent potential sites of action of antitussive drugs. These regions include the raphe nuclei, pontine nuclei, and rostral ventrolateral medulla. Specific receptor subtypes have been associated with the suppression of cough at central sites, including 5-HT1A, opioid (mu, kappa, and delta), GABA-B, tachykinin neurokinin-1 (NK-1) and neurokinin-2, non-opioid (NOP-1), cannabinoid, dopaminergic, and sigma receptors. Aside from tachykinin NK-1 receptors in the NTS, relatively little is known regarding the receptor specificity of putative antitussive drugs in particular brainstem regions. Our understanding of the mechanisms of action of antitussive drugs would be significantly advanced by further work in this area. PMID:18825342

  17. Management of hyperosmolar hyperglycaemic state in adults with diabetes.

    Science.gov (United States)

    Scott, A R

    2015-06-01

    Hyperglycaemic hyperosmolar state (HHS) is a medical emergency, which differs from diabetic ketoacidosis (DKA) and requires a different approach. The present article summarizes the recent guidance on HHS that has been produced by the Joint British Diabetes Societies for Inpatient Care, available in full at http://www.diabetologists-abcd.org.uk/JBDS/JBDS_IP_HHS_Adults.pdf. HHS has a higher mortality rate than DKA and may be complicated by myocardial infarction, stroke, seizures, cerebral oedema and central pontine myelinolysis and there is some evidence that rapid changes in osmolality during treatment may be the precipitant of central pontine myelinolysis. Whilst DKA presents within hours of onset, HHS comes on over many days, and the dehydration and metabolic disturbances are more extreme. The key points in these HHS guidelines include: (1) monitoring of the response to treatment: (i) measure or calculate the serum osmolality regularly to monitor the response to treatment and (ii) aim to reduce osmolality by 3-8 mOsm/kg/h; (2) fluid and insulin administration: (i) use i.v. 0.9% sodium chloride solution as the principal fluid to restore circulating volume and reverse dehydration, (ii) fluid replacement alone will cause a fall in blood glucose (BG) level, (iii) withhold insulin until the BG level is no longer falling with i.v. fluids alone (unless ketonaemic), (iv) an initial rise in sodium level is expected and is not itself an indication for hypotonic fluids and (v) early use of insulin (before fluids) may be detrimental; and (3) delivery of care: (i) The diabetes specialist team should be involved as soon as possible and (ii) patients should be nursed in areas where staff are experienced in the management of HHS. PMID:25980647

  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. 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.)

  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

    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.

  2. 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.

  3. 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.

  4. Clinical and imaging features of hypertrophic olivary degeneration secondary to Pontine hemorrhage%脑桥出血后继发肥大性下橄榄核变性的临床及影像学特点

    Institute of Scientific and Technical Information of China (English)

    祝淑贞; 卢达国; 田时雨

    2012-01-01

    目的 探讨脑桥出血后继发肥大性下橄榄核变性症(hypertrophic inferior olivary degeneration syndrome,HOD)的临床及影像学特点.方法 对2009年1月至2011年6月在我院确诊的脑桥出血的65例,其中63例患者进行为期1年的随访,并对随访过程中发现有继发性下橄榄核变性症的9例患者的临床资料进行分析.结果 HOD发生影像学改变时仅有3例患者有临床症状,主要表现为眼震、软腭阵挛、躯干粗大震颤.脑桥出血均发生在被盖区.头颅MRI下橄榄核信号改变距离出血时间平均为4.05个月.出血病灶9例中有8例存在含铁血红素沉着.肥大的橄榄核直径多数在0.7~ 0.8 cm左右,下橄榄核信号改变6例为等T1WI,长T2WI改变,3例为长T1WI长T2WI改变,其中2例长T1WI患者出现典型临床症状.7例Flair显像为高信号,1例低信号,1例为等信号.治疗上,1例患者先后予森福罗、氯硝西泮、心得安、氟哌啶醇、美多巴等治疗,其中氯硝西泮及心得安有效.结论 HOD多发生在脑桥被盖部出血1个月后,头颅MRI特征为下橄榄核区的圆形的T2WI长信号改变;予心得安及氯硝西泮可能有效.%Objective To investigate the clinical and imaging features of hypertrophic inferior olivary degeneration syndrome (HOD) after pontine hemorrhage. Method All the patients with hypertrophic inferior olivary degeneration after pontine hemorrhage from January 2009 to June 2011 in hospital were enrolled to this study. Clinical manifestations, imaging and treatment were retrospectively observed. Results Nine cases were diagonosed as having HOD. Among them, only three patients with hemorrhage lesions in the tegmental area had clinical symptoms, presenting with dentatorubral tremor, palatal myoclonus and Nystagmus. The changes of MRI signals in the inferior olivary nucleus occurred at an average of 4.05 months following pontine hemorrhage. The hemosiderin staining was evident in eight patients and the

  5. Central Pain Syndrome

    Science.gov (United States)

    ... Enhancing Diversity Find People About NINDS NINDS Central Pain Syndrome Information Page Table of Contents (click to ... being done? Clinical Trials Organizations What is Central Pain Syndrome? Central pain syndrome is a neurological condition ...

  6. Central venous line - infants

    Science.gov (United States)

    CVL - infants; Central catheter - infants - surgically placed ... plastic tube that is put into a large vein in the chest. WHY IS A ... central catheter (PICC) or midline central catheter (MCC). A CVL ...

  7. 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.

  8. Group III metabotropic glutamate receptors inhibit startle-mediating giant neurons in the caudal pontine reticular nucleus but do not mediate synaptic depression/short-term habituation of startle.

    Science.gov (United States)

    Schmid, Susanne; Brown, Tyler; Simons-Weidenmaier, Nadine; Weber, Maruschka; Fendt, Markus

    2010-08-01

    Short-term habituation is a basic form of learning that is analyzed in different species and using different behavioral models. Previous studies on mechanisms of short-term habituation yielded evidence for a potential role of group III metabotropic glutamate receptors (mGluRIIIs). Here we tested the hypothesis that mGluRIII mediate short-term habituation of startle in rats, combining electrophysiological experiments in vitro with behavioral studies in vivo. We applied different mGluRIII agonists and antagonists on rat brainstem slices while recording from startle-mediating neurons in the caudal pontine reticular nucleus (PnC) and monitoring synaptic depression presumably underlying habituation. Furthermore, we injected the mGluRIII antagonist (RS)-alpha-phosphonophenylglycine (MPPG) and the agonist L-(+)-2-amino-4-phosphonobutyric acid (L-AP4) into the PnC of rats in vivo and measured its effect on startle habituation. Our results show that activation of mGluRIIIs in the PnC strongly inhibits startle-mediating giant neurons in vitro. Accordingly, L-AP4 reduced startle responses in vivo. However, synaptic depression in the slice was not disrupted by mGluRIII antagonists or agonists. Correspondingly, the in vivo application of the mGluRIII antagonist MPPG failed to show any effect on short-term habituation of startle responses. We therefore conclude that mGluRs are expressed within the primary startle pathway and that they inhibit startle responses upon activation; however, this inhibition does not play any role in synaptic depression and short-term habituation of startle. This is in contrast to the role of mGluRIIIs in other forms of habituation and supports the notion that there are different mechanisms involved in habituation of sensory-evoked behaviors. PMID:20685984

  9. To centralize or not to centralize?

    OpenAIRE

    Campbell, Andrew; Kunisch, Sven; Müller-Stewens, Günter

    2011-01-01

    The CEO's dilemma-were the gains of centralization worth the pain it could cause?-is a perennial one. Business leaders dating back at least to Alfred Sloan, who laid out GM's influential philosophy of decentralization in a series of memos during the 1920s, have recognized that badly judged centralization can stifle initiative, constrain the ability to tailor products and services locally, and burden business divisions with high costs and poor service.1 Insufficient centralization can deny bus...

  10. 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...

  11. Central and peripheral demyelination

    OpenAIRE

    Man Mohan Mehndiratta; Natasha Singh Gulati

    2014-01-01

    Several conditions cause damage to the inherently normal myelin of central nervous system, perepheral nervous system or both central and perepheral nervous system and hence termed as central demyelinating diseases, perepheral demyelinating diseases and combined central and perepheral demyelinating diseases respectively. Here we analysed and foccused on the etiology, prevalance, incidence and age of these demyelinating disorders. Clinical attention and various diagnostic tests are needed to ad...

  12. 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....

  13. Central centrifugal cicatricial alopecia

    OpenAIRE

    Collin Blattner; Dennis C Polley; Frank Ferritto; Elston, Dirk M

    2013-01-01

    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.

  14. Optimal Central Bank Transparency

    NARCIS (Netherlands)

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

    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

  15. Optimal central bank transparency

    NARCIS (Netherlands)

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

    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

  16. Optimal central bank transparency

    NARCIS (Netherlands)

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

    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

  17. Central Diffraction at ALICE

    CERN Document Server

    Lämsä, Jerry W

    2011-01-01

    The ALICE experiment is shown to be well suited for studies of exclusive final states from central diffractive reactions. The gluon-rich environment of the central system allows detailed QCD studies and searches for exotic meson states, such as glueballs, hybrids and new charmonium-like states. It would also provide a good testing ground for detailed studies of heavy quarkonia. Due to its central barrel performance, ALICE can accurately measure the low-mass central systems with good purity. The efficiency of the Forward Multiplicity Detector (FMD) and the Forward Shower Counter (FSC) system for detecting rapidity gaps is shown to be adequate for the proposed studies. With this detector arrangement, valuable new data can be obtained by tagging central diffractive processes.

  18. Central diffraction at ALICE

    Energy Technology Data Exchange (ETDEWEB)

    Laemsae, J W; Orava, R, E-mail: risto.orava@helsinki.fi [Helsinki Insitute of Physics, and Division of Elementary Particle Physics, Department of Physics, PL 64 (Gustaf Haellstroeminkatu 2a), FI-00014 University of Helsinki (Finland)

    2011-02-01

    The ALICE experiment is shown to be well suited for studies of exclusive final states from central diffractive reactions. The gluon-rich environment of the central system allows detailed QCD studies and searches for exotic meson states, such as glueballs, hybrids and new charmonium-like states. It would also provide a good testing ground for detailed studies of heavy quarkonia. Due to its central barrel performance, ALICE can accurately measure the low-mass central systems with good purity. The efficiency of the Forward Multiplicity Detector (FMD) and the Forward Shower Counter (FSC) system for detecting rapidity gaps is shown to be adequate for the proposed studies. With this detector arrangement, valuable new data can be obtained by tagging central diffractive processes.

  19. Organizational centralization in radiology.

    Science.gov (United States)

    Aas, I H Monrad

    2006-01-01

    Traditionally, hospitals have a radiology department, where images are taken and interpretation occurs. Teleradiology makes it possible to capture images in one location and transmit them elsewhere for interpretation. Organizational centralization of radiology interpretations is therefore of interest. Empirical data have been collected in qualitative interviews of 26 resource persons with substantial experience with picture archiving and communication systems and teleradiology, from 12 departments of radiology in Norway. The response rate was 90%. A total of 21 theoretically possible types of centralization of image interpretation were identified, representing combinations of three categories of geographical centralization, and seven categories of centralization according to function. Various advantages and disadvantages of centralization were identified. Organizational changes may be decisive for the future of teleradiology, but it may be wise to plan for change in small steps, since we know little about how broad future organizational changes based on teleradiology will be, or what will decide how far particular organizations will go. PMID:16438776

  20. 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.

  1. [Contralateral hyperhidrosis secondary to the pontine infarct].

    Science.gov (United States)

    Rey, A; Martí-Vilalta, J L; Abellán, M T

    1996-04-01

    Unilateral hyperhydrosis due to a cerebral infarct is a clinical sign rarely described in the literature, the significance of which is unknown and may be due to a lesion of the crossed sympathetic inhibitory tract. We describe the case of a patient with contralateral hyperhydrosis due to a hemipontine infarct. PMID:8721928

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

    Directory of Open Access Journals (Sweden)

    Hugo D Critchley

    Full Text Available 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.

  3. 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.

  4. 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.

  5. 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...

  6. Central Data Exchange

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Central Data Exchange (CDX) enables fast, efficient and more accurate environmental data submissions from state and local governments, industry and tribes to...

  7. "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

  8. 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...

  9. 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...

  10. Centralization and political accountability

    OpenAIRE

    Hindriks, Jean; Lockwood, Ben

    2004-01-01

    In this paper we abstract from the usual gains and costs of decentralization (e.g. preference matching, spillovers and economies of scale). Instead we compare the political accountability of decentralized governments relative to centralized ones when there is a risk of "bad" governance. We study both the selection and incentive effects of accountability. A key aspect of centralization is to make the politician answerable to multiple constituencies subject to a common budget constraint. Our ma...

  11. Central Bank independence

    OpenAIRE

    Vasile DEDU; Tiberiu STOICA

    2012-01-01

    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 disin...

  12. 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....

  13. 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

  14. 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.

  15. Colloquium on Central Asia

    International Nuclear Information System (INIS)

    This colloquium on Azerbaijan was organized by the direction of international relations of the French Senate and the French center of foreign trade (CFCE). This document gathers the interventions of the participants and the debates with the audience following these interventions. The topics treated concern: - the present day political-economical situation of Central Asia countries (problem of borders, relations with Russia and China); - the economies of Central Asia countries: short term problems and medium-term perspectives; - the relations with the European Union (political, economical, trade and investments, perspectives); - the European energy stakes of Caspian sea (oil and gas reserves, development of hydrocarbon resources, exploitation and transport constraints, stakes for Europe and France); - TotalFinaElf company in Central Asia (Kazakhstan, Azerbaijan, enclavement problem); - the economical impacts of the TRACECA pathway (Transport Corridor Europe Caucasus Asia). (J.S.)

  16. 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.

  17. 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.

  18. Hale Central Peak

    Science.gov (United States)

    2004-01-01

    19 September 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows some of the mountains that make up the central peak region of Hale Crater, located near 35.8oS, 36.5oW. Dark, smooth-surfaced sand dunes are seen to be climbing up the mountainous slopes. The central peak of a crater consists of rock brought up during the impact from below the crater floor. This autumn image is illuminated from the upper left and covers an area approximately 3 km (1.9 mi) across.

  19. 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.

  20. 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...

  1. ORIC central region calculations

    International Nuclear Information System (INIS)

    The central region for the K = 100 Oak Ridge Isochronous Cyclotron, ORIC, will be modified to provide better orbit centering, focusing of orbits in the axial direction, and phase selection, in order to improve extraction efficiency, and reduce radioactive activation of cyclotron components. The central region is specifically designed for the acceleration of intense light ion beams such as 60 MeV protons and 15--100 MeV alphas. These beams will be used in the production of radioactive atoms in the Radioactive Ion Beam Project at Oak Ridge National Laboratory

  2. 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.

  3. 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

  4. 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. PMID:26821744

  5. 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

  6. 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

  7. Forward central jets correlations

    International Nuclear Information System (INIS)

    The azimuthal correlation between forward and central jets has been measured in pp collisions with the CMS detector at the LHC at the centre-of-mass energy of 7 TeV. The forward jet is required to be reconstructed in the hadronic forward calorimeter, within the pseudo-rapidity 3.2t>35 GeV. The measurement of the azimuthal angle between the jets is performed for different separations in pseudo-rapidity between the jets, with the largest separation being 7.5 units. The measurement is repeated for two subsamples of events, one in which an additional jet is required between the forward and the central jet, and one where the additional jet is vetoed. The measurement is compared to several different Monte Carlo models and tunes.

  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. 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.

  10. Measuring Central Bank Communication:

    OpenAIRE

    David Lucca; Francesco Trebbi

    2008-01-01

    We present a new automated, objective and intuitive scoring method to measure the content of central bank communication about future policy rate moves. We apply the methodology to statements released by the Federal Open Market Commitee (FOMC) after monetary policy meetings. Using high-frequency financial data, we find that yields on short-term risk-free nominal rates respond both to changes in policy rates and the content of the statements, whereas, medium and long-term rates only respond to ...

  11. Central nervous system diseases

    International Nuclear Information System (INIS)

    It is shown that roentgenological examination plays an important role in diagnosis of central nervous system diseases in children. The methods of roentgenological examinations are divided into 3 groups: roentgenography without contrast media (conventional roentgenography), roentgenography with artificial contrasting of liquor space (ventriculopneumoencelography, myelography) and contrasting of brain and spinal blood vessels (angiography). Conventional contrastless roentgenography of skull and vertebral column occupies leadership in diagnosis of brain neoplasms and some vascular diseases

  12. Centrally Banked Cryptocurrencies

    OpenAIRE

    Danezis, George; Meiklejohn, Sarah

    2015-01-01

    Current cryptocurrencies, starting with Bitcoin, build a decentralized blockchain-based transaction ledger, maintained through proofs-of-work that also generate a monetary supply. Such decentralization has benefits, such as independence from national political control, but also significant limitations in terms of scalability and computational cost. We introduce RSCoin, a cryptocurrency framework in which central banks maintain complete control over the monetary supply, but rely on a distribut...

  13. Centrally Banked Cryptocurrencies

    OpenAIRE

    Danezis, G.; Meiklejohn, S.

    2016-01-01

    Current cryptocurrencies, starting with Bitcoin, build a decentralized blockchain-based transaction ledger, maintained through proofs-of-work that also serve to generate a monetary supply. Such decentralization has benefits, such as independence from national political control, but also significant limitations in terms of computational costs and scalability. We introduce RSCoin, a cryptocurrency framework in which central banks maintain complete control over the monetary supply, but rely on...

  14. 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.

  15. Water intoxication presenting as maternal and neonatal seizures: a case report

    Directory of Open Access Journals (Sweden)

    Chapman Timothy H

    2008-12-01

    Full Text Available Abstract Introduction We present an unusual case of fitting in the mother and newborn child, and the challenges faced in the management of their hyponatraemia due to water intoxication. Case presentation A previously well 37-year-old, primigravid Caucasian woman presented with features mimicking eclampsia during labour. These included confusion, reduced consciousness and seizures but without a significant history of hypertension, proteinuria or other features of pre-eclampsia. Her serum sodium was noted to be low at 111 mmol/litre as was that of her newborn baby. She needed anti-convulsants with subsequent intubation to stop the fitting and was commenced on a hypertonic saline infusion with frequent monitoring of serum sodium. There is a risk of long-term neurological damage from central pontine myelinolysis if the hyponatraemia is corrected too rapidly. Mother and baby went on to make a full recovery without any long-term neurological complications. Conclusion There is little consensus on the treatment of life-threatening hyponatraemia. Previous articles have outlined several possible management strategies as well as their risks. After literature review, an increase in serum sodium concentration of no more than 8–10 mmol/litre in 24 hours is felt to be safe but can be exceeded with extreme caution if life-threatening symptoms do not resolve. Formulae exist to calculate the amount of sodium needed and how much hypertonic intravenous fluid will be required to allow safer correction. We hypothesise the possible causes of hyponatraemia in this patient and underline its similarity in symptom presentation to eclampsia.

  16. How quickly can acute symptomatic hyponatremia be corrected?

    Science.gov (United States)

    Yaprak, Mustafa; Turan, Mehmet Nuri; Tamer, Abdulkerim Furkan; Peker, Nuri; Demirci, Meltem Sezis; Çırpan, Teksin; Aşçı, Gülay

    2013-12-01

    The systemic absorption of the flush liquid, including sorbitol, glycine or mannitol, can lead to complications, such as hyponatremia, volume overload and pulmonary or cerebral edema. Acute hyponatremia is defined as a reduction in the plasma sodium level in less than 48 h. Acute symptomatic hyponatremia should be corrected aggressively because it may cause irreversible neurological damage and death. Rapid correction of hyponatremia causes severe neurologic deficits, such as central pontine myelinolysis; thus, the optimal therapeutic approach has been debated. This article examined acute symptomatic hyponatremia in a patient undergoing transcervical myomectomy for a submucosal myoma. A thirty-seven-year-old patient was evaluated in obstetrics and gynecology clinic because of altered mental status and agitation. There was no history of chronic illness or drug use. It was discovered that during the operation, 12 L of the flush fluid, which contained 5 % mannitol, had been infused, but only 7 L of the flush fluid had been collected. On physical examination, the patient's general condition was moderate, her cooperation was limited, she was agitated, and her blood pressure was 120/70 mmHg. The sodium level was 99 mEq/L. Furosemid and 3 % NaCl solution were given. Her serum sodium returned to normal by increasing 39 mEq/L within 14 h. Her recovery was uneventful, and she was discharged 24 h after her serum sodium returned to normal. In conclusion, if there is a difference between the infused and collected volumes of the mannitol irrigant, severe hyponatremia may develop due to the flush fluid used during transcervical hysteroscopy and myomectomy. In these patients, acute symptomatic hyponatremia may be corrected as rapidly as the sodium level dropped. PMID:23054312

  17. Amantadine reduces glucagon and enhances insulin secretion throughout the oral glucose tolerance test: central plus peripheral nervous system mechanisms

    Directory of Open Access Journals (Sweden)

    Fuad Lechin

    2009-12-01

    Full Text Available Fuad Lechin1, Bertha van der Dijs1, Betty Pardey-Maldonado1, Jairo E Rivera1, Marcel E Lechin2, Scarlet Baez11Department of Physiological Sciences, Sections of Neuroendocrinology, Neuropharmacology, and Neurochemistry, Instituto de Medicina Experimental, Faculty of Medicine, Universidad Central de Venezuela, Caracas, Venezuela; 2Department of Internal Medicine, Texas A & M Health Science Center, College of Medicine, TX, USAObjective: The purpose of the trial was to examine the effects of amantadine, a N-methyl-D-aspartate (NMDA antagonist, on the oral glucose tolerance test (OGTT plus insulin, glucagon and neurotransmitters circulating levels. Previous findings showed that hyperinsulinism and type 2 diabetes are positively associated with neural sympathetic and adrenal sympathetic activities, respectively. These peripheral sympathetic branches depend on the pontine (A5-noradrenergic and the rostral ventrolateral (C1-adrenergic medullary nuclei. They are excited by glutamate axons which act at NMDA postsynaptic receptors.Research design and methods: One OGTT plus placebo and one OGTT plus oral amantadine test were carried out two weeks apart in 15 caucasic normal voluntary humans. Noradrenaline, adrenaline, dopamine, plasma-free serotonin, platelet serotonin, glucose, glucagon, and insulin were measured throughout the 180-minute testing period.Results: Maximal reductions of plasma glucose and glucagon plus exacerbated insulin rises were significantly greater throughout the oral glucose plus amantadine test than those registered throughout the oral glucose plus placebo challenge. The above findings were paralleled by greater than normal noradrenaline/adrenaline plasma ratio increases. In addition, maximal reductions of the platelet serotonin and plasma serotonin circulating values contrasted with the normal rises of these parameters, always registered during the glucose load plus placebo challenge.Conclusion: This study supports the theory that

  18. 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.

  19. 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

  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. Flooding in Central Siberia

    Science.gov (United States)

    2002-01-01

    A mixture of snowmelt and ice jams in late May and June of this year caused the Taz River (left) and the Yenisey River (right) in central Siberia to overflow their banks. The flooding can be seen in this image taken on June 11, 2002, by the MODIS (Moderate Resolution Imaging Spectroradiometer) instrument aboard the Terra satellite. Normally, the rivers would resemble thin black lines in MODIS imagery. In the false-color images sage green and rusty orange is land, and water is black. Clouds are white and pink. Credit: Image courtesy Jacques Descloitres, MODIS Land Rapid Response Team at NASA GSFC

  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 m...... 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. 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

  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. 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...

  6. Centralizer for well casing

    International Nuclear Information System (INIS)

    This patent describes an improved centralizer for centering a well casing in a wellbore. It comprises: a first anchor adapted to fit around and be securely fixed to the casing, the first anchor being threaded on its external surface; a first collar adapted to fit around and be threadedly engaged by the first anchor; a second collar adapted to fit around and free to rotate and move axially with respect to the casing; a second anchor adapted to fit around and be securely fixed to the casing spaced from the first anchor and comprising a bearing surface for restraining axial movement of the second collar along the casing; and metallic straps extending between the first collar and the second collar, and being securely fixed to each

  7. 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.

  8. Central solar energy receiver

    Science.gov (United States)

    Drost, M. Kevin

    1983-01-01

    An improved tower-mounted central solar energy receiver for heating air drawn through the receiver by an induced draft fan. A number of vertically oriented, energy absorbing, fin-shaped slats are radially arranged in a number of concentric cylindrical arrays on top of the tower coaxially surrounding a pipe having air holes through which the fan draws air which is heated by the slats which receive the solar radiation from a heliostat field. A number of vertically oriented and wedge-shaped columns are radially arranged in a number of concentric cylindrical clusters surrounding the slat arrays. The columns have two mirror-reflecting sides to reflect radiation into the slat arrays and one energy absorbing side to reduce reradiation and reflection from the slat arrays.

  9. Flooding in Central China

    Science.gov (United States)

    2002-01-01

    During the summer of 2002, frequent, heavy rains gave rise to floods and landslides throughout China that have killed over 1,000 people and affected millions. This false-color image of the western Yangtze River and Dongting Lake in central China was acquired on August 21, 2002, by the Moderate-resolution Imaging Spectroradiometer (MODIS), flying aboard NASA's Terra spacecraft. (right) The latest flooding crisis in China centers on Dingtong Lake in the center of the image. Heavy rains have caused it to swell over its banks and swamp lakefront towns in the province of Hunan. As of August 23, 2002, more than 250,000 people have been evacuated, and over one million people have been brought in to fortify the dikes around the lake. Normally the lake would appear much smaller and more defined in the MODIS image. Credit: Image courtesy Jacques Descloitres, MODIS Land Rapid Response Team at NASA GSFC.

  10. 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.

  11. Hope for Central China

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The cities surrounding Changsha and Wuhan in the middle reaches of the Yangtze River will ally to form a new pilot zone to boost regional economic development China’s fourth pilot zone for compre- hensive and coordinated economic reform will soon debut in the middle reaches of the Yangtze River,open- ing a new area to attract foreign investment. The application has been submitted to the State Council for approval. The pilot zone will include two clusters of cities in central China:One consists of Wuhan,capital of Hubei Province,and eight surrounding cities in Hubei,and the other is composed of Changsha,Zhuzhou and Xiangtan,three major cities in Hunan Province.

  12. Sucker rod centralizer

    Energy Technology Data Exchange (ETDEWEB)

    Rivas, O.; Newski, A.

    1989-10-03

    This patent describes a device for centralizing at least one sucker rod within a production pipe downhole in a well and for reducing frictional forces between the pipe and at least one sucker rod. It comprises an elongate, substantially cylindrical body member having a longitudinal axis, a plurality of slots within the member and a rotatable member mounted within each slot, each of the plurality of slots has its major dimension along a first axis parallel to the longitudinal axis of the body member and is oriented with respect to the other seats so as to form a helicoidal array for maximizing the total surface contact area between the rotatable members and the pipe and for decreasing the forces acting on each rotatable member.

  13. [Central auditory prosthesis].

    Science.gov (United States)

    Lenarz, T; Lim, H; Joseph, G; Reuter, G; Lenarz, M

    2009-06-01

    Deaf patients with severe sensory hearing loss can benefit from a cochlear implant (CI), which stimulates the auditory nerve fibers. However, patients who do not have an intact auditory nerve cannot benefit from a CI. The majority of these patients are neurofibromatosis type 2 (NF2) patients who developed neural deafness due to growth or surgical removal of a bilateral acoustic neuroma. The only current solution is the auditory brainstem implant (ABI), which stimulates the surface of the cochlear nucleus in the brainstem. Although the ABI provides improvement in environmental awareness and lip-reading capabilities, only a few NF2 patients have achieved some limited open set speech perception. In the search for alternative procedures our research group in collaboration with Cochlear Ltd. (Australia) developed a human prototype auditory midbrain implant (AMI), which is designed to electrically stimulate the inferior colliculus (IC). The IC has the potential as a new target for an auditory prosthesis as it provides access to neural projections necessary for speech perception as well as a systematic map of spectral information. In this paper the present status of research and development in the field of central auditory prostheses is presented with respect to technology, surgical technique and hearing results as well as the background concepts of ABI and AMI. PMID:19517084

  14. 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.

  15. Central nervous system tumors

    International Nuclear Information System (INIS)

    Central nervous system (CNS) tumors are relatively common in veterinary medicine, with most diagnoses occurring in the canine and feline species. Numerous tumor types from various cells or origins have been identified with the most common tumors being meningiomas and glial cell tumors. Radiation therapy is often used as an aid to control the clinical signs associated with these neoplasms. In general, these tumors have a very low metastatic potential, such that local control offers substantial benefit. Experience in veterinary radiation oncology would indicate that many patients benefit from radiation treatment. Current practice indicates the need for computed tomography or magnetic resonance imaging studies. These highly beneficial studies are used for diagnosis, treatment planning, and to monitor treatment response. Improvements in treatment planning and radiation delivered to the tumor, while sparing the normal tissues, should improve local control and decrease potential radiation related problems to the CNS. When possible, multiple fractions of 3 Gy or less should be used. The tolerance dose to the normal tissue with this fractionation schedule is 50 to 55 Gy. The most common and serious complications of radiation for CNS tumors is delayed radiation myelopathy and necrosis. Medical management of the patient during radiation therapy requires careful attention to anesthetic protocols, and medications to reduce intracranial pressure that is often elevated in these patients. Canine brain tumors have served as an experimental model to test numerous new treatments. Increased availability of advanced imaging modalities has spawned increased detection of these neoplasms. Early detection of these tumors with appropriate aggressive therapy should prove beneficial to many patients

  16. 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.

  17. 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

  18. Central bank independence and ageing

    OpenAIRE

    Farvaque, Etienne; Héricourt, Jérôme; Lagadec, Gaël

    2008-01-01

    We contrast the influence of demography and central bank independence on inflation. The recent demographic trends in developed countries are shown to weight more on inflation than central bank independence, while the contrary stands for the period from 1960 to 1979.

  19. Capillary telangiectasias of the pons. Does diffusion-weighted MR increase diagnostic accuracy?

    Energy Technology Data Exchange (ETDEWEB)

    Finkenzeller, Thomas, E-mail: thomas.finkenzeller@kliniken-nordoberpfalz.a [Institute of Diagnostic Radiology, University of Regensburg (Germany); Institute of Radiology, Landes-Nervenklinik Wagner-Jauregg, Linz (Austria); Fellner, Franz A. [Institute of Radiology, AKH Linz, Linz (Austria); Trenkler, Johannes [Institute of Radiology, Landes-Nervenklinik Wagner-Jauregg, Linz (Austria); Schreyer, Andreas [Institute of Diagnostic Radiology, University of Regensburg (Germany); Fellner, Claudia [Institute of Diagnostic Radiology, University of Regensburg (Germany); Institute of Radiology, Landes-Nervenklinik Wagner-Jauregg, Linz (Austria)

    2010-06-15

    Background and Purpose: Capillary telangiectasias are benign lesions of the brainstem which are sometimes difficult to distinguish from other lesions in standard MRI. The purpose of this study was to evaluate if diffusion-weighted imaging (DWI) could help to improve diagnostic accuracy. Methods: 148 MR examinations of patients with pontine lesions were evaluated retrospectively and revealed capillary telangiectasia (n = 18), presumed microvascular disease (n = 20), encephalitis disseminata (n = 21), pontine myelinolysis (n = 16), tumor (n = 20), acute infarction (n = 20), subacute infarction (n = 13) and chronic infarction (n = 20). All patients were examined using identical measurement parameters for DWI, Fluid attenuated inversion recovery, T2-weighted turbo spin-echo, and T1-weighted spin-echo before and after application of contrast agent in transverse orientation. Results: All capillary telangiectasias showed low signal intensity in DWI and significant contrast enhancement after application of gadolinium. Hypointense signal on DWI was very rare for the remaining lesions: only 1 pontine myelinolysis, 1 tumor, 4 subacute infarctions, and 19 chronic infarctions also revealed low signal intensity on DWI. The combination of high signal intensity on T1-weighted post-contrast images and low signal intensity on DWI was found for all capillary telangiectasias, but only for 1/20 tumor and for 4/13 subacute infarctions. These lesions could be differentiated by their clinical course and/or MRI follow-up examinations. The results of the visual assessment were confirmed by quantitative evaluation. Conclusion: DWI seems to be a useful adjunct for the diagnosis of capillary telangiectasias which will facilitate the differential diagnosis concerning tumorous, inflammatory and ischemic lesions.

  20. SQUARE AND RHOMBUS CENTRAL CONFIGURATIONS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    In this paper, we consider the flat central configurations of bodies using the characteristic set method. We completely solve two special cases of four planets, namely,the square and the rhombus. For the square case, we obtain that a square is a central configuration only in the case where the masses are equal and there exactly are two different square central configurations determined by the mass and the angular velocity; for the rhombus case, we obtain that if a rhombus is a central configuration, then the masses of the diagonal vertices must be equal. Furthermore, there are two or three or four different rhombus central configurations determined by the masses and the angular velocity.

  1. Central control of body temperature.

    Science.gov (United States)

    Morrison, Shaun F

    2016-01-01

    Central neural circuits orchestrate the behavioral and autonomic repertoire that maintains body temperature during environmental temperature challenges and alters body temperature during the inflammatory response and behavioral states and in response to declining energy homeostasis. This review summarizes the central nervous system circuit mechanisms controlling the principal thermoeffectors for body temperature regulation: cutaneous vasoconstriction regulating heat loss and shivering and brown adipose tissue for thermogenesis. The activation of these thermoeffectors is regulated by parallel but distinct efferent pathways within the central nervous system that share a common peripheral thermal sensory input. The model for the neural circuit mechanism underlying central thermoregulatory control provides a useful platform for further understanding of the functional organization of central thermoregulation, for elucidating the hypothalamic circuitry and neurotransmitters involved in body temperature regulation, and for the discovery of novel therapeutic approaches to modulating body temperature and energy homeostasis. PMID:27239289

  2. 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.

  3. 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...

  4. Central chemoreceptors: locations and functions.

    Science.gov (United States)

    Nattie, Eugene; Li, Aihua

    2012-01-01

    Central chemoreception traditionally refers to a change in ventilation attributable to changes in CO2/H(+) detected within the brain. Interest in central chemoreception has grown substantially since the previous Handbook of Physiology published in 1986. Initially, central chemoreception was localized to areas on the ventral medullary surface, a hypothesis complemented by the recent identification of neurons with specific phenotypes near one of these areas as putative chemoreceptor cells. However, there is substantial evidence that many sites participate in central chemoreception some located at a distance from the ventral medulla. Functionally, central chemoreception, via the sensing of brain interstitial fluid H(+), serves to detect and integrate information on (i) alveolar ventilation (arterial PCO2), (ii) brain blood flow and metabolism, and (iii) acid-base balance, and, in response, can affect breathing, airway resistance, blood pressure (sympathetic tone), and arousal. In addition, central chemoreception provides a tonic "drive" (source of excitation) at the normal, baseline PCO2 level that maintains a degree of functional connectivity among brainstem respiratory neurons necessary to produce eupneic breathing. Central chemoreception responds to small variations in PCO2 to regulate normal gas exchange and to large changes in PCO2 to minimize acid-base changes. Central chemoreceptor sites vary in function with sex and with development. From an evolutionary perspective, central chemoreception grew out of the demands posed by air versus water breathing, homeothermy, sleep, optimization of the work of breathing with the "ideal" arterial PCO2, and the maintenance of the appropriate pH at 37°C for optimal protein structure and function.

  5. Central European gas market perspectives

    International Nuclear Information System (INIS)

    This presentation deals with (1) Definition of the Central European market, (2) Factors driving up consumption of natural gas in Central and Eastern Europe, (3) Role of natural gas in regional energy consumption, (4) Position of natural gas in individual country markets, (5) Future sources of imported natural gas into the region. The Central European market are the eleven countries Albania, Bulgaria, Croatia, Czech Republic, Hungary, Macedonia, Poland, Romania, Serbia and Montenegro, Slovakia, and Slovenia, with a total population of 121 million. This market is comparable to combined France and Italy in terms of population, but only 30% of its size in terms of GDP

  6. Centralized digital control of accelerators

    International Nuclear Information System (INIS)

    In contrasting the title of this paper with a second paper to be presented at this conference entitled Distributed Digital Control of Accelerators, a potential reader might be led to believe that this paper will focus on systems whose computing intelligence is centered in one or more computers in a centralized location. Instead, this paper will describe the architectural evolution of SLAC's computer based accelerator control systems with respect to the distribution of their intelligence. However, the use of the word centralized in the title is appropriate because these systems are based on the use of centralized large and computationally powerful processors that are typically supported by networks of smaller distributed processors

  7. 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

  8. 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.

  9. Audit Committees in Central Banks

    OpenAIRE

    Kenneth Sullivan; Marie-Therese Camilleri; Tonny Lybek

    2007-01-01

    This paper reviews the tasks and design of audit committees, increasingly recommended as a way to strengthen financial accountability and good central bank governance. It outlines the motivations for the establishment of audit committees in commercial corporations and public sector entities, and explains how audit committees interact with other governance bodies within a central bank. The paper focuses on the functions of an audit committee, since the terminology of the governance structure i...

  10. 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.

  11. Rogoff's 'Conservative' Central Banker Restored

    OpenAIRE

    Herrendorf, Berthold; Lockwood, Ben

    1996-01-01

    This paper shows that delegation of monetary policy to a weight-conservative central banker is optimal, although the government can also use an inflation contract, an employment target, an inflation target, or any combination of these, to control the central banker. The key feature of our model is a stochastic inflation bias, arising when wage-setters receive some information about a supply shock prior to signing nominal wage contracts. Weight-conservatism is shown to be desirable if the stoc...

  12. Congenital nystagmus and central hypothyroidism

    OpenAIRE

    Reynaert, Nele; Braat, Elke; de Zegher, Francis

    2015-01-01

    We observed a male newborn with bilateral nystagmus and central hypothyroidism without hypoprolactinemia due to a deletion of chromosome band Xq26.1q26.2, containing FRMD7 and IGSF1. These two loss-of function mutations are known to cause, respectively, congenital nystagmus and the ensemble of central hypothyroidism, hypoprolactinemia and testicular enlargement. These latter two features may not yet be present in early life.

  13. 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

  14. Network centrality of metro systems.

    Directory of Open Access Journals (Sweden)

    Sybil Derrible

    Full Text Available Whilst being hailed as the remedy to the world's ills, cities will need to adapt in the 21(st century. In particular, the role of public transport is likely to increase significantly, and new methods and technics to better plan transit systems are in dire need. This paper examines one fundamental aspect of transit: network centrality. By applying the notion of betweenness centrality to 28 worldwide metro systems, the main goal of this paper is to study the emergence of global trends in the evolution of centrality with network size and examine several individual systems in more detail. Betweenness was notably found to consistently become more evenly distributed with size (i.e. no "winner takes all" unlike other complex network properties. Two distinct regimes were also observed that are representative of their structure. Moreover, the share of betweenness was found to decrease in a power law with size (with exponent 1 for the average node, but the share of most central nodes decreases much slower than least central nodes (0.87 vs. 2.48. Finally the betweenness of individual stations in several systems were examined, which can be useful to locate stations where passengers can be redistributed to relieve pressure from overcrowded stations. Overall, this study offers significant insights that can help planners in their task to design the systems of tomorrow, and similar undertakings can easily be imagined to other urban infrastructure systems (e.g., electricity grid, water/wastewater system, etc. to develop more sustainable cities.

  15. Network centrality of metro systems.

    Science.gov (United States)

    Derrible, Sybil

    2012-01-01

    Whilst being hailed as the remedy to the world's ills, cities will need to adapt in the 21(st) century. In particular, the role of public transport is likely to increase significantly, and new methods and technics to better plan transit systems are in dire need. This paper examines one fundamental aspect of transit: network centrality. By applying the notion of betweenness centrality to 28 worldwide metro systems, the main goal of this paper is to study the emergence of global trends in the evolution of centrality with network size and examine several individual systems in more detail. Betweenness was notably found to consistently become more evenly distributed with size (i.e. no "winner takes all") unlike other complex network properties. Two distinct regimes were also observed that are representative of their structure. Moreover, the share of betweenness was found to decrease in a power law with size (with exponent 1 for the average node), but the share of most central nodes decreases much slower than least central nodes (0.87 vs. 2.48). Finally the betweenness of individual stations in several systems were examined, which can be useful to locate stations where passengers can be redistributed to relieve pressure from overcrowded stations. Overall, this study offers significant insights that can help planners in their task to design the systems of tomorrow, and similar undertakings can easily be imagined to other urban infrastructure systems (e.g., electricity grid, water/wastewater system, etc.) to develop more sustainable cities. PMID:22792373

  16. 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...

  17. Pathophysiology of central sleep apneas.

    Science.gov (United States)

    Hernandez, Adam B; Patil, Susheel P

    2016-05-01

    The transition from wake to sleep is accompanied by a host of physiologic changes, which result in major alterations in respiratory control and may result in sleep-related breathing disorders. The central sleep apneas are a group of sleep-related breathing disorders that are characterized by recurrent episodes of airflow reduction or cessation due to a temporary reduction or absence of central respiratory drive. The fundamental hallmark of central sleep apnea (CSA) disorders is the presence of ventilatory control instability; however, additional mechanisms play a role in one or more specific manifestations of CSA. CSA may manifest during conditions of eucapnia/hypocapnia or chronic hypercapnia, which is a useful clinical classification that lends understanding to the underlying pathophysiology and potential therapies. In this review, an overview of normal breathing physiology is provided, followed by a discussion of pathophysiologic mechanisms that promote CSA and the mechanisms that are specific to different manifestations of CSA. PMID:26782104

  18. Central Clearing of OTC Derivatives

    DEFF Research Database (Denmark)

    Cont, Rama; Kokholm, Thomas

    2014-01-01

    We study the impact of central clearing of over-the-counter (OTC) transactions on counterparty exposures in a market with OTC transactions across several asset classes with heterogeneous characteristics. The impact of introducing a central counterparty (CCP) on expected interdealer exposure...... is determined by the tradeoff between multilateral netting across dealers on one hand and bilateral netting across asset classes on the other hand. We find this tradeoff to be sensitive to assumptions on heterogeneity of asset classes in terms of `riskyness' of the asset class as well as correlation...... of exposures across asset classes. In particular, while an analysis assuming independent, homogeneous exposures suggests that central clearing is efficient only if one has an unrealistically high number of participants, the opposite conclusion is reached if differences in riskyness and correlation across asset...

  19. Network Centrality of Metro Systems

    OpenAIRE

    Sybil Derrible

    2012-01-01

    Whilst being hailed as the remedy to the world's ills, cities will need to adapt in the 21(st) century. In particular, the role of public transport is likely to increase significantly, and new methods and technics to better plan transit systems are in dire need. This paper examines one fundamental aspect of transit: network centrality. By applying the notion of betweenness centrality to 28 worldwide metro systems, the main goal of this paper is to study the emergence of global trends in the e...

  20. 《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

  1. /S/ in Central American Spanish.

    Science.gov (United States)

    Lipski, John M.

    1985-01-01

    Describes the behavior of the phoneme /s/ in Central American Spanish by comparing the speech patterns of residents of Guatemala City, San Salvador, Tegucigalpa, San Jose, and Managua. Considers the possible diachronic processes which could have given rise to the current configurations and the theoretical consequences implied by the…

  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. Illustrating the Central Limit Theorem

    Science.gov (United States)

    Corcoran, Mimi

    2016-01-01

    Statistics is enjoying some well-deserved limelight across mathematics curricula of late. Some statistical concepts, however, are not especially intuitive, and students struggle to comprehend and apply them. As an AP Statistics teacher, the author appreciates the central limit theorem as a foundational concept that plays a crucial role in…

  4. 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 e...

  5. 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

  6. The CMS central hadron calorimeter

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, J.; E892 Collaboration

    1996-12-31

    The CMS central hadron calorimeter is a copper absorber/ scintillator sampling structure. We describe design choices that led us to this concept, details of the mechanical and optical structure, and test beam results. We discuss calibration techniques, and finally the anticipated construction schedule.

  7. Centrality Metric for Dynamic Networks

    CERN Document Server

    Lerman, Kristina; Kang, Jeon Hyung

    2010-01-01

    Centrality is an important notion in network analysis and is used to measure the degree to which network structure contributes to the importance of a node in a network. While many different centrality measures exist, most of them apply to static networks. Most networks, on the other hand, are dynamic in nature, evolving over time through the addition or deletion of nodes and edges. A popular approach to analyzing such networks represents them by a static network that aggregates all edges observed over some time period. This approach, however, under or overestimates centrality of some nodes. We address this problem by introducing a novel centrality metric for dynamic network analysis. This metric exploits an intuition that in order for one node in a dynamic network to influence another over some period of time, there must exist a path that connects the source and destination nodes through intermediaries at different times. We demonstrate on an example network that the proposed metric leads to a very different ...

  8. A First for Central America

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    FTA gives impetus to China’s trade with Costa Rica and other countries in the region The free trade agreement (FTA) between China and Costa Rica, signed in April 2010,came into effect on August 1.It was the first free trade pact between China and a Central

  9. 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),

  10. 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.…

  11. From Centrality to Temporary Fame: Dynamic Centrality in Complex Networks

    OpenAIRE

    Braha, Dan; Bar-Yam, Yaneer

    2006-01-01

    We develop a new approach to the study of the dynamics of link utilization in complex networks using records of communication in a large social network. Counter to the perspective that nodes have particular roles, we find roles change dramatically from day to day. "Local hubs" have a power law degree distribution over time, with no characteristic degree value. Our results imply a significant reinterpretation of the concept of node centrality in complex networks, and among other conclusions su...

  12. 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...

  13. 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...

  14. 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...

  15. 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.

  16. PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA

    Directory of Open Access Journals (Sweden)

    S.S. Anvari

    2009-08-01

    Full Text Available ObjectivePrimary central nervous system lymphoma (PCNSL is an extremely rare condition in childhood. We report the first case of PCNSL in a child in Iran.Clinical presentationA nine-year-old boy was referred to Mofid Hospital with the history of headache of four months and seizure of 2 months duration. Magnetic resonance imaging of the brain revealed a hyper-intense lesion in left fronto-parietal area with secondary satellite lesions. Biopsy of the brain mass was performed. Pathologic findings showed brain lymphoma and immunohistochemistry confirmed this diagnosis. The treatment started with intrathecal and systemic chemotherapy in combination with radiotherapy.Keywords:Lymphoma, Primary central nervous system lymphoma (PCNSL, Children

  17. 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.

  18. 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

  19. Wine markets in central Europe

    OpenAIRE

    Š BOJNEC

    2013-01-01

    This paper analyses the tendencies of grapes growing, wine trading and wine price competitiveness in Central European region. Croatia is net exporter of wines, Hungary is net exporter of grapes and wines, and Austria, Slovakia, and Slovenia are net importers of grapes and wines. Reductions in vineyards and increase in yields are found for Austria, Hungary, and Slovakia. More stable developments in vineyards, but decline in yields, are found for Croatia and Slovenia. Grape production increases...

  20. Central collisions of heavy ions

    International Nuclear Information System (INIS)

    This report describes the activities of the Heavy Ion Physics Group at the University of California, Riverside from October 1, 1991 to September 30, 1992. During this period, the program focused on particle production at AGS energies, and correlation studies at the Bevalac in nucleus-nucleus central collisions. As part of the PHENIX collaboration, contributions were made to the Preliminary Conceptual Design Report (pCDR), and work on a RHIC silicon microstrip detector R ampersand D project was performed

  1. Plague in Central Java, Indonesia

    OpenAIRE

    Williams, J.E.; Hudson, B. W.; Turner, R W; Saroso, J. Sulianti; Cavanaugh, D. C.

    1980-01-01

    Plague in man occurred from 1968 to 1970 in mountain villages of the Boyolali Regency in Central Java. Infected fleas, infected rats, and seropositive rats were collected in villages with human plague cases. Subsequent isolations of Yersinia pestis and seropositive rodents, detected during investigations of rodent plague undertaken by the Government of Indonesia and the WHO, attested to the persistence of plague in the region from 1972 to 1974.

  2. Central Asian drug trafficking dilemma

    OpenAIRE

    McGowen, Richard S.

    2003-01-01

    Tajikistan, a state that is completely landlocked, consists of very rough terrain that is comprised of mountains, cliffs and glaciers. There are very few transportation links through the area that gives Tajikistan limited access to neighboring countries. Security problems resulting from the increasing flow of narcotics illegally smuggled across the 1200 km Tajikistan- Afghanistan border have become critical in understanding the nature of political instability within Central Asia. This thesis ...

  3. Optimal Central Counterparty Risk Management

    OpenAIRE

    Philipp Haene; Andy Sturm

    2009-01-01

    In order to protect themselves against the potential losses in case of a participant's default and to contain systemic risk, central counterparties (CCPs) need to maintain sufficient financial resources. Typically, these financial resources consist of margin requirements and contributions to a collective default fund. Based on a stylized model of CCP risk management, this article analyzes the main factors affecting the trade-off between margins and default fund. The optimal balance between th...

  4. Political centralization and government accountability

    OpenAIRE

    Boffa, Federico; Piolatto, Amedeo; Giacomo A. M. Ponzetto

    2011-01-01

    This paper explains why decentralization can undermine accountability and answers three questions: what determines if power should be centralized or decentralized when regions are heterogeneous? How many levels of government should there be? How should state borders be drawn? We develop a model of political agency in which voters differ in their ability to monitor rent-seeking politicians. We find that rent extraction is a decreasing and convex function of the share of informed...

  5. Kalmanovitz y la Banca central / Kalmanovitz and central banking

    OpenAIRE

    Maya Muñoz, Guillermo

    2004-01-01

    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. From Centrality to Temporary Fame: Dynamic Centrality in Complex Networks

    CERN Document Server

    Braha, D; Braha, Dan; Bar-Yam, Yaneer

    2006-01-01

    We develop a new approach to the study of the dynamics of link utilization in complex networks using records of communication in a large social network. Counter to the perspective that nodes have particular roles, we find roles change dramatically from day to day. "Local hubs" have a power law degree distribution over time, with no characteristic degree value. Our results imply a significant reinterpretation of the concept of node centrality in complex networks, and among other conclusions suggest that interventions targeting hubs will have significantly less effect than previously thought.

  7. 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

  8. 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.

  9. 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.

  10. Central diffractive resonance production at the LHC

    Directory of Open Access Journals (Sweden)

    Fiore Roberto

    2016-01-01

    Full Text Available Central production of resonances resulting from the scattering of Pomerons in the central rapidity region of proton-proton scattering is studied. Estimates for relevant cross sections are presented.

  11. Biomass energy in Central America

    International Nuclear Information System (INIS)

    The objective of this paper is to introduce the concept of biomass to energy issues and opportunities in Central America. In this region, made up of seven countries (Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama), the biomass sector has the potential to play a crucial role in alleviating the environmental and development predicaments faced by all economies of the region. This paper assesses the available biomass resources at the regional and country levels and gives an overview of the current utilization of biomass fuels. It also describes the overall context in which the biomass-to-energy initiatives are immersed. At the regional level, biomass energy consumption accounts for more than 50% of total energy consumption. In regard to the utilization of biomass for energy purposes, it is clear that Central America faces a critical juncture at two levels, both mainly in rural areas: in the productive sector and at the household level. The absence of sustainable development policies and practices has jeopardized the availability of biomass fuels, particularly wood. Firewood is an important source of energy for rural industries such as coffee processing, which is one of the largest productive activities in the region. This paper comments on some of the most successful technological innovations already in place in the region, for instance, the rapid development of co-generation projects by the sugar cane industry, especially in El Salvador and Guatemala, the substitution of coffee husks for firewood in coffee processing plants in Costa Rica and El Salvador and the sustainable use of pine forests for co-generation in Honduras. Only one out of every two inhabitants in Central America now has access to electricity from the public grid. Biomass fuels, mainly firewood but also, to a lesser extent, other crop residues such as corn stalks, are the main source of energy for cooking and heating by most of the population. (It is foreseen that by the end

  12. The ZEUS central tracking detector

    International Nuclear Information System (INIS)

    The Central Tracking Detector (CTD) of ZEUS covers a wide angular range, whilst the Forward Detector - comprising the Forward Tracking Detector (FTD) and electron identification by transition radiation - concentrates on the important forward cone. The RTD (Rear Tracking Detector) provides accurate angle measurement of the recoil electron and the vertex detector (VXD) aims to find particles from heavy flavour decay. To measure momentum accurately the CTD sits in a high magnetic field (B=1,8 T) within the ZEUS calorimeter. (orig./HSI)

  13. Legal and actual central bank independence

    OpenAIRE

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

    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...

  14. Accountability of central banks: aspects and quantification

    Directory of Open Access Journals (Sweden)

    J. DE HAAN

    1999-06-01

    Full Text Available The work examines the relationship between central bank independence and accountability. The authors do this by using an indicator for central bank accountability based on the laws of 16 central banks. Central bank accountability is identified as having three distinct features, namely, the explicit definition and ranking of the objectives of monetary policy, the transparency of the actual monetary policy, and the final responsibility to monetary policy.

  15. 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.

  16. 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

  17. Accountability of Central Banks : Aspects and Quantification

    NARCIS (Netherlands)

    de Haan, J.; Amtenbrink, F.; Eijffinger, S.C.W.

    1998-01-01

    This paper starts with a discussion of the various aspects of accountability of central banks. On the basis of this discussion we construct an indicator for accountability for 16 central banks, including the European Central Bank. It is shown that the degree of accountability differs considerably an

  18. "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

  19. Central and forward tracking collaboration

    International Nuclear Information System (INIS)

    The goal of this subsystem R ampersand D project is to carry out a detailed study and design of a complete wire chamber tracking system covering pseudorapidity |η| ≤ 2.5 in a solenoidal detector for the SSC. Most of our group are now part of the Solenoidal Detector Collaboration (SDC), so the work has evolved into developing a tracking system conceptual design for the SDC detector. The design discussed in this report uses straw tube drift chambers for the central tracking region. Because of the high rates in the SSC environment, a small cell design is needed for wire chambers in the central region. Straw tubes as small cells offer many advantages because the sense wire is enclosed in a continuous cathode, and the wire tension due to the sense wire only can be supported without a massive structure. The straw tubes are grouped together to form superlayers in order to provide local track segments. The superlayers are composed of modules consisting of about two hundred straw tubes enclosed in a carbon fiber composite shell. Straw tubes have been used in previous experiments for small vertex drift chambers. However, they have never before been used for a large tracking system

  20. 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.

  1. Central Equatorial Pacific Experiment (CEPEX)

    Energy Technology Data Exchange (ETDEWEB)

    1993-01-01

    The Earth's climate has varied significantly in the past, yet climate records reveal that in the tropics, sea surface temperatures seem to have been remarkably stable, varying by less than a few degrees Celsius over geologic time. Today, the large warm pool of the western Pacific shows similar characteristics. Its surface temperature always exceeds 27[degree]C, but never 31[degree]C. Heightened interest in this observation has been stimulated by questions of global climate change and the exploration of stabilizing climate feedback processes. Efforts to understand the observed weak sensitivity of tropical sea surface temperatures to climate forcing has led to a number of competing ideas about the nature of this apparent thermostat. Although there remains disagreement on the processes that regulate tropical sea surface temperature, most agree that further progress in resolving these differences requires comprehensive field observations of three-dimensional water vapor concentrations, solar and infrared radiative fluxes, surface fluxes of heat and water vapor, and cloud microphysical properties. This document describes the Central Equatorial Pacific Experiment (CEPEX) plan to collect such observations over the central equatorial Pacific Ocean during March of 1993.

  2. 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.

  3. 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

  4. Performance contracting in central government in Denmark

    DEFF Research Database (Denmark)

    Kristiansen, Mads Bøge

    2015-01-01

    for maintaining the MBOR system including setting requirements and recommendations for the design and use of performance contracts, which means that a common central government framework for performance contracting exists. Despite of this common framework, differences in the contract content (scale and focus......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...

  5. 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,...

  6. WINE MARKETS IN CENTRAL EUROPE

    Directory of Open Access Journals (Sweden)

    Š BOJNEC

    2007-04-01

    Full Text Available This paper analyses the tendencies of grapes growing, wine trading and wine price competitiveness in Central European region. Croatia is net exporter of wines, Hungary is net exporter of grapes and wines, and Austria, Slovakia, and Slovenia are net importers of grapes and wines. Reductions in vineyards and increase in yields are found for Austria, Hungary, and Slovakia. More stable developments in vineyards, but decline in yields, are found for Croatia and Slovenia. Grape production increases in Austria, remains stable in Croatia, explores annual oscillations in Hungary, and declines in Slovakia and Slovenia. Export-to-import wine prices deteriorate for Austria and Hungary with most recent stabilization and price similarity, which hold also for Slovakia. Slovenian export-to-import wine prices are unstable, while Croatia experiences a bit higher export than import wine prices. Wine marketing, wine brand image of quality, and wine tourism are seen as tools to improve competitiveness in the wine sector.

  7. 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...

  8. Central solar-energy receiver

    Science.gov (United States)

    Not Available

    1981-10-27

    An improved tower-mounted central solar energy receiver for heating air drawn through the receiver by an induced draft fan is described. A number of vertically oriented, energy absorbing, fin-shaped slats are radially arranged in a number of concentric cylindrical arrays on top of the tower coaxially surrounding a pipe having air holes through which the fan draws air which is heated by the slats which receive the solar radiation from a heliostat field. A number of vertically oriented and wedge-shaped columns are radially arranged in a number of concentric cylindrical clusters surrounding the slat arrays. The columns have two mirror-reflecting sides to reflect radiation into the slat arrays and one energy absorbing side to reduce reradiation and reflection from the slat arrays.

  9. 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.

  10. 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。

  11. Wooden Calendars from Central Rhodopes

    Science.gov (United States)

    Koleva, V.

    2008-10-01

    Four wooden calendars from the village of Polkovnik Serafimovo, Smolyan region, in the Central Rhodopes are presented here, and three of them - for the first time. The shape and size, the kind of the signs and structure of the calendar record bear the characteristic features of the rest of the Bulgarian wooden calendars. The short notches on the edges represent the days of the year in the Julian (solar) calendar. The special signs on the sides mark the fixed festivals of the Orthodox Church calendar and are also influenced by the local tradition. The type of the signs confirms that the wooden sticks belong to the group of calendars from the Central Rhodopes. According to the beginning date of the calendar record on the sticks, two of the calendars are of the April (May) or October (November) type which corresponds to the very popular economic division of the year in the folk calendar into two periods -- warm and cold. The other two sticks, which are very similar to each other, make an exception in this respect among the rest of the Bulgarian wooden calendars. The months are divided into four groups (seasons) on each of the four edges of the stick (only one calendar from Burgas region has the same structure). The most interesting thing about the two sticks is that this is the only case among all known Bulgarian calendars that the beginning of the calendar record coincides with the beginning of the civil year on 1st January (January type) like some wooden calendars from Western Europe. Nowadays it is getting harder and harder to find wooden calendars in Bulgaria and in the neighbouring Balkan countries. The thorough knowledge about them could be helpful in various scientific fields, e.g. history of religion, ethnology, history of astronomy and mathematics, as well as semiotics.

  12. 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.

  13. Reduced central blood volume in cirrhosis

    DEFF Research Database (Denmark)

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

    1989-01-01

    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...... 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...... 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...

  14. 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.

  15. Central sleep apnea – a case report

    OpenAIRE

    Dybala Andrzej; Dyczko Monika; Makaruk Boguslaw; Kicinski Pawel; Bartoszek Elzbieta; Myslinski Wojciech; Rahnama Mansur; Mosiewicz Jerzy

    2014-01-01

    Central sleep apnea (CSA) is a disease characterized by repetitive episodes of the socalled central apneas during sleep. The disease has a very complex etiology. In clinical practice, the most important causes of CSA are disorders of the central nervous system, congestive heart failure or certain pathological changes of the respiratory muscles. We present a case of a 43-year-old male with severe CSA, who was successfully treated with BiPAP ST equipment.

  16. Central sleep apnea – a case report

    Directory of Open Access Journals (Sweden)

    Dybala Andrzej

    2014-06-01

    Full Text Available Central sleep apnea (CSA is a disease characterized by repetitive episodes of the socalled central apneas during sleep. The disease has a very complex etiology. In clinical practice, the most important causes of CSA are disorders of the central nervous system, congestive heart failure or certain pathological changes of the respiratory muscles. We present a case of a 43-year-old male with severe CSA, who was successfully treated with BiPAP ST equipment.

  17. Central Neurogenic Respiratory Failure: A Challenging Diagnosis

    OpenAIRE

    Carvalho, Flávio A.; Bernardino, Tenille; Maciel, Ricardo O.H.; Felizola, Sérgio F.A.; Costa, Eduardo L.V.; Silva, Gisele S

    2011-01-01

    Background Central nervous system lesions are rare causes of respiratory failure. Simple observation of the breathing pattern can help localize the lesion, but the examiner needs to be aware of potential pitfalls such as metabolic or pulmonary alterations. Methods We describe 3 cases in which central neurogenic respiratory failure occurred simultaneously with other alterations or in an unusual presentation. Results All patients were diagnosed with central neurogenic respiratory failure and tr...

  18. Transparency in Central Bank Financial Statement Disclosures

    OpenAIRE

    Kenneth Sullivan

    2000-01-01

    The IMF's development of the Code of Good Practices on Transparency in Monetary and Financial Policies and the introduction of safeguards assessments have increased emphasis on transparency of the disclosures made in central bank financial statements. This paper, which updates WP/00/186, looks at the disclosure requirements for central banks under International Financial Reporting Standards and provides practical guidance for those responsible for preparing central bank financial statements.

  19. On the Central Coefficients of Riordan Matrices

    OpenAIRE

    Barry, Paul

    2013-01-01

    We use the Lagrange-Bürmann inversion theorem to characterize the generating function of the central coefficients of the elements of the Riordan group of matrices. We apply this result to calculate the generating function of the central elements of a number of explicit Riordan arrays, defined by rational expressions, and in two cases we use the generating functions thus found to calculate the Hankel transforms of the central elements, which are themselves expressible as combinatorial polynomi...

  20. Clarity of Central Bank Communication About Inflation

    OpenAIRE

    Ales Bulir; David-Jan Jansen; Martin Cihak

    2011-01-01

    This paper examines whether the clarity of central bank communication about inflation has changed with the economic environment. We use readability statistics and content analysis to study the clarity of communication on the inflation outlook by seven central banks between 1997 and 2010. Overall, we find no strong indications that central banks were less clear in explaining their policies when faced with higher uncertainty or a less favorable inflation outlook. The global financial crisis, ho...

  1. 2. The Central American gang phenomenon

    OpenAIRE

    Does, Antonia

    2013-01-01

    2.1. Differentiating between pandillas and maras Youth gangs have existed since the 1960s and 1970s in Central America. However, there are different types of Central American gangs and thus one has to distinguish between pandillas and maras. The former are localized, homegrown gangs, which are “direct inheritors” (Jütersonke, Rodgers & Muggah 2009: 379) of the gangs that have historically characterized Central American societies, while the latter are a more recent phenomenon with transnationa...

  2. Urban history and modernity in Central Europe

    OpenAIRE

    Klautke, E. F.

    2010-01-01

    This historiographical review discusses recent literature on cities in modern Central Europe – mainly on Berlin and Vienna – which reflects the great variety of approaches to urban history and underlines the importance of urban history for the study of modernity. The history of urbanisation was a central event in the history of modernity. Especially in the Central European capitals of Berlin and Vienna, where modernisation and urban growth started later and then advanced quicker than in West ...

  3. 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...

  4. 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.

  5. 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.

  6. A Central Theory of Biology

    Science.gov (United States)

    Torday, John S.

    2015-01-01

    The history of physiologic cellular–molecular interrelationships can be traced all the way back to the unicellular state by following the pathway formed by lipids ubiquitously accommodating calcium homeostasis, and its consequent adaptive effects on oxygen uptake by cells, tissues and organs. As a result, a cohesive, mechanistically integrated view of physiology can be formulated by recognizing the continuum comprising conception, development, physiologic homeostasis and death mediated by soluble growth factor signaling. Seeing such seemingly disparate processes as embryogenesis, chronic disease and dying as the gain and subsequent loss of cell–cell signaling provides a novel perspective for physiology and medicine. It is emblematic of the self-organizing, self-referential nature of life, starting from its origins. Such organizing principles obviate the pitfalls of teleologic evolution, conversely providing a way of resolving such seeming dichotomies as holism and reductionism, genotype and phenotype, emergence and contingence, proximate and ultimate causation in evolution, cells and organisms. The proposed approach is scale-free and predictive, offering a Central Theory of Biology. PMID:25911556

  7. 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.

  8. Towards a centralized Grid Speedometer

    Science.gov (United States)

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

    2014-06-01

    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.

  9. Towards a centralized Grid Speedometer

    International Nuclear Information System (INIS)

    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.

  10. A partitioned central solar receiver

    International Nuclear Information System (INIS)

    Else of solar energy as substitute for conventional fuels at a competitive cost requires efficient conversion from solar radiation to usable forms of energy. In solar thermal or thermochemical applications, high efficiency usually re- quires high temperature and high concentration of incoming radiation. The main form of energy loss from high temperature solar central receivers is thermal emission ('re radiation'), at an effective temperature close to the maximum receiver temperature. This loss is reduced if the aperture is divided into segments, most of which are maintained at lower temperatures. A two-stage partitioned receiver demonstrating this concept is under construction at the Weizman Solar Tower. The high-temperature stage is the DIAPR (Directly Irradiated Annular Pressurized Receiver). The low-temperature stage is made of tubular cavity receivers of simpler design. Preliminary optical and thermal design of the partitioned receiver is presented. For the design exit temperature of 1500 K, the aperture size of the partitioned receiver is about 60% of the equivalent single-stage receiver, indicating a significant increase of conversion efficiency. The exit temperature of the low-temperature stage is around 1100 K, allowing simpler design and inexpensive construction. (authors)

  11. 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.

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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

  17. 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

  18. Nuclear Energy in Central Europe 98, Proceedings

    International Nuclear Information System (INIS)

    Regional Meeting for Nuclear Energy in Central Europe is an annual meeting of the Nuclear Society of Slovenia. The proceedings contain 63 articles from Slovenia, sorounding countries and countries of the Central and Eastern European Region. Topics are: Research Reactors, Nuclear Methods, Reactor Physics, Thermal Hydraulics, Structural Analysis, Probabilistic Safety Assessment, Severe Accidents, NPP Operation and Nuclear Waste disposal

  19. Visualizing the Central Limit Theorem through Simulation

    Science.gov (United States)

    Ruggieri, Eric

    2016-01-01

    The Central Limit Theorem is one of the most important concepts taught in an introductory statistics course, however, it may be the least understood by students. Sure, students can plug numbers into a formula and solve problems, but conceptually, do they really understand what the Central Limit Theorem is saying? This paper describes a simulation…

  20. 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.

  1. The economic impact of central bank transparency

    NARCIS (Netherlands)

    van der Cruijsen, C.A.B.

    2008-01-01

    During the last decades a lot of central banks have become more transparent about their monetary policy. The research question that is addressed in this book is whether central bank transparency is desirable from an economic viewpoint. It is shown that transparency increases have been beneficial. Th

  2. The European Central Bank and financial supervision

    OpenAIRE

    Eijffinger, S.C.W.

    2004-01-01

    Analyzing ongoing changes in the design of regulatory and supervisory authorities over the banking and financial industry in Europe, this comprehensive Handbook pays particular attention to the role of national central banks, the new financial supervisory authorities and the European Central Bank (ECB).

  3. 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.

  4. 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.

  5. 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...

  6. 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.

  7. 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…

  8. 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.

  9. Guidance and Orientation Manual : Internal Diseases Ward 11 - Central Finland Central Hospital

    OpenAIRE

    Hirjaba, Marina

    2009-01-01

    The purpose of this Bachelor’s Thesis is to create an initiation manual for the foreign students, foreign visitors or anyone else interested about Internal Diseases ward 11, Central Finland Central Hospital. The aim of the guidance material is to help the foreign students, who are practicing on ward 11, to become acquainted with the Finnish Healthcare System, Central Finland Central Hospital and to offer orientation upon the nursing and organisation of Internal Diseases ward 11. It is taken i...

  10. 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.

  11. Central station market development strategies for photovoltaics

    Science.gov (United States)

    1980-11-01

    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.

  12. 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.

  13. 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, ...

  14. Reduced central blood volume in cirrhosis

    DEFF Research Database (Denmark)

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

    1989-01-01

    was inversely correlated to the systemic vascular resistance (r = -0.49, p less than 0.001), the latter being significantly reduced in the patient group. Patients with cirrhosis apparently are unable to maintain a normal central blood volume. This may be due to arteriolar vasodilation, portosystemic collateral......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...... 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...

  15. The central curve in linear programming

    CERN Document Server

    De Loera, Jesús A; Vinzant, Cynthia

    2010-01-01

    The central curve of a linear program is an algebraic curve specified by linear and quadratic constraints arising from complementary slackness. It is the union of the various central paths for minimizing or maximizing the cost function over any region in the associated hyperplane arrangement. We determine the degree, arithmetic genus and defining prime ideal of the central curve, thereby answering a question of Bayer and Lagarias. These invariants, along with the degree of the Gauss image of the curve, are expressed in terms of the matroid of the input matrix. Extending work of Dedieu, Malajovich and Shub, this yields an instance-specific bound on the total curvature of the central path, a quantity relevant for interior point methods. The global geometry of central curves is studied in detail.

  16. Actual versus Perceived Central Bank Transparency : The Case of the European Central Bank

    NARCIS (Netherlands)

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

    2007-01-01

    Central banks have become more and more transparent about their monetary policy making process. In the central bank transparency lit- erature the distinction between actual and perceived central bank trans- parency is often lacking. However, as perceptions are crucial for the ac- tions of economic a

  17. FROM CENTRAL ASIA TO GREAT CENTRAL ASIA: THE GOALS AND ADJUSTMENTS OF U.S. CENTRAL ASIAN STRATEGY

    OpenAIRE

    Tian, Robert

    2009-01-01

    To penetrate and maintain peaceful development of the Central Asian region is a consistent goal of the United States for its international interests. With the 9/11 event as the baseline, since 2001 America's awareness of the strategic importance of Central Asia and the latter's weight in U.S. global strategy has been greatly changed. According to Charles Manes, the 9/11 terrorist attack enabled the U.S. to "discover Central Asia. As a result of this discovery the United States effectively gai...

  18. 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.

  19. 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.

  20. 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.

  1. Central versus institutional self-archiving

    OpenAIRE

    Harnad, Stevan

    2006-01-01

    NIH's, PLoS's, the Wellcome Trust's and now the UK MRC's unreflective support for PubMed Central (PMC), a Central Repository (CR), as the locus for direct self-archiving by authors is very unfortunate for Institutional Repositories (IRs), for self-archiving, and for Open Access (OA) progress in general. Alma Swan has published key papers on both OA self-archiving policy and institutional versus central self-archiving (IRs vs. CRs) analysing the reasons. (a) Institutional self-archiving and ce...

  2. [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.

  3. Searchability of central nodes in networks

    CERN Document Server

    Klemm, Konstantin

    2013-01-01

    Social networks are discrete systems with a large amount of heterogeneity among nodes (individuals). Measures of centrality aim at a quantification of nodes' importance for structure and function. Here we ask to which extent the most central nodes can be found by purely local search. We find that many networks have close-to-optimal searchability under eigenvector centrality, outperforming searches for degree and betweenness. Searchability of the strongest spreaders in epidemic dynamics tends to be substantially larger for supercritical than for subcritical spreading.

  4. Francis Crick, DNA, and the Central Dogma

    Science.gov (United States)

    Olby, Robert

    1970-01-01

    This essay describes how Francis Crick, ex-physicist, entered the field of biology and discovered the structure of DNA. Emphasis is upon the double helix, the sequence hypothesis, the central dogma, and the genetic code. (VW)

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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

  10. 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...

  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. New Neanurinae (Collembola: Neanuridae) from Central China.

    Science.gov (United States)

    Wang, Ya-Ru; Wang, Wen-Bin; Jiang, Jigang

    2016-01-01

    Three new species, two of Vitronura and one of Lobellina of subfamily Neanurinae (Neanuridae, Collembola) from Central China are described. In addition a key for valid Lobellina species is included. PMID:27470797

  13. 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,...

  14. Random walk centrality in interconnected multilayer networks

    Science.gov (United States)

    Solé-Ribalta, Albert; De Domenico, Manlio; Gómez, Sergio; Arenas, Alex

    2016-06-01

    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) influent 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.

  15. 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...

  16. Central Station DHC Phase 1 feasibility

    Energy Technology Data Exchange (ETDEWEB)

    Henderson, H.L.

    1992-03-01

    This project assisted a private real estate developer in technically assessing the feasibility of integrating a central DHC system into a proposed 72 acre area mixed-use Planned Development (Central Station) just south of the Chicago Central Business District (Loop). The technical assessment concluded that a district heating and cooling system for Central Station will be feasible, provided that a major anchor load can be connected to the system. The system conceived for the site employs a modular approach that adjusts production capacity to actual load growth. The design concept includes gas-fired boilers for heating, gas turbine driven chillers for base loading, electric motor driven chillers for peaking, steam turbines for peak power and back pressure operation, and chilled water storage. Energy will be supplied to the users in the form of steam or low temperature hot water for heating, and low temperature chilled water for cooling.

  17. EXPLAINING TRAFFIC FLOW PATTERNS USING CENTRALITY MEASURES

    Directory of Open Access Journals (Sweden)

    Amila Jayasinghe

    2015-06-01

    Full Text Available This study examines the capability of centrality parameters of the road network to explain and predict traffic flow by types of vehicles. The case study was conducted in Colombo Metropolitan Area, Sri Lanka. Study used four centrality parameters i.e. connectivity, global integration, local integration and choice; and three analysis methods i.e. topological, metric and angular which introduced by space syntax analysis method to compute network centrality of the road network. Findings of this study stress that, (1 human beings perceive the space mostly from geometrical distance (topological and angular distance in comparison to metric distance. Further to this, it was found that angular distance is more powerful in global level whereas topological distance is more powerful in local level; (2 it is more appropriate to consider the multiple influences from multiple centrality parameters rather being confined to a single best parameter and influence of each parameter varies based on type of vehicles.

  18. 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...

  19. 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...

  20. Central California 3 arc-second DEM

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 3-second Central California Elevation Grid provides bathymetric data in ASCII raster format of 3-second resolution in geographic coordinates. This grid is...

  1. Staging Childhood Central Nervous System Embryonal Tumors

    Science.gov (United States)

    ... children. See the PDQ summary on Adult Central Nervous System Tumors Treatment for more information on the treatment of adults. There are different types of CNS embryonal tumors. Enlarge Anatomy of the inside of the brain, showing the ...

  2. Initial TMX central-cell ICRH experiments

    International Nuclear Information System (INIS)

    Four topics are discussed in this report: the feasibility of applying ion cyclotron resonance heating (ICRH) in the TMX central cell, some applications of heating, the results of preliminary experiments, and plans for further ICRH experiments

  3. 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

  4. 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. PMID:26632483

  5. Hitherto unreported Agaricus species of Central India

    OpenAIRE

    MAHENDRA KUMAR RAI; ALKA KARWA

    2010-01-01

    Karwa A, Rai MK. 2010. Hitherto unreported Agaricus species of Central India. Nusantara Bioscience 2: 141-145. Melghat forest region from Central India was surveyed for occurrence of medicinal and culinary mushrooms during the years 2005-2008. Out of total 153 species, ten species of Agaricus were recorded from different localities. Of these, seven species namely Agaricus bitorquis, A. subrufescens, A. augustus, A. placomyces, A. essettei, A. basioanolosus and Agaricus sp. nov (a new species)...

  6. Focal lesions in the central nervous system

    International Nuclear Information System (INIS)

    This report reviews the animal and human studies currently in progress at LBL with heavy-ion beams to induce focal lesions in the central nervous system, and discusses the potential future prospects of fundamental and applied brain research with heavy-ion beams. Methods are being developed for producing discrete focal lesions in the central nervous system using the Bragg ionization peak to investigate nerve pathways and neuroendocrine responses, and for treating pathological disorders of the brain

  7. Central Institute for Nuclear Research (1956 - 1979)

    International Nuclear Information System (INIS)

    The Central Institute for Nuclear Research (ZfK) of the Academy of Sciences of the GDR is presented. This first overall survey covers the development of the ZfK since 1956, the main research activities and results, a description of the departments responsible for the complex implementation of nuclear research, the social services for staff and the activities of different organizations in the largest central institute of the Academy of Sciences of the GDR. (author)

  8. Central diffractive resonance production at the LHC

    Science.gov (United States)

    Fiore, Roberto; Jenkovszky, Laszlo; Schicker, Rainer

    2016-07-01

    Central production of resonances resulting from the scattering of Pomerons in the central rapidity region of proton-proton scattering is studied. Estimates for relevant cross sections are presented. L.J. gratefully acknowledges an EMMI visiting Professorship at the University of Heidelberg for completion of this work. He is grateful to the organizers of this meeting for their hospitality and support. His work was supported also by DOMUS, Hungarian Academy of Sciences

  9. Central Asia's comparative advantage in international trade

    OpenAIRE

    Lücke, Matthias; Rothert, Jacek

    2006-01-01

    This paper outlines a strategy for identifying the pattern of Central Asia’s comparative advantage in international trade, based on factor prices and transport costs, historical production patterns, and recent trends in the geographical and product composition of Central Asian trade. The paper focuses on Kazakhstan, the Kyrgyz Republic, Tajikistan, and Uzbekistan, along with Azerbaijan and Mongolia. A country’s comparative advantage cannot be determined at the level of individual industries o...

  10. "Lessons from an Unconventional Central Banker"

    OpenAIRE

    Thorvald Grung Moe

    2013-01-01

    The global financial crisis has generated renewed interest in the 1951 Treasury - Federal Reserve Accord and its lessons for central bank independence. A broader interpretation of the Accord and of Marriner S. Eccles's role at the Federal Reserve should teach central bankers that independence can be crucial for fighting inflation, but also encourage them to be more supportive of government efforts to fight deflation and mass unemployment.

  11. Association and Centrality in Criminal Networks

    DEFF Research Database (Denmark)

    Petersen, Rasmus Rosenqvist

    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...... three of these associations and extend and test two centrality measures using CrimeFighter Investigator, a novel tool for criminal network investigation. Our findings show that the extended centrality measures offer new insights into criminal networks....

  12. Role of Central Bank in Islamic Finance

    OpenAIRE

    Shaikh, Salman

    2009-01-01

    The rapid growth in Islamic finance industry urges us to not only look for alternatives in the Islamic commercial banking, but also focus on the regulator and its role and functions to enable it to work in conformity with Islamic principles. This study reviews limited, but precious academic literature on central banking and monetary management in an environment where Islamic finance is in vogue. Refinance ratio and Qard-e-Hasan ratio and Mudarabah between central bank and Islamic commercial b...

  13. Yes, we need a central bank

    OpenAIRE

    Hanif, Muhammad Nadim

    2002-01-01

    The financial system of a country comprises entities engaged in transactions involving financial instruments in money, capital, and foreign exchange markets. This sector has strong linkages with other sectors of the economy like external, fiscal and real sectors. The apex financial institution in every country is its Central Bank and the State Bank of Pakistan functions as our Central Bank. Section 9A. 1. of the State Bank of Pakistan Act 1956 shoulders the function of securing the soundness ...

  14. Peritoneal dissemination from central neurocytoma: case report

    OpenAIRE

    Coelho Neto Maurício; Ramina Ricardo; Meneses Murilo Sousa de; Arruda Walter Oleschko; Milano Jerônimo Buzetti

    2003-01-01

    OBJECTIVE: central neurocytoma is a low grade tumor of neuroglial origin and a relatively new histological entity. Only a few cases have been reported and its biological behavior is still uncertain. Some cases have shown an aggressive behavior (local recurrence, malignant dedifferentiation or CSF dissemination) and challenged the initial view of its relative benignity. A case of central neurocytoma with peritoneal dissemination is presented. CASE: a six years-old boy with recurrent neurocytom...

  15. The ultimate determinants of central bank independence

    OpenAIRE

    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 the structural parameters of the model. Next, we show that optimal central bank independence is higher, the higher the natural rate of unemployment, the greater the benefits of unanticipated inflat...

  16. 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.

  17. Central regions of keloids are severely ischaemic.

    Science.gov (United States)

    Touchi, Ryoma; Ueda, Koichi; Kurokawa, Norifumi; Tsuji, Motomu

    2016-02-01

    We classified scars as keloids, hypertrophic scars and mature scars, and then examined the scars for differences in central and marginal vascularization. We found significant differences in localized hypoxia-induced factor-1α (HIF-1α) expression and vascular density in keloids, but no localized differences in hypertrophic or mature scars. The central areas of keloids exhibited higher HIF-1α expression and lower vascular density than marginal areas, suggesting that the former are severely ischaemic. PMID:26794626

  18. De-centralized and centralized control for realistic EMS Maglev systems

    Science.gov (United States)

    Moawad, Mohamed M. Aly M.

    A comparative study of de-centralized and centralized controllers when used with real EMS Maglev Systems is introduced. This comparison is divided into two parts. Part I is concerned with numerical simulation and experimental testing on a two ton six-magnet EMS Maglev vehicle. Levitation and lateral control with these controllers individually and when including flux feedback control in combination with these controllers to enhance stability are introduced. The centralized controller is better than the de-centralized one when the system is exposed to a lateral disturbing force such as wind gusts. The flux feedback control when combined with de-centralized or centralized controllers does improve the stability and is more resistant and robust with respect to the air gap variations. Part II is concerned with the study of Maglev vehicle-girder dynamic interaction system and the comparison between these two controllers on this typical system based on performance and ride quality achieved. Numerical simulations of the ODU EMS Maglev vehicle interacting with girder are conducted with these two different controllers. The de-centralized and centralized control for EMS Maglev systems that interact with a flexible girder provides similar ride quality. Centralized control with flux feedback could be the best controller for the ODU Maglev system when operating on girder. The centralized control will guarantee the suppression of the undesired lateral displacements; hence it will provide smoother ride quality. Flux feedback will suppress air gap variations due to the track discontinuities.

  19. 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.

  20. Peripheral chemoreceptors in congenital central hypoventilation syndrome.

    Science.gov (United States)

    Perez, Iris A; Keens, Thomas G

    2013-01-01

    Congenital central hypoventilation syndrome is a rare disorder caused by a mutation in the PHOX2B gene resulting in hypoventilation that is worse during sleep. Human physiologic studies show that patients with CCHS have absent or decreased rebreathing ventilatory responses to hypercapnia and hypoxemia during sleep as well as during wakefulness. Some ventilatory responses to hypoxia and hyperoxia can be demonstrated using a step change in inspired oxygen. However, these suggest that both central and peripheral chemoreceptor functions are generally defective in all states in children with CCHS. The defect in CCHS may lie in central nervous system pathways regulating ventilation, whose development and function are controlled by PHOX2B. Moreover, the retrotrapezoid nucleus (RTN) may be the major defect in CCHS, where central and peripheral inputs converge. Human physiological studies predicted that the defect in CCHS lies in central integration of the central and peripheral chemoreceptor signals. New evidence suggests the RTN may be the respiratory controller where chemoreceptor inputs are integrated. In this review we present the clinical presentation of CCHS, revisit results of human physiologic studies, and discuss the findings in light of new knowledge about the role of PHOX2B and RTN in CCHS.

  1. 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.

  2. 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.

  3. 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.

  4. 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. PMID:26440071

  5. 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.

  6. Central Banker Contracts, Incomplete Information, and Monetary Policy Surprises: In Search of a Selfish Central Banker?

    OpenAIRE

    Georgios E. Chortareas; Miller, Stephen M.

    2002-01-01

    Approaching monetary policy as a principal agent problem provides a useful framework for interpreting alternative delegation schemes. In this paper, we consider the effectiveness of central banker incentive schemes when the principal delegates monetary policy through contracts but remains uncertain about the central banker's responsiveness to such schemes. We adopt a simple principal-agent model and assume that the central banker's trade-off between social welfare and the incentive scheme is ...

  7. 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.

  8. Correcting intermittent central suppression improves binocular marksmanship.

    Science.gov (United States)

    Hussey, Eric S

    2007-04-01

    Intermittent central suppression (ICS) is a defect in normal binocular (two-eyed) vision that causes confusion in visual detail. ICS is a repetitive intermittent loss of visual sensation in the central area of vision. As the central vision of either eye "turns on and off", aiming errors in sight can occur that must be corrected when both eyes are seeing again. Any aiming errors in sight might be expected to interfere with marksmanship during two-eyed seeing. We compared monocular (one-eyed, patched) and binocular (two-eyed) marksmanship with pistol shooting with an Army ROTC cadet before and after successful therapy for diagnosed ICS. Pretreatment, monocular marksmanship was significantly better than binocular marksmanship, suggesting defective binocularity reduced accuracy. After treatment for ICS, binocular and monocular marksmanship were essentially the same. Results confirmed predictions that with increased visual stability from correcting the suppression, binocular and monocular marksmanship accuracies should merge. PMID:17484315

  9. 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.

  10. Estimation for large non-centrality parameters

    Science.gov (United States)

    Inácio, Sónia; Mexia, João; Fonseca, Miguel; Carvalho, Francisco

    2016-06-01

    We introduce the concept of estimability for models for which accurate estimators can be obtained for the respective parameters. The study was conducted for model with almost scalar matrix using the study of estimability after validation of these models. In the validation of these models we use F statistics with non centrality parameter τ =‖λ/‖2 σ2 when this parameter is sufficiently large we obtain good estimators for λ and α so there is estimability. Thus, we are interested in obtaining a lower bound for the non-centrality parameter. In this context we use for the statistical inference inducing pivot variables, see Ferreira et al. 2013, and asymptotic linearity, introduced by Mexia & Oliveira 2011, to derive confidence intervals for large non-centrality parameters (see Inácio et al. 2015). These results enable us to measure relevance of effects and interactions in multifactors models when we get highly statistically significant the values of F tests statistics.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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...

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

    NARCIS (Netherlands)

    C. van der Cruijsen; S. Eijffinger

    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

  18. 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...

  19. Solitary median maxillary central incisor (SMMCI) syndrome

    OpenAIRE

    Hall Roger K

    2006-01-01

    Abstract Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th–38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; i...

  20. [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

  1. 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.

  2. 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.

  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. MRI of central nervous system anomalies

    International Nuclear Information System (INIS)

    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. (author)

  5. Central helium density measurements in PLT

    International Nuclear Information System (INIS)

    The central helium density in PLT has been deduced from measurements of the ratio of d-3He to d-d fusion reactions during deuterium neutral beam injection. The inward transport time for 3He puffed at the edge plasma was 10 → 30 msec. The decay time of the central 3He density increased with electron density, varying from 0.3 sec to greater than 1.0 sec over the density range of (1 → 5) x 1013 cm-3

  6. Centralized surveillance and control of satellite networks

    Science.gov (United States)

    Rzewnicki, S. E.; McBeath, J. W.; Brostrup-Jensen, P.

    Satellite based services and networks are increasing in number. This paper describes how such networks can be operated efficiently using software based systems to do satellite transmission surveillance and remote earth station status, alarm and control monitoring at a centralized operations control center. Arrangements are available to accomplish real time, customer controlled configuration of space segments and earth station equipment. Application of the system elements satellite transmission surveillance, alarm and control central, earth station remote, and customer control terminals - to a number of typical networks is described.

  7. Centralized vs. Distributed Databases. Case Study

    Directory of Open Access Journals (Sweden)

    Nicoleta Magdalena Iacob

    2015-12-01

    Full Text Available Currently, in information technology domain and implicit in databases domain can be noticed two apparently contradictory approaches: centralization and distribution respectively. Although both aim to produce some benefits, it is a known fact that for any advantage a price must be paid. In addition, in this paper we have presented a case study, e-learning portal performance optimization by using distributed databases technology. In the stage of development in which institutions have branches distributed over a wide geographic area, distributed database systems become more appropriate to use, because they offer a higher degree of flexibility and adaptability then centralized ones.

  8. 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...

  9. Metabolic syndrome and central retinal artery occlusion

    OpenAIRE

    Kosanović-Jaković Natalija; Petrović Lidija; Risimić Dijana; Milenković Svetislav; Matić Danica

    2005-01-01

    Background. The accumulation of risk factors for central retinal artery occlusion can be seen in a single person and might be explained by the metabolic syndrome. Case report. We presented the case of a 52-year-old man with no light perception in his right eye. The visual loss was monocular and painless, fundoscopy showed central retinal artery occlusion and the laboratory investigation showed the raised erythrocyte sedimentation rate of 105 mm/h and the raised C-reactive protein of 22 mg/l. ...

  10. Probabilistic seismic hazard assessment for Central Asia

    OpenAIRE

    Shahid Ullah; Dino Bindi; Marco Pilz; Laurentiu Danciu; Graeme Weatherill; Elisa Zuccolo; Anatoly Ischuk; Natalya N. Mikhailova; Kanat Abdrakhmatov; Stefano Parolai

    2015-01-01

    Central Asia is one of the seismically most active regions in the world. Its complex seismicity due to the collision of the Eurasian and Indian plates has resulted in some of the world’s largest intra-plate events over history. The region is dominated by reverse faulting over strike slip and normal faulting events. The GSHAP project (1999), aiming at a hazard assessment on a global scale, indicated that the region of Central Asia is characterized by peak ground accelerations for 10% probabili...

  11. Progress in ATLAS central solenoid magnet

    CERN Document Server

    Yamamoto, A; Makida, Y; Tanaka, K; Haruyama, T; Yamaoka, H; Kondo, T; Mizumaki, S; Mine, S; Wada, K; Meguro, S; Sotoki, T; Kikuchi, K; ten Kate, H H J

    2000-01-01

    The ATLAS central solenoid magnet is being developed to provide a magnetic field of 2 Tesla in the central tracking volume of the ATLAS detector under construction at the CERN/LHC project. The solenoid coil design features high-strength aluminum stabilized superconductor to make the coil thinnest while maintaining its stability and the pure-aluminum strip technique for quench protection and safety. The solenoid coil is installed in a common cryostat with the LAr calorimeter in order to minimize the cryostat wall. A transparency of 0.66 radiation length is achieved with these integrated efforts. The progress in the solenoid coil fabrication is reported. (8 refs).

  12. 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.

  13. Church Orientations in Central and Eastern Europe

    Science.gov (United States)

    Laužikas, Rimvydas

    The objective of this case study is to discuss church orientation in Central and Eastern Europe. Due to its geographical situation, this region is a specific part of European cultural space: it is remote from the main cultural centers, it was the last to adopt Christianity, and it experienced intensive interactions with Byzantine culture. Therefore, we can assess church orientation in Central and Eastern Europe as a tradition affected by multicultural interactions and in which there is an interlacement of Catholicism from Western Europe, Byzantinism, local pagan faiths and, in part, the ideas of conception of geographical space of the Jews, Karaites, and Muslims.

  14. 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.

  15. 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...... exhibiting various tradeoffs with respect to performance. Two of the algorithms are cache-oblivious. We describe general algorithms for networks with weighted and unweighted edges and a specialized algorithm for networks with small diameters, as is common in social networks exhibiting the “small worlds...

  16. Centrality measures for networks with community structure

    Science.gov (United States)

    Gupta, Naveen; Singh, Anurag; Cherifi, Hocine

    2016-06-01

    Understanding the network structure, and finding out the influential nodes is a challenging issue in large networks. Identifying the most influential nodes in a network can be useful in many applications like immunization of nodes in case of epidemic spreading, during intentional attacks on complex networks. A lot of research is being done to devise centrality measures which could efficiently identify the most influential nodes in a network. There are two major approaches to this problem: On one hand, deterministic strategies that exploit knowledge about the overall network topology, while on the other end, random strategies are completely agnostic about the network structure. Centrality measures that can deal with a limited knowledge of the network structure are of prime importance. Indeed, in practice, information about the global structure of the overall network is rarely available or hard to acquire. Even if available, the structure of the network might be too large that it is too much computationally expensive to calculate global centrality measures. To that end, a centrality measure is proposed here that requires information only at the community level. Indeed, most of the real-world networks exhibit a community structure that can be exploited efficiently to discover the influential nodes. We performed a comparative evaluation of prominent global deterministic strategies together with stochastic strategies, an available and the proposed deterministic community-based strategy. Effectiveness of the proposed method is evaluated by performing experiments on synthetic and real-world networks with community structure in the case of immunization of nodes for epidemic control.

  17. Central Endoscopy Reading in Inflammatory Bowel Diseases.

    Science.gov (United States)

    Panés, Julián; Feagan, Brian G; Hussain, Fez; Levesque, Barrett G; Travis, Simon P

    2016-09-01

    Endoscopic assessment of the presence and severity of endoscopic lesions has become an essential part of clinical trials in ulcerative colitis and Crohn's disease, for both patient eligibility and outcome measures. Variability in lesion interpretation between and within observers and the potential bias of local investigators in patient assessment have long been recognized. This variability can be reduced, although not completely removed, by independent evaluation of the examinations by experienced off-site (central) readers, properly trained in regard to lesion definition and identification, that should be removed from direct patient contact and blinded to any other clinical or study data. Adding endoscopic demonstration of active disease to eligibility criteria has the potential to reduce placebo response rates, whereas in outcome assessment it has the potential to provide a more precise estimation of the treatment effect, increasing the efficiency of the study. Central endoscopy reading is still at the beginning of its development, and the paradigms of central reading need refinement in terms of the number of readers, the process by which a final score is assigned, the selection and sequence of central readers, and the endoscopic indices of choice. PMID:27604978

  18. 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.

  19. Caupolicana in Central America (Hymenoptera, Colletidae, Diphaglossinae

    Directory of Open Access Journals (Sweden)

    Charles Michener

    2009-02-01

    Full Text Available Caupolicana (Zikanapis wileyi n. sp. from Guatemala is described. New locality records are noted for other species, and the hitherto unknown female of C. (Z. rozenorum Michener, Engel, and Ayala from Guatemala is described. A key for the identification of Central American Caupolicana is provided.

  20. 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

  1. On the dimension of twisted centralizer codes

    OpenAIRE

    Glasby, S. P.; Praeger, Cheryl E.; Alahmadi, Adel

    2016-01-01

    Given a field $F$, a scalar $\\lambda\\in F$ and a matrix $A\\in F^{n\\times n}$, the twisted centralizer code $C_F(A,\\lambda):=\\{B\\in F^{n\\times n}\\mid AB-\\lambda BA=0\\}$ is a linear code of length $n^2$. When $A$ is cyclic and $\\lambda\

  2. 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...

  3. Exercise, Stress Resistance, and Central Serotonergic Systems

    OpenAIRE

    Greenwood, Benjamin N.; Fleshner, Monika

    2011-01-01

    Voluntary exercise reduces the incidence of stress-related psychiatric disorders in humans and prevents serotonin-dependent behavioral consequences of stress in rodents. Evidence reviewed herein is consistent with the hypothesis that exercise increases stress resistance by producing neuroplasticity at multiple sites of the central serotonergic system, which all help to limit the behavioral impact of acute increases in serotonin during stressor exposure.

  4. Internationalisation in Central and Eastern Europe

    DEFF Research Database (Denmark)

    Marinov, Marin Alexandrov

    This is a unique volume among the existing variety of publications on foreign direct investment (FDI) in Central and Eastern Europe (CEE) because it focuses on the internationalization process taking place there. It addresses the rapid changes of the business climate in the region that have led t...

  5. 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...

  6. 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

  7. 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.

  8. 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…

  9. 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.

  10. Best Minds Sought for Central Office, Startups

    Science.gov (United States)

    Maxwell, Lesli A.

    2009-01-01

    The central office isn't being overlooked in the movement to find and develop top talent for school districts. Although ways to recruit, groom, and keep top teachers and strong principals tend to dominate discussions of "human capital" needs in education, a handful of nonprofit organizations and foundations also see providing smart managers as…

  11. 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.

  12. Ablated tektite from the central Indian Ocean

    Digital Repository Service at National Institute of Oceanography (India)

    Glass, B.P.; Chapman, D.R.; ShyamPrasad, M.

    A well-preserved ablated (button-shaped) tektite recovered from the surface sediments of the central Indian Ocean lacks flow ridges and has apparently undergone ablation of 6.9 to 7.9 mm. The lack of flow ridges and amount of ablation indicate that...

  13. Petrology of tectonically segmented Central Indian Ridge

    Digital Repository Service at National Institute of Oceanography (India)

    Mukhopadhyay, R.; Iyer, S.D.

    Distribution and mineralogy of various rock types along the 4200-km-long slow-spreading Central Indian Ridge, between Owen fracture zone in the north and Indian Ocean triple junction in the south, is studied in the light of ridge segmentation...

  14. Azole-Resistant Central Nervous System Aspergillosis

    NARCIS (Netherlands)

    J.W.M. van der Linden; R.R. Jansen; D. Bresters; C.E. Visser; S.E. Geerlings; E.J. Kuijper; W.J.G. Melchers; P.E. Verweij

    2009-01-01

    Three patients with central nervous system aspergillosis due to azole-resistant Aspergillus fumigatus (associated with a leucine substitution for histidine at codon 98 [L98H] and a 34-base pair repeat in tandem in the promoter region) are described. The patients were treated with combination therapy

  15. Azole-resistant central nervous system aspergillosis.

    NARCIS (Netherlands)

    Linden, J.W.M. van der; Jansen, R.R.; Bresters, D.; Visser, C.E.; Geerlings, S.E.; Kuijper, E.J.; Melchers, W.J.G.; Verweij, P.E.

    2009-01-01

    Three patients with central nervous system aspergillosis due to azole-resistant Aspergillus fumigatus (associated with a leucine substitution for histidine at codon 98 [L98H] and a 34-base pair repeat in tandem in the promoter region) are described. The patients were treated with combination therapy

  16. 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

  17. 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.

  18. 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.

  19. Enhancing the Capability of Central Finance Agencies

    OpenAIRE

    Allen, Richard; Grigoli, Francesco

    2012-01-01

    A well-organized and effective finance ministry and its associated central finance agencies (CFAs) are essential to good fiscal outcomes. Recent studies of CFAs in selected low-income countries demonstrate that their organizational structure varies widely and that decision making on public finance is strongly influenced by political economy factors. This note presents some common themes ar...

  20. Central Virginia Community College 1999 Fact Book.

    Science.gov (United States)

    Hicks, Geoffrey

    The Fact Book is an annual publication of the Office of Research, Assessment and Planning at Central Virginia Community College (CVCC). It includes data and trends from 1994-1998 and is divided into six parts: (1) "The College" includes information on the College Board, institutional history, facilities, mission and goals, revenues and…

  1. 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

  2. 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.

  3. Central rotations of Milky Way Globular Clusters

    CERN Document Server

    Fabricius, Maximilian H; Rukdee, Surangkhana; Saglia, Roberto P; Bender, Ralf; Hopp, Ulrich; Thomas, Jens; Opitsch, Michael; Williams, Michael J

    2014-01-01

    Most Milky Way globular clusters (GCs) exhibit measurable flattening, even if on a very low level. Both cluster rotation and tidal fields are thought to cause this flattening. Nevertheless, rotation has only been confirmed in a handful of GCs, based mostly on individual radial velocities at large radii. We are conducting a survey of the central kinematics of Galactic GCs using the new Integral Field Unit instrument VIRUS-W. We detect rotation in all 11 GCs that we have observed so far, rendering it likely that a large majority of the Milky Way GCs rotate. We use published catalogs of the ACS survey of GCs to derive central ellipticities and position angles. We show that in all cases where the central ellipticity permits an accurate measurement of the position angle, those angles are in excellent agreement with the kinematic position angles that we derive from the VIRUS-W velocity fields. We find an unexpected tight correlation between central rotation and outer ellipticity, indicating that rotation drives fla...

  4. 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.…

  5. 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...

  6. 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.

  7. 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.

  8. 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...

  9. Eye Movement Correlates of Acquired Central Dyslexia

    Science.gov (United States)

    Schattka, Kerstin I.; Radach, Ralph; Huber, Walter

    2010-01-01

    Based on recent progress in theory and measurement techniques, the analysis of eye movements has become one of the major methodological tools in experimental reading research. Our work uses this approach to advance the understanding of impaired information processing in acquired central dyslexia of stroke patients with aphasia. Up to now there has…

  10. 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).

  11. 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

  12. The Mediterranean fruit fly in Central America

    International Nuclear Information System (INIS)

    Various methods of controlling the medfly are available and include the use of insecticides, bait sprays and the sterile insect technique (SIT). Each of these control strategies may be used alone or in sequence. With regard to the application of the SIT, the Joint FAO/IAEA Division of Atomic Energy in Food and Agriculture through its Insect and Pest Control Section and Entomology Laboratory is in an excellent position to assist in containing the medfly in Central America. For the past 12 years, the laboratory has participated in all phases of medfly control by sterile insect releases in various climates. This involvement has included planning of medfly campaigns, development of pre-release techniques (bait spraying, trapping, etc.) and shipment and release of sterilized medflies. Small-scale field tests utilizing the SIT have been carried out by nine countries: Italy (Procida, Capri), Spain, Cyprus, Israel, Tunisia, Peru, Panama, Costa Rica and Nicaragua. Other field projects presently being counselled and serviced are located in Argentina, Venezuela and the Canary Islands. The research and development that are still needed to effectively stabilize and gain control of the medfly situation in Central America include: The development and use of effective quarantine procedures in various countries; Development of effective conventional medfly control procedures under the conditions found in Central America; Development of methods to determine the geographic origin of medflies introduced into new areas; Medfly mass production (viz. all aspects of rearing Central American strains); Assessing the performance (competitiveness, etc.) of various strains; Logistics, including the development of systems for releasing pre-adult stages; Genetic rearing methods: developmental research in this area is particularly promising since the preferential production of males would allow considerable savings in the rearing costs of medflies for release; Development of adequate surveillance

  13. 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.

  14. Clinical significance of central corneal thickness and comparison of central corneal thickness

    Directory of Open Access Journals (Sweden)

    Özgür Çakıcı

    2014-03-01

    Full Text Available Significance of central corneal thickness has been increasing in ophthalmology practice. It is an important clinical evaluation tool especially prior to refractive surgery and in diagnosis of glaucoma and keratoconus. Refractive surgery is planned according to preoperative central corneal thickness measurements. Besides, in order to determine actual intraocular pressure, central corneal thickness is measured and corrected eye pressure is obtained. Today, devices used in measurement of central corneal thickness do the measurement according to two principles. First and relatively older method is ultrasonic method. Optic method is the second and more recent method. In daily practice, the most commonly used clinical method in measurement of central corneal thickness is ultrasound pachymeter. However, this measurement technique requires contact between cornea and probe and gives thinner measurement results compared to the methods that use optic principle. Recently, several technologic methods based on optics have been put in use; they provide advantages of non-contact technique and objective determination of central corneal thickness. Of these methods, most commonly used include Specular Microscopy, Optical coherence tomography, Laser Doppler Interferometry, Optical low coherence reflectometry pachymetry, Optic based topographic mapping (also called screening section pachymetry and Pentacam. In this article, it was aimed to evaluate importance of central corneal thickness in clinical use and compare measurement methods. J Clin Exp Invest 2014; 5 (1: 153-158

  15. Solitary Median Maxillary Central Incisor Versus Agenesis of the Maxillary Central Incisor.

    Science.gov (United States)

    de Carvalho, Fabrício Kitazono; Arid, Juliana; De Rossi, Andiara; Paula-Silva, Francisco W G; Nelson-Filho, Paulo

    2016-01-01

    A solitary median maxillary central incisor (SMMCI) is rare and affected individuals may carry a potentially serious condition known as SMMCI syndrome. However, many of these cases do not receive proper attention because they are misdiagnosed as agenesis of the maxillary central incisor. The purpose of this manuscript is to report two cases of children with only one maxillary central incisor and draw diagnostic differences between the entities. A correct diagnosis is very important because if an SMMCI is confirmed, the patient should be referred for genetic counseling. PMID:27098718

  16. Harada Group Uniquely Determined by Centralizer of a 2-Central Involution

    Institute of Scientific and Technical Information of China (English)

    M. Kratzer; G.O. Michler; M. Weller

    2003-01-01

    In this article we show that the sporadic simple Harada group G is uniquely determined up to isomorphism by the centralizer CG(z) of a 2-central involution z of G. This strengthens Y. Segev's uniqueness theorem [24] which required the known structure of the centralizers of two non-conjugate involutions.Using the second author's algorithm [19], we also provide a self-contained existence proof for the Harada group G by giving matrix generators inside GL133(19).Furthermore, the character table of G is determined and representatives for the conjugacy classes of the group are given as short words in the generating matrices.

  17. HANFORD SITE CENTRAL PLATEAU CLEANUP COMPLETION STRATEGY

    Energy Technology Data Exchange (ETDEWEB)

    BERGMAN TB

    2011-01-14

    Cleanup of the Hanford Site is a complex and challenging undertaking. The U.S. Department of Energy (DOE) has developed a comprehensive vision for completing Hanford's cleanup mission including transition to post-cleanup activities. This vision includes 3 principle components of cleanup: the {approx}200 square miles ofland adjacent to the Columbia River, known as the River Corridor; the 75 square miles of land in the center of the Hanford Site, where the majority of the reprocessing and waste management activities have occurred, known as the Central Plateau; and the stored reprocessing wastes in the Central Plateau, the Tank Wastes. Cleanup of the River Corridor is well underway and is progressing towards completion of most cleanup actions by 2015. Tank waste cleanup is progressing on a longer schedule due to the complexity of the mission, with construction of the largest nuclear construction project in the United States, the Waste Treatment Plant, over 50% complete. With the progress on the River Corridor and Tank Waste, it is time to place increased emphasis on moving forward with cleanup of the Central Plateau. Cleanup of the Hanford Site has been proceeding under a framework defmed in the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement). In early 2009, the DOE, the State of Washington Department of Ecology, and the U.S. Environmental Protection Agency signed an Agreement in Principle in which the parties recognized the need to develop a more comprehensive strategy for cleanup of the Central Plateau. DOE agreed to develop a Central Plateau Cleanup Completion Strategy as a starting point for discussions. This DOE Strategy was the basis for negotiations between the Parties, discussions with the State of Oregon, the Hanford Advisory Board, and other Stakeholder groups (including open public meetings), and consultation with the Tribal Nations. The change packages to incorporate the Central Plateau Cleanup Completion Strategy were

  18. 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.

  19. Central Asia's raging waters the prospects of water conflict in Central Asia

    OpenAIRE

    Hartman, William B.

    2007-01-01

    This thesis examines the prospects of conflict caused by water scarcity in Central Asia. The thesis analyzes the three most recent political eras of Central Asia, Tsarist Russia, the Soviet Union and independence, utilizing indicators of water tensions including: water quality, water quantity, the management of water for multiple uses, the political divisions and geopolitical setting, state institutions and national water ethos. Although water is not likely to be the sole cause of a majo...

  20. Central nervous control of energy and glucose balance: focus on the central melanocortin system

    OpenAIRE

    Xu, Yong; Elmquist, Joel K.; Fukuda, Makoto

    2011-01-01

    Studies have suggested that manipulations of the central melanocortin circuitry by pharmacological agents produce robust effects on the regulation of body weight and glucose homeostasis. In this review, we discuss recent findings from genetic mouse models that have further established the physiological relevance of this circuitry in the context of glucose and energy balance. In addition, we will discuss distinct neuronal populations that respond to central melanocortins to regulate food intak...

  1. FINANCIAL CRISIS AND THE CENTRAL BANK SYSTEM

    Directory of Open Access Journals (Sweden)

    Richard POSPISIL

    2015-07-01

    Full Text Available The financial crisis that began in 2008 gradually developed into a global economic crisis and continues to this day. There is a lot of causes standing behind the creation, depth and process of the crisis, which is the deepest since the thirties of last centrury. One of the reasons can be found in the risky behavior of commercial banks, especially in the excessive lending of credits and mortgages. Its share on the financial crisis have central banks and their failure as the financial supervisory authority. But there is a lot of another causes of failures in the commercial banking system. And some of the causes lies outside the banking system and monetary policy. Its share of the blame has also become from state and its expenditure on the social policy.This article analyzes the role of the commercial banking system and the central banks on the financial crisis including prevention options and measures.

  2. Financial Crisis and the Central Bank System

    Directory of Open Access Journals (Sweden)

    RICHARD POSPISIL

    2015-05-01

    Full Text Available The financial crisis that began in 2008 gradually developed into a global economic crisis and continues to this day. There is a lot of causes standing behind the creation, depth and process of the crisis, which is the deepest since the thirties of last centrury. One of the reasons can be found in the risky behavior of commercial banks, especially in the excessive lending of credits and mortgages. Its share on the financial crisis have central banks and their failure as the financial supervisory authority. But there is a lot of another causes of failures in the commercial banking system. And some of the causes lies outside the banking system and monetary policy. Its share of the blame has also become from state and its expenditure on the social policy.This article analyzes the role of the commercial banking system and the central banks on the financial crisis including prevention options and measures.

  3. A Review of Select Centralized Pain Syndromes

    Directory of Open Access Journals (Sweden)

    David R. Spiegel

    2015-01-01

    Full Text Available Pain can be broadly divided into 3 classes, including nociceptive or inflammatory pain (protective, neuropathic (pathological, occurring after damage to the nervous system, or centralized (pathological, due to abnormal function but with no damage or inflammation to the nervous system. The latter has been posited to occur when descending analgesic pathways are attenuated and/or glutamatergic transmission is facilitated. Additionally, this “pain prone phenotype” can be associated with early life trauma and a suboptimal response to opiates. This article will review the relationships between centralized pain syndromes (ie, fibromyalgia, chronic low back pain, childhood sexual abuse, and opiate misuse. Finally, treatment implications, potentially effecting primary care physicians, will be discussed.

  4. Diagnosis and treatment of central diabetes insipidus

    Directory of Open Access Journals (Sweden)

    Ekaterina Aleksandrovna Pigarova

    2014-11-01

    Full Text Available Diabetes insipidus represents a serious disease that dramatically interferes with the everyday life of patients due to the need to constantly replenish of fluid lost in the urine, which comes amid shortage of synthesis, secretion or action of pituitary hormone vasopressin. The main difficulty is the differential diagnosis of types of diabetes insipidus in patients with the syndrome of polydipsia-polyuria as the correct differential diagnosis of these forms predetermine the safety and efficacy of further treatment. This lecture presents the current concepts of etiology, diagnosis and treatment of central diabetes insipidus (CDI. We give the comparative characteristics of various preparations of desmopressin for the treatment of the central form of the disease. We also consider the features of the management of selected patient populations with CDI: during pregnancy and lactation, pathology of the thirst sensation, after traumatic brain injury and neurosurgery.

  5. Hitherto unreported Agaricus species of Central India

    Directory of Open Access Journals (Sweden)

    MAHENDRA KUMAR RAI

    2010-11-01

    Full Text Available Karwa A, Rai MK. 2010. Hitherto unreported Agaricus species of Central India. Nusantara Bioscience 2: 141-145. Melghat forest region from Central India was surveyed for occurrence of medicinal and culinary mushrooms during the years 2005-2008. Out of total 153 species, ten species of Agaricus were recorded from different localities. Of these, seven species namely Agaricus bitorquis, A. subrufescens, A. augustus, A. placomyces, A. essettei, A. basioanolosus and Agaricus sp. nov (a new species are being reported for the first time from the region. The commercial button mushroom Agaricus bisporus lacks good breeding characters due to its bisporic nature. These wild cousins of the button mushroom can definitely prove to be a good source of genetic manipulations to the existing strains and also to develop new strains with improved characters.

  6. Central auditory neurons have composite receptive fields.

    Science.gov (United States)

    Kozlov, Andrei S; Gentner, Timothy Q

    2016-02-01

    High-level neurons processing complex, behaviorally relevant signals are sensitive to conjunctions of features. Characterizing the receptive fields of such neurons is difficult with standard statistical tools, however, and the principles governing their organization remain poorly understood. Here, we demonstrate multiple distinct receptive-field features in individual high-level auditory neurons in a songbird, European starling, in response to natural vocal signals (songs). We then show that receptive fields with similar characteristics can be reproduced by an unsupervised neural network trained to represent starling songs with a single learning rule that enforces sparseness and divisive normalization. We conclude that central auditory neurons have composite receptive fields that can arise through a combination of sparseness and normalization in neural circuits. Our results, along with descriptions of random, discontinuous receptive fields in the central olfactory neurons in mammals and insects, suggest general principles of neural computation across sensory systems and animal classes. PMID:26787894

  7. Hydropower development in the Central Himalayas

    Energy Technology Data Exchange (ETDEWEB)

    Singh, N. (Irrigation Design Organization, Rourkee (India))

    1992-10-01

    The Central Himalayas comprise eight hill districts of the State of Uttar Pradesh, India. These mountains are the source of the Ganga and its main tributaries: the Yamuna, Ramganga and Sarda rivers. The identified hydro potential of the Ganga, Yamuna, Sarda and their tributaries in the Central Himalayas is about 30 000 MW, with an annual average energy potential of 100 TWh. The projects which have been completed so far have only developed 3.2 per cent of this potential. The projects which are now under construction will exploit another 10.4 per cent of the potential. Thus, the untapped potential is as much as 85 per cent of the total. The minor tributaries also offer vast potential for mini and micro hydroelectric stations. In most conservative estimates, this potential is about 2000 MW. (author).

  8. [Central nervous system tumors in pregnancy].

    Science.gov (United States)

    Podciechowski, Lech; Nowakowska, Dorota; Bielak, Adam; Nowosławska, Emilia; Szymański, Wojciech; Polis, Lech; Krasomski, Grzechorz; Fiks, Tomasz; Wilczyński, Jan

    2003-12-01

    Central nervous system tumour in pregnancy constitutes a serious complication. Considering frequent difficulties in diagnostics and therapy, the aim of the study was to present our experience in management with pregnant women with brain and spinal cord tumours. Between 1988-2000, in The Research Institute Polish Mother's Memorial Hospital in Lodzi, 4 pregnant women had been diagnosed with brain and spinal cord tumours. The incidence of tumours complicating pregnancy was 1/11460. Two patients diagnosed at 29 weeks' gestation, underwent craniotomy and tumour resection during pregnancy. Two other women with central nervous system tumours diagnosed at 39 weeks' gestation, were operated in the postpartum period. The analysis of the postoperative period, gestation and/or postpartum period in all women and well-being of their new-borns confirm undertaken medical decisions. PMID:15029742

  9. Spherical explosion with central energy source

    CERN Document Server

    Masuyama, Miyu; Tsuboki, Yoichiro

    2015-01-01

    We present a novel semi-analytic solution describing the propagation of a spherical blast wave driven by a central energy source. The initial density profile has a power-law function of the distance from the center and the energy is injected only into the central region at a rate given by a power-law function of time. This solution is composed of three regions separated by the contact surface and the shock front. The innermost region is assumed to be uniform and the outside of the contact surface includes the shocked matter described by self-similar solutions. We analytically derive the applicable range of parameters of this solution from requirements to satisfy boundary conditions. We perform numerical simulations for flows with various values of parameters, some of which reside out of the thus derived applicable range, and compare with the semi-analytic solutions.

  10. Spherical explosion with a central energy source

    Science.gov (United States)

    Masuyama, Miyu; Shigeyama, Toshikazu; Tsuboki, Yoichiro

    2016-04-01

    We present a novel semi-analytic solution that describes the propagation of a spherical blast wave driven by a central energy source. The initial density profile has a power-law function of the distance from the center and the energy is injected only into the central region at a rate given by a power-law function of time. This solution is composed of three regions separated by the contact surface and the shock front. The innermost region is assumed to be uniform and the outside of the contact surface includes the shocked matter described by self-similar solutions. We analytically derive the applicable range of parameters of this solution from requirements needed to satisfy the boundary conditions. We perform numerical simulations for flows with various values of parameters, some of which reside out of the thus-derived applicable range, and compare the results with the semi-analytic solutions.

  11. A study of Central Exclusive Production

    Energy Technology Data Exchange (ETDEWEB)

    Monk, James; /Manchester U.

    2008-09-01

    Central exclusive production of a system X in a collision between two hadrons h is defined as hh {yields} h + X + h with no other activity apart from the decay products of X. This thesis presents predictions for the production cross section of a CP violating supersymmetric Higgs boson and the radion of the Randall-Sundrum model. The ExHuME Monte Carlo generator was written to simulate central exclusive processes and is described and explored. A comparison to di-jet observations made by the D0 detector at the Tevatron, Fermilab between January and June 2004 is made and the distributions found support the predictions of ExHuME.

  12. 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 ${ |N_i| | iin mathbf{N}$.

  13. Infections associated with the central venous catheters.

    Science.gov (United States)

    Drasković, Biljana; Fabri, Izabella; Benka, Anna Uram; Rakić, Goran

    2014-01-01

    Central venous catheters are of an essential importance to critically ill patients who require long-term venous access for various purposes. Their use made the treatment much easier, but still they are not harmless and are prone to numerous complications. Catheter infections represent the most significant complication in their use. The frequency of infections varies in different patient care settings, but their appearance mostly depends on the patient's health condition, catheter insertion time, localization of the catheter and type of the used catheter. Since they are one of the leading causes of nosocomial infections and related to significant number of morbidity and mortality in intensive care units, it is very important that maximal aseptic precautions are taken during the insertion and the maintenance period. Prevention of infection of the central venous catheters demands several measures that should be applied routinely.

  14. Expansion of museums in Central Europe?

    Directory of Open Access Journals (Sweden)

    Jagodzińska, Katarzyna

    2015-06-01

    Full Text Available The paper presents reflections on the specificity of collections and museums of contemporary art in Central Europe and considers a possibility of creating a regional alternative for the West. The analysis is conducted in the context of the expansionist policy of contemporary museums – notably the Louvre, the Guggenheim Foundation, and the Hermitage – whose numerous new development projects gave rise to a number of dilemmas in the museological world. The author discusses global "museum brands" that invest in Central Europe and addresses the possible profits of the expansion of such "concerns" for culture in the region, as well as emphasises the potential of the region itself, which may be used for its development without the avail of the internationally renowned collectors' names.

  15. Iowa Central Quality Fuel Testing Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Heach, Don; Bidieman, Julaine

    2013-09-30

    The objective of this project is to finalize the creation of an independent quality fuel testing laboratory on the campus of Iowa Central Community College in Fort Dodge, Iowa that shall provide the exploding biofuels industry a timely and cost-effective centrally located laboratory to complete all state and federal fuel and related tests that are required. The recipient shall work with various state regulatory agencies, biofuel companies and state and national industry associations to ensure that training and testing needs of their members and American consumers are met. The recipient shall work with the Iowa Department of Ag and Land Stewardship on the development of an Iowa Biofuel Quality Standard along with the Development of a standard that can be used throughout industry.

  16. Sensitivity Analysis of Centralized Dynamic Cell Selection

    DEFF Research Database (Denmark)

    Lopez, Victor Fernandez; Alvarez, Beatriz Soret; Pedersen, Klaus I.;

    2016-01-01

    and a suboptimal optimization algorithm that nearly achieves the performance of the optimal Hungarian assignment. Moreover, an exhaustive sensitivity analysis with different network and traffic configurations is carried out in order to understand what conditions are more appropriate for the use of the proposed...... with two different traffic models, and it is not necessary to be able to connect to a large number of cells in order to reap most of the benefits of the centralized dynamic cell selection.......Centralized architectures with fronthauls can be used to deal with some of the problems inherently associated with dense small cell deployments. This study examines a joint cell assignment and scheduling solution for the downlink to increase the users’ data rates, based on cell switching...

  17. [Central nervous system malformations: neurosurgery correlates].

    Science.gov (United States)

    Jiménez-León, Juan C; Betancourt-Fursow, Yaline M; Jiménez-Betancourt, Cristina S

    2013-09-01

    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.

  18. 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...... 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...... 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....

  19. Second-generation central receiver technology comparison

    Science.gov (United States)

    Klimas, P. C.; Becker, M.

    Fifteen years of solar thermal technology development have produced a considerable amount of knowledge relating to the production of electricity from central receiver power plants. This body of knowledge is under examination by researchers from the United States and the Federal Republic of Germany for the purpose of defining the next generation central receiver electricity producers. This second generation power plant is expected to represent a significant step towards commercialization of these systems. During the course of the study, specific activities needed to realize this next-step technology are being defined. The study is an international team effort. Under the International Energy Agency Small Solar Power Systems project, researchers from DLR, Interatom, Sandia National Laboratories, and Bechtel have designed a study in which technologies relating to existing systems are quantified, logical next-step systems are characterized, and future potential advances are identified. The receiver concepts under investigation are: salt-in-tube, volumetric, and direct absorption. Two plant performance levels are examined, 30 and 100 MW(sub e). Each concept is applied with common capacity factors, solar multiples, and types and sizes of heliostats at each performance level. Availability and uncertainty analyses are also performed. Annual energy production figures are calculated using the SOLERGY computer code. Capital and Operation and Maintenance cost methodologies are mutually agreed upon in order that levelized energy cost calculations will be consistent for each power plant. During the course of this effort, further potential advances in central receiver technology have continued to become apparent. These possible areas for improvement will be described. An additional comparison is being made between central receivers and trough-based systems.

  20. Virasoro central charges for Nichols algebras

    CERN Document Server

    Semikhatov, A M

    2011-01-01

    Virasoro central charge associated with Nichols algebras is invariant under the Weyl groupoid action and takes very suggestive values for some items in Heckenberger's list of rank-2 Nichols algebras. In particular, this might be taken as an indication of the existence of reasonable logarithmic extensions of W3==WA2, WB2, and WG2 models of conformal field theory. In the W3 case, the construction of an octuplet extended algebra is outlined.

  1. Ethnobotanical remarks on Central and Southern Italy

    OpenAIRE

    Lucia Leporatti; Guarrera Paolo

    2007-01-01

    Abstract Background The present paper is a brief survey on the ethnobotanical works published by the Authors since 1981, concerning the research carried out in some southern and central Italian regions. Before Roman domination these territories were first inhabited by local people, while the southern areas were colonized by the Greeks. These different cultural contributions left certain traces, both in the toponyms and in the vernacular names of the plants and, more generally, in the culture ...

  2. CDF Central Preshower and Crack Detector Upgrade

    OpenAIRE

    Artikov, A.

    2007-01-01

    The CDF Central Preshower and Crack Detector Upgrade consist of scintillator tiles with embedded wavelength-shifting fibers, clear-fiber optical cables, and multi-anode photomultiplier readout. A description of the detector design, test results from R&D studies, and construction phase are reported. The upgrade was installed late in 2004, and a large amount of proton-antiproton collider data has been collected since then. Detector studies using those data are also discussed.

  3. The central part of CMS is lowered

    CERN Multimedia

    Maximilien Brice

    2007-01-01

    On 28 February 2007, the CMS central piece containing the magnet and weighing as much as five Jumbo jets (1920 tonnes) was gently lowered into place. Only 20 cm separated the detector, which was suspended by four huge cables, each with 55 strands and sophisticated monitoring to minimize sway and tilt, from the walls of the shaft. The entire process took about 10 hours to complete.

  4. A Central Limit Theorem for Punctuated Equilibrium

    OpenAIRE

    Bartoszek, Krzysztof

    2016-01-01

    Current evolutionary biology models usually assume that a phenotype undergoes gradual change. This is in stark contrast to biological intuition, which indicates that change can also be punctuated - the phenotype can jump. Such a jump can especially occur at speciation, i.e. dramatic change occurs that drives the species apart. Here we derive a central limit theorem for punctuated equilibrium. We show that, if adaptation is fast, for weak convergence to hold, dramatic change has to be a rare e...

  5. Gas industry in Central and Eastern Europe

    Energy Technology Data Exchange (ETDEWEB)

    Razavi, H. [World Bank, Washington, DC (United States)

    1997-09-01

    The transition to a market economy in Central and Eastern Europe (CEE) has had many implications for the gas sector, in particular on the market development and prices, on the structure of the sector and on the investment level. The institutional and financial barriers to the development of CEE`s gas markets are summarized. Technical and marketing barriers are discussed, covering system design and integrity, metering, markets and energy efficiency. Finally, World Bank role and objectives are outlined. (R.P.)

  6. Tectonomagmatic Associations on the Central Andean Plateau

    Science.gov (United States)

    de Silva, S. L.; Viramonte, J. G.

    2012-12-01

    The Neogene evolution of the Central Andes is characterized by a strong association between plate convergence, mountain building and plateau formation, and magmatism. Plateau uplift by crustal shortening and thickening in the lower crust is broadly coincident with large scale silicic magmatism defined by the Neogene Central Andean ignimbrite province. Of particular interest here are the spatiotemporal correlations between silicic magmatism and tectonic evolution of the Altiplano-Puna plateau. Although magmatism is driven by the subduction-related flux from mantle to crust, the shift to "crustal" magmatism as indicated by elevated crustal isotopic indices after ~10Ma suggests a link between crustal thickening, plateau formation and silicic magmatism. In particular, elevated geotherms associated with crustal thickening and enhanced mantle flux associated with lithospheric delamination may have played a role in thermally preparing the Central Andean crust for enhanced silicic magma production during the extensive Neogene ignimbrite flare-up. Emplacement of these magmas in the upper crust throughout the Neogene may have fuelled a period of significant interaction between magmatism and tectonism on the plateau. With particular reference to the 21° to 24°S segment of the Central Andes, spatial and structural coincidence of calderas of the Altiplano Puna Volcanic Complex with the NW-SE striking Calama-Olacapata-El Toro fault zone suggests significant tectonomagmatic interaction. Location of calderas suggest that these regional faults focused magma intrusion and storage, while spatially and temporally correlated eruption pulses connote a tectonic control. Indeed, current thermomechanical models of magma chamber development and eruption triggering promote a role for external triggering of "perched" upper crustal magma chambers. This might have been achieved by melt-enhanced deformation, or alternatively, significant uplift (~1km) associated with the development of large

  7. RETAIL SUPPLY CHAIN MANAGEMENT THROUGH CENTRALIZED DISTRIBUTION

    OpenAIRE

    Davor Dujak

    2012-01-01

    The paper reviews the trends in the design of distribution systems in retail supply chain management. Through goals, design decisions and costs of distribution system or distribution network, the paper points to the complexity and importance of this area of supply chain management. The goal of paper is to present modern trends in the distribution system, as well as specify the advantages and disadvantages of the leading distribution systems, with a special emphasis on the central distribution...

  8. Strategy as Central and Peripheral Processes

    OpenAIRE

    Juul Andersen, Torben; Fredens, Kjeld

    2012-01-01

    Corporate entrepreneurship is deemed essential to uncover opportunities that shape the future strategic path and adapt the firm to environmental change (e.g., Covin and Miles, 1999; Wolcott and Lippitz, 2007). At the same time, rational central processes are important to execute strategic actions in a coordinated manner (e.g., Baum and Wally, 2003; Brews and Hunt, 1999; Goll and Rasheed, 1997). That is, the organization’s adaptive responses and dynamic capabilities are embedded...

  9. Human Rights Training for Central Government Officials

    Institute of Scientific and Technical Information of China (English)

    OUR STAFF REPORTER

    2007-01-01

    @@ More than 50 officials from central government departments attended a human rights training class held in Nanchang,Jiangxi Province, on May 29-June 2. The class was sponsored by the State Council Information Office, during which the trainees attended lectures given on China's human rights concepts and the current human rights conditions in the country,human rights theories and international human rights instruments and protection of human rights under the rule of law.

  10. Sensitivity Analysis of Centralized Dynamic Cell Selection

    DEFF Research Database (Denmark)

    Lopez, Victor Fernandez; Alvarez, Beatriz Soret; Pedersen, Klaus I.;

    2016-01-01

    and a suboptimal optimization algorithm that nearly achieves the performance of the optimal Hungarian assignment. Moreover, an exhaustive sensitivity analysis with different network and traffic configurations is carried out in order to understand what conditions are more appropriate for the use of the proposed...... with two different traffic models, and it is not necessary to be able to connect to a large number of cells in order to reap most of the benefits of the centralized dynamic cell selection....

  11. INTERNATIONAL TERRORISM AND CENTRAL ASIA: PREMATURE ASSESSMENTS

    OpenAIRE

    Sabol, Steven

    2008-01-01

    In the months leading up to, and the first few years after, the Soviet Union collapsed numerous articles and books were published that claimed Islamic "fundamentalism" was likely to emerge in Central Asia. These fears were predicated on numerous scenarios, the most important being the ongoing political and military crisis in Afghanistan and Iranian attempts to increase its influence in the region. I will argue, however, that these concerns were premature and that the real threat to the stabil...

  12. CENTRAL ASIA IN SEARCH OF STABILITY

    OpenAIRE

    Plastun, Vladimir

    2008-01-01

    The tension in the Central Asian Region, particularly in its southern part, which includes Afghanistan, Pakistan, and Iran, largely affects the rest of this vast area and forces the United States and its allies to seek prompt settlement of the crisis they have on their hands. The situation in occupied Iraq is tense; the Turkish invasion into Iraqi Kurdistan in search of terrorists of the Kurdistan Workers’ Party did nothing to relieve the tension; the conflict area spread even further. Two ot...

  13. Central sleep apnoea—a clinical review

    OpenAIRE

    Muza, Rexford T.

    2015-01-01

    Central sleep apnoea (CSA) is characterised by recurrent apnoeas during sleep with no associated respiratory effort. It mostly results from withdrawal of the wakefulness drive in sleep leaving ventilation under metabolic control. A detailed physiological understanding of the control of breathing in wakefulness and sleep is essential to the understanding of CSA. It encompasses a diverse group of conditions with differing aetiologies and pathophysiology. Likewise treatment varies according to u...

  14. The Journal Rankings of Central Banks

    OpenAIRE

    Kohlscheen, Emanuel

    2011-01-01

    This paper analyzes the citation patterns of the central banks of the 15 largest monetary areas of the world that had an active working paper series in 2010. It proceeds to construct a novel journal ranking that is more suited for monetary authorities than the academic journal rankings currently in vogue. We report individual country rankings as well as the global rankings. While important regional differences emerge, the Journal of Monetary Economics, the American Economic Review, the Journa...

  15. Time perception mechanisms at central nervous system

    OpenAIRE

    Rhailana Fontes; Jéssica Ribeiro; Gupta, Daya S.; Dionis Machado; Fernando Lopes-Júnior; Francisco Magalhães; Victor Hugo Bastos; Kaline Rocha; Victor Marinho; Gildário Lima; Bruna Velasques; Pedro Ribeiro; Marco Orsini; Bruno Pessoa; Marco Antonio Araujo Leite

    2016-01-01

    The five senses have specific ways to receive environmental information and lead to central nervous system. The perception of time is the sum of stimuli associated with cognitive processes and environmental changes. Thus, the perception of time requires a complex neural mechanism and may be changed by emotional state, level of attention, memory and diseases. Despite this knowledge, the neural mechanisms of time perception are not yet fully understood. The objective is to relate the mechanisms...

  16. Geochemical drainage survey of central Argyll, Scotland

    OpenAIRE

    Coats, J.S.; Tandy, B.C.; Michie, U.McL

    1982-01-01

    A reconnaissance geochemical drainage survey of 720 km2 of Dalradian outcrop in central Argyll identified base-metal anomalies in the Pyrite Zone, Ardrishaig Phyllites, Loch Tay Limestone and the Green Beds. Faulting and igneous intrusion modified the distribution of metal content within these formations. In the results of the reconnaissance survey, copper reached maxima of 170 ppm and 1454 ppm in stream sediments and panned concentrates respectively; lead 1050 ppm ...

  17. Central Serous Chorioretinopathy Mistaken for Tuberculous Choroiditis

    OpenAIRE

    Marina Papadia; Herbort, Carl P.

    2011-01-01

    Purpose: To report a patient erroneously diagnosed with tuberculous choroiditis who was accordingly treated with long term steroids which in turn, worsened the actual disease process that turned out to be central serous chorioretinopathy (CSC). Case Report: A 59-year-old Caucasian man developed a chorioretinal disease in his right eye in 1997. Having a positive tuberculin skin test, tuberculous chorioretinitis was suspected and antituberculous therapy was administered for 4 months. In 200...

  18. The emergence of echinococcosis in central Asia

    OpenAIRE

    Torgerson, P.R.

    2013-01-01

    Following the collapse of the Soviet Union in 1991, there was an increase in the number of cases of human echinococcosis recorded throughout central Asia. Between 1991 and 2001 incidence rates of cystic echinococcosis (CE) increased by 4 fold or more. There also appeared to be increases in prevalence of CE in livestock and prevalences of Echinococcus granulosus reported in dogs. The increase in human echinococcosis was associated with changes in livestock husbandry, decline in veterinary publ...

  19. Lagrange, central norms, and quadratic Diophantine equations

    OpenAIRE

    R. A. Mollin

    2005-01-01

    We consider the Diophantine equation of the form x2−Dy2=c, where c=±1,±2, and provide a generalization of results of Lagrange with elementary proofs using only basic properties of simple continued fractions. As a consequence, we achieve a completely general, simple, and elegant criterion for the central norm to be 2 in the simple continued fraction expansion of D.

  20. Lagrange, central norms, and quadratic Diophantine equations

    Directory of Open Access Journals (Sweden)

    R. A. Mollin

    2005-01-01

    Full Text Available We consider the Diophantine equation of the form x2−Dy2=c, where c=±1,±2, and provide a generalization of results of Lagrange with elementary proofs using only basic properties of simple continued fractions. As a consequence, we achieve a completely general, simple, and elegant criterion for the central norm to be 2 in the simple continued fraction expansion of D.