WorldWideScience

Sample records for dual objective multifocal

  1. Multifocal electroretinography.

    Science.gov (United States)

    Mendoza-Santiesteban, Carlos E; Fernández-Cherkasova, Lilia; Echavarria, Odelaisys Hernández; Rodríguez, Ramón Cabal; Columbié-Garbey, Yannara; Riesgo, Tamara Juvier

    2010-07-01

    Multifocal electroretinography (mfERG) provides functional and objective evidence of retinal dysfunction. We have found mfERG to be especially useful in the management of occult outer retinopathy and Stargardt's disease.

  2. Building complex reference objects from dual sets.

    Science.gov (United States)

    Patson, Nikole D; Warren, Tessa

    2011-05-01

    There has been considerable psycholinguistic investigation into the conditions that allow separately introduced individuals to be joined into a plural set and represented as a complex reference object (e.g., Eschenbach, et al., 1989; Garrod & Sanford, 1982; Koh & Clifton, 2002; Koh et al., 2008; Moxey et al., 2004; Sanford & Lockhart, 1990). The current paper reports three eye-tracking experiments that investigate the less-well understood question of what conditions allow pointers to be assigned to the individuals within a previously undifferentiated set, turning it into a complex reference object. The experiments made use of a methodology used in Patson and Ferreira (2009) to distinguish between complex reference objects and undifferentiated sets. Experiments 1 and 2 demonstrated that assigning different properties to the members of an undifferentiated dual set via a conjoined modifier or a comparative modifier transformed it into a complex reference object. Experiment 3 indicated that assigning a property to only one member of an undifferentiated dual set introduced pointers to both members. These results demonstrate that pointers can be established to referents within a plural set without picking them out via anaphors; they set boundaries on the kinds of implicit contrasts between referents that establish pointers; and they illustrate that extremely subtle properties of the semantic and referential context can affect early parsing decisions.

  3. Robust Abandoned Object Detection Using Dual Foregrounds

    Directory of Open Access Journals (Sweden)

    Tetsuji Haga

    2007-11-01

    Full Text Available As an alternative to the tracking-based approaches that heavily depend on accurate detection of moving objects, which often fail for crowded scenarios, we present a pixelwise method that employs dual foregrounds to extract temporally static image regions. Depending on the application, these regions indicate objects that do not constitute the original background but were brought into the scene at a subsequent time, such as abandoned and removed items, illegally parked vehicles. We construct separate long- and short-term backgrounds that are implemented as pixelwise multivariate Gaussian models. Background parameters are adapted online using a Bayesian update mechanism imposed at different learning rates. By comparing each frame with these models, we estimate two foregrounds. We infer an evidence score at each pixel by applying a set of hypotheses on the foreground responses, and then aggregate the evidence in time to provide temporal consistency. Unlike optical flow-based approaches that smear boundaries, our method can accurately segment out objects even if they are fully occluded. It does not require on-site training to compensate for particular imaging conditions. While having a low-computational load, it readily lends itself to parallelization if further speed improvement is necessary.

  4. Dual-band infrared capabilities for imaging buried object sites

    Energy Technology Data Exchange (ETDEWEB)

    Del Grande, N.K.; Durbin, P.F.; Gorvad, M.R.; Perkins, D.E.; Clark, G.A.; Hernandez, J.E.; Sherwood, R.J.

    1993-04-02

    We discuss dual-band infrared (DBIR) capabilities for imaging buried object sizes. We identify physical features affecting thermal contrast needed to distinguish buried object sites from undisturbed sites or surface clutter. Apart from atmospheric transmission and system performance, these features include: object size, shape, and burial depth; ambient soil, disturbed soil and object site thermal diffusivity differences; surface temperature, emissivity, plant-cover, slope, albedo and roughness variations; weather conditions and measurement times. We use good instrumentation to measure the time-varying temperature differences between buried object sites and undisturbed soil sites. We compare near surface soil temperature differences with radiometric infrared (IR) surface temperature differences recorded at 4.7 {plus_minus} 0.4 {mu}m and at 10.6 {plus_minus} 1.0 {mu}m. By producing selective DBIR image ratio maps, we distinguish temperature-difference patterns from surface emissivity effects. We discuss temperature differences between buried object sites, filled hole site (without buried objects), cleared (undisturbed) soil sites, and grass-covered sites (with and without different types of surface clutter). We compare temperature, emissivity-ratio, visible and near-IR reflectance signatures of surface objects, leafy plants and sod. We discuss the physical aspects of environmental, surface and buried target features affecting interpretation of buried targets, surface objects and natural backgrounds.

  5. Objective assessment of laparoscopic skills: dual-task approach.

    Science.gov (United States)

    Meneghetti, Adam T; Pachev, George; Zheng, Bin; Panton, Ormond Neely; Qayumi, Karim

    2012-12-01

    Assessment of surgical performance is often accomplished with traditional methods that often provide only subjective data. Trainees who perform well on a simulator in a controlled environment may not perform well in a real operating room environment with distractions. This project uses the ideas of dual-task methodology and applies them to the assessment of performance of laparoscopic surgical skills. The level of performance on distracting secondary tasks while trying to perform a primary task becomes an indirect but objective measure of the surgical skill of the trainee. Nine surgery residents and 6 experienced laparoscopic surgeons performed 3 primary tasks on a laparoscopic virtual reality simulator (camera position, grasping, and cholecystectomy) while being distracted by 3 secondary tasks (counting beeps, selective responses, and mental arithmetic). Completion time and error rates were recorded for each combination of tasks. When performed separately, time to completion and error rates for primary and secondary tasks were similar for learners and experts. When performing the tasks simultaneously, learners had more errors than experts. Error rates increased for learners when distracting tasks became more difficult or required more attention. Expert surgeons maintained consistent error rates despite the increasing difficulty of task combinations. The use of dual-task methodology may help trainers to identify which surgical trainees require more preparation before entering the real operating room environment. Expert surgeons are capable of maintaining performance levels on a primary task in the face of distractions that may occur in the operating room.

  6. The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects

    Directory of Open Access Journals (Sweden)

    Mousa MF

    2013-05-01

    % respectively and 89% and 79% in glaucoma suspects. These results showed that the new analysis protocol was able to confirm existing visual field defects detected by standard perimetry, was able to differentiate between the three study groups with a clear distinction between normal patients and those with suspected glaucoma, and was able to detect early visual field changes not detected by standard perimetry. In addition, the distinction between normal and glaucoma patients was especially clear and significant using this analysis.Conclusion: The new hemifield sector analysis protocol used in mfVEP testing can be used to detect glaucomatous visual field defects in both glaucoma and glaucoma suspect patients. Using this protocol, it can provide information about focal visual field differences across the horizontal midline, which can be utilized to differentiate between glaucoma and normal subjects. The sensitivity and specificity of the mfVEP test showed very promising results and correlated with other anatomical changes in glaucomatous visual field loss. The intersector analysis protocol can detect early field changes not detected by the standard Humphrey Field Analyzer test.Keywords: objective perimetry, multifocal VEP, visual field testing, glaucomatous field loss, glaucoma suspect, SAP, HFA

  7. Multifocal Motor Neuropathy

    Science.gov (United States)

    ... of finding ways to prevent, treat, and, ultimately, cure them. Show More Show Less ... Definition Multifocal motor neuropathy is a progressive muscle disorder characterized by muscle weakness in the hands, with differences from one side of the body ...

  8. A case of progressive multifocal leukoencephalopathy with chronic renal failure, whose JC virus in cerebrospinal fluid disappeared after mefloquine-mirtazapine dual therapy.

    Science.gov (United States)

    Ohnuki, Eiichi; Asayama, Shinya; Asayama, Tomoko; Nakamichi, Kazuo; Saijo, Masayuki; Kosaka, Satoru

    2016-10-28

    An 83-year-old man with chronic renal failure was referred to our hospital because of subacute progressive right hemiparesis. A brain MRI showed high-intensity lesions in bilateral middle cerebellar peduncles and white matter of the left frontal lobe on T 2 -weighted images. The lesions increased gradually, so we suspected a brain tumor because 1 H-MRS images showed elevated Cho and decreased NAA, and also pathologic findings of the brain biopsy suggested glioblastoma. However, JC virus (JCV) in cerebrospinal fluid was revealed highly positive by PCR. So we reconsidered pathologically and finally found bizarre astrocytes which were infected with JCV in immunohistochemical studies and we diagnosed progressive multifocal leukoencephalopathy at last. Then we medicated with mefloquine and mirtazapine, and the JCV in cerebrospinal fluid disappeared, without new MRI lesions. This is a rare case in respect of the background of the patient and the clinical course.

  9. Chronic Recurrent Multifocal Osteomyelitis

    African Journals Online (AJOL)

    Administrator

    psoriasis. The disease is now considered as part of the synovitis, acne, palmo- plantar pustulosis, hyperostosis, and osteitis (SAPHO) syndrome.3 Majeed syndrome which consists of CRMO, congenital dyserythropoietic anaemia and inflammatory dermatosis, has also been reported in families.6. Chronic recurrent multifocal.

  10. The multifaceted presentation of chronic recurrent multifocal osteomyelitis

    DEFF Research Database (Denmark)

    Girschick, Hermann; Finetti, Martina; Orlando, Francesca

    2018-01-01

    Objectives: Chronic non-bacterial osteomyelitis (CNO) or chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disorder characterized by sterile bone osteolytic lesions. The aim of this study was to evaluate the demographic data and clinical, instrumental and therapeutic featur...

  11. Primary multifocal leptomeningeal gliomatosis

    International Nuclear Information System (INIS)

    Yik Kong Tsui, Edmund; Tai Loo, Ka; Keung Mok, Chun; Keung Yuen, Ming; Keung Cheung, Yu

    2001-01-01

    A 23-year-old female university student was presented with recent onset of non-specific headache and dizziness. She had no neurological deficit on neurological examination and magnetic resonance imaging of the brain revealed diffuse enhancement in the basal cisterns and cerebral sulci. She was treated as tuberculous meningitis but she did not improve and developed respiratory arrest. Autopsy showed primary multifocal leptomeningeal gliomatosis

  12. Primary multifocal leptomeningeal gliomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Yik Kong Tsui, Edmund; Tai Loo, Ka; Keung Mok, Chun; Keung Yuen, Ming; Keung Cheung, Yu E-mail: hykcheung@hotmail.com

    2001-01-01

    A 23-year-old female university student was presented with recent onset of non-specific headache and dizziness. She had no neurological deficit on neurological examination and magnetic resonance imaging of the brain revealed diffuse enhancement in the basal cisterns and cerebral sulci. She was treated as tuberculous meningitis but she did not improve and developed respiratory arrest. Autopsy showed primary multifocal leptomeningeal gliomatosis.

  13. Dual-Objective Item Selection Criteria in Cognitive Diagnostic Computerized Adaptive Testing

    Science.gov (United States)

    Kang, Hyeon-Ah; Zhang, Susu; Chang, Hua-Hua

    2017-01-01

    The development of cognitive diagnostic-computerized adaptive testing (CD-CAT) has provided a new perspective for gaining information about examinees' mastery on a set of cognitive attributes. This study proposes a new item selection method within the framework of dual-objective CD-CAT that simultaneously addresses examinees' attribute mastery…

  14. [Progressive multifocal leukoencephalopathy].

    Science.gov (United States)

    Warnke, C; Wattjes, M P; Adams, O; Hartung, H-P; Martin, R; Weber, T; Stangel, M

    2016-12-01

    Progressive multifocal leukoencephalopathy (PML) is a disease of immunosuppressed patients caused by the JC polyomavirus (JCPyV). Due to the elevated risk in patients treated with natalizumab for multiple sclerosis (MS) and also treatment with other biologicals for different indications, the relevance of PML has increased in recent years. This article summarizes the published knowledge on the biology and pathogenesis of PML with a focus on the role of cerebrospinal fluid diagnostics in the work-up for PML and the current PML case definition. Current recommendations regarding risk management are discussed, as are possible therapies and prevention.

  15. Lente intra-ocular multifocal difrativa apodizada: resultados Diffractive apodized multifocal intraocular lens: results

    Directory of Open Access Journals (Sweden)

    Virgilio Centurion

    2007-12-01

    Full Text Available OBJETIVO: Mostrar os resultados visuais e refracionais com lente intra-ocular multifocal difrativa apodizada. MÉTODOS: Estudo de 100 olhos de 50 pacientes com catarata, submetidos à facoemulsificação com implante bilateral de lente intra-ocular (LIO multifocal difrativa apodizada. Foi avaliada a acuidade visual binocular sem e com correção para longe e perto, a previsibilidade refracional e a freqüência de uso de óculos. RESULTADOS: A acuidade visual sem correção para longe foi de e " 20/30 em 97,56% dos olhos operados e e" J2 em 100%, sendo que 82% dos pacientes nunca usam óculos e 16% usam de forma esporádica. CONCLUSÃO: A LIO multifocal difrativa apodizada mostrou ser uma opção previsível, reproduzível e segura na correção dos vícios de refração para longe e perto durante a cirurgia da catarata, permitindo elevado índice de independência ao uso de óculos.OBJECTIVE: To show visual and refraction results using multifocal diffractive apodized intraocular lens. METHODS: The study of 100 eyes of 50 patients with cataract, submitted to phacoemulsification with bilateral implant of multifocal diffractive apodized intraocular lens (IOL. Binocular visual acuity was evaluated with and without correction for near and distance, and refraction previsibility and frequency of wearing glasses. RESULTS: Visual acuity without correction for distance was e" 20/30 in 97.56% of eyes operated on and e" J2 in 100%, of these 82% of patients never wear glasses and 16% wear glasses sporadically. CONCLUSION: Multifocal diffractive apodized IOL proved to be a foreseeable option, reproducible and safe in the correction of refraction errors for distance and near during cataract surgery, enabling a high rate of independence from the use of glasses.

  16. Pediatric multifocal liver lesions evaluated by MRI

    Directory of Open Access Journals (Sweden)

    Majed Almotairi

    2015-01-01

    Full Text Available Objective: The purpose of this study is to present our experience with MRI evaluation of multifocal liver lesions in children and describe the MRI characteristics of these lesions. Patients and Methods: A retrospective review of consecutive MRI exams performed for the evaluation of multiple liver lesions between 1 January 2007 and 31 December 2012 was done to note the number of lesions, the size of the largest lesion, MR signal characteristics, and background liver. Final diagnosis was assigned to each case based on pathology in the available cases and a combination of clinical features, imaging features, and follow-up in the remaining cases. Results: A total of 48 children (22 boys, 26 girls; age between 3 months and 18 years with average age 10.58 years and median age 11 years were included in the study. Totally 51 lesion diagnoses were seen in 48 children that included 17 focal nodular hyperplasia (FNH, 8 hemangiomas, 7 metastases, 6 regenerative nodules, 3 adenomas, 3 abscesses, and one each of angiomyolipoma, epithelioid hemangioendothelioma, focal fatty infiltration, hepatocellular carcinoma, hepatic infarction, nodular regenerative hyperplasia, and hepatic cyst. Background liver was normal in 33, cirrhotic in 10, fatty in 3, and siderotic in 2 children. Most FNH, hemangiomas, and regenerative nodules showed characteristic MRI features, while metastases were variable in signal pattern. Conclusion: Many commonly seen multifocal liver lesions in children have characteristic MRI features. MRI can help to arrive at reasonable differential diagnoses for multifocal liver lesions in children and guide further investigation and management.

  17. Complexity analysis of dual-channel game model with different managers' business objectives

    Science.gov (United States)

    Li, Ting; Ma, Junhai

    2015-01-01

    This paper considers dual-channel game model with bounded rationality, using the theory of bifurcations of dynamical system. The business objectives of retailers are assumed to be different, which is closer to reality than previous studies. We study the local stable region of Nash equilibrium point and find that business objectives can expand the stable region and play an important role in price strategy. One interesting finding is that a fiercer competition tends to stabilize the Nash equilibrium. Simulation shows the complex behavior of two dimensional dynamic system, we find period doubling bifurcation and chaos phenomenon. We measure performances of the model in different period by using the index of average profit. The results show that unstable behavior in economic system is often an unfavorable outcome. So this paper discusses the application of adaptive adjustment mechanism when the model exhibits chaotic behavior and then allows the retailers to eliminate the negative effects.

  18. Exploring R&D Influences on Financial Performance for Business Sustainability Considering Dual Profitability Objectives

    Directory of Open Access Journals (Sweden)

    Kao-Yi Shen

    2017-10-01

    Full Text Available The importance of research and development (R&D for business sustainability have gained increasing interests, especially in the high-tech sector. However, the efforts of R&D might cause complex and mixed impacts on the financial results considering the associated expenses. Thus, this study aims to examine how R&D efforts may influence business to improve its financial performance considering the dual objectives: the gross and the net profitability. This research integrates a rough-set-based soft computing technique and multiple criteria decision-making (MCDM methods to explore this complex and yet valuable issue. A group of public listed companies from Taiwan, all in the semiconductor sector, is analyzed as a case study. More than 30 variables are considered, and the adopted soft computing technique retrieves 14 core attributes—for the dual profitability objectives—to form the evaluation model. The importance of R&D for pursuing superior financial prospects is confirmed, and the empirical case demonstrates how to guide an individual company to plan for improvements to achieve its long-term sustainability by this hybrid approach.

  19. A Compact Dual-Band RFID Tag Antenna Mountable on Metallic Objects

    Directory of Open Access Journals (Sweden)

    Byeonggwi Mun

    2015-01-01

    Full Text Available A compact (50 × 50 × 4 mm3 dual-band radio frequency identification (RFID tag antenna mountable on metallic objects is proposed for the ultra-high frequency (UHF band (917∼923.5 MHz and the microwave (MW band (2.4∼2.45 GHz. With the proximity-coupled feed loop, the proposed antenna consists of two symmetric planar inverted-F antenna (PIFA elements for the UHF band passive tag and a meander microstrip patch antenna for the MW band active tag. The performance of the proposed antenna is verified by mounting it on the different sizes of the metallic object. Furthermore, the passive tag antenna in the UHF band furthermore may be used for energy harvesting techniques to improve the lifetime of the active tag in the MW band. The measured maximum read range is 5.50 m in the UHF band and 14.15 m in the MW band when the proposed tag antenna is mounted on the metallic objects. The total efficiency for all operating frequency bands is higher than 50%. High isolation (>12 dB between tag antennas in the UHF band and the MW band is achieved.

  20. [Multifocal tuberculosis in immunocompetent patients].

    Science.gov (United States)

    Rezgui, Amel; Fredj, Fatma Ben; Mzabi, Anis; Karmani, Monia; Laouani, Chadia

    2016-01-01

    Multifocal tuberculosis is defined as the presence of lesions affecting at least two extrapulmonary sites, with or without pulmonary involvement. This retrospective study of 10 cases aims to investigate the clinical and evolutionary characteristics of multifocal tuberculosis. It included 41 cases with tuberculosis collected between 1999 and 2013. Ten patients had multifocal tuberculosis (24%): 9 women and 1 man, the average age was 50 years (30-68 years). Our patients were correctly BCG vaccinated. The evaluation of immunodepression was negative in all patients. 7 cases had lymph node tuberculosis, 3 cases digestive tuberculosis, 2 cases pericardial tuberculosis, 2 cases osteoarticular tuberculosis, 1 case brain tuberculosis, 2 cases urinary tuberculosis, 4 cases urogenital tuberculosis, 1 case adrenal tuberculosis, 1 case cutaneous and 1 case muscle tuberculosis. All patients received anti-tuberculosis treatment for a mean duration of 10 months, with good evolution. Multifocal tuberculosis is difficult to diagnose. It can affect immunocompetent patients but often has good prognosis. Anti-tuberculosis therapy must be initiated as soon as possible to avoid sequelae.

  1. Numerical investigation of a dual-loop EGR split strategy using a split index and multi-objective Pareto optimization

    International Nuclear Information System (INIS)

    Park, Jungsoo; Song, Soonho; Lee, Kyo Seung

    2015-01-01

    Highlights: • Model-based control of dual-loop EGR system is performed. • EGR split index is developed to provide non-dimensional index for optimization. • EGR rates are calibrated using EGR split index at specific operating conditions. • Multi-objective Pareto optimization is performed to minimize NO X and BSFC. • Optimum split strategies are suggested with LP-rich dual-loop EGR at high load. - Abstract: A proposed dual-loop exhaust-gas recirculation (EGR) system that combines the features of high-pressure (HP) and low-pressure (LP) systems is considered a key technology for improving the combustion behavior of diesel engines. The fraction of HP and LP flows, known as the EGR split, for a given dual-loop EGR rate play an important role in determining the engine performance and emission characteristics. Therefore, identifying the proper EGR split is important for the engine optimization and calibration processes, which affect the EGR response and deNO X efficiencies. The objective of this research was to develop a dual-loop EGR split strategy using numerical analysis and one-dimensional (1D) cycle simulation. A control system was modeled by coupling the 1D cycle simulation and the control logic. An EGR split index was developed to investigate the HP/LP split effects on the engine performance and emissions. Using the model-based control system, a multi-objective Pareto (MOP) analysis was used to minimize the NO X formation and fuel consumption through optimized engine operating parameters. The MOP analysis was performed using a response surface model extracted from Latin hypercube sampling as a fractional factorial design of experiment. By using an LP rich dual-loop EGR, a high EGR rate was attained at low, medium, and high engine speeds, increasing the applicable load ranges compared to base conditions

  2. The development of a green supply chain dual-objective facility by considering different levels of uncertainty

    Science.gov (United States)

    Khorasani, Sasan Torabzadeh; Almasifard, Maryam

    2017-11-01

    This paper presents a dual-objective facility programming model for a green supply chain network. The main objectives of the presented model are minimizing overall expenditure and negative environmental impacts of the supply chain. This study contributes to the existing literature by incorporating uncertainty in customer demand, suppliers, production, and casting capacity. An industrial case study is also analyzed to reveal the feasibility of the proposed model and its application. A fuzzy approach which is known as TH is used to solve the suggested dual-objective model. TH approach is integration of a max-min method (LH) and modified version of Werners' approach (MW). The outcome of this study reveals that the presented model can support green supply chain network in different levels of uncertainty. In presented model, cost and negative environmental impacts derived from the supply chain network will increase of higher levels of uncertainty.

  3. Primary multifocal osseous lymphoma in a child

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Takashi S.P. [University of Iowa, Carver College of Medicine, Iowa City, IA (United States); Ferguson, Polly J. [University of Iowa, Department of Pediatrics, Iowa City, IA (United States); Khanna, Geetika [Washington University, Mallinckrodt Institute of Radiology, St Louis, MO (United States)

    2008-12-15

    We report a case of primary multifocal osseous lymphoma in a 6-year-old girl presenting with multifocal osteolytic lesions without systemic symptoms or identifiable non-osseous primary tumor. The differential diagnoses for such a presentation include histiocytosis X, chronic recurrent multifocal osteomyelitis, acute lymphoblastic leukemia, metastatic disease, and primary bone lymphoma. Although non-Hodgkin lymphoma is common in the pediatric population, its presentation as a primary bone tumor, especially with multifocal disease, is extremely rare and is frequently misdiagnosed. We hope that awareness of this entity will help radiologists achieve timely diagnosis and intervention. (orig.)

  4. Primary multifocal osseous lymphoma in a child

    International Nuclear Information System (INIS)

    Sato, Takashi S.P.; Ferguson, Polly J.; Khanna, Geetika

    2008-01-01

    We report a case of primary multifocal osseous lymphoma in a 6-year-old girl presenting with multifocal osteolytic lesions without systemic symptoms or identifiable non-osseous primary tumor. The differential diagnoses for such a presentation include histiocytosis X, chronic recurrent multifocal osteomyelitis, acute lymphoblastic leukemia, metastatic disease, and primary bone lymphoma. Although non-Hodgkin lymphoma is common in the pediatric population, its presentation as a primary bone tumor, especially with multifocal disease, is extremely rare and is frequently misdiagnosed. We hope that awareness of this entity will help radiologists achieve timely diagnosis and intervention. (orig.)

  5. Multifocal versus monofocal intraocular lenses after cataract extraction

    Directory of Open Access Journals (Sweden)

    Daniel Calladine

    Full Text Available BACKGROUND: Good unaided distance visual acuity is now a realistic expectation following cataract surgery and intraocular lens (IOL implantation. Near vision, however, still requires additional refractive power, usually in the form of reading glasses. Multiple optic (multifocal IOLs are available which claim to allow good vision at a range of distances. It is unclear whether this benefit outweighs the optical compromises inherent in multifocal IOLs. OBJECTIVES: The objective of this review was to assess the effects of multifocal IOLs, including effects on visual acuity, subjective visual satisfaction, spectacle dependence, glare and contrast sensitivity, compared to standard monofocal lenses in people undergoing cataract surgery. METHODS: Search methods: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register, The Cochrane Library 2012, Issue 2, MEDLINE (January 1946 to March 2012, EMBASE (January 1980 to March 2012, the metaRegister of Controlled Trials (mRCT (www.controlled-trials.com, ClinicalTrials.gov (www.clinicaltrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP (www.who.int/ictrp/search/en. We did not use any date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 6 March 2012. We searched the reference lists of relevant articles and contacted investigators of included studies and manufacturers of multifocal IOLs for information about additional published and unpublished studies. Selection criteria: All randomised controlled trials comparing a multifocal IOL of any type with a monofocal IOL as control were included. Both unilateral and bilateral implantation trials were included. Data collection and analysis: Two authors collected data and assessed trial quality. Where possible, we pooled data from the individual studies using a random-effects model, otherwise we tabulated data. MAIN RESULTS: Sixteen completed trials

  6. Optics of diffractive multifocal IOL

    Directory of Open Access Journals (Sweden)

    Fatahi B

    1994-04-01

    Full Text Available The diffractive multifocal IOL provides simultaneous bifocal imaging by utilizing both diffractive and refractive optics. In both distant and near vision, there is a clear highly focused image on the retina. The second image is highly defocused, providing only faint background illumination. A small amount of the light goes to the higher orders of diffraction which are not perceptible by eyes. The bright spot produced by a zone plate is so intense that the plate acts much like a converging lens. There are also fainter images corresponding to focal lengths f/3, f/5, f/7, ...

  7. Primary multifocal osseous Hodgkin's lymphoma

    Directory of Open Access Journals (Sweden)

    Kohler Janice

    2008-03-01

    Full Text Available Abstract Background Hodgkin's disease (HD most commonly presents with progressive painless enlargement of peripheral lymph nodes, especially around the cervical region. A few children have systemic symptoms and weight loss. At the time of diagnosis, osseous involvement is uncommon Case presentation A case is described of Primary Multifocal Osseous Hodgkin's Lymphoma in a seven-year-old boy. He presented with a painful swelling in the sternum, and further investigations revealed deposits in his L1 vertebra, the left sacro-iliac joint and the right acetabulum. Conclusion The clinical, radiological and histological features of this disease can mimic other medical conditions, including Tuberculosis, making the diagnosis difficult and often leading to delays in treatment. This is a very rare condition and we believe this to be the youngest reported case in the literature.

  8. Progressive multifocal leukoencephalopathy: new concepts

    Directory of Open Access Journals (Sweden)

    Marco A. Lima

    2013-09-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML is a demyelinating disease of the CNS caused by reactivation of JC virus (JCV in a setting of cellular immunosuppression. Originally, PML was observed in patients with advanced HIV infection, lymphoproliferative disorders and transplant recipients. However, the widespread use of HIV antiretroviral drugs and the new selective immunomodulatory and immunosuppressive medications, such as Rituximab and Natalizumab, has recently modified the epidemiology, clinical presentation and prognosis of PML. Herein, we discuss the new concepts on PML, emphasizing the recent modification in the epidemiology; the impact of new immunomodulatory treatments in the disease, PML-IRIS (Immune reconstitution inflammatory síndrome, new treatment strategies and other JCV related CNS diseases.

  9. Chronic recurrent multifocal osteomyelitis (CRMO)

    International Nuclear Information System (INIS)

    Schilling, F.

    1998-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an unusual clinical entity. More than 200 cases are described in the literature and it is presented here with special reference to its radiological aspects. It is an acquired disease of the skeleton which occurs predominantly during childhood and adolescence. About ten per cent of cases begin in early or, rarely, in later adult life. This variant is described here for the first time and is discussed as 'adult CRMO'. The underlying pathology is a bland, predominantly lympho-plasma cellular osteomyelitis which is self-limiting and leads to bone sclerosis (Garre). It probably involves an abnormal immune process which follows an infection but remains clinically latent and remains aseptic and sterile. In a quarter of cases there is an association with pustulosis palmo-plantaris and its relationship with psoriatic arthropathy is discussed. The clinical, histopathological and imaging features (radiological and particularly MRT) and the bone changes are described. (orig./AJ) [de

  10. Objective measurement of gait parameters in healthy and cognitively impaired elderly using the dual-task paradigm.

    Science.gov (United States)

    König, Alexandra; Klaming, Laura; Pijl, Marten; Demeurraux, Alexandre; David, Renaud; Robert, Philippe

    2017-12-01

    The present study explores the differences in gait parameters in elderly subjects with or without cognitive impairment measured by means of ambulatory actigraphy while performing a single and a dual task. Sixty-nine participants of which 23 individuals were diagnosed with Alzheimer's disease (AD), 24 individuals with mild cognitive impairment (MCI), and 22 healthy controls performed a single and dual walking task while wearing a wrist-worn accelerometer. Objective measures of gait features such as walking speed, cadence (i.e., number of steps per minute), and step variance (i.e., variance in time between two consecutive steps) were derived and analyzed. While differences in several gait parameters, namely walking speed, were found between MCI and AD patients, no differences between healthy elderly and MCI patients were found. Walking speed seems to be a gait-related feature that differs significantly between MCI and AD patients and thus could be used as an additional measurement in clinical assessment. However, differences in gait may not be salient enough in the early stages of dementia to be detected by actigraphy. More research comparing different methods to measure gait in early stages of dementia under different dual task conditions is neccessary.

  11. Multifocal osteogenic sarcoma in Paget's disease

    International Nuclear Information System (INIS)

    Vuillemin-Bodaghi, V.; Parlier-Cuau, C.; Laredo, J.D.; Cywiner-Golenzer, C.; Quillard, A.; Kaplan, G.

    2000-01-01

    The most serious complication of Paget's disease is sarcomatous degeneration of pagetic bone. Multifocal sarcomatous degeneration occurs mainly in polyostotic Paget's disease. Multifocal Paget's sarcoma is uncommon and can arise in any site. We report two cases of synchronous multifocal sarcomatous degeneration. The two patients were elderly women (aged 77 and 86 years, respectively) who developed sarcomatous lesions concomitantly, in the first case report in left ilium, left tibia, and first lumbar vertebra and in the second case report in the skull, right ilium, and sacrum. Whether these cases are due to the simultaneous development of several primaries or to metastases from a single primary remains unclear. (orig.)

  12. Multifocal, chronic osteomyelitis of unknown etiology

    International Nuclear Information System (INIS)

    Kozlowski, K.; Beluffi, G.; Feltham, C.; James, M.; Nespoli, L.; Tamaela, L.; Pavia Univ.; Municipal Hospital, Nelson; Medical School, Jakarta

    1985-01-01

    Four cases of multifocal osteomyelitis of unknown origin in childhood are reported. The variable clinical and radiographic appearances of the disease are illustrated and the diagnostic difficulties in the early stages of the disease are stressed. (orig.) [de

  13. Multifocal bone tuberculosis: a case report.

    Science.gov (United States)

    Dlimi, F; Abouzahir, M; Mahfoud, M; Berrada, M S; El Bardouni, A; El Yaacoubi, M

    2011-12-01

    Multifocal long bones tuberculosis without articular involvement is very rare. Pain and swelling are the common presenting symptoms. Difficulties in diagnosis often lead to delayed treatment, sometimes with devastating consequences for patients. Radiographs may mimic other diseases. Histopathological study is necessary to establish the diagnosis. The antibacillary chemotherapy produces excellent results. We report a case of a 60-year-old woman afflicted with multifocal tibial tuberculosis. Copyright © 2011 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  14. Multifocal atrial tachycardia in two neonates.

    Science.gov (United States)

    Farooki, Z Q; Green, E W

    1977-01-01

    Two neonates with rapid and irregular pulse rate had an uncommon form of atrial tachycardia. The irregular heart rate was first detected during fetal monitoring. Postnatal electrocardiograms were compatible with the diagnosis of multifocal atrial tachycardia or chaotic atrial rhythm. Both patients were treated with digoxin and the rhythm gradually reverted to sinus. This may represent the first description of multifocal atrial tachycardia in the newborn. Images PMID:901681

  15. An Objective Prototype-Based Method for Dual-Polarization Radar Clutter Identification

    Directory of Open Access Journals (Sweden)

    Guang Wen

    2017-04-01

    Full Text Available A prototype-based method is developed to discriminate different types of clutter (ground clutter, sea clutter, and insects from weather echoes using polarimetric measurements and their textures. This method employs a clustering algorithm to generate data groups from the training dataset, each of which is modeled as a weighted Gaussian distribution called a “prototype.” Two classification algorithms are proposed based on the prototypes, namely maximum prototype likelihood classifier (MPLC and Bayesian classifier (BC. In the MPLC, the probability of a data point with respect to each prototype is estimated to retrieve the final class label under the maximum likelihood criterion. The BC models the probability density function as a Gaussian mixture composed by the prototypes. The class label is obtained under the maximum a posterior criterion. The two algorithms are applied to S-band dual-polarization CP-2 weather radar data in Southeast Queensland, Australia. The classification results for the test dataset are compared with the NCAR fuzzy-logic particle identification algorithm. Generally good agreement is found for weather echo and ground clutter; however, the confusion matrix indicates that the techniques tend to differ from each other on the recognition of insects.

  16. Static Object Detection Based on a Dual Background Model and a Finite-State Machine

    Directory of Open Access Journals (Sweden)

    Heras Evangelio Rubén

    2011-01-01

    Full Text Available Detecting static objects in video sequences has a high relevance in many surveillance applications, such as the detection of abandoned objects in public areas. In this paper, we present a system for the detection of static objects in crowded scenes. Based on the detection of two background models learning at different rates, pixels are classified with the help of a finite-state machine. The background is modelled by two mixtures of Gaussians with identical parameters except for the learning rate. The state machine provides the meaning for the interpretation of the results obtained from background subtraction; it can be implemented as a look-up table with negligible computational cost and it can be easily extended. Due to the definition of the states in the state machine, the system can be used either full automatically or interactively, making it extremely suitable for real-life surveillance applications. The system was successfully validated with several public datasets.

  17. Moving Object Tracking and Its Application to an Indoor Dual-Robot Patrol

    Directory of Open Access Journals (Sweden)

    Cheng-Han Shih

    2016-11-01

    Full Text Available This paper presents an application of image tracking using an omnidirectional wheeled mobile robot (WMR. The objective of this study is to integrate image processing of hue, saturation, and lightness (HSL for fuzzy color space, and use mean shift tracking for object detection and a Radio Frequency Identification (RFID reader for confirming destination. Fuzzy control is applied to omnidirectional WMR for indoor patrol and intruder detection. Experimental results show that the proposed control scheme can make the WMRs perform indoor security service.

  18. Creation of diffraction-limited non-Airy multifocal arrays using a spatially shifted vortex beam

    Science.gov (United States)

    Lin, Han; Gu, Min

    2013-02-01

    Diffraction-limited non-Airy multifocal arrays are created by focusing a phase-modulated vortex beam through a high numerical-aperture objective. The modulated phase at the back aperture of the objective resulting from the superposition of two concentric phase-modulated vortex beams allows for the generation of a multifocal array of cylindrically polarized non-Airy patterns. Furthermore, we shift the spatial positions of the phase vortices to manipulate the intensity distribution at each focal spot, leading to the creation of a multifocal array of split-ring patterns. Our method is experimentally validated by generating the predicted phase modulation through a spatial light modulator. Consequently, the spatially shifted circularly polarized vortex beam adopted in a dynamic laser direct writing system facilitates the fabrication of a split-ring microstructure array in a polymer material by a single exposure of a femtosecond laser beam.

  19. Objective image characterization of a spectral CT scanner with dual-layer detector

    Science.gov (United States)

    Ozguner, Orhan; Dhanantwari, Amar; Halliburton, Sandra; Wen, Gezheng; Utrup, Steven; Jordan, David

    2018-01-01

    This work evaluated the performance of a detector-based spectral CT system by obtaining objective reference data, evaluating attenuation response of iodine and accuracy of iodine quantification, and comparing conventional CT and virtual monoenergetic images in three common phantoms. Scanning was performed using the hospital’s clinical adult body protocol. Modulation transfer function (MTF) was calculated for a tungsten wire and visual line pair targets were evaluated. Image noise power spectrum (NPS) and pixel standard deviation were calculated. MTF for monoenergetic images agreed with conventional images within 0.05 lp cm‑1. NPS curves indicated that noise texture of 70 keV monoenergetic images is similar to conventional images. Standard deviation measurements showed monoenergetic images have lower noise except at 40 keV. Mean CT number and CNR agreed with conventional images at 75 keV. Measured iodine concentration agreed with true concentration within 6% for inserts at the center of the phantom. Performance of monoenergetic images at detector based spectral CT is the same as, or better than, that of conventional images. Spectral acquisition and reconstruction with a detector based platform represents the physical behaviour of iodine as expected and accurately quantifies the material concentration.

  20. Drug-induced progressive multifocal leukoencephalopathy

    DEFF Research Database (Denmark)

    Vermeer, N S; Straus, S M J M; Mantel-Teeuwisse, A K

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) has been identified as a serious adverse drug reaction (ADR) of several immunomodulatory biologicals. In this study, we contrasted the reporting patterns of PML for two biologicals for which the risk was identified at different points in their life......Progressive multifocal leukoencephalopathy (PML) has been identified as a serious adverse drug reaction (ADR) of several immunomodulatory biologicals. In this study, we contrasted the reporting patterns of PML for two biologicals for which the risk was identified at different points...

  1. A multifocal collimator with circularly distributed focal points for SPECT imaging

    International Nuclear Information System (INIS)

    Guillemaud, R.; Grangeat, P.

    1994-01-01

    The authors propose a new circular multifocal collimator which has multiple axial focal points distributed on a transverse circle. This distribution provides a strong focusing at the center of the detector like a cone-beam collimator, with a good sensitivity, and a weak transverse focusing at the periphery, to ensure acquisition of sufficient data, in order to prevent truncation artifacts. For a circular acquisition trajectory, each projection set of the multifocal geometry is equivalent to a virtual cone-beam projection set with a larger detector. Due to this equivalence, the authors derive a first solution for an analytical multifocal reconstruction algorithm: to rebin the projection set from multifocal to cone-beam geometry, then to use a 3D cone-beam reconstruction algorithm. The authors propose to use the Grangeat algorithm in order to deal with a large cone-beam aperture. Finally, the authors present results on simulated data for heart phantom, for a Defrise phantom and for a MTF study. The conclusion is that, from a multifocal projection set, objects are reconstructed without truncation artifacts, with a good precision at their center and with a loss of resolution at the periphery. In addition, the 3D cone-beam artifacts are reduced with the use of the Grangeat algorithm for the reconstruction step

  2. Multifocal necrotizing fasciitis following Hirshsprung's disease ...

    African Journals Online (AJOL)

    Multifocal necrotizing fasciitis following Hirshsprung's disease surgery away from the surgical wound site. Ahmed A. Haseeb, Shadi Okasha and Atef Elbarawi. Necrotizing fasciitis (NF) is a life-threatening infection with rapidly progressive necrosis. Escherichia coli is rarely reported as causative agent of type 2 NF.

  3. Objectivity

    CERN Document Server

    Daston, Lorraine

    2010-01-01

    Objectivity has a history, and it is full of surprises. In Objectivity, Lorraine Daston and Peter Galison chart the emergence of objectivity in the mid-nineteenth-century sciences--and show how the concept differs from its alternatives, truth-to-nature and trained judgment. This is a story of lofty epistemic ideals fused with workaday practices in the making of scientific images. From the eighteenth through the early twenty-first centuries, the images that reveal the deepest commitments of the empirical sciences--from anatomy to crystallography--are those featured in scientific atlases, the compendia that teach practitioners what is worth looking at and how to look at it. Galison and Daston use atlas images to uncover a hidden history of scientific objectivity and its rivals. Whether an atlas maker idealizes an image to capture the essentials in the name of truth-to-nature or refuses to erase even the most incidental detail in the name of objectivity or highlights patterns in the name of trained judgment is a...

  4. Influence of Multifocal Intraocular Lenses on Standard Automated Perimetry Test Results

    NARCIS (Netherlands)

    Aychoua, Nancy; Montolio, Francisco G. Junoy; Jansonius, Nomdo M.

    Importance: A multifocal intraocular lens (MFIOL) allows for spectacle independence after cataract surgery and is thus a seemingly attractive option. However, several optical limitations have been reported or can be hypothesized. Objective: To evaluate the influence of an MFIOL on standard automated

  5. European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of multifocal motor neuropathy

    NARCIS (Netherlands)

    van Schaik, I. N.; Bouche, P.; Illa, I.; Léger, J.-M.; van den Bergh, P.; Cornblath, D. R.; Evers, E. M. A.; Hadden, R. D. M.; Hughes, R. A. C.; Koski, C. L.; Nobile-Orazio, E.; Pollard, J.; Sommer, C.; van Doorn, P. A.

    2006-01-01

    Several diagnostic criteria for multifocal motor neuropathy have been proposed in recent years and a beneficial effect of intravenous immunoglobulin (IVIg) and various other immunomodulatory drugs has been suggested in several trials and uncontrolled studies. The objectives were to prepare consensus

  6. [RET/PTCrearrangement affects multifocal formation of papillary thyroid carcinoma].

    Science.gov (United States)

    Zhang, X; Su, X; Chen, W C; Li, Y; Yang, Z Y; Deng, W Z; Deng, T C; Yang, A K

    2017-06-07

    Objective: RET / PTC gene rearrangement can lead to aberrant activation of tyrosine kinase receptors, which is a common mutation in papillary thyroid carcinoma (PTC). This study focuses on the association of RET / PTC rearrangements with PTC clinical factors. Methods: From January 2011 to December 2013, a total of 114 patients with PTC were enrolled in this study. Clinicopathological parameters, lifestyle, and thyroid hormone levels were collected. RET / PTC rearrangements were detected by TaqMan PCR and verified by Sanger sequencing.Data were analyzed with SPSS software, including chi-square test, Fisher ' s exact test, Mann - Whitney U test, Student ' s t -test, and Logistic regression. Results: RET / PTC rearrangements were not found in all paracancerous normal thyroid tissues, and were detected in 23.68% (27/114) of PTC. Further analysis revealed no correlation between RET / PTC rearrangement and thyroid function, clinicopathologic parameters, and lifestyle in the total PTC group or in the subgroup of patients with concomitant diseases (including Hashimoto's thyroiditis and nodular goiter). But in the subgroup of PTC without concomitant disease, RET / PTC rearrangement was associated with tumor multifocal ( P =0.018), and RET / PTC -positive PTC patients had an increased risk of tumor multifocal ( OR =5.57, 95% CI 1.39-22.33). It was also found that RET / PTC rearrangement was associated with an abnormal increase in TSH level of one month after surgery ( P = 0.037). Conclusion: Nodular goiter and Hashimoto 's thyroiditis may be a confounding factor in PTC. RET / PTC rearrangement may play an important role in the occurrence of thyroid carcinoma multifocal after exclusion of this confounding factor.

  7. Dual-objective optimization of organic Rankine cycle (ORC) systems using genetic algorithm: a comparison between basic and recuperative cycles

    Science.gov (United States)

    Hayat, Nasir; Ameen, Muhammad Tahir; Tariq, Muhammad Kashif; Shah, Syed Nadeem Abbas; Naveed, Ahmad

    2017-08-01

    Exploitation of low potential waste thermal energy for useful net power output can be done by manipulating organic Rankine cycle systems. In the current article dual-objectives (η_{th} and SIC) optimization of ORC systems [basic organic Rankine cycle (BORC) and recuperative organic Rankine cycle (RORC)] has been done using non-dominated sorting genetic algorithm (II). Seven organic compounds (R-123, R-1234ze, R-152a, R-21, R-236ea, R-245ca and R-601) have been employed in basic cycle and four dry compounds (R-123, R-236ea, R-245ca and R-601) have been employed in recuperative cycle to investigate the behaviour of two systems and compare their performance. Sensitivity analyses show that recuperation boosts the thermodynamic behaviour of systems but it also raises specific investment cost significantly. R-21, R-245ca and R-601 show attractive performance in BORC whereas R-601 and R-236ea in RORC. RORC, due to higher total investment cost and operation & maintenance costs, has longer payback periods as compared to BORC.

  8. [Incremental cost effectiveness of multifocal cataract surgery].

    Science.gov (United States)

    Pagel, N; Dick, H B; Krummenauer, F

    2007-02-01

    Supplementation of cataract patients with multifocal intraocular lenses involves an additional financial investment when compared to the corresponding monofocal supplementation, which usually is not funded by German health care insurers. In the context of recent resource allocation discussions, however, the cost effectiveness of multifocal cataract surgery could become an important rationale. Therefore an evidence-based estimation of its cost effectiveness was carried out. Three independent meta-analyses were implemented to estimate the gain in uncorrected near visual acuity and best corrected visual acuity (vision lines) as well as the predictability (fraction of patients without need for reading aids) of multifocal supplementation. Study reports published between 1995 and 2004 (English or German language) were screened for appropriate key words. Meta effects in visual gain and predictability were estimated by means and standard deviations of the reported effect measures. Cost data were estimated by German DRG rates and individual lens costs; the cost effectiveness of multifocal cataract surgery was then computed in terms of its marginal cost effectiveness ratio (MCER) for each clinical benefit endpoint; the incremental costs of multifocal versus monofocal cataract surgery were further estimated by means of their respective incremental cost effectiveness ratio (ICER). An independent meta-analysis estimated the complication profiles to be expected after monofocal and multifocal cataract surgery in order to evaluate expectable complication-associated additional costs of both procedures; the marginal and incremental cost effectiveness estimates were adjusted accordingly. A sensitivity analysis comprised cost variations of +/- 10 % and utility variations alongside the meta effect estimate's 95 % confidence intervals. Total direct costs from the health care insurer's perspective were estimated 3363 euro, associated with a visual meta benefit in best corrected visual

  9. Basic characterization of normal multifocal electroretinogram

    International Nuclear Information System (INIS)

    Fernandez Cherkasova, Lilia; Rojas Rondon, Irene; Castro Perez, Pedro Daniel; Lopez Felipe, Daniel; Santiesteban Freixas, Rosaralis; Mendoza Santiesteban, Carlos E

    2008-01-01

    A scientific literature review was made on the novel multifocal electroretinogram technique, the involved cell mechanisms and some of the factors modifying its results together with the form of presentation. The basic characteristics of this electrophysiological record obtained from several regions of the retina of normal subjects is important in order to create at a small scale a comparative database to evaluate pathological eye tracing. All this will greatly help in early less invasive electrodiagnosis of localized retinal lesions. (Author)

  10. Multifocal lichen sclerosus. Case report

    Directory of Open Access Journals (Sweden)

    Ewa Hadas

    2015-03-01

    Full Text Available Introduction. Lichen sclerosus (LS is a chronic, inflammatory dermatosis of unknown etiology affecting skin and mucous membranes. It was first described in 1887 by Darier. Lichen sclerosus usually begins as a single or multiple plaques (rarely as lichenoid papules gradually transforming into porcelain-white atrophic lesions. Depending on localization, it may manifest with itching, pain or a burning sensation and often may cause sexual dysfunction. Objective. Presentation of an LS case that posed diagnostic difficulties. Case report. We present a patient with clinical diagnosis of lichen planus hypertrophicus on the skin of forearms and hands which demonstrated histopathological features of LS. Additionally, the presence of LS lesions was found on the skin of the eyelid and penis. Conclusions . Our case seems to be interesting because of the differences between clinical and histopathological findings and multiple localization of lesions.

  11. Progressive subretinal fibrosis and multifocal granulomatous chorioretinitis Fibrose sub-retiniana progressiva e corioretinite granulomatosa multifocal

    Directory of Open Access Journals (Sweden)

    Miguel Hage Amaro

    2006-06-01

    Full Text Available We describe a case of progressive subretinal fibrosis and multifocal chorioretinitis along with its findings on both fluorescein and indocyanine green angiography. The progressive subretinal fibrosis syndrome is a severe subset of multifocal choroiditis. The clustering of lesions around the nerve optic head may mean that the disease is spread through the flow in and out of the eye around the optic nerve.Descrevemos um caso de fibrose sub-retiniana progressiva e corrioretinite multifocal granulomatosa junto com os achados de angiografia fluoresceínica e com indocianina verde e propomos uma nova fisiopatologia para a fibrose em anel justa-papilar. A síndrome de fibrose sub-retiniana progressiva é uma doença grave, rara e constitui um subtipo grave da coroidite multifocal. As múltiplas lesões com fibrose circundando o disco óptico podem significar que a doença é oriunda do fluxo do líquido céfalo-raqueano, ao redor do nervo óptico.

  12. Polyomavirus-Associated Progressive Multifocal Leukoencephalopathy (PML) in HAART era

    OpenAIRE

    Abedi Kiasari, B.

    2016-01-01

    Polyomaviruses may cause human disease, particularly in immunocompromised hosts. JCV, one of the members of polyomaviridae family, is the causative agent of the neurological disease progressive multifocal leukoencephalopathy (PML), which occurs mostly in immunocompromised patients. Progressive Multifocal leukoencephalopathy (PML) is a progressive demyelinating disorder of the central nervous system (CNS) resulting from infection of oligodendrocytes by JC polyomavirus. Whereas after highly act...

  13. Multifocal microlens for bionic compound eye

    Science.gov (United States)

    Cao, Axiu; Wang, Jiazhou; Pang, Hui; Zhang, Man; Shi, Lifang; Deng, Qiling; Hu, Song

    2017-10-01

    Bionic compound eye optical element composed of multi-dimensional sub-eye microlenses plays an important role in miniaturizing the volume and weight of an imaging system. In this manuscript, we present a novel structure of the bionic compound eye with multiple focal lengths. By the division of the microlens into two concentric radial zones including the inner zone and the outer zone with independent radius, the sub-eye which is a multi-level micro-scale structure can be formed with multiple focal lengths. The imaging capability of the structure has been simulated. The results show that the optical information in different depths can be acquired by the structure. Meanwhile, the parameters including aperture and radius of the two zones, which have an influence on the imaging quality have been analyzed and discussed. With the increasing of the ratio of inner and outer aperture, the imaging quality of the inner zone is becoming better, and instead the outer zone will become worse. In addition, through controlling the radius of the inner and outer zone independently, the design of sub-eye with different focal lengths can be realized. With the difference between the radius of the inner and outer zone becoming larger, the imaging resolution of the sub-eye will decrease. Therefore, the optimization of the multifocal structure should be carried out according to the actual imaging quality demands. Meanwhile, this study can provide references for the further applications of multifocal microlens in bionic compound eye.

  14. Why we use AT.Lisa multifocals?

    Science.gov (United States)

    Filip, M; Nicolae, Miruna; Filip, A; Dragne, Carmen; Triantafyllidis, G; Antonescu, Cristina

    2014-01-01

    In this paper, the authors try to motivate their preference for implanting AT.Lisa Multifocals from all other premium IOL's from the market. It is emphasized, through clinical examples, that their choice comes after a long experience with this type of mul- tifocals IOL's. We make a short presentation of this particular type of MIOL's with their good but also weak points and try to motivate our decision to change from other types. We present the steps that each patient has to follow in our clinic prior to surgery itself, stressing out the idea that the discussion with the patient is very important in taking a decision regarding the implantation of a Premium IOL.

  15. Carcinoembryonic antigen in multifocal colon cancer

    International Nuclear Information System (INIS)

    Vladanov, I.P.; Kuznetsova, L.F.; Anan'ev, V.S.

    1988-01-01

    The paper is concerned with analysis of CEA indices in 43 patients with multifocal colon cancer (22 with synchronous and 21 with metachronous colon cancer). The level of CEA was elevated in the group of patients with metachronous cancer in 85.7 % in the group of patients with synchronous cancer in 90.9 %, and in the entire group of colon cancer patients in 88.4 %. No correlation between the level of CEA and the presence of the second (third of more) tumor simultaneously was not revealed. CEA can be used as a test for diagnosis of recurrences and metachronous colon cancer during a follow-up of patients subjected to radical treatment for a primary colon tumor

  16. Patient acceptability of the Tecnis® multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Sood P

    2011-03-01

    Full Text Available Priyanka Sood1, Maria A Woodward21Emory Eye Center, Atlanta, GA, USA; 2Kellogg Eye Center, Ann Arbor, MI, USAAbstract: Cataract surgery has evolved. The goal of the surgeon includes both restoration of vision and refinement of vision. Patients' desire for spectacle independence has driven the market for presbyopia-correcting cataract surgery and development of novel intraocular lens (IOL designs. The Tecnis® Multifocal Intraocular Lens incorporates an aspheric, modified anterior prolate IOL with a diffractive multifocal lens design. The design aims to minimize spherical aberration and improve range of focus. The purpose of this review is to assess patient acceptability of the Tecnis® multifocal intraocular lens.Keywords: Tecnis®, intraocular lens, multifocal, presbyopia 

  17. Multifocal tuberculous osteomyelitis/osteochondritis of ribs in patient ...

    African Journals Online (AJOL)

    Multifocal tuberculous osteomyelitis/osteochondritis of ribs in patient with sickle cell disease. I Kocko, L.O. Ngolet, I Ondzotto, J.D. Guelongo Okouango Ova, F.O. Galiba Atipo-Tsiba, Elira Dokekias ...

  18. The Dual Self: First and third person categorisations of the self and the role of objective self-awareness

    Directory of Open Access Journals (Sweden)

    Guido Peeters

    2007-10-01

    Full Text Available The classic duality of self-subject and self-object is related to the linguistic duality of self as a pronoun of the first and the third person. The latter duality is related to alternative ways of categorising people either as self versus other (SO categorisation or as objects conceived in the third person (3P categorisation. Research is reviewed showing that these categorisations underlie personalised and depersonalised representations, respectively. Nevertheless, depersonalising 3P categorisation has been found more prominent in self-other comparisons than in comparisons between hypothetical others. In search for an explanation Duval and Wicklund's theory of subjective and objective self-awareness as well as causal attribution theory are discussed. In an experiment it is shown that conditions associated with objective self-awareness (e.g., presence of a mirror, instructions stimulating self-evaluation increase 3P categorisation in self-other comparisons. The results add to our understanding of the role of objective self-awareness in self-other comparisons and in causal attributions from actors' and observers' perspectives.

  19. Bilateral implantation of +2.5 D multifocal intraocular lens and contralateral implantation of +2.5 D and +3.0 D multifocal intraocular lenses: Clinical outcomes

    NARCIS (Netherlands)

    Nuijts, Rudy M. M. A.; Jonker, Soraya M. R.; Kaufer, Robert A.; Lapid-Gortzak, Ruth; Mendicute, Javier; Martinez, Cristina Peris; Schmickler, Stefanie; Kohnen, Thomas

    2016-01-01

    To assess the clinical visual outcomes of bilateral implantation of Restor +2.5 diopter (D) multifocal intraocular lenses (IOLs) and contralateral implantation of a Restor +2.5 D multifocal IOL in the dominant eye and Restor +3.0 D multifocal IOL in the fellow eye. Multicenter study at 8

  20. The pathogenesis of progressive multifocal leukoencephalopathy.

    Science.gov (United States)

    Berger, Joseph R; Khalili, Kamel

    2011-12-01

    Interest in pathogenesis of progressive multifocal leukoencephalopathy (PML) followed the observation of the high risk for the disease in HIV infection and the recent observation of an association with a variety of newer therapeutic modalities, e.g., natalizumab, an α4β1 integrin inhibitor, and efalizumab, an anti-CD11a monoclonal antibody. Any hypothesis of PML pathogenesis must account for a number of facts. Firstly, the causative agent JC virus is ubiquitously present, yet only a vanishingly small number of infected persons develop the disease. Secondly, disorders of cell-mediated immunity increase the risk of the disease, particularly HIV infection. Impaired innate immunity is not a risk for PML, and antibodies against JC virus are not protective. Thirdly, a latent period of several months appears necessary following the administration of natalizumab and efalizumab before PML develops. Fourthly, restoration of the immune system can arrest the PML. It is possible that infection with JC virus occurs with a form of the virus shed in the urine of as many as 40% of all adults and present in sewage worldwide. Once acquired, perhaps through an oropharyngeal route, it may replicate and disseminate. A neurotropic form of JC virus that replicates in glial tissues causes PML when immunosurveillance is impaired. There are many unanswered questions with respect to PML pathogenesis. How is virus acquired? What tissues are infected? What is the origin of the neurotropic form? When does virus enter brain? What is the role of central nervous system immunosurveillance? The lack of an animal model has made answering these questions challenging. © Discovery Medicine

  1. Progressive multifocal leukoencephalopathy after fingolimod treatment.

    Science.gov (United States)

    Berger, Joseph R; Cree, Bruce A; Greenberg, Benjamin; Hemmer, Bernhard; Ward, Brian J; Dong, Victor M; Merschhemke, Martin

    2018-04-18

    We describe the characteristics of the 15 patients with fingolimod-associated progressive multifocal leukoencephalopathy (PML) identified from the Novartis data safety base and provide risk estimates for the disorder. The Novartis safety database was searched for PML cases with a data lock point of August 31, 2017. PML classification was based on previously published criteria. The risk and incidence were estimated using the 15 patients with confirmed PML and the overall population of patients treated with fingolimod. As of August 31, 2017, 15 fingolimod-treated patients had developed PML in the absence of natalizumab treatment in the preceding 6 months. Eleven (73%) were women and the mean age was 53 years (median: 53 years). Fourteen of the 15 patients were treated with fingolimod for >2 years. Two patients had confounding medical conditions. Two patients had natalizumab treatment. This included one patient whose last dose of natalizumab was 3 years and 9 months before the diagnosis of PML. The second patient was receiving fingolimod for 4 years and 6 months, which was discontinued to start natalizumab and was diagnosed with PML 3 months after starting natalizumab. Absolute lymphocyte counts were available for 14 of the 15 patients and none exhibited a sustained grade 4 lymphopenia (≤200 cells/μL). The risk of PML with fingolimod in the absence of prior natalizumab treatment is low. The estimated risk was 0.069 per 1,000 patients (95% confidence interval: 0.039-0.114), and the estimated incidence rate was 3.12 per 100,000 patient-years (95% confidence interval: 1.75-5.15). Neither clinical manifestations nor radiographic features suggested any unique features of fingolimod-associated PML. © 2018 American Academy of Neurology.

  2. Autorefraction versus subjective refraction in a radially asymmetric multifocal intraocular lens

    NARCIS (Netherlands)

    van der Linden, Jan Willem; Vrijman, Violette; Al-Saady, Rana; El-Saady, Rana; van der Meulen, Ivanka J.; Mourits, Maarten P.; Lapid-Gortzak, Ruth

    2014-01-01

    To evaluate whether the automated refraction (AR) correlates with subjective manifest (MR) refraction in eyes implanted with radially asymmetric multifocal intraocular lens (IOLs). This retrospective study evaluated 52 eyes (52 patients) implanted with a radially asymmetric multifocal IOL (LS-312

  3. Scleral fixation of a single-piece multifocal intraocular lens.

    Science.gov (United States)

    Can, Ertugrul; Basaran, M Resat; Gül, Adem

    2013-01-01

    We describe an ab interno technique for injector implantation of a one-piece multifocal intraocular lens (IOL). Transscleral fixation of multifocal posterior chamber IOL implantation using an injector with ab interno technique was performed in an eye of a 9-year-old girl who had undergone pars plana lensectomy 2 years before for bilateral lens subluxation with unknown etiology. No major complications were encountered during a 3-month follow-up of the patient and excellent centration was observed during the follow-up period. Her preoperative best spectacle-corrected distance visual acuity of 20/32 improved to uncorrected distance visual acuity of 20/25. Closed-loop design of IOL served the function of eyelets and position of the IOL was provided using only a 2-point fixation. Intraoperative position adjustment of the IOL provided an excellent centralization of multifocal IOL.

  4. Multifocal osteogenic sarcoma in Paget's disease

    Energy Technology Data Exchange (ETDEWEB)

    Vuillemin-Bodaghi, V. [Dept. of Bone and Joint Radiology, Lariboisiere Teaching Hospital, Paris (France); Service de Radiologie Osteoarticulaire, Hopital Lariboisiere, Paris (France); Parlier-Cuau, C.; Laredo, J.D. [Dept. of Bone and Joint Radiology, Lariboisiere Teaching Hospital, Paris (France); Cywiner-Golenzer, C.; Quillard, A. [Dept. of Pathology, Lariboisiere Teaching Hospital, Paris (France); Kaplan, G. [Dept. of Rheumatology, Saint Antoine Teaching Hospital, Paris (France)

    2000-06-01

    The most serious complication of Paget's disease is sarcomatous degeneration of pagetic bone. Multifocal sarcomatous degeneration occurs mainly in polyostotic Paget's disease. Multifocal Paget's sarcoma is uncommon and can arise in any site. We report two cases of synchronous multifocal sarcomatous degeneration. The two patients were elderly women (aged 77 and 86 years, respectively) who developed sarcomatous lesions concomitantly, in the first case report in left ilium, left tibia, and first lumbar vertebra and in the second case report in the skull, right ilium, and sacrum. Whether these cases are due to the simultaneous development of several primaries or to metastases from a single primary remains unclear. (orig.)

  5. Multifocal osteosarcoma as second tumor after childhood retinoblastoma

    International Nuclear Information System (INIS)

    Potepan, P.; Laffranchi, A.; Danesini, G.M.; Spagnoli, I.; Luksch, R.; Sozzi, G.; Testi, A.; Parafioriti, A.; Giardini, R.

    1999-01-01

    We present a case of multifocal osteosarcoma (MFOS) arising 11.5 years after successful treatment of bilateral retinoblastoma. The clinical, imaging and pathological findings at onset, after therapy, and during follow-up are described. Fluorescent in situ hybridization did not reveal a deletion of the RB-1 retinoblastoma gene, although the presence of an inactivating mutation invisible to this method cannot be ruled out. The MFOS may have been a second multifocal tumor associated with the original retinoblastoma or a post-irradiation sarcoma with extensive metastases. (orig.)

  6. Research advances on multifocal electroretinogram in primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Feng-Fei Mo

    2013-10-01

    Full Text Available Primary open angle glaucoma is a chronic and progressive optic neuropathy. It can lead to serious damage of visual impairment, and it is an important eye disease of blindness. Multifocal electroretinogram is a new way to measure visual electrophysiology. It can measure electroretinogram of the whole visual field of many small parts in a relatively short period of time, and it can reflect the function of regional retina. It has an extremely important value for early diagnosis of primary open angle glaucoma. The research advances on multifocal electroretinogram in diagnosing primary open angle glaucoma were summarized in this paper.

  7. Processes for manufacturing multifocal diffractive-refractive intraocular lenses

    Science.gov (United States)

    Iskakov, I. A.

    2017-09-01

    Manufacturing methods and design features of modern diffractive-refractive intraocular lenses are discussed. The implantation of multifocal intraocular lenses is the most optimal method of restoring the accommodative ability of the eye after removal of the natural lens. Diffractive-refractive intraocular lenses are the most widely used implantable multifocal lenses worldwide. Existing methods for manufacturing such lenses implement various design solutions to provide the best vision function after surgery. The wide variety of available diffractive-refractive intraocular lens designs reflects the demand for this method of vision correction in clinical practice and the importance of further applied research and development of new technologies for designing improved lens models.

  8. Human immunodeficiency virus-associated lipodystrophy: an objective definition based on dual-energy x-ray absorptiometry-derived regional fat ratios in a South Asian population.

    Science.gov (United States)

    Asha, Hesarghatta Shyamasunder; Seshadri, Mandalam Subramaniam; Paul, Thomas Vizhalil; Abraham, Ooriapadickal Cherian; Rupali, Priscilla; Thomas, Nihal

    2012-01-01

    To develop an objective definition of human immunodeficiency virus (HIV)-associated lipodystrophy by using regional fat mass ratios and to assess the utility of anthropometric and skinfold measurements in the initial screening for lipodystrophy. Male patients between 25 and 50 years old with proven HIV infection (highly active antiretroviral therapy [HAART]-naïve subjects and those receiving successful HAART) were studied and compared with body mass index (BMI)-matched HIV-negative control subjects. Anthropometric variables, body composition, dual-energy x-ray absorptiometry findings, and metabolic variables were compared among the 3 study groups and between those patients with and those without lipodystrophy. Trunk fat/lower limb fat mass ratio >2.28 identified 54.3% of patients with HIV receiving HAART as having lipodystrophy and had the highest odds ratio for predicting metabolic syndrome. The "clinical diagnosis of lipodystrophy" and the "clinical scoring system" had too many false-positive and false-negative results. Triceps skinfold thickness (SFT)/BMI ratio ≤0.49 and abdominal SFT/triceps SFT ratio >1.385 have good sensitivity but poor specificity in identifying lipodystrophy. In comparison with HAART-naïve patients with HIV, those receiving HAART had significantly higher insulin resistance, and a significantly greater proportion had impaired glucose tolerance and dyslipidemia. Among patients receiving HAART, those with lipodystrophy had a greater degree of insulin resistance, higher triglyceride levels, and lower levels of high-density lipoprotein cholesterol. The trunk fat/lower limb fat mass ratio in BMI-matched normal subjects can be used to derive cutoff values to define lipodystrophy objectively in HIV-infected patients. Defining lipodystrophy in this way is better than other methods of identifying those patients with increased cardiovascular risk. Triceps SFT/BMI and abdominal SFT/triceps SFT ratios may be useful as screening tools in resource

  9. Impaired spatial learning strategies and novel object recognition in mice haploinsufficient for the dual specificity tyrosine-regulated kinase-1A (Dyrk1A.

    Directory of Open Access Journals (Sweden)

    Glòria Arqué

    Full Text Available BACKGROUND: Pathogenic aneuploidies involve the concept of dosage-sensitive genes leading to over- and underexpression phenotypes. Monosomy 21 in human leads to mental retardation and skeletal, immune and respiratory function disturbances. Most of the human condition corresponds to partial monosomies suggesting that critical haploinsufficient genes may be responsible for the phenotypes. The DYRK1A gene is localized on the human chromosome 21q22.2 region, and has been proposed to participate in monosomy 21 phenotypes. It encodes a dual-specificity kinase involved in neuronal development and in adult brain physiology, but its possible role as critical haploinsufficient gene in cognitive function has not been explored. METHODOLOGY/PRINCIPAL FINDINGS: We used mice heterozygous for a Dyrk1A targeted mutation (Dyrk1A+/- to investigate the implication of this gene in the cognitive phenotypes of monosomy 21. Performance of Dyrk1A+/- mice was assayed 1/ in a navigational task using the standard hippocampally related version of the Morris water maze, 2/ in a swimming test designed to reveal potential kinesthetic and stress-related behavioral differences between control and heterozygous mice under two levels of aversiveness (25 degrees C and 17 degrees C and 3/ in a long-term novel object recognition task, sensitive to hippocampal damage. Dyrk1A+/- mice showed impairment in the development of spatial learning strategies in a hippocampally-dependent memory task, they were impaired in their novel object recognition ability and were more sensitive to aversive conditions in the swimming test than euploid control animals. CONCLUSIONS/SIGNIFICANCE: The present results are clear examples where removal of a single gene has a profound effect on phenotype and indicate that haploinsufficiency of DYRK1A might contribute to an impairment of cognitive functions and stress coping behavior in human monosomy 21.

  10. Corneal multifocality with excimer laser for presbyopia correction.

    Science.gov (United States)

    Alió, Jorge L; Amparo, Francisco; Ortiz, Dolores; Moreno, Luis

    2009-07-01

    To offer a comprehensive perspective on corneal multifocality created by excimer laser surgery, with the different approaches used for the purpose and its reported outcomes. Three different approaches have been used for corneal multifocality: transitional multifocality, central presbyLasik (center for near) and peripheral presbyLasik (peripheral cornea for near). Although central presbyLasik creates a bifocal cornea, the other techniques increase the depth of focus based on the ablation of the peripheral cornea. Transitional multifocality creates intentionally an increase in coma aberration. According to the reported results, both central and peripheral presbyLasik obtain adequate spectacle independence simultaneously for far and for near. A neuroadaptation process is necessary for peripheral presbyLasik. Transitional techniques have a very limited use and very few outcomes reported. The level of scientific evidence from the literature is enough to consider that presbyLasik is a useful tool in the correction of presbyopia. However, most of the techniques are still under development in clinical investigations and further clinical data will validate the outcomes reported for the different techniques.

  11. Bioptics in sutureless intrascleral multifocal posterior chamber intraocular lens fixation.

    Science.gov (United States)

    Pavlidis, Mitrofanis; de Ortueta, Diego; Scharioth, Gabor B

    2011-05-01

    To present a technique for sutureless fixation of a three-piece, multifocal, posterior chamber intraocular lens (IOL) in the ciliary sulcus. A 24-year-old woman presented with bilateral subluxation of the crystalline lens. Two straight sclerotomies were prepared with a 24-gauge cannula 2.0 mm from the limbus 180° apart from each other. The cannula was used to create a 2.0- to 3.0-mm tunnel parallel to the limbus starting from the sclerotomies. The leading haptic of the multifocal IOL was grasped at its tip with end-gripping, 25-gauge forceps and pulled through the sclerotomy. The forceps was used to introduce the IOL haptic into the scleral tunnel parallel to the limbus. Multifocal posterior chamber IOLs were stable and well centered. No postoperative complications occurred in the 16-month follow-up period. Preoperative astigmatism was corrected after IOL implantation with corneal wavefront-guided laser epithelial keratomileusis. Sutureless fixation of multifocal posterior chamber IOL haptics in a scleral tunnel parallel to the limbus can be successful, resulting in long-term centration and three-dimensional axial stability for optimal refractive results. If necessary, postoperative wavefront-guided refractive correction can be performed to optimize final refraction. Copyright 2011, SLACK Incorporated.

  12. MULTIFOCAL GIANT CELL TUMOR WITH DIFFERENT CLINICOPATHOLOGICAL BEHAVIOR

    OpenAIRE

    M. Mirsaidi

    1997-01-01

    A 26 year old woman attended to our hospital with multifocal giant cell tumor in different sites, one in distal end of right radius with aggresive behavior and amputation of the mid forearm and the second in the head of the right humerus with benign and non aggresive clinical appearance.

  13. MULTIFOCAL GIANT CELL TUMOR WITH DIFFERENT CLINICOPATHOLOGICAL BEHAVIOR

    Directory of Open Access Journals (Sweden)

    M. Mirsaidi

    1997-06-01

    Full Text Available A 26 year old woman attended to our hospital with multifocal giant cell tumor in different sites, one in distal end of right radius with aggresive behavior and amputation of the mid forearm and the second in the head of the right humerus with benign and non aggresive clinical appearance.

  14. Imaging of chronic recurrent multifocal osteomyelitis of childhood first presenting with isolated primary spinal involvement

    International Nuclear Information System (INIS)

    Anderson, S.E.; Heini, P.; Kalbermatten, D.; Sauvain, M.J.; Stauffer, E.; Geiger, L.; Johnston, J.O.; Roggo, A.; Steinbach, L.S.

    2003-01-01

    Initial presentation with primary spinal involvement in chronic recurrent multifocal osteomyelitis of childhood (CRMO) is rare. Our objective was to review the imaging appearances of three patients who had CRMO who initially presented with isolated primary spinal involvement.Design and patients The imaging, clinical, laboratory and histology findings of the three patients were retrospectively reviewed. Imaging included seven spinal MR imaging scans, one computed tomography scan, nine bone scans, two tomograms and 16 radiographs. These were reviewed by two musculoskeletal radiologists and a consensus view is reported. All three patients presented with atraumatic spinal pain and had extensive bone spinal pathology. The patients were aged 11, 13 and 12 years. There were two females and one male.Results and conclusions The initial patient had thoracic T6 and T8 vertebra plana. Bone scan showed additional vertebral body involvement. Follow-up was available over a 3 year period. The second patient had partial collapse of T9 and, 2 years later, of C6. Subsequently extensive multifocal disease ensued and follow-up was available over 8 years. The third patient initially had L3 inferior partial collapse and 1 year later T8 involvement with multifocal disease. Follow-up was available over 3 years. The imaging findings of the three patients include partial and complete vertebra plana with a subchondral line adjacent to endplates associated with bone marrow MR signal alterations. Awareness of the imaging appearances may help the radiologist to include this entity in the differential diagnosis in children who present with spinal pathology and no history of trauma. Histopathological examination excludes tumor and infection but with typical imaging findings may not always be necessary. (orig.)

  15. Eletrorretinograma multifocal em pacientes tratadas com tamoxifeno em baixa dosagem Multifocal ERG in patients treated with low-dose tamoxifen

    Directory of Open Access Journals (Sweden)

    Adriana Berezovsky

    2004-08-01

    Full Text Available OBJETIVO: O tamoxifeno é um antiestrógeno utilizado como agente terapêutico eficaz no câncer de mama. A droga pode causar efeitos tóxicos oculares em dosagens altas. O objetivo deste estudo foi determinar possíveis efeitos retino-tóxicos centrais usando o eletrorretinograma multifocal (mfERG em grupo de pacientes tratadas com baixa dosagem de tamoxifeno (20 mg/dia após cirurgia do câncer de mama. MÉTODOS: O eletrorretinograma multifocal (mfERG de 30 graus centrais da retina foi obtido em 3 diferentes grupos: Grupo experimental - 15 mulheres (41-59 anos, média 48,6 ± 4,5 com fundo de olho normal, tratadas com tamoxifeno em baixa dosagem por 1 a 55 meses. Grupo controle - 6 mulheres (30 -76 anos, média 49,9±18,8 com diagnóstico prévio de câncer de mama que não receberam tratamento com tamoxifeno até o teste do eletrorretinograma multifocal. Grupo controle normal - 15 voluntárias normais (30-71 anos, média 47,7 ± 12,9. A amplitude e a latência de eletrorretinograma multifocal para N1-P1 foram analisados estatisticamente (análise de variância de uma via. RESULTADOS: As amplitudes médias N1-P1 (nV/grau² foram comparáveis para respostas de diferentes excentricidades (0 a 25 graus nos três grupos. Não houve diferença estatisticamente significativa para a latência de N1 e P1 (ms do eletrorretinograma multifocal entre os 3 grupos. CONCLUSÕES: O tratamento com baixa dosagem de tamoxifeno não mostrou efeitos retino-tóxicos em pequeno grupo de mulheres após cirurgia do câncer de mama. Investigação seriada proporcionará melhor compreensão desses efeitos.PURPOSE: Tamoxifen, an antiestrogen, has been used as an effective therapeutic agent in the treatment of breast cancer. The drug has been shown to cause ocular toxic effects. The purpose of this study was to determine possible central retinal toxicity by multifocal electroretinograms (mfERGs in a cohort of patients treated with low-dose tamoxifen (20 mg/day for breast

  16. A multifocal electroretinogram model predicting the development of diabetic retinopathy.

    Science.gov (United States)

    Bearse, Marcus A; Adams, Anthony J; Han, Ying; Schneck, Marilyn E; Ng, Jason; Bronson-Castain, Kevin; Barez, Shirin

    2006-09-01

    The prevalence of diabetes has been accelerating at an alarming rate in the last decade; some describe it as an epidemic. Diabetic eye complications are the leading cause of blindness in adults aged 25-74 in the United States. Early diagnosis and development of effective preventatives and treatments of diabetic retinopathy are essential to save sight. We describe efforts to establish functional indicators of retinal health and predictors of diabetic retinopathy. These indicators and predictors will be needed as markers of the efficacy of new therapies. Clinical trials aimed at either prevention or early treatments will rely heavily on the discovery of sensitive methods to identify patients and retinal locations at risk, as well as to evaluate treatment effects. We report on recent success in revealing local functional changes of the retina with the multifocal electroretinogram (mfERG). This objective measure allows the simultaneous recording of responses from over 100 small retinal patches across the central 45 degrees field. We describe the sensitivity of mfERG implicit time measurement for revealing functional alterations of the retina in diabetes, the local correspondence between functional (mfERG) and structural (vascular) abnormalities in eyes with early nonproliferative retinopathy, and longitudinal studies to formulate models to predict the retinal sites of future retinopathic signs. A multivariate model including mfERG implicit time delays and 'person' risk factors achieved 86% sensitivity and 84% specificity for prediction of new retinopathy development over one year at specific locations in eyes with some retinopathy at baseline. A preliminary test of the model yielded very positive results. This model appears to be the first to predict, quantitatively, the retinal locations of new nonproliferative diabetic retinopathy development over a one-year period. In a separate study, the predictive power of a model was assessed over one- and two-year follow

  17. A Rare Case of Multifocal Prostatic Blue Nevus

    Directory of Open Access Journals (Sweden)

    Elias J. Farran

    2018-01-01

    Full Text Available Prostatic blue nevus is a rare benign pathologic diagnosis most commonly diagnosed incidentally on many different types of prostate specimens. Blue nevus is the deposition of stromal melanin characterized by spindle cells within the fibromuscular stroma which stains positive for melanin-specific stains Fontana-Masson and S100 and stains negative for CD68, HMB45, and iron stains. We report the case of a multifocal and bilateral blue nevus in a 52-year-old Hispanic male who presented with an elevated prostate-specific antigen of 4.3 and mild obstructive lower urinary tract symptoms, found by transrectal ultrasound-guided prostate needle biopsy. The biopsy also revealed benign prostatic tissue with postatrophic hyperplasia and chronic inflammation. This is the 35th reported case of prostatic blue nevus and the third to show multifocal blue nevus.

  18. Multifocal epithelioid hemangioendothelioma of the phalanges of the hand

    International Nuclear Information System (INIS)

    Bruegel, Melanie; Waldt, Simone; Woertler, Klaus; Rummeny, Ernst J.; Weirich, Gregor

    2006-01-01

    Epithelioid hemangioendothelioma (EH) of bone is a rare vascular neoplasm characterized by epithelioid endothelial cells and a variable biologic behaviour. The principal sites of occurrence of this osteolytic tumor are the lower extremity and the axial skeleton. Approximately half of the cases present with multifocal disease. The latter feature can be helpful in suggesting the diagnosis of a vascular tumor; on the other hand, it strengthens the need for a skeletal survey or whole-body MRI/CT. We report on the clinical, histologic and radiologic features - including CT and MRI findings - of EH in a case of multifocal disease of the phalanges of the hand, a very uncommon anatomic site of affliction. (orig.)

  19. Multifocal choroiditis - an unusual finding in Crohns disease.

    Science.gov (United States)

    Vianna, R N G; Ozdal, P C; Deschnes, J

    To report a patient with Crohns disease and acute decreased vision in one eye secondary to multifocal choroiditis and serous retinal detachment. A complete ocular examination, including fluorescein angiography, was performed. Fundus biomicroscopy disclosed multifocal, deep, discretely elevated yellowish lesions at the posterior pole of the affected eye. Fluorescein angiographic study of these lesions revealed early hypofluorescence followed by late yperfluorescence. Subtenonian injection of corticosteroids rapidly induced remission of the choroidal lesions. Chorioretinal involvement in patients with Crohns disease may or may not be related to reactivation of this disorder. Therefore, even patients without gastrointestinal symptoms who present with posterior segment inflammation must be informed of this. The chorioretinal inflammatory lesions do seem to respond promptly to periocular injection of corticosteroids. (Eur J Ophthalmol 2004; 14: 345-9).

  20. Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report

    OpenAIRE

    Troppmann, Martina; Büttner, Roland; Boewer, Michael; Salzberger, Bernd

    2012-01-01

    Abstract Introduction Progressive multifocal leukoencephalopathy is an opportunistic infection occurring in patients with severe cellular immunodeficiency. This case highlights the role of cellular immunodeficiency in the reactivation of John Cunningham virus in a case of an early stage plasmacytoma. Case presentation A 76-year-old Caucasian woman presented with progressive left-sided hemiparesis, accompanied by hypoesthesia, hypoalgesia and neuropsychological symptoms. Magnetic resonance ima...

  1. Multiphoton multifocal microscopy exploiting a diffractive optical element

    Science.gov (United States)

    Sacconi, L.; Froner, E.; Antolini, R.; Taghizadeh, M. R.; Choudhury, A.; Pavone, F. S.

    2003-10-01

    Multiphoton multifocal microscopy (MMM) usually has been achieved through a combination of galvo scanners with microlens arrays, with rotating disks of microlens arrays, and cascaded beam splitters with asynchronous rastering of scanning mirrors. Here we describe the achievement of a neat and compact MMM by use of a high-diffraction-efficiency diffractive-optic element that generates a multiple-spot grid of uniform intensity to achieve higher fidelity in imaging of live cells at adequate speeds.

  2. The multifocal electroretinogram (mfERG) in the pig

    DEFF Research Database (Denmark)

    Voss Kyhn, Maria; Kiilgaard, Jens Folke; Lopez, Ana Garcia

    2007-01-01

    To establish a method allowing multifocal electroretinography (mfERG) recording with simultaneous fundus monitoring on anaesthetized pigs. In addition we characterize the peaks of the porcine mfERG trace, and compare the visual streak area with the optic nerve head, a known non-response area....... Finally we illustrate the feasibility of the method by performing mfERG after an induced laser burn in the visual streak....

  3. Outcomes in multifocal neuroblastoma as part of the neurocristopathy syndrome.

    Science.gov (United States)

    Williams, Phoebe; Wegner, Eva; Ziegler, David S

    2014-08-01

    The neurocristopathy syndrome occurs because of a germline mutation of the paired-like homeobox 2b (PHOX2B) gene at 4p12, a neurogenesis regulator gene. The result is abnormal neural crest cell development resulting in congenital central hypoventilation syndrome, Hirschsprung disease, and neuroblastoma (NB), which is often multifocal and disseminated in its presentation. Previously, such widespread disease was regarded as highly aggressive and treated either with palliative intent or, conversely, with very intense, high-dose chemotherapy. We now present a patient who had neurocristopathy syndrome who had multifocal NB associated with an underlying germline PHOX2B mutation. He was treated conservatively with surgery and low-dose chemotherapy. After treatment he had extensive residual disease that has continued to mature despite no further treatment. A literature review identified 26 similar patients presenting with multifocal NB as part of the neurocristopathy syndrome. In all cases the NB behaved in an indolent manner with no deaths from tumor reported when patients received appropriate treatment. These provocative findings suggest for the first time that children who have neurocristopathy-associated NB should be treated conservatively, despite the aggressive appearance of their disease. Copyright © 2014 by the American Academy of Pediatrics.

  4. Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report

    Directory of Open Access Journals (Sweden)

    Troppmann Martina

    2012-07-01

    Full Text Available Abstract Introduction Progressive multifocal leukoencephalopathy is an opportunistic infection occurring in patients with severe cellular immunodeficiency. This case highlights the role of cellular immunodeficiency in the reactivation of John Cunningham virus in a case of an early stage plasmacytoma. Case presentation A 76-year-old Caucasian woman presented with progressive left-sided hemiparesis, accompanied by hypoesthesia, hypoalgesia and neuropsychological symptoms. Magnetic resonance imaging demonstrated new hyperattenuating lesions in the right thalamus and left-sided subcortically. A polymerase chain reaction test revealed 4500 copies of John Cunningham virus-deoxyribonucleic acid/ml in cerebrospinal fluid. Human immunodeficiency virus infection was ruled out. A bone marrow biopsy showed an early stage immunoglobulin G-kappa plasmacytoma. Cidofovir (5mg/kg weekly for three weeks was started. A significant improvement of her neuropsychological symptoms was achieved, but motor system and sensory symptoms did not change. Conclusions This case shows a rapid course of progressive multifocal leukoencephalopathy with severe residual deficits. In the diagnostic workup of all patients with atypical neurologic symptoms or immunodeficiency, progressive multifocal leukoencephalopathy should be included as a differential diagnosis.

  5. Dual Dynamic Programming - DDP

    International Nuclear Information System (INIS)

    Velasquez Bermudez, Jesus M

    1998-01-01

    Objections are presented to the mathematical formulation of the denominated Dual Dynamic programming-PDD that is the theoretical base of several computational model available for the optimal formulation of interconnected hydrothermal systems

  6. High Resolution Depth-Resolved Imaging From Multi-Focal Images for Medical Ultrasound

    DEFF Research Database (Denmark)

    Diamantis, Konstantinos; Dalgarno, Paul A.; Greenaway, Alan H.

    2015-01-01

    An ultrasound imaging technique providing subdiffraction limit axial resolution for point sources is proposed. It is based on simultaneously acquired multi-focal images of the same object, and on the image metric of sharpness. The sharpness is extracted by image data and presents higher values...... for in-focus images. The technique is derived from biological microscopy and is validated here with simulated ultrasound data. A linear array probe is used to scan a point scatterer phantom that moves in depth with a controlled step. From the beamformed responses of each scatterer position the image...... calibration curves combined with the use of a maximum-likelihood algorithm is then able to estimate, with high precision, the depth location of any emitter fron each single image. Estimated values are compared with the ground truth demonstrating that an accuracy of 28.6 µm (0.13λ) is achieved for a 4 mm depth...

  7. Chronic multifocal non-bacterial osteomyelitis in hypophosphatasia mimicking malignancy

    Directory of Open Access Journals (Sweden)

    Warmuth-Metz Monika

    2007-01-01

    Full Text Available Abstract Background Hypophosphatasia (HP is characterized by a genetic defect in the tissue-nonspecific alkaline phosphatase (TNSALP gene and predominantly an autosomal recessive trait. HP patients suffer from reduced bone mineralization. Biochemically, elevated concentrations of substrates of TNSALP, including pyridoxal-5'-phosphate and inorganic pyrophosphate occur in serum, tissues and urine. The latter has been associated with chronic inflammation and hyperprostaglandinism. Case presentation We report on 2 affected children presenting with multifocal inflammatory bone lesions mimicking malignancy: A 6 years old girl with short stature had been treated with human growth hormone since 6 months. Then she started to complain about a painful swelling of her left cheek. MRI suggested a malignant bone lesion. Bone biopsy, however, revealed chronic inflammation. A bone scan showed a second rib lesion. Since biopsy was sterile, the descriptive diagnosis of chronic non-bacterial osteomyelitis (CNO was established. The diagnostic tests related to growth failure were repeated and subsequent analyses demonstrated a molecular defect in the TNSALP gene. The second girl (10 years old complained about back pain after she had fallen from her bike. X rays of her spine revealed compressions of 2 thoracic vertebrae. At first these were considered trauma related, however a bone scan did show an additional lesion in the right 4th rib. A biopsy of this rib revealed a sterile lympho- plasmocytoid osteomyelitis suggesting multifocal CNO. Further analyses did show a decreased TNSALP in leukocytes and elevated pyridoxal phosphate in plasma, suggesting a heterozygous carrier status of HP. Conclusion Chronic bone oedema in adult HP and chronic hyper-prostaglandinism in childhood HP do suggest that in some HP patients bone inflammation is present in conjunction with the metabolic defect. Sterile multifocal osteomyelitis could be demonstrated. Non-steroidal anti

  8. Subcutaneous versus intravenous immunoglobulin in multifocal motor neuropathy

    DEFF Research Database (Denmark)

    Harbo, T; Andersen, Henning; Hess, A

    2009-01-01

    Background and purpose: For treatment of multifocal motor neuropathy (MMN), we hypothesized that (i) infusion of equivalent dosages of subcutaneous immunoglobulin (SCIG) is as effective as intravenous immunoglobulin (IVIG) and that (ii) subcutaneous infusion at home is associated with a better...... at the injection sites for a few weeks. All other adverse effects during SCIG were mild and transient. No differences between treatments of health-related quality of life occurred. Conclusion: In MMN, short-term subcutaneous infusion of immunoglobulin is feasible, safe and as effective as intravenous infusion...

  9. A role for susceptibility weighted imaging in progressive multifocal leukoencephalopathy

    LENUS (Irish Health Repository)

    Yap, SM

    2017-04-01

    We report a radiologic finding on magnetic resonance imaging (MRI) of the brain of two cases of progressive multifocal leukoencephalopathy (PML) of hypointense signal of subcortical U-fibres on susceptibility weighted (SW) sequence. The first case is a 50-year-old man recently treated with chemotherapy including rituximab for non-Hodgkin\\'s lymphoma. The second case is a 64-year-old woman with human immunodeficiency virus (HIV) infection. Iron deposition is a likely causative factor. We propose that SWI may be especially useful in the assessment of indeterminate cases to reduce the likelihood of a missed diagnosis of PML

  10. Multifocal visual evoked potentials in optic neuritis and multiple sclerosis

    DEFF Research Database (Denmark)

    Pihl-Jensen, Gorm; Schmidt, Mathias Falck; Frederiksen, Jette Lautrup

    2017-01-01

    Multifocal visual evoked potential (mf-VEP) represents a new approach to the classical full field (ff-)VEP with separate responses from up to 60 sectors of the visual field. A thorough literature survey of the use of mf-VEP in optic neuritis (ON) and multiple sclerosis (MS) is presented (38...... was shown between mf-VEP and OCT, ff-VEP, MRI (MTR, DTI), 30-2 standard automated perimetry and low-contrast-visual acuity. All but one study showed superior sensitivity and specificity compared to ff-VEP, especially with regards to small, peripheral lesions or lesions of the upper visual field. Mf-VEP has...

  11. Multifocal electroretinography in diabetic retinopathy and diabetic macular edema.

    Science.gov (United States)

    Bearse, Marcus A; Ozawa, Glen Y

    2014-01-01

    In this review article, we first present a brief overview of the vascular and neural components of diabetic retinopathy. Next, the multifocal electroretinogram (mfERG) technique, which can map neuroretinal function noninvasively, is described. Findings in diabetic retinal disease using the mfERG are reviewed. We then describe the progress that has been made to predict the onset and progression of diabetic retinopathy and edema in specific retinal locations, using quantitative models based on the mfERG. Finally, we consider the implications for the future of these predictive models.

  12. Aggressive and multifocal pulmonary inflammatory myofiberblastic tumor in young woman

    International Nuclear Information System (INIS)

    Choi, Yang Sean; Chung, Myung Hee; Kim, Hyun Jung; Park, Ki Hoon; Kim, Jeanna; Kwon, Soon Suck; Yoo, Won Jong

    2016-01-01

    We report a case of pulmonary inflammatory myofibroblastic tumor (IMT) showing aggressive and unusually rapid progression. A 27-year-old woman was admitted to the emergency room due to dry cough, fever and blood-tinged sputum that lasted one week. Initial chest radiograph and computed tomography scan revealed multifocal pulmonary nodules, which subsequently progressed into large necrotic masses within two months. She underwent a fine needle biopsy of the largest mass in the right middle lung zone which revealed inflammatory myofibroblastic cells consistent with IMT. The masses showed complete regression after six months of corticosteroid therapy. This unusual clinical manifestation could help explain the reactive inflammatory nature associated with IMTs

  13. Aggressive and multifocal pulmonary inflammatory myofiberblastic tumor in young woman

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yang Sean; Chung, Myung Hee; Kim, Hyun Jung; Park, Ki Hoon; Kim, Jeanna; Kwon, Soon Suck; Yoo, Won Jong [Bucheon St. Mary' s Hospital, The Catholic University of Korea, Bucheon (Korea, Republic of)

    2016-08-15

    We report a case of pulmonary inflammatory myofibroblastic tumor (IMT) showing aggressive and unusually rapid progression. A 27-year-old woman was admitted to the emergency room due to dry cough, fever and blood-tinged sputum that lasted one week. Initial chest radiograph and computed tomography scan revealed multifocal pulmonary nodules, which subsequently progressed into large necrotic masses within two months. She underwent a fine needle biopsy of the largest mass in the right middle lung zone which revealed inflammatory myofibroblastic cells consistent with IMT. The masses showed complete regression after six months of corticosteroid therapy. This unusual clinical manifestation could help explain the reactive inflammatory nature associated with IMTs.

  14. Progressive multifocal leukoencephalopathy: diffusion-weighted imaging and pathological correlations.

    Science.gov (United States)

    Bergui, M; Bradac, G B; Oguz, K K; Boghi, A; Geda, C; Gatti, G; Schiffer, D

    2004-01-01

    We examined MRI of two patients with progressive multifocal leukoencephalopathy (PML), including diffusion-weighted imaging (DWI), with calculation of apparent diffusion coefficients (ADC). The pathology findings of one patient were compared with those of MRI. The lesions had different ADC and DWI appearances, depending on the stage of the disease. Newer lesions and the advancing edge of large lesions had normal-to-low ADC and gave high signal on DWI. Older lesions and the centre of large lesions had increased ADC and gave low signal. High signal on DWI and low ADC mark the regions of active infection and cell swelling, distinguishing them from areas of reparative gliosis.

  15. Progressive multifocal leukoencephalopathy: diffusion-weighted imaging and pathological correlations

    Energy Technology Data Exchange (ETDEWEB)

    Bergui, M.; Bradac, G.B.; Boghi, A. [Department of Neuroradiology, University of Turin, Via Cherasco 15, 10126, Torino (Italy); Oguz, K.K. [Department of Radiology, Hacettepe University, Sihhiye, Ankara (Turkey); Geda, C.; Gatti, G. [Chivasso General Hospital, Torino (Italy); Schiffer, D. [Department of Neuropathology, University of Turin, Via Cherasco 15, 10126, Torino (Italy)

    2004-01-01

    We examined MRI of two patients with progressive multifocal leukoencephalopathy (PML), including diffusion-weighted imaging (DWI), with calculation of apparent diffusion coefficients (ADC). The pathology findings of one patient were compared with those of MRI. The lesions had different ADC and DWI appearances, depending on the stage of the disease. Newer lesions and the advancing edge of large lesions had normal-to-low ADC and gave high signal on DWI. Older lesions and the centre of large lesions had increased ADC and gave low signal. High signal on DWI and low ADC mark the regions of active infection and cell swelling, distinguishing them from areas of reparative gliosis. (orig.)

  16. Multifocal Langerhans Cell Granulomatosis (Hand-schuller - Christian Disease

    Directory of Open Access Journals (Sweden)

    MPS Sawhney

    1989-01-01

    Full Text Available A 47 year old female developed multifocal Langerhans cell granulomatosis (Hand-Schuller-Christian disease manifesting as papulo-pustular, nodular, crusted and scaly lesions, xanthelasma, ulceration of gingival mucosa with loss of teeth, vaginal granulomatosis, diabetes insipidus, multiple osteolytic bone lesions and honeycombing of the lungs. Skin biopsy confirmed the diagnosis. Treatment with prednisolone 45 mg methotrexate 2.5 mg daily, led to regression of lesions, reduction of bone of partial clearance of lung lesions and osteolytic bone lesions. However, the patient died due to widespread nature of the disease.

  17. Whole body MRI in the diagnosis of chronic recurrent multifocal osteomyelitis.

    LENUS (Irish Health Repository)

    Kennedy, M T

    2012-06-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a diagnosis of exclusion primarily in children and adolescents. As part of the essential criteria for the diagnosis of CRMO, multifocal lesions must be identified. We present the case of an 11-year-old boy with CRMO, whose diagnosis was facilitated by the use of whole body magnetic resonance imaging (WBMR), but not isotope bone scanning.

  18. Caracterización básica del electrorretinograma multifocal normal Basic characterization of normal multifocal electroretinogram

    Directory of Open Access Journals (Sweden)

    Lilia Fernández Cherkásova

    2008-12-01

    Full Text Available Se realizó una revisión de la literatura científica publicada sobre la técnica novedosa del electrorretinograma multifocal, los mecanismos celulares involucrados y algunos de los factores que modifican sus resultados, así como la forma de su presentación. La caracterización básica de este registro electrofisiológico obtenido en varias regiones de la retina en sujetos normales es importante para establecer a pequeña escala, una base de datos comparativa que permita evaluar los trazados en ojos patológicos, lo cual contribuiría enormemente al electrodiagnóstico precoz y poco invasivo de las lesiones retinales localizadas.A scientific literature review was made on the novel multifocal electroretinogram technique, the involved cell mechanisms and some of the factors modifying its results together with the form of presentation. The basic characteristics of this electrophysiological record obtained from several regions of the retina of normal subjects is important in order to create at a small scale a comparative database to evaluate pathological eye tracing. All this will greatly help in early less invasive electrodiagnosis of localized retinal lesions.

  19. Dual Diagnosis

    Science.gov (United States)

    A person with dual diagnosis has both a mental disorder and an alcohol or drug problem. These conditions occur together frequently. In particular, ... to emotional and mental problems. Someone with a dual diagnosis must treat both conditions. For the treatment ...

  20. Bilateral implantation of +2.5 D multifocal intraocular lens and contralateral implantation of +2.5 D and +3.0 D multifocal intraocular lenses: Clinical outcomes.

    Science.gov (United States)

    Nuijts, Rudy M M A; Jonker, Soraya M R; Kaufer, Robert A; Lapid-Gortzak, Ruth; Mendicute, Javier; Martinez, Cristina Peris; Schmickler, Stefanie; Kohnen, Thomas

    2016-02-01

    To assess the clinical visual outcomes of bilateral implantation of Restor +2.5 diopter (D) multifocal intraocular lenses (IOLs) and contralateral implantation of a Restor +2.5 D multifocal IOL in the dominant eye and Restor +3.0 D multifocal IOL in the fellow eye. Multicenter study at 8 investigative sites. Prospective randomized parallel-group patient-masked 2-arm study. This study comprised adults requiring bilateral cataract extraction followed by multifocal IOL implantation. The primary endpoint was corrected intermediate visual acuity (CIVA) at 60 cm, and the secondary endpoint was corrected near visual acuity (CNVA) at 40 cm. Both endpoints were measured 3 months after implantation with a noninferiority margin of Δ = 0.1 logMAR. In total, 103 patients completed the study (53 bilateral, 50 contralateral). At 3 months, the mean CIVA at 60 cm was 0.13 logMAR and 0.10 logMAR in the bilateral group and contralateral group, respectively (difference 0.04 logMAR), achieving noninferiority. Noninferiority was not attained for CNVA at 40 cm; mean values at 3 months for bilateral and contralateral implantation were 0.26 logMAR and 0.11 logMAR, respectively (difference 0.15 logMAR). Binocular defocus curves suggested similar performance in distance vision between the 2 groups. Treatment-emergent ocular adverse events rates were similar between the groups. Bilateral implantation of the +2.5 D multifocal IOL resulted in similar distance as contralateral implantation of the +2.5 D multifocal IOL and +3.0 D multifocal IOL for intermediate vision (60 cm), while noninferiority was not achieved for near distances (40 cm). Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  1. Progressive multifocal leukoencephalopathy limited to the brain stem

    International Nuclear Information System (INIS)

    Kastrup, O.; Maschke, M.; Diener, H.C.; Wanke, I.

    2002-01-01

    Progressive multifocal leukoencephalopathy (PML) is a subacute demyelinating slow-virus encephalitis caused by the JC polyomavirus in 2-5% of patients with AIDS. MRI typically shows multiple lesions in the cerebral hemispheres. We present a rare case of rapidly evolving and lethal PML with a severe bulbar syndrome and spastic tetraparesis in a patient with AIDS. MRI showed high-signal lesions on T2-weighted images confined to the brain stem, extending from the medulla oblongata to the midbrain. JC virus polymerase chain reaction in cerebrospinal fluid was positive, and neuropathology showed the findings of PML. This case was also notable because of the rapid progression despite improved immune status with antiretroviral therapy. (orig.)

  2. Multifocal bone and bone marrow lesions in children - MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Raissaki, Maria; Demetriou, Stelios; Spanakis, Konstantinos; Skiadas, Christos; Karantanas, Apostolos H. [University of Crete, Faculty of Medicine, Department of Radiology, University Hospital of Heraklion, Heraklion, Crete (Greece); Katzilakis, Nikolaos; Stiakaki, Eftichia [University of Crete, Faculty of Medicine, Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, Heraklion, Crete (Greece); Velivassakis, Emmanouil G. [University Hospital of Heraklion, Orthopedic Clinic, Heraklion, Crete (Greece)

    2017-03-15

    Polyostotic bone and bone marrow lesions in children may be due to various disorders. Radiographically, lytic lesions may become apparent after loss of more than 50% of the bone mineral content. Scintigraphy requires osteoblastic activity and is not specific. MRI may significantly contribute to the correct diagnosis and management. Accurate interpretation of MRI examinations requires understanding of the normal conversion pattern of bone marrow in childhood and of the appearances of red marrow rests and hyperplasia. Differential diagnosis is wide: Malignancies include metastases, multifocal primary sarcomas and hematological diseases. Benign entities include benign tumors and tumor-like lesions, histiocytosis, infectious and inflammatory diseases, multiple stress fractures/reactions and bone infarcts/ischemia. (orig.)

  3. Progressive multifocal leukoencephalopathy in two psoriasis patients treated with efalizumab.

    Science.gov (United States)

    Gadzia, Joseph; Turner, James

    2010-08-01

    Progressive multifocal leukoencephalopathy (PML) is a rare neurological disorder that occurs almost exclusively in immunocompromised individuals by reactivation of the John Cunningham virus (JC virus), a polyomavirus found latent in more than 80 percent of healthy adults. Efalizumab, an immunosuppressive monoclonal antibody targeting T cells, has been used for treatment of moderate-to-severe chronic psoriasis. The authors describe two cases of PML that occurred in patients < or = 70 years old treated with efalizumab for more than three years. Both presented with symptoms resembling cerebral infarction (slurred speech, reduced motor control, personality changes) and were assessed for evidence of stroke. Multiple magnetic resonance images over successive weeks demonstrated progression of cerebral abnormalities. PML was diagnosed, and the presence of JC virus was confirmed in spinal fluid samples. Both patients died shortly after diagnosis. Dermatologists treating patients with immunosuppressive agents should be alert for the symptoms of PML and seek immediate consultation with a neurologist should symptoms arise.

  4. Progressive Multifocal Leukoencephalopathy [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Laura Adang

    2015-12-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML is a devastating demyelinating disease with significant morbidity and mortality and no effective, targeted therapies. It is most often observed in association with abnormalities of cell-mediated immunity, in particular human immunodeficiency virus (HIV infection, but also occurs in association with lymphoproliferative diseases, certain immunosuppressive and immunomodulatory regimens, and other conditions. The etiologic agent of PML is a small, ubiquitous polyomavirus, the JC virus (JCV, also known as JCPyV, for which at least 50% of the adult general population is seropositive. PML results when JCV replicates within cerebral oligodendrocytes and astrocytes, leading to oligodendrocyte death and demyelination. Unfortunately, no treatments have been convincingly demonstrated to be effective, though some have been employed in desperation; treatment otherwise includes attempts to restore any immune system defect, such as the withdrawal of the causative agent if possible, and general supportive care.

  5. Synchronous multifocal medullary and papillary thyroid microcarcinoma detected by elastography.

    Science.gov (United States)

    Koudounarakis, Eleftherios; Karatzanis, Alexander; Chatzidakis, Alkiviadis; Tzardi, Maria; Velegrakis, George

    2014-01-01

    A few cases of concomitant medullary and papillary carcinoma in the same thyroid nodule have been described in the literature. However, the presence of multiple foci of both types of malignancy in the same gland is very rare. A 39 year-old female with multiple thyroid nodules, elevated serum calcitonin levels and elastographic findings suggestive of thyroid malignancy, underwent total thyroidectomy and central neck dissection. Histology revealed the presence of one focus of medullary and one focus of papillary carcinoma on each thyroid lobe. Subsequently, the patient underwent treatment with radioactive iodine. This is the third case of synchronous multifocal medullary and papillary thyroid carcinoma reported in the literature. Several theories for the simultaneous development of these malignant entities have been proposed. Ultrasound elastography can be a useful, noninvasive tool in the assessment of thyroid nodules. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. [Perinatal Presentation and Complicated Course of a Multifocal Atrial Tachycardia].

    Science.gov (United States)

    Braun, M; Siauw, C; Schirrmeister, J; Wirbelauer, J

    2016-12-01

    We report a male newborn who became symptomatic with supraventricular tachycardia on the first day of life. Neither adenosine nor electric cardioversion could terminate the tachycardia, therefore intravenous esmolol (β-receptor blocker) was initiated. Inspite of subsequent administration of various antiarrhythmic medications in increasingly higher doses, repeated supraventricular tachycardic episodes occurred. The electrocardiogram showed typical findings of a multifocal atrial tachycardia as the underlying cause. When tachycardic episodes occurred, they also presented as atrial flutter at 460 bpm and a 2:1 block. Finally, high dosage of amiodarone (10 mg/kgbw/d) led to continuous control of the heart rate without tachycardic episodes. To date our patient is mostly in sinus rhythm but without tachycardic episodes and doing well. © Georg Thieme Verlag KG Stuttgart · New York.

  7. MONTE CARLO SIMULATION OF MULTIFOCAL STOCHASTIC SCANNING SYSTEM

    Directory of Open Access Journals (Sweden)

    LIXIN LIU

    2014-01-01

    Full Text Available Multifocal multiphoton microscopy (MMM has greatly improved the utilization of excitation light and imaging speed due to parallel multiphoton excitation of the samples and simultaneous detection of the signals, which allows it to perform three-dimensional fast fluorescence imaging. Stochastic scanning can provide continuous, uniform and high-speed excitation of the sample, which makes it a suitable scanning scheme for MMM. In this paper, the graphical programming language — LabVIEW is used to achieve stochastic scanning of the two-dimensional galvo scanners by using white noise signals to control the x and y mirrors independently. Moreover, the stochastic scanning process is simulated by using Monte Carlo method. Our results show that MMM can avoid oversampling or subsampling in the scanning area and meet the requirements of uniform sampling by stochastically scanning the individual units of the N × N foci array. Therefore, continuous and uniform scanning in the whole field of view is implemented.

  8. Multifocal Abrikossoff's granular cell tumor of the oesophagus: Case report

    Directory of Open Access Journals (Sweden)

    Ranđelović Tomislav D.

    2008-01-01

    Full Text Available INTRODUCTION Granular cell tumors, relatively uncommon soft tissue tumors, have been a matter of debate among pathologists regarding histogenesis for a long time. Less common locations are in the aerodigestive tract including the oesophagus. CASE OUTLINE We have recently treated a rare case, a 37-year old male, who was admitted due to dysphagia and a painful swallow with occasional pharyngo-nasal regurgitation followed with a mild loss of weight. Standard clinical examination including X-ray chest, ECG and laboratory tests did not show pathological findings. Barium contrast oesophagography demonstrated multiple ovoid defects in the wall of the oesophagus. CT scan of the chest confirmed luminal narrowing owing to the tumor of the upper oesophagus. Upper endoscopy showed unusual multifocal nodular lesions alongside the oesophageal axis covered by smooth mucosa. A primary biopsy specimen taken from the largest nodules confirmed an unusual pathological finding of the granular cell tumor. Subtotal, transpleural oesophagectomy was performed and reconstruction was derived by long colon segment interposition through the posterior mediastinum. The postoperative course was uneventful. The operative specimen consisted of four ovoid tumors alongside the oesophagus (the greatest diameter 0.5-1.8, average 1.25. All verified tumors histologicaly consisted of a spindle-shaped or polygonal cells containing small and large eosinophilic granules and central nuclei. Most tumor cells showed strongly positive immunohistochemical staining for S-100 protein. These tumor cells were partially positive for p-53 and Ki-67. No lymph node metastases were detected histologically. CONCLUSION Multifocal granular cell tumor of the oesophagus is an unusual finding with low incidence, and rarely caused symptoms. Pathological features and multiplicity of such tumors emphasized malignant predisposition requiring surgical resection of the oesophagus.

  9. IDIOPATHIC MULTIFOCAL CHOROIDITIS PRESENTING WITH A TRANSIENT PERIPAPILLARY WHITE RING.

    Science.gov (United States)

    Gattoussi, Sarra; Ghadiali, Quraish; Dolz-Marco, Rosa; Freund, K Bailey

    2017-11-22

    We describe with multimodal imaging the presentation and follow-up for a patient with idiopathic multifocal choroiditis and a transient peripapillary white ring. Case report. A 39-year-old Asian woman was initially seen for an evaluation of lattice degeneration in 2015. Her medical history included Graves disease and psoriasis. Best-corrected visual acuity was 20/25 in her right eye and 20/25 in her left eye. Ultra-widefield fundus autofluorescence imaging showed a curvilinear hyperautofluorescent line in her right eye. One year later, the patient returned complaining of floaters in her right eye for 1 month. Her visual acuity was unchanged. Funduscopic examination showed new inflammatory yellowish lesions in the right eye corresponding to hyperreflective sub-retinal pigment epithelium lesions on structural spectral domain optical coherence tomography. Fluorescein angiography showed corresponding late staining of these active lesions. Late-phase indocyanine green angiography showed multiple nummular hypocyanescent dots. Ultra-widefield fundus autofluorescence showed large areas of hyperautofluorescence. The patient was started on a 60-mg oral prednisone taper and demonstrated subsequent regression of the inflammatory lesions. Ten months later, the patient returned emergently with complaints of floaters in both eyes for 2 days and a new temporal scotoma in her left eye. Funduscopic examination demonstrated a white ring around the optic nerve of the left eye corresponding to a hyperautofluorescent lesion. Ultra-widefield fundus autofluorescence showed new areas of hyperautofluorescence in both eyes. Structural spectral domain optical coherence tomography showed new sub-retinal pigment epithelium inflammatory lesions and a disruption of the ellipsoid zone in both eyes. The patient was again treated with a 60-mg oral prednisone taper and demonstrated subsequent restoration of the ellipsoid zone. To our knowledge, this is the first report of a transient annular white

  10. Clinical application of multifocal visual evoked potentials in children with epilepsy caused by intracranial disease

    International Nuclear Information System (INIS)

    Yukawa, Eiichi; Kim, Yeong-Jin; Kawasaki, Kensuke; Yoshii, Toshiaki; Hara, Yoshiaki

    2006-01-01

    We investigated whether visual field defects could be objectively evaluated using multifocal visual evoked potential (m-VEP) in two children with epilepsy caused by intracranial disease in whom it was difficult to measure the visual field. To determine normal waves in m-VEP, recording was performed using a visual evoked response imaging system (VERIS) Junior Science program (Mayo, Aichi, Japan) in 20 healthy children (20 eyes) peak latency and amplitude were used for assessment. In the two children with epilepsy, m-VEPs were recorded, and compared with the results of static perimetry or the lesions observed by Magnetic Resonance Imaging (MRI). In the 20 healthy children, there was no significant difference in the peak latency or amplitude among 4 quadrants by one-way analysis of variance. m-VEP in the children with epilepsy showed abnormal waves, corresponding to the visual field defects in the static perimetry or the lesions observed by MRI. Objective evaluation of visual field defects using m-VEP may be useful in children with epilepsy caused by intracranial disease in whom kinetic/static perimetry as a subjective examination is difficult. (author)

  11. Case report of a patient with progressive multifocal leukoencephalopathy under treatment with dimethyl fumarate

    OpenAIRE

    Dammeier, Nele; Schubert, Victoria; Hauser, Till-Karsten; Bornemann, Antje; Bischof, Felix

    2015-01-01

    Background Progressive multifocal leukoencephalopathy is a severe demyelinating disease caused by the polyoma JC virus in patients with reduced immunocompetence. A few cases of progressive multifocal leukoencephalopathy have been reported in patients treated with fumaric acid esters. Case presentation A 53-year-old Caucasian woman reported to our clinic with a first focal epileptic seizure and mild cognitive impairment. Since 1.5?years, she was treated with fumaderm for her psoriasis. During ...

  12. Detection of multifocal osteonecrosis in an adolescent with dermatomyositis using whole-body MRI

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Tania C.M.; Terreri, Maria Teresa A.; Hilario, Maria Odete E. [Federal University of Sao Paulo, Department of Pediatrics, Division of Allergy, Clinical Immunology and Rheumatology, Sao Paulo, SP (Brazil); Lederman, Henrique [Federal University of Sao Paulo, Image Diagnosis Department, Sao Paulo (Brazil); Kaste, Sue C. [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Division of Diagnostic Imaging, Memphis, TN (United States)

    2010-09-15

    Osteonecrosis is a well-recognized complication of corticosteroid use resulting in significant morbidity, often requiring surgical intervention. Whole-body MRI is a promising method that allows imaging of the whole patient in a reasonable time without the use of ionizing radiation. This technique has the potential for evaluating nonmalignant multifocal skeletal disease like osteonecrosis. This case highlights the value of whole-body MR in an adolescent with dermatomyositis who developed multifocal osteonecrosis. (orig.)

  13. Multifocal peritoneal splenosis in Tc-99m-labeled heat-denatured red blood cell scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Min Ki; Hwang, Kyung Hoon; Choe, Won Sick [Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2006-06-15

    A 44-year-old man with a past medical history of splenectomy came to hospital because of epigastric pain abdominopelvic computed tomography(CT) showed a soft tissue mass and multifocal variable-sized nodules as well as finding suggestive of cholecystitis. Subsequently, he underwent Tc-99m-labeled heat- denatured red blood cell(RBC) scintigraphy to evaluate the mass and nodules. The scintigraphy confirmed multifocal peritoneal splenosis in the abdominopelvic cavity.

  14. Test-retest reliability of the multifocal photopic negative response.

    Science.gov (United States)

    Van Alstine, Anthony W; Viswanathan, Suresh

    2017-02-01

    To assess the test-retest reliability of the multifocal photopic negative response (mfPhNR) of normal human subjects. Multifocal electroretinograms were recorded from one eye of 61 healthy adult subjects on two separate days using a Visual Evoked Response Imaging System software version 4.3 (EDI, San Mateo, California). The visual stimulus delivered on a 75-Hz monitor consisted of seven equal-sized hexagons each subtending 12° of visual angle. The m-step exponent was 9, and the m-sequence was slowed to include at least 30 blank frames after each flash. Only the first slice of the first-order kernel was analyzed. The mfPhNR amplitude was measured at a fixed time in the trough from baseline (BT) as well as at the same fixed time in the trough from the preceding b-wave peak (PT). Additionally, we also analyzed BT normalized either to PT (BT/PT) or to the b-wave amplitude (BT/b-wave). The relative reliability of test-retest differences for each test location was estimated by the Wilcoxon matched-pair signed-rank test and intraclass correlation coefficients (ICC). Absolute test-retest reliability was estimated by Bland-Altman analysis. The test-retest amplitude differences for neither of the two measurement techniques were statistically significant as determined by Wilcoxon matched-pair signed-rank test. PT measurements showed greater ICC values than BT amplitude measurements for all test locations. For each measurement technique, the ICC value of the macular response was greater than that of the surrounding locations. The mean test-retest difference was close to zero for both techniques at each of the test locations, and while the coefficient of reliability (COR-1.96 times the standard deviation of the test-retest difference) was comparable for the two techniques at each test location when expressed in nanovolts, the %COR (COR normalized to the mean test and retest amplitudes) was superior for PT than BT measurements. The ICC and COR were comparable for the BT/PT and

  15. Osteomielite crônica multifocal recorrente da mandíbula: relato de três casos Chronic recurrent multifocal osteomyelitis of the mandible: report of three cases

    Directory of Open Access Journals (Sweden)

    Luciana B. Paim

    2003-10-01

    Full Text Available OBJETIVO: Relatar três casos de osteomielite crônica multifocal recorrente de mandíbula. A osteomielite crônica multifocal recorrente é uma doença inflamatória, com acometimento de um ou mais ossos, sem patógenos isolados nas áreas afetadas, sendo o envolvimento da mandíbula raramente descrito na literatura. DESCRIÇÃO: Caso 1 - paciente feminina, com 13 anos, após tratamento dentário evoluiu com dor mandibular e febre. A paciente foi tratada com antibióticos por osteomielite, evoluindo com aumento progressivo da mandíbula e pustulose palmoplantar. A cintilografia óssea mostrou hipercaptação difusa da mandíbula. A redução da tumoração mandibular foi evidenciada com a indometacina e sessões de câmara hiperbárica. Caso 2 - paciente feminina, com 9 anos, apresentou dor e edema em região de mandíbula direita recorrente por três anos. O diagnóstico de osteomielite foi realizado e introduzido amoxicilina. Após três meses, a tomografia computadorizada mostrou osteólise mandibular difusa. Indometacina e câmara hiperbárica foram introduzidas, porém a paciente apresentou recidiva e foi tratada com prednisona, rofecoxib e metotrexato. Caso 3 - paciente masculino, com 10 anos, apresentou pustulose palmoplantar e aumento difuso da mandíbula recorrente. A tomografia computadorizada de mandíbula evidenciou osteólise mandibular, e a cintilografia óssea, hipercaptação difusa. O paciente foi tratado com prednisona. O rofecoxib foi substituído após duas recidivas. COMENTÁRIOS: A osteomielite crônica multifocal recorrente da mandíbula pode apresentar um curso doloroso prolongado, com intervalos de atividade e remissão do processo inflamatório. O seu reconhecimento é importante para evitar uma antibioticoterapia prolongada e procedimentos invasivos desnecessários.OBJECTIVE: To report three cases of chronic recurrent multifocal osteomyelitis of the mandible, an inflammatory disease affecting one or more bones with

  16. Progressive Multifocal Leukoencephalopathy and Systemic Lupus Erythematosus: Focus on Etiology

    Directory of Open Access Journals (Sweden)

    Shala Ghaderi Berntsson

    2016-03-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML caused by reactivation of the JC virus (JCV, a human polyomavirus, occurs in autoimmune disorders, most frequently in systemic lupus erythematosus (SLE. We describe a HIV-negative 34-year-old female with SLE who had been treated with immunosuppressant therapy (IST; steroids and azathioprine since 2004. In 2011, she developed decreased sensation and weakness of the right hand, followed by vertigo and gait instability. The diagnosis of PML was made on the basis of brain MRI findings (posterior fossa lesions and JCV isolation from the cerebrospinal fluid (700 copies/ml. IST was immediately discontinued. Cidofovir, mirtazapine, mefloquine and cycles of cytarabine were sequentially added, but there was progressive deterioration with a fatal outcome 1 year after disease onset. This report discusses current therapeutic choices for PML and the importance of early infection screening when SLE patients present with neurological symptoms. In the light of recent reports of PML in SLE patients treated with rituximab or belimumab, we highlight that other IST may just as well be implicated. We conclude that severe lymphopenia was most likely responsible for JCV reactivation in this patient and discuss how effective management of lymphopenia in SLE and PML therapy remains an unmet need.

  17. The effects of fundus photography on the multifocal electroretinogram.

    Science.gov (United States)

    Suresh, Sandip; Tienor, Brian J; Smith, Scott D; Lee, Michael S

    2016-02-01

    To determine the effect of flash fundus photography (FFP) on the multifocal electroretinogram (mfERG). Ten subjects underwent mfERG testing on three separate dates. Subjects received either mfERG without FFP, mfERG at 5 and 15 min after FFP, or mfERG at 30 and 45 min after FFP on each date. The FFP groups received 10 fundus photographs followed by mfERG testing, first of the right eye then of the left eye 10 min later. Data were averaged and analyzed in six concentric rings at each time point. Average amplitude and implicit times of the N1, P1, and N2 peaks for each concentric ring at each time point after FFP were compared to baseline. Flash fundus photography did not lead to a significant change of amplitude or implicit times of N1, P1, or N2 at 5 min after light exposure. These findings suggest that it is acceptable to perform mfERG testing without delay after performance of FFP.

  18. Multifocal Toric Intraocular Lens for Traumatic Cataract in a Child

    Directory of Open Access Journals (Sweden)

    Yanfeng Zeng

    2016-10-01

    Full Text Available A child suffering from traumatic cataract and corneal astigmatism of 2.14 D had a phacoemulsification operation and implantation of a ReSTOR Toric intraocular lens (IOL to correct the astigmatism. The primary outcome measurements were the uncorrected distance visual acuity (UDVA, uncorrected near vision at 40 cm, intraocular pressure, spherical equivalent refraction, residual astigmatism, corneal astigmatism, presence of unusual optical phenomena, and use of spectacles. At 7 months postoperatively, UDVA was maintained between 16/20 and 24/20, near vision was between J1 and J3, residual spherical refraction was 0–0.37 D, and residual refractive cylinder was between 0 and 0.67 D. A multifocal toric IOL can provide the possibility of satisfactory vision for both distant and near conditions without the use of spectacles to meet children’s needs when studying and doing sports. Additionally, binocular vision can be reconstructed. This intervention, therefore, seems to be a satisfactory alternative.

  19. Clinical, therapeutic, and pathogenic aspects of chronic oral multifocal candidiasis.

    Science.gov (United States)

    Holmstrup, P; Bessermann, M

    1983-10-01

    In 32 patients (11 females, 21 males) the diagnosis of chronic oral multifocal candidiasis was established on the basis of erythematous, plaquelike, or nodular lesions in two or more of the following locations: commissural area, palate, or dorsum of the tongue. Hyphae and/or pseudohyphae of Candida-like organisms were demonstrated in PAS-stained smears from all lesions. Ninety-seven separate lesions were registered. Thirty patients experienced pain, burning, or itching from affected areas. All of the patients were tobacco smokers, and 21 were denture wearers. The patients were treated with antimycotics; the median length of treatment was 46 days for denture wearers and 44 days for nondenture wearers. After antimycotic therapy the change in the lesions followed certain patterns which were determined by the original type of lesion. Palatal lesions in nondenture wearers and nodular lesions of the commissural areas showed the highest recurrence rate after 6 and 12 months. The pathogenic role of tobacco and other factors in the development of candidal infection are discussed.

  20. Multifocal nodular episcleritis and scleritis with undiagnosed Hodgkin's lymphoma.

    Science.gov (United States)

    Thakker, Manoj M; Perez, Victor L; Moulin, Alexandre; Cremers, Sandra L; Foster, C Stephen

    2003-05-01

    To report the case of a patient with undiagnosed Hodgkin's lymphoma who presented with coexistent unilateral nodular episcleritis and scleritis. Interventional case report and literature review Review of clinical history, laboratory findings, histology of episcleral and cervical lymph node biopsies, and follow-up. A 20-year-old female presented with a 5-month history of redness and pain in her left eye, with associated symptoms of dyspnea, malaise, and fever. The patient was found to have multifocal nodular episcleritis and scleritis that was not responsive to topical steroids or systemic nonsteroidal anti-inflammatory treatment. Laboratory tests subsequently revealed evidence of systemic inflammation, and radiologic studies showed extensive mediastinal and cervical adenopathy. A cervical lymph node biopsy showed Reed-Sternberg cells and a chronic lymphocytic infiltrate consistent with nodular sclerosing Hodgkin's lymphoma. Histopathologic analysis of an episcleral nodule revealed a necrotizing granuloma with vasculitis. Systemic chemotherapy was instituted for the Hodgkin's disease; this therapy abolished the nodular scleritis. This case raises the possibility of concurrent undiagnosed systemic vasculitis with only an ocular manifestation with Hodgkin's lymphoma, either as a coincidence or as a paraneoplastic syndrome. Moreover, it emphasizes the important role of tissue biopsy in establishing diagnosis and directing treatment. Copyright 2003 by the American Academy of Ophthalmology.

  1. Multifocal motor neuropathy: a review of pathogenesis, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Lawson VH

    2014-04-01

    Full Text Available Victoria H Lawson,1 W David Arnold1,2 1Division of Neuromuscular Disorders, Department of Neurology, 2Department of Physical Medicine and Rehabilitation, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA Abstract: Multifocal motor neuropathy (MMN is an uncommon, purely motor neuropathy associated with asymmetric deficits with predilection for upper limb involvement. Even in the early descriptions of MMN, the associations of anti-GM1 antibodies and robust response to immunomodulatory treatment were recognized. These features highlight the likelihood of an underlying autoimmune etiology of MMN. The clinical presentation of MMN can closely mimic several neurological conditions including those with more malignant prognoses such as motor neuron disease. Therefore early and rapid recognition of MMN is critical. Serological evidence of anti GM-1 antibodies and electrodiagnostic findings of conduction block are helpful diagnostic clues for MMN. Importantly, these diagnostic features are not universally present, and patients lacking these characteristic findings can demonstrate similar robust response to immunodulatory treatment. In the current review, recent research in the areas of diagnosis, pathogenesis, and treatment of MMN and needs for the future are discussed. The characteristic findings of MMN and treatment implications are reviewed and contrasted with other mimicking disorders. Keywords: autoimmune, conduction block, electrodiagnosis, motor neuron, nerve, inflammatory

  2. Multifocal atherosclerosis in patient after acute first degree radiation sickness.

    Directory of Open Access Journals (Sweden)

    Metlyaeva N.A.

    2014-12-01

    Full Text Available Purpose: assessment the heavy psychosomatic and all-somatic cardiovascular and cerebrovascular pathology of patient, transferred an acute I degree radiation sickness, from the general evenly gamma-beta radiation. Conclusions. The subdepressive and disturbing-depressive syndrome of patient, transferred an acute radiation sickness (ARS of I degree, from the general evenly gamma-beta radiation, was independent risk factor of development of multifocal atherosclerosis; Features of development of all-somatic and psychosomatic pathology of patient are based on a combination of genetic prerequisites, environment influences (the stress caused by accident on the ChNPP and social factors, influencing on him during a course of life, especially during early socialization. Thus at development of psychosomatic frustration the combination of feature of the mental reaction connected with the personal characteristic and special relationship between mental (stress and physiological (somatic by aspects of reaction which led to metabolism violation, to aging, decrease in adaptation opportunities of an organism and development age — dependent pathology took place.

  3. Progressive multifocal leukoencephalopathy and other forms of JC virus disease.

    Science.gov (United States)

    Brew, Bruce J; Davies, Nicholas W S; Cinque, Paola; Clifford, David B; Nath, Avindra

    2010-12-01

    Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the brain caused by the JC virus (JCV). PML usually occurs via reactivation of JCV when an immune system becomes compromised. A diagnosis of PML is normally made on the basis of distinguishing neurological features at presentation, characteristic brain MRI changes and the presence of JCV DNA in cerebrospinal fluid. PML has a 3 month mortality rate of 20-50%, so prompt intervention is essential. Currently, reconstitution of the immune system affords the best prognosis for this condition. When PML is first suspected, and where possible, immunosuppressant or immunomodulatory therapy should be suspended or reduced. If PML is associated with a protein therapy that has a long half-life the use of plasma exchange to accelerate the removal of the drug from the circulation may aid the restoration of immune system function. Rapid improvements in immune function, however, might lead to transient worsening of the disease. In this Review, we critically appraise the controversies surrounding JCV infection, and provide practical management guidelines for PML.

  4. Changes of multifocal electroretinogram in subclinical diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Kai Gong

    2017-10-01

    Full Text Available AIM: To investigate the changes of first order kernel(FOKand second order kernel(SOKof multifocal electroretinogram(mf-ERGin detecting the early retinal abnormalities in sub-clinical stage of diabetic retinopathy.METHODS: Totally 32 patients(58 eyeswith type 2 diabetes mellitus(DMwithout apparent diabetic retinopathy(DRwere detected by mf-ERG, from June 2014 to May 2015. Thirty cases(60 eyesof normal control group had also been taken to compare the difference of the amplitude and latency between the two groups.RESULTS: Compared with the control group: there was no statistical difference in the FOK b-wave latency of the diabetic group, and the FOK b-wave amplitude was significantly decreased(t=3.099, P=0.012. The SOK b-wave latency in diabetes group was statistically delayed(t=2.643, P=0.025, and the SOK b-wave amplitude statistically decreased(t=4.833, PCONCLUSION: The function of the post-polar outer and inner retina detected by FOK and SOK had been damage even before retinopathy. The anomaly is mainly reflected by the decreasing amplitude of b-wave.

  5. Multifocal Electroretinography after High Dose Chloroquine Therapy for Malaria

    Directory of Open Access Journals (Sweden)

    Aline Correa de Carvalho

    2013-01-01

    Full Text Available Purpose: To investigate changes in multifocal electroretinography (mfERG parameters associated with high dose chloroquine therapy for treatment of malaria in the Amazonia region of Brazil. Methods: Forty-eight subjects who had received chloroquine treatment for single or multiple malaria infections with a cumulative dose ranging from 1,050 to 27,000mg were included. The control group consisted of 37 healthy aged-matched subjects. Data was collected on amplitude and implicit time of the N1, P1 and N2 waves in the central macular hexagon (R1 and in five concentric rings at different retinal eccentricities (R2-R6. Results: No significant difference was observed in any mfERG parameter between chloroquine treated patients and control subjects. A comparison with previous data obtained from patients with rheumatologic disorders in the same region of Brazil who had received larger cumulative doses of chloroquine and had displayed mfERG changes, indicated that retinal toxicity seems to be dependent on cumulative dose. Conclusion: Lack of mfERG changes in the current study suggests that intensive high dose chloroquine therapy for treatment of malaria is not associated with retinal toxicity.

  6. Multifocal ERG Guiding Therapy in a Case of Hydroxychloroquine Premaculopathy

    Directory of Open Access Journals (Sweden)

    José Antonio Sáez-Moreno

    2015-01-01

    Full Text Available We report the case of a 28-year-old female treated for systemic lupus erythematosus with hydroxychloroquine (200 mg/day for 11 years. She was visually asymptomatic, with normal fundus appearance, normal colour vision testing findings, 20/20 visual acuity in both eyes, and only mild central bilateral defects on 10-2 perimetry. Multifocal electroretinography (mfERG showed low density values for ring 1 in both eyes. Because the patient had not previously responded to alternative treatments and in consultation with her physician, the hydroxychloroquine dose was reduced to 200 mg four days/week. Four serial mfERGs performed at 4, 18, 25, and 34 months after dose reduction showed a progressive improvement in the definition and density of the responses until they were normalized at the third mfERG (25 months after hydroxychloroquine dose reduction. The fourth and final mfERG at 34 months confirmed the recovery in both eyes. Perimetry defects were mostly normalized. These results demonstrate the importance of mfERG for the safe management of patients under long-term hydroxychloroquine treatment.

  7. Progressive multifocal leukoencephalopathy. Epidemiology, clinical pictures, diagnosis and therapy

    International Nuclear Information System (INIS)

    Kishida, Shuji

    2007-01-01

    Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by the reactivation of a ubiquitous polyomavirus JC (JCV). PML was for many years a rare disease occurring only in patients with underlying severe impaired immunity. Over the past three decades, the incidence of PML has significantly increased related to the AIDS (acquired immunodeficiency syndrome) pandemic and, more recently, to the growing use of immunosuppressive drugs. The clinical presentation of PML is variable with neurological symptoms corresponding to affected cerebral areas. Usually, the clinical outcome of patients with PML is poor with an inexorable progression to death within 6 months of symptom onset. Although PML usually requires a brain biopsy or autopsy for confirmation, radiological imaging and a demonstration of JCV-DNA in the CSF (cerebrospinal fluid) provide supportive evidence for the diagnosis. Although there is no proven effective therapy for PML, patients with HIV (human immunodeficeincy virus)-related PML may benefit significantly from HAART (highly active antiretroviral therapy). In this article the author reviews the epidemiology, especially in Japan, current challenges in the diagnosis and the treatment guidelines of patients with PML based on recent advances in the understanding of the JC virus biology. (author)

  8. Frontal and occipital horn ratio is associated with multifocal intraparenchymal hemorrhages in neonatal shunted hydrocephalus.

    Science.gov (United States)

    Oushy, Soliman; Parker, Jonathon J; Campbell, Kristen; Palmer, Claire; Wilkinson, Corbett; Stence, Nicholas V; Handler, Michael H; Mirsky, David M

    2017-11-01

    OBJECTIVE Placement of a cerebrospinal fluid diversion device (i.e., shunt) is a routine pediatric neurosurgical procedure, often performed in the first weeks of life for treatment of congenital hydrocephalus. In the postoperative period, shunt placement may be complicated by subdural, catheter tract, parenchymal, and intraventricular hemorrhages. The authors observed a subset of infants and neonates who developed multifocal intraparenchymal hemorrhages (MIPH) following shunt placement and sought to determine any predisposing perioperative variables. METHODS A retrospective review of the electronic medical record at a tertiary-care children's hospital was performed for the period 1998-2015. Inclusion criteria consisted of shunt placement, age hydrocephalus. Markers of severity of ventriculomegaly (FOR) and ventricular response to CSF diversion (∆FOR) were significantly associated with occurrence of MIPH. Choice of shunt and etiology of hydrocephalus were also significantly associated with MIPH. After adjusting for corrected age, etiology of hydrocephalus, and shunt setting, the authors found that ∆FOR after shunting was still associated with MIPH. A prospective study of MIPH prevention strategies and assessment of possible implications for patient outcomes is needed.

  9. Multifocal Pupillography Identifies Changes in Visual Sensitivity According to Severity of Diabetic Retinopathy in Type 2 Diabetes.

    Science.gov (United States)

    Sabeti, Faran; Nolan, Chris J; James, Andrew C; Jenkins, Alicia; Maddess, Ted

    2015-07-01

    Retinal light sensitivity loss has been shown to occur prior to other signs of retinopathy and may predict the sight-threatening sequelae. A rapid, objective perimetric test could augment diabetes care. We investigated the clinical use of multifocal pupillographic objective perimetry (mfPOP) to identify patients with and without diabetic retinopathy. Retinopathy severity was determined using the Early Treatment of Diabetic Retinopathy Study (ETDRS) standard for fundus photography. Pupillary responses were measured from both eyes of 25 adults with none to moderate diabetic retinopathy and 24 age-matched controls, using three mfPOP stimulus variants. Multifocal pupillographic objective perimetry stimulus variants tested 44 regions per eye arranged in a five-ring dartboard layout presented within either the central 30° or 60° of fixation. Receiver operator characteristic (ROC) curves were produced from contraction amplitudes and time to peak responses. Regression analysis revealed that mean amplitude deviations were larger with severity of early retinopathy. On average, the longest delays were measured in patients with no retinopathy. The brightest wide-field stimuli produced the highest area under the ROC curve for differentiating eyes with no retinopathy from nonproliferative diabetic retinopathy (NPDR) and from healthy eyes (100 ± 0.0%, mean ± SE). The asymmetry in local delay deviations between eyes tended to produce higher sensitivity and specificity than amplitude deviations. Asymmetry in local response delays measured by mfPOP may provide useful information regarding the severity of diabetic retinopathy and may have clinical use as a rapid, noninvasive method for identifying functional loss even in the absence of NPDR.

  10. Comparison of outcomes with multifocal intraocular lenses: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Béatrice Cochener

    2011-01-01

    Full Text Available Béatrice Cochener1, Antoine Lafuma2, Babak Khoshnood2, Laurène Courouve2, Gilles Berdeaux3,41Centre Hospitalier Universitaire Brest, Brest, France; 2Cemka Eval, Bourg la Reine, France; 3Alcon France, Rueil-Malmaison, France; 4Conservatoire National des Arts et Métiers, Paris, FrancePurpose: To compare the clinical outcome of different multifocal intraocular lenses (IOLs based on information reported in the international literature.Methods: All comparative clinical trials that involved implanting at least one multifocal IOL in patients with cataract or presbyopia were extracted from the literature. Clinical outcomes included uncorrected near visual acuity, uncorrected distance visual acuity, visual acuity, spectacle independence, and halos. Random effects meta-analyses were conducted to compare outcomes for the different IOL types.Results: Twenty papers were identified describing 11 monofocal IOLs and 35 multifocal IOLs (19 diffractive, including 12 ReSTOR®, 14 refractive, and two accommodative patient cohorts. Multifocal and monofocal uncorrected distance visual acuity was 0.165 (0.090–0.240 and 0.093 (0.088–0.098, respectively. Compared with monofocal IOLs, multifocal IOLs produced better uncorrected near visual acuity (0.470 [0.322–0.618] versus 0.141 [0.131–0.152]; P < 0.0001, resulting in higher spectacle independence (incidence rate ratio [IRR] 3.62 [2.90–4.52]; P < 0.0001. Compared with refractive multifocal IOLs, diffractive multifocal IOLs produced a similar uncorrected distance visual acuity (0.105 [0.098–0.111] versus 0.085 [0.029–0.140]; P ≤ 0.78, not significant and better uncorrected near visual acuity (0.217 [0.118–0.317] versus 0.082 [0.067–0.098]; P < 0.0001 resulting in higher spectacle independence (IRR 1.75 [1.24–2.48]; P < 0.001. Compared with other multifocal IOLs, ReSTOR produced a better uncorrected distance visual acuity (0.067 [0.059–0.076] versus 0.093 [0.088–0.098]; P < 0.0001 and better

  11. Sensitivity of imaging for multifocal-multicentric breast carcinoma

    Directory of Open Access Journals (Sweden)

    Viale Giuseppe

    2008-09-01

    Full Text Available Abstract Background This retrospective study aims to determine: 1 the sensitivity of preoperative mammography (Mx and ultrasound (US, and re-reviewed Mx to detect multifocal multicentric breast carcinoma (MMBC, defined by pathology on surgical specimens, and 2 to analyze the characteristics of both detected and undetected foci on Mx and US. Methods Three experienced breast radiologists re-reviewed, independently, digital mammography of 97 women with MMBC pathologically diagnosed on surgical specimens. The radiologists were informed of all neoplastic foci, and blinded to the original mammograms and US reports. With regards to Mx, they considered the breast density, number of foci, the Mx characteristics of the lesions and their BI-RADS classification. For US, they considered size of the lesions, BI-RADS classification and US pattern and lesion characteristics. According to the histological size, the lesions were classified as: index cancer, 2nd lesion, 3rd lesion, and 4th lesion. Any pathologically identified malignant foci not previously described in the original imaging reports, were defined as undetected or missed lesions. Sensitivity was calculated for Mx, US and re-reviewed Mx for detecting the presence of the index cancer as well as additional satellite lesions. Results Pathological examination revealed 13 multifocal and 84 multicentric cancers with a total of 303 malignant foci (282 invasive and 21 non invasive. Original Mx and US reports had an overall sensitivity of 45.5% and 52.9%, respectively. Mx detected 83/97 index cancers with a sensitivity of 85.6%. The number of lesions undetected by original Mx was 165/303. The Mx pattern of breasts with undetected lesions were: fatty in 3 (1.8%; scattered fibroglandular density in 40 (24.3%, heterogeneously dense in 91 (55.1% and dense in 31 (18.8% cases. In breasts with an almost entirely fatty pattern, Mx sensitivity was 100%, while in fibroglandular or dense pattern it was reduced to 45

  12. Multifocal juvenile osteochondritis dissecans of the knee: a case series.

    Science.gov (United States)

    Backes, Jeffrey R; Durbin, Thomas C; Bentley, Jared C; Klingele, Kevin E

    2014-06-01

    This retrospective case series reports on a group of patients with multifocal juvenile osteochondritis dissecans (MJOCD) of the knee and discusses demographic data, lesion location, stage, and treatment results. Records of patients identified with MJOCD of the knee at a single institution were retrospectively reviewed. Demographic, radiographic, and surgical results were recorded. Lesions were descriptively classified and lesions undergoing surgical treatment were staged. Results of operative and nonoperative treatment were recorded. Fifty-nine lesions were identified in 28 patients who met the inclusion criteria. There were 22 males (78%) and 6 females (21%). Average age was 11.8 years (males, 6 to 17; females, 10 to 14). Thirty-six (61%) lesions were on the medial femoral condyle (MFC), 19 (32%) on the lateral femoral condyle, 2 (3%) on the trochlea, 1 (2%) on the patella, and 1 (2%) on the anteromedial tibial plateau. Forty-four (74%) lesions required operative treatment. Of the 32 stable lesions managed surgically, 25 (78%) achieved healing with operative treatment. All 12 unstable lesions identified were managed surgically with 5 (41%) healed after the initial operation. Lesions located on the MFC had a significantly higher rate of healing (89%) compared with lateral femoral condyle lesions (37%) (P1 identified lesion occurring in the same or the contralateral knee. Prevalence of MJOCD of the knee is unknown. A high percentage of these patients require surgical intervention with only one quarter of stable lesions healing with conservative treatment. Healing rates of stable lesions after surgery was nearly twice that of unstable lesions undergoing surgical intervention. Lesions located on the MFC healed at a statistically significant greater rate than other locations within the knee. Sex, age, and associated discoid menisci had no effect on healing prognosis. Level IV-case series.

  13. Prevalence of Multifocal Primary Hyperhidrosis and Symptom Severity Over Time: Results of a Targeted Survey.

    Science.gov (United States)

    Glaser, Dee Anna; Ballard, Angela M; Hunt, Niquette L; Pieretti, Lisa J; Pariser, David M

    2016-12-01

    There is a paucity of data on the prevalence of multifocal primary hyperhidrosis and changes in hyperhidrosis severity over time. The goal of this study was to better understand multifocal primary hyperhidrosis, prevalence and distribution of hyperhidrosis by focal site, age of onset of symptoms by focal area, and change in hyperhidrosis severity over time and with seasons. The International Hyperhidrosis Society, through an unrestricted research grant from Revance Therapeutics, conducted an online survey of registered visitors to its Web site. Participants identified as having "excessive sweating" and opted to participate in the survey (23 questions) after an e-mail invitation. The survey data illustrate that multifocal primary hyperhidrosis is more common than previously believed and that multifocal hyperhidrosis is more common than singular focal hyperhidrosis (81% of patients reported 3 or more focal hyperhidrotic sites). The data also show that sweating symptom severity does not improve with age but stays the same or gets worse and is "bothersome" throughout the year. Recognition of the chronic and multifocal nature of primary hyperhidrosis is useful for treating hyperhidrosis patients long term and illustrates a need for treatments or treatment combinations that are effective for multiple body areas.

  14. Very low-dose (0.15 mGy) chest CT protocols using the COPDGene 2 test object and a third-generation dual-source CT scanner with corresponding third-generation iterative reconstruction software.

    Science.gov (United States)

    Newell, John D; Fuld, Matthew K; Allmendinger, Thomas; Sieren, Jered P; Chan, Kung-Sik; Guo, Junfeng; Hoffman, Eric A

    2015-01-01

    The purpose of this study was to evaluate the impact of ultralow radiation dose single-energy computed tomographic (CT) acquisitions with Sn prefiltration and third-generation iterative reconstruction on density-based quantitative measures of growing interest in phenotyping pulmonary disease. The effects of both decreasing dose and different body habitus on the accuracy of the mean CT attenuation measurements and the level of image noise (SD) were evaluated using the COPDGene 2 test object, containing 8 different materials of interest ranging from air to acrylic and including various density foams. A third-generation dual-source multidetector CT scanner (Siemens SOMATOM FORCE; Siemens Healthcare AG, Erlangen, Germany) running advanced modeled iterative reconstruction (ADMIRE) software (Siemens Healthcare AG) was used.We used normal and very large body habitus rings at dose levels varying from 1.5 to 0.15 mGy using a spectral-shaped (0.6-mm Sn) tube output of 100 kV(p). Three CT scans were obtained at each dose level using both rings. Regions of interest for each material in the test object scans were automatically extracted. The Hounsfield unit values of each material using weighted filtered back projection (WFBP) at 1.5 mGy was used as the reference value to evaluate shifts in CT attenuation at lower dose levels using either WFBP or ADMIRE. Statistical analysis included basic statistics, Welch t tests, multivariable covariant model using the F test to assess the significance of the explanatory (independent) variables on the response (dependent) variable, and CT mean attenuation, in the multivariable covariant model including reconstruction method. Multivariable regression analysis of the mean CT attenuation values showed a significant difference with decreasing dose between ADMIRE and WFBP. The ADMIRE has reduced noise and more stable CT attenuation compared with WFBP. There was a strong effect on the mean CT attenuation values of the scanned materials for ring

  15. Multifocal tenosynovial giant cell tumors in a child with Noonan syndrome

    International Nuclear Information System (INIS)

    Meyers, Arthur B.; Awomolo, Agboola O.; Szabo, Sara

    2017-01-01

    Noonan syndrome is a genetic disorder with variable expression of distinctive facial features, webbed neck, chest deformity, short stature, cryptorchidism and congenital heart disease. The association of Noonan syndrome and giant cell granulomas of the mandible is widely reported. However, Noonan syndrome may also be associated with single or multifocal tenosynovial giant cell tumors, also referred to as pigmented villonodular synovitis. We report a child with Noonan syndrome, giant cell granulomas of the mandible and synovial and tenosynovial giant cell tumors involving multiple joints and tendon sheaths who was initially misdiagnosed with juvenile idiopathic arthritis. It is important for radiologists to be aware of the association of Noonan syndrome and multifocal giant cell lesions, which can range from the more commonly described giant cell granulomas of the mandible to isolated or multifocal intra- or extra-articular tenosynovial giant cell tumors or a combination of all of these lesions. (orig.)

  16. MULTIFOCAL CHOROIDAL MELANOMA IN A PATIENT WITH GERM LINE BRCA-ASSOCIATED PROTEIN 1 MUTATION.

    Science.gov (United States)

    Rao, Raksha; Pointdujour-Lim, Renelle; Ganguly, Arupa; Shields, Carol L

    2018-01-01

    To report a case of unilateral multifocal melanoma in a patient with germ line BRCA-associated protein 1 mutation. Case report. A 67-year-old white woman with a family history of lung and liver cancers developed blurred visual acuity of 20/30 in the left eye. She was discovered to have two independent pigmented choroidal melanomas in the macula and superotemporally, both demonstrating overlying subretinal fluid and orange pigment. Both melanomas were treated with a single custom-designed Iodine 125 brachytherapy device. Upon systemic evaluation, asymptomatic renal cell carcinoma was found, and blood lymphocyte testing for germ line BRCA-associated protein 1 mutation was positive. Multifocal choroidal melanoma is exceedingly rare. Patients with uveal melanoma, especially if multifocal, and those with other systemic malignancy or family history of cancers should be tested for germ line BRCA-associated protein 1 mutation. Lifelong monitoring for other systemic malignancies is advised.

  17. Multifocal tenosynovial giant cell tumors in a child with Noonan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, Arthur B. [Children' s Hospital of Wisconsin, Department of Radiology, Milwaukee, WI (United States); Nemours Children' s Health System/Nemours Children' s Hospital, Department of Radiology, Orlando, FL (United States); Awomolo, Agboola O. [Children' s Hospital of Wisconsin, Department of Radiology, Milwaukee, WI (United States); Szabo, Sara [Medical College of Wisconsin and Children' s Hospital of Wisconsin, Department of Pathology, Milwaukee, WI (United States); Cincinnati Children' s Hospital Medical Center, Division of Pathology and Laboratory Medicine, Cincinnati, OH (United States)

    2017-03-15

    Noonan syndrome is a genetic disorder with variable expression of distinctive facial features, webbed neck, chest deformity, short stature, cryptorchidism and congenital heart disease. The association of Noonan syndrome and giant cell granulomas of the mandible is widely reported. However, Noonan syndrome may also be associated with single or multifocal tenosynovial giant cell tumors, also referred to as pigmented villonodular synovitis. We report a child with Noonan syndrome, giant cell granulomas of the mandible and synovial and tenosynovial giant cell tumors involving multiple joints and tendon sheaths who was initially misdiagnosed with juvenile idiopathic arthritis. It is important for radiologists to be aware of the association of Noonan syndrome and multifocal giant cell lesions, which can range from the more commonly described giant cell granulomas of the mandible to isolated or multifocal intra- or extra-articular tenosynovial giant cell tumors or a combination of all of these lesions. (orig.)

  18. N-3 Polyunsaturated Fatty Acids of Marine Origin and Multifocality in Human Breast Cancer.

    Science.gov (United States)

    Ouldamer, Lobna; Goupille, Caroline; Vildé, Anne; Arbion, Flavie; Body, Gilles; Chevalier, Stephan; Cottier, Jean Philippe; Bougnoux, Philippe

    2016-01-01

    The microenvironment of breast epithelial tissue may contribute to the clinical expression of breast cancer. Breast epithelial tissue, whether healthy or tumoral, is directly in contact with fat cells, which in turn could influence tumor multifocality. In this pilot study we investigated whether the fatty acid composition of breast adipose tissue differed according to breast cancer focality. Twenty-three consecutive women presenting with non-metastatic breast cancer underwent breast-imaging procedures including Magnetic Resonance Imaging prior to treatment. Breast adipose tissue specimens were collected during breast surgery. We established a biochemical profile of adipose tissue fatty acids by gas chromatography. We assessed whether there were differences according to breast cancer focality. We found that decreased levels in breast adipose tissue of docosahexaenoic and eicosapentaenoic acids, the two main polyunsaturated n-3 fatty acids of marine origin, were associated with multifocality. These differences in lipid content may contribute to mechanisms through which peritumoral adipose tissue fuels breast cancer multifocality.

  19. [The Clinical and Molecular Characteristics of Adenocarcinoma Presented 
by Multi-focal GGO].

    Science.gov (United States)

    Song, Yang; Liang, Naixin; Li, Shanqing

    2018-03-20

    Due to emphasis on early screening for lung cancer, the detection rate of multiple ground glass opacities (GGOs) on computed tomography (CT) image increases in recent years, and research on multifocal adenocarcinomas presented by GGOs has been thriving. It is more common in women and non-smokers and has excellent prognosis both in patients with natural history and after surgery. These clinical features suggest that it is likely to be a distinct disease entity. From the perspective of molecular genetics, lesions in the same individual are likely to have distinct clonal features. Therefore, genetic heterogeneity is the most prominent feature of multifocal pulmonary adenocarcinomas with GGOs. The genetic heterogeneity is expected to assist the diagnosis of multifocal pulmonary adenocarcinoma and intrapulmonary metastasis, and also suggests that genetic testing of the GGO lesions is of great therapeutic significance. Some GGO lesions may harvest the similar clonal feature, which provide new evidence for the theory of spread through air spaces (STAS).
.

  20. Multi-objective optimization of MOSFETs channel widths and supply voltage in the proposed dual edge-triggered static D flip-flop with minimum average power and delay by using fuzzy non-dominated sorting genetic algorithm-II.

    Science.gov (United States)

    Keivanian, Farshid; Mehrshad, Nasser; Bijari, Abolfazl

    2016-01-01

    D Flip-Flop as a digital circuit can be used as a timing element in many sophisticated circuits. Therefore the optimum performance with the lowest power consumption and acceptable delay time will be critical issue in electronics circuits. The newly proposed Dual-Edge Triggered Static D Flip-Flop circuit layout is defined as a multi-objective optimization problem. For this, an optimum fuzzy inference system with fuzzy rules is proposed to enhance the performance and convergence of non-dominated sorting Genetic Algorithm-II by adaptive control of the exploration and exploitation parameters. By using proposed Fuzzy NSGA-II algorithm, the more optimum values for MOSFET channel widths and power supply are discovered in search space than ordinary NSGA types. What is more, the design parameters involving NMOS and PMOS channel widths and power supply voltage and the performance parameters including average power consumption and propagation delay time are linked. To do this, the required mathematical backgrounds are presented in this study. The optimum values for the design parameters of MOSFETs channel widths and power supply are discovered. Based on them the power delay product quantity (PDP) is 6.32 PJ at 125 MHz Clock Frequency, L = 0.18 µm, and T = 27 °C.

  1. Multifocality in "basal-like" breast carcinomas and its influence on lymph node status.

    Science.gov (United States)

    Tot, Tibor; Pekár, Gyula

    2011-06-01

    Basal-like breast carcinomas often are regarded for circumscribed solitary lesions having unfavorable prognosis. On the other hand, a considerable proportion of breast carcinomas is multifocal and has increased metastatic potential. In this study, we analyzed the subgross distribution of the lesions in a series of basal-like carcinomas, compared it with that in nonbasal-like tumors and studied the frequency of vascular invasion and lymph node metastasis in relation to focality of the lesions. A total of 511 consecutive cases documented in large-format histologic sections were studied. Tumors expressing at least one of the basal (myoepithelial) markers (CK5/6, CK14, EGFR) in at least one of the invasive tumor foci were categorized as basal-like tumors. Triple-negative (ER/PR/HER-2-negative) basal-like carcinomas also were analyzed. The distribution of lesions and the frequency of vascular invasion and lymph node metastasis were analyzed. The study was approved by the Regional Ethical Committee Uppsala-Örebro. In 44% of cases, the invasive component was multifocal or diffuse. Combining the in situ and invasive tumor components resulted in 61% of cases with multifocal/diffuse distribution. The only statistically significant difference observed was that basal-like tumors lacked in situ components more often (21% vs. 9%; P = 0.0075). No significant differences could be demonstrated regarding vascular invasion and lymph node status. Lymph node metastasis appeared significantly more frequently in multifocal cases in both tumor categories. Basal-like breast carcinomas are as frequently multifocal as their non-basal-like counterparts; multifocality is associated with increased risk for vascular invasion and lymph node metastasis in both tumor categories.

  2. The Explicit Determinations Of Dual Plane Curves And Dual Helices In Terms Of Its Dual Curvature And Dual Torsion

    OpenAIRE

    Lee Jae Won; Choi Jin Ho; Jin Dae Ho

    2014-01-01

    In this paper, we give the explicit determinations of dual plane curves, general dual helices and dual slant helices in terms of its dual curvature and dual torsion as a fundamental theory of dual curves in a dual 3-space

  3. Comparison of vision through surface modulated and spatial light modulated multifocal optics.

    Science.gov (United States)

    Vinas, Maria; Dorronsoro, Carlos; Radhakrishnan, Aiswaryah; Benedi-Garcia, Clara; LaVilla, Edward Anthony; Schwiegerling, Jim; Marcos, Susana

    2017-04-01

    Spatial-light-modulators (SLM) are increasingly used as active elements in adaptive optics (AO) systems to simulate optical corrections, in particular multifocal presbyopic corrections. In this study, we compared vision with lathe-manufactured multi-zone (2-4) multifocal, angularly and radially, segmented surfaces and through the same corrections simulated with a SLM in a custom-developed two-active-element AO visual simulator. We found that perceived visual quality measured through real manufactured surfaces and SLM-simulated phase maps corresponded highly. Optical simulations predicted differences in perceived visual quality across different designs at Far distance, but showed some discrepancies at intermediate and near.

  4. Torpedo maculopathy with multifocal central serous chorioretinopathy: A rare case report.

    Science.gov (United States)

    Panigrahi, Pradeep Kumar; Minj, Anita; Satapathy, Jasmita

    2018-02-01

    We present a very rare case of torpedo maculopathy (TM) with multifocal central serous chorioretinopathy. A 26-year-old male presented with painless loss of vision in the right eye of 2 months duration. Clinical examination showed a torpedo-shaped lesion temporal to fovea and subretinal fluid in foveal center. Fluorescein angiography showed multifocal leaks. Optical coherence tomography showed an optically clear space/neurosensory detachment at the site of lesion. Patient underwent focal laser to the leaks. TM is a rare congenital disorder detected accidentally during routine fundus examination. It is usually unilateral and does not affect vision.

  5. Multifocal fibrosclerosis: a new case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Oguz, Kader Karli; Oguz, Oguzhan; Cila, Aysenur; Oto, Aytekin [Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara (Turkey); Kiratli, Hayyam [Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara (Turkey); Gokoz, Aytac [Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara (Turkey)

    2002-05-01

    A case of multifocal fibrosclerosis is presented with MR images. Bilateral sclerosing orbital pseudotumor invading cavernous sinuses were the presenting disorder. Magnetic resonance imaging showed involvement of paranasal sinuses bilaterally and multiple supratentorial dural masses. Retroperitoneal fibrosis was associated with the condition. Multifocal involvement should be considered in patients with sclerosing orbital pseudotumor and an imaging approach should be performed on the appropriate clinical condition to document possible coexistence of other disorders including retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, and Riedel's thyroiditis (orig.)

  6. A Rare Multifocal Pattern of Type 2 Autoimmune Pancreatitis with Negative IgG4: A Potential Diagnostic Pitfall That May Mimic Multifocal Pancreatic Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Partha Hota

    2018-02-01

    Full Text Available Autoimmune pancreatitis (AIP is an increasingly recognized form of acute pancreatitis characterized by obstructive jaundice with a rapid and dramatic treatment response to steroid therapy. Recently, AIP has been divided into two distinct phenotypes: lymphoplasmocytic sclerosing pancreatitis AIP (type 1 and idiopathic duct-centric pancreatitis AIP (type 2; each of which have their own distinct demographics, diagnostic criteria, and histopathological features. We report, to the best of our knowledge, the first case of a multifocal pattern of type 2 AIP characterized with both CT and MR imaging. This rare imaging pattern of AIP may mimic the appearance of more worrisome malignant etiologies such as multifocal pancreatic adenocarcinoma or lymphoma, with overlapping imaging characteristics potentially complicating or delaying diagnosis. Therefore, recognition of this atypical pattern of AIP and avoidance of this potential diagnostic pitfall is crucial.

  7. Drug-induced progressive multifocal leukoencephalopathy: a case/noncase study in the French pharmacovigilance database.

    Science.gov (United States)

    Colin, Olivier; Favrelière, Sylvie; Quillet, Alexandre; Neau, Jean-Philippe; Houeto, Jean-Luc; Lafay-Chebassier, Claire; Pérault-Pochat, Marie-Christine

    2017-04-01

    Progressive multifocal leukoencephalopathy (PML) is an often fatal demyelinating disease of the central nervous system. As effective treatment is unavailable, identification of all drugs that could be associated with PML is essential. The objective of this study was to investigate the putative association of reports of PML and drugs. We used the case/noncase method in the French PharmacoVigilance database (FPVD). Cases were reports of PML in the FPVD between January 2008 and December 2015. Noncases were all other reports during the same period. To assess the association between PML and drug intake, we calculated an adverse drug report odds ratio (ROR) with its 95% confidence interval. We have studied the delay of onset of PML for each drug concerned. Among the 101 cases of PML, 39 drugs were mentioned as suspect. The main therapeutic classes suspected with significant ROR were antineoplastic agents (n = 85), immunosuppressants (n = 67), and corticosteroids. A latent interval from the time of drug initiation to the development of PML is established: the median time to onset was 365 days (123-1095 days). The onset of PML is highly variable and differs among drug classes [from 1 to 96 months (IQR: 39.0-126)]. An association between PML and some immunosuppressant drugs was found as expected, but also with antineoplastic agents and glucocorticoids. An important delay of PML onset after stopping treatment is suspected and should alert prescribers. Prescribers but also patients should be informed about the potential associations with all these drugs. Monitoring could be necessary for many drugs to early detect PML. © 2016 Société Française de Pharmacologie et de Thérapeutique.

  8. Multifocal visual evoked potential in optic neuritis, ischemic optic neuropathy and compressive optic neuropathy

    Directory of Open Access Journals (Sweden)

    Manju Jayaraman

    2014-01-01

    Full Text Available Purpose: To investigate the effect of optic neuritis (ON, ischemic optic neuropathy (ION and compressive optic neuropathy (CON on multifocal visual evoked potential (mfVEP amplitudes and latencies, and to compare the parameters among three optic nerve disorders. Materials and Methods: mfVEP was recorded for 71 eyes of controls and 48 eyes of optic nerve disorders with subgroups of optic neuritis (ON, n = 21 eyes, ischemic optic neuropathy (ION, n = 14 eyes, and compressive optic neuropathy (CON, n = 13 eyes. The size of defect in mfVEP amplitude probability plots and relative latency plots were analyzed. The pattern of the defect in amplitude probability plot was classified according to the visual field profile of optic neuritis treatment trail (ONTT. Results: Median of mfVEP amplitude (log SNR averaged across 60 sectors were reduced in ON (0.17 (0.13-0.33, ION (0.14 (0.12-0.21 and CON (0.21 (0.14-0.30 when compared to controls. The median mfVEP relative latencies compared to controls were significantly prolonged in ON and CON group of 10.53 (2.62-15.50 ms and 5.73 (2.67-14.14 ms respectively compared to ION group (2.06 (-4.09-13.02. The common mfVEP amplitude defects observed in probability plots were diffuse pattern in ON, inferior altitudinal defect in ION and temporal hemianopia in CON eyes. Conclusions: Optic nerve disorders cause reduction in mfVEP amplitudes. The extent of delayed latency noted in ischemic optic neuropathy was significantly lesser compared to subjects with optic neuritis and compressive optic neuropathy. mfVEP amplitudes can be used to objectively assess the topography of the visual field defect.

  9. QCD Dual

    DEFF Research Database (Denmark)

    Sannino, Francesco

    2009-01-01

    We uncover a novel solution of the 't Hooft anomaly matching conditions for QCD. Interestingly in the perturbative regime the new gauge theory, if interpreted as a possible QCD dual, predicts the critical number of flavors above which QCD in the nonperturbative regime, develops an infrared stable...

  10. Effect of Nd:YAG Laser Capsulotomy on Refraction in Multifocal Apodized Diffractive Pseudophakia

    NARCIS (Netherlands)

    Vrijman, Violette; van der Linden, Jan Willem; Nieuwendaal, Carla P.; van der Meulen, Ivanka J. E.; Mourits, Maarten P.; Lapid-Gortzak, Ruth

    2012-01-01

    PURPOSE: To evaluate the effect on refraction of neodymium:YAG (Nd:YAG) laser posterior capsulotomy for posterior capsule opacification (PCO), and to evaluate the correlation between automated and subjective refraction in multifocal apodized diffractive pseudophakia. METHODS: A retrospective study

  11. Effect of Nd:YAG laser capsulotomy on refraction in multifocal apodized diffractive pseudophakia.

    NARCIS (Netherlands)

    Vrijman, V.; Linden, J.W.M. van der; Nieuwendaal, C.P.; Meulen, I.J. van der; Mourits, M.P.; Lapid-Gortzak, R.

    2012-01-01

    PURPOSE: To evaluate the effect on refraction of neodymium:YAG (Nd:YAG) laser posterior capsulotomy for posterior capsule opacification (PCO), and to evaluate the correlation between automated and subjective refraction in multifocal apodized diffractive pseudophakia. METHODS: A retrospective study

  12. Multifocal non-Hodgkin lymphoma in an infant with cardiac involvement: whole-body MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Jyoti; Seith, Ashu; Sharma, Raju; Kumar, Atin [All India Institute of Medical Sciences, Department of Radiology, New Delhi (India); Bakhshi, Sameer [All India Institute of Medical Sciences, Department of Medical Oncology, New Delhi (India)

    2007-03-15

    Non-Hodgkin lymphoma (NHL) is rare in infancy, and we present a case of aggressive NHL of T-cell lineage in an infant with multifocal bone, cardiac, mediastinal nodal, paranasal sinus, calvarial, and soft-tissue deposits on presentation that were detected on whole-body MRI. (orig.)

  13. The value of local treatment in patients with primary, disseminated, multifocal Ewing sarcoma (PDMES)

    NARCIS (Netherlands)

    Haeusler, Julia; Ranft, Andreas; Boelling, Tobias; Gosheger, Georg; Braun-Munzinger, Gabriele; Vieth, Volker; Burdach, Stefan; van den Berg, Henk; Juergens, Heribert; Dirksen, Uta

    2010-01-01

    The value of local treatment in patients with primary, disseminated, multifocal Ewing sarcoma (PDMES) was investigated. We analyzed 120 patients registered into the European Ewing Tumor Working Initiative of National Groups (EURO-E.W.I.N.G. 99) trial at the trial center of Muenster from 1998 to

  14. Primary Disseminated Multifocal Ewing Sarcoma: Results of the Euro-EWING 99 Trial

    NARCIS (Netherlands)

    Ladenstein, Ruth; Pötschger, Ulrike; Le Deley, Marie Cécile; Whelan, Jeremy; Paulussen, Michael; Oberlin, Odile; van den Berg, Henk; Dirksen, Uta; Hjorth, Lars; Michon, Jean; Lewis, Ian; Craft, Alan; Jürgens, Heribert

    2010-01-01

    Purpose To improve the poor prognosis of patients with primary disseminated multifocal Ewing sarcomas (PDMES) with a dose-intense treatment concept. Patients and Methods From 1999 to 2005, 281 patients with PDMES were enrolled onto the Euro-EWING 99 R3 study. Median age was 16.2 years (range, 0.4 to

  15. Exploring the methods of data analysis in multifocal visual evoked potentials

    DEFF Research Database (Denmark)

    Malmqvist, Lasse; Santiago de Abreu, Lucimar; Fraser, C.

    2016-01-01

    Purpose: The multifocal visual evoked potential (mfVEP) provides a topographical assessment of visual function, which has already shown potential for use in patients with glaucoma and multiple sclerosis. However, the variability in mfVEP measurements has limited its broader application. The purpo...

  16. An Unusual Case of Unilateral Multifocal Choroiditis in a Young Male

    African Journals Online (AJOL)

    SRNVM) in macula due to multifocal choroiditis. The SRNVM regressed with repeated intra-vitreal injection of bevacizumab and the visual acuity improved from. 6/24 at presentation to 6/12 after repeated intra-vitreal injections of bevacizumab.

  17. An Unusual Case of Unilateral Multifocal Choroiditis in a Young Male

    African Journals Online (AJOL)

    SRNVM) in macula due to multifocal choroiditis. The SRNVM regressed with repeated intra‑vitreal injection of bevacizumab and the visual acuity improved from 6/24 at presentation to 6/12 after repeated intra‑vitreal injections of bevacizumab.

  18. The spatial resolution of the porcine multifocal electroretinogram for detection of laser-induced retinal lesions

    DEFF Research Database (Denmark)

    Kyhn, Maria Voss; Kiilgaard, Jens Folke; Scherfig, Erik

    2008-01-01

    This study aimed to investigate the spatial resolution of a porcine multifocal electroretinogram (mfERG) protocol by testing its ability to detect laser-induced retinal lesions. Furthermore, we wanted to describe time-dependent changes in implicit time and amplitude of the different mfERG peaks...

  19. Late hemodynamic failure following percutaneous transluminal angioplasty for long and multifocal femoropopliteal stenoses

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Holstein, P

    1991-01-01

    separate segments were dilated. Following 98% initial technical success, 3-year patency was 68% for single short stenoses, as opposed to 20% for long and multifocal stenoses (p = 0.05, logrank test). Antiplatelet therapy with acetylsalicyclic acid was not found to influence occurrence of restenosis...

  20. Correction to: Progressive multifocal leukoencephalopathy in rituximab-treated rheumatic diseases: a rare event.

    Science.gov (United States)

    Berger, Joseph R; Malik, Vineeta; Lacey, Stuart; Brunetta, Paul; Lehane, Patricia B

    2018-04-10

    The article "Progressive multifocal leukoencephalopathy in rituximab-treated rheumatic diseases: a rare event," written by Joseph R. Berger, Vineeta Malik, Stuart Lacey, Paul Brunetta, and Patricia B. Lehane 3 , was originally published electronically on the publisher's internet portal (currently SpringerLink).

  1. Multifocal osteolysis following limb-sparing procedures: imaging findings and a review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Kaste, S.C. [Diagnostic Imaging, St. Jude`s Children`s Research Hospital, 332 N. Lauderdale, Memphis, TN 38101 (United States)]|[Department of Radiology, University of Tennessee, Memphis, TN (United States); Rao, B.N. [Department of Surgery, St. Jude`s Children`s Research Hospital, Memphis, TN (United States)]|[Department of Surgery, University of Tennessee, Memphis, TN (United States); Lynch, M.H. [Department of Surgery, St. Jude`s Children`s Research Hospital, Memphis, TN (United States)]|[Department of Surgery, Methodist Hospitals, Memphis, TN (United States); Parham, D.M. [Department of Pathology and Laboratory Medicine, St. Jude`s Children`s Research, Hospital, Memphis, TN (United States)]|[Department of Pathology, University of Tennessee, Memphis, TN (United States); Meyer, W.H. [Department of Hematology Oncology, St. Jude`s Children`s Research Hospital, Memphis, TN (United States)]|[Department of Pediatrics, University of Tennessee, Memphis, TN (United States)

    1996-02-01

    Limb-sparing procedures utilizing endoprostheses improve both the quality of life and functional level of patients treated for primary bone sarcomas. Herein, we present the imaging findings of an uncommon cause of prosthetic failure, i. e., foreign body reaction, manifested by progressive multifocal osteolysis along the prosthetic femoral shaft. (orig.). With 3 figs.

  2. Effect of Unifocal versus Multifocal Lenses on Cervical Spine Posture in Patients with Presbyopia.

    Science.gov (United States)

    Abbas, Rami L; Houri, Mohamad T; Rayyan, Mohammad M; Hamada, Hamada Ahmad; Saab, Ibtissam M

    2018-04-04

    There are many environmental considerations which may or may not lead to the development of faulty cervical mechanics. The design of near vision lenses could contribute to the development of such cervical dysfunction and consequently neck pain. Decision making regarding proper type of lens prescription seems important for presbyopic individuals. To investigate the effect of unifocal and multifocal lenses on cervical posture. Thirty subjects (18 females and 12 males) participated in the study with an age range from 40 to 64 years. Each subject wore consequently both unifocal and multifocal lenses randomly while reading. Then lateral cervical spine X-ray films were taken for each subject during each lens wearing. X-ray films were analyzed with digital software (Autocad software, 2 D) to measure segmental angles of the cervical vertebrae (Occiput/C1, C1/C2, C2/C3, C3/C4, C4/C5, C5/C6, C6/C7, C3/C7, C0/C3, and occiput/C7). Higher significant extension angle in the segments C0/C7, C1/C2, C5/C6, C6/C7, and C3/C7 (p<0.05) during multifocal lenses wearing were observed in contrast with higher flexion angle between C3/C4 and C4/C5 (p<0.05) with unifocal lenses wear. Multifocal lens spectacles produces increased extension in the cervical vertebrae angles when compared with the use of unifocal lenses.

  3. Dual Entwining Structures and Dual Entwined Modules

    OpenAIRE

    Abuhlail, Jawad Y.

    2003-01-01

    In this note we introduce and investigate the concepts of dual entwining structures and dual entwined modules. This generalizes the concepts of dual Doi-Koppinen structures and dual Doi-Koppinen modules introduced (in the infinite case over rings) by the author is his dissertation.

  4. The DUAL mission concept

    Science.gov (United States)

    von Ballmoos, Peter; Alvarez, Jose; Barriere, Nicolas; Boggs, Steve; Bykov, Andrei; Del Cura Velayos, Juan Manuel; Frontera, Filippo; Hanlon, Lorraine; Hernanz, Margarita; Hinglais, Emmanuel; Isern, Jordi; Jean, Pierre; Knödlseder, Jürgen; Kuiper, Lucien; Leising, Mark; Pirard, Benoît; Prost, Jean-Pierre; da Silva, Rui; Takahashi, Tadayuki; Tomsick, John; Walter, Roland; Zoglauer, Andreas

    2011-09-01

    DUAL will study the origin and evolution of the elements and explores new frontiers of physics: extreme energies that drive powerful stellar explosions and accelerate particles to macroscopic energies; extreme densities that modify the laws of physics around the most compact objects known; and extreme fields that influence matter in a way that is unknown on Earth. The variability of these extreme objects requires continuous all-sky coverage, while detailed study demands an improvement in sensitivity over previous technologies by at least an order of magnitude. The DUAL payload is composed of an All-Sky Compton Imager (ASCI), and two optical modules, the Laue-Lens Optic (LLO) and the Coded-Mask Optic (CMO). The ASCI serves dual roles simultaneously, both as an optimal focal-plane sensor for deep observations with the optical modules and as a sensitive true all-sky telescope in its own right for all-sky surveys and monitoring. While the optical modules are located on the main satellite, the All-Sky Compton Imager is situated on a deployable structure at a distance of 30 m from the satellite. This configuration not only permits to maintain the less massive payload at the focal distance, it also greatly reduces the spacecraft-induced detector background, and, above all it provides ASCI with a continuous all-sky exposure.

  5. Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

    Directory of Open Access Journals (Sweden)

    Kassi Komenan

    2013-01-01

    Full Text Available Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune reconstitution inflammatory syndrome (IRIS occurrence and Mycobacterium dissemination. The deep immune depression, the underline biological, and clinical disorders of the patient might contribute to IRIS occurrence and Buruli ulcer dissemination. Future investigations have to be conducted on the mechanism of IRIS on set and on Mycobacterium ulcerans dissemination after ARV drugs initiation and the patient related underline clinical or biological disorders.

  6. Brucella spondylodiscitis: Multifocal involvement in thoracic and lumbar areas; a rare case

    Directory of Open Access Journals (Sweden)

    Pınar Korkmaz

    2015-09-01

    Full Text Available Brucellosis is a zoonosis that can affect many organs or systems. Musculoskeletal system is the most commonly affected site in brucellosis and the frequency of musculoskeletal system involvement varies between 2% and 53%. Multifocal spinal involvement is rare. Here, it was aimed to present our case with brucellar spondylodiscitis involving the thoracic and lumbar regions simultaneously. MRI is a useful imaging method in the diagnosis of multifocal spinal infection caused by brucellosis. Especially in endemic regions, at least two serological tests should be used in the diagnosis of brucellosis. Brucellosis should be absolutely kept in mind for the differential diagnosis of the lderly patients with complaint of longstanding thoracic and back pain in the regions where brucellosis is endemic. J Microbiol Infect Dis 2015;5(3: 129-132

  7. Optical implementation of multifocal programmable lens with single and multiple axes

    Science.gov (United States)

    Romero, Lenny A.; Millán, María S.; Pérez-Cabré, Elisabet

    2011-01-01

    In this work we analyse the generation of a diffractive optical element (DOE) consisting of a multifocal Fresnel lens by means of an LCoS (liquid cristal on silicon) spatial light modulator (SLM). The multifocal lens is composed of a set of lenses of different focal length that share a common optical axis (coaxial combination) or have different axes in parallel (multi-axis combination). For both configurations, we present several ways to combine the phase distributions for three lenses with different focal lengths (f1, f2, f3), into a single-phase distribution addressed to the SLM. Numerical simulations were carried out along with the experimental analysis to corroborate the results.

  8. An adult multifocal medulloblastoma with diffuse acute postoperative cerebellar swelling: immunohistochemical and molecular genetics analysis.

    Science.gov (United States)

    Balik, Vladimir; Trojanec, Radek; Holzerova, Milena; Tuckova, Lucie; Sulla, Igor; Megova, Magdalena; Vaverka, Miroslav; Hrabalek, Lumir; Ehrmann, Jiri

    2015-01-01

    Medulloblastoma (MB), the most common malignant tumor typically affecting children, occurs only exceptionally in adults. Multifocal presentation of this malignancy in adulthood is even much rarer—only four cases with favorable postoperative course have been reported, so far. The study illustrates a very rare rapid postoperative clinical deterioration due to diffuse cerebellar swelling (DCS) in an adult multifocal MB (MMB). To the best of their knowledge, authors for the first time performed genetic analysis of MMB and demonstrated expression patterns of selected markers that put the patient within the sonic hedgehog (SHH) molecular subgroup and at least partially explain her unsatisfactory clinical course. Herein, authors summarized the relevant literature concerning this issue with the aim to determine features that would facilitate diagnosis and therapy of such a scarce clinical entity.

  9. Test-retest reliability and inter-ocular symmetry of multi-focal electroretinography in Stargardt disease.

    Science.gov (United States)

    Tosha, Chinatsu; Gorin, Michael B; Nusinowitz, Steven

    2010-01-01

    To evaluate test-retest reliability and inter-ocular symmetry of multi-focal electroretinography recordings in Stargardt disease and in patients without retinal pathology. Multi-focal electroretinography were recorded with continuous fundus monitoring using the VERIS multifocal recording system using an array of 103 hexagons spanning 50 degrees of central retina. Recordings were made sequentially from one eye (test-retest) followed by recordings from the fellow eye. A departure score, expressed as a percentage difference from the first recording (or from the fellow eye), was calculated for each comparison and parameter. Multi-focal electroretinography response topographies were similar within and between eyes for a particular individual and parameter. However, local response variability within and between eyes was significantly higher in Stargardt disease than in patients without retinal pathology for both amplitude and timing parameters. Amplitude variability in Stargardt disease decreased with more peripheral targets and with larger stimuli but never to the levels achieved with normal observers. Both test-retest reliability and inter-ocular symmetry of multi-focal electroretinography responses were significantly lower in Stargardt disease compared to normal eyes, a finding attributable primarily to unsteady fixation. The greater variability between eyes in Stargardt disease may also reflect pathological differences in the topography of retinal function. This inherent variability must be taken into consideration if the multi-focal electroretinography is to be sufficiently sensitive to reliably detect small differences in retinal function.

  10. Comprehensive treatment of a functional pancreatic neuroendocrine tumor with multifocal liver metastases

    OpenAIRE

    Wang, Wei; Seeruttun, Sharvesh Raj; Fang, Cheng; Zhou, Zhiwei

    2014-01-01

    A 64-year-old man was admitted to the Sun Yat-Sen University Cancer Center with chief complaints of recurrent abdominal pain and diarrhea for about 3 years and with a history of surgical repair for intestinal perforation owing to stress ulcer. Positron emission tomography (PET)/computed tomography (CT) demonstrated a primary tumor on the pancreatic tail with multifocal liver metastases. Pathological and immunohistochemistry staining revealed the lesion to be a pancreatic neuroendocrine tumor ...

  11. Multi-focal lobular carcinoma in situ arising in benign phylodes tumor: A case report

    International Nuclear Information System (INIS)

    Lee, Taeg Ki; Choi, Chang Hwan; Kim, Youn Jeong; Kim, Mi Young; Lee, Kyung Hee; Cho, Soon Gu

    2015-01-01

    Coexistent breast malignancy arising in phyllodes tumor is extremely rare, and most of them are incidental reports after surgical excision. Coexistent malignancy in phyllodes tumor can vary from in-situ to invasive carcinoma. Lobular neoplasia is separated into atypical lobular hyperplasia and lobular carcinoma in situ (LCIS). LCIS is known to have a higher risk of developing invasive cancer. We reported imaging findings of multifocal LCIS arising in benign phyllodes tumor

  12. Multi-focal lobular carcinoma in situ arising in benign phylodes tumor: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Taeg Ki; Choi, Chang Hwan; Kim, Youn Jeong; Kim, Mi Young; Lee, Kyung Hee; Cho, Soon Gu [Inha University Hospital, Incheon (Korea, Republic of)

    2015-08-15

    Coexistent breast malignancy arising in phyllodes tumor is extremely rare, and most of them are incidental reports after surgical excision. Coexistent malignancy in phyllodes tumor can vary from in-situ to invasive carcinoma. Lobular neoplasia is separated into atypical lobular hyperplasia and lobular carcinoma in situ (LCIS). LCIS is known to have a higher risk of developing invasive cancer. We reported imaging findings of multifocal LCIS arising in benign phyllodes tumor.

  13. [Relationship between coeliac disease and multifocal tuberculosis: about a case and literature review].

    Science.gov (United States)

    Sarghini, Khadija; Oubaha, Sofia; Samlani, Zouhour; Krati, Khadija

    2017-01-01

    Coeliac disease is an autoimmune enteropathy related to gluten intolerance which occurs in subjects genetically disposed. The diagnosis is based on the combination of clinical biological and histological arguments. It is associated with many complications, including lymphoma. The risk of tuberculosis in patients with coeliac disease is increased. Several hypotheses explaining this association have been discussed. We report a case of coeliac disease associated with multifocal tuberculosis in a 17-year old patient.

  14. Strategy in Regulatory Decision-Making for Management of Progressive Multifocal Leukoencephalopathy

    DEFF Research Database (Denmark)

    Segec, A; Keller-Stanislawski, B; Vermeer, N S

    2015-01-01

    Progressive multifocal leukoencephalopathy (PML) has been observed after the use of several medicines, including monoclonal antibodies. As these drugs play important roles in the therapeutic armamentarium, it is important to address the challenges that this severe adverse reaction poses to the sa...... use of medicines. Considering the need for consistent outcomes of regulatory decisions, the European Medicines Agency Pharmacovigilance Risk Assessment Committee (PRAC) used PML as an example to develop a systematic approach to labeling and risk minimization....

  15. Progressive multifocal leukoence-phalopathy presenting as homonymous hemianopia in a patient with acquired immunodeficiency syndrome

    Directory of Open Access Journals (Sweden)

    Amit Pandey

    2012-01-01

    Full Text Available We present a case of a Human Immunodeficiency Virus (HIV positive patient who was referred for retinal evaluation to rule out ophthalmic manifestations of Acquired Immunodeficiency Syndrome (AIDS. She complained of some disturbance in vision in both eyes. Fundus examination showed no abnormality. Perimetry, done to rule out optic nerve pathology, showed a left homonymous hemianopia. Magnetic Resonance Imaging (MRI scan showed features of Progressive Multifocal Leukoencephalopathy (PML. She had no other neurological symptoms or signs.

  16. Risk stratification for progressive multifocal leukoencephalopathy in patients treated with natalizumab

    DEFF Research Database (Denmark)

    Sørensen, Per Soelberg; Bertolotto, Antonio; Edan, Gilles

    2012-01-01

    Natalizumab is a highly effective immunomodulator in the treatment of multiple sclerosis (MS). Treatment with natalizumab has been associated with progressive multifocal leukoencephalopathy (PML), an infection of the central nervous system (CNS) caused by a pathogenic form of the normally benign JC...... facilitate benefit-risk discussions between health care professionals and patients. Continued research and data collection will further develop our understanding of PML and the mechanisms by which these risk factors contribute to its development....

  17. Quality of life evaluation after implantation of 2 multifocal intraocular lens models and a monofocal model.

    Science.gov (United States)

    Alió, Jorge L; Plaza-Puche, Ana B; Piñero, David P; Amparo, Francisco; Rodríguez-Prats, Jose L; Ayala, María José

    2011-04-01

    To compare vision-related quality of life using the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) in patients with 1 of 3 types of intraocular lenses (IOLs) and to correlate it with postoperative visual outcomes. Vissum Corporation-Instituto Oftalmológico de Alicante, Alicante, Spain. Comparative case series. This study comprised eyes having cataract surgery with bilateral implantation of a monofocal IOL (Group A), apodized multifocal IOL (Group B), or full diffractive multifocal IOL (Group C). Distance and near visual acuities, contrast sensitivity, and quality of life were evaluated preoperatively and postoperatively. The study enrolled 106 eyes (53 patients; age range 49 to 80 years). All groups had significant improvement in uncorrected and corrected distance visual acuities postoperatively (P ≤.05). Near vision outcomes were significantly better in Groups B and C (P ≤.01). Groups B and C had significantly less difficulty in some near tasks, such as reading the newspaper (A-B, P=.02; A-C, P=.02) or reading bills (A-B, P=.04; A-C, P=.004). Group C also had significantly less difficulty driving at night than Group B (P<.01). Near visual acuity and contrast sensitivity were significantly correlated with difficulty in near visual tasks in Groups B and C. Night-driving difficulty correlated significantly with contrast sensitivity in Group B. Patients with multifocal IOLs could perform several daily tasks at near and intermediate distances, with less night-driving limitation with the full diffractive IOL than with apodized multifocal and monofocal IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. Multifocal electroretinogram for functional evaluation of retinal injury following ischemia-reperfusion in pigs

    DEFF Research Database (Denmark)

    Morén, Håkan; Gesslein, Bodil; Andreasson, Sten

    2010-01-01

    Multifocal electroretinogram (mfERG) has the power to discriminate between localized functional losses and overall retinal changes when evaluating retinal injury. So far, full-field ERG has been the gold standard for examining retinal ischemia and the effects of different neuroprotectants...... in experimental conditions. The aim of the present study was to establish mfERG, with simultaneous fundus monitoring, for analyzing the localized functional response in the retina after ischemia-reperfusion in the porcine eye....

  19. Peripheral refraction with dominant design multifocal contact lenses in young myopes

    Directory of Open Access Journals (Sweden)

    Daniela Lopes-Ferreira

    2013-04-01

    Conclusion: It is possible to induce significant changes in the pattern of relative peripheral refraction in the myopic direction with commercially available dominant design multifocal contact lenses. The higher add (+3.00 D induced an significantly higher effect than the +2.00 D add lens, although an increase of 1 D in add power does not correspond to the same amount of increase in RPRE.

  20. Capecitabine Induced Multifocal Leukoencephalopathy: Do We Have Always to Switch off the Chemotherapy?

    Directory of Open Access Journals (Sweden)

    Anastasia Bougea

    2016-01-01

    Full Text Available Capecitabine is a well tolerated and safe 5-fluorouracil agent for adjuvant, neoadjuvant chemotherapy or metastatic cases. Neurological side effects require discontinuation of chemotherapy. We report this unique case of a 50-year-old female, who presented an isolated episode of dysarthria and ataxia under bevacizumab, capecitabine, and oxaliplatin treatment due to reversible multifocal leukoencephalopathy that did not recur after readministration of chemotherapy.

  1. Recurrent multifocal cutaneous Kaposiform hemangioendothelioma: A rare vascular tumor of infancy and childhood

    Directory of Open Access Journals (Sweden)

    Bhagyalakshmi Atla

    2016-01-01

    Full Text Available Kaposiform hemangioendothelioma (KHE is a locally aggressive vascular tumor of childhood although cases occurring in adulthood are also described. The features overlap with juvenile capillary hemangioma and Kaposi sarcoma. We report a rare case of recurrent, multifocal (nose and chin cutaneous KHE initially occurring in a 3-year-old female child, uncomplicated by Kasabach–Merritt syndrome. Recurrences occurred over the next 6 years and resulted in complete distortion of the nose, requiring plastic repair.

  2. Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O' Donovan, Raquel, E-mail: goncalves.neuroradio@gmail.com [McGill University Health Center Montreal General Hospital (Canada)

    2011-11-15

    Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

  3. Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O'Donovan, Raquel

    2011-01-01

    Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

  4. Successful medical management of a domestic longhair cat with subdural intracranial empyema and multifocal pneumonia.

    Science.gov (United States)

    Cardy, Thomas J A; Lam, Richard; Peters, Laureen M; McLaren, Philippa J; Matas Riera, Màrian; De Decker, Steven

    2017-03-01

    To describe a case of successful medical management of subdural intracranial empyema and multifocal pneumonia in a domestic longhaired cat. A 7-year-and-8-month-old male neutered domestic longhair cat presented with tachypnea, respiratory compromise, vestibular ataxia, obtundation, left-sided head tilt, and multiple cranial nerve deficits. Neuroanatomical localization was multifocal with central vestibular involvement. Magnetic resonance imaging of the head indicated diffuse subdural empyema, mainly affecting the middle cranial fossa and the right cerebrum. Analysis of cerebrospinal fluid revealed degenerate neutrophils with a mixed population of intracellular bacilli. Computed tomography (CT) of the thorax was suggestive for multifocal pneumonia. Aggressive medical management with IV fluids, oxygen supplementation, mannitol boluses, dexamethasone, and broad-spectrum antimicrobials was initiated. The cat demonstrated gradual improvement within 24 hours following initiation of treatment. General physical and neurological examinations, 9 weeks after initiating treatment, did not reveal any abnormalities. A CT examination performed at this time revealed resolution of the cat's pulmonary lesions. The cat was still free of clinical signs, 9 months after treatment was started. Subdural empyema is infrequently reported in cats and has high mortality rates even following surgical treatment. To the authors' knowledge, this is the first reported case of successful medical management of a cat with subdural empyema and suggests that aggressive medical management should be attempted in cats that are not considered surgical candidates. © Veterinary Emergency and Critical Care Society 2017.

  5. N-3 Polyunsaturated Fatty Acids of Marine Origin and Multifocality in Human Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Lobna Ouldamer

    Full Text Available The microenvironment of breast epithelial tissue may contribute to the clinical expression of breast cancer. Breast epithelial tissue, whether healthy or tumoral, is directly in contact with fat cells, which in turn could influence tumor multifocality. In this pilot study we investigated whether the fatty acid composition of breast adipose tissue differed according to breast cancer focality.Twenty-three consecutive women presenting with non-metastatic breast cancer underwent breast-imaging procedures including Magnetic Resonance Imaging prior to treatment. Breast adipose tissue specimens were collected during breast surgery. We established a biochemical profile of adipose tissue fatty acids by gas chromatography. We assessed whether there were differences according to breast cancer focality.We found that decreased levels in breast adipose tissue of docosahexaenoic and eicosapentaenoic acids, the two main polyunsaturated n-3 fatty acids of marine origin, were associated with multifocality.These differences in lipid content may contribute to mechanisms through which peritumoral adipose tissue fuels breast cancer multifocality.

  6. Some properties of dual and approximate dual of fusion frames

    OpenAIRE

    Arefijamaal, Ali Akbar; Neyshaburi, Fahimeh Arabyani

    2016-01-01

    In this paper we extend the notion of approximate dual to fusion frames and present some approaches to obtain dual and approximate alternate dual fusion frames. Also, we study the stability of dual and approximate alternate dual fusion frames.

  7. Object and Objective Lost?

    DEFF Research Database (Denmark)

    Lopdrup-Hjorth, Thomas

    2015-01-01

    This paper explores the erosion and problematization of ‘the organization’ as a demarcated entity. Utilizing Foucault's reflections on ‘state-phobia’ as a source of inspiration, I show how an organization-phobia has gained a hold within Organization Theory (OT). By attending to the history...... of this organization-phobia, the paper argues that OT has become increasingly incapable of speaking about its core object. I show how organizations went from being conceptualized as entities of major importance to becoming theoretically deconstructed and associated with all kinds of ills. Through this history......, organizations as distinct entities have been rendered so problematic that they have gradually come to be removed from the center of OT. The costs of this have been rather significant. Besides undermining the grounds that gave OT intellectual credibility and legitimacy to begin with, the organization-phobia...

  8. Outcomes of excimer laser enhancements in pseudophakic patients with multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Schallhorn SC

    2016-04-01

    Full Text Available Steven C Schallhorn,1–3 Jan A Venter,2 David Teenan,2 Julie M Schallhorn,3 Keith A Hettinger,2 Stephen J Hannan,2 Martina Pelouskova2 1Department of Ophthalmology, University of California, San Francisco, CA, USA; 2Optical Express, Glasgow, UK; 3Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA Purpose: The aim of this study was to assess visual and refractive outcomes of laser vision correction (LVC to correct residual refraction after multifocal intraocular lens (IOL implantation. Patients and methods: In this retrospective study, 782 eyes that underwent LVC to correct unintended ametropia after multifocal IOL implantation were evaluated. Of all multifocal lenses implanted during primary procedure, 98.7% were refractive and 1.3% had a diffractive design. All eyes were treated with VISX STAR S4 IR excimer laser using a convectional ablation profile. Refractive outcomes, visual acuities, patient satisfaction, and quality of life were evaluated at the last available visit. Results: The mean time between enhancement and last visit was 6.3±4.4 months. Manifest spherical equivalent changed from -0.02±0.83 D (-3.38 D to +2.25 D pre-enhancement to 0.00±0.34 D (-1.38 D to +1.25 D post-enhancement. At the last follow-up, the percentage of eyes within 0.50 D and 1.00 D of emmetropia was 90.4% and 99.5%, respectively. Of all eyes, 74.9% achieved monocular uncorrected distance visual acuity 20/20 or better. The mean corrected distance visual acuity remained the same before (-0.04±0.06 logMAR [logarithm of the minimum angle of resolution] and after LVC procedure (-0.04±0.07 logMAR; P=0.70. There was a slight improvement in visual phenomena (starburst, halo, glare, ghosting/double vision following the enhancement. No sight-threatening complications related to LVC occurred in this study. Conclusion: LVC in pseudophakic patients with multifocal IOL was safe, effective, and predictable in a large cohort of

  9. Human papillomavirus 13 in a Mexican Mayan community with multifocal epithelial hyperplasia: could saliva be involved in household transmission?

    Science.gov (United States)

    Lopez-Villanueva, Maria Eugenia; Conde-Ferráez, Laura; Ayora-Talavera, Guadalupe; Cerón-Espinosa, Jose D; González-Losa, Maria del Refugio

    2011-01-01

    Multifocal epithelial hyperplasia (MEH) is a disease of the oral mucosa. Human papillomaviruses 13 and 32 have been detected in these lesions. We describe the epidemiology and clinical characteristics of patients with MEH in a rural community in the Mayan area of Mexico with 53 cases and 54 controls. Clinical and epidemiological data were collected through a direct interview. Oral cell samples were collected with a cytobrush. Subjects collected their own saliva sample in a sterile bottle. All samples were tested for HPV 13 and 32 by polymerase chain reaction using specific primers. Of the 53 patients and 54 healthy subjects, 56% were jugal mucosa, and tongue, 96% had multiple lesions. From 53 patients, fifty samples of oral cells and 31 samples of saliva were analyzed. HPV 13 was detected in 100% oral cell and 100% saliva samples studied. 16 healthy subjects were HVP 13 positive. A highly significant association of HPV 13 infection and MEH was found, as determined by chi square test (p = 0.00) Household transmission of HPV 13 may happen through saliva and the shared use of contaminated objects.

  10. Diagnosis of dual human immunodeficiency virus types 1 & 2 ...

    African Journals Online (AJOL)

    Background: The presence of dual HlV-l/HIV-2 infection in Ghana and the different drug requirements for the treatment of HlV-1 and HIV-2 presents difficulties for the treatment of dual infections with both viruses. Objectives: To determine the prevalence of the dual sero-positive profile in treatment naive patients at a principal ...

  11. Fatores técnicos intervenientes na realização do exame de eletrorretinograma multifocal (ERGmf Technical factors that influence multifocal electroretinogram (mfERG recording

    Directory of Open Access Journals (Sweden)

    Maria Kiyoko Oyamada

    2007-08-01

    Full Text Available OBJETIVO: Descrever os principais fatores intervenientes observados durante a aquisição e análise do exame de eletrorretinograma multifocal (ERGmf, que afetam o registro gráfico das ondas obtidas e portanto sua análise. MÉTODOS: Análise dos fatores de erro observados durante a aquisição de 100 exames seqüenciais de eletrorretinograma multifocal, realizados com o Reti System da Roland Consult, no período de maio a julho de 2005. Os exames de eletrorretinograma multifocal foram realizados conforme recomendações internacionais, respeitando-se os parâmetros preestabelecidos do equipamento, com 61 elementos, e ângulo visual de 30º. Todos os pacientes foram submetidos à avaliação oftalmológica completa, excluindo-se aqueles com transparência inadequada de meios, córneas planas e os incapazes de visualizar as linhas de fixação. RESULTADOS: Os fatores intervenientes, que poderiam causar erros na interpretação dos resultados obtidos, observados e corrigidos durante a realização dos exames foram: fixação excêntrica, movimentação dos olhos, contração do orbicular, contração da musculatura cervical, não-correção adequada, não-transparência adequada do eletrodo corneano, deslocamento do eletrodo em geral para baixo, descentralização do suporte da lente corretora, distância inadequada paciente-monitor em pacientes com alta ametropia, altura inadequada dos olhos em relação ao centro da tela, ruído na freqüência de 60 HZ (rede elétrica e de campo eletromagnético, impedâncias elevadas. No processamento das ondas, a utilização excessiva de filtros para remoção de ruídos dos registros obtidos, pode interferir na análise dos resultados obtidos. CONCLUSÕES: Cuidados simplesmente observacionais durante a aquisição dos sinais são de importância significativa para a obtenção de registros com boa morfologia e baixo nível de ruído. Permitindo, por meio de sua pronta correção, a análise correta e

  12. Renal Function Outcomes for Multifocal Renal Neoplasms Managed by Radiofrequency Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Pushpender, E-mail: pugupta@wakehealth.edu; Allen, Brian C., E-mail: bcallen2@wakehealth.edu; Chen, Michael Y., E-mail: mchen@wakehealth.edu; Childs, David D., E-mail: dchilds@wakehealth.edu; Kota, Gopi, E-mail: gkota@wakehealth.edu; Zagoria, Ronald J., E-mail: rzagoria@wakehealth.edu [Wake Forest University School of Medicine, Department of Radiology (United States)

    2013-10-15

    Purpose: To evaluate renal function changes related to radiofrequency ablation (RFA) for the treatment of multifocal renal neoplasms. Methods: This is an institutional review board-approved, Health Insurance Portability and Accountability Act compliant retrospective study of all patients treated with computed tomography guided RFA for multifocal renal neoplasms at one institution. Fifty-seven subjects, mean age 70 (range 37-88) years, underwent RFA of 169 renal neoplasms (average size 2.0 cm). Subjects had between 2 and 8 (mean 2.96) neoplasms ablated. Estimated glomerular filtration rate (eGFR) was measured before and after RFA. Complications related to RFA were recorded. Results: eGFR decreased on average of 4.4 % per tumor treated and 6.7 % per ablation session (average 1.76 tumors treated per session). For subjects with the largest neoplasm measuring >3 cm, eGFR decreased an average of 14.5 % during the course of their treatment. If the largest neoplasm measured 2-3 cm, eGFR decreased an average of 7.7 %, and if the largest neoplasm measured <2 cm, eGFR decreased an average of 3.8 %. Subjects with reduced baseline renal function were more likely to have a greater decline in eGFR after RFA. There was a minor complication rate of 6.3 % (6 of 96 sessions), none of which required treatment, and a major complication rate of 4.2 % (4 of 96 sessions). Conclusion: RFA for the treatment of multifocal renal neoplasms results in mild decline of renal function.

  13. Nerve ultrasound as follow-up tool in treated multifocal motor neuropathy.

    Science.gov (United States)

    Rattay, T W; Winter, N; Décard, B F; Dammeier, N M; Härtig, F; Ceanga, M; Axer, H; Grimm, A

    2017-09-01

    High-resolution ultrasound is a valuable tool in supporting the diagnosis of multifocal motor neuropathy (MMN) but longitudinal data under therapy are lacking. The change in peripheral nerve ultrasound pattern in patients with MMN was assessed over time. Patients with MMN received a thorough initial examination and follow-up over a period of 6-12 months using high-resolution ultrasound of the cervical roots and the nerves of the arms and legs, nerve conduction studies, Medical Research Council Sum Score (MRCSS) and Rotterdam Inflammatory Neuropathy Cause and Treatment Group (INCAT) score to evaluate changes under treatment. The Ultrasound Pattern Sum Score (UPSS) was used as standardized peripheral nerve ultrasound protocol. Seventeen patients with MMN received initial examinations of whom 12 were successfully followed up. All patients with MMN showed at least localized but often multifocal peripheral nerve enlargement. An enlarged overall cross-sectional area as well as enlarged single fascicles (>3 mm²) in clinically and electrophysiologically affected (>90%) and unaffected (>70%) nerves were found. The UPSS did not correlate with clinical disability at both visits. However, the change in clinical disability (evaluated as difference in MRCSS) and the change in UPSS correlated significantly inversely (P = 0.004). High-resolution sonography of peripheral nerves revealed multifocal nerve enlargement in MMN. Distinct enlargement patterns may support the diagnosis. Ultrasound findings did not correlate well with clinical severity or electrophysiological findings at initial presentation. As changes in UPSS correlated significantly with the clinical course in terms of muscle strength (MRCSS), sonographic assessment may represent a useful tool for therapeutic monitoring. © 2017 EAN.

  14. Varicella-zoster virus vasculopathy. A review description of a new case with multifocal brain hemorrhage.

    Science.gov (United States)

    González-Suárez, Inés; Fuentes-Gimeno, Blanca; Ruiz-Ares, Gerardo; Martínez-Sánchez, Patricia; Diez-Tejedor, Exuperio

    2014-03-15

    The varicella zoster virus (VZV) is a highly neurotropic virus that, after the primary infection, remains latent in the nerve cells and can reactivate many years later, resulting in various conditions affecting the central nervous system, such as vasculopathy and stroke. We report on a review of the published literature that included all case reports identified via PubMed and an additional unpublished case of VZV vasculopathy. All epidemiological, clinical, laboratory, imaging, virologic, treatment and outcome data collected are described. Of the 62 patients, 41.6% were immunocompromised. Ischemic stroke occurred in 77.2% of the patients, comprising cases of isolated (37.1%) and multifocal stroke (17.7%). Multifocal, ischemic and hemorrhagic stroke was only described in the newly reported case. The magnetic resonance imaging results were normal in 2.9% of the cases. The vascular studies (angiography and magnetic resonance angiography [MRA]) revealed signs of angiitis in 74.4% of the cases; the small arteries were involved in 38.5% of the cases, large arteries in 17.7% and mixed in 43.5%. For 95.2% of the patients, the cerebrospinal fluid (CSF) was positive for VZV IgG antibodies, and for 46.1% of the patients, the CSF was positive for polymerase chain reaction (PCR); however, the diagnosis was confirmed in only 3 of 6 biopsies. VZV vasculopathy can occur in both immunocompetent and immunosuppressed patients. Neuroimaging can reveal stroke and angiitis, and the detection of VZV-specific IgG antibodies in the CSF is a reliable and highly sensitive diagnostic tool. The multifocal nature of VZV vasculopathy makes biopsy a test with low sensitivity and high morbidity. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Multifocal T4 non-small cell lung cancer: a subset with improved prognosis.

    Science.gov (United States)

    Trousse, Delphine; D'Journo, Xavier Benoît; Avaro, Jean-Philippe; Doddoli, Christophe; Giudicelli, Roger; Fuentes, Pierre Antoine; Thomas, Pascal Alexandre

    2008-01-01

    T4-disease for non-small cell lung cancer (NSCLC) includes different conditions: mediastinal invasion, neoplastic pleural cytology, and multifocal disease in the same lobe; regarding the last category, no strict criteria allow to differentiate satellite nodules from synchronous multiple primary tumours. Retrospective study of 56 patients who underwent a complete resection from 1985 to 2006 of a NSCLC graded pT4N0 due to multifocal disease. A small nodule (satellite nodule (pT4sn). Multiple tumours, sized more than 1cm, with an identical histology, located in the same lobe but in different segment were considered as synchronous cancers (pT4sc). There were 44 males and 12 females: 35 patients were graded T4sn and 21 patients T4sc. The median age was 62.5 years. The two groups were similar for sex, age, tobacco consumption, ASA score, NYHA, Charlson's index, spirometric parameters, cardiovascular comorbidity and history of previous extra-thoracic malignancies. All had a complete anatomic resection with mediastinal lymphadenectomy. Thirty-day mortality rate was 3.6%. Overall 5-year and 10-year survival rates were 48.2% and 29.9%, respectively. There was a non-significant trend for a worse survival in T4sn group patients when compared to that of T4sc group patients: 42.9% vs 52.3% at 5 years, and 25% vs 34.9% at 10 years (p=0.62). Multifocal T4 stage IIIB disease is a heterogeneous category where overall prognosis is far better than those of other T4 subgroups. Survival rates associated with pT4sn and pT4sc look roughly similar because of the small size of the subgroups usually submitted to comparison in most series. In the present experience, respective survival figures diverge, suggesting different biological behaviours.

  16. Progressive multifocal leucoencephalopathy in a patient with idiopathic CD4+ lymphocytopenia.

    LENUS (Irish Health Repository)

    Moloney, F

    2012-03-01

    Progressive multifocal leucoencephalopathy (PML) is an opportunistic, demyelinating neurological disease caused by reactivation of the JC polyomavirus. PML occurs almost exclusively in immunosuppressed individuals, with only isolated case reports of PML occurring in patients without apparent immunosuppression. Idiopathic CD4+ lymohocytopenia (ICL) is a syndrome defined by the Centre for Disease Control and Prevention as a CD4+ count <300 cells\\/uL or <20% of total T cell count on >1 occasion, with no evidence of human immunodeficiency virus (HIV) infection, and the absence of other known immunodeficiency or therapy associated with lymphocytopenia. We describe a case of PML occurring in a patient with idiopathic CD4+ lymphocytopenia.

  17. uper-resolution Axial Localization of Ultrasound Scatter Using Multi-focal Imaging

    DEFF Research Database (Denmark)

    Diamantis, Konstantinos; Greenaway, Alan H.; Anderson, Tom

    2017-01-01

    to noise ratio in each image. Conclusion: Super-resolution axial imaging from optical microscopy has been successfully translated into ultrasound imaging by using raw ultrasound data and standard beamforming. Significance: The normalized sharpness method has the potential to be used in scatterer...... localization applications and contribute in current super-resolution ultrasound imaging techniques.......This paper aims to develop a method for achieving micrometre axial scatterer localization for medical ultrasound, surpassing the inherent, pulse length dependence limiting ultrasound imaging. Methods: The method, directly translated from cellular microscopy, is based on multi-focal imaging...

  18. Multifocal, recurrent malignant chondroid syringoma with visceral metastases: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Ann Meredith Garcia

    2016-03-01

    Full Text Available We present the unusual case of malignant chondroid syringoma (MCS in a 64-year-old male with recurrent nodular skin lesions and visceral metastases. The patient underwent repeated excisions, with eventual development of widespread nodules and multiple pulmonary and hepatic nodules. Systemic chemotherapy was planned. MCS is a very rare skin adnexal tumor of the sweat glands with only around 50 cases reported worldwide. To the authors’ knowledge, this is the first reported case of MCS with a multifocal presentation and mucosal involvement.

  19. Multifocal splenic abscesses in immunocompetent adult due to cat-scratch disease.

    Science.gov (United States)

    Gkamprela, E; Papadimitropoulos, V; Papadopoulos, N; Deutsch, M

    2016-01-01

    Cat-scratch disease is caused by Bartonella henselae and transmitted to humans via the cats. Patients usually present with cutaneous lesions, regional lymphadenopathy and a brief period of fever. We report a rare case of an isolated splenic cat-scratch disease in an immunocompetent 27-year-old woman who presented with prolonged fever and multifocal splenic lesions. The patient was treated successfully with a long course of antibiotics. Isolated splenic lesions and fever is a rare manifestation of the cat-scratch disease. There is need of high suspicion index by the physicians to diagnose the disease promptly without invasive methods. Hippokratia 2016, 20(4): 306-308.

  20. Time-Dependent Decline in Multifocal Electroretinogram Requires Faster Recording Procedures in Anesthetized Pigs

    DEFF Research Database (Denmark)

    Sørensen, Nina Buus; Christiansen, Anders Tolstrup; Kjær, Troels Wesenberg

    2017-01-01

    PURPOSE: The time-dependent effect of anesthetics on the retinal function is debated. We hypothesize that in anesthetized animals there is a time-dependent decline that requires optimized multifocal electroretinogram (mfERG) recording procedures. METHODS: Conventional and four-frame global-flash mf...... by determining the necessary time-of-delay from intraocular injection of a drug to full effect. TRANSLATIONAL RELEVANCE: General anesthesia is a possible source of error in mfERG recordings. Therefore, it is important to investigate the translational relevance of the results to mfERG recordings in children...

  1. [Wave front aberrations -- practical conclusions in eye with Restor 3+ difractive multifocal lens].

    Science.gov (United States)

    Staicu, Corina; Moraru, Ozana; Moraru, Cristian

    2014-01-01

    Implantation of multifocal intraocular lenses has become a rutine nowadays, but achieving good visual results requires a perfect intraoperative technique and also an adequate preoperative selection of the patients. We analysed the wave front aberrations (spherical aberations, coma and astigmatism) in the eyes implanted with ReStor + 3 IOL, and we realized some clinical correlations of these aberations with the pupil diameter in scotopic and fotopic conditions, kappa angle, IOL centration, residual refraction errors postoperatively. Taking into account the causes of postoperative high order aberration will allow the surgeon to make a good selection of the patiens and to a higher degree of satisfaction of both sides.

  2. Multifocal Tubercular Dactylitis: A Rare Presentation of Skeletal Tuberculosis in an Adult.

    Science.gov (United States)

    Thatoi, Pravat; Parida, Manoj; Barik, Rakesh; Das, Bidyut

    2017-06-01

    Tubercular dactylitis is an uncommon form of osteo-articular tuberculosis seen in children. Multifocal involvement, simultaneously involving hands and feet is extremely uncommon. Here we report an adult patient with tubercular dactylitis involving multiple digits of both hands and second digit of right foot in absence of any risk factors like immunodeficiency or any debilitating condition. The patient was successfully treated with anti-tubercular drugs for six months. Mycobacterium tuberculosis infection of bones and joints can present in an unusual way but early diagnosis and treatment caries a good prognosis.

  3. Phase II trial of upfront bevacizumab and temozolomide for unresectable or multifocal glioblastoma

    OpenAIRE

    Lou, Emil; Peters, Katherine B; Sumrall, Ashley L; Desjardins, Annick; Reardon, David A; Lipp, Eric S; Herndon, James E; Coan, April; Bailey, Leighann; Turner, Scott; Friedman, Henry S; Vredenburgh, James J

    2013-01-01

    Patients with unresectable glioblastomas have a poor prognosis, with median survival of 6?10 months. We conducted a phase II trial of upfront 5-day temozolomide (TMZ) and bevacizumab (BV) in patients with newly diagnosed unresectable or multifocal glioblastoma. Patients received up to four cycles of TMZ at 200 mg/m2 on days 1?5, and BV at 10 mg/kg on days 1 and 15 of a 28-day cycle. Brain magnetic resonance imaging (MRI) was performed monthly. Therapy was continued as long as there was no tum...

  4. Noncontiguous multifocal brucellar spondylitis involving the cervical, thoracic, and lumbar spine: A case report

    Directory of Open Access Journals (Sweden)

    Rong Wang

    2017-06-01

    Full Text Available Brucellosis is a zoonosis infectious disease, brucellar spondylitis primarily infects the lumbar, the cervical is uncommon. Multiple-level involvement is extremely rare. This report describes a 46-year-old man with noncontiguous multifocal brucellar spondylitis involving the cervical, thoracic, and lumbar spine. Brucellar spondylitis is difficult to diagnose. Routine laboratory findings for the disease have little diagnostic value. Manifestations and radiological features are usually nonspecific. Radiological features of brucellar spondylitis are similar to tuberculous spondylitis and pyogenic spondylitis. MRI findings have diagnostic value. Suspicious patients with unexplained fever, musculoskeletal complaints at risk of infection should be considered.

  5. [Visual quality comparison after multifocal toric intraocular lens or monofocal toric intraocular lens implantation].

    Science.gov (United States)

    Feng, K; Guo, H K; Zhang, Y L; Wu, Z

    2017-04-11

    Objective: To compare visual quality and satisfaction after multifocal toric intraocular lens (Acrysof IQ Restor toric, ART) and monofocal toric intraocular lens implantation in patients. Methods: It was a prospective nonrandomized Phase Ⅲ clinical trial. Patients with age-related cataract and corneal astigmatism were enrolled and accepted phacoemulsification combined with implantation of intraocular lens (IOL) in Henan Provincial Eye Hospital during March 2013 to December 2014. Fifty-six cases were divided into two groups according to which IOL they chose. ART group included 28 cases (3l eyes) aged from 41.0 to 72.0 years, with an average age of 61.5 years; toric group included 28 cases (33 eyes) aged from 42.0 to 75.0 years, with an average age of 63.5 years. Three months postoperatively, uncorrected distance visual acuity (UDVA) at 5, 70, 40 cm, corrected distance, intermediate, and near visual acuities, defocus curve, residual refractive astigmatism, rotational stability of the IOL, contrast sensitivity and patientsatisfaction were evaluated. All data were processed by statistic package deal SPSS 16.0. Postoperative visual acuity, residual astigmatism, IOL axial rotation and contrast sensitivity were compared by independent samples t test; preoperative and postoperative corneal astigmatism were compared by paired t -test; spectacle independency and halo incidence were processed by χ(2) test; visual satisfaction score was analyzed by Mann-Whitney test. Results: At 3 months postoperatively, in ART group, UDVA was (0.04±0.05), UIVA was (0.24±0.15), UNVA was (0.20±0.24). While in Toric group, UDVA was (0.06±0.04), UIVA was (0.30±0.13), UNVA was (0.47±0.21). There was no significant difference in UDVA between two groups( t= 0.79, P= 0.433). But in ART group, UIVA and UNVA were markedly better than those in Toric group( t= 2.74, P= 0.008; t= 3.45, PART group and 2.50 D (+1.00--1.50 D) in the Toric group. Average postoperative residual astigmatism was (-0.45

  6. Clinical and patient-reported outcomes of bilateral implantation of a +2.5 diopter multifocal intraocular lens.

    Science.gov (United States)

    Maxwell, Andrew; Holland, Edward; Cibik, Lisa; Fakadej, Anna; Foster, Gary; Grosinger, Les; Moyes, Andrew; Nielsen, Stephen; Silverstein, Steven; Toyos, Melissa; Weinstein, Arthur; Hartzell, Scott

    2017-01-01

    To assess the effectiveness and safety of a multifocal intraocular lens (IOL) with +2.5 diopter (D) additional power compared with a monofocal IOL. Fifteen sites in the United States. Prospective randomized patient- and observer-masked clinical trial. Randomized patients received multifocal or monofocal IOLs bilaterally. Visual acuity (33 cm, 40 cm, 53 cm, 60 cm, 4 m) was measured; safety was assessed through adverse event rates. Patient-reported visual outcomes were evaluated using the Visual Tasks questionnaire. The frequency and severity of visual disturbances were evaluated using the Assessment of Photic Phenomena and Lens EffectS questionnaire. The multifocal IOL (n = 155) provided better corrected distance visual acuity at 53 cm than the monofocal IOL (n = 165) (0.322 versus 0.512 logMAR; between-group difference, -0.190 logMAR; P < .0001) and 40 cm but not at 4 m. Ocular adverse event rates were less than 3.84% in both groups. Serious adverse event rates were comparable between the 2 IOL types. Patients with multifocal IOLs reported less difficulty with near tasks (with and without correction) and intermediate tasks (without correction). Difficulty with extended-intermediate and distance tasks was similar between groups. The most frequently reported self-rated severe phenomena were halos, starbursts, and glare. Most patients (monofocal ≥72%; multifocal ≥73%) reported never experiencing blurred, distorted, or double vision. The +2.5 D multifocal IOL provided better vision at 40 cm and 53 cm and similar vision at 4 m compared with the monofocal IOL. Safety profiles and visual phenomena were comparable between groups. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Osteoblastomatosis of bone. A benign, multifocal osteoblastic lesion, distinct from osteoid osteoma and osteoblastoma, radiologically simulating a vascular tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kyriakos, Michael [Washington University School of Medicine, Division of Surgical Pathology, Campus Box 8118, St. Louis, MO (United States); El-Khoury, Georges Y. [University of Iowa, Department of Radiology, Roy J. and Lucille A. Carver School of Medicine, Iowa City, IA (United States); McDonald, Douglas J. [Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO (United States); Buckwalter, Joseph A. [University of Iowa, Department of Orthopaedics, Roy J. and Lucille A. Carver School of Medicine, Iowa City, IA (United States); Sundaram, Murali [Cleveland Clinic Foundation, Department of Radiology, Cleveland, OH (United States); DeYoung, Barry [University of Iowa, Department of Pathology, School of Medicine, Iowa City, IA (United States); O' Brien, Michael P. [University of Wisconsin Hospital, Department of Radiology, Madison, WI (United States)

    2007-03-15

    Two adult patients are described with multifocal osteolytic lesions radiologically simulating a vascular tumor. One patient had multiple bones involved. Histologically, the individual lesions had the features of the nidus of osteoid osteoma/osteoblastoma. A review of the English language medical literature yielded only one other reported case with similar features. The process is designated as osteoblastomatosis to indicate its bone-forming character, prominent osteoblast proliferation, and multiplicity. The cases are distinguished from multifocal/multicentric osteoid osteoma and osteoblastoma, and from benign and malignant vascular tumors. (orig.)

  8. Osteoblastomatosis of bone. A benign, multifocal osteoblastic lesion, distinct from osteoid osteoma and osteoblastoma, radiologically simulating a vascular tumor

    International Nuclear Information System (INIS)

    Kyriakos, Michael; El-Khoury, Georges Y.; McDonald, Douglas J.; Buckwalter, Joseph A.; Sundaram, Murali; DeYoung, Barry; O'Brien, Michael P.

    2007-01-01

    Two adult patients are described with multifocal osteolytic lesions radiologically simulating a vascular tumor. One patient had multiple bones involved. Histologically, the individual lesions had the features of the nidus of osteoid osteoma/osteoblastoma. A review of the English language medical literature yielded only one other reported case with similar features. The process is designated as osteoblastomatosis to indicate its bone-forming character, prominent osteoblast proliferation, and multiplicity. The cases are distinguished from multifocal/multicentric osteoid osteoma and osteoblastoma, and from benign and malignant vascular tumors. (orig.)

  9. Nuclear myocardial perfusion imaging using thallium-201 with a novel multifocal collimator SPECT/CT: IQ-SPECT versus conventional protocols in normal subjects.

    Science.gov (United States)

    Matsuo, Shinro; Nakajima, Kenichi; Onoguchi, Masahisa; Wakabayash, Hiroshi; Okuda, Koichi; Kinuya, Seigo

    2015-06-01

    A novel multifocal collimator, IQ-SPECT (Siemens) consists of SMARTZOOM, cardio-centric and 3D iterative SPECT reconstruction and makes it possible to perform MPI scans in a short time. The aims are to delineate the normal uptake in thallium-201 ((201)Tl) SPECT in each acquisition method and to compare the distribution between new and conventional protocol, especially in patients with normal imaging. Forty patients (eight women, mean age of 75 years) who underwent myocardial perfusion imaging were included in the study. All patients underwent one-day protocol perfusion scan after an adenosine-stress test and at rest after administering (201)Tl and showed normal results. Acquisition was performed on a Symbia T6 equipped with a conventional dual-headed gamma camera system (Siemens ECAM) and with a multifocal SMARTZOOM collimator. Imaging was performed with a conventional system followed by IQ-SPECT/computed tomography (CT). Reconstruction was performed with or without X-ray CT-derived attenuation correction (AC). Two nuclear physicians blinded to clinical information interpreted all myocardial perfusion images. A semi-quantitative myocardial perfusion was analyzed by a 17-segment model with a 5-point visual scoring. The uptake of each segment was measured and left ventricular functions were analyzed by QPS software. IQ-SPECT provided good or excellent image quality. The quality of IQ-SPECT images without AC was similar to those of conventional LEHR study. Mid-inferior defect score (0.3 ± 0.5) in the conventional LEHR study was increased significantly in IQ-SPECT with AC (0 ± 0). IQ-SPECT with AC improved the mid-inferior decreased perfusion shown in conventional images. The apical tracer count in IQ-SPECT with AC was decreased compared to that in LEHR (0.1 ± 0.3 vs. 0.5 ± 0.7, p IQ-SPECT was significantly higher than that from the LEHR collimator (p = 0.0009). The images of IQ-SPECT acquired in a short time are equivalent to that of conventional LEHR

  10. Multifocal epithelial hyperplasia in a community in the Mayan area of Mexico.

    Science.gov (United States)

    González-Losa, Maria R; Suarez-Allén, Rosa E; Canul-Canche, Jaqueline; Conde-Ferráez, Laura; Eljure-Lopez, Nixma

    2011-03-01

    Multifocal epithelial hyperplasia is a pathology of the oral mucosa which has been reported in diverse ethnic groups. Human papillomavirus (HPV) types 13 and 32 DNA has been detected in these lesions. The aims of this paper are to describe the epidemiological and clinical characteristics of an outbreak in a rural community in the Mayan area of Mexico and to identify a possible route of transmission through saliva. A cross-sectional study was conducted in Chemax (Yucatan, Mexico). Clinical and epidemiological data were obtained through direct interviews. Samples of oral cells and saliva were taken. HPV 13 and 32 were identified by polymerase chain reaction using specific primers. A total of 57 patients were studied, of whom 79.1% were aged jugal mucosa, and more frequently, the tongue. HPV 13 was found in all the patients and HPV 32 in none. A total of 42 saliva samples were positive for HPV 13. Human papillomavirus type 13 is involved in multifocal epithelial hyperplasia among the Mexican Mayan population. The presence of HPV 13 in cells from saliva, combined with poor hygiene behaviors, may explain the familial distribution of the pathology. © 2011 The International Society of Dermatology.

  11. Wide-field two-dimensional multifocal optical-resolution photoacoustic computed microscopy

    Science.gov (United States)

    Xia, Jun; Li, Guo; Wang, Lidai; Nasiriavanaki, Mohammadreza; Maslov, Konstantin; Engelbach, John A.; Garbow, Joel R.; Wang, Lihong V.

    2014-01-01

    Optical-resolution photoacoustic microscopy (OR-PAM) is an emerging technique that directly images optical absorption in tissue at high spatial resolution. To date, the majority of OR-PAM systems are based on single focused optical excitation and ultrasonic detection, limiting the wide-field imaging speed. While one-dimensional multifocal OR-PAM (1D-MFOR-PAM) has been developed, the potential of microlens and transducer arrays has not been fully realized. Here, we present the development of two-dimensional multifocal optical-resolution photoacoustic computed microscopy (2D-MFOR-PACM), using a 2D microlens array and a full-ring ultrasonic transducer array. The 10 × 10 mm2 microlens array generates 1800 optical foci within the focal plane of the 512-element transducer array, and raster scanning the microlens array yields optical-resolution photoacoustic images. The system has improved the in-plane resolution of a full-ring transducer array from ≥100 µm to 29 µm and achieved an imaging time of 36 seconds over a 10 × 10 mm2 field of view. In comparison, the 1D-MFOR-PAM would take more than 4 minutes to image over the same field of view. The imaging capability of the system was demonstrated on phantoms and animals both ex vivo and in vivo. PMID:24322226

  12. Barriers, motivators and enablers for dispensing multifocal contact lenses in Mumbai, India.

    Science.gov (United States)

    Thite, Nilesh; Shah, Ukti; Mehta, Jasmin; Jurkus, Janice

    2015-01-01

    To understand the potential barriers, motivators and enablers in dispensing multifocal contact lenses (MFCL). Two focus group discussions were conducted to design questionnaires regarding the prescribing habits for multifocal contact lenses (MFCL). Questions on potential barriers and motivators were included. The questionnaires were distributed among 133 eye care practitioners across Mumbai, India. Practitioners fitting one or less patient per month with MFCL completed the survey describing potential barriers, while those who prescribed more MFCL's per month completed the survey describing enablers and motivators. Responses from 102 practitioners were received. Most common potential barriers in prescribing MFCL were increased chair time (75%), lack of readily available trials (69%) and limitation in power range (63%). Lack of awareness among patients (90%) was the most common barrier from patients' outlook. Professional satisfaction (88%) and better business proposition (82%) were observed as main motivators while availability of the trials (84%) and correct patient selection (82%) were the major enablers. Graduate Optometrists felt dispensing MFCL did not offer a good business proposition (p=0.02). Experienced practitioners were observed to be least motivated (p=0.01) and believed that their patients found these lenses expensive (p=0.02). To enhance the MFCL practice, barriers like lack of awareness and limitations in power range must be addressed. Trial lens availability may motivate practitioners to prescribe MFCL. Further probing is required to understand lack of motivation among experienced practitioners. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  13. Therapeutic mammoplasty allows for clear surgical margins in large and multifocal tumours without delaying adjuvant therapy.

    Science.gov (United States)

    Bamford, Richard; Sutton, Richard; McIntosh, Jamie

    2015-04-01

    Therapeutic mammoplasty (TM) is suggested to have a number of advantages by comparison to standard breast conservation surgery in selected patients, however, data to support such assertions are sparse and outcomes remain uncertain. We assess the ability of TM to achieve some of its suggested benefits, specifically obtaining clear surgical margins (CSM) around large or multifocal tumours, and examine whether TM is associated with delay in administering adjuvant therapies. Data were extracted from a prospectively maintained database on all patients undergoing TM over 8 years. Key oncological outcomes and time to initiation of adjuvant therapies were recorded. Sixty eight patients underwent TM, sixty two for invasive disease and six for in-situ disease only. Tumour size ranged from 3 mm to 85 mm. Twenty-one (30.8%) patients received neo-adjuvant therapy, with 15 (22.0%) receiving chemotherapy and six (8.8%) receiving endocrine therapy prior to surgery. CSM were obtained in 65 patients (95.6%). Where margins were involved, two were due to Ductal Carcinoma in situ and one from undiagnosed invasive lobular cancer, resulting in one wider excision and two completion mastectomies. Radiotherapy was delayed in one patient with delayed wound healing. No local recurrence has been recorded. These data support the ability of TM to consistently achieve CSM around large and multifocal tumours in selected patients, with acceptable local control and minimal morbidity and delay in adjuvant therapies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. [Multiple meningeal and cerebral involvement revealing multifocal tuberculosis in an immunocompetent patient].

    Science.gov (United States)

    Boulahri, Tarik; Taous, Abdellah; Berri, Maha Aït; Traibi, Imane; Rouimi, Abdelhadi

    2016-01-01

    Tuberculosis is a public health problem in Morocco. Central nervous system involvement is nevertheless rare, occurring in the context of multifocal or miliary tuberculosis. However, it may be a mode of revelation even in an immunocompetent subject. We report the case of a 30-year old man with language disorder accompanied by significant impairment of general condition. Clinical examination showed Broca's motor aphasia, right-sided pyramidal syndrome and latero-cervical adenopathies. HIV serologic test was negative. Brain MRI showed lesions associating multiple intracranial tuberculomas and meningoencephalitis. Thoracic CT scan showed multiple pulmonary micronodules, cavity wall thickening and bronchiectasia of the right fowler and culmen. Lymph node biopsy revealed typical architecture of a TB granuloma. The diagnosis of multifocal tuberculosis was retained and the patient received anti-bacillary therapy associated with corticosteroid therapy with good clinico-radiological evolution. This study is peculiar due to the appearance and the seat of tuberculous lesions on brain imaging, the absence of immunodeficiency, a good evolution under treatment. It highlights the role of active and exhaustive assessment of associated extracerebral tuberculous infection in the case of cerebromeningeal lesion suggestive of tuberculosis.

  15. Correction of High Astigmatism after Penetrating Keratoplasty with Toric Multifocal Intraocular Lens Implantation

    Directory of Open Access Journals (Sweden)

    Raffaele Nuzzi

    2017-07-01

    Full Text Available After penetrating keratoplasty (PK, high astigmatism is often induced, being frequently about 4–6 dpt. According to the entity and typology of astigmatism, different methods of correction can be used. Selective suture removal, relaxing incisions, wedge resections, compression sutures, photorefractive keratectomy, and laser-assisted in situ keratomileusis can reduce corneal astigmatism and ametropia, but meanwhile they can cause a reduction in the corneal integrity and cause an over- or undercorrection. In case of moderate-to-high regular astigmatisms, the authors propose a toric multifocal intraocular lens (IOL implantation to preserve the corneal integrity (especially in PK after herpetic corneal leukoma keratitis. We evaluated a 45-year-old patient who at the age of 30 was subjected to PK in his left eye due to corneal leukoma herpetic keratitis, which led to high astigmatism (7.50 dpt cyl. 5°. The patient was subjected to phacoemulsification and customized toric multifocal IOL implantation in his left eye. The correction of PK-induced residual astigmatism with a toric IOL implantation is an excellent choice but has to be evaluated in relation to patient age, corneal integrity, longevity graft, and surgical risk. It seems to be a well-tolerated therapeutic choice and with good results.

  16. The brain triuno and the ethical intelligence: fundamental counterfoil of the multifocal intelligence

    Directory of Open Access Journals (Sweden)

    C. Seijo

    2013-10-01

    Full Text Available This study has for aim offer an analysis as for the brain triuno and the ethical intelligence: fundamental Counterfoil of the multifocal intelligence, taking in tells one of the theories that it sustains her like they are the different types of multiple intelligences established by Beauport and Cury (2004. The theoretical sustenance, it is based on the contents of Martin (2005, Belohlavek (2007, Galicians (2002, Beauport and Cury (2004, between others, being realized under a symbolic interpretive approach, across a qualitative methodology, type descriptive and not experimental design, by means of a documentary analysis. In this regard, it is found that the ethical intelligence is a mental mechanism that constructs the structural preconceptos and the rules of game with which an individual approaches the reality, that is to say, it is the capacity of the general formation, predicting the behavior for the achievement of aims organizacionales. As for the final considerations they focused in obtaining the most wide knowledge inside the organizations, allowing to reflect before the weaknesses that they present thinking about the brain triuno applying the multifocal intelligence, fundamental counterfoil of the ethical intelligence and of what way the rationing visualizes the strengths, nevertheless of the weaknesses that they present. 

  17. Multifocal Metachronous Giant Cell Tumor: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    B. Ghostine

    2014-01-01

    Full Text Available Introduction. Giant cell tumors (GCTs of bone are known for their local aggressiveness and high recurrence rate. There are rare cases of multicentric GCT and most are synchronous. We herein review metachronous multicentric GCT reported in the literature. Material and Methods. A MEDLINE, Cochrane, and Google Scholar search was done to collect all cases of multicentric metachronous GCT specifying the clinical, radiological, and histological characteristics of each location and its treatment. Results. A total of 37 multifocal giant cell tumors were found in the literature. 68% of cases of multicentric giant cell tumors occur in less than 4 years following treatment of the first lesion. Thirty-seven cases of multifocal metachronous GCT were identified in the literature until 2012. Patients with multicentric GCT tend to be younger averaging 23. There is a slight female predominance in metachronous GCT. The most common site of the primary GCT is around the knee followed by wrist and hand and feet. Recurrence rate of multicentric GCT is 28.5%. Conclusion. Multicentric giant cell tumor is rare. The correct diagnosis relies on correlation of clinical and radiographic findings with confirmation of the diagnosis by histopathologic examination.

  18. Visual function and reading speed after bilateral implantation of 2 types of diffractive multifocal intraocular lenses: Add-on versus capsular bag design.

    Science.gov (United States)

    Liekfeld, Anja; Ehmer, Angela; Schröter, Ulrike

    2015-10-01

    To compare the functional outcomes of primary implantation of a monofocal intraocular lens (IOL) in the capsular bag and an add-on multifocal IOL in the sulcus with the functional results of a conventional multifocal posterior chamber IOL and to evaluate the multifocal add-on IOL as an effective alternative to a conventional multifocal IOL. Ernst von Bergmann Eye Clinic, Potsdam, Germany. Prospective nonrandomized case series. Cataract surgery patients were assigned to have bilateral implantation of a monofocal IOL (Aspira-aAY) in the capsular bag followed by a multifocal add-on IOL (Diff-sPB) in the sulcus (Group A) or with a conventional multifocal IOL (Diffractiva-s) in the capsular bag (Group B). The main study outcomes were assessed at the last follow-up visit (6 months postoperatively) and included refraction, intraocular pressure, visual acuity, reading speed, contrast sensitivity, defocus curve, and patient satisfaction. The study comprised 26 patients (52 eyes) Cataract surgery was uneventful in all cases. No severe complications were observed 6 months postoperatively. Visual performance with a multifocal diffractive add-on IOL was equivalent to that achieved with a conventional multifocal diffractive posterior chamber IOL. Similarly, there were no significant differences in patient satisfaction and reading speed for any type of letter size between groups (P > .05). Implanting a multifocal add-on IOL in the sulcus in addition to a monofocal IOL in the capsular bag produced outcomes similar to those of single implantation of a standard multifocal IOL in the capsular bag. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  19. Dual Diagnosis - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Dual Diagnosis URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Dual Diagnosis - Multiple Languages To use the sharing features ...

  20. Dual Youla parameterization

    DEFF Research Database (Denmark)

    Niemann, Hans Henrik

    2003-01-01

    A different aspect of using the parameterisation of all systems stabilised by a given controller, i.e. the dual Youla parameterisation, is considered. The relation between system change and the dual Youla parameter is derived in explicit form. A number of standard uncertain model descriptions...... are considered and the relation with the dual Youla parameter given. Some applications of the dual Youla parameterisation are considered in connection with the design of controllers and model/performance validation....

  1. Central retinal function as measured by the multifocal electroretinogram and flicker perimetry in early age-related macular degeneration.

    Science.gov (United States)

    Gin, Thomas J; Luu, Chi D; Guymer, Robyn H

    2011-11-29

    To determine the retinal function in early age-related macular degeneration (AMD) assessed by the multifocal electroretinogram (mfERG) and flicker perimetry and to seek a relationship between local objective mfERG parameters and subjective flicker perimetry thresholds. mfERG and flicker perimetry were performed in 15 patients (15 eyes) with early AMD and 14 controls (14 eyes) of similar age. The mfERG P1 response amplitude density (nV/deg²) and P1 implicit time of the first-order kernel and the flicker thresholds of each concentric ring were analyzed. The relationship between individual mfERG responses and the corresponding individual flicker sensitivity outcomes was determined. The mfERG response amplitude of the central ring (ring 1) was significantly reduced in early AMD eyes compared with the controls (P = 0.009). No significant difference in mfERG amplitude between early AMD and control eyes was detected in the other rings. The mfERG implicit time was significantly increased in the early AMD eyes but only within the central four rings of 12°. A significant reduction in flicker sensitivity was also detected in early AMD eyes but only within the central 6°. There was a significant, moderate correlation (r = -0.477; P flicker sensitivity from the same tested locations within the central 6°. There was a weak correlation (r = 0.200; P = 0.014) between mfERG amplitude and flicker sensitivity. Both mfERG and flicker perimetry show abnormal retinal function, but only in the very central macula, in early AMD. A novel relationship between mfERG and flicker sensitivity should enhance the clinical monitoring of disease progression.

  2. DUAL TIMELIKE NORMAL AND DUAL TIMELIKE SPHERICAL CURVES IN DUAL MINKOWSKI SPACE

    OpenAIRE

    ÖNDER, Mehmet

    2009-01-01

    Abstract: In this paper, we give characterizations of dual timelike normal and dual timelike spherical curves in the dual Minkowski 3-space and we show that every dual timelike normal curve is also a dual timelike spherical curve. Keywords: Normal curves, Dual Minkowski 3-Space, Dual Timelike curves. Mathematics Subject Classifications (2000): 53C50, 53C40. DUAL MINKOWSKI UZAYINDA DUAL TIMELIKE NORMAL VE DUAL TIMELIKE KÜRESEL EĞRİLER Özet: Bu çalışmada, dual Minkowski 3-...

  3. A comparative study of brachial plexus sonography and magnetic resonance imaging in chronic inflammatory demyelinating neuropathy and multifocal motor neuropathy

    NARCIS (Netherlands)

    Goedee, H S; Jongbloed, B A; van Asseldonk, J.T.H.; Hendrikse, J; Vrancken, A F J E; Franssen, H; Nikolakopoulos, S; Visser, L H; van der Pol, W L; van den Berg, L H

    2017-01-01

    BACKGROUND AND PURPOSE: To compare the performance of neuroimaging techniques, i.e. high-resolution ultrasound (HRUS) and magnetic resonance imaging (MRI), when applied to the brachial plexus, as part of the diagnostic work-up of chronic inflammatory demyelinating neuropathy (CIDP) and multifocal

  4. Multifocal Visual Evoked Potential in Eyes With Temporal Hemianopia From Chiasmal Compression: Correlation With Standard Automated Perimetry and OCT Findings.

    Science.gov (United States)

    Sousa, Rafael M; Oyamada, Maria K; Cunha, Leonardo P; Monteiro, Mário L R

    2017-09-01

    To verify whether multifocal visual evoked potential (mfVEP) can differentiate eyes with temporal hemianopia due to chiasmal compression from healthy controls. To assess the relationship between mfVEP, standard automated perimetry (SAP), and Fourier domain-optical coherence tomography (FD-OCT) macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements. Twenty-seven eyes with permanent temporal visual field (VF) defects from chiasmal compression on SAP and 43 eyes of healthy controls were submitted to mfVEP and FD-OCT scanning. Multifocal visual evoked potential was elicited using a stimulus pattern of 60 sectors and the responses were averaged for the four quadrants and two hemifields. Optical coherence tomography macular measurements were averaged in quadrants and halves, while peripapillary RNFL thickness was averaged in four sectors around the disc. Visual field loss was estimated in four quadrants and each half of the 24-2 strategy test points. Multifocal visual evoked potential measurements in the two groups were compared using generalized estimated equations, and the correlations between mfVEP, VF, and OCT findings were quantified. Multifocal visual evoked potential-measured temporal P1 and N2 amplitudes were significantly smaller in patients than in controls. No significant difference in amplitude was observed for nasal parameters. A significant correlation was found between mfVEP amplitudes and temporal VF loss, and between mfVEP amplitudes and the corresponding OCT-measured macular and RNFL thickness parameters. Multifocal visual evoked potential amplitude parameters were able to differentiate eyes with temporal hemianopia from controls and were significantly correlated with VF and OCT findings, suggesting mfVEP is a useful tool for the detection of visual abnormalities in patients with chiasmal compression.

  5. Rare lung manifestation of multifocal micronodular pneumocyte hyperplasia in a teenage girl with tuberous sclerosis complex

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Seung Mi; Yoon, Hye Kyung; Lee, Seung Koo [Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-08-15

    Multifocal micronodular pneumocyte hyperplasia (MMPH) is a relatively rare pulmonary disorder that can be associated with tuberous sclerosis complex (TSC). It has been rarely reported in children or adolescents. MMPH is a hamartomatous process of the lung with multiple small nodules, composed of type II pneumocytes. Plain radiography and chest CT in MMPH may demonstrate numerous small nodules measuring 1-10 mm in diameters, distributed randomly throughout both lungs. If MMPH is an initial presentation of TSC, and unless we are familiar with this lung manifestation of TSC, radiologic findings can mimic miliary tuberculosis or metastatic disease. We report a teenage girl with TSC and histologically confirmed MMPH which mimicked miliary tuberculosis at the initial presentation.

  6. Chronic recurrent multifocal osteomyelitis with an atypical presentation in an adult man

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Cheng William [University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Cleveland Clinic, Lerner College of Medicine, Cleveland, OH (United States); Hsiao, Edward C. [University of California San Francisco, Division of Endocrinology and Metabolism, and the Institute for Human Genetics, Department of Medicine, San Francisco, CA (United States); Horvai, Andrew E. [University of California San Francisco, Department of Pathology, San Francisco, CA (United States); Link, Thomas M. [University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States)

    2015-09-15

    We present the case of a 33-year-old man with no significant medical history who developed right scapular pain, left-sided sacroiliac joint pain, and lower back pain, and was eventually diagnosed with chronic recurrent multifocal osteomyelitis (CRMO). Imaging demonstrated multiple scattered T2-hyperintense lesions on MRI at the spine and the left SI joint, some of which progressed and one regressed in size on follow-up. Histopathology demonstrated only non-specific chronic inflammation compatible with CRMO. No evidence of infectious organisms or neoplastic processes was found. The pain was relapsing and remitting in nature. Laboratory investigations were notable for no evidence of hematologic malignancy or infection, but only a mild increase in alkaline phosphatase. This case highlights that CRMO, despite being thought of as a childhood-onset disease, can present in adults as well, and also provides illustrative examples of imaging and histological findings. (orig.)

  7. Whack-a-mole strategy for multifocal ground glass opacities of the lung.

    Science.gov (United States)

    Suzuki, Kenji

    2017-04-01

    Ground glass opacity (GGO) is a good prognostic indicator for lung cancer and is useful for physicians to predict prognosis. Due to recent advances in computed tomography (CT), the chance to encounter GGO is rapidly increasing in clinical practice. Based on the studies on radiological pathological correlation, GGO represents pathological lepidic growth and consolidation on CT represents pathologically invasive components. Thus, consolidation tumor ratio 0.5 or less means pathological less invasiveness for lung cancer. Not a few studies have shown that sublobar resection is equivalent to lobectomy for radiological early lung cancers. Additionally, observation of GGO is one of the options for physicians. Indication of surgical intervention remains unclear. Physician observing GGO in practice should know the natural history of GGO to reach an optimal treatment decision. For multifocal GGO lesions clinical management is surely challenging. Whack-a-mole strategy, which means sublobar resection for radiological invasive cancer is one of the most promising strategies for such lesions.

  8. Posterior reversible encephalopathy syndrome masquerading as progressive multifocal leukoencephalopathy in rituximab treated neuromyelitis optica.

    Science.gov (United States)

    Berger, Joseph R; Neltner, Janna; Smith, Charles; Cambi, Franca

    2014-11-01

    Both progressive multifocal leukoencephalopathy (PML) and posterior reversible encephalopathy syndrome (PRES) have been reported as complications of rituximab therapy. These disorders may appear indistinguishable on magnetic resonance imaging (MRI). We report on a 42 year old woman with neuromyelitis optica (NMO) of 10 years duration who developed extensive white matter disease affecting chiefly both parietal lobes 6 months after her first and only dose of rituximab. The MRI findings suggested the diagnosis of PML, but her history was more consistent with PRES. Ultimately, a brain biopsy was performed which was consistent with the diagnosis of PRES. PRES and PML may have overlapping symptomatology and be indistinguishable on MRI. An approach to distinguishing between these two disorders is addressed. Copyright © 2014. Published by Elsevier B.V.

  9. TBC1D24 Mutations in a Sibship with Multifocal Polymyoclonus

    Directory of Open Access Journals (Sweden)

    Adeline Ngoh

    2017-04-01

    Full Text Available Background: Advances in molecular genetic technologies have improved our understanding of genetic causes of rare neurological disorders with features of myoclonus.Case Report: A family with two affected siblings, presenting with multifocal polymyoclonus and neurodevelopmental delay, was recruited for whole-exome sequencing following unyielding diagnostic neurometabolic investigations. Compound heterozygous mutations in TBC1D24, a gene previously associated with various epilepsy phenotypes and hearing loss, were identified in both siblings. The mutations included a missense change c.457G>A (p.Glu157Lys, and a novel frameshift mutation c.545del (p.Thr182Serfs*6.Discussion: We propose that TBC1D24-related diseases should be in the differential diagnosis for children with polymyoclonus. 

  10. Skull involvement in a pediatric case of chronic recurrent multifocal osteomyelitis.

    Science.gov (United States)

    Watanabe, Toru; Ono, Hiroyuki; Morimoto, Yoshitaka; Otsuki, Yoshiro; Shirai, Masami; Endoh, Akira; Naito, Masaaki; Inoue, Yoshiya; Hongo, Teruaki

    2015-08-01

    An 11-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis (CRMO) and presented with right sacro-femoral and occipital lesions. Initially, a tumor was suspected. However, the bone biopsy showed osteomyelitis with a negative bacterial culture. Bone scintigraphy revealed inflammatory changes on multiple bone lesions. The slight elevation in inflammatory markers such as C-reactive protein was of little clinical value. He was diagnosed with CRMO by sacral biopsy, and the clinical course progressed, with the presence of a new occipital lesion observed after the 1-year follow-up. The administration of non-steroidal anti-inflammatory drugs successfully improved his clinical symptoms. The presence of a skull lesion in the occipital bone of a pediatric patient with CRMO has not been previously reported.

  11. Adaptive panoramic tomography with a circular rotational movement for the formation of multifocal image layers

    Energy Technology Data Exchange (ETDEWEB)

    Kim, D. S.; Cho, H. S.; Park, Y. O.; Je, U. K.; Hong, D. K.; Choi, S. I.; Koo, Y. S. [Yonsei University, Wonju (Korea, Republic of)

    2012-02-15

    Panoramic radiography with which only structures within a certain image layer are in focus and others out of focus on the panoramic image has become a popular imaging technique especially in dentistry. However, the major drawback to the technique is a mismatch between the structures to be focused and the predefined image layer mainly due to the various shapes and sizes of dental arches and/or to malpositioning of the patient. These result in image quality typically inferior to that obtained using intraoral radiographic techniques. In this paper, to overcome these difficulties, we suggest a new panoramic reconstruction algorithm, the so-called adaptive panoramic tomography (APT), capable of reconstructing multifocal image layers with no additional exposure. In order to verify the effectiveness of the proposed algorithm, we performed systematic simulation studies with a circular rotational movement and investigated the image performance.

  12. Adaptive panoramic tomography with a circular rotational movement for the formation of multifocal image layers

    International Nuclear Information System (INIS)

    Kim, D. S.; Cho, H. S.; Park, Y. O.; Je, U. K.; Hong, D. K.; Choi, S. I.; Koo, Y. S.

    2012-01-01

    Panoramic radiography with which only structures within a certain image layer are in focus and others out of focus on the panoramic image has become a popular imaging technique especially in dentistry. However, the major drawback to the technique is a mismatch between the structures to be focused and the predefined image layer mainly due to the various shapes and sizes of dental arches and/or to malpositioning of the patient. These result in image quality typically inferior to that obtained using intraoral radiographic techniques. In this paper, to overcome these difficulties, we suggest a new panoramic reconstruction algorithm, the so-called adaptive panoramic tomography (APT), capable of reconstructing multifocal image layers with no additional exposure. In order to verify the effectiveness of the proposed algorithm, we performed systematic simulation studies with a circular rotational movement and investigated the image performance.

  13. Adaptive panoramic tomography with a circular rotational movement for the formation of multifocal image layers

    Science.gov (United States)

    Kim, D. S.; Cho, H. S.; Park, Y. O.; Je, U. K.; Hong, D. K.; Choi, S. I.; Koo, Y. S.

    2012-02-01

    Panoramic radiography with which only structures within a certain image layer are in focus and others out of focus on the panoramic image has become a popular imaging technique especially in dentistry. However, the major drawback to the technique is a mismatch between the structures to be focused and the predefined image layer mainly due to the various shapes and sizes of dental arches and/or to malpositioning of the patient. These result in image quality typically inferior to that obtained using intraoral radiographic techniques. In this paper, to overcome these difficulties, we suggest a new panoramic reconstruction algorithm, the so-called adaptive panoramic tomography ( APT), capable of reconstructing multifocal image layers with no additional exposure. In order to verify the effectiveness of the proposed algorithm, we performed systematic simulation studies with a circular rotational movement and investigated the image performance.

  14. A Case of Radiation-Induced Multifocal Laryngeal Angiosarcoma Presenting as a Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Jayme R. Dowdall

    2012-01-01

    Full Text Available Head and neck sarcomas are relatively rare tumors, with angiosarcomas representing a small subset. Angiosarcoma is a malignant endothelial neoplasm characterized by atypical, multilayered, or solid endothelial proliferation with vasoformative architecture. The global incidence of irradiation-associated sarcoma is estimated as between 0.03% and 0.08%. Here we reported the case of an elderly woman previously treated with radiation more than 20 years ago for an unknown primary of head and neck. This interesting case presented as a diagnostic challenge, and multiple biopsies were required to eventually establish the diagnosis of laryngeal angiosarcoma. We additionally have confirmation from our prior radiation records that the patient did, in fact, receive a substantial dose of radiation to the site previously. To our knowledge, this case represents the first report of a documented radiation-induced multifocal laryngeal angiosarcoma.

  15. Bilateral Multifocal Central Serous-Like Chorioretinopathy due to MEK Inhibition for Metastatic Cutaneous Melanoma

    Directory of Open Access Journals (Sweden)

    Scott D. Schoenberger

    2013-01-01

    Full Text Available Newer chemotherapeutic agents target extracellular signaling, including the mitogen-activated protein kinase kinase (MEK pathway. We present a case of a 54-year-old female who developed bilateral multifocal central serous-like chorioretinopathy shortly after starting MEK inhibition for metastatic cutaneous melanoma. There was a complete resolution of findings after drug stoppage. After resuming a lower dose of the MEK inhibitor, the findings recurred again but resolved after drug stoppage. Other etiologies were unlikely given the clinical course. The presumed mechanism involves toxicity to the retinal pigment epithelium, with breakdown of the blood-retinal barrier. Recognition of this side effect is important with this new class of chemotherapy.

  16. Multifocal visual evoked potentials for quantifying optic nerve dysfunction in patients with optic disc drusen

    DEFF Research Database (Denmark)

    Malmqvist, Lasse; de Santiago, Luis; Boquete, Luciano

    2017-01-01

    and 22 control subjects were examined. Mean amplitude, mean inner ring (IR) amplitude (0.87-5.67° of visual field) and mean outer ring amplitude (5.68-24° of visual field) were calculated using signal-to-noise ratio (SNR) and peak-to-peak analysis. Monocular latency was calculated using second peak......PURPOSE: To explore the applicability of multifocal visual evoked potentials (mfVEPs) for research and clinical diagnosis in patients with optic disc drusen (ODD). This is the first assessment of mfVEP amplitude in patients with ODD. METHODS: MfVEP amplitude and latency from 33 patients with ODD......, full eye and IR. In the control group, SNR intersubject variability was 17.6% and second peak latency intersubject variability was 2.8%. CONCLUSION: Decreased mfVEP amplitude in patients with ODD suggests a direct mechanical compression of the optic nerve axons. Our results suggest that mfVEP amplitude...

  17. The effect of high- to low-altitude adaptation on the multifocal electroretinogram

    DEFF Research Database (Denmark)

    Kofoed, Peter Kristian; Sander, Birgit; Zubieta-Calleja, Gustavo

    2009-01-01

    PURPOSE: To examine variations in retinal electrophysiology assessed by multifocal electroretinogram (mfERG) during acclimatization of native highlanders to normobaric normoxia at sea level. METHODS: Eight healthy residents of the greater La Paz area in Bolivia (3600 m above sea level) were...... examined over 72 days after arriving in Copenhagen, Denmark (sea level). A control group of eight healthy lowlanders was used for comparison. RESULTS: During the period of observation, hemoglobin decreased from 16.7 to 15.0 g/dL (P = 0.0031), erythrocytes decreased from 5.3 to 4.6 trillion cells/L (P = 0...... of 73.2% to 87.0% higher in the highlanders than in the lowlanders (P sea level, the highlanders had...

  18. Rare lung manifestation of multifocal micronodular pneumocyte hyperplasia in a teenage girl with tuberous sclerosis complex

    International Nuclear Information System (INIS)

    Ha, Seung Mi; Yoon, Hye Kyung; Lee, Seung Koo

    2016-01-01

    Multifocal micronodular pneumocyte hyperplasia (MMPH) is a relatively rare pulmonary disorder that can be associated with tuberous sclerosis complex (TSC). It has been rarely reported in children or adolescents. MMPH is a hamartomatous process of the lung with multiple small nodules, composed of type II pneumocytes. Plain radiography and chest CT in MMPH may demonstrate numerous small nodules measuring 1-10 mm in diameters, distributed randomly throughout both lungs. If MMPH is an initial presentation of TSC, and unless we are familiar with this lung manifestation of TSC, radiologic findings can mimic miliary tuberculosis or metastatic disease. We report a teenage girl with TSC and histologically confirmed MMPH which mimicked miliary tuberculosis at the initial presentation

  19. Multifocal Epithelial Hyperplasia of Oral Cavity Expressing HPV 16 Gene: A Rare Entity

    Directory of Open Access Journals (Sweden)

    M. P. V. Prabhat

    2013-01-01

    Full Text Available Focal epithelial hyperplasia is a rare contagious disease caused by human papilloma virus. Usually HPV involves either cutaneous or mucosal surfaces, whereas concomitant mucocutaneous involvement is extremely rare. We report such a unique case of multifocal epithelial hyperplasia involving multiple sites of oral cavity along with skin lesions in a 65-year-old female. We also discuss the probable multifactorial etiology and variable clinical presentations of the lesions, including evidence of HPV 16 expression, as detected by polymerase chain reaction. The present report illustrates the need for careful examination and prompt diagnosis of the disease, as it might be associated with high risk genotypes such as HPV 16 and 18.

  20. Multifocal Epithelioid Hemangioendothelioma Derived from the Spine Region: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    G. Kerry

    2012-02-01

    Full Text Available Background: Epithelioid hemangioendothelioma (EHE is a rare vascular tumor with malignant biological behavior. It arises from endothelial cells, usually within soft tissues, and can occur in almost all locations. Case Report: We report a unique case of a 25-year-old man who presented with sudden attacks of severe back pain followed by acute non-traumatic paraplegia. Emergency diagnostics revealed a pathologic fracture of the T7 vertebra with tumor tissue invasion of the spinal canal. Furthermore, multifocal metastases were found. Results: To achieve en bloc resection, interdisciplinary surgical approaches were indicated. Despite multimodal therapy concepts, including radiotherapy and chemotherapy as well as endovascular embolization, the patient died within 8 weeks. Conclusion: Prognosis of EHE is unpredictable and mainly determined by its location. The lesions are potentially aggressive; therefore, en bloc resection should be attempted whenever possible. However, as shown in the literature, only 15% of patients are suitable for total resection.

  1. Chronic recurrent multifocal osteomyelitis with an atypical presentation in an adult man

    International Nuclear Information System (INIS)

    Hong, Cheng William; Hsiao, Edward C.; Horvai, Andrew E.; Link, Thomas M.

    2015-01-01

    We present the case of a 33-year-old man with no significant medical history who developed right scapular pain, left-sided sacroiliac joint pain, and lower back pain, and was eventually diagnosed with chronic recurrent multifocal osteomyelitis (CRMO). Imaging demonstrated multiple scattered T2-hyperintense lesions on MRI at the spine and the left SI joint, some of which progressed and one regressed in size on follow-up. Histopathology demonstrated only non-specific chronic inflammation compatible with CRMO. No evidence of infectious organisms or neoplastic processes was found. The pain was relapsing and remitting in nature. Laboratory investigations were notable for no evidence of hematologic malignancy or infection, but only a mild increase in alkaline phosphatase. This case highlights that CRMO, despite being thought of as a childhood-onset disease, can present in adults as well, and also provides illustrative examples of imaging and histological findings. (orig.)

  2. Chronic Recurrent Multifocal Osteomyelitis in a 9-year-old Boy

    Directory of Open Access Journals (Sweden)

    Abdolreza Malek

    2017-05-01

    Full Text Available Chronic recurrent multifocal osteomyelitis (CRMO is a rare aseptic, auto-inflammatory bone disorder. CRMO presents with bone pain with or without fever. The diagnosis of CRMO is a diagnosis of exclusion and should be included in the differential diagnosis of chronic inflammatory bone lesions in children. Cultures of the bone are typically sterile, antibiotic therapy does not result in clinical improvement whereas anti-inflammatory drugs improve the condition. Furthermore, biopsy should be considered in chronic and relapsing bone pain and swelling unresponsive to treatment. Herein, we present a nine-year-old boy complaining of recurrent pain in his upper and lower extremities. On examination he had mild fever and cervical lymphadenopathy. He also had experienced bone pain and weight loss in the recent month. Based on biopsy and bone scan he was finally diagnosed with CRMO. Naproxen and Pamidronate was prescribed and he was getting better and returned to normal life and activity without need to corticosteroids.

  3. The surgery and early postoperative radicular pain in cases with multifocal lumbar disc herniation

    Science.gov (United States)

    Ulutaş, Murat; Çınar, Kadir; Seçer, Mehmet

    2017-01-01

    Abstract Persistence of postoperative radicular pain after surgery for multifocal disc herniation (MFDH) is a clinical problem. This study aims to evaluate the effects of a combined treatment approach compared with unilateral stabilization on early postoperative radicular pain in patients with MFDH. Age, sex, level of operation, clinical findings, and radicular pain visual analogue scale (VAS) scores before surgery in the early postoperative period and at 3 months after surgery were retrospectively reviewed for 20 cases of multifocal lumbar disc herniation. The combined approach (translaminar and far lateral) was used for 13 cases. Seven cases underwent transforaminal lumbar interbody fusion (TLIF) and unilateral transpedicular stabilization following total facetectomy. The mean age of the sample was 49.4 ± 10.1 years and the female-to-male ratio was 8:12. The mean VAS scores for radicular pain in cases treated with the combined approach were 8.2, 4.07, and 2.3 in the preoperative and early postoperative periods and 3 months after surgery, respectively. The mean score for radicular pain improved by 50.4% in the early postoperative period and by 72% in the late postoperative period. The mean VAS scores for radicular pain in cases who underwent TLIF and unilateral stabilization after facetectomy were 8.4, 2.1, and 1.4 in the preoperative and early postoperative periods and 3 months after surgery, respectively. The mean VAS score for radicular pain improved by 75% in the early postoperative period and by 83.3% in the late postoperative period. The combined approach is an effective alternative in cases with MFDH. TLIF and unilateral segmental stabilization provide substantial decompression and eliminate mechanical compression by conserving the height of the intervertebral foramen in the event that sufficient decompression is unable to obtain. We suggest that elimination of chemical mediators, particularly those causing pain in the dorsal ganglion, contributes to

  4. Visual impairment due to bilateral multifocal choroidal metastasis of parotid adenocarcinoma: a case report.

    Directory of Open Access Journals (Sweden)

    Gerard eWalls

    2014-06-01

    Full Text Available BackgroundOrbital metastases are an uncommon finding, being present in just 9% deceased patients with metastatic cancer. Only a quarter of patients with choroidal metastases have bilateral disease. Parotid cancer is not a common form of head and neck malignancy. Bilateral multifocal metastases from adenocarcinoma ex pleomorphic of parotid gland have been documented just once before in the literature. We present a similar case where palliative EBRT was used to gain local control with minimal toxicity.Case PresentationThe case of a 45 year old Caucasian gentleman who presented to his general practitioner with otalgia and weight loss. Imaging revealed a mass in the deep lobe of the left parotid gland, invading into the medial pterygoid muscle. PET-CT revealed locoregional and distant lymphatic involvement plus disseminated skeletal metastases. Lymph node examination revealed adenocarcinoma ex pleomorphic histology. Within weeks of this diagnosis, the patient developed rapidly progressive visual impairment. Ophthalmologists found multifocal uveal masses bilaterally. Palliative fractions of external beam radiotherapy were delivered to the orbits before combination chemotherapy. We discuss the patient's presentation, histopathology and management, with support from the literature regarding applied and related therapies. SummaryIn this rare presentation of disseminated malignancy affecting the choroid bilaterally, the authors demonstrate the application of palliative EBRT to good local effect. Given the nature of this treatment and that of the metastases, in the setting of incurable disease orbital morbidity is likely to occur again before the patient's death. Awareness of the initial symptoms is important to provide prompt care and maintain quality of life.

  5. Visual outcomes after implantation of a novel refractive toric multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Talita Shimoda

    2014-04-01

    Full Text Available Purpose: To assess the postoperative outcomes of a novel toric multifocal in traocular lens (IOL in patients with cataract and corneal astigmatism. Methods: This prospective nonrandomized study included patients with cataract, corneal astigmatism, and a motivation for spectacle independence. In all patients, a Rayner M-flex® T toric IOL was implanted in the capsular bag. Three months after surgery, the distance, intermediate, and near visual acuities; spherical equivalent; residual refractive astigmatism; defocus curve; and contrast sensitivity were evaluated. A patient satisfaction and visual phenomena questionnaire was administered to all patients. Results: Thirty-four eyes of 18 patients were included in this study. Three months after surgery, the mean corrected distance visual acuity (logMAR was 0.00 ± 0.08 at 6 m, 0.20 ± 0.09 at 70 cm, and 0.08 ± 0.11 at 40 cm. Uncorrected distance vision acuity was 20/40 or better in 100% eyes. The preoperative mean refractive cylinder (RC was -2.19 (SD: ± 0.53. After a 3-month follow-up, the average RC was -0.44 D (SD: ± 0.27; p<0.001. Contrast sensitivity levels were high. At the last follow-up, 87.5% patients were spectacle-independent for near, intermediate, and distance vision, and approximately 44% patients reported halos and glare. Conclusion: Toric multifocal IOL implantation in patients with cataract and corneal astigmatism using the Rayner M-flex® T toric IOL was a simple, safe, and accurate option. This technology provides surgeons with a feasible option for meeting patient expectations of an enhanced lifestyle resulting from decreased spectacle dependence.

  6. MULTIPLE OBJECTS

    Directory of Open Access Journals (Sweden)

    A. A. Bosov

    2015-04-01

    Full Text Available Purpose. The development of complicated techniques of production and management processes, information systems, computer science, applied objects of systems theory and others requires improvement of mathematical methods, new approaches for researches of application systems. And the variety and diversity of subject systems makes necessary the development of a model that generalizes the classical sets and their development – sets of sets. Multiple objects unlike sets are constructed by multiple structures and represented by the structure and content. The aim of the work is the analysis of multiple structures, generating multiple objects, the further development of operations on these objects in application systems. Methodology. To achieve the objectives of the researches, the structure of multiple objects represents as constructive trio, consisting of media, signatures and axiomatic. Multiple object is determined by the structure and content, as well as represented by hybrid superposition, composed of sets, multi-sets, ordered sets (lists and heterogeneous sets (sequences, corteges. Findings. In this paper we study the properties and characteristics of the components of hybrid multiple objects of complex systems, proposed assessments of their complexity, shown the rules of internal and external operations on objects of implementation. We introduce the relation of arbitrary order over multiple objects, we define the description of functions and display on objects of multiple structures. Originality.In this paper we consider the development of multiple structures, generating multiple objects.Practical value. The transition from the abstract to the subject of multiple structures requires the transformation of the system and multiple objects. Transformation involves three successive stages: specification (binding to the domain, interpretation (multiple sites and particularization (goals. The proposed describe systems approach based on hybrid sets

  7. Desempenho visual após implante de uma lente intraocular asférica multifocal difrativa Visual performance after implantation of an aspheric multifocal diffractive intraocular lens

    Directory of Open Access Journals (Sweden)

    Leonardo Akaishi

    2010-08-01

    Full Text Available OBJETIVO: Avaliar a acuidade visual a distancia, intermediária e perto após o implante de uma lente intraocular (LIO asférica multifocal difrativa AcrySof® ReSTOR® SN6AD1. MÉTODOS: Estudo prospectivo de 50 pacientes com catarata submetidos à facoemulsificação e implante de LIO AcrySof® ReSTOR®. Foram avaliados acuidade visual sem correção (AVSC, acuidade visual com correção (AVCC para longe, acuidade visual para perto corrigida para longe (AVPC e acuidade visual intermediária corrigida para longe (AVIC. Um questionário de satisfação e fenômenos visuais foi administrado ao final do estudo. RESULTADO: Após três meses de cirurgia, a média das acuidades (logMAR era: AVSC, 0,05 ± 0,07; AVCC, 0,00 ± 0,01; AVPC, 0,00 ± 0,0, e AVIC, 0,15 ± 0,05. A AVCC e AVPC era de 20/25 ou melhor em todos os pacientes, sendo a AVIC J3 ou melhor em 83% dos pacientes. Pacientes relataram excelente desempenho visual nas questões relacionadas a atividades para distância, intermediário, e perto com pouca ou nenhuma dificuldade. Nenhum paciente relatou halos ou 'glare' severos, sendo os mesmos caracterizados entre nenhum a moderado. CONCLUSÃO: A LIO asférica AcrySof® ReSTOR® SN6AD1 mostrou excelentes resultados na visão para longe, perto e intermediário, além de apresentar uma baixa incidência de fenômenos visuais.PURPOSE: To evaluate distance, intermediate, and near vision after aspheric multifocal diffractive AcrySof® ReSTOR® SN6AD1 intraocular lens (IOL implantation. METHODS: Prospective study of 50 patients with cataract that had phacoemulsification and AcrySof® ReSTOR® IOL implantation. Uncorrected distance vision acuity (UDVA, corrected distance visual acuity (CDVA, distance-corrected near visual acuity (DCNVA, and distance-corrected intermediate visual acuity (DCIVA were measured postoperatively. A patient-satisfaction and visual phenomena questionnaire was administered at the end of the study. RESULTS: Three months

  8. Performance Objectives

    Science.gov (United States)

    1978-12-01

    mathematics program. Ir this study he measured mathenatics skills, mathematics application, ard student attitudes. Ne used the Stanford Achievement...34most vague" (5). Means and variances were computed for each Item on the questionnaire, Correlations were then ccinputed between and among the...between subjects’ ratings of objectives with direct objects and objectives containing "x" and "y." This is reflected in tests computed separately for

  9. Dual Supervised Learning

    OpenAIRE

    Xia, Yingce; Qin, Tao; Chen, Wei; Bian, Jiang; Yu, Nenghai; Liu, Tie-Yan

    2017-01-01

    Many supervised learning tasks are emerged in dual forms, e.g., English-to-French translation vs. French-to-English translation, speech recognition vs. text to speech, and image classification vs. image generation. Two dual tasks have intrinsic connections with each other due to the probabilistic correlation between their models. This connection is, however, not effectively utilized today, since people usually train the models of two dual tasks separately and independently. In this work, we p...

  10. Dual-energy performance of dual kVp in comparison to dual-layer and quantum-counting CT system concepts

    Science.gov (United States)

    Kappler, S.; Grasruck, M.; Niederlöhner, D.; Strassburg, M.; Wirth, S.

    2009-02-01

    Recent publications in the field of Computed Tomography (CT) demonstrate the rising interest in applying dual-energy methods for material classification during clinical routine examinations. Based on today's standard of technology, dual-energy CT can be realized by either scanning with different X-ray spectra or by deployment of energy selective detector technologies. The list of so-called dual-kVp methods contains sequential scans, fast kVp-switching and dual-source CT. Examples of energy selective detectors are scintillator-based energyintegrating dual-layer devices or direct converter with quantum counting electronics. The general difference of the approaches lies in the shape of the effectively detected X-ray energy spectra and in the presence of crossscatter radiation in the case of dual-source devices. This leads to different material classification capabilities for the various techniques. In this work, we present detector response simulations of realistic CT scans with subsequent CT image reconstruction. Analysis of the image data allows direct and objective comparison of the dual-kVp, dual-layer, and quantum counting CT system concepts. The dual-energy performance is benchmarked in terms of image noise and Iodine-bone separation power at given image sharpness and dose exposure. For the case of dual-source devices the effect of cross-scatter radiation, as well as the benefit of additional filtering are taken into account.

  11. Objective lens

    Science.gov (United States)

    Olczak, Eugene G. (Inventor)

    2011-01-01

    An objective lens and a method for using same. The objective lens has a first end, a second end, and a plurality of optical elements. The optical elements are positioned between the first end and the second end and are at least substantially symmetric about a plane centered between the first end and the second end.

  12. Agile Objects

    Science.gov (United States)

    German, Senta; Harris, Jim

    2017-01-01

    In this article, the authors argue that the art-historical canon, however it is construed, has little relevance to the selection of objects for museum-based teaching. Their contention is that all objects are fundamentally agile and capable of interrogation from any number of disciplinary standpoints, and that the canon of museum education,…

  13. Dual Income Taxes

    DEFF Research Database (Denmark)

    Sørensen, Peter Birch

    This paper discusses the principles and practices of dual income taxation in the Nordic countries. The first part of the paper explains the rationale and the historical background for the introduction of the dual income tax and describes the current Nordic tax practices. The second part...... of the paper focuses on the problems of taxing income from small businesses and the issue of corporate-personal tax integration under the dual income tax, considering alternative ways of dealing with these challenges. In the third and final part of the paper, I briefly discuss whether introducing a dual income...

  14. Dual quaternions and dual projective spaces

    Energy Technology Data Exchange (ETDEWEB)

    Ata, Erhan [Department of Mathematics, Dumlupinar University, 43100 Kutahya (Turkey)], E-mail: eata@dumlupinar.edu.tr; Yayli, Yusuf [Department of Mathematics, Ankara University, 06100 Ankara (Turkey)

    2009-05-15

    In this study, dual unitary matrices SU{sub D}(2) were obtained. We correspond to one to one elements of the unit dual sphere S{sub D}{sup 3} with the dual unitary matrices SU{sub D}(2). Thus, we express spherical concepts such as meridians of longitude and parallels of latitude on SU{sub D}(2). The equality SO(R{sup 3}) {approx_equal} S{sup 3}/{l_brace}{+-}1{r_brace} = RP{sup 3} known as the real projective spaces was generalized to the dual projective space and then, the equality SO(D{sup 3}){approx_equal}S{sub D}{sup 3}/{l_brace}{+-}1{r_brace}=DP{sup 3} was acquired. In particular, 2-sphere S{sup 2} was obtained by considering dual parts as zero of S{sub D}{sup 3}. Hence, it was found that Hop fibriation map of S{sup 2} can be used for Twistors in quantum mechanics applications.

  15. Progressive multifocal leukoencephalopathy in a child with acquired immunodeficiency syndrome (AIDS Leucoencefalopatia multifocal progressiva em uma criança com síndrome da imunodeficiênda adquirida

    Directory of Open Access Journals (Sweden)

    Alexandra Prufer de Q.C. Araujo

    1997-01-01

    Full Text Available Progressive multifocal leukoencephalopathy is a rare viral-induced demyelinating disease associated to immunodeficiency. A 10-year-old boy with AIDS is reported, who developed subacute cerebellar signs and symptoms with multiple cranial nerve involvement and dementia. A computed tomography scan revealed a focal nonenhancing area of low attenuation in the cerebellum. On magnetic resonance imaging high signal lesions in T2 weighted sequences were shown. The biopsy of one of those lesions showed the typical histological findings of progressive multifocal leukoencephalopathy. It seems important to consider this diagnosis in children with AIDS who present with progressive neurological features.A leucoencefalopatia multifocal progressiva é uma doença desmielinizante rara, induzida por vírus em indivíduos imunodeficientes. Relata-se o caso de um menino de 10 anos de idade com síndrome da imunodeficiência adquirida (SIDA, que desenvolveu quadro subagudo de sinais e sintomas cerebelares com acometimento de nervos cranianos e demência. A tomografia computadorizada de crânio mostrou uma área de hipodensidade não captante no cerebelo. A ressonância magnética evidenciou áreas de hipersinal na seqüência em T2. A biópsia de uma destas lesões revelou os achados histológicos típicos da leucoencefalopatia multifocal progressiva. Esta hipótese, portanto, deve ser considerada em crianças com SIDA que apresentem deterioração neurológica progressiva.

  16. Trusted Objects

    Energy Technology Data Exchange (ETDEWEB)

    CAMPBELL,PHILIP L.; PIERSON,LYNDON G.; WITZKE,EDWARD L.

    1999-10-27

    In the world of computers a trusted object is a collection of possibly-sensitive data and programs that can be allowed to reside and execute on a computer, even on an adversary's machine. Beyond the scope of one computer we believe that network-based agents in high-consequence and highly reliable applications will depend on this approach, and that the basis for such objects is what we call ''faithful execution.''

  17. The dual burden household and the nutrition transition paradox

    NARCIS (Netherlands)

    Doak, C.M.; Adair, L.S.; Bentley, M.; Monteiro, C.; Popkin, B.M.

    2005-01-01

    OBJECTIVE: The purpose of this study is to document the prevalence of households with underweight and overweight persons (henceforth referred to as dual burden households) and their association with income and urban residence. The explorations by urban residence and income will test whether dual

  18. Diagnostic value of combined magnetic resonance imaging examination of brachial plexus and electrophysiological studies in multifocal motor neuropathy

    Directory of Open Access Journals (Sweden)

    Basta Ivana

    2014-01-01

    Full Text Available Background/Aim. Multifocal motor neuropathy (MMN is an immune-mediated disorder characterized by slowly progressive asymetrical weakness of limbs without sensory loss. The objective of this study was to investigate the involvement of brachial plexus using combined cervical magnetic stimulation and magnetic resonance imaging (MRI of plexus brachialis in patients with MMN. We payed special attention to the nerve roots forming nerves inervating weak muscles, but without detectable conduction block (CB using conventional nerve conduction studies. Methods. Nine patients with proven MMN were included in the study. In all of them MRI of the cervical spine and brachial plexus was performed using a Siemens Avanto 1.5 T unit, applying T1 and turbo spinecho T1 sequence, axial turbo spin-echo T2 sequence and a coronal fat-saturated turbo spin-echo T2 sequence. Results. In all the patients severe asymmetric distal weakness of muscles inervated by radial, ulnar, median and peroneal nerves was observed and the most striking presentation was bilateral wrist and finger drop. Three of them had additional proximal weakness of muscles inervated by axillar and femoral nerves. The majority of the patients had slightly increased cerebrospinal fluid (CSF protein content. Six of the patients had positive serum polyclonal IgM anti-GM1 antibodies. Electromyoneurography (EMG showed neurogenic changes, the most severe in distal muscles inervated by radial nerves. All the patients had persistent partial CBs outside the usual sites of nerve compression in radial, ulnar, median and peroneal nerves. In three of the patients cervical magnetic stimulation suggested proximal CBs between cervical root emergence and Erb’s point (prolonged motor root conduction time. In all the patients T2-weighted MRI revealed increased signal intensity in at least one cervical root, truncus or fasciculus of brachial plexus. Conclusion. We found clinical correlation between muscle weakness

  19. Multifocal Head and Neck Neurofibromas with Osseous Abnormalities and Muscular Hypoplasia in a Child with Neurofibromatosis: Type I

    Directory of Open Access Journals (Sweden)

    Rachna Rath

    2016-01-01

    Full Text Available Neurofibromatosis type 1 (NF1 is a clinically and genetically distinct disease involving both neuroectodermal and mesenchymal derivatives. Orofacial manifestations in NF1 have been documented before but occurrence of multifocal intraosseous (IO and extraosseous (EO neurofibromas is rare. The present case highlights the importance of imaging findings in the diagnosis and management of multifocal jaw, infratemporal, and parotid neurofibromas with muscular hypoplasia in an eight-year-old girl with NF1. Apart from orthopantomograms (OPG, three-dimensional computed tomography (3D CT and cross-sectional reformations were valuable in delineating the extent of the lytic lesion and identifying additional bony deformities of the mandible. Magnetic resonance imaging (MRI helped to identify the solid nature of the lesion and true extent of the soft tissue mass.

  20. Dual gravity and matter

    NARCIS (Netherlands)

    Bergshoeff, Eric A.; Roo, Mees de; Kerstan, Sven F.; Kleinschmidt, Axel; Riccioni, Fabio

    We consider the problem of finding a dual formulation of gravity in the presence of non-trivial matter couplings. In the absence of matter a dual graviton can be introduced only for linearised gravitational interactions. We show that the coupling of linearised gravity to matter poses obstructions to

  1. A Dual Egalitarian Solution

    NARCIS (Netherlands)

    Klijn, F.; Slikker, M.; Tijs, S.H.

    2000-01-01

    In this note we introduce an egalitarian solution, called the dual egalitarian solution, that is the natural counterpart of the egalitarian solution of Dutta and Ray (1989).We prove, among others, that for a convex game the egalitarian solution coincides with the dual egalitarian solution for its

  2. Dual Credit Report

    Science.gov (United States)

    Light, Noreen

    2016-01-01

    In 2015, legislation to improve access to dual-credit programs and to reduce disparities in access and completion--particularly for low income and underrepresented students--was enacted. The new law focused on expanding access to College in the High School but acknowledged issues in other dual-credit programs and reinforced the notion that cost…

  3. The Dual Career Family.

    Science.gov (United States)

    Gurtin, Lee

    1980-01-01

    The dual career couple is forced to make a series of choices and compromises that impact the realms of marriage and career. The dilemmas that confront dual career marriages can be overcome only by compromise, accommodation, and mutual understanding on the part of the individuals involved. A revamping of human resources and recruitment programs is…

  4. Comparison of Contrast Sensitivity and Through Focus in Small-Aperture Inlay, Accommodating Intraocular Lens, or Multifocal Intraocular Lens Subjects.

    Science.gov (United States)

    Vilupuru, Srividhya; Lin, Ling; Pepose, Jay S

    2015-07-01

    To compare monocular and binocular mesopic contrast sensitivity and through focus following monocular implantation with KAMRA small-aperture inlay (AcuFocus, Irvine, California, USA) vs binocular implantation with an accommodating or multifocal intraocular lens (IOL) implant. Three-treatment randomized clinical trial of presbyopia-correcting IOLs with comparison to results from a previous nonrandomized multicenter clinical trial on the KAMRA corneal inlay. Study population of 507 subjects with KAMRA inlays; predetermined subgroups included 327 subjects that underwent contrast sensitivity testing and another 114 subjects for defocus curve testing, along with 78 subjects randomized between bilateral Crystalens Advanced Optics (AO) (Bausch + Lomb Surgical, Aliso Viejo, California, USA), AcrySof IQ ReSTOR +3.0 D (Alcon Laboratories, Fort Worth, Texas, USA), or Tecnis +4D Multifocal (MF) (Abbott Medical Optics, Santa Ana, California, USA) IOL. KAMRA inlay subjects demonstrated improved intermediate and near vision with minimal to no change to distance vision, better contrast sensitivity in the inlay eye when compared to the multifocals, and better binocular contrast sensitivity when compared to all 3 intraocular lenses. Crystalens AO was superior in uncorrected intermediate vision compared to the KAMRA inlay, but not in distance-corrected intermediate, and was worse in near vision. The multifocals were superior in near vision at their respective optimum near focus points, but worse in intermediate vision compared to both KAMRA inlay and Crystalens AO. The demonstrated performance of these devices should be considered, along with subjects' visual demands and expectations, degree of crystalline lens dysfunction, and other ocular characteristics, in guiding the selection of small-aperture corneal inlay or specific intraocular lens in the correction of presbyopia. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. The effect of dimethyl fumarate (Tecfidera™) on lymphocyte counts: A potential contributor to progressive multifocal leukoencephalopathy risk.

    Science.gov (United States)

    Khatri, Bhupendra O; Garland, Jeffery; Berger, Joseph; Kramer, John; Sershon, Lisa; Olapo, Tayo; Sesing, Jean; Dukic, Mary; Rehn, Eileen

    2015-07-01

    Dimethyl fumarate (Tecfidera™) is an effective therapy for relapsing forms of multiple sclerosis (MS). Our study suggests that this drug may have immunosuppressive properties evidenced by significant sustained reduction in CD8 lymphocyte counts and, to a lesser extent, CD4 lymphocyte counts. This observation is relevant in light of the recent case of progressive multifocal leukoencephalopathy in a patient receiving this drug. Copyright © 2015. Published by Elsevier B.V.

  6. Fashion Objects

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2009-01-01

    This article attempts to create a framework for understanding modern fashion phenomena on the basis of Durkheim's sociology of religion. It focuses on Durkheim's conception of the relation between the cult and the sacred object, on his notion of 'exteriorisation', and on his theory of the social...... symbol in an attempt to describe the peculiar attraction of the fashion object and its social constitution. However, Durkheim's notions of cult and ritual must undergo profound changes if they are to be used in an analysis of fashion. The article tries to expand the Durkheimian cult, radically enlarging...... it without totally dispersing it; depicting it as held together exclusively by the sheer 'force' of the sacred object. Firstly, the article introduces the themes and problems surrounding Durkheim's conception of the sacred. Next, it briefly sketches an outline of fashion phenomena in Durkheimian categories...

  7. Accuracy of iodine quantification using dual energy CT in latest generation dual source and dual layer CT

    NARCIS (Netherlands)

    Pelgrim, Gert Jan; van Hamersvelt, Robbert W; Willemink, Martin J; Schmidt, Bernhard T; Flohr, Thomas; Schilham, Arnold; Milles, Julien; Oudkerk, Matthijs; Leiner, Tim; Vliegenthart, Rozemarijn

    OBJECTIVE: To determine the accuracy of iodine quantification with dual energy computed tomography (DECT) in two high-end CT systems with different spectral imaging techniques. METHODS: Five tubes with different iodine concentrations (0, 5, 10, 15, 20 mg/ml) were analysed in an anthropomorphic

  8. Fashion Objects

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2009-01-01

    This article attempts to create a framework for understanding modern fashion phenomena on the basis of Durkheim's sociology of religion. It focuses on Durkheim's conception of the relation between the cult and the sacred object, on his notion of 'exteriorisation', and on his theory of the social...... symbol in an attempt to describe the peculiar attraction of the fashion object and its social constitution. However, Durkheim's notions of cult and ritual must undergo profound changes if they are to be used in an analysis of fashion. The article tries to expand the Durkheimian cult, radically enlarging...... of the enlargement of the cult into individual behaviour....

  9. Training dual tasks together or apart in Parkinson's disease: Results from the DUALITY trial

    NARCIS (Netherlands)

    Strouwen, C.; Molenaar, E.A.L.M.; Munks, L.; Keus, S.H.; Zijlmans, J.C.; Vandenberghe, W.; Bloem, B.R.; Nieuwboer, A.

    2017-01-01

    BACKGROUND AND OBJECTIVES: Many controversies surround the usefulness of dual-task training in Parkinson's disease (PD). This study (1) compared the efficacy of two different dual-task training programs for improving dual-task gait and (2) assessed the possible fall risk of such training. METHODS:

  10. Executive functioning in dual-diagnosis

    NARCIS (Netherlands)

    Duijkers, J.C.L.M.; Vissers, C.T.W.M.; Egger, J.I.M.

    2016-01-01

    Objectives: In mental health, the term dual-diagnosis (DD) is used for the co-occurrence of Substance Use Disorder (SUD: alcohol/drugs) with another mental disorder. These co-occurring disorders can have a shared cause, and can cause/intensify each other's expression. Forming a threat to health and

  11. Distributed Model Predictive Control via Dual Decomposition

    DEFF Research Database (Denmark)

    Biegel, Benjamin; Stoustrup, Jakob; Andersen, Palle

    2014-01-01

    . This allows coordination of all the subsystems without the need of sharing local dynamics, objectives and constraints. To illustrate this, an example is included where dual decomposition is used to resolve power grid congestion in a distributed manner among a number of players coupled by distribution grid...

  12. Comprehensive treatment of a functional pancreatic neuroendocrine tumor with multifocal liver metastases.

    Science.gov (United States)

    Wang, Wei; Seeruttun, Sharvesh Raj; Fang, Cheng; Zhou, Zhiwei

    2014-08-01

    A 64-year-old man was admitted to the Sun Yat-Sen University Cancer Center with chief complaints of recurrent abdominal pain and diarrhea for about 3 years and with a history of surgical repair for intestinal perforation owing to stress ulcer. Positron emission tomography (PET)/computed tomography (CT) demonstrated a primary tumor on the pancreatic tail with multifocal liver metastases. Pathological and immunohistochemistry staining revealed the lesion to be a pancreatic neuroendocrine tumor (pNET). According to the latest World Health Organization (WHO, 2013) classification, the tumor was classified as stage IV functional G1 pNET. After referral to the multidisciplinary treatment board (MDT), the patient was started on periodic dose of omeprazole, somatostatin analogues and Interferon α (IFNα) and had scanning follow-ups. Based upon the imaging results, CT-guided radioactive iodine-125 ((125)I) seeds implantation therapy, radiofrequency ablation therapy (RFA) or microwave ablation technique were chosen for the treatment of the primary tumor. Transarterial chemoembolization (TACE), RFA and microwave ablation techniques were decided upon for liver metastases. The patient showed beneficial response to the treatment with clinically manageable low-grade side effects and attained partial remission (RECIST criteria) with a good quality of life.

  13. Successful treatment of chronic recurrent multifocal osteomyelitis using low-dose radiotherapy. A case report

    International Nuclear Information System (INIS)

    Dietzel, Christian T.; Vordermark, Dirk; Schaefer, Christoph

    2017-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory disease, which lacks an infectious genesis and predominantly involves the metaphysis of long bones. Common treatments range from nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids at first onset of disease, to immunosuppressive drugs and bisphosphonates in cases of insufficient remission. The therapeutic use of low-dose radiotherapy for CRMO constitutes a novelty. A 67-year-old female patient presented with radiologically proven CRMO affecting the right tibia/talus and no response to immunosuppressive therapy. Two treatment series of radiation therapy were applied with an interval of 6 weeks. Each series contained six fractions (three fractions per week) with single doses of 0.5 Gy, thus the total applied dose was 6 Gy. Ten months later, pain and symptoms of osteomyelitis had completely vanished. Radiotherapy seems to be an efficient and feasible complementary treatment option for conventional treatment refractory CRMO in adulthood. The application of low doses per fraction is justified by the inflammatory pathomechanism of disease. (orig.) [de

  14. New Insights on Human Polyomavirus JC and Pathogenesis of Progressive Multifocal Leukoencephalopathy

    Directory of Open Access Journals (Sweden)

    Anna Bellizzi

    2013-01-01

    Full Text Available John Cunningham virus (JCV is a member of the Polyomaviridae family. It was first isolated from the brain of a patient with Hodgkin disease in 1971, and since then the etiological agent of the progressive multifocal leukoencephalopathy (PML was considered. Until the human immunodeficiency virus (HIV pandemic, PML was rare: in fact HIV-induced immunodeficiency is the most common predisposing factor accounting for 85% of all instances of PML. This data led to intense research on JCV infection and resulted in better understanding of epidemiology and clinic-pathologic spectrum. Recently, cases of PML have been observed after the introduction of monoclonal antibodies, such as natalizumab, rituximab, efalizumab, and infliximab, in the treatment of autoimmune disease, underlining the important role of host immunity in PML pathogenesis. In this review current understanding of the JCV infection and the new findings relating to the pathogenesis of PML has been comprehensively revised, focusing our attention on the interaction between the cellular and viral molecular pathways implicated in the JCV infection and the modulating role of host immune surveillance in the viral reactivation from a latent state.

  15. Multifocal pancreatic serous cystadenoma with atypical cells and focal perineural invasion.

    Science.gov (United States)

    Kamei, K; Funabiki, T; Ochiai, M; Amano, H; Kasahara, M; Sakamoto, T

    1991-10-01

    A case of multifocal pancreatic serous cystadenoma with atypical cells is reported. The patient was a 72-yr-old female who complained of jaundice. The distal common bile duct was obstructed, and the proximal bile duct was remarkably dilated on cholangiography. The main portal vein was obstructed and collateral vessels had developed on portal angiography. Total pancreatectomy was performed. The resected specimen contained one tumor in the head of the pancreas, five in the body, and one in the tail. The tumors of the head and body were morphologically the same. Microscopically, both contained spongelike multilocular cysts on their cut surfaces. These cysts were covered with low cuboid epithelium containing clear cytoplasm and abundant glycogen. Neural invasion was also found. The tumor cells exhibited an increased N/C ratio, variable nuclear size, irregular nuclear margins, and coarse nuclear chromatin. These tumors had aneuploid nuclear DNA with a DNA index of 1.9 and a proliferation index of 0.28. We feel that it is necessary to reconsider the biological concept of serous cystadenoma.

  16. [Multiple myeloma with significant multifocal osteolysis in a dog without a detectible gammopathy].

    Science.gov (United States)

    Souchon, F; Koch, A; Sohns, A

    2013-01-01

    Description of a variant of multiple myeloma in a dog lacking the gammopathy normally associated with this type of neoplasm. A Border Collie mongrel was presented with symptoms of progressive hind-leg weakness, lethargy and tiredness, which had started to appear 6 weeks previously. Radiographic examination showed small osteolytic areas in the spinal column, but also diffuse small areas of increased opacity as well as evidence of decreased bone density in the pelvis and of both femoral necks. Moderate regenerative anaemia, hypogammopathy and hypercalcaemia were diagnosed. Computed tomography scans displayed multifocal osteolysis and bone destruction in the skull, spinal column, scapulae, proximal humeri, pelvis and femoral necks. H&E staining of the biopsies showed bone destruction and monomorphic plasmacyotid cell populations, causing infiltrative bone marrow lesions and osteolysis. In many areas neoplastic plasma cell infiltration of the bone marrow was 70% and in some areas reached 100%. The diagnosis was non-secretory multiple myeloma without apparent secretion of paraproteins into the blood.

  17. Mefloquine improved progressive multifocal leukoencephalopathy in a patient with immunoglobulin A nephropathy.

    Science.gov (United States)

    Shin, Jung-Won; Jung, Keun-Hwa; Lee, Soon-Tae; Moon, Jangsup; Lim, Jung-Ah; Byun, Jung-Ick; Park, Kyung-Il; Lee, Sang Kun; Chu, Kon

    2014-10-01

    We describe a patient with immunoglobulin A nephropathy who was diagnosed with progressive multifocal leukoencephalopathy (PML) and successfully treated with mefloquine, an antimalarial medication. A 67-year-old man with immunoglobulin A nephropathy presented to the hospital emergency room with fever and generalized tonic-clonic seizure. Cerebrospinal fluid (CSF) nested polymerase chain reaction (PCR) was positive for John Cunningham virus and brain MRI displayed high signal intensity in the white matter in the right parietal lobe without gadolinium enhancement. Tapering of prednisone did not arrest the disease progression and a new lesion was detected on the cerebellum. Administration of mefloquine stopped lesion progression and resulted in dramatic clinical improvement. The CSF nested PCR for the John Cunningham virus also became negative. In reviewing the literature, mefloquine has had a heterogeneous effect in PML patients, and P-glycoprotein polymorphism and proper dosage could contribute to the various effects seen. Mefloquine may be a favorable treatment option in some patients with PML, and P-glycoprotein polymorphism may play an important role in its efficacy. More large studies in other ethnic groups including polymorphism studies for the gene encoding P-glycoprotein (ABCB1/MDR1) and taking into account various underlying conditions with secondary immunosuppression should be carried out to investigate whether mefloquine is effective for treating PML. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Macular and Multifocal PERG and FD-OCT in Preperimetric and Hemifield Loss Glaucoma.

    Science.gov (United States)

    Kreuz, André C; de Moraes, Carlos G; Hatanaka, Marcelo; Oyamada, Maria K; Monteiro, Mario L R

    2018-02-01

    To evaluate the ability of macular and multifocal (mf) pattern electroretinogram (PERG) to differentiate preperimetric glaucoma (PG) and glaucoma with hemifield loss (GHL) from controls, to compare the discrimination ability of PERG and fourier-domain optical coherence tomography (FD-OCT), and to assess the relationship between measurements. Standard automated perimetry, steady-state and transient PERG and mfPERG measurements were obtained from PG (n=14, 24 eyes), GHL (n=5, 7 eyes), and controls (n=19, 22 eyes). Circumpapillary retinal nerve fiber layer (cpRNFL), full-thickness macula, and segmented macular layer thicknesses on FD-OCT were investigated. Measurements were compared using mixed effects linear models. The relationships between measurements and the diagnostic performance of each technology were assessed. Compared with controls, average P50 peak time transient PERG responses were reduced in PG and GHL, whereas average latency and amplitude steady-state and mfPERG responses were abnormal only in GHL. cpRNFL and macular thickness measurements in PG and GHL differed significantly from controls. A significant relationship was found between PERG and most FD-OCT or SAP parameters. Partial least squares discriminant analysis revealed that OCT parameters, along with mfPERG and transient PERG parameters had similar ability to discriminate PG and GHL from healthy controls. PERG and OCT parameters may be abnormal, with significant correlations between measurements, in PG eyes. Both technologies may be useful for detection of early glaucoma.

  19. CHARACTERIZING PHOTORECEPTOR CHANGES IN ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY USING ADAPTIVE OPTICS.

    Science.gov (United States)

    Roberts, Philipp K; Nesper, Peter L; Onishi, Alex C; Skondra, Dimitra; Jampol, Lee M; Fawzi, Amani A

    2018-01-01

    To characterize lesions of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) by multimodal imaging including adaptive optics scanning laser ophthalmoscopy (AOSLO). We included patients with APMPPE at different stages of evolution of the placoid lesions. Color fundus photography, spectral domain optical coherence tomography, infrared reflectance, fundus autofluorescence, and AOSLO images were obtained and registered to correlate microstructural changes. Eight eyes of four patients (two women) were included and analyzed by multimodal imaging. Photoreceptor reflectivity within APMPPE lesions was more heterogeneous than in adjacent healthy areas. Hyperpigmentation on color fundus photography appeared hyperreflective on infrared reflectance and on AOSLO. Irregularity of the interdigitation zone and the photoreceptor inner and outer segment junctions (IS/OS) on spectral domain optical coherence tomography was associated with photoreceptor hyporeflectivity on AOSLO. Interruption of the interdigitation zone or IS/OS was associated with loss of photoreceptor reflectivity on AOSLO. Irregularities in the reflectivity of the photoreceptor mosaic are visible on AOSLO even in inactive APMPPE lesions, where the photoreceptor bands on spectral domain optical coherence tomography have recovered. Adaptive optics scanning laser ophthalmoscopy combined with multimodal imaging has the potential to enhance our understanding of photoreceptor involvement in APMPPE.

  20. Perspectives of Cosmesis following Breast Conservation for Multifocal and Multicentric Breast Cancers

    Directory of Open Access Journals (Sweden)

    Mona P. Tan

    2015-01-01

    Full Text Available Background. Contemporary data suggest that breast conservation treatment (BCT for multifocal and multicentric breast cancer (MFMCBC may be appropriate with noninferior local control rates. However, there is a paucity of data to evaluate patient’s satisfaction with cosmetic outcomes after BCT for MFMCBC. This study was performed to bridge this information gap. Methods. All patients treated at the authors’ healthcare facility were included in the study. Patients with MFMCBC who were assessed to be eligible for BCT underwent tumour resection using standard surgical techniques with direct parenchymal closure through a single incision. After at least three years of follow-up, they were invited to participate in a survey regarding their cosmetic outcomes. Results. Of a total of 160 patients, 40 had MFMCBC, of whom 34 (85% underwent successful BCT. Five-year cancer-specific survival and disease-free survival were 95.7%. Twenty of the 34 patients responded to the survey. No patient rated her cosmetic outcome as “poor.” Analysis indicated low agreement between patients’ self-assessment and clinician-directed evaluation of aesthetic results. Conclusion. BCT for MFMCBC is feasible with acceptable survival and cosmetic outcomes. However, there appears to be a disparity between patient and clinician-directed evaluation of cosmetic results which warrant further research.

  1. Multifocal spectral-domain optical coherence tomography based on Bessel beam for extended imaging depth

    Science.gov (United States)

    Yi, Luying; Sun, Liqun; Ding, Wuwen

    2017-10-01

    To advance the practical application of optical coherence tomography (OCT) in the field of biomedical imaging, the imaging depth must be extended without sacrificing resolution while maintaining sufficient sensitivity. However, there is an inherent trade-off between lateral resolution and depth of field (DOF) in OCT. To address this shortcoming, this article proposes a multifocal Bessel beam spectral-domain optical coherence tomography (MBSDOCT) capable of increasing the DOF with unchanged lateral resolution and a high signal-to-noise ratio. The proposed technique is demonstrated by simulation and experiment. A three-focal MBSDOCT with an axicon lens theoretically achieved a DOF of ˜6 mm with a lateral resolution of ˜13 μm. In imaging experiments performed on the acinar cells of orange tissue, a measured DOF of ˜4 mm was demonstrated with a sensitivity penalty of ˜18.1 dB, relative to the Gaussian beam spectral-domain OCT, with a 9-mW light source.

  2. Acute Posterior Multifocal Placoid Pigment Epitheliopathy as the Initial Manifestation of Sarcoidosis

    Directory of Open Access Journals (Sweden)

    Adil Darugar

    2011-01-01

    Full Text Available Purpose: To report an undiagnosed case of systemic sarcoidosis manifesting with bilateral acute posterior multifocal placoid pigment epitheliopathy (APMPPE. Case Report: A 26-year-old Caucasian man was referred for management of unilateral visual loss together with a paracentral scotoma developing 2 weeks after a flu-like syndrome. Clinical signs and ancillary diagnostic investigations suggested APMPPE. Laboratory tests demonstrated elevated serum angiotensin converting enzyme and lysozyme levels. Chest CT-scan disclosed moderate hilar lymph node calcifications but QuantiFERON-TB gold test was negative and bronchoalveolar lavage and biopsies were unremarkable. Accessory salivary gland biopsy disclosed epithelioid and gigantocellular granuloma formation without caseum, confirming a diagnosis of sarcoidosis. The fellow eye was involved a few days later and the patient complained of dyspnea. Echocardiography disclosed severe granulomatous myocardial infiltration and high dose corticosteroids and intravenous cyclophosphamide were initiated. Systemic treatment controlled both cardiac and ocular lesions, and was tapered accordingly. Conclusion: The constellation of "white dot syndromes" and systemic symptoms necessitates a general work-up to exclude granulomatous disorders such as sarcoidosis or tuberculosis. Delayed diagnosis of cardiac sarcoidosis may have life-threatening consequences and the ophthalmologist may be the first physician to diagnose the condition.

  3. High b-value diffusion-weighted imaging in progressive multifocal leukoencephalopathy in HIV patients

    International Nuclear Information System (INIS)

    Godi, Claudia; De Vita, Enrico; Davagnanam, Indran; Tombetti, Enrico; Haddow, Lewis; Jaeger, Hans Rolf

    2017-01-01

    An ill-defined hyperintense edge and hypointense core on diffusion-weighted imaging (DWI) is typical of progressive multifocal leukoencephalopathy (PML). We aimed to investigate whether a b-value of 3,000 s/mm 2 (b3000) can improve visualisation of PML, or provide different structural information compared to 1,000 s/mm 2 (b1000). We retrospectively identified HIV-positive patients with confirmed PML studied under a clinical protocol including both b1000 and b3000 DWI. The rim and core of each PML lesion and normal-appearing white matter (NAWM) were outlined on trace-weighted DWI. Signal intensities, apparent diffusion coefficient (ADC) values and volumes were measured and compared between b1000 and b3000. Nine lesions from seven patients were analysed. The rim and core were better visualised on b3000, with higher signal of the rim and lower signal of the core compared to NAWM. The hyperintense rim had non-restricted average ADCs, but included foci of low ADC on both b3000 and b1000. Despite similar total lesion volumes, b3000 displayed significantly larger core and smaller rim volumes than b1000. b3000 improves visualisation of this important PML hallmark. Moreover, b3000 partly reclassifies tissue from rim into core, and might provide potentially more accurate biomarkers of PML activity and prognosis. (orig.)

  4. Multifocal Breast Cancer in Young Women with Prolonged Contact between Their Breasts and Their Cellular Phones

    Directory of Open Access Journals (Sweden)

    John G. West

    2013-01-01

    Full Text Available Breast cancer occurring in women under the age of 40 is uncommon in the absence of family history or genetic predisposition, and prompts the exploration of other possible exposures or environmental risks. We report a case series of four young women—ages from 21 to 39—with multifocal invasive breast cancer that raises the concern of a possible association with nonionizing radiation of electromagnetic field exposures from cellular phones. All patients regularly carried their smartphones directly against their breasts in their brassieres for up to 10 hours a day, for several years, and developed tumors in areas of their breasts immediately underlying the phones. All patients had no family history of breast cancer, tested negative for BRCA1 and BRCA2, and had no other known breast cancer risks. Their breast imaging is reviewed, showing clustering of multiple tumor foci in the breast directly under the area of phone contact. Pathology of all four cases shows striking similarity; all tumors are hormone-positive, low-intermediate grade, having an extensive intraductal component, and all tumors have near identical morphology. These cases raise awareness to the lack of safety data of prolonged direct contact with cellular phones.

  5. High-quality three-dimensional reconstruction and noise reduction of multifocal images from oversized samples

    Science.gov (United States)

    Martišek, Dalibor; Procházková, Jana; Ficker, Tomáš

    2015-09-01

    Three-dimensional (3-D) reconstruction is an indispensable tool in areas such as biology, chemistry, medicine, material sciences, etc. The sample can be reconstructed using confocal or nonconfocal mode of a microscope. The limitation of the confocal approach is the sample size. Currently used devices work mostly with sample surface area up to 1 cm2. We suggest a three-step method that creates 3-D reconstruction from multifocal images in nonconfocal mode that is qualitatively comparable to the confocal results. Our method, thus, takes advantage of both microscope modes-high-quality results without sample size limitation. The preprocessing step eliminates the additive noise with Linderberg-Lévi theorem. The main focus criterion is based on adjusted Fourier transform. In the final step, we eliminate the defective clusters using the adaptive pixel neighborhood algorithm. We proved the effectiveness of our noise reduction and 3-D reconstruction method by the statistical comparisons; the correlation coefficients average 0.987 for all types of Fourier transforms.

  6. Aspherical Lens Design Using Genetic Algorithm for Reducing Aberrations in Multifocal Artificial Intraocular Lens

    Directory of Open Access Journals (Sweden)

    Chih-Ta Yen

    2015-09-01

    Full Text Available A complex intraocular lens (IOL design involving numerous uncertain variables is proposed. We integrated a genetic algorithm (GA with the commercial optical design software of (CODE V to design a multifocal IOL for the human eye. We mainly used an aspherical lens in the initial state to the crystalline type; therefore, we used the internal human eye model in the software. The proposed optimized algorithm employs a GA method for optimally simulating the focusing function of the human eye; in this method, the thickness and curvature of the anterior lens and the posterior part of the IOL were varied. A comparison of the proposed GA-designed IOLs and those designed using a CODE V built-in optimal algorithm for 550 degrees myopia and 175 degrees astigmatism conditions of the human eye for pupil size 6 mm showed that the proposed IOL design improved the spot size of root mean square (RMS, tangential coma (TCO and modulation transfer function (MTF at a spatial frequency of 30 with a pupil size of 6 mm by approximately 17%, 43% and 35%, respectively. However, the worst performance of spherical aberration (SA was lower than 46%, because the optical design involves a tradeoff between all aberrations. Compared with the traditional CODE V built-in optimal scheme, the proposed IOL design can efficiently improve the critical parameters, namely TCO, RMS, and MTF.

  7. Multiple endocrine neoplasia type 1-associated cystic pancreatic endocrine neoplasia and multifocal cholesterol granulomas.

    Science.gov (United States)

    Kimura, Noriko; Komuro, Kazuteru; Uchino, Shinya; Yagihashi, Soroku; Ishidate, Takuzo; Ishizaka, Masanori

    2010-04-01

    A novel combination of tumors was found in a 68 year-old female with Multiple Endocrine Neoplasia type-1 (MEN 1) that included a cystic pancreatic endocrine neoplasm (CPEN), a pituitary adenoma, and multifocal cholesterol granulomas (MCGs) in the breast, pleura, and the extremities. The pancreatic tumor displayed a single central locule surrounded by a thin rim of neoplastic parenchyma. The tumor showed heterogeneity in the architecture that included glandular, trabecular and solid patterns. The tumor cells of the pancreas were immunohistochemically positive for both endocrine and pancreatic acinar markers including chromogranin A, synaptophysin, glucagon, lipase, and reg protein. Electron microscopy revealed that there were numerous smaller dense-cored neurosecretory granules, larger zymogen-like granules and microvilli on the apical side of the tumor cells. The pancreatic tumor was diagnosed as CPEN with acinar cell features. Analysis of the DNA extracted from the tissues revealed that there is a MEN1 germline mutation in exon 10 codon 527, and somatic mutation in exon 2 codon 32 in the pancreatic tumor, and one base pair deletion in exon 2 codon 79 in the pituitary adenoma. Here, we report the case and discuss possible pathogenesis of CPEN and MCGs in a patient with MEN 1.

  8. Multifocal electroretinogram in normal emmetropic subjects: Correlation with optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Rajvardhan Azad

    2012-01-01

    Full Text Available Aim of the Study: To establish the normative database for multifocal electroretinogram (mfERG parameters in a normal emmetropic population. To correlate the data so obtained with the central macular thickness obtained using the optical coherence tomography (OCT scan. Materials and Methods: mfERG data were obtained from 222 eyes of 111 emmetropic subjects. The amplitude (nv/deg 2 and implicit times (ms of the first-order kernel mfERG responses (N1, P1, and N2 waves were obtained and grouped into five rings (Ring 1: Central 2°, Ring 2: 2-5°, Ring 3: 5-10°, Ring 4: 10-15°, Ring 5: >15°. The central macular thickness (CMT was obtained using the macular thickness scan protocol of the OCT. Results: The mfERG data obtained were used to create a normative database. The amplitudes of the mfERG waves were maximum in the fovea and progressively decreased with increasing eccentricity (P = 0.0001. The latencies of the P1 and N2 waves were longest in the central ring and progressively shortened with eccentricity (P = 0.0001. No statistically significant correlations were observed between central ring 1 parameters and the CMT. Conclusion: This study establishes normative database for mfERG parameters in an emmetropic population. No statistically significant correlation was noted between CMT and mfERG parameters.

  9. Neurophysiologic aspects of patients with generalized or multifocal tonic dystonia of reflex sympathetic dystrophy.

    Science.gov (United States)

    van de Beek, Willem-Johan T; Vein, Alla; Hilgevoord, Anthony A J; van Dijk, J Gert; van Hilten, Bob J

    2002-01-01

    Reflex sympathetic dystrophy (RSD) is a syndrome dominated by sensory, autonomic, and motor features of the extremities. In this study, 10 severely affected RSD patients who progressed to multifocal or generalized tonic dystonia underwent H-reflex evaluation, needle electromyography (EMG), polysomnography, somatosensory evoked potentials, and transcranial magnetic stimulation. H-reflex evaluation revealed an impaired vibratory inhibition of the H-reflex and a higher facilitation peak in the recovery curve between 200 to 350 msec. Needle EMG revealed an impaired reciprocal inhibition, and many patients were unable to alter the amount of muscle activity voluntarily. Evaluations of the stretch reflex showed a markedly decreased threshold and abnormal responses to tonic and phasic changes. Polysomnography performed in five patients revealed no abnormal EMG activity during nonrapid eye movement and rapid eye movement sleep, but EEG arousal phenomena provoked abnormally high and brief bursts of surface EMG activity in all registered muscle groups. Somatosensory evoked potentials and transcranial magnetic stimulation were normal. Taken together, the findings in these patients with tonic dystonia of RSD are in accordance with an impairment of inhibitory interneuronal circuits at the level of the brainstem or spinal cord.

  10. Multifocal atrial tachycardia: an unusual cause of cardiogenic shock in a newborn.

    Science.gov (United States)

    Bouziri, Asma; Khaldi, Ammar; Hamdi, Asma; Ben Massoud, Ines; Borgi, Aida; Menif, Khaled; Ben Jaballah, Nejla

    2011-01-01

    Chaotic or multifocal atrial tachycardia (MAT) is a rare tachyarrhythmia in children, accounting for less than 1% of supraventricular tachycardia seen in childhood. The majority of children with MAT are healthy; a few may exhibit mild to life threatening cardiorespiratory disease. To report a new case of MAT revealed by a severe respiratory distress and cardiogenic shock. We report a rare case of MAT revealed by a severe respiratory distress and cardiogenic shock in a 12-day-old newborn. The echocardiogram demonstrated an isolated secundum-type atrial septal defect with a decreased left ventricular function. He was successfully treated with intravenous amiodarone. A relay by oral amiodarone and digoxine was made. Four months later, he had no recurrence of arrhythmia and left ventricular function returned to normal. Our case is original by its association to an isolated ostium secondum-type atrial septal defect and by the occurrence of a congestive heart failure revealing the arrhythmia and the structural heart disease during the neonatal period.

  11. Mitoxantrone Therapy for Acute Posterior Multifocal Placoid Pigment Epitheliopathy with Cerebral Vasculitis

    Directory of Open Access Journals (Sweden)

    Hélène Massé

    2009-01-01

    Full Text Available Purpose. To report favorable outcome of a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE associated with cerebral vasculitis after treatment with immunosuppressive therapy by mitoxantrone. Design. Single case report. Method. A 22-year-old man presented with acute isolated bilateral loss of vision revealing APMPPE. Corticosteroid therapy was initiated and visual acuity gradually improved. Seventeen days later, visual function deteriorated again, associated with flu-like syndrome and severe headaches. A relapse of APMPPE was diagnosed, complicated with lymphocytic meningitis and cerebral ischemia. Intravenous therapy with mitoxantrone was performed in combination with methylprednisolone. Results. Headaches disappeared in a few days whereas visual acuity gradually improved and stabilized at 20/40 in the right eye and 20/32 in the left eye. No adverse event was observed. Clinical improvement was confirmed by magnetic resonance imaging. Conclusion. Cerebral vasculitis is the most severe complication of the extraocular manifestations of APMPEE. This diagnosis should be evoked when severe headaches or behavior disorder are associated with APMPEE.

  12. High b-value diffusion-weighted imaging in progressive multifocal leukoencephalopathy in HIV patients

    Energy Technology Data Exchange (ETDEWEB)

    Godi, Claudia [San Raffaele Scientific Institute, Neuroradiology Department, Milan (Italy); The National Hospital for Neurology and Neurosurgery, Lysholm Department of Neuroradiology, London (United Kingdom); UCL Institute of Neurology, Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, London (United Kingdom); De Vita, Enrico; Davagnanam, Indran [The National Hospital for Neurology and Neurosurgery, Lysholm Department of Neuroradiology, London (United Kingdom); UCL Institute of Neurology, Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, London (United Kingdom); Tombetti, Enrico [Vita-Salute San Raffaele University, Milan (Italy); Haddow, Lewis [University College London, Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, London (United Kingdom); Jaeger, Hans Rolf [The National Hospital for Neurology and Neurosurgery, Lysholm Department of Neuroradiology, London (United Kingdom); UCL Institute of Neurology, Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, London (United Kingdom); University College Hospital, Centre of Medical Imaging, London (United Kingdom)

    2017-09-15

    An ill-defined hyperintense edge and hypointense core on diffusion-weighted imaging (DWI) is typical of progressive multifocal leukoencephalopathy (PML). We aimed to investigate whether a b-value of 3,000 s/mm{sup 2} (b3000) can improve visualisation of PML, or provide different structural information compared to 1,000 s/mm{sup 2} (b1000). We retrospectively identified HIV-positive patients with confirmed PML studied under a clinical protocol including both b1000 and b3000 DWI. The rim and core of each PML lesion and normal-appearing white matter (NAWM) were outlined on trace-weighted DWI. Signal intensities, apparent diffusion coefficient (ADC) values and volumes were measured and compared between b1000 and b3000. Nine lesions from seven patients were analysed. The rim and core were better visualised on b3000, with higher signal of the rim and lower signal of the core compared to NAWM. The hyperintense rim had non-restricted average ADCs, but included foci of low ADC on both b3000 and b1000. Despite similar total lesion volumes, b3000 displayed significantly larger core and smaller rim volumes than b1000. b3000 improves visualisation of this important PML hallmark. Moreover, b3000 partly reclassifies tissue from rim into core, and might provide potentially more accurate biomarkers of PML activity and prognosis. (orig.)

  13. Localization of multifocal electroretinogram abnormalities to the lesion site: findings in a family with Best disease.

    Science.gov (United States)

    Glybina, Inna V; Frank, Robert N

    2006-11-01

    To determine the association between multifocal electroretinogram (mfERG) abnormalities and macular lesions, as shown by retinal photography and optical coherence tomography (OCT), in a 3-generation family with vitelliform macular dystrophy. Five family members were examined using OCT, mfERG, and retinal photography. To localize mfERG abnormalities in relation to retinal findings, we overlaid the mfERG trace arrays on the retinal images and aligned the mfERGs and OCT images in the 180 degrees meridian. Family members had typical macular lesions, normal full-field ERGs, and reduced electro-oculogram light-dark ratios. The OCT images demonstrated variable lesion severity. Some individuals with good vision and normal-appearing fundi showed OCT abnormalities of the choroid and retinal pigment epithelium. The overlay technique revealed that the depressed mfERGs corresponded with the lesions detected by OCT and retinal photography. The latencies of mfERG components in the 2 central stimulus rings in our patients were often prolonged. The mfERG abnormalities matched the localization of the macular lesions in our patients. The latencies of the mfERG N1 and P1 components in the first 2 concentric stimulus rings were often significantly (>2 SDs) delayed, an observation that has not been previously reported, to our knowledge.

  14. [Costo-vertebral collection complicating multifocal echinococcosis: surgical drainage via an anterior approach].

    Science.gov (United States)

    Kolsi, M; Ghorbel, M; Abdennadher, M; Chabchoub, I; Ben Mansour, H; Sahnoun, Y

    2005-09-01

    Costo-vertebral echinoccoccus is a rare and serious condition which often presents with neurological complications requiring urgent surgical intervention. We report the case of a seven year old girl admitted with a clinical picture suggesting medullary compression secondary to multifocal Hydatid disease. As well as a costo-vertebral cyst with extension into the spinal canal, lesions were also seen in the lower lobe of her right lung and throughout the liver, confirmed by CT scan and by magnetic resonance imaging. A resection of Hydatid material as well as the posterior part of the 4th rib, the transverse process of the 4th costal vertebra and adjacent bone was carried out via a posterolateral thoracotomy. The cyst in the right lung was successfully excised at the same operation. Three months later six hepatic lesions were removed via a subcostal approach again without complication. A scan 23 months later revealed no evidence of residual hydatid disease. This case illustrates the pathophysiological features of costovertebral Hydatid disease and the advantages of an anterior surgical approach.

  15. Recurrent multifocal chronic osteitis in children; Osteite chronique multifocale recurrente de l`enfant

    Energy Technology Data Exchange (ETDEWEB)

    Quelquejay, C.; Hamidou, A.; Benosman, A.; Adamsbaum, C. [Hopital Saint-Vincent-de-Paul, 75 - Paris (France); Job-Deslandre, Ch. [Hopital Cochin, 75 - Paris (France)

    1997-09-01

    We have studied retrospectively a series of 10 children presenting with chronic multifocal osteomyelitis (8 girls, 2 boys, 7 to 16 years). All patients had plain films, bone scintigraphies and histological studies. Three had CT scan and/or MRI. Compared with literature data, we observed only one case of palmo-plantar pustulosis and only 2 cases of lysis of the medial extremity of the clavicle; in addition, we report one case of lateral extremity of the clavicle and 2 vertebral locations. The radiological pattern was typical: at the beginning of the disease, plain films showed lytic areas which became progressively osteosclerotic with enlargement of the bone. In all the cases, bone scintigraphy revealed high uptake areas which were often infra-clinical. The diagnosis was delayed from 3 months to 3 years. This emphasizes the difficulty of the diagnosis which relies on the association of clinical, biological and radiological elements. Biopsies are required to rule out an infectious bacterial osteomyelitis or a tumoral process. The pathogenesis of OCMR remains unknown, but the relation with the SAPHO (synovitis, acne, pustulosis, Hyperostosis, osteitis) syndrome is general accepted because of the similar features of the osteitis. The long term follow up appears to be uncertain: 6 of our patients are still symptomatic after five years despite anti inflammatory treatment. (authors). 22 refs.

  16. Dual Credit/Dual Enrollment and Data Driven Policy Implementation

    Science.gov (United States)

    Lichtenberger, Eric; Witt, M. Allison; Blankenberger, Bob; Franklin, Doug

    2014-01-01

    The use of dual credit has been expanding rapidly. Dual credit is a college course taken by a high school student for which both college and high school credit is given. Previous studies provided limited quantitative evidence that dual credit/dual enrollment is directly connected to positive student outcomes. In this study, predictive statistics…

  17. Functional assessment of the visual pathway with multifocal visual evoked potentials, and their relationship with disability in patients with multiple sclerosis.

    Science.gov (United States)

    Blanco, Román; Pérez-Rico, Consuelo; Puertas-Muñoz, Inmaculada; Ayuso-Peralta, Lucía; Boquete, Luciano; Arévalo-Serrano, Juan

    2014-02-01

    To objectively evaluate the visual function, and the relationship between disability and optic nerve dysfunction, in patients with multiple sclerosis (MS) and optic neuritis (ON), using multifocal visual evoked potentials (mfVEP). This observational, cross-sectional study assessed 28 consecutive patients with clinically definite MS, according to the McDonald criteria, and 19 age-matched healthy subjects. Disability was recorded using the Expanded Disability Status Scale (EDSS) score. The patients' mfVEP were compared to their clinical, psychophysical (Humphrey perimetry) and structural (optic coherence tomography (OCT)) diagnostic test data. We observed a significant agreement between mfVEP amplitude and Humphrey perimetry/OCT in MS-ON eyes, and between mfVEP amplitude and OCT in MS but non-ON eyes. We found significant differences in EDSS score between patients with abnormal and normal mfVEP amplitudes. Abnormal mfVEP amplitude defects (from interocular and monocular probability analysis) were found in 67.9% and 73.7% of the MS-ON and MS-non-ON group eyes, respectively. Delayed mfVEP latencies (interocular and monocular probability analysis) were seen in 70.3% and 73.7% of the MS-ON and MS-non-ON groups, respectively. We found a significant relationship between mfVEP amplitude and disease severity, as measured by EDSS score, that suggested there is a role for mfVEP amplitude as a functional biomarker of axonal loss in MS.

  18. Dual energy CT

    DEFF Research Database (Denmark)

    Al-Najami, Issam; Drue, Henrik Christian; Steele, Robert

    2017-01-01

    and inaccurate with existing methods. Dual Energy Computed Tomography (DECT) enables qualitative tissue differentiation by simultaneous scanning with different levels of energy. We aimed to assess the feasibility of DECT in quantifying tumor response to neoadjuvant therapy in loco-advanced rectal cancer. METHODS...... to determine the average quantitative parameters; effective-Z, water- and iodine-concentration, Dual Energy Index (DEI), and Dual Energy Ratio (DER). These parameters were compared to the regression in the resection specimen as measured by the pathologist. RESULTS: Changes in the quantitative parameters...

  19. Dual-Hierarchy Graph Method for Object Indexing and Recognition

    Science.gov (United States)

    2014-07-01

    INDEXING AND RECOGNITION 5a. CONTRACT NUMBER FA8750-12-C-0117 5b. GRANT NUMBER N/A 5c. PROGRAM ELEMENT NUMBER 62305E 6. AUTHOR(S) Isaac Weiss, Fan...hierarchies. We then adjust the position and orientation of the node by minimizing its total energy using a simple one-step Newton method. Next we adjust

  20. Losing focus: how lens position and viewing angle affect the function of multifocal lenses in fishes.

    Science.gov (United States)

    Gagnon, Yakir Luc; Wilby, David; Temple, Shelby Eric

    2016-09-01

    Light rays of different wavelengths are focused at different distances when they pass through a lens (longitudinal chromatic aberration [LCA]). For animals with color vision this can pose a serious problem, because in order to perceive a sharp image the rays must be focused at the shallow plane of the photoreceptor's outer segments in the retina. A variety of fish and tetrapods have been found to possess multifocal lenses, which correct for LCA by assigning concentric zones to correctly focus specific wavelengths. Each zone receives light from a specific beam entrance position (BEP) (the lateral distance between incoming light and the center of the lens). Any occlusion of incoming light at specific BEPs changes the composition of the wavelengths that are correctly focused on the retina. Here, we calculated the effect of lens position relative to the plane of the iris and light entering the eye at oblique angles on how much of the lens was involved in focusing the image on the retina (measured as the availability of BEPs). We used rotational photography of fish eyes and mathematical modeling to quantify the degree of lens occlusion. We found that, at most lens positions and viewing angles, there was a decrease of BEP availability and in some cases complete absence of some BEPs. Given the implications of these effects on image quality, we postulate that three morphological features (aphakic spaces, curvature of the iris, and intraretinal variability in spectral sensitivity) may, in part, be adaptations to mitigate the loss of spectral image quality in the periphery of the eyes of fishes.

  1. Paucity of bone scan abnormalities in a child with multifocal osteomyelitis and disseminated sepsis

    International Nuclear Information System (INIS)

    Trpezanovski, J.; Porn, U.; Uren, R.; Howman-Giles, R.; Mansberg, R.

    2000-01-01

    Full text: We present an unusual case of multifocal osteomyelitis with minimal bone scan abnormalities and markedly discordant findings on Magnetic Resonance Imaging(MRI) and gallium scans. A seven-year-old female presented with left leg, right elbow pain and fever. A bone scan was performed. Mild increased vascularity was demonstrated on the dynamic and blood pool phases of the study in the area of the right elbow. In the delayed images there was a photopenic lesion in the left distal femoral metadiaphysis and also irregular uptake in the metaphyseal regions of the long bones. Low grade soft tissue tracer uptake was seen in the left thigh and right forearm. The patient deteriorated clinically and underwent further investigations with MRI and gallium scans. The MRI showed extensive abnormalities with mulitlocular fluid collection seen throughout most of the muscle groups of both thighs suggesting myositis with an associated cellulitis and osteomyelitis of the left femur. The gallium study was markedly abnormal with increased uptake in the distal 2/3rds of the left femur, proximal 1/2 of the right femur, right proximal forearm (mid forearm extending to mid upper arm), left proximal humerus and right hemithorax especially the lower zones. Staphylococcal aureus was cultured. The patient required intensive care management and slowly responded to antibiotic therapy and surgery to drain abscesses in the thighs. A bone marrow biopsy was normal and immunological tests were performed but a result has yet to be determined. The lack of increased bone uptake in the demonstrated areas of osteomyelitis maybe explained on the basis of an overwhelming infective process inhibiting the patient's healing response. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  2. Remission of progressive multifocal leukoencephalopathy following highly active antiretroviral therapy in a man with AIDS

    Directory of Open Access Journals (Sweden)

    Yoganathan K

    2012-04-01

    Full Text Available Katie Yoganathan1, David Brown2, Kathir Yoganathan31Cardiff Medical School, Cardiff, Wales, UK; 2Virus Reference Department, Microbiology Services, Health Protection Agency, London, UK; 3Singleton Hospital, Abertawe Bro Morgannwg University Health Board, Swansea, UKAbstract: A 43-year-old Caucasian homosexual man with AIDS presented with blurring of vision, change of personality, and memory loss in March 1999. He had first been admitted 2 months previously for treatment of Pneumocystis jiroveci pneumonia. A magnetic resonance imaging scan on admission showed multiple white matter lesions involving both subcortical cerebral hemispheres and cerebellar regions, with no mass effect or surrounding edema. JC virus was detected by nested polymerase chain reaction in the cerebrospinal fluid. These findings were diagnostic of progressive multifocal leukoencephalopathy (PML. His CD4 count was 34 cells/mL, and his HIV ribonucleic acid level was 800,789 copies/mL. He was treated with a combination antiretroviral therapy. He was last reviewed in October 2011. He was fully independent socially and mentally, but he still had some residual neurologic signs with right-sided homonymous hemianopia and visual agnosia. His HIV ribonucleic acid level was undetectable, and his CD4 count was 574 cells/mm3. Although the median survival of patients with PML was poor before the antiretroviral therapy era, our patient, who is now aged 55 years, is still alive 12 years after the diagnosis. The diagnosis of PML and differential diagnosis of focal neurologic signs in HIV-positive patients are discussed in this case report.Keywords: HIV, focal neurologic signs, cerebral toxoplasmosis, primary brain lymphoma, ischaemic stroke

  3. Progressive multifocal leukoencephalopathy in common variable immunodeficiency: mitigated course under mirtazapine and mefloquine.

    Science.gov (United States)

    Kurmann, Rebekka; Weisstanner, Christian; Kardas, Piotr; Hirsch, Hans H; Wiest, Roland; Lämmle, Bernhard; Furrer, Hansjakob; Du Pasquier, Renaud; Bassetti, Claudio L; Sturzenegger, Mathias; Krestel, Heinz

    2015-12-01

    Demonstration of survival and outcome of progressive multifocal leukoencephalopathy (PML) in a 56-year-old patient with common variable immunodeficiency, consisting of severe hypogammaglobulinemia and CD4+ T lymphocytopenia, during continuous treatment with mirtazapine (30 mg/day) and mefloquine (250 mg/week) over 23 months. Regular clinical examinations including Rankin scale and Barthel index, nine-hole peg and box and block tests, Berg balance, 10-m walking tests, and Montreal Cognitive Assessment (MoCA) were done. Laboratory diagnostics included complete blood count and JC virus (JCV) concentration in cerebrospinal fluid (CSF). The noncoding control region (NCCR) of JCV, important for neurotropism and neurovirulence, was sequenced. Repetitive MRI investigated the course of brain lesions. JCV was detected in increasing concentrations (peak 2568 copies/ml CSF), and its NCCR was genetically rearranged. Under treatment, the rearrangement changed toward the archetype sequence, and later JCV DNA became undetectable. Total brain lesion volume decreased (8.54 to 3.97 cm(3)) and atrophy increased. Barthel (60 to 100 to 80 points) and Rankin (4 to 2 to 3) scores, gait stability, and box and block (7, 35, 25 pieces) and nine-hole peg (300, 50, 300 s) test performances first improved but subsequently worsened. Cognition and walking speed remained stable. Despite initial rapid deterioration, the patient survived under continuous treatment with mirtazapine and mefloquine even though he belongs to a PML subgroup that is usually fatal within a few months. This course was paralleled by JCV clones with presumably lower replication capability before JCV became undetectable. Neurological deficits were due to PML lesions and progressive brain atrophy.

  4. MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Haakma, Wieke [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Aarhus University, Department of Forensic Medicine and Comparative Medicine Lab, Aarhus (Denmark); Jongbloed, Bas A.; Goedee, H.S.; Berg, Leonard H. van den; Pol, W.L. van der [University Medical Center Utrecht, Brain Centre Rudolf Magnus, Department of Neurology and Neurosurgery, Utrecht (Netherlands); Froeling, Martijn; Bos, Clemens; Hendrikse, Jeroen [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Leemans, Alexander [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2017-05-15

    To study disease mechanisms in multifocal motor neuropathy (MMN) with magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) of the median and ulnar nerves. We enrolled ten MMN patients, ten patients with amyotrophic lateral sclerosis (ALS) and ten healthy controls (HCs). Patients underwent MRI (in a prone position) and nerve conduction studies. DTI and fat-suppressed T2-weighted scans of the forearms were performed on a 3.0T MRI scanner. Fibre tractography of the median and ulnar nerves was performed to extract diffusion parameters: fractional anisotropy (FA), mean (MD), axial (AD) and radial (RD) diffusivity. Cross-sectional areas (CSA) were measured on T2-weighted scans. Forty-five out of 60 arms were included in the analysis. AD was significantly lower in MMN patients (2.20 ± 0.12 x 10{sup -3} mm{sup 2}/s) compared to ALS patients (2.31 ± 0.17 x 10{sup -3} mm{sup 2}/s; p < 0.05) and HCs (2.31± 0.17 x 10{sup -3} mm{sup 2}/s; p < 0.05). Segmental analysis showed significant restriction of AD, RD and MD (p < 0.005) in the proximal third of the nerves. CSA was significantly larger in MMN patients compared to ALS patients and HCs (p < 0.01). Thickening of nerves is compatible with changes in the myelin sheath structure, whereas lowered AD values suggest axonal dysfunction. These findings suggest that myelin and axons are diffusely involved in MMN pathogenesis. (orig.)

  5. Results of a TcTUs-optimized radioiodine therapy of multifocal and disseminated functional thyroid autonomy

    International Nuclear Information System (INIS)

    Dunkelmann, S.; Endlicher, D.; Prillwitz, A.; Rudolph, F.; Groth, P.; Schuemichen, C.

    1999-01-01

    Aim: The presented study prospectively evaluates the efficacy of optimized radioiodine therapy in patients (pts) with multifocal (MFA) and disseminated (DISA) autonomy. The target dose was related to the total thyroid volume and was increased in moderate and nonlinear increments for 150 to 300 Gy dependent on the pretherapeutic Tc-99m pertechnetate thyroid uptake under suppression (TcTUs). Patients with focal autonomy were treated with a target dose independent of TcTUs and were used as control group. Methods: The data of 641 pts (518 women, 123 men) were evaluated, 466 pts with MFA or DISA and 175 pts with focal autonomy. In pts with MFA and DISA the target dose was increased in four steps: TcTUs 3-6%: 200 Gy, >6-12%: 250 Gy and >12%: 300 Gy. In pts with focal autonomy a fixed target dose of 300 or 400 Gy was applied. The radioactivity to be administered was calculated using a modified Marinelli formula. The follow-up examination was performed at the earliest after four, on average after eight months. Normalization of TSH was the only criterion for successful therapy. Results: The success rate in pts with latent or manifest hyperthyroidism in focal autonomy was 91.5%, thereby was not successful in 5.1% and hypothyroidism occurred in 3.4%. The average success rate in pts with MFA and DISA was 91.5%, therapy failed in 7.5% and a very low rate of 1% with hypothyroidism was seen. Conclusion: The presented optimized therapy concept with calculated, nonlinear increase of the target dose according to the TcTUs-level guaranteed even in MFA and DISA a high success rate comparable to that in focal autonomy along with a very low rate of hypothyroidism. (orig.) [de

  6. Bestrophin gene mutations cause canine multifocal retinopathy: a novel animal model for best disease.

    Science.gov (United States)

    Guziewicz, Karina E; Zangerl, Barbara; Lindauer, Sarah J; Mullins, Robert F; Sandmeyer, Lynne S; Grahn, Bruce H; Stone, Edwin M; Acland, Gregory M; Aguirre, Gustavo D

    2007-05-01

    Canine multifocal retinopathy (cmr) is an autosomal recessive disorder of multiple dog breeds. The disease shares a number of clinical and pathologic similarities with Best macular dystrophy (BMD), and cmr is proposed as a new large animal model for Best disease. cmr was characterized by ophthalmoscopy and histopathology and compared with BMD-affected patients. BEST1 (alias VMD2), the bestrophin gene causally associated with BMD, was evaluated in the dog. Canine ortholog cDNA sequence was cloned and verified using RPE/choroid 5'- and 3'-RACE. Expression of the canine gene transcripts and protein was analyzed by Northern and Western blotting and immunocytochemistry. All exons and the flanking splice junctions were screened by direct sequencing. The clinical phenotype and pathology of cmr closely resemble lesions of BMD. Canine VMD2 spans 13.7 kb of genomic DNA on CFA18 and shows a high level of conservation among eukaryotes. The transcript is predominantly expressed in RPE/choroid and encodes bestrophin, a 580-amino acid protein of 66 kDa. Immunocytochemistry of normal canine retina demonstrated specific localization of protein to the RPE basolateral plasma membranes. Two disease-specific sequence alterations were identified in the canine VMD2 gene: a C(73)T stop mutation in cmr1 and a G(482)A missense mutation in cmr2. The authors propose these two spontaneous mutations in the canine VMD2 gene, which cause cmr, as the first naturally occurring animal model of BMD. Further development of the cmr models will permit elucidation of the complex molecular mechanism of these retinopathies and the development of potential therapies.

  7. Visual and optical performance with two different diffractive multifocal intraocular lenses compared to a monofocal lens.

    Science.gov (United States)

    Alió, Jorge L; Piñero, David P; Plaza-Puche, Ana B; Amparo, Francisco; Jiménez, Ramón; Rodríguez-Prats, Jose L; Javaloy, Jaime

    2011-08-01

    To compare the visual acuity outcomes as well as the ocular optical performance of eyes implanted with either a monofocal or one of two diffractive multifocal intraocular lenses (IOLs). One hundred two consecutive eyes of 51 bilateral cataract patients (age 49 to 80 years) were divided into three groups: 22 eyes were implanted with a monofocal IOL (monofocal group), 40 eyes with the Acrysof ReSTOR SN6AD3 IOL (ReSTOR group), and 40 eyes with the Acri.Lisa 366D IOL (Acri.Lisa group). Visual acuity and contrast sensitivity were evaluated pre- and postoperatively. Additionally, ocular optical quality and intraocular aberrations were evaluated postoperatively. Significant improvement after surgery in uncorrected and corrected distance and near visual acuity was observed in all three groups (P≤.05). Uncorrected near visual acuity was significantly better in eyes from the ReSTOR and Acri.Lisa groups compared to the monofocal group (P≤.01). Photopic contrast sensitivity was significantly better for the spatial frequency of 3 cycles/degree in the monofocal group (P<.01). Significantly higher values of the ocular Strehl ratio and cutoff modulation transfer function spatial frequency were also found in the Acri.Lisa group (P=.01). An acceptable range of vision between near and distance peaks was observed in the defocus curves of the ReSTOR and Acri.Lisa groups. The AcrySof ReSTOR and Acri.Lisa 366D IOLs are able to successfully restore near and intermediate visual function after cataract surgery; however, the Acri.Lisa design seems to provide better optical performance. These results need to be confirmed in a randomized, prospective trial. Copyright 2011, SLACK Incorporated.

  8. [Focal presentation of progressive multifocal leukoencephalopathy: first manifestation of human immunodeficiency virus infection].

    Science.gov (United States)

    Martínez, L; Cuesta, J; Santos, S; Tejero, C

    2008-10-01

    Progressive multifocal leukoencephalopathy (PML) is a subacute demyelinating disorder of central nervous system caused by an opportunistic papovavirus infection of oligodendroglial cells, the JC virus. This virus remains latent in the human host. Their antibodies are detectable in 70% of healthy adult subjects. It is reactivated by different diseases and medical therapies impairing cellular immunity. A 35 year-old man, smoker, allergic to penicillin and derivatives, with a history of endovenous drug abuse, was admitted to Neurology Department due to a progressive left facial palsy and hand weakness. An alteration in the cellular immune ratio (CD4/CD8 0.07) and a positive human immunodeficiency virus serology were demonstrated. Highly active antiretroviral therapy (HAART) was started. A unique wide hyperintense subcortical right temporoparietal lobe lesion was shown by a cerebral magnetic resonance imaging (MRI), suggesting a differential diagnosis between PLM and low grade glial tumor. Cerebrospinal fluid study was normal and the polymerase chain reaction (PCR) was negative for JC virus. A steroataxic cerebral biopsy was made in order to establish a correct diagnosis due to patient's age and the good response to treatment. The pathology study showed changes suggestive of PLM and a positive-PCR test for JC virus. We report this case to suggest that inva- sive diagnosis methods may be useful to differentiate between PLM and low grade glial tumors and to establish a correct prognosis. HAART is becoming a good treatment option because it seems to make long term survival longer, as is the case of this patient who is practically asymptomatic after more than 2 years of evolution.

  9. Multifocal electroretinograms predict onset of diabetic retinopathy in adult patients with diabetes.

    Science.gov (United States)

    Harrison, Wendy W; Bearse, Marcus A; Ng, Jason S; Jewell, Nicholas P; Barez, Shirin; Burger, Dennis; Schneck, Marilyn E; Adams, Anthony J

    2011-02-01

    The authors' previous models predicted local formation of diabetic retinopathy (DR) in adults with diabetes and existing retinopathy. Here they derived a multivariate model for local prediction of DR onset in patients with no previous retinopathy. Seventy-eight eyes from 41 diabetes patients were tested annually for several years. The presence or absence of DR at the last study visit was the outcome measure, and measurements of risk factors from the previous visit were used for prediction. Logistic regression was used to assess the relationship between DR development and 7 factors: multifocal ERG (mfERG) implicit time (IT) Z-score, sex, diabetes duration, blood glucose, HbA1c, age, and diabetes type. Thirty-five retinal zones, spanning 45°, were constructed from the mfERG stimulus elements. The maximum IT Z-score for each zone was calculated based on data from 50 control subjects. ROC curve analysis, using fivefold cross-validation, was used to determine the model's predictive properties. Mild DR developed in 80 of 2730 retinal zones (3%) in 29 of 78 eyes (37%). Multivariate analysis showed mfERG IT to be predictive for DR development in a zone after adjusting for diabetes type. The multivariate model has a sensitivity of 80% and a specificity of 74%. mfERG IT is a good predictor of DR onset, 1 year later, in patients with diabetes without DR. It can be used to assess the risk for DR development in these patients and may be a valuable outcome measure in evaluation of novel prophylactic therapeutics directed at impeding DR.

  10. Spreading of amyotrophic lateral sclerosis lesions--multifocal hits and local propagation?

    Science.gov (United States)

    Sekiguchi, Teruhiko; Kanouchi, Tadashi; Shibuya, Kazumoto; Noto, Yu-ichi; Yagi, Yohsuke; Inaba, Akira; Abe, Keisuke; Misawa, Sonoko; Orimo, Satoshi; Kobayashi, Takayoshi; Kamata, Tomoyuki; Nakagawa, Masanori; Kuwabara, Satoshi; Mizusawa, Hidehiro; Yokota, Takanori

    2014-01-01

    To investigate whether or not the lesions in sporadic amyotrophic lateral sclerosis (ALS) originate from a single focal onset site and spread contiguously by prion-like cell-to-cell propagation in the rostrocaudal direction along the spinal cord, as has been hypothesised (the 'single seed and simple propagation' hypothesis). Subjects included 36 patients with sporadic ALS and initial symptoms in the bulbar, respiratory or upper limb regions. Abnormal spontaneous activities in needle electromyography (nEMG)-that is, fibrillation potentials, positive sharp waves (Fib/PSWs) or fasciculation potentials (FPs)-were compared among the unilateral muscles innervated by different spinal segments, especially between the T10 and L5 paraspinal muscles, and between the vastus medialis and biceps femoris. Axon length and the proportion of muscle fibre types, which are both related to motoneuronal vulnerability in ALS, are similar in the paired muscles. Fourteen of 36 patients showed a non-contiguous distribution of nEMG abnormalities from the onset site, with skipping of intermediate segments. In eight of them, the non-contiguous pattern was evident between paired muscles with the same motoneuronal vulnerability. The non-contiguously affected lumbosacral lesions involved motoneuron columns horizontally or radially proximate to one another, appearing to form a cluster in four of the eight patients. FPs, known to precede Fib/PSWs, were shown more frequently than Fib/PSWs in all the lumbosacral segments but L5, suggesting that 2nd hits occur at L5 and then spread to other lumbosacral segments. In sporadic ALS, the distribution of lower motoneuron involvement cannot be explained by the 'single seed and simple propagation' hypothesis alone. We propose a 'multifocal hits and local propagation' hypothesis instead.

  11. Recurrent multifocal osteomyelitis in children: Experience in a tertiary care center.

    Science.gov (United States)

    Ariza Jiménez, Ana Belén; Núñez Cuadros, Esmeralda; Galindo Zavala, Rocío; Núñez Caro, Leticia; Díaz-Cordobés Rego, Gisela; Urda Cardona, Antonio

    2017-05-19

    Chronic recurrent multifocal osteomyelitis is a rare aseptic bone inflammation that affects pediatric patients. Its management and treatment have not yet been standardized. Retrospective, descriptive study of patients under 14 years of age diagnosed with chronic nonbacterial osteomyelitis (CNBO) in a tertiary hospital. We included patients diagnosed over the last 6 years (2010-2015) who met the Jansson criteria. The clinical and radiological characteristics of CNBO were analyzed, as was the outcome after different therapeutic options. We report 12 patients, with a mean age of 11 years (±1.6 standard deviation [SD]) and female predominance (10:2). The mean number of foci was 3.5 (±2.2 SD). The most common locations were ankle (58%), clavicle (50%), sternum (33%) and hip (25%). The mean disease duration was 10.5 months (±10.3 SD), and the median time to diagnosis was 2.38 months (range 0.17-16). Bone scintigraphy detected asymptomatic foci in 33% and we detected lytic lesions in 50% through magnetic resonance imaging. Biopsy was performed in 60%; 2/12 (16%) were associated with inflammatory disease and 1/12 (8.3%) later developed lymphoma. In all, 58% received antibiotic therapy with little response, 100% anti-inflammatory agents, 50% systemic corticosteroids, 41.6% methotrexate/pamidronate and 16% anti-tumor necrosis factor (TNF) α. The mean duration of treatment was 14.8 months (±12.4 SD) and 66% had recurrences. Currently, 83% are in clinical remission without treatment. When CNBO is refractory to treatment with anti-inflammatory drugs, intravenous pamidronate can be an alternative. Anti-TNF drugs can be considered in patients who fail with pamidronate, as can agents associated with other autoimmune conditions. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  12. Facilitating the analysis of the multifocal electroretinogram using the free software environment R.

    Science.gov (United States)

    Bergholz, Richard; Rossel, Mirjam; Dutescu, Ralf M; Vöge, Klaas P; Salchow, Daniel J

    2018-01-01

    The large amount of data rendered by the multifocal electroretinogram (mfERG) can be analyzed and visualized in various ways. The evaluation and comparison of more than one examination is time-consuming and prone to create errors. Using the free software environment R we developed a solution to average the data of multiple examinations and to allow a comparison of different patient groups. Data of single mfERG recordings as exported in .csv format from a RETIport 21 system (version 7/03, Roland Consult) or manually compiled .csv files are the basis for the calculations. The R software extracts response densities and implicit times of N1 and P1 for the sum response, each ring eccentricity, and each single hexagon. Averages can be calculated for as many subjects as needed. The mentioned parameters can then be compared to another group of patients or healthy subjects. Application of the software is illustrated by comparing 11 patients with chloroquine maculopathy to a control group of 7 healthy subjects. The software scripts display response density and implicit time 3D plots of each examination as well as of the group averages. Differences of the group averages are presented as 3D and grayscale 2D plots. Both groups are compared using the t-test with Bonferroni correction. The group comparison is furthermore illustrated by the average waveforms and by boxplots of each eccentricity. This software solution on the basis of the programming language R facilitates the clinical and scientific use of the mfERG and aids in interpretation and analysis.

  13. What monitor can replace the cathode-ray tube for visual stimulation to elicit multifocal electroretinograms?

    Science.gov (United States)

    Matsumoto, Celso Soiti; Shinoda, Kei; Matsumoto, Harue; Seki, Keisuke; Nagasaka, Eiichiro; Iwata, Takeshi; Mizota, Atsushi

    2014-08-05

    To compare a conventional cathode-ray tube (CRT) screen to organic light-emitting diode (OLED) and liquid crystal display (LCD) screens as visual stimulators to elicit multifocal electroretinograms (mfERGs), mfERGs were recorded from seven eyes of seven healthy volunteers (21 ± 2 years). The mfERGs elicited by a conventional CRT screen (S710, Compaq Computer Co.) were compared to those elicited by a studio-grade master OLED monitor (PVM-1741, Sony, Japan) and a conventional LCD (S1721, Flexscan, Eizo Nanao Corp., Japan). The luminance changes of each monitor were measured with a photodiode. CRT, OLED, and LCD screens with a frame frequency of 60 Hz were studied. A hexagonal stimulus array with 61 stimulus elements was created on each monitor. The serial white stimuli of the OLED screen at 60 Hz did not fuse, and that of the LCD screens fused. The amplitudes of P1 and P2 of the first-order kernels of the mfERGs were not significantly different from those elicited by the CRT and OLED screens, and the P1 amplitude of the first-order kernel elicited by the LCD stimuli was significantly smaller than that elicited by the CRT in all the groups of the averaged hexagonal elements. The implicit times were approximately 10 ms longer in almost all components elicited by the LCD screen compared to those elicited by the CRT screen. The mfERGs elicited by monitors other than the CRT should be carefully interpreted, especially those elicited by LCD screens. The OLED had good performance, and we conclude that it can replace the CRT as a stimulator for mfERGs; however, a collection of normative data is recommended. © 2014 ARVO.

  14. Infectious agents identified in pigs with multifocal interstitial nephritis at slaughter.

    Science.gov (United States)

    Drolet, R; D'Allaire, S; Larochelle, R; Magar, R; Ribotta, M; Higgins, R

    2002-02-02

    One kidney was taken from each of 100 pigs at slaughter; 50 had gross lesions of multifocal interstitial nephritis and 50 had no gross lesions. Forty-nine of the affected kidneys had lesions that were characterised by the presence of either a few randomly distributed or numerous widely disseminated pale foci, 1 to 3 mm in diameter, on the cortical surface (white-dotted kidneys). Microscopically, these focal inflammatory lesions often had a distinct lymphofollicular pattern (follicular nephritis). Lesions of chronic vasculitis were observed in 21 of the affected kidneys. Histologically, the control kidneys had only small and sparse inflammatory foci. Standard bacterial cultures of kidneys of both groups were not significant, and cultures for the isolation of leptospires were all negative. Virological examination of the kidney homogenates by PCR did not reveal any porcine reproductive and respiratory syndrome virus and only a few cases were positive for the porcine circovirus type 1. However, porcine parvovirus (PPV) and porcine circovirus type 2 (PCV-2) were detected in many kidneys of both groups but in a significantly higher proportion of the kidneys with interstitial nephritis. There was a significant association between the lesions and the presence of PPV and PCV-2 with odds ratios of 7.5 (P<0.0001) and 3.4 (P=0.0074), respectively, and the odds ratio increased to 22.7 (P<0.0001) when both viruses were identified in the same kidney. However, a subsample of kidneys taken from both groups were negative by immunohistochemistry for the presence of PPV and PCV-2 antigens.

  15. Demonstration and evaluation of dual-fuel technology; Demonstration och utvaerdering av dual-fuel-tekniken

    Energy Technology Data Exchange (ETDEWEB)

    Staalhammar, Per; Erlandsson, Lennart; Willner, Kristina (AVL MTC Motortestcenter AB (Sweden)); Johannesson, Staffan (Ecoplan AB (Sweden))

    2011-06-15

    There is an increased interest for Dual Fuel (methane-Diesel) applications in Sweden since this technology is seen as one of the more interesting options for a fast and cost effective introduction of biomethane as fuel for HD engines. The Dual Fuel technology has been used for many years, mainly for stationary purpose (generators, pumps and ships) while the Spark Ignited (SI) 'Otto' technology has been used for trucks and busses. One obstacle for introducing Dual Fuel technology for busses and trucks is the EU legislation that don't allow for HD on road certification of Dual Fuel applications. Challenges with the Dual Fuel technology is to develop cost effective applications that is capable of reaching low emissions (especially CH{sub 4} and NO{sub x}) in combination with high Diesel replacement in the test cycles used for on road applications. AVL MTC Motortestcenter AB (hereinafter called AVL) has on commission by SGC (Swedish Gas technical Centre) carried out this project with the objectives to analyze the Dual Fuel (Diesel-methane) technology with focus on emissions, fuel consumption and technical challenges. One important part of this project was to carry out emission tests on selected Dual Fuel applications in Sweden and to compile experiences from existing Dual Fuel technology. This report also summarizes other commonly used technologies for methane engines and compares the Dual Fuel with conventional Diesel and Otto technologies. The major challenges with Dual Fuel applications for on road vehicles will be to develop robust and cost effective solutions that meet the emission legislations (with aged catalysts) and to increase the Diesel replacement to achieve reasonable reduction of green house gases (GHG). This is especially important when biomethane is available as fuel but not Bio-Diesel. It will probably be possible to reach EURO V emission limits with advanced Dual Fuel systems but none of the tested systems reached EURO V emission levels

  16. Optical analysis, reading performance, and quality-of-life evaluation after implantation of a diffractive multifocal intraocular lens.

    Science.gov (United States)

    Alió, Jorge L; Plaza-Puche, Ana B; Piñero, David P; Amparo, Francisco; Jiménez, Ramón; Rodríguez-Prats, Jose L; Javaloy, Jaime; Pongo, Vanessa

    2011-01-01

    To evaluate the reading performance, changes in quality of life, and optical performance after cataract surgery with multifocal diffractive intraocular lens (IOL) implantation. Vissum Corporation, Alicante, Spain. Prospective case series. Patients with bilateral cataract had implantation of Acri.LISA 366D multifocal IOLs. Visual acuity and contrast sensitivity outcomes were evaluated during a 6-month follow-up. Other parameters evaluated included reading performance (Salzburg Reading Desk), a 25-item quality-of-life questionnaire (National Eye Institute Visual Functioning Questionnaire-25 [NEI VFQ-25] and appendix NEI VFQ-39), and ocular optical performance (ocular aberrometry and modulation transfer function). The study included 48 eyes (24 patients) ranging in age from 47 to 77 years. The mean uncorrected distance visual acuity (logMAR) improved significantly 1 month postoperatively (P<.01), with no significant changes afterward (6 months, P≥.06). The mean reading acuity without correction improved significantly from 0.68 logRAD ± 0.20 (SD) to 0.16 ± 0.08 logRAD 1 month after surgery (P < .01). However, it was worse by the end of the follow-up (6 months, P = .04). During the follow-up, no significant changes were found in the mean reading speed without near correction (6 months, P = .50). Contrast sensitivity improved significantly at all spatial frequencies under photopic and scotopic conditions after surgery (6 months, P≤.02). The quality-of-life index related to reading ability also improved significantly (3 months, P = .03). Implantation of the multifocal diffractive IOL significantly improved reading performance, which had a positive effect on the patient's quality of life postoperatively. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  17. [Sentinel node biopsy in patients with multifocal and multicentric breast cancer: A 5-year follow-up].

    Science.gov (United States)

    Blanco Saiz, I; López Carballo, M T; Martínez Fernández, J; Carrión Maldonado, J; Cabrera Pereira, A; Moral Alvarez, S; Santamaría Girón, L; Cantero Cerquella, F; López Secades, A; Díaz González, D; Llaneza Folgueras, A; Aira Delgado, F J

    2014-01-01

    Sentinel lymph node biopsy (SLNB) as a staging procedure in multiple breast cancer is a controversial issue. We have aimed to evaluate the efficacy of sentinel node (SN) detection in patients with multifocal or multicentric breast cancer as well as the safety of its clinical application after a long follow-up. A prospective descriptive study was performed. Eighty-nine patients diagnosed of multiple breast cancer (73 multifocal; 16 multicentric) underwent SLNB. These patients were compared to those with unifocal neoplasia. Periareolar radiocolloid administration was performed in most of the patients. Evaluation was made at an average of 67.2 months of follow-up (32-126 months). Scintigraphic and surgical SN localization in patients with multiple breast cancer were 95.5% and 92.1%, respectively. A higher percentage of extra-axillary nodes was observed than in the unifocal group (11.7% vs 5.4%) as well as a significantly higher number of SN per patient (1.70 vs 1.38). The rate of SN localization in multicentric cancer was slightly lower than in multifocal cancer (87.5% vs 93.1%), and the finding of extra-axillary drainages was higher (20% vs 10%). Number of SN per patient was significantly higher in multicentric breast cancer (2.33 vs 1.57). No axillary relapses have been demonstrated in the follow-up in multiple breast cancer patients group. SLNB performed by periareolar injection is a reliable and accurate staging procedure of patients with multiple breast cancer, including those with multicentric processes. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  18. Variation of stemness markers expression in tumor nodules from synchronous multi-focal hepatocellular carcinoma - an immunohistochemical study.

    Science.gov (United States)

    Lo, Regina Cheuk-Lam; Leung, Carmen Oi-Ning; Chok, Kenneth Siu-Ho; Ng, Irene Oi-Lin

    2017-08-01

    Advancing knowledge in molecular pathogenesis of hepatocellular carcinoma (HCC) opens up new horizons in the diagnostic, prognostic and therapeutic perspectives. Assessing the expression of molecular targets prior to definitive treatment is gaining importance in clinical practice. In this study, we investigated the variation in expression pattern of stemness markers in synchronous multi-focal HCC. In the first cohort, 21 liver explants with multi-focal HCC were examined for expression of stemness markers EpCAM, Sox9 and CK19 by immunohistochemistry (IHC). Expression data of 50 tumor nodules were analyzed to determine the concordance of expression among nodules in the same livers. In the second cohort, 14 tumor nodules from 6 multi-focal HCC cases proven as intra-hepatic metastasis were examined for Soc9 immunoexpression. In the first cohort, thirty nodules from 16 cases expressed one or more markers, with Sox9 being most frequently expressed. Complete concordance of expression pattern for all 3 markers was observed in 6 cases. Discrepancy of staining degree was noted in 4 cases for EpCAM, 14 cases for Sox9, and 6 cases for CK19. A two-tier or three-tier difference in staining scores was noted in 5 cases for Sox9 and one case for CK19. With Sox9, identical tumor morphology in terms of Edmondson grading and growth pattern did not infer the same degree of immunoexpression; and the largest tumor nodule was not representative of highest IHC score. In the second cohort of intra-hepatic metastasis, complete concordance of Sox9 expression level was observed in 5 out of 6 cases; while the remaining case showed a 1-tier difference of positive staining. Our findings suggested that clonality of tumor nodules is apparently an important factor to infer immunoexpression pattern. When there is limited information to discern multiple primaries versus intra-hepatic metastasis in multi-focal HCC, discordant degree of stemness markers expression among tumor nodules was commonly

  19. Hemosuccus Pancreaticus in the Era of Capsule Endoscopy and Double Balloon Enteroscopy Complicated by Multifocal Mycobacterium chelonae/abscessus Infection

    Directory of Open Access Journals (Sweden)

    Shabana F. Pasha

    2007-08-01

    Full Text Available Hemosuccus pancreaticus is a rare etiology of obscure gastrointestinal bleeding characterized by bleeding into the pancreatic duct. The diagnosis may be delayed for months to years, due to the episodic nature of bleeding and failure to consider the diagnosis. Patients often undergo multiple endoscopies and radiologic evaluations prior to diagnosis. Incidental gastrointestinal findings may lead to unnecessary endoscopic and surgical interventions. This report describes a patient with hemosuccus pancreaticus diagnosed in the era of video capsule endoscopy and double balloon enteroscopy, whose management was complicated by multifocal Mycobacteria chelonae/abscessus infection.

  20. Medium-Term Visual Outcomes of Apodized Diffractive Multifocal Intraocular Lens with +3.00 D Addition Power

    OpenAIRE

    Guo, Xiaohong; Sun, Yi; Zhang, Bowen; Zheng, Danying

    2014-01-01

    Purpose. To evaluate 2-year visual acuities and questionnaire after bilateral implantation of SN6AD1 multifocal intraocular lens (MIOL) or SN60WF IOL. Methods. Patients randomly scheduled for bilateral implantation of SN6AD1 MIOL and SN60WF IOL with 2-year follow-up were enrolled. Uncorrected/corrected distance and near visual acuity, uncorrected intermediate visual acuity at 63 cm under high and low contrast, reading activity, the defocus curve, and a quality-of-life questionnaire were evalu...

  1. Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis (SAPHO) and chronic recurrent multifocal osteomyelitis (CRMO): Role of imaging in diagnosis

    International Nuclear Information System (INIS)

    Thakur, Uma; Blacksin, Marcia; Beebe, Kathleen; Neilson, J.C.; Dashefsky, Barry; Tagoylo, Gino

    2012-01-01

    There is a spectrum of musculoskeletal disorders which can be associated with dermatologic findings, the fundamental component of which is a nonbacterial osteitis. CRMO (Chronic recurrent multifocal osteomyelitis) and SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) describe paediatric and adult conditions, respectively, of inflammatory osteitis that can be associated with palmoplantar pustulosis and acne. Imaging findings are similar and a key component to the diagnosis in both conditions. This report describes two patients with strikingly similar radiologic presentations of clavicular osteitis in whom the diagnosis was made predominantly on the basis of imaging findings. The typical imaging features and radiographic hallmarks of both conditions will also be discussed.

  2. Self-dual Hopf quivers

    International Nuclear Information System (INIS)

    Huang Hualin; Li Libin; Ye Yu

    2004-07-01

    We study pointed graded self-dual Hopf algebras with a help of the dual Gabriel theorem for pointed Hopf algebras. Quivers of such Hopf algebras are said to be self-dual. An explicit classification of self-dual Hopf quivers is obtained. We also prove that finite dimensional coradically graded pointed self-dual Hopf algebras are generated by group-like and skew-primitive elements as associative algebras. This partially justifies a conjecture of Andruskiewitsch and Schneider and may help to classify finite dimensional self-dual pointed Hopf algebras

  3. Paracoccidioidomicose crônica multifocal tendo como primeira manifestação o envolvimento palpebral: relato de caso Chronical and multifocal paracoccidioidomycosis having the lid involvement as the first sign: case report

    Directory of Open Access Journals (Sweden)

    Tiago Nelson de Oliveira Rassi

    2009-12-01

    Full Text Available O acometimento ocular da paracoccidioidomicose é raro e quando ocorre é geralmente secundário à disseminação hematogênica. Descrição de um caso de paracococcidioidomicose multifocal em homem de 73 anos com história de trauma contuso no olho direito por pedaço de madeira e que teve como primeira manifestação clínica lesão palpebro-conjuntival. Interroga-se possível infecção primária ocular por contiguidade e alerta-se para a manifestação da doença em idade mais avançada.Ocular involvement of paracoccidioidomycosis is rare and when it occurs it is usually secondary to hematogenic dissemination. A case of multifocal paracoccidioidomycosis in a 73 year-old male after history of blunt trauma in the right eye with a stick of wood that presented as the first clinical sign a lid-conjunctival lesion is described. The possible primary ocular infection spreading by contiguity is argued and the disease manifestation in an advanced age is highlighted.

  4. Numerical Analysis Objects

    Science.gov (United States)

    Henderson, Michael

    1997-08-01

    The Numerical Analysis Objects project (NAO) is a project in the Mathematics Department of IBM's TJ Watson Research Center. While there are plenty of numerical tools available today, it is not an easy task to combine them into a custom application. NAO is directed at the dual problems of building applications from a set of tools, and creating those tools. There are several "reuse" projects, which focus on the problems of identifying and cataloging tools. NAO is directed at the specific context of scientific computing. Because the type of tools is restricted, problems such as tools with incompatible data structures for input and output, and dissimilar interfaces to tools which solve similar problems can be addressed. The approach we've taken is to define interfaces to those objects used in numerical analysis, such as geometries, functions and operators, and to start collecting (and building) a set of tools which use these interfaces. We have written a class library (a set of abstract classes and implementations) in C++ which demonstrates the approach. Besides the classes, the class library includes "stub" routines which allow the library to be used from C or Fortran, and an interface to a Visual Programming Language. The library has been used to build a simulator for petroleum reservoirs, using a set of tools for discretizing nonlinear differential equations that we have written, and includes "wrapped" versions of packages from the Netlib repository. Documentation can be found on the Web at "http://www.research.ibm.com/nao". I will describe the objects and their interfaces, and give examples ranging from mesh generation to solving differential equations.

  5. Dual phase evolution

    CERN Document Server

    Green, David G; Abbass, Hussein A

    2014-01-01

    This book explains how dual phase evolution operates in all these settings and provides a detailed treatment of the subject. The authors discuss the theoretical foundations for the theory, how it relates to other phase transition phenomena and its advantages in evolutionary computation and complex adaptive systems. The book provides methods and techniques to use this concept for problem solving. Dual phase evolution concerns systems that evolve via repeated phase shifts in the connectivity of their elements. It occurs in vast range of settings, including natural systems (species evolution, landscape ecology, geomorphology), socio-economic systems (social networks) and in artificial systems (annealing, evolutionary computing).

  6. Dual-Mode Combustor

    Science.gov (United States)

    Trefny, Charles J (Inventor); Dippold, Vance F (Inventor)

    2013-01-01

    A new dual-mode ramjet combustor used for operation over a wide flight Mach number range is described. Subsonic combustion mode is usable to lower flight Mach numbers than current dual-mode scramjets. High speed mode is characterized by supersonic combustion in a free-jet that traverses the subsonic combustion chamber to a variable nozzle throat. Although a variable combustor exit aperture is required, the need for fuel staging to accommodate the combustion process is eliminated. Local heating from shock-boundary-layer interactions on combustor walls is also eliminated.

  7. Dual-anticipating, dual and dual-lag synchronization in modulated time-delayed systems

    International Nuclear Information System (INIS)

    Ghosh, Dibakar; Chowdhury, A. Roy

    2010-01-01

    In this Letter, dual synchronization in modulated time delay system using delay feedback controller is proposed. Based on Lyapunov stability theory, we suggest a general method to achieve the dual-anticipating, dual, dual-lag synchronization of time-delayed chaotic systems and we find both its existing and sufficient stability conditions. Numerically it is shown that the dual synchronization is also possible when driving system contain two completely different systems. Effect of parameter mismatch on dual synchronization is also discussed. As an example, numerical simulations for the Mackey-Glass and Ikeda systems are conducted, which is in good agreement with the theoretical analysis.

  8. Characteristics of progressive multifocal leukoencephalopathy clarified through internet-assisted laboratory surveillance in Japan

    Directory of Open Access Journals (Sweden)

    Nakamichi Kazuo

    2012-10-01

    Full Text Available Abstract Background Progressive multifocal leukoencephalopathy (PML, a rare but fatal demyelinating disease caused by JC virus (JCV, occurs mainly in immunocompromised patients. As PML develops in individuals with various underlying disorders sporadically and infrequently, a nationwide survey of PML is difficult. This study was conducted to elucidate the characteristics of PML in Japan through an internet-assisted laboratory surveillance program. Methods A diagnostic support system for PML was established using a real-time PCR assay of JCV DNA in cerebrospinal fluid (CSF, and requests for testing were received from clinicians via specialized websites. Medical histories of patients were collected through standardized questionnaires, and a database of CSF JCV loads and clinical information was created and analyzed. Results For 4 years from April 2007 to March 2011, CSF specimens from 419 patients were tested. Forty-eight individuals were found positive for JCV DNA in their CSF and were diagnosed with PML. PML primarily occurred not only in HIV-positive patients (33.3% but also in patients with hematologic disorders after receiving stem cell transplantation, chemotherapy, and/or immunosuppressive treatment (39.6%. The frequencies of PML cases among the subjects in these two categories were 20.3% and 23.5%, respectively. Although no significant features were observed with respect to CSF JCV loads in PML patients with an HIV infection or hematologic disorder, males were predominant in both groups (100% and 89.5%, respectively. The proportion of PML cases with autoimmune disorders (6.3% or solid-organ transplants (2.1% was smaller than those with HIV infection or hematologic disorders, probably due to the limited availability of therapeutic monoclonal antibodies and transplantation from brain dead donors. Conclusions The results suggest that the internet-assisted laboratory surveillance program might be a useful strategy for collecting precise real

  9. Successful treatment of chronic recurrent multifocal osteomyelitis using low-dose radiotherapy. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Dietzel, Christian T.; Vordermark, Dirk [Klinikum der Martin-Luther-Universitaet Halle-Wittenberg, Universitaetslinik und Poliklinik fuer Strahlentherapie, Halle (Saale) (Germany); Schaefer, Christoph [Klinikum der Martin-Luther-Universitaet Halle-Wittenberg, Universitaetsklinik und Poliklinik fuer Innere Medizin II, Halle (Saale) (Germany)

    2017-03-15

    Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory disease, which lacks an infectious genesis and predominantly involves the metaphysis of long bones. Common treatments range from nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids at first onset of disease, to immunosuppressive drugs and bisphosphonates in cases of insufficient remission. The therapeutic use of low-dose radiotherapy for CRMO constitutes a novelty. A 67-year-old female patient presented with radiologically proven CRMO affecting the right tibia/talus and no response to immunosuppressive therapy. Two treatment series of radiation therapy were applied with an interval of 6 weeks. Each series contained six fractions (three fractions per week) with single doses of 0.5 Gy, thus the total applied dose was 6 Gy. Ten months later, pain and symptoms of osteomyelitis had completely vanished. Radiotherapy seems to be an efficient and feasible complementary treatment option for conventional treatment refractory CRMO in adulthood. The application of low doses per fraction is justified by the inflammatory pathomechanism of disease. (orig.) [German] Die chronisch rekurrierende multifokale Osteomyelitis (CRMO) ist eine seltene autoimmunologische Erkrankung und befaellt vorzugsweise die Metaphysen der langen Roehrenknochen. Die Therapie umfasst nichtsteroidale Antirheumatika (NSAIDs) und Kortikosteroide bei Erstbefall und reicht bis hin zu Immunsuppressiva und Bisphosphonaten bei insuffizientem Ansprechen. Die Anwendung einer niedrigdosierten Radiatio stellt ein therapeutisches Novum dar. Eine 67-jaehrige Patientin stellte sich mit einem radiologisch gesicherten Befall im Sinne einer CRMO im Bereich des rechten Talus und der Tibia vor. Eine initiale Behandlung mit Immunsuppressiva verblieb erfolglos. Wir fuehrten zwei Bestrahlungsserien im Intervall von 6 Wochen durch. Jede Serie bestand aus 6 Fraktionen (3 Fraktionen/Woche), mit einer Einzeldosis von jeweils 0,5 Gy. Die

  10. [Commercial sexual exploitation of minor girls. A multifocal, exploratory and prospective study in Cameroon].

    Science.gov (United States)

    Mbassa Menick, D; Dassa, K S; Kenmogne, J B; Abanda Ngon, G

    2009-02-01

    To obtain reliable information on commercial sexual exploitation of minor girls under the age of 21, a multifocal, exploratry and prospective using a questionnaire was undertaken in Cameroon. This investigation was initiated and funded by the Cercle International pour la Promotion de la Création (CIPCRE) and carried out by the Cameroon Society for the Prevention of Child Abuse and Neglect (CASPCAN). The survey was performed during the last quarter of year 2004 in four major cities of Cameroon, i.e. Yaoundé, Douala, Bamenca and Bafoussam. Of the 800 questionnaires that were distributed, 722 were considered as suitable for analysis (90.3%). A total of 291 minor girls were victims of commercial sexual exploitation, i.e., 40% of the population studied. The mean age of the victims was 16.6 years (range, 9-20 years). The main reason given for entering prostitution was poverty. The victims were fairly well educated but the level of instruction was not sufficient to find a job paying an income comparable to prostitution. Many were from large families (mean, 7.1 children). The victims' family was monogamous in 40.2% of cases, polygamous in 24.4%, and monoparental in 35.4%. Eighty percent of the victims already had run away from home at least once due to problems in their families ranging from severe corporal punishment (25.8%) and mistreatment linked to parental alcohol and drug abuse to forced early marriage (27.5%) and intrafamilial sexual abuse. A large proportion of the victims (36.4%) were mothers who could not attend school and could not find work. Many victims were completely neglected by their own parents with 43.4% of parents being aware of the activities of their daughters but only 10.6% being opposed to it. Most (78.5%) had good knowledge of the risk of HIV and used condoms regular. These results confirms the general hypothesis of the authors that commercial exploitation of minor girls is widespread in Cameroon. The authors recommend development of a national

  11. Beta-zone parapapillary atrophy and multifocal visual evoked potentials in eyes with glaucomatous optic neuropathy

    Science.gov (United States)

    Ketner, Scott; Teng, Christopher C.; Ehrlich, Joshua R.; Raza, Ali S.; Liebmann, Jeffrey M.; Ritch, Robert; Hood, Donald C.

    2015-01-01

    We investigated changes in multifocal visual evoked potential (mfVEP) responses due to beta-zone parapapillary atrophy (βPPA). Patients with glaucomatous optic neuropathy (GON) with or without standard achromatic perimetry (SAP) abnormalities were referred for mfVEP testing during a 2-year period. Eyes with good quality optic disc stereophotographs and reliable SAP results were included. The mfVEP monocular mean latency delays (ms) and amplitudes (SNR) were analyzed. Age, SAP mean deviation (MD), pattern standard deviation (PSD), and spherical equivalent (SE) were analyzed in the multivariate model. Generalized estimated equations were used for comparisons between groups after adjusting for inter-eye associations. Of 394 eyes of 200 patients, 223 (57%) had βPPA. The βPPA eyes were older (59.6 ± 13.7 vs. 56.5 ± 13.7 year, P = 0.02), more myopic (−4.0 ± 3.5 vs. −1.3 ± 3.5 D, P < 0.01), and had poorer SAP scores (MD: −4.9 ± 5.2 vs. −2.6 ± 5.2 dB, P < 0.01; PSD: 4.3 ± 2.9 vs. 2.5 ± 3.0 dB, P < 0.01). By univariate analysis, mean latencies were longer in βPPA eyes (6.1 ± 5.3 vs. 4.0 ± 5.5 ms, P < 0.01). After adjusting for differences in SE, age, and SAP MD, there was no significant difference between the two groups (P = 0.09). βPPA eyes had lower amplitude log SNR (0.49 ± 0.16 vs. 0.56 ± 0.15, P < 0.01), which lost significance (P = 0.51) after adjusting for MD and PSD. Although eyes with βPPA had significantly lower amplitudes and prolonged latencies than eyes without βPPA, these differences were attributable to differences in SAP severity, age, and refractive error. Thus, βPPA does not appear to be an independent factor affecting mfVEP responses in eyes with GON. PMID:21735265

  12. What is the best pre-therapeutic dosimetry for successful radioiodine therapy of multifocal autonomy?

    International Nuclear Information System (INIS)

    Gotthardt, M.; Philipps Univ., Marburg; Rubner, C.; Bauhofer, A.

    2006-01-01

    Purpose: Dose calculation for radioiodine therapy (RIT) of multifocal autonomies (MFA) is a problem as therapeutic outcome may be worse than in other kinds of autonomies. We compared different dosimetric concepts in our patients. Patients, methods: Data from 187 patients who had undergone RIT for MFA (Marinelli algorithm, volumetric compromise) were included in the study. For calculation, either a standard or a measured half-life had been used and the dosimetric compromise (150 Gy, total thyroid volume). Therapeutic activities were calculated by 2 alternative concepts and compared to therapeutic success achieved (concept of TcTUs-based calculation of autonomous volume with 300 Gy and TcTUs-based adaptation of target dose on total thyroid volume). Results: If a standard half-life is used, therapeutic success was achieved in 90.2% (hypothyroidism 23,1%, n=143). If a measured half-life was used the success rate was 93.1% (13,6% hypothyroidism, n=44). These differences were statistically not significant, neither for all patients together nor for subgroups eu-, hypo-, or hyperthyroid after therapy (ANOVA, all p>0.05). The alternative dosimetric concepts would have resulted either in significantly lower organ doses (TcTUs-based calculation of autonomous volume; 80.76±80.6 Gy versus 125.6±46.3 Gy; p<0.0001) or in systematic over-treatment with significantly higher doses (TcTUs-adapted concept; 164.2±101.7 Gy versus 125.6±46.3 Gy; p=0.0097). Conclusions: TcTUs-based determination of the autonomous volume should not be performed, the TcTUs-based adaptation of the target dose will only increase the rate of hypothyroidism. A standard half-life may be used in pre-therapeutic dosimetry for RIT of MFA. If so, individual therapeutic activities may be calculated based on thyroid size corrected to the 24h ITUs without using Marinelli's algorithm. (orig.)

  13. Vertebral manifestation of chronic recurrent multifocal osteomyelitis (CRMO); Wirbelsaeulenmanifestationen der chronischen rekurrierenden multifokalen Osteomyelitis (CRMO)

    Energy Technology Data Exchange (ETDEWEB)

    Schilling, F. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Rheinland-Pfaelzisches Rheumazentrum, Mainz/Bad Kreuznach (Germany); Fedlmeier, M. [Rheuma-Kinderklinik, Garmisch-Partenkirchen (Germany); Eckardt, A. [Mainz Univ. (Germany). Orthopaedische Klinik und Poliklinik; Kessler, S. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie

    2002-10-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a systemic osteo-articular disease that is characterized by a sterile, primarily chronic osteomyelitis with various distribution patterns of the individual lesions. In this article, we describe the 'axial type' with predominant involvement of the spine, which represents 13 of our 41 CMRO cases of different age groups. The important element of its diagnosis is the typical lympho-plasmacellular spondylitis that can be detected and staged by scintigraphy, MRI and conventional radiography. Potentially affected are all vertebrae from the mid-cervical spine to the sacrum. One or several segments can be involved, sometimes as transient inflammatory edema, sometimes as 'migratory spondylitis' or 'saltatory spondylitis', but also as chronic sclerosing type with early radiographically detectable manifestation. Vertebral deformity due to compression and total collapse (vertebra plana) are rare. A complicated course with patulous perivertebral edema can lead to concomitant symptomatic inflammatory changes in adjacent regions and organs. In the course of CRMO, spondylodiscitis only develops as secondary destruction following the spondylitis. This can help to differentiate spondyloarthropathies from CRMO that is initially detected as primary lesion in the spine. While CRMO generally has a good prognosis, its radiological differentiation from rheumatology conditions plays an important role. (orig.) [German] Die chronische rekurrierende multifokale Osteomyelitis (CRMO) ist ein osteo-artikulaeres Systemleiden, das durch sterile, primaer chronische Osteomyelitiden gekennzeichnet ist und mit krankheitsdominanten Lokalisationen verschiedene Befallmustertypen aufweist. In dieser Arbeit wird die Wirbelsaeulenmanifestation ('Vertebraltyp') geschildert, die ein Drittel aller CRMO-Faelle betrifft und im Rahmen unseres CRMO-Kollektivs (n=41) mit 13 Faellen aller Altersstufen vertreten ist. Das

  14. The effect of pentobarbital sodium and propofol anesthesia on multifocal electroretinograms in rhesus macaques

    Science.gov (United States)

    Kim, Charlene B. Y.; Ver Hoeve, James N.; Nork, T. Michael

    2012-01-01

    We compared the suitability of pentobarbital sodium (PB) and propofol (PF) anesthetics for multifocal electroretinograms (mfERGs) in rhesus macaques. mfERGs were collected from 4 ocularly normal rhesus macaques. All animals were pre-anesthetized with intramuscular ketamine (10-15 mg/kg). Intravenous PB induction/maintenance levels were 15 mg/kg/2-10 mg/kg, and for PF, 2-5 mg/kg/6-24 mg/kg/h. There were 3 testing sessions with PB anesthesia and 5-7 testing sessions with PF anesthesia. All PB sessions were carried out before PF. First-order (K1) and second-order (first slice) kernels (K2.1) response density amplitude (RDA), implicit time (IT), and root mean square signal-to-noise ratios (RMS SNR) of the low-frequency (LFC) and high-frequency (HFC) components were evaluated. The use of PF or PB anesthesia resulted in robust, replicable mfERGs in rhesus macaques; however, RMS SNR of K1 LFC in ring and quadrant analyses was significantly larger for PF than for PB. Additionally, K1 RDA under PF was significantly larger than under PB for N1, P1 and P2 components (ring and quadrant), and for N2 (quadrant). PF IT was significantly prolonged (<1 ms) relative to PB IT for N1, P1 (ring) and N1 (quadrant) while PB IT was significantly prolonged (0.8-4.2 ms) relative to PF IT for N2 and P2 (ring and quadrant). K1 HFC and K2.1 LFC did not differ significantly between PB and PF in the ring or quadrant analyses. The response differences found with PB and PF anesthesia likely arise from variable relative effects of the anesthetics on retinal γ-aminobutyric acid (GABAA) receptors, and in part, on glycine and on glutamate receptors. Given the advantages of a stable anesthetic plane with continuous intravenous infusion and a smoother, more rapid recovery, PF is an appealing alternative for mfERG testing in rhesus macaques. PMID:22200766

  15. spinning self-dual particles

    International Nuclear Information System (INIS)

    Gamboa, J.; Rivelles, V.O.

    1989-01-01

    Self-dual particles in two-dimensions are presented. They were obtained from chiral boson particle by square root technique. The propagator of spinning self-dual particle is calculated using the BFV formalism. (M.C.K.)

  16. Dual Symmetry in Gauge Theories

    OpenAIRE

    Koshkarov, A. L.

    1997-01-01

    Continuous dual symmetry in electrodynamics, Yang-Mills theory and gravitation is investigated. Dual invariant which leads to badly nonlinear motion equations is chosen as a Lagrangian of the pure classical dual nonlinear electrodynamics. In a natural manner some dual angle which is determined by the electromagnetic strengths at the point of the time-space appears in the model. Motion equations may well be interpreted as the equations of the standard Maxwell theory with source. Alternative in...

  17. Physician Dual Practice: A Descriptive Mapping Review of Literature.

    Science.gov (United States)

    Moghri, Javad; Arab, Mohammad; Rashidian, Arash; Akbari Sari, Ali

    2016-03-01

    Physician dual practice is a common phenomenon in almost all countries throughout the world, which could potential impacts on access, equity and quality of services. This paper aims to review studies in physician dual practice and categorize them in order to their main objectives and purposes. Comprehensive literature searches were undertaken in order to obtain main papers and documents in the field of physician dual practice. Systematic searches in Medline and Embase from 1960 to 2013, and general searches in some popular search engines were carried out in this way. After that, descriptive mapping review methods were utilized to categorize eligible studies in this area. The searches obtained 404 titles, of which 81 full texts were assessed. Finally, 24 studies were eligible for inclusion in our review. These studies were categorized into four groups - "motivation and forces behind dual practice", "consequences of dual practice", "dual practice Policies and their impacts", and "other studies" - based on their main objectives. Our findings showed a dearth of scientifically reliable literature in some areas of dual practice, like the prevalence of the phenomenon, the real consequences of it, and the impacts of the implemented policy measures. Rigorous empirical and evaluative studies should be designed to detect the real consequences of DP and assess the effects of interventions and regulations, which governments have implemented in this field.

  18. Dual Smarandache Curves and Smarandache Ruled Surfaces

    OpenAIRE

    Tanju KAHRAMAN; Mehmet ÖNDER; H. Hüseyin UGURLU

    2013-01-01

    In this paper, by considering dual geodesic trihedron (dual Darboux frame) we define dual Smarandache curves lying fully on dual unit sphere S^2 and corresponding to ruled surfaces. We obtain the relationships between the elements of curvature of dual spherical curve (ruled surface) x(s) and its dual Smarandache curve (Smarandache ruled surface) x1(s) and we give an example for dual Smarandache curves of a dual spherical curve.

  19. Dual beam vidicon digitizer

    International Nuclear Information System (INIS)

    Evans, T.L.

    1976-01-01

    A vidicon waveform digitizer which can simultaneously digitize two independent signals has been developed. Either transient or repetitive waveforms can be digitized with this system. A dual beam oscilloscope is used as the signal input device. The light from the oscilloscope traces is optically coupled to a television camera, where the signals are temporarily stored prior to digitizing

  20. Towards a Dual Approach

    DEFF Research Database (Denmark)

    Holli, Anne Maria; Harder, Mette Marie Stæhr

    2016-01-01

    Drawing on insights from state feminism and legislative studies on parliamentary committees, this article develops a dual approach for the comparative analysis of committees on gender equality. Empirically, it compares the standing committees on gender equality in Denmark and Finland, two Nordic...

  1. Dual Criteria Decisions

    DEFF Research Database (Denmark)

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten Igel

    2014-01-01

    The most popular models of decision making use a single criterion to evaluate projects or lotteries. However, decision makers may actually consider multiple criteria when evaluating projects. We consider a dual criteria model from psychology. This model integrates the familiar tradeoffs between...

  2. Dual ionization chamber

    International Nuclear Information System (INIS)

    Mallory, J.; Turlej, Z.

    1981-01-01

    Dual ionization chambers are provided for use with an electronic smoke detector. The chambers are separated by electrically-conductive partition. A single radiation source extends through the partition into both chambers, ionizing the air in each. The mid-point current of the device may be balanced by adjusting the position of the source

  3. Screening for hearing, visual and dual sensory impairment in older adults using behavioural cues : A validation study

    NARCIS (Netherlands)

    Roets-Merken, Lieve M.; Zuidema, Sytse U.; Vernooij-Dassen, Myrra J. F. J.; Kempen, Gertrudis I. J. M.

    2014-01-01

    Objective: This study investigated the psychometric properties of the Severe Dual Sensory Loss screening tool, a tool designed to help nurses and care assistants to identify hearing, visual and dual sensory impairment in older adults. Design: Construct validity of the Severe Dual Sensory Loss

  4. Regularity of Dual Gabor Windows

    Directory of Open Access Journals (Sweden)

    Ole Christensen

    2013-01-01

    Full Text Available We present a construction of dual windows associated with Gabor frames with compactly supported windows. The size of the support of the dual windows is comparable to that of the given window. Under certain conditions, we prove that there exist dual windows with higher regularity than the canonical dual window. On the other hand, there are cases where no differentiable dual window exists, even in the overcomplete case. As a special case of our results, we show that there exists a common smooth dual window for an interesting class of Gabor frames. In particular, for any value of K∈ℕ, there is a smooth function h which simultaneously is a dual window for all B-spline generated Gabor frames {EmbTnBN(x/2}m,n∈ℕ for B-splines BN of order N=1,…,2K+1 with a fixed and sufficiently small value of b.

  5. Preventing falls in older multifocal glasses wearers by providing single-lens distance glasses: the protocol for the VISIBLE randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Lee Bonsan B

    2009-03-01

    Full Text Available Abstract Background Recent research has shown that wearing multifocal glasses increases the risk of trips and falls in older people. The aim of this study is to determine whether the provision of single-lens distance glasses to older multifocal glasses wearers, with recommendations for wearing them for walking and outdoor activities, can prevent falls. We will also measure the effect of the intervention on health status, lifestyle activities and fear of falling, as well as the extent of adherence to the program. Methods/Design Approximately 580 older people who are regular wearers of multifocal glasses people will be recruited. Participants will be randomly allocated to either an intervention group (provision of single lens glasses, with counselling and advice about appropriate use or a control group (usual care. The primary outcome measure will be falls (measured with 13 monthly calendars. Secondary measures will be quality of life, falls efficacy, physical activity levels and adverse events. Discussions The study will determine the impact of providing single-lens glasses, with advice about appropriate use, on preventing falls in older regular wearers of multifocal glasses. This pragmatic intervention, if found to be effective, will guide practitioners with regard to recommending appropriate glasses for minimising the risk of falls in older people. Trial Registration The protocol for this study was registered with the Clinical Trials.gov Protocol Registration System on June 7th 2006 (#350855.

  6. Preliminary study of single contrast enhanced dual energy heart imaging using dual-source CT

    International Nuclear Information System (INIS)

    Peng Jin; Zhang Longjiang; Zhou Changsheng; Lu Guangming; Ma Yan; Gu Haifeng

    2009-01-01

    Objective: To evaluate the feasibility and preliminary applications of single contrast enhanced dual energy heart imaging using dual-source CT (DSCT). Methods: Thirty patients underwent dual energy heart imaging with DSCT, of which 6 cases underwent SPECT or DSA within one week. Two experienced radiologists assessed image quality of coronary arteries and iodine map of myocardium. and correlated the coronary artery stenosis with the perfusion distribution of iodine map. Results: l00% (300/300) segments reached diagnostic standards. The mean score of image for all patients was 4.68±0.57. Mural coronary artery was present in 10 segments in S cases, atherosclerotic plaques in 32 segments in 12 cases, of which 20 segments having ≥50% stenosis, 12 segments ≤50% stenosis; dual energy CT coronary angiography was consistent with the DSA in 3 patients. 37 segmental perfusion abnormalities on iodine map were found in 15 cases, including 28 coronary blood supply segment narrow segment and 9 no coronary stenosis (including three negative segments in SPECD. Conclusion: Single contrast enhanced dual energy heart imaging can provide good coronary artery and myocardium perfusion images in the patients with appropriate heart rate, which has a potential to be used in the clinic and further studies are needed. (authors)

  7. Multifocal diffusion of KPC-3-producing ST512 Klebsiella pneumoniae in Italy

    Directory of Open Access Journals (Sweden)

    Aurora Piazza

    2012-03-01

    Full Text Available Introduction. The dissemination of carbapenemase-producing Klebsiella pneumoniae strains is an increasing problem worldwide. KPC ß-lactamases are Ambler class A enzymes mostly plasmid-encoded; their global spread represents a threat to clinical patients care and public health. Multi locus sequence type (ST258 is currently the most spread K. pneumoniae clone associated with KPC enzymes. Here we report the first identification and multifocal spread of KPC-3 producing K. pneumoniae clinical strains belonging to ST512 in Italy. Materials and Methods. Fifty six carbapenem-resistant K. pneumoniae isolates were collected from 7 Italian hospitals during the period June 2009-May 2011. Isolates were obtained from different wards (spinal unit, medicine, hematology, etc. and biological samples (mostly rectal swabs, urine and blood. Species identification and antimicrobial susceptibilities were obtained by NBC46/NM40 Microscan panels (Siemens. MICs values were interpreted according to EUCAST 2011 breakpoints. Modified Hodge test and combined disk test with phenyl-boronic acid (BOR and EDTA were performed.The presence of blaKPC genes were confirmed by PCR and sequencing. A complete characterization of the produced ß-lactamases (BLs was obtained by IEF followed by PCR experiments using primers specific for the detection of blaCTX-M-, blaTEM- and blaSHV type genes. PFGE and multilocus sequence typing (MLST were both used to investigate clonal isolates relatedness. Results. All 56 isolates resulted positive for the presence of KPC-type carbapenemases by both phenotypical and molecular analysis. Fifteen isolates, chosen as representative, were further investigated. Ten out of 15 isolates harboring the blaKPC-2 gene clustered with the known ST258, while the remaining 5/10 belonged to the newly described ST512 and harbored the blaKPC-3 gene. ST512 isolates, from 3/7 hospitals, were collected from rectal swabs (40%, blood (20%, endotracheal aspirate (20% and

  8. Linfoma no Hodgkin óseo primario multifocal en preadolescente: A propósito de un caso Primary multifocal non-Hodgkin's Lymphoma of the bone in the preadolescent: A case report

    OpenAIRE

    A. Restrepo Rincón; M.M. Suarez Galvis; C. Estrada Ríos; J.H. Donado Gómez; L.M. Quiroz Duque

    2012-01-01

    Los linfomas óseos primarios son tumores poco frecuentes en la edad pediátrica. Su presentación clínica es inespecífica, requiriéndose un alto nivel de sospecha clínica y el apoyo con diferentes pruebas complementarias para poder establecer el diagnóstico adecuado y así brindar un manejo integral. Se expone el caso de una paciente de 9 años, a quien a las 6,5 semanas de inicio de síntomas se diagnosticó un linfoma no Hodgkin Linfoblástico de células B óseo primario multifocal. Recibió tratami...

  9. Avaliação da sensibilidade ao contraste e da estereopsia em pacientes com lente intra-ocular multifocal Contrast sensitivity and stereopsis in pseudophakic patients with multifocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Filipe de Oliveira

    2005-08-01

    Full Text Available OBJETIVO: Avaliar a sensibilidade ao contraste e a acuidade estereoscópica em pacientes pseudofácicos, que receberam implante bilateral de lente intra-ocular multifocal. MÉTODOS: Prospectivamente foram realizados testes de sensibilidade ao contraste com o uso da tabela Pelli-Robson e teste de acuidade estereoscópica com emprego do Titmus Stereo Test, em 20 pacientes com implante bilateral de lente intra-ocular multifocal Acrysof Restor®, no pós-operatório de 1 a 2 meses e sem uso de qualquer correção óptica. RESULTADOS:O teste de sensibilidade ao contraste binocular demonstrou que 6 pacientes (30% apresentaram 1,80 unid. log, 13 (65% 1,65 e 1 (5% 1,50. No teste monocular, ocorreram as seguintes respostas: 17 pacientes (85% 1,65 unid. log e 3 (15% 1,50 para o teste do olho direito. O teste do olho esquerdo mostrou que 16 pacientes (80% apresentaram 1,65 unid. log e 4 (20% 1,50. A média e o desvio-padrão da sensibilidade ao contraste testada binocularmente foi 1,69 (±0,08, ao passo que monocularmente foi 1,63 (±0,05 para OD e 1,62 (±0,06 para OE. O teste de acuidade estereoscópica revelou que 12 pacientes (60% obtiveram 40", 6 (30% 50" e 2 (10% 60", com média de 45" e desvio-padrão de ±6,88". CONCLUSÃO: A lente intra-ocular empregada no estudo, proporcionou resultados de sensibilidade ao contraste e acuidade estereoscópica compatíveis e de acordo com critérios de normalidade estabelecidos anteriormente por outros estudos em grupos de pacientes fácicos e pseudofácicos, e portanto, impacto positivo na funcionalidade visual.PURPOSE: To evaluate the contrast sensitivity and stereopsis tests in patients who underwent bilateral implantation of multifocal intraocular lens. METHODS: Tests of contrast sensitivity using the Pelli-Robson chart and stereopsis evaluation with the Titmus Stereo Test were performed in 20 patients 30-60 days after the bilateral implantation of Acrysof Restor® multifocal intraocular lens. RESULTS: The

  10. Technical Note: Insertion of digital lesions in the projection domain for dual-source, dual-energy CT.

    Science.gov (United States)

    Ferrero, Andrea; Chen, Baiyu; Li, Zhoubo; Yu, Lifeng; McCollough, Cynthia

    2017-05-01

    To compare algorithms performing material decomposition and classification in dual-energy CT, it is desirable to know the ground truth of the lesion to be analyzed in real patient data. In this work, we developed and validated a framework to insert digital lesions of arbitrary chemical composition into patient projection data acquired on a dual-source, dual-energy CT system. A model that takes into account beam-hardening effects was developed to predict the CT number of objects with known chemical composition. The model utilizes information about the x-ray energy spectra, the patient/phantom attenuation, and the x-ray detector energy response. The beam-hardening model was validated on samples of iodine (I) and calcium (Ca) for a second-generation dual-source, dual-energy CT scanner for all tube potentials available and a wide range of patient sizes. The seven most prevalent mineral components of renal stones were modeled and digital stones were created with CT numbers computed for each patient/phantom size and x-ray energy spectra using the developed beam-hardening model. Each digital stone was inserted in the dual-energy projection data of a water phantom scanned on a dual-source scanner and reconstructed with the routine algorithms in use in our practice. The geometry of the forward projection for dual-energy data was validated by comparing CT number accuracy and high-contrast resolution of simulated dual-energy CT data of the ACR phantom with experimentally acquired data. The beam-hardening model and forward projection method accurately predicted the CT number of I and Ca over a wide range of tube potentials and phantom sizes. The images reconstructed after the insertion of digital kidney stones were consistent with the images reconstructed from the scanner, and the CT number ratios for different kidney stone types were consistent with data in the literature. A sample application of the proposed tool was also demonstrated. A framework was developed and validated

  11. Higher Representations Duals

    DEFF Research Database (Denmark)

    Sannino, Francesco

    2010-01-01

    We uncover novel solutions of the 't Hooft anomaly matching conditions for scalarless gauge theories with matter transforming according to higher dimensional representations of the underlying gauge group. We argue that, if the duals exist, they are gauge theories with fermions transforming accord......-Dyson approximation. We use the solutions to gain useful insight on the conformal window of the associated electric theory. A consistent picture emerges corroborating previous results obtained via different analytic methods and in agreement with first principle lattice explorations....

  12. Dual isotope assays

    International Nuclear Information System (INIS)

    Smith, G.F.W.; Stevens, R.A.J.; Jacoby, B.

    1980-01-01

    Dual isotope assays for thyroid function are performed by carrying out a radio-immunoassay for two of thyroxine (T4), tri-iodothyronine (T3), thyroid stimulating hormone (TSH), and thyroxine binding globulin (TBG), by a method wherein a version of one of the thyroid components, preferably T4 or T3 is labelled with Selenium-75 and the version of the other thyroid component is labelled with a different radionuclide, preferably Iodine-125. (author)

  13. Dual-Schemata Model

    Science.gov (United States)

    Taniguchi, Tadahiro; Sawaragi, Tetsuo

    In this paper, a new machine-learning method, called Dual-Schemata model, is presented. Dual-Schemata model is a kind of self-organizational machine learning methods for an autonomous robot interacting with an unknown dynamical environment. This is based on Piaget's Schema model, that is a classical psychological model to explain memory and cognitive development of human beings. Our Dual-Schemata model is developed as a computational model of Piaget's Schema model, especially focusing on sensori-motor developing period. This developmental process is characterized by a couple of two mutually-interacting dynamics; one is a dynamics formed by assimilation and accommodation, and the other dynamics is formed by equilibration and differentiation. By these dynamics schema system enables an agent to act well in a real world. This schema's differentiation process corresponds to a symbol formation process occurring within an autonomous agent when it interacts with an unknown, dynamically changing environment. Experiment results obtained from an autonomous facial robot in which our model is embedded are presented; an autonomous facial robot becomes able to chase a ball moving in various ways without any rewards nor teaching signals from outside. Moreover, emergence of concepts on the target movements within a robot is shown and discussed in terms of fuzzy logics on set-subset inclusive relationships.

  14. Infrequent detection of KI, WU and MC polyomaviruses in immunosuppressed individuals with or without progressive multifocal leukoencephalopathy.

    Directory of Open Access Journals (Sweden)

    Xin Dang

    Full Text Available Conflicting prevalence of newly identified KI (KIPyV, WU (WUPyV and Merkel Cell Carcinoma (MCPyV polyomaviruses have been reported in progressive multifocal leukoencephalopathy (PML patient samples, ranging from 0 to 14.3%. We analyzed the prevalence of these polyomaviruses in cerebrospinal fluid (CSF, peripheral blood mononuclear cells (PBMC, and bone marrow samples from PML patients, immunosuppressed individuals with or without HIV, and multiple sclerosis (MS patients. Distinct PCR tests for KIPyV, WUPyV and MCPyV DNA performed in two independent laboratories detected low levels of MCPyV DNA only in 1/269 samples. The infrequent detections of these viruses in multiple samples from immunosuppressed individuals including those with PML suggest that their reactivation mechanisms may be different from that of JC polyomavirus (JCPyV and that they do not play a role in the pathogenesis of PML.

  15. A joint Richardson—Lucy deconvolution algorithm for the reconstruction of multifocal structured illumination microscopy data

    International Nuclear Information System (INIS)

    Ströhl, Florian; Kaminski, Clemens F

    2015-01-01

    We demonstrate the reconstruction of images obtained by multifocal structured illumination microscopy, MSIM, using a joint Richardson–Lucy, jRL-MSIM, deconvolution algorithm, which is based on an underlying widefield image-formation model. The method is efficient in the suppression of out-of-focus light and greatly improves image contrast and resolution. Furthermore, it is particularly well suited for the processing of noise corrupted data. The principle is verified on simulated as well as experimental data and a comparison of the jRL-MSIM approach with the standard reconstruction procedure, which is based on image scanning microscopy, ISM, is made. Our algorithm is efficient and freely available in a user friendly software package. (paper)

  16. Rituximab-associated progressive multifocal leukoencephalopathy derived from non-Hodgkin lymphoma: neuropathological findings and results of mefloquine treatment.

    Science.gov (United States)

    Sano, Yasuteru; Nakano, Yuta; Omoto, Masatoshi; Takao, Masaki; Ikeda, Eiji; Oga, Atsunori; Nakamichi, Kazuo; Saijo, Masayuki; Maoka, Takashi; Sano, Hironori; Kawai, Motoharu; Kanda, Takashi

    2015-01-01

    A 66-year-old man with non-Hodgkin lymphoma (NHL) developed progressive multifocal leukoencephalopathy (PML) after undergoing chemotherapy including rituximab. Although the administration of mefloquine at a dose of 500 mg weekly temporarily led to a dramatic decrease in the copy number of JC Virus DNA in the cerebrospinal fluid, the patient's symptoms gradually worsened. The CD4(+) T count remained continuously low, at least until approximately five months after the last cycle of chemotherapy. A postmortem examination performed 10 months after the onset of PML disclosed a severe condition associated with rituximab-treated PML originating from NHL and a high mefloquine concentration in the brain. The accumulation of further data regarding mefloquine treatment in PML cases may help to elucidate the optimal dosage and time window for effectively treating PML.

  17. Multifocal Gastric Ulcers Caused by Diffuse Large B Cell Lymphoma in a Patient With Significant Weight Loss

    Directory of Open Access Journals (Sweden)

    Mark A. Gromski MD

    2016-12-01

    Full Text Available Primary gastrointestinal (GI lymphoma is a heterogeneous disease with varied clinical presentations. The stomach is the most common GI site and accounts for 70% to 75% of GI lymphomas. We present a patient with gastric diffuse large B cell lymphoma (DLBCL who presented with significant weight loss, early satiety, and multifocal ulcerated gastric lesions. Esophagoduodenoscopy should be performed in patients presenting with warning symptoms as in our case. Diagnosis is usually made by endoscopic biopsies. Multiple treatment modalities including surgery, radiotherapy, and chemotherapy have been used. Advancements in endoscopic and pathologic technology decrease turnaround time for diagnosis and treatment initiation, thus reducing the need for surgery. Health care providers should maintain a high level of suspicion and consider gastric DLBCL as part of the differential diagnosis, especially in those with warning symptoms such as weight loss and early satiety with abnormal endoscopic findings.

  18. Progressive multifocal encephalopathy after cyclophosphamide in granulomatosis with polyangiitis (Wegener) patients: case report and review of literature.

    Science.gov (United States)

    Pugnet, G; Pagnoux, C; Bézanahary, H; Ly, K H; Vidal, E; Guillevin, L

    2013-01-01

    Progressive multifocal encephalopathy (PML) is a rare demyelinating disorder targeting the central nervous system and resulting from JC virus reactivation. PML occurs in patients immunocompromised because of haematological malignancies, HIV infection or treatment with cytotoxic drugs. Herein, we describe PML occurring in 2 granulomatosis with polyangiitis (Wegener) patients treated with steroids and cyclophosphamide. The outcome was progressively favourable after immunosuppressant discontinuation for 1 patient and fatal for the other. Four previously reported GPA patients developed PML in the course of their disease. One of them improved gradually after immunosuppressant withdrawal. PML should be strongly suspected whenever unusual central neurological manifestations appear in this context. No effective treatment is available, but immunosuppressants should be discontinued if possible.

  19. [Multifocal histoplasmosis due to Histoplasma capsulatum var. duboisii in a 22 year-old Senegalese patient without proven immunodepression].

    Science.gov (United States)

    Diadie, S; Diatta, B; Ndiaye, M; Gaye, M; Sow, D; Ndiaye, M T; Seck, B; Diallo, S; Diop, A; Diallo, M; Ly, F; Niang, S O; Kane, A; Dieng, M T

    2016-09-01

    The authors report a case of multifocal African histoplasmosis with polymorphic skin involvement occuring in a patient without proven immunosuppression. He was a young 22-year-old patient from eastern Senegal - but born in Ouganda - who presented with polymorphic skin lesions: ombilicated papulo-nodules, gums and ulcerative and budding lesions. He showed lymphadenopathies without clinical inflammation and with a cheesy appearance of the biopsy but without tuberculosis and also hepatosplenic and bone involvement. Mycological samples of the skin and lymph nodes biopsies revealed yeasts of Histoplasma capsulatum var. duboisii with a positive culture on Sabouraud medium. HIV serology, HTLV1et 2, the serum proteins electrophoresis were unremarkable. Treatment with amphotericin B was irregular because of its inaccessibility in the national territory and its cost. The patient died of sepsis together with the aggravation of his disease. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Simultaneous Dual-Arm Motion Planning for Minimizing Operation Time

    Directory of Open Access Journals (Sweden)

    Jun Kurosu

    2017-11-01

    Full Text Available Dual-arm robots are expected to perform work in a dynamic environment. One of the most basic tasks that a dual-arm robot does is pick-and-place work. However, this work is more complicated when there are several objects in the robot’s workspace. Additionally, it is likely to take a long time to finish the work as the number of objects increases. Therefore, we propose a method using a combination of two approaches to achieve efficient pick-and-place performance by a dual-arm robot to minimize its operation time. First, we use mixed integer linear programming (MILP for the pick-and-place work to determine which arm should move an object and in which order these objects should be moved while considering the dual-arm robot’s operation range. Second, we plan the path using the rapidly exploring random tree so that the arms do not collide, enabling the robot to perform efficient pick-and-place work based on the MILP planning solution. The effectiveness of the proposed method is confirmed by simulations and experiments using an actual dual-arm robot.

  1. Reirradiation of multiple brain metastases with helical tomotherapy. A multifocal simultaneous integrated boost for eight or more lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sterzing, Florian; Welzel, Thomas; Sroka-Perez, Gabriele; Schubert, Kai; Debus, Juergen; Herfarth, Klaus K. [Heidelberg Univ. (Germany). Dept. of Radiation Oncology

    2009-02-15

    Recurrent brain metastases or new brain lesions after whole-brain radiotherapy represent a therapeutic challenge. While several treatment methods for single or few lesions have been described, options for multiple lesions are limited. This case report is intended to show an approach of whole-brain reirradiation with a simultaneous multifocal integrated boost using helical tomotherapy. Technique, feasibility, and acute side effects are presented. Two patients with multiple relapsed brain metastases (eight and eleven lesions) were reirradiated after previous whole-brain radiotherapy (total dose of 40 Gy 18 months before). Whole-brain reirradiation was performed using helical tomotherapy with a total dose of 15 Gy (single dose 1.5 Gy) and a multifocal simultaneous integrated boost with a total dose of 30 Gy (single dose 3 Gy) to the brain lesions. The boost planning target volume was delineated around the lesions visible on MRI plus a 2-mm margin. Follow-up of these patients was 6 and 12 months. Radiation plans with excellent conformity and homogeneity were obtained. High dose exposure to normal brain tissue was kept minimal. Mean radiation time was 13 min. The only acute side effect observed was a mild headache over 2 days at the end of treatment. So far, no further side effects and no signs of recurrence have been observed. Helical tomotherapy offers new treatment options for the reirradiation of multiple brain metastases. The number of cases treated with the described protocol is very limited but it is considered a promising option for patients that have responded well to the initial radiotherapy and are in a good performance status. (orig.)

  2. Test-retest variability of multifocal electroretinography in normal volunteers and short-term variability in hydroxychloroquine users

    Directory of Open Access Journals (Sweden)

    Browning DJ

    2014-08-01

    Full Text Available David J Browning,1 Chong Lee2 1Charlotte Eye, Ear, Nose and Throat Associates, 2University of North Carolina – Charlotte, Charlotte, NC, USA Purpose: To determine measurement variability of N1P1 amplitudes and the R1/R2 ratio in normal subjects and hydroxychloroquine users without retinopathy. Design: Retrospective, observational study. Subjects: Normal subjects (n=21 and 44 patients taking hydroxychloroquine (n=44 without retinopathy. Methods: Multifocal electroretinography (mfERG was performed twice in one session in the 21 normal subjects and twice within 1 year in the hydroxychloroquine users, during which time no clinical change in macular status occurred. Main outcome measures: N1P1 amplitudes of rings R1–R5, the R1/R2 ratio, and coefficients of repeatability (COR for these measurements. Results: Values for N1P1 amplitudes in hydroxychloroquine users were reduced compared with normal subjects by the known effect of age, but R1/R2 was not affected by age. The COR for R1–R5 ranged from 43% to 52% for normal subjects and from 43% to 59% for hydroxychloroquine users; for R1/R2 the COR was 29% in normal subjects and 45% in hydroxychloroquine users. Conclusion: mfERG measurements show high test-retest variability, limiting the ability of a single mfERG test to influence a decision to stop hydroxychloroquine; corroborative evidence with a different ancillary test is recommended in a suspicious case. Keywords: multifocal electroretinography, hydroxychloroquine, test-retest variability 

  3. A DUAL mission for nuclear astrophysics

    Science.gov (United States)

    von Ballmoos, Peter; Alvarez, Jose; Barrière, Nicolas; Boggs, Steve; Bykov, Andrei; Del Cura Velayos, Juan Manuel; Frontera, Filippo; Hanlon, Lorraine; Hernanz, Margarita; Hinglais, Emmanuel; Isern, Jordi; Jean, Pierre; Knödlseder, Jürgen; Kuiper, Lucien; Leising, Mark; Pirard, Benoît; Prost, Jean-Pierre; da Silva, Rui M. Curado; Takahashi, Tadayuki; Tomsick, John; Walter, Roland; Zoglauer, Andreas

    2012-10-01

    DUAL will study the origin and evolution of the elements and explores new frontiers of physics: extreme energies that drive powerful stellar explosions and accelerate particles to macroscopic energies; extreme densities that modify the laws of physics around the most compact objects known; and extreme fields that influence matter in a way that is unknown on Earth. The variability of these extreme objects requires continuous all-sky coverage, while detailed study demands an improvement in sensitivity over previous technologies by at least an order of magnitude. The DUAL payload is composed of an All-Sky Compton Imager (ASCI), and two optical modules, the Laue-Lens Optic (LLO) and the Coded-Mask Optic (CMO). The ASCI serves dual roles simultaneously, both as an optimal focal-plane sensor for deep observations with the optical modules and as a sensitive true all-sky telescope in its own right for all-sky surveys and monitoring. While the optical modules are located on the main satellite, the All-Sky Compton Imager is situated on a deployable structure at a distance of 30 m from the satellite. This configuration not only permits to maintain the less massive payload at the focal distance, it also greatly reduces the spacecraft-induced detector background, and, above all it provides ASCI with a continuous all-sky exposure.

  4. Dual containment in the Persian Gulf: strategic considerations and policy options

    OpenAIRE

    Mraz, Jerry L; McCallen, John P.

    1996-01-01

    This thesis is a critical analysis of US foreign policy toward Iran and Iraq known as a policy of dual containment. The objective of dual containment is to isolate these regimes politically, economically and militarily. This thesis evaluates American conduct in the region for the last 50 years, in order to show how previous strategies culminated in the present policy. It discusses both the merits and problems inherent in dual containment, as well as the impact of this policy on its two intend...

  5. Dual station visualization measuring method of LRCS

    Science.gov (United States)

    Jia, Bing; Cao, Guohuaa; Lv, Qiongyinga; Zhang, Xina

    2016-10-01

    Based on the physical meaning of the laser radar scattering cross section (LRCS), When the target is the standard target or the extension target, the LRCS analytical expressions and numerical expression are deduced. Based on the LRCS expression, Proposed a dual station visualization comparison measurement method, the purpose is to use a known radar cross section of the standard target, by the power detector, and CCD images obtained gray value, calculated the target's radar cross section. In the paper, we designed the optical emission system and the optical receiving system, then detected target backscatter light power, Sampled the target image, Using MATLAB calculate the power density ratio of test objectives and reference target., compared the measured data with the empirical data, verify the feasibility of the dual station visualization comparison measurement method.

  6. Adaptive upscaling with the dual mesh method

    Energy Technology Data Exchange (ETDEWEB)

    Guerillot, D.; Verdiere, S.

    1997-08-01

    The objective of this paper is to demonstrate that upscaling should be calculated during the flow simulation instead of trying to enhance the a priori upscaling methods. Hence, counter-examples are given to motivate our approach, the so-called Dual Mesh Method. The main steps of this numerical algorithm are recalled. Applications illustrate the necessity to consider different average relative permeability values depending on the direction in space. Moreover, these values could be different for the same average saturation. This proves that an a priori upscaling cannot be the answer even in homogeneous cases because of the {open_quotes}dynamical heterogeneity{close_quotes} created by the saturation profile. Other examples show the efficiency of the Dual Mesh Method applied to heterogeneous medium and to an actual field case in South America.

  7. Dual Smarandache Curves of a Timelike Curve lying on Unit dual Lorentzian Sphere

    OpenAIRE

    Kahraman, Tanju; Hüseyin Ugurlu, Hasan

    2016-01-01

    In this paper, we give Darboux approximation for dual Smarandache curves of time like curve on unit dual Lorentzian sphere. Firstly, we define the four types of dual Smarandache curves of a timelike curve lying on dual Lorentzian sphere.

  8. Self-dual electromagnetic fields

    Science.gov (United States)

    Chubykalo, Andrew E.; Espinoza, Augusto; Kosyakov, B. P.

    2010-08-01

    We demonstrate the utility of self-dual fields in electrodynamics. Stable configurations of free electromagnetic fields can be represented as superpositions of standing waves, each possessing zero Poynting vector and zero orbital angular momentum. The standing waves are themselves superpositions of self-dual and anti-self-dual solutions. The idea of self-duality provides additional insights into the geometrical and spectral properties of stable electromagnetic configurations, such as those responsible for the formation of ball lightning.

  9. Dual symmetry in gauge theories

    International Nuclear Information System (INIS)

    Koshkarov, A.L.

    1997-01-01

    Continuous dual symmetry in electrodynamics, Yang-Mills theory and gravitation is investigated. Dual invariant which leads to badly nonlinear motion equations is chosen as a Lagrangian of the pure classical dual nonlinear electrodynamics. In a natural manner some dual angle which is determined by the electromagnetic strengths at the point of the time-space appears in the model. Motion equations may well be interpreted as the equations of the standard Maxwell theory with source. Alternative interpretation is the quasi-Maxwell linear theory with magnetic charge. Analogous approach is possible in the Yang-Mills theory. In this case the dual-invariant non-Abelian theory motion equations possess the same instanton solutions as the conventional Yang-Mills equations have. An Abelian two-parameter dual group is found to exist in gravitation. Irreducible representations have been obtained: the curvature tensor was expanded into the sum of twice anti-self-dual and self-dual parts. Gravitational instantons are defined as (real )solutions to the usual duality equations. Central symmetry solutions to these equations are obtained. The twice anti-self-dual part of the curvature tensor may be used for introduction of new gravitational equations generalizing Einstein''s equations. However, the theory obtained reduces to the conformal-flat Nordstroem theory

  10. Dual-beam CRT

    International Nuclear Information System (INIS)

    1975-01-01

    A dual-beam cathode-ray tube having a pair of electron guns and associated deflection means disposed side-by-side on each side of a central axis is described. The electron guns are parallel and the deflection means includes beam centering plates and angled horizontal deflection plates to direct the electron beams toward the central axis, precluding the need for a large-diameter tube neck in which the entire gun structures are angled. Bowing control plates are disposed adjacent to the beam centering plates to minimize trace bowing, and an intergun shield is disposed between the horizontal deflection plates to control and correct display pattern geometry distortion

  11. Dual-band dual-polarized array for WLAN applications

    CSIR Research Space (South Africa)

    Steyn, JM

    2009-01-01

    Full Text Available Paper presents a dual-band dual-polarized antenna array design for WLAN applications. Four double-dipole elements are orthogonally interleaved to facilitate operation in both the standard WLAN frequency bands (IEEE 802.11b and IEEE 802.11a...

  12. Causal Video Object Segmentation From Persistence of Occlusions

    Science.gov (United States)

    2015-05-01

    spond to “objects” is elusive absent an explicit definition of objects that has a measurable correlate in the image. Gestalt principles [33] provide...primal-dual scheme. Our proposed method is competitive to state-of-the-art approaches qualitatively in visual boundaries and quantitatively in...by Gestalt principles to arrive at a con- vex optimization scheme that can be efficiently solved with primal-dual methods. To compare with existing

  13. Freudenthal Dual Lagrangians

    CERN Document Server

    Borsten, L; Ferrara, S; Marrani, A

    2013-01-01

    The global U-dualities of extended supergravity have played a central role in differentiating the distinct classes of extremal black hole solutions. When the U-duality group satisfies certain algebraic conditions, as is the case for a broad class of supergravities, the extremal black holes enjoy a further symmetry known as Freudenthal duality (F-duality), which although distinct from U-duality preserves the Bekenstein-Hawking entropy. Here it is shown that, by adopting the doubled Lagrangian formalism, F-duality, defined on the doubled field strengths, is not only a symmetry of the black hole solutions, but also of the equations of motion themselves. A further role for F-duality is introduced in the context of world-sheet actions. The Nambu-Goto world-sheet action in any (t, s) signature spacetime can be written in terms of the F-dual. The corresponding field equations and Bianchi identities are then related by F-duality allowing for an F-dual formulation of Gaillard-Zumino duality on the world-sheet. An equi...

  14. Assessment of dual tasking has no clinical value for fall prediction in Parkinson's disease

    NARCIS (Netherlands)

    Smulders, K.; Esselink, R.A.J.; Weiss, A; Kessels, R.P.C.; Geurts, A.C.H.; Bloem, B.R.

    2012-01-01

    The objective of this study is to investigate the value of dual-task performance for the prediction of falls inpatients with Parkinson's disease (PD). Two hundred sixty three patients with PD (H&Y 1-3, 65.2 +/- 7.9 years)walked two times along a 10-m trajectory, both under single-task and dual-task

  15. Effects of permanent dual chamber pacing on myocardial perfusion in symptomatic hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Posma, JL; Blanksma, PK; VanderWall, EE; Vaalburg, W; Crijns, HJGM; Lie, KI

    1996-01-01

    Objective-Angina and the presence of myocardial ischaemia are common in hypertrophic cardiomyopathy. Dual chamber pacing results in clinical improvement in these patients. This study evaluates the effects of permanent dual chamber pacing on absolute regional myocardial perfusion and perfusion

  16. Comparative study on optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis ® ZMB00 and AcrySof ® IQ ReSTOR ® Multifocal IOL SN6AD1

    Directory of Open Access Journals (Sweden)

    Mario Augusto Pereira Dias Chaves

    2016-06-01

    Full Text Available ABSTRACT Purpose: To compare the optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis® ZMB00 and AcrySof® ReSTOR® SN6AD1. Methods: This prospective, non-randomized comparative study included the assessment of 74 eyes in 37 patients referred for cataract surgery and candidates for multifocal intraocular lens implants. Exclusion criteria included existence of any other eye disease, previous eye surgery, high axial myopia, preoperative corneal astigmatism of >1.00 cylindrical diopter (D, and intraoperative or postoperative complications. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA, corrected distance visual acuity (CDVA, distance-corrected near visual acuity (DCNVA, and distance-corrected intermediate visual acuity (DCIVA, with analysis of contrast sensitivity (CS, wavefront, and visual defocus curve. Results: Postoperative UDVA was 0.09 and 0.08 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.868; postoperative CDVA was 0.04 and 0.02 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.68; DCIVA was 0.17 and 0.54 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.000; and DCNVA was 0.04 and 0.09 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.001. In both cases, there was an improvement in the spherical equivalent and UDVA (p<0.05. Under photopic conditions, the SN6AD1 group had better CS at low frequencies without glare (p=0.04; however, the ZMB00 group achieved better sensitivity at high frequencies with glare (p=0.003. The SN6AD1 and ZMB00 lenses exhibited similar behavior for intermediate vision, according to the defocus curve; however, the ZMB00 group showed a shorter reading distance than the SN6AD1 group. There were no significant differences regarding aberrometry between the two groups. Conclusion: Both lenses promoted better quality of vision for both long and short distances and exhibited a similar behavior for

  17. Asymmetry in Dual Language Practice

    Directory of Open Access Journals (Sweden)

    Audrey Amrein

    2000-01-01

    Full Text Available The capacity for dual-language programs to deliver specific benefits to students with different primary and secondary language skills continues to be debated. Individuals favoring dual language assert that as it relies upon a reciprocal approach, dual language students acquire dual language proficiency without the need for teachers to translate from one language to another. By utilizing and conserving the language skills that students bring, dual language students also gain cross-cultural understandings and an expanded opportunity to realize academic success in the future. Research that explores whether these programs meet the needs of monolingual and bilingual students is limited. The intent of this study is not to criticize dual language practice. Instead, it is to describe a newly implemented dual language immersion program that exists and operates in Phoenix, Arizona. In particular, this study examines the practices of dual language teachers at Leigh Elementary School and the challenges encountered as school personnel worked to provide students with different primary and secondary language skills increased opportunities to learn.

  18. Dual-core Itanium Processor

    CERN Multimedia

    2006-01-01

    Intel’s first dual-core Itanium processor, code-named "Montecito" is a major release of Intel's Itanium 2 Processor Family, which implements the Intel Itanium architecture on a dual-core processor with two cores per die (integrated circuit). Itanium 2 is much more powerful than its predecessor. It has lower power consumption and thermal dissipation.

  19. Dual energy scanning beam X-radiography

    Science.gov (United States)

    Wojcik, Randolph Frank

    Dual energy X-radiography is a method first developed in the mid-1970's by which one uses the information contained in the energy spectrum of the transmitted X-ray flux through an object. With this information one can distinguish the types of materials present in a radiograph and thus allow a computer to subtract them from the image enhancing the contrast of the remaining materials. Using this method, one can see details, which would have been hidden by overlying structures of other materials such as seen in radiographs of parts, made up of mixtures of metals and composites. There is also great interest in this technique for medical imaging of the chest where images of the organs are significantly improved by subtracting the bones. However, even with the enhanced capabilities realized with this technique, the majority of X-radiography systems only measures the bulk transmitted X-ray intensity and ignores the information contained in the energy spectrum. This is due to the added expense, time requirements, and registration problems incurred using standard radiographic methods to obtain dual energy radiographs. This dissertation describes a novel method which overcomes these problems and allows one to perform inexpensive, near real time, single shot dual energy X-radiography. The work of this thesis resulted in US patent #5,742,660.

  20. Oncocytic Variant of Medullary Thyroid Carcinoma: A Rare Case of Sporadic Multifocal and Bilateral RET Wild-Type Neoplasm with Revision of the Literature.

    Science.gov (United States)

    Vinciguerra, Gian Luca Rampioni; Noccioli, Niccolò; Cippitelli, Claudia; Minucci, Angelo; Capoluongo, Ettore; Bartolazzi, Armando

    2016-11-17

    Oncocytic variant of medullary thyroid carcinoma (OV-MTC) is a very unusual entity, up to date only 17 cases have been reported in the literature. MTC is a neuro-endocrine malignancy arising from the para-follicular C cells of the thyroid gland. It generally has a slight female predominance and appears as a single lesion. However in the Multiple Endocrine Neoplasia Syndrome 2, linked to the point mutation of RET oncogene, multifocal MTCs may also occur. Herein, we report the case of a 75 years old man with a rare form of sporadic multifocal and bilateral OV-MTC expressing wild-type RET gene. The histological and molecular features of this rare entity are presented and discussed with revision of the pertinent literature.

  1. Oncocytic variant of medullary thyroid carcinoma: a rare case of sporadic multifocal and bilateral RET wild-type neoplasm with revision of the literature

    Directory of Open Access Journals (Sweden)

    Gian Luca Rampioni Vinciguerra

    2016-12-01

    Full Text Available Oncocytic variant of medullary thyroid carcinoma (OV-MTC is a very unusual entity, up to date only 17 cases have been reported in the literature. MTC is a neuro-endocrine malignancy arising from the para-follicular C cells of the thyroid gland. It generally has a slight female predominance and appears as a single lesion. However in the Multiple Endocrine Neoplasia Syndrome 2, linked to the point mutation of RET oncogene, multifocal MTCs may also occur. Herein, we report the case of a 75 years old man with a rare form of sporadic multifocal and bilateral OV-MTC expressing wild-type RET gene. The histological and molecular features of this rare entity are presented and discussed with revision of the pertinent literature.

  2. Chronic recurrent multifocal osteomyelitis: how to suggest this diagnosis?; L`osteite chronique recurrente multifocale. Un diagnostic qu`il faut savoir evoquer

    Energy Technology Data Exchange (ETDEWEB)

    Saint-Martin, Ch. [UCL Cliniques Saint-Luc, Bruxelles (Belgium); Kurelovic, I.; Soler, C.; Geoffray, A. [Fondation Laval, 06 - Nice (France); Durckel, J. [Hopital Hautepierre, 67 - Strasbourg (France)

    1997-09-01

    Chronic recurrent multifocal osteomyelitis is a rare disorder that affects children and teenagers. Clinically, it is characterized by insidious onset of local swelling and pain in several metaphyses. A symmetric, recurrent and multifocal pattern is usual. Spinal involvement is possible. Inconstant association with a cutaneous affection (palmo-plantar pustulosis, acne fulminans, psoriasis), or less frequently with an inflammatory chronic gut disorder is described. Pathogenesis usually recognized is an enthesopathy. Enthesitis may progress to the osseous part of the enthese and produce an aseptic chronic osteomyelitis. Biopsy specimen with culture is certainly necessary to rule out bacterial osteomyelitis and bone tumor. It is particularly true when the bone lesion is isolated. Disease course is benign and self-limited. The clinical course is characterized by recurrences and remissions occurring for 6 to 10 years. Treatment based on non steroid anti-inflammatory drugs is usually effective. (authors). 17 refs.

  3. Postoperative Physical Therapy Management of Tendon Transfer for Digital/Wrist Extension Due to Multifocal Motor Neuropathy.

    Science.gov (United States)

    Volpe, Steve

    2016-12-01

    Study Design Case report. Background Multifocal motor neuropathy is a progressive motor nerve disorder characterized by muscle weakness in the extremities. Muscle imbalance and weakness can become so severe that the involved extremity can be rendered nonfunctional. The purpose of this case report is to describe the physical therapy postoperative management of a patient who underwent a multiple tendon transfer to correct the loss of digital/wrist extension of the right upper extremity. Case Description A 38-year-old woman with a medical diagnosis of multifocal motor neuropathy, which caused muscle imbalance and weakness in the right hand, underwent a multiple tendon transfer to correct the loss of digit and wrist extension. The pronator teres was transferred and attached to the extensor carpi radialis longus and brevis. The palmaris longus was transferred and attached to the extensor pollicis longus. The flexor carpi radialis was transferred and attached to the extensor digitorum communis. The patient underwent static and dynamic splinting and a modified tendon transfer protocol starting at 3 weeks and ending at 16 weeks postsurgery. The patient attended therapy 1 to 3 times a week, depending on protocol stage and need for skilled therapy intervention. Outcomes Patient-reported outcome measures included the Disabilities of the Arm, Shoulder and Hand (DASH) survey to monitor the return of function and the numeric pain-rating scale to assess pain. At the initial evaluation (3 weeks postsurgery), the patient's DASH score was 87.5 and her pain score was 7/10. At discharge (16 weeks postsurgery), the patient's DASH score was 37.5 and her pain score was 0/10. Strength impairment was monitored with hydraulic hand dynamometers and manual muscle testing. At discharge, her hand grip strength was 4.5 kg, her key pinch strength was 4.1 kg, and her 3-jaw pinch strength was 2.3 kg. Manual muscle testing grades were 5/5 for elbow extension/flexion, 4/5 for forearm pronation

  4. Quasi-objects, Cult Objects and Fashion Objects

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2011-01-01

    This article attempts to rehabilitate the concept of fetishism and to contribute to the debate on the social role of objects as well as to fashion theory. Extrapolating from Michel Serres’ theory of the quasi-objects, I distinguish two phenomenologies possessing almost opposite characteristics....... These two phenomenologies are, so I argue, essential to quasi-object theory, yet largely ignored by Serres’ sociological interpreters. They correspond with the two different theories of fetishism found in Marx and Durkheim, respectively. In the second half of the article, I introduce the fashion object...... as a unique opportunity for studying the interchange between these two forms of fetishism and their respective phenomenologies. Finally, returning to Serres, I briefly consider the theoretical consequences of introducing the fashion object as a quasi-object....

  5. Comparing the relative peripheral refraction effect of single vision and multifocal contact lenses measured using an autorefractor and an aberrometer: A pilot study

    Directory of Open Access Journals (Sweden)

    Ravi C. Bakaraju

    2015-07-01

    Conclusion: For most test conditions, distinct differences were observed between the RPR measures obtained with the two modified instruments. The differences varied with CL design and centration. Although the pilot study supports the interchangeable use of the two instruments for on- and off-axis refraction in unaided eyes or eyes corrected with low/no spherical aberration; we advocate the use of the COAS-HD over the SN for special purposes like refracting through multifocal CLs.

  6. Avaliação do desempenho visual da lente intraocular difrativa multifocal - Zeiss AT Lisa 809 MTM

    Directory of Open Access Journals (Sweden)

    Lucas Monferrari Monteiro Vianna

    2014-04-01

    Full Text Available Objetivo: Avaliar a função visual dos pacientes com implante bilateral da LIO multifocal difrativa AT-Lisa 809 MTM por meio dos exames de acuidade visual com e sem correção óptica, curva de sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF39. Métodos: Estudo clínico, prospectivo e de intervenção, que avaliou os resultados de 20 olhos de 10 pacientes, submetidos à facoemulsificação e implante de LIO, entre fevereiro e junho de 2012. Resultados: A ametropia residual média pós-operatória foi de 0,05 ± 0,42 (-0,75 a +1,25 D dioptrias esféricas e -0,30 ± 0,42 (0 a -1,25 D dioptrias cilíndricas. Na curva de desenfoque mono e binocular, a melhor acuidade visual média obtida com 0.00 D de desenfoque (AV de longe. O segundo pico foi obtido com desenfoque de -3,00 D, o que equivale à visão de perto a 33 cm. Entre esses picos, observamos uma perda de desempenho visual, com desenfoque de -2,00 D, que equivale a visão intermediária a 50 cm. A sensibilidade ao contraste foi similar aos relatados na literatura com este tipo de LIO, tanto com quanto sem ofuscamento, e é mostrada em gráficos. O questionário de função visual (VFQ-39 teve valor médio de 91,91 +- 6,82. Conclusão: A LIO multifocal difrativa AT-Lisa 809MTM (Carl Zeiss Meditec Company - Alemanha apresentou resultados condizentes com a literatura quando avaliada pelos exames de acuidade visual com e sem correção óptica, sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF 39.

  7. Hamilton principle for the dual electrodynamics

    International Nuclear Information System (INIS)

    Souza Silva, Saulo Carneiro de

    1995-01-01

    The present work discusses the classical electromagnetic theory in the presence of magnetic monopoles. We review the connection between such objects and the long standing problem of charge quantization and the main theoretical difficulties in formulating the classical dual electromagnetic theory in terms of an action principle. We show that a deeper understanding of the source of such difficulties leads naturally to the construction of a variational principle for a non-local Lagrangian from which all the (local) dynamical equations for electric, magnetic charges and fields can be obtained. (author)

  8. Multifocal hemosiderin depositions on T2*-weighted magnetic resonance imaging in a patient with pathology-proven systemic diffuse large B-cell lymphoma.

    Science.gov (United States)

    Yang, Xun-zhe; Ni, Jun; Cui, Li-ying

    2014-09-25

    Intracranial hemorrhage in central nervous system lymphoma is extremely rare. T2*-weighted gradient-echo magnetic resonance imaging is of particularly use in detecting silent hemorrhage as hypointense signals due to the deposition of paramagnetic hemosiderin or mineralization. Multifocal hemosiderin depositions caused by chronic silent hemorrhage have not yet been identified in patients with central nervous system involvement of systemic lymphoma. We present an unexpected radiographic feature on T2*-weighted gradient-echo magnetic resonance imaging in a patient with central nervous system involvement of pathologically confirmed systemic diffuse large B-cell lymphoma. A 56-year-old woman presented with lower extremities weakness and progressive cognitive decline for four months. Conventional brain magnetic resonance imaging demonstrated multiple lesions with hypointensities on T1-weighted images and hyperintensities on T2-weighted images and fluid attenuated inversion recovery in both hemispheres. She was then transferred to our hospital. This is the first report of pathologically confirmed case of CNS involvement of systemic diffuse large B-cell lymphoma with multifocal silent hemosiderin depositions detected by T2*-weighted gradient-echo magnetic resonance imaging. Even though uncommon, our report offers an insight that CNS lymphoma could present with multifocal silent hemosiderin depositions on T2*-weighted gradient-echo magnetic resonance imaging. Further studies were expected for exploring the association between this radiologic feature and systemic lymphoma and their underlying mechanisms.

  9. PROGNOSTIC FACTORS OF POSITIVE RESULTS OF MULTIFOCAL TRUS-GUIDED VESICOURETHRAL ANASTOMOSIS BIOPSY IN PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY

    Directory of Open Access Journals (Sweden)

    P. D. Demeshko

    2014-07-01

    Full Text Available Purpose. To evaluate influence of clinical, biochemical and histological factors to detection rate of local recurrence following radical prostatectomy (RPE using multifocal TRUS-guided vesicourethral anastomosis (VUA biopsy.Material and methods. 59 patients with newly diagnosed biochemical recurrence (BR after RPE were included into prospective study. All of them underwent multifocal TRUS-guided VUA biopsy. Сlinical variables (serum prostate-specifi c antigen [PSA] level and PSA kinetics, time RPE-BR, Gleason grade, stage after RPE and clinical findings were evaluated. Logistic regression and receiver operating characteristic (ROC curve analyses were performed.Results. The detection rate of local prostate recurrence with TRUS-guided VUA biopsy was 45,8 % (95 % CI 33,7–58,3. At multivariate analysis only PSA level at the moment of biopsy (≤ 1,5 ng/ml vs > 1,5 ng/ml and time RPE-BR (≤ 15 months vs > 15 months were significantly associated with positive results of multifocal TRUS-guided VUA biopsy (p < 0,05.Conclusion The detection rate of local prostate recurrence with TRUS-guided VUA biopsy depends on combination of independent predictors (PSA level at the moment of biopsy and time RPE—BR.

  10. Dual Tank Fuel System

    Science.gov (United States)

    Wagner, Richard William; Burkhard, James Frank; Dauer, Kenneth John

    1999-11-16

    A dual tank fuel system has primary and secondary fuel tanks, with the primary tank including a filler pipe to receive fuel and a discharge line to deliver fuel to an engine, and with a balance pipe interconnecting the primary tank and the secondary tank. The balance pipe opens close to the bottom of each tank to direct fuel from the primary tank to the secondary tank as the primary tank is filled, and to direct fuel from the secondary tank to the primary tank as fuel is discharged from the primary tank through the discharge line. A vent line has branches connected to each tank to direct fuel vapor from the tanks as the tanks are filled, and to admit air to the tanks as fuel is delivered to the engine.

  11. Dual THz comb spectroscopy

    Science.gov (United States)

    Yasui, Takeshi

    2017-08-01

    Optical frequency combs are innovative tools for broadband spectroscopy because a series of comb modes can serve as frequency markers that are traceable to a microwave frequency standard. However, a mode distribution that is too discrete limits the spectral sampling interval to the mode frequency spacing even though individual mode linewidth is sufficiently narrow. Here, using a combination of a spectral interleaving and dual-comb spectroscopy in the terahertz (THz) region, we achieved a spectral sampling interval equal to the mode linewidth rather than the mode spacing. The spectrally interleaved THz comb was realized by sweeping the laser repetition frequency and interleaving additional frequency marks. In low-pressure gas spectroscopy, we achieved an improved spectral sampling density of 2.5 MHz and enhanced spectral accuracy of 8.39 × 10-7 in the THz region. The proposed method is a powerful tool for simultaneously achieving high resolution, high accuracy, and broad spectral coverage in THz spectroscopy.

  12. Dual coolant blanket concept

    International Nuclear Information System (INIS)

    Malang, S.; Schleisiek, K.

    1994-11-01

    A self-cooled liquid metal breeder blanket with helium-cooled first wall ('Dual Coolant Blanket Concept') for a fusion DEMO reactor is described. This is one of the four blanket concepts under development in the frame of the European fusion technology program with the aim to select in 1995 the two most promising ones for further development. Described are the design of the blankets including the ancillary loop system and the results of the theoretical and experimental work in the fields of neutronics, magnetohydrodynamics, thermohydraulics, mechanical stresses, compatibility and purification of lead-lithium, tritium control, safety, reliability, and electrically insulating coatings. The remaining open questions and the required R and D programme are identified. (orig.) [de

  13. Multifocal Ectopic Purkinje-Related Premature Contractions A New SCN5A-Related Cardiac Channelopathy

    NARCIS (Netherlands)

    Laurent, Gabriel; Saal, Samuel; Amarouch, Mohamed Yassine; Béziau, Delphine M.; Marsman, Roos F. J.; Faivre, Laurence; Barc, Julien; Dina, Christian; Bertaux, Geraldine; Barthez, Olivier; Thauvin-Robinet, Christel; Charron, Philippe; Fressart, Véronique; Maltret, Alice; Villain, Elisabeth; Baron, Estelle; Mérot, Jean; Turpault, Rodolphe; Coudière, Yves; Charpentier, Flavien; Schott, Jean-Jacques; Loussouarn, Gildas; Wilde, Arthur A. M.; Wolf, Jean-Eric; Baró, Isabelle; Kyndt, Florence; Probst, Vincent

    2012-01-01

    Objectives The aim of this study was to describe a new familial cardiac phenotype and to elucidate the electrophysiological mechanism responsible for the disease. Background Mutations in several genes encoding ion channels, especially SCN5A, have emerged as the basis for a variety of inherited

  14. Quantitative Prediction of Stone Fragility From Routine Dual Energy CT

    DEFF Research Database (Denmark)

    Ferrero, Andrea; Montoya, Juan C; Vaughan, Lisa E

    2016-01-01

    RATIONALE AND OBJECTIVES: Previous studies have demonstrated a qualitative relationship between stone fragility and internal stone morphology. The goal of this study was to quantify morphologic features from dual-energy computed tomography (CT) images and assess their relationship to stone fragil...

  15. The Utility of Dual Energy Computed Tomography in Musculoskeletal Imaging

    Directory of Open Access Journals (Sweden)

    Sachin Khanduri

    2017-01-01

    Full Text Available The objective of this article is to review the mechanisms, advantages and disadvantages of dual energy computed tomography (DECT over conventional tomography (CT in musculoskeletal imaging as DECT provides additional information about tissue composition and artifact reduction. This provides clinical utility in detection of urate crystals, bone marrow edema, reduction of beam hardening metallic artifact, and ligament and tendon analysis.

  16. Dual protection in sexually active women | Kleinschmidt | South ...

    African Journals Online (AJOL)

    Objective. To determine the prevalence and co-factors associated with the practice of dual protection against sexually transmitted infections (STis) and unwanted pregnancy in a cross-sectional sample of South African women. Design. Secondary analysis of cross-sectional household survey data. Methods. Statistical ...

  17. Sound objects – Auditory objects – Musical objects

    DEFF Research Database (Denmark)

    Hjortkjær, Jens

    2016-01-01

    The auditory system transforms patterns of sound energy into perceptual objects but the precise definition of an ‘auditory object’ is much debated. In the context of music listening, Pierre Schaeffer argued that ‘sound objects’ are the fundamental perceptual units in ‘musical objects...

  18. Sound objects – Auditory objects – Musical objects

    DEFF Research Database (Denmark)

    Hjortkjær, Jens

    2015-01-01

    The auditory system transforms patterns of sound energy into perceptual objects but the precise definition of an ‘auditory object’ is much debated. In the context of music listening, Pierre Schaeffer argued that ‘sound objects’ are the fundamental perceptual units in ‘musical objects...

  19. Learning Object Repositories

    Science.gov (United States)

    Lehman, Rosemary

    2007-01-01

    This chapter looks at the development and nature of learning objects, meta-tagging standards and taxonomies, learning object repositories, learning object repository characteristics, and types of learning object repositories, with type examples. (Contains 1 table.)

  20. Presymptomatic diagnosis with MRI and adequate treatment ameliorate the outcome after natalizumab-associated progressive multifocal leukoencephalopathy (PML.

    Directory of Open Access Journals (Sweden)

    Hans eLindå

    2013-02-01

    Full Text Available Natalizumab (Tysabri® is a monoclonal antibody that prevents inflammatory cells from binding to brain endothelial cells and passing into the brain parenchyma. Natalizumab is a highly effective treatment for relapsing-remitting multiple sclerosis (MS. Progressive multifocal leukoencephalopathy (PML is an opportunistic brain JC virus infection that has been shown to be associated with natalizumab treatment. We describe PML in a patient with MS after 44 monthly infusions of natalizumab. With the aid of a routine MRI scan, PML was detected before any unambiguous clinical manifestations had emerged. PML was treated with plasma exchange to accelerate removal of natalizumab. Mirtazapine and mefloquine was promptly added and approximately one month after plasma exchange, when an immune-reconstitution-inflammatory-syndrome (IRIS appeared, steroid treatment was initiated. Steroid treatment was then continued until no virus could be detected in the cerebrospinal fluid. The outcome was favourable. We believe that this case clearly illustrates the importance of an early, presymptomatic, detection of PML and an adequate treatment. We also propose that surveillance with MRI scans, every 3 months after 24 months of treatment, should be performed in JC virus antibody positive natalizumab-treated MS patients in order to detect PML in an early phase.

  1. A shower of second hit events as the cause of multifocal renal cell carcinoma in tuberous sclerosis complex.

    Science.gov (United States)

    Tyburczy, Magdalena E; Jozwiak, Sergiusz; Malinowska, Izabela A; Chekaluk, Yvonne; Pugh, Trevor J; Wu, Chin-Lee; Nussbaum, Robert L; Seepo, Sara; Dzik, Tomasz; Kotulska, Katarzyna; Kwiatkowski, David J

    2015-04-01

    Tuberous sclerosis complex (TSC) is a genetic disorder characterized by seizures and tumor formation in multiple organs, mainly in the brain, skin, kidney, lung and heart. Renal cell carcinoma (RCC) occurs in ∼3% of TSC patients, and typically develops at age 1 tumor. The second (male) TSC patient had bilateral partial nephrectomies (both at age 36), with similar findings of multifocal PRCC. NGS analysis of TSC2 in two of these tumors identified a second hit mutation c.2355+1G>T in one sample that was not seen in other tumors. In conclusion, we report the first detailed genetic analysis of RCCs in TSC patients. Molecular studies indicate that tumors developed independently due to various second hit events, suggesting that these patients experienced a 'shower' of second hit mutations in TSC2 during kidney development leading to this severe phenotype. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Failure of mefloquine therapy in progressive multifocal leukoencephalopathy: report of two Japanese patients without human immunodeficiency virus infection.

    Science.gov (United States)

    Kobayashi, Zen; Akaza, Miho; Numasawa, Yoshiyuki; Ishihara, Shoichiro; Tomimitsu, Hiroyuki; Nakamichi, Kazuo; Saijo, Masayuki; Morio, Tomohiro; Shimizu, Norio; Sanjo, Nobuo; Shintani, Shuzo; Mizusawa, Hidehiro

    2013-01-15

    Although progressive multifocal leukoencephalopathy (PML) cases showing responses to mefloquine therapy have been reported, the efficacy of mefloquine for PML remains unclear. We report on the failure of mefloquine therapy in two Japanese patients with PML unrelated to human immunodeficiency virus. One of the patients was a 47-year-old male who had been treated with chemotherapy for Waldenström macroglobulinemia, and the other was an 81-year-old male with idiopathic CD4(+) lymphocytopenia. Diagnosis of PML was established based on MRI findings and increased JC virus DNA in the cerebrospinal fluid in both patients. Mefloquine was initiated about 5 months and 2 months after the onset of PML, respectively. During mefloquine therapy, clinical and radiological progression was observed, and JC virus DNA in the cerebrospinal fluid was increased in both patients. Both patients died about 4 months and 2 months after initiation of mefloquine, respectively. Further studies are necessary to clarify the differences between mefloquine responders and non-responders in PML. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. A study of mefloquine treatment for progressive multifocal leukoencephalopathy: results and exploration of predictors of PML outcomes.

    Science.gov (United States)

    Clifford, David B; Nath, Avindra; Cinque, Paola; Brew, Bruce J; Zivadinov, Robert; Gorelik, Leonid; Zhao, Zhenming; Duda, Petra

    2013-08-01

    Immune reconstitution has improved outcomes for progressive multifocal leukoencephalopathy (PML), a potentially lethal brain disease caused by JC virus (JCV). However, an antiviral treatment to control JCV is needed when immune reconstitution is delayed or not possible. On the basis of in vitro efficacy, this study evaluated the effect of mefloquine on PML and factors that may predict PML outcomes. This 38-week, open-label, randomized, parallel-group, proof-of-concept study compared patients with PML who received standard of care (SOC) with those who received SOC plus mefloquine (250 mg for 3 days, then 250 mg weekly). Patients randomized to SOC could add mefloquine treatment at week 4. The primary endpoint was change from baseline to weeks 4 and 8 in JCV DNA copy number (load) in cerebrospinal fluid (CSF). Exploratory analyses evaluated factors that might correlate with clinical outcome. The majority of enrolled patients were HIV positive. Preplanned interim data analyses suggested that the study was unlikely to successfully demonstrate a significant difference between groups; therefore, the study was terminated prematurely. There was no significant difference between groups in CSF JCV DNA loads or clinical/MRI findings. Decrease in CSF JCV DNA load from baseline to week 4 was associated with a better clinical outcome at 16 weeks, as measured by Karnofsky scores. This study found no evidence of anti-JCV activity by mefloquine. An early decrease of CSF JCV DNA load appears to be associated with a better clinical outcome.

  4. Multifocal outbreaks of metallo-beta-lactamase-producing Pseudomonas aeruginosa resistant to broad-spectrum beta-lactams, including carbapenems.

    Science.gov (United States)

    Senda, K; Arakawa, Y; Nakashima, K; Ito, H; Ichiyama, S; Shimokata, K; Kato, N; Ohta, M

    1996-02-01

    A total of 3,700 Pseudomonas aeruginosa isolates were collected from 17 general hospitals in Japan from 1992 to 1994. Of these isolates, 132 carbapenem-resistant strains were subjected to DNA hybridization analysis with the metallo-beta-lactamase gene (blaIMP)-specific probe. Fifteen strains carrying the metallo-beta-lactamase gene were identified in five hospitals in different geographical areas. Three strains of P. aeruginosa demonstrated high-level imipenem resistance (MIC, > or = 128 micrograms/ml), two strains exhibited low-level imipenem resistance (MIC, carbapenems. In several strains, the metallo-beta-lactamase gene was carried by large plasmids, and carbapenem resistance was transferred from P. aeruginosa to Escherichia coli by electroporation in association with the acquisition of the large plasmid. Southern hybridization analysis and genomic DNA fingerprinting profiles revealed different genetic backgrounds for these 15 isolates, although considerable similarity was observed for the strains isolated from the same hospital. These findings suggest that the metallo-beta-lactamase-producing P. aeruginosa strains are not confined to a unique clonal lineage but proliferated multifocally by plasmid-mediated dissemination of the metallo-beta-lactamase gene in strains of different genetic backgrounds. Thus, further proliferation of metallo-beta-lactamase-producing strains with resistance to various beta-lactams may well be inevitable in the future, which emphasizes the need for early recognition of metallo-beta-lactamase-producing strains, rigorous infection control, and restricted clinical use of broad-spectrum beta-lactams including carbapenems.

  5. Multifocal electroretinogram and Optical Coherence tomography spectral-domain in arc welding macular injury: a case report.

    Science.gov (United States)

    Cellini, Mauro; Gattegna, Roberto; Toschi, Pier Giorgio; Strobbe, Ernesto; Campos, Emilio C

    2011-12-30

    the purpose of this study was to report a binocular photic retinal injury induced by plasma arc welding and the follow-up after treatment with vitamin supplements for a month. In our study, we used different diagnostic tools such as fluorescein angiography (FA), optical coherence tomography (OCT) and multifocal electroretinogram (mfERG). in the first visit after five days from arc welding injury in the left eye (LE) the visual acuity was 0.9 and 1.0 in the right eye (RE). FA was normal in both eyes. OCT in the left eye showed normal profile and normal reflectivity and one month later, a hyperreflectivity appeared in the external limiting membrane (ELM). The mfERG signal in the LE was 102.30 nV/deg2 five days after the injury and 112.62 nV/deg2 after one month and in the RE respectively 142.70 nV/deg2 and 159.46 nV/deg2. in cases of retinal photo injury it is important for the ophthalmologist to evaluate tests such as OCT and the mfERG in the diagnosis and follow-up of the patient because the recovery of visual acuity cannot exclude the persistence of phototoxic damage charged to the complex inner-outer segment of photoreceptors.

  6. Epiteliopatía pigmentaria placoide posterior multifocal aguda unilateral. A propósito de un caso

    Directory of Open Access Journals (Sweden)

    Ana Isabel Díaz Zapién

    2016-07-01

    Full Text Available Se presenta el caso de una mujer de 48 años de edad, que inicia su cuadro clínico con disminución súbita de agudeza visual acompañado de la presencia de un escotoma central en ojo derecho unilateral, sin otros síntomas acompañantes, antecedentes personales patológicos negados, 4 semanas después la paciente recupera visión llegando a un 20/20 sin la presencia del escotoma. La epiteliopatía pigmentaria placoide posterior multifocal aguda (EPPPMA es una patología inflamatoria coriorretiniana, que se presenta en adultos jóvenes, sanos, sin predominio por algún género, produciendo alteraciones visuales agudas, con hallazgos fundoscópicos característicos de lesiones placoides blanco-amarillentas a nivel del epitelio pigmentario de la retina. El diagnóstico se basa en los datos clínicos y la evolución complementado con la fluorangiografía, la mayoría de los casos con buen pronóstico visual, con una recuperación de la agudeza visual completa dentro de las primeras 3-6 semanas.

  7. Medium-term visual outcomes of apodized diffractive multifocal intraocular lens with +3.00 d addition power.

    Science.gov (United States)

    Guo, Xiaohong; Sun, Yi; Zhang, Bowen; Zheng, Danying

    2014-01-01

    Purpose. To evaluate 2-year visual acuities and questionnaire after bilateral implantation of SN6AD1 multifocal intraocular lens (MIOL) or SN60WF IOL. Methods. Patients randomly scheduled for bilateral implantation of SN6AD1 MIOL and SN60WF IOL with 2-year follow-up were enrolled. Uncorrected/corrected distance and near visual acuity, uncorrected intermediate visual acuity at 63 cm under high and low contrast, reading activity, the defocus curve, and a quality-of-life questionnaire were evaluated. Results. Each group comprised 20 patients. Uncorrected intermediate visual acuities and uncorrected near visual acuity were better in SN6AD1 group than in SN60WF group (P = 0.005, P = 0.011, and P visual acuities 1 year and 2 years postoperatively were reduced than postoperative 3-month outcomes, respectively. SN6AD1 group reported superior overall spectacle independence and inferior satisfaction. SN6AD1 group had a longer reading newspaper duration than SN60WF group (P = 0.036). When using mobile phone, SN6AD1 group had a more comfortable distance than SN60WF group (P visual acuities and questionnaire performance 2 years postoperatively. One-year and 2-year uncorrected near and intermediate visual acuities of SN6AD1 MIOL were lower than those 3 months postoperatively.

  8. All-Metal Dual-Polarized W-band Patch Element for Phased Array Antenna Applications

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of this work is to design and demonstrate an interlaced patch array aperture for transmission and reception of dual-polarized radar signals at 94 GHz...

  9. Dual of QCD with One Adjoint Fermion

    DEFF Research Database (Denmark)

    Mojaza, Matin; Nardecchia, Marco; Pica, Claudio

    2011-01-01

    We construct the magnetic dual of QCD with one adjoint Weyl fermion. The dual is a consistent solution of the 't Hooft anomaly matching conditions, allows for flavor decoupling and remarkably constitutes the first nonsupersymmetric dual valid for any number of colors. The dual allows to bound...

  10. Nuclearity for dual operator spaces

    Indian Academy of Sciences (India)

    In this short paper, we study the nuclearity for the dual operator space V ∗ of an operator space . We show that V ∗ is nuclear if and only if V ∗ ∗ ∗ is injective, where V ∗ ∗ ∗ is the third dual of . This is in striking contrast to the situation for general operator spaces. This result is used to prove that V ∗ ∗ is nuclear if and ...

  11. Symmetries of the dual metrics

    International Nuclear Information System (INIS)

    Baleanu, D.

    1998-01-01

    The geometric duality between the metric g μν and a Killing tensor K μν is studied. The conditions were found when the symmetries of the metric g μν and the dual metric K μν are the same. Dual spinning space was constructed without introduction of torsion. The general results are applied to the case of Kerr-Newmann metric

  12. Dual temperature concentration system

    International Nuclear Information System (INIS)

    Spevack, J.S.

    1975-01-01

    In a dual temperature isotope exchange system--exemplified by exchange of deuterium and protium between water and hydrogen sulfide gas in hot and cold towers, in which the feed stream (water) containing the desired isotope is passed through a pair of towers maintained at different temperatures wherein it effects isotope exchange with countercurrently circulated auxiliary fluid (H 2 S) and is impoverished in said isotope and then disposed of, e.g. discharged to waste,--the flow of isotope enriched auxiliary fluid between said towers (hot H 2 S saturated with water vapor) is divided and a part thereof is adjusted in its temperature (to cold tower conditions) and then passed to the auxiliary fluid impoverishing (cold) tower, while the remainder of the divided flow of such enriched auxiliary fluid is passed through a subsequent isotope concentration treatment to produce a product more highly enriched in the desired isotope and wherein it is also adjusted in its temperature and is impoverished in said isotope during said subsequent treatment before it is delivered to the said auxiliary fluid impoverishing (cold) tower. Certain provisions are made for returning to the hot tower liquid carried as vapor by the remainder of the divided flow to the subsequent isotope concentration treatment, for recovering sensible and latent heat, and for reducing passage of auxiliary fluid to waste

  13. Structural control of void formation in dual phase steels

    DEFF Research Database (Denmark)

    Azuma, Masafumi

    The objective of this study is to explore the void formation mechanisms and to clarify the influence of the hardness and structural parameters (volume fraction, size and morphology) of martensite particles on the void formation and mechanical properties in dual phase steels composed of ferrite...... and martensite. Two dual phase steels (Fe-0.099mass%C-1.63mass%Mn and Fe-0.148mass%-1.60mass%Mn) with martensite particles of different hardness values, volume fractions, sizes and shapes were produced by hot rolling and annealing. Mechanical properties were characterised by Vickers hardness and nanohardness...... particles but are not caused by the decohesion of martensite/ferrite interfaces. Three key factors that control the void formation behaviour in dual phase steels have been established: (i) a critical strain for void formation in the martensite, (ii) strain partitioning between the martensite and ferrite...

  14. Per Object statistical analysis

    DEFF Research Database (Denmark)

    2008-01-01

    This RS code is to do Object-by-Object analysis of each Object's sub-objects, e.g. statistical analysis of an object's individual image data pixels. Statistics, such as percentiles (so-called "quartiles") are derived by the process, but the return of that can only be a Scene Variable, not an Object...... an analysis of the values of the object's pixels in MS-Excel. The shell of the proceedure could also be used for purposes other than just the derivation of Object - Sub-object statistics, e.g. rule-based assigment processes....... Variable. This procedure was developed in order to be able to export objects as ESRI shape data with the 90-percentile of the Hue of each object's pixels as an item in the shape attribute table. This procedure uses a sub-level single pixel chessboard segmentation, loops for each of the objects...

  15. Application of OCT-angiography to characterise the evolution of chorioretinal lesions in acute posterior multifocal placoid pigment epitheliopathy.

    Science.gov (United States)

    Burke, T R; Chu, C J; Salvatore, S; Bailey, C; Dick, A D; Lee, R W J; Ross, A H; Carreño, E

    2017-10-01

    PurposeThe aim of this study was to determine a sequence of structural changes in acute posterior multifocal placoid pigment epitheliopathy (APMPPE) using optical coherence tomography-angiography (OCT-A) and comparing with other imaging modalities.Patients and methodsPatients with a new diagnosis of acute-onset APMPPE referred to a regional specialist centre from October 2015 to October 2016 were included. Multimodal imaging employed on all patients from diagnosis included the following: fundus fluorescein angiography, indocyanine green angiography, fundus autofluorescence, spectral domain-OCT (SD-OCT), and OCT-A. All non-invasive imaging processes were repeated during follow-up.ResultsTen eyes of five patients were included in the study, three males and two females, with a mean age of 26.2 years (range: 21-32) and a mean follow-up of 6.4 months (range: 2.6-13.3). All patients presented with bilateral disease and macular involving lesions. OCT-A imaging of the choriocapillaris was supportive of hypoperfusion at the site of APMPPE lesions during the acute phase of this condition with normalisation of choroidal vasculature during follow-up. Multimodal imaging consistently highlighted four sequential phases from presentation to resolution of active disease.ConclusionsMultimodal imaging in patients with APMPPE in acute and long-term follow-up demonstrates a reversible choroidal hypoperfusion supporting the primary inciting pathology as a choriocapillaritis. The evolution shows resolution of the ischaemia through a defined sequence that results in persistent changes at the level of the retinal pigment epithelium and outer retina. OCT-A was able to detect preclinical changes and chart resolution at the level of the choriocapillaris.

  16. Neurovirulence of H5N1 infection in ferrets is mediated by multifocal replication in distinct permissive neuronal cell regions.

    Directory of Open Access Journals (Sweden)

    Jennifer R Plourde

    Full Text Available Highly pathogenic avian influenza A (HPAI, subtype H5N1, remains an emergent threat to the human population. While respiratory disease is a hallmark of influenza infection, H5N1 has a high incidence of neurological sequelae in many animal species and sporadically in humans. We elucidate the temporal/spatial infection of H5N1 in the brain of ferrets following a low dose, intranasal infection of two HPAI strains of varying neurovirulence and lethality. A/Vietnam/1203/2004 (VN1203 induced mortality in 100% of infected ferrets while A/Hong Kong/483/1997 (HK483 induced lethality in only 20% of ferrets, with death occurring significantly later following infection. Neurological signs were prominent in VN1203 infection, but not HK483, with seizures observed three days post challenge and torticollis or paresis at later time points. VN1203 and HK483 replication kinetics were similar in primary differentiated ferret nasal turbinate cells, and similar viral titers were measured in the nasal turbinates of infected ferrets. Pulmonary viral titers were not different between strains and pathological findings in the lungs were similar in severity. VN1203 replicated to high titers in the olfactory bulb, cerebral cortex, and brain stem; whereas HK483 was not recovered in these tissues. VN1203 was identified adjacent to and within the olfactory nerve tract, and multifocal infection was observed throughout the frontal cortex and cerebrum. VN1203 was also detected throughout the cerebellum, specifically in Purkinje cells and regions that coordinate voluntary movements. These findings suggest the increased lethality of VN1203 in ferrets is due to increased replication in brain regions important in higher order function and explains the neurological signs observed during H5N1 neurovirulence.

  17. First results of radioiodine therapy of multifocal and disseminated functional thyroid autonomy using a TcTUs-adapted dose concept

    International Nuclear Information System (INIS)

    Oexle, C.; Reinhardt, M.; Moser, E.

    1998-01-01

    Aim: The presented study examines prospectively the efficiency of a dose concept for radioiodine therapy (RIT) adapted to the pretherapeutic 99m Tc-pertechnetate thyroid uptake under suppression (TcTU s ) in patients with multifocal (MFA) and disseminated (DISA) autonomy. This concept considers the total thyroid as target volume and uses target doses from 150 Gy to 300 Gy according to the TcTU s , which is as a measure for the 'autonomous volume' of the thyroid. Methods: The data of 75 patients (54 female, 21 male; age 71±9 years) with MFA or DISA were evaluated. RIT was performed on patients presenting with normal values for free triiodothyronine and thyroxine and endogenous suppression of the basal thyrotropin (TSH). The following target doses were used: For a TcTU s of 1,5-2,5% 150 Gy, for 2,51-3,5% 200 Gy, for 3,51-4,5% 250 Gy, and for >4,5% 300 Gy. The radiation dose to be administered was calculated using a modified Marinelli formula. The therapy was considered as successful when the basal TSH was above 0,5 mU/l and autonomous areas had disapeared in thyroid scintigraphy or the TcTU was below 1,5%, respectively. The average follow-up period was 8±4 months. Results: The success rates average to 92%. Only in one case a subsequent subclinical hypothyroidism and in a further case an immunogenic hyperthyroidism occured. Conclusion: The presented data indicate, that even patients with a marked autonomy (TcTU s >3,5%) can thus expected to be cured by of a onetime therapy with success rate of over 90% using the presented dose concept. The rate of early hypothyroidism can alltogether be estimated as very low. (orig.) [de

  18. Human polyomavirus JC reactivation and pathogenetic mechanisms of progressive multifocal leukoencephalopathy and cancer in the era of monoclonal antibody therapies.

    Science.gov (United States)

    Bellizzi, A; Nardis, C; Anzivino, E; Rodìo, D M; Fioriti, D; Mischitelli, M; Chiarini, F; Pietropaolo, V

    2012-02-01

    Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by the neurotropic human polyomavirus JC (JCV) lytic infection of oligodendrocytes. PML was first described as a complication of lymphoproliferative disorders more than 50 years ago and emerged as a major complication of human immunodeficiency virus (HIV) infection in the 1980s. Despite the ubiquity of this virus, PML is rare and always seen in association with underlying immunosuppressive condition, such as HIV infection, autoimmune diseases, cancer, and organ transplantation. JCV remains quiescent in the kidneys, where it displays a stable archetypal non-coding control region (NCCR). Conversely, rearranged JCV NCCR, including tandem repeat patterns found in the brain of PML patients, have been associated with neurovirulence. The specific site and mechanism of JCV NCCR transformation is unknown. According to one model, during the course of immunosuppression, JCV departs from its latent state and after entering the brain, productively infects and destroys oligodendrocytes. Although the majority of PML cases occur in severely immunesuppressed individuals, PML has been increasingly diagnosed in patients treated with biological therapies such as monoclonal antibodies (mAbs) that modulate immune system functions: in fact, CD4+ and CD8+ T lymphopenia, resulting from this immunomodulatory therapy, are the primary risk factor. Furthermore, JCV reactivation in nonpermissive cells after treatment with mAbs, such as intestinal epithelial cells in Crohn's disease patients, in association with other host tumor-inducing factors, could provide valid information on the role of JCV in several malignancies, such as colorectal cancer.

  19. Assessing understanding of individual risk and symptoms of progressive multifocal leukoencephalopathy in patients prescribed natalizumab for multiple sclerosis.

    Science.gov (United States)

    Rath, Louise; Vijiaratnam, Nirosen; Skibina, Olga

    2017-02-01

    Natalizumab, a monoclonal antibody directed against α4 integrin, is a highly efficacious treatment commonly used in relapsing remitting multiple sclerosis. Natalizumab is associated with the potentially fatal, rare, demyelinating, opportunistic brain infection, progressive multifocal leukoencephalopathy (PML). Prognosis and disability from PML are determined by early diagnosis. Written tools are mandated in Australia and other prescribing countries with the aim to help patients understand the risks associated with treatment and ensure familiarity with the early symptoms of PML. We aimed to assess if these tools achieve such an outcome. A cross-sectional survey was conducted using a convenience sample of multiple sclerosis patients prescribed natalizumab presenting to the infusion centre at a major tertiary hospital. Patients were offered a multi-choice questionnaire to assess their knowledge on the treatment risks and surveillance requirements of their therapy. Three specific questions were highlighted by the researchers as crucial to patient understanding of PML and defined as basic knowledge. A total of 48 patients in our hospital was prescribed natalizumab; 37 responded. A total of 16 (43.2%) patients answered all three basic knowledge questions correctly. There was no difference in the ability to answer these questions based on length of treatment or co-ownership knowledge between patients with base knowledge and without. Natalizumab is associated with an increased risk of PML. Early detection and treatment of PML results in improved patient outcomes. Patient knowledge and co-partnership in the utilisation of PML risk tools is relevant in ensuring early detection. Our findings question the ability of currently sanctioned tools to inform patients of basic knowledge of PML and their risk of developing PML. A future study with a repetitive education approach and repeating the questionnaire at multiple time points would be of interest. © 2016 Royal Australasian

  20. Synthetic antibodies and peptides recognizing progressive multifocal leukoencephalopathy-specific point mutations in polyomavirus JC capsid viral protein 1.

    Science.gov (United States)

    Chen, Gang; Gorelik, Leonid; Simon, Kenneth J; Pavlenco, Alevtina; Cheung, Anne; Brickelmaier, Margot; Chen, Ling Ling; Jin, Ping; Weinreb, Paul H; Sidhu, Sachdev S

    2015-01-01

    Polyomavirus JC (JCV) is the causative agent of progressive multifocal leukoencephalopathy (PML), a rare and frequently fatal brain disease that afflicts a small fraction of the immune-compromised population, including those affected by AIDS and transplantation recipients on immunosuppressive drug therapy. Currently there is no specific therapy for PML. The major capsid viral protein 1 (VP1) involved in binding to sialic acid cell receptors is believed to be a key player in pathogenesis. PML-specific mutations in JCV VP1 sequences present at the binding pocket of sialic acid cell receptors, such as L55F and S269F, abolish sialic acid recognition and might favor PML onset. Early diagnosis of these PML-specific mutations may help identify patients at high risk of PML, thus reducing the risks associated with immunosuppressive therapy. As a first step in the development of such early diagnostic tools, we report identification and characterization of affinity reagents that specifically recognize PML-specific mutations in VP1 variants using phage display technology. We first identified 2 peptides targeting wild type VP1 with moderate specificity. Fine-tuning via selection of biased libraries designed based on 2 parental peptides yielded peptides with different, yet still moderate, bindinspecificities. In contrast, we had great success in identifying synthetic antibodies that recognize one of the PML-specific mutations (L55F) with high specificity from the phage-displayed libraries. These peptides and synthetic antibodies represent potential candidates for developing tailored immune-based assays for PML risk stratification in addition to complementing affinity reagents currently available for the study of PML and JCV.

  1. Medium-Term Visual Outcomes of Apodized Diffractive Multifocal Intraocular Lens with +3.00 D Addition Power

    Directory of Open Access Journals (Sweden)

    Xiaohong Guo

    2014-01-01

    Full Text Available Purpose. To evaluate 2-year visual acuities and questionnaire after bilateral implantation of SN6AD1 multifocal intraocular lens (MIOL or SN60WF IOL. Methods. Patients randomly scheduled for bilateral implantation of SN6AD1 MIOL and SN60WF IOL with 2-year follow-up were enrolled. Uncorrected/corrected distance and near visual acuity, uncorrected intermediate visual acuity at 63 cm under high and low contrast, reading activity, the defocus curve, and a quality-of-life questionnaire were evaluated. Results. Each group comprised 20 patients. Uncorrected intermediate visual acuities and uncorrected near visual acuity were better in SN6AD1 group than in SN60WF group (P=0.005, P=0.011, and P<0.001. In SN6AD1 group, the uncorrected intermediate and near visual acuities 1 year and 2 years postoperatively were reduced than postoperative 3-month outcomes, respectively. SN6AD1 group reported superior overall spectacle independence and inferior satisfaction. SN6AD1 group had a longer reading newspaper duration than SN60WF group (P=0.036. When using mobile phone, SN6AD1 group had a more comfortable distance than SN60WF group (P<0.001 and higher speed of reading fixed text message (P<0.001. Conclusion. SN6AD1 MIOL provided a satisfactory full range of visual acuities and questionnaire performance 2 years postoperatively. One-year and 2-year uncorrected near and intermediate visual acuities of SN6AD1 MIOL were lower than those 3 months postoperatively.

  2. Multidisciplinary Rehabilitation is Efficacious and Induces Neural Plasticity in Multiple Sclerosis even when Complicated by Progressive Multifocal Leukoencephalopathy

    Directory of Open Access Journals (Sweden)

    Elisabetta Groppo

    2017-09-01

    Full Text Available A 48-year-old woman with multiple sclerosis (MS, treated with natalizumab for more than one year without clinical and magnetic resonance imaging (MRI signs of disease activity, was diagnosed with definite progressive multifocal leukoencephalopathy (PML. She presented with subacute motor deficit of the right upper limb (UL, followed by involvement of the homolateral leg and urinary urgency. The patient was treated with steroids and plasma exchange. On follow-up MRI scans, the PML lesion remained stable and no MS rebounds were observed, but the patient complained of a progressive worsening of the right UL motor impairment, becoming dependent in most activities of daily living. A cycle of multidisciplinary rehabilitation (MDR was then started, including daily sessions of UL robot therapy and occupational therapy. Functional MRI (fMRI was acquired before and at the end of the MDR cycle using a motor task which consisted of 2 runs: in one run the patient was asked to observe while the second one consisted of hand grasping movements. At the end of the rehabilitation period, both the velocity and the smoothness of arm trajectories during robot-based reaching movements were significantly improved. After MDR, compared with baseline, fMRI showed significantly increased functional activation within the sensory-motor network in the active, motor task, while no significant differences were found in the observational task. MDR in MS, including robot-assisted UL training, seems to be clinically efficacious and to have a significant impact on brain functional reorganization on a short-term, even in the presence of superimposed tissue damage provoked by PML.

  3. Multidisciplinary Rehabilitation is Efficacious and Induces Neural Plasticity in Multiple Sclerosis even when Complicated by Progressive Multifocal Leukoencephalopathy.

    Science.gov (United States)

    Groppo, Elisabetta; Baglio, Francesca; Cattaneo, Davide; Tavazzi, Eleonora; Bergsland, Niels; Di Tella, Sonia; Parelli, Riccardo; Carpinella, Ilaria; Grosso, Cristina; Capra, Ruggero; Rovaris, Marco

    2017-01-01

    A 48-year-old woman with multiple sclerosis (MS), treated with natalizumab for more than one year without clinical and magnetic resonance imaging (MRI) signs of disease activity, was diagnosed with definite progressive multifocal leukoencephalopathy (PML). She presented with subacute motor deficit of the right upper limb (UL), followed by involvement of the homolateral leg and urinary urgency. The patient was treated with steroids and plasma exchange. On follow-up MRI scans, the PML lesion remained stable and no MS rebounds were observed, but the patient complained of a progressive worsening of the right UL motor impairment, becoming dependent in most activities of daily living. A cycle of multidisciplinary rehabilitation (MDR) was then started, including daily sessions of UL robot therapy and occupational therapy. Functional MRI (fMRI) was acquired before and at the end of the MDR cycle using a motor task which consisted of 2 runs: in one run the patient was asked to observe while the second one consisted of hand grasping movements. At the end of the rehabilitation period, both the velocity and the smoothness of arm trajectories during robot-based reaching movements were significantly improved. After MDR, compared with baseline, fMRI showed significantly increased functional activation within the sensory-motor network in the active, motor task, while no significant differences were found in the observational task. MDR in MS, including robot-assisted UL training, seems to be clinically efficacious and to have a significant impact on brain functional reorganization on a short-term, even in the presence of superimposed tissue damage provoked by PML.

  4. Object models and object representation Tutorial 4

    CERN Document Server

    CERN. Geneva; Mahey, Mahendra

    2007-01-01

    This tutorial will provide a practical overview of current practices in modelling complex or compound digital objects. It will examine some of the key scenarios around creating complex objects and will explore a number of approaches to packaging and transport. Taking research papers, or scholarly works, as an example, the tutorial will explore the different ways in which these, and their descriptive metadata, can be treated as complex objects. Relevant application profiles and metadata formats will be introduced and compared, such as Dublin Core, in particular the DCMI Abstract Model, and MODS, alongside content packaging standards, such as METS MPEG 21 DIDL and IMS CP. Finally, we will consider some future issues and activities that are seeking to address these. The tutorial will be of interest to librarians and technical staff with an interest in metadata or complex objects, their creation, management and re-use.

  5. VISUAL ACUITY AND CLINICAL REFRACTION FOLLOWING IMPLANTATION OF VARIOUS MULTIFOCAL INTRAOCULAR LENSES

    Directory of Open Access Journals (Sweden)

    N. N. Temirov

    2015-01-01

    Full Text Available Aim. To analyze visual acuity, clinical refraction, and defocusing tolerance after the implantation of monofocal IOL with rotational asymmetric optic (Lentis Mplus 313 MF compared with Acrysof ReSTOR SN6AD1.Materials and methods. Phacoemulsification was performed in a total of 194 patients (288 eyes, i.e., 144 patients (188 eyes with cataract and 50 patients (100 eyes with presbyopia and high ametropia. The patients were divided into two groups. Study group included 132 patients (194 eyes implanted with Lentis Mplus while control group included 62 patients (94 eyes implanted with Acrysof ReSTOR. Uncorrected distance (5 m, intermediate (50‑70 cm, and near (20‑40 cm visual acuity under photopic (85 cd/m2 and mesopic (8 cd/m2 conditions were measured, objective and subjective refractometry were performed, and defocusing tolerance was evaluated.Results. Postoperatively, uncorrected distance and near visual acuity was high while intermediate visual acuity was moderately low. Lentis Mplus patients had better near and intermediate visual acuity under mesopic conditions as compared with Acrysof ReSTOR patients. Emmetropia (target refraction was achieved in 90.2% of study group patients and in 87.2% of control group patients. In patients implanted with Lentis Mplus, refraction was measured by subjective method. Optimal A-constant for Lentis Mplus and Acrysof ReSTOR was 118.0 and 118.6, respectively. Under defocusing, Lentis Mplus patients had better visual acuity than Acrysof ReSTOR patients. This indirectly confirms better intermediate vision.Conclusions. Lentis Mplus provides better vision at various distances that does not almost depend on light levels and induces minimal dysphotopsia. 

  6. Visual acuity and patient satisfaction at varied distances and lighting conditions after implantation of an aspheric diffractive multifocal one-piece intraocular lens.

    Science.gov (United States)

    Chang, Daniel H

    2016-01-01

    The aim of the study is to evaluate the visual acuity and patient satisfaction at varied distances under photopic and mesopic lighting conditions in patients bilaterally implanted with aspheric diffractive multifocal one-piece intraocular lenses. In this retrospective-prospective study, 16 patients with a mean age of 66.2±9.2 years (range: 50-81 years) who had undergone bilateral phacoemulsification surgery with implantation of a Tecnis multifocal one-piece intraocular lens (ZMB00) were evaluated. Monocular and binocular uncorrected and distance-corrected visual acuities were measured at distance (20 ft), intermediate (70-80 cm), and near (35-40 cm) under photopic (85 cd/m(2)) and mesopic (3 cd/m(2)) lighting conditions and were compared using the paired t-test. All patients also completed a subjective questionnaire. At a mean follow-up of 9.5±3.9 months, distance, near, and intermediate visual acuity improved significantly from preoperative acuity. Under photopic and mesopic conditions, 93.8% and 62.5% of patients, respectively, had binocular uncorrected intermediate visual acuity of 20/40 or better, and 62.5% and 31.3% of patients had binocular uncorrected near visual acuity of 20/20 or better. All patients were satisfied with their overall vision without using glasses and/or contact lenses when compared with before surgery. A total of 87.5% of patients reported no glare and 68.8% of patients reported no halos around lights at night. Tecnis multifocal one-piece intraocular lenses provide good distance, intermediate, and near visual acuity under photopic as well as mesopic lighting conditions. High levels of spectacle independence with low levels of photic phenomenon were achieved, resulting in excellent patient satisfaction.

  7. A case of osseous scintigraphy showing focuses of multifocal tuberculosis; Un cas de scintigraphie osseuse montrant des foyers de tuberculose multifocale

    Energy Technology Data Exchange (ETDEWEB)

    Faurous-Vanaud, R. [Services de Medecine Nucleaire, Clinique Clementville, Montpellier (France); Faurous, P. [CRLC, Montpellier (France); Kalfa, G.; Collet, H. [Services de Medecine Nucleaire, Clinique Clementville, Montpellier (France); Couty, H.; Artus, J.C. [CRLC, Montpellier (France)

    1997-12-31

    Incidence of tuberculosis in developed countries presents in the last years a spectacular boost. However, the osteo-articular system is afflicted by tuberculosis only in a few percent of cases and the multifocal character represents less than 5% of osseous tuberculosis. It is presented here a case of multifocal osseous tuberculosis only to stress its rarity. A woman 28 years old from Djibouti presents since 8 months an asthenia and dorsal pains long thought as psychalgia. The examination has shown a major vertebral stiffness and limitation of right haunch. The radiographs showed a scoliosis centered on D8 with modifications. The biologic data are VS = 90, CRP = 124 and the hemogram is normal. The intradermal reaction (10 U of tuberculin) is phlyctenular. The TDM indicates lytic vertebral extension on D7 - D8, the osseous scintigraphy with MDP - 99 mTc indicates no anomaly in the vascular arrival time; a few minutes after injection: dorsal and upper and of right femur hyperactivity; 2 h after injection: hyper-fixation of D7 to D9 and of the upper end of right femur. The IRM indicates para-vertebral abscess of D7 to D9 with epidural abscess; abscess in the upper part of the loge of right adductors with osseous affliction of the femur`s upper end; a bacillary infectious process was a priori evoked. The patient was then placed under quadruple antibiotic-therapy anti-tuberculous care. In case of anomalous multifocal osseous scintigraphy the tuberculous affliction is part of the differential diagnosis, particularly in the immigrant populations or in HIV+ persons

  8. Specification of Concurrent Objects

    DEFF Research Database (Denmark)

    Sørensen, Morten U.

    relation over two objects and an event. In the model, objects can be composed by parallel composition, encapsulation, and hiding of operations. Refinement between objects is defined as fair trace inclusion.A specification language is presented where objects can be specified operationally by abstract...

  9. Paradigms in object recognition

    International Nuclear Information System (INIS)

    Mutihac, R.; Mutihac, R.C.

    1999-09-01

    A broad range of approaches has been proposed and applied for the complex and rather difficult task of object recognition that involves the determination of object characteristics and object classification into one of many a priori object types. Our paper revises briefly the three main different paradigms in pattern recognition, namely Bayesian statistics, neural networks, and expert systems. (author)

  10. BL Lacertae objects

    International Nuclear Information System (INIS)

    Disney, M.J.; Veron, P.

    1977-01-01

    The properties of BL Lacertae objects are discussed including their spectra, variability, and brightness. The historical development of observation, and the conclusion that these objects are possibly quasar-related objects rather than variable stars as originally supposed are treated. The possible mechanisms for the unusual luminosity of these objects are considered

  11. Hamilton principle for the dual electrodynamics; Principio de Hamilton para a eletrodinamica dual

    Energy Technology Data Exchange (ETDEWEB)

    Souza Silva, Saulo Carneiro de

    1995-12-31

    The present work discusses the classical electromagnetic theory in the presence of magnetic monopoles. We review the connection between such objects and the long standing problem of charge quantization and the main theoretical difficulties in formulating the classical dual electromagnetic theory in terms of an action principle. We show that a deeper understanding of the source of such difficulties leads naturally to the construction of a variational principle for a non-local Lagrangian from which all the (local) dynamical equations for electric, magnetic charges and fields can be obtained. (author) 53 refs.

  12. Physician dual practice: A review of literature

    DEFF Research Database (Denmark)

    Socha, Karolina; Bech, Mickael

    2010-01-01

    of dual practice effects for the public health care. Methods A systematic literature review identified 23 positions on the subject consisting of journal articles, academic working papers, book chapter, and publications of the WHO. Results The subject is short on evidence. Theoretical analyses indicate...... of the public one mainly to increase income, it remains uncertain whether dual practice is an income-maximising combination of jobs. Moreover, costs of enforcing restrictions on dual practice are rarely considered. Conclusions Further research is needed that compares dual practitioners and other physicians...... in uniform settings, investigates how the dual practitioners divide labour between the two jobs, and analyses the costs of enforcing restrictions on dual practice....

  13. Health care utilization among Medicare-Medicaid dual eligibles: a count data analysis

    Directory of Open Access Journals (Sweden)

    Shin Jaeun

    2006-04-01

    Full Text Available Abstract Background Medicare-Medicaid dual eligibles are the beneficiaries of both Medicare and Medicaid. Dual eligibles satisfy the eligibility conditions for Medicare benefit. Dual eligibles also qualify for Medicaid because they are aged, blind, or disabled and meet the income and asset requirements for receiving Supplement Security Income (SSI assistance. The objective of this study is to explore the relationship between dual eligibility and health care utilization among Medicare beneficiaries. Methods The household component of the nationally representative Medical Expenditure Panel Survey (MEPS 1996–2000 is used for the analysis. Total 8,262 Medicare beneficiaries are selected from the MEPS data. The Medicare beneficiary sample includes individuals who are covered by Medicare and do not have private health insurance during a given year. Zero-inflated negative binomial (ZINB regression model is used to analyse the count data regarding health care utilization: office-based physician visits, hospital inpatient nights, agency-sponsored home health provider days, and total dental visits. Results Dual eligibility is positively correlated with the likelihood of using hospital inpatient care and agency-sponsored home health services and the frequency of agency-sponsored home health days. Frequency of dental visits is inversely associated with dual eligibility. With respect to racial differences, dually eligible Afro-Americans use more office-based physician and dental services than white duals. Asian duals use more home health services than white duals at the 5% statistical significance level. The dual eligibility programs seem particularly beneficial to Afro-American duals. Conclusion Dual eligibility has varied impact on health care utilization across service types. More utilization of home healthcare among dual eligibles appears to be the result of delayed realization of their unmet healthcare needs under the traditional Medicare-only program

  14. Designing the Object Game

    DEFF Research Database (Denmark)

    Filip, Diane; Lindegaard, Hanne

    2016-01-01

    The Object Game is an exploratory design game and an experiment of developing a tangible object that can spark dialogue and retrospection between collaborative partners and act as a boundary object. The objective of this article is to show and elaborate on the development of the Object Game......, and to provide case examples of the game in action. The Object Game has two parts – Story-building and Co-rating of objects – with the aim of stimulating a collaborative reflection on knowledge sharing with different objects. In Story-building, the participants visualize their knowledge sharing process...... these facilitated knowledge transfer, knowledge exchange, knowledge generation, and knowledge integration. The participants collaborative reflected on their use of different objects for knowledge sharing and learn which objects have been effective (and which have not been effective) in their collaborative...

  15. Methodology for attainment of density and effective atomic number through dual energy technique using microtomographic images

    International Nuclear Information System (INIS)

    Alves, H.; Lima, I.; Lopes, R.T.

    2014-01-01

    Dual energy technique for computerized microtomography shows itself as a promising method for identification of mineralogy on geological samples of heterogeneous composition. It can also assist with differentiating very similar objects regarding the attenuation coefficient, which are usually not separable during image processing and analysis of microtomographic data. Therefore, the development of a feasible and applicable methodology of dual energy in the analysis of microtomographic images was sought. - Highlights: • Dual energy technique is promising for identification of distribution of minerals. • A feasible methodology of dual energy in analysis of tomographic images was sought. • The dual energy technique is efficient for density and atomic number identification. • Simulation showed that the proposed methodology agrees with theoretical data. • Nondestructive characterization of distribution of density and chemical composition

  16. Bone age assessment by dual-energy X-ray absorptiometry in children: An alternative for X-ray?

    NARCIS (Netherlands)

    D.H.M. Heppe (Denise); H.R. Taal (Rob); G.D.S. Ernst (Gesina); E.L.T. van den Akker (Erica); M.H. Lequin (Maarten); A.C.S. Hokken-Koelega (Anita); J.J.M. Geelhoed (Miranda); V.W.V. Jaddoe (Vincent)

    2012-01-01

    textabstractObjective: The aim of the study was to validate dual-energy X-ray absorptiometry (DXA) as a method to assess bone age in children. Methods: Paired dual-energy X-ray absorptiometry (DXA) scans and X-rays of the left hand were performed in 95 children who attended the paediatric

  17. Dual recycling for GEO 600

    International Nuclear Information System (INIS)

    Grote, H; Freise, A; Malec, M; Heinzel, G; Willke, B; Lueck, H; Strain, K A; Hough, J; Danzmann, K

    2004-01-01

    Dual recycling is the combination of signal recycling and power recycling; both optical techniques improve the shot-noise-limited sensitivity of interferometric gravitational-wave detectors. In addition, signal recycling can reduce the loss of light power due to imperfect interference and allows us, in principle, to beat the standard quantum limit. The interferometric gravitational-wave detector GEO 600 is the first of the kilometre-scale detectors to use signal recycling. We have recently equipped the detector with a signal-recycling mirror with a transmittance of 1%. In this paper, we present details of the detector commissioning and the first locks of the dual-recycled interferometer

  18. Pairs of dual periodic frames

    DEFF Research Database (Denmark)

    Christensen, Ole; Goh, Say Song

    2012-01-01

    The time–frequency analysis of a signal is often performed via a series expansion arising from well-localized building blocks. Typically, the building blocks are based on frames having either Gabor or wavelet structure. In order to calculate the coefficients in the series expansion, a dual frame...... is needed. The purpose of the present paper is to provide constructions of dual pairs of frames in the setting of the Hilbert space of periodic functions L2(0,2π). The frames constructed are given explicitly as trigonometric polynomials, which allows for an efficient calculation of the coefficients...

  19. UWB dual burst transmit driver

    Science.gov (United States)

    Dallum, Gregory E [Livermore, CA; Pratt, Garth C [Discovery Bay, CA; Haugen, Peter C [Livermore, CA; Zumstein, James M [Livermore, CA; Vigars, Mark L [Livermore, CA; Romero, Carlos E [Livermore, CA

    2012-04-17

    A dual burst transmitter for ultra-wideband (UWB) communication systems generates a pair of precisely spaced RF bursts from a single trigger event. An input trigger pulse produces two oscillator trigger pulses, an initial pulse and a delayed pulse, in a dual trigger generator. The two oscillator trigger pulses drive a gated RF burst (power output) oscillator. A bias driver circuit gates the RF output oscillator on and off and sets the RF burst packet width. The bias driver also level shifts the drive signal to the level that is required for the RF output device.

  20. Dual recycling for GEO 600

    CERN Document Server

    Heinzel, G; Grote, H; Strain, K; Danzmann, K

    2002-01-01

    Dual recycling is the combination of power recycling and signal recycling. GEO 600, a German-British interferometric gravitational wave detector being built in Germany, has no arm cavities and needs to use dual recycling from the beginning, while the other interferometric detectors may use it at a later stage to enhance their sensitivity. The control scheme to be used in GEO 600 has been demonstrated at the Garching 30 m prototype. This paper summarizes those results and the adaptions necessary in order to apply the scheme for GEO 600.

  1. CARDIOVASCULAR ENDOCRINOLOGY Dual RAAS blockade has dual effects on outcome

    NARCIS (Netherlands)

    Heerspink, Hiddo J. Lambers; de Zeeuw, Dick

    Makani and colleagues report that dual blockade of the renin-angiotensin-aldosterone system is associated with harm despite previous studies showing that this approach decreases blood pressure and albuminuria. Do these results imply that we should abandon surrogate markers? Or should we become more

  2. Dual Diagnosis: Substance Abuse and Mental Illness

    Science.gov (United States)

    ... an effective dual diagnosis treatment plan. In particular, cognitive behavioral therapy ( CBT ) helps people with dual diagnosis learn how ... groups for people recovering from alcohol or drug addiction. Be sure to find a group that understands ...

  3. A dual method for maximum entropy restoration

    Science.gov (United States)

    Smith, C. B.

    1979-01-01

    A simple iterative dual algorithm for maximum entropy image restoration is presented. The dual algorithm involves fewer parameters than conventional minimization in the image space. Minicomputer test results for Fourier synthesis with inadequate phantom data are given.

  4. Dual-Doppler Feasibility Study

    Science.gov (United States)

    Huddleston, Lisa L.

    2012-01-01

    When two or more Doppler weather radar systems are monitoring the same region, the Doppler velocities can be combined to form a three-dimensional (3-D) wind vector field thus providing for a more intuitive analysis of the wind field. A real-time display of the 3-D winds can assist forecasters in predicting the onset of convection and severe weather. The data can also be used to initialize local numerical weather prediction models. Two operational Doppler Radar systems are in the vicinity of Kennedy Space Center (KSC) and Cape Canaveral Air Force Station (CCAFS); these systems are operated by the 45th Space Wing (45 SW) and the National Weather Service Melbourne, Fla. (NWS MLB). Dual-Doppler applications were considered by the 45 SW in choosing the site for the new radar. Accordingly, the 45th Weather Squadron (45 WS), NWS MLB and the National Aeronautics and Space Administration tasked the Applied Meteorology Unit (AMU) to investigate the feasibility of establishing dual-Doppler capability using the two existing systems. This study investigated technical, hardware, and software requirements necessary to enable the establishment of a dual-Doppler capability. Review of the available literature pertaining to the dual-Doppler technique and consultation with experts revealed that the physical locations and resulting beam crossing angles of the 45 SW and NWS MLB radars make them ideally suited for a dual-Doppler capability. The dual-Doppler equations were derived to facilitate complete understanding of dual-Doppler synthesis; to determine the technical information requirements; and to determine the components of wind velocity from the equation of continuity and radial velocity data collected by the two Doppler radars. Analysis confirmed the suitability of the existing systems to provide the desired capability. In addition, it is possible that both 45 SW radar data and Terminal Doppler Weather Radar data from Orlando International Airport could be used to alleviate any

  5. Dual-source dual-energy CT for the differentiation of urinary stone composition: preliminary study

    International Nuclear Information System (INIS)

    Yang Qifang; Zhang Wanshi; Meng Limin; Shi Huiping; Wang Dong; Bi Yongmin; Li Xiangsheng; Fang Hong; Guo Heqing; Yan Jingmin

    2011-01-01

    Objective: To evaluate dual-source dual-energy CT (DSCT) for the differentiation of' urinary stone composition in vitro. Methods: Ninety-seven urinary stones were obtained by endoscopic lithotripsy and scanned using dual-source dual-energy CT. The stones were divided into six groups according to infrared spectroscopy stone analysis: uric acid (UA) stones (n=10), cystine stones (n=5), struvite stones (n=6), calcium oxalate (CaOx) stones (n=22), mixed UA stones (n=7) and mixed calcium stones (n=47). Hounsfield units (HU) of each stone were recorded for the 80 kV and the 140 kV datasets by hand-drawing method. HU difference, HU ratio and dual energy index (DEI) were calculated and compared among the stone groups with one-way ANOVA. Using dual energy software to determine the composition of all stones, results were compared to infrared spectroscopy analysis. Results: There were statistical differences in HU difference [(-17±13), (229±34), (309±45), (512±97), (201±64) and (530±71) HU respectively], in HU ratio (0.96±0.03, 1.34±0.04, 1.41±0.03, 1.47±0.03, 1.30±0.07, and 1.49±0.03 respectively), and DEI (-0.006±0.004, 0.064±0.007, 0.080± 0.007, 0.108±0.011, 0.055±0.014 and 0.112±0.008 respectively) among different stone groups (F= 124.894, 407.028, 322.864 respectively, P<0.01). There were statistical differences in HU difference, HU ratio and DEI between UA stones and the other groups (P<0.01). There were statistical differences in HU difference, HU ratio and DEI between CaOx or mixed calcium stones and the other four groups (P< 0.01). There was statistical difference in HU ratio between cystine and struvite stones (P<0.01). There were statistical differences in HU difference, HU ratio and DEI between struvite and mixed UA stones (P< 0.05). Dual energy software correctly characterized 10 UA stones, 4 cystine stones, 22 CaOx stones and 6 mixed UA stones. Two struvite stones were considered to contain cystine. One cystine stone, 1 mixed UA stone, 4

  6. Muscles Activity in the elderly with Balance Impairments in walking under Dual tasks

    Directory of Open Access Journals (Sweden)

    Elaheh Azadian

    2016-09-01

    Full Text Available Objectives: Each step during gait requires different attention demands that will affect muscles activity. The study of changes in the timing and intensity of the muscles activity in walking with dual task has received less attention from researchers. The purpose of this study was to evaluate changes in electromyography patterns of gait with cognitive dual tasks in balance impaired elderly. Methods: Thirty older adults were recruited for this study. People were selected through berg balance test. Subjects walked 12-meters in two conditions, normal walking and walking with a cognitive dual task. Spatial-temporal kinematic parameters were recorded through the motion analysis and muscles activities were recorded through electromyography system. The data obtained was analyzed using repeated measures ANOVA at a significant level of p< 0.05.  Results: The results showed that walking under dual tasks would decrease gait speed and increase stride time and stance time. Also muscle activity in Tibialis anterior and Vastus lateralis in stance-phase would decrease significantly in dual tasks as compared with single task (p< 0.05, but timing of muscle activity would not change in dual task conditions.  Conclusions: Based on the results, it can be argued that walking under a dual task can change spatial-temporal parameters and muscle activity in gait pattern in the elderly with balance impairment. One explanation could be that the decreased control of the central nervous system on muscle activity in stance phase due to the performing of a dual task.

  7. Dual roles of endogenous and exogenous galectin-1 in the control of testicular immunopathology.

    Science.gov (United States)

    Pérez, Cecilia V; Gómez, Leticia G; Gualdoni, Gisela S; Lustig, Livia; Rabinovich, Gabriel A; Guazzone, Vanesa A

    2015-07-30

    Galectin-1 (Gal-1), a proto-type member of galectin family, is highly expressed in immune privileged sites, including the testis. However, in spite of considerable progress the relevance of endogenous and exogenous Gal-1 in testis pathophysiology have not yet been explored. Here we evaluated the in vivo roles of Gal-1 in experimental autoimmune orchitis (EAO), a well-established model of autoimmune testicular inflammation associated with subfertility and infertility. A significant reduction in the incidence and severity of EAO was observed in mice genetically deficient in Gal-1 (Lgals1(-/-)) versus wild-type (WT) mice. Testicular histopathology revealed the presence of multifocal testicular damage in WT mice characterized by an interstitial mononuclear cell infiltrate and different degrees of germ cell sloughing of seminiferous tubules. TUNEL assay and assessment of active caspase-3 expression, revealed the prevalence of apoptotic spermatocytes mainly localized in the adluminal compartment of seminiferous tubules in EAO mice. A significant increased number of TUNEL-positive germ cells was detected in EAO testis from WT compared with Lgals1(-/-) mice. In contrast, exogenous administration of recombinant Gal-1 to WT mice undergoing EAO attenuated the severity of the disease. Our results unveil a dual role of endogenous versus exogenous Gal-1 in the control of autoimmune testis inflammation.

  8. Grasping trapezoidal objects.

    Science.gov (United States)

    Kleinholdermann, Urs; Brenner, Eli; Franz, Volker H; Smeets, Jeroen B J

    2007-07-01

    When grasping rectangular or circular objects with a precision grip the digits close in on the object in opposite directions. In doing so the digits move perpendicular to the local surface orientation as they approach opposite sides of the object. This perpendicular approach is advantageous for accurately placing the digits. Trapezoidal objects have non-parallel surfaces so that moving the digits in opposite directions would make the digits approach the contact surfaces at an angle that is not 90 degrees . In this study we examined whether this happens, or whether subjects tend to approach trapezoidal objects' surfaces perpendicularly. We used objects of different sizes and with different surface slants. Subjects tended to approach the object's surfaces orthogonally, suggesting that they aim for an optimal precision of digit placement rather than simply closing their hand as it reaches the object.

  9. Choosing for learning objects

    NARCIS (Netherlands)

    Schoonenboom, Judith; Emans, Bruno; Meijer, Joost

    2006-01-01

    Choosing for learning objects discusses eight educational ambitions and the possible roles of learning objects in realising these ambitions. The eight educational ambitions are: (1) Creating independent learning pathways, for example for lifelong learners; (2) Making education more flexible; (3)

  10. Dual Headquarters Involvement in Multibusiness Firms

    DEFF Research Database (Denmark)

    Nell, Phillip Christopher; Kappen, Philip; Dellestrand, Henrik

    development projects of subsidiaries. Analyses of 85 innovation development projects reveal that dual innovation importance (innovation that is important for the division and the rest of the firm), and dual dual embeddedness (innovating subsidiary is embedded both within the division and in the rest...... of the firm) lead to greater dual headquarters involvement, especially when the innovation development network is large. The results contribute to the literature on complex parenting and theory of selective headquarters involvement....

  11. Grasping trapezoidal objects

    OpenAIRE

    Kleinholdermann, Urs; Brenner, Eli; Franz, Volker H.; Smeets, Jeroen B. J.

    2007-01-01

    When grasping rectangular or circular objects with a precision grip the digits close in on the object in opposite directions. In doing so the digits move perpendicular to the local surface orientation as they approach opposite sides of the object. This perpendicular approach is advantageous for accurately placing the digits. Trapezoidal objects have non-parallel surfaces so that moving the digits in opposite directions would make the digits approach the contact surfaces at an angle that is no...

  12. [Historiography of medical objects].

    Science.gov (United States)

    Cid, Felip

    2008-01-01

    It has become acceptable among historians of medicine to profess a predilection for the historiography of medical ideas. But it is justified all the same to ask whether the logical connection really caused the origin, the change, or the disappearance of the medical objects. The interaction of ideas and medical objects assure as much objectivity as possible. In consequence, the contents of the museums, medical objects, is an aspect rather that a branch of the history of medicine.

  13. On the Crime Object

    Science.gov (United States)

    Akutaev, Rasul M.; Magomedov, Guseyn B.

    2016-01-01

    The relevance of the research of this problem is caused by the theoretical and practical needs of a specific concept of the crime object as one of the corpus delicti signs essentially the determining and defining its object and objective side, thereby--the nature of socially dangerous act. Besides, being a facultative sign of corpus delicti, the…

  14. Grasping trapezoidal objects

    NARCIS (Netherlands)

    U. Kleinholdermann (Urs); E. Brenner (Eli); V.H. Franz (Volker); J.B.J. Smeets (Jeroen)

    2007-01-01

    textabstractWhen grasping rectangular or circular objects with a precision grip the digits close in on the object in opposite directions. In doing so the digits move perpendicular to the local surface orientation as they approach opposite sides of the object. This perpendicular approach is

  15. Grasping trapezoidal objects

    NARCIS (Netherlands)

    Kleinholdermann, U; Brenner, E.; Franz, V.H.; Smeets, J.B.J.

    2007-01-01

    When grasping rectangular or circular objects with a precision grip the digits close in on the object in opposite directions. In doing so the digits move perpendicular to the local surface orientation as they approach opposite sides of the object. This perpendicular approach is advantageous for

  16. The Language of Objection

    Science.gov (United States)

    Duffy, Francis M.

    2010-01-01

    Whenever the author talks to audiences about transforming school systems, without exception people raise objections. The half dozen most common objections often come in the form of "Yes, nice idea but..." What follows the "but" is the objection. The author learned a technique for responding to these "buts" from family members who work in sales.…

  17. Survivability via Control Objectives

    Energy Technology Data Exchange (ETDEWEB)

    CAMPBELL,PHILIP L.

    2000-08-11

    Control objectives open an additional front in the survivability battle. A given set of control objectives is valuable if it represents good practices, it is complete (it covers all the necessary areas), and it is auditable. CobiT and BS 7799 are two examples of control objective sets.

  18. Shared Recoverable Objects

    OpenAIRE

    Kienzle, Jörg; Strohmeier, Alfred; Harbour, Michael Gonzalez; de la Puente, Juan A.

    1999-01-01

    This document describes an implementation of recoverable objects that can be accessed concurrently. After a brief description of the possible uses of recoverable objects and after reviewing some of the new features of Ada 95 used in the implementation, the design issues are discussed and the interface of the recoverable object class is presented. An example application using multitasking demonstrates its applicability.

  19. Objects in Motion

    Science.gov (United States)

    Damonte, Kathleen

    2004-01-01

    One thing scientists study is how objects move. A famous scientist named Sir Isaac Newton (1642-1727) spent a lot of time observing objects in motion and came up with three laws that describe how things move. This explanation only deals with the first of his three laws of motion. Newton's First Law of Motion says that moving objects will continue…

  20. Solitary Extramedullary Plasmacytoma of the Maxillary Sinus, Progressing to Smoldering Multiple Myeloma with Multifocal Skeletal Involvement, which Resolved Completely Following Chemotherapy Alone.

    Science.gov (United States)

    Jeyaraj, Priya; Venkatesan, Manu; Nijhawan, V S

    2016-07-01

    Plasmacytoma is an uncommon malignant tumor originating either from plasma cells located in the bone marrow also known as the solitary bone plasmacytoma, or from plasma cells located outside the bone, for e.g. in mucosal surfaces, referred to as the extramedullary plasmacytoma also called the solitary extramedullary plasmacytoma. Both, solitary as well as extramedullary bone plasmacytomas may, particularly in later stages, be accompanied by other osteolytic bone lesions (multifocal bone involvement) and features such as anemia, hypercalcemia, or renal impairment attributable to and indicative of progression to multiple myeloma. These three distinct disorders together comprise the plasma cell neoplasms and essentially represent a continuum of related disease processes. Extramedullary and solitary bone plasmacytomas of the head and neck region are extremely uncommon, and amongst them plasmacytoma of the maxilla is extremely rare. Such a case is being reported here for its rarity. Also, it was associated with multifocal skeletal involvement, making a correct categorization difficult as well as imperative in order to institute the correct treatment. Radiotherapy is considered to be the treatment of choice of plasmacytoma, with adjuvant chemotherapy for multi focal involvement. Surgery is usually limited to biopsy and excision of any residual disease following radiotherapy. The case presented responded extremely well to chemotherapy alone, with a complete resolution of the maxillary tumor, obviating the need for radiotherapy.

  1. Anti-N-methyl-D-aspartate receptor encephalitis concomitant with multifocal subcortical white matter lesions on magnetic resonance imaging: a case report and review of the literature.

    Science.gov (United States)

    Wang, Rui-Jin; Chen, Bu-Dong; Qi, Dong

    2015-07-08

    Anti-N-methyl-D-aspartate receptor encephalitis is a severe autoimmune disorder characterized by severe psychiatric symptoms, seizures, decreased consciousness, autonomic dysregulation, and dyskinesias. Multifocal subcortical white matter lesions on fluid-attenuated inversion recovery and diffuse weighted images have rarely been reported in previous literature, and serial magnetic resonance imaging changes after plasma exchange have not been presented before. A previously healthy 24-year-old Chinese woman presented with acute psychiatric symptoms characterized by fear and agitation followed by decreased consciousness, dyskinesias, and seizures. Magnetic resonance imaging revealed hyperintense lesions on fluid-attenuated inversion recovery and diffuse weighted images in bilateral subcortical white matter. Cerebrospinal fluid analysis revealed a mild pleocytosis with lymphocytic predominance. Protein and glucose levels were normal. Aquaporin-4 antibodies in serum and cerebrospinal fluid were negative. Identification of anti-N-methyl-D-aspartate receptor antibodies in serum and cerebrospinal fluid confirmed the diagnosis of anti-N-methyl-D-aspartate receptor encephalitis. She was initially treated with combined intravenous immunoglobulin and methylprednisolone without improvement. Plasma exchange was then initiated with good response; the patient made a full recovery after several cycles of plasma exchange. Repeat magnetic resonance imaging performed 1 month after plasma exchange showed partial resolution of the hyperintense lesions in bilateral subcortical white matter, and follow-up magnetic resonance imaging 2 months after plasma exchange showed complete resolution. Anti-N-methyl-D-aspartate receptor encephalitis may be concomitant with multifocal subcortical white matter lesions. Such lesions may resolve after appropriate immunotherapy.

  2. [A multifocal form of cutaneous leishmaniasis caused by Leishmania infantum in an immunocompetent child treated with a short course of liposomal amphotericin B].

    Science.gov (United States)

    Taquin, H; Chiaverini, C; Marty, P; Lacour, J-P

    2016-10-01

    Cutaneous leishmaniasis (CL) is a parasitic infestation caused by various species of Leishmania protozoa transmitted by the bite of phlebotomine sand flies. Herein we report a case of multifocal CL due to Leishmania infantum in an immunocompetent child treated with liposomal amphotericin B. A 10-month-old baby was referred for multiple ulcerated nodules of the face and upper limbs present for 5 months and following travel to North Morocco. Histological and parasitological examinations resulted in a diagnosis of CL due to L. infantum. The child was treated with intravenous liposomal amphotericin B in accordance with the schedule for visceral leishmaniasis (10mg/kg over 2 days), and rapid improvement of the lesions was seen within 10 days. Clinical polymorphism of CL exists according to the infecting species. The multifocal presentation in our patient is very unusual for CL due to L. infantum in an immunocompetent child. To our knowledge, there have been no previous reports of successful use of parenteral liposomal amphotericin B for CL caused by L. infantum as described in our case. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Exploring the Link between Radiation Exposure and Multifocal Basal Cell Carcinomas in a Former Chernobyl Clean-up Worker by Combining Different Molecular Biological Techniques.

    Science.gov (United States)

    Becker, Benjamin V; Richter, Claus; Ullmann, Reinhard; Beinke, Christina; Majewski, Matthäus; Exner, Viktoria; Weisel, Guido; Abend, Michael; Port, Matthias

    2017-11-01

    Thirty years after the Chernobyl nuclear power plant accident we report on a patient who was a clean-up worker, who subsequently developed multiple cutaneous basal cell carcinomas (BCCs). We used several methods to assess the biological long-term effects related to low-dose external and internal radiation exposure. Specifically, because BCC risk may be increased with ionizing radiation exposure, we endeavored to determine whether the multifocal BCCs were related to the patient's past clean-up work. We assessed cytogenetic changes using peripheral blood, and internal incorporation was measured with a whole-body counter. Gene expression alterations were determined and array-based comparative genomic hybridization was performed for copy number aberration analysis of available BCC samples. In 1,053 metaphase cells, the dicentric yield of 0.005 dicentrics, with acentrics/cell, was significantly increased compared to the established calibration curve (P 0-0.055 Gy). Relevant DNA copy number changes were only detected within the most aggressive BCC focus. Our results suggest that the examined worker had low and more recent radiation exposure with presumably internalized radionuclides that were below the detection level of a whole-body counter. The multifocal BCC could not be related to past occupational radiation exposure. The findings from our study suggest that integrating different methodologies potentially provides an improved overall assessment of individual health risks associated with or excluding occupational radiation exposure.

  4. Improved visualization of breast cancer features in multifocal carcinoma using phase-contrast and dark-field mammography: an ex vivo study

    Energy Technology Data Exchange (ETDEWEB)

    Grandl, Susanne; Sztrokay-Gaul, Aniko; Auweter, Sigrid D.; Hellerhoff, Karin [Ludwig-Maximilians-University Hospital Munich, Institute of Clinical Radiology, Munich (Germany); Scherer, Kai; Birnbacher, Lorenz; Willer, Konstantin; Chabior, Michael; Herzen, Julia; Pfeiffer, Franz [Technische Universitaet Muenchen, Department of Physics and Institute of Medical Engineering, Garching (Germany); Mayr, Doris [Ludwig-Maximilians-Universitaet Muenchen, Institute of Pathology, Munich (Germany); Bamberg, Fabian [University Hospital Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2015-12-15

    Conventional X-ray attenuation-based contrast is inherently low for the soft-tissue components of the female breast. To overcome this limitation, we investigate the diagnostic merits arising from dark-field mammography by means of certain tumour structures enclosed within freshly dissected mastectomy samples. We performed grating-based absorption, absolute phase and dark-field mammography of three freshly dissected mastectomy samples containing bi- and multifocal carcinoma using a compact, laboratory Talbot-Lau interferometer. Preoperative in vivo imaging (digital mammography, ultrasound, MRI), postoperative histopathological analysis and ex vivo digital mammograms of all samples were acquired for the diagnostic verification of our results. In the diagnosis of multifocal tumour growth, dark-field mammography seems superior to standard breast imaging modalities, providing a better resolution of small, calcified tumour nodules, demarcation of tumour boundaries with desmoplastic stromal response and spiculated soft-tissue strands extending from an invasive ductal breast cancer. On the basis of selected cases, we demonstrate that dark-field mammography is capable of outperforming conventional mammographic imaging of tumour features in both calcified and non-calcified tumours. Presuming dose optimization, our results encourage further studies on larger patient cohorts to identify those patients that will benefit the most from this promising additional imaging modality. (orig.)

  5. The Use of Dual Forms in the “Collection of Lives of Greek Saints” by Saint Nilus of Sora

    Directory of Open Access Journals (Sweden)

    Polina Yuryevna Karavaeva

    2015-09-01

    Full Text Available In this article we reveal the key principles of dual contexts in Hagiography 'Life of Saint Simeon Stylites of the Admirable Mountain' and 'Life of Saint Onoufrios of the Desert', which are included into the "Collection of Lives of Greek Saints". We proceed from the discrepancy between the history of dual number in colloquial language and book-Slavic language. And we consider the form of dual number as a sign of book-Slavic grammatical norm in the period of the end of 15th - beginning of the 16th centuries. St. Nilus of Sora uses dual number not only with certain stylistic purposes, but also as a clear indication that a text is a monument, that implements strict grammatical norms of Church Slavonic Russian. We provide the most detailed description of the features of the use of free dual forms and also the description of the features of the use of associated dual number. According to the classification, which was proposed by A. Belich, free dual number refers to symmetrical objects, usually of the free dual number are the most stable and consistent in its use. So, one of the features of the representations of St. Nilus of Sora and his disciples about the grammatical norm of using dual number forms is used as a grammatical synonymic forms of the plural and dual number of verb forms in the combination of a noun with a numeral "two".

  6. Dual Enrollment in Spanish: One Working Model

    Science.gov (United States)

    Bloom, Melanie; Chambers, Laura

    2009-01-01

    Dual enrollment is now a nation-wide phenomenon as all 50 states currently offer some form of dual-enrollment program to secondary-school students (Karp, Bailey, Hughes, and Fermin 2005). However, dual enrollment itself is often difficult to define as programs vary from school to school (Jordan, Cavalluzzo, and Corallo 2006). Therefore, language…

  7. 7 CFR 247.19 - Dual participation.

    Science.gov (United States)

    2010-01-01

    ... CHILD NUTRITION PROGRAMS COMMODITY SUPPLEMENTAL FOOD PROGRAM § 247.19 Dual participation. (a) What must State and local agencies do to prevent and detect dual participation? The State agency must work with... 7 Agriculture 4 2010-01-01 2010-01-01 false Dual participation. 247.19 Section 247.19 Agriculture...

  8. Sparsity and spectral properties of dual frames

    DEFF Research Database (Denmark)

    Krahmer, Felix; Kutyniok, Gitta; Lemvig, Jakob

    2013-01-01

    We study sparsity and spectral properties of dual frames of a given finite frame. We show that any finite frame has a dual with no more than $n^2$ non-vanishing entries, where $n$ denotes the ambient dimension, and that for most frames no sparser dual is possible. Moreover, we derive an expressio...

  9. Dual Enrollment for High School Students

    Science.gov (United States)

    Edwards, Linsey; Hughes, Katherine

    2011-01-01

    Dual enrollment programs allow high school students to enroll in college courses and potentially earn college credit. The term concurrent enrollment is sometimes used interchangeably with dual enrollment, and sometimes to refer to a particular model of dual enrollment. In some programs, students earn high school and college credit simultaneously;…

  10. Study of dual redundant Ethernet communication system centered on W5200 IC

    Directory of Open Access Journals (Sweden)

    ZHANG Gaoming

    2018-02-01

    Full Text Available [Objectives] At present, the power management systems of ships require highly reliable Ethernet, and Ethernet communication cannot be interrupted when the system encounters a fault. [Methods] This paper introduces the working principle of the dual-redundant Ethernet system, and the processor ARM and the Ethernet control chip W5200 are used for the dual redundant Ethernet communication system. [Results] When the network fails or the line is damaged, the dual redundant Ethernet communication system can automatically reconnect so as to ensure that the communication system is healthy, safe and continuous. [Conclusions] The redundant communication system is verified by ship prototype with high application and promotion value.

  11. Dual temperature isotope exchange system

    International Nuclear Information System (INIS)

    Spevack, J.S.

    1976-01-01

    Improvements in the method for isotope concentration by dual temperature exchange between feed and auxiliary fluids in a multistage system are described. In a preferred embodiment the first is a vaporizable liquid and the auxiliary fluid a gas, comprising steps for improving the heating and/or cooling and/or humidifying and/or dehumidifying operations

  12. Dual Processing and Diagnostic Errors

    Science.gov (United States)

    Norman, Geoff

    2009-01-01

    In this paper, I review evidence from two theories in psychology relevant to diagnosis and diagnostic errors. "Dual Process" theories of thinking, frequently mentioned with respect to diagnostic error, propose that categorization decisions can be made with either a fast, unconscious, contextual process called System 1 or a slow, analytical,…

  13. Dual fields and E11

    International Nuclear Information System (INIS)

    Riccioni, Fabio; West, Peter

    2007-01-01

    We show that the adjoint representation of E 11 contains generators corresponding to the infinite possible dual descriptions of the bosonic on-shell degrees of freedom of eleven-dimensional supergravity. We also give an interpretation for the fields corresponding to many of the other generators in the adjoint representation

  14. Electronic cigarette use: comparing smokers, vapers, and dual users on characteristics and motivational factors

    OpenAIRE

    Claire Schoren; Karin Hummel; Hein de Vries

    2017-01-01

    Introduction This study examined vaping behaviour, precursors of vaping, and motivational differences between smokers, dual users and vapers. The objectives were to assess a) vaping characteristics and reasons for use, b) differences in motivational factors and behavioural precursors associated with e-cigarette use, and c) socio-demographic and motivational factors associated with electronic cigarette use. Methods A cross-sectional survey among 259 vapers, 135 smokers, and 83 dual u...

  15. Assessment of dual tasking has no clinical value for fall prediction in Parkinson’s disease

    NARCIS (Netherlands)

    Katrijn Smulders; Bastiaan Bloem; Roy Kessels; Alexander Geurts; Aner Weiss; Rianne Esselink

    2012-01-01

    The objective of this study is to investigate the value of dual-task performance for the prediction of falls inpatients with Parkinson’s disease (PD). Two hundred sixty three patients with PD (H&Y 1–3, 65.2 ± 7.9 years)walked two times along a 10-m trajectory, both under single-task and dual-task

  16. Object Categorization: Reversals and Explanations of the Basic-Level Advantage

    Science.gov (United States)

    Rogers, Timothy T.; Patterson, Karalyn

    2007-01-01

    People are generally faster and more accurate to name or categorize objects at the basic level (e.g., dog) relative to more general (animal) or specific (collie) levels, an effect replicated in Experiment 1 for categorization of object pictures. To some, this pattern suggests a dual-process mechanism, in which objects first activate basic-level…

  17. Objects, materiality and meaning

    DEFF Research Database (Denmark)

    Lenau, Torben Anker; Lindegaard, Hanne

    2008-01-01

    The present research work investigates the relation between physical objects, their materiality, understood as the physical substances they are made from, and the communication from the objects. In product design of physical objects the communicative aspects are just as important as the function...... of the object, and the designers aim is therefore to tune both in order to achieve a desired goal. To do so the designer basically has 2 options: Alteration of the physical shape of the object and the selection of materials. Through the manipulation of shape and materials can symbolic and sensory information...... be written into the object. The materials are therefore carriers of communication, even though this is dependent of the cultural context and the environment which the object will be part of. However the designer has only minor influence on those....

  18. Birth of the Object: Detection of Objectness and Extraction of Object Shape through Object Action Complexes

    DEFF Research Database (Denmark)

    Kraft, Dirk; Pugeault, Nicolas; Baseski, Emre

    2008-01-01

    by the robot. This also leads to the concept of an "object" as a set of features that change predictably over different frames. The system is equipped with a certain degree of generic prior knowledge about the world in terms of a sophisticated visual feature extraction process in an early cognitive vision......We describe a process in which the segmentation of objects as well as the extraction of the object shape becomes realized through active exploration of a robot vision system. In the exploration process, two behavioral modules that link robot actions to the visual and haptic perception of objects...... interact. First, by making use of an object independent grasping mechanism, physical control over potential objects can be gained. Having evaluated the initial grasping mechanism as being successful, a second behavior extracts the object shape by making use of prediction based on the motion induced...

  19. Progressive Multifocal Leukoencephalopathy

    Science.gov (United States)

    ... most prominent symptoms are clumsiness; progressive weakness; and visual, speech, and sometimes personality changes. The progression of deficits leads to life-threatening disability and (frequently) death. A diagnosis of PML can ...

  20. Early object relations into new objects.

    Science.gov (United States)

    Downey, T W

    2001-01-01

    Two strands of change are suggested by this review, one maturational, the other therapeutic or developmental (Hartmann and Kris, 1945). By "maturational" I mean to suggest energies that infuse the individual from earliest life in a manner that includes object relations, but for the healthy exercise of which object relations per se need not be of central and crucial importance. Within wide limits such energies may be delayed until growth conditions prevail without significant distortion of certain of the organism's ego functions. Therapeutic change is analogous to developmental change in that both involve the crucial presence of another to release energies. In therapeutic change these are energies that have been repressed beyond the reach of developmental dynamics. In everyday development crisis and synthesis alternate in conjunction with new and emerging objects to add to the psychological structures brought to the fore by maturation. In many instances, as we see with John, over time and in a less focussed manner, developmental changes can approximate therapeutic change and visa versa. Freud-Dann in their "experiment" pursued one line, in which the equipmental delay brought on by extremely adverse living circumstances was redressed by providing an interpersonally enriching, loving, developmentally facilitating milieu. The sketches of individual children and John's subsequent story provide a perspective into what becomes the stuff of growth and what remains the stuff of neurosis. The developmental reserves and ego resilience of these children were impressive but probably not extraordinary. Usual growth ensued as soon as they were provided with the rich soil of Bulldogs Bank instead of the desert sand of the Tereszin concentration camp. However, no one can escape such adverse circumstances without having taken in the stuff of neurosis. Affects and percepts that were not assimilatable or even available to consciousness at the time remain buried in the unconscious

  1. Interactive multiple object tracking (iMOT.

    Directory of Open Access Journals (Sweden)

    Ian M Thornton

    Full Text Available We introduce a new task for exploring the relationship between action and attention. In this interactive multiple object tracking (iMOT task, implemented as an iPad app, participants were presented with a display of multiple, visually identical disks which moved independently. The task was to prevent any collisions during a fixed duration. Participants could perturb object trajectories via the touchscreen. In Experiment 1, we used a staircase procedure to measure the ability to control moving objects. Object speed was set to 1°/s. On average participants could control 8.4 items without collision. Individual control strategies were quite variable, but did not predict overall performance. In Experiment 2, we compared iMOT with standard MOT performance using identical displays. Object speed was set to 2°/s. Participants could reliably control more objects (M = 6.6 than they could track (M = 4.0, but performance in the two tasks was positively correlated. In Experiment 3, we used a dual-task design. Compared to single-task baseline, iMOT performance decreased and MOT performance increased when the two tasks had to be completed together. Overall, these findings suggest: 1 There is a clear limit to the number of items that can be simultaneously controlled, for a given speed and display density; 2 participants can control more items than they can track; 3 task-relevant action appears not to disrupt MOT performance in the current experimental context.

  2. Reasoning about Function Objects

    Science.gov (United States)

    Nordio, Martin; Calcagno, Cristiano; Meyer, Bertrand; Müller, Peter; Tschannen, Julian

    Modern object-oriented languages support higher-order implementations through function objects such as delegates in C#, agents in Eiffel, or closures in Scala. Function objects bring a new level of abstraction to the object-oriented programming model, and require a comparable extension to specification and verification techniques. We introduce a verification methodology that extends function objects with auxiliary side-effect free (pure) methods to model logical artifacts: preconditions, postconditions and modifies clauses. These pure methods can be used to specify client code abstractly, that is, independently from specific instantiations of the function objects. To demonstrate the feasibility of our approach, we have implemented an automatic prover, which verifies several non-trivial examples.

  3. Robot Grasps Rotating Object

    Science.gov (United States)

    Wilcox, Brian H.; Tso, Kam S.; Litwin, Todd E.; Hayati, Samad A.; Bon, Bruce B.

    1991-01-01

    Experimental robotic system semiautomatically grasps rotating object, stops rotation, and pulls object to rest in fixture. Based on combination of advanced techniques for sensing and control, constructed to test concepts for robotic recapture of spinning artificial satellites. Potential terrestrial applications for technology developed with help of system includes tracking and grasping of industrial parts on conveyor belts, tracking of vehicles and animals, and soft grasping of moving objects in general.

  4. Cultivating objects in interaction

    DEFF Research Database (Denmark)

    Hazel, Spencer

    2014-01-01

    This paper demonstrates how an initial indexing of objects through gesture and talk provides a residual basis for later indexical development across a stretch of discourse. I show how participants are able to perform an initial mobilization of affordances (Hutchby, 2001) of objects in the immediate...... the interactional resources which mundane everyday objects provide interactants in the multimodal design of their turns-at-talk. Although the objects which feature in the data – for example notepads, tables, computer monitors – have practical functions within the social ecology of these institutional settings...

  5. Objective-C

    CERN Document Server

    DeVoe, Jiva

    2011-01-01

    A soup-to-nuts guide on the Objective-C programming language. Objective-C is the language behind Cocoa and Cocoa Touch, which is the Framework of applications written for the Macintosh, iPod touch, iPhone, and iPad platforms. Part of the Developer Reference series covering the hottest Apple topics, this book covers everything from the basics of the C language to advanced aspects of Apple development. You'll examine Objective-C and high-level subjects of frameworks, threading, networking, and much more.: Covers the basics of the C language and then quickly moves onto Objective-C and more advanc

  6. Wavelet frames and their duals

    DEFF Research Database (Denmark)

    Lemvig, Jakob

    2008-01-01

    This thesis is concerned with computational and theoretical aspects of wavelet frame analysis in higher dimensions and, in particular, with the study of so-called dual frames of wavelet frames. A frame is a system of "simple" functions or building blocks which deliver ways of analyzing signals....... The signals are then represented by linear combinations of the building blocks with coefficients found by an associated frame, called a dual frame. A wavelet frame is a frame where the building blocks are stretched (dilated) and translated versions of a single function; such a frame is said to have wavelet...... structure. The dilation of the wavelet building blocks in higher dimension is done via a square matrix which is usually taken to be integer valued. In this thesis we step away from the "usual" integer, expansive dilation and consider more general, expansive dilations. In most applications of wavelet frames...

  7. Vacuum transitions in dual models

    International Nuclear Information System (INIS)

    Pashnev, A.I.; Volkov, D.V.; Zheltukhin, A.A.

    1976-01-01

    The investigation is continued of the spontaneous vacuum transition problem in the Neview-Schwartz dual model (NSDM). It is shown that vacuum transitions allow disclosing of supplementary degeneration in the resonance state spectrum. The dual amplitudes possess an internal structure corresponding to the presence of an infinite number of quarks with increasing masses and retained charges. The Adler principle holds. Analytic continuation on the constant of induced vacuum transitions makes it possible to establish the existence of spontaneous vacuum transitions in the NSDM. The consequence of this fact is the exact SU(2) symmetry of π, rho meson trajectories and the Higgs mechanism in the model. In this case the ratios of masses of particles leading trajectories are analogous to those obtained in the current algebra. It is shown that in the NSDM there arises chiral SU(2) x SU(2) x U(1) x U(1) x ... symmetry resulting from spontaneous vacuum transitions

  8. Cultivating objects in interaction

    DEFF Research Database (Denmark)

    Hazel, Spencer

    2014-01-01

    is chapter explores patterns of repeated orientations to physical objects in interactants’ visuo-spatial and haptic surround. A number of examples are presented from advice-giving activities in various institutional settings, where participants-in-interaction initially draw on material objects...

  9. Investigating Music Information Objects

    Science.gov (United States)

    Weissenberger, Lynnsey K.

    2016-01-01

    This dissertation, titled "Investigating Music Information Objects," is a study of the nature, description, representations, and ideas related to music information objects (MIOs). This research study investigates how music practitioners from various traditions describe and conceptualize MIOs, using a theoretical framework to classify…

  10. Programs as Data Objects

    DEFF Research Database (Denmark)

    This book constitutes the refereed proceedings of the Second Symposium on Programs as Data Objects, PADO 2001, held in Aarhus, Denmark, in May 2001. The 14 revised full papers presented were carefully reviewed and selected from 30 submissions. Various aspects of looking at programs as data objects...

  11. Composing Concurrent Objects

    NARCIS (Netherlands)

    Bergmans, Lodewijk

    1994-01-01

    Adopting the object-oriented paradigm for the development of large and complex software systems offers several advantages, of which increased extensibility and reusability are the most prominent ones. The object-oriented model is also quite suitable for modelling concurrent systems. However, it

  12. Near Earth Objects

    DEFF Research Database (Denmark)

    Wolff, Stefan

    2006-01-01

    , Near Earth Objects: Asteroids and comets following paths that bring them near the Earth. NEOs have collided with the Earth since its formation, some causing local devastation, some causing global climate changes, yet the threat from a collision with a near Earth object has only recently been recognised...

  13. On Objects and Events

    DEFF Research Database (Denmark)

    Eugster, Patrick Thomas; Guerraoui, Rachid; Damm, Christian Heide

    2001-01-01

    This paper presents linguistic primitives for publish/subscribe programming using events and objects. We integrate our primitives into a strongly typed object-oriented language through four mechanisms: (1) serialization, (2) multiple sub typing, (3) closures, and (4) deferred code evaluation. We...

  14. Dual energy CTA of the supraaortic arteries: Technical improvements with a novel dual source CT system

    International Nuclear Information System (INIS)

    Lell, Michael M.; Hinkmann, Fabian; Nkenke, Emeka; Schmidt, Bernhard; Seidensticker, Peter; Kalender, Willi A.; Uder, Michael; Achenbach, Stephan

    2010-01-01

    Objectives: Computed tomography angiography (CTA) is a well-accepted imaging modality to evaluate the supraaortic vessels. Initial reports have suggested that dual energy CTA (DE-CTA) can enhance diagnosis by creating bone-free data sets, which can be visualized in 3D, but a number of limitations of this technique have also been addressed. We sought to describe the performance of DE-CTA of the supraaortic vessels with a novel dual source CT system with special emphasis on image quality and post-processing related artifacts. Materials and methods: Thirty-three patients underwent carotid CT angiography on a second generation dual source CT system. Simultaneous acquisitions of 100 and 140 kV data sets in arterial phase were performed. Two examiners evaluated overall bone suppression with a 3-point scale (1 = poor; 3 = excellent) and image quality regarding integrity of the vessel lumen of different vessel segments (n = 26) with a 5-point scale (1 = poor; 5 = excellent), CTA source data served as the reference. Results: Excellent bone suppression could be achieved in the head and neck. Only minor bone remnants occurred, mean score for bone removal was 2.9. Mean score for vessel integrity was 4.3. Eight hundred fifty-seven vessel segments could be evaluated. Six hundred thirty-five segments (74%) showed no lumen alteration, 65 segments (7.6%) lumen alterations 10% resulting in a total luminal reduction 50%, and 113 segments (13.2%) showed a gap in the vessel course (100% total lumen reduction). Artificial gaps of the vessel lumen occurred in 28 vessel segments due to artifacts caused by dental hardware and in all but one (65) ophthalmic arteries. Conclusions: Excellent bone suppression could be achieved, DE imaging with 100 and 140 kV lead to improved image quality and vessel integrity in the shoulder region than previously reported. The ophthalmic artery still cannot be adequately visualized.

  15. Dual arm master controller concept

    International Nuclear Information System (INIS)

    Kuban, D.P.; Perkins, G.S.

    1984-01-01

    The Advanced Servomanipulator (ASM) slave was designed with an anthropomorphic stance, gear/torque tube power drives, and modular construction. These features resulted in increased inertia, friction, and backlash relative to tape-driven manipulators. Studies were performed which addressed the human factors design and performance trade-offs associated with the corresponding master controller best suited for the ASM. The results of these studies, as well as the conceptual design of the dual arm master controller, are presented. 6 references, 3 figures

  16. Beginning Objective-C

    CERN Document Server

    Dovey, James

    2012-01-01

    Objective-C is today's fastest growing programming language, at least in part due to the popularity of Apple's Mac, iPhone and iPad. Beginning Objective-C is for you if you have some programming experience, but you're new to the Objective-C programming language and you want a modern-and fast-way forwards to your own coding projects. Beginning Objective-C offers you a modern programmer's perspective on Objective-C courtesy of two of the best iOS and Mac developers in the field today, and gets you programming to the best of your ability in this important language.  It gets you rolling fast into

  17. Tobacco and psychiatric dual disorders.

    Science.gov (United States)

    Graham, Noni A; Frost-Pineda, Kimberly; Gold, Mark S

    2007-01-01

    Smoking is a leading cause of morbidity and premature mortality in the United States. The relationship between tobacco smoking and several forms of cancer, heart disease, stroke, chronic lung disease, and other medical diseases is well recognized and accepted. Recent epidemiological studies are now focusing on the link between tobacco use and psychiatric diseases. Experts now suggest that in the differential diagnosis of "smoker," depression, alcohol dependence, and schizophrenia are highest on the list. Studies are also focusing on the role of secondhand tobacco exposure, either in utero or during childhood, in the risk of dual disorders. Prenatal exposure may alter gene expression and change the risk for a variety of life-long psychiatric diseases, e.g., ADD/ADHD, antisocial personality disorders, substance use disorders, and major depression. Considerable time and effort have been devoted to studying the link between smoking and depression and also schizophrenia. We will focus on less well-studied areas in tobacco use and psychiatric dual disorders (including eating disorders), prenatal and early childhood secondhand smoke (SHS) exposure, and the relationship to the genesis of these dual disorders.

  18. Dual targeting of peroxisomal proteins

    Directory of Open Access Journals (Sweden)

    Julia eAst

    2013-10-01

    Full Text Available Cellular compartmentalization into organelles serves to separate biological processes within the environment of a single cell. While some metabolic reactions are specific to a single organelle, others occur in more than one cellular compartment. Specific targeting of proteins to compartments inside of eukaryotic cells is mediated by defined sequence motifs. To achieve multiple targeting to different compartments cells use a variety of strategies. Here, we focus on mechanisms leading to dual targeting of peroxisomal proteins. In many instances, isoforms of peroxisomal proteins with distinct intracellular localization are encoded by separate genes. But also single genes can give rise to differentially localized proteins. Different isoforms can be generated by use of alternative transcriptional start sites, by differential splicing or ribosomal read-through of stop codons. In all these cases different peptide variants are produced, of which only one carries a peroxisomal targeting signal. Alternatively, peroxisomal proteins contain additional signals that compete for intracellular targeting. Dual localization of proteins residing in both the cytoplasm and in peroxisomes may also result from use of inefficient targeting signals. The recent observation that some bona fide cytoplasmic enzymes were also found in peroxisomes indicates that dual targeting of proteins to both the cytoplasm and the peroxisome might be more widespread. Although current knowledge of proteins exhibiting only partial peroxisomal targeting is far from being complete, we speculate that the metabolic capacity of peroxisomes might be larger than previously assumed.

  19. Dual use of electronic and tobacco cigarettes among adolescents: a cross-sectional study in Poland.

    Science.gov (United States)

    Goniewicz, Maciej L; Leigh, Noel J; Gawron, Michal; Nadolska, Justyna; Balwicki, Lukasz; McGuire, Connor; Sobczak, Andrzej

    2016-03-01

    Electronic cigarettes (e-cigarettes) are gaining in popularity among youth. While these products may be beneficial in adult smokers, the effect on young users of electronic and tobacco cigarettes (dual users) is unknown. The objective of this study was to assess the frequency of dual use among adolescents and to compare tobacco cigarette consumption among dual and exclusive tobacco cigarette users. A cross-sectional survey of a sample of 2213 Polish students aged 16-18 conducted between December 2013 and February 2014. Overall, 21.8 % of students were dual users. Dual users were more likely to smoke tobacco cigarettes on a daily basis [adjusted odds ratio, AOR 3.54 (95 % CI 2.34-5.36) and less likely to smoke fewer cigarettes per day (AOR 0.27 (95 % CI 0.12-0.57)] than exclusive tobacco cigarette users. The frequency of dual use was higher than exclusive use of a single product among Polish adolescents. Young dual users do not smoke a lower number of tobacco cigarettes per day than exclusive tobacco cigarette users.

  20. Dual filtered backprojection for micro-rotation confocal microscopy

    International Nuclear Information System (INIS)

    Laksameethanasan, Danai; Brandt, Sami S; Renaud, Olivier; Shorte, Spencer L

    2009-01-01

    Micro-rotation confocal microscopy is a novel optical imaging technique which employs dielectric fields to trap and rotate individual cells to facilitate 3D fluorescence imaging using a confocal microscope. In contrast to computed tomography (CT) where an image can be modelled as parallel projection of an object, the ideal confocal image is recorded as a central slice of the object corresponding to the focal plane. In CT, the projection images and the 3D object are related by the Fourier slice theorem which states that the Fourier transform of a CT image is equal to the central slice of the Fourier transform of the 3D object. In the micro-rotation application, we have a dual form of this setting, i.e. the Fourier transform of the confocal image equals the parallel projection of the Fourier transform of the 3D object. Based on the observed duality, we present here the dual of the classical filtered back projection (FBP) algorithm and apply it in micro-rotation confocal imaging. Our experiments on real data demonstrate that the proposed method is a fast and reliable algorithm for the micro-rotation application, as FBP is for CT application