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Sample records for extraocular muscle enlargement

  1. Extraocular muscle function testing

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    ... page: //medlineplus.gov/ency/article/003397.htm Extraocular muscle function testing To use the sharing features on this page, please enable JavaScript. Extraocular muscle function testing examines the function of the eye ...

  2. Congenital Fibrosis of the Extraocular Muscles

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    Leyla Niyaz

    2014-08-01

    Full Text Available Congenital fibrosis of the extraocular muscles (CFEOM is a rare disorder characterized by hereditary non-progressive restrictive strabismus and blepharoptosis. Although most of the cases are bilateral and isolated, some patients may have systemic findings. CFEOM is divided into three groups as CFEOM 1, 2, and 3 according to the phenotype. Primary responsible genes are KIF21A for CFEOM type 1 and 3 and PHOX2A/ARIX gene for CFEOM type 2. Studies suggest that abnormal innervation of the extraocular muscles is the cause of muscle fibrosis. Early treatment is important because of the risk of amblyopia. Surgery is the primary treatment option for strabismus and blepharoptosis. (Turk J Ophthalmol 2014; 44: 312-5

  3. Creep Behavior of Passive Bovine Extraocular Muscle

    OpenAIRE

    Lawrence Yoo; Hansang Kim; Andrew Shin; Vijay Gupta; Demer, Joseph L.

    2011-01-01

    This paper characterized bovine extraocular muscles (EOMs) using creep, which represents long-term stretching induced by a constant force. After preliminary optimization of testing conditions, 20 fresh EOM samples were subjected to four different loading rates of 1.67, 3.33, 8.33, and 16.67%/s, after which creep was observed for 1,500 s. A published quasilinear viscoelastic (QLV) relaxation function was transformed to a creep function that was compared with data. Repeatable creep was observed...

  4. Microanatomy of adult zebrafish extraocular muscles.

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    Daniel S Kasprick

    Full Text Available Binocular vision requires intricate control of eye movement to align overlapping visual fields for fusion in the visual cortex, and each eye is controlled by 6 extraocular muscles (EOMs. Disorders of EOMs are an important cause of symptomatic vision loss. Importantly, EOMs represent specialized skeletal muscles with distinct gene expression profile and susceptibility to neuromuscular disorders. We aim to investigate and describe the anatomy of adult zebrafish extraocular muscles (EOMs to enable comparison with human EOM anatomy and facilitate the use of zebrafish as a model for EOM research. Using differential interference contrast (DIC, epifluorescence microscopy, and precise sectioning techniques, we evaluate the anatomy of zebrafish EOM origin, muscle course, and insertion on the eye. Immunofluorescence is used to identify components of tendons, basement membrane and neuromuscular junctions (NMJs, and to analyze myofiber characteristics. We find that adult zebrafish EOM insertions on the globe parallel the organization of human EOMs, including the close proximity of specific EOM insertions to one another. However, analysis of EOM origins reveals important differences between human and zebrafish, such as the common rostral origin of both oblique muscles and the caudal origin of the lateral rectus muscles. Thrombospondin 4 marks the EOM tendons in regions that are highly innervated, and laminin marks the basement membrane, enabling evaluation of myofiber size and distribution. The NMJs appear to include both en plaque and en grappe synapses, while NMJ density is much higher in EOMs than in somatic muscles. In conclusion, zebrafish and human EOM anatomy are generally homologous, supporting the use of zebrafish for studying EOM biology. However, anatomic differences exist, revealing divergent evolutionary pressures.

  5. Extraocular muscle dynamics in diplopia from enophthalmos.

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    Yoon, Michael K; Economides, John R; Horton, Jonathan C

    2011-12-01

    The mechanism of diplopia from enophthalmos is not well understood. We describe a 55-year-old man who underwent a left transorbital craniotomy for clipping of a basilar aneurysm. The lateral orbital wall was not reconstructed properly, resulting in 8 mm of left enophthalmos. Months after surgery the patient developed diplopia with ocular excursions, although he remained orthotropic in primary gaze. The left eye was limited in elevation, adduction, and abduction. These findings were confirmed by eye movement recordings, which showed ocular separation increasing with gaze eccentricity. A CT scan demonstrated a defect in the sphenoid and frontal bones, profound enophthalmos, and shortening of the rectus muscles. Slack in the extraocular muscles reduced the force generated by each muscle, causing diplopia with ocular rotation. This case underscores the value of careful orbital wall reconstruction after orbitotomy and suggests a mechanism for diplopia produced by postoperative enophthalmos.

  6. Extraocular muscle afferent signals modulate visual attention.

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    Balslev, Daniela; Newman, William; Knox, Paul C

    2012-10-09

    Extraocular muscle afferent signals contribute to oculomotor control and visual localization. Prompted by the close links between the oculomotor and attention systems, it was investigated whether these proprioceptive signals also modulated the allocation of attention in space. A suction sclera contact lens was used to impose an eye rotation on the nonviewing, dominant eye. With their viewing, nondominant eye, participants (n = 4) fixated centrally and detected targets presented at 5° in the left or right visual hemifield. The position of the viewing eye was monitored throughout the experiment. As a control, visual localization was tested using finger pointing without visual feedback of the hand, whereas the nonviewing eye remained deviated. The sustained passive rotation of the occluded, dominant eye, while the other eye maintained central fixation, resulted in a lateralized change in the detectability of visual targets. In all participants, the advantage in speed and accuracy for detecting right versus left hemifield targets that occurred during a sustained rightward eye rotation of the dominant eye was reduced or reversed by a leftward eye rotation. The control experiment confirmed that the eye deviation procedure caused pointing errors consistent with an approximately 2° shift in perceived eye position, in the direction of rotation of the nonviewing eye. With the caveat of the small number of participants, these results suggest that extraocular muscle afferent signals modulate the deployment of attention in visual space.

  7. Determinants of Extraocular Muscle Volume in Patients with Graves' Disease

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    Samer El-Kaissi

    2012-01-01

    Full Text Available Background. To examine factors contributing to extraocular muscle (EOM volume enlargement in patients with Graves’ hyperthyroidism. Methods. EOM volumes were measured with orbital magnetic resonance imaging (MRI in 39 patients with recently diagnosed Graves’ disease, and compared to EOM volumes of 13 normal volunteers. Thyroid function tests, uptake on thyroid scintigraphy, anti-TSH-receptor antibody positivity and other parameters were then evaluated in patients with EOM enlargement. Results. 31/39 patients had one or more enlarged EOM, of whom only 2 patients had clinical EOM dysfunction. Compared to Graves’ disease patients with normal EOM volumes, those with EOM enlargement had significantly higher mean serum TSH (0.020±0.005 versus 0.007±0.002 mIU/L; P value 0.012, free-T4 (52.9±3.3 versus 41.2±1.7 pmol/L; P value 0.003 and technetium uptake on thyroid scintigraphy (13.51±1.7% versus 8.55±1.6%; P value 0.045. There were no differences between the 2 groups in anti-TSH-receptor antibody positivity, the proportion of males, tobacco smokers, or those with active ophthalmopathy. Conclusions. Patients with recently diagnosed Graves’ disease and EOM volume enlargement have higher serum TSH and more severe hyperthyroidism than patients with normal EOM volumes, with no difference in anti-TSH-receptor antibody positivity between the two groups.

  8. Superior calcium homeostasis of extraocular muscles.

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    Zeiger, Ulrike; Mitchell, Claire H; Khurana, Tejvir S

    2010-11-01

    Extraocular muscles (EOMs) are a unique group of skeletal muscles with unusual physiological properties such as being able to undergo rapid twitch contractions over extended periods and escape damage in the presence of excess intracellular calcium (Ca(2+)) in Duchenne's muscular dystrophy (DMD). Enhanced Ca(2+) buffering has been proposed as a contributory mechanism to explain these properties; however, the mechanisms are not well understood. We investigated mechanisms modulating Ca(2+) levels in EOM and tibialis anterior (TA) limb muscles. Using Fura-2 based ratiometric Ca(2+) imaging of primary myotubes we found that EOM myotubes reduced elevated Ca(2+) ˜2-fold faster than TA myotubes, demonstrating more efficient Ca(2+) buffering. Quantitative PCR (qPCR) and western blotting revealed higher expression of key components of the Ca(2+) regulation system in EOM, such as the cardiac/slow isoforms sarcoplasmic Ca(2+)-ATPase 2 (Serca2) and calsequestrin 2 (Casq2). Interestingly EOM expressed monomeric rather than multimeric forms of phospholamban (Pln), which was phosphorylated at threonine 17 (Thr17) but not at the serine 16 (Ser16) residue. EOM Pln remained monomeric and unphosphorylated at Ser16 despite protein kinase A (PKA) treatment, suggesting differential signalling and modulation cascades involving Pln-mediated Ca(2+) regulation in EOM. Increased expression of Ca(2+)/SR mRNA, proteins, differential post-translational modification of Pln and superior Ca(2+) buffering is consistent with the improved ability of EOM to handle elevated intracellular Ca(2+) levels. These characteristics provide mechanistic insight for the potential role of superior Ca(2+) buffering in the unusual physiology of EOM and their sparing in DMD.

  9. Creep behavior of passive bovine extraocular muscle.

    Science.gov (United States)

    Yoo, Lawrence; Kim, Hansang; Shin, Andrew; Gupta, Vijay; Demer, Joseph L

    2011-01-01

    This paper characterized bovine extraocular muscles (EOMs) using creep, which represents long-term stretching induced by a constant force. After preliminary optimization of testing conditions, 20 fresh EOM samples were subjected to four different loading rates of 1.67, 3.33, 8.33, and 16.67%/s, after which creep was observed for 1,500 s. A published quasilinear viscoelastic (QLV) relaxation function was transformed to a creep function that was compared with data. Repeatable creep was observed for each loading rate and was similar among all six anatomical EOMs. The mean creep coefficient after 1,500 seconds for a wide range of initial loading rates was at 1.37 ± 0.03 (standard deviation, SD). The creep function derived from the relaxation-based QLV model agreed with observed creep to within 2.7% following 16.67%/s ramp loading. Measured creep agrees closely with a derived QLV model of EOM relaxation, validating a previous QLV model for characterization of EOM biomechanics.

  10. Creep Behavior of Passive Bovine Extraocular Muscle

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    Lawrence Yoo

    2011-01-01

    Full Text Available This paper characterized bovine extraocular muscles (EOMs using creep, which represents long-term stretching induced by a constant force. After preliminary optimization of testing conditions, 20 fresh EOM samples were subjected to four different loading rates of 1.67, 3.33, 8.33, and 16.67%/s, after which creep was observed for 1,500 s. A published quasilinear viscoelastic (QLV relaxation function was transformed to a creep function that was compared with data. Repeatable creep was observed for each loading rate and was similar among all six anatomical EOMs. The mean creep coefficient after 1,500 seconds for a wide range of initial loading rates was at 1.37±0.03 (standard deviation, SD. The creep function derived from the relaxation-based QLV model agreed with observed creep to within 2.7% following 16.67%/s ramp loading. Measured creep agrees closely with a derived QLV model of EOM relaxation, validating a previous QLV model for characterization of EOM biomechanics.

  11. Wnt and Extraocular Muscle Sparing in Amyotrophic Lateral Sclerosis

    OpenAIRE

    2014-01-01

    The potential role of Wnt signaling factors in extraocular muscle (EOM) sparing in amyotrophic lateral sclerosis (ALS) was examined. Three of the Wnts were preferentially upregulated in EOM, suggesting that they may be involved in maintenance of neuromuscular junctions in the EOM of ALS patients.

  12. Fatigue resistance of rat extraocular muscles does not depend on creatine kinase activity.

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    McMullen, Colleen A; Hayess, Katrin; Andrade, Francisco H

    2005-08-17

    Creatine kinase (CK) links phosphocreatine, an energy storage system, to cellular ATPases. CK activity serves as a temporal and spatial buffer for ATP content, particularly in fast-twitch skeletal muscles. The extraocular muscles are notoriously fast and active, suggesting the need for efficient ATP buffering. This study tested the hypotheses that (1) CK isoform expression and activity in rat extraocular muscles would be higher, and (2) the resistance of these muscles to fatigue would depend on CK activity. We found that mRNA and protein levels for cytosolic and mitochondrial CK isoforms were lower in the extraocular muscles than in extensor digitorum longus (EDL). Total CK activity was correspondingly decreased in the extraocular muscles. Moreover, cytoskeletal components of the sarcomeric M line, where a fraction of CK activity is found, were downregulated in the extraocular muscles as was shown by immunocytochemistry and western blotting. CK inhibition significantly accelerated the development of fatigue in EDL muscle bundles, but had no major effect on the extraocular muscles. Searching for alternative ATP buffers that could compensate for the relative lack of CK in extraocular muscles, we determined that mRNAs for two adenylate kinase (AK) isoforms were expressed at higher levels in these muscles. Total AK activity was similar in EDL and extraocular muscles. These data indicate that the characteristic fatigue resistance of the extraocular muscles does not depend on CK activity.

  13. Fatigue resistance of rat extraocular muscles does not depend on creatine kinase activity

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    Hayeß Katrin

    2005-08-01

    Full Text Available Abstract Background Creatine kinase (CK links phosphocreatine, an energy storage system, to cellular ATPases. CK activity serves as a temporal and spatial buffer for ATP content, particularly in fast-twitch skeletal muscles. The extraocular muscles are notoriously fast and active, suggesting the need for efficient ATP buffering. This study tested the hypotheses that (1 CK isoform expression and activity in rat extraocular muscles would be higher, and (2 the resistance of these muscles to fatigue would depend on CK activity. Results We found that mRNA and protein levels for cytosolic and mitochondrial CK isoforms were lower in the extraocular muscles than in extensor digitorum longus (EDL. Total CK activity was correspondingly decreased in the extraocular muscles. Moreover, cytoskeletal components of the sarcomeric M line, where a fraction of CK activity is found, were downregulated in the extraocular muscles as was shown by immunocytochemistry and western blotting. CK inhibition significantly accelerated the development of fatigue in EDL muscle bundles, but had no major effect on the extraocular muscles. Searching for alternative ATP buffers that could compensate for the relative lack of CK in extraocular muscles, we determined that mRNAs for two adenylate kinase (AK isoforms were expressed at higher levels in these muscles. Total AK activity was similar in EDL and extraocular muscles. Conclusion These data indicate that the characteristic fatigue resistance of the extraocular muscles does not depend on CK activity.

  14. Bilateral multiple extraocular muscle metastasis from breast carcinoma

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    Ramesh Murthy

    2011-01-01

    Full Text Available We report a rare presentation of an initially misdiagnosed case of a pseudotumor, which on histopathology was diagnosed as bilateral breast metastases of lobular carcinoma involving multiple extraocular muscles. A 61-year-old lady presented with external ophthalmoplegia and diplopia. Incisional biopsy was performed using a lid crease approach and the patient received radiotherapy and hormonal therapy. Following prolonged hormonal therapy, complete remission was achieved, with improvement in ocular motility and resolution of diplopia, about 18 months after the initial presentation. Multiple extraocular muscle involvement by breast carcinoma metastasis is very rare and should be considered in the differential diagnosis, especially in patients with a prior history of breast carcinoma.

  15. Traumatic avulsion of extraocular muscles: case reports

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    Nilza Minguini

    2013-04-01

    Full Text Available We described the clinical, surgical details and results (motor and sensory of the retrieving procedure of traumatically avulsed muscles in three patients with no previous history of strabismus or diplopia seen in the Department of Ophthalmology, State University of Campinas, Brazil. The slipped muscle portion was reinserted at the original insertion and under the remaining stump, which was sutured over the reinserted muscle. For all three cases there was recovery of single binocular vision and stereopsis.

  16. Ultrastructural organization of muscle fiber types and their distribution in the rat superior rectus extraocular muscle.

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    Rashed, Rashed M; El-Alfy, Sherif H

    2012-05-01

    Extraocular muscles (EOMs) are unique as they show greater variation in anatomical and physiological properties than any other skeletal muscles. To investigate the muscle fiber types and to understand better the structure-function correlation of the extraocular muscles, the present study examined the ultrastructural characteristics of the superior rectus muscle of rat. The superior rectus muscle is organized into two layers: a central global layer of mainly large-diameter fibers and an outer C-shaped orbital layer of principally small-diameter fibers. Six morphologically distinct fiber types were identified within the superior rectus muscle. Four muscle fiber types, three single innervated fibers (SIFs) and one multiple innervated fiber (MIF), were recognized in the global layer. The single innervated fibers included red, white and intermediate fibers. They differed from one another with respect to diameter, mitochondrial size and distribution, sarcoplasmic reticulum and myofibrillar size. The orbital layer contained two distinct MIFs in addition to the red and intermediate SIFs. The orbital MIFs were categorized into low oxidative and high oxidative types according to their mitochondrial content and distribution. The highly specialized function of the superior rectus extraocular muscle is reflected in the multiplicity of its fiber types, which exhibit unique structural features. The unique ultrastructural features of the extraocular muscles and their possible relation to muscle function are discussed. Copyright © 2011 Elsevier GmbH. All rights reserved.

  17. A new teaching model for demonstrating the movement of the extraocular muscles.

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    Iwanaga, Joe; Refsland, Jason; Iovino, Lee; Holley, Gary; Laws, Tyler; Oskouian, Rod J; Tubbs, R Shane

    2017-09-01

    The extraocular muscles consist of the superior, inferior, lateral, and medial rectus muscles and the superior and inferior oblique muscles. This study aimed to create a new teaching model for demonstrating the function of the extraocular muscles. A coronal section of the head was prepared and sutures attached to the levator palpebral superioris muscle and six extraocular muscles. Tension was placed on each muscle from a posterior approach and movement of the eye documented from an anterior view. All movements were clearly seen less than that of the inferior rectus muscle. To our knowledge, this is the first cadaveric teaching model for demonstrating the movements of the extraocular muscles. Clin. Anat. 30:733-735, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  18. Successful repair of injury to the eyelid, lacrimal passage, and extraocular muscle

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    Shah, Shreya Mehul

    2016-03-01

    Full Text Available Introduction: Injury is a known cause of monocular blindness. Ocular trauma may affect lacrimal canaliculi and the extraocular muscle. We report this case as it includes injury to lid, lacrimal canaliculi and inferior rectus. Case description: A 25-year-old male presented with an injury caused by a sharp object that resulted in a conjunctival tear, lid tear involving the lacrimal canal, and rupture of the inferior rectus muscle. All of the structures were repaired successfully during a single procedure. Conclusion: An extraocular injury involving the conjunctiva, lid, lacrimal passages, and extraocular muscles can be repaired successfully during a single procedure.

  19. An unusual extraocular muscle anomaly in a patient with Crouzon's disease.

    OpenAIRE

    SNIR, M.; Gilad, E.; Ben-Sira, I

    1982-01-01

    A 29-year-old female suffering from Crouzon's disease was admitted to hospital with retinal detachment in the right eye. At operation agenesis of 4 extraocular muscles (superior and inferior recti and obliquus) was found, together with abnormal insertion of the 2 horizontal muscles. The same extraocular muscular abnormalities were found in the left eye. We suggest here a new surgical treatment in such cases and discuss the reasons for the limitation of ocular motility in such cases.

  20. An unusual extraocular muscle anomaly in a patient with Crouzon's disease.

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    Snir, M.; Gilad, E.; Ben-Sira, I.

    1982-01-01

    A 29-year-old female suffering from Crouzon's disease was admitted to hospital with retinal detachment in the right eye. At operation agenesis of 4 extraocular muscles (superior and inferior recti and obliquus) was found, together with abnormal insertion of the 2 horizontal muscles. The same extraocular muscular abnormalities were found in the left eye. We suggest here a new surgical treatment in such cases and discuss the reasons for the limitation of ocular motility in such cases. Images PMID:7066280

  1. Graves' disease: measurement of the extraocular muscle thickness with the echobiometer.

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    Schenome, M; Polizzi, A; Buono, C; Ciurlo, C; Ciurlo, G

    1998-01-01

    The authors measured extraocular muscle thickness in normal subjects and in patients affected by Graves' disease, using a Sonomed A-2000 echobiometer (probe with 10-MHz frequency); Hertel's exophthalmometry was also performed. Statistically significant differences in muscle thickness between normals and patients were found. This technique seems to be sufficiently useful and reliable in extraocular thickness evaluation, showing data similar to those of the recent literature.

  2. Extraocular muscle is spared despite the absence of an intact sarcoglycan complex in gamma- or delta-sarcoglycan-deficient mice.

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    Porter, J D; Merriam, A P; Hack, A A; Andrade, F H; McNally, E M

    2001-03-01

    Models of the dystrophin-glycoprotein complex do not reconcile the novel sparing of extraocular muscle in muscular dystrophy. Extraocular muscle sparing in Duchenne muscular dystrophy implies the existence of adaptive properties in these muscles that may extend protection to other neuromuscular diseases. We studied the extraocular muscle morphology and dystrophin-glycoprotein complex organization in murine targeted deletion of the gamma-sarcoglycan (gsg(-/-)) and delta-sarcoglycan (dsg(-/-)) genes, two models of autosomal recessive limb girdle muscular dystrophy. In contrast to limb and diaphragm, the principal extraocular muscles were intact in gsg(-/-) and dsg(-/-) mice. However, central nucleated, presumptive regenerative, fibers were seen in the accessory extraocular muscles (retractor bulbi, levator palpebrae superioris) of both strains. Skeletal muscles of gsg(-/-) mice exhibited in vivo Evans Blue dye permeability, while the principal extraocular muscles did not. Disruption of gamma-sarcoglycan produced secondary displacement of alpha- and beta-sarcoglycans in the extraocular muscles. The intensity of immunofluorescence for dystrophin and alpha- and beta-dystroglycan also appeared to be slightly reduced. Utrophin localization was unchanged. The finding that sarcoglycan disruption was insufficient to elicit alterations in extraocular muscle suggests that loss of mechanical stability and increased sarcolemmal permeability are not inevitable consequences of mutations that disrupt the dystrophin-glycoprotein complex organization and must be accounted for in models of muscular dystrophy.

  3. Differential involvement of orbital fat and extraocular muscles in graves' ophthalmopathy.

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    Wiersinga, Wilmar M; Regensburg, Noortje I; Mourits, Maarten P

    2013-03-01

    Graves' ophthalmopathy (GO) is characterized by swelling of orbital fat and extraocular muscles, but little attention has been given to differential involvement of fat and muscles. Advancements in imaging allow rather accurate measurements of orbital bony cavity volume (OV), fat volume (FV) and muscle volume (MV), and are the topics of this review. Ratios of FV/OV and MV/OV neutralize gender differences. In adult Caucasian controls, mean values ± SD of FV/OV are 0.56 ± 0.11 and of MV/OV are 0.15 ± 0.02. FV increases substantially and MV decreases slightly with advancing age, requiring age-specific reference ranges. In 95 consecutive untreated Caucasian GO patients, both FV and MV were within normal limits in 25%, increased FV but normal MV was present in 5%, normal FV but increased MV was detected in 61%, and both increased FV and MV was evident in 9%. Increased FV was associated with more proptosis and longer GO duration. Increased MV was associated with older age, more severe GO (more proptosis and diplopia, worse eye muscle ductions), higher TBII and current smoking. At the cellular and molecular level differential involvement of fat and muscles might be related to differences between fibroblast phenotypes and cytokine profiles in each compartment, to different orbital T cell subsets during the course of the disease and to peroxisome proliferator activator receptor-γ polymorphisms and modulation of 11β-hydroxysteroid dehydrogenase-1. Enlarged muscles are apparently a rather early phenomenon in GO, whereas increases in fat mass occur relatively late. Why a minor subset of GO patients presents with an increase of only fat remains poorly understood.

  4. Transcriptional and functional differences in stem cell populations isolated from Extraocular and Limb muscles

    DEFF Research Database (Denmark)

    Pacheco-Pinedo, Eugenia Cristina; Budak, Murat T; Zeiger, Ulrike

    2008-01-01

    The extraocular muscles (EOMs) are a distinct muscle group that displays an array of unique contractile, structural and regenerative properties. They also have differential sensitivity to certain diseases and are enigmatically spared in Duchenne muscular dystrophy (DMD). The EOMs are so distinct ...

  5. MAGNETIC RESONANCE IMAGING CONTRAST ENHANCEMENT OF EXTRA-OCULAR MUSCLES IN DOGS WITH NO CLINICAL EVIDENCE OF ORBITAL DISEASE

    NARCIS (Netherlands)

    JOSLYN, S.; Richards, S.; Boroffka, S.A.E.B.; Mitchell, M.; Hammond, G.; Sullivan, M.T.

    2013-01-01

    Enhancement of extra-ocular muscles has been reported in cases of orbital pathology in both veterinary and medical magnetic resonance imaging.We have also observed this finding in the absence of orbital disease. The purpose of this retrospective study was to describe extra-ocular muscle contrast enh

  6. MAGNETIC RESONANCE IMAGING CONTRAST ENHANCEMENT OF EXTRA-OCULAR MUSCLES IN DOGS WITH NO CLINICAL EVIDENCE OF ORBITAL DISEASE

    NARCIS (Netherlands)

    JOSLYN, S.; Richards, S.; Boroffka, S.A.E.B.; Mitchell, M.; Hammond, G.; Sullivan, M.T.

    2013-01-01

    Enhancement of extra-ocular muscles has been reported in cases of orbital pathology in both veterinary and medical magnetic resonance imaging.We have also observed this finding in the absence of orbital disease. The purpose of this retrospective study was to describe extra-ocular muscle contrast enh

  7. Painful unilateral temporalis muscle enlargement: reactive masticatory muscle hypertrophy.

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    Katsetos, Christos D; Bianchi, Michael A; Jaffery, Fizza; Koutzaki, Sirma; Zarella, Mark; Slater, Robert

    2014-06-01

    An instance of isolated unilateral temporalis muscle hypertrophy (reactive masticatory muscle hypertrophy with fiber type 1 predominance) confirmed by muscle biopsy with histochemical fiber typing and image analysis in a 62 year-old man is reported. The patient presented with bruxism and a painful swelling of the temple. Absence of asymmetry or other abnormalities of the craniofacial skeleton was confirmed by magnetic resonance imaging and cephalometric analyses. The patient achieved symptomatic improvement only after undergoing botulinum toxin injections. Muscle biopsy is key in the diagnosis of reactive masticatory muscle hypertrophy and its distinction from masticatory muscle myopathy (hypertrophic branchial myopathy) and other non-reactive causes of painful asymmetric temporalis muscle enlargement.

  8. Effects of the Rho-Kinase Inhibitor Y-27632 on Extraocular Muscle Surgery in Rabbits

    OpenAIRE

    Ji‐Sun Moon; Hyun Kyung Kim; Sun Young Shin

    2017-01-01

    Purpose. To evaluate the effect of the Rho-kinase inhibitor Y-27632 on postoperative inflammation and adhesion following extraocular muscle surgery in rabbits. Methods. The superior rectus muscle reinsertion was performed on both eyes of 8 New Zealand white rabbits. After reinsertion, the rabbits received subconjunctival injections of the Rho-kinase inhibitor and saline on each eye. To assess acute and late inflammatory changes, Ki-67, CD11β+, and F4/80 were evaluated and the sites of muscle ...

  9. Altered Protein Composition and Gene Expression in Strabismic Human Extraocular Muscles and Tendons

    Science.gov (United States)

    Agarwal, Andrea B.; Feng, Cheng-Yuan; Altick, Amy L.; Quilici, David R.; Wen, Dan; Johnson, L. Alan; von Bartheld, Christopher S.

    2016-01-01

    Purpose To determine whether structural protein composition and expression of key regulatory genes are altered in strabismic human extraocular muscles. Methods Samples from strabismic horizontal extraocular muscles were obtained during strabismus surgery and compared with normal muscles from organ donors. We used proteomics, standard and customized PCR arrays, and microarrays to identify changes in major structural proteins and changes in gene expression. We focused on muscle and connective tissue and its control by enzymes, growth factors, and cytokines. Results Strabismic muscles showed downregulation of myosins, tropomyosins, troponins, and titin. Expression of collagens and regulators of collagen synthesis and degradation, the collagenase matrix metalloproteinase (MMP)2 and its inhibitors, tissue inhibitor of metalloproteinase (TIMP)1 and TIMP2, was upregulated, along with tumor necrosis factor (TNF), TNF receptors, and connective tissue growth factor (CTGF), as well as proteoglycans. Growth factors controlling extracellular matrix (ECM) were also upregulated. Among 410 signaling genes examined by PCR arrays, molecules with downregulation in the strabismic phenotype included GDNF, NRG1, and PAX7; CTGF, CXCR4, NPY1R, TNF, NTRK1, and NTRK2 were upregulated. Signaling molecules known to control extraocular muscle plasticity were predominantly expressed in the tendon rather than the muscle component. The two horizontal muscles, medial and lateral rectus, displayed similar changes in protein and gene expression, and no obvious effect of age. Conclusions Quantification of proteins and gene expression showed significant differences in the composition of extraocular muscles of strabismic patients with respect to important motor proteins, elements of the ECM, and connective tissue. Therefore, our study supports the emerging view that the molecular composition of strabismic muscles is substantially altered. PMID:27768799

  10. Absence of all cyclovertical extraocular muscles in a child who has Apert syndrome.

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    Bustos, Daniel E; Donahue, Sean P

    2007-08-01

    A 6-month-old patient with Apert syndrome underwent strabismus surgery for a hypertropic eye. At surgery, the patient was found to have agenesis of all four cyclovertical muscles in one eye. Further investigation by computed tomography demonstrated absence of all four cyclovertical muscles in the fellow eye as well. A transposition procedure corrected the strabismus. While isolated aberrant or missing extraocular muscles are well documented in patients with craniofacial syndromes, bilateral absence of all four cyclovertical muscles, as demonstrated in this patient, poses unique treatment challenges.

  11. Use of extraocular muscle flaps in the correction of orbital implant exposure.

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    Hsueh-Yen Chu

    Full Text Available PURPOSES: The study is to describe a new surgical technique for correcting large orbital implant exposure with extraocular muscle flaps and to propose a treatment algorithm for orbital implant exposure. METHODS: In a retrospective study, seven patients with orbital implant exposure were treated with extraocular muscle flaps. All data were collected from patients in Chang Gung Memorial Hospital, Taiwan during 2007-2012. All surgeries were performed by one surgeon (Y.J.T. Patient demographics, the original etiology, details of surgical procedures, implant types, and follow-up interval were recorded. Small exposure, defined as exposure area smaller than 3 mm in diameter, was treated conservatively first with topical lubricant and prophylactic antibiotics. Larger defects were managed surgically. RESULTS: Seven patients consisting of two males and five females were successfully treated for orbital implant exposure with extraocular muscle flaps. The average age was 36.4 (range, 3-55 years old. Five patients were referred from other hospitals. One eye was enucleated for retinoblastoma. The other six eyes were eviscerated, including one for endophthalmitis and five for trauma. Mean follow-up time of all seven patients was 19.5 (range, 2-60 months. No patient developed recurrence of exposure during follow-up. All patients were fitted with an acceptable prosthesis and had satisfactory cosmetic and functional results. CONCLUSIONS: The most common complication of orbital implant is exposure, caused by breakdown of the covering layers, leading to extrusion. Several methods were reported to manage the exposed implants. We report our experience of treating implant exposure with extraocular muscle flaps to establish a well-vascularized environment that supplies both the wrapping material and the overlying ocular surface tissue. We believe it can work as a good strategy to manage or to prevent orbital implant exposure.

  12. The properties of the extraocular muscles of the frog. II. Pharmacological properties of the isolated superior oblique and superior rectus muscles.

    Science.gov (United States)

    Asmussen, G

    1978-01-01

    The pharmacological properties of the superior oblique and the superior rectus muscles of the frog's eye were investigated in comparison with those of a skeletal muscle (iliofibularis muscle) of the same animal. Acetylcholine causes sustained contractures of the extraocular muscles; this effect is increased by physostigmine and decreased or abolished by d-tubocurarine. Also the applications of succinylcholine, choline or caffeine are able to evoke contractures. There are no striking differences in pharmacological properties between extraocular and skeletal muscles of the frog. The time-course of the contractures and the sensitivity of the muscle preparations to the drugs which evoke contractures are identical in extraocular and iliofibularis muscles. In comparison with skeletal muscles there is no higher sensitivity of the extraocular muscles against curare-like drugs. The existence of adrenergic receptors could not be found neither in extraocular nor in skeletal muscles of the frog. It is concluded that in frogs no pharmacological differences exist between the muscle fibre types which compose the extraocular and the skeletal muscles.

  13. Magnetic resonance imaging of the extraocular muscles and corresponding cranial nerves in patients with special forms of strabismus

    Institute of Scientific and Technical Information of China (English)

    JIAO Yong-hong; ZHAO Kan-xing; WANG Zhen-chang; QIAN Xue-han; WU Xiao; MAN Feng-yuan; LU Wei; SHE Hai-cheng

    2009-01-01

    Background With the technical advances, magnetic resonance imaging (MRI) is now sensitive enough to detect subtle structural abnormalities of ocular motor nerves arising from the brainstem and orbits of living subjects. This study was designed to delineate the MRI characteristics in patients with special forms of strabismus.Methods A total of 29 patients with special forms of strabismus underwent orbital and intracalvarium MRI. Imaging of the ocular motor nerves in the brainstem was performed in 0.8 mm thickness image planes using the three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) sequence. Nerves to extraocular muscles (EOMs), EOMs and their associated connective tissues were imaged with T1 weighting in tri-planar scans by dual-phased coils within 2.0 mm thick planes.Results Patients with congenital fibrosis of the extraocular muscles exhibited hypoplasia of the oculomotor (CN3), abducens (CN6), trochlear (CN4) nerves, and the EOMs; hypoplasia of CN6 in the brainstem and an extra branch of the inferior division of CN3 to the lateral rectus were the most common but not the only presentation of Duane's retraction syndrome. Hypoplasia of CN6, facial (CN7) and hypoglossal (CN12) nerves were revealed in patients with M(o)bius syndrome. In a rare case of bilateral synergistic convergence and divergence, an enlarged branch of CN3 to the medial rectus and a questionable branch of CN3 to the inferior rectus bilaterally were found.Conclusion MRI can reveal subtle structures of the ocular motor nerves and their corresponding EOMs. This can provide valuable information regarding pathogenesis in some special forms of strabismus.

  14. Contractile properties of extraocular muscle in Siamese cat.

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    Lennerstrand, G

    1979-01-01

    Siamese cats are albinos with poor visual resolution and severely impaired binocular vision. Eey muscle phyiology was studied in Siamese cats as a part of a more extensive project on eye muscle properties in cats with deficient binocular vision. Isometric contractions of the inferior oblique muscle were recorded in response to single and repetitive muscle nerve stimulation. Speed of contraction, measured as twitch contraction time, fusion frequency and rate of tetanic tension rise, was lower in Siamese than in normal cats. Eye muscles of Siamese cats fatiqued more easily to continuous activation than normal cat eye mucle. These functional changes have also been found in cats with binocular defects from monocular lid suture, but were much more marked in Siamese cats. It is suggested that the eye muscle changes represent muscular adaptations to genetically caused impairments of binocular vision and visual resolution in Siamese cats.

  15. The development of longitudinal variation of Myosin isoforms in the orbital fibers of extraocular muscles of rats.

    Science.gov (United States)

    Rubinstein, Neal A; Porter, John D; Hoh, Joseph F Y

    2004-09-01

    To examine the appearance of longitudinal variation of extraocular and embryonic myosin heavy chain (MyHC) isoforms during the development of orbital singly innervated fibers of rat extraocular muscles (EOMs). EOMs were dissected from rat pups of various ages and stained with isoform-specific monoclonal antibodies to the embryonic and extraocular MyHC isoforms and to neurofilaments, as well as with labeled alpha-bungarotoxin. The orbital layers of whole muscles were examined by confocal microscopy. RNase protection assays for the embryonic (Myh3) and extraocular (Myh13) MyHC isoform mRNAs were also performed. At 10 days postpartum, the EOM MyHC RNA was first detected by RNase protection assay. At 11 days postpartum, the extraocular isoform was detected in the orbital fibers as two thin stripes just proximal and distal to the neuromuscular junction (NMJ). Over the next few weeks, the area occupied by the extraocular isoform increased to include the entire central region of the orbital fibers at and surrounding the NMJ. At the same time, the embryonic isoform became excluded from the region of the NMJ. The orbital layer fibers of rat EOMs contain a longitudinal variation in MyHC isoforms not seen in other skeletal muscles. Development of this longitudinal variation begins as a late event postpartum; and the first appearance of it may be closely linked to neural contact. This targeting of MyHC isoforms to distinct domains is unique to EOMs. Copyright Association for Research in Vision and Ophthalmology

  16. The properties of the extraocular muscles of the frog. I. Mechanical properties of the isolated superior oblique and superior rectus muscles.

    Science.gov (United States)

    Asmussen, G

    1978-01-01

    The mechanical properties of two extraocular muscles (superior oblique and superior rectus muscles) of the frog were studied and compared with those of a frog's skeletal muscle (iliofibularis muscle) which contains the same types of muscle fibres as the oculorotatory muscles. The extraocular muscles are very fast twitching muscles. They exhibit a smaller contraction time, a smaller half-relaxation time, a higher fusion frequency, and a lower twitch-tetanus ratio than the skeletal muscles. The maximum isometric tetanic tension produced per unit cross-sectional area is lower in the extraocular muscles than in skeletal muscles. However, the extraocular muscles show a higher fatigue resistance than the skeletal muscles. With respect to the dynamic properties there are some differences between the various oculorotatory muscles of the frog. The superior rectus muscle exhibits a faster time-course of the contraction, a higher fusion frequency, and a higher fatigability than the superior oblique muscle. An increase of the extracellular K+-concentration evokes sustained contractures not only in the extraocular muscles but also in the iliofibularis muscle; between these muscles there are no striking differences in the mechanical threshold of the whole muscle preparation. The mechanical threshold depends on the Ca++-concentration of the bathing solution and it is found in a range between 12.5 and 17.5 mM K+ in a normal Ringer solution containing 1.8 mM Ca++. The static-mechanical properties of the extraocular muscles of the frog and the dependence of the active developed tension on the muscle extension are very similar to those which are known to exist in the extraocular muscles of other vertebrates. In tetanic activated frog's oculorotatory muscles a linear relationship exists between length and tension. A variation of the stimulation frequency does not change the slope of this curve but causes parallel shifts of the curve. The peculiar properties of the extraocular muscles

  17. Changes of orbital tissue volumes and proptosis in patients with thyroid extraocular muscle swelling after methylprednisolone pulse therapy.

    Science.gov (United States)

    Higashiyama, Tomoaki; Nishida, Yasuhiro; Ohji, Masahito

    2015-11-01

    To evaluate the changes of orbital tissue volumes and proptosis after methylprednisolone pulse therapy in thyroid-associated ophthalmopathy (TAO). The cross-sectional areas of orbital tissues and proptosis were measured with magnetic resonance imaging in 40 orbits of 20 patients with TAO before and after methylprednisolone pulse therapy. The volumes of the whole orbit, orbital fatty tissue, and extraocular muscles were calculated. The volumes and proptosis were compared before and after treatment using a paired t test. Before treatment, the mean volumes were 33.0 ± 4.8 cm(3) in the whole orbit, 19.9 ± 4.1 cm(3) in the orbital fatty tissue, and 4.6 ± 1.2 cm(3) in the total extraocular muscles. After treatment, the mean volumes were 32.5 ± 4.4 cm(3) in the whole orbit, 19.9 ± 3.7 cm(3) in the orbital fatty tissue, and 4.0 ± 1.0 cm(3) in the total extraocular muscles. The mean volumes of the whole orbit (P = 0.17) and orbital fatty tissue (P = 0.82) were not significantly decreased after treatment, while the mean volume of total extraocular muscles was significantly decreased (P tissue seemed to be unchanged after methylprednisolone pulse therapy while that of total extraocular muscles was decreased. The proptosis value seemed to be unchanged after treatment.

  18. Crotoxin in humans: analysis of the effects on extraocular and facial muscles

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    Geraldo de Barros Ribeiro

    2012-12-01

    Full Text Available PURPOSE: Crotoxin is the main neurotoxin of South American rattlesnake Crotalus durissus terrificus. The neurotoxic action is characterized by a presynaptic blockade. The purpose of this research is to assess the ability of crotoxin to induce temporary paralysis of extraocular and facial muscles in humans. METHODS: Doses of crotoxin used ranged from 2 to 5 units (U, each unit corresponding to one LD50. We first applied 2U of crotoxin in one of the extraocular muscles of 3 amaurotic individuals to be submitted to ocular evisceration. In the second stage, we applied crotoxin in 12 extraocular muscles of 9 patients with strabismic amblyopia. In the last stage, crotoxin was used in the treatment of blepharospasm in another 3 patients. RESULTS: No patient showed any systemic side effect or change in vision or any eye structure problem after the procedure. The only local side effects observed were slight conjunctival hyperemia, which recovered spontaneously. In 2 patients there was no change in ocular deviation after 2U crotoxin application. Limitation of the muscle action was observed in 8 of the 12 applications. The change in ocular deviation after application of 2U of crotoxin (9 injections was in average 15.7 prism diopters (PD. When the dose was 4U (2 applications the change was in average 37.5 PD and a single application of 5U produced a change of 16 PD in ocular deviation. This effect lasted from 1 to 3 months. Two of the 3 patients with blepharospasm had the hemifacial spasm improved with crotoxin, which returned after 2 months. CONCLUSIONS: This study provides data suggesting that crotoxin may be a useful new therapeutic option for the treatment of strabismus and blepharospasm. We expect that with further studies crotoxin could be an option for many other medical areas.

  19. Effects of the Rho-Kinase Inhibitor Y-27632 on Extraocular Muscle Surgery in Rabbits

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    Ji‐Sun Moon

    2017-01-01

    Full Text Available Purpose. To evaluate the effect of the Rho-kinase inhibitor Y-27632 on postoperative inflammation and adhesion following extraocular muscle surgery in rabbits. Methods. The superior rectus muscle reinsertion was performed on both eyes of 8 New Zealand white rabbits. After reinsertion, the rabbits received subconjunctival injections of the Rho-kinase inhibitor and saline on each eye. To assess acute and late inflammatory changes, Ki-67, CD11β+, and F4/80 were evaluated and the sites of muscle reattachment were evaluated for a postoperative adhesion score and histopathologically for collagen formation. Results. F4/80 antibody expression was significantly different in the Rho-kinase inhibitor-injected group at both postoperative day 3 and week 4 (p=0.038, 0.031. However, Ki-67 and CD11β+ were not different the between two groups. The difference in the SRM/conjunctiva adhesion score between the two groups was also significant (p=0.034. Conclusion. Intraoperative subconjunctival injection of the Rho-kinase inhibitor may be effective for adjunctive management of inflammation and fibrosis in rabbit eyes following extraocular muscle surgery.

  20. Dynamic Imaging of the Eye, Optic Nerve, and Extraocular Muscles With Golden Angle Radial MRI.

    Science.gov (United States)

    Sengupta, Saikat; Smith, David S; Smith, Alex K; Welch, E Brian; Smith, Seth A

    2017-08-01

    The eye and its accessory structures, the optic nerve and the extraocular muscles, form a complex dynamic system. In vivo magnetic resonance imaging (MRI) of this system in motion can have substantial benefits in understanding oculomotor functioning in health and disease, but has been restricted to date to imaging of static gazes only. The purpose of this work was to develop a technique to image the eye and its accessory visual structures in motion. Dynamic imaging of the eye was developed on a 3-Tesla MRI scanner, based on a golden angle radial sequence that allows freely selectable frame-rate and temporal-span image reconstructions from the same acquired data set. Retrospective image reconstructions at a chosen frame rate of 57 ms per image yielded high-quality in vivo movies of various eye motion tasks performed in the scanner. Motion analysis was performed for a left-right version task where motion paths, lengths, and strains/globe angle of the medial and lateral extraocular muscles and the optic nerves were estimated. Offline image reconstructions resulted in dynamic images of bilateral visual structures of healthy adults in only ∼15-s imaging time. Qualitative and quantitative analyses of the motion enabled estimation of trajectories, lengths, and strains on the optic nerves and extraocular muscles at very high frame rates of ∼18 frames/s. This work presents an MRI technique that enables high-frame-rate dynamic imaging of the eyes and orbital structures. The presented sequence has the potential to be used in furthering the understanding of oculomotor mechanics in vivo, both in health and disease.

  1. Surgically mismanaged ptosis in a patient with congenital fibrosis of the extraocular muscles type I

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    Hatem A Tawfik

    2012-01-01

    Full Text Available Fibrosis syndromes comprise a rare form of severe limitation of ocular motility. An 11-year-old girl was referred for the correction of eyelid retraction. The eyelid retraction occurred immediately following levator resection surgery performed by a plastic surgeon who missed the restrictive extraocular muscle abnormalities. On examination, both eyes were fixed in an infraducted position (20 prism diopters (Δ, with a chin-up position and significant lagophthalmos. Bilateral 12-mm inferior rectus recession with adjustable sutures was performed, which resulted in significant reduction of lagophthalmos and elimination of the head tilt.

  2. Evaluation of dysthyroid optic neuropathy using T2-relaxation time of extraocular muscle as parameter

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    Yu, Fumihiko; Maeda, Toshine; Inoue, Toyoko; Inoue, Yoichi [Olympia Eye Hospital, Tokyo (Japan)

    2001-11-01

    The T2 value of magnetic resonance imaging (MRI) is useful in evaluating the activity of dysthyroid ophthlamopathy. We applied this method in evaluating dysthyroid optic neuropathy in 15 affected eyes of 15 patients. Another group of 40 eyes of 20 patients of dysthyroid opthalmopathy without hypertrophy of extraocular muscles served as control. The T2 value in dysthyroid optic neuropathy significantly decreased following treatment with corticosteroid but the value was still higher than that in control eyes. The findings show that the T2 value of MRI is useful in evaluating the therapeutic effect of dysthyroid optic neuropathy. (author)

  3. Sparing of the extraocular muscles in mdx mice with absent or reduced utrophin expression: A life span analysis.

    Science.gov (United States)

    McDonald, Abby A; Hebert, Sadie L; McLoon, Linda K

    2015-11-01

    Sparing of the extraocular muscles in muscular dystrophy is controversial. To address the potential role of utrophin in this sparing, mdx:utrophin(+/-) and mdx:utrophin(-/-) mice were examined for changes in myofiber size, central nucleation, and Pax7-positive and MyoD-positive cell density at intervals over their life span. Known to be spared in the mdx mouse, and contrary to previous reports, the extraocular muscles from both the mdx:utrophin(+/-) and mdx:utrophin(-/-) mice were also morphologically spared. In the mdx:utrophin(+/)(-) mice, which have a normal life span compared to the mdx:utrophin(-/-) mice, the myofibers were larger at 3 and 12 months than the wild type age-matched eye muscles. While there was a significant increase in central nucleation in the extraocular muscles from all mdx:utrophin(+/)(-) mice, the levels were still very low compared to age-matched limb skeletal muscles. Pax7- and MyoD-positive myogenic precursor cell populations were retained and were similar to age-matched wild type controls. These results support the hypothesis that utrophin is not involved in extraocular muscle sparing in these genotypes. In addition, it appears that these muscles retain the myogenic precursors that would allow them to maintain their regenerative capacity and normal morphology over a lifetime even in these more severe models of muscular dystrophy.

  4. Surgical management of hypotropia in congenital fibrosis of extraocular muscles (CFEOM presented by pseudoptosis

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    Tawfik HA

    2012-12-01

    Full Text Available Hatem A Tawfik,1 Mohammad A Rashad21Oculoplastic Service, 2Pediatric Ophthalmology Service, Ophthalmology Department, Ain Shams University, Cairo, EgyptPurpose: To describe the demographics, characteristics, management pitfalls, and outcomes of pseudoptosis associated with congenital fibrosis of the extraocular muscles (CFEOM.Methods: A retrospective review was performed of eight patients presenting with ptosis and hypotropia to oculoplastic service. All patients underwent full ocular evaluation and magnetic resonance imaging of brain and orbit. Five of these patients underwent stepwise correction of hypotropia by single-stage adjustable strabismus surgery (SSASS, followed by a frontalis sling if needed.Results: Eight patients had congenital strabismus with severe ptosis and a positive forced duction test. There was a highly significant improvement from preoperative mean hypotropia angle of 30 prism diopters (PD to 9 PD mean postoperative angle (P = 0.006. Surgery for ptosis was not needed in 80% of eyes.Conclusion: CFEOM involving both ptosis and hypotropia could be properly managed with the correct sequence of surgical steps. Proper vertical alignment by correction of hypotropia utilizing SSASS may alleviate the need for ptosis surgery.Keywords: congenital fibrosis of extraocular muscles, CFEOM, single-stage adjustable suture surgery, SSASS, pseudoptosis

  5. Single motor unit activity in human extraocular muscles during the vestibulo-ocular reflex.

    Science.gov (United States)

    Weber, Konrad P; Rosengren, Sally M; Michels, Rike; Sturm, Veit; Straumann, Dominik; Landau, Klara

    2012-07-01

    Motor unit activity in human eye muscles during the vestibulo-ocular reflex (VOR) is not well understood, since the associated head and eye movements normally preclude single unit recordings. Therefore we recorded single motor unit activity following bursts of skull vibration and sound, two vestibular otolith stimuli that elicit only small head and eye movements. Inferior oblique (IO) and inferior rectus (IR) muscle activity was measured in healthy humans with concentric needle electrodes. Vibration elicited highly synchronous, short-latency bursts of motor unit activity in the IO (latency: 10.5 ms) and IR (14.5 ms) muscles. The activation patterns of the two muscles were similar, but reciprocal, with delayed activation of the IR muscle. Sound produced short-latency excitation of the IO muscle (13.3 ms) in the eye contralateral to the stimulus. Simultaneous needle and surface recordings identified the IO as the muscle of origin of the vestibular evoked myogenic potential (oVEMP) thus validating the physiological basis of this recently developed clinical test of otolith function. Single extraocular motor unit recordings provide a window into neural activity in humans that can normally only be examined using animal models and help identify the pathways of the translational VOR from otoliths to individual eye muscles.

  6. Analysis of neurotrophic factors in limb and extraocular muscles of mouse model of amyotrophic lateral sclerosis.

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    Vahid M Harandi

    Full Text Available Amyotrophic lateral sclerosis (ALS is currently an incurable fatal motor neuron syndrome characterized by progressive weakness, muscle wasting and death ensuing 3-5 years after diagnosis. Neurotrophic factors (NTFs are known to be important in both nervous system development and maintenance. However, the attempt to translate the potential of NTFs into the therapeutic options remains limited despite substantial number of approaches, which have been tested clinically. Using quantitative RT-PCR (qRT-PCR technique, the present study investigated mRNA expression of four different NTFs: brain-derived neurotrophic factor (BDNF, neurotrophin-3 (NT-3, neurotrophin-4/5 (NT-4 and glial cell line-derived neurotrophic factor (GDNF in limb muscles and extraocular muscles (EOMs from SOD1G93A transgenic mice at early and terminal stages of ALS. General morphological examination revealed that muscle fibres were well preserved in both limb muscles and EOMs in early stage ALS mice. However, in terminal ALS mice, most muscle fibres were either atrophied or hypertrophied in limb muscles but unaffected in EOMs. qRT-PCR analysis showed that in early stage ALS mice, NT-4 was significantly down-regulated in limb muscles whereas NT-3 and GDNF were markedly up-regulated in EOMs. In terminal ALS mice, only GDNF was significantly up-regulated in limb muscles. We concluded that the early down-regulation of NT-4 in limb muscles is closely associated with muscle dystrophy and dysfunction at late stage, whereas the early up-regulations of GDNF and NT-3 in EOMs are closely associated with the relatively well-preserved muscle morphology at late stage. Collectively, the data suggested that comparing NTFs expression between limb muscles and EOMs from different stages of ALS animal models is a useful method in revealing the patho-physiology and progression of ALS, and eventually rescuing motor neuron in ALS patients.

  7. Heterozygous mutations of the kinesin KIF21A in congenital fibrosis of the extraocular muscles type 1 (CFEOM1)

    NARCIS (Netherlands)

    Yamada, K; Andrews, C; Chan, WM; McKeown, CA; Magli, A; de Berardinis, T; Loewenstein, A; Lazar, M; O'Keefe, M; Letson, R; London, A; Ruttum, M; Matsumoto, N; Saito, N; Morris, L; Del Monte, M; Johnson, RH; Uyama, E; Houtman, WA; de Vries, B; Carlow, TJ; Hart, BL; Krawiecki, N; Shoffner, J; Vogel, MC; Katowitz, J; Goldstein, SM; Levin, AV; Sener, EC; Ozturk, BT; Akarsu, AN; Brodsky, MC; Hanisch, F; Cruse, RP; Zubcov, AA; Robb, RM; Roggenkaemper, P; Gottlob, [No Value; Kowal, L; Battu, R; Traboulsi, EI; Franceschini, P; Newlin, A; Demer, JL; Engle, EC

    2003-01-01

    Congenital fibrosis of the extraocular muscles type 1 (CFEOM1; OMIM #135700) is an autosomal dominant strabismus disorder associated with defects of the oculomotor nerve. We show that individuals with CFEOM1 harbor heterozygous missense mutations in a kinesin motor protein encoded by KIF21A. We iden

  8. Constitutive properties, not molecular adaptations, mediate extraocular muscle sparing in dystrophic mdx mice.

    Science.gov (United States)

    Porter, John D; Merriam, Anita P; Khanna, Sangeeta; Andrade, Francisco H; Richmonds, Chelliah R; Leahy, Patrick; Cheng, Georgiana; Karathanasis, Paraskevi; Zhou, Xiaohua; Kusner, Linda L; Adams, Marvin E; Willem, Michael; Mayer, Ulrike; Kaminski, Henry J

    2003-05-01

    Extraocular muscle (EOM) is spared in Duchenne muscular dystrophy. Here, we tested putative EOM sparing mechanisms predicted from existing dystrophinopathy models. Data show that mdx mouse EOM contains dystrophin-glycoprotein complex (DGC)-competent and DGC-deficient myofibers distributed in a fiber type-specific pattern. Up-regulation of a dystrophin homologue, utrophin, mediates selective DGC retention. Counter to the DGC mechanical hypothesis, an intact DGC is not a precondition for EOM sarcolemmal integrity, and active adaptation at the level of calcium homeostasis is not mechanistic in protection. A partial, fiber type-specific retention of antiischemic nitric oxide to vascular smooth muscle signaling is not a factor in EOM sparing, because mice deficient in dystrophin and alpha-syntrophin, which localizes neuronal nitric oxide synthase to the sarcolemma, have normal EOMs. Moreover, an alternative transmembrane protein, alpha7beta1 integrin, does not appear to substitute for the DGC in EOM. Finally, genomewide expression profiling showed that EOM does not actively adapt to dystrophinopathy but identified candidate genes for the constitutive protection of mdx EOM. Taken together, data emphasize the conditional nature of dystrophinopathy and the potential importance of nonmechanical DGC roles and support the hypothesis that broad, constitutive structural cell signaling, and/or biochemical differences between EOM and other skeletal muscles are determinants of differential disease responsiveness.

  9. Study of crotoxin on the induction of paralysis in extraocular muscle in animal model

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    Geraldo de Barros Ribeiro

    2012-10-01

    Full Text Available PURPOSE: Crotoxin is the major toxin of the venom of the South American rattlesnake Crotalus durissus terrificus, capable of causing a blockade of the neurotransmitters at the neuromuscular junction. The objective of this study was to appraise the action and effectiveness of the crotoxin induced paralysis of the extraocular muscle and to compare its effects with the botulinum toxin type A (BT-A. METHODS: The crotoxin, with LD50 of 1.5 µg, was injected into the superior rectus muscle in ten New Zealand rabbits. The concentration variance was 0.015 up to 150 µg. Two rabbits received 2 units of botulinum toxin type A for comparative analysis. The evaluation of the paralysis was performed using serial electromyography. After the functional recovery of the muscles, which occurred after two months, six rabbits were sacrificed for anatomopathology study. RESULTS: The animals did not show any evidence of systemic toxicity. Transitory ptosis was observed in almost every animal and remained up to fourteen days. These toxins caused immediate blockade of the electrical potentials. The recovery was gradual in the average of one month with regeneration signs evident on the electromyography. The paralysis effect of the crotoxin on the muscle was proportional to its concentration. The changes with 1.5 µg crotoxin were similar to those produced by the botulinum toxin type A. The histopathology findings were localized to the site of the injection. No signs of muscle fiber's necrosis were seen in any sample. The alterations induced by crotoxin were also proportional to the concentration and similar to botulinum toxin type A in concentration of 1.5 µg. CONCLUSION: Crotoxin was able to induce transitory paralysis of the superior rectus muscle. This effect was characterized by reduction of action potentials and non-specific signs of fibrillation. Crotoxin, in concentration of 1.5 µg was able to induce similar effects as botulinum toxin type A.

  10. Regenerating nerve fiber innervation of extraocular muscles and motor functional changes following oculomotor nerve injuries at different sites

    Institute of Scientific and Technical Information of China (English)

    Wenchuan Zhang; Massimiliano Visocchi; Eduardo Fernandez; Xuhui Wang; Xinyuan Li; Shiting Li

    2011-01-01

    In the present study, the oculomotor nerves were sectioned at the proximal (subtentorial) and distal (superior orbital fissure) ends and repaired. After 24 weeks, vestibulo-ocular reflex evaluation confirmed that the regenerating nerve fibers following oculomotor nerve injury in the superior orbital fissure had a high level of specificity for innervating extraocular muscles. The level of functional recovery of extraocular muscles in rats in the superior orbital fissure injury group was remarkably superior over that in rats undergoing oculomotor nerve injuries at the proximal end (subtentorium). Horseradish peroxidase retrograde tracing through the right superior rectus muscle showed that the distribution of neurons in the nucleus of the oculomotor nerve was directly associated with the injury site, and that crude fibers were badly damaged. The closer the site of injury of the oculomotor nerve was to the extraocular muscle, the better the recovery of neurological function was. The mechanism may be associated with the aberrant number of regenerated nerve fibers passing through the injury site.

  11. Dystrophic changes in extraocular muscles after gamma irradiation in mdx:utrophin(+/-) mice.

    Science.gov (United States)

    McDonald, Abby A; Kunz, Matthew D; McLoon, Linda K

    2014-01-01

    Extraocular muscles (EOM) have a strikingly different disease profile than limb skeletal muscles. It has long been known that they are spared in Duchenne (DMD) and other forms of muscular dystrophy. Despite many studies, the cause for this sparing is not understood. We have proposed that differences in myogenic precursor cell properties in EOM maintain normal morphology over the lifetime of individuals with DMD due to either greater proliferative potential or greater resistance to injury. This hypothesis was tested by exposing wild type and mdx:utrophin(+/-) (het) mouse EOM and limb skeletal muscles to 18 Gy gamma irradiation, a dose known to inhibit satellite cell proliferation in limb muscles. As expected, over time het limb skeletal muscles displayed reduced central nucleation mirrored by a reduction in Pax7-positive cells, demonstrating a significant loss in regenerative potential. In contrast, in the first month post-irradiation in the het EOM, myofiber cross-sectional areas first decreased, then increased, but ultimately returned to normal compared to non-irradiated het EOM. Central nucleation significantly increased in the first post-irradiation month, resembling the dystrophic limb phenotype. This correlated with decreased EECD34 stem cells and a concomitant increase and subsequent return to normalcy of both Pax7 and Pitx2-positive cell density. By two months, normal het EOM morphology returned. It appears that irradiation disrupts the normal method of EOM remodeling, which react paradoxically to produce increased numbers of myogenic precursor cells. This suggests that the EOM contain myogenic precursor cell types resistant to 18 Gy gamma irradiation, allowing return to normal morphology 2 months post-irradiation. This supports our hypothesis that ongoing proliferation of specialized regenerative populations in the het EOM actively maintains normal EOM morphology in DMD. Ongoing studies are working to define the differences in the myogenic precursor cells

  12. The role of extraocular muscle pulleys in incomitant non-paralytic strabismus

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    Robert A Clark

    2015-01-01

    Full Text Available The rectus extraocular muscles (EOMs and inferior oblique muscle have paths through the orbit constrained by connective tissue pulleys. These pulleys shift position during contraction and relaxation of the EOMs, dynamically changing the biomechanics of force transfer from the tendon onto the globe. The paths of the EOMs are tightly conserved in normal patients and disorders in the location and/or stability of the pulleys can create patterns of incomitant strabismus that may mimic oblique muscle dysfunction and cranial nerve paresis. Developmental disorders of pulley location can occur in conjunction with large, obvious abnormalities of orbital anatomy (e.g., craniosynostosis syndromes or subtle, isolated abnormalities in the location of one or more pulleys. Acquired disorders of pulley location can be divided into four broad categories: Connective tissue disorders (e.g., Marfan syndrome, globe size disorders (e.g., high myopia, senile degeneration (e.g., sagging eye syndrome, and trauma (e.g., orbital fracture or postsurgical. Recognition of these disorders is important because abnormalities in pulley location and movement are often resistant to standard surgical approaches that involve strengthening or weakening the oblique muscles or changing the positions of the EOM insertions. Preoperative diagnosis is aided by: (1 Clinical history of predisposing risk factors, (2 observation of malpositioning of the medial canthus, lateral canthus, and globe, and (3 gaze-controlled orbital imaging using direct coronal slices. Finally, surgical correction frequently involves novel techniques that reposition and stabilize the pulley and posterior muscle belly within the orbit using permanent scleral sutures or silicone bands without changing the location of the muscle′s insertion.

  13. Sparing of extraocular muscle in aging and muscular dystrophies: A myogenic precursor cell hypothesis

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    Kallestad, Kristen M.; Hebert, Sadie L.; McDonald, Abby A.; Daniel, Mark L.; Cu, Sharon R.; McLoon, Linda K., E-mail: mcloo001@tc.umn.edu

    2011-04-01

    The extraocular muscles (EOM) are spared from pathology in aging and many forms of muscular dystrophy. Despite many studies, this sparing remains an enigma. The EOM have a distinct embryonic lineage compared to somite-derived muscles, and we have shown that they continuously remodel throughout life, maintaining a population of activated satellite cells even in aging. These data suggested the hypothesis that there is a population of myogenic precursor cells (mpcs) in EOM that is different from those in limb, with either elevated numbers of stem cells and/or mpcs with superior proliferative capacity compared to mpcs in limb. Using flow cytometry, EOM and limb muscle mononuclear cells were compared, and a number of differences were seen. Using two different cell isolation methods, EOM have significantly more mpcs per mg muscle than limb skeletal muscle. One specific subpopulation significantly increased in EOM compared to limb was positive for CD34 and negative for Sca-1, M-cadherin, CD31, and CD45. We named these the EOMCD34 cells. Similar percentages of EOMCD34 cells were present in both newborn EOM and limb muscle. They were retained in aged EOM, whereas the population decreased significantly in adult limb muscle and were extremely scarce in aged limb muscle. Most importantly, the percentage of EOMCD34 cells was elevated in the EOM from both the mdx and the mdx/utrophin{sup -/-} (DKO) mouse models of DMD and extremely scarce in the limb muscles of these mice. In vitro, the EOMCD34 cells had myogenic potential, forming myotubes in differentiation media. After determining a media better able to induce proliferation in these cells, a fusion index was calculated. The cells isolated from EOM had a 40% higher fusion index compared to the same cells isolated from limb muscle. The EOMCD34 cells were resistant to both oxidative stress and mechanical injury. These data support our hypothesis that the EOM may be spared in aging and in muscular dystrophies due to a

  14. Sparing of extraocular muscle in aging and muscular dystrophies: a myogenic precursor cell hypothesis.

    Science.gov (United States)

    Kallestad, Kristen M; Hebert, Sadie L; McDonald, Abby A; Daniel, Mark L; Cu, Sharon R; McLoon, Linda K

    2011-04-01

    The extraocular muscles (EOM) are spared from pathology in aging and many forms of muscular dystrophy. Despite many studies, this sparing remains an enigma. The EOM have a distinct embryonic lineage compared to somite-derived muscles, and we have shown that they continuously remodel throughout life, maintaining a population of activated satellite cells even in aging. These data suggested the hypothesis that there is a population of myogenic precursor cells (mpcs) in EOM that is different from those in limb, with either elevated numbers of stem cells and/or mpcs with superior proliferative capacity compared to mpcs in limb. Using flow cytometry, EOM and limb muscle mononuclear cells were compared, and a number of differences were seen. Using two different cell isolation methods, EOM have significantly more mpcs per mg muscle than limb skeletal muscle. One specific subpopulation significantly increased in EOM compared to limb was positive for CD34 and negative for Sca-1, M-cadherin, CD31, and CD45. We named these the EOMCD34 cells. Similar percentages of EOMCD34 cells were present in both newborn EOM and limb muscle. They were retained in aged EOM, whereas the population decreased significantly in adult limb muscle and were extremely scarce in aged limb muscle. Most importantly, the percentage of EOMCD34 cells was elevated in the EOM from both the mdx and the mdx/utrophin(-/-) (DKO) mouse models of DMD and extremely scarce in the limb muscles of these mice. In vitro, the EOMCD34 cells had myogenic potential, forming myotubes in differentiation media. After determining a media better able to induce proliferation in these cells, a fusion index was calculated. The cells isolated from EOM had a 40% higher fusion index compared to the same cells isolated from limb muscle. The EOMCD34 cells were resistant to both oxidative stress and mechanical injury. These data support our hypothesis that the EOM may be spared in aging and in muscular dystrophies due to a subpopulation

  15. Extra-ocular muscle MRI in genetically-defined mitochondrial disease

    Energy Technology Data Exchange (ETDEWEB)

    Pitceathly, Robert D.S.; Morrow, Jasper M.; Hanna, Michael G. [UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, MRC Centre for Neuromuscular Diseases, London (United Kingdom); Sinclair, Christopher D.J.; Yousry, Tarek A.; Thornton, John S. [UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, MRC Centre for Neuromuscular Diseases, London (United Kingdom); UCL Institute of Neurology, Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, London (United Kingdom); Woodward, Cathy; Sweeney, Mary G. [National Hospital for Neurology and Neurosurgery, Neurogenetics Unit, London (United Kingdom); Rahman, Shamima [UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, MRC Centre for Neuromuscular Diseases, London (United Kingdom); UCL Institute of Child Health, Mitochondrial Research Group, Clinical and Molecular Genetics Unit, London (United Kingdom); Plant, Gordon T.; Ali, Nadeem [National Hospital for Neurology and Neurosurgery, Department of Neuro-ophthalmology, London (United Kingdom); Moorfields Eye Hospital, Department of Neuro-ophthalmology, London (United Kingdom); Bremner, Fion [National Hospital for Neurology and Neurosurgery, Department of Neuro-ophthalmology, London (United Kingdom); Davagnanam, Indran [National Hospital for Neurology and Neurosurgery, The Lysholm Department of Neuroradiology, London (United Kingdom)

    2016-01-15

    Conventional and quantitative MRI was performed in patients with chronic progressive external ophthalmoplegia (CPEO), a common manifestation of mitochondrial disease, to characterise MRI findings in the extra-ocular muscles (EOMs) and investigate whether quantitative MRI provides clinically relevant measures of disease. Patients with CPEO due to single mitochondrial DNA deletions were compared with controls. Range of eye movement (ROEM) measurements, peri-orbital 3 T MRI T1-weighted (T1w) and short-tau-inversion-recovery (STIR) images, and T2 relaxation time maps were obtained. Blinded observers graded muscle atrophy and T1w/STIR hyperintensity. Cross-sectional areas and EOM mean T2s were recorded and correlated with clinical parameters. Nine patients and nine healthy controls were examined. Patients had reduced ROEM (patients 13.3 , controls 49.3 , p < 0.001), greater mean atrophy score and increased T1w hyperintensities. EOM mean cross-sectional area was 43 % of controls and mean T2s were prolonged (patients 75.6 ± 7.0 ms, controls 55.2 ± 4.1 ms, p < 0.001). ROEM correlated negatively with EOM T2 (rho = -0.89, p < 0.01), whilst cross-sectional area failed to correlate with any clinical measures. MRI demonstrates EOM atrophy, characteristic signal changes and prolonged T2 in CPEO. Correlation between elevated EOM T2 and ROEM impairment represents a potential measure of disease severity that warrants further evaluation. (orig.)

  16. Conserved and muscle-group-specific gene expression patterns shape postnatal development of the novel extraocular muscle phenotype.

    Science.gov (United States)

    Cheng, Georgiana; Merriam, Anita P; Gong, Bendi; Leahy, Patrick; Khanna, Sangeeta; Porter, John D

    2004-07-08

    Current models in skeletal muscle biology do not fully account for the breadth, causes, and consequences of phenotypic variation among skeletal muscle groups. The muscle allotype concept arose to explain frank differences between limb, masticatory, and extraocular (EOM) muscles, but there is little understanding of the developmental regulation of the skeletal muscle phenotypic range. Here, we used morphological and DNA microarray analyses to generate a comprehensive temporal profile for rat EOM development. Based upon coordinate regulation of morphologic/gene expression traits with key events in visual, vestibular, and oculomotor system development, we propose a model that the EOM phenotype is a consequence of extrinsic factors that are unique to its local environment and sensory-motor control system, acting upon a novel myoblast lineage. We identified a broad spectrum of differences between the postnatal transcriptional patterns of EOM and limb muscle allotypes, including numerous transcripts not traditionally associated with muscle fiber/group differences. Several transcription factors were differentially regulated and may be responsible for signaling muscle allotype specificity. Significant differences in cellular energetic mechanisms defined the EOM and limb allotypes. The allotypes were divergent in many other functional transcript classes that remain to be further explored. Taken together, we suggest that the EOM allotype is the consequence of tissue-specific mechanisms that direct expression of a limited number of EOM-specific transcripts and broader, incremental differences in transcripts that are conserved by the two allotypes. This represents an important first step in dissecting allotype-specific regulatory mechanisms that may, in turn, explain differential muscle group sensitivity to a variety of metabolic and neuromuscular diseases.

  17. Impact of Amyotrophic Lateral Sclerosis on Slow Tonic Myofiber Composition in Human Extraocular Muscles.

    Science.gov (United States)

    Tjust, Anton E; Danielsson, Adam; Andersen, Peter M; Brännström, Thomas; Pedrosa Domellöf, Fatima

    2017-07-01

    To analyze the proportion and cross-sectional area of myofibers containing myosin heavy chain slow-twitch (MyHCI) and myosin heavy chain slow tonic (MyHCsto) in extraocular muscles of autopsied amyotrophic lateral sclerosis (ALS) patients with either spinal or bulbar site of disease onset. Whole-muscle cross sections from the middle portion of the medial rectus were labeled with antibodies against MyHCI or MyHCsto and laminin. Myofibers labeled with the MyHC antibodies (MyHCI+sto) and the total number of myofibers were quantified in the orbital and global layer of 6 control individuals and 18 ALS patients. The cross-sectional area of myofibers labeled for either MyHC was quantified in 130 to 472 fibers/individual in the orbital and in 180 to 573 fibers/individual in the global layer of each specimen. The proportion of MyHCI+sto myofibers was significantly smaller in the orbital and global layer of ALS compared to control individuals. MyHCI+sto myofibers were significantly smaller in the global layer than in the orbital layer of ALS, whereas they were of similar size in control subjects. The decreased proportion of MyHCI+sto fibers correlated significantly with the age of death, but not disease duration, in patients who had the bulbar-onset variant of ALS but not in patients with spinal variant. ALS, regardless of site of onset, involves a loss of myofibers containing MyHCI+sto. Only in bulbar-onset cases did aging seem to play a role in the pathophysiological processes underlying the loss of MyHCI+sto fibers.

  18. Painful Unilateral Temporalis Muscle Enlargement: Reactive Masticatory Muscle Hypertrophy

    OpenAIRE

    Katsetos, Christos D.; Bianchi, Michael A.; Jaffery, Fizza; Koutzaki, Sirma; Zarella, Mark; Slater, Robert

    2013-01-01

    An instance of isolated unilateral temporalis muscle hypertrophy (reactive masticatory muscle hypertrophy with fiber type 1 predominance) confirmed by muscle biopsy with histochemical fiber typing and image analysis in a 62 year-old man is reported. The patient presented with bruxism and a painful swelling of the temple. Absence of asymmetry or other abnormalities of the craniofacial skeleton was confirmed by magnetic resonance imaging and cephalometric analyses. The patient achieved symptoma...

  19. Extraocular muscle atrophy and central nervous system involvement in chronic progressive external ophthalmoplegia.

    Directory of Open Access Journals (Sweden)

    Cynthia Yu-Wai-Man

    Full Text Available Chronic progressive external ophthalmoplegia (CPEO is a classical mitochondrial ocular disorder characterised by bilateral progressive ptosis and ophthalmoplegia. These ocular features can develop either in isolation or in association with other prominent neurological deficits (CPEO+. Molecularly, CPEO can be classified into two distinct genetic subgroups depending on whether patients harbour single, large-scale mitochondrial DNA (mtDNA deletions or multiple mtDNA deletions secondary to a nuclear mutation disrupting mtDNA replication or repair. The aim of this magnetic resonance imaging (MRI study was to investigate whether the ophthalmoplegia in CPEO is primarily myopathic in origin or whether there is evidence of contributory supranuclear pathway dysfunction.Ten age-matched normal controls and twenty patients with CPEO were recruited nine patients with single, large-scale mtDNA deletions and eleven patients with multiple mtDNA deletions secondary to mutations in POLG, PEO1, OPA1, and RRM2B. All subjects underwent a standardised brain and orbital MRI protocol, together with proton magnetic resonance spectroscopy in two voxels located within the parietal white matter and the brainstem.There was evidence of significant extraocular muscle atrophy in patients with single or multiple mtDNA deletions compared with controls. There was no significant difference in metabolite concentrations between the patient and control groups in both the parietal white matter and brainstem voxels. Volumetric brain measurements revealed marked cortical and cerebellar atrophy among patients with CPEO+ phenotypes.The results of this study support a primary myopathic aetiology for the progressive limitation of eye movements that develops in CPEO.

  20. An unusual myopathy: speckled muscle fibers due to enlarged mitochondria.

    Science.gov (United States)

    Jeffree, Rosalind L; Wills, Edward J; Harper, Clive

    2007-07-01

    We report a 52-year-old woman who presented with a 6-month history of proximal muscle weakness, elevated serum creatine kinase, and myopathic pattern on electromyography (EMG). Histology of the muscle shows a speckled pattern due to clustering of enlarged mitochondria. The pathology resembles that of selenium deficiency. The patient was found to have borderline low serum selenium and also low vitamin D and thyroid-stimulating hormone. The cause of this unusual myopathy is probably multifactorial. This case is important because the unusual pathological picture represents a potentially treatable myopathy. In addition, we hope that publication of the complex clinical and biochemical abnormalities of this case, in conjunction with other case reports, may facilitate future elucidation of muscle mitochondrial function and dysfunction.

  1. Myosin heavy chain isoform expression in human extraocular muscles: longitudinal variation and patterns of expression in global and orbital layers.

    Science.gov (United States)

    Park, Kyung-Ah; Lim, Jeonghee; Sohn, Seongsoo; Oh, Sei Yeul

    2012-05-01

    We investigated the distribution of myosin heavy chain (MyHC) isoforms along the length of the global and orbital layers of human extraocular muscles (EOMs). Whole muscle tissue extracts of human EOMs were cross-sectioned consecutively and separated into orbital and global layers. The extracts from these layers were subjected to electrophoretic analysis, followed by quantification with scanning densitometry. MyHC isoforms displayed different distributions along the lengths of EOMs. In the orbital and global layers of all EOMs except for the superior oblique muscle, MyHCeom was enriched in the central regions. MyHCIIa and MyHCI were most abundant in the proximal and distal ends. A variation in MyHC isoform expression was apparent along the lengths of human EOMs. These results provide a basis for understanding the molecular mechanisms underlying the functional diversity of EOMs. Copyright © 2012 Wiley Periodicals, Inc.

  2. Lymphomas and metastases of the extra-ocular musculature

    Energy Technology Data Exchange (ETDEWEB)

    Surov, Alexey; Behrmann, Curd; Koesling, Sabrina [Martin Luther University of Halle-Wittenberg, Department of Radiology, Halle (Germany); Holzhausen, Hans-Juergen [Martin Luther University of Halle-Wittenberg, Department of Pathology, Halle (Germany)

    2011-11-15

    The involvement of extra-ocular muscles in malignant diseases has been described only sporadically. The purpose of this study was to estimate the prevalence of orbital muscle lymphoma and metastases and to analyse their radiological findings. In the time period from January 2000 to January 2010, 11 patients with extra-ocular muscle malignancies (EOMM) were retrospectively identified in the radiological database of our institution. There were four women and seven men with a median age of 58 years (range, 47 to 72 years). In three patients non-Hodgkin lymphoma (NHL), in seven cases intramuscular metastases of solid tumours and in one patient plasmacytoma of orbital muscles were diagnosed. In all, magnetic resonance imaging (MRI) was performed on 11 patients using a 1.5-T MRI scanner (Magnetom Vision Sonata Upgrade, Siemens, Germany). The diagnosis of EOMM was confirmed histopathologically by muscle biopsy in all cases. The prevalence of orbital muscle involvement in plasmacytoma was 0.3%, in NHL 0.4% and in carcinomas 0.1%. Clinically, EOMM presented as painless proptosis and motility disturbance. Medial and lateral rectus muscles were involved in most patients. On T2-weighted images, the lesions were isointense or mixed iso-to-hyperintense in comparison to the unaffected musculature. On T1-weighted images, all tumours were homogeneously isointense. After intravenous administration of contrast medium, most lesions showed moderate heterogeneous enhancement. Lymphomas and metastases are rare lesions of the extra-ocular musculature with a prevalence below 0.5%. Their radiological and clinical signs are non-specific and include painless muscle enlargement or masses. They should be considered in the differential diagnosis of diseases of extra-ocular muscles. (orig.)

  3. [The gene mutation screening of a family with congenital fibrosis of the extraocular muscles associated with corpus callosum agenesis].

    Science.gov (United States)

    Zhang, Jun-tao; Zhou, Lian-hong; Zha, Yun-fei; Liu, Tian; Tian, Ming-xing; Yuan, Jing; Xing, Yi-qiao

    2013-07-01

    To identify TUBB3 gene mutations in a Chinese family with congenital fibrosis of the extraocular muscle associated with corpus callosum agenesis. We have found a family with CFEOM associated with corpus callosum agenesis, including 4 affected individuals in three generations of 11 familial members. 4 affected individuals were sequenced by direct TUBB3 sequencing, 4 unaffected individuals in the family and 100 cases of unrelated normal person as a control. This family is in line with Mendelian autosomal dominant inheritance. Clinical manifestations belongs to CFEOM3. All affected individuals were detected with TUBB3 c.1249G > A mutation, the mutation is in exon 4, resulting in wild-type gene encoding the Aspartic acid ( Asp or D ) replaced .by Asparagine (Asn or N ). Our study supports that TUBB3 gene mutation c.1249G > A (p. Asp417Asn), is the underlying molecular pathogenesis of this family with CFEOM3.

  4. A functional SNP in the regulatory region of the decay-accelerating factor gene associates with extraocular muscle pareses in myasthenia gravis

    OpenAIRE

    Heckmann, J M; Uwimpuhwe, H; Ballo, R; Kaur, M.; Bajic, V.B.; Prince, S.

    2009-01-01

    Complement activation in myasthenia gravis (MG) may damage muscle endplate and complement regulatory proteins such as decay-accelerating factor (DAF) or CD55 may be protective. We hypothesize that the increased prevalence of severe extraocular muscle (EOM) dysfunction among African MG subjects reported earlier may result from altered DAF expression. To test this hypothesis, we screened the DAF gene sequences relevant to the classical complement pathway and found an association between myasthe...

  5. Phenothiourea sensitizes zebrafish cranial neural crest and extraocular muscle development to changes in retinoic acid and IGF signaling.

    Directory of Open Access Journals (Sweden)

    Brenda L Bohnsack

    Full Text Available 1-Phenyl 2-thiourea (PTU is a tyrosinase inhibitor commonly used to block pigmentation and aid visualization of zebrafish development. At the standard concentration of 0.003% (200 µM, PTU inhibits melanogenesis and reportedly has minimal other effects on zebrafish embryogenesis. We found that 0.003% PTU altered retinoic acid and insulin-like growth factor (IGF regulation of neural crest and mesodermal components of craniofacial development. Reduction of retinoic acid synthesis by the pan-aldehyde dehydrogenase inhibitor diethylbenzaldehyde, only when combined with 0.003% PTU, resulted in extraocular muscle disorganization. PTU also decreased retinoic acid-induced teratogenic effects on pharyngeal arch and jaw cartilage despite morphologically normal appearing PTU-treated controls. Furthermore, 0.003% PTU in combination with inhibition of IGF signaling through either morpholino knockdown or pharmacologic inhibition of tyrosine kinase receptor phosphorylation, disrupted jaw development and extraocular muscle organization. PTU in and of itself inhibited neural crest development at higher concentrations (0.03% and had the greatest inhibitory effect when added prior to 22 hours post fertilization (hpf. Addition of 0.003% PTU between 4 and 20 hpf decreased thyroxine (T4 in thyroid follicles in the nasopharynx of 96 hpf embryos. Treatment with exogenous triiodothyronine (T3 and T4 improved, but did not completely rescue, PTU-induced neural crest defects. Thus, PTU should be used with caution when studying zebrafish embryogenesis as it alters the threshold of different signaling pathways important during craniofacial development. The effects of PTU on neural crest development are partially caused by thyroid hormone signaling.

  6. Phenothiourea sensitizes zebrafish cranial neural crest and extraocular muscle development to changes in retinoic acid and IGF signaling.

    Science.gov (United States)

    Bohnsack, Brenda L; Gallina, Donika; Kahana, Alon

    2011-01-01

    1-Phenyl 2-thiourea (PTU) is a tyrosinase inhibitor commonly used to block pigmentation and aid visualization of zebrafish development. At the standard concentration of 0.003% (200 µM), PTU inhibits melanogenesis and reportedly has minimal other effects on zebrafish embryogenesis. We found that 0.003% PTU altered retinoic acid and insulin-like growth factor (IGF) regulation of neural crest and mesodermal components of craniofacial development. Reduction of retinoic acid synthesis by the pan-aldehyde dehydrogenase inhibitor diethylbenzaldehyde, only when combined with 0.003% PTU, resulted in extraocular muscle disorganization. PTU also decreased retinoic acid-induced teratogenic effects on pharyngeal arch and jaw cartilage despite morphologically normal appearing PTU-treated controls. Furthermore, 0.003% PTU in combination with inhibition of IGF signaling through either morpholino knockdown or pharmacologic inhibition of tyrosine kinase receptor phosphorylation, disrupted jaw development and extraocular muscle organization. PTU in and of itself inhibited neural crest development at higher concentrations (0.03%) and had the greatest inhibitory effect when added prior to 22 hours post fertilization (hpf). Addition of 0.003% PTU between 4 and 20 hpf decreased thyroxine (T4) in thyroid follicles in the nasopharynx of 96 hpf embryos. Treatment with exogenous triiodothyronine (T3) and T4 improved, but did not completely rescue, PTU-induced neural crest defects. Thus, PTU should be used with caution when studying zebrafish embryogenesis as it alters the threshold of different signaling pathways important during craniofacial development. The effects of PTU on neural crest development are partially caused by thyroid hormone signaling.

  7. MRI manifestations of enlarged superior ophthalmic vein

    Institute of Scientific and Technical Information of China (English)

    WEI Rui-li; MA Xiao-ye; CAI Ji-ping; ZHU Huang

    2002-01-01

    Objective:To assess MRI in the evaluation of enlarged superior ophthalmic vein (SOV). Methods: MRI manifestations and etiology of forty-six patients with enlarged SOV were analyzed. Results: SOV enlargement was noted to occur in carotid-cavernous fistula, ophthalmic Graves'disease, Tolosa-Hunt syndrome, inflammation at the apex of the orbit, orbital pseudotumor and thrombosis of cavernous sinus. The dilated vein appeared as signal void tubular shadows on both T1 and T2 weighted images. The diameter of the enlarged vein was 3.5-6.0 mm. Extraocular muscle enlargement, orbital pathologies, enlarged carotid cavernous sinus etc were also revealed by MRI. Conclusion: The dilated SOV may be well demonstrated by MRI. The etiological diagnosis of enlarged SOV can be made in combination with the associated findings.

  8. Myostatin shows a specific expression pattern in pig skeletal and extraocular muscles during pre- and post-natal growth.

    Science.gov (United States)

    Patruno, Marco; Caliaro, Francesca; Maccatrozzo, Lisa; Sacchetto, Roberta; Martinello, Tiziana; Toniolo, Luana; Reggiani, Carlo; Mascarello, Francesco

    2008-02-01

    Myogenesis is driven by an extraordinary array of cellular signals that follow a common expression pattern among different animal phyla. Myostatin (mstn) is a secreted growth factor that plays a pivotal role in skeletal muscle mass regulation. The aim of the present study was to investigate mstn expression in a large mammal (the pig) in order to ascertain whether distinct expression changes of this factor might be linked to the fiber-type composition of the muscle examined and/or to specific developmental stages. To assess the expression pattern of mstn in relation to myogenic proliferative (Pax7 and MyoD) and differentiative (myogenin) markers, we evaluated muscles with different myosin heavy-chain compositions sampled during pre- and post-natal development and on myogenic cells isolated from the same muscles. Skeletal muscles showed higher levels of mRNA for mstn and all other genes examined during fetal development than after birth. The wide distribution of mstn was also confirmed by immunohistochemistry experiments supporting evidence for cytoplasmic staining in early fetal periods as well as the localization in type 1 fibers at the end of the gestation period. Extraocular muscles, in contrast, did not exhibit decreasing mRNA levels for mstn or other genes even in adult samples and expressed higher levels of both mstn mRNA and protein compared with skeletal muscles. Experiments carried out on myogenic cells showed that mstn mRNA levels decreased when myoblasts entered the differentiation program and that cells isolated at early post-natal stages maintained a high level of Pax7 expression. Our results showed that mstn had a specific expression pattern whose variations depended on the muscle type examined, thus supporting the hypothesis that at birth, porcine myogenic cells continue to be influenced by hyperplastic/proliferative mechanisms.

  9. Structural Functional Associations of the Orbit in Thyroid Eye Disease: Kalman Filters to Track Extraocular Rectal Muscles.

    Science.gov (United States)

    Chaganti, Shikha; Nelson, Katrina; Mundy, Kevin; Luo, Yifu; Harrigan, Robert L; Damon, Steve; Fabbri, Daniel; Mawn, Louise; Landman, Bennett

    2016-02-27

    Pathologies of the optic nerve and orbit impact millions of Americans and quantitative assessment of the orbital structures on 3-D imaging would provide objective markers to enhance diagnostic accuracy, improve timely intervention and eventually preserve visual function. Recent studies have shown that the multi-atlas methodology is suitable for identifying orbital structures, but challenges arise in the identification of the individual extraocular rectus muscles that control eye movement. This is increasingly problematic in diseased eyes, where these muscles often appear to fuse at the back of the orbit (at the resolution of clinical computed tomography imaging) due to inflammation or crowding. We propose the use of Kalman filters to track the muscles in three-dimensions to refine multi-atlas segmentation and resolve ambiguity due to imaging resolution, noise, and artifacts. The purpose of our study is to investigate a method of automatically generating orbital metrics from CT imaging and demonstrate the utility of the approach by correlating structural metrics of the eye orbit with clinical data and visual function measures in subjects with thyroid eye disease. The pilot study demonstrates that automatically calculated orbital metrics are strongly correlated with several clinical characteristics. Moreover, the superior, inferior, medial and lateral rectus muscles obtained using Kalman filters are each correlated with different categories of functional deficit. These findings serve as foundation for further investigation in the use of CT imaging in the study, analysis and diagnosis of ocular diseases, specifically thyroid eye disease.

  10. Loss of MAFB Function in Humans and Mice Causes Duane Syndrome, Aberrant Extraocular Muscle Innervation, and Inner-Ear Defects.

    Science.gov (United States)

    Park, Jong G; Tischfield, Max A; Nugent, Alicia A; Cheng, Long; Di Gioia, Silvio Alessandro; Chan, Wai-Man; Maconachie, Gail; Bosley, Thomas M; Summers, C Gail; Hunter, David G; Robson, Caroline D; Gottlob, Irene; Engle, Elizabeth C

    2016-06-02

    Duane retraction syndrome (DRS) is a congenital eye-movement disorder defined by limited outward gaze and retraction of the eye on attempted inward gaze. Here, we report on three heterozygous loss-of-function MAFB mutations causing DRS and a dominant-negative MAFB mutation causing DRS and deafness. Using genotype-phenotype correlations in humans and Mafb-knockout mice, we propose a threshold model for variable loss of MAFB function. Postmortem studies of DRS have reported abducens nerve hypoplasia and aberrant innervation of the lateral rectus muscle by the oculomotor nerve. Our studies in mice now confirm this human DRS pathology. Moreover, we demonstrate that selectively disrupting abducens nerve development is sufficient to cause secondary innervation of the lateral rectus muscle by aberrant oculomotor nerve branches, which form at developmental decision regions close to target extraocular muscles. Thus, we present evidence that the primary cause of DRS is failure of the abducens nerve to fully innervate the lateral rectus muscle in early development.

  11. Structural functional associations of the orbit in thyroid eye disease: Kalman filters to track extraocular rectal muscles

    Science.gov (United States)

    Chaganti, Shikha; Nelson, Katrina; Mundy, Kevin; Luo, Yifu; Harrigan, Robert L.; Damon, Steve; Fabbri, Daniel; Mawn, Louise; Landman, Bennett

    2016-03-01

    Pathologies of the optic nerve and orbit impact millions of Americans and quantitative assessment of the orbital structures on 3-D imaging would provide objective markers to enhance diagnostic accuracy, improve timely intervention, and eventually preserve visual function. Recent studies have shown that the multi-atlas methodology is suitable for identifying orbital structures, but challenges arise in the identification of the individual extraocular rectus muscles that control eye movement. This is increasingly problematic in diseased eyes, where these muscles often appear to fuse at the back of the orbit (at the resolution of clinical computed tomography imaging) due to inflammation or crowding. We propose the use of Kalman filters to track the muscles in three-dimensions to refine multi-atlas segmentation and resolve ambiguity due to imaging resolution, noise, and artifacts. The purpose of our study is to investigate a method of automatically generating orbital metrics from CT imaging and demonstrate the utility of the approach by correlating structural metrics of the eye orbit with clinical data and visual function measures in subjects with thyroid eye disease. The pilot study demonstrates that automatically calculated orbital metrics are strongly correlated with several clinical characteristics. Moreover, it is shown that the superior, inferior, medial and lateral rectus muscles obtained using Kalman filters are each correlated with different categories of functional deficit. These findings serve as foundation for further investigation in the use of CT imaging in the study, analysis and diagnosis of ocular diseases, specifically thyroid eye disease.

  12. Agreement between intraoperative measurements and optical coherence tomography of the limbus-insertion distance of the extraocular muscles.

    Science.gov (United States)

    de-Pablo-Gómez-de-Liaño, L; Fernández-Vigo, J I; Ventura-Abreu, N; Morales-Fernández, L; García-Feijóo, J; Gómez-de-Liaño, R

    2016-12-01

    To assess the agreement between intraoperative measurements of the limbus-insertion distance of the extraocular muscles with those measured by spectral domain optical coherence tomography. An analysis was made of a total of 67 muscles of 21 patients with strabismus. The limbus-insertion distance of the horizontal rectus muscles were measured using pre-operative SD-OCT and intra-operatively in 2 ways: 1) direct, after a conjunctival dissection in patients who underwent surgery, or 2) transconjunctival in patients who were treated with botulinum toxin, or in those who were not going to be operated. The intraclass correlation coefficient and Bland-Altman plots were calculated to determine the concordance between the 2 methods. The mean age was 45.9 ±20.9 years (range 16 to 85), with 52% being women. The percentage of identification by direct intraoperative measurement was 95.6% (22/23), by transconjunctival intraoperative measurement 90.9% (40/44), and by OCT 85% (57/67), with 22 muscles finally being analysed for the agreement study between direct intraoperative measurement and OCT measurements, and 35 muscles for the agreement between transconjuctival intraoperative measurement and OCT. The intraclass correlation coefficient showed good agreement with OCT and direct intraoperative measurements (0.931; 95% confidence interval (95% CI): 0.839-0.972; P<.001), and with transconjunctival intraoperative measurements (0.889; 95% CI: 0.790-0.942; P<.001). The SD-OCT is an effective technique to measure the distance from the insertion of the horizontal rectus muscles to the limbus, with a high agreement with intraoperative measurements being demonstrated. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. A continuum of myofibers in adult rabbit extraocular muscle: force, shortening velocity, and patterns of myosin heavy chain colocalization.

    Science.gov (United States)

    McLoon, Linda K; Park, Han Na; Kim, Jong-Hee; Pedrosa-Domellöf, Fatima; Thompson, Ladora V

    2011-10-01

    Extraocular muscle (EOM) myofibers do not fit the traditional fiber typing classifications normally used in noncranial skeletal muscle, in part, due to the complexity of their individual myofibers. With single skinned myofibers isolated from rectus muscles of normal adult rabbits, force and shortening velocity were determined for 220 fibers. Each fiber was examined for myosin heavy chain (MyHC) isoform composition by densitometric analysis of electrophoresis gels. Rectus muscle serial sections were examined for coexpression of eight MyHC isoforms. A continuum was seen in single myofiber shortening velocities as well as force generation, both in absolute force (g) and specific tension (kN/m(2)). Shortening velocity correlated with MyHCIIB, IIA, and I content, the more abundant MyHC isoforms expressed within individual myofibers. Importantly, single fibers with similar or identical shortening velocities expressed significantly different ratios of MyHC isoforms. The vast majority of myofibers in both the orbital and global layers expressed more than one MyHC isoform, with up to six isoforms in single fiber segments. MyHC expression varied significantly and unpredictably along the length of single myofibers. Thus EOM myofibers represent a continuum in their histological and physiological characteristics. This continuum would facilitate fine motor control of eye position, speed, and direction of movement in all positions of gaze and with all types of eye movements-from slow vergence movements to fast saccades. To fully understand how the brain controls eye position and movements, it is critical that this significant EOM myofiber heterogeneity be integrated into hypotheses of oculomotor control.

  14. Abnormal expression of seven myogenesis-related genes in extraocular muscles of patients with concomitant strabismus

    National Research Council Canada - National Science Library

    ZHU, YUJUAN; DENG, DAMING; LONG, CHONGDE; JIN, GUORONG; ZHANG, QINGJIONG; SHEN, HUANGXUAN

    2013-01-01

    ...) and muscle creatine kinase (MCK). This study evaluated the expression of the above seven myogenesis-related genes by real-time quantitative RT-PCR in 18 resected extrocular muscles of patients with concomitant strabismus and 12...

  15. Crotoxin in humans: analysis of the effects on extraocular and facial muscles Crotoxina em humanos: estudo da ação em músculos extraoculares e faciais

    Directory of Open Access Journals (Sweden)

    Geraldo de Barros Ribeiro

    2012-12-01

    Full Text Available PURPOSE: Crotoxin is the main neurotoxin of South American rattlesnake Crotalus durissus terrificus. The neurotoxic action is characterized by a presynaptic blockade. The purpose of this research is to assess the ability of crotoxin to induce temporary paralysis of extraocular and facial muscles in humans. METHODS: Doses of crotoxin used ranged from 2 to 5 units (U, each unit corresponding to one LD50. We first applied 2U of crotoxin in one of the extraocular muscles of 3 amaurotic individuals to be submitted to ocular evisceration. In the second stage, we applied crotoxin in 12 extraocular muscles of 9 patients with strabismic amblyopia. In the last stage, crotoxin was used in the treatment of blepharospasm in another 3 patients. RESULTS: No patient showed any systemic side effect or change in vision or any eye structure problem after the procedure. The only local side effects observed were slight conjunctival hyperemia, which recovered spontaneously. In 2 patients there was no change in ocular deviation after 2U crotoxin application. Limitation of the muscle action was observed in 8 of the 12 applications. The change in ocular deviation after application of 2U of crotoxin (9 injections was in average 15.7 prism diopters (PD. When the dose was 4U (2 applications the change was in average 37.5 PD and a single application of 5U produced a change of 16 PD in ocular deviation. This effect lasted from 1 to 3 months. Two of the 3 patients with blepharospasm had the hemifacial spasm improved with crotoxin, which returned after 2 months. CONCLUSIONS: This study provides data suggesting that crotoxin may be a useful new therapeutic option for the treatment of strabismus and blepharospasm. We expect that with further studies crotoxin could be an option for many other medical areas.OBJETIVO: A crotoxina é a principal neurotoxina da cascavel sul-americana Crotalus durissus terrificus e sua ação neurotóxica caracteriza-se por um bloqueio pr

  16. CT in the diagnosis of isolated cysticercal infestation of extraocular muscle

    Energy Technology Data Exchange (ETDEWEB)

    Rauniyar, R.K.; Thakur, S.K.D.; Panda, A

    2003-02-01

    AIM: To evaluate the use of computed tomography (CT) and ultrasound (US) to diagnose orbital cysticercosis, and present the diagnostic features. METHOD: US and CT were used to evaluate patients with proptosis. Four patients were diagnosed as having orbital myocysticercosis and treated with oral albendazole and corticosteroid. Follow-up was undertaken with US and CT. RESULT: US features were confirmatory of myocysticercosis in two eyes where as CT was effective in diagnosing the condition in all four eyes. In two patients the medial rectus was involved, in one the superior rectus and, in the other, the inferior rectus muscles. Serial US and CT revealed complete resolution of the lesions in 3 months. CONCLUSION: CT is useful method in diagnosing isolated orbital myocysticercosis. Our report demonstrated that ophthalmic signs and symptoms in the presence of proptosis, especially in an endemic region, should alert the clinician to the possibility of myocysticercosis. Though CT is superior, US can be used as a economical follow-up investigation. Rauniyar, R. K. etal. (2003) Clinical Radiology58, 154--156.

  17. [Central nervous system abnormalities related to congenital fibrosis of extraocular muscles].

    Science.gov (United States)

    Moguel-Ancheita, Silvia; Rodríguez-Garcidueñas, Wendolyn

    2009-01-01

    We undertook this study to describe central nervous system (CNS) abnormalities associated with congenital cranial dysinnervation disorders (CCDD). This was a retrospective, observational, transversal and descriptive study including patients with congenital fibrotic strabismus. We analyzed clinical files of patients from 2001 to 2006. Neurological lesions were reported. Restrictive strabismus was demonstrated in all cases. Sixteen patients were included: nine males and seven females. Different neurological lesions were reported: corpus callosum anomalies, severe cortipathy, epilepsy, cavum vergae, nystagmus, occipital subarachnoid cyst, and hydrocephalus. Mental retardation was reported in 56% of patients. Different malformations were reported: genital malformations, trigonocephalus, camptodactyly, mild facial hypoplasia, low set ears, and agenesis of left ear. Blepharoptosis was present in 81% of patients. The most frequent form of strabismus was exotropia (56%), hypotropia in 37.5%, hypertropia 18.7%, "A" pattern 18.7%, and esotropia in 6.25%. Affection was cranial nerve III, 93.75%; cranial nerve VI, 6.25%; cranial nerve VII, 6.25%; and lesion to cranial nerve II in eight cases (50%). We have suggested that failure in early stages of embryology of the CNS can lead to the development of paralytic strabismus and generate secondary fibrotic changes, not only in muscle structures but also in other orbital tissues. That is the reason why we have used the term "congenital fibrotic strabismus" to report cases included in CCDD. We have demonstrated the strong association of mental retardation and neurological alterations. Multidisciplinary rehabilitation is relevant for these patients.

  18. Unilateral blindness with third cranial nerve palsy and abnormal enhancement of extraocular muscles on magnetic resonance imaging of orbit after the ingestion of methanol.

    Science.gov (United States)

    Chung, Tae Nyoung; Kim, Sun Wook; Park, Yoo Seok; Park, Incheol

    2010-05-01

    Methanol is generally known to cause visual impairment and various systemic manifestations. There are a few reported specific findings for methanol intoxication on magnetic resonance imaging (MRI) of the brain. A case is reported of unilateral blindness with third cranial nerve palsy oculus sinister (OS) after the ingestion of methanol. Unilateral damage of the retina and optic nerve were confirmed by fundoscopy, flourescein angiography, visual evoked potential and electroretinogram. The optic nerve and extraocular muscles (superior rectus, medial rectus, inferior rectus and inferior oblique muscle) were enhanced by gadolinium-DTPA on MRI of the orbit. This is the first case report of permanent monocular blindness with confirmed unilateral damage of the retina and optic nerve, combined with third cranial nerve palsy after methanol ingestion.

  19. Extraocular Muscles Tension, Tonus, and Proprioception in Infantile Strabismus: Role of the Oculomotor System in the Pathogenesis of Infantile Strabismus—Review of the Literature

    Directory of Open Access Journals (Sweden)

    Costantino Schiavi

    2016-01-01

    Full Text Available The role played by the extraocular muscles (EOMs in the etiology of concomitant infantile strabismus is still debated and it has not yet definitively established if the sensory anomalies in concomitant strabismus are a consequence or a primary cause of the deviation. The commonest theory supposes that most strabismus results from abnormal innervation of the EOMs, but the cause of this dysfunction and its origin, whether central or peripheral, are still unknown. The interaction between sensory factors and innervational factors, that is, esotonus, accommodation, convergence, divergence, and vestibular reflexes in visually immature infants with family predisposition, is suspected to create conditions that prevent binocular alignment from stabilizing and strengthening. Some role in the onset of fixation instability and infantile strabismus could be played by the feedback control of eye movements and by dysfunction of eye muscle proprioception during the critical period of development of the visual sensory system. A possible role in the onset, maintenance, or worsening of the deviation of abnormalities of muscle force which have their clinical equivalent in eye muscle overaction and underaction has been investigated under either isometric or isotonic conditions, and in essence no significant anomalies of muscle force have been found in concomitant strabismus.

  20. Restrictive extraocular myopathy: A presenting feature of acromegaly

    Directory of Open Access Journals (Sweden)

    Steven Heireman

    2011-01-01

    Full Text Available A 45-year-old man presented with binocular diplopia in primary gaze for 1 year. Orthoptic evaluation showed 10-prism diopter right eye hypotropia and 6-prism diopter right eye esotropia. The elevation and abduction of the right eye were mechanically restricted. This was associated with systemic features suggestive of acromegaly. Magnetic resonance imaging (MRI of the brain demonstrated a pituitary macroadenoma. An elevated serum insulin-like growth factor I level and the failure of growth hormone suppression after an oral glucose load biochemically confirmed the diagnosis of acromegaly. Computed tomography (CT of the orbit demonstrated bilateral symmetrical enlargement of the medial rectus and inferior rectus muscle bellies. All tests regarding Graves-Basedow disease were negative. Although rare, diplopia due to a restrictive extraocular myopathy could be the presenting symptom of acromegaly.

  1. A functional SNP in the regulatory region of the decay-accelerating factor gene associates with extraocular muscle pareses in myasthenia gravis

    KAUST Repository

    Heckmann, J M

    2009-08-13

    Complement activation in myasthenia gravis (MG) may damage muscle endplate and complement regulatory proteins such as decay-accelerating factor (DAF) or CD55 may be protective. We hypothesize that the increased prevalence of severe extraocular muscle (EOM) dysfunction among African MG subjects reported earlier may result from altered DAF expression. To test this hypothesis, we screened the DAF gene sequences relevant to the classical complement pathway and found an association between myasthenics with EOM paresis and the DAF regulatory region c.-198CG SNP (odds ratio8.6; P0.0003). This single nucleotide polymorphism (SNP) results in a twofold activation of a DAF 5?-flanking region luciferase reporter transfected into three different cell lines. Direct matching of the surrounding SNP sequence within the DAF regulatory region with the known transcription factor-binding sites suggests a loss of an Sp1-binding site. This was supported by the observation that the c.-198CG SNP did not show the normal lipopolysaccharide-induced DAF transcriptional upregulation in lymphoblasts from four patients. Our findings suggest that at critical periods during autoimmune MG, this SNP may result in inadequate DAF upregulation with consequent complement-mediated EOM damage. Susceptible individuals may benefit from anti-complement therapy in addition to immunosuppression. © 2010 Macmillan Publishers Limited. All rights reserved.

  2. A functional SNP in the regulatory region of the decay-accelerating factor gene associates with extraocular muscle pareses in myasthenia gravis.

    Science.gov (United States)

    Heckmann, J M; Uwimpuhwe, H; Ballo, R; Kaur, M; Bajic, V B; Prince, S

    2010-01-01

    Complement activation in myasthenia gravis (MG) may damage muscle endplate and complement regulatory proteins such as decay-accelerating factor (DAF) or CD55 may be protective. We hypothesize that the increased prevalence of severe extraocular muscle (EOM) dysfunction among African MG subjects reported earlier may result from altered DAF expression. To test this hypothesis, we screened the DAF gene sequences relevant to the classical complement pathway and found an association between myasthenics with EOM paresis and the DAF regulatory region c.-198C>G SNP (odds ratio=8.6; P=0.0003). This single nucleotide polymorphism (SNP) results in a twofold activation of a DAF 5'-flanking region luciferase reporter transfected into three different cell lines. Direct matching of the surrounding SNP sequence within the DAF regulatory region with the known transcription factor-binding sites suggests a loss of an Sp1-binding site. This was supported by the observation that the c.-198C>G SNP did not show the normal lipopolysaccharide-induced DAF transcriptional upregulation in lymphoblasts from four patients. Our findings suggest that at critical periods during autoimmune MG, this SNP may result in inadequate DAF upregulation with consequent complement-mediated EOM damage. Susceptible individuals may benefit from anti-complement therapy in addition to immunosuppression.

  3. Study of crotoxin on the induction of paralysis in extraocular muscle in animal model Estudo da crotoxina na indução de paralisia da musculatura extraocular em modelo animal

    Directory of Open Access Journals (Sweden)

    Geraldo de Barros Ribeiro

    2012-10-01

    Full Text Available PURPOSE: Crotoxin is the major toxin of the venom of the South American rattlesnake Crotalus durissus terrificus, capable of causing a blockade of the neurotransmitters at the neuromuscular junction. The objective of this study was to appraise the action and effectiveness of the crotoxin induced paralysis of the extraocular muscle and to compare its effects with the botulinum toxin type A (BT-A. METHODS: The crotoxin, with LD50 of 1.5 µg, was injected into the superior rectus muscle in ten New Zealand rabbits. The concentration variance was 0.015 up to 150 µg. Two rabbits received 2 units of botulinum toxin type A for comparative analysis. The evaluation of the paralysis was performed using serial electromyography. After the functional recovery of the muscles, which occurred after two months, six rabbits were sacrificed for anatomopathology study. RESULTS: The animals did not show any evidence of systemic toxicity. Transitory ptosis was observed in almost every animal and remained up to fourteen days. These toxins caused immediate blockade of the electrical potentials. The recovery was gradual in the average of one month with regeneration signs evident on the electromyography. The paralysis effect of the crotoxin on the muscle was proportional to its concentration. The changes with 1.5 µg crotoxin were similar to those produced by the botulinum toxin type A. The histopathology findings were localized to the site of the injection. No signs of muscle fiber's necrosis were seen in any sample. The alterations induced by crotoxin were also proportional to the concentration and similar to botulinum toxin type A in concentration of 1.5 µg. CONCLUSION: Crotoxin was able to induce transitory paralysis of the superior rectus muscle. This effect was characterized by reduction of action potentials and non-specific signs of fibrillation. Crotoxin, in concentration of 1.5 µg was able to induce similar effects as botulinum toxin type A.OBJETIVO: A

  4. Autologous grafting of extraocular muscles: experimental study in rabbits Transplante autólogo de musculatura ocular extrínseca: estudo experimental em coelhos

    Directory of Open Access Journals (Sweden)

    Jorge Meireles-Teixeira

    2005-06-01

    Full Text Available PURPOSE: To evaluate the feasibility of autologous extraocular muscle grafting as a type of muscle expansion surgery. METHODS: The left superior rectus muscle of twenty-nine rabbits was resected and this fragment was attached to the endpoint of the respective right superior rectus (test group. Thereafter, the superior rectus of the left eye was reattached to the sclera (control group. Both groups were examined during different postoperative periods in order to assess their outcomes. RESULTS: The presence of hyperemia was slightly more frequent in the grafted group. Secretion and muscle atrophy were negligible in both groups. Fibrosis was greater in grafted animals. These muscles were weaker than the control muscles, although the force required to split muscular parts was always greater than the physiological one. CONCLUSIONS: This surgical technique was reliable and useful if one intends to achieve muscle expansion without the intrinsic risks of dealing with heterologous/artificial materials.OBJETIVO: Avaliar a viabilidade do uso de segmentos de músculos oculares extrínsecos como expansores de tendões musculares. MÉTODOS: Vinte e nove coelhos tiveram seu músculo reto superior esquerdo ressecado e o fragmento de cada um foi transplantado para o reto superior contralateral (grupo-teste. Então, o reto superior esquerdo foi reinserido na esclera (grupo-controle. Os animais foram então examinados em diversos períodos pós-operatórios, até os seus sacrifícios, para que se avaliasse o desenrolar dessa técnica cirúrgica. RESULTADOS: A hiperemia foi maior entre os testes. A secreção e a atrofia muscular foram mínimas nos dois grupos. Houve maior presença de fibrose no grupo-teste, mas não tão expressiva a ponto de inviabilizar os efeitos da cirurgia. Esses músculos também se romperam mais facilmente do que os do grupo-controle, porém, a força de rompimento foi sempre bem maior do que aquela presente numa contração muscular normal

  5. Susceptible mechanisms of extraocular muscles in the passive transferred experimental myasthenia gravis rats%重症肌无力被动转移大鼠模型眼外肌的易感机制研究

    Institute of Scientific and Technical Information of China (English)

    刘睿; 王桂平; 杜婴; 周琼; 苗建亭; 李柱一

    2012-01-01

    目的 探讨眼外肌在重症肌无力发病过程中的易感机制.方法 给予SD大鼠腹腔注射mAb35建立重症肌无力被动转移(PTMG)大鼠模型,对照组大鼠注射等量生理盐水.选取PTMG组和对照组大鼠眼外肌、膈肌、胫前肌3种骨骼肌组织.采用乙酰胆碱酯酶(AChE)染色法观察神经肌肉接头(NMJ)并检测NMJ面积和灰度;采用银环蛇毒免疫组化法检测乙酰胆碱受体( AChR)数量;采用电镜观察NMJ超微结构和其AChR情况,并分析比较神经末端面积和突触后膜面积的比值以及突触前后膜长度的比值.结果 AChE染色结果显示,对照组眼外肌NMJ面积相对其他两种骨骼肌更小(P<0.01),PTMG组眼外肌与其他两种骨骼肌NMJ面积比较无统计学差异(P>0.05).银环蛇毒免疫组化结果显示,PTMG组和对照组眼外肌与其它两种骨骼肌间AChR灰度值比较均有统计学差异(P<0.01).电镜观察结果显示,PTMG组3种骨骼肌突触前后膜长度比值均较对照组下降(P<0.01),神经末端面积与突触后膜面积比值较对照组增加(P<0.01),其中眼外肌的变化较其他骨骼肌更为显著.结论 PTMG大鼠模型眼外肌易感机制可能与眼外肌和其他骨骼肌间NMJ面积、AChR数量差异造成眼外肌NMJ安全系数较低有关.%Objective To investigate the susceptible mechanisms of extraocular muscles in passive transferred experimental myasthenia gravis ( PTMG) rats. Methods PTMG model was induced by intraperitoneally injection of purified monoclonal antibody 35. The control group were intraperitoneally injected with normal saline. The extraocular muscles, diaphragms and tibial front muscles in the PTMG group and control group were dissected. Acetylcholinesterase staining, which showed neuromuscular junctions, and alpha bungarotoxin immunohistochemical reaction, which showed acetylcholine receptors (AChR) were used. Neuromuscular junction (NMJ) ultrastructure was observed by transmission

  6. Accommodation: The role of the external muscles of the eye: A consideration of refractive errors in relation to extraocular malfunction.

    Science.gov (United States)

    Hargrave, B K

    2014-11-01

    Speculation as to optical malfunction has led to dissatisfaction with the theory that the lens is the sole agent in accommodation and to the suggestion that other parts of the eye are also conjointly involved. Around half-a-century ago, Robert Brooks Simpkins suggested that the mechanical features of the human eye were precisely such as to allow for a lengthening of the globe when the eye accommodated. Simpkins was not an optical man but his theory is both imaginative and comprehensive and deserves consideration. It is submitted here that accommodation is in fact a twofold process, and that although involving the lens, is achieved primarily by means of a give - and - take interplay between adducting and abducting external muscles, whereby an elongation of the eyeball is brought about by a stretching of the delicate elastic fibres immediately behind the cornea. The three muscles responsible for convergence (superior, internal and inferior recti) all pull from in front backwards, while of the three abductors (external rectus and the two obliques) the obliques pull from behind forwards, allowing for an easy elongation as the eye turns inwards and a return to its original length as the abducting muscles regain their former tension, returning the eye to distance vision. In refractive errors, the altered length of the eyeball disturbs the harmonious give - and - take relationship between adductors and abductors. Such stresses are likely to be perpetuated and the error exacerbated. Speculation is not directed towards a search for a possible cause of the muscular imbalance, since none is suspected. Muscles not used rapidly lose tone, as evidenced after removal of a limb from plaster. Early attention to the need for restorative exercise is essential and results usually impressive. If flexibility of the external muscles of the eyes is essential for continuing good sight, presbyopia can be avoided and with it the supposed necessity of glasses in middle life. Early attention

  7. 先天性眼外肌纤维化一家系临床分析及手术治疗%Clinical features and surgical treatment on a family with congenital fibrosis of the extraocular muscles

    Institute of Scientific and Technical Information of China (English)

    张剑飞; 王亚丽; 陈静; 乔珊丽

    2014-01-01

    AIM: To investigate the clinical characteristics, surgical outcome and curative effect of congenital fibrosis of the extraocular muscles ( CFEOM) . METHODS: The eye exam of members in a Chinese family with CFEOM includes visual acuity, intraocular pressure, dilated fundus exam, extraocular muscle function test, orbital CT scan, and ultrasound. We did extraocular muscle surgery or frontalis suspension procedure for affected subjects in the family. RESULTS: The incidence of CFEOM in this family was 31%. All patients were affected bilateraly with symptom of congenital eye movement disorder, ptosis, hypotropia, perverted convergence on upgaze and chin up head position. As the age grows, the diseases worsen unobviously. No other systemic disorder was found. Surgical treatment improved the anomalous head position although the ocular movement disorder preserved. CONCLUSION: The pattern of inheritance in our serial patients are autosomal dominant. Surgery can improve chin up head position and cosmetic appearance. However, the eye movement deficiency cannot be improved.%目的:探讨家族性先天性眼外肌纤维化的临床特点、手术治疗方法及疗效。  方法:对先天性眼外肌纤维化家系成员进行眼部的各项检查,包括:视力、眼压、眼底、眼外肌功能、眼眶CT、双眼B超等检查,并对部分患者行斜视矫正术及额肌悬吊术。  结果:该家系眼外肌纤维化发病率为31%。该家系各患者均双眼受累,自幼表现为眼球运动障碍、上睑下垂,眼球位于下转位,向正前方注视时伴有异常辐辏,向前注视抬下颌。随年龄增长病情加重不明显。其他全身系统器官未见异常。经手术治疗,下颌上抬及外观可获得明显改善,眼球运动改善不明显。  结论:该家系具有常染色体显性遗传特征。通过手术治疗可改善头位及外观。眼球运动无明显改善。

  8. 80例以复视为首发症状的眼外肌麻痹病因分析%Analysis of 80 cases of extraocular muscles paralysis with diplopia

    Institute of Scientific and Technical Information of China (English)

    李彬

    2014-01-01

    目的:探讨以复视为首发症状的眼肌麻痹患者的临床特征、鉴别诊断,探讨其病因及发病机制。方法回顾分析2008至2013年我院神经内科收治以复视症状为主症的眼肌麻痹患者80例,根据病史、详细的查体和眼部检查,分析其发病原因。结果80例病例中,糖尿病性眼肌麻痹24例(动眼神经麻痹16例,外展神经麻痹6例,合并动眼神经、外展神经麻痹2例),脑血管病20例,动脉粥样硬化性动眼神经、外展神经麻痹18例,颅内动脉瘤者10例,重症肌无力眼肌型2例,躯体形式障碍1例,颅内肿瘤2例,多发性硬化1例,神经梅毒1例,脑干脑炎1例。结论很多神经系统疾病可引起复视的神经眼科体征,其中糖尿病性眼肌麻痹为最主要病因,脑血管病、动脉瘤眼肌麻痹、动脉粥样硬化也是重要原因,其他还有重症肌无力(眼肌型)、躯体形式障碍、颅内占位等。以复视为首发症状的急性眼外肌麻痹病因复杂,容易误诊,临床医生应高度重视,明确诊断,以达到正确治疗。%Objective To evaluate clinical features of extraocular muscles paralysis that initially presented with di -plopia.Methods Eighty cases with extraocular muscles paralysis were analyzed for causes of disease by reviewing medical history, a thorough physical examination and a complete eye examination .The clinical features were studied .Results Twenty-four patients with extraocular muscles paralysis were caused by diabetes , including oculomotor nerve paralysis ( 16 cases), abducent nerve paralysis (6 cases), and combination of oculomotor nerve and abducent nerve paralysis (2 cases). Twenty cases were caused by cerebrovascular diseases , and 18 cases were caused by arteriosclerosis resulted oculomotor and abducent nerve paralysis .Ten cases were caused by intracranial aneurysms ,two cases by myasthenia gravis ,one case by so-matization disorder ,two by

  9. 带状疱疹并发眼外肌麻痹11例临床分析%Analysis of 11 cases of herpes zoster complicated by extraocular muscles paralysis

    Institute of Scientific and Technical Information of China (English)

    杨晓鸥

    2012-01-01

    11例带状疱疹并发眼外肌麻痹患者均表现为眼睑及周围皮肤带状疱疹,疹后14天~2个月出现复视、斜视,持续4周~2个月.早期眼部外用、严重者系统应用糖皮质激素治疗可防止眼部后遗症的发生.%Eleven cases of herpes zoster complicated by extraocular muscles paralysis were reported. All cases presented herpes zoster of eyelids and nearby skin. Ten days to two months after the onset of herpes zoster, diplopia and esotropia occurred and lasted for 4 weeks to 2 months. Early application of glucocorticoids can prevent the occurrence of ocular sequelae.

  10. Metástase no músculo reto inferior como sinal de apresentação de adenocarcinoma renal: relato de caso Inferior rectus muscle metastasis as a presenting sign of renal cell carcinoma: case report

    Directory of Open Access Journals (Sweden)

    Allan Christian Pieroni Gonçalves

    2006-06-01

    Full Text Available Proptose e diplopia decorrentes de alargamento de músculo extra-ocular representam importante sinal de apresentação de várias afecções da órbita. Embora a causa mais comum de alargamento de músculo extra-ocular seja a orbitopatia distiroidiana, o diagnóstico diferencial destas doenças é extenso. Relatamos neste trabalho o caso de um paciente com história de diplopia e proptose unilateral de três meses que apresentava importante espessamento isolado do músculo reto inferior direito e após investigação clínica, radiológica e biopsia incisional teve o diagnóstico de tumor metastático de células renais para o músculo reto inferior. Há poucos casos relatados de metástases para a musculatura ocular extrínseca sendo assim nosso objetivo relatar um novo caso, revisar a literatura e reforçar a inclusão deste distúrbio no diagnóstico diferencial do espessamento da musculatura extra-ocular.Proptosis and diplopia due to enlargement of extraocular muscles represent important presenting signs of many orbital disorders. Although dysthyroid ophthalmopathy is the most common cause of enlargement of extraocular muscles, the differential diagnosis is extensive. We report a patient with a 3-month history of diplopia and unilateral proptosis and a markedly enlarged inferior rectus muscle on imaging studies. A biopsy of the lesion followed by systemic evaluation established the diagnosis of metastatic renal cell carcinoma. There are few cases of metastatic tumors to the extraocular muscles reported in the literature and thus our objective is to report a new case, review the literature and reiterate the inclusion of this disorder in the differential diagnosis of enlargement of the extraocular muscles.

  11. Human Brain Reacts to Transcranial Extraocular Light.

    Science.gov (United States)

    Sun, Lihua; Peräkylä, Jari; Kovalainen, Anselmi; Ogawa, Keith H; Karhunen, Pekka J; Hartikainen, Kaisa M

    2016-01-01

    Transcranial extraocular light affects the brains of birds and modulates their seasonal changes in physiology and behavior. However, whether the human brain is sensitive to extraocular light is unknown. To test whether extraocular light has any effect on human brain functioning, we measured brain electrophysiology of 18 young healthy subjects using event-related potentials while they performed a visual attention task embedded with emotional distractors. Extraocular light delivered via ear canals abolished normal emotional modulation of attention related brain responses. With no extraocular light delivered, emotional distractors reduced centro-parietal P300 amplitude compared to neutral distractors. This phenomenon disappeared with extraocular light delivery. Extraocular light delivered through the ear canals was shown to penetrate at the base of the scull of a cadaver. Thus, we have shown that extraocular light impacts human brain functioning calling for further research on the mechanisms of action of light on the human brain.

  12. Original hydroxyapatite orbital implant covered with small autoscleral flap with extraocular rectus muscles orbital implantation%直肌及其止端处小巩膜瓣下义眼台植入术研究

    Institute of Scientific and Technical Information of China (English)

    景明; 孙琰; 周哲; 高玉; 马戈; 葛茸茸; 王传星; 蔡金辉

    2015-01-01

    目的 观察自创的带直肌止点处小巩膜瓣下羟基磷灰石(HA)义眼台植入术的临床效果.方法 用自创方法行义眼台植入术296例(296只眼),随机对其中32例(32只眼)进行眼眶增强MRI检查以观察术后1周、1、2、3、4、5、6及18个月义眼台血管化进程.结果 所有病例随访1 ~18个月,义眼台活动良好,无义眼台外露发生.增强MRI检查显示义眼台于术后1个月即完全血管化,随着时间进展,血管化密度逐渐增大.结论 作者自创的带直肌止点区域小巩膜瓣下HA义眼台植入术,彻底解决了HA义眼台植入术外露的问题,促进义眼台血管化的优势明显,具有良好的使用前景.%Objective To observe the clinical efficacy of orbital implantation with original hydroxyapatite (HA) orbital implant covered with small autoscleral flap at extraocular rectus muscles insertions area which was designed by the author.Methods Thirty-two cases were randomly selected from a total of 296 patients who were treated with the original hydroxyapatite implantation method.Serial precontrast and postcontrast T1-weighted magnetic resonance imaging (MRI) were obtained at 1 week,1,2,3,4,5,6 and 18 months after implantation to assess the fibrovascularization of HA orbital implants.Results Patients were followed up for 1to18 months.In all cases HAs were fixed to orbit and moved well.There was no complication of prostheses exposure.Contrast-enhanced MRI showed the HA spheres had achieved complete vascularization 1 month after implantation.The vascularization density increased with time.Conclusion The author' s original hydroxyapatite orbital implantation covered with small autoscleral flap with extraocular rectus muscles method completely solves the problem of prostheses exposure complication and its advantage of promoting the fibrovascularization is obvious.The application prospect is good.

  13. Gingival Enlargement

    Science.gov (United States)

    ... 2) medication-induced gingival enlargement, 3) hereditary gingival fibromatosis, and 4) systemic causes of gingival enlargement. Inflammatory ... hygiene measures will reduce the severity. Hereditary Gingival Fibromatosis This is a rare hereditary condition that usually ...

  14. Study of extraocular muscle with direct injection of insulin-like growth factorⅠ%胰岛素样生长因子局部注射对眼外肌作用的实验研究

    Institute of Scientific and Technical Information of China (English)

    余新平; 许金玲; 陈洁; 黄盈; 余焕云; 张芳; 高军

    2010-01-01

    Objective To evaluate the effects on muscle mass and force generation of IGF-I injection in adult rabbit superior rectus muscle. Methods One superior rectus muscle in normal adult rabbits received a single injection of 10ug (0.05ml) IGF-I, and the contralateral muscle received an injection of 0.05ml saline only. One week after injection, muscle force and muscle morphology were studied both in IGF treated and control muscles. Results In the treated muscles, the mean single-twitch force generation was 2.4515+1.1019mN compared with 1.1511+0.6755mN (t =2.58, P =0.049) in control muscles. Mean titanic force generation was increased significantly at all stimulation frequencies. The cross-sectional area of muscles was 10.04+2.52mm2 compared with 7.79+1.85 mm2 (t =2.84, P =0.047) in control. The frequency of activated satellite cells was 30.63+6.76% compared with 17.07+5.36% in control (t =8.73, P =0.000). Conclusions Direct injection of IGF-I effectively increase extraocular muscle force generation with increased number of activated satellite cells.%目的 探讨局部注射胰岛素样生长因子(insulin-like growth factor-Ⅰ,IGF-Ⅰ)对成年兔眼外肌的作用及机制.方法 7只成年新西兰大白兔,双眼上直肌随机注射0.05ml(10靏)IGF-Ⅰ或0.05ml生理盐水,1周后肌肉张力换能器检测上直肌肌肉力量,获取上直肌行组织学检查.结果 实验组上直肌单刺激收缩力为(2.4515±1.1019)mN,对照组上直肌为(1.1511±0.6755)mN,差异有统计学意义(t =2.58,P =0.049),实验组上直肌各刺激频率的强直收缩力比对照组明显更大,均有显著性差别.实验组单位重量肌肉的收缩力比对照组更大,各刺激频率均有显著性差异.实验组上直肌横截面面积为(10.04±2.52)mm2较对照组(7.79±1.85) mm2明显更大,差异有统计学意义(t =2.84,P =0.047);实验组上直肌中活化的卫星细胞为(30.63±6.76)%,比对照组(17.07±5.36)%显著更高(t =8.73,P =0.000).结论 成年动物

  15. Eye muscle repair - discharge

    Science.gov (United States)

    ... Lazy eye repair - discharge; Strabismus repair - discharge; Extraocular muscle surgery - discharge ... You or your child had eye muscle repair surgery to correct eye muscle ... term for crossed eyes is strabismus. Children most often ...

  16. Histotopographical study of human periocular elastic fibers using aldehyde-fuchsin staining with special reference to the sleeve and pulley system for extraocular rectus muscles.

    Science.gov (United States)

    Osanai, Hajime; Murakami, Gen; Ohtsuka, Aiji; Suzuki, Daisuke; Nakagawa, Takashi; Tatsumi, Haruyuki

    2009-09-01

    The aim of this study was to investigate the detailed configuration of periocular elastic fibers. Semiserial paraffin sections were made using 40 whole orbital contents from 27 elderly cadavers and stained by the aldehyde-fuchsin method. Periocular tissues were classified into three types according to directions of the elastic fibers, i.e., tissues containing anteroposteriorly running elastic fibers, those with mediolateral fibers, and those with meshwork of fibers. Anteroposterior elastic fiber-dominant tissue was seen in the upper eyelid and newly defined pulley plate for the medial and lateral recti (MR, LR). Mediolateral fibers were predominant in the central part of the inferior rectus pulley. In the pulley plates for the MR and LR, anteroposteriorly running fibers encased the striated muscle. Tenon's capsule and the epimysium of the recti were mediolateral fiber-dominant. However, at the entrance of the muscle terminal where Tenon's capsule reflects and continues to the epimysium, composite elastic fibers provided a meshwork-like skeleton. The elastic mesh was also seen around the lacrimal canaliculi. The pulley for the recti seemed to be composed of two parts--a connective tissue plate encasing the recti and specialized Tenon's capsule at an entrance or porta of the muscle. For both parts, elastic fibers were major functional components. The anteroposterior elastic fibers in the MR and LR pulley plates, especially, seemed to receive anteroposteriorly directed stress and tension from these striated muscles. The elastic interfaces seemed to prevent any concentration of stress that would interfere with periocular striated muscle functions, including hypothetical active pulleys.

  17. 4D-visualization of the orbit based on dynamic MRI with special focus on the extra-ocular muscles and the optic nerves

    Energy Technology Data Exchange (ETDEWEB)

    Kober, C. [Univ. of Applied Sciences Osnabrueck (Germany); Boerner, B.I.; Buitrago, C.; Klarhoefer, M.; Scheffler, K.; Kunz, C.; Zeilhofer, H.F. [Univ. Hospital Basle (Switzerland)

    2007-06-15

    By recording time dependent patients' behaviour, dynamic radiology is dedicated to capturing functional anatomy. Dynamic 'quasi-continuous' MRI data of lateral eye movements of a healthy volunteer were acquired using SE imaging sequence (Siemens, 1.5 T). By means of combined application of several image processing and visualization techniques, namely shaded and transparent surface reconstruction as well as direct volume rendering, 4D-visualization of the dynamics of the extra ocular muscles was possible. Though the original MRI data were quite coarse vascular structures could be recognized to some extent. For the sake of 4D-visualization of the optic nerve, the optic cavity was opened by axial clipping of the visualization. Superimposition of the original MRI slices to the visualization, either transparently or opaque, served as validation and comparison to conventional diagnosis. For facilitation of the analysis of the visualization results, stereoscopic rendering was rated as quite significant especially in the clinical setting. (orig.)

  18. Enlarged Adenoids

    Science.gov (United States)

    ... a teen. Symptoms of Enlarged Adenoids Because adenoids trap germs that enter the body, adenoid tissue sometimes ... Nemours Foundation, iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart.com

  19. Enlarged prostate

    Science.gov (United States)

    ... prostate URL of this page: //medlineplus.gov/ency/article/000381.htm Enlarged prostate To use the sharing ... sperm during ejaculation. The prostate gland surrounds the urethra, the tube ... hyperplasia (BPH). It is not cancer, and it does not raise your risk for ...

  20. EU Enlargement

    DEFF Research Database (Denmark)

    Pedersen, Peder J.; Pytlikova, Mariola

    countries chose a transition period in relation to the "new" EU members. We employ a differences-in-differences estimator in our analysis. The results show that the estimated effect of the opening of Swedish labour market in 2004 on migration is insignificantly different from zero. Further, we......We look at migration flows from 8 Central and Eastern European Countries (CEECs) to 5 Nordic countries over the years 1985 - 2005 and we can exploit a natural experiment that arose from the fact that while Sweden opened its labour market from the day one of the 2004 EU enlargement, the other Nordic...

  1. Palisade endings of extraocular muscles in eyes with congenital nystagmus%先天性眼球震颤眼外肌栅栏状终末结构的研究

    Institute of Scientific and Technical Information of China (English)

    尚艳峰; 张静; 宫华青; 陈霞

    2012-01-01

    Objective To evaluate the morphology,distribution and function of palisade endings (PE) in human extraocular muscles (EOM),and observe the alterations in eyes with congenital nystagmus (CN).The etiology and pathogenesis of CN were also investigated.Methods It was a experimental study.The distal myotendinous junctions of the EOM were obtained during operation for CN ( CN group) and concomitant strabismus ( control group). The samples from patients with similar age and same extraction sites in the two groups were compared.The muscles cut during operation were immediately put into 4% glutaraldehyde fixative solution.And 1 - 2 transverse bands of tissue were cut every 1 mm from tendon insertion for specimens processing.The ultrastructure of EOM and PE in the two groups was observed by transmission electron microscopy. The distal parts of EOM cut during operation were put into 4% paraformaldehyde promptly.Myotendinous junction region whole mounts were labeled with antibodies against choline acetyltransferase (ChAT).Muscle fibers were counterstained with phalloidin.And longitudinal and transverse cryostat serial sections were cut at 25 μm and analyzed by confocal laser scanning microscopy.The ChAT expression,morphology and distribution of PE were observed.The same fragment of myotendinous junction in the two groups was selected.After the total protein was extracted,ChAT was detected by western blot.The expression level of ChAT was analyzed.Results Compared with the controls,the ultrastructure in the CN group had considerable variations.The axon of PE was swelled and deformed partly.The electron density was increased and presented as addicted to osmic acid. In the muscle cells,mitochondria was swelled,and sarcoplasmic reticulum was dilated.All PE exhibited ChAT immunoreactivity in human EOM.In the longitudinal section,nerve fibers extended from the muscle into the tendon,looped back and divided into several terminal arborizations (palisade endings) around the muscle

  2. 21 CFR 886.3340 - Extraocular orbital implant.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Extraocular orbital implant. 886.3340 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3340 Extraocular orbital implant. (a) Identification. An extraocular orbital implant is a nonabsorbable device intended to be implanted during...

  3. A study of the pathological changes and expression of the hepatocyte growth factor in the extraocular muscle in concomitant strabismus%共同性斜视眼外肌的病理变化及肝细胞生长因子表达研究

    Institute of Scientific and Technical Information of China (English)

    罗琪; 周炼红; 易贝茜; 叶美红; 徐永红

    2015-01-01

    目的:研究共同性斜视弱侧眼外肌的病理变化及肝细胞生长因子(HGF)的表达。方法实验研究。收集在武汉大学人民医院眼科行共同性斜视手术的58例患者手术中切下的眼外肌作为斜视组,将其分成共同性外斜视(32例)和共同性内斜视(26例)2组,同期10例角膜移植供体眼眼外肌作为对照组(供体均无斜视)。观察眼外肌的组织结构变化,用免疫组织化学法检测眼外肌中HGF的表达,并测定其平均光密度值。比较斜视组与对照组眼外肌HGF的表达差异,并分析其与斜视度、患者年龄之间相关性。所得数据采用t检验及直线相关分析进行统计学处理。结果①共同性外斜视组内直肌肌纤维横截面积(308.9±68.4)μm2,显著低于对照组内直肌[(738.4±56.3)μm2](t=16.74,P<0.05),共同性内斜视组外直肌肌纤维横截面积(217.9±34.7)μm2,显著低于对照组外直肌[(620.9±46.5)μm2](t=28.34,P<0.05),差异有统计学意义。②Masson染色显示共同性斜视弱侧眼外肌肌纤维数量减少,排列紊乱,胶原纤维含量增多,纤维组织、脂肪组织和肌纤维间隙增宽。③免疫组化检测HGF在对照眼眼外肌及斜视眼弱侧眼外肌中均有阳性表达,主要表达于胞浆,细胞外基质中有少量的表达。其中共同性外斜视组内直肌(t=6.33,P<0.05)、共同性内斜视组外直肌(t=4.75,P<0.05)HGF的表达均低于对照组。④HGF的表达与患者病程(r=-0.856,P<0.05)以及斜视度(r=-0.525,P<0.05)呈负相关。结论共同性斜视弱侧眼外肌出现胶原纤维增生,肌纤维横截面积减小等萎缩性病理改变;HGF的低表达可能是共同性斜视发生的危险因素。%Objective To study the pathomorphological changes and expression of hepatocyte growth factor (HGF) in the extraocular muscle in concomitant strabismus

  4. Breast enlargement in males

    Science.gov (United States)

    ... substances can cause breast enlargement: Alcohol Amphetamines Heroin Marijuana Methadone Men who have enlarged breasts may have an increased risk for breast cancer . Breast cancer in men is rare. Signs that ...

  5. Presumed isotretinoin-induced extraocular myopathy

    Directory of Open Access Journals (Sweden)

    Md. Shahid Alam

    2016-01-01

    Full Text Available Isotretinoin a synthetic analogue of vitamin A is primarily used for cystic acne not responding to conventional treatment. Several ocular side effects including blurring of vision, decreased dark adaptation, corneal opacities and meibomian gland atrophy have been reported with prolonged use of isotretinoin. There have been reports of muscular damage caused by isotretinoin. Extra ocular myopathy as an adverse effect of long term used of isotretinoin has never been mentioned in literature. We report a case of a young male who presented to us with complaints of diplopia after using isotretinoin for a prolonged period. He was diagnosed as a case of presumed isotretinoin extraocular myopathy after imaging and other blood investigations.

  6. Magnetic resonance imaging of congenital fibrosis of extraocular muscle associated with limb movement disorder in a family%伴有肢体运动障碍的先天性眼外肌纤维化综合征家系的影像学研究

    Institute of Scientific and Technical Information of China (English)

    周炼红; 李春义; 查云飞; 张俊涛; 刘甜

    2013-01-01

    Background Congenital fibrosis of extraocular muscles (CFEOM) affects patient' s appearance and quality of life,and no effective treatment for this disease is available.Imaging study is helpful for exploring the pathogenesis of CFEOM.Objective This study was to describe the characteristics of CFEOM associated with limb movement disorder using magnetic resonance imaging (MRI).Methods A family with CFEOM associated with limb movement disorder was investigated in Renmin Hospital of Wuhan University.Disease history was collected and the pedigree was investigated.Ophthalmologic examinations,including corrected visual acuity,refractive error,slitlamp examination,ophthalmoscopic examination,force of levator palpebrae superioris,ocular movement,eye position,forced duction test,and bell phenomenon examination,were performed.Ocular orbital and cranial MRI was performed in 4 CFEOM patients and 10 normal subjects to compare the structures of the extraocular muscles,motor nerve and cranium.Oral informed consent was obtained from each patient prior to any medical examination.Results A total of 1 1 members from 3 generations were investigated in this study,presenting with 4 cases of disease.The mode of inheritance of this family complied with the Mendelian autosomal dominant inheritance law.Clinical signs included disturbance of eye movement,deviation of eye position,ptosis,lack of Bell sign and positive reaction of passive pull test.In addition,unstable gait,improper body limb alignment,dysphasia and mental retardation were ohserved in 1 patient,which coincided with the diagnostic criteria of type 3 CFEOM.MRI results demonstrated that the levator palpebrae superioris,superior rectus and superior oblique muscle were clearly thinner,and the medial rectus,lateral rectus,inferior rectus muscle were thinning in the patients,showing significant differences in comparison with the normal controls(P<O.05).The oculomotor and abducens nerves became thinner and even absent in the patients

  7. Bilateral enlargement of the orbital muscles: first manifestation of renal adenocarcinoma; Espessamento da musculatura extrinseca orbitaria bilateralmente: manifestacao primaria de adenocarcinoma renal

    Energy Technology Data Exchange (ETDEWEB)

    Wolosker, Angela M. Borri; Bekhor, Daniel [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Escola Paulista de Medicina. Dept. de Diagnostico por Imagem; Goes, Paulo [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Escola Paulista de Medicina. Dept. de Oftalmologia; Attie, Greicie Cristina Gerra [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Escola Paulista de Medicina. Dept. de Patologia

    2000-06-01

    The authors present an unusual case of a patient with orbital metastases from renal carcinoma involving the extra ocular muscles bilaterally. The importance of computed tomography for the differential diagnosis with other orbital lesions is emphasized. (author)

  8. PROGRAMMED CELL DEATH IN EXTRAOCULAR MUSCLE TENDON/SCLERA PRECURSORS

    Science.gov (United States)

    AbstractPurpose: This study was designed to examine the occurrence of natural cell death in the periocular mesenchyme of mouse embryos. Methods: Vital staining with LysoTracker Red and Nile blue sulphate as well as terminal nick end labeling (TUNEL) were utiliz...

  9. PROGRAMMED CELL DEATH IN EXTRAOCULAR MUSCLE TENDON/SCLERA PRECURSORS

    Science.gov (United States)

    AbstractPurpose: This study was designed to examine the occurrence of natural cell death in the periocular mesenchyme of mouse embryos. Methods: Vital staining with LysoTracker Red and Nile blue sulphate as well as terminal nick end labeling (TUNEL) were utiliz...

  10. Genetics Home Reference: congenital fibrosis of the extraocular muscles

    Science.gov (United States)

    ... Cruse RP, Zubcov AA, Robb RM, Roggenkäemper P, Gottlob I, Kowal L, Battu R, Traboulsi EI, Franceschini ... Akarsu AN, Sabol LJ, Demer JL, Sullivan TJ, Gottlob I, Roggenkäemper P, Mackey DA, De Uzcategui CE, ...

  11. Enlargements of positive sets

    CERN Document Server

    Bot, Radu Ioan

    2008-01-01

    In this paper we introduce the notion of enlargement of a positive set in SSD spaces. To a maximally positive set $A$ we associate a family of enlargements $\\E(A)$ and characterize the smallest and biggest element in this family with respect to the inclusion relation. We also emphasize the existence of a bijection between the subfamily of closed enlargements of $\\E(A)$ and the family of so-called representative functions of $A$. We show that the extremal elements of the latter family are two functions recently introduced and studied by Stephen Simons. In this way we extend to SSD spaces some former results given for monotone and maximally monotone sets in Banach spaces.

  12. Amlodipine induced gingival enlargement

    Directory of Open Access Journals (Sweden)

    Shankar Gittaboyina

    2016-01-01

    Full Text Available Drug-induced gingival overgrowth or enlargement is an abnormal growth of the gingiva due to an adverse drug reaction in patients treated with anticonvulsants, immunosuppressants, and calcium channel blockers (CCBs. CCBs are considered as one of the etiologic factors among patients seeking dental care for drug-induced gingival enlargement or overgrowth. This enlargement can be localized or generalized and can range from mild to extremely severe, affecting patient's appearance, and function. CCBs are one of the most commonly used drugs for the management of cardiovascular disorders and are known for causing gingival over growth. Amlodipine is a new CCB and has been used with increasing frequency in the management of hypertension and angina. Although amlodipine is considered as a safe drug, very rarely it may induce gingival overgrowth. A rare case of amlodipine-induced gingival overgrowth has been reported herein a 45-year-old female patient. The treatment aspect included scaling and root planing, substitution of the drug, the surgical excision, and the maintenance and supportive therapy resulting in an excellent clinical outcome.

  13. Enlargements of filtrations and applications

    CERN Document Server

    Corcuera, J M

    2012-01-01

    In this paper we review some old and new results about the enlargement of filtrations problem, as well as their applications to credit risk and insider trading problems. The enlargement of filtrations problem consists in the study of conditions under which a semimartingale remains a semimartingale when the filtration is enlarged, and, in such a case, how to find the Doob-Meyer decomposition. Filtrations may be enlarged in different ways. In this paper we consider initial and progressive filtration enlargements made by random variables and processes. Keywords: Credit Risk, Insider Trading, Enlargement of Filtrations

  14. Comparação entre os métodos de injeção de toxina botulínica em músculo ocular externo com o uso do eletromiógrafo e com o uso da pinça de Mendonça Electromyograph assistance and Mendonça's forceps - a comparison between two methods of botulinum toxin A injection into the extraocular muscle

    Directory of Open Access Journals (Sweden)

    Tomás Fernando Scalamandré Mendonça

    2005-04-01

    Full Text Available OBJETIVO: Comparar dois métodos de aplicação de toxina botulínica A (TBA em músculo ocular externo: com auxílio de eletromiógrafo (EMG e com a pinça de Mendonça. MÉTODOS: Foram analisados no Departamento de Oftalmologia da UNIFESP 29 pacientes que apresentavam estrabismo e baixa acuidade visual em um olho. Foram divididos em dois grupos: grupo I - 17 pacientes que receberam a toxina botulínica A por meio de injeção com auxílio da pinça de Mendonça e grupo II - 12 pacientes que receberam a toxina botulínica A por injeção guiada pelo eletromiógrafo. Os pacientes dos dois grupos foram avaliados no 7º e no 14º dia após aplicação. Compararam-se os resultados dos dois grupos neste período de tempo. Os testes de correlação de Friedman e Mann-Whitney foram usados para análise estatística. RESULTADOS: Houve diferença estatística entre as médias de desvio pré-aplicação e em pelo menos um período (7º ou 14º dia após aplicação, tanto no grupo dos pacientes em que foi utilizada a pinça, quanto no grupo de pacientes em que foi utilizado o eletromiógrafo. Não houve diferença estatística dos desvios pré-aplicação e pós-aplicação entre os dois grupos. CONCLUSÃO: Os dois métodos de aplicação da toxina botulínica A são equivalentes e portanto, o uso da pinça de Mendonça pode ser método alternativo ao uso do eletromiógrafo, para guiar a injeção de toxina botulínica A.PURPOSE: To compare two methods of botulinum toxin A (BTA injection into the extraocular muscle (EOM: the electromyographically (EMG guided injection and the injection using Mendonça's forceps. METHODS: Twenty-nine (29 patients with strabismus and low visual acuity in one eye were examined at the Department of Ophthalmology of UNIFESP. They were divided into 2 groups - group I with 17 patients receiving the botulinum toxin A injection using Mendonça's forceps, and group II with 12 patients receiving the toxin with electromyographical

  15. [Treatment of primary retinal detachment. Minimal extraocular or intraocular?].

    Science.gov (United States)

    Kreissig, I

    2002-06-01

    The developments in treatment modalities for a primary retinal detachment over the last 70 years have been reviewed. There was a change from a surgery limited to the area of the break to a form of prophylactic surgery including the extent of the detachment. In between Rosengren had limited the treatment to the break with an intraocular gas bubble. A change was brought about by Custodis in 1953 who limited surgery to the break and omitted drainage. This procedure had serious postoperative complications which were eliminated by Lincoff by developing the cryosurgical detachment operation which was subsequently refined to extraocular minimal surgery. The ultimate realization of a minimal extraocular approach was the operation with a temporary balloon. Two additional intraocular procedures evolved, pneumatic retinopexy and primary vitrectomy, following one or the other pattern of treatment. With all four methods reattachment can result in 94-99% of the cases but differences can be seen in the morbidity and rate of reoperations.

  16. Intraocular and extraocular hemorrhage associated with ligature release of non-valved glaucoma drainage implant

    Directory of Open Access Journals (Sweden)

    Michelle Go

    2017-04-01

    Conclusions: and importance: This is the first report of a rare occurrence of intraocular and extraocular hemorrhage associated following spontaneous release of ligature of a non-valved glaucoma drainage implant. The presumed mechanism was sudden shallowing of the anterior chamber resulting in the tube irritating uveal vasculature. We do not have an explanation for the extraocular blood.

  17. Methods of Enlarging English Vocabulary

    Institute of Scientific and Technical Information of China (English)

    丁小航

    2012-01-01

      In order to enlarge English vocabulary , we need to have some methods. I’d like to share my experience with begin⁃ners how I enlarge English vocabulary when when I am learning English. It is a long process and needs hard work and patience.

  18. Stimulation of the retina with a multielectrode extraocular visual prosthesis.

    Science.gov (United States)

    Chowdhury, Vivek; Morley, John W; Coroneo, Minas T

    2005-08-01

    An extraocular approach to developing a retinal prosthesis for blind patients using electrodes placed on the outer surface of the eye is suggested. Experiments were carried out to determine the feasibility of this approach, and evaluate electrode configurations and parameters for stimulation. In anaesthetized cats, a 21-electrode extraocular retinal prosthesis (ERP) array was sutured to the sclera over the lateral surface of the eye. Electrically evoked potentials (EEP) were recorded at the visual cortex bilaterally in response to retinal stimulation with the electrode array. Bipolar stimulation of the ERP array electrodes in horizontal and vertical configurations and at different interelectrode separations was investigated with biphasic constant-current pulses. Electrical stimulation of the lateral retina with an ERP elicited EEP that were higher in the ipsilateral visual cortex. The threshold for bipolar retinal stimulation was 500 microA. EEP amplitude increased with increases in stimulus pulse duration and current intensity. Retinal stimulation was slightly more effective with electrodes in a vertical as opposed to horizontal orientation. A larger interelectrode separation resulted in a higher EEP amplitude. Retinal stimulation with a prototype ERP array is demonstrated. The thresholds for retinal excitation are below safe charge-density limits for chronic neural stimulation. Ipsilateral localization of the EEP suggests that localized retinal stimulation is occurring. An ERP is a new approach to retinal prosthesis research, and might lead to the development of a low-resolution visual prosthesis for blind patients.

  19. MRI of extraocular orbital diseases; Comparison with CT

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, Hiroyuki (Nagasaki Univ. (Japan). School of Medicine)

    1990-12-01

    The author investigated the usefulness of MRI in the diagnosis of extraocular orbital diseases, and the diagnostic ability of MRI was compared with that of CT. The materials consisted of 38 cases of diseases in extraocular orbital region (all cases were examined with MRI and 34 of them were also examined with CT). MRI was performed with spin echo or STIR sequences using a 1.5 tesla superconductive unit (GE SIGNA). CT was performed using SOMATOM CR and DR-H. The study showed that MRI was equally or more useful than CT in detecting lesions as well as assessing the internal architecture and extension of the lesions. Differentiation between benign and malignant tumors by MRI is difficult from their signal intensity only and can be made from their extraorbital extension, just as by CT. In Graves' orbitopathy, T{sub 2}-weighted images were more sensitive in reflecting its new or old pathological changes than CT. T{sub 1}-weighted images enhanced with Gd-DTPA were useful in differentiating sphenoid wing meningiomas from other tumors, but not useful in assessing the degree of intraorbital extension. STIR sequences were particularly useful in the diagnosis of optic nerve atrophy and expectd to be applied to the lesions which were not detected or poorly demonstrated with CT and spin echo sequences. (author).

  20. Prevalence of Diplopia and Extraocular Movement Limitation according to the Location of Isolated Pure Blowout Fractures

    Directory of Open Access Journals (Sweden)

    Min Seok Park

    2012-05-01

    Full Text Available Background Isolated pure blowout fractures are clinically important because they are themain cause of serious complications such as diplopia and limitation of extraocular movement.Many reports have described the incidence of blowout fractures associated with diplopiaand limitation of extraocular movement; however, no studies have statistically analyzedthis relationship. The purpose of this study was to demonstrate the correlation betweenthe location of isolated pure blowout fractures and orbital symptoms such as diplopia andlimitation of extraocular movement.Methods We enrolled a total of 354 patients who had been diagnosed with isolated pureblowout fractures, based on computed tomography, from June 2008 to November 2011.Medical records were reviewed, and the prevalence of extraocular movement limitations anddiplopia were determined.Results There were 14 patients with extraocular movement limitation and 58 patientscomplained of diplopia. Extraocular movement limitation was associated with the followingfindings, in decreasing order of frequency: floor fracture (7.1%, extended fracture (3.6%,and medial wall (1.7%. However, there was no significant difference among the types offractures (P=0.60. Diplopia was more commonly associated with floor fractures (21.4%and extended type fractures (23.6% than medial wall fractures (10.4%. The difference wasstatistically significant (Bonferroni-corrected chi-squared test P<0.016.Conclusions Data indicate that extended type fractures and orbital floor fractures tend tocause diplopia more commonly than medial wall fractures. However, extraocular movementlimitation was not found to be dependent on the location of the orbital wall fracture.

  1. Atomic Force Microscopy Determination of Young’s Modulus of Bovine Extra-ocular Tendon Fiber Bundles

    Science.gov (United States)

    Yoo, Lawrence; Reed, Jason; Shin, Andrew; Demer, Joseph L.

    2014-01-01

    Extra-ocular tendons (EOTs) transmit the oculorotary force of the muscles to the eyeball to generate dynamic eye movements and align the eyes, yet the mechanical properties of the EOTs remain undefined. The EOTs are known to be composed of parallel bundles of small fibers whose mechanical properties must be determined in order to characterize the overall behavior of EOTs. The current study aimed to investigate the transverse Young’s modulus of EOT fiber bundles using atomic force microscopy (AFM). Fresh bovine EOT fiber bundle specimens were maintained under temperature and humidity control, and indented 100 nm by the inverted pyramid tip of an AFM (Veeco Digital Instruments, NY). Ten indentations were conducted for each of 3 different locations of 10 different specimens from each of 6 EOTs, comprising a total of 1,800 indentations. Young’s modulus for each EOT was determined using a Hertzian contact model. Young’s moduli for fiber bundles from all six EOTs were determined. Mean Young’s moduli for fiber bundles were similar for the six anatomical EOTs: lateral rectus 60.12 ± 2.69 (±SD) MPa, inferior rectus 59.69 ± 5.34 MPa, medial rectus 56.92 ±1.91 MPa, superior rectus 59.66 ±2.64 MPa, inferior oblique 57.7± 1.36 MPa, and superior oblique 59.15± 2.03. Variation in Young’s moduli among the six EOTs was not significant (P > 0.25). The Young’s modulus of bovine EOT fibers is highly uniform among the six extraocular muscles, suggesting that each EOT is assembled from fiber bundles representing the same biomechanical elements. This uniformity will simplify overall modeling. PMID:24767704

  2. Gingival enlargement in myelodysplastic syndrome

    Directory of Open Access Journals (Sweden)

    Navia George

    2015-01-01

    Full Text Available The myelodysplastic syndrome (MDS is characterized by peripheral blood cytopenias and increased risk of transformation to acute myeloid leukemia. This syndrome affects blood cell production and behavior. MDS is difficult to diagnose because of the absence of symptoms in the early stage of the disease. Often it is accidentally discovered during a routine physical exam/blood test. Till date, only a few cases of gingival enlargement associated with MDS are reported in the literature. Here is a remarkable case of gingival enlargement heralding the presence of MDS.

  3. EU ENLARGEMENT AT A CROSSROADS

    Directory of Open Access Journals (Sweden)

    Andreea Cătălina Paul

    2012-06-01

    Full Text Available The present article aims to explore the general theme of the EU enlargement strategy in the new 2012 European context. Until now, the EU’s enlargement strategy has yielded impressive results. It succeeded in transforming ten central and eastern European countries from post-communism confusion into open-market, mature and effective systems of democratic governments, and even on the economic front, they have also made astonishing progress. It is no doubt that people in the new EU countries live better then before. In this context, the EU must continue the enlargement process to help stabilize the Balkan region that lie beyond its expanded eastern border. No one can deny that major issues concerning western Balkan countries’ accession are still on the table, and they even exert a geopolitical influence of sorts. This makes it all the more important to see stability and regional co-operation there are strategically vital. An all-out effort must now be made to complete the enlargement process and ensure there is no strategic vacuum. This article provides the framework of analyses for the EU problems and the challenges for the Balkans governments as for Brussels.

  4. Gingival enlargement in partial hemifacial hyperplasia

    OpenAIRE

    Jagtap, Rasika Ravindra; Deshpande, Gaurav Shekhar

    2014-01-01

    Hemifacial hypertrophy is a rare developmental disorder, characterized by unilateral enlargement of facial tissues. The hemifacial hyperplasia is classified as true hemifacial hypertrophy and partial hemifacial hypertrophy. It is unilateral enlargement of viscerocranial condition in which not all structures are enlarged. We present a rare case of gingival enlargement in partial hemifacial hyperplasia highlighting the clinical and radiological findings with the corrective treatment offered for...

  5. Extraocular Light Therapy in Winter Depression : A Double-blind Placebo-controlled Study

    NARCIS (Netherlands)

    Koorengevel, Kathelijne M.; Gordijn, Marijke C.M.; Beersma, Domien G.M.; Meesters, Ybe; den Boer, Johan; Hoofdakker, Rutger H. van den; Daan, Serge

    2001-01-01

    Background: It has been hypothesized that the circadian pacemaker is phase delayed in seasonal affective disorder, (SAD) winter type, and that the phase advance resulting from morning ocular light accounts for the efficacy of light therapy. Extraocular light has been reported to produce phase-shifts

  6. The Fungal Defensin Family Enlarged

    Directory of Open Access Journals (Sweden)

    Jiajia Wu

    2014-08-01

    Full Text Available Fungi are an emerging source of peptide antibiotics. With the availability of a large number of model fungal genome sequences, we can expect that more and more fungal defensin-like peptides (fDLPs will be discovered by sequence similarity search. Here, we report a total of 69 new fDLPs encoded by 63 genes, in which a group of fDLPs derived from dermatophytes are defined as a new family (fDEF8 according to sequence and phylogenetic analyses. In the oleaginous fungus Mortierella alpine, fDLPs have undergone extensive gene expansion. Our work further enlarges the fungal defensin family and will help characterize new peptide antibiotics with therapeutic potential.

  7. Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base.

    Science.gov (United States)

    Thirumala, Parthasarathy D; Mohanraj, Santhosh Kumar; Habeych, Miguel; Wichman, Kelley; Chang, Yue-Fang; Gardner, Paul; Snyderman, Carl; Crammond, Donald J; Balzer, Jeffrey

    2013-06-01

    Objective To evaluate the value of free-run electromyography (f-EMG) monitoring of extraocular cranial nerves (EOCN) III, IV, and VI during expanded endonasal surgery (EES) of the skull base in reducing iatrogenic cranial nerve (CN) deficits. Design We retrospectively identified 200 patients out of 990 who had at least one EOCN monitored during EES. We further separated patients into groups according to the specific CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as Group I and those who did not as Group II. Results A total of 696 EOCNs were monitored. The number of muscles supplied by EOCNs that had SG f-EMG activity was 88, including CN III = 46, CN IV = 21, and CN VI = 21. There were two deficits involving CN VI in patients who had SG f-EMG activity during surgery. There were 14 deficits observed, including CN III = 3, CN IV = 2, and CN VI = 9 in patients who did not have SG f-EMG activity during surgery. Conclusions f-EMG monitoring of EOCN during EES can be useful in identifying the location of the nerve. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of EOCN during EES need to be done with both f-EMG and triggered EMG.

  8. Idiopathic gingival enlargement and its management

    Directory of Open Access Journals (Sweden)

    Pawan Kumar

    2015-01-01

    Full Text Available Increase in the size of gingiva referred to as "gingival enlargement," usually overfills the interproximal spaces, ballooning out over the teeth and sometimes even protruding into the oral cavity. It may occur as localized enlargement in relation to a single tooth, a group of teeth, or may be generalized involving the entire dentition. It is multifactorial in origin having the influence of bacterial plaque, systemic factors or conditions, genetic predisposition (hereditary or familial, and various medications. Sometimes, it may appear as diffuse enlargement of gingiva without any specific etiologic factor. It is then considered as idiopathic enlargement. In this case report, an idiopathic gingival enlargement was successfully treated using gingivectomy by ledge and wedge procedure. The surgical technique performed yielded functionally as well as esthetically satisfying results. Gingivectomy provides a viable option to manage diffuse enlargement cases. This procedure provides the functional as well as esthetic demands and at the same time, it maintains the integrity of periodontium.

  9. Unusual Gingival Enlargement: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Ashutosh Dixit

    2014-01-01

    Full Text Available This is an atypical case report of a 20-year-old male patient who suffered from unusual unilateral, gingival enlargement together with rapidly progressive alveolar bone loss. The enlarged gingiva completely covered his left posterior teeth in both arches. The patient was diagnosed with gingival fibromatosis and aggressive periodontitis based on the clinical, histological, and radiographic findings. The gingival enlargement was treated by conventional gingivectomy under local anaesthesia. The postoperative result was uneventful.

  10. Aggressive Extraocular Sebaceous Carcinoma Recurring after Mohs Micrographic Surgery

    Directory of Open Access Journals (Sweden)

    Konstantin V. Grigoryan

    2015-01-01

    Full Text Available Sebaceous carcinomas (SC are rare adnexal tumors with possible aggressive behavior usually arising in the head and neck region of adults in the seventh decade of life. Treatment has traditionally been with surgical excision with 5-6 mm wide margins but Mohs micrographic surgery (MMS has also been reported as an effective treatment modality. We present a case of a Caucasian female renal transplant patient with a rapidly enlarging nodule on the left preauricular cheek that was excised with MMS with negative margins. The tumor recurred rapidly and metastasized ultimately leading to the death of the patient. There was some disagreement amongst pathologists as to the possible nature of the diagnosis with the original biopsy being labeled as a poorly differentiated carcinoma. We aim to highlight the potential aggressive nature of SC and review the features of the neoplasm including histological features that help in making the diagnosis.

  11. The European Union's Eastward Enlargement

    Directory of Open Access Journals (Sweden)

    Hanns-D. Jacobsen

    1997-08-01

    Full Text Available In July 1997 the Commission of the European Union presented its Agenda 2000. This document not only suggested to start accession talks with some East and Central European countries (CEEC in early 1998 but it also provided proposals for a restructuring of EU expenditures. On this background this contribution discusses the state of readiness of the Central and East European countries to become EU members over the next few years and the Union's capacity to absorb up to ten CEEC over the next decade or so. This study concludes that the European Union has become an anchor of stability to the CEEC that guarantees both democracy and economic security--much more than could be expected only a couple of years ago. The Union's readiness to accept the membership of CEEC has, in a decisive way, contributed to their societal, political and economic stabilization. There is almost a contest among the CEEC on which one is going to meet the accession criteria first and best. The enlargement process, however, is connected to problems the resolution of which realistically postpone its successful conclusion at least into the year 2005. The main reasons are (1 the welfare gap between the EU area and the CEEC, (2 the need for more institutional and economic changes in the CEEC to make them ready for acces-sion, and, most importantly, (3 the necessity for the European Union to prepare herself for accession by a comprehensive financial reform and fundamental institutional changes.

  12. Treatment of the Enlarged Clitoris

    Science.gov (United States)

    Kaefer, Martin; Rink, Richard C.

    2017-01-01

    Management of the enlarged clitoris, because of its import for sexual function, has been and remains one of the most controversial topics in pediatric urology. Early controversy surrounding clitoroplasty resulted from many factors including an incomplete understanding of clitoral anatomy and incorrect assumptions of the role of the clitoris in sexual function. With a better understanding of anatomy and function, procedures have evolved to preserve clitoral tissue, especially with respect to the neurovascular bundles. These changes have been made in an effort to preserve clitoral sensation and preserve orgasmic potential. It is the goal of this manuscript to describe the different procedures that have been developed for the surgical management of clitoromegally, with emphasis on the risks and benefits of each. Equally important to any discussion of such a sensitive topic is an understanding of long-term patient outcomes. As we will see, despite its importance, there has been a dearth of data in this regard. Future work in the arena of patient satisfaction will undoubtedly play a major role in directing our surgical approach. PMID:28894728

  13. Treatment of the Enlarged Clitoris

    Directory of Open Access Journals (Sweden)

    Martin Kaefer

    2017-08-01

    Full Text Available Management of the enlarged clitoris, because of its import for sexual function, has been and remains one of the most controversial topics in pediatric urology. Early controversy surrounding clitoroplasty resulted from many factors including an incomplete understanding of clitoral anatomy and incorrect assumptions of the role of the clitoris in sexual function. With a better understanding of anatomy and function, procedures have evolved to preserve clitoral tissue, especially with respect to the neurovascular bundles. These changes have been made in an effort to preserve clitoral sensation and preserve orgasmic potential. It is the goal of this manuscript to describe the different procedures that have been developed for the surgical management of clitoromegally, with emphasis on the risks and benefits of each. Equally important to any discussion of such a sensitive topic is an understanding of long-term patient outcomes. As we will see, despite its importance, there has been a dearth of data in this regard. Future work in the arena of patient satisfaction will undoubtedly play a major role in directing our surgical approach.

  14. The European Union's Eastward Enlargement

    Directory of Open Access Journals (Sweden)

    Hanns-D. Jacobsen

    1997-08-01

    Full Text Available In July 1997 the Commission of the European Union presented its Agenda 2000. This document not only suggested to start accession talks with some East and Central European countries (CEEC in early 1998 but it also provided proposals for a restructuring of EU expenditures. On this background this contribution discusses the state of readiness of the Central and East European countries to become EU members over the next few years and the Union's capacity to absorb up to ten CEEC over the next decade or so. This study concludes that the European Union has become an anchor of stability to the CEEC that guarantees both democracy and economic security--much more than could be expected only a couple of years ago. The Union's readiness to accept the membership of CEEC has, in a decisive way, contributed to their societal, political and economic stabilization. There is almost a contest among the CEEC on which one is going to meet the accession criteria first and best. The enlargement process, however, is connected to problems the resolution of which realistically postpone its successful conclusion at least into the year 2005. The main reasons are (1 the welfare gap between the EU area and the CEEC, (2 the need for more institutional and economic changes in the CEEC to make them ready for acces-sion, and, most importantly, (3 the necessity for the European Union to prepare herself for accession by a comprehensive financial reform and fundamental institutional changes.

  15. Tendinous muscle insertions (scleromuscular junctions of the recti muscles) in patients with ocular alignment problems.

    Science.gov (United States)

    Todorova, M G; Palmowski-Wolfe, A M; Meyer, P

    2015-04-01

    The purpose of this study was to prove the hypothesis whether the scleromuscular junction of extraocular recti muscle is tendinous. Muscle samples of the 41 extraocular recti muscles of 33 patients and 4 muscle-/eye-matched samples from 2 postmortem eyes, were processed for light/electron microscopy and immunohistochemistry with antibodies against desmin, smooth-muscle actin and muscle regulating proteins like myf3 and myf4 (myogenin), tenascin C and for 8 samples against collagens I to IV. Histological examination of the muscle samples confirmed a thick collagen-structured tissue, specific for muscle tendon; without appearance of muscle tissue. This was confirmed by immunohistochemistry with antibodies against desmin, smooth-muscle actin, myf3 and myf4 (myogenin) and for eight samples with collagens I to IV. Anti-tenascin C marker was only strongly positive in the connective tissue of the blood vessel walls. Electron microscopy demonstrated collagen bundles composed of parallel oriented fibrils with a moderate amount of ground substance. The absence of contractile fibers at the sclerotendinous junction is an entirely normal finding in humans and cannot be related to ocular alignment pathogenesis. Georg Thieme Verlag KG Stuttgart · New York.

  16. The "New Politics" of EU's Eastern Enlargement

    DEFF Research Database (Denmark)

    Zank, Wolfgang

    The paper gives an overview of EU's eastern enlargement and draws some theoretical conclusions. In particular, it stresses the point that the EU member states in the process of enlargement have entered a phase of "new politics", characterised by multilateralism, conditionality, help and binding a...

  17. Squamous cell carcinoma of the conjunctiva with extraocular involvement: case report and literature review

    Directory of Open Access Journals (Sweden)

    Ignacio Goñi Espildora

    2016-05-01

    Full Text Available Resumen El carcinoma escamoso de la conjuntiva es el tumor maligno más frecuente de la superficie ocular. Constituye una enfermedad rara con una incidencia de 0,13 a 1,9 por 100 000 habitantes que afecta principalmente a individuos entre los 50 y los 75 años. Suele tener un curso lento y poco agresivo. El tratamiento depende de la extensión tumoral. En presencia de compromiso intraocular la enucleación está indicada y en presencia de compromiso extraocular la exanteración orbitaria es el tratamiento estándar. Reportamos el caso de un paciente de 82 años con carcinoma escamoso conjuntival con compromiso intra y extraocular, se discute el caso y se revisa la literatura.

  18. Pseudoangiomatous stromal hyperplasia causing massive breast enlargement.

    Science.gov (United States)

    Bourke, Anita Geraldine; Tiang, Stephen; Harvey, Nathan; McClure, Robert

    2015-10-16

    Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign mesenchymal proliferative process, initially described by Vuitch et al. We report an unusual case of a 46-year-old woman who presented with a 6-week history of bilateral massive, asymmetrical, painful enlargement of her breasts, without a history of trauma. On clinical examination, both breasts were markedly enlarged and oedematous, but there were no discrete palpable masses. Preoperative image-guided core biopsies and surgery showed PASH. PASH is increasingly recognised as an incidental finding on image-guided core biopsy performed for screen detected lesions. There are a few reported cases of PASH presenting as rapid breast enlargement. In our case, the patient presented with painful, asymmetrical, massive breast enlargement. Awareness needs to be raised of this entity as a differential diagnosis in massive, painful breast enlargement.

  19. Prevention of oculocardiac reflex (O.C.R during extraocular muscle surgery

    Directory of Open Access Journals (Sweden)

    Misurya V

    1990-01-01

    Full Text Available In the present study the effectiveness of intravenous atropine sulphate which blocks the peripheral muscarinic receptors at the heart and retrobulbar xylocaine hydrochloride which blocks the conduction at ciliary ganglion on the afferent limb of OCR was studied during strabismus surgery. The study was conducted on fifty three patients of either sex having squint of more than ten years duration. The patients were randomly allocated into four groups. No preanaesthetic medication with atropine or retrobulbar block with xylocaine was given in control group of patients. In the second group, only preanaesthetic medication with atropine was given; while in the third group only retrobulbar injection of xylocaine was given five minutes before operation. In the last group both atropine as preanaesthetic medication and xylocaine as retrobulbar block were given. The electrocardiographic recordings were taken before and throughout the operative procedure. It was interesting to note that in the group where atropine and xylocaine were used none of the patients exhibited activation of OCR. Results have been discussed.

  20. Massive pregnancy gingival enlargement: A rare case.

    Science.gov (United States)

    Srivastava, Amitabh; Gupta, Krishna Kumar; Srivastava, Sunita; Garg, Jaishree

    2013-07-01

    Gingival enlargement related to pregnancy is sometimes seen in the oral cavity. Pregnancy is a physiological state that brings full of changes in a woman's life. The metabolism and immunology of the body are modified by progesterone and estrogen as well as other local factors, these sex hormones may modify the oral mucosa and may lead to various periodontal diseases. A case of female patient 23 yrs of age reported during 8(th) month of pregnancy with a localised gingival enlargement affecting the buccal aspect of left maxillary central incisor upto canine. The hormonal changes occurring during pregnancy may be associated with generalized or localised gingival enlargement and the presence of local factors may accentuate the gingival response. Rarely the enlargement becomes maasive and protrude out extraorally.

  1. Idiopathic gingival enlargement and its management

    Directory of Open Access Journals (Sweden)

    Shetty Arvind

    2010-01-01

    Full Text Available Idiopathic gingival enlargement is a proliferative fibrous lesion of the gingival tissue that causes esthetic and functional problems. Both genetically and pharmacologically induced forms of gingival enlargement exist. This case report addresses the diagnosis and treatment of a case of idiopathic gingival enlargement in a 13-year-old female. The patient presented with generalized diffuse gingival enlargement involving the maxillary and mandibular arches extending on buccal and lingual/palatal surfaces and covering incisal / occlusal third of the tooth resulting in difficulty in speech and mastication since last three years. Patient also gave a history of surgical treatment being carried out four years back in upper anterior region suggesting of recurrence. Biopsy report confirmed the diagnosis of gingival hyperplasia. Gingivectomy was carried out in all four quadrants by using four different methods.

  2. Severe gingival enlargement associated with aggressive periodontitis

    Directory of Open Access Journals (Sweden)

    Shyam Padmanabhan

    2013-01-01

    Full Text Available Enlargement of the gingiva can be due to various causes. Most prevalent are the inflammatory type and drug-induced type of gingival hyperplasia. However, sever enlargement associated with an aggressive type of periodontitis is an infrequent finding. Reported here is a case of a female patient aged 18 years who presented with severe enlargement of the maxillary and mandibular gingiva. Examination revealed enlargement extending up to the incisal edge of all the teeth and also an associated generalized loss of attachment with radiographic evidence of reduced bone height resembling an aggressive type of periodontitis. There were no associated systemic signs and symptoms or any family history except that there was generalized vitiligo of the skin and oral mucous membrane. The case was treated by gross electrosection of the gingiva.

  3. Enlarged prostate - what to ask your doctor

    Science.gov (United States)

    What to ask your doctor about enlarged prostate; Benign prostatic hypertrophy - what to ask your doctor; BPH - what to ... nlm.nih.gov/pubmed/23234640 . Roehrborn CG. Benign prostatic hyperplasia: Etiology, pathophysiology, epidemiology, and natural history. In: Wein ...

  4. Massive pregnancy gingival enlargement: A rare case

    OpenAIRE

    2013-01-01

    Gingival enlargement related to pregnancy is sometimes seen in the oral cavity. Pregnancy is a physiological state that brings full of changes in a woman's life. The metabolism and immunology of the body are modified by progesterone and estrogen as well as other local factors, these sex hormones may modify the oral mucosa and may lead to various periodontal diseases. A case of female patient 23 yrs of age reported during 8th month of pregnancy with a localised gingival enlargement affecting t...

  5. Acute exacerbation of airspace enlargement with fibrosis

    Directory of Open Access Journals (Sweden)

    Tomoyuki Kakugawa

    2014-01-01

    Full Text Available In 2008, Kawabata et al. described a lesion which they termed “airspace enlargement with fibrosis” that could be included on the spectrum of smoking-related interstitial lung diseases. This group also reported that patients with airspace enlargement with fibrosis but without coexisting interstitial pneumonia of another type had no acute exacerbations and favorable prognoses on clinical follow-up. Here we describe the first case, to our knowledge, of acute exacerbation of airspace enlargement with fibrosis without coexisting interstitial pneumonia of another type. An 82-year-old man was referred to our department for worsening dyspnea and new alveolar opacities on chest radiograph following left pulmonary segmentectomy (S6 for cancer. A diagnosis of acute exacerbation of airspace enlargement with fibrosis without coexisting interstitial pneumonia of other types was made, based on pathological evidence of airspace enlargement with fibrosis and organizing diffuse alveolar damage. Treatment with high-dose methylprednisolone followed by tapered oral prednisolone resulted in gradual improvement of the clinical condition and chest radiographic findings. Clinicians should be aware that patients with airspace enlargement with fibrosis may experience acute exacerbation.

  6. Multi-purpose extraocular forceps for small-gauge pars plana vitrectomy.

    Science.gov (United States)

    Reichel, Elias; Chun, Dal W; Gurley, Kiersten

    2012-01-01

    A multi-purpose titanium forceps has been developed for small-gauge pars plana vitrectomy surgery. These forceps were designed to provide the vitreoretinal surgeon with a single tool for the extraocular manipulations that are necessary for the placement and removal of 23- and 25-gauge trochars for small-incision, sutureless pars plana vitrectomy surgery. The forceps has been designed to allow for the atraumatic manipulation of the conjunctiva, measurement of distance from the limbus, and a strong purchase of the trochar for both its fixation and removal.

  7. Sushruta in 600 B.C. introduced extraocular expulsion of lens material.

    Science.gov (United States)

    Grzybowski, Andrzej; Ascaso, Francisco J

    2014-03-01

    It is generally accepted that Jacques Daviel introduced in the 18th century the extracapsular technique of extraction of the lens while the couching method of cataract operation had already been practiced since ancient times. Present study analyses the first known cataract surgery description in three translations into English from the original Sanskrit Sushruta textbook and all the available literature on the subject. We found evidences that some sort of extraocular expulsion of lens material through a limbal puncture (paracentesis) was described by the Indian surgeon. Nevertheless, this incision cannot be considered as a classic extracapsular procedure because it was not large enough to allow the extraction of the entire lens.

  8. Clinical and morphological study of calf enlargement following S-1 radiculopathy

    Directory of Open Access Journals (Sweden)

    Osvaldo J. M. Nascimento

    1992-09-01

    Full Text Available Calf enlargement following sciatica is a rare condition. It is reported the case of a 28-year-old woman who complained of repeated episodes of lower back pain radiating into the left buttock and foot. One year after the beginning of her symptoms, she noticed enlargement of her left calf. X-ray studies disclosed L5-S1 disk degeneration. EMG showed muscle denervation with normal motor conduction velocity. Open biopsies of the gastrocnemius muscles were performed. The left gastrocnemius muscle showed hypertrophic type 2 fibers in comparison with the right gastrocnemius. Electron microscopy showed mildly increased number of mitochondria in these fibers. A satisfactory explanation for denervation hypertrophy has yet to be provided.

  9. Aortic Annular Enlargement during Aortic Valve Replacement

    Directory of Open Access Journals (Sweden)

    Selman Dumani

    2016-09-01

    Full Text Available In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery. We used Manouguian technique to enlarge aortic anulus with excellent results during the fourth time of surgery.

  10. Atypical And Severe Enlargement Of Right Atrium.

    Science.gov (United States)

    Siniscalchi, Carmine; Rossetti, Pietro; Rocci, Anna; Rubino, Pasquale; Basaglia, Manuela; Gaibazzi, Nicola; Quintavalla, Roberto

    2016-09-13

    A 76 year-old woman was admitted to the Emergency Department for recent-onset dyspnea and cough. The electrocardiogram was considered inconclusive. A thoracic X-ray showed global cardiac profile enlargement. Computed tomography, acutely performed in the clinical suspicion of atypical pneumonia/myocarditis or pericardial effusion, showed cardiac enlargement especially of the right chambers. In order to investigate Ebstein's anomaly, pericardial cysts, tumors or other conditions of the right heart a simple trans-thoracic echocardiogram was performed. Four chambers view showed a giant right atrium aneurysm with moderate tricuspid regurgitation without stenosis or typical Ebstein's echocardiographic pattern.

  11. Simple Eyes, Extraocular Photoreceptors and Opsins in the American Horseshoe Crab.

    Science.gov (United States)

    Battelle, Barbara-Anne

    2016-11-01

    The eyes and photoreceptors of the American horseshoe crab Limulus polyphemus have been studied since the 1930s, and this work has been critical for understanding basic mechanisms of vision. One of the attractions of Limulus as a preparation for studies of vision is that it has three different types of eyes-a pair of later compound, image-forming eyes and two types of simple eyes, a pair of median ocelli, and three pair of larval eyes. Each eye type is tractable for experimentation. Limulus also has extraocular photoreceptors in its segmental ganglia and tail. The current contribution focuses on photoreceptors in Limulus larval eyes and ocelli and its extraocular photoreceptors with the goal of summarizing what is currently known and not known about their physiology and function and the opsins they express. The Limulus genome encodes a surprisingly large number of opsins (18), and studies of their expression pattern have raised new questions about the role of opsin co-expression, the functions of peropsins expressed outside of eyes, and the physiological relevance of opsins with apparently very low expression levels. Studies of opsin expression in Limulus lead one to wonder whether photoreceptors yet to be discovered might be present throughout its central nervous system. © The Author 2016. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

  12. Nato enlarging into the Baltic States

    Index Scriptorium Estoniae

    2003-01-01

    Prahas 21.-22. novembrini 2002 toimunud NATO tippkohtumisest ja seal vastu võetud otsusest Balti riikide alliansiga ühinemise kohta. Vt. samas: Russia's attitude to the NATO enlargement; Bush in Vilnius; Baltic states' prime ministers' met; Supporting USA?

  13. Penile Enlargement : From Medication to Surgery

    NARCIS (Netherlands)

    Nugteren, Helena M.; Balkema, G. T.; Pascal, A. L.; Schultz, W. C. M. Weijmar; Nijman, J. M.; Van Driel, M. F.

    2010-01-01

    Penis lengthening pills, stretch apparatus, vacuum pumps, silicone injections, and lengthening and thickening operations are available for men who worry about their penis size. Surgery is thus far the only proven scientific method for penile enlargement. In this article, we consider patient

  14. Field-enlarging transformations and chiral theories

    CERN Document Server

    Sladkowski, J

    1995-01-01

    A field-enlarging transformation in the chiral electrodynamics is performed. This introduces an additional gauge symmetry to the model that is unitary and anomaly-free and allows for comparison of different models discussed in the literature. The problem of superfluous degrees of freedom and their influence on quantization is discussed. Several "mysteries" are explained from this point of view.

  15. A rapidly enlarging cutaneous hemangioma in pregnancy.

    LENUS (Irish Health Repository)

    Ma'ayeh, Marwan

    2014-06-18

    This is a case of a rapidly enlarging cutaneous pedunculated tumor on a patient\\'s thumb during her pregnancy. This was excised and identified as a hemangioma. A literature search identified a possible hormonal factor in causing an accelerated growth of this tumor.

  16. A rapidly enlarging cutaneous hemangioma in pregnancy

    Directory of Open Access Journals (Sweden)

    Marwan Ma’ayeh

    2014-10-01

    Full Text Available This is a case of a rapidly enlarging cutaneous pedunculated tumor on a patient’s thumb during her pregnancy. This was excised and identified as a hemangioma. A literature search identified a possible hormonal factor in causing an accelerated growth of this tumor.

  17. Nato enlarging into the Baltic States

    Index Scriptorium Estoniae

    2003-01-01

    Prahas 21.-22. novembrini 2002 toimunud NATO tippkohtumisest ja seal vastu võetud otsusest Balti riikide alliansiga ühinemise kohta. Vt. samas: Russia's attitude to the NATO enlargement; Bush in Vilnius; Baltic states' prime ministers' met; Supporting USA?

  18. Subdifferentials of Distance Functions, Approximations and Enlargements

    Institute of Scientific and Technical Information of China (English)

    Jean-Paul PENOT; Robert RATSIMAHALO

    2007-01-01

    In this work, we study some subdifferentials of the distance function to a nonempty non-convex closed subset of a general Banach space. We relate them to the normal cone of the enlargements of the set which can be considered as regularizations of the set.

  19. Hearts and Flowers: Learning To Enlarge Images.

    Science.gov (United States)

    Kalil, Judy

    2003-01-01

    Describes a lesson that teaches kindergarten students how to enlarge a smaller drawing onto a bigger piece of paper. Explains that the students create their heart-shape designs using tempera paint and pastels in the larger picture. Includes a list of materials. (CMK)

  20. Liver enlargement demonstrated by scintigraphy in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Tiger, L.H.; Gordon, M.H.; Ehrlich, G.E.; Shapiro, B.

    1976-03-01

    Scintigraphic scanning employing technetium-99m sulfur colloid was used to assess the size of the liver and spleen in 32 consecutive patients with rheumatoid arthritis. The data were correlated with clinical and laboratory assessment. Seven patients had enlarged livers, three enlarged spleens. An expected correlation of liver enlargement with Sjogren's syndrome did not materialize. Splenic enlargement and liver enlargement were discordant. Liver enlargement correlation best with elevations of rheumatoid factor as measured by latex fixation. As liver enlargement is not an appreciated feature of rheumatoid arthritis, these findings suggest that hepatomegaly need not necessarily imply adverse treatment results or the development of lymphoproliferative disorders.

  1. Ocular and extra-ocular features of patients with Leber congenital amaurosis and mutations in CEP290

    NARCIS (Netherlands)

    Yzer, Suzanne; den Hollander, Anneke I.; Lopez, Irma; Pott, Jan-Willem R.; de Faber, Jan Tjeerd H. N.; Cremers, Frans P. M.; Koenekoop, Robert K.; van den Born, L. Ingeborgh

    2012-01-01

    Purpose: This study investigated the centrosomal protein, 290-KD (CEP290) associated genotype and ocular and extra-ocular phenotype in 18 patients with Leber congenital amaurosis (LCA). Methods: Eighteen patients with LCA from 14 families with mutations in the CEP290 gene were identified with sequen

  2. Ocular and extra-ocular features of patients with Leber congenital amaurosis and mutations in CEP290

    NARCIS (Netherlands)

    Yzer, S.; Hollander, A.I. den; Lopez, I.; Pott, J.W.; Faber, J.T. de; Cremers, F.P.; Koenekoop, R.K.; Born, L.I. van den

    2012-01-01

    PURPOSE: This study investigated the centrosomal protein, 290-KD (CEP290) associated genotype and ocular and extra-ocular phenotype in 18 patients with Leber congenital amaurosis (LCA). METHODS: Eighteen patients with LCA from 14 families with mutations in the CEP290 gene were identified with sequen

  3. Ocular and extra-ocular features of patients with Leber congenital amaurosis and mutations in CEP290

    NARCIS (Netherlands)

    Yzer, Suzanne; den Hollander, Anneke I.; Lopez, Irma; Pott, Jan-Willem R.; de Faber, Jan Tjeerd H. N.; Cremers, Frans P. M.; Koenekoop, Robert K.; van den Born, L. Ingeborgh

    2012-01-01

    Purpose: This study investigated the centrosomal protein, 290-KD (CEP290) associated genotype and ocular and extra-ocular phenotype in 18 patients with Leber congenital amaurosis (LCA). Methods: Eighteen patients with LCA from 14 families with mutations in the CEP290 gene were identified with sequen

  4. Application of the FlexiForce contact surface force sensor to continuous extraocular compression monitoring during craniotomy for cerebral aneurysms.

    Science.gov (United States)

    Mutoh, Tatsushi; Ishikawa, Tatsuya; Nishimura, Hiromi; Yasui, Nobuyuki

    2010-01-01

    The aims of this study were to introduce our newly developed device equipped with a contact surface force sensor (FlexiForce) for monitoring extraocular compression continuously, and to illustrate its potential clinical application using this device in patients undergoing uncomplicated frontotemporal or bifrontal craniotomy for surgical clipping of unruptured anterior circulation aneurysms. In a pilot study with volunteers, we determined the critical force of 100 gf to cause painful ocular sensation. Then we performed the bilateral extraocular force measurements in 15 patients undergoing uncomplicated frontotemporal or bifrontal craniotomy for surgical clipping of unruptured anterior circulation aneurysms. Extraocular force increased immediately after retraction of the flap, increased to 144+/-26 gf (mean+/-SD) during lower craniotomy close to the orbit, was maintained at 91+/-18 gf during microsurgery, and returned close to baseline at 24+/-14 gf after restoration of skin flap retraction. Such changes were observed only on the surgical side in frontotemporal craniotomy. Abnormal increase in extraocular force was effectively reduced by placing a real-time digital panel meter to warn surgeons to avoid excessive skin flap retraction during the surgical procedure. In conclusion, this new tool may allow us to monitor the external forces that can be applied intraoperatively to the ocular globe in the supine position.

  5. Inferior oblique muscle paresis as a sign of myasthenia gravis.

    Science.gov (United States)

    Almog, Yehoshua; Ben-David, Merav; Nemet, Arie Y

    2016-03-01

    Myasthenia gravis may affect any of the six extra-ocular muscles, masquerading as any type of ocular motor pathology. The frequency of involvement of each muscle is not well established in the medical literature. This study was designed to determine whether a specific muscle or combination of muscles tends to be predominantly affected. This retrospective review included 30 patients with a clinical diagnosis of myasthenia gravis who had extra-ocular muscle involvement with diplopia at presentation. The diagnosis was confirmed by at least one of the following tests: Tensilon test, acetylcholine receptor antibodies, thymoma on chest CT scan, or suggestive electromyography. Frequency of involvement of each muscle in this cohort was inferior oblique 19 (63.3%), lateral rectus nine (30%), superior rectus four (13.3%), inferior rectus six (20%), medial rectus four (13.3%), and superior oblique three (10%). The inferior oblique was involved more often than any other muscle (pmyasthenia gravis can be difficult, because the disease may mimic every pupil-sparing pattern of ocular misalignment. In addition diplopia caused by paresis of the inferior oblique muscle is rarely encountered (other than as a part of oculomotor nerve palsy). Hence, when a patient presents with vertical diplopia resulting from an isolated inferior oblique palsy, myasthenic etiology should be highly suspected.

  6. Aortic Root Enlargement or Sutureless Valve Implantation?

    Directory of Open Access Journals (Sweden)

    Nikolaos G. Baikoussis

    2016-11-01

    Full Text Available Aortic valve replacement (AVR in patients with a small aortic annulus is a challenging issue. The importance of prosthesis–patient mismatch (PPM post aortic valve replacement (AVR is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR and the transcatheter valve implantation (TAVI.

  7. Why do objects appear enlarged under water?

    Directory of Open Access Journals (Sweden)

    Helen E. Ross

    2003-01-01

    Full Text Available Objects appear enlarged in water by less than the 4/3 angular magnification. They usually appear beyond their optical distance and slightly enlarged in linear size, but not in accordance with size-distance invariance (SDI. We investigated whether misperceptions of angular size could explain the discrepancies. Twenty observers viewed targets of various sizes and distances within transparent tanks 40 cm long containing air or water. They judged distance by hidden reaching, and linear or angular size by adjusting the size of a target in air at a further distance. Matched distance was close to physical distance in air and optical distance in water. All size matches were close to true linear size, and were larger in water than in air. Angular size matches were much too small to explain departures from SDI. Size perception under water is best explained by incomplete adaptation to optical distortion, and by the use of various size cues.

  8. Enlarged Molecules from Excited Atoms in Nanochannels

    CERN Document Server

    Boström, Mathias; Sernelius, Bo E; Dou, Maofeng; Persson, Clas; Ninham, Barry W

    2012-01-01

    The resonance interaction that takes place in planar nanochannels between pairs of excited state atoms is explored. We consider interactions in channels of silica, zinc oxide and gold. The nanosized channels induce a dramatically different interaction from that in free space. Illustrative calculations for two lithium and cesium atoms, demonstrate that there is a short range repulsion followed by long range attraction. The binding energy is strongest near the surfaces. The size of the enlarged molecule is biggest at the center of the cavity and increases with channel width. Since the interaction is generic, we predict that enlarged molecules are formed in porous structures, and that the molecule size depends on the size of the nanochannels

  9. Enlarged pancreas: not always a cancer.

    Science.gov (United States)

    Calculli, Lucia; Festi, Davide; Pezzilli, Raffaele

    2015-02-01

    Pancreatic fat accumulation has been described with various terms including pancreatic lipomatosis, pancreatic steatosis, fatty replacement, fatty infiltration, fatty pancreas, lipomatous pseudohypertrophy and nonalcoholic fatty pancreas disease. It has been reported to be associated with type 2 diabetes mellitus, acute pancreatitis, pancreatic cancer and the formation of pancreatic fistula. The real incidence of this condition is still unknown. We report a case of pancreatic steatosis in a non-obese female patient initially diagnosed with a mass in the head of the pancreas. Magnetic resonance imaging (MRI) was carried out to define the characteristics of the pancreatic mass. MRI confirmed the diagnosis of fat pancreas. Enlarged pancreas is not always a cancer, but pancreatic steatosis is characterized by pancreatic enlargement. MRI could give a definite diagnosis of pancreatic steatosis or cancer.

  10. Enlarged pancreas:not always a cancer

    Institute of Scientific and Technical Information of China (English)

    Lucia Calculli; Davide Festi; Raffaele Pezzilli

    2015-01-01

    Pancreatic fat accumulation has been described with various terms including pancreatic lipomatosis, pancre-atic steatosis, fatty replacement, fatty infiltration, fatty pan-creas, lipomatous pseudohypertrophy and nonalcoholic fatty pancreas disease. It has been reported to be associated with type 2 diabetes mellitus, acute pancreatitis, pancreatic cancer and the formation of pancreatic fistula. The real incidence of this condition is still unknown. We report a case of pancreatic steatosis in a non-obese female patient initially diagnosed with a mass in the head of the pancreas. Magnetic resonance imaging (MRI) was carried out to define the characteristics of the pancreatic mass. MRI confirmed the diagnosis of fat pan-creas. Enlarged pancreas is not always a cancer, but pancreatic steatosis is characterized by pancreatic enlargement. MRI could give a definite diagnosis of pancreatic steatosis or cancer.

  11. An enlarged sella turcica on cephalometric radiograph.

    Science.gov (United States)

    Chang, H-P; Tseng, Y-C; Chou, T-M

    2005-09-01

    A 28-year-old male presented to the Orthodontic clinic for correction of his anterior crossbite due to mandibular prognathism as a result of pituitary adenoma with acromegaly. A radiographic cephalometric analysis and clinical orthodontic examination were made. This article describes in detail the methods of correcting the magnification of cephalometric linear measurements in sellar dimensions (length, depth and width) from lateral and posteroanterior cephalograms. Cephalometric findings revealed that the sella enlarged in all its dimensions with a deepening of the floor in this acromegalic case. We discuss the radiographic diagnosis of an enlarged sella turcica in intrasellar tumours and also emphasise the dentist's important role in the initial diagnosis of pituitary adenoma cases.

  12. Fiscal Convergence in an Enlarged European Union

    Directory of Open Access Journals (Sweden)

    Georgeta VINTILĂ

    2014-02-01

    Full Text Available Taxation convergence in the European Union has always been a heatedly debated issue, and it has constantly resurfaced to the limelight as more and more fiscal directive proposals are being discussed. The current study is an analysis of the evolution of taxation convergence tendencies within the European Union in recent years, using sigma-convergence and cluster analysis. Our goal is to analyze the fiscal convergence trends in the context of European Union enlargement over the last two decades.

  13. NIFEDIPINE - INDUCED GINGIVAL ENLARGEMENT (IN SPANISH)

    OpenAIRE

    Manzur-Villalobos Isabella; Manzur-Jattin Fernando; Díaz-Caballero Antonio José

    2014-01-01

    Introduction: the gingival enlargement is the increase of the size of the gingiva caused by diverse factors, between which are the drugs, mainly the antihypertensive, immunosuppressive and anticonvulsant medications. Between the first ones, the nifedipine, an antagonist of the calcium, is one of the most frequently indicated. Clinical case: A 62-year-old-male patient with arterial hypertension treated with nifedipine for more of fifteenth years, who presented chronic gingival e...

  14. Particularities of the European Union enlargement process

    Directory of Open Access Journals (Sweden)

    Andreea Bucur

    2009-12-01

    Full Text Available The European integration model has proven to be so far a successful one, with a high consideration from the other countries of the world and their attempts to replicate its components and to learn from its experience of regional integration is perhaps the most sincere form of appreciation. Contemporary global economy knows various other models of economic integration, but none of the existing forms of regional integration was not up to the achievements of the EU which is distinguished primarily by the stage reached and function andits ability to create unity in the context of diversity. Irreversible process, and currently ongoing, and designed to produce positive results in perspective, the enlargement is one of the most significant factors of European construction success, always accompanying its history, marking the development, institutional structure, mode of cooperation and its policies. For these reasons, the present paper aims to approach the European integration model by the factors that influenced the enlargement and also by the course of events that are reflected in so-called “waves” of EU enlargement.

  15. THE CRUCIAL THEMES OF EU ENLARGEMENT

    Directory of Open Access Journals (Sweden)

    Jacques Pelkmans

    2001-12-01

    Full Text Available This article provides a critical review of the “terms” of the ongoing EU enlargement, in the light of the European public interest. The European public interest ought to include the prospective (Central European members, within a perspective of an enlarged Union in 2010, or so. The following forms a personalised summary of a major report published (in Dutch in September 2001 by the WRR in The Hague (a think-tank, formally under the Dutch Prime Minister, but by statute fully independent. The author was one of the lead-writers of this report. The present article merely focuses on the policy recommendations of the report. It is hoped that these kinds of critical analyses will help to stimulate solid policy debate on the EU in Romania, on the road to EU membership. The article discusses why the notion of a “core-acquis” would improve the enlargement strategy; the application of the core acquis to the internal market, environment and justice and home affairs; judicial and administrative capacity; accession to “euro-land”; the rapid reform of the CAP; a reform of “cohesion” approaches; and a note on the EU budgetary implications.

  16. Followup of a Dog with an Intraocular Silicone Prosthesis Combined with an Extraocular Glass Prosthesis

    Directory of Open Access Journals (Sweden)

    Gwendolyna Romkes

    2012-01-01

    Full Text Available Because of unpredictable corneal changes, evisceration and implantation of a silicone prosthesis does not always lead to a satisfying cosmetic result. This paper describes the use of an intraocular silicone prosthesis in combination with an extraocular glass prosthesis and shows a followup of two and a half years in a nonexperimental study. An intraocular silicone prosthesis was implanted after evisceration of the left eye in a five-month-old Bernese mountain dog. A glass prosthesis was fitted four weeks after evisceration. Two and a half years after the operation, the dog is in good health and free of medication. No short-term or long-term complications were seen. The owners do not have trouble with handling the glass prosthesis. The combination of both prostheses shows a perfect solution to retrieve a normal looking and moving eye after evisceration.

  17. An unusual case of generalized severe gingival enlargement during pregnancy.

    Science.gov (United States)

    McIntosh, Crystal L; Kolhatkar, Shilpa; Winkler, James R; Ojha, Junu; Bhola, Monish

    2010-01-01

    Increased hormone levels that are present during puberty and pregnancy are associated with localized or generalized gingival enlargement. This article reviews the gingival alterations that can occur during pregnancy and describes a case of generalized severe gingival enlargement associated with pregnancy and its management. A 36-year-old woman had severe bilateral gingival enlargement of short duration. The patient denied taking any medications. The laboratory report revealed no systemic abnormalities; however, the report disclosed that she was pregnant. Surgical therapy for the gingival enlargement included gingivectomy and gingivoplasty of all quadrants, which reduced the size of the enlarged gingiva. Postoperative visits demonstrated uneventful healing, with no recurrence seen at the one-year follow-up appointment. It appears that the English literature includes only one other case report that discusses generalized gingival enlargement during pregnancy. Pregnancy-related gingival enlargement should be included as a differential diagnosis in women who have non-drug-induced generalized gingival enlargement.

  18. Idiopathic gingival enlargement: A case report

    Directory of Open Access Journals (Sweden)

    Rajesh Shah

    2015-09-01

    Full Text Available Idiopathic gingival fibromatosis is a relatively rare condition characterized by the proliferation of the gingival tissues resulting in masticatory, esthetics, phonetics and psychological disturbances. We present a case with generalized diffuse gingival enlargement involving the maxillary and mandibular arches extending on buccal and lingual/palatal surfaces and covering incisal/occlusal third of the tooth in the left maxillary region. Gingivectomy was carried out in all four quadrants. Periodic recalls showed maintenance of good oral hygiene and one year follow-up revealed no recurrence.JCMS Nepal. 2015;11(1: 26-28

  19. Martingale representation property in progressively enlarged filtrations

    CERN Document Server

    Jeanblanc, M

    2012-01-01

    Consider $\\mathbb{G}$ the progressive enlargement of a filtration $\\mathbb{F}$ with a random time $\\tau$. Assuming that, in $\\mathbb{F}$, the martingale representation property holds, we examine conditions under which the martingale representation property holds also in $\\mathbb{G}$. It is noted that the classical results on this subject are no more sufficient to deal with all examples coming from credit risk modeling. In this paper, we introduce a new methodology which extends the various classical results and applies on recent examples.

  20. Irradiation followed by muscle surgery for dysthyroid ophthalmopathy with diplopia

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Satoko; Asakura, Akiko [Iwate Prefectural Central Hospital, Morioka (Japan); Ogasawara, Kosuke; Mori, Toshiro; Shibuya, Masako; Kurihara, Hideo; Tazawa, Yutaka

    1995-10-01

    We obtained favorable therapeutic outcome in 12 cases of dysthyroid ophthalmopathy with diplopia. All the patients underwent Lineac irradiation to the retrobulbar tissue totalling 15 to 20 Gy over 10 days. Extraocular muscle surgery was performed 30 days after irradiation. Diplopia at the primary position almost disappeared one day after surgery. An additional surgery was necessary in one case. The interval between onset of diplopia and surgery averaged 6.1 months. Irradiation prior to muscle surgery appeared to be beneficial in allowing an early surgery and in avoiding surgical overcorrection. (author).

  1. Anterior transposition of the inferior oblique muscle as the initial treatment of a snapped inferior rectus muscle.

    Science.gov (United States)

    Aguirre-Aquino, B I; Riemann, C D; Lewis, H; Traboulsi, E I

    2001-02-01

    Snapping or tearing of an extraocular muscle refers to its rupture across its width, usually at the junction between muscle and tendon several millimeters behind the insertion. Tearing occurs during strabismus or retinal reattachment surgery, or after trauma. If the proximal end of the muscle cannot be located, transposition procedures are necessary to achieve ocular realignment. These surgical procedures carry the risk of anterior segment ischemia, especially in the elderly. Anterior transposition of the inferior oblique muscle has been used for the treatment of inferior oblique overaction, especially in the presence of a dissociated vertical deviation, and in patients with fourth nerve palsy. We transposed the inferior oblique muscle insertion in a 73-year-old woman with a snapped inferior rectus muscle.

  2. Enlargements of Monotone Operators Determined by Representing Function

    Directory of Open Access Journals (Sweden)

    M. Rezaei

    2012-03-01

    Full Text Available In this paper, we study a new enlargement of subdifferential for any proper lower semicontinuous function. We know that ε-subdifferential of any proper lower semicontinuous function is an enlargement of its subfifferential and any point from the graph of ε- subdifferential can be approximated by a point from the graph of sub- fifferential. This nice property, apart from its theoretical importance, gives also the possibility to use the enlargement of subdifferentials in finding approximate solutions of inclusions determined by subdifferentials. We define a new enlargement and observe, in the case subdifferentials, the relation between this new enlargement and the ε- subdifferentia

  3. A Study of Digital Image Enlargement and Enhancement

    Directory of Open Access Journals (Sweden)

    Hsueh-Yi Lin

    2014-01-01

    Full Text Available Most image enlargement techniques suffer the problem of zigzagged edges and jagged images following enlargement. Humans are sensitive to the edges of objects; if the edges in the image are sharp, the visual is considered to be high quality. To solve this problem, this paper presents a new and effective method for image enlargement and enhancement based on adaptive inverse hyperbolic tangent (AIHT algorithm. Conventional image enlargement and enhancement methods enlarge the image using interpolation, and subsequently enhance the image without considering image features. However, this study presents the method based on Adaptive Inverse Hyperbolic Tangent algorithm to enhance images according to image features before enlarging the image. Experimental results indicate that the proposed algorithm is capable of adaptively enhancing the image and extruding object details, thereby improving enlargements by smoothing the edge of the objects in the image.

  4. EU Enlargement between Economic and Political Criteria

    Directory of Open Access Journals (Sweden)

    Romeo-Victor Ionescu

    2013-05-01

    Full Text Available The paper answers at two important questions: Is the EU able to support new adhering processes? and Is the Euro area able to enlarge in 2014? The comparative analysis in the paper covers four economic competitors: EU, USA, China and Japan, and is based on GDP growth rate, unemployment and inflation rates. The second part of the paper deals with an economic forecast during 2015-2016, focused on EU27, Euro area, Croatia and Latvia, in order to discuss the effects of the adhering to EU and Euro area. The results of the two-level analysis are supported by pertinent diagrams and annexes. The analysis uses a neutral statistical database – Eurostat – and dedicated forecast software. The main conclusion of the paper is that the adhering processes from 2013 and 2014 are based on economic and political criteria.

  5. Streamlining Education System Through Waqf Enlargement

    Directory of Open Access Journals (Sweden)

    Imam Bahroni

    2016-06-01

    Full Text Available This paper is aimed at discussing the development of education systembased on the Waqf Empowerment. It is an experience of Gontor ModernIntegrated Islamic Institution to maintain its existence through the activitiesof Waqf Enlargement. The spirit of self-reliance which has been implementedby Gontor through various economic enterprise activities inside the campus isthe total processes of educational activities, carried out by students andteachers themselves. They act as the subjects and objects of the education atthe same time. They teach themselves through various activities, creativitiesand social interaction for their character and personality building. Thislearning process is purposely undertaken in Gontor, because the basicprinciple of this system is to actualize the community orientation throughwhich the students in the campus guided and prepared to have a spirit ofself reliance. So when they back to the society to undertake the real life theyconfidently take their role to develop their society for the sake of Allah andunity of muslim ummah.

  6. [Somatotopic Representation of the Anterior Horn within Cervical Enlargement: Reappraisal of Known Doctrine Based on Clinicopathological Findings Seen in Hirayama Disease].

    Science.gov (United States)

    Hirayama, Keizo

    2016-05-01

    Clinical features (weakness and amyotrophy of intrinsic hand muscles and obliquely distributed amyotrophy of forearm muscles, figure 1), needle electromyographic findings (distribution of neurogenic activities, figure 2), and pathological findings (ischemic necroses of the anterior horns between C6 and T1, figure 3) of Hirayama disease suggest that understanding of somatotopic representation of the anterior horn innervating arm muscles in the cervical enlargement of spinal cord differs from the known doctrine. Anterior horn cells of the intrinsic hand muscles are located between C7 and T1, those of forearm muscles and triceps brachii muscle as elbow extensor are, contrary to the known doctrine, located in C5 and C6, and those of elbow flexors such as biceps brachii and brachioradialis are located in C4 and above (figure 5). Development of dexterity in human hand may reflect development of cervical enlargement in accord with larger areas representing the hand and fingers on cerebral motor cortex.

  7. Enlarged spinoglenoid notch veins causing suprascapular nerve compression

    Energy Technology Data Exchange (ETDEWEB)

    Carroll, Kevin W. [Radiology Regional Center, 700 Goodlette Road, Naples, FL 34102 (United States); Helms, Clyde A. [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States); Otte, Michael T. [Invision Medical Imaging and Radiology, 8200 East Belleview Avenue, Suite 124, Greenwood Village, CO 80111 (United States); Moellken, S.M.C. [San Francisco Magnetic Resonance Center, 3333 California Street, Suite 105, San Francisco, CA 94118 (United States); Fritz, R. [National Orthopedic Associates, 1260 South Eliseo Drive, Greenbrae, CA 94904 (United States)

    2003-02-01

    To report the magnetic resonance (MR) imaging findings of enlarged veins in the spinoglenoid notch as a cause of suprascapular nerve compression.Design and patients Six patients presented to MR imaging for evaluation of chronic shoulder pain. Clinical information and MR imaging studies were reviewed. The spinoglenoid notch vascular structures were compared with measurements made in 10 age-matched controls. Spinoglenoid notch vascular structures measured in 10 asymptomatic age-matched control patients ranged from 1 to 4 mm in diameter with an average of 2.2 mm. The six study patients had vascular structures that ranged from 6 to 10 mm in diameter with an average of 8.4 mm. Atrophy and fatty infiltration of the infraspinatus muscle was noted as an associated finding at MR imaging in all six patients. Surgery was performed in three of the six patients, at which time a venous varix was identified in the spinoglenoid notch in all three patients. We describe distended veins in the spinoglenoid notch. These may be readily apparent at MR imaging and should be distinguished from paralabral ganglion cysts compressing the suprascapular nerve in the absence of labral tears, especially if percutaneous aspiration of a ganglion cyst is entertained. (orig.)

  8. DISTRIBUTION ANALYSIS OF ENLARGED CELLS DERIVED FROM GROUPER SLEEPY DISEASE IRIDOVIRUS (GSDIV INFECTED HUMPBACK GROUPER Cromileptes altivelis

    Directory of Open Access Journals (Sweden)

    Indah Mastuti

    2012-06-01

    Full Text Available Characteristic of Megalocytivirus infection has been known to produce formation of inclusion body bearing cells (IBCs on internals organs of fish predominantly on spleen and kidney. Megalocytivirus that infected grouper is known as Grouper Sleepy Disease Iridovirus (GSDIV. This study was conducted to answer the effect of entry sites of GSDIV on distribution of enlarged cells formed on the internal organs of humpback grouper Cromileptes altivelis. Enlarged cells were observed histologically under the light microscope on spleen, head kidney, trunk kidney, liver, gill, heart, stomach, intestine, muscle and brain. Entry sites were designated to intramuscularly injection, intraperitoneally injection, dipped gill and inoculum added feed. Enlarged cells were formed on spleen, head kidney, trunk kidney, liver, gill, heart, stomach, muscle, except on intestine and brain. All the entry sites resulted in formation of enlarged cells on spleen, head kidney, trunk kidney, liver, heart. Spleen and head kidney were the most frequent observed organ. These results suggested that distribution of enlarged cells were not affected by the entry site of GSDIV.

  9. EU Enlargement Law: History and Recent Developments: Treaty Custom Concubinage?

    Directory of Open Access Journals (Sweden)

    Dimitry Kochenov

    2005-04-01

    Full Text Available This note provides a detailed account of the development of the EU enlargement law. Based on the material provided by the latest enlargement round, it outlines the main set of enlargement principles, criteria and procedural tools employed by the Union in the process, also making a sketch of the actual chronology of enlargement events. Based on the analysis of the legal regulation of five rounds of enlargement and making parallels with the notion of customary law as understood in public international law, it argues that the Union enlargements have always enjoyed a dual regulation: by written (mostly Treaty based and also by customary enlargement law. The existence of customary law explains the consistency of enlargement regulation throughout all the rounds of this process, notwithstanding the stage of the Treaty reform in force at the time of every particular accession. The minimal amendments introduced into the enlargement article by the Treaty Establishing a Constitution for Europe (Art. I-58 suggest that the future enlargements are likely to be building on the body of customary law in force to date. The process of gradual incorporation of customary law into the written law of the EU is also likely to continue.

  10. Oxidative Stress and Upregulation of Antioxidant Proteins, Including Adiponectin, in Extraocular Muscular Cells, Orbital Adipocytes, and Thyrocytes in Graves' Disease Associated with Orbitopathy.

    Science.gov (United States)

    Marique, Lancelot; Senou, Maximin; Craps, Julie; Delaigle, Aurélie; Van Regemorter, Elliott; Wérion, Alexis; Van Regemorter, Victoria; Mourad, Michel; Nyssen-Behets, Catherine; Lengelé, Benoit; Baldeschi, Lelio; Boschi, Antonella; Brichard, Sonia; Daumerie, Chantal; Many, Marie-Christine

    2015-09-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation associated with Graves' disease (GD). It is characterized by reduced eye motility due to an increased volume of orbital fat and/or of extraocular muscles (EOMs) infiltrated by fibrosis and adipose tissue. The pathogenetic mechanisms leading to fibrosis and adipogenesis are mainly based on the interaction between orbital fibroblasts and immune cells (lymphocytes and mast cells) infiltrating the GO EOMs. Analysis of the morphological status, oxidative stress (OS), and antioxidant defenses in the orbital muscular cells and adipocytes in GO patients compared with controls was conducted. Both cell types are affected by OS, as shown by the increased expression of 4-hydroxynonenal, which leads to apoptosis in muscular cells. However, the EOMs and the adipocytes possess antioxidant defenses (peroxiredoxin 5 and catalase) against the OS, which are also upregulated in thyrocytes in GD. The expression of adiponectin (ApN) and proliferator-activated receptor gamma (PPARγ) is also increased in GO muscular cells and adipocytes. OS and antioxidant proteins expression are correlated to the level of blood antithyrotropin receptor antibodies (TSHR-Ab). Even when TSHR-Ab level is normalized, OS and antioxidant protein expression is high in EOM muscular cells and adipocytes in GO compared with controls. This justifies a supplementation with antioxidants in active as well as chronic GO patients. Orbital muscular cells are also the sources of PPARγ and ApN, which have direct or indirect local protective effects against OS. Modulation of these proteins could be considered as a future therapeutic approach for GO.

  11. Management of phenytoin-induced gingival enlargement: a case report.

    Science.gov (United States)

    Parwani, Rajkumar N; Parwani, Simran R

    2013-01-01

    Gingival enlargements may adversely affect speech, mastication, tooth eruption, and esthetics. These enlargements can occur as a result of the administration of certain anticonvulsants, immunosuppressants, and calcium channel blockers. The present case report describes the treatment of a patient with a phenytoin-induced gingival enlargement. A case of gingival enlargement should be treated in a step-wise manner, including consultation with the patient's physician, substitution of the drug, nonsurgical therapy, surgical therapy (if needed), and supportive periodontal therapy after every 3 months. In this case, healing was uneventful, and no recurrences occurred 3 months postoperatively.

  12. Pseudohypertrophy of the calf muscles in a patient with diabetic neuropathy: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Jin; Lee, Young Hwan; Jung, Kyung Jae; Park, Young Chan; Kim, Ho Kyun; Kim, Ok Dong [School of Medicine, Catholic University of Daegu, Daegu (Korea, Republic of)

    2007-09-15

    Partial or complete loss of innervation of skeletal muscle leads to muscle weakness and atrophic changes, resulting in decreased muscle volume with fatty replacement. Rarely, enlargement of the affected muscle may occur, related to two processes: true hypertrophy and pseudohypertrophy. We report CT and MR findings of the pseudohypertrophy of calf muscles, especially the soleus and gastrocnemius muscles, in a patient with diabetic neuropathy that showed increased muscle volume with diffuse fatty replacement and the presence of scanty muscle fibers.

  13. A methodology to enlarge narrow stability windows

    Energy Technology Data Exchange (ETDEWEB)

    Araujo, Ewerton M.P.; Pastor, Jorge A.S.C.; Fontoura, Sergio A.B. [Pontificia Univ. Catolica do Rio de Janeiro (PUC-Rio), RJ (Brazil). Dept. de Engenharia Civil. Grupo de Tecnologia e Engenharia de Petroleo

    2004-07-01

    The stability window in a wellbore design is defined by the difference between fracture pressure and collapse pressure. Deep water environments typically present narrow stability windows, because rocks have low strength due to under-compaction process. Often also, horizontal wells are drilled to obtain a better development of reservoirs placed in thin layers of sandstone. In this scenario, several challenges are faced when drilling in deep water. The traditional approach for predicting instabilities is to determine collapses and fractures at borehole wall. However, the initiation of rupture does not indicate that the borehole fails to perform its function as a wellbore. Thus, a methodology in which the stability window may be enlarged is desirable. This paper presents one practical analytical methodology that consists in allowing wellbore pressures smaller than the conventional collapse pressure, i.e., based upon failure on the borehole wall. This means that a collapse region (shear failure) will be developed around the borehole wall. This collapse region is pre-defined and to estimate its size is used a failure criterion. The aforementioned methodology is implemented in a user-friendly software, which can perform analyses of stress, pore pressure, formation failure, mud weight and mud salinity design for drilling in shale formations. Simulations of a wellbore drilling in a narrow stability window environment are performed to demonstrate the improvements of using the methodology. (author)

  14. Amygdalar enlargement associated with unique perception.

    Science.gov (United States)

    Asari, Tomoki; Konishi, Seiki; Jimura, Koji; Chikazoe, Junichi; Nakamura, Noriko; Miyashita, Yasushi

    2010-01-01

    Interference by amygdalar activity in perceptual processes has been reported in many previous studies. Consistent with these reports, previous clinical studies have shown amygdalar volume change in multiple types of psychotic disease presenting with unusual perception. However, the relationship between variation in amygdalar volume in the normal population and the tendency toward unusual or unique perception has never been investigated. To address this issue, we defined an index to represent the tendency toward unique perception using ambiguous stimuli: subjects were instructed to state what the figures looked like to them, and "unique responses" were defined depending on the appearance frequency of the same responses in an age- and gender-matched control group. The index was defined as the ratio of unique responses to total responses per subject. We obtained structural brain images and values of the index from sixty-eight normal subjects. Voxel-based morphometry analyses revealed a positive correlation between amygdalar volume and the index. Since previous reports have indicated that unique responses were observed at higher frequency in the artistic population than in the nonartistic normal population, this positive correlation suggests that amygdalar enlargement in the normal population might be related to creative mental activity.

  15. [Enlargement in managment of lumbar spinal stenosis].

    Science.gov (United States)

    Steib, J P; Averous, C; Brinckert, D; Lang, G

    1996-05-01

    Lumbar stenosis has been well discussed recently, especially at the 64th French Orthopaedic Society (SOFCOT: July 1989). The results of different surgical treatments were considered as good, but the indications for surgical treatment were not clear cut. Laminectomy is not the only treatment of spinal stenosis. Laminectomy is an approach with its own rate of complications (dural tear, fibrosis, instability... ).Eight years ago, J. Sénégas described what he called the "recalibrage" (enlargement). His feeling was that, in the spinal canal, we can find two different AP diameters. The first one is a fixed constitutional AP diameter (FCAPD) at the cephalic part of the lamina. The second one is a mobile constitutional AP diameter (MCAPD) marked by the disc and the ligamentum flavum. This diameter is maximal in flexion, minimal in extension. The nerve root proceeds through the lateral part of the canal: first above, between the disc and the superior articular process, then below, in the lateral recess bordered by the pedicle, the vertebral body and the posterior articulation. With the degenerative change the disc space becomes shorter, the superior articular process is worn out with osteophytes. These degenerative events are complicated by inter vertebral instability increasing the stenosis. The idea of the "recalibrage" is to remove only the upper part of the lamina with the ligamentum flavum and to cut the hypertrophied anterior part of the articular process from inside. If needed the disc and other osteophytes are removed. The surgery is finished with a ligamentoplasty reducing the flexion and preventing the extension by a posterior wedge.Our experience in spine surgery especially in scoliosis surgery, showed us that it was possible to cure a radicular compression without opening the canal. The compression is then lifted by the 3D reduction and restoration of an anatomy as normal as possible. Lumbar stenosis is the consequence of a degenerative process. Indeed, hip

  16. Generalised Leukaemic Gingival Enlargement: a Case Report

    Directory of Open Access Journals (Sweden)

    Mechery Reenesh

    2012-09-01

    Full Text Available Background: Acute myeloblastic leukaemia is a malignant bone marrow neoplasm of myeloid precursors of white blood cells. Due to its high morbidity rate, early diagnosis and appropriate medical therapy is essential. Methods: The article highlights normal blood alterations like anaemia, thrombocytopenia, leukocytosis and advanced diagnostic aids like flow cytometry, special staining as a diagnostic modality as well as for prognostic information in acute leukaemia, particularly as a tool for assigning lineage and facilitating further pathologic classification which may be helpful in influencing treatment strategies.Results: On clinical examination the case presented with features of inflammatory gingival enlargement with presence of local deposits and calculus. Routine blood examination anaemia, thrombocytopenia, leukocytosis with haemoglobin 5.6 gm% and total leukocyte count of 1,12,000 / cu mm suggestive of leukaemia. Myeloperoxidase and leukocyte nonspecific esterase (NSE special stain were used which showed presence of myeloblasts in the peripheral smear suggestive of acute myelocytic leukaemia. Flow cytometry were done which further helped in interpretation of these cells which showed to be strongly positive for CD45, CD13, CD14, and anti HLADR and moderately positive for CD4, CD34 and Anti MPO confirming to be case of AML-M4 with 57.73% gating.Conclusions: Fact that gingival alterations are sometimes the first manifestations of the disease implies that dental professionals must be sufficiently familiarized with the clinical manifestations of systemic diseases. The timely referral by the general dentist for a suspicious lesion provided an early diagnosis and early intervention reducing the patient morbidity.

  17. Orbital Myositis Complicating Sinusitis: Case Report and Review

    Directory of Open Access Journals (Sweden)

    Joe S Dylewski

    2001-01-01

    Full Text Available Orbital myositis is a common cause of extraocular muscle enlargement. It is characterized by nonspecific inflammation of one or more extraocular muscles. Although often idiopathic in origin, orbital myositis has been associated with various noninfectious diseases. Several cases have also been reported as occurring after upper respiratory tract infections. The present report describes a case of orbital myositis together with subclinical sinusitis and its rapid resolution after antibiotic treatment. The literature on this clinical entity is also reviewed.

  18. Isolated abscess in superior rectus muscle in a child

    Directory of Open Access Journals (Sweden)

    Sushank Ashok Bhalerao

    2015-01-01

    Full Text Available Pyomyositis is a primary bacterial infection of striated muscles nearly always caused by Staphylococcus aureus. Development of the intramuscular abscess involving the extra-ocular muscles (EOMs remains an extremely rare process. We herein present a case of isolated EOM pyomyositis involving superior rectus muscle in a 2-year male child who was referred with complaints of swelling in left eye (LE and inability to open LE since last 1-month. Orbital computed tomography (CT scan showed a well-defined, hypo-dense, peripheral rim-enhancing lesion in relation to left superior rectus muscle suggestive of left superior rectus abscess. The abscess was drained through skin approach. We concluded that pyomyositis of EOM should be considered in any patient presenting with acute onset of orbital inflammation and characteristic CT or magnetic resonance imaging features. Management consists of incision and drainage coupled with antibiotic therapy.

  19. The differentiation and morphogenesis of craniofacial muscles.

    Science.gov (United States)

    Noden, Drew M; Francis-West, Philippa

    2006-05-01

    Unraveling the complex tissue interactions necessary to generate the structural and functional diversity present among craniofacial muscles is challenging. These muscles initiate their development within a mesenchymal population bounded by the brain, pharyngeal endoderm, surface ectoderm, and neural crest cells. This set of spatial relations, and in particular the segmental properties of these adjacent tissues, are unique to the head. Additionally, the lack of early epithelialization in head mesoderm necessitates strategies for generating discrete myogenic foci that may differ from those operating in the trunk. Molecular data indeed indicate dissimilar methods of regulation, yet transplantation studies suggest that some head and trunk myogenic populations are interchangeable. The first goal of this review is to present key features of these diversities, identifying and comparing tissue and molecular interactions regulating myogenesis in the head and trunk. Our second focus is on the diverse morphogenetic movements exhibited by craniofacial muscles. Precursors of tongue muscles partly mimic migrations of appendicular myoblasts, whereas myoblasts destined to form extraocular muscles condense within paraxial mesoderm, then as large cohorts they cross the mesoderm:neural crest interface en route to periocular regions. Branchial muscle precursors exhibit yet another strategy, establishing contacts with neural crest populations before branchial arch formation and maintaining these relations through subsequent stages of morphogenesis. With many of the prerequisite stepping-stones in our knowledge of craniofacial myogenesis now in place, discovering the cellular and molecular interactions necessary to initiate and sustain the differentiation and morphogenesis of these neglected craniofacial muscles is now an attainable goal.

  20. Chest radiographs fail to detect right ventricular enlargement and right atrial enlargement in patients with a pure restrictive ventilatory impairment.

    Science.gov (United States)

    Shivkumar, K; Ravi, K; Henry, J W; Eichenhorn, M S; Stein, P D

    1994-08-01

    The validity of measurements of the cardiac silhouette on chest radiographs for the evaluation of right ventricular enlargement and right atrial enlargement in patients with a pure restrictive ventilatory impairment was investigated in 19 patients. The forced vital capacity (FVC) percent predicted in these patients was 59 +/- 12 percent (mean +/- SD) (range, 29 to 79 percent). Right ventricular enlargement, by two-dimensional echocardiography, was defined as a right ventricular area > 20.4 cm2 and right atrial enlargement was defined as a right atrial area > 15.3 cm2. Chest radiographic measurements in the posteroanterior (PA) projection included distance from the midline to the farthest point of the right border of the cardiac silhouette, transverse cardiac diameter, and cardiothoracic ratio. Measurements in the lateral projection included the lateral horizontal transverse diameter, ventral portion of the lateral broad diameter, and obliteration of the retrosternal space. Neither the right ventricular area nor the right atrial area correlated with any of these radiographic measurements. There were no differences in these chest radiographic measurements among patients with normal right ventricular and right atrial dimensions, patients with right ventricular enlargement, and patients with right atrial enlargement. We conclude, therefore, that PA and lateral chest radiographs do not reliably detect right ventricular enlargement or right atrial enlargement in patients with a pure restrictive ventilatory impairment.

  1. Primary and secondary overacting inferior oblique muscles: an ultrastructural study.

    OpenAIRE

    Meyer, E.; Ludatscher, R. M.; Zonis, S

    1984-01-01

    Biopsy material from primary and secondary overacting inferior oblique muscles were examined by light and electron microscopy. Most muscle fibres were in different stages of atrophy. A high variation of alterations was encountered in all muscles. The most striking abnormalities were huge accumulations of mitochondria and muscle vacuolisation related mainly to the enlargement of the tubules of sarcoplasmic reticulum. The mitochondrial aggregates and vacuolisation occupied more muscle surface i...

  2. Intraocular and extraocular cameras for retinal prostheses: Effects of foveation by means of visual prosthesis simulation

    Science.gov (United States)

    McIntosh, Benjamin Patrick

    Blindness due to Age-Related Macular Degeneration and Retinitis Pigmentosa is unfortunately both widespread and largely incurable. Advances in visual prostheses that can restore functional vision in those afflicted by these diseases have evolved rapidly from new areas of research in ophthalmology and biomedical engineering. This thesis is focused on further advancing the state-of-the-art of both visual prostheses and implantable biomedical devices. A novel real-time system with a high performance head-mounted display is described that enables enhanced realistic simulation of intraocular retinal prostheses. A set of visual psychophysics experiments is presented using the visual prosthesis simulator that quantify, in several ways, the benefit of foveation afforded by an eye-pointed camera (such as an eye-tracked extraocular camera or an implantable intraocular camera) as compared with a head-pointed camera. A visual search experiment demonstrates a significant improvement in the time to locate a target on a screen when using an eye-pointed camera. A reach and grasp experiment demonstrates a 20% to 70% improvement in time to grasp an object when using an eye-pointed camera, with the improvement maximized when the percept is blurred. A navigation and mobility experiment shows a 10% faster walking speed and a 50% better ability to avoid obstacles when using an eye-pointed camera. Improvements to implantable biomedical devices are also described, including the design and testing of VLSI-integrable positive mobile ion contamination sensors and humidity sensors that can validate the hermeticity of biomedical device packages encapsulated by hermetic coatings, and can provide early warning of leaks or contamination that may jeopardize the implant. The positive mobile ion contamination sensors are shown to be sensitive to externally applied contamination. A model is proposed to describe sensitivity as a function of device geometry, and verified experimentally. Guidelines are

  3. Doorkeepers and Gatecrashers: EU Enlargement and Negotiation Strategies

    DEFF Research Database (Denmark)

    Brücker, Herbert; Schröder, Philipp; Weise, Christian

    2004-01-01

    This paper discusses the eastward enlargement process of the EU in the framework of a simple war of attrition bargaining game. Both players -- the existing EU members and the applicants -- benefit from enlargement, yet for the applicants, reform to the acquis is costly, while the EU prefers...... substantially reformed candidates. A waiting game unfolds. Within this framework the present enlargement round is analysed and policy results are deduced. For example, it is shown that delegating the evaluation of applicants to a third party, compensating applicants for their reform efforts or increasing...... the benefits for new members are all effective negotiation strategies for the EU that have been applied in the process....

  4. Growth and the Enlargement of a Common Market

    Directory of Open Access Journals (Sweden)

    Cheng-Te Lee

    2013-12-01

    Full Text Available This paper explores the growth effects of the enlargement of a common market from two to three countries by making use of a three-country equilibrium growth model with heterogeneous labour. We prove that the enlargement will stimulate the backward countries’ economic growth. In addition, we also demonstrate that the higher the new member country’s average talent level is, the more likely it is that the enlargement can speed up the initial integrated-economy’s economic growth.

  5. Challenges for monetary policy in the enlarged European monetary Union

    Directory of Open Access Journals (Sweden)

    Radović Irena

    2009-01-01

    Full Text Available The eastward enlargement of the Euro area entails significant implications for the accession candidates in Central and Eastern Europe (CEE, the existing Euro system and the monetary policy of the European Central Bank (ECB. The present analysis assesses the challenges and critical aspects in monetary policy modeling with special emphasis to enlargement. The focus is on the difficulty of implementing a unique currency policy in view or growing heterogeneity within the enlarged monetary union, and secondly - the issue of the voting mechanism within the ECB. When analyzing those two issues, it is conclusive that the difficulties for the ECB and the current Euro zone members will increase. For the enlarged Euro zone, which is becoming more divergent, it will be very hard to find adequate recipes to meet the needs and requirements of all. The big question is: whether centralization of monetary policy is a sustainable and superior solution?.

  6. How do plants enlarge? A balancing act; Final report

    Energy Technology Data Exchange (ETDEWEB)

    Boyer, J.S.

    1996-12-31

    Cells of plants are surrounded by strong walls that prevent rupture from internal pressures that can be two or three times that of an automobile tire. In this way, the walls protect the cytoplasm. However, at the same time, the cells can enlarge as they grow. How this balancing act works and how it enlarges the plant were the subject of a recent conference at the University of Delaware in Lewes. The aim was to identify areas for future research that could explain the enlargement of whole plants. There is a large practical need to predict and modify plant enlargement but the additional processes that overlie the molecular ones need to be integrated with the molecular information before a picture will emerge. How best to accomplish this involved input from cross-disciplinary areas in biomechanics, physics and engineering as well as molecular biology, biochemistry and ultrastructure.

  7. POSSIBLE TRADE EFFECTS OF THE NEXT EUROPEAN UNION ENLARGEMENT

    Directory of Open Access Journals (Sweden)

    Nedelescu-Ionescu Daniela

    2012-07-01

    Full Text Available The European Union next enlargement will constitute a significant qualitative change in the structure of the current Union, as the accession of the Western Balkan countries and of Turkey in particular will bring a brand new set of economic problems. It is expected that this enlargement to have a considerable effect for the new entrants, as well as for the European Union as a whole.\\r\

  8. Doorkeepers and Gatecrashers: EU Enlargement and Negotiation Strategies

    DEFF Research Database (Denmark)

    Brücker, Herbert; Schröder, Philipp; Weise, Christian

    2004-01-01

    This paper discusses the eastward enlargement process of the EU in the framework of a simple war of attrition bargaining game. Both players -- the existing EU members and the applicants -- benefit from enlargement, yet for the applicants, reform to the acquis is costly, while the EU prefers subst...... the benefits for new members are all effective negotiation strategies for the EU that have been applied in the process....

  9. Ubx Regulates Differential Enlargement and Diversification of Insect Hind Legs

    Science.gov (United States)

    Mahfooz, Najmus; Turchyn, Nataliya; Mihajlovic, Michelle; Hrycaj, Steven; Popadić, Aleksandar

    2007-01-01

    Differential enlargement of hind (T3) legs represents one of the hallmarks of insect evolution. However, the actual mechanism(s) responsible are yet to be determined. To address this issue, we have now studied the molecular basis of T3 leg enlargement in Oncopeltus fasciatus (milkweed bug) and Acheta domesticus (house cricket). In Oncopeltus, the T3 tibia displays a moderate increase in size, whereas in Acheta, the T3 femur, tibia, and tarsus are all greatly enlarged. Here, we show that the hox gene Ultrabithorax (Ubx) is expressed in the enlarged segments of hind legs. Furthermore, we demonstrate that depletion of Ubx during embryogenesis has a primary effect in T3 legs and causes shortening of leg segments that are enlarged in a wild type. This result shows that Ubx is regulating the differential growth and enlargement of T3 legs in both Oncopeltus and Acheta. The emerging view suggests that Ubx was co-opted for a novel role in regulating leg growth and that the transcriptional modification of its expression may be a universal mechanism for the evolutionary diversification of insect hind legs. PMID:17848997

  10. Rib enlargement in premature infants with bronchopulmonary dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung; Han, Kim Bokyung; Chang, Yun Sil; Choo, In Wook [Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul (Korea, Republic of); Kim, Kyeong Ah [Anyang General Hospital, Anyang (Korea, Republic of)

    2000-04-01

    The purpose of this study is to describe the rib changes seen in patients with brochopulmonary dysplasia (BPD). Serial chest radiographs of nine premature infants with BPD who showed diffuse rib enlargement were reviewed for hyperinflation, which was compared with the observed degree of rib enlargement. Vibrator chest physiotherapy was performed in all cases, and five infants underwent conventional ventilation plus high frequency oscillatory ventilation therapy. Their calcium level was normal whereas alkaline phosphatase and phosphate levels were high. In all infants except one, liver enzyme levels were normal. For the treatment of patent ductus arteriosus, infection, and BPD, medications including indomethacin, antibiotics, and dexamethasone were administered. Vitamin D was given to all patients with total parenteral nutrition. Rib enlargement was found to be severe (n=3D4), moderate (n=3D3), or mild (n=3D2) with undulating margins or posterior tapering (n=3D2). Hyperinflation was noted in eight patients, in seven of whom it was moderate to severe. Among these seven, rib enlargement was severe (n=3D2), moderate (n=3D3), or mild (n=3D2). In one infant with mild hyperinflation, rib enlargement was severe. Bilateral irregular infiltrates and atelectases were noted in all patients. In BPD patients, rib enlargement may be seen. In order to differentiate this process from systemic bone disease or bony dysplasia, an awareness of the rib changes occurring in patients with BPD may be important. (author)

  11. Ubx regulates differential enlargement and diversification of insect hind legs.

    Directory of Open Access Journals (Sweden)

    Najmus Mahfooz

    Full Text Available Differential enlargement of hind (T3 legs represents one of the hallmarks of insect evolution. However, the actual mechanism(s responsible are yet to be determined. To address this issue, we have now studied the molecular basis of T3 leg enlargement in Oncopeltus fasciatus (milkweed bug and Acheta domesticus (house cricket. In Oncopeltus, the T3 tibia displays a moderate increase in size, whereas in Acheta, the T3 femur, tibia, and tarsus are all greatly enlarged. Here, we show that the hox gene Ultrabithorax (Ubx is expressed in the enlarged segments of hind legs. Furthermore, we demonstrate that depletion of Ubx during embryogenesis has a primary effect in T3 legs and causes shortening of leg segments that are enlarged in a wild type. This result shows that Ubx is regulating the differential growth and enlargement of T3 legs in both Oncopeltus and Acheta. The emerging view suggests that Ubx was co-opted for a novel role in regulating leg growth and that the transcriptional modification of its expression may be a universal mechanism for the evolutionary diversification of insect hind legs.

  12. [Intraorbital extraocular Langerhans' cell granuloma: primary surgical approach. Why? - case report].

    Science.gov (United States)

    Valentim Neto, João Guilherme; Schaurich, Cristina Góes

    2009-01-01

    We present a case in which a patient with intraorbital Langerhans' cell granuloma, with anatomical and functional skills compromised by intraorbital hypertension, which was treated with urgency orbitotomy by cranial approach. Male, two years-old, presented conjuntival proptosis, red eye, complete ophthalmoplegy, exophthalmos, with non-fotoreactive mydriasis and blepharoptosis of the right eye. Fundoscopy presented venous enlargement with optic disc edema. A cranial approach with orbitotomy was carried out, removed the lesion with total remission of clinical presentation and anatomic appearance as well. The handling of Langerhans' cell granuloma can vary from primary surgical approach as corticotherapy to chemotherapy and radiotherapy. In this case, the surgery was the first option due to the imminent risk of loss of visual function.

  13. A rare case of unusual gingival enlargement post radiotherapy

    Directory of Open Access Journals (Sweden)

    Vishal Singh

    2011-01-01

    Full Text Available Oral changes following radiotherapy are not uncommon. Oral mucositis, alteration in salivary gland function, radiation caries, and gingival changes have all been reported following radiotherapy and chemotherapy. The gingival changes seen after radiotherapy may be unusual and often cause diagnostic dilemma. Metastasis to the gingiva has also to be ruled out in these cases. A 30-year-old female patient presented with enlargement of the gingiva of 6 months′ duration and lower lip swelling of 7 months′ duration. She was a known case of carcinoma of nasopharynx and had received radiotherapy and chemotherapy. Based on the history, the clinical appearance of the gingiva, and the other oral changes we considered both post-radiotherapy gingival enlargement and secondary metastasis to gingiva as possibilities. An incisional biopsy was performed (internal bevel gingivectomy. The histopathological report did not reveal any metastatic changes. Thus, we diagnosed post-radiotherapy gingival enlargement. For the multiple carious teeth, extraction and root canal treatment was carried out as necessary. The patient was referred to the department of Oral and Maxillofacial Surgery for management of swelling of the lips, which was diagnosed as lymphedema of the lip. Gingival enlargement is rare post radiotherapy. Such nonplaque-associated gingival enlargement in a patient who has undergone radiotherapy should be subjected to biopsy and histopathological examination to distinguish between secondary metastasis and post-radiation changes.

  14. Peculiar enlargement of the nasopharynx in patients with anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Okamoto, K. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Ito, J. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Tokiguchi, S. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Kuwabara, G. [Department of Radiology, School of Medicine, Niigata University, Niigata (Japan); Nishihara, M. [Department of Radiology, School of Medicine, Niigata University, Niigata (Japan)

    1995-11-01

    We examined the nasopharynx and brain in 17 patients with anorexia nervosa by CT and compared the findings with those of 44 normal subjects and of 5 patients of the same age with marked emaciation caused by various psychiatric disorders. An enlarged nasopharyngeal space with a flattened posterior wall and enlarged lateral pharyngeal recesses were demonstrated in all patients with anorexia nervosa whose weight was lowest at the time of the CT examination, and these CT features regressed or became normal quickly after they had gained some weight. This characteristic enlargement of the nasopharynx and lateral pharyngeal recesses was observed neither in the markedly emaciated patients (2 with schizophrenia, 1 with major depression, 1 with stupor and the other with an extremely unbalanced diet) nor in 44 normal subjects without emaciation. These features were therefore thought to be characteristic and of diagnostic significance. (orig.). With 5 figs., 3 tabs.

  15. Intrinsic laryngeal muscles are spared from myonecrosis in the mdx mouse model of Duchenne muscular dystrophy.

    Science.gov (United States)

    Marques, Maria Julia; Ferretti, Renato; Vomero, Viviane Urbini; Minatel, Elaine; Neto, Humberto Santo

    2007-03-01

    Intrinsic laryngeal muscles share many anatomical and physiological properties with extraocular muscles, which are unaffected in both Duchenne muscular dystrophy and mdx mice. We hypothesized that intrinsic laryngeal muscles are spared from myonecrosis in mdx mice and may serve as an additional tool to understand the mechanisms of muscle sparing in dystrophinopathy. Intrinsic laryngeal muscles and tibialis anterior (TA) muscle of adult and aged mdx and control C57Bl/10 mice were investigated. The percentage of central nucleated fibers, as a sign of muscle fibers that had undergone injury and regeneration, and myofiber labeling with Evans blue dye, as a marker of myofiber damage, were studied. Except for the cricothyroid muscle, none of the intrinsic laryngeal muscles from adult and old mdx mice showed signs of myofiber damage or Evans blue dye labeling, and all appeared to be normal. Central nucleation was readily visible in the TA of the same mdx mice. A significant increase in the percentage of central nucleated fibers was observed in adult cricothyroid muscle compared to the other intrinsic laryngeal muscles, which worsened with age. Thus, we have shown that the intrinsic laryngeal muscles are spared from the lack of dystrophin and may serve as a useful model to study the mechanisms of muscle sparing in dystrophinopathy.

  16. Enlarged Right Ventricle Without Shock in Acute Pulmonary Embolism: Prognosis

    Science.gov (United States)

    Stein, Paul D.; Beemath, Afzal; Matta, Fadi; Goodman, Lawrence R.; Weg, John G.; Hales, Charles A.; Hull, Russell D.; Leeper, Kenneth V.; Dirk Sostman, H; Woodard, Pamela K.

    2008-01-01

    Background An unsettled issue is use of thrombolytic agents in patients with acute pulmonary embolism who are hemodynamically stable, but have right ventricular enlargement. Purpose To assess in-hospital mortality of hemodynamically stable patients with pulmonary embolism and right ventricular enlargement. Methods Patients were enrolled in the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II). Exclusions included shock, critically ill, ventilatory support, myocardial infarction within 1 month, or ventricular tachycardia or ventricular fibrillation within 24 hours. We evaluated the ratio of the right ventricular minor axis to the left ventricular minor axis measured on transverse images during computed tomographic angiography. Results Among 76 patients with right ventricular enlargement treated with anticoagulants and/or inferior vena cava filters, in–hospital deaths from pulmonary embolism were 0 of 76 (0%) and all-cause mortality was 2 of 76 (2.6%). No septal motion abnormality was observed in 49 (64%), septal flattening in 25 (33%) and septal deviation in 2 (3%). None required ventilatory support, vasopressor therapy, rescue thrombolytic therapy, or catheter embolectomy. There were no in-hospital deaths due to pulmonary embolism. There was no difference in all-cause mortality comparing patients with and without right ventricular enlargement (relative risk = 1.04) Conclusion In-hospital prognosis is good in patients with pulmonary embolism and right ventricular enlargement if not in shock, acutely ill, on ventilatory support, recent myocardial infarction or life threatening arrhythmia. Right ventricular enlargement alone in patients with pulmonary embolism, therefore, does not appear to indicate a poor prognosis or an indication for thrombolytic therapy. PMID:18187071

  17. Gingival enlargement unveiling sarcoidosis: Report of a rare case

    Directory of Open Access Journals (Sweden)

    Sabeeha Abbas Kadiwala

    2013-01-01

    Full Text Available Sarcoidosis is classified as an acquired systemic granulomatous disease. Because of the fact that sarcoidosis affects multiple tissues and organs, it is characterized by many potential signs and symptoms, as well as by the presence of non-caseating granulomas in the organs involved. Although oral sarcoidosis is relatively rare, it may however, present in the oral cavity. This report presents a rare case of sarcoidosis with the initial presenting symptom as severe generalized gingival enlargement. The gingival enlargement was treated by gingivectomy. After histopathological examination of gingival biopsy and certain special investigations, a diagnosis of sarcoidosis was made.

  18. Image enlargement using biharmonic Said-Ball surface

    Science.gov (United States)

    Saaban, A.; Kherd, A.; Jameel, A. F.; Akhadkulov, H.; Alipiah, F. M.

    2017-09-01

    This paper discusses the use of biharmonic cubic Said-Ball surfaces in image enlargement area. Resizing an image through up sampling or down sampling is generally common for making smaller image fit a bigger screen in full screen mode or reducing a higher resolution image to a smaller resolution. However due to some limitation, this paper will focus on image enlargement based on scaling factor of two. We use biharmonic cubic Said-Ball subject to a given four boundary curves condition respectively. We implement and evaluate the performance of the proposed method based on peak signal to noise ratio (PSNR) indicator using well-known gray-scale test images.

  19. Spleen and liver enlargement in a patient with rheumatoid arthritis.

    Science.gov (United States)

    Bedoya, María Eugenia; Ceccato, Federico; Paira, Sergio

    2015-01-01

    We describe the case of a 51-year-old woman with a seropositive, erosive, and non-nodular rheumatoid arthritis of 15 year of evolution. The patient had poor compliance with medical visits and treatment. She came to the clinic with persistent pancytopenia and spleen and liver enlargement. Liver and bone marrow biopsies were carried out and amyloidosis, neoplasias and infections were ruled out. We discuss the differential diagnosis of pancytopenia and spleen and liver enlargement in a long-standing rheumatoid arthritis patient. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  20. Mitral-aortic annular enlargement: modification of Manouguian's technique

    Directory of Open Access Journals (Sweden)

    Costa Mario Gesteira

    2002-01-01

    Full Text Available We hereby present a technical modification for mitral-aortic annular enlargement. The mitral valve is replaced through the retro-septal approach, avoiding patches for left atrial roof closure. We report a mitral-aortic valve replacement in a patient whose original annuli would preclude adequate prostheses. The simultaneous annular enlargement may be necessary for avoiding patient-prosthesis mismatch and for reconstructing destroyed mitral and aortic annuli. The technique may minimize the risk of bleeding and of paravalvular leakage, using an approach well known to cardiac surgeons.

  1. Pure myopathy with enlarged mitochondria associated to a new mutation in MTND2 gene

    Directory of Open Access Journals (Sweden)

    Alice Zanolini

    2017-03-01

    Full Text Available To date, only few mutations in the mitochondrial DNA (mtDNA-encoded ND2 subunit of Complex I have been reported, usually presenting a severe phenotype characterized by early onset encephalomyopathy and early death. In this report, we describe a new mutation in the MTND2 gene in a 21-year-old man with a mild myopathic phenotype characterized by exercise intolerance and increased plasma lactate at rest. Electromyography and brain NMR were normal, and no cardiac involvement was present. Muscle biopsy showed a massive presence of ragged red – COX-positive fibres, with enlarged mitochondria containing osmiophilic inclusions. Biochemical assays revealed a severe isolated complex I deficiency. We identified a novel, heteroplasmic mutation m.4831G>A in the MTND2 gene, causing the p.Gly121Asp substitution in the ND2 protein. The mutation was present in the 95% of mitochondrial genomes from patient's muscle tissue, at a lower level in cells from the urinary tract and at a lowest level in lymphocytes from patient's blood; the base substitution was absent in fibroblasts and in the tissues from proband's healthy mother and brother. The specific skeletal muscle tissue involvement can explain the childhood-onset and the relatively benign, exclusively myopathic course of the disease.

  2. Debate on Global Impact of EU Enlargement Held in Guangzhou

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    <正>On the afternoon of April 27, the CPAFFC, the China- EU Association (CEUA), the Guangdong Provincial People’s Association for Friendship with Foreign Countries (GPPAFFC) and the Delegation of the European Commission of the European Union jointly held a debate on the global impact brought about by the 15+10 enlargement of European Union in Zhongshan University, Guangzhou.

  3. The Trade and FDI Effects of EMU Enlargement

    NARCIS (Netherlands)

    R. Paap (Richard); J.M.A. Viaene (Jean-Marie); J. Brouwer (Jelle)

    2007-01-01

    textabstractThis paper considers the nature and the distribution of trade and FDI effects of a potential enlargement of the European Monetary Union (EMU) to the ten countries that obtained EU membership in 2004. Intuitively, the implementation of a single currency for these countries means replacing

  4. Amygdala and hippocampus enlargement during adolescence in autism.

    NARCIS (Netherlands)

    Groen, W.B.; Teluij, M.; Buitelaar, J.K.; Tendolkar, I.

    2010-01-01

    OBJECTIVE: The amygdala and hippocampus are key components of the neural system mediating emotion perception and regulation and are thought to be involved in the pathophysiology of autism. Although some studies in children with autism suggest that there is an enlargement of amygdala and hippocampal

  5. Congress announcement: PHARM Connect Congress for Enlarged Europe 2012

    Directory of Open Access Journals (Sweden)

    Silvia Maina

    2012-01-01

    Full Text Available PHARM Connect Congress for Enlarged Europe 2012 is a must-attend event for Pharmaceutical industry professionals. Over two days (8-9 February, in Budapest, the conference will include the most up-to-date market insights into R&D, Production, Packaging, Supply Chain and Quality Management-related topics.

  6. [Enlargement of the buccal aperture via. Technical consideration (author's transl)].

    Science.gov (United States)

    Pons, J; Pasturel, A; Pochan, Y; Barbier, M

    1979-01-01

    For a long time we know that it is possible to take out from the mouth a part or all the mandibule which presents a local malignant tumour. When the tumour is too extensed, the buccal aperture can be enlarged. The authors describe a new surgical technique which resolves this problem with notable and faithful advantages.

  7. The Trade and FDI Effects of EMU Enlargement

    NARCIS (Netherlands)

    R. Paap (Richard); J.M.A. Viaene (Jean-Marie); J. Brouwer (Jelle)

    2007-01-01

    textabstractThis paper considers the nature and the distribution of trade and FDI effects of a potential enlargement of the European Monetary Union (EMU) to the ten countries that obtained EU membership in 2004. Intuitively, the implementation of a single currency for these countries means replacing

  8. Construction and enlargement of traversable wormholes from Schwarzschild black holes

    CERN Document Server

    Koyama, H; Koyama, Hiroko; Hayward, Sean A.

    2004-01-01

    Analytic solutions are presented which describe the construction of a traversable wormhole from a Schwarzschild black hole, and the enlargement of such a wormhole, in Einstein gravity. The matter model is pure radiation which may have negative energy density (phantom or ghost radiation) and the idealization of impulsive radiation (infinitesimally thin null shells) is employed.

  9. Collision and containment detection between biomechanically based eye muscle volumes.

    Science.gov (United States)

    Santana Sosa, Graciela; Kaltofen, Thomas

    2011-01-01

    Collision and containment detection between three-dimensional objects is a common requirement in simulation systems. However, few solutions exist when exclusively working with deformable bodies. In our ophthalmologic diagnostic software system, the extraocular eye muscles are represented by surface models, which have been reconstructed from magnetic resonance images. Those models are projected onto the muscle paths calculated by the system's biomechanical model. Due to this projection collisions occur. For their detection, three approaches have been implemented, which we present in this paper: one based on image-space techniques using OpenGL, one based on the Bullet physics library and one using an optimized space-array data structure together with software rendering. Finally, an outlook on a possible response to the detected collisions is given.

  10. The posterior cricoarytenoid muscle is spared from MuRF1-mediated muscle atrophy in mice with acute lung injury.

    Science.gov (United States)

    Files, D Clark; Xiao, Kunhong; Zhang, Tan; Liu, Chun; Qian, Jiang; Zhao, Weiling; Morris, Peter E; Delbono, Osvaldo; Feng, Xin

    2014-01-01

    Skeletal muscle wasting in acute lung injury (ALI) patients increases the morbidity and mortality associated with this critical illness. The contribution of laryngeal muscle wasting to these outcomes is unknown, though voice impairments and aspiration are common in intensive care unit (ICU) survivors. We evaluated the intrinsic laryngeal abductor (PCA, posterior cricoarytenoid), adductor (CT, cricothyroid) and limb (EDL, extensor digitorum longus) muscles in a mouse model of ALI. Escherichia coli lipopolysaccharides were instilled into the lungs of adult male C57Bl6J mice (ALI mice). Limb and intrinsic laryngeal muscles were analyzed for fiber size, type, protein expression and myosin heavy chain (MyHC) composition by SDS-PAGE and mass spectroscopy. Marked muscle atrophy occurred in the CT and EDL muscles, while the PCA was spared. The E3 ubiquitin ligase muscle ring finger-1 protein (MuRF1), a known mediator of limb muscle atrophy in this model, was upregulated in the CT and EDL, but not in the PCA. Genetic inhibition of MuRF1 protected the CT and EDL from ALI-induced muscle atrophy. MyHC-Extraocular (MyHC-EO) comprised 27% of the total MyHC in the PCA, distributed as hybrid fibers throughout 72% of PCA muscle fibers. The vocal cord abductor (PCA) contains a large proportion of fibers expressing MyHC-EO and is spared from muscle atrophy in ALI mice. The lack of MuRF1 expression in the PCA suggests a previously unrecognized mechanism whereby this muscle is spared from atrophy. Atrophy of the vocal cord adductor (CT) may contribute to the impaired voice and increased aspiration observed in ICU survivors. Further evaluation of the sparing of muscles involved in systemic wasting diseases may lead to potential therapeutic targets for these illnesses.

  11. Fgf regulates dedifferentiation during skeletal muscle regeneration in adult zebrafish.

    Science.gov (United States)

    Saera-Vila, Alfonso; Kish, Phillip E; Kahana, Alon

    2016-09-01

    Fibroblast growth factors (Fgfs) regulate critical biological processes such as embryonic development, tissue homeostasis, wound healing, and tissue regeneration. In zebrafish, Fgf signaling plays an important role in the regeneration of the spinal cord, liver, heart, fin, and photoreceptors, although its exact mechanism of action is not fully understood. Utilizing an adult zebrafish extraocular muscle (EOM) regeneration model, we demonstrate that blocking Fgf receptor function using either a chemical inhibitor (SU5402) or a dominant-negative transgenic construct (dnFGFR1a:EGFP) impairs muscle regeneration. Adult zebrafish EOMs regenerate through a myocyte dedifferentiation process, which involves a muscle-to-mesenchyme transition and cell cycle reentry by differentiated myocytes. Blocking Fgf signaling reduced cell proliferation and active caspase 3 levels in the regenerating muscle with no detectable levels of apoptosis, supporting the hypothesis that Fgf signaling is involved in the early steps of dedifferentiation. Fgf signaling in regenerating myocytes involves the MAPK/ERK pathway: inhibition of MEK activity with U0126 mimicked the phenotype of the Fgf receptor inhibition on both muscle regeneration and cell proliferation, and activated ERK (p-ERK) was detected in injured muscles by immunofluorescence and western blot. Interestingly, following injury, ERK2 expression is specifically induced and activated by phosphorylation, suggesting a key role in muscle regeneration. We conclude that the critical early steps of myocyte dedifferentiation in EOM regeneration are dependent on Fgf signaling.

  12. Muscle Disorders

    Science.gov (United States)

    Your muscles help you move and help your body work. Different types of muscles have different jobs. There are many problems that can affect muscles. Muscle disorders can cause weakness, pain or even ...

  13. Muscle Cramps

    Science.gov (United States)

    Muscle cramps are sudden, involuntary contractions or spasms in one or more of your muscles. They often occur ... minutes. It is a very common muscle problem. Muscle cramps can be caused by nerves that malfunction. Sometimes ...

  14. Phenytoin, folic acid and gingival enlargement: Breaking myths

    Directory of Open Access Journals (Sweden)

    Abhishek Singh Nayyar

    2014-01-01

    Full Text Available Background: Epilepsy is described as a chronic neurological disorder characterized by recurrent seizures of cerebral origin, presenting with episodes of sensory, motor or autonomic phenomenon with or, without loss of consciousness. A recent meta-analysis of published and unpublished studies puts an overall prevalence rate of epilepsy in India at 5.59 per 1,000 populations.There have been studies that report clinical benefits of the use of folic acid as an adjuvant to the anti-epileptic therapy in the prevention of anti-epileptic drug induced gingival enlargement. However, studies conducted in the past have also reported precipitation of epileptic attacks in patients on folic acid adjuvant therapy due to fall in sera levels of phenytoin due to drug interactions. The study was planned to investigate the association of phenytoin induced gingival enlargement and sera levels of folic acid in epileptic patients on phenytoin therapy so as to justify the use of folic acid as a routine adjuvant to the usual anti-epileptic therapy to prevent this inevitable adverse effect without destabilizing the ongoing regimen leading to the precipitation of seizures in an otherwise stable patient (breakthrough seizures. Materials and Methods: A total of 100 patients between the ages 18 and 50 years were clinically diagnosed with epilepsy prior to the start of phenytoin therapy were included based on selection criteria and written informed consents were obtained. Assessment of serum folic acid levels and gingival enlargement was performed prior to the start of and after 1 year of phenytoin therapy. Statistical Analysis Used: The statistical analysis was carried out using t-test and the baseline serum folate levels and the serum folate levels obtained after 1 year of phenytoin therapy were correlated with the respective grades of gingival enlargement using Pearson′s coefficient formula. Results: The results of the study confirmed a significant association between low

  15. Masseter and medial pterygoid muscle hypertrophy

    OpenAIRE

    R, Guruprasad; Rishi, Sudhirkumar; Nair, Preeti P; Thomas, Shaji

    2011-01-01

    Hypertrophy refers to an enlargement caused by an increase in the size but not in the number of cells. Generalised masticatory muscle hypertrophy may affect the temporalis muscle, masseters and medial pterygoids in a variety of combinations. Masseteric hypertrophy may present as either unilateral or bilateral painless swelling of unknown origin in the region of angle of mandible. It is a relatively rare condition and presents a diagnostic dilemma. While the history and clinical examination ar...

  16. Enlargement of the European Union and agricultural policy reform

    DEFF Research Database (Denmark)

    Jensen, Maria Skovager; Lind, Kim Martin Hjorth; Zobbe, Henrik

    2009-01-01

    A connection exists between enlargement of the European Union and reforms of the Common Agricultural Policy (CAP). Based upon rational choice theory, we examine whether the member states’ CAP positions are related to structures in their agricultural sectors. The overall hypothesis...... is that intensiveness of agricultural production corresponds to the willingness to reform the CAP. Political CAP positions, together with the development of member states’ structural fundamentals, are analysed using cluster analysis. The results show that EU enlargements have extensified agricultural production...... at the EU level, and that extensive agricultural production in a member state is often an indicator of reduced willingness to reform. However, the intensiveness of agricultural production is only part of the explanation. Moreover, negotiation tactics play an important role for the positions on the CAP....

  17. The EU Eastern enlargement: Policy choices of the Spanish government

    Directory of Open Access Journals (Sweden)

    Sonia Piedrafita Tremosa

    2005-01-01

    Full Text Available Eastern enlargement is a process in which the very identity of the European Union is under construction, with its constitutive principles and values being challenged. Policy choices of the member governments participating in this process can not exclusively being explained by rational choice assumptions, but a sociological approach to the issue also becomes necessary. Through the analysis of the Spanish government's policy on enlargement, this paper aims to show how policy preferences might not only respond to a cost-benefit calculus and how policy contents might develop endogenously during the process of policy formation in the EU. In this process there is room for member states to pursue their goals and search a collective decision that better accommodates their self-interest. However, deliberation also matters, and governments have to justify their actions in terms considered legitimate by all according to the constitutive principles and values of the EU polity.

  18. The Study on Pipe Sudden Enlargement Local Resistant Coefficient

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    During the design of pipeline,the determination of local resistant coefficient is often come arcoss. The sudden enlargement local resistant coefficient ζ1 = [1A1-A2]2 is determined through theory. In the paper,the sudden enlargement local resistant coefficient under the conditions of three kinds of A1-A2 was studied in experi-ment. In the end ,the result shows that ζ1 is related not only to two flow cross sections ,but also to the veloci research ,the relationship between ζ1A1-A2 and V1 was determined. In a word ,the hy-draulic calculation of pipeline can be done by taking correspondent ζ1 ,according to the design velocity V1 and A1/A2.

  19. Hypoplastic uterus and clitoris enlargement in Swyer syndrome.

    Science.gov (United States)

    Hétu, Valérie; Caron, Evelyne; Francoeur, Diane

    2010-02-01

    Swyer syndrome is associated with absent testicular differentiation in a 46XY phenotypic female. A 17-year-old female presented with primary amenorrhea and 46XY karyotype. Breast and pubic hair development were Tanner 2, and clitoral enlargement was noted. Magnetic resonance imaging revealed a hypoplastic uterus and 2 "normal ovaries." Serum follicle-stimulating hormone and luteinizing hormone were elevated. Testosterone and androstenedione were in the female range. Dehydroepiandrosterone sulfate was slightly elevated. Laparoscopic bilateral gonadectomy was performed. Pathology reports showed bilateral microscopic benign hilar cell tumors. The diagnosis was a real puzzle for the clinicians because of the association of clitoral hypertrophy without hirsutism, female internal genitalia, and a 46XY karyotype. Clitoral enlargement can be explained by transient androgen secretion by the hilar cells found in the resected gonads. Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  20. Old 'foundations' and new 'rules' - For an enlarged European Union

    Directory of Open Access Journals (Sweden)

    Philippe C. Schmitter

    1997-04-01

    Full Text Available This paper presents a novel arrangement for the distribution of votes and the rules of decision-making in an enlarged European Union (EU. We make two assumptions: (1 that the EU is condemned to enlarge its membership in the near future; and (2 if it does this without changing the existing rules for voting in the Council of Ministers and distributing seats in the European Parliament, such an expanded EU would suffer severe distortions and disequilibria. However, if it were to adopt a new, simplified system that would combine arrangements for proportional proportionality in representation and concurrent majorities in decision-making, this impending dilemma could be avoided. Moreover, if these reforms were introduced sooner rather than later, they would be easier to agree upon, their impact would be phased in gradually, and their legitimacy could be stabilized in the face of far greater challenges in the future.

  1. Performance of enlarged blood pump models with five different impellers.

    Science.gov (United States)

    Chua, L P; Yu, S C; Leo, H L

    2000-01-01

    In earlier studies, a 5:1 enlarged pump model of the Kyoto-NTN Magnetically Suspended Centrifugal Blood Pump had been constructed and the flow characteristics investigated. Although the results obtained were satisfactory, the medium used was air. A 5:1 enlarged pump model using water as the medium thus was designed and constructed. Five different impeller blade profile designs were used in the present study. By varying (1) the blade profile design: forward, radial, and backward, (2) the number of blades used, and (3) the rotating speed, the flow characteristics of the pump were investigated. It was found that the impeller with the higher number of blades, used in the forward and straight blade profiles, have the best performance.

  2. Childhood asymmetrical labium majus enlargement sonographic and MR imaging appearances

    Energy Technology Data Exchange (ETDEWEB)

    Gokli, Ami; Neuman, Jeremy; Lukse, Ruby; Koshy, June [Staten Island University Hospital, Department of Radiology, Staten Island, NY (United States); Kong, Fanyi [Staten Island University Hospital, Department of Pathology, Staten Island, NY (United States); Laor, Tal [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2016-05-15

    Childhood asymmetrical labium majus enlargement (CALME) has been described sparsely in recent surgery, pathology, pediatric and gynecology literature; however, no comprehensive description from a radiology perspective has been developed. The purpose of this case series is to describe the imaging findings of CALME and to review the current understanding of this recently described clinical entity with regard to clinical presentation, pathophysiology, differential diagnosis and treatment options. This is a retrospective analysis of 3 girls, ages 5-7 years, who presented for imaging evaluation with subsequent pathologically proven CALME. Each child's clinical history, length of symptoms, imaging appearance and pathological findings were reviewed. All three girls presented with unilateral enlargement of the labium majus (two right-side, one left-side) with no history of trauma or other inciting cause. Two girls had painless labial enlargement that was recognized for weeks, and one had similar symptoms for 1 year prior to presentation. One girl was evaluated initially with sonography, and all three children underwent MR imaging. Sonographic evaluation showed asymmetrical labial enlargement without a definable mass. In each girl, the MR imaging findings were characterized by relatively ill-defined T1-weighted hypointense signal, T2-weighted hypo- to isointense signal with interspersed hyperintense septae, and heterogeneous patchy and feathery strands of enhancement on post-contrast imaging. Biopsy from each child showed benign fibrous tissue with intervening mature fibroadipose tissue, vessels and nerves without findings of inflammation or neoplasia. The MR imaging appearance of CALME is consistent. Recognition and appreciation of this unique pediatric entity by the radiologist may be essential for appropriate diagnosis and can help to guide therapy. Current preferred treatment approach is conservative. (orig.)

  3. Obesity and prostate enlargement in men with localized prostate cancer.

    Science.gov (United States)

    Kopp, Ryan P; Han, Misop; Partin, Alan W; Humphreys, Elizabeth; Freedland, Stephen J; Parsons, J Kellogg

    2011-12-01

    What's known on the subject? and What does the study add? Obesity is associated with prostate enlargement in men without prostate cancer. This study demonstrates an association between obesity and prostate enlargement in men with prostate cancer, and leads to possible implications for prostate cancer screening and diagnosis. • To determine if obesity is associated with prostate size in men with prostate cancer. • We examined preoperative body mass index (BMI) and whole prostate weight in a cohort of 16,325 patients undergoing radical prostatectomy for localized prostate cancer from 1975 to 2008 at a single institution. • We used multivariable regression modelling adjusting for age, year of surgery, preoperative serum prostate-specific antigen (PSA), pathological stage and Gleason grade. • Of the entire cohort, 13,343 (82%) patients had a prostate weight of at least 40 g. These men were older (P prostate weight: for each 1 kg/m(2) increase in BMI, prostate weight increased by 0.45 g (95% CI 0.35-0.55, P-trend prostate weight of at least 40 g and a 70% (odds ratio 1.70, 95% CI 1.32-2.20) increased risk of prostate weight of at least 50 g. • In men with localized prostate cancer, obesity is associated with an increased risk of prostate enlargement. • These data validate other observations linking obesity with prostate enlargement and may have important ramifications for prostate cancer diagnosis in obese men. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  4. Amlodepine induced gingival enlargement - presentation of a clinical case series

    OpenAIRE

    Chaturvedi, Rashi; Jain, Ashish

    2011-01-01

    Objectives: Gingival enlargement as an adverse effects of drugs has been found to be long associated with the use of anticonvulsants; phenytoin, anti-hypertensives; calcium channel blockers and immunosuppressants; cyclosporine. Nifedepine was found to cause gingival overgrowth with an incidence ranging from 15-85%. However, Amlodepine a relatively newer agent of the same group which is being routinely and vastly prescribed either alone or as part of combination therapy to middle t...

  5. [Randomly discovered enlargement in the region of sella turcica].

    Science.gov (United States)

    Hána, V; Seidl, Z; Vanĕcková, M; Diblík, P; Weiss, V; Masopust, V; Krsek, M; Marek, J

    2007-01-01

    Computer tomography (CT) and magnetic resonance imaging (MRI) quite often detect unexpected cases of enlargement in the hypothalamus-hypophysial region, without the above methods being indicated for clinical manifested symptomatology provoked by the tumour. This is not surprising if we consider that autopsies show the presence of hypophysial adenomas of 10-15% of population on an average. X ray, CT or MRI are indicated in the case of head traumas, lateral nasal cavity inflammations, headaches, strokes, neurological diseases and other disorders. A number of tumours of diverse etiology occur in the hypothalamus-hypophysial region, but hypophysial adenomas are by far the most frequent among all (above 90 %). Among other primary enlargements, the most frequent are craniopharyngeomas and meningeomas, while other enlargements are by fare less common. Such randomly detected tumours are mostly asymptomatic, but targeted anamnesis may show some of the symptoms quite clearly. The symptomatology can be linked with possible slight hormonal overproduction of hypophysial adenomas, a deficit of hypophysial hormones or local manifestations of expansion. Exact assessment of MRI results, of hormonal activity of the enlargement, of the relation to surrounding structures, especially the optic nerves, and the assessment of hypophysial functions are important for the therapeutic decision. Depending on the type and extension of the tumour the options considered are pharmacotherapy (the treatment of choice in the case of prolactinomas), surgery, radiotherapy (today prevailingly using the gamma knife), and if no intervention is necessary, follow up with regular MRI examinations. Tumorous growth is more often observed in "macroadenomas" than in "microadenomas" (up to 10 mm).

  6. Enlargement of the sella turcica in pseudotumor cerebri: Clinical article

    OpenAIRE

    Kyung, SEE; Botelho, JV; Horton, JC

    2014-01-01

    Object. The sella turcica usually appears partially empty in MR images obtained from patients with chronic elevation of intracranial pressure. The authors measured the size of the sella turcica to determine if enlargement of the pituitary fossa explains the partially empty sella associated with pseudotumor cerebri. Methods. The medical records from 2005 to 2011 of a single neuro-ophthalmologist were searched to identify consecutive patients with pseudotumor cerebri. Age-matched control patien...

  7. Western Balkan States and the European Union Enlargement

    Directory of Open Access Journals (Sweden)

    Gelina Maliqi (Ramolli

    2011-07-01

    Full Text Available For half a century, European Union-(EU has pursued ever-deeper integration while taking in new members. It’s marked as an important step in relationship deepening between EU and Western Balkans-(WBs where Albania is part of. In 2003, EU declared that the future of WBs is within EU. Initially it adopted a generous strategy that linked the timetable for accession to the pace of reform in WBs. The declaration contained a conditional promise; EU would consider WBs for membership only if they reached EU standards. The EU was motivated by usual economic considerations connected to enlargement and a desire to increase regional stability. The enlargement process regarding Albania will bring several reforms on different fields. Our country will benefit from a share of multibeneficiary funds for competitiveness, SMEs, energy efficiency and banking sector regulation. This presentation handles out these main issues: EU policy and the enlargement process regarding Albania inspecting the way and progress done up to now by our country, the main features of our national EUcoordination system, concluding in a SWOT Analysis of EU-coordination system in Albania. Eventually, I believe that Albania being part of WBs is at one time an opportunity and a challenge for the future of EU.

  8. Size and composition of the calf and quadriceps muscles in Duchenne muscular dystrophy. A tomographic and histochemical study.

    Science.gov (United States)

    Jones, D A; Round, J M; Edwards, R H; Grindwood, S R; Tofts, P S

    1983-08-01

    Calf and quadriceps muscle size and composition have been examined in 5 control subjects and 12 boys (aged 7-18 years) with Duchenne muscular dystrophy using computed tomography (CT) and quantitative histochemistry of needle biopsy samples of muscle. In assessing the size of leg muscles it was found that in control subjects the muscle cross-sectional area was related to the cross-sectional area of the femur. The calf muscles in the patients were enlarged both relative to the quadriceps and absolutely when related to the cross-sectional area of the femur used as an index of stature. The enlargement of the calf was the result of accumulations of fat and connective tissue in the presence of relatively normal (compared to femur size) amounts of muscle tissue. Although hypertrophied muscle fibres were a feature of the biopsy samples in the calf the extent of this was insufficient to contribute appreciably to the total muscle enlargement.

  9. Study on etiologic causes of binocular diplopia in patients with extraocular related diseases in department of ophthalmology%眼科首诊双眼复视患者的眼外相关病因分析

    Institute of Scientific and Technical Information of China (English)

    王珣竹

    2012-01-01

    Objective To explore the etiologic causes of binocular diplopia as the first onset symptom in patients with extraocular related ophthalmic diseases. Methods On the basis of medical history, routine ophthalmologic examination and ocular muscle examination, general check - up and blood biochemical examinations were applied to explore the pathogenic causes. Results The main aetiological cause was vascular disease, then traumatic injury of cranial nerves and abducent nerve palsy were its secondary causes. Conclusion The pathogenic factors of binocular diplopia were complicated, therefore detail clinical data should be correctly collected and necessary diagnostic examinations should be performed for proper diagnosis and treatment.%目的 探讨眼科以双眼复视为首发症状的眼外相关病因的分布情况.方法 根据病史、眼科专科检查、全身相关检查及相关科室检查会诊意见分析病因.结果 68例双眼复视患者中,发病原因中以血管性疾病居多(占32.3%);外伤次之,占16.2%.眼外肌及颅神经受累情况,外展神经麻痹居多24例,占35.3%.结论 双眼复视病因复杂,详细正确的临床资料和必要的辅助检查有助于明确病因.

  10. Progression of Fatty Muscle Degeneration in Atraumatic Rotator Cuff Tears.

    Science.gov (United States)

    Hebert-Davies, Jonah; Teefey, Sharlene A; Steger-May, Karen; Chamberlain, Aaron M; Middleton, William; Robinson, Kathryn; Yamaguchi, Ken; Keener, Jay D

    2017-05-17

    The purpose of this prospective study was to examine the progression of fatty muscle degeneration over time in asymptomatic shoulders with degenerative rotator cuff tears. Subjects with an asymptomatic rotator cuff tear in 1 shoulder and pain due to rotator cuff disease in the contralateral shoulder were enrolled in a prospective cohort. Subjects were followed annually with shoulder ultrasonography, which evaluated tear size, location, and fatty muscle degeneration. Tears that were either full-thickness at enrollment or progressed to a full-thickness defect during follow-up were examined. A minimum follow-up of 2 years was necessary for eligibility. One hundred and fifty-six shoulders with full-thickness rotator cuff tears were potentially eligible. Seventy shoulders had measurable fatty muscle degeneration of at least 1 rotator cuff muscle at some time point. Patients with fatty muscle degeneration in the shoulder were older than those without degeneration (mean, 65.8 years [95% confidence interval (CI), 64.0 to 67.6 years] compared with 61.0 years [95% CI, 59.1 to 62.9 years]; p tears at baseline was larger in shoulders with degeneration than in shoulders that did not develop degeneration (13 and 10 mm wide, respectively, and 13 and 10 mm long; p Tears with fatty muscle degeneration were more likely to have enlarged during follow-up than were tears that never developed muscle degeneration (79% compared with 58%; odds ratio, 2.64 [95% CI, 1.29 to 5.39]; p muscle degeneration occurred more frequently in shoulders with tears that had enlarged (43%; 45 of 105) than in shoulders with tears that had not enlarged (20%; 10 of 51; p tears with enlargement and progression of muscle degeneration were more likely to extend into the anterior supraspinatus than were those without progression (53% and 17%, respectively; p tear size (p = 0.56). The median time from tear enlargement to progression of fatty muscle degeneration was 1.0 year (range, -2.0 to 6.9 years) for the

  11. Sporadic and familial blepharophimosis -ptosis-epicanthus inversus syndrome: FOXL2 mutation screen and MRI study of the superior levator eyelid muscle.

    Science.gov (United States)

    Dollfus, H; Stoetzel, C; Riehm, S; Lahlou Boukoffa, W; Bediard Boulaneb, F; Quillet, R; Abu-Eid, M; Speeg-Schatz, C; Francfort, J J; Flament, J; Veillon, F; Perrin-Schmitt, F

    2003-02-01

    The analysis of the FOXL2 gene (3q23) in a series of two families and two sporadic cases affected with Blepharophimosis-Ptosis-Epicanthus Inversus Syndrome (BPES) is presented. This study detected two novel FOXL2 mutations (missence and nonsens mutations) and confirmed the recurrence of a previously described duplication. Magnetic Resonance Imaging (MRI) of the orbit, in one family, showed absence or hypotrophy of the eyelid superior levator muscle suggesting a possible role of FOXL2 in the development of this extra-ocular muscle.

  12. Immunohistochemical analysis of laryngeal muscles in normal horses and horses with subclinical recurrent laryngeal neuropathy.

    Science.gov (United States)

    Rhee, Hannah S; Steel, Catherine M; Derksen, Frederik J; Robinson, N Edward; Hoh, Joseph F Y

    2009-08-01

    We used immunohistochemistry to examine myosin heavy-chain (MyHC)-based fiber-type profiles of the right and left cricoarytenoideus dorsalis (CAD) and arytenoideus transversus (TrA) muscles of six horses without laryngoscopic evidence of recurrent laryngeal neuropathy (RLN). Results showed that CAD and TrA muscles have the same slow, 2a, and 2x fibers as equine limb muscles, but not the faster contracting fibers expressing extraocular and 2B MyHCs found in laryngeal muscles of small mammals. Muscles from three horses showed fiber-type grouping bilaterally in the TrA muscles, but only in the left CAD. Fiber-type grouping suggests that denervation and reinnervation of fibers had occurred, and that these horses had subclinical RLN. There was a virtual elimination of 2x fibers in these muscles, accompanied by a significant increase in the percentage of 2a and slow fibers, and hypertrophy of these fiber types. The results suggest that multiple pathophysiological mechanisms are at work in early RLN, including selective denervation and reinnervation of 2x muscle fibers, corruption of neural impulse traffic that regulates 2x and slow muscle fiber types, and compensatory hypertrophy of remaining fibers. We conclude that horses afflicted with mild RLN are able to remain subclinical by compensatory hypertrophy of surviving muscle fibers.

  13. Skeletal muscle

    Science.gov (United States)

    There are approximately 650-850 muscles in the human body these include skeletal (striated), smooth and cardiac muscle. The approximation is based on what some anatomists consider separate muscle or muscle systems. Muscles are classified based on their anatomy (striated vs. smooth) and if they are v...

  14. Sodium valproate induced gingival enlargement with pre-existing chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Vaibhavi Joshipura

    2012-01-01

    Full Text Available Gingival enlargement is a common clinical feature of gingival and periodontal diseases. Currently, more than 20 prescription medications are associated with gingival enlargement. Although the mechanisms of action may be different, the clinical and microscopic appearance of drug-induced gingival enlargement is similar with any drug. Gingival enlargement produces esthetic changes, and clinical symptoms including pain, tenderness, bleeding, speech disturbances, abnormal tooth movement, dental occlusion problems, enhancement of caries development and periodontal disorders. Sodium valproate is considered to produce gingival enlargement, but very rarely. This case report features sodium valproate induced gingival enlargement in a patient with pre-existing chronic periodontitis, who came to the Dental Department, Chinmaya Mission Hospital, Bangalore. The case is special as the patient did not develop the enlargement in spite of taking phenytoin for 1 year and developed enlargement with sodium valproate within 6 months.

  15. Sodium valproate induced gingival enlargement with pre-existing chronic periodontitis.

    Science.gov (United States)

    Joshipura, Vaibhavi

    2012-04-01

    Gingival enlargement is a common clinical feature of gingival and periodontal diseases. Currently, more than 20 prescription medications are associated with gingival enlargement. Although the mechanisms of action may be different, the clinical and microscopic appearance of drug-induced gingival enlargement is similar with any drug. Gingival enlargement produces esthetic changes, and clinical symptoms including pain, tenderness, bleeding, speech disturbances, abnormal tooth movement, dental occlusion problems, enhancement of caries development and periodontal disorders. Sodium valproate is considered to produce gingival enlargement, but very rarely. This case report features sodium valproate induced gingival enlargement in a patient with pre-existing chronic periodontitis, who came to the Dental Department, Chinmaya Mission Hospital, Bangalore. The case is special as the patient did not develop the enlargement in spite of taking phenytoin for 1 year and developed enlargement with sodium valproate within 6 months.

  16. Muscle Deoxygenation Causes Muscle Fatigue

    Science.gov (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D.

    1999-01-01

    Muscle fatigue is a common musculoskeletal disorder in the work place, and may be a harbinger for more disabling cumulative trauma disorders. Although the cause of fatigue is multifactorial, reduced blood flow and muscle oxygenation may be the primary factor in causing muscle fatigue during low intensity muscle exertion. Muscle fatigue is defined as a reduction in muscle force production, and also occurs among astronauts who are subjected to postural constraints while performing lengthy, repetitive tasks. The objectives of this research are to: 1) develop an objective tool to study the role of decreased muscle oxygenation on muscle force production, and 2) to evaluate muscle fatigue during prolonged glovebox work.

  17. Glaucoma and globe enlargement associated with neurofibromatosis type 1.

    Science.gov (United States)

    Morales, Jose; Chaudhry, Imtiaz A; Bosley, Thomas M

    2009-09-01

    To describe the features of glaucoma and globe enlargement sometimes associated with neurofibromatosis type 1 (NF1). Single institution, retrospective, and cross-sectional study. Eighty medical records of patients treated at King Khaled Eye Specialist Hospital in Saudi Arabia with NF1 were reviewed, and 46 patients were examined. We reviewed the charts of patients with NF1 and examined available individuals, including gonioscopy, axial length, and ultrasound biomicroscopy in appropriate patients. Presence and type of glaucoma, anterior chamber angle abnormalities, globe axial length, ultrasound biomicroscopy, and visual outcome. Two patient groups were identified: Group 1 had 56 patients with orbito-facial NF1, and group 2 had 24 patients with NF1 but without orbito-facial involvement. Group 1 included 13 patients with glaucoma (23%), which occurred only ipsilateral to the orbito-facial involvement and generally presented before age 3 years. Glaucoma surgery was required in all of these patients, and visual prognosis was poor. In group 1, mean axial length on the side affected by NF1 was 29.8+/-4.1 mm in patients with glaucoma and 25.6+/-2.0 mm in patients without glaucoma. Patients with glaucoma (Pglobes on the affected side. Group 2 patients had a mean axial length of 23.6+/-1.6 mm for both eyes without significant globe asymmetry. In this Arab population, glaucoma associated with orbito-facial NF1 occurred less often than the 50% rate that is typically cited. Glaucoma presented early in life and only in patients with ipsilateral orbito-facial involvement. Glaucoma in this setting was always associated with globe enlargement. Glaucoma required surgery, and visual prognosis was poor because of glaucoma and concurrent pathology. Globe enlargement was most severe when associated with glaucoma but also present on the side with orbito-facial involvement in patients without glaucoma. The presence of neurofibroma may induce globe enlargement on the affected side in

  18. Bilateral parotid enlargement following snake bite:A rare sign

    Institute of Scientific and Technical Information of China (English)

    Madi Deepak; Achappa Basavaprabhu; John T Ramapuram; Chowta Nithyananda; Soundarya Mahalingam

    2013-01-01

    Snakebite is a common medical emergency in India. Unusual complications may occur after viper bite. Bilateral parotid enlargement after viper bite is a rare entity. An 18-year old gentleman presented to our hospital with history of viper bite. On examination he had cellulitis of right lower limb. He developed swelling of both the parotid glands 12 h after admission. He developed coagulopathy, acute renal failure and died within 48 h of hospital admission. Development of parotid swelling after snake bite is associated with poor prognosis. This case is found worth reporting as it is an unusual complication having prognostic value.

  19. Enlarged transacromial superior approach with reverse shoulder arthroplasty for fractures

    Directory of Open Access Journals (Sweden)

    Alexandre Poignard

    2013-10-01

    Full Text Available The authors describe a step-by-step technique for reverse total shoulder arthroplasty using arthrotomy via the enlarged transacromial superior approach. This technique seems ideal for reinsertion of the tuberosities and to ensure adequate postoperative tensional balance of the infraspinatus and the subscapularis, which is critical for the rotator cuffs to function properly and to achieve optimal arthroplasty stability. Reviewing these different steps helps understanding each rotator cuff individual component's contribution to achieve optimal arthroplasty stability and external rotation with a reverse shoulder arthroplasty.

  20. Muscle disorder

    Science.gov (United States)

    Myopathic changes; Myopathy; Muscle problem ... Blood tests sometimes show abnormally high muscle enzymes. If a muscle disorder might also affect other family members, genetic testing may be done. When someone has symptoms and signs ...

  1. Congenital hypertrophy of multiple intrinsic muscles of the foot.

    Science.gov (United States)

    Shiraishi, Tomohiro; Park, Susam; Niu, Atushi; Hasegawa, Hiromi

    2014-12-01

    Congenital hypertrophy of a single intrinsic muscle of the foot is rare, and as far as we know, only six cases have been reported. We describe a case of congenital anomaly that showed hypertrophy of multiple intrinsic muscles of the foot; the affected muscles were all the intrinsic muscles of the foot except the extensor digitorum brevis or extensor hallucis. Other tissues such as adipose tissue, nervous tissue, or osseous tissue showed no abnormalities. To reduce the volume of the foot we removed parts of the enlarged muscles.

  2. Skeletal muscle metastasis from uterine leiomyosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, J.M.; Brennan, D.D.; Taylor, D.H.; Eustace, S.J. [Cappagh National Orthopaedic Hospital, Department of Radiology, Dublin (Ireland); Holloway, D.P.; O' Keane, J.C. [Cappagh National Orthopaedic Hospital, Department of Pathology, Dublin (Ireland); Hurson, B. [Cappagh National Orthopaedic Hospital, Department of Orthopaedics, Dublin (Ireland)

    2004-11-01

    A case of a 68-year-old woman who presented with a rapidly enlarging painful right thigh mass is presented. She had a known diagnosis of uterine leiomyosarcoma following a hysterectomy for dysfunctional uterine bleeding. She subsequently developed a single hepatic metastatic deposit that responded well to radiofrequency ablation. Whole-body MRI and MRA revealed a vascular mass in the sartorius muscle and a smaller adjacent mass in the gracilis muscle, proven to represent metastatic leiomyosarcoma of uterine origin. To our knowledge, metastatic uterine leiomyosarcoma to the skeletal muscle has not been described previously in the English medical literature. (orig.)

  3. Skeletal muscle metastasis from uterine leiomyosarcoma.

    Science.gov (United States)

    O'Brien, J M; Brennan, D D; Taylor, D H; Holloway, D P; Hurson, B; O'Keane, J C; Eustace, S J

    2004-11-01

    A case of a 68-year-old woman who presented with a rapidly enlarging painful right thigh mass is presented. She had a known diagnosis of uterine leiomyosarcoma following a hysterectomy for dysfunctional uterine bleeding. She subsequently developed a single hepatic metastatic deposit that responded well to radiofrequency ablation. Whole-body MRI and MRA revealed a vascular mass in the sartorius muscle and a smaller adjacent mass in the gracilis muscle, proven to represent metastatic leiomyosarcoma of uterine origin. To our knowledge, metastatic uterine leiomyosarcoma to the skeletal muscle has not been described previously in the English medical literature.

  4. Unilateral Enlarged Vestibular Aqueduct Syndrome and Bilateral Endolymphatic Hydrops

    Directory of Open Access Journals (Sweden)

    Massimo Ralli

    2017-01-01

    Full Text Available Enlarged vestibular aqueduct (EVA syndrome is a common congenital inner ear malformation characterized by a vestibular aqueduct with a diameter larger than 1.5 mm, mixed or sensorineural hearing loss that ranges from mild to profound, and vestibular disorders that may be present with a range from mild imbalance to episodic objective vertigo. In our study, we present the case of a patient with unilateral enlarged vestibular aqueduct and bilateral endolymphatic hydrops (EH. EH was confirmed through anamnestic history and audiological exams; EVA was diagnosed using high-resolution CT scans and MRI images. Therapy included intratympanic infusion of corticosteroids with a significant hearing improvement, more evident in the ear contralateral to EVA. Although most probably unrelated, EVA and EH may present with similar symptoms and therefore the diagnostic workup should always include the proper steps to perform a correct diagnosis. Association between progression of hearing loss and head trauma in patients with a diagnosis of EVA syndrome is still uncertain; however, these individuals should be advised to avoid activities that increase intracranial pressure to prevent further hearing deterioration. Intratympanic treatment with steroids is a safe and well-tolerated procedure that has demonstrated its efficacy in hearing, tinnitus, and vertigo control in EH.

  5. Enlarged tongue due to primary systemic amyloidosis:clinicopathologic observation

    Institute of Scientific and Technical Information of China (English)

    潘卫红; 李娜萍; 梁国芬

    2004-01-01

    @@Primary amyloidosis (AL) is characterized by deposition of abnormal extra cellular protein in the form of fibrils in many organs, especially the heart, kidneys, gastrointestinal tract, and peripheral nervous system.1 Involvement of the tongue is not uncommon in primary AL. In 22 % to 26 % of patients suffering from AL, amyloid deposition in the tongue can result in an enlarged tongue.2 Lingual changes arising from localization or from all over, AL has been reported frequently as initial signs of the disease. Macroscopically, it is difficult to distinguish AL of the tongue from other lesions. In view of the variety of protein species involved and the wide spectrum of possible clinical presentations,3 the diagnosis of lingual AL is frequently overlooked, because immunohistochemical studies of such cases have not been undertaken. Here we describe two male patients with primary systemic AL who developed enlarged tongues. In addition to the manifestation of lingual AL, in which oral signs were the primary indicators of the disease, we describe the immunohistochemical findings of the tongue to discuss diagnostic criteria for lingual amyloid in primary AL.

  6. CHANGING FROM WITHIN? THE INTRA-ORGANIZATIONAL DYNAMICS OF EU ENLARGEMENT

    Directory of Open Access Journals (Sweden)

    Velibor JAKOVLESKI

    2015-12-01

    Full Text Available This paper opens up the black box of enlargement, focusing on how the intra-organizational relationships among the Council of the European Union, the European Commission, and the European Parliament affect the process of enlargement. Formally speaking, enlargement is an intergovernmental process, suggesting that member states are firmly in control of its outcomes. However, the EU’s supranational actors, specifically the European Parliament and European Commission also attempt to influence enlargement at various stages. I posit that the process of enlargement to the Western Balkans has evolved, influenced by changing constraints which are operating on the aforementioned actors. The added value of this work is in disaggregating the enlargement process based on its institutionalized relationships in both a vertical and horizontal dimension. It provides a supply-side argument for how enlargement policy has evolved from within the EU, rather than simply as a function of external factors.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    The cortical representation of eye position is still uncertain. In the monkey a proprioceptive representation of the extraocular muscles (EOM) of an eye were recently found within the contralateral central sulcus. In humans, we have previously shown a change in the perceived position of the right...... eye after a virtual lesion with rTMS over the left somatosensory area. However, it is possible that the proprioceptive representation of the EOM extends to other brain sites, which were not examined in these previous studies. The aim of this fMRI study was to sample the whole brain to identify...... the proprioceptive representation for the left and the right eye separately. Data were acquired while passive eye movement was used to stimulate EOM proprioceptors in the absence of a motor command. We also controlled for the tactile stimulation of the eyelid by removing from the analysis voxels activated by eyelid...

  8. Acute respiratory failure in a rapidly enlarging benign cervical goitre.

    Science.gov (United States)

    Garingarao, Carlo Jan; Añonuevo-Cruz, Cecille; Gasacao, Ryan

    2013-07-22

    Benign goitres have the potential to reach massive sizes if neglected, but most have a protracted course that may or may not present with compressive symptoms. We report the case of a 57-year-old man who presented with a rapidly enlarging nodular goitre resulting in acute respiratory failure. Endotracheal intubation and emergency total thyroidectomy were performed, revealing massive thyroid nodules with minimal intrathoracic extension and tracheal erosion. Despite a course and clinical findings suggestive of malignant disease, histopathology was consistent with a benign multinodular goitre. Several cases of benign goitres necessitating endotracheal intubation have been reported. Airway compromise was attributed to a significant intrathoracic component, or inciting events such as thyroid haemorrhage, pregnancy, radioiodine uptake or major surgery. Obstructive symptoms may not correlate well with objective measures of upper airway obstruction such as radiographs or flow volume loops.

  9. A Digitally Programmable Differential Integrator with Enlarged Time Constant

    Directory of Open Access Journals (Sweden)

    S. K. Debroy

    1994-12-01

    Full Text Available A new Operational Amplifier (OA-RC integrator network is described. The novelties of the design are used of single grounded capacitor, ideal integration function realization with dual-input capability and design flexibility for extremely large time constant involving an enlargement factor (K using product of resistor ratios. The aspect of the digital control of K through a programmable resistor array (PRA controlled by a microprocessor has also been implemented. The effect of the OA-poles has been analyzed which indicates degradation of the integrator-Q at higher frequencies. An appropriate Q-compensation design scheme exhibiting 1 : |A|2 order of Q-improvement has been proposed with supporting experimental observations.

  10. Uptake of thallium-201 in enlarged thyroid glands. Concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Fukuchi, M.; Kido, A.; Hyodo, K.; Tachibana, K.; Onoue, K.; Morita, T.; Nagai, K.

    1979-08-01

    We have investigated the thyroid uptake of Tl-201 in 37 patients with various types of goiter, and in six with normal thyroids. Significant thallium uptake was found in all cases in which there was thyroid enlargement, including Graves' disease, toxic thyroid nodule, primary hypothyroidism, simple goiter, Hashimoto's disease, thyroid carcinoma, and thyroid adenoma. If goiter was absent, however, there was no demonstrable uptake - e.g., in secondary hypothyroidism, subacute thyroiditis, and the normal controls. Thallium uptake did not correlate with thyroid function tests such as BMR, T/sub 3/-RU, T/sub 3/, T/sub 4/, TSH, antithyroid antibodies, or the 24-hr I-131 uptake. In 23 patients with diffuse goiter, on the other hand, maximum Tl-201 uptake correlated well with thyroid weight: r = 0.836 (p < 0.001); y = 0.02 x + 0.06.

  11. Drug-associated gingival enlargement in pediatric patients

    Directory of Open Access Journals (Sweden)

    Nowzari H.

    2009-03-01

    Full Text Available "nGingival overgrowth is a drug-associated side effect occurs in pediatric patients. Phenytoin, cyclosporine, calcium channel blockers, and amphetamine are primary drugs that can cause gingival enlargement in children. Pediatric patients are more prone to drug-associated gingival overgrowth rather than adults. Gingival overgrowth may cause functional, phonetic, and nutritional difficulties, and more importantly, may affect the psycho-social development, self-esteem, and quality of life in children. However, the researches about this issue are rare. This Part I paper provides an analysis of pediatric systemic disease and corresponding prescribed medications for selected physical and mental health conditions. This paper describes the morbidity and risk for children related to gingival overgrowth and proposes a framework for action that will be more completely described in a part II paper on this topic.

  12. REFLECTIONS ON THE IMPACT OF ENLARGEMENT FOR THE EU INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Aurel Ciobanu Dordea

    2005-10-01

    Full Text Available Possibly the most important lessons of the 2005 referenda is that Europe, instead of running into the future in order to hide from the difficulties of the present, should stop for a while and try to solve its major current problems that are symbolic in the citizens' eyes: economic growth and stability, employment international competitiveness, the solidity of the euro, the completeness of the freedom, justice and security area. These are major achievements or objectives of the last 10-15 years that have once boosted the interest and hopes of public opinions and economic actors. They should become and remain rock-solid in order to allow the Union another leap forward, and only this will help solve the marginal difficulties created by the enlargement, allowing a full integration in the Union of the new members.

  13. Measurements of enlarged blood pump models using Laser Doppler Anemometer.

    Science.gov (United States)

    Chua, L P; Yu, S C; Leo, H L

    2000-01-01

    In an earlier study (Chua et al., 1998, 1999a), a 5:1 enlarged model of the Kyoto-NTN Magnetically Suspended Centrifugal Blood Pump (Akamatsu et al., 1995) with five different impeller blade profiles was designed and constructed. Their respective flow characteristics with respect to (1) the three different blade profile designs: forward, radial, and backward, (2) the number of blades used, and (3) the rotating speed were investigated. Among the five impeller designs, the results obtained suggested that impellers A and C designs should be adopted if higher head is required. Impellers A and C therefore were selected for the flow in between their blades to be measured using Laser Doppler Anemometer (LDA), so as to have a better understanding of the flow physics with respect to the design parameters.

  14. The Staff Association (SA) in the Enlarged Directorate (ED) meeting!

    CERN Multimedia

    Staff Association

    2017-01-01

    The Vice-President and the President presented the plan of activities of the Staff Association for 2017 and expressed the Staff Association’s concerns at the meeting of the Enlarged Directorate (Directors and Heads of Departments and Units) on 3 April. Five topics were presented, starting with the implementation of the decisions made during the 2015 Five-Yearly Review. Five-Yearly Review – Follow-up (see Echo No. 257) 2016 – Key points of implementation Several changes were already implemented in 2016: review of the Staff Rules and Regulations in January 2016 for the diversity aspects, and in September 2016 to incorporate the new career structure and the new salary grid with grades; review of the Administrative Circular No. 26 (Rev. 11) on the “Recognition of Merit”; placement in grades and provisional placement in benchmark jobs of all staff members; definition of guidelines for the 2017 MERIT exercise. The Staff Association was extensively involved in the...

  15. Myosin Heavy Chain 2B isoform is expressed in specialized eye muscles but not in trunk and limb muscles of cattle

    Directory of Open Access Journals (Sweden)

    L Maccatrozzo

    2009-06-01

    Full Text Available Myosin heavy chain isoforms (MHC of adult skeletal muscles are codified by four genes named: slow, or type 1, and fast types 2A, 2X and 2B. The slow, 2A and 2X isoforms have been found expressed in all mammalian species studied so far whereas there is a large inter-species variability in the expression of MHC-2B. In this study histochemistry (m- ATPase, immunohistochemistry with the use of specific monoclonal antibodies and RT-PCR were combined together to assess whether the MHC-2B gene is expressed in bovine muscles. ATPase staining and RT-PCR experiments showed that three MHC isoforms (1, 2A, 2X were expressed in trunk and limb muscles. Slow or type 1 expression was confirmed using a specific antibody (BA-F8 whereas the detection of fast MHC isoforms were validate by means of BF-35 antibody although not by the SC-71 antibody. MHC-2B was absent in limb and trunk muscles, but was present in specialized eye muscles (rectus lateralis and retractor bulbi as consistently showed by RT-PCR and reactivity with a specific antibody (BF-F3. Interestingly, a cardiac isoform, MHC-a- cardiac was found to be expressed not only in extraocular muscles but also in masticatory muscles as masseter.

  16. OCT Minimum Intensity as a Predictor of Geographic Atrophy Enlargement

    Science.gov (United States)

    Stetson, Paul F.; Yehoshua, Zohar; Garcia Filho, Carlos Alexandre A.; Portella Nunes, Renata; Gregori, Giovanni; Rosenfeld, Philip J.

    2014-01-01

    Purpose. We determined whether the minimum intensity (MI) of the optical coherence tomography (OCT) A-scans within the retina can predict locations of growth at the margin of geographic atrophy (GA) and the growth rate outside the margin. Methods. The OCT scans were analyzed at baseline and 52 weeks. Expert graders manually segmented OCT images of GA. The 52-week follow-up scans were registered to the baseline scan coordinates for comparison. The OCT MI values were studied within a 180-μm margin around the boundary of GA at baseline. Baseline MI values were compared in areas of progression and nonprogression of the GA, and sensitivity and specificity were assessed for prediction of growth at the margin. Average MI values in the margins were compared to overall growth rates to evaluate the prediction of growth outside the margins. Results. A statistically significant increase in MI (P < 0.05) was seen in areas of growth in 21/24 cases (88%), and 22/24 cases (92%) when the foveal subfield was excluded. Locations of growth within the margins at 52 weeks were predicted with 61% sensitivity and 61% specificity. The MI values correlated significantly with overall growth rate, and high and low growth rate subjects were identified with 80% sensitivity and 64% specificity. Conclusions. The MI may be increased at the margins of GA lesions before enlargement, which may indicate disruption or atrophy of the photoreceptors in these areas before GA becomes apparent. Increased MI may help predict areas of enlargement of GA, and may relate to overall growth rate and be a useful screening tool for GA. (ClinicalTrials.gov number, NCT00935883.) PMID:24408973

  17. 甲状腺相关性眼病眼外肌病变的手术治疗%Operative effect about extraocular myopathy in patients with Thyroid-associated ophthalmopathy

    Institute of Scientific and Technical Information of China (English)

    黄勇志; 何剑峰

    2016-01-01

    Objective:To discuss surgery effect about extraocular myopathy in patients with Thyroid -associated ophthalmopathy . Methods:The surgical management of strabismus in 13 cases with Thyroid -associated ophthalmopathy who received extraocular muscle surgery in our hospital were retrospectively analyzed .Nine cases were males and 4 were females,ranging in age from 28 to 61 years(mean:46 years).All patients were Vertical strabismus.The preoperative deciation of all cases was 25°to 45°.The patients were followed up for 3 ~18 months.Postoperative results were divided into 2 categories:successful outcome :orthotropia, or deviation ≤5°,there was no di-plopia or residual little diplopia could being corrected by low degree prism in primary position or reading position ,compensatory head pos-ture disappeared;Failure:deviation >5°in primary position,There are persistent diplopia that it was not easy being corrected by prism in primary position or reading position ,Compensatory head posture could not being significantly improved .Results:All patients accepted sin-gle vertical rectus recession .Postoperatively,76.9% patients were orthotropic in primary position , rebuilded binocular field of single vi-sion.There was small residual deviation (≤5°) in primary position in 15.4%patients .All patients could significantly improve compensa-tory head posture. Surgical success rate was 92.8%.Diplopia could not being eliminated in secondary positions .Postoperative eyeball motility improved markedly .Serious complications were not found .Conclusion:The surgical management of extraocular myopathy in pa-tients with TAO was safe and effective after inflammation disappeared and stable eye position , single rectus recession could correct large deviation in patients with restrictive strabismus , It could significantly improve diplopia and compensatory head posture .%目的:观察甲状腺相关性眼病眼外肌病变手术治疗临床效果. 方法:回顾性分析我院13例14眼TAO

  18. EU Enlargement Law: History and Recent Developments: Treaty – Custom Concubinage?

    Directory of Open Access Journals (Sweden)

    Kochenov

    2005-04-01

    Full Text Available This note provides a detailed account of the development of the EU enlargement law. Based on the material provided by the latest enlargement round, it outlines the main set of enlargement principles, criteria and procedural tools employed by the Union in the process, also making a sketch of the actual chronology of enlargement events. Based on the analysis of the legal regulation of five rounds of enlargement and making parallels with the notion of customary law as understood in public international law, it argues that the Union enlargements have always enjoyed a dual regulation: by written (mostly Treaty based and also by customary enlargement law. The existence of customary law explains the consistency of enlargement regulation throughout all the rounds of this process, notwithstanding the stage of the Treaty reform in force at the time of every particular accession. The minimal amendments introduced into the enlargement article by the Treaty Establishing a Constitution for Europe (Art. I-58 suggest that the future enlargements are likely to be building on the body of customary law in force to date. The process of gradual incorporation of customary law into the written law of the EU is also likely to continue.

  19. Low dose amlodipine-induced gingival enlargement: A clinical case series

    OpenAIRE

    Amitandra Kumar Tripathi; Sudarshana Mukherjee; Charanjit Singh Saimbi; Vivek Kumar

    2015-01-01

    Gingival enlargement sometimes has an adverse effect of certain systemic drugs such as the use of anticonvulsants, phenytoin, antihypertensive, calcium channel blockers and immunosuppressant, cyclosporine. Amlodipine, a relatively newer calcium channel blocker drugs, exhibit adverse effect of gingival enlargement in middle to older aged adults. There are very few reports of amlodipine-induced gingival enlargement at a lower dose (5 mg). In this article, three cases of amlodipine-induced gingi...

  20. Localising rectus muscle insertions using high frequency wide-field ultrasound biomicroscopy.

    Science.gov (United States)

    Khan, Hayat Ahmad; Smith, David R; Kraft, Stephen P

    2012-05-01

    The ultrasound biomicroscope (UBM) can accurately locate an extraocular muscle (EOM) insertion. The authors compared the accuracy of the Sonomed UBM (SUBM), a new 'wide-field ultrasound biomicroscope', with the older model Humphrey UBM (HUBM) in localising EOM insertions and compared their ranges of detection of muscle insertions. Prospective, double-masked, observational study of 27 patients undergoing primary (n=40 muscles) or repeat (n=10 muscles) horizontal or vertical rectus muscle surgery. EOM insertional distances were measured with SUBM, and then intraoperatively with callipers. A Bland-Altman analysis and intraclass correlation coefficient were used to compare the SUBM and surgical data. For all muscles, the differences between SUBM and surgery measurements were less than 1.0 mm. The mean of the SUBM insertion distances was 6.67 mm (SD 1.65 mm) versus 6.7 mm (SD 1.6 mm) at surgery. The intraclass correlation coefficient showed 'excellent' correlation between the two sets of data and was higher than that reported with HUBM. The image quality with the SUBM was superior to the HUBM, and its range of field was much larger (14×18 mm vs 5×6 mm). The SUBM with its smaller, more manoeuvrable probe handpiece and a wider scanning field was more accurate in detecting muscle insertions compared with HUBM.

  1. Gingival Enlargement in a Case of Variant Jones Syndrome: a Case Report

    Directory of Open Access Journals (Sweden)

    Roopa DA

    2016-03-01

    Full Text Available Gingival enlargement can be caused by a variety of etiological factors like inflammation, drugs, and systemic diseases or can be presented as a part of a syndrome. One such syndrome is Jones Syndrome, which is associated with gingival enlargement and progressive hearing loss. We present here a case of fifteen-year-old boy with gingival enlargement, hearing loss, and generalized alveolar bone loss and diagnosed as Jones syndrome. The diagnosis was made based on history, clinical, radiographic, and histopathological findings. Gingival enlargement was surgically managed using gingivectomy and no recurrence was observed. The patient showed remarkable esthetical and functional improvement.

  2. Gingival Enlargement in a Case of Variant Jones Syndrome: a Case Report

    Science.gov (United States)

    DA, Roopa; Singh, Shinkhala; Gupta, Ira; Gopal, Saumiya

    2016-01-01

    Gingival enlargement can be caused by a variety of etiological factors like inflammation, drugs, and systemic diseases or can be presented as a part of a syndrome. One such syndrome is Jones Syndrome, which is associated with gingival enlargement and progressive hearing loss. We present here a case of fifteen-year-old boy with gingival enlargement, hearing loss, and generalized alveolar bone loss and diagnosed as Jones syndrome. The diagnosis was made based on history, clinical, radiographic, and histopathological findings. Gingival enlargement was surgically managed using gingivectomy and no recurrence was observed. The patient showed remarkable esthetical and functional improvement. PMID:26966711

  3. Comparison of transcriptomes of enlarged spheroplasts of Erythrobacter litoralis and Lelliottia amnigena

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    Sawako Takahashi

    2016-05-01

    Full Text Available Bacterial spheroplasts do not divide but they grow and enlarge with DNA replication in a broth containing an inhibitor of peptidoglycan synthesis and high salt concentration. The enlarged spheroplasts of Lelliottia amnigena, belonging to the family Enterobacteriaceae, formed vacuole-like structures, while those of the aerobic photosynthetic marine bacterium Erythrobacter litoralis did not form such structures. In addition, the enlarged spheroplasts of L. amnigena, which differ in the size of inner and outer membranes, were larger than those of E. litoralis. To elucidate the reason for these differences, we analyzed the transcriptome (RNA-seq of spheroplasts at the beginning of growth and upon enlargement. After sequencing the RNAs expressed in normal and enlarged spheroplasts, we compared the gene expression levels of the 1100 orthologs in E. litoralis and L. amnigena. Among these, 347 and 213 genes were more than 2-fold upregulated in enlarged spheroplasts of E. litoralis and L. amnigena, respectively; 193 and 269 genes were less than 0.5-fold downregulated in those of E. litoralis and L. amnigena, respectively. Thirty six genes were upregulated in L. amnigena enlarged spheroplasts but were downregulated in E. litoralis enlarged spheroplasts, and may be related to vacuole-like structure generation. Fourteen of the 36 genes encoded a membrane protein. Our findings indicate that spheroplast enlargement varies between different organisms with respect to gene expression.

  4. A technique of aortic annulus enlargement with a Freestyle stentless bioprosthesis.

    Science.gov (United States)

    Bical, Olivier M; Nutu, Ovidiu; Deleuze, Philippe

    2012-02-01

    We describe our surgical technique to manage a small aortic annulus during aortic valve replacement. Starting with the posterior annular enlargement incision described by Manouguian, a stentless porcine aortic root, with excision of the left and right porcine coronary segments and conservation of the mural wall (Freestyle MS design, Medtronic, Minneapolis, MN ), was used. The Freestyle bioprosthesis enlarges the aortic annulus using a direct suture of the valve on the enlarged annulus, and the aorta is closed by a direct suture of the mural wall of the bioprosthesis. Therefore, the aortic annulus enlargement is made only using the aortic bioprosthesis, without other material.

  5. Low dose amlodipine-induced gingival enlargement: A clinical case series

    Directory of Open Access Journals (Sweden)

    Amitandra Kumar Tripathi

    2015-01-01

    Full Text Available Gingival enlargement sometimes has an adverse effect of certain systemic drugs such as the use of anticonvulsants, phenytoin, antihypertensive, calcium channel blockers and immunosuppressant, cyclosporine. Amlodipine, a relatively newer calcium channel blocker drugs, exhibit adverse effect of gingival enlargement in middle to older aged adults. There are very few reports of amlodipine-induced gingival enlargement at a lower dose (5 mg. In this article, three cases of amlodipine-induced gingival enlargement in the age range of 50-65 years old hypertensive patient with a lower dose of amlodipine (5 mg.

  6. Muscle biopsy

    Science.gov (United States)

    ... Inflammatory diseases of muscle (such as polymyositis or dermatomyositis ) Diseases of the connective tissue and blood vessels ( ... disease that involves inflammation and a skin rash ( dermatomyositis ) Inherited muscle disorder ( Duchenne muscular dystrophy ) Inflammation of ...

  7. Muscle atrophy

    Science.gov (United States)

    ... atrophy. Exercises may include ones done in a swimming pool to reduce the muscle workload, and other types ... a physical examination and ask about your medical history and symptoms, including: When did the muscle atrophy ...

  8. Interface fluctuations for deposition on enlarging flat substrates

    Science.gov (United States)

    Carrasco, I. S. S.; Takeuchi, K. A.; Ferreira, S. C.; Oliveira, T. J.

    2014-12-01

    We investigate solid-on-solid models that belong to the Kardar-Parisi-Zhang (KPZ) universality class on substrates that expand laterally at a constant rate by duplication of columns. Despite the null global curvature, we show that all investigated models have asymptotic height distributions and spatial covariances in agreement with those expected for the KPZ subclass for curved surfaces. In 1 + 1 dimensions, the height distribution and covariance are given by the GUE Tracy-Widom distribution and the Airy2 process instead of the GOE and Airy1 foreseen for flat interfaces. These results imply that when the KPZ class splits into curved and flat subclasses, as conventionally considered, the expanding substrate may play a role equivalent to, or perhaps more important than, the global curvature. Moreover, the translational invariance of the interfaces evolving on growing domains allowed us to accurately determine, in 2 + 1 dimensions, the analog of the GUE Tracy-Widom distribution for height distribution and that of the Airy2 process for spatial covariance. Temporal covariance is also calculated and shown to be universal in each dimension and in each of the two subclasses. A logarithmic correction associated with the duplication of columns is observed and theoretically elucidated. Finally, crossover between regimes with fixed-size and enlarging substrates is also investigated.

  9. Minority Rights, Multiculturalism and EU Enlargement: the Case of Estonia

    Directory of Open Access Journals (Sweden)

    David J. Smith

    2003-04-01

    Full Text Available This article examines the process of EU enlargement and its impact upon ethnopolitics in contemporary Estonia. After discussing the construction of the post-communist state order within the context of emerging CSCE and Council of Europe norms on minority rights, the author looks at how Estonia was able to reconcile its so-called 'ethnic democracy' with the EU Copenhagen criteria requiring the 'respect for and protection of minorities'. The author draws attention to the subsequent shift away from 'nationlizing statehood' in Estonia towards a new strategy of 'multicultural integration' (where 'multicultural democracy' is portrayed as the ideal end-point of the integrative processes currently underway. In conclusion, the author discusses some of the ambiguities surrounding the concept of 'multicultural integration'. Whilst deemed consistent with EU norms, it is argued that the meaning of this term remains vague and contested within an Estonian context. As a consequence, its relationship to existing Western models - and its applicability to post-Soviet Estonia - is still not entirely clear.

  10. A Visible QCD Axion from an Enlarged Color Group

    CERN Document Server

    Gherghetta, Tony; Shifman, Mikhail

    2016-01-01

    We consider the possibility of an enlarged QCD color group, SU(3+$N^\\prime$) spontaneously broken to SU(3)$_c\\times$SU($N^\\prime$)$\\times$U(1)$_X$ with extra vector-like quarks transforming in the fundamental representation. When the heavy quarks are integrated out below the PQ-breaking scale, they generate an axion coupling which simultaneously solves the strong CP problem for both gauge groups. However, the axion mass now receives a new nonperturbative contribution from the SU($N^\\prime$) confinement scale, which can be substantially larger than the QCD scale. This can increase the axion mass to be at or above the electroweak scale. This visible axion can then decay into gluons and photons giving rise to observable signals at Run-II of the LHC. In particular, if the mass is identified with the 750 GeV diphoton resonance then the new confinement scale $\\sim$ TeV and the PQ-breaking scale $\\sim$ 10 TeV. This predicts vector-like quarks and a PQ scalar resonance in the multi-TeV range, with the possibility tha...

  11. Enlargement of cerebral ventricles as an early indicator of encephalomyelitis.

    Directory of Open Access Journals (Sweden)

    Stefano Lepore

    Full Text Available Inflammatory disorders of the central nervous system such as multiple sclerosis and acute disseminated encephalomyelitis involve an invasion of immune cells that ultimately leads to white matter demyelination, neurodegeneration and development of neurological symptoms. A clinical diagnosis is often made when neurodegenerative processes are already ongoing. In an attempt to seek early indicators of disease, we studied the temporal and spatial distribution of brain modifications in experimental autoimmune encephalomyelitis (EAE. In a thorough magnetic resonance imaging study performed with EAE mice, we observed significant enlargement of the ventricles prior to disease clinical manifestation and an increase in free water content within the cerebrospinal fluid as demonstrated by changes in T2 relaxation times. The increase in ventricle size was seen in the lateral, third and fourth ventricles. In some EAE mice the ventricle size started returning to normal values during disease remission. In parallel to this macroscopic phenomenon, we studied the temporal evolution of microscopic lesions commonly observed in the cerebellum also starting prior to disease onset. Our data suggest that changes in ventricle size during the early stages of brain inflammation could be an early indicator of the events preceding neurological disease and warrant further exploration in preclinical and clinical studies.

  12. Your Muscles

    Science.gov (United States)

    ... develops. There they help to push the baby out of the mother's body when it's time to be born. You'll find smooth muscles at work behind the scenes in your eyes, too. These muscles keep the eyes ... thick muscles of the heart contract to pump blood out and then relax to let blood back in ...

  13. Modeling Muscles

    Science.gov (United States)

    Goodwyn, Lauren; Salm, Sarah

    2007-01-01

    Teaching the anatomy of the muscle system to high school students can be challenging. Students often learn about muscle anatomy by memorizing information from textbooks or by observing plastic, inflexible models. Although these mediums help students learn about muscle placement, the mediums do not facilitate understanding regarding integration of…

  14. 眼外肌矫正术治疗先天性下睑退缩%Repair of lower eyelid retraction via diorthosis of the extraocular muscle

    Institute of Scientific and Technical Information of China (English)

    张丽蓉; 胡兰; 何伟

    2013-01-01

    Objective To assess the effects of balanced adjustment of superior or inferior rectus insertion in both eye for the treatment of lower eyelid retraction.Methods The anatomical structure of eyelid and eyeball was analyzed,and the binocular vision function and fundus in 2 adult lower eyelid retractors were totally examined.Plication of both inferior rectus was performed in one case,and the other with recession of both superior rectus.Eye position and binocular vision were assessed intraoperatively and postoperative follow-up was carried out.Results Eye movement was normal in both cases,non accompanied with diplopia,decreased vision,headache and dizziness.The width of palpebral fissure is normal in all eye,and there were no scar and pathological changes.Patients looked naturelly and the satisfaction was obtained.Conclusion Surgery of superior or inferior rectus is effective with little damage and quick recovery.%目的 通过均衡调整双眼球上、下直肌的附着点,使眼球向下移位,矫正下睑退缩外观.方法 对2例成年先天性下睑退缩患者,进行眼睑及眼球解剖结构特点的分析,全面检查分析双眼视功能及眼底功能,选择局部麻醉下双眼下直肌折叠缩短术1例,双眼上直肌后徙术1例,并在术中调整眼球位置及观察双眼视觉效果,术后跟踪随访.结果 本组2例患者术后眼球各向运动无明显受限,双眼无复视,无视力下降及头痛头晕,双眼无不适感.双眼睑裂高度正常,眼睑皮肤无手术瘢痕及病理性改变,患者容貌自然美观,效果满意.结论 此术式损伤轻微,术后恢复快,效果理想.

  15. The Impact of Amlodipine on Gingival Enlargement After Kidney Transplantation

    Science.gov (United States)

    Rostami, Zohreh; Einollahi, Behzad; Einollahi, Mohammad Javad; lessan, Simin

    2012-01-01

    Abstract Background: Although cyclosporine (CsA) and calcium channel blockers (CCBs) parallel to each other may provoke gingival enlargement (GE), there are few considerations about combined effects of CsA and CCBs on gingival tissues. Objectives: This study aimed to determine prevalence of GE among renal transplant recipients and to compare its occurrence in patients who received only CsA and those who were on CsA and amlodipine. Patients and Methods: We conducted a prospective randomized case-control trial including 213 renal transplant recipients between February 2010 and August 2010. They were randomly divided into two groups including control group (on continuous treatment with CsA alone; n = 112) and trial group (treated with combined CsA and amlodipine; n = 101). Buccal, lingual, and inter-proximal membranes at last 12 anterior teeth were assessed for GE and packet depth (PD) using Gingival Index of McGaw and others, and Packet Index of Turesky–Gilmore–Glickman, respectively. Results: Marked GE was observed in 26 patients (25.7%) in trial group and only in 4 individuals (3.6%) in control group (P = 0.000). In logistic regression analysis, obese (OR = 3, P = 0.04), older (OR = 2.8, P = 0.03), and female (OR = 1.3, P = 0.03) recipients as well as who received high dose amlodipine (OR = 4.4, P = 0.000) were at risk for marked GE. Conclusions: There is a strong correlation between GE, in particular marked GE, and combination therapy with CsA and amlodipine in transplant patients compared to those treated by CsA alone. We suggest CsA dose reduction may restrain this adverse effect. PMID:23573487

  16. Enlarged perivascular spaces and lacunar infarction Cerebral magnetic resonance evaluation

    Institute of Scientific and Technical Information of China (English)

    Weihong Yan; Jing Fang; Cuijuan Zhou

    2008-01-01

    BACKGROUND:Previous studies have demonstrated that enlarged perivascular spaces(EPVS)arg a result of microvaseular disease.To date,there age few reports about the relationship between EPVS and lacunar infarction.OBJECTIVE:To investigate whether EPVS is associated with lacunar infarction on the basis of cerebral magnetic resonance(MR)examination,clinical symptoms and signs,and past medical history of patients.DESIGN,TIME AND SETTING:Case contrast analysis was performed at the Department of Neurology,Shanghai Ninth People's Hospital from January 2007 to January 2008.PARTICIPANTS:Sixty-eight patients with lacunar infarction were admired to the Department of Neurology of Shanghai Ninth People's Hospital,including 37 cases with first-ever infarction,and 31 with infarction recurrence.In addition,53 healthy people were selected as controls.METHODS:All participants underwent past medical history investigation,nervous system examination.and cranial MR.The subjects were assessed using the JMW rating scale to identify the EPVS grade.MAIN OUTCOME MEASURES:EPVS scores of patients and controls;risk factors for cerebral vascular disease in patients with first-ever or recurrence of lacunar infarction.RESULTS:The EPVS grade from lacunar infarction patients was significantly higher than of the control group(P<0.05).The EPVS grade in patients with recurring lacunar infarction was significantly higher than in patients with first-ever infarction(P<0.05).In addition,hypertension incidence in patients with recurring lacunar infarction was significantly higher than in patients wim first-ever infarction (P<0.05).CONCLUSION:Results indicate that EPVS is related to the incidence of lacunar infarction.Earlier screening of EPVS.and the evaluation of EPVS severity,is of great importance to control the risk factors for cerebral vascular disease and to prevent lacunar infarction.

  17. Masseter and medial pterygoid muscle hypertrophy.

    Science.gov (United States)

    Guruprasad, R; Rishi, Sudhirkumar; Nair, Preeti P; Thomas, Shaji

    2011-09-26

    Hypertrophy refers to an enlargement caused by an increase in the size but not in the number of cells. Generalised masticatory muscle hypertrophy may affect the temporalis muscle, masseters and medial pterygoids in a variety of combinations. Masseteric hypertrophy may present as either unilateral or bilateral painless swelling of unknown origin in the region of angle of mandible. It is a relatively rare condition and presents a diagnostic dilemma. While the history and clinical examination are important in differentiating this benign condition from parotid or dental pathology, they cannot necessarily exclude rare malignant lesion within the muscle. Advanced imaging modalities like CT and MRI are essential to confirm the diagnosis. Here the authors are reporting a unique case of masseter muscle hypertrophy along with medial pterygoid hypertrophy which was missed clinically but confirmed using CT and MRI.

  18. Prevalence of enlarged mediastinal lymph nodes in heavy smokers - a comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Kirchner, Johannes; Lorenz, Vivian-Wilma [Allgemeines Krankenhaus Hagen, Department of Diagnostic and Interventional Radiology, Hagen (Germany); Kirchner, Esther Maria [Staedtisches Klinikum Wedau, Clinic for Medicine, Duisburg (Germany); Goltz, Jan Peter; Kickuth, Ralph [University Hospital of Wuerzburg, Department of Radiology, Wuerzburg (Germany)

    2011-08-15

    To evaluate the frequency of enlarged hilar or mediastinal lymph nodes in heavy smokers (more than 10 pack years) compared with non- smokers. In a prospective study the CT findings of 88 consecutive patients (44 heavy smokers, 44 non- smokers) were analysed. Exclusion criteria were history of thoracic malignancy, sarcoidosis, occupational dust exposure or clinical evidence of pneumonia. Prevalence, size and site of enlarged lymph nodes were assessed by multidetector computed tomography (MDCT) and correlated with the cigarette consumption and the CT- findings of bronchitis and emphysema. Twenty-three of the 44 heavy smokers (52%) showed enlarged mediastinal lymph nodes. Non- smokers showed enlarged lymph nodes in 9% (4/44). The most common site of enlarged lymph nodes was the regional station 7 according to the ATS mapping (subcarinal). The difference between the frequency of enlarged lymph nodes in heavy smokers and non- smokers was significant (chi- square 19.3, p < 0.0001). Airway wall thickening and emphysema were often associated with an increased number of enlarged nodes. The present study demonstrates that enlarged mediastinal lymph nodes may occur in a rather high percentage of heavy smokers, especially in those with a MDCT finding of severe bronchitis. (orig.)

  19. Body-enlarging effect of royal jelly in a non-holometabolous insect species, Gryllus bimaculatus

    Directory of Open Access Journals (Sweden)

    Atsushi Miyashita

    2016-06-01

    Full Text Available Honeybee royal jelly is reported to have body-enlarging effects in holometabolous insects such as the honeybee, fly and silkmoth, but its effect in non-holometabolous insect species has not yet been examined. The present study confirmed the body-enlarging effect in silkmoths fed an artificial diet instead of mulberry leaves used in the previous literature. Administration of honeybee royal jelly to silkmoth from early larval stage increased the size of female pupae and adult moths, but not larvae (at the late larval stage or male pupae. We further examined the body-enlarging effect of royal jelly in a non-holometabolous species, the two-spotted cricket Gryllus bimaculatus, which belongs to the evolutionarily primitive group Polyneoptera. Administration of royal jelly to G. bimaculatus from its early nymph stage enlarged both males and females at the mid-nymph and adult stages. In the cricket, the body parts were uniformly enlarged in both males and females; whereas the enlarged female silkmoths had swollen abdomens. Administration of royal jelly increased the number, but not the size, of eggs loaded in the abdomen of silkmoth females. In addition, fat body cells were enlarged by royal jelly in the silkmoth, but not in the cricket. These findings suggest that the body-enlarging effect of royal jelly is common in non-holometabolous species, G. bimaculatus, but it acts in a different manner than in holometabolous species.

  20. Histological and immunohistochemical features of gingival enlargement in a patient with AML

    NARCIS (Netherlands)

    Sonoi, N.; Soga, Y.; Maeda, H.; Ichimura, K.; Yoshino, T.; Aoyama, K.; Fujii, N.; Maeda, Y.; Tanimoto, M.; Logan, R.; Raber-Durlacher, J.; Takashiba, S.

    2012-01-01

    Here, we discuss the pathophysiology of leukemia-associated gingival enlargement based on a case of acute myelomonocytic leukemia (AML-M4) with typical gingival enlargement. Uniquely, this patient was well enough to allow full periodontal examination and incisional gingival biopsy to be performed bo

  1. Comparative study of vaginal hysterectomy and abdominal hysterectomy for enlarged uterus

    Directory of Open Access Journals (Sweden)

    Chandrika S.

    2016-09-01

    Conclusions: Bulk reducing techniques were used to remove the moderately enlarged uterus through vaginal route. Vaginal hysterectomy is invasive route, safe and feasible in cases with enlarged uteri up to 14 weeks due to benign causes. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3116-3120

  2. Histological and immunohistochemical features of gingival enlargement in a patient with AML

    NARCIS (Netherlands)

    Sonoi, N.; Soga, Y.; Maeda, H.; Ichimura, K.; Yoshino, T.; Aoyama, K.; Fujii, N.; Maeda, Y.; Tanimoto, M.; Logan, R.; Raber-Durlacher, J.; Takashiba, S.

    2012-01-01

    Here, we discuss the pathophysiology of leukemia-associated gingival enlargement based on a case of acute myelomonocytic leukemia (AML-M4) with typical gingival enlargement. Uniquely, this patient was well enough to allow full periodontal examination and incisional gingival biopsy to be performed

  3. Calcium-binding proteins in skeletal muscles of the mdx mice: potential role in the pathogenesis of Duchenne muscular dystrophy.

    Science.gov (United States)

    Pertille, Adriana; de Carvalho, Candida Luiza Tonizza; Matsumura, Cintia Yuri; Neto, Humberto Santo; Marques, Maria Julia

    2010-02-01

    Duchenne muscular dystrophy is one of the most common hereditary diseases. Abnormal ion handling renders dystrophic muscle fibers more susceptible to necrosis and a rise in intracellular calcium is an important initiating event in dystrophic muscle pathogenesis. In the mdx mice, muscles are affected with different intensities and some muscles are spared. We investigated the levels of the calcium-binding proteins calsequestrin and calmodulin in the non-spared axial (sternomastoid and diaphragm), limb (tibialis anterior and soleus), cardiac and in the spared extraocular muscles (EOM) of control and mdx mice. Immunoblotting analysis showed a significant increase of the proteins in the spared mdx EOM and a significant decrease in the most affected diaphragm. Both proteins were comparable to the cardiac muscle controls. In limb and sternomastoid muscles, calmodulin and calsequestrin were affected differently. These results suggest that differential levels of the calcium-handling proteins may be involved in the pathogenesis of myonecrosis in mdx muscles. Understanding the signaling mechanisms involving Ca(2+)-calmodulin activation and calsequestrin expression may be a valuable way to develop new therapeutic approaches to the dystrophinopaties.

  4. Expression and identification of 10 sarcomeric MyHC isoforms in human skeletal muscles of different embryological origin. Diversity and similarity in mammalian species.

    Science.gov (United States)

    Mascarello, Francesco; Toniolo, Luana; Cancellara, Pasqua; Reggiani, Carlo; Maccatrozzo, Lisa

    2016-09-01

    In the mammalian genome, among myosin heavy chain (MyHC) isoforms a family can be identified as sarcomeric based on their molecular structure which allows thick filament formation. In this study we aimed to assess the expression of the 10 sarcomeric isoforms in human skeletal muscles, adopting this species as a reference for comparison with all other mammalian species. To this aim, we set up the condition for quantitative Real Time PCR assay to detect and quantify MyHC mRNA expression in a wide variety of human muscles from somitic, presomitic and preotic origin. Specific patterns of expression of the following genes MYH1, MYH2, MYH3, MYH4, MYH6, MYH7, MYH8, MYH13, MYH14/7b and MYH15 were demonstrated in various muscle samples. On the same muscle samples which were analysed for mRNA expression, the corresponding MyHC proteins were studied with SDS PAGE and Western blot. The mRNA-protein comparison allowed the identification of 10 distinct proteins based on the electrophoretic migration rate. Three groups were formed based on the migration rate: fast migrating comprising beta/slow/1, alpha cardiac and fast 2B, slow migrating comprising fast 2X, fast 2A and two developmental isoforms (NEO and EMB), intermediate migrating comprising EO MyHC, slow B (product of MYH15), slow tonic (product of MYH14/7b). Of special interest was the demonstration of a protein band corresponding to 2B-MyHC in laryngeal muscles and the finding that all 10 isoforms are expressed in extraocular muscles. These latter muscles are the unique localization for extraocular, slow B (product of MYH15) and slow tonic (product of MYH14/7b).

  5. Clinicopathological study of three cases of infantile fibromatosis of the orbit.

    Science.gov (United States)

    Hayashi, Kengo; Katori, Nobutada; Otsuki, Yoshiro; Ohno-Matsui, Kyoko

    2014-10-01

    We report the clinical and pathological findings in three infants with infantile fibromatosis that involved several extraocular muscles which led to disorders of ocular motility. We also describe their clinical features before and after surgery. This was a retrospective interventional case study with clinicopathological correlations. We present three cases of infantile fibromatosis that were diagnosed by clinical features and histopathlogical examination of biopsy specimens. The three patients were all female children aged 1, 3, and 3 years at their initial visit. The orbital tumor was unilateral in all patients. All three patients had disorders of ocular motility because the tumors involved ≥2 extraocular muscles. The margins between the tumor and the involved extraocular muscles were not distinct. We performed partial resection of the tumors to preserve the extraocular muscles. In all cases, the tumors partially remained, but periodic postoperative magnetic resonance imaging showed no enlargement of the tumors during the follow-up period. All three patients had residual limitations of eye movements. We should consider the postoperative binocular function when we treat infantile benign fibrous tumors involving the extraocular muscles.

  6. Left atrial enlargement in the early stage of hypertensive heart disease: a common but ignored condition.

    Science.gov (United States)

    Su, Guanhua; Cao, Heng; Xu, Sudan; Lu, Yongxin; Shuai, Xinxin; Sun, Yufei; Liao, Yuhua; Li, Jingdong

    2014-03-01

    How to identify the early signs of hypertensive heart disease is the key to block or reverse the process of heart failure. The aim of this study was to evaluate the predictive value of left atrial (LA) enlargement in the early stage of hypertensive heart disease and to explore the correlations between LA enlargement and heart failure with normal ejection fraction (HFnEF), as well as the metabolic syndrome (MetS). Baseline clinical characteristics, biochemical indices, electrocardiographic and echocardiographic data were collected from 341 consecutive patients with essential hypertension. Among those patients, LA enlargement was more frequently presented than LV enlargement (57.2% vs 17.9%). Compared with patients without HFnEF, the prevalence of LA enlargement was higher in patients with HFnEF (82.9% vs 49.0%, Page, body mass index, waist circumference, triglyceride level, and left ventricular diameter were independent predictors of LA enlargement. The simple measurement for identification of LA enlargement potentially allows early recognition of those patients at risk for heart failure, particularly among patients with MetS.

  7. EFFECT OF ENLARGED FREE JET ON ENERGY CONVERSION IN PELTON TURBINE

    Institute of Scientific and Technical Information of China (English)

    LIU Jie; WEI Cai-xin; HAN Feng-qin

    2006-01-01

    In Pelton turbines, when the water jet emerges in the air, its velocity decreases downstream and its diameter increases to meet the continuity. In this paper, a physical parameter, the enlarging rate of jet diameter kDj was introduced and measured experimentally. The measurement of enlarging rate was carried out in three model turbines with different distributing Y-branch and nozzle configurations under various operating conditions. The effect of jet enlarging rate on the unsteady water sheet flow in the rotating buckets has not been investigated so far. This paper also presents the comparative numerical analysis of the flow in buckets at different enlarging rates of jet. It is shown that the effect of jet enlargement is so large that the flow pattern in the bucket is drastically changed by the latter half of the frames. The jet with large enlarging rate also introduces worse energy behavior to the hydraulic performance of the Pelton turbine. Besides, the phenomenon of jet interference was also discussed by using the results of numerical simulation for one jet. It indicates that the jet with large enlarging rate takes more risk that jet interference may damage the performance of multi-nozzle Pelton turbine.

  8. ES1 is a mitochondrial enlarging factor contributing to form mega-mitochondria in zebrafish cones.

    Science.gov (United States)

    Masuda, Takamasa; Wada, Yasutaka; Kawamura, Satoru

    2016-03-01

    Total mass of mitochondria increases during cell proliferation and differentiation through mitochondrial biogenesis, which includes mitochondrial proliferation and growth. During the mitochondrial growth, individual mitochondria have been considered to be enlarged independently of mitochondrial fusion. However, molecular basis for this enlarging process has been poorly understood. Cone photoreceptor cells in the retina possess large mitochondria, so-called mega-mitochondria that have been considered to arise via the enlarging process. Here we show that ES1 is a novel mitochondria-enlarging factor contributing to form mega-mitochondria in cones. ES1 is specifically expressed in cones and localized to mitochondria including mega-mitochondria. Knockdown of ES1 markedly reduced the mitochondrial size in cones. In contrast, ectopic expression of ES1 in rods significantly increased both the size of individual mitochondria and the total mass of the mitochondrial cluster without changing the number of them. RNA-seq analysis showed that ERRα and its downstream mitochondrial genes were significantly up-regulated in the ES1-expressing rods, suggesting facilitation of mitochondrial enlargement via ERRα-dependent processes. Furthermore, higher energy state was detected in the ES1-expressing rods, indicating that the enlarged mitochondria by ES1 are capable of producing high energy. ES1 is the mitochondrial protein that is first found to promote enlargement of individual mitochondria.

  9. Phospholipids trigger Cryptococcus neoformans capsular enlargement during interactions with amoebae and macrophages.

    Directory of Open Access Journals (Sweden)

    Cara J Chrisman

    2011-05-01

    Full Text Available A remarkable aspect of the interaction of Cryptococcus neoformans with mammalian hosts is a consistent increase in capsule volume. Given that many aspects of the interaction of C. neoformans with macrophages are also observed with amoebae, we hypothesized that the capsule enlargement phenomenon also had a protozoan parallel. Incubation of C. neoformans with Acanthamoeba castellanii resulted in C. neoformans capsular enlargement. The phenomenon required contact between fungal and protozoan cells but did not require amoeba viability. Analysis of amoebae extracts showed that the likely stimuli for capsule enlargement were protozoan polar lipids. Extracts from macrophages and mammalian serum also triggered cryptococcal capsular enlargement. C. neoformans capsule enlargement required expression of fungal phospholipase B, but not phospholipase C. Purified phospholipids, in particular, phosphatidylcholine, and derived molecules triggered capsular enlargement with the subsequent formation of giant cells. These results implicate phospholipids as a trigger for both C. neoformans capsule enlargement in vivo and exopolysaccharide production. The observation that the incubation of C. neoformans with phospholipids led to the formation of giant cells provides the means to generate these enigmatic cells in vitro. Protozoan- or mammalian-derived polar lipids could represent a danger signal for C. neoformans that triggers capsular enlargement as a non-specific defense mechanism against potential predatory cells. Hence, phospholipids are the first host-derived molecules identified to trigger capsular enlargement. The parallels apparent in the capsular response of C. neoformans to both amoebae and macrophages provide additional support for the notion that certain aspects of cryptococcal virulence emerged as a consequence of environmental interactions with other microorganisms such as protists.

  10. Flap tear of rectus muscles: an underlying cause of strabismus after orbital trauma.

    Science.gov (United States)

    Ludwig, Irene H; Brown, Mark S

    2002-11-01

    To present an avulsion injury of the rectus muscle after orbital trauma, usually the inferior rectus, and detail its diagnosis and operative repair. Forty-three patients underwent repair of flap tears of 62 rectus muscles. During surgery, we found the muscle abnormality was often subtle, with narrowing or thinning of the remaining attached global layer of muscle. The detached flap of external (orbital) muscle was found embedded in surrounding orbital fat and connective tissue. Retrieval and repair were performed in each case. The causes of orbital trauma were as follows: orbital fractures (15 patients), blunt trauma with no fracture (11 patients), suspected trauma but did not undergo computerized tomographic scan (12 patients), and status after retinal detachment repair (5 patients). Of note, 15 of the 43 patients (35%) underwent repair of the flap tear alone, without any additional orbital or strabismus surgery. Diagnostically, the predominant motility defect in 45 muscles was limitation toward the field of action of the muscle, presumably as a result of a tether created by the torn flap; these tethers simulated muscle palsy. Seventeen muscles were restricted away from their field of action, simulating entrapment. The direction taken by the flap during healing determined the resultant strabismus pattern. All patients with gaze limitation toward an orbital fracture had flap tears. The worst results after flap tear repair were seen in patients (1) who had undergone orbital fracture repair before presentation, (2) who had undergone previous attempts at strabismus repair, and (3) who had the longest intervals between the precipitating event and the repair. The best results were obtained in patients who underwent simultaneous fracture and strabismus repair or early strabismus repair alone. Avulsion-type flap tears of the extraocular muscles are a common cause of posttraumatic strabismus. Early repair produces the best results, but improvement is possible despite long

  11. Cooperative diplomacy: Citizens, sovereignty, and the logic of democratic enlargement

    Science.gov (United States)

    Ndungu, Anthony Mark

    2000-12-01

    that intergovernmental agreement on compliance questions is most likely to occur when decision-making and policy-implementing processes are decentralized, and when governments establish and support decentralized intra- and trans-governmental institutions that enable private domestic groups of individuals to participate in international governance through two mechanisms. First, those decentralized institutions facilitate the formation of transnational coalitions of politically autonomous private domestic groups that can serve as a ``horizontal transmission belt'' for ideas and practices among private and public proponents of the major opposing domestic positions, thereby generating public transnational deliberation on compliance, monitoring and distributive questions. Second, politically autonomous private domestic groups can, by engaging in performance-based partnerships with senior government officials, also serve as a ``vertical transmission belt'' between domestic and intergovernmental regimes and vice versa, thereby encouraging their respective governments to adapt the social practices in issue-specific domestic regimes to international structural forces. These findings have significant ramifications for the concept of democratic enlargement, the institutionalization of competitive pluralism in non- liberal states. The robustness, across changes in administrations both at home and abroad, of the norms codified in international agreements may hinge on institutionalizing the participation of politically autonomous private domestic groups in decentralized intra- and trans-governmental decision-making and policy- implementing processes.

  12. Unilateral fibrotic enlargement of gingiva with unknown etiology: A rare findings

    Directory of Open Access Journals (Sweden)

    Mohammad Arif Khan

    2015-01-01

    Full Text Available Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It can be an isolated entity or may be associated with syndrome. In this case report, A 15-year-old female reported with a chief complaint of swollen gums which was slowly progressive since last 2 years that affects the esthetic appearance and functional movement such as mastication. On her intraoral examination revealed that there was unilateral, generalized, diffuse fibrotic gingival enlargement with pseudopockets. The lesion was surgically removed. Postoperative healing was satisfactory with significant improvement in esthetic appearance and mastication. There was no postoperative recurrence during 2 years of follow-up.

  13. Successful management of phenytoin and phenobarbitone induced gingival enlargement: A multimodal approach

    Directory of Open Access Journals (Sweden)

    V Priyadharshini

    2014-01-01

    Full Text Available Medication-related gingival enlargement is a common reactionary phenomenon that occurs with the use of several types of therapeutic agents, including antiepileptic drugs (AEDs. This disorder has been documented since 1939, shortly after the introduction of phenytoin. In the present case, a concise review of literature concerning the etiopathogenesis and management of AEDs (phenobarbitone and phenytoin induced gingival enlargement has been described. It is vital that not only the periodontist, but also dental surgeons and medical practitioners should become aware of the potential etiologic agents, characteristic features, and the differential diagnosis of drug induced gingival enlargement in order to be able to prevent, diagnose and successfully manage the condition.

  14. A unique case of two sources of right ventricle enlargement in tetralogy of Fallot.

    Science.gov (United States)

    Bradley, Elisa A; Bachuwar, Alok; Ludbrook, Philip A

    2013-01-01

    The most common long-term sequelae of tetralogy of Fallot (TOF) are related to acquired late postsurgical pulmonary valve pathology. This is often in the form of pulmonic insufficiency (PI) ultimately leading to right ventricular (RV) enlargement and failure, which may necessitate pulmonary valve replacement. We present a case of severe PI in TOF with an incidental large circumflex to RV fistula and single-vessel coronary artery stenosis in a patient with an enlarged RV. The diagnostic dilemma was to determine whether the RV enlargement was caused by severe PI, shunting from the coronary fistula, or a combination of both.

  15. Gingival Enlargement In Epileptic Patients On Phenytoin Therapy-An Overview Of Possible Etiologies And Studies

    Directory of Open Access Journals (Sweden)

    Abhishek Singh Nayyar

    2013-01-01

    Full Text Available Epilepsy is a common neurological disorder with recurrent seizures due to a chronic underlying process. Despite tremendous advances in the field of understanding regarding the etio-pathogenesis of epilepsy, phenytoin still remains the drug of choice in its management. Chronic administration of phenytoin has been associated to have a number of adverse effects. Gingival enlargement is one such most often reported adverse drug sequela of long term phenytoin usage with exclusion of local factors contributing towards gingival enlargement. This review gives an overview regarding the association of phenytoin and gingival enlargement seen in epileptic patients being treated with phenytoin.

  16. Eponyms related to genetic disorders associated with gingival enlargement; part II

    Directory of Open Access Journals (Sweden)

    Nora Mohammed Al-Aboud

    2015-01-01

    Full Text Available There are genetic disorders associated with gingival enlargement. In our part I, we reviewed the eponyms linked to Hereditary Gingival Fibromatosis (HGF [1]. Historical Article How to cite this article: Al Aboud A, Al-Aboud NM, Barnawi H, Al Hakami A. Eponyms related to genetic disorders associated with gingival enlargement: Part II. Our Dermatol Online. 2015;6(1:114-117. Submission: 27.05.2013; Acceptance: 21.09.2014 DOI: 10.7241/ourd.20151.32 In this part II of this review, we are going to shed some light on eponyms linked to groups of genetic disorders which may feature gingival enlargement.

  17. Management of amlodipine-induced gingival enlargement: Series of three cases

    Directory of Open Access Journals (Sweden)

    Srivastava Amit

    2010-01-01

    Full Text Available Gingival enlargement is one of the side effects associated with certain drugs. Amlodipine, a calcium channel blocker, used as antihypertensive drug has been found associated with gingival hyperplasia. This case series presents diagnosis and management of amlodipine-induced gingival hyperplasia. Amlodipine-induced gingival enlargement was diagnosed and managed by thorough scaling and root planning. Drug substitution and surgical intervention was performed in first two cases. The pathogenesis of gingival enlargement is uncertain and the treatment is still largely limited to the maintenance of an improved level of oral hygiene and surgical removal of the overgrown tissue. Several factors may influence the relationship between the drugs and gingival tissues as discussed by Seymour et al. Meticulous oral hygiene maintenance, switchover to alternative drug, professional scaling and root planning and surgical excision of enlarged gingival tissue may help overcome the effect of these drugs.

  18. Postpartum amenorrhoea-galactorrhoea associated with hyperprolactinaemia and pituitary enlargement in primary hypothyroidism

    NARCIS (Netherlands)

    J.M. Kroese; A.F. Grootendorst; L.J. Schelfhout

    2004-01-01

    textabstractWe report a 36-year-old woman with primary hypothyroidism revealed by postpartum amenorrhoea-galactorrhoea associated with hyperprolactinaemia and suprasellar pituitary enlargement on magnetic resonance imaging (MRI). On thyroid hormone replacement therapy all clinical,

  19. Aortic valve replacement with concomitant annular enlargement for small aortic annulus of less than 19 mm.

    Science.gov (United States)

    Takakura, H; Sasaki, T; Hashimoto, K; Hachiya, T; Onoguchi, K; Oshiumi, M; Takeuchi, S

    2000-06-01

    Three female patients with aortic stenosis associated with a severely small annulus underwent aortic valve replacement. In intraoperative measurements, a 19-mm obtulator could not pass through the aortic annulus in each case. We therefore concluded that it would be difficult to implant an appropriate-sized prosthesis in a routine fashion, so we performed an annular enlargement in a modified Nicks procedure. By using a wide teardrop-shaped patch for enlargement and slightly tilting insertion of a prosthesis, a 21 mm bileaflet mechanical prosthesis could be inserted into the enlarged annulus. Despite being a simpler method than other enlarging procedures, a two- or three-sizes larger prosthesis than the native annulus can be inserted with relative ease. Thus, the use of a 19 mm mechanical prosthesis may be avoidable in most adult cases.

  20. Postpartum amenorrhoea-galactorrhoea associated with hyperprolactinaemia and pituitary enlargement in primary hypothyroidism

    NARCIS (Netherlands)

    J.M. Kroese; A.F. Grootendorst; L.J. Schelfhout

    2004-01-01

    textabstractWe report a 36-year-old woman with primary hypothyroidism revealed by postpartum amenorrhoea-galactorrhoea associated with hyperprolactinaemia and suprasellar pituitary enlargement on magnetic resonance imaging (MRI). On thyroid hormone replacement therapy all clinical,

  1. Aberrant muscle syndrome: hypertrophy of the hand and arm due to aberrant muscles with or without hypertrophy of the muscles.

    Science.gov (United States)

    Ogino, Toshihiko; Satake, Hiroshi; Takahara, Masatoshi; Kikuchi, Noriaki; Watanabe, Tadayosi; Iba, Kousuke; Ishii, Seiichi

    2010-06-01

    Five patients were reported in our congenital anomaly registry who had six hands in total with muscular hyperplasia, aberrant muscles, ulnar drift of the fingers in the metacarpophalangeal (MP) joints, flexion contractures of the MP joints, and enlargement of the metacarpal spaces. Thirty patients with unilateral involvement of this condition have been reported previously. We reviewed these cases and found that the condition varied in severity and that it was reported using different names. However, this condition seems different from true macrodactyly and multiple camptodactyly, including windblown hand, and seems to be an isolated entity of congenital upper limb anomaly. The authors recommend 'aberrant muscle syndrome' or 'accessory muscle syndrome' as a diagnostic name, because this seems to be the most common pathological finding in this condition.

  2. Management of phenytoin induced gingival enlargement associated with cerebral palsy: A challenge to the clinician

    OpenAIRE

    Anupama Shriram Rao; Amit K Walvekar; Rao, Subramaniam M; Biju Thomas

    2013-01-01

    Phenytoin, which is the drug of choice for treatment of grandmal, psychomotor seizures associated with cerebral palsy, has serious side effect like gingival enlargement. Drug induced gingival enlargement is not only esthetically disfiguring but often impairs speech, mastication, nutrition and plaque control measures. In addition, poor oral hygiene, lack of motor coordination and muscular limitations in mentally disabled individuals results in increased susceptibility to periodontal disease. T...

  3. Congenital infiltrating lipomatosis of the face with enlargement of the ipsilateral cerebellar hemisphere

    Directory of Open Access Journals (Sweden)

    Eric Gous

    2015-03-01

    Full Text Available Congenital infiltrating lipomatosis of the face (CILF is a rare disorder in which overgrowth of fatty tissue with infiltration of underlying structures leads to craniofacial deformities and asymmetry. Imaging plays an important role in the diagnosis, surgical planning and evaluation of underlying structures. To our knowledge, our case is the first to describe CILF associated with isolated enlargement of a cerebellar hemisphere in the absence of an enlarged ipsilateral cerebral hemisphere (hemimegalencephaly.

  4. Severe Gingival Enlargement with Coexisting Erosive Lichen Planus in Severe Chronic Periodontitis Patient

    Directory of Open Access Journals (Sweden)

    Ambika Sharma

    2015-01-01

    Full Text Available Plaque induced gingival enlargement is most commonly seen and when encountered simultaneously with erosive lichen planus poses a challenge to the treating dentist. Prognosis of one condition may influence the prognosis of another condition. The presented case highlights the significance of proper diagnosis and the management of simultaneously occurring gingival lesions. A 49-year-old hypertensive female presented with painful enlarged bleeding and suppurating gums with burning sensation on eating food along with long-term usage of antihypertensive drug amlodipine known for its gingival enlargement effect. All these multiple factors led to diagnostic dilemma. Effective management of the gingival enlargement was done by using electrocautery to rehabilitate the functions and esthetics of the patient. Gingival condition was also complicated by the presence of coexisting lichen planus which was predominantly erosive for which topical corticosteroid, antifungal, and antimicrobial agents were prescribed. Eight-month follow-up did not show recurrence of gingival enlargement. Electrocautery is an effective tool for the gingivectomy in severe inflammatory type of gingival enlargement because of rapid postoperative hemostasis. For the management of erosive lichen planus, long-term use of topical corticosteroids is an effective approach. Maintenance of oral hygiene and regular follow-ups are essential for these conditions.

  5. Histological and immunohistochemical features of gingival enlargement in a patient with AML.

    Science.gov (United States)

    Sonoi, Norihiro; Soga, Yoshihiko; Maeda, Hiroshi; Ichimura, Koichi; Yoshino, Tadashi; Aoyama, Kazutoshi; Fujii, Nobuharu; Maeda, Yoshinobu; Tanimoto, Mitsune; Logan, Richard; Raber-Durlacher, Judith; Takashiba, Shogo

    2012-07-01

    Here, we discuss the pathophysiology of leukemia-associated gingival enlargement based on a case of acute myelomonocytic leukemia (AML-M4) with typical gingival enlargement. Uniquely, this patient was well enough to allow full periodontal examination and incisional gingival biopsy to be performed both before and after chemotherapy. The patient was a 39-year-old Japanese woman with AML-M4 showing gingival enlargement. Histological and immunohistochemical features of gingiva and bacterial counts in the periodontal pockets were examined before and after chemotherapy. The results were as follows: (1) infiltration of myelomonocytic blasts in enlarged gingiva; (2) resolution of gingival enlargement with complete remission of AML by anticancer chemotherapy; and (3) the numbers of bacteria in the periodontal pockets were not high and were not altered before or after chemotherapy. In patients with AML-M4, remarkable mucosal enlargement is not generally observed in the body except in the gingiva. We hypothesized that antigens derived from periodontal bacteria, even if they are not present in large numbers, could act as chemoattractants for myelomonocytic leukemic cells.

  6. Relationship between intracranial internal carotid artery calcification and enlarged cerebral perivascular space

    Energy Technology Data Exchange (ETDEWEB)

    Tao, Xiao-Xiao [Shanghai Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Neurology, Shanghai (China); The First People' s Hospital of Wenling, Department of Neurology, Wenling (China); Li, Ge-Fei; Wu, Yi-Lan; Liu, Yi-Sheng; Zhao, Ying; Shi, Yan-Hui; Zhuang, Mei-Ting; Hou, Tian-Yu; Zhao, Rong; Liu, Feng-Di; Wang, Xue-Mei; Shen, Ying; Cui, Guo-Hong; Su, Jing-Jing; Chen, Wei [Shanghai Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Neurology, Shanghai (China); Tang, Xue-Mei; Sun, Ji; Liu, Jian-Ren [Shanghai Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Neurology, Shanghai (China); Shanghai Jiao Tong University School of Medicine, Clinical Research Center, Shanghai (China)

    2017-06-15

    The association between intracranial internal carotid artery (IICA) calcification and lacunes, white matter hyperintensity (WMH), and cerebral microbleeds (CMBs) has been well researched. However, enlarged cerebral perivascular space (PVS) has not yet been reported to correlate with intracranial internal carotid artery calcification. Therefore, the primary aim of this study was to investigate the relationship between IICA calcification and enlarged PVS. A total of 189 patients with ischemic stroke in the middle cerebral artery territory who presented within 7 days of ictus from 2012 to 2015 were enrolled respectively. All patients were required to have undergone head computed tomography, magnetic resonance imaging, susceptibility-weighted magnetic resonance imaging, magnetic resonance angiography, or computed tomography angiography. Clinical characteristics were recorded. IICA calcification and enlarged PVS were semi-quantitatively evaluated, and the presence of lacunes, WMH, and CMBs was recorded. Of the 189 patients, 63.5% were male. Mean age of the patients was 68.6 ± 12.2 years. There were 104 patients with IICA calcification. Age, diabetes mellitus, lacunes, and white matter hyperintensity were significantly associated with IICA calcification (P < 0.05). Multivariate logistic regression analysis showed that age, diabetes mellitus, and lacunes were independent predictors of IICA calcification (P < 0.05). A lower risk of IICA calcification was found in patients with a higher enlarged PVS score (P = 0.004). Higher enlarged PVS scores were associated with a lesser degree of IICA calcification. There appears to be a relationship between reduced risk of IICA calcification and enlarged PVS. (orig.)

  7. Associations between 'valentine' heart shape, atrial enlargement and cardiomyopathy in cats.

    Science.gov (United States)

    Winter, Matthew D; Giglio, Robson F; Berry, Clifford R; Reese, David J; Maisenbacher, Herbert W; Hernandez, Jorge A

    2015-06-01

    'Valentine' heart shape is a common qualifier used in veterinary radiology to describe a cardiac silhouette with focal enlargement at the level of the base of the heart in feline patients. Anecdotally, this sign has been thought to be related to biatrial enlargement and also to hypertrophic cardiomyopathy (HCM). However, to our knowledge, there has been no study performed to assess the association between cardiac chamber enlargement and cardiac disease with the 'valentine'-shaped heart. The aim of this study was to verify the association between the 'valentine' heart shape observed in ventrodorsal thoracic radiographs and the presence of singular or combined cardiac chamber enlargement, and also the presence and type of cardiomyopathy (CM) in cats. A search of the database of the Small Animal Veterinary Hospital of the University of Florida for cats with a radiology report of thoracic radiographs that contained the words 'valentine' and 'biatrial', and echocardiography performed within 1 week, was undertaken; 41 cases met the inclusion criteria. Eighty-two percent of the cats of the study sample had some form of CM. The 'valentine' heart shape was associated with biatrial enlargement in 41% of the patients in our study sample that had some form of CM and just 8% of cases diagnosed with HCM, suggesting that the 'valentine' heart shape has a low association with HCM or biatrial enlargement; however, it should be considered a sign of feline CM.

  8. Methods of artificial enlargement of the training set for statistical shape models.

    Science.gov (United States)

    Koikkalainen, Juha; Tölli, Tuomas; Lauerma, Kirsi; Antila, Kari; Mattila, Elina; Lilja, Mikko; Lötjönen, Jyrki

    2008-11-01

    Due to the small size of training sets, statistical shape models often over-constrain the deformation in medical image segmentation. Hence, artificial enlargement of the training set has been proposed as a solution for the problem to increase the flexibility of the models. In this paper, different methods were evaluated to artificially enlarge a training set. Furthermore, the objectives were to study the effects of the size of the training set, to estimate the optimal number of deformation modes, to study the effects of different error sources, and to compare different deformation methods. The study was performed for a cardiac shape model consisting of ventricles, atria, and epicardium, and built from magnetic resonance (MR) volume images of 25 subjects. Both shape modeling and image segmentation accuracies were studied. The objectives were reached by utilizing different training sets and datasets, and two deformation methods. The evaluation proved that artificial enlargement of the training set improves both the modeling and segmentation accuracy. All but one enlargement techniques gave statistically significantly (p < 0.05) better segmentation results than the standard method without enlargement. The two best enlargement techniques were the nonrigid movement technique and the technique that combines principal component analysis (PCA) and finite element model (FEM). The optimal number of deformation modes was found to be near 100 modes in our application. The active shape model segmentation gave better segmentation accuracy than the one based on the simulated annealing optimization of the model weights.

  9. Muscle pain

    African Journals Online (AJOL)

    Causes of muscle pain include stress, physical activity, infections, hyper or .... Acupuncture. It is a traditional Chinese-based therapeutic method which ..... and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical.

  10. Experimental investigation of impingement cooling with turbulators or surface enlarging elements

    Energy Technology Data Exchange (ETDEWEB)

    Persson, Johan

    2000-02-01

    For the materials in modern gas turbines to sustain, a considerable amount of cooling is required. In cases where large amounts of heat need to be removed, impingement cooling with its high heat transfer coefficients may be the only alternative. In this work the possibilities of enhancing impingement cooling by introducing surface enlarging - turbulence enhancing elements are examined experimentally. A configuration consisting of a staggered array of 45 impingement jets distributed over 10 rows is used for the purpose. A thermo camera is used to measure the temperature distribution on the target plate, giving an opportunity to separately evaluate the Nusselt number enhancement for different areas. Experiments are conducted for five different area enlarging geometries: triangle, wing, cylinder, dashed rib, and angel, all made from aluminium. Comparison between each area enlarged surface and a flat plate is made, with results presented as Nusselt number enhancement factors. The effect of pumping power required is also investigated in order to maximize the cooling efficiency. Parameters varied are Reynolds number and jet to plate distance. Overall Nusselt number enhancement factors show values of 1 to 1.3, the trend being decreasing with increased jet to plane distance and Reynolds number. When taking into account pumping power the enhancement factors drop to 0.4 to 1.2. The best results are achieved with the rib geometry and when not using a too large value of enlarger height over jet to plate distance (h/z). Row wise evaluation of Nusselt number enhancement shows an increased enhancement with row number and thereby crossflow ratio (Gc/Gj). Typical increases in enhancement of 1 to 1.5 with Gc/Gj from 0 to 0.8 are found. The thermo camera pictures reveal that the enhancement is found in three different areas, on the enlarger base area, the area just downstream the enlarger and in diagonal streaks with increased turbulence caused by the enlargers. Tests using an

  11. Referred pain elicited by manual exploration of the lateral rectus muscle in chronic tension-type headache.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Cuadrado, Maria Luz; Gerwin, Robert D; Pareja, Juan A

    2009-01-01

    To analyze the presence of referred pain elicited by manual examination of the lateral rectus muscle in patients with chronic tension-type headache (CTTH). A case-control blinded study. It has been found previously that the manual examination of the superior oblique muscle can elicit referred pain to the head in some patients with migraine or tension-type headache. However, a referred pain from other extraocular muscles has not been investigated. Fifteen patients with CTTH and 15 healthy subjects without headache history were included. A blinded assessor performed a manual examination focused on the search for myofascial trigger points (TrPs) in the right and left lateral rectus muscles. TrP diagnosis was made when there was referred pain evoked by maintained pressure on the lateral corner of the orbit (anatomical projection of the lateral rectus muscle) for 20 seconds, and increased referred pain while the subject maintained a medial gaze on the corresponding side (active stretching of the muscle) for 15 seconds. On each side, a 10-point numerical pain rate scale was used to assess the intensity of referred pain at both stages of the examination. Ten patients with CTTH (66.6%) had referred pain that satisfied TrPs diagnostic criteria, while only one healthy control (0.07%) reported referred pain upon the examination of the lateral rectus muscles (P < 0.001). The elicited referred pain was perceived as a deep ache located at the supraorbital region or the homolateral forehead. Pain was evoked on both sides in all subjects with TrPs, with no difference in pain intensity between the right and the left. The average pain intensity was significantly greater in the patient group (P < 0.001). All CTTH patients with referred pain recognized it as the frontal pain that they usually experienced during their headache attacks, which was consistent with active TrPs. In some patients with CTTH, the manual examination of lateral rectus muscle TrPs elicits a referred pain that

  12. Primary skeletal muscle lymphoma presenting as refractory cellulitis.

    Science.gov (United States)

    Baddour, L M; Haden, K H; Allen, J W

    2001-09-01

    The right torso of a 55-year-old woman showed diffuse skin and soft-tissue changes suggestive of cellulitis. However, several clinical and radiologic features, including the subacute and non-toxic nature of the illness and the patient's lack of response to antibiotic therapy, indicated a noninfectious etiology. Malignancy was suggested by striking changes seen on computed tomographic scanning--including extensive infiltration and enlargement of the musculature of the right shoulder girdle, the intercostal musculature, the latissimus dorsi, and the rhomboids; focal enlargement of the right paraspinal muscles; and enlargement of the psoas and the iliacus muscles and of the musculature around the hip joint. The mediastinal, hilar, and paraaortic regions showed no adenopathy. A large hypodense lesion of approximately 4.5 cm, which was seen in the caudate lobe of the liver, raised the concern of a metastatic focus of malignancy. Because of these findings, an immediate muscle biopsy was performed. Results showed a non-Hodgkin's lymphoma with a B-cell phenotype. Although primary skeletal muscle lymphoma is very uncommon in patients without human immunodeficiency virus infection, clinical presentation of refractory cellulitis, as seen in the current case, is extremely rare.

  13. Right Ventricular Enlargement within Months of Arteriovenous Fistula Creation in 2 Hemodialysis Patients.

    Science.gov (United States)

    Ragupathi, Loheetha; Johnson, Drew; Marhefka, Gregary D

    2016-08-01

    Surgically created arteriovenous fistulae (AVF) for hemodialysis can contribute to hemodynamic changes. We describe the cases of 2 male patients in whom new right ventricular enlargement developed after an AVF was created for hemodialysis. Patient 1 sustained high-output heart failure solely attributable to the AVF. After AVF banding and subsequent ligation, his heart failure and right ventricular enlargement resolved. In Patient 2, the AVF contributed to new-onset right ventricular enlargement, heart failure, and ascites. His severe pulmonary hypertension was caused by diastolic heart failure, diabetes mellitus, and obstructive sleep apnea. His right ventricular enlargement and heart failure symptoms did not improve after AVF ligation. We think that our report is the first to specifically correlate the echocardiographic finding of right ventricular enlargement with AVF sequelae. Clinicians who treat end-stage renal disease patients should be aware of this potential sequela of AVF creation, particularly in the upper arm. We recommend obtaining preoperative echocardiograms in all patients who will undergo upper-arm AVF creation, so that comparisons can be made postoperatively. Alternative consideration should be given to creating the AVF in the radial artery, because of less shunting and therefore less potential for right-sided heart failure and pulmonary hypertension. A multidisciplinary approach is optimal when selecting patients for AVF banding or ligation.

  14. Morphology and morphometry of the human sublingual glands in mouth floor enlargements of edentulous patients

    Directory of Open Access Journals (Sweden)

    Josiane Costa Rodrigues de SA

    2013-12-01

    Full Text Available Asymptomatic mouth floor enlargements may be observed in edentulous patients. These masses, which protrude from the mouth floor, may complicate the fitting of dentures and require surgery. Whether this "entity" may be considered an anatomical variation of the mouth floor or represent specific alterations in the sublingual gland is not known. Objective: The aim of this work is to investigate the morphological and morphometric aspects of the sublingual glands of edentulous patients with mouth floor enlargements and compare the glands of these patients with the sublingual glands of human cadavers. Material and Methods: Microscopic evaluation was performed on human sublingual glands from edentulous patients with mouth floor enlargements (n=20 and edentulous cadavers (n=20. The patients and cadavers were of similar ages. The data were compared using Mann-Whitney U, Fisher's exact and Student's t tests (p0.05. Only the variables "autolysis" and "congested blood vessels" presented statistical difference between groups (p=0.014; p=0.043. The morphometric study revealed that the volume densities of acini, ducts, stroma and adipose tissue were similar between the groups (p>0.05. CONCLUSION: The microscopic characteristics of the sublingual glands in mouth floor enlargements in edentulous patients correspond to characteristics associated with the normal aging process. The glands are not pathological and represent an age-related alteration that occurs with or without the presence of the mouth floor enlargements.

  15. Morphology and morphometry of the human sublingual glands in mouth floor enlargements of edentulous patients.

    Science.gov (United States)

    Sá, Josiane Costa Rodrigues de; Tolentino, Elen de Souza; Azevedo-Alanis, Luciana Reis; Iwaki Filho, Liogi; Lara, Vanessa Soares; Damante, José Humberto

    2013-01-01

    Asymptomatic mouth floor enlargements may be observed in edentulous patients. These masses, which protrude from the mouth floor, may complicate the fitting of dentures and require surgery. Whether this "entity" may be considered an anatomical variation of the mouth floor or represent specific alterations in the sublingual gland is not known. The aim of this work is to investigate the morphological and morphometric aspects of the sublingual glands of edentulous patients with mouth floor enlargements and compare the glands of these patients with the sublingual glands of human cadavers. Microscopic evaluation was performed on human sublingual glands from edentulous patients with mouth floor enlargements (n=20) and edentulous cadavers (n=20). The patients and cadavers were of similar ages. The data were compared using Mann-Whitney U, Fisher's exact and Student's t tests (p0.05). Only the variables "autolysis" and "congested blood vessels" presented statistical difference between groups (p=0.014; p=0.043). The morphometric study revealed that the volume densities of acini, ducts, stroma and adipose tissue were similar between the groups (p>0.05). The microscopic characteristics of the sublingual glands in mouth floor enlargements in edentulous patients correspond to characteristics associated with the normal aging process. The glands are not pathological and represent an age-related alteration that occurs with or without the presence of the mouth floor enlargements.

  16. Portugal and the EU’s Eastern Enlargement: A logic of identity endorsement

    Directory of Open Access Journals (Sweden)

    Arne Niemann

    2012-07-01

    Full Text Available This paper addresses the puzzle of why Portugal has consistently supported the EU’s fifth enlargement. We argue that standard explanations, based on welfare maximisation, geopolitics, or rhetorical action, cannot persuasively account for this policy choice. Instead, we advance an alternative explanation – subsequently referred to as ‘identity endorsement –that is based on a logic of appropriateness where behaviour is shaped by aspects of similarity and congruence, and where the development of Portuguese identity has constituted what has been perceived as appropriate in the context of Eastern enlargement. We argue that EC/EU membership has provided Portuguese political elites with a renewed collective identity, in which a choice for membership has been equated with a choice for democracy, stability and openness. Portuguese support for Eastern enlargement has consistently been based on these concepts that originated from Portugal’s own period of accession negotiations. By fully supporting Eastern enlargement, Portugal could act together with the ‘European core’, and Portugal itself would become more ‘core’, i.e. more European. For Portuguese political elites, supporting Eastern enlargement thus constituted an act of ‘identity endorsement’, i.e. the confirmation, (re-production and reinforcement of existing identity constructions. We tentatively suggest that the notion of identity endorsement may also shed light on other empirical puzzles related to European integration.

  17. A lifespan MRI evaluation of ventricular enlargement in normal aging mice.

    Science.gov (United States)

    Chen, Chiao-Chi V; Tung, Yu-Ying; Chang, Chen

    2011-12-01

    Ventricular enlargement has been proposed as a structural biomarker for the progression of Alzheimer's disease (AD). This biomarker, established in human patients, needs to be translated to animals to facilitate drug development for the disease. However, ventricular enlargement is not exclusive to AD, since the ventricle size increases during normal aging. A longitudinal characterization of ventricular enlargement in normal aging in mice is therefore crucial before further evaluations of mouse models or neurodegenerative diseases associated to brain atrophy. To this end, ventricular enlargement in normal aging mice was characterized over the lifespan (i.e., 2 years). The results showed that the overall ventricle size increased with age, with the expansion beginning during the early life stages and continuing to old age. The reported data represent a biomarker benchmark for normal aging mice under unmodified conditions. This provides a foundation for evaluating the validity of AD mouse models or the effects of potential drugs. The considerable physiological ventricular enlargement during normal aging must be considered in related experiments.

  18. How to make rapid eye movements “rapid”: the role of growth factors for muscle contractile properties

    Science.gov (United States)

    Li, Tian; Feng, Cheng-Yuan

    2011-01-01

    Different muscle functions require different muscle contraction properties. Saccade-generating extraocular muscles (EOMs) are the fastest muscles in the human body, significantly faster than limb skeletal muscles. Muscle contraction speed is subjected to plasticity, i.e., contraction speed can be adjusted to serve different demands, but little is known about the molecular mechanisms that control contraction speed. Therefore, we examined whether myogenic growth factors modulate contractile properties, including twitch contraction time (onset of force to peak force) and half relaxation time (peak force to half relaxation). We examined effects of three muscle-derived growth factors: insulin-like growth factor 1 (IGF1), cardiotrophin-1 (CT1), and glial cell line-derived neurotrophic factor (GDNF). In gain-of-function experiments, CT1 or GDNF injected into the orbit shortened contraction time, and IGF1 or CT1 shortened half relaxation time. In loss-of-function experiments with binding proteins or neutralizing antibodies, elimination of endogenous IGFs prolonged both contraction time and half relaxation time, while eliminating endogenous GDNF prolonged contraction time, with no effect on half relaxation time. Elimination of endogenous IGFs or CT1, but not GDNF, significantly reduced contractile force. Thus, IGF1, CT1, and GDNF have partially overlapping but not identical effects on muscle contractile properties. Expression of these three growth factors was measured in chicken and/or rat EOMs by real-time PCR. The “fast” EOMs express significantly more message encoding these growth factors and their receptors than skeletal muscles with slower contractile properties. Taken together, these findings indicate that EOM contractile kinetics is regulated by the amount of myogenic growth factors available to the muscle. PMID:21279379

  19. Modeling the Effect of Enlarging Seating Room on Passengers' Preference of Taiwan's Domestic Airlines

    Science.gov (United States)

    Lu, Jin-Long; Tsai, Li-Non

    2003-01-01

    This study addresses the need for measuring the effect of enlarging seating room in airplane on passengers' preferences of airline in Taiwan. The results can assist Taiwan's domestic air carriers in better understanding their customers' expectations. Stated choice experiment is used to incorporate passengers' trade-offs in the preferred measurement, and three major attributes are taken into account in the stated choice experiment: (1) type of seat (enlarged or not), (2) price, and (3) brand names of airlines. Furthermore, a binary logit model is used to model the choice behavior of air passengers. The findings show that the type of seat is a major significant variable; price and airline's brand are also significant as well. It concludes that air carriers should put more emphasis on the issue of improving the quality of seat comfort. Keywords: Passengers' preference, Enlarged seating room, Stated choice experiment, Binary logit model.

  20. Management of phenytoin induced gingival enlargement associated with cerebral palsy: A challenge to the clinician

    Directory of Open Access Journals (Sweden)

    Anupama Shriram Rao

    2013-01-01

    Full Text Available Phenytoin, which is the drug of choice for treatment of grandmal, psychomotor seizures associated with cerebral palsy, has serious side effect like gingival enlargement. Drug induced gingival enlargement is not only esthetically disfiguring but often impairs speech, mastication, nutrition and plaque control measures. In addition, poor oral hygiene, lack of motor coordination and muscular limitations in mentally disabled individuals results in increased susceptibility to periodontal disease. The present case report unfolds a complex nature of the management of phenytoin induced gingival enlargement, secondarily complicated by inflammation, and in the cerebral palsy patient. A supportive team work of periodontist, neurophysician, and general anesthetist plays a significant role in maintaining the quality of life in mentally disabled patient.

  1. A Rare Case Report of Amlodipine-Induced Gingival Enlargement and Review of Its Pathogenesis

    Directory of Open Access Journals (Sweden)

    Sanjeev Joshi

    2013-01-01

    Full Text Available Gingival enlargement is a common clinical feature of gingival and periodontal diseases. It is an unwanted side effect of certain systemic drugs given for nondental treatment. It is being reported with three main groups of drugs like calcium channel blockers (CCBs, immunosuppressants, and anticonvulsants. Among calcium channel blockers, nifedipine causes gingival hyperplasia in about 10% of patients, whereas the incidence of amlodipine-, a third generation calcium channel blocker, induced gingival hyperplasia is very limited. There are very few reports of amlodipine-induced gingival enlargement at a dose of 5 mg. We report a case of amlodipine-induced gingival enlargement in a 45-year-old hypertensive patient taking amlodipine at a dose of 5 mg.

  2. A female infant with Silver Russell Syndrome, mesocardia and enlargement of the clitoris.

    Science.gov (United States)

    Galli-Tsinopoulou, Assimina; Emmanouilidou, Eleftheria; Karagianni, Paraskevi; Grigoriadou, Maria; Kirkos, John; Varlamis, George S

    2008-01-01

    Silver Russell Syndrome (SRS) is a rare condition (1/3000 - 1/100,000 newborns). We present a female infant with SRS, cardiac malposition and asymmetric enlargement of the clitoris. She is the first child of Greek nonconsanguinous parents, born at 38 weeks gestation, following in vitro fertilisation (IVF). The patient had intrauterine growth retardation, body asymmetry, enlarged clitoris, hemihypertrophy of external genitalia and features characteristic of SRS. Electrocardiography and chest X-rays revealed a median position of the heart. The infant fulfilled the criteria proposed by Price et al for SRS. Genetic analysis did not reveal mUPD of chromosome 7. This is the first report of a patient with SRS presenting ìmesocardiaî and asymmetric enlargement of the clitoris. Our case constitutes another paradigm of SRS following IVF, which possibly supports the hypothesis that IVF may be associated with higher prevalence of SRS than natural fertilisation.

  3. Primary tuberculous gingival enlargement - A rare clinical entity: Case report and brief review of the literature

    Directory of Open Access Journals (Sweden)

    Suhail Majid Jan

    2014-01-01

    Full Text Available Tuberculosis (TB is a chronic specific granulomatous disease and a major cause of death in developing countries. The clinical presentation of TB lesions of the oral cavity varies widely and can manifest as ulcerations, diffuse inflammatory lesions, granulomas and fissures. Oral lesions generally appear secondary to primary TB infection elsewhere, although primary infection of the oral mucosa by Mycobacterium tuberculosis has also been described. We hereby report a case of primary TB of the gingiva manifesting as gingival enlargement. Diagnosis was based on histopathological examination, complete blood count, X-ray chest and immunological investigations with detection of antibodies against M. tuberculosis. Anti-tuberculous therapy was carried out for over 6 months and was followed by surgical excision of the residual enlargement under local anesthesia. After 1-year follow-up, there was no recurrence of the disease. This case report emphasizes the need for dentists to include TB in the differential diagnosis of various types of gingival enlargements.

  4. Analysis of reforming process of large distorted ring in final enlarging forging

    Energy Technology Data Exchange (ETDEWEB)

    Miyazawa, Takeshi; Murai, Etsuo [Kushiro National College of Technology, Dept. of Mechanical Engineering, Kushiro, Hokkaido (Japan)

    2002-10-01

    In the construction of reactors or pressure vessels for oil chemical plants and nuclear power stations, mono block open-die forging rings are often utilized. Generally, a large forged ring is manufactured by means of enlarging forging with reductions of the wall thickness. During the enlarging process the circular ring is often distorted and becomes an ellipse in shape. However the shape control of the ring is a complicated work. This phenomenon makes the matter still worse in forging of larger rings. In order to make precision forging of large rings, we have developed the forging method using a v-shape anvil. The v-shape anvil is geometrically adjusted to fit the distorted ring in the final circle and reform automatically the shape of the ring during enlarging forging. This paper has analyzed the reforming process of distorted ring by computer program based on F.E.M. and examined the effect on the precision of ring forging. (author)

  5. [Impacts of physical exercise on remodeling and hypertrophy of skeletal muscle.

    Science.gov (United States)

    Sakashita, Yoshihiro; Uchida, Takayuki; Nikawa, Takeshi

    The skeletal muscle has high sensitivity for the mechanical stress. Because it is enlarged by training, whereas it is easily withered by lack of exercise. When we exercise, skeletal muscle cells per se sense mechanical loading, and muscular remodeling and the muscular hypertrophy occur. It has been revealed that the intracellular signaling through PGC-1α participates in the remodeling of the skeletal muscle, while PGC-1α4, an isoform of PGC-1α, and the dystrophin-glycoprotein complex play important roles in muscular hypertrophy. This review describes the impact of physical exercise gives on the remodeling and hypertrophy of muscle through the signaling.

  6. Pediatric intracranial aneurysms: new and enlarging aneurysms after index aneurysm treatment or observation.

    Science.gov (United States)

    Hetts, S W; English, J D; Dowd, C F; Higashida, R T; Scanlon, J T; Halbach, V V

    2011-12-01

    Children with brain aneurysms may be at higher risk than adults to develop new or enlarging aneurysms in a relatively short time. We sought to identify comorbidities and angiographic features in children that predict new aneurysm formation or enlargement of untreated aneurysms. Retrospective analysis of the University of California-San Francisco Pediatric Aneurysm Cohort data base including medical records and imaging studies was performed. Of 83 patients harboring 114 intracranial aneurysms not associated with brain arteriovenous malformations or intracranial arteriovenous fistulas, 9 (8.4%) developed new or enlarging brain aneurysms an average of 4.2 years after initial presentation. Comorbidities that may be related to aneurysm formation were significantly higher in patients who developed new aneurysms (89%) as opposed to patients who did not develop new or enlarging aneurysms (41%; RR, 9.5; 95% CI, 1.9%-48%; P = .0099). Patients with multiple aneurysms at initial presentation were more likely than patients with a single aneurysm at presentation to develop a new or enlarging aneurysm (RR, 6.2; 95% CI, 2.1%-185; P = .0058). Patients who initially presented with at least 1 fusiform aneurysm were more likely to develop a new or enlarging aneurysm than patients who did not present with a fusiform aneurysm (RR, 22; 95% CI, 3.6%-68%; P = .00050). Index aneurysm treatment with parent artery occlusion also was associated with higher risk of new aneurysm formation (RR, 4.2; 95% CI, 1.3%-13%; P = .024). New aneurysms did not necessarily arise near index aneurysms. The only fatality in the series was due to subarachnoid hemorrhage from a new posterior circulation aneurysm arising 20 months after index anterior circulation aneurysm treatment in an immunosuppressed patient. Patients who presented with a fusiform aneurysm had a significantly greater incidence of developing a new aneurysm or enlargement of an index aneurysm than did those who presented with a saccular aneurysm

  7. The Effects of Guide Pads on Bore Diameter Enlargement Magnitude in Deep Hole Drilling

    Directory of Open Access Journals (Sweden)

    Zhang Huang

    2016-01-01

    Full Text Available Deep hole machining accuracy plays a crucial role in product’s quality. The results of an investigation into the machining accuracy of deep drilling holes which highlights problems of bore diameter enlargement magnitude assessment are presented in this paper. Through the study of BTA deep drilling tool properties and mechanism, as well as the formation rule of deep hole surface, clarified the burnishing mechanism of guide pad in deep hole drilling, and obtained the directly relationship between surface formation rule and the guide pad. After drilling experimentrevealed the effect of guide pad on bore diameter enlargement magnitude.

  8. Unusual presentation of localized gingival enlargement associated with a slow-growing odontogenic myxoma

    Institute of Scientific and Technical Information of China (English)

    Jaume Miranda Rius; Alfons Nadal; Eduard Lahor; Beatus Mtui; Llus Brunet

    2013-01-01

    Unusual presentation of localized gingival enlargement associated with a subjacent tumoural pathology is reported. The patient was a 55-year-old black male, whose chief complaint was a progressive gingival overgrowth for more than ten years, in the buccal area of the anterior left mandible. According to the clinical features and the radiological diagnosis of odontogenic keratocyst, a conservative surgery with enucleation and curettage was performed. Tissue submitted for histopathological analysis rendered the diagnosis of odontogenic myxoma. After 12-month of follow-up, no evidence of recurrence was found. Clinicians should be cautious when facing any gingival enlargement to avoid diagnostic pitfalls and to indicate the appropriate treatment.

  9. Gingival enlargement and mesiodens associated with generalized aggressive periodontitis: a case report.

    Science.gov (United States)

    Ramachandra, Srinivas Sulugodu; Hegde, Manjunath; Prasad, Umesh Chandra

    2012-06-01

    This case report describes the management of an 18-year-old female who presented with generalized aggressive periodontitis, gingival enlargement and a mesiodens. Diagnosis for aggressive periodontitis was determined based on history, clinical findings and radiographic examination. Treatment included oral prophylaxis, extraction of the mesiodens and elimination of infectious microorganisms, using a combination of surgical intervention and antimicrobial therapy with long-term maintenance. Presence of gingival enlargement in cases of aggressive periodontitis may be clinically confusing; hence, the diagnosis should always be based on the patient's history as well as the clinical and radiographic findings.

  10. Muscle strain (image)

    Science.gov (United States)

    A muscle strain is the stretching or tearing of muscle fibers. A muscle strain can be caused by sports, exercise, a ... something that is too heavy. Symptoms of a muscle strain include pain, tightness, swelling, tenderness, and the ...

  11. Structure and function of masticatory muscles in a case of muscular dystrophy

    DEFF Research Database (Denmark)

    Bakke, M; Kirkeby, S; Jensen, B L

    1990-01-01

    Histologic examination of muscle biopsies and functional examination comprising electromyography and force measurements in a 19-yr-old boy with muscular dystrophy showed different wasting patterns of mandibular elevator and depressor muscles. Pronounced histopathologic changes were present...... in the masseter muscle, whereas pathologic findings in the anterior digastric muscle were limited to increased number of cells in slightly enlarged interfiber connective tissue. The masticatory pattern was distorted, and strength of mandibular elevator muscles was less than one third of the norm, whereas...... depressor strength corresponded more to reference values. This difference of muscular wasting might be caused by protective enzymes in the digastric muscle and/or functionally induced damage of the masseter. As affection from muscular dystrophy may vary greatly between the masticatory muscles, structural...

  12. MYOSITIS OSSIFICANS TRAUMATICA OF THE MASSETER MUSCLE- review of the literature and case report.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-11-01

    Full Text Available Introduction: Myositis ossificans traumatica (MOT is known mostly in the orthopedic literature as non-neoplastic, heterotopic bone formation within muscle or fascia, presumably due to acute trauma or repeated injury. Myositis ossificans traumatica of the masseter muscle is uncommon disease producing limitation of opening of the jaws. Purpose: To present a case of MOT of the masseter muscle in patient with history of facial trauma. Material and methods: The medical history of a 53 years patient with complaint of decreasing ability to open his mouth over the past 10 years after a blow to face. CT revealed enlarged calcification in the left masseter muscle.Conclusion: Treatment of MOT of the masseter muscle is surgical- total extirpation of the ossified muscle but also surgical techniques including osteotomy that involve the muscle attachment region should be considered and after that appropriate physical therapy.

  13. CT screening for lung cancer: Frequency of enlarged adrenal glands identified in baseline and annual repeat rounds

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Minxia [Icahn School of Medicine at Mount Sinai, Department of Radiology, New York, NY (United States); Capital Medical University, Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Beijing (China); Yip, Rowena; Yankelevitz, David Y.; Henschke, Claudia I. [Icahn School of Medicine at Mount Sinai, Department of Radiology, New York, NY (United States)

    2016-12-15

    To determine the frequency of adrenal enlargement of participants in a CT-screening program for lung cancer and demonstrate the progression during follow-up, separately for baseline and annual repeat rounds. HIPAA-compliant informed consent was obtained in 4,776 participants. The adrenal gland was defined as enlarged if it measured ≥6 mm at its largest diameter. Logistic regression analyses were performed. At baseline, 202 (4 %) of 4,776 participants had adrenal enlargement. Significant factors were age (OR = 1.4, 95 % CI: 1.2-1.7) and current smoker (OR = 1.8, 95 % CI: 1.3-2.4). Follow-up 7-18 months after baseline for 133 cases with adrenal enlargement <40 mm showed it decreased or was stable in 85 (64 %), and increased by <10 mm in 48 (36 %). Five (0.04 %) cases of adrenal enlargement were newly identified, none increased beyond 40 mm on follow-up. Adrenal enlargement was a significant predictor of a subsequent diagnosis of lung cancer (OR = 2.0, 95 % CI: 1.2-3.4). Participants with adrenal enlargement <40 mm identified at baseline and on repeat screening could be reasonably assessed on subsequent annual screening. Adrenal enlargement increased with increasing pack-years of smoking. Adrenal enlargement was an independent predictor of a subsequent diagnosis of lung cancer. (orig.)

  14. Differential expression of genes involved in the calcium homeostasis in masticatory muscles of MDX mice.

    Science.gov (United States)

    Kunert-Keil, C H; Gredes, T; Lucke, S; Botzenhart, U; Dominiak, M; Gedrange, T

    2014-04-01

    Duchenne Muscular Dystrophy (DMD) and its murine model, mdx, are characterized by Ca(2+) induced muscle damage and muscle weakness followed by distorted dentofacial morphology. In both, DMD patients and in mdx mice, could be proven so far that only the extraocular muscles (EOM) are not affected by muscular dystrophy. The EOMs are protected against calcium overload by enhanced expression of genes involved in the Ca(2+) homeostasis. We could recently demonstrate that masticatory muscles of mdx mice are differentially affected by muscle dystrophy. The dystrophic masseter and temporalis shows muscle histology comparable to all other skeletal muscles in this animal model, whereas dystrophic tongue muscles seem to develop a milder phenotype. Due to this fact it is to hypothesize that an altered Ca(2+) homeostasis seems to underlie the mdx masticatory muscle pathology. Aim of this study was to examine the mRNA and protein levels of the sarcoplasmic reticulum Ca(2+) ATPases SERCA1 and SERCA2, the plasma membrane Ca(2+) ATPases Atp2b1 and Atp2b4, the sodium/calcium exchanger NCX1, the ryanodine receptor 1, parvalbumin, sarcolipin, phospholamban and the L-type Ca(2+) channel alpha-1 subunit (Cacna1s) in Musculus masseter, temporalis, and tongue of 100 day old control and mdx mice. In mdx masseter muscle significant increased mRNA levels of NCX1 and Cacna1s were found compared to control mice. In contrast, the mRNA amount of RYR1 was significant reduced in mdx temporalis muscle, whereas ATP2b4 was significant increased. In mdx tongue a down-regulation of the ATP2b1, sarcolipin and parvalbumin mRNA expression was found, whereas the phospholamban mRNA level was significantly increased compared to controls. These data were verified by western blot analyses. Our findings revealed that mdx masticatory muscles showed an unequally altered expression of genes involved in the Ca(2+) homeostasis that can support the differences in masticatory muscles response to dystrophin deficiency.

  15. On the Method of Multiplier-enlargement and Approximation of Unbounded Continuous Functions

    Institute of Scientific and Technical Information of China (English)

    ZHENG Cheng-De; WANG Ren-Hong

    2001-01-01

    By combining the classical appropriate functions “1, x, x2” with the method of multiplier enlargement, this paper establishes a theorem to approximate any unbounded continuous functions with modified positive linear operators. As an example, Hermite-Fejéinterpolation polynomial operators are analysed and studied, and a general conclusion is obtained.

  16. Detailed histopathologic characterization of the retinopathy, globe enlarged (rge) chick phenotype.

    NARCIS (Netherlands)

    Montiani-Ferreira, F.; Fischer, A.; Cernuda-Cernuda, R.; Kiupel, M.; Grip, W.J. de; Sherry, D.; Cho, S.S.; Shaw, G.C.; Evans, M.G.; Hocking, P.; Petersen-Jones, S.M.

    2005-01-01

    PURPOSE: The purpose of this study was to characterize the morphological abnormalities in the retinas of chicks (Gallus gallus) suffering from the autosomal recessive disease, retinopathy, globe enlarged (rge/rge). METHODS: rge/rge affected and age matched control retinas were examined from hatch up

  17. Dual Enlargement of Gold Nanoparticles: From Mechanism to Scanometric Detection of Pathogenic Bacteria

    DEFF Research Database (Denmark)

    Cao, Cuong; Gontard, Lionel Cervera; Le Ly, Tram Thuy

    2011-01-01

    capturing the target bacteria, gold‐tagged immunoprobes are added to create a signal on a solid substrate. The signal is then amplified by the dual enlargement process, resulting in a strong color intensity that can easily be recognized by the unaided eye, or measured by an inexpensive flatbed scanner...

  18. Misdiagnosis of otosclerosis in a patient with enlarged vestibular aqueduct syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Távora-Vieira Dayse

    2012-07-01

    Full Text Available Abstract Introduction In the present case we report on the mismanagement of a patient misdiagnosed with otosclerosis, who was subsequently found to have enlarged vestibular aqueduct syndrome bilaterally. This highlights the need to not only be vigilant in pre-operative assessment of otosclerosis but also in post-operative investigations of stapedectomy failures. Case presentation Our patient, a 56-year-old Caucasian Australian woman, lost the hearing in her right ear following a stapedectomy approximately 25 years ago. It is thought that preoperative imaging was not conducted, while an inadequate (unmasked audiogram was used to formulate the initial diagnosis of otosclerosis. The hearing in her left ear deteriorated to the point that a cochlear implant was now being considered for her right ear. Imaging performed as part of our pre-cochlear implant battery revealed bilateral enlarged vestibular aqueducts and thus the decision to proceed with a right cochlear implant was made following discussion with our patient and her family in regard to not only general surgical risks but specifically the remote risk that the surgical drilling required during the procedure could risk a deterioration of the hearing in her left ear because of the enlarged vestibular aqueduct on that side. Conclusions This report illustrates a case of misdiagnosis and mismanagement of bilateral enlarged vestibular aqueduct resulting in profound hearing loss. Fortunately our patient has been successfully implanted with a right cochlear implant with remarkable outcomes.

  19. Spontaneous breast enlargement following liposuction of the abdominal wall : Does a link exist?

    NARCIS (Netherlands)

    van der Lei, Berend; Halbesma, Gert-Jan; van Nieuwenhoven, Christianne A.; van Wingerden, Jan J.

    2007-01-01

    Background: A retrospective study was undertaken to determine the specific incidence of breast enlargement following liposuction of the abdomen (alone or in combination with the flanks), and to compare its effect with a control group of patients who had undergone abdominoplasty only and, where

  20. Quantitative detection of DNA by autocatalytic enlargement of hybridized gold nanoprobes

    DEFF Research Database (Denmark)

    Zhan, Zongrui; Cao, Cuong; Sim, Sang Jun

    2010-01-01

    nanoprobes via the surface reduction of AuCl4− to Au0 on their surface in the presence of ascorbic acid (AA) and cetyltrimethylammonium bromide (CTAB). On this basis, signal enhancements in the absorbance intensity and kinetic behavior of gold enlargement in the aqueous phase have been well investigated...

  1. Micro-CT analyses of apical enlargement and molar root canal complexity

    DEFF Research Database (Denmark)

    Markvart, Merete; Darvann, Tron Andre; Larsen, Per

    2012-01-01

    AIM: To compare the effectiveness of two rotary hybrid instrumentation techniques with focus on apical enlargement in molar teeth and to quantify and visualize spatial details of instrumentation efficacy in root canals of different complexity. METHODOLOGY: Maxillary and mandibular molar teeth wer...

  2. Micro‐CT analyses of apical enlargement and molar root canal complexity

    DEFF Research Database (Denmark)

    Markvart, M.; Darvann, Tron Andre; Larsen, P.

    2012-01-01

    Markvart M, Darvann TA, Larsen P, Dalstra M, Kreiborg S, Bjørndal L. Micro‐CT analyses of apical enlargement and molar root canal complexity. International Endodontic Journal, 45, 273–281, 2012. Aim To compare the effectiveness of two rotary hybrid instrumentation techniques with focus on apical...

  3. Differential diagnosis of arachnoid cyst from subarachnoid space enlargement by phase-contrast cine MRI

    Institute of Scientific and Technical Information of China (English)

    于群; 孔祥泉; 刘定西

    2003-01-01

    Objectives To reveal the relationship of brain motion and cerebrospinal fluid (CSF) flow by phase-contrast cine MRI, and to evaluate this technique in differentiating between arachnoid cysts and subarachnoid space enlargement. Methods Using a phase-contrast cine MRI pulse sequence, we measured brain motion and CSF flow during the cardiac cycle in 10 healthy volunteers and 10 patients with MRI-suspected arachnoid cyst or subarachnoid space enlargement. CSF stroke volume curve was illustrated according to flow quantification, and time-signal intensity curve was traced. The two curves were compared. Results This study showed that brain motion was due to the volume difference between arterial and venous blood flow during a cardiac cycle, and thus drives CSF pulsation. Arachnoid cysts and subarachnoid space enlargement carried different curve patterns, demonstrating that phase-contrast MRI and flow quantification can be a useful and reliable technique for non-invasive evaluation of brain motion and CSF flow. Conclusion Arachnoid cysts can be successfully differentiated using phase-contrast cine MRI from subarachnoid space enlargement.

  4. Diaphragmatic hernia and right-sided heart enlargement in a Florida manatee (Trichechus manatus latirostris).

    Science.gov (United States)

    Gerlach, Trevor J; de Wit, Martine; Landolfi, Jennifer A

    2012-10-01

    Postmortem evaluation of a Florida manatee (Trichechus manatus latirostris) revealed cold stress lesions and previous watercraft trauma that included broken ribs, a diaphragmatic hernia, an enlarged vena cava, and right-sided cardiomegaly. We discuss these findings and present a possible pathogenesis for the cardiomegaly.

  5. "Off-line": the 2004 European parliamentary elections on television news in the enlarged Europe

    NARCIS (Netherlands)

    Vreese, de Claes H.; Banducci, Susan A.; Semetko, Holli A.; Boomgaarden, Hajo G.

    2005-01-01

    We outline the competitive television news market in the enlarged European Union (EU) and demonstrate the continued importance of traditional media, in particular television, in the context of proliferation in choice of news sources, including on-line news services. Drawing upon a content analysis o

  6. The Post-enlargement European Order: Europe ‘United in Diversity’?

    Directory of Open Access Journals (Sweden)

    Paul Blokker

    2006-09-01

    Full Text Available The enlargement of the European Union has led to an increase of diversity within the European area. While the project of enlargement can be understood as one in which the European Union has sought to defend an exclusive understanding of European identity (a ‘Fortress Europe’, the combined process of enlargement and constitutionalisation can be seen to have ultimately contributed to an opening up as well as a rendering more contingent of the European project. The theoretical argument of the paper holds that the tendency towards this diversity and contingency is not reflected and difficult to deal with in some of the major theories on European integration. The argument is flanked by a substantive account which analyses the actual transformation of the European project. I conclude that the post-enlargement situation can indeed be more adequately described as one of diversity and openness rather than homogeneity and increasing unity. Nevertheless, the incorporation of diversity still leaves much to be desired, not in the least because of a ‘procedural’ interpretation of the deliberative mode. In order to effectively take difference into account, deliberation should include the recognition of difference and an emphasis on mutual understanding, rather than being focused on consensus-building.

  7. Spontaneous breast enlargement following liposuction of the abdominal wall : Does a link exist?

    NARCIS (Netherlands)

    van der Lei, Berend; Halbesma, Gert-Jan; van Nieuwenhoven, Christianne A.; van Wingerden, Jan J.

    2007-01-01

    Background: A retrospective study was undertaken to determine the specific incidence of breast enlargement following liposuction of the abdomen (alone or in combination with the flanks), and to compare its effect with a control group of patients who had undergone abdominoplasty only and, where possi

  8. Aortic valve replacement with the Nicks annulus enlargement procedure 12 years after mitral valve replacement.

    Science.gov (United States)

    Kazama, S; Kurata, A; Yamashita, Y

    1999-10-01

    An aortic valve replacement was successfully performed employing the Nicks annulus enlargement procedure in a case of aortic valve stenosis with small annulus 12 years after mitral valve replacement. Previous mitral valve replacement does not preclude feasibility of the Nicks procedure.

  9. Calcium localization and tipburn development in lettuce leaves during early enlargement

    Science.gov (United States)

    Barta, D. J.; Tibbitts, T. W.

    2000-01-01

    Tissue concentrations of Ca, Mg, and K were determined across immature leaves of lettuce (Lactuca sativa L. 'Buttercrunch') at different stages of enlargement using electron microprobe x-ray analysis. The analysis was with a wavelength dispersive spectrometer to permit detection of low concentrations of Ca. Patterns of mineral accumulation in immature leaves that were exposed were compared to patterns of accumulation in leaves that were enclosed within a developing head. The leaves developing without enclosure were free to transpire and developed normally whereas leaves developing with enclosure were restricted in transpiration and developed an injury that was characteristic of Ca deficiency. In the exposed leaves, Ca concentrations increased from an average of 1.0 to 2.1 mg g-1 dry weight (DW) as the leaves enlarged from 5 to 30 mm in length. In the enclosed leaves, Ca concentrations decreased from 1.0 to 0.7 mg g-1 DW as the leaves enlarged from 5 to 30 mm in length. At the tips of these enclosed leaves a larger decrease was found, from 0.9 to 0.3 mg g-1 DW during enlargement. Necrotic injury first became apparent in this tip area when the concentration was approximate to 0.4 mg g-1 DW. Magnesium concentrations across the exposed leaves were similar to concentrations across the enclosed leaves, and did not change with enlargement. Magnesium concentrations averaged 3.5. mg g-1 DW in both enclosed and exposed leaves during enlargement from 5 to 30 mm. In both exposed and enclosed leaves, K concentrations increased during enlargement from 40 to approximate to 60 mg g-1 DW. Potassium concentrations were highest toward the leaf apex and upper margin where injury symptoms occurred, and this may have enhanced injury development. This research documents the critical low levels of Ca (0.2 to 0.4 mg g-1 DW) that can occur in enclosed leaves of plants and which apparently leads to the marginal apex necrosis of developing leaves seen frequently on lettuce and other crops.

  10. [A swollen, painless calf caused by neurogenic muscle (pseudo)-hypertrophy

    NARCIS (Netherlands)

    Warrenburg, B.P.C. van de; Zwarts, M.J.; Engelen, B.G.M. van

    2003-01-01

    Neurogenic muscle (pseudo) hypertrophy of the calf was diagnosed in a 60-year-old man, who presented with chronic, painless and unilateral calf enlargement caused by a chronic S1 radiculopathy due to a lumbar disc hernia in the L5-S1 interspace. The differential diagnosis of a swelling of the calf i

  11. [A swollen, painless calf caused by neurogenic muscle (pseudo)-hypertrophy

    NARCIS (Netherlands)

    Warrenburg, B.P.C. van de; Zwarts, M.J.; Engelen, B.G.M. van

    2003-01-01

    Neurogenic muscle (pseudo) hypertrophy of the calf was diagnosed in a 60-year-old man, who presented with chronic, painless and unilateral calf enlargement caused by a chronic S1 radiculopathy due to a lumbar disc hernia in the L5-S1 interspace. The differential diagnosis of a swelling of the calf

  12. Enlarged Liver

    Science.gov (United States)

    ... ma huang, valerian root, kava, celandine and green tea extracts. References Longo DL, et al., eds. Approach ... Clinic does not endorse any of the third party products and services advertised. Advertising and sponsorship policy ...

  13. NATO Enlargement.

    Science.gov (United States)

    Volker, Karen

    1998-01-01

    Reviews the history of the North Atlantic Treaty Organization (NATO) and describes the debate over expanding its membership. Includes a discussion of the process for adding NATO members and a copy of the treaty. Suggests several exercises to help students better understand the NATO-expansion debate. (DSK)

  14. Extensive sonographic ulnar nerve enlargement above the medial epicondyle is a characteristic sign in Hansen's neuropathy.

    Science.gov (United States)

    Bathala, Lokesh; N Krishnam, Venkataramana; Kumar, Hari Kishan; Neladimmanahally, Vivekananda; Nagaraju, Umashankar; Kumar, Himanshu M; Telleman, Johan A; Visser, Leo H

    2017-07-01

    Earlier studies have shown sonographic enlargement of the ulnar nerve in patients with Hansen's neuropathy. The present study was performed to determine whether sonography or electrophysiological studies can detect the specific site of ulnar nerve pathology in leprosy. Eighteen patients (thirty arms) with Hansen's disease and an ulnar neuropathy of whom 66% had borderline tuberculoid (BT), 27% lepromatous leprosy (LL) and 7% mid-borderline (BB) leprosy were included in the study. Cross-sectional area (CSA) of ulnar nerve was measured every two centimeters from wrist to medial epicondyle and from there to axilla. All patients underwent standard motor and sensory nerve conduction studies of the ulnar nerve. Thirty age and sex matched controls underwent similar ulnar nerve CSA measurements and conduction studies. Ulnar nerve was clinically palpable in 19 of the 30 arms of patients. Motor and sensory nerve conduction studies of the ulnar nerve showed a reduced compound motor action potential and sensory nerve action potential amplitude in all patients. Motor Conduction Velocity (MCV) in patients were slower in comparison to controls, especially at the elbow and upper arm, but unable to exactly locate the site of the lesion. In comparison to controls the ulnar nerveCSA was larger in the whole arm in patients and quite specific the maximum enlargement was seen between nulnar sulcus and axilla, peaking at four centimeters above the sulcus. A unique sonographic pattern of nerve enlargement is noted in patients with ulnar neuropathy due to Hansen's disease, while this was not the case for the technique used until now, the electrodiagnostic testing. The enlargement starts at ulnar sulcus and is maximum four centimeters above the medial epicondyle and starts reducing further along the tract. This characteristic finding can help especially in diagnosing pure neuritic type of Hansen's disease, in which skin lesions are absent, and alsoto differentiate leprosy from other

  15. Improving the effect and efficiency of FMD control by enlarging protection or surveillance zone

    Directory of Open Access Journals (Sweden)

    Tariq eHalasa

    2015-12-01

    Full Text Available An epidemic of foot-and-mouth disease (FMD in a FMD-free country with large exports of livestock and livestock products would result in profound economic damage. This could be reduced by rapid and efficient control of the disease spread. The objectives of this study were to estimate the economic impact of a hypothetical FMD outbreak in Denmark based on changes to the economic assumptions of the model, and to investigate whether the control of an FMD epidemic can be improved by combining the enlargement of protection or surveillance zones with pre-emptive depopulation or emergency vaccination.The stochastic spatial simulation model DTU-DADS was used to simulate the spread of FMD in Denmark. The control strategies were: the basic EU and Danish strategy; pre-emptive depopulation; suppressive or protective vaccination; enlarging protection or surveillance zones, and a combination of pre-emptive depopulation or emergency vaccination with enlarged protection or surveillance zones. Herds are detected either based on basic detection through the appearance of clinical signs, or as a result of surveillance in the control zones. The economic analyses consisted of direct costs and export losses. Sensitivity analysis was performed on uncertain and potentially influential input parameters.Enlarging the surveillance zones from 10km to 15km, combined with pre-emptive depopulation over a 1km radius around detected herds resulted in the lowest total costs. This was still the case even when the different input parameters were changed in the sensitivity analysis. Changing the resources for clinical surveillance did not affect the epidemic consequences. In conclusion, an FMD epidemic in Denmark would have a larger economic impact on the agricultural sector than previously anticipated. Furthermore, the control of a potential FMD outbreak in Denmark may be improved by combining pre-emptive depopulation with an enlarged protection or surveillance zone.

  16. Influence of the endodontic irrigation needle and root canal enlargement on endodontic cleaning efficacy

    Directory of Open Access Journals (Sweden)

    Livia Etchebehere de Loiola

    2011-04-01

    Full Text Available ntroduction: The irrigation of root canals aims to their cleaning and disinfection, improving endodontic treatment success. Objective: To investigate the influence of the diameter and type of irrigation needle and the root canal enlargement on the mechanical efficacy of endodontic irrigation. Material and methods: Twelve human single-rooted mandibular incisors were used. During some instrumentation stages (enlargement by #20, #30, and #40 K file, root canals were filled with radiographic contrast solution mixed to propyleneglycol and zinc oxide. Needles with different diameters and designs were employed: G1 – 23G and lateral opening; G2 – 22G and apical opening; G3 – 30G and lateral opening; G4 – 30G and apical opening. The needles were inserted up to resistance, with 1 mm step-back to avoid root canal obliteration. The irrigation was performed with 2 mL of distilled water. Before and after irrigation/aspiration, teeth were radiographed at bucco-lingual and mesiodistal direction, using a digital radiographic system. Then, root canal areas, before (filled by contrast solution and after irrigation (remnant of contrast solution, were submitted to image subtraction with Adobe Photoshop CS4 software. Subsequently, the areas were measured by Image Tool 3.0 software, allowing the obtaining of the cleaning percentage for each modality. Data were analysed byusing Anova and Tukey’s test. The level of significance was set at P < 0.05. Results: For all root canal enlargements, 30G needles (G3 e G4 presented a better cleaning efficacy. In all groups, higher cleaning efficacy percentage was observed at #30 and #40 K file enlargement. Conclusion: Regardless their design, thinner needles were more effective; a better cleaning efficacy occurred in more enlarged root canals.

  17. Cigarette smoke exposure aggravates air space enlargement and alveolar cell apoptosis in Smad3 knockout mice.

    Science.gov (United States)

    Farkas, Laszlo; Farkas, Daniela; Warburton, David; Gauldie, Jack; Shi, Wei; Stampfli, Martin R; Voelkel, Norbert F; Kolb, Martin

    2011-10-01

    The concept of genetic susceptibility factors predisposing cigarette smokers to develop emphysema stems from the clinical observation that only a fraction of smokers develop clinically significant chronic obstructive pulmonary disease. We investigated whether Smad3 knockout mice, which develop spontaneous air space enlargement after birth because of a defect in transforming growth factor-β (TGF-β) signaling, develop enhanced alveolar cell apoptosis and air space enlargement following cigarette smoke exposure. We investigated Smad3(-/-) and Smad3(+/+) mice at different adult ages and determined air space enlargement, alveolar cell proliferation, and apoptosis. Furthermore, laser-capture microdissection and real-time PCR were used to measure compartment-specific gene expression. We then compared the effects of cigarette smoke exposure on Smad3(-/-) and littermate controls. Smad3 knockout resulted in the development of air space enlargement in the adult mouse and was associated with decreased alveolar VEGF levels and activity and increased alveolar cell apoptosis. Cigarette smoke exposure aggravated air space enlargement and alveolar cell apoptosis. We also found increased Smad2 protein expression and phosphorylation, which was enhanced following cigarette smoke exposure, in Smad3-knockout animals. Double immunofluorescence analysis revealed that endothelial apoptosis started before epithelial apoptosis. Our data indicate that balanced TGF-β signaling is not only important for regulation of extracellular matrix turnover, but also for alveolar cell homeostasis. Impaired signaling via the Smad3 pathway results in alveolar cell apoptosis and alveolar destruction, likely via increased Smad2 and reduced VEGF expression and might represent a predisposition for accelerated development of emphysema due to cigarette smoke exposure.

  18. Thyroid Eye Disease With Significant Levator Involvement and Ptosis: A Case Report.

    Science.gov (United States)

    Scruggs, Ryan T; Black, Evan H

    2015-01-01

    A case of an 87-year-old woman with a history of Graves disease presenting with a 5-year history of severe ptosis and very poor levator function of the left side is presented. MRI revealed marked enlargement of all extraocular muscles and significant enlargement of the left levator muscle. Given the patient's age and atypical presentation of thyroid eye disease (TED), she was taken to the operating room for biopsy and ptosis repair with frontalis suspension. Histopathological analysis revealed chronic inflammation and fibrosis consistent with Graves disease.

  19. Isobaric Tagging-Based Quantification for Proteomic Analysis: A Comparative Study of Spared and Affected Muscles from mdx Mice at the Early Phase of Dystrophy.

    Directory of Open Access Journals (Sweden)

    Cintia Yuri Matsumura

    Full Text Available Duchenne muscular dystrophy (DMD is the most common childhood myopathy, characterized by muscle loss and cardiorespiratory failure. While the genetic basis of DMD is well established, secondary mechanisms associated with dystrophic pathophysiology are not fully clarified yet. In order to obtain new insights into the molecular mechanisms of muscle dystrophy during earlier stages of the disease, we performed a comparative proteomic profile of the spared extraocular muscles (EOM vs. affected diaphragm from the mdx mice, using a label based shotgun proteomic approach. Out of the 857 identified proteins, 42 to 62 proteins had differential abundance of peptide ions. The calcium-handling proteins sarcalumenin and calsequestrin-1 were increased in control EOM compared with control DIA, reinforcing the view that constitutional properties of EOM are important for their protection against myonecrosis. The finding that galectin-1 (muscle regeneration, annexin A1 (anti-inflammatory and HSP 47 (fibrosis were increased in dystrophic diaphragm provides novel insights into the mechanisms through which mdx affected muscles are able to counteract dystrophy, during the early stage of the disease. Overall, the shotgun technique proved to be suitable to perform quantitative comparisons between distinct dystrophic muscles and allowed the suggestion of new potential biomarkers and drug targets for dystrophinopaties.

  20. Sac enlargement due to seroma after endovascular abdominal aortic aneurysm repair with the Endologix PowerLink device.

    Science.gov (United States)

    Nano, Giovanni; Dalainas, Ilias; Bianchi, Paolo G; Gotti, Riccardo; Casana, Renato; Malacrida, Giovanni; Tealdi, Domenico G

    2006-01-01

    A patient who had undergone endovascular repair of an abdominal aortic aneurysm with the Endologix PowerLink bifurcated system presented with delayed aortic aneurysm enlargement due to assumed endotension. He was treated with aortic sac evacuation and wrapping of the endograft. This is the first report of endotension and aneurysm sac enlargement after implantation of the PowerLink endograft.

  1. Muscle disease.

    Science.gov (United States)

    Tsao, Chang-Yong

    2014-02-01

    On the basis of strong research evidence, Duchenne muscular dystrophy (DMD), the most common severe childhood form of muscular dystrophy, is an X-linked recessive disorder caused by out-of-frame mutations of the dystrophin gene. Thus, it is classified asa dystrophinopathy. The disease onset is before age 5 years. Patients with DMD present with progressive symmetrical limb-girdle muscle weakness and become wheelchair dependent after age 12 years. (2)(3). On the basis of some research evidence,cardiomyopathy and congestive heart failure are usually seen in the late teens in patients with DMD. Progressive scoliosis and respiratory in sufficiency often develop once wheelchair dependency occurs. Respiratory failure and cardiomyopathy are common causes of death, and few survive beyond the third decade of life. (2)(3)(4)(5)(6)(7). On the basis of some research evidence, prednisone at 0.75 mg/kg daily (maximum dose, 40 mg/d) or deflazacort at 0.9 mg/kg daily (maximum dose, 39 mg/d), a derivative of prednisolone (not available in the United States), as a single morning dose is recommended for DMD patients older than 5 years, which may prolong independent walking from a few months to 2 years. (2)(3)(16)(17). Based on some research evidence, treatment with angiotensin-converting enzyme inhibitors, b-blockers, and diuretics has been reported to be beneficial in DMD patients with cardiac abnormalities. (2)(3)(5)(18). Based on expert opinion, children with muscle weakness and increased serum creatine kinase levels may be associated with either genetic or acquired muscle disorders (Tables 1 and 3). (14)(15)

  2. Muscle channelopathies.

    Science.gov (United States)

    Statland, Jeffrey; Phillips, Lauren; Trivedi, Jaya R

    2014-08-01

    Skeletal muscle channelopathies are rare heterogeneous diseases with marked genotypic and phenotypic variability. Despite advances in understanding of the molecular pathology of these disorders, the diverse phenotypic manifestations remain a challenge in diagnosis and therapeutics. These disorders can cause lifetime disability and affect quality of life. There is no treatment of these disorders approved by the US Food and Drug Administration at this time. Recognition and treatment of symptoms might reduce morbidity and improve quality of life. This article summarizes the clinical manifestations, diagnostic studies, pathophysiology, and treatment options in nondystrophic myotonia, congenital myasthenic syndrome, and periodic paralyses. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Enlargement of zero averaged refractive index gaps in the photonic heterostructures containing negative-index materials.

    Science.gov (United States)

    Xiang, Yuanjiang; Dai, Xiaoyu; Wen, Shuangchun; Fan, Dianyuan

    2007-11-01

    We show that the frequency range of the zero averaged refractive index gap in a photonic heterostructure containing negative-index materials can be enlarged owing to the property that its lower and upper frequency edges depend on the thickness ratio of the positive- and negative-index materials. Compared to the zero averaged refractive index gap of a single photonic crystal, the frequency range of the zero averaged refractive index gaps in a photonic heterostructure can be notably enlarged. Moreover, it is shown that the band edge of the zero averaged refractive index gap is determined not only by the TM polarization but also by the TE polarization, which is obviously different from the omnidirectional band gaps in conventional photonic crystals, whose bandwidth is determined by the TM polarization.

  4. Improving the Effect and Efficiency of FMD Control by Enlarging Protection or Surveillance Zones

    DEFF Research Database (Denmark)

    Hisham Beshara Halasa, Tariq; Toft, Nils; Boklund, Anette

    2015-01-01

    An epidemic of foot-and-mouth disease (FMD) in a FMD-free country with large exports of livestock and livestock products would result in profound economic damage. This could be reduced by rapid and efficient control of the disease spread. The objectives of this study were to estimate the economic....... The stochastic spatial simulation model DTU-DADS was used to simulate the spread of FMD in Denmark. The control strategies were the basic EU and Danish strategy, pre-emptive depopulation, suppressive or protective vaccination, enlarging protection or surveillance zones, and a combination of pre......-emptive depopulation or emergency vaccination with enlarged protection or surveillance zones. Herds are detected either based on basic detection through the appearance of clinical signs, or as a result of surveillance in the control zones. The economic analyses consisted of direct costs and export losses. Sensitivity...

  5. Nasal turbinate enlargement due to cartilage and bone proliferation: a normal developmental finding in young ferrets.

    Science.gov (United States)

    Funk, Kathleen A; Frantz, Christopher; Dyke, Amy S; Ryan, Patricia C; Jin, Hong; Kemble, George; Dixit, Rakesh; Leininger, Joel R

    2010-12-01

    Toxicity studies of intranasally administered, live attenuated influenza virus vaccine candidates conducted in male and female ferrets led to the microscopic observation of individual differences in the size of nasal turbinates, especially in the dorsal aspect of the nasal cavity. The association of these enlarged turbinates with acute to subacute inflammation, which is sometimes common in ferrets given live attenuated influenza virus vaccine candidates, led to this detailed microscopic evaluation of turbinate enlargement (cartilaginous and osseous thickening, or COT) in control animals dosed intranasally with saline. Results of this evaluation led to the conclusion that COT is a normal developmental feature of growing ferrets, irrespective of inflammation in nasal tissues or inflammatory exudate in the nasal cavity.

  6. Ectopic opening of cystic dilatation of the ejaculatory duct into enlarged prostatic utricle.

    Science.gov (United States)

    Lin, Jian-Zhong; Wu, Hong-Fei; Wang, Ji-Chen; Le, Mei-Zhao; Yu, Hong-Bo; Zhou, He-Tong

    2012-01-01

    A 28-year-old man was referred to our department for the management of recurrent hemospermia during the past 5 years. Genital examination and hormonal levels were normal. Semen analysis showed no change in volume and pH; however, hemospermia and asthenozoospermia were observed. Ultrasonography and computed tomography scan revealed the presence of a cystic lesion with calcification in the terminal part of seminal vesicles adjoining the prostate gland. The following vasography and endoscopic retrograde urethrography demonstrated 2 communicating cystic dilatations arising from the verumontanum. The diagnosis of cystic dilatation of the ejaculatory duct opening into an enlarged prostatic utricle was reached. Transurethral unroofing of the cyst was separately performed with a successful outcome. The characteristic of the 2 cystic dilatations was confirmed by pathologic examination. To the best of our knowledge, this is the first case of ectopic cystic dilatation of the ejaculatory duct opening into an enlarged prostatic utricle.

  7. Clinical significance of ventricular enlargement and cortical atrophy in computed tomography of the brain

    Energy Technology Data Exchange (ETDEWEB)

    Busse, O.; Agnoli, A.L.; Lippmann, R.; Schuetz, H.J.

    1981-02-01

    The diagnosis of atrophy of the brain based on the visual interpretation of CT findings appears questionable. In 56 patients there was no correlation between the CT findings of enlarged ventricles and sulci and clinical findings of psychoorganic syndromes. Only the group of 60 to 80 year old patients showed a statistically significant correlation between psychoorganic findings and the area of the lateral ventricles - measured planimetrically - and the diameter of the cella medica, but not the group of the 40 to 60 year old. There was no relationship between the number of cortical sulci and psychopathology. The morphological findings of ventricular enlargement and cortical atrophy in CT - even with exact measurements - do not allow any conclusions in regard to psychoorganic findings.

  8. Stochastic control under progressive enlargement of filtrations and applications to multiple defaults risk management

    CERN Document Server

    Pham, Huyen

    2010-01-01

    We formulate and investigate a general stochastic control problem under a progressive enlargement of filtration. The global information is enlarged from a reference filtration and the knowledge of multiple random times together with associated marks when they occur. By working under a density hypothesis on the conditional joint distribution of the random times and marks, we prove a decomposition of the original stochastic control problem under the global filtration into classical stochastic control problems under the reference filtration, which are determined in a finite backward induction. Our method revisits and extends in particular stochastic control of diffusion processes with finite number of jumps. This study is motivated by optimization problems arising in default risk management, and we provide applications of our decomposition result for the indifference pricing of defaultable claims, and the optimal investment under bilateral counterparty risk. The solutions are expressed in terms of BSDEs involvin...

  9. Insulation co-ordination and the enlargement law for the GM counter tube

    Directory of Open Access Journals (Sweden)

    Dolićanin Edin Ć.

    2016-01-01

    Full Text Available In this paper we analyze application of contemporary methods of insulation co-ordination and the enlargement law in designing a GM counting tube. It has been shown that by applying insulation co-ordination methods the counting tube can be optimally dimensioned. The application of the enlargement law was demonstrated in generalizing the results of test obtained by the GM tube to those obtained by the counting tube with m-times greater dimensions. The investigations were conducted both theoretically and by experiment. Using theoretical analysis, we derived the expressions that may be applied if a performance function of a random variable breakdown voltage is known. The experiments were conducted on a GM counter model under well controlled laboratory conditions.

  10. Enlarged clitoris in wild polar bears (Ursus maritimus) can be misdiagnosed as pseudohermaphroditism

    DEFF Research Database (Denmark)

    Sonne, C; Leifsson, P S; Dietz, R

    2004-01-01

    A 23-year-old female polar bear (Ursus maritimus) killed in an Inuit hunt in East Greenland on July 9, 1999 had a significantly enlarged clitoris resembling, in size, form and colour, those of previously reported 'pseudohermaphroditic' polar bears from Svalbard. It has been suggested that an enzyme...... and internal reproductive organs of the present were similar to a reference group of 23 normal adult female polar bears from East Greenland collected in 1999-2002. The aberrant bear was a female genotype, and macroscopic examination of her internal reproductive organs indicated that she was reproductively....... It is hence possible that the previously reported adult female polar bear pseudohermaphrodites from Svalbard are in fact misdiagnoses. Therefore, future studies examining pseudohermaphroditism in wildlife should consider that certain occurrences are natural events, e.g., enlarged clitoris in the present East...

  11. Refractive index insensitive temperature sensor based on waist-enlarged few mode fiber bitapers

    Science.gov (United States)

    Liu, Qiang; Wang, Si-wen; Fu, Xing-hu; Fu, Guang-wei; Jin, Wa; Bi, Wei-hong

    2017-01-01

    A refractive index insensitive temperature sensor based on waist-enlarged few mode fiber (FMF) bitapers is presented. The first section of FMF is spliced between two single-mode fibers. In fusion process, the waist-enlarged FMF bitapers can be obtained by large current discharging repeatedly. The refractive index and temperature sensing mechanisms are analyzed. For the sensors with different sizes, the refractive index and temperature experiments have been performed. The results show that in the refractive index ranges of 1.335 0—1.346 6 and 1.348 2—1.419 3, the refractive index insensitivity is verified. In a temperature range of 31.9—90 °C, the sensor sensitivity can be up to 85.57 pm/°C. In addition, it has a compact structure. Therefore, the sensor can avoid the cross sensitivity for measuring the refractive index and temperature simultaneously.

  12. Foveated scanning: dynamic monodimensional enlargement of resolved field of view in lenses of scanner systems.

    Science.gov (United States)

    Javaherian, Farhang; Rashidian, Bizhan

    2016-09-10

    An inconsistency between the circular symmetric geometry of conventional optical imagers and the geometry of long linear sensors used in today's line-scan cameras results in suboptimal separate design of optics and electronics of scanner systems. Based on the method of foveated optical imaging, a technique named foveated scanning (FS) is proposed in this paper. The FS technique is employed to enlarge the one-dimensional resolved field of view (RFOV) of conventional lenses and permits optimized performance on a line-of-interest in the image plane where the optoelectronic sensor is located. The achieved enlargement of RFOV is verified on a proof-of-concept basic telephoto lens. Both modulation transfer function analysis and the imaging simulation of a standard target have been performed. Results show a twofold increase in RFOV by this technique.

  13. Mediastinal lymph node enlargement in patients with valvular heart disease: CT evaluation and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Ju; Jung, Jung Im; Ahn, Myeong Im; Han, Dae Hee; Park, Seog Hee [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-04-15

    To evaluate the presence, size and location of enlarged mediastinal lymph nodes (LNs) in patients with valvular heart disease (VHD) using computed tomography scans in correlation with ejection fraction (EF). We retrospectively evaluated 30 patients with VHD, without pre-existing diseases that could cause lymphadenopathy (LAP). The presence, size, and location of LNs greater than 1 cm in short axis diameter were evaluated. The location of mediastinal LNs was recorded according to the International Association for the Study of Lung Cancer. Furthermore, we evaluated the presence of pulmonary edema, pleural effusion, and other thoracic abnormalities and evaluated EF of the heart on transthoracic echocardiography. Sixteen patients (53%) had at least 1 enlarged mediastinal LN. The most frequent locations were lower paratracheal (4R, n = 8/4L, n = 6), subcarinal (7, n = 5) and right upper paratracheal (2R, n = 4) regions. The frequency of mediastinal LAP was higher in patients with aortic regurgitation (2 of 2, 100%) followed by mitral regurgitation (8 of 11, 73%); it was also high in patients with pulmonary edema (80%), pleural effusion (81%), or both (77%), as compared to patients without pulmonary edema or pleural effusion (17%) (p = 0.001). Ten of 30 patients showed an abnormal EF of < 55%; among them, 8 had mediastinal LAP. However, the relationship between EF and LAP was not statistically significant (p = 0.058). Mediastinal LN enlargement is common in patients with VHD, especially in cases of pulmonary edema and pleural effusion. Enlarged mediastinal LNs were frequently observed with abnormal EF, however, the relationship between EF and mediastinal LAP was not statistically significant.

  14. The Effects of Guide Pads on Bore Diameter Enlargement Magnitude in Deep Hole Drilling

    OpenAIRE

    Zhang Huang; Shen Xingquan; Li Yaoming; Yang Fuhe; Kwon Paul

    2016-01-01

    Deep hole machining accuracy plays a crucial role in product’s quality. The results of an investigation into the machining accuracy of deep drilling holes which highlights problems of bore diameter enlargement magnitude assessment are presented in this paper. Through the study of BTA deep drilling tool properties and mechanism, as well as the formation rule of deep hole surface, clarified the burnishing mechanism of guide pad in deep hole drilling, and obtained the directly relationship betwe...

  15. Clinical correlates of enlarged prostate size in subjects with sexual dysfunction

    Directory of Open Access Journals (Sweden)

    Giovanni Corona

    2014-10-01

    Full Text Available Digito-rectal examination (DRE of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction (SD. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects (n = 1823; mean age 54.7 ± 11.4 selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome (HR = 1.346 (1.129-1.759; P = 0.030, type 2 diabetes mellitus (HR = 1.489 (1.120-1.980; P = 0.006, increased LDL cholesterol (>100 mg dl−1 ; HR = 1.354 (1.018-1.801; P = 0.037 and increased mean blood pressure (BP values (HR = 1.017 (1.007-1.027 for each mmHg increment; P = 0.001. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction (ED, as well as with other andrological conditions, such as varicocele and premature ejaculation (PE. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample (HR = 3.318 (2.304; 4.799 for each log unit increment in PSA levels; P < 0.0001. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical (DRE or biochemical (PSA inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular (CV background of the patient.

  16. Gingival Enlargement In Epileptic Patients On Phenytoin Therapy-An Overview Of Possible Etiologies And Studies

    OpenAIRE

    Abhishek Singh Nayyar

    2013-01-01

    Epilepsy is a common neurological disorder with recurrent seizures due to a chronic underlying process. Despite tremendous advances in the field of understanding regarding the etio-pathogenesis of epilepsy, phenytoin still remains the drug of choice in its management. Chronic administration of phenytoin has been associated to have a number of adverse effects. Gingival enlargement is one such most often reported adverse drug sequela of long term phenytoin usage with exclusion of local factors ...

  17. A Constructivist Discourse Analysis of the German Debate over the Eastern Enlargement of the European Union

    OpenAIRE

    Ecker-Ehrhardt, Matthias

    2010-01-01

    With a view to the Eastern enlargement of the European Union (EU), political debate in Germany took a remarkable turn. After the 1990s little has remained of the earlier euphoria over German unification and the establishment of friendly relations with the country's Eastern European neighbors. In its stead there have been vehement demands for stricter accession criteria, greater reform of the EU, and the institution of transition periods for member candidates prior to full accession. This stud...

  18. "Off-line": the 2004 European parliamentary elections on television news in the enlarged Europe

    OpenAIRE

    Vreese, de, Claes H.; Banducci, Susan A.; Semetko, Holli A.; Boomgaarden, Hajo G.

    2005-01-01

    We outline the competitive television news market in the enlarged European Union (EU) and demonstrate the continued importance of traditional media, in particular television, in the context of proliferation in choice of news sources, including on-line news services. Drawing upon a content analysis of the most widely watched evening television news programs in each of the EU countries, we find that on average, EU news in 2004 was more visible in the new member states than in the old member sta...

  19. Amygdala enlargement in patients with mesial temporal lobe epilepsy without hippocampal sclerosis

    Directory of Open Access Journals (Sweden)

    Ana Carolina Coan

    2013-10-01

    Full Text Available Purpose: Patients with mesial temporal lobe epilepsy (MTLE without MRI abnormalities (MTLE-NL represent a challenge for definition of underlying pathology and for presurgical evaluation. In a recent study we observed significant amygdala enlargement in 14% of MTLE patients with MRI signs of HS. Areas of gray matter volume (GMV increase could represent structural abnormalities related to the epileptogenic zone or part of a developmental abnormality. Our objective was to look for undetected areas of increased GMV in MTLE-NL using post processing MRI techniques to better understand the pathophysiology of this condition.Methods: We evaluated 66 patients with MTLE-NL on visual analysis and 82 controls. Voxel-based morphometry (VBM group analysis was performed with VBM8/SPM8 looking for areas of increased GMV. We then performed automatic amygdala volumetry using Freesurfer software and T2 relaxometry to confirm VBM findings.Results: VBM group-analysis demonstrated increased amygdala volume in the MTLE-NL group compared to controls. Individual volumetric analysis confirmed amygdala enlargement (AE in eight (12% patients. Overall, from all patients with AE and defined epileptic focus, four (57% had the predominant increased volume ipsilateral to the epileptic focus. These results were cross-validated by a secondary VBM analysis including subgroups of patients according to the volumetric data. T2 relaxometry demonstrated no amygdala hyperintense signal in any individual with significant amygdala enlargement. There were no clinical differences between patients with and without AE.Discussion: This exploratory study demonstrates the occurrence of AE in 12% of patients with MTLE-NL. This finding supports the hypothesis that there might be a subgroup of patients with MTLE-NL in which the enlarged amygdala could be related to the epileptogenic process. Further studies are necessary but this finding could be of great importance in the understanding of MTLE-NL.

  20. A Rare Case Report of Amlodipine-Induced Gingival Enlargement and Review of Its Pathogenesis

    OpenAIRE

    Sanjeev Joshi; Sucheta Bansal

    2013-01-01

    Gingival enlargement is a common clinical feature of gingival and periodontal diseases. It is an unwanted side effect of certain systemic drugs given for nondental treatment. It is being reported with three main groups of drugs like calcium channel blockers (CCBs), immunosuppressants, and anticonvulsants. Among calcium channel blockers, nifedipine causes gingival hyperplasia in about 10% of patients, whereas the incidence of amlodipine-, a third generation calcium channel blocker, induced gin...

  1. Trepanation and enlarged parietal foramen on skulls from the Loyalty Islands (Melanesia).

    Science.gov (United States)

    Vasilyev, Sergey V; Sviridov, Alexey A

    2017-06-01

    The goal of this study is a comprehensive examination of openings discovered on two skulls in the collection of skeletal remains from the Loyalty Islands (Melanesia). The skull No. 1524 displayed an evidence of successful trepanation, and the skull No. 7985 revealed openings that were reminiscent of a trepanation, however, we are inclined to believe that in the latter case we are dealing with a rare genetic anomaly - enlarged parietal foramen.

  2. Molecular weight enlargement--a molecular approach to continuous homogeneous catalysis.

    Science.gov (United States)

    Janssen, Michèle; Müller, Christian; Vogt, Dieter

    2010-09-28

    Molecular weight enlargement (MWE) is an attractive method for homogeneous catalyst recycling. Applications of MWE in combination with either catalyst precipitation or nanofiltration have demonstrated their great potential as a method for process intensification in homogeneous catalysis. Selected, recent advances in MWE in combination with catalyst recovery are discussed, together with their implication for future developments. These examples demonstrate that this strategy is applicable in many different homogeneously catalyzed transformations.

  3. Radiographic enlargement of mandibular canal as first feature of non-Hodgkin's lymphoma.

    Science.gov (United States)

    Buric, N; Jovanovic, G; Radovanovic, Z; Buric, M; Tijanic, M

    2010-09-01

    Non-Hodgkin's lymphoma has the propensity to affect non-lymphoid tissue including oral tissue. Primary non-Hodgkin's lymphoma of the mandible mistreated as chronic periodontitis with diffuse enlargement of the mandibular canal and ice-cold numbness is very rarely described in English medical literature. A 57-year-old patient presented with a painful swelling on the left side of the mandible with a clinically chronic periodontitis associated with ice-cold numbness. A panoramic radiograph showed a diffuse uniform enlargement of the mandibular canal. Histological examination showed that the lesion was a primary intraosseous non-Hodgkin's lymphoma of the mandible. Immunohistochemical examination showed a positive reaction for CD20+, Ki-67+. Seven months after chemotherapy the patient was observed for possible life-threatening propagation of the disease. In conclusion, primary (extra-nodal) non-Hodgkin's lymphoma of the mandible usually clinically presents with bone swelling, teeth mobility and neurological disturbance. Radiographic features presenting as diffuse enlargement of the mandibular canal could be considered as non-Hodgkin's lymphoma.

  4. Reversible and non-reversible enlargement of cerebral spinal fluid spaces in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Artmann, H.; Grau, H.; Adelmann, M.; Schleiffer, R.

    1985-07-01

    Brain CT studies of 35 patients with anoxia nervosa confirmed the observations of other authors: cerebral dystrophic changes correlate with weight loss and the reversibility of these changes also correlates with the normalization of body weight. Other corroborated facts are: the most numerous and most pronounced enlargements are of the cortical sulci and the interhemispheric fissure, moderate widening affects the ventricles and the rarest and most insignificant changes are those of the cerebellum. The reversibility of the changes showed a parallel to the extent of the changes themselves and to the duration of improvement of the body weight. The reversibility of the enlargement of the cortical sulci and of the distances between the frontal horns of the lateral ventricles was more often significant than that of the abnormal measurements of the cella media. This difference is based on minimal early acquired brain damage which occurs in 60% of our patients. This high incidence of early acquired minimal brain disease in patients with anorexia nervosa is here discussed as a nonspecific predisposing factor. Although there is no exact explanation of the etiology of the reversible enlargement of cerenral spinal fluid (CSF) spaces in anorexia nervosa, the changes resemble those in alcoholics. The mechanisms of brain changes in alcoholism, as shown experimentally, seem to us to throw light on the probable mechanism of reversible dystrophic brain changes in anorexia nervosa.

  5. Is the prefrontal cortex especially enlarged in the human brain allometric relations and remapping factors.

    Science.gov (United States)

    Passingham, Richard E; Smaers, Jeroen B

    2014-01-01

    There has been no agreement as to whether the prefrontal cortex is especially enlarged in the human brain. To answer this question, we analyzed the only two datasets that provide information on total prefrontal cortex volume based on cytoarchitectonic criteria. One delineated the prefrontal cortex proper on the basis of cytoarchitectonic criteria; the other used a proxy of the prefrontal cortex based on a cytoarchitectonic delineation of the frontal lobe. To investigate whether all cortical association areas, including the prefrontal cortex, are enlarged in the human brain, we scaled the different areas to a common reference, the primary visual cortex. To investigate whether the prefrontal cortex is more enlarged than other association areas, we scaled it relative to its inputs from and outputs to other nonprimary areas. We carried out separate regression analyses using different data samples as a predictive baseline group: data for monkeys alone informs us on whether great apes are different from monkeys; data for all non-human anthropoids, including great apes, informs us on whether humans are different from all other primates. The analyses show that the value for the human prefrontal cortex is greater than expected, and that this is true even when data for the great apes are included in the analysis. They also show that the chimpanzee prefrontal cortex is greater than expected for a monkey with a similar sized cortex. We discuss possible functional consequences.

  6. Efficient stereological approaches for the volumetry of a normal or enlarged spleen from MDCT images

    Energy Technology Data Exchange (ETDEWEB)

    Mazonakis, Michalis; Stratakis, John; Damilakis, John [University of Crete, Department of Medical Physics, Faculty of Medicine, P.O. Box 2208, Iraklion, Crete (Greece)

    2015-06-01

    To introduce efficient stereological approaches for estimating the volume of a normal or enlarged spleen from MDCT. All study participants underwent an abdominal MDCT. The first group included 20 consecutive patients with splenomegaly and the second group consisted of 20 subjects with a normal spleen. Splenic volume estimations were performed using the stereological point counting method. Stereological assessments were optimized using the systematic slice sampling procedure. Planimetric measurements based on manual tracing of splenic boundaries on each slice were taken as reference values. Stereological analysis using five to eight systematically sampled slices provided enlarged splenic volume estimations with a mean precision of 4.9 ± 1.0 % in a mean time of 2.3 ± 0.4 min. A similar measurement duration and error was observed for normal splenic volume assessment using four to seven systematically selected slices. These stereological approaches slightly but insignificantly overestimated the volume of a normal and enlarged spleen compared to planimetry (P > 0.05) with a mean difference of -1.3 ± 4.3 % and -2.7 ± 5.2 %, respectively. The two methods were highly correlated (r ≥ 0.96). The variability of repeated stereological estimations was below 3.8 %. The proposed stereological approaches enable the rapid, reproducible, and accurate splenic volume estimation from MDCT data in patients with or without splenomegaly. (orig.)

  7. Disodium cromoglycate attenuates hypoxia induced enlargement of end-expiratory lung volume in rats.

    Science.gov (United States)

    Maxová, H; Hezinová, A; Vízek, M

    2011-01-01

    Mechanism responsible for the enlargement of end-expiratory lung volume (EELV) induced by chronic hypoxia remains unclear. The fact that the increase in EELV persists after return to normoxia suggests involvement of morphological changes. Because hypoxia has been also shown to activate lung mast cells, we speculated that they could play in the mechanism increasing EELV similar role as in vessel remodeling in hypoxic pulmonary hypertension (HPH). We, therefore, tested an effect of mast cells degranulation blocker disodium cromoglycate (DSCG) on hypoxia induced EELV enlargement. Ventilatory parameters, EELV and right to left heart weight ratio (RV/LV+S) were measured in male Wistar rats. The experimental group (H+DSCG) was exposed to 3 weeks of normobaric hypoxia and treated with DSCG during the first four days of hypoxia, control group was exposed to hypoxia only (H), two others were kept in normoxia as non-treated (N) and treated (N+DSCG) groups. DSCG treatment significantly attenuated the EELV enlargement (H+DSCG = 6.1+/-0.8; H = 9.2+/-0.9; ml +/-SE) together with the increase in minute ventilation (H + DSCG = 190+/-8; H = 273 +/- 10; ml/min +/- SE) and RV/LV + S (H + DSCG = 0.39 +/- 0.03; H = 0.50 +/- 0.06).

  8. Kv1.1 null mice have enlarged hippocampus and ventral cortex

    Directory of Open Access Journals (Sweden)

    Wang Fu-Hua

    2007-01-01

    Full Text Available Abstract Background Mutations in the Shaker-like voltage-gated potassium channel Kv1.1 are known to cause episodic ataxia type 1 and temporal lobe epilepsy. Mice that express a malfunctional, truncated Kv1.1 (BALB/cByJ-Kv1.1mceph/mceph show a markedly enlarged hippocampus and ventral cortex in adulthood. Results To determine if mice lacking Kv1.1 also develop a brain enlargement similar to mceph/mceph, we transferred Kv1.1 null alleles to the BALB/cByJ background. Hippocampus and ventral cortex was then studied using in vivo 3D-magnetic resonance imaging and volume segmentation in adult Kv1.1 null mice, BALB/cByJ-Kv1.1mceph/mceph, BALB/cByJ-Kv1.1mceph/+, BALB.C3HeB -Kv1.1-/+ and wild type littermates. The Kv1.1 null brains had dramatically enlarged hippocampus and ventral cortex. Mice heterozygous for either the null allele or the mceph allele had normal-sized hippocampus and ventral cortex. Conclusion Total absence of Kv1.1 can induce excessive overgrowth of hippocampus and ventral cortex in mice with a BALB/cByJ background, while mice with one wild type Kv1.1 allele develop normal-sized brains.

  9. [Mother and son with enlarged parietal foramina, persistent fetal vein, and ALX4 mutation].

    Science.gov (United States)

    Morita, Motoaki; Nanba, Eiji; Adachi, Kaori; Ohno, Kousaku

    2016-05-01

    Enlarged parietal foramina (EPF) are rare congenital skull defects. These round or oval defects are situated on each parietal bone approximately 1 cm from the midline. Most patients with EPF have a positive family history. The condition is inherited as an autosomal dominant trait with relatively high, but not full, penetrance. Mutation in either MSX2 or ALX4 genes is associated with enlarged parietal foramina. Case 1 is a boy who was noticed to have a large anterior fontanelle, large posterior fontanelle, and widely opened sagittal suture at 2 months. During development, the anterior fontanelle and sagittal suture closed at 3 years and the posterior fontanelle subsequently divided into two foramina with ossification of the midline bridge by 4 years. The foramina were about 2.5 x 2.5 cm in diameter at 8 years. Case 2 is the 34-year-old mother of Case 1. She showed similar bone defects in her cranium, again about 2.5 x 2.5 cm in diameter. Neither patient showed any neurological symptoms. Genetic analysis revealed a mutation in the ALX4 gene in both patients, and magnetic resonance imaging showed a persistent falcine sinus and a hypoplastic straight sinus. Further evaluation revealed that the mother of Case 2 also had a mutation in the ALX4 gene, but no enlarged parietal foramina. Although high penetrance of this condition has been reported, this family suggests incomplete penetrance of this disorder.

  10. Canal enlargement by Er:YAG laser using a cone-shaped irradiation tip.

    Science.gov (United States)

    Shoji, S; Hariu, H; Horiuchi, H

    2000-08-01

    To solve the problem of mechanical instrumentation, we developed a cone-shaped laser irradiation tip. This tip delivers 80% of the energy of the laser laterally and 20% of the energy forward. The tip was equipped with a water nozzle. The aim of this study was to examine the effect of Er:YAG laser irradiation using this tip on root canal enlargement and debridement. As a root canal model, a hole (0.5 x 5 mm) was drilled into a bovine dentin block. The tip was inserted into this hole and moved from the apex to the orifice (45 mm/min). The power of 10 mJ x 10 pps caused enlargement of the canal dimension by 106.5%. 20 and 40 mJ x 10 pps caused enlargements of 116.3 and 118.6%. 30 mJ x 10 pps caused the biggest change (129.8%). Scanning electron microscopic observations indicated that the dentin surface after laser preparation appeared cleaner than that obtained after preparation by drilling. This technique may have the advantage of decreasing the preparation time.

  11. Anatomy of the Eye

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Anatomy of the Eye En Español Read in Chinese External (Extraocular) Anatomy Extraocular Muscles: There are six muscles that are ...

  12. Chronic expanding hematoma extending over multiple gluteal muscles associated with piriformis syndrome.

    Science.gov (United States)

    Kitagawa, Yasuyuki; Yokoyama, Munehiro; Tamai, Kensuke; Takai, Shinro

    2012-01-01

    We report on a patient with an unusual, slowly enlarging hematoma of the left buttock. A 62-year-old man presented with a 6-year history of an enlarging mass of the left buttock. He had first noted the mass 6 years earlier and had had sciatica of the left lower limb for the last 2 months. He denied any history of antecedent trauma. The lesion extended over 3 gluteal muscles (the gluteus medius, gluteus minimus, and piriformis). On microscopic examination, the lesion showed typical signs of chronic expanding hematoma. The sciatica was relieved after surgical removal of the lesion. The lesion had not recurred at the last follow-up 4 years after the operation. The present case suggested that chronic expanding hematoma can extend into multiple muscles due, perhaps, to long-term growth and the anatomical and functional conditions of the affected muscles. Our case also suggests that chronic expanding hematoma can be a cause of piriformis syndrome.

  13. Swelling of the temporal region: a case of benign masticatory muscle hypertrophy

    DEFF Research Database (Denmark)

    Gniadecka, M; Weismann, K; Herning, Gudrun Margrethe

    1997-01-01

    A 35-year-old Caucasian woman had bilateral indolent swelling of the temporal regions. Imaging studies with nuclear magnetic resonance, ultrasonography and histopathological investigation revealed enlargement of the temporal and masseter muscles, with no pathology in the skin or subcutaneous tiss....... A small prolactinoma of the pituitary gland was incidentally found. The condition, designated benign masticatory muscle hypertrophy, should be distinguished from similar diseases affecting the skin and the subcutaneous tissue of the scalp. The cause remains unknown......A 35-year-old Caucasian woman had bilateral indolent swelling of the temporal regions. Imaging studies with nuclear magnetic resonance, ultrasonography and histopathological investigation revealed enlargement of the temporal and masseter muscles, with no pathology in the skin or subcutaneous tissue...

  14. Swelling of the temporal region: a case of benign masticatory muscle hypertrophy

    DEFF Research Database (Denmark)

    Gniadecka, M; Weismann, K; Herning, Gudrun Margrethe

    1997-01-01

    A 35-year-old Caucasian woman had bilateral indolent swelling of the temporal regions. Imaging studies with nuclear magnetic resonance, ultrasonography and histopathological investigation revealed enlargement of the temporal and masseter muscles, with no pathology in the skin or subcutaneous tiss....... A small prolactinoma of the pituitary gland was incidentally found. The condition, designated benign masticatory muscle hypertrophy, should be distinguished from similar diseases affecting the skin and the subcutaneous tissue of the scalp. The cause remains unknown......A 35-year-old Caucasian woman had bilateral indolent swelling of the temporal regions. Imaging studies with nuclear magnetic resonance, ultrasonography and histopathological investigation revealed enlargement of the temporal and masseter muscles, with no pathology in the skin or subcutaneous tissue...

  15. Muscle strain treatment

    Science.gov (United States)

    Treatment - muscle strain ... Question: How do you treat a muscle strain ? Answer: Rest the strained muscle and apply ice for the first few days after the injury. Anti-inflammatory medicines or acetaminophen ( ...

  16. Correlations of Ventricular Enlargement with Rheologically Active Surfactant Proteins in Cerebrospinal Fluid

    Science.gov (United States)

    Schob, Stefan; Weiß, Alexander; Dieckow, Julia; Richter, Cindy; Pirlich, Mandy; Voigt, Peter; Surov, Alexey; Hoffmann, Karl-Titus; Quaeschling, Ulf; Preuß, Matthias

    2017-01-01

    Purpose: Surfactant proteins (SPs) are involved in the regulation of rheological properties of body fluids. Concentrations of SPs are altered in the cerebrospinal fluid (CSF) of hydrocephalus patients. The common hallmark of hydrocephalus is enlargement of the brain ventricles. The relationship of both phenomena has not yet been investigated. The aim of this study was to evaluate the association between SP concentrations in the CSF and enlargement of the brain ventricles. Procedures: Ninty-six individuals (41 healthy subjects and 55 hydrocephalus patients) were included in this retrospective analysis. CSF specimens were analyzed for SP-A, SP-B, SP-C and SP-D concentrations by use of enzyme linked immunosorbent assays (ELISA). Ventricular enlargement was quantified in T2 weighted (T2w) magnetic resonance imaging (MRI) sections using an uni-dimensional (Evans’ Index) and a two-dimensional approach (lateral ventricles area index, LVAI). Results: CSF-SP concentrations (mean ± standard deviation in ng/ml) were as follows: SP-A 0.71 ± 0.58, SP-B 0.18 ± 0.43, SP-C 0.89 ± 0.77 and SP-D 7.4 ± 5.4. Calculated values of Evans’ Index were 0.37 ± 0.11, a calculation of LVAI resulted in 0.18 ± 0.15 (each mean ± standard deviation). Significant correlations were identified for Evans’ Index with SP-A (r = 0.388, p < 0.001) and SP-C (r = 0.392, p < 0.001), LVAI with SP-A (r = 0.352, p = 0.001), SP-C (r = 0.471, p < 0.001) and SP-D (r = 0.233, p = 0.025). Furthermore, SP-C showed a clear inverse correlation with age (r = −0.357, p = 0.011). Conclusion: The present study confirmed significant correlations between SPs A, C and D in the CSF with enlargement of the inner CSF spaces. In conclusion, SPs clearly play an important role for CSF rheology. CSF rheology is profoundly altered in hydrocephalic diseases, however, diagnosis and therapy of hydrocephalic conditions are still almost exclusively based on ventricular enlargement. Until now it was unclear, whether the

  17. Effective fiber hypertrophy in satellite cell-depleted skeletal muscle.

    Science.gov (United States)

    McCarthy, John J; Mula, Jyothi; Miyazaki, Mitsunori; Erfani, Rod; Garrison, Kelcye; Farooqui, Amreen B; Srikuea, Ratchakrit; Lawson, Benjamin A; Grimes, Barry; Keller, Charles; Van Zant, Gary; Campbell, Kenneth S; Esser, Karyn A; Dupont-Versteegden, Esther E; Peterson, Charlotte A

    2011-09-01

    An important unresolved question in skeletal muscle plasticity is whether satellite cells are necessary for muscle fiber hypertrophy. To address this issue, a novel mouse strain (Pax7-DTA) was created which enabled the conditional ablation of >90% of satellite cells in mature skeletal muscle following tamoxifen administration. To test the hypothesis that satellite cells are necessary for skeletal muscle hypertrophy, the plantaris muscle of adult Pax7-DTA mice was subjected to mechanical overload by surgical removal of the synergist muscle. Following two weeks of overload, satellite cell-depleted muscle showed the same increases in muscle mass (approximately twofold) and fiber cross-sectional area with hypertrophy as observed in the vehicle-treated group. The typical increase in myonuclei with hypertrophy was absent in satellite cell-depleted fibers, resulting in expansion of the myonuclear domain. Consistent with lack of nuclear addition to enlarged fibers, long-term BrdU labeling showed a significant reduction in the number of BrdU-positive myonuclei in satellite cell-depleted muscle compared with vehicle-treated muscle. Single fiber functional analyses showed no difference in specific force, Ca(2+) sensitivity, rate of cross-bridge cycling and cooperativity between hypertrophied fibers from vehicle and tamoxifen-treated groups. Although a small component of the hypertrophic response, both fiber hyperplasia and regeneration were significantly blunted following satellite cell depletion, indicating a distinct requirement for satellite cells during these processes. These results provide convincing evidence that skeletal muscle fibers are capable of mounting a robust hypertrophic response to mechanical overload that is not dependent on satellite cells.

  18. Ultrasound Findings of Delayed-Onset Muscle Soreness.

    Science.gov (United States)

    Longo, Victor; Jacobson, Jon A; Fessell, David P; Mautner, Kenneth

    2016-11-01

    The purpose of this series was to retrospectively characterize the ultrasound findings of delayed-onset muscle soreness (DOMS). The Institutional Review Board approved our study, and informed consent was waived. A retrospective search of radiology reports using the key phrase "delayed-onset muscle soreness" and key word "DOMS" from 2001 to 2015 and teaching files was completed to identify cases. The sonograms were reviewed by 3 fellowship-trained musculoskeletal radiologists by consensus. Sonograms were retrospectively characterized with respect to echogenicity (hypoechoic, isoechoic, or hyperechoic), distribution of muscle involvement, and intramuscular pattern (focal versus diffuse and well defined versus poorly defined). Images were also reviewed for muscle enlargement, fluid collection, muscle fiber disruption, and increased flow on color or power Doppler imaging. There were a total of 6 patients identified (5 male and 1 female). The average age was 22 years (range, 7-44 years). Of the 6 patients, there were a total of 11 affected muscles in 7 extremities (1 bilateral case). The involved muscles were in the upper extremity: triceps brachii in 27% (3 of 11), biceps brachii in 18% (2 of 11), brachialis in 18% (2 of 11), brachioradialis in 18% (2 of 11), infraspinatus in 9% (1 of 11), and deltoid in 9% (1 of 11). On ultrasound imaging, the abnormal muscle was hyperechoic in 100% (11 of 11), well defined in 73% (8 of 11), poorly defined in 27% (3 of 11), diffuse in 73% (8 of 11), and focal in 27% (3 of 11). Increased muscle size was found in 82% (9 of 11) and minimal hyperemia in 87.5% (7 of 8). The ultrasound findings of DOMS include hyperechoic involvement of an upper extremity muscle, most commonly appearing well defined and diffuse with increased muscle size and minimal hyperemia.

  19. Effective fiber hypertrophy in satellite cell-depleted skeletal muscle

    Science.gov (United States)

    McCarthy, John J.; Mula, Jyothi; Miyazaki, Mitsunori; Erfani, Rod; Garrison, Kelcye; Farooqui, Amreen B.; Srikuea, Ratchakrit; Lawson, Benjamin A.; Grimes, Barry; Keller, Charles; Van Zant, Gary; Campbell, Kenneth S.; Esser, Karyn A.; Dupont-Versteegden, Esther E.; Peterson, Charlotte A.

    2011-01-01

    An important unresolved question in skeletal muscle plasticity is whether satellite cells are necessary for muscle fiber hypertrophy. To address this issue, a novel mouse strain (Pax7-DTA) was created which enabled the conditional ablation of >90% of satellite cells in mature skeletal muscle following tamoxifen administration. To test the hypothesis that satellite cells are necessary for skeletal muscle hypertrophy, the plantaris muscle of adult Pax7-DTA mice was subjected to mechanical overload by surgical removal of the synergist muscle. Following two weeks of overload, satellite cell-depleted muscle showed the same increases in muscle mass (approximately twofold) and fiber cross-sectional area with hypertrophy as observed in the vehicle-treated group. The typical increase in myonuclei with hypertrophy was absent in satellite cell-depleted fibers, resulting in expansion of the myonuclear domain. Consistent with lack of nuclear addition to enlarged fibers, long-term BrdU labeling showed a significant reduction in the number of BrdU-positive myonuclei in satellite cell-depleted muscle compared with vehicle-treated muscle. Single fiber functional analyses showed no difference in specific force, Ca2+ sensitivity, rate of cross-bridge cycling and cooperativity between hypertrophied fibers from vehicle and tamoxifen-treated groups. Although a small component of the hypertrophic response, both fiber hyperplasia and regeneration were significantly blunted following satellite cell depletion, indicating a distinct requirement for satellite cells during these processes. These results provide convincing evidence that skeletal muscle fibers are capable of mounting a robust hypertrophic response to mechanical overload that is not dependent on satellite cells. PMID:21828094

  20. Wellbore enlargement investigation: Potential analogs to the Waste Isolation Pilot Plant during inadvertent intrusion of the repository

    Energy Technology Data Exchange (ETDEWEB)

    Boak, D.M.; Dotson, L.; Aguilar, R. [and others

    1997-01-01

    This study involved the evaluation and documentation of cases in which petroleum wellbores were enlarged beyond the nominal hole diameter as a consequence of erosion during exploratory drilling, particularly as a function of gas flow into the wellbore during blowout conditions. A primary objective was to identify analogs to potential wellbore enlargement at the Waste Isolation Pilot Plant (WIPP) during inadvertent human intrusion. Secondary objectives were to identify drilling scenarios associated with enlargement, determine the physical extent of enlargement, and establish the physical properties of the formation in which the enlargement occurred. No analogs of sufficient quality to establish quantitative limits on wellbore enlargement at the WIPP disposal system were identified. However, some information was obtained regarding the frequency of petroleum well blowouts and the likelihood that such blowouts would bridge downhole, self-limiting the surface release of disposal-system material. Further work would be necessary, however, to determine the conditions under which bridging could occur and the extent to which the bridging might be applicable to WIPP. In addition, data on casing sizes of petroleum boreholes in the WIPP vicinity support the use of a 12-{1/4} inch borehole size in WIPP performance assessment calculations. Finally, although data are limited, there was no evidence of significant wellbore enlargement in any of three blowouts that occur-red in wellbores in the Delaware Basin (South Culebra Bluff Unit No. 1, Energy Research and Development Administration (ERDA) 6, and WIPP 12).

  1. Arthroscopic gluteal muscle contracture release with radiofrequency energy.

    Science.gov (United States)

    Liu, Yu-Jie; Wang, Yan; Xue, Jing; Lui, Pauline Po-Yee; Chan, Kai-Ming

    2009-03-01

    Gluteal muscle contracture is common after repeated intramuscular injections and sometimes is sufficiently debilitating to require open surgery. We asked whether arthroscopic release of gluteal muscle contracture using radiofrequency energy would decrease complications with clinically acceptable results. We retrospectively reviewed 108 patients with bilateral gluteal muscle contractures (57 males, 51 females; mean age, 23.7 years). We used inferior, anterosuperior, and posterosuperior portals. With the patient lying laterally, we developed and enlarged a potential space between the gluteal muscle group and the subcutaneous fat using blunt dissection. Under arthroscopic guidance through the inferior portal, we débrided and removed fatty tissue overlying the contractile band of the gluteal muscle group using a motorized shaver introduced through the superior portal. Radiofrequency then was introduced through the superior portal to gradually excise the contracted bands from superior to inferior. Finally, hemostasis was ensured using radiofrequency. Patients were followed a minimum of 7 months (mean, 17.4 months; range, 7-42 months). At last followup, the adduction and flexion ranges of the hip were 45.3 degrees +/- 8.7 degrees and 110.2 degrees +/- 11.9 degrees, compared with 10.4 degrees +/- 7.2 degrees and 44.8 degrees +/- 14.1 degrees before surgery. No hip abductor contracture recurred and no patient had residual hip pain or gluteal muscle wasting. We found gluteal muscle contracture could be released effectively with radiofrequency energy.

  2. Hearing loss in enlarged vestibular aqueduct and incomplete partition type II.

    Science.gov (United States)

    Ahadizadeh, Emily; Ascha, Mustafa; Manzoor, Nauman; Gupta, Amit; Semaan, Maroun; Megerian, Cliff; Otteson, Todd

    2017-06-23

    The purpose of this work is to identify the role of incomplete partition type II on hearing loss among patients with enlarged vestibular aqueduct (EVA). EVA is a common congenital inner ear malformation among children with hearing loss, where vestibular aqueduct morphology in this population has been shown to correlate to hearing loss. However, the impact of incomplete partition between cochlear turns on hearing loss has not been, despite meaningful implications for EVA pathophysiology. A retrospective review of radiology reports for patients who had computed tomography (CT) scans with diagnoses of hearing loss at a tertiary medical center between January 2000 and June 2016 were screened for EVA. CT scans of the internal auditory canal (IAC) for those patients with EVA were examined for evidence of incomplete partition type II (IP-II), measurements of midpoint width and operculum width a second time, and patients meeting Cincinnati criteria for EVA selected for analysis. Statistical analysis including chi-square, Wilcoxon rank-sum, and t-tests were used to identify differences in outcomes and clinical predictors, as appropriate for the distribution of the data. Linear mixed models of hearing test results for all available tests were constructed, both univariable and adjusting for vestibular aqueduct morphometric features, with ear-specific intercepts and slopes over time. There were no statistically significant differences in any hearing test results or vestibular aqueduct midpoint and operculum widths. Linear mixed models, both univariable and those adjusting for midpoint and operculum widths, did not indicate a statistically significant effect of incomplete partition type II on hearing test results. Hearing loss due to enlarged vestibular aqueduct does not appear to be affected by the presence of incomplete partition type II. Our results suggest that the pathophysiological processes underlying hearing loss in enlarged vestibular aqueduct may not be a result of

  3. Electronic length measurement using small and large files in enlarged canals.

    Science.gov (United States)

    Nguyen, H Q; Kaufman, A Y; Komorowski, R C; Friedman, S

    1996-11-01

    Electronic apex locators are frequently used attached to a small size endodontic file; however, the effect on the measurement of the relative diameters of the file and the root canal has not been clarified. In this study, the length of enlarged canals was measured using small size files and files matching the canal diameter to observe a possible discrepancy. The accuracy of electronic length control during canal preparation with rotary files was also assessed. The root canals in 21 extracted, single rooted teeth were accessed, and their actual length (AL) established by passing a size 10 file just through the minor apical foramen. The teeth were then embedded in an alginate mold. The initial canal length (IL) was measured with the Root ZX apex locator by negotiating a size 10 file to the apical constriction. The canal was enlarged to size 60 with rotary files while the length was continuously controlled with the apex locator. Then, the final length measurements were obtained with a size 10 file and a size 60 file (FL-10 and FL-60, respectively). The average values of IL, FL-10 and FL-60 were calculated and compared using Repeated Measures Analysis of Variance followed by Tukey's Studentized Range test (P apical 4 mm of the canal was exposed by grinding the buccal aspect of the root. The IL was 0.45 mm shorter than AL (P apical constriction was absent in all the teeth, but the file tips were confined within the root. This study concluded that the Root ZX indicated the location of an apical constriction even when the anatomic constriction was eliminated. In the enlarged canals, length measurements obtained with small and large size files were comparable.

  4. Proximal tubular hypertrophy and enlarged glomerular and proximal tubular urinary space in obese subjects with proteinuria.

    Directory of Open Access Journals (Sweden)

    Ana Tobar

    Full Text Available BACKGROUND: Obesity is associated with glomerular hyperfiltration, increased proximal tubular sodium reabsorption, glomerular enlargement and renal hypertrophy. A single experimental study reported an increased glomerular urinary space in obese dogs. Whether proximal tubular volume is increased in obese subjects and whether their glomerular and tubular urinary spaces are enlarged is unknown. OBJECTIVE: To determine whether proximal tubules and glomerular and tubular urinary space are enlarged in obese subjects with proteinuria and glomerular hyperfiltration. METHODS: Kidney biopsies from 11 non-diabetic obese with proteinuria and 14 non-diabetic lean patients with a creatinine clearance above 50 ml/min and with mild or no interstitial fibrosis were retrospectively analyzed using morphometric methods. The cross-sectional area of the proximal tubular epithelium and lumen, the volume of the glomerular tuft and of Bowman's space and the nuclei number per tubular profile were estimated. RESULTS: Creatinine clearance was higher in the obese than in the lean group (P=0.03. Proteinuria was similarly increased in both groups. Compared to the lean group, the obese group displayed a 104% higher glomerular tuft volume (P=0.001, a 94% higher Bowman's space volume (P=0.003, a 33% higher cross-sectional area of the proximal tubular epithelium (P=0.02 and a 54% higher cross-sectional area of the proximal tubular lumen (P=0.01. The nuclei number per proximal tubular profile was similar in both groups, suggesting that the increase in tubular volume is due to hypertrophy and not to hyperplasia. CONCLUSIONS: Obesity-related glomerular hyperfiltration is associated with proximal tubular epithelial hypertrophy and increased glomerular and tubular urinary space volume in subjects with proteinuria. The expanded glomerular and urinary space is probably a direct consequence of glomerular hyperfiltration. These effects may be involved in the pathogenesis of obesity

  5. Communities, Boundaries and New Neighbours: the Discursive Construction of EU Enlargement

    Directory of Open Access Journals (Sweden)

    Giuditta Caliendo

    2008-12-01

    Full Text Available The institutional discourse of the European Union (EU is undergoing important changes that are also reflected by new initiatives in its communication policy. Against a background of widespread scepticism towards EU enlargement among the public, this change is driven by the need to promote the widening of its borders in a more effective way in order to prompt popular endorsement. Through the use of its textual and visual communicative strategies, the EU is thus finding new ways to buttress its legitimacy and raise consensus around its political actions. The node of interaction between citizens and institutions is represented by the informative publications of the EU (also made available on the europa website, which become a constitutive element in building Union-to-citizen communication. The analysis of textual and visual formulations of the European Commission’s key booklets on EU enlargement in the period from 2004 to 2007 - in terms of their content and pragmatic aims - reveals the emergence of new consensus-building strategies. Results show that a sense of allegiance and belonging attributed to a deepening of European integration is now increasingly linked to the practical advantages of EU enlargement, as expressed through the use of ‘promotional’ and strategic discursive practices. Moving away from a merely informative content, communication modes ‘migrate’ towards a more direct and ‘commodified’ type of message, while an increase in visual elements plays a complementing role in promoting legitimacy and a feeling of mutual belonging between ‘old’ and ‘new’ members of the European family.

  6. [Position statement for the diagnosis and treatment of men with benign prostate enlargement and lower urinary tract symptoms].

    Science.gov (United States)

    Greenstein, Alexander; Ferman, Zvi; Stav, Kobi; Gruenwald, Ilan; Matzkin, Haim; Ramon, Jacob

    2014-09-01

    Benign prostate enlargement causing lower urinary symptoms is a common progressive phenomenon in adult men. Lower urinary tract symptoms may emerge during the storage, voiding, and post micturition phases, harm quality of life and may be caused by a variety of factors. The purpose of evaluation is to identify benign prostate enlargement and factors other than enlarged prostate as the cause of symptoms, and recognize the risk factors for progression of the condition. The goal of treatment is to alleviate symptoms and improve quality of life, and to prevent deterioration of symptoms and development of complications. Medical therapy is the basic approach, whereas surgery and minimally invasive procedures are reserved for patients not interested in medical therapy or for those in whom symptoms were not alleviated by means of medical therapy. In the present position statement, we present the approach to the evaluation and treatment of lower urinary tract symptoms in men with benign prostate enlargement.

  7. Muscle Weakness

    Science.gov (United States)

    Al Kaissi, Ali; Ryabykh, Sergey; Ochirova, Polina; Kenis, Vladimir; Hofstätter, Jochen G.; Grill, Franz; Ganger, Rudolf; Kircher, Susanne Gerit

    2017-01-01

    Marked ligamentous hyperlaxity and muscle weakness/wasting associated with awkward gait are the main deficits confused with the diagnosis of myopathy. Seven children (6 boys and 1 girl with an average age of 8 years) were referred to our department because of diverse forms of skeletal abnormalities. No definitive diagnosis was made, and all underwent a series of sophisticated investigations in other institutes in favor of myopathy. We applied our methodology through the clinical and radiographic phenotypes followed by targeted genotypic confirmation. Three children (2 boys and 1 girl) were compatible with the diagnosis of progressive pseudorheumatoid chondrodysplasia. The genetic mutation was correlated with the WISP 3 gene actively expressed by articular chondrocytes and located on chromosome 6. Klinefelter syndrome was the diagnosis in 2 boys. Karyotyping confirmed 47,XXY (aneuploidy of Klinefelter syndrome). And 2 boys were finally diagnosed with Morquio syndrome (MPS type IV A) as both showed missense mutations in the N-acetylgalactosamine-sulfate sulfatase gene. Misdiagnosis can lead to the initiation of a long list of sophisticated investigations. PMID:28210640

  8. Use of minocycline as systemic antimicrobial therapy in refractory periodontitis with chronic gingival enlargement

    Directory of Open Access Journals (Sweden)

    Parag M Khatri

    2012-01-01

    Full Text Available Periodontal disease is a multifactorial disease having various risk factors, but a dynamic interaction between bacterial products and host response in association with genetic and environmental factors is considered as the primary cause for periodontal tissue destruction in periodontitis. This bacterial-host interaction which is ever-so-present in periodontitis directs us toward utilizing antimicrobial agents along with the routine mechanical debridement. This case report present a case of a female patient with recurrent periodontal infections with gingival enlargement treated with systemic Minocycline in conjunction with the conventional non-surgical approach.

  9. GINGIVAL ENLARGEMENT ASSOCIATED WITH NOCTURNAL FRONTAL LOBE EPILEPSY. A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sharma ANAMIKA

    2012-12-01

    Full Text Available „Epilepsy” refers to a group of neurological disorders characterized by chronic, recurrent, paroxysmal seizure activity. Nocturnal frontal lobe epilepsy is a neurological disorder characterized by brief, recurring seizures produ‑ ced in the frontal lobes of the brain, often while the patient is sleeping, and also by clusters of brief motor seizures. Seizure disorders may affect the dental status and oral health of patients. Epileptic drugs lead to gingival hyper‑ plasia, namely tissue enlargement, caused by an increased number of cells.

  10. Enlarged Right Atrium Falsely Interpreted as a Mediastinal Mass: A Case Report

    Directory of Open Access Journals (Sweden)

    Farid Zand

    2015-09-01

    Full Text Available Right atrial dilation due to left heart disease is a common complication among adults. The present review aimed to describe a case of massively dilated right atrium in a female patient presenting with valvular heart disease and no atrial fibrillation. The results of chest X-ray revealed a large opacity filling the lower right hemithorax, falsely interpreted as a mediastinal mass. During the transesophageal echocardiography, severe enlargement of the right atrium was detected, and open mitral and tricuspid valve replacements were performed successfully.

  11. Influence of the apical enlargement size on the endotoxin level reduction of dental root canals

    Directory of Open Access Journals (Sweden)

    Ariane Cassia Salustiano Marinho

    2012-12-01

    Full Text Available Gram-negative bacteria play an essential role in endodontic infections because they have virulence factors such as endotoxin. Due to its potential cytotoxic activity, special attention has been given to the removal/neutralization of this endotoxin in the root canal system. OBJECTIVE: The aim of this study was to evaluate the influence of the apical enlargement size (AES by using rotary instruments on the endotoxin level reduction of dental root canals. MATERIAL AND METHODS: Forty root canals of the mandibular premolar teeth were used. Escherichia coli endotoxin (055: B55 was inoculated into thirty root canals. Ten teeth served as the negative control group. After the incubation period, the first endotoxin samples were collected from the root canals with a sterile/apyrogenic paper point for the analysis of the endotoxin units (EU/mL present before instrumentation (S1. Specimen instrumentation was performed with the Mtwo® rotary system in the sequence 10/.04, 15/.05, 20/.06, 25/.06, 30/.05, 35/.04 and 40/.04. To monitor the effectiveness of increasing apical enlargement on endotoxin removal, the second endotoxin samples were collected from all the root canals after instrumentation with the following instruments: #25/.06- (S2; #30/.05- (S3; # 35/.04- (S4; and #40/.04- (S5. Limulus amebocyte lysate (LAL was used to quantify the levels of endotoxin. The results were statistically compared by using repeated measures of ANOVA with post hoc Tukey testing. RESULTS: Increasing levels of endotoxin removal was achieved by large sized apical enlargement: S2 (AES #25/.06- 89.2%, S3 (AES #30/.05- 95.9%, S4 (AES #35/.04- 97.8% and S5 (AES #40/.04- 98.2%. Substantial reduction of endotoxin content was obtained in S4 and S5 compared to S2 (p<0.05, however, the root canal preparation was not able to eliminate the endotoxin. CONCLUSIONS: Under the conditions of this study, it was concluded that the reduction of endotoxin levels of the dental root canals could be

  12. Unusual looping of the internal carotid artery in relation to an enlarged lymph node

    Directory of Open Access Journals (Sweden)

    Nayak SB

    2010-06-01

    Full Text Available Knowledge of variations of internal carotid artery is important to surgeons doing head and neck surgery as well as to radiologists doing imaging and invasive techniques. In the current case, the right internal carotid artery showed a characteristic loop at its beginning. An abnormal, enlarged lymph node was found at the carotid bifurcation, which was projecting into the loop. The left internal carotid artery was normal. The unusual looping of internal carotid artery at its beginning might result in altered blood flow to the brain and may lead to confusions in surgical, imaging and invasive techniques.

  13. Engrosamiento peneano: complicación de lipotransferencia Penis enlargement: complication of lipotransfer

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    C.G. Conde

    2012-12-01

    Full Text Available La solicitud de engrosamiento del pene por parte de los pacientes tiene un crecimiento sostenido. El empleo de grasa autóloga como relleno puede causar una deformidad que provoca un menoscabo funcional y estético. Presentamos un caso de complicación que requirió de tratamiento quirúrgico.Penis enlargement is a practice widely requested by the patients. The use of autologous fat transplantation can produce deformity and functional and aesthetic deficiency. The authors present a clinical case of complication and its surgical resolution.

  14. Prostate adenocarcinoma presenting with supraclavicular node enlargement: report of a case.

    Science.gov (United States)

    Platania, Marco; Bajetta, Emilio; Guadalupi, Valentina; Buzzoni, Roberto; Colecchia, Maurizio

    2008-01-01

    This report describes a case of prostate adenocarcinoma presenting with supraclavicular adenopathy and deep venous thrombosis in the ipsilateral arm. Biopsy revealed the enlarged node to be an undifferentiated adenocarcinoma of unknown origin, while CT scan evidenced widespread adenopathies. Because of the increase in serum PSA, the immunohistochemical staining of the biopsy specimen was reviewed and strong positivity for PSA suggested a prostatic origin. We emphasize the importance of PSA immunohistochemistry and serum PSA level monitoring in men presenting with carcinoma of undetermined origin and generalized lymphadenopathies.

  15. A Randomly Enlarging Critical Core Theory of Unidirectionally Fiber-reinforced Composites

    Institute of Scientific and Technical Information of China (English)

    范赋群; 曾庆敦

    1994-01-01

    Based upon the micro-stochastic failure mechanisms of composites,a new micromechanical statistical model,i.e.randomly enlarging critical core theory,for the tensile failure of unidirectional composites is proposed,with which we can overcome the primary imperfections of the existing chain-of-bundles probability model.On the basis of the established statistical model,the strength distribution and the failure criterion of composites are derived.The predictions of strength for T300/5208 and glass/epoxy show very good agreement with the existing experimental results,thus verifying the reasonableness and correctness of the present theory.

  16. Clinical correlates of enlarged prostate size in subjects with sexual dysfunction

    Institute of Scientific and Technical Information of China (English)

    Giovanni Corona; Mauro Gacci; Elisa Maseroli; Giulia Rastrelli; Linda Vignozzi; Alessandra Sforza; Gianni Forti; Edoardo Mannucci; Mario Maggi

    2014-01-01

    Digito‑rectal examination(DRE) of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of ifnding an enlarged prostate size at DRE in subjects with sexual dysfunction(SD). Aconsecutive series of 2379patients was retrospectively studied. The analysis was focused on a subset of subjects(n=1823; mean age 54.7±11.4) selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome(HR=1.346(1.129–1.759);P=0.030), type2 diabetes mellitus(HR=1.489(1.120–1.980);P=0.006), increased LDL cholesterol(>100mgdl−1; HR=1.354(1.018–1.801);P=0.037) and increased mean blood pressure(BP) values(HR=1.017(1.007–1.027) for each mmHg increment;P=0.001). Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction(ED), as well as with other andrological conditions, such as varicocele and premature ejaculation(PE). PSA levels were signiifcantly higher in subjects with enlarged prostate size when compared to the rest of the sample(HR=3.318(2.304; 4.799) for each log unit increment in PSA levels;P<0.0001). Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical(DRE) or biochemical(PSA) inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular(CV) background of the patient.

  17. Spatial bandwidth enlargement and field enhancement of shear horizontal waves in finite graded piezoelectric layered media

    KAUST Repository

    Xu, Yanlong

    2015-09-01

    Shear horizontal (SH) wave propagation in finite graded piezoelectric layered media is investigated by transfer matrix method. Different from the previous studies on SH wave propagation in completely periodic layered media, calculations on band structure and transmission in this paper show that the graded layered media possess very large band gaps. Harmonic wave simulation by finite element method (FEM) confirms that the reason of bandwidth enlargement is that waves within the band gap ranges are spatially enhanced and stopped by the corresponding graded units. The study suggests that the graded structure possesses the property of manipulating elastic waves spatially, which shows potential applications in strengthening energy trapping and harvesting. © 2015.

  18. Bilateral giant adrenal myelolipomas presenting as an enlarging ventral hernia: Radiologic-pathologic correlation and literature review

    Directory of Open Access Journals (Sweden)

    Najeeb Crossley, BS

    2015-01-01

    Full Text Available Adrenal myelolipomas are fat-containing tumors that are rare, usually small, and unilateral, as well as asymptomatic. They can, however, occur bilaterally and enlarge significantly, resulting in clinical symptoms. A middle-aged male presented with an enlarging ventral hernia that was attributed to giant bilateral adrenal myelolipomas. With a combined measurement of at least 20 × 15 cm, to our knowledge, the size of the masses is one of the largest reported for this particular entity.

  19. Reconditioning aging muscles.

    Science.gov (United States)

    Kraus, H

    1978-06-01

    Weakness or stiffness of key posture muscles can cause much of the disability seen in elderly patients. Too much tension and too little exercise greatly increase the natural loss of muscular fitness with age. A systematic program of exercise, stressing relaxation and stretching of tight muscles and strenghthening of weak muscles, can improve physical fitness. The program must be tailored to the patient, starting with relaxation and gentle limbering exercises and proceeding ultimately to vigorous muscle-stretching exercises. Muscle aches and pain from tension and muscle imbalance are to be expected. Relaxation relieves tension pain, and strengthening weak muscles and stretching tight muscles will correct muscle imbalance. To prevent acute muscle spasm, the patient should avoid excessive exertion and increase exercise intensity gradually.

  20. Influence of sex hormone levels on gingival enlargement in adolescent patients undergoing fixed orthodontic therapy: A pilot study

    Science.gov (United States)

    Hosadurga, Rajesh; Nabeel Althaf, M. S.; Hegde, Shashikanth; Rajesh, Kashyap S.; Arun Kumar, M. S.

    2016-01-01

    Background: Sex hormones may be a modifying factor in the periodontal disease pathogenesis. Aim: The association between gingival enlargement and sex hormone levels in adolescent patients undergoing fixed orthodontic therapy needs to be determined. Settings and Design: This study was conducted in the Department of Periodontology in association with the Department of Orthodontics, Yenepoya Dental College, Yenepoya University, Mangaluru. Materials and Methods: A pilot study was conducted on 21 adolescent patients between the age group of 13–19 years, who had undergone fixed orthodontic therapy for at least 3 months. Apicocoronally, the gingival enlargement was assessed by the index described by Miller and Damm. Miranda and Brunet index was used to assess gingival overgrowth in the buccal–lingual direction in the interdental papilla. Furthermore, the patients were assigned to two groups - Group 1-GE and Group 2-non-GE. Sex hormones assessed were estradiol and progesterone in females and testosterone in males in both groups. Results: 57.1% of the study population had enlargement of the gingiva. The mean plaque score was 0.59 and 0.56, respectively, in both groups. A statistically significant relationship was found between estradiol and testosterone levels with gingival enlargement. However, a significant relationship was not obtained for progesterone levels with the gingival enlargement. Conclusion: Direct correlation between estradiol, testosterone, and gingival enlargement was seen. PMID:27994419

  1. Influence of sex hormone levels on gingival enlargement in adolescent patients undergoing fixed orthodontic therapy: A pilot study

    Directory of Open Access Journals (Sweden)

    Rajesh Hosadurga

    2016-01-01

    Full Text Available Background: Sex hormones may be a modifying factor in the periodontal disease pathogenesis. Aim: The association between gingival enlargement and sex hormone levels in adolescent patients undergoing fixed orthodontic therapy needs to be determined. Settings and Design: This study was conducted in the Department of Periodontology in association with the Department of Orthodontics, Yenepoya Dental College, Yenepoya University, Mangaluru. Materials and Methods: A pilot study was conducted on 21 adolescent patients between the age group of 13–19 years, who had undergone fixed orthodontic therapy for at least 3 months. Apicocoronally, the gingival enlargement was assessed by the index described by Miller and Damm. Miranda and Brunet index was used to assess gingival overgrowth in the buccal–lingual direction in the interdental papilla. Furthermore, the patients were assigned to two groups - Group 1-GE and Group 2-non-GE. Sex hormones assessed were estradiol and progesterone in females and testosterone in males in both groups. Results: 57.1% of the study population had enlargement of the gingiva. The mean plaque score was 0.59 and 0.56, respectively, in both groups. A statistically significant relationship was found between estradiol and testosterone levels with gingival enlargement. However, a significant relationship was not obtained for progesterone levels with the gingival enlargement. Conclusion: Direct correlation between estradiol, testosterone, and gingival enlargement was seen.

  2. Referred pain areas of active myofascial trigger points in head, neck, and shoulder muscles, in chronic tension type headache.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Ge, Hong-You; Alonso-Blanco, Cristina; González-Iglesias, Javier; Arendt-Nielsen, Lars

    2010-10-01

    Our aim was to analyze the differences in the referred pain patterns and size of the areas of those myofascial trigger points (TrPs) involved in chronic tension type headache (CTTH) including a number of muscles not investigated in previous studies. Thirteen right handed women with CTTH (mean age: 38 ± 6 years) were included. TrPs were bilaterally searched in upper trapezius, sternocleidomastoid, splenius capitis, masseter, levator scapulae, superior oblique (extra-ocular), and suboccipital muscles. TrPs were considered active when both local and referred pain evoked by manual palpation reproduced total or partial pattern similar to a headache attack. The size of the referred pain area of TrPs of each muscle was calculated. The mean number of active TrPs within each CTTH patient was 7 (95% CI 6.2-8.0). A greater number (T = 2.79; p = 0.016) of active TrPs was found at the right side (4.2 ± 1.5) when compared to the left side (2.9 ± 1.0). TrPs in the suboccipital muscles were most prevalent (n = 12; 92%), followed by the superior oblique muscle (n =11/n = 9 right/left side), the upper trapezius muscle (n = 11/n = 6) and the masseter muscle (n = 9/n=7). The ANOVA showed significant differences in the size of the referred pain area between muscles (F = 4.7, p = 0.001), but not between sides (F = 1.1; p = 0.3): as determined by a Bonferroni post hoc analysis the referred pain area elicited by levator scapulae TrPs was significantly greater than the area from the sternocleidomastoid (p = 0.02), masseter (p = 0.003) and superior oblique (p = 0.001) muscles. Multiple active TrPs exist in head, neck and shoulder muscles in women with CTTH. The referred pain areas of TrPs located in neck muscles were larger than the referred pain areas of head muscles. Spatial summation of nociceptive inputs from multiple active TrPs may contribute to clinical manifestations of CTTH. Copyright © 2009 Elsevier Ltd. All rights reserved.

  3. Fetal development of the pulley for muscle insertion tendons: A review and new findings related to the tensor tympani tendon.

    Science.gov (United States)

    Rodríguez-Vázquez, Jose Francisco; Honkura, Yohei; Katori, Yukio; Murakami, Gen; Abe, Hiroshi

    2017-01-01

    The existence of hard tissue pulleys that act to change the direction of a muscle insertion tendon is well known in the human body. These include (1) the trochlea for the extraocular obliquus superior muscle, (2) the pterygoid hamulus for the tensor veli palatini muscle, (3) the deep sulcus on the plantar aspect of the cuboid bone for the peroneus longus tendon, (4) the lesser sciatic notch for the obturator internus muscle, and (5) the bony trochleariformis process for the tensor tympani muscle tendon. In addition, (6) the stapedius muscle tendon shows a lesser or greater angulation at the pyramidal eminence of the temporal bone. Our recent studies have shown that the development of pulleys Nos. 1 and 2 can be explained by a change in the topographical relationship between the pulley and the tendon, that of pulley No. 3 by the rapidly growing calcaneus pushing the tendon, and that of pulley No. 4 by migration of the insertion along the sciatic nerve and gluteus medius tendon. Therefore, in Nos. 1-4, an initially direct tendon curves secondarily and obtains an attachment to the pulley. In case No. 6, the terminal part of the stapedius tendon originates secondarily from the interzone mesenchymal tissue of the incudostapedial joint. In the case of pulley No. 5, we newly demonstrated that its initial phase of development was similar to No. 6, but the tensor tympani tendon achieved a right-angled turn under guidance by a specific fibrous tissue and it migrated along the growing malleus manubrium. Copyright © 2016 Elsevier GmbH. All rights reserved.

  4. Identification of a new target muscle for treatment in patients with Parkinson's disease who have lateral trunk flexion?

    Science.gov (United States)

    Kataoka, Hiroshi; Sawa, Nobuhiro; Ueno, Satoshi

    2015-11-15

    Parkinson's disease (PD) can present with lateral trunk flexion (LTF). Abnormal posture associated with PD has been treated, but the effectiveness of these treatments is limited, resulting in unsatisfactory outcomes. Unilateral hypertrophy and unilateral hyperactivity may be useful for deciding targets for injection of botulinum toxin or physical rehabilitation. However, such findings may be limited such as the obliquus abdominis muscle or thoracic paraspinal muscles, and several other muscles may have a causative role in LTF. We investigated 8 patients whether other muscles show unilateral hypertrophy by analyzing computed tomographic scans. Cobb's angle was 11° to 34°. The area of the paravertebral muscles was large contralateral to the bending side and this trend intensified from L4 to Th10. The lumbar quadrate muscle and psoas major muscle showed unilateral enlargement. These larger muscles were prominent contralateral to the bending side in five patients and ipsilateral to the bending side in two patients. This unilateral muscle change was mildly seen in the internal and external abdominal oblique muscles. The lumbar quadrate muscle or psoas major muscle showed two hypertrophic patterns, and these muscles might be new therapeutic targets for treatments such as botulinum toxin.

  5. Alice is not missing wonderland the eastward enlargement of the European Union

    Directory of Open Access Journals (Sweden)

    Prokopijević Miroslav

    2005-01-01

    Full Text Available In this paper I will try to show that the EU enlargement from 2004 is not a good economic move for eight newcomers from Central and Eastern Europe (CEECs. It is unlikely that newcomers will get larger FDI, speed up their economic growth and catch up with richer EU countries, although this was broadly advertised both academically and by the EU "propaganda for happiness." The EU subsidies, intended to offset accession costs, turn out to be useless if not damaging for acceding economies, because they change the structure of incentives. So, instead of being rewarded for accession accession countries are going to be punished twice. Firstly, by lower FDI and a persisting GDP gap. Secondly, by getting subsidies which worsen the situation. CEECs would be better off staying outside the EU and continuing to improve economic freedom and the rule of law. But even after they have acceded, there is still some space for reasonable objectives of the CEECs due to unintended consequences of the socialist enlargement design.

  6. Positive selection at the ASPM gene coincides with brain size enlargements in cetaceans.

    Science.gov (United States)

    Xu, Shixia; Chen, Yuan; Cheng, Yuefeng; Yang, Dan; Zhou, Xuming; Xu, Junxiao; Zhou, Kaiya; Yang, Guang

    2012-11-07

    The enlargement of cetacean brain size represents an enigmatic event in mammalian evolution, yet its genetic basis remains poorly explored. One candidate gene associated with brain size evolution is the abnormal spindle-like microcephaly associated (ASPM), as mutations in this gene cause severe reductions in the cortical size of humans. Here, we investigated the ASPM gene in representative cetacean lineages and previously published sequences from other mammals to test whether the expansion of the cetacean brain matched adaptive ASPM evolution patterns. Our analyses yielded significant evidence of positive selection on the ASPM gene during cetacean evolution, especially for the Odontoceti and Delphinoidea lineages. These molecular patterns were associated with two major events of relative brain size enlargement in odontocetes and delphinoids. It is of particular interest to find that positive selection was restricted to cetaceans and primates, two distant lineages both characterized by a massive expansion of brain size. This result is suggestive of convergent molecular evolution, although no site-specific convergence at the amino acid level was found.

  7. Enlarged piloid astrocytoma of the midbrain: recurrence or pseudoprogression? A clinical case

    Directory of Open Access Journals (Sweden)

    Yu. Yu. Trunin

    2016-01-01

    Full Text Available Piloid astrocytoma (PA is a glioma that is most frequently encountered in children (WHO grade I. According to most authors, stereotactic radiation (radiotherapy and radiosurgery is an effective method to control tumor growth in patients with incomplete removal of PA and its recurrence. The authors describe a clinical case of a female patient with PA of the midbrain; during the first 7 months after radiation she showed an obvious enlargement of the tumor, as evidenced by magnetic resonance imaging (MRI, with its further regression without any antitumor treatment. A follow-up of the patient and a regular evaluation of her clinical status and MRI changes, as compared to the similar clinical cases and literature data, may suggest that PA enlargement early after radiotherapy is generally pseudoprogression rather than true progression of the tumor. An understanding of this phenomenon will be able to improve the assessment of radiotherapy results in patients with PA and to rule out unnecessary antitumor treatment in this category of patients. 

  8. Clinical Features and Differential Diagnosis of Acute Idio-pathic Blind Spot Enlargement Syndrome

    Institute of Scientific and Technical Information of China (English)

    Xiaocui Liu; Bing Chen; Maonian Zhang; Houbin Huang

    2014-01-01

    Purpose:.To study the clinical manifestations and the diag-nostic and differential diagnostic characteristics of acute idio-pathic blind spot enlargement syndrome (AIBSES).Methods:.Six patients diagnosed with AIBSES underwent complete eye examinations including fundus photography, fundus fluorescein angiography(FFA), indocyanine green an-giography (ICGA), optical coherence tomography (OCT), electroretinogram (ERG), and visual field examinations.Results: All patients had enlarged blind spots of variable sizes and densities..Three eyes had mild swelling of the optic disc and one eye had peripapillary scarring that corresponded to the permanent field defect. Two patients who underwent FFA had fluorescein leakage of blood vessels around the optic disc and ICGA highlighted diffuse, small hypofluorescent spots scatter-ing throughout the posterior pole..OCT showed that the inner and outer segment (IS / OS).line were absent in five patients and the middle cone outer segment tip line was absent in the nasal macular area in one eye.Conclusion: AIBSES is a rare outer retinopathy. Visual field examination and OCT are the most important means of detec-tion. ICGA and FAF can determine the range of lesions earli-er, and the progress of the disease should be taken into ac-count when making a diagnosis.(Eye Science 2014; 29:143-150)

  9. Surgical treatment of cyclosporine A- and nifedipine-induced gingival enlargement: gingivectomy versus periodontal flap.

    Science.gov (United States)

    Pilloni, A; Camargo, P M; Carere, M; Carranza, F A

    1998-07-01

    The purpose of this study was to compare probing depth resolution achieved by gingivectomy and periodontal flap techniques in the treatment of cyclosporine A- and nifedipine-induced gingival enlargement. Ten kidney transplant patients who were receiving cyclosporine A and nifedipine for at least 6 months participated in the study. Five patients were randomly assigned to the gingivectomy group and 5 patients to the periodontal flap group. Only anterior segments of the oral cavity (canine to canine) were surgically treated. Clinical measurements, including probing depths, plaque index, and gingival sulcus index, were taken at baseline, 6 weeks, 6 months, and 1 year. Results showed that probing depths, while similar for both groups in the first 6 weeks of the study, were significantly shallower for the periodontal flap group when compared to the gingivectomy group at 6 months (2.48 +/- 0.34 mm versus 4.87 +/- 0.79 mm, respectively) and 1 year (322 +/- 0.65 mm versus 6.40 +/- 1.02 mm, respectively). Within its limitations, this study suggests that the pocket reduction achieved by the periodontal flap may be sustained for longer periods of time than by the gingivectomy technique in the treatment of cyclosporine A- and nifedipine-induced gingival enlargement.

  10. Optical fiber waist-enlarged bitaper-based Michelson interferometric humidity sensor

    Science.gov (United States)

    Hu, Pengbing; Chen, Zhemin; Pan, Sunqiang; Li, Guoshui; Zhang, Jianfeng; Cheng, Jia

    2015-02-01

    An optical fiber waist-enlarged bitaper-based Michelson interferometric sensor is proposed and experimentally demonstrated for humidity measurement. The waist enlarged bitaper is created for light coupling between core mode and cladding modes propagating in the fiber interferometer. A chitason layer is plated onto the surface of the interferometer to act as a humidity-to-refractive index (RI) transducer and thus humidity measurement can be realized by monitoring the wavelength shifts of its interferogram induced by RI variations. The influence of the coating thickness and concentration of chitason on relative humidity (RH) measurement is experimentally studied. The coating sensor demonstrates an optimal humidity-sensing ability, with a humidity sensitivity and fast time-response of ~26 pm/%RH and ~5 s respectively, when it is 3-dip coated in chitason solutions of the concentration of 1 wt.%. The proposed humidity sensor is compact, cost-effective and of easy-operation, therefore it has potentials in many practical applications.

  11. ENLARGEMENT OF THE REGIONS AS A MODEL OF THE NEW ECONOMIC POLICY OF RUSSIA

    Directory of Open Access Journals (Sweden)

    Aleko Alexandrovich Adamesku

    2016-01-01

    Full Text Available At a meeting of the Council of legislators dedicated to addressing the priorities, including designated in the Message of the President of the Federal Assembly December 13, 2012 Russian President Vladimir Putin on the issue of integration of Russian regions he noted that "coarsen" should be "based on the need to better address the social-economic problems combined into larger entities. " April 27, 2016 Speaker of the Federation Council V. Matviyenko said that "it is necessary to enlarge the regions, and not just on someone's will, but having by this economic, investment and other studies." However, today, against the background of political decisions on enlargement areas necessary methodological study of issues of their eff ectiveness, the formation of methodological tools allowing to carry out a preliminary assessment and to give reasonable suggestions to relevant federal authorities on the issue of integration of regions. The article presents the historical experience of integration of regions and methodological approaches that have been put in its basis SOPS. The authors also put forward the aspects on which we must focus in continuing the policy of integration of regions at the present stage of economic development and regional policy in Russia.

  12. Cryptococcus neoformans capsular enlargement and cellular gigantism during Galleria mellonella infection.

    Directory of Open Access Journals (Sweden)

    Rocío García-Rodas

    Full Text Available We have studied infection of Cryptococcus neoformans in the non-vertebrate host Galleria mellonella with particular interest in the morphological response of the yeast. Inoculation of C. neoformans in caterpillars induced a capsule-independent increase in haemocyte density 2 h after infection. C. neoformans manifested a significant increase in capsule size after inoculation into the caterpillar. The magnitude of capsule increase depended on the temperature, being more pronounced at 37°C than at 30°C, which correlated with an increased virulence of the fungus and reduced phagocytosis at 37°C. Capsule enlargement impaired phagocytosis by haemocytes. Incubation of the yeast in G. mellonella extracts also resulted in capsule enlargement, with the polar lipidic fraction having a prominent role in this effect. During infection, the capsule decreased in permeability. A low proportion of the cells (<5% recovered from caterpillars measured more than 30 µm and were considered giant cells. Giant cells recovered from mice were able to kill the caterpillars in a manner similar to regular cells obtained from in vivo or grown in vitro, establishing their capacity to cause disease. Our results indicate that the morphological transitions exhibited by C. neoformans in mammals also occur in a non-vertebrate host system. The similarities in morphological transitions observed in different animal hosts and in their triggers are consistent with the hypothesis that the cell body and capsular responses represent an adaptation of environmental survival strategies to pathogenesis.

  13. Vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy for enlarged myomatous uterus: a randomized clinical trial

    Institute of Scientific and Technical Information of China (English)

    Fan Rong; Zhu Lan; Lang Jing-he; Shi Hong-hui; Gong Xiao-ming

    2011-01-01

    Objective:To compare the intraoperative condition and short-term outcomes of vaginal hysterectomy (VH) and laparoscopic assisted vaginal hysterectomy (LAVH) for enlarged myomatous uterus.Methods:Fifty patients from Peking Union Medical College Hospital (PUMCH) were randomly assigned to two treatment groups:VH (n=23) and LAVH (n=27).All procedures were performed by a single senior surgeon to maintain homogeneity.Results:The baseline characteristics of the two groups were comparable.The operative time for LAVH was significantly longer than for VH (76.7±23.2 vs.57.6±23.5 min,P<0.05),and LAVH costs more money than VH (6,923.07±622.96 vs.5,974.46±1,408.08 RMB,P<0.05).Major complications,uterine weight and the length of hospital stay were comparable between VH and LAVH group.One case of VH was converted to LAVH due to adhesion.Conclusions:Compared with LAVH,VH is a time- and cost-saving operative technique for enlarged myomatous uterus.VH should be the primary method for uterine removal,but LAVH may have advantages when adhesion is present.

  14. Conduit enlargement during the precursory Plinian eruption of Aira Caldera, Japan

    Science.gov (United States)

    Geshi, Nobuo; Miyabuchi, Yasuo

    2016-09-01

    Increase in magma flux as the result of conduit enlargement is one of the key processes that triggered caldera collapse and eruption of the Ito ignimbrite from Aira Caldera at ~29 ka. We examine the total volume of the pumice fall deposit, vertical variations in grain size of pumice, and the lithic content in the Osumi pumice deposit to investigate the trigger for caldera collapse. Wider distribution of the later-stage unit and the upward coarsening of grain size throughout the Osumi pumice fall deposit indicate an increase in magma discharge toward the onset of collapse. The total volume of lithic fragments in the Osumi pumice fall deposit is estimated as ~1.6 km3, based on the lithic content in several representative outcrops and the total volume of the Osumi pumice fall deposit. The lithic fragments in the Osumi pumice fall deposit indicate intense mechanical erosion of the conduit during the Plinian eruption prior to caldera collapse. Caldera collapse requires decompression of the magma chamber by withdrawal of magma; effective enlargement of the conduit diameter during precursory eruptive phases is one of the important processes that subsequently allow the rapid discharge of a large volume of magma, which in turn facilitates decompression of the reservoir and induces caldera collapse.

  15. Geometrical characteristics of the enlarged fused hard sphere models of simple molecules.

    Science.gov (United States)

    Boublík, Tomas

    2005-10-20

    The enlarged fused hard sphere model represents a compromise between fused hard sphere- and hard convex body models of repulsive interactions of nonspherical molecules. Geometric functionals of the enlarged fused hard sphere models, i.e., the hard body volume, surface area, and "mean radius" for 25 molecules of the linear and approximately planar shapes (cycloalkanes and aromatic compounds), neopentane and cyclohexane were determined from the bond lengths and bond angles and expressed in the dimensionless form. The hard sphere diameters, first approximated by the values found from the correlation of the second virial coefficients, were then adjusted to heats of vaporization of the studied compounds. Parameters of nonsphericity and molar volumes, evaluated from these characteristics, are compared with parameters of modern semiempirical equations of state (BACK, BACKONE, SAFT). The calculated geometric quantities for a series of compounds make it possible to improve methods of determining the characteristic parameters of the modern semiempirical equations of state, as well as those from the perturbation approaches.

  16. Endobronchial ultrasound guided transbronchial needle aspiration of enlarged mediastinal lymph nodes

    Directory of Open Access Journals (Sweden)

    Nadja Triller

    2005-01-01

    Full Text Available Background: Conventional transbronchial needle aspiration (TBNA of enlarged mediastinal lymph nodes is a fairly blind technique. Endobronchial ultrasound (EBUS guided TBNA resulted in higher success rate. The needle can be inserted safely into the lymph node. We examined the diagnostic yield of EBUS guided TBNA in clinical circumstances.Patients and methods: Patients with enlarged mediastinal lymph nodes, detected on chest X-ray and/or CT scan, underwent bronchoscopy. The exact location of lymph nodes was established by EBUS. 20 MHz ultrasound probe with a balloon catheter was used.Results: Seventy-five patients aged between 20 and 79 years (median age 55 years, underwent EBUS examination followed by TBNA of the target lymph node. Lymph nodes pathology was correctly diagnosed in 65 (87% of them. In 52 (70% patients the lymph nodes were infiltrated with malignoma, 13 (17% had benign diseases and in 10 (13% patients with non definitive disease the final diagnosis was obtained by surgery or by follow up. No major complication was encountered after EBUS-guided TBNA.Conclusions: Diagnostic yield of EBUS-guided TBNA is high. There were no major complications and the procedure was tolerated well.

  17. Autopsy report of disseminated histoplasmosis: An important differential of adrenal enlargement

    Directory of Open Access Journals (Sweden)

    Alka Dattaray Kalgutkar

    2015-01-01

    Full Text Available A 57-year-old diabetic male, presented with altered sensorium since 2 days. He had a history of weight loss, loss of appetite, intermittent low-grade fever of 6 months duration. He had been administered empirical antituberculous therapy some months ago with no alleviation of symptoms. On examination, he was asthenic, normotensive, and anemic with hepatosplenomegaly. Ultra-sonography abdomen revealed bilateral enlarged adrenals with hepatosplenomegaly. Clinically impression was of tuberculosis disseminated malignancy. He expired within 2 days of admission. At autopsy, both the adrenals were markedly enlarged showing extensive areas of necrosis on the cut surface. Histology showed them to be brimming with colonies of yeast-forms of Histoplasma capsulatum. These organisms were also seen in the spleen, lungs and kidneys. The patient had died of septicemia following disseminated histoplasmosis that was, unfortunately, not diagnosed during his life. Histoplasmosis is amenable to treatment with Amphotericin B. Prompt diagnosis and treatment could have helped in salvaging this patient.

  18. Alternative management of early anastomotic transplant renal artery stenosis: the prosthetic enlargement patch.

    Science.gov (United States)

    Doerfler, Arnaud; Lee-Bion, Adrien; Tillou, Xavier

    2014-04-04

    We describe a surgical technique to manage anastomotic transplant renal artery stenosis (TRAS). TRAS is one of the most common vascular complications and is usually treated by percutaneous angioplasty (PA) with good results. To our knowledge, management of early (less than a month) anastomotic TRAS with a prosthetic enlargement patch has never been described in the literature. Two men (ages 67 and 57 years) underwent deceased and living donor renal transplantation, respectively. At 1 week post-transplantation, they each presented with a tight arterial anastomotic stenosis. Because percutaneous angioplasty soon after renal transplantation has a risk of acute bleeding, it was decided that a surgical intervention should be used. Follow-up at 4 months showed that surgical addition of the prosthetic enlargement patch normalized arterial pressure and improved kidney function as documented by decreased serum creatinine levels. No surgical complications were associated with these cases. This technique provided significant benefits in terms of technical simplicity and safety. When a new anastomosis seems to be difficult to perform, this approach represents a good alternative if percutaneous angioplasty is not available or is medically unadvisable.

  19. PROGRESS AND OBSTACLES IN THE AREA OF JUSTICE AND HOME AFFAIRS IN AN ENLARGING EUROPE

    Directory of Open Access Journals (Sweden)

    Joanna Apap

    2003-09-01

    Full Text Available This article makes an assessment of the legislative achievements made so far of the objectives set by the Amsterdam Treaty and the Tampere European Council. A number of Justice and Home Affairs (JHA policy areas have experienced a major degree of development or convergence more than others. Why? This is a most sensitive field of study, which has been until now guarded very much as an area primarily of national sovereignty or where sovereignty issues could be at stake. The existence of frictions and strains can be considered as the main justification for this to happen. The way in which certain frictions between member states have affected the implementation of policy as well as how these may be further exacerbated by the forthcoming enlargement will be equally analyzed. The article is divided into two main parts: the evaluation of the main progress in implementing the Tampere Scoreboard on the eve of enlargement, as well as the analysis of the reasons why some JHA policy areas have not achieved the expected level of development.

  20. How do plants enlarge? A balancing act. Workship on plant growth: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Boyer, J.S.

    1996-12-31

    There are signals that coordinate the development of various plant parts and thus the rates of enlargement of various plant parts and these were explored during the workshop. The participants tried to systematize their knowledge and identify over-arching concepts that need more investigation. It was generally agreed that the cell wall cannot be viewed as a passive plastic material. Synthesis and deposition take place and cause changes in the molecular architecture of the wall. Questions arise from the fact that the wall is not a constant or uniform structure but undergoes highly organized changes during enlargement while bearing a considerable load. Recent advances in signaling, biochemical analysis and ultrastructure visualization are beginning to relate to the molecular load-bearing and enzymatic activities in the wall. The participants agreed that there probably is enough information to begin developing a comprehensive model that would balance wall effects with the limitation of growth by transport, especially for water, and this could help clarify events occurring at different time scales and places. Beyond that, there seems to be a need to resolve problems of solute transport and wall behavior that are poorly understood in growing regions, leaving many promising areas for future experiments. Understanding each balancing act seems to be just the beginning.

  1. Diagnostic assessment of enlarged superficial lymph nodes by fine needle aspiration.

    Science.gov (United States)

    Pilotti, S; Di Palma, S; Alasio, L; Bartoli, C; Rilke, F

    1993-01-01

    Two hundred eighty-five consecutive outpatients with enlarged superficial lymph node either clinically suspicious (152) or with a previous diagnosis of a malignant tumor (133) underwent fine needle aspiration (FNA) followed by excisional biopsy. Cytologic and/or cytologic-immunophenotypic diagnoses made on direct smears were compared with subsequent histologic findings. The comparison demonstrated (1) a high rate of conclusive cytologic diagnoses in the assessment of metastatic malignancies, with an overall accuracy rate of 99.1% and a typing accuracy rate of 96.5%; (2) a high rate of conclusive diagnoses in the assessment of high grade non-Hodgkin's lymphomas and Hodgkin's disease, with the exception of the lymphocytic predominance variant of the latter; and (3) significant limitations in the assessment of low grade non-Hodgkin's lymphomas because of the high rate of false-negative diagnoses in cases with a substantial nonmalignant cell component. This was particularly evident in follicular centroblastic-centrocytic lymphomas. Immunocytochemistry appeared to be of limited value in the distinction between centroblastic-centrocytic follicular lymphomas and reactive follicular hyperplasia. The results confirmed the diagnostic value of fine needle aspiration as the first step in the workup of patients with nodal enlargement suspicious for malignancy. In the area of low grade non-Hodgkin's lymphomas, morphologic and immunocytochemical methods need to be supplemented by molecular techniques in order to achieve conclusive diagnoses.

  2. Optimization of membrane stack configuration in enlarged microbial desalination cells for efficient water desalination

    Science.gov (United States)

    Chen, Xi; Sun, Haotian; Liang, Peng; Zhang, Xiaoyuan; Huang, Xia

    2016-08-01

    Microbial desalination cells are considered a low-energy-consumption, clean technology to simultaneously purify wastewater and desalinate saline water by utilizing the in situ energy source contained in wastewater. To enhance desalination performance and achieve an optimal membrane stack configuration, an enlarged stacked microbial desalination cell (SMDC) has been developed and tested with 6-14 desalination cells. The cross-membrane area of the enlarged SMDC is 100 cm2. The anode and cathode volumes are both 200 mL. To reduce internal resistance, the width of desalination cells is kept as <0.5 mm. The optimal configuration with 10 desalination cells achieves the highest total desalination rate (TDR) of 423 mg/h and the highest charge transfer efficiency (CTE) of 836% when treating the 20 g/L NaCl solution. During this process, the junction potential across membranes increases from 0 to 374 mV, and occupies up to 74% of the total potential loss inside the SMDC. This shows that the SMDC used in this work achieves the highest TDR and CTE among the reported studies, and the junction potential should be effectively controlled to achieve the desired desalination performance in future practical applications.

  3. The Eurosafe Forum 2003: Nuclear expertise and challenges of the enlargement of the European Union

    Energy Technology Data Exchange (ETDEWEB)

    Lacronique, Jean-Francois; Repussard, Jacques (eds.) [Institut de Radioprotection et de Surete Nucleaire, IRSN, B.P. 17, F - 92262 Fontenay-aux-Roses Cedex (France); Hahn, Lothar (ed.) [Gesellschaft fuer Anlagen- und Reaktorsicherheit mbH, GRS, Schwertnergasse 1, D - 50667 Koeln (Germany)

    2003-07-01

    EUROSAFE is an international forum for discussions among experts from technical safety organisations, research institutes, safety authorities, utilities, the industry, public authorities and non-governmental organisations concerning the status of and recent achievements in nuclear installation safety, waste management, radiation safety and nuclear material security. The Eurosafe Forum 2003 - the fifth of its kind - was held at the Palais Brongniart in Paris on November 25 and 26, 2003. This year's theme was: 'Nuclear expertise and challenges of the enlargement of the European Union: speakers in the various European countries about the environmental scan before enlargement, development and structuring perspectives within the enlarged Europe'. The event brought together 445 experts and researchers from around the world (including 124 from Germany, 184 from France, 88 from Eastern Europe, as well as representatives from Korea, Japan, the United States, Canada, Cuba, and Armenia. The proceedings of the symposium can now be consulted online. The fifth edition of the forum focused on nuclear expertise and the challenge of EU-enlargement and the latest work carried out by GRS, IRSN and their partners from the European Union, Switzerland and Eastern Europe. Nuclear energy contributes approximately one third of European electricity production. A high level of nuclear safety is a priority for the countries of Europe. The technical safety organisations play an important role in contributing to that objective through appropriate approaches to major safety issues as part of their assessments and research activities. The challenges to nuclear safety are increasingly international. Changes in underlying technologies such as instrumentation and control, the impact of electricity market deregulation, demands for improved safety, the ageing of nuclear facilities, waste management, maintaining and improving scientific and technical knowledge and the need for greater

  4. Adipose tissue dysregulation and reduced insulin sensitivity in non-obese individuals with enlarged abdominal adipose cells.

    Science.gov (United States)

    Hammarstedt, Ann; Graham, Timothy E; Kahn, Barbara B

    2012-09-19

    Obesity contributes to Type 2 diabetes by promoting systemic insulin resistance. Obesity causes features of metabolic dysfunction in the adipose tissue that may contribute to later impairments of insulin action in skeletal muscle and liver; these include reduced insulin-stimulated glucose transport, reduced expression of GLUT4, altered expression of adipokines, and adipocyte hypertrophy. Animal studies have shown that expansion of adipose tissue alone is not sufficient to cause systemic insulin resistance in the absence of adipose tissue metabolic dysfunction. To determine if this holds true for humans, we studied the relationship between insulin resistance and markers of adipose tissue dysfunction in non-obese individuals. 32 non-obese first-degree relatives of Type 2 diabetic patients were recruited. Glucose tolerance was determined by an oral glucose tolerance test and insulin sensitivity was measured with the hyperinsulinaemic-euglycaemic clamp. Blood samples were collected and subcutaneous abdominal adipose tissue biopsies obtained for gene/protein expression and adipocyte cell size measurements. Our findings show that also in non-obese individuals low insulin sensitivity is associated with signs of adipose tissue metabolic dysfunction characterized by low expression of GLUT4, altered adipokine profile and enlarged adipocyte cell size. In this group, insulin sensitivity is positively correlated to GLUT4 mRNA (R = 0.49, p = 0.011) and protein (R = 0.51, p = 0.004) expression, as well as with circulating adiponectin levels (R = 0.46, 0 = 0.009). In addition, insulin sensitivity is inversely correlated to circulating RBP4 (R = -0.61, 0 = 0.003) and adipocyte cell size (R = -0.40, p = 0.022). Furthermore, these features are inter-correlated and also associated with other clinical features of the metabolic syndrome in the absence of obesity. No association could be found between the hypertrophy-associated adipocyte

  5. Adipose tissue dysregulation and reduced insulin sensitivity in non-obese individuals with enlarged abdominal adipose cells

    Directory of Open Access Journals (Sweden)

    Hammarstedt Ann

    2012-09-01

    Full Text Available Abstract Background Obesity contributes to Type 2 diabetes by promoting systemic insulin resistance. Obesity causes features of metabolic dysfunction in the adipose tissue that may contribute to later impairments of insulin action in skeletal muscle and liver; these include reduced insulin-stimulated glucose transport, reduced expression of GLUT4, altered expression of adipokines, and adipocyte hypertrophy. Animal studies have shown that expansion of adipose tissue alone is not sufficient to cause systemic insulin resistance in the absence of adipose tissue metabolic dysfunction. To determine if this holds true for humans, we studied the relationship between insulin resistance and markers of adipose tissue dysfunction in non-obese individuals. Method 32 non-obese first-degree relatives of Type 2 diabetic patients were recruited. Glucose tolerance was determined by an oral glucose tolerance test and insulin sensitivity was measured with the hyperinsulinaemic-euglycaemic clamp. Blood samples were collected and subcutaneous abdominal adipose tissue biopsies obtained for gene/protein expression and adipocyte cell size measurements. Results Our findings show that also in non-obese individuals low insulin sensitivity is associated with signs of adipose tissue metabolic dysfunction characterized by low expression of GLUT4, altered adipokine profile and enlarged adipocyte cell size. In this group, insulin sensitivity is positively correlated to GLUT4 mRNA (R = 0.49, p = 0.011 and protein (R = 0.51, p = 0.004 expression, as well as with circulating adiponectin levels (R = 0.46, 0 = 0.009. In addition, insulin sensitivity is inversely correlated to circulating RBP4 (R = −0.61, 0 = 0.003 and adipocyte cell size (R = −0.40, p = 0.022. Furthermore, these features are inter-correlated and also associated with other clinical features of the metabolic syndrome in the absence of obesity. No association could be found

  6. Three-dimensional interactive and stereotactic atlas of head muscles and glands correlated with cranial nerves and surface and sectional neuroanatomy.

    Science.gov (United States)

    Nowinski, Wieslaw L; Chua, Beng Choon; Johnson, Aleksandra; Qian, Guoyu; Poh, Lan Eng; Yi, Su Hnin Wut; Bivi, Aminah; Nowinska, Natalia G

    2013-04-30

    Three-dimensional (3D) relationships between head muscles and cranial nerves innervating them are complicated. Existing sources present these relationships in illustrations, radiologic scans, or autopsy photographs, which are limited for learning and use. Developed electronic atlases are limited in content, quality, functionality, and/or presentation. We create a truly 3D interactive, stereotactic and high quality atlas, which provides spatial relationships among head muscles, glands and cranial nerves, and correlates them to surface and sectional neuroanatomy. The head muscles and glands were created from a 3T scan by contouring them and generating 3D models. They were named and structured according to Terminologia anatomica. The muscles were divided into: extra-ocular, facial, masticatory and other muscles, and glands into mouth and other glands. The muscles, glands (and also head) were placed in a stereotactic coordinate system. This content was integrated with cranial nerves and neuroanatomy created earlier. To explore this complex content, a scalable user interface was designed with 12 modules including central nervous system (cerebrum, cerebellum, brainstem, spinal cord), cranial nerves, muscles, glands, arterial system, venous system, tracts, deep gray nuclei, ventricles, white matter, visual system, head. Anatomy exploration operations include compositing/decompositing, individual/group selection, 3D view-index mapping, 3D labeling, highlighting, distance measuring, 3D brain cutting, and axial/coronal/sagittal triplanar display. To our best knowledge, this is the first truly 3D, stereotactic, interactive, fairly complete atlas of head muscles, and the first attempt to create a 3D stereotactic atlas of glands. Its use ranges from education of students and patients to research to potential clinical applications.

  7. Experiment K-7-29: Connective Tissue Studies. Part 3; Rodent Tissue Repair: Skeletal Muscle

    Science.gov (United States)

    Stauber, W.; Fritz, V. K.; Burkovskaya, T. E.; Ilyina-Kakueva, E. I.

    1994-01-01

    Myofiber injury-repair was studied in the rat gastrocnemius following a crush injury to the lower leg prior to flight in order to understand if the regenerative responses of muscles are altered by the lack of gravitational forces during Cosmos 2044 flight. After 14 days of flight, the gastrocnemius muscle was removed from the 5 injured flight rodents and various Earth-based treatment groups for comparison. The Earth-based animals consisted of three groups of five rats with injured muscles from a simulated, tail-suspended, and vivarium as well as an uninjured basal group. The gastrocnemius muscle from each was evaluated by histochemical and immunohistochemical techniques to document myofiber, vascular, and connective tissue alterations following injury. In general the repair process was somewhat similar in all injured muscle samples with regard to extracellular matrix organization and myofiber regeneration. Small and large myofibers were present with a newly organized extracellular matrix indicative of myogenesis and muscle regeneration. In the tail-suspended animals, a more complete repair was observed with no enlarged area of non-muscle cells or matrix material visible. In contrast, the muscle samples from the flight animals were less well differentiated with more macrophages and blood vessels in the repair region but small myofibers and proteoglycans, nevertheless, were in their usual configuration. Thus, myofiber repair did vary in muscles from the different groups, but for the most part, resulted in functional muscle tissue.

  8. Diffusion-weighted MRI of denervated muscle: a clinical and experimental study

    Energy Technology Data Exchange (ETDEWEB)

    Holl, Nathalie; Bierry, Guillaume; Moser, Thomas; Dietemann, Jean-Louis; Kremer, Stephane [Hopitaux Universitaires de Strasbourg, Service de Radiologie 2, Strasbourg (France); Echaniz-Laguna, Andoni [Hopitaux Universitaires de Strasbourg, Departement de Neurologie, BP 426, Strasbourg (France); Mohr, Michel [Hopitaux Universitaires de Strasbourg, Departement d' Anatomie Pathologique, Strasbourg (France); Loeffler, Jean-Philippe [INSERM U692, Laboratoire de Signalisations Moleculaires et Neurodegenerescence, Faculte de Medecine, Strasbourg (France)

    2008-12-15

    The aim of this study was to investigate skeletal muscle denervation using diffusion-weighted magnetic resonance imaging (DWMRI). Sciatic nerve axotomy was performed in a group of nine New Zealand White rabbits, and electromyographic (EMG), pathological, and DWMRI studies were conducted on ipsilateral hamstring muscles 1 and 8 days after axotomy. In addition, DWMRI studies were carried out on leg muscles of ten patients with acute and subacute lumbosacral radiculopathy. High intensity signals on short tau inversion recovery (STIR) magnetic resonance imaging and an increased apparent diffusion coefficient (ADC) were observed in denervated muscles of the animals 1 and 8 days after axotomy as well as in denervated muscles of the patients with radiculopathy. In the clinical study, ADC was 1.26{+-}0.18 x 10{sup -9} m{sup 2}/s in normal muscle and increased to 1.56{+-}0.23 x 10{sup -9} m{sup 2}/s in denervated muscles (p =0.0016). In animals, EMG and muscle pathological studies were normal 1 day after axotomy, and the muscles demonstrated spontaneous activity on EMG and neurogenic atrophy on histological studies 7 days later. This DWMRI study demonstrates that enlargement of extracellular fluid space in muscle denervation is an early phenomenon occurring several days before the appearance of EMG and histological abnormalities. (orig.)

  9. Experiment K-7-29: Connective Tissue Studies. Part 3; Rodent Tissue Repair: Skeletal Muscle

    Science.gov (United States)

    Stauber, W.; Fritz, V. K.; Burkovskaya, T. E.; Ilyina-Kakueva, E. I.

    1994-01-01

    Myofiber injury-repair was studied in the rat gastrocnemius following a crush injury to the lower leg prior to flight in order to understand if the regenerative responses of muscles are altered by the lack of gravitational forces during Cosmos 2044 flight. After 14 days of flight, the gastrocnemius muscle was removed from the 5 injured flight rodents and various Earth-based treatment groups for comparison. The Earth-based animals consisted of three groups of five rats with injured muscles from a simulated, tail-suspended, and vivarium as well as an uninjured basal group. The gastrocnemius muscle from each was evaluated by histochemical and immunohistochemical techniques to document myofiber, vascular, and connective tissue alterations following injury. In general the repair process was somewhat similar in all injured muscle samples with regard to extracellular matrix organization and myofiber regeneration. Small and large myofibers were present with a newly organized extracellular matrix indicative of myogenesis and muscle regeneration. In the tail-suspended animals, a more complete repair was observed with no enlarged area of non-muscle cells or matrix material visible. In contrast, the muscle samples from the flight animals were less well differentiated with more macrophages and blood vessels in the repair region but small myofibers and proteoglycans, nevertheless, were in their usual configuration. Thus, myofiber repair did vary in muscles from the different groups, but for the most part, resulted in functional muscle tissue.

  10. A muscle stem cell for every muscle: variability of satellite cell biology among different muscle groups

    OpenAIRE

    Matthew Emerson Randolph; Pavlath, Grace K.

    2015-01-01

    The human body contains approximately 640 individual skeletal muscles. Despite the fact that all of these muscles are composed of striated muscle tissue, the biology of these muscles and their associated muscle stem cell populations are quite diverse. Skeletal muscles are affected differentially by various muscular dystrophies, such that certain genetic mutations specifically alter muscle function in only a subset of muscles. Additionally, defective muscle stem cells have been implicated in t...

  11. Muscle strain injuries.

    Science.gov (United States)

    Garrett, W E

    1996-01-01

    One of the most common injuries seen in the office of the practicing physician is the muscle strain. Until recently, little data were available on the basic science and clinical application of this basic science for the treatment and prevention of muscle strains. Studies in the last 10 years represent action taken on the direction of investigation into muscle strain injuries from the laboratory and clinical fronts. Findings from the laboratory indicate that certain muscles are susceptible to strain injury (muscles that cross multiple joints or have complex architecture). These muscles have a strain threshold for both passive and active injury. Strain injury is not the result of muscle contraction alone, rather, strains are the result of excessive stretch or stretch while the muscle is being activated. When the muscle tears, the damage is localized very near the muscle-tendon junction. After injury, the muscle is weaker and at risk for further injury. The force output of the muscle returns over the following days as the muscle undertakes a predictable progression toward tissue healing. Current imaging studies have been used clinically to document the site of injury to the muscle-tendon junction. The commonly injured muscles have been described and include the hamstring, the rectus femoris, gastrocnemius, and adductor longus muscles. Injuries inconsistent with involvement of a single muscle-tendon junction proved to be at tendinous origins rather than within the muscle belly. Important information has also been provided regarding injuries with poor prognosis, which are potentially repairable surgically, including injuries to the rectus femoris muscle, the hamstring origin, and the abdominal wall. Data important to the management of common muscle injuries have been published. The risks of reinjury have been documented. The early efficacy and potential for long-term risks of nonsteroidal antiinflammatory agents have been shown. New data can also be applied to the field

  12. Botulinum Neurotoxin A for Parotid Enlargement in Cystic Fibrosis: The First Case Report.

    Science.gov (United States)

    El Khoury, Joseph; Habre, Samer; Nasr, Marwan; Hokayem, Nabil

    2016-09-01

    Cystic fibrosis (CF) is the most common lethal autosomal recessive genetic disease associated with exocrine gland dysfunction. Salivary gland involvement is a common finding. The literature on submaxillary gland involvement has failed to address the parotid gland and any specific treatment of salivary gland manifestations of CF. Treatment is mainly symptomatic, consisting of analgesics, gustatory stimulation, and massage. Salivary secretion has clearly been linked to parasympathetic and sympathetic signals through intracellular calcium release. CF alters salivary composition with increased calcium and phosphorus concentrations and causes histologic changes (duct enlargement, dilation of acini, and abnormal mucous plugs). This study investigated whether botulinum toxin injected into the parotid gland during an acute exacerbation of CF-associated salivary gland disease could alleviate pain and control future exacerbations.

  13. Primary intraoral granulocytic sarcoma: A rare case presenting as generalized gingival enlargement

    Directory of Open Access Journals (Sweden)

    Thayalan Dineshkumar

    2016-01-01

    Full Text Available Granulocytic sarcoma (GS is an extremely rare condition involving infiltration of myeloblasts or immature myeloid cells in an extramedullary site. It is also known as chloroma, myeloid sarcoma or extramedullary myeloid tumor. It usually occurs concomitantly with acute myelogenous leukemia or with the onset of blastic phase of chronic myelogenous leukemia. On rare occasions, it evolves even before the onset of leukemias, and when it precedes leukemias without any overt signs, it is referred to as the primary type. Although GSs can involve any body part, localization in the oral cavity is extremely rare. The recognition of this rare primary entity is important because early aggressive chemotherapy can cause regression of the tumor and improve survival. Here, we report a rare case of GS in a nonleukemic 62-year-old female who presented with generalized gingival enlargement involving both maxilla and mandible.

  14. The “transforming power” of EU Enlargement policy in Serbia. An anthropological reflection

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    Francesco Florindi

    2012-05-01

    Full Text Available The enlargement process of the European Union contributed substantially to the harmonisation of legal systems over the continent. The article provides an anthropological critique to the way harmonisation to EU law is implemented in the Balkans, underlining the general lack of awareness by both Serbian government and the EU of Serbian social and legal systems. While applying the anthropological method to EU law’s effects in Serbia, the author investigates also the inner value of the EU project itself. For instance the State's failure to regulate anti-corruption matters has been experienced even when the State's provision in question were in full compliance with several other international obligations and with a positively hierarchically superior legal system: the Constitution.

  15. Endovascular conversion with femorofemoral bypass as a treatment of endotension and aneurysm sac enlargement.

    Science.gov (United States)

    Smith, Stephen T; Clagett, G Patrick; Arko, Frank R

    2007-02-01

    We report a case of a patient treated with a Gore Excluder endograft for AAA in November 2003 with subsequent aneurysm sac enlargement in the absence of an identified endoleak. The patient had a Type I endoleak treated with a Palmaz stent at the neck and later developed a Type II endoleak treated with translumbar coil embolization. This was successful with absence of pressure in the sac after the procedure and stable aneurysm size over the next nine months. Surveillance of the patient with both CT and ultrasound then revealed an increase in the aortic sac diameter in the absence of endoleak. A Cook Zenith converter was used to reline this PTFE endograft. Subsequently, imaging showed aneurysm sac shrinkage. This is a report of endotension with aneurysm expansion following Gore Excluder placement which was treated successfully with a dacron endograft.

  16. Lysosomal enlargement and lysosomal membrane destabilisation in mussel digestive cells measured by an integrative index

    Energy Technology Data Exchange (ETDEWEB)

    Izagirre, Urtzi [Cell Biology in Environmental Toxicology Research Group, Department of Zoology and Cell Biology, School of Sciences and Technology, University of the Basque Country, P.O. box 644, E-48080 Bilbo (Spain); Marigomez, Ionan, E-mail: ionan.marigomez@ehu.e [Cell Biology in Environmental Toxicology Research Group, Department of Zoology and Cell Biology, School of Sciences and Technology, University of the Basque Country, P.O. box 644, E-48080 Bilbo (Spain)

    2009-05-15

    Lysosomal responses (enlargement and membrane destabilisation) in mussel digestive cells are well-known environmental stress biomarkers in pollution effects monitoring in marine ecosystems. Presently, in laboratory and field studies, both responses were measured separately (in terms of lysosomal volume density - Vv - and labilisation period -LP) and combined (lysosomal response index - LRI) in order to contribute to their understanding and to develop an index useful for decisions makers. LRI integrates Vv and LP, which are not necessarily dependent lysosomal responses. It is unbiased and more sensitive than Vv and LP alone and diminishes background due to confounding factors. LRI provides a simple numerical index (consensus reference = 0; critical threshold = 1) directly related to the pollution impact degree. Moreover, LRI can be represented in a way that allows the interpretation of lysosomal responses, which is useful for environmental scientists. - Lysosomal responses to pollutants measured by an integrative index.

  17. Sinus histiocytosis with massive lymphadenopathy. Is the lymph node enlargement always massive?

    Science.gov (United States)

    Sachdev, Ritesh; Setia, Namrata; Jain, Shyama

    2007-05-01

    Sinus histiocytosis with massive lymphadenopathy (SHML) is a benign proliferating histiocytic disorder, predominantly of lymph nodes with extra-nodal involvement in some cases. It is a self-limiting disease and has a good prognosis; however some patients need steroid therapy. Therein lays a need to differentiate it from other lympho proliferative disorders of poorer prognosis. Clinically, it is suspected only when there is a significant lymph node enlargement in younger age group as the term signifies. Recently, we came across a case where a middle-aged female presented with a subtle swelling in submental region, clinically suspected of reactive or tubercular etiology. However on fine needle aspiration cytology, the smears showed many histiocytes, some of them showing lymphocytes and plasma cells in their cytoplasm, a morphological feature called as "emperipolesis" classically seen in SHML. The present case is reported because of unusual clinical presentation and possibly the need for a revision of existing terminology.

  18. Fixed Size of Enlarged Calcified Lymph Nodes in Esophageal Adenocarcinoma despite Complete Remission

    Directory of Open Access Journals (Sweden)

    B.A. Grotenhuis

    2009-07-01

    Full Text Available Untreated malignant lymph nodes that are calcified are rare. Publications on such calcifications are restricted to case reports. We present a case of calcified lymph nodes in a patient with adenocarcinoma of the gastroesophageal junction that seemed to be nonresponsive to induction chemotherapy, as they did not decrease in size. However, on pathological examination of the resected lymph nodes no vital tumor cells could be detected anymore. Therefore, we hypothesize that a calcified lymph node is unable to shrink, even after adequate remission on induction chemotherapy. This should be taken into account when clinical decision-making depends on the change in size of an enlarged, calcified lymph node as a measure of treatment effect.

  19. A case report of gingival enlargement associated with invasive cervical resorption.

    Science.gov (United States)

    Bal, M V; Yıldırım, Ş; Saygun, I

    2015-01-01

    Invasive cervical resorption (ICR) is a rare external dental resorption with unknown etiology; it progresses asymptomatically in the cervical area of the permanent teeth. Lesions are mostly misdiagnosed as internal resorption or caries, which leads to erroneous treatments. This case report presents the clinical and radiological diagnosis, as well as the results of treatment and 3-year follow-up in a 50-year-old female patient with gingival enlargement associated with ICR in tooth No. 25. Granulation tissue was removed by accessing the cervical resorption area through a flap operation. Following the endodontic treatment, the tooth was restored using composite resin and the hyperplastic lesion was excised. In conclusion, it should be kept in mind that clinical, radiological, and pathological evaluation in the differential diagnosis of localized hyperplastic lesions in the gingiva is of importance and that ICR could play a role in the etiology of these lesions.

  20. Enlarged test catalysts during the hydrogenation of 1,4-butynediol to 1,4-butanediol

    Directory of Open Access Journals (Sweden)

    Zhaksyntay Kairbekov

    2013-09-01

    Full Text Available The highly effective catalyzer for butynediol-1;4 hydrogenation was designed and synthesized. Enlarged tests showed that the selectivity on butanediol-1.4 at the hydrogenation of butynediol-1.4 on the alloyed catalyst SKN-39H during 320 h was 84.6 %; that on 18 % higher than for  industrial MNH. The yield of product on the catalyst SKN-39 increases slowly from 3.1 to 7.3 % when on a catalyst MNH – 7.1 to 11.7 % from the initial content of butynediol-1;4. At the hydrogenation of  butynediol on catalyst SKN-39H process efficiency increases in 1.5-2 times and product purity on 2-3 % is higher in comparing with the industrial catalyst MNH. 

  1. About a peri-Gondwanan-North African enlarged acceptance of the Caledonian Orogeny

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    Ioan Balintoni

    2011-04-01

    Full Text Available The notion of “Caledonian Orogeny” is restricted by most authors to the Ordovician-Devonian thermotectonic events associated with the Laurentia-Baltica- Avalonia suturing. However, some views consider an orogeny as the sum of tectonic, metamorphic and magmatic events accompanying an entire supercontinent assembly or Wilson cycle. Following this line of thinking, the Caledonian and Variscan orogenies successively assembled Pangea. During the Ordovician Period, rifting, collision, deformation, metamorphism and magmatism took place within the Gondwana margin. All these events are known today in the basement of the Cadomian terranes from Iberia through the Alps up to the Romanian Carpathians and Balkans. We plead here for an enlargement of the “Caledonian Orogeny” terminology to these events and places, under the name of the “Caledonian North African orogenic event" or "Caledonian North African orogeny"

  2. [A patient with muscular torticollis caused by nodular fasciitis in the sternocleidomastoid muscle (SCM)].

    Science.gov (United States)

    Hemmi, Shoji; Murakami, Tatufumi; Shirabe, Teruo; Sunada, Yoshihide

    2002-09-01

    Nodular fasciitis is a benign pseudosarcomatous proliferative lesion which is frequently misdiagnosed as malignant tumor clinically and microscopically. It usually occurs as a rapidly enlarging subcutaneous mass on the upper extremities, especially on the forearm. Here we report a patient showing muscular torticollis caused by nodular fasciitis in the sternocleidomastoid muscle (SCM). A 17-year-old woman was hospitalized because of rapidly progressive torticollis. The right SCM was markedly enlarged and firm on palpation. Muscle biopsy taken from the right SCM revealed massive proliferation of spindle shaped fibroblasts infiltrating into the endomysium. These findings coincided with the intramuscular nodular fasciitis. However, different from typical nodular fasciitis, no apparent nodule formation was found in this patient. Instead, diffuse proliferative lesion extended widely into the neck soft tissue. To our knowledge, this is the first report of muscular torticollis caused by nodular fasciitis involving the SCM.

  3. Parotid enlargement due to adenovirus infection in patient with human immunodeficiency virus infection

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    Maria Irma Seixas Duarte

    1996-10-01

    Full Text Available The authors report a case of adenovirus- induced enlargement of the parotid gland involving a patient infected with human immunodeficiency virus (HIV. Physical examination revealed good general condition, no fever and bilateral enlargement of the parotid region, which was of increased consistency and slightly tender to palpation. Histological examination of the parotid gland demonstrated a slight periductal lymphomononuclear inflammatory infiltrate with the presence of focal points of necrosis. Tests to determine the presence of fungi and alcohol-acid resistent bacilli were negative. Immunohistochemistry for cytomegalovirus, heipes simplex, HIV p24 antigen and adenovirus showed positivity only for adenovirus in the epithelial nuclei of numerous gland ducts. Tins is the third case of this type reported in the literature, indicating the importance of including adenovirus in the differential diagnosis of this condition.Os autores relatam um caso de aumento da glândula parótida ocasionado por adenovirus, em paciente infectado pelo vírus da imunodeficiência humana. Ao exame físico, este se apresentava em bom estado geral, afebril e com aumento bilateral de parõtidas, de consistência aumentada e discretamente dolorosas ã palpação. O exame histológico da parótida demonstrou discreto infiltrado inflamatório linfomononuclear periductal com presença de focos de necrose, as pesquisas para fungos e bacilos ãlcool ãcido resistentes foram negativas. A técnica de imuno-histoquímica para citomegalovírus, beipes simples, antígeno p24 do HIVe adenovirus, somente evidenciou posítividade para o último. Este é o terceiro caso descrito na literatura, destacando a importância de incluir o adenovíms, no diagnóstico diferencial, deste acometimento.

  4. The M1 muscarinic antagonist pirenzepine reduces myopia and eye enlargement in the tree shrew.

    Science.gov (United States)

    Cottriall, C L; McBrien, N A

    1996-06-01

    To determine the efficacy of the M1-selective muscarinic antagonist, pirenzepine, in preventing experimentally induced myopia in a mammalian model, the tree shrew. Tree shrews were monocularly deprived (MD) using translucent goggles or negative lenses for a period of 12 days. In two of the MD groups, tree shrews received daily subconjunctival administration of either pirenzepine (17.7 mumol; n = 9) or vehicle control (n = 6). Control groups (n = 6) were used to assess the effects of MD, injection regimen, and drug effects. In sham-injected and saline-injected MD tree shrews, 12 days of MD produced-13.2 D +/- 0.8 D and -14.1 D +/- 0.5 D of axial myopia, respectively. In pirenzepine-injected MD tree shrews, 12 days of MD induced an axial myopia of only -2.1 D +/- 1.4 D. The significant reduction in myopia in pirenzepine-injected MD tree shrews was caused by significantly less vitreous chamber elongation of the deprived eye (0.05 mm +/- 0.04 mm) relative to the contralateral control eye when compared to sham-injected and saline-injected MD tree shrews (0.24 mm +/- 0.02 mm and 0.29 mm +/- 0.01 mm). Mean equatorial enlargement and increased eye weight were prevented in pirenzepine-injected MD tree shrews (P Pirenzepine also was found to reduce myopia and ocular enlargement in lens defocus-induced myopia. Control experiments demonstrated that pirenzepine did not cause a significant reduction in amplitude of carbachol-induced accommodation. Findings demonstrate that chronic administration of the M1-selective muscarinic antagonist, pirenzepine, prevents experimentally induced myopia in this mammalian model by a nonaccommodative mechanism.

  5. Compensatory enlargement in transplant coronary artery disease: an intravascular ultrasound study

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background It is unclear to what extent the "Glagov phenomenon" occurs in transplant coronary artery disease (TCAD). The objective of this study was to evaluate the relationship between intimal hyperplasia and compensatory enlargement in TCAD. Methods Intravascular ultrasound imaging was performed on 190 cardiac transplant recipients at (1.4±0.6) months and again (12.1±0.7) months after cardiac transplantation. Studies 1 year apart were matched at 625 sites. There were 345 coronary artery sites that had an increase in intimal area >10% from baseline to one year, and this comprised the data set of the present study. Results At the first year, 91% of coronary artery sites with intimal growth had a total cross-sectional area stenosis ≤40%, but 38% of the sites showed a decrease of >10% in lumen area. Receiver operating characteristic curve demonstrated that the change in cross-sectional area stenosis cut-off level at year 1 was 8% with a sensitivity of 75% and a specificity of 82% in predicting lumen loss. At a total cross-sectional area stenosis of 20%, sensitivity was 65% with a specificity of 81% in predicting lumen loss. Conclusions In TCAD, vessel enlargement as a compensatory mechanism for plaque growth is generally inadequate. Instead of continued vessel expansion, luminal narrowing develops when there is more than 8% cross-sectional area filled with intimal hyperplasia. In distinction to native coronary artery atherosclerotic disease, the transition point in transplant vasculopathy where the lumen is diminished by increasing intimal growth, occurs at a lower threshold, 20% vs 40% of vessel cross-sectional area.

  6. Compensatory enlargement of Ossabaw miniature swine coronary arteries in diffuse atherosclerosis

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    Jenny S. Choy

    2015-03-01

    Full Text Available Studies in human and non-human primates have confirmed the compensatory enlargement or positive remodeling (Glagov phenomenon of coronary vessels in the presence of focal stenosis. To our knowledge, this is the first study to document arterial enlargement in a metabolic syndrome animal model with diffuse coronary artery disease (DCAD in the absence of severe focal stenosis. Two different groups of Ossabaw miniature pigs were fed a high fat atherogenic diet for 4 months (Group I and 12 months (Group II, respectively. Group I (6 pigs underwent contrast enhanced computed tomographic angiography (CCTA and intravascular ultrasound (IVUS at baseline and after 4 months of high fat diet, whereas Group II (7 pigs underwent only IVUS at 12 months of high fat diet. IVUS measurements of the left anterior descending (LAD, left circumflex (LCX and right coronary (RCA arteries in Group I showed an average increase in their lumen cross-sectional areas (CSA of 25.8%, 11.4%, and 43.4%, respectively, as compared to baseline. The lumen CSA values of LAD in Group II were found to be between the baseline and 4 month values in Group I. IVUS and CCTA measurements showed a similar trend and positive correlation. Fractional flow reserve (FFR was 0.91 ± 0.07 at baseline and 0.93 ± 0.05 at 4 months with only 2.2%, 1.6% and 1% stenosis in the LAD, LCX and RCA, respectively. The relation between percent stenosis and lumen CSA shows a classical Glagov phenomenon in this animal model of DCAD.

  7. The Border-making Policy of the European Union: Eastern Enlargement

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    Lika Mkrtchyan

    2012-12-01

    Full Text Available Having no internal borders, what is a border for the European Union (EU? Which criteria does this powerful organization pursue in its decision-making on further expansion: geographical, political, cultural, economic or all of these? What is the profi t of the Union in advancing its external borders to the east? And why to the east and not the south or west across the Atlantic? Does it still mean that there is the reason for enlarging eastward based on the geographical belonging to Europe? This paper discusses the expansion of the European Union to the east with the main focus on its political and economic aspects of integration. The fi rst part includes introduction to the concept of Europe, historic background about the formation of the united Europe in terms of geography, culture, politics and economy, juxtaposing opinions and viewpoints of different experts and political scientists on “what is Europe?” and what are the core issues of its enlargement. The second and third parts are dedicated to the advantages and disadvantages of European Integration for both parties concerned – the EU and the candidate/member state, in the case of the former having its own “demarcation policy” towards certain regions of the continent when it comes to unifi cation. And the fourth part is about the communication and miscommunication of the informative bodies of the European Union that are responsible for public awareness on any process that goes on within the European family. The lack of information results in the ignorance of citizens of European and partner countries, which, of course, refl ects on the further processes of expansion on the political level and cultural perception and mentality on the social level. The conclusion sums up the research, and the bibliography lists the books, articles, monographs and Internet sources used in the course of the study.

  8. Enlarged vestibular aqueduct (EVA) related with recurrent benign paroxysmal positional vertigo (BPPV).

    Science.gov (United States)

    Manzari, Leonardo

    2008-01-01

    The vestibular aqueduct is a bony canal related to the bony labyrinth of the inner ear and represents the non-sensory components of the endolymph-filled, closed, membranous labyrinth. The association of congenital sensorineural hearing loss with a large or enlarged vestibular aqueduct is well known as the large vestibular aqueduct syndrome (LVAS). The enlarged VA (EVA) comprises abnormalities not only in the structure of the inner ear, but also in the physiology of the auditory and vestibular systems. The clinical picture of this clinical entity is variable [Yetiser S, Kertment M, Ozkaptan Y. Vestibular disturbance in patients with Large Vestibular Aqueduct Syndrome (LVAS). Acta Otolaryngol (StochK) 1999;119: 641-646]. Signs and symptoms of the auditory impairment are more commonly described in the literature: hearing loss ranges from mild to profound, arising from fluctuating to stepwise progressive or sudden. Vestibular disturbances, ranging from mild imbalance to episodic vertigo, are rarely described in the literature. Benign paroxysmal positional vertigo (BPPV) is a labyrinthine disorder with a typical behavior: intense crises of rotational vertigo induced by postural changes of the head, with short duration and usually good responsiveness to rehabilitative maneuvers. These maneuvers are effective in about 80% of patients with BPPV. BPPV often recurs. About 1/3 of patients have a recurrence in the first year after treatment, and by five years, about half of all patients have a recurrence. Vestibular aqueduct has been demonstrated by conventional tomography and computed tomography (CT), however, CT scans cannot show the membranous labyrinth itself. On MR images it is not the vestibular aqueduct that is visualized but its contents, the endolymphatic duct and sac, and can show the abnormalities of the fluid spaces related to the membranous labyrinth. It is proposed that recurrent benign paroxysmal positional vertigo (BPPV) is related with volumetric abnormalities

  9. Correlation between adenoidal nasopharyngeal ratio and symptoms of enlarged adenoids in children with adenoidal hypertrophy

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    Taiwo Olugbemiga Adedeji

    2016-01-01

    Full Text Available Background: Adenoid hypertrophy is one of the most common health problems affecting the paediatric population. This study aims to correlate adenoidal nasopharyngeal ratio (ANR with symptoms of enlarged adenoids in children with enlarged adenoids. Materials and Methods: It was a year, cross-sectional, hospital-based study conducted at Lautech Teaching Hospital, Osogbo. ANR was determined by dividing adenoidal depth with nasopharyngeal depth on the plain lateral radiographs. Results: A total of 90 consecutive children consisting of 61 males and 29 females were included in the study with M:F ratio of 2.1:1. Their ages ranged from 8 months to 11 years. All the patients presented with nasal obstruction, mouth breathing and noisy breathing. Majority (64.5% had severe obstructions with preponderance among children of 3-5 years (39.9%. Linear regression analysis showed significant association between age and ANR (t = 10.447, P < 0.001. There was high significant association (P < 0.05 between presenting symptoms and degree of nasopharyngeal airway obstruction; for snoring (r = 0.251, P = 0.000, sleep apnoea (r = 0.594, P = 0.000, nasal discharge (r = 0.314, P = 0.001, excessive daytime sleepiness (r = 0.219, P = 0.019 and failure to thrive (r = 0.240, P = 0.011. Conclusion: Lateral X-ray of the nasopharynx is an effective tool to evaluate children with suspected adenoid hypertrophy. It correlates well with patients′ symptoms and provides objective measures of adenoid hypertrophy.

  10. Segmental arterial mediolysis accompanied by renal infarction and pancreatic enlargement: a case report

    Directory of Open Access Journals (Sweden)

    Ito Nobuhisa

    2012-09-01

    Full Text Available Abstract Introduction Due to recent advances in imaging diagnostic techniques, there are an increasing number of case reports of segmental arterial mediolysis. However, there are only a limited number of reports on segmental arterial mediolysis-related abnormalities of abdominal organs other than the intestine. This report describes a case of segmental arterial mediolysis accompanied by abnormalities of abdominal organs without clinical symptoms. Case presentation A 52-year-old Japanese man with hematuria and no prior medical history was referred to a urologist and was diagnosed as having urinary bladder cancer. He underwent trans-urethral resection of the bladder tumor and intra-vesical instillation therapy, which was followed by observation. During follow-up, although no abdominal symptoms were observed, an abdominal computed tomography scan revealed a dissection of the superior mesenteric artery. A false lumen partially occluded by a thrombus was located distal to this occlusion. The lumen was irregularly shaped with narrow and wide sections. Similar irregularities were also observed in the wall of the inferior mesenteric artery. Arterial dissection with thromboembolism in the left renal artery and renal infarction was also observed. Follow-up computed tomography after two months revealed an enlargement of the pancreatic tail adjacent to the splenic artery. Follow-up three-dimensional computed tomography showed gradual re-expansion of the true lumen of the superior mesenteric artery, improvement in arterial wall irregularities, and a reduction in the pancreas enlargement and renal infarction. Over the following 15 months, these changes gradually normalized. On the basis of the vascular changes in multiple arterial systems that resolved spontaneously, we considered that the lesions were associated with segmental arterial mediolysis. Conclusions We present a rare case of segmental arterial mediolysis accompanied by abnormalities of abdominal

  11. Serial cardiac MRIs in adult Fontan patients detect progressive hepatic enlargement and congestion.

    Science.gov (United States)

    Lewis, Matthew J; Hecht, Elizabeth; Ginns, Jonathan; Benton, Joshua; Prince, Martin; Rosenbaum, Marlon S

    2017-03-01

    The progression of hepatic disease in adult Fontan patients is not well understood. They reviewed the experience with serial cardiac MRIs (CMR) in adult Fontan patients to determine if hepatic anatomic markers of prolonged Fontan exposure were present and if clinical predictors of progressive hepatic congestion could be identified. A retrospective cohort study of all adult Fontan patients who had undergone at least two CMRs was performed. Hepatic dimensions, inferior vena cava (IVC) size, right hepatic vein (RHV) size and spleen diameter were determined from images acquired at the time of clinically guided CMR. Two radiologists with expertise in hepatic imaging graded congestion and liver size independently using post-gadolinium contrast sequences. Twenty-seven patients met inclusion criteria. Over a mean time of 5.1 years between CMRs, there was a significant increase in mean lateral-medial hepatic dimension (P = .005), mean RHV diameter (P = .004), and mean splenic diameter (P = .001). Serial post-gadolinium imaging was available in 25/27 (93%) patients of which 15/27 (55%) showed evidence of progressive hepatic congestion across serial studies. Progressive hepatic congestion was associated with single ventricle ejection fraction (SVEF) less than 50% (P = .008), and larger indexed end-diastolic (EDVI) and end-systolic volume (ESVI). RHV diameter was the only anatomic variable significantly correlated with time from Fontan completion (P = .004). Serial CMRs detected progressive liver and hepatic vein enlargement in our cohort of adult Fontan patients over a mean time of 5.2 years. Progressive hepatic congestion occurs in a significant number of adult Fontan patients and may be associated with ventricular enlargement and decreased ventricular function by CMR. © 2016 Wiley Periodicals, Inc.

  12. Eye muscle repair - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100062.htm Eye muscle repair - series—Normal anatomy To use the sharing ... the eyeball to the eye socket. The external muscles of the eye are found behind the conjunctiva. ...

  13. Obturator internus muscle strains

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    Caoimhe Byrne, MB BCh, BAO

    2017-03-01

    Full Text Available We report 2 cases of obturator internus muscle strains. The injuries occurred in young male athletes involved in kicking sports. Case 1 details an acute obturator internus muscle strain with associated adductor longus strain. Case 2 details an overuse injury of the bilateral obturator internus muscles. In each case, magnetic resonance imaging played a crucial role in accurate diagnosis.

  14. Hearing loss associated with enlargement of the vestibular aqueduct: mechanistic insights from clinical phenotypes, genotypes, and mouse models.

    Science.gov (United States)

    Griffith, Andrew J; Wangemann, Philine

    2011-11-01

    Enlargement of the vestibular aqueduct (EVA) is one of the most common inner ear malformations associated with sensorineural hearing loss in children. The delayed onset and progressive nature of this phenotype offer a window of opportunity to prevent or retard progression of hearing loss. EVA is not the direct cause of hearing loss in these patients, but rather is a radiologic marker for some underlying pathogenetic defect. Mutations of the SLC26A4 gene are a common cause of EVA. Studies of an Slc26a4 knockout mouse demonstrate that acidification and enlargement of the scala media are early events in the pathogenesis of deafness. The enlargement is driven by fluid secretion in the vestibular labyrinth and a failure of fluid absorption in the embryonic endolymphatic sac. Elucidating the mechanism of hearing loss may offer clues to potential therapeutic strategies. Published by Elsevier B.V.

  15. Ipsilateral idiopathic gingival enlargement and it's management using conventional gingivectomy and diode laser: A recurrent case after 15 years.

    Science.gov (United States)

    Devi, Potharaju Kamala; Kumar, Gudi Pavan; Bai, Yendluri Durga; Ammaji, Annamdevula Durga

    2013-05-01

    Idiopathic gingival fibromatosis is a relatively rare condition characterized by the proliferation of the gingival tissues resulting in masticatory, esthetics, phonetics and psychological disturbances. The severity of the overgrowth can range from a solitary isolated mass to a more generalized and diffused enlargement. The etiopathogenesis of this bizarre condition is poorly understood and has been attributed to various factors. It can present as a single disorder or may manifest as part of a syndrome. This case reports an ipsilateral diffused idiopathic gingival enlargement in a middle aged adult recurring after a gap of 15 years. External bevel gingivectomy on the buccal aspects of maxillary and mandibular gingiva and diode laser for excision of the enlarged tissue on the lingual/palatal aspect was carried out to eliminate the excessive tissue. Periodic recalls showed maintenance of good oral hygiene and 1 year follow-up revealed no recurrence.

  16. QUANTITATIVE HISTOPATHOLOGICAL ANALYSIS OF ENLARGED CELLS DERIVED FROM HUMPBACK GROUPER, Cromileptes altivelis INFECTED WITH GROUPER SLEEPY DISEASE IRIDOVIRUS (GSDIV

    Directory of Open Access Journals (Sweden)

    Indah Mastuti

    2010-12-01

    Full Text Available Pathognomonic sign of grouper sleepy disease iridovirus (GSDIV was proposed to be the formation of enlarged cells and necrotic cells, in which under electron microscope, it is revealed to be the inclusion body bearing cells (IBCs and necrotic cells containing GSDIV viral particles. Spleen and kidney tissues are the major sites for formation of enlarged cells. This paper described the result of histopatological analysis of enlarged cells found in the spleen and kidney of moribund fish after GSDIV challenge. A pathogenicity test was conducted on fish stocked in two tanks for infected groups and the other two tanks for uninfected control groups (15 fish per tank. The infected groups were injected intramuscularly with 0.1 ml of the viral inoculum. The uninfected groups were injected with the same amount of EMEM-2. The GSDIV-infected humpback grouper began to die after 6 days post infection and all died after 7 dpi, excluding one fish which had survived until the end of experimental infection periods (93% to 100% mortality. All of the diseased fish showed massive formation of enlarged cells in their spleen, head kidney and trunk kidney. The largest number of enlarged cells was observed on head kidneys and subsequently followed by spleens, trunk kidney (2.0-200.3/field of view. This result suggested that the number of enlarged cells in the affected organs was not the direct factor that led to the mortality of fish.

  17. An intelligent system for calculating the scale of rational, enlarged production of an underground non-ferrous metal mine

    Institute of Scientific and Technical Information of China (English)

    ZHENG Ming-gui; CAI Si-jing

    2008-01-01

    The enlarged production scale of underground non-ferrous metal mines is affected by many uncertain factors difficult to describe mathematically with any level of accuracy. The problem can be solved by a synthesis of artificial intelligence. Based on the analysis of the major factors affecting the scale of enlarged production, we first interpreted in detail the design principles and structure of the intelligent system. Secondly, we introduced an ANN subsystem. In order to ensure technological and scale efficiencies of the training samples for ANN, we filtrated the samples with a DEA method. Finally, we trained the intelligent system, which was proved to be very efficient.

  18. Bronchial compression by an enlarged left atrium in infants; a cause of hypovascularity of the left lung

    Energy Technology Data Exchange (ETDEWEB)

    Corr, L.; Hallidie-Smith, K.A.; McCarthy, P.A.; Lavender, J.P.

    1988-09-01

    In three infants seen recently at our institution we noted signs of compression of the left main bronchus associated with enlarged left atria. None of our cases demonstrated the more usual signs of hyperinflation which are a hyperlucent lung field, depressed hemidiaphragm and mediastinal shift away from the affected side. In addition, hypoperfusion of the left lung was noted in each case. We believe that bronchial compression due to an enlarged left atrium, with consequent hypoxic vasoconstriction is a clinically significant entity, which is not well described and may be unappreciated in infants in whom the typical signs of hyperinflation are absent.

  19. An Improved Genetic Fuzzy Logic Control Method to Reduce the Enlargement of Coal Floor Deformation in Shearer Memory Cutting Process.

    Science.gov (United States)

    Tan, Chao; Xu, Rongxin; Wang, Zhongbin; Si, Lei; Liu, Xinhua

    2016-01-01

    In order to reduce the enlargement of coal floor deformation and the manual adjustment frequency of rocker arms, an improved approach through integration of improved genetic algorithm and fuzzy logic control (GFLC) method is proposed. The enlargement of coal floor deformation is analyzed and a model is built. Then, the framework of proposed approach is built. Moreover, the constituents of GA such as tangent function roulette wheel selection (Tan-RWS) selection, uniform crossover, and nonuniform mutation are employed to enhance the performance of GFLC. Finally, two simulation examples and an industrial application example are carried out and the results indicate that the proposed method is feasible and efficient.

  20. A surgical case of frontal lobe epilepsy due to focal cortical dysplasia accompanied by olfactory nerve enlargement: case report.

    Science.gov (United States)

    Minami, Noriaki; Uda, Takehiro; Matsumoto, Takahiro; Nagai, Taiki; Uchida, Tatsuya; Kamei, Takamasa; Morino, Michiharu

    2014-01-01

    A 45-year-old man came to our clinic due to refractory general tonic seizure and an attack of unintended yelling. Magnetic resonance imaging (MRI) demonstrated mild cortical hyperintensity on fluid attenuated inversion recovery (FLAIR) image in the left basal frontal area. Enlargement of the left olfactory nerve was also detected below the affected gyrus. Subtotal resection of the MRI-visible epileptogenic lesion was performed without any neurological deficit. The final pathological diagnosis was focal cortical dysplasia (FCD) type IIa. Seizures and yelling attacks subsided after surgery. Extracerebral abnormalities, including cranial nerve enlargement, are common in patients with hemimegalencephaly. However, such abnormalities are rare with FCD.