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Sample records for hemifacial microsomia hfm

  1. Hemifacial Microsomia

    GB

    2017-01-01

    Jan 1, 2017 ... Goldenhar syndrome is a variant of HFM, which includes vertebral anomalies and ... maxillary teeth and carious left central and lateral incisors. Figure 3: ... condition and proposed treatment were explained to the patient and ...

  2. Nonsurgical Treatment of Hemifacial Microsomia: A Case Report.

    Nouri, Mahtab; Farzan, Arash

    2015-11-01

    Hemifacial microsomia (HFM) is a birth defect involving craniofacial structures derived from the first and second branchial arches. Although it is a relatively uncommon malformation, it is the second most common craniofacial birth defect after cleft lip and palate (CL/P). This is a case report about the successful orthodontic treatment of a patient with mild hemifacial microsomia (HFM), using a non-surgical orthopedic and orthodontic treatment approach. The aim of this approach was to make the best noninvasive modality to treat HFM. A 7-year-old boy with a mild HFM presented with a convex profile and slight chin deviation. Orthopedic treatment performed using a hybrid functional and high pulls headgear. Treatment continued by fixed orthodontic straight wire appliance to achieve perfect occlusion. Excellent esthetic and functional results achieved; total treatment duration was about 72 months.

  3. Hemifacial microsomia: A case report

    Kapur R

    2008-05-01

    Full Text Available Hemifacial microsomia is a congenital malformation in which there is a deficiency in the amount of hard and soft tissue on one side of the face. It is primarily a syndrome of the first branchial arch, involving underdevelopment of the temporomandibular joint, mandibular ramus, masticatory muscles and the ear. The affected ear may have an external soft-tissue malformation in addition to being lower set than on the contra lateral side. Hearing loss may result from underdevelopment of the osseous components of the auditory system and a diminished or absent external auditory meatus. Occasionally, second branchial arch defects involving the facial nerve and facial muscles coexist with Hemifacial microsomia. Radiographic examination in case of Hemifacial microsomia is of limited value because of superimposition of normal and abnormal bony structures. The skeletal and soft-tissue findings of a patient with Hemifacial microsomia who underwent three-dimensional computerized tomography is presented here to improve our knowledge and diagnostic skill of this uncommon entity.

  4. Hemifacial Microsomia: A Case Report and Overview

    Medhini Madi

    2014-06-01

    Full Text Available Hemifacial Microsomia is a developmental craniofacial anomaly typically displaying reduced growth and development of half of the face as a result of abnormal development of first and second branchial arches. The patients with Hemifacial Microsomia usually exhibit unilateral involvement of the face but occasionally might involve both the sides. Cases which show vertebral anomalies and epibulbar dermoids have been considered to form a separate category within this condition . The condition is now known to be extremely complex and heterogenous. Here we present a case of Hemifacial Microsomia with its characteristic clinical and radiographic features that will help us in diagnosing and differentiating this rare entity from other closely related syndromes [Cukurova Med J 2014; 39(3.000: 625-635

  5. Hemifacial microsomia: clinicoradiological insight and report of a case

    Background: Hemifacial microsomia is a congenital malformation characterized by deficiency in the amount of hard and soft tissue on one side of the face. It is primarily a syndrome of the first branchial arch, involving underdevelopment of the temporomandibular joint, masticatory muscles, mandibular ramus, ear and, ...

  6. [The effect of mandibular distraction on the maxilla growth in children with hemifacial microsomia].

    Yang, Renkai; Tang, Xiaojun; Shi, Lei; Yin, Lin; Yang, Bin; Yin, Hongyu; Liu, Wei; Zhang, Zhiyong

    2014-11-01

    To analyze the effect of mandibular distraction on the maxilla growth in children with hemifacial microsomia through measurement with the posterior-anterior cephalometric X-ray films and Three-dimensional CT reconstruction images. The deviation angular of maxilla occlusion plane and nasal base plane from the infra-orbital plane were measured on the posterior-anterior cephalometric X-ray films in 22 patients before and half a year after operation. The vertical distance from the midpoint of 5th teeth alveolar and the lowest point of maxillary sinus to reference plane were measured on 3D reconstruction images in 15 patients. The data were statistically analyzed. On posterior-anterior cephalometric X-ray films, the cant of occlusion plane were significantly reduced (P maxillary sinus on normal side. Distraction osteogenesis of mandible can promote the growth of the maxilla in children with HFM, the accelerated growth parts include alveolar bone and maxillary sinus.

  7. Combined Bimaxillary Distraction Osteogenesis Associated with Orthognathic Surgery for Hemifacial Microsomia in Adults.

    Liu, Hanghang; Zhang, Xiaohui; Liu, Li; Chen, Qianming; Shao, Jun; Luo, En

    2017-06-01

    Hemifacial microsomia (HFM) is one of the most common congenital craniofacial asymmetries. Distraction osteogenesis (DO) is always recommended as an effective option for the treatment of HFM, but some studies showed that the asymmetry remained after DO. In comparison with DO, stable clinical outcomes could be achieved by orthognathic surgery approach as well. However, soft tissue expansion cannot be performed. In this study, we aim to assess the radiographic and clinical results of bimaxillary DO associated with staged orthognathic surgery in the treatment of craniofacial asymmetry for adult HFM patients. Twelve HFM patients who had been treated with bimaxillary DO and secondary orthognathic surgery between 2006 and 2013 were included in this study. Bimaxillary DO and staged orthognathic surgery were performed according to the particular condition. Clinical and cephalometric photographs were carried out pre- and postoperatively to evaluate the outcomes. No significant complications occurred postoperatively. Excellent cosmetic outcomes such as notable improvement in facial pattern and occlusion were achieved. Cephalometrically, the height ratios of the affected/unaffected ramus were improved by 23.81% on average, and the photographic analysis demonstrated a rotation of the chin point toward the mid-line. Moreover, the occlusal cant was corrected from the slant to level by 8.95° on average. The application of bimaxillary DO associated with staged orthognathic surgery in correcting the asymmetry of adult patients with HFM could have satisfactory aesthetic results, and it should be considered an alternative option for these patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  8. Hemifacial microsomia: management of the vertical ramus compartment

    Maurice Yves Mommaerts

    2015-06-01

    Full Text Available Hemifacial microsomia and Goldenhar syndrome pose unique challenges to the craniofacial surgeon. The O.M.E.N.S. classification provides a description of the craniofacial features. For the "M" of O.M.E.N.S. (the mandible, the Pruzansky-Kaban classification provides therapeutic guidelines for joint and face reconstruction. A sequence of standard procedures, including temporomandibular joint reconstruction, facial rotation surgery, gluteal fat grafting, and patient-specific titanium implantation, each have their intricacies. The author provides his expert opinion, acquired over thirty years of experience, with an emphasis on descriptions of and solutions for ten problematic issues.

  9. Ramus marginalis mandibulae nervus facialis palsy in hemifacial microsomia.

    Silvestri, A; Mariani, G; Vernucci, R A

    2008-12-01

    The paralysis of the ramus marginalis mandibulae nervus facialis may occur in Hemifacial Microsomia (HM); the combination of both HM and palsy contributes to an elongation of the mandibular body. This study explores a possible correlation between neurological deficit, muscular atony, and structural deficiency. Of 58 patients with HM who had come to the University of Rome (Sapienza) Pre-surgical Orthodontics Unit, 4 patients were afflicted with Hemifacial Microsomia and ramus marginalis mandibulae nervus palsy; these patients underwent physical, neurological, opthamologic and systemic examinations. The results were then analysed in order to determine a possible correlation between neuro-muscular and structural deficit. Electroneurographic and electromyographic examinations were performed to estimate facial nerve and muscles involvement. Neuroelectrographic exam showed a damage of the nervous motor fibres of the facial nerve ipsilateral to HM, with an associated damage of the muscular function, while neuro-muscular functions on the healthy side were normal. The peripheral nervous and muscular deficits affect the function of facial soft tissues and the growth of mandibular body with an asymmetry characterised by a hypodevelopment of the ramus (due to the HM) and by an elongation of the mandibular body (due to ramus marginalis mandibulae nerve palsy), so that the chin deviation is contralateral to HM. In these forms, a neurological examination is necessary to assess the neurological damage on the HM side. Neuromuscular deficiency can also contribute to a relapse tendency after a surgical-orthodontic treatment.

  10. Stress in Parents of a Child with Hemifacial Microsomia: The Role of Child Characteristics and Parental Coping Strategies.

    Ongkosuwito, Edwin; van der Vlies, Lieneke; Kraaij, Vivian; Garnefski, Nadia; van Neck, Han; Kuijpers-Jagtman, Anne Marie; Hovius, Steven

    2018-01-01

    Objective Examine stress levels of parents of children with hemifacial microsomia (HFM) and the relationship of parental stress to child characteristics and cognitive coping strategies. Design Prospective cross-sectional study. Participants and Setting Parents with a child (age 3-19 years) with HFM (N = 31) were recruited through the Department of Orthodontics and the Craniofacial Center, Sophia-Erasmus Medical Center, Rotterdam, The Netherlands. Intervention and Outcome Measures The adapted and shortened Dutch version of the parental stress index (NOSI-K) was used to measure parental stress, and the cognitive emotion-regulation questionnaire was used to measure cognitive coping strategies. Pearson correlations and a multiple regression analysis were performed. Results The hierarchical multiple regression analysis showed associations between increased parental stress and learning difficulties and use of acceptance as a coping strategy. This suggests that problems other than the characteristic visual appearance of the child's face in HFM have a greater influence on parental stress. Conclusions Learning difficulties of the child with HFM and parental acceptance affect stress in parents with a child with HFM the most and are important in the search for a targeted tailoring of intervention for parents with high levels of parental stress.

  11. Cleft characteristics and treatment outcomes in hemifacial microsomia compared to non-syndromic cleft lip/palate.

    Dentino, K M; Valstar, A; Padwa, B L

    2016-06-01

    The goal of this study was to describe the clinical characteristics and treatment outcomes of patients with hemifacial microsomia (HFM) and cleft lip/palate (CL/P), and to compare them to a historic cohort of patients with non-syndromic CL/P treated at the same centre. A retrospective review of patients with HFM and CL/P was performed; the main outcome measures assessed were cleft type/side, surgical outcome, midfacial retrusion, and speech. Twenty-six patients (13 male, 13 female; mean age 22.7±14.9, range 1-52 years) with cleft lip with/without cleft palate (CL±P) were identified: three with cleft lip (12%), two with cleft lip and alveolus and an intact secondary palate (8%), and 21 with cleft lip and palate (CLP) (81%; 15 unilateral and six bilateral). Four patients (19%) had a palatal fistula after palatoplasty. Twelve of 22 patients aged >5 years (55%) had midfacial retrusion and two (9%) required a pharyngeal flap for velopharyngeal insufficiency (VPI). Fisher's exact test demonstrated a higher frequency of complete labial clefting (P=0.004), CLP (P=0.009), midfacial retrusion (P=0.0009), and postoperative palatal fistula (P=0.03) in HFM compared to non-syndromic CL±P. There was no difference in VPI prevalence. This study revealed that patients with HFM and CL±P have more severe forms of orofacial clefting than patients with non-syndromic CL±P. Patients with HFM and CL±P have more severe midfacial retrusion and a higher palatal fistula rate compared to patients with non-syndromic CL±P. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Nonsurgical treatment of hemifacial microsomia by therapeutic ultrasound and hybrid functional appliance

    Tarek El-Bialy

    2010-03-01

    Full Text Available Tarek El-Bialy1, Ali Hasan2, Ahmad Janadas3, Tarik Albaghdadi41Division of Orthodontics, Department of Dentistry, University of Alberta, Edmonton, Alberta, Canada; 2Division of Orthodontics, Department of Preventive Dental Sciences, Faculty of Dentistry; 3Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry; 4Division of Radiology, Faculty of Medicine, King Abdul Aziz University, Jeddah, Saudi ArabiaAim: Conventional treatment of patients with hemifacial microsomia involves orthognathic surgery and/or distraction osteogenesis of the mandible. Previous reports showed that low-intensity pulsed ultrasound (LIPUS enhances mandibular growth in growing rabbits and monkeys. In monkeys, LIPUS enhanced mandibular growth when combined with functional jaw orthopedic appliances. The purpose of this pilot study was to investigate if LIPUS could enhance mandibular growth in children with hemifacial microsomia.Methods: Five children (age range 3–11 years with hemifacial microsomia were treated with hybrid jaw orthopedic functional appliances and treatment of the affected mandibular condyle by LIPUS for 20 minutes per day.Results: The results showed that after one year of treatment, significant improvement of the underdeveloped side of patients’ faces and mandibles was recognized both clinically and radiographically.Discussion: Although improvement took a longer time than did a surgical approach, optimizing this technique may achieve better results in a shorter treatment time. A randomized controlled clinical trial to investigate the effect of optimized LIPUS application or functional appliances in the treatment of hemifacial microsomia is warranted.Keywords: hemifacial microsomia, LIPUS, non-surgical treatment, children

  13. Three-dimensional photogrammetry for surgical planning of tissue expansion in hemifacial microsomia.

    Jayaratne, Yasas S N; Lo, John; Zwahlen, Roger A; Cheung, Lim K

    2010-12-01

    We aim to illustrate the applications of 3-dimensional (3-D) photogrammetry for surgical planning and longitudinal assessment of the volumetric changes in hemifacial microsomia. A 3-D photogrammetric system was employed for planning soft tissue expansion and transplantation of a vascularized scapular flap for a patient with hemifacial microsomia. The facial deficiency was calculated by superimposing a mirror of the normal side on the preoperative image. Postsurgical volumetric changes were monitored by serial superimposition of 3-D images. A total of 31 cm(3) of tissue expansion was achieved within a period of 4 weeks. A scapular free flap measuring 8 cm × 5 cm was transplanted to augment the facial deficiency. Postsurgical shrinkage of the flap was observed mainly in the first 3 months and it was minimal thereafter. 3-D photogrammetry can be used as a noninvasive objective tool for assessing facial deformity, planning, and postoperative follow-up of surgical correction of facial asymmetry.

  14. Precise positioning of an intraoral distractor using augmented reality in patients with hemifacial microsomia.

    Qu, Miao; Hou, Yikang; Xu, Yourong; Shen, Congcong; Zhu, Ming; Xie, Le; Wang, Hao; Zhang, Yan; Chai, Gang

    2015-01-01

    Through three-dimensional real time imaging, augmented reality (AR) can provide an overlay of the anatomical structure, or visual cues for specific landmarks. In this study, an AR Toolkit was used for distraction osteogenesis with hemifacial microsomia to define the mandibular osteotomy line and assist with intraoral distractor placement. 20 patients with hemifacial microsomia were studied and were randomly assigned to experimental and control groups. Pre-operative computed tomography was used in both groups, whereas AR was used in the experimental group. Afterwards, pre- and post-operative computed tomographic scans of both groups were superimposed, and several measurements were made and analysed. Both the conventional method and AR technique achieved proper positioning of the osteotomy planes, although the AR was more accurate. The difference in average vertical distance from the coronoid and condyle process to the pre- and post-operative cutting planes was significant (p 0.05) was observed in the average angle between the two planes. The difference in deviations between the intersection points of the overlaid mandible across two cutting planes was also significant (p Augmented reality tools such as the AR Toolkit may be helpful for precise positioning of intraoral distractors in patients with hemifacial microsomia in craniofacial surgery. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  15. [Mandibular-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia with rapid prototyping technology].

    Gao, Quan-Wen; Song, Hui-Feng; Xu, Ming-Huo; Liu, Chun-Ming; Chai, Jia-Ke

    2013-11-01

    To explore the clinical application of mandibular-driven simultaneous maxillo-mandihular distraction to correct hemifacial microsomia with rapid prototyping technology. The patient' s skull resin model was manufactured with rapid prototyping technology. The osteotomy was designed on skull resin model. According to the preoperative design, the patients underwent Le Fort I osteotomy and mandibular ramus osteotomy. The internal mandible distractor was embedded onto the osteotomy position. The occlusal titanium pin was implanted. Distraction were carried out by mandibular-driven simultaneous maxillo-mandihular distraction 5 days after operation. The distraction in five patients was complete as designed. No infection and dysosteogenesis happened. The longest distance of distraction was 28 mm, and the shortest distance was 16 mm. The facial asymmetry deformity was significantly improved at the end of distraction. The ocelusal plane of patients obviously improved. Rapid prototyping technology is helpful to design precisely osteotomy before operation. Mandibular-driven simultaneous maxillo-mandibular distraction can correct hemifacial microsomia. It is worth to clinical application.

  16. A fetus with hemifacial microsomia and sirenomelia. The same mesodermal defect spectrum?

    López-Valdez, Jaime Asael; Estrada-Juárez, Higinio; Moreno-Verduzco, Elsa Romelia; Aguinaga-Ríos, Mónica

    2013-04-01

    Sirenomelia is the most severe malformation complex affecting the human caudal pole, although its etiology is unclear, a primary defect of blastogenesis has been proposed. Studies consider sirenomelia as the most severe form of caudal dysgenesis, VACTERL association, or axial mesodermal dysplasia, although others still support the idea of a different pathologic entity. We report the prenatal, clinical, and pathologic features of a fetus with cleft lip and palate, microtia, cardiac, renal and intestinal malformations, radial aplasia, and sirenomelia. Karyotype, chromosomal breakage studies, and SHH sequence analysis were normal. The occurrence of cephalic, midline-paramedial, and caudal malformations in the same patient imply the diagnosis of hemifacial microsomia and sirenomelia. These entities are part of the same mesodermal malformation spectrum and the clinical presentation depends on environmental and genetic interactions in embrionic development. Future clinical and genome wide studies will help to better delineate this spectrum.

  17. Maxillary-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia.

    Nakajima, Hideo; Sakamoto, Yoshiaki; Tamada, Ikkei; Ogata, Hisao; Kishi, Kazuo; Sakamoto, Teruo

    2011-12-01

    We treat hemifacial microsomia with a combination of surgery and orthodontic treatment during the growth period, resulting in early improvement in facial asymmetry and the induction of normal growth. We previously used gradual distraction of the mandibular ramus for Pruzansky's type II classification (Pruzansky, 1969). In type II cases, the maxilla should also be treated actively as, using this technique, improvement of the occlusal plane is difficult to achieve, resulting in a cross bite and difficulties in post-operative orthodontic treatment-especially in older patients. Morphologically, the mandibular angle region of the operative side is flat, and the angle of the mouth remains elevated. We performed mandibular-driven simultaneous maxillo-mandibular distraction while the occlusion was maintained using intermaxillary anchorage. However, mandibular-driven distraction tended to elongate the face because the mandible only elongated downwards and the mandibular ramus did not reach the glenoid. Furthermore, external distraction devices produce significant distress for patients until removal of the device and cause scars on the face. We developed a new internal distraction device with a variable angle and performed maxillary-driven simultaneous maxillo-mandibular distraction using this device. The result was morphologically satisfactory and solved the above problems. Because the patient was in the growth period, careful follow-up and induction to normal growth were important while the inferior growth of the affected side was monitored. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Combined maxillary and mandibular distraction osteogenesis in patients with hemifacial microsomia.

    Sant'Anna, Eduardo Franzotti; Lau, Geórgia W T; Marquezan, Mariana; de Souza Araújo, Mônica Tirre; Polley, John W; Figueroa, Alvaro A

    2015-05-01

    Hemifacial microsomia is a deformity of variable expressivity with unilateral hypoplasia of the mandible and the ear. In this study, we evaluated skeletal soft tissue changes after bimaxillary unilateral vertical distraction. Eight patients (4 preadolescents 4 adolescents) each with a grade II mandibular deformity underwent a LeFort I osteotomy and an ipsilateral horizontal mandibular ramus osteotomy. A semiburied distraction device was placed over the ramus, and intermaxillary fixation was applied. Anteroposterior cephalometric and frontal photographic analyses were conducted before and after distraction. Statistics were used to analyze the preoperative and postoperative changes. Cephalometrically, the nasal floor and the occlusal and gonial plane angles decreased. The ratios of affected-unaffected ramus and gonial angle heights improved by 15% and 20%, respectively. The position of menton moved toward the midline. The photographic analysis showed a decrease of the nasal and commissure plane angles, and the chin moved to the unaffected side. The parallelism between the horizontal skeletal and soft tissue planes improved, with an increase in the affected side ramus height and correction of the chin point toward the midline. Simultaneous maxillary and mandibular distraction improved facial balance and symmetry. Patients in the permanent dentition with fixed orthodontic appliances and well-aligned dental arches responded well to this intervention. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  19. Development of a morphing technique for predicting the position and size of an artificial ear in hemifacial microsomia patients.

    Coward, Trevor J; Richards, Robin; Scott, Brendan J J

    2014-01-01

    People with hemifacial microsomia may be missing an ear on the affected side of the face. The principal aim of the study was to develop a morphing technique and to determine whether it could be used to appropriately position an artificial ear, as well as to give an indication of prosthesis size in comparison with the natural ear. Comparisons also were made between the artificial ears being worn by the patients with their natural ears. Data from stereophotogrammetry images of the faces of 10 people were converted into stereolithographic format. Anthropometric points on the face and ear of the unaffected side were plotted. By a process of scaling, the distance between facial landmarks on the unaffected side was estimated for the affected side so as to identify where the morphed ear would be positioned once generated. Generally, the morphed ears appeared to be in acceptable positions. There was a statistically significant difference between the position of the morphed and natural ears (P = .011), as well as the artificial and natural ears (P = .001), but this was unlikely to have any clinical implications. There were no significant differences among the sizes of the natural, morphed, and artificial ears (P = .072). Morphing appears to offer a more precise way of planning the positioning and construction of an artificial ear on patients with hemifacial microsomia than traditional methods. Differences in facial shape on either side of the face may impact on the process. This requires further study.

  20. PREFACE: The International Conference on Highly Frustrated Magnetism HFM2008

    Eremin, Ilya; Brenig, Wolfram; Kremer, Reinhard; Litterst, Jochen

    2009-01-01

    The International Conference on Highly Frustrated Magnetism 2008 (HFM2008) took place on 7-12 September 2008 at the Technische Universität Carolo-Wilhelmina zu Braunschweig, Germany. This conference was the fourth event in a series of meetings, which started in Waterloo, Canada (HFM 2000), followed by the second one in Grenoble, France (HFM 2003), and the third meeting in Osaka, Japan (HFM 2006). HFM2008 attracted more than 220 participants from all over the world. The number of participants of the HFM conference series has been increasing steadily, from about 80 participants at HFM 2000, to 120 participants at HFM 2003, and 190 participants at HFM 2006, demonstrating that highly frustrated magnetism remains a rapidly growing area of research in condensed matter physics. At the end of HFM2008 it was decided that the next International Conference on Highly Frustrated Magnetism will be held in Baltimore, USA in 2010. HFM2008 saw four plenary talks by R Moessner, S Nakatsuji, S-W Cheong, and S Sachdev, 18 invited presentations, 30 contributed talks and about 160 poster presentations from all areas of frustrated magnetism. The subjects covered by the conference included: Kagome systems Itinerant frustrated systems Spinels and pyrochlore materials Triangular systems Unconventional order and spin liquids Chain systems Chain systems Novel frustrated systems This volume of Journal of Physics: Conference Series contains the proceedings of HFM2008 with 83 papers that provide a scientific record of the scientific topics covered by the conference. All articles have been refereed by experts in the field. It is our hope that the reader will enjoy and profit from the HFM2008 Proceedings. Ilya Eremin Proceedings Editor Wolfram Brenig, Reinhard Kremer, and Jochen Litterst Co-Editors International Advisory Board L Balents (USA) F Becca (Italy) S Bramwell (UK) P Fulde (Germany) B D Gaulin (Canada) J E Greedan (Canada) A Harrison (France) Z Hiroi (Japan) H Kawamura (Japan) A Keren

  1. Orthognathic Surgery in Craniofacial Microsomia: Treatment Algorithm

    Valladares, Salvador; Torrealba, Ramón; Nuñez, Marcelo; Uribe, Francisca

    2015-01-01

    Summary: Craniofacial microsomia is a broad term that covers a variety of craniofacial malformation conditions that are caused by alterations in the derivatives of the first and second pharyngeal arches. In general terms, diverse therapeutic alternatives are proposed according to the growth stage and the severity of the alteration. When craniofacial growth has concluded, conventional orthognathic surgery (Le Fort I osteotomy, bilateral sagittal split osteotomy, and genioplasty) provides good alternatives for MI and MIIA type cases. Reconstruction of the mandibular ramus and temporomandibular joint before orthognathic surgery is the indicated treatment for cases MIIB and MIII. The goal of this article is to establish a surgical treatment algorithm for orthognathic surgery on patients with craniofacial microsomia, analyzing the points that allow the ideal treatment for each patient to be chosen. PMID:25674375

  2. EuCARD-HFM dipole model design options

    Bruchon, Mélanie; Durante, Maria; Karppinen, Mikko; Kircher, François; Manil, Pierre; Milanese, Attilio; Oberli, Luc; Perez, Juan Carlos; Rifflet, Jean-Michel; Rondeaux, Françoise; Todesco, Ezio

    2010-01-01

    The EuCARD-HFM task aims at realizing a 13 T dipole magnet with an aperture of 100 mm, which is a challenging step towards very high field accelerator magnets. This dipole, utilizing Nb$_{3}$Sn superconductor, will be used in the Fresca test facility at CERN. A preliminary design study has compared two possible design layouts for the EuCARD-HFM magnet: the cos-θ and the block. This report summarizes the conclusions of this study and justifies, on the base of quantitative and qualitative arguments, our decision to pursue the detailed design with the block layout.

  3. Hemifacial spasm; The value of vertebral angiography

    Yang, Hak Seok; Kim, Myung Soon; Han, Yong Pyo

    1992-01-01

    In order to evaluate the value of vertebral angiography in assesment of hemifacial spasm, We reviewed retrospectively the vertebral angiography of 28 patients (30 cases) with surgically proved hemifacial spasm but normal CT scans of posterior fossa. There were 9 males and 19 females. Angiography revealed vascular focus of hemifacial spasm located at anterior inferior cerebellar artery , posterior inferior cerebellar artery, and vertebral artery in 19, 9, and 2 cases respectively. Right side was involved in 20 cases. All involved vessels were elongated, tortuous, and dilated. In conclusion, vertebral angiography was valuable in evaluating hemifacial spasm of vascular origin in the posterior fossa

  4. Triggering of 178Hfm2 by photoinduced electron transition

    A. Ya. Dzyublik

    2013-03-01

    Full Text Available We considered the NEET (nuclear excitation by electron transition as a possible triggering mechanism of the isomer 178Hfm2 during ionization of the L3 atomic shell by x-rays. This isomer is assumed to be excited into an intermediate state by E1 electronic transition between M5 and L3 shells. Simple nonrelativistic formulas are derived for the NEET probability. The estimations show the probability to be less than the experimental data of [1] by one order of magnitude. The intermediate level is found to decay bypassing the isomeric level 16+, if the nucleus attributes a triaxial shape in the state and, besides, there exists a level 13- shifted with respect to 15- by 400 keV. We have shown also that the NEET cross section as a function of the energy of x-ray photons , has to accept constant value above the L photoionization threshold in contrast to narrow peak observed by [1].

  5. Hemifacial atrophy treated with autologous fat transplantation

    Gandhi Vijay

    2005-01-01

    Full Text Available A 23-year-old male developed right hemifacial atrophy following marphea profunda. Facial asymmetry due to residual atrophy was treated with autologous fat harvested from buttocks with marked cosmetic improvement.

  6. Lipomatosis: a diverse form of hemifacial hyperplasia

    Arora, Preeti Chawla; Umarji, Hemant R.; Arora, Aman; Ramaswami, Easwaran

    2012-01-01

    A case of hemifacial hyperplasia that presented with muscular, skeletal, and dental hyperplasia along with lipomatous infiltration was described. Advanced imaging was useful in identifying the lipomatous infiltration present in the lesion, which raises the possibility of lipomatosis having a diverse presentation in hemifacial hyperplasia. As there was a scarcity of related literature in the field of dentomaxillofacial radiology, this report would make us familiar with its computed tomographic and magnetic resonance image findings.

  7. Acute hemifacial dystonia possibly induced by clebopride.

    Bosco, Domenico; Plastino, Massimiliano; Marcello, Maria Giovanna; Mungari, Pasquale; Fava, Antonietta

    2009-01-01

    Dystonic reactions produce twisting and repetitive movements or abnormal posturing. Severe dystonic reactions have been shown to occur in concert with numerous medications. This report details the case of a patient who developed hemifacial dystonia as acute side reaction from administration of clebopride for dyspeptic prophylaxis. When the drug was immediately stopped, the dystonic posture disappeared completely within 2 weeks. The use of clebopride may be associated with not only a reversible or persistent parkinsonism syndrome but also hemifacial dystonia; therefore, attention must be drawn to this possible side effect.

  8. Hemifacial spasm: conservative and surgical treatment options.

    Rosenstengel, Christian; Matthes, Marc; Baldauf, Jörg; Fleck, Steffen; Schroeder, Henry

    2012-10-01

    Hemifacial spasm is a neuromuscular movement disorder characterized by brief or persistent involuntary contractions of the muscles innervated by the facial nerve. Its prevalence has been estimated at 11 cases per 100 000 individuals. Among the patients who were operated on by our team, the mean interval from diagnosis to surgery was 8.2 years, and more than half of them learned of the possibility of surgical treatment only through a personal search for information on the condition. These facts motivated us to write this article to raise the awareness of hemifacial spasm and its neurosurgical treatment among physicians who will encounter it. This review article is based on a selective literature search and on our own clinical experience. Hemifacial spasm is usually caused by an artery compressing the facial nerve at the root exit zone of the brainstem. 85-95% of patients obtain moderate or marked relief from local injections of botulinum toxin (BTX), which must be repeated every 3 to 4 months. Alternatively, microvascular decompression has a success rate of about 85%. Local botulinum-toxin injection is a safe and well-tolerated symptomatic treatment for hemifacial spasm. In the long term, however, lasting relief can only be achieved by microvascular decompression, a microsurgical intervention with a relatively low risk and a high success rate.

  9. [A girl with congenital hemifacial hypertrophy

    Broeke, S.M. van den; Wolvius, E.B.; Adrichem, L.N. van; Baat, C. de

    2006-01-01

    A girl with congenital hemifacial hypertrophy had been observed and treated by a multidisciplinary team for craniofacial disorders in an academic medical centre since birth. At the age of 8 she was treated on account of considerable facial asymmetry and multiple intraoral problems. The two-step

  10. Progressive Hemifacial Atrophy with Morphea of Cheek

    Ajit Auluck

    2006-01-01

    Full Text Available Scleroderma is a rare collagen disorder in which fibrosis of skin, subcutaneous tissues and muscles can occur with occasional involvement of bones. Localized scleroderma is a benign condition but can cause significant deformity when it affects the face. We report a case of localized scleroderma of the face causing progressive hemifacial atrophy.

  11. The 8th International Conference on Highly Frustrated Magnetism (HFM 2016)

    Gardner, J. S.; Kao, Y. J.

    2017-04-01

    The 8th International Conference on Highly Frustrated Magnetism 2016 (HFM 2016) took place between the 7th and 11th of September 2016 at the GIS Convention Center at National Taiwan University, Taipei, Taiwan. Over 260 participants from all over the world, attended the meeting making it the largest HFM to-date and revealing the impressive growth in the community since the original meeting in Waterloo, Canada where 80 participants attended. Preceding the meeting a school was held at the National Synchrotron Radiation Research Center to help those new to the field understand the material they were likely to see at HFM2016. Our thanks to the international speakers who attended this school John Chalker, Michel Kenzelmann, Philippe Mendels, Luigi Paolasini, Kirrily Rule, Yixi Su, Isao Watanabe and those from Taiwan W. T. Chen, Y-J, Kao, L. J. Chang and C. S. Ku, for their enlightening presentations. The HFM 2016 conference consisted of five plenary talks by H Takagi, B D Gaulin, L Balents, Y Tokura and S T Bramwell, 20 invited and 40 contributed presentations, and about 160 poster presentations from all aspects of theoretical and experimental frustrated magnetism. During the conference period, many stimulating discussions were held both inside and outside the conference room. Excursions to Taipei 101 and the National Palace Museum, as well as several organized dinners and receptions allowed the participants to initiate collaborations and discuss the hottest issues. The subjects covered in the conference included: · Quantum frustrated magnetism and spin liquids · Novel ordering of geometrically frustrated magnets · Frustration effect on the coupling to lattice, orbital and charge degrees of freedom · Exotic phenomena induced by macroscopic degeneracy · Field effect on frustrated magnetism etc. These proceeding represent a very small, but valuable contribution to the community. I hope you enjoy reading them. In view of the rapid growth of the field, it has been

  12. Initial Design and Quick Analysis of SAW Ultra–Wideband HFM Transducers

    A. Janeliauskas

    2017-09-01

    Full Text Available This paper presents techniques for initial design and quick fundamental and harmonic operation analysis of surface acoustic waves ultra–wideband hyperbolically frequency modulated (HFM interdigital transducer (IDT. The primary analysis is based on the quasi–static method. Quasi–electrostatic charge's density distribution was approximated by Chebyshev polynomials and the method of Green’s function. It assesses the non uniform charge distribution of electrodes, electric field interaction and the end effects of a whole transducer. It was found that numerical integration (e.g. Romberg, Gauss–Chebyshev requires a lot of machine time for calculation of the Chebyshev polynomial and the Green’s function convolution when integration includes coordinates of a large number of neighboring electrodes. In order to accelerate the charge density calculation, the analytic expressions are derived. Evaluation of HFM transducer fundamental and harmonics' operation amplitude response with simulation single–dispersive interdigital chirp filter structure is presented. Elapsed time of HFM IDT with 589 electrodes simulations and 2000 frequency response point is only 54 seconds (0.027 s/point on PC with CPU Intel Core I7–4770S. Amplitude response is compared with linear frequency modulated (LFM IDT response. It was determined that the HFM transducer characteristic is less distorted in comparison with LFM transducer.

  13. Espasmo hemifacial familiar: relato de dois casos Familial hemifacial spasm: report of two cases

    EGBERTO REIS BARBOSA

    1998-03-01

    Full Text Available Os autores relatam os achados clínicos e angiográficos de dois casos de espasmo hemifacial familiar. Esta é a quinta descrição sobre esse tema na literatura e apresenta mãe e filha com idades de 76 e 51 anos respectivamente, nas quais o lado esquerdo foi o acometido. Exames de angiorressonância realizados nas pacientes revelaram dolicobasilar com origem lateralizada à esquerda para ambos os casos. Também demonstraram artéria cerebelar póstero-inferior muito desenvolvida e irregularidades murais nas artérias vertebrais e basilar sugestivas de arteriosclerose na mãe e vasos intracranianos levemente alongados na filha. Dados de revisão da literatura e sobre a etiologia do espasmo hemifacial são enfocados.The authors report the clinical and angiographical findings of two cases of familial hemifacial spasm. This is the fifth description in the literature and presents mother and daughter at the ages of 76 and 51 respectively, in whom the left side was affected. They underwent exams of angioresonance that showed dolichobasilar with left side origin in both patients. The exams also demonstrated postero-inferior cerebellar artery very developed and irregularities in the walls of the vertebral and basilar arteries suggestive of arteriosclerosis in the mother and slightly elongated intracranial vessels in the daughter. Literature review and etiology data of the hemifacial spasm are focused.

  14. Anteverted internal auditory canal as an inner ear anomaly in patients with craniofacial microsomia.

    L'Heureux-Lebeau, Bénédicte; Saliba, Issam

    2014-09-01

    Craniofacial microsomia involves structure of the first and second branchial arches. A wide range of ear anomalies, affecting external, middle and inner ear, has been described in association with this condition. We report three cases of anteverted internal auditory canal in patients presenting craniofacial microsomia. This unique internal auditory canal orientation was found on high-resolution computed tomography of the temporal bones. This internal auditory canal anomaly is yet unreported in craniofacial anomalies. Copyright © 2014. Published by Elsevier Ireland Ltd.

  15. Pomelo peels as alternative substrate for extracellular pectinase production by Aspergillus niger HFM-8

    Ibrahim, D.

    2013-12-01

    Full Text Available Aims: The aim of this work was to develop an effective bioprocess to enhance the pectinase production by solid-state cultures of Aspergillus niger HFM-8. Methodology and results: The pectinase production produced by A. niger HFM-8 was studied under solid state fermentation using Malaysian pomelo (Citrus grandis peel as the substrate. This local agricultural waste is rich with lignocellulolytic material including pectin acts as the inducer of pectinase production. Under optimized conditions, 5 g of 0.75 mm pomelo peel size, moisture content of 60% (v/w sterile distilled water pH 5.0, inoculums size of 1x10^4 spores/mL, cultivation temperature of room temperature (30 ± 2 °C, no mixing incurred and with the addition of 1% (w/w citrus pectin and 0.1% (w/w urea has produced pectinase production of 306.89 U/g substrate and 0.78 mg glucosamine/g substrate of fungal growth on the 8th day of cultivation. Conclusion, significance and impact of study: There was 48.82% increment in enzyme production after the improvement of parameters. It was found that pomelo peel is a suitable feedstock for pectinase production.

  16. Efficacy of levetiracetam in primary hemifacial spasm.

    Kuroda, Takeshi; Saito, Yu; Fujita, Kazuhisa; Yano, Satoshi; Ishigaki, Seiichiro; Kato, Hirotaka; Murakami, Hidetomo; Ono, Kenjiro

    2016-12-01

    Hemifacial spasm (HFS) is a peripherally-induced movement disorder characterized by the involuntary, unilateral, intermittent, irregular, tonic or clonic contractions of muscles innervated by the ipsilateral facial nerve. Kindling-like hyperactivity of the facial nucleus induced by constant stimulation of compressing artery is considered as the predominant mechanism underlying the pathogenesis of HFS. As a treatment for HFS, microsurgical decompression and botulinum toxin injection have been shown to be highly successful. Anticonvulsant drugs relieve HFS in some patients; however, the use of such drugs is limited owing to their side effects, predominantly in elderly patients. We experienced two elderly HFS patients who exhibited a marked response to levetiracetam (LEV) without side effects. Although the exact underlying pharmacological mechanism remains unknown, we assume anti-kindling effect as one of the important pharmacological mechanism underlying the effect of LEV against HFS. Moreover, LEV is considered to be suitable for use in elderly patients because of its good tolerability. In addition, the lack of hepatic induction or inhibition makes it an easy and safe drug when used in addition to other anticonvulsants. Although the long-term benefit remains unknown, LEV may represent an alternative treatment for elderly HFS patients who are unable to undergo or decline surgical intervention and/or botulinum toxin injections or are intolerant to other anticonvulsants. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. EXPERIENCE OF ADMINISTRATION OF GROWTH HORMONE IN TREATMENT OF DIFFERENT TYPES OF MICROSOMIA IN CHILDREN

    V.A. Peterkova

    2009-01-01

    Full Text Available The opportunities of receiving of genetically engineered medications, e.g. somatotropic hormone (STG are almost unrestricted, and treatment and monitoring of patients with different types of microsomia can be held on modern, new level with the help of it. STG provides normal stature and valuable quality of life in these patients. Treatment with growth hormone influences on hormonal, metabolic and psychical status of patient. Metabolic effects are: increasing of muscle strength, improving of renal blood flow, increasing of cardiac output, absorbability of calcium in intestines and mineralization of bones. The level of blood cholesterol, lipoproteins is descended; blood alkaline phosphatase, phosphorus, urine and fatty acid are increased. Patients' vitality and quality of life are normalized. Besides somatotropic insufficiency, growth hormone is widely used in growth_stimulating treatment of different types of dwarism in children: microsomia due to pre_natal growth delay, genetic syndromes: Silwer–Russell, Shereshevsky–Turner, Nunan, Prader–Willi, and microsomia in patients with chronic renal disease.Key words: children, microsomia, somatotropic hormone, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:86-93

  18. Epidermoid cyst causing hemifacial spasm epidermoid cyst in cerebellopontine angle presenting with hemifacial spasm

    Murat Alemdar

    2012-01-01

    Full Text Available Hemifacial Spasm (HS occurs idiopathically or secondary to the lesions compressing the root exit zone of the facial nerve symptomatically. Symptomatic HS is generally due to vascular compression. We report on a 23-year-old male with right sided HS for a month. Magnetic resonance imaging (MRI of the brain revealed a well-demarcated epidermoid cyst in the right cerebellopontine cistern. It was hypointense on T1-weighted imaging, hyperintense on T2-weighted imaging without contrast enhancement, hyperintense on DWI, and slightly hypointense on ADC relative to the brain. Although it caused shifting of the pons and medulla to the left side and compression of the right cerebellar peduncles and fourth ventricle, the sole symptom of the patient was HS. Clinicians are advised to request MRI/scan for brainstem lesions from the patients with HS. Epidermoid cysts in cerebellopontine cistern may present with HS as the sole symptom.

  19. Reliable classification of facial phenotypic variation in craniofacial microsomia: a comparison of physical exam and photographs.

    Birgfeld, Craig B; Heike, Carrie L; Saltzman, Babette S; Leroux, Brian G; Evans, Kelly N; Luquetti, Daniela V

    2016-03-31

    Craniofacial microsomia is a common congenital condition for which children receive longitudinal, multidisciplinary team care. However, little is known about the etiology of craniofacial microsomia and few outcome studies have been published. In order to facilitate large, multicenter studies in craniofacial microsomia, we assessed the reliability of phenotypic classification based on photographs by comparison with direct physical examination. Thirty-nine children with craniofacial microsomia underwent a physical examination and photographs according to a standardized protocol. Three clinicians completed ratings during the physical examination and, at least a month later, using respective photographs for each participant. We used descriptive statistics for participant characteristics and intraclass correlation coefficients (ICCs) to assess reliability. The agreement between ratings on photographs and physical exam was greater than 80 % for all 15 categories included in the analysis. The ICC estimates were higher than 0.6 for most features. Features with the highest ICC included: presence of epibulbar dermoids, ear abnormalities, and colobomas (ICC 0.85, 0.81, and 0.80, respectively). Orbital size, presence of pits, tongue abnormalities, and strabismus had the lowest ICC, values (0.17 or less). There was not a strong tendency for either type of rating, physical exam or photograph, to be more likely to designate a feature as abnormal. The agreement between photographs and physical exam regarding the presence of a prior surgery was greater than 90 % for most features. Our results suggest that categorization of facial phenotype in children with CFM based on photographs is reliable relative to physical examination for most facial features.

  20. A de novo 1.38 Mb duplication of 1q31.1 in a boy with hemifacial microsomia, anophthalmia, anotia, macrostomia, and cleft lip and palate.

    Huang, Xue-shuang; Zhu, Bao; Jiang, Hai-ou; Wu, Su-fan; Zhang, Zai-qi; Xiao, Lin; Yi, Li-lan; Zhang, Jian-xiang

    2013-04-01

    We reported a 2-year-old boy with developmental delay, mild mental retardation, and severe craniofacial malformation, including facial asymmetry with hypoplasia of the left zygoma, maxilla, and mandible, and left anophthalmia and anotia. A genome-wide screen revealed a 1.38 Mb duplication on chromosome 1q31.1, which was absent in his parents and 27 healthy controls. The duplication region contains two Refseq genes, PLA2G4A and C1orf99, which have not been reported to be implicated in craniofacial malformation. Functional studies of these genes and additional clinical analysis are necessary to elucidate the pathogenesis of craniofacial malformation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Hemifacial spasm due to vertebrobasilar dolichoectasia: a case report

    Mustafa AbdelHamid, MD

    2015-12-01

    Full Text Available Hemifacial spasm (HFS happens because of vascular compression of the facial nerve at the root exit zone. Vertebrobasilar dolichoectasia (VBD is a very rare cause of HFS. VBD is diagnosed by computed tomography angiography and magnetic resonance imaging. Here, we report a case of 65-year-old female patient with HFS due to VBD. We discuss the complications and the treatment options for the case.

  2. Decompression of the facial nerve in cases of hemifacial spasm

    Karsten Kettel

    1954-12-01

    Full Text Available Among 11 patients a complete cure was obtained in one case, a fair result in 4 cases, while in 6 cases the effect of the operation has only been temporary and full recurrence has taken place. Even if decompression has thus resulted in a few recoveries and improvements, the results in the majority of cases have been disappointing. Everything points to hemifacial spasm being due to a disorder of the lower motor neuron. Intracranial lesions in the vicinity of the facial nerve are known to have resulted in irritation and spasm. It may be perfectly true that the majority of cases of hemifacial spasm are due to a lesion, the nature of which may vary, in the Fallopian canal near the stylomastoid foramen, not least the postparalytic following Bell's palsy. But the disappointing results of decompression seems to indicate that at the time of operation irreparable damage to the nerve has in the majority of cases been already done. Consequently I gave up decompression in cases of hemifacial spasm some years ago. Good results from injections of alcohol into the nerve have been reported13 but I prefer selective sections of the branches to the muscles involved as described by German and Greenwood8.

  3. Blink reflexes and lateral spreading in patients with synkinesia after Bell's palsy and in hemifacial spasm

    Eekhof, J. L.; Aramideh, M.; Speelman, J. D.; Devriese, P. P.; Ongerboer de Visser, B. W.

    2000-01-01

    We compared various electrodiagnostical tests in patients with hemifacial spasm and in patients who developed synkinesia after Bell's palsy. We examined the evoked blink reflexes in the orbicularis oculi (o. oculi) and orbicularis oris (o. oris) muscles in 23 patients with hemifacial spasm (HFS), in

  4. Manejo ortodóncico-ortopédico del niño con microsomía facial Orthodontic-orthopedic management of a child with facial microsomia

    María Elena González Espíndola

    2004-04-01

    Full Text Available Se conoce que la complejidad de las malformaciones congénitas craneofaciales deben tratarse en edades tempranas por medio de un equipo multidisciplinario donde el ortodoncista asume un rol protagónico destacado, aprovechando el potencial de crecimiento y desarrollo de los niños en esta etapa, lo que en ocasiones evita que al llegar a la etapa quirúrgica esta sea menos compleja, tanto para el paciente como para el cirujano. La microsomía hemifacial es una malformación congénita derivada de la alteración del primer y segundo arcos branquiales que puede estar asociada con otros síndromes. Puede existir afección unilateral o bilateral, pero con afectación más severa en uno de los 2 lados, y su etiología es multifactorial. La asimetría facial es una de las características propias de este síndrome, por ello en edades tempranas tratamos de redireccionar el crecimiento con el uso de un aparato funcional híbrido, o sea, adaptado específicamente a las características propias de cada paciente, con el que pueden obtenerse resultados altamente satisfactorios.It is well known that complex congenital craniofacial malformations should be treated at early ages by a multidisciplinary team where the orthodontist takes on a leading role, taking advantage of the potentialities of growth and development of children at this stage, which occasionally makes it possible that the disorder be less complex when reaching the surgical stage, both for the patient and the surgeon. Hemifacial microsomia is a congenital malformation derived from alterations in the first and second brachial arches that might be associated to other syndromes. There can be unilateral or bilateral damage, although the most severe effect is often found in one of the two sides of the face and it has a multi-factor etiology. Facial asymmetry is one of the characteristics inherent to this syndrome, so at early ages, we try to re-direct the growth with the use of a hybrid functional

  5. Hemifacial Display of Emotion in the Resting State

    M. K. Mandal

    1992-01-01

    Full Text Available The human face at rest displays distinguishable asymmetries with some lateralization of emotion or expression. The asymmetrical nature of the resting face was examined by preparing hemifacial composites, left–left, right–right, along with normal facial orientation. The left side and right side composites were constructed by using the lateral half of one side of the face and its mirror-reversal. The left side facial composites were found to be more emotional than the right side or normal facial orientations of neutral expressions.

  6. Exploring the Medical and Psychosocial Concerns of Adolescents and Young Adults With Craniofacial Microsomia: A Qualitative Study.

    Hamilton, Kayla V; Ormond, Kelly E; Moscarello, Tia; Bruce, Janine S; Bereknyei Merrell, Sylvia; Chang, Kay W; Bernstein, Jonathan A

    2018-01-01

    This study explores the experiences of adolescents and young adults with craniofacial microsomia, including the impact of growing up with this craniofacial condition on daily life and sense of self. The results may guide future research on optimally supporting individuals with craniofacial microsomia during this critical life phase. Participants were recruited through a craniofacial center, online patient support groups, and social media sites. Eleven individual semistructured interviews with participants between 12 and 22 years old were conducted by a single interviewer, transcribed, iteratively coded, and thematically analyzed. Five themes were evident in the data: (1) impact on personal growth and character development, (2) negative psychosocial impact, (3) deciding to hide or reveal the condition, (4) desire to make personal surgical decisions, and (5) struggles with hearing loss. We identified both medical and psychosocial concerns prevalent among adolescents with craniofacial microsomia. Although adolescents with craniofacial microsomia exhibit considerable resilience, the challenges they face impact their sense of self and should be addressed through psychosocial support and counseling. Further research should investigate the potential benefit of the wider use of hearing aids, as well as the involvement of patients in decision-making about reconstructive ear surgery.

  7. [Microvascular decompression for hemifacial spasm. Ten years of experience].

    Revuelta-Gutiérrez, Rogelio; Vales-Hidalgo, Lourdes Olivia; Arvizu-Saldaña, Emiliano; Hinojosa-González, Ramón; Reyes-Moreno, Ignacio

    2003-01-01

    Hemifacial spasm characterized by involuntary paroxistic contractions of the face is more frequent on left side and in females. Evolution is progressive and in a few cases may disappear. Management includes medical treatment, botulinum toxin, and microvascular decompression of the nerve. We present the results of 116 microvascular decompressions performed in 88 patients over 10 years. All patients had previous medical treatment. All patients were operated on with microsurgical technique by asterional craniotomy. Vascular compression was present in all cases with one exception. Follow-up was from 1 month to 133 months. Were achieved excellent results in 70.45% of cases after first operation, good results in 9.09%, and poor results in 20.45% of patients. Long-term results were excellent in 81.82%, good in 6.82%, and poor in 11.36% of patients. Hypoacusia and transitory facial palsy were the main complications. Hemifacial spasm is a painless but disabling entity. Medical treatment is effective in a limited fashion. Injection of botulinum toxin has good response but benefit is transitory. Microvascular decompression is treatment of choice because it is minimally invasive, not destructive, requires minimum technical support, and yields best long-term results.

  8. Progressive hemifacial atrophy with ciliary body atrophy and ocular hypotony

    T Ashwini Kini

    2015-01-01

    Full Text Available Progressive hemifacial atrophy (PHA is a disease of unknown etiology affecting one-half of the face. Ocular involvement is uncommon. Atrophy of iris is rare, with only a few cases of partial atrophy being reported in the literature. We report a case of total atrophy of iris and ciliary body with associated ocular hypotony in a 16-year-old girl with PHA. We believe this is the first reported case of complete atrophy of iris and ciliary body in PHA. Ocular hypotony in PHA was thought to be due to intra-ocular inflammation. However in our case it appears to be secondary to severe atrophy of the ciliary body.

  9. Idiopathic hemifacial spasm responsive to zonisamide: a case report.

    Siniscalchi, Antonio; Gallelli, Luca; Palleria, Caterina; De Sarro, Giovambattista

    2009-01-01

    We describe a patient with idiopathic hemifacial spasm (HFS) that was responsive to zonisamide treatment. A 65-year-old woman presented with a 4-year history of left-sided HFS developing gradually, starting from the upper facial muscles. After several analyses, the diagnosis of idiopathic HFS was made, and the clonazepam treatment (0.5 mg every 8 hours) was started, without a complete remission of symptoms. Therefore, zonisamide (150 mg twice a day for a 6-week period) was added, with a complete resolution. The rechallenge with zonisamide after its dechallenge confirmed its effectiveness. During follow-up, the patient remained symptom-free, with no adverse drug reactions. We suggest that zonisamide could represent a useful therapeutic option in the treatment of idiopathic HFS.

  10. Treatment of hemifacial spasm with botulinum A toxin. Results and rationale.

    Gonnering, R S

    1986-01-01

    Hemifacial spasm is characterized by unilateral, periodic, tonic contractions of facial muscles, thought to be caused by mechanical compression at the root-exit zone of the facial nerve. Electrophysiologic abnormalities such as ectopic excitation and synkinesis are typical. Although posterior fossa microsurgical nerve decompression is successful in bringing about relief of the spasm in most cases, it carries a risk to hearing. As an alternative treatment, 15 patients with hemifacial spasm were given a total of 41 sets of injections with botulinum A toxin, with a mean follow-up of 14.3 +/- 1.1 months. Relief of symptoms lasted a mean of 108.3 +/- 4.2 days. Mild transient lagophthalmos and ptosis were the only complications. Although the exact mechanism of its action and beneficial effect is speculative at this time, botulinum A toxin appears to offer an effective, safe alternative to more radical intracranial surgery for patients with hemifacial spasm.

  11. Use of various free flaps in progressive hemifacial atrophy.

    Baek, Rongmin; Heo, Chanyeong; Kim, Baek-kyu

    2011-11-01

    Romberg disease is an uncommon condition manifested by progressive hemifacial atrophy of the skin, soft tissue, and bone. Facial asymmetry with soft tissue deficiency in Romberg disease causes a significant disability affecting the social life and can bring about many psychological problems. The aim of surgical treatment is cosmetic amelioration of the defect. Several conventional reconstructive procedures have been used for correcting facial asymmetry. They include fat injections, dermal fat grafts, filler injections, cartilage and bone grafts, and pedicled and free flaps. We report our experiences with 11 patients involving 11 free flaps with a minimum 1-year follow-up. All patients were classified as having moderate to severe atrophy. The average age at disease onset was 4.5 years; the average duration of atrophy was 5.2 years. No patients were operated on with a quiescent interval of less than 1 year. The average age at operation was 20.1 years, ranging from 10 to 55 years. Reconstruction was performed using 4 groin dermofat free flaps, 4 latissimus dorsi muscle free flaps, and 3 other perforator flaps. To achieve the finest symmetrical and aesthetic results, several ancillary procedures were performed in 4 patients. These procedures included Le Fort I leveling osteotomy, sagittal split ramus osteotomy, reduction malarplasty and angle plasty, rib and calvarial bone graft, correction of alopecia, and additional fat graft. All patients were satisfied with the results. We believe that a free flap transfer is the requisite treatment modality for severe degree of facial asymmetry in Romberg disease.

  12. Effect of Hemifacial Spasm on Intraocular Pressure Measurement.

    Cicik, Erdogan; Yildirim, Rengin; Arici, Ceyhun; Dikkaya, Funda; Arslan, Osman Sevki

    2018-01-01

    To evaluate the effect of hemifacial spasm (HFS) on intraocular pressure (IOP) measurement. Twenty-four consecutive patients with HFS and 25 age- and gender-matched randomly selected eyes of healthy volunteers underwent corneal pachymetry and IOP measurements using Goldmann applanation tonometer (GAT) and noncontact tonometer (NCT). IOP measurements were performed before (during HFS) and 2 weeks after Botox injections in HFS patients and in healthy volunteers without Botox injections. There was no statistical difference between involved eye side and uninvolved eye side of HFS patients in measured central corneal thickness. Similarly, no difference was found between involved eye side of HFS patients and controls. There were no statistically significant differences comparing IOP values before treatment and levels measured at 2 weeks of Botox injections, either with GAT ( p = 0.33, 0.11) or NCT ( p = 0.80, 0.43) devices in the involved eyes and uninvolved eyes of patients with HFS, respectively. There were also no significant differences in these parameters (GAT ( p = 0.63) and NCT ( p = 0.54)) in controls. Contractions in facial muscles may not lead to significant increase in IOP in HFS patients. This result may help clinical decision making in the treatment of glaucoma patients with HFS. This trial is registered with NCT03390803.

  13. Persistent hemifacial spasm after microvascular decompression: a risk assessment model.

    Shah, Aalap; Horowitz, Michael

    2017-06-01

    Microvascular decompression (MVD) for hemifacial spasm (HFS) provides resolution of disabling symptoms such as eyelid twitching and muscle contractions of the entire hemiface. The primary aim of this study was to evaluate the predictive value of patient demographics and spasm characteristics on long-term outcomes, with or without intraoperative lateral spread response (LSR) as an additional variable in a risk assessment model. A retrospective study was undertaken to evaluate the associations of pre-operative patient characteristics, as well as intraoperative LSR and need for a staged procedure on the presence of persistent or recurrent HFS at the time of hospital discharge and at follow-up. A risk assessment model was constructed with the inclusion of six clinically or statistically significant variables from the univariate analyses. A receiving operator characteristic curve was generated, and area under the curve was calculated to determine the strength of the predictive model. A risk assessment model was first created consisting of significant pre-operative variables (Model 1) (age >50, female gender, history of botulinum toxin use, platysma muscle involvement). This model demonstrated borderline predictive value for persistent spasm at discharge (AUC .60; p=.045) and fair predictive value at follow-up (AUC .75; p=.001). Intraoperative variables (e.g. LSR persistence) demonstrated little additive value (Model 2) (AUC .67). Patients with a higher risk score (three or greater) demonstrated greater odds of persistent HFS at the time of discharge (OR 1.5 [95%CI 1.16-1.97]; p=.035), as well as greater odds of persistent or recurrent spasm at the time of follow-up (OR 3.0 [95%CI 1.52-5.95]; p=.002) Conclusions: A risk assessment model consisting of pre-operative clinical characteristics is useful in prognosticating HFS persistence at follow-up.

  14. Hemifacial spasm : Intraoperative electromyographic monitoring as a guide for microvascular decompression

    Mooij, JJA; Mustafa, MK; van Weerden, TW

    2001-01-01

    OBJECTIVE: Microvascular decompression is the logical and well-accepted treatment of choice for hemifacial spasm (HFS). In experienced hands, good to excellent results can be obtained. However, sometimes the exact site of the vascular compression is unclear. The aim of this study was to analyze

  15. Hemifacial spasm in a patient with basilar artery dolichoectasia caused by uncontrolled hypertension

    Gordon S. Crabtree

    2016-10-01

    Full Text Available A 47-year-old male presented with a 2-year history of hemifacial spasm. Magnetic resonance imaging performed showed his tortuous basilar artery with nerve compression, and the patient was treated conservatively with botulinum toxin injections with complete resolution of symptoms. This rare disease was caused by his long history of hypertension, which led to his major basilar artery dolichoectasia.

  16. Prevalence of Bruxism in Hemifacial-Spasm Patients.

    Ella, Bruno; Guillaud, Etienne; Langbour, Nicolas; Guehl, Dominique; Burbaud, Pierre

    2017-06-01

    A previous study reported an increased prevalence of bruxism (25%) in patients with cranio-cervical dystonia (CCD) compared to normal controls (13%). CCD can affect the muscles of the head and neck. Besides the CCD affecting these muscles, hemifacial spasm (HFS) is a form of peripheral myoclonus due to a neurovascular conflict affecting the muscles of the face. The fact that they affect the same muscle regions could lead to other links in clinical manifestations such as bruxism, which is more common in patients with CCD than in the normal population. The aim was to study the prevalence of bruxism in patients with HFS. Patients with HFS were enrolled in the department of clinical neurophysiology (Bordeaux University Hospital) over a 6-month period. They were paired regarding age, the absence of neurological pathology or neuroleptics intake. To be included in the study, patients needed to have had unilateral involuntary facial muscle contractions affecting one hemiface. A hetero-questionnaire and a clinicial study were performed. The diagnostic criteria of bruxism included parafunction items such as grinding and clenching and at least one of the following clinical signs: abnormal tooth wear, temporomandibular joint (TMJ) pain, TMJ clicking, muscle hypertonia (masseter or temporal muscles). Additional epidemiological data were collected including age, sex, disease duration, stress, and sleep disorders. Stress symptoms inventory included symptoms like depression, strong heartbeat, dry mouth, anger, inability to concentrate, weakness, fatigability, insomnia, headache, and excessive sweating. The sleep disorder diagnosis included at least two of the symptoms described in the ICSD-3. All these criteria were recorded as either present (scored "1") or absent (scored "0"). The prevalence of bruxism in the two groups (normal and HFS) was not significantly different (p = 0.37). The rate was not significantly different between sleep and awake bruxism (p = 0.15) in both groups

  17. Mandibular transformations in prepubertal patients following treatment for craniofacial microsomia: thin-plate spline analysis.

    Hay, A D; Singh, G D

    2000-01-01

    To analyze correction of mandibular deformity using an inverted L osteotomy and autogenous bone graft in patients exhibiting unilateral craniofacial microsomia (CFM), thin-plate spline analysis was undertaken. Preoperative, early postoperative, and approximately 3.5-year postoperative posteroanterior cephalographs of 15 children (age 10+/-3 years) with CFM were scanned, and eight homologous mandibular landmarks digitized. Average mandibular geometries, scaled to an equivalent size, were generated using Procrustes superimposition. Results indicated that the mean pre- and postoperative mandibular configurations differed statistically (PThin-plate spline analysis indicated that the total spline (Cartesian transformation grid) of the pre- to early postoperative configuration showed mandibular body elongation on the treated side and inferior symphyseal displacement. The affine component of the total spline revealed a clockwise rotation of the preoperative configuration, whereas the nonaffine component was responsible for ramus, body, and symphyseal displacements. The transformation grid for the early and late postoperative comparison showed bilateral ramus elongation. A superior symphyseal displacement contrasted with its earlier inferior displacement, the affine component had translocated the symphyseal landmarks towards the midline. The nonaffine component demonstrated bilateral ramus lengthening, and partial warps suggested that these elongations were slightly greater on the nontreated side. The affine component of the pre- and late postoperative comparison also demonstrated a clockwise rotation. The nonaffine component produced the bilateral ramus elongations-the nontreated side ramus lengthening slightly more than the treated side. It is concluded that an inverted L osteotomy improves mandibular morphology significantly in CFM patients and permits continued bilateral ramus growth. Copyright 2000 Wiley-Liss, Inc.

  18. Mandibular asymmetry and the fourth dimension.

    Kaban, Leonard B

    2009-03-01

    This paper represents more than 30 years of discussion and collaboration with Drs Joseph Murray and John Mulliken in an attempt to understand growth patterns over time (ie, fourth dimension) in patients with hemifacial microsomia (HFM). This is essential for the development of rational treatment protocols for children and adults with jaw asymmetry. Traditionally, HFM was thought of as a unilateral deformity, but it was recognized that 20% to 30% of patients had bilateral abnormalities. However, early descriptions of skeletal correction addressed almost exclusively lengthening of the short (affected) side of the face. Based on longitudinal clinical observations of unoperated HFM patients, we hypothesized that abnormal mandibular growth is the earliest skeletal manifestation and that restricted growth of the mandible plays a pivotal role in progressive distortion of both the ipsilateral and contralateral facial skeleton. This hypothesis explains the progressive nature of the asymmetry in patients with HFM and provides the rationale for surgical lengthening of the mandible in children to prevent end-stage deformity. During the past 30 years, we have learned that this phenomenon of progressive distortion of the adjacent and contralateral facial skeleton occurs with other asymmetric mandibular undergrowth (tumor resection, radiation therapy, or posttraumatic defects) and overgrowth (mandibular condylar hyperplasia) conditions. In this paper, I describe the progression of deformity with time in patients with mandibular asymmetry as a result of undergrowth and overgrowth. Understanding these concepts is critical for the development of rational treatment protocols for adults with end-stage asymmetry and for children to minimize secondary deformity.

  19. Progressive Hemifacial Atrophy and Linear Scleroderma En Coup de Sabre: A Spectrum of the Same Disease?

    Irina Khamaganova

    2018-01-01

    Full Text Available Similar clinical and histhopathological features in progressive hemifacial atrophy and linear scleroderma en coup de sabre are well known. Trauma may predispose to the development of both diseases. The lack of association with anti-Borrelia antibodies was shown in both cases as well. The otolaryngological and endocrine disorders may be associated findings in both diseases. However, there are certain differences in neurological and ophthalmological changes in the diseases.

  20. Espasmo hemifacial: resultados do tratamento cirúrgico em 14 casos Hemifacial spasm: report of 14 cases submitted to surgical treatment

    Rui R. D. Carvalho

    1973-06-01

    Full Text Available Quatorze pacientes com espasmo hemifacial foram submetidos a exploração cirúrgica e neurolise do 7º par craniano no ângulo ponto-cerebelar. Em 7 pacientes havia indubitável compressão do nervo facial por alça anômala da artéria cerebelar anterior e inferior sendo que um paciente também apresentava malformação de Arnold-Chiari. Em um paciente havia aracnoidite envolvendo o nervo. Em 6 outros, o nervo achava-se aparentemente livre. Houve alívio imediato e duradouro do espasmo em 10 pacientes, 2 permaneceram inalterados e um apresentou recidiva após 10 meses. Houve um óbito no pós-operatório imediato, conseqüente a traumatismo craniano por queda do paciente.Fourteen patients with hemifacial spasm were submitted to surgical exposure and neurolysis of the seventh nerve at the cerebellopontine angle. Seven patients had an anomalous anterior inferior cerebellar artery pulsating on the nerve, being present in one patient also Arnold-Chiari malformation. Another patient had chronic arachnoiditis involving the facial nerve. In 6 patients no abnormalities were found in the posterior fossa. There was complete relief of the spasm in 10 patients, 2 were unchanged, 1 had recurrence 10 months later and 1 died in the post-operative period due to head injury sustained during a fall.

  1. The Clinical Observation on 10 cases of patients with Hemifacial Spasm Treated by Soyeom Pharmacupuncture at G20(Pungji

    Jin Heo

    2010-06-01

    Full Text Available Objectives : The main purpose of this research is to evaluate the effect of treatment with Soyeom Pharmacupuncture at G20(Punji for ten patients with hemifacial spasm. Methods : We have treated them with acupuncture treatment and Soyeom Pharmacupuncture at G20(Pungji, and evaluated the effect by Scott`s scale. Results : After treatment, the grades of spasm intensity classified by Scott`s description were improved in 9 cases. Conclusion : This data suggested that Soyeom Pharmacupuncture at G20(Pungji for hemifacial spasm was effective and will be attempted to the patients with it.

  2. Spastic paretic hemifacial contracture as a presenting feature of multiple sclerosis.

    Koutsis, Georgios; Breza, Marianthi; Evangelopoulos, Maria-Eleftheria; Anagnostouli, Maria; Andreadou, Elisavet; Karagiorgis, Georgios; Kokotis, Panagiotis; Kilidireas, Costas; Karandreas, Nikolaos

    2017-04-01

    Spastic paretic hemifacial contracture (SPHC) is characterized by sustained unilateral contraction of the facial muscles associated with mild ipsilateral facial paresis. Rarely described in the context of multiple sclerosis (MS), it has never been reported as presenting symptom of MS. Two patients developed SPHC within the context of a clinically isolated syndrome suggestive of MS. EMG revealed continuous resting activity of irregularly firing motor unit potentials, associated with impaired recruitment upon voluntary contraction. SPHC remitted fully in both patients. SPHC, a rare but distinct clinical and EMG entity, can occasionally be the presenting feature of MS. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Parry-Romberg syndrome (progressive hemifacial atrophy) with spasmodic dysphonia--a rare association.

    Mugundhan, K; Selvakumar, C J; Gunasekaran, K; Thiruvarutchelvan, K; Sivakumar, S; Anguraj, M; Arun, S

    2014-04-01

    Parry-Romberg syndrome is a rare clinical entity characterised by progressive hemifacial atrophy with appearance of 'saber'. Various neurological and otorhinolaryngological disorders are associated with this syndrome. The association of Parry -Romberg syndrome with Spasmodic dysphonia has rarely been reported. A 37 year old female presented with progressive atrophy of tissues of left side of face for 10 years and change in voice for 1 year. On examination, wasting and atrophy of tissues including tongue was noted on left side of the face. ENT examination revealed adductor spasmodic dysphonia. We report the rare association of Parry -Romberg syndrome with spasmodic dysphonia.

  4. Espasmo hemifacial e impressão basilar associados a malformação de arnold-chiari relato de caso

    Manoel Baldoino Leal Filho

    1992-09-01

    Full Text Available Os autores relatam o caso de uma paciente com espasmo hemifacial e impressão basilar associados a malformação de Arnold-Chiari. Com a descompressão cirúrgica da fossa posterior, empregada no tratamento da impressão basilar, houve melhora do quadro clínico e o espasmo hemifacial se reduziu quanto à frequência, duração e intensidade. É enfatizada a necessidade do tratamento etiológico do espasmo hemifacial, antes de se recorrer à toxina botulínica.

  5. Espasmo hemifacial: resultados do tratamento cirúrgico em 14 casos

    Rui R. D. Carvalho

    1973-06-01

    Full Text Available Quatorze pacientes com espasmo hemifacial foram submetidos a exploração cirúrgica e neurolise do 7º par craniano no ângulo ponto-cerebelar. Em 7 pacientes havia indubitável compressão do nervo facial por alça anômala da artéria cerebelar anterior e inferior sendo que um paciente também apresentava malformação de Arnold-Chiari. Em um paciente havia aracnoidite envolvendo o nervo. Em 6 outros, o nervo achava-se aparentemente livre. Houve alívio imediato e duradouro do espasmo em 10 pacientes, 2 permaneceram inalterados e um apresentou recidiva após 10 meses. Houve um óbito no pós-operatório imediato, conseqüente a traumatismo craniano por queda do paciente.

  6. Sexual well-being in patients with blepharospasm, spasmodic torticollis and hemifacial spasm: a pilot study

    Paola Perozzo

    2016-10-01

    Full Text Available Mood, anxiety and other psychological symptoms are common in dystonic patients suffering from blepharospam (BSP and spasmodic torticollis (ST. Since sexual well-being is an important aspect of mental health, here, we investigated whether these patients may also experience a worsening of their sexual life. In particular, quality of sexual life was evaluated in patients suffering from BSP (N=30, ST (N=30, and in a control group of patient with Hemifacial spasm (HFS; N=30, undergoing botulinum toxin type A therapy. A group of 30 age-matched healthy volunteers constituted an additional control group. Patients were evaluated just before the periodic injection of botulinum toxin. Sexual functioning was assessed using the Sexual Functioning Inventory (SFI, a reduced form of the Gollombok Rust Inventory, previously employed in patients with Parkinson’s disease. Depression (Beck Depression Inventory and anxiety (STAI-X1/X2 were also assessed. Results revealed that sexual functioning was significantly affected in patients with BSP, ST, and HFS with respect to healthy controls. Dystonic patients manifested more sexual dysfunction than patients with HFS. Overall, females had a poorer quality of sexual life than males and, among females, women with BSP were the most dysfunctional. Psychological symptoms were present in patients with dystonia, but not in patients with HFS. As discussed in the paper, several factors might be taken into account to explain worse quality of sexual life in patients with dystonia compared to patients with hemifacial spasm. Among them an important role might be played by the central origin of dystonia pathophysiology (i.e. altered activity of cortico-striato-thalamic-cortical circuits. Future investigations are necessary to further explore these preliminary findings, considering that this is the first time that sexual well-being is evaluated in patients with BSP, ST and HFS, and comparable data are not available.

  7. Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve

    Son, Byung-chul; Choi, Jin-gyu

    2017-01-01

    Here we report a unique case of chronic occipital neuralgia caused by pathological vascular contact of the left greater occipital nerve. After 12 months of left-sided, unremitting occipital neuralgia, a hypesthesia and facial pain developed in the left hemiface. The decompression of the left greater occipital nerve from pathological contacts with the occipital artery resulted in immediate relief for hemifacial sensory change and facial pain, as well as chronic occipital neuralgia. Although re...

  8. Hemifacial Spasm

    ... the face (facial). The disorder occurs in both men and women, although it more frequently affects middle-aged or elderly women. It is much more ... the face (facial). The disorder occurs in both men and women, although it more frequently affects middle-aged or elderly women. It is much more ...

  9. Structural brain alterations in hemifacial spasm: A voxel-based morphometry and diffusion tensor imaging study.

    Tu, Ye; Yu, Tian; Wei, Yongxu; Sun, Kun; Zhao, Weiguo; Yu, Buwei

    2016-02-01

    Hemifacial spasm (HFS) is characterized by involuntary, irregular clonic or tonic movement of muscles innervated by the facial nerve. We evaluated structural reorganization in brain gray matter and white matter and whether neuroplasticity is linked to clinical features in HFS patients. High-resolution structural magnetic resonance imaging and diffusion tensor imaging data were acquired by 3.0 T MRI from 42 patients with HFS and 30 healthy subjects. The severity of the spasm was assessed according to Jankovic disability rating scale. Voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis were performed to identify regional grey matter volume (GMV) changes and whole-brain microstructural integrity disruption measured by fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). The VBM analysis showed that patients with HFS reduced GMV in the right inferior parietal lobule and increased GMV in the cerebellar lobule VIII, when compared with healthy subjects. Furthermore, within the HFS disease group, GMV decreased with the disease duration in the right inferior parietal lobule. TBSS did not identify group differences in diffusivity parameters. While no white matter integrity disruption was detected in the brain of patients with HFS, our study identified evident GMV changes in brain areas which were known to be involved in motor control. Our results suggest that HFS, a chronic neurovascular conflict disease, is related to structural reorganization in the brain. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Botulinum toxin A is effective to treat tension-type headache caused by hemifacial spasm.

    Mizuma, Atsushi; Nagata, Eiichiro; Yasuda, Takashi; Kouchi, Maiko; Nakayama, Taira; Honma, Kazunari; Tokuoka, Kentaro; Kitagawa, Yasuhisa; Nogawa, Shigeru; Takizawa, Shunya

    2017-10-01

    We examined the relationship between hemifacial spasm (HFS; a form of cranio-cervical dystonia) and chronic primary headache, including tension-type headache (TTH). We also examined whether botulinum toxin A (BoNT/A) therapy for HFS ameliorates concomitant TTH. Fifty-one HFS patients receiving BoNT/A therapy were recruited. Patients' characteristics (including age, gender, chronic headache history, exercise habits, stiff neck, cervical spondylolysis history), stress factors, worsening/new onset of headache associated with HFS, and dose of BoNT/A were examined. We diagnosed headache types according to The International Classification of Headache Disorders, 3rd edition, beta. Numerical Rating Scale (NRS) and Headache Impact Test-6 (HIT-6) scores for headache severity were compared between the 6-week baseline before BoNT/A therapy and 6-week follow-up after BoNT/A therapy. Of 51 patients with HFS, 17 (33.3%) reported worsening or new onset of headache (especially TTH) associated with HFS (Group-S), and 34 were not aware of headache (Group-N). Twelve patients (70.6%) in group-S reported improvement of headache after BoNT/A therapy. NRS (from 7 [5-9] to 0 [0-5], pheadache (odds ratio 28.53: 2.96-275.10, pheadache, especially TTH, is associated with HFS. BoNT/A therapy for HFS may also be indirectly effective for treatment of TTH. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Treatment of hemifacial spasm with botulinum toxin type a: effective, long lasting and well tolerated

    Jean Pierre Mette Batisti

    Full Text Available ABSTRACT Hemifacial spasm (HFS is a common movement disorder characterized by involuntary tonic or clonic contractions of the muscles innervated by the facial nerve. Objective To evaluate the long-term effect of botulinum toxin type A (BTX-A in the treatment of HFS. Methods A retrospective analysis of patients treated at the Movement Disorders Outpatient Clinic in the Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, from 2009 to 2013 was carried out. A total of 550 BTX-A injections were administered to 100 HFS patients. Results Mean duration of improvement following each injection session was 3.1 months, mean latency to detection of improvement was 7.1 days and mean success rate was 94.7%. Patients were evaluated at an interval of 5.8 months after each application. Adverse effects, which were mostly minor, were observed in 37% of the patients at least once during follow-up. The most frequent was ptosis (35.1%. Conclusion Treatment of HFS with BTX-A was effective, sustainable and safe and had minimal, well-tolerated side effects.

  12. MICROVASCULAR DECOMPRESSION FOR HEMIFACIAL SPASM--TECHNICAL NOTES AND COMPLICATION PRE VENTION: EXPERIENCE OF 338 CASES

    赵卫国; 沈建康; 成侃; 胡锦清; 濮春华; 卞留贯; 孙青芳; 朱军

    2003-01-01

    Objective To summarize our clinical experience of microvascular decompression (MVD) for medically intractable hemifacial spasm(HFS) patients with emphasis on microsurgical manipulation and to improve cure rate and avoid surgical complications.MethodsThree hundred and thirty eight patients with HFS underwent MVD under general anesthesia. With the help of "zero retraction" technique, prosthesis can be properly inserted between offending vessel loop and affected facial nerve REZ in a "rolling ball" fashion under operative microscope.ResultsSurgical intervention achieved high relief rate of 91.4% and no major complications, with low recurrence rate of only 3.2% after averaging more than two years follow up (M=32 months).ConclusionIt is possible to approach to the facial nerve REZ with "zero retraction", which is fundamentally important to clear from cranial nerve and cerebellar injury. Skilled microsurgical technique along with correct recognition and mobilization of offending vessels are a must to assure MVD a highly efficacious and low risk treatment of choice for HFS patients.

  13. Altered spontaneous brain activity in patients with hemifacial spasm: a resting-state functional MRI study.

    Ye Tu

    Full Text Available Resting-state functional magnetic resonance imaging (fMRI has been used to detect the alterations of spontaneous neuronal activity in various neurological and neuropsychiatric diseases, but rarely in hemifacial spasm (HFS, a nervous system disorder. We used resting-state fMRI with regional homogeneity (ReHo analysis to investigate changes in spontaneous brain activity of patients with HFS and to determine the relationship of these functional changes with clinical features. Thirty patients with HFS and 33 age-, sex-, and education-matched healthy controls were included in this study. Compared with controls, HFS patients had significantly decreased ReHo values in left middle frontal gyrus (MFG, left medial cingulate cortex (MCC, left lingual gyrus, right superior temporal gyrus (STG and right precuneus; and increased ReHo values in left precentral gyrus, anterior cingulate cortex (ACC, right brainstem, and right cerebellum. Furthermore, the mean ReHo value in brainstem showed a positive correlation with the spasm severity (r = 0.404, p = 0.027, and the mean ReHo value in MFG was inversely related with spasm severity in HFS group (r = -0.398, p = 0.028. This study reveals that HFS is associated with abnormal spontaneous brain activity in brain regions most involved in motor control and blinking movement. The disturbances of spontaneous brain activity reflected by ReHo measurements may provide insights into the neurological pathophysiology of HFS.

  14. Challenges in the management of massive intraorbital and hemifacial arteriovenous malformation as causing life-threatening epistaxis

    Anura Michelle Manuel

    2017-03-01

    Full Text Available Arteriovenous malformations are congenital lesions that may evolve with time and manifest in a plethora of presentations. They can occur as torrential epistaxis when it extensively involves the facial region. Multi-imaging modalities are available to assist in characterizing the structure of the lesion as well as its location and extent. This complex disease requires a multidisciplinary team approach with preoperative embolization and surgery. We present a rare cause of life-threatening epistaxis in a gentleman with a longstanding orbital and hemifacial arteriovenous malformation and discuss the complexities involved in its management.

  15. Challenges in the management of massive intraorbital and hemifacial arteriovenous malformation as causing life-threatening epistaxis.

    Manuel, Anura Michelle; Kalimuthu, Santhi; Pathmanathan, Sitra Siri; Narayanan, Prepageran; Zainal Abidin, Zurina; Azmi, Khairul; Khalil, Alizan

    2017-04-01

    Arteriovenous malformations are congenital lesions that may evolve with time and manifest in a plethora of presentations. They can occur as torrential epistaxis when it extensively involves the facial region. Multi-imaging modalities are available to assist in characterizing the structure of the lesion as well as its location and extent. This complex disease requires a multidisciplinary team approach with preoperative embolization and surgery. We present a rare cause of life-threatening epistaxis in a gentleman with a longstanding orbital and hemifacial arteriovenous malformation and discuss the complexities involved in its management. Copyright © 2017. Published by Elsevier Taiwan.

  16. Hemifacial spasm in a patient with neurofibromatosis and Arnold-Chiari malformation: a unique case association Espasmo hemifacial em paciente com neurofibromatose e malformação de Arnold-Chiari: uma associação rara

    Andre Carvalho Felício

    2007-09-01

    Full Text Available BACKGROUND: The association of hemifacial spasm (HFS, Chiari type I malformation (CIM and neurofibromatosis type 1 (NF1 has not been described yet. CASE REPORT: We report the case of a 31-year-old woman with NF1 who developed a right-sided HFS. On magnetic resonance imaging (MRI a CIM was seen without syringomyelia. The patient has been successfully treated with botulinum toxin type A injections for 5 years without major side effects. CONCLUSION:Clinical features of HFS, CMI and NF1 are highlighted together with their possible relationship. Also, therapeutic strategies are also discussed.INTRODUÇÃO: A associação entre espasmo hemifacial (EHF, malformação de Chiari tipo I (MCI e neurofibromatose tipo I (NFI ainda não foi descrita. RELATO DO CASO: Relatamos o caso de mulher com 31 anos com NFI que desenvolveu EHF à direita. Na ressonância magnética (RM foi observada MCI sem seringomielia associada. A paciente foi tratada com sucesso com toxina botulínica tipo A por 5 anos sem efeitos colaterais. CONCLUSÃO: Ressaltamos as características clínicas do EHF, MCI e NFI assim como uma possível relação entre elas. Além disto, discutimos também estratégias terapêuticas.

  17. Severe Hemifacial Spasm is a Predictor of Severe Indentation and Facial Palsy after Microdecompression Surgery.

    Na, Boo Suk; Cho, Jin Whan; Park, Kwan; Kwon, Soonwook; Kim, Ye Sel; Kim, Ji Sun; Youn, Jinyoung

    2018-04-27

    Hemifacial spasm (HFS) is mostly caused by the compression of the facial nerve by cerebral vessels, but the significance of spasm severity remains unclear. We investigated the clinical significance of spasm severity in patients with HFS who underwent microvascular decompression (MVD). We enrolled 636 patients with HFS who underwent MVD between May 2010 and December 2013 at Samsung Medical Center (SMC), Seoul, Korea. Subjects were divided into two groups based on spasm severity: severe (SMC grade 3 or 4) and mild (SMC grade 1 or 2). We compared demographic, clinical, and surgical data between these two groups. The severe-spasm group was older and had a longer disease duration at the time of MVD compared to the mild-spasm group. Additionally, hypertension and diabetes mellitus were more common in the severe-spasm group than in the mild-spasm group. Regarding surgical findings, there were more patients with multiple offending vessels and more-severe indentations in the severe-spasm group than in the mild-spasm group. Even though the surgical outcomes did not differ, the incidence of delayed facial palsy after MVD was higher in the severe-spasm group than in the mild-spasm group. Logistic regression analysis showed that severe-spasm was correlated with longer disease duration, hypertension, severe indentation, multiple offending vessels, and delayed facial palsy after MVD. Spasm severity does not predict surgical outcomes, but it can be used as a marker of pathologic compression in MVD for HFS, and be considered as a predictor of delayed facial palsy after MVD. Copyright © 2018 Korean Neurological Association.

  18. Differentiating non-motor symptoms in Parkinson's disease from controls and hemifacial spasm.

    Ming-Hui Yong

    Full Text Available BACKGROUND AND AIMS: Non-motor symptoms (NMS are important manifestations of Parkinson's disease (PD that reduce patients' health-related quality of life. Some NMS may also be caused by age-related changes, or manifested as a psychological reaction to a chronic neurological condition. This case-control study compared the NMS burden among PD patients, healthy controls and hemifacial spasm (HFS patients. In addition, we determined the NMS that discriminated between PD and non-PD subjects. METHODS: 425 subjects were recruited from a tertiary hospital in Singapore (200 PD patients, 150 healthy controls and 75 HFS patients. NMS burden in subjects was measured using the Non-Motor Symptoms Scale (NMSS. RESULTS: NMSS total score was significantly higher in PD patients (37.9±2.6 compared to healthy controls (11.2±0.9 (p<0.0001 and HFS patients (18.0±2.1 (p<0.0001. In addition, NMSS total score was significantly higher in HFS patients compared to healthy controls (p = 0.003. PD patients experienced a higher NMS burden than healthy controls in all domains, and a higher NMS burden than HFS patients in all but attention/memory and urinary domains. NMS burden for HFS and healthy controls differed only in the sleep/fatigue and urinary domains. Using stepwise logistic regression, problems of 'constipation', 'restless legs', 'dribbling saliva', 'altered interest in sex' and 'change in taste or smell' were found to have significant discriminative power in differentiating between PD patients and healthy controls and between PD patients and HFS patients. CONCLUSION: PD patients experienced a greater overall NMS burden compared to both healthy controls and HFS patients. HFS patients demonstrated a higher NMS burden than controls, and some NMS may be common to chronic neurological conditions while others are more specific to PD. Differentiating patients using NMS domains may help refine the clinical management of NMS in PD patients.

  19. Magnetic resonance imaging of vascular compression in trigeminal neuralgia and hemifacial spasms

    Nagaseki, Yoshishige; Horikoshi, Tohru; Omata, Tomohiro; Sugita, Masao; Nukui, Hideaki; Sakamoto, Hajime; Kumagai, Hiroshi; Sasaki, Hideo; Tsuji, Reizou.

    1991-01-01

    We show how neurosurgical planning can benefit from the better visualization of the precise vascular compression of the nerve provided by the oblique-sagittal and gradient-echo method (OS-GR image) using magnetic resonance images (MRI). The scans of 3 patients with trigeminal neuralgia (TN) and of 15 with hemifacial spasm (HFS) were analyzed for the presence and appearance of the vascular compression of the nerves. Imaging sequences consisted of an OS-GR image (TR/TE: 200/20, 3-mm-thick slice) cut along each nerve shown by the axial view, which was scanned at the angle of 105 degrees taken between the dorsal line of the brain stem and the line corresponding to the pontomedullary junction. In the OS-GR images of the TN's, the vascular compressions of the root entry zone (REZ) of the trigeminal nerve were well visualized as high-intensity lines in the 2 cases whose vessels were confirmed intraoperatively. In the other case, with atypical facial pain, vascular compression was confirmed at the rostral distal site on the fifth nerve, apart from the REZ. In the 15 cases of HFS, twelve OS-GR images (80%) demonstrated vascular compressions at the REZ of the facial nerves from the direction of the caudoventral side. During the surgery for these 12 cases, in 11 cases (excepting the 1 case whose facial nerve was not compressed by any vessels), vascular compressions were confirmed corresponding to the findings of the OS-GR images. Among the 10 OS-GR images on the non-affected side, two false-positive findings were visualized. It is concluded that OS-GR images obtained by means of MRI may serve as a useful planning aid prior to microvascular decompression for cases of TN and HFS. (author)

  20. Successful surgical treatment of intractable hemifacial spasm: A case report and review of cerebellar hamartomas of the floor of the fourth ventricle

    Joseph H. Miller

    2016-12-01

    Full Text Available Introduction: Hamartomas involving the floor of the fourth ventricle and cerebellum are rare, but can be associated with medically recalcitrant hemifacial spasm. These lesions present early in the neonatal or infantile period and respond well to surgical excision. Case Report: A 3-month-old white male presented with recurrent left hemifacial spasm, left eye deviation, and absent movement of the extremities. The patient was found to have a left eccentric lesion in the floor of the fourth ventricle and cerebellum. The patient showed no improvement with medical therapy by 6 months of age. He was taken to the operating room for suboccipital craniotomy and removal of the posterior arch of C1 followed by intralesional recording of epileptogenic activity and gross total resection of the lesion. After histologic analysis, the lesion was determined to be ectopic cerebral tissue consistent with a hamartoma. Postoperative MRI showed complete removal of the lesion, and the patient exhibited complete remission of his hemifacial spasm and associated symptoms. Conclusions: Hamartomas involving the floor of the fourth ventricle can present with hemifacial spasm and respond well to surgical excision. Keywords: Cerebellar, Seizure, Epilepsy, Hamartoma

  1. Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve.

    Son, Byung-Chul; Choi, Jin-Gyu

    2017-01-01

    Here we report a unique case of chronic occipital neuralgia caused by pathological vascular contact of the left greater occipital nerve. After 12 months of left-sided, unremitting occipital neuralgia, a hypesthesia and facial pain developed in the left hemiface. The decompression of the left greater occipital nerve from pathological contacts with the occipital artery resulted in immediate relief for hemifacial sensory change and facial pain, as well as chronic occipital neuralgia. Although referral of pain from the stimulation of occipital and cervical structures innervated by upper cervical nerves to the frontal head of V1 trigeminal distribution has been reported, the development of hemifacial sensory change associated with referred trigeminal pain from chronic occipital neuralgia is extremely rare. Chronic continuous and strong afferent input of occipital neuralgia caused by pathological vascular contact with the greater occipital nerve seemed to be associated with sensitization and hypersensitivity of the second-order neurons in the trigeminocervical complex, a population of neurons in the C2 dorsal horn characterized by receiving convergent input from dural and cervical structures.

  2. Multimodal Image-Based Virtual Reality Presurgical Simulation and Evaluation for Trigeminal Neuralgia and Hemifacial Spasm.

    Yao, Shujing; Zhang, Jiashu; Zhao, Yining; Hou, Yuanzheng; Xu, Xinghua; Zhang, Zhizhong; Kikinis, Ron; Chen, Xiaolei

    2018-05-01

    To address the feasibility and predictive value of multimodal image-based virtual reality in detecting and assessing features of neurovascular confliction (NVC), particularly regarding the detection of offending vessels, degree of compression exerted on the nerve root, in patients who underwent microvascular decompression for nonlesional trigeminal neuralgia and hemifacial spasm (HFS). This prospective study includes 42 consecutive patients who underwent microvascular decompression for classic primary trigeminal neuralgia or HFS. All patients underwent preoperative 1.5-T magnetic resonance imaging (MRI) with T2-weighted three-dimensional (3D) sampling perfection with application-optimized contrasts by using different flip angle evolutions, 3D time-of-flight magnetic resonance angiography, and 3D T1-weighted gadolinium-enhanced sequences in combination, whereas 2 patients underwent extra experimental preoperative 7.0-T MRI scans with the same imaging protocol. Multimodal MRIs were then coregistered with open-source software 3D Slicer, followed by 3D image reconstruction to generate virtual reality (VR) images for detection of possible NVC in the cerebellopontine angle. Evaluations were performed by 2 reviewers and compared with the intraoperative findings. For detection of NVC, multimodal image-based VR sensitivity was 97.6% (40/41) and specificity was 100% (1/1). Compared with the intraoperative findings, the κ coefficients for predicting the offending vessel and the degree of compression were >0.75 (P < 0.001). The 7.0-T scans have a clearer view of vessels in the cerebellopontine angle, which may have significant impact on detection of small-caliber offending vessels with relatively slow flow speed in cases of HFS. Multimodal image-based VR using 3D sampling perfection with application-optimized contrasts by using different flip angle evolutions in combination with 3D time-of-flight magnetic resonance angiography sequences proved to be reliable in detecting NVC

  3. Immunomodulatory effects of bone marrow-derived mesenchymal stem cells in a swine hemi-facial allotransplantation model.

    Yur-Ren Kuo

    Full Text Available BACKGROUND: In this study, we investigated whether the infusion of bone marrow-derived mesenchymal stem cells (MSCs, combined with transient immunosuppressant treatment, could suppress allograft rejection and modulate T-cell regulation in a swine orthotopic hemi-facial composite tissue allotransplantation (CTA model. METHODOLOGY/PRINCIPAL FINDINGS: Outbred miniature swine underwent hemi-facial allotransplantation (day 0. Group-I (n = 5 consisted of untreated control animals. Group-II (n = 3 animals received MSCs alone (given on days -1, +1, +3, +7, +14, and +21. Group-III (n = 3 animals received CsA (days 0 to +28. Group-IV (n = 5 animals received CsA (days 0 to +28 and MSCs (days -1, +1, +3, +7, +14, and +21. The transplanted face tissue was observed daily for signs of rejection. Biopsies of donor tissues and recipient blood sample were obtained at specified predetermined times (per 2 weeks post-transplant or at the time of clinically evident rejection. Our results indicated that the MSC-CsA group had significantly prolonged allograft survival compared to the other groups (P<0.001. Histological examination of the MSC-CsA group displayed the lowest degree of rejection in alloskin and lymphoid gland tissues. TNF-α expression in circulating blood revealed significant suppression in the MSC and MSC-CsA treatment groups, as compared to that in controls. IHC staining showed CD45 and IL-6 expression were significantly decreased in MSC-CsA treatment groups compared to controls. The number of CD4+/CD25+ regulatory T-cells and IL-10 expressions in the circulating blood significantly increased in the MSC-CsA group compared to the other groups. IHC staining of alloskin tissue biopsies revealed a significant increase in the numbers of foxp3(+T-cells and TGF-β1 positive cells in the MSC-CsA group compared to the other groups. CONCLUSIONS: These results demonstrate that MSCs significantly prolong hemifacial CTA survival. Our data indicate the MSCs did not

  4. 3D virtual planning in orthognathic surgery and CAD/CAM surgical splints generation in one patient with craniofacial microsomia: a case report

    Vale, Francisco; Scherzberg, Jessica; Cavaleiro, João; Sanz, David; Caramelo, Francisco; Maló, Luísa; Marcelino, João Pedro

    2016-01-01

    Objective: In this case report, the feasibility and precision of tridimensional (3D) virtual planning in one patient with craniofacial microsomia is tested using Nemoceph 3D-OS software (Software Nemotec SL, Madrid, Spain) to predict postoperative outcomes on hard tissue and produce CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) surgical splints. Methods: The clinical protocol consists of 3D data acquisition of the craniofacial complex by cone-beam computed tomography (CBCT) and surface scanning of the plaster dental casts. The ''virtual patient'' created underwent virtual surgery and a simulation of postoperative results on hard tissues. Surgical splints were manufactured using CAD/CAM technology in order to transfer the virtual surgical plan to the operating room. Intraoperatively, both CAD/CAM and conventional surgical splints are comparable. A second set of 3D images was obtained after surgery to acquire linear measurements and compare them with measurements obtained when predicting postoperative results virtually. Results: It was found a high similarity between both types of surgical splints with equal fitting on the dental arches. The linear measurements presented some discrepancies between the actual surgical outcomes and the predicted results from the 3D virtual simulation, but caution must be taken in the analysis of these results due to several variables. Conclusions: The reported case confirms the clinical feasibility of the described computer-assisted orthognathic surgical protocol. Further progress in the development of technologies for 3D image acquisition and improvements on software programs to simulate postoperative changes on soft tissue are required. PMID:27007767

  5. Toxina botulínica no blefaroespasmo, no espasmo hemifacial e na distonia cervical: resultados em 33 pacientes Botulinum toxin in blepharospasm, hemifacial spasm and cervical dystonia: results in 33 patients

    Sérgio Ap. Novis

    1995-09-01

    Full Text Available Avaliamos os resultados terapêuticos obtidos com o emprego de toxina botulínica do tipo A em 33 pacientes com distonia (12 com blefaroespamo; 10 com espasmo hemifacial e 11 com torcicolo espasmódico. Utilizamos uma escala de pontuação de gravidade antes de cada aplicação, sendo reavaliados duas semanas após, seguindo a mesma escala. Entre os com blefaroespasmo, oito eram mulheres e quatro homens; a média de idade foi 57,7 anos; a média do tempo de doença de quatro anos; três tinham história similar na família; nove eram essenciais e três fizeram uso de neurolépticos (distonia tardia. A dose média empregada ficou em 51,3 U, com a duração média do efeito benéfico de 2,8 meses. Do total de 22 aplicações (injeções e reinjeções, 14 (63,7% tiveram resultado ótimo, 5 (22,7% bom e três (13,6% nulo. Naqueles com espasmo hemifacial, oito eram mulheres e dois homens; a média de idade foi 52,6 anos; a média do tempo de doença 7,4 anos; oito eram essenciais e dois pós-páralíticos. A dose média empregada ficou em 32 U. Do total de 15 aplicações, todos (100% tiveram resultado ótimo, com a duração média do efeito benéfico de 3,4 meses. Nos pacientes com distonia cervical, oito eram homens e três mulheres; a média de idade foi 44,2 anos; a média do tempo de doença 12,2 anos; seis eram essenciais, três fizeram uso de neuroléptico e dois tinham história familiar. A dose média empregada ficou em 238,6 U, com a duração média do efeito benéfico de 4,7 meses. Do total de 20 aplicações, 18 (90% tiveram resultado bom, 1 (5% regular e 1 (5% nulo. Ptose palpebral, paresia facial e disfagia foram os efeitos colaterais mais encontrados. Concluímos que a toxina botulínica revelou-se eficaz no tratamento destas condições.The effects of botulinum toxin type A were studied in 33 patients with dystonia (12 blepharospasms, 10 hemifacial spasms and 11 spasmodic torticollis. A rate scale was used to evaluate the severity

  6. Asian over-representation among patients with hemifacial spasm compared to patients with cranial-cervical dystonia.

    Wu, Yuncheng; Davidson, Anthony L; Pan, Tianhong; Jankovic, Joseph

    2010-11-15

    Hemifacial spasm (HFS) is a common movement disorder, but its prevalence in different populations has not been elucidated. We reviewed all patients with HFS currently followed at the Baylor College of Medicine Movement Disorders Clinic and compared their demographic and clinical data with a control group of patients with cranial-cervical dystonia (CD). In contrast to patients with CD (N=145, mean age 48.64±13.61 years), of whom 117 (80.69%) were Caucasians, 13 (8.97%) Hispanic, 10 (6.90%) African-American, and 5 (3.45%) were of Asian origin, there were 81 (61.36%) Caucasians, 24 (18.18%) Hispanic, 13 (9.85%) African-Americans, and 14 (10.61%) Asians in the HFS group (N=132, mean age 49.33±13.25). Although there was no statistical difference in the age and gender distribution between the two groups, the frequency of Asians in HFS group was 3.1 times higher than that in CD group (Pmovement disorder. Copyright © 2010 Elsevier B.V. All rights reserved.

  7. Qualidade de vida e custos diretos em pacientes com blefaroespasmo essencial e espasmo hemifacial, tratados com toxina botulínica-A

    Osaki Midori Hentona

    2004-01-01

    Full Text Available OBJETIVO: Avaliar os custos e a qualidade de vida dos pacientes com blefaroespasmo essencial e espasmo hemifacial, submetidos à terapia com a toxina botulínica-A. MÉTODOS: Vinte e oito pacientes, sendo 16 com blefaroespasmo essencial e 12 com espasmo hemifacial, tratados com toxina botulínica-A, foram avaliados por meio de dois instrumentos: o SF-36 e a Escala de Disfunção de Blefaroespasmo. Os custos foram calculados segundo o número de unidades da toxina utilizadas por cada paciente no período de um ano. RESULTADOS: O custo total direto foi estimado em 1081,62 reais por ano (±89,39 para blefaroespasmo essencial e 618,06 reais por ano (±60,06 para espasmo hemifacial, para tratamento ambulatorial (p<0,001. Antes do tratamento, todos os domínios do SF-36 foram significantemente piores em ambas as doenças. Sob tratamento efetivo com toxina botulínica-A, os aumentos nos índices do SF-36 evidenciaram mudanças nas taxas de saúde geral da população em estudo, com diferença estatisticamente significante entre as respostas pré e pós-tratamento (p<0,05. Relacionando-se o SF-36 com Escala de Disfunção de Blefaroespasmo, foram observadas nos casos de blefaroespasmo essencial, relações significantes positivas (capacidade funcional, estado geral, aspecto emocional e aspectos sociais, ao passo que nos pacientes com espasmo hemifacial não foi encontrada nenhuma correlação. CONCLUSÃO: Este estudo demonstra notável impacto negativo das doenças na qualidade de vida desses pacientes, e uma significante melhora em ambas as doenças após tratamento com toxina botulínica-A. Além disso, os dados fornecem subsídios para justificar o alto custo da aquisição da toxina botulínica-A, devido a seus consideráveis benefícios para a qualidade de vida.

  8. Prefabricated Cervical Skin Flaps for Hemi-Facial Resurfacing: Elucidating the Natural History of Postoperative Edema Using Indocyanine Green.

    Li, Ke; Min, Peiru; Sadigh, Parviz; Grassetti, Luca; Lazzeri, Davide; Torresetti, Matteo; Marsili, Riccardo; Feng, Shaoqing; Liu, Ningfei; Zhang, Yi Xin

    2018-02-01

    The increases in capillary wall permeability and capillary hydrostatic pressure are considered to be the causes for the acute swelling seen in flaps; however, disruption of the circulating flap lymphatics could be another contributory factor. In this study we monitor the development of flap edema in a series of 18 prefabricated flaps and aim to delineate the natural history of this phenomenon by use of lymphography. Postoperative swelling was monitored in a series of 18 pre-expanded prefabricated cervical skin flaps used for hemi-facial burns-scar resurfacing. Time to spontaneous resolution, presence or absence of venous congestion, and clinical outcome were recorded. In two cases, indocyanine-green (ICG) lymphography was used to monitor the dermal backflow pattern until swelling had completely resolved. Average moving velocity of ICG after injection as well as flap thickness was also recorded over the follow-up period. The average moving velocity of ICG in the flap lymphatics improved from 0.48 cm/min to 1.5 cm/min in the first 12 days after flap transfer. The dermal backflow pattern was stardust in the first 12 days, indicating moderate lymphedema, transforming to splash from week three, and a robust collecting lymphatic vessel occurring from the fifth month, indicating mild lymphedema and lymphatic channel recovery, respectively. Transient swelling was observed in all prefabricated flaps in our series. We postulate that this is mostly secondary to lymphatic disruption that subsides as lymphangiogenesis takes place. ICG lymphography is an inexpensive, safe, and easy-to-use imaging technology that could be used in the monitoring of postoperative lymphedema seen in prefabricated flaps.

  9. Identification of offending vessele in trigeminal neuralgia and hemifacial spasm using SPGR-MRI and 3D-TOF-MRA

    Niwa, Yoshikazu; Shiotani, Masahiro; Karasawa, Hidetake; Ohseto, Kiyoshige; Naganuma, Yoshikazu

    1996-01-01

    We investigated 100 consecutive patients with trigeminal neuralgia (TN) and 53 patients with hemifacial spasm (HFS) concerning the anatomical relationship between the root entry (exit) zone (REZ) of cranial nerve and the offending artery, using spoiled GRASS MRI (SPGR-MRI) and three dimensional-time of fly-MRA (MRA). In 67 of 100 (67%) patients with TN, this new radiological method, SPGR-MRI and MRA demonstrated the relationship between the fifth cranial nerve root and offending artery causing neurovascular compression (NVC), and in 46 of 53 (87%) with HFS, demonstrated the similar relationship between seventh and eighth nerve complex and offending artery. Microvascular decompression (MVD) was performed in 10 with HFS, and NVC of the REZ of the facial nerve caused by the offending artery was exactly predicted by SPGR-MRI and MRA in 9 (90%). The combination of SPGR-MRI and MRA is very useful for demonstrating NVC as the cause of TN and HFS. On the other hand, we investigated asymptomatic 206 trigemimal and 253 facial nerves about the relationship between their REZ and the surrounding structures using the similar method. The contact of REZ of cranial nerve with surrounding artery is demonstrated in 31.6% of trigeminal nerves and in 22.5% of facial nerves. These results indicate that the contact of REZ of cranial nerve with surrounding artery is not rare in healthy subjects, though causing TN and HFS in particular patients. In this context, we discussed the difference between the contact which is asymptomatic and the compression which is symptomatic. (author)

  10. A novel osteogenic distraction device for the transversal correction of temporozygomatic hypoplasia.

    Pagnoni, Mario; Fadda, Maria Teresa; Cascone, Piero; Iannetti, Giorgio

    2014-07-01

    Hemifacial microsomia (HFM) is a congenital disorder characterized by craniofacial malformation of one or both sides of the lower face. Since these anomalies are associated with soft-tissue deficiencies, corrective surgery is often difficult. Bone grafts have typically been used for augmentation, but distraction osteogenesis now offers an alternative for many craniofacial deficiencies, but there are few if any appropriate distraction devices and surgical procedures for the augmentation of craniofacial transversal dimensions. The aim of this study was to evaluate a technique for guided augmentation of craniofacial transversal dimensions through distraction osteogenesis. We tested the efficacy of a prototype distractor, developed in collaboration with Medartis, using cadavers and demonstrated its application for the correction of the transverse dimension of the temporozygomatic region in a patient with Goldenhar syndrome. CT scans showed a 4-mm transverse augmentation of the bony surface after 9 days and a 10-mm increase after 30 days. Upon removal of the distractor (60 days after the first surgery) CT indicated good bony fusion and a stable result in the transverse plane. Six months after removal of the distractor, 3D computed tomography confirmed the success of the transverse augmentation, as it appeared to be stable and reliable. Distraction osteogenesis, using our device, can be used to correct the transverse dimension of the temporozygomatic region in HFM patients. It should also be considered for the correction of residual postsurgical skeletal deficiency due to surgical relapse or deficient growth, and unsatisfactory skeletal contour. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  11. Descompresión microvascular en espasmo hemifacial: Reporte de 13 casos y revisión de la literatura

    Campero, Alvaro; Herreros, Isabel Cuervo-Arango; Barrenechea, Ignacio; Andjel, Germán; Ajler, Pablo; Rhoton, Albert

    2016-01-01

    Objetivo: El propósito del presente trabajo es presentar los resultados de 13 pacientes con diagnóstico de espasmo hemifacial (EHF), en los cuales se realizó una descompresión microvascular (DMV). Material y Método: Desde Junio de 2005 a Mayo de 2014, 13 pacientes con diagnóstico de EHF fueron intervenidos quirúrgicamente, realizando una DMV. Se evaluó: edad, sexo, tiempo de evolución de la sintomatología, hallazgos intraoperatorios y resultados postoperatorios. Resultados: De los 13 pacientes intervenidos, 7 fueron mujeres y 6 varones. La media de edad fue de 53 años. El tiempo medio entre el inicio de la sintomatología y la intervención quirúrgica osciló entre 3 y 9 años. En todos los casos el EHF era típico, uno de ellos con neuralgia trigeminal concomitante, observándose en todos compresión neurovascular intraoperatoria. Por orden decreciente de frecuencia la causa de la compresión fue arteria cerebelosa anteroinferior, arteria cerebelosa posteroinferior, arteria dolicomega basilar y arteria dolicomega vertebral. El seguimiento postoperatorio fue en promedio de 24 meses. El 62% presentó desaparición postquirúrgica inmediata de la sintomatología preoperatoria, el 30% desaparición tras un período de 3 semanas a 2 meses (8% con mejoría parcial), y en el 8% no hubo mejoría. En cuanto a las complicaciones postoperatorias: 3 pacientes presentaron paresia facial II-III en la escala de House-Brackman (se recuperaron en un período de 6 meses), y 1 paciente presentó fístula de líquido cefalorraquídeo. Ninguno de los pacientes de la serie presentaron hipoacusia transitorio o permanente. Conclusión: La DMV como tratamiento del EHF es un procedimiento efectivo y seguro, que permite la resolución completa de la patología en la mayoría de los casos. PMID:27127708

  12. Examination of craniofacial bones associated with auricular anomaly using three-dimensional computer tomography

    Ono, Ichiro; Ohura, Takehiko; Iwao, Fumiya

    1989-01-01

    Three-dimensional computer tomography (3D-CT) was performed in 60 patients with auricular anomaly to determine the site and severity of deformity in the hemifacial microsomia. Auricular anomaly, underdevelopment and malposition of the cranium, temporo-mandibular joint, zygoma, maxilla and mandible were observed in almost all of the patients; however, the severity of these malformations varied from patient to patient. Regarding severest deformity, there were positional differences among patients. According to impairment sites, hemifacial microsomia fell into the following five types: (1) cranium type, (2) maxillary alveolar process type, (3) localized mandibular ramus type, (4) overall mandibular type, and (5) complex type (combination of the aforementioned types). Facial asymmetry accompanied by auricular anomaly was associated with various pathologic conditions. The temporomandibular joint was often deviated towards the anteromedial side for localized mandibular ramus type and overall mandibular type. Posterial deviation was predominant for cranium type. In patients with hemifacial microsomia of the cranium type associated with protrusion mainly in the occipital region on the affected side, deformity was considered attributable to underdevelopment of the temporal bone and delay in closure of the temporo-occipital suture. The deformity for cranium type may be defined as the second branchial syndrome. In conclusion, hemifacial microsomia have various deformities and may fall into five categories. Craniofacial microsomia and hemi-auriculo-temporo-mandibular dysplastic syndrome give a more precise concept for auricular anomaly. (N.K.)

  13. Examination of craniofacial bones associated with auricular anomaly using three-dimensional computer tomography

    Ono, Ichiro; Ohura, Takehiko; Iwao, Fumiya (Hokkaido Univ., Sapporo (Japan). School of Medicine) (and others)

    1989-07-01

    Three-dimensional computer tomography (3D-CT) was performed in 60 patients with auricular anomaly to determine the site and severity of deformity in the hemifacial microsomia. Auricular anomaly, underdevelopment and malposition of the cranium, temporo-mandibular joint, zygoma, maxilla and mandible were observed in almost all of the patients; however, the severity of these malformations varied from patient to patient. Regarding severest deformity, there were positional differences among patients. According to impairment sites, hemifacial microsomia fell into the following five types: (1) cranium type, (2) maxillary alveolar process type, (3) localized mandibular ramus type, (4) overall mandibular type, and (5) complex type (combination of the aforementioned types). Facial asymmetry accompanied by auricular anomaly was associated with various pathologic conditions. The temporomandibular joint was often deviated towards the anteromedial side for localized mandibular ramus type and overall mandibular type. Posterial deviation was predominant for cranium type. In patients with hemifacial microsomia of the cranium type associated with protrusion mainly in the occipital region on the affected side, deformity was considered attributable to underdevelopment of the temporal bone and delay in closure of the temporo-occipital suture. The deformity for cranium type may be defined as the second branchial syndrome. In conclusion, hemifacial microsomia have various deformities and may fall into five categories. Craniofacial microsomia and hemi-auriculo-temporo-mandibular dysplastic syndrome give a more precise concept for auricular anomaly. (N.K.).

  14. Genetics Home Reference: craniofacial microsomia

    ... the first and second pharyngeal arches (also called branchial or visceral arches). Tissue layers in the six ... dysplasia CFM facioauriculovertebral dysplasia FAV first and second branchial arch syndrome first and second pharyngeal arch syndromes ...

  15. Preoperative assessment of trigeminal neuralgia and hemifacial spasm using constructive interference in steady state-three-dimensional fourier transformation magnetic resonance imaging

    Yamakami, Iwao; Kobayashi, Eiichi; Hirai, Shinji; Yamaura, Akira [Chiba Univ. (Japan). School of Medicine

    2000-11-01

    Results of microvascular decompression (MVD) for trigeminal neuralgia (TN) and hemifacial spasm (HFS) may be improved by accurate preoperative assessment of neurovascular relationships at the root entry/exit zone (REZ). Constructive interference in steady state (CISS)-three-dimensional Fourier transformation (3DFT) magnetic resonance (MR) imaging was evaluated for visualizing the neurovascular relationships at the REZ. Fourteen patients with TN and eight patients with HFS underwent MR imaging using CISS-3DFT and 3D fast inflow with steady-state precession (FISP) sequences. Axial images of the cerebellopontine angle (CPA) obtained by the two sequences were reviewed to assess the neurovascular relationships at the REZ of the trigeminal and facial nerves. Eleven patients subsequently underwent MVD. Preoperative MR imaging findings were related to surgical observations and results. CISS MR imaging provided excellent contrast between the cranial nerves, small vessels, and cerebrospinal fluid (CSF) in the CPA. CISS was significantly better than FISP for delineating anatomic detail in the CPA (trigeminal and facial nerves, petrosal vein) and abnormal neurovascular relationships responsible for TN and HFS (vascular contact and deformity at the REZ). Preoperative CISS MR imaging demonstrated precisely the neurovascular relationships at the REZ and identified the offending artery in all seven patients with TN undergoing MVD. CISS MR imaging has high resolution and excellent contrast between cranial nerves, small vessels, and CSF, so can precisely and accurately delineate normal and abnormal neurovascular relationships at the REZ in the CPA, and is a valuable preoperative examination for MVD. (author)

  16. Simultaneous display of MRA and MPR in detecting vascular compression for trigeminal neuralgia or hemifacial spasm: comparison with oblique sagittal views of MRI

    Arbab, A.S.; Aoki, S.; Yoshikawa, T.; Kumagai, H.; Araki, T.; Nishiyama, Y.; Nagaseki, Y.; Nukui, H.

    2000-01-01

    A new technique, simultaneous display of magnetic resonance angiography (MRA) and multiplanar reconstruction (MPR), was performed by a workstation to identify the involved vessels in patients with trigeminal neuralgia (TN) or hemifacial spasm (HFS), and the results were compared with those of oblique sagittal MRI technique. Twelve patients with either HFS or TN were prospectively assessed by simultaneous display of MRA and MPR, and oblique sagittal techniques, to point out the neurovascular compression and to identify the involved vessels. Three-dimensional (3D) time-of-flight (TOF) spoiled gradient-echo (SPGR) images were acquired to create MRA and MPR. Oblique sagittal views were also created and displayed on films. A total of 15 vessels in 12 patients were identified as compressing vessels during surgery. Simultaneous display of MRA and MPR technique pointed out the presence of vessels at and/or around root entry/exit zone (REZ) in all 12 patients, but proper identification by the name of the individual vessel was correct in 13 of 15 cases. However, oblique sagittal technique indicated the presence of vessels at and/or around REZ in 11 patients, but only 8 of 14 vessels were correctly identified. Our new method, simultaneous display of MRA-MPR, facilitated correct identification of the involved vessels compared with the oblique sagittal view method. (orig.)

  17. Preoperative assessment of trigeminal neuralgia and hemifacial spasm using constructive interference in steady state-three-dimensional fourier transformation magnetic resonance imaging

    Yamakami, Iwao; Kobayashi, Eiichi; Hirai, Shinji; Yamaura, Akira

    2000-01-01

    Results of microvascular decompression (MVD) for trigeminal neuralgia (TN) and hemifacial spasm (HFS) may be improved by accurate preoperative assessment of neurovascular relationships at the root entry/exit zone (REZ). Constructive interference in steady state (CISS)-three-dimensional Fourier transformation (3DFT) magnetic resonance (MR) imaging was evaluated for visualizing the neurovascular relationships at the REZ. Fourteen patients with TN and eight patients with HFS underwent MR imaging using CISS-3DFT and 3D fast inflow with steady-state precession (FISP) sequences. Axial images of the cerebellopontine angle (CPA) obtained by the two sequences were reviewed to assess the neurovascular relationships at the REZ of the trigeminal and facial nerves. Eleven patients subsequently underwent MVD. Preoperative MR imaging findings were related to surgical observations and results. CISS MR imaging provided excellent contrast between the cranial nerves, small vessels, and cerebrospinal fluid (CSF) in the CPA. CISS was significantly better than FISP for delineating anatomic detail in the CPA (trigeminal and facial nerves, petrosal vein) and abnormal neurovascular relationships responsible for TN and HFS (vascular contact and deformity at the REZ). Preoperative CISS MR imaging demonstrated precisely the neurovascular relationships at the REZ and identified the offending artery in all seven patients with TN undergoing MVD. CISS MR imaging has high resolution and excellent contrast between cranial nerves, small vessels, and CSF, so can precisely and accurately delineate normal and abnormal neurovascular relationships at the REZ in the CPA, and is a valuable preoperative examination for MVD. (author)

  18. Three-dimensional short-range MR angiography and multiplanar reconstruction images in the evaluation of neurovascular compression in hemifacial spasm

    Choi, Woo Suk; Kim, Eui Jong; Lee, Jae Gue; Rhee, Bong Arm [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

    1998-08-01

    To evaluate the diagnostic efficacy of three-dimensional(3D) short-range MR angiography(MRA) and multiplanar reconstruction(MPR) imaging in hemifacial spasm(HS). Materials and Methods : Two hundreds patients with HS were studied using a 1.5T MRI system with a 3D time-of-flight(TOF) MRA sequence. To reconstruct short-range MRA, 6-10 source images near the 7-8th cranial nerve complex were processed using a maximum-intensity projection technique. In addition, an MPR technique was used to investigate neurovascular compression. We observed the relationship between the root-exit zone(REZ) of the 7th cranial nerve and compressive vessel, and identified the compressive vessels on symptomatic sides. To investigate neurovascular contact, asymptomatic contralateral sides were also evaluated. Results : MRI showed that in 197 of 200 patients there was vascular compression or contact with the facial nerve REZ on symptomatic sides. One of the three remaining patients was suffering from acoustic neurinoma on the symptomatic side, while in two patients there were no definite abnormal findings.Compressive vessels were demonstrated in all 197 patients; 80 cases involved the anterior inferior cerebellar artery(AICA), 74 the posterior cerebellar artery(PICA), 13 the vertebral artery(VA), 16 the VA and AICA, eight the VA and PICA, and six the AICA and PICA. In all 197 patients, compressive vessels were reconstructed on one 3D short-range MRA image without discontinuation from vertebral or basilar arteries. 3D MPR studies provided additional information such as the direction of compression and course of the compressive vessel. In 31 patients there was neurovascular contact on the contralateral side at the 7-8th cranial nerve complex. Conclusion : Inpatients with HS, 3D short-range MRA and MPR images are excellent and very helpful for the investigation of neurovascular compression and the identification of compressive vessels.

  19. Three-dimensional short-range MR angiography and multiplanar reconstruction images in the evaluation of neurovascular compression in hemifacial spasm

    Choi, Woo Suk; Kim, Eui Jong; Lee, Jae Gue; Rhee, Bong Arm

    1998-01-01

    To evaluate the diagnostic efficacy of three-dimensional(3D) short-range MR angiography(MRA) and multiplanar reconstruction(MPR) imaging in hemifacial spasm(HS). Materials and Methods : Two hundreds patients with HS were studied using a 1.5T MRI system with a 3D time-of-flight(TOF) MRA sequence. To reconstruct short-range MRA, 6-10 source images near the 7-8th cranial nerve complex were processed using a maximum-intensity projection technique. In addition, an MPR technique was used to investigate neurovascular compression. We observed the relationship between the root-exit zone(REZ) of the 7th cranial nerve and compressive vessel, and identified the compressive vessels on symptomatic sides. To investigate neurovascular contact, asymptomatic contralateral sides were also evaluated. Results : MRI showed that in 197 of 200 patients there was vascular compression or contact with the facial nerve REZ on symptomatic sides. One of the three remaining patients was suffering from acoustic neurinoma on the symptomatic side, while in two patients there were no definite abnormal findings.Compressive vessels were demonstrated in all 197 patients; 80 cases involved the anterior inferior cerebellar artery(AICA), 74 the posterior cerebellar artery(PICA), 13 the vertebral artery(VA), 16 the VA and AICA, eight the VA and PICA, and six the AICA and PICA. In all 197 patients, compressive vessels were reconstructed on one 3D short-range MRA image without discontinuation from vertebral or basilar arteries. 3D MPR studies provided additional information such as the direction of compression and course of the compressive vessel. In 31 patients there was neurovascular contact on the contralateral side at the 7-8th cranial nerve complex. Conclusion : Inpatients with HS, 3D short-range MRA and MPR images are excellent and very helpful for the investigation of neurovascular compression and the identification of compressive vessels

  20. HFM web-site linked to the technical & administrative databases

    Szeberenyi, A

    2013-01-01

    The EuCARD project has been using various databases to store scientific and contractual information, as well as working documents. This report documents the methods used during the life of the project and the strategy chosen to archive the technical and administrative material after the project completion. Special care is given to provide easy and open access for the foreground produced, especially for the EuCARD-2 community at large, including its network partners worldwide.

  1. Cross section for inelastic neutron acceleration by 178Hfm2

    Karamyan, S.A.; Carroll, J.J.

    2009-01-01

    The scattering of thermal neutrons from isomeric nuclei may include events in which the outgoing neutrons have increased kinetic energy. This process has been called Inelastic Neutron Acceleration (INNA) and occurs when the final nucleus after emission of the neutron is left in a state with lower energy than that of the isomer. The result, therefore, is an induced depletion of the isomeric population to the ground state. A cascade of several gammas must accompany the neutron emission to release the high angular momentum of the initial isomeric state. INNA was previously observed in a few cases and the associated cross sections were only in modest agreement with theoretical estimates. The most recent measurement of an INNA cross section was σ INNA = (258 ± 58) b for neutron scattering by 177 Lu m . In the present work, an INNA cross section of σ INNA = 152 -36 +51 b was deduced from measurements of the total burn-up of the high-spin, four-quasiparticle isomer 178 Hf m2 during irradiation by thermal neutrons. Statistical estimates for the probability of different reaction channels past neutron absorption were used in the analysis, and the deduced σ INNA is compared to the theoretically predicted cross section

  2. Clinical application of human adipose tissue-derived mesenchymal stem cells in progressive hemifacial atrophy (Parry-Romberg disease) with microfat grafting techniques using 3-dimensional computed tomography and 3-dimensional camera.

    Koh, Kyung Suk; Oh, Tae Suk; Kim, Hoon; Chung, In Wook; Lee, Kang Woo; Lee, Hyo Bo; Park, Eun Jung; Jung, Jae Seob; Shin, Il Seob; Ra, Jeong Chan; Choi, Jong Woo

    2012-09-01

    Parry-Romberg disease is a rare condition that results in progressive hemifacial atrophy, involving the skin, dermis, subcutaneous fat, muscle, and, finally, cartilage and bone. Patients have been treated with dermofat or fat grafts or by microvascular free flap transfer. We hypothesized that adipose-derived stem cells (ASCs) may improve the results of microfat grafting through enhancing angiogenesis. We evaluated the utility of ASC in microfat grafting of patients with Parry-Romberg disease by measuring the change in the hemifacial volumes after injection of ASCs with microfat grafts or microfat grafts alone. In April 2008, this investigation was approved by the Korean Food and Drug Administration and the institutional review board of the Asan Medical Center (Seoul, Korea) that monitor investigator-initiated trials. Between May 2008 and January 2009, 10 volunteers with Parry-Romberg disease (5 men and 5 women; mean age, 28 y) were recruited; 5 received ASC and microfat grafts and 5 received microfat grafts only. The mean follow-up period was 15 months. Adipose-derived stem cells were obtained from abdominal fat by liposuction and were cultured for 2 weeks. On day 14, patients were injected with fat grafts alone or plus (in the test group) 1 × 10 ASCs. Patients were evaluated postoperatively using a 3-dimensional camera and 3-dimensional CT scans, and grafted fat volumes were objectively calculated. Successful outcomes were evident in all 5 patients receiving microfat grafts and ASCs, and the survival of grafted fat was better than in patients receiving microfat grafts alone. Before surgery, the mean difference between ipsilateral and contralateral hemiface volume in patients receiving microfat grafts and ASCs was 21.71 mL decreasing to 4.47 mL after surgery. Overall resorption in this ASC group was 20.59%. The mean preoperative difference in hemiface volume in those receiving microfat grafts alone was 8.32 mL decreasing to 3.89 mL after surgery. Overall

  3. Transverse facial cleft: A series of 17 cases

    L K Makhija

    2011-01-01

    Full Text Available Introduction: Transverse facial cleft (Tessier type 7 or congenital macrostomia is a rare congenital anomaly seldom occurring alone and is frequently associated with deformities of the structures developing from the first and second branchial arches. The reported incidence of No. 7 cleft varies from 1 in 60,000 to 1 in 300,000 live births. Material and Methods: Seventeen patients of transeverse facial cleft who presented to us in last 5 years were included in the study. Their history regarding familial and environmental predispositions was recorded. The cases were analysed on basis of sex, laterality, severity, associated anomalies and were graded according to severity. They were operated by z plasty technique and were followed up for 2 years to look for effectiveness of the technique and its complications. Result: Out of the seventeen patients of transverse cleft, none had familial predilection or any environmental etiology like antenatal radiological exposure or intake of drugs of teratogenic potential. Most of the patients (9/17 were associated with hemifacial microsomia and 1 patient was associated with Treacher Colin′s Syndrome. Out of the 6 cases of Grade I clefts, 4 were isolated transverse clefts and of the 10 patients of Grade II clefts, 7 were associated with hemifacial microsomia. We encountered only one case of Grade III Transverse Cleft which was not only associated with hemifacial microsomia but also had cardiac anomaly. Out of the17 cases, 15 were operated and in most of them the outcome was satisfactory.

  4. Scientific skepticism and new discoveries: an analysis of a report of zinc/phytase supplementation and the efficacy of botulinum toxins in treating cosmetic facial rhytides, hemifacial spasm and benign essential blepharospasm.

    Cohen, Joel L

    2014-10-01

    A recent paper in the Journal of Drugs in Dermatology by Koshy and colleagues (2012, 11( 4 ):507-512) report on "Effect of Dietary Zinc and Phytase Supplementation on Botulinum Toxin Treatments" and conclude by claiming the discovery of "a potentially meaningful role for zinc and/or phytase supplementation in increasing the degree and duration of botulinum toxin effect in the treatment of cosmetic facial rhytids, benign essential blepharospasm, and hemifacial spasm". The purpose of this paper is to examine these published claims for possible methodological and design errors and potential sources of bias. The authors evaluated the published results in comparison to the published literature on zinc deficiency, the role of phytase, prior reports of an effect of zinc on activity of botulinum toxin, issues of study design and execution and if the reported results of the study supported the study's conclusions. Multiple issues are present in the reported study, which appear to invalidate its conclusions. These areas include lack of direct evidence for the presence of clinical or subclinical zinc deficiency in the study population or for the level of phytate in the study population sufficient to interfere with zinc absorption in these subjects. Additionally, there is ambiguity as to the actual dose of zinc used as well as in the study design itself. Also there is a failure of the study through the "unmasking" of the crossover design. There is potential financial conflict of interest in the study execution that may have biased the reported results. Finally there is inadequate data presented to evaluate the claims made of a "new discovery" as to the three disease entities reported on and the various botulinum toxins used in each of the three treatment arms of the study. Based on this evaluation, it appears that a high level of clinical and scientific skepticism is warranted concerning any claim of a beneficial effect of zinc and phytase supplementation on the efficacy or

  5. Effects of a child with a craniofacial anomaly on stability of the parental relationship.

    St John, Dane; Pai, Lori; Belfer, Myron L; Mulliken, John B

    2003-09-01

    The purpose of this study was to determine rates of divorce in parents of children with various types of craniofacial anomalies and to analyze possible confounding factors. A 29-question survey was sent to parents of all children evaluated in the Craniofacial Centre between 1992 and 1997. Parents were questioned regarding pre- and postnatal marital stability, whether the child's facial anomaly contributed to divorce, and involvement in the child's welfare. Using deformational posterior plagiocephaly as a control group, rates of divorce vs. non-divorce were compared for craniofacial anomalies, categorized as asymmetric (hemifacial microsomia, unilateral coronal synostosis, cleft lip, cleft lip/palate) or symmetric (syndromic-craniosynostosis, orbital hypertelorism, Treacher Collins syndrome). Major anomalies (hemifacial microsomia, craniosynostosis, orbital hypertelorism, Treacher Collins syndrome) were also compared to minor anomalies (cleft lip, cleft lip/palate). Surveys were sent to both parents in 412 families; 403 surveys were returned; and the results were evaluated in 275 families (67%). Frequency analysis demonstrated an overall divorce rate of 6.8% and 4.9% separation. Anomalies associated with the highest rate of divorce were hemifacial microsomia (24.0%), syndromic craniosynostosis (12.2%), and cleft lip/palate (6.8%). 79% of non-divorced couples reported a strong prenatal relationship, whereas 59% of divorced couples reported a problematic relationship. Following birth of the affected child, 47% of non-divorced couples responded that the bonds became stronger and 41% of divorced couples thought the relationship worsened. Two-sided Fisher exact test comparing control vs. all other anomalies showed significance (p=.030) for rates of divorce. Separation of anomalies into asymmetric vs. symmetric and major vs. minor categories demonstrated no significant difference in divorce rate (p>.05). The mother was more likely to become a child's primary caregiver

  6. Ectopic external auditory canal and ossicular formation in the oculo-auriculo-vertebral spectrum

    Supakul, Nucharin [Indiana University School of Medicine, Department of Radiology, Indianapolis, IN (United States); Ramathibodi Hospital, Mahidol University, Department of Diagnostic and Therapeutic Radiology, Bangkok (Thailand); Kralik, Stephen F. [Indiana University School of Medicine, Department of Radiology, Indianapolis, IN (United States); Ho, Chang Y. [Indiana University School of Medicine, Department of Radiology, Indianapolis, IN (United States); Riley Children' s Hospital, MRI Department, Indianapolis, IN (United States)

    2015-07-15

    Ear abnormalities in oculo-auricular-vertebral spectrum commonly present with varying degrees of external and middle ear atresias, usually in the expected locations of the temporal bone and associated soft tissues, without ectopia of the external auditory canal. We present the unique imaging of a 4-year-old girl with right hemifacial microsomia and ectopic location of an atretic external auditory canal, terminating in a hypoplastic temporomandibular joint containing bony structures with the appearance of auditory ossicles. This finding suggests an early embryological dysfunction involving Meckel's cartilage of the first branchial arch. (orig.)

  7. Confirmation of parity violation in the γ decay of 180Hfm

    Stone, J.R.; Zákoucký, Dalibor

    2007-01-01

    Roč. 76, č. 2 (2007), 025502-025502 ISSN 0556-2813 Institutional research plan: CEZ:AV0Z10480505 Keywords : nuclear orientation Subject RIV: BF - Elementary Particles and High Energy Physics Impact factor: 3.302, year: 2007

  8. Confirmation of parity violation in the $\\gamma$ decay of $^{180}$Hf$^{m}$

    Stone, J R; Stone, N J; Severijns, N; Hass, M; Zakoucky, D; Giles, T; Köster, U; Kraev, I S; Lakshmi, S; Lindroos, M; Wauters, F

    2007-01-01

    This paper reports measurements using the technique of On Line Nuclear Orientation (OLNO) which reexamine the gamma decay of isomeric $^{\\rm 180}$Hf$^{\\rm m}$ and specifically the 501 keV 8$^{\\rm -}$ -- 6$^{\\rm +}$ transition. The irregular admixture of E2 to M2/E3 multipolarity in this transition, deduced from the forward-backward asymmetry of its angular distribution, has for decades stood as the prime evidence for parity mixing in nuclear states. The experiment, based on ion implantation of the newly developed mass-separated $^{\\rm 180}$Hf$^{\\rm m}$ beam at ISOLDE, CERN into an iron foil maintained at millikelvin temperatures, produces higher degrees of polarization than were achieved in previous studies of this system. The value found for the E2/M2 mixing ratio, $\\epsilon$ = -0.0324(16)(17), is in close agreement with the previous published average value $\\epsilon$ = - 0.030(2), in full confirmation of the presence of the irregular E2 admixture in the 501 keV transition. The temperature dependence of the ...

  9. Acute hemifacial ischemia as a late complication of carotid stenting

    Maurizio Domanin, MD

    2017-06-01

    Full Text Available Concerns about carotid artery stenting (CAS center primarily on procedural complications like acute occlusion, stroke, and long-term intrastent restenosis. External carotid artery (ECA thrombosis is observed during CAS follow-up, but it often remains asymptomatic or, at worst, results in jaw claudication. We report here a case of late occlusion of the ECA after CAS with symptoms of acute homolateral facial ischemia as well as pain, cyanosis, tongue numbness, and skin coldness. The patient was submitted to local thrombolysis and balloon angioplasty with regression of symptoms after recanalization. With this report, we add a caveat about blockage of the ECA ostium during CAS.

  10. The Committee of the Chiefs of Military Medical Services in NATO (COMEDS) and Its Relation to RTO/HFM Panel

    2004-09-01

    technically in the underdog situation. It obviously has made it crucial to “win the media war”. Media coverage now has a dramatic effect on public opinion...Ever more effective body armour reduces fatal casualty numbers but increases significantly the medical challenge to save the survivor’s limbs. As a

  11. Goldenhar syndrome: Report of two cases with review of literature

    Ananya Madiyal

    2018-01-01

    Full Text Available Goldenhar syndrome consists of a varied group of malformations that can involve multiple systems of the body. It is believed to be a variant of hemifacial microsomia with ocular and vertebral involvement. Characteristic findings, such as hypoplasia of one half of the face, epibulbar dermoids, ear tags, and spinal cord defects, warrant the name occulo-auriculo-vertebral dysplasia. The syndrome occurs due to imbalance in cells during the blastogenesis period of embryo formation. It is found to involve the derivatives of first and second branchial arches. The condition is apparent at birth, but the phenotype can vary greatly in its severity depending on the activation and expression of the defective gene. Reported here are detailed clinical and radiographic features of two sporadic cases of Goldenhar syndrome in young males. This work mainly highlights the various theories of etiopathogenesis as well as step-wise management protocol for patients diagnosed with the syndrome.

  12. [Diagnosis of facial and craniofacial asymmetry].

    Arnaud, E; Marchac, D; Renier, D

    2001-10-01

    Craniofacial asymmetry is caused by various aetiologies but clinical examination remains the most important criteria since minor asymmetry is always present. The diagnosis can be confirmed by anthropometric measurements and radiological examinations but only severe asymmetries or asymmetries with an associated functional impairment should be treated. The treatment depends on the cause, and on the time of appearance. Congenital asymmetries might be treated early, during the first year of life if a craniosynostosis is present. Hemifacial microsomia are treated later if there is no breathing impairment. Since the pediatricians have recommended the dorsal position for infant sleeping, an increasing number of posterior flattening of the skull has been appearing, and could be prevented by adequate nursing. Other causes of craniofacial asymmetries are rare and should be adapted to the cause (tumors, atrophies, neurological paralysis, hypertrophies) by a specialized multidisciplinar team.

  13. Three-dimensional analysis of craniofacial bones using three-dimensional computer tomography

    Ono, Ichiro; Ohura, Takehiko; Kimura, Chu

    1989-01-01

    Three-dimensional computer tomography (3DCT) was performed in patients with various diseases to visualize stereoscopically the deformity of the craniofacial bones. The data obtained were analyzed by the 3DCT analyzing system. A new coordinate system was established using the median sagittal plane of the face (a plane passing through sella, nasion and basion) on the three-dimensional image. Three-dimensional profilograms were prepared for detailed analysis of the deformation of craniofacial bones for cleft lip and palate, mandibular prognathia and hemifacial microsomia. For patients, asymmetry in the frontal view and twist-formed complicated deformities were observed, as well as deformity of profiles in the anteroposterior and up-and-down directions. A newly developed technique allows three-dimensional visualization of changes in craniofacial deformity. It would aid in determining surgical strategy, including crani-facial surgery and maxillo-facial surgery, and in evaluating surgical outcome. (N.K.)

  14. Three-dimensional analysis of craniofacial bones using three-dimensional computer tomography

    Ono, Ichiro; Ohura, Takehiko; Kimura, Chu (Hokkaido Univ., Sapporo (Japan). School of Medicine) (and others)

    1989-08-01

    Three-dimensional computer tomography (3DCT) was performed in patients with various diseases to visualize stereoscopically the deformity of the craniofacial bones. The data obtained were analyzed by the 3DCT analyzing system. A new coordinate system was established using the median sagittal plane of the face (a plane passing through sella, nasion and basion) on the three-dimensional image. Three-dimensional profilograms were prepared for detailed analysis of the deformation of craniofacial bones for cleft lip and palate, mandibular prognathia and hemifacial microsomia. For patients, asymmetry in the frontal view and twist-formed complicated deformities were observed, as well as deformity of profiles in the anteroposterior and up-and-down directions. A newly developed technique allows three-dimensional visualization of changes in craniofacial deformity. It would aid in determining surgical strategy, including crani-facial surgery and maxillo-facial surgery, and in evaluating surgical outcome. (N.K.).

  15. Distraction osteogenesis therapy in patients affected by Goldenhar syndrome: a case series

    Francesco Grecchi

    2011-06-01

    Full Text Available Background: Hemifacial microsomia (HM is a syndrome characterized by the presence of structural alterations of the skeletal, nervous, vascular, and muscular structures derived from the first and second branchial arch. Goldenhar syndrome (Gs consistisof the triad of craniofacial microsomia, ocular dermoid cysts, and spinal anomalies. When the patient has hypoplasia of the mandible, orthognatic surgery or distraction osteogenesis (DO can be used to correct the asymmetry. Mandibular DO has been applied for many years, but long-term reports showed controversial results. The aim of this paper is to describe three cases of patients affected by Gs in which DO was performed to correct the mandibular asymmetry. Case series: The cases reported show an increasing degree of dismorphism which required a increasing complexity of the surgical approach: a single mandibular DO in the first patient, and a mandibular DO associated with a Le Fort I osteotomy in the second one, a double mandibular DO associated with Le Fort I and surgical disjunction of the middle palatal suture in the third case. Discussion: The effects of DO involve not only the skeletal segment but also all the surrounding soft tissues. DO leads to rapid and remarkable improvement in facial symmetry due to emimandible hypoplasia. When correct spatial repositioning of the maxilla cann ot be expected, mandibular DO can be carried out by associating a Le Fort I osteotomy. In this way DO minimize the need for major osteotomies and allows an earlier treatment in selected cases.

  16. Prevalence, prenatal diagnosis and clinical features of oculo-auriculo-vertebral spectrum: a registry-based study in Europe.

    Barisic, Ingeborg

    2014-01-08

    Oculo-auriculo-vertebral spectrum is a complex developmental disorder characterised mainly by anomalies of the ear, hemifacial microsomia, epibulbar dermoids and vertebral anomalies. The aetiology is largely unknown, and the epidemiological data are limited and inconsistent. We present the largest population-based epidemiological study to date, using data provided by the large network of congenital anomalies registries in Europe. The study population included infants diagnosed with oculo-auriculo-vertebral spectrum during the 1990-2009 period from 34 registries active in 16 European countries. Of the 355 infants diagnosed with oculo-auriculo-vertebral spectrum, there were 95.8% (340\\/355) live born, 0.8% (3\\/355) fetal deaths, 3.4% (12\\/355) terminations of pregnancy for fetal anomaly and 1.5% (5\\/340) neonatal deaths. In 18.9%, there was prenatal detection of anomaly\\/anomalies associated with oculo-auriculo-vertebral spectrum, 69.7% were diagnosed at birth, 3.9% in the first week of life and 6.1% within 1 year of life. Microtia (88.8%), hemifacial microsomia (49.0%) and ear tags (44.4%) were the most frequent anomalies, followed by atresia\\/stenosis of external auditory canal (25.1%), diverse vertebral (24.3%) and eye (24.3%) anomalies. There was a high rate (69.5%) of associated anomalies of other organs\\/systems. The most common were congenital heart defects present in 27.8% of patients. The prevalence of oculo-auriculo-vertebral spectrum, defined as microtia\\/ear anomalies and at least one major characteristic anomaly, was 3.8 per 100 000 births. Twinning, assisted reproductive techniques and maternal pre-pregnancy diabetes were confirmed as risk factors. The high rate of different associated anomalies points to the need of performing an early ultrasound screening in all infants born with this disorder.European Journal of Human Genetics advance online publication, 8 January 2014; doi:10.1038\\/ejhg.2013.287.

  17. Achieving aesthetic results in facial reconstructive microsurgery: planning and executing secondary refinements.

    Haddock, Nicholas T; Saadeh, Pierre B; Siebert, John W

    2012-12-01

    Free tissue transfer to improve bulk and contour in facial deformities has been proven useful, yet refinements that turn an acceptable result into an excellent result are essential to reconstruction. The authors reviewed their experience and described these refinements. The charts of 371 free tissue transfer cases (1989 to 2010) performed by the senior author (J.W.S.) were reviewed. Free tissue transfer of a circumflex scapular variant flap or superficial inferior epigastric was performed to treat deformities arising from hemifacial atrophy (n = 126), hemifacial microsomia (n = 89), radiation therapy (n = 40), bilateral malformations including lupus and polymyositis (n = 50), other congenital anomalies (n = 25), facial palsy (n = 17), and burns and trauma (n = 24). Revision surgery planning began at initial flap operation where the flap was stretched maximally and interdigitated with recipient tissue. More tissue was required in the malar region. Revision refinement was indicated in all cases (after 6 months). Flap revision involved liposuction, debulking, reelevation, and release of tethering, followed by tissue rearrangement by means of advancement, rotation, transposition, and/or turnover flaps of subcutaneous tissues from the previous free flap. The jawline frequently required more debulking. Periorbital reconstruction was combined with lower lid support with or without canthal repositioning. Conventional face-lift techniques with the flap as superficial musculoaponeurotic system augmented the result. Autologous fat injection to the alar rim, medial canthus, upper eyelid, and lip was a useful adjunct. Severe lip deficiencies were addressed with local flaps. The keys to improving results were continual critical reassessment, open-mindedness to new approaches, and maintaining high expectations. Therapeutic, V.

  18. Innominate Vein Stenosis in Association with Ipsilateral Hyperdynamic Brachiobasilic Fistula Causing Ipsilateral Limb and Hemifacial Swelling.

    Narendra, J B; Sreenivas, J; Karthikeyan, V S; Nagaraja, N H

    2017-01-01

    A 34-year-old hypertensive woman with a hyperdynamic, left brachiobasilic dialysis fistula presented with a long history of throbbing in her head and swelling of the left side of the face. Tight stenosis of left brachiocephalic vein was found to be causing retrograde flow into the left jugular vein which normalized after dilatation and stenting with resolution of all the symptoms and patient is asymptomatic for 1 year.

  19. First and second branchial arch syndromes: multimodality approach

    Senggen, Elodie; Laswed, Tarek; Meuwly, Jean-Yves; Maestre, Leonor Alamo; Meuli, Reto; Gudinchet, Francois; Jaques, Bertrand

    2011-01-01

    First and second branchial arch syndromes (BAS) manifest as combined tissue deficiencies and hypoplasias of the face, external ear, middle ear and maxillary and mandibular arches. They represent the second most common craniofacial malformation after cleft lip and palate. Extended knowledge of the embryology and anatomy of each branchial arch derivative is mandatory for the diagnosis and grading of different BAS lesions and in the follow-up of postoperative patients. In recent years, many new complex surgical approaches and procedures have been designed by maxillofacial surgeons to treat extensive maxillary, mandibular and external and internal ear deformations. The purpose of this review is to evaluate the role of different imaging modalities (orthopantomogram (OPG), lateral and posteroanterior cephalometric radiographs, CT and MRI) in the diagnosis of a wide spectrum of first and second BAS, including hemifacial microsomia, mandibulofacial dysostosis, branchio-oto-renal syndrome, Pierre Robin sequence and Nager acrofacial dysostosis. Additionally, we aim to emphasize the importance of the systematic use of a multimodality imaging approach to facilitate the precise grading of these syndromes, as well as the preoperative planning of different reconstructive surgical procedures and their follow-up during treatment. (orig.)

  20. Goldenhar syndrome: a cause of secondary immunodeficiency?

    De Golovine Serge

    2012-07-01

    Full Text Available Abstract Goldenhar syndrome (GS results from an aberrant development of the 1st and 2nd branchial arches. There is a wide range of clinical manifestations, the most common being microtia, hemifacial microsomia, epibulbar dermoids and vertebral malformations. We present two cases of GS and secondary immunodeficiency due to anatomical defects characteristic of this disorder. Case 1 (3-year-old female averaged 6 episodes of sinusitis and otitis media per year. Case 2 (7-year-old female also had recurrent otitis media, an episode of bacterial pneumonia, and 2 episodes of bacterial meningitis. Their immune evaluation included a complete blood count with differential, serum immunoglobulin levels and specific antibody concentrations, lymphocyte phenotyping, and mitogen and antigen responses, the results of which were all within normal ranges. Both children demonstrated major structural abnormalities of the inner and middle ear structures, retention of fluid in mastoid air cells, and chronic sinusitis by computed tomography. These two cases illustrate how a genetically-associated deviation of the middle ear cleft can cause recurrent infections and chronic inflammation of the middle ear and adjacent sinuses, even meninges, leading to a greatly reduced quality of life for the child and parents.

  1. First and second branchial arch syndromes: multimodality approach

    Senggen, Elodie; Laswed, Tarek; Meuwly, Jean-Yves; Maestre, Leonor Alamo; Meuli, Reto; Gudinchet, Francois [University Hospital of Lausanne, Radiology Department, Lausanne (Switzerland); Jaques, Bertrand [University Hospital of Lausanne, Department of Otorhinolaryngology, Lausanne (Switzerland)

    2011-05-15

    First and second branchial arch syndromes (BAS) manifest as combined tissue deficiencies and hypoplasias of the face, external ear, middle ear and maxillary and mandibular arches. They represent the second most common craniofacial malformation after cleft lip and palate. Extended knowledge of the embryology and anatomy of each branchial arch derivative is mandatory for the diagnosis and grading of different BAS lesions and in the follow-up of postoperative patients. In recent years, many new complex surgical approaches and procedures have been designed by maxillofacial surgeons to treat extensive maxillary, mandibular and external and internal ear deformations. The purpose of this review is to evaluate the role of different imaging modalities (orthopantomogram (OPG), lateral and posteroanterior cephalometric radiographs, CT and MRI) in the diagnosis of a wide spectrum of first and second BAS, including hemifacial microsomia, mandibulofacial dysostosis, branchio-oto-renal syndrome, Pierre Robin sequence and Nager acrofacial dysostosis. Additionally, we aim to emphasize the importance of the systematic use of a multimodality imaging approach to facilitate the precise grading of these syndromes, as well as the preoperative planning of different reconstructive surgical procedures and their follow-up during treatment. (orig.)

  2. Prevalence, prenatal diagnosis and clinical features of oculo-auriculo-vertebral spectrum

    Barisic, Ingeborg; Odak, Ljubica; Loane, Maria

    2014-01-01

    . Of the 355 infants diagnosed with oculo-auriculo-vertebral spectrum, there were 95.8% (340/355) live born, 0.8% (3/355) fetal deaths, 3.4% (12/355) terminations of pregnancy for fetal anomaly and 1.5% (5/340) neonatal deaths. In 18.9%, there was prenatal detection of anomaly/anomalies associated with oculo......-auriculo-vertebral spectrum, 69.7% were diagnosed at birth, 3.9% in the first week of life and 6.1% within 1 year of life. Microtia (88.8%), hemifacial microsomia (49.0%) and ear tags (44.4%) were the most frequent anomalies, followed by atresia/stenosis of external auditory canal (25.1%), diverse vertebral (24.3%) and eye...... anomaly, was 3.8 per 100,000 births. Twinning, assisted reproductive techniques and maternal pre-pregnancy diabetes were confirmed as risk factors. The high rate of different associated anomalies points to the need of performing an early ultrasound screening in all infants born with this disorder....

  3. Lengthening Temporalis Myoplasty for Single-Stage Smile Reconstruction in Children with Facial Paralysis.

    Panossian, Andre

    2016-04-01

    Free muscle transfer for dynamic smile reanimation in facial paralysis is not always predictable with regard to cosmesis. Hospital stays range from 5 to 7 days. Prolonged operative times, longer hospital stays, and excessive cheek bulk are associated with free flap options. Lengthening temporalis myoplasty offers single-stage smile reanimation with theoretical advantages over free tissue transfer. From 2012 to 2014, 18 lengthening temporalis myoplasties were performed in 14 children for smile reconstruction. A retrospective chart review was completed for demographics, operative times, length of hospital stay, and perioperative complications. Fourteen consecutive patients with complete facial paralysis were included. Four patients underwent single-stage bilateral reconstruction, and 10 underwent unilateral procedures. Diagnoses included Möbius syndrome (n = 5), posterior cranial fossa tumors (n = 4), posttraumatic (n = 2), hemifacial microsomia (n = 1), and idiopathic (n = 2). Average patient age was 10.1 years. Average operative time was 410 minutes (499 minutes for bilateral lengthening temporalis myoplasty and 373 for unilateral lengthening temporalis myoplasty). Average length of stay was 3.3 days (4.75 days for bilateral lengthening temporalis myoplasty and 2.8 for unilateral lengthening temporalis myoplasty). Nine patients required minor revisions. Lengthening temporalis myoplasty is a safe alternative to free tissue transfer for dynamic smile reconstruction in children with facial paralysis. Limited donor-site morbidity, shorter operative times, and shorter hospital stays are some benefits over free flap options. However, revisions are required frequently secondary to tendon avulsions and adhesions. Therapeutic, IV.

  4. The use of expanded polytetrafluoroethylene in depressed deformities of the face.

    Liu, Xiaowei; Zhang, Yiming; Wang, Shaoliang; Lei, Zeyuan; Li, Xiang; Fan, Dongli

    2016-11-01

    Expanded polytetrafluoroethylene (ePTFE) has been extensively used for facial soft tissue augmentation procedures, and is regarded as safe and reliable and suitable as a permanent implant. This implant is generally used in the lower third of the face for lips filling, nasal augmentation, nasolabial folds and chin augmentation, and rarely for congenital or acquired depressed deformities of the face. The aim of the present study was to assess the effects of ePTFE in congenital or acquired depressed deformities of the face. From September, 2008 to January, 2014, 26 patients were implanted with the material ePTFE to correct depressed deformities of the face. The average age at operation was 23.2 years, with a range of 17-45 years. The depressed deformities were lateralized. The follow-up period was 6-18 months (average 9 months). The etiologies of the depressed deformities included stable hemifacial atrophy (3 cases), craniofacial microsomia (13 cases), bony depression after trauma (8 cases), and other unclear reasons (2 cases). The operations were performed under local anesthesia. ePTFE was inserted in different tissue planes that varied among the different subanatomical areas in the face: beneath the superficial temporal fascia in the temporal area, and on the surface of the superficial musculoaponeurotic system in the zygomatic area, cheek and mandibular area. All of the patients were followed up. Most of the patients [25 of 26 patients (96.2%)] were satisfied with the results, while 1 patient (3.8%) was not satisfied for incomplete correction of the depressed deformity. In conclusion, aside from lipofilling and a free flap transfer, the results showed that ePTFE was an alternative treatment for facial depressed deformity.

  5. Whole-exome sequencing identified a variant in EFTUD2 gene in establishing a genetic diagnosis.

    Rengasamy Venugopalan, S; Farrow, E G; Lypka, M

    2017-06-01

    Craniofacial anomalies are complex and have an overlapping phenotype. Mandibulofacial Dysostosis and Oculo-Auriculo-Vertebral Spectrum are conditions that share common craniofacial phenotype and present a challenge in arriving at a diagnosis. In this report, we present a case of female proband who was given a differential diagnosis of Treacher Collins syndrome or Hemifacial Microsomia without certainty. Prior genetic testing reported negative for 22q deletion and FGFR screenings. The objective of this study was to demonstrate the critical role of whole-exome sequencing in establishing a genetic diagnosis of the proband. The participants were 14½-year-old affected female proband/parent trio. Proband/parent trio were enrolled in the study. Surgical tissue sample from the proband and parental blood samples were collected and prepared for whole-exome sequencing. Illumina HiSeq 2500 instrument was used for sequencing (125 nucleotide reads/84X coverage). Analyses of variants were performed using custom-developed software, RUNES and VIKING. Variant analyses following whole-exome sequencing identified a heterozygous de novo pathogenic variant, c.259C>T (p.Gln87*), in EFTUD2 (NM_004247.3) gene in the proband. Previous studies have reported that the variants in EFTUD2 gene were associated with Mandibulofacial Dysostosis with Microcephaly. Patients with facial asymmetry, micrognathia, choanal atresia and microcephaly should be analyzed for variants in EFTUD2 gene. Next-generation sequencing techniques, such as whole-exome sequencing offer great promise to improve the understanding of etiologies of sporadic genetic diseases. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Hydrometallurgical minor actinide separation in hollow fiber modules

    Geist, A.; Weigl, M.; Gompper, K.

    2004-01-01

    Hollow fiber modules (HFM) were used as phase contacting devices for hydrometallurgical minor actinide separation in the Partitioning and Transmutation context. Two single-HFM setups, one using commercially available HFM, the other one using miniature HFM, have been developed and manufactured. Several very successful DIAMEX and SANEX once-through tests were performed. The major advantage of the new miniature HFM is their size drastically reducing chemicals consumption: only several 10 mL of feed phases are required for a test. (authors)

  7. Variabilidade fenotípica na síndrome do cromossomo supernumerário der(22t(11;22 (síndrome de Emanuel Phenotypical variability in supernumerary chromosome der(22t(11;22 syndrome (Emanuel syndrome

    Rafael Fabiano M. Rosa

    2010-09-01

    hypotonia, neuropsychomotor delay, stereotypic movements, microcephaly, ptosis, prominent ears, preauricular pits with skin tag, and imperforate anus. Additional evaluations identified cerebral hypoplasia and pulmonar valvar stenosis. She also had laryngotracheomalacia and cleft palate. The second patient was a six months white boy with hypotonia, choreoatetotic movements, growth retardation, microcephaly, hemifacial microsomia, cleft palate, microtia, preauricular skin tags and thumbs proximally placed. Echocardiography disclosed pulmonary valvar stenosis, interatrial and ventricular septal defects, patent ductus arteriosus and persistence of left upper vein cava. Radiography study of thorax identified a cervical rib. GTG-Banding karyotype showed, in both patients, a supernumerary chromosome der(22t(11;22 secondary in the first case to a maternal balanced translocation and in the second one to a paternal translocation. COMMENTS: The first patient presented frequent features of ES, but the second one is the second description in the literature of a phenotype of oculo-auriculo-vertebral spectrum (OAVS. Thus, both patients highlight the clinical variability observed in ES and the importance of the karyotype analysis in patients with OAVS phenotype.

  8. 78 FR 70306 - Distribution of In Vitro Diagnostic Products Labeled for Research Use Only or Investigational Use...

    2013-11-25

    ... Development (HFM-40), Center for Biologics Evaluation and Research (CBER), Food and Drug Administration, 1401...: Guidance for Industry and Food and Drug Administration Staff; Availability AGENCY: Food and Drug... Research (HFM-17), Food and Drug Administration, 1401 Rockville Pike, Suite 200N, Rockville, MD 20852-1448...

  9. Need for speed? Exchange latency and liquidity

    Menkveld, Albert J.; Zoican, Marius A.

    2017-01-01

    A faster exchange does not necessarily improve liquidity. On the one hand, speed enables a high-frequency market maker (HFM) to update quotes faster on incoming news. This reduces payoff risk and thus lowers the competitive bid-ask spread. On the other hand, HFM price quotes are more likely to meet

  10. Significant Effect of a Pre-Exercise High-Fat Meal after a 3-Day High-Carbohydrate Diet on Endurance Performance

    Ikuma Murakami

    2012-06-01

    Full Text Available We investigated the effect of macronutrient composition of pre-exercise meals on endurance performance. Subjects consumed a high-carbohydrate diet at each meal for 3 days, followed by a high-fat meal (HFM; 1007 ± 21 kcal, 30% CHO, 55% F and 15% P or high-carbohydrate meal (HCM; 1007 ± 21 kcal, 71% CHO, 20% F and 9% P 4 h before exercise. Furthermore, just prior to the test, subjects in the HFM group ingested either maltodextrin jelly (M or a placebo jelly (P, while subjects in the HCM ingested a placebo jelly. Endurance performance was measured as running time until exhaustion at a speed between lactate threshold and the onset of blood lactate accumulation. All subjects participated in each trial, randomly assigned at weekly intervals. We observed that the time until exhaustion was significantly longer in the HFM + M (p < 0.05 than in HFM + P and HCM + P conditions. Furthermore, the total amount of fat oxidation during exercise was significantly higher in HFM + M and HFM + P than in HCM + P (p < 0.05. These results suggest that ingestion of a HFM prior to exercise is more favorable for endurance performance than HCM. In addition, HFM and maltodextrin ingestion following 3 days of carbohydrate loading enhances endurance running performance.

  11. Características clínicas de uma amostra de pacientes com a síndrome do olho do gato Clinical characteristics of a sample of patients with cat eye syndrome

    Rafael Fabiano Machado Rosa

    2010-01-01

    Full Text Available OBJETIVO: A síndrome do olho do gato é considerada uma doença cromossômica rara e fenotipicamente bastante variável. O objetivo deste trabalho foi descrever as características clínicas de uma amostra de pacientes com a síndrome avaliada em nosso serviço. MÉTODOS: Foram analisados, retrospectivamente, seis pacientes com diagnóstico de síndrome do olho do gato. Todos eles apresentavam cariótipo com a presença de um cromossomo marcador adicional, inv dup(22(pter->q11.2::q11.2->pter. Um deles, ainda, possuía mosacismo com uma linhagem com constituição cromossômica normal. A partir dos prontuários médicos foram coletados dados clínicos e de evolução dos pacientes. Para comparação entre as frequências encontradas em nosso estudo e a literatura foi utilizado o teste exato de Fisher (POBJECTIVE: The cat eye syndrome is considered a rare chromosomal disease and a phenotypically quite variable condition. The objective of this study was to describe the clinical characteristics of a sample of patients with the syndrome evaluated in our Service. METHODS: Six patients with diagnosis of cat eye syndrome were retrospectively evaluated. All presented a karyotype with presence of an additional chromosome marker, inv dup(22(pter->q11.2::q11.2->pter. One of them still had a mosaicism with a lineage with a normal chromosomal constitution. Clinical and evolution data were collected from their medical records. Fisher exact test (P<0.05 was used for comparison between the frequencies found in our study and literature. RESULTS: The main abnormalities found were preauricular skin tags/pits and imperforate anus (both observed in 83% of cases. Iris coloboma, an important feature of the syndrome was verified in 2 cases (33%. Congenital heart defect observed in 4 patients (67%, with the atrial septal defect (75% as the most observed. Uncommon features included the hemifacial microsomia associated to microtia, besides biliary atresia. In relation to

  12. Stemcell Information: SKIP000652 [SKIP Stemcell Database[Archive

    Full Text Available both neonatal and maternal cells. 羊膜(母胎・胎児)由来線維芽細胞(HFM-1)由来iPS細胞. human ES-like Research Grade Retrovirus Oc... SKIP000652 ... amnion 羊膜 Normal HiPS-RIKEN-3D HiPS-RIKEN-3D ... Fetus Male ... -- No Human iPS cel...l line. Parent cell line of HFM-1(amniotic membrane cells).HFM-1 were derived from ...2010.00091.x Establishment of induced pluripotent stem cells from human neonatal tissues. Fujioka T, Shimizu

  13. Stemcell Information: SKIP000655 [SKIP Stemcell Database[Archive

    Full Text Available both neonatal and maternal cells. 羊膜(母胎・胎児)由来線維芽細胞(HFM-1)由来iPS細胞. human ES-like Research Grade Lentivirus Oc... SKIP000655 ... amnion 羊膜 Normal HiPS-RIKEN-4B HiPS-RIKEN-4B ... Fetus Male ... -- No Human iPS cel...l line. Parent cell line of HFM-1(amniotic membrane cells).HFM-1 were derived from ...4.2010.00091.x Establishment of induced pluripotent stem cells from human neonatal tissues. Fujioka T, Shimi

  14. Stemcell Information: SKIP000653 [SKIP Stemcell Database[Archive

    Full Text Available both neonatal and maternal cells. 羊膜(母胎・胎児)由来線維芽細胞(HFM-1)由来iPS細胞. human ES-like Research Grade Retrovirus Oc... SKIP000653 ... amnion 羊膜 Normal HiPS-RIKEN-3E HiPS-RIKEN-3E ... Fetus Male ... -- No Human iPS cel...l line. Parent cell line of HFM-1(amniotic membrane cells).HFM-1 were derived from ...2010.00091.x Establishment of induced pluripotent stem cells from human neonatal tissues. Fujioka T, Shimizu

  15. Collaborative crew performance in complex operational systems: L'Efficacité du travail en équipage dans des systèmes opérationnel complexes

    1999-01-01

    Contains the proceedings of the first RTO Human Factors and Medical Panel (HFM) Symposium, held in Edinburgh, Scotland, April 20-22, 1998, including the Technical Evaluation Report and Keynote Addresses...

  16. The Human Effects of Non-Lethal Technologies (Impacts humain des technologies non letales) (CD-ROM)

    2006-01-01

    .... In response to NATO RTO tasking, based on the recommendations of the 2000 Defence Capabilities Initiative, to support preparations for a NATO NLW capability, the Human Factors and Medicine Panel (HFM...

  17. NATO Guidelines on Human Engineering Testing and Evaluation

    Geddie, J

    2001-01-01

    The purpose of this report is to document the efforts of RSC-24, which was initiated by DRG Panel 8 in 1992, and was sponsored after the merger of DRG and AGARD by the Human Factors and Medicine (HFM...

  18. Stress and Psychological Support in Modern Military Operations (Stress et aide psychologique dans les operations militaires modernes)

    2008-01-01

    NATO Task Group HFM-081/RTG on "Stress and Psychological Support in Modern Military Operations" has produced, in the form of a Military Leaders Guide, a series of guidelines for psychological support...

  19. 78 FR 49529 - Radio Frequency Wireless Technology in Medical Devices; Guidance for Industry and Food and Drug...

    2013-08-14

    ..., 301-796-2483; or Stephen Ripley, Center for Biologics Evaluation and Research (HFM- 17), Food and Drug... information in 21 CFR part 814, subpart H have been approved under OMB control number 0910-0332; and the...

  20. Advancements in Distributed Learning (ADL) Environment in Support of Transformation

    2017-01-01

    take a variety of forms, including Task Groups, Workshops, Symposia, Specialists’ Meetings, Lecture Series and Technical Courses . The content of this... MySQL and PHP Apache xAPI Extensive Application Program Interface viii STO-TR-HFM-212 HFM-212 Membership List Dr. Oleksandr BUROV Institute...in Paris, France, initiated a new management infrastructure for collaboration and integration of learning courses and technologies. This ADL effort

  1. Moral, Ethical and Legal Considerations with the Use of Drugs for Performance Maintenance in the Canadian Forces

    2009-10-01

    drugs . Most controlled drugs with performance maintenance characteristics would fall under schedule 3 of the Act. CF members’ consumption of performance...21 - 4 RTO-MP-HFM-181 Disorder (ADHD) to increase attention. Caffeine itself is the world’s most widely used psychoactive drug and by far the...RTO-MP-HFM-181 21 - 1 Moral, Ethical and Legal Considerations with the Use of Drugs for Performance Maintenance in the Canadian Forces

  2. Transcriptome profiling of liver of non-genetic low birth weight and long term health consequences

    Miranda Bedate, Alberto; López-Cardona, Angela P; Laguna-Barraza, Ricardo; Calle, Alexandra; López-Vidriero, Irene; Pintado, Belén; Gutiérrez-Adán, Alfonso

    2014-01-01

    BACKGROUND: It is believed that the main factors of low prenatal growth in mammals are genetic and environmental. We used isogenic mice maintained in standard conditions to analyze how natural non-genetic microsomia (low birth weight) is produced in inbred mice and its long term effect on health. To

  3. EFEKTIFITAS TOXIN BOTULLINUM UNTUK MANAJEMEN BLEFAROSPASME ESSENSIAL DAN SPASME HEMIFASIAL

    Hendriati Hendriati

    2010-09-01

    Full Text Available AbstrakUntuk mengukur efektifikas toxin Botullinum pada kasus-kasus okuloplastik (blefarospasme essensial dan spasme hemifasial.Laporan kasus 16 pasien yang terdiri dari 14 kasus spasme hemifasial dan 2 kasus blefarospasme essensial. Digunakan 6 vial toxin Botullinum. Vial pertama digunakan untuk pasien spasme hemifasial dan 1 pasien blefasrospasme di minggu berikutnya. vial kedua dan ketiga masing-masing digunakan untuk 2 pasien spasme hemifasial. Vial keempat digunakan untuk pasien blefarospasme yang menggunakan vial pertama (setelah 6 bulan, dan 1 pasien spasme hemifasial yang menggunakan vial kedua ( setelah 4 bulan dan 1 pasien spasme hemifasial baru. Setelah 1 minggu, toxin Botullinum vial keempat digunakan untuk 6 pasien spasme hemifasial dan 1 pasien blefarospasme essensial yang menggunakan vial pertama 8 hari berikutnya (setelah 7 bulan.Terdapat 16 pasien pada studi ini ; 14 spasme hemifasial dan 2 blefarospasme essensial. Pada 5 pasien dilakukan injeksi ulangan dengan jangka waktu yang berbeda. Tidak ditemukan efek samping pada pasien-pasien ini.Toxin Botulinum efektif untuk manajemen spasme hemifasial dan blefarospasme essensial tetapi efeknya temporer. Pada studi ini, jangka waktu injeksi ulangan bervariasi sekitar 4 – 7 bulan pada 5 pasien.Kata Kunci : Toxin Botulinum toxin, spasme hemifasial, blefarospasmeAbstractTo asses Botulinum Toxin efficacy in oculoplastic cases (blepharospasm and hemifacial spasm.A case report on 16 patients consisted of 14 hemifacial spasms and 2 essential blepharospasm. Six vials of botulinum toxin were used. First vial was used for two patients of hemifacial spasm and one blepharospasm patient one week later. Second and third vials were used each for two patients of hemifacial spasms. Fourth vial was used for one blepharospasm patient from first vial user (after six month, one hemifacial spasm from second vial user (after four months and one new hemifacial spasm. After one week, Botulinum toxin from

  4. Case of Rapid Progression of Hemiatrophy on the Face: A New Clinical Entity?

    Hisashi Nomura

    2015-01-01

    Full Text Available A lot of diseases, including lupus profundus, morphea, lipodystrophy, and Parry-Romberg syndrome, may manifest progressive hemifacial atrophy. These diseases usually progress slowly and rapid progression of atrophy is extremely rare. We report a case of elderly-onset rapid progression of hemifacial atrophy only in three weeks. Our case did not meet variable differential diagnoses. We discuss the clinical character of the patient against the past of literature and suppose it may be a new clinical entity.

  5. Prevalence and characteristics of coronary artery disease in heart failure with preserved and mid-range ejection fractions: A systematic angiography approach.

    Trevisan, Lory; Cautela, Jennifer; Resseguier, Noemie; Laine, Marc; Arques, Stephane; Pinto, Johan; Orabona, Morgane; Barraud, Jeremie; Peyrol, Michael; Paganelli, Franck; Bonello, Laurent; Thuny, Franck

    2018-02-01

    Guidelines recommend careful screening and treatment of coronary artery disease (CAD) in heart failure with preserved or mid-range ejection fraction (HFpEF/HFmEF). We aimed to determine the prevalence and characteristics of CAD using a prospective systematic coronary angiography approach. A systematic coronary angiography protocol was applied in consecutive patients admitted for HFpEF/HFmEF during a 6-month period in a single centre. History of CAD and results of angiography, including revascularization, were reported. Of the 164 patients with HFpEF/HFmEF who were included, an angiography assessment was applied in 108 (66%) (median age: 79 years [interquartile range: 70-85 years]; 54% were women). In our analysis, 64% (95% confidence interval [CI] 55-73%) of patients had a significant coronary stenosis corresponding to a global CAD prevalence of 80% (95% CI 73-88%). The prevalence of CAD was similar for HFpEF and HFmEF. The left main coronary artery presented a significant stenosis in 6.5% of cases and 39% of patients had a two- or three-vessel disease. The rate of significant coronary stenosis was non-significantly higher in patients with a history of CAD. Patients with HFpEF/HFmEF with and without CAD did not differ in clinically meaningful ways, in terms of symptoms or laboratory and echocardiography results. This strategy led to complete revascularization in 36% of patients with significant stenosis and in 23% of all patients with HFpEF/HFmEF. Our study differs from others in that we used a systematic angiography approach. The results suggest a much higher prevalence of CAD in HFpEF/HFmEF than previously reported and should encourage clinicians to aggressively identify this co-morbidity. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Probiotic yogurt and acidified milk similarly reduce postprandial inflammation and both alter the gut microbiota of healthy, young men.

    Burton, Kathryn J; Rosikiewicz, Marta; Pimentel, Grégory; Bütikofer, Ueli; von Ah, Ueli; Voirol, Marie-Jeanne; Croxatto, Antony; Aeby, Sébastien; Drai, Jocelyne; McTernan, Philip G; Greub, Gilbert; Pralong, François P; Vergères, Guy; Vionnet, Nathalie

    2017-05-01

    Probiotic yogurt and milk supplemented with probiotics have been investigated for their role in 'low-grade' inflammation but evidence for their efficacy is inconclusive. This study explores the impact of probiotic yogurt on metabolic and inflammatory biomarkers, with a parallel study of gut microbiota dynamics. The randomised cross-over study was conducted in fourteen healthy, young men to test probiotic yogurt compared with milk acidified with 2 % d-(+)-glucono-δ-lactone during a 2-week intervention (400 g/d). Fasting assessments, a high-fat meal test (HFM) and microbiota analyses were used to assess the intervention effects. Baseline assessments for the HFM were carried out after a run-in during which normal milk was provided. No significant differences in the inflammatory response to the HFM were observed after probiotic yogurt compared with acidified milk intake; however, both products were associated with significant reductions in the inflammatory response to the HFM compared with the baseline tests (assessed by IL6, TNFα and chemokine ligand 5) (Pyogurt intake (FC=-1·3, P adj=0·03), increased abundance of Bifidobacterium species after acidified milk intake (FC=1·4, P adj=0·04) and detection of Lactobacillus delbrueckii spp. bulgaricus (FC=7·0, P adjyogurt intake. Probiotic yogurt and acidified milk similarly reduce postprandial inflammation that is associated with a HFM while inducing distinct changes in the gut microbiota of healthy men. These observations could be relevant for dietary treatments that target 'low-grade' inflammation.

  7. Síndrome de Goldenhar: relato de um caso com discordância em gêmeas monozigóticas Monozygotic twins discordant for Goldenhar syndrome

    Leonardo Lima Verona

    2006-02-01

    section at 35 weeks' gestation. Her birth weight was 2,170 g, length 42.5 cm, head circumference 30 cm and her Apgar scores were 3/7. After birth the child developed severe respiratory distress and had to be moved to the neonatal intensive care unit (ICU. The other twin was a girl, born weighing 3,200 g with a length of 49 cm, head circumference of 34 cm and Apgar scores of 8/10. She was transferred to the mother-baby unit soon after birth and was discharged two days later. There was no consanguinity between the twins' parents, who were young and healthy at the time of their conception. The affected child's dysmorphic features included left hemifacial microsomia, severe micrognathia, abnormal ears, bilateral preauricular tags and epibulbar dermoid in the right eye. She developed obstructive apnea due to micrognathia and required tracheostomy. Abdominal and cranial ultrasound findings were normal, as was an ophthalmological assessment. Spine x-ray showed hemivertebra at T9 and T10. An echocardiogram showed Tetralogy of Fallot. GTG-banded karyotyping was performed on peripheral blood cells and revealed 46,XX. Zygosity testing established the pair of twins to be monozygotic with a probability greater than 99:1. COMMENT: Goldenhar syndrome was diagnosed in one of the twins described here. There are several reports of twins discordant for this disorder and therefore non-genetic factors may also play an important role, for instance vascular disruption during morphogenesis.

  8. Safe Ride Standards for Casualty Evacuation Using Unmanned Aerial Vehicles (Normes de transport sans danger pour l’evacuation des blesses par vehicules aeriens sans pilote)

    2012-12-01

    September 2008. 11.2 CLINICAL AND OPERATIONAL DOCUMENTS Aerospace Medical Association Air Transport Committee, “Medical Guidelines for Airline ...RTO-MP-HFM-157////MP-HFM-157-19.doc. Turner, S., Ruth, M.J. and Bruce, D.L., “In Flight Catering : Feeding Critical Care Patients During Aeromedical...feet. 8 Turner, S., Ruth, M.J. and Bruce, D.L. “In flight catering : Feeding critical care patients during aeromedical evacuation”. 9 Renz, E.M

  9. Medically Unexplained Physical Symptoms in Military Health (Symptomes physiques medicalement inexpliques dans la sante militaire)

    2017-12-01

    REPORT TR-HFM-175 Medically Unexplained Physical Symptoms in Military Health (Symptômes physiques médicalement inexpliqués dans la santé militaire...STO TECHNICAL REPORT TR-HFM-175 Medically Unexplained Physical Symptoms in Military Health (Symptômes physiques médicalement inexpliqués dans...The General Internist 10-7 10.5.1 The Health Psychologist 10-8 10.5.2 Medical Specialists 10-8 10.5.3 The Physiatrist 10-9 10.5.4 The Physical

  10. Survival at Sea for Mariners, Aviators and Search and Rescue Personnel (Survie en mer pour les marins, les aviateurs et le personnel de recherche et de sauvetage)

    2008-02-01

    of Figures viii List of Tables ix Preface x Technical Course HFM-152 xi Executive Summary and Synthèse ES-1 Chapter 1 – Introduction to the RTO...Survival at Sea for Mariners, Aviators and Search and Rescue Personnel (RTO-AG-HFM-152) Executive Summary This NATO RTO Technical Course on Marine...Lors d’accidents en eau froide, il est fort probable que le choc thermique dû au froid ainsi que l’épuisement à la nage entraînent davantage la

  11. Block 4 and Cluster D - Safety

    CERN. Geneva

    2016-01-01

    After transfer of Bloc4 test facility to SM18 its safety system was upgraded in 2014/2015 for its 3 existing test cryostats. In 2016 a new test facility HFM (High Field Magnet) was integrated in the Bloc4. A new test facility Cluster D which is similar to HFM is in a process of installation in SM18. The Presentation is dedicated to safety strategy of Bloc4 and Cluster D and focused on an analysis of risk conditions and on the real behaviour of safety valves in case of discharge. Protection of sub-atmospheric circuits is also discussed.

  12. [Facial tics and spasms].

    Potgieser, Adriaan R E; van Dijk, J Marc C; Elting, Jan Willem J; de Koning-Tijssen, Marina A J

    2014-01-01

    Facial tics and spasms are socially incapacitating, but effective treatment is often available. The clinical picture is sufficient for distinguishing between the different diseases that cause this affliction.We describe three cases of patients with facial tics or spasms: one case of tics, which are familiar to many physicians; one case of blepharospasms; and one case of hemifacial spasms. We discuss the differential diagnosis and the treatment possibilities for facial tics and spasms. Early diagnosis and treatment is important, because of the associated social incapacitation. Botulin toxin should be considered as a treatment option for facial tics and a curative neurosurgical intervention should be considered for hemifacial spasms.

  13. 21 CFR 601.29 - Guidance documents.

    2010-04-01

    ... Manufacturers Assistance (HFM-40), Center for Biologics Evaluation and Research, Food and Drug Administration... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Guidance documents. 601.29 Section 601.29 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS...

  14. 75 FR 6401 - Medical Devices Regulated by the Center for Biologics Evaluation and Research; Availability of...

    2010-02-09

    ... Biologics Evaluation and Research (HFM-17), Food and Drug Administration, suite 200N, 1401 Rockville Pike... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-M-0513] Medical Devices Regulated by the Center for Biologics Evaluation and Research; Availability of Summaries...

  15. 21 CFR 203.12 - An appeal from an adverse decision by the district office.

    2010-04-01

    ... to the Office of Compliance, Center for Drug Evaluation and Research, Food and Drug Administration... and Biologics Quality (HFM-600), Center for Biologics Evaluation and Research, Food and Drug... and Research, Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993-0002...

  16. Using Neurological Feedback to Enhance Resilience and Recuperation

    2011-04-01

    17 - 8 RTO-MP-HFM-205 assigned to redeploy Dutch equipment. These soldiers are randomly assigned to either: ‘ Treatment as usual’ (TAU...Integrating cognitive neuroscience research and cognitive behavioral treatment with neurofeedback therapy in drug addiction comorbid with...Dep. Military Mental Health Care 3769 DE Soesterberg Central Military Hospital / tel.: +31 888662891 Dutch Ministry of Defense Fax: +31

  17. 75 FR 1790 - Draft Guidance for Institutional Review Boards, Clinical Investigators, and Sponsors: IRB...

    2010-01-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-D-0605... clinical investigators and sponsors better understand their responsibilities related to continuing review...-463-6332 or 301-796-3400); or the Office of Communication, Outreach and Development (HFM-40), Center...

  18. Role of functional nanoparticles to enhance the polymeric membrane performance for mixture gas separation

    Ingole, Pravin G.; Baig, Muhammad Irshad; Choi, Wook; An, Xinghai; Choi, Won Kil; Lee, Hyung Keun

    2017-01-01

    To improve the water vapor/gas separation the hydroxylated TiO2(OH-TiO2) nanopartilces have been synthesized and surface of polysulfone (PSf) hollow fiber membrane (HFM) has been coated as thin film nanocomposite (TFN) membranes. To remove the water vapor from mixture gas, hollow fiber membrane has

  19. 75 FR 15639 - Revision of the Requirements for Constituent Materials

    2010-03-30

    ... preservative, except that a preservative need not be added to Yellow Fever Vaccine; Poliovirus Vaccine Live... and Research (CBER) or the Director of the Center for Drug Evaluation and Research (CDER), as... and Research (HFM-17), Food and Drug Administration, 1401 Rockville Pike, suite 200N, Rockville, MD...

  20. 76 FR 18226 - Guidance for Industry on Postmarketing Studies and Clinical Trials-Implementation of Section 505...

    2011-04-01

    ... and Development (HFM-40), Center for Biologics Evaluation and Research (CBER), Food and Drug... Drug Information, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New..., Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 51...

  1. 78 FR 32667 - Draft Guidance for Industry on Rheumatoid Arthritis: Developing Drug Products for Treatment...

    2013-05-31

    ... products. This guidance revises the guidance for industry entitled ``Clinical Development Programs for... Information, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Ave... (HFM-40), Center for Biologics Evaluation and Research, Food and Drug Administration, 1401 Rockville...

  2. 76 FR 4360 - Guidance for Industry on Process Validation: General Principles and Practices; Availability

    2011-01-25

    ... and Development (HFM-40), Center for Biologics Evaluation and Research (CBER), Food and Drug...] Guidance for Industry on Process Validation: General Principles and Practices; Availability AGENCY: Food... of Drug Information, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New...

  3. 75 FR 35493 - Guidance for Industry on Systemic Lupus Erythematosus-Developing Medical Products for Treatment...

    2010-06-22

    ...: The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry... and Research (CBER), Food and Drug Administration, 1401 Rockville Pike, suite 200N, Rockville, MD...-0002, 301- 796-2280; or Stephen Ripley, Center for Biologics Evaluation and Research (HFM- 17), Food...

  4. 78 FR 15955 - Draft Guidance for Industry and Review Staff on Formal Dispute Resolution: Appeals Above the...

    2013-03-13

    ... and Development (HFM-40), Center for Biologics Evaluation and Research, Food and Drug Administration... Drug Information, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New..., Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 22...

  5. 75 FR 35492 - Guidance for Industry on Lupus Nephritis Caused By Systemic Lupus Erythematosus-Developing...

    2010-06-22

    ... Communication, Outreach and Development (HFM-40), Center for Biologics Evaluation and Research (CBER), Food and...: The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry... the Division of Drug Information, Center for Drug Evaluation and Research, Food and Drug...

  6. 78 FR 20924 - Center for Biologics Evaluation and Research eSubmitter Pilot Evaluation Program for...

    2013-04-08

    ..., Office of Blood Research and Review, Center for Biologics Evaluation and Research (HFM-375), Food and... assist CBER in the final development and release of this electronic program for use by industry. III... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0248...

  7. 77 FR 69637 - Development of Prioritized Therapeutic Area Data Standards; Request for Comments

    2012-11-20

    ... regulatory information. FDA has developed a roadmap that provides its current thinking on therapeutic area... Clinical Data Interchange Standards Consortium (CDISC), the Critical Path Institute, Health Level 7's (HL7... 20993-0002, or the Office of Communication, Outreach and Development (HFM-40), Center for Biologics...

  8. 78 FR 19492 - Draft Guidance for Industry on Formal Meetings Between FDA and Biosimilar Biological Product...

    2013-04-01

    ..., or Office of Communication, Outreach, and Development (HFM-40), Center for Biologics Evaluation and... biological product. This draft guidance describes the Agency's current thinking on how it intends to... review of biosimilar biological products. Because these meetings often will represent critical points in...

  9. Transformation of the System of Values of Autonomous Learning for English Acquisition in Blended E-Studies for Adults: A Holistic Fractal Model

    Bojare, Inara; Skrinda, Astrida

    2016-01-01

    The present study is aimed at creating a holistic fractal model (HFM) of autonomous learning for English acquisition in a blended environment of e-studies in adult non-formal education on the basis of the theories and paradigms of philosophy, psychology and education for sustainable development to promote the development of adult learners'…

  10. Risk management of exposure to chemicals under operational conditions

    Langenberg, J.P.

    2007-01-01

    The HFM panel has decided to install an Exploratory Team, ET-078, which should advise whether or not a Technical Group (TG) should be established on the subject of risk management of exposure to chemicals under operational conditions. This paper described the context and approach of ET-078.

  11. Hollow fiber membrane based H-2 diffusion for efficient in situ biogas upgrading in an anaerobic reactor

    Luo, Gang; Angelidaki, Irini

    2013-01-01

    Bubbleless gas transfer through a hollow fiber membrane (HFM) module was used to supply H2 to an anaerobic reactor for in situ biogas upgrading, and it creates a novel system that could achieve a CH4 content higher than 90 % in the biogas. The increase of CH4 content and pH, and the decrease...

  12. A Survey of Blast Injury across the Full Landscape of Military Science (Etude d’ensemble des blessures dues aux explosions a travers le panorama complet de la science militaire)

    2011-04-01

    Military Science (RTO-MP-HFM-207) Executive Summary Blast injury is a significant source of casualties in current NATO operations. The term “blast...toxicologique du souffle incluant les mécanismes de dose (par exemple, normes d’exposition à un tube à choc ), la description des points limites dose

  13. Performance and microbial community analysis of the anaerobic reactor with coke oven gas biomethanation and in situ biogas upgrading

    Wang, Wen; Xie, Li; Luo, Gang

    2013-01-01

    (HFM). With pH control at 8.0, the added H2 and CO were fully consumed and no negative effects on the anaerobic degradation of sewage sludge were observed. The maximum CH4 content in the biogas was 99%. The addition of SCOG resulted in enrichment and dominance of homoacetogenetic genus Treponema...

  14. An Approach to Embedded Training for Future Leaders and Staff

    2009-10-01

    13. SUPPLEMENTARY NOTES See also ADA562526. RTO-MP-HFM-169 Human Dimensions in Embedded Virtual Simulation (Les dimensions humaines dans la...order to better capitalize on follow-on operations. 4.10 Theme 7: Sustain Unit Operations Theme 7 is defined as the ability of Soldiers and

  15. 21 CFR 99.201 - Manufacturer's submission to the agency.

    2010-04-01

    ... Division of Drug Marketing, Advertising, and Communications (HFD-42), Center for Drug Evaluation and... Advertising and Promotional Labeling Staff (HFM-602), Center for Biologics Evaluation and Research, Food and..., the Promotion and Advertising Policy Staff (HFZ-302), Office of Compliance, Center for Devices and...

  16. Review of Well-Being in the Context of Suicide Prevention and Resilience

    2011-04-01

    RTO-MP-HFM-205 religion and morals , the economy, politics and society, the environment, allocation of resources, contemporary social issues...Indicators Research, 97 (1), 7-21. [22] Brickman, P., & Campbell, D.T. (1971). Hedonic relativism and planning the good society. In M. H. Appley (Ed

  17. Gamma knife radiosurgery for cerebellopontine angle epidermoid tumors.

    El-Shehaby, Amr M N; Reda, Wael A; Abdel Karim, Khaled M; Emad Eldin, Reem M; Nabeel, Ahmed M

    2017-01-01

    Intracranial epidermoid tumors are commonly found in the cerebellopontine angle where they usually present with either trigeminal neuralgia or hemifacial spasm. Radiosurgery for these tumors has rarely been reported. The purpose of this study is to assess the safety and clinical outcome of the treatment of cerebellopontine epidermoid tumors with gamma knife radiosurgery. This is a retrospective study involving 12 patients harboring cerebellopontine angle epidermoid tumors who underwent 15 sessions of gamma knife radiosurgery. Trigeminal pain was present in 8 patients and hemifacial spasm in 3 patients. All cases with trigeminal pain were receiving medication and still uncontrolled. One patient with hemifacial spasm was medically controlled before gamma knife and the other two were not. Two patients had undergone surgical resection prior to gamma knife treatment. The median prescription dose was 11 Gy (10-11 Gy). The tumor volumes ranged from 3.7 to 23.9 cc (median 10.5 cc). The median radiological follow up was 2 years (1-5 years). All tumors were controlled and one tumor shrank. The median clinical follow-up was 5 years. The trigeminal pain improved or disappeared in 5 patients, and of these, 4 cases stopped their medication and one decreased it. The hemifacial spasm resolved in 2 patients who were able to stop their medication. Facial palsy developed in 1 patient and improved with conservative treatment. Transient diplopia was also reported in 2 cases. Gamma knife radiosurgery provides good clinical control for cerebellopontine angle epidermoid tumors.

  18. Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo : a systematic review and meta-analysis of individual patient data

    van den Berge, Minke J C; van Dijk, J. Marc C.; Posthumus, Iris A; Smidt, Nynke; van Dijk, Pim; Free, Rolien H

    OBJECTIVE Microvascular decompression (MVD) is regarded as a valid treatment modality in neurovascular conflicts (NVCs) causing, for example, trigeminal neuralgia and hemifacial spasms. An NVC of the cochleovestibular nerve might cause tinnitus and/or vertigo; however, general acceptance of MVD for

  19. Prepontine Schwannoma Presenting With Atypical Facial Symptoms - A Case Report

    Rishi Kumar Bali

    2005-01-01

    Full Text Available Face is an important landmark and any pathological condition affecting it has tremendous bearing on psychological make up of the patient. This report describes a rare case of a young female who presented with Hemifacial dysaesthesia complicated by ipsilateral masticatory complex dyskinesia.

  20. Theoretical Analyses of the Functional Regions of the Heavy Chain of Botulinum Neurotoxin

    1994-01-01

    SE. Schulz GM. liallctt M. Effects of hb)tulinum toxin injections on speech in adductor spasmodic dysphonia . Neurology 1988,38:1220-1225. 3. Jankovic...hemifacial spasm. Mov Disord 1987:4:237-254. 5. Brin MF. Blitzer A, Fahn S, Gould W. Lovelace RE. Adductor laryngeal dystonia (spastic dysphonia ): treatment

  1. Documentation for the Computer Assisted Diagnostic Program for Dental Pain

    1989-04-10

    FistulCI.IS tract from periapical abscessjpanllis *~thyroidism (brown tumor) *IDeal malignancy *Pericoronitis Epllis granulomatosum Antral polyp...drug-imuced (ex. Dilantin) Amyloidosis Hemifacial hypertrophy C-3 7. Cystic lesions of gingiva Eruption cyst Gingival cyst Parulis...Nasoalveolar cyst Nasopalatine duct cyst 8. Keratotic non-sloughing, non-ulcerated, non-eroded, non-papillazy, lesions Linea alba HYPerkeratosis

  2. Coherent edge fluctuation measurements in H-mode discharges on JFT-2M

    Nagashima, Y; Shinohara, K; Hoshino, K; Ejiri, A; Tsuzuki, K; Ido, T; Uehara, K; Kawashima, H; Kamiya, K; Ogawa, H; Yamada, T; Shiraiwa, S; Ohara, S; Takase, Y; Asakura, N; Oyama, N; Fujita, T; Ide, S; Takenaga, H; Kusama, Y; Miura, Y

    2004-01-01

    Results of coherent edge fluctuation measurements using three diagnostics (a reciprocating Langmuir probe, a two channel O-mode reflectometer, and fast magnetic probes) in H-mode discharges on JFT-2M are presented. In discharges in which a high recycling steady (HRS) H-mode phase is obtained through a transient phase with slightly enhanced D α intensity, two types of coherent fluctuations are observed. The higher frequency mode (around 300 kHz) is the high frequency mode (HFM) observed in the HRS H-mode (Kamiya K et al 2003 9th IAEA Tech. Meeting H-mode Workshop Topic B-14). The lower frequency mode has a frequency of around 80 kHz. The HFM is detected by a Langmuir probe over a wide region in the SOL, as well as by the reflectometer and magnetic probes. However, the HFM is not detected by the higher frequency (38 GHz) channel of the reflectometer after the HRS transition, suggesting that the HFM is not located deeply inside the plasma. The 80 kHz mode is detected by both channels of the reflectometer and by a Langmuir probe, but not by magnetic probes, suggesting that it is an electrostatic mode. In contrast to the HFM, the 80 kHz mode is detected by the Langmuir probe only near the separatrix during the transient phase, which leads to either the HRS phase or the ELMy phase, and is similar to the fluctuations reported in Shinohara K et al (1998 J. Plasma Fusion Res. 74 607)

  3. Effectiveness of an interactive platform, and the ESC/HFA heartfailurematters.org website in patients with heart failure: design of the multicentre randomized e-Vita heart failure trial.

    Wagenaar, Kim P; Broekhuizen, Berna D L; Dickstein, Kenneth; Jaarsma, Tiny; Hoes, Arno W; Rutten, Frans H

    2015-12-01

    Electronic health support (e-health) may improve self-care of patients with heart failure (HF). We aim to assess whether an adjusted care pathway with replacement of routine consultations by e-health improves self-care as compared with usual care. In addition, we will determine whether the ESC/HFA (European Society of Cardiology/Heart Failure Association) website heartfailurematters.org (HFM website) improves self-care when added to usual care. Finally, we aim to evaluate the cost-effectiveness of these interventions. A three-arm parallel randomized trial will be conducted. Arm 1 consists of usual care; arm 2 consists of usual care plus the HFM website; and arm 3 is the adjusted care pathway with an interactive platform for disease management (e-Vita platform), with a link to the HFM website, which replaces routine consultations with HF nurses at the outpatient clinic. In total, 414 patients managed in 10 Dutch HF outpatient clinics or in general practice will be included and followed for 12 months. Participants are included if they have had an established diagnosis of HF for at least 3 months. The primary outcome is self-care as measured by the European Heart Failure Self-care Behaviour scale (EHFScB scale). Secondary outcomes are quality of life, cardiovascular- and HF-related mortality, hospitalization, and its duration as captured by hospital and general practitioner registries, use of and user satisfaction with the HFM website, and cost-effectiveness. This study will provide important prospective data on the impact and cost-effectiveness of an interactive platform for disease management and the HFM website. unique identifier: NCT01755988. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

  4. Hydrogeologic Framework Model for the Saturated Zone Site Scale flow and Transport Model

    T. Miller

    2004-11-15

    The purpose of this report is to document the 19-unit, hydrogeologic framework model (19-layer version, output of this report) (HFM-19) with regard to input data, modeling methods, assumptions, uncertainties, limitations, and validation of the model results in accordance with AP-SIII.10Q, Models. The HFM-19 is developed as a conceptual model of the geometric extent of the hydrogeologic units at Yucca Mountain and is intended specifically for use in the development of the ''Saturated Zone Site-Scale Flow Model'' (BSC 2004 [DIRS 170037]). Primary inputs to this model report include the GFM 3.1 (DTN: MO9901MWDGFM31.000 [DIRS 103769]), borehole lithologic logs, geologic maps, geologic cross sections, water level data, topographic information, and geophysical data as discussed in Section 4.1. Figure 1-1 shows the information flow among all of the saturated zone (SZ) reports and the relationship of this conceptual model in that flow. The HFM-19 is a three-dimensional (3-D) representation of the hydrogeologic units surrounding the location of the Yucca Mountain geologic repository for spent nuclear fuel and high-level radioactive waste. The HFM-19 represents the hydrogeologic setting for the Yucca Mountain area that covers about 1,350 km2 and includes a saturated thickness of about 2.75 km. The boundaries of the conceptual model were primarily chosen to be coincident with grid cells in the Death Valley regional groundwater flow model (DTN: GS960808312144.003 [DIRS 105121]) such that the base of the site-scale SZ flow model is consistent with the base of the regional model (2,750 meters below a smoothed version of the potentiometric surface), encompasses the exploratory boreholes, and provides a framework over the area of interest for groundwater flow and radionuclide transport modeling. In depth, the model domain extends from land surface to the base of the regional groundwater flow model (D'Agnese et al. 1997 [DIRS 100131], p 2). For the site

  5. Hydrogeologic Framework Model for the Saturated Zone Site Scale flow and Transport Model

    Miller, T.

    2004-01-01

    The purpose of this report is to document the 19-unit, hydrogeologic framework model (19-layer version, output of this report) (HFM-19) with regard to input data, modeling methods, assumptions, uncertainties, limitations, and validation of the model results in accordance with AP-SIII.10Q, Models. The HFM-19 is developed as a conceptual model of the geometric extent of the hydrogeologic units at Yucca Mountain and is intended specifically for use in the development of the ''Saturated Zone Site-Scale Flow Model'' (BSC 2004 [DIRS 170037]). Primary inputs to this model report include the GFM 3.1 (DTN: MO9901MWDGFM31.000 [DIRS 103769]), borehole lithologic logs, geologic maps, geologic cross sections, water level data, topographic information, and geophysical data as discussed in Section 4.1. Figure 1-1 shows the information flow among all of the saturated zone (SZ) reports and the relationship of this conceptual model in that flow. The HFM-19 is a three-dimensional (3-D) representation of the hydrogeologic units surrounding the location of the Yucca Mountain geologic repository for spent nuclear fuel and high-level radioactive waste. The HFM-19 represents the hydrogeologic setting for the Yucca Mountain area that covers about 1,350 km2 and includes a saturated thickness of about 2.75 km. The boundaries of the conceptual model were primarily chosen to be coincident with grid cells in the Death Valley regional groundwater flow model (DTN: GS960808312144.003 [DIRS 105121]) such that the base of the site-scale SZ flow model is consistent with the base of the regional model (2,750 meters below a smoothed version of the potentiometric surface), encompasses the exploratory boreholes, and provides a framework over the area of interest for groundwater flow and radionuclide transport modeling. In depth, the model domain extends from land surface to the base of the regional groundwater flow model (D'Agnese et al. 1997 [DIRS 100131], p 2). For the site-scale SZ flow model, the HFM

  6. Hydrogeologic Framework Model for the Saturated-Zone Site-Scale Flow

    Z. Peterman

    2003-03-05

    Yucca Mountain is being evaluated as a potential site for development of a geologic repository for the permanent disposal of spent nuclear fuel and high-level radioactive waste. Ground water is considered to be the principal means for transporting radionuclides that may be released from the potential repository to the accessible environment, thereby possibly affecting public health and safety. The ground-water hydrology of the region is a result of both the arid climatic conditions and the complex geology. Ground-water flow in the Yucca Mountain region generally can be described as consisting of two main components: a series of relatively shallow and localized flow paths that are superimposed on deeper regional flow paths. A significant component of the regional ground-water flow is through a thick, generally deep-lying, Paleozoic carbonate rock sequence. Locally within the potential repository area, the flow is through a vertical sequence of welded and nonwelded tuffs that overlie the carbonate aquifer. Downgradient from the site, these tuffs terminate in basin fill deposits that are dominated by alluvium. Throughout the system, extensive and prevalent faults and fractures may control ground-water flow. The purpose of this Analysis/Modeling Report (AMR) is to document the three-dimensional (3D) hydrogeologic framework model (HFM) that has been constructed specifically to support development of a site-scale ground-water flow and transport model. Because the HFM provides the fundamental geometric framework for constructing the site-scale 3D ground-water flow model that will be used to evaluate potential radionuclide transport through the saturated zone (SZ) from beneath the potential repository to down-gradient compliance points, the HFM is important for assessing potential repository system performance. This AMR documents the progress of the understanding of the site-scale SZ ground-water flow system framework at Yucca Mountain based on data through July 1999. The

  7. Growth and development of skeletal anomalies in diploid and triploid Atlantic salmon (Salmo salar) fed phosphorus-rich diets with fish meal and hydrolyzed fish protein

    Puvanendran, Velmurugu; Riesen, Guido; Seim, Rudi Ripman; Hagen, Ørjan; Martínez-Llorens, Silvia; Falk-Petersen, Inger-Britt; Fernandes, Jorge M. O.; Jobling, Malcolm

    2018-01-01

    Diploid and triploid Atlantic salmon, Salmo salar were fed high-protein, phosphorus-rich diets (56–60% protein; ca 18g phosphorus kg-1 diet) whilst being reared at low temperature from start-feeding until parr-smolt transformation. Performances of salmon fed diets based on fish meal (STD) or a mix of fishmeal and hydrolysed fish proteins (HFM) as the major protein sources were compared in terms of mortality, diet digestibility, growth and skeletal deformities. Separate groups of diploids and triploids were reared in triplicate tanks (initially 3000 fish per tank; tank biomass ca. 620 g) from 0–2745 degree-days post-start feeding (ddPSF). Growth metrics (weight, length, condition factor) were recorded at ca. 4 week intervals, external signs of deformities to the operculum, jaws and spinal column were examined in parr sampled at 1390 ddPSF, and external signs of deformity and vertebral anomalies (by radiography) were examined in fish sampled at the end of the trial (2745 ddPSF). The triploid salmon generally had a lower mass per unit length, i.e. lower condition factor, throughout the trial, but this did not seem to reflect any consistent dietary or ploidy effects on either dietary digestibility or the growth of the fish. By the end of the trial fish in all treatment groups had achieved a weight of 50+ g, and had completed the parr-smolt transformation. The triploids had slightly, but significantly, fewer vertebrae (Triploids STD 58.74 ± 0.10; HFM 58.68 ± 0.05) than the diploids (Diploids STD 58.97 ± 0.14; HFM 58.89 ± 0.01), and the incidence of skeletal (vertebral) abnormalities was higher in triploids (Triploids STD 31 ± 0.90%; HFM 15 ± 1.44%) than in diploids (Diploids STD 4 ± 0.80%; HFM 4 ± 0.83%). The HFM diet gave a significant reduction in the numbers of triploid salmon with vertebral anomalies in comparison with the triploids fed the STD diet possibly as a result of differences in phosphorus bioavailability between the two diets. Overall, the

  8. Impact of MAC Delay on AUV Localization: Underwater Localization Based on Hyperbolic Frequency Modulation Signal.

    Kim, Sungryul; Yoo, Younghwan

    2018-01-26

    Medium Access Control (MAC) delay which occurs between the anchor node's transmissions is one of the error sources in underwater localization. In particular, in AUV localization, the MAC delay significantly degrades the ranging accuracy. The Cramer-Rao Low Bound (CRLB) definition theoretically proves that the MAC delay significantly degrades the localization performance. This paper proposes underwater localization combined with multiple access technology to decouple the localization performance from the MAC delay. Towards this goal, we adopt hyperbolic frequency modulation (HFM) signal that provides multiplexing based on its good property, high-temporal correlation. Owing to the multiplexing ability of the HFM signal, the anchor nodes can transmit packets without MAC delay, i.e., simultaneous transmission is possible. In addition, the simulation results show that the simultaneous transmission is not an optional communication scheme, but essential for the localization of mobile object in underwater.

  9. Acute toxicity of the hydrolysis products of uranium hexafluoride (UF6) when inhaled by the rat and guinea pig. Final report

    Leach, L.J.; Gelein, R.M.; Panner, B.J.; Yulie, C.L.; Cox, C.C.; Balys, M.M.; Rolchigo, P.M.

    1984-04-01

    This report presents the experimental animal data base from which human health consequences may be predicted from exposures mimicing accidental discharges of uranium hexafluoride (UF 6 ) in the uranium industry. Rats or guinea pigs were exposed for two, five, or ten minutes duration to air having 0.44 g U/m 3 + 0.16 g HF/m 3 to 276.67 g U/m 3 + 94.07 g HF/m 3 . Survivors of each exposure were observed for 14 days for signs of U or HF intoxication. Selected animals were necropsied and samples of major organs were studied histopathologically. When enriched UF 6 (94 percent 235 U) was used, the urine and feces from each animal were measured daily for U content. Selected samples of urine were bioassayed in order to trace the course of renal injury during the two week postexposure period. 28 references, 51 figures, 23 tables

  10. Ultra Wideband Wireless Body Area Network for Medical Applications

    2010-04-01

    Medical Applications RTO-MP-HFM-182 42 - 11 z x y Tumour Fat Skin Chest Figure 8: A Simple Hemispherical Brest Model. Table 2...x y Tumour Fat Skin Chest wall  Glands Nipple Figure 9: A Comprehensive Hemispherical Brest Model. The base diameter of the breast is...34 in Proc. 2nd European Radar Conference (EuRAD), Paris , France, October 6–7, 2005, pp. 97–100. [38] M. Sugawara, K. Niki, H. Furuhata, S. Ohnishi

  11. Evolution of Subjective Hurricane Risk Perceptions: A Bayesian Approach

    David Kelly; David Letson; Forest Nelson; David S. Nolan; Daniel Solis

    2009-01-01

    This paper studies how individuals update subjective risk perceptions in response to hurricane track forecast information, using a unique data set from an event market, the Hurricane Futures Market (HFM). We derive a theoretical Bayesian framework which predicts how traders update their perceptions of the probability of a hurricane making landfall in a certain range of coastline. Our results suggest that traders behave in a way consistent with Bayesian updating but this behavior is based on t...

  12. Comparison of an Intermittent Hypoxic Exposure Acclimatization Program to Staging at Moderate Altitude on Endurance Performance at 4300 m

    2009-10-01

    Endurance Performance at 4300 m 7 - 6 RTO-MP-HFM-181 breakfast volunteers were provided with two commercially available energy bars and fruit juice ...food composition = 510 kcal, 14 gm fat, 65 gm carbohydrate, 32 gm protein) at 1 to 2 hrs prior to the beginning of each of the cycle endurance test...JE, Robinson SR, Skrinar GS, Lewis SF and Sawka MN. Intermittent altitude exposures improve muscular performance at 4,300 m. J Appl Physiol 95

  13. Neuropsychometric Test in Royal Netherlands Navy Mine-Clearance Divers

    2001-06-01

    Issues in Hypo-and Hyperbaric Conditions [les Questions medicales a caractere oprationel liees aux conditions hypobares ou hyperbares ] To order the...Digit Memo Sjan Test (F/B DMST-F/B Learnin /memoie Paper presented at the RTO HFM Symposium on "Operational Medical Issues in Hypo- and Hyperbaric ... Hyperbaric Medicine Annual Meeting 1995, Florida, USA. Abstract 46: 35. 6. Baker EL, R Letz, A Fidler. A computer-administered Neurobehavioural Evaluation

  14. Pharmacological Correction of the Human Functional State in High Altitude Conditions

    2001-06-01

    Operational Medical Issues in Hypo-and Hyperbaric Conditions [les Questions medicales a caractere oprationel liees aux conditions hypobares ou hyperbares ...Cholesterol, Adaptation Paper presented at the RTO HFM Symposium on "Operational Medical Issues in Hypo- and Hyperbaric Conditions", held in Toronto...T.D., 1986, Recovery after Extreme Hypobaric Hypoxia as a Method of Study of Antihypoxic Activity of Chemical Compounds. In: Farmakologicheskaya

  15. Designing Efficient and Effective, Operationally Relevant, High Altitude Training Profiles

    2001-06-01

    Operational Medical Issues in Hypo-and Hyperbaric Conditions [les Questions medicales a caractere oprationel liees aux conditions hypobares ou... hyperbares ] To order the complete compilation report, use: ADA395680 The component part is provided here to allow users access to individually authored...Airforce was felt to meet this need and was recommended. Paper presented at the RTO HFM Symposium on "Operational Medical Issues in Hypo- and Hyperbaric

  16. Impact of Positive Emotions Enhancement on Physiological Processes and Psychological Functioning in Military Pilots

    2009-10-01

    behavioral therapy for bulimia nervosa: time course and mechanisms of change. Journal of Clinical consulting Psychology 2002, 20, 267-274. [44...RTO-MP-HFM-181 14 - 1 Impact of Positive Emotions Enhancement on Physiological Processes and Psychological Functioning in Military Pilots...practical tool using different techniques in order to improve regulation of emotions before, during and after actions [3]. This psychological training is

  17. Advanced Authoring Technologies, Capabilities and Opportunities (Technologies avancees d’authoring, possibilites et opportunites)

    2011-02-01

    Standardization initiatives (e.g., Reusable eLearning Object Authoring And Delivery (RELOAD)). CURRENT STATUS OF AUTHORING 5 - 2 RTO-TR-HFM-129...produced from existing content in a matter of hours and made available globally on the web or whatever the global information infrastructure becomes in the...computer, but we seem to be heading toward a future in which domain knowledge will be pulled out of the global information infrastructure – on demand and

  18. Morale as a Protection Factor against Mission Related Stress

    2006-04-01

    Inventory [34]. Morale as a Protection Factor against Mission Related Stress RTO-MP HFM-134 10 - 7 - Inventario de Valoración y Afrontamiento...17-37. [27] Miguel-Tobal, J. J. and Cano Vindel, A. (1986). Inventario de Situaciones y Respuestas de Ansiedad. Madrid: Tea Ediciones. (2ª Edic...Psychology, 56, 2, 267-283. [35] Cano Vindel, A. and Miguel-Tobal, J. J. (1992). Inventario de Valoración y Afrontamiento (IVA). Mimeo: Universidad

  19. The Belgian End of Mission Transition Period: Lessons Learned from Third Location Decompression after Operational Deployment

    2011-04-01

    Third Location Decompression after Operational Deployment 11 - 2 RTO-MP-HFM-205 programs is based upon the literature on combat motivation ...exposure to normal leisure activities and tourism . Massage is another interesting element in the French program. Each soldier receives at least one... gastronomy ; during the French TLD, soldiers were allowed to drink wine or beer with their meal starting at 7pm and bars closed at 1am ultimately. Alcohol

  20. Managing Fatigue in Long Duration Airlift Operations 1994

    2001-03-01

    Air Force Research Laboratory Brooks Air Force Base, Texas, USA Abstract During September, 1994 the operational tempo for US Air Force C-5 transport...Nandina Terrace, Winter Springs, Fl 32708, USA Paper presented at the RTO HFM Workshop on "The Effect of Prolonged Military Activities in Man...drink. They were drinking lots of coffee and beer and most were eating a gastronomically difficult creation called a jumbo burger. We were given 24 hours

  1. 'heartfailurematters.org', an educational website for patients and carers from the Heart Failure Association of the European Society of Cardiology: objectives, use and future directions.

    Wagenaar, Kim P; Rutten, Frans H; Klompstra, Leonie; Bhana, Yusuf; Sieverink, Floor; Ruschitzka, Frank; Seferovic, Petar M; Lainscak, Mitja; Piepoli, Massimo F; Broekhuizen, Berna D L; Strömberg, Anna; Jaarsma, Tiny; Hoes, Arno W; Dickstein, Kenneth

    2017-11-01

    In 2007, the Heart Failure Association of the European Society of Cardiology (ESC) launched the information website heartfailurematters.org (HFM site) with the aim of creating a practical tool through which to provide advice and guidelines for living with heart failure to patients, their carers, health care professionals and the general public worldwide. The website is managed by the ESC at the European Heart House and is currently available in nine languages. The aim of this study is to describe the background, objectives, use, lessons learned and future directions of the HFM site. Data on the number of visitor sessions on the site as measured by Google Analytics were used to explore use of the HFM site from 2010 to 2015. Worldwide, the annual number of sessions increased from 416 345 in 2010 to 1 636 368 in 2015. Most users (72-75%) found the site by using a search engine. Desktops and, more recently, smartphones were used to visit the website, accounting for 50% and 38%, respectively, of visits to the site in 2015. Although its use has increased, the HFM site has not yet reached its full potential: fewer than 2 million users have visited the website, whereas the number of people living with heart failure worldwide is estimated to be 23 million. Uptake and use could be further improved by a continuous process of qualitative assessment of users' preferences, and the provision of professional helpdesk facilities, comprehensive information technology, and promotional support. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  2. Social Radar

    2012-01-01

    RTA HFM-201/RSM PAPER 3 - 1 © 2012 The MITRE Corporation. All Rights Reserved. Social Radar Barry Costa and John Boiney MITRE Corporation...defenders require an integrated set of capabilities that we refer to as a “ social radar.” Such a system would support strategic- to operational-level...situation awareness, alerting, course of action analysis, and measures of effectiveness for each action undertaken. Success of a social radar

  3. Helicopter Aircrew Training Using Fused Reality

    2006-06-01

    PROCESS Blue screening involving human filming usually employs a blue or green backdrop, since skin contains little blue or green hue. These backdrops...Helicopter Aircrew Training Using Fused Reality 27 - 10 RTO-MP-HFM-136 a. b. c. d. e. f. Figure 13: Frames Showing Physical Object ( witch ... filming . However, when a user’s hands disrupt the light from a helmet-mounted light source, the shadows cast onto the distant background are diffuse and

  4. Health-Related Fitness in the Royal Netherlands Army

    2009-10-01

    breakfast 5% skipped breakfast 1 Dutch nutritional standards: 2 pieces of fruit plus 200 grams of vegetables a day The frequency of junk food (fried...RTO-MP-HFM-181 60%) did not meet Dutch standards for physical fitness and healthy food , almost half of this group (45%) did not meet the Dutch...be examined, such as alcohol consumption , physical activity, information on smoking prevalence, back problem prevalence, height, weight, body fat

  5. EUCARD magnet development

    de Rijk, Gijs

    2011-01-01

    The FP7-EuCARD work package 7 (WP7), "HFM: Superconducting High Field Magnets for higher luminosities and energies" is a collaboration between 12 European institutes and firms with the objective of developing high field magnet technology. WP7 foresees to construct a 13 T dipole with a 100 mm aperture, a B = 6 T high temperature superconductor (HTS) dipole insert, a superconducting HTS link and a superconducting helical undulator.

  6. Management of Heat and Cold Stress -- Guidance to NATO Medical Personnel (Gestion des contraintes thermiques (chaleur et froid) Conseils aux personnels medicaux de I’OTAN)

    2013-12-01

    and Decontamination 3-15 3.12 Food and Fluid Requirements 3-15 RTO-TR-HFM-187 iii Appendix A – Heat Stress Management Material for Information...Heat Stress CO Carbon monoxide MTF Medical Treatment Facility POLs Petroleum, Oil and Lubricants UCHS Uncompensable Heat Stress UV...or surfaces above 46°C (114°F) can produce pain and slightly higher temperatures can produce burns . 4) Evaporative heat loss becomes more important

  7. A Conceptual Model of Military Recruitment

    2009-10-01

    Hiring Expectancies – Expectancy (VIE) Theory ( Vroom , 1996) states individuals choose among a set of employment alternatives on the basis of the...A Conceptual Model of Military Recruitment Presented at NATO Technical Course HFM 180 – Strategies to Address Recruiting and Retention Issues in...the Military Fariya Syed October, 2009 Based on A Proposed Model Of Military Recruitment (Schreurs & Syed, 2007) Report Documentation Page

  8. Crispin: capital requirements and reinsurance protect against insolvency.

    Crispin, C

    2001-12-01

    Charles Crispin is president of Evergreen Re, a managed care consulting firm with expertise in the reinsurance industry. Before Joining Evergreen Re, Crispin served as a consultant to the managed care industry. He is a member of the American Association of Integrated Delivery Systems, Glen Allen, Virginia, and the Provider Excess Loss Association, Princeton, New Jersey. Crispin recently talked with HFM about risk-based capital requirements for health plans and the Impact these solvency guidelines could have on healthcare providers.

  9. Acidic sweep gas with carbonic anhydrase coated hollow fiber membranes synergistically accelerates CO2 removal from blood

    Arazawa, D. T.; Kimmel, J. D.; Finn, M.C.; Federspiel, W. J.

    2015-01-01

    The use of extracorporeal carbon dioxide removal (ECCO2R) is well established as a therapy for patients suffering from acute respiratory failure. Development of next generation low blood flow (< 500 mL/min) ECCO2R devices necessitates more efficient gas exchange devices. Since over 90% of blood CO2 is transported as bicarbonate (HCO3−), we previously reported development of a carbonic anhydrase (CA) immobilized bioactive hollow fiber membrane (HFM) which significantly accelerates CO2 removal ...

  10. CLINICAL AND RADIOGRAPHIC FEATURES OF PARRY-ROMBERG SYNDROME

    Mithula NAIR

    2017-10-01

    Full Text Available Parry-Romberg syndrome or progressive hemifacial atrophy is a craniofacial disorder characterized by slow and progressive atrophy, generally unilateral, of facial tissues including muscles, bones and skin. The coup de sabre is a clear line of demarcation seen between the normal and abnormal structures. The severity of the facial deformity is dependent on the age of onset of the disease. Cosmetic management is the only available treatment and has to be delayed until facial growth is completed. The present case report deals with a 43-year-old woman with progressive hemifacial atrophy which started from the age of 10 months. Despite almost complete involvement of the right paramedian area and the early age of onset, she had neither eye changes nor any dental malformations.

  11. Facial hemiatrophy: Review of literature and a case report

    Manisha S Tijare

    2011-01-01

    Full Text Available A case report of hemifacial atrophy is presented in this paper. It is also known as Parry-Romberg syndrome, is an uncommon degenerative and poorly understood condition. It is characterized by progressive atrophy of the skin, subcutaneous tissue, muscle, cartilage or bone; the condition can leave a marked deformity on one side of the face. The incidence and the cause of this alteration is debatable. The most common complications that appear in association to this health disorder are: trigeminal neuritis, facial paresthesia, severe headache and epilepsy. Now, plastic surgery with graft of autogenous fat can be performed, after stabilization of the disease, to correct the deformity. Orthodontic treatment can help in the correction of any associated malformation. This presentation gives a review of concern literature about the etiology, physiopathology, differential diagnosis and treatment of hemifacial atrophy.

  12. Sound-induced facial synkinesis following facial nerve paralysis.

    Ma, Ming-San; van der Hoeven, Johannes H; Nicolai, Jean-Philippe A; Meek, Marcel F

    2009-08-01

    Facial synkinesis (or synkinesia) (FS) occurs frequently after paresis or paralysis of the facial nerve and is in most cases due to aberrant regeneration of (branches of) the facial nerve. Patients suffer from inappropriate and involuntary synchronous facial muscle contractions. Here we describe two cases of sound-induced facial synkinesis (SFS) after facial nerve injury. As far as we know, this phenomenon has not been described in the English literature before. Patient A presented with right hemifacial palsy after lesion of the facial nerve due to skull base fracture. He reported involuntary muscle activity at the right corner of the mouth, specifically on hearing ringing keys. Patient B suffered from left hemifacial palsy following otitis media and developed involuntary muscle contraction in the facial musculature specifically on hearing clapping hands or a trumpet sound. Both patients were evaluated by means of video, audio and EMG analysis. Possible mechanisms in the pathophysiology of SFS are postulated and therapeutic options are discussed.

  13. R&D of Nb$_{3}$Sn accelerator magnets at Fermilab

    Zlobin, A V; Andreev, N; Barzi, E; Bordini, B; Bossert, R; Carcagno, R; Chichili, D R; Di Marco, J; Elementi, L; Fehér, S; Kashikhin, V S; Kashikhin, V V; Kephart, R; Lamm, M J; Limon, P J; Novitski, I; Orris, D; Pischalnikov, Y; Schlabach, P; Stanek, R; Strait, J; Sylvester, C D; Tartaglia, M; Tompkins, J C; Turrioni, D; Velev, G; Yamada, R; Yarba, V A; 10.1109/TASC.2005.849507

    2005-01-01

    Fermilab is developing and investigating different high-field magnets (HFM) for present and future accelerators. The HFM R&D program focused on the 10-12 T magnets based on Nb/sub 3/Sn superconductor and explored both basic magnet technologies for brittle superconductors-wind-and-react and react-and-wind. Magnet design studies in support of LHC upgrades and VLHC were conducted. A series of 1-m long cos-theta dipole models based on the wind-and-react technique was fabricated and tested. Three 1-m long flat racetracks and the common coil dipole model, based on a single-layer coil and react-and-wind technique, were also fabricated and tested. Extensive theoretical and experimental studies of electro-magnetic instabilities in Nb/sub 3/Sn strands, cables and magnets were performed and led to a successful 10 T dipole model. This paper presents the details of Fermilab's HFM program, reports its status and major results, and formulates the next steps for the program.

  14. Teflon granulomas mimicking cerebellopontine angle tumors following microvascular decompression.

    Deep, Nicholas L; Graffeo, Christopher S; Copeland, William R; Link, Michael J; Atkinson, John L; Neff, Brian A; Raghunathan, Aditya; Carlson, Matthew L

    2017-03-01

    To report two patients with a history of microvascular decompression (MVD) for hemifacial spasm who presented with Teflon granulomas (TG) mimicking cerebellopontine angle (CPA) tumors and to perform a systematic review of the English-language literature. Case series at a single tertiary academic referral center and systematic review. Retrospective chart review with analysis of clinical, radiological, and histopathological findings. Systematic review using PubMed, Embase, MEDLINE, and Web of Science databases. Two patients with large skull base TGs mimicking CPA tumors clinically and radiographically were managed at the authors' institution. The first presented 4 years after MVD with asymmetrical sensorineural hearing loss, multiple progressive cranial neuropathies, and brainstem edema due to a growing TG. Reoperation with resection of the granuloma confirmed a foreign-body reaction consisting of multinucleated giant cells containing intracytoplasmic Teflon particles. The second patient presented 11 years after MVD with asymmetrical sensorineural hearing loss and recurrent hemifacial spasm. No growth was noted over 2 years, and the patient has been managed expectantly. Only one prior case of TG after MVD for hemifacial spasm has been reported in the English literature. TG is a rare complication of MVD for hemifacial spasm. The diagnosis should be suspected in patients presenting with a new-onset enhancing mass of the CPA after MVD, even when performed decades earlier. A thorough clinical and surgical history is critical toward establishing an accurate diagnosis to guide management and prevent unnecessary morbidity. Surgical intervention is not required unless progressive neurologic complications ensue. 4 Laryngoscope, 127:715-719, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Botulinum toxin for treatment of Frey's syndrome: report of two cases

    Teive Hélio A.G.

    2003-01-01

    Full Text Available Frey's syndrome is a phenomenon of hemifacial flushing and sweating after gustatory stimulus, usually secondary to surgical trauma over the parotid gland, although other injury mechanisms may be seen. It is accepted as a result of aberrant regeneration of facial autonomic nerve fibers. Treatment evolved from ineffective medical and surgical approaches to botulinum toxin. We evaluate the effectiveness and safety of botulinum toxin in the treatment of this complication in two patients.

  16. The use of three-dimensional imaging to evaluate the effect of conventional orthodontic approach in treating a subject with facial asymmetry

    Kheir, Nadia Abou; Kau, Chung How

    2016-01-01

    The growth of the craniofacial skeleton takes place from the 3rd week of intra-uterine life until 18 years of age. During this period, the craniofacial complex is affected by extrinsic and intrinsic factors which guide or alter the pattern of growth. Asymmetry can be encountered due to these multifactorial effects or as the normal divergence of the hemifacial counterpart occurs. At present, an orthodontist plays a major role not only in diagnosing dental asymmetry but also facial asymmetry. H...

  17. Parry-Romberg syndrome: findings in advanced magnetic resonance imaging sequences - case report

    Paula, Rafael Alfenas de; Ribeiro, Bruno Niemeyer de Freitas, E-mail: alfenas85@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Hospital Universitario Clementino Fraga Filho; Bahia, Paulo Roberto Valle [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Dept. de radiologia; Ribeiro, Renato Niemeyer de Freitas [Hospital de Clinica de Jacarepagua, Rio de Janeiro, RJ (Brazil); Carvalho, Lais Balbi de [Universidade Presidente Antonio Carlos (Unipac), Juiz de Fora, MG (Brazil)

    2014-05-15

    Parry-Romberg syndrome is a rare disease characterized by progressive hemifacial atrophy associated with other systemic changes, including neurological symptoms. Currently, there are few studies exploring the utilization of advanced magnetic resonance sequences in the investigation of this disease. The authors report the case of a 45-year-old patient and describe the findings at structural magnetic resonance imaging and at advanced sequences, correlating them with pathophysiological data. (author)

  18. Acute Cervical Dystonia Induced by Clebopride.

    Choi, Jin Kyo; Hong, Jin Yong

    2017-01-01

    Antidopaminergic drugs are known to induce extrapyramidal symptoms. Clebopride, a dopamine antagonist, also can produce parkinsonism, tardive dyskinesia, tardive dystonia, hemifacial dystonia, or oculogyric crisis; however, acute dystonic reaction caused by clebopride has not been reported in adults. We report two young men who experienced acute cervical dystonia within a few days of taking clebopride. The patients recovered after discontinuation of the drug. Physicians prescribing clebopride should be aware of the adverse effects of this drug.

  19. Acute Cervical Dystonia Induced by Clebopride

    Choi, Jin Kyo; Hong, Jin Yong

    2017-01-01

    Antidopaminergic drugs are known to induce extrapyramidal symptoms. Clebopride, a dopamine antagonist, also can produce parkinsonism, tardive dyskinesia, tardive dystonia, hemifacial dystonia, or oculogyric crisis; however, acute dystonic reaction caused by clebopride has not been reported in adults. We report two young men who experienced acute cervical dystonia within a few days of taking clebopride. The patients recovered after discontinuation of the drug. Physicians prescribing clebopride...

  20. Acute Cervical Dystonia Induced by Clebopride

    Jin Kyo Choi

    2017-01-01

    Full Text Available Antidopaminergic drugs are known to induce extrapyramidal symptoms. Clebopride, a dopamine antagonist, also can produce parkinsonism, tardive dyskinesia, tardive dystonia, hemifacial dystonia, or oculogyric crisis; however, acute dystonic reaction caused by clebopride has not been reported in adults. We report two young men who experienced acute cervical dystonia within a few days of taking clebopride. The patients recovered after discontinuation of the drug. Physicians prescribing clebopride should be aware of the adverse effects of this drug.

  1. A case report of Parry Romberg Syndrome initially presenting as periodontitis

    Taylor, Greig; Culshaw, Shauna; Armas, Jose; Savarrio, Lee; Goodall, Christine

    2017-01-01

    Parry Romberg Syndrome (PRS) is a rare disorder of progressive hemifacial atrophy, involving soft tissues, fat and occasionally bone. It can co-exist with presentations of Morphea. We describe an unusual case of persistent periodontal and alveolar destruction associated with PRS. A 56-year-old African female initially presented with persistent periodontal destruction, which showed minimal response to conventional periodontal treatment. After non-surgical treatment, surgical debridement follow...

  2. Diet-resistant obesity is characterized by a distinct plasma proteomic signature and impaired muscle fiber metabolism

    Thrush, A B; Antoun, G; Nikpay, M; Patten, D A; DeVlugt, C; Mauger, J-F; Beauchamp, B L; Lau, P; Reshke, R; Doucet, É; Imbeault, P; Boushel, R; Gibbings, D; Hager, J; Valsesia, A; Slack, R S; Al-Dirbashi, O Y; Dent, R; McPherson, R; Harper, M-E

    2018-01-01

    Background/Objectives: Inter-individual variability in weight loss during obesity treatment is complex and poorly understood. Here we use whole body and tissue approaches to investigate fuel oxidation characteristics in skeletal muscle fibers, cells and distinct circulating protein biomarkers before and after a high fat meal (HFM) challenge in those who lost the most (obese diet-sensitive; ODS) vs the least (obese diet-resistant; ODR) amount of weight in a highly controlled weight management program. Subjects/Methods: In 20 weight stable-matched ODS and ODR women who previously completed a standardized clinical weight loss program, we analyzed whole-body energetics and metabolic parameters in vastus lateralis biopsies and plasma samples that were obtained in the fasting state and 6 h after a defined HFM, equivalent to 35% of total daily energy requirements. Results: At baseline (fasting) and post-HFM, muscle fatty acid oxidation and maximal oxidative phosphorylation were significantly greater in ODS vs ODR, as was reactive oxygen species emission. Plasma proteomics of 1130 proteins pre and 1, 2, 5 and 6 h after the HFM demonstrated distinct group and interaction differences. Group differences identified S-formyl glutathione hydratase, heat shock 70 kDA protein 1A/B (HSP72), and eukaryotic translation initiation factor 5 (eIF5) to be higher in ODS vs ODR. Group-time differences included aryl hydrocarbon interacting protein (AIP), peptidylpropyl isomerase D (PPID) and tyrosine protein-kinase Fgr, which increased in ODR vs ODS over time. HSP72 levels correlated with muscle oxidation and citrate synthase activity. These proteins circulate in exosomes; exosomes isolated from ODS plasma increased resting, leak and maximal respiration rates in C2C12 myotubes by 58%, 21% and 51%, respectively, vs those isolated from ODR plasma. Conclusions: Findings demonstrate distinct muscle metabolism and plasma proteomics in fasting and post-HFM states corresponding in diet

  3. Acidic sweep gas with carbonic anhydrase coated hollow fiber membranes synergistically accelerates CO2 removal from blood.

    Arazawa, D T; Kimmel, J D; Finn, M C; Federspiel, W J

    2015-10-01

    The use of extracorporeal carbon dioxide removal (ECCO2R) is well established as a therapy for patients suffering from acute respiratory failure. Development of next generation low blood flow (carbonic anhydrase (CA) immobilized bioactive hollow fiber membrane (HFM) which significantly accelerates CO2 removal from blood in model gas exchange devices by converting bicarbonate to CO2 directly at the HFM surface. This present study tested the hypothesis that dilute sulfur dioxide (SO2) in oxygen sweep gas could further increase CO2 removal by creating an acidic microenvironment within the diffusional boundary layer adjacent to the HFM surface, facilitating dehydration of bicarbonate to CO2. CA was covalently immobilized onto poly (methyl pentene) (PMP) HFMs through glutaraldehyde activated chitosan spacers, potted in model gas exchange devices (0.0151 m(2)) and tested for CO2 removal rate with oxygen (O2) sweep gas and a 2.2% SO2 in oxygen sweep gas mixture. Using pure O2 sweep gas, CA-PMP increased CO2 removal by 31% (258 mL/min/m(2)) compared to PMP (197 mL/min/m(2)) (Premoval by 17% (230 mL/min/m(2)) compared to pure oxygen sweep gas control (Premoval increased by 109% (411 mL/min/m(2)) (Premoval, and when used in combination with bioactive CA-HFMs has a synergistic effect to more than double CO2 removal while maintaining physiologic pH. Through these technologies the next generation of intravascular and paracorporeal respiratory assist devices can remove more CO2 with smaller blood contacting surface areas. A clinical need exists for more efficient respiratory assist devices which utilize low blood flow rates (removal efficiency by shifting equilibrium from bicarbonate to gaseous CO2, through either a bioactive carbonic anhydrase enzyme coating or bulk blood acidification with lactic acid. In this study we demonstrate a novel approach to local blood acidification using an acidified sweep gas in combination with a bioactive coating to more than double CO2 removal

  4. Oculoauriculovertebral spectrum with radial anomaly in child.

    Taksande, Amar; Vilhekar, Krishna

    2013-01-01

    Oculoauriculovertebral spectrum (OAVS) or Goldenhar syndrome is a wide spectrum of congenital anomalies that involves structures arising from the first and second branchial arches. It is characterized by a wide spectrum of symptoms and physical features. These abnormalities mainly involve the cheekbones, jaws, mouth, ears, eyes, or vertebrae. Other conditions with ear and/or radial involvement, such as, the Nager syndrome, Holt-Oram syndrome, Radial-renal syndrome, facioauriculoradial dysplasia, Fanconi anemia, and Vertebral, Anal atresia, Cardiac, Trachea, Esophageal, Renal, and Limb (VACTERL) association should be considered for differential diagnosis. Here we report a child who had facial asymmetry, microsomia, microtia, congenital facial nerve palsy, conductive hearing loss, skin tags, iris coloboma, and preaxial polydactyly.

  5. Oculoauriculovertebral spectrum with radial anomaly in child

    Amar Taksande

    2013-01-01

    Full Text Available Oculoauriculovertebral spectrum (OAVS or Goldenhar syndrome is a wide spectrum of congenital anomalies that involves structures arising from the first and second branchial arches. It is characterized by a wide spectrum of symptoms and physical features. These abnormalities mainly involve the cheekbones, jaws, mouth, ears, eyes, or vertebrae. Other conditions with ear and/or radial involvement, such as, the Nager syndrome, Holt-Oram syndrome, Radial-renal syndrome, facioauriculoradial dysplasia, Fanconi anemia, and Vertebral, Anal atresia, Cardiac, Trachea, Esophageal, Renal, and Limb (VACTERL association should be considered for differential diagnosis. Here we report a child who had facial asymmetry, microsomia, microtia, congenital facial nerve palsy, conductive hearing loss, skin tags, iris coloboma, and preaxial polydactyly.

  6. Development and testing of an implementation strategy for a complex housing intervention: protocol for a mixed methods study.

    Watson, Dennis P; Young, Jeani; Ahonen, Emily; Xu, Huiping; Henderson, Macey; Shuman, Valery; Tolliver, Randi

    2014-10-17

    There is currently a lack of scientifically designed and tested implementation strategies. Such strategies are particularly important for highly complex interventions that require coordination between multiple parts to be successful. This paper presents a protocol for the development and testing of an implementation strategy for a complex intervention known as the Housing First model (HFM). Housing First is an evidence-based practice for chronically homeless individuals demonstrated to significantly improve a number of outcomes. Drawing on practices demonstrated to be useful in implementation and e-learning theory, our team is currently adapting a face-to-face implementation strategy so that it can be delivered over a distance. Research activities will be divided between Chicago and Central Indiana, two areas with significantly different barriers to HFM implementation. Ten housing providers (five from Chicago and five from Indiana) will be recruited to conduct an alpha test of each of four e-learning modules as they are developed. Providers will be requested to keep a detailed log of their experience completing the modules and participate in one of two focus groups. After refining the modules based on alpha test results, we will test the strategy among a sample of four housing organizations (two from Chicago and two from Indiana). We will collect and analyze both qualitative and quantitative data from administration and staff. Measures of interest include causal factors affecting implementation, training outcomes, and implementation outcomes. This project is an important first step in the development of an evidence-based implementation strategy to increase scalability and impact of the HFM. The project also has strong potential to increase limited scientific knowledge regarding implementation strategies in general.

  7. Development and evaluation of elastomeric hollow fiber membranes as small diameter vascular graft substitutes

    Mercado-Pagán, Ángel E.; Kang, Yunqing [Department of Orthopedic Surgery, Stanford University, Stanford, CA (United States); Findlay, Michael W. [Department of Plastic and Reconstructive Surgery, Stanford University, Stanford, CA (United States); University of Melbourne Department of Surgery, Royal Melbourne Hospital, Parkville, VIC (Australia); Yang, Yunzhi, E-mail: ypyang@stanford.edu [Department of Orthopedic Surgery, Stanford University, Stanford, CA (United States); Department of Materials Science and Engineering, Stanford University, Stanford, CA (United States)

    2015-04-01

    Engineering of small diameter (< 6 mm) vascular grafts (SDVGs) for clinical use remains a significant challenge. Here, elastomeric polyester urethane (PEU)-based hollow fiber membranes (HFMs) are presented as an SDVG candidate to target the limitations of current technologies and improve tissue engineering designs. HFMs are fabricated by a simple phase inversion method. HFM dimensions are tailored through adjustments to fabrication parameters. The walls of HFMs are highly porous. The HFMs are very elastic, with moduli ranging from 1–4 MPa, strengths from 1–5 MPa, and max strains from 300–500%. Permeability of the HFMs varies from 0.5–3.5 × 10{sup −6} cm/s, while burst pressure varies from 25 to 35 psi. The suture retention forces of HFMs are in the range of 0.8 to 1.2 N. These properties match those of blood vessels. A slow degradation profile is observed for all HFMs, with 71 to 78% of the original mass remaining after 8 weeks, providing a suitable profile for potential cellular incorporation and tissue replacement. Both human endothelial cells and human mesenchymal stem cells proliferate well in the presence of HFMs up to 7 days. These results demonstrate a promising customizable PEU HFMs for small diameter vascular repair and tissue engineering applications. - Highlights: • Hollow fiber membranes (HFMs) were fabricated and evaluated. • HFM properties could be tailored through adjustments to fabrication parameters. • Properties could match or exceed those of blood vessels. • HFM showed excellent compatibility in vitro. • HFMs have the potential to be used for small diameter vascular grafts.

  8. Synthesis and characterization of polycaprolactone urethane hollow fiber membranes as small diameter vascular grafts

    Mercado-Pagán, Ángel E. [Department of Orthopedic Surgery, Stanford University, Stanford, CA (United States); Stahl, Alexander M. [Department of Orthopedic Surgery, Stanford University, Stanford, CA (United States); Department of Chemistry, Stanford University, Stanford, CA (United States); Ramseier, Michelle L. [Department of Orthopedic Surgery, Stanford University, Stanford, CA (United States); Department of Chemical Engineering, Stanford University, Stanford, CA (United States); Behn, Anthony W. [Department of Orthopedic Surgery, Stanford University, Stanford, CA (United States); Yang, Yunzhi, E-mail: ypyang@stanford.edu [Department of Orthopedic Surgery, Stanford University, Stanford, CA (United States); Department of Materials Science and Engineering, Stanford University, Stanford, CA (United States); Department of Bioengineering, Stanford University, Stanford, CA (United States)

    2016-07-01

    The design of bioresorbable synthetic small diameter (< 6 mm) vascular grafts (SDVGs) capable of sustaining long-term patency and endothelialization is a daunting challenge in vascular tissue engineering. Here, we synthesized a family of biocompatible and biodegradable polycaprolactone (PCL) urethane macromers to fabricate hollow fiber membranes (HFMs) as SDVG candidates, and characterized their mechanical properties, degradability, hemocompatibility, and endothelial development. The HFMs had smooth surfaces and porous internal structures. Their tensile stiffness ranged from 0.09 to 0.11 N/mm and their maximum tensile force from 0.86 to 1.03 N, with minimum failure strains of approximately 130%. Permeability varied from 1 to 14 × 10{sup −6} cm/s, burst pressures from 1158 to 1468 mm Hg, and compliance from 0.52 to 1.48%/100 mm Hg. The suture retention forces ranged from 0.55 to 0.81 N. HFMs had slow degradation profiles, with 15 to 30% degradation after 8 weeks. Human endothelial cells proliferated well on the HFMs, creating stable cell layer coverage. Hemocompatibility studies demonstrated low hemolysis (< 2%), platelet activation, and protein adsorption. There were no significant differences in the hemocompatibility of HFMs in the absence and presence of endothelial layers. These encouraging results suggest great promise of our newly developed materials and biodegradable elastomeric HFMs as SDVG candidates. - Highlights: • Polyester urethane hollow fiber membranes (HFMs) were fabricated and evaluated. • HFM properties varied according to composition. • HFM inner and outer surfaces were successfully seeded with cells. • HFMs showed excellent hemocompatibility in vitro. • HFM has the potential to be used for small diameter vascular grafts.

  9. CD36 Modulates Fasting and Preabsorptive Hormone and Bile Acid Levels.

    Shibao, Cyndya A; Celedonio, Jorge E; Tamboli, Robyn; Sidani, Reem; Love-Gregory, Latisha; Pietka, Terri; Xiong, Yanhua; Wei, Yan; Abumrad, Naji N; Abumrad, Nada A; Flynn, Charles Robb

    2018-05-01

    Abnormal fatty acid (FA) metabolism contributes to diabetes and cardiovascular disease. The FA receptor CD36 has been linked to risk of metabolic syndrome. In rodents CD36 regulates various aspects of fat metabolism, but whether it has similar actions in humans is unknown. We examined the impact of a coding single-nucleotide polymorphism in CD36 on postprandial hormone and bile acid (BA) responses. To examine whether the minor allele (G) of coding CD36 variant rs3211938 (G/T), which reduces CD36 level by ∼50%, influences hormonal responses to a high-fat meal (HFM). Obese African American (AA) women carriers of the G allele of rs3211938 (G/T) and weight-matched noncarriers (T/T) were studied before and after a HFM. Two-center study. Obese AA women. HFM. Early preabsorptive responses (10 minutes) and extended excursions in plasma hormones [C-peptide, insulin, incretins, ghrelin fibroblast growth factor (FGF)19, FGF21], BAs, and serum lipoproteins (chylomicrons, very-low-density lipoprotein) were determined. At fasting, G-allele carriers had significantly reduced cholesterol and glycodeoxycholic acid and consistent but nonsignificant reductions of serum lipoproteins. Levels of GLP-1 and pancreatic polypeptide (PP) were reduced 60% to 70% and those of total BAs were 1.8-fold higher. After the meal, G-allele carriers displayed attenuated early (-10 to 10 minute) responses in insulin, C-peptide, GLP-1, gastric inhibitory peptide, and PP. BAs exhibited divergent trends in G allele carriers vs noncarriers concomitant with differential FGF19 responses. CD36 plays an important role in the preabsorptive hormone and BA responses that coordinate brain and gut regulation of energy metabolism.

  10. Development and evaluation of elastomeric hollow fiber membranes as small diameter vascular graft substitutes

    Mercado-Pagán, Ángel E.; Kang, Yunqing; Findlay, Michael W.; Yang, Yunzhi

    2015-01-01

    Engineering of small diameter (< 6 mm) vascular grafts (SDVGs) for clinical use remains a significant challenge. Here, elastomeric polyester urethane (PEU)-based hollow fiber membranes (HFMs) are presented as an SDVG candidate to target the limitations of current technologies and improve tissue engineering designs. HFMs are fabricated by a simple phase inversion method. HFM dimensions are tailored through adjustments to fabrication parameters. The walls of HFMs are highly porous. The HFMs are very elastic, with moduli ranging from 1–4 MPa, strengths from 1–5 MPa, and max strains from 300–500%. Permeability of the HFMs varies from 0.5–3.5 × 10 −6 cm/s, while burst pressure varies from 25 to 35 psi. The suture retention forces of HFMs are in the range of 0.8 to 1.2 N. These properties match those of blood vessels. A slow degradation profile is observed for all HFMs, with 71 to 78% of the original mass remaining after 8 weeks, providing a suitable profile for potential cellular incorporation and tissue replacement. Both human endothelial cells and human mesenchymal stem cells proliferate well in the presence of HFMs up to 7 days. These results demonstrate a promising customizable PEU HFMs for small diameter vascular repair and tissue engineering applications. - Highlights: • Hollow fiber membranes (HFMs) were fabricated and evaluated. • HFM properties could be tailored through adjustments to fabrication parameters. • Properties could match or exceed those of blood vessels. • HFM showed excellent compatibility in vitro. • HFMs have the potential to be used for small diameter vascular grafts

  11. Development of a robotic evaluation system for the ability of proprioceptive sensation in slow hand motion.

    Tanaka, Yoshiyuki; Mizoe, Genki; Kawaguchi, Tomohiro

    2015-01-01

    This paper proposes a simple diagnostic methodology for checking the ability of proprioceptive/kinesthetic sensation by using a robotic device. The perception ability of virtual frictional forces is examined in operations of the robotic device by the hand at a uniform slow velocity along the virtual straight/circular path. Experimental results by healthy subjects demonstrate that percentage of correct answers for the designed perceptual tests changes in the motion direction as well as the arm configuration and the HFM (human force manipulability) measure. It can be supposed that the proposed methodology can be applied into the early detection of neuromuscular/neurological disorders.

  12. Deployable Laboratory Applications of Nano- and Bio-Technology (Applications de nanotechnologie et biotechnologie destinees a un laboratoire deployable)

    2014-10-01

    specialists in hygiene, microbiology , epidemiology or veterinary epidemiology; 3 laboratory technicians and 4 engineers. Designation of special...Transportable Microbiology Laboratory 3-1 3.1 Challenges and Issues 3-1 3.2 Objectives 3-1 3.3 Responses 3-1 3.3.1 Constitution 3-1 3.3.2 Deployment 3-3 3.4...Bundeswehr Institute of Microbiology Neuherbergstrasse 11 80937 Munich GERMANY Email: Romanwoelfel@bundeswehr.org viii STO-TR-HFM-177

  13. Test Methodology for Protection of Vehicle Occupants against Anti-Vehicular Landmine Effects (Methodologie d’essais pour la protection des occupants de vehicules contre les effets des mines terrestres anti-vehicules)

    2007-04-01

    xvii Acknowledgements xviii Executive Summary and Synthèse ES-1 Chapter 1 – Introduction 1-1 1.1 Background and Problem Definition 1-1 1.1.1...for Protection of Vehicle Occupants against Anti-Vehicular Landmine Effects (RTO-TR-HFM-090) Executive Summary In the last decade, national and...occupants. Suite à la détonation, apparaissent des effets de choc , de déformation structurelle et de mouvement global qui peuvent causer des

  14. Inhibition of Platelet Aggregation by Supernates from Stored Red Blood Cells

    2010-04-01

    450 μl of blood or 450 μl of platelet rich plasma (PRP) was mixed with 225 μl of supernate plus 225 μl of Tyrode’s buffer and incubated for ten... platelet counts, prothrombin time, activated partial thromboplastin time, fibrinogen, fibrin split products, and FVIII:Rag also measured 30 minutes...RTO-MP-HFM-182 22 - 1 Inhibition of Platelet Aggregation by Supernates from Stored Red Blood Cells Dr. Steve J. McFaul, LT Frederick A

  15. Exercise and postprandial lipemia: effects on vascular health in inactive adults.

    Ramírez-Vélez, Robinson; Correa-Rodríguez, María; Tordecilla-Sanders, Alejandra; Aya-Aldana, Viviana; Izquierdo, Mikel; Correa-Bautista, Jorge Enrique; Álvarez, Cristian; Garcia-Hermoso, Antonio

    2018-04-03

    There is evidence to suggest that postprandial lipemia are is linked to the impairment of endothelial function, which is characterized by an imbalance between the actions of vasodilators and vasoconstrictors. The aim of this study was to determine the effects of a 12-week high-intensity training (HIT) and moderate continuous training (MCT) protocol on postprandial lipemia, vascular function and arterial stiffness in inactive adults after high-fat meal (HFM) ingestion. A randomized clinical trial was conducted in 20 healthy, inactive adults (31.6 ± 7.1 years). Participants followed the two exercise protocols for 12 weeks. To induce a state of postprandial lipemia (PPL), all subjects received a HFM. Endothelial function was measured using flow-mediated vasodilation (FMD), normalized brachial artery FMD (nFMD), aortic pulse wave velocity (PWV) and augmentation index (AIx). Plasma total cholesterol, high-density lipoprotein cholesterol (HDL-c), triglycerides and glucose were also measured. The effects of a HFM were evaluated in a fasted state and 60, 120, 180, and 240 min postprandially. A significant decrease in serum glucose between 0 min (fasted state) and 120 min postprandially was found in the HIT group (P = 0.035). Likewise, FMD (%) was significantly different between the fasted state and 60 min after a HFM in the HIT group (P = 0.042). The total cholesterol response expressed as area under curve (AUC) (0-240) was lower following HIT than following MCT, but no significant differences were observed (8%, P > 0.05). Similarly, triglycerides AUC (0-240) was also lower after HIT compared with MCT, which trended towards significance (24%, P = 0.076). The AUC (0-240) for the glucose response was significantly lower following HIT than MCT (10%, P = 0.008). FMD and nFMD AUC (0-240) were significantly higher following HIT than following MCT (46.9%, P = 0.021 and 67.3%, P = 0.009, respectively). PWV AUC (0-240) did not differ following

  16. Facial nerve problems and Bell's palsy

    Sala, DV; Venter, C; Valenas, O

    2015-01-01

    Bell's palsy is paralysis or weakness of muscle at the hemifacial level, a form of temporary facial paralysis, probable a virus infection or trauma, to one or two facial nerves. Damage to the facial nerve innervating the muscles on one side of the face result in a flabby appearance, fell the respective hemiface. Nerve damage can also affect the sense of taste and salivary and lacrimal secretion. This condition begins suddenly, often overnight, and usually gets better on its own within a few w...

  17. Determinación de HLA en pacientes con Síndrome de Parry Romberg atendidos en el Servicio de Cirugía Plástica y Reconstructiva del Hospital General "Dr. Manuel Gea González"

    Palafox, Damián; Gutiérrez-Gómez, Claudia; Granados, Julio; Barquera, Rodrigo; Ortega-Hernández, Esteban; Hernández-Zaragoza, Diana I.; Pérez-Dosal, Marcia; Pacheco-Ubaldo, Hanna R.; Lona-Sánchez, Abraham

    2016-01-01

    Introducción y Objetivo. El síndrome de Parry Romberg se caracteriza por atrofia hemifacial progresiva; afecta piel y tejidos blandos y en ocasiones provoca también atrofia de músculos, cartílago y estructuras óseas subyacentes. Su diagnóstico diferencial incluye: esclerodermia generalizada, morfea y síndrome de CREST. Las alteraciones en piel se asocian con variantes alélicas (polimórficas) del sistema HLA (antígeno leucocitario humano). La esclerodermia se ha asociado con HLA DR11, el CREST...

  18. Distracción ósea y cirugía ortognática en paciente previamente radiado

    Martínez-Pérez, Fátima; Arribas-García, Ignacio; Álvarez-Flórez, Modesto; Gómez-Oliveira, Guillermo; Serrano Álvarez-Buylla, Adriana; Martínez-Gimeno, Carlos

    2016-01-01

    Introducción: Presentamos a un paciente que recibió tratamiento radioterápico en la infancia por un retinoblastoma. Como principal secuela presenta una severa hipoplasia ósea hemifacial, alteración de la dentición y atrofia muscular. Se realiza cirugía correctora facial mediante distracción ósea, cirugía ortognática y lipoescultura facial con un resultado estético y funcional excelente y estable hasta el momento actual. Caso clínico: Varón de 15 años con hipoplasia témporo-parieto-frontal,...

  19. Fabrication of nanocrystalline hydroxyapatite doped degradable composite hollow fiber for guided and biomimetic bone tissue engineering

    Zhang Ning [Department of Bioengineering, Clemson University, Clemson, SC, 29634 (United States); Nichols, Heather L. [Department of Bioengineering, Clemson University, Clemson, SC, 29634 (United States); Tylor, Shila [Department of Bioengineering, Clemson University, Clemson, SC, 29634 (United States); Wen Xuejun [Department of Bioengineering, Clemson University, Clemson, SC, 29634 (United States)]. E-mail: xjwen@clemson.edu

    2007-04-15

    Natural bone tissue possesses a nanocomposite structure interwoven in a three-dimensional (3-D) matrix, which plays critical roles in conferring appropriate physical and biological properties to the bone tissue. Single type of material may not be sufficient to mimic the composition, structure and properties of native bone, therefore, composite materials consisting of both polymers, bioceramics, and other inorganic materials have to be designed. Among a variety of candidate materials, polymer-nanoparticle composites appear most promising for bone tissue engineering applications because of superior mechanical properties, improved durability, and surface bioactivity when compared with conventional polymers or composites. The long term objective of this project is to use highly aligned, bioactive, biodegradable scaffold mimicking natural histological structure of human long bone, and to engineer and regenerate human long bone both in vitro and in vivo. In this study, bioactive, degradable, and highly permeable composite hollow fiber membranes (HFMs) were fabricated using a wet phase phase-inversion approach. The structure of the hollow fiber membranes was examined using scanning electron microscopy (SEM); degradation behavior was examined using weigh loss assay, gel permeation chromatography (GPC), and differential scanning calorimetry (DSC); and bioactivity was evaluated with the amount of calcium deposition from the culture media onto HFM surface. Doping PLGA HFMs with nanoHA results in a more bioactive and slower degrading HFM than pure PLGA HFMs.

  20. Analysis of hydrogen separation methods in low pressure industrial processes

    Milidoni, M.; Somoza, J.; Borzone, E.M.; Blanco, M.V.; Cestau, D.; Baruj, A.; Meyer, G.

    2012-01-01

    In this work we present strategies for removing part of the hydrogen contained in a tank of 500 1 at a total pressure of 95 kPa. Hydrogen is mixed with other gases in a relation 95:5. The gas is generated as an end product during the production of radioisotopes. Main impurities are N 2 , humidity and activated gases. Two separation methods are proposed: one of them based on the use of a commercial Pd/Cu membrane, while the other involves the use of materials capable of forming metal hydrides (HFM). Characterization of hydrogen separation properties using a Pd/Cu membrane from pure H 2 and H 2 /Ar mixture were performed in the laboratory. We present simulations of a device containing HFM of the LaNi 5 -xSnx (0.x.0,5), using the properties of reaction with hydrogen measured in our laboratory. The performance of the different options was evaluated. Results were compared using as evaluation criteria the value of the pressure in the tank after 3 h of separation process and the time needed to separate the same amount of hydrogen generated during a batch of the process (author)

  1. Magnon specific heat and free energy of Heisenberg ferromagnetic single-walled nanotubes: Green's function approach

    Mi, Bin-Zhou, E-mail: mbzfjerry2008@126.com [Department of Basic Curriculum, North China Institute of Science and Technology, Beijing 101601 (China); Department of Physics, School of Mathematics and Physics, University of Science and Technology Beijing, Beijing 100083 (China); Zhai, Liang-Jun [The School of Mathematics and Physics, Jiangsu University of Technology, Changzhou 213001 (China); Hua, Ling-Ling [Department of Basic Curriculum, North China Institute of Science and Technology, Beijing 101601 (China)

    2016-01-15

    The effect of magnetic spin correlation on the thermodynamic properties of Heisenberg ferromagnetic single-walled nanotubes are comprehensively investigated by use of the double-time Green's function method. The influence of temperature, spin quantum number, diameter of the tube, anisotropy strength and external magnetic field to internal energy, free energy, and magnon specific heat are carefully calculated. Compared to the mean field approximation, the consideration of the magnetic correlation effect significantly improves the internal energy values at finite temperature, while it does not so near zero temperature, and this effect is related to the diameter of the tube, anisotropy strength, and spin quantum number. The magnetic correlation effect lowers the internal energy at finite temperature. As a natural consequence of the reduction of the internal energy, the specific heat is reduced, and the free energy is elevated. - Highlights: • Magnon specific heat and free energy of Heisenberg ferromagnetic single-walled nanotubes (HFM-SWNTs) are investigated. • The magnetic correlations effect has a considerable contribution to the thermodynamics properties of HFM-SWNTs. • Magnetic correlation effects are always to lower the internal energy at finite temperature. • At Curie point, magnetic correlation energy is much less than zero. • The peak values of magnon specific heat curves rise and shift right towards higher temperatures with the diameter of tubes, the anisotropy strength, and the spin quantum number rising.

  2. Arterial compression of nerve is the primary cause of trigeminal neuralgia.

    Chen, Guo-Qiang; Wang, Xiao-Song; Wang, Lin; Zheng, Jia-Ping

    2014-01-01

    Whether arterial or venous compression or arachnoid adhesions are primarily responsible for compression of the trigeminal nerve in patients with trigeminal neuralgia is unclear. The aim of this study was to determine the causes of trigeminal nerve compression in patients with trigeminal neuralgia. The surgical findings in patients with trigeminal neuralgia who were treated by micro vascular decompression were compared to those in patients with hemifacial spasm without any signs or symptoms of trigeminal neuralgia who were treated with microvascular decompression. The study included 99 patients with trigeminal neuralgia (median age, 57 years) and 101 patients with hemifacial spasm (median age, 47 years). There were significant differences between the groups in the relationship of artery to nerve (p relationship of vein to nerve. After adjustment for age, gender, and other factors, patients with vein compression of nerve or with artery compression of nerve were more likely to have trigeminal neuralgia (OR = 5.21 and 42.54, p = 0.026 and p compression of the trigeminal nerve is the primary cause of trigeminal neuralgia and therefore, decompression of veins need not be a priority when performing microvascular dissection in patients with trigeminal neuralgia.

  3. Microvascular decompression for the patient with painful tic convulsif after Bell palsy.

    Jiao, Wei; Zhong, Jun; Sun, Hui; Zhu, Jin; Zhou, Qiu-Meng; Yang, Xiao-Sheng; Li, Shi-Ting

    2013-05-01

    Painful tic convulsif is referred to as the concurrent trigeminal neuralgia and hemifacial spasm. However, painful tic convulsif after ipsilateral Bell palsy has never been reported before. We report a case of a 77-year-old woman with coexistent trigeminal neuralgia and hemifacial spasm who had experienced Bell palsy half a year ago. The patient underwent microvascular decompression. Intraoperatively, the vertebrobasilar artery was found to deviate to the symptomatic side and a severe adhesion was observed in the cerebellopontine angle. Meanwhile, an ectatic anterior inferior cerebellar artery and 2 branches of the superior cerebellar artery were identified to compress the caudal root entry zone (REZ) of the VII nerve and the rostroventral cisternal portion of the V nerve, respectively. Postoperatively, the symptoms of spasm ceased immediately and the pain disappeared within 3 months. In this article, the pathogenesis of the patient's illness was discussed and it was assumed that the adhesions developed from inflammatory reactions after Bell palsy and the anatomic features of the patient were the factors that generated the disorder. Microvascular decompression surgery is the suggested treatment of the disease, and the dissection should be started from the caudal cranial nerves while performing the operation.

  4. Preoperative evaluation of neurovascular relationships for microvascular decompression in the cerebellopontine angle in a virtual reality environment.

    Du, Zhuo-Ying; Gao, Xiang; Zhang, Xiao-Luo; Wang, Zhi-Qiu; Tang, Wei-Jun

    2010-09-01

    In this paper the authors' goal was to evaluate the feasibility and efficacy of a virtual reality (VR) system in preoperative planning for microvascular decompression (MVD) procedures treating idiopathic trigeminal neuralgia and hemifacial spasm. The system's role in surgical simulation and training was also assessed. Between May 2008 and April 2009, the authors used the Dextroscope system to visualize the neurovascular complex and simulate MVD in the cerebellopontine angle in a VR environment in 16 patients (6 patients had trigeminal neuralgia and 10 had hemifacial spasm). Reconstructions were carried out 2-3 days before MVD. Images were printed in a red-blue stereoscopic format for teaching and discussion and were brought into the operating room to be compared with real-time intraoperative findings. The VR environment was a powerful aid for spatial understanding of the neurovascular relationship in MVD for operating surgeons and trainees. Through an initial series of comparison/confirmation experiences, the senior neurosurgeon became accustomed to the system. He could predict intraoperative problems and simulate surgical maneuvering, which increased his confidence in performing the procedure. The Dextroscope system is an easy and rapid method to create a stereoscopic neurovascular model for MVD that is highly concordant with intraoperative findings. It effectively shortens the learning curve and adds to the surgeon's confidence.

  5. Prefabricated neck expanded skin flap with the superficial temporal vessels for facial resurfacing.

    Lazzeri, Davide; Su, Weijie; Qian, Yunliang; Messmer, Caroline; Agostini, Tommaso; Spinelli, Giuseppe; Marcus, Jeffrey R; Levin, L Scott; Zenn, Micheal R; Zhang, Yi Xin

    2013-05-01

    The achievement of a normal-appearing face after surgical resurfacing remains an elusive goal. This is due in part to insufficient color matching, restoration of contours, and the persistence of visible scars. Flap prefabrication is a staged procedure that provides an independent axial blood supply to local expanded tissues. We describe a new reconstructive alternative with superior reconstructive surgical options for facial resurfacing that better matches damaged or discarded facial tissues. A superficial temporal fascial flap was harvested as the vascular supply of the prefabricated neck flap and located in a subcutaneous neck pocket over a tissue expander. After a 5-month period for expansion and maturation, the prefabricated skin flap was raised, islanded, and rotated to resurface the facial defect. Four patients with hemifacial postburn contracture and two patients affected by hemifacial vascular malformations aged 17 to 42 years (mean 29 years) were successfully treated with no major complication after a mean period of 15 months. Prefabricated neck-expanded skin flap demonstrated an excellent color and texture match with facial skin that surrounded the repair sites, and optimal aesthetic results were obtained. Importantly, facial expression was completely maintained due to thinness and pliability of the rotated skin. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Efficacy of Botulinum Toxin Injections in the Treatment of Various Types of Facial Region Disorders

    Arzu Çoban

    2012-12-01

    Full Text Available OBJECTIVE: Local injection of botulinum toxin is a highly effective treatment option for a wide range of movement disorders and there are reliable sources of information on its indications, effects and safety in clinical practice. In this study, we report our experience with botulinum toxin in the treatment of facial region disorders. METHODS: Patients who had been followed in the Botulinum Toxin Outpatient Clinic of the Neurology Department were retrospectively evaluated. Two preparations of botulinum toxin type A (BT-A were used. The efficacy of BT-A injections was rated according to the improvement in symptoms as follows: marked - 75-100% improvement, good - 50-74%, moderate - 25-49%, and insufficient - less than 25% symptom relief. RESULTS: One hundred eighty-two patients (73 male, 109 female with various facial region disorders were included. The efficacy rates for patients who had very good and good improvement were high in the treatment of blepharospasm, hemifacial spasm, facial synkinesis, and Meige syndrome and moderate for oromandibular dystonia and hypersalivation. Ptosis was the most common side effect. CONCLUSION: According to our results, botulinum toxin was very effective treatment for blepharospasm, Meige syndrome, hemifacial spasm and facial synkinesis, whereas it demonstrated good efficacy in oromandibular dystonia and hypersalivation

  7. Interactive virtual simulation using a 3D computer graphics model for microvascular decompression surgery.

    Oishi, Makoto; Fukuda, Masafumi; Hiraishi, Tetsuya; Yajima, Naoki; Sato, Yosuke; Fujii, Yukihiko

    2012-09-01

    The purpose of this paper is to report on the authors' advanced presurgical interactive virtual simulation technique using a 3D computer graphics model for microvascular decompression (MVD) surgery. The authors performed interactive virtual simulation prior to surgery in 26 patients with trigeminal neuralgia or hemifacial spasm. The 3D computer graphics models for interactive virtual simulation were composed of the brainstem, cerebellum, cranial nerves, vessels, and skull individually created by the image analysis, including segmentation, surface rendering, and data fusion for data collected by 3-T MRI and 64-row multidetector CT systems. Interactive virtual simulation was performed by employing novel computer-aided design software with manipulation of a haptic device to imitate the surgical procedures of bone drilling and retraction of the cerebellum. The findings were compared with intraoperative findings. In all patients, interactive virtual simulation provided detailed and realistic surgical perspectives, of sufficient quality, representing the lateral suboccipital route. The causes of trigeminal neuralgia or hemifacial spasm determined by observing 3D computer graphics models were concordant with those identified intraoperatively in 25 (96%) of 26 patients, which was a significantly higher rate than the 73% concordance rate (concordance in 19 of 26 patients) obtained by review of 2D images only (p computer graphics model provided a realistic environment for performing virtual simulations prior to MVD surgery and enabled us to ascertain complex microsurgical anatomy.

  8. Reduced-order modeling with sparse polynomial chaos expansion and dimension reduction for evaluating the impact of CO2 and brine leakage on groundwater

    Liu, Y.; Zheng, L.; Pau, G. S. H.

    2016-12-01

    A careful assessment of the risk associated with geologic CO2 storage is critical to the deployment of large-scale storage projects. While numerical modeling is an indispensable tool for risk assessment, there has been increasing need in considering and addressing uncertainties in the numerical models. However, uncertainty analyses have been significantly hindered by the computational complexity of the model. As a remedy, reduced-order models (ROM), which serve as computationally efficient surrogates for high-fidelity models (HFM), have been employed. The ROM is constructed at the expense of an initial set of HFM simulations, and afterwards can be relied upon to predict the model output values at minimal cost. The ROM presented here is part of National Risk Assessment Program (NRAP) and intends to predict the water quality change in groundwater in response to hypothetical CO2 and brine leakage. The HFM based on which the ROM is derived is a multiphase flow and reactive transport model, with 3-D heterogeneous flow field and complex chemical reactions including aqueous complexation, mineral dissolution/precipitation, adsorption/desorption via surface complexation and cation exchange. Reduced-order modeling techniques based on polynomial basis expansion, such as polynomial chaos expansion (PCE), are widely used in the literature. However, the accuracy of such ROMs can be affected by the sparse structure of the coefficients of the expansion. Failing to identify vanishing polynomial coefficients introduces unnecessary sampling errors, the accumulation of which deteriorates the accuracy of the ROMs. To address this issue, we treat the PCE as a sparse Bayesian learning (SBL) problem, and the sparsity is obtained by detecting and including only the non-zero PCE coefficients one at a time by iteratively selecting the most contributing coefficients. The computational complexity due to predicting the entire 3-D concentration fields is further mitigated by a dimension

  9. Effects of protein hydrolysates supplementation in low fish meal diets on growth performance, innate immunity and disease resistance of red sea bream Pagrus major.

    Khosravi, Sanaz; Rahimnejad, Samad; Herault, Mikaël; Fournier, Vincent; Lee, Cho-Rong; Dio Bui, Hien Thi; Jeong, Jun-Bum; Lee, Kyeong-Jun

    2015-08-01

    This study was conducted to evaluate the supplemental effects of three different types of protein hydrolysates in a low fish meal (FM) diet on growth performance, feed utilization, intestinal morphology, innate immunity and disease resistance of juvenile red sea bream. A FM-based diet was used as a high fish meal diet (HFM) and a low fish meal (LFM) diet was prepared by replacing 50% of FM by soy protein concentrate. Three other diets were prepared by supplementing shrimp, tilapia or krill hydrolysate to the LFM diet (designated as SH, TH and KH, respectively). Triplicate groups of fish (4.9 ± 0.1 g) were fed one of the test diets to apparent satiation twice daily for 13 weeks and then challenged by Edwardsiella tarda. At the end of the feeding trial, significantly (P red sea bream. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Cryogenic Design of the New High Field Magnet Test Facility at CERN

    Benda, V.; Pirotte, O.; De Rijk, G.; Bajko, M.; Craen, A. Vande; Perret, Ph.; Hanzelka, P.

    In the framework of the R&D program related to the Large Hadron Collider (LHC) upgrades, a new High Field Magnet (HFM) vertical test bench is required. This facility located in the SM18 cryogenic test hall shall allow testing of up to 15 tons superconducting magnets with energy up to 10 MJ in a temperature range between 1.9 K and 4.5 K. The article describes the cryogenic architecture to be inserted in the general infrastructure of SM18 including the process and instrumentation diagram, the different operating phases including strategy for magnet cool down and warm up at controlled speed and quench management as well as the design of the main components.

  11. Comparison of different cryogenic control strategies via simulation applied to a superconducting magnet test bench at CERN

    Arpaia, P.; Coppier, H.; De Paola, D.; di Bernardo, M.; Guarino, A.; Pedemonte, B. Luz; Pezzetti, M.

    2017-12-01

    Industrial process controllers for cryogenic systems used in test facilities for superconducting magnets are typically PIDs, tuned by operational expertise according to users’ requirements (covering cryogenic transients and associated thermo-mechanical constraints). In this paper, an alternative fully-automatic solution, equally based on PID controllers, is proposed. Following the comparison of the operational expertise and alternative fully-automatic approaches, a new process control configuration, based on an estimated multiple-input/multiple-output (MIMO) model is proposed. The new MIMO model-based approach fulfils the required operational constraints while improving performance compared to existing solutions. The analysis and design work is carried out using both theoretical and numerical tools and is validated on the case study of the High Field Magnet (HFM) cryogenic test bench running at the SM18 test facility located at CERN. The proposed solution have been validated by simulation using the CERN ECOSIMPRO software tools using the cryogenic library (CRYOLIB [1]) developed at CERN.

  12. Hall B927, Work on new LHC magnet prototype.

    Maximilien Brice

    2011-01-01

    Photo 1 : Presse de Collaring vertical pour le quadrupole d’insertion MQXC (Juan Carlos Perez). Photo 8 : Presse de polymérisation équipée pour les bobines MQXC. Photo 10 : Bobine en Nb$_{3}$Sn pour le SMC (Short Model Coil) dans le cadre du programme HFM (High Field Magnets). Photo 19 : Mise en place des jauges de contrainte sur l’outillage de mesure de module élastique pour les bobines du quadrupole MQXC (Eugenie Gallay). Photo 21 : Installation du programme d’acquisition de données pour l’outillage de mesure du module élastique des bobines pour le quadrupole MQXC (Andrey Kuzmin). Photo 24 : Bobines modèle réduit du quadrupole MQXC. Photo 28 : Equipement du mandrin de bobinage pour les bobines du quadrupole MQXC (Hugues Dupont).

  13. 6th International Conference on the History of General Relativity

    Eisenstaedt, Jean; The Universe of General Relativity; GR 6

    2005-01-01

    This volume from the Einstein Studies Series is based largely on papers presented at the Sixth International Conference on the History of General Relativity, held in Amsterdam on June 26-29, 2002. These contributions from notable experts offer both new and historical insights on gravitation, general relativity, cosmology, unified field theory, and the history of science. Topics discussed include the prehistory of special relativity, early attempts at a relativistic theory of gravitation, the beginnings of general relativity, the problem of motion in the context of relativity, conservation laws, the axiomatization of relativity, classical and contemporary cosmology, gravitation and electromagnetism, quantum gravity, and relativity as seen through the eyes of the public and renowned relativists. Contributors: K. Brading; G. Gale; H.F.M. Goenner; J. Goldberg; S. Katzir; D. Kennefick; H. Kragh; C. Lehner; U. Majer; J. Mattingly; E.T. Newman; J.D. Norton; J. Renn; R. Rynasiewicz; J.M. Sánchez-Ron; T. Sauer; C. Sm...

  14. Modeling and Optimization of the Thermal Performance of a Wood-Cement Block in a Low-Energy House Construction

    Iole Nardi

    2016-08-01

    Full Text Available The reduction of building energy consumption requires appropriate planning and design of the building’s envelope. In the last years, new innovative materials and construction technologies used in new or refurbished buildings have been developed in order to achieve this objective, which are also needed for reducing greenhouse gases emissions and building maintenance costs. In this work, the thermal conductance of a brick, made of wood and cement, used in a low-rise building, was investigated with a heat flow meter (HFM and with numerical simulation using the Ansys® software package (Canonsburg, PA, USA. Due to their influence on the buildings’ thermal efficiency, it is important to choose an appropriate design for the building blocks. Results obtained by the finite element modeling of the construction material and by in-situ analysis conducted on a real building are compared, and furthermore a thermal optimization of the shape of the material is suggested.

  15. A2e High Fidelity Modeling: Strategic Planning Meetings

    Hammond, Steven W. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sprague, Michael A. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Womble, David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Barone, Matt [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-11-01

    Atmosphere to electrons (A2e) is a multi-year U.S. Department of Energy (DOE) research initiative targeting significant reductions in the cost of wind energy through an improved understanding of the complex physics governing wind flow into and through whole wind farms. Better insight into the flow physics of large multi-turbine arrays will address the plant-level energy losses, is likely to reduce annual operational costs by hundreds of millions of dollars, and will improve project financing terms to more closely resemble traditional capital projects. In support of this initiative, two planning meetings were convened, bringing together professionals from universities, national laboratories, and industry to discuss wind plant modeling challenges, requirements, best practices, and priorities. This report documents the combined work of the two meetings and serves as a key part of the foundation for the A2e/HFM effort for predictive modeling of whole wind plant physics.

  16. Changes of Microbiological Quality in Aquaculture tilapia (Oreochromis niloticus) After Irradiation Treatment

    Ali, H.A.S.

    2015-01-01

    The effect of different doses of gamma irradiation (1, 3 and 5 kGy) on the microbial flora of aquacultured Nile tilapia fish (Oreochromis niloticus) in cages inserted in Manzala Lake, Egypt, was investigated. These fish were fed on poultry by-product meal (PBM) in practical diets as replacement for fish meal protein in which herring fish meal (HFM) were replaced by PBM at ratio of 25 %, 50 %, 75% and 100% in the diet. Based on the results, it could be noticed that there was non-significant effect after partial (25, 50 and 75%) and complete replacement of fish meal protein by poultry by-product meal on the total bacterial count TBC, mould and yeast and Staphylococcus aureus counts (log cfu/g) of tilapia fish. Significant increases in the counts of Escherichia coli, Enterobacteriaceae and Enterobacter aerogenes were recorded, specially at the high levels of replacement (75 and 100%). Concerning the effect of gamma irradiation on fish samples, it could be observed that gamma irradiation with the doses 1,3 and 5 kGy significantly reduced TBC, mould and yeast, S. aureus. E. coli, Enterobacter aerogenes and Enterobacteriaceae counts of all treatments which reached undetectable values by using gamma irradiation doses of 3 and 5 kGy. From the present results, it could be concluded that using poultry by-product meal (PBM) in diets for Nile tilapia as replacement for fish meal protein supplied by herring fish meal (HFM) in the diet (to reduce feeding economic cost) significantly increase the log count of Enterobacteriaceae, Escherichia coli and Enterobacter aerogenes. However using gamma irradiation significantly reduced these counts which were undetectable using 3 and 5 kGy. It could be concluded that using gamma irradiation with dose 3 kGy can improve the hygienic quality of aquacultured Nile tilapia.

  17. Estrabismo após toxina botulínica para fins estéticos

    Marta Halfeld Ferrari Alves Lacordia

    2011-06-01

    Full Text Available RESUMO Nas últimas décadas, a toxina botulínica tem sido aplicada para fins terapêuticos em inúmeras afecções. A toxina do tipo A foi aprovada primeiramente em 1989 para o uso em estrabismo, blefaroespasmo e espasmo hemifacial de pacientes maiores que 12 anos de idade. A observação de que pacientes tratados de blefaroespasmo com toxina botulínica apresentavam um efeito adicional de diminuição das rugas de expressão inspirou estudos sobre a aplicação cosmética da toxina. Recentemente, a toxina botulínica do tipo A foi aprovada para fins estéticos. Este trabalho relata um caso de ocorrência de estrabismo após aplicação de toxina botulínica na face para fins estéticos.

  18. [Extensive tumor of the skull base: sphenoid sinus adenocarcinoma].

    Kallel, Souha; Sellami, Moncef

    2017-01-01

    We report a rare case of adenocarcinoma of the sphenoid sinus manifesting as extended skull base tumor. The patient included in the study was a 42-year old woman presenting with unilateral right symptomatology consisting of nasal obstruction, diplopia and hemifacial neuralgias. Clinical examination showed paralysis of the cranial nerve pairs V and VI. Brain scanner showed voluminous heterogeneous sphenoid and clival mass reaching the right cavernous sinus, with a peripheral tissue component at the level of the sphenoid sinus. Biopsy was performed under general anesthesia, through endonasal sphenoidotomy approach. Histological examination showed non-intestinal adenocarcinoma. The patient died due to impaired general condition occurred during examinations. Skull base adenocarcinomas mainly occur in the ethmoid bone. Sphenoid origin is exceptional. Radiological appearance is not specific and suggests malignancy. Diagnosis should be suspected in patients with aggressive tumor, even when it occurs in the midline skull base.

  19. Evaluation of MR cisternography of the cerebellopontine angle using a balanced fast-field-echo sequence: preliminary findings

    Tsuchiya, Kazuhiro; Aoki, Chinatsu; Hachiya, Junichi [Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, 181-8611, Tokyo (Japan)

    2004-02-01

    We evaluated the feasibility of MR cisternography by the balanced fast-field-echo (bFFE) sequence, comparing with that by a turbo-spin-echo (TSE) sequence, for cerebellopontine angle lesions on a 1.5-T imager (Gyroscan Intera, Philips, Best, The Netherlands). The bFFE MR cisternograms depicted target cranial nerves with less cerebrospinal fluid pulsation artifacts than TSE cisternograms and visualized an acoustic schwannoma in 6 of 44 patients with suspicion and a causative vessel of hemifacial spasm in all of 3 patients in a short scanning time (1 min 53 s). The bFFE sequence can be promising for MR cisternography in the diagnosis of cerebellopontine angle lesions. (orig.)

  20. MRI-based diagnostic imaging of the intratemporal facial nerve

    Kress, B.; Baehren, W.

    2001-01-01

    Detailed imaging of the five sections of the full intratemporal course of the facial nerve can be achieved by MRI and using thin tomographic section techniques and surface coils. Contrast media are required for tomographic imaging of pathological processes. Established methods are available for diagnostic evaluation of cerebellopontine angle tumors and chronic Bell's palsy, as well as hemifacial spasms. A method still under discussion is MRI for diagnostic evaluation of Bell's palsy in the presence of fractures of the petrous bone, when blood volumes in the petrous bone make evaluation even more difficult. MRI-based diagnostic evaluation of the idiopatic facial paralysis currently is subject to change. Its usual application cannot be recommended for routine evaluation at present. However, a quantitative analysis of contrast medium uptake of the nerve may be an approach to improve the prognostic value of MRI in acute phases of Bell's palsy. (orig./CB) [de

  1. The use of botulinum toxin in head and face medicine: An interdisciplinary field

    Laskawi Rainer

    2008-03-01

    Full Text Available Abstract Background In this review article different interdisciplinary relevant applications of botulinum toxin type A (BTA in the head and face region are demonstrated. Patients with head and face disorders of different etiology often suffer from disorders concerning their musculature (example: synkinesis in mimic muscles or gland-secretion. This leads to many problems and reduces their quality of life. The application of BTA can improve movement disorders like blepharospasm, hemifacial spasm, synkinesis following defective healing of the facial nerve, palatal tremor, severe bruxism, oromandibular dystonias hypertrophy of the masseter muscle and disorders of the autonomous nerve system like hypersalivation, hyperlacrimation, pathological sweating and intrinsic rhinitis. Conclusion The application of botulinum toxin type A is a helpful and minimally invasive treatment option to improve the quality of life in patients with head and face disorders of different quality and etiology. Side effects are rare.

  2. Unilateral facial pain and lung cancer

    Shakespeare, T.P.; Stevens, M.J.

    1996-01-01

    Facial pain in lung cancer patients may be secondary to metastatic disease to the brain or skull base. Since 1983 there have been 19 published reports of hemi-facial pain as a non-metastatic complication of lung carcinoma. This report describes an additional case in whom unilateral face pain preceded the diagnosis of lung cancer by 9 months. A clinical diagnosis of trigeminal neuralgia was made after a normal brain CT scan. Later on the patient complained of global lethargy, weight loss and haemoptysis. A chest X-ray disclosed a 6 cm right hilar mass that was further defined with a whole body CT scan. The neural mechanism of the unilateral facial pain is discussed and the literature reviewed. 14 refs., 1 tab

  3. Unilateral facial pain and lung cancer

    Shakespeare, T.P.; Stevens, M.J. [Royal North Shore Hospital, Crows Nest, NSW (Australia)

    1996-02-01

    Facial pain in lung cancer patients may be secondary to metastatic disease to the brain or skull base. Since 1983 there have been 19 published reports of hemi-facial pain as a non-metastatic complication of lung carcinoma. This report describes an additional case in whom unilateral face pain preceded the diagnosis of lung cancer by 9 months. A clinical diagnosis of trigeminal neuralgia was made after a normal brain CT scan. Later on the patient complained of global lethargy, weight loss and haemoptysis. A chest X-ray disclosed a 6 cm right hilar mass that was further defined with a whole body CT scan. The neural mechanism of the unilateral facial pain is discussed and the literature reviewed. 14 refs., 1 tab.

  4. Painful tic convulsif syndrome due to vertebrobasilar dolichoectasia

    Puneet Mittal

    2011-01-01

    Full Text Available Combined clinical presentation of hemifacial spasm and ipsilateral trigeminal neuralgia is also known as painful tic convulsif (PTC. It is a rare condition and the most common cause is vascular compression. Vertebrobasilar dolichoectasia (VBD is characterized by dilated and tortuous vertebral and basilar arteries. VBD is an uncommon and rarely reported cause of PTC. Magnetic resonance imaging (MRI, due to its inherent excellent contrast resolution, is an excellent modality for demonstrating the nerve compression by dilated and tortuous vessels seen in this condition. For this purpose, 3D MRI sequences are especially useful like constructive interference in steady state (CISS and MR angiography. Both of these have been reported to be helpful in the diagnosis of this condition. We report a case of PTC in which we were able to document facial and trigeminal nerve compression by VBD on MRI, using CISS and time-of-flight MR angiography.

  5. Clinical Review of the Effects of Hominis Placental Pharmacopuncture in the Treatment of Facial Spasm Patients

    Jo Na-Young

    2013-09-01

    Full Text Available Objectives: The main purpose of this research is to investigate the effect of treatment with Hominis Placental pharmacopuncture (HPP for 32 patients with hemifacial spasm. Methods: We treated facial spasm patients with acupuncture and HPP at Sabaek (ST2, Seung-eup (ST1, Gwallyeo (SI18, Chanjuk (BL2, Sajukgong (TE23, Hagwan (ST7, Hyeopgeo (ST6, Jichang (ST4, Wan-gol (SI4 and Yepung (TE17, and we investigated the effect by using Scott’s scale. The data were analyzed by using the SPSS/10.0 for windows program with descriptive statistics, the paired t-test, and the Shapiro-Wilk normality test. Results: After treatment, the grade of the spasm’s intensity based on Scott’s description were decreased significantly. About 72% of the patients felt that the combination treatment had produced excellent results. Conclusion: These data suggested that HPP can be useful for treating facial spasm patients.

  6. Neuroimaging findings in movement disorders

    Topalov, N.

    2015-01-01

    Full text: Neuroimaging methods are of great importance for the differential diagnostic delimitation of movement disorders associated with structural damage (neoplasms, ischemic lesions, neuroinfections) from those associated with specific pathophysiological mechanisms (dysmetabolic disorders, neurotransmitter disorders). Learning objective: Presentation of typical imaging findings contributing to nosological differentiation in groups of movement disorders with similar clinical signs. In this presentation are discussed neuroimaging findings in Parkinson‘s disease, atypical parkinsonian syndromes (multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration), parkinsonism in genetically mediated diseases (Wilson’s disease, pantothenate kinase-associated neurodegeneration – PKAN), vascular parkinsonism, hyperkinetic movement disorders (palatal tremor, Huntington‘s chorea, symptomatic chorea in ischemic stroke and diabetes, rubral tremor, ballismus, hemifacial spasm). Contemporary neuroimaging methods enable support for diagnostic and differential diagnostic precision of a number of hypo- and hyperkinetic movement disorders, which is essential for neurological clinical practice

  7. Vascular anomalies of the cerebellopontine angle

    Papanagiotou, P.; Grunwald, I.Q.; Politi, M.; Struffert, T.; Ahlhelm, F.; Reith, W.

    2006-01-01

    Vascular anomalies of the cerebellopontine angle are rare compared to tumors in this area. Irritation of the trigeminal, facial, or vestibulocochlear nerve may cause trigeminal neuralgia, hemifacial spasm and vertigo, or tinnitus accordingly. Vessel loops in the cerebellopontine cisterns may cause compression at the root entry or exit zone of the cranial nerves V, VII, and VIII, a phenomenon which is called ''vascular loop syndrome.'' Megadolichobasilar artery and aneurysms of the vertebrobasilar system can also lead to dislocation and compression of the cranial nerves and brain stem. Three-dimensional CISS MR imaging and MR angiography are useful in the detection of neurovascular compression. Microvascular decompression is an effective surgical procedure in the management of compression syndromes of the cranial nerves V, VII, and VIII. (orig.) [de

  8. Vestibular schwannoma with contralateral facial pain – case report

    Ghodsi Mohammad

    2003-03-01

    Full Text Available Abstract Background Vestibular schwannoma (acoustic neuroma most commonly presents with ipsilateral disturbances of acoustic, vestibular, trigeminal and facial nerves. Presentation of vestibular schwannoma with contralateral facial pain is quite uncommon. Case presentation Among 156 cases of operated vestibular schwannoma, we found one case with unusual presentation of contralateral hemifacial pain. Conclusion The presentation of contralateral facial pain in the vestibular schwannoma is rare. It seems that displacement and distortion of the brainstem and compression of the contralateral trigeminal nerve in Meckel's cave by the large mass lesion may lead to this atypical presentation. The best practice in these patients is removal of the tumour, although persistent contralateral pain after operation has been reported.

  9. Facial nerve hemangioma: a rare case involving the vertical segment.

    Ahmadi, Neda; Newkirk, Kenneth; Kim, H Jeffrey

    2013-02-01

    This case report and literature review reports on a rare case of facial nerve hemangioma (FNH) involving the vertical facial nerve (FN) segment, and discusses the clinical presentation, imaging, pathogenesis, and management of these rare lesions. A 53-year-old male presented with a 10-year history of right hemifacial twitching and progressive facial paresis (House-Brackmann grading score V/VI). The computed tomography and magnetic resonance imaging studies confirmed an expansile lesion along the vertical FN segment. Excision and histopathologic examination demonstrated FNH. FNHs involving the vertical FN segment are extremely rare. Despite being rare lesions, we believe that familiarity with the presentation and management of FNHs are imperative. Laryngoscope, 2012. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  10. Value of MR cisternography using three-dimensional half-fourier single-shot fast spin-echo sequences in the diagnosis of diseases related to cranial nerves VII and VIII

    Yamakami, Norio [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

    1999-05-01

    The purpose of this study was to evaluate the value of MR cisternography using three-dimensional half-Fourier single-shot fast spin-echo sequences in the diagnosis of diseasea related to cranial nerves VII and VIII. With a 0.5-T imager, the most appropriate setting of echo time and section thickness was first assessed in five volunteers. This resulted in echo time of 250 msec and section thickness of 2 mm as the most effective parameters. Second, using echo time of 120 msec and section thickness of 1.5 mm that were available from the beginning of this study, the demonstration of four nerves within the audistory canal was assessed in seven volunteers. In all of the volunteers, the facial, cochlear, and vestibular nerves were determined with demonstration of each of superior and inferior vestibular nerves in four of them. Next, MR cisternography using the same echo time and section thickness was applied in 368 patients with suspicion of acoustic neurinoma and 14 with hemifacial spasm. In 28 of the 368 patients, MR cisternograms depicted an acoustic neurinoma that was confirmed on postcontrast T1-weighted images. Meanwhile, in five of the 14 patients with hemifacial spasm, MR cisternograms revealed a vessel compressing the root exit zone of the affected facial nerve. It is concluded that MR cisternography using three-dimensional half-Fourier single-shot fast spin-echo sequences can be a useful means for demonstrating nerves within the auditory nerve as well as for the screening of acoustic neurionoma. (author)

  11. Value of MR cisternography using three-dimensional half-fourier single-shot fast spin-echo sequences in the diagnosis of diseases related to cranial nerves VII and VIII

    Yamakami, Norio

    1999-01-01

    The purpose of this study was to evaluate the value of MR cisternography using three-dimensional half-Fourier single-shot fast spin-echo sequences in the diagnosis of diseasea related to cranial nerves VII and VIII. With a 0.5-T imager, the most appropriate setting of echo time and section thickness was first assessed in five volunteers. This resulted in echo time of 250 msec and section thickness of 2 mm as the most effective parameters. Second, using echo time of 120 msec and section thickness of 1.5 mm that were available from the beginning of this study, the demonstration of four nerves within the audistory canal was assessed in seven volunteers. In all of the volunteers, the facial, cochlear, and vestibular nerves were determined with demonstration of each of superior and inferior vestibular nerves in four of them. Next, MR cisternography using the same echo time and section thickness was applied in 368 patients with suspicion of acoustic neurinoma and 14 with hemifacial spasm. In 28 of the 368 patients, MR cisternograms depicted an acoustic neurinoma that was confirmed on postcontrast T1-weighted images. Meanwhile, in five of the 14 patients with hemifacial spasm, MR cisternograms revealed a vessel compressing the root exit zone of the affected facial nerve. It is concluded that MR cisternography using three-dimensional half-Fourier single-shot fast spin-echo sequences can be a useful means for demonstrating nerves within the auditory nerve as well as for the screening of acoustic neurionoma. (author)

  12. A case of trigeminal hypersensitivity after administration of intrathecal sufentanil and bupivacaine for labor analgesia

    Adriano Bechara de Souza Hobaika

    2014-01-01

    Full Text Available Rostral spread of intrathecal drugs and sensitization of supraspinal sites may provoke several adverse effects. This case describes a patient with right hemifacial paresthesia, trismus and dysphasia on the trigeminal nerve distribution after intrathecal sufentanil administration. Primigravida, 34 years, 39 weeks of pregnancy, with hypothyroidism and pregnancy induced hypertension. Allergic to latex. In the use of puran T4, 50 μg /day. When the patient presented cervical dilatation of 4 cm, she requested analgesia. She was placed in the sitting position and a spinal puncture was performed with a 27G needle pencil point in L4/L5 (1.5 mg of bupivacaine plus 7.5 μg of sufentanil. Next, was performed an epidural puncture in the same space. It was injected bupivacaine 0.065%, 10 ml, to facilitate the passage of the catheter. After 5 min lying down in the lateral upright position, she complained of perioral and right hemifacial paresthesia, mainly maxillary and periorbital, as well as trismus and difficulty to speak. The symptoms lasted for 30 min and resolved spontaneously. After 1 h, patient requested supplementary analgesia (12 ml of bupivacaine 0.125% and a healthy baby girl was born. Temporary mental alterations have been described with the use of fentanyl and sufentanil in combined epidural-spinal analgesia, such as aphasia, difficulty of swallowing, mental confusion and even unconsciousness. In this patient, facial areas with paresthesia indicated by patient appear in clear association with the ophthalmic and maxillary branches of the trigeminal nerve and the occurrence of trismus and dysphagia are in association with the mandibular motor branch. The exact mechanism of rostral spread is not known, but it is speculated that after spinal drug administration, a subsequent epidural dose may reduce the intratecal space and propel the drug into the supraspinal sites.

  13. Developing and testing temperature models for regulated systems: a case study on the Upper Delaware River

    Cole, Jeffrey C.; Maloney, Kelly O.; Schmid, Matthias; McKenna, James E.

    2014-01-01

    Water temperature is an important driver of many processes in riverine ecosystems. If reservoirs are present, their releases can greatly influence downstream water temperatures. Models are important tools in understanding the influence these releases may have on the thermal regimes of downstream rivers. In this study, we developed and tested a suite of models to predict river temperature at a location downstream of two reservoirs in the Upper Delaware River (USA), a section of river that is managed to support a world-class coldwater fishery. Three empirical models were tested, including a Generalized Least Squares Model with a cosine trend (GLScos), AutoRegressive Integrated Moving Average (ARIMA), and Artificial Neural Network (ANN). We also tested one mechanistic Heat Flux Model (HFM) that was based on energy gain and loss. Predictor variables used in model development included climate data (e.g., solar radiation, wind speed, etc.) collected from a nearby weather station and temperature and hydrologic data from upstream U.S. Geological Survey gages. Models were developed with a training dataset that consisted of data from 2008 to 2011; they were then independently validated with a test dataset from 2012. Model accuracy was evaluated using root mean square error (RMSE), Nash Sutcliffe efficiency (NSE), percent bias (PBIAS), and index of agreement (d) statistics. Model forecast success was evaluated using baseline-modified prime index of agreement (md) at the one, three, and five day predictions. All five models accurately predicted daily mean river temperature across the entire training dataset (RMSE = 0.58–1.311, NSE = 0.99–0.97, d = 0.98–0.99); ARIMA was most accurate (RMSE = 0.57, NSE = 0.99), but each model, other than ARIMA, showed short periods of under- or over-predicting observed warmer temperatures. For the training dataset, all models besides ARIMA had overestimation bias (PBIAS = −0.10 to −1.30). Validation analyses showed all models performed

  14. Developing and testing temperature models for regulated systems: A case study on the Upper Delaware River

    Cole, Jeffrey C.; Maloney, Kelly O.; Schmid, Matthias; McKenna, James E.

    2014-11-01

    Water temperature is an important driver of many processes in riverine ecosystems. If reservoirs are present, their releases can greatly influence downstream water temperatures. Models are important tools in understanding the influence these releases may have on the thermal regimes of downstream rivers. In this study, we developed and tested a suite of models to predict river temperature at a location downstream of two reservoirs in the Upper Delaware River (USA), a section of river that is managed to support a world-class coldwater fishery. Three empirical models were tested, including a Generalized Least Squares Model with a cosine trend (GLScos), AutoRegressive Integrated Moving Average (ARIMA), and Artificial Neural Network (ANN). We also tested one mechanistic Heat Flux Model (HFM) that was based on energy gain and loss. Predictor variables used in model development included climate data (e.g., solar radiation, wind speed, etc.) collected from a nearby weather station and temperature and hydrologic data from upstream U.S. Geological Survey gages. Models were developed with a training dataset that consisted of data from 2008 to 2011; they were then independently validated with a test dataset from 2012. Model accuracy was evaluated using root mean square error (RMSE), Nash Sutcliffe efficiency (NSE), percent bias (PBIAS), and index of agreement (d) statistics. Model forecast success was evaluated using baseline-modified prime index of agreement (md) at the one, three, and five day predictions. All five models accurately predicted daily mean river temperature across the entire training dataset (RMSE = 0.58-1.311, NSE = 0.99-0.97, d = 0.98-0.99); ARIMA was most accurate (RMSE = 0.57, NSE = 0.99), but each model, other than ARIMA, showed short periods of under- or over-predicting observed warmer temperatures. For the training dataset, all models besides ARIMA had overestimation bias (PBIAS = -0.10 to -1.30). Validation analyses showed all models performed well; the

  15. Hydrogeologic framework of the middle San Pedro watershed, southeastern Arizona

    Dickinson, Jesse; Kennedy, Jeffrey R.; Pool, D.R.; Cordova, Jeffrey T.; Parker, John T.; Macy, J.P.; Thomas, Blakemore

    2010-01-01

    Water managers in rural Arizona are under increasing pressure to provide sustainable supplies of water despite rapid population growth and demands for environmental protection. This report describes the results of a study of the hydrogeologic framework of the middle San Pedro watershed. The components of this report include: (1) a description of the geologic setting and depositional history of basin fill sediments that form the primary aquifer system, (2) updated bedrock altitudes underlying basin fill sediments calculated using a subsurface density model of gravity data, (3) delineation of hydrogeologic units in the basin fill using lithologic descriptions in driller's logs and models of airborne electrical resistivity data, (4) a digital three-dimensional (3D) hydrogeologic framework model (HFM) that represents spatial extents and thicknesses of the hydrogeologic units (HGUs), and (5) description of the hydrologic properties of the HGUs. The lithologic interpretations based on geophysical data and unit thickness and extent of the HGUs included in the HFM define potential configurations of hydraulic zones and parameters that can be incorporated in groundwater-flow models. The hydrogeologic framework comprises permeable and impermeable stratigraphic units: (1) bedrock, (2) sedimentary rocks predating basin-and-range deformation, (3) lower basin fill, (4) upper basin fill, and (5) stream alluvium. The bedrock unit includes Proterozoic to Cretaceous crystalline rocks, sedimentary rocks, and limestone that are relatively impermeable and poor aquifers, except for saturated portions of limestone. The pre-basin-and-range sediments underlie the lower basin fill but are relatively impermeable owing to cementation. However, they may be an important water-bearing unit where fractured. Alluvium of the lower basin fill, the main water-bearing unit, was deposited in the structural trough between the uplifted ridges of bedrock and (or) pre-basin-and-range sediments. Alluvium of

  16. Nutritional status of pregnant women: prevalence and associated pregnancy outcomes

    Nucci Luciana Bertoldi

    2001-01-01

    Full Text Available INTRODUCTION: Although obesity is well recognized as a current public health problem, its prevalence and impact among pregnant women have been less investigated in Brazil. The objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant women, describing its prevalence and risk factors, and their association with adverse pregnancy outcomes. METHODS: A cohort of 5,564 pregnant women, aged 20 years or more, enrolled at aproximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age, educational level and parity were obtained from a standard questionnaire. Height was measured in duplicate and the interviewer assigned the skin color. Nutritional status was defined using body mass index (BMI, according to World Health Organization (WHO criteria. Odds ratios and 95% confidence interval were calculated using logistic regression. RESULTS: Age-adjusted prevalences (and 95% CI based on prepregnancy weight were: underweight 5.7% (5.1%-6.3%, overweight 19.2% (18.1%-20.3%, and obesity 5.5% (4.9%-6.2%. Obesity was more frequently observed in older black women, with a lower educational level and multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia, hypertensive disorders, and lower risk of microsomia. CONCLUSIONS: Overweight nutritional status (obesity and pre-obesity was seen in 25% of adult pregnant women and it was associated with increased risk for several adverse pregnancy outcomes, such as gestational diabetes and pre-eclampsia.

  17. Orbital Expansion for Congenital Anophthalmia May Be Achievable in Infancy But Not in Childhood.

    Morrow, Brad T; Albright, William B; Neves, Rogerio I; Wilkinson, Michael J; Samson, Thomas D

    2016-10-01

    Congenital anophthalmia is a rare anomaly that results in micro-orbitism and craniofacial microsomia. Treatment with static conformers is labor-intensive and provides minimal stimulation for orbital growth that requires eventual reconstruction with orbital osteotomies after skeletal maturity. A protocol for the treatment of congenital anophthalmia is presented. Patients underwent a preoperative low-dose radiation computed tomography (CT) scan of the facial bones to assess orbital volume. An intraorbital expander was placed and was filled on a monthly basis. Quantitative changes in the affected and unaffected orbits were assessed by a repeat CT scan obtained 1 year postoperatively. Two patients with left unilateral congenital anophthalmia were prospectively followed. In a 4-month-old, the affected orbital width and height increased by 171.6% and 116.7% respectively compared with the unaffected orbit. In a 4-year-old, the affected orbital width increased by 36.1% but the height decreased by 35.3% compared with the unaffected orbit. At 18 months follow-up, no complications, ruptures, infections, or extrusions have been observed. Our results support that accelerated expansion can be achieved in a 4-month-old orbit reversing the effects of anophthalmia. However, in a 4-year-old, minimal growth was observed. The lack of accelerated growth in this study may be explained by synostosis of the orbital sutures. As such, expansion should be initiated at the earliest age possible. Further longitudinal study is ongoing to determine if sustained catch-up growth will obviate or reduce the complexity of a secondary correction.

  18. Identification of a botanical inhibitor of intestinal diacylglyceride acyltransferase 1 activity via in vitro screening and a parallel, randomized, blinded, placebo-controlled clinical trial.

    Velliquette, Rodney A; Grann, Kerry; Missler, Stephen R; Patterson, Jennifer; Hu, Chun; Gellenbeck, Kevin W; Scholten, Jeffrey D; Randolph, R Keith

    2015-01-01

    Diacylglyceride acyltransferase 1 (DGAT1) is the enzyme that adds the final fatty acid on to a diacylglyceride during triglyceride (TG) synthesis. DGAT1 plays a key role in the repackaging of dietary TG into circulating TG rich chylomicrons. A growing amount of research has indicated that an exaggerated postprandial circulating TG level is a risk indicator for cardiovascular and metabolic disorders. The aim of this research was to identify a botanical extract that inhibits intestinal DGAT1 activity and attenuates postprandial hypertriglyceridemia in overweight and obese humans. Twenty individual phytochemicals and an internal proprietary botanical extract library were screened with a primary cell-free DGAT1 enzyme assay that contained dioleoyl glycerol and palmitoleoyl Coenzyme A as substrates plus human intestinal microsomes as the DGAT1 enzyme source. Botanical extracts with IC50 values botanical extracts were then evaluated in a parallel, double-blind, placebo-controlled clinical trial. Ninety healthy, overweight and obese participants were randomized to receive 2 g daily of placebo or individual botanical extracts (the investigational product) for seven days. Serum TG levels were measured before and after consuming a high fat meal (HFM) challenge (0.354 L drink/shake; 77 g fat, 25 g carbohydrate and 9 g protein) as a marker of intestinal DGAT1 enzyme activity. Phenolic acids (i.e., gallic acid) and polyphenols (i.e., cyanidin) abundantly found in nature appeared to inhibit DGAT1 enzyme activity in vitro. Four polyphenolic rich botanical extracts were identified from in vitro evaluation in both cell-free and cellular model systems: apple peel extract (APE), grape extract (GE), red raspberry leaf extract (RLE) and apricot/nectarine extract (ANE) (IC50 = 1.4, 5.6, and 10.4 and 3.4 μg/mL, respectively). In the seven day clinical trial, compared to placebo, only GE significantly reduced the baseline subtracted change in serum TG AUC following

  19. Bile components and lecithin supplemented to plant based diets do not diminish diet related intestinal inflammation in Atlantic salmon.

    Kortner, Trond M; Penn, Michael H; Bjӧrkhem, Ingemar; Måsøval, Kjell; Krogdahl, Åshild

    2016-09-07

    The present study was undertaken to gain knowledge on the role of bile components and lecithin on development of aberrations in digestive functions which seemingly have increased in Atlantic salmon in parallel with the increased use of plant ingredients in fish feed. Post smolt Atlantic salmon were fed for 77 days one of three basal diets: a high fish meal diet (HFM), a low fishmeal diet (LFM), or a diet with high protein soybean meal (HPS). Five additional diets were made from the LFM diet by supplementing with: purified taurocholate (1.8 %), bovine bile salt (1.8 %), taurine (0.4 %), lecithin (1.5 %), or a mix of supplements (suppl mix) containing taurocholate (1.8 %), cholesterol (1.5 %) and lecithin (0.4 %). Two additional diets were made from the HPS diet by supplementing with: bovine bile salt (1.8 %) or the suppl mix. Body and intestinal weights were recorded, and blood, bile, intestinal tissues and digesta were sampled for evaluation of growth, nutrient metabolism and intestinal structure and function. In comparison with fish fed the HFM diet fish fed the LFM and HPS diets grew less and showed reduced plasma bile salt and cholesterol levels. Histological examination of the distal intestine showed signs of enteritis in both LFM and HPS diet groups, though more pronounced in the HPS diet group. The HPS diet reduced digesta dry matter and capacity of leucine amino peptidase in the distal intestine. None of the dietary supplements improved endpoints regarding fish performance, gut function or inflammation in the distal intestine. Some endpoints rather indicated negative effects. Dietary supplementation with bile components or lecithin in general did not improve endpoints regarding performance or gut health in Atlantic salmon, in clear contrast to what has been previously reported for rainbow trout. Follow-up studies are needed to clarify if lower levels of bile salts and cholesterol may give different and beneficial effects, or if other supplements

  20. Hafnium Isotopic Variations in Central Atlantic Intraplate Volcanism

    Geldmacher, J.; Hanan, B. B.; Hoernle, K.; Blichert-Toft, J.

    2008-12-01

    Although one of the geochemically best investigated volcanic regions on Earth, almost no Hf isotopic data have been published from the broad belt of intraplate seamounts and islands in the East Atlantic between 25° and 36° N. This study presents 176Hf/177Hf ratios from 61 representative samples from the Canary, Selvagen and Madeira Islands and nearby large seamounts, encompassing the full range of different evolutionary stages and geochemical endmembers. The majority of samples have mafic, mainly basaltic compositions with Mg-numbers within or near the range of magmas in equilibrium with mantle olivine (68-75). No correlation was found between Mg-number and 176Hf/177Hf ratios in the data set. In comparison to observed Nd isotope variations published for this volcanic province (6 ɛNd units), 176Hf/177Hf ratios span a larger range (14 ɛHf units). Samples from the Madeira archipelago have the most radiogenic compositions (176Hf/177Hfm= 0.283132-0.283335), widely overlapping the field for central Atlantic N-MORB. They form a relatively narrow, elongated trend (stretching over >6 ɛHf units) between a radiogenic MORB-like endmember and a composition located on the Nd-Hf mantle array. In contrast, all Canary Islands samples plot below the mantle array (176Hf/177Hfm = 0.282943-0.283067) and, despite being from an archipelago that stretches over a much larger geographic area, form a much denser cluster with less compositional variation (~4 ɛHf units). All samples from the seamounts NE of the Canaries, proposed to belong to the same Canary hotspot track (e.g. Geldmacher et al., 2001, JVGR 111; Geldmacher et al., 2005, EPSL 237), fall within the Hf isotopic range of this cluster. The cluster largely overlaps the composition of the proposed common mantle endmember 'C' (Hanan and Graham, 1996, Science 272) but spans a space between a more radiogenic (depleted) composition and a HIMU-type endmember. Although samples of Seine and Unicorn seamounts, attributed to the Madeira

  1. The adult brain tissue response to hollow fiber membranes of varying surface architecture with or without cotransplanted cells

    Zhang, Ning

    A variety of biomaterials have been chronically implanted into the central nervous system (CNS) for repair or therapeutic purposes. Regardless of the application, chronic implantation of materials into the CNS induces injury and elicits a wound healing response, eventually leading to the formation of a dense extracellular matrix (ECM)-rich scar tissue that is associated with the segregation of implanted materials from the surrounding normal tissue. Often this reaction results in impaired performance of indwelling CNS devices. In order to enhance the performance of biomaterial-based implantable devices in the CNS, this thesis investigated whether adult brain tissue response to implanted biomaterials could be manipulated by changing biomaterial surface properties or further by utilizing the biology of co-transplanted cells. Specifically, the adult rat brain tissue response to chronically implanted poly(acrylonitrile-vinylchloride) (PAN-PVC) hollow fiber membranes (HFMs) of varying surface architecture were examined temporally at 2, 4, and 12 weeks postimplantation. Significant differences were discovered in the brain tissue response to the PAN-PVC HFMs of varying surface architecture at 4 and 12 weeks. To extend this work, whether the soluble factors derived from a co-transplanted cellular component further affect the brain tissue response to an implanted HFM in a significant way was critically exploited. The cells used were astrocytes, whose ability to influence scar formation process following CNS injury by physical contact with the host tissue had been documented in the literature. Data indicated for the first time that astrocyte-derived soluble factors ameliorate the adult brain tissue reactivity toward HFM implants in an age-dependent manner. While immature astrocytes secreted soluble factors that suppressed the brain tissue reactivity around the implants, mature astrocytes secreted factors that enhanced the gliotic response. These findings prove the feasibility

  2. Studies in the development of a bridging device for guiding regenerating axons

    Wen, Xuejun

    At present there is no clinically effective treatment for injuries or pathological processes that disrupt the continuity of axons in the mature central nervous system. However, a number of studies suggest that a tremendous potential exists for developing therapies. In particular biomaterials in the form of bridging substrates been shown to support at least some level of axonal regeneration across the lesion site, but display a limited capacity for directing axons toward their targets. To influence the directionality of the regeneration process filaments and tubes appear promising but the technology is far from optimized. As a step toward optimization, we investigated various components of a tissue-engineered bridging device consisting of numerous filaments surrounded by a semipermeable biodegradable hollow fiber membrane (HFM). In the first part of the thesis, we studied the influence of filament diameter and various extracellular matrix coatings on neuron regeneration suing a dorsal root ganglion explant model. We found that laminin surface treated filaments that approached the size of spinal axons support significantly longer regenerative outgrowth than similarly treated filaments of larger diameter, and exceed outgrowth distance on similarly sized filaments treated with fibronectin. Such substrates also consistently supported the attachment and alignment of glial cells and directed the outgrowth of regenerating axons along the long axis of the filaments. In the last part of the thesis, biodegradable hollow fiber membranes were fabricated and their physical, chemical and degradation properties were analyzed. We found that it is possible to use phase inversion methods to fabricate hollow fiber membranes of widely varying properties that degrade of the course of several months. We then evaluated the biocompatibility of the new materials after implantation in the CNS using an adult rat model. We found that the implants were well tolerated and elicited a reaction

  3. Randomized clinical trial on the efficacy of hesperidin 2S on validated cardiovascular biomarkers in healthy overweight individuals.

    Salden, Bouke N; Troost, Freddy J; de Groot, Eric; Stevens, Yala R; Garcés-Rimón, Marta; Possemiers, Sam; Winkens, Bjorn; Masclee, Ad A

    2016-12-01

    Endothelial dysfunction (ED) is involved in the development of atherosclerosis. Hesperidin, a citrus flavonoid with antioxidant and other biological properties, potentially exerts beneficial effects on endothelial function (EF). We investigated the effect of hesperidin 2S supplementation on EF in overweight individuals. This was a randomized, double-blind, placebo-controlled study in which 68 individuals were randomly assigned to receive hesperidin 2S (450 mg/d) or a placebo for 6 wk. At baseline and after 6 wk of intervention, flow-mediated dilation (FMD), soluble vascular adhesion molecule-1 (sVCAM-1), soluble intracellular adhesion molecule-1 (sICAM-1), soluble P-selectin (sP-selectin), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed. Acute, reversible ED was induced by intake of a high-fat meal (HFM). A second FMD scan was performed 2 h postprandially, and adhesion molecules were assessed 2 and 4 h postprandially. An additional exploratory analysis was performed in subjects with baseline FMD ≥3%. No significant change in fasting or postprandial FMD was observed after 6 wk of hesperidin intake compared with placebo intake. However, there was a trend for a reduction of sVCAM-1, sICAM-1, sP-selectin, SBP, and DBP after 6 wk of hesperidin treatment. In the FMD ≥3% group, hesperidin protected individuals from postprandial ED (P = 0.050) and significantly downregulated sVCAM-1 and sICAM-1 (all P ≤ 0.030). The results reported in the current article were not adjusted for multiplicity. Six weeks of consumption of hesperidin 2S did not improve basal or postprandial FMD in our total study population. There was a tendency toward a reduction of adhesion molecules and a decrease in SBP and DBP. Further exploratory analyses revealed that, in subjects with baseline FMD ≥3%, hesperidin 2S improved ED after an HFM and reduced adhesion molecules. These results indicate the cardiovascular health benefits of hesperidin 2S in overweight and

  4. Avaliação do filme lacrimal de pacientes com distonia facial durante tratamento com toxina botulínica tipo A Lacrimal film evaluation of patients with facial dystonia during botulinum toxin type A treatment

    Patricia Grativol Costa

    2006-06-01

    Full Text Available OBJETIVO: Determinar o efeito da toxina botulínica no filme lacrimal em pacientes com distonia facial. MÉTODOS: Foram incluídos 24 pacientes portadores de blefaroespasmo essencial e espasmo hemifacial que receberam aplicação de toxina botulínica tipo A que foram submetidos à propedêutica do filme lacrimal previamente à aplicação e após, com 7 e 30 dias. RESULTADOS: Houve diminuição das queixas de olho seco trinta dias após a aplicação, entretanto, o tempo de ruptura do filme lacrimal e o teste de Schirmer não demonstraram variação significativa entre os períodos pré-tratamento e 1 mês da aplicação. Em relação ao teste de coloração com rosa bengala, todos os olhos que coraram no pré-tratamento, melhoraram na última avaliação. CONCLUSÃO: A injeção de toxina botulínica pode aliviar as queixas de olho seco nos pacientes com distonia facial pela provável ação de inibição do orbicular na sua função de bomba lacrimal.PURPOSE: To determine the effect of botulinum toxin injection in the eyelid on lacrimal film in patients with facial dystonia. METHODS: Twenty-four patients with essential blepharospasm and hemifacial spasm were submitted to botulinum toxin injection and lacrimal film tests were performed before the application and after seven and thirty days. RESULTS: There was improvement in symptoms of dry eye and rose bengal test, however, the breakup time and Schirmer's test did not show significant variation between pretreatment and after 1 month of follow-up. CONCLUSION: The dry eye symptoms in patients with facial dystonia may be attenuated by botulinum toxin due to its possible inhibitory effect on the orbicular muscle leading to a decrease in lacrimal pump.

  5. Osteogénesis por distracción esquelética maxilomandibular: Análisis de esta novedosa terapéutica OSTEOGENESIS BY MAXILLOMANDIBULAR SKELETAL DISTRACTION: ANALYSIS OF THIS NOVEL THERAPEUTICS

    Dadonim Vila Morales

    2005-04-01

    Full Text Available El proceso de generación de nuevo hueso por estiramiento del callo óseo se denomina osteogénesis por distracción. Este proceso se aplica también a los huesos del macizo craneofacial, y en especial a la mandíbula, para tratar defectos mandibulares que aparecen en diferentes síndromes, como el Treacher Collins, microsomía hemifacial, Pierre Robins, apnea obstructiva del sueño y otras deformidades secundarias a anquilosis de la articulación temporomandibular y traumas. Se realizó una revisión bibliográfica del tema. Nuestro estudio de 45 series publicadas arrojó que el tipo de distractor más usado es el extraoral, que el hueso más tratado es la mandíbula, que solo el 4,4 % de los autores realizan estudios cefalométricos para la evaluación de los resultados y que las complicaciones más frecuentes son la avulsión parcial de los pines, dolor en la ATM y limitación de la apertura bucal.The process of generation of a new bone by lengthening the osteal callus is called osteogenesis by distraction. This process is also applied to bones of the craniofacial skeleton and, specially, to the mandible to treat mandibular defects appearing in different syndromes, such as Treacher Collins, hemifacial microsomy, Pierre Robins, obstructive sleeping apnea, and other deformities secondary to ankylosis of the temporomandibular joint and traumas. A bibliographic review of the topic was made. Our study of 45 series published showed that the extraoral was the most used type of distractor, that the mandible was the most treated bone, that only 4.4 % of the authors conduct cephalometric studies to evaluate the results, and that partial avulsion of the pins, pain in the TMA and limitation to open the mouth were the most frequent complications.

  6. Síndrome de Parry-Romberg: Visión de su tratamiento Parry-Romberg's syndrome: View of its treatment

    María Elena González Espíndola

    2005-08-01

    Full Text Available El síndrome de Parry-Romberg o atrofia hemifacial progresiva, enfermedad de Romberg o también denominada trofoneurosis facial, fue descrito por Parry en 1925 y por Romberg en 1946. Se considera una malformación craneofacial poco frecuente en la práctica diaria y en edades tempranas, ya que es una enfermedad progresiva que suele empezar en la adolescencia. Se caracteriza por presentar la atrofia del tejido graso (celular subcutáneo, piel, músculos faciales y en algunos casos pueden estar afectados también los huesos y cartílagos de un lado de la cara; su evolución dura de 2 a 12 años, pero puede detenerse en cualquier momento. Su diagnóstico temprano, así como un adecuado plan de tratamiento, resultan importantes y se deben ejecutar por un equipo multidisciplinario para lograr un buen desarrollo funcional y psicológico, así como el establecimiento de una buena relación de oclusión que mejore la armonía facial, que eleve la calidad de vida de estos pacientes. El objetivo del presente trabajo es mostrar un caso que ha sido tratado por el equipo multidisciplinario de Cirugía Maxilofacial del Hospital Pediátrico de Centro Habana.Parry-Romberg's syndrome or progressive hemifacial atrophy, Romberg's disease, or facial trophoneurosis as it is also called, was described by Parry in 1925 and by Romberg in 1926. It is considered an uncommon craniofacial malformation in the daily practice and at early ages, since it is a progressive disease that usually appears in adolescence. It is characterized by the atrophy of the fatty tissue (cellular subcutaneous, skin, facial muscles and in some cases the bones and cartilages of a side of the face may be affected. Its evolution lasts from 2 to 12 years, but it may stop at any time. Its early diagnosis, as well as an adequate treatment plan are important and they should be made by a multidisciplinary team to achieve a good functional and psychological development and the establishment of a good

  7. Quality of life differences in patients with right- versus left-sided facial paralysis: Universal preference of right-sided human face recognition.

    Ryu, Nam Gyu; Lim, Byung Woo; Cho, Jae Keun; Kim, Jin

    2016-09-01

    We investigated whether experiencing right- or left-sided facial paralysis would affect an individual's ability to recognize one side of the human face using hybrid hemi-facial photos by preliminary study. Further investigation looked at the relationship between facial recognition ability, stress, and quality of life. To investigate predominance of one side of the human face for face recognition, 100 normal participants (right-handed: n = 97, left-handed: n = 3, right brain dominance: n = 56, left brain dominance: n = 44) answered a questionnaire that included hybrid hemi-facial photos developed to determine decide superiority of one side for human face recognition. To determine differences of stress level and quality of life between individuals experiencing right- and left-sided facial paralysis, 100 patients (right side:50, left side:50, not including traumatic facial nerve paralysis) answered a questionnaire about facial disability index test and quality of life (SF-36 Korean version). Regardless of handedness or hemispheric dominance, the proportion of predominance of the right side in human face recognition was larger than the left side (71% versus 12%, neutral: 17%). Facial distress index of the patients with right-sided facial paralysis was lower than that of left-sided patients (68.8 ± 9.42 versus 76.4 ± 8.28), and the SF-36 scores of right-sided patients were lower than left-sided patients (119.07 ± 15.24 versus 123.25 ± 16.48, total score: 166). Universal preference for the right side in human face recognition showed worse psychological mood and social interaction in patients with right-side facial paralysis than left-sided paralysis. This information is helpful to clinicians in that psychological and social factors should be considered when treating patients with facial-paralysis. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. High productivity mould robotic milling in Al-5083

    Urresti, Iker; Arrazola, Pedro Jose; Ørskov, Klaus Bonde; Pelegay, Jose Angel

    2018-05-01

    Industrial serial robots were usually limited to welding, handling or spray painting operations until very recent years. However, some industries have already realized about their important capabilities in terms of flexibility, working space, adaptability and cost. Hence, currently they are seriously being considered to carry out certain metal machining tasks. Therefore, robot based machining is presented as a cost-saving and flexible manufacturing alternative compared to conventional CNC machines especially for roughing or even pre-roughing of large parts. Nevertheless, there are still some drawbacks usually referred as low rigidity, accuracy and repeatability. Thus, the process productivity is usually sacrificed getting low Material Removal Rates (MRR), and consequently not being competitive. Nevertheless, in this paper different techniques to obtain increased productivity are presented, though an appropriate selection of cutting strategies and parameters that are essential for it. During this research some rough milling tests in Al-5083 are presented where High Feed Milling (HFM) is implemented as productive cutting strategy and the experimental modal analysis named Tap-testing is used for the suitable choice of cutting conditions. Competitive productivity rates are experienced while process stability is checked through the cutting forces measurements in order to prove the effectiveness of the experimental modal analysis for robotic machining.

  9. Surface monofunctionalized polymethyl pentene hollow fiber membranes by plasma treatment and hemocompatibility modification for membrane oxygenators

    Huang, Xin; Wang, Weiping; Zheng, Zhi; Fan, Wenling; Mao, Chun; Shi, Jialiang; Li, Lei

    2016-01-01

    The hemocompatibility of polymethyl pentene (PMP) hollow fiber membranes (HFMs) was improved through surface modification for membrane oxygenator applications. The modification was performed stepwise with the following: (1) oxygen plasma treatment, (2) functionalization of monosort hydroxyl groups through NaBH4 reduction, and (3) grafting 2-methacryloyloxyethyl phosphorylcholine (MPC) or heparin. SEM, ATR-FTIR, and XPS analyses were conducted to confirm successful grafting during the modification. The hemocompatibility of PMP HFMs was analyzed and compared through protein adsorption, platelet adhesion, and coagulation tests. Pure CO2 and O2 permeation rates, as well as in vitro gas exchange rates, were determined to evaluate the mass transfer properties of PMP HFMs. SEM results showed that different nanofibril topographies were introduced on the HFM surface. ATR-FTIR and XPS spectra indicated the presence of functionalization of monosort hydroxyl group and the grafting of MPC and heparin. Hemocompatibility evaluation results showed that the modified PMP HFMs presented optimal hemocompatibility compared with pristine HFMs. Gas permeation results revealed that gas permeation flux increased in the modified HFMs because of dense surface etching during the plasma treatment. The results of in vitro gas exchange rates showed that all modified PMP HFMs presented decreased gas exchange rates because of potential surface fluid wetting. The proposed strategy exhibits a potential for fabricating membrane oxygenators for biomedical applications to prevent coagulation formation and alter plasma-induced surface topology and composition.

  10. Hereditary folate malabsorption: A positively charged amino acid at position 113 of the proton-coupled folate transporter (PCFT/SLC46A1) is required for folic acid binding

    Lasry, Inbal; Berman, Bluma; Glaser, Fabian; Jansen, Gerrit; Assaraf, Yehuda G.

    2009-01-01

    The proton-coupled folate transporter (PCFT/SLC46A1) mediates intestinal folate uptake at acidic pH. Some loss of folic acid (FA) transport mutations in PCFT from hereditary folate malabsorption (HFM) patients cluster in R113, thereby suggesting a functional role for this residue. Herein, unlike non-conservative substitutions, an R113H mutant displayed 80-fold increase in the FA transport Km while retaining parental Vmax, hence indicating a major fall in folate substrate affinity. Furthermore, consistent with the preservation of 9% of parental transport activity, R113H transfectants displayed a substantial decrease in the FA growth requirement relative to mock transfectants. Homology modeling based on the crystal structures of the Escherichia coli transporter homologues EmrD and glycerol-3-phosphate transporter revealed that the R113H rotamer properly protrudes into the cytoplasmic face of the minor cleft normally occupied by R113. These findings constitute the first demonstration that a basic amino acid at position 113 is required for folate substrate binding.

  11. A bioartificial kidney device with polarized secretion of immune modulators.

    Chevtchik, N V; Mihajlovic, M; Fedecostante, M; Bolhuis-Versteeg, L; Sastre Toraño, J; Masereeuw, R; Stamatialis, D

    2018-05-15

    The accumulation of protein-bound toxins in dialyzed patients is strongly associated with their high morbidity and mortality. The bioartificial kidney device (BAK), containing proximal tubule epithelial cells (PTEC) seeded on functionalized synthetic hollow fiber membranes (HFM), may be a powerful solution for the active removal of those metabolites. In an earlier study, we developed an upscaled BAK containing conditionally immortalized human PTEC (ciPTEC) with functional organic cationic transporter 2 (OCT2). Here, we first extended this development to a BAK device having cells with the organic anionic transporter 1 (OAT1), capable of removing anionic uremic wastes. We confirmed the quality of the ciPTEC monolayer by confocal microscopy and paracellular inulin-FITC leakage, as well as, by the active transport of anionic toxin, indoxyl sulfate (IS). Furthermore, we assessed the immune-safety of our system by measuring the production of relevant cytokines by the cells after lipopolysaccharide (LPS) stimulation. Upon LPS treatment, we observed a polarized secretion of pro-inflammatory cytokines by the cells: 10-fold higher in the extraluminal space, corresponding to the urine compartment, as compared to the intraluminal space, corresponding to the blood compartment. To the best of our knowledge, our work is the first to show this favorable cell polarization in a BAK upscaled device. This article is protected by copyright. All rights reserved.

  12. Bubble coalescence suppression driven carbon monoxide (CO)-water mass transfer increase by electrolyte addition in a hollow fiber membrane bioreactor (HFMBR) for microbial CO conversion to ethanol.

    Jang, Nulee; Yasin, Muhammad; Kang, Hyunsoo; Lee, Yeubin; Park, Gwon Woo; Park, Shinyoung; Chang, In Seop

    2018-05-04

    This study investigated the effects of electrolytes (CaCl 2 , K 2 HPO 4 , MgSO 4 , NaCl, and NH 4 Cl) on CO mass transfer and ethanol production in a HFMBR. The hollow fiber membranes (HFM) were found to generate tiny gas bubbles; the bubble coalescence was significantly suppressed in electrolyte solution. The volumetric gas-liquid mass transfer coefficients (k L a) increased up to 414% compared to the control. Saturated CO (C ∗ ) decreased as electrolyte concentrations increased. Overall, the maximum mass transfer rate (R max ) in electrolyte solution ranged from 106% to 339% of the value obtained in water. The electrolyte toxicity on cell growth was tested using Clostridium autoethanogenum. Most electrolytes, except for MgSO 4 , inhibited cell growth. The HFMBR operation using a medium containing 1% MgSO 4 achieved 119% ethanol production compared to that without electrolytes. Finally, a kinetic simulation using the parameters got from the 1% MgSO 4 medium predicted a higher ethanol production compared to the control. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Role of Vitamin D in Maintaining Renal Epithelial Barrier Function in Uremic Conditions

    Milos Mihajlovic

    2017-11-01

    Full Text Available As current kidney replacement therapies are not efficient enough for end-stage renal disease (ESRD treatment, a bioartificial kidney (BAK device, based on conditionally immortalized human proximal tubule epithelial cells (ciPTEC, could represent an attractive solution. The active transport activity of such a system was recently demonstrated. In addition, endocrine functions of the cells, such as vitamin D activation, are relevant. The organic anion transporter 1 (OAT-1 overexpressing ciPTEC line presented 1α-hydroxylase (CYP27B1, 24-hydroxylase (CYP24A1 and vitamin D receptor (VDR, responsible for vitamin D activation, degradation and function, respectively. The ability to produce and secrete 1α,25-dihydroxy-vitamin D3, was shown after incubation with the precursor, 25-hydroxy-vitamin D3. The beneficial effect of vitamin D on cell function and behavior in uremic conditions was studied in the presence of an anionic uremic toxins mixture. Vitamin D could restore cell viability, and inflammatory and oxidative status, as shown by cell metabolic activity, interleukin-6 (IL-6 levels and reactive oxygen species (ROS production, respectively. Finally, vitamin D restored transepithelial barrier function, as evidenced by decreased inulin-FITC leakage in biofunctionalized hollow fiber membranes (HFM carrying ciPTEC-OAT1. In conclusion, the protective effects of vitamin D in uremic conditions and proven ciPTEC-OAT1 endocrine function encourage the use of these cells for BAK application.

  14. Synergistic effect of obesity and lipid ingestion in suppressing the growth hormone response to exercise in children.

    Oliver, Stacy R; Hingorani, Sunita R; Rosa, Jaime S; Zaldivar, Frank P; Galassetti, Pietro R

    2012-07-01

    Diet plays an important role in modulating exercise responses, including activation of the growth hormone (GH)/insulin-like growth factor-I (IGF-1) axis. Obesity and fat ingestion were separately shown to reduce exercise GH responses, but their combined effect, especially important in children, has not been studied. We therefore measured the GH response to exercise [30-min intermittent cycling, ten 2-min bouts at ~80% maximal aerobic capacity (Vo(2max)), separated by 1-min rest], started 45 min after ingestion of a high-fat meal (HFM) in 16 healthy [controls; body mass index percentile (BMI%ile) 51 ± 7], and 19 obese (Ob, BMI%ile 97 ± 0.4) children. Samples were drawn at baseline (premeal), and at start, peak, and 30 min postexercise. In the Ob group, a marked ~75% suppression of the GH response (ng/ml) to exercise was observed (2.4 ± 0.6 vs. 10.6 ± 2.1, P fasting conditions. Our data indicate that the reduction in the GH response to exercise, already present in obese children vs. healthy controls, is considerably amplified by ingestion of fat nutrients shortly before exercise, implying a potentially downstream negative impact on growth factor homeostasis and long-term modulation of physiological growth.

  15. In vivo evaluation of the biocompatibility of surface modified hemodialysis polysulfone hollow fibers in rat.

    Ganpat J Dahe

    Full Text Available Polysulfone (Psf hollow fiber membranes (HFMs have been widely used in blood purification but their biocompatibility remains a concern. To enhance their biocompatibility, Psf/TPGS (d-α-tocopheryl polyethylene glycol 1000 succinate composite HFMs and 2-methacryloyloxyethyl phosphorylcholine (MPC coated Psf HFMs have been prepared. They have been evaluated for in vivo biocompatibility and graft acceptance and compared with sham and commercial membranes by intra-peritoneal implantation in rats at day 7 and 21. Normal body weights, tissue formation and angiogenesis indicate acceptance of implants by the animals. Hematological observations show presence of post-surgical stress which subsides over time. Serum biochemistry results reveal normal organ function and elevated liver ALP levels at day 21. Histological studies exhibit fibroblast recruitment cells, angiogenesis and collagen deposition at the implant surface indicating new tissue formation. Immuno-histochemistry studies show non-activation of MHC molecules signifying biocompatibilty. Additionally, Psf/TPGS exhibit most favorable tissue response as compared with other HFMs making them the material of choice for HFM preparation for hemodialysis applications.

  16. Magnon energy renormalization and low-temperature thermodynamics of O(3) Heisenberg ferromagnets

    Radošević, Slobodan M.; Pantić, Milan R.; Pavkov-Hrvojević, Milica V.; Kapor, Darko V.

    2013-01-01

    We present the perturbation theory for lattice magnon fields of the D-dimensional O(3) Heisenberg ferromagnet. The effective Hamiltonian for the lattice magnon fields is obtained starting from the effective Lagrangian, with two dominant contributions that describe magnon–magnon interactions identified as a usual gradient term for the unit vector field and a part originating in the Wess–Zumino–Witten term of the effective Lagrangian. Feynman diagrams for lattice scalar fields with derivative couplings are introduced, on the basis of which we investigate the influence of magnon–magnon interactions on magnon self-energy and ferromagnet free energy. We also comment appearance of spurious terms in low-temperature series for the free energy by examining magnon–magnon interactions and internal symmetry of the effective Hamiltonian (Lagrangian). -- Highlights: •Lattice magnon Hamiltonian constructed from the effective Lagrangian. •New Feynman diagrams with colored propagators and vertices for lattice scalar fields. •Influence of magnon–magnon interactions from the WZW term on magnon energies and free energy of O(3) HFM

  17. Human-Autonomy Teaming in a Flight Following Task

    Shively, Robert J.

    2017-01-01

    The NATO HFM-247 Working Group is creating a summary report of the group's activities on human-autonomy teaming. This chapter is a summary of our at NASA Ames work toward developing a framework for human-autonomy teaming (HAT) in aviation. The purpose of this project was to demonstrate and evaluate proposed tenets of HAT. The HAT features were derived from three tenets and were built into an automated recommender system on a ground station. These tenets include bi-directional communication, automation transparency, and operator directed interface. This study focused primarily on interactions with one piece of automation, the Autonomous Constrained Flight Planner (ACFP). The ACFP is designed to support rapid diversion decisions for commercial pilots in off-nominal situations. Much effort has gone into enhancing this tool not only in capability but also in transparency. In this study, participants used the ACFP at a ground station designed to aid dispatchers in a flight following role to reroute aircraft in situations such as inclement weather, system failures and medical emergencies. Participants performed this task both with HAT features enabled and without and provided feedback. We examined subjective and behavioral indicators of HAT collaborations using a proof-of-concept demonstration of HAT tenets. The data collected suggest potential advantages and disadvantages of HAT.

  18. Magnetic Design and Code Benchmarking of the SMC (Short Model Coil) Dipole Magnet

    Manil, P; Rochford, J; Fessia, P; Canfer, S; Baynham, E; Nunio, F; de Rijk, G; Védrine, P

    2010-01-01

    The Short Model Coil (SMC) working group was set in February 2007 to complement the Next European Dipole (NED) program, in order to develop a short-scale model of a Nb$_{3}$Sn dipole magnet. In 2009, the EuCARD/HFM (High Field Magnets) program took over these programs. The SMC group comprises four laboratories: CERN/TE-MSC group (CH), CEA/IRFU (FR), RAL (UK) and LBNL (US). The SMC magnet is designed to reach a peak field of about 13 Tesla (T) on conductor, using a 2500 A/mm2 Powder-In-Tube (PIT) strand. The aim of this magnet device is to study the degradation of the magnetic properties of the Nb$_{3}$Sn cable, by applying different levels of pre-stress. To fully satisfy this purpose, a versatile and easy-to-assemble structure has been realized. The design of the SMC magnet has been developed from an existing dipole magnet, the SD01, designed, built and tested at LBNL with support from CEA. The goal of the magnetic design presented in this paper is to match the high field region with the high stress region, l...

  19. A novel anaerobic electrochemical membrane bioreactor (AnEMBR) with conductive hollow-fiber membrane for treatment of low-organic strength solutions

    Katuri, Krishna; Werner, Craig M.; Jimenez Sandoval, Rodrigo J.; Chen, Wei; Jeon, Sungil; Logan, Bruce E.; Lai, Zhiping; Amy, Gary L.; Saikaly, Pascal

    2014-01-01

    A new anaerobic treatment system that combined a microbial electrolysis cell (MEC) with membrane filtration using electrically conductive, porous, nickel-based hollow-fiber membranes (Ni-HFMs) was developed to treat low organic strength solution and recover energy in the form of biogas. This new system is called an anaerobic electrochemical membrane bioreactor (AnEMBR). The Ni-HFM served the dual function as the cathode for hydrogen evolution reaction (HER) and the membrane for filtration of the effluent. The AnEMBR system was operated for 70 days with synthetic acetate solution having a chemical oxygen demand (COD) of 320 mg/L. Removal of COD was >95% at all applied voltages tested. Up to 71% of the substrate energy was recovered at an applied voltage of 0.7 V as methane rich biogas (83% CH4; < 1% H2) due to biological conversion of the hydrogen evolved at the cathode to methane. A combination of factors (hydrogen bubble formation, low cathode potential and localized high pH at the cathode surface) contributed to reduced membrane fouling in the AnEMBR compared to the control reactor (open circuit voltage). The net energy required to operate the AnEMBR system at an applied voltage of 0.7 V was significantly less (0.27 kWh/m3) than that typically needed for wastewater treatment using aerobic membrane bioreactors (1-2 kWh/m3).

  20. HTS Insert Magnet Design Study

    Devaux, M; Fleiter, J; Fazilleau, P; Lécrevisse, T; Pes, C; Rey, J-M; Rifflet, J-M; Sorbi, M; Stenvall, A; Tixador, P; Volpini, G

    2011-01-01

    Future accelerator magnets will need to reach higher field in the range of 20 T. This field level is very difficult to reach using only Low Temperature Superconductor materials whereas High Temperature Superconductors (HTS) provide interesting opportunities. High current densities and stress levels are needed to design such magnets. YBCO superconductor indeed carries large current densities under high magnetic field and provides good mechanical properties especially when produced using the IBAD approach. The HFM EUCARD program studies the design and the realization of an HTS insert of 6 T inside a Nb$_{3}$Sn dipole of 13T at 4.2 K. In the2HTS insert, engineering current densities higher than 250 MA/m under 19 T are required to fulfill the specifications. The stress level is also very severe. YBCO IBAD tapes theoretically meet these challenges from presented measurements. The insert protection is also a critical because HTS materials show low quench propagation velocities and the coupling with the Nb$_{3}$Sn m...

  1. Fabrication of Functionalized MOFs Incorporated Mixed Matrix Hollow Fiber Membrane for Gas Separation

    Haitao Zhu

    2017-01-01

    Full Text Available The metal-organic framework (MOFs of MIL-53 was functionalized by aminosilane grafting and then incorporated into Ultem®1000 polymer matrix to fabricate mixed matrix hollow fiber membrane (MMHFM with high separation performance. SEM, XRD, and TGA were performed to characterize the functionalized MIL-53 and prepared MMHFM. The filler particles were embedded in membrane successfully and dispersed well in the polymer matrix. The incorporation of MOFs endowed MMHFM better thermal stability. Moreover, effects of solvent ratio in spinning dope, spinning condition, and testing temperature on gas separation performance of MMHFM were investigated. By optimizing dope composition, air gap distance, and bore fluid composition, MMHFM containing functionalized MIL-53 achieved excellent gas permeance and CO2/N2 selectivity. The CO2 permeance increased from 12.2 GPU for pure Ultem HFM to 30.9 GPU and the ideal CO2/N2 selectivity was enhanced from 25.4 to 34.7 simultaneously. Additionally, gas permeance increased but the selectivity decreased with the temperature increase, which followed the solution-diffusion based transport mechanism.

  2. A novel anaerobic electrochemical membrane bioreactor (AnEMBR) with conductive hollow-fiber membrane for treatment of low-organic strength solutions

    Katuri, Krishna

    2014-11-04

    A new anaerobic treatment system that combined a microbial electrolysis cell (MEC) with membrane filtration using electrically conductive, porous, nickel-based hollow-fiber membranes (Ni-HFMs) was developed to treat low organic strength solution and recover energy in the form of biogas. This new system is called an anaerobic electrochemical membrane bioreactor (AnEMBR). The Ni-HFM served the dual function as the cathode for hydrogen evolution reaction (HER) and the membrane for filtration of the effluent. The AnEMBR system was operated for 70 days with synthetic acetate solution having a chemical oxygen demand (COD) of 320 mg/L. Removal of COD was >95% at all applied voltages tested. Up to 71% of the substrate energy was recovered at an applied voltage of 0.7 V as methane rich biogas (83% CH4; < 1% H2) due to biological conversion of the hydrogen evolved at the cathode to methane. A combination of factors (hydrogen bubble formation, low cathode potential and localized high pH at the cathode surface) contributed to reduced membrane fouling in the AnEMBR compared to the control reactor (open circuit voltage). The net energy required to operate the AnEMBR system at an applied voltage of 0.7 V was significantly less (0.27 kWh/m3) than that typically needed for wastewater treatment using aerobic membrane bioreactors (1-2 kWh/m3).

  3. CLINICAL APPLICATION OF BOTULINUM TOXIN TYPE B IN MOVEMENT DISORDERS AND AUTONOMIC SYMPTOMS

    Xin-hua Wan; Kevin Dat Vuong; Joseph Jankovic

    2005-01-01

    Objective To evaluate efficacy and safety of botulinum toxin type B (BTX-B) in treatment of movement disorders including blepharospasm, oromandibular dystonia, hemifacial spasm, tremor, tics, and hypersecretory disorders such as sialorrhea and hyperhidrosis.Methods A retrospective study of BTX-B injections in treatment of 58 patients with various neurological disorders was performed. The mean follow-up time was 0.9 ± 0.8 years. Results of the first and last treatment of patients with at least 3injection sessions were compared.Results The response of 58 patients to a total of 157 BTX-B treatment sessions was analyzed. Of the 157 treatment sessions, 120 sessions (76.4%) resulted in moderate or marked improvement while 17 sessions (10.8%) had no response.The clinical benefits after BTX-B treatment lasted an average of 14 weeks. Of the 41 patients with at least 3 injection sessions (mean 10 ± 8.6), most patients needed increased dosage upon the last session compared to the first session. Nineteen patients (32.8%) with 27 sessions (17.2%) reported adverse effects with BTX-B treatment.Conclusios Though most patients require increased dosage to maintain effective response after repeated injections,BTX-B is an effective and safe treatment drug for a variety of movement disorders, as well as drooling and hyperhidrosis.

  4. Parry-Romberg syndrome in a pediatric patient. A case report.

    Edgar Reyes

    2015-07-01

    Full Text Available The Parry-Romberg syndrome is a rare degenerative disease of unknown etiology that has dental implications. It is characterized by a progressive hemifacial atrophy that appears in the early stages of life. It causes aesthetic, functional and psychological alterations, and has social implications for the patient. There is no definitive treatment for the Parry-Romberg syndrome. Systemic and immune alterations produce oral and maxillofacial manifestations, which need to be managed by specialized dental professionals. The aim of this paper is to do a literature review of the Parry-Romberg syndrome and describe the oral and clinical characteristics of this condition in a 12-year-old male pediatric patient, who had a history of neurological disorders and facial asymmetry on the left side. Dentists require an adequate knowledge of the clinical and dental characteristics of this syndrome. With early diagnosis and appropriate surgical and orthodontic treatment at an early age, they can improve the quality of life of patients and minimize invasive long-term effects.

  5. Floor of the nose mucosa lysis and labial abscess caused by a bee sting.

    Alemán Navas, Ramón Manuel; Martínez Mendoza, María Guadalupe; Herrera, Henry; Herrera, Helen Piccolo de

    2009-01-01

    Hymenoptera order includes bees, which have a stinging apparatus at the tail capable of delivering venom to the affected tissues. Myocardial infarction, acute renal failure, Necrotizing fasciitis, fatal infection and hemifacial asymmetry, are some of the unusual reactions reported following hymenoptera stings. This paper reports a case of bee sting in the right floor of the nose that mimicked an odontogenic infection affecting the upper lip, canine space and nasal cavity such as in cases of infection secondary to pulpal or periodontal pathology of the anterior teeth. After a thorough clinical and radiographic examination, odontogenic infection was discarded and the diagnosis of floor of the nose mucosal lysis and lip abscess secondary to a bee sting was made. This case was successfully managed with adequate incision, drainage and antibiotics without any further complication. There are several reports of unusual reactions following hymenoptera stings. However, just a few of them referred to infections of local reactions and none of them related to the anatomic location affected in the patient of the present case. Early diagnosis and treatment prevented infection dissemination and the likelihood of tissue necrosis as in previously reported cases of Necrotizing fasciitis.

  6. Virtual endoscopic images by 3D FASE cisternography for neurovascular compression

    Ishimori, Takashi; Nakano, Satoru; Kagawa, Masahiro

    2003-01-01

    Three-dimensional fast asymmetric spin echo (3D FASE) cisternography provides high spatial resolution and excellent contrast as a water image acquisition technique. It is also useful for the evaluation of various anatomical regions. This study investigated the usefulness and limitations of virtual endoscopic images obtained by 3D FASE MR cisternography in the preoperative evaluation of patients with neurovascular compression. The study included 12 patients with neurovascular compression: 10 with hemifacial spasm and two with trigeminal neuralgia. The diagnosis was surgically confirmed in all patients. The virtual endoscopic images obtained were judged to be of acceptable quality for interpretation in all cases. The areas of compression identified in preoperative diagnosis with virtual endoscopic images showed good agreement with those observed from surgery, except in one case in which the common trunk of the anterior inferior cerebellar artery and posterior inferior cerebellar artery (AICA-PICA) bifurcated near the root exit zone of the facial nerve. The veins are displayed in some cases but not in others. The main advantage of generating virtual endoscopic images is that such images can be used for surgical simulation, allowing the neurosurgeon to perform surgical procedures with greater confidence. (author)

  7. Single Neurosurgeon Operative Experience at Craig Joint Theater Hospital During the Afghanistan Surge (November 2010 to April 2011), Part II: Humanitarian Cases.

    Steele, John Joseph

    2017-01-01

    The Afghanistan Surge saw NATO troops working with their Afghan partners to remove Taliban governance and replace it with a more democratic model. As part of this endeavor, medical support for both trauma and humanitarian cases was needed. Identify and discuss disease trends to better prepare for future combat medical treatments. Retrospective review of operative experience from a neurosurgeon from November 2010 to April 2011. 63 cases were performed on 20 NATO and 43 Afghan patients. Combat-related neurotrauma represented 73% (46/63) of cases and humanitarian cases represented the remainder. The most common diseases among humanitarian cases were benign tumors (29%, 5/17), cranioplasty (23%, 4/17), obstructive hydrocephalus (11%, 2/17), nonobstructive hydrocephalus (11%, 2/17), hemifacial spasm (11%, 2/17), and cerebral angiography (11%, 2/17). There was 1 death from ventriculitis for a complication rate of 6%. In select well-nourished, patients with minimal risk of needing tracheostomy, humanitarian neurosurgery can be safely performed in theater with a complication rate (6%) no worse than patients operated on in the United States. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  8. Avaliação da fenda palpebral após aplicação de toxina botulínica tipo A em pacientes com distonias faciais

    Mariana Eleonora Pereira Cunial

    2012-12-01

    Full Text Available OBJETIVO: Avaliar a medida da fenda palpebral em pacientes com blefaroespasmo essencial benigno (BEB e espasmo hemifacial (EHF após a aplicação periocular de toxina botulínica tipo A. MÉTODOS: Foram estudados pacientes portadores de BEB e EHF submetidos à injeção periocular de toxina botulínica tipo A pela técnica inner orbital de aplicação. Os pacientes foram fotografados em PPO antes da aplicação e catorze dias depois dela. A fenda palpebral foi mensurada nestas imagens por meio de processamento computadorizado de imagens, utilizando o programa ImageJ. As alterações da fenda palpebral foram observadas comparando-se as medidas obtidas no pré e pós-aplicação. RESULTADOS: Comparando-se as imagens obtidas com o programa ImageJ, houve aumento estatisticamente significante (p<0,001 da fenda palpebral em 14 olhos (51,8% após a aplicação de injeção periocular da toxina botulínica e nenhuma das imagens analisadas apresentou diminuição da fenda palpebral. CONCLUSÃO: No presente estudo, os pacientes portadores de distonias faciais apresentaram aumento de fenda palpebral estatisticamente significante após aplicação periocular de toxina botulínica tipo A.

  9. Hemilingual spasm: defining a new entity, its electrophysiological correlates and surgical treatment through microvascular decompression.

    Osburn, Leisha L; Møller, Aage R; Bhatt, Jay R; Cohen-Gadol, Aaron A

    2010-07-01

    We report on vascular compression syndrome of the 12th cranial nerve (hypoglossal), an occurrence not previously reported, and demonstrate, through corresponding objective electrophysiological evidence, that microvascular decompression of the hypoglossal nerve root can cure hemilingual spasm. A 52-year-old man had lower face muscle twitching and tongue spasms, which worsened with talking, chewing, or emotional stress. Carbamazepine offered only temporary relief, and relief from injections of botulinum toxin was insignificant. He was referred for surgical treatment. High-resolution magnetic resonance imaging of his posterior fossa contents revealed no obvious evidence of any compressive vessel along the facial nerve, but a compressive vessel along the hypoglossal nerve was apparent. The presence of preoperative tongue spasms encouraged interoperative monitoring of tongue motor responses. The facial nerve exit zone was explored, but microsurgical inspection of the seventh/eighth cranial nerve complex did not reveal any compressive vessel. However, at the anterolateral aspect of the medulla oblongata, the hypoglossal nerve was clearly compressed and distorted laterally by a large tortuous vertebral artery. When the artery was mobilized away from the nerve, the abnormal late electromyographic response to transcranial electrical stimulation disappeared; immediately after shredded Teflon was interpositioned between the artery and the nerve, the abnormal spontaneous tongue fasciculation also disappeared. The patient has remained spasm free 6 months after surgery. Hemilingual spasm may be caused by vascular contact/compression along cranial nerve XII at the lower brainstem and belong to the same family of cranial nerve hyperactivity disorders as hemifacial spasm.

  10. Virtual MRI endoscopy of the intracranial cerebrospinal fluid spaces

    Shigematsu, Y.; Korogi, Y.; Hirai, T.; Okuda, T.; Ikushima, I.; Sugahara, T.; Liang, L.; Ge, Y.; Takahashi, M.

    1998-01-01

    We used constructive interference in steady state (CISS) 3D Fourier transform (3DFT) MRI data sets to obtain three-dimensional (3D) virtual MRI endoscopic views of the intracranial cerebrospinal fluid (CSF) spaces, processing them with a commercially available perspective endoscopic algorithm. We investigated the potential of the intracranial virtual MRI endoscopy applied to visualisation of the pathology in 13 patients with surgically confirmed trigeminal neuralgia (3), hemifacial spasm (3), acoustic neuroma (3), suprasellar germinoma (1), Langerhans cell histiocytosis (1), lateral ventricle nodules (1) and pituitary dwarfism (1). All images were acquired using a 1.5-T imager employing a circular polarised head coil. The CISS-3DFT data sets were transferred to a workstation for processing with the perspective endoscopic algorithm. Postprocessing for virtual MRI endoscopy was possible for all data sets. The lesions in 12 patients, and their complex anatomical relationships with the surrounding structures, were well seen on the 3D images. A small acoustic neuroma in the internal auditory meatus was not seen using virtual endoscopy. Although virtual MRI endoscopy has limitations, it provides 3D images which cannot be acquired using any other procedure. (orig.)

  11. Neuropatía sensitiva trigeminal secundaria a granuloma de colesterol de la punta del peñasco del temporal Trigeminal neuralgia secondary to cholesterol granuloma of the petrous bone apex

    M.A. Pons García

    2009-10-01

    Full Text Available La neuropatía aislada de la rama sensitiva del trigémino es una entidad poco habitual. Los pacientes suelen referir hipoestesia y /o disestesia generalmente a nivel de la segunda y tercera rama del trigémino, mientras que la neuralgia es muy infrecuente.¹ Su asociación con enfermedades sistémicas del tejido conectivo es bien conocida.² Se ha descrito asociada a distintas lesiones del SNC sobre todo tumores de fosa posterior o base de cráneo, así como neoplasias mandibulares.3,4 Presentamos una paciente con hipoestesia en el territorio V2-V3 asociada a dolor hemifacial paroxístico secundario a una lesión del peñasco del temporal.Trigeminal Neuralgia is an uncommon entity. The patients report hypoesthesia and/or dysesthesia of the second and third ramus of trigeminal nerve, while neuralgia is very rare.¹ Its association with systemic diseases of connective tissue is well know.² It has been described as being associated with different lesions of the central nervous system, especially with the posterior cavity or cranial base tumors, as well as jaw neoplasias.3,4 We presented a patient with hypoesthesia V2-V3 and hemi facial paroxysmal pain secondary to lesion of petrous apex of temporal bone.

  12. A prospective study of risk for Sturge-Weber syndrome in children with upper facial port-wine stain.

    Dutkiewicz, Anne-Sophie; Ezzedine, Khaled; Mazereeuw-Hautier, Juliette; Lacour, Jean-Philippe; Barbarot, Sébastien; Vabres, Pierre; Miquel, Juliette; Balguerie, Xavier; Martin, Ludovic; Boralevi, Franck; Bessou, Pierre; Chateil, Jean-François; Léauté-Labrèze, Christine

    2015-03-01

    Upper facial port-wine stain (PWS) is a feature of Sturge-Weber syndrome (SWS). Recent studies suggest that the distribution of the PWS corresponds to genetic mosaicism rather than to trigeminal nerve impairment. We sought to refine the cutaneous distribution of upper facial PWS at risk for SWS. This was a prospective multicenter study of consecutive cases of upper facial PWS larger than 1 cm² located in the ophthalmic division of trigeminal nerve distribution in infants aged less than 1 year, seen in 8 French pediatric dermatology departments between 2006 and 2012. Clinical data, magnetic resonance imaging, and photographs were systematically collected and studied. PWS were classified into 6 distinct patterns. In all, 66 patients were included. Eleven presented with SWS (magnetic resonance imaging signs and seizure). Four additional infants had suspected SWS without neurologic manifestations. Hemifacial (odds ratio 7.7, P = .003) and median (odds ratio 17.08, P = .008) PWS patterns were found to be at high risk for SWS. A nonmedian linear pattern was not associated with SWS. Small number of patients translated to limited power of the study. Specific PWS distribution patterns are associated with an increased risk of SWS. These PWS patterns conform to areas of somatic mosaicism. Terminology stipulating ophthalmic division of trigeminal nerve territory involvement in SWS should be abandoned. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  13. [Evidence of facial palsy and facial malformations in pottery from Peruvian Moche and Lambayeque pre-Columbian cultures].

    Carod-Artal, F J; Vázquez Cabrera, C B

    2006-01-01

    Moche (100-700 AD) and Lambayeque-Sicán (750-1100 AD) are pre-Columbian cultures from Regional States Period, developed in Northern Peru. Information about daily life, religion and medicine has been obtained through the study of Moche ceramics found in lords and priests tombs, pyramids and temples. To analyze archeological evidences of Moche Medicine and neurological diseases through ceramics. Representations of diseases in Moche and Lambayeque iconography and Moche pottery collections exposed in Casinelli museum from Trujillo, and Brüning National Archeological museum from Lambayeque, Peru, were studied. The most representative cases were analyzed and photographed, previous authorization from authorities and curators of the museums. The following pathologies were observed in ceramic collections: peripheral facial palsy, facial malformations such as cleft lip, hemifacial spasm, legs and arm amputations, scoliosis and Siamese patients. Male and females Moche doctors were also observed in the ceramics in ritual ceremonies treating patients. The main pathologies observed in Moche and Lambayeque pottery are facial palsy and cleft lip. These are one of the earliest registries of these pathologies in pre-Columbian cultures in South-America.

  14. Advanced and standardized evaluation of neurovascular compression syndromes

    Hastreiter, Peter; Vega Higuera, Fernando; Tomandl, Bernd; Fahlbusch, Rudolf; Naraghi, Ramin

    2004-05-01

    Caused by a contact between vascular structures and the root entry or exit zone of cranial nerves neurovascular compression syndromes are combined with different neurological diseases (trigeminal neurolagia, hemifacial spasm, vertigo, glossopharyngeal neuralgia) and show a relation with essential arterial hypertension. As presented previously, the semi-automatic segmentation and 3D visualization of strongly T2 weighted MR volumes has proven to be an effective strategy for a better spatial understanding prior to operative microvascular decompression. After explicit segmentation of coarse structures, the tiny target nerves and vessels contained in the area of cerebrospinal fluid are segmented implicitly using direct volume rendering. However, based on this strategy the delineation of vessels in the vicinity of the brainstem and those at the border of the segmented CSF subvolume are critical. Therefore, we suggest registration with MR angiography and introduce consecutive fusion after semi-automatic labeling of the vascular information. Additionally, we present an approach of automatic 3D visualization and video generation based on predefined flight paths. Thereby, a standardized evaluation of the fused image data is supported and the visualization results are optimally prepared for intraoperative application. Overall, our new strategy contributes to a significantly improved 3D representation and evaluation of vascular compression syndromes. Its value for diagnosis and surgery is demonstrated with various clinical examples.

  15. CT and MRI of haemorrhage into intracranial neuromas

    Asari, S. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Katayama, S. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Itoh, T. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Tsuchida, S. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Ohmoto, T. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan))

    1993-04-01

    Six patients with haemorrhage into intracranial neuromas were studied by computed tomography (CT) and magnetic resonance imaging (MRI) at 0.5 T with spin-echo pulse sequences. The nature of the tumour and the presence of a haematoma were confirmed by surgery and microscopic examination in all cases. Four neuromas arose from the acoustic nerves and two from the trigeminal. Four of the six patients suffered from sudden onset or rapid worsening of symptoms including headache, vertigo and/or hemifacial motor and sensory disturbances. CT in the acute stage revealed a hyperdense area or a fluid-fluid level (FFL). The hyperdense area disappeared on CT repeated in the chronic stage. On MRI in subacute and chronic stages the haemorrhage showed hyperintensity on both T1 and T2 weighting in five cases examined between 16 and 46 days after the onset, and isointensity on T1 weighting and an FFL on T2 weighting in one case examined 12 days after the onset of symptoms. A well-defined low intensity rim indicating prior haemorrhage was observed on T2-weighted images in three cases. MRI was more effectie than CT in detecting haemorrhage into the tumours and in staging it. (orig.)

  16. An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions

    Persaud, Ricardo; Garas, George; Silva, Sanjeev; Stamatoglou, Constantine; Chatrath, Paul; Patel, Kalpesh

    2013-01-01

    Botulinum toxin (Botox) is an exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles or glands innervated. Botox is best known for its beneficial role in facial aesthetics but recent literature has highlighted its usage in multiple non-cosmetic medical and surgical conditions. This article reviews the current evidence pertaining to Botox use in the head and neck. A literature review was conducted using The Cochrane Controlled Trials Register, Medline and EMBASE databases limited to English Language articles published from 1980 to 2012. The findings suggest that there is level 1 evidence supporting the efficacy of Botox in the treatment of spasmodic dysphonia, essential voice tremor, headache, cervical dystonia, masticatory myalgia, sialorrhoea, temporomandibular joint disorders, bruxism, blepharospasm, hemifacial spasm and rhinitis. For chronic neck pain there is level 1 evidence to show that Botox is ineffective. Level 2 evidence exists for vocal tics, trigeminal neuralgia, dysphagia and post-laryngectomy oesophageal speech. For stuttering, ‘first bite syndrome’, facial nerve paresis, Frey's syndrome, oromandibular dystonia and palatal/stapedial myoclonus the evidence is level 4. Thus, the literature highlights a therapeutic role for Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence). With ongoing research, the spectrum of clinical applications and number of people receiving Botox will no doubt increase. Botox appears to justify its title as ‘the poison that heals’. PMID:23476731

  17. The therapeutic usage of botulinum toxin (Botox in non-cosmetic head and neck conditions – An evidence based review

    Kamran Habib Awan

    2017-01-01

    Full Text Available Botulinum toxin (Botox is an exotoxin produced from Clostridium botulinum. It blocks the release of acetylcholine from the cholinergic nerve end plates resulting in inactivity of the muscles or glands innervated. The efficacy of Botox in facial aesthetics is well established; however, recent literature has highlighted its utilization in multiple non-cosmetic medical and surgical conditions. The present article reviews the current evidence pertaining to Botox use in the non-cosmetic head and neck conditions. A literature search was conducted using MEDLINE, EMBASE, ISI Web of Science and the Cochrane databases limited to English Language articles published from January 1980 to December 2014. The findings showed that there is level 1 evidence supporting the efficacy of Botox in the treatment of laryngeal dystonia, headache, cervical dystonia, masticatory myalgia, sialorrhoea, temporomandibular joint disorders, bruxism, blepharospasm, hemifacial spasm and rhinitis. For chronic neck pain there is level 1 evidence to show that Botox is ineffective. Level 2 evidence exists for vocal tics and trigeminal. For stuttering, facial nerve paresis, Frey’s syndrome and oromandibular dystonia the evidence is level 4. Thus, there is compelling evidence in the published literature to demonstrate the beneficial role of Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence. With more and more research, the range of clinical applications and number of individuals getting Botox will doubtlessly increase. Botox appears to justify its title as ‘the poison that heals’.

  18. Conversion Ratio between Botox®, Dysport®, and Xeomin® in Clinical Practice

    Francesco Scaglione

    2016-03-01

    Full Text Available Botulinum neurotoxin has revolutionized the treatment of spasticity and is now administered worldwide. There are currently three leading botulinum neurotoxin type A products available in the Western Hemisphere: onabotulinum toxin-A (ONA Botox®, abobotulinum toxin-A (ABO, Dysport®, and incobotulinum toxin A (INCO, Xeomin®. Although the efficacies are similar, there is an intense debate regarding the comparability of various preparations. Here we will address the clinical issues of potency and conversion ratios, as well as safety issues such as toxin spread and immunogenicity, to provide guidance for BoNT-A use in clinical practice. INCO was shown to be as effective as ONA with a comparable adverse event profile when a clinical conversion ratio of 1:1 was used. The available clinical and preclinical data suggest that a conversion ratio ABO:ONA of 3:1—or even lower—could be appropriate for treating spasticity, cervical dystonia, and blepharospasm or hemifacial spasm. A higher conversion ratio may lead to an overdosing of ABO. While uncommon, distant spread may occur; however, several factors other than the pharmaceutical preparation are thought to affect spread. Finally, whereas the three products have similar efficacy when properly dosed, ABO has a better cost-efficacy profile.

  19. Virtual MRI endoscopy of the intracranial cerebrospinal fluid spaces

    Shigematsu, Y.; Korogi, Y.; Hirai, T. [Kumamoto Univ. (Japan). Dept. of Radiology; Okuda, T.; Ikushima, I.; Sugahara, T.; Liang, L.; Ge, Y.; Takahashi, M.

    1998-10-01

    We used constructive interference in steady state (CISS) 3D Fourier transform (3DFT) MRI data sets to obtain three-dimensional (3D) virtual MRI endoscopic views of the intracranial cerebrospinal fluid (CSF) spaces, processing them with a commercially available perspective endoscopic algorithm. We investigated the potential of the intracranial virtual MRI endoscopy applied to visualisation of the pathology in 13 patients with surgically confirmed trigeminal neuralgia (3), hemifacial spasm (3), acoustic neuroma (3), suprasellar germinoma (1), Langerhans cell histiocytosis (1), lateral ventricle nodules (1) and pituitary dwarfism (1). All images were acquired using a 1.5-T imager employing a circular polarised head coil. The CISS-3DFT data sets were transferred to a workstation for processing with the perspective endoscopic algorithm. Postprocessing for virtual MRI endoscopy was possible for all data sets. The lesions in 12 patients, and their complex anatomical relationships with the surrounding structures, were well seen on the 3D images. A small acoustic neuroma in the internal auditory meatus was not seen using virtual endoscopy. Although virtual MRI endoscopy has limitations, it provides 3D images which cannot be acquired using any other procedure. (orig.) With 6 figs., 16 refs.

  20. Lack of IgG antibody seropositivity to Borrelia burgdorferi in patients with Parry-Romberg syndrome and linear morphea en coup de sabre in Mexico.

    Gutiérrez-Gómez, Claudia; Godínez-Hana, Ana L; García-Hernández, Marisela; Suárez-Roa, María de Lourdes; Toussaint-Caire, Sonia; Vega-Memije, Elisa; Gutiérrez-Mendoza, Daniela; Pérez-Dosal, Marcia; Medina-De la Garza, Carlos E

    2014-08-01

    Progressive hemifacial atrophy or Parry-Romberg Syndrome (PRS) is a rare, acquired, progressive dysplasia of subcutaneous tissue and bone characterized by unilateral facial involvement. Its etiology is unknown, but theories about its pathogenesis include infectious, degenerative, autoimmune, and traumatic causes among others. The causal relationship of PRS and linear morphea en coup de sabre (LMCS) with Borrelia burgdorferi infection remains controversial. Our goal was to serologically determine anti-B. burgdorferi antibodies in patients diagnosed with PRS and LMCS to establish a possible association as a causative agent. We conducted a serology study with patients belonging to a group of 21 individuals diagnosed with PRS, six with LMCS, and 21 matched controls. Anti-Borrelia IgG antibodies were determined by ELISA. A descriptive statistical analysis and Fischer's exact test were done. In serological tests, only two cases had borderline values and were further analyzed by Western blot with non-confirmatory results. For both the PRS and LMCS group, the association test was not significant, suggesting a lack of association between PRS or LMCS and the presence of anti-Borrelia antibodies. In Mexico there are no previous studies on Borrelia infection and its relationship between PRS or LMCS. Our result showed a lack of association of either clinical entities with anti-Borrelia-antibodies. Former reports of this association may suggest coincidental findings without causal relationship. © 2014 The International Society of Dermatology.

  1. Predictors of Longitudinal Quality of Life in Juvenile Localized Scleroderma.

    Ardalan, Kaveh; Zigler, Christina K; Torok, Kathryn S

    2017-07-01

    Localized scleroderma can negatively affect children's quality of life (QoL), but predictors of impact have not been well described. We sought to identify predictors of QoL impact in juvenile localized scleroderma patients. We analyzed longitudinal data from a single-center cohort of juvenile localized scleroderma patients, using hierarchical generalized linear modeling (HGLM) to identify predictors of QoL impact. HGLM is useful for nested data and allows for evaluation of both time-variant and time-invariant predictors. The number of extracutaneous manifestations (ECMs; e.g., joint contracture and hemifacial atrophy) and female sex predicted negative QoL impact, defined as a Children's Dermatology Life Quality Index score >1 (P = 0.019 for ECMs and P = 0.002 for female sex). As the time since the initial visit increased, the odds of reporting a negative QoL impact decreased (P scleroderma than cutaneous features. Further study is required to determine which ECMs have the most impact on QoL, which factors underlie sex differences in QoL in localized scleroderma, and why increasing the time since the initial visit appears to be protective. An improved understanding of predictors of QoL impact may allow for the identification of patients at risk of poorer outcomes and for the tailoring of treatment and psychosocial support. © 2016, American College of Rheumatology.

  2. Botulinum toxin

    Nigam P

    2010-01-01

    Full Text Available Botulinum toxin, one of the most poisonous biological substances known, is a neurotoxin produced by the bacterium Clostridium botulinum. C. botulinum elaborates eight antigenically distinguishable exotoxins (A, B, C 1 , C 2 , D, E, F and G. All serotypes interfere with neural transmission by blocking the release of acetylcholine, the principal neurotransmitter at the neuromuscular junction, causing muscle paralysis. The weakness induced by injection with botulinum toxin A usually lasts about three months. Botulinum toxins now play a very significant role in the management of a wide variety of medical conditions, especially strabismus and focal dystonias, hemifacial spasm, and various spastic movement disorders, headaches, hypersalivation, hyperhidrosis, and some chronic conditions that respond only partially to medical treatment. The list of possible new indications is rapidly expanding. The cosmetological applications include correction of lines, creases and wrinkling all over the face, chin, neck, and chest to dermatological applications such as hyperhidrosis. Injections with botulinum toxin are generally well tolerated and side effects are few. A precise knowledge and understanding of the functional anatomy of the mimetic muscles is absolutely necessary to correctly use botulinum toxins in clinical practice.

  3. Dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease)

    Uki, Jiro; Kanda, Shinji; Asakura, Ken; Takeda, Fumikazu

    1985-01-01

    A case of dysplastic gangliocytoma of the cerebellum, or Lhermitte-Duclos disease, is reported along with its CT findings, and the cases so far reported in the literature are reviewed. This is the 50th case report since the first description in 1920. This 61-year-old female had suffered from right hemifacial spasms for more than 20 years and from bilateral tinnitus with auditory disturbances for two years. Four years before admission, she underwent gastric resection and cancer chemotherapy for gastric cancer. Plain craniograms showed a thinned and ballooned occipital squama on the right side. Vertebral angiograms revealed a large tumor stain, with early venous filling, in the right posterior fossa. A CT scan showed a large, low-density mass, with small calcified areas in it, in the right posterior fossa. A postcontrast CT scan revealed no contrast enhancement, except for dilated vascular enhancement, within the tumor. No hydrocephalus was observed. Metrizamide CT cisternography revealed a huge intraaxial mass compressing the brain stem. (J.P.N.)

  4. Dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease). Case report with CT findings

    Uki, Jiro; Kanda, Shinji; Asakura, Ken; Takeda, Fumikazu

    1985-08-01

    A case of dysplastic gangliocytoma of the cerebellum, or Lhermitte-Duclos disease, is reported along with its CT findings, and the cases so far reported in the literature are reviewed. This is the 50th case report since the first description in 1920. This 61-year-old female had suffered from right hemifacial spasms for more than 20 years and from bilateral tinnitus with auditory disturbances for two years. Four years before admission, she underwent gastric resection and cancer chemotherapy for gastric cancer. Plain craniograms showed a thinned and ballooned occipital squama on the right side. Vertebral angiograms revealed a large tumor stain, with early venous filling, in the right posterior fossa. A CT scan showed a large, low-density mass, with small calcified areas in it, in the right posterior fossa. A postcontrast CT scan revealed no contrast enhancement, except for dilated vascular enhancement, within the tumor. No hydrocephalus was observed. Metrizamide CT cisternography revealed a huge intraaxial mass compressing the brain stem. (J.P.N.).

  5. Vascular anomalies of the cerebellopontine angle; Vaskulaere Erkrankungen des Kleinhirnbrueckenwinkels

    Papanagiotou, P; Grunwald, I Q; Politi, M; Struffert, T; Ahlhelm, F; Reith, W [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie

    2006-03-15

    Vascular anomalies of the cerebellopontine angle are rare compared to tumors in this area. Irritation of the trigeminal, facial, or vestibulocochlear nerve may cause trigeminal neuralgia, hemifacial spasm and vertigo, or tinnitus accordingly. Vessel loops in the cerebellopontine cisterns may cause compression at the root entry or exit zone of the cranial nerves V, VII, and VIII, a phenomenon which is called ''vascular loop syndrome.'' Megadolichobasilar artery and aneurysms of the vertebrobasilar system can also lead to dislocation and compression of the cranial nerves and brain stem. Three-dimensional CISS MR imaging and MR angiography are useful in the detection of neurovascular compression. Microvascular decompression is an effective surgical procedure in the management of compression syndromes of the cranial nerves V, VII, and VIII. (orig.) [German] Gegenueber den Raumforderungen stellen vaskulaere Veraenderungen des Kleinhirnbrueckenwinkels eher eine Ausnahme dar. Trigeminusneuralgie, hemifazialer Spasmus und Schwindel oder Tinnitus koennen bei Irritationen des Nervus trigeminus, facialis und vestibulocochlearis auftreten. Schlingenbildungen der Gefaesse in den Kleinhirnzisternen koennen eine Kompression der Eintritts- oder Austrittszonen der Hirnnerven V, VII und VIII am Hirnstamm hervorrufen, was als ''Vascular-loop-Syndrom'' bezeichnet wird. Zu Verlagerungen und Kompressionen von Hirnnerven und Hirnstamm koennen, wenn auch seltener, die Megadolichobasilaris und Aneurysmen des vertebrobasilaeren Systems fuehren. Bezueglich der Bildgebung ist die Magnetresonanztomographie (MRT) die Methode der Wahl. Die 3D-CISS-Sequenz und die MR-Angiographie sind hilfreich zur Darstellung der neurovaskulaeren Kompression. Die Methode der mikrovaskulaeren Dekompression ist eine wirkungsvolle Methode zur Beseitigung gefaessbedingter Kompressionen der Hirnnerven V, VII und VIII. (orig.)

  6. Microvascular decompression in treating cranial nerve diseases%微血管减压术治疗颅神经疾病疗效分析

    张志强; 黄涛; 罗小川; 谢才军; 谢绍盈; 沈有碧; 隋立森; 韩富

    2008-01-01

    Objective To study the efficacy of microvascular decompression in treating cranial nerve diseases. Methods 156 patients were treated with microvaseular decompression,of whom 119 were with trigeminal neuralgia,34 with hemifacial spasm and three with glossopharyngeal neuralgia.Rusults The overall effective rate was 96.8%(151/156) and the corresponding effective rate for the above three conditions were 94.2%,97.1% and 66.7%. Conlusions Mierovaseular decompression iS an effective treatment for cranial nerve diseases.%目的 探讨微血管减压术治疗三叉神经痛、面肌痉挛、舌咽神经痛的疗效. 方法 微血管减压手术治疗颅神经疾病156例(三叉神经痛119例,面肌痉挛34例,舌咽神经痛3例). 结果 总有效151例,有效率96.8%,其中三又神经痛、面肌痉挛和舌咽神经痛患者手术有效率分别为94.2%、97.1%和66.7%. 结论 微血管减压术治疗颅神经疾病疗效确切.

  7. Facial reanimation by muscle-nerve neurotization after facial nerve sacrifice. Case report.

    Taupin, A; Labbé, D; Babin, E; Fromager, G

    2016-12-01

    Recovering a certain degree of mimicry after sacrifice of the facial nerve is a clinically recognized finding. The authors report a case of hemifacial reanimation suggesting a phenomenon of neurotization from muscle-to-nerve. A woman benefited from a parotidectomy with sacrifice of the left facial nerve indicated for recurrent tumor in the gland. The distal branches of the facial nerve, isolated at the time of resection, were buried in the masseter muscle underneath. The patient recovered a voluntary hémifacial motricity. The electromyographic analysis of the motor activity of the zygomaticus major before and after block of the masseter nerve showed a dependence between mimic muscles and the masseter muscle. Several hypotheses have been advanced to explain the spontaneous reanimation of facial paralysis. The clinical case makes it possible to argue in favor of muscle-to-nerve neurotization from masseter muscle to distal branches of the facial nerve. It illustrates the quality of motricity that can be obtained thanks to this procedure. The authors describe a simple implantation technique of distal branches of the facial nerve in the masseter muscle during a radical parotidectomy with facial nerve sacrifice and recovery of resting tone but also a quality voluntary mimicry. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Paralisia Facial Periférica por comprometimento do tronco cerebral: A propósito de um caso clínico Peripheral Facial Paralisys of brainstem origin: A clinical case description

    Paulo R. Lazarini

    Full Text Available É apresentado um caso clínico de paciente portador de paralisia facial periférica com comprometimento de toda a hemiface direita. Durante a investigação clínica, esperava-se que o comprometimento topográfico do nervo facial se desse a partir de sua emergência na ponte. Após exames de imagem, evidenciou-se lesão expansiva no tronco cerebral. Deste modo, a classificação de paralisia facial como periférica ou central não atende a este caso. O uso de uma classificação utilizando os núcleos do nervo facial como referência pode ser mais adequado na investigação clínica da paralisia facial.It is presented a clinical case of a patient with a peripheral facial paralysis with hemifacial compromise. During the clinical investigation it was expected that the topographic compromise of the facial nerve would arise out of the emergence of the nerve from the pons. After some image examinations, an expansive brain trunk lesion was evidenced. Thus, the classification of facial paralysis - either peripheral or central - is not applicable to this case. The use of a classification having the facial nerve nucleus as reference could be more adequate in the clinical investigation of the paralysis.

  9. Impact of Compound Hydrate Dynamics on Phase Boundary Changes

    Osegovic, J. P.; Max, M. D.

    2006-12-01

    Compound hydrate reactions are affected by the local concentration of hydrate forming materials (HFM). The relationship between HFM composition and the phase boundary is as significant as temperature and pressure. Selective uptake and sequestration of preferred hydrate formers (PF) has wide ranging implications for the state and potential use of natural hydrate formation, including impact on climate. Rising mineralizing fluids of hydrate formers (such as those that occur on Earth and are postulated to exist elsewhere in the solar system) will sequester PF before methane, resulting in a positive relationship between depth and BTU content as ethane and propane are removed before methane. In industrial settings the role of preferred formers can separate gases. When depressurizing gas hydrate to release the stored gas, the hydrate initial composition will set the decomposition phase boundary because the supporting solution takes on the composition of the hydrate phase. In other settings where hydrate is formed, transported, and then dissociated, similar effects can control the process. The behavior of compound hydrate systems can primarily fit into three categories: 1) In classically closed systems, all the material that can form hydrate is isolated, such as in a sealed laboratory vessel. In such systems, formation and decomposition are reversible processes with observed hysteresis related to mass or heat transfer limitations, or the order and magnitude in which individual hydrate forming gases are taken up from the mixture and subsequently released. 2) Kinetically closed systems are exposed to a solution mass flow across a hydrate mass. These systems can have multiple P-T phase boundaries based on the local conditions at each face of the hydrate mass. A portion of hydrate that is exposed to fresh mineralizing solution will contain more preferred hydrate formers than another portion that is exposed to a partially depleted solution. Examples of kinetically closed

  10. Bedrock geology Forsmark. Modelling stage 2.3. Implications for and verification of the deterministic geological models based on complementary data

    Stephens, Michael B. (Geological Survey of Sweden, Uppsala (Sweden)); Simeonov, Assen (Swedish Nuclear Fuel and Waste Management Co., Stockholm (Sweden)); Isaksson, Hans (GeoVista AB, Luleaa (Sweden))

    2008-12-15

    The Swedish Nuclear Fuel and Waste Management Company is in the process of completing site descriptive modelling at two locations in Sweden, with the objective to site a deep geological repository for spent nuclear fuel. At Forsmark, the results of the stage 2.2 geological modelling formed the input for downstream users. Since complementary ground and borehole geological and geophysical data, acquired after model stage 2.2, were not planned to be included in the deterministic rock domain, fracture domain and deformation zone models supplied to the users, it was deemed necessary to evaluate the implications of these stage 2.3 data for the stage 2.2 deterministic geological models and, if possible, to make use of these data to verify the models. This report presents the results of the analysis of the complementary stage 2.3 geological and geophysical data. Model verification from borehole data has been implemented in the form of a prediction-outcome test. The stage 2.3 geological and geophysical data at Forsmark mostly provide information on the bedrock outside the target volume. Additional high-resolution ground magnetic data and the data from the boreholes KFM02B, KFM11A, KFM12A and HFM33 to HFM37 can be included in this category. Other data complement older information of identical character, both inside and outside this volume. These include the character and kinematics of deformation zones and fracture mineralogy. In general terms, it can be stated that all these new data either confirm the geological modelling work completed during stage 2.2 or are in good agreement with the data that were used in this work. In particular, although the new high-resolution ground magnetic data modify slightly the position and trace length of some stage 2.2 deformation zones at the ground surface, no new or modified deformation zones with a trace length longer than 3,000 m at the ground surface have emerged. It is also apparent that the revision of fracture orientation data

  11. Death Valley regional ground-water flow system, Nevada and California -- hydrogeologic framework and transient ground-water flow model

    Belcher, Wayne R.

    2004-01-01

    A numerical three-dimensional (3D) transient ground-water flow model of the Death Valley region was developed by the U.S. Geological Survey for the U.S. Department of Energy programs at the Nevada Test Site and at Yucca Mountain, Nevada. Decades of study of aspects of the ground-water flow system and previous less extensive ground-water flow models were incorporated and reevaluated together with new data to provide greater detail for the complex, digital model. A 3D digital hydrogeologic framework model (HFM) was developed from digital elevation models, geologic maps, borehole information, geologic and hydrogeologic cross sections, and other 3D models to represent the geometry of the hydrogeologic units (HGUs). Structural features, such as faults and fractures, that affect ground-water flow also were added. The HFM represents Precambrian and Paleozoic crystalline and sedimentary rocks, Mesozoic sedimentary rocks, Mesozoic to Cenozoic intrusive rocks, Cenozoic volcanic tuffs and lavas, and late Cenozoic sedimentary deposits of the Death Valley Regional Ground-Water Flow System (DVRFS) region in 27 HGUs. Information from a series of investigations was compiled to conceptualize and quantify hydrologic components of the ground-water flow system within the DVRFS model domain and to provide hydraulic-property and head-observation data used in the calibration of the transient-flow model. These studies reevaluated natural ground-water discharge occurring through evapotranspiration and spring flow; the history of ground-water pumping from 1913 through 1998; ground-water recharge simulated as net infiltration; model boundary inflows and outflows based on regional hydraulic gradients and water budgets of surrounding areas; hydraulic conductivity and its relation to depth; and water levels appropriate for regional simulation of prepumped and pumped conditions within the DVRFS model domain. Simulation results appropriate for the regional extent and scale of the model were

  12. Death Valley regional groundwater flow system, Nevada and California-Hydrogeologic framework and transient groundwater flow model

    Belcher, Wayne R.; Sweetkind, Donald S.

    2010-01-01

    A numerical three-dimensional (3D) transient groundwater flow model of the Death Valley region was developed by the U.S. Geological Survey for the U.S. Department of Energy programs at the Nevada Test Site and at Yucca Mountain, Nevada. Decades of study of aspects of the groundwater flow system and previous less extensive groundwater flow models were incorporated and reevaluated together with new data to provide greater detail for the complex, digital model. A 3D digital hydrogeologic framework model (HFM) was developed from digital elevation models, geologic maps, borehole information, geologic and hydrogeologic cross sections, and other 3D models to represent the geometry of the hydrogeologic units (HGUs). Structural features, such as faults and fractures, that affect groundwater flow also were added. The HFM represents Precambrian and Paleozoic crystalline and sedimentary rocks, Mesozoic sedimentary rocks, Mesozoic to Cenozoic intrusive rocks, Cenozoic volcanic tuffs and lavas, and late Cenozoic sedimentary deposits of the Death Valley regional groundwater flow system (DVRFS) region in 27 HGUs. Information from a series of investigations was compiled to conceptualize and quantify hydrologic components of the groundwater flow system within the DVRFS model domain and to provide hydraulic-property and head-observation data used in the calibration of the transient-flow model. These studies reevaluated natural groundwater discharge occurring through evapotranspiration (ET) and spring flow; the history of groundwater pumping from 1913 through 1998; groundwater recharge simulated as net infiltration; model boundary inflows and outflows based on regional hydraulic gradients and water budgets of surrounding areas; hydraulic conductivity and its relation to depth; and water levels appropriate for regional simulation of prepumped and pumped conditions within the DVRFS model domain. Simulation results appropriate for the regional extent and scale of the model were provided

  13. Discrete fracture network for the Forsmark site

    Darcel, C. [Itasca Consultants, Ecully (France); Davy, P.; Bour, O.; Dreuzy, J.R. de [Geosciences, Rennes (France)

    2006-08-15

    depth (based on boreholes KFM02A, KFM05A, HFM04 and HFM05) and outcrop DFN models. The main conclusions drawn from the consistency analysis are the following: There exists an important sub horizontal fracturing that occurs close to surface, which makes outcrop fracturing different, in term of density, from the fracturing observed in deep geological units from boreholes. The difference between surface and deep units does not exist for fractures dipping more than 30-40 deg. The rock units are remarkably consistent with outcrops for dips larger than 30-40 deg, and for Model A (a{sub 3d}=3.5). Model B tends to predict larger fracture densities in outcrops than in rock units defined in boreholes (in the dip range of 30-40 deg). There is no equivalence, in the outcrops, of the Deformation Zones, identified at depth. The best-fitting model is defined for l{sub min} (the smallest fracture diameter consistent with the power law model; l{sub min}=2r{sub 0} with r{sub 0} the location parameter) smaller than the borehole diameter. With this method, it is not possible to say more about l{sub min}. Models that consider larger values of l{sub min} do not ensure the consistency between outcrops and boreholes. The shear zones, as well as the lineaments, may belong to a different global scaling model than rock units. Further investigations and more data are necessary to characterize this additional GSM. Along the project, the issue of DFN model and of the fracture definition consistency across scales is often raised. It should be further investigated, together with a more complete description of the model variability.

  14. Discrete fracture network for the Forsmark site

    Darcel, C.; Davy, P.; Bour, O.; Dreuzy, J.R. de

    2006-08-01

    05A, HFM04 and HFM05) and outcrop DFN models. The main conclusions drawn from the consistency analysis are the following: There exists an important sub horizontal fracturing that occurs close to surface, which makes outcrop fracturing different, in term of density, from the fracturing observed in deep geological units from boreholes. The difference between surface and deep units does not exist for fractures dipping more than 30-40 deg. The rock units are remarkably consistent with outcrops for dips larger than 30-40 deg, and for Model A (a 3d =3.5). Model B tends to predict larger fracture densities in outcrops than in rock units defined in boreholes (in the dip range of 30-40 deg). There is no equivalence, in the outcrops, of the Deformation Zones, identified at depth. The best-fitting model is defined for l min (the smallest fracture diameter consistent with the power law model; l min =2r 0 with r 0 the location parameter) smaller than the borehole diameter. With this method, it is not possible to say more about l min . Models that consider larger values of l min do not ensure the consistency between outcrops and boreholes. The shear zones, as well as the lineaments, may belong to a different global scaling model than rock units. Further investigations and more data are necessary to characterize this additional GSM. Along the project, the issue of DFN model and of the fracture definition consistency across scales is often raised. It should be further investigated, together with a more complete description of the model variability

  15. Bedrock geology Forsmark. Modelling stage 2.3. Implications for and verification of the deterministic geological models based on complementary data

    Stephens, Michael B.; Simeonov, Assen; Isaksson, Hans

    2008-12-01

    The Swedish Nuclear Fuel and Waste Management Company is in the process of completing site descriptive modelling at two locations in Sweden, with the objective to site a deep geological repository for spent nuclear fuel. At Forsmark, the results of the stage 2.2 geological modelling formed the input for downstream users. Since complementary ground and borehole geological and geophysical data, acquired after model stage 2.2, were not planned to be included in the deterministic rock domain, fracture domain and deformation zone models supplied to the users, it was deemed necessary to evaluate the implications of these stage 2.3 data for the stage 2.2 deterministic geological models and, if possible, to make use of these data to verify the models. This report presents the results of the analysis of the complementary stage 2.3 geological and geophysical data. Model verification from borehole data has been implemented in the form of a prediction-outcome test. The stage 2.3 geological and geophysical data at Forsmark mostly provide information on the bedrock outside the target volume. Additional high-resolution ground magnetic data and the data from the boreholes KFM02B, KFM11A, KFM12A and HFM33 to HFM37 can be included in this category. Other data complement older information of identical character, both inside and outside this volume. These include the character and kinematics of deformation zones and fracture mineralogy. In general terms, it can be stated that all these new data either confirm the geological modelling work completed during stage 2.2 or are in good agreement with the data that were used in this work. In particular, although the new high-resolution ground magnetic data modify slightly the position and trace length of some stage 2.2 deformation zones at the ground surface, no new or modified deformation zones with a trace length longer than 3,000 m at the ground surface have emerged. It is also apparent that the revision of fracture orientation data

  16. A saturated zone site-scale flow model for Yucca mountain

    Eddebbarh, Al Aziz [Los Alamos National Laboratory

    2008-01-01

    A saturated zone site-scale flow model (YMSZFM) was developed for licensing requirements for the Yucca Mountain nuclear waste repository to incorporate recent data and analyses including recent stratigraphic and water-level data from Nye County wells, single-and multiple-well hydraulic testing data, and recent hydrochemistry data. Analyses include use of data from the 2004 transient Death Valley Regional (ground-water) Flow System (DVRFS) model, the 2003 unsaturated zone flow model, and the latest hydrogeologic framework model (HFM). This model includes: (1) the latest understanding of SZ flow, (2) enhanced model validation and uncertainty analyses, (3) improved locations and definitions of fault zones, (4) refined grid resolution (500-to 250-m grid spacing), and (5) use of new data. The flow model was completed using the three-dimensional, Finite-Element Heat and Mass Transfer computer code (FEHM). The SZ site-scale flow model was calibrated with the commercial parameter estimation code, PEST to achieve a minimum difference between observed water levels and predicted water levels, and also between volumetric/mass flow rates along specific boundary segments as supplied by the DVRFS. A total of 161 water level and head measurements with varied weights were used for calibration. A comparison between measured water-level data and the potentiometric surface yielded an RMSE of 20.7 m (weighted RMSE of 8.8 m). The calibrated model was used to generate flow paths and specific discharge predictions. Model confidence was built by comparing: (l) calculated to observed hydraulic heads, and (2) calibrated to measured permeabilities (and therefore specific discharge). In addition, flowpaths emanating from below the repository footprint are consistent with those inferred both from gradients of measured head and from independent water-chemistry data. Uncertainties in the SZ site-scale flow model were quantified because all uncertainty contributes to inaccuracy in system

  17. Imaging of Au nanoparticles deeply buried in polymer matrix by various atomic force microscopy techniques

    Kimura, Kuniko; Kobayashi, Kei; Matsushige, Kazumi; Yamada, Hirofumi

    2013-01-01

    Recently, some papers reported successful imaging of subsurface features using atomic force microscopy (AFM). Some theoretical studies have also been presented, however the imaging mechanisms are not fully understood yet. In the preceeding papers, imaging of deeply buried nanometer-scale features has been successful only if they were buried in a soft matrix. In this paper, subsurface features (Au nanoparticles) buried in a soft polymer matrix were visualized. To elucidate the imaging mechanisms, various AFM techniques; heterodyne force microscopy, ultrasonic atomic force microscopy (UAFM), 2nd-harmonic UAFM and force modulation microscopy (FMM) were employed. The particles buried under 960 nm from the surface were successfully visualized which has never been achieved. The results elucidated that it is important for subsurface imaging to choose a cantilever with a suitable stiffness range for a matrix. In case of using the most suitable cantilever, the nanoparticles were visualized using every technique shown above except for FMM. The experimental results suggest that the subsurface features buried in a soft matrix with a depth of at least 1 µm can affect the local viscoelasticity (mainly viscosity) detected as the variation of the amplitude and phase of the tip oscillation on the surface. This phenomenon presumably makes it possible to visualize such deeply buried nanometer-scale features in a soft matrix. - Highlights: • We visualized subsurface features buried in soft matrix, and investigated its imaging mechanism. • AFM techniques; UAFM, FMM, HFM and 2nd-harmonic UAFM were applied to elucidate the mechanism. • Au nanoparticles buried under 960 nm from surface were visualized, which has never been achieved. • Imaging at contact resonance using a cantilever of suitable stiffness is important. • Subsurface features in a soft matrix affect surface viscoelasticity, which are detected by AFM

  18. Mercury transfer from soil to olive trees. A comparison of three different contaminated sites.

    Higueras, Pablo L; Amorós, José Á; Esbrí, José Maria; Pérez-de-los-Reyes, Caridad; López-Berdonces, Miguel A; García-Navarro, Francisco J

    2016-04-01

    Mercury contents in soil and olive tree leaves have been studied in 69 plots around three different source areas of this element in Spain: Almadén (Ciudad Real), Flix (Tarragona) and Jódar (Jaén). Almadén was the world's largest cinnabar (HgS) mining district and was active until 2003, Flix is the oldest Spanish chlor-alkali plant (CAP) and has been active from 1898 to the present day and Jódar is a decommissioned CAP that was active for 14 years (1977-1991). Total mercury contents have been measured by high-frequency modulation atomic absorption spectrometry with Zeeman effect (ZAAS-HFM) in the soils and olive tree leaves from the three studied areas. The average soil contents range from 182 μg kg(-1) in Flix to 23,488 μg kg(-1) in Almadén, while the average leaf content ranges from 161 μg kg(-1) in Jódar to 1213 μg kg(-1) in Almadén. Despite the wide range of data, a relationship between soil-leaf contents has been identified: in Almadén and Jódar, multiplicative (bilogarithmic) models show significant correlations (R = 0.769 and R = 0.484, respectively). Significant correlations were not identified between soil and leaf contents in Flix. The continuous activity of the Flix CAP, which remains open today, can explain the different uptake patterns for mercury, which is mainly atmospheric in origin, in comparison to the other two sites, where activity ceased more than 10 years ago and only soil uptake patterns based on the Michaelis-Menten enzymatic model curve are observed.

  19. Status report [Parameters for calculation of nuclear reactions of relevance to non-energy nuclear applications

    Koning, A.

    2008-01-01

    Full text: Masses: Adopted Goriely HFB masses in TALYS as theoretical default instead of Moeller. Audi-Wapstra, Moeller and HFB masses tested formally with TALYS. Levels. Adopted latest discrete level update (2006) by Belgya (as sent by Capote) in TALYS. Tested with TALYS. Resonances. Adopted RIPL-2 D0 collection in TALYS. Tested by TALYS. Optical model. Coordinated Optical model segment for RIPL-3. Adopted Soukhovitskii CC potential as default for actinides. Covariances: Confirmed OMP parameter uncertainties from last meeting. Level density. Produced consistent set of level density parameters for CTM, BFM, GSM and HFM. Local models (per nucleus) and global models (systematics). With and without effective collective enhancement. Included and tested with TALYS Gamma-ray strength. Adopted Goriely HFB strength function tables as option (not default) in TALYS. Both formally tested and validated with TALYS. Fission. Adopted Sin-Capote WKB approximation in TALYS as option for fission calculations. Formally tested. RIPL-2/3 validation. Very extensive formal tests and validation procedures with TALYS. MONKEY code for random input files (has found RIPL errors in the past). Automatic comparison with all available EXFOR cross section data (for level density study). Started work on global parameter uncertainties (for covariances). SALTY nuclear data library (final version under construction): - 60 MeV n,g,p,d,t,h,a activation files for 1200 nuclides - 200 MeV n,g,p,d,t,h,a transport files for 250 nuclides RIPL is automatically being used by all TALYS users (and TALYS-related publications). TALYS-1.0 release in December 2007 (delay because of level densities). (author)

  20. Crystallo-chemistry of actinide nitrides (U1-yPuy)N and effect of impurities

    Beauvy, M.; Coulon-Picard, E.; Pelletier, M.

    2004-01-01

    Investigations on actinide nitrides has been done in our Laboratories for Fast Breeder Reactors since the seventies and some properties are reported to show the interest for these fuels. Today, the actinide nitrides are reconsidered as possible fuels for the future fission reactors (GFR and LMFR selected by the international forum Generation IV). The results of new investigations on crystal structure of mixed mono-nitrides (U,Pu)N, and the effects of oxygen and carbon contaminations on this structure are presented. The cubic 'NaCl-fcc' type structure of actinide nitrides AnN with space group O5/h-Fm3m does not respect the 'Vegard law' model for the mixed nitrides (U 1-y Pu y )N. These nitrides are usually considered with strong metallic character associated with partial ionic bonding, but the ionic contribution in the An-N bonding determined in this work is very important and near 41.6% for UN and PuN. From results published on resistivity of mixed nitrides, the data on bonding must be also modified for partial covalence. This is in good agreement with the experimental lattice parameters which are not compatible with dominant metallic bonding. The numbers of bonding electrons in the nitrides (U 1-y Pu y )N are reevaluated and the low values proposed comparatively with those previously published confirm the strong ionic character with high concentration of An 3+ ions. The solubility of oxygen and carbon in actinide nitrides (U 1-y Pu y )N are discussed from measurements on volume concentration of actinide oxide phase, total oxygen and carbon contents, and lattice parameter of nitrides. The oxygen solubility limit in UN is near 1000 ppm, with a lightly higher value of 1200 ppm for the mixed nitride (U 0.8 Pu 0.2 )N. The effects of oxygen or carbon atoms in the lattice of (U 1-y Pu y )N are analysed

  1. A saturated zone site-scale flow model for Yucca Mountain

    Eddebbarh, Al Aziz

    2008-01-01

    A saturated zone site-scale flow model (YMSZFM) was developed for licensing requirements for the Yucca Mountain nuclear waste repository to incorporate recent data and analyses including recent stratigraphic and water-level data from Nye County wells, single-and multiple-well hydraulic testing data, and recent hydrochemistry data. Analyses include use of data from the 2004 transient Death Valley Regional (ground-water) Flow System (DVRFS) model, the 2003 unsaturated zone flow model, and the latest hydrogeologic framework model (HFM). This model includes: (1) the latest understanding of SZ flow, (2) enhanced model validation and uncertainty analyses, (3) improved locations and definitions of fault zones, (4) refined grid resolution (500-to 250-m grid spacing), and (5) use of new data. The flow model was completed using the three-dimensional, Finite-Element Heat and Mass Transfer computer code (FEHM). The SZ site-scale flow model was calibrated with the commercial parameter estimation code, PEST to achieve a minimum difference between observed water levels and predicted water levels, and also between volumetric/mass flow rates along specific boundary segments as supplied by the DVRFS. A total of 161 water level and head measurements with varied weights were used for calibration. A comparison between measured water-level data and the potentiometric surface yielded an RMSE of 20.7 m (weighted RMSE of 8.8 m). The calibrated model was used to generate flow paths and specific discharge predictions. Model confidence was built by comparing: (l) calculated to observed hydraulic heads, and (2) calibrated to measured permeabilities (and therefore specific discharge). In addition, flowpaths emanating from below the repository footprint are consistent with those inferred both from gradients of measured head and from independent water-chemistry data. Uncertainties in the SZ site-scale flow model were quantified because all uncertainty contributes to inaccuracy in system

  2. Thermal treatment of moroccan phosphogypsum

    El Issiouy S.

    2013-07-01

    Full Text Available Phosphogypsum (PG is produced as a by-product during treatment of phosphate rock with sulphuric acid to produce phosphoric acid according to the following simplified reaction: Ca10(PO26F2+10H2SO4 + 20H2O →70 à 80°C 6H3PO4 + 2HF + 10(CaSO4.2H2O$Ca_{10} (PO_2 _6 F_2 + 10H_2 SO_4 {m{ }} + {m{ }}20H_2 O{m{ }}uildrel {70{m{ }}`a {m{ }}80^circ C} over longrightarrow {m{ }}6H_3 PO_4 {m{ }} + {m{ }}2HF{m{ }} + {m{ }}10(CaSO_4 .2H_2 O$ Minerai Phosphogypse PG is mainly CaSO4·2H2O but also contains impurities such as free phosphoric acid, phosphates, fluorides and organic matter that adhere to the surface of the gypsum crystals. Phosphogypsum is discharged directly to the Sea or into the natural evaporation ponds. Previous studies have focused on reducing impurity levels in PG. Phosphogypsum impurities can be removed by simple techniques. Washing with water removes the soluble impurities. By cons, other contaminants (radioactive elements, heavy metals ... a specific treatment method required a complex technique where the treatment is likely to be expensive. In this study, we studied purification of phosphogypsum using water and the thermal behavior of the natural gypsum and Moroccan phosphogypsum to calculation of parameters for drying and dehydration reactions. Also, the effects of different heating temperature on the course of dehydration are investigated.

  3. Thermo-responsive poly(N-isopropylacrylamide)-grafted hollow fiber membranes for osteoblasts culture and non-invasive harvest

    Zhuang, Meiling, E-mail: zhuangmeiling2006@126.com; Liu, Tianqing, E-mail: liutq@dlut.edu.cn; Song, Kedong, E-mail: kedongsong@dlut.edu.cn; Ge, Dan, E-mail: gedan@dlut.edu.cn; Li, Xiangqin, E-mail: xiangqinli@163.com

    2015-10-01

    Hollow fiber membrane (HFM) culture system is one of the most important bioreactors for the large-scale culture and expansion of therapeutic cells. However, enzymatic and mechanical treatments are traditionally applied to harvest the expanded cells from HFMs, which inevitably causes harm to the cells. In this study, thermo-responsive cellulose acetate HFMs for cell culture and non-invasive harvest were prepared for the first time via free radical polymerization in the presence of cerium (IV). ATR-FTIR and elemental analysis results indicated that the poly(N-isopropylacrylamide) (PNIPAAm) was covalently grafted on HFMs successfully. Dynamic contact angle measurements at different temperatures revealed that the magnitude of volume phase transition was decreased with increasing grafted amount of PNIPAAm. And the amount of serum protein adsorbed on HFMs surface also displayed the same pattern. Meanwhile osteoblasts adhered and spread well on the surface of PNIPAAm-grafted HFMs at 37 °C. And Calcein-AM/PI staining, AB assay, ALP activity and OCN protein expression level all showed that PNIPAAm-grafted HFMs had good cell compatibility. After incubation at 20 °C for 120 min, the adhering cells on PNIPAAm-grafted HFMs turned to be round and detached after being gently pipetted. These results suggest that thermo-responsive HFMs are attractive cell culture substrates which enable cell culture, expansion and the recovery without proteolytic enzyme treatment for the application in tissue engineering and regenerative medicine. - Highlights: • PNIPAAm-grafted HFMs exhibited thermoresponsive characteristic. • The OB cells could adhere and spread well on the surface of PNIPAAm-grafted HFMs. • PNIPAAm-grafted HFMs do not significantly impact ALP activity and OCN protein expression level of OB cells. • Cell could be detached from PNIPAAm-grafted HFMs when temperature decreased from 37 °C to 20 °C.

  4. Síndrome de dificultad respiratoria secundario a miasis sinusal y traqueopulmonar Acute respiratory distress syndrome secondary to sinus and tracheopulmonary myiasis

    Héctor Julio Meléndez

    2012-06-01

    Full Text Available La miasis es una enfermedad causada por la infestación de larvas en tejidos vivos o muertos; se clasifica entomológicamente o según el tropismo por los tejidos. Se reporta un caso de síndrome de dificultad respiratoria aguda secundario a miasis sinusal y traqueopulmonar en un hombre de 65 años, quien ingresó al servicio con epistaxis y sensación de obstrucción nasal. Se le hizo diagnóstico de crisis hipertensiva, se dio tratamiento sintomático y se hizo taponamiento nasal. El paciente reingresó a las 24 horas por edema hemifacial derecho, bradilalia y dificultad respiratoria; se retiró el tapón nasal y se evidenció salida de larvas. Se remitió a una institución de tercer nivel de atención, en donde fue valorado por otorrinolaringología y decidieron revisar las vías respiratorias bajo anestesia general, y desobstruirlas por infestación masiva de larvas. El paciente fue trasladado a la unidad de cuidados intensivos donde se diagnosticó síndrome de dificultad respiratoria aguda, y fue tratado con ivermectina y antibióticos. Posteriormente, se obtuvo una evolución satisfactoria a pesar de la gravedad del cuadro clínico. Se presenta un caso de síndrome de dificultad respiratoria aguda secundario a miasis sinusal y traqueopulmonar, y parece ser el primer caso reportado en Latinoamérica. Se destaca la adecuada evolución posterior al manejo médico sintomático y específico, a pesar de la alta mortalidad de este sindrome.Myiasis is a disease caused by the infestation of larvae in dead or living tissue. It is classified entomologically or according to tropism of the tissues. We report a case of acute respiratory distress syndrome (ARDS secondary to sinus and tracheopulmonary myiasis in a 65-year-old man who entered the service with epistaxis and nasal obstruction sensation. He was diagnosis with a hypertensive crisis, and symptomatic management and nasal plugging were performed. The patient was readmitted 24 hours later with

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

    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.

  6. Correction of Facial Deformity in Sturge–Weber Syndrome

    Yamaguchi, Kazuaki; Lonic, Daniel; Chen, Chit

    2016-01-01

    Background: Although previous studies have reported soft-tissue management in surgical treatment of Sturge–Weber syndrome (SWS), there are few reports describing facial bone surgery in this patient group. The purpose of this study is to examine the validity of our multidisciplinary algorithm for correcting facial deformities associated with SWS. To the best of our knowledge, this is the first study on orthognathic surgery for SWS patients. Methods: A retrospective chart review included 2 SWS patients who completed the surgical treatment algorithm. Radiographic and clinical data were recorded, and a treatment algorithm was derived. Results: According to the Roach classification, the first patient was classified as type I presenting with both facial and leptomeningeal vascular anomalies without glaucoma and the second patient as type II presenting only with a hemifacial capillary malformation. Considering positive findings in seizure history and intracranial vascular anomalies in the first case, the anesthetic management was modified to omit hypotensive anesthesia because of the potential risk of intracranial pressure elevation. Primarily, both patients underwent 2-jaw orthognathic surgery and facial bone contouring including genioplasty, zygomatic reduction, buccal fat pad removal, and masseter reduction without major complications. In the second step, the volume and distribution of facial soft tissues were altered by surgical resection and reposition. Both patients were satisfied with the surgical result. Conclusions: Our multidisciplinary algorithm can systematically detect potential risk factors. Correction of the asymmetric face by successive bone and soft-tissue surgery enables the patients to reduce their psychosocial burden and increase their quality of life. PMID:27622111

  7. MRI-based diagnostic imaging of the intratemporal facial nerve; Die kernspintomographische Darstellung des intratemporalen N. facialis

    Kress, B.; Baehren, W. [Bundeswehrkrankenhaus Ulm (Germany). Abt. fuer Radiologie

    2001-07-01

    Detailed imaging of the five sections of the full intratemporal course of the facial nerve can be achieved by MRI and using thin tomographic section techniques and surface coils. Contrast media are required for tomographic imaging of pathological processes. Established methods are available for diagnostic evaluation of cerebellopontine angle tumors and chronic Bell's palsy, as well as hemifacial spasms. A method still under discussion is MRI for diagnostic evaluation of Bell's palsy in the presence of fractures of the petrous bone, when blood volumes in the petrous bone make evaluation even more difficult. MRI-based diagnostic evaluation of the idiopatic facial paralysis currently is subject to change. Its usual application cannot be recommended for routine evaluation at present. However, a quantitative analysis of contrast medium uptake of the nerve may be an approach to improve the prognostic value of MRI in acute phases of Bell's palsy. (orig./CB) [German] Die detaillierte kernspintomographische Darstellung des aus 5 Abschnitten bestehenden intratemporalen Verlaufes des N. facialis gelingt mit der MRI unter Einsatz von Duennschichttechniken und Oberflaechenspulen. Zur Darstellung von pathologischen Vorgaengen ist die Gabe von Kontrastmittel notwendig. Die Untersuchung in der Diagnostik von Kleinhirnbrueckenwinkeltumoren und der chronischen Facialisparese ist etabliert, ebenso wie die Diagnostik des Hemispasmus facialis. In der Diskussion ist die MRI zur Dokumentation der Facialisparese bei Felsenbeinfrakturen, wobei die Einblutungen im Felsenbein die Beurteilung erschweren. Die kernspintomographische Diagnostik der idiopathischen Facialisparese befindet sich im Wandel. In der herkoemmlichen Form wird sie nicht zur Routinediagnostik empfohlen. Die quantitative Analyse der Kontrastmittelaufnahme im Nerv koennte jedoch die prognostische Bedeutung der MRI in der Akutphase der Bell's palsy erhoehen. (orig.)

  8. Primary Intestinal Lymphangiectasia Manifested as Unusual Edemas and Effusions: A Case Report.

    Wang, Xuefeng; Jin, Hong; Wu, Weilu

    2016-03-01

    Primary intestinal lymphangiectasia (PIL) is a rare disorder of unknown etiology characterized by diffuse or localized dilation and eventual rupture of the enteric lymphatic vessels in mucosa, submucosa, and/or subserosa. Lymph, rich in all kinds of proteins and lymphocytes, leaks into the gastrointestinal tract via the affected lymphatic vessels causing hypoproteinemia and lymphopenia. The main symptom is variable degrees of pitting edemas of bilateral lower limbs. But edemas of any other parts of body, and mild serous effusions may also occur sometimes. PIL occurs in conjunction with a right hemifacial edema, a right upper limb lymphedema, asymmetric bilateral calves edemas, and a unilateral massive pleural effusion seems never to be reported before. In addition, increased enteric protein loss that may cause severe hypoproteinemia usually get overlooked, and the lymphatic system disorders always put the diagnoses in a dilemma.We described a case of a 17-year-old Chinese girl with a history of gradually progressive swellings of right-sided face, right upper limb, and bilateral calves since 3 to 4 months of age. A right-sided massive pleural effusion, a moderate pericardial effusion, and a mild ascites have been proved unchanged by a series of computerized tomography (CT) scans since 5 years ago. The diagnosis of PIL was finally confirmed by severe hypoproteinemia, endoscopic changes, and histology of jejunum biopsy. Further lymphoscintigraphy and lymphangiography also identified lymph leakage in her bowel and several abnormal lymphatic vessels. A high-protein, low-fat diet supplemented with medium-chain triglycerides (MCT) showed some benefit.This case suggested that PIL was a rare but important etiology of hypoproteinemia, effusions, and edemas. PIL, effusions, and lymphedema can be the features of multisegmental generalized lymphatic dysplasia. In addition, both lymphoscintigraphy and intranodal lymphangiography could be considered when lymphatic system

  9. Primary Intestinal Lymphangiectasia Manifested as Unusual Edemas and Effusions

    Wang, Xuefeng; Jin, Hong; Wu, Weilu

    2016-01-01

    Abstract Primary intestinal lymphangiectasia (PIL) is a rare disorder of unknown etiology characterized by diffuse or localized dilation and eventual rupture of the enteric lymphatic vessels in mucosa, submucosa, and/or subserosa. Lymph, rich in all kinds of proteins and lymphocytes, leaks into the gastrointestinal tract via the affected lymphatic vessels causing hypoproteinemia and lymphopenia. The main symptom is variable degrees of pitting edemas of bilateral lower limbs. But edemas of any other parts of body, and mild serous effusions may also occur sometimes. PIL occurs in conjunction with a right hemifacial edema, a right upper limb lymphedema, asymmetric bilateral calves edemas, and a unilateral massive pleural effusion seems never to be reported before. In addition, increased enteric protein loss that may cause severe hypoproteinemia usually get overlooked, and the lymphatic system disorders always put the diagnoses in a dilemma. We described a case of a 17-year-old Chinese girl with a history of gradually progressive swellings of right-sided face, right upper limb, and bilateral calves since 3 to 4 months of age. A right-sided massive pleural effusion, a moderate pericardial effusion, and a mild ascites have been proved unchanged by a series of computerized tomography (CT) scans since 5 years ago. The diagnosis of PIL was finally confirmed by severe hypoproteinemia, endoscopic changes, and histology of jejunum biopsy. Further lymphoscintigraphy and lymphangiography also identified lymph leakage in her bowel and several abnormal lymphatic vessels. A high-protein, low-fat diet supplemented with medium-chain triglycerides (MCT) showed some benefit. This case suggested that PIL was a rare but important etiology of hypoproteinemia, effusions, and edemas. PIL, effusions, and lymphedema can be the features of multisegmental generalized lymphatic dysplasia. In addition, both lymphoscintigraphy and intranodal lymphangiography could be considered when lymphatic

  10. Vascular anomalies of the cerebellopontine angle; Vaskulaere Erkrankungen des Kleinhirnbrueckenwinkels

    Papanagiotou, P.; Grunwald, I.Q.; Politi, M.; Struffert, T.; Ahlhelm, F.; Reith, W. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie

    2006-03-15

    Vascular anomalies of the cerebellopontine angle are rare compared to tumors in this area. Irritation of the trigeminal, facial, or vestibulocochlear nerve may cause trigeminal neuralgia, hemifacial spasm and vertigo, or tinnitus accordingly. Vessel loops in the cerebellopontine cisterns may cause compression at the root entry or exit zone of the cranial nerves V, VII, and VIII, a phenomenon which is called ''vascular loop syndrome.'' Megadolichobasilar artery and aneurysms of the vertebrobasilar system can also lead to dislocation and compression of the cranial nerves and brain stem. Three-dimensional CISS MR imaging and MR angiography are useful in the detection of neurovascular compression. Microvascular decompression is an effective surgical procedure in the management of compression syndromes of the cranial nerves V, VII, and VIII. (orig.) [German] Gegenueber den Raumforderungen stellen vaskulaere Veraenderungen des Kleinhirnbrueckenwinkels eher eine Ausnahme dar. Trigeminusneuralgie, hemifazialer Spasmus und Schwindel oder Tinnitus koennen bei Irritationen des Nervus trigeminus, facialis und vestibulocochlearis auftreten. Schlingenbildungen der Gefaesse in den Kleinhirnzisternen koennen eine Kompression der Eintritts- oder Austrittszonen der Hirnnerven V, VII und VIII am Hirnstamm hervorrufen, was als ''Vascular-loop-Syndrom'' bezeichnet wird. Zu Verlagerungen und Kompressionen von Hirnnerven und Hirnstamm koennen, wenn auch seltener, die Megadolichobasilaris und Aneurysmen des vertebrobasilaeren Systems fuehren. Bezueglich der Bildgebung ist die Magnetresonanztomographie (MRT) die Methode der Wahl. Die 3D-CISS-Sequenz und die MR-Angiographie sind hilfreich zur Darstellung der neurovaskulaeren Kompression. Die Methode der mikrovaskulaeren Dekompression ist eine wirkungsvolle Methode zur Beseitigung gefaessbedingter Kompressionen der Hirnnerven V, VII und VIII. (orig.)

  11. Effects of parasagittal meningiomas on intracranial venous circulation assessed by the virtual reality technology.

    Wang, Shousen; Ying, Jianbin; Wei, Liangfeng; Li, Shiqing; Jing, Junjie

    2015-01-01

    This study is to investigate the compensatory intracranial venous pathways in parasagittal meningiomas (PSM) patients by virtual reality technology. A total of 48 PSM patients (tumor group) and 20 patients with trigeminal neuralgia and hemifacial spasm but without intracranial venous diseases (control group) were enrolled. All patients underwent 3D CE-MRV examination. The 3D reconstructed images by virtual reality technology were used for assessment of diameter and number of intracranial veins, tumor location, venous sinus invasion degree and collateral circulation formation. Diameter of bridging veins in posterior 1/3 superior sagittal sinus (SSS) in tumor group was significantly smaller than that of the control group (P < 0.05). For tumors located in mid 1/3 SSS, diameter of bridging veins and vein of Labbé (VL) in posterior 1/3 SSS decreased significantly (P < 0.05). For tumors located in posterior 1/3 SSS, bridging vein number and transverse sinus (TS) diameter significantly decreased while superficial Sylvian vein (SSV) diameter increased significantly (P < 0.05). Compared with tumor in posterior 1/3 SSS subgroup, number of bridging veins in the tumor in mid 1/3 SSS subgroup increased significantly (P < 0.05). Compared with control group, only the bridging vein number in anterior 1/3 SSS segment in invasion Type 3-4 tumor subgroup decreased significantly (P < 0.05). Diameter of TS and bridging veins in posterior 1/3 SSS segment in sinus invasion Type 5-6 tumor subgroup decreased significantly (P < 0.05). Compared with control group, only the diameter of VL and TS of collateral circulation Grade 1 tumor subgroup decreased significantly (P < 0.05) while in Grade 3 tumor subgroup, TS diameter decreased and SSV diameter increased significantly (P < 0.05). The intracranial blood flow is mainly drained through SSV drainage after SSS occlusion by PSM.

  12. Predicting Nonauditory Adverse Radiation Effects Following Radiosurgery for Vestibular Schwannoma: A Volume and Dosimetric Analysis

    Hayhurst, Caroline; Monsalves, Eric; Bernstein, Mark; Gentili, Fred; Heydarian, Mostafa; Tsao, May; Schwartz, Michael; Prooijen, Monique van; Millar, Barbara-Ann; Ménard, Cynthia; Kulkarni, Abhaya V.; Laperriere, Norm; Zadeh, Gelareh

    2012-01-01

    Purpose: To define clinical and dosimetric predictors of nonauditory adverse radiation effects after radiosurgery for vestibular schwannoma treated with a 12 Gy prescription dose. Methods: We retrospectively reviewed our experience of vestibular schwannoma patients treated between September 2005 and December 2009. Two hundred patients were treated at a 12 Gy prescription dose; 80 had complete clinical and radiological follow-up for at least 24 months (median, 28.5 months). All treatment plans were reviewed for target volume and dosimetry characteristics; gradient index; homogeneity index, defined as the maximum dose in the treatment volume divided by the prescription dose; conformity index; brainstem; and trigeminal nerve dose. All adverse radiation effects (ARE) were recorded. Because the intent of our study was to focus on the nonauditory adverse effects, hearing outcome was not evaluated in this study. Results: Twenty-seven (33.8%) patients developed ARE, 5 (6%) developed hydrocephalus, 10 (12.5%) reported new ataxia, 17 (21%) developed trigeminal dysfunction, 3 (3.75%) had facial weakness, and 1 patient developed hemifacial spasm. The development of edema within the pons was significantly associated with ARE (p = 0.001). On multivariate analysis, only target volume is a significant predictor of ARE (p = 0.001). There is a target volume threshold of 5 cm3, above which ARE are more likely. The treatment plan dosimetric characteristics are not associated with ARE, although the maximum dose to the 5th nerve is a significant predictor of trigeminal dysfunction, with a threshold of 9 Gy. The overall 2-year tumor control rate was 96%. Conclusions: Target volume is the most important predictor of adverse radiation effects, and we identified the significant treatment volume threshold to be 5 cm3. We also established through our series that the maximum tolerable dose to the 5th nerve is 9 Gy.

  13. Recognizing Uncommon Presentations of Psychogenic (Functional Movement Disorders

    José Fidel Baizabal-Carvallo

    2015-01-01

    Full Text Available Background: Psychogenic or functional movement disorders (PMDs pose a challenge in clinical diagnosis. There are several clues, including sudden onset, incongruous symptoms, distractibility, suggestibility, entrainment of symptoms, and lack of response to otherwise effective pharmacological therapies, that help identify the most common psychogenic movements such as tremor, dystonia, and myoclonus.Methods: In this manuscript, we review the frequency, distinct clinical features, functional imaging, and neurophysiological tests that can help in the diagnosis of uncommon presentations of PMDs, such as psychogenic parkinsonism, tics, and chorea; facial, palatal, and ocular movements are also reviewed. In addition, we discuss PMDs at the extremes of age and mass psychogenic illness.Results: Psychogenic parkinsonism (PP is observed in less than 10% of the case series about PMDs, with a female–male ratio of roughly 1:1. Lack of amplitude decrement in repetitive movements and of cogwheel rigidity help to differentiate PP from true parkinsonism. Dopamine transporter imaging with photon emission tomography can also help in the diagnostic process. Psychogenic movements resembling tics are reported in about 5% of PMD patients. Lack of transient suppressibility of abnormal movements helps to differentiate them from organic tics. Psychogenic facial movements can present with hemifacial spasm, blepharospasm, and other movements. Some patients with essential palatal tremor have been shown to be psychogenic. Convergence ocular spasm has demonstrated a high specificity for psychogenic movements. PMDs can also present in the context of mass psychogenic illness or at the extremes of age.Discussion: Clinical features and ancillary studies are helpful in the diagnosis of patients with uncommon presentations of psychogenic movement disorders.

  14. [Bell's palsy].

    Prud'hon, S; Kubis, N

    2018-03-30

    Idiopathic peripheral facial palsy, also named Bell's palsy, is the most common cause of peripheral facial palsy in adults. Although it is considered as a benign condition, its social and psychological impact can be dramatic, especially in the case of incomplete recovery. The main pathophysiological hypothesis is the reactivation of HSV 1 virus in the geniculate ganglia, leading to nerve edema and its compression through the petrosal bone. Patients experience an acute (less than 24 hours) motor deficit involving ipsilateral muscles of the upper and lower face and reaching its peak within the first three days. Frequently, symptoms are preceded or accompanied by retro-auricular pain and/or ipsilateral face numbness. Diagnosis is usually clinical but one should look for negative signs to eliminate central facial palsy or peripheral facial palsy secondary to infectious, neoplastic or autoimmune diseases. About 75% of the patients will experience spontaneous full recovery, this rate can be improved with oral corticotherapy when introduced within the first 72 hours. To date, no benefit has been demonstrated by adding an antiviral treatment. Hemifacial spasms (involuntary muscles contractions of the hemiface) or syncinesia (involuntary muscles contractions elicited by voluntary ones, due to aberrant reinnervation) may complicate the disease's course. Electroneuromyography can be useful at different stages: it can first reveal the early conduction bloc, then estimate the axonal loss, then bring evidence of the reinnervation process and, lastly, help for the diagnosis of complications. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  15. Predicting Nonauditory Adverse Radiation Effects Following Radiosurgery for Vestibular Schwannoma: A Volume and Dosimetric Analysis

    Hayhurst, Caroline; Monsalves, Eric; Bernstein, Mark; Gentili, Fred [Gamma Knife Unit, Division of Neurosurgery, University Health Network, Toronto (Canada); Heydarian, Mostafa; Tsao, May [Radiation Medicine Program, Princess Margaret Hospital, Toronto (Canada); Schwartz, Michael [Radiation Oncology Program and Division of Neurosurgery, Sunnybrook Hospital, Toronto (Canada); Prooijen, Monique van [Radiation Medicine Program, Princess Margaret Hospital, Toronto (Canada); Millar, Barbara-Ann; Menard, Cynthia [Radiation Oncology Program, Princess Margaret Hospital, Toronto (Canada); Kulkarni, Abhaya V. [Division of Neurosurgery, Hospital for Sick Children, University of Toronto (Canada); Laperriere, Norm [Radiation Oncology Program, Princess Margaret Hospital, Toronto (Canada); Zadeh, Gelareh, E-mail: Gelareh.Zadeh@uhn.on.ca [Gamma Knife Unit, Division of Neurosurgery, University Health Network, Toronto (Canada)

    2012-04-01

    Purpose: To define clinical and dosimetric predictors of nonauditory adverse radiation effects after radiosurgery for vestibular schwannoma treated with a 12 Gy prescription dose. Methods: We retrospectively reviewed our experience of vestibular schwannoma patients treated between September 2005 and December 2009. Two hundred patients were treated at a 12 Gy prescription dose; 80 had complete clinical and radiological follow-up for at least 24 months (median, 28.5 months). All treatment plans were reviewed for target volume and dosimetry characteristics; gradient index; homogeneity index, defined as the maximum dose in the treatment volume divided by the prescription dose; conformity index; brainstem; and trigeminal nerve dose. All adverse radiation effects (ARE) were recorded. Because the intent of our study was to focus on the nonauditory adverse effects, hearing outcome was not evaluated in this study. Results: Twenty-seven (33.8%) patients developed ARE, 5 (6%) developed hydrocephalus, 10 (12.5%) reported new ataxia, 17 (21%) developed trigeminal dysfunction, 3 (3.75%) had facial weakness, and 1 patient developed hemifacial spasm. The development of edema within the pons was significantly associated with ARE (p = 0.001). On multivariate analysis, only target volume is a significant predictor of ARE (p = 0.001). There is a target volume threshold of 5 cm3, above which ARE are more likely. The treatment plan dosimetric characteristics are not associated with ARE, although the maximum dose to the 5th nerve is a significant predictor of trigeminal dysfunction, with a threshold of 9 Gy. The overall 2-year tumor control rate was 96%. Conclusions: Target volume is the most important predictor of adverse radiation effects, and we identified the significant treatment volume threshold to be 5 cm3. We also established through our series that the maximum tolerable dose to the 5th nerve is 9 Gy.

  16. TRIAD OF SENSORY FINDINGS LOCALISES TO CORTEX- ANALYSIS OF 5 CASES

    Beena Vasanthy Vijayan

    2018-02-01

    Full Text Available BACKGROUND A fifty-two-year-old man presented with acute onset right lower facial and ear numbness and facial weakness, after two weeks of the onset of symptoms. Examination revealed right central facial palsy, depressed corneal reflex and hemifacial sensory loss (mild over forehead, severe over lower cheek, jaw & pinna Localization was proposed in brainstem Vs Cerebellopontine angle. MRI Brain revealed infarct in peri Rolandic area; four more patients had similar presentation over next few years. 1 Core findings were ipsilateral graded facial sensory impairment with central facial palsy, ear involvement & impaired corneal reflex. Four had spastic hand. Hypothesis- Cortical lesions can have LMN- like presentation; impairment of facial and external ear (pinna sensations, and attenuated corneal reflex. MATERIALS AND METHODS Settings and Design- Patients presenting to the Neurology OPD with facial weakness and isolated sensory loss of face were admitted and evaluated with detailed neurological examination, including facial & ear sensations and corneal reflex; Stroke work up & MRI Brain with MRA was done. They were treated and kept under follow up. RESULTS Patients with post central gyrus infarct had uniformity in presentation, graded sensory loss over face, depressed corneal reflex & ear involvement, had uniformity in presentations and medical help seeking usually were delayed. Two had lower face (mandibular region severely affected; while three had maxillary involvement. Spastic hand weakness was found in four. CONCLUSION Cortical lesions can produce LMN-like sensory phenomena, of face. Corneal reflex abnormality & ear involvement occur in cortical lesions. Ear representation is closer to lower face in sensory cortex. Four out of five patients had spastic hand in this series. Hence in spastic hand due to cortical lesions, triad of sensory findings should be specifically elicited.

  17. Considerations on patient-related outcomes with the use of botulinum toxins: is switching products safe?

    Fraint A

    2016-02-01

    Full Text Available Avram Fraint,1 Padmaja Vittal,2 Cynthia Comella2 1Department of Neurological Sciences, 2Section of Movement Disorders, Rush University Medical Center, Chicago, IL, USA Introduction: Botulinum toxin (BoNT is the treatment of choice for many neurologic movement disorders, including blepharospasm, hemifacial spasm, and cervical dystonia. There are two serotypes approved for use by the US Food and Drug Administration: three brands of serotype A and one of serotype B. Many attempts have been made at establishing dose conversion ratios between brands and serotypes. This review focuses on the existing data comparing different formulations of the same BoNT serotypes as well as that comparing different serotypes with one another. We focus on existing data regarding switching from one formulation or serotype to another and will also discuss the issue of immunogenicity of BoNT. With this information as a foundation, recommendations on safety of switching agents are addressed. Method: Literature review searching PubMed and Google Scholar using the search terms “switching botox”, “dosing equivalency in botox”, and “comparing botox”. Results/conclusion: Overall, there are many studies that demonstrate the efficacy and safety of each of the brands of BoNTs used in clinical practice. However, determination of dosing equivalencies among these brands and serotypes is complex with inconsistencies among the studies. When switching from one brand to another, the clinician should be aware of these issues, and not make the assumption that such ratios exist. Tailoring the dosage of each brand of BoNT to the clinical situation is the most prudent treatment strategy rather than focusing closely on conversion factors and concerns for immunogenicity. Keywords: botulinum toxin, BoNT, abobotulinumtoxin A, onabotulinumtoxin A, incobotulinumtoxin A, rimabotulinumtoxin B

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

    Amauri Batista da Silva

    1972-03-01

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

  19. Anterior Inferior Cerebellar Arteries Juxtaposed with the Internal Acoustic Meatus and Their Relationship to the Cranial Nerve VII/VIII Complex.

    Alonso, Fernando; Kassem, Mohammad W; Iwanaga, Joe; Oskouian, Rod J; Loukas, Marios; Demerdash, Amin; Tubbs, R Shane

    2017-08-16

    Vascular loops in the cerebellopontine angle (CPA) and their relationship to cranial nerves have been used to explain neurological symptoms. The anterior inferior cerebellar artery (AICA) has variable branches producing vascular loops that can compress the facial cranial nerve (CN) VII and vestibulocochlear (CN VIII) nerves. AICA compression of the facial-vestibulocochlear nerve complex can lead to various clinical presentations, including hemifacial spasm (HFS), tinnitus, and hemiataxia. The formation of arterial loops inside or outside of the internal auditory meatus (IAM) can cause abutment or compression of CN VII and CN VIII. Twenty-five (50 sides) fresh adult cadavers underwent dissection of the cerebellopontine angle in the supine position. In regard to relationships between the AICA and the nerves of the facial/vestibulocochlear complex, 33 arteries (66%) traveled in a plane between the facial/nervus intermedius nerves and the cochlear and vestibular nerves. Five arteries (10%) traveled below the CN VII/VIII complex, six (12%) traveled posterior to the nerve complex, four (8%) formed a semi-circle around the upper half of the nerve complex, and two (4%) traveled between and partially separated the nervus intermedius and facial nerve proper. Our study found that the majority of AICA will travel in a plane between the facial/nervus intermedius nerves and the cochlear and vestibular nerves. Although the relationship between the AICA and porus acusticus and AICA and the nerves of the CN VII/VIII complex are variable, based on our findings, some themes exist. Surgeons should consider these with approaches to the cerebellopontine angle.

  20. A cross-sectional electromyography assessment in linear scleroderma patients

    2014-01-01

    Background Muscle atrophy and asymmetric extremity growth is a common feature of linear scleroderma (LS). Extra-cutaneous features are also common and primary neurologic involvement, with sympathetic dysfunction, may have a pathogenic role in subcutaneous and muscle atrophy. The aim was investigate nerve conduction and muscle involvement by electromyography in pediatric patients with LS. Methods We conducted a retrospective review of LS pediatric patients who had regular follow up at a single pediatric center from 1997–2013. We selected participants if they had consistently good follow up and enrolled consecutive patients in the study. We examined LS photos as well as clinical, serological and imaging findings. Electromyograms (EMG) were performed with bilateral symmetric technique, using surface and needle electrodes, comparing the affected side with the contralateral side. Abnormal muscle activity was categorized as a myopathic or neurogenic pattern. Results Nine LS subjects were selected for EMG, 2 with Parry-Romberg/Hemifacial Atrophy Syndrome, 7 linear scleroderma of an extremity and 2 with mixed forms (linear and morphea). Electromyogram analysis indicated that all but one had asymmetric myopathic pattern in muscles underlying the linear streaks. Motor and sensory nerve conduction was also evaluated in upper and lower limbs and one presented a neurogenic pattern. Masticatory muscle testing showed a myopathic pattern in the atrophic face of 2 cases with head and face involvement. Conclusion In our small series of LS patients, we found a surprising amount of muscle dysfunction by EMG. The muscle involvement may be possibly related to a secondary peripheral nerve involvement due to LS inflammation and fibrosis. Further collaborative studies to confirm these findings are needed. PMID:25053924

  1. Application of platelet-rich plasma in plastic surgery: clinical and in vitro evaluation.

    Cervelli, Valerio; Gentile, Pietro; Scioli, Maria Giovanna; Grimaldi, Monica; Casciani, Carlo Umberto; Spagnoli, Luigi Giusto; Orlandi, Augusto

    2009-12-01

    The clinical use of platelet-rich plasma (PRP) for a wide variety of application has been reportedly employed most prevalently in problematic wounds, maxillofacial and hemi-facial atrophy, Romberg Syndrome, and diabetic foot ulcers. To our knowledge, PRP has never been described in the enhancement of fat grafting during tissue-engineering application in vivo. The authors describe the preparation of PRP and its use in a series of 43 patients who underwent plastic, reconstructive, and maxillofacial surgery for chronic lower extremity ulcers (n = 18) and multiple facial applications (n = 25). PRP mixed with fat grafting was used in 76% patients affected by multiple facial diseases and in 88.9% patients affected by lower extremity ulcers. PRP injection alone was used in the remaining patients. The authors observed that after a 7.1-week and 9.7-week (average) course of twice-daily wound treatment with PRP suspended on a collagen base, 61.1% and 88.9% of chronic lower extremity ulcers underwent to 100% reepithelization compared with 40% and 60% of controls (n = 10) treated with hyaluronic acid and collagen medication. In patients treated with reconstructing three-dimensional projection of face by fat grafting and PRP, we observed a 70% maintenance of contour restoring and three-dimensional volume after 1 year compared to only 31% of controls (n = 10) treated with fat grafting alone. In vitro, PRP induced a significant increase in the number of adipose-tissue-derived stem cells compared to control cultures. These results documented that PRP accelerates chronic skin ulcer reepithelization and improves maintenance and function of fat graft in patients who underwent plastic reconstructive surgery, possibly by stimulating adipose-tissue-derived stem cell proliferation.

  2. Baclofen Intoxication

    Canan Bor

    2015-12-01

    Full Text Available Baclofen is a β-(ρ-chlorophenyl derivative of the neurotransmitter gamma-aminobutyric acid (GABA and is usually prescribed for spasticity of spinal cord origin, intractable hiccup, trigeminal neuralgia, hemifacial spasm, and tardive dyskinesia. The usual recommended daily dose ranges from 40-80 mg, and the total dose should not exceed 80 mg per day. A 41 year old woman using baclofen for migraine therapy intended suicide after a bitter headache attack by taking 37 tablets, 10 mg in each. On arrival to emergency room, she was conscious and co-operable, but somnolent, her pupils were normoisocoric and light reflex was intact bilaterally. On her follow up, respiratory insufficiency and unconsciousness was observed so she was entubated orotracheally and transferred to intensive care unit (ICU for advanced tests and therapy. No pathology was determined on cranial CT. On ICU follow up, she was unconscious and mechanically ventilated, her Glasgow Coma Scale was 3/15 (E1M1VE and pupils were mid-dilated with no light reflex. Since she was again conscious, oriented and co-operable on 19th hour of arrival to ICU and 20th hour of arrival to emergency room, spontaneous breathing trials was started. Extubation was carried out on her 31th hour of arrival to ICU and 32th hour of arrival to emergency room. In conclusion; since baclofen overdose may cause deep coma, it should also be included in differential diagnosis. According to our opinion, performing diagnostic toxicological tests is not always possible that’s why history and physical examination is fundamental in case of baclofen intoxication and we can get good results by giving frequent neurological examination, supportive and extracorporeal therapy in such a case.

  3. Pertinent anatomy and analysis for midface volumizing procedures.

    Surek, Christopher C; Beut, Javier; Stephens, Robert; Jelks, Glenn; Lamb, Jerome

    2015-05-01

    The study was conducted to construct an anatomically inspired midfacial analysis facilitating safe, accurate, and dynamic nonsurgical rejuvenation. Emphasis is placed on determining injection target areas and adverse event zones. Twelve hemifacial fresh cadavers were dissected in a layered fashion. Dimensional measurements between the midfacial fat compartments, prezygomatic space, mimetic muscles, and neurovascular bundles were used to develop a topographic analysis for clinical injections. A longitudinal line from the base of the alar crease to the medial edge of the levator anguli oris muscle (1.9 cm), lateral edge of the levator anguli oris muscle (2.6 cm), and zygomaticus major muscle (4.6 cm) partitions the cheek into two aesthetic regions. A six-step facial analysis outlines three target zones and two adverse event zones and triangulates the point of maximum cheek projection. The lower adverse event zone yields an anatomical explanation to inadvertent jowling during anterior cheek injection. The upper adverse event zone localizes the palpebral branch of the infraorbital artery. The medial malar target area isolates quadrants for anterior cheek projection and tear trough effacement. The middle malar target area addresses lid-cheek blending and superficial compartment turgor. The lateral malar target area highlights lateral cheek projection and locates the prezygomatic space. This stepwise analysis illustrates target areas and adverse event zones to achieve midfacial support, contour, and profile in the repose position and simultaneous molding of a natural shape during animation. This reproducible method can be used both procedurally and in record-keeping for midface volumizing procedures.

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

    Ribeiro, Geraldo de Barros; Almeida, Henderson Celestino de; Velarde, David Toledo

    2012-01-01

    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. 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. 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. 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.

  5. Botulinum Toxin and Muscle Atrophy: A Wanted or Unwanted Effect.

    Durand, Paul D; Couto, Rafael A; Isakov, Raymond; Yoo, Donald B; Azizzadeh, Babak; Guyuron, Bahman; Zins, James E

    2016-04-01

    While the facial rejuvenating effect of botulinum toxin type A is well known and widespread, its use in body and facial contouring is less common. We first describe its use for deliberate muscle volume reduction, and then document instances of unanticipated and undesirable muscle atrophy. Finally, we investigate the potential long-term adverse effects of botulinum toxin-induced muscle atrophy. Although the use of botulinum toxin type A in the cosmetic patient has been extensively studied, there are several questions yet to be addressed. Does prolonged botulinum toxin treatment increase its duration of action? What is the mechanism of muscle atrophy and what is the cause of its reversibility once treatment has stopped? We proceed to examine how prolonged chemodenervation with botulinum toxin can increase its duration of effect and potentially contribute to muscle atrophy. Instances of inadvertent botulinum toxin-induced atrophy are also described. These include the "hourglass deformity" secondary to botulinum toxin type A treatment for migraine headaches, and a patient with atrophy of multiple facial muscles from injections for hemifacial spasm. Numerous reports demonstrate that muscle atrophy after botulinum toxin type A treatment occurs and is both reversible and temporary, with current literature supporting the notion that repeated chemodenervation with botulinum toxin likely responsible for both therapeutic and incidental temporary muscle atrophy. Furthermore, duration of response may be increased with subsequent treatments, thus minimizing frequency of reinjection. Practitioners should be aware of the temporary and reversible effect of botulinum toxin-induced muscle atrophy and be prepared to reassure patients on this matter. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  6. Hydrogen bonds in concreto and in computro: the sequel

    Stouten, Pieter F. W.; Van Eijck, Bouke P.; Kroon, Jan

    1991-02-01

    In the framework of our comparative research concerning hydrogen bonding in the crystalline and liquid phases we have carried out molecular dynamics (MD) simulations of liquid methanol. Six different rigid three site models are compared. Five of them had been reported in the literature and one (OM2) we developed by a fit to the experimental molar volume, heat of vaporization and neutron weighted radial distribution function. In general the agreement with experiment is satisfactory for the different models. None of the models has an explicit hydrogen bond potential, but five of the six models show a degree of hydrogen bonding comparable to experiments on liquid methanol. The analysis of the simulation hydrogen bonds indicates that there is a distinct preference of the O⋯O axis to lie in the acceptor lone pairs plane, but hardly any for the lone pair directions. Ab initio calculations and crystal structure statistics of OH⋯O hydrogen bonds agree with this observation. The O⋯O hydrogen bond length distributions are similar for most models. The crystal structures show a sharper O⋯O distribution. Explicit introduction of harmonic motion with a quite realistic root mean square amplitude of 0.08 Å to the thermally averaged crystal distribution results in a distribution comparable to OM2 although the maximum of the former is found at shorter distance. On the basis of the analysis of the static properties of all models we conclude that our OM2, Jorgenson's OPLS and Haughney, Ferrario and McDonald's HFM1 models are good candidates for simulations of liquid methanol under isothermal, isochoric conditions. Partly flexible and completely rigid OM2 are simulated at constant pressure and with fixed volume. The flexible simulations give essentially the same (correct) results under both conditions, which is not surprising because the flexible form was fitted under both conditions. Rigid OM2 has a similar potential energy but larger pressure in the

  7. Eight joint BER II and BESSY II users meeting. Abstracts

    NONE

    2016-07-01

    The following topics were dealt with: Accelerator operation and projecs, photon science and instrumentation at BESSY II, status of energy materials in-situ Lab at BESSY II, high resolution spectrometer PEAXIS at BESSY II, sample environment at BESSY II, molecular control mechanisms in the Brr2 RNA helicase for efficient and regulated splicing, the Li conversion reaction of 4CoFe{sub 2}O{sub 4} nanoparticles, buried interfaces in lithium ion batteries probed with HAXPES, ARPES studies of the STO(001) 2DEG, all-in/all-out magnetic order in rare earth iridates, oxygen reduction reaction on graphene in Li-air batteries, electronic order in high-T{sub c} superconductors, in-siu observation of novel switching phenomena in highly porous metal-organic frameworks, photoinduced demagnetization and insulator-to-metal transition in ferromagnetic insulating BaFeO{sub 3} thin films, ARPES measurement of the ferroelectric bulk Rashba system GeTe, bisphenol A on Cu(111) and Ag(111), reverse water-gas shift or Sabathier methanation on N(110), structural studies of molecular machines, multi-MHz time-of-flight electronic band-structure imaging of graphene on Ir(111), diffusion pathways in ion conductors, ground-state potential energy surfaces around selected atoms from resonant inelastic X-ray scattering, solar energy in an emerging country, in-situ neutron analysis of electrode materials for electrochemical energy storage, structure and transport properties in thermoelectric skutterudites, investigation of the interphase formation on solid lithium-ion conductors by neutron reflectometry, load partitin and damage characterization of cast AlSi{sub 12}CuMgNi alloy with ceramic reinforcement, methane adsorption in highly porous metal-organics, structure and magnetic interactions in dimer system Ba{sub (3-x)}Sr{sub x}Cr{sub 2}O{sub 8}, distribution of S in C-S nanocomposites, current status of HFM-EXED FACITIY; SPIN NEAMTICITY IN s=1/2 frustrated zigzag chaIN β-TeVO{sub 4}, electronic

  8. olor changes and 5-hydroxymethyl furfural formation in zile pekmezi during storage

    Tosun, Ilkay

    2004-09-01

    Full Text Available Zile pekmezi (white hard pekmez is a traditional Turkish food which is produced from grape juice. Color, flavour and 5-hydroxymethyl furfural (HMF contents are the most important quality parameters in Zile pekmezi. Browning is the most common quality problem in pekmez. In this study, reaction orders, rate constants and activation energies were evaluated for HMF formation and color difference ( ? E variation in Zile pekmezi stored at 55, 65 and 75 °C over 9 days. The results indicated that HMF formation and ?E variation during thermal processing of Zile pekmezi followed zero order reaction kinetics at 55, 65 and 75 °C . Calculated activation energy for HMF and ?E were 158.63 kJ mol-1 and 40.04 kJ mol-1, respectively.El Zile pekmezi (pekmez duro blanco es un alimento turco tradicional que se produce a partir del zumo del uva. El color, el sabor y el contenido en 5-hidroximetilfurfural (HMF son los parámetros de calidad más importantes en el Zile pekmezi. El pardeaminto es el problema más común que afecta a la calidad del pekmez. En este estudio se evalúa la cinética de formación del HFM determinándose los ordenes de reacción, las constantes de formación y la energía de activación así como las variaciones en las diferencias de color (?E en Zile Pekmezi, almacenado a 55, 65 y 75 °C durante 9 días. Los resultados indicaron que la formación de HMF y la variación del color durante el proceso termal del Zile pekmezi siguieron una cinética de orden cero. Las energías de activación calculadas para HMF y el ?E fueron de 158.63 kJ mol-1 y 40.04 kJ mol-1, respectivamente.

  9. Eight joint BER II and BESSY II users meeting. Abstracts

    2016-01-01

    The following topics were dealt with: Accelerator operation and projecs, photon science and instrumentation at BESSY II, status of energy materials in-situ Lab at BESSY II, high resolution spectrometer PEAXIS at BESSY II, sample environment at BESSY II, molecular control mechanisms in the Brr2 RNA helicase for efficient and regulated splicing, the Li conversion reaction of 4CoFe_2O_4 nanoparticles, buried interfaces in lithium ion batteries probed with HAXPES, ARPES studies of the STO(001) 2DEG, all-in/all-out magnetic order in rare earth iridates, oxygen reduction reaction on graphene in Li-air batteries, electronic order in high-T_c superconductors, in-siu observation of novel switching phenomena in highly porous metal-organic frameworks, photoinduced demagnetization and insulator-to-metal transition in ferromagnetic insulating BaFeO_3 thin films, ARPES measurement of the ferroelectric bulk Rashba system GeTe, bisphenol A on Cu(111) and Ag(111), reverse water-gas shift or Sabathier methanation on N(110), structural studies of molecular machines, multi-MHz time-of-flight electronic band-structure imaging of graphene on Ir(111), diffusion pathways in ion conductors, ground-state potential energy surfaces around selected atoms from resonant inelastic X-ray scattering, solar energy in an emerging country, in-situ neutron analysis of electrode materials for electrochemical energy storage, structure and transport properties in thermoelectric skutterudites, investigation of the interphase formation on solid lithium-ion conductors by neutron reflectometry, load partitin and damage characterization of cast AlSi_1_2CuMgNi alloy with ceramic reinforcement, methane adsorption in highly porous metal-organics, structure and magnetic interactions in dimer system Ba_(_3_-_x_)Sr_xCr_2O_8, distribution of S in C-S nanocomposites, current status of HFM-EXED FACITIY; SPIN NEAMTICITY IN s=1/2 frustrated zigzag chaIN β-TeVO_4, electronic properties of U(Ru_0_._9_2Rh_0_._0_8)_2Si_2 in

  10. Site-Scale Saturated Zone Flow Model

    G. Zyvoloski

    2003-01-01

    The purpose of this model report is to document the components of the site-scale saturated-zone flow model at Yucca Mountain, Nevada, in accordance with administrative procedure (AP)-SIII.lOQ, ''Models''. This report provides validation and confidence in the flow model that was developed for site recommendation (SR) and will be used to provide flow fields in support of the Total Systems Performance Assessment (TSPA) for the License Application. The output from this report provides the flow model used in the ''Site-Scale Saturated Zone Transport'', MDL-NBS-HS-000010 Rev 01 (BSC 2003 [162419]). The Site-Scale Saturated Zone Transport model then provides output to the SZ Transport Abstraction Model (BSC 2003 [164870]). In particular, the output from the SZ site-scale flow model is used to simulate the groundwater flow pathways and radionuclide transport to the accessible environment for use in the TSPA calculations. Since the development and calibration of the saturated-zone flow model, more data have been gathered for use in model validation and confidence building, including new water-level data from Nye County wells, single- and multiple-well hydraulic testing data, and new hydrochemistry data. In addition, a new hydrogeologic framework model (HFM), which incorporates Nye County wells lithology, also provides geologic data for corroboration and confidence in the flow model. The intended use of this work is to provide a flow model that generates flow fields to simulate radionuclide transport in saturated porous rock and alluvium under natural or forced gradient flow conditions. The flow model simulations are completed using the three-dimensional (3-D), finite-element, flow, heat, and transport computer code, FEHM Version (V) 2.20 (software tracking number (STN): 10086-2.20-00; LANL 2003 [161725]). Concurrently, process-level transport model and methodology for calculating radionuclide transport in the saturated zone at Yucca Mountain using FEHM V 2.20 are being

  11. Single-fraction Radiosurgery for Presumed Intracranial Meningiomas: Efficacy and Complications From a 22-Year Experience

    Pollock, Bruce E., E-mail: pollock.bruce@mayo.edu [Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, MN (United States); Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States); Stafford, Scott L. [Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States); Link, Michael J. [Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, MN (United States); Garces, Yolanda I.; Foote, Robert L. [Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States)

    2012-08-01

    Purpose: To define the rate of tumor control and factors associated with radiation-related complications after single-fraction radiosurgery (SRS) for patients with imaging defined intracranial meningiomas. Materials and Methods: Retrospective review of 251 patients (192 women, 59 men) having SRS for imaging-defined intracranial meningiomas between 1990 and 2008. Excluded were patients with radiation-induced tumors, meningiomatosis, or neurofibromatosis. The mean patient age was 58.6 {+-} 13.4 years. The majority of tumors involved the skull base/tentorium (n = 210, 83.7%). The mean treatment volume was 7.7 {+-} 6.2 cm{sup 3}; the mean tumor margin dose was 15.8 {+-} 2.0 Gy. Follow-up (mean, 62.9 {+-} 43.9 months) was censored at last evaluation (n = 224), death (n = 22), or tumor resection (n = 5). Results: No patient died from tumor progression or radiation-related complications. Tumor size decreased in 181 patients (72.1%) and was unchanged in 67 patients (26.7%). Three patients (1.2%) had in-field tumor progression noted at 28, 145, and 150 months, respectively. No patient had a marginal tumor progression. The 3- and 10-year local control rate was 99.4%. One patient had distant tumor progression at 105 months and underwent repeat SRS. Thirty-one patients (12.4%) had either temporary (n = 8, 3.2%) or permanent (n = 23, 9.2%) symptomatic radiation-related complications including cranial nerve deficits (n = 14), headaches (n = 5), hemiparesis (n = 5), new/worsened seizure (n = 4), cyst-formation (n = 1), hemifacial spasm (n = 1), and stroke (n = 1). The 1- and 5-year complication rates were 8.3% and 11.5%, respectively. Radiation-related complications were associated with convexity/falx tumors (HR = 2.8, 95% CI 1.3-6.1, p = 0.009) and increasing tumor volume (HR = 1.05, 95% CI 1.0-1.1, p = 0.04) on multivariate analysis. No patient developed a radiation-induced tumor. Conclusions: Single-fraction SRS at the used dose range provides a high rate of tumor control for

  12. Tercer molar ectópico a nivel de región infraorbitaria-seno maxilar Ectopic third molar of the maxillary sinus-infraorbital region

    C. Moreno García

    2007-06-01

    Full Text Available Introducción. Los cordales ectópicos son aquellos incluidos en posiciones inusuales o desplazados a distancia de su normal localización anatómica. La erupción ectópica de un diente dentro de la cavidad oral es común pero en otros lugares es raro. La erupción ectópica puede ir asociada con alteraciones en el desarrollo, procesos patológicos o yatrogenia. Caso Clínico. Mujer de 56 años de edad con tercer molar superior derecho ectópico a nivel de región infraorbitaria-seno maxilar. Presentaba dolor e inflamación hemifacial derecha de larga evolución y resistente a tratamiento médico. Se realizó exéresis quirúrgica de dicho cordal mediante abordaje de Caldwell-Luc. Discusión. En muchos casos la etiología de un cordal ectópico no puede ser identificada. La mayor parte de las veces son asintomáticos y diagnosticados mediante estudios radiológicos. Conclusión. La indicación de la exodoncia en el caso de un diente ectópico en general viene determinada por la presencia de sintomatología o en prevención de futuras complicaciones.Introduction. Ectopic third molar teeth are those that are impacted in unusual positions, or that have been displaced and are at a distance from their normal anatomic location. Ectopic eruption of a tooth within the oral cavity is common, but rare in other sites. Ectopic eruption can be associated with developmental disturbances, pathologic processes or iatrogenic activity. Case Report. Female, fifty-six years old, with an upper right ectopic third molar located in the maxillary sinus-infraorbital region. She presented with pain and inflammation of the right side of her face that she had been experiencing for along time and which had been resistant to treatment. Surgical excision was carried out of the third molar tooth using the Caldwell-Luc approach. Discussion. In many cases the etiology of ectopic third molars cannot be identified. Generally they are asymptomatic and diagnosed by radiology

  13. Clinical and biometrological efficacy of a hyaluronic acid-based mesotherapy product: a randomised controlled study.

    Baspeyras, Martine; Rouvrais, Céline; Liégard, Laetitia; Delalleau, Alexandre; Letellier, Sandrine; Bacle, Irène; Courrech, Laetitia; Murat, Pascale; Mengeaud, Valérie; Schmitt, Anne-Marie

    2013-10-01

    Data demonstrating the efficacy of hyaluronic acid (HA)-based mesotherapy for skin rejuvenation are scarce. The aim of the study is to assess the efficacy of non-reticulated HA-based mesotherapy on skin elasticity and complexion radiance. 55 women with cutaneous ageing signs included in the Full Analysis Set (FAS) population blindly received intradermal micro-injections (50 × 0.02 mL) of non-cross-linked HA filler with mannitol (Glytone 1, HA concentration: 14 mg/g) in one cheek and saline physiological solution in the other according to hemifacial randomisation in 3 monthly sessions. Elasticity (E1 and E2 stiffness parameters) and dermis thickness were measured by cutometry and 20 MHz echography, before (D0) treatment and 1 (1M) and 3 months (3M) after the last injection. A trained panel blindly scored skin complexion radiance from standardised and calibrated photographs, using 100 mm analogue scales. In the FAS population, only HA filler significantly decreased E1 at 1M (-10.9 %, p = 0.026) and 3M (-10.5 %, p = 0.035) compared with D0; its effect versus the control tended to be more persistent, with a difference between treatments at 3M close to significance (p = 0.063). E2 also decreased at 1M (-8.2 %, p = 0.027 in the per protocol population, n = 53) and 3M after HA-treatment only. Dermis thickness significantly increased after HA-treatment at 1M (+3.4 %, p = 0.028) and 3M (+4 %, p = 0.008), and after control-treatment at 1M only (+2.5 %, p = 0.015). The HA filler significantly improved complexion radiance at 3M compared with the control (p = 0.012) and for 51 % of subjects, their skin status. Non-reticulated HA-based mesotherapy significantly and sustainably improves skin elasticity and complexion radiance.

  14. Temporal plus epilepsy: Anatomo-electroclinical subtypes

    Andrade-Machado, René; Benjumea-Cuartas, Vanessa

    2016-01-01

    Background: Mesial temporal lobe epilepsy (TLE) is a remediable epileptic syndrome. About 40% of patients continue to have seizures after standard temporal lobectomy. It has been suggested that some of these patients could actually suffer from a more complex epileptogenic network. Because a few papers have been dedicated to this topic, we decided to write an article updating this theme. Methods: We performed a literature search using the following terminology: “temporal plus epilepsy and networks,” “temporal plus epilepsy,” “orbito-temporal epilepsy,” “temporo-insular epilepsy,” “temporo-parieto-occipital (TPO) epilepsy,” “parieto-temporal epilepsy,” “intracortical evoked potential and temporal plus epilepsy,” “temporal lobe connectivity and epilepsy,” “intracortical evoked potential and epilepsy surgery,” “role of extratemporal structures in TLE,” “surgical failure after temporal lobectomy,” “Diffusion tensor imaging (DTI) and temporal epilepsy,” and “positron emission tomography (PET) in temporal plus lobe epilepsy” in the existing PubMed databases. We searched only English and Spanish literature. Only papers that fit with the above-mentioned descriptors were included as part of the evidence. Other articles were used to reference some aspects of the temporal plus epilepsy. Results: A total of 48 papers from 2334 were revised. The most frequently reported auras in these groups of patients are gustatory hallucinations, vestibular illusions, laryngeal and throat constriction, atypical distribution of somatosensory symptoms (perioral and hands, bilaterally hands paresthesias, trunk and other). The most common signs are tonic posturing, hemifacial twist, and frequent bilateral clonic movements. Interictal electroencephalographic (EEG) patterns exhibit regional and frequently bilateral spikes and/or slow waves. The first ictal electrographic change is mostly regional. It is important to note that the evidence is

  15. The use of three-dimensional imaging to evaluate the effect of conventional orthodontic approach in treating a subject with facial asymmetry.

    Kheir, Nadia Abou; Kau, Chung How

    2016-01-01

    The growth of the craniofacial skeleton takes place from the 3(rd) week of intra-uterine life until 18 years of age. During this period, the craniofacial complex is affected by extrinsic and intrinsic factors which guide or alter the pattern of growth. Asymmetry can be encountered due to these multifactorial effects or as the normal divergence of the hemifacial counterpart occurs. At present, an orthodontist plays a major role not only in diagnosing dental asymmetry but also facial asymmetry. However, an orthodontist's role in treating or camouflaging the asymmetry can be limited due to the severity. The aim of this research is to report a technique for facial three-dimensional (3D) analysis used to measure the progress of nonsurgical orthodontic treatment approach for a subject with maxillary asymmetry combined with mandibular angular asymmetry. The facial analysis was composed of five parts: Upper face asymmetry analysis, maxillary analysis, maxillary cant analysis, mandibular cant analysis, and mandibular asymmetry analysis which were applied using 3D software InVivoDental 5.2.3 (Anatomage Company, San Jose, CA, USA). The five components of the facial analysis were applied in the initial cone-beam computed tomography (T1) for diagnosis. Maxillary analysis, maxillary cant analysis, and mandibular cant analysis were applied to measure the progress of the orthodontics treatment (T2). Twenty-two linear measurements bilaterally and sixteen angular criteria were used to analyze the facial structures using different anthropometric landmarks. Only angular mandibular asymmetry was reported. However, the subject had maxillary alveolar ridge cant of 9.96°and dental maxillary cant was 2.95° in T1. The mandibular alveolar ridge cant was 7.41° and the mandibular dental cant was 8.39°. Highest decrease in the cant was reported maxillary alveolar ridge around 2.35° and in the mandibular alveolar ridge around 3.96° in T2. Facial 3D analysis is considered a useful adjunct

  16. Single-fraction Radiosurgery for Presumed Intracranial Meningiomas: Efficacy and Complications From a 22-Year Experience

    Pollock, Bruce E.; Stafford, Scott L.; Link, Michael J.; Garces, Yolanda I.; Foote, Robert L.

    2012-01-01

    Purpose: To define the rate of tumor control and factors associated with radiation-related complications after single-fraction radiosurgery (SRS) for patients with imaging defined intracranial meningiomas. Materials and Methods: Retrospective review of 251 patients (192 women, 59 men) having SRS for imaging-defined intracranial meningiomas between 1990 and 2008. Excluded were patients with radiation-induced tumors, meningiomatosis, or neurofibromatosis. The mean patient age was 58.6 ± 13.4 years. The majority of tumors involved the skull base/tentorium (n = 210, 83.7%). The mean treatment volume was 7.7 ± 6.2 cm 3 ; the mean tumor margin dose was 15.8 ± 2.0 Gy. Follow-up (mean, 62.9 ± 43.9 months) was censored at last evaluation (n = 224), death (n = 22), or tumor resection (n = 5). Results: No patient died from tumor progression or radiation-related complications. Tumor size decreased in 181 patients (72.1%) and was unchanged in 67 patients (26.7%). Three patients (1.2%) had in-field tumor progression noted at 28, 145, and 150 months, respectively. No patient had a marginal tumor progression. The 3- and 10-year local control rate was 99.4%. One patient had distant tumor progression at 105 months and underwent repeat SRS. Thirty-one patients (12.4%) had either temporary (n = 8, 3.2%) or permanent (n = 23, 9.2%) symptomatic radiation-related complications including cranial nerve deficits (n = 14), headaches (n = 5), hemiparesis (n = 5), new/worsened seizure (n = 4), cyst-formation (n = 1), hemifacial spasm (n = 1), and stroke (n = 1). The 1- and 5-year complication rates were 8.3% and 11.5%, respectively. Radiation-related complications were associated with convexity/falx tumors (HR = 2.8, 95% CI 1.3–6.1, p = 0.009) and increasing tumor volume (HR = 1.05, 95% CI 1.0–1.1, p = 0.04) on multivariate analysis. No patient developed a radiation-induced tumor. Conclusions: Single-fraction SRS at the used dose range provides a high rate of tumor control for patients

  17. The Rare Painful Phenomena - Chronic Paroxysmal Hemicrania-tic Syndrome as a Clinically Isolated Syndrome of the Central Nervous System.

    Ljubisavljevic, Srdjan; Prazic, Ana; Lazarevic, Miodrag; Stojanov, Dragan; Savic, Dejan; Vojinovic, Slobadan

    2017-02-01

    The association of paroxysmal hemicrania with trigeminal neuralgia (TN) has been described and called paroxysmal hemicrania-tic syndrome (PH-tic). We report the case of a patient diagnosed as having chronic PH-tic (CPH-tic) syndrome as a clinically isolated syndrome of the central nervous system (CNS) (CIS).A forty year old woman was admitted to our hospital suffering from right facial pain for the last 2 years. The attacks were paroxysmal, neuralgiform, consisting of throb-like sensations, which developed spontaneously or were triggered by different stimuli in right facial (maxilar and mandibular) areas. Parallel with those, she felt a throbbing orbital and frontal pain with homolateral autonomic symptoms such as conjunctival injection, lacrimation, and the feeling that the ear on the same side was full. This pain lasted most often between 15 and 20 minutes. Beyond hemifacial hypoesthesia in the region of right maxilar and mandibular nerve, the other neurological finding was normal. Magnetic resonance imaging (MRI) study showed a T2-weighted multiple hyperintense paraventricular lesion and hyperintense lesion in the right trigeminal main sensory nucleus and root inlet, all of them being hypointense on T1-weighted image. All of these lesions were hypointense in gadolinium-enhanced T1-weighted images. Neurophysiological studies of trigeminal nerve (somatosensory evoked potentials and blink reflex) correlated with MRI described lesions. The patient's pain bouts were improved immediately after treatment with indomethacin, and were completely relieved with lamotrigine for a longer period. According to the actual McDonald's criteria, clinical state was defined as CIS which was clinically presented by CPH-tic syndrome.Even though it is a clinical rarity and its etiology is usually idiopathic, CPH-tic syndrome can also be symptomatic. When dealing with symptomatic cases, like the one described here, when causal therapy is not possible due to the nature of the primary

  18. Scleroderma and dentistry: Two case reports.

    Dixit, Shantanu; Kalkur, Chaithra; Sattur, Atul P; Bornstein, Michael M; Melton, Fred

    2016-10-24

    Scleroderma is a chronic connective tissue disorder with unknown etiology. It is characterized by excessive deposition of extracellular matrix in the connective tissues causing vascular disturbances which can result in tissue hypoxia. These changes are manifested as atrophy of the skin and/or mucosa, subcutaneous tissue, muscles, and internal organs. Such changes can be classified into two types, namely, morphea (localized) and diffuse (systemic). Morphea can manifest itself as hemifacial atrophy (Parry-Romberg syndrome) although this remains debatable. Hence, we present a case of morphea, associated with Parry-Romberg syndrome, and a second case with the classical signs of progressive systemic sclerosis. Case one: A 20-year-old man of Dravidian origin presented to our out-patient department with a complaint of facial asymmetry, difficulty in speech, and loss of taste sensation over the last 2 years. There was no history of facial trauma. After physical and radiological investigations, we found gross asymmetry of the left side of his face, a scar on his chin, tongue atrophy, relative microdontia, thinning of the ramus/body of his mandible, and sclerotic lesions on his trunk. Serological investigations were positive for antinuclear antibody for double-stranded deoxyribonucleic acid and mitochondria. A biopsy was suggestive of morphea. Hence, our final diagnosis was mixed morphea with Parry-Romberg syndrome. Case two: A 53-year-old woman of Dravidian origin presented to our out-patient department with a complaint of gradually decreasing mouth opening over the past 7 years. Her medical history was noncontributory. On clinical examination, we found her perioral, neck, and hand skin to be sclerotic. Also, her fingers exhibited bilateral telangiectasia. An oral examination revealed completely edentulous arches as well as xerostomia and candidiasis. Her serological reports were positive for antinuclear antibodies against centromere B, Scl-70, and Ro-52. A hand and

  19. Cranial nerve vascular compression syndromes of the trigeminal, facial and vago-glossopharyngeal nerves: comparative anatomical study of the central myelin portion and transitional zone; correlations with incidences of corresponding hyperactive dysfunctional syndromes.

    Guclu, Bulent; Sindou, Marc; Meyronet, David; Streichenberger, Nathalie; Simon, Emile; Mertens, Patrick

    2011-12-01

    The aim of this study was to evaluate the anatomy of the central myelin portion and the central myelin-peripheral myelin transitional zone of the trigeminal, facial, glossopharyngeal and vagus nerves from fresh cadavers. The aim was also to investigate the relationship between the length and volume of the central myelin portion of these nerves with the incidences of the corresponding cranial dysfunctional syndromes caused by their compression to provide some more insights for a better understanding of mechanisms. The trigeminal, facial, glossopharyngeal and vagus nerves from six fresh cadavers were examined. The length of these nerves from the brainstem to the foramen that they exit were measured. Longitudinal sections were stained and photographed to make measurements. The diameters of the nerves where they exit/enter from/to brainstem, the diameters where the transitional zone begins, the distances to the most distal part of transitional zone from brainstem and depths of the transitional zones were measured. Most importantly, the volume of the central myelin portion of the nerves was calculated. Correlation between length and volume of the central myelin portion of these nerves and the incidences of the corresponding hyperactive dysfunctional syndromes as reported in the literature were studied. The distance of the most distal part of the transitional zone from the brainstem was 4.19  ±  0.81 mm for the trigeminal nerve, 2.86  ±  1.19 mm for the facial nerve, 1.51  ±  0.39 mm for the glossopharyngeal nerve, and 1.63  ±  1.15 mm for the vagus nerve. The volume of central myelin portion was 24.54  ±  9.82 mm(3) in trigeminal nerve; 4.43  ±  2.55 mm(3) in facial nerve; 1.55  ±  1.08 mm(3) in glossopharyngeal nerve; 2.56  ±  1.32 mm(3) in vagus nerve. Correlations (p  nerves and incidences of the corresponding diseases. At present it is rather well-established that primary trigeminal neuralgia, hemifacial spasm and vago

  20. Linear accelerator stereotactic radiosurgery for vestibular schwannomas: a UK series.

    Benghiat, H; Heyes, G; Nightingale, P; Hartley, A; Tiffany, M; Spooner, D; Geh, J I; Cruickshank, G; Irving, R M; Sanghera, P

    2014-06-01

    To evaluate non-auditory toxicity and local control after linear accelerator stereotactic radiosurgery (SRS) for the treatment of vestibular schwannomas. The institutional policy was to use SRS for radiologically progressing vestibular schwannomas. Case notes and plans were retrospectively reviewed for all patients undergoing SRS for vestibular schwannomas between September 2002 and June 2012. All patients were surgically immobilised using a BrainLab stereotactic head frame. The treatment plan was generated using BrainLab software (BrainScan 5.03). The aim was to deliver 12 Gy to the surface of the target with no margin. Patients with a minimum of 12 months of follow-up were included for toxicity and local control assessment. Radiological progression was defined as growth on imaging beyond 2 years of follow-up. Overall local control was defined in line with other series as absence of surgical salvage. Ninety-nine patients were identified. Two patients were lost to follow-up. After a median follow-up interval of 2.4 years, the actuarial radiological progression-free survival at 3 years was 100% and overall local control was also 100%. However, two patients progressed radiologically at 3.3 and 4.5 years, respectively. Twenty-one of 97 (22%) evaluable patients suffered trigeminal toxicity and this was persistent in 8/97 (8%). Two of 97 (2%) suffered long-term facial nerve toxicity (one with associated radiological progression causing hemi-facial spasm alone). One of 97 (1%) required intervention for obstructive hydrocephalus. No statistically significant dosimetric relationship could be shown to cause trigeminal or facial nerve toxicity. However, 7/8 patients with persistent trigeminal nerve toxicity had tumours in contact with the trigeminal nerve. SRS delivering 12 Gy using a linear accelerator leads to high local control rates, but only prospective evaluation will fully establish short-term toxicity. In this study, persistent trigeminal toxicity occurred almost

  1. Paralisia facial periférica idiopática de Bell: a propósito de 180 pacientes Idiopathic facial paralysis (Bell´s palsy: a study of 180 patients

    Marcelo Moraes Valença

    2001-09-01

    Full Text Available O objetivo deste estudo foi analisar aspectos clínicos, epidemiológicos e evolutivos da paralisia facial periférica idiopática em 180 pacientes. Houve ligeiro predomínio do sexo feminino (66,7%. Quanto à faixa etária mais acometida, foram observados dois picos de incidência um nas terceira e quarta décadas, e o outro na sexta década de vida. Nos 180 pacientes houve 198 episódios de paralisia facial periférica, sendo 17 recorrências e em um paciente a paralisia foi de instalação inicial bilateral. Em 15 pacientes (8,3% houve recidiva da paralisia facial, em dois casos a paralisia se repetindo por mais duas vezes. Em 12 casos (70,6% a recidiva ocorreu no mesmo lado da paralisia anterior. O lado esquerdo da face estava envolvido em 55,6% dos casos. Em oito pacientes a paralisia aconteceu na gestação (n=5 ou no pós-parto (n=3. Quatro das pacientes grávidas apresentaram paralisia de Bell no terceiro trimestre. Uma paciente com 18 anos de idade desenvolveu paralisia facial do lado direito no sétimo mês da gravidez, havendo recidiva da paralisia no mesmo lado aos 23 anos de idade, no 15º dia pós-parto. Como condicões associadas encontramos hipertensão arterial sistêmica (11,7%, diabete mélito (11,1%, gravidez ou pós-parto imediato (4,4%; 6,7% nas mulheres e neurocisticercose (1,1%. Em 72,8% dos casos não encontramos associação com outras afecções. Em 22,8% dos pacientes observou-se uma das seguintes sequelas: espasmo hemifacial (12,8%, recuperação parcial do déficit motor (10,6%, síndrome das lágrimas do crocodilo (3,3%, contrações sincinéticas (2,8%, lacrimejamento (1,1% e fenômeno de Marcus Gunn invertido (1,1%. Concluíndo, no estudo foi demonstrado que a paralisia facial periférica idiopática pode provocar sequelas importantes, cosméticas ou funcionais, em mais de 20% dos pacientes.The objective of this study was to analyze some clinical and epidemiologic aspects, as well as the follow up of 180 patients

  2. Genetics of primary ovarian insufficiency: new developments and opportunities.

    Qin, Yingying; Jiao, Xue; Simpson, Joe Leigh; Chen, Zi-Jiang

    2015-01-01

    consistent results, the resolution of arrays has varied and replication is uncommon. Whole-exome sequencing in non-syndromic POI kindreds has only recently begun, revealing mutations in the Stromal antigen 3 (STAG3), Synaptonemal complex central element 1 (SYCE1), minichromosome maintenance complex component 8 and 9 (MCM8, MCM9) and ATP-dependent DNA helicase homolog (HFM1) genes. Given the slow progress in candidate-gene analysis and relatively small sample sizes available for GWAS, family-based whole exome and whole genome sequencing appear to be the most promising approaches for detecting potential genes responsible for POI. Taken together, the cytogenetic, cytogenomic (array CGH) and exome sequencing approaches have revealed a genetic causation in ∼20-25% of POI cases. Uncovering the remainder of the causative genes will be facilitated not only by whole genome approaches involving larger cohorts in multiple populations but also incorporating environmental exposures and exploring signaling pathways in intragenic and intergenic regions that point to perturbations in regulatory genes and networks. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.

  3. Corticosteroids for Bell's palsy (idiopathic facial paralysis).

    Madhok, Vishnu B; Gagyor, Ildiko; Daly, Fergus; Somasundara, Dhruvashree; Sullivan, Michael; Gammie, Fiona; Sullivan, Frank

    2016-07-18

    Inflammation and oedema of the facial nerve are implicated in causing Bell's palsy. Corticosteroids have a potent anti-inflammatory action that should minimise nerve damage. This is an update of a review first published in 2002 and last updated in 2010. To determine the effectiveness and safety of corticosteroid therapy in people with Bell's palsy. On 4 March 2016, we searched the Cochrane Neuromuscular Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and LILACS. We reviewed the bibliographies of the randomised trials and contacted known experts in the field to identify additional published or unpublished trials. We also searched clinical trials registries for ongoing trials. Randomised trials and quasi-randomised trials comparing different routes of administration and dosage schemes of corticosteroid or adrenocorticotrophic hormone therapy versus a control group receiving no therapy considered effective for this condition, unless the same therapy was given in a similar way to the experimental group. We used standard Cochrane methodology. The main outcome of interest was incomplete recovery of facial motor function (i.e. residual facial weakness). Secondary outcomes were cosmetically disabling persistent sequelae, development of motor synkinesis or autonomic dysfunction (i.e. hemifacial spasm, crocodile tears) and adverse effects of corticosteroid therapy manifested during follow-up. We identified seven trials, with 895 evaluable participants for this review. All provided data suitable for the primary outcome meta-analysis. One of the trials was new since the last version of this Cochrane systematic review. Risk of bias in the older, smaller studies included some unclear- or high-risk assessments, whereas we deemed the larger studies at low risk of bias. Overall, 79/452 (17%) participants allocated to corticosteroids had incomplete recovery of facial motor function six months or more after randomisation

  4. 三叉神经痛与面肌痉挛显微血管减压的显微解剖%Microdissection study of CPA for the functional neuprosurgery

    黄建军; 马东; 伊志强; 白永文; 武日富; 马喜; 殷凤义; 鲍圣德

    2009-01-01

    目的 研究小脑脑桥角区的解剖结构,为三叉神经痛与面肌痉挛微血管减压手术提供解剖学依据.方法 16例成人头颅湿标本,采用乙状窦后入路,对小脑脑桥角区行显微解剖研究.结果 (1)上界为上项线中点下2 cm,下界为枕骨大孔上缘1 cm,内侧界距枕窦缘3 cm,外侧界为乳突基底内侧0.5 cm的骨窗中心恰与面听神经垂直对应,是微血管减压的最佳骨窗.(2)脑池段三叉神经与面听神经最宽距离平均为(11.19±0.12)mm.(3)岩静脉距离面听神经平均为(10.05±0.11)mm.结论 该区手术骨窗中心位置可行最佳选择.利用岩静脉与面听神经的间隙行微血管减压术无需切断岩静脉.%Objective To study the anatomy relationship among the vessles, nerves and bone landmarks in the region of CPA and provide operation-related anatomy knowledge for microvascular decompression of trigeminal neuralgia and hemifacial spasm. Method 16 cadaver specimens were used. 32 sides of CPA region were dissected with retrosigmoid approach. The optimal bone window center for Ⅶ,Ⅷ cranial nerves was localized and the relationship of nerves and vessels were observed and measured. Results (1)The bone window was 2 cm under the midpoint of superior nuchal line superiorly, 1 cm above superior margin of foramen magnum inferiorly, 3 cm lateral to occipital sinus medially, 0.5 cm medial to mamillary process base laterally. The center of the bone window was properly above the Ⅶ,Ⅷ cranial nerves. (2)The widest distance between the Ⅶ,Ⅷ cranial nerves and trigeminal nerve was 10.20~12.18 mm, mean (11.19±0. 12)mm in the cistern. (3)The distance between Ⅶ,Ⅷ cranial nerve and petrosal vein is 9.10±11.22 mm, mean(10.05±0.11)mm,and this interspace can be used to perform microvascular decompression without cutting off petrosal vein. Conclusions The bone window for microvascular decompression in CPA can be optimized to a special location. The locations of trigeminal

  5. Determinación de HLA en pacientes con Síndrome de Parry Romberg atendidos en el Servicio de Cirugía Plástica y Reconstructiva del Hospital General "Dr. Manuel Gea González"

    Damián Palafox

    Full Text Available Introducción y Objetivo. El síndrome de Parry Romberg se caracteriza por atrofia hemifacial progresiva; afecta piel y tejidos blandos y en ocasiones provoca también atrofia de músculos, cartílago y estructuras óseas subyacentes. Su diagnóstico diferencial incluye: esclerodermia generalizada, morfea y síndrome de CREST. Las alteraciones en piel se asocian con variantes alélicas (polimórficas del sistema HLA (antígeno leucocitario humano. La esclerodermia se ha asociado con HLA DR11, el CREST con DR1 y DR3, en tanto que la morfea no parece asociarse a genes del HLA en población mexicana. El propósito de este trabajo es explorar la posibilidad de asociación del síndrome de Parry Romberg con algún alelo del sistema HLA con el fin de entender el mecanismo fisiopatogénico y el probable papel de la etnicidad en la prevalencia e incidencia de esta enfermedad en individuos mestizos mexicanos. Material y método. Estudiamos 24 pacientes con Parry Romberg, de la consulta externa de Cirugía Plástica y Reconstructiva del Hospital General "Dr. Manuel Gea González" de la Ciudad de México. El diagnóstico se basó en hallazgos clínicos, imagenología e histopatología de las lesiones dérmicas. Establecimos las frecuencias génicas y haplotípicas de los antígenos del sistema HLA en los 24 pacientes (48 haplotipos. El estudio incluyó los loci HLA A, B, DR, DQ. Comparamos los resultados con las frecuencias presentes en un grupo de 99 controles mestizos mexicanos sin antecedentes de enfermedades autoinmunes y/o metabólicas. Analizamos las diferencias en las frecuencias génicas mediante estadística no paramétrica que incluyó prueba de Chi cuadrado y exacta de Fisher, además de determinación de RM (razón de momios e intervalos de confianza de 95%. Resultados. Encontramos en los pacientes con Parry Romberg aumento significativo del HLA DRB1*16 (frecuencia génica: 14% en SPR vs 1% en normales. p=0.002, OR: 6.5, IC 95%: 1.9-21.7 y

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

    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